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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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The number of cases at the synthetic detergents plant has increased diseases of rhinitis, vasorinitis, pharyngitis, dermatitis. In the air of the work area detergent dust is present. Experts believe that clinical manifestations and growth morbidity is due to exposure to dust. What are the features of the action of dust are the basis pathogenesis?
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A 56-year-old man has been suffering from bronchiectasis for 18 years. For the last half a year the expressed hypostases of shins, the person are observed. In the proteinogramindicated: total protein - 52 g/l, albumin-globulin ratio - 0.7, α2-globulins - 14%, β-globulins - 17%, γ-globulins - 24 g/l. ESR - 52 mm/year. Daily proteinuria - 4.5 g ECG: sinus tachycardia. Which disease is most likely?
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A 18-year-old boy complains of cramping abdominal pain, loose stools up to 6 times a day with mucus and fresh blood. Ill for a year. Lose weight by 10 kg.Objectively established: the abdomen is soft, painful along the colon, especially on the left. Sigmoid colon spasmed. In the blood found: erythrocytes - 3,2 × 1012 / l, Hb - 92 g/l, leukocytes - 10.6 × 10 ^ g/l, ESR - 34 mm/year. Irigoscopy showed: the colon is narrowed, gaustras are absent, contours are indistinct, a symptom of a "water pipe". Which is the most probable diagnosis?
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The man was picked up on the street in an unconscious state and taken to a sanitary pass. He has recurrent attacks of tonic and clonic seizures of arms and legs with small intervals, involuntary urination. Pupils are wide, do not respond to light. On the tongue -traces of biting. Focal neurological symptoms were not detected. AT - 140/90 mm rt. Art. The patient's head can be freely brought to the chest. Determine the most probable pathology:
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A mother and a 6-year-old girl went to a dermatologist. The child is ill for 5 days. The child on against the background of the common cold appeared a large number of purulent rashes. Objectively set: on the skin face there are numerous flikteny filled with serous-purulent contents, on some formed golden-yellow crust. What is the probable diagnosis?
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A 45-year-old woman went to the hospital 12 days after the onset of the disease with complaints on pain and swelling of the first finger of the left hand. The examination revealed an increase body temperature up to 38.9°C. The nail phalanx and the finger are bulbous thickened, blue-purple color. Pus is visible under the nail plate and in places under the epidermis. He feels sharp pain on palpation. The Ro-gram of the finger shows destructive changes in the bone nail phalanx. What kind of panaritium in a patient?
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A 35-year-old man has been working in a foundry for 14 years, where he is concentrated quartz dust is 4 times higher than the MPC. For 4 years he has been bothered by cough and shortness of breath during exercise. Weakened breathing was detected during auscultation. OGK radiography revealed: emphysema, small-spotted shadows on all pulmonary fields. What is the most likely diagnosis?
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The woman in labor, 29 years old, vomited on the 3rd day after the caesarean section, severe pain in the lower abdomen, then all over the abdomen, delayed stool and gas. General condition heavy. The skin is pale, lips and tongue are dry. Body temperature - 39.4 °C. The abdomen is bloated, symptoms of peritoneal irritation are positive in all departments. Intestinal motility weakened. Diuresis is reduced. The uterus is large, painful on palpation, with unpleasant the smell of vaginal discharge. What pathology can you think of?
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A 42-year-old man was hospitalized with a diagnosis of bronchiectasis, aggravation. On X-rays, bronchiectasis is localized within individual segments one fate. What are the further treatment tactics?
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A 32-year-old pregnant woman was vaccinated against influenza with a non-living vaccine within 5-6 weeks together with the whole family. She did not know about the pregnancy at that time. Pregnancy is desirable. The patient consulted a family doctor for advice on what was possible the impact of the vaccine on the development and course of pregnancy, the occurrence of malformations in the fetus. Which advice should be given to a pregnant woman?
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A 50-year-old man complains of a rash on the skin of the torso without subjective sensations, sick for 3 months, not treated, the rash progresses. Objectively set: on the skin trunk disseminated rash in the form of red non-inflammatory lenticular and numular papules with clear borders, covered with silvery scales, which are easyare removed when scraping with a glass slide, more intensive scraping leads to spotting. What is the probable diagnosis?
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A 16-year-old girl came for a preventive medical examination. During the collection of anamnesis she reported that she became ill with chickenpox at the age of three. Other serious diseases in no history. Parents did not write about vaccination refusals, she was vaccinated in kindergarten and schools according to the National Calendar of Preventive Vaccinations. Physical examination without deviations. Which vaccines will be most appropriate now?
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A 47-year-old man complains of insomnia, heaviness throughout the body, constantly depressed mood. He considers himself insignificant, incapable. He thinks he is a burden to his family, prefers to die. Depressed, sedentary, hypomimic, sad face. Quiet language monotonous, the answers are short. Which diagnosis is most likely?
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During the pre-conscription commission, a 17-year-old boy was diagnosed with arterial disease hypertension - AT on the hands of 190/110 mm Hg. Art. No complaints. Draws attention to itself disproportionate body structure - well-developed shoulder girdle and underdeveloped lower limbs. Which research method is most likely the most informative for diagnosis?
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A 10-month-old child developed recurrent clonic seizures on the background of a mild course of SARS. Under At the time of the examination, clear manifestations of rickets of moderate severity were noted. The level of calcium in the blood is 1.6 mmol/l, the QT interval on the ECG is prolonged. Data on perinatal CNS damage no. Cerebrospinal fluid is intact, leaking under pressure. Artificial feeding, without vegetable dishes. What disease manifested against the background of SARS?
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A 60-year-old man complains of frequent painful difficulty urinating, intermittent urine stream. Urination up to 5 times at night. After exercise notesblood impurities in the urine. Rectally established: the prostate is enlarged, densely elastic, painless, without knots. It is observed in urine; specific weight - 1020, protein - 0,1 g/l, leukocytes - 20-30 in p / z, erythrocytes - 10-20 in p / z. Which method of examination is paramount?
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At the kid of 9 months the delay of development of teeth is observed and the term is prolonged overgrowth of the temples, weakness and sweating. What kind of hypovitaminosis can a baby have?
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A 45-year-old man has complaints of constant headache, pain in the heart, knee joints. Three years ago there was a tick bite with ring erythema on the skin. Objectively established: acrodermatitis, bilateral pyramidal insufficiency, coordination disorders. What a diagnosis most likely?
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A 39-year-old worker complained to a doctor about aching pain and numbness in the hands and forearms, decreased muscle strength of the hands, sleep disturbances, irritability and hearing loss. The data of the professional anamnesis testify that the worker within 12 years working as a driller, using a drill weighing 20 kg. Objectively established: the skin of the hands has a bluish tinge, there is swelling of the fingertips, abrasion skin pattern, slight deformation of the interphalangeal joints, decreased tactile, temperature and pain sensitivity. What is the most likely diagnosis?
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A 52-year-old woman went to the doctor with complaints of fatigue and shortness of breath during the last year with intermittent dry cough. The patient notes that the latter at times it became difficult for her to raise both hands and comb her hair. During the physical examination found: body temperature - 37.4°C, pulse - 76/min., blood pressure - 130/85 mm Hg st., SpO2 - 95%. During the neurological examination revealed: insignificant decrease in the strength of the deltoid muscle. During lung auscultation revealed: common dry rales. It is observed on the cheeks, around the eyes and on the elbowserythematous rash. Which method is most likely to confirm the diagnosis in this patient?
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The child was born from the 1st pregnancy, which occurred with preeclampsia of the 1st and 2nd half. Childbirth occurred by cesarean section. Score on the Hangar scale - 6 points. The weight of the child is 3000 Mr. Breasts sucked actively, did not vomit. In two weeks there was vomiting "fountain" from impurities of curdled milk, the volume exceeded what was eaten. The child became lethargic, ill gaining weight, decreased amount of urine and feces. What is the probable diagnosis?
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A 61-year-old man complained to the district doctor about the compression attacks sternum, which occur when walking up to 200 m and disappear if stopped. Considers myself sick for about a year. The boundaries of the heart are normal, the tones are moderately muted, ChCC = Ps = 76 / xv., AT - 130/80 mm Hg. Art. What is the most likely diagnosis in a patient?
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In a woman in labor weighing 70 kg 40 minutes after birth, a large fetus (4500 g) appeared significant bloody discharge from the genital tract. Bladder emptying was performed and external uterine massage; after which the uterus contracted, but for 5 minutes bleeding recovered. After the introduction of uterotopics, manual examination of the uterine cavity blood loss was 1200 ml. What should be the next tactic?
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A 22-year-old girl complains of irritability, tearfulness, headache, nausea, sometimes vomiting, palpitations, swelling of the mammary glands, swelling of the arms and legs, flatulence. Complaints appear 6-10 days before menstruation and disappear with the onset of menstruation. Bimanually installed: uterus and appendages without changes. What is the probable diagnosis?
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A 45-year-old man was hospitalized with complaints of pain that appeared suddenly in the left half chest and epigastric region, shortness of breath, shortness of breath, nausea, singlevomiting. Ill acutely, after lifting heavy weights. Objectively established: respiration superficial, CDR - 38/min. the left half of the chest lags behind during respiration. During percussion the tympanic sound is listened, breath is not listened. Pulse - 110/min. weak filling. AT - 100/60 mm Hg. Art. What pathology did the patient develop?
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A 45-year-old woman complained of general weakness fatigue, irritability, anxiety, memory loss, repeated diarrhea, peeling and pigmentation of exposed areas of the body (neck, hands and soles). Failure of which vitamin can be the cause of this condition of the patient?
