Int All Ques

Cardiology

(special pathology)

#

What is the best recommendation for diet of patient with cardiac insufficiency:

0

Don’t change any food habits

0

Extend the level of carbohydrates

0

Reduce the level of potassium, extend the level of natrium

1

Extend the level of potassium, reduce the level of natrium

0

Extend the level of calcium, reduce the level of potassium

#

Artic stenosis happens together with all deseases, exept:

0

Chronic rheumatic disease

0

Syphilis

1

Myocarditis

0

Infective endocarditis

0

Atherosclerosis

#

Cor pulmonale isn’t a complication of:

0

Emphysema

0

Sarcoidosis

0

Pulmonary tuberculosis

0

Funnel breast

1

Atherosclerosis

#

What is not usual for exertional angina:

0

Pain appears during physical activity

0

Pain can be reducted with nitroglycerine

1

Pain can be reducted with validol

0

Pain appears with rise of heart rate and blood pressure

0

Pain continues for 15min

#

Pathognomonic and the most frequent skin changes during acute rheumatic fever are:

0

Nettle-rash

0

Unstable patches and papules

1

Annular erythema

0

Hemorrhages

0

Petechias

#

Acute rheumatic fever differs from allergic infectious myocarditis in such features, exept:

0

Connection with rhinopharyngeal streptococcic infection

0

Latent period from the end of previous infection till the firsr clinical presentations

0

Detection of polyarthritis and arthralgia as initial manifestation of illness

0

Symptoms of cardiopathy

1

Neuropathy (chorea)

#

What signs are not characteristic of acute rheumatic fever:

0

Appearing at children and youths

1

Chronological connection with non-streptococcic infection

0

Acute beginning

0

Articular syndrome at the beginning of illness

0

Cardiopathy

#

Carditis during acute rheumatic fever is:

0

Infectious disease induced with streptococcus

1

Slow hyperergic reaction on streptococcus antigen

0

Disease induced with virus

0

Disease induced with protozoa

0

Disease induced with fungi

#

Symptoms of what desease are carditis, polyarthritis, erythema:

0


1

Acute rheumatic fever

0

Pericarditis

0

Cardiomyopathy

0

Myocarditis

#

Man, 48 years old. Suffers from stenocardia attack appeared during light physical activity, sometimes during rest. Latest days attacks became frequent, medical treat has no effect. On EKG signs of hypertrophy of left ventricle. Results of what method are the most important for further treatment:

0

Scintigraphy of myocardium

0

Echocardiography

1

Holter’s monitoring

0

Velorgomethry

0

Coronarography

#

The main clinical symptom of acute rheumatic fever is:

0

Weakness

0

Osteoporosis

0

Arthropathy of hands and feet

0

Low efficiency

1

Carditis

#

Name symptoms of rheumatic endocarditis:

0

Shivering

0

Polyserositis

0

Endothelial symptoms

1

Heart trouble

0

Paleness

#

Clinical symptom of diffusive myocarditis:

1

Systemic circulation insufficiency

0

Hemorrhages

0

Splenomegaly

0

Diastolic murmur

0

Accent of II tone over aorta

#

Pain at cardiac region in the presence of myocarditis often happens to be:

1

Ache

0

Shooting-pain

0

Pressing

0

Constricting pain

0

Pinching

#

What is the main diagnostic criterion of acute rheumatic fever:

0

Hemarthros

0

Low grade fever

1

Chorea

0

Nasal hemorrhages

0

Pain at cardiac region

#

What antibacterial agent is used against acute rheumatic fever:

0

Tetracycline

0

Aminoglycosides

1

Penicillines

0

Rifampicin

0

Lincomycin

#

Direct symptom of mitral stenosis is:

0

Weakening of the first tone over the apex of heart

1

Intensification of the first tone over the apex of heart

0

Systolic murmur over the apex of heart

0

Systolic murmur over auscultation point of aortic valve

0

Accent of II tone over pulmonary artery

#

The complication of mitral stenosis is:

0

Pneumonia

1

Atrial fibrillation or atrial flutter

0

Pleurisy

0

Thromboembolism of peripheric vessels

0

Hepatitis

#

Direct symptom of mitral insufficiency is:

0

Weakening of the second tone over auscultation point of aortic valve

0


0

Systolic murmur over xiphoid process

1

Systolic murmur over the apex of heart in conjunction with weakening of the first tone

0

Diastolic murmur over the Botkin’s point

#

Physical symptom of mitral insufficiency is:

0

Heart boundary displacement up and to the left

1

Weakening of the first heart tone

0

Diastolic murmur over the apex of heart

0

Systolic thrill

0

Heart boundary displacement up and to the right

#

Vascular symptom of aortic insufficiency is:

0

Systolic pressure decrease

1

Carotid shudder

0

Traube’s tone

0

Durosier’s murmur

0

Absence of arteriole pulsation

#

Direct symptom of aortic stenosis is:

0

Systolic murmur at II intercostal space to the left from sternum

0

Diastolic murmur over the apex of heart

0

Intensification of the first tone

0


1

Systolic murmur at II intercostal space to the right from sternum in conjunction with weakening of the II tone

#

Symptom of tricuspid insufficiency is:

0

Diastolic murmur

0

Systolic thrill

1


0

Accent of II tone over auscultation point of aortic valve

0


#

Upper border of normal blood pressure at adults is:

0

120/70 millimeters of mercury

0


0


1


0


#

The first heart tone intensifies at:

0

Thyrotoxicosis

1

Mitral stenosis

0

Deranged atrioventricular conduction

0

Aterosclerotic cardiosclerosis

0

Aortic stenosis

#

Pericardial murmur is auscultated best of all at:

0

The region of apical thrust

0

The basis of xiphoid process

0

The base of heart

0

The interscapular region

1

The left border of sternum

#

Pain at cardiac region in the presence of stenocardia is:

0

Ache

0

Knife-like pain

1

Pressing

0

Shooting-pain

0

Pinching

#

One of the most often clinical beginings of myocardial infarction is:

0

Asymptomatic

0

Anemic

0

Cerebral

1

Painful

0

Hemorrhagic

#

Postinfarction period after myocardial infarction lasts:

0

From 30 min. till 2 h. from the beginning of illness

0

From 1 till 10 days

0

From 10 days till 5th week

0

From 1 till 2 months

1

From 2 till 6 months from myocardial scarring

#

What foodstuff has to be limited at nutrition of myocardial infarction patient:

0

Water

0

Sugar

0

Salt

0

Spicery

1

All correct

#

What is the main diagnostic criterion of essential hypertension of ² stage:

0

Transient constriction of retina arteries

0

Large pulse pressure

1

Rise of basis blood pressure to 160/95

0

Myocardial hypertrophy

0

Abdominal vascular murmur

#

What is the basic pressor humoral factor of pathogenesis of early stages of essential hypertension:

0

Angiotensin II

0

Aldosterone

0

Vasopressin

1

Catecholamines

0

Natrium delay

#

The most frequent complaint of patient with diffusive myocarditis:

0

Arthralgia

0

Headache

0

Pain at cardiac region

1

Breathlessness

0

Low diuresis

#

During fibrillation atrial waves are characterized with:

0

Irregularity

0

Variety of forms

0

Variety of amplitudes

1

All features

0

During fibrillation atrial waves are lacking

#

Morgany-Adams-Stocks’es attack can be registered at:

1

Total transverse atrioventricular heart block

0

Atrial flutter

0

Ventricular paroxysmal tachycardia

0

Atrial fibrillation

0

All abnormalities

#

What clinical symptom is less characteristic for aortic stenosis:

0

Stenocardia

0

Dead syncope

1

Sudden death

0

Carotid shudder

0

Cardiac insufficiency

#

Aortic insufficiency can be an effect of:

0

Dissecting aortic aneurysm

0


0

Bacterial endocarditis

1

Malignant hypertension

0

All causes

#

The most frequent reason of cardiac insufficiency at aged people (after 75) is:

0

CHD, cardiosclerosis

0

Amyloidosis

0

Aortic stenosis

0

Arterial hypertension

1

Calcification of mitral valve

#

The first symptom of mitral stenosis is usually:

1

Peripheral edema

0

Pain at abdominal cavity after liver enlargement

0

Palpitation as a result of arrhythmia

0

Breathlessness

0

Orthopnea

#

The most frequent arrhythmia at patients with mitral stenosis is:

0

Paroxysmal supraventricular tachycardia

0

Atrial flutter

0

Atrial fibrillation

1

Ventricular extrasystolic arrhythmia

0

Supraventricular extrasystolic arrhythmia

#

Patient, 19 years old, complaints of breathlessness after physical activity. Has suffered for two weeks. After quinsy appeared pain in joints, temperature rised to 37,80Ñ. Provisional diagnosis:

0


0

Myocardosis

1

Acute myocardial infarction

0


0

Atherosclerosis

#

Patient, 68 years old. Has suffered from constringent pain after the slightest physical activity during 3 years. Attack usually lasts 15 min., finishes without medicines. Patient don’t use nitroglycerine because of strong headache. Had a treatment on account of CHD, transmitted myocardial infarction. Systolic murmur can be auscultated upon aorta. On EKG: cicatricial changes at back side of left ventricle. Provisional diagnosis:

1

Recurrent myocardial infarction

0

Stable exertional angina, class IV

0

Dissecting aortic aneurysm

0

Instable angina

0

Atherosclerosis of aorta

#

Woman, 37 years old, complaints of palpitation, giddiness, breathlessness, ache at cardiac region. Has been ill during 3 months. At first attacks appeared 1-2 times per month, stopped after breath-holding. Latest time they become more frequent. Objective data: skin is moist, tones are clear, rhythmic. Heart rate 80/min., blood pressure - 140/90 millimeters of mercury. Abdomen is resilient, painless, frequent urination. On EKG: during attack - heart rate 160/min., QRS without changes, T is combened with P. What type of tachycardia does she have:

0

Group ventricular ectopic beating

1

Paroxysmal atrial fibrillation

0

Supraventricular paroxysmal tachycardia

0

Ventricular paroxysmal tachycardia

0

Sinus tachycardia

#

Woman, 30 years old, suffers from breathlessness after the slightest physical activity, cough with phlegm and blood streaks. In anamnesis – frequent quinsies, an episode of fever with pain in joints. . Objective data: pulsation under xiphoid process, flapping I tone and diastolic murmur on the apex of heart. Heart rate 120/min., rhytm is irregular, at basis of both lungs – rales. Liver goes beyond the costal margin on 3 cm., moderately painful. Probable heart trouble:

0

Mitral stenosis

0

Mitral insufficiency

1

Tricuspid stenosis

0

Aortic insufficiency

0

Interventricular septum defect

#

Man, 59 years old, has chronic obstructive lung desease, emphysema, lung insufficiency II-III st. Complaints of recurring pain at cardiac region. Objective data: pulsation under xiphoid process, tones are impaired, rhythmic, accent of II tone over pulmonary artery. Liver goes beyond the costal margin on 5 cm., shanks and feet are hydropic. What complication has he got:

1

Heart trouble

0

Cor pulmonale

0

Myocarditis

0

Pneumosclerosis

0

Dilated cardiomyopathy

#

Patient, 28 years old, against a background of adenovirus infection has pain at cardiac region, breathlessness, palpitation. Patient is pale, acrocyanosis, heart rate 92/min., filiform, blood pressure - 90/60 millimeters of mercury. Cardiac borders increased to the left and to the right for 2 cm., tones are subdued. On EKG: complete left bundle-branch block, low voltage. What desease is the most characteristic for such symptoms:

0

Exudative pericarditis

1

Myocarditis

0


0


0


#

Man, 67 years old, complaints of headache, giddiness, image flicker. It happens periodically once in 4 years. At the same time blood pressure - 200/90 millimeters of mercury. Cardiac borders increased to the left for 1 cm., tones are impaired, rhythmic, accent of II tone over aorta, lungs and liver without features. Provisional diagnosis:

0

Atherosclerosis

1

Myocarditis

0


0


0

Essential hypertension

#

Woman, 53 years old, complaints of headache, giddiness, constricting pain at cardiac region during rest. Has suffered for 5 years. Blood pressure - 180/100 millimeters of mercury. Objective data: cardiac borders increased to the left for 1,5 cm., tones are impaired, rhythmic, accent of II tone over aorta, m=100kg,

Provisional diagnosis:

0

Essential hypertension

0

Myocardosis

0

Myocarditis

0

CHD, stenocardia

1

Cushing's syndrome

#

Man, 57 years old, complaints of breathlessness, hydropic shanks, heart outage, pain at left half of chest with irradiation to left scapula. Objective data: fine moist rales at lower parts of lungs, tones are impaired, systolic murmur over the apex of heart, heart rate 100/min., arrhythmic, blood pressure - 115/75 millimeters of mercury. Liver goes beyond the costal margin on 2 cm., painful. After X-ray imaging enlarged heart shadow was discovered, pulsation is weak. On EÑG – ventricular extrasystolic arrhythmia, low voltage. What stage of cardiac insufficiency is it:

1

² st.

0

²²À st.

0

²²B st.

0

²²² st.

0

Is lacking

#

Man, 72 years old, had three times short loss of consciousness. Objective data: heart rate 42/min., blood pressure - 140/70 millimeters of mercury. On EKG: P-P – 80/min., R-R - 40/min, rhytm is regular. What disorder of conduction does he have:

0

Sinoauricular block I st.

1

AV-block III st.

0

AV-block II st.

0

AV-block I st.

Diseases of endocrinal system

#

Normal basal level of glucose in blood (in pure glucose) is:

0

8.3-10.1 mmol/l

0

6.2-9.3 mmol/l

0

2.7-5.5 mmol/l

0

3.8-6.7 mmol/l

1

3.3-5.5 mmol/l

#

Maximally admitted (for healthy) level of glucose in blood 2 hours after peroral glucose loading is:

0

8.43 mmol/l

0

7.22 mmol/l

0

9.6 mmol/l

0

10.1 mmol/l

1

7.8 mmol/l

#

To reveal diabetes mellitus and its type such examinations are carried out:

0

Tolerance test to glucose

0

Glucocorticoid test

0

Examination with test breakfast which consists of 30gr easily digested carbohydrates with subsequent (2 hours later) determining sugar in blood

1

All enumerated

0

Urine sugar

#

Severe form of diabetes is characterized by all enumerated signs except:

0

Ketoacidosis

0

Labile course

0

Presence of vascular complications (retinopathy, nephropathy, neuropathy)

1

Cataract

0

Necessity in insulin high doses

#

Injury of vision organ in diabetes mellitus includes:

0

Diabetic retinopathy

0

Blepharitis

0

Sty

0

Dystrophic cornea changes

1

All enumerated

#

First type diabetes mellitus is characterized by all enumerated signs, except:

1

Gradually onset of the disease

0

Young age

0

Acute form of clinical symptoms

0

Insulin dependence, B-cells affect

0

Obesity absence

#

For diabetic nephropathy early diagnosis all enumerated of examinations must be used, except:

0

General urinanalysis

0

Roedberg test

0

Zimnitskii’s test

0

Kidney puncture biopsy

1

Creatine content determination in blood

#

Ketoacidotic coma is clinically manifested by all enumerated signs, except:

0

Pallor and dryness of skin integuments

0

Normal temperature of body

0

Arterial hypotension

1

Arterial hypertension

0

Kussmaul’s breathing, acetone smell in the air breathed out

#

Hypoglycemic coma clinically manifested by all enumerated signs, except:

0

Pallor and moistures of skin integuments

0

Hyper tonus of muscules, convulsions

1

Blood pressure decreasing

0

Crepitation in lungs

0

Sudden onset

#

Absolute indication for insulintherapy in diabetes mellitus is all enumerated, except:

0

Ketoacidosis, precomatose condition

0

pregnancy, labor

0

Severe dystrophic skin injury (trophic ulcer, necrobiosis)

0

Nephrosclerotic stage of diabetic glomerulosclerosis

1

Ischemic heart disease exacerbation

#

All enumerated alimentary factors contribute to obesity development, except:

0

Frequent high-caloric meals in small doses

1

Surplus use of vegetable food

0

Surplus use of carbohydrates

0

Surplus use of fats

0

Overeating

#

From enumerated symptoms the following ones are characteristic for diffuse toxic goiter:

0

Loosing weight

0

Constant palpitation

0

Generally perhidrosis

0

Trembling of extremities, muscle weakness

1

All enumerated

#

In diffuse toxic goiter therapy all enumerated preparation can be used, except:

0

Lithium carbonate

1

Veroshpiron

0

Merkazolil

0

Glucocorticoids

0

B-adrenoblockers

#

For hypothyroidoses all enumerated is characteristic, except:

0

Dryness of skin

0

Inclination to constipation

0

Sleepiness

0

Bradicardia

1

Loss of body mass

#

Sugar lowering effect of sulfanilurea preparation is associated with:

0

Increasing secretion of endogenous insulin

0

Insulin effect potentiating

0

Insulin antagonist effect neutralizing

0

Improvement of glucose utilization

1

All enumerated

#

Stable tachycardia in patients with insulin dependent diabetes mellitus may be caused by all enumerated, except:

0

Combination with toxic goiter

0


1

Hypochromic anemia

0

Autonomic cardiac neuropathy

0

Hyperinsulin anemia

#

Name an important factor of insulin secretion regulation:

0

Lipids level in blood

0

Lactate level in blood

0

Pyruvate level in blood

0

Glycerin level in blood

1

Glucose level in blood

#

Indication of insulin independent diabetes mellitus is:

0

Acute disease onset

0

Diabetes frequency in relatives

1

Age older than 40 years at the onset of the disease

0

Insulinpenia

0

Severe course, inclination to ketoacidosis

#

The main symptom of diabetes is:

0

Bradicardia

0

Exophtalmos

1

Polyuria

0

Pollakiuria

0

Loosing weight

#

Which patients develop hypersmolar coma most frequently?

