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KROK 2 Medicine 2004 Questions | KROKEXAM
Browse 2004 KROK 2 Medicine exam questions with answers and explanations.
Exam questions
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A patient complains of intense pressing pain in the pharynx, mainly to the right, impossibility to swallow even liquid food. The illness started 5 days ago. The patients condition is grave. Body temperature - 38,9°С, speech is difficult, voice is constrained, difficulties in opening the mouth. Submaxillary glands to the right are painful, enlarged. What is the most probable diagnosis?
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A pediatrician examines a healthy mature breast-fed baby, aged 1 month. Prevention of what condition should be recommended in the first place?
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A patient, aged 70, complains of pain, lacrimation, loss of visual acuity on the right eye. Fell ill 3 days ago after eye injury with a tree branch. On examination: palpebral fissure is narrowed, photophobia, mixed injection. On the cornea there is an opacity area with irregular borders, progressive edge and epithelial defect. Cornea sensitivity is normal. Hypopyon. Chronic dacryocystitis. What is the most likely diagnosis?
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A 45-year-old man was brought to clinic with complaints of a sudden pain in the left chest part and epigastric area, shortness of breath, nausea, one-time vomiting. The acute pain started after considerable weight lifting. On physical examination: shallow breathing, RR - 38/min, left chest part is getting behind during respiration, by percussion - tympanitic sound, respiration is not auscultated. Ps - 110 bpm, of weak filling. BP - 100/60 mm Hg, insignificant displacement of heart to the right, sounds are dull. What examination is the most expedient?
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A 48-year-old man was taken to the emergency department in a grave condition. Medical history: 3 hours ago he was treating potato plantations with the pesticides against Colorado beetles. Physical examination: acrocyanosis, bronchorrhea, tachypnea, BP - 100/60 mm Hg, Ps - 44 bpm. What method of efferent therapy is the most expedient on this stage?
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A diagnosis of chronic arsenous intoxication was set to patient who is working as a nightman. What form of anaemia is characteristic for this disease?
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A 43-year-old male complains of stomach pain, which relieves with defecation, and is accompanied by abdominal winds, rumbling, the feeling of incomplete evacuation or urgent need for bowel movement, constipation or diarrhea in alternation. These symptoms have lasted for over 3 months. No changes in laboratory tests. What is the most likely diagnosis?
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A patient, aged 14, suffering from heart failure, undergoes in-patient treatment. On ECG: changes in the form of a trough-shaped displacement of ST segment below isoline and frequent ventricular extrasystoles. What is the most probable cause of these changes?
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Study of pulmonary tuberculosis provided data about social and everyday conditions of life and bad habits of patients. Which of the following methods allows to assess degree of influence of smoking on tuberculosis incidence?
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A victim of a road accident suffered multiple fractures of extremities and pelvis bones. In medical history: hemophilia. On examination: hematomes are forming on the injured areas. The patients condition is aggravating. BP - 90/50 mm Hg. What is the most expedient combination of infusion medications for patients treatment after administering polyglukine and saline?
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In 10 min after childbirth by a 22-year-old woman, the placenta was spontaneously delivered and 100 ml of blood came out. Woman weight - 80 kg, infant weight - 4100 g, length - 53 cm. The uterus contracted. In 10 minutes the hemorrhage renewed and the amount of blood constituted 300 ml. What amount of blood loss is permissible for this woman?
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A 37-year-old patient has sudden acute pain in the right epigastric area after taking fatty food. What method of radiological investigation is to be used on the first stage of examining the patient?
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A 20-year-old woman complains of weakness, wet cough, body temperature raise up to 37,5°С in the evenings during one month. In childhood she was under physiatric observation due to conversion of tubercular tests (PPD). The condition is good. No rales in lungs. Chest X-ray: a shadow with dim contours 3х4 cm with a clearing and focuses near the shadow in the upper lobe of the right lung. Blood analysis: ESR - 20 mm/hour, WBC - 7,6*109/L. What is the most likely diagnosis?
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A neonate was born from the 1st gestation on term. The jaundice was discovered on the 2nd day of life, then it became more acute. The adynamia, vomiting and hepatomegaly were observed. Indirect bilirubin level was 275 mmol/L, direct bilirubin level - 5 mmol/L, Hb- 150 g/l. Mother’s blood group - 0[I], Rh+, child’s blood group- A[II], Rh+. What is the most probable diagnosis?
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A girl, aged 14, complains of sleep disorders, weight loss, palpitations, heartaches, fatigue. On examination: thyroid gland hyperplasia ІІ degree, exophthalmos. What disorders of hormones level are the most characteristic for this disease?
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A baby, aged 8 months, is examined and a diagnosis of atypical community-acquired pneumonia of chlamydial etiology is made. What is the optimum alternative of antibiotic therapy in this case?
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A district physician has diagnosed domestic accident at worker of chemical factory who is at home. The worker is temporarily disable. What document should be given to legalize his disability?
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A 40-year-old woman complains of yellow colour discharges from the vagina. Bimanual examination: no pathological changes. Smear test: Trichomonas vaginalis and mixed flora. Colposcopy: two hazy fields on the front labium, with a negative Iodine probing. What is your tactics?
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A 65 y.o. patient complains of shortness of breath, cough with red foamy sputum, feeling of air deficit, fear of death. On examination: orthopnea, pale skin, acrocyanosis, cold sticky sweat. Rough breathing sounds, in inferior-posterior arias on both sides - small and medium moist rales. BR - 40/min. Heart sounds are distinctly muffled. On the cardiac apex - gallop rhythm. What is the most probable preliminary diagnosis?
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A 10-year-old child fell ill acutely a week ago after overcooling when there appeared pain in the stomach and the back, fever up to 38°С. Urine analysis: leukocytes 25-30 per v/f, protein 0,33 g/L. Which of the following is the most appropriate test for prescribing etiotropic treatment?
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A 23-year-old man has a gun-wound on the left arm. The arm bones are undamaged. What appropriate surgical help must be provided to such a patient?
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A patient complains of an ulceration on the inner surface of the lower third of the right shin. On examination: the ulcer is round-shaped, up to 5 cm in diameter, with sloping edges. On the inner surface of this shin there are varicose veins. What complication appeared in this patient?
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A patient, aged 25, suffering from stomach ulcer. Had a course of treatment in the gastroenterological unit. 2 weeks later developed constant pain, increasing and resistant to medication. The abdomen is painful in epigastric area, moderate defense in pyloroduodenal area. Development of which complication aggravated the patients state?
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A victim of a road accident, aged 44, is operated on account of intraperitoneal hemorrhage. In which case the patients blood from the abdominal cavity can be used for autotransfusion?
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A patient, aged 50, during 15 years is ill with essential hypertension, not under treatment. BP - 220/140 mm Hg, Ps - 80bmp, rhythmic. On percussion: the left heart border is 2 cm to the outside from the left midclavicular line. Sound 1 is moderately weakened. Sound 2 is accentuated over the pulmonary artery. What changes will be characteristic on ultrasound heart examination?
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A patient, while making repairs at home, suddenly stood quite still with the painting brush in his hand. This state lasted for a few seconds. After that the patient was rather confused, for some moments he couldn’t understand what was happening. He totally forgot the state he was in and the events around him, occurring while he was in that state. What disorder is the most probable?
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District physician was charged with plan preparation concerning the conducting of medical and preventive measures among the population in the area he is assigned to. What measures must he include in this plan as regards secondary prevention of illness?
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A 65-year-old patient complains of gradual worsening of the left eye vision during 10 months. On physical examination: acuity of vision of the left eye is 0,01, not correctable. The eye is not irritated, the pupil of the eye is greyish, reflex from the fundus is absent. Intraocular pressure is 18 mm Hg. What is the most probable preliminary diagnosis?
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A patient, aged 34, has been suffering for 7 years from pulmonary tuberculosis. He complains of muscle weakness, weight loss, diarrhea, frequent urination. On examination: hyperpigmentation of skin, gums, and inner sides of the cheeks. BP - 90/58 mm Hg. In blood: RBC - 3,1×1012/l, Hb - 95 g/L, colour index of blood – 0,92; WBC - 9,4×109/l, eosinophils - 7, segmented neutrophils - 45, band neutrophils - 1, lymphocytes - 40, monocytes - 7, Na - 115 mmol/L, К - 7,3 mmol/L. What is the preliminary diagnosis?
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A 30-year-old man has a history of recurrent pneumonia and chronic cough with foul smell, purulent sputum, occasionally blood tinged, which becomes worse in the morning and in reclining position. On physical examination, it is a chronic patient with clubbing of fingers, wet inspiratory rales at the root of lungs from behind. What is the most probable diagnosis?
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A patient, aged 64, complains of pain in the knee-joints, appearing 2–3 hours after walking. On examination: knee-joint deformation, restriction of joints movements due to painfulness, crackling on movement, on both hands there are Heberdens nodes. In medical history: stomach ulcer. Which of the mentioned medications is expedient to prescribe to this patient?
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A man, aged 30, complains of intense pain, reddening of skin, edema in the ankle-joint area, fever up to 39°С. Sudden onset of the illness. In the past there were similar attacks lasting 5-6 days without residual changes in the joint. The skin over the joint is hyperemic without definite borders and without infiltrative bank on the periphery. What is the most likely diagnosis?
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A female, aged 20, after smoking notices a peculiar inebriation with the feeling of burst of energy, elation, irreality and changing of surroundings: the world gets full of bright colours, the objects change their dimensions, peoples faces get cartoon features, loss of time and space judgement. What is the most likely diagnosis?
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A child, aged 6, suffers from "bold" patches on the head. On examination: single large focuses, in which the hairs are broken on the same level - 6-8 mm from the skin surface. What is the most probable preliminary diagnosis?
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A woman aged 35 has been suffering with pulmonary tuberculosis for 10 years. When in physiatric clinic, she started to act strangely: put on a gaudy make-up, gathered the other patients around herself, was singing and dancing with them. Highly excited, passed all the time among males, flirted, started sexually-biased conversations. The whole night absented from the clinic ("was on a date"). What leading syndrome of mental disorders is observed?
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A 62-year-old patient with DM-2. Diabetes is being compensated by diet and Maninilum. Patient has to undergo an operation for inguinal hernia. What should be the tactics of hypoglycemic therapy?
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A 48-year-old woman complains of fatigue, weight and appetite loss, headache. Suffered from acute glomerulonephritis as adolescent. Suffers from arterial hypertension since age 25. Has not systematically undergone medical treatment, consulted doctor very rarely. On laboratory investigation signs of chronic renal failure first degree were found. (creatinine - 0,23 mmol/L). What nutrition recommendations are the most suitable for this patient?
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A youth aged 17 complains of a sudden onset of palpitation 10 minutes ago. On examination: skin has normal colour. Heart borders without changes, HR=Ps=200bmp, regular rhythm, BP - 135/75 mm Hg. Heart sounds are intensified. On ECG: QRS = 0,09 sec. What measure should be done on the first stage of aid?
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A woman aged 30 complains of dizziness, weakness, nails fragility, falling-out of hair, taste disorder. On examination: pale skin, Ps - 98bmp, BP - 100/60 mm Hg. In blood: Hb - 80 g/L, RBC - 3,4×1012/l, colour index of blood - 0,7, ESR - 20 mm/h. Serum iron - 7,2 mmol/L. What medicine is expedient to prescribe?
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A 41-year-old woman complains of weakness, fatigue, fever up to 38°С, rash on the face skin, pain in the wrists and elbows. Physical exam: erythematous rash on the cheeks with "butterfly" appearance. The wrist and elbow joints are affected symmetrically, swollen, tender on motions. Pleural friction rub over the lungs, the heart sounds are weak, regular, HR - 88/min, BP - 160/95 mm Hg. CBA: anaemia, leucopenia, lymphopenia. Urinalysis: proteinuria, leukocyturia, cylinders. What is the main mechanism of disease development?
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