1

In 31-year-old patient is a sharp chill, T 39.0 0 C, which has been kept and suddenly 9:00
decreased to normal with strong sweating. The next day, T 36.8, pulse
70 beats. for 1 min. Abdomen soft, not painful. Liver 2 cm, spleen 3 cm year ago
returned from South Asia, where there have been several episodes of malaria. What research
best to hold fast to confirm the diagnosis?
A study of large drops of blood from malaria.
B blood test for sterility
C Bakterioskopiyu large drops of blood on meningococcal
D blood test for anti-HEV Ig M.
E Bakterioskopiyu large drop of blood for leptospirosis.

2
76-year old patient complains within 7 days of continuous rise in temperature to
38 - 38.7 0 C, moderate headache, insomnia, terrifying dreams, dry
cough. With 4 days of illness - on the trunk-rozeolozno petehialna exanthema. In
child suffered from fever. T - 38,4 0 C, pulse 98, hepatolienalnyy syndrome
Bilateral focal pneumonia. What is the disease most likely?
A clump disease.
B Typhoid
C Lyme disease
D Malaria
E Leptospirosis

3
The patient complains of 1942 constant pain in the epigastric with irradiation in
back, nausea, vomiting, pechiyu.Hvoriye from ulcer duodenum for 20
rokiv.Ob-no: reduced feeding, tongue furred, humid. Stomach
stressful, painful palpation in pyloroduodenal zone.(+) c-m Obraztsova.
Subfebrilitet. An.krovi: Lake-10,0 x10 ^ 9 / L, SHZE-24 mm / hour. X-ray: in
Three-layer laminated duodenum bulb immersed niche 0,7 x1, 0 sm.Reaktsiya Hrehersena (-).
What complication occurs in this case?
A * penetration
B Perforation
C Bleeding
D malignancy
E goalkeeper stenosis

4
The patient complains of shortness of breath sharply, which increases with exercise.
Complaints appeared sharply 2 hours ago at work: a sharp pain in left chest,
cough. Pain decreased, but increased shortness of breath, dizziness, paleness, cold
perspiration, cyanosis. No vesicular breathing, radiography - eclipse of the left
side. What kind of pathology can be suspected?
A * Spontaneous pneumothorax nearside
B Myocardial lung
C pleurisy
D nearside pneumonia
E Abstsess lung

5
Man 15 years with childhood atopic dermatitis suffer from allergies to meat
crustaceans. Last 3 months after buying aquarium fish were rhinitis,
conjunctivitis, itchiness in the nose. Level which immunological parameters should be defined
the patient?
A IgE
B IgJ
C IgM
D IgA
E Circulating immune complexes

6
The patient complains of 1956 with shortness of breath difficulty exhaling, the selection of
specimens
morning for 22 years. Smokes one pack of cigarettes in the afternoon with 18 years of
age. During
conducting tests on FDD reversible obstruction is 10 \%. What preparations should
be the beginning of treatment?
A Inhalation holinolityky (atrovent)
B Antibiotics
C Inhalation sympathomimetics (Berotec)
D membrane stabilizers (intal, tayled)
E Inhalation glucocorticosteroids

7
The patient complains of 1966 palpitation, general weakness, paresthesia, decreased
sensitivity in the legs, disturbance of taste, smell. In the blood: er. - $ 2.1 * 10 ^ {12} / l $ Nb - 84
g/l
MP - 1,2, makrotsytoz, polisehmentatsiya nuclei of neutrophils. What plays a leading role in
pathogenesis of this condition?
A breach of DNA synthesis, hematopoiesis mehaloblastychnyy type
B Violation of hemoglobin synthesis by chronic iron deficiency
C Dyzerytropoez violation through utilization of iron at the level of bone marrow
D Increased destruction of erythrocytes
E bone marrow damage by toxic factors

8
Excited sick all the time trying to peek behind doors and in an adjacent room,
For sure, there are his friends. Asserts that hears the conversation
friends and strangers, though this time no one nearby. Tries
convince the doctor that the wall is controversy over "his sentence"
loudly repeated phrases that they be heard from behind the wall. Identify patient
A * Acute halyutsinoz
B Verbal Illusions
C frenzy
D Konfabulyatsiyi
E Navier "yazlyvi ideas

9
Girl, 22 years, within 2 days complaining about rashes in the face and
expressed itchy rash. Diseases linked to the use of cosmetic cream.
Ob-no: pronounced reddening and swelling of the skin in the cheeks, chin, Lobo, small
papules-vezykulozna rash. Your diagnosis.
A * Allergic dermatitis.
B Simple dermatitis.
C Eczema.
D Erysipelas.
E neurodermatitis.

10
The patient complained of the 1918 eruption on the skin of the knee and elbow joints.
Ob-no: symmetrically on the skin surface of these joints rozhynalnoyi lentykulyarni
pinkish-red papules round shape with clear borders, covered with silver
scales. When poshkryabuvanni papules observed symptom stearic spots
terminal film, blood dew. Isomorphic reaction Kebnera positive. Your
diagnosis.
A * Psoriasis
B lichen ruber planus.
C papular syfilid.
D Rubrofitiya smooth skin.
E nodular prurigo adults.
 11
The patient was 27 years old, whose history of asthma, bitten by a bee. There
feeling of pressure in the chest, lack of air, difficulty exhaling, feeling the heat at the top
half of the body, dizziness, expressed itching, seizures. Ob-no: noisy breathing,
Wheezing, SC - 90/60 mmHg, P - 110/hv. heart - rhythmic tones, weakened over
lungs - breathing hard, dry whistling wheezing. Which group of drugs should
apply a priority?
A * Glucocorticoids
B methylxanthine
C Cardiac glycosides
D Anticonvulsant
E Analgesics

12
Patient 1941 complaining of pain in the epigastrium after exercise, heartburn,
prolonged hiccups, increased salivation. Ob-no: hipohromnoyi signs of anemia, positive
occult blood reaction. Radiography of the stomach in the decree of the patient upside down -
go get the barium mixture in the fore-stomach. What is the diagnosis most
probable?
A * Kyla hiatal.
B gastritis with reduced gastric acid-function
C Hastroezofahalna reflux disease.
D ulcer.
E duodenogastrical reflux

13
The patient suffers from a stomach ulcer for more than 15 years, repeatedly
treated on exacerbations. During the year, notes a sense of heaviness in the stomach
belching with foul odor. Over the past three days was vomiting several times
digested food eaten. Which of the following methods is most
helpful to verify the diagnosis?
A * X-ray study
B ultrasonic study
C pH-metry.
D Multi duodenal sensing.
E study for the presence of Helicobacter pulori.

14
Patient 68 years old over 35 years suffer from chronic pancreatitis. In recent
5-year notes reduction of pain syndrome, bloating, frequent bowel movements
(Grayish color, shiny, with undigested food additives) to 3-4 times a day,
progressive loss of body weight. Change in patient symptoms caused by
Accession:
A * Zovnishnosekretornoyi pancreatic insufficiency
B Vnutrishnosekretornoyi pancreatic insufficiency
C deficiency Syndrome laktaznoyi
Irritable bowel Syndrome D
E chronic enterocolitis

15
In patient AM, 1950, marked shortness of breath during physical exertion, intermittent
loss of consciousness. Auscultatory - systolic murmur in the third mizhreber'yi left of the
sternum.
When ultrasound of the heart - symmetrical left ventricular hypertrophy, diastolic dysfunction it
with some
reduced cavity. There is a front-systolic anterior motion of the leaf
mitral valve. What is the pathology of the patient?
A * Hypertrophic Cardiomyopathy
B Restrictive cardiomyopathy
C dilated cardiomyopathy
D postinfarction myocardiosclerosis
Aortic stenosis mouth E

16
The patient, 24 years old, asked the doctor to discover in themselves enlarged submandibular
lymph nodes. Upon further examination the doctor discovered enlarged underarm and
inguinal lymph nodes. On the radiograph of the chest - increased
mediastinal lymph nodes. In the blood: erythrocytes 3.4 h1012 / l, hemoglobin 100 g / l
color index - 0.88, platelets - 190h109 / l, leucocytes - 7,5 h109 / l
Eosinophils - 8 \% palychkoyaderni - 2 \% sehmentoyaderni - 67 \%, lymphocytes - 23 \%
ESR - 22 mm / hour. What research is indicated to verify the reasons
lymphadenopathy?
A * open biopsy of lymph nodes.
B ultrasound of abdomen poprozhnyny
C Tomography mediastinum.
D needle biopsy of lymph nodes.
E Sternalna puncture.

17
Patients 32 years of complaints addressed to the fluctuations in the heart, dizziness,
shortness of breath during exercise. By this time, not sick. Ob-no: Ps-74/hv.,
rhythmic. AT-130/80 mmHg At auscultation: the first normal tone sonority,
systolic murmur over the aorta. ECG: left ventricular hypertrophy, signs of
repolarization in $ I $, $ V_5 $, $ V_6 $ assignments. ɗhoKH: interventricular peretenka 2
see What is the most likely diagnosis?
A * Hypertrophic Cardiomyopathy
B aortic stenosis mouth
C Hypertension
D myocardial infarction
E Koarktatsiya aorta

18
The patient complains of a sense of gravity and periodic chest feeling stop
food dysphagia. In contrast radiographic examination reveals baric
single protrusion mishkopodibne perednopravoyi esophageal wall equal
contours and clearly defined neck. Your diagnosis.
A * diverticulosis esophagus.
B esophageal carcinoma.
Kyla C hiatal.
D Varicose veins of esophagus.
E polyp esophagus.

19
Female 60 years old, about 15 years suffers from hypertension. After
repeat stroke complains unjustified lowering of mood, difficulty
focus, forgetting to close the door, remembers the events of the last day. On
CT-area changes in postinfarct zadnolobnyh cortical areas. What is the diagnosis
most likely in patients?
A * Vascular dementia
B Alzheimer's Disease
C disease Hentinhtona
D Pick Disease
E Dissociate amnesia

20
In 1918 the patient developed jaundice. After examination diagnosed syndrome
Gilbert-Meylenhrahta. What linked the mechanism of jaundice in a patient?
A insufficient glucuronosyltransferase
B insufficient hlyutamattransferazy
Intravascular hemolysis C
D obturation of common bile duct
E insufficient tyrozynsulfotransferazy
 21
Patient 35 years, operating nurse, wrote to the doctor on Day 8
gradual development of the disease complaining of general weakness, rapid
tiredness, dark urine. Morning noticed scleral jaundice. At survey
T-36, 8? S. Revealed enlargement of the liver 3 cm Change a laboratory value
most helpful in this disease?
A * alaninaminotransferase
B alkaline phosphatase
C hemodiastase
D prothrombin index
E cholesterol

22
In dye automobile diagnosed acute poisoning amidospolukamy
benzene medium severity. After patient treatment takes place
significant improvement of the state. What the experts should take a decision in this case?
A * issue "profbyuleten for outpatient treatment
B may continue, subject to sanitary standards
C leaf disability issue for outpatient treatment
D Route to MSEK to determine the rate of loss of professional capacity
E Route to MSEK for a disability group in connection with professional
disease

23 In 1938 women in blood: HB - 84 g / l, erythrocytes - 3,5 T / l, color index -

0.72, leucocytes - 4,1 g / l, reticulocytes - 2 \% o, SHZE - 26 mm / hour. Serum iron
blood - 9,0 mmol / liter. Patients were assigned likuvannyayi. At the 6-day treatment
A study of peripheral blood. What changes will most indicators
likely to confirm the adequacy of the therapy?
A * Increasing the number of reticulocytes
Normalization of hemoglobin level B
C Normalization erythrocytes
D Increase the color index
E Slow clotting of red blood cells

24
Summer camp in diseases of Pleasure Boats: Inflatable Never Knew Existed,
soprovozhdayuschehosya vɵsokoy
temperaturoy, headache pain in frontal-vysochnɵh regions, pains in various
mɵshts group. In two zabolevshyh, except that nablyudalas dyareya, at one -
otmechalys pyatnystɵe vɵsɵpanyya to face tulovysche. Total zabolelo 18 people.
Specify the most veroyatnɵy transfer factor INFECTION:
A * Water
B Pyscha
C Ukusɵ Komarov
D Ukusɵ mites
E Through povrezhdennuyu kozhu and slyzystɵe

25
Bolnoy 37 years, chemist-technologist. Bespokoyt Sinyakov emergence of living, hips,
shin injury after nebolshyh or besprychynno. When the inspection mnohochyslennɵe
melkye and more than CU, revenge slyvnɵe bruises (from 1x1 to 4x5 cm). Second
Revision no. Monthly up to 7 days. Selezɺnka not proschupɵvaetsya. In the analysis of blood:
Hp-92 g / l, leyk.-7 2h109 / l trombotsytɵ-6h109 / l SOɗ-33 mm / h. What is given pathogenesis
podobnoho diseases of?
A * Ukorochenye trombotsytov life.
B Level Meter antyhemofylnoho hlobulyna decline.
C Level Meter decline protrombyna blood.
D decline fybrynohena Level Meter.
E Improving fybrynolytycheskoy activity.

26
In bolnoho 56 years after you transmural myocardial zheludochka of left appeared
odɵshka of physical carrying capacity, and Then the feeling of tyazhesty podrebere in law,
otɺky on his feet. When ɷhokardyoskopyy levoe predserdye 48 mm, konechnɵy
dyastolycheskyy size of left zheludochka - 62 mm faction vɵbrosa -40 \%,
otmechayutsya core verhushky dyskinesia in the field of heart. According
ɷhokardyoskopyy can think on the availability of bolnoho:
A * Systolycheskoy dysfunction infarction.
B Dyastolycheskoy dysfunction infarction.
C Vnutryserdechnoho verhushky clot in the field of heart.
D Prohressyrovanyya kardyoskleroza.
E Nachynayuschehosya razrɵva verhushky in the field of heart.