0

Suffering from insulin dependent diabetes

1

Suffering from insulin independent diabetes

0

Suffering from diseases of pancreas (tumor)

0

Suffering from congenital genetic syndromes

0

Suffering from pheohromocytoma

#

The cause of hyperglycemic coma is:

1

Insufficient dose of insulin

0

Surplus quantity of insulin injected

0

Absence of meal after insulin injection

0

Introduction of excess liquid into the organism

0

Overeating

#

Pathogeneic factor of ketoacidosis development is:

0

Insulin surplus

1

Insulin insufficiency

0

Insufficient of contrinsular hormones

0

Surplus of contrinsular hormones

0

Cellular dehydratation

#

Name the main drawback of diabetic coma treatment by injecting high doses of insulin:

0

Hypotonia

1

Hypoglycemia

0

Hypopotassemia

0

Hypertension

0

Hyperleukocytosis

#

What is Dylrimp symptom?

0

Rare winking

0

Eyeball bulging

0

Eyelid skin pigmentation

0

A site of sclera between a lower eyelid and an iris when looking up

1

Sclera strip between an upper eyelid and an iris when looking straight

#

The most dangerous thyrotoxic crisis complication is:

0

Anemia crisis

0

Hemorrhages

Acute disorder of brain circulation

0

Acute cardio-vascular insufficiency

1

Acute hepatic insufficiency

#

Indicator of antithyroid therapy effectiveness is:

0

Main metabolism determination

0

Content of general and free T4 and T3

0

Number of thyroxinbinding proteins

1

17-KS determination

0

Thyrotrophic hormone

#

What is the general pathogenetic link in diabetic glomerylosclerosis development?

0

Hyperpotassemia

1

Disturbance in proteins and fats synthesis

0

Adrenal glands and pituitary body superactivity

0

Autoallergy

0

Hypercholesteremia

#

Which of the given symptom occurs both in hypothyroid coma and cardiogenic shock?

0

Slow onset

0

Pale skin and mucosa

1

Lood pressure lowering

0

Skin swelling

0

Tendon reflexes are reduced

#

Which of the given symptom occurs both in thyrotoxic crisis and uremic coma?

0

Dilated pupils

0

Tachypnea, superficial one

1

Hypertension

0

Decreased skin turgor

0

Smell of ammonia in atmospheric air

#

Which of these symptoms occurs in hypoglycemic coma and hypothyroid coma?

0

Gradual onset

0

Slow soft pulse

1

Dilated pupils

0

Tendon reflexes are diminished

0

Occasional stomachache

#

What is affected in diabetic retinopathy?

0

Cornea

0

Conjunctiva

0

Iris

0

Vitreous body

1

Blood vessels of retina

#

Which organ is affected in diabetes mellitus?

0

Adrenal glands

0

Thyroid gland

1

Kidneys

0

Stomach

0

Intestine

#

Small symptom of diabetes mellitus is?

0

Polyarthralgias

0

Asphyxia

1

Skin and genital itch

0

Periodical thirst

0

Teeth loosening and dedentition

#

In what age is type II diabetes mellitus most frequent?

0

Since 10 till 20 years

0


0


0


1

Older than 50 years

#

What kind of coma is in diabetes mellitus?

0

Uremic

0

Hepatic

0

Anemic

1

Acidotic

0

Thyrotoxic

#

What is particular feature of hyperosmolar coma ?

0

Presense of ketoacidosis

1

Absence of ketoacidosis

0

Dehydration

0

frequent oliguria

0

frequent azotemia

#

What is the sign of hypoglycemic coma?

0

Flaccidity of muscles, absence of tendon reflexes

1

Rigidity of muscles, tremor of extremities, convulsions

0

Absence of appetite

0

Increased appetite

0

Proteinuria, cilindruria, glycosuria

#

How to help out a patient from diabetic coma?

0

To decrease a daily dose of insulin

1

To increase a daily dose of insulin

0

To eliminate fats from food ration

0

To increase caloric value of dialy ration at the expense of fats

0

To increase caloric value of dialy ration at the expense of proteins

#

What is the indications for treatment with biguanids?

0

Ketoacidosis

0

I type diabetes mellitus

1

II type diabetes mellitus in excessive body weight

0

Insulin-resistance

0

Renal insufficiency

#

What is Kocher's symptom?

0

Eyelid’s skin pigmentation

0

Infrequent winking

0

Eyeball bulging

0

A site of sclera between an upper eyelid and an iris while looking down

1

A site of sclera between a lower eyelid and an iris while looking up

#

What is Ellenek's symptom?

0

Infrequent winking

0

Eyeball bulging

1

Eyelid skin pigmentation in thyrotoxicosis

0

A strip of sclera between an upper eyelid and an iris while looking straight

0

Sensation of sand in the eyes

#

What is pretibial myxedema?

0

Eyelids edema

0

Face edema

0

Feet edema

1

Crus anterior surface skin lesion

0

Face skin lesion

#

Which cardiac rhythm disturbance is the most frequent in diffuse toxic goiter?

0

Sinus bradycardia

0

Extrasystole

1

Complete arrhythmia

0

Sinus tachycardia

0

Paroxysmal tachycardia

#

What is the particular feature of thyrotoxicosis in eldery people?

0

attack of sinus tachycardia

0

attack of paroxysmal tachycardia

0

effectiveness of foxglove medication

0

nonsusceptibility to foxglove medication

1

attack of complete arrhythmia

#

Which scanning of thyroid gland do You know?

0

scanning with gold preparations

0

scanning with the help of caesium

0

scanning with the help of strontium

0

scanning with the help of technetium

1

scanning with the help of radioactive iodine

#

Characteristic symptom of diabetes mellitus is:

1

Hyperglycemia

0

glycosuria

0

Tachycardia

0

Cough

0

Jaundice

#

The most frequent cause of diabetes mellitus is:

0

psychic and physical injury

1

Infection

0

Heredity

0

Obesity

0

Hypothermia

#

Which cells of pancreas produce insulin?

0

cells of excretory ducts

0

acynous cells of pancreas

0

alpha-cells of Langerhans’s islets

1

beta-cells of Langerhans’s islets

0

pancreas vessels and capillaries endothelium

#

What does hormones injection result in?

0

reduces glucose content in blood

1

raises glucose content in blood

0

raises arterial pressure

0

lowers arterial pressure

0

raises blood viscosity

#

The cause of hyperglycemic coma is?

0

excessive administration of insulin

0

insufficient caloric value of daily food ration

0

high doses of diuretics

0

dehydration as a result of diarrhea

1

insufficient quantity of insulin or sudden discontinuation of its administration

#

The sign of cetoacedotic coma is?

0

sudden onset

1

gradual onset

0

humid skin

0

withered skin

0

stable breathing

#

How to help out a patient from hypoglycemic coma?

0

to introduce additional insulin

0

to prescribe intravenously isotonic solution of natrium chloride (NaCl)

1

to inject intravenously 40% solution of glucose 40-50 ml

0

to introduce 0,5-1,0 ml 0,1% solution of adrenaline subcutaneously

0

to introduce intravenously50-100 mg of cocarboxylase

#

The trend in the teratment of hyperglycemic coma is:

0

glucocorticaid therapy

0

correction of obstructive disturbances

1

insuline-therapy

0

recovery of water deficiency

0

correction of electrolytic disturbances

#

Indications to prescribe insulin are:

0

increase of body weight

0

insulin-independent diabetes mellitus

1

insulin-dependent diabetes mellitus

0

Ketoacidosis

0

significant loosing of weight

#

What is Grefe’s symptom?

