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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 35-year-old woman was admitted to thoracic surgery department with fever up to 40°С, onset of pain in the side caused by deep breathing, cough with considerable quantity of purulent sputum and blood with bad smell. What is the most likely diagnosis?
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A pupil of the 8th form after trauma has acute atrophy of the left leg muscles, tonus of which is distinctly decreased, active movements are only in the knee joint, his foot is deformed. Support function of the left leg is absent, support function of the right leg is preserved. The boy wears an orthopedic footwear. What group of physical training does the boy belong to?
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A patient, aged 40, ailing during approximately 8 years, complains of exertion pain in the lumbar part of the spine, in cervical and thoracal part (especially when coughing), pain in the hip and knee joints on the right. On examination: the body is fixed in the forward inclination with head down, gluteal muscles atrophy. Spine roentgenography: ribs osteoporosis, longitudinal ligament ossification. What is the most likely diagnosis?
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A man, aged 56, complains of shortness of breath with difficult expiration, sputum excretion in the mornings during 22 years. Smokes 1 packet of cigarettes per day starting from the age of 18. On external respiration tests with bronchial spasmolytic: respiratory obstruction reversibility is 10%. What medication should be prescribed in the beginning of the treatment?
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A female patient, aged 25, is hospitalized due to exudative pericarditis. Complains of shortness of breath, weakness, compression in the chest. Believes that she got ill 2 weeks ago, after common cold. What peculiarity found during examination will tell about chronic pericardium affection?
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A patient, aged 28, complains of pain in the legs during walking, chilliness of feet, toes. Has being ill for a year. On examination: pale and cool legs skin, turgor diminished, hypotrichosis. Weakened pulsation on the hip and popliteal arteries, pulsation on the feet arteries is felt after nitroglycerine test. Rheographic index <1. What is the most likely diagnosis?
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A baby, aged 2 years, has a syndrome of malabsorbtion. On ECG: S-T segment depression, wave T inversion and high wave U. What is the cause of these changes?
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A patient was operated on account of perforated stomach ulcer, terminal stage of diffuse peritonitisAfter endotoxic shock in the post-operative period the artificial pulmonary ventilation is carried out with inhalation of 60% oxygen. Blood gasses: РаО2 = 70-78 mm Hg, hypoxemia is not diminishing, CVP - 150-180 mm H2O, BP - 90/60 mm Hg (with administering of dopamine in high doses). Radiologically: diffuse pulmonary infiltration. What is the reason of the resistant arterial hypoxemia?
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A 49-year-old patient complains of fever of 37,5°С, chest pain, dyspnea. On physical examination: Sound 1 is clapping; Sound 2 is accentuated in the pulmonary artery, opening snap, presystolic murmurs are auscultated. What is the most useful investigation for valvular disorder assessment?
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A woman, aged 28, consulted a doctor with the complaints of increasing size of pigment nevus which was present from birth, its maceration, itching. What method of investigation should be used for diagnostic in this case?
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A 40-year-old man complains of headache in occipital area. On physical examination: the skin is pale; face and hand edema, BP - 170/130 mm Hg. On EchOCG: concentric hypertrophy of the left ventricle. Ultrasound examination of the kidneys reveals thinned cortical layer. Urine analysis shows proteinuria of 3,5 g/day. What is the probable diagnosis?
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To study physical development of children and adolescents, anthropometric investigations are widely used. Choose a physiometric method of investigation from the below given
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A 2,5-month-old child presents with muscle hypotonia, sweating, alopecia of the back of the head. The child is prescribed massage, curative gymnastics and vitamind. What is the dosage and frequency of vitamin D administration?
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Biological development indices for the secondary and high school pupils are the following: height, annual height increase, hand ossification, number of permanent teeth. What other index has a special importance for this age group?
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In a college with the majority of 14-year-old students preventive anti-tuberculosis planned examination is taking place. Which method from the following should be used?
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A 2–year-old girl has been ill for 3 days. Today she has low–grade fever, severe catarrhal symptoms, non-abundant maculopapular rash on her buttocks and enlarged occipital glands. What is your diagnosis?
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Woman in childbirth, 25 years old, the second period of labour. During internal obstetric examination, opening of the uterine cervix is full. Fetus membranes are absent. The head of the fetus is represented, the head occupies sacral cavity. Sciatic bones are undeterminable. During contractions perineum is sticking out. Where is the head of the fetus situated?
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Left eye vision disorders were registered in a male patient aged 22. A year later there developed a weakness of the right foot. On examination: lateral nystagmus, paling of temporal half of the left disk of optic nerve, absence of abdominal reflexes, hyperreflexia on the extremities, clonus of the left foot, Babinskis signs on both sides. What is the most likely diagnosis?
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A 68-year-old patient with long-term hypertension complains of dizziness, difficulties by swallowing, nasal voice, wobbly walking. These symptoms appeared about three years ago and are gradually progressing. What diagnosis is the most probable?
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A patient is unconscious, with head injuries in the form of calvarium fracture, BP - 60/40 mm Hg, with pathological neurologic signs. On what basis these injuries can be considered as severe?
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A woman, aged 60, complains of unendurable pain in the right hypochondrium. In medical history: acute pancreatitis. The body temperature - 38,2°С. On examination: scleral icteritiousness. No signs of peritoneum irritation. Positive Ortners symptom, Gubergrits-Skulsky symptom. Urine diastasis - 320 g/h. What diagnosis is the most likely?
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A man aged 68 complains of tiredness, sweating, enlargement of cervical, submaxillary and axillary lymph nodes. Blood tests: WBC - 35×109/l, lymphocytes - 60%, Botkin and Gumprecht bodies, level of haemoglobin and quantity of thrombocytes is normal. Myelogram showed 40% of lymphocytes. What is the most probable diagnosis?
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A patient, aged 35, complains of frequent heart-burns, air and acid eructation, burning, constringent pains behind the breast-bone, along esophagus, that appear after meals, during forward inclination of body. The patient was not examined, takes Almagel by self-medication, after the intake of which feels better. What is the most probable diagnosis?
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A man with meningococcus meningitis has been taking penicillin for 7 days. During last 4 days a body temperature is normal. Meningitic signs are absent. When is it possible to cancel antibiotic?
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A 5-year-old child with stigmas of dysembryogenesis (small chin, thick lips, opened mouth, hyperthelorismus) has systolic murmur in the second intercostal to the right of the sternum. The murmur passes to the neck and along the sternum left edge. The pulse on the left brachial artery is weakened. BP on the right arm is 110/60 mm Hg, on the left - 100/60 mm Hg. ECG results: hypertrophy of the right ventricle. What defect is the most probable?
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A 32-year-old patient complains of severe weakness, tremor of extremities. On physical examination, there is loss of body weight, wet and warm skin. The thyroid gland is enlarged up to the 3rd degree, painless, elastic. Ps: 108 bpm. BP- 160/55 mm Hg. The rest is in norm. What can be diagnosed?
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A 27-year-old woman was admitted to clinic with complaints of pain in right ankle joint, impossibility to stand on those extremity. Clinical examination: the patient had a fracture of anterior part of distal metaepiphisis of tibia -Pott-Destos fracture. What is the mechanism of such injury?
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In the structure of the population of N-region, person category of age from 0 till 14 years constituted 31%, for people from 50 years and older - 20%. Estimate the population structure that characterises the given demographic situation in a most efficient way.
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A baby boy with body weight 3700 g is born in a maternity hospital. The general condition of the baby is satisfactory. In the centre of the abdomen there is a formation circa 12 cm in diameter. The formation is covered with smooth membranes through which the intestinal loops and liver are seen. What is the most likely diagnosis?
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A 28-years-old man, without permanent residence, was hospitalized with the preliminary diagnosis of "influenza". On the 5th day of the disease there appeared typhoid maculopapular and petechial skin rash on trunk and inner sides of extremities. t°- 41°С, euphoria, facial hyperaemia, sclera reddening, tongue tremor. Ps - 104 bpm. Splenomegalia. What is the most likely diagnosis?
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A 26-year-old woman gave birth to a child 6 months ago. She consulted a gynecologist complaining of menstruation absence. The child is breast-fed. Vagina exam: uterus is of normal form, dense consistence. What is the most probable diagnosis?
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You suspect that a 34-year-old patient has got an abscess of Douglas spaces. What method of investigation is preferable to diagnostics?
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A woman, aged 30, in the second childbirth there is a baby born with anaemic-icteric form of the hemolytic disease. Blood group of the mother is А(ІІ) Rh-, blood group of the new-born is В(ІІІ) Rh, blood group of the father is В(ІІІ) Rh. What is the most probable cause of immune conflict?
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A man, aged 28, suddenly fell ill. There appeared chills, sensation of heat, fever up to 38,5°С, intermitting pain in the left iliac area, frequent liquid stool in the form of sanguinomucoid mass. On palpation: the left part of the abdomen is painful, spastic sigmoid colon. What is the most likely diagnosis?
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A 60-year-old boiler-house worker presents to factorys sectorial doctor with headache and tiredness. Lab tests: carboxyhemoglobin in blood. Poisoning with which substance is the most likely to cause formation of carboxyhemoglobin in blood?
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A patient, aged 25, complains of pain in the I finger on the right hand. On examination: the finger is homogeneously hydropic, in bent position. On attempt to unbend the finger the pain gets worseAcute pain appears on touching with the probe in ligament projection. What disease is the most likely?
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A 52-year-old man has recurrent transient ischemic attacksAuscultation of the carotid arteries detects murmur. What diagnostic method is necessary to apply first?
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A 20-year-old man complains of pain and edema in the right buttock. Physical examination: limited tenderness, painful swelling with skin hyperaemia and local hyperthermia. Positive fluctuation symptomAbscess is diagnosed. What are the tactics for the therapy?
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In laboratory a sample of milk is analyzed. There determined the following: colour – whitish, smell – without peculiarities, taste – specific for milk, density – 1,038, acidity – 350 Turner, fats – 3,2%. What is the degree of milk quality?
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A 47-year-old man with gastric cancer, complicated by profuse hemorrhage was successfully treated by surgical intervention. After the operation the native blood plasma transfusion was performed. During transfusion developed acrocyanosis, hypersalivation, hyperpnea, BP - 80/40 mm Hg, Ps- 120 bpm. With injection of which substance the initial medication has to begin?
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