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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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Student B. lives in the canalized house in the flat with complete set of sanitary equipment (WC, bath, shower, local water heater). How much water consumption has he got?
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The observed patient's movements are retarded, she answers no questions. Sometimes she spontaneously stiffens 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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Examination of a 9 month old girl revealed skin pallor, cyanosis during excitement. Percussion revealed transverse dilatation of cardiac borders. Auscultation revealed continuous systolic murmur on the left from the breastbone in the 3-4 intercostal space. This murmur is conducted above the whole cardiac region to the back. What congenital cardiac pathology can be suspected?
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A 25-year-old patient had pharyngitis 2 weeks ago. Now he complains about body temperature rise up to 38°C', general weakness, dyspnea during walking, swelling and shifting pain in the articulations. Objectively: cyanosis of lips, rhythmic pulse of poor volume -100 bpm. Left cardiac border deviates outwards from the mediaclavicular line by 1 cm. The first heart sound is weakened on the apex, auscultation revealed systolic souffle. What is the most probable aeti-ological factor that caused this pathological process?
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A 72-year-old male patient complains about itch in his left shin, especially around a trophic ulcer. Skin is reddened and edematic, there are some oozing lesions, single yellowish crusts. The focus of affection is well-defined. What is the most probable diagnosis?
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Administration of a plant producing red lead paint intends to form a group of medical specialists for periodical medical examinations. What specialist must be obligatory included into this group?
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A pediatrician talked to a mother of a 7 month old breast-fed boy and found out that the child was fed 7 times a day. How many times should the child of such age be fed?
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On the second day after preventive vaccination a 2-year-old boy got abdominal pain without clear localization, body temperature rose up to 38°C'. On the third day the child got red papular haemorrhagic eruption on the extensor surfaces of limbs and around the joints. Knee joints were edematic and slightly painful. Examination of other organs and systems revealed no pathological changes. What is the most probable diagnosis?
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What guarantees against the preconceived attitude to the physician in cases of professional law violations do you know?
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The man, aged 42, applied to the therapeutist with complaints of pricking pains in scapulas area, dyspnea on physical exertion, cough with discharge of small amount of sputum. During 10 years he works in coal mining. On percussion-box-note sound in the lower parts, on auscultation- a harsh breathing. There were no changes in the heart. Possible diagnosis?
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A 32-year-old patient complains about cardiac irregularities, dizziness, dyspnea at physical stress. He has never suffered from this before. Objectively: Ps- 74 bpm, rhythmic. AP-130/80 mm Hg. Auscultation revealed systolic murmur above aorta, the first heart sound was normal. ECG showed hypertrophy of the left ventricle, signs of repolarization disturbance in the I, V5 and V6 leads. Echocardiogram revealed that interventricular septum was 2 cm. What is the most probable diagnosis?
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A 50-year-old locksmith was diagnosed with typhoid fever. The patient lives in a separate apartment with all facilities. Apart of him there are also 2 adults in his family. What actions should be taken about persons communicating with the patient?
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A 29-year-old female patient complains about periodical right-sided headache that is usually provoked by strong smells or excitement. The patient's mother suffers from the same disease. Objectively: examination of internal organs revealed no pathology. During the attack there are general hyperesthesia and nausea, at the end of the attack polyuria is observed. Palpation of the right temporal artery during the attack revealed tension and painfulness of the artery. Complete blood count and urine analysis reveale dno pecularities. What is the most probable diagnosis?
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A 42-year-old man works in a boiler room. He complains about girdle headache and recurring vomiting. There was also short-term consciousness loss. Objectively: increase of tendon reflexes, spontaneous myofibrillations. AP is 150/80 mm Hg, Ps- 104 bpm. Visible mucous membranes and cutaneous surfaces have crimson colouring. What is the most probable diagnosis?
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In order to study impact of microclimate upon the human organism it is necessary to make systematic observation of air temperature over 3 days. Choose a device that will allow to make the most precise temperature records:
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On the 6th day of life a child got multiple vesicles filled with seropurulent fluid in the region of occiput, neck and buttocks. General condition of the child is normal. What disease should be suspected?
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A 63-year-old patient was diagnosed with purulent mediastinitis. What of the below listed diseases are NOT the cause of purulent mediastinitis?
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A man, aged 37, working on the collective farm on sowing, was admitted to the infectious hospital with the clinical symptoms: miosis, labored breathing, sweating. What kind of poisoning is it and what is the first aid?
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An 8-year-old boy suffering from hemophilia was undergoing transfusion of packed red cells. Suddenly he got pain behind the breastbone and in the lumbar area, dyspnea, cold sweat. Objectively: pale skin, heart rate - 100/min, AP- 60/40 Hg; oliguria, brown urine. For treatment of this complication the following drug should be administered:
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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 biochemical index has the greatest diagnostic importance in this case?
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A 52-year-old woman complains about face distortion. It turned up 2 days ago after supercooling. Objectively: body temperature is 38,2°C. Face asymmetry is present. Frontal folds are flattened. Left eye is wider than right one and doesn't close. Left nasolabial fold is flattened, mouth corner is lowered. Examination revealed no other pathology. Blood count: leukocytes - 10 × 109/l, ESR - 20 mm/h. What is the most probable diagnosis?
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The amount of ultraviolet radiation dose was measured in minutes. What device was applied for measurement of the biodose?
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A prematurely born girl is now 8 months old. She has dyspnea, tachycardia, hepatosplenomegaly, physical developmental lag, limb cyanosis. There is also parasternal cardiac hump, auscultation revealed systolodiastolic murmur in the II intercostal space on the left. AP is 90/0 mm Hg. What disease should be suspected?
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A 4 month old child was admitted to a surgical department 8 hours after the first attack of anxiety. The attacks happen every 10 minutes and last for 2-3 minutes, there was also one-time vomi- ting. Objectively: the child's condition is grave. Abdomen is soft, palpation reveals a tumour-like formation in the right iliac area. After rectal examination the doctor's finger was stained with blood. What is the most probable diagnosis?
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A 36-year-old patient was diagnosed with right-sided pneumothorax. What method of treatment is indicated to the patient?
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The 25-year-old patient was admitted on the 1st day of the disease with complaints of double vision in the eyes, difficult respiration. The day before the patient ate home-made mushrooms. On objective examination: paleness, widened pupils, disorder of swallowing, bradycardia, constipation are marked. What is the diagnosis?
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A maternity hospital registered 616 live births, 1 stillbirth, 1 death on the 5th day of life over a 1 year period. What index allows the most precise estimation of this situation?
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A 43-year-old patient was admitted to the infectious diseases hospital with high body temperature and intense headache. The iIlness has lasted for 2 days. Examination revealed a carbuncle on his forearm. The area around it was apparently edematic and slightly painful. Regional lymphadenitis and hepatoli-enal syndrome were also present. It is known from the anamnesis that the patient works at a cattle-breeding farm. What disease should be suspected in the first place?
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A 10-year-old boy suffers from chronic viral hepatitis type B with maximal activity. What laboratory test can give the most precise characteristic of cytolysis degree?
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A 63-year-old patient complained about pain in the lumbar area. He underwent a course of physiological treatment on account of radiculitis but this led to no improvement of his condition. R-graphy of spinal column and pelvic bones revealed osteoporosis and serious bone defects. Blood analysis revealed moderate normochromic anaemia, urine analysis revealed proteinuria. Whole blood protein made up 10,7 g/l. What disease should be suspected?
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A 72-year-old patient complains about pain and bleeding during defecation. Digital rectal investigation revealed a tumour of anal canal. After verification of the diagnosis the patient was diagnosed with squamous cell carcinoma. The secondary (metastatic) tumour will be most probably found in:
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Estimation of physical development of a child involved dynamometry and estimation of body weight and length, annual gain in body length, chest circumference, number of permanent teeth, secondary sexual characters, lung vital capacity. Which of the mentioned indices relates to the physiometric ones?
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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 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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After objective clinical examination a 12-year-old child was diagnosed with mitral valve prolapse. What complementary instrumental method of examination should be applied for the diagnosis confirmation?
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Study of morbidity with temporary disability among workers of a machine building plant revealed that average duration of a case was 20 days. What diseases influenced upon the index value?
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Examination of a 12-year-old chi- ld revealed diffuse thyroid enlargement of the II-degree. Heart auscultation revealed dullness of heart sounds, heart rate was 64/min. The child has frequent constipations, anemia. Concentration of thyreoglobulin antibodies is increased. What disease might have caused such symptoms?
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A sergeant was injured by a shell splinter in the left subcostal area. He was bandaged with a first-aid pack on a battlefield. The patient was delivered to the regiment medical aid station. He complains about dizziness, weakness, thirst, abdominal pain. General condition is grave, the patient is pale. Ps is 120 bpm. Abdomen is soft, painful on palpation. The bandage is well fixed but a little bit soaked with blood. The patient should be evacuated to the medical battalion with the following transport and in the following turn:
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A 52-year-old patient complains about headache, weakness of his upper left extremity. Neurological symptoms become more intense during physical stress of the left extremity. Pulsation on the arteries of the left extremity is sharply dampened but it remains unchanged on the carotid arteries. What is the most probable diagnosis?
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During preventive examination a 16-year-old patient presented no problems. Objectively: the patient has signs of malnutrition, he is asthenic, AP is 110/70 mm Hg, Ps is 80 bpm, cardiac border is normal, auscultation above the cardiac apex reveals three sounds, cardiac murmur is absent. ECG shows no pathological changes, phonocardiogram shows that the third sound comes 0,15 s after the second one above the apex. How are these changes called?
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