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A 3-month-old child with subfebrile body temperature and rhinitis is observed pallor, cyanosis of the nasolabial triangle, pronounced expiratory dyspnea, swollen chest, dry cough, involvement of accessory muscles in respiration. Percussion established: above the lungs box sound, during auscultation on the background of elongated exhalation audible scattered dry and fine-bubble wet rales on both sides. In the blooddetected: Hb - 112 g/l, erythrocytes - 3.2 × 1012/ l, leukocytes - 15.4 × 10 ^ g/l, lymphocytes - 72%. What is the previous diagnosis?
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A 78-year-old woman suffering from hypertension had three episodes of sudden transient loss of vision in the left eye. During auscultation of the carotid arteries at the bifurcation points noise is heard on both sides. What additional study is most appropriate to appoint?
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A 45-year-old man complains of loss of appetite, dizziness, severe general weakness, low-grade fever. Pale skin, bruises on the torso and limbs. ZAK found: erythrocytes - 2,9 × 1012/ l, Hb - 96 g/l, KP - 0,99, reticulocytes - 0,02%, leukocytes - 2.9 × 10 ^ g/l, platelets - 85 × 10 ^ g/l, ESR - 45 mm/h. What additional research is there most appropriate for verification of the diagnosis?
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A 28-year-old woman complains of general weakness, headache, and elevation body temperature up to 37-38°C, slight sore throat. Sick on the 3rd day. Objectively found: pale skin, cyanotic lips. Oropharyngeal hyperemia with a cyanotic tinge, swollen tongue, palate, tonsils. On the surface of the tonsils - solid dense whitish with a pearly tinge plaques, which are removed with a spatula with great effort, after their removal the underlying mucous membrane bleeds. Enlarged submandibular lymph nodes. Swelling of the neck. Tachycardia. AT - 105/65 mm Hg. Art. Which is most likely diagnosis?
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A 10-year-old boy observed by a hematologist for hemophilia during exercise damaged the right knee joint. During the examination one hour after the injury the joint is significantly increased in size, the symptom of running on the patella is positive. Which should the initial treatment tactics be chosen?
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A 4-year-old girl became acutely ill after suffering from streptococcal 3 weeks agoskin infections. There was swelling of the face, lower extremities, headache, dark color urine (color "Coca-Cola"), AT - 125/60 mm Hg. Art. Urine analysis revealed: protein - 3.3 ‰, specific gravity - 1012, leukocytes - 1-3 in p / s, erythrocytes cover all p / s. Daily proteinuria - 980 mg. Diuresis - 550 ml. Total blood protein - 60 g/l. Albumins - 55%. Cholesterol - 4.5 mmol/l. Serum creatinine - 89 μmol / l. What is the most likely diagnosis?
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During the examination of a 64-year-old patient, the doctor diagnosed obesity (body mass index - 36 kg / m2, waist circumference - 118 cm), hypertension (170/105 mm Hg), disorders carbohydrate tolerance. The examination revealed an increase in cholesterol levels blood. What is the patient's diagnosis?
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A 28-year-old man with circular injuries was taken to the cremation ward burns of the torso and lower extremities. Determine the size of the burn surface of the victim:
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A 40-year-old patient was taken with complaints of cramping pains in the lower abdomen and excessive blood secretions from the genital tract. The last two years of menstruation last until 16 days, excessive, with clots, painful. During the bimanual examination it was established the presence of a fibrotic nodule. Choose the right tactics:
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A woman experienced difficulty opening her mouth 10 days after the foot injury. The next day I could hardly eat, there was tension in the muscles of the back of the head, spins, life. During admission to the hospital on day 3 of the disease set tonic tension of all muscle groups, generalized convulsions every 10-15 minutes. Which is the most probable diagnosis?
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A 26-year-old dentist during the examination revealed moderate hyperenzymemia, positive test for HBsAg. His wife of 24 years is not vaccinated against hepatitis B virus.A 2-year-old child is properly vaccinated according to the age schedule. What is the prevention of viral hepatitis B should be carried out in the family?
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A study was conducted to establish a link between obesity and heart attack myocardium in nurses. The frequency was recorded and compared for several years emergence of new cases of myocardial infarction in groups and changes in BMI. Specify the type epidemiological study:
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On a representative set of patients with influenza conducted a study of the relationship between body temperature and heart rate. The calculated correlation coefficient is equal to +0.5. Which characteristics of the strength and direction of the relationship between the studied features are the most accurate?
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An 18-year-old boy is being treated in the therapeutic department exacerbation of chronic bronchitis. From the age of 6 he suffers from epilepsy. Against the background of increase temperature to febrile figures developed status epilepticus in the form tonic-clonic seizures. What is your first tactic in this case?
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