27
Bolnoy 44-years with mourning for obratylsya zatrudnenye mocheyspuskanyya, feeling of
nepolnoho oporozhnenyya mochevoho bubbles. When sonohrafycheskom Studies
mochevoho bubbles at the entrance to the urethra opredelyaetsya ovalnoe hyperɷhohennoe
education with contours rovnɵmy size 2x3 cm, during a peremeschayuscheesya
Studies. Your conclusion of?
A (calculus
B Zlokachestvennaya opuhol mochevoho bubbles
C Polyp mochevoho puzirya
D Adenoma predstatelnoy zhelezɵ
E opuhol nachalnoy part mochetochnyka

28
Bolnoy 43 years, slesar, plumbers, zhaluetsya shustkamy to vomit blood, weakness,
holovokruzhenye. Ob-no: leather blednaya, tonɵ Heart pryhlushenɵ, HR-104 in minutes, AD
- 100/50 mm Hg Vzdut abdomen, hot 5 cm s plotnɵm zaostrɺnnɵm kraem,
bezboleznennaya, selezɺnka vɵstupaet 2 cm from the edges rebernoy under-arc.FGDS-
the expansion of veins of the lower third pyschevoda co shustkamy blood. For prevention
razvyvshehosya oslozhnenyya bolnomu it was is necessary dlytelno Apply:
A * Nytratɵ prolonhyrovannoho Actions (nytrosorbyd).
B Hepatoprotektorɵ (sylymaryn).
C Hlyukokortykosteroydɵ (prednyzolon).
D Antyoksydantɵ (vytamyn E).
E Antatsydɵ (almagel).

29
Bolnoy CHRONIC Alcoholism. At 5-day stay is in terapevtycheskom
statsyonare on occasion dezoryentatsyya pneumonia appeared in the place, time,
yspɵtɵval ustrashayuschye galljucinacii auditorium, was a dvyhatelno vozbuzhden.
Tremor Total PE limbs. Renthenolohychesky and fyzykalno - mark
permission of pneumonia. Your tactics of the given bolnoho AGAINST?
A * Translation in narkolohycheskyy statsyonar
B continued treatment in terapevtycheskom offices
C Translation in neyroreanymatsyyu
D Prynudytelnoe treatment on occasion Alcoholism
E Vɵpyska Domains

30
Patient 40 years within five months of complaining of headache, in perevazhnno
morning, vomiting. Lately pain amplified when changing position
head. OBJECTIVE: anostiya, stagnation nipples optic nerves, ataxia, a symptom
Yanishevsky, snyzhennya memory and criticism. Kraniohrama: Signs
hipertenziono-liquor syndrome. In EhoEH: displacement in median brain structures
right side 5 mm. Set the diagnosis.
A * fate frontal tumor of the brain.
B abscess potylochnoyi fate of the brain.
C chronic insufficiency of cerebral circulation.
D tumor left hemisphere of the cerebellum.
E Alzheimer's Disease

31
Patient 20 years. After the wasps penetrate developed swelling edema, rashes on the trunk
in the form of vesicles, papules. Emergency care must begin with:
A * prednisolone, antihistamines
B Reopoliglyukin, hemodez
C Noradrenaline, mezaton
Fresh frozen plasma D, E-aminokapronovaya acid
E Hipotiazyd, furosemide

32
Patient 32 years, a pharmacist, worked with anestezinom. 5 days later, on wrists
Retrieved induratsiya erytematoz skin. Set the diagnosis.
A * contact-allergic dermatitis
B Atopic dermatitis
C Psoriasis
D rheumatocelis
E pigmentary urticaria

33
Patient 35 years complained of pain skovanist joints more than 30 minutes, cysts hands
chelyustnyh joints. ill for 2 years. Objectively: swelling of the proximal interphalangeal
Ovarian joints, limited movement in joints, bone. What is necessary to
examination of the patient?
A * Radiography cysts hands
B Total blood
C reaction Baal-Rose
D immunogram
E Proteinohrama

34
Patient 25 years complains of weakness, dizziness, hemorrhagic rash
skin. Sick month. In the blood: er .- $ 1,0 \ cdot10 ^ {12} $ / l, Hb-37 g / l, 0.9-MP, Lake .-
$ 1,2 \ cdot10 ^ 9 $ / l, tr .- $ 42 \ cdot10 ^ 9 $ / liter. What research method would be most
appropriate for vstonovlennya diagnosis?
A puncture Sternalna
B spleen biopsy
C liver biopsy
D Koahulohramma
E ZHKT U.S.

35
Patients 36 years complains of palpitations, sweating, weight loss for the last 3
Months 5-6 kg, sick for 3 months. Appetite saved. Objectively: Leather
moisture, heat, pulse 140 per min., rhythmic, SC 130/60 mm Hg Thyroid
increased uniformly, the symptoms Gref, Kocher negative. What you must do
research to establish a diagnosis?
A * Tireotropni hormones (research level)
ECG B
Urine C
D Blood Sugar
E complete blood count

36
Patient 68 years we complained about the temperature increase to $ 38,3 ^ oC $, hematuria.
SHZE-55 mm / hour. Antibacterial therapy is not effective. What is the diagnosis may
assume?
A * Kidney Cancer
B multicystic kidney
C renal amyloidosis
D Chronic lung disease
E Chronic glomerulonephritis

37
A young man of 16 years complains of tiredness, pain in the heart, palpitation,
fluctuations in heart, a sense of lack of air zaterplist, cold extremities.
OBJECTIVE: ill asthenic body build. Borders of the heart is increased. Tones sounding at
top - systolic murmur without iradiatsiyi. ECG - sinus tachycardia. What is the diagnosis
patient?
A * NCD for cardiac-type
B Tonzillohennyy myocarditis
C myocardial dystrophy
Lack of D E by transmission valve
E membrane defect interventricular

38
Patient 68 years old, clerk. About two years ago began violation
memory: a forgetful at work and home, could not cope with officers
responsibilities. Gradually began to forget the names of relatives, names of subjects was
helpless porushylas language. Lost skills of reading, writing, care
themselves. When computed tomography study: atrophy of the brain hemispheres
brain. What is the most likely diagnosis?
A * Alzheimer's Disease
Pick B disease
C atherosclerotic dementia
Senile dementia D
E paralysis

39
Patient 34 years at two years of suffering from anxiety disorders with panic attacks.
Treated in psychotherapy. There was incomplete remission. In connection with the move in
Another City interrupted psychotherapy. Will soon become much worse, feels almost
constant anxiety, panic attacks to 5-6 times a day, accompanied by strong
palpitations, shortness of breath, cold sweat, fear of death. Which group of drugs is
most appropriate for drug therapy?
A * antidepressant
B sedative effect of antipsychotics
C antipsychotics antipsychotic action
D medication lithium
E Kardiotoniky, respiratory analeptic

40
Patient Z., 49. Long time abusing alcohol are registered in narcologist.
Reported that hears voices "near the ear, which discuss his call
"Miserable drunkard, obzyvayut dirty words. Most voices are quiet enough,
but sometimes "cry like women in a bazaar. Slightly depressed patient, orientation in time and
place saved. Lighthouse ideas were found. Install the most likely diagnosis.
A * Alcohol hallucinosis.
B paranoid schizophrenia, complicated by alcoholism.
C Liquor paranoid.
D alcoholic delirium, delirium tremens."
E aging paranoid.

41
Patient 31, an economist with adolescents suffering from epilepsy with large
convulsive seizures, constantly received anticonvulsant treatment. Entered into
hospital in connection with the attacks becoming more frequent significant. The department
observed
serial seizures between which the patient comes to mind. What measures are most
should take?
A * Dovenne sibazonu input.
B aminazynu parenteral administration.
C Increase dose usual for patient medication.
D Introduction of drugs camphor.
E Electro-shock therapy.

42
25-year old patient hospitalized in connection with vypotnym pericarditis. Complains
shortness of breath, weakness, chest tightness. Believes that sick 2 weeks ago after
colds. Which of the features identified in the survey will indicate
chronic nature of the pericardium injury?
A Signs of pericardial calcification
B Reduced-voltage electrocardiogram
C Attenuates heart tones
D Signs of stagnation in the big circle
E Significant expansion of cardiac tissue attenuation ripple

43
In 1940 a patient with acute hepatitis B for 10 days inpatient
treatment has deteriorated general condition, have appeared nausea, repeated vomiting,
increased pain in the right pidrebir Ji, knap scleral jaundice and skin. In blood
leukocytosis, with a predominance of indirect hyperbilirubinemia faction. What complications
developed?
A * Hepatic encephalopathy
B Aggravation cholecystitis
C Renal failure
D obstructive jaundice
Intrahepatic cholestasis E

44
In 1956 women climax against the background of the attacks are characterized by strong
headache, increased blood pressure to 180/100 mm hg, tachycardia,
shortness of breath, general trembling. Duration of attacks 30-40 minutes. The attack ends
sechovyvedennyam. Which type of crises may be attributed those attacks?
A * Sympato-adrenal crises
B-Weight thyroid, blood management
C hypotonic crises
D hypertensive crisis
E epileptic seizure

45
The families and timely, ongoing 8 hours in mitral stenosis with women in the third hole
Art. Puerperal sitting in bed hanging legs. Complaints of shortness of breath, breathing open
mouth, face and upper body covered with sweat, cyanosis. In the distance hear
wheezing, and stands out from the mouth foamy, with admixtures of blood, sputum.Pulse 130-
150. What
complications occurred during the families?
A * pulmonary edema.
B asthma
C paroxysmal tachycardia
D Atrial fibrillation
E Chronic heart failure

46
In chronic smokers aged 52 years while lifting a bag of potato suddenly appeared
severe stabbing pain in the left half of the chest, coughing, severe shortness of breath,
tachycardia, decreased blood pressure. ECG signs of overload of right
ventricular. On the roentgenogram of thorax absent pulmonary picture in
left half of the chest, mediastinum shifted to the right authorities. This clinical
the picture says:
A * Spontaneous pneumothorax
B acute myocardial infarction
C pulmonary embolism
D nearside Acute pneumonia
E exudative pleurisy

47
The patient, aged 26 years, 2 days ago during a car accident was a closed injury
thorax. In addition to pain in the affected area has a strong dyspnea, tachycardia, general
weakness. Above the lungs right below the rib VI prytuplennya perkutornoho sound sharply
weakened breathing. If puncture of pleural cavity returned haemorrhagic
liquid. About that post-traumatic complications in question?
A * Pravobichnyy hemathorax
B closed pneumothorax
C exudative pleuritis
D Pravobichnyy hidrotoraks
E Post-traumatic hilotoraks
 48
Bolnoy 38 years we entered the village of mourning for headache pain, holovokruzhenye,
uchaschɺnnoe serdtsebyenye of physical carrying capacity. Improving Blood
said the pressure for a period of 3 years, figures Maximum - 180/110 mmHg
Objectively: the state of the secondary degrees tyazhesty, AD-160/100 mmHg, heart rate-
97/myn. On EKG: synusovɵy rhythm with HR-98/myn., The situation of horyzontalnoe
Heart of electrical wasps, redkaya supraventrykulyarnaya ɷkstrasystolyya. C whatsoever
preferably begin drug treatment?
A * atenolol
B nifedipina
C klofelin
D Papazol
E Captopril

49
Patient S., 30, complained of increased appetite, obesity, dyspnea at
physical activities. In review: the excessive accumulation of fat in the abdomen,
shoulder belts, leather pale pink color, hair cut on the body by
male type, no tuning, heart rate 90 beats / min, SC 120/80 mm. In additional
studies: blood sugar 4.9 mmol / l, cholesterol 6.2 mmol / liter. Ophthalmoscopy:
eyeground unchanged. Neurologist Review: healthy. Diagnosis.
A * Primary alimentary-constitutional obesity androyinyy type.
B Primary alimentary-constitutional obesity hinoyidnyy type.
C Secondary cerebral obesity.
D Secondary edokrynne hypothyroid obesity.
E Secondary endocrine hipoovarialne obesity.

50
Patient 52 years came to hospital complaining of increased bleeding from
mucous membranes, extensive hemorrhages into the skin as ekhimoziv, stains, nasal and
variceal bleeding. After the clinical examinations were vsanovleno diagnosis:
thrombocytopenic purpura. What is the most probable cause of this
disease?
A * Formation of antiplatelet autoantibodies
B Violation of hemostasis
C deficiency clotting factor VIII
D Hereditary deficiency of plasma coagulation factors
E deficiency of iron in serum, bone marrow and depot

51
Patients 35 years complaining about the appearance of the skin hnoyachkiv beard during the
year,
slight pain, not treated. Objectively leather with beards desho hiperemiyovana
bluish tint, against this background of multiple follicular pustules in hair
centers and acute kirochky from affected areas of hair easily and vysmykuyetsya
It shows a small muftochku. Your diagnosis?
A * Normal sycosis
B Dermatofitiya beard
C Impetigo
D Dermatitis
E Eczema

52
In the sea vtopyvsya man 54 years old, which could be found and evacuated to the shore.
OBJECTIVE: consciousness is absent. Face pale, breathing is not bugged, the pulse
filamentary. After resuscitation measures could save the patient.
What complications may develop in the near future?
A * Pulmonary Edema
B apnea
C cephalopathy
D heart failure
E Acute respiratory failure

53
After exposure to the hospital brought a young man 26 years. Index
individual dosimeter December 5. Complaints of sharp general weakness, headache,
nausea, repeated vomiting. The objective: the facial skin erythema, heart rate - 100 per. Min.,
AT - 90/60 mm Hg. Art., vomiting continues. In a period of acute clinical
radiation sickness is sick?
A * period of initial reaction
B Period of secondary reactions
Period C height
D Period expressed clinical manifestations
E Period inflammation

54
When working with aminoz "associations of benzene derivatives (dynitrobenzol, aminotoluol) in
women in 1928 was acute poisoning pairs of amino-derivatives of benzene.Complaints
general weakness, palpitations, nausea. The objective: cyanosis of skin and mucous
shells with greenish tinge; subikterychnist sclera. Blood tinged brown
due to methemoglobin, which is 30 \%. What type of hypoxia developed in the patient?
A * hemic
B hypoxic
C Histotoksychna
D Hipoksemichna
Tissue E

55
Female 23 years complained of acute pain in the left half of the chest, shortness of breath,
which increases with any movement. Sick with asthma, the above
complaints occurred during the typical asthma attack, which was accompanied by prolonged
cough. At
moderate cyanosis face examination, the left half of the chest behind the act
breathing. Perkutornoho tympanit left, weakened breathing. RR - 26/hv. Heart tones
weakened. HR - 96/hv. What is most informative survey?
A * X-ray of thorax
B ultrasound examination
C ECG examination
D tomography of the chest
E Computed tomography

56
The patient was hospitalized in 1965 in the intensive care unit in a coma. Ill
diabetes mellitus type II 10 years. Last 2 weeks was observed expressed
polyuria, polydipsia. Glucose serum - 30 mmol / l, pH of arterial blood -
7.3. Osmolyalnost plasma - 350 mOsm / liter. Patients diagnosed:
hiperosmolyarna diabetic coma. What is the primary pathogenic mechanism of coma?
A * Dehydration
B Hipokoahulyatsiya
C hyponatremia
Increased tubular reabsorption D
E Increased glomerular filtration

57
Patient 23 years in the last 6 months was closed, avoiding communication
with others, usamitnyuvavsya, talked to himself. In conversation with
psychiatrist initially concealed his feelings, but then talked about
special, unrealistic rates contained in it himself ("nest in the brain). What
a disorder of perception?

