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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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Mother with an infant visited the pediatrician. Her baby was born with body mass of 3,2 kg and 50 cm length. He is 1-year-old now. How many teeth the baby should have?
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A 42-year-old man has died in a road accident after the hemorrhage on the site, due to acute hemorrhagic anaemia. Loss of what minimum percentage of the total blood volume would result in death at acute hemorrhage?
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A man, aged 30, intravenous drug addict complains of weakness, moderate jaundice, sensation of heaviness in the right hypochondrium. The patients condition aggravated gradually. Biochemical tests: Total bilirubin - 48,2 mmol/L; ALT - 3,0 mmol/hL. What examination will verify the diagnosis?
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A 8-year-old boy has suffered from tonsillitis. In 2 weeks he started complaining of migratory joint pain, edema of joints, restriction of movements, fever. On examination, an acute rheumatic heart disease, activity of the III-rd degree, primary rheumocarditis, polyarthritis; acute course of disease, cardiovascular failure IIA. What medication is to be prescribed?
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A 52-year-old woman suffering from obesity, complains of bloody discharges from genital tracts during 4 days. Last normal menses were 2 years ago. Histological investigation of biopsy of the endometrium has revealed adenomatous hyperplasia. What reason from the mentioned below caused the development of disease?
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A woman was hospitalized with full-term pregnancy. Examination: the uterus is tender, the abdomen is tense, cardiac tones of the fetus are not auscultated. What is the most probable complication of pregnancy?
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A baby, aged 1,5 months, in the right parietotemporal area has from the birth a tumour-like formation of purple colour, rising over the skin surface, not disappearing on pressure, dimensions 2–3 cm. What is the most likely diagnosis?
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A 72-year-old patient after operation of holecystectomia was prescribed gentamicyn (80 mg every 8 hours) and cephalothin (2 g every 6 hours) because of fever. In 10 days there was an increase of creatinine up to 310 mu mol/L. BP - 130/80 mm Hg, daily quantity of the urine is 1200 ml. Urine tests are without pathology. Ultrasound: the size of kidneys is normal. What is the most probable reason for renal failure?
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89A 29-year-old woman is critically ill. The illness was manifested by high fever, chills, sweating, aching pain in lumbar area, a discomfort during urination, and frequent bowel voiding. Pasternatsky’s sign is positive in both sides. On lab exam, WBC - 20×109/l; Urinalysis: protein - 0,6 g/L, leukocyturia, bacteriuria. What is the preliminary diagnosis?
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A patient, aged 49, was operated on account of acute catarrhal appendicitis. 8 days later there appeared vomiting, no passage of gasses or defecation. On examination: the abdomen is inflated, positive Sklyarovs and Wahls symptoms. Leucocytosis. Acute intestinal obstruction is suspected. What supplementary examination methods are the most informative to diagnose the complication?
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A patient was operated 2 years ago on account of perforated duodenal ulcer, suture plication was performed. In the last 2 months lost 12 kg, which explains by dread of solid food intake because of pain and exhausting nausea appearing after meals. Self-induced vomiting brings relief. What is the most probable preliminary diagnosis?
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A child fell abruptly ill. Frequent watery stool developed 6 hours ago. The body temperature is normal. Then vomiting took place. On physical examination: child 's voice is hoarse, eyes are deeply set in the orbits. The pulse is frequent. Blood pressure is low. There is no urine. What is the preliminary diagnosis?
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A patient with nosocomial pneumonia has signs of collapse. Which of the following pneumonia complication is the most likely to be accompanied with collapse?
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A patient is suffering from a severe attack of bronchial asthma lasting for over 1 hour in spite of administration of beta -adrenoceptor agonists by inhalation and I.V., aminophilline and anticholinergics. What medication should be added to the urgent treatment?
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A 10-year-old child is sick with chronic viral hepatitis B with marked activity of the process. Total bilirubin - 70 mmol/L, direct - 26 mmol/L, indirect - 44 mmol/L. АSТ - 6,2 mmol/L, АLТ - 4,8 mmol/L. What mechanism underlies the transaminase level increase of this patient?
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District physician was charged with plan drafting concerning medical and preventive measures among the population in the area he is assigned to. What measures must he include in this plan as regarding primary prevention of illness?
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During intramuscular DTP vaccination in clinic, a 3-month-old child developed signs of laryngospasm, paleness of skin, cyanosis of lips, "cock cry", stop of respiration, tension of the whole body with overturned backward headAllergological history of the child is not complicated. What is the most probable diagnosis?
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A patient, aged 25, is brought to the infection diseases unit with suspected rabies, excitement stage. Four weeks ago on the hunting was bitten in a hand by a fox. What leading symptom will verify the diagnosis
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A 43-year-old woman complains of contact hemorrhages during the last 6 months. Bimanual exam: cervix of the uterus is enlarged, restricted in mobility. Mirrors showed the following: cervix of the uterus is in the form of cauliflower. Chrobak and Schiller tests are positive. What is the most probable diagnosis?
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A 6-year-old asthmatic child is brought to the emergency room with severe coughing and wheezing during the prior 24 h. The child has been taking theophylline without relief. Physical examination reveals a child who is anxious, has intercostal and suprasternal retractions, expiratory wheezing throughout all lung fields, and RR - 60/min. Initial treatment may include the administration of which of the following?
