FINAL ANSWERS BY :Anas ,Maksood ,Shabina

1. What pathogen ranks first in the development of community-acquired

pneumonia?
A. pneumococcus
B. staphylococcus
C. viruses
D. mycoplasma
E. legionella

2. Nosocomial pneumonia is characterized by:

A. Development of pneumonia 24 hours after hospitalization.
B. Development of pneumonia 48-72 hours after hospitalization.
С. The development of pneumonia is associated with the presence of secondary
immunodeficiency in the patient.
D. Develops only in patients on artificial ventilation.
E. Severe lymphocytosis

3. What pathogen is leading in the development of hospital pneumonia?

A viruses
B. gram-positive flora
C. gram-negative flora
D. candida
E. chlamydia

4. What group of antibiotics is used to start treatment for pneumococcal

pneumonia?
A. aminoglycosides
B. penicillin
C. macrolides
D. carbopenems
E. fluoroquinolones
5. What examination method allows you to verify the diagnosis of pneumonia?
a. bronchoscopy
b. chest X-ray or CT
c. spirometry
d. bronchography
e. peak flowmetry

6. What are the features of the course of pneumonia in the elderly?

a. acute onset
b. high fever
c. pronounced signs of intoxication
d. poor clinical picture, minor physical changes
e. distinct physical manifestations

7. What pneumonia is characterized by the defeat of the whole lobe of the lung,
constant fever, the release of rusty sputum:
A. staphylococcal
B. pneumococcal
C. pneumonia caused by anaerobes
D. pneumonia caused by fungi
E. viral pneumonia

8. A 27-year-old woman was admitted to the hospital with suspected severe

pneumonia. Which of the following methods is decisive in making a diagnosis?
A. chest x-ray
B.fibrobronchoscopy
C. bronchography
D. peak flowmetry
E. spirography

9. A homogeneous shadow with a characteristic fluid level, displacement of the

mediastinal organs to the healthy side on X-ray are characteristic for:
exudative pleurisy
lung atelectasis
tuberculosis
pleuropneumonia
lung cancer

10. The patient has chills, dry cough, pain in the left side, aggravated by deep
breathing and coughing, temperature 38.5 C. X-ray examination revealed a
homogeneous darkening of the right lung in the lower sections. Your preliminary
diagnosis:

А. Pneumonia
В. Chronic bronchitis
С. Chronic obstructive pulmonary disease
D. Bronchial asthma
E. Pleuritis

11. A diagnosis of chronic bronchitis can be made to a patient with the following
symptoms:
A. Cough with phlegm for at least 3 months a year for 2 or more years.
B. Cough with phlegm for 3 months a year during the year.
C. Occurrence of acute bronchitis three times in the last 2 years.
D. Cough with phlegm for 4 months during the year.
E. Cough with sputum within 3 months after pneumonia.

12. The main clinical signs of chronic bronchitis:

A. Cough, sputum production
B. Syndrome of the upper lobe
C. Middle lobe syndrome
D. Increased body temperature
E. Hemoptysis

13. The main clinical signs of acute bronchitis:

A. cough dry, painful, mucous sputum,
B. barking rough cough
C. inspiratory dyspnea x
D. increase in body temperature up to 40 ° C
E. hemoptysis

14. Bronchial obstruction is detected by:

A. spirography
B. bronchoscopy
C. blood gas tests
D echocardiography
E.ECG

15. Patient I., 22 years old, complains of chills, paroxysmal dry cough, pain in the
chest when coughing, temperature rise up to 38.0 ° С, headaches, general
weakness. Your preliminary diagnosis? is antibiotic therapy indicated?
A. Acute bronchitis, antibiotic therapy is not indicated
B. Acute bronchitis, antibiotic therapy is indicated
C. Chronic bronchitis, antibiotic therapy is not indicated
D. Chronic bronchitis, antibiotic therapy is indicated
E. Chronic obstructive pulmonary disease
16. With an attack of bronchial asthma over the lungs are heard:
A. wet wheezing
B. dry wheezing
C. amphoric breathing
D. crepitus
E. pleural rub

17. Examination revealed dyspnea of an expiratory nature in a patient; forced

position - sits in bed, resting his hands on the edge of the bed; cyanosis,
emphysematous chest, distant wheezing; percussion-box sound; auscultatory-
weakened vesicular breathing, a mass of dry wheezing. What syndrome does the
patient have:
A. pulmonary inflammatory infiltration syndrome
B. bronchial obstruction syndrome
C. respiratory distress syndrome
D. syndrome of accumulation of fluid in the pleural cavity
E. pleural air congestion syndrome
18. A 32-year-old patient complains of choking. He sits with his hands on the edge
of the bed. The skin is moist, slight cyanosis of the lips. Breathing with remote
wheezing. An unproductive cough increases choking. From the anamnesis: there
were similar attacks before, a real attack developed suddenly during the renovation
of the apartment. Physical exam: breathing is weak in the lungs. The number of
breaths is 26 per minute, a mass of dry wheezing rales. Heart sounds are clear.
Heart rate 92 per minute. BP 120/80 mm Hg . What disease should you think
about?
А. Pneumonia
В. Chronic bronchitis
С. Chronic obstructive pulmonary disease
D. Bronchial asthma
C. Pleuritis

19. The major diagnostic criteria for acute rheumatic fever is:
carditis
morning stiffness
rheumatoid nodules
arthralgia
ankylosisç

20. The normal mean pulmonary artery pressure is:

A. 4-8 mm Hg
B. 9-16 mm Hg
C. 20-25 mm Hg
D. 40-50 mm Hg
E. 60-70 mm Hg
21. Patient L., 57 years old, complains of rapid fatigue, pronounced drowsiness,
dyspnea at rest of a mixed nature, aggravated by physical exertion.
Physical exam: Height - 173 cm.Weight - 80 kg. Kyphosis of the thoracic region.
Swelling of the feet, legs. Warm diffuse cyanosis. Vesicular breathing over the
lungs, no wheezing. BR - 19 per minute. Heart sounds are rhythmic, muffled, heart
rate - 96 per minute. BP - 140/88 mm Hg
Complete blood count: Hb - 174 g / l, leukocytes - 5.5 x 109 / l, erythrocytes - 6.7
x 1011 / l, ESR - 4 mm / h. What disease should you think about?
А. Pneumonia, complicated by pleurisy
В. Chronic bronchitis
С. Chronic obstructive pulmonary disease
D. Moderate persistent bronchial asthma
C. Cor pulmonary, stage of decompensation.

22. Intermittent bronchial asthma is characterized by //

episodic symptoms less than 1 time per week //
attacks 1-2 times a week //
exacerbations more than 1-2 times a week //
frequent exacerbations, constant presence of symptoms //
constant use of three or more drugs
23. What hormone does the pituitary gland produce:
adrenalin
Calcitonin
Thyroxine
antidiuretic hormonе
insulin
24. The etiological and provoking factors of Cushing's syndrome are:
A) Pituitary tumors
B) Tumors of the adrenal gland
C) Traumatic brain injury
D) Neuroinfection
E) Stresses

25. The etiological and provoking factors of Cushing's diseases are:

A) Neuroinfection
B) Tumors of the adrenal gland
C) Traumatic brain injury
D) Pituitary tumors
E) Stresses

26. What hormone belongs to mineralocorticoids:

Aldosterone
Hydrocortisone
antidiuretic hormonе
insulin

Cortison

27. Cause of primary hyperaldosteronism:

A) Hypothalamic tumor
B) Tumor adrenal medulla
C) Adrenal hyperplasia
D) Pituitary tumors
E) Stresses

28. Cause of pheochromocytoma:

A) Hypothalamic tumor
B) Tumor adrenal medulla
C) Adrenal hyperplasia
D) Pituitary tumor
E) Stress

29. A 56-year-old female patient. Complaints of tiredness, weight gain, mental

lathery. She was treated for goiter with radio-iodine (RI).
Physical exam: The condition is moderate, face swollen, dry and yellow skin. HR-
50. BP 90/60 mmHg.
Choose the method of treatment for this patient:
A) Anti-thyroid therapy
B) Gluosteroid therapy
C) Continue radio - iodine therapy
D) T 4 replacement therapy
E) Surgical

30. A 39-year-old female patient. Complains of palpitations, emotional lability,

weight loss. She got sick first after stress. She is receiving an anti- thyroid drug
(carbimazole) but no effect.
Physical exam: The condition is moderate, exophthalmoses, hot, moist palms,
trembling. Thyroid goiter and bruit. HR- 110. BP 150/55 mmHg.
Choose the method of treatment for this patient:

A) Continue anti-thyroid therapy

B) Gluosteroid therapy
C) Radio - iodine therapy
D) T 4 replacement therapy
E) Recommend surgery

