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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 22-year-old woman complains ofitching and profuse discharge from her genital tracts. The condition developed 10 days ago after a sexual contact. Bacterioscopy of a discharge sample detected trichomonads. What drug should be prescribed for treatment in this case?
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A parturient woman has been in labor for 8 hours. The labor activity is weak, contractions last for 25 seconds and occur twice per 10 minutes. Vaginal examination shows cervical opening of 4 cm, the baby is in the cephalic presentation. During examination the woman's waters broke. The waters contained meconium. Fetal heart rate is 90/min., dull. What tactics of labor management must be chosen in this case?
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In the factory cafeteria there was an outbreak of food poisoning Clinical presentation indicates staphylococcal etiology of this disease, 15 people are sick. To confirm the diagnosis of food poisoning. samples need to be sent to the laboratory. What samples should be obtained to find out the etiological factor of this food poisoning?
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On examination a man presents with the following signs: progressing weakness, loss of working ability, rapid physical and mental fatigability, sensations of cold and hunger, and weight loss. What type of alimentary disorder is it?
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A 62-year-old man complains of a moderate pain in his left foot in the area of his metatarsophalangeal joint. The pain intensifies on movement. The disease onset was 12 years ago, when he first had an (acute pain attack). Two years ago, a yellow white nodule appeared under the skin that covers the joint. Examination shows that the joint is deformed and cyanotic. X-ray of the affected joint shows narrowing of the joint space and well-defined bone tissue defects in the epiphysis (punched out erosions). What is the most likely diagnosis in this case?
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A 37-year-old man complains of a pain in his lumbar and thoracic spine and limited spinal mobility for the last 5 years. After examination he was diagnosed with central ankylosing spondylitis. This man is likley to be a carrier of the following HLA antigen:
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A 57-year-old man complains of cough with profuse mucopurulent sputum (up to 150 mL per 24 hours). Objectively, he has drumstick fingers with watch-glass nails. Percussion produces a shortened sound over the lungs. Auscultation detects moderate and large bubbling crackles. Complete blood count shows leukocytosis and a left shift in the leukogram. Chest X-ray shows intensified pulmonary pattern and ring-like shadows. Bronchography detects multiple cylindrical thickenings of the bronchi with clear margins. Make the provisional diagnosis: empyema
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40% of the workers who polish the art glass, using an abrasive disk, and have a long record of employment, are diagnosed with ulnar neuntis, 21% - with vegetative polyneuritis, and 12% - with vegetomyofascitis of the upper limbs These pathologies are associated with the following harmful factor
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A regional cardiologist is given a task to develop a plan for preventive measures aimed at decreasing cardiovascular mortality rates. What measures should be planned for secondary prevention?
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A 59-year-old man for a month has been presenting with short-term periodical loss of strength in his limbs on the left. Later he developed a persistent morning weakness in the affected limbs after wakening. Objectively, he is conscious and has central paresis of the VII and XII pairs of his cranial nerves on the left. Central hemiparesis and hemihypersthesia are observed on the left side. What are the drugs of choice for treatment of this man?
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A 30-year-old man complains of itching and a rash on the skin of his feet. The disease onset was 3 years ago. Objectively, on the soles of his feet there are clusters of vesicles that resemble boiled sago beans, as well as erosions with flaps of macerated epidermis on the periphery of the foci. Interdigital folds on both feet have fissures crosions. What is the most likely pathology in this case?
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A 1-year-old child with a case of URTI suddenly developed noisy respirations with difficult inspiration, intercostal retractions, and barking cough on the 2nd night after the disease onset. What is the most likely diagnosis?
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In a city, the levels of manganese are elevated in the at what air, water, and type of these factors have on the health of the population?
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When her car collided with a tree, a 37-year-old woman felt a sharp pain in her left hip joint. She was unable to get out of the car. Her position is forced, the hip is pressed to the abdomen, fixed, and rotated inwards; the limb is flexed in the knee, any attempt to change the position results in sharp pain. Make the diagnosis:
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An 18-year-old young man during hospitalization complains of general weakness, body temperature of 37.5°C, loss of appetite, nausea, heaviness in the right subcostal region, and discolored stool and urine. The disease onset was 5 days ago. Objectively, his skin and sclerae are slightly icteric. The liver protrudes by 3 cm and is tender to palpation. Patient's urine is dark brown, while his stool is light-colored. He usually drinks water from a tap. What is the most likely diagnosis in this case?
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A 32-year-old man has been hospitalized with fever episodes that are accompanied by excessive sweating and occur every 48 hours. Twelve years ago he was in military service in Tajikistan, where he had a case of malaria. Objectively, he sclerae are subicteric, his skin is pale, th liver is dense and enlarged by 2 cm, the spleen is enlarged by 5 cm. What test is necessary to clarify and confirm the diagnosis in this case?
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An 8-year-old girl with complaints of painful urination, frequent low-volume urination, and leukocyturia was diagnosed with acute cystitis. 10 days before the disease onset she was treated by the gynecologist for acute vulvitis. 5 days ago she presented with mild catarrhal symptoms. Her mother ascribes the child's disease to her overexposure to cold. Specify the most likely infection route:
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A 35-year-old man was hospitalized with signs of surgical sepsis that has likely been caused by a large carbuncle in his scapular region. Examination detected secondary purulent foci in the liver and right lung. What stage of surgical sepsis is it ?
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In the computer lab of the research sector at a polytechnic institute, the workstations of laboratory technicians are located close in front of the screens. Throughout their whole working day, the technicians are exposed to the electromagnetic waves of ultra high frequencies. Exposure to intense electromagnetic waves of such frequency is especially dangerous for the
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A 43-year-old man, a coal-face worker with a 15-year-long record of work, complains of cough, thoracic pain, and dyspnea. The cough is mild, usually dry, occurs mostly in the morning. The pain is localized in the interscapular region and aggravates during a deep intake of breath. Dyspnea occurs during physical exertion. Vesicular respiration in the lungs is weakened. Heart sounds are rhythmic, heart rate is 86/min., blood pressure is 135/80 mm Hg. The abdomen is soft and painless. X-ray shows micronodular pulmonary fibrosis. Make the provisional diagnosis:
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A newborn boy, born at 38 weeks of gestation with weight of 2200 g. presents with a ventricular septal defect, cataracts in both eyes, and sensorineural deafness At the term of 12 weeks, the mother of the boy had a case of an influenza-like disease accompanied by a rash. In this case, the newborn will most likely be diagnosed with:
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A 10-year-old girl was hospitalized with signs of carditis. According to her medical history, two weeks ago she had an exacerbation of chronic tonsillitis. What etiological factor is the most likely in this case?
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A 39-year-old man suffers from chronic rheumatic heart disease. He complains of dyspnea during physical exertion, cough with expectoration, and palpitations. Ausculation detects intensified I heart sound and diastolic murmur; the sound of opening mitral valve can be auscultated at the cardiac apex. The II heart sound is accentuated over the pulmonary artery. The patient is cyanotic. X-ray shows dilated pulmonary root and enlargement of the right ventricle and left atrium. What is the most likely diagnosis?
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A 50-year-old man complains of general weakness, dizziness, periodical episodes of unconsciousness, and an intense pain in the small of his back and right subcostal region. These signs appeared after an accident at a paint factory, where he works. His skin is earth gray and his sclerac are icteric. He has acrocyanosis, His blood pressure is 100/60 mm Hg. His heart sounds are muffled. His liver is-3 cm and has a dense edge. Blood test shows the following erythrocytes - 2.0 × 10/L. Hb - 90 g/L. Heinz-Ehrlich bodies, leukocytes 5.6 × 10/L, ESR 15 mm/hour, methemoglobin - 62%, total bilirubin-84.0 mcmol indirect bilirubin 71.7 mcmol/L. What is the most likely diagnosis in this case?
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A 38-year-old man has been drinking alcohol excessively for the last 3 years. Three days after a drinking bout, he developed anxiety and fear. He started to see spiders and worms around him, hear accusatory voices, and behave aggressively. He is oriented in himself but disoriented in time and space. What is the most likely diagnosis in this case?
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During medical examination a cadet in the naval college was detected to have a painless dense ulcer 1.5x0.5 in size in his perianal area at the 2 o'clock position. The ulcer floor resembles «old fat». What is the provisional diagnosis?
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The body of a 35-year-old man was found in a forest, hanging from a no tied to a tree branch. Face and neck is of the diseased are gyanotic, while the leg are normally colored. The ligature mark is closed and dearly defined. What are the cause and manner of death in this case?
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A 45-year-old man, provisionally diagnosed with a transient ischemic attack, was brought by an ambulance from an aniline-producing factory. Objectively, his skin and mucosa are cyanotic. His speech is dysarthric. The man is disoriented in space. His blood test shows the following: erythrocytes 4.6 × 1012/L, Hb 143 g/L, color index 0.9, leukocytes - 5.6 × 10°/L, Heinz bodies 14%, reticulocytes 18%, methemoglobin 36%, ESR 5 mm/hour. The patient was diagnosed with a moderately severe acute aniline intoxication. What antidote agent will be the most effective in this case?
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A 3-year-old boy was hospitalized in a severe condition. Objectively, he has somnolence, hyperreflexia, convulsions, hyperesthesia, and intractable vomiting. His body temperature is 39.9°C, heart rate - 160/min., blood pressure - 80/40 mm. What test must be conducted first in this case?
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A 26-year-old man complains of chills, rhinitis, dry cough, and fever up to 38°C. Examination shows him to be in a moderately severe condition, there are small pale pink non-coalescing spots on the skin of his back, abdomen, and extremities Palpation reveals enlarged occipital and axillary lymph nodes. No information about vaccination history could be obtained. What is the likely etiology of this disease?
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A 12-year-old girl for two weeks presents with periodical body temperature elevations to 39°C, spindle-shaped swelling of the interphalangeal joints, pain in the upper chest and neck, and morning stiffness. What is the most likely diagnosis?
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A 23-year-old woman, para 2, full term, is in labor. Her waters were clear and broke three hours ago. The labor activity is regular. The contractions last 25-30 seconds, with intervals of 4-5 minutes. The baby is in the longitudinal lie, cephalic presentation. The head is pressed to the entrance into the lesser pelvis, Fetal heart rate is 136/min. Internal examination shows that the cervix is smoothed out, the opening of the external orifice of uterus is 3 cm, no amniotic sac, the lower pole of the fetal head is at the level of terminalis. What stage of labor is it?
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To fight against the tobacco smoking, Ukraine has ratified the World Health Organization Framework Convention on Tobacco Control and prohibited public smoking. What type of prevention is it?
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A 16-year-old teenager has been bitten by a dog. The bites are located in the area of face and fingertips. The dog is a stray and cannot be observed. Primary surgical treatment of the wound was performed without removal of the wound edges. What tactics should be chosen by a doctor for rabies prevention?
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A 40-year-old man was brought into a hospital with a closed chest trauma. Examination shows that the right side of his chest lags behind during breathing. Palpation detects a sharp pain in the projection of ribs V, VI, and VII on the anterior axillary line and subcutaneous emphysema on the right side of the torso. Percussion reveals tympanitis over the right-sided segments of the chest. Auscultation detects no breathing on the right and vesicular breathing on the left. What surgical procedure is necessary for this patient?
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A man diagnosed with closed-angle glaucoma, grade IIa, of the right eye is registered for regular medical check-ups. In the evening an acute glaucoma attack occurred in his right eye; an ambulance was called. What emergency aid would be optimal in this case?
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A one-month-old child regurgitates every time after being put to bed after a breastfeeding. Pediatrician's examination revealed no pathology in the child's condition. The doctor explained the regurgitations as a result of digestive system built, characteristic for this age, and gave advise, how to take care of the child this case. What advise is it?
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External obstetric examination shows the the mother's belly is ovoid; the fetal back can be palpated in the left lateral portion of the uterus, in the right portion there are fetal small parts, and at the uterine fundus there is a firm balloting part. Fetal heartbeat can be heard on the left, above the navel. What are the lie, position, and presentation of the fetus?
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The condition of a full-term newborn deteriorated on the first day of life. The haty was born from the third pregnancy during the second half of which gestosis was observed. The mother's blood group is Rh- Examination shows that the baby is inert and has icteric skin and mucos baby's urine and stool are of normal color Blood serum bilirubin i 248 mmol/L because of indirect bilirubin levels. What is the most likely cause of this pathologic condition?
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One year ago a 46-year-old woman underwent a partial thyroidectomy duc so multinodular goiler Now she complains of general weakness, drowsiness, constant fatigue, low working ability, constipations edema of her face and limbs. Objectively her body temperature is 36°C. Her skin is dry and wrinkled. She started losing her hair and developed amenorrhea. What condition is it?
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