Contents module "CARDIOLOGY" (Hospital of Emergency Medicine)

Вы зашли под именем Шеікх Прінс (Выход)

Буковинський державний медичний

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СДН БДМУ ► Cardiology (Int.medicine 5 year) ► Тесты ► KROK 2. General Medical Preparation ► Обзор
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KROK 2. General Medical Preparation
Обзор попытки 9

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Тест начат Пятница 26 Март 2021, 09:12

Завершен Пятница 26 Март 2021, 09:13
Прошло времени 5 сек
Баллов 0/30
Оценка 0 из максимума 100 (0%)

1 37-year-old patient, after a car accident, slight bleeding in the middle third of the
Баллов:right thigh. Objectively: a wound on the front surface of the right thigh with
1 massive bleeding, pathological motion on the level of the middle third of the thigh.
What should start to help?

Выберите a. Perform finger cuff pressing of the femoral artery

один ответ.
b. To introduce analgesic drug
c. Put the tourniquet
d. Run venipuncture and begin intravenous infusion of
polyglycine
e. Immobilize the link with the transport bu

Неверно
Баллов за ответ: 0/1.

2 Patient P., 52 years old, the experience of work with a welder 18 years old,
Баллов:complains about poisoning and dry cough. With Ro OGK: in the lungs in the
background of the reinforced, mesh-deformed pulmonary pattern, a large number
1
of shallow, rounded clearly defined shadows in the middle and lower parts on both
sides, symmetrically determine The roots of the lungs are thickened, enlarge Your
diagnosis.
 Выберите a. Military carcinomatosis.
один ответ.
b. Sarcoidosis.
c. Pneumoconiosis.
d. Disseminated pulmonary tuberculosis.
e. Cardiogenic pneumosclerosi

Неверно
Баллов за ответ: 0/1.

3 A 60-year-old female patient has been admitted to a hospital due to acute

transmural infarction. An hour later the patient’s condition got wors She developed
Баллов:
1 progressing dyspnea, dry cough. Respiratory rate - 30/min, heart rate - 130/min,
AP- 90/60 mm Hg. Heart sounds were muffled, there was also diastolic murmur
on the pulmonary artery. The patient presented with medium moist rales in the
lower parts of lungs on the right and on the left. Body temperature - 36,4o What
drug should be given in the first place?

Выберите a. Aminophylline
один ответ.
b. Digoxin
c. Promedol
d. Dopamine
e. Heparin

Неверно
Баллов за ответ: 0/1.

4 Ambulance is delivered the patient after a height drop, with clinical signs of
multiple fractures of both lower endings. Objectively: the condition of the patient is
Баллов:
severe, the consciousness is preserved, but psychologically obstructed, skin is a
1
bluish-gray color, on the forehead is a cold perspiration. Breathing is superficial, up
to 30 / min, AT-80/60 mm Hg, Ps-120 / min, poor filling. What complication does
the victim suffer from?

Выберите a. Traumatic shock 3 st

один ответ.
b. Traumatic shock of 4 st
c. Faint
d. Traumatic shock 1 st
e. Traumatic shock 2 st
 Неверно
Баллов за ответ: 0/1.

5 A girl is 12 y.o. Yesterday she was overcoole Now she is complaining on pain in
suprapubic area, frequent painful urination by small portions, temperature is 37,80
Баллов:
Pasternatsky symptom is negativ Urine analysis: protein - 0,033 g/L,WBC-20-
1
25inf/vis,RBC-1-2inf/vis. What diagnosis is the most probable?

Выберите a. Acute glomerulonephritis

один ответ.
b. Urolithiasis
c. Acute cystitis
d. Acute pyelonephritis
e. Dysmetabolic nephropathy

Неверно
Баллов за ответ: 0/1.

6 A 56 y.o. teacher consulted a department therapist about a corresponding diet.

Баллов:Complaints: frequent constipations [defecation once in 2-3 days], flatulence and
1 unpleasant aftertaste; blunt pain in the lower half of abdomen after intake of ice
cream or soda drinks. At 17-20 she was treated for duodenal ulcer. Objectively:
height – 164cm, weight – 62kg. Abdomen is oval, palpation doesn’t detect
pathological changes. What diet is necessary for prevention of transition of
chronic disease into acute?