31. A 56 -year-old female patient. Complains of palpitations, emotional lability,

weight loss. She has been ill for a long time and receives anti-thyroid therapy
(carbimazole) for a long time and but there is no effect.
Physical exam: The condition is moderate, exophthalmoses, hot, moist palms,
trembling. Thyroid goiter and bruit. HR- 110. BP 150/55 mmHg.
Choose the method of treatment for this patient:
A) Continue anti-thyroid therapy
B) Gluosteroid therapy
C) Radio - iodine therapy
D) T 4 replacement therapy
E) Recommend surgery

32. A 17 -year-old male patient. Regularly receives insulin after the next dose did
not eat and felt weakness, dizziness, hand tremors.
Physical exam: The condition is moderate, the skin is wet. HR 100. BP 140/85
mmHg. Laboratory test: Plasma glucose 63mg/dl (>3.5 mmol/L).
This state reflects:
A) Hyperglycemic hyperosmolar state
B) Diabetic ketoacidosis
C) Hypoglycemia
D) Metabolic imbalance
E) Impaired glucose tolerance (IGT)

33. Laboratory sign of hyperthyroidism:

A) high TSH and T4
B) high TSH and low T4
C) low TSH and high T3±T4
D) low ACTH and high cortisol
E) high ACTH and low cortisol

34. What hormone does the adrenal gland produce:

adrenalin
Calcitonin
Thyroxine
antidiuretic hormonе
insulin

35. Laboratory sign of Cushing's syndrome:

A) high TSH and T4
B) normal TSH and low T4
C) low TSH and high T3±T4
D) low ACTH and high cortisol
E) high ACTH and low cortisol

36. Laboratory sign of primary hyperaldosteronism:

A) High aldosterone and Na, low renin and K
B) High aldosterone and Na, high renin and K
C) High renin and aldosterone, low K and Na
D) Low aldosterone and K, high Na
E) High Na and K, low renin, aldosterone

37. Laboratory signs of nephrotic syndrome:

A) hyperproteinemia, hypercholesterolemia
B) hypalbuminemia, hypercholesterolemia
C) hyperproteinemia, hyperlipidemia
D) hyperalbuminemia, hypercholesterolemia
E) hypoproteinemia, hypolipidemia

38 The study revealed a GFR of 30-59 (ml/min/1.73m2). This indicator

corresponds to what stages of kidney damage?
A) 5 (kidney failure)
B) 4 (severe)
C) 3 (moderate)
D) 2 (mild)
E) 1 (normal or increased kidney function)

39. A 48 -year-old female patient, complaints of fatigue and weakness. She has a
hormonal disorder of the menstrual cycle.
CBC: RWC - 3.8 million mm3, Hb - 6.5 g/dl, Ht- 28.2%, MCV - 60 fl, MCH - 22
pg, MCHC - 29%, reticulocytes 0.8 %.
This state of what severity of anemia corresponds?
A) Normal
B) Mild
C) Moderate
D) Severe
E) Very severe

40. A 65 -year-old male patient, complaints of fatigue and weakness.

He's a vegetarian.
CBC: RWC - 3.8 million mm3, Hb - 9.0g/dl, Ht-35%, MCV - 110fl, MCH - 34 pg,
MCHC - 36%. RWC with Howell Jolly bodies. What type of anemia corresponds
to:
A) Iron deficiency
B) Vitamin B12 deficiency
C) Aplastic
D) Hemorrhagic
E) Hemolytic

41. A 37-year-old man, a genetic study revealed a translocation of chromosome 9

to 22. This change corresponds to:
A) Acute lymphoblastic leukemia
B) Acute myeloid leukemia
C) Chronic lymphocytic leukemia
D) Chronic myeloid leukemia
E) Aplastic anemia

42. A 32-year-old man, a morphological study of renal biopsy revealed a

mesangioproliferative changes. These changes correspond to damage to
A) Mesangial cells
B) Epithelial cells
C) Endothelial cells
D) Neuronal cells
E) Cooper cells

43. A 48-year-old man, a morphological study of renal biopsy revealed a

membranous changes. These changes correspond to damage to
A) Mesangial cells
B) Epithelial cells
C) Endothelial cells
D) Neuronal cells
E) Cooper cells

44. A 48-year-old man, a morphological study of renal biopsy revealed a

mesangylocapillary changes. These changes correspond to damage to
A) Mesangial cells
B) Epithelial cells
C) Endothelial cells
D) Neuronal cells
E) Cooper cells

45. Patient T., 59 years old, consulted a doctor with complaints of tightening pains
in the calf muscles of the left leg when walking, fatigue in both legs, a feeling of
numbness and chilliness in the legs at rest, headaches, rapid fatigability. From the
anamnesis: Ill for a year. Smokes from the age of 10, 1 pack of cigarettes a day.
Both parents suffer from cardiovascular diseases.
Atherosclerotic lesion of which arteries is clinically manifested in this patient?
A. atherosclerotic coronary artery disease
B. atherosclerotic lesions of the carotid arteries
C. atherosclerotic lesions of the renal arteries
D. atherosclerotic lesions of the arteries of the lower extremities
E. atherosclerotic lesions of the mesenteric arteries

46. Patient K., 60 years old, turned to the outpatient clinic for pain in the left side
of the chest arising when walking at a normal pace at a distance of up to 200 m,
emotional experiences that pass for 3 minutes at rest and after taking nitroglycerin,
which she began to take herself. Atherosclerotic lesion of which arteries is
clinically manifested in this patient?
A. atherosclerotic coronary artery disease
B. atherosclerotic lesions of the carotid arteries
C. atherosclerotic lesions of the renal arteries
D. atherosclerotic lesions of the arteries of the lower extremities
E. atherosclerotic lesions of the mesenteric arteries

47. Patient K., 65 years old, turned to the polyclinic for pain in the left hand arising
when walking at a normal pace at a distance of up to 200 m, emotional experiences
that pass for 3 minutes at rest and after taking nitroglycerin, which she began to
take herself. The "gold standard" in the diagnosis of this pathology is:
A. EchoCG
B. coronary angiography
C. ECG
D. Pasitron emission tomography.
E. stress echocardiography

48. Patient F., 58 years old, was taken to the cardiac intensive care unit by an
ambulance brigade with complaints of intense chest pain for the first time for 6
hours, accompanied by fear of death, weakness, and dizziness. The pain attack
developed after emotional stress. On examination: serious condition. Heart rate -
115 per minute. The rhythm is correct. ВР - 100/60 mm Hg. ECG:
your preliminary diagnosis:
A.Anterior MI
B. anterolateral MI
C. anterior widespread MI
D. Inferior MІ
E. Posterior MI

49. Paroxysmal tachycardia is:

premature contraction of the whole heart
premature contraction of the heart
attacks of increased heart rate
the appearance of an ectopic focus of excitation
the presence of a compensatory pause

50. A 50-year-old patient in the last year notes pain in the upper third of the
sternum, which lasts about 15 minutes, disappears on its own, the pain is
associated with physical activity. BP - 120/80 mm Hg. Art., pulse 92 beats per
minute, resting ECG without pathological changes. On the ECG during an attack
of pain, an elevation of the ST segment in the chest leads was recorded. Is it
advisable for the patient to appoint?
A. prolonged-release nitrates
B. calcium antagonists
C. beta blockers
D. antiplatelet agents
E. ACE inhibitors

51. A 52-year-old patient complains of chest pain at night, which lasts about 15
minutes, passes on its own, blood pressure is 120/80 mm Hg. Art., pulse 62 beats
per minute, resting ECG without pathological changes.
Is it advisable for the patient to appoint?
A. prolonged-release nitrates
B. calcium antagonists
C. beta blockers
D. antiplatelet agents
E. ACE inhibitors

52. Target organs of hypertension include:

A. Kidneys, liver, brain, retina, heart.
B. Heart, retina, skeletal muscles, brain.
С. Arteries, liver, kidneys, heart, retina.
D. Heart, kidneys, brain, arteries, retina.
Е. Heart, liver, arteries, brain, kidneys.

53. Determine the level of risk of developing cardiovascular diseases in a patient,

60 years old, a man with increased blood pressure 150/90 mm Hg. Heredity is
weighed down along the line of matter.
A. Moderate or low risk.
B. Low risk.
B. Moderate risk.
D. High risk.
E. Very high risk.

54. determine the rhythm disturbance on the ECG:

A. ventricular extrasystole
B. atrial extrasystole
C. atrial fibrillation
D. paroxysmal supraventricular tachycardia
E. paroxysmal ventricular tachycardia

55. determine the violation of conduction on the ECG:

A. ventricular extrasystole
B. atrial extrasystole
C. AV block І
D. AV block ІІ
E. AV block ІІІ

56. The clinic of pulmonary edema is characterized by:

A. Cough with serous, bloody, or foamy sputum
B. Dry wheezing rales over the entire surface of the lungs
C. Cough with purulent sputum
D. Cough with vitreous sputum
E. Dry cough

57. Indicate the factors contributing to the occurrence of duodenal ulcer:

A. High level of antibodies to parietal cells of the stomach.
B. Hypersecretion of hydrochloric acid.
С. High level of amylase in the blood.
D. Achilia.
E. Abuse of fatty foods.

58. The patient is worry of heartburn and spitting up when tilting the body. the
most probable diagnosis is
A. chronic gastritis
B. duodenal ulcer
C. gastric ulcer
D. chronic pancreatitis
E. GORD

59. What hormones are produced by a-cells of the pancreas?

Glucogon
pancreatic polipeptic
Insulin.
Somatostatin
serotonin.
60. The following laboratory parameters are used to assess liver function in Child-
Pugh cirrhosis:
A. Cholesterol, alkaline phosphatase, y-glutamyl transpeptidase.
B. Total bilirubin, albumin, prothrombin time.
C. Hepatic transaminases, fibrinogen, direct bilirubin.
D. Gamma globulins, α-fetoprotein, alkaline phosphatase.
E. Sediment samples, LDH, hepatic transaminases.

61. The most reliable method for diagnosing liver cirrhosis is:
A. Ultrasound of the abdominal organs.
B. CT scan of the abdominal organs.
С. Liver scintigraphy.
D. Liver biopsy.
Е. Plain radiography of the abdominal cavity.

62. Which of the following mechanisms take place during the development of
myocardial ischemia?
A. Decreased oxygen utilization
B. decrease in minute blood volume
C. increase in minute blood volume
D. imbalance between myocardial oxygen demand and suply
E. Intravascular resistance

63. The replication phase of the hepatitis B virus is characterized by:

Damage to hepatocytes by immunocompetent cells.
Stimulation of other infectious agents.
Increased alkaline phosphatase activity in blood serum.
An increase in the activity of ALT, AST by 5-10 times.
Changes in the antigenic structure of the hepatocyte.

64. The "major" criteria for acute rheumatic fever are:

Carditis, arthralgia, chorea, erythema nodosum.
Carditis,polyarthritis, erythema annulus, tophus.
Valvulitis, arthralgia, chorea, fever.
Carditis,polyarthritis, chorea, erythema marginatum.
Endocarditis, polyarthritis, rheumatic nodules, xanthelasma.

65. In a patient suffering from coronary artery disease, the ECG revealed the
absence of the P wave in all leads, random f-waves, R-R intervals of different
duration, unchanged QRS complexes. Are ECG changes typical for?
atrial flutter
fibrillation of the ventricles
ventricular paroxysmal tachycardia
atrial paroxysmal tachycardia
atrial fibrillation

66. A 46-year-old patient complains of weakness, lumbar pain, severe headache.

Anamnesis: chronic cystitis.
In the analysis of urine, the relative density: 1005-1010, leukocytes 10x10 9 / l.
What is the presumptive diagnosis:
A. renal amyloidosis
B. acute glomerulonephritis
C. exacerbation of chronic glomerulonephritis
D. chronic pyelonephritis
E. Chronic Kidney Disease

67. A 28-year-old woman has pain in the small joints of the hands with limited
mobility. What disease should you think about?
A) Systemic sclerosis (Ssc)
B) Rheumatoid Arthritis (RA)
C) Acute Rheumatic Fever (ARF)
D) Osteoarthritis (OA)
E) Systemic Lupus Erythematosus (SLE)

68. A 45-year-old patient has Raynaud's syndrome up to necrotic changes in the

fingers, impaired swallowing, pulmonary hypertension, difficult flexion of the
fingers, thickening of the skin in the area of the hands, shortening of the fingers
due to lysis of the terminal phalanges. What disease should you think about?
A) Systemic sclerosis (Ssc)
B) Rheumatoid Arthritis (RA)
C) Acute Rheumatic Fever (ARF)
D) Osteoarthritis (OA)
E) Systemic Lupus Erythematosus (SLE)

69. A 64-year-old patient complains of limited mobility in the distal

interphalangeal joints of both hands, which arose about 12 years ago and is
gradually progressing. On examination, attention is drawn to the Heberden’s and
Boucher’s nodules in the region of the distal interphalangeal joints of both hands,
the fingers are deformed, and the mobility in them is limited. No pathology was
revealed on the part of the internal organs. What disease should you think about?
A) Systemic sclerosis (Ssc)
B) Rheumatoid Arthritis (RA)
C) Acute Rheumatic Fever (ARF)
D) Osteoarthritis (OA)
E) Systemic Lupus Erythematosus (SLE)

70. A 47-year-old patient has the following combination of symptoms: early

involvement in the process of the metatarsophalangeal joint of the big toe, during
the period of exacerbation, sharp redness, deformed joints, fever, nephropathy,
attacks of renal colic, subcutaneous nodules on the ears and elbows. What disease
is it typical for:
A) Osteoarthritis (OA)
B) Rheumatoid Arthritis (RA)
C) Acute Rheumatic Fever (ARF)
D) Gout (podagra)
Е) Systemic sclerosis (Ssc)

71. A 49-year-old female patient was admitted to the rheumatology department due
to an exacerbation of rheumatoid arthritis, which she has been suffering from for 3
years, stiffness throughout the day. CBC: ESR - 40 mm/h. Increased CRP. What is
the degree of RA activity?
A) Early stage
B) Mile
C) Moderate
D) Severe
E) High severe

72. A 40-year-old patient has been under the supervision of a rheumatologist for a
long time. Symptoms: breathlessness, peripheral oedema. On physical
examination: cyanosis, hypertrophy of the left atrium and right ventricle. On
auscultation loud first heart sound, opening snap and mid-diastolic murmur at the
apex, atrial fibrillation. The auscultatory sing is typical for:
A) Mitral regurgitation
B) Mitral stenosis
C) Aortic regurgitation
D) Aortic stenosis
E) Tricuspid regurgitation

73. Specific laboratory test for Rheumatoid Arthritis (RA):

A) ESR (erythrocyte sedimentation rate) and CRP (C- reactive protein)
B) RF (rheumatoid factor) and ACP (anti- citrulline peptide)
C) ANA (ant inuclear antibodies) and CFK (creatinine phosphokinase)
D) Anticentromere and anti-topoisomerase-1 (Scl-70)
E) Antistreptolysin O (ASO) and anti-DNA-se B titer

74. Specific laboratory test for Systemic Lupus Erythematosus (SLE):

A) ESR (erythrocyte sedimentation rate) and CRP (C- reactive protein)
B) RF (rheumatoid factor) and ACP (anti- citrulline peptide)
C) ANA (anti-nuclear antibodies) and Anti-Sm
D) Anticentromere and anti-topoisomerase-1 (ScL-70)
E) Antistreptolysin O (ASO) and anti-DNA-se B titer
75. Specific laboratory test for Systemic sclerosis (Ssc):
A) ESR (erythrocyte sedimentation rate) and CRP (C- reactive protein)
B) RF (rheumatoid factor) and ACP (anti- citrulline peptide)
C) ANA (anti-nuclear antibodies) and Anti-Sm
D) Anticentromere and anti-topoisomerase-1 (ScL-70)
E) Antistreptolysin O (ASO) and anti-DNA-se B titer

76. Serological test for Acute Rheumatic Fever (ARF):

A) ESR (erythrocyte sedimentation rate) and CRP (C- reactive protein)
B) RF (rheumatoid factor) and ACP (anti- citrulline peptide)
C) ANA (anti-nuclear antibodies) and Anti-Sm
D) Anticentromere and anti-topoisomerase-1 (ScL-70)
E) Antistreptolysin O (ASO) and anti-DNA-se B titer

77. Specify the method of treatment for coarctation of the aorta:

A. aortic plastic
B. appointment of β-adrenergic blockers
C. prescribing angiotensin-converting enzyme inhibitors
D. reduction of physical activity
E. prescribing aldosterone receptor inhibitors

78. Which joints are affected by gout:

first metatarsophalangeal joint of the foot
proximal interphalangeal and metacarpophalangeal joints of the hands
most often develops on large joints - knees, hips, joints of the spine
distal interphalangeal and metacarpophalangeal joints of the hands
Atlanto-occipital joint

79. Laboratory indicator to diagnosis of dermatomyositis?

A. Anti-cyclic Citrullinated Peptide
B. Rheumatoid factor
C. creatine phosphokinase, myoglobin
D. Oxyproline
E. uric acid

80. A 27-year-old woman has noticed short-term blanching of the fingers for six
months, and during the last month - constant pain in the metacarpophalangeal and
wrist joints. Shortness of breath when walking and palpitations appeared. On
examination: the skin on the back of the hands, fingers, forearms is dense, shiny,
does not gather in a fold; The metacarpophalangeal and wrist joints are moderately
deformed due to edema. What is the most reasonable preliminary diagnosis:
systemic lupus erythematosus
systemic sclerosis
systemic vasculitis
acute rheumatic fever
dermatomyositis

81. In atherosclerosis, most of the changes in the arterial wall associated with the
formation of a fibrous plaque occur in:
A. intima of arteries
B. Media Arteries
C. Adventitia of arteriescarcinoidqy aneurysm
E. all layers of the vessel wall

82. An ECG sign of atrial fibrillation is:

A. The rhythm is correct, the P wave is negative in standard leads.
B. F waves with a frequency of less than 340 per minute, wide, the same amplitude
and duration, the same R-R intervals.
C. Polymorphic f waves of various amplitudes and widths, with a frequency of 350
to 700 per minute, unequal R-R intervals.
D. The presence of a QS wave in the chest leads.
E. P waves and QRS complexes have different frequencies.

83.Signs characteristic of heart failure in the systemic circulation:

A. shortness of breath
B. heartbeat
C. choking
D. hemoptysis
E. Edema

84. A 40-year-old man with complaints of headache, edema on the face, legs,
lower back, dull pain in the lumbar region, a decrease in the amount of urine
excreted. I fell ill a week ago, after severe hypothermia.
Physical exam: the face is pale, edematous. Pulse - 80 per minute, slightly tense.
BP 160/100 mm Hg. Art. Heart sounds are muffled, rhythmic. The abdomen is soft
and painless on palpation.
What disease should you think about?
A. renal amyloidosis
B. acute glomerulonephritis
C. exacerbation of chronic glomerulonephritisD. chronic pyelonephritis
E. Chronic Kidney Disease

85. What are the ways of transmission of viral hepatitis B:

A. Parenteral
В. with food
С. Water
D. Contact and household
E. airborne
86. The difference between liver cirrhosis and chronic hepatitis:
A. Syndrome of сholestasis
B. Syndrome of cytolysis.
B. Syndrome of hepatocellular failure.
D. Syndrome of portal hypertension.
Е. Syndrome of Jaundice.

87. The causative agent of acute rheumatic fever is:

Staphylococcus aureus.
Pseudomonas aeruginosa.
B-Hemolytic streptococcus group A.
fungus of the genus Candida.
Epstein-Barr virus.

88. A 45-year-old obese woman accidentally (during a dispensary examination)

revealed fasting glycemia of 9.2 mmol / l, glucosuria 3%, acetone in urine is not
detected. The patient's brother suffers from diabetes mellitus. The type of diabetes
in the patient:
A. type 1 diabetes mellitus;
B. type 2 diabetes mellitus;
C. type 2 diabetes mellitus is insulin dependent;
D. type 2 diabetes mellitus in young people (MODY);
E. secondary diabetes mellitus.

89. Patient L., 34 years old. Complains of excess body weight, increased fatigue,
recurrent pain in the right hypochondrium, worsening after eating. Body weight
has increased significantly 5 years ago after childbirth. Developed normally.
Menses from 13 years of age, regular. Objectively. Height - 168 cm, body weight -
96 kg. The deposition of subcutaneous fatty tissue is uniform.
Gluocosae test: on an empty stomach - 4.5 mmol / l, after 2 hours - 5.5 mmol / l
What disease can you think of?
A. Diabetes mellitus type 1
B. Metabolic syndrome
C. Diabetes mellitus type 2
D. Pheochromocytoma
E. Hypothyroidism

90. What pathomorphological changes are most typical for chronic pyelonephritis:
A. narrowing of the renal artery
B. diffuse inflammation of all or almost all glomeruli.
C. changes in the interstitium and renal tubules
D. microscopically changes in epithelial cells of the Shumlyansky-Bowman
capsule are found
E. deposition of immune complexes on the membrane.

91. The drugs of choice in the treatment of hypertension in patients with

myocardial infarction are:
A. Thiazide diuretics.
B. b-blockers.
C. Dihydropyridine slow calcium channel blockers.
D. Non-dihydropyridine blockers of slow calcium channels.
E. a-blockers.

92. A 60-year-old man came to the doctor with complaints of headache, heaviness
in the occipital region. From the anamnesis: Suffers from arterial hypertension for
more than 3 years, does not take antihypertensive therapy regularly. The maximum
rise in blood pressure is up to 150/100 mm Hg. Smokes. Heredity is burdened by
the mother. Physical exam: the general condition is satisfactory. BP 150/100 mm
Hg On the ECG:
Determine which CV risk is this patient?
A. Low risk
B. Moderate risk
C. High risk
D. Very high risk
E. No risk of developing CVD

93. Laboratory indicator to diagnosis of gout?

A. Anti-cyclic Citrullinated Peptide
B. Rheumatoid factor
C. creatine phosphokinase
D. Oxyproline
E. uric acid

94. The pathognomonic manifestation of dermatomyositis is

A. paraorbital edema with lilac ("heliotropic") erythema of the upper eyelid
B. erythema on open skin areas , reactive hyperemia of the skin of the fingers and
toes
C. poikiloderma
D. "whitening" of fingers and toes as a result of vasoconstriction
E. Raynaud's syndrome

95. Parietal cells of the gastric mucosa secrete:

hydrochloric acid
lactic acid
gastromucoprotein
mucin
Pepsinogen

96. Additional cells of the gastric mucosa secrete:

Mucin
Bicarbonates
Gastrin
Secretin
hydrochloric acid

97. A 55-year-old man complains of pain in the big toe, fever. It started suddenly.
What research method is needed for the patient?
A) ESR (erythrocyte sedimentation rate) and CRP (C- reactive protein)
B) RF (rheumatoid factor) and ACP (anti- citrulline peptide)
C) ANA (ant inuclear antibodies) and CFK (creatinine phosphokinase)
D) Uric acid
E) Antistreptolysin O (ASO) and anti-DNA-se B titer

98. Systemic scleroderma is characterized by:

A.Corvisart facies
B.Hippocrates face
C.mask-like facies
D.symptom of "butterfly"
E. paraorbital edema

99. To define diagnosis of dermatomyositis it is advisable to carry out:

A.biopsy of the skin-muscle flap
B.radiological examination
C.electromyogram
D.spirography
E.biochemical blood test

100. A 38-year-old patient was admitted to the clinic with a diagnosis of acute
pancreatitis. Indicate the most informative indicator in the diagnosis of the disease:

A. trypsinogen

B. blood amylase

C. aldolase

D. creatinine

E. cholesterol

101. What hormones are produced by в-cells of the pancreas?

Glucogon
pancreatic polipeptic
Insulin
Somatostatin
serotonin.
102. What hormones are produced by d-cells of the pancreas?
Glucogon
pancreatic polipeptic
Insulin
Somatostatin
serotonin
103. What hormones are produced by p-cells of the pancreas?
Glucogon
pancreatic polipeptic
Insulin.
Somatostatin
serotonin.
104. Which joints are affected by rheumatoid artritis:
first metatarsophalangeal joint of the foot
proximal interphalangeal and metacarpophalangeal joints of the hands
most often develops on large joints - knees, hips, joints of the spine
distal interphalangeal and metacarpophalangeal joints of the hands
Atlanto-occipital joint

105. Which joints are affected by osteoarthrosis/it:

first metatarsophalangeal joint of the foot
proximal interphalangeal and metacarpophalangeal joints of the hands
most often develops on large joints - knees, hips, joints of the spine
distal interphalangeal and metacarpophalangeal joints of the hands
Atlanto-occipital joint

106. The clinical manifestations of portal hypertension syndrome in liver cirrhosis

are:
jaundice, pruritus, istechia, nosebleeds
sleep inversion, asterixis, irritability
weight loss, increase in parotid glands, telangiectasia
polyuria, increased thirst, hypotension, bradycardia
ascites, splenomegaly, varicose veins of the esophagus, "medusa's head"

107. What changes in blood pressure are observed with Takayasu's disease:
malignant arterial hypertension
BP is higher on the arms than on the legs
difference in blood pressure on the hands of more than 10 mm Hg.
isolated systolic hypertension
collaptoid decrease in blood pressure

108. The defeat of the respiratory tract, lungs and kidneys are typical for?
Takayasu's disease
Wegener's granulomatosis
periarteritis nodosa
Behcet's disease
Goodpasture syndrome

109. A 25-year-old patient developed fever, erythema on the face, swollen lymph
nodes, pain in joints and muscles, and weight loss after sun exposure procedures.
After 6 months, she began to notice swelling on her face and legs. In OAM:
proteinuria, red blood cells in large numbers, casts. Your diagnosis //
lupus - nephritis
renal tuberculosis
amyloidosis of the kidneys
chronic glomerulonephritis x
chronic pyelonephritis

110. A 57-year-old man complains of weakness, malaise, shortness of breath on

exertion, abdominal pain, progressive numbness of the feet. Ill for 2 months,
during this time he lost almost 10 kg. The signs of mononeuritis of the right
median nerve are determined. Chest X-ray: cardiomegaly and signs of incipient
pulmonary congestion. Which test can confirm your diagnosis:
blood for rheumatoid factor
biopsy of musculocutaneous flap
determination of anti-nuclear antibodies
angiography of the vessels of the right hand
blood for lupus cells
111. The patient has dense nodules on the auricles. When examined, crystals of
uric acid were found in them. What are these formations called:
osteophytes
tophus
lymph nodes
calcifications
rheumatic nodules

112. In a patient with rheumatoid arthritis, radiographs of both hands show

periarticular osteoporosis, narrowing of the joint space, multiple usures and bone
ankylosis. What X-ray stage does this picture correspond to:
R 0 stage x
R stage I
R stage II
R stage III
R Stage IV

113. In a patient with rheumatoid arthritis, only periarticular osteoporosis is noted

on the radiographs of both hands. What X-ray stage does this picture correspond
to:
R 0 stage
R stage I
R stage II
R stage III
R stage IV

114. To assess the function of the thyroid gland, the most informative:
Thyroid scan
Determination of TSH in the blood
Lymphography
Determination of antibodies to thyroglobulin in the blood
Ultrasound examination of the thyroid gland

115. Which of the following indicators is the most informative in making a

diagnosis of pheochromocytoma:
potassium excretion
excretion of catecholamines x
plasma level of catecholamines
plasma sodium level
magnesium excretion

116. The main pathophysiological differences between type I diabetes mellitus

and type II diabetes mellitus are:
Absolute insulin deficiency
High level of c-peptide
Metabolic syndrome
Insulin resistance
Ketoacidosis resistance

117. Changes in the cardiovascular system characteristic of diffuse-toxic goiter:

severe bradycardia
paroxysmal tachycardia or / and atrial flutter
persistent sinus tachycardia and / or atrial fibrillation
rough systolic murmur at the apex of the heart
atrioventricular block

118. The decrease in iron stores in the body is primarily determined:

an increase in the content of erythrocyte protoporphyrin
decrease in serum ferritin
macrocytosis
decrease in the total iron-binding capacity
increase in urine iron content after administration of desferal.

119. Necessary factor for absorption of Vitamin B12

hydrochloc acid
gastrin
pepsin
gastromucoprotein
folic acid

120. Bone marrow changes characteristic of B-12-deficiency anemia

hypoplasia of hematopoiesis
increase in the number of myeloblasts
megaloblastic erythropoiesis
increase in the number of lymphocytes
hyperplasia of the erythroid origin

121. Choose the causative agent that most often causes the development of
nephritis:
staphylococci
beta-hemolytic streptococci
gonococci
viruses
mycoplasma

122. Indicate the most reasonable point of view on the pathogenesis of nephritis:
bacterial inflammation
aseptic inflammation
immune-allergic inflammation
viral inflammation
all of the above

123. Hemophilia A is characterized by:

leukemoid reaction
women suffer more often
erythremia
bleeding duration increased
presence of hemarthrosis

124. With hemarthrosis of the knee joints, increased bleeding, with the formation
of extensive hematomas, the presumptive diagnosis is:
hemorrhagic vasculitis
chronic lymphoblastic leukemia
hemophilia
Randu-Osler disease
acute leukemia

125. What are the changes in the bone marrow with B12 - deficiency anemia:
predominance of lymphocytes
normoblastic type of hematopoiesis
decrease in the number of megakaryocytes x
myeloid metaplasia
megaloblastosis

126. Which of the following gives reason to suspect chronic myeloid leukemia:
splenomegaly and hyperleukocytosis
enlargement of the liver and macrocytic hyperchromic anemia
enlargement of cervical lymph nodes and leukopenia
bleeding and itching
fever treatable

127. A disease for which it is most characteristic: hypochromia, microcytosis, low

levels of ferritin, serum iron, and a positive response to iron therapy:
thalassemias
B12-deficiency anemia
iron deficiency anemia
folate deficiency anemia
Minkowski-Shoffard disease

128. Patient G., 68 years old in the blood test: er-3.1 million, HB-93 g / l, CІ-1.1,
leuk-3.8 *10 9/l, thrombus-120 *10 9/l, reticulocytes - 0.4 %, ESR-14 mm / h.
What tactics of patient management is the most appropriate:
introduction of desferal
vitamin B12 prescription
prescription of iron preparations
introduction of platelet mass
introduction of fresh frozen plasma

129. Triggers for bronchial asthma include:

atopy and hereditary predisposition
non-infectious atopic allergens
cold air, physical activity, aerosols
viral infections
air pollutants

130. Age over 40 years, long history of smoking, progressive course, persistent
cough with phlegm are characteristic of:
bronchial asthma
COPD
cardiac asthma
carcinoid tumor
angioedema

131. Immunological research in bronchial asthma includes:

determination of IgE, setting of skin-allergic test
test with inhaled bronchodilators
IgG definitio2n
determination of IgA
determination of eosinophils in sputum

132. The main structural changes characteristic of decompensated chronic cor

pulmonale:
left ventricular hypertrophy
hypertrophy of the right ventricle
left ventricular dilatation
dilatation of the right ventricle
hypertrophy and dilatation of the right ventricle

133. What is the nature of pain in irritable bowel syndrome:

dull, pressing pain in the epigastrium, aggravated by eating
cramping pain decreasing after passing stool and gas
constricting chest pain, not associated with eating
aching pain in the left hypochondrium when eating fatty foods
constant dull pain unrelated to food intake
134. Which of the following diseases most often causes the development of
chronic pancreatitis:
chronic gastritis
chronic acalculous cholecystitis
gallstone disease
duodenal ulcer
stomach ulcer

135. Indicate the most frequent location of Helicobacterpylori:

antrum of the stomach
cardiac stomach
fundic stomach
small curvature of the stomach
greater curvature of the stomach

136. The main laboratory marker for hepatitis C is:

Anti-HAV IgM
anti-HCV IgM
Anti-HDV IgM
anti-HВV IgM
HbsAg
137. The main laboratory marker for hepatitis D is:
Anti-HAV IgM
anti-HCV IgM
Anti-HDV IgM
anti-HВV IgM
HbsAg

138. The main symptom of GORD:

Dysphagia
Burping
Heartburn
Diarrhea
Hiccups

139. Diabetes insipidus develops as a result of:

decrease in aldosterone
decrease in growth hormone
decrease in antidiuretic hormone
decreased adrenaline
decreased renin

140. A 16-year - old girl. A CBC test revealed over 20,000 leukocytosis.
Determine the next phase of the patient study:
A) Cytochemical
B) Bone marrow biopsy
C) Immunological
D) Genetic
E) Tissue biopsy

141. The major diagnostic criteria for acute rheumatic fever is:
polyarthritis
morning stiffness
rheumatoid nodules
arthralgia
ankylosis

142. The morphology of aplastic (secondary) anemia is characterized by:

A) Proliferation of pre-mature cells
B) Proliferation of the primitive stem cells
C) Proliferation of mature cells in the bone marrow
D) Increase in bone marrow cellularity
E) Decrease in bone marrow cellularity

143. Select the causes of thrombocytopenia:

A. Increased destruction of platelets.
B. Increase in bone marrow cellularity
C. Hemolytic jaundice.
D. Ischemic organ damage. X
E. High concentration of fibrinogen.

144. It is a sensitive marker of chronic kidney disease:

A.excretion of albumin
B. excretion of urea
C. excretion of uric acid
D. glucose excretion
E. excretion of bilirubin

145. Renovascular hypertension develops due to:

renal artery stenosis
hypoplasia of the kidneys
polycystic kidney disease
aortic stenosis
pyelonephritis

146. The ECG fragment recorded:

supraventricular extrasystole
monotopic ventricular extrasystole
ventricular extrasystole trigeminia
ventricular extrasystole bigeminia //
group ventricular extrasystole

147. The development of atherosclerosis and coronary heart disease is promoted

by:

hyperlipidemia
gammaglobulinemia
hypoprotenemia
creatininemia
hypoglycemia

148. A 47-year-old man has been complaining for two months of compressive pain
in the chest that occurs when walking at an average pace after 500 m, or when
climbing the stairs to the 3rd floor. What is the class of angina pectoris in the
patient?

first-onset angina
Prinzmetal angina (variant)
stable exertional angina FC II
stable exertional angina FC III
unstable angina

149. Patient I., 64 years old, complains of constricting pains of the sternum, not
dependent on breathing. Taking nitroglycerin is not effective. Required research
method to confirm the diagnosis:
ECG, troponin T
scintigraphy with Tl201
EchoCG with dobutamine
Exercise ECG
Holter ECG monitoring x

150. A characteristic X-ray picture with pneumococcal pneumonia:

infiltration of various sizes with an inhomogeneous internal structure
small focal infiltration against the background of increased pulmonary pattern
x
strengthening of the pulmonary pattern due to peribronchial interstitial seals
the upper lobes are more often affected
minor effusion

151. Hormon regulating thyroid function:

"Lacquer" language
aphthous stomatitis
koilonychia
thrombosis
funicular myelosis

152. A 20-year-old girl complains of joint pain, headaches, dizziness, fainting. The
pulse is not detected on the radial arteries. Blood pressure is increased, asymmetry,
systolic murmur at the navel is heard. What is your diagnosis?
A) glomerulonephritis
B) periarteritis nodosa
C) Takayasu's disease
D) Cohn's disease x
E) pyelonephritis
153. What disease is characterized by an increase in blood pressure in overweight
people with a moon-shaped face, uneven distribution of fat and crimson striae?
A) primary aldosteronism
B) Itsenko-Cushing's disease
C) pheochromacytoma
D) Takayasu disease
E) thyrotoxicosis

154. The "gold" standard for the diagnosis of renovascular arterial hypertension:
A) intravenous urography
B) ultrasound of the kidneys
C) radioisotope kidney scintigraphy
D) renal arteriography
E) CT of the adrenal glands

155. In a 36-year-old woman, an employee of a large hotel, in the summer, her

temperature 40 C, chills appeared. Physical exam: in the lungs with percussion
below the angle of the scapula on the right, there is a shortening of sound,
weakened vesicular breathing, moist fine bubbling rales. What presumably
pathogen can you think of ?
A. pneumococcus
B. Staphylococcus
С. Legionella
D. Klebsiella
E. fungus
156. Side effects of nitroglycerin:
ventricular premature contractions
vomiting
arterial hypertension
headache
difficulty urinating

157. The level of troponin I in the blood increases with:

acute MI
acute pneumonia
myocarditis
cardiopathies
pericarditis

158. Renovascular hypertension develops due to:

renal artery stenosis
hypoplasia of the kidneys
polycystic kidney disease
aortic stenosis
pyelonephritis of the kidneys

159. A 32-year-old man showed an increase in blood pressure up to 230/120 mm

Hg. and severe tachycardia. For several years, intermittent attacks of fear,
sweating, nausea, vomiting and headache, ending with polyuria, have been
disturbed. The increase in blood pressure is due to:
hyperthyroidism
pheochromocytoma
Itsenko-Cushing's syndrome
renovascular hypertension
chronic glomerulonephritis

160. ECG registered:

paroxysmal tachycardia
atrial fibrillation
atrial flutter
sinus tachycardia
ventricular fibrillation

161. Auscultatory data for an attack of bronchial asthma:

crepitus
dry wheezing
wet wheezing
pleural friction noise
bronchial breathing

162. Liver cirrhosis is most often a consequence:

hemochromatosis
viral hepatitis B and C
chronic heart failure
Konovalov-Wilson disease
alcoholic liver disease
163. Violation of the sequence of contraction and relaxation of the biliary tract and
the sphincter system is:
cholangitis
cholecystitis
dyskinesia
discrimination
cholestasis

164. The basis of the hepatopathogenic action of the hepatitis B virus is:
damage to hepatocytes directly by the virus
severity of the immune response to the introduction of the virus
stimulation of other infectious responses
impact on the hepatocyte of decay products of other tissues damaged by the virus
stimulation of lipogenesis

165. The cause of hemorrhagic syndrome in liver cirrhosis is:

decrease in albumin content
increase in the content of globulins
decrease in prothrombin
increased prothrombin
increased vascular permeability

166. A 55-year-old patient suffering from obesity developed pains and crunching
in the knee joints, increasing in the evening. What is the diagnosis:
rheumatoid arthritis
rheumatoid arthritis
systemic lupus erythematosus
osteoarthritis
Gout
167. A 28-year-old woman has for the first time in her life atrial fibrillation with a
heart rate of up to 130 per minute. Objectively: pale, blush on the cheeks, loud I
tone at the top. The ECG shows right ventricular hypertrophy, atrial fibrillation.
Your preliminary diagnosis:
myocarditis
thyrotoxicosis
mitral stenosis
atherosclerotic cardiosclerosis
myocardial dystrophy

168. The patient is diagnosed with rheumatoid arthritis. What change can be
detected when examining this patient:
tophus
Bouchard's nodules
Heberden's nodules
ulnar deviation
Sclerodactyly

169. The patient has an acute attack of gout. To relieve pain, you should prescribe:
colchicine
quinidine
aspirin
prednisolone
delagil

170. With hypothyroidism, there is:

bradycardia
Weight loss
Irritability
Diarrhea
Tachycardia

171. Used in the treatment of hypothyroidism:

Mercazolil
Thyroxine
Methimazole
Thiamazole
Propicil

172. Pathogenetic therapy for thyrotoxicosis:

antistramine
adiurecrine
mercazolil
thyroidin
adrenalin

173. In the treatment of type 2 diabetes mellitus, the following can be used:
Veroshpiron
β-blockers
lisinopril
glibenclamide
Insulin

174. Atherosclerotic changes in diabetes mellitus are primarily detected in the

vessels:
coronary
spleen
kidney
lower limbs
brain

175. The pathogenesis of insulin-dependent diabetes mellitus is due:

destruction of β -cells
disorders of the receptor apparatus of β-cells
hormonal insulin antagonists
non-hormonal insulin antagonists
decreasing the number of insulin receptors
176. Causes of hypoglycemic coma:
stopping insulin administration
excessive insulin delivery
carbohydrate abuse
administration of glucocorticoids
intravenous glucose

177. A 23-year-old patient was admitted to the clinic unconscious. The skin is dry,
the cheeks are flushed. In the exhaled air there is a pungent smell of acetone. In the
blood sugar is 28.4 mmol / l, in urine 6%, the reaction to acetone is sharply
positive. Diagnose:
ketoacidotic coma
hyposmolar coma
lactocytic coma
cerebral coma
hypoglycemic coma

178. Male 45 years old. I went to the doctor with complaints of dry mouth, thirst,
overweight. Blood glucose level up to 7.0 mmol /l. physical exam: satisfactory
condition. Increased nutrition (height - 168 cm, weight - 102 kg.). The skin is dry,
pale, impure, acne on the face. Your preliminary diagnosis.
Itsenko-Cushing's syndrome
type 2 diabetes mellitus
metabolic syndrome
type 1 diabetes mellitus
hypothyroidism

179. What type of bleeding is typical for hemophilia:

hematoma
in the form of petechiae
petechial-spotted
angiomatous
mixed

180. Vitamin B 12 is absorbed:

in the stomach
in the proximal ileum
in the distal ileum
in the small intestine
in the duodenum

181. The most effective method for stopping bleeding in hemophilia is the
appointment:
thromboplastin
cryoprecipitate
E - aminocaproic acid
glucocorticoids
plasma substitutes
182. Laboratory indicator, when changing which the diagnosis of B12-deficiency
anemia becomes undoubted:
increasing the color index
decrease in the number of erythrocytes
erythrocyte macrocytosis
bone marrow megaloblastosis
decrease in the number of leukocytes

183. Treatment for B-12 deficiency anemia:

course appointment of pyridoxine
the use of glucocorticosteroids
use of cyanocobalamin
combination of cyanocobalamin with iron preparations
plasma transfusion

184. The diagnostic sign of acute leukemia is:

combination of anemic and hemorrhagic syndromes
combination of septic-necrotic and anemic syndromes
blast transformation of bone marrow (blastosis more than 30%)
presence of Berezovsky-Sternberg cells in lymph node punctures
presence in peripheral blood of Botkin-Gumprecht shadows

185. The most reliable sign of chronic renal failure is:

arterial hypertension
hyperkalemia
increased blood creatinine
oliguria
anemia
186. With lymphadenopathy and the presence of blasts in the blood, it can be
assumed:
aplastic anemia
acute lymphocytic leukemia
lymphogranulomatosis
hemolytic anemia
Infectious mononucleosis

187. For duodenal ulcer disease are characterized by:

the onset of pain in 1.5-2 hours. after eating
pain in the right hypochondrium
pain in the left hypochondrium
pain on an empty stomach and at night
the onset of pain 30 minutes after eating x

188. Hormon regulating thyroid function:

ACTH
Melanocyte-stimulating hormone
Thyroid stimulating hormone
Cortisol
Somatostatin

189. Pain in angina pectoris differs from pain in myocardial infarction:

localization
irradiation
intensitу
character
provoking factors
190. Cold skin of a gray-pale color, covered with sweat, a threadlike pulse, a
decrease in systolic pressure in a patient with myocardial infarction are
manifestations:
pulmonary edema
circulatory failure in a large circle
cardiogenic shock
rhythm disturbances
impaired cerebral circulation
191. Patient K., 46 years old, suddenly on the street felt pain in the epigastric
region, nausea, vomiting twice. The patient was taken to the infectious diseases
hospital. After gastric lavage, the condition worsened. ECG: QS II, III, aVF, ST
elevation. Your diagnosis:
salmonellosis
acute gastritis
myocardial infarction
acute pancreatitis
food poisoning

192. Patient 3., 46 years old, was delivered by an ambulance in a serious condition
with complaints of general weakness. examination: the e, moist, gray cyanosis,
cold extremities. Muffled heart sounds, gallop rhythm, heart rate 110 / min. BP
85/55 mm Hg Oliguria - less than 20 ml / hour. ECG: sinus tachycardia, QS V1-
V6, ST segment V1-V6 as a monophasic curve. This picture of the disease
corresponds to:
hypovolemia
cardiogenic shock
acute blood loss
variant angina x
acute renal failure
193. In a patient with a heart defect presenting with episodes of loss
consciousness against the background of physical activity, an intense systolic
murmur is heard over the entire surface of the heart. ECG - left ventricular
hypertrophy, otherwise unremarkable. What defect do you diagnose:
mitral stenosis
mitral regurgitation
aortic regurgitation
aortic stenosis
tricuspid regurgitation

194. When examining the patient, the displacement of the apical impulse to the left
was established, the borders of the heart were displaced to the left and upward, the
heart waist was smoothed. On auscultation - at the apex, a weakening of the I tone,
there is also a systolic murmur, an accent of the II tone over the pulmonary artery.
Your diagnosis:
mitral stenosis
mitral regurgitation
aortic regurgitation
aortic stenosis
tricuspid regurgitation

195. Patient A., 53 years old, a hairdresser, has been complaining of pain in the
knee joints for 5 years, which intensifies in the evening. A patient with increased
nutrition, in the area of the distal interphalangeal joints of the hands - nodules,
knee joints are enlarged and deformed. When moving, there is a crunch in the knee
joints. X-ray of the knee joints: a narrowing of the joint space, osteophytes in the
area of the condyles of the femur and tibia were found. Your diagnosis:
eforming osteoarthritis
acute rheumatic fever
rheumatoid arthritis
ankylosing spondylitis
gout
196. Such phenomena as fever, polyneuritis, hypertension, broncho-obstructive
syndrome are most characteristic:
for systemic lupus erythematosus
for systemic sclerosis
for periarteritis nodosa
for acute rheumatic fever
for infective endocarditis

197. A 52-year-old man complains of malaise, general weakness, erymatous rash

on the upper eyelids and on the hands. Sick for about 3 months, in the last 2 weeks
there were arthralgias and weakness in the proximal muscle groups. In a blood test:
an increase in CPK. Probable diagnosis:
polymyositis
dermatomyositis
hypothyroidism x
myasthenia gravis
Cohn's syndrome

198. The combination of the defeat of the small joints of the hand with morning
stiffness and the subsequent development of deformities is characteristic of :
systemic scleroderma
systemic lupus erythematosus
rheumatoid arthritis
polyarteritis nodosa
hemorrhagic vasculitis
199. A patient with rheumatoid arthritis on the X-ray of both hands shows
periarticular osteoporosis, narrowing of the joint space and single usuria. What X-
ray stage does this picture correspond to:
R 0 stage
R stage I
R stage II
R stage III x
R stage IV

200. A patient with rheumatoid arthritis on radiographs of both hands shows

periarticular osteoporosis, narrowing of the joint space and multiple usuria. What
X-ray stage does this picture correspond to:
R 0 stage
R stage I
R stage II
R stage III
R stage IV

201. In a patient with COPD, the following indicators were recorded during
spirography: FEV1 / FVC 50%. FEV1 -40%. Determine the severity of the course
of the disease:
heavy
easy
medium
extremely hard
cannot be estimated according to these indicators

202. The main instrumental method to confirm the diagnosis of COPD is:
chest x-ray
general sputum analysis
ECG
fibrobronchoscopy
spirography

203. Which of the following diseases is characterized by the reversible nature of

the syndrome of bronchial obstruction:
bronchiectasis
COPD
bronchial asthma
pulmonary embolism
obstructive pulmonary emphysema

204. The drugs of choice in patients with COPD category D are:

short-acting bronchodilators
long-acting bronchodilators
a combination of two long-acting bronchodilators x
theophylline preparations
combination of two bronchodilators with inhaled steroid
205. In a patient with AIDS, complaining of dry cough, shortness of breath and
fever, the X-ray showed increased pulmonary pattern and bilateral small-focal
shadows, mainly in the central parts of the lungs. What kind of pneumonia in this
case should you think about:
pneumonia with immunodeficiency
community-acquired
aspiration
nosocomial
interstitial

206. The most common cause of the thoracodiaphragmatic form of chronic cor
pulmonale is:
chest deformity
lung cancer
primary pulmonary hypertension x
recurrent pulmonary embolism
myocardial infarction

207. The following mechanisms are involved in the pathogenesis of broncho-

obstructive syndrome in bronchial asthma:
laryngospasm
decrease in surfactant x
bronchospasm
enhanced collagen synthesis
pulmonary fibrosis

208. An 80-year-old patient was admitted to the department with a diagnosis of

acute posterior myocardial infarction. During the observation period, the patient
periodically experiences episodes of loss of consciousness with epileptiform
seizures and Cheyne-Stokes-type breathing. On the ECG, the P waves are not
associated with QRS complexes with a rigid interval, the duration of the interval is
PP = 0.8 s, RR = 1.5 s. Heart rate = 35 / min. Presumptive diagnosis:

Epilepsy x
atrial fibrillation
complete atrioventricular block
ventricular tachycardia
ventricular premature beats

209. A 50-year-old patient in the last year notes pain in the upper third of the
sternum at night, which lasts about 15 minutes, disappears on its own or after
taking nitroglycerin, pain not associated with exercise. BP - 120/80 mm Hg. Art.,
pulse 92 beats per minute, resting ECG without pathological changes. On the ECG
during an attack of pain, an elevation of the ST segment in the chest leads was
recorded. The patient should be assigned:
 ACE inhibitors
calcium antagonists
β-blockers
angiotensin II receptor blockers (sartans)
diuretics

210. The absolute diagnostic criteria for arterial hypertension in

pheochromocytoma is:
increase in plasma concentration of aldosterone x
signs of an adrenal tumor and overproduction of catecholamines
high urinary 5-hydroxyindoleacetic acid
low level of catecholamines in the blood flowing through the renal veins, and
their concentration in urine
lack of the hypotensive effect of beta-blockers

211. Arterial hypertension of the first degree (recommendations of WHO / MTF

experts) mm Hg:
systolic blood pressure 140-159, diastolic - 90-99
systolic blood pressure lower 120, diastolic - lower 85
systolic blood pressure lower 120, diastolic – lower 90
systolic blood pressure lower 140, diastolic – lower 90
systolic blood pressure 140-150, diastolic - 94-100

212. Second-degree arterial hypertension (WHO / MTF experts) mm Hg:

systolic blood pressure 160-179, diastolic - 100-109
systolic blood pressure 140-150, diastolic - 94-100
systolic blood pressure 140-159, diastolic - 90-99
systolic blood pressure 150-160, diastolic - 94-100
systolic blood pressure 160-180, diastolic - 94-100

213. Arterial hypertension with massive proteinuria and decrease in glomerular

filtration is the most character for:
cystitis
pyelonephritis
urolithiasis
glomerulonephritis
circulatory disorders of the kidneys

214. Definition of sinus bradycardia:

blocking the impulses of the sinus-atrial node
deceleration of the heart rate less than 60 in 1 minute
deceleration of the heart rate less than 80 in 1 minute
strengthening the automatic function of the AV node
increase in heart rate more than 140 per minute
 215. Definition of sinus tachycardia:
blocking the impulses of the sinus-atrial node
deceleration of the heart rate less than 60 in 1 minute
deceleration of the heart rate less than 80 in 1 minute
increase in heart rate more than 90 per minute
strengthening the automatic function of the AV node

216. A patient with alcoholic cirrhosis of the liver developed a pronounced

edematous-ascitic syndrome. Bed rest, salt-free diet and limitation of fluid intake
to 1000 ml per day for 3 days did not lead to a decrease in edema. What measures
should be taken:
veroshpiron in increasing doses
paracentesis
intravenous lasix
taking hypothiazide
taking uregit

217. A 56-year-old patient complains of heartburn and chest pain arising after
eating, when working in an incline, wearing a tight belt. She was observed by a
cardiologist for chest pain, took nitrates, but did not notice any improvement. Most
likely diagnosis:
rest angina
gastroesophageal reflux disease
progressive angina
achalasia of the cardia
dyskinesia of the esophagus

218. A 38-year-old patient developed yellowness of the skin and mucous

membranes, pruritus in the evening, xanthomatosis, an increase in total bilirubin
mainly due to the direct fraction, an increase in the level of alkaline phosphatase,
cholesterol. Most likely diagnosis:
acute hepatitis
primary biliary cirrhosis
chronic hepatitis
Gilbert's syndrome
chronic pancreatitis

219.Indicate the main clinical symptoms characteristic of peptic ulcer of the

antrum of the stomach:
paroxysmal pain in the right hypochondrium
pain after eating in the epigastric region
persistent epigastric pain, fever, melena
"Dagger pain" in the epigastrium
"Pain on an empty stomach", "night" pain in the epigastric region
220. Specify the optimal combination of drugs for the treatment of duodenal ulcer
НР(+):
omeprazole + bismuth subcitrate (de-nol)
omeprazole + amoxicillin + clarithromycin
domperidone (motilium) + rabeprazole (pariet)
maalox + famotidine
omeprazole + trichopolum + tetracycline

221. A 45-year-old woman, 2 days ago after drinking alcohol, sour cream,
mushrooms, developed intense pain in the epigastrium, radiating to the back,
nausea, vomiting, loose stools of gray-yellow color. The most common causes of
this condition is:
hyperparathyroidism
smoking
alcohol
hyperlipidemia
opisthorchiasis

222. The most specific sign of type B gastritis is:

defeat of the antrum
more frequent affection of young people
high gastrin levels
pronounced inflammatory changes in the gastric mucosa x
detecting the presence of H. pylori

223. A 64-year-old woman, suffering from peptic ulcer disease, has been losing 10
kg and has growing weakness for two months. Black stools have appeared in the
last 2 weeks. The skin is pale. Most likely source of bleeding:
stomach
small intestine
colon
rectum
varicose veins of the esophagus

224. Melena is called:

uniform brown-colored stool
decorated chair in black
unformed, irregular brown stool
unformed uniform black stool
loose stools mixed with fresh blood

225. Patient Н., 55 years old, was admitted to the emergency room with
complaints of a sharp headache, nausea, vomiting, pain in the right
hypochondrium. Two years ago he had a severe form of hepatitis A. Indicate which
research method is necessary to clarify the diagnosis:
 liver function tests
diastasis of urine
blood amylase
blood sugar
ECG

226. Amilorrhea is an appearance in the feces:

Starch +
neutral fat
squirrel
blood x
slime

227. Creatorrhea is an appearance in the feces:

Starch
undigested fibers of muscle and connective tissue
neutral fat
squirrel
slime

228. Steatorrhea is an appearance in the feces:

undigested fibers of muscle and connective tissue
starch
squirrel
neutral fat
slime

229. Manifestation of intrasecretory pancreatic insufficiency:

hyperglycemia +
steatorrhea
polyfecalia
weight loss x
diarrhea

230. Hepatic coma develops as a result:

extensive fibrosis
prolonged venous stasis in the liver
massive necrosis of liver cells
microcirculation disorders with thrombus formation
use of hepatoprotectors

231. The earliest sign of primary biliary cirrhosis is:

splenomegaly
dyspeptic phenomena
pain in the right hypochondrium
 itchy skin
hemorrhagic syndrome

232.When the ulcer penetrates into the pancreas, the blood level rises:
amylase activity
lipase activity
glucose level
alkaline phosphatase activity
AST, ALT

233. The patient complains of epigastric pain, appearing 1.5-2 hours after eating
and on an empty stomach. What pathology is this symptom supposed to indicate:
chronic gastritis
stomach ulcer
duodenal ulcer
cholecystitis
pancreatitis

234. A 19-year-old patient developed acute rheumatic fever after a sore throat.
Prescribe a drug for secondary prevention:

vitamins (ascorbic acid)

long-acting penicillins (extencillin)
NSAIDs (acetylsalicylic acid)
glucocorticosteroids (prednisone)
cardiac glycosides (digoxin)

235. A 25-year-old patient has critical mitral stenosis without decompensation.

What is the most preferable management tactic for this patient:
outpatient observation
bicillin therapy
inpatient treatment with antibiotics
cardiac glycoside treatment
surgical treatment

236. A 37-year-old woman complains of bruising, an increase in blood pressure to

170/105 mm Hg, and headaches. On examination - height 158 cm, weight 79 kg,
purple-cyanotic striae, moon-shaped face. On MRT of the brain, formation of
0.30.3 mm, MRT of the adrenal glands - adrenal hyperplasia. Is the test the most
suitable for differential diagnosis?
with synactin depot
with metyrapone
with dexamethasone
with desmopressin
with dipyridamole
237. A 32-year-old man was admitted with complaints of muscle weakness, thirst,
frequent urination, headache, convulsions. These complaints have been troubling
for a year. It is treated by a cardiologist for hypertension, without effect. Height -
180 cm.Weight - 76 kg. Heart rate - 56 / min. BP- 170/105 mm Hg. Art. Test
results: potassium - 2.5 mmol / l, sodium - 150 mmol / l, chlorine - 95 mmol / l.
The specific gravity of urine is 1007, protein is 0.033 g / l. What is the most
probable diagnosis?
primary hyperaldosteronism
arterial hypertension
chronic pyelonephritis
diabetes insipidus
hypoparathyroidism

238. A 45-year-old woman was hospitalized with complaints of severe headache,

palpitations, sweating. Notes a periodic increase BP. Taking antihypertensive
drugs is not effective. BP 220/120 mm Hg, pulse 110 per minute. What is the most
probable diagnosis?

diabetes
myocardial ischemia
pheochromocytoma
ischemic stroke
arterial hypertension

239. Hormones are transported to target organs using:

proteins
fat
carbohydrates
glycoproteins
vitamins

240. Pathognomonic symptom for thyrotoxicosis:

low temperature
dry skin
exophthalmos
bradycardia
pasty face

241. A young woman consulted a doctor with complaints of a constant heartbeat,

increased blood pressure, weight loss, loose stools, sweating, bulging, an enlarged
thyroid gland. Objectively: Fidgety, excited. Weight deficit - 18 kg. Heart rate -
115 beats per minute. The thyroid gland is enlarged to 3 degrees, dense, painless.
Your preliminary diagnosis:
 autoimmune thyroiditis hypertrophic form
diffuse toxic goiter
autoimmune thyroiditis, hasitotoxicosis x
endemic goiter
hypothyroidism

242. Patient K., 30 years old, came to the doctor's office with complaints of
lethargy, drowsiness, chilliness, constipation, shortness of breath during exercise.
Over the past 6 months, I have gained about 7 kg. Objectively: The condition is
satisfactory. The skin is pale, dry, scaly. The face is puffy, amimic. The voice is
low, hoarse. The thyroid gland cannot be palpated. Blood tests show hypochromic
anemia. Your preliminary diagnosis:

autoimmune thyroiditis
heart disease
diffuse toxic goiter x
hypothyroidism
endemic goiter

243. A 50-year-old patient with diabetes mellitus is undergoing regular medical

examination. Analysis of morning urine: relative density - 1.015, protein - 0.066
g / l, leukocytes - 20-23 in the field of view. Bacteria ++. This can be interpreted
as:

chronic glomerulonephritis
acute glomerulonephritis
chronic pyelonephritis
acute pyelonephritis
nephrotic syndrome

244. Anemia in chronic renal failure is caused by:

iron deficiency
vitamin B12 deficiency
autoimmune hemolysis
decrease in the synthesis of erythropoietins
folic acid deficiency

245. What is the level of GFR (glomerular filtration rate in ml / min) typical for
stage III b CKD (chronic kidney disease):
89 - 60
30 - 44
59 - 30
29 - 15
<15
246. What is the level of GFR (glomerular filtration rate in ml / min) typical for
stage III a CKD (chronic kidney disease):
45 - 59
30 - 44
59 - 30
29 - 15
<15

247. The study revealed a GFR of <15 (ml/min/1.73m2). This indicator

corresponds to what stages of kidney damage?
3 (moderate)
4 (severe)
5 (terminal)
2 (mild)
1 (normal or increased kidney function)

248. Aplastic anemia is characterized by:

megaloblastic type of hematopoiesis
funicular myelosis
pancytopenia
lacquer tongue
paresthesias

249. Patient Z., 19 years old, complains of bleeding gums, sore throat, weakness.
Objectively: body temperature 39˚. Pale skin, multiple petechiae and ecchymosis.
On the tonsils - necrotic plaque. Submandibular lymph nodes are enlarged. The
liver, spleen protrude from under the edge of the costal arch by 2 cm.In the blood:
er-2.5 * 10 12/l , HB-75 g/l, CI-0.9 leuk-29 *10 9/l, blasts-98%, segm- 2%,
thrombus-28 thousand, ESR-66 mm / h. Which of the following indicators is the
most informative to clarify the diagnosis:
ESR acceleration
anemia
leukocytosis x
blastemia
thrombocytopenia

250. Patient S., 60 years old, complains of weakness, epigastric pain, unstable
stool. General blood test: er-2.6*10 12/l, HB-104 g/l, CI-1.2 leuke-2.7 *10 9 /l,
thrombus-115 *10 9 /l, ESR-30 mm / h, macrocytosis, polysegmentation of
neutrophils. Bilirubin-38.5 μmol / L. Myelogram: megaloblastic type of
hematopoiesis. Which of the following diagnoses is the most likely:
aplastic anemia
Iron-deficiency anemia
Markiafava-Mikeli disease
 autoimmune hemolytic anemia
B12-deficiency anemia

251. In the differential diagnosis of hypoplastic anemia and immune

thrombocytopenia, the main research is:
general blood analysis x
trepanobiopsy
coagulogram
Ultrasound
bone radiography