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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 20-year-old patient took 50 sleeping pills, attempting to commit suicide. Objectively, the patient's condition is severe, the pupils are dilated and unresponsive to light. The patient's breathing is hoarse, noisy at a distance, respiratory rate 48/min, auxiliary muscles are involved in the act of breathing. Marked cyanosis is observed. Auscultation detects numerous wet crackles in the lungs. Pulse 126/min, shallow, blood pressure 85/45 mm Hg. What aid must be provided to the patient first?
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A 27-year-old patient complains of irregular menstruation with delays of 2-3 months, significant body weight gain, hirsutism. She has been married for the last 5 years and had no pregnancies. Vaginal examination shows that the uterus is under 4 cm in size, on both sides there are dense mobile ovaries 4-5 cm in size that are painless during palpation. Ultrasound detects bilateral enlargement of the ovaries to 10.5 cm³, thickening of the ovarian capsule, and 8 immature follicles 5-6 mm in diameter, located on the periphery like a "necklace". What is the most likely diagnosis in this case?
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A 28-year-old woman has been hospitalized with complaints of dizziness, bloody discharge from her genital tract, and pain that suddenly appeared in her lower abdomen and radiates into the anal region. According to the patient's medical history, the delay of menstruation is 4 weeks. Signs of peritoneal irritation are positive. During bimanual examination, the uterus and its appendages are sharply painful and cannot be clearly outlined. "Fluctuating uterus sign" and protrusion and tenderness of the posterior fornix are observed. Body temperature 36.7°C. Blood test results: hemoglobin 82 g/L, erythrocytes 2.8-1012/L. What is the most likely diagnosis in this case?
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A 25-year-old patient complains of general weakness, low appetite, heaviness and pain in the right hypochondrium, nausea, and dark urine. According to the patient's medical history, the patient was undergoing outpatient treatment for an acute respiratory viral infection for 3 days. Objectively, icteric sclerae, vesicular respiration, and rhythmic heart sounds are observed. The abdomen is soft and painful in the right hypochondrium. Hepatomegaly is observed. What is the most likely diagnosis in this case?
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A 32-year-old woman complains of redness, burning, and sensation of a foreign body in her right eye. The disease onset was sudden.Objectively, visual acuity of the right and left eye = 10, In the right eye, hyperemia and edema of the conjunctiva, surface injection, and purulent discharge in the conjunctival sac are observed. The cornea is transparent, the color and pattern of the iris are unchanged, the pupil is mobile. What is the most likely diagnosis in this case?
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An 89-year-old patient complains of dry hacking cough that occurs mainly in the morning. He has history of ischemic heart disease, stable angina pectoris, functional class II, and essential hypertension, stage 2, degree 2. The patient constantly takes lisinopril, bisoprolol, aspirin, and rosuvastatin. What drug has caused the cough in the patient?
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A 40-year-old woman complains of white watery discharge and periodic contact-provoked bleeding from the vagina, observed over the last three months. She has history of childbirth complicated by cervical rupture. Examination of the cervix in the mirrors shows that the cervix is hypertrophied and has ulcerated areas that are easily injured and start bleeding when touched. What is the most likely diagnosis in this case?
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The parents of a 6-year-old girl complain that their child has rhinitis, conjunctivitis, pertussis-like cough, and subfebrile body temperature. Chest X-ray shows small focal infiltration shadows. Blood test detects monocytosis and IgM to Chlamydophila pneumoniae. What group of antibiotics should be used in this case?
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A 37-year-old patient complains of throbbing headache in the frontal region, frequent episodes of nausea, palpitations, and elevated blood pressure of 240/140 mm Hg. According to the patient's medical history, two days ago she experienced an episode of debilitating headache, palpitations, pulsation of blood vessels, dyspnea, and fear of approaching death. At that time, her face became pale and her hands and feet became sweaty. After examination, elevated levels of metanephrines were detected in the patient's urine. What is the most likely diagnosis in this case?
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A 5-year-old boy had an acute onset of the disease with fever of 38.2 and harsh dry cough. Objectively, his condition is moderately severe. Percussion produces a clear pulmonary sound. Auscultation detects harsh respiration and scattered dry and moderate vesicular crackles on both sides. What is the most likely diagnosis in this case?
