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KROK 2 Medicine 2010 Questions | KROKEXAM
Browse 2010 KROK 2 Medicine exam questions with answers and explanations.
Exam questions
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A neonate is 5 days old. What vaccination dose of BCG vaccine (in mg) is necessary for vaccination of this child?
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Ten hours before initial observation patient had frequent feces and vomiting. Fecal and vomiting masses looked like rice-water. Nausea and abdominal pain weren't observed. Hiccup and convulsions of lower limbs, temperature 35,4°C, hoarse voice, greyish wry face, acrocyanosis were observed. Respiratory rate 40/min, threadlike pulse 120/min, blood pressure 40/0 mm/Hg, abdomen is drawn. What treatment measures should be taken first of all?
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A 68-year-old female patient complains about temperature rise up to 38,3°C, haematuria. ESR - 55 mm/h. Antibacterial therapy turned out to be ineffective. What diagnosis might be suspected?
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A 16-year-old boy was admitted to the hospital for the reason of intractable nasal hemorrhage and intolerable pain in the right cubital articulation. Objectively: the affected articulation is enlarged and exhibits defiguration and skin hyperaemia. There are manifestations of arthropathy in the other articulations. Ps- 90 bpm; colour index - 1,0, WBC - 5,6 × 109/l, thrombocytes- 220 × 109/l, ESR - 6 mm/h. Lee-White coagulation time: start - 24', finish - 2710" What drug will be the most effective for this patient treatment?
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A 19-year-old patient complains about skin rash that appeared 2 days ago after eating smoked fish. The rash disappears after 4-6 hours but then turns up again. It is accompanied by itch. Objectively: trunk and upper limbs are covered with multiple pink blisters as big as a pea or a bean. What is the most likely diagnosis?
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A heat station working on solid fuel is located in a residential district. On cloudy foggy days in december there was an increase in diseases with upper airway affection and signs of general intoxication. There were also mortal cases among the elderly people. What is the most likely factor that provoked toxic effect?
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A 58-year-old patient complains about sensation of numbness, sudden paleness of II-IV fingers, muscle rigidness, intermittent pulse. The patient presents also with polyarthralgia, dysphagia, constipations. The patient's face is masklike, solid edema of hands is present. The heart is enlarged; auscultation revealed dry rales in lungs. In blood: ESR - 20 mm/h, crude protein - 85/l, y-globulines - 25%. What is the most likely diagnosis?
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Estimation of community health level involved analysis of a report on diseases registered among the population of district under charge (reporting form 12). What index is calculated on the grounds of this report?
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Patient, male, 16 years old was behind other children in development since early childhood and still has moderate mental retardation. He is short, has dismorphic body, his face is round, flattened, his eyes are narrow and slanted, and there are epi-cantial folds in the corners of his eyes. There is only one transversal flexor line on his palms. What is the probable etiology of this state?
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A nurse of the kindergarten was taken to the hospital with complaints of accute pain in parumbilical region, convulsions of lower limbs, multiple bile vomiting, frequent watery foul feces of green colour in huge amounts. At the same time all the staff in the kindergarden got ill. Two days ago all of them ate cottage cheese with sour cream. General condition of patients is of moderate severity. Temperature 38,2°C. Heart tones: rhythmic and muted. Heart rate 95/min, arterial pressure: 160 mm/Hg. Abdomen is slightly swollen, painful. Liver 2 cm. What is the most likely diagnosis?
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Bacterial analysis of air in a living space in winter period by means of Krotov's apparatus revealed that total number of microorganisms in 1m3 of air was 7200. What is the allowed number of microorganisms for the air to be characterized as "pure"?
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A 42-year-old woman complains about bruises on her both legs and prolonged menstruation; general weakness, tinnitus cerebri. Objectively: multiple macular hemorrhages on the legs and body. The patient presents with tachypnoe, tachycardia, systolic murmur in all auscultatory points. AP- 75/50 mm Hg. Blood count: RBC - 1,9 × 1012/l, Hb- 60 g/l, colour index - 0,9, WBC - 6,5 × 109/l, thrombocytes - 20 × 109/l, ESR - 12 mm/h. Duke bleeding time - 12 minutes. Bone marrow analysis revealed plenty of juvenile immature forms of megacaryocytes without signs of thrombocyte pinch-off. What is the most likely diagnosis?