A * Psevdohalyutsynatsiyi
B Illusions
C Delusions true
D Metamorfopsiyi
E de realization

58
Patient 62 years, arrived complaining of pain in the right half of the thorax
breathing, shortness of breath, dry cough. 10 days ago on the street slipped, fell and
severely
hit the right side. In review: lying on left side. Right half of December
behind the cage when breathing. Crepitus and tenderness III-IV ribs on the right. Right
determined perkutornoho sound blunt and sharply weakened breathing.
Kilns - signs of fluid, fractured ribs III-IV. Pleural -
received blood. Your continued tactics?
A * Transfer to Department of Thoracic
B appoint conservative therapy
C Repeated puncture of pleural cavity
D Fixing bandage on the chest
E Assign trauma counseling

59
The boy in 1916 without clinical symptoms of heart auscultation revealed
Tone and accent II systolic murmur at the pulmonary artery. Heart tones sounding,
rhythmic.
Diagnosis?
A * functional noise
B valve stenosis pulmonary artery
C valvular insufficiency of pulmonary artery
D Nezaroschennya Botalovoyi Strait
E defect interatrial membrane

60
Patient 1958 is suffering from diabetes type 2. Delivered to the clinic in a heavy
condition, unconscious. The patient received large doses of diuretics. OBJECTIVE:
state heavy smell of acetone in exhaled air is not. The skin is dry, the pulse -
In 120 min., SC - 80/40 mmHg, blood glucose 52 mmol / L, urine acetone +, pH 7, 30;
kreatynyn Plasma-230 mmol / liter. What kind of a coma patient came in?
A comma Hiperosmolyarna *
B Ketoatsydotychna coma
C hypoglycemic coma
D lactic coma
E uremic coma

61
Patients 74 years suffers from hypertension at 20 years. Skarzhytsya on
frequent headaches, dizziness, takes enapril. Objective: focus on the tones II
aorta, Ps-84/hv., rhythmic, AO-180/120 mmHg Which group of hypotensive drugs
should be additionally taking into account age?
A * Tazidni diuretics
B Loop diuretics
C Beta-blocker
D Alpha-blocker
E Central sympatolityky

62
Patients 54 years complained of constant dull pain in mezohastralniy plot
weight loss, admixture of dark blood in stool, constipation. Within a year weight loss of
10 kg.
In the blood: er .- $ 3,5 \ cdot10 ^ {12} $ / l, Hb-87h / l, Lake .- $ 12,6 \ cdot10 ^ 9 $ / l,
sticks-nuclear
shift SHZE-43 mm / hour. What is the most likely diagnosis?
A * cross-Cancer of the colon
B gastric ulcer
C Chronic Colitis
D Hronichnyyy pancreatitis
E Stomach Cancer

63
Patient 1935 for 5 years complained of giddiness, pain
zdavlyuyuchoho nature in the heart area, shortness of breath during exercise. ECG:
signs of left ventricular hypertrophy, deep negative prong T in V3-V6, depression
ST 4 mm in V3-V6. Echocardiography: left ventricular cavity reduced interventricular
membrane is thickened (1.7 cm), hipokinetychna.Yakyy preliminary diagnosis?
A * Hypertrophic Cardiomyopathy.
B Hypertension.
C Acute myocardial infarction.
D Aortic Atherosclerosis with stenosis mouth.
E Dilyatatsiyna cardiomyopathy.

64
In patients 60 years over 20 years suffers from hypertension, after
stressful situation suddenly arose attack of breathlessness. OBJECTIVE: ortopnoe
position, Ps
- 120 for 1 min., AT 210/120 mm Hg. Art. I tone over the tip of the heart is weakened, in
auscultated diastolic additional tons, RR - 32/hv. Breathing on the lower
weakened lungs, single noteless dribnopuhyrchasti moist rales. What
complications arose in patients?
A * acute left ventricular failure.
B attack of hysteria
C branches of pulmonary artery thromboembolism
D Pneumonia.
E dissected aorta

65
Female 64 years old, with unstable angina while walking suddenly collapsed. Another
physician review the patient has been confirmed by the absence of consciousness, a
ripple of a.carotis
and heart sounds, pupils and liquid tight, shallow breathing. Where in this case
to start resuscitation measures?
A * with punch by sternad
B / B input of adrenaline
C / O input atropine
D with a transesophageal kardyostymulyatsiyi
E intubation and ventilation

66
The patient entered 1942 with complaints of aching in the back, more right, sometimes
fever to subfebrylnyh figures headache. 10 years ago
during pregnancy the patient had an attack of pain in the right half back, which
accompanied by chills, sudden fever. 5 years ago was
marked increase of antibodies to 200/110 mmHg In the analysis of urine: protein - 0.99
grams per liter,
leukocytes - 10-15, erythrocytes - 2-4, 1-2 in hyaline cylinders sight. Creatinine
serum - 102 mmol / liter. Which most likely diagnosis in this patient?
A * Chronic pyelonephritis
B Chronic glomerulonephritis
C kidney Tuberculosis
D renal amyloidosis
E Hypertension

67
The patient entered 1939 with complaints of rapid fatigue, headache,
decreased appetite, nausea and vomiting in the morning, occasional nasal bleeding.At
age 15
years of acute glomerulonephritis. When examining the marked increase of AT
to 220 / 120 mmHg, pale skin and mucous, traces rozchuhiv and hemorrhages in the
skin. In
urinalysis: protein - 3,3 g / l, leucocytes - 3-5, erythrocytes - 8-10, hyaline cylinders in
the 4.3
sight. Which of these biochemical parameters most accurately estimate
patient's condition?
A * serum creatinine .262 mmol / l
B plasma sodium 148 mmmol / l
C uric acid in blood of 0.41 mmol / l
D blood fibrinogen 5.9 g / l
E blood bilirubin 20.2 mmol / l

68
Patient 20 years, admitted to the clinic 7 days of illness with complaints of yellowness
skin and sclera, dark urine, vomiting Each time, decrease appetite, increase
body temperature to the 38s within 2 days. 3 weeks ago fishing with friends
posudom.Ob enjoyed a 'subjective: dopey, t - 36,8 C, skin and sclera
zhovtushni, liver performs under rebir'ya 3 cm, sensitive palpation, the spleen
palpatory not found. Dark urine, stool partially aholichnyy. What previous
diagnosis?
A * Viral Hepatitis A
B Leptospirosis
C Infectious mononucleosis
D hemolytic anemia
E enteric iyersinioz

69
1937 Woman complains of pain without squeezing chest that occurs during
physical activity. Ob-no: landmark heart frequently left sistolychnyy noise
aorta, heart rate = AC = 72 per min., AT-130/80 mmHg ECG - signs HLV
ventricle. The most informative method of examination in this instance is
A * Echocardiography
B Fonokardiohrafiya
C coronarography
D Sfihmohrafiya
E Radiography

70
Male 26 years old, drug addict, is treated in the cardiology department of
diagnosis of infective endocarditis. Ill 3 months, three times changed the scheme
antibiotic, currently stored subfebrylna temperature
have appeared signs of left ventricular failure, failure detected
aortic valve III level. Crucial for treatment at this stage
are:
A * Prosthetic aortic valve
B Change of antibacterial drugs
C Connection xenobiotics spleen
D cardiotonic therapy
E immunomodulatory therapy
 71
A man in 1937 during piyelohrafiyi by verohrafinu emerged
itchy skin, swelling of the face, dizziness, fear of death. SC 70/40 mmHg century., PS
130 beats in a minute .. Noisy breathing, wheezing heard in the distance, auscultation of
breath
weakened, isolated, dry rales. Which drug should enter the patient first
place?
A * Adrenaline.
B prednisolone.
C Laziks
D Suprastyn.
E Eufilin.

72
Patient 58 years, accountant, 2 years suffering from osteoarthritis of the knee. 2
weeks was treated in hospital. Discharged in satisfactory condition with complaints
slight pain syndrome after long-term static load. Local
hyperthermia and exudative phenomena in the joints missing. What is most expedient
Further tactics?
A * Treatment in a sanatorium.
B Re-patient treatment.
C perform arthroscopy.
D Route to MSEK.
E podiatrist in consultation.

73
The patient complains of 1932. chills. backache, brawn shins, weight loss to
10 kg, tartness of hand. Ob-no: leather curtains of pale, her. Muffled heart tones, t to
38.5 C HR = AC = 110 per min., AT 190/115 mm Hg. Art. Symptom Pasternatskoho
weakly
positive with both sides. In blood eritr .- 2,8 ‡ 1012 / l, Hb - 65 g / l, ESR - 58 mm / hr.,
A / C - 0.82, (Globe. - 30 \%. An. Urine - protein - 0,8 g / l, Lake. In 20-25 p / s ep. 100 in
p / s,
creatinine - 0.190 mmol / liter. What is the likely diagnosis in this case.
A * nodular periarteriyit
B Systemic lupus sleeper
C Acute nephritis
D pseudotrichiniasis
E clear-a stone disease

74
The patient, 52 years old, complained of pain in joints, muscles, weakness in
muscles. Ill at
year. Treatment of nonsteroidal anti-inflammatory drugs had no effect. At
Review: independent movements of trunk and limbs is difficult, in dark-field
paraorbitalniy
erythema. Palpation of the shoulder girdle muscles and painful hips. Weakened heart
tones,
systolic murmur over the top. What is the most likely primary pathogenic
mechanism of this disease?
Synthesis of myosin A * - specific antibodies.
B collagen hyperproduction
C Antibody to the RNA.
D Antibody to native DNA.
E Formation of circulating immune complexes

75
Bolnaya 48 years on zhaluetsya noyuschye boly bokovɵh Division in abdomen
umenshayuschyesya after defekatsyy othozhdenyya and gas, diarrhea and cheredovanye
zaporov. 2 years ago suffered dyzenteryyu. When abdominal palpation vɵyavlyaetsya
boleznennost, cheredovanye spazmyrovannɵh and atonychnɵh, and urchaschyh departments
intestine. Nvaybolee ynformatyvnɵm for staging dyahnoza yavlyaetsya?
A * Kolonoskopyya
Study B finger straight gut
C Rektoromanoskopyya
D Koprotsytohramma in dynamics
E Ultrasonography organs bryushnoy polosty

76
Bolnoy N., 32 years accepted the massyvnuyu antybakteryalnuyu terapyyu.Zhaluetsya on
razlytɵe abdominal pain, chastɵy of liquid stool (4-6 times a day), general weakness.
Ob-no: state of udovletvorytelnoe. BP 120/70 mm Hg century, heart rate 84 beats in
minutes. Belly
palpation of soft, painful in the lower abdomen Division. Hot and selezenka
palpyruyutsya not. The application of medication whatsoever lekarstvennoho tselesoobrazno in
this case?
A * Lynneks
B Panzynorm.
C ɗssentsyale N.
D Motylyum.
E Ymodyum

77
Bolnaya N. zabolela Island: increasing the temperature to 39.4 C in Headache pain
LTA region and temperomandibular, pain in hlaznɵh apple, an ache Quantity to all television,
zalozhennost
nose, cough DRY. What the dyahnoz veroyatnɵy the most?
A * flu.
B Parahrypp.
C Adenovyrusnaya INFECTION.
D Rynovyrusnaya INFECTION.
E parrot disease.

78
In the office of pryɺmnoe Hospital delivered on day vtorɵe disease in man
heavy condition. When the inspection temperature $ 36,1 ^ C $, chertɵ Face zaostrenɵ,
leather dry and is going to skladkuu, afonyya, sudorozhnɵe podɺrhyvanyya otdelnɵh
mɵshts groups. Akrotsyanoz. Tonɵ hluhye hearts, Ps-102/myn., AD-50/20 mmHg
Soft belly, vtyanut, bezboleznennɵy. Anuryya. Of liquid stool in the form of "rice
otvara.veroyatnɵy dyahnoz What the the most?
A * Cholera
B Ostraya dyzenteryya
C Salmonellez
D ɗsheryhyoz
E Kyshechnɵy amebyaz

79
In muzhchynɵ 22 years, and with polyartralhyey vɵsokoy lyhoradkoy, discovered
ɷkssudatyvnɵy side pleurisy. Renthenolohychesky right ribs from downwards IV
- Homohennoe zatemnenye. Quantity Left II segment - an isolated plotnɵe ochahovɵe
shadows.
Test with Mantu 2TE - 16 mm papule. In plevralnoy povɵsheno fluid content of
protein, the reaction polozhytelnaya Ryvalta, uvelychennoe number of leykotsytov s
preobladanyem limfotsitov. Identify the most veroyatnuyu aetiology pleurisy:

A * Tuberkulɺznaya
Malignant B
C Stafylokokkovaya
D Vyrusnaya
E Autoymunnaya

80
You nablyudaete bolnuyu 64 years from dyahnozom IBS: stabylnaya stenokardyya FC II, CH
IIA. Prynymaya you appointed to complex treatment (nytratɵ, ynhybytorɵ ACE
statynɵ), she noted the decrease in incidence and the forces of prystupov stenokardyy, but
Headache pain appeared, holovokruzhenye. ɗty phenomenon poten Being sprovotsyrovanɵ
accepting:
A * Nytrosorbyda
B Renyteka
C lovastatin
D Anaprylyna
E Aspyryna

81
Bolnaya 23 years delivered in travmpunkt zahryaznennoy with push-rezanoy early
Modify stopɵ. An ranɵ primary surgical treatment, introduced
anti tetanus serum. Nekotoroe come down sharply during a state of bolnoy
uhudshylos: rezkaya appeared weakness holovokruzhenye, chastɵe serdtsebyenyya.
Ob-no: otmechaetsya blednost kozhnɵh pokrovov, cold sweat, pulse chastɵy
Filling feeble to 100 beats / min., BP 90/40 mm Hg. Art. In connection with something
happened
The sharp uhudshenye bolnoy condition?
A * anafylaktycheskyy shock
B gemorragichesky shock
C bolevoy shock
D-ynfektsyonno toksycheskyy shock
E Lekarstvennaya (sɵvorotochnaya) disease.

