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KROK 2 Medicine 2021 Questions | KROKEXAM
Browse 2021 KROK 2 Medicine exam questions with answers and explanations.
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A 30-year-old man has receives second-degree burns that cover 40% of his body. On the fourth day after the injury, his general condition acutely deteriorated. He developed inspiratory dyspnea, freque cough with frothy sputum, and cyane skin. Auscultation detects numerous crackles in the lungs. His blood press is 110/60 mm Hg, heart rate - 100/m respiration rate 32/ min., central ves pressure 100 mm H₂O, total prote 50 g/L, Ht 30%, Hb - 90 g/L. Shows sinus tachycardia. What mechanism of pulmonary edema pathogenesis is the main one in this case?
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A 28-year-old man after lifting weight felt an intense lumbar pain that irradiated to the right leg. He made an appointment with a doctor, After examination, the doctor diagnosed him with acute discogenic lumbosacral radiculitis. What additional examination is necessary to confirm this diagnosis?
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A man complains of a heaviness behind his sternum, periodical sensation of food the barium contrast reveals a single pouch like protrusion in the right anterior wall of the esophagus. The protrusion has clear margins and a clearly defined neck. What is the most likely diagnosis in this case?
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Analysis of the population morbidity in a village, located near a chemical factory, shows that within the last several years the number of gout and esophageal cancer cases has significantly increased. What pollutant of the environment is the likely cause of such dynamics?
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A 56-year-old woman was diagnosed with stage 2 hypertension of the 2nd degree. She belongs to the group of moderate risk and has bronchial asthma. What group of drugs is contraindicated to this patient?
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A 47-year-old man has been ill for 3 days already. Palpation detects a painful inflamed infiltration in his right subcostal region. His body temperature is 38.9°C. Sonography allowed diagnosing him with calculous destructive cholecystitis. Clinical and laboratory data are not indicative of choledocholithiasis. What tactics should be chosen for the treatment of this man?
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A 55-year-old woman complains of pain and popping sounds in her left knee joint, which occur when she climbs the stairs. Occasionally, during movements her joint becomes «stuck». 5 years ago she received a trauma of the left knee. Complete blood count and biochemical blood analysis show normal results. X-ray shows marked osteosclerosis and osteophytes. The joint space is narrowed. Make the provisional diagnosis:
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A 7-year-old child complains of stomachache episodes that occur after mental stress, cold drinks, or ice cream. After clinical and instrumental examination the boy was diagnosed with hypertensive biliary dyskinesia. What medicines should be prescribed first for the treatment in this case?
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A 32-year-old woman presents with obesity (mostly her shoulders and torso are affected), hirsutism, and menstrual irregularities. She has purple-cyanotic striae and stretch marks on her shoulders, chest, abdomen, and thighs. What is the cause of striae development in this case?
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A 3-year-old child, while playing. suddenly developed cough attacks and problems with breathing. Objectively, the child has a dry cough and mixed type dyspnea. Auscultation detects a small amount of dry crackles in the lungs. Respiration is weakened on the right. The child does not attend kindergarden and has all necessary immunizations for that age. What pathology can be suspected?
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A man, who one day ago returned from a trip to Africa, presents with a sharply painful cluster of lymph nodes in his armpit. The skin over the lymph node cluster is hyperemic. Bubonic plague is suspected. What must the contact persons use for urgent prevention of this discase?
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You witness a car accident, When examination the place of the accident you noticed a man of about 30 years, who was hit by the car. He is unconscious. On the neck on the left there is a profuse hemorrhage with bright-red blood. How to stop this hemorrhage?
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A 21-year-old woman came to a surgeon 5 hours after she had scalded her left forearm with boiling water. Objectively, a skin patch 17x10 cm in size had flaccid vesicles; epidermis there was torn and displaced in some areas. The wound bottom was whitish-gray, dry, and its pain sensitivity was reduced. After a treatment with bandages soaked with a solution of furacilin (nitrofural), levosin, and hiposol, on the 29th day after the burn, the necrotic scab came off, leaving a pink superficial scar in its place. What was the degree of the burn in this case?
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A man suddenly developed a sharp pain in the right side of his chest. Dyspnea has rapidly progressed. Objectively, the patient has marked acrocyanosis and is in a severe condition. Subcutaneous emphysema is observed in the area of the patient's neck and upper chest. Over the right lung a bandbox resonance can be heard, respiration is absent there. The heart borders are displaced to the left. The patient's heart rate is 110/min., blood pressure -100/60 mm Hg. What is the most likely disease in this case?