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A 29-year-old woman with the gestation period of 39-40 weeks was hospitalized into a maternity hospital with vaginal bleeding and sharp abdominal pain that started one hour ago. Objectively, her blood pressure is 180/100 mm Hg. The fetal heart rate cannot be auscultated. Vaginal examination detects hemorrhagic discharge with blood clots. The cervix is smoothed out and fully open. The amniotic sac is intact and constantly tense. The baby is in cephalic presentation, with the large segment directed towards the entrance into the lesser pelvis. The placental tissue cannot be detected. What is the most likely diagnosis in this case?
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Throughout the working day, a worker was performing electric welding (joining metal constructions). Because of poor lighting in the welding area and because he was working in an uncomfortable position, the worker was not using his protective screen and mask. A few hours later, the worker developed complaints of "sand in the eyes", pain, burning, lachrymation, and photophobia. What occupational factor could have caused these symptoms?
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A 21-year-old patient complains of an itchy rash that appeared in the morning. The rash consisted of small blisters that disappeared after a few hours, leaving spots. According to the patient's history, the day before she was staying for a long time outdoors, among flowering plants. Objectively, her general condition is satisfactory, erythematous spots with infiltration can be visualized in the area of her forehead, eyes, upper and lower limbs. What is the most likely diagnosis in this case?
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A 64-year-old man complains of the absence of urination during the last 12 hours. Objectively, a painful mass is palpable above the pubis, the upper edge of the mass reaches the navel. Rectal examination detects an enlarged prostate. The prostate is painless, lumpy and has a stone-like density. Blood levels of prostate-specific antigen are 24.2 ng/ml. What is the cause of the acute urinary retention in this case?
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A 5-year-old boy has been hospitalized unconscious. According to his parents, the child has a 2-year-long history of severe decompensated type 1 diabetes mellitus. Objectively, the skin is dry, its turgor is reduced, there is a smell of acetones from the oral cavity, Kussmaul breathing is observed. Blood pressure 100/60 mm Hg, heart rate 100/min. Blood glucose 16.4 mmol/L. What type of coma has developed in the child?
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A 44-year-old patient complains of chest pain on the right, shortness of breath, and cough with expectoration of a large amount of purulent sputum. Objectively, the following is observed: heart rate 116/min, body temperature 39.8°C, cyanosis of the skin, the right half of the chest lagging behind in the act of breathing, dull percussion sound, and weakened breathing on the right. Chest X-ray reveals homogeneous darkening of the right half of the chest. What is the most likely diagnosis in this case?
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After the birth of twins, the postparturient woman developed a massive hemorrhage from the natural birth canal. The placenta and birth canal are intact. The uterine fundus is located above the navel, the uterus is soft to palpation and does not respond to the administration of uterotonics. What is the most likely cause of the bleeding in this case?
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Pinkish-red round nodules up to 7 mm in diameter can be visualized on the back surface of both hands of a 37-year-old patient. The nodules have silvery scales in their center and are not accompanied by subjective sensations. Scraping reveals such symptoms as "stearin drop", "terminal film", and "blood dew" (in the order of their reveal). What is the most likely diagnosis in this case?
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A 53-year-old patient complains of shortness of breath during moderate physical exertion and cough with expectoration of a small amount of mucous or mucopurulent sputum. According to the patient's medical history, she has been smoking since the age of 15, as an adult she usually smokes 1 pack per day. She notes deterioration of her condition 3-4 times a year, which requires prescription of antibiotics. Objectively, the following is observed: body temperature 36.4°C, respiratory rate 20/min, pulse 78/min, blood pressure 130/85 mm Hg, the patient is hypersthenic. Percussion produces a bandbox sound over the lungs. Auscultation detects harsh and mildly weakened respiration and scattered dry crackles, the heart sounds are muffled and rhythmic. No pathology was detected in organs of the abdominal cavity. What is the most likely diagnosis in this case?
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After spending her vacation at the seaside, a 25-year-old woman developed complaints of weakness, myalgia, fever of 38.5°C, and pain and edema in her radiocarpal and elbow joints. Objectively, she has an erythematous rash on her cheeks and nasal dorsum and ulcers on her oral mucosa. Serological testing detects an increase in the titers of anti-nuclear antibodies to native DNA. What is the most likely diagnosis in this case?
