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KROK 2 Medicine 2023 Questions | KROKEXAM
Browse 2023 KROK 2 Medicine exam questions with answers and explanations.
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A food poisoning occurred in a canteen, affecting 15 people. The clinical presentation of the poisoning indicates its staphylococcal etiology. What biological materials, obtained from the patients, must be sent for laboratory testing to confirm food poisoning?
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A 14-year-old girl has short stature, broad shoulders, webbed neck, and no signs of puberty. Her intelligence is normal. Ultrasound of the lesser pelvis shows hypoplasia of the uterus and the absence of ovaries. Karyotype of the child is 45, XO. What pathological syndrome can be suspected in this case?
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A man suddenly developed a sharp retrosternal pain that radiated into the left arm. Objectively, the patient was excited, his skin was pale, the respiration rate was 38 / min., the blood pressure was 180/110 mm Hg. Later he lost his consciousness, fell down, the pulse on the major vessels could not be detected, the pupils were evenly dilated. What is the diagnosis in this case?
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A woman complains of frequent and copious foamy stools without pathological admixtures, cramp-like pain in her periumbilical region, rumbling in the stomach, and fever. From her history, it is known that she was eating soft-boiled duck eggs. What is the most likely causative agent of her condition?
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After giving birth, a 25-year-old woman developed increased weakness in her legs and unsteady walking. She has been suffering from this condition for 6 years already. Every autumn, she notes a deterioration of her condition. Objectively, the woman is euphoric and exhibits a reduced critical attitude towards her condition. She has horizontal nystagmus, high tendon reflexes, foot clonus, pathological foot reflexes, no abdominal reflexes, ataxia during the Romberg test, and intentional tremor and missing during coordination tests. Temporal pallor of the optic discs is observed on the eye fundus. What is the most likely diagnosis in this case?
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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 chest takes no part in the act of breathing. Percussion detects tympanitis in this region, 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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A 48-year-old woman complains that within the last 8-9 months she had very heavy periods that impair her ability to work. For 2 years, her health has been monitored by a gynecologist for uterine fibroids. Objectively, her cervix is cylindrical, clean, the cervical opening is closed; the body of the uterus is enlarged up to 9-10 weeks of pregnancy, firm, mobile, and painless; the appendages on both sides cannot be determined; the parametria are free; the fornices are deep; mucous discharge is being produced. What is the most likely diagnosis in this case?
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After the birth of twins, the postparturient woman developed a massive hemorrhage from the natural birth canal. The placenta and birth canal are intact. The uterine fundus is located above the navel, the uterus is soft to palpation and does not respond to the administration of uterotonics. What is the most likely cause of the bleeding in this case?
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After semolina was introduced into diet, a 1-year-old child for 2 months has been presenting with loss of appetite, irritability, loss of body mass, and copious and foul smelling stools. The skin is pale and dry, the hair is brittle. The abdomen is distended, while the limbs are thin. Stool test shows high levels of fatty acids. What is the most likely diagnosis in this case?
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After falling and hitting the back of the head, a child lost hearing in the right ear and developed peripheral paralysis of the right facial nerve, discharge of a clear fluid from the right auditory canal, and diffuse neurological symptoms. Make the provisional diagnosis.
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An 82-year-old woman was hospitalized into the cardiac intensive care unit with complaints of a sharp pain behind the sternum, a sensation of lack of air, and weakness. Chest X-ray shows that the transverse size of the cardiac shadow is enlarged, the shape of the shadow is tri angular and has rounded cardiodiaphragmal corners. Cardiac contractions are of small amplitude and arrhythmic. These X-ray findings most likely correspond with:
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A 59-year-old woman complains of pain and edema in the small joints of her hands, shortness of breath, weakness. This condition lasts for 8 years already. Objectively, her body temperature is 37.8 ° C, she has fine punctate hemorrhages on her torso and limbs, ulnar deviation of the hands is observed. The borders of the heart are shifted to the left, a systolic murmur can be detected over the apex. Her pulse is 96 / min. Her blood pressure is 170/100 mm Hg. Complete blood count shows the following: erythrocytes-3.2 10¹2 / L, Hb-108 g / L, leukocytes-6.8 10 % / L, platelets-220-10 / L, ESR-48 mm/hour, C-reactive protein (+++). General urinalysis shows the following: specific gravity-1016, protein-2.8 g / L, leukocytes 10-12 in the vision field, erythrocytes-2-4 in the vision field. What is the most likely diagnosis in this case
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A boy suffering from bronchial asthma started to experience suffocation attacks several times a day. During the last attack, inhalation of astmopent (orciprenaline) had no effect. Intensive therapy was unable to stop the attack. The child was transferred into the intensive care unit with the diagnosis of II degree status asthmaticus. What was the leading mechanism of the development of this condition in the child?
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A three-year-old boy has been suffering from stool retention since birth. Every 3-4 days, the mother gives her child enemas. The boy lags behind his peers in physical development. Objectively, he has pale skin and distended abdomen. What disease can be suspected in this child?
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An 18-year-old adolescent was diagnosed with a duodenal ulcer for the first time. The test for Helicobacter pylori is positive, the pH of gastric juice is 1.0. What would be the optimal treatment plan in this case?
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On the fourth day of life, a healthy newborn child developed melena and started vomiting blood. Coagulogram reveals prolonged prothrombin time, decreased prothrombin index, and deficiency of plasma factors II, VII, IX, and
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A 24-year-old woman complains of a popular-rash on her external genitalia. The rash is painless, without itching, clearly separated from the healthy skin. Two months ago, a round ulcer with a hard smooth bottom located on the patient's labia majora disappeared on its own without a treatment. What is the likely diagnosis in this case?
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A person has been hospitalized with the diagnosis of trichinellosis. What food product is the likely cause of this helminthiasis?
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A 26-year-old pregnant woman was hospitalized into the intensive care unit at 36 weeks of her pregnancy with complaints of an intense headache in the frontal region: Physical examination detected the following: blood pressure-170/90 mm Hg, pulse 85 /min., respiratory rate-15 /min., body temperature-36.9° C, edema of the limbs, fetal heart rate-159 /min. During the examination, the woman developed an attack of generalized tonic-clonic seizures. What drug must be administered first in this case?
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One week ago, a 68-year-old woman suddenly developed pain in the left half of her chest and shortness of breath. Objectively. the following is observed: cyanosis, distended neck veins, pulse- 100 /min, blood pressure –110/70 mm Hg, respiratory rate-28 /min., liver +4 cm, the left lower leg is edematous and sharply painful to palpation Auscultation detects a dull lung sound on the left, below the scapula; sonorous moist fine vesicular crackles are present; the borders of the heart are expanded on the right, the II heart sound is accentuated over the pulmonary artery. ECG shows deep S waves in leads I and aVL well as deep Q waves in leads III and aVE and a negative T wave in leads III and aVE What is the most likely diagnosis in this case?
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A 6-year-old child developed a fever of 375° C, stuffed nose with a small amount of mucous discharge, and a scratchy sensation in the throat. On the fourth day after the onset of the disease, the temperature. normalized but complaints of pain in the legs appeared. The child started limping and dragging the left leg. Muscle tone and reflexes are decreased, while sensitivity is retained. What disease can be suspected in this case?
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On day 3 of life, a newborn presented with a deformation, edema, and hematoma of soft tissues in the left supraclavicular region. The arm is pressed to the torso, passive movements are accompanied by fussiness of the child. What is the likely diagnosis in this case?
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A 26-year-old woman complains of cramping abdominal pain, diarrhea with a significant amount of mucus and blood, and fever of 37.5-38.0°C. Objectively, her skin and mucosa are pale, the body type is asthenic. Palpation detects pain along the large intestine. Colonofibroscopy reveals edematous wall of the rectum and sigmoid colon erosions, small ulcers, and mucus with blood in the lumen. What is the likely diagnosis in this case?
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A patient complains of pain in the lower back, weakness in the right foot, and impaired walking, Examination reveals painful palpation of lumbar paravertebral points. Cough impulse sign is positive. The Lasegue sign is positive on the right at the angle of 70. The Achilles reflex on the right is absent. There is t weakness in the extensor muscles of the right foot, the patient has problems with standing on the right heel. The patient was diagnosed with lumbosacral radiculitis and right foot paresis. What group of medicines must be prescribed in this case?
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A 25-year-old pregnant woman complains of fever of 38.5° C that lasts for two days already, cough, and shortness of breath. She developed these complaints after an overexposure to cold. Auscultation detects-crepitation and localized moist crackles in the lower part of the right lung. Percussion-detects there a dull sound. Complete blood count shows the following: leukocytes 11.0-10 % /L, ESR-22 mm /hour. What antibacterial agent must be prescribed in this case?
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The patient, a chemical plant worker, while working with an aggressive liquid, accidentally spilled it on his overalls, receiving a chemical burn on his right thigh and lower leg. After removing his clothes, the following was revealed: on the front inner surface of the right thigh and the front surface of the right lower leg with a transition to the dorsum of the foot, there are yellow-gray patches with fragments of epidermis in some places. The affected skin areas exhibit tactile and painful hypoesthesia. What emergency aid must be provided first in this case?
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A 55-year-old woman complains of diarrhea, irritability, and peeling, and pigmentation of the open areas of her body (neck, hands, and feet). Her history indicates that corn is one of the main components in her diet. The woman rarely eats other vegetables and legumes and does not eat meat or fish. What is the most likely diagnosis in this case?
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A 6-year-old child became acutely ill and developed fever, headache, and pain during swallowing. Three hours later, a bright-red fine punctate rash appeared on a hyperemic skin. The rash is more numerous on the lateral surfaces of the body and in the natural folds. The oropharyngeal mucosa has a clearly demarcated hyperemia and there is a purulent plaque on the tonsils. What disease can be suspected in the child?
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A 28-year-old woman came to a doctor with complaints of a sharp pain in her lower abdomen and a short-term loss of consciousness at home. The last menstruation was 12 days ago. Vaginal examination shows that her uterus is of normal shape and painless; the appendages on the left are slightly enlarged and painful to palpation, the posterior fornix is overhanging, tense, and sharply painful. What is the provisional diagnosis in this case?
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A 42-year-old patient has been hospitalized into the trauma department. X-ray reveals a pelvic fracture. Objectively, unassisted urination is not possible, urethrorrhagia is observed. Palpation detects an enlarged bladder and a painful swelling in the perineum. What is the provisional diagnosis in this case?
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A 45-year-old man complains of an intense retrosternal pain that radiates into the lower jaw and occurs at rest, at night, several times for 10-15 minutes. During a pain attack, an elevation of the ST segment can be recorded on the ECG in leads V 3-4. What is the provisional diagnosis in this case?
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Forensic autopsy of the body of a 59-year-old man, who died suddenly at home without signs of violent death, shows pink skin and mucosa, liquid bright-red blood, and bright-red plethoric internal organs. Forensic toxicology blood testing detected 1.44 ° / 00 of ethanol in the blood and carboxyhemoglobin levels of 55 %. What is the cause of death in this case?
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A 65-year-old patient was prescribed pharmacotherapy (ramipril, atorvastatin, amlodipine, acetylsalicylic acid, bisoprolol) for essential hypertension with concomitant ischemic heart disease. Two weeks later, he consulted a doctor about a dry cough. Examination detects no signs of acute respiratory viral infection or damage to the bronchopulmonary apparatus. A side effect of ramipril is suspected. What drug can be used to replace ramipril in the treatment plan?
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The mother of a 6-month-old boy came to a pediatrician. She is concerned that her child has not received any vaccinations. There are no health complaints. Objectively, the following is observed: body temperature-371° C, respiratory rate 20 /min., blood pressure -100/70 mm Hg, the child's height and weight are within the range between the 50th and 75th percentile. What tactics must the doctor choose in the immunization of this child according to the regulatory documents issued by the Ministry of Health?
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A newborn baby developed a rash on the body. The mother was not registered for prenatal care checkups. After birth, the child scored on the Apgar scale 7 and 9 points at 1 and 5 minutes of life respectively. Physical examination revealed the following: body temperature-37 ° C, pulse- 145 / min. respiratory rate-33 / min., petechial rash on the torso, Auscultation of the heart detects a systolic-diastolic murmur in the left subclavian region. What is the most likely diagnosis in this case?
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In recent months, a 29-year-old woman developed complaints of pain in her right iliac region, diarrhea with mucus and pus, pain in the hip joints, and periodic increases in body temperature. The abdomen during palpation is soft, with tenderness in the right iliac region. Irrigography shows that the mucosa resembles a cobblestone pavement, the ileocecal junction is narrowed. What disease can be suspected in this case?
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Within several days, a person developed a reduction in the peripheral vision, resembling a flap, on the outer side. The patient does not know the cause of this condition. The eye is calm, the optical media are transparent. On the nasal side of eye, ophthalmoscopy detects a gray “sail” with vessels that wavers during eye movements. The optic disc and blood vessels are without changes. What is the most likely diagnosis in this case?
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A 31-year-old woman came to a gynecologist with complaints of a menstruation delay of 2 weeks, morning sickness, and smearing bloody discharge from the vagina. The pregnancy test was positive. Ultrasound detects no fertile egg in the uterine cavity. In this case, the patient must be referred for the following study:
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An 18-year-old adolescent bought at a store a salad with smoked fish, mushrooms, and mayonnaise. Six hours after eating the salad, he developed progressive weakness, vision impairment, "fog in the eyes", and problems with swallowing. He was hospitalized. Examination detects the body temperature of 36.0 °C and pale skin and mucosa. The patient is adynamic, answers questions sluggishly. The pupils are dilated, with reduced response to fight. The patient's voice is hoarse, his oral mucosa is dry. What type of food poisoning can be suspected in this case?
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A premature newborn boy (pregnancy 5, birth 1, gestation term-27 weeks) has irregular respiration of < 30 /min, after birth and SpO₂ of 70 %. Retractions of the pliable areas of the chest and expiratory groaning are observed. Without oxygen support, generalized cyanosis occurs. Auscultation reveals crepitus in the basal segments. There are no data on the prevention of respiratory distress syndrome in the baby What treatment tactics must be chosen in this case?
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