Written questions

1. A continuous murmur you can heard in patient with:

Ductus arteriosus (Botalli)
Aortopulmonary window
Shunts – mitral valve obstruction

2. A patient with extensive right sided fluidothorax will probably lie in

the position:
Right side

3. A weakened heart sounds occurs in:

Patients with pulmonary emphysema
Obese people

4. A hard, irregular prostatic gland suggests:

A Normal prostate
B Prostatic hyperplasia
C Prostatic carcinoma
D hypogonadism

5. A tense ascites may be confirmed by:

Undulation test (fluid wave)
Bulging flanks and dullness
Lateral decubital position exam for transfer

6. Abdominal angina:
Is a symptom of the coronary heart disease
Is a symptom of the peripheral artery disease
Is a symptom of the gastric ulcer
Is a symptom of the stenosis, occlusion of the mesenterial arteries

7. Abdominal bruit:
A Is physiological
B The most frequent cause is occlusive arterial disease in the aorto-iliac
vessels or renal artery stenosis
C Is very uncommon
D Can never be heard

8. Abdominal type of respiration is:

A Common in women
B Common in men
C Typical for childhood
D Sign of peritoneal irritation

9. According to etiology there is:

Etiology refers to causes of diseases/pathologies
When no etiology = idiopathic

10. Acromegaly is due to:

 Growth hormone secreted after epiphyseal seal from anterior pituitary
gland

11. After enlighting an eye, in normal direct photoreaction we observe:

Myosis – contraction of pupils

12. After enlighting an eye, in normal indirect photoreaction we observe:

Myosis – contraction of both pupils

13. Alopecia areata means:

Hair loss from head or body

14. Amplitude 1mV on ECG equals :

10mm in vertical direction

15. An enlarged left kidney from the enlarged spleen may be

differentiated by palpation:
“The position in the abdomen, characteristics of the palpated "edge," and
movement on inspiration are usually sufficient to identify with confidence
an enlarged spleen. If any question exists, however, it can be resolved by
an abdominal ultrasound examination.”

16. Anasarca is the:

A Loss of hair in hypothyreosis
B Edema of the whole body
C Subcutaneous bleeding
D Lymphedema of the lower limbs

Usually caused by liver failure, renal failure or heart right side failure,
severe malnutrition and protein deficiency

17. Ankle - brachial index informs about:

is the ratio of the blood pressure in the lower legs to the blood pressure in
the arms. Compared to the arm, lower blood pressure in the leg is
an indication of blocked arteries (peripheral vascular disease). The ABI is
calculated by dividing the systolic blood pressure at the ankle by the
systolic blood pressures in the arm.
Indication of blocked arteries (hand leg BO). Normal ABI 1,0-1,4

18. Anuria is when the urine output is decreased under:

<50ml/day (which indicates a kidney damage)

19. Arteriovenous fistule (malformation):

A Is a connection between atria and vein
B Causes continual murmur and palpable whiol (?)
C Causes aggravation of the blood flow in the vein, sometimes it can be
used therapeutically
D All choices are correct
 May be due to congenital reason, hemodialysis treatment or acquired by
path. Process.

20. Assembly of dilated veins around the naval in liver cirrhosis is called:
Caput Medusa

21. Asymmetrical edema of the lower extremities is often caused by:

A Heart failure
B Renal failure
C Deep vein thrombosis
D hyperaldosteronism

Also: venous isufficiency, peripheral cyst, cellulitis, local trauma

22. Auscultatory place for a.pulmonalis is:

2nd left parasternal ICS

23. Auscultatory place for aorta is:

2nd right parasternal ICS

24. Barrel chest is:

A Older name for normal, physiologic shape of the chest
B Abnormal chest shape typical in emphysema
C Abnormal chest shape typical in cachexia
D Abnormal chest shape common in rickets

25. Biot´s breathing:

A Means irregular breathing of varying amplitude alternating with
apneic pauses
B Is the type of breathing with diminished amplitude and frequency of
respiratory cycles
C Is breathing phenomenon with regular cyclic alternation of apnea and
hyperpnea
D Occurs also in healthy individuals on exertion

26. Blumberg sign is positive in inflammation of:

A peritoneum
B larynx
C pericardium
D The brain

27. Bradypnea:
Abnormal slow breathing
28. Bronchial, tubular, breathing is audible by:
Stethoscope

29. Bronze diabetes is a sign of metabolic disorder of:

A Copper
B silver
C Iron
D calcium

30. By manual examination of rectum in women we palpate on anterior

side:
Cervix

31. By Naegeli the second grade of liver stiffness is by:

A Carcinoma of the liver
B normal, healthy liver
C venostasis, chronic hepatitis and some types of liver cirrhosis
D Liver cirrhosis

32. By normal body weight body mass index (BMI) is:

A Over 30
B Between 25-30
C Between 20-24
D Below 19

33. By obesity body mass index (BMI) is:

>30kg/cm2

34. Caput medusae is common in:

Liver cirrhosis

35. Carotid artery pulsation can be observed:

A In Aortic valve insufficiency
B In pulmonary valve insufficiency
C In aortic valve stenosis
D In pulmonary valve stenosis

36. Carotid sinus syndrome will manifest as:

Temporary loss of consciousness, syncope
Convulsive seizures as pressure rises, bradycardia

37. Central paresis of n. facialis manifests as:

paralysis or paresis of the lower half of one side of the face. It usually
results from damage to upper motor neurons of the facial nerve.

38. Central type of cyanosis is characterized:

A Is not the sign of organic heart disease
B Can be modified with oxygen administration
 C With oxygen inhalation is unchanged
D Skin usually cold or pale
39. Cirrhosis of the liver can cause:
A Palmar erythema
B Plantar erythema
C Spider naevi
D All of the above

40. Claudication pain in peripheral artery disease:

These MAYBE the options:

A Angiography of arteris
B Ultrasound Doppler examination of arteries
C CT examination of arteries
D Pletysmorraphy

41. Claudication pain of lower extremities:

A A typical night resting pain
B Pain is provoked by change in position, mainly by lowering extremity
C Pain occurs during waling and patient cannot continue walking until
receiving vasodilate drugs
D Pain occurs during walking and spontaneously disappears at rest,
then patient can continue walking again

42. Cold and pale lower limb is typical for:

Peripheral cyanosis

43. Collapse is characterized by:

Decrease in diuresis
Edema of lower limbs
Sudden failure of the peripheral circulation
All answers are correct

44. Continual heart murmur is present in:

A Mitral valve insufficiency
B Aortal valve insufficiency
C Open ductus arteriosus Botalli
D Tricuspid valve insufficiency

45. Coronary T wave is:

Repolarisation of ventricles

46. Corrigan's pulse is present in:

a pulse characterized by a sharp rise to full expansion followed by
immediate collapse that is seen in aortic insufficiency—called also water-
hammer pulse.

47. Costal type of respiration is:

A Common in women
B Typical for childhood
 C Common in men
D Sign of hypermobility of thoractic spine

48. Crooked neck can occur:

At birth

49. Cullen sign:

A A superficial edema and bruising in a subcutaneous fatty tissue
around the umbilicus in severe acute pancreatitis or ruptured ectopic
pregnancy
B Venous assembly round the naval in liver cirrhosis
C Pain in the culf in phlebothrombosis
D Pain on deep palpation under right costal margin in cholecystitis

50. Deep palpation is usually not limited in:

A Asthenics
B In increased amount of gas inside the bowels (meteorism)
C In obese individuals
D In the presence of free fluid (ascites) in the abdominal cavity

51. Defence musculaire is:

Is the tensing of the abdominal wall muscles, to guard inflamed organs
within the abdomen from the pain of pressure upon them. The tensing is
detected when the abdominal wall is pressed. (appendicitis, diverticulitis).
The tensed muscles of the abdominal wall automatically go into spasm to
keep the tender underlying tissues from being disturbed. Abdominal
guarding, diverticulitis, appendicitis, fucking abdomen is hard.

52. Diabetic foot:

Is a foot that exhibits any pathology that results directly from diabetes
mellitus or any long-term (or "chronic") complication of diabetes
mellitus. Presence of several characteristic diabetic foot pathologies is
called diabetic foot syndrome. Is blue

53. Diastolic murmur is present in:

Mitral stenosis, aortic/pulmonary insufficiency

54. Diastolic murmur with the propagation along the sternum border:
Aortic insufficiency

55. Different size of pupil diameter is:

A Isokoria
B Anisokoria
C miosis
D mydriasis

56. Dry rales by lung auscultation include:

 wheezing and sonorous rales

57. Dull percussion sound over the abdomen can be present in:
Tumor, mass, fluid

58. Duration of PQ interval 0,22 seconds is present in:

AV block, hypokalemia, rheumatic fever, carditis (assoc. with Lyme
disease)

59. During first heart sound is present:

Mitral, tricuspid (AV valves closing)

60. During inspiration, the liver:

A Descends
B Elevates
C Disappears
D All of the mentioned

61. During physiologic conditions with inspiration leads to:

Diaphragm down, liver too

62. Durozier’s sign is present in:

Aortic insufficiency. It consists of an audible diastolic murmur which can
be heard over the femoral artery when it is compressed.

63. Dysartria is:

Weakness in muscles for talking

64. Dyspareunia is:

A Pain related to sexual intercourse
B Postpartal psychosis
C Change in bowel habits
D None of the mentioned

65. Dyspnea is:

Shortness of breath

66. Dysuria is:

Pain during urination

67. ECG changes on anterior wall of left ventricle are best seen in leads:
V2, V3, V4

68. ECG changes on inferior (diaphragmatic) wall of left ventricle are

best seen in leads:
II, III, AVF
69. ECG changes on lateral wall of left ventricle are best seen in leads:
I, AVL, V5, V6

70. ECG changes on posterior wall of left ventricle are best seen in leads:
V1, V2, V3

71. Ecchymoses are:

A Haemorrhages from ruptured blood vessels into subcutaneous tissue
B Tiny pinpoint haemmorhage ( petechiae)
C More or less extensive patches of subcutaneous extravasation of
blood
D Bleeding from stomach

72. Ectropion means:

Lower eyelids turned outward

73. Edema of acute glomerulonephritis usually affects:

Starts in eyelids and face then the lower and upper limbs then generalized
(e.g. hydrocele, ascites. pericardial and pleural effusion.)

74. Elevated niveau of abdomen above chest can be present in:

Ascites

75. Elevation of ST segment is not present in:

Hypokalemia (st depression)

These CAUSE elevation:

-Myocardial infarction
-acute pericarditis
-LV aneurism
- Acute myocarditis
- Embolism
- Hypothermia, J point elevation, trauma, angina

76. Endofthalmus means:

posterior displacement of the eyeball within the orbit

77. Examination of first choice when deep vein trombosis is suspected is:
A major presenting feature is pain in the calf, often with swelling, redness
and engorged superficial veins. The affected calf is often warmer and
there may be ankle oedema. Homan’s sign (pain in the calf on dorsiflexion
of the foot) is often present, but is not diagnostic and occurs with all
lesions of the calf. Clinical diagnosis is unreliable but combined with D-
dimer level it has a sensitivity of 80%. Confirmation of an iliofemoral
thrombosis can usually be made with B mode venous com- pression,
ultrasonography or Doppler ultrasound with a sen- sitivity and specificity
over 90%.
78. Existence of secondary female gender signs in men or boys is named:
A Feminisation
B Virilisation
C Feminism
D None of the above

79. Exoftalmus means:

Sink of eyebulb into socket eye (orbita)
Oedema of upper lids
Oedema of both lids
Protrusion of bulbus from socket eye (orbita)

80. Expressive aphasia is:

loss of the ability to produce language (spoken or written).

81. Facies lunata is typical for:

Cushing syndrome

82. Finding of 3rd heart sound suggests for the:

Rapid ventricular filling, heart failure

83. Finger clubbing is usually caused by:

chronic hypoxia, or lung cancer, can be from LUNG, HEART, GIT

84. Fixed split of 2nd sound is present in:

Is present in atrial septal defect. Both components are clearly separated
and their distance in time does not change during inspiration or
expiration. Blood basically flows to the right heart, bcz of the septal
defect, causing the Pulmonary valve to close later than the aortic.

85. Fixed splitting of the second heart sound on the basis of heart:
A Suggests significant aortic stenosis
B Is found in hemodynamically significant atrial septal defect
C Is frequent finding in mitral valve prolapse
D Is found in hemodynamically nonsignificant mitral valve stenosis

86. Flapping tremor (asterixis) is usually the result of:

A Hyperglycemia
B Uraemia
C Hypoglycemia
D cirrhosis

87. Flush may be a sign of:

Fever, stress, arousal, embarrassment  carcinoid syndrome:
endogenous secretion of serotonin and kalikrein

88. For asthenic people is not typical that they:

A Have a Metabolic syndrome
B Are neurovegetative sensible
 C Have stomach ulcers
D Are thin and tall

89. For central cyanosis is typical the:

A Red tongue
B Cold skin
C Normal saturation of arterial blood
D The presence of reduced haemoglobin over 50g/l in the capillary
blood

90. For the auscultation of aortic valve the most suitable area is:
2nd intercostal space, parasternally right

91. Fourth heart sound is not present in:

A By higher tonus of sympaticus
B Lowering of ventricle? (compliance?)
C By atrial fibrillation
D In late phase diastole

92. Fourth heart sound is present:

A In first phase of systole
B In first phase of diastole
C In late phase of systole
D In late phase of diastole

93. Fourth heart sound:

Late diastole

94. Funnel breast is:

Inward deformaty of the sternum ( pectus excavatum ) heart is pushed to
the left.(MVP, base lung capacity is decreased)

95. Galactorrhea:
Spontaneous milk secretion

96. Grafit marks on bucal mucose are signs of:

Addison’s disease

97. Grey-Turner sign: ???

A It is a sign of retroperitoneal hemorrhagemost frequently accompanying
necrotizing
B Pancreatitis
C Located in lateral parts of abdomen
D Are (usually multiple) blue to purple ecchymoses (no?!)
Refers to bruising of the flanks, the part of the body between the last
rip and the top of the hip The bruising appears as a blue discoloration,
and is a sign of retroperitoneal hemorrhage, or bleeding behind the
 peritoneum, which is a lining of the abdominal cavity. Grey Turner's
sign takes 24–48 hours to develop, and can predict a severe attack of
acute pancreatitis

98. Gynecomastia is not:

A Means enlarged breasts in men
B Is a finding that may indicate endocrine disturbances
C Is a dinfing that may indicate cirrhosis of the liver
D Means abnormal secretion from the nipples (no?!)
 Is the benign enlargement of male breast tissue caused by
extensive estrogen action
  so probably C is right?!

99. Heart sounds are louder:

Young healthy humans

100. Hemoptoe it can be caused by:

A Bleeding from the stomach
B Tuberculosis
C Acute hemorrhagic pancreatitis
D Pleural effusion

101. Hemoptysis is:

Coughing blood

102. Hepatic jaundice is caused by:

A Haemolytic anemia
B Obstruction of the bile duct
C Excessive consumption of carrotts
D Hepatic cell necrosis

103. Hepatojugular reflux is present in:

Right heart failure/insufficiency

104. Hirsutism means:

excessive hairiness on women

105. Homans´s sign:

A Is examined when a blood pressure cuff is placed around the calf and
slowly inflated
B Is examined when the examiner performs dorsiflexion of the
patients foot
C Is examined when the examiner performs plantar flexion of the patients
foot
D Is examined by pressing the sole of the foot with thumb
106. How can you diferentiate between pleural and pericardial friction rub
by auscultation:
A you will say to the patient to raise both arms
B you will say to the patient to lean forward
C you will say to the patient to hold his breath
D you will say to the patient to spell numbers 333, 666, 999

107. Hunter glositis is sign of:

Aneamia, glossitis, vitamin B12 deficiency

108. Hyperpyrexia means:

Fever higher than or equal to 41.1°C (according to his presentation)

109. Hypersonorous percussion above the lungs can be found by:

Pneumothorax or air filled lung tissue
Acute asthma

110. Hypertrichosis is:

is an abnormal amount of hair growth on the body

111. Hypertrichosis means:

is an abnormal amount of hair growth on the body

112. Hypotrichosis may be seen by:

Hallerman-streiff syndrome, or chemotherapy

113. Cheyne-Stokes periodic respiration is not:

IS: Deeper breathing, then slowing, then apnea. The cycle repeats..

114. Choose the true saying about adventitious breath sounds:

A Dry rales are audible in acute bronchitis
B Dry rales are typical for cardiac venostasis in the pulmonary c
circulation
C Are audible only by upper respiratory airway infection
Dry moist rales can not occur simultaneously

115. If the patient has a gallop rhythm, what heart rate does he/she usually
have:
Tachycardia (heart failure as well as pulomary oedema
Triple sound resembles the three beat run of a horse
Mostly left ventricular heart failure
Can also be heard in young patients with healthy hearts and with
tachycardia due to fever

116. Impaired posture with limited movements of the back can be seen in
patients with:
A stroke
 B Bechterews desease( angylosing spondilitis )
C Parkinsons disease
D Gauchers disease
117. In acute appendicitis is positive:
A McBurneys Sign
B Homans sign
C Murphys sign
D Cullens sign

118. In acute peritonitis one can find out:

A Diffuse rigidity of abdominal wall
B Painful palpation and percussion over abdominal wall
C Tense abdominal wall
D All of the above

119. In acute thyroiditis:

Piriform sinus,- bacterial infection
Thyroiditis is a group of disorders that all cause thyroidal inflammation.
In the case of acute thyroiditis , the thyroid hormone within the gland
leaks out into the bloodstream causing symptoms of thyrotoxicosis, which
is similar to those of hyperthyroidism. Symptoms: include weight loss,
irritability, anxiety, insomnia, fast heart rate, and fatigue. Elevated levels
of thyroid hormone in the bloodstream cause both conditions, but
thyrotoxicosis is the term used with thyroiditis since the thyroid gland is
not overactive, as in the case of hyperthyroidism.

120. In case of positive result of III Romberg´s test it´s a sign of:
A Vestibular problem
B Cerebellar tumor
C Myocardial infarction
D Diabetic ketoacidosis

121. In case of superior vena cava syndrome, on the neck can be found:
A Increased filling of neck veins
B Pulsation of carotid arteries
C Diffuse goiter
D Reduced filling of neck veins

122. In case of suspicion of peripheral artery disease of lower limbs, is is

necessary to realise:
it will lead to changes in the lumen of the vessel, most frequently to its
narrowing(stenosis) or total occlusion ischemia of extremity.

123. In central paresis of facial nerve on right side we can find:

Unilateral facial weakness
Loss of sensation
Higher sensitivity to sounds
Decreased production of saliva and tears
124. In diaphragmatic myocardial infarction the typical ECG changes are
in leads:
ST elevation in the inferior leads II, III and aVF
reciprocal ST depression in the anterior leads

125. In exudative pleuritis the patient has a relief position when lies:
A On his back
B On the not affected side
C On his abdomen
D On the effected side of the pain?

126. In Graves-Basedow disease of the thyroid:

A Thyroid is diffusely enlarged, has a smooth surface and elastic
consistency
B Thyroid is not enlarged, has not a smooth surface and is of solid
consistency
C thyroid is nodularly restricted
D is a case of hypothyroidism

127. In healthy individual the abdominal wall is:

normosthenic

128. In hemmorrhagic-necrotising pancreatitis one may notice:

sudden inflammation of the pancreas.

129. In lateral parts of epigastrium (laterally off both midclavicular lines)

are: the right/left hypochondriac regions.
Duodenum, liver, pancreas, stomach.. not quite sure what they want here

130. In left axis deviation on ECG the axis angle is:

the mean electrical axis of ventricular contraction of the heart lies in a
frontal plane direction between -30° and -90°. This is reflected by a QRS
complex +ve in lead I and -ve in leads aVF and II.
 Angle is less then -20

131. In non-ST elevation myocardial infarction, you will not find on ECG:
Q waves

132. In normal electrical axis on ECG the axis angle is:

0-90° about

133. In physical examination of the abdomen one can use:

A Deep palpation
BTwo-handed deep palpation
C Light palpation
D All of above
134. In right axis deviation on ECG the axis angle is:
+105°

135. In surface palpation of abdomen:

p. 141

136. In suspicion of acute abdomen:

Sudden, severe abdominal pain of unclear etiology
 Often peritnonitis, ischaemic acute abdomen

137. In tonsillitis neck lymphatic nodes are:

A Painful and large
B Non-painful and enlarged
C Non-painful and not enlarged
D Not palpable

138. In what type of valvular heart disease there is a strong 1st heart sound
at apex:
A Aortic stenosis
B Pulmonic stenosis
C Tricuspid stenosis
D Mitral stenosis

139. In which position of the patient with acute pericarditis there is less
chest pain?
A In sitting
B In supine
C In standing
D In sitting forward

140. Incarcerated hernia is:

A Hernia that cannot be pushed back into abdominal cavity
B Hernia that can be pushed back
C Reducible hernia
D Non visible hernia

141. Increased filling of neck veins is found:

In constrictive pericarditis
In endocarditis
In lymphoma
In dilated cardiomyopathy

142. Increased filling of neck veins:

Caused by Superior vena cava syndrome

143. Increased finding in vocal (pectoral) fremitus:

 is a vibration felt on the patient's chest during low frequency vocalization/
phrase “99”. Tactile fremitus is pathologically increased over areas of
consolidation and decreased or absent over areas of pleural effusion or
pneumothorax when there is air outside the lung in the chest cavity,
preventing lung expansion.

144. Inferior borders of the lungs by percussion are moving by inspirium:

A 8 cm towards down in the mid axillary line, 6 cm in the scapular
line and 4 cm in the paravertebral line
B 8 cm upwards in the mid axillary line, 6 cm in the scapular line and 4
cm in the paravertebral line
C 4 cm towards down in the mid axillary line, 2 cm in the scapular line
and 1 cm in the paravertebral line
D 4 cm upwards in the mid axillary line, 2 cm in the scapular line and 1
cm in the paravertebral line

145. Inspiratory crepitations by lung auscultation are typical for:

A Bronchial asthma
B Cardiac venostasis in the pulmonary circulation (congestive heart
failure)
C Chronic obstructive pulmonary disease
D Pneumonia

146. Intensified ( Increased ) vesicular breathing by auscultation can we

hear by:
Pulmonary consolidation ( lobar pneumonia, pneumothorax, massive
pleural effusion)

147. Jaundice, septic fever and right upper quadrant pain is a common
characteristic of:
(Charcot triad) caused by Acute cholangitis. (bile duct stones, obstructive
jaundice)

148. Kayser-Fleischer ring is present in metabolic disorder of:

Copper in liver, Wilsons disease

149. Kussmaul´s breathing:

Deep breathing due to diabetic-metabolic acidosis, regular, deep and fast

150. Leucoplakia on tongue manifests as:

Yellowish coating on tongue
Black coating on tongue
White coating on tongue, which can be scratched away
White coating on tongue, which cannot be scratched away

151. Lowenberg´s sign:

Pressure around cuff on leg, pain. For deep vein thrombosis

152. Makroglosia is typical sign of:

A Acromegaly
 B Glositis
C Angioneurotic oedema
D All of the above

153. Malignant goiter is:

A Asymmetric, hard, not painful (non-mobile)
B Inflamed, painful
C Diffusely enlarged, painful, soft
D Always hyperfunctional

154. Massive edema of conjunctivae is called:

chemosis

155. McBurney's sign is a deep tenderness at McBurney's point in

inflammation of:
Appendix

156. Miosis means:

Constriction of pupils

157. Murmur is the sound caused by:

A The vibration of the heart valves
B Turbulent blood flow
C The vibration of the cordiae tendinae
D All of the above

158. Murmur over the thyroid is typical:

A For Graves-Basedow disease of the thyroid
B For multinodular goiter
C For Hashimoto goiter
D For Riedl goiter

159. Murphy´s sign is typically positive:

A Typically, it is positive in appendicitis
B Typically, it is positive in diverticulitis
C Typically, it is positive in liver cirrhosis
D Typically, it is + in cholecystitis , (- choledocholithiasis)

160. Musset sign ( movements of head current with heart systole) we can
see:
A In insufficiency of aortic valve
B In mitral valve insufficiency
C In aortic valve stenosis
D In tricuspid valve insufficiency

161. Mydriasis means:

Dilation of pupils
162. Myxedema mostly often occurs:
A in peripheral hyperthyroidism
B On the hands
C in hypothyroidism
D In central hyperthyroidism

163. Neck stiffness:

A Is a symptom of meningitis
B Is a symptom of otitis
C Is a symptom of thyroiditis
D Is a symptom of tonsillitis

164. Negative T waves on ECG are present in:

Coronary ischemia, wellen’s syndrome, Left ventricular hypertrophy, Cns
disorder

165. Normal blood pressure in adults is:

120/80 mmHg

166. Normal duration of PQ interval is:

A 0,12-0,20 sec
B 0,08-0,10 sec
C 0,12-0,22 sec
D 0,16-0,20 sec

167. Normal duration of QRS is:

0,06-0,10 sec

168. Normal percussion over the abdomen is:

(differential tympanic )
Tympanitic (drum-like) sounds produced by percussing over air filled
structures. Dull sounds: occuring when a solid structure (e.g. liver) or
fluid (e.g. ascites) lies beneath the region being examined.

169. Normal respiration is called:

A Normopnea
B apnea
C eupnea
D dyspnea

170. Normal respiratory rate in resting adult is:

A Approximately 16-20
B Called apnea
C Approximately 20-30
D Approximately 8-16
171. Number of axillary (orientation) lines on one side of the body is:
A1
B2
C3
D4
See link:
https://www.google.sk/search?q=lowenberg+sign&source=lnms&tbm=isc
h&sa=X&ei=TbPQVObWKoaAUcTxgdgH&ved=0CAgQ_AUoAQ&biw
=1366&bih=631#tbm=isch&q=axillary+line&spell=1&imgdii=_&imgrc=
Ofgdx4cc6jFIEM%253A%3Bslm8hRMVtOioIM%3Bhttp%253A%252F
%252Fo.quizlet.com%252Fi%252FyjJ57A5pYgJ-
azjv8XNQWA_m.jpg%3Bhttp%253A%252F%252Fquizlet.com%252F69
38176%252Fchest-wall-flash-cards%252F%3B240%3B240

172. Nycturia is typically present in:

getting up in the night to urinate, thus interrupting sleep. Pregnant women
and elderly, aslso present in apnea, hyperparathyroidism, chronic renal
failure, urinary incontinence, bladder infection, interstitial
cystitis, diabetes, congestive heart failure, benign prostatic hyperplasia,
ureteral pelvic junction obstruction, uterine fibroids, eating disorders,
or prostate cancer.

173. Nycturia means:

A Urination during night
B Incontinention of urine
C Pain by urination
D Obsedant urination

174. Oedema of lids are signs of:

Hypoalbuminemia, kidney disease, blepharitis, allergy, myxedema ( graves
disease)

175. Oedema of lower extremities caused by renal diseases:

nephritic syndrome- mainly caused by protein loss in urine (Albumin =
which is responsible for maintaining the oncotic pressure)
hypoalbuminemia  fluid accumulation because of decrease in oncotic
pressure and edema occurs. Malnutrition, liver diseases as well. First sign
is lid edema… or in ankle… long term ascites.

176. Oedemas from cardiac origin are:

from backward caused by congestive heart failure , leading to 
peripheral edema: accumulation of fluids causing most often swelling of
the lower extremities.

177. On the anterior surface of the chest one recognizes (as orientation
lines):
Sternal lines
Scapular lines
 Paravertebral lines
Diagonal lines

178. Opening snap of the mitral valve in mitral stenosis is:

A Beginning of systole
B End of systole
C Beginning of diastole
D End of diastole

179. Opisthotonus:
severe hyperextension + spasticity in which an individual's head, neck +
spinal column enter into a complete "arching" position => caused
by spasm of the axial muscles along the spinal column.

180. Organic murmur is not caused by:

due to a lesion in an organ, e.g., the heart, a vessel, or a lung. (stenosis,
insufficiency, shunt problems. It can be diastolic or systolic )

181. Orthopnoic position is observed in patients with:

Dyspnea when lying flat. heart failure + pulmonary diseas + ascites

182. Osler's nodes are caused by:

painful, red, raised lesions found on the hands and feet. They are
associated with a number of conditions, including infective endocarditis,
and are caused by immune complex deposition. result from the deposition
of immune complexes.The resulting inflammatory response leads to
swelling, redness, and pain that characterize these lesions.

183. Over carotid artery can be heard:

Cardiac murmurs (aortic stenosis/insufficiency, systolic ejection murmur),
buit (atheromatous plaque), anauresmic dialation.

184. P mitrale on ECG is caused by:

is a P wave shaped like an “M”. It is indicative of a bulky left atrium and
Left atrial Hypertrophy.

185. P mitrale on ECG is:

same

186. P pulmonale on ECG is caused by:

is a big, tall, peaked P wave. Associated with lung disease + Right atrial
hypertrophy

187. P pulmonale on ECG is:

same

188. Pain is:

189. Palpable abdominal mass (lump) until it is specified is called:

Lesion, tenderness (?)
190. Palpable and non-painful neck glands are mostly typical for:
Metastases => Virchow’s gland => Troisier’s sign.

191. Palpable whirl is sign of:

Left Ventricular Hypertrophy. (Rising apex beat palpable whirl over
the aortic opening)

192. Palpable subcutaneous crepitus in the chest region reminds us of the

possibility of:
Subcutaneous emphysema

193. Palpation in abdomen is usually performed:

Not one but 2, 2 hands

194. Palpation of the abdomen is:

A Light and deep
B Direct and indirect
C The least important method of physical examination of the abdomen
D Is always performed only by one hand

195. Paradoxical splitting of 2nd heart sound occures in the:

Splitting of second heart sound (S2) into A2 (aortic) and P2 (pulmonary)
occurs normally during inspiration. Conditions which increase the right
ventricular contraction time (eg. volume overload or pressure overload)
will cause P2 to be delayed and hence wide splitting of S2.

196. Pardee wave is characteristic for:

Myocardial infarction

197. Pathologic Q wave is present in:

Myocardial infarction

198. Patient with heart disease, having dyspnea in rest is classified after
NYHA to class:
class number 4 ( the highest ).
IN GENERAL. class 1: HD but no symptoms / limitations and normal
physical activity, class 2: light symptoms = shortess of breath, angina and
during ordinary activities, class 3: marked limitations, confortable at rest,
but limitations during activities- in walking short distances.

199. Percussion by lung emphysema is:

A Flat
B Amphoric
C Hypersonorous
D Sonorous, Resonant

200. Percussion above healthy lung can we describe as:

 A Hypersonorous
B Tympanic
C Dull to Flat
D None of the options are correct

201. Percussion by fluidothorax is:

Dull& flat

202. Periferal paresis of n. facialis manifests as:

A Unilateral paresis of upper and lower ramus
B Assymetria of slit lid
C Disability to close eyes, bul scres up (Bel sign) by closing of eyes
D All of the above?

203. Peripheral pulsation is mostly examined by palpation of:

Carotid, Radial, brachial, femoral, popliteal and tibialis posterior.

204. Peripheral type of cyanosis is characterised:

205. Peripheral cyanosis is the blue tint in fingers or extremities, due to
inadequate circulation. The blood reaching the extremities is not oxygen
rich and when viewed through the skin, a combination of factors can lead
to the appearance of a blue color. All factors contributing to central
cyanosis can also cause peripheral symptoms to appear, however
peripheral cyanosis can be observed without there being heart or lung
failures. Small blood vessels may be restricted and can be treated by
increasing the normal oxygenation level of the blood.

206. Peristalsis:
A May be sometimes visible in thin individuals under abnormal skin
in intestinal obstruction and is then resembling the winding snake
B Never visible
C Increased in paralytic ileus
D Is always absent in ileus

207. Phlegmasia coerulea dolens is sign of:

Deep venous thrombosis

208. Physical examination of the lung affected by abscessus cavity after

spontaneous drainage will be:
Only possible if cavity is > 6 cm, near lung surface surrounded by
infiltration, condensed tissue  X-ray

209. Physical examination of the lungs by obese, otherwise healthy, can

reveal:
?

210. Physical findings above the lung with pneumothorax will be:
Insepction: decrease of respiratory movements + expansion of
hemithorax.
 Percussion: hyperresonant-tympanic and in higher interthoracic pressure
can be metallic sound.
Auscultation: Vesicular weak / absent
Bronchophony + VF =complete (absence)
= partial ( weak )

211. Physical findings by cardiac venostasis in the pulmonary circulation

will be:
A Tubular (bronchial) breathing, dull percussion, increased fremitus
pectoralis
B Prolonged expirium, hypersonous percussion and dry rales
C Audible bronchitic phenomena (rales), or decreased breathing, dull
percussion, increased fremitus pectoralis
D Slightly decreased (weakened) breathing, sonorous, resonant percussion
and inspiratory crepitations

212. Physical findings by pleural effusion will be:

A Weakened breathing, dull percussion, increased fremitus pectoralis
B Intensified vesicular breathing with crackles and rhonchi
C Weakened breathing, dull percussion, decreased fremitus pectoralis
D Intensified vesicular breathing, hypersonous percussion, increased
fremitus pectoralis

213. Physiological thyroid:

Not visible or palpable

214. Physiological ( normal ) breathing by lung auscultation can be

decribed as:
Eupnoea-vesicular

215. Pigeon breast is: (pectus carinatum )

A Abnormal chest shape caused by emphysema
B The same as pectus excavatum
C Abnormal chest shape caused by kyphoscoliosis
D Abnormal chest shape common in rickets

216. Pleural friction rub is:

Friction of inflamed and roughened pleural layers

217. Pleural friction rub:

Heard in axilla as sound like walking on snow

218. Polakisuria is:

A Urination of a large volume of urine
B Pain during urination
C Frequent urination
D Nocturnal urination

219. Polytopic ventricular extrasystoles:

In metabolic disorders, systoles originate from 2 or more locations
220. Polyuria is:
A Increased fluid intake
B Excessive thirst
C Frequent passage of small volumes of urine
D Increased urinary volume

221. Positive Sokolow - Lyon index indicates:

Determines left ventricular hypertrophy on ECG

222. Posterior axillary line goes:

Along lateral border of the latissimus dorsi muscle

223. Postphlebitic syndrome:

A manifestations include: varices, oedema, atrophic skin, crural ulcers
B Always occurs shortly after deep vein thrombosis
C Manifestation include: pain of legs with warm skin, fever, elevated
inflammation markers
D Causes only pain, without any pathological signs during physical
examination

224. PQ interval is measured:

0.12- 0.2s (also known as atrioventricular transmission time)

225. Precordial lead V2 is placed in:

4th ICS, parasternal left

226. Precordial lead V4 is placed in:

5 ICS, midclavicular line

227. Prolapse of the mitral valve is characterised by:

mid or late systolic click
ejection systolic click
opening snap of mitral valve
diastolic click

228. Prolonged expirium with expiratory wheezing can be found by:

A Cystic fibrosis
B Lung tumors
C haemothorax
D Asthma (none of the above)

229. Propagation of the heart murmur is:

230. Proper colours of ECG limb leads are:

Yellow, red, black, green
Red cable: Right arm,
yellow cable: Left arm,
 Green cable: Left leg,
black cable: Right leg,
(White cable: chest lead)

231. Pulse deficiency is:

difference between the heart rate and the pulse rate in atrial fibrillation.

232. Pulse of the ATP (arteria tibialis posterior) is palpable:

A Behind the lateral malleolus
B On the dorsum of foot
C On the distal crural part
D Behind medial malleus

233. Pulse of the ADP (arteria dorsalis pedis) is palpable:

Extensor halluces longus

234. Pulse over carotid artery is physiologically:

A Less palpable on the right
B Less palpable on the left
C Symmetrical
D Palpable only over one carotid artery

235. Pulsus alternans is in:

A Constrictive pericarditis
B Heart failure
C Ventricular thachycardia
D Lung embolism

236. Pulsus paradoxus is:

nothing to do with Pulse Rate and HR. Is an abnormally large decrease in
SBP and Pulse Wave during inspiration.
Normal fall in P. = less than 10mmHg, if more than that = pulsus
paradoxus. Found in conditions like: cardiac tamponade, pericarditis,
chronic sleep apnea, croup, and obstructive lung
disease (e.g. asthma, COPD) On cardiac auscultation during inspiration:
beats are detected which cannot be palpated at the radial pulse
(accentuated decrease of BP). May be accompanied by an increase in
the jugular venous pressure height (Kussmaul's sign). As is usual with
inspiration, the heart rate is slightly increased, due to decreased left
ventricular output.

237. Pulsus parvus et tardus is present in:

Aortic stenosis

238. Punctum maximum of the murmur is the:

Location where most murmurs are heard

239. Purple striae characteristically occur:

 a form of scarring on the skin with an off-color hue. They are caused by
tearing of the dermis, which over time may diminish, but will not
disappear completely.

240. Purpura means:

A Pitting bleeding to skin
B areas bleeding
C Big confluence hematomas
D Higher numbers of petechias

241. QRS complex on ECG:

Depolarisation of ventricles

242. QT interval is not influenced by:

IT IS influenced by: Heart rate, potassium, magnesium, and calcium. (
LQT=hypokalemia, hypomagnesimia, low K. SQT = high K )

243. Qualitative impaired consciousness is:

Delirium
Somnolence
Coma
stupor

244. Quantitative impaired consciousness is:

A Obnubilation
B Delirium
C Stupor ?
D hallucinations

245. Quincke pulsations are present in:

Aortic insufficiency

Watch this: http://www.youtube.com/watch?v=8eu7xpK3r_0

246. Raynaud phenomenon:

A Is vasoneurosis, with palor, cyanosis and hyperrenia of the fingers
B Mostly occurs when exposed to cold
C Is painful
D All of the above

247. Rectal examination should be routine in the following circumstances:

prostate examination, sphincter (neurologically) , any enlargements in
intestines, rectal tumors, in women: cervix (tenderness, or masses,
tumors).

248. Reduced liver dullness may be due to:

Blunt abdominal trauma
249. Resistance of malign origin upon palpation is usually:
Tumor wall (?)

250. Respiratory mobility upon palpation is typical for:

A Intraperitoneal organs or masses
B Retroperitoneal organs or masses
C Both intra and retro organs or masses
D Mediastinal organs

251. Rhythmical speech is sign of:

Hepatic encephalopathy ?
Stroke

252. Second degree AV block, Mobitz II type, is characterized by:

AV-BLOCK => refers to a electrical conduction block between
the atria and ventricles. Its presence is diagnosed when one or more (but
not all) of the atrial impulses fail to conduct to the ventricles due to
impaired conduction.
MOBITZ II => disease of the AV node  progressive prolongation of the
PR interval on ECG on consecutive beats followed by a blocked P wave.
( ie. 'dropped' QRS complex )

253. Second degree AV-block, Wenckebach type, is characterized by:

problem of the distal conduction system  His –purkinje
system. Characterised on ECG, by non-conducted P waves not preceded
by PR prolongation and not followed by PR shortening. It can lead to
complete heart block.
252. 253: not vice versa?! Look Wikipedia: 2nd degree AV-block

254. Second heart sound is caused by:

Closing of the semilunar valves

255. Second standard limb lead shows difference of potentials between:

I+III

256. Sensoric aphasia is:

Fluent but meaningless speech

257. Shortened (dull) percussion above the lungs can be found by:
fluidothorax

258. Sign for left ventricular dilatation with physical examination is:
A Increased lifting movement of the apex
B Hepatojugular rephlux
C Movement of apex of the heart to the left and down
D Pulsation of epigastrium
259. Sign for left ventricular hypertrophy in physical examination is:
Sokolow-Lyon Index et al.

260. Sign is an:

A Objective sign found during physical examination
B Subjective feeling of the patient
C History
D Previous history of the patient

261. Sign of hyperkalemia on ECG is:

Atrial/ Ventricular fibrillation
P wave: absent
QRS: wide
ST segment: absent or shortened
T waves: wide, tall, tended
262. Sign of myocardial ischaemia on ECG is:
Prolongation of QT interval
Denevelisation of ST segment
Arrhythmia
Prolongation of QRS complex

263. Signs of acute myocardial infarction on ECG:

ST elevation

264. Sinus bradycardia is present in:

Increased vagal tone.
Sleep
Hypothermia
Hypothyroidism

265. Sinus rhythm is characterized by positive P wave in leads:

2.5 mm in leads II and / or III

266. Sinus tachycardia can be present in:

is a heart rhythm with elevated rate of impulses originating from
the sinoatrial node, defined as a rate greater than100 beats/min (bpm) in
an average adult. The normal heart rate in the average adult ranges from
60–100 beats/min. Note that the normal heart rate varies with age, with
infants having normal heart rate of 110–150 bpm to the elderly, who have
slower normals.
-hyperthyrodism
-hypovolemia with hypotension
-fever pain
-pulmonary embolism
- Heart failure
-anemia

267. Skin turgor is :

A The sign of nutrition
 B The sign of obesity
C lymphodema
D Sign used to see hydration

268. Slow monotone speech is typical in:

Parkinsons

269. Slow movements and impaired balance is associated with:

Parkinsons

270. Sokolow - Lyon index is positive if there is:

LVH

271. Sonorous, resonant percussion can be found above:

A Healthy lungs
B pneumothorax
C Bronchectasis
D none of the above

272. Spider naevi (angiomas):

They occur in patients with hepatic cirrhosis
They can be seen mostly in the upper part of the chest and on the face
They are telenagiectasia
All of the above

273. Spreading of systolic murmur in mitral insufficiency:

in sternum ( caused by a” jet effect” of the regurgitant blood ejected from
the left ventricle backwards to the atrium)  to axilla

274. Striae albae are typical for:

Pregnancy, stretch marks

275. Striae rubrae are typical for:

cushing syndrome
by tearing of the dermis  may diminish but not completely disappear
result of rapid stretching of skin, associated with weight/growth change
276. Stridor is:
high-pitched wheezing sound resulting from turbulent air flow in the
upper airway.

277. Subclavian steal syndrome:

constellation of signs and symptoms that arise from retrograde (reversed)
flow of blood in the vertebral artery or the internal thoracic artery, due to
a proximal stenosis (narrowing) and/or occlusion of the subclavian artery.
The arm may be supplied by blood flowing in a retrograde direction down
the vertebral artery at the expense of the vertebrobasilar circulation. This
is called the subclavian steal.
  Vertebral artery and basilar artery communicate

278. Subjective feelings of the patient are:

A Syndromes
B Symptoms
C history
D Signs

279. Superior vena cava syndrome is a condition not caused by:

IS CAUSED by cancer, lymphoma, leukemia, syphilis, tuberculosis

280. Supraventricular extrasystole is characterized by:

extrasystole or premature electrical impulse in the heart, generated above
the level of ventricle.  either premature atrial contraction or premature
impulse from the AVNode. (QRS changes)

281. Syncope is:

Fainting

282. Syncope origin can be:

Recovery, due to global cerebral hypoperfusion, often due to hypotension
283. Systolic murmur in the second intercostal space in right parasternal
region:
A Is a sign of aortic stenosis
B Suggests the trucuspidal insuficiency
C Is the sign of mitral stenosis
D Adrenal adenoma

284. Systolic murmur is present in:

They can be classified by when the murmur begins and ends,
between S1 and S2. p.106-111
Mitral/tricuspid insuff + A/P stenosis

285. Systolic murmur on the apex spreading to axilla:

A Is present in the significant aortic stenosis caused by aortosclerosis
B Is a sign of heamodynamically significant mitral insufficiency
C Is a sign of heamodynamically significant mitral
Stenosis
D Suggest hemodynamically non-signifficant aortic valve stenosis

 B should be correct?! Regurgitation causes murmur during systole, in

mitral stenosis valve is closed, no murmur possible..

286. Tachypnea is not:

IT IS rapid breathing

287. The absence of urobilinogen in urine is typical:

A In complete biliary obstruction
B In haemolytic jaundice
C In hepatocellular jaundice
 D Urobilinogen does not appear

288. The auscultation site for the aortic valve is:

2nd right ICS, parasternally

289. The auscultation site for the mitral valve is:

A Left 2nd interspace parasternal
B Right 2nd interspace parasternal
C Over lower Sternum
D In the area of the apex

290. The auscultation site for the pulmonary valve is:

A Left 2nd interspace parasternal
B Right 2nd interspace parasternal
C Over lower Sternum
D In the area of the apex

291. The auscultation site for the tricuspid valve is:

5th intercostal, lower left sternal border

292. The auscultatory finding In Mitral valve stenosis is:

Apex of heart

293. The fourth heart sound can be heard:

A During the rapid filling of ventricles during beginning of systole
B On the end of diastole, after systole of atria
C On the beginning of the systole of the ventricles
D On the end of the systole of ventricles

294. The interval between first and second heart sound is:
A Shorter than the interval between 2nd and next 1st heart sound
B Longer than the interval between 2nd and next 1st heart sound
C The same than the interval between 2nd and next 1st heart sound
D May be shorter or longer than the interval between 2nd and next 1st heart
sound

295. The Levine scale for intensity of the murmurs have:

A 4°
B 5°
C 6°
D 7°

296. The origin of the first heart sound relates to closure of the:
AV valves

297. The origin of the second heart sound relates to closure of the:
A Aortic and pulmonary valve
B Aortic and mitral valve
C Mitral and pulmonary valve
 D Mitral and tricuspid valve

298. The patient lying on his side with flexed legs has usually:
(note last year said lying on his back)
A An acute painful abdomen (I think)
B Pulmonary embolism
C Back pain
D stroke
299. The physiologic splitting of the second heart sound is:
happens during maximum expiration (inspiration vice versa!!), where the
left ventricle expels more blood than the right ventricle and so the ejection
phase of both ventricles take the same time ( unlike in deep inspiration,
where the right ventricle is filled with more blood, expelling more blood
and thus having a bigger ejection phase than the left ventricle). This way,
one can hear 2 components of the 2nd heart sound.
300. The propagation of the murmur in aortic stenosis is:
A Into the axilla
B Between the scapulas
C Into the epigastrium
D Into the carotids

301. The respiratory movements from xiphoid to both inguinal regions

(abdominal breathing) are completely absent in:
Ascites

302. The scar parallel to right costal margin is typical for:

cholycystectomy

303. The third heart sound can be heard:

A During the rapid filling of ventricles during beginning of systole
B On the end of diastole, after systole of atria
C On the beginning of the systole of the ventricles
D On the end of the systole of ventricles

304. The upper border of the liver in mid-clavicular line may be assessed:
By percussion

305. Third degree AV block is characterized by:

Complete heart block (impulse generated in SAN in atrium doesn’t
propagate to the ventricles. accessory pacemaker in the lower chambers
will typically activate the ventricles. This is known as an escape rhythm.
P waves: with a regular PP interval represents the first rhythm.
QRS complexes: with a regular RR interval represent the second rhythm.
The PR interval will be variable.

306. Third heart sound can be present in:

Left ventricular failure, constructive pericarditis

307. Third heart sound is present:

 same
308. Third sound gallop:
A Is a sign of left-sided heart failure ?
B Arrises in the pressure overload of left ventricle in aortic stenosis
C Is a sign of left atrial dilatation in diastolic failure of left ventricle
D Is a sign of large pericardial effusion
309. Third space fluid is typical in:
A Left heart failure
B Right heart failure?
C Anteroseptal myocardial infarction
D Adrenal adenoma
Large amount of fluid in pleural + peritoneal cavity  oedema, ascites,
pleural effusion

310. Torsades de points ventricular tachycardia is:

illusion of a twisting of the QRS complex around the isoelectric baseline.

311. Torticollis is:

is a stiff neck associated with muscle spasm, classically causing lateral
flexion contracture of the cervical spine musculature (a condition in which
the head is tilted to one side). The muscles affected are principally those
supplied by the spinal accessory nerve.

312. Tremor by movement, not presenting in rest is:

Essential tremor

313. Turricephaly is :
Oxycephaly: pointed vertex bcz of premature closure of sutures

314. Typical finding on ECG in incomplete right bundle branch block is:
wide QRS, more than 120 ms (3 small squares)
secondary R wave in lead V1
other features including: slurred S wave in lateral leads and T wave
changes in the septal leads

315. Typical finding on ECG in left anterior fascicular block is:

caused by only the anterior half of the left bundle branch being defective.
Abnormal left axis deviation ( btw –45° and –60°)
QRS in the lateral limb leads (I and aVL)
RS pattern in the inferior leads (II, III, and aVF)

316. Typical finding on ECG in left bundle branch block is:

ST changes in the same direction as the QRS (as shown here)
ST elevation more than you'd expect from LBBB alone (e.g. > 5 mm in
leads V1 - 3)
Q waves in two consecutive lateral leads (indicating anteroseptal MI)

317. Typical finding on ECG in WPW syndrome is:

 Theory: walf-parkinson-left-syndrome: is caused by the presence of an
abnormal accessory electrical conduction pathway between the atria and
the ventricles. Electrical signals travelling down this abnormal pathway
(known as the bundle of Kent) may stimulate the ventricles to contract
prematurely, resulting in a unique type of supraventricular
tachycardia referred to as anatrioventricular reciprocating tachycardia.
Usually asymptomatic, but may have: palpitations, dizziness, shortness of
breath, or syncope during episodes of supraventricular tachycardia. The
telltale "delta wave" may sometimes—but not always—be seen on
an electrocardiogram.

318. Typical for acute arterial embolus in lower extremity is:

A A leg is painless, cyanotic and pulseless proximal to the embolus
B A leg is pale, cold, painfull pulseless proximal to the embolus
C A leg is pale, cold, painfull pulseless distal to the embolus
D A leg is painful, warm and pulseless distal to the embolus

319. Typical for lipoedema:

chronic disorder of the adipose tissue generally affecting the legs, which
causes the legs, arms, but not the feet, to accumulate fatty tissue.

320. Typical quality of pulse in atrial fibrillation is:

Celar et altus
Paradoxus
Irregularis et inaequalis
filiformis

321. Typical symptoms of obstructive jaundice are:

A Erythema, pale urine and dark stools
B Upper abdominal pain
C Itching, pale urine and dark stools
D Amentia

322. Typical physical finding by an acute spastic bronchitis will be:

narrowed lumen ( bcz of increased secretion of mucus ). Inspection :
prolonged expiration bcz of bronchial narrowing. Percussion: resonant,
auscultation: DRY+MOIST RALES(crackles) + WHEEZES. Can lead to
pulmonary emphysema percussion: hyperresonant, auscultation:
WHEEZES + WHISTLES + MOIST RALES(crackles)

323. Typical physical findings above the lungs affected by pneumonia will
be:
3 stages 
Lungs: inflamed, engorged, serous excudation into alveoli PP:
Percussion: resonant, dulled(aff area) Ascultation: Vesicular br.,
weakend, CREPITATIONS
Lungs: increase of excudation, fills alveoli. PP: Perc: flat, Asc:
bronchial+accentuated. Fremitus and bronchophony increase,
pectoriloquy is present.
 lungs: leucocytic enzymes dissolve alveolar exudates then gets absorbed
PP: percussion: resonant + dulled. Asc: vesicular, CREPITATIONS,
pleural rub

324. Under what conditions (diseases) would a hepato-jugular reflux be

found:
A In pulmonary ambolism
B In pericardial effusion
C In right heart failure
D In acute myocardial infarction

325. Under what conditions would a pulsatile liver be found:

Tricuspid insufficiency

326. Undulation (fluid wave) test is used in the examination of:

A Gall bladder
B Deep venous thrombosis
C Ascites
D Pleural effusion

327. Venous crural ulcer:

leg ulcer, caused by chronic venous insufficiency ( faulty venous valves,
increasing the pressure in veins.)

328. Ventricular bigeminia is characterized by: heartbeat is initiated by

Purkinje fibres in the ventricles rather than by the sinoatrial node, the
normal pacemaker.

329. Ventricular extrasystole is characterized by:

Heartbeat initiated by Purkinje fibres in the ventricles rather than by
the sinoatrial node.

330. Ventricular tachycardia is characterized by:

is a heart rate that exceeds the normal range. A heart rate over 100 beats
per minute is generally accepted as tachycardia. Tachycardia can be
caused by various factors which often are benign. However, tachycardia
can be dangerous depending on the speed and type of rhythm.

331. Vesicular breathing with prolonged expirium can be heard by:

A acute spastic bronchitis
B lung emphysema
C asthma bronciale
D all of the above

332. Virchow’s node is palpable:

In stomach tumor
In lung tumor
In leukemia
 In kidney tumor

333. Virchow’s node:

is a lymph node in the left supraclavicular fossa

334. Vitiligo is:

Loss of skin pigmentation
Overload of skin pigmentation
Sign of bleeding
None of the above

335. Vocal (pectoral) fremitus:

A Is the perception of vibration of the chest wall caused by phonation
of the patient
B Is a rub occasionally found in pleurisy
C Is the perception of vibration of the abdominal wall caused by phonation
of the patient
D Is a breathing phenomenon with regular cystic alternation of apnea and
hyperpnea

336. What blood pressure (BP) values indicate isolated systolic

hypertension:
165/90 mmHg

337. What influence has aortic regurgitation on systolic and diastolic blood
pressure:
A There is high systolic and high diastolic blood pressure
B There is high systolic and normal diastolic blood pressure
C There is high systolic and low diastolic blood pressure
D There is low systolic and low diastolic blood pressure

338. What influence has aortic stenosis on systolic and diastolic blood
pressure:
systolic decrease, and diastolic increase

339. What is a cardiac asthma:

A Wheezing at the thorax during left heart acute failure
B Wheezing at the thorax in cor pulmonale
C Wheezing at the thorax in chronic heart failure?
D Wheezing at the thorax in large pulmonary embolism
 Left heart failure causing whooping cough

340. What is the high normal blood pressure (BP):

140/90 mmHg

341. What is the mechanism of Durozier’s sign:

A It is a murmur on the a.femoralis and comes through a small
(volume) pulse (AS)
 B It is a murmur on the a.femoralis and comes through a great (volume)
pulse
C It is a murmur on the a.tibialis posterior or on a.dorsalis pedis and comes
through a small (volume) pulse
D It is a murmur on the a.tibialis posterior or on a.dorsalis pedis and
comes through a great (volume) pulse

342. What is the pathophysiology of 3rd heart sound in gallop rhythm:

A A splitting of the second heart sound
B A splitting of the first heart sound
C A rapid filling of left ventricle during diastole
D An atrial contraction (with filling of the left ventricle)

343. What is the typical physical finding by bronchial asthma attack:

Inspection: symmetrically reduced respiratory movements of lungs. NO
mediastinal displacement. Percussion: resonant->hyperresonant.
Ascultation: vesicular with prolonged expiration. Adventitious breath
sounds: WHISTLES.
Normal bronchophony + pectoral fremitus.

344. What kind of percussion do we use by physical examination of the

lungs:
A Only comparative percussion
B Only topographic percussion
C Comparative and topographic
D None of the above

345. What percussion of lungs you would expect by large lung tumor:
A Sonorous, resonant
B Hypersonorous
C Tympanic
D Dull, flat

346. Which arteries are not usually palpated on lower limbs:

These are: femoral, popliteal, posterior tibial, dorsalis pedis

347. Which couple of pulse types is not opposite:

348. Which disease creates the presence of a "gallop rhythm":

A In serious arterial hypertension
B In serious pulmonary embolism
C In acute myocardial infarction
D Heart failure

349. Which nerve endings are examined by palpation on face:

Trigeminal (V) & facial (VII)

350. Which of the following is not a cause of cachexia:

 A Mental anorrhexia
B Addison disease
C malignancy
D Hypothyroidism

351. Which of the following is not a symptom of right heart failure:

Symptoms of right side failure:
Backward failure of the right ventricle leads to congestion of systemic
capillaries. This generates excess fluid accumulation in the body. This
causes swelling under the skin (termed peripheral edema oranasarca) and
usually affects the dependent parts of the body first (causing foot and
ankle swelling in people who are standing up, and sacral edema in people
who are predominantly lying down). Nocturia (frequent nighttime
urination) may occur when fluid from the legs is returned to the
bloodstream while lying down at night. In progressively severe
cases, ascites (fluid accumulation in the abdominal cavity causing
swelling) and hepatomegaly (enlargement of the liver) may develop.
Significant liver congestion may result in impaired liver function, and
jaundice and even coagulopathy (problems of decreased blood clotting)
may occur.

352. Which of the signs is not positive in acute appendicitis:

These are: Blumberg, Rousing(Rovsing’s sign?!), Plenies

353. Which of the signs is not typical for cardiovascular system:

354. Which organs project to right upper abdominal quadrant:

Liver, gall bladder

355. Which statement about gall bladder is true:

A Gallbladder is never palpable
B Gallbladder is always palpable
C A Palpable gallbladder is an abnormal finding
D A Palpable gallbladder is a normal finding

356. White coffee likes skin, Osler´s nodes, syncopes are typical in:
Probably endocarditis

357. White colour of the skin and edema of the eyelids are typical in
patients with:
Hypoalbuminemia

358. With aortic insufficiency murmur is:

long diastolic decrescendo murmur beginning immediately after the aortic
component of 2nd HS.
Auscultation over aortic valve (Right 2nd ICS) systolic ejection murmur is
brief and reaches its maximum early.

359. With mitral stenosis is:

 A Systolic murmurs above apex
B accentation of the 1st beat above apex
C accentation of the 1st beat above aorta
D present opening snap in diastole

360. Wound that heals per primam:

wound leaving a little scarring

361. Wound that heals per secundam:

occurs in situations when tissue defects have to be refilled or when pus
formation interferes with the direct reassociation of wound edges. Here,
the wound surfaces do not lie closely adjacent to each other, but rather
split, more or less away from each other. To close this wound, new tissue,
granulation tissue, must be grown. The energy demand placed upon the
organism is higher.

362. Xanthelasmata are due to:

A Infections
B Metabolic disorders of glycosydes
C allergies
D Hyperlipideamia

363. Yellow color of sclera with normal color of skin is called:

Conjunctival icterus