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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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A primagravida with pregnancy of 37-38 weeks complains of headache, nausea, pain in epigastrium. Objective: the skin is acyanotic. Face is hydropic, there is short fibrillar twitching of blepharons, muscles of the face and the inferior extremities. The look is fixed. AP- 200/110 mm Hg; sphygmus of 92 bpm, intense. Respiration rate is 32/min. Heart activity is rhythmical. Appreciable edemata of the inferior extremities are present. Urine is cloudy. What medication should be administered?
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A 41-year-old patient was admitted to the intensive care unit with haemorrhagic shock due to gastric bleeding. He has a history of hepatitis B during the last 5 years. The source of bleeding are esophageal veins. What is the most effective method for control of the bleeding?
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A 27-year-old man complains of pains in epigastrium which are relieved by food intake. EGDFS shows antral erosive gastritis, biopsy of antral mucous presents Helicobacter Pylori. Diagnosis is:
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The highest risk of congenital anomalies probably occurs when human embryos or fetuses are exposed to ionizing radiation. At what stage of gestational period does it occur?
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A child with tetralogy of Fallot is most likely to exhibit:
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A 30-year-old woman ill with influenza felt palpitation and dull cardiac pain during moderate physical exercise. Objectively: Ps - 96 bpm, AP - 100/60 mm Hg. The first sound is quiet above the apex, soft systolic murmur is present. What complication is indicated by these clinical presentations?
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A child is 1 day old. During delivery there had been problems with extraction of shoulders. Body weight is 4300,0. Right arm hangs down along the body, hand is pronated, movement in the arm is absent. "Scarf" symptom is positive. What is the most probable diagnosis?
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A woman consulted a therapeutist about fatigability, significant weight loss, weakness, loss of appetite. She has been having amenorrhea for 8 months. A year ago she born a full-term child. Haemorrhage during labour made up 2 l. She got blood and blood substitute transfusions. What is the most probable diagnosis?
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A 40-year-old woman has changes of mammary gland. What are the most often symtomps that precede the malignization?
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It is suspected that a 34-year-old patient has an abscess of Douglas pouches. What diagnostic method is to be chosen?
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A 62-year-old patient suffers from DM-2. Diabetes is being compensated by diet and Maninilum. The patient has to undergo an operation on inguinal hernia. What tactics of hypoglycemic therapy should be chosen?
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A 28-year-old woman was admitted to the emergency room with a slightly reddened, painful "knot" 8 cm above the medial malleolus. Examination in the standing position demonstrates a distended vein above and below the mass. There are no other abnormalities on physical examination. The most likely diagnosis is:
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In treatment and prevention establishments, regardless of their organisational and proprietary form, the rights of patients should be observed. Which of these rights is the most significant?
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A 5 month old boy was born prematurely, he didn't suffer from any disease at the infant age and later on. Examination at an outpatient's hospital revealed paleness of skin, sleepiness. Blood count: Hb - 95 g/l, erythrocytes - 3,5 × 1012/l, reticulocytes - 9%o, colour index - 0,7, osmotic stability of erythrocytes - 0,44-0,33%, serum iron - 4,9 micromole/l. What is the most probable cause of anemia?
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An outbreak of food poisoning was recorded in an urban settlement. The illness was diagnosed as botulism on the grounds of clinical presentations. What foodstuffs should be chosen for analysis in the first place in order to confirm the diagnosis?
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A 68-year-old patient complains about acute pain in his right foot, toe edema and darkening of skin of the IV toe. He has been suffering from diabetes mellitus for 15 years, doesn't receive regular treatment. What complication of diabetes mellitus is it?
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A patient who takes diuretics has developed arrhythmia as a result of cardiac glycoside overdose. What is the treatment tactics in this case?
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A 52-year-old man has recurrent transient ischemic attacks. Auscultation of the carotid arteries detected murmur. What diagnostic method is to be applied in the first place?
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Prophylactic photoroentgenography examination of a 25-year-old man revealed focal shadowings of small and medium intensity with irregular contours in the 1st and 2nd segments of the right lung. Which clinical form can be suspected?
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A 25-year-old patient complains of pain in the I finger on his right hand. On examination: the finger is homogeneously hydropic, in bent position. On attempt to unbend the finger the pain is getting worse. Acute pain appears during the probe in ligament projection. What disease is the most likely?
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A military unit stopped for 3-day's rest in an inhabited locality after a long march. The sanitary-epidemiological reconnaissance found several water sources. It is necessary to choose the source complying with the hygienic standards for drinking water in the field conditions:
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A 13-year-old girl consulted the school doctor on account of moderate bloody discharge from the genital tracts, which appeared 2 days ago. Secondary sexual characters are developed. What is the most probable cause of bloody discharge?
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A 42-year-old metalworker has been working at the turning machine for production of heavy large-size parts for 5 years. His work requires using of hand and pedal levers that involves considerable physical force. What means for osteoarthrosis prevention should be recommended?
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Preventive examination of an 11-year-old boy helped to determine his habitus type. It was established that the child's shoulders were deviated and brought forward, with forward flexion of head, the thorax was flattened, abdomen was convex. The child's backbone had signs of deepened cervical and lumbar curvatures. What habitus is it?
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An onset of severe preeclampsia at 16 weeks gestation might be caused by:
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A 34-year-old woman in the 10th week of gestation (the second pregnancy) consulted a doctor of antenatal clinic in order to be registered there. In the previous pregnancy hydramnion was observed, the child's birth weight was 4086 g. What examination method should be applied in the first place?
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A triad of symptoms ("stearing spot", "terminal film", "blood dew") has been revealed on examination of a patient. What disease should you think about?
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A 30-year-old man complains of acute pain in his right ear, hearing loss, high temperature for three days. Objectively: right ear whispering language - 0,5 mm, external ear is intact, otoscopically - eardrum protrusion, hyperemia and swelling, loss of landmarks. What disease is it?
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A man in grave condition was delivered to the admission ward of a hospital on the 2nd day of illness. Examination revealed body temperature of 36,1°C, sharpened features of face, dry skin that makes a fold, aphonia, convulsive twitching of some muscle groups. Acrocyanosis is present. Heart sounds are muffled, Ps is 102 bpm, AP is 50/20 mm Hg. Abdomen is soft, drawn-in, painless. Anuria is presnt. Stool is liquid in form of rice water. What is the most probable diagnosis?
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An 8-year-old girl complains about joint pain, temperature rise up to 38°C, dyspnea. Objectively: the left cardiac border is deviated by 2,5 cm to the left, tachycardia, systolic murmur on the apex and in the V point are present. Blood count: leukocytes - 20,0 × 109/l, ESR - 18 mm/h. What sign gives the most substantial proof for rheumatism diagnosis?
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A 30-year-old patient undergoes treatment because of Werlhof's disease. Objectively: the patient is pale, there are petechial hemorrhages on the extension surfaces of forearms. Ps is 92 bpm, AP is 100/60 mm Hg. The lower edge of spleen is at a level with umbilicus. Blood count: erythrocytes: 2,8 × 1012/l, Hb - 90 g/l, Ht -0,38, thrombocytes - 30 × 109/l. The patient is being prepared for splenectomy. What transfusion medium should be chosen in the first place for the preoperational preparation?
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During hygienic examination of a hospital it was established that the area for each bed in a double ward was: in the infectious department for children - 7 m2, in the infectious department for adults -8 m2, in the burns department - 9 m2, in the radiological department -10 m2, in the critical care department - 13 m2. In which wards the area for each bed doesn't correspond with hygienic requirements?
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A 9-year-old girl with a history of intermittent wheezing for several years is brought to the pediatrician. The child has been taking no medications for some time. Physical examination reveals agitation and perioral cyanosis. Intercostal and suprasternal retractions are present. The breath sounds are quiet, and wheezing is audible bilaterally. The child is admitted to the hospital. Appropriate interventions might include all of the following EXCEPT:
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A patient with acute purulent otitis media complicated by mastoiditis was admitted to a hospital. Roentgenogram of mastoid processes showed the shadiowi-ng of the cellular system on the lesion, absence of bone septa was present. What are the necessary therapeutic actions at the second stage of mastoiditis?
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A female 28 years old patient became depressed, her mood is melancholic; this state is accompanied by hypobulia, hypokinesia, slow speed of thinking. Her attitude towards her past, present and future is pessimistic. The pathogenetic mechanism of this state is supposed to involve dysfunction in the:
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Among the following causes of acute renal failure, the one that would be classified as "postrenal"is:
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At year-end hospital administration has obtained the following data: annual number of treated patients and average annual number of beds used for patients' treatment. What index of hospital work can be calculated on the base of this data?
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During inspection of sanitary conditions of studying at a technical university it was necessary to evaluate the visual regimen of students, who study from 9 a.m to 3 p.m. What index of natural light will be the most informative?
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A 19-year-old boy was admitted to a hospital with closed abdominal trauma. In course of operation multiple ruptures of spleen and small intestine were revealed. AP is falling rapidly, it is necessary to perform hemotransfusion. Who can specify the patient's blood group and rhesus compatibility?
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A 2-year-old child has been ill with acute respiratory viral infection of upper thrice a year - in February, in April and in December. How should these occurences be recorded?
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