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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 45-year-old patient complains of abdominal pain and discomfort that occur in emotionally straining situations. Objectively, no changes were detected in the gastrointestinal tract. The complaints first arose over 10 years ago against the background of a severe alcohol poisoning. The patient has been repeatedly visiting gastroenterologists, who were unable to detect any significant changes. The prescribed therapy was ineffective. What is the most likely diagnosis in this case?
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A 29-year-old patient suffers from hormone-dependent bronchial asthma. Fluorography detects a round shadow of medium intensity with clear even contours in C2 of the right lung. Around the shadow, there are several polymorphic focal shadows. There is a calcination at the root of the lung. Examination detects a banbox resonance in the percussion sound over the lungs, diffuse dry crackles can be heard. Blood test detects no changes. Mantoux test reaction with 2 tuberculin units PPD-L resulted in a papule 22 mm in size. What is the most likely diagnosis in this case?
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A 35-year-old woman complains of frequent, painful, difficult urination, constant urges to urinate, and several drops of blood appearing in her urine at the end of the process. She fell ill suddenly, after overexposure to cold, when the complaints above appeared. Body temperature - 36.6°C. During palpation, pain is observed in the area of the urinary bladder. Ultrasound shows a small amount of urine in the bladder, the walls of the bladder are edematous and uniformly thickened. Urinanalysis detects leukocyturia (30-40 in sight), proteinuria (0.099g/l), and erythrocytosis (5-7 unchanged erythrocytes). What is the most likely diagnosis in this case?
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After a hemorrhagic stroke, the patient undergoes a course of massage, physical therapy, and classes with a speech therapist to restore speech and movements of the left arm and leg. What type of prevention includes such rehabilitation procedures?
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A 25-year-old woman complains of profuse, foul-smelling, foamy discharge from her vagina and burning and itching in the area of her genitals. She has been ill for a week and has no regular sexual partner. Vaginal examination detects foamy discharge and hyperemic vaginal mucosa that bleeds when touched. What is the most likely diagnosis in this case?
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A 30-year-old woman complains of sudden reddening of her right eye, photophobia, a feeling of sand in the eye, and lacrimation that appeared 3 days ago, as well as rhinitis and a fever of 38°C. Objectively, she has marked edema of the eyelids, hyperemia of the conjunctiva of transitional folds, and fine punctate hemorrhages in the conjunctiva of the upper eyelid. A small amount of mucopurulent secretion is observed. What is the most likely diagnosis in this case?
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An 18-year-old patient complains of cramping abdominal pain, and loose stools up to 6 times a day with mucus and fresh blood. He has been ill for a year and lost 10 kg. Objectively, the abdomen is soft and painful along the large intestine, especially on the left. The sigmoid colon is spastic. Blood test results are as follows: erythrocytes 3.2-1012/L, hemoglobin 92 g/L, Icukocytes 10.6x109/L, ESR - 34 mm/hour. Irrigoscopy shows that the large intestine is narrowed, there are no haustra, the contours are unclear, the "lead pipe" sign is observed. What is the most likely diagnosis in this case?
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An 8-month-old child's examination revealed a loud systolic murmur over the entire cardiac region with an epicenter in the III-IV intercostal spaces to the left of the sternum and a systolic tremor, the second tone over the pulmonary artery is of increased volume. Blood pressure - 110/70 mm Hg. There are no complaints, X-ray shows that the size and shape of the cardiac shadow are without changes What is the most likely diagnosis in this case?
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An agitated patient keeps trying to behind the look door and into the next room, because he is convinced that his friends are there. He claims that he hears a conversation between his friends and strangers, despite there being no one nearby. He tries to convince the doctor that arguing about "his punishment" is occurring behind the wall. He loudly repeats the phrases that he claims he has heard from behind the wall. What pathological condition is observed in the patient?
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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, bright red blood, and bright red plethoric internal organs. Forensic toxicology blood testing detected 1.44/of ethanol in his blood and carboxyhemoglobin levels of 55%. What substance has caused the poisoning that became the cause of death in this case?
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A 35-year-old man complains of cough and shortness of breath during physical exertion. This health condition has been observed for the past 4 years. The patient has been working at a foundry for the last 14 years, where the concentration of quartz dust in the air of the workshop was 4 times higher than the maximum permissible concentration. Auscultation detected weakened respiration. Chest X-ray revealed emphysema and line macular shadows in all lung fields. What is the most likely diagnosis in this case?
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A 44-year-old woman complains of generally feeling unwell, chills, a fever of 39°C, and constant burning pain, skin redness, and edema in the area of her left lower leg. The onset of the disease she associates with a scratch on the skin of her left lower leg that she received two days ago. Objectively, in the middle third of the left lower leg, there is a bright area of skin hyperemia with clear borders raised above the unchanged skin. Moderate edema of soft tissues is observed, the soft tissues are painful during palpation. In the center of the hyperemic skin, there is a scab 2x0.2 cm in size that covers a small superficial wound. What complication of microtrauma of the left lower leg is observed in the patient?
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Laboratory quality control of drinking water from the tap had the following results: turbidity -15 mg/m³, odor -3 points, taste -2 points, metallic, color - light yellow, chromaticity 20°, temperature - 12°C. What parameter does not meet the hygienic requirements?
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A 37-year-old patient complains of general weakness, spastic pain in the lower segments of the abdomen, mainly in the left iliac region, and loose stools with mucus and blood up to 18 times a day. The disease onset was acute and occurred three days ago with chills, feeling hot, and a headache. The patient's general condition is moderately severe, body temperature - 37.8°C, Palpation detects spastic and painful sigmoid colon. What is the most likely diagnosis in this case?
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A woman has been hospitalized into a gynecological inpatient department with complaints of pain in her lower abdomen and dizziness. Her last menstruation was 6 weeks ago. Objectively, her skin is pale, blood pressure 80/60 mm Hg, pulse - 94/min. The sign of peritoneal irritation in the lower segments is positive. Bimanual examination shows that the uterus is slightly enlarged, the appendages are enlarged on the right and painful. Promtov's sign is positive. What is the most likely diagnosis in this case?
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Examination detected 24-hour proteinuria of 22 g in a 30-year-old woman. Biopsy revealed changes in the glomerular capillary walls in the shape of wire loops. What morphological form of kidney damage is indicated by the biopsy results?
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The microclimate of industrial premises can be characterized by the following parameters: average air temperature +35°C, radiant temperature + 30°C, relative air humidity 50%, air flow velocity 0.01 m/s. Name the main type of heat transfer that takes place in such microclimatic conditions.
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During the medical examination of a patient, the doctor noted a pericorneal injection of the vessels in the sclera of the eyes (a "violet-blue corolla"). conjunctivitis, cheilosis, angular stomatitis, hypertrophic glossitis. What vitamin is deficient in this case. causing such clinical presentation in the patient?
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A 14-year-old girl complains of a maculopapular rash along her body, a fever of 38.5°C, and a sore throat. Objectively, she has enlarged cervical and submandibular lymph nodes and hyperemic oropharyngeal mucosa, her tongue and tonsils are coated with white plaque. Palpation revealed hepato and splenomegaly. What is the most likely diagnosis in this case?
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A 60-year-old woman complains of limited mobility in her distal interphalangeal joints of both hands observed for 12 years and periodic pain in her back. Objectively, nodular thickening of the distal interphalangeal joints of both hands is observed, fingers are deformed, mobility is limited. No other pathology was detected. Results of blood and urine tests are within the normal range. What is the most likely diagnosis in this case?
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Examination of a 14-year-old tall boy detected arachnodactyly, pectus carinatum deformity of the chest, kyphoscoliosis, flat feet, valgus deformity of the feet, myopic astigmatism, enophthalmos, mitral valve prolapse, aortic root enlargement, and positive thumb and wrist sign. What is the most likely diagnosis in this case?
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A 20-year-old woman complains that for the last three years she has been observing a cold feeling in her fingers. First they turn bluish-white and numb and then 5-10 minutes later the skin becomes red and the fingers warm up, which is accompanied by sharp pain. What is the most likely diagnosis in this case?
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A patient complains of pain, photophobia, lacrimation, and impaired vision in the right eye. The visual acuity of the right eye is 0.5, cannot be corrected, the visual acuity of the left eye is 1.0. Objectively, the palpebral fissure is narrowed in the right eye, pericorneal injection of the eyeball is observed. Precipitates were detected on the posterior corneal surface. The pupil is narrowed, the response to light is slowed. Floating opacities are observed in the anterior part of the vitreous body. The fundus is normal. What is the most likely diagnosis in this case?
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A 35-year-old patient complains of weakness, excessive sweating, fatigability pain in the right side during breathing, and a fever of 38°C. Objectively, the following is observed: respiratory rate - 28/min, pulse - 100/min. The right half of the chest lags behind during the act of breathing. Voice tremor is not conducted on the right. Percussion detects a dull sound, breathing is weakened. The borders of the heart are shifted to the left. Complete blood count: leukocytes - 12 x 109/L , band neutrophils -13%, lymphocytes 13%, ESR - 38 mm/hour. What is the most likely diagnosis in this case?
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A 65-year-old patient complains of shortness of breath, cough with foaming pink sputum, lack of air, and fear of death. Objectively, orthopnea, pale skin, acrocyanosis, and cold sticky sweat are observed in the patient. Auscultation detects coarse breathing with wet fine and medium vesicular crackles in the inferioposterior segments on both sides. Respiratory rate - 40/min. The heart sounds are sharply muffled. At the top of the heart, a gallop rhythm is observed. What is the most likely diagnosis in this case?
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A routine examination of a 22-year-old woman at week 30 of her pregnancy detected isolated bacteriuria twice in her urine. The pregnancy course is without pathology. Specify the further tactics of managing this pregnant woman.
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A 12-year-old girl became acutely ill with a fever of 38.5°C and a rash appearing on her skin. Objectively, her condition is of moderate severity, she has hepatosplenomegaly, fine puncture rash and maculopapular rash on the flexor surfaces of her limbs, lateral surfaces of the trunk, and lower abdomen. Demarkated bluish-pink coloring is observed on her hands and feet. What is the most likely diagnosis in this case?
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Throughout the last month a 2-month-old baby had paroxysms of irritability, restlessness, and crying that start for no apparent reason. Such episodes occur during the feeding or immediately after. Noticeable relief often occurs after defecation. The duration of the episodes is approximately three hours a day. Between the episodes, the child is calm, has a good appetite, the increase in body weight is physiological. What is the most likely diagnosis in this case?
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A 14-year-old girl complains of vaginal bleeding that lasts for 10 days and occurred after a three-month delay of menstruation. She had menarche at the age of 13, her menstrual cycle is irregular. Complete blood count detects hemoglobin levels of 90 g/L. What is the most likely diagnosis in this case?
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A 30-year-old patient has been hospitalized. The patient's history states that the disease onset was acute and started with frequent watery stools, later followed by thirst and profuse vomiting without nausea. Objectively, the body temperature is 35.4°C. The patient's condition is severe, the skin is cold. Tissue turgor and skin elasticity are significantly reduced. The facial features are drawn. The voice is hoarse. Acrocyanosis and anuria are observed. Pulse - 130/min, weak. Blood pressure - 60/30 mm Hg. The tongue is dry. The abdomen is sunken and painless, palpation detects noticeable rumbling in the intestines. What is the most likely diagnosis in this case?
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A 16-year-old boy developed dizziness. Objectively the following is observed: heart rate - 35/min, blood pressure 85/45 mm Hg. The borders of the heart are not expanded. The heart sounds are sonorous and clear ECG revealed that P waves are not associated with QRS complexes, dissociation and different rhythm of the atria and ventricles is accompanied by a varying location of the P wave in relation to the QRST complex. What is the most likely diagnosis in this case?
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A 24-year-old patient complains of sharp pain and a rash in the form of small vesicles on the left side of the trunk. The patient associates this condition with overexposure to cold. Objectively small vesicles cluster together on the skin of the trunk on the left. along the nerve. Inflammatory erythema is observed on the periphery of the vesicles. What is the most likely diagnosis in this case?
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A 45-year-old woman complains of an induration in her left breast. Objectively, in the upper-outer quadrant of her left mammary gland, she has a tumor-like formation approximately 2.5 cm in diameter without clear contours. The formation is mobile and painless. The "lemon rind" sign is positive. In the left axillary region, there is lymph node enlarged to 1.5cm. What is the most likely diagnosis in this case?
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A 32-year-old woman complains of general weakness, headache, excess body weight, pain in her bones, and irregular menstrual cycle. Objectively, her skin is dry and cyanotic Purple-cyanotic stretch marks are observed in the area of her abdomen, shoulders, and thighs. Fat deposition is mainly observed on the face, neck, and trunk. Blood pressure 165/100 mm Hg. Blood testing revealed glucose of 72 mmol/L and elevated ACTH levels. X-ray of the bones revealed signs of osteoporosis. What is the most likely diagnosis in this case?
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After being stung by a bee, an 18-year-old patient feels hot and presents with dyspnea and edema of her lip, face, and neck. The patient's breathing is difficult and noisy, the patient has cough. The skin is pale and cold to the touch. Blood pressure - 75/50 mm Hg. Pulse 98/min, thready. Tachycardia is observed, the heart sounds are muffled and rhythmic. What is the most likely diagnosis in this case?
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A 30-year-old woman on the fifth day after the physiological childbirth complained of swelling of her left breast, pain, reddened skin, and a fever of 38°C. Objectively, her left mammary gland is enlarged, the skin there is red, with cyanosis in the upper-outer quadrant. A sharply painful infiltrate without clear borders can be palpated. Expressing milk does not bring relief. What is the most likely diagnosis in this case?
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A 50-year-old woman has been hospitalized with complaints of palpitations, irregular cardiac activity, dizziness, and shortness of breath that occurred in the morning. During the examination, the following is observed: the patient's condition is severe, her skin is pale, her limbs are cold. Pulse-150/min, of poor volume, blood pressure - 80/50 mm Hg. The heart sounds are weakened, arrhythmia is observed. ECG revealed missing P wave, f-waves, and varying RR intervals. What type of heart rhythm disorder has developed in the patient?
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A patient came to a doctor with complaints of enlarged cervical and axillary lymph nodes and heaviness in the left hypochondrium. During palpation, the lymph nodes are soft, painless, not fused together. Splenomegaly is observed. Complete blood count: leukocytes-70-109/L. lymphocytes -80%, Gumprecht shadows. What is the most likely diagnosis in this case?
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A 20-year-old patient came to a doctor with complaints of a rash that appeared on the skin. Objectively, on the skin of the trunk, arms, and the back of the neck, there is a macular rash with light brown spots 1-3 cm in size that in some places merge together. The results of Balzer test are positive. What is the most likely diagnosis in this case?
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Objectively, a 22-year-old patient has numerous non-inflammatory yellowish-brown and pale pink spots on the skin of the chest, neck, shoulders, and the sides of the torso. When the spots are scratched, the sign of shavings is observed. The disease onset was 2 years ago, the rashes were first noticed after a summer vacation by the sea. What is the most likely diagnosis in this case?
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