Крок 2 Загальна лікарська підготовка_2004-2005

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The patient, 52 years, show complaints on a *Stenocardia stable Stenocardia unstable Myocarditis Q miocardial Cardiomyopathy
retrosternal burning pain, appearing at physical on exertion infarction
loading and disappearing after it. Objectively: a
condition of the patient is satisfactory, pulse beat
- 86 times a minute, during auscultation the
1.
tones of heart are rhythmical, are muffled. The
arterial pressure - 130/80. On the
electrocardiogram a pathological changes are
not revealed. What is yours preliminary
diagnosis?
Patient p, 45y.o. was delivered by an ambulance Gastric bleeding Intestinal bleeding Bleeding from Bleeding from Thrombocytopenia
with complaints of pain in the epigastrium, esophageal veins hemorrhoidal veins
vomit at the height of pain with impurity of
2. blood; heartburn, weakness, dizziness, “black”
stool in the morning. He has been ill for 10
years, nutrition is irregular. What complication
has developed in the patient?
A 65 year old patient was admitted in the Serum B-12 and folic Endoscopic X ray of abdomen Osmotic resistance of Iron content of serum
hospital with a complains of fatigue,feeling of acid level examination of the erythrocytes
“cotton like “legs,loss of sensitivitiy of toes. On stomach
examination pale of the skin,subecteric sclera..
Heart sounds of low intensity,systolic murmur
heard over the heart area ,liver
3. +2cm,painless,spleen not
enlarged.Blood analysis: Hb 58mg/l, E-
1.3 x10 12/l, color index-1.3,
reticulocytes-0.2\%. ESR 30mm/hr,
megaloblasts-2:100, macrocytosis.
Jolly bodies, кebots ring. Most
informative method of investigation
The 63y.o. patient’s complaints are dyspnea Raised function of Hypertrophy of Frank-Starling’s Vasoconstriction Activation of renin-
during physical exercise, palpitation and parasympathetic myocardium mechanism angiotensine-
swelling of the ankles. He had a transmural nervous system aldosterone system
myocardial infarction a year ago. Objectively: T
–36.5(C, BR – 22 pm, Ps – 96 bpm, AP –
4. 110/70. Acrocyanosis. Vesicular respiration is
evident; it is raised in the lower areas with single
faint rales. Left cardiac bound is 1.5cm inward
of lin. medioclavicularis. Cardiac tones raised,
rhythm is correct, Liver – 2cm below arcus
costalis. What is the mechanism of tachycardia:
 A 56y.o. teacher consulted a department Table #4 by Pevzner Table #4a by Pevzner General table Table #2 by Pevzner Table #9 by Pevzner
therapist about a corresponding diet.
Complaints: frequent constipations [defecation
once in 2-3 days], flatulence and unpleasant
aftertaste; blunt pain in the lower half of
abdomen after intake of ice cream or soda
5.
drinks. At 17-20 she was treated for duodenal
ulcer. Objectively: height – 164cm, weight –
62kg. Abdomen is oval, palpation doesn’t detect
pathological changes. What diet is necessary for
prevention of transition of chronic disease into
acute?
A 30y.o. patient complains of local pressing Thyroxin Mercazolin Digoxin Furosemid Ferroplex
heartache, dyspnea during physical exercise,
memory aggravation and constipation for 3
months. Menstruation is small. Objectively:
Skin is dry and pale. T- 35.4(C. Expressive
6.
edema of face and limbs. Tones are dull,
rhythmic. Ps – 52 bpm, AP – 90/60. Hemogram:
RBC – 2.8T/l, Hb – 92G/l, ESR – 10 mm/hour.
I2-absorbtion is15( in 24 hours. What
medication would you prescribe to the patient?
A 35y.o. patient has been admitted to Truskavets Yalta Morshen Esentuki Shoyani
nephrology department of OCH with chronic
pyelonephritis with frequent recurrences. It is
7. necessary to send a patient to a sanatorium in 1-
2 months after treatment for prevention of
recurrences. What health resort is best for the
peatient?
A 48yr old obse diadetic with impariment of Enalapril and insulin Phetenoforminand Nefidipine and Nefidipine and insulin Insulin and
visin for 3 weeks .on examintaion he is found to enalapril phenoformin phenoformin
show evidence of peripheral neuropathy and
grade of II diabetic retinopathy.His blood
pressure 160 to 250mm hg ,blood sugar 10to
8.
250mg\%,while taking 5mg glibenclamide 3
time daily ,urine examination shows sugar
+urine ,ni ablumin excretion ans acteone .urine
excretion druning 24hrs is 400mg.whch is
following mangment is approprirate?
A 50yrs ols male has had precaridal pain for 4 Lignocaine,streptokin Lignocanineand Morphineand Streptokineases and Nitoglcine +Digoxine
hrs. on examintion his BP 110/80mmhg.pulse aseand morphine streptokineases dobtutamine morphine
10beats /mint anf respiratory rate is 206/min.
9.
His ECG maked S-T segement elvation and left
ventricle ectopies.The initial therepeutoc
modilaties in his case would include.
 A 60 year old woman mother of 6 children Choledocholithiasis Infectious hepatitis Hemoytic jaundice Choledochal cyst Ascariasis
developed sudden onset of upper abdominal
pain radiating to back,associtated with
nausea,vomiting ,fever and chills.She noticed
10.
yellow discoloration of her sclera and skin.On
physical examination the patient was found to be
febril with temperature of 38.9C, along with
right upper quadrant tenderness
A 40 year old male pesents with headache and Nitropruside+Furose Diazoxide+trimaterenc Nitroprusside+Triamt Resaprine Captopril
convulisons.His blodd pressure is 120\140 mide e erence
mmhg. Fundus examination revelas
11.
papillooedema.Which of the following drug
examination will be most suitable for this
patient?
A 75 year old man who had developed diabetes Carcinoma of the head Metastatic disease of Pancreatitis Choledocholithiasis Hemolytic jaundice
within last 6 months was found to be of the pancreas the liver
jaundiced.He has remained asymptomatic,expect
for weight loss about10 pounds in 6 months.On
12. physical examination he is found to have a non-
tender ,globular ,right upper quadrant mass that
moves with respiration.A CT scan shows
enlargement of the head of the pancreas, with no
filling defects in the liver
First patient A. 35 years old with Acute Viral *All the given below. Electrophysiological Laboratory test. Hospitalisation. None of the above.
Respiratory Infection complains of pain in the test.
cardiac region, palpitation, dyspnea. Objective:
13. acrocyanosis, heart sounds are reduces, systolic
noise above the apex, extrasystole, blood
pressure 90/60 mm Hg. Which among the
following is true?
A 55 years old man complaints with chest pain *Non-stable Stable sternocardia. Myocarditis. Q-Myocardial Cardiomyopathy.
for a duration of 25 min. With radiation to the sternocardia. Infarction.
left side which took place 3 days ago at rest and
dissapeared without any medical treatment. The
last day attack took place for 5-6 times per day
14.
with increases in pain intensity. The results of
laboratory test: Troponin-0,17ng/mg, L-5,6 (109
/l, alaninaminotransferase-100 mmol/l, Lactat
Dehydrohenase-350 mmol/l. Which disease do
you suggested?
A 20y.o. student fell ill with acute Streptococcus Virus Staphylococcus Blue-purulent bacillus Intestinal bacillus
glomerulonephritis. He was ill with angina a
week ago. Objectively: skin and mucous layers
pallor, edema of face, limbs and trunk. AP –
15.
180/110. Urogram: protein – 6.6 g/l, RBC –
100-120 in f/v, hyaline cylinders – 2-3 in f/v,
oligoanuria. What infection had in important
part in development of disease?
 The patient has peptic ulcer of stomach with Once in 3 months Twice a year Each year Each month After each recurrence
16. frequent recurrences. Courses of anti-recurrent
therapy must be:
A 65y.o. patient is in the reanimation Hypodynamia Failure of nervous Non-adequate Colon abnormality Failure of aqueous-
department with transmural myocardial regulation alimentation saline exchange
infarction. He complains of abdominal pain,
17. flatulence and constipation. Objectively:
Abdomen is algestic in the region of colon, with
continent inflation; its lower part is full. What is
the main mechanism of this condition?
A patient complains of resting dyspnea, high Punction of pleural Bronchoscopy Bronchography Pneumotachometria Spirography
temperature and chest pain. Objectively: The cavity
right half of chest is behind in the act of
respiration. During percussion a blunt sound is
18.
evident. Sounds are absent in lungs during
auscultation. X-ray: a homogenous opacity 2/3
of right lung. The most informative for diagnosis
is:
A 62y.o. patient is ill with chronic obstructive All measures Training of respiratory Refusal from Optimization of Balanced alimentation
bronchitis. He has smoked for 20 years. Point muscles smoking microclimate
19.
out the non-medicamentous prevention of
recurrences in this pathology:
A 53y.o. woman is suffering from essential Therapeutic diet Psychotherapy Physical therapy Rodone baths Collar zone massage
arterial hypertension of the I degree combined
20. with obesity of the II degree. Which of the
following methods assist an accurate decrease of
EAH progression risk?
A 34y.o. patient has been admitted to clinic with Chronic hepatitis Cirrhosis of liver Active hepatitis Chronic cholecystitis Chronic pancreatitis
complaints of heaviness in the right subrib,
nausea and emesis after intake of fried pork;
dark urine and light feces. He was ill with viral
hepatitis half a year ago, but wasn’t on a diet.
21. Objectively: Scleras are subicteric. Abdomen is
with continent inflation. Liver is +2cm of costal
arc margin on lin. medioclavicularis dextra. Its
surface is smooth and it has an elastic
consistence. What disease would you think
about?
A 40 year pateint of rhenmatic heart disease Subacute bacteria Recurrence of Throbocytopenia Mital stenosis A ortic stenosis
complains of anoxeria,weaknessand loss of endocardidtis rheumatic fever purpure
weigth,breathlessnesss and swelling of feet . on
22. examination temp 39C pu;lse is 100/mint
.Asucultation distolic murmur in the mitral
area.Petchical lesion round clavicle and spleen
was palpable,Tooth extraction one month ago.
 If a 55year male presents with normotension, Hypernephroma Amyloidosis Papillary necrosis Periarteritis Liver Cirrhosis
nephroticsyndrome, azotemia, collateral
23. abdominal veins with upward flow and there is
history of gross, painless haematuria 6 months
back, the mostly likely diagnosis is
A 70 yrs old women is admitted to the hospital Cngestive cardiac Adult respiratory A trial fribrillation Rebound hypertensive Pulumonary edema
with icreasiing fatigabality and dyspone for the failure distress syndrome crisis
several month. Physical examintaion heat rate
100/min regular rhythm and BP of
24.
150/100mmhg engorged neck veins ,third heart
sound and rales over lung fields.Skigram on
chest show and prominent vascular markings
.This patient is likely to be having
A 45yrs old executive who is a heavy smoker, Prinzmetal s angina Acute myocardial Dissecting aneurysm Acute pericarditis Stable angina
had severe retrostrenal discomfort while going infraction of arota pectilors
to the toilet at 7.00 a.m .ECG done immediately
25.
showed that S-T segement elevation in the
infrrioe leads which normalised within an hour.
This likely mostly diagnosis is
A 50 year old patient previously in good health Pulmonary embolus Pneumococcal Bronchogenic Bronchoscopy needs to Viral pnenumonia is
and sudden onset of right anterior chest pain must be cosidered pneumonia is mostly carcinoma is most be done promptly most likely diagnosis
without chills,feveror cough.On examintion he promptly ans penicilline should likely
26.
has tanchypneic.Over the right lower rib cage be given
there was an inspiratory rub.Chest X –ray was
negative.Which statement is correct
A 43 year old man begins to wheeze.There is no Aminophylline Digitalis Cortisone Epinephrine Salbutarole
27. way to tell whether this is bronchial asthma or
cardiac asthmaThe best drug to be use would be
A middle –aged patient presents with ashort Lobar pneumonia Lung abscess Bronchial pneumonia Plerual effusion Acute bronchitis
history of hight fever and rigors.On examination
the pulse rate is 140/min and there are signs of
toxaemia.Chest examination shows restriction of
28. movement over left infraclavicular region and
there is dullness on percussion. Vocal resonance
is increased with low pitched bronchial breath
sounds over the above area.The mostly likely
diagnosis
A 48 year-old man presnets with Whipple s disease Coeliac disease Inflammatory bowel Tropical sprue Chronic enterocolitis
arthralagia,abdominal pain,diarrhoea disease
,progressive weight loss,low-grade
fever,confusion,memoryloss and
29. opthalamoplegia.Investigation reveal
steatorrhoea,imparied
xyloseobsorption,abnormal samll- bowel X rays
hypoalbuminaemia and anemia.The mostly
likely diagnosis
 An indian adult who has neve travelled abroad Leptospirosis{weil s Viral hepatitis Yellow fever Haemolytic uraemic Haemolytic jaundice
come with a history of high disease} syndrome
fever,headache,jaundice,marked
30.
oliguria,heptospleenomegaly and shock with
TLC of 16,000/cumm.The mostly likely
diagnosis is
A patient is noted to have paroxysmal episodes Pheocromocytoma Cushing syndrome Conns disease Essential Cushing disease
of hypertension,tremors,weakness and hypertension.Crisis
sweating.Physical examination reveals conditions
tachycardia and hypertension.The urinary
31.
catecholamines and their metabolites are
elevated and a computerised tomography scan
detects a mass within the adrenal gland.Which is
the most likely diagnosis
A 76-year old woman presents with an acute Metoprolol Lidocaine Procaineamide Digoxin Diltiazem
myocardial infarction.Her symptoms stared 4 hrs
before admission and resolved after 1
sublingual nitroglycerine.She has history of
32. hypertension,pulse is 104beats/min and BP is
180/106mmHg.A third heart sound is present.No
venticular ectopy is observed druning ECG
monitoring.Appropriate initial therapy may
include
A 40 year old woman in good gernal health Pulmonary embolus Atypical pneumonia Tracheobronchitis Bacterial pneumonia Lung cancer
experiences sudden chest pain,fever and
shortness of breath.She is heavy smoker and
takes takes no medication except oral
33. contraceptives.Tachypnea and temperature of
38C are found on physical examination. Chest
auscultation,percussion and radiographic
findings are normal.Which of the following
diagnosis is likely
A 17y.o. patient complains of acute pain in the Rheumatism, Systemic lupus Reactive polyarthritis Infectious-allergic Rheumarthritis
knee joint and T – 38(C. He was ill with angina polyarthritis eritematodes polyarthritis
3 weeks ago. Objectively: Deformation and
34.
swelling of the knee joints with skin hyperemia.
Small movement causes and acute pain in the
joints. Which diagnose is the most correct?
A 12- year old boy had sever vomiting and Prerenal azotemia Haemolytic uremic Acute Acute tubular necrosis Acute pyelonephritis
diarrhoea.He was brought to the hosptial syndrome glomerulonephritis
because of severe oliguria.He was give IV fluids
35. and furosemide without any diuresis.Blood
biochemistry revealed : Urea 120 mg\% and
serum creatinine 4mg\%.The most likely
diagnosis is
 A 56 year old woman has an elevated serum Serum para thyroid Serum ionized calcium Serum phosphate CT scan of the neck 24 hrs urine calcium
calicum level of 12.2mg/dl.She has no history of hormone excretion
any illness,or treatment associated with
36.
hypercalcemia.Which of the following studies
would be most helpful in making diagnosis of
primary hyperparathyriodism
A 13 year old girl with sickle cell anemia Splenic sequestration Hemorragic shock Septic shock Cardiogenic shock Hypovolemic shock
presents with pallor,tachycardia,hypotension and
37.
massive splenomegaly.The most likely
explanation is
A 30 year old female with rheumatoid arthritis Carpal tunnel Atlanto-axial Sensory peripheral Rheumatoid vacultis Rheumatoid arthrits
of five years duration complains of pain in the syndrome sublaxation of cervical neuropathy without complication
frist three fingers of her right hand over past 6 spine
38.
weeks. The pain seems especially severe at night
often awakening her from sleep.The most likelly
cause is
A 27 year old woman presents with muscle Myasthenia gravis Toxic {drug Duchenne musclar Peripheral neuropathy None of the above
weakness,ptosis,has been receiving gentamicin induced}myopathy dystrophy
injections for the last 7 days for a urinary
infection.Thyroid function tests,serum creatine
39. kinase, eletromyogram and musle biopsy are
noraml.I/V administration of
edrophoniumresults isn adramtic improvements
in the pateints muscle strength.Which of the
following is most likely diagnosis
A 56 year old woman is admitted after 2 weeks Severe Crohns disease Sigmoid colectomy Splenectomy Segmental jejunal Sigmoid colectomy
of frequent vomiting.She is dehydrated.Work – resection
up showss complete gastric outlet due to
longstanding peptic ulcer disease.Her serum
40.
dueto longstanding peptic ulce disease.Her
serum chloride is 90mEq/dl {low},sodium
134mEq/dl [low},bicarbonate 35mEq/dl
[high},and her urine PH is low {acidic}
A 47-year old man presents to his physician with Thrombosis of the Congestive hear failure Portal vein Chronic hepatitis
progressive abdominal swelling.On examination hepatic vein {Budd- thrombosis
he is found to have ascites and a tender,erlarged Chiari syndrome}
41.
liver.If the patient describes the ascites as having
been of abrupt onset and preceded by trauma,
tha most likely diagnosis is
A 60 year old woman was admitted in ths Carcinoid syndrome Gastroenteritis Uclerative colitis Lactose intolerance Short gut syndrome
hospital with abdominal cramps,watery diarrhea
42.
and flushing with episodes of wheezing.Select
the appropriate diagnosis
 A 20- year old woman with 3-4 months history Ulcerative colitis Gastroenteritis Carcinoid syndrome Granulomatous colitis Lactose intolerance
of bloody diarrhea ,stool examination negative
for a ova and parasites,stool culutre negative for
43. Clostridium,Campylobacter and Yersinia,normal
bowel series edema,hypermia and ulceration of
rectum and sigmoid colon seen on
sigmoidoscopic examination
An 80-year old woman with a history of Discontinue Perform a temporal Begin propranolol Begin sublingual Obtain a brain CT
Congestive Heart Faliure develops angina nitroglycerin artery biopsy ergotamine scan
pectoris.Her medications are adjusted to include
furosemide,digoxin,nitroglycerine and
44.
potassium supplements.Shortky there after
develops intermittent frontal throbbing
headache.Which of the following should the
physician do frist?