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A 68-year-old patient consulted a doctor about a tumour in her left breast. Objectively: in the upper internal quadrant of the left breast there is a neoplasm up to 2,5 cm in diameter, dense, uneven, painless on palpation. Regional lymph nodes are not enlarged. What is the most likely diagnosis?
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A 32-year-old female patient consulted a doctor about a skin affection of her body, face and extremities which turned up after peroral intake of biseptol. The patient was diagnosed with drug toxi-coderma. What treatment methods would be the most effective for this patient?
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A 36-year-old female patient complains of general weakness, edemata of her face and hands, rapid fatiguability during walking, difficult deglutition, cardiac irregularities. These symptoms turned up 11 days after a holiday at the seaside. Objectively: face erythema, edema of shin muscles. Heart sounds are muffled, AP is 100/70 mm Hg. In blood: ASAT activity is 0,95 millimole/h-l, ALAT - 1,3 millimole/h-l, aldolase - 9,2 IU/l, creatine phosphokinase - 2,5 millimole P/g-l. What method of study would be the most specific?
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A 49-year-old patient undergoes regular medical check-up for uterine fi-bromyoma. Within the last year the uterus has enlarged up to 20 weeks of gestation. What is the rational way of treatment?
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A patient who works as a nightman was diagnosed with of chronic arseni-ous intoxication. What form of anemia is characteristic for this disease?
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A 45-year-old woman, mother of four children, comes to the emergency room complaining of a sudden onset of the epigastric and right upper quadrant pain, radiating to the back, accompanied by vomiting. On examination, tenderness is elicited in the right upper quadrant, bowel sounds are decreased, and laboratory data shows leukocytosis, normal serum levels of amylase, lipase, and bilirubin. The most likely diagnosis is:
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A patient who has been consuming refined foodstuffs for a long time complains about headache, fatiguability, depression, insomnia, irritability. Objectively: muscle asthenia, pain and cramps in the gastrocnemius muscles, during walking the patient lands onto his heel first, then on the external edge of foot. Cardiovascular system exhibits tachycardia, hypoxia, dystrophic changes of myocardium. There are also gastrointestinal disorders. What is the most likely diagnosis?
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A 43-year-old man who often contacts with ethyl gasoline was admitted to a hospital with complaints of general weakness, dizziness, memory impairment, sleepiness at daytime and insomnia at night, sense of hair in the mouth, colicky pains in the right subcostal region. What is the most likely diagnosis?
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A 40-year-old female patient has been observing profuse menses 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 likely diagnosis?
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A 42-year-old woman has had hyperpolymenorrhea and progressing algodismenorrhea for the last 10 years. Gynecological examination revealed no changes of uterine cervix; discharges are moderate, of chocolate colour, uterus is slightly enlarged and painful, appendages are not palpable, the fornices are deep and painless. What is the most likely diagnosis?
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A 33-year-old patient has acute blood loss: erythrocytes - 2,2 x 1012/l, Hb- 55 g/l, blood group is A(II)Rh+. Accidentally the patient got a transfusion of donor erythrocyte mass of AB(IV)Rh+ group. An hour later the patient became anxious, got abdominal and lumbar pain. Ps- 134 bpm, AP - 100/65 mm Hg, body temperature - 38,6°C. After catheterization of urinary bladder 12 ml/h of dark-brown urine were obtained. What complication is it?
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A patient is being prepared for the operation on account of varix dilatation of lower extremities veins. Examination of the patient's soles revealed flour-like desquamation along the skin folds. All the toenails are greyish-yellow, thickened and partially decayed. What dermatosis should be suspected?
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A patient, aged 52, works as a street cleaner. He has been suffering from pneumoconiosis for 2 years. What treatment should be recommended?
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A 50-year-old man comes to the emergency room with a history of vomiting of 3 days' duration. His past history examination reveals that for about 20 years he has been suffering from epigasric pain lasting for 2 to 3 weeks, during early spring and autumn. He remembers getting relief from pain by taking milk and antacids. Physical examination showed a fullness in the epigastric area with visible peristalsis, absence of tenderness, and normal active bowel sounds. The most likely diagnosis is:
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A 9-year-old boy has been suffering from bronchoectasis since he was 3. Exacerbations occur quite often, 3-4 times a year. Conservative therapy results in short periods of remission. The disease is progressing, the child has physical retardation. The child's skin is pale, acrocyanotic, he has "watch glass"nail deformation. Bronchography revealed saccular bronchiectases of the lower lobe of his right lung. What is the further treatment tactics?
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A 30-year-old woman taken by influenza has empty stomach glycemia at the rate of 11,3 millimole/l, glucosuria at the rate of 25 g/l. The patient is 168 cm tall and weighs 67 kg. What test would be the most informative for the diagnosis specification?
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A 65-year-old patient complains about pain in the lumbar spine, moderate disuria. He has been suffering from these presentations for about half a year. Prostate volume is 45 cm3 (there are hypoechogenic nodes in both lobes, capsule invasion). Prostate-specific antigen is 60 ng/l. Prostate biopsy revealed an adenocarcinoma. Which of the supplemental examination methods will allow to determine the stage of neoplastic process in this patient?
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On the tenth day after discharge from the maternity house a 2-year-old patient consulted a doctor about body temperature rise up to 39°C, pain in the right breast. Objectively: the mammary gland is enlarged, there is a hyperemized area in the upper external quadrant, in the same place there is an ill-defined induration, lactostasis, fluctuation is absent. Lymph nodes of the right axillary region are enlarged and painful. What is the most likely diagnosis?
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A 45-year-old man has been exhibiting high activity for the last 2 weeks, he became talkative, euphoric, had little sleep, claimed being able "to save the humanity"and solve the problem of cancer and AIDS, gave money the starangers. What is the most likely diagnosis?
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A 46-year-old patient was issued a 10-day sick list because of exacerbation of chronic cholecystitis. The patient's general condition got better, but the clinical manifestations of the disease are still present. What authority is entitled to extend the sick list?
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A 28-year-old patient was hospitalized with preliminary diagnosis "influenza". Roseolous-petechial rash appeared on the 5th day of disease on the trunk. The temperature is 41°C. Hyperemia of face, reddening of scleras, tremor of tongue, tachycardia, splenomegaly are present. What is the most likely diagnosis?
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A 24-year-old law student is brought to the emergency room complaining of severe abdominal pain of 6-8 hours duration. He had been to a party the night before. The pain is in the epigastrium radiating to the back and is accompanied by nausea. The patient had vomited twice prior to coming to the emergency room. Clinical examination revealed that the young man was anxious, with acute condition, with a regular pulse rate of 100/min, blood pressure of 100/68 mm Hg, and body temperature of 38,1°C. The most likely diagnosis is:
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A 46-year-old patient once took part in elimination of breakdown at an atomic power plant. Currently he is being treated at an in-patient hospital. He was diagnosed with progressing vegetative insufficiency. This disease relates to the following group of ionizing radiation effects:
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A 52-year-old male patient has an 18 year history of diabetes mellitus. One year ago he had cystitis. The patient takes 0,005 g of maninil thrice a day. Objectively: height - 176 cm, weight - 82 kg. Glycemia variability on an empy stomach is at the rate of 10,3-12,4 millimole/l. Analyses revealed proteinuria at the rate of 0,033 g/l. The most efficient way to prevent diabetic nephropathy progress will be:
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A 44-year-old man has been working in coke industry for 16 years. Dust concentration at his workplace is 5-10 times higher than maximum permissible concentration. Roentgenography of lungs revealed changes that are typical for pneumoconiosis. What is the most probable type of pneumoconiosis in this case?
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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 67-year-old female patient suffering from the essential hypertension suddenly at night developed headache, dyspnea that quickly progressed to asphyxia. Objectively: the patient is pale, with sweaty forehead, AP- 210/140 mm Hg, heart rate - 120/min, auscultation revealed solitary dry rales and moist rales in the lower parts. The shins are pastose. What kind of emergency aid would be the most efficient in this case?
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A 43-year-old female patient was delivered to the hospital in grave condition. She suffers from Addison's disease. The patient had been regularly taking prednisolone but a week before she stopped taking this drug. Objectively: sopor, skin and visible mucous membranes are pigmented, skin and muscle turgor is decreased. Heart sounds are muffled, rapid. AP- 60/40 mm Hg, heart rate - 96/min. In blood: Na -120 mi-llimole/l, K - 5,8 millimole/l. Development of this complication is primarily caused by the deficit of the following hormone:
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