0

eyeball bulging

0

infrequent winking

0

pigmentation of eyelid skin

0

a site of sclera between a lower eyelid and an iris when looking up in diffuse toxic goiter

1

a site of sclera between an upper eyelid and an iris when looking down in diffuse toxic goiter

#

What is Shtelvag’s symptom?

0

eyelid skin pigmentation

0

eyeball bulging

1

infrequent winking in diffuse toxic goiter

0

a strip of sclera between an upper eyelid and an iris when looking straight in diffuse toxic goiter

0

scintillation of the eyes

#

What is exophthalmos?

0

eyeball pain

0

sensation of sand in the eyes

1

expelling of eyeball from the eye-socket

0

sclera vessels injection

0

eyelids edema

#

Does diffuse toxic goiter differ from ophthalmopathy?

0

No

1

Yes

0

not always

0

Combine

0

possibly

#

What is the manifestation of sexual gland function disturbance in women in diffuse toxic goiter?

0

increased libido

0

reducted libido

0

early abortions

0

Menorrhagia

1

Oligo- or amenorrhea

#

What does the value of basal metabolism characterize?

0

protein metabolism disturbance

0

lipid exchange disturbance

0

carbohydrate metabolism disturbance

0

hydro-electrolytic metabolism disturbance

1

biological effect of thyroid hormones on tissue level

#

What are the main complaints of patients with thyrotoxicosis?

0

increased psychological excitability, groundless anxiety

0

sleep disturbance, deterioration of memory

1

all enumerated

0

tremor of fingers or the whole body tremor, hyperhidrosis

0

tachycardia, emaciation

#

What can be revealed on examination of patient with thyrotoxicosis?

0

anxious conduct, lots of unnecessary movements;

1

all enumerated;

0

incompleteness of thoughts, quick distractibility

0

eyelids, lips, tongue, head trembling, sometimes trembling of the whole body

0

subcutaneous fatty tissue thinning, exophthalmos

#

Which ophthalmic symptoms can be revealed in patient with thyrotoxicosis?

0

Mobius's symptom;

1

all enumerated;

0

Graefe's sign

0

Shtelvag’s sign

0

Kocher's sign

#

What changes are revealed during heart auscultation in thyrotoxic patients?

0

I tone above the apex of the heart at the onset of disease is intensified, but it is diminished when dystrophic changes in the myocardium occur;

0

systolic murmur above the heart apex

0

Tachycardia

0

intermissions of cardiac function;

1

all enumerated

#

What ECG changes can be revealed during thyrotoxicosis?

0

all waves amplitude increase, especially T wave;

0

sinus tachycardia

0

Extrasystole

0

ciliary arrhythmia

1

all enumerated

#

What kind of pulse is typical for thyrotoxicosis?

0

abrupt pulsus magnus;

0

rapid;

0

sometimes irregular;

1

all enumerated;

0

Deficient

#

What basic clinical manifestations are typical for thyrotoxical crisis?

0

Acute onset and lightning-fast course, coma in severe cases;

0

Progressive rise of body temperature, uncontrollable vomiting, diarrhea;

0

Abrupt excitement with delirium and hallucinations

1

All enumerated

0

Tachycardia within the range of 150-200 per minute, atrial fibrillation.

#

What kind of laboratory-instrumental methods of pancreas diagnoses are known?

0

determination of basal metabolism;

0

determination of plasma iodine bound with protein

1

all enumerated

0

radionuclide scanning

0

ultrasonic examination

#

What are the main complaints of patients with hypothyroidism?

0

general weakness, increased fatigue, depressed mood

1

all enumerated

0

general edema

0

defective memory and mental faculties drowsiness

0

lowering of voice timbre, constipation

#

What skin changes are revealed in hypothyroidism patient?

0

dry skin, cool, by touch, scaling off, dense isn’t folded, there is no pit after pressing

0

secretion of sudoriferous and sebaceous glands is abruptly reduced

0

hyperkeratosis, especially in the field of palms and soles

0

subcutaneous fatty tissue edema

1

all enumerated

#

What neuropsychic sphere changes are observed in patients with hypothyroidism?

0

Acute psychologic slowing down, flaccid psychic functions, emotional poorness, apathy, indifference to surroundings;

0

memory impairment

0

Hypersomnia

0

mental deficiency right up to the development of dementia oligophrenia type

1

all enumerated

#

What cardiovascular system changes can be revealed in patient with hypothyroidism?

0

heart borders dilation

1

all enumerated

0

slow, weak pulse

0

Normal or slightly reduced blood pressure, in the course of time symptomatic arterial hypertension may occur

0

heart sounds weakening

#

What electrocardiogram changes can be revealed in patient with hypothyroidism?

0

sinus bradycardia

0

low voltage of all waves

0

disposition of ST segment below the isoline

0

possibly lengthening of P-Q interval

1

all enumerated

#

What are the clinical manifestations of diabetes mellitus?

0

excessive thirst (polydipsia), expressed polyuria, increased appetite (polyphagia)

1

all enumerated

0

loosing weight, increasing weakness, dry mouth

0

skin itch predominantly in the field of genitals, perineum

0

generalized angiopathy with lesions of cerebral vessels, vessels of kidneys, liver, heart, extremities, poor wound and fractures healing, polyneuritis, furunculosis, parodontosis, low resistance to infections susceptibility to development of tuberculosis

#

What digestive system changes can be revealed in diabetes mellitus?

1

all enumerated

0

dry mouth, diarrhea

0

increase of appetite right up to bulimia

0

hypo- and achlorhydria

0

in decompensated form - fatty degeneration of liver (fatty hepatosis)

#

Which symptoms testify to kidney lesions in diabetes mellitus?

0

Hypoisosthenuria

0

Albuminuria

0

arterial hypertension

0

Retinopathy

1

all enumerated

#

The characteristics of type I diabetes mellitus(insulin-dependent) are all enumerated with the exception of:

0

absolute insulin dependence may be observed

0

severe course, susceptibility to ketoacidosis

0

insulin level is abruptly reducted

1

genetic defect of antiviral immunity

0

there are expressied morphological changes B-cells of islet of Langerhans

The characteristics of type II diabetes (insulin-independent) are all enumerated with the exception of:

0

gradually onset, usually at the age older than 40 years, often occurs in overweight patient

0

stable mild course, no susceptibility to ketoacidosis

0

at the onset there is no expressied damage of B-cells, in this connection sulfanilamide glucose-reducing preparations are effective

0

insulin blood level is slightly lowered, normal, or increased at the expense of combined insulin

1

insulin level is abruptly reduced

#

Who can be diagnosed potential diabetes?

0

people hereditary predisposed

0

women, who gave birth to the child with body weight more than 4,5 kg

0

patients with adiposity

0

women, who gave birth to a dead child

1

all enumerated

#

What can provoke the development of diabetic coma in patients with diabetes mellitus?

0

improper treatment

0

acute infections and injuries

1

all enumerated

0

psycho-emotional stress

0

using a lot of sweet and fatty food

#

What clinical picture is observed in diabetic coma?

0

gradual onset, deep, noisy breathing (Kussmaul's respiration), odour of acetone from one's mouth

1

all enumerated

0

rapid pulse, decreasing of arterial pressure

0

glucose and acetone revealing in urine

0

xeroderma, hypotonia of eyeballs

#

What main principles of treatment of diabetic coma are known?

0

compensating for insulin deficiency

0

struggle against ketoacidosis

0

struggle against dehydration

0

correction of all types of metabolism disorder

1

all enumerated

#

First aid in diabetic coma consists of the following measures with the exception of:

0

administering of simple insulin (half of dose is injected intravenously, and the second half – subcutaneously)

0

intravenous drop-by-drop administering of 4% solution of sodium hydrocarbonate

0

warm soda clysters (300 ml 4% solution of sodium hydrocarbonate)

1

intravenous introduction 40% solution of glucose

0

in case of pernicious vomiting - gastric lavage by isotonic solution of sodium chloride or 1% solution of sodium hydrocarbonate

#

What clinical picture is observed in hypoglycemic coma?

0

sudden development, usual respiration, no odour of acetone

0

possible clonic and tonic convulsions

1

all enumerated

0

blood pressure is normal or elevated, pulse is not rapid

0

sweating is sharply expressed

#

In what time is blood glucose level maximally elevated after carbohydrate load?

0

in 10-20 minutes

1

in 30-60 minutes

0

in 90 minutes

0

in 120 minutes

0

in 180 minutes

#

Name the most important trend in the treatment of mild form of diabetes mellitus:

1

a diet

0

Immunosuppressants

0

usage of preparations in tablets decreasing the level of blood sugar

0

insulin therapy

0

Corticosteroids

#

Which arrhythmia is characteristic for thyroid heart?