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A 65-year-old woman suddenly developed a severe episode of dyspnea after physical exertion (quickly climbing the stairs). She has history of a myocardial infarction that occurred 8 years ago. Objectively, the following is observed: heart rate 112/min, blood pressure 170/110 mm Hg, respiratory rate 25/min. Auscultation detects arrhythmic cardiac activity, frequent extrasystole, severely weakened heart sounds, systolic murmur at the apex, weakened respiration and wet non-homogeneous crackles in the lower segments. What treatment regimen would be optimal in this case?
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A 42-year-old patient has been hospitalized into the trauma department of a hospital. X-ray reveals a pelvic fracture. Objectively, unassisted urination is not possible, urethrorrhagia is observed. Palpation detects an enlarged bladder and a painful swelling in the perineal region. What is the provisional diagnosis in this case?
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A 30-year-old pregnant woman complains of pain in her lower abdomen and mild bloody discharge from the genital tract, observed over the first 3 hours. Her last menstruation was 3 months ago. Vaginal examination detects the body of the uterus enlarged to 16 weeks of pregnancy, the external os allows inserting a fingertip, the discharge is bloody, in a small amount, contains small bubbles. Ultrasound shows a "snowstorm pattern" in the uterine cavity. What is the most likely diagnosis in this case?
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A 15-year-old girl complains of the absence of menstruations. Objectively, she has a short stature, a short neck with vertical skin folds on both sides, deformed auricles, and a low line of hair growth on her neck. Her chest is barrel-shaped, her elbow joints are deformed. There are multiple pigment spots on the skin of her torso and limbs. Her mammary glands are absent and the nipples are underdeveloped. Her intelligence is not impaired. There are no Barr bodies in the cells of her buccal epithelium. What is the most likely diagnosis in this case?
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A 40-year-old patient complains of severe expiratory dyspnea and dry cough. Objectively, he is in a forced position - he sits with his hands pressed to the edge of the chair for support. Palpation detects weakened vesicular respiration over the entire surface of the lungs and dry wheezes What is the most likely diagnosis in this case?
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A 24-year-old woman has been hospitalized with complaints of fever of 39.2°C and pain in her lower abdominal segments. Objectively, pulse 102/min, blood pressure 120/70 mm Hg. The abdomen is moderately distended and sharply painful during palpation in the hypogastric region. During bimanual examination, the uterus and its appendages are not palpable because of tension of the anterior abdominal wall, the posterior fornix overhangs and is sharply painful. What is the most likely diagnosis in this case?
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An 8-year-old boy has a circular spot under 1.0 cm in diameter on his scalp. Objectively, the skin in the area of the spot is pink and covered in small flour-like scales, the hair there is broken at the height of 4-5 mm from the skin surface. The patient feels no subjective sensations there. His sister has a similar spot. What is the most likely diagnosis in this case?
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A 54-year-old patient complains of heaviness in the right hypochondrium, yellowing of the skin and sclera, dark urine and colorless stools. According to the patient's medical history, the jaundice has been persisting for the last 3 weeks and before that the patient was noting general weakness. Objectively, the patient's condition is satisfactory, the skin and sclerae are icteric. The abdomen is soft, an enlarged painless gallbladder can be palpated in the right hypochondrium. There are no signs of peritoneal irritation. What is the most likely diagnosis in this case?
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A 20-year-old patient complains of a rash in the area of his hands, trunk, buttocks, and penis. The rash is accompanied by intense itching, especially in the evening and at night. According to the patient's medical history, he fell ill one week ago and he lives in a dormitory. Objectively, paired papules and vesicles are localized on the skin of the patient's hands, trunk, buttocks, and penis. What is the most likely diagnosis in this case?
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A 54-year-old man has been hospitalized with complaints of general weakness,fever of 38.6 shortness of breath during significant physical exertion, and frequent nosebleeds. He works in production of plastics, where he comes into contact with aromatic compounds. Objectively, his skin is pale and dry. Complete blood count: erythrocytes 2.11012/L, hemoglobin 90 g/L, leukocytes 2.2109/L, eosinophils 1%, band neutrophils 1%, segmented neutrophils 75%, lymphocytes 20%, myelocytes 3%, platelets 30*109/L, ESR 32 mm/hours. What is the most likely diagnosis in this case?
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A 45-year-old woman complains of constant pain in her right iliac region and frequent urination. According to the patient's history, the disease onset was 12 hours ago. First she felt nausea and pain in her epigastric region. Five hours later the pain moved into the right iliac region. Objectively, the patient's condition is moderately severe, she lies on her right side with the legs pulled up to the stomach, body temperature 37.9°C. The abdomen is symmetrical and not distended. During palpation there is tension and pain in the right iliac region. Rovsing, Blumberg and Rosenstein (Sitkovsky) signs are positive. Rectal examination detects pain when pressing on the front wall of the rectum. What is the most likely diagnosis in this case?
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A 28-year-old patient complains of periodic palpitation attacks. Objectively, the following is observed: blood pressure 130/80 mm Hg, pulse 65/min, the heart sounds are unchanged. ECG shows shortening of the P-Q interval, an additional excitation wave appearing in the QRS complex, deformation of the QRS complex, and a negative P wave. What is the most likely diagnosis in this case?
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A 28-year-old woman complains of infertility, observed for the last three years. She has history of gonorrhoea. Objectively, the development of her genitals is normal. Her basal temperature, observed for three cycles, is biphasic. What is the most likely cause of the infertility in this case?
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A 72-year-old patient complains of a rash, intense pain in her right subscapular region, general weakness, and fever of 37.7°C. According to the patient's medical history, the disease onset was three days ago. Objectively, grouped vesicles with transparent contents, arranged in a line, can be detected in the right subscapular region on hyperemic, slightly infiltrated skin. What is the most likely diagnosis in this case?
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A 13-year-old boy suddenly lost his consciousness and developed generalized tonic-clonic seizures. Objectively, he presents with dilated pupils, no photoresponses, marked cyanosis of the face, biting of the tongue, white foam from the mouth, involuntary urination and defecation. According to the patient's medical history, such attacks occur from the age of three several times a year, the child constantly takes sedatives and anticonvulsants. What drug must be administered in this case?
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After a fall, a 65-year-old woman complains of pain in her hip joint during movements and inability to rest her full weight on this limb. Objectively, the pain intensifies during palpation, the limb is rotated outwards and shortened. "Stuck heel sign" is positive - the patient is unable to raise her straight leg and hold it in this position, the heel slides on the floor when bending the leg. What is the most likely diagnosis in this case?
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A 6-year-old child complains of a headache, weakness, and pain during chewing. Objectively, bilateral enlargement of the salivary glands is observed. The enlarged glands are located in the retromandibular fossa. The skin over the glands is tense, glossy, and normal-colored. Body temperature 39°C. The oral mucosa is dry, the external opening of the salivary gland duct is edematous. What is the most likely diagnosis in this case?
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A 25-year-old woman complains of general weakness, drowsiness , reduced ability to work , dizziness, difficulty swallowing food, dry skin and visible mucosa are pale, the nails are brittle and transversely striate. What nutrient is deficient in this case causing this condition in the patient?
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A 53-year-old woman complains of nausea, vomiting bile, and acute pain in the right hypochondrium. The pain occurred 2 hours after a dinner. According to the patient's history, the symptoms appeared 18 hours ago. Objectively, the patient is agitated and fidgets in the bed, pulse 98/min, the tongue is moist and coated with white deposits. Body temperature 38.2°C. Palpation detects that the right half of the chest lags behind of breathing, muscle tension and tenderness can be observed in the right hypochondrium. Phrenicus symptom and Grekov-Ortner sign are positive. Signs of peritoneal irritation are negative. What is the most likely diagnosis in this case?
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A 35-year-old patient developed general anxiety, brief agitation, dyspnea, and pain behind the sternum and in the lumbar region during the transfusion of 400 ml of packed erythrocytes. Objectively, the following is observed: cyanosis of the skin and mucosa, tachycardia110/min, blood pressure 90/40 mm Hg. What is the most likely diagnosis in this case?
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