82
Man, 2 days ago ymevshyy Sexual contact, as it turned out Later, with
HIV-ynfytsyrovannɵm partner obratylsya with a request probability ysklyuchyt
ynfytsyrovanyya. When the holds is necessary for the first Study antytel
HIV?
A * A month after sexual contact
B On the day of the treatment
C After 3 months
After 6 months of D
E 1,5 years

83
A man 18 years in connection with the headache pain pill took aspyryna. After 20 minutes
razvylsya libraries century, lips, appeared zatrudnennoe breathing, excoriated by Elements
kozhe. In periodic otmechalas otechnost father, cheeks, lips after ɷkstraktsyy teeth.
Reaction of migration tormozhenyya leykotsytov with aspyrynom otrytsatelnaya.
Ymmunohlobulyn E - 115 ng / ml. Specify the most veroyatnɵy dyahnoz.
A * Nasledstvennɵy anhyonevrotycheskyy libraries
B libraries Kvynke
C attack bronhyalnoy astmɵ
D Allerhycheskyy dermatitis
E Pyhmentnaya krapyvnytsa

84
In bolnoy 17 years, after his stay in Crimea appeared in sylnɵe boly of major
joints of hands, hearts in the field, serdtsebyenyya, libraries noh. Wherein temperature - 38,8 C.
Blednost skin, joints over porazhennɵmy - ɷrytematoznaya sɵp. ɗrozyy on
border Krasnaya kaymɵ lips hnezdnoe vɵpadenye hair. Noise trenyya plevrɵ etc.
levoy lopatkoy. Tonɵ hluhye hearts. Pulse - 124 beats / min, BP - 160/100 mm.
Hemoglobin - 92 Ed SOɗ - 66 mm / hour. SRB - + + +. Polozhytelnaya a response
Wassermann. What the Studies of additional will be from the most ynformatyvno
of the given to diseases of?
A * antinuclear antytytela
B reaction of rhythm and RIF
C revmatoydnoho determining factor
D titer LDA - O
E Byopsyya leather and mɵshtsɵ

85
Bolnoy 33 years from the first time vɵyavlennɵm saharnɵm dyabetom with the help dyetɵ
supports edɵ glycaemia after less than 10.0 mmol / liter. That insulinotherapy
vozderzhyvaetsya. For dyfferentsyatsyy 1 (ynsulynzavysymɵy) and 2 nd
(Ynsulynnezavysymɵy) dyabeta the most frequently hard to hold:
A * k determining antytel ostrovkovɵm kletkam
B Hlyukozotolerantnɵy test.
C Study natoschak glycaemia.
D hlykozylyrovannoho determining blood hemoglobin.
E determining fructosamine in blood

86
Patient V., came to the clinic complaining of weakness pronounced, increasing
temperature of 39.2 C, sore throat when swallowing, haemorrhagic skin rash
trunk. When examining the blood in anemia, thrombocytopenia, and blast - 14% SHZE
40 mm / hour. What examination is required to clarify the diagnosis?
A * Sternalna puncture
B X-ray skull bones
Advanced C blood
D Sowing of tonsils
E Koagulogramma
 87
Patient complains of 1923 pronounced weakness, drowsiness, darkening of the eyes,
dizziness, disturbance of taste. In menorahiyi history. Objective: expressed
weakness, pale skin cover, cracks in the corners of the mouth, layer nails, systolic
noise over the top. Blood: Er3, 4 T / L, Hb 70 g / L, ATP 0.75. Thrombus. - 140 g / l, Lake. -
6.2 g / dL. Your diagnosis?
A * Chronic posthemorrhagic anemia
B Acute leukemia
C Acute posthemorrhagic anemia
D B12-deficiency anemia
E Verlhofa Disease

88
Patient 60, suffers from chronic lymphocytic leukemia within 5 years. In the last
month worsened, increased limfouzlɵ all groups, the spleen. Er 3.6 * 1012 / l, Hb
102 g / liter. , Lake. - 92 g / l What therapy is shown to the patient?
A * Leykeran
B Milosan
C Prednyzolon
D Vitamin therapy
E Rubomitsyn

89
In patients 25 years old, temperature of 38.0 C, sore throat. Tonsils swollen, moderately
congested, dense gray-coated film, which extended to the brackets, uvula.
Film removed with difficulty. After removal of surface bleeding. The likely diagnosis.
A * Diphtheria
B lacunar angina
C Paratonzelyarnyy abscess
D Skorlotyna
E Infectious mononucleosis

90
In patients 35 years (working milkmaids) in the forearm skin black nebolyuchyy
thick crust. Around him on inflammatory red roller secondary
bubbles that surround his crown, headache, weakness, temperature 38.5 C. In
sector there are cases padezhu cows. The likely diagnosis.
A * Anthrax
B tularemia
C Plague
D Erysipelas
E staphylococcal carbuncle

91
Patient 46 years, livestock specialist, fever for 2 weeks to 39C, chills, a significant
sweating, pain in muscles and joints. Hepatosplenomehaliya, increased lymph nodes,
test Byurne - 6,5 cm The likely diagnosis.
A * Brucellosis
B Psevdotuberkuloz
C Infectious mononucleosis
D Revmatoidnyy polyarthritis
E lymphogranulomatosis

92
In 1916 a young man in 2 weeks after angina were sharp pains and swelling of small
Ovarian joints of hands and knee joints, fever up to 38s, palpitations,
choking. Pain in the joints are migratory in nature, without permanent disabilities
function. In the blood: neutrophilic leukocytosis with moderate palochkoyadernɵm shift
ESR - 30 mm / hod.S-reactive protein "+". Your diagnosis?
A * Rheumatism
B reactive arthritis
C Bacterial (purulent) arthritis
D Reiter's disease
E Rheumatoid arthritis

93
Patient R., 30, complained of headache and palpitation after emotional
stress. High incidence of hypertension within 2 years. When examining the patient
excited hiperemiyovane face, the skin moisturised. Pulse 100 beats / min, AT180/90 mm
Hg. What should be the patient primarily for kupyrovannya crisis?
A * propranolol
B Apresin
Furosemide C
D Klofelin
E Dibazol

94
Patient 1963 is suffering a form of insulin dependent diabetes. Against
breaking acute cerebral circulation developed high hyperglycemia, dramatically
dehydration, hiperhloryemiya, hipernatriemiya. Ketonemiya and atsetonuriya missing.
Specify the correct diagnosis.
A * hiperosmolyarna neatsydotychna coma
B acute renal failure
C hiperketonemichna diabetic coma
D chronic renal failure
E hiperlaktatsydemichna coma

95
In the women 45 years vnezapno serdtsebyenyya attack is there, and holovokruzhenyya. Ps-
175/myn., AD-100/60 mmHg EKG: RR - 0,33 sec., QRS - 0,08 sec. C whatsoever
Actions should be a start a terapevtycheskoho Assist assistance?
A * Vosproyzvedenye rvotnoho reflexes test Valsalvɵ
B Nepryamoy massage hearts, YVL
2 ml ATP C 1 \% y-ra / v ink (20 mg for a period of 5.10 sec)
D Novokaynamyd 10% - 10 ml vnutryvenno
E Chrezpyschevodnaya electrical stimulation (CHPɗS)

96
Bolnoy M. 40 years entered the office of hastroɷnterolohycheskoe with mourning for itching
kozhnɵh pokrovov, zheltuhu, tyazhest podrebere in law, and weak. Objectively:
kozhnɵe pokrovɵ zheltushnɵ, sledɵ raschesov, roast + 5 cm, 6x8 cm in selezenka
blood: schelochnaya fosfotaza - 2,0 mmol / l ‡ h, Common bylyrubyn 60 mmol / l
cholesterol - 8.0 mmol / liter. What the Senior syndrome can allocate in bolnoho?
A * Holestatycheskyy
B cytolytic
C-mesenchymal vospalytelnɵy
D Astenycheskyy
E-Pechenochno kletochnoy nedostatochnosty

97
A man entered with 67 years of mourning for povtoryayuschyesya dizziness. When the
inspection:
tonɵ Heart hluhye, otmechaetsya vɵrazhennaya bradykardyya. Pulse in 1936 udarov
minute, rytmychnɵy. BP 150/70 mm. tr. Art. Data in EKG: number zheludochkovɵh
sokraschenyy 32 per minute, and predserdnɵe zheludochkovɵe kompleksɵ sleduyut
regardless of friend from friend. The most probable reason obmorokov:
A * Complete a-in block
B synusovaya bradykardyya
C synusovaya arytmyya
Sino-D atryalnaya blockade
E nepolnaya a-blockade in

98
Hypothermia in patients after sudden fever to 39C, a
pain in the chest during breathing and coughing. O Objective: Respiratory surface-28 1
min., reducing sound perkutornoho lower right corner of shovels against cruel
relaxation breathing-crepitation. Which is the most common microorganisms
etiological factor for this disease?
A * pneumococcus
B streptococcus
C staphylococcus
D Escherichia coli
E bacillus Friedlander

99
In patients 36 years after physical exertion appeared asthma, cough with
selection of sputum. Suffer from rheumatic mitral heart defect.
Auscultatory over the lower lung small-and wet serednopuhyrchati
wheezing. What is the mechanism of degradation is leading?
A * Increasing the hydrostatic pressure of blood.
B Reduced oncotic pressure of blood.
C Increased platelet aggregation and eritrotsytiv.
D decrease lymphatic outflow.
E hypoxia increase and decrease of gas diffusion

100
Shakhtar with experience in the shaft 18 and complaining of shortness of breath, dry cough,
general weakness, sweating, chest pain, breathing hard in the lungs
R-graph of the lungs: vuzlikovi shadow in the lower and middle parts, calcination
lymph nodes of type "eggshell". For a disease peculiar to these changes?
A * silicosis.
B Tuberculosis.
C carcinomatosis.
D Kolahenoza.
E mycoses.

101
After bee sting in a patient appeared itchy skin, voice hoarseness, barking
cough, anxiety, Ob-no: swelling of the lips, eyelids, cyanosis. Which of the following drugs
used in the first place?
A * prednisolone.
B Adrenaline.
C Eufilin.
D Laziks.
E Seduksen.

102
Patient 31, complained of the increase in lymph nodes above the left collarbone, night
itchy skin. Sick during the year. Ob-no: palpating enlarged nebolyuchi
lymph nodes in left supraclavicular area. Blood: Hb - 110 g / l
leukocytes - 9,6 * 109 / l, eozynofily4 \%, para-6 \%, St. 63 \% limf.-20 \%-mon. 7 \%.,
ESR-55 mm / hr., Tromfotsyty 135 * 10 * 9. In Rh-graph of the chest is determined
infiltrate in left field prykorenovoyi. What research should be undertaken for
confirm the diagnosis?
A * lymph node biopsy.
B punch biopsy.
C Sternalna puncture.
D Bronchoscopy
E tomogram of the lungs.

103
A citizen of Pakistan in 1930 acutely ill: is frequent watery stools,
much like rice otvar. Objectively - t 35,4 C, cold extremities, acrocyanosis,
dry mouth, sharply reduced tissue turgor. What should be done to assess the
Dehydration?
A * Determine the density of plasma
B measure central venous pressure
C Determine the level of urea and creatinine in blood
Measure D AT
Identify the level of hemoglobin E

104
Students in 1920 during the month concerned significant fatigue, increased
body temperature [39C], profuse sweats, weight loss. OBJECTIVE: all groups increased
peripheral lymph nodes, oral candidiasis, herpetic
rashes on the lips. In the blood: Lake. 3.3 * 109 / l, SHZE 15 mm / hr
B-lymphocytes 12 \%, the ratio of Th / Tc <0.5. Specific diagnostic methods
disease?
A * Detection of antibodies in response to the HIV ELISA
Lymph node biopsy B
C Sternalna puncture
D bacteriological examination of blood
E test Mantu

105
Girl in 1918 acutely ill: runny nose, cough, abdominal pain, temperature 38.5 C.
By the third day catarrhal phenomena diminished, and temperature 36.6 C. On the fourth
day of illness weakness in right leg. Objectively: active movements in the leg missing, passive -
painful. Thigh muscles limp, pain along the nerve trunks. Knee and ahilovyy
reflex on the right foot is caused, the symptom of "tripod" positive. In blood
Lake. - 4,2 * 109 / l., SHZE - 6 mm / hr. Preliminary diagnosis?
A * Poliomyelitis, spinal form
B polio pontynna form
C botulism
D encephalomyelitis
E tick borne encephalitis

106
In patients 56 years, scientist, there squeezing pain behind the breastbone in
roziv several a day at the course at a distance of 100-150 meters, up to 10 minutes. ,
removed nitroglycerin. OBJECTIVE: increased supply, the border of heart
normal, rhythmic tones, pulse 78 beats. in min., AT-130/80 mmHg century. ECG: low T in
V4-5. On any illness you can think of?
A * Stable angina FC III.
B Unstable angina.
C I FC stable angina.
D Stable angina FC II.
E Stable angina FC IV.

107
Patient 1927 was treated for 5 years in a neurologist about osteoarthritis
spine with radicular syndrome. Last 2 years of treatment was conducted without clinical
effect. The doctor noticed a growth in the laboratory process activity, disappearance
physiological lordozu. Bechterew's disease was suspected. What research
help confirm the diagnosis?
A * Radiography ileosakralnyh connections.
B Determination of HLA-B27 antigen
C CIC level in the blood.
D punctate kosnoho brain
E Presence of rheumatoid factor.
 108
In patients 25 years, appeared in autumn pain in the epigastrium, arising out of 1,5-2
hr. after meals and at night, heartburn, constipation. Pain worse on admission spicy, salted
and acidic foods, reduced - after application of ash and hot-water bottle. Sick during the year.
The tongue is furred, humid. On palpation the abdomen - pain in the epigastrium case in
this plot - resistance of the abdominal muscles. What is the disease most
likely?
A * 12-ulcer duodenum.
B chronic cholecystitis.
C diaphragmatic hernia.
D gastric ulcer.
E Chronic pancreatitis.