0

respiratory arrhythmia

0

sinus bradycardia

0

paroxysmal ventricular tachycardia

1

complete arrhythmia

0

ventricular flutter

#

Which respiration is observed in hypoglycemic coma?

1

Normal

0

Chane-Stock’s

0

Biott’s

0

expiratory dyspnea

0

Kussmaul’s

#

The symptoms of cardiovascular system damage in hypothyroidism are the following except:

0

Bradycardia

0

arterial hypotonia

1

Pericarditis

0

decrease of cardiac output

0

waves amplitude decrement on electrocardiogram

#

The following changes of cardiovascular system are characteristics for the thyreotoxicosis, except:

0

elevation of systolic arterial pressure

0

elevation of pulse pressure

0

Tachycardia

0

increase of minute blood volume

1

decrease of minute blood volume

#

What is characteristic for glucose tolerance disorder?

0

absence of clinical symptoms of diabetes

0

normal level of blood sugar on an empty stomach

0

pathological glucose tolerance test

1

all enumerated

0

insulin secretion on the background of thyrotropia hormone above norm.

#

Insulin dependent diabetes mellitus is characterized by the following signs, except:

0

disease occurs at a young age

0

acute onset

0

decrease of body mass

1

stable course

0

necessity in insulin therapy

#

Insulin independent diabetes mellitus is characterized by the following signs, except:

0

onset of disease at an elderly age

0

gradual development of disease

1

labile course

0

excessive body mass

0

absence of susceptibility to ketoacidosis

#

Which coma develops violently, beginning from anxiety, fear, hallucinations, headache and locomotive excitation?

0

Hyperosmolar

0

Ketoacidotic

0

Hyperlactacidemic

1

Hypoglycemic

0

any of the enumerated

#

The following factors promote to the development of ketoacidotic coma, except:

0

unwarranted decrease of insulin dose

0

physical and psychic traumas

1

short-time decrease of food caloric value

0

Usage of alcohol beverages

0

concomitant infectious diseases

#

Rubeosis is characteristic for:

0

Myxedema

0

Obesity

1

diabetes mellitus

0

Thyreotoxicosis

0

Acromegalia

#

Complete arrhythmia is characteristic for:

0

diabetes mellitus

0

Myxedema

0

Obesity

0

Acromegalia

1

Thyreotoxicosis

#

Which disease complication is Kimmelstil-Wilson glomerulosclerosis?

0

Thyreotoxicosis

1

diabetes mellitus

0

Obesity

0

Myxedema

0

Acromegalia

#

In the 1-st degree obesity body mass exceeds the norm for:

1

20-30?

0

30-50?

0

50-100?

0

more than for 100?

0

5-10?

#

In the 4 degree obesity body mass exceeds norm for:

0

50-100?

0

5-10?

1

more than for 100?

0

20-30?

0

30-50?

#

For what kind of a chronic gastritis is typically: localization mainly in a body of a stomach, prevalence of atrophic changes in mucous tunic of stomach, reduced acidity of gastric juice and presence of antibodies to parietal cells?

1

Gastritis of type A

0

Gastritis of type B

#

For what kind of a chronic gastritis is typically: localization mainly in pyloric department of a stomach, prevalence of inflammatory changes in a mucous tunic of stomach, the increased acidity of gastric juice and presence Helicobacter pylori in mucous tunic of a stomach?

0

Gastritis of type A

1

Gastritis of type B

#

High figures of acidity are most typical for localization of ulcer:

0

In a body of a stomach

1

In a bulb of a duodenal gut (first part of duodenum)

#

Presence of a portal hypertension is most typical for:

0

Acute hepatitis

0

Chronic hepatitis

1

Cirrhosis of a liver

0

Stomach ulcer

#

Name a symptom that is not typical for distal colitis?

0

Blood in a stool

1

Watery diarrhea

0

Tenesmus

0

Spasmodic sigmoid gut

#

One of principal causes of development of an acute pancreatitis is:

0

Trauma of abdomen

0

Smoking

1

Cholelithiasis

0

Abusing sweet food

#

One of principal causes of development of a chronic pancreatitis is:

0

Trauma of abdomen

0

Smoking

1

Alcohol abuse

0

Sweet stuff abuse

#

What is typical for hemolytic jaundice?

0

Pain syndrome

1

Amplified disintegration of erythrocytes

0

Infringement of intestinal digestion

0

Portal hypertension syndrome

0

Liver impairment

#

For what localization of an ulcer late and night pains are typical?

0

Ulcerative esophagitis

0

Ulcer of small curvature of stomach

0

Ulcer of a bottom of stomach

0

Ulcer of the big curvature

1

Ulcer of a bulb of duodenal gut (first part of duodenum)

#

What symptom of stomach ulcer is basic?

0

Nausea

1

Pain

0

Vomitting

0

Diarrhea

0

Weight loss

#

Where the pain is mostly felt at pyloroduodenal ulcers?

0

In a zone of xiphoid process

0

In paraumbilical area

0

In right hypochondrium

1

In pyloroduodenal area

0

In left hypochondrium

#

What method of diagnostics of a stomach ulcer is the most informative?

0

The common analysis of blood

0

The analysis stool on the latent blood

0

Radiological

1

Esophagogastroduodenoscopy

0

Research of gastric secretion

#

Presence of melena is typical for:

0

Bleeding hemorrhoids

0

Ulcerative colitis

1

Gastric bleeding

0

Cracks of an anus

0

Cancer of sigma particle

#

What etiological factor is recognized in development of a chronic hepatitis as basic?

0

Alcohol

0

Illnesses of metabolism and accumulation

0

Chemical influences

1

Viral hepatitis

0

Medicines

#

What method of diagnostics of a chronic gastritis is the most reliable?

0

Laparoscopy

0

Ultrasound (US)

1

Biopsy a mucous membrane of a stomach

0

Cholangiography

0

X-ray a stomach

#

Concept “hypersplenism” contains:

0

Presence of an anemia

0

Enlargement of a spleen

1

Presence of an anemia, a leukocytopenia, a thrombocytopenia

0

Presence of a thrombocytopenia

0

Presence of a leukocytopenia

#

The portal hypertension is characterized by all listed symptoms, except one:

0

Varicose expansion of veins of a gullet

0

Varicose expansion of hypodermic veins of an abdomen

0


1

Hypertensic crisises (attack)

0

Ascites

#

What is the principal cause of bleedings from varicose veins of a gullet at patients with a portal cirrhosis of a liver?

0

Decrease of prothrombin

0

Decrease of proconvertin

1

The portal hypertension

0

Reduction of thrombocytes

0

Reduction of fibrinolysis

#

One of the following groups covers “early” symptoms of a cancer of stomach:

0

Causeless weakness, decrease in work capacity, apathy

0

Absence of appetite, disgust for food

0

The phenomena of gastric discomfort

0

Unmotivated weight loss

1

All mentioned above symptoms

#

At what disease from the listed gastric anacidity happens more often?

0

A chronic superficial gastritis

1

A chronic atrophic gastritis

0

A cancer of a stomach

0

A duodenitis

0

A stenosis of the pylorus

#

The most often a cancer of stomach is situated:

1

Antral department of stomach

0

Small curvature of stomach

0

Big curvature of stomach

0

Cardiac department of stomach

0

A bottom of stomach

#

The most often histological form of a cancer of a stomach is:

1

Adenocarcinoma

0

Scirrhous carcinoma

0

A solid cancer

0

Epidermoid cancer

0

Not differentiated cancer

#

To precancer diseases of a stomach concerns:

0

Ulcer of a bulb of a duodenal gut

0

Retrobulb ulcer of a duodenal gut

1

A stomach ulcer

0

A chronic gastritis with the raised secretion

0

An acute gastritis

#

To precancer diseases of a stomach concerns:

0

Ulcer of a bulb of a duodenal gut

0

Retrobulb ulcer of a duodenal gut

1

Polyposes of a stomach

0

A chronic gastritis with the raised secretion

0

An acute gastritis

#

Choose a symptom that doesn’t characterize a portal hypertension:

0

Bleeding from the expanded veins of a gullet

0

Varicose expansion of hypodermic veins of a stomach

0


1

Rise in temperature of a body

0

Ascites

#

What treatment from listed below isn’t recommended for patients with a hypotonia of a gall bladder:

1

Spasmolytics

0

Choleretic

0

Cholecystokinetic

0

Duodenal intubation

#

Complaints: on intensive colicky pains in the right hypochondrium, provoked by reception of fat, fried food; a nausea, bitterness in a mouth, etc. At the patient clinic of a dyskinesia of a gall bladder on:

1

To hypermotor type

0

To hypomotor type

#

Complaints: on long, constant, blunt pains or heavy feeling in the right hypochondrium; a nausea, bitterness in a mouth, etc. At the patient clinic of a dyskinesia of a gall bladder on:

0

To hypermotor type

1

To hypomotor type

#

What from preparations is not a stimulator of gastric secretion?

