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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 36-year-old man went to the doctor with complaints of burning chest pain usually occurs 1-1.5 hours after eating. Notes that the pain intensifies in horizontal position. During EGDS 2 focal lesions of the lower were detected thirds of the mucous membrane of the esophagus up to 5 mm within one fold. What are the tactics of the doctor will be the most appropriate?
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A 38-year-old man complains of a periodic rash in the area of his beard and mustache, which accompanied by moderate pain. Ill for 2 years. Objectively established: y area of the beard and mustache on the background of redness and moderate infiltration is observed multiple grouped pustular elements, small erosions and purulent crusts. On what concomitant disease should the patient be examined first?
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A 20-year-old patient complains of delayed menstruation for ten days, violation notes menstrual function for the first time. Sex is regular. Objectively established: satisfactory condition, the abdomen is soft, painless. AT - 120/80 mm Hg. Art., pulse - 72/min. During Ultrasound suspected the presence of a progressive tubal pregnancy. What are the tactics of the doctor women's consultation?
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A 25-year-old man arrived 2 hours after a car accident from complaints of constant intense pain in the right groin and pelvic symphysis, inability to move independently. During the examination it was established: the position of the patient forced - outside the "frog" (a positive symptom of Volkovich). Abrasions and bruises on the skin projection of the symphysis and the horizontal branch of the pubic bone on the right, severe edema soft tissues. Positive symptom of "stuck heel" on the right. Put the previous one diagnosis:
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A 35-year-old woman complained of lower abdominal pain, which worsened over time menstruation and sexual intercourse and irradiate into the vagina, smearing bloody discharge before and after menstruation for 5 days. Infertility for 9 years. Anti-inflammatory treatment effect did not give. During the bimanual examination revealed: the uterus is enlarged, dense, painful, smooth. During hysteroscopy in the area of the bottom of the uterus you can see dark red formations, of which dark blood is released. Which diagnosis corresponds to this clinical picture?
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A 40-year-old worker has been working at a flax factory with 12 years of experience. Presents complaints of shortness of breath, cough, weakness. The general condition improves on weekends, but again gets worse when you go to work. Scattered dry rales from both are heard in the lungs parties. There is a slight leukocytosis in the blood. What is the most likely diagnosis?
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A 38-year-old woman developed dizziness and weakness after an argument. The anamnesis indicates: anorexia, weight loss, nausea, diarrhea. Hypotension - 60/30 mm Hg. Art. in the vertical position. Pulse - 110/min., Small, rhythmic. Blood glucose - 3.3 mm / liter. Hyponatremia. Hyperkalemia. Hyperpigmentation of the skin. Urinary excretion of 17-CS and 17-ACS is reduced. Which previous diagnosis?
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In a postoperative patient who underwent removal of the lower lobe 6 days ago left lung due to bacterial destruction and the development of pneumothorax, increased shortness of breath to 48/min., PaO2 decreased to 50 mm Hg. Art., PaCO2 increased to 65 mm Hg. Art., there was a cough, excretion of large amounts of sputum, general cyanosis of the skin, hypotension - 60/20 mm Hg. Art. During auscultation of the right and left lungs, a large number of different calibers are heard wheezing, sharply weakened breathing. What emergency care should be given to the patient to to eliminate respiratory failure?
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The man was hospitalized after a blunt chest injury. AT - 100/60 mm Hg. st., pulse- 98/min. The radiograph revealed: OGK without features. Echocardiography found: free fluid in the pericardial cavity in the amount of 100 ml. In an hour it is observed reduction of AT to 85/50 mm of mercury. Art., swelling of the jugular veins, pulse - 106/min., heart sounds sharply weakened. What are the first steps to take?
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A girl with a Fallot notebook, after psycho-emotional arousal arose asthma-cyanotic attack. In this condition, the mother and child turned to a pediatrician who held a reception at the children's clinic. Which emergency medication is needed enter first?
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A 36-year-old man complains of constant dull pain in the left hypochondrium after admission fatty and smoked foods, vomiting that does not bring relief. Fecal masses are shiny, with unpleasant odor. Ill for 8 years; abuses alcohol, smokes a lot. Objectively established: asthenic physique, pale and dry skin, tongue with white plaque, the abdomen is moderately bloated. During palpation - pain in the areas of Schoffar, Hubergritz-Skulski, points of Desjardins, Mayo-Robson. What disease can you think of first?
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A 50-year-old woman was hospitalized on the 5th day of illness with complaints of severe headache, body temperature 39°C, insomnia. Objectively established: condition heavy, slightly agitated, facial skin hyperemic, sclera injected. Positive Govorov-Godelier symptom. On the trunk and extremities abundant roseola-petechial rash; tachycardia, AT - 140/70 mm Hg. Art. For emergency chemoprophylaxis at the site of this infection appoint:
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In women, type 1 diabetes mellitus of moderate severity. Disease complicated by retinopathy and polyneuropathy. In addition, during repeated study of daily urine for albumin excretion revealed microalbuminuria (200-300 mg / day). The glomerular filtration rate is 105 ml/min. AT within normal limits. For secondary prevention of diabetic nephropathy should first seek to normalize this indicator:
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A 23-year-old girl went to the clinic with complaints of palpitations, sweating, weakness, decreased efficiency, trembling fingers. Within a month I lost 10 kg. During examination found: heart rate - 120/min., blood pressure - 130/70 mm Hg. Art. An ultrasound examination (US) of the thyroid gland revealed a 2 × 2 cm nodule. During the scan, an area of increased accumulation was detected at the site of the node radiopharmaceutical. The rest of the thyroid tissue RFP does not accumulate. Which is the most probable diagnosis?
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When studying the average level and nature of the diversity of some laboratories indicators, the following data were obtained: for total blood protein - root mean square deviation ± 4 g/l, coefficient of variation - 6%; for the sedimentation rate of erythrocytes, respectively ± 2 mm/year, 23%. Which of the traits being studied is the most diverse?
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A 62-year-old man complains of weakness, fever in the tongue, numbness of the lower extremities. Objectively established: pale skin with a subicteric tinge, bright red tongue, taste buds smoothed. Liver - +3 cm. Gastroscopy revealed mucosal atrophy shell. In the blood found: erythrocytes -1,2 × 1012/ l, Hb - 56 g/l, KP - 1,4, macrocytosis, leukocytes - 2,8 × 10 ^ g/l, eosinophils - 2%, rod - 4%, segmental - 50%, lymphocytes - 42%, monocytes -2%, reticulocytes - 0.1%, platelets - 120 × 10 ^ g/l, ESR - 36 mm/h, bilirubin - 29 mmol/l, indirect - 26 mmol/l. What is the most likely diagnosis?
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A 49-year-old patient complains of irregular menstruation for 18 months, intermenstrual bleeding and "tides", which are very disturbing to her; insists on immediate carrying out treatment. What procedure should be performed before prescribing therapy?
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A 30-year-old woman stopped menstruating and then began to experience visual acuity.Primary optic nerve atrophy, bitemporal hemianopsia was detected. During 2 For years, the patient was treated by ophthalmologists on an outpatient and inpatient basis, but her vision was progressively declining. Ophthalmologist consultation: visual acuity OD = 0,02, OS = 0,03, severe primary atrophy optic nerves. What auxiliary method of examination can help in staging diagnosis?
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During the examination of the student, the doctor found dryness and keratinization of the skin on the elbows and knees. On the skin of the buttocks, thighs and calf keratinization of the epithelium, if held by hand, there is a roughness of the skin of these areas, which resembled "goosebumps". Student also complained of impaired vision at dusk. Which of the following diseases is possible to assume?
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At the man on various sites of a skin cover, generally symmetrically, are located depigmented, non-peeling spots of different sizes and shapes. Part of the hair on them discolored. The disease began in childhood. The appearance of spots was not preceded by anyelements of rash. What is the probable diagnosis?
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A 28-year-old woman came to a gynecologist with complaints of infertility for the last 3 years. Her menstrual function is normal. She has a history of one artificial abortion and chronic salpingo oophoritis. She uses no contraception. The spermogram of her husband is normal. What method should be used first to determine the cause of this woman's infertility
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A 58-year-old man complains of weakness and tumor-like formations that appeared on the anterior surface of his neck and in the inguinal region. Palpation detects soft painless mobile cervical and inguinal lymph nodes up to 2 cm in diameter. The liver protrudes by 2 cm from the edge of the costal margin, the pole is at the umbilical level lower splenic In blood: erythrocytes 3.5 × 1012/L, Hb 88 g/L, leukocytes 86 × 10/L, ban neutrophils - 1%, segmented neutrophils- 10%, lymphocytes - 85%, eosinophilia 2%, basophil - 0%, monocytes 2%, erythrocyte sedimentation rate mm/hour, Gumprecht shadows. What is the most likely diagnosis?
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A 43-year-old woman complains of persistent stomachache with recurrent pain attacks, nausea, repeated vomiting with stagnant bowel content, abdominal distension, and flatulence. She has been presenting with these signs for 7 hours. Pulse is 116/min. The tongue is dry and brown. The abdomen is symmetrically distended, soft, painful. Percussion reveals tympanitis. On auscultation there are bowel sounds with metallic overtone, splashing, and dripping. Make the diagnosis?
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A 30-year-old man, a cable presser, complains of inertness, memory problems, and pain in his limbs. Objectively, he presents with skin pallor, anemia, reticulocytosis, basophilic stippling of erythrocytes, and high levels of porphyrin in urine. This man has the signs of the following disease:
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A 35-year-old man after an overexposure to cold developed complaints of frequent painful urination in small portions, elevated body temperature of 38.6°C that persists for 24 hours already, and chills. Digital rectal examination detects enlarged and painful prostate. Blood test shows leukocytosis of 14.2 × 10°/L, while urinalysis detects leukocyturia of 20-25 in the vision field. What is the most likely diagnosis in this case?
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A woman has undergone a surgery for diffuse toxic goiter, degree II. Twelve hours after the surgery, she developed complaints of hoarseness and voice loss, problems with breathing, dyspnea, and anxiety Her post-surgery wound is normal. What complication developed in this woman?
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A 28-year-old woman complains of weakness, dizziness, nosebleeds, and hemorrhages on her torso. The condition onset was 4 months ago. Objectively, her condition is of moderate severity. There are multicolored painless hemorrhages 1-2 cm in size on her back and abdomen. The peripheral lymph nodes are not enlarged. The liver is (-), the spleen is (+). Blood test shows the following: Hb - 120 g/L, erythrocytes - 3.4 × 10/L, color index 0.9, reticulocytes - 0.9%, serum iron - 15.01 mmol/l, leukocytes - 4.2 × 109/L, eosinophils - 2%, basophils - 0%, band neutrophils - 7%, segmented neutrophils - 40%, monocytes - 6%, lymphocytes 45%, platelets 47.1 × 10/L, ESR – 27 mm/hour. What is the most likely diagnosis in this case?
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On the 5th day after giving birth a postparturient woman complains of a pain in her left mammary gland and body temperature up to 38.1°C. Examination shows that her mammary gland is enlarged and painful on palpation, the nipple is edematous and has fissures, the upper external quadrant of the gland is hyperemic. Name the measures that would have prevented the development of this complication in the patient:
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A 38-year-old woman came to a dermatologist complaining of dry and peeling skin. Examination reveals a papullar rash and fine peeling on the exterior surfaces of her knee and elbow joints, in the area of hair follicles there are wax-colored nodules that rise from the skin. These clinical signs are likely caused by insuficient dietary intake of the following substance
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A 32-year-old man has a closed cerebrocranial trauma, a closed chest trauma, and a closed right femoral fracture. His blood pressure was 100/60 mm Hg, pulse 124/ rate min., respiration 28/ min. Two hours after the skeletal traction was performed under topical lidocaine anesthesia, the patient's condition suddenly became worse. His face and neck became cyanotic, blood pressure 60/40 mm Hg. heart rate 160/min.. respiration rate 44/min. What complication has likely developed in this case?
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A 51-year-old man after an overexposure to cold has developed acute pain in his lower abdomen and a burning pain that occurs at the end of urination. Urination occurs up to 15 times per 24 hours. The urine is turbid and contains blood. Clinical urinalysis shows leukocytes the whole vision field and isolated erythrocytes. What provisional diagnosis can be made?
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It is the 11th day after a woman has given birth and for the last 5 days she has been ill. She complains of chills. Her body temperature fluctuates between 35.8°C and 39.9°C. She cannot pump milk from her left breast. Objectively, her skin and mucosa are pale, her left mammary gland is significantly larger than the right one, the skin there is hyperemic, the upper and lower quadrants are dense, palpation detects a fluctuation and provokes sharp pain. The nipple is edematous and has a fissure with a purulent crust. The right mammary gland is normal. Make the provisional diagnosis:
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A 7-year-old boy after a fall from a height presents with rapid and shallow breathing and cyanotic face. The right half of his thorax is distended and takes no part in the respiration. Percussion detects tympanitis in the affected area, while auscultation detects no breathing there. What pathology is the most likely cause of this clinical presentation? What instrumental examination would be the most informative in this case?
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An industrial arca has high levels of noise pollution and the air of the working area is highly polluted with sulfur anhydride. What type of harmful effect can these factors have on the body in such conditions?
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A 73-year-old man has a 5-year-long history of benign prostatic hyperplasia. One morning he developed an acute urinary retention. Catheterization of his bladder is impossible. What urgent aid must be provided for this man?
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A 14-year-old boy complains of fatigability, face edema, headache, and urination in small portions. The urine resembles meat slops in color. The boy is registered for regular check-ups since the age of 8 because of chronic glomerulonephritis. His blood creatinine is 0.350 mmol/L, blood urea - 10.4 mmol/L. What complication is the most likely cause of this clinical presentation?
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A 45-year-old woman complains of general weakness, dyspnea, and dizziness within one year her hair became gray, her nails started peeling, and she developed gustatory disorders. For the last 5 years she has been registered for regular check-ups with a gynecologist for uterine fibromyoma. Her blood test shows the following: erythrocytes 3.0 × 1012/L, Hb -76 g/L, color index - 0.7, reticulocytes 0.7%, platelets - 160 × 10/L, leukocytes - 5.0 × 10/L, eosinophils - 2%, band neutrophils - 3%, segmented neutrophils 63%, lymphocytes - 28%, monocytes - 4%, aniso- and microcytosis, ESR - 30 mm/hour. What type of anemia can be suspected in this case?
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A 3-month-old child has been formu fed since the age of 2.5 months, because She complains of general weakness, the child's mother has no me. The mett notes that despite her taking care of her child, the baby developed pendent redness in the skin folds Three or d later, the duld developed king and hyperemic skin patches in the checks and chin. The patches are filled with ser exudate that forme yellowish sabe, when dried out Schorrheic sales are observed on the child's scalp. What is the most likely diagnosis in this case?
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When examining blood coagulation system of a man before a surgery, he was found to have a deficiency of factor VIII antihemophilic globulin A. What disease is it?
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A man, who was diagnosed with scabies and underwent a specific treatment, has made a follow-up appointment with a doctor. What measures must he take to prevent a recurrence of scabies?
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