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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 68-year-old woman has been hospitalized with complaints of headache in the occipital region, marked dyspnea at rest that becomes worse when lying down, and dry cough. Objectively, the woman is in an orthopneic position, acrocyanosis is observed. Over the lungs, weakened vesicular breathing can be heard with medium and fine vesicular wet crackles in the lower segments. The heart sounds are weakened gallop rhythm is observed. Pulse - 102/min., blood pressure - 210/110 mm Hg. The liver protrudes 2 cm from under the edge of the costal arch and is tender during palpation. There are edemas on the lower legs. What drugs should be used to provide emergency aid for this patient?
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Examination of a milk sample detected the following: color - whitish, odor normal, taste characteristic of milk, density - 1,038, acidity 35°C Th (Thorner degrees), fat content quality 3.2%. Determine the milk quality.
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A 15-year-old girl complains of delayed growth and absence of menstruationsons and secondary sexual characteristics. Objectively, she has the height of 153 cm, anti- mongoloid slant of the eyes, wide neck, wing-like folds on the neck (webbed neck), low line of hair growth on the neck. Her shoulder girdle prevails over the pelvic girdle, the mammary glands are not developed, pubic hair is absent. Uterine hypoplasia was detected. What is the most likely diagnosis in this case?
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On the second day after a thyroidectomy, the patient presents with seizures, numbness and sensation of "crawling ants" in her hands and feet, and positive Chvostek and Trousseau signs. What complication has developed in the patient?
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A patient complains of a rash and itching that becomes worse in the evening and at night and has been observed for 2 weeks already. Objectively, a papulovesicular rash with its elements arranged in pairs is observed on the lateral areas of the chest and abdomen and in the interdigital folds. What is the most likely diagnosis in this case?
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A children's preschool institution is located near a highway, where carbon monoxide levels in the air are 3-4 times higher than the maximum permissible concentration. What substance, detected in the children's blood, will confirm the harmful effect of polluted air?
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One hour after being fed with a milk formula, the baby developed cyanosis of the lips, mucosa, nails, and face. Later the baby developed nausea, increased salivation, pain in the epigastric region, vomiting, and diarrhea. The pediatrician detected signs of cardiopulmonary failure in the baby. Investigation determined that the milk formula was prepared using the water from a well. What is the most likely diagnosis in this case?
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A 3-year-old child has episodes accompanied by cyanosis, sudden anxiety, and squatting. Objectively, the child has drum-stick deformation of the finger phalanges and nails that resemble a clockface. The cardiac dullness boundaries are shifted to the left and right. A systolic tremor can be detected in the second intercostal space near the left edge of the sternum. A coarse systolic murmur can be heard with p.max in the second intercostal space. The second heart sound is weakened over the base of the heart. X-ray shows that the heart is in the form of a "wooden shoe", the pulmonary pattern is poorly visible. What is the most likely diagnosis in this case?
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A 38-year-old patient complains of cramping abdominal pain, nausea, vomiting, abdominal distension, inability to pass gas, constipation. The patient had a recent surgery for appendicitis in his medical history. On palpation, the abdomen is painful in all its segments and tense. A splashing noise, unclear signs of peritoneal irritation, and hyperperistalsis are observed in the patient. What is the most likely diagnosis in this case?
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A 43-year-old patient was hospitalized 40 minutes after the onset of acute pain in the epigastrium. The pain later moved into the right iliac region. Objectively, the following is observed: sharp tension of the muscles of the anterior abdominal wall, positive signs of Blumberg, Mussy-Georgievsky, Chugaev, and Bernstein. Hepatic dullness is absent. What is the most likely diagnosis in this case?
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A 17-year-old boy has been diagnosed with Prasad's syndrome. It is characterized by short stature, sexual underdevelopment enlargement of the liver and spleen, and iron-deficiency anemia. This health condition is caused by the insufficient content of a certain microelement in the diet. Name this microelement.
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A woman complains of a severe pain in her throat on the left, difficult swallowing and mouth opening, elevated body temperature, and generally feeling unwell. She was provisionally diagnosed with acute pharyngitis. Examination detects a trismus of the masticatory muscles, the left tonsil is displaced towards the midline, the anterior palatal arch is infiltrated and protruding. The regional lymph nodes on the left are enlarged and painful to palpation. What is the most likely diagnosis in this case?
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Assess the physical development of a 10- year-old girl according to the regression scale, if her body weight and chest circumference parameters are within + 1 sigma.
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A 54-year-old woman complains of a fogged vision in her right eye, rainbow circles in her vision field, headache, and nausea. Within the last month she twice experienced a similar condition, but back then all the signs eventually disappeared and her sight was restored. Currently, all the signs have been persisting for over 2 days. Objectively, the patient has eyelid edema, congestive injection of the eyeball, corneal opacity, shallow anterior chamber of the eye, and dilated pupil that is unresponsive to the light. Her intraocular pressure is 48 mm Hg. What is the most likely diagnosis in this case?
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A 65-year-old woman with diabetes mellitus was undergoing treatment with metformin. Because of high blood pressure, she was taking diuretics. Gradually, the effectiveness of the diuretic decreased and nausea and vomiting appeared. Objectively the patient does not respond to stimuli, her skin is dry, the smell of acetone is absent. Blood pressure - 180/100 mm Hg. The heart sounds are muffled, pulse - 98/min. Her respiration is vesicular. The liver is +4 cm. Blood testing revealed the following glucose - 48 mmol/L, Na - 156 mmol/L K-52 mmol/L, urea 15 mmol/L. What complication has developed in the patient?
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A 27-year-old woman complains of sharp pain in her lower abdomen and dizziness. Her last menstruation was 2 weeks ago. HCG test results are negative. Objectively, her skin is pale, blood pressure pressure-80 -80/60 mm Hg. pulse -92/min. The abdomen is tense, painful more on the right in its lower segments Vaginal examination detects normal sized uterus, the appendages are painful to palpation, the posterior fornix overhangs. What is the most likely diagnosis in this case?
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A 20-year-old man complains of headache, general weakness, and face edema that appears in the morning. Eighteen days earlier he had a case of acute pharyngitis. Objectively, his skin is pale, edema is observed under his eyes. Heart rate - 60/min, blood pressure - 185/100 mm Hg. The sign of costovertebral angle tenderness (percussion test in the lumbar region) is negative on both sides. Urinalysis shows the following color - dirty-red, protein - 4.5 L, altered erythrocytes 40-45 in sight, leukocytes - 5-6 in sight. 24-hour diuresis is 400 mL. What is the most likely diagnosis in this case?
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A 25-year-old woman was hospitalized into the maternity hospital at 34 weeks of her pregnancy with complaints of bright-colored bloody discharge with clots that appeared after a defecation. Objectively, the fetal head is palpable near the uterine fundus. Fetal heart rate-140/min. No labor activity. Vaginal examination shows that the cervix is 3 cm long, its opening allows inserting a fingertip, a soft formation can be palpated through the vaginal fornix. The discharge is hemorrhagic and bright-colored. What is the most likely diagnosis in this case?
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A 38-year-old patient complains of pain in the lower back and left knee and ankle joints. Blood test results were as follows: leukocytes 11-109/L, ESR-38 mm/hour, CRP ++, ASL-O titer 125 units, uric acid 375 memol/L, rheumatoid factor negative. Chlamydia were detected in the urethral swab. X-ray shows that the articular surfaces on the left are uneven, indistinct, the joint space is narrowed. What is the most likely diagnosis in this case?
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A 34-year-old woman after rapidly changing her position from horizontal to vertical suddenly paled, fell down, her skin became moist, her limbs are cold, her pupils are dilated. Her pulse is rapid and thready blood pressure - 50/25 mm Hg. What emergency condition has developed in the patient?
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A 38-year-old patient complains of a fever of 39°C, chills, profuse sweat, and dull lumbar pain that radiates into the suprapubic region. Objectively, muscle tension is observed in the lumbar region, percussion test in the lumbar region provokes painful sensations on both sides. Complete blood count shows leukocytosis of 12x109/L. General urinalysis revealed the following: proteinuria - 0.7 g/L, leukocyturia 15-20 in sight, bacteriuria of over 100,000 bacteria per 1 mL of urine What is the most likely diagnosis in this case?
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A 50-year-old patient complains of headache, itchy skin, and pain in the toes and muscles, especially during walking Objectively, the skin of the face has a red-cyanotic tint. Lymph nodes are not palpable. Pulse - 76/min. Blood pressure - 180/100 mm Hg. The lungs have no abnormalities. The borders of the heart are displaced to the left by 2 cm. The liver is +2 cm. The spleen is near the edge of the costal arch, dense and painless. Complete blood count: erythrocytes 6,3.1012/L, hemoglobin - 201 g/1., color index - 0.8, leukocytes - 10.5 109/L, eosinophils - 4%, band neutrophils - 7%, segmented neutrophils - 62%, lymphocytes 22%, monocytes 5%, platelets - 500. 109/L, ESR - 1 mm/hour, hematocrit - 55%, What is the most likely diagnosis in this case?
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After repeated disinfection of the surgical instruments with a weak solution of a liquid disinfectant, a nurse gradually developed skin inflammation on the palmar surfaces of her hands. Objectively, her palms are edematous. Diffuse erythema without clear boundaries is observed on the palms, with isolated papular rash elements present against its background. The results of allergic skin testing are negative. What is the most likely diagnosis in this case?
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A 30-year-old woman has a history of three spontaneous miscarriages and one premature childbirth. Examination revealed a positive reaction to anticardiolipin antibodies and lupus anticoagulant. What is the most likely diagnosis in this case?
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A child was born from the first pregnancy, accompanied by gestosis of the first and second half. The delivery was via a cesarean section. Apgar score - 6 points. The baby's weight - 3000 g. The baby was suckling actively, no burping. Two weeks later, the baby developed projectile vomiting with curdled milk in the vomitus that exceeded in volume the amount of baby's meals. The baby has become lethargic, is poorly gaining weight, the amount of urine and feces has decreased. What is the most likely diagnosis in this case?
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After semolina was introduced into the diet of a 1-year-old child, the child for 2 months has been presenting with decreased appetite, irritability, loss of body mass, and loss of previously learned skills. The feces are copious and foul-smelling. The skin is pale and dry, the hair is brittle. The abdomen is distended, 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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A 32-year-old patient complains of pain in the left leg, observed for a year, with intermittent limping after walking 50-100 meters and periodical nocturnal pain. Objectively the left leg is pale and cold. Arterial pulsatis absent in the left lower leg. What is the most likely diagnosis in this case?
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Such parameters as blood pressure and the patient's age were studied in 200 patients with essential hypertension. What statistical value should be used to measure how strong the connection is between these two parameters?
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A 22-year-old woman is agitated, her behavior is abnormal, her consciousness is clouded. She has a history of type 1 diabetes for the last 4 years with the labile course. She receives insulin therapy in the dose of 54 units per 24 hours. Objectively, her skin is moist and cold to the touch, she has hyperreflexia and dilated pupils. Her respiration is vesicular. Blood pressure -140/90 mm Hg, pulse 88/min. Blood testing revealed glycemia of 2.3 mmol/L. and aglucosuria. What is the most likely diagnosis in this case?
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A 15-year-old girl complains of the absence of menstruations and periodic pain in her vagina. Examination of the external genitalia detected the following: the girl has the female pattern of hair growth, the labia majora are normally developed and cover the labia minora, the entrance to the vagina is covered with a protruding bluish-purple septum. What is the most likely diagnosis in this case?
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A 6-month-old child started refusing to eat and developed an acute fever of 39°C, vomiting, and short-term tonic-clonic seizures. Objectively, the child is sluggish and sleepy. Nuchal rigidity, Kernig's signs, and a bulging and tense fontanel are observed. What laboratory and instrumental study is necessary to confirm the diagnosis in this case?
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The history of a 70-year-old patient states that the disease onset was approximately six months ago. According to her relatives, her memory of current events was sharply deteriorating, in particular, she was forgetting the way home when returning from the store and started experiencing difficulties while performing her usual daily activities. The memory of past events was retained. Signs of semantic and amnestic aphasia were observed. Echolalia is periodically noted. The patient is in a low mood and has slight anxiety. She has a history of craniocerebral trauma and had diabetes mellitus for approximately 15 years. What is the most likely diagnosis in this case?
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A pregnant woman at 32 weeks of gestation with the risk of preterm labor undergoes a treatment to prevent fetal respiratory distress syndrome. What medicine was she prescribed?
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A 10-month-old boy is poorly gaining weight. His mother complains about his constant persistent cough. Sputum is thick and viscous. The boy had pneumonia three times. His sweat chloride levels are over 80 mEq/L What is the most likely diagnosis in this case?
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A 30-year-old woman complains of abdominal discomfort on the left, pain in the joints, fever, and periodic hemorrhages, Objectively hepatolienal syndrome is observed. Complete blood count revealed the following: leukocytes - 200 x 109/L, numerous granulocytes at various degrees myeloblasts -
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A 28-year-old woman complains of a feeling of unreality, of her own body being changed somehow. When she stands in front of a mirror, she recognizes herself, but her hands, legs, and face seem alien like they do not belong to her. What is the most likely psychopathological disorder in the patient?
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A 4-day-old boy developed signs of hemorrhagic disease of the newborn in the form of melena. What drug should the doctor have prescribed in the first hours of life to prevent this disease?
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A 35-year-old woman came to a doctor with complaints of shortness of breath, deteriorated vision ("a haze before her eyes"), double vision, strabismus, nystagmus markedly dry mouth, nasal voice, difficulty swallowing, muscle weakness, and abdominal distension. According to her diet history, 20 hours ago she was eating canned meat and home-cooked fish. What is the most likely diagnosis in this case?
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A 12-year-old girl complains of weakness, dizziness, headache, and a fever of 38°C. Objectively, her body temperature is 37,8°C, her mucosa and skin are pale, her pharynx is without changes. Palpation detects submandibular and cervical lymph nodes that are enlarged to 2 cm, dense and painless. No pathological changes of internal organs were detected. Complete blood count: erythrocytes - 2,8x1012/L, hemoglobin - 85 g/L, color index - 0.9, leukocytes 10-109/L, eosinophils- 0%, band neutrophils 1%, segmented neutrophils 8%. lymphocytes - 47%, reticulocytes - 0.5%. platelets-60.109/1, blast cells - 44%. What is the most likely diagnosis in this case?
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A 50-year-old man complains of shortness of breath that becomes worse during physical exertion. The patient's history states that he has been smoking for the last 30 years. Objectively, the following is observed: body temperature 36.5°C, respiratory rate - 22/min, heart rate - 88/min, blood pressure - 130/85 mm Hg. The chest is barrel-shaped, auscultation detects weakened vesicular respiration with a bandbox resonance over the entire surface of the lungs. What is the most likely diagnosis in this case?
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