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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 64-year-old man is undergoing outpatient treatment for ischemic heart disease, diffuse cardiosclerosis, persistent atrial fibrillation, and functional class III heart failure. The pharmacotherapy consists of amiodarone twice a day, torasemide every other day, and trimetazidine twice a day. The family physician recommended taking warfarin 3mg per day to prevent thrombus formation. What parameter should be measured in this case for the optimal control of the effectiveness and safety of the anticoagulant therapy?
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A 30-year-old woman complains of no menstruations occurring over the last year. She has history of a massive postpartum hemorrhage. Objectively, her secondary sex organs are normally developed, the hair growth pattern is of the female type. Bimanual examination detects normal uterus and uterine appendages. What is a possible cause of amenorrhea in this case?
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A 14-year-old girl complains of headache, nausea, fever of 39°C, chills, lumbar pain, and dizziness. It is the second day after the onset of the disease. Blood pressure 130/80 mm Hg. Blood test results: hemoglobin 128 g/L, erythrocytes 4.1012/L, leukocytes 14.109/L, ESR 27 mm/hour. Urinalysis results: specific gravity 1.010, leukocytes 20-35 in sight, erythrocytes 4-6 in sight, protein 0.099 g/L. What is the most likely diagnosis in this case?
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At the dentist's office, a 23-year-old woman developed sudden dyspnea, dizziness, and tightness in her chest 3 minutes after the administration of lidocaine. Objectively, the patient's condition is severe, blood pressure - 70/30 mm Hg, pulse - 108/min, thready, Auscultation detects harsh vesicular breathing in the lungs, with numerous diffuse dry wheezes and crackles that can be heard from a distance.What drug should be administered first in this case, to provide emergency aid for the patient?
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A 26-year-old min complains of a rush on his face, itching, feeling of heat, and pain. According to the patient's medical history, this condition has been observed over the last two. years. Objectively, there are infiltrated bright red patches on the skin of his face in the area of the chin. The patches are covered in pustules, scabs, and numerous grosions and have papulo-pustular elements located on their periphery. What is the most likely diagnosis in this case?
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A 15-year-old girl complains of enlarged cervical lymph nodes and dry unproductive cough. According to the patient's medical history, the disease onset was 6 months ago. Objectively, enlarged lymph nodes form a conglomerate over the left clavicle, they are painless and not fused with the surrounding tissues, the skin above them is unchanged. Other groups of lymph nodes are normal. Auscultation detects vesicular breathing over the lungs, there are no wheezes. The liver protrudes 3 cm from under the edge of the costal arch, the spleen protrudes 2 cm. No pathology has been detected in other organs and systems. What is the most likely diagnosis in this case?
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Over the course of the last half a year, a 22-year old patient has been complaining of weakness in the afternoon and after physical exertion and double vision in her eyes. In the morning she feels satisfactory. Objectively, she presents with ptosis of the eyelids on both sides, divergent strabismus, hypomimia, and nasal voice. She has the full range of active movements in her limbs. Her skeletal muscle strength is reduced to 4 points. What is the most likely diagnosis in this case?
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A 75-year-old woman complains of a tumor in her right breast. In her left mammary gland, palpation detects no pathology. In her right mammary gland, a lumpy dense, painless, non-mobile formation was detected. The skin above the formation resembles a "lemon rind." The nipple is retracted. Axillary, subclavian, and supraclavicular lymph nodes are not palpable. What pathological condition has most likely developed in the right mammary gland of the patient?
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During a routine medical examination of a 14-year-old boy, the following data were obtained: body length 142 cm (+2 sigma), body weight 36 kg (+1.5 sigma), chest circumference 74 cm (+0.2 sigma). Make an assessment of the harmoniousness of the child's physical development.
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Examination of a one-month-old child detects microphthalmia, microcephaly, hypotelorism, bilateral cleft lip and palate, polydactyly, and a ventricular septal defect. Genetic studies revealed trisomy 13. What is the most likely diagnosis in this case?
