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KROK 2 Medicine 2009 Questions | KROKEXAM
Browse 2009 KROK 2 Medicine exam questions with answers and explanations.
Exam questions
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A patient was delivered to a surgical department after a road accident with a closed trauma of chest and right-sided rib fracture. The patient was diagnosed with right-sided pneumothorax, it is indicated to perform drainage of pleural cavity. Pleural puncture should be made in:
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Infant is 6,5 months now and is given natural feeding since birth. Body mass was 3,5 kg, with length 52 cm at birth. How many times per day the supplement (up feeding) should be given?
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A male patient, 60 years old, tobacco smoker for 30 years, alcoholic, has dysphagia and weight loss since 4 months. Suggested diagnosis?
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A 37-year-old patient applied to a local therapeutist. As a result of exacerbation of chronic obstructive bronchitis the patient had been temporarily disabled for 117 days within 1 year. What tactics will be legally correct?
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A woman consulted a doctor on the 14th day after labour about sudden pain, hyperemy and induration of the left mammary gland, body temperature rise up to 39°C, headache, indisposition. Objectively: fissure of nipple, enlargement of the left mammary gland, pain on palpation. What pathology would you think about in this case?
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A 23-year-old patient fell ill 3 weeks ago when she noticed a very painful induration in her axillary crease. 4-5 days later it burst and discharged a lot of pus. After that some new infiltrations appeared around the affected area. The patient has never suffered from skin diseases before. What is the most probable diagnosis?
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A 37-year-old miner has lifted significant loads and afterwards felt pain in the lumbar area irradiating to his left leg. He walks slowly and carefully. Lumbar lordosis is flattened. There is also left-sided scoliosis and tension of paravertebral muscles. Neri's and Dejerine's symptoms are positive, there is Lasegue's sign on the left from the angle of 350. What method will help to specify the diagnosis?
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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 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 12-year-old child has the ulcer disease of stomach. What is the etiology of this disease?
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Which of the following symptoms would occur only if a total-body acute radiation exposure exceeded 5.000 rad (50 Gy)
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A 54-year-old male patient complains about permanent dull pain in the mesogastral region, weight loss, dark blood admixtures in the feces, constipations. He put off 10 kg within a year. In blood: erythrocytes: 3,5• 1012/l, Hb- 87 g/l, leukocytes - 12,6 × 109/l, stab neutrophil shift, ESR - 43 mm/h. What is the most probable diagnosis?
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A 32-year-old patient suffering from chronic viral hepatitis complains about dull pain in the right subcostal area, nausea, dry mouth. Objectively: liver dimensions are 13-21-11 cm (according to Kurlov), spleen is by 2 cm enlarged, aspartate aminotransferase is 3,2 micromole/l-h, alanine aminotransferase - 4,8 millimole/l-h. Serological study revealed HBeAg, high concentration of DNA HBV. What drug should be chosen for treatment of this patient?
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A 28-year-old woman has bursting pain in the lower abdomen during menstruation; chocolate-like discharges from vagina. It is known from the anamnesis that the patient suffers from chronic adnexitis. Bimanual examination revealed a tumour-like formation of heterogenous consistency 7x7 cm large to the left from the uterus. The formation is restrictedly movable, painful when moved. What is the most probable diagnosis?
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A 47-year-old male patient got a flame burn of trunk and upper extremities and was delivered to the hospital. The patient is in grave condition, confused mental state, with fever. AP- 80/50 mm Hg, Ps-118 bpm. It was locally stated that the patient got III B degree burns with total area of 20%. What medical actions should be taken?
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A patient suffering from gastroesophageal reflux has taken from time to time a certain drug that "reduces acidity" for 5 years. This drug was recommended by a pharmaceutist. The following side effects are observed: osteoporosis, muscle weakness, indisposition. What drug has such following effects?
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A 20-year-old patient was delivered to the hospital in summer from the street with haemorrage from the brachial artery. First medical aid involved aplication of a tourniquet for provisional arrest of bleeding. What is the maximal exposure of the tourniquet?
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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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In the 43rd week of gestation a long, thin infant was delivered. He is apneic, limp, pale, and covered with "pea soup" amniotic fluid. The first step in the resuscitation of this infant at delivery should be:
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A 10 month old boy has been ill for 5 days after consumption of unboiled milk. Body temperature is 38 - 39°C, there is vomiting, liquid stool. The child is pale and inert. His tongue is covered with white deposition. Heart sounds are muffled. Abdomen is swollen, there is borborygmus in the region of ubbilicus, liver is enlarged by 3 cm. Stool is liquid, dark-green, with admixtures of mucus, 5 times a day. What is the most probable diagnosis?
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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 - 90/oo, 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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As a result of prophylactic medical examination a 35-year-old woman was diagnosed with alimentary and constitutive obesity of the III-degree. It is known from her anamnesis that the patient doesn't observe rules of rational nutrition: she often overeats, the last food intake is usually 10-15 minutes before going to bed, prefers fattening and rich in carbohydrates food. What is the main alimentary risk factor of obesity development?
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A 54-year-old female patient was admitted to the hospital with evident acrocyanosis, swollen cervical veins, enlarged liver, ascites. Cardiac borders are dilated. Heart sounds cannot be auscultated, apical beat is undetectable. AP is 100/50 mm Hg. X-ray picture of chest shows enlarged heart shadow in form of a trapezium. What pathology might have caused these symptoms?
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A 34-year-old patient complains of profuse sweating at night, skin itching, weight loss (9 kg within the last 3 months). Examination revealed malnutrition, skin pallor. Palpation of neck and inguinal areas revealed dense elastic lymph nodes for about 1 cm in diameter, nonmobile, non-adhering to skin. What is the most probable diagnosis?
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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 in order to compare degree of variability of these signs?
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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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Examination of a 22-year-old man suffering from polyarthralgia and high fever revealed right-sided exudative pleuritis. X-ray picture showed a homogenous shadow below the IV rib on the right. In the II segment there were single dense focal shadows. Mantoux test with 2 TU resulted in formation of a papula 16 mm large. Pleural liquid has increased protein concentration, Ri-valta's reaction is positive, there was also increased number of leukocytes with prevailing lymphocytes. What is the most probable etiology of pleuritis?
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A 45-year-old woman complains about unbearable pain attacks in the left part of face lasting 1-2 minutes. Such attacks are provoked by mastication. These symptoms appeared 2 months ago after exposure to cold. Objectively: the pain is localized in the ending points of trigeminus on the left. A touch near nose wing provokes another pain attack and tonic spasm of face muscles. What is the most probable diagnosis?
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A 40-year-old female patient has been observing excessive menstruation accompanied by spasmodic pain in the lower abdomen for a year. Bimanual examination performed during menstruation revealed a dense formation up to 5 cm in diameter in the cervical canal. Uterus is enlarged up to 5-6 weeks of pregnancy, movable, painful, of normal consistency. Appendages are not palpable. Bloody discharges are profuse. What is the most probable diagnosis?
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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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15 minutes after the second vaccination with diphteria and tetanus toxoids and pertussis vaccine a 4 month old boy manifested symptoms of Quincke's edema. What medication should be applied for emergency aid?
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A department chief of an in-patient hospital is going to examine resident doctors as to observation of medical-technological standards of patient service. What documentation should be checked for this purpose?
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Indicate the registration medical document for the patient, who 21.02. was addressed to the doctor with diagnosis ARVD for the first time in this year:
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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 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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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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A 38-year-old man was delivered to the hospital in unconscious state. The symptoms of illness turned up a day before: headache, nausea, vomiting, to-38,5°C, dizziness, delusion. For the last 4 days he had been complaining of pain and hearing loss in the left ear. Objectively: sopor, rigidity of occipital muscles, bilateral Kernig's symptom, general hyperesthesia, purulent discharges from the left ear. What is the most probable diagnosis?
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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 16-year-old female patient underwent an operation on account of diffuse toxic goiter of the III-IV degree 12 years ago. Now she has recurrence of thyrotoxicosis. The patient was offered operative intervention, but it is necessary first to localize the functioning gland tissue. What method should be applied for this purpose?
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A woman is 34 years old, it is her tenth labor at full term. It is known from the anamnesis that the labor started 11 hours ago, labor was active, painful contractions started after discharge of waters and became continuous. Suddenly the parturient got knife-like pain in the lower abdomen and labor activity stopped. Examination revealed positive symptoms of peritoneum irritation, ill-defined uterus outlines. Fetus was easily palpable, movable. Fetal heartbeats wasn't auscultable. What is the most probable diagnosis?
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