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KROK 2 Medicine 2024 Questions | KROKEXAM
Browse 2024 KROK 2 Medicine exam questions with answers and explanations.
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A 32-year-old woman, gravida 1, at the term of 38 weeks complains of irregular spastic pain in her lower abdomen and lumbar region. The pain is observed for 2 days, the patient did not sleep well at night. External obstetric examination detected increased tone of the uterus; the fetus is in the longitudinal lie, position the fetal head is position I, occiput anterior, the fetal head is mobile and located above the entrance to the lesser pelvis. Vaginal examination detects that the cervix is up to 2.5 cm, tilted backwards, unevenly softened, the external os is open to 0.5 cm, the internal os is closed. What is the most likely diagnosis in this case?
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Three days ago a 29-year-old patient developed throbbing pain in the rectum, increased body temperature, and general weakness. Palpation detected local soreness in the anal region at 6 o'clock. Digital examination of the rectum revealed a painful infiltrate that reached no higher than the pectinate line. What is the most likely diagnosis in this case?
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A 65-year-old patient with a history of arterial hypertension complains of dizziness and palpitations that occurred throughout the last hour. Objectively, the following is observed: blood pressure - 80/40 mm Hg, heart rate-150 min, pulse-106/min. ECG revealed missing P wave and varying RR intervals, ventricular contraction rate is 136-148/min. What aid must be provided to the patient first?
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An 11-year-old girl complains of pain in the joints, a fever of 38°C, and weakness. She fell ill 5 days ago. Objectively, she has a maculopapular rash on the bridge of her nose and on her face, the joints are not changed, the heart sounds are weakened. Blood pressure 100/80 mm Hg. Complete blood count: erythrocytes 26 1012/L, leukocytes - 3.7-109/L, platelets-12-109/L, ESR - 45 mm/hour, CRP (+++). General urinalysis: protein - 0.063 g/L, erythrocytes -15-20 in sight, leukocytes 10-14 in sight. What is the most likely diagnosis in this case?
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A premature baby born at 34 weeks of gestation presents with the following at 4 hours after birth: tachypnea, respiration with a seesaw motion, sternum depression, expiratory murmurs. Respiratory rate - 80/min. Auscultation detects weakened breathing with non-constant heterogeneous crackles over the lungs. X-ray of the lungs shows air bronchogram and a nodose-reticular lung pattern. What is the most likely diagnosis in this case?
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A certain statistical method can be used to study the relation between the duration of smoking and the frequency of malignant lung neoplasms being detected. What method of statistical analysis should be used in this study?
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A 45-year-old patient complains of a skin rash on the trunk and upper and lower limbs. The patient associates the development of this rash with a recently experienced stressful situation. Objectively, there are inflammatory papules on the skin, which have a tendency to spread and are covered with loose silvery-yellow scales. When elements of the rash are scraped, the "stearin spot" symptom is observed. The patient's genealogical history is normal. What is the most likely diagnosis in this case?
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A 27-year-old patient complains of pain in the symmetrical joints of the hands. fever, and morning stiffness. The disease onset was acute. Laboratory testing detected rheumatoid factor, high titer of C-reactive protein, and high titer of antibodies to citrullinated vimentin. X-ray revealed isolated erosions of interphalangeal joints. What initial basic treatment must be prescribed in this case?
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A district center is being supplied with water from an interlayer water-bearing stratum with high levels of calcium and magnesium salts. What is the optimal method of water treatment that should be applied before pumping the water into the distribution network?
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Examination of a 4-day-old baby detected vesicles with seropurulent content on the neck, back of the head, and buttocks. The patient's condition is satisfactory, the child is active, all newborn reflexes can be fully induced, the umbilical cord is at the stage of mummification, the umbilical region is normal. What is the most likely diagnosis in this case?
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A 32-year-old woman complains of aching pain in her lower abdomen and intensified and painful menstruations. She has a history of 2 abortions and no childbirth. Objectively, the skin is pale, the abdomen is soft and painless, a tumor-like mass is palpable above the pubis. Bimanual examination shows that the body of the uterus is enlarged to 14 weeks of pregnancy, dense, mobile, with an uneven surface. The appendages are not palpable What is the most likely diagnosis in this case?
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A 13-year-old girl complains of pain in the area of her heart, palpitations, feeling hot, dizziness, weakness. These complaints appeared 12 months ago, the girl lost 4 kg of weight, her performance at school became worse, and she developed sleep problems. Objectively, she is tearful and irritable, presents with finger tremor, increased moisture of her skin, and reduced tissue turgor Heart rate - 104/min. Palpation detects dense and painless thyroid gland that is enlarged to a third-degree goiter. What is the most likely diagnosis in this case?
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During the last week a 26-year-old woman started doing many things that were new and unusual for her. In particular, she started painting the walls in the house entranceway on her own and was writing poems at night, while making illustrations for them. Objectively, she is talkative, quickly changes topics of conversation, actively gestures, jokes, and flirts with men. She believes that she could have been a great actress, writer, and artist, and invites everyone to attend her evening "art recitals". What psychopathological condition is observed in the patient?
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A 20-year-old patient came to a doctor with complaints of general weakness, increased body temperature, swelling and pain in the joints, a rash on the lower legs. Chest X-ray revealed enlarged internal thoracic lymph nodes. What is the most likely diagnosis in this case?
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On the fifth day of life, a newborn presents with excessive abdominal distension with contouring of intestinal loops on the anterior abdominal wall. Meconium passed after the enema. Abdominal X-ray shows dilation of the loops of the large intestine. What is the most likely diagnosis in this case?
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A 26-year-old woman has been married for 5 years. Despite not using contraception and having a regular sex life, she was unable to become pregnant. Her husband has been examined and is fertile. The woman has a history of surgery for diffuse peritonitis at the age of 19. What study must be conducted to determine the cause of her infertility?
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A 50-year-old woman complains of acute pain in the epigastric region, vomiting, and sudden general weakness. The disease onset was 2 days ago. Objectively, she has pale skin and dry tongue. Pulse 100/min., of poor volume, blood pressure 110/70 mm Hg. During palpation, the abdomen is soft, moderately painful in the epigastrium and mesogastrium, there are no signs of peritoneal irritation. Peristalsis is significantly increased in the mesogastrium on the left. X-ray detected Kloiber bowls (air-fluid levels) on the left. What is the most likely diagnosis in this case?
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A patient complains of a fever of 39°C, chills, headache, difficulty sleeping, and poor appetite. Objectively, on the back surface of the neck, there is a large, purple-cyanotic, sharply painful, dense infiltrate. In the center of the Infiltrate, there are several openings, through which thick yellow-green pus is being discharged. What is the most likely diagnosis in this case?
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A 19-year-old young woman complains of absence of menstruations, lethargy, and weight loss. One year ago she had a pathological childbirth with significant blood loss and no lactation after the childbirth. Vaginal examination shows that the vagina is narrow, the uterus is reduced in size, and the ovaries are not palpable. Laboratory testing detected hypoestrogenemia. What is the most likely diagnosis In this case?
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An 18-year-old young man was hospitalized after a fight with signs of internal bleeding. Anamnesis states that he has hemophilia A. He was diagnosed with an extraperitoneal hematoma. What must be prescribed to the patient first?
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During physical exercises, a 32-year-old patient suddenly felt lack of air, weakness, chest pain on the right that radiated into the right shoulder, shortness of breath, and palpitations. Objectively, the patient's condition is severe, tachycardia is up to 100/min, blood pressure - 90/60 mm Hg, respiratory rate 28/min, the right half of the chest lags behind during breathing. Percussion detects tympanic sound on the right, no respiratory sounds were detected there. The body temperature is normal. What is the most likely diagnosis in this case?
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When performing a comprehensive assessment of the microclimate at the premises, it is necessary to measure the radian temperature. What instrument must be used for this purpose?
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A 42-year-old woman has been hospitalized with complaints of dull, aching pain in her lower back, more on the right side, and her body temperature sometimes increasing to subfebrile levels. The patient's medical history states that 10 years ago during pregnancy she had a pain attack in her lumbar region on the right and a fever of 39°C. She underwent treatment with antibiotics. In recent years, she was feeling satisfactory. An increase in blood pressure has been observed for the past 5 years. Urinalysis revealed the following: protein 0.66 g/L, leukocytes - 10-15 in sight, erythrocytes 2-3 in sight. What is the most likely diagnosis in this case?
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A 58-year-old woman complains of dizziness, weakness, and losing 14 kg within 2 months. The patient has a past history of tuberculosis. Objectively, she presents with increased skin pigmentation, body weight deficit of 10 kg, and blood pressure of 90/55 mm Hg. Blood test revealed the following Na - 117 mmol/L, K - 6.4 mmol/L, CL - 116 mmol/L, [HCO₃] - 27 mEq/L, glucose - 2.9 mmol/l. What is the most likely diagnosis in this case?
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A 32-year-old primipara woman developed intense contractions that last 55-60 seconds with an interval of 1-2 minutes between them. Objectively, the disengagement of the fetal head begins. The perineum protrudes excessively and has the height of 4 cm. The skin of the perineum is pale and tense. After a contraction stopped, a thin stream of blood appeared from the genital opening. Specify the further tactics of managing the delivery.
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Examination of the placenta that was just delivered detected a defect 2x3 cm in size. There is no bleeding. What would be the further tactics of the patient's management?
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A 45-year-old woman complains of discomfort during reading, redness of the edges of her eyelids, and white foamy discharge in the corners of her palpebral fissures, observed for the past two months. Objectively, the following is observed: hyperemia and thickening of the loose eyelid margins, widened excretory ducts of the glands in the eyelid cartilage. What is the most likely diagnosis in this case?
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A 65-year-old man was diagnosed with hypertension and ischemic heart disease and prescribed pharmacotherapy. Two weeks later, he consulted a doctor about edemas on his lower legs. Examination detected no signs of diseases with the course that includes edematous syndrome. A side effect of the medication is suspected. What drug has such a side effect?
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A 3-day-old full-term baby has the following blood test results: indirect bilirubin levels - 345 memol/L, hourly increase 6.8 memol/L. The child's condition is severe. Objectively, the child presents with decreased reflexes, muscle hypotonia, and limb tremor. The blood of the child and the mother is Rh-incompatible What would be the most effective method of treatment in this case?
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A 50-year-old man has been hospitalized in a severe condition. ECG revealed signs of acute myocardial infarction. Objectively, the patient is anxious, tense, disoriented in the place and time and correctly oriented in his own person. The patient experiences auditory and bright visual hallucinations of a frightening nature, under the influence of which he is agitated and prone aggressive actions. The patient expresses fragmentary delusions. What leading psychopathological syndrome is observed in the patient?
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A man complains of dizziness and vomiting. Vomitus is dark-colored. The patient's history states that he often drinks alcohol, Esophagogastroduodenoscopy detected that the contents of the stomach resembled "coffee grounds", in the area of the cardia, there were four longitudinal fissures in the mucosa, from which a small amount of blood was leaking. What is the most likely diagnosis in this case?
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A multipara woman developed vaginal bleeding with the onset of full-term delivery. Internal obstetric examination detected the following the cervix is smoothed out the opening is 6 cm, 1/3 of the internal os is obstructed by a spongy tissue. The amniotic sac is palpable in the rest of this area. The labor is active. Specify the further tactics of the delivery management in this case.
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A 42-year-old woman complains of morning stiffness in the joints of her hands, a feeling of tightness in the skin of her face, and difficulty swallowing food. Objectively, she has facial amimia, her oral cavity has a "pouch-like" narrowing, her fingertips are pale and cold to the touch. Auscultation detects arrhythmic and weakened heart sounds and systolic murmur over the apex. Blood test revealed the following erythrocytes 3.2 1012/L, leukocytes - 6.7 109/L, ESR-35 mm/hour. What is the most likely diagnosis in this case?
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An 8-year-old child is being monitored for growth retardation. The child was born with asphyxia and the body weight of 2800g. He studies well at school. His parents are of average height. Objectively, height - 107 cm, body weight - 23 kg, he has underdeveloped facial skeleton that resembles a doll's face. The hair is thin, the skin is dry with an icteric tint. Subcutaneous adipose tissue is well developed on the neck, chest, and abdomen. The muscles are underdeveloped. What is the most likely diagnosis in this case?
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A 56-year-old patient complains of decreased appetite, weakness, palpitations, pain and a burning sensation in the tongue, heaviness in the epigastric region, and numbness in the limbs. Objectively, the following is observed: pale skin with a lemon-colored tint, Hunter's glossitis, enlarged liver and spleen. Complete blood count: erythrocytes-2.8-1012/L, hemoglobin -100 g/L, color index 1.2. Erythrocytes are large, often oval, with Jolly bodies and Cabot rings. What is the most likely diagnosis in this case?
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A 34-year-old woman with previously normal menstrual function developed irregular cycles that are anovulatory according to functional diagnostic tests. Her breasts are painful to palpation and secrete milk (galactorrhea). What study must be conducted to establish the patient's diagnosis?
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A 58-year-old patient complains of profuse macrohematuria with discharge of shapeless blood clots and stranguria. Macrohematuria was not accompanied by pain and dysuria and first appeared 5 months ago for no apparent reason. After a few days the bleeding stopped on its own. What is the most likely diagnosis in this case?
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A 44-year-old woman complains of general weakness, drowsiness, palpitations, dry skin, and reduced working ability. Objectively, she has normal-colored skin, pulse - 72/min, blood pressure - 125/80 mm Hg, the thyroid gland is diffusely enlarged to the Il degree, dense, mobile, and painful. Ultrasound reveals decreased echogenicity, non-homogeneity of the echo structure, thickening of the gland capsule. Blood test shows that T4 levels are decreased, TSH levels are increased, and the levels of antibodies to thyroperoxidase and anti-microsomal antibodies are significantly increased. What is the most likely diagnosis in this case?
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A person with peptic ulcer disease of the stomach, who undergoes no treatment and periodically has pain in the epigastrium and sour eructation, suddenly developed general weakness, palpitations, dizziness, and "coffee grounds" vomiting, later melena appeared as well. Objectively, the patient has pain in the epigastrium and positive Mendel sign. Blood test revealed the following: hemoglobin - 82 g/L, leukocytes - 7.5 109/L, ESR-22 mm/hour. What complication has developed in the patient?
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A patient has been diagnosed with right-sided pneumothorax and prescribed urgent drainage of the pleural cavity. What site should be used for the pleural tap in this case?
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