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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 32-year-old woman developed a fever 6 hours after fibrophagogastroscopy up to 39°C, chest pain, dry mouth, shortness of breath. The examination revealed positive Romanov-Bitter symptom and subcutaneous emphysema in the supraclavicular space left. What is the previous diagnosis?
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A 11-year-old child with type 1 diabetes mellitus on the background of acute respiratory viral infection increased thirst, nausea and vomiting. In the exhaled air sharp the smell of acetone. His eyes lit up. Breathing is noisy, arrhythmic, like Kusmaul. Heart rate - 128/min., Deafness heart tones. Diagnosed with xoacidotic coma. Specify the leading pathogenetic mechanism of development of an emergency condition at the child:
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A 10-year-old patient was diagnosed with hemorrhagic vasculitis, skin form. One of The main treatment is long-term prednisolone therapy. For what purpose it is usedthis therapy?
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A 6-year-old boy complained of swelling of the face and lower extremities. Objectively found: in the lower lungs dullness, weakened breathing. Puffiness anterior abdominal wall. Ascites. AT - 90/50 mm Hg. Art. General analysis of urine revealed: protein - 4.2 g/l, leukocytes - 5-6 in p / z, erythrocytes -2-3 in p / z. Total blood protein - 48.6 g/l, cholesterol - 8.2 mmol/l. Preliminary diagnosis: acute glomerulonephritis. Specify clinical disease variant:
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The corpse of a 45-50-year-old man with skin was found in the dry sandy soil brownish-brown color, parchment density. During the examination of the corpse it was established: no traumatic injuries, body length 172 cm, reduced internal organs, dry, shapeless, separate membranous organs. In what state of corpse changes is the corpse?
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The doctor examines a premature newborn baby. Objectively observed single apnea lasting up to 5 seconds. What is the main functional feature respiratory system can explain the attacks of apnea in a premature baby?
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Mineral dust acts on passers-by during work in mine workings in the form of aerosols of disintegration. To determine the level of danger of professional occurrence dust diseases studied the chemical and physical properties of dust. Which of the properties of dust determines the overall depth of its penetration into the respiratory tract?
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A girl weighing 3100 g was born from the third pregnancy at home. On the 3rd day the mother noticed small hemorrhages in the umbilical cord, as well as "red spots" on the sclera eyes. The mother was not registered for pregnancy in the prenatal period. Nourishes baby breast milk as needed. During the physical examination is observed subconjunctival hemorrhage. During the laboratory examination it was established hemoglobin concentration - 155 g/l. Blood group in mother B (III) Rh-positive, in child - A (II)Rh-negative. What tactics to prevent the progression of this condition in a child will be most appropriate?
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A 38-year-old man fell ill 2 weeks ago, had a cough, weakness, increased temperature up to 38.0°C. The condition deteriorated sharply by the end of the 1st week, when there was a cold, heavy sweat, in the evening the temperature rose to 39.0°C. 2 days before hospitalization in the patient during coughing a large amount of foul-smelling sputum with blood, after which improved the patient's condition. Pulse - 80/min., Respiratory rate - 20/min., Body temperature - 37.6°C. What changes are possible on the chest radiograph?
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The mother complains of rashes and intense itching of the skin in an 11-year-old child fell ill in the 1st year of life. The skin is dry. Mainly on the bends of the knees and elbow joints, anterior surface of the neck, face visible foci of lichenization with a large the number of exorcisms, flat nodular rashes, normal skin color, peeling, hyperpigmentation. Make a probable diagnosis:
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A 22-year-old man developed severe pain in the lower back, which radiates to heel bones, the inner surface of the thighs, there is a rise in temperature to 38.2°C. For three weeks he felt immobility in the spine, pain in the ileosacral joints. X-ray revealed: expansion of the slit of the ileosacral junction, sclerosis spinal ligaments. What disease should you think about?