0

Caffeine

0

Histamine

0

Pentagastrin

1

Atropine sulfate

0

Insulin

#

What from the listed preparations is applied as a stimulator of gastric secretion:

0

Atropine sulfate

0

Omeprazol

1

Histamine

0

Almagel

0

Ranitidin

#

An attribute of a bleeding from a stomach ulcer is:

0

Strengthening of a previous pain

1

Vomitting by "a coffee grounds"

0

An irradiating (eccentric) pain in a back

0

Heartburn and sour smack in a mouth

0

A constipation

#

Its following forms concern to 1-st clinical stage of a cancer of a stomach:

0

The growth of a tumour limited to a muscular layer

1

The growth of a tumour limited mucous and submucous to layers

0

The growth of a tumour limited to a serous layer

0

Growth, within the limits of all wall of a stomach without metastasises

#

Its following forms concern to 4-th clinical stage of a cancer of a stomach:

0

The growth of a tumour limited mucous and submucous to layers

0

Growth within the limits of all wall of a stomach with metastasizes in regional nodes

0

Growth within the limits of all wall of a stomach without metastasizes in regional nodes

1

Growth of a tumour with germination in the next organs

0

A tumour of any sizes with the remote metastasises

#

Complication is typical of what disease as a pyloric stenosis:

0

A superficial gastritis

0


0

A cancer of a body of a stomach

1

A stomach ulcer

0

Àn atrophic gastritis

#

What attributes of disease are characteristic for a stenosis of the pylorus?

0

Black stool

0

Bloody vomiting

1

Vomitting character with the rests of the food eaten on the eve

0

Vomitting by " a coffee grounds "

0

Suddenly developed sharp epigastric pain

#

Duodenal ulcer are characteristic the following symptoms, except one:

0

A heartburn

0

A pain

0

Increase of acidity of gastric juice

1

Decrease of acidity of gastric juice

0

A constipation

#

Deep, methodical, sliding palpation is spent in the following sequence:

0

Sigmoid colon, blind, ascending, descending, a stomach, cross-section, a spleen, a liver, kidneys

1

Sigmoid colon, descending, blind, ascending, a stomach, cross-section, a liver, a spleen, kidneys

0

Sigmoid colon, descending, blind, ascending, cross-section, a stomach, a liver, a spleen, kidneys

0

Blind, sigmoid colon, ascending, descending, a stomach, cross-section, a liver, a spleen, kidneys

0

Blind, ascending, sigmoid colon, descending, a stomach, cross-section, a liver, a spleen, kidneys

#

Parameters testify to what condition of acidity of a stomach ðÍ - 0,9 in a body of a stomach in a basal phase of secretion?

1


0


0

Norm acidity

0

Gastric achylia

#


0


0


1

Norm acidity

0

Gastric achylia

#


0


1


0

Norm acidity

0

Gastric achylia

#

Obstructive (subhepatic) jaundice is characterized:

0

Increase of bilirubin due to indirect

1

Increase of bilirubin due to direct

0

Increase of thymol test

0

Increase scale of globulins

0


#

Attributes of a chronic pancreatitis are below-mentioned, except for one:

0

Localization of a pain in epigastric areas at the left

0

A diarrhea

0

Amplification{strengthening} of a pain after meal

1

A portal hypertensia

#

What from the listed radiological attributes of a stomach ulcer of a stomach specify functional frustration?

0

Presence of ulcer "niche"

0

Presence of deformation of a stomach

1

Hypersecretion

0

Cicatricial deformation of a bulb

0

Convergence plications of stomach

#

For a gastritis such as B all below-mentioned symptoms are characteristic except for one:

0

Presence Helicobacter pylori in a mucous membrane of a stomach

0

Localization mainly in antral department

0

Hyperacid condition

0

Prevalence of inflammatory changes

1

Presence of antibodies to own accessory cells

#

What therapy is most preferable at a gastritis of type A?

0

Antacid

0

NSAID

1

Replaceable therapy

0

Spasmolytics

0

Anticholinergic drugs

#

What therapy is most preferable at a gastritis of type B?

1

Antihelicobacteric therapy

0

Cholagogic preparations

0

Replaceable therapy

0

Spasmolytics

0

Fermental preparations

#

What from gastritises, as a rule, precedes a stomach ulcer:

0

Rigid

0

Polypous

0

Atrophic

1

Antral

0

Phlegmonous

#

Where the pain more often is felt at ulcers of cardial department of a stomach?

1

Under xiphoid process

0

In periumbilical areas

0

In epigastric areas at the left

0

In piloroduodenal areas

0

In epigastric areas on the right

#

What is contributing factor in development of a chronic cholecystitis?

0

A sensitization

1

A dyskinesia bile-excreting ways

0

Insufficiency of function of a pancreas

0

Hypochlorhydria

0

Hyperchlorhydria

#

What virus is the reason of a chronic hepatites?

0

A virus A

1

A virus B

0

Virus Å

0

Anyone

#

What complex of biochemical tests specifies on cholestasis?

0

Increase transaminases, sedimentary tests

1

Increase alkaline phosphatases, cholesterol, direct bilirubin

0

Decrease albumin, Ñ-jet fiber

0

Occurrence of rheumatoid factor

0

Decrease in blood of amount of erythrocytes, leukocytes, thrombocytes

#

Precancer disease of a stomach is not:

0

A chronic gastritis with thrombocyte on intestinal type

0


0

A chronic stomach ulcer

1

A duodenal ulcer

#

Colonoscopy with the help of flexible fiber-optic endoscop allows to make the following manipulations:

0

To examine all thick gut

0

To receive bioptic material

0

To execute simple surgical manipulations

0

To examine rectal, sigmoideum and descending guts

1

To execute all manipulations resulted here

#

Occurrence of disgust for meat food the most typical complaint of the patient:

0

Àtrophic gastritis

0

A stomach ulcer of a stomach

0

A duodenal ulcer

1

A cancer of a stomach

0

A gastritis with increased secretory function of a stomach

#

Early pains in epigastric areas at a stomach ulcer arise:

0

In 1,5 hours after meal

1

Through 30 - 40 minutes after meal

0

Early in the morning on an empty stomach

0

At night at dawn o'clock

0

On a hungry stomach

#

Palpation of ascending and descending part of colon is spent:

0

One right hand

0

One left hand

1

Bimanual palpation

0

A double hand

0

Slanting palpation

#

With what it is necessary to begin treatment of a simple sharp gastritis?

1

From washing a stomach

0

Introduction anticholinergic drugs

0

Purpose of antibacterial preparations

0

Introduction of caffeine

0

Introduction of glucose

#

The most typical features of a pain at a chronic gastritis with reduced secretory function of a stomach:

0

Sharp

0

Colicky pain

1

A painful symptom is not characteristic

0

A night pain

0

A hungry pain

#

What department of a stomach is mainly struck at a gastritis of type B?

0

Fundus

1

Antral

0

All stomach

0

A body

0

Cardiac part

#

Specify the basic action of alkalis at treatment of a stomach ulcer?

1

Antacidic

0

Spasmolytic

0

Regenerative

0

Motor-evacuating

0

Replaceable

#

What attribute speaks about connection cholangitis at a chronic cholecystitis is more often?

0

Vomitting

0

Sialorrhea

0

A pain

0

Feeling burst open in epigastrium

1

Hectic fever

#

A conducting clinical symptom of a cancer of cardial department of a stomach is:

0

Gastric discomfort

0

Absence of appetite

0

Weight loss

0

Feeling of an alien body behind a brest

1

Dysphagy

#

The seasonal pain is most typical for what disease of digestive system?

0

Cholecystitis

0

Cholelithiasis

1

A duodenal ulcer

0

Colitis

0

Hepatitis

#

For what disease of digestive system the "hungry" pain is characteristic?

0

Cholecystitis

0

Cholelithiasis

1

A duodenal ulcer

0

Colitis

0

Hepatitis

#

A pain in epigastric zone, that has surrounding character with irradiation in a back, testifies to:

0

A gastritis

0

A duodenal ulcer

1

A pancreatitis

0

A cholecystitis

0

A stomach ulcer of a stomach

#

What appetite characteristic for patients with a not complicated duodenal ulcer?

