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KROK 2 Medicine 2025 Questions | KROKEXAM
Browse 2025 KROK 2 Medicine exam questions with answers and explanations.
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A 52-year-old patient complains of mixed-type dyspnea and chronic cough with the expectoration of a large amount of foul-smelling mucopurulent sputum, sometimes with blood, that occurs mostly in the morning as a "full mouth." He has a history of frequent exacerbations of chronic bronchitis. Objectively, he has acrocyanosis and clubbed "drumstick" fingers. Respiratory rate - 22/min. Auscultation detects harsh breathing, fine and medium bubbling crackles can be heard in the lower lung segments on both sides. Spiral computed tomography of the chest detects areas of carnification, thin-walled cavities, and cylindrical dilatations of the bronchi. What is the most likely diagnosis in this case?
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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, increased tendon reflexes, foot clonus, pathological reflexes, no abdominal reflexes, ataxia during the Romberg test, and intention 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 36-year-old patient has a radiologically confirmed fracture of both bones in the left lower leg at the level of the middle third of the diaphysis, Objectively, the following is observed: tense edema of soft tissues, decreased sensitivity of the skin below the fracture site, and decreased peripheral pulsation on the dorsalis pedis artery. What additional test should be performed in this case to confirm the existing complication?
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A 10-year-old boy complains of muscle pain and difficulty climbing stairs and getting dressed. According to the patient's history, the complaints first arose 4 months ago, but lately he has developed intensified muscle pain, low appetite, and difficulty swallowing. Objectively, facial edema, purple periorbital erythema, and desquamation of the skin of the abdomen and torso are observed. What is the most likely diagnosis in this case?
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A 5-year-old girl has been hospitalized with an electrical injury. Objectively, the child's condition is extremely severe, she is unconscious and incapable of unassisted breathing. During cardiopulmonary resuscitation, ECG shows waves of varying shape and amplitude with the rate of 320/min. There is no pulse on the peripheral vessels and central arteries. What first aid must be provided in this case?
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A 49-year-old patient has been diagnosed with a fracture of the pelvic bones. A bladder injury is suspected. What method of examination is necessary in this case?
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A 43-year-old patient complains of watery diarrhea that occurs up to 10 times a day, cramping abdominal pain, and fever. The patient has history of recent antibiotic therapy (clindamycin and tobramycin) for pancreonecrosis. Blood test detects leukocytosis. What is the most likely diagnosis in this case?
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A 36-year-old patient was hospitalized on the seventh day after the onset of the disease with complaints of marked weakness, fever, headache, and pain in the calf muscles. Objectively, the skin and sclera are icteric, a hemorrhagic rash is observed on the skin. Diuresis 200 ml. According to the patient's history, the patient went fishing 2 weeks ago. What is the most likely diagnosis in this case?
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A 12-year-old girl complains of general weakness, rapid fatigability, and intense periodical pain in her upper abdomen. The pain occurs immediately after eating or 15-20 minutes later. Periodically, she develops pain at night, sour eructation, and vomiting with just eaten food. According to the patient's medical history, she has been suffering from chronic gastritis for the past 3 years. The patient's father has a long history of peptic ulcer disease of the duodenum. Objectively, the patient's skin is pale, the tongue has a white coating, the abdomen is soft and painful in the epigastrium during palpation. Mendel's sign is positive. 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 the 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. There is a purulent plaque on the tonsils. What disease has developed in the child?
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A 25-year-old patient complains of headache, an elevated body temperature, and a rash. According to the patient's medical history, three weeks ago he had a case of an acute respiratory viral infection. Objectively, the following is observed: petechial rash located symmetrically on the body, mainly on the legs and buttocks, body temperature 37.4°C, blood pressure 110/80 mm Hg. Complete blood count: erythrocytes 3.21012/L, hemoglobin 110 g/L, color index 0.9, platelets 100109/L, leukocytes 8.7*109/L, eosinophils 4%, basophils 0%, band neutrophils 7%, segmented neutrophils 56%, lymphocytes 26%, monocytes 7%, ESR 17 mm/hour. What is the most likely diagnosis in this case?