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A 68-year-old man, undergoing inpatient treatment for unstable angina pectoris, suddenly lost his consciousness while walking and fell down. Objectively, there is no pulsation on the arteries, the pupils are constricted and unresponsive to light. Rare low amplitude movements of the chest (8-10/min) are observed, the blood pressure cannot be measured. ECG shows a sinusoidal curve with frequent waves, differing in shape and amplitude, with the rate of 350-400/min. What complication has developed in the patient?
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A 5-year-old child complains of a cough that gradually intensifies. According to the patient's medical history, the onset of the disease was 12 days ago. Objectively, the body temperature is 37.1°C, the skin is pale, the oropharyngeal mucosa is pale pink. There is a small ulcer on the frenulum of the tongue. Coughing fits occur up to 20 times per 24 hours and can be characterized by a series of cough impulses, followed by a wheezing inhalation. A coughing fit ends with the expectoration of vitreous sputum. Auscultation detects harsh respiration and dry (sometimes wet) crackles in the lungs. Chest X-ray shows a horizontal position of the ribs, increased transparency of the lungs, and an expanded pulmonary pattern in the roots of the lungs. Complete blood count: leukocytosis 23.109/L, eosinophils 1%, band neutrophils 3%, segmented neutrophils _23%, lymphocytes - 70%, monocytes - 3%, ESR - 3 mm/hour. What is the most likely diagnosis in this case?
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A case of occupational poisoning is being investigated, where an auto mechanic, who was testing a diesel engine in a garage with damaged exhaust ventilation, developed the following symptoms at the end of the working day: headache, tinnitus, nausea, vomiting, and pulse lability. Objectively, his skin and mucosa are colored cherry-red. What toxic agent has caused the acute poisoning in this worker?
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A 56-year-old overweight patient complains of pain in her knee joints. The pain intensifies when she walks, climbs stairs, or remains standing for a long time. The disease onset was 5 years ago. Objectively, the knee joints are deformed, edematous, and painful during movements. X-ray of the knee joints shows joint space narrowing, subchondral sclerosis, and marginal osteophytes. What is the most likely diagnosis in this case?
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A 27-year-old patient complains of cough with purulent sputum, pain in the chest during breathing, and fever of 38.6°C. According to the patient's medical history, the disease onset was acute and occurred after overexposure to cold. Laboratory tests and X-ray scan allowed diagnosing community acquired pneumonia. What group of antibiotics should be prescribed first when starting the treatment?
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A sanitary-epidemiological station at a rural region received an emergency message that a patient diagnosed with typhoid fever was admitted to the infectious diseases department of the central regional hospital. What is the main transmission route of this disease?
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During examination, the patient presents with a lacerated wound in the area of the right lower leg. Dark blood constantly flows from the wound. What emergency aid should be provided in this case?
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A 5-year-old girl developed repeated vomiting and loss of consciousness on the fifth day after the onset of an acute respiratory viral infection. According to the patient’s medical history, her mother was giving her acetylsalicylic acid and metamizole sodium without a prescription.the following is observed: the score or 5-6 at the Glasgow Coma Scale, hemorrhagic syndrome,hepatomegaly blood pressure 100/60 mm Hg.Blood test results: hypoglycemia, normal bilirubin and creatinine levels, hyperammonemia, a tenfold increase in ALT and AST levels, decreased prothrombin index and albumin levels. What emergency condition has developed in the child?
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A 25-year-old woman complains of discomfort in the area of her external genitalia. The discomfort developed a few days ago. Objectively, in the area of the left labia, there is a painless red ulcerative skin lesion with clear and smooth edges dense at its base. Painless enlargement of the right inguinal regional lymph node was detected. What is the most likely diagnosis in this case?
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A 58-year-old patient complains of dizziness, diplopia, and disturbed gait. The patient has history of three similar episodes. Objectively, the following is observed: horizontal nystagmus, diplopia, ataxia on the right in the Romberg's position. The patient performs coordination tests unsteadily on the right. Three hours later, the neurological symptoms repressed. What is the most likely diagnosis in this case?
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A 37-year-old woman complains of weakness, feeling unwell, nervousness, mild discharge of dark blood from the vagina before and after menstruation, and periodical pain in her lower abdomen that intensifies during menstruation. Bimanual examination detects enlarged body of the uterus, the appendages cannot be clearly outlined, an uneven surface is detected on the posterior fornix. Laparoscopy detects bluish "eyelets" on the ovaries, peritoneum of the rectouterine pouch, and perirectal fat. What is the most likely diagnosis in this case?
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A 65-year-old patient complains of frequent painful urination, moderate weight loss observed over the last 3-4 months, and massive microhematuria with excretion of shapeless blood clots. According to the patient's medical history, macrohematuria first appeared 3 months ago with no apparent cause and was not accompanied by pain and dysuria back then, a few days later the bleeding stopped on its own. What is the most likely diagnosis in this case?
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Workers at the mining sites are exposed to mineral dust in the form of disintegration-produced aerosols. Chemical and physical properties of dust were studied to measure the risk of workers developing occupational lung Diseases caused by dust. What characteristic of dust generally determines how deep into the respiratory tract can it reach?
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A 73-year-old patient has been suffering from chronic atrophic gastritis for over 10 years. Objectively, her skin and mucosa are pale and subicteric, the tongue is bright red, with marked atrophy. The patient is hemodynamically stable. Sensitivity is symmetrically reduced in the patient's legs. Complete blood count: erythrocytes 1.5-1012/L, hemoglobin 60 g/L, color index -1.2, platelets 120-109/L, leukocytes 3.0-109/L, megalocytes, hypersegmentation of neutrophil nuclei. What complication of chronic atrophic gastritis has occurred in the patient?
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A 9-month-old child with an acute respiratory viral infection was receiving antipyretics in a syrup for 2 days. On the second day, the parents note that their child has developed skin redness, neck edema, hoarseness of the voice, barking cough, difficulty breathing, and agitation. If the family's medical history has atopic anamnesis complicated on the father's side. What is the most likely diagnosis in this case?
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An 8-year-old boy received a hit to the head with a ball during a physical training lesson. Over the next few days he was complaining of headache and nausea and had three episodes of vomiting. His parents did not take him to a physician. Six months later, the parents and the teachers began to notice that the boy started experiencing episodes, when his face would become red and he would freeze for a few seconds, focusing his gaze on a single point. While in this state, the boy was not responding to people calling his name. What is the most likely diagnosis in this case?
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A 60-year-old patient has been hospitalized in an unconscious state. According to the patient's medical history, he has diabetes mellitus and arterial hypertension and takes insulin and hypotensive drugs. Objectively, the patient's condition is severe, the skin is dry, the turgor is reduced, the tongue is dry and has a brown coating, the tone of the muscles and eyeballs is reduced. Body temperature 38.2°C, Pulse 108/min, of poor volume. Auscultation detects muffled heart sounds. Blood pressure 90/50 mm Hg, the breathing is rapid and shallow. There is no smell of acetone. Blood test: glucose 58 mmol/L, total protein 105g/L, urea 16 mmol/L, sodium 238 mmol/L, potassium 5.5 mmol/L, lactic acid 0.8 mmol/L. Urinalysis: glucose 15 mmol/L, no ketone bodies. What type of coma has most likely occurred in the patient?
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A 2-year-old child with an acute respiratory viral infection has acutely developed a hoarse voice and noisy inhalation. When the child cries, depression of the supraclavicular and subclavian fossae and increasing inspiratory dyspnea are observed. When the child is at rest, these signs disappear. What is the most likely diagnosis in this case?
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A 64-year-old patient with a tumor of the sigmoid colon and chronic thrombophlebitis of the deep veins of the right leg is scheduled for a surgery. What is the optimal medicine for prevention of deep vein thrombosis in this patient?
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A 56-year-old patient complains of unbearable pain behind her sternum that does not stop even after taking three tablets of nitroglycerin. She has history of essential hypertension since the age of 45, ischemic heart disease, and frequent stresses at work. Objectively, the following is observed: noti-coable skin pallor, acrocyanosis, cold sticky sweat, respiratory rate 24/min, inspiratory dyspnea, heart rate - 118/min, the pulse is rapid, of poor volume, blood pressure - 90/50 mm Hg. The left border of the relative cardiac dullness is shifted outwards. Auscultation detects weakened heart sounds at the apex, tachycardia, and gallop rhythm, ECG registers OS waves in leads I, a VL, V4-V6. What is the most likely diagnosis in this case?
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