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A 48-year-old woman was arrived to the surgical unit with wounds in her thigh. On examination the wound surface has dirty-gray coating with unpleasam sweet smell. Wound content resembles raspberry jelly Skin tissues around the wound are glossy and turgid. Palpation reveals moderate crepitation in the tissues. What microflora is the most likely to cause such inflammation?
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When helping a man with a bleeding the emergency physician has pricked hi own finger. The patient is an injecting dru user, who underwent a test for HIV, bu the results of the test are unknown. What measures must the doctor take in this case
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A 2-year-old boy against the background of lacunar tonsillitis developed problematic breathing through the nose and mouth. Mesopharyngoscopy shows hyperemic palatine tonsils and posterior pharyngeal wall, yellow films in the openings of the tonsillar crypts, and a protrusion on the posterior wall of the oropharynx that fluctuates during palpation. What complication must be avoided during the surgical treatment of this condition?
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Employees work in conditions of high dust concentration. Certain chemical (silicon dioxide content) and physical properties of dust acrosols contribute to the development of occupational dust induced diseases. What is the main physical property of dust aerosols?
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A 46-year-old woman has diarrhea with abdominal distension, loss of body mass, and large amounts of porridge-like foul smelling stool without blood streaks or tenesmus. Objective examination detects moderate tenderness in the mesogastrium and left abdominal flank. Stool analysis detects steatorrhea with neutral fat and creatorrhea. What prescription would be the most advisable in this case?
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An 18-year-old girl complains of sneezing attacks that occur mostly in the morning 15-20 times in a row, an itch in her nose and throat, profuse watery discharge from her nose, rhinitis, and pain in her eyes. What test will be the most informative for diagnosis-making in this case?
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A 56-year-old woman has been working as a disinfector for 19 years. She complains of general weakness, nausea, bitter taste in her mouth, heavy sensation in her right subcostal area, and rapid fatigability. Objectively, her body temperature is 37.1°C, the sclerae are icteric, and the liver is enlarged. Total bilirubin is 40 mcmol/L. What is the likely diagnosis?
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A 45-year-old man complains of painless nodules that appeared on the skin of his limbs and on the small of his back. The nodules have a tendency to grow peripherally and merge together. The disease onset was 2 years ago, family history states that his father had a similar skin condition. Objectively, the pathologic elements manifest as drop shaped and coin-shaped nodules and plaques, covered in white scales. Make the provisional diagnosis:
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A patient was brought into the pulmonology department with complaints of inspiratory dyspnea and dry cough at the highest point of inhalation. On examination the following is observed: pale skin, cyanotic lips, «Hippocratic» fingers. Auscultation detects Velcro-type crackles (like opening a Velcro fastener). X-ray shows a «ground glass opacity pattern. What is the most likely diagnosis
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A 62-year-old woman has an acute onset of the disease: high temperature of 39.8°C, chills, intense headache, and aching body. She complains of nausea and one episode of vomiting. 18 hours later, her right inguinal lymph nodes became enlarged and sharply painful. After another 6 hours, she developed edema of the right shin and skin hyperemia with irregular-shaped clear margins. What is the most likely diagnosis in this case?
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A 17-year-old young man demands a plastic surgery. He thinks that it's impossible to live with such an ugly nose as his. He claims that wherever he is, everyone is laughing at him and mocking him behind his back. He walks with a cap pulled low over his face, turns his face downwards, and pulls up his scarf up to his eyes. Objectively, there are no indications for rhinoplasty the young man has a nearly classical shape of the nose. What psychopathological condition is it?
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A 36-year-old woman complains of a headache, paresthesia, muscle weakness, spasms, thirst, and polyuria. Objectively, herre is 36.6°C, respiration 92/ pressure 180/110 mm Hg. Her ECG shows ST depression. Her potassium levels in blood plasma are low, sodium levels are high, plasma renin activity is significantly decreased, aldosterone concentration is high. 24-hour urine specific gravity does not exceed 1.008-1,011, alkaline reaction is observed. Spironolactone test is positive. CT scan shows enlarged right adrenal gland. What is the most likely diagnosis in this case?
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A 13-year-old girl was brought into the gynecological department with complaints of profuse bloody discharge from her genital tracts for the last 10 days. Menarche was at the age of 11, the menstrual cycle is irregular. Rectoabdominal examination detects no pathology. Make the provisional diagnosis:
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A woman with blood group B(III) Rh(+) gave birth to a full-term healthy boy Examination on the 3rd day of the infant's life shows him to have icteric tint to his skin. The child has no problems with suckling, sleep is nondisturbed. The abdomen is soft, the liver protrudes by 2 cm from under the costal margin. Complete blood count: hemoglobin 200 g/L, erythrocytes 5.5 × 1012/L, total bilirubin 62 mcmol/L, indirect bilirubin 52 mcmol/L. What condition can be suspected?