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A 34-year-old woman came to a doctor with complaints of muscle weakness, thirst, increased urination at night, paresthesias, and seizure attacks. Objectively her general condition is satisfactory, her face and legs are doughy, her pulse is 80/min, her blood pressure is 200/110 mm Hg, the second heart sound is accentuated over the aorta. Complete blood count: K 3.1 mmol/L, Na 165 mmol/L, ECG shows inversion of T waves and depression of S-T segments. Ultrasound detects hyperplasia of the right adrenal gland. What is the provisional diagnosis in this case?
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A 32-year-old man was injured as a result of a blow to the head. He did not lose his consciousness. The next day, his consciousness became disturbed - 10 points at the Glasgow Coma Scale. During examination he presents with right-sided hemiparesis and paralytic mydriasis on the right. The CT scan of the brain detects an intracranial hemorrhage in the shape of a biconvex lens in his left frontotemporal region. What is the most likely diagnosis in this case?
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A 42-year-old woman complains of general weakness and producing bloody discharges at the end of an act of defecation. Examination with a rectal speculum detects soft, painless, dark cherry-red protrusions with an eroded surface in the anal canal. What is the most likely diagnosis in this case?
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Clinical examination of a man, who works as a driver, detects elevated levels of calcium salts of phosphoric acid in his urine. His diet includes rye and wheat bread, pasta, butter, oil, mashed potatoes, milk, cheese, coffee, tea, rosehip tea, and currant jelly. The energy value of the patient's diet matches his energy expenditure. What products should the patient limit in his diet?
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An 18-year-old patient complains of pain in her lower abdomen, fever of 37.5°C, a significant amount of mucopurulent discharge being produced from her genital tract, and burning pain during urination. Mirror examination and vaginal examination reveal an infiltrated urethra and hyperemic and eroded cervix. The uterus is painful to palpation, the appendages are painful and thickened, the fornices are free. Bacterioscopy of the discharge detects diplococci. What is the most likely diagnosis in this case?
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A 20-year-old woman complains of fever of 39°C, headache in the frontal region, pain in the eyes, photosensitivity, muscle pain, and dry cough. According to the patient's medical history, she became acutely ill the day before. Objectively, her condition is severe, her face is hyperemic, her eyes are shiny, with injected sclerae. Pulse 96/min, rhythmic. Heart sounds are muffled. Scattered dry crackles can be heard in the lungs. The oropharyngeal mucosa is hyperemic, granular, with dilated vessels. There are no meningeal symptoms. Complete blood count: leukocytes - 13.0*109/L, eosinophils - 1%, band neutrophils - 6%, segmented neutrophils - 51%, lymphocytes - 35%, monocytes - 7%. What is the most likely diagnosis in this case?
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A 26-year-old patient complains of inability to open his mouth, fever of 40°C, and sharp pain in the throat on the right. The pain radiates to the left ear. Objectively, noticeable trismus of the masticatory muscles and asymmetry of the right side are observed. The left palatine tonsil is hyperemic and displaced towards the middle of the oropharynx, the uvula is displaced to the left. Infiltration, bad breath, and hypersalivation are observed. Retromandibular lymph nodes on the right are enlarged and painful during palpation. Rhinoscopic and otoscopic presentations are normal. What is the most likely diagnosis in this case?
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A 36-year-old patient developed an attack of acute arthritis in the metatarsophalangeal joint of the right foot after drinking alcohol and eating fatty food the night before. Objectively, the first toe of the right foot is edematous, the skin there is cyanotic and hot to the touch. Complete blood count: leukocytes - 12 - 10°/L. left shift, ESR- 42 mm/hour. What drug should be prescribed first in this case?
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A 28-year-old patient complains of a pustular rash on the skin of both his shoulders, fever of 38.5°C, and feeling unwell. According to the patient's medical history, the disease onset was three days ago, after he received skin abrasions from wearing a knapsack. Objectively, the skin in the area of both his forearms is hyperemic and edematous. There are multiple small foci of superficial pustular papular rash elements. Bacteriological testing of the contents of the papules detects Staphylococcus aureus. What is the most likely diagnosis in this case?
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A trial was conducted to study the effectiveness of arterial hypertension treatment using a new drug, compared with traditional therapy. There were 3,000 participants in the trial, divided into two identical groups, taking into account their age, sex, stage of the disease, etc. One group was receiving treatment with the new drug, while the other was receiving traditional therapy and was the control group. The trial participants did not know which therapy they were receiving. What type of trial was conducted in this case?
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Several chemical substances enter the human body from atmospheric air. What is the type of joint action, where the overall effect on the human body is more than the sum of the individual effects of each separate substance included in the combination?
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45-year-old patient complains of cramping abdominal pain, tenesmus, and frequent liquid stools with blood. The disease onset was 5 years ago. Objectively, the following is observed: body temperature 37.5°C, blood pressure 110/60 mm Hg, pulse - 98/min, the abdomen is soft, painful during palpation along the course of the large intestine. Irrigography results: the large intestine is narrowed, the haustra are absent, the contours are uneven and indistinct. Complete blood count: erythrocytes 3.2 * 1012/L, hemoglobin 110 g/L, color index 0.85, leukocytes 8.1 * 109/L, band neutrophils - 5%, lymphocytes 30%, monocytes 3%, eosinophils 3%, segmented neutrophils 59%, ESR 24 mm/hour. Fecal calprotectin - 95 units. What drug must be prescribed first in this case?
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A 27-year-old woman complains of frequent and painful urination over the course of the last 3 months. Urinalysis detects significant leukocyturia. The patient has no history of other urologic diseases. What test should the patient undergo first?
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A 14-year-old patient complains of pain that occurs on an empty stomach and at night, nausea, and constipations observed over the last year. Endoscopy detects erosive bulbitis and increased secretory function of the stomach. What type of drug should be included in the complex treatment as an antisecretory agent?
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A 24-year-old woman with the gestation term of 18-19 weeks was hospitalized into the gynecological department of a hospital because of isthmic-cervical insufficiency diagnosed during an ultrasound scan. Examination shows that the cervix is shortened to 1.5 cm, the epithelium is without pathological changes, the cervical canal allows inserting one finger. The amniotic sac is intact, the uterus is enlarged to 18-19 weeks of pregnancy and normotonic. What aid must be provided for the pregnant woman?
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A 44-year-old woman complains of generally feeling unwell, chills, fever of 39°C, constant burning pain, skin redness, and edema in the area of her left lower leg. She associates the onset of the disease 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 that is 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 the microtrauma of the left lower leg is observed in the patient?
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A 2-year-old child has abdominal distension and constipations. According to the patient's medical history, these symptoms first appeared at the age of nine months. Irrigography detects a narrowed area in the distal segments of the large intestine with a funnel-shaped narrowing. like transition into a suprastenotic expansion, What is the most likely diagnosis in this case?
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A 35-year-old woman, gravida 1, is at 39 weeks of her full-term pregnancy. The duration of the second stage of labor is 1.5 hours. Objectively, the dimensions of the pelvis are 26-29-32-20, the expected weight of the fetus - 4400 g, contractions are active, the fetus is in a cephalic presentation with the head pressed to the entrance to the lesser pelvis, Henkel-Vasten sign is positive. The fetal heart rate is 118-126/min, sonorous, rhythmic. Vaginal examination detects complete opening of the cervix, the head is one finger-width in the lesser pelvis, severe caput succedaneum and edema of the vulva are observed. What complication has occurred during the childbirth?
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A 38-year-old woman complains of a pustular rash on her body progressive growth of hair on her body and face and constant headache. Objectively, the following is observed: height - 164 cm, body weight - 102 kg, uneven distribution of adipose tissue - mainly on the stomach, trunk, and face, hypotrophy of the muscles of the buttocks and thighs. Blood pressure 205/110 mm Hg pulse — 105/min. Blood test: glucose 11 mmol/L, sodium - 155 mmol/L, potassium 3.7 mmol/L, total cholesterol - 6.5 mmol/L. Blood cortisol in the morning- 720 nmol/L,ACTH - 87 pg/mL. What is the most likely diagnosis in this case?
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An 18-year-old patient complains of liquid foul-smelling discharge from her vagina, discomfort during sexual life. Her menstrual cycle is irregular. Examination of the external genitalia detects hyperemia and edema of the vulva. Examination in the mirrors shows that the vaginal mucosa is hyperemic, the cervix is clean, the discharge is profuse and foamy. What is the most likely diagnosis in this case?
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A 17-year-old patient complains of headache, sore throat, and fever. According to the patient's medical history, the onset of the disease was 2 days ago. Objectively, the patient's condition is severe, body temperature 38°C. The oropharyngeal mucosa is moderately hyperemic and edematous. Filmy deposits that are difficult to are observed on the tonsils, palate, and uvula. Palpation detects enlarged submandibular lymph nodes and edematous subcutaneous tissue on the neck. What is the most likely diagnosis in this case?
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A 53-year-old patient complains of weakness, lack of appetite, weight loss, and an increased body temperature. Objectively, hepatomegaly and lymphadenopathy with doughy lymph nodes are observed. Complete blood count: erythrocytes - 4.01012/L, hemoglobin - 110 g/L, leukocytes - 100-110109/L, basophils - 1%, eosinophils - 1%, band neutrophils - 1%, segmented neutrophils - 50%, lymphocytes - 47%, monocytes 2%,73%, Gumprecht shadows . What is the most likely diagnosis in this case?
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On the second day after a total thyroi-dectomy, a 56-year-old woman developed severe agitation, fear of death, hand tremor nausea, vomiting, diarrhea , and fever, Objectively, the following is observed; hot and moist skin, profuse sweating, acute muscle weakness, adynamia, dry tongue and lips, body temperature - 40°C,Heart rate increases from 60-70/min to 130-220/min. Blood pressure - 210/70 mm Hg. Auscultation detects intensified and arrhythmic heart sounds, systolic murmur can be heard at the apex and in the Botkin-Erb's point. ECG shows a non-sinusoidal irregular rhythm and atrial fibrillation, the ventricular contraction rate is 140-160-220/min. What is the most likely diagnosis in this case?
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A 60-year-old woman suddenly developed dyspnea on the third day after a venectomy due to thrombophlebitis of the subcutaneous veins. Her skin first became markedly cyanotic and then ash-colored. Marked psychomotor agitation, tachypnea, and retrosternal pain are observed in the patient. What complication of the postoperative period has occurred in this case?
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A 42-year-old woman lost her consciousness after physical overexertion. Her blood pressure dropped to 40/20 mm Hg. She has a history of long-term (5 years) use of glucocorticoids because she has bronchial asthma. She has not been taking glucocorticoids for the last 4 days. Objectively, she is inert, her skin is of normal color and normal moisture level. Auscultation detects muffled heart sounds, heart rate 100/min, of poor volume, rhythmic. Blood test: glucose 3.0 mmol/L, sodium 117 mmol/L, potassium 6.0 mmol/L. What is the most likely diagnosis in this case?
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A 28-year-old woman at 36 weeks of her pregnancy complains of headache, nausea, vomiting, and pain in the right hypochondrium. Objectively, the following is observed: skin pallor icteric mucosa , the blood pressure of 160/100 mm Hg on both hands, edema of the legs and anterior abdominal wall, hemorrhages at the injection sites. Palpation detects sharp pain in the epigastric region and an enlarged liver. Blood test results: elevated ALT and AST levels, thrombocytopenia, hemoglobin-85g/L, hyperbilirubinemia. What complication has developed in the pregnant woman?
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During the hygienic assessment of the microclimate in a classroom, the results were as follows: average temperature in the classroom – +17°C, horizontal temperature distribution on – 3°C, vertical temperature distribution – 2°C, 24-hour fluctuation – 6°C, dry-bulb temperature – +17°C, wet-bulb temperature – +14°C, atmospheric air pressure – 745 mm Hg, air velocity – 0.3 m/s. Make the hygienic assessment of the microclimate in the classroom.
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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 45-year-old patient complains of general weakness, headache, impaired memory, decreased appetite, enlarged tongue, dull abdominal pain, constipation, and hair loss. He has history of chronic gastritis type A alcoholism, and essential hypertension Objectively, the following is observed: cold and dry skin, edematous face, blood pressure - 140/80 mm Hg, pulse 62/min, body temperature - 36.2°
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