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A 52-year-old patient has hypervolemic type of essential hypertension. What medication is necessary to prescribe either as monotherapy or in complex with other antihypertensive remedies?
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Water that is used for supply of the city, contains fluoride - 2,0 mg/L, nitrates - 43 mg/L, chlorides - 250 mg/L, ferrum - 0,2 mg/L, residual nitrogen - 0,5 mg/L. What medical condition is the most likely to occur among the inhabitants of this city?
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Public health is characterized by a group of indices. Which of the following indices are demographic?
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A woman complains of fever up to 39°С the next day after the child-birth. Fetal membranes rupture took place 36 hours before delivery. Pelvic examination: the uterus is soft, tender. Discharges are bloody, mixed with pus. Uterine culture: haemolytic streptococcus, groupa. What is the most probable postnatal complication?
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A boy, aged 10, is under treatment in cardiological unit on account of rheumatic fever. The first onset of the disease. Discharged in the satisfactory condition. What medication is the most expedient for secondary rheumatism prevention?
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During dynamic investigation of a patient the increase of central venous pressure is combined with the decrease of arterial pressure. What process is proved by such combination?
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A primipara is in labour for 19 hours, amniotic fluid has discharged 7 hours ago. Pelvic sizes are: 24-25-29-18 cm. Fetal position is longitudinal, head presents and is engaged to pelvic inlet. Fetus heart rate is 160 bpm. No autonomous urination. Vaginal inspection: cervix is smoothed and 8 cm dilated. Head is presented, sagittal suture occupies the transverse diameter of pelvic inlet; small fontanel is on the left. Lower uterine segment is tender on pressing. What medical tactics should be chosen?
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After delivery and revision of placenta there was found the defect of placental lobe. General condition of woman is normal, uterine is firm, there is moderate bloody discharge. Inspection of birth canal with mirrors shows absence of lacerations. What is the following necessary action?
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A 37-year-old patient has come to clinic being wounded in the area of umbilicus an hour ago. On physical exam, there is a prick and cut painful wound of about 0,5x1 cm around umbilicus on the abdominal skin with slight bleeding. How would you help this patient?
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A patient was admitted to the hospital on the 7th day of the disease with complaints of high temperature, headache, pain in the muscles, especially in calf muscles. Dermal integuments and scleras are icteric. There is hemorrhagic rash on the skin. Urine is bloody. The patient was fishing two weeks ago. What is the most likely diagnosis?
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A woman, aged 64, is hospitalized on account of metrorrhagia and anaemia. After 12 years of menstruation absence, 7-8 months ago there appeared at first sero-watery discharge from vagina, then - sero-bloody, with "meat slops" colour, pain in the lower abdomen. What pathology is the most probable?
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A patient complains of pathological lump, appearing in the right inguinal region on exercise. The lump is round-shaped, circa 4 cm in diameter, on palpation: soft elastic consistency, positions near the medial part of Pouparts ligament. The lump is situated inwards from the spermatic cord. What is the most probable preliminary diagnosis?
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A 30-year-old man who suffered from headaches, felt an intense headache in the form of the blow on his head while lifting up a heavy object with the following onset of nausea, vomiting, light dizziness. In a day there was an objectively presented meningeal syndrome, t°- 37,6°С. The doctor have suspected subarachnoidal hemorrhage. What additional examination is necessary to confirm the diagnosis?
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A 14-year-old boy periodically complains of pain in the epigastrium on an empty stomach, nausea and heartburn during 3 years. Gastroduodenoscopy: signs of gastroduodenitis and ulcer defect of the mucous membrane of the duodenum. What is the most effective medication to treat this child?
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In morgue there are dead bodies with the following causes of death: electrotrauma; rupture of the spleen with acute anaemia. There is one unknown person; one ethyl alcohol poisoned person and one drowned man. What dead body should the blood group be determined for?
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In order to differentiate diagnosis of anuria and ishuria what supplementary examination should be carried out?
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A patient complains of fever up to 38,2 degree С, an edema of the upper lip. On examination: the upper lip is distinctly hydropic, in the centre of the edema there is a cone-shaped swelling. The skin and the mucosa over it are deep-red. A furuncle of the upper lip is diagnosed. Surgeon executed a lancing of furuncle, cleansed the wound with peroxide solution and dressed it with hypertonic solution. What therapeutic regimen should be recommended to the patient?
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A 3-day-old new-born who has suffered from asphyxia in birth, presents with bleeding from umbilical sore. Lab tests: hypocoagulation, thrombocytopenia, hypothrombinemia. What is the most likely cause of clinical and laboratory changes?
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Parents of 5-year-old boy complain of ventral curvature of boys penis. Physical examination: external urethral meatus is on the apex of penis, prepuce is hood-like. What is the most likely diagnosis?
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A 75-year-old patient can not tell the month, date and season of the yearAfter long deliberations she manages to tell her name. She is in irritable and dissatisfied mood. She always carries a bundle with belongings with her, hides a parcel with bread, shoes in her underwear in her bosom as well as "invaluable books". What is the most probable diagnosis?
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