109
Patient 50 years for the year suffer attacks of pain in right hypochondrium,
arising mainly after fatty foods. Last week attacks
repeated daily become more painful. At 3-day stay in
hospital appeared yellowness of skin and sclera, white stools and dark urine.
Blood tests: HB - 128 g / l, reticulocytes - 2%, neutrophilic leukocytosis (13,1 * 109 / l)
SHZE-28 mm / h. What is the most likely cause of jaundice?
A * gall-stone disease.
B Chronic pancreatitis
Chronic cholestatic hepatitis C.
D hemolytic anemia.
E Acute viral hepatitis

110
Male 1955 complains of general weakness, reduced output of fluid, pain
in the area of heart aching character. At 15 years suffers from chronic
pyelonephritis, treated in hospitals. OBJECTIVE: leather curtains dry, with
yellowish color. PS -80 for 1 min., Rhythmic, SC -100/70 mmHg At
auscultation of the heart tone deaf, pericardial friction sound auscultated. In the study:
creatinine -1.1 mmol / L, glomerular filtration rate of 5 ml / min. What treatment is most
yefektyvnym?
A * Hemodialysis.
B Hemosorbtsyya.
C Plasmapheresis
D intestinal dialysis
E Conservative therapy

111
The patients appeared attacks posmykuvan right foot, which was extended to the whole leg
and
lasted for several minutes. Consciousness is not lost. During examination: right paresis
foot after the attack, deep reflexes on the right leg elevated, symptom Babinskoho
right. Specify the type of attack:
A * Jacksonian epilepsy
B Kozhevnikovska epilepsy
C Miokloniya
D Generalized tonic-clonic attack
E Absans

112
Patient S., 1951, complaining of dull pain in right hypochondrium and epigastrium, nausea,
reduced appetite for the past 6 months .. In the history of stomach ulcer.
Ob-no: the weight is reduced. Pulse - 70 per minute. A / T - 120 / 70 mm Hg. Spills
muscle pain and resistance in the epigastrium on palpation. Above the left collarbone
palpated dense lymph node size 1x1 cm What method of research
would be most appropriate?

a. * ȿɡɨɮɚɝɨɝɚɫɬɪɨɞɭɨɞɟɧɨɫɤɨɩɿɹ with biopsy

B bryushnoyi cavity of Ultrasonic
C pH-metry
D Ureaznyy test
E Radiography stomach

113
Patient in 1937 observes frequent nasal bleeding and metrorahiyi, periodic movements
bruises on himself shkiri.Pochuvala zadovilno.10 days ago after a significant nasal
bleeding
intensified weakness, dizziness resurfaced and palpitations .. Pale skin
front surface of the torso, legs and arms spread petehialni hemorrahiyi and single
ekhimozy.Analiz blood: Hp-93h / l, er-4, 0x10 ^ 12 / l, CP-0, 7; Lake-5, 3x10 ^ 9 / l, trom-
10x10 ^ 9 / L,
SHZE-15 mm / hod.Yakyy diagnosis was possible?
A * Disease Verlhofa
Hemophilia B
C Hemorrahichnyy vasculitis
D Iron deficiency anemia
E aplastic anemia

114
After the liquidation paroksyzmu atrial fibrillation in a patient suddenly have a pain in the
chest, shortness of breath. OBJECTIVE: skin covered with sweat, neck veins nabuhli
eyes
wide open. Pulse small, 140 per min., SC, 80/40 mmHg At the turn of ECG
axis deviation to the right of heart. What complication has arisen in the patient?
A * pulmonary embolism
B Myocardial infarction
C gap intraventricular septum
D tamponade
E cardiac asthma

115
In patients with mitral defect formed with the advantage of mitral insufficiency
valve gradually appeared malaise, shortness of breath expressed. At survey
found acrocyanosis, swelling of the legs, moist rales in the lower lung
expanding the boundaries of the heart. The emergence of data shows signs of
development:
A * congestive heart failure.
B chronic vascular insufficiency
C Acute heart failure
D Pneumonia.
Pericardial effusion E

116
Male 1935 1913 bulldozer worked. Complains of dizziness,
headache at the end of the day, numbing fingers and pain in muscles soft feet at night.
When examining the breach of pain and tactile sensitivity for
peripheral type, painful calf muscles, and on the ripple. dorsalis pedis
saved. What is the disease most likely?
A * vibration disease
B Raynaud's disease
C syringomyelia
D vegetative polyneuritis
E obliterating atherosclerosis

117
The patient complains of weakness, dizziness, bruising, nasal bleeding,
weight loss. Ill 3 months. During examination: general condition of moderate, low
nutrition, skin pale with presence on the front surface of the hands, feet and torso of
different
period of multiple bruises in diameter from 0,2 to 3,0 cm without pigmentation. What type
of
bleeding in patients?
A * Petehialno-spotted.
B Hematomnyy.
C Mixed.
D Vaskulitno-purple.
E Anhiomatoznyy.

118
Patient attacks in 1930 concerned a fever, fever, sweating profuznoy who
repeated every third day. Ill 2 weeks. I leather with bright sclera icteric.
The liver and spleen were enlarged. A year ago, worked in Africa. Which of the following
MOST LIKELY diahnoziv?
A * Malyariya.
B Cancer head of pancreas.
C septicemia.
D Virusnyy hepatitis.
E leptospirosis.

119
In patients 49 years of age with stable angina FC II, suddenly emerged
stenokardiotychnyy pain usunuvsya only 6 pills nitroglycerin. OBJECTIVE:
AT-120/80 mm Hg, Ps-104/hv., Isolated extrasystoles. On the electrocardiogram: Liquid
livoshlunochkovi extrasystoles, depression segment $ ST $ in $ I $, $ aVL $ and high
spiky teeth $ T $ in $ V_2 $, $ V_3 $, $ V_4 $ assignments. What is the most likely
diagnosis?
A * Unstable angina
B Stable angina, FC II
C transmural myocardial infarction
D stable angina, IV FC
E variant angina

120
Man 32 years last year worried about the pain in the buttocks and hips
joints, pain and stiffness with movement in the lumbar spine. ESR - 56
mm / hour. X-ray revealed signs of duplex sakroileyitu. The patient is a carrier
NLA V27 antigen. What is the most likely diagnosis?
A * Ankylosing spodiloartryt
B hip
C Rheumatoid arthritis
D Reiter's disease
E Spondiloz

121
In patients 46 years diagnosed with angina pectoris of functional class II
background of hypertension stage. Blood pressure within the 160/105 mmHg
Which antihypertensive drug opt?
A * Metoprolol
B enalapril
C doxazosin
D Klofelin
E Adelfan

122
Bolnaya 58 years zhaluetsya peryodycheskuyu for headache pain, and
holovokruzhenye
noise in the ears. Within 15 years stradaet saharnɵm dyabetom. Objectively: tonɵ
Heart rytmychnɵe, HR-76/myn., focus on aortoy II ton, AD-180/110 mmHg In
Moche: OP - 1.014. Sutochnaya rubbed with protein mochoy to 1,5 g. Preparations for
choice
treatment of arterial hypertension in dannoy patsyentky will:
A * Ynhybytor ACE
B $ \ beta $-blocker
C Antahonyst kaltsyevɵh channels
D Tyazydovɵy diuretiki
E $ \ alpha $-blocker

123
In bolnoy pneumonia at the bottom of left Fractions of light appeared on the complaints
in boly
levoy half hrudnoy kletky. Objectively opredelyaetsya obshyrnaya Zone
prytuplenyya on levoy half hrudnoy kletky (Line-Sokolov-Damuazo Eliasson).
C method whatsoever Research survey of light tselesoobrazno begin with a view
dyahnoza refining.
A * X-ray
B Bronhoskopyy with byopsyey
C Bronhohrafyy
D Spyrohrafyy
E thoracoscopy

124
Patients 25 years 2 weeks after pharyngitis began to complain of increasing
temperature of $ 38 ^ oC $, general weakness, breathlessness while walking, swelling
and pain
joints in a flying character. OBJECTIVE: cyanosis of lips, Ps-100/hv., Weak
content, rhythmic. Left heart border shifted outside of mediaklyavikulyarnoyi line
1 cm and tone at the top loosened, soft systolic murmur bugged. Which
etiologic factor that caused the pathological process, most likely?
A * $ \ beta $-hemolytic streptococci
B staphylococcus
C pneumococcus
D virus
E Mushrooms

125
In patient 26 from postoperative hipoteriozom, which received 100 ug tiroksin 2
times a day, there were tachycardia, sweating, irritability, sleep disturbance.
Identify tactics to further treatment.
A * Reduce the dose of thyroxine.
B Increase dose thyroxine.
C Assign a beta-blocker.
D Add to mercazolil treatment.
E Assign sedative.

126
Go to the doctor asked the woman 35 years with bone and skin lesions in the lower third
forearm in a significant edema, flushing, vezykulyatsiyi, moknuttya.
Diseases rozvylos after use for laundry powder "Lotus"
which the patient uses during the month. Previously, dermatological diseases not
was. What is the most likely diagnosis?
A * Allergic dermatitis
B Simple dermatitis
C Toksykoalerhichnyy dermatitis
D microbial eczema
E Limited neurodermatitis

127
In the 12-year-old girl after taking two aspirin tvbletok 4-5 hours
body temperature rose to 39-40 ° C complains of general malaise,
dizziness, sudden appearance of red spots on the skin, blistering or
peeling of the epidermis erozuvannyam surface of the skin lesions resembled
second-degree burns. Nikolsky Symptom - What is the most likely positive
diagnosis?
A * Acute epidermal necrolysis - Layyela syndrome.
B pemphigus vulgar.
C polymorphic exudative erythema.
D bullous dermatitis.
E Herpetyformnyy duhring dermatosis.

128
Male 32 years complains of heartburn and aching in nadcherev'yi 2-3 hours
after eating. Aggravation - spring and autumn. Food intolerance of eggs
and fish. OBJECTIVE: palpation abdomen - pain in the gastroduodenal area.
EFHDS: 5 mm ulcer on the front wall of the duodenum. Positive
ureaznyy test. What is the most likely driving mechanism of the disease?
A * helicobacter infection
B Food allergies
AUTO-C production of antibodies
Reduced synthesis of prostaglandin D
E gastric dysmotility

129
Female 48 years complains of weakness, weight loss, decreased appetite, Chief
pain. In his youth, acute glomerulonephritis. With 25 years of age suffering from
arterial hypertension. Not systematically treated, the doctor rarely addressed.
After the investigation revealed signs of chronic renal failure and art.
(Creatinine - 0.43 mg / l). What recommendations regarding the most appropriate food
for this patient?
A * Restrictions protein
B reduced fat
C hydrocarbon Restriction
D Eat higher content of "alkaline" foods
E Increased fluid

130
Radiation Bolnoy received irradiation. Zhaluetsya of weakness chastɵe nosovɵe
krovotechenyya, "bruises" on television, serdtsebyenye, odɵshku. Often boleet
respyratornɵmy diseases. In blood: ER .- $ 1,2 \ cdot10 ^ {12} $ / l, Hb-54 g / l, Lake .-
$ 1,7 \ cdot10 ^ 9 $ / L, E .- 0% § - 0%, 32% .- c, l .- 62% of - 6%; SOɗ-52 mm / h; clot. -
$ 30 \ cdot10 ^ 9 $ / liter. The most tselesoobraznoe treatment in this case:
A * marrow transplant kostnoho
B Perelyvanye trombotsytarnoy massɵ
C Perelyvanye ɷrytotsytarnoy massɵ
D Perelyvanye tselnoy blood
E antilymphocytic ymmunohlobulyn

131
Rabochy obohatytelnoy factory 37 years during a conflagration has been at the core
vɵsokoy
CO concentrations. In the clinic delivered in bessoznatelnom condition. In the analysis
blood: ER - $ 4,5 * 10 ^ {12} / l $ Nb - 136 g / l, tsv.p. - 0,89, Lake. - $ 17.2 * 10 ^ 9 / L $,
X - 0 \%, n -
15 \% s - 55 \%, l - 22 \%, m - 3 \% SOɗ - 3 mm / hour, karboksyhemohlobyn in blood - 5
\%.
What the criterion for determining the most powers Class tyazhesty postradavsheho?
A * Duration of loss of consciousness
B violations availability of respiratory
C Results of the EKG and spyrohrafyy
D Prevalence trofycheskyh violations
The development of E sosudystɵh violations

132
Patient complains of 1937 a sharp pain, which appeared suddenly in the right
hypochondrium and
then quickly spread to the entire abdomen. Belly involved, it is painful palpation,
Blyumberha Schotkina symptom-positive. In the review of abdominal renthenhrami
cavity, made in the vertical position of the patient, determined sickle
enlightenment under the dome of the diaphragm. What is the most likely diagnosis?
A * Perforation of gastric ulcer
B Acute cholecystitis
C Acute appendicitis
D Hepatic colic
E Acute intestinal obstruction

133
Patient 1952 addressed to the doctor complaining of weakness, painful itchy skin
after wash, washing in the bathroom, the severity of the head. OBJECTIVE:
integuments
face, neck, limbs hiperemiyovani. AT-180/100 mmHg Spleen 4 cm below
edge rib arc. What is the most likely diagnosis?
A * ɗrytremiya
B Hypertension
C pseudotrichiniasis
D Allergic dermatitis
E Systemic scleroderma

134
Patient D., 37, entered the intensive care department. Overall condition is very
hard. Sopor. Skin gray, damp. Turgor reduced. Pulse frequent,
stressful. Blood pressure 160/110 mm Hg. Art. Increased muscle tone.
Hiperrefleksiya. In the air the smell of ammonia. Preliminary diagnosis?
A * uremic coma.
B Alcohol coma.
C Hiperhlikemichna coma.
D hypoglycemic coma.
E cerebral coma

135
Patient complains of 1965 attacks of breathlessness, pain in heart palpitations after
physical
load. Three months ago velykovohneschevyy suffered myocardial infarction.
The patient is covered with cold sweat, acrocyanosis, swollen neck veins, pulse 110/hv.,
SC -
100/60 mmHg Heart beat is weak. Breathing heavy, noticeable from a distance.During
coughing
allocated spumy specimens, painted in pink color. What causes
development of this condition?
A * Acute livoshlunkova failure
B Acute vascular insufficiency
Detention C in the body of water and sodium
D Acute pulmonary heart
E Increasing the allocation of catecholamines

136
Patient 50 years complained of dull pain in the heart, asthma, increased
temperature of $ 38 ^ C $. A week ago, suffered a flu. Ob-no: Ps-100/hv. Disappears at
inhalation. AT-100/70 mmHg, heart beat is weak. ECG: lower voltage, segment $ ST $
raised above in all isolines vidvdennyah. In X-ray: enlarged heart shadow in all
sides. Heartbeat of small amplitude. What is the most likely diagnosis?
A * pericardial effusion
B Myocardial infarction
C dilated cardiomyopathy
D Myocarditis
E Angina
 137
In 1935 men during weight lifting is a sharp pain in the left half of December
cells. Degradation progressed, increased shortness of breath, weakness,
dizziness. Perkutornoho left tympanit, auscultatory - no breathing. Which
the most likely diagnosis?
A * Pneumothorax
B pulmonary embolism
C Myocardial infarction
D sinistral hrudnynnyy sciatica
E myositis

138
Bolnoy 55 years on zhalovalsya vzdutye and rumbling in the live, povɵshennoe
othozhdenye
gas, process liquid stool penystoho character with kyslɵm smell, which poyavlyayutsya
upotreblenyya after meals of milk. As ymenuetsya DATA symptoms?
A * Syndrome brodylnoy dyspepsyy
B syndrome hnylostnoy dyspepsyy
C Syndrome zhyrovoy dyspepsyy
D dyskinesia syndrome
E syndrome malabsorbtsyy

139
Patients suffering from chronic recurrent pancreatitis with severe violation
zovnishnosekretornoyi function. Using a greasy spicy food, alcohol,
of `is' oil-" cal. Reduced production of which factor is most likely
cause of steatorrhea?
Lipase A *
Trypsin B
C gastric acidity
D amylase
E alkaline fosfotazy

140
Patient 1954 was suffering from osteomyelitis of the femur over 20 years. Last
Moon appeared and gradually increasing swelling of the lower extremities.Proteinuria in
urine 6.6
g / l in blood dysproteinemia as hypoalbuminemia, increased $ \ alpha $ -2 - and
$ \ Gamma $-globulins, SHZE - 50 mm / hour. What is the most likely diagnosis?
A * Secondary renal amyloidosis
B Acute glomerulonephritis
C multiple myeloma
D Chronic glomerulonephritis
E Systemic lupus erythematosus

141
Diagnosis of "typhoid fever" was set man aged 50 years, working
mechanic and lives in an isolated apartment with all amenities. In addition to his family
two
adults. What measures are conducted on persons who had communicated with
patients?
A * Bacteriological study
B antibiotic
C Insulation
D dispensary supervision
E Vaccination

142
In patient 4 days after surgery on the right ovary kystomy
suddenly appeared pain in the right half of the chest of phlegm discharge
pink, fever up to $ 37.7 ^ 0C $. In a survey
lung revealed pulmonary prytuplennya sound in the lower right there,
vysluhovuyutsya single moist rales. Which most likely complication?
A * Myocardial lung
B Pneumonia
C lung abscess
D exudative pleuritis
E Pneumothorax

143
Bolnaya 22 years on zhaluetsya prystupoobraznoe pobelenye konchykov Paltsev,
razvyvayuscheesya of fans. When sohrevanyy paltsɵ pryobretayut First,
synyushnuyu and Then the bahrovuyu okrasku. Preparations for the treatment of choice
of the given
yavlyaetsya syndrome:
A * nifedipina
B Dypyrydamol
But C-shpa
D Aspyryn
E Nytratɵ
 144
Patients 39 years turned to the doctor complaining of morning headaches,
decreased appetite, nausea, morning vomiting, intermittent nasal bleeding. In 15
age suffered acute glomerulonephritis. When examining the marked increase
blood pressure to 220/130 mmHg, hemorrhages on the skin, toes, pale skin and
mucous membranes. Which of the following biochemical parameters has diagnostic
significance in this case?
A blood creatinine
B Bilirubin Blood
C Blood Sodium
D Uric acid
E Fibrinogen

145
In the mental status of 1932 patients sustained pathological decrease in mood.
Contact briefly, but basically answers the question. Language production is extremely
laconic, in slow motion. Movement bound and retarded. Expresses the idea
self-accusation and self-abasement. Preparations of the group first show
patient?
A antidepressant
B antipsychotics
C Hippotyky
D tranquilizers
E Normotymiky

146
In 1940 women with palpation in the left thyroid lobe revealed knot
compacted, moderately painful during palpation. When ultrasound examination he
high density, "cold" at scintigraphy with I * 131. What is the test most
appropriate to clarify the diagnosis?
A fine-needle aspiration biopsy
B Determination of TSH level in blood
C Refleksometriya
D Determination of iodine excretion in the urine
E thermography

147
Patient 29 years of disease, acute fever, head pain, ache in tili, pain in horli,
temperature 38 ° C. At 2-day temperature 39,5 ° C vidmityla slabist,
dizziness. The same day, was inspected by the doctor who discovered in the form of
raids
siryh dense films on both tonsils, increase i bolyuchist pidschelepnyh
limfatychnyh nodes. It zapidozreno diphtheria. What is the most effective method
tests to ensure the diagnosis?
A method Bakteriolohichnyy
Total analysis of blood B
C Punktsiya pidschelepnyh limfatychnyh nodes
D Serolohichnyy method
E Vnutrishnoshkirna allergic test

148
In the patient's 42-years for each 48-hour week appear flush,
that vary heat. Body temperature pidvyschuyetsya to $ 40 ^ C $. Reduction
temperature in 3-4 hours followed by excess potovydilennyam.
Pohirshyvsya appetite, have a common slabkist. Shkirni covering blidi with earthy
vidtinkom. Livers Zbilsheni i selezinka at palpatsiyi - schilni. What is the most
tests to ensure effective method of diagnosis?
A blood smear microscopy i large drop
Total analysis of blood B
C Bakteriolohichnyy method
D immunoferment analysis
E microscopy hanging drop of blood

149
Hospital infectious to hospital patients 43 years complaining of high
body temperature i strong headaches later. Hvoriye Day 2. When ohlyadi detected
peredplichchi anthrax around which expressed little swelling i bolyuchist.
Rehionarnyy lymphadenitis. Hepatoliyenalnyy syndrome. It follows from history is well
known that patient
working on tvarynnytskiy Fermi. On any illness should think first?
A Sybirka
B Erysipelas
C Eryzypeloyid
D skin cancer
E Eczema

150
Patient 28-years addict. Hvoriye during the year, when total vidmityv slabist,
the increased pitlyvist, weight loss. Often hvoriv respiratornymy diseases. By
last two days with fever was peremizhna uncontrolled Night potamy, intensified
total slabist joined diarrhea with mucus i blood impurities. When ohlyadi
polilimfoadenopatiya in the mouth cavity herpetychni rash when palpatsiyi
Belly-zbilsheni Livers and selezinka. What is the most likely diagnosis?
A AIDS
B Tuberculosis
C chronic lymphocytic leukemia
D colon cancer
E Hroniosepsys

151
In bolnoho vnezapno rezkaya pain appeared in Modify half hrudnoy kletky.
Quickly narasla odɵshka. Objectively: vɵrazhennɵy akrotsyanoz. Condition bolnoho
toughest. Opredelyaetsya podkozhnaya ɷmfyzema shey in the area and the upper
divisions
hrudnoy kletky. Above Right-Hand korobochnɵy sound easy, breathing is
absent.Boundaries
Heart smeschenɵ vlevo. HR - 85-110/myn, AD-100/60 mmHg What the diseases of
veroyatno bolnoho in the most?
A spontaneous pneumothorax
B myocardial infarction
C mild myocardial
D Vnehospytalnaya pneumonia
E ɗksudatyvnɵy pleurisy

152
After dlytelnoho period subfebrylyteta bolnoy enhance odɵshky remarked,
boly podrebere in law, libraries noh. Sheynɵe venɵ nabuhshye. Pulse-120 in minutes.,
ferry inspiration is stated yschezaet.Tonɵ Heart oslablenɵ sharply. On EKG - declining
voltage
zubtsov zheludochkovoho complex. A month ago otmechalsya podɴem ST segment
V1-V4. Shadow hearts rasshyrna, okruhlaya. Specify the most veroyatnɵy dyahnoz.
A ɗksudatyvnɵy pericarditis
B Melkoochahovɵy myocardial infarction
C Postynfarktnɵy kardyoskleroz
D Metabolycheskaya postynfektsyonnaya myokardyopatyya
E Pervychnɵy rheumatic heart disease

153
A man on the street in podobran bessoznatelnom condition and delivered in
sanpropusknyk. C nebolshymy interval in him nablyudayutsya povtornɵe
prystupɵ tonic seizures and klonycheskyh hands and noh. Lost consciousness, pupils
shyrokye not reahyruyut to light. In the language - sledɵ prykusɵvanyya. He was
neproyzvolnoe mocheyspuskanye. Pryznakov ochahovoho defeat Anatomy of the brain
did not reveal. AD - 140/90mm Hg Chairman bolnoho Maybe freely given
k breasts. Identify the most veroyatnuyu Abnormalities.
A ɗpylepsyya, ɷpyleptycheskyy status
B Parenhymatoznoe krovoyzlyyanye
C marrow myocardial
D Stolbnyak
E Ostrɵy menynhoɷntsefalyt

154
In accepting physician k obratylas bolnaya with mourning for raising temperature to
37,8 ° C umerennɵe boly throat for a period of 3 days. Objectively: uhlochelyustnɵe
lymfouzlɵ uvelychenɵ to 3cm. Nebnɵe myndalynɵ hypertrofyrovanɵ, pokrɵtɵ
serɵm, struck, rasprostranyayuschymsya on reed, perednye nebnɵe brackets. What is
given
veroyatnɵy dyahnoz the most?
A Dyfteryya oropharynx
Infectious mononucleosis B
C Anhyna Symonovskoho - Vincent
D agranulocytosis
E oropharyngeal candidiasis

155
Bolnaya 21 th year, without as Permanent mesta zhytelstva, zhaluetsya on poslablenye
stool for a period of 2 months, rubbed vesa to 13 kg, weakness, a continuous
subfebrylnuyu temperature, recurrent herpes. On lips herpetycheskye
vɵsɵpanyya, heneralyzovannaya lymfoadenopatyya, roast an increase to 2 cm in
blood: ER. - $ 4,4 \ cdot10 ^ {12} $ / l, Hb-115 mg / l, SOɗ-15 mm / hour, Lake .-
$ 10,0 \ cdot10 ^ 9 $ / L, E .- 2 \%, Mrs. - 6 \% s .- 61 \%, l .- 17 \%, m - 3
\%.Atypychnɵe
mononuklearɵ - 6 \%. What the the most veroyatnɵy dyahnoz?
A AIDS
B Zatyazhnaya dyzenteryya
Infectious mononucleosis C
D Lymfohranulematoz
E Amebyaz

156
Podrostok 16 years of periodic zhaluetsya voznykayuschye weakness
holovokruzhenye, a feeling in tyazhesty podrebere lion. Kozhnɵe pokrovɵ and
vydymɵe
slyzystɵe zheltushnɵ. Bashennɵy skull. Hot + 2cm, Lower pole on selezenky
level of the navel. In blood: ɷr.-2, 7h10 * 12 / l, Hb-88h / l leyk.-5, * 6h10 9hl, SOɗ-15mm
/ h.
Specify the most veroyatnoe Changing Level Meter bylyrubyna bolnoho as these.
A free and Raising bylyrubyna
B Raising svyazannoho bylyrubyna
C Improving svyazannoho and freely bylyrubyna
D decline svyazannoho bylyrubyna
E decline freely bylyrubyna

157
Woman 28 years with physician obratylas k mourning into otechnost Face, nerezkye
libraries
noh, sometimes said the urine Colors "myasnɵh pomoev. In adolescents aged often
anhynamy sick. Objectively: blednɵe kozhnɵe pokrovɵ, temperature - 36,8 ° C
pulse - 68 in minutes., rytmychnɵy. AD - 170/110 mmHg What are the changes in the
Moche
veroyatnɵ the most?
A proteinuria, hematuryya, cylindruria
B Raising otnosytelnoy density, hemoturyya, bakteryuryya
C otnosytelnoy density decline, proteinuria, skudnɵy mochevoy sediment
D ɗrytrotsyturyya and urynozuryya
E otnosytelnoy density decline, proteinuria, myohlobynuryya

158
A woman 60 years hospytalyzyrovana on occasion of acute transmural myocardial.
Time ago was the state of bolnoy uhudshatsya. Appeared narastayuschaya
odɵshka, SOLID cough. CHDD - 30/myn. And HR - 130/myn., AD - 90/60 mmHgTonɵ
hluhye hearts, focus on the tones II lehochnoy artery. Division in the lower right lung
and
Hotels Perepelochka vlazhnɵe srednepuzɵrchatɵe hrypɵ. Temperature - $ 36,4 ^ 0C
$. What the drug
tselesoobrazno Apply in the first place?
A Promedol
B ɗufyllyn
C Dopamyn
D Heparin
E Digoxin

159
Bolnaya 64 years zhaluetsya obschuyu of weakness, the noise in the head osyplost
voice. At
the inspection: blednost with zheltushnɵm ottenkom, language Red SB shlazhennɵmy
papilla, and asymmetryya taktylnoy bolevoy chuvstvytelnosty. Pulse 120/myn., AD
- 80/50 mm Hg, palpyruetsya selezenka. In the analysis of blood: Nb - 58 g / l, ER. -
$ 1,2 * 10 ^ {12} $ / L, Lake. - $ 2.8 * 10 ^ 9 $ / l, tr .- $ 140 * 10 ^ 9 $ / l SOɗ - 17 mm /
hour, anisocytosis,
microplania - vɵrazhenɵ (++). What the Study will reshayuschym in vɵyasnenyy
Genesis anemyy?
A Sternalnaya punktsyya
B Nepryamaya test Kumbsa
C Kumbsa a direct test
D Fybrohastroskopyya
E ɗndolyumbalnaya punktsyya

160
Man hospitalized in the 1962 block of intensive therapy with long-term attack
retrosternal pain that persists while receiving nitroglycerin. OBJECTIVE: AT -
80/60 mmHg, heart rate - 106/hv., RR - 22/hv., Auscultation of heart beat is weak, the
rhythm
gallop. How to explain the decrease in SC?
A decrease in cardiac output
B Reduction of peripheral resistance
C depositing blood in the abdominal cavity
Adrenergic receptor blockade of D
E internal bleeding

161
Man with 52 years complain of attacks of breathlessness, pain in the right botsi during
respiration.
Zahvoriv suddenly. Since history is well known that the last month he likuvavsya about
tromboflebitu kintsivky right bottom. In the admission department suddenly lost
Consciousness, a choking pain in i botsi. OBJECTIVE: HR-102/hv., CHDR-28/hv., AT-
90/70 mmHg Auscultatory: focus on tone II pulmonary arteries, gallop,
lungs on the right side under scapula dribnopuhyrtsevi wheezing, pleural friction noise.
What are the most informatyvnym investigation to establish the diagnosis?
A pulmonary vascular Anhiohrafiya
B Ehokardioskopiya
C Study of external respiratory function
ECG D
E Koagulogramma

162
The patient complains of 1958 weakness, leg swelling, shortness of breath,
anorexia.For
years suffering from chronic bronchitis. Last 5 years, note the
selection of specimens, often purulent character. OBJECTIVE: HR - 80 beats. per min.,
SC -
120/80 mmHg Common swelling, skin pale, dry, turgor decreased. At
urine analysis revealed considerable significance proteinuria and thus cylindruria.Specify
the most
probable pathological process in the kidneys.
A renal amyloidosis
B Chronic glomerulonephritis
C Chronic pyelonephritis
D interstitial nephritis
E Acute glomerulonephritis

163
In patients in 1927 in 10 hours after drinking canned mushrooms appeared
diplopia, bilateral ptosis, swallowing violation, shallow breathing frequency
40/hv., Muscle weakness, paresis of the intestines. What is the medical action is
necessary to
primary thing?
A tracheal intubation for artificial respiration
B Flushing stomach and intestines
Introduction protybotulinichnoyi C Serum
D Introduction corticosteroids
E Intravenous detoxification therapy.

164
In 1972 patients with acute myocardial infarction ECG monitor revealed
paroxysmal tachycardia shlunochovu. At the same time, the patient developed clinical
acute ventricular failure. AT - 90/50 mmHg What is the most effective and
safe in treating a patient?
A countershock
B Novokayinamid
C Lidocaine
D Kordaron
E Meksytyl

165
Male 39 years old, who was treated at the surgical department at the
acute cholecystitis, transferred to the therapeutic department of the rise
Antibodies to 180/120 mmHg, the appearance of protein in urine, sustained fever.Steady
subfebrylitet
was resistant to antibiotic therapy. After 10 days of treatment the patient
typical asthma attack came with a heavy exhale Soon arthralgia and erythematous
skin lesions. In the analysis of blood - 18 \% eosinophils. What is the disease emerged
in
patient?
A nodular periarteritis
Nonspecific B aortoarteriyit
C Acute glomerulonephritis
D Systemic lupus vivchak
E rheumatocelis

166
Male 23 years complaining about the presence of edema on the face, headache,
dizziness, reduced urine, urine discoloration (dark red).
These complaints appeared after acute pharyngitis. During examination: swelling of
face, pale skin covering, the temperature - $ 37,4 ^ 0C $; HR-86/hv., AT-170/110 mm
hg Heart sounds are muted, focus on the second tone of the aorta. What is the causative
factor
possible with this disease?
A beta-hemolytic streptococcus
B Staphylococcus aureus
C Zelenyachyy streptococcus
D pyogenic streptococcus
E saprofitnymi staphylococcus

167
Patient 1920 delivered Brigade ambulance in coma
condition. Sharply narrowed pupils, cyanosis and dry mucous membranes, skin and
body
pale, wet and cold. Ps - 60/hv., SC - 80/60 mmHg RR - 8-10/hv. What is the most
probable diagnosis?
A opiate poisoning
B atropism
C Poisoning barbiturates
D Poisoning benzodiazepine derivatives
E substitutes alcohol poisoning

168
Patients 35 years is in the fourth day VRIT after experimental hemorrhage and
hemorrhagic shock. Daily diuresis 50ml. Second day notes vomiting
properly determine their condition. CHP - 159 mm vod.st., auscultation of the lungs
last 3 hours marked by sporadic moist rales. RR - 32 per min. In blood:
Residual nitrogen - 82 mg / l, K - 7,1 mmol / l, Cl - 78 mmol / L, Na - 130 mmol / l, Ht
- 0,32, Hb - 100g / l, creatinine blood - 0,9 mmol / liter. What is the complication most
likely
evolved in a patient?
A Acute renal failure
B cardiac
C hypostatic pneumonia
D due to dehydration with hypovolemia
E Posthipoksychna encephalopathy

169
1935 Woman on pneumonia was appointed Ampicillin. 30 minutes
intramuscular injections of the patient felt sharp weakness, itching face
hands, nausea, cough, shortness of breath, chest pain. OBJECTIVE: cyanosis, edema
eyelids, face red with rashes. Pulse - 120 per min., SC - 70/20 mmHg Tones
deaf heart, respiration, frequent, shallow, with different calibers wet wheezing.
Varicose veins on the right homiltsi. What is the most probable cause
sudden deterioration of the patient?
A serum shock
B angioneurotic edema
C Urticaria
D asthmatic attack
E branches of pulmonary artery thromboembolism

170
Woman in 1941 for 8 years suffering from chronic cholecystitis. Worryingly almost
constant monotonous aching or feeling of heaviness in the right pidrebir'yi, bitterness
morning mouth, constipation. During palpation of the abdominal pain was observed in
small
point projection of the gall bladder. Bladder volume decreased after bile breakfast
only 15 \% (according to the U.S.). Appointments are drugs most
appropriate?
A Holekinetykiv
Peripheral B M-holinolitykiv
C Miotropnyh antispasmodic
D nonnarcotic analgesics
E Holeretykiv
 171
Electric in 1927 was elektrotravmu, referring to the bare hand
electrical wiring. There was a stop of circulation and respiration. Resuscitation
measures provided the restoration of cardiac activity by 5 min. Which of complications
as possible in a few hours or even days after the shock
shock?
A cardiac arrest
B apnea
C Acute liver failure
D Acute renal failure
E pulmonary edema

172
In 1932 a patient with a diagnosis of polytrauma. ZCHMT.Nonpenetrating trauma of the
chest.
Closed fracture of right hip. "As - 100/60 mm Hg, PS - 124 per min. RR - 28 per min.
After 2 hours of stretching on skeletal m / and lidocaine,
There was a dramatic deterioration: is cyanosis of face and neck, SC - 60/40 mmHg,
HR - 160 beats. Per min., RR - 44 min. What complications are most likely increased
severity of polytrauma?
A fat pulmonary embolism
B Myocardial infarction, cardiogenic shock
C Painful shock
D pulmonary embolism
E Acute anemia

173
Patient in 1920 to clarify the functional state of kidneys made
X-ray studies of I / kardiotrastu introduction. After entering the state
the patient has deteriorated, appeared short of breath, skin hyperemia, itching. SA -
60/20
mmHg, PS - 132/hv. A similar study was conducted 3 months because of side
effects were not observed. What is the most likely diagnosis?
A medication anaphylactic shock
B idiosyncrasy to kardiotrastu
C pulmonary embolism
D Fainting due to the stress manipulation undertaken
E Myocardial infarction

174
SHMD Brigade delivered a girl, which was extended from the river by 5 min. after
True drowning. Cardiac activity resumed through 3hv. a team of rescuers.
A method of endotracheal mechanical ventilation. What is characteristic of
pathological changes in blood biochemical studies affected?
A Increased plasma potassium
B Increased hematocrit
C lowering of plasma potassium
D Increased plasma sodium
E Metabolic alkalosis

175
The patient was hospitalized in 1942 to 12 th day of illness. The disease began
sharply - fever, which has changed the feeling of heat, temperature $ 39,5 ^ 0C $,
intoxication.
Flush lasted 6 hours, after which the temperature dropped to
$ 36,5 ^ 0C $ with excessive sweating. Ague repeated every 3 rd day.
OBJECTIVE: herpetic eruption on lips, light scleral jaundice. Hepatoliyenalnyy
syndrome. Blood: anemia, leukopenia, lymphocytosis, SHZE - 19 mm / hour. Which
most informative method of diagnosis of this disease?
A smear and a thick drop of blood
B Bacteriological study of urine
C seroreaction Vidal
D blood count
E Determination of the sterility of blood

176
Patient 1945 was delivered by emergency vehicles from Enterprise
production of aniline with a diagnosis of vegetative-vascular dystonia. OBJECTIVE: Skin
cover, cyanotic mucous membranes. Language dyzartrychna. Celebrated disorientation
in space. In the blood: er. - 4,6 x10 * 12 / l, Nb - 143h / l CP - 0,9, Lake. -5.6 X10 * 9 / L,
cells
Heinz - 14%, reticulocytes - 18% methemoglobin - 36% SHZE - 5mm/hod. Patient
the diagnosis of acute intoxication aniline moderate. What is the most
effective way of antidote therapy in this case?
A Methylene blue
B Desferal
C sodium thiosulfate
D Suktsymer
E Pentatsyn

177
Patient train conductor in 1939 hospitalized on Day 4 of illness complaints
of headache, weakness, dizziness, sweating, insomnia, fever.
Hiperemiyovane face, swollen, conjunctivitis. In the transitional fold test conjunctiva -
rare petechiae. The skin of trunk, chest, abdomen, limbs abundant
rozeolozno-petehialna rash. Tachycardia. AT - 100/60 mmHg Underlined
tongue tremor. Palpated liver, spleen. Draining delayed. Which
the most likely diagnosis?
A typhus
B Typhoid
Influenza C
D Meninhokoktsemiya
E Leptospirosis

178
In the girls 15 years suddenly have arthralgia, headache, nausea, vomiting,
pain and muscle tension in the lumbar area, increased body temperature to
$ 38-39 ^ oC $. Cymptom Pasternatskoho - dramatically positive to the right. In urine:
bacteriuria, piuriya. What is the most likely diagnosis?
A Acute pyelonephritis
B Renal colic
C Acute glomerulonephritis
D Paranefralnyy abscess
E Cystitis

179
Patient 1918 complaining of pain in the shin and knee joints, increase
body temperature to $ 39,5 ^ 0C $. Over a half weeks before had a respiratory
disease. During examination: body temperature of $ 38,5 ^ 0C $. Swelling is noted
shin and knee joints. Pulse - 106/hv., Rhythmic. AT - 90/60 mmHg Limits
hearts are changed, loosened tones, soft systolic murmur at the top. What Score
most associated with the possible etiology of the process?
A Antystreptolizyn-0
B 1-antitrypsin
C Creatine
D Rheumatoid factor
E Serumokoyid

180
In 1928 patients without permanent residence, taken from previous
diagnosis of influenza, 5 days of illness is rozeolezno-petehialna rash on the trunk and
internal surfaces of the extremities. Temperature of 41 ° C, euphoria, facial hyperemia,
redness of the sclera, tongue tremor, tachycardia, splenomegaly, excitement. Which
most likely diagnosis?
A typhus
B alcoholic delirium
C Leptospirosis
D Measles
E typhoid

181
4 days after transfusion of incompatible (by group) in the blood of the patient decreased
sharply
diuresis, developed anuria, has deteriorated general condition improved
blood pressure. In a laboratory study: plasma creatinine - 680
mmol / l, plasma urea - 24 mg / liter. What kind of illness and what stage of the disease
should
think first?
A Hemotransfuziyna acute renal failure, anuria
B anaphylactic shock, acute renal failure, anuria
C Hemotransfuziynyy shock postrenalna acute renal failure, anuria
D Transfusion
E Hemosorbtion

197
Working 37 years at the time of the fire was in a zone of high CO concentrations. In the
clinic
delivered in an unconscious state. Skin of the face and hands crimson color. BH-
20/min. On an electrocardiogram - gipopsicheskie specific changes in the
myocardium. Hourly
diuresis 40 ml. In an. Blood: Air - 4.5 x 10 * 12 / l, Hb - 136 g / l, tsv.p. - 0,89. ESR - 3
mm / hr
carboxyhemoglobin - 5%. By what criteria determined by the severity of
victim?
A concentration of carboxyhemoglobin
B The presence of respiratory disorders
C an ECG
D abundances of trophic disorders.
E for chronic renal failure

198
In the clinic delivered sovhoha working 48 years with complaints of headache, nausea,
vomiting, cough, shortness of breath, blurred vision, sweating,
drooling. He worked in the brigade to spray garden organophosphate
pesticides. In an. Blood: Air. - 4,10 x 10 * 12 / l, Hb - 136 g / l, tsv.p. - 0,9, L - 13,0 x10 *
9 / L,
ESR - 17 mm / hour. Diagnosis: acute intoxication by organophosphorus
pesticides. What is the most important diagnostic criterion in this case?
A level of cholinesterase
B serum proteins
C Formolovaya test
D Bilirubin Blood
E Creatinine

199
Miner 49 years profstazh 14 years, 75% of their time working pneumatic
hammer, which generates vibration 30-45 Hz. Complains of pain and numbness of the
hands,
concerns in a period of rest, pain in the elbow and wrist joints in the cervical
spine, poor sleep, periodic aching in the heart.
The development of the disease can be assumed on the basis of complaints of the
patient?
A vibration disease
B Neuritis ulnar nerve
C Deforming arthrosis elbow
D Osteochondrosis of the cervical spine
E Raynaud's syndrome

200
Because of safety violations at work ionizing
radiation workers are exposed to radiation in general for an hour at a dose of about 8
Nat. Which form of radiation sickness occurred in a patient?
A Acute radiation sickness, bone and brain form
B Acute radiation sickness, toksemicheskaya form
C Acute radiation sickness, cerebral form
D Acute radiation sickness, intestinal form.
E Chronic radiation sickness, bone marrow form

201
In a patient with symptoms of malnutrition, steatorrhea, 4 hours after eating
pains in the abdomen, especially above the navel and the left. Diarrhea can be replaced
constipation for 3-5 days. Palpation - moderate pain in
holedohopankreaticheskoy zone. The level of amylase in blood is not increased.
Radiographically detected calcifications, is located above the navel. What
preliminary diagnosis?
A Chronic pancreatitis
B Chronic gastroduodenitis
C ulcer 12 Duodenal
D Zollinger-Ellison Syndrome
E Chronic calculous cholecystitis

202
Patient 20 years underwent chemotherapy according to the scheme VAMP for acute
lymphoblastic leukemia. What is the morphological pattern of the bone marrow may
indicate the occurrence of remission?
A content of blast cells to 5%
B content of blast cells to 15%
C content of blast cells to 10%
D content of blast cells to 1%
E No blast cells

203
Patient 58 years are examined by a physician in connection with general weakness,
fatigue, mild pain in the left upper quadrant, sometimes rapid
urination with rezyu. Revealed moderate splenomegaly. In the blood:
neutrophilic leukocytosis with a shift to myelocytes, basophils - 2% eosinophils
- 5%. In the urine - mass urate, erythrocyte -2-3 field sp. What is a preliminary
diagnosis?
A chronic myelogenous leukemia
B leukemoid reaction
C lymphogranulomatosis
D Cirrhosis
E Urolithiasis

204
The patient aged 56 with diffuse toxic goiter observed atrial
arrhythmia with PE - 110/min, arterial hypertension, blood pressure - 165/90
mmHgWhat
treatment along with merkazolilom should be encouraged in this case?
A Anaprilin
B Radioactive iodine
C novokainamid
D Verapamil
E corinfar
 205
In the cardiology department patients admitted to hospital with complaints of aching
pain predserdechnoy area, moderate shortness of breath, swelling of the feet,
chilliness. On ECG
There was a negative teeth. T v2-v6 (3-4mm). The skin is dry. Voice hoarse.
Puffy face, with a touch of jaundice. Heart sounds are muffled. Pulse - 60/min, BP
160/90 mmHg Swollen feet, under pressure hole is formed with difficulty. HB - 76
g / l, ESR - 17 mm / hour. What is the most likely diagnosis?
A Hypothyroidism, myocardial
B Chronic glomerulonephritis, chronic renal failure
C CHD: small focal myocardial infarction, heart failure II Art.
D Hypertension II Art., SN II Art.
E B-12 deficiency anemia

206
The patient was 46 years complains of paroxysmal pain in the right lumbar region,
smack down the abdomen, nausea. Previously, these pains were not. At the Review
radiograph of the abdominal cavity of pathological shadows is not defined.
On ultrasound sonogram of enlarged right renal pelvis
defined hyperechoic formation with a diameter of 1.5 cm, from which
waste "soundtrack." What is the most likely diagnosis?
A stone in the kidney
B benign kidney tumor
C cyst in the kidney
D Tuberculosis of kidneys
E kidney tumor malignant

207
The 24-year-old man on the 5 th day of respiratory disease with high
temperature increased headaches, dizziness system appeared,
sense of ghosting, paresis of facial muscles on the right, choking if swallowed.
Ostrovirusny diagnosed encephalitis. Identify the main direction
emergency treatment.
A Zovirax
B Glucocorticoids
C Ceftriaxone
D Lasix
E gemodez

208
In 25-year-old woman amid signs of vegetative dystonia developed attack
the following nature: pains in the heart, choking sensation,
nausea, dizziness, facial flushing, and then came the loss of consciousness
lasted about a minute. BP - 80/60 mm Hg Pulse rate - 56 / min.
Diagnosed vagoinsulyarny crisis, syncopation. What are the main
Therapy?
A sympathomimetic drugs
B sympatholytic
C cholinomimetic
D vasodilator
E dehydrating

209
In the intensive care unit on day 2 of illness in critical condition
delivered to the patient. Objective: be able to prostratsii.Temperatura - 35,8 C. AD
- 40 / 0 mm Hg. Art. Pulse is not defined. On the limbs, trunk - abundant,
different size and shape of hemorrhagic rash with a bluish tint. What
the most probable causative agent of the disease?
A Neisseria meningitidis
B Salmonella typhi
C Rickettsia prowazekii
D Yersinia enterocolitica
E Yersinia pseudotuberculosis

210
In the department with suspected meningitis taken ill, a geologist in
South-East Asia. The disease began very hot, very fast and
accompanied by hyperthermia, headache, vomiting. Objective: to the right in
inguinal region showed an increased to 3x5 cm is very painful with fuzzy
contours bubo. The skin over his crimson-colored, shiny. Meningeal signs
negative. What is the most likely diagnosis?
A Plague
B Acute Leukemia
C Tularemia
D Anthrax
E Benign limforetikulez (felinoz)

211
The patient has the disease emerged 17 years is very sharp and very fast: chill
raising the temperature to 40.0 C, severe diffuse headache, vomiting,
Later came the loss of consciousness. OBJECTIVE: meningeal signs.
Cerebrospinal fluid turbid. Cytosis - 4600 / ml., Protein - 1680 mg / l, sugar - 2.5 mmol / l,
chlorides
-100 Mg / dL, neutrophils - 98%, lymphocytes - 2%. What is the most likely
diagnosis?
A Meningococcal meningitis
B Tuberculous meningitis
Lymphocytic choriomeningitis C
D enterovirus meningitis
E Mumps meningitis

212
In milkmaids on the right hand is sore 3x3 cm, covered with thick black scab.
Brush sharply edematous, painless. Skin color in the edema was not changed.
Enlarged axillary lymph node on the right. Palpation of lymph nodes painless.
Symptoms of toxicity are expressed in moderation. What is the most likely diagnosis?
A cutaneous form of anthrax
B Skin bubonic form of plague
C ulcer - the bubonic form of tularemia
D Banal carbuncle
E-Face

213
The patient was 65 years 10 days after the trauma of the foot noted the difficulty
when you open your mouth. The next day, could hardly eat,
joined the muscle tension neck, back and abdomen. During the reception in
hospital on the third day of illness marked tonic tension of all groups
muscles, generalized convulsions every 10 - 15 minutes. What is the most
probable diagnosis?
A Tetanus
B tetany
C Meningitoentsefalit
D Hemorrhagic Stroke
E Epilepsy

214
A young man 16 years old hospitalized with complaints of bleeding from
nekupiruyuscheesya
nose and unbearable pain in the right elbow. OBJECTIVE: sick joint
increased in size, defigurirovan, flushing of skin above it. There
manifestations of arthropathy other joints. Ps - 90/min. In an.krovi: er .- 3,9 ‡ 10 * 12
/ L, Hb 130 g / l, ts.p.-1, 0, leyk.-5, 6 ‡ 10 * 9 / L, Tr.-220 ‡ 10 * 9 / L, ESR-6 mm /
h.Convolution. blood
Lee-White: Top-24 ', the end-27'10''. Which drug is most effective in the treatment of
this patient?
A Cryoprecipitate
B Calcium chloride
C Eritromassa
D Aminocaproic acid
E Vikasol

215
Female 42 years complains of the appearance of bruises on the legs and prolonged
monthly, general weakness, ringing in my head. Objective: the abundance of sika
hemorrhages on the legs and torso. Tachypnea, tachycardia, systolic murmur at all
points. AD-75/50 mmHg In the blood: er.-1, 9 ‡ 10 * 12 / l, Hb-60 g / L, FB .- 0,9, Lake .-
6,5 ‡ 10 * 9
/ L, Tr.-20 ‡ 10 / l, ESR - 12 mm / h. Duration of bleeding in Duque - 12 min. In
bone marrow - an abundance of young immature forms of megakaryocytes without
evidence
otshnurovki platelets. Your preliminary diagnosis?
A True thrombocytopenic purpura
B Hemophilia A
C Disease Villebranta
D megacaryoblastic Acute Leukemia
E Hemophilia B

216
The patient of 47 years, long observed about asthma
infectious etiology, frequent bouts of the latter, which is not stoped
inhalation astmopenta and berotek. With the appointment of appropriate drug
begin intensive treatment?
A Glucocorticoids
B bronchodilators
C Oxygen
D Infusion therapy
E Cardiac glycosides

217
The patient was 32 years old complaining of pain in small joints of the hands,
paresthesias in the tips
fingers, weakness, difficulty in swallowing. Ill for 13 years.
OBJECTIVE: amimichnost face, shortening nail phalanges. Seal skin
the shoulder girdle. In the lungs when Ro-study - basal pneumosclerosis.
With FGS - narrowing of the esophagus in the cardiac department. In the blood: Lake .-
$ 9,8 \ cdot10 ^ $ 9 / l, ESR-22 mm / h, $ \ gamma $-globulin - 22 \%. What is the
diagnosis most
probable?
A Systemic scleroderma
B Systemic lupus erythematosus
C Rheumatoid arthritis
D Dermatomiozid
E myxedema

218
Zhinka 37 rokiv skarzhitsya on zaduhu, stiskuyuchy bil behind the breastbone.Tyzhden
to
suffered grip. Ob'ɽktivno: akrotsianoz, HR - 98/hv., AT - 90/75 mm Hg. Art., BH - 26
/ Min. Mezhi Serce zmischeni vlivo i left 3 cm Tony Serce gluhi over verhivkoyu
protodiastolichny gallop rhythm, sistolichny noise. Hb - 100 g / l, SHZE - 25 mm /
year.Yaky
Mauger Booty poperedniy diagnoz?
A Infektsiyno - alergɿchny mɿokardit
B Dilyatatsiyna kardiomiopatiya
C Eksudativny pericarditis
D Mɿokardɿodistrofɿya
E IHS, stenokardiya

219
Coed 18 rokɿv skarzhitsya on zadishku at digit fɿzichnomu navantazhennɿ.
Stan pogɿrshivsya pɿvroku that. Ob'ɽktivno: Pulse - 88/hv, Visoko. AT-180/20mm Hg.
Art. Shkɿra blɿda. Rozmɿri Serce zbɿlshenɿ vlɿvo, top to bottom. In II mɿzhrebɿr'ʀ
systole-dɿastolɿchny noise, II tone over legenevoyu arterɿɽyu pɿdsileny. At EHC acquaint
gɿpertrofɿʀ oboh shlunochkɿv. When rentgenologɿchnomu doslɿdzhennɿ grudnoʀ porozhnini
-
pulsatsɿya that vibuhannya legenevogo Stovbur, lɿvogo shlunochka. Yakoyu blame
Booty
lɿkarya tactics?
A Konsultatsɿya kardɿohɿrurga
B Dispensary sposterezhennya
C Priznachennya terapevtichnogo lɿkuvannya
D Prodovzhennya doslɿdzhennya
E Zvɿlnennya vɿd fɿzichnih navantazhen

220
Cholovɿk 49 rokɿv skarzhitsya on zadishku zmɿshanogo nature, cough, nabryaki
gomɿlok, zbɿlshennya rahunok abdomen for ascites. Hvorɿɽ bɿlsh nɿzh 20 rokɿv on
hronɿchny
bronhɿt. Ostannɿ 3 Rocky ɽ ɿnvalɿdom II group through zmɿni is a side Serce.Ob'ɽktivno:
tsɿanoz zmɿshanogo character nabryaki. Pulse - 92 / min, ritmɿchny, AT -120/70 mm
Hg. Art.,
BH - 24/hv. Accent II tone over legenevoyu arterɿɽyu. Above legenyami-vorotkovy
sound.
Suhɿ rales over vsɿɽyu surface legenɿv. Yaky mehanɿzm rozvitku zmɿn is a side Serce
tsogo ailing?
A Reflex Eylera-Lɿlɽstranda
B Reflex Kitaɽva
C Reflex Beynbrɿdzha
D Kardɿovaskulyarny reflex
E Dihalny reflex

221
Zhɿnka 62 rokɿv hvorɿɽ on bronhɿalnu asthma. Skarzhitsya on the appearance of bolɿ
grudninoyu
stenokarditichnogo character pereboʀ in robotɿ Serce. Ob'ɽktivno: t = 36,6 C, pulse -
78/hv, ekstrasistolɿchna aritmɿya, AT - 160/95 mm Hg. Art., BH - 18/hv. In legenyah
visluhovuɽtsya zhorstke dihannya is podovzhenim vidohom, rozsɿyanɿ suhɿ
wheezing.Yaky is
preparatɿv protipokazany in danɿy situatsɿʀ?
A Obzɿdan
B corinfar
C Nɿtrosorbɿd
D Sustak
E Ritmɿlen

222
Zhɿnka 36 rokɿv skarzhitsya on bɿl in nadcherevnɿy dɿlyantsɿ, scho vinikaɽ pɿslya priyam
ʀzhɿ, nudotu, vɿdrizhku, nestɿykɿst chair. Hvoroba postupovoprogresuɽ bɿlya 2 rokɿv.
Ob'ɽktivno: blɿdɿst i suhɿst shkɿri, Yazikov obkladeny, vology is vɿdbitkami zubɿv on
edges. When palpatsɿʀ stomach - rozpovsyudzheny bɿl in nadcherevnɿy dɿlyantsɿ. Yaky
naybɿlsh ɿnformativny method doslɿdzhennya in danomu vipadku slɿd zastosuvati?
A Fɿbrogastroskopɿya is bɿopsɿɽyu slizovoʀ shlunkua
B Rozgornuty klɿnɿchny analɿz krovɿ
C Rentgenologɿchne doslɿdzhennya shlunka i gut
D Fraktsɿyne doslɿdzhennya shlunkovoʀ sekretsɿʀ
E Komp'yuterne doslɿdzhennya cherevnoʀ porozhnini
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Cholovɿk 42 rokɿv skarzhitsya on slabkɿst, sertsebittya, nosovɿ krovotechɿ appears
krovovilivɿv have shkɿrɿ. Stan progresivno pogɿrshuɽtsya protyagom
mɿsyatsya.Ob'ɽktivno:
Stan heavy on shkɿrɿ kɿntsɿvok i Tulub petehɿalnɿ i plyamistɿ krovovilivi.
Lɿmfovuzli not palpuyutsya. Pulse - 116 / min, pechɿnka 2 cm selezɿnka not
palpuɽtsya. In krovɿ bend pantsitopenɿya. About yak zahvoryuvannya Treba dumati in
Persha Cherga?
A Gɿpoplastichna anemɿya
B GOSTR leukemia
C Hvoroba Verlgofa
D Gemoragɿchny vaskulɿt
E GOSTR agranulocytosis

224
In ailing 30 rokɿv on 9-of Dobou hvorobi, yak broach postupovo, is povɿlnim
knots in garyachki that ɿntoksikatsɿʀ, z'yavivsya neryasny roseolous visip on shkɿrɿ
abdomen. Ob'ɽktivno: blɿdy, T-40 ° C, puls-80/hv, AT-100/65mm Hg Yazikov obkladeny,
zhivɿt zduty, palpuɽtsya selezɿnka that zbɿlshena pechɿnka. Obstezhennya by yak
zahvoryuvannya potrɿbno held in Persha Cherga?
A Cherevny fever
B Visipny fever
C Kɿr
D Scarlet Fever
E Sepsis

225
In ailing 35 rokɿv hvoroba broach burhlivo: h chill, the temperature to pɿdvischennya
39 ° C, blyuvannya, bolyu in epɿgastrɿʀ, Bringing a set watery smerdyuchimi
viporozhnennyami. For 6 to Godin zahvoryuvannya z'ʀv Seer egg smazhenu kartoplyu is
tushkovanim m `yasom, vipiv sɿk. Yaky zbudnik skorɿsh for all viklikav podɿbny camp?
A Salmonella
B Kishkova palichka
C Kampɿlobakter
D Shigella
E Cholera vɿbrɿon

226
Khvorov 20 rokɿv on Day 2 hvorobi is raptovi cob, skarzhitsya on strong
Head bɿl have skronyah that dɿlyantsɿ orbɿt, aching tili, Sukhiy bolyuchy cough.
T-39 ° C. Adinamɿchny, mucous obolonka oropharynx "palayucha" in legenyah wheezing
not
visluhovuyutsya. Yaky dɿagnoz ɽ naybɿlsh ymovɿrnɿm?
A Grip
B Paragrip
C Respɿratorny mɿkoplazmoz
D Pnevmonɿya
E Menɿngokokova ɿnfektsɿya‘