0

Perverted

0

Reduced

1

Increased

0

Disgust for meat food

#

The eructation from a smell of rotten eggs is characteristic for:

0

Not complicated stomach ulcer

0

A cirrhosis of a liver

0

A chronic pancreatitis

1

A stenosis of pyloric department of a stomach

0

A chronic hepatites

#

Feature of vomitting at patients from a stenosis pyloric department of a stomach:

0

At emetic weights an impurity of bile

0

At emetic weights an impurity of blood

0

At emetic weights an impurity of slime

1

At emetic weights the food accepted on the eve

#

Heartburn is based on:

0

An atrophy of a mucous membrane of a stomach

0

Hypochlorhydria

0

Achlorhydria

0

Gastroduodenal reflex

1

Gastroesophageal reflux

#

Vomitting similar to coffee ground is characteristic for:

0

A stenosis of the gatekeeper

0

Jaundices

1

A gastric bleeding

0

Achlorhydria

0

Abusings coffee

#

What does tarry stool (melena) testify to?

0

An intestinal bleeding

0

A bleeding from sigmoid colon

1

A gastric bleeding

0

A bleeding from hemorrhoidal veins

#

What kind of faeces is characteristic for a gastric bleeding?

0

With an impurity of fresh blood

1

Tarry stool

0

With an impurity of slime

0

Decoloured

0

Normal

#

What kind of stool do patients with the increased acidity of gastric juice have?

1

Constipation

0

Diarrheas

0

Alternation of locks with diarrheas

0

Faeces with an impurity of not digested food

0

Normal

#

There is a frog-like abdomen in case of:

0

Wind

0

Pregnancy

1

Ascites

0

Peritonitis

0

Adiposity

#

By what percussion sound is defined during percussion of an abdomen of healthy person?

0

Dull sound

0

Deadened sound

0

Deadened tympany sound

1

Tympany

0

Vesiculotympanitic resonance

#

What percussion sound is characteristic for ascites?

1

Dull sound

0

Deadened tympany sound

0

Tympany

0

Vesiculotympanitic resonance

0

Low tympany

#

Noise of hippocratic splash can testify to:

0

Wind

0

Ascites

0

Adiposity

1

Pylorostenosis

0

A hypostasis to a forward belly wall

#

A symptom of fluctuation characteristic for:

0

Wind

1

Ascites

0

Adiposity

0

Pylorostenosis

0

A hypostasis of a forward belly wall

#

Wooden belly at palpation characteristic for:

0

Wind

0

Ascites

0

Pregnancy

1

Perforations of an ulcer

0

A stenosis of the gatekeeper

#

What attribute is the most typical for a stenosis of the gatekeeper?

0

Retraction of a stomach in epigastric part

0

A swelling of an abdomen

0

Asymmetry of an abdomen

1

Visible peristalsis in the field of a stomach

0

Wooden belly

#

From what department of large intestines deep palpation on Obraztsov-Straghesko begins?

0

A blind gut

0

A colon

0

An ascending department of a large gut

1

A sigmoid colon

0

A descending department of a thick gut

#

Where is the bottom border of a stomach situated normally?

0

At the level of navel

0

2-3 sm lower navel

1

2-3 sm higher navel

0

4-5 sm lower navel

0

4-5 sm higher navel

#

What radiological symptom the most typical for a cancer of a stomach?

0

Smoothness of plications in mucous membrane

0

The slowed down evacuation

0

A symptom of "niche"

0

Deformation of a stomach

1

Defect of filling

#

What radiological symptom the most typical for a stomach ulcer with presence of an open ulcer?

0

Rough plications in mucous membrane

0

Slowed down evacuation

0

Deformation of a stomach

1

A symptom of a ”niche“

0

A symptom of defect of filling

#

What is irrigoscopy?

0

Endoscopic examination of small intestines

0

Endoscopic examination of large intestines

1

Radiological examination of large intestines

0

Radiological examination of small intestines

0

Laparoscopic examination of abdominal cavity

#

What does positive reaction on benzidine test during the research of faeces testify to?

0

Presence of eggs of worms

1

Presence of the latent blood

0

Presence of bilious pigments

0

Presence of stercobilin

0

Presence of slime

#

For what disease Gregersen’s reaction is positive?

0

A mechanical jaundice

0

Irritated intestines

1

A stomach ulcer

0

A hepatitis

0

A pancreatitis

#

Occurrence of an jaundice is connected with increase of the content:

0

Bilious acids in blood

0

Urobilinogen

0

Stercobilinogen

1

Bilirubin in blood

#

The reason of ascites at patients with a cirrhosis of a liver is:

0

Increase of bilirubin in blood

0

Increase of a spleen

0

Increase of a liver

1

A portal hypertensia

0

Increase of arterial pressure

#

Where is the bottom border of a liver defined normally according to the right mediclavicular line ?

1

At a level of the right costal arch

0

2 sm higher than the right costal arch

0

2 sm below right costal arch

0

At a level of navel

0

1 sm higher than the right costal arch

#

Normal size of a liver, according to Kurlov (in centimeters)

0

7 õ 8 õ 9

0

8 õ 7 õ 9

1

9 õ 8 õ 7

0

9 õ 7 õ 8

0

8 õ 9 õ 10

#

The most typical symptom of portal hypertension is:

0

Constipations

0

Diarrheas

1

Ascites

0

Jaundice

0

Skin itch

#

What is Kurvuazje’s symptom?

0

Morbidity in a point of projection of sigmoid colon

0

Morbidity in pyloroduodenal area

0

Morbidity in epigastric area

1

Palpation of increased and painful gall-bladder

0

Palpation of pylorus of stomach

#

What symptom is typical for a chronic cholecystitis:

0

Schetkin-Blyumberg’s symptom

1

Ker’s symptom

0

Pasternatskiy’s symptom

0

Mendel’s symptom

0

A symptom of fluctuation

#

What is Orthner’s symptom?

0

Morbidity in a point of a projection of a gall-bladder during palpation

1

Morbidity during tapotement with an edge of a palm on the right costal arch

0

Morbidity in Shoffar’s zone

0

Morbidity in Dejarden’s point

0


#

What is Ker’s symptom?

1

Morbidity in a point of a projection of a gall-bladder, especially on a breath

0


0


0

Morbidity in Dejarden’s point

0


#

What is Myussi-Georgievskiy’s symptom, or a phrenicus-symptom?

0

Morbidity in a point of a projection of a gall-bladder, especially on a breath

0


0


1

Morbidity in a zone of a projection of a gall-bladder during pressing between peduncles of right sternocleidomastoid muscle

0


#

What kind of bilirubin is determined normally?

0

Only a direct bilirubin

0

Only an indirect bilirubin

0

75 % of direct bilirubin from total

1

75 % of indirect bilirubin from total

0

25 % of indirect bilirubin from total

#

What function of a liver is characterized with sedimentary tests:

0

Antitoxic

0

Participation in a carbohydrate exchange

0

Enzyme formative

1

Protein formative

#

What function of a liver can be defined during the research of blood prothrombin?

1

Protein formative

0

Antitoxic

0

Participation in a carbohydrate exchange

0

Enzyme formative

#

What does increase of activity of alkaline phosphatase testify to?

1

Cholestasis

0

Infringement of carbohydrate function of a liver

0

Infringement antitoxic functions of a liver

0

Infringement protein formative functions of a liver

0

Affection of parenchyma of a liver

#

What does increase of a level of blood transaminase testify to?

0

Cholestasis

0

Infringement of carbohydrate function of a liver

0

Infringement antitoxic functions of a liver

0

Infringement protein formative functions of a liver

1

Affection of parenchyma of a liver

#

With a help of what method is participation of a liver in a lipid exchange studied?

0

Sedimentary tests

1

Definition of a level of cholesterol

0

Definition of enzymes of blood

0

Definition of albuminous fractions

0

Definition of prothrombin

#

For what kind of jaundices increase of whole bilirubin in blood is typical?

0

Mechanical

0

Hemolytic

0

Parenchymatous

1

All kinds of jaundices

#

Increase of conjugated bilirubin is observed in a case of:

0

Hemolytic jaundices

0

Iron-deficiency anemia

1

Mechanical jaundice

0

Hemolytic anemia

0

Pernicious anemia

#

Increase of unconjugated bilirubin is observed in a case of:

1

Hemolytic jaundices

0

Iron-deficiency anemia

0

Mechanical jaundice

0

Pernicious anemia

#

What method of inspection has the greatest value in diagnostics of bilious - stone illness?

0

Palpation

0

Auscultation

0

Percussion

1

Ultrasonic research

0

Duodenal intubation

#

Scanning a liver is a research with the help of:

1

Radioactive isotopes

0

X-ray radiation

0

Laparoscopies

0

Biopsy of a liver

0

Pneumoperitoneum

#

With a help of what method it is possible to study life-time morphology of a liver?

0

Scannings a liver

1

Puncture biopsy

0

Laparoscopies

0

Cholecystography

0

Splenoportography

#

How does portion B (cystic bile) usually received during duodenal intubation?

0

Follows independently through a probe

0

After an injection of atropine

1

After introduction through a probe of magnesium of sulfate

0

After introduction through a probe of a cabbage breakfast

0

After an injection histamine of hydrochloride

#

Bile of a portion B has a color:

0

Yellow

0

Light yellow

1

Olive

0

Golden-yellow

#

What does presence of crystals of cholesterol in bile testify to?

0

Nephrolithiasis

1

Cholelithiasis

0

Broncholithiasis

0

Gastrolithiasis

#

What is the name of faeces with a plenty of fat?

1

Steatorrhea

0

Melena

0

Fragmentation stool

0

Colorless

0

Kreatorrhea

#

For what disease it is characteristic colourless faeces?

0

Stomach ulcer

0

Colitis

0

Enteritis

1

Mechanical jaundice

0

Gastritis

#

What color are faeces at patients with a mechanical jaundice?

0

Black

1

Colorless

0

Grey

0

Brown

0

Dark brown

#

An attribute of insufficiency of a pancreas at patients with a chronic pancreatitis:

0

Presence of stercobilinogen in faeces

0

Presence of urobilinogen in faeces

0

Steatorrhea

0

Black color of faeces

0

Decoloured faeces

#

What viruses cause a chronic hepatitis?

0

A, Å

1

B, C, D

0

A, B, C, D, Å

PULMONOLOGY (pathology)

#

What clinical attribute is not characteristic for spontaneous pneumothorax?

0

Acute started from pains in a thorax

0

Dyspnea.

0

Cynosis

1

Dull sound at percussion on the obstructed part{side}

0

The compelled position of the patient

#

What clinical attribute the most typical at acute development ATELECTASIS?

1

Not sudden dyspnea or an asthma

0

Pain in a thorax

0

Strong sudden cough

0

Hemoptesis

0

Deposition of bodies of mediastinum in the pathological side

#

The factors contributing to occurrence of a acute bronchitis

1

Overcooling and influence of dampness

0

Smoking

0

Local an infection of a nasopharynx

0

Abusing alcohol

0

Overeating

#

The acute obstructive bronchitis is characterized

1

Dyspnea

0

Poor and badly departing sputum

0

Sibilant rales on expiration

0

Lengthening a phase of inspiration

0

Occurrence of moist sonorous rales

#

Duration of a acute bronchitis promotes except

1

Infringement of bronchial passage

0

Irrational application of antibiotic

0

Decrease in resistency of an organism

0

Oldage patients

0

Absence in a diet of enough of carbohydrates

#

Convincing criteria of diagnostics of a acute bronchitis is

1

The clinical data

0

The data of laboratory research of blood

0

The data of biochemical research of blood

0

Research of sputem

0

Roentgenchanges in lungs

#

For an obstructive bronchitis are characteristic

0

Cough with sputum

0

Absence of complaints to a dyspnea

1

Presence of the complicated breath

0

Small quantity viscous of sputum

0

Normalization of ventilation of the lungs in a phase of remission

#

Occurrence of a dyspnea at a chronic obstructive bronchitis is caused by lesions of

0

Tracheas

0

Large bronchial tubes

0

Bronchial tubes of average calibre

1

Fine bronchial tubes

0

Bronchioles

#

When patient need for treatment of a chronic bronchitis by antibiotics

0

Bad weather conditions

0

Allocation mucous sputum

1

Allocation purulent sputum

0

Strengthening a dyspnia

0

Antibiotics to apply does not follow

#

Sputum at a chronic bronchitis it is characterized

1

Change rheological properties

0

Increase in viscosity

0

Decrease in elasticity

0

Increase cryoproteines

0

Increase in quantity

#

Diagnostics of a degree of activity of a chronic bronchitis is based on

0

The clinical data

0

Parameters of the clinical analysis of blood

0

Definition proteinanalesis, , the Ñ-reactive protein

1

Cytological research of the sputum

0

Angiography of the lungs

#

A primary emphysema (type À) characterized

0

Increase in volume of a thorax

0

Decrease respiratory abilities of the lungs

1

Increase of the residual lung capacity

0

Increase of the transparenñy lungs

#

A secondary emphysema whith a chronic obstructive bronchitis characterized except

1

Clinical attributes of the pulmonary heart

0

Decrease diffusive abilities of the lungs

0

Increase of the residual lung capacity

0

Hypoxemia. and hypercapnia in the rest

0

Pneumosclerosis on the roentgenogram

#

Located emphysema is not

0

Vicarious emphysema

1

Senile emphysema

0

Periscar emphysema

0

Congenital lobe emphysema

0

Congenital unilateral emphysema

#

Vicarious emphysema develops from

0

A chronic bronchitis

0

The main bronchial tube

0

Narrowing trachea

1

Atelectasis of the lung

0

A bronchiectasis

#

The often reason of bacterial pneumonias (according to domestic researchers) is

0

Inhalation of toxic substances

0

Stresses

0

A hyperthyroidism

1

A pneumoccocus

0

Diseases of a liver.

#

Often clinical symptom of a acute pneumonia are

0

Ecchymosis

1

Nonsonorous fine moist rales

0

A pleura friction rub

0

Coarse moist rales

0

Completely absent of voice resonance

#

Often extrapulmonary complication of a acute pneumonia is

0

A hyperthyroidism

0

A hyperglycemia

1

An infective - toxic shock

0

A hepatites

0

A meningitis

#

Changes, present always at bronchial asthma:

0

Changes hematopoietic systems

1

The changed reactance of bronchial tubes

0

Changes of function of vegetative nervous system

0

Changes of function endocrine systems

0

A sensitization of an organism respiratory allergens

#

Woman, 57 years old, wad delivered to cardiology department. Suffers from pressing pain behind the sternum, which irradiates to left hand. Pain appeared 8 hours ago, its strength slowly increased. Objective data: heightened feeding, cyanosis, tones are subdued. Heart rate 88/min., blood pressure - 140/80 millimeters of mercury. On EKG deep Q at I, aVL, V1-V3, segment ST is higher than isoline and joined to positive T. What is localization of myocardial infarction:

1

Front-partition

0

Ventrolateral

0

Lateral

0

Posterolateral

0

Posterodiaphragmatic

#

Man, 62 years old, complains of scorch pain behind the sternum. Has essential hypertension for 7 years. Objective data: heightened feeding. Cardiac borders increased to the left, tones are subdued. Heart rate 72/min., blood pressure - 150/90 millimeters of mercury. On EKG segment ST is depressed, wave T is negative at V2–V6. Provisional diagnosis:

1

Acute myocardial infarction

0

Prinzmetal's angina

0

Exertional angina

0

Vertebral osteochondrosis

0

Myocardiodystrophy

#

Man, 48 years old, appeared to have constringent pain at cardiac region and behind the sternum during walking on 150-200m and going upstairs on 1 floor. Pain disappears during rest. Heart rate 62/min., blood pressure - 120/70 millimeters of mercury. On EKG regular sinus rhythm. What is the class of stenocardia:

0

CHD, progressive angina

1

CHD, stable exertional angina, class III

0

CHD, stable exertional angina, class IV

0

CHD, variant angina

0

CHD, stable exertional angina, class II

#

Man, 56 years old, scientist, appeared to have constringent pain behind the sternum several times a day during walking on 500m for 10min. Reducts pain with nitroglycerine. Objective data: inreased nourishment, cardiac borders normal, tones rhythmical, heart rate 78/min., blood pressure - 130/80 millimeters of mercury. On EKG wave T is leveled at V4-V5. Provisional diagnosis:

0

CHD, instable angina

0

CHD, stable angina, class I

1

CHD, stable angina, class II

0

CHD, stable angina, class III

0

CHD, stable angina, class IV

#

Female patient, 25 years. Suffers from ache at cardiac region, palpitation, feeling of heart intermission, breathlessness. Chronic rheumatic heart disease at anamnesis. Objective data: joints unchanged, diffusive cyanosis. Heart rate 96/min., arythmