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KROK 2 Medicine 2008 Questions | KROKEXAM
Browse 2008 KROK 2 Medicine exam questions with answers and explanations.
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An 8-year-old child has low-grade fever, arthritis, colicky abdominal pain and a purpuric rash localized on the lower extremities. Laboratory studies reveal a guaiac-positive stool, urinalysis with red blood cell (RBC) casts and mild proteinuria, and a normal platelet count. The most likely diagnosis is:
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A 38-year-old man, previously in good health, suddenly develops severe abdominal pain radiating from the left loin to groin and accompanied by nausea, perspiration and the need for frequent urination. He is restless, tossing in bed but has no abnormal findings. The most likely diagnosis is:
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A 2 month old healthy infant with good appetite is given artificial feeding since he turned 1 month old. When is it recommended to start the corrective feeding (fruit juice)?
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A 56-year-old woman has an acute onset of fever up to 39°C with chills, cough, and pain on respiration in the right side of her chest. On physical examination: HR - 90/min, BP- 95/60 mm Hg, RR-26/min. There is dullness over the right lung on percussion. On X-ray: infiltrate in the right middle lobe of the lung. What is the diagnosis?
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A 40-year-old patient complains of yellowish discharges from the vagina. Bimanual examination revealed no pathological changes. The smear contains Trichomonas vaginalis and blended flora. Colposcopy revealed two hazy fields on the frontal labium, with a negative Iodine test. Your tactics:
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A 39-year-old patient complained about morning headache, appetite loss, nausea, morning vomiting, periodic nasal hemorrhages. The patient had acute glomerulonephritis at the age of 15. Examination revealed rise of arterial pressure up to 220/130 mm Hg, skin hemorrhages on his arms and legs, pallor of skin and mucous membranes. What chemestry test has the greatest diagnostic importance in this case?
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A 24-year-old patient complains about general weakness, dizziness, body temperature rise up to 37,5°C, sore throat, neck edema, enlargement of submaxillary lymph nodes. Objectively: mucous membrane of oropharynx is edematic and cyanotic, tonsils are enlarged and covered with films that spread beyond the tonsils and cannot be easily removed. What is the leading mechanism of this illness' development?
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A 3 month old child has occiput alopecia, anxious sleep, excessive sweating. What disease might be suspected?
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A woman complains of having slight dark bloody discharges and mild pains in the lower part of abdomen for several days. Last menses were 7 weeks ago. The pregnancy test is positive. Bimanual investigation: the body of the uterus indicates for about 5-6 weeks of pregnancy, it is soft, painless. In the left appendage there is a retort-like formation, 7x5 cm large, mobile, painless. What examination is necessary for detection of fetus localization?
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A 40-year-old woman has a selfdetected hard breast mass. The procedure of choice for confirming the diagnosis is:
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A nine-year-old child is at a hospital with acute glomerulonephritis. Clinical and laboratory examinations show acute condition. What nutrients must not be limited during the acute period of glomerulonephritis?
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A 26-year-old man was admitted to the hospital because of stabbing back pain on inspiration and dyspnea. Examination results: BT of 37°C, Ps of 24/min, HR of 92/min, vesicular breath sounds. There is a dry, grating, low-pitched sound heard on both expiration and inspiration in the left inferior lateral part of the chest. What is the most likely diagnosis?
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A patient complained about problems with pain and tactile sensitivity, pain in the nail bones at the end of the working day. He works at a plant with mechanical devices. What pathology can be suspected?
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A 14-year-old child suffers from vegetovascular dystonia of pubertal period. He has got sympathoadrenal atack. What medicine should be used for attack reduction?
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A 38-year-old man complains about mild pain and muscle weakness of shoulder and pelvic girdles and back that has been progressing for the last 3 weeks. He has also significant problems with getting up, going up and down the stairs and shaving. It is suspected that the patient is suffering from dermatomyositis. Blood count: Hb - 114 g/l, leukocytes - 10,8*109/l, eosin - 9%, ESR - 22 mm/h, C-reactive protein (++). Change of the following laboratory factor will be of the greatest diagnostic importance:
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After delivery and revision of placenta there was found the defect of placental lobule. General condition of woman is normal, uterus is firm, there is moderate bloody discharge. Speculum inspection of birth canal shows absence of lacerations and raptures. What action is nesessary?
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A pregnant woman in her 40th week of pregnancy undergoes obstetric examination: the cervix of uterus is undeveloped. The oxytocin test is negative. Examination at 32 weeks revealed: AP 140/90 mm Hg, proteinuria 1 g/l, peripheral edemata. Reflexes are normal. Choose the most correct tactics:
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A 38-year-old man was admitted to a hospital from his working place on July 19 because of hip fracture. He was invalid till November 19. Requires prolongation of treatment. Who decides on the issue of further temporary invalidity?
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Examination of a 3-month-old child revealed scrotum growth on the right. This formation has elastic consistency, its size decreases during sleep and increases when the child is crying. What examination will be helpful for making a correct diagnosis?
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A 34-year-old woman fell ill 3 months ago after cold exposure. She complained of pain in her hand and knee joints, morning stiffness and fever up to 38°C. Interphalangeal, metacarpophalangeal and knee joints are swollen, hot, with reduced ranges of motions; ESR of 45 mm/h, CRP (+++), Vaaler-Rouse test of 1:128. What group of medicines would you recommend the patient?
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A 25-year-old patient complains about weakness, dizziness, appearance of haemorrhagic skin rash. She has been suffering from this for a month. Blood count: erythrocytes: 1,0 × 1012/l, Hb- 37 g/l, colour index - 0,9, leukocytes - 1,2 × 109/l, thrombocytes - 42 × 109/l. What diagnostic method will be the most effective?
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A 23-year-old man complains about face edemata, headache, dizziness, reduced urination, change of urine colour (dark-red). These presentations appeared after pharyngitis. Objectively: face edemata, pale skin, temperature -37,4°C; heart rate - 86/min, AP - 170/110 mm Hg. Heart sounds are muffled, the II sound is accentuated above aorta. What etiological factor is probable in this case?
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A 9-year-old boy has been suffering from diabetes mellitus for a year. He gets insulin injections (humulin R, NPH), the dose makes up 0,4 units per 1 kg of body weight a day. Insulin is untroduced subcutaneously (into the shoulder) by means of a syringe. What measures should be taken in order to prevent lipodystrophy?
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A 7-year-old boy has periods of loss of attention that last 10-15 seconds and occur several times a day. During these periods he stands still in one position, doesn't answer the questions or react when he is called by his name. Neurological examination revealed no changes. What diagnostic method should be applied to specify his diagnosis?
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A 26-year-old woman had the second labour within the last 2 years with oxytocin application. The child's weight is 4080 gr. After the placent birth there were massive bleeding, signs of hemorrhagic shock. Despite the introduction of contractive agents, good contraction of the uterus and absence of any cervical and vaginal disorders, the bleeding proceeds. Choose the most probable cause of bleeding:
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During investigation for chronic, severe, epigastric pain, a 40-year-old alcoholic man is found to have multiple areas of narrowing alternating with dilatation ("chain of lakes" appearance) of the main pancreatic duct. The operation of choice is:
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A rounded well-defined shadow was found in the costo-vertebral angle on the chest roentgenogram of an otherwise healthy 9-year-old girl. Make a preliminary diagnosis:
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A 50-year-old woman complained of attacks of right subcostal pain after fatty meal she has been suffering from for a year. Last week the attacks repeated every day and became more painful. What diagnostic study would you recommend?
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A 28-year-old woman had the second labour and born a girl with manifestations of anemia and progressing jaundice. The childs weight was 3.400 g, the length was 52 cm. The womans blood group is B (III) Rh-, the fathers blood group is A (III) Rh+, the childs blood group is B (III) Rh+. What is the cause of anemia?
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A 12-year-old girl complains about abrupt weakness, nausea, dizziness, vision impairment. The day before she ate home-made stockfish, beef. Examination revealed skin pallor, a scratch on the left knee, dryness of mucous membranes of oral pharynx, bilateral ptosis, mydriatic pupils. The girl is unable to read a simple text (mist over the eyes). What therapy would be the most adequate in this case?
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A 25-year-old pediatrician fell ill a week ago: body temperature rose up to 37,6°C, there appeared a slight swelling on his neck. His illness was diagnosed as ARD, cervical lymphadenitis. Treatment course included erythromycin, hot compress on the neck. In course of treatment body tempearture rose up to 39°C, there appeared headache, repeated vomiting, meningeal syndrome. What studies are necessary for the final diagnosis?
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A 52-year-old patient complains about pain in the right part of her chest, dyspnea, cough with a lot of foul-smelling albuminoid sputum in form of "meat slops". Objectively: the patient's condition is grave, cyanosis is present, breathing rate is 31/min, percussion sound above the right lung is shortened, auscultation revealed different rales. What is the most probable diagnosis?
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On the first day after labour a woman had the rise of temperature up to 39°C. Rupture of fetal membranes took place 36 hours before labour. Examination of the bacterial flora of cervix of the uterus revealed hemocatheretic streptococcus of A group. The uterus body is soft, tender. Discharges are bloody, with admixtures of pus. Specify the most probable postnatal complication:
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The treatment of choice for duodenal obstruction caused by secondary duodenal hematoma that developed a few days after blunt abdominal injury is:
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A 52-year-old patient with history of functional Class II angina complains of having intense and prolonged retrosternal pains, decreased exercise tolerance for 5 days. Angina is less responsive to nitroglycerine. What is the most probable diagnosis?
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A 25-year-old woman complained of edema on her face and legs, rise of blood pressure up to 160/100 mm Hg and weakness. She fell ill 3 weeks after recovering from angina. Urinalysis data: protein of 0,5 g/l, erythrocytes of 17-20/field, leukocytes of 2-3/field, erythrocyte casts. What treatment should be initiated after specifying the diagnosis?
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A 25-year-old patient was admitted on the 1st day of the disease with complaints of double vision in the eyes, heavy breathing. The day before the patient ate home-made mushrooms. On objective examination: paleness, mydriatic pupils, difficult deglutition, bradycardia, constipation. What is the diagnosis?
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A 19-year-old patient was admitted to a hospital with acute destructive appendicitis. He suffers from hemophilia of B type. What antihemophilic medications should be included in pre- and postoperative treatment plan?
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A 41-year-old woman has suffered from nonspecific ulcerative colitis for 5 years. On rectoromanoscopy: evident inflammatory process of lower intestinal parts, pseudopolyposive changes of mucous membrane. In blood: WBC- 9,8 × 109/l, RBC- 3,0 × 1012/l, ESR - 52 mm/hour. What medication provides pathogenetic treatment of this patient?
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A 15-year-old patient suffers from headache, nasal hemorrhages, sense of lower extremity coldness. Objectively: muscles of shoulder girdle are developed, lower extremities are hypotrophied. Pulsation on the pedal and femoral arteries is sharply dampened. AP is 150/90 mm Hg, 90/60 on the legs. Systolic murmur can be auscultated above carotid arteries. What is the most probable diagnosis?
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