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A 19-year-old young man after a treatment for bilateral pneumonia developed thirst, high appetite, weight loss, and dry mouth. The signs continue to intensify. Examiantion shows fasting glycemia of 19.7 mmol/L, glucosuria of 2.8 g/L, and signs of acetonuria. What treatment should he be prescribed?
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A man complains of a headache, problematic breathing through the nose, and purulent discharge from the nose that are observed for the last 3 months. Four months ago he underwent a treatment of his upper right premolar. X-ray shows a shadow over the right maxillary sinus. Its diagnostic puncture yielded a large amount of thick foul-smelling granulated pus. What is the most likely diagnosis in this case?
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A 9-year-old boy is in a severe condition. His body temperature is 38 of pain in his bones. Objectively, the boy presents with acute pallor, hemorrhagic rash, and ulcerative necrotizing stomatitis. All the enlarged. The liver is +5 cm. The spleen is +4 cm. What test will be decisive for diagnosis-making in this case?
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A 38-year-old man has been for many years suffering from epilepsy. Three days ago he had an episode of clouded consciousness that started suddenly and was accompained by anger. In this state he was speaking nonsense, breaking furniture, and hit his wife. He remained in this state for about an hour, after which he fell asleep. Later he was claiming that he didn't remember any of the events that had happened during the episode. What is the most likley definition of this condition?
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Two weeks after an antibacterial therapy for a febrile illness, a 25-year-old woman developed severe watery diarrhea, colicky abdominal pain, and elevated body temperature. Proctosigmoscopy detects focal mucosal lesions with a pale yellow coating. What is the most likely diagnosis in this case?
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Daily diet of a 10-year-old girl contains the following: vitamin B1 - 1.2 mg, vitamin B2 - 0,6 mg, vitamin Ba- 1.4 mg, vitamin PP - 15 mg, vitamin C - 65 mg. Assessment of the girl's nutrition status reveals that she has cheilosis, glossitis, angular cheilitis, and conjunctivitis. The girl is likely to have:
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A 38-year-old woman complains of a tensive pain in her lower abdomen and the small of her back that is observed within the last month and intensifies on the day before menstruation Premenstrual dark bloody discharge was observed She has a history of four medical abortions and one birth Ultrasound shows isolated foci of increased echogenicity in the myometrium, increased anteroposterior size of the uterus, and round hypoechogenic inclusions 2 mun in diameter: What is the most likely diagnosis in this case?
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During analysis of morhidity in the city it was determined that age structure of population is different in each district. What statistical method allows to exclude this factor, so that it would not skew the morbidity data?
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A 35-year-old woman, a polisher, complains of chills, cold bluish fingertips, low mobility of her hand joints, and a contracted sensation in the skin of her face and hands. Examination detects amimia. pouch-like pursing of the mouth, thickened skin of checks and hands, pale and cold fingertips. A bandbox resonance and isolated fine inspiratory crackles can be heard over the lungs. Blood test shows the following: erythrocytes - 3.8 × 1012/L, leukocytes - 4.8 × 109/L, ESR-45 mm/hour. CRP++. What is the most likely diagnosis in this case?
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A 73-year-old man against the background of acute transmural anterior myocardial infarction has developed a decrease in systolic pressure (70 mm and an increase in blood creatinine (480 memol/L). Proteinuria observed in the urine (0.066 g per 24 hours). What is the cause of decreased diuresis?
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A 74-year-old woman came to a doctor complaining of a pain in her right inguinal region. The signs appeared suddenly, approximately 2 hours ago. The woman notes that she already had these signs 3 weeks ago, but back then they disappeared on their own after she lay down. Objectively, palpatio detects below the Poupart's ligament a sharply painful, dense, and tense formation 3.5 cm in diameter. The Dejerine sign (aggravation on coughing) is negative. What is the most likely diagnosis in this case?
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When investigating a case of mass poisoning, it was determined that the car mechanics, who tested diesel engines in a repair bay with a broken exhaust ventilation, at the end of their working day developed the following signs: headache, nausea, vomiting, tinnitus, labile pulse. Objectively, their skin and mucosa are cherry-red. What toxic factor has caused mass poisoning of the car mechanics?
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