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A 19-year-old girl complains of severe lumbar pain, more on the right, increase in body temperature to 38.5°C, frequent urination, symptoms appeared 5 days therefore, after hypothermia (hiking in the mountains). Objectively established: pale skin, moisture. Pulse - 100/min., AT - 120/65 mm Hg. Art. The abdomen is soft, Pasternatsky's symptom is positive more right. ZAK found: erythrocytes - 3,5 × 1012/ l, Hb - 115 g/l, leukocytes - 10 × 10 ^ g/l, ESR - 22 mm/year. ZAS found: density - 1018 g/l, protein - 0,099 g/l, leukocytes - 35-45 in p / s, dominated by segmental, erythrocytes - 3-4 in p / s. a large amount of mucus, bacteria. Which previous diagnosis?
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At the bus stop, an elderly man grabbed his heart and then lost it consciousness. He took several deep breaths with an interval of 8-10 seconds, and then stopped breathe. The skin is pale, cold. The pulse in the carotid arteries is not determined. Pupils dilated, react to light. Diagnosed with sudden coronary death. Where to start cardiopulmonary resuscitation?
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For a clinically healthy 6-month-old infant who is breastfed it is necessary to appoint the first supplementary food. Which dish is most appropriate to use in this case?
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A man with hypertension gradually developed signs of heart disease insufficiency: shortness of breath, wet rales in the lungs, enlarged liver. What an instrumental the study has greater diagnostic value for establishing a variant of dysfunction myocardium?
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An 11-year-old girl (with a history of frequent sore throats) had a gradual development. There was irritability, inattention, hyperkinesis. The examination revealed violations coordination of movements, muscle hypotension, hypsroreflexia. Which diseases are characterized by the following changes in the central nervous system?
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A 40-year-old man has been suffering from chronic glomerulonephritis for 10 years. Complains of vomiting, muscle cramps in the lower extremities. AT - 180/120 mm Hg. Art., creatinine in serum - 770 μmol/l, glomerular filtration rate - 5 ml/min. For the last two days, diuresis decreased to 400 ml per day. What treatment tactics are indicated for this patient?
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An 18-year-old patient has been ill since early childhood. During the examination it was found: Hb - 110 g/l, erythrocytes - 3,9 × 1012/ l, KP - 0,8, leukocytes - b, 0 × 10 ^ g/l; ESR - 30 mm/year. Coagulogram showed: prothrombin index - 95%, blood clot retraction - 50%,blood clotting time - did not occur in 40 minutes, bleeding duration - 3 minutes. What mechanisms form the basis of the pathogenesis of this disease?
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A 25-year-old man is admitted to a psychiatric hospital for the first time. Excited, he says quickly and loudly, actively gesturing. He jokes non-stop, laughs, never leaves his face smile. Talks to the doctor on "you", offers him to play cards, caresses nurses, invites them on a date. He says that he has not slept for the last 2 days, but not at all does not feel tired. Which drug should be used?
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A boy of 18 years 2 weeks after the sore throat appeared swelling under the eyes, on the legs, blood pressure increased, the amount of urine decreased and its color changed. General urine analysis revealed: protein - 1.9 g/l, erythrocytes - cover the entire field of view, leukocytes - 10-12 in sight. Which disease is characterized by such symptoms?
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A 55-year-old woman complains of diarrhea, peeling and pigmentation of exposed areas of the body (neck, arms and feet), irritability and anxiety. From the anamnesis it is known that the main the food for her is corn. Salad vegetables and legumes woman rarely eats meat and does not eat fish at all. What disease is it?
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A 69-year-old man has seen progressive progress over the last few years urination disorders. During the last day he noted the absence of urination, constant stabbing pain over the womb. What diagnostic measures should be suggested in in this case?
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A 35-year-old man was hit by a car and hit his head on the asphalt. Objectively found: severe condition, unconscious, in a coma, shortness of breath, noisy, painful stimuli do not respond. In the forehead, a large wound of the soft tissues of the head, fragments are visible bone, cerebral detritus, there is bleeding. Define treatment tactics onprehospital stage:
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A 20-year-old boy underwent a course of polychemotherapy according to the VAMP scheme for acute lymphoblastic leukemia. What is the morphological picture of the bone marrow can indicate onset of remission?
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A 64-year-old man was admitted to the infectious diseases department. During the examination diagnosed with viral hepatitis A, from the anamnesis it is known that he suffers from diabetes Type 2, in connection with which he has received glibenclamide 20 mg per days. Fasting blood glucose - 15.6 mmol/liter. What should be the further treatment tactics?
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A 22-year-old woman with suspected systemic lupus erythematosus complains of "flying" pain in the joints of the arms and legs, fever up to 38.5-39°C for 3 weeks, shortness of breath,palpitations, weakness. Objectively established: erythema on the cheeks and nose. In the blood found: Hb - 90 g/l, platelets - 135 × 10 ^ g/l, ESR - 43 mm/h. In the urine found: protein - 2.66 g/l, erythrocytes - 8-10 in p/s. Detection of which antibodies in patients is most important for diagnosis?
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A 29-year-old woman applied to the Family Planning and Reproductive Health Center complaints of infertility during 6 years of married life. Monthly from 14 years to 3-4 days, the number of discharges is insignificant, irregular. Objectively established: hirsutism, galactorrhea. Basal temperature - single-phase. What is the most likely cause of female infertility?
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A pregnant woman within 34 weeks was taken to the maternity hospital due to bleeding from genital tract, which appeared during sleep. The pain does not bother. Bleeding about 300 ml. Which probable diagnosis?
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At the patient of 2 years with recurrent bronchopulmonary disease, malnutrition, diagnosed with cystic fibrosis. Which study should confirm the clinical diagnosis?
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During the examination of a newborn born in the buttocks, a pediatrician established a restriction on the passive abduction of the right thigh and clicking in its case abduction, asymmetry of the inguinal and femoral buttocks. Which sign is credible indicates the presence of congenital hip dislocation in a child?
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A 22-year-old man is lying in bed with his head held high, not feeling uncomfortable such a pose. He enters the conversation reluctantly, reacts to whispered language, the answers are one-word. Face indifferent, hypomimic, forehead wrinkled, lips elongated tube. It moves very little, often freezes for a long time in an awkward position. This condition developed gradually over time week for no apparent reason. Diagnose the mental state of the patient:
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A 1.5-year-old child ate walnut in the midst of an acute respiratory viral infection (ARI) nut. Suddenly coughed. The child is cyanotic. Periodic dry cough with wheezing on exhalation continues. The condition of the child is mild, respiratory failure. Shortening of percussion sound, hard breathing, dry and wet rales, bronchospasm on exhale over the right lung. What will be the next tactics?
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After repeated processing of the operating instrument weakly concentrated inflammation of the skin gradually appeared in the nurse's disinfectant solution palmar surface of the hands. Objectively established: the palmar surfaces are swollen, on them diffuse erythema without clear borders is defined, against which there are single papular rash. Skin allergy tests are negative. What is the previous diagnosis?
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A 37-year-old patient was diagnosed with a diffuse form after history taking and examination. mastopathy of both mammary glands. What is the most instrumental research method informative in this case?
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A man with chronic purulent otitis had a severe headache, vomiting, increased body temperature. There are meningeal symptoms. Focal neurological no symptoms. What are the priority measures for patient management?
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A 56-year-old overweight woman complains of pain in the knee joints, which intensifies when walking, especially on the stairs, during prolonged standing. It hurts 5 years. Objectively established: knee joints are deformed, swollen, while moving - painful. The radiograph of the joints showed: the joint space is narrowed, subchondral sclerosis, marginal osteophytes. Which diagnosis is most likely?
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The daughter called the family doctor to her 77-year-old mother. The patient has cancer disease in the terminal stage. She complains of constant pain and other debilitating symptoms. To which health care institution is it most expedient to hospitalize this woman?
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During the medical examination of the sick man, the doctor paid attention to precorneal injection of the vessels of the sclera of the eyes ("corolla violet-blue"), conjunctivitis, heilosis, angular stomatitis, hypertrophic glossitis. Which of the following diseases can be assumed?
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The citizen concluded a declaration with the family doctor of a private institution. For undergoing a regular medical examination, the doctor referred the patient for biochemical blood test. Who is the payer of medical services in this case?
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A 35-year-old man was admitted to the clinic with signs of surgical sepsis, the source of which, there was probably a large carbuncle of the scapular region. The examination revealed secondary purulent foci in the liver and right lung. Name the phase of surgical sepsis:
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