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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 18-year-old woman consulted a gynecologist with complaints of the pain in the lower part of the abdomen, fever up to 37,5°С, considerable mucopurulent discharges from the genital tract, colic during urinatingAfter mirror and vagina exam the results are the following: the urethra is infiltrated, cervix of the uterus is hyperemic, erosive. The uterus is painful, ovaries are painful, thickened, free. Bacterioscopy test showed diplococcus. What diagnosis is the most probable?
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A full-term new-born suffered ante- and intranatal hypoxia, was born in asphyxia (Apgar score 2-5 points)After birth babys excitation is progressing, occurs vomiting, nystagmus, spasms, squint, spontaneous Babinski and Moros reflexes. What is the most probable location of the intracranial hemorrhage in this case?
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In the development of the inflammation processes glucocorticoids reduce the level of a certain most important active enzyme. It results also in the reducing of the synthesis of prostaglandins and leucotrienes which have a key role in the development of inflammation processes. What is the exact name of this enzyme?
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A patient aged 18 with a cranial injury was in comatose state during several hours. In post-comatose period gets tired quickly, non-productive in dialog - in the beginning answers 2-3 questions, then gets tired and can not understand the point of the question. Which psychotropic should be given to the patient to prevent psychoorganic syndrome?
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In an inhabited locality there is an increase of diphtheria during the last 3 years with separate outbursts in families. What measure can effectively influence the epidemic process of diphtheria and reduce the morbidity rate to single cases?
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A patient, aged 36, is diagnosed with ascites, splenomegaly, liver dimensions by Kurlov 11х9х8 cm, varicose esophagus veins. In medical history: abdominal injury, stomach bleeding.AST – 0,46 mmol/gL; ALT – 0,68 mmol/gL; total bilirubin – 21 mu mol/L, unconjugated bilirubin – 17,1 mu mol/L. What is the preliminary diagnosis?
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A woman, aged 26, is brought to emergency department with complaints of sudden pain in the lower abdomen, weakness, loss of consciousness at home. The previous menstruation absented. Hb - 106 g/L, Ps - 120/min, BP - 80/50 mm Hg. Painfulness and peritoneum irritation symptoms in the lower right flank. What is the most likely diagnosis?
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The district doctor is charged with the analysis of the morbidity rate in the area he is assigned to. Which type of morbidity characterises the group of protractedly and frequently ill?
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A woman, aged 37, primigravida, is in labour during 10 hours. The contractions last 20-25 sec every 6-7 min. Fetal position is longitudinal, head presents and is engaged to pelvic inlet. Vaginal inspection: cervix is 1 cm long, lets in 2 horizontal fingers. Fetal bladder is absent. What is the most likely diagnosis?
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A 43-year-old woman complains of severe pain in the right abdominal side irradiating in the right supraclavicular area, fever, dryness and bitterness in the mouth. There was multiple vomiting without relief. Patient relates the onset of pain to the taking of fat and fried food. Physical examination: the patient lies on the right side, pale, dry tongue, tachycardia. Right side of abdomen is painful during palpation and somewhat tense in right hypochondrium. What is the most likely diagnosis?
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A 2-months baby, after preventive vaccination, suffered from protracted hemorrhage from the point of injection, later there developed an intramuscular hematoma. On examination: a significant growth of prothrombine consumption and distinct prolongation of activated partial thromboplastin time. What is the most likely diagnosis?
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A 2,5-year-old child fell ill 10 hours ago, became anxious, held on the stomach, had fever up to 38 degree С. In 7 hours condition has worsened with vomiting and diarrhea. Physical examination: tongue is dry, coated. Abdomen barely participates in breathing. Palpation is impossible due to childs anxiety. Digital rectal investigation reveals overhang of front rectum wall. What is the most likely diagnosis?
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A man, aged 28, power-supply system operator, was at his working place during the breakdown on the nuclear power plant. In the result of the steam-air explosion there was an emission of circa 30 kg radioactive iodine (І131). Which radioprotector is expedient in this case?
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A worker of the chemical plant complains of fatigue, insomnia, headache. Works at the amalgam production. On examination: tremor, asymmetry of reflexes, labile pulse, stable red dermographism. Excretory gingivitis. What is the cause of the illness?
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A patient, aged 24, is suffering from an asthmatic fit with non-productive cough and skin itch after diclofenac intake. In medical history: urticaria. On examination: edematous face, swelling of the cervical veins, the patient is supporting himself in a seated position, audible stridor breathing. What is the most likely diagnosis?
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A patient, aged 38, had acute glomerulonephritis 10 years ago, complains of face and legs swelling, headache, dull pain in loins. BP - 220/130 mm Hg. Urinalysis: protein - 9,9 g/L, WBC - 3-4 in the field of vision, RBC - 10-12 in the field of vision, hyaline cylinders - 3-4 in the field of vision, ceraceous - 2-3 in the field of vision. Creatinine - 102 mu mol/L. Which of the mentioned antihypertensive agents are expedient to prescribe in this case?
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A boy, aged 9, is examined: height – 127 cm (-0,36), weight – 28,2 kg ( 0,96), chest circumference - 64,9 cm ( 0,66), lung vital capacity – 1520 ml (-0,16). What is the integrated assessment of the childs physical development?
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A boy, aged 13, suffers from an abrupt aggravation of condition, there appeared shortness of breath, skin paleness with cyanosis. BP - 80/55 mm Hg, Ps- 128/min, heart sounds weakened. On ECG: diffuse muscular changes, polytopic extrasystole. Radiologically: acute enlargement of the heart borders in all directions. Two weeks ago there occurred a reaction on analgin administration. What is the most likely diagnosis?
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In 2 weeks after pharyngitis a 25-year-old patient started complaining of rise in temperature to 38°С, fatigue, shortness of breath during walking, migrating joint intumescence and pain. On physical exam: cyanosis of lips, pulse is weak, rhythmical, 100 bpm. The left heart border is moved outwards from mediaclavicular line for 1 cm. Sound I on the apex is weakened, soft systolic murmur is auscultated. What etiologic factor caused this pathological process in the most probable way?
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A man consults a physician with complaints of cramping pain in left side of the chest, general weakness, fever and headache that have appeared 2 days ago. This morning the patient noticed a skin rash on the chest. Physical examination: multiple aggregated vesicles with edematous covers filled with transparent liquid, 2-4 mm in diameter. Vesicles are situated on the erythematous and edematous background along 4-5 intercostals. What is the most likely diagnosis?
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A breakdown on a nuclear power-plant caused the radioactive fuel material release in the atmosphere, which resulted in the radionuclid pollution of a large territory and increasing of the background ionising radiation. The incidence of what diseases will be increased among the population of this territory in the future?
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A 27-year-old patient was admitted to the psychiatric hospital for the 4-th time during 2 years. He heard voices commenting on his actions, had delusions of persecution (was sure that mafia wanted to kill him). He was discharged from the hospital with the diagnosis of schizophrenia, state of remission after a course of treatment with neuroleptics. What is necessary to do to prevent relapses of schizophrenia?
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A 14-year-old victim was drawn out of the water in winter after 15 minutes after drowning. The victim shows no vital signs. What measures are to be taken?
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A 36-year-old male, at 4:00 a.m. had an intensive attack of lacerating chest pain, which was accompanied by weakness, cold perspiration, fear of death. ECG: dome-shaped ST segment elevation in leads ІІ, ІІІ, aVF, V5, V6. After pain relieving the ECG has normalised. What is the preliminary diagnosis?
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A woman, aged 64, suffering from unstable angina, suddenly collapsed during walking. On examination: unconscious, absence of pulsation on a. carotis and heart sounds, miotic pupils and infrequent shallow respiration. What is the first measure to start resuscitation?
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A child, aged 5, is ill with fever, vesicular rash mainly on the trunk and head skin. On the 8th day there appeared severe headache, ataxia, lethargy, movement discoordination, tremor of the extremities. On the second wave of the fever encephalitis is diagnosed. Complication of what disease can be encephalitis in this case?
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A pregnant woman, aged 35, is in grave condition, complains of headache, vision disorders, "midges" before the eyes. On examination: anasarca, BP - 180/120 mm Hg. Suddenly there appeared fibrillar twitching of the facial muscles, tonic spasms. Breathing stopped. 1 minute later breathing restartedA profuse foam discharge from the mouthAmnesia. In clinical urine analysis: protein - 7 g/L. What is the most likely diagnosis
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A 48-year-old patient complains of heaviness in the right hypochondrium, itching of the skin. He had been treated in infectious diseases hospital repeatedly due to icterus and itch. On physical exam: meteorism, ascitis, dilation of abdominal wall veins, protruded umbilicus, spleen enlargement. What can be diagnosed in this case?
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A worker, aged 38, working in the slate production during 15 years, complains of expiratory exertional dyspnea, dry cough. On examination: deafening of the percutory sounds in interscapular region, rough breath sounds, dry disseminated rales. On fingers skin – greyish warts. Factorys sectorial doctor suspects asbestosis. Which method is the most informative for diagnosis verification?
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At the radiological unit of the hospital, gamma-devices of radiotherapy of "Agat" type and other closed sources of ionising radiation are used for treatment of malignant neoplasms. What are the measures to be taken to protect personnel at the time of work with radioactive sources of such type?
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A youth, aged 15, from childhood suffers from atopic dermatitis and allergy to the shellfish. In the last 3 months, after acquiring aquarium fish, developed rhinitis, conjunctivitis, itching in the nose. The level of what immunologic index should be defined in this case?
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A 29-year-old patient complains of sterility. Sexual life is during 4 years of marriage, does not use contraception. There was no pregnancy before. On physical examination, genitals are developed normally. Uterine tubes are passable. Rectal temperature during three menstrual cycles is monophase. What is the most probable reason for sterility?
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During 3 years a patient with diagnosis of chronic bronchitis has been under regular observation in the clinic. This year he applied 3 times for medical aid on account of exacerbation of this disease. What should be the statistical record of this disease?
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The mental status of a 22-year-old man is characterized by a stable pathological depressed mood. The patient is sociable, replies briefly but to the point. The speech is laconic, in slowed tempo, movements are constrained and inhibited. Speaks on the ideas of self-accusation and self-humiliation. Medications of what group are to be prescribed to this patient?
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During 2 hours after delivery the condition of the woman is good: the uterus is firm, spherical, the fundus of uterus is on level of the navel, no hemorrhage. The clamp, placed on the umbilical cord segment, remains on the same level. On deep inhalation and on pressing with edge of the hand above symphysis the umbilical cord retraction into the vagina. There is no bloody discharge from the genital tracts. What should be the further tactics of the doctor?
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In a new-born baby-girl on the 4 day of life there determined the swelling of the mammary glands with secretions, swelling of the vulva, bloody discharge from the genital tracts. What is the most probable cause of this condition?
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A woman complains of unpleasant feelings in different body parts and organs, and sometimes very burdensome feelings of compression, torsion, turning-over. Repeated consultations with specialists, clinical examinations, after that - referral for psychiatric advice. What psychopathological disorder is most likely?
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A mother who is on partially paid maternity leave got sick and was hospitalized. What document is to be issued to a working father who will be taking care of a child during his mothers illness?
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The district pediatrician is charged with the analysis of infant mortality. What is taken for the unit of observation in infant mortality investigation?
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A 34-year-old patient is hospitalized with complaints of cervical and axillary lymph nodes enlargement, subfebrile temperature during the last 2 months, increased sweating. There are Reed- Sternberg (Berezovsky) cells in the puncture of lymph nodes. What method of investigation is expedient to study the extent of tumour process?
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