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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 patient has been hospitalized into the surgical department with clinical signs of hemorrhagic shock two hours after receiving a closed abdominal injury. During the surgery, a rupture of the spleen was diagnosed, the patient has up to 1.5 liters of liquid blood in the abdominal cavity. No damage to the hollow organs was detected. What type of transfusion must be provided in this case?
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A 27-year-old woman came to a doctor with complaints of enlarged lymph nodes on the right side of her neck and in the axillary region, night sweats, and a fever over 38°C. Morphological study of the biopsy material obtained from a lymph node detected Reed - Sternberg cells. What is the most likely diagnosis in this case?
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A 45-year-old patient complains of constant headache, pain in the heart and knee joints. Three years ago the patient was bitten by a tick and ring-shaped erythema appeared on the skin at the site of the bite. Objectively, the patient has acrodermatitis, bilateral pyramidal insufficiency, and coordination disorders. What is the most likely diagnosis in this case?
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A 5-year-old child had acute onset of the disease with a fever of 39.5°C, marked chills, weakness, lethargy, skin pallor, and headache. Eight hours later a hemorrhagic rash developed on the skin of the buttocks and legs. The child is sluggish, the body temperature has dropped, blood pressure - 80/40 mm Hg. respiratory rate-28-30/min, diuresis is decreased. What is the most likely diagnosis in this case?
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A 75-year-old complains of dyspnea at rest, marked weakness, and arrhythmia. Examination detected abdominal aortic pulsation and a systolic murmur observed distally. Palpation reveals a volumetric formation in the mesogastrium. Blood pressure 70/40 mm Hg. There is no pulsation over the femoral arteries. Oliguria is observed. What is the most likely diagnosis in this case?
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A 29-year-old woman complains of profuse bloody discharge from her genital tracts. She notes a three-month delay of menstruation. She has a history of one childbirth and one medical abortion. Vaginal examination detects a significant amount of hemorrhagic discharge with vesicles from the cervix, the body of the uterus is enlarged to 15-16 weeks of pregnancy, softened, painless. Both ovaries are enlarged, mobile, and painless. Chorionic gonadotropin in the blood - 200,000 units. What is the most likely diagnosis in this case?
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A 32-year-old woman complains of marked shortness of breath, dry cough, a fever of 39°C, and excessive sweating. Bacterioscopy of her sputum detected acid-fast bacteria [+]. Mantoux test with 2 tuberculin units resulted in a papule 21 mm in size. X-ray visualizes numerous symmetrically located focal shadows 1-2 mm in size in both lungs. The shadows are low-intensity and have blurry contours. What is the most likely diagnosis in this case?
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What food product can cause diphyllobotriasis, if insufficiently processed?
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A 12-year-old girl complains of high body temperature, muscle pain, and difficulty swallowing food. Objectively, the following is observed: periorbital edema with a pink-purple tint, pain and decreased muscle tone on palpation, capillaritis in the area of the finger pads and palms, expanded borders of the heart, muffled heart sounds, hepatosplenomegaly. Laboratory testing revealed increased levels of creatinine in blood and urine. What is the most likely diagnosis in this case?
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A 17-year-old girl complains of pain and swelling of the second finger on the right hand. She had a manicure done three days ago. The pain appeared on the second day. Objectively, the periungual ridge is edematous, hyperemic, overhangs the nail plate, painful during palpation. What is the most likely diagnosis in this case?
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A 28-year-old man without the permanent place of residence was hospitalized with the provisional diagnosis of influenza. On day 5 after the onset of the disease, a roscolar petechial rash appeared on his trunk and on the inner surfaces of the limbs. Objectively, the patient presents with the body temperature of 40°C, euphoria, facial hyperemia, redness of the sclera, tremor of the tongue, tachycardia, splenomegaly and agitation. What is the most likely diagnosis in this case?
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A 5-year-old child complains of attacks of spasmodic cough. The child has been ill for 2 weeks after the dry cough appeared. After the treatment that was ineffective, relapses started occurring. During a cough attack, the child's face becomes red and neck veins swell. Objectively, the patient is pale, with edematous face and hemorrhages in the sclera. Auscultation detects a bandbox resonance over the lungs on percussion and dry crackles. X-ray detects increased transparency of the lung fields and intensified bronchial pattern. Blood test results are as follows: leukocytes - 16 x 109/L, lymphocytes -72%, ESR - 4 mm/hour. What is the most likely diagnosis in this case?
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A 57-year-old man complains of a pain in his chest, dyspnea during physical exertion, excessive sweating, constant subfebrile body temperature, and cough that produces blood-streaked sputum. He has been smoking for approximately 40 years (2 packs a day) and says that he frequently has “pneumonias". Survey chest X-ray shows a triangular shadow in the middle lobe of the right lung. One of the apices of the shadow points towards the lung root. Cardiac and mediastinal shadows are displaced towards the affected area. What is the most likely diagnosis in this case?
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A 17-year-old patient objectively presents with no facial hair growth, gynecomastia, fat deposition on the hips, and a high-pitched voice. The patient is tall due to elongated lower limbs with a relatively short torso. Mental retardation is noted. Sex chromatin was detected in the buccal epithelium. What is the most likely diagnosis in this case?
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Six hours after fibroesophagogastroscopy, a 32-year-old woman developed a fever of 39°C, retrosternal pain, dry mouth, and increasing dyspnea. Examination detected positive Romanov-Gerke sign and subcutaneous emphysema in the left supraclavicular space. What is the most likely diagnosis in this case?
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A 27-year-old woman complains of pain and morning stiffness in the small joints of her hands. Her condition is weather-dependent. Objectively, she presents with swelling and deformation of her proximal interphalangeal joints and her second and third metacarpophalangeal joints. X-ray of the hands detects bone erosions (usurations) and signs of osteoporosis. What is the most likely diagnosis in this case?
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A study was conducted to establish the connection between obesity and myocardial infarction in nurses. For several years, the frequency of new cases of myocardial infarction in the groups and changes in body mass index were recorded and compared. What type of epidemiological study was used?
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A man complains of unbearable cough with putrid-smelling chocolate-colored purulent sputum. The discharge of sputum reaches 600 mL. per 24 hours. The patient's history states that the disease onset was acute, with irregular fever and the body temperature reaching 39°C. X-ray shows a shadowed area with a cavity in its center that has irregular contours and a fluid level. What is the most likely diagnosis in this case?
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A 19-year-old girl complains of weakness, moderate headache, and sore throat when swallowing. She has been ill for 3 days already. Objectively, her body temperature is 38.2°C. Generalized lymphadenopathy, signs of tonsillopharyngitis, and moderate hepatosplenomegaly are observed. Complete blood count detected 35% of atypical mononuclear cells. What study should she be referred for, to verify the diagnosis?
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A 47-year-old patient complains of pain in the lumbar region. The patient was provisionally diagnosed with radiculitis and a course of physiotherapy was carried out. However, the patient's condition did not improve. X-ray of the spine and pelvis revealed osteoporosis and significant bone defects. Complete blood count revealed normochromic anemia and total protein of 107 g/L. General urinalysis revealed proteinuria of 4.0 g/L. What study is necessary to establish the final diagnosis in this case?
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A 62-year-old woman undergoes treatment for bilateral gonarthrosis and has been regularly taking diclofenac sodium for 2 years. During the last six months she notes elevations of her blood pressure to 160/100 mm Hg. X-ray of the knee joints shows decreased height of the inter-articular space, marginal growths on the articular surfaces, and epiphyseal osteoporosis. General urinalysis shows the following specific gravity - 1010, erythrocytes-5-6 in sight, leukocytes - 10-12 in sight, casts (cylinders)-0-1 in sight, glucose-not detected, protein - 0.22 g/L. Fasting plasma glucose - 63 mmol/L What is the most likely cause of the changes observed in the general urinalysis?
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A military medical committee detected arterial hypertension in a 17-year-old boy - his blood pressure on the arms is 190/110 mm Hg. He has no complaints. A disproportionate body structure is observed a well-developed shoulder girdle and underdeveloped legs. What study would be most informative in this case and should be used to est establish the diagnosis?
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Examination of pork detected 2 trichinella in 24 sections on the compressorium. What should be done with this meat?
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A 63-year-old woman for the last 5 weeks presents with progressing painless jaundice, skin itching, weight loss of 10 kg, and acholia. Positive Courvoisier sign was detected during palpation. What is the most likely diagnosis in this case?
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A 19-year-old patient developed persistent macrohematuria, dyspnea, and hemoptysis after a case of acute respiratory viral infection. Chest X-ray shows signs of bí lateral disseminated damage. Within 2 weeks, the patient's condition sharply deteriorated, creatinine levels increased to 327 mmol/L. What is the most likely diagnosis in this case?
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A 38-year-old man complains of cough with purulent sputum (up to 60-80 mL per day) and a fever of 39°C. He associates his condition with overexposure to cold. Objectively, his pulse is 96/min., rhythmic. Blood pressure-110/60 mm Hg. Examination revealed that the right side was lagging behind in the process of breathing. Respiratory rate- 30/min. Percussion detects local dullness of the sound near the angle of the scapula. Auscultation detects heterogeneous wet crackles and amphoric breathing. What is the most likely diagnosis in this case?
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A neonatologist examines a full-term baby born from the second pregnancy, second full-term delivery, with the body weight of 3980 g. During the delivery, primary weakness of the labor activity was observed and obstetric assistance was used. Objectively, the right hand is adducted to the trunk and rotated, there are no movements in the shoulder and elbow joints, the "doll's arm" sign is observed, the hand is in the position of palmar flexion. The baby breastfeeds suckles actively. What is the most likely diagnosis in this case?
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Chemical analysis of the water has detected increased concentration of nitrogen-containing salts, iron and sulfates. What parameter of water quality is most informative in such cases and indicates fresh contamination of water with organic substances of animal origin?
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A 27-year-old woman at 17 weeks of her pregnancy has been hospitalized for treatment. She has a history of two spontaneous miscarriages. Bimanual examination reveals that her uterus is enlarged to 17 weeks of pregnancy, the cervix is shortened, and the opening allows inserting a fingertip. The woman was diagnosed with cervico-isthmic insufficiency. Specify the further tactics of managing this patient.
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A 29-year-old woman complains of infertility and an oligomenorrhea type of abnormal menstrual cycle. Objectively, she has the height of 160 cm and the body weight of 91 kg, growth of hair is observed on her face and thighs. Bimanual examination detects enlarged dense ovaries 5x6 cm in size on both sides. These data were confirmed by ultrasound. What is the most likely diagnosis in this case?
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