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KROK 2 Medicine 2008 Questions | KROKEXAM
Browse 2008 KROK 2 Medicine exam questions with answers and explanations.
Exam questions
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Routine examination of an otherwise healthy child with a history of bronchial asthma reveals AP of 140/90 mm Hg. The most likely cause of the hypertension is:
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A 22-year-old patient was admitted to trauma center with complaints of pain in the left ankle joint that was getting worse during moving and weight bearing. On the clinical examination it was found that the patient had the closed fracture of medial malleolus without displacement. In which position should the foot be fixed in plaster cast?
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The observed patient's movements are retarded, she answers no questions. Sometimes she spontaneously stays in strange postures. It is possible to set her body and limbs into different positions artificially. If the psychiatrist lifts her arm or leg, so that she remains standing on the other leg, the patient can stay in such a position for quite a long time. Name the probable disorder:
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A patient complains about strong dyspnea that is getting worse during physical activity. Presentations appeared suddenly 2 hours ago at work: acute chest pain on the left, cough. The pain was abating, but dyspnea, dizziness, pallor, cold sweat and cyanosis were progressing. Vesicular respiration is absent, X-ray picture shows a shadow on the left. What pathology might be suspected?
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A 3-year-old child with weight deficiency suffers from permanent moist cough. In history there are some pneumonia with obstruction. On examination: distended chest, dullness on percussion over the lower parts of lungs. On auscultation: a great number of different rales. Level of sweat chloride is 80 millimol/l. What is the most probable diagnosis?
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A 70-year-old man is suffering from coronary heart disease. His mood is evidently depressed, anxious. As a result of continious sleeplessness he has got fears, suicidal thoughts. He would sit for a long time in the same pose, answer after a pause, in a low, monotonous voice. His face has a look of suffering, pain, fear. What is the main psychopathologic syndrome?
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Clinical and statistical study was devoted to the effect of a new pharmacological medication upon the patients with coronary heart disease. What parametric criterion (coefficient) can be used for estimation of results validity?
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Researchers studied disease incidence of influenza and acute respiratory viral infection within the last 5 years. What kind of graphic presentation should be used for the best visualization of this data?
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The average body lenth of newborn boys is 50,9 cm at a sigma 1,66; and average mass - 3432 at a sigma 5,00. What criterion is necessary to compare degree of variability of these signs?
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A patient with acute respiratory viral infection (3rd day of disease) complains of pain in lumbar region, nausea, dysuria, oliguria. Urinalysis - hematuria (100-200 RBC in eyeshot spot), specific gravity -1002. The blood creatinin level is 0,18 mi-llimole/l, potassium level - 6,4 millimole/l. Make the diagnosis:
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A 50-year-old patient has been admitted to the clinics with atrophic gastritis. Blood count: erythrocytes -3,8 × 1012/l, Hb - 68 g/l, c.i. - 1, macroanisocytosis, poikilocytosis. There is megaloblastic type of haemopoesis. A number of leukocytes, reticulocytes and thrombocytes is lreduced. Which pathology is suspected?
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During an operation for presumed appendicitis the appendix was found to be normal; however, the terminal ileum is evidently thickened and feels rubbery, its serosa is covered with grayish-white exudate, and several loops of apparently normal small intestine are adherent to it. The most likely diagnosis is:
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A 14-year-old girl complains of profuse bloody discharges from genital tracts during 10 days after suppresion of menses for 1,5 month. Similiar bleedings recur since 12 years on the background of disordered menstrual cycle. On rectal examination: no pathology of the internal genitalia. In blood: Hb - 70 g/l, RBC-2,3 × 1012/l, Ht - 20. What is the most probable diagnosis?
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A 37-year-old farmer complains about general weakness, spastic pain in the lower parts of his abdomen, mainly in the left iliac area, frequent defecations up to 18 times a day, feces contain admixtures of mucus and blood. The illness began abruptly 3 days ago with chill, fever, headache. General condition is moderately severe, body temperature is 37,8°C. Sigmoid colon is spasmed and painful. What is the most probable diagnosis?
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It is planned to make complete isolation boxes in the infectious department in order to prevent nosocomial airborne infections. The boxes consist of a tambour, a ward and a lock chamber. What structure should be also included in a complete isolation box?
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A 55-year-old patient felt suddenly sick in a hospital corridor, he was immediately examined by a doctor. Examination revealed that the patient's skin was pale, autonomous respiration was absent, pulse on carotid arteries couldn't be felt, pupils were mydriatic. What action should be taken at the beginning of cardiac resuscitation?
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What method is applied to establish rate of correlation between age of men and their mortality due to myocardial infarction?
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A 3 month old infant suffering from acute segmental pneumonia has dyspnea (respiration rate - 80 per minute), paradoxical breathing, tachycardia, total cyanosis. Respiration / pulse ratio is 1:2. The heart dullness under normal size. Such signs characterise:
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A 28-year-old patient was admitted to the clinic with complaints of the temperature rise up to 39,0°C, headache, weakness, constipation on the 9th day of the disease. On examination: single roseolas on the skin of the abdomen are present. The pulse rate is 78 bpm. The liver is enlarged by 2 cm. What is the most probable diagnosis?
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A 50-year-old woman with a 2-year history of mild, diffuse, tender thyroid enlargement complains of 10 pound weight gain and fatigue. What is the most probable diagnosis?
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A 43-year-old patient had cholecystectomy 6 years ago because of chronic calculous cholecystitis. Lately he has been suffering from pain in the right subcostal area and recurrent jaundice. Jaundice hasn't gone for the last 2 weeks. Stenosing papillitis 0,5 cm long has been revealed. What is the best way of treatment?
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A 3-year-old child fell acutely ill, body temperature rose up to 39,5°C, the child became inert, there appeared recurrent vomiting, headache. Examination revealed positive meningeal symptoms, after this lumbal puncture was performed. Spinal fluid is turbid, runs out under pressure, protein concentration is 1,8 g/l; Pandy reaction is, sugar concentration is 2,2 millimole/l, chloride concentration - 123 millimole/l, cytosis is 2, 35 × 109 (80% of neutrophils, 20% of lymphocytes). What is the most probable diagnosis?
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A 30-year-old man complains of intense pain, reddening of skin, edema in the ankle-joint area, fever up to 39°C. There was an acute onset of the illness. In the past there were similar attacks lasting 5-6 days without residual changes in the joint. The skin over the joint is hyperemic and ill-defined, without infiltrative bank on the periphery. What is the most likely diagnosis?
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A 24-year-old patient complained about putting on weight, limosis. Objectively: the patient's constitution is of hypersthenic type, body weight index is 33,2 kg/m2, waist circumference is 100 cm. Correlation of waist circumference to the thigh circumference is 0,95. What is the most probable diagnosis?
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Adenosine triphosphate may be expected to convert which of the following arrhythmias to sinus rhythm?
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A 3-year-old child has been suffering from fever, cough, coryza, conjunctivitis for 4 days. He has been taking sulfadimethoxine. Today it has fever up to 39°C and maculopapular rash on its face. Except of rash the child's skin has no changes. What is your diagnosis?
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A patient has been in a hospital. The beginning of the disease was gradual: nausea, vomiting, dark urine, acholic stools, yellowness of the skin and scleras. The liver is protruded by 3 cm. Jaundice progressed on the 14th day of the disease. The liver diminished in size. What complication of viral hepatitis caused deterioration of the patient's condition?
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A severely traumatized patient who has been receiving prolonged parenteral alimentation develops diarrhea, mental depression, alopecia and perioral and periorbital dermatitis. Administration of which of the following trace elements is most likely to reverse these complications?
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A full-term infant is 3 days old. On the different parts of skin there are erythemas, erosive spots, cracks, areas of epidermis peeling. The infant has scalded skin syndrome. Nikolsky's symptom is positive. General condition of the infant is grave. Anxiety, hyperesthesia, febrile temperature are evident. What is the most probable diagnosis?
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A 39-year-old patient suffering from hypertension felt suddenly intense headache in the region of occiput; there appeared recurrent vomiting. These presentations has been lasting for 5 hours. Objectively: Ps - 88 bpm, AP - 205/100 mm Hg, painfulness of occipital points, rigidity of occipital muscles are present. Kernig's symptom is bilaterally positive. Subarachnoid hemorrhage is also suspected. What diagnostic method will be of the greatest importance for confirmation of provisional diagnosis?
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Preventive examination of a 55-year-old patient revealed diabetes mellitus. The patient hasn't received treatment for it. Objectively: height is 170 cm, weight is 106 kg, skin humidity is normal. Ps is 76 bpm, rhythmic, left border of relative heart dullness is deviated by 1 cm to the left from the middle clavicular line, heart sounds are quiet, AP is 140/80 mm Hg. Glycemia on an empty stomach is 6,9 millimole/l. Glucose rate in the daily urine is 0,5%, diuresis makes up 2,5 l. What treatment tactics should be chosen?
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A parturient woman is 27-year-old, it was her second labour, delivery was at term, normal course. On the 3rd day of postpartum period body temperature is 36,8°C, Ps - 72/min, AP - 120/80 mm Hg. Mammary glands are moderately swollen, nipples are clean. Abdomen is soft and painless. Fundus of uterus is 3 fingers below the umbilicus. Lochia are bloody, moderate. What is the most probable diagnosis?
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A 48-year-old man complains of fati-que and shortness of breath. His Ht is 32%, and Hb - 103 g/l. Peripheral blood smear reveals macrocytosis. Serum vitamin Bi2 level is 90 pg/ml (normal is 170 to 940); serum folate level is 6 ng/ml (normal is 2 to 14). Possible causes to consider include all of the following EXCEPT:
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A 2-year-old girl has been ill for 3 days. Today she has low grade fever, severe catarrhal presentations, slight maculopapular rash on her buttocks and enlarged occipital lymph nodes. What is your diagnosis?
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An 18-year-old patient was admitted to a hospital with complaints of headache, weakness, high temperature, sore throat. Objectively: enlargement of all groups of lymph nodes was revealed. The liver is enlarged by 3 cm, spleen - by 1 cm. In blood: leukocytosis, atypical lymphocytes - 15%. What is the most probable diagnosis?
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A patient has got pain in the axillary area, rise of temperature developed 10 hours ago. On examination: shaky gait is evident, the tongue is coated with white deposit. The pulse is frequent. The painful lymphatic nodes are revealed in the axillary area. The skin over the lymph nodes is erythematous and glistering. What is the most probable diagnosis?
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An outpatient hospital made record of 11600 diseases within one year. Among them influenza and ARD make up 5800, circulatory system diseases - 3480, digestion diseases - 1300, other diseases - 1020. What relative index can be calculated according this data?
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A 10-year-old girl complains about abdominal pain that is arising and getting worse after eating rough or spicy food. She complains also about sour eructation, heartburn, frequent constipations, headache, irritability. She has been suffering from this for 12 months. Objectively: the girl's diet is adequate. Tongue is moist with white deposit at the root. Abdomen is soft, painful in its epigastric part. What study method will help to make a diagnosis?
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The results of 5 year monitoring allowed to estimate the level of environmental influence upon health indices of popultaion. What statistic method should be chosen?
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Esophagus wall of a 72-year-old patient with severe concomitant pathology was injured during urgent fi-broesophagogastroscopy. This resulted in progressing of acute respiratory failure and collapse of the left lung. What aid should be rendered?
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