A patient 54 years old, admitted in hospital with *Troponin I and T. Activity of the Activity of the Activity of the general Activity of the general
intensive and tremendous retrosternal pain alaninaminotrasferasa. aspartataminotrasfera lactactdehydrogenase. creatinphospokenase
without radiation, pain lasted for 40 minutes, no sa.
changes were observed after taking
45. nitroglycerin. Objectively : pale face, sweatting,
hypotonia (pulse rate 108/min), “gallop”rythm.
ECG: elevation of ST to 6 mm at III and AVF
leads. Read the above given information and
select the correct diagnose from the following:
A patient 60 years old with ischemic heart *Increase of Decrease of oncotic Raise in activity of Increase in volume of Retention of water
disease, post infract cardiosclerosis. After hydrostatic pressure in pressure in the blood sympathoadrenergic circulating blood. and sodium in the
physical exercise, there is weakness, small circulating plasma. system. organism.
breathlessness at rest, strong heart beat, sputum blood vessels.
is reddish in colour, cyanotic skin, patient is half
46. seated, half lying , cold sweat. Breathing rate is
30/min, heart rate 100/min, blood pressure
100/60 mm.hg., different kinds of rattling,
hummid sounds in lungs and heart murmurs.
Which mechanism leads to development of
acute heart failure?
A patient 28 years old, during 10 years diagnosis *Dillation of the heart Hypertrophy of the Increase in minute Decrease in minute Decrease of heart
of reumatism, failure of aortic valve, admitted in and decrease in heart heart and decrease in volume of blood. volume of blood. output.
the clinic with cardiac deficiency at the II B output. heart output.
47.
stage. Which of the following hemodynamics is
of importance in the diagnosis of systolic
dysfunction?
The patient has had the non-specific hecoid Each year Twice a year Each month Once in 3 months Once in 2 years
colitis for many years. He is in remission now.
48.
During dispanserisation the doctor must
prescribe colonoscopy to him:
 Throughout the year after an attack of acute *Hollter’s monitering Investigation of Coronarography. Physical test. Stress-
myocardial infection, a patient complains of electrocardiogram. electrolytes in blood. echocardiography.
periodic pain in the heart area. At the time of
observation of the electrocardiogram except
49.
pathological Q in II, III and AVF leads other
changes were not observed. Which
investigation is the most apropriate in order to
diagnose and treat the patient?
A patient with unstable stenocardia was given a *Coronarography Stress-ecocardiogram. Test with doses of Oesophageal Myocardial
complex treatment of the following : physical exercises. electrocardio syncitigraphy.
anticoagulants, lyins nitrates, (-adrenoblockers. stimulator.
50.
But on the third day of treatment the pain was
continous, which tests are carried out on this
patient to get the proper diagnosis?
The patient who after ‘Q’ positive myocardial *Disease + low Disease + high cardiac Low cardiac out put + Increased resistance of Increased activity of
infarction of left ventricle: experienced dyspnea, cardiac output + output + increased accumlation of Na+1 vesseles + increased sympathoadrenegic
edema and hepatomegalia. Echocardiograph: accumulation of vascular resistance. + accumulation of activity of sympatho system + increased
51. Increase in end diastole volume & liquid. liquid. adrenergic system. activity of renin –
intraventricular pressure of left ventricle. What angiotensin –
is the main reason of congestive heart failure of aldosteron system.
the patient?
A patient with hypertension in 2nd stage, has *Diastolic function of Systolic function of the Diastolic function of Systolic function of Systolic – diastolic
inspiratory breathelessness, cough, weakness the left ventricle. left ventricle. the right ventricle. the right ventricle. function of the heart.
after physical exercise. Echo cardigraphy
revealed: hypertrophy of left ventricle
52.
myocardium. There is a decrease of final
diastolic volume with a fraction of excreation of
58\%. Destrution of heamodynamic regulation
is the main cause of failure of :
A patient 57 years old, admitted in hospital with *Treatment of the Treatment of the Diet with controlled Satisfactory climatic Control of physical
small focal myocardial infraction from the past 3 basic disease. cardiac insufficiency. amount of liquid, salt treatment. tolerance.
months is reported to have cardiac insufficiency and animal fats.
of first stage functional class 1 (Fc1). At present
53.
he complains dyspnea, fatigue, palpitation in
normal physical maintinance. Which of the
following is the best method of prophylaxis for
the given patient?
The patient aged 58 suddenly had headache, * Corinfar Adelfan Analgin Cristepin Egilok
syncope, nausea, fear, “net” glimmering in the
visual field, palpitation, cardiac pain. He has
been suffering from hypertension for 18 years.
54.
Clinical examination revealed cardiac rate 96
per 1 min., BP = 210/115 mm Hg. What
preparation should be prescribed to this patient
most currently?
 A 26 years old patient was admitted to the * Lobar pneumonia Lung gangrene Non complicated Lobar pneumonia Chronic lung abscess
hospital with complains of pain in the right complicated by acute pneumonia complicated by
chest, fever up to 38-40 C and cough with abscess of lung chronic abscess of
purulent sputum discharge. Before he has been lung
ill within 2 weeks with common cold and lower
lobe pneumonia on the right. He was treated as a
out-patient but 3 days ago his general condition
was worsened and above mentioned complaints
was appeared. On physical examination the
patient is asthenic, exhausted, with pale grey
skin. An unpleasant smell from the mouth is
55. noted. On auscultation: the air entering in the
lower right lobe is diminished. In other chest
there is crapitation. On percussion: there is
dullness over the lower lobe on the right. CBC
reveals high WBCs count (leucocytosis) with the
formula band shift and low RBCs count
(anemia). On the X-Ray graph the right middle
and low lung fields are very dense. In the lower
lobe there is intrapulmonary destructive cavity
with horizontal fluid level surrounded by
inflammatory wall. Haw could you define the
chest disease?
What kind of cereals mentioned doesn’t produce *rice wheat oats rye barley
56. worsening the course of celiac disease (non-
tropical sprue):
A 19 years old patient complains of long-term What clinical *Hemophilia Hemorrhagic Iron deficiency anemia Aplastic anemia
bleeding started after tooth extraction. It is diagnosis is the most vasculitis
57. known from the case history that he has had probable?
large haematomas in the childhood. His uncle
from mother’s side died from bleeding.
A man aged 32 yr notes general weakness, *Acute leukosis Chronic Chronic Aplastic anemia Thrombocytopenic
elevation of the body t°, pains in the throat while lympholeukosis myeloleukemia purpura
swallowing. He is ill 2 months and treated from
tonsillitis by antibiotics without any effect. The
main clinical features are body t° 38,4 °C, RR
(respiratory rate) 22 per min; pulse 108, BP
(blood pressure) 100/60 mm of Hg. The skin is
pale. There are purpura (hemorrhagic rash) on
58. extremities, systemic enlargement of lymphatic
nodes and hepatosplenomegaly. In CBC RBC
are 2,2*1012/l, Hb 70 g/l; WBC (leuc.)
13,5*109/l; atypical cells (blastocytes) 32\%;
metamyelocytes 1\%; stab neutrophils 3\%;
segm. neutr. – 35\%; lymph. – 20\%; monocytes
– 8\%; thrombocytes 37*109/l; ESR –
30mm/hour. What clinical diagnosis is the most
probable?
 A men, 25 years, appealed to the policlinic *Infection-tocsical Sharp Sharp pyelonephrit. Sheynleyn’s – Genoh’s Berger’s illness.
concerning a quinsy. Appointed soulfanilamidi bud. glomerulonephrit. illness.
and aminoglicozidi. On 5-those day an urinary
59. syndrome turned out, arterial hypertension was
not present. A to 15 day an infection ended and
an urinary syndrome gradually vanished. What
diagnosis must it be?
Which of the diseases doesn’t trigger cancer of *amebiasis diffusive family Crohn's disease ulcerative colitis immunodeficiency
60.
the rectum: polyposis
The arterial hypertensive patient aged 30 during *reno-vascular hypertension disease polycystic kidney coarctation of aorta glomerulonephritis
last 5 years has had a constant BP index hypertension
170/100 – 200/120 mm Hg. On objective
61.
examining systolic murmur is heard above the
navel in the right. What’s the reason of
hypertension?
The patient aged 30 complains of headache, *chronical renal chronical renal Heart failure 3 stage chronical renal acute renal
general weakness, nocturia. Proteinuria has been insufficiency 1 stage insufficiency 2 stage insufficiency 4 stage insufficiency 1 stage
noted 5 years and arterial hypertention 2 years
62. ago. Heart rate is 88 beats per min, blood
pressure – 150/100 mm Hg, creatinine – 0.23
mkmole/l, urea – 9,1 mlmole/l, glomerular
filtration rate 50 ml/min. Diagnosis?
The patient aged 31, called in with complaints of *Polysorb Furosemid Hypothiazid Guttalax Verapamil
headache, nausea, vomiting. Diagnosis of
chronical glomerulonephritis with renal failure
63.
was made in stationary. What medical drug
again high blood urea nitrogen would you
recommend to the patient?
A sick man, who is 43, started to complain to his *Ulcerous stenosis of Gullet cancer Stomach cancer Ahalaziya of the gullet Reactive pancreatitis.
therapeutist about the heaviness in the stomach the exit part of the
after a meal, bad belch, vomiting with food, he gullet
had eaten the day before. He has suffered from
64.
ulcer of duodenum for 10 years. He has applied
to the doctor (therapeutist) two times but he
started to feel worse last month. What pathology
must it be?
The patient, aged 65 rising to the first floor have * Progressive Prinzmetal’s angina Angina on exertion Myocardial infarction Acute myocarditis
felt pain behind the sternum lasting nearly 5 – stenocardia III funct.class
8 minutes radiated to the left shoulder and
blade. For the next 10 days the attacks of pain
65. have become more frequent. A feeling as if he
lacks air to breathe (breathleeness) was
appeared. The pain didn’t cease after taking one
nitroglycerin tablet. What is the most probable
diagnosis?
 Patient after over cooling complained about *Pulmonary abscess. Bronchiectatic illnes. Lobar pneumonia. Pulmonary Cancer of a lung.
continuos fever up to 38?C, cough with small tuberculosis..
amount of serous sputum. Was under treatment
at district policlinic, in ten days hectic fever
appeared in spite of treatment. In three days
66.
after this suddenly expectorated sputum with
“full mouth” and very bad smell. Amphoric
respiration was auscultated over middle part of
the upper lobe from the right side. About what
disease is it necessary to think?
The patient aged 25 yr has dyspnea, cyanotic * Abramov – Fiedler’s Hypertrophic Exudative pericarditis Endocardial Mitral stenosis.
skin pallor occurred suddenly. Cardiac rate is idiopathic myocarditis cardiomyopathy fibroelastosis
130 beats per minute. BP is 85/50 mm. Hg. The
heart sounds are significantly quiet. On ECG
there are polytopic premature bites, diffuse
67.
myocardial changes. On X-ray there is a
cardiomegaly. The onset of illness the patient
connects with analgin intake adverse reaction
occurred 15 days ago. What is the most probable
diagnosis?
A patient aged 26 years complains of the * chronic lymphatic acute lymphoblastic infectious leukomoidal reaction
enlargement of cervical, subclavicular, grain lymphogranulomatosi leukemia leukosis mononucleosis
lymphatic nodes, skin itching, considerable s
68.
sweating at night, fever up to 390C. In CBC
there are leukocytosis, lymphopenia, high ESR.
What clinical diagnosis is the most probable?
A 42 years old man suddenly felt worsening of *post-hemorrhagic hemolytic anemia hypoplastic anemia DVC – syndrome pernicious anemia
his general condition and complains of anemia
dizziness, weakness and appetite loss. From the
clinical history it is known that the patient
suffers from the duodenal ulcer disease within
15 years and it is written down in his individual
69. medical file. In CBC erythrocytes(RBC) are
1,9*1012/l , Hb 57g/l , KP 0,9, reticulocytes 1\%
, thromb. 2,1*109/l , WBC (leuc.) 11,5*109/l ,
eosinophils-1\%; stabneutrophils-10\%;
seg.neutrophils-65\%; lymph/-19\%; mon.-5\%;
ESR-35 mm/hour. What clinical diagnosis is the
most probable?
The therapeutist must prescribe to *Pregnant women Patients after 60 All children Patients after operation Workers of industrial
patients primary prophylaxis iron interprises.
70. deficiency anemia to prevent its
development. Whо is adminested this
prophylaxis?
 The man os 25 years complains of periodic *Famotidin Cerucal Vicalinum Maalox Gastropharm*Famotid
epigastralgia. At inspection the chronic gastritis in
with the increased acidity is revealed. Treatment
71.
is lead. What preparation is expedient for using
for primary preventive maintenance of a
stomach ulcer?
A 21 years old patient with history of multiple *aplastic anemia, hemolytic anemia iron-deficiency B12-dificiency anemia acquired hypoplastic
pneumonias complains of malaise, hemorrhagic anemia anemia
breathlessness, palpitation, fillings of noisy ears syndrome
and “flies” in front of eyes. The patient is ill
within one month. On physical examination the
skin is pale. In the mouth there is ulceretive
necrotizing stomatitis. Also purpura in the
femoral and abdominal skin areas is noted. The
72.
peripheral lymphatic nodes are not enlarged.
CBC: RBC are 1,8*1012/l, Hb 56g/l K.P-
0,9 , WBC 2,3*109/l; eosinohyils-2\% , stub
neutrophils 3\%, segmented neutrophils 65\%,
lymphocyes 22\%, monocytes 8\%,
thrombocytes 16*109/l , ESR 25mm/h. In urine
analysis the macrohaematuria is revealed. What
clinical diagnosis is the most probable?
A 70 year old patient has got an unhospital *Spiramycin in Penicillin Ampicillin 0,5 6 Etazol endovenous. None of the variants is
pneumonia of the second category. Prescribe the combination with intramusculary times a day right.
73.
empiric therapy that is most appropriate for this doxycycline per os.
case.
Patient P., age 52 has IHD (ischemic heart *The incapacity of The presence of the Pathological Hemodynamic factors The breach of the
disease) for 5 years. He is worried about the injuried coronary spasm in injured adhession and of blood flow in the coronary blood flow
retrosternal pain that occurs after physical arteria to increase its coronary arteria. aggregation of the time of efforts in aorta. on account of arteritis.
exerxises. The pain lasts for 7-8 minutes and opening on when thrombocytes with
stops indepently at rest. The patient doesn’t use oxygen in needed. the extraction of
nitrats now. There are no pathologic changes of vasoactive
74.
segment ST and wave T on the ECG at rest; substanses.
during the coronary angiography, decrease in
diameter of the left coronary arteria by 50\%
was found. What is the pathogenesis of
retrosternal pain development of the patient in
this case?
 The atrial flutter with heart rate up to 130 per *Mitral stenosis Myocarditis Thyrotoxicosis Artherosclerotic Myocardiodistrophy
min firstly appeared in a woman aged 28 yr cardiosclerosis
considered before healthy. Physical examination
reveals pale bluish cheeks. The respiratory rate
is 24 per min. Cardiac auscultation is difficult
75. because of high rate but S1 tone is loud. The
chest is free and abdomen is soft and painless.
