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KROK 2 Medicine 2010 Questions | KROKEXAM
Browse 2010 KROK 2 Medicine exam questions with answers and explanations.
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The diagnostics of the AIDS epidemic initially was made in the USA by means of:
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In which of the following disorders does the pathophysiology of portal hypertension involve presinusoidal intrahepatic obstruction?
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A child is 4 years old, has been ill for 5 days. There are complaints of cough, skin rash, to- 38,2°C, face puffiness, photophobia, conjunctivitis. Objectively: there is bright, maculo-papulous, in some areas confluent rash on the face, neck, upper chest. The pharynx is hyperemic. There are seropurulent discharges from the nose. Auscultation revealed dry rales in lungs. What is the most likely diagnosis?
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A 34-year-old female patient complains about weakness, 12 kg weight loss within 6 months, sweating, palpitation, irritability. Objectively: III grade thyroid gland is elastic, diffuse enlargement is present, there is also a node in the right lobe. Cervical lymph nodes are not enlarged. What treatment tactics would be the most rational?
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Study of morbidity rate in a city N revealed that population of different administrative districts differed in age structure. What statistic method allows to eliminate influence of this factor upon morbidity indices?
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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 patient suffering from gastroesophageal reflux has taken from time to time a certain drug that "reduces acidity"over 5 years. This drug was recommended by a pharmaceutist. The following side effects are observed: osteoporosis, muscle asthenia, indisposition. What drug has such following effects?
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Forensic medical expertise of corpse of a newborn revealed: body weight 3500 g, body length 50 cm, the umbilical cord was smooth, moist, glossy, without any signs of drying. Hydrostatic tests were positive. The test results are the evidence of:
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A 20-year-old woman has a 3-4 month history of bloody diarrhoea; stool examination proved negative for ova and parasites; stool cultures negative for clostridium, campylobacter and yersinia; normal small bowel series; edema, hyperemia and ulceration of the rectum and sigmoid colon seen on sigmoidoscopic examination. Select the most likely diagnosis:
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A 25-year-old man was admitted to a hospital with a 2 month history of cough and fever. A chest X-ray showed extensive left upper lobe disease with a 2 cm cavity. All three points were strongly positive on direct smear and grew M. Tuberculosis, fully sensitive to all first-line drugs. Patient must be treated with:
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A female patient has been suffering from pain in the right subcostal area, bitter taste in the mouth, periodical bile vomiting for a month. The patient put off 12 kg. Body temperature in the evening is 37,6°C. Sonography revealed that bile bladder was 5,5x2,7 cm large, its wall -0,4 cm, choledochus - 0,8 cm in diameter. Anterior liver segment contains a roundish hypoechoic formation up to 5 cm in diameter and another two up to 1,5 cm each, walls of these formations are up to 0,3 cm thick. What is the most likely diagnosis?
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On the next day after being taken by influenza a 46-year-old woman presented with intensified headache, dizziness, nausea. Objectively: the patient is conscious, psychomotor excitement is present; there is general hyperesthesia, moderate meningeal syndrome, nystagmus. Tendon teflexes are higher on the right, right extremities display muscle weakness, right-sided pathological Babinski's sign is present. Liquor is transparent, pressure is 220 mm of water column; cytosis is 46/3 with prevailing lymphocytes. What is the most likely diagnosis?
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A driver had been fixing a car in a closed garage and afterwards complained about headache, dizziness, nausea, muscle asthenia, sleepiness. Objectively: pulse and respiratory rate elevation, excitement, hypertension, delirium of persecution. What is the most likely 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 26-year-old patient complains about considerable muscle weakness, dizziness, extended abdominal pain, nausea and vomiting giving no relief. The disease has been gradually developing within 6 months. There was progress of general weakness, skin darkening. The patient fell into grave condition after an ARD: there appeared abdominal pain and frequent vomiting. Objectively: the skin is dry with diffuse pigmentation. Heart sounds are significantly weakened, heart rate - 60/min, AP- 80/40 mm Hg. The abdomen is slightly painful in the epigastrial region. In blood: WBCs - 8,1 × 109/l, glucose - 3,0 millimole/l. What is the most likely diagnosis?
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A maternity house has admitted a primagravida complaining of irregular, intense labour pains that have been lasting for 36 hours. The woman is tired, failed to fall asleep at night. The fetus is in longitudinal lie, with cephalic presentation. The fetus heartbeat is clear and rhythmic, 145/min. Vaginal examination revealed that the uterine cervix was up to 3 cm long, dense, with retroflexion; the external orifice was closed; the discharges were of mucous nature. What is the most likely diagnosis?
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A 36-year-old alcoholic patient has cirrhosis and pancreatic insufficiency due to recurrent pancreatitis. He complains of night blindness, decreased ability to taste food, and dry skin with hyperpigmentation. These complaints suggest deficiency of:
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A 5-year-old boy was progressively getting worse compared to the previous 2 months. A chest X-ray has shown right middle lobe collapse. A tuberculin skin test was strongly positive. What is the most characteristic finding in primary tuberculosis?
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A 46-year-old patient is to be prepared to the operation on account of stomach cancer. Preoperative preparation involves infusion therapy. It was injected up to 3,0 l of solutions into his right lunar vein. On the next day he got tensive pain in the region of his right shoulder. Examination of interior brachial surface revealed a stripe of hyperemia, skin edema and a painful cord. What complication is it?
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After examination a 46-year-old patient was diagnosed with left breast cancer T2N2M0, cl. gr. II-a. What will be the treatment plan for this patient?
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A worker who undergoes regular medical check-up for duodenal ulcer received a subsidized 24-day sanatorium voucher from his plant. The term of annual leave of a worker is 24 calender days, it will take 4 days more to get to the sanatorium and back home. What is the procedure of obtaining a 4-day sick-leave?
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A 26-year-old woman complains of having bloody discharges from the genitals for the last 14 days, abdominal pain, general fatiguability, weakness, weight loss, body temperature rise, chest pain, obstructed respiration. 5 weeks ago she underwent induced abortion in the 6-7 week of gestation. Objectively: the patient is pale and inert. Bimanual examination revealed that the uterus was enlarges up to 8-9 weeks of gestation. In blood: Hb- 72 g/l. Urine test for chorionic gonadotropin gave the positive result. What is the most likely diagnosis?
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A puerpera is 25 years old, it is her second day of postpartum period. It was her first labour, it took place at full term. The lochia should be:
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A 52-year-old patient works as a secretary and has 30 year record of service. She complains of spasms in her right hand during working and inability to type and write. Up to 80% of her work involves hand load. The patient has been presenting with these symptoms for 2 years. Objectively: the right hand is tense, there is an increase in muscle tone, attempts to write cause spasms. Examination revealed no pathological changes of CNS. What is the most likely diagnosis?
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A 60-year-old woman, mother of 6 children, developed a sudden onset of upper abdominal pain radiating to the back, accompanied by nausea, vomiting, fever and chills. Subsequently, she noticed yellow discoloration of her sclera and skin. On physical examination the patient was found to be febrile with temp. of 38,9°C, along with right upper quadrant tenderness. The most likely diagnosis is:
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A 50-year-old man was examined in the clinic for persistent cavitation and sputum. He was treated with rifampi-cin, isoniazid, ethambuthol. The most common toxic effect of ethambutol is:
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A children's health camp received a party of tinned food. External examination of the tins revealed that they had deep dents; formed a concavity when pressed and didn't immediately return to the initial state; rust was absent; the tins were greased with inedible fat. Specify the bloat type:
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A 34-year-old male patient was delivered to the neurological department with complaints of intense headache, double vision, light and noise intolerance. The attack came suddenly while load lifting. Objectively: torpor, moderate divergent strabismus, diplonia. Bilateral Kernig's symptoms. No paresises. Bloody liquor. What medication should be administered in the first line?
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The total area of a ward at the therapeutical department is 28 m2. What is the maximum number of beds that can be exploited in this ward?
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A 1,5-year-old child was taken by an acute disease: body temperature up to 39°C, frequent vomiting up to 5 times. Nervous system tests revealed positive Kernig's and Brudzinski's signs. The given symptoms relate to:
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A 32-year-old patient consulted a doctor about being inable to get pregnant for 5-6 years. 5 ago the primi pregnancy ended in artificial abortion. After the vaginal examination and USI the patient was diagnosed with endometrioid cyst of the right ovary. What is the optimal treatment method?
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During examination at a military commissariat a 15-year-old teenager was found to have interval sysolic murmur on the cardiac apex, diastolic shock above the pulmonary artery, tachycardia. Which of the suuplemental examination methods will be the most informative for the diagnosis specification?
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A 30-year-old patient with complaints of occipital headache, disturbed sleep with nightmares came to a policlinic. BP was 150/95 mm Hg. He was diagnosed with hypertensic crisis. The patient should be registered in the following dispensary group for arterial hypertension surveillance:
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A 3-year-old child has been admi- tted to a hospital because of ostealgia and body temperature rise up to 39°C. Objectively: the patient is in grave condition, unable to stand for ostealgia, there is apparent intoxication, lymph nodesare enlarged up to 1,5 cm. Liver can be palpated 3 cm below the costal margin, spleen - 2 cm below the costal margin. In blood: RBCs - 3,0- 1012/l, Hb- 87 g/l, colour index - 0,9, thrombocytes - 190 - 109/l, WBCs - 3,2 - 109/l, eosinophils - 1, stab neutrophils - 1, segmented neutrophils -0, lymphocytes - 87, monocytes - 2, ESR - 36 mm/h. What examination should be conducted in order to specify the diagnosis?
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In autumn a 25-year-old patient developed stomach ache that arose 1,5-2 hours after having meals and at night. He complains about pyrosis and constipation. The pain is getting worse after consuming spicy, salty and sour food, it can be relieved by means of soda and hot-water bag. The patient has been suffering from this disease for a year. Objectively: furred moist tongue. Abdomen palpation reveals epigastrial pain on the right, resistance of abdominal muscles in the same region. What is the most likely diagnosis?
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A patient suffering from acute posttraumatic pain received an injection of morphine that brought him a significant relief. Which of the following mechanisms of action provided antishock effect of morphine in this patient?
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2 days ago a patient presented with acute pain in the left half of chest, gneral weakness, fever and headache. Objectively: between the 4 and 5 rib on the left the skin is erythematous, there are multiple groups of vesicles 2-4 mm in diameter filled with transparent liquid. What diease are these symptoms typical for?
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A pediatrician had a conversation with 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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A 20-year-old man complains about pain arising in the lower third of femoral bone under stress and at rest. He denies having a trauma. Objectively: the skin is of normal colour, deep palpation reveals pastosity and pain, knee joint motions are limited. X-ray picture of the meta-epyphisis of distal femur shows a destruction zone and spicules. In blood: immature cell forms, no signs of inflammation. What is the most likely diagnosis?
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A 67-year-old female patient complains about edemata of face and legs, pain in the lumbar area that is getting worse at moving; great weakness, sometimes nasal hemorrhages, rise of body temperature up to 38,4°C. Objectively: painfulness of vertebral column and ribs on palpation. Laboratorial study revealed daily proteinuria of 4,2 g, ESR - 52 mm/h. What changes of laboratory indices are to be expected?
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