Выберите a. General table

один ответ.
b. Table №7 by Pevzner
c. Table №2 by Pevzner
d. Table №9 by Pevzner
e. Table №4 by Pevzner

Неверно
Баллов за ответ: 0/1.

7 A 45-year-old male develops reactive arthritis after an episode of Yersinia

Баллов:enterocolitica diarrhe He is im¬proving after 3 days of indomethacin 50 mg ti He is
1 asking about the long-term prognosis because he has been quite disabled since
his illness. He is currently ambulating with crutches owing to severe right knee and
ankle pain. In addition, he has had significant low back pain and dac-tylitis in the
hands and feet. He had an episode of uveitis that has resolve He is known to be
 HLA-B27-negativ What information do you give the patient in regard to the
prognosis?

Выберите a. The likelihood of recurrence is less than 10% because this is

один ответ. a self-limited process after an acute infection.
b. С.Persons who develop reactive arthritis after Yersi¬nia
infection have less chronic disease compared with those who
have had Shigella infection Joint symptoms persist in more
than 80% of patients with reactive arthritis.
c. -
d. As he is HLA-B27-negative, he has a higher chance of
recurrence compared with persons who are HLA-B27-positiv

e. The patient should expect to be disabled as a result of his

episode of reactive arthritis as 50% of per sons are unable to
work after the onset of this dis¬ea

Неверно
Баллов за ответ: 0/1.

8 A 29 y.o. woman is critically ill. The illness is presented by high fever, chills,
Баллов:sweating, aching pain in lumbar area, discomfort during urination and frequent
1 voiding. Pasternatsky’s sign is positive in both sides. On lab examination: WBC20 ?
109/L; on urine analysis: protein 0,6g/L, leukocyturia, bacteriuri Your preliminary
diagnosis.

Выберите a. Nephrolithiasis
один ответ.
b. Exacerbation of chronic pyelonephritis
c. Acute cystitis
d. Acute pyelonephritis
e. Acute glomerulonephritis

Неверно
Баллов за ответ: 0/1.

9 A 44-year-old patient complains of difficult urination, sensation of incomplete

urinary bladder emptying. Sonographic examination of the urinary bladder near the
Баллов:
urethra entrance revealed an oval well-defined hyperechogenic formation 2x3 cm
1
large that was changing its position during the examination. What conclusion can
be made?
 Выберите a. Malignant tumor of the urinary bladder
один ответ.
b. Urinary bladder polyp
c. Prostate adenoma
d. Stone
e. Primary ureter tumor

Неверно
Баллов за ответ: 0/1.

10 A 32-year-old patient has developed an acute condition after hypothermia:

Баллов:temperature - 40°C, cough with 200 ml of sputum per day. The sputum is purulent,
1 foul-smelling. To the right of the lower lobe the mixed moist rales can be
auscultate Blood test results: WBCs - 18,0?109/l, ESR - 45 mm/h. Radiographically:
in the lower lobe of the right lung there is a thick-walled cavity up to 6 cm in
diameter with a high horizontal level. What is the most likely diagnosis?

Выберите a. Lung absce

один ответ.
b. Decomposing lung carcinoma
c. Infiltrative pulmonary tuberculosi
d. Lung cyst
e. Fibro-cavernous pulmonary tuberculosi

Неверно
Баллов за ответ: 0/1.

11 A 36-year-old female presents to the emergency de¬partment for evaluation of a

Баллов:pruritic rash on the back, knees, buttocks, and elbows. She has noticed the rash
1 for the last 2 weeks, and in addition to the pruritus, she has noted a severe burning
quality to the rash. It has pro¬gressed despite the application of 1%
hydrocortisone cream. The patient also has had a long history of mild diarrhea
that previously was diagnosed as most likely be¬ing diarrhea-predominant irritable
bowel syndrom She has lost 10 lb despite having a good appetit She has also had
bouts of an unexplained arthritis affecting the knees. She currently takes no
medications. On physical exami¬nation, there are multiple excoriations and a
papulovesi-cular rash on the back and buttocks. Similar lesions are present on the
elbows and knees with plaquelike lesions. A biopsy of one of the lesions shows
granular deposits of IgA in the papillary dermis and along the epidermal
base¬ment membrane zon The patient is started on therapy with dapsone 100 mg
daily. What adjunctive treatment is likely to control the skin disease?

Выберите a. Initiation of a gluten-free diet

один ответ.
 b. Initiation of psoralen plus ultraviolet light (PU VA) therapy
c. Triamcinolone 0.5% cream
d. Azathioprine 100 mg/d
e. Cyclophosphamide 50 mg/d

Неверно
Баллов за ответ: 0/1.

12 A fitter of a metallurgic factory with occupational exposure to high concentrations

Баллов:of mercury fumes for 16 years presents instability of pulse and blood pressure,
1 general hyperhydrosis, asymmetric innervations of facial muscles and tongue,
positive subcortical reflexes, hand tremor on physical examination. A dentist
revealed paradontosis and chronic stomatitis. What is the most probable
diagnosis?

Выберите a. Neuroinfection
один ответ.
b. Chronic mercury intoxication
c. Parkinson syndrome
d. Acute mercury intoxication
e. Mercury encephalopathy

Неверно
Баллов за ответ: 0/1.

13 A soldier after he left the lesion of the OR, he had appeared a deterioration of
Баллов:vision, headache, general weakness, and a lack of air. Objectively: cyanosis of
1 mucous membranes, fibrillary twitching of facial muscles. In the lungs, rigid
breathing, unusual dry whistling wheezing: bradycardia, AT- 90/60 mmHg is
observe What kind of medical drug from an individual first aid kit is used to
provide first aid?

Выберите a. Isonitrosin
один ответ.
b. Afinin
c. Budaksim
d. Cystamine
e. Atropine

Неверно
Баллов за ответ: 0/1.
14 On the 4th day after suturing the perforative stomach ulcer a patient with
Баллов:pulmonary emphysema developed spontaneous pneumothorax. What is the best
1 place for pleural drainage?

Выберите a. The seventh intercostal space along the anterior axillary

один ответ. furrow
b. The eighth intercostal space along the posterior axillary
furrow
c. The fifth intercostal space along the medioclavicular line
d. The second intercostal space along the medioclavicular line

e. The sixth intercostal space along the anterior axillary furrow

Неверно
Баллов за ответ: 0/1.

15 A 30-year-old woman with a long history of chronic pyelonephritis complains

Баллов:about considerable weakness, sleepiness, decrease in diuresis down to 100 ml per
1 day.AP-200/120mmHg.Inblood: creatinine - 0,62 millimole/l, hypoproteinemia,
albumins - 32 g/l, potassium - 6,8 millimole/l, hypochromic anemia, increased ESR.
What is the ?rst step in the patient treatment tactics?

Выберите a. Haemodialysis
один ответ.
b. Antibacterial therapy
c. Blood transfusion
d. Enterosorption
e. Haemosorption

Неверно
Баллов за ответ: 0/1.

16 A patient has been suffering from morning cough accompanied by discharge of

Баллов:small amount of sputum, dyspnea for 8 years. He has been smoking for 10 years.
1 Objectively: cyanosis, prolonged expiration, dry rales. What is the most probable
diagnosis?

Выберите a. Chronic non-obstructive bronchiti

один ответ.
b. Chronic obstructive bronchiti
c. Multiple bronchiectasi
 d. Bronchial asthma
e. Idiopathic fibrosing alveoliti

Неверно
Баллов за ответ: 0/1.

17 A 61 y.o. man complained of sneezing and substernal pain on exertion. In the last
2 weeks such pain appeared at rest, with increased frequency, and couldn't be
Баллов:
suppressed by 1 tablet of nitroglycerin. What is the most likely diagnosis?
1

Выберите a. Unstable angina pectoris

один ответ.
b. Stable angina pectoris of the III functional class
c. Myocarditis
d. Radiculitis
e. Angina pectoris of a new onset

Неверно
Баллов за ответ: 0/1.

18 A woman has developed sudden thoracic pain on the right with expectoration of
Баллов:pink sputum and body temperature rise up to 37,7°C on the 4th day after the
1 surgery for cystoma of the right ovary. On lung examination: dullness of the lung
sound on the lower right is observe Isolated moist crackles can be auscultated in
the same are What complication is the most likely?

Выберите a. Pneumothorax
один ответ.
b. Pulmonary infarction
c. Exudative pleurisy
d. Pulmonary absce
e. Pneumonia

Неверно
Баллов за ответ: 0/1.

19 A worker who participated of the liquidation of a fire where 2 kg of metallic

Баллов:mercury was stored, taken to the clinic with complaints of emotional distress,
1 palpitations, vividness, trembling of the body, in the region of the heart. The
deterioration occurred during the day. Objectively: pale skin, moistur Patient has a
state of depression, persistent red dermographism, heresitism, unstable level of
arterial pressur Which of the drugs is an antidote in this case?
 Выберите a. Atropine sulfate
один ответ.
b. Unithiol
c. Amylnitrite
d. Dipiroxam
e. Teatzin calcium

Неверно
Баллов за ответ: 0/1.

20 A 12-year-old boy has a 6-year history of insulin-dependent diabetes. The disease

Баллов:is labil Since recently there have been periodical rises in blood pressur
1 Microalbuminuria test gave positive results. The patient’s condition corresponds
with the following stage of diabetic nephropathy:

Выберите a. Stage IV - advanced clinical nephropathy

один ответ.
b. Stage III - early-stage nephropathy
c. V stage - chronic renal failure
d. Stage I - renal hypertrophy and hyperfunction
e. Stage II - histological changes in the kidneys

Неверно
Баллов за ответ: 0/1.

21 A patient of 55 years complained of bloating and rumbling in the abdomen,

Баллов:increased leakage of gases, a liquid stool of a foamy nature with a sour smell that
1 appear after eating dishes on milk. What is the name of this symptom complex?

Выберите a. The syndrome of putrefactive dyspepsia

один ответ.
b. Fat Dyspepsia Syndrome
c. The syndrome of fermentation dyspepsia
d. Malabsorption syndrome
e. Dyskinesia syndrome

Неверно
Баллов за ответ: 0/1.

22 A 40 y.o. patient with rheumatic heart disease complains of anorexia, weakness

and loss of weight, breathlessness and swelling of feet. The patient had tooth
Баллов:extraction one month ago. On examination: t0- 390C, Ps- 100/min. Auscultation:
1 diastolic murmur in the mitral are Petechial lesion around the clavicle; spleen was
palpabl

Выберите a. Recurrence of rheumatic fever

один ответ.
b. Aortic stenosis
c. Mitral stenosis
d. Thrombocytopenia purpura
e. Subacute bacteria endocarditis

Неверно
Баллов за ответ: 0/1.

23 A 62-year-old patient complains of rest dyspnea, heart pains. 3 years ago, he had
Баллов:myocardial infarction. Physical examination: orthopnea, acrocyanosis, swollen
1 cervical veins. Ps - 92, total heart enlargement, the liver is enlarged by 7 cm, shin
edem What is the stage of chronic heart failure (CHF)?

Выберите a. CHF- 2 А
один ответ.
b. CHF- 1
c. CHF- 0
d. CHF- 3
e. CHF- 2 B

Неверно
Баллов за ответ: 0/1.

24 A 25-year old woman complained of fatigue, hair loss and brittle nails. The
Баллов:examination revealed pallor of skin, Ps - 94/min, BP - 110/70 mm Hg. On blood
1 count: Hb - 90 g/L, RBC - 3,5x1012/L, I.- 0,7; ESR - 20 mm/h. Serum iron level was
8,7 mcmol/l. What treatment would you initiate?

Выберите a. Iron dextrin injections

один ответ.
b. Vitamin B12 intramuscularly
c. Packed RBCs transfusion
d. Blood transfusion
e. Ferrous sulfate orally

Неверно
 Баллов за ответ: 0/1.

25 For the population living on the radio-contaminated territory, in order to remove the
Баллов:radionuclides from the organism, is recommended to include pectin to the diet.
1 Which of the following products is the main source of pectins?

Выберите a. Bread
один ответ.
b. Milk
c. Meat
d. Macaroni
e. Vegetables and fruit

Неверно
Баллов за ответ: 0/1.

26 A 52-year-old patient works as a secretary and has 30 year record of servic She
Баллов:complains of spasms in her right hand during working and inability to type and writ
1 Up to 80% of her work involves hand loa The patient has been presenting with
these symptoms for 2 years. Objectively: the right hand is tense, there is an
increase in muscle tone, attempts to write cause spasms. Examination revealed
no pathological changes of CNS. What is the most likely diagnosis?

Выберите a. Paretic form of coordination neurosis

один ответ.
b. Chronic manganese intoxication
c. Hysteric neurosis
d. Neuralgic form of coordination neurosis
e. Spastic form of coordination neurosis

Неверно
Баллов за ответ: 0/1.

27 Among the officials of the institution in the current year, wasn’t ill - 10%, one time -
Баллов:30%, two times - 15%, four times - 5%, all the others - 5 and more times. What is
1 the proportion of employees assigned to the I group of health?

Выберите a. 10%
один ответ.
b. 40%
c. 55%
 d. 60%
e. 22%

Неверно
Баллов за ответ: 0/1.

28 At the woman of 28 years, transferred 1,5 years ago laporoskopicheskuju a

Баллов:cholecystectomy there were pains in right hypochondrium of former intensity. She
1 noted an achalic chair, darkening of urin Which method is most indicated to clarify
the diagnosis?

Выберите a. Thermography of the trunk

один ответ.
b. Liver scintigraphy
c. Ultrasonography
d. Esophagogastroduodenoscopy
e. Retrograde cholangiography

Неверно
Баллов за ответ: 0/1.

29 A 35-year-old female presents to her primary care doctor complaining of diffuse

Баллов:body and joint pain. When asked to describe which of her joints are most affected,
1 she answers, "All of them." There is no associated stiff¬ness, redness, or swelling
of the joints. No Raynaud's phe¬nomenon has been appreciate Occasionally she
notes numbness in the ringers and toes. The patient complains of chronic pain
and poor sleep quality that she feels is due to her pairi. She previously was seen in
the clinic for chronic headaches that were felt to be tension-relate She has tried
taking over-the-counter Motrin twice daily with¬out relief of pain. She has no other
medical problems. On physical examination, the patient appears comfortabl Her
joints exhibit full range of motion without evidence of inflammatory arthritis. She
does have pain with pal¬pation at bilateral suboccipital muscle insertions, at C5,
at the lateral epicondyle, in the upper outer quadrant of the buttock, at the medial
fat pad of the knee proximal to the joint line, and unilaterally on the second right ri
The erythrocyte sedimentation rate is 12 s. Antinuclear anti¬bodies are positive at
a titer of 1:40 in a speckled pattern. The patient is HLA-B27-positiv Rheumatoid
factor is negativ Radiograms of the cervical spine, hips, and el¬bows are normal.
What is the most likely diagnosis?

Выберите a. С.Fibromyalgia
один ответ.
b. Rheumatoid arthriti
c. Disseminated gonococcal infection
d. Systemic lupus erythematosu
 e. Ankylosing spondyliti

Неверно
Баллов за ответ: 0/1.

30 A 46-year-old woman complains of pain attacks in the right lumbar area, which
Баллов:irradiate to the lower abdomen, and nause This kind of pain attacks has never
1 been detected in the patient befor Survey X-ray of the abdominal cavity reveals no
pathologic shadows. Ultrasonic scan detects a hyperechogenic growth 1,5 cm in
diameter, which reflects sound wave, in the enlarged right renal pelvis. What
diagnosis is most likely?

Выберите a. Renal calculu

один ответ.
b. Renal cyst
c. Malignant renal tumor
d. Renal tuberculosi
e. Benign renal tumor

Неверно
Баллов за ответ: 0/1.

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