ECG revealed right ventricle hypertrophy and
atrial flutter. This woman was not consulted by
any doctor because she lives in a small village.
What is the most probable diagnosis?
In the patient, aged 45 after physical exertion * Acute myocardial Progressive Acute myocarditis Lung artery Aortic dissection
burning pain near the heart, fear of death, infarction of the stenocardia thromboembolism
sweating occurred. On the ECG there are the QS anterior wall of left
76.
wave, cupola – like ST elevation and negative ventricle
T in I, AVL, V1 – V3 leads. What is the most
probable diagnosis?
Patient A. Complains about the shortness of *Insufficiency of Feochromocytoma Chronic nephritis Hypertensive illness Coarctation of aorta
breath, pains in area of heart, sense of aortic valve
widespread pulsation. In anamnesis - frequent
quinsies (tonsillitis). Objectively: skin covers are
pale; positive capillary pulse, “dance of
carotids”, dome-shaped apex beat displaced
77.
downward and to the left, a pulse is quick, high.
The left border of heart is displaced to the left.
Weakening I and II tones, diastolic murmur over
aorta. BP - 180/40 mm Hg. ECG: signs of
hypertrophy of left ventricle. What most
credible preliminary diagnosis?
Patient 47 years is delivered at a clinic due to the *Acute myocardial Attack of bronchial Acute Acute Pneumothorax
attack of difficulty in breathing. Objectively: infarction asthma bronchopneumonia pleuropneumonia
skin is pallid-cyanotic. Position abed –
semisitting. Breathing is bubbling, 36 per a
78. minute. The heart sounds are dull, accent of II
tone above an aorta. Above lungs different moist
rales are hearing to. The WBC–10,5G/l; ESR 4
mm/hour; AST 1,8 mkmol/l; ALT 1,2 mkmol/l;
KFK 2,8 mkmol/l. Set a diagnosis:
Patient 28 years complains about the suddenly *Paroxysmal Atrial flutter Atrial fibrillation Atrioventricular block Respiratory arrhysmia
appearing strong and frequent blows of heart. In tachycardia of the III digree
anamnesis the cardiac diseases are not present,
was much nervous. Objectively: a patient is
excited, pulse 160 in a minute, BP-150/30 of
79.
mm Hg, contractions of heart are rhythmic,
sounds loud, clear. ECG: heartbeats 160 per a
minute, the QRS complex is stored, the P wave
is not determined. In the chest leads the voltage
of the T wave is megascopic. Your diagnosis:
 The ECG of 10 years old child *Narrow complex Atrial hypertrophy Ventricular WPW (Wolf – Premature bites
demonstrates high cardiac rate up 180 supraventricular hypertrophy Parkinson – White)
per minute. Р wave is accumulated on tachycardia syndrome
80.
Т and deforms it. The PQ interval is
slightly prolonged. QRS complex doesn’t
changed. What cardiac disorder has this child?
Patient 50 years, after heavy physical loading *First arising angina Diaphragmal hernia Prinzmetal’s angina Myocardial infarction Acute pericarditis
substernal pain of cutting character appears pectoris up pectoris
suddenly. BP-140/80 of mm Hg; pulse-80 in a
minute. The rhythm of heart regular, heart
81.
sounds clear. Pain disappeared in 10 minutes
independently. It is known from anamnesis, that
except attack of ARVI a patient was nothing ill.
About what is it necessary to think?
At a patient 58 years, 2 years being ill of stable *Progressive angina First arising angina Stable angina pectoris Myocardial infarction Acute myocarditis
angina pectoris of tension, the character of pectoris pectoris up of tenssion
clinical displays of angina pectoris changed
82. suddenly, more often and making of attacks
heavier appeared, began anymore to accept
nitroglycerine, an effect from acceptance
diminished. About what is it necessary to think?
A patient 56 years is at a clinic concerning the *Heart postinfarction Heart postinfarction Tromboemboliya of Aneurysm of heart Pleurisy
acute myocardial infarction the third week. He syndrome of Dressler cardiac insufficiency pulmonary artery
complains about the increase of temperature,
pains in area of heart of a different intensity and
83. character, pains in area of humeral joint and
defeat of skin. There is leukocytosis in a blood,
eosinophiliya, the ESR, level of (-2 and (-
globulin, C-reactive protein increased. About
what is it necessary to think?
A patient 65 years during a few days disturbs *Diaphragmal Peptic ulcer Acute gastritis Solyarit Diaphragmal hernia
pain in an epigastric region, once or twice was myocardial infarction
vomiting. Appealed to the doctor. It was
diagnosed acute gastritis. Got medical treatment.
84.
However much being of patient continued to get
worse – weakness, pallor of skin covers, sticky
sweat, BP-80/50 mm Hg, heart sounds very dull.
About what it is necessary to think:
Patient 30 years with complaints about the *Dilated (congestive) Insufficiency of aortic Insufficiency of Myocarditis Innate heart disease
expressed shortness of breath and palpitation cardiomyopathy valve mitral valve
during the last year. On X-ray of the chest
considerable expansion of heart is exposed. On
an electrocardiogram – decline of amplitude of
85.
the R wave in all leads and negative T. On
echocardiogram – dilatation of ventricles of
heart with the decline of fraction of the ejection
to 35 \%. A valvular apparatus not changed. It is
possible to suppose:
 Woman, 32 years, during 2 years was treated by *Peroral preparations Vitamins of B group Folic acid Parenteral Vitamin C
internist because of neurocyrculatory dystonya of iron preparationsof iron
and by gynecologist because of menorrhagia.
Complaints about the promoted fatigability,
muscular weakness, predilection for strong
86. smells (petrol, ether), the desires eat chalk.
Common analysis of blood: RBC- 3,5 T/l; Hb –
105 g/l; C.i. – 0,8; hypochromiya, anisocytosis;
WBC. - 6,8 g/l; B-0\%; E-2\%; St-4\%; S-60\%;
L-26\%; M-8\%; ESR 12mm/ch. Whey iron 7-8
mkm/l. What is it necessary to appoint?
The woman aged 30, is suffering from *Hemodialysis antibacterial therapy sorbents blood transfusion Hypotensive therapy
polycystic kidney. She was admitted to the
hospital because of weakness thirst, nocturia.
Diuresis was about 1800 ml per day. Blood
pressure 200/100mm Hg. Blood test:
87. erythrocytes: 1,8*109. Hg-68 g/l. Urine specific
gravity is 1005, leucocytes- 50-60, erythrocytes
in microscopic fild - 3-5, creatinine- 0,82
mmole/l, potassium – 6,5 mmole/l, provision
urine filtration rate 10 ml/min. What’s the
immediate task in the case treatment?
A patient is 60 years. In anamnesis - *Myocardial Hypertensive crisis Attack of angina Fainting-fit Cardiac asthma
hypertensive illness, angina pectoris. Felt off infarction pectoris
suddenly palpitation, heaviness in area of heart,
difficult breath appeared. At examination: it is
88. pale, it is all of a cold sweat, lips are cyanotic.
A pulse is frequent, it is difficult to count up. BP
100/50 mm Hg. The heart sounds are dull. A
patient is quickly hospitalized. How do you
think, with what diagnosis?
The sick man aged 40 has been suffering from * hemodialisis sorbents hemo – absorption plasmapheresis hemofiltration
glomerulonephritis. He complains of vomiting,
muscle cramps in the distal extremity. Blood
89. pressure 180/120 mm Hg, creatinine in blood
serum – 770 mkmole/l, glomerular filtration – 5
ml/min. What treatment methods are indicated
to this patient ?
A patient 55 years complains about pain, slight *Rheumatoid factor, Determination of uric Titers of Presence of LE-cells Determination of
swelling in the joints of brushes, long constraint X-ray of brushes acid in blood antichlamidias blood lipids level
at mornings, limitation of mobility. 1 year is ill. joints antibodies
Treated oneself with ibuprofen with a small
effect. Objectively: swelling of metacarpal-
90.
phalange, proximal interphalange joints of the
II-III fingers of both brushes with pain limitation
of mobility. ESR 37 mm/hour. What researches
are most informing for clarification of diagnosis
of rheumatoid arthritis?
 A patient 24 years complains about nausea, *Chronic nephritis Feochromocitoma Hypertensive illness Nephrotic syndrome Stenosis of kidney
vomiting, headache, shortness of breath. In 10 with violation of of the II degree artery
years had an acute nephritis. Proteinuria was kidney function
found out in urine. Objectively: a skin is grey-
pale, the edema is not present. Accent of II tone
above an aorta. BP 140/100 - 180/100 mm Hg.
91.
Blood level of residual N2 6,6 mmol/L,
creatinine 406 µmol/L. Day's diuresis 2300 ml,
nicturia. Spac. gravity. of urine is1009,
albumen 0,9 g/L, WBC-0-2 in f/vis. RBC.-sin. in
f/vis., hyaline casts single in specimen. Your
diagnosis?
A patient 70 years suffers of hypertensive illness *Cardiac asthma Myocardial infarction Acute violation of Fainting-fit Pulmonary edema
more than 20 years. Woke up at night due a cerebral blood
suddenly arised attack of shortness of breath circulation
with difficult inhalation. Objectively: orthopnoe.
92. Pulse 108 per/min, rhythmic. The heart sounds
are dull, on an apex the rhythm of gallop. In the
lower parts of lungs moist wheezes. What
complication of hypertensive illness arose up at
a patient?
Patient M., 52 years. Complains about headache, *Hypertensive illness Stenosis of bulb of Insufficiency of Coarctation of aorta Atherosclerosis of
palpitation. About 5 years suffers of of the III degree aorta aortic valve aorta
hypertension. Had the myocardial infarction one
year ago, 6 months ago - cerebral stroke.
93. Objectively: being of middleweight. The left
border of heart is displaced laterally on 2,5 sm.
Accent of II tone on an aorta, systole murmur on
an apex. Ps - 96 in a minute, arrhythmic. BP
190/105 mm Hg. Your diagnosis?
Man 40 years complains about gradually *Hypertensive illness Ishemic heart disease Chronic Itsenko-Kushing Coarctation of aorta
increasing headache, nausea, inclinations to of the II degree, crisis pyelonephritis Illness
vomiting, somnolence, pains in a heart, fog
before eyes. Suffers with hypertensive illness 12
years. Closing dates much worked, got tired.
Objectively: it is pale, a face is puffy, Ps-62
94.
/min, is hard. BP 200/120 mm Hg. The left
border of heart is displaced to the left on 2 cm.
Accent of II tone above an aorta, slight edema of
shins. Specific gravity of the urine is 1015.
WBC - single in f/vision. ECG: signs of
hypertrophy of left ventricle. Your diagnosis?
 Patient I., 50 years, complains about headache, *Hypertensive illness Feochromocitoma Acute Atherosclerosis of Insufficiency of aortic
flashing of beauty spot before eyes, excitation, of the II degree, crisis glomerulonephritis aorta valve
trembling in all body. Suffers of hypertensive
illness 5 years. Arterial pressure 140/90 -
180/100 mm Hg. Objectively: skin covers are
moist, red color. Ps is tense, 96 per/min. BP -
95.
190/105 mm Hg. Left border of cardiac dullness
- 1 cm laterally from a left middle clavicular
line. Accent of II tone on an aorta. ECG has the
signs of hypertrophy of the left ventricle. Spec.
grav. of urine 1019. WBC. - 2-4 in f/vis. RBC. -
0-1 in f/vis. Your diagnosis?
A patient has complaints about a tormental *Gangrene of lung . Tuberculosis. Bronchiectatic Abcetic pneumonia. Lobar pneumonia.
(agonizing) cough with expectoration to 600- illness.
ml/daily purulent chocolate color of sputum with
a decay smell. Onset of illness was abrupt,
96.
temperature 39(C, fever of irregular type. There
is the area of darkening with a cavity in a center
on X-ray film, with irregular contours and level
of liquid. What disease is the question?
A female patient complains of weakness, * Anemia due to Iron deficient anemia В12 – folic acid Coexistence of Aplastic anemia
dizziness, breathlessness on physical exertion gastricectomy deficient anemia Iron deficient
and, diarrhea. In history the patient started to be anemia with
ill 3 years ago after operative stomach hereditary В12 –
resection by B-II done against a chronic gastric folic acid deficient
ulcer disease complicated with severe bleeding. anemia
On physical examination the skin is pale and
97.
tongue brightly “lacquered” red. The CBC
reveals a low HB and hyperchromic enlarged in
size RBCs, their degenerative forms and
poikilocytosis, Zholy’s intra cell inclusions. She
was treated by iron preparations and vitamin
B12 and then her condition became much better.
What is the type of anemia?
Disease began abruptly with shaking chills, * Tympanic sound. Bandbox sound Clear lung sound. Dull-tympanic. Hip sound.
severe headache and fever up to 39-40?C. Pain
appears from the left side of the chest in 4 hours
during respiration. Cough at once was dry, but in
4 days rusty sputum was expectorated.
98.
Percussion revealed hip sound over left low
lobe, vocal fremitus was intensified, during
auscultation was listened bronchial respiration
over affected lobe. What percussion sound will
be over space of Traube?
 Patient C., age 32, is admitted in a hospital for a *Decrease of Decrease of difference Exceeding Exceeding hydrostatic Increase of the left
long time due to toxico-allergic myocorditis. difference between the between the oncotic hydrostatic over the over the oncotic ventrical of the heart
There is dyspnea at rest, heart rate 104 per min, oncotic and the and the venous oncotic pressure in pressure in arterioles. filling pressure.
arrhythmia was also observed. The pulsation of venous hydrostatic hydrostatic pressure. arterioles. Secondary Primary Primary
cervical veins occured in bed. There is an edema pressure. Secondary Primary hyperaldosteronism. hyperaldosteronism. hyperaldosteronism.
99.
in the lower limbs, the skin is pale, and cold hyperaldosteronism. hyperaldosteronism.
palpation on skin. The cap-shaped depression
disappears in 2 minutes. What is the main
pathogenic mechanism of the edema in this
case?
Woman, 56 years, complaints about the skin *Chronic Chronic myeloleucosis Chronic Acute myeloblastic Chronic
itching, sweating, subfebrile fever with the myeloleucosis (leucemic form) myeloleucosis leucosis lympholeucosis
periodic increases of temperature to 38-39 C(, (subleucemic form) (Aleucemic form)
loss of weight, heaviness in right and left
hypochondria, dyspeptic disorders. Objectively:
a skin is pale, some icteric. A liver palpate at the
100.
level of umbilicus, a spleen on 2 cm is below
than umbilicus, dense consistency. Common
analysis of blood: RBC -3,0 T/L, Hb-110 g/L,
C.I.-0,8; WBC-28 G/L, bas. – 4\%, eos.-5,
myel.-6, St.-8, seg.-70, L-5, M-3,
trom.180g/L,ESR mm/hour. Your diagnosis:
Rectoromanoscopy showed a 1 cm polyp in the *irrigoscopy rectum resection endoscopy repeated analysis of repeated
patient. On histological examination there was polypectomy the occult blood in rectoromanoscopy
101.
found an adenomatous polyp. The further feces
reasonable step in treating this patient can be?
The patient, 45 years, show complaints on *Acute miocardial Attack of a Thromboembolism of Acute miocardial Acute pericarditis.
severe retrosternal pains, not decreasing after infarction anterior- stenocardia. the pulmonary artery. infarction of posterior
usage of nitroglycerine. Objectively: septal-apex. wall of the left
integument’s are pale, there is cold perspiration, ventricular.
the respiration is vesicular and weakened, the
102. tones of heart are rhythmical, pulse beat - 78,
arterial pressure - 110/70. On the
electrocardiogram: a rhythm is right sinus, there
is pathological wave Q in the V1-V4, depression
of segment ST in III AVF. What is your
preliminary diagnosis?
 Of the patient of nephrological department, who *Uremic coma. Hyperosmotic coma. Toxic coma. Coma, which Hepatic coma.
is ill on chronic glomerulonephritis, changed for conditioned by damage
the worse. The patient is delayed, it is of central nervous
impossible to get in touch with him, painful system.
sensitivity is kept, integument’s are pale and
dry, the face is swollen, there is a fibrillary
103.
twitching of muscles, pupils are narrowed, the
respiration is vesicular and weakened, the tones
of heart are rhythmical, pulse beat - 96, arterial
pressure - 190/115. The blood test: creatinine -
0,352 mmol/liters. What condition was
developed at the patient?
Patient C aged 47 yr complains of intensive skin *primary biliary liver primary liver cancer chronic viral hepatitis acute viral hepatitis B alcoholic liver
itching, jaundice, bone pain. The skin is cirrhosis B cirrhosis
hyperpigmentated. There is multiple
xanthelasma palpebrarum. The liver is +6 cm
enlarged, hard with acute edge. The blood
analysis revealed total bilirubin 160 mkmol/l,
104.
direct – 110 mkmol/l, AST (asparate
aminotransferase) 2,1 mmol/l per hour, ALT –
1.8 mmol/l, alkaline phosphotase 4,6 mmol/l per
hour, cholesterol – 9,2 mmol/l,
antimitochondrial antibodies M2 in a high titer.
What is the probable diagnosis?
The patient aged 60 yr feels dyspnea on a even * Digoxin Egilok Isoptine Corinfar Preductal
slight physical exertion and complains of lower
limbs swelling in the daytime. He is suffering
from Ischemic Heart Disease and persistent
atrial flutter within 2 years. On physical
105. examination the patient appears acrocyanotic.
Heart rate is 120 per min., PS 68, BP 105/63
mm Hg. Heart sounds are loud, arrhythmic.
Chest auscultation reveals moist rales in the
lower lung regions. What treatment is the most
advisable for this patient?
The complications of acute cholecystitis which *Jaundice Empyema of the gall- Emphysematous gall- Gall-bladder Cholangitis
require surgical intervention are as follows bladder bladder perforation conditioned by the
106.
except: presence of stones in
the bile tract
The serologic profile of the patient having been *anti-НВс HBsAg anti-HBe anti--HBs anti - HBc and anti
inoculated with recombinant vaccine against -HBs
107.
hepatitis B (HBV includes the positive result of
the test for:
Which of the following substances (drugs) can *allopurinolum alchohol paracetamol methyldopha cordaron
108.
cause granulomatous hepatitis?
 The patient is 36. For a few years he has *polycystosis of the cirrhosis of the liver; multiple metastases echinococcosis of the acute hepatitis.
complained of heaviness and a dull ache in the liver; of liver cancer; liver;
abdomen. The liver is enlarged, hard and has an
109. uneven surface. CT (computer tomography) has
shown multiple pathological changes in the
organs of abdominal cavity. The correct
diagnosis is:
In the patient with the pulsating formation in the *aneurysm rupture ulcer perforation acute appendicitis peritonitis acute pancreatitis
epigastrium where systolic murmur has been
110. heard a sudden acute pain in the abdomen has
occurred. After the shock condition with loss of
consciousness was developed. The diagnosis is:
The 48 years old patient has the left ventricle *Dilatative Ischemic heart disease Hypertonic disease Hypertrophic Myocarditis
wall hypertrophy according to the data of cardiomyopathy cardiomyopathy
111.
echocardiography. What disease has no such a
symptom ?
Splenomegaly, the low RBC (red blood cells) *hemolytic jaundice extrahepatic intrahepatic sepsis mechanical jaundise
112. count, the high content of urobilinogen in feces cholestasia cholestasia
of the patient with jaundice are the symptoms of:
The patient, 32 years, complains of a constant *Chronic Acute pyelonephritis. Acute Chronic Paranephritis.
aching lumbar pains, frequent painful urination, pyelonephritis. glomerulonephritis. glomerulonephritis.
subfibrile temperature, a headache. Urine test:
relative density - 1015, protein - 0,066 gr/liters,
113.
leukocytes on all field of vision, erythrocytes -
4-5, oxalates. On the roentgenogram: expansion
of kidney plelois. What is your preliminary
diagnosis?
A patient K. aged 35 years complains of * Acquired hemolytic Acute liver Iron-deficiency В12- deficiency Viral hepatitis
weakness, dizziness, headache, palpitation, anemia insufficiency anemia anemia
attacks of pain in umbilical, sacral areas, fever
up to 38,20C, urine discoloration resembled
smoky brown and normal stool. The condition
started after bee sting. On clinical examination
the jaundice is noted. BP (blood pressure) is
100/60 mm of Hg, spleen is enlarged.
114. RBC ( erythrocytes) are 2,3 * 1012/l,
НB 72 g/l, K - 0,9, reticulocytes
13,1\%, WBC (leucocytes) 6,2 * 109/l,
ESR -25 mm/hour. In urine urobilin
reaction is strongly positive, bilirubin
pigments are absent. The total bilirubin is
60 mkmol/l, indirect 40 mkmol/l. Serum iron is
20,4 mkmol/l. What clinical diagnosis is the
most probable?
 A 30 years old woman complains of dizziness, *Iron per os Fresh blood Erythrocytal mass Iron pareuterally Vitamin B12-
weakness, increased nails fragility, alopecia and intramuscularly
pica. On clinical examination body t° is 36,7°,
the skin is pale, RR (respiration rate) is 20 per
min; Ps 98, BP (blood pressure) 100/60 mm of
Hg. In CBC erythrocytes are 2,8*1012/l,
115. Hemoglobin (Hb) 85 g/l, KP-0,9, reticulocytes-
2\%; WBC (leucocytes) 4,7*109/l; eosinophils-
2\%; stub neutrophils-3\%, segmented
neutrophils-62\%, lymphacytes-26\%,
monocytes-5\%, ESR-20mm/hour. Serum iron is
6,8 mkmol/l. What preparation is necessary to
prescribe to a patient?
Patient P 34 years old was diagnosed long- *beclometasone 1000 ?2-antagonist of the beclometasone 500 beclometasone 2000 ?2-antagonist of the
lasting bronchial asthma 3rd type and 3rd type mkg/day and at night, short action during the mkg /day, salmeterol mkg/day, oral short action 6 times
of exacerbation. Pulmonary insufficiency is of salmeterol 100 attack of breathlessness 50 mkg /day. prednisolon 10 per day, oral
the I type. What therapy should be administered mkg/day and at night, mg/day, salmeterol prednisolon 20
116. in this case? if necessary short 100 mkg/day. mg/day (2 times in the
acting ?2-antagonist morning).
but not more than 3-4
times per day and at
night
A patient aged 43 years was admitted to the *sever Moderate to severe mild Moderate Life threatening
hospital. She has been suffering from the
bronchial asthma for 7 years. The main clinical
features are following. The patient`s position is
orthopnoic and she speaks only with separate
words. The additional muscles take part in the
act of respiration. Respiratory rate is 32 per min.
117.
Wheezes are heard in all lung’s surface. The
heart rate 125 per min. Expiratory peak volume
after short acting B2 antagonists intake is 55\%
from the normal value. PaO2 is 58 mm of Hg,
PaCO2 42 mm Hg, SaO2 – 90\%. Haw should
be classified the bronchial asthma observed in
this case?
A 52 years old hard smoker patient complains *Chronic obstructive Bronchial asthma Mucoviscidosis Bronchoectatic disease Aspergillosis
of persistent cough with purulent sputum lung disease
discharge especially in mornings, dyspnea
provoked even by slight physical exertion,
wheezing chest, tahypnoe, general weakness.
118.
He considers himself to be ill during 12 years.
The overwritten conditions appear 3-4 times per
year usually after common cold and have
tendency to progress. About what disease do you
think first of all?
 Patient P. aged 62 yr was diagnosed non- *Protected Fluoroquinolones of Aryfromycin or Clindamycin Amycacin
hospital bilateral localized in lower lobes aminopenicillin the III-IV generation quarithromycin
pneumonia group III and risk class IV with intravenously or intravenously
119. exacerbated chronic obstructive lung disease in cephalosporin of the
III stage. What antibacterial preparation should II-III generation plus
be chosen for this patient for treating in the in- macrolid
patient department?
Patient F. aged 23 yr complains of the BT *Antihistamine Antibiotics Histaglobulin. Autoserum. Antipyretic drugs.
elevation up to 380 C, marked itching of the skin preparations of the 3-
120. , an appearance of rash on the whole body. She rd generation.
ate strawberries in the evening. What
preparations should be administered first of all?
A boy aged 15 yr periodically has been *De-nol Nos-pa Papaverin Atropin Almagel
complaining of the epigastric pains, nausea and
heartburn. Gastroduodenoscopy revealed the
121. sings of gastroduodenitis and ulcer impairment
of the duodenal mucous membrane. What drug
will be the most effective in the treatment of this
patient ?
3 weeks ago the patient was ill with tonsillitis. *Glomerulonephritis Cystitis Pyelonephritis Intestinal nephritis Renal amyloidosis
Clinical examination revealed edema, arterial
122. hypertension, hematuria, proteinuria (1,8g/per
day) granular and erythrocital casts. What is the
suggestive diagnosis?
The 52 years old patient has been admitted to *esophagogastroduod rectoromanoscopy irrigoscopy roentgenoscopy of the laparoscopy
the hospital. He complains of vomiting, soft enoscopy stomach
black repeated stools (melena) during the day.
Such cases have never been before. The pulse
123.
rate is 96 beats per minute, the blood pressure
100/70 mm Hg. On finger examination of the
rectum there was found black feces. The
appropriate examining is:
The 58 years old patient complains of the *ІІ І ІІІ IV Progressive ischemic
burning pain behind her breastbone which heart disease
appears when she walks more then 300 m of
distance and when she rises on the second floor.
124.
The stereotype pain propagated into the left
shoulder disappears within 1-2 minutes after
sublingual nitroglycerin intake. Identify the
functional class of ischemic heart disease:
 A patient T. 33 years was admitted to a hospital. *Ulcerous illness of Ulcerous illness of Erosive gastritis Acute pleurisy Acute myocardial
A patient is pale, at an attempt to stand up stomach, complicated duodenum, infarction, abdominal
complains about strong dizziness. There was with bleeding complicated with form
approximately hour ago vomiting like coffee- bleeding
125. grounds. BP - 90/60 mm Hg., pulse - 120 b/min.
It is known from anamnesis, that a patient
during 4 years suffers with ulcerous illness of
the stomach, painless form. An ulcer was
exposed at gastrofiberoscopy. Your diagnosis:
Patient T., 48 years. Complaints about the *Liver cirrhosis Chronic active Acute hepatitis A Acute cholecystitis Acute pancreatitis
decline of appetite, heaviness in an epigastria hepatitis
region after a meal, pains in right hypochondria,
aching character, increasing after a meal,
especially fat. Disturbs nausea, flatulence,
126. disorders of stool, loss of weight. At
examination – jaundice of skin, vascular spiders,
gynecomastia, ascites, “caput medusae”. A liver
at palpation is painless, dense, an edge is sharp,
a spleen is enlarged. Your preliminary
diagnosis:
Patient complains about significant dyspnoe. *Will be absent. Amphoric. Vesicular. Bronchial.. Cogwheel.
During inspection has forced posture
(orthopnea). Percussion of the lungs revealed
hip dullness to the 2-nd rib (backside) with
127.
upper boundary as parabolic line on the left side.
Respiratory sounds and vocal fremitus over
dullness are absent. What breathing will be in
the area of dullness?
A patient is ill 20 years with chronic bronchitis, *Bronchiectatic Abscess of lung Pulmonary Lobar pneumonia Gangrene of lungs
complains about cough with purulent sputum up illness tuberculosis
to 200-300 ml/daily. Lately discharge about 2
liters of purulent sputum per day with the
128.
biggest amount of sputum in a morning time,
fingers as “drumsticks”, nails have type of
“watch glasses”. About what disease is it
necessary to think?
Patient L., 38 years. Complaints about dull, *Chronic cholecystitis Cirrhosis of liver Acute hepatitis Chronic hepatitis Acute cholecystitis
aching pains in area of right hypochondria,
permanent or arising up in 1-3 hours after the
reception of abundant and especially fat food
and fried dishes. Pain radiates upwards, in the
region of right shoulder and neck. In addition,
129.
often disturbs feeling of bitter taste and metallic
taste into the mouth, belch with air, flatulence.
At palpation of abdomen tenderness in area of
projection of gall bladder. A liver is not
enlarged, a spleen not palpate. Your preliminary
diagnosis:
 The 62 year old patient complains of the 10 kg *kidney tumor kidney carbuncle kidney tuberculosis acute urolithic disease
weight loss within last 2 months, some times glomerulonephritis
dark red urine voiding occurs and pain in the
middle back. The patient is feverish up to 390C.
On palpation there is the left kidney tenderness.
130.
In blood: hemoglobin is 90 g/l, erythrocytes –
2,8*1012/l, leukocytes – 8,8*109/l, erythrocytes
sedimentation rate – 42mm/h. In urine: specific
gravity is 1018, protein – 0,.66 g/l,
mycroerytrocyturia . The previous diagnosis is:
The patient aged 38 within 2 weeks fills pain in * The first attack of Myocardial infarction Angina on exertion Angina on exertion IV Vegetative vascular
the upper one third part of the sternum that angina III ph. class ph. class dystonia
occurs usually when he rises to the 2nd floor.
131.
The pain lasts up to 5-10 minutes. BP is 120/80
mm Hg. ECG T-waves are smoothed out in V1-
V4. What is the most probable diagnosis?
A patient aged 45 yr long time suffers with *Thromboembolism Perforated duodenal Acute pancreatitis Acute cholecystitis All mentioned above
mitral stenosis and arrhythmia joined it last year. of superior mesenteric ulcer
Acute burning pains in the epigastrical region, artery
weakness, dizziness appeared suddenly 2 hours
ago. The main clinical features of the case are
following. The patient’s general condition is
severe. Pulse is 120 beats per minute and weak.
BP (blood pressure) is 90/40 mm Hg).
132.
Abdomen is paifull and rigid (does not take part
in respiration). The symptoms of peritoneum
irritation are observed. Peristaltic sounds are not
heard. Usual percussive liver’s dullness is
preserved. But there is not dullness in the
sloping parts of abdomen. The plane abdomen
X-ray does not reveal disorders. What is the
diagnosis?
Point out the sign which is not a criterion for the
*Increasing the The segment ST The development of The paroxysmal The signs of
cessation of a physical load test in patients cardiovascular depression more than 2 the ECG compete or ventricular tachycardia inadequate cerebral
133. suffering from cardiovascular pathology: frequency more than mm from the midline partial heart block development blood supply
30\% as compared
with the initial value
A 70 year old patient is on residential *Antagonists Ca++, Antagonists Ca++, Nitrates of durable (-adrenoreceptor (-adrenoreceptor
follow-up with the diagnosis: ischemic verapamil group nifedipine group action blocking agents, blocking agents, with
heart disease, stable angina of effort, selective intrinsic
134. II functional class. Ciliary arrhythmia, sympathomimetic
tachysystolic form. Сhronic heart activity.
failure II. Secondary diagnosis:
diabetes mellitus, type II.
Which of the following antiarhythmic *verapamil metoprolol ethacizine amyodaron propaphenon
135. preparations is contraindicated in treatment of
ventricular premature bites:
 The patient, 67 years, shows complaints on *Paroxismal Sinus tachycardia. Thimmer arrythmia. Ventricular Atrial tachycardia.
palpitation, dizziness, noise in ears, feeling of ventricular extrasystole.
shortage of air. Objectively: the patient is pale, tachycardia.
integument’s are damp, respiration is vesicular,
frequency of respiratory movements - 22, pulse
beat - 200 times a minute, arterial pressure -
100/70. On the electrocardiogram: frequency of
heart beat - 200, ventricular complexes
136.
are widened, deformed, the
arrangements of segments ST and of
wave T is discordant. The wave Р is
not changed accumulates on QRST,
conformity to natural laws between Р
and QRS is not present. What
infringement of a rhythm was developed
at the patient?
The patient, 32 years, complains of the general *Nephrotic. Uric. Acute nephritic. Hypertensive. Edematous.
weakness, loss of appetite, thirst, dryness in a
mouth, a headache, decrease of urinary
excretion, aching lumbar pains, edema on legs
and the face. Arterial pressure - 165/80. The
137.
blood test: creatinine - 0,18 mmol/liters,
hypoalbuminemia, hyperlipidemia. Urine test:
density - 1026, protein - 3, 5 gr/liters. Daily
proteinuria - 4. What clinical syndrome
conducting at the given patient?
The patient, 40 years, with combined mitral *Thromboembolism Acute miocardial Attack of bronchial Attack of heart asthma. Attack paroxysmal
defect with prevalence of a stenosis suddenly of the pulmonary infarction. asthma. tachycardias.
felt a sharp retrosternal pain, difficulty of breath artery
(dyspnea). Objectively: a condition of the
patient is grave, cyanosis, swelling of cervical
veins, tachipnea - 40 times a minute, vesicular
138.
respiration, tachycardia - 120 times a minute,
arterial pressure - 80/50 . On the roentgenogram:
an enlightenment of pulmonary fields on the
limited site, expansion of a shadow top of
superior cava. What is yours preliminary
diagnosis?
The 46 years old patient complains of the *Prinzmetal’s angina Progressive Early postinfarction Angina on exertion Angina at rest
anginous attacks development at night chiefly stenocardia stenocardia
from 3 to 4 AM without apparent cause. Within
139. valoergometric examination at time of 50 w
physical load the slight cardiac pain was noted
by the patient and this pain disappeared at 75 w
load moment. Make a diagnosis :
 The patient aged 60 had myocardial infarction * Egilok Corinfal Clophelin Triampur Prazozin.
10 years ago. He has been suffering from arterial
hypertension for about 15 years. Now he feels
palpitation and pain behind the breastbone. BP is
190/100 mm Hg, heart rate 100 per min. On
140.
ECG there are supraventricular premature bites,
left ventricular hypertrophy and scar on the
posterior myocardial wall. PQ interval longs
0,18 s. What preparation is indicated to the
patient?
The patient complains of syncope *artificial pacemaker prescription of nitrates atropine regular prescription of neopinephrine regular
(unconsciousness fits) that started to occur after implantation intake preductal intake
myocardial infarction which he had 6 months
ago. On clinical examination the heart sounds
141. are quiet, heart rate is 40 per min. and BP
110/70 mm Hg. On Holter ECG monitoring
second degree Mobitz type 2 (3:1, 4:1) A – V
block was established. Asystolic periods long
up to 3-4 sec. What is current treatment?
The female patient aged 28 had had a flu. Two * Pericarditis The second myocardial Acute muocarditis Idiopathic Angina Pectoris
weeks later she felt pain behind the breastbone. infarction cardiomyopathy
On clinical examination there are hoarse voice,
142. neck vein’s swelling, absence of relative cardiac
dullness. ECG voltage is low and segment ST
rises above the midline in all leads. What is the
most probable diagnosis?
The female patient aged 25 had had a flu. Two * Acute myocarditis Pneumonia Dilatation Infectious endocarditis Unstable stenocardia
weeks later severe weakness, mild fever, cardiomyopathy
breathlessness and constant aching cardiac pain
there occurred. On clinical examination the first
143.
heart sound (S1) is quite (s1). Body temperature
is 37,30 C. The ECG voltage is low and first
degree AV block noted. ESR is 30 mm/h. What
is the most probable diagnosis?
According to the New-York Cardiologists *metoprolol clophelinum doxasozine nitroglycerin indapamide
Association Recommendations the 55 years old
patient has been made the diagnosis ischemic
heart disease, angina on exertion functional
144.
class II, heart failure functional class I, arterial
hypertension of the second degree, hypertensive
heart. Point out the preparation of choice in
treatment of this case:
The 42 years old woman suffers from viral * admission to the the blood prothrombin the aminocapronic the antibiotics the dynamic
hepatitis B. On examination there has been intensive care unit control acid preparation prescribe observation of vital
determined the absence of comprehensive (ICU) infusion functions
145.
contact, confusion (patient`s disorientation in
place and time), the mild smell of acetone out of
the mouth. What is your immediate action?
 In a 6 year-old child infiltrate of 18 mm in Hyperergic Hypoergic Normergic Anergic Postvaccinal allergy
diameter was detected as a result of the Montoux
146. test. A 1 year ago Montoux test showed
infiltrate of 10 mm. Determine the result of
Montoux test.
18 years old patient complains of cramping * Shigellosis Thyphoid fever Food toxicoinfection Salmonellosis Escherichiosis
abdomen pain, weakness, body temperature up
to 38,5 for 2 days, scanty portions of stool with
147. mucous up to 10 times per day. The patient`s
tongue is white coated and dry. The abdomen is
painful in the left iliac region. Sigma is
spasmodic. What is the suspected diagnosis?
19 years old patient has an acute onset of * Cholera Shigellosis Campilobacteriosis Botulism Salmonellosis
disease. The body temperature is 36. He
complains of weakness, vomiting without any
148.
nausea and abdomen pain. The large amounts of
stool like rice-water with smell of grated
potatoes is the feature of this case . Diagnosis?
Within 20 days the 20 years old man has had a * ascaridiasis bronchitis bronchial asthma embolism of lobar pneumonia
fever and productive cough. By auscultation pulmonary artery
there has been detected bilateral diminished air
149.
entry and moist rales. The X-Ray showed
volatile (migrants) infiltrates. Point out the
diagnosis:
The 19 years old patient was admitted in the in- * acute joining of the biliary ducts acute hemolytic infective toxic shock
patient department with viral hepatitis B. On the encephalopathy secondary infection obstruction anemia
5th day of the disease the patient become to be
excited, speaks much. The jaundice is
deteriorating. There is tachycardia. The size of
150. liver is decreasing up to 2.5 cm per day. The
total serum bilirubin increased 2 times
comparison with day of admission and ALAT
(alanine aminotranspherase) fall from 8.0
mmole/l to 3.8 mmole/l. What cause triggered
the patient’s deterioration?
A child from tuberculosis place was admitted to Bipolar Pneumonic Consolidation Calcification Fibrous
the children's department of tuberculosis
hospital with primary tuberculous complex. On
the X-ray there is shadowing of medium
151.
intensity with poor defined outline in 2-nd
segment of the right lung, bound "track" with the
root, increased root lymphonodes. Determine
the stage of primary tuberculous complex.
 The 30 years old patient jast now arrived from * malaria adenoviral infection sepsis typhoid leptospirosis
Tadjikistan. There are complains of fever up
to 40 ?С, which is accompanied by
chills and sweating. There has been
revealed hepatosplenomegaly in this
152. case. Blood analysis shows the red
cells count (RBC) 3.0 x 10e12/l, Нв
80 g/l, white blood cells count (WBC)
4.0 x 10E9/l, Еos 1\%, Neutro 65\%,
Limph 24\%, Мon 10\%, ESR- 25
mm/hour. The previous diagnosis is:
A pain in the axillary area, increase of the *Plague Acute purulent Lymphogranulomatos Anthrax Tularemia
temperature developed 10 hours ago in the lymphadenitis is
patient. On exa-mination: shaky gait is marked,
the tongue is coated by white fur. The pulse is
153.
frequent. The painful lymp-hatic nodules are
determined in the axillary area. The skin is
bloodshot, glistening above the lymphatic
nodules. What is the most probable diagnosis?
In a surgical department * Yersiniosis Dysentery Typhoid fever Amebiasis Salmonellosis
appendectomy was performed on the
patient Н. of 30 years old. Subfebrile
temperature persisted operation.
Periodical watery stool developed.
154.
Since the 10th day of the disease the
temperature has been 39,5С, with
chill. Eruption, enlarged liver,
moderate jaundice, polyarthralgia are
marked. What is the diagnosis?
The patient S. was admitted to the hospital with * Tetanus Rabies Meningitis Poisoning with Epilepsy
complaints of general cramps, anxiety. He fell ill Strychninum
two days ago. During the last 6 hours the attacks
became more frequent and prolonged. On
155.
examination: sardonic smile, rigidity of occipital
muscles, trunk and extremities are marked. The
patient injured his foot by rusty wire a month
ago. What is a diagnosis?
The patient E. has complaints of rough *Diphtheria of Foreign body of larynx Wide-spread form of ARVI - acute Localized form of
barking cough, loss of voice, difficult stomatopharynx and diphtheria of laryngotracheitis diphtheria of
respiration. He has been ill for 4 days. larynx, croup stomatopharynx stomatopharynx
The temperature is 38(С. Objectively: the
156. patient is restless, irritable, stenotic respiration,
the tonsils are enlarged, covered by dense, pale-
gray coats, which are spread to the soft palate.
The mucous membrane of the pharynx is
cyanotic. What is the preliminary diagnosis:
 The patient of 20 years old complained of *Erysipeloid Erysipilatous Phlegmon Panaritium Paronichy
dermal itching, bright reddening and edema in 4 inflammation
days after microtrauma in the area of nail
157.
phalanx of the 3-rd finger, received due to
preparation of pig meat. What is it necessary to
think about first?
The patient of 42 years old had attacks of the *Microscopy of blood Virological method General analysis of Bacteriological Immunoenzyme
fever every 48 hours during one week. The smear and thick drop blood method analysis
temperature of the body increased to 40(C and
decreased in 3-4 hours and accompanied by
158.
excessive sweating, general weakness
developed. The liver and spleen are enlarged and
firm on palpation. What is the most effective
method for verification of the diagnosis?
The patient consulted to the doctor * Diphtheria of Candidiasis of Ulcer-necrotic angina Agranulocytic angina Infectious
with complaints of high temperature stomatopharynx stomatopharynx of Symanovsky- mononucleosis
to 37,8(С, moderate pain in his throat for 3 Viensan
days. Objectively: the submandibular lymphatic
159. nodules are enlarged. The palatine tonsils are
hypertrophy, covered by gray, smooth fur,
which is spread to the uvula and forward
palatine arches. What is the most probable
diagnosis?
A patient T. fell ill acutely with headache, chill, * Bacteriological Puncture of Serological method Intracutaneous allergic General blood
pain in her throat, temperature 38(С. The method submandibular test analysis
patient was examined by the doctor lymphatic nodes
the same day. The doctor revealed
gray firm membranes on the tonsils,
160.
enlarged and painful lymphatic
submandibular nodules. Diphtheria
was suspected. What is the most
effective method for verification of the
diagnosis?
The patient С. fell ill 3 days ago. The *Leptospirosis Viral hepatitis A Influenza Trichinosis Typhoid fever
disease began by increase of the
temperature up to 39,5(С, pains in the
161. muscles of the legs and trunk. There
are weakness, bleeding from gums
and nose. The skin and sclera are
yellow. What is the diagnosis?
 The patient С. fell ill acutely: a high *Salmonellosis Lambliasis Dysentery Escherihioses Acute pancreatitis
temperature (38,0(С), pain in the
epigastric area, vomiting, plentiful
watery stool without admixtures and
tenesmus in 3-4 hours after using
162.
insufficiently fried meat. Objectively:
the paleness of dermal integuments,
acrocyanosis, tachycardia, hypotonia. The
stomach is painful on palpation. What is the
preliminary diagnosis?
The patient М., was admitted with *Culture of feces and Culture of blood on a Culture of duodenal Virological blood Biochemical blood
complaints of nau-sea, vomiting, spastic wash waters bile broth contents analysis analysis (bilirubin,
abdominal pains, chill. She be-came ill acutely 2 amintransferases,
hours ago after taking the pasta with meat. In prothrombin)
163. objective examination: temperature - 38,5(C, Ps-
110, BP-110/60 mm Hg, the tongue is coated
and dry. Stool was one time without admixtures.
What investigation is necessary for making a
diagnosis?
The patient С. of 18 years has *Infectious Typhoid fever Sepsis Diphtheria Lacunar angina
complaints of sore throat, headache, mononucleosis
weakness, fatigue. On examination:
enlarged cervical, axillary and inguinal
lymphatic nodules up to 1-3 cm in
164.
diameter, of dense consistence, non-
adhered, motile are revealed. There are
hyperemia of the fauces and purulent coats on
tonsils. Hepatosplenomegaly. What is the
diagnosis?
The preliminary diagnosis was made to the * Chloramphenicol Quinine intravenously Etazolum Penicillin Streptomycin
patient – meningococcal disease: meningitis, intramuscularly intravenously intramuscularly intramuscularly
meningococcemia. The condition is grave. The
patient is pale, adynamic. There are many
165. hemorrhagic elements on the skin. Meningeal
signs are positive. The pulse is frequent,
weak, BP – 80/40 mm Hg. The
temperature is 40(С. What etiotropic
therapy would you prescribe?
The 32 years old man-fisherman has fever up to *Leptospirosis The increasing of The high aldosterone Serum prothrombin Leptospirosis liver
400 C, headache and calf muscles pain. At the 5 nephrosonephritis protein catabolism secretion deficiency affection
166. th day of disease onset the depleted urine
output and increased blood urea and creatinine
are noted. Point out the cause of this condition:
 A man-hunter complains of a headache, severe * anthrax tularemia. brucellosis plague forelosis
weakness, fever about 39 (C and right upper
167. limb edema. On the hand there are an painful
ulcer covered by dark crust on the bottom and
small vesicles around it.
A 70-year old woman has fallen ill acutely. The * Brill’s disease Meningitis infection Typhoid fever Flu Epidemic Typhus
fever is about 39 0C. The patient is excited, out-
168. self reflexive, talkative. The other features of the
case are scleral injection, facial hyperemia,
Rosenberg’s anathema. Diagnosis?
A patient with the body temperature 38,40 C * Parainfluenza Adenovirus infection Pneumonia Grippe Enterovirus infection
developed severe barking cough, respiratory
distress with intercostal chest retractions. The
169. patient looks moderate cyanotic espesially in
appearance of the nasolabial triangle. What
illness provokes this symptoms more
frequently then others?
On the 18th day of the disease in the patient * hemorrhage infective toxic shock perforative peritonitis anemia joining the secondary
suffering from typhoid fever the sudden body infection
temperature fall down up to 370 C, the rapid
170.
pulse, thirst and hypotension were noted. The
stool assay (Gregersen) for occult blood is
positive. What complication was occurred?
The patient complains on high * Influenza Epidemic typhus Typhoid fever Q fever Acute tonsillitis
temperature (38,5(С), chill, severe
headache, dry cough. The skin of his
face and conjunctiva are bloodshot. His
171. throat is bloodshot, granular enanthema and
punctate hemorrhages are on the soft palate. The
pulse rate is 90 beats per minute, rhythmical, of
satisfactory properties. What is the probable
diagnosis?
In a 32-year-old patient with infiltrative right Segmental lung Artificial Thoracoplastic Pulmonectomy Extrapleural
upper lobe pulmonary tuberculosis tuberculoma resection pneumothorax surgery pneumolisis
172. of 3 cm in diameter was formed in 6 months
after hospital treatment. What radical method of
treatment may be used?
A 19-year-old patient was admitted to the Tuberculous Viral Pyrulent Insult Tumor
hospital with the diagnosis: meningitis of the
unknown etiology. She was investigated. Blood
test: leucocytes- 10,0 x 109/L, neutrophile shift
to the left, lymphopenia, monocytosis, ESR-19
173.
mm/hr. CSF: increase in protein value, decrease
in glucose and chloride counts, leucocytes-130
in 1 ml., 100\% lymphocytes, MBT (-). In 48 hrs
the fibrin layer was formed. What etiology of
meningitis can be suspected in this patient?
 A 42 year-old patient with the Workers of sanitary Patient Members of patient’s Medical personnel of a District doctor
diagnosis: Infiltrative pulmonary epidemic control family polyclinic
tuberculosis in the phase of
disintegration, МBТ (+), was
174.
hospitalized to specialized hospital.
Who should conduct final disinfection
at the place contaminated by
infection?
The disease in a child’s institution began *Toxic food infection Poisoning with salts of Bacterial toxicosis Acute intestinal Mycotoxicosis
suddenly in 2-3 hours after having the cottage hard metals infection
cheese, which didn’t undergo thermal
treatment. All patients had plentiful
repeated vomiting, abdominal pain,
175.
watery stool, paleness of the dermal
integuments. The body’s temperature
is 37,3(С. The clinical manifestations
passed during a day. What is the
probable diagnosis?
A patient N. was admitted to the hospital in the *Hypovolemic shock Infectious-toxic shock Distress syndrome Acute renal Mixed shock
extremely serious condition: cold extremities, insufficiency
acro-cyanosis, dry skin and mucous membranes,
dark circles around eyes. The pulse rate is
176.
frequent, thread. BP - 40/0 mm Hg. The disease
began 10 hours ago: plentiful repeated watery
stool without admixtures and repeated vomiting.
The severity of the condition is caused by:
The patient C. fell ill acutely 12 hours ago: *Acute dysentery Typhoid fever Acute amebiasis Cholera Salmonellosis
tempera-ture 38(C, chill, general weakness,
spastic pains in the low parts of the abdomen. 5
177. hours later frequent scan-ty stool with
admixtures of mucus and blood occurred. The
patient drank unboiled milk. What is the
preliminary diagnosis?
A 3-year-old girl was admitted to the hospital in Decreased glucose Increased glucose and Normal glucose and Decreased protein Huge quantity of cells
critical condition with temperature 39.60C. She and chlorides contents chlorides contents chlorides contents contents
has been sick for the last 10 days: she has
dyspnea, severe headache. Her mother says she
178.
has been in contact with her uncle who is
suffering from tuberculosis. Muscles of nucha
are rigid. Sharp dyspnea. What changes in liquor
are characteristic for tuberculosis meningitis?
 The patient D. was admitted to the hospital on *Acute dysentery Cholera Esherichiosis Toxic food-borne Typhoid fever
the second day of the disease with complaints of infection
temperature increase up to 39(C, paroxysmal
pains in the lower part of the abdomen, frequent
179.
watery stool with admixture of the mucus. On
examination: the stomach is painful in the left
iliac area. The sigmoid is spasmodic. What is the
preliminary diagnosis?
A patient is suffering from disseminated lung Pleurisy Cardio-pulmonary Kidney insufficiency Amyloidosis Pulmonary bleeding
180. tuberculosis. What is the most common insufficiency
complication of this process?
Tuberculosis of the right intrathoracical lymph- In 6 -8 weeks In a weeks In 3 days In 3 months In a day
nodes complicated with bronchonodular fistula
was diagnosed in a 9-year-old child at a
tuberculous dispensary, confirmed by
181.
bronchography. A sputum culture examination
for finding mycobacte-rium tuberculosis was
performed. In what period of time it will be
possible to get the result?
Virage of tuberculin test is found in a 7 year-old Infiltrative Small Tumorous Fibrous Cirrhotic
child from a tuberculous epidemic place. The
lung X-ray reveals enlargement of the right lung
182.
root and dilated contours. Preliminary diagnosis:
Tuberculous bronchoadenitis. What form of
tuberculous bronchoadenitis this child has?
A 6-year-old child has virage of the Montoux 5 mg/kg 12 mg/kg 10 mg/kgs 25 mg/kg 15 mg/kg
test. He is healthy. What dose of isoniazid must
183.
be prescribed to this child for prophylaxis of
tuberculosis?
CSF is taken in the patient with suspected Lymphocytous Neutrocytous Monocytous Eosinophilous Basophilous
184. tuberculous meningitis. Which kind of cytosis is
characteristic in tuberculous meningitis?
A 6-year-old child complain of weakiness, bad Primary tuberculous Pneumonia Lung cancer Eosinophilous Pulmonary
appetite and cough. He has virage of tuberculin complex infiltrate echinococcus
test. He is pale, malnourished, has
185. micropolyadenia. BCG cicatrice is absent. On
the X-ray there is shadowing in the upper right
lobe associated with infiltrated lung root. What
disease can be thought of in this patient?
A 37-year-old patient with disseminated Streptomycin Rifampicin Isoniazid Ethambutol Pyrazinamid
pulmonary tuberculosis was treated by HRZS in
tuberculous hospital, in three weeks after
186.
begining of treatment he felt tinnitus aurium,
giddiness, decrease of hearing. Which
medication can lead to such symptoms?
 In a 25-year-old student during prophylactic 1, 2 2, 3 1, 5 9, 10 7, 8
examination foci in the right lung are found.
187.
Call the most common localization of focal
tuberculosis in the lung segments?
The inhabitant of India periodically had sharp *Chronic amebiasis, Chronic relapsing Helminthiasis Balanthidiasis Hypovitaminosis
abdominal pains, indulgence of stool. Stool is abscess of the liver dysentery (diphyllobotriasis)
sometimes viscous of brown color, with
admixture of mucus. The patient lost weight
188.
significantly. The pains in the right
hypogastrium, chills, and high temperature
developed two weeks ago. What is the
preliminary diagnosis?
The disease began acutely: frequent watery stool * Cholera Typhoid fever Dysentery Salmonellosis Toxic food-borne
developed 6 hours ago. The body temperature is infection
normal. Then the vomiting developed. On
examination: his voice is hoarse, eyes are deeply
189.
sunken in the orbits. The pulse is frequent.
Blood pressure is low. There is no urine. There
are cramps of the low extremities. What is the
preliminary diagnosis?
In a 3 year-old child with right-sided tumorous Atelectasis Pneumonia Apical pleurisy Miliary tuberculosis Abscess of the lung
bronchadenitis dyspnea, cyanosis and extensive
dry cough appeared on the ground of receiving
specific therapy in tuberculosis hospital. During
190.
X-ray control upper lobe of the right lung had
shadowing and reduced in volume, organs of
mediastinum are displaced to the right. What
complication had arisen in the child?
A patient was admitted with the loss of Hyperosmolar Hyperlactacidotic Ketoacidotic Hypoglycemic Alcoholic
consciousness. He has history of diabetes
mellitus type 1 for 12 years and acute
191.
gastroenteritis during the last week. There are
dry skin, soft eyeballs, shallow breathing, no
acetone smell. What is the most probable coma?
A patient presents with the loss of Intravenous insulin Intravenous injection Intravenous injection Intravenous injection Hydrocortisone +
consciousness, dry hot skin, facial hyperemia, injection of glucose of glutamic acid of sodium chlorine thyrotropin
192. Kussmaul’s breathing, acetone smell. Blood solution
gluse level - 33 mmol/l. Ketoacidotic coma was
diagnosed. What is to be done first of all ?
A 41 years old woman complains of infertility, ( Ridel's thyroiditis Autoimmune Nodular goiter Acute purulent
memory disturbance, appetite loss, skin dryness thyroiditis thyroiditis
and mild swelling (pastosity).On physical
examination there are evident bradycardia and
193. dull heart sounds. Thyroid gland is diffusely
enlarged and very hard. The serum
thyreoglobulin antibodies are in 1: 1000 titer.
What thyroid gland disease is presented most
probably in this patient?
 A 45 years old patient long time suffers from * Secondary Multiple myeloma Primary Neurofibromatosis Siple’s syndrome
kidney polycystic disease with 4th degree of hyperparathyroidism disease hyperparathyroidism,
chronic renal failure and is treating with chronic osteopenic form
hemodialysis. She complains of skin itching,
lower extremities joints pain. The X-ray of feet
194.
shows the metatarsus-phalangeal junctions
resorption. The patient takes calcium
preparations. Serum calcium is 2,2 mmol/l,
phosphorus 0,95 mmol/l, parathormone 554
ph/ml. What diagnosis is proposed?
A 38 years old patient was urgently admitted to Addisonic crisis Acute gastroenteritis Meningoencephalitis Scleroderma Pellagra
the hospital with complaints of sudden
weakness, dizziness, loss of consciousness, body
195. weight loss, , nausea, vomiting, severe pain in
epigastric area, diarrhea, skin
hyperpigmentation. What is the most probable
diagnosis?
A 33 years old female has diabetes mellitus for 5 Insulin resistance Dawn phenomenon Diabetic nephropathy Diabetic neuropathy Insulin allergy
years. She uses more than 100 insulin units per
day for the last 6 months. Her body weight
gained for 10 kg. Fasting glucose level is 13
196.
mmol/l, daily urine glucose – 3\%. Generalized
microangiopathy. Hypoglycemia was reported
after attempts of insulin dosage increase. What
is the diagnosis?
An unconscious patient presents with moist skin, Hypoglycemic coma Hyperglycemic coma Hyperosmolar coma Hyperlactacidotic Stroke
shallow breathing. There are signs of previous coma
injection on the shoulders and hips. BP 110/70
197. mmHg. Tonus of skeletal muscles and relexes
are increased. Cramps of muscles of the
extremities are seen. What is the most likely
disorder?
A 67 years old female with diabetes mellitus Diabetic acute painful Autonomic neuropathy Central chronic Radiculoneuropathy Asthenic syndrome
type 2 presents with severe pain and soreness of neuropathy neuropathy
198. the legs, most of all of hips. The touch is
extremely painful. What is the most probable
diagnosis ?
A 32 years old patient was presented with No changes 50 \% increase 100 \% increase 50 \% decrease 100 \% decrease
primary chronic adrenal insufficiency of
199. moderate severity. How will be changed the
level if 17-KS after the test with ACTH
(synacthen)?
A 42 years old female complaints of nausea, Determination of Hands X-ray Urinalysis Determination of urine Determination of
frequent defecation, weakness, dizziness, body urine 17-КS and catecholamines urine calcium
weight loss. Skin colour is similar to intensive 17- OHCS
200.
tan. Hyperpigmentation is the greatest on joints,
palms. BP 86/60 mmHg. What is necessary to
be performed to define the cause of the disorder?
 A 26 years old patient was revealed on a street Hypoglycemic coma Ketoacidotic coma Alcoholic coma Drugs intoxication Cerebral Hemorrhage
with the loss of conscioucness. He was admitted
to the hospital with provisional diagnosis of
alcoholic intoxication. Episodes of cramps were
registered. The skin is dry, skeletal muscles
201.
tonus is increased. Pathological reflexes are
positive. The smell from his mouth is normal.
There are signs of injections on the abdomen
and hips. Pulse 90 per min, BP 104/75 mmHg.
What is the most probable diagnosis?
A 28 years old patient had used simple insulin Hypoglycemic coma Hyperosmolar coma Uremic coma Ketoacidotic coma Stroke
for 2 years. Two days ago he started to use new
scheme of therapy with Protaphan. Previous
202. evening he was presented with sudden
weakness, increased sweating, loss of
consciousness. What is the most probable
diagnosis?
The 56 years old patient has worked at the * fluorine intoxication mercury intoxication lead intoxication phosphorus manganese
aluminium plant more than 20 years. Within 3 intoxication intoxication
203. last years he has developed loosening of teeth,
bone and joint pains, piercing pains in heart
area, vomiting. The previous diagnosis was:
A sick 37 years old woman was admitted to the *Unitol Atropin Dipiroxim Izonitrazin Mecaptid
district hospital with symptoms of mercury-
204. organic pesticide poisoning (she ate bread made
from pickled seeds). Chose the antidote therapy
in this case:
A 55 years old patient was diagnosed infiltrative *rifampicyn Isoniazidum pyrazinamide ethambutol streptomycin
tuberculosis of the right lung upper lobe with
destructive lesion. AFB (acid fast bacilli) in
sputum are positive. The history: 5 years ago he
was ill with focus lung tuberculosis. In the in-
patient department he was administered anti TB
205.
(tuberculosis) therapy recommended DOTS as
for the patient of the 3rd category. After the
month of treatment the mild jaundice is
appeared. Biochemical blood analysis reveals.
the increased activities of AST and ALT. What
anti TB preparation caused such complication?
A 45-year-old woman complains of periodical *Culture urine test for Ultrasound Direct smear test of X-kidneys, Mantoux Laparoscopy, direct
painless bleeding during urination, weakness, micobacteria, excretal examination of the the sputum skin test. smear urine test
hyperhidrosis, losing flesh (about 10 kg for last urography. kidneys, biochemical
six months) and continual fever with ague blood test
206.
attacks. Blood and urine test haven’t revealed
any peculiarities. Tuberculosis of kidney had
been suspected. Choose the most expedient
programme of additional examination.
 A 7 years old boy began to complain of the *tuberculosis TB contamination Chest tuberculosis primary tuberculosis vegetovascular
body t0 elevation up to 37,50C in the evenings, intoxication complex dystonia
weakness, loss of appetite. Mantoux test is 12
mm. Last year it was 5 mm. On clinical
examination the skin is pale and enlarged groin
lymph nodes are palpated. Chest is clear and a
207. vesicular type of respiration is heard in the
lungs. Heart sounds are clear, rhythmical. X-ray
examination: roots of the lung are of normal
configuration, lung fields are transparent.
Sinuses are free. The CBC: leucocytes are
7,5*109 /L, ESR 17 mm/hour. Clinical
diagnosis is:
18-years-old man complains of pain in the right Tuberculosis if the hip Arthritis deformans of Gouty arthritis. Gonorrheal arthritis. Epiphyseal aseptic
hip joint. Contracted year and a half ago. joint. the hip joint. necrosis of upper end
Movement in the affected joint is restricted, of femur.
right leg is short-cut and on the right hip there is
208. a cold abscess. Blood test: leucocytes–11,5(109;
slight neutrophilia and lymphopenia. X-picture:
signs of osteoporosis, joint space constriction,
destruction of the pelvic bones and the head of
thigh bone. Choose the most likely diagnosis.
A six-year-child whose father suffers from *not earliar, than in 3 in a month. in two days. during a year. in 3 weeks.
bacterial lung tuberculosis shown negative days and not later,
209.
Mantoux skin test. In what term he has to be than in 2 weeks.
BCG-revaccinated?
A patient aged 52 years works at the chicken *infiltrative right-side abscess right lung cancer pneumoconiosis infarction –
farm. The main complains are slight fever up to tuberculosis of the formation pneumonia pneumonia of the
380C and a cough with mucopurulent sputum lung on the right right lung
discharge. He associates the disease with the
commoncold. The last fluorography
examination was done 2 years ago.. Now the X-
210. ray examination shows in 6 segment projection
non-homogenous infiltrative density with
destructive lesion up to 3 cm in size. The ESR
is 13 mm per hour. The WBCs (Leucocytes) are
6,8*109 /L in blood. AFB (acid fast bacilli) are
found in the sputum. What disease is the most
probable?
Choose the minimal duration of treatment course *6 months 4 months 8 months 9 months 3 months
211. in the case of destructive and bacterial lung
tuberculosis effective treatment?
 A 47 years old man after lifting a considerable *spontaneous pulmanonary exudative pleurisy right lung atelectasis croupous pneumonia
heavy weight suddenly felt an acute pain in the pneumothorox thromboembolism
right side of the chest and breathlessness. A
symptoms increased and mucous and skin
became cyanotic. An emergency doctor learned
that 7 years ago the patient was ill with an
212. infiltrative chest tuberculosis of the right lung,
had recovered and was not examined within the
last 3 years. On percussion exaggerated
tympanitis was revealed over the right part of
chest and auscultation revealed the sharply
weakened breath sounds here. What disease
should be the first thought?
A 2 months old child (an infant) was born in *BCG-M Diphtheria, tetanus BCG ADP ADP-M
term with 3550 g of weight and had had the toxoids and pertussis
symptoms of hemolytic disease of the new- born vaccine
213. appeared in the first days after delivery. No
vaccinations were made in maternity home. The
infant is healthy now. What vaccine should be
inoculated firstly?
Laboratory assistant of the bacteriological *immediate contagion alimentary infection inhalant infection unknown intrauterine infection
laboratory contracted tuberculosis. What
214.
mechanism of contamination is the most
probable in this case?
Patient K, 26 years old, has rosy-red spots, *Disseminated lupus Tuberculosis of the Photo dermatitis. Mycosis of the face Face eczema.
plaques with distinct borders on the skin of his erythematousus. face skin. skin.
face, hairy part of the head. On the surface of
215. most foci there are closely set scales. If the
patient scratch them off, he feels pain.
Subjectively: moderate itch. What is the
diagnosis?
After delivery a women felt weakness, *Systemic lupus Mycosis of the skin Psoriasiform syphilid Ruber planus lichen Toxiderma
hyperthermia. On the skin of the nose, cheeks, erythematousus
breast there are rosy-red spots with grayish
scales. In the center of the foci there’s a scurry
216.
atrophy. Small joints of the extremity are
edematic, the skin around them is red, their
function is destroyed. What’s the clinical
diagnosis?
A worker of the cement plant visited doctor with *Microbus eczema True eczema Professional eczema Allergic professional Staphylococci sycosis
the complaints on itch, edema and weeping of dermatitis
217. the skin near the fistula from osteomyelitis on
the right cruse. Margins of the focus are clear.
What’s the most possible diagnosis?
 A 34-year-old driver saw the doctor because of *Chronicle eczema Acute eczema Pyoderma Scabies Neurodermatitis
the lesion of the skin of the extremity significant
itch weeping. He has been ill for 5 months.
During examination of the skin of the back of
218.
the hands and lower one-third part of the
forearm a lot of papules, vesicles, pustules,
scales, erosions, with a large amount of exudates
were revealed. What disease can it be?
In patient B, 34 years old on the skin of the back *True eczema Streptodermia Microbic eczema Neurodermitis Scabies
of the hands, abdomen and thigh there’re
symmetrical apparent foci of the lesion of
different sizes with unclear borders, where on
219.
the erymatous background one can see small
papulas, vesiculas, single pustules and in the
centre – erosion, scabs, weeping. Make your
diagnosis?
Primary seronegative syphilis has been *Tuberculosis Reinfection Treatment of the Massiveness of the Bad sanitary and
established in the patient [28 y.o.] on the basis pulmonary, intercurrent illnesses infection hygienic conditions
220. of confrontation and laboratory researches. oncological problems, by antibiotics
However terms of the incubatory period are narcotics
reduced considerably. In what case it can be?
The patient [29 y.o.] has consulted a *Primary Syphilis Acute Gonorrhoea Soft Chancre Chancriform Scabies
venereologist on the occasion of ulcers on the Pyoderma
penis. He had a casual sexual connection with
the unfamiliar woman for 1,5 months ago. The
failure of penis has found for 2 weeks ago. Two
ulcer elements have been found out at survey.
They had the round form, equal edges and they
221. were painless. The lymphadenitis of dense-
elastic consistence is palpated in the inguinal
region. Lymphatic nodes are painless and
mobile, the skin above them is without an
inflammation, they are not connected with each
other and neighbouring tissues. The skin of the
trunk and limbs has no rash. What about
diagnosis is it necessary to think?
The accoucheur-gynecologist has found out the *Inspection on Finding of herpetic Inspection of sexual Inspection on the agent Inspection on the
ulcer with the round form and the size about 10 T.pallidum and antibodies in the whey partners of Soft Chancre Gonorrhoea,
mm on the small sexual lip in the student [19 serological reactions of blood Trichomoniasis and
y.o.] at medical survey. The ulcer did not worry of blood on the other infections
222.
the patient. Objectively: the edges are precise syphilis transmitted by the
and equal, its colour meat-red, the condensation sexual way
is in the basis of the ulcer. The priority in the
plan of patient’s inspection will be:
 The women, 45 years old, has many bullas in *Pemphigus vulgaris Vesical toxidermia Vesical toxidermia Vesical streptodermia Vesical epidermolisis
here skin. The bullas resemble the peas in
dimension. The rest skin is free of spots, without
223. inflammation. The red erosion are in the oral
cavity. They are very sickly. The patient notices
the put of weight, feels herself bad. What is the
diagnosis?
The patient [19 y.o.] has consulted a *Scabies Urticaria Duhring’s dermatitis Diffuse Skin itch
dermatologist with complaint of the strong inch, neurodermatitis
which amplifies appreciably at night. He has
224. steam papulo-vesicular elements of excoriation
on the skin of the trunk, superior limbs and
internal surface of the hips. What is preliminary
diagnosis?
Very strong itch at the area of pubis and inguinal *Pediculosis Scabies Neurodermitis Epidermofitia Erythrasma
folds disturbers the patient, 42 years old, who
has returned from a foreign mission. During the
225. examination it was revealed many scratchings,
haemoragical scabs and spots on the skin of the
lower part of abdomen and internal surfaces of
thighs. What is the diagnosis?
It was known that woman in childbirth, being in *To treat of all natural To treat of all natural To treat of all natural To treat of all natural To treat of all natural
pangs, had known gonococcus from the urethra foramens by the 30\% foramens by foramens by foramens by acid foramens by strong
226.
and vagina. What have to be a treatment of solution albucidi manganese 1:10000 penicillin borici tea
newborn child?
The man, 55 years old, complaints for *Pemphigus vulgaris Duhring’s dermatitis Candidiasis Aphthous stomatitis Toxiderma
appearance of many rashes in the oral cavity.
They are very sickly, especially during the
227.
eating. During the examination there are spread
red round erosions, without inflammation. What
kind of diseases you must think at first?
The patient, 65 years old, has big bullas with *Pemphigus Toxiderma Duhring’s dermatitis Epidermolisis Candidiasis
flabby tegmen, red erosions in the mucosan
membrane of the oral cavity, in the limbs and
228.
inquinal area, without any reason. She has a
pain, especially during the eating. What is the
diagnoses?
The patient, 46 years old, has inflammatory *Follicular Ballonic degeneration Vacuolar Parakeratosis Spongiosis
spots and papules at the skin of nose and cheeks. hyperkeratosis degeneration
They after being in the skin over a long time.
229. There is burning at the areas. The symptom of
Benje-Mesherskiy is positive. What kind of
pathological appearance was formed this
symptom?
 The patient has many uncavitary infiltraty *Papules by lichen Papules by psoriasis Papules by secondary Papules by eczema Papules by toxiderma
elements, increasing in the surface of skin. The rubber planus syphilis chronicle
elements resemble the grain. There are red, flat,
230. poligonalis, with impression in the center. The
network of Wikchem is present. What kind of
morphological elements and disease the patient
has?
The patient, 39 years old, has a big pink *Condilomas Condilomas lata Varicose of Pyodermia VICH
papilomatosic growths on the skin near the anus. acuminates haemorrhoidal veins
The growths resemble the cauliflower and hold
231. on the thin stalk. The surface of growths is red
and macerated. The pain and burning at the area
of affection trouble the patient. What is the
diagnosis?
The boy 3 years old, fell ill in the first years of *Simple bulla Pemphigus Polimorfic Duhring’s dermatitis Vesical pyodermia
life. The are bullas at the place of traumatism of epidermolysis exudativum eritemae
skin. The same diseases has his mother. During
232. of the examine it was reveal serous bullas at the
skin of hands and feet. In the place of opening
bullas we can see erosions and serous crusts.
What is the diagnosis?
Some foci of failure have appeared on the head *Trichophytose Alopecia Areata Alopecia Syphilitica Lupus Erythematosus Leprosy
in the patient during last 2 months. The skin has Superficial [discoid form]
a light pink colour, it is covered by grey-white
scales. The loss of hair is marked as a result of
233. their break-down on 2-3 mm above a level of the
skin. Grey-white prickles are found among the
scales. Separate black points are observed in a
place of exit from the follicle. By your diagnosis
is:
The patient, 32 years old, came to the doctor *Reyter’s disease Psoriatic arthritis Behterev’s disease Lupus aerytematosis Arthritis rheumatoidis
with complaints for the increase of body
temperature up to 38 degrees Celsius, pain in his
joints, conjunctivitis. He felt ill acute after the
234.
accidental sexual contact. During the
examination the skin over the right ankle joint,
the left knee joint and the right hip joint was
hyperemic, hot to the touch.
The chlamydiosis (clamidiosis) infection is due * Elementary bodies Reticular bodies Anaerobic bacteria L – form bacteria А, B are correct
235.
to …
What pathologic process in the skin define * Acantholysis Acanthosis Spongiosis Hydropic degeneration Papillomatosis
236.
Nikolsky symptom:
To confirm a diagnosis of the tinea versicolor * Baltser’s test Three – glass test Salt – solution test Nikolsky symptom Benye – Meshchersky
237.
(branny lichen) what diagnostic test is used? (blister test) symptom
 After the 10th days at the accidental sexual * Repeated The treatment of Examine for Examine for Examine for
connection the women had purulent secretion examination for gonorrhea chlamidiosis chlamidiosis candidacies
from the genitals, burning. Syringing, genital- syphilis
bath with soda, chamomile, didn’t give any
effects during one week. During of the examine
238.
by gynecologists /after two weeks from the
beginning of disease/ it was reveal for erosions
the big genitals sexual lips, at the smears-
gonococcus. Control serological reaction /CSR/
for syphilis is negative. What will a doctor do?
The patient, 28 years old, living impropriety *Metranidozoli Sulfanilamide Penicillin Abactali Cyprinid
sexual life, it has diagnosed-trichomoniasis.
239.
What kind of preparations must be use for it
etiology treatment?
The women, 29 years old, applied to the doctor *Trichomoniasis Gonorrhea Candidacies Chlamidiosis Bacterial vaginosis
with completions for massive secretion from the
vagina, itch, burning, pain during urination.
240. During of the examine it was reveal hyperemia
external sexual organs, vagina. Much quantity of
yellow foamy discharge, urethritis,
endocervicitis. What is the diagnosis?
The patient, 27 years old, single, living *Chronicle gonorrhea Acute gonorrhea Trichomoniasis Candidacies Herpes
impropriety sexual life. During the last 2 month
looks unimportance mucous, sometimes
241. purulent secretion from urethra, subjective-
inconstant itch or sensation burning from
urethra. He didn’t apply to the doctor. What is
the diagnosis?
The pregnant is in her second half pregnancy *Penicillin Tetracycline Riphampicini Pirogenali Gonovaccini
242. diagnosis chronicle aendocerviciti and urethrity.
What prescribe, to the patient?
The man, 27 years old, applied to the doctor *Gonorrhea Tuberculosis Cancer of testis Varicocele of testis Abscess of testis
with completions for pain in appended right aepididimitis epididimitis
testis, have a higher temperature until 40 degree
Calcium, headache, indisposition. At the
243.
anamnesis had gonorrhea. During examine-
appendage of right testis is hyperemier, increase,
during of the palpation it was reveal compact
sickly infiltration. What is the diagnosis?
At the 16th day after the abortion the women *Gonorrhea Syphilis Candidiasis VICH Herpes
had abdomen pain, indisposition, the higher of
temperature until 39,5 degree Cesium. It was
reveal from the anamnesis- accidental sexual
244.
connection with unknown man. She treated
independently, only by the external preparations.
Rate erythrocyte sedimentation \ESR\ - 44
mm/h. What is the diagnosis
 The women suffering from the chronic *Clinical and Clinical and Clinical and Clinical and Removal from the
gonorrhea finished the complete course of serological control serological control serological control serological control register
245.
treatment. The source of the infection was not during 6 months during 3 months during 1 month during 12 months
establish. What will a doctor do?
The women, 60 years old, hospitalized with *Circular lichen Pemphig Pemphigus Toxiderma Duhring’s dermatitis
complaints for strong pain at the right side and
rash on skin. She having ill during 5 days.
During of the examine it was reveal grope
246.
vesiclaes with serous exudation at the
erithematosis skin of intercostals space. During
the palpation she has pain. What is the
diagnosis?
The pregnant women applied to the doctor with *Penicillin Penicillin Metranidazol Tetraciclin Рirogenal
completions for pain during the urination and
secretion from the vagina. She is ill during 4
247.
days. During examine it was the clinic of acute
vulvovaginitis. In the smears – are gonococcus.
What must be a treatment of the patient?
The woman, who has just returned from a *Pediculosis Scabies Toxicodermia Pyodermia Neurodermitis
foreign mission, has the bladders on the skin of
her neck and shoulder-blade. Very strong itch
inconveniences the patient. At the examination
248.
we can see many folliculates, excoriations near
the bladders. This disease the woman connects
with the wearing orhers clothes. What is your
diagnosis?
The women, 28 years old, applied to doctor with *Examine for VICH Examine for at Examine for Examine for fungi Examine for
completions for limited falling out the hairs. In neuropathology gonorrhea trichomoniasis
the anamnesis- she had frequent headache
249.
indisposition, artromyalgia, fever, impropriety
sexual life, using narcotics. RW is negative.
What of examines must be the first?
The patient has the spots of contagious mollusk *VICH Syphilis Lupus tuberculosis Lupus erithematodes Pyodermia
at the face, hairiness part of head, sexual organs.
Rash steady to the therapy, with often
recidivations. Beside, the patient has often
250. fevers infections, height temperature, until 38
degree of Celsius, pain in the right side. During
the examine it was reveal is anemia, leukopenia,
importance lowering of T-helpers. What is the
diagnosis?
The women 32 years old, has periodical *VICH Pemphigus Duhring’s dermatitis Dermathomyazitis Lupus erithematodes
hyperthermia, feels bad, put of weight. She has
systemic candidiasis, nothing of any
251. anticandidiasis preparations doesn’t give effects.
During of the examine it was limphocytopenia,
anemia, leucopenia, lowering of T-helpers. What
is the diagnosis?
 The man, 40 years old, appealed to the doctor *VICH Pyodermia Syphilis Syphilis Candidiasis
with the complaints for defeats and pain at
sexual organs. He is ill during one year. He
received some treatment, with out any results,
more of it hearth begins to transformate to ulcers
252.
being over a long of period of time. During of
the examine it was ulcer with not right margins,
considerable appliances of immunodeficiency.
During the palpation were pain, polyadenitis.
What is the diagnosis?
The patient, 27 years old, has erythematous * VICH Syphilis Toxiderma Psoriasis Reyters diseases
spots, plates with fat hyperkeratotic scales
yellow color, which had appeared one week ago
on the face, hairiness part of head, extensor
surface of extremities. He had this disease some
253. month, after blood transfusion. The patient
complaints of a bad state, put of weight,
diarrhea, the treatment result didn’t give. During
of the examine it was reveal importance
lowering of index of immunity. What is the
diagnosis?
The patient complaints of bad state, increase of *VICH Secondary syphilis Eczema Toxiderma Psoriasis
temperature of body until 38-39 degree of
Celsius, pain in throat, diffusion increase of
lymphatic nodes. He has disease during 2 weeks.
In anamnesis is narcotism. During of the
254. examine there are wide spread rash pink color
(spots and papules), on the head and body,
(having peripheral increase, violet and brown
colors, (reminding haemangiomae). During of
the examine it was importance lowering of index
T-cells immunity. What is the diagnosis?
The women 28 years old, complaints for *Vesical lichen Duhring’s dermatitis Pemphigus Toxiderma Candidiasis stomatitis
appearance of vesical rashes at the red margin in
255. a low lip, after over a long time stay at the cold.
During of the examine – the skin is free from the
rashes. What is the diagnosis?
After the 5 days the accidental sexual *Gonococci acute Gonococci acute front Gonococci acute Gonococci acute total Gonococci acute
connection the man had purulent secretion from back urethritis urethritis totals urethritis prostatitis epididimitis
the urethra, sick at the end of urination,
256. discomfort. During of the examine of the smears
– the leukocytosis in all field of vision, insude
and extracellular the are many gonococcus.
What is the diagnosis?
 The patient [56 y.o.] with the chronic *Research on the Wassermann’s reaction Research on HIV Hepatic tests Research of the
furunculosis has consulted a dermatologist with maintenance of sugar immune status
257. complaints of the deterioration of his condition in blood
during last year. What researches should be
prescribed to this patient first of all?
The young man [25 y.o.] has consulted a *Wheals Papules Nodules Pustules Vesicles
dermatologist with complaints of the appearance
of a rash on the skin of the face, trunk and limbs.
It disappears quickly and it is accompanied by
258.
intensive itch. Separate non-cavitary elevated
porcelain elements are marked on the skin. What
is the primary morphological element make a
clinical picture?
The patient, 62 years old, who is being treated *For the For the mycobacterium For the LE-cells For the treponema For the RIF, RITP
by the newropatologist for the neurithis of mycobacterium of of tuberculosis pallidum
neuros facialis, the doctor noticed on his body, lepra
face and limbs the achromic spots of different
sizes and the gradual disappearance of
259.
sensuality: at first of temperature, then of pain
and at last tactile and also falling of hair of his
eyebrows and eyelashes. What kind of
examination must be prescribe for the patient at
the first time?
The patient, 49 years old, has the erythematosic *Lepra Tuberculosis Toxiderma Sclerodermia Herpes
spots and plates on the skin of her face, body
and limbs, consist of the dense small knots. On
the places of some of them there are hearths of
260.
atrophies. During the examination it were
revealed the breach of temperature, painful and
tactile sensuality. What do you think the disease
is?
Nikolsky's positive symptom is found in the *Pemphigus vere Solar burn Duhring’s hepetiform Herpes Zoster Lupus Erythematosus
261. patient [66 y.o.] by the dermatovenereologist. dermatitis
By your preliminary diagnosis is:
Ardy’s positive symptom [that is the presence of *Scabies Psoriasis Avitaminosis A Hyperkeratose Lichen Ruber Planus
a rash of impetigo’s character in the region of
262. the both ulnar shoots] is found in the patient [23
y.o.] by the dermatovenereologist. By your
preliminary diagnosis is:
The man [23 y.o.] has small pustules on the skin *Ostial Folliculitis Chancriform Pyoderma Parasitic Sycosis Furuncle Pseudofurunculosis
of the face. They are located in the centre of the
263. hair follicle and surrounded by a narrow
hyperaemic band. Subjective sensations are
absent. By your clinic diagnosis is:
 The patient has consulted a dermatological clinic *Acantholysis Acanthosis Dyskeratosis Granulosis Vacuole degeneration
for consultation. His clinical lesions have caused
of carrying out of special researches. The fusion
264.
of intercellular epithelial bridges was found in
the prickle-cell layer at histological research of
the struck epidermis. These changes are signs of:
The signs of acanthosis are marked at the patient *Amplified Disturbance of Thickening of the Necrobiotic and Fusion of intracellular
with the psoriasis at histological research of the duplication of prickle- keratinization of the granular layer of the degenerative changes epithelial bridges in
265.
struck skin. For this process is typically: cell layer epidermis epidermis of the Malpighian the prickle-cell layer
layer
Wickham’s positive symptom [that is the small *Lichen Ruber Planus Psoriasis Molluscum Tuberculosis Cutis Syphilis Secundaria
netting and web-shaped lines on a surface of the Contagiosum Papulonecrotica
papules as a result of focal granulotosis] is found
266.
in the patient [23 y.o.] by the
dermatovenereologist. By your preliminary
diagnosis is:
Tarnovsky’s hypertrichosis is found in the *Late Congenital Hirsutism Itsenko-Cushing’s Chronic Psoriasis
267. patient [26 y.o.] by the dermatovenereologist. It Syphilis syndrome Trichophytosis
can speak about:
After the trauma of the right cruse on external *Syphilis tertiary Tjuberculosis of skin Furunculosis Phlegmonous Vasculitis of nodus
surface the man of 27 years old had nodes,
which later opened with secretion which had a
lot of glue substance yellow color. The ulcer had
268.
appeared, which was spherical shape with hand
over margins and necrotic masses on the fundus.
The patient doesn’t have subjective sensations.
What is the diagnosis?
The mother with her doter applied to the *Pediculosis Seborea Trihophytia Psoriasis Microsporia
dermatologist with complains for the itch of
hairiness part of head and the back surface of the
269. neck. During the examine it was reveal the white
and gray dandruff, fixating strong to the hair.
The girl has the excoriations, single pustules at
the neck. What is the diagnosis?
The man, 23 years old, came to the doctor with *Syphilis primaria Pyodermia Periproctitis Ecthyma scabiosus Hemorrhoids
complaints for onset the ulcus near the anus 1
270. month ago. The patient doesn’t have subjective
sensations. He is bisexual. What is the
diagnosis?
Neoplasm of red colors, has been revealed in the *Vegetations Warts Scars Papules Nodes
region of the patient’s anus. It reminds color
271. cabbage or a cock’s comb, in palpation it’s soft.
About what morphological element can we
speak?
 In patient, 56 years old, on the internal surface *Microbus eczema Vasculitis of the skin Ulcer pyoderma Tuberculosis of the Tertiary syphilis
of the lower one-third of the left cruse there’s an skin
apparent ulcer of three-kopecks-coin size with
272.
even raised margins and flat fundus. The skin
around it is red and there’re a lot of vesicles,
erosions, massive scabs. What’s your diagnosis?
On the patients elbows and knees there’re rosy- *Papulas. Turbcles. Pustules. Nodes. Spots.
red elements; size: under 2 cm. Picture of the
skin on their surface is clear. In palpation there
273.
is some infiltration, in vitropressure elements get
pale. What morphogical element can we think
about?
A patient saw the doctor because of the lesion of *Vesicles. Pustules. Blisters. Vesicles. Papulo-vesicles.
the face skin. Examination showed grouped
small elements with transparent contents on the
274.
cheeks and skin of the upper lip on the
eritemathosus background. What are the
morphological element here?
On the trunk of the patient a lot of white and *Spots without Papulas. Spots with Blister. Lichenification.
yellowish-brown elements of various inflammation. inflammation.
configuration and size, situated apart on the
275. sunburned skin have been revealed. Relief and
picture of the skin in the foci haven’t changed.
About what morphological element can we
think?
Spherical skin defect, size: under 3 cm in the *Ulcer. Erosion. Fissure. Profound pustule. Superficial pustule.
diameter, with gentle margins, necrotic profound
fondues, easily, bleeding has been revealed on
276.
the patients skin of the lateral surface of the
lower part one-third part of the left crush. What
morphogical element can we think about?
The patient, 28 years old, came to the doctor *Chlamydeous Trichomonadia Gonorrhoeal Candidal urethritis Bacterial urethritis
with complaints for the discomfort during the urethritis urethritis urethritis
urination , itch and scanty secretions from his
urethra, mainly in the morning, pain in the lower
277. part of his abdomen. He has been ill for about
one month. During the examination there was
found hyperemiae near the external outlet from
his urethra and leycocitosis in the smears. What
is the diagnosis?
The boy, 12 years old, has numerous small *Contagious mollusk Streptodermia. Toxicodermia. Simple verruca. Acne vulgaris.
papules (up to 2 mm in diameter) on the skin of
forehead and limbs. They have the color of
278. normal skin and shine. Papules have the hollows
is the center. If we try to press the elements,
some white crumlike mass secretes. . What is the
diagnosis?
 The patient, 35 years old, had a treatment 5 *Syphilis tertiary Furunculous Tuberculosis of skin Nodules vasculitis Phlegmonous
years ago for syphilis secundaria recidiva. He
didn’t complete his treatment ( he changed his
279.
home address). Now he has tuberculums on his
nose and forehead. RW, RITP and RIF are
positive. What is the diagnosis?
The patient, 57 years old, has some plates on the *Psoriasis Lichen rubber planus Eczema Neurodermitis Mycosis
skin of the extension surfaces of his limbs, a lot
280. of squamules, which are easily shelled away.
Isomorphic reaction of Kebner and triad of
Auspic are positive. What is the diagnosis?
The women, 33 has scanty secretions, itch in the *Tetracycline Penicillin Biseptol Retarpen Cephazolin
external genitals, unpleasant sensations during
urination, sometimes she feels pain in the lower
281.
part of her abdomen. It was diagnoses
chlamidioses. What kind of preparations are
more effective?
The positive symptom of “the handles of a *Tuberculosis Cutis Syphilis Tertiaria Leprosy Leishmaniasis Bejel
suitcase” [that is the presence of bridge-shaped Colliquativa
282. cicatrices with a free space] is found in the [Scrofuloderma]
patient [22 y.o.] by the dermatologist. By your
preliminary diagnosis is:
A 50-years-old man experienced the severe low * Tabes dorsalis Myelitis Acute Disorder of spinal Syringomyelia
limbs pain more often at night. The localization (locomotor ataxia) encephalomyelitis blood circulation
of the pain was not constant. Short time later
the ataxia developed and became worse at bad
light. On ophthalmologic examination the
weakness of pupils reaction to light and eyes
283.
convergence are noted. The accommodation is
good. On the fundus of eyes the disks of optic
nerve are of grey colour. Also the nevrological
disorders of deep sensitivity were revealed. The
Wassermann’s reaction assay of Treponema
pallidum immobilization are positive.
A 4 years old boy developed the impairment of * Dushenne myopathy Multiple sclerosis Verdnig-Goffmann Schtrumpel spastic Erb-Rott miopathy
free motility, he began walk badly, the spinal amyotrophy paraplegia
difficulties in getting up appeared. The main
284. clinical features are absence of muscle
hyportrophy, weakness of deep tendon
reflexes, mild tetraparesis with insufficiency of
muscle tonus, bilateral positive Babynsky’s sign.
 Man 27 y.o. has been outside, on the cold air, for * Neuritis of left n. Neuritis of left n. Neuralgia of left n. Tumour of the left Neuritis of right n.
some time. On the following day, after waking facialis trigeminus trigeminus pondo-cerebellar facialis
up, he has found inability to close left eye, corner
running tears, hyperacusia, and change of
285. sensation of frontal 2/3 of the tongue.
Objectively: flattening of naso-labial fold, left
corner of the mouth drop and its paralyses, the
“sail” symptom is positive, left corneal reflex is
missing. Your diagnosis:
Patient 38 y.o., suddenly started to feel * Subarachnoid Trombosis vessels of Brain vessels Haemorrhage on the Meningitis
headache, accompanied by nausea, vomiting haemorrhage the brain embolism brain
and loss of consciousness.
Objectively: АP 190/30 mmHg, pulse
94/min, tense; skin is hyperemic.
Craniocerebral nerves are normal,
286.
changes in movement and
coordination are not seen. There are
positive meningial signs (rigidity of
nack muscles, Kerning’s and Brudsinski
symptoms). Liquor is blood stained. Your
primary diagnosis:
A 43-year-old woman complains of the low *Vertebrogenic Vertebrogenic Arthritis of the left Endarteritis of the Spinal stroke
back pain irradiating to the left lower extremity lumboischialgia on the radicular syndrome L 5 hip joint lower extremities
which become worse in movements. left –S1 on the left
Simultaneously the patient notes numbness in
287. the leg and cricks (crumps). The palpation of
shank and hip muscles is tenderness. The hip
flexion with knee extension is painful and can
not be done. There is not sensitivity and
reflexes loss disorders.
Girl 10 y.o. last three years often suffers from * Chorea minor Parkinsonism Huntington's chorea Viral encephalitis Wilsons – Konovalov
otitis. Has had rheumatic endocarditis. Vague, disease
288. easy to get tired. Objectively: Patient constantly
moving. All involuntary movements are quick,
broad and constantly changing. Your diagnosis:
Patient 23 y.o. – general constriction, arm * Postencephalic Wilsons-Konovalov Huntington's chorea Convexital Basal arachnoiditis
tremor, that gradually developed one year after a parkinsonism disease arachnoiditis
289. serious respiratory viral infection. Objectively:
greasiness, mask-like face, quieting speech,
hypersalivation, shuffling gait. Your diagnosis:
 After sleep in the morning a 60 years old patient *Ischemic insult in the Hemorrhagic insult in Multiple sclerosis Encephalomyelitis in Infarction in the
noticed that his left extremities are stillness and right hemisphere of the right hemisphere of the brainstem brainstem
left-sided sensitivity of skin is impaired. The the brain the brain
patient has had a history of two same attacks.
The conditions are the humid and pale skin, BP
100/65 mm Hg, pulse rate 60 beats per minute.
290.
The left nasolabial fold is smoothed. The active
movements in the left extremities are absent but
reflexes from the ones are higher. Positive
Babinsky’s sign on the left foot and unilateral
left sided hyperesthesia there are. The
meningeal irritation tests are negative.
During 3 weeks a 27 years old woman suffers *Acute disseminated Spinal form of Acute focal myelitis Tumor of spinal cord Cystic arachnoiditis
from common weakness, sleep disturbances, myelitis multiple sclerosis
anxiety, subfebrility up to 37,6 0C, numbness
and weakness of legs mostly on the left, some
times urine retention. The main neurological
features are following. Cranial nerves function
291.
isn't impaired. Tendon reflexes are equable from
the upper limbs and S>D from lower limbs. The
exaggerated knee reflexes and absent left
Achilles’ reflex are noted. The sensitive surfaces
on the feet are reduced. The muscle hypotrophy
of the lower extremities attaches the attention. .
Within the last 3 months a 22 years old women *myasthenia Parkinson disease encephalitis ischemic insult in the multiple sclerosis
complains of the common weakness. In the brainsteam
evenings she notes a doubling of vision. In the
morning she insists that her general condition is
good. The active movements in extremities are
292. in a full volume but the muscle strength in the
extremities is depleted. The clinical examination
revealed eye lids ptosis, divergent squint, mask-
like face and quiet voice. All clinical
manifestations disappeared after proserin
injection.
On patient’s examination it was revealed that he *Motor aphasia Sensor aphasia Amnestic aphasia Semantic aphasia Dysarthria
understands speech addressed to him but he
293. cannot speak but there were no motor
impairments of the vocal apparatus. What is
your diagnosis?
The patient V., aged 32, complains of staggering * Cerebellar Sensitive Vestibular Functional Astasia-abasia
294. gait in the dark and in good light. Determine the
kind of ataxia.
The patient has a tumour of hypophysis. What *Bitemporal Quadrant hemianopsia Binasal hemianopsia Hononimic right-sided Hononimic left sided
295.
kind of hemianopsia will develop in it? hemianopsia hemianopsia hemianopsia
Dissociated anesthesia develops in damage of … *Posterior horns of Anterior horns of the Radices of the spinal Plexuses Peripheral nerves
296.
the spinal cord spinal cord cord
 A great spastic epileptic episode in a patient * Middle part of the Posterior part of the Upper part of the Middle part of the Posterior part of the
began when he turned his head and eyes to the middle frontal gyrus lower frontal gyrus postcentral gyrus postcentral gyrus upper temporal gyrus
297.
right. Determine the localization of the
pathological focus.
A 52 year-old patient has damage of the Broca’s * Motor aphasia Sensor aphasia Amnestic aphasia Semantic aphasia Dysarthria
298. centre after hemorrhage in the brain. What
speech disorder occurs?
Which type of sensitivity is the most affected * Vibration Pain Stereognosis Temperature Tactile
299.
during early stages of multiple sclerosis?
A tumour of the left frontal lobe base * Left -sided Olfactory Right-sided anosmia Hyperosmia Bilateral anosmia
300. compresses the olfactory bulb (bulbus anosmia hallucinations
olfactorius). What symptoms are developing?
A patient has spastic left-sided hemiplegia *The inner capsule The anterior central The posterior central Cerebral peduncle Medulla oblongata
which is accompanied by impairment of all gyrus gyrus
301.
kinds of sensitivity on the same side. Where is
the focus of affection?
A patient had thrombosis of the cortical *Central monoplegia Central monoplegia of Central monoplegia Central monoplegia of Left-sided
branches of the middle cerebral artery that of the left arm the right arm of the left leg the right leg hemiparesis
302. resulted in destruction of the middle part of the
right precentral gyrus. What motor disorders
occurred?
A child is observed to have arrhythmic * Chorea Hemiballism Myoclonias Torsion spasm Athetosis
involuntary movements of the extremities and
trunk. He makes faces, smacks his lips, and
303.
often pulls out his tongue. The muscular tonus
of the extremities is reduced. What character
are the forced movements in this patient?
A 42-year-old patient is troubled by difficulty in *Pallidonigral system Hypothalamus- Cerebellum Striatum system Pyramidal system
walking. Objectively: Hypomimia, slowing hypophysis zone
down of movements, increased muscular tension
304.
of plastic type; his steps are slow and shuffling.
His speech is quiet and monotonous. Determine
localization of the process.
Patient, 35 y.o. has had an illness with fewer and * Diphtherial Neuropathia of n. Neuropathia of n. Truncal encephalitis Pseudobulbar
sore throat. Shortly after he has developed polyneuropathy sublingualis glossopharyngeus syndrome
dysphagia, dysarthria, weakness and changes of
305. movement in feet and hands, hyporeflexia,
changes of sensitivity of extremities by
polyneuritic type. Which disease would you
suspect first?
 Patient C. 68 y.o. has general and cerebral * Iscemic stroke Subarachnoid Hemorrhagic stroke Transient iscemic attac Acute encephalytis
arteriosclerosis, arterial hypotonia. Woke up in haemorrhage
the morning, can’t move left extremities. There
is no feeling in the left side of the body.
Objectively: pale skin, covered with cold sweat.
306. AP 100/65 mmHg, HR 60/min, weak.
Respiration is weak. Active movement in the left
extremities is not present. Tendinous reflexes
are more vivid on the right when on the left.
Babinski symptom on the left. Meningial signs
are not present. Primary diagnosis?
Male 22 y.o. has returned from military service. * Multiple sclerosis Cerebral Lateral amyotrophic Acute disseminated Acute transversal
Started to feel transient changes of eyesight arteriosclerosis sclerosis encephalomyelitis myelitis
sharpness. Weakness of the right foot has
appeared one year later. Objectively: horizontal
307. nystagmus, absence of abdominal reflexes,
hypereflexia of tendentious and periostal
reflexes, right foot clonus, Babinski, Chaddock
and Rossolimo symptoms, bilateral Zhukovski
symptom. Primary diagnosis?
Patient N. 45 y.o., stoker, complains of taking * Siringomyelia Multipl sclerosis Lateral amyotrophic Poliomyelitis Encefalomyelitis
too long to heal burns, he can’t feel. First time sclerosis
painfree burn had place 10 years ago. On
308. examination: sluggish paraparesis of upper
extremities and segmental dissociated bilateral
loss of sensitivity on the level C4-T2 segments.
Your diagnosis:
Patient 28 y.o. complains of headache, nausea. *Brain concussion Brain contusion Brain compression Subarachnoidal Soft tissue injury of
Has been punched to face a day ago. Loss of hemorrhage the head
309. conscience lasted for 3-5 minutes. Objectively:
bloodshot left eyeball. Pronounced vegetatic
stigmas. Your diagnosis:
Patient has had craniocerebral injury, with * Subdural Epidural haematoma Subarachnoid Сerebral Introcerebral
satisfactory condition after it. However, 10 days haematoma hemorrhage ventriclar haematoma
later, the patient has become weak and drowsy hemorrhage
310. with following development of comatose state.
Neurological status: broad right pupil, left sided
hemiparesis. Which diagnosis has to be
suspected?
Ambulance was called to a 48 y.o. man. From * Major epileptic fit Vegetatic crisis Absence Episode of hysteria Fainting
the words of relatives he has had three episodes
of lost conscience and fitting during the day. On
examination: the following fit is observed:
311. patient lost conscience, fell on the floor, tonic
and then clonic cramps of trunk and extremities
happened. The fit lasted for 4 minute, ended by
involuntary urination. What type of fit was
observed?
 Female 29 y.o. complains of head and * Hepatolenticular Huntington's chorea Pier –Marie’s ataxia Friedreich's ataxia Chorea minor
extremities tremor, poor memory. On degeneration
312. examination: choreotic hyperkinesis, Kaiser-
Fleishner’s rings on the eyball, reduction of
ceruloplasmin blood level. Your diagnosis:
Male 30 y.o., noted growing fingers and facial * Adenoma of Encephalitis of truncus Optico - hiasmatic Adrenal gland tumor Tumor of pondo-
scull, changed face. Complains of poor eyesight, hypophys arachnoiditis cerebellar corner
tiredness, skin darkening, loss of body weight.
313. X-ray shows broadening of sella turcica,
thinning of tuberculin sphenoidale, signs of
increased intracranial pressure. What diagnosis
can you make?
Patient, complains of pains in the mid thoracic * Extramedular spinal Intramedular spinal Acute thorax myelitis Iscemic spinal stroke Thorax
part of spine for last 3 months. Recently, tumor tumor hemathomyelia
gradually increasing weakness of the right leg is
314. noted. Objectively: central paresis of the right
leg and loss of pain sensitivity from the nipple
level on the left leg. Which disease can be
suspected?
Patient 27 y.o. 5th day of respiratory disease, *Meningial syndrome Liquor hypertension Liquor hypotension Radicular syndrome Vegetative crisis
appeared strong headache, accompanied by syndrome syndrome
nausea, repeated vomiting, hyperestesia,
photophobia. On examination: lying down with
315. thrown back head, legs are brought to trunk,
pronounced rigidity of neck muscles, positive
Kernig and Brudsinski symptoms. There are no
paresises extremitis. Select the main
neurological syndrome: