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Quiz navigation Started on Wednesday, 7 June 2023, 2:16 PM

1 2 3 4 5 State Finished
Completed on Wednesday, 7 June 2023, 2:17 PM
6 7 8 9 10 Time taken 42 secs
Marks 0.00/150.00
11 12 13 14 15 Grade 0.00 out of 100.00

16 17 18 19 20 Question 1 A 48-year-old man was brought to the doctor in

Not answered an unconscious state. A history of alcohol abuse.
21 22 23 24 25 During the examination, the skin is pale, there are
Marked out of
1.00 "vascular stars" on the body, a liver odor from the
26 27 28 29 30 Flag mouth, and the tongue is covered with a brown
question coating. The subcutaneous veins of the front
31 32 33 34 35 abdominal wall are dilated in the form (caput
medusae). When palpating the organs of the
36 37 38 39 40 abdominal cavity, there is a positive symptom of
fluctuation, hepatomegaly, splenomegaly. Swelling
41 42 43 44 45 of the lower extremities. What is the most
probable condition of the patient?
46 47 48 49 50
Select one:
51 52 53 54 55 A. Hypoglycemic coma

B. Acute gastrointestinal bleeding

56 57 58 59 60
C. Acute liver failure
61 62 63 64 65
D. Hyperglycemic coma

66 67 68 69 70 E. Perforating stomach ulcer

71 72 73 74 75
The correct answer is: Acute liver failure
76 77 78 79 80

81 82 83 84 85
Question 2 A 58-year-old woman with sensorineural deafness
Not answered as a result of a complication after purulent
86 87 88 89 90
Marked out of meningitis plans to install a cochlear implant.
1.00 Vaccination against which infection is necessary
91 92 93 94 95
Flag to prevent infectious diseases of the central
question nervous system and hearing organs?
96 97 98 99 100

Select one:
101 102 103 104 105
A. Tick-borne encephalitis virus

106 107 108 109 110 B. Tuberculosis after a negative Mantoux test
result
111 112 113 114 115 C. Pneumococcal infection

116 117 118 119 120 D. Poliomyelitis

E. Hemophilic infection
121 122 123 124 125

126 127 128 129 130

The correct answer is: Pneumococcal infection

131 132 133 134 135

136 137 138 139 140 Question 3 A 47-year-old man is a worker in a weaving
Not answered workshop, has 15 years of experience in this
141 142 143 144 145 Marked out of industry, and works in conditions of high-
1.00 frequency, intense noise. During a periodic
146 147 148 149 150 Flag medical examination, he was diagnosed with
question "occupational deafness". What is the basis for
such a diagnosis?
Show one page at a time
Finish review Select one:
A. Work experience in this production

B. Results of the study of the condition of the

inner ear

C. Data of audiometry and hygienic

assessment of working conditions

D. Characteristics of noise at this production

E. The results of the study of indicators of the

central nervous system

The correct answer is: Data from audiometry and

hygienic assessment of working conditions

Question 4 After a Q-myocardial infarction, the patient is

Not answered troubled by shortness of breath with minor
Marked out of exertion, night attacks of dry cough, a feeling of
1.00 wheezing in the chest and orthopnea. During the
Flag examination: acrocyanosis, heart rate - 96/min.,
question tachycardia, weakening of the 1st tone above the
apex, the 3rd tone is heard. Voiceless wheezing in
the lungs in the basal parts. During
echocardioscopy, dilatation of the left ventricle,
thinning and dyskinesia of the interventricular
septum, ejection fraction - 39%. What variant of
myocardial dysfunction is the most likely?

Select one:
A. Mixed dysfunction of both ventricles

B. Diastolic dysfunction of the right ventricle

C. Systolic dysfunction of the right ventricle

D. Diastolic dysfunction of the left ventricle

E. Systolic dysfunction of the left ventricle

The correct answer is: Systolic dysfunction of the

left ventricle

Question 5 A 52-year-old patient complained of sudden

Not answered weakness and numbness in the left limbs,
Marked out of difficulty in walking. Objectively, left-sided
1.00 hemihypesthesia and mild hemiparesis were
Flag noted. After 4 hours, the patient's condition
question normalized, focal symptoms regressed, the
patient was able to walk normally. Blood pressure
- 120/80 mm Hg. What is the most likely
diagnosis?

Select one:
A. Transient ischemic attack

B. Associated migraine

C. Hypertensive crisis

D. Ischemic stroke

E. Hemorrhagic stroke

The correct answer is: Transient ischemic attack

Question 6 A 22-year-old woman in labor had continuous,

Not answered very painful cramps after her water broke.
Marked out of Objectively: the dimensions of the pelvis are 25-
1.00 28-31-21 cm, the weight of the fetus is 4200 g.
Flag The uterus is constantly in tone, the contraction
question ring is at the level of the navel. The lower segment
of the uterus is painful. During vaginal
examination: the cervix is fully open, there is no
fetal bladder, the fetal head fills the terminal line,
the sagittal suture is straight. Fetal heart rate -
136/min. What tactics of the doctor will be most
appropriate?

Select one:
A. Exclude labor and perform a caesarean
section

B. Perform a fertility-destructive operation

C. Apply obstetric forceps

D. Carry out vacuum extraction of the fetus

E. Make a combined rotation of the fetus on

the leg, followed by its extraction

The correct answer is: Exclude labor and perform

a caesarean section

Question 7 A 12-year-old boy came to the clinic with

Not answered complaints of palpitations, interruptions and pain
Marked out of in the heart, shortness of breath. These symptoms
1.00 most often occurred after physical exertion and
Flag ended with syncopal states. Later, the doctor
question diagnosed hypertrophic obstructive
cardiomyopathy. What drug is contraindicated in
the treatment of this pathology?

Select one:
A. Verapamil

B. Enalapril

C. Digoxin

D. Bisoprolol

E. -

The correct answer is: Digoxin

Question 8 The patient is 54 years old. During the year, he

Not answered was treated for an undifferentiated form of lung
Marked out of cancer. Currently, a feeling of heaviness and pain
1.00 in the right hypochondrium have joined. What
Flag diagnostic method will be the most informative in
question this case?

Select one:
A. Computed tomography of abdominal
organs

B. Ultrasound biolocation with targeted

puncture biopsy

C. Vasography of the liver

D. Radioisotope hepatography

E. Diagnostic laparoscopy

The correct answer is: Computed tomography of

the abdominal cavity

Question 9 A 16-year-old boy has multiple comedones,

Not answered follicular nodules, and pustules periodically
Marked out of appear against the background of increased
1.00 oiliness of the skin of the face, upper back, front
Flag surface of the chest. There are no subjective
question feelings. What is the most likely diagnosis?

Select one:
A. Pink eels

B. Vulgar sycosis

C. Furunculosis

D. Common acne

E. Secondary syphilis

The correct answer is: Common acne

Question 10 A study of the relationship between body

Not answered temperature and pulse rate was conducted on a
Marked out of representative population of flu patients. The
1.00 calculated correlation coefficient is +0.5. What is
Flag the most accurate characteristic of the strength
question and directionality of the connection between the
signs being studied?

Select one:
A. Average inverse

B. Weak straight

C. Medium straight

D. Strong straight

E. -

The correct answer is: Average straight line

Question 11 A 39-year-old patient complains of dizziness,

Not answered rapid fatigue. Three days ago, he was operated on
Marked out of for an active duodenal ulcer complicated by
1.00 bleeding. Operation - suturing of a bleeding ulcer.
Flag Objectively: the skin is pale. Blood pressure -
question 100/60 mm Hg, pulse - 98/min. In the blood:
erythrocytes - 2.8 . 10 12 /l, Hb - 76 g/l, CP - 0.8,
reticulocytes - 8%, platelets - 320 . 10 9/ l,
leukocytes - 9.0 G/l, erythrocyte sedimentation
rate - 20 mm/h. What is the most likely diagnosis?

Select one:
A. Hemolytic anemia

B. Acute posthemorrhagic anemia

C. Hypoplastic anemia

D. Neurocirculatory dystonia

E. B₁₂-deficiency anemia

The correct answer is: Acute posthemorrhagic

anemia

Question 12 A 23-year-old man turned to the doctor with

Not answered complaints of facial swelling, headaches,
Marked out of dizziness, decreased urine output, and brown
1.00 urine. The mentioned complaints appeared after
Flag the transferred pharyngitis. During the physical
question examination, body temperature is 37.4°C, blood
pressure is 170/110 mm Hg, pulse is 86/min.,
swelling on the face, pale skin. On auscultation,
the heart sounds are muffled, the accent of the II
tone over the aorta. What changes are most likely
to be observed in the general urinalysis?

Select one:
A. Erythrocyturia, proteinuria, hyaline
cylinders

B. Erythrocyturia, oxalaturia, erythrocyte

cylinders

C. Leukocyturia, proteinuria, epithelial

cylinders

D. Erythrocyturia, leukocyturia, leukocyte

cylinders

E. Hemoglobinuria, bilirubinuria, granular

cylinders

The correct answer is: Erythrocyturia, proteinuria,

hyaline cylinders

Question 13 A woman, 6-7 weeks pregnant, turned to a doctor

Not answered for women's consultation. From the anamnesis, it
Marked out of was found that he has been suffering from
1.00 diabetes in a severe form since the age of 15.
Flag According to the oculist's conclusion, retinopathy
question of the II century. Had 2 pregnancies that ended in
stillbirth. Blood sugar content - 15 mmol/l. During
a bimanual examination, it was established that
the uterus is enlarged (as in pregnancy, up to 7
weeks). What are the doctor's tactics?

Select one:
A. Genetic consultation

B. Consultation of an endocrinologist

C. Termination of pregnancy is indicated

D. Hospitalization in critical periods of

pregnancy

E. Prolongation of pregnancy under blood

sugar control

The correct answer is: Termination of pregnancy is

indicated

Question 14 The parents of a 2-year-old boy approached the

Not answered polyclinic with complaints about the absence of
Marked out of the right testicle in the child's scrotum. During the
1.00 examination, hypoplasia of the right half of the
Flag valve is revealed, the testicle is absent. It is
question reduced in size, palpable along the course of the
inguinal canal, but does not descend into the
portico. What is the most likely diagnosis?

Select one:
A. Right-sided cryptorchidism, inguinal form

B. Left-sided monarchism

C. Retraction of the right testicle

(pseudocryptorchism)

D. Ectopia of the right testicle, pubic form

E. Right-sided cryptorchidism, ventral form

The correct answer is: Right-sided

cryptorchidism, inguinal form

Question 15 The child is 8 years old. Complaints about body

Not answered temperature of 39.3°C, headache, vomiting. 1st
Marked out of day of illness. The skin is clean. The throat is
1.00 hyperemic. The tongue is coated. Conjunctivitis.
Flag Scleritis. Weakly expressed rigidity of the occipital
question muscles. Positive Kernig sign on the right. CSF:
cytosis - 340/µl, lymphocytes - 87%, neutrophils -
13%, protein - 140 mg/l. What would be the most
likely diagnosis?

Select one:
A. Arachnoiditis

B. Brain tumor

C. Serous meningitis

D. Purulent meningitis

E. Neurotoxicosis

The correct answer is: Serous meningitis

Question 16 A 27-year-old electrician was electrocuted by

Not answered touching bare electrical wiring with his hand.
Marked out of Blood circulation and breathing stopped.
1.00 Resuscitation measures ensured the recovery of
Flag cardiac activity after 5 minutes. Which of the
question complications is most likely a few hours or even
days after an electric shock?

Select one:
A. Acute liver failure

B. Pulmonary edema

C. Cessation of blood circulation

D. Acute renal failure

E. Stop breathing

The correct answer is: Cessation of blood

circulation

Question 17 A 20-year-old patient with symptoms of

Not answered polyarthritis came to the rheumatology
Marked out of department. Redness in the form of a "butterfly"
1.00 on the skin of the face. In urine: protein - 4.8 g/l.
Flag The doctor assumed that the patient had systemic
question lupus erythematosus. What additional research
method is the most informative for verifying the
diagnosis?

Select one:
A. Blood analysis for antinuclear antibodies

B. Immunological examination of blood

C. General blood test

D. Blood analysis for rheumatoid factor

E. Blood analysis for LE cells

The correct answer is: Blood test for antinuclear

antibodies

Question 18 During resuscitation measures, a 77-year-old

Not answered patient cannot perform chest compressions to a
Marked out of depth of 5-6 cm due to chest stiffness. What will
1.00 be your actions?
Flag
question Select one:
A. Place the pressure point in the direction of
the xiphoid process

B. Increase the frequency of clicks to 150

times per minute

C. Continue pressing with the previous force

D. Increase the force of pressing without

taking into account the risk of rib fracture

E. Reduce the pressure to prevent rib and

sternum fractures

The correct answer is: Increase the strength of the

presses, regardless of the risk of rib fractures

Question 19 A 35-year-old patient turned to the doctor with

Not answered complaints about the presence of a neoplasm on
Marked out of the skin of her right lower leg. Objectively: a nevus
1.00 of an irregular shape with a diameter of 1 cm,
Flag without clear boundaries, with a dry surface, dark
question brown in color. The diagnosis was established:
probable melanoma of the skin of the right lower
leg. What is the method of verifying the diagnosis
of skin melanoma?

Select one:
A. Positron emission tomography - computer
tomography (PET-CT)

B. Excisional biopsy

C. Smudge-imprint

D. Ultrasound examination (ultrasound)

E. Incisional biopsy

The correct answer is: Excisional biopsy

Question 20 A girl weighing 3100 g was born from her third

Not answered pregnancy at home. On the 3rd day, the mother
Marked out of noticed small hemorrhages in the umbilical
1.00 wound, as well as "red spots" on the sclera of the
Flag eyes. The mother was not registered for
question pregnancy in the prenatal period. Feeds the baby
with breast milk as needed. During physical
examination, subconjunctival hemorrhages.
During the laboratory examination, the
hemoglobin concentration is 155 g/l, the mother's
blood group is B (III) Rh-positive, the child's blood
group is A (II) Rh-negative. What tactic to prevent
the progression of this condition in a child would
be the most appropriate?

Select one:
A. Enter vitamin K

B. Administration of human anti-Rhesus Rh0

(D) immunoglobulin

C. Transition to artificial feeding with iron-

containing mixtures

D. Transfusion of erythrocyte mass

E. Prescribe oral iron preparations

The correct answer is: Enter vitamin K

Question 21 An eight-year-old child complains of a long wet

Not answered cough with the release of a large amount of
Marked out of sputum of a purulent nature with an unpleasant
1.00 smell, sometimes with an admixture of blood. The
Flag general condition is severe, the body temperature
question is 38.7°C, the skin is pale, perioral cyanosis,
fingers in the form of "drumsticks". Over the
lungs: weakened breathing, wet rales of various
calibers. X-ray: atelectatic areas. Which of the
examinations to clarify the diagnosis will be the
most appropriate?

Select one:
A. Bronchoscopy

B. Computed tomography with high resolution

C. -

D. Echocardiography

E. X-ray of OGK

The correct answer is: Computed tomography

with high resolution

Question 22 A 35-year-old woman complains of heart failure,

Not answered weight loss, pain in the front of the neck, which
Marked out of started after SARS. Pulse --- 110/min, blood
1.00 pressure --- 130/60 mm Hg. Art. The thyroid
Flag gland is slightly enlarged, painful on palpation.
question Laboratory revealed: ESR--- 40 mm/h. TSH ---
0.05 mU/l, T4 --- 34.3 pmol/l. What is the most
likely diagnosis?

a. Subacute thyroiditis

b. Hashimoto's thyroiditis

c. Paroxysmal tachycardia

d. Diffuse toxic goiter

e. Acute thyroiditis

The correct answer is: Subacute thyroiditis

Question 23 A 7-year-old boy was brought to the doctor with

Not answered complaints of pronounced total cyanosis with a
Marked out of purple tint, shortness of breath, which is relieved
1.00 in a squatting position with knees pressed to the
Flag abdomen. When examining fingers in the form of
question "drumsticks" and nails as "watch glasses",
auscultatory blowing noise over the pulmonary
artery. During instrumental examination, the
vertical axis of the heart is shown on the
electrocardiogram. On echocardiography,
pulmonary artery stenosis, right ventricular wall
hypertrophy, ventricular septal defect, aortic
dextroposition. What is the most likely diagnosis?

Select one:
A. Ventricular septal defect

B. Stenosis of the opening of the pulmonary

artery

C. Transposition of the main vessels

D. The ductus arteriosus is open

E. Tetralogy of Fallot

The correct answer is: Tetrada Fallo

Question 24 A 14-year-old student came to the family doctor

Not answered with complaints about scratches on her face
Marked out of caused by a neighbor's cat 2 days ago. When
1.00 examined, the scratches are superficial, covered
Flag with a scab. Primary surgical treatment of wounds
question was performed. It is known that the child received
all scheduled vaccinations according to the
calendar. What will be the next steps?

Select one:
A. Administration of anti-rabies vaccine

B. Administration of anti-rabies vaccine +

anti-rabies immunoglobulin

C. Observation of the animal

D. Administration of rabies vaccine + tetanus

toxoid

E. Administration of anti-rabies
immunoglobulin

The correct answer is: Observation of an animal

Question 25 On the shore of the sea you saw a young boy lying
Not answered on the ground. Goosebumps, sharply cyanotic
Marked out of skin, white foam on the lips. The pulse is frequent,
1.00 arrhythmic, breathing is not heard in the lungs.
Flag What will be the first actions at the pre-hospital
question stage?

Select one:
A. Remove mucus and foam from the mouth
and oropharynx, perform artificial
respiration

B. Provide a position with raised legs

 C. Make a sharp blow to the sternum

D. Rub and warm the patient

E. Leave alone, call an ambulance

The correct answer is: Remove mucus and foam

from the mouth and oropharynx, perform artificial
respiration

Question 26 During the last 6 months, the 23-year-old patient

Not answered became withdrawn, avoided communication with
Marked out of others, secluded himself, and talked to himself.
1.00 During the conversation with the psychiatrist, at
Flag first he hid his feelings, but then he told about
question special, unreal voices contained in himself
("nesting in the brain"). What are these perception
disorders?

Select one:
A. Pseudohallucinations

B. Illusions

C. Metamorphopsia

D. Hallucinations are real

E. Derealization

The correct answer is: Pseudohallucinations

Question 27 A 35-year-old patient was hospitalized with

Not answered attacks of fever, which were accompanied by
Marked out of sweating and recurred every 4 days. Objectively:
1.00 subicteric sclera, pale skin, liver enlargement by 2
Flag cm and its compaction, spleen enlargement by 5
question cm. What research will allow to verify the
diagnosis?

Select one:
A. Research on the activity of ALT and AST

B. Microscopy of a thick drop and blood

smear for malarial plasmodium

C. Biochemical analysis of blood

D. Serological examination of blood

E. Determination of the level of bilirubin in

blood serum

The correct answer is: Microscopy of a thick drop

and blood smear for malarial plasmodium

Question 28 A 49-year-old woman consulted a doctor with

Not answered complaints of headache, hot flushes to the head
Marked out of and neck, increased sweating, palpitations,
1.00 increased blood pressure up to 170/100 mm Hg,
Flag irritability, insomnia, tearfulness, memory loss,
question infrequent scanty menstruation, an increase in
body weight by 5 kg during the last six months.
What is the most likely diagnosis?

Select one:
A. Somatoform disorder

B. Premenstrual syndrome

C. Climacteric syndrome

D. Post-castration syndrome

E. Arterial hypertension

The correct answer is: Climacteric syndrome

Question 29 A 36-year-old woman consulted a doctor with

Not answered complaints of frequent urination, pain in the left
Marked out of side, nausea, and high temperature. During
1.00 physical examination, body temperature is 39.4°C,
Flag blood pressure is 120/80 mm Hg, pulse is 89/min,
question respiratory rate is 18/min, SpO₂ is 98% in room air.
On palpation, soreness in the left costovertebral
corner and left side. What would be the most
appropriate next step for the doctor in the
management of the patient?

Select one:
A. Start intravenous ceftriaxone

B. Prescribe trimethoprim-sulfamethoxazole
for 10 days

C. Administer nitrofurantoin orally for 10 days

D. Recommend taking a pregnancy test

E. Pass a general urinalysis and perform a

bacteriological examination of urine

The correct answer is: Take a general urinalysis

and perform a bacteriological examination of the
urine

Question 30 A 3-year-old child has been sick for 3 days. Fever,

Not answered cough, runny nose, conjunctivitis, photophobia, a
Marked out of whitish dot rash on the mucous membrane of the
1.00 gums and the inner surface of the cheeks and
Flag spotted enanthema of the hard and soft palate are
question observed. What disease can be diagnosed?

Select one:
A. Enterovirus infection

B. Acute respiratory viral infection

C. Herpetic infection

D. Infectious mononucleosis

E. Enter

The correct answer is: Кір

Question 31 The mother of a 1-year-old child complains of

Not answered constant intrusive, frequent, unproductive cough,
Marked out of sometimes leading to vomiting. During an
1.00 objective examination, the patient has rapid
Flag breathing, moderate retraction of the lower
question intercostal muscles, and an increase in the
anteroposterior size of the chest. Broncho-
obstruction appears during respiratory infections.
During the newborn period, he suffered meconium
ileus. Choose the primary examination:

Select one:
A. Studies of sweat chlorides

B. Research on chlamydia and mycoplasma

C. Genetic testing

D. X-ray of chest organs

E. CT scan of the lungs

The correct answer is: Examination of sweat

chlorides

Question 32 The employee was hospitalized for 16 days for

Not answered pneumonia. What is the procedure for issuing a
Marked out of certificate of incapacity for work in this case?
1.00

Flag Select one:

question
A. The attending physician from the day of
admission to the hospital for a maximum of
14 days

B. The supervising physician together with the

head of the department for the entire
period of treatment

C. The attending physician from the day of

admission to the hospital for a maximum of
5 days

D. According to the conclusion of the medical

and advisory commission for the entire
period of treatment

E. The supervising physician from the day of

admission to the hospital for a maximum of
10 days

The correct answer is: The supervising physician

together with the head of the department for the
entire period of treatment

Question 33 After a hemorrhagic stroke, the patient undergoes

Not answered a course of massage, physical therapy, and
Marked out of speech therapy to restore speech and movements
1.00 of the left lower and upper limbs. What type of
Flag prevention do these rehabilitation measures
question belong to?

Select one:
A. Public prevention

B. Secondary prevention

C. Primary prevention

D. Tertiary prevention

E. Individual prevention

The correct answer is: Tertiary prevention

Question 34 A 39-year-old woman went to the doctor for the

Not answered first time with complaints of heavy menstruation
Marked out of for 10-12 days. The last menstruation started 3
1.00 weeks ago and continues until now. From the
Flag anamnesis: the cycle was broken 3 months ago,
question childbirth - 2, abortions - 5. On examination: the
cervix is cylindrical, the eye is closed. Uterus and
appendages without pathological changes.
Discharges are bloody, excessive. What tactics of
the doctor will be most appropriate?

Select one:
A. Hemostatic therapy

B. Supravaginal amputation of the uterus

C. Cryocoagulation of the endometrium

D. Hormonal therapy

E. Scraping of the uterine cavity

The correct answer is: Scraping the uterine cavity

Question 35 A 24-year-old woman in labor is in the postpartum

Not answered period, the 4th day. The birth took place first, on
Marked out of time, without complications. The general condition
1.00 of the woman in labor is satisfactory. Body
Flag temperature - 36.6 o C. Ps - 78/min., rhythmic.
question Mammary glands in a state of swelling. The
bottom of the uterus is 2 cm below the navel. The
uterus is normal, painless. Blood lochia, moderate.
Defecation, urination is normal. What treatment
should be prescribed?

Select one:
A. Analgesics

B. Antibiotics

C. Estrogenic hormones

D. Uterotonic drugs

E. Drugs that stop lactation

The correct answer is: Uterotonic drugs

Question 36 A 49-year-old patient with a prolonged bronchial

Not answered asthma attack was hospitalized. Weak breathing in
Marked out of the lungs, a lot of dry wheezing. ChDR - 32/min.,
1.00 BP - 140/90 mm Hg, Ps - 90/min. An intravenous
Flag injection of 1 ml of adrenaline was made. The
question condition has not improved: shortness of breath
remains at 28/min., the number of dry wheezes in
the lungs has decreased. Blood pressure rose to
170/110 mm Hg, tachycardia 130/min. To provide
emergency aid, it is advisable to use:

Select one:
A. Intravenous verapamil

B. β-blockers IV

C. Corinfarus rozzhuvati

D. Atrovent through a nebulizer

E. Cordaron internally

The correct answer is: Verapamil IV

Question 37 A 55-year-old patient complains of defecation 3-4

Not answered times within 1-2 hours, mainly in the morning,
Marked out of after breakfast. Increased diarrhea is associated
1.00 with increased demands from the environment,
Flag anxiety, and anticipation of danger. Objectively:
question fussy, multilingual, overweight. The skin is
unchanged, the turgor is normal, the abdomen is
soft and painless. There are no changes in the
blood test; stool analysis: unformed, a small
amount of starch grains and muscle fibers,
leukocytes - 3-4 in p/z; colonoscopy without
pathology. Which drug would be most appropriate
to prescribe?

Select one:
A. Anaprilin

B. Ampicillin

C. Loperamide

D. Bisacodyl

E. Drotaverin

The correct answer is: Loperamide

Question 38 A 68-year-old patient turned to the doctor with

Not answered complaints about the presence of a tumor in the
Marked out of left mammary gland. During the examination in the
1.00 upper inner quadrant of the left mammary gland,
Flag there is a mass up to 2.5 cm in diameter, dense,
question lumpy, painless during palpation. Regional lymph
nodes are not enlarged. What is the most likely
diagnosis?

Select one:
A. Mastopathy

B. Cyst

C. Cancer

D. Fibroadenoma

E. Lipoma

The correct answer is: Раĸ

Question 39 A 72-year-old patient turned to the doctor with

Not answered complaints of tremors in the hands, more in the
Marked out of right, general stiffness, slowness of gait, speech,
1.00 difficulty in performing usual housework. During
Flag the physical examination, general bradykinesia,
question hypomimia, emprostotonus, "shuffling" gait,
acheirokinesis, rest tremor in the hands, D>S,
increased muscle tone of the plastic type,
"cogwheel" phenomenon, pronounced postural
instability. What drugs, first of all, should be in the
treatment scheme of this patient?

Select one:
A. Cholinolytics

B. Anticholinesterase drugs

C. Medicines that improve microcirculation

D. Medicines containing levodopa

E. Antidepressants

The correct answer is: Medicines containing

levodopa

Question 40 The patient developed an itchy skin rash 4 days

Not answered ago. Abdominal bloating, dull pain in the right
Marked out of hypochondrium, constipation bothers. The day
1.00 before, she ate smoked meat. Previously, similar
Flag reactions appeared after eating a significant
question amount of tomatoes, strawberries, chocolate.
Objectively: urticarial rash on the skin of the face,
trunk, limbs. The level of total IgE is normal. What
is the most likely diagnosis?

Select one:
A. Chronic urticaria

B. Pseudoallergy

C. Idiosyncrasy

D. Food allergy

E. Atopic dermatitis

The correct answer is: Pseudoallergy

Question 41 The parents of a 3-month-old child turned to the

Not answered orthopedist with complaints about the asymmetry
Marked out of of the skin folds of the right thigh. The
1.00 examination revealed: a different number of skin
Flag folds on the right and left thigh, their asymmetry,
question limitation of extension of the right lower limb bent
at an angle of 90 o in the hip and knee joints. What
is the most likely diagnosis?

Select one:
A. Dysplasia of the hip joint

B. -

C. Damage to the hip joint during childbirth

D. Congenital hip dislocation

E. Contracture of the hip joint

The correct answer is: Dysplasia of the hip joint

Question 42 A 43-year-old patient was hospitalized 2 months

Not answered after tonsillitis with complaints of shortness of
Marked out of breath, heart pain, dizziness, palpitations.
1.00 Objectively: the general condition is difficult.
Flag Breathing rate - 35/min., pulse - 100/min.,
question arrhythmic (extrasystole). Blood pressure - 145/60
mm Hg. Heart sounds are arrhythmic
(extrasystole), weakening of the first sound,
systolic murmur over the apex. The liver is
enlarged. ECG: sinus tachycardia, single
ventricular extrasystoles. Echocardiography of the
heart cavity is within normal limits, FV-50%. What
is the most likely diagnosis?

Select one:
A. Dilated cardiomyopathy

B. Dressler syndrome

C. Infectious pericarditis

D. Infectious myocarditis

E. Myocardial cardiofibrosis

The correct answer is: Infectious myocarditis

Question 43 In an eight-month-old child, tonic tension of facial

Not answered muscles, carpopedal spasm, and laryngospasm
Marked out of are noted, followed by generalized clonic
1.00 convulsions with loss of consciousness for several
Flag minutes. Positive symptoms of Khvostek,
question Trousseau, Lust. What emergency condition is
observed in the child?

a. Epileptic attack

b. Hypocalcemic (tetanic) convulsions

c. Affective respiratory convulsions

d. Choking and cyanotic attack

e. Febrile convulsions

The correct answer is: Hypocalcemic (tetanic)

convulsions

Question 44 A 45-year-old man turned to the doctor with

Not answered complaints of irritability, increased fatigue, weight
Marked out of loss, palpitations, heart failure. When palpating
1.00 the left lobe of the thyroid gland, a dense, elastic
Flag mass is palpable, painless, which moves along
question with the thyroid gland when swallowing. Positive
eye symptoms, exophthalmos, convergence
disorder. Blood pressure - 135/80 mm Hg, pulse -
110/min. An ultrasound examination of the thyroid
gland in the left lobe visualizes a hyperechoic
rounded mass measuring 2 x 3 cm, with clear
contours and a homogeneous structure. What
conclusion of the doctor after the examination will
be the most correct?

Select one:
A. Thyroid nodule

B. Acute thyroiditis

C. Thyroid cancer

D. Thyroid cyst

E. Diffuse toxic goiter

The correct answer is: Thyroid nodule

Question 45 A 46-year-old woman, who has been suffering

Not answered from hypertension for 5 years, developed a
Marked out of hypertensive crisis. Complaints about palpitations,
1.00 a feeling of pulsation in the head, heart rate -
Flag 100/min., blood pressure - 190/100 mm Hg.
question (hyperkinetic type of hemodynamics). Which drug
should be preferred?

Select one:
A. β-blocker

B. α-blocker

C. Dihydropyridine calcium antagonist

D. Diuretic

E. ACE inhibitor

The correct answer is: β-blocker

Question 46 The city is provided with drinking water from

Not answered underground artesian springs, which is
Marked out of characterized by high quality and purity. Which of
1.00 the listed methods of treatment of water obtained
Flag from underground interlayer pressure sources is
question provided by sanitary requirements?

Select one:
A. Coagulation

B. Decontamination

C. Bleaching

D. Desalination

E. Defluorination

The correct answer is: Decontamination

Question 47 A 28-year-old patient discovered a tumor in the

Not answered upper outer quadrant of the right mammary gland
Marked out of during a self-examination. During palpation, there
1.00 is a painless, hard, mobile mass in the mammary
Flag gland with a diameter of 2 cm, the peripheral
question lymph nodes are not changed. Ultrasound
examination of the mammary glands: in the upper
outer quadrant of the right mammary gland, a
volumetric formation of increased echogenicity, 21
x 18 mm in size. What is the most likely diagnosis?

Select one:
A. Breast cyst

B. Diffuse mastopathy

C. Mastitis

D. Fibroadenoma

E. Breast cancer

The correct answer is: Fibroadenoma

Question 48 The city has a centralized drinking water supply

Not answered system. Its source is a surface reservoir - a river,
Marked out of which according to water quality indicators
1.00 belongs to the II class of water sources. During
Flag the current laboratory control of water quality at
question the point "before the water enters the external
distribution network", the local SES recorded two
consecutive deviations of water quality according
to the indicators of epidemic safety. What is the
most likely reason for the deterioration of water
quality according to epidemic indicators?

Select one:
A. Unsatisfactory operation of water
treatment (main) facilities

B. Unsatisfactory transportation of the sample

to the laboratory

C. Deterioration of the sanitary condition of

the reservoir - river

D. Violation of sampling rules

E. Stagnation of water in the distribution

network

The correct answer is: Unsatisfactory operation of

water treatment (main) facilities

Question 49 A 42-year-old patient complains of a painful mass

Not answered in the left buttock, an increase in body
Marked out of temperature to 38.2°C. A week ago, she
1.00 completed a course of treatment for lumbar
Flag sciatica. Hyperemia, swelling in the upper outer
question quadrant of the left buttock. On palpation -
sharply painful compaction up to 6 cm in diameter
with softening in the center. Your previous
diagnosis:

Select one:
A. Purulent atheroma

B. Buttock carbuncle

C. Post-injection abscess

D. Abscessive furuncle

E. Subcutaneous paraproctitis

The correct answer is: Post-injection abscess

Question 50 A 35-year-old woman turned to the doctor with

Not answered complaints of increasing pain during menstruation
Marked out of during the 1st year. The duration of the menstrual
1.00 cycle is 28 days. Laparoscopic tubal ligation was
Flag performed 2 years ago. On palpation, the uterus is
question enlarged to 8 weeks of pregnancy, soft, painful.
The appendages on both sides are not enlarged,
they are painless on palpation. What is the most
likely diagnosis?

Select one:
A. Hydrosalpinx

B. Adenomyosis

C. Ectopic pregnancy

D. Polycystic ovaries

E. External endometriosis

The correct answer is: Adenomyosis

Question 51 The child's skin turned yellowish on the 3rd day of

Not answered life. The child was born weighing 3200 kg, body
Marked out of length 52 cm. Active. Puerile breathing above the
1.00 lungs. ChD- 36/min. Heart tones are rhythmic.
Flag Heart rate - 130/min. The stomach is soft. The
question liver protrudes from under the costal arch by 2
cm, the spleen is not palpable. Excretion in the
form of meconium. What is the most likely
diagnosis?
 Select one:
A. Hemolytic disease of newborns

B. Minkowski-Shofar anemia

C. Sepsis of newborns

D. Physiological jaundice

E. Biliary atresia

The correct answer is: Physiological jaundice

Question 52 A 48-year-old patient was hospitalized with

Not answered seizures. He has been suffering from a duodenal
Marked out of ulcer for many years. During the last month, he
1.00 has been vomiting daily, he has lost 20 kg.
Flag Objectively: the patient is exhausted. A "slap
question noise" is determined in the epigastric region. The
lower border of the stomach is at the level of the
comb line. Laboratory: total protein - 47 g/l; K - 2.1
mmol/l, Na - 118 mmol/l, Ca - 1.6 mmol/l, chlorides
- 82 mmol/l, hematocrit - 64%. What is the
previous diagnosis?

Select one:
A. Bleeding ulcer of the duodenum

B. Malignant stomach ulcer

C. Subcompensated stenosis of the

gatekeeper

D. Compensated stenosis of the gatekeeper

E. Decompensated stenosis of the gatekeeper

The correct answer is: Decompensated stenosis

of the goalkeeper

Question 53 A 64-year-old patient developed a feeling of

Not answered difficulty swallowing solid food with its retention in
Marked out of the middle of the esophagus during the last 2
1.00 months. Weight loss - 4 kg. The patient's father
Flag died of stomach cancer. Esophageal cancer is
question suspected. What research is most likely to verify
this pathology?

Select one:
A. FEGDS with biopsy

B. Breath urease test

C. X-ray contrast examination of the

esophagus and stomach

D. Intraesophageal pH-metry

E. Computer tomography of the chest

The correct answer is: FEGDS with biopsy

Question 54 A 35-year-old patient was brought to the

Not answered gynecological department of the oncology clinic
Marked out of with complaints of bloody discharge after sexual
1.00 intercourse. When examined in mirrors: an
Flag epithelial defect on the cervix around the external
question eye. Uterus, appendages and parameters without
pathological changes. A histological examination
of a cervical biopsy revealed cancer in situ. What
treatment would be most appropriate?

Select one:
A. Cryodestruction of the cervix

B. Radiation therapy

C. Extended extirpation of the uterus with

appendages

D. Cone-shaped electroexcision of the cervix

E. Chemotherapy treatment

The correct answer is: Cone-shaped

electroexcision of the cervix

Question 55 A 40-year-old patient was operated on for

Not answered phlegmon of the lumbar region. After the
Marked out of operation, his body temperature rose sharply to
1.00 38°C, signs of intoxication appeared, and the
Flag number of leukocytes in the blood increased. In
question the postoperative wound, which was almost
cleared of necrotic tissues and filled with
granulations, purulent secretions appeared, the
granulations became pale. What complication did
the patient have?

a. Allergic reaction

b. Putrid phlegmon

c. Besichov inflammation

d. Sepsis

e. Repeated phlegmon

The correct answer is: Sepsis

Question 56 A 31-year-old patient turned to the doctor with

Not answered complaints of an increase in lymph nodes on the
Marked out of left above the collarbone. Pain in the chest and
1.00 abdomen, itching of the skin at night. Sick for a
Flag year. Objectively: enlarged painless lymph nodes
question are palpable on the left in the supraclavicular area.
The liver and spleen are not enlarged. In the
blood: Hb - 70 g/l, leukocytes - 19.6 . 10 9 /l, eoz.-
1%, pal.- 8%, s.- 83%, lymph.- 2%, mon.- 6%,
erythrocyte sedimentation rate - 55 mm/h,
platelets - 58 . 10 9 /l. On Ro-graphy of the chest
cavity in the apex of the right lung, an infiltrate is
determined, which contrasts with the lung tissue.
What studies are most appropriate to conduct to
confirm the diagnosis?

Select one:
A. X-ray examination of the stomach

B. Lymph node biopsy

C. Urine analysis for Ben-Jones protein

D. Sternal puncture

E. Trepanobiopsy

The correct answer is: Lymph node biopsy

Question 57 A 52-year-old man consulted a doctor

Not answered complaining of episodes of unbearable pain in his
Marked out of thumb. During history taking, the physician
1.00 discovered that the patient had recently started
Flag taking hydrochlorothiazide. During the physical
question examination, swelling, erythematous and warm to
the touch skin were found on the left in the area of
the proximal interphalangeal joint of the first
finger. Laboratory analysis of synovial fluid
revealed sodium monourate crystals. What
recommendation should the doctor make
regarding the patient's diet?

Select one:
A. Reduce the use of grain products

B. Increase the consumption of dairy products

C. Reduce the consumption of meat products

D. Increase the consumption of vegetables

and fruits

E. No need to change the diet

The correct answer is: Reduce the consumption of

meat products

Question 58 A 42-year-old road accident victim was

Not answered hospitalized with a diagnosis of polytrauma,
Marked out of rupture of the spleen, fracture of the right hip.
1.00 Objectively observed: inhibited, skin covered with
Flag sticky cold sweat, pale. Breathing is shallow,
question frequent. Pulse --- 140/min, weak filling, BP ---
65/40 mm Hg, CVT --- 0. Surgical intervention
under intravenous anesthesia with artificial
ventilation is planned. What anesthetic should be
chosen for general anesthesia?

a. Sodium thiopental

b. Propofol

c. Ketamine

d. Sevoflurane

e. Isoflurane

The correct answer is: Кетамін

Question 59 A 3-month-old girl has diarrhea and hypotrophy.

Not answered She was born with a weight of 3300 g. From the
Marked out of age of 2 months, she was transferred to artificial
1.00 feeding with cow's milk. The skin is dry, the
Flag muscle tone is reduced, the stools are liquid,
question greenish, smelly. There is a lot of neutral fat in the
program. Sweat chlorides - 70 meq/l. What
disease is most likely?

Select one:
A. Celiac disease

B. Cow's milk protein intolerance

C. Disaccharide deficiency

D. Cystic fibrosis

E. Intestinal infection

The correct answer is: Cystic fibrosis

Question 60 A 7-year-old child was hospitalized with

Not answered complaints of an increase in body temperature up
Marked out of to 39.8 o C, lethargy, moderate headache,
1.00 vomiting. Meningeal symptoms were revealed
Flag during the examination. A lumbar puncture was
question performed. A liquid under high pressure was
obtained, transparent, cytosis of 450 cells in 1 µl
(mostly lymphocytes - 90%), glucose content -
2.6 mmol/l. What causative agent can cause a
disease in a child?

Select one:
A. Enterovirus

B. Pneumococcus

C. Meningococcus

D. Tuberculosis bacillus

E. Staphylococcus

The correct answer is: Enterovirus

Question 61 A 64-year-old patient has been suffering from

Not answered diabetes for 14 years. About three weeks ago, the
Marked out of skin of the distal phalanx and toe of the left foot
1.00 became cold, bluish-black. The pain is mild. The
Flag pulse on the arteries of the foot is not determined,
question on the popliteal artery it is preserved. Glycemia
level - 12.4 mmol/l. Ultrasound scan - stenosis of
the lower leg arteries, blood flow - collateral
compensated. Tibial-brachial index - 0.7. On the
x-ray of the foot - the destruction of the distal
phalanx of the first finger. Determine the degree
of diabetic foot according to Wagner:

Select one:
A. The first

B. Another one

C. Fourth

D. Fifth

E. The third

The correct answer is: Four

Question 62 An 18-year-old girl went to the doctor in the

Not answered evening with complaints of severe pain in the
Marked out of lower right, nausea and a single episode of
1.00 vomiting. In the morning, I visited the street food
Flag festival. The pain started 4 hours ago, began with
question the epigastrium and gradually moved to the right
iliac region. During physical examination, blood
pressure is 110/70 mm Hg, heart rate is 79/min,
respiratory rate is 16/min, temperature is 37.4°C.
When palpating the left lower quadrant of the
abdominal wall, pain occurs in the right.
Gynecological and rectal examination without
pathological changes. Laboratory data: leukocytes
- 12 10 9 /l, erythrocytes - 4.4 10 12 /l, hemoglobin
- 130 g/l, hematocrit - 39%, platelets - 225 10 9/l,
β-hCG - 2 mU/ml (norm - less than 5 mU/l in non-
pregnant women). What is the most likely
diagnosis?

Select one:
A. Tubal pregnancy

B. Embolism of mesenteric vessels

C. Food poisoning

D. Intestinal obstruction

E. Acute appendicitis

The correct answer is: Hostria appendicitis

Question 63 A 20-year-old woman complains of pain, an

Not answered unpleasant heavy feeling in the area of the heart,
Marked out of frequent heartbeat. ECG - without pathology.
1.00 Sedative drugs relieved the pain, but anxiety
Flag remained, the certainty of a serious heart disease,
question the fear of death, the expectation of another
attack and the fear of it. What is the leading
psychopathological syndrome?

Select one:
A. Hypochondriac

B. Cardiophobic

C. Hysterical

D. obsessive

E. Depressed

The correct answer is: Cardiophobic

Question 64 A patient with congestive heart failure II B, systolic

Not answered variant, III FK was prescribed digoxin, capoten,
Marked out of verospiron, preductal. After 3 weeks, loss of
1.00 appetite, nausea, and dizziness occurred. On the
Flag ECG: heart rate - 52/min., ventricular bighemenia.
question PO2 - 0.26 sec. Which of the used medications
provoked the specified condition?

Select one:
A. Verospiron

B. α-tocopherol

C. Nitrogranulong

D. Digoxin

E. Kapoten

The correct answer is: Digoxin

Question 65 The patient complains of weight loss, pain in the

Not answered lower abdomen, bowel movements with impurities
Marked out of of mucus and blood up to 15 times a day. During
1.00 fibrocolonoscopy in the area of the sigmoid colon,
Flag local pseudopolypous growths, flat superficial
question ulcerated areas of an irregular shape, which do
not merge, covered with mucus and fibrin, were
detected; contact bleeding. What is the most
likely diagnosis?

Select one:
A. Pseudomembranous colitis

B. Crohn's disease

C. Intestinal polyposis

D. Nonspecific ulcerative colitis

E. Irritable bowel syndrome

The correct answer is: Nonspecific ulcerative

colitis

Question 66 A 28-year-old patient came to the intensive care

Not answered unit with complaints of abdominal pain, vomiting,
Marked out of and double vision. Objectively: disoriented, dilated
1.00 pupils, weak reaction to light, dry, hyperemic skin,
Flag slight cyanosis, blood pressure - 90/60 mm Hg,
question pulse - 100/min. It is known from the anamnesis
that two days before hospitalization he consumed
alcohol of unknown origin. Specific therapy
consists in intravenous administration of:

Select one:
A. Omeprazole

B. thiamine

C. 40% glucose solution

D. Ethanol

E. Sodium bicarbonate

The correct answer is: Ethanol

Question 67 A 29-year-old patient complains of the absence of

Not answered menstruation during the year, rapid fatigue,
Marked out of hypotension with syncopal states, loss of memory,
1.00 dry skin. It is known from the anamnesis that 1.5
Flag years ago in the second period of labor there was
question significant bleeding, extirpation of the uterus,
hemotransfusion was performed, and she was on
mechanical ventilation for 3 days. What is the
most likely diagnosis?

Select one:
A. Aronze del Castillo syndrome

B. Shijen's syndrome

C. Chiari-Frommel syndrome

D. Adrenogenital syndrome

E. Farbsa-Albright syndrome

The correct answer is: Shien's Syndrome

Question 68 A 38-year-old man arrived at the hospital in an

Not answered unconscious state. I fell ill yesterday: headache,
Marked out of nausea, vomiting, body temperature - 38.5°C,
1.00 dizziness, delirium appeared. During the last 4
Flag days, he complained of pain and hearing loss in
question his left ear. Objectively: a soporose state, stiffness
of the occipital muscles, Kernig's symptom on
both sides, general hyperesthesia, purulent
discharge from the left ear. Which of the listed
diagnoses is the most likely?

Select one:
A. Primary purulent meningitis

B. Secondary purulent meningitis

C. Subarachnoid hemorrhage

D. Parenchymatous-subarachnoid
hemorrhage

E. Tuberculous meningitis

The correct answer is: Secondary purulent

meningitis

Question 69 A 17-year-old girl developed shortness of breath,

Not answered a feeling of a "foreign body" in her throat, and
Marked out of stabbing and aching pain in the area of the apex of
1.00 the heart after nervous stress. Objectively: red
Flag spots on the face and neck, vesicular breathing,
question respiratory rate - 26/min. Heart boundaries are
normal, tones are clear, rhythmic, heart rate -
120/min., blood pressure - 130/80 mm Hg. The
"emergency" doctor believes that this is a
somatoform disorder. Which drug will be most
useful in this situation?

Select one:
A. Aspirin

B. Drotaverin

C. Paracetamol

D. Nitroglycerin

E. Corvalol

The correct answer is: Corvalol

Question 70 A 62-year-old woman complains of difficulty

Not answered urinating and defecating, a tumor protruding from
Marked out of the genital opening, which interferes with walking.
1.00 Gynecological status: a tumor protrudes from the
Flag genital opening, at the lower pole of which a hole
question is visible. The walls of the tumor are similar to
matte and shiny dry skin, several ulcers are
visible. The part of the uterus that completely
protrudes from the genital opening can be felt in
the tumor. What is the most likely diagnosis?

Select one:
A. Complete prolapse of the uterus with a
decubitus ulcer

B. Prolapse of the back wall of the vagina

C. Incomplete uterine prolapse with cervical

ulcers

D. Prolapse of the cervix with a pressure ulcer

E. Lowering of the front wall of the vagina

The correct answer is: Complete prolapse of the

uterus with a decubitus ulcer

Question 71 A 42-year-old man, a miner, was freed from the

Not answered rubble after 12 hours. Objectively: both lower legs
Marked out of and feet are pale. There is no pulsation of
1.00 peripheral vessels. Sensitivity and passive
Flag movements in the joints are absent. Delivered with
question harnesses on both ends. What urgent first aid
measures should be taken to prevent
myoglobinuria and acute renal failure?

Select one:
A. Do not remove the tourniquet, hyperbaric
oxygenation

B. Do not remove the tourniquet, amputation

of limbs above the tourniquet

C. Remove the tourniquet, detoxification

therapy

D. Remove the tourniquet, hyperbaric

oxygenation

E. Do not remove the tourniquet,

detoxification therapy

The correct answer is: Do not remove the

tourniquet, amputation of limbs above the
tourniquet

Question 72 As a result of long-term pollution of the

Not answered environment by emissions from a metallurgical
Marked out of plant, a biogeochemical province was formed in
1.00 the adjacent residential area of the city. By what
Flag leading sign can you give it a hygienic
question assessment?

Select one:
A. The increased level of morbidity of the
population

B. Deterioration of the quality of products of

plant origin

C. Atmospheric air pollution

D. Restrictions on the conditions of sanitary

and domestic water use

E. Accumulation of specific chemicals in the

soil

The correct answer is: Accumulation of specific

chemicals in the soil

Question 73 A 14-year-old boy, against the background of

Not answered chronic tonsillitis and sinusitis, had a feeling of
Marked out of interruptions in the heart area and additional pulse
1.00 beats. Heart rate - 83/min. On the ECG: after
Flag every two sinus contractions, there are regularly
question pulses in which there is no P wave, QRS is
extended for more than 0.11 s, sharply deformed,
discordant T wave, after which a complete
compensatory pause is registered. Specify the
nature of rhythm disturbances:

Select one:
A. Extrasystole according to the type of
bigeminy

B. Blockade of the left leg of the bundle of His

C. Complete AV block

D. Partial AV block

E. Extrasystole according to the type of

trigeminy

The correct answer is: Extrasystole according to

the type of trigeminy

Question 74 A 42-year-old man underwent a

Not answered hemithyroidectomy for a nodular euthyroid goiter.
Marked out of Which treatment is most likely to help prevent
1.00 disease recurrence?
Flag
question Select one:
A. Anti-current

B. Thyrotropin

C. Mercazolil

D. Radioactive iodine

E. L-thyroxine

The correct answer is: L-thyroxine

Question 75 The Department of Health Care needs to assess

Not answered the effectiveness of the implementation of
Marked out of maternity and childhood care programs in the
1.00 region. The level of which integral indicator is the
Flag most expedient to use for such an analysis?
question
Select one:
A. Diseases of women

B. Children's disabilities

C. Infant mortality

D. Physical development

E. Diseases of children

The correct answer is: Infant mortality

Question 76 A 32-year-old woman, a primary school teacher,

Not answered undergoes a mandatory preventive medical
Marked out of examination. It is known that there is an outbreak
1.00 of measles in the region of residence. The woman
Flag has no complaints. According to the preventive
question vaccination card, there are no calendar violations,
she received all the necessary vaccinations as a
child. The last vaccination against diphtheria and
tetanus at the age of 26. The last Pap test was
done at the age of 30, with no abnormalities.
During physical examination, body temperature is
37.2°C, pulse is 80/min, blood pressure is 130/80
mm Hg. Which of the following is the most
appropriate doctor's tactic for this patient?

Select one:
 A. Determine the level of IgG to the measles
virus

B. Send for mammography

C. Administer ADS-M vaccine

D. Take a test for the human papilloma virus

(HPV test)

E. Vaccination and screening are not required

The correct answer is: Determine the level of IgG

to the measles virus

Question 77 A 67-year-old patient suddenly developed acute

Not answered respiratory failure on the 6th day after a planned
Marked out of operation. Heart rate - 130/min. The upper half of
1.00 the body, neck and face are cyanotic, cough,
Flag sharp pain behind the sternum. Arterial pressure -
question 90/60 mm Hg, central venous pressure - 330 mm
Hg. On the ECG, there is an inversion of the T
wave. What complication developed in the
patient?

Select one:
A. Acute myocardial infarction

B. Hypovolemic shock

C. Thromboembolism of the pulmonary artery

D. Recurrent bleeding

E. Acute insufficiency of coronary arteries

The correct answer is: Thromboembolism of the

pulmonary artery

Question 78 Parents of a 2-month-old child complain of

Not answered frequent retching, vomiting after eating
Marked out of undigested milk. Objectively: restless. Body
1.00 weight corresponds to age. Soft tissue turgor is
Flag satisfactory. The abdomen is moderately swollen,
question soft. Stools 5 times a day, yellow, without mucus.
Coprogram and bacterial examination of stools
without pathology. What is the most likely
diagnosis?

Select one:
A. Pylorostenosis

B. Intestinal malformation

C. Pylorospasm

D. Intestinal infection

E. Intestinal dysbiosis

The correct answer is: Pylorospasm

Question 79 A 19-year-old man turned to the doctor with

Not answered complaints of painless erosions on the head of the
Marked out of penis that appeared 2-3 days ago. There is a
1.00 history of unprotected sexual contact about a
Flag month ago. When examining the head of the
question penis, there is an oval-shaped erosion up to 5 mm
in diameter, painless, bright red in color. Inguinal
lymph nodes are not enlarged. What primary
laboratory test would be most appropriate?

Select one:
A. Reaction of immobilization of pale
treponema

B. -

C. Immunofluorescence reaction

D. Cultural research

E. Microreaction of precipitation with

cardiolipin antigen

The correct answer is: Microreaction of

precipitation with cardiolipin antigen

Question 80 A 43-year-old woman complains of pain in the

Not answered carpal, ankle, interphalangeal joints of the hands
Marked out of and feet, stiffness of movements in the morning.
1.00 He has been ill for 7 years. The disease began
Flag with symmetrical damage to the small joints of the
question hands and feet. Deformation of the feet is
observed, their movements are limited and sharply
painful. Internal organs without features. Which
indicator will be the most informative for making a
diagnosis?

Select one:
A. Rheumatoid factor

B. Dysproteinemia

C. Leukocytosis

D. Elevated erythrocyte sedimentation rate

(ESR)

E. C-reactive protein

The correct answer is: Rheumatoid factor

Question 81 A 14-year-old patient has suddenly gained 7 kg of

Not answered weight over the past year, she has frequent
Marked out of headaches and general weakness. Objectively: the
1.00 accumulation of adipose tissue is more
Flag pronounced on the neck, chest, and abdomen.
question Stretch marks on the lateral surfaces of the
abdomen. The mammary glands are
underdeveloped, there is no menstruation, there is
male pattern hair loss. Blood pressure - 160/100
mm Hg, heart rate - 92/min. X-rays show
pronounced osteoporosis, an enlarged Turkish
saddle. Clinical diagnosis:

Select one:
A. Puberty dyspituitarism

B. Stein-Leventhal syndrome

C. Itsenko-Cushing syndrome

D. Lawrence-Moon-Barde-Bídl syndrome

E. Itsenko-Cushing's disease

The correct answer is: Itsenko-Cushing's disease

Question 82 A 48-year-old man complains of squeezing pain

Not answered behind the sternum, which first appeared 1.5
Marked out of hours ago after physical exertion and is not
1.00 relieved by taking nitroglycerin. Objectively
Flag observed: HR --- 75/min, BH --- 16/min, BP ---
question 140/80 mm Hg. During the ECG study, it was
found that the ST segment is shifted downward
from the isoline by 1--2 mm in leads V4--V6.
Determining the level of which indicator will help
establish a diagnosis in this case?

a. D-dimer

b. Uretic peptide sodium

c. Troponin

d. KFC

e. JSC

The correct answer is: Тропоніну

Question 83 A 3-year-old boy was discharged from the

Not answered cardiology department, where he was in
Marked out of connection with frequent suffocation-cyanotic
1.00 attacks due to the tetrad of Fallot. What drug is
Flag the most appropriate to use for further prevention
question of attacks?

Select one:
A. Relanium

B. Digoxin

C. Clockwork

D. Employees

E. Obzidan

The correct answer is: Обзідан

Question 84 A 43-year-old patient complains of a cough with a

Not answered small amount of colorless sputum, pain in the right
Marked out of half of the chest when breathing, shortness of
1.00 breath, temperature rise to 39°C. He became
Flag acutely ill. Took aspirin. Objectively: herpes on the
question lips. In the projection of the lower lobe of the right
lung - dulling of the percussion sound, increased
vocal tremor, bronchial breathing. X-ray:
homogeneous darkening of the lobe with clear
contours. What is the most likely etiology of
pneumonia?

Select one:
A. Staphylococcus pneumoniae

B. Klebsiella pneumoniae

C. Legionella pneumoniae

D. Streptococcus pneumoniae

E. Mycoplasma pneumoniae

The correct answer is: Streptococcus pneumoniae

Question 85 On the 4th day after a cold, the patient was

Not answered hospitalized with complaints of a cough with
Marked out of single spits of mucous sputum. On the 2nd day,
1.00 about 250 ml of purulent sputum with streaks of
Flag blood was released once. Objectively: a condition
question of medium severity. ChDR- 28-30/min., Ps-
96/min., BP- 110/70 mm Hg. Breathing over the
left lung is vesicular, over the right - weakened,
various moist rales over the lower lobe and
amphoric breathing near the angle of the shoulder
blade. What is the most likely diagnosis?

Select one:
A. Acute lung abscess

B. Pyopneumothorax

C. Acute focal pneumonia

D. Pleural empyema

E. Exudative pleurisy

The correct answer is: Acute lung abscess

Question 86 A 22-year-old patient turned to a women's

Not answered consultation with complaints of delayed
Marked out of menstruation for 1.5 months, nausea, fatigue,
1.00 drowsiness, irritability. During the examination,
Flag pronounced pigmentation was found on her face
question and nipples. No pathology was detected on the
part of the internal organs. During examination in
mirrors, cyanosis of the mucous membrane of the
vagina and cervix is determined; in the course of
bimanual examination - enlargement of the uterus,
its hyperanteflexion, asymmetry. What are the
listed complaints and bimanual examination data
most likely related to?

Select one:
A. Diseases of the gastrointestinal tract

B. Uterine pregnancy

C. Uterine tumor

D. Violation of the menstrual cycle

E. Ectopic pregnancy

The correct answer is: Uterine pregnancy

Question 87 A 22-year-old patient complains of an attack-like

Not answered whitening of the fingertips, which develops as a
Marked out of result of cooling. When the fingers are warmed up,
1.00 they first acquire a bluish, then crimson color. The
Flag drug of choice for the treatment of this syndrome
question is:

Select one:
A. Dipyridamole

B. But-shpa

C. Aspirin

D. Nifedipine

E. Nitrates

The correct answer is: Nifedipine

Question 88 A 26-year-old pregnant woman was brought to

Not answered the emergency department at the 36th week of
Marked out of pregnancy with complaints of an intense
1.00 headache in the frontal area. During physical
Flag examination: blood pressure - 170/90 mm Hg,
question pulse - 85/min, respiratory rate - 15/min,
temperature - 36.9°C, swelling of extremities.
Fetal heartbeat - 159/min. During the examination,
the woman develops an attack of generalized
tonic-clonic convulsions. What drug should the
doctor introduce first?

Select one:
A. Sodium valproate

B. Lamotrigine

C. Diazepam

D. Magnesium sulfate

E. Phenytoin

The correct answer is: Magnesium sulfate

Question 89 A man was injured with a circular saw on the first

Not answered finger of his right hand. Medical assistance was
Marked out of provided in the trauma center. Data of the
1.00 outpatient: "The condition is satisfactory, blood
Flag pressure - 90/60 mm Hg, pulse - 100/min. The
question first finger of the right hand is separated from the
main phalanx and is held by a skin flap." At the
reception of the forensic medical expert: "The first
finger of the right hand is missing at the level of
the main phalanx. The cult is formed." Determine
the severity of the injury:

Select one:
A. This injury is classified as a serious injury
based on the criterion of a percentage loss
of working capacity of more than 30%

B. This physical injury belongs to the medium

degree of severity according to the
criterion of the duration of the health
disorder

C. This physical injury belongs to the medium

degree of severity according to the
criterion of percentage loss of working
capacity up to 30%

D. This physical injury belongs to the category

of light physical injuries that caused a
short-term health disorder

E. This bodily injury belongs to severe bodily

injuries according to the criterion of danger
to life

The correct answer is: This physical injury belongs

to the medium degree of severity according to the
criterion of percentage loss of working capacity
up to 30%

Question 90 The district doctor was instructed to prepare a

Not answered plan for carrying out a complex of medical and
Marked out of preventive measures among the population in the
1.00 subordinate territory. What secondary prevention
Flag measures should he include in this plan?
question

Select one:
A. Prevention of complications of diseases

B. Elimination of the factors of the occurrence

of diseases

C. Improvement of living conditions of the

population

D. Prevention of diseases

E. Implementation of rehabilitation measures

The correct answer is: Prevention of complications

of diseases

Question 91 A 14-year-old girl turned to the doctor with

Not answered complaints of a feeling of compression in the neck
Marked out of area, coughing, thickening of the neck. On
1.00 physical examination, the thyroid gland is diffusely
Flag enlarged, dense on palpation, painless, and the
question surface is smooth. During ultrasound examination,
the tissue of the thyroid gland is heterogeneous.
What laboratory test would be most appropriate?

Select one:
A. Iodine content in daily urine

B. Titer of antibodies to thyroglobulin

C. Calcitonin content

D. Growth hormone content

E. Parathyroid hormone content

The correct answer is: Titer of antibodies to

thyroglobulin

Question 92 A 3-month-old child was taken to the hospital with

Not answered complaints of sluggish sucking and shortness of
Marked out of breath, which worsens during feeding,
1.00 restlessness. Symptoms appeared within the last
Flag hours. The skin is pale, with an ashy tint, the
question extremities are cold. Axillary temperature -
36.8°C. Breathing rate - 66/min. Heart rate cannot
be calculated. The pulse is weak. The liver is
palpated 4 cm below the costal arch. On the ECG:
heart rate - 230/min., rhythm is correct, wave P on
T, complexes lasting 0.08 s. What is the drug of
choice for providing emergency care to this child?

Select one:
A. Lidocaine

B. Digoxin

C. Verapamil

D. Adenosine

E. Propranolol

The correct answer is: Adenosine

Question 93 A 73-year-old obese woman developed a clinical

Not answered picture of submassive pulmonary embolism on the
Marked out of 4th day after umbilical hernia repair. During the
1.00 duplex sonography of the veins of the lower
Flag extremities, a floating thrombus was detected in
question the femoral vein. What is the best way to prevent
recurrence of embolism?

Select one:
A. Low molecular weight heparins

B. Continuous intravenous infusion of heparin

C. Implantation of a coffee filter

D. Plication of the inferior vena cava

E. Thrombectomy

The correct answer is: Implantation of a coffee

filter

Question 94 A 58-year-old patient turned to the doctor with a

Not answered complaint of a small painless protrusion in the
Marked out of groin area during the last month. The protrusion
1.00 does not increase, appears when standing and
Flag disappears when lying on the back. Difficulty
question urinating and no constipation. Palpation of the
abdominal wall is painless. Rectal examination did
not reveal pathological changes. Which of the
following is the most appropriate next step for the
doctor in this situation?

Select one:
A. Apply a bandage

B. Perform a fine-needle puncture biopsy

C. Inform the patient about the signs of

entrapment and let him go home

D. Send for a CT scan of the abdomen and

pelvis

E. Carry out the exposed plastic with the use

of a mesh immediately

The correct answer is: Inform the patient about

the signs of entrapment and let him go home

Question 95 The mother of a five-year-old child turned to a

Not answered gynecologist about the girl's severe itching and
Marked out of burning sensation in the vagina. It is known from
1.00 the anamnesis that the child took antibiotics for
Flag the treatment of pneumonia. During the
question examination, it was revealed: hyperemia and
swelling of the vulva, discharge of a thick, cheese-
like mass. What complication did the girl have?

a. Gonorrheal vulvovaginitis

b. Candidal vulvovaginitis

c. Trichomonas vulvovaginitis

d. Bacterial vaginosis

e. Bacterial vulvovaginitis

The correct answer is: Candida vulvovaginitis

Question 96 The baby was born from the second full-term

Not answered pregnancy, the second term delivery to a mother
Marked out of who has blood type A(II) Rh_. The child's blood
1.00 group is 0(I) Rh+. The level of indirect bilirubin in
Flag cord blood was 45 µmol/l. After 3 hours, the
question indirect bilirubin content in the child's blood
serum was 170 µmol/l. At this moment, the child
should be prescribed:

Select one:
A. Infusion therapy

B. Replacement blood transfusion

C. Phenobarbital

D. Phototherapy

E. Enterosorbents

The correct answer is: Replacement blood

transfusion

Question 97 A 48-year-old patient came to the surgical

Not answered department with thigh wounds. During the
Marked out of examination, it was found that the surface of the
1.00 wound is covered with a dirty gray coating with an
Flag unpleasant sweet smell. The wound contents
question resemble raspberry jelly. The skin around the
wound is tense, shiny. A moderate crepitation is
observed during tissue palpation. Which
microflora most likely caused the inflammation?

Select one:
A. Blue fire bacillus

B. Staphylococci

C. Anaerobic non-clostridial

D. Anaerobic clostridial

E. Streptococci

The correct answer is: Anaerobic clostridial

Question 98 A 38-year-old patient turned to the doctor with

Not answered complaints of pain and discomfort behind the
Marked out of sternum, which have lasted for the past 4 hours,
1.00 the symptoms appeared after dinner. The pain
Flag sometimes intensifies, then subsides, irradiation in
question the left scapula and hand is not noted. It is known
from the anamnesis that the patient's father died
at the age of 55 due to an acute myocardial
infarction. Objectively observed: body
temperature 37.3°C, blood pressure --- 138/85
mm Hg. st., pulse --- 115/min, BH --- 16/min.
During auscultation, vesicular breathing is
determined. ECG revealed: sinus tachycardia.
Previously, the patient took 3 tablets of
nitroglycerin with an interval of 5 minutes and
aspirin, which improved his condition. What are
the further tactics in the management of this
patient?

a. Chest CT and FGDS

b. X-ray with barium mixture

c. Determination of cardiac biomarkers (CFC-

MV, troponin I, N-terminal peptide of
natriuretic hormone)

d. Give the patient a pain reliever

e. Conduct a physical exercise test

The correct answer is: Determination of cardiac

biomarkers (CFC-MV, troponin I, N-terminal
peptide of natriuretic hormone)

Question 99 The victim has a burn injury of 15% of the body

Not answered surface II-III degree. On the 20th day after the
Marked out of injury, the patient has a sharp increase in body
1.00 temperature, general weakness, frequent
Flag vesicular breathing, worsening of facial features,
question blood pressure - 90/50 mm Hg, pulse - 112/min.
What complications can be assumed?

Select one:
A. Acute intoxication

B. Purulent bronchitis

C. Sepsis

D. Anaerobic infection

E. Pneumonia

The correct answer is: Sepsis

Question 100 The mother of a 6-month-old boy came to see a

Not answered pediatrician worried that her child had not
Marked out of received any vaccinations. They have no
1.00 complaints. Objectively: temperature - 37.1°C,
Flag respiratory rate - 20/min., blood pressure - 100/70
question mm Hg. Height and weight correspond to the
range between the 50th and 75th percentile.
According to the regulatory and legal documents
of the Ministry of Health, what tactics should the
doctor follow regarding the immunization of this
child?

Select one:
A. Conduct a Mantoux test and make an
appointment in 2-3 days

B. Administer the BCG, KPK and DTP vaccine

C. Administer the BCG vaccine

D. -

E. Postpone the vaccination and make an

appointment a week later

The correct answer is: Conduct a Mantoux test

and make an appointment in 2-3 days

Question 101 The labor activity of the worker requires

Not answered concentration of attention, emotional tension.
Marked out of There are visual and auditory motor reactions, a
1.00 high density of working hours. This work should
 Flag be evaluated from the point of view of:
question

Select one:
A. Oxygen consumption

B. Nervous tension

C. Static load

D. Physical difficulty

E. Quantities of energy consumption

The correct answer is: Nervous tension

Question 102 A 55-year-old patient turned to the doctor of the

Not answered women's consultation with complaints of pain in
Marked out of the lower abdomen, the appearance of bloody
1.00 discharge 3 years after the cessation of
Flag menstruation. What additional examination
question methods should be performed on this patient to
clarify the diagnosis?

Select one:
A. Laparoscopy

B. Separate diagnostic curettage of the uterus

C. Scraping for oncocytology

D. Colposcopy

E. Ultrasound of the pelvic organs

The correct answer is: Separate diagnostic

curettage of the uterus

Question 103 A 24-year-old woman came to the women's

Not answered consultation with complaints about a delay in
Marked out of menstruation for 10 weeks. She has a history of 2
1.00 spontaneous miscarriages. During the ultrasound
Flag examination, one fertile egg was found, which
question corresponds to 6-7 weeks of pregnancy, the
heartbeat of the fetus is not determined. What is
the next tactic in this situation?

Select one:
A. Use of uterotonic agents

B. Observation for 1 week followed by

ultrasound control

C. Appointment of hormone therapy

D. Scraping of the walls of the uterine cavity

E. Appointment of antibacterial therapy

The correct answer is: Scraping the walls of the

uterine cavity

Question 104 A 42-year-old woman came to the doctor for a

Not answered preventive appointment. He has no complaints.
Marked out of The general condition is satisfactory. Height 162
1.00 cm, body weight 87 kg, BMI = 33 kg/m². Blood
Flag pressure on the right - 140/90 mm Hg, on the left
question - 145/85 mm Hg, pulse - 72/min. Auscultatively,
heart sounds are muffled, noises are not audible.
In the lungs, breathing is vesicular. The lower edge
of the liver protrudes 1.5-2 cm from the lower
edge. No swelling was found. How should the
doctor assess the constitutional structure of this
patient's body (according to WHO
recommendations)?

Select one:
A. Obesity of the III degree

B. Overweight

C. Obesity II degree

D. Normal weight

E. Obesity of the first degree

The correct answer is: Obesity of the first degree

Question 105 A 36-year-old woman consulted a doctor with

Not answered complaints of general weakness, abdominal pain,
Marked out of and yellowing of the skin. These complaints have
1.00 been gradually increasing over the past 3 months.
Flag The patient reported that she had no serious
question medical history. Denies drug use and unprotected
sex. During physical examination, ictericity of the
sclera and yellowness of the skin, pain upon
palpation of the right subcostal area. During
laboratory examination of blood serum: total
bilirubin - 64.5 µmol/l, direct - 22.7 µmol/l, AST -
822 U/l, ALT - 1237 U/l, HBsAg - positive, HBeAg -
positive. What tactics of treatment of this patient
is the most appropriate?

Select one:
A. Prednisone and ribavirin

B. Specific immunoglobulin against hepatitis B

virus

C. Human immunoglobulin is normal

D. PEG-interferon alpha-2a

E. Hepatitis B vaccine and lamivudine

The correct answer is: PEG-interferon alfa-2a

Question 106 A 60-year-old patient complains of pain in the

Not answered interphalangeal joints of the hands, which worsens
Marked out of during work. Objectively: the distal and proximal
1.00 joints of II-IV fingers are deformed, with
Flag Heberden's and Bouchard's nodes, painful, with
question limited mobility. X-ray of the joints: narrowed joint
spaces, marginal osteophytes, subchondral
sclerosis. What is the most likely diagnosis?

Select one:
A. Rheumatic arthritis

B. Psoriatic arthritis

C. Reiter's disease

D. Bekhterev's disease

E. Deforming osteoarthritis

The correct answer is: Deforming osteoarthritis

Question 107 The employee has been sick for 4 months, further
Not answered treatment is necessary, the patient is unable to
Marked out of work. Who is authorized to conduct an
1.00 examination of the patient's incapacity for work?
Flag
question Select one:
A. Deputy chief physician for disability
examination

B. Medical and social expert commission

C. Supervising doctor with the head of the

department

D. The chief doctor of the medical and

preventive institution

E. Medical advisory commission

The correct answer is: Medical and social expert

commission

Question 108 In a 23-year-old woman in labor, on the tenth day

Not answered after childbirth, the general condition worsened: a
Marked out of cold appeared, pain in the right mammary gland,
1.00 the body temperature rose to 39 o C. Objectively:
Flag the right mammary gland is slightly enlarged,
question palpable in the upper-outer quadrant painful
dense infiltrate measuring 5 x 7 cm with a
softening area in the center, the skin above it is
hyperemic with a bluish tint. Axillary lymph nodes
on the right are enlarged, painful during palpation.
What is the most likely diagnosis?

Select one:
A. Serous mastitis

B. Lactostasis

C. Breast fibroadenoma

D. Breast cancer

E. Purulent mastitis

The correct answer is: Purulent mastitis

Question 109 A previously healthy 22-year-old boy came to the

Not answered doctor's appointment with complaints of high
Marked out of temperature and cough with yellow sputum, which
1.00 continued for 7 days. During physical examination,
Flag temperature is 38.3°C, blood pressure is 130/70
question mm Hg, heart rate is 79/min, respiratory rate is
17/min, SpO₂ is 95% in room air. On auscultation,
moist rales are heard on the left. On the X-ray
examination, consolidation in the lower lobe of the
left lung. Which of the listed drugs would be the
most appropriate to prescribe for this patient?

Select one:
A. Ciprofloxacin

B. Azithromycin

C. Gentamicin

D. Levofloxacin

E. Trimethoprim-sulfamethoxazole

The correct answer is: Azithromycin

Question 110 A 39-year-old patient consulted a doctor with

Not answered complaints of morning headache, decreased
Marked out of appetite, nausea, morning vomiting, and periodic
1.00 nosebleeds. At the age of 15, he suffered acute
Flag glomerulonephritis. During the examination, an
question increase in blood pressure up to 220/130 mm Hg,
pallor of the skin and mucous membranes was
revealed. Which of the following biochemical
indicators of blood has diagnostic significance in
this case?

Select one:
A. Uric acid

B. Sodium

C. Bilirubin

D. Fibrinogen

E. Creatinine

The correct answer is: Creatine

Question 111 According to the results of the hospital-

Not answered pedagogical observation of the physical education
Marked out of lesson in the 9th grade, a physiological curve was
1.00 constructed, characterized by a gradual increase
Flag in the pulse rate in the introductory part, an
question increase in the pulse rate by 80% during the main
part, the curve has a 4-toothed appearance. How
can you evaluate the organization of a physical
education lesson?

Select one:
A. Long intervals between exercises

B. The lesson is structured correctly

C. Physical activity is sufficient

D. Excessive physical exertion

E. Physical activity is not enough

The correct answer is: Long intervals between

exercises

Question 112 A 49-year-old woman complains of pain in the

Not answered shoulder joints, which worsens during movements,
Marked out of limitation of mobility, short-term morning
1.00 stiffness. He has been sick for several years. In
Flag the past, she was engaged in gymnastics. On the
question x-ray of the shoulder joints - narrowing of the joint
space, subchondral osteosclerosis, osteophytes in
the lower inner part of the head of the humerus.
What is the basis of the pathogenesis of joint
damage in the patient?

Select one:
A. Deposits of calcium pyrophosphate in the
joints

B. Disorders of uric acid metabolism

C. Damage to the synovial membrane by an

infectious agent

D. Disturbance of cartilage metabolism

E. Deposition of immune complexes in the

synovial membrane

The correct answer is: Violation of cartilage

metabolism

Question 113 A healthy 16-year-old girl came for a preventive

Not answered medical examination. During history taking, she
Marked out of reported that she had chicken pox at the age of 3.
1.00 There are no other serious diseases in the
Flag anamnesis. Parents did not write refusals from
question vaccinations, she was vaccinated in kindergarten
and school in accordance with the National
calendar of preventive vaccinations. Physical
examination without abnormalities. Which
vaccines would be most appropriate to prescribe
at this time?

Select one:
A. IPV, AaKDP

B. Hepatitis B, AaKDP

C. KPK, ADP, VPL

D. ADP-M, VPL

E. Hepatitis B, ADP-M

The correct answer is: ADP-M, VPL

Question 114 In a patient operated on for acute paraproctitis,

Not answered chills, hyperthermia, tachycardia, and euphoria are
Marked out of observed for 5 days against the background of
1.00 antibacterial and detoxifying therapy, with positive
Flag dynamics of the local course of the disease. The
question doctor assumes that the patient has developed
sepsis. What research can confirm the diagnosis?

Select one:
A. Blood culture for the presence of the
causative agent

B. Determination of the level of molecules of

average mass

C. Ultrasound examination of the liver

D. X-ray of the lungs

E. Determination of the degree of microbial

contamination of the wound

The correct answer is: Blood culture for the

presence of the pathogen

Question 115 The head of a newborn has a dolichocephalic

Not answered shape, elongated from front to back. During the
Marked out of examination of the head on the occipital part, a
1.00 birth tumor is determined, located in the middle
Flag between the large and small occiput. In what
question presentation of the fetal head did the birth take
place?

Select one:
A. Posterior view of the occipital presentation

B. Front view of occipital presentation

C. Frontal presentation

D. Anteroparietal presentation

E. Face-to-face presentation

The correct answer is: Posterior view of occipital

presentation

Question 116 The man had an attack of severe chest pain at 5

Not answered o'clock in the morning, which was accompanied
Marked out of by weakness and cold sweat. The ECG revealed:
1.00 dome-shaped elevation of the ST segment in
Flag leads II, III, avF, V5--V6. After the pain subsided,
question the ECG parameters returned to normal. What is
the most likely diagnosis?

a. Dilated cardiomyopathy

b. Myocarditis

c. Acute myocardial infarction in the

posterolateral area of the left ventricle

d. Pericarditis

e. Spontaneous angina pectoris of the

Prinzmetal type

The correct answer is: Spontaneous angina

pectoris of the Prinzmetal type

Question 117 A 14-year-old girl complains of sleep

Not answered disturbances, weight loss, palpitations, cardiac
Marked out of pain, and fatigue. II stage hyperplasia of the
1.00 thyroid gland, exophthalmos is observed. What
Flag hormonal disorders are most characteristic of this
question disease?

Select one:
A. An increase in thyroid-stimulating hormone

B. Increasing the level of iodine bound to

protein

C. Reduction of thyroxine

D. Reduction of triiodothyronine

E. Increase in thyroxine and triiodothyronine

The correct answer is: Increase in thyroxine and

triiodothyronine

Question 118 A 32-year-old woman complains of bilateral pain

Not answered in her hands and swelling of her fingers, a feeling
Marked out of of stiffness for several hours after waking up, and
1.00 fatigue. Objectively observed: swelling of the
Flag second and third metacarpal-phalangeal and
question proximal interphalangeal joints, positive symptoms
of transverse compression of the hand. What
disease is most likely in a woman?

a. Rheumatic arthritis

b. Reactive arthritis

c. Osteoarthritis

d. Rheumatoid arthritis

e. Gouty arthritis

The correct answer is: Rheumatoid arthritis

Question 119 A 28-year-old patient came to the reception

Not answered department with complaints of pain in the area of
Marked out of the left shoulder joint, which worsens with
1.00 movement. On examination: in the area of the
Flag clavicular-acromial joint, swelling and step-like
question deformation are revealed. On palpation -
soreness, a positive symptom of "keys". What is
the previous diagnosis?

Select one:
A. Dislocation of the acromial end of the
clavicle

B. Fracture of the acromial process of the

scapula

C. Fracture of the acromial end of the clavicle

D. Anterior-superior dislocation of the

humerus

E. Fracture of the head of the humerus

The correct answer is: Dislocation of the acromial

end of the clavicle

Question 120 A 33-year-old man came to the doctor for a

Not answered preventive appointment. He has no complaints.
Marked out of During the physical examination, the doctor
1.00 accidentally detected a rough systolic murmur at
Flag Botkin's point, which is performed at the point of
question auscultation of the apex and the vessels of the
neck. The patient refused further examination.
After 2 months, the patient developed symptoms
of heart failure against the background of
influenza. What defect was most likely detected
by the doctor?

Select one:
A. Congenital lesion of the tricuspid valve

B. Mitral insufficiency

C. Mitral stenosis

D. Aortic insufficiency

E. Aortic stenosis

The correct answer is: Aortic stenosis

Question 121 When the gestation period was 32 weeks, the

Not answered pregnant woman went into premature labor. Take
Marked out of over after 10-15 minutes, 15-20 seconds each.
1.00 The fetal heartbeat is clear, rhythmic, 145/min.
Flag During the vaginal examination, the cervix is
question shortened, the external eye is opened by 1.5 cm,
the amniotic sac is intact, the head is present,
mucous discharge, body temperature is 36.5 o C.
In the blood: no abnormalities. In a smear from the
vagina, 4-5 leukocytes in the p/z. What obstetric
tactics?

Select one:
A. Antispasmodics, analgesics

B. Tocolysis. Prevention of fetal distress

syndrome

C. Give intravenous anesthesia to relieve labor

D. Cesarean section operation

E. Give birth through the natural birth canal

The correct answer is: Tocolysis. Prevention of

fetal distress syndrome

Question 122 A 42-year-old man with a diagnosis of spastic

Not answered paraparesis was prescribed the muscle relaxant
Marked out of tizanidine according to the scheme of gradually
1.00 increasing the dose. The patient violated the
Flag recommendation and immediately took the daily
question dose, after which he felt general weakness,
dizziness, decreased strength in his legs and lost
consciousness for a short time. During physical
examination, blood pressure - 75/55 mm Hg, pulse
- 69/min, body temperature - 36.6°C, general
muscular hypotonia. What emergency condition
most likely occurred in the patient?

Select one:
A. Vago-insular crisis

B. Panic attack

C. Syncopal state

D. Transient ischemic attack

E. Sympatho-adrenal crisis

The correct answer is: Syncopal state

Question 123 A 37-year-old patient was hospitalized with a

Not answered diagnosis of chronic kidney disease, stage I. ---
Marked out of mesangioproliferative glomerulonephritis. Blood
1.00 pressure --- 140/90 mm Hg. Art. The daily loss of
Flag protein with urine is --- 5.1 g. In the clinical blood
question analysis: total protein --- 48.2 g/l; urea --- 5.7
mmol/l; creatinine --- 76.3 µmol/l; cholesterol ---
8.1 mmol/l. What group of drugs should be
prescribed to the patient?

a. Glucocorticosteroids

b. Nitrofurans

c. Antibiotics

d. Sulfanilamides

e. Nonsteroidal anti-inflammatory

The correct answer is: Glucocorticosteroids

Question 124 A 21-year-old girl consulted a doctor with a flu-

Not answered like illness, low-grade fever, malaise, and mild
Marked out of jaundice for 2 days. Laboratory indicators of blood
1.00 serum: aspartate aminotransferase (AST) - 456
Flag U/l, alanine aminotransferase (ALT) - 745 U/l, IgM
question to HAV - positive result. What tactics in relation to
contact persons will be most appropriate?

Select one:
A. Vaccination against hepatitis A during the
first week

B. Administration of interferon alpha-2b

during the first week

C. Administration of normal human

immunoglobulin within 24 hours

D. Prophylactic administration of
sofosbuvir/ledipasvir for 1 month

E. Vaccination against hepatitis B during the

first week

The correct answer is: Hepatitis A vaccination

during the first week

Question 125 The age of bruising can be determined by:

Not answered

Marked out of Select one:

1.00
A. By changing the shape of the bruise
Flag
question B. The color of the bruise

C. The speed of blood circulation through the

subcutaneous tissue

D. By the number of bruises

E. The temperature of the skin in the bruise

The correct answer is: The color of the bruise

Question 126 As a result of the traffic accident, the victim

Not answered received multiple fractures of the limbs and pelvic
Marked out of bones. In the anamnesis: hemophilia A. During the
1.00 examination, hematomas form on the damaged
Flag areas. The condition worsens. Blood pressure -
question 90/50 mm Hg. Specify the most appropriate
combination of infusion drugs for the treatment of
the patient after the use of polyglucin and saline
solutions:

Select one:
A. Cryoprecipitate, erythrocyte mass

B. Erythrocyte mass, fresh frozen plasma

C. Erythrocyte mass

D. Fresh frozen plasma, albumin

E. Cryoprecipitate, glucose

The correct answer is: Cryoprecipitate,

erythrocyte mass

Question 127
 During the examination of a 5-year-old child with
Not answered complaints of a constant cough with purulent
Marked out of sputum discharge and wet wheezing on the right
1.00 in the lower back, it was found: purulent
Flag endobronchitis of the II-III degree, mainly on the
question right, sweat chlorides - 36 mmol/l, on CT scan -
cylindrical bronchiectasis in S9 and S10. Suggest
the optimal method of treatment for this child:

Select one:
A. Physiotherapy

B. Prolonged antibiotic therapy

C. Lavage of the bronchial tree

D. Removal of affected lung segments

E. Genetic engineering therapy

The correct answer is: Removal of affected lung

segments

Question 128 A 25-year-old patient is seen by a hematologist

Not answered for hemophilia A. Acute hemarthrosis of the knee
Marked out of joint developed after falling from a horizontal bar.
1.00 Objectively: the right knee joint is sharply
Flag increased in volume, the skin over it is hyperemic.
question Bleeding time according to Duke - 3 minutes,
blood settling time according to Lee-White - 20
minutes. Which drug is the most effective for the
treatment of this patient?

Select one:
A. Recombinant factor VIII

B. Thromboconcentrate

C. Amben

D. Aminocaproic acid

E. Recombinant X factor

The correct answer is: Recombinant factor VIII

Question 129 What documentation should be checked in order

Not answered to carry out an expert assessment of the
Marked out of fulfillment of medical and technological standards
1.00 of patient care by resident doctors?
Flag
question a. Maps of medical appointments

b. Statistical maps of patients discharged

from the hospital

c. Medical cards of inpatients

d. Journal of accounting for operative

interventions

e. Annual report of the treatment and

prevention institution

The correct answer is: Medical cards of inpatients

Question 130 During the laboratory examination of a pork

Not answered sample, 1 dead trichinella was found in 24
Marked out of sections. Such meat should be transferred for:
1.00

Flag Select one:

question
A. Implementation through a network of
catering establishments

B. Freezing to a temperature of 10°C in the

thickness of the meat with further exposure
for 15 days

C. Processing for making boiled sausages

D. Implementations without restrictions

E. Technical disposal

The correct answer is: Technical disposal

Question 131 An 18-year-old hemophilia A patient complained

Not answered of acute pain in the left knee joint and an increase
Marked out of in its volume. The joint is sharply painful during
1.00 movements and palpation, the skin above it is hot
Flag to the touch. What treatment should be used?
question

Select one:
A. Apply cold and immobilize the joint

B. Perform a therapeutic puncture of the joint

C. Intravenous administration of fresh frozen

plasma

D. Intravenous administration of factor IX

concentrate

E. Intravenous administration of factor VIII

concentrate

The correct answer is: Intravenous administration

of factor VIII concentrate

Question 132 During the examination, a 26-year-old dentist was

Not answered found to have moderate hyperfermentemia and a
Marked out of positive test for HBsAg. His 24-year-old wife is
1.00 not vaccinated against viral hepatitis B. The 2-
Flag year-old child is properly vaccinated according to
question the age schedule. What prevention of viral
hepatitis B should be carried out in the family?

Select one:
A. Immediate vaccination of the wife with a
negative HBsAg test

B. Prescribing specific immunoglobulin to the

wife and child

C. Prescribing specific chemoprophylaxis to

the wife with non-nucleoside analogues

D. Appointment of specific immunoglobulin to

the child

E. Appointment of specific chemoprophylaxis

with non-nucleoside analogs to the wife
and child

The correct answer is: Immediate vaccination of

the wife with a negative HBsAg test

Question 133 The emergency medical team took the patient

Not answered with an acute myocardial infarction to the regional
Marked out of cardiology center, where cardiac surgery was
1.00 performed. Within what type of medical care were
Flag the specified medical services provided?
question

Select one:
A. Highly specialized medical care

B. Emergency medical assistance

C. Palliative medical care

D. Specialized medical assistance

E. Qualified medical assistance

The correct answer is: Highly specialized medical

care

Question 134 During the medical examination of the workers of

Not answered the metallurgical plant, after measuring the body
Marked out of mass index (BMI), 20% of them were found to be
1.00 overweight. The content of which products must
Flag be reduced in the diet in the first place to
question normalize body weight in this group of people?

Select one:
A. Bakery products

B. Vegetables

C. fruits

D. Milk and dairy products

E. Meat and fish products

The correct answer is: Bakery products

Question 135 In a 5-month-old child, broncho-obstructive

Not answered syndrome recurred three times without previous
Marked out of catarrhal phenomena, cough with difficult sputum
1.00 was observed almost constantly. Faeces are
Flag greasy, smelly from the first days of life. Cystic
question fibrosis is assumed. What research can confirm
the diagnosis?

Select one:
A. X-ray of chest organs

B. Determination of the level of lipids in the

blood

C. Chloride sweat

D. Lung scintigraphy

E. Coprocytogram

The correct answer is: Sweat chloride

Question 136 The 40-year-old victim was stabbed under the

Not answered right shoulder blade. Objectively: normal-colored
Marked out of skin, pulse - 96/min., rhythmic, vesicular breathing
1.00 on both sides, respiratory rate - 20/min., blood
Flag pressure - 130/90 mm Hg. There is a wound on
question the back - 4.0 x 0.5 cm, it is bleeding. No
pathology was detected on the X-ray examination.
What will be the tactics?

Select one:
A. Puncture of the pleural cavity

B. Thoracoscopy

C. Thoracentesis

D. Primary surgical treatment of the wound

E. Thoracotomy

The correct answer is: Primary surgical treatment

of the wound

Question 137 A 57-year-old patient is being treated for

Not answered polytrauma. After 8 days, there were complaints of
Marked out of severe cough with purulent sputum, severe
1.00 shortness of breath, temperature rise to 38.8°C.
Flag History: chronic bronchitis, smoker for 20 years.
question Objectively: hard breathing is heard in the lungs,
moist fine-bubble rales in the lower parts of the
right lung. The HIV test is negative. What is the
diagnosis of this patient?

Select one:
A. Aspiration pneumonia

B. Pneumonia of persons with

immunodeficiency

C. Nosocomial pneumonia

D. Infectious exacerbation of bronchitis

E. Community-acquired pneumonia

The correct answer is: Nosocomial pneumonia

Question 138 A 23-year-old woman. After the experienced

Not answered stress, thirst, polydipsia, polyuria, weight loss,
Marked out of increasing weakness appeared, then nausea,
1.00 vomiting, drowsiness, fainting appeared.
Flag Hospitalized. Glycemia - 28 mmol/l, acetone in
question urine is sharply positive. Treatment of ketoacidotic
coma was started. When is it advisable to start
prevention of hypoglycemia by introducing 5%
glucose solution?

Select one:
A. After the normalization of the level of
glycemia

B. 2 hours after the start of insulin therapy

C. At a rate of decrease in blood glucose level

of more than 5 mmol/l per hour

D. After lowering the level of glycemia to 13-

14 mmol/l

E. After regaining consciousness of the

patient

The correct answer is: After lowering the blood

sugar level to 13-14 mmol/l

Question 139 The patient is 52 years old, secretary-typist, 30

Not answered years of work experience. He complains of cramps
Marked out of in the right hand while working and the inability to
1.00 type and write. The load on the brush is up to 80%
Flag of the working time. He has been sick for 2 years.
question Objectively: the brush of the right hand is tense,
muscle tone is increased, cramps occur when
trying to write. No pathological manifestations of
the central nervous system were found during the
examination. What is the most likely diagnosis?

Select one:
A. Paretic form of coordination neurosis

B. Convulsive form of coordination neurosis

C. Neuralgic form of coordination neurosis

D. Chronic manganese intoxication

E. Hysterical neurosis

The correct answer is: Convulsive form of

coordination neurosis

Question 140 In a 3-year-old boy, the right half of the scrotum

Not answered increases during walking and running, which
Marked out of decreases to normal size when lying down.
1.00 Diagnosis:
Flag
question Select one:
A. Orchiepididymitis

B. Conjunctival dropsy of the membranes of

the right testicle

C. Paraphimosis

D. Phimosis

E. cystocele

The correct answer is: Conjunctival dropsy of the

membranes of the right testicle

Question 141 A 52-year-old man came to the emergency

Not answered department with complaints of sudden shortness
Marked out of of breath and rapid heartbeat. For a month, he
1.00 was treated in a hospital for septic shock, which
Flag developed after a urinary tract infection. During
question physical examination, blood pressure - 100/60 mm
Hg, pulse - 128/min, respiratory rate - 28/min,
SpO₂ - 89%. During a laboratory study, serum
creatinine is 96 µmol/l, troponin I is 1.0 ng/ml
(normal <0.1 ng/ml). On the radiograph of the
chest cavity, there is a slight hydrothorax on the
right and subsegmental atelectasis. On the ECG:
sinus tachycardia, right bundle branch block and
inversion of T waves in leads III and V1. What first
step in patient management would be most
appropriate?

Select one:
A. Echocardiography

B. CT angiography

C. Compression ultrasonography of veins

D. Prescribing aspirin and intravenous

metoprolol

E. Urgent cardiac catheterization

The correct answer is: CT angiography

Question 142 A 32-year-old woman turned to the doctor with

Not answered complaints about the absence of pregnancy for 4
Marked out of years. In the anamnesis: 5 years ago, the first
1.00 pregnancy ended with an artificial abortion.
Flag According to vaginal examination and ultrasound
question examination (ultrasound), the diagnosis was
established: endometrioid cyst of the right ovary.
What is the optimal method of treatment?

Select one:
A. Operative laparoscopy

B. Sanatorium-resort treatment

C. Anti-inflammatory therapy

D. Androgen therapy

E. Conservative therapy with estrogen-

gestagen drugs

The correct answer is: Operative laparoscopy

Question 143 A 25-year-old patient complains of the presence

Not answered of several dense, painful nodes in the right axillary
Marked out of region, an increase in body temperature to 38°C,
1.00 general weakness. Sick for 3 days. Locally: in the
Flag right axillary region there are three nodular
question formations that rise above the surface of the skin,
the size of which is from 0.5 cm to 1.5 cm in
diameter, sharply painful when palpated, with
clear contours, the skin above them has a
purplish-bluish tint, raising the upper the limbs are
limited due to pain. Make a diagnosis:

Select one:
A. Abscess

B. Purulent lymphadenitis

C. Furuncle

D. Carbuncle

E. Purulent hidradenitis

The correct answer is: Purulent hidradenitis

Question 144 A 19-year-old patient has weakness, moderate

Not answered headache, sore throat when swallowing. Sick for 3
Marked out of days. Objectively: body temperature - 38.2°C,
1.00 generalized lymphadenopathy. Signs of
Flag tonsillopharyngitis. Moderate
question hepatosplenomegaly. ZAK: 35% of atypical
mononuclear cells. What research should be
prescribed to verify the diagnosis?

Select one:
A. Blood test for IgM anti-CMV

B. Blood test for IgM anti-HHV-7

C. Blood test for IgM anti-HHV-6

D. Blood test for IgM anti-VCA EBV

E. Blood test for total HIV antibodies

The correct answer is: Blood test for IgM anti-VCA

EBV

Question 145 A 10-year-old boy was admitted to the polytrauma

Not answered department after a blunt chest injury as a result of
Marked out of falling from a bicycle. On admission, blood
1.00 pressure - 110/80 mm Hg, pulse - 96/min. X-ray of
Flag the chest is unweighted. An echocardiogram
question showed free fluid in the pericardial cavity, in the
amount of up to 100 milliliters. An hour after
admission, signs of heart failure began to
increase: swelling of the neck veins, a decrease in
blood pressure to 90/70 mm Hg, an acceleration
of the pulse to 120/min. Auscultatory heart sounds
are barely audible. What should be the primary
medical tactics?

Select one:
A. Continuous oxygen therapy

B. Intravenous cardiac glycosides

C. Intravenous diuretics

D. Intravenous antibiotics

E. Pericardial puncture

The correct answer is: Pericardial puncture

Question 146 A 32-year-old patient developed pain in the lower

Not answered abdomen, frequent and painful urination, and low-
Marked out of grade fever after hypothermia. In the urine
1.00 analysis: protein - 0.3 g/l, leukocytes in the field of
Flag vision, erythrocytes - 12-15 in the field of vision.
question What disease can be assumed?

Select one:
A. Acute pyelonephritis

B. Ectopic pregnancy

C. Acute cystitis

D. Acute adnexitis

E. Acute appendicitis

The correct answer is: Hostric cystitis

Question 147 A 25-year-old patient has had no menstruation for

Not answered 6 months. Menstruation from the age of 16 to 3-5
Marked out of days with delays of a month, moderate, painful.
1.00 The woman has excess body weight, hirsutism,
Flag infertility. During bimanual examination, the body
question of the uterus is of normal size. On both sides of
the uterus, enlarged ovaries up to 4 cm in
diameter, dense consistency, painless, mobile
when shifted are palpated. What will be the
diagnosis?

Select one:
A. Polycystic ovaries

B. Galactorrhea and amenorrhea syndrome

C. Chronic bilateral adnexitis

D. Sheehan syndrome

E. Ovarian dermoid cysts

The correct answer is: Polycystic ovaries

Question 148 The mother brought a 5-year-old boy to the

Not answered doctor with complaints of a facial rash that
Marked out of appeared 5 days ago. Objectively: several blisters
1.00 0.5-1.5 cm in diameter are visible on the face, with
Flag thin flaccid lids, filled with serous cloudy exudate
question and located on a hyperemic, swollen base. Along
with these lesions, erosions with the release of
serous-purulent fluid and thick honey-yellow
crusts are observed. Make a clinical diagnosis:

Select one:
A. Children's eczema

B. Contact dermatitis

C. Simple bullous lichen

D. Impetigo vulgaris

E. Candidiasis

The correct answer is: Impetigo vulgaris

Question 149 A 23-year-old patient came to the clinic with

Not answered complaints of palpitations, sweating, weakness,
Marked out of reduced work capacity, and trembling of the
1.00 fingers. She lost 10 kg in a month. During
Flag examination: heart rate - 120/min., blood pressure
question - 130/70 mm Hg. During an ultrasound
examination, a 2 x 2 cm nodule was found in the
thyroid gland. During scanning, an area of
increased accumulation of the
radiopharmaceutical was found at the site of the
nodule. The remaining tissues of the thyroid gland
do not accumulate RFP. What is the most likely
diagnosis?

Select one:
A. Toxic thyroid adenoma

B. Subacute thyroiditis

C. Autoimmune thyroiditis

D. Mixed toxic goiter

E. Thyrotropinoma

The correct answer is: Toxic thyroid adenoma

Question 150 A 25-year-old patient is admitted to a psychiatric

Not answered hospital for the first time. Excited, speaks quickly
Marked out of and loudly, gestures actively. Nonstop jokes,
1.00 laughs, a smile never leaves his face. He talks to
Flag the doctor in "you", offers him to play cards, flirts
question with the nurses, invites them on a date. He says
that he hasn't slept in the last 2 days, but he
doesn't feel tired at all. What drug should be
used?

Select one:
A. Sedative

B. Antidepressant

C. Soporific

D. Nootropic

E. Antipsychotic

The correct answer is: Antipsychotic

Finish review

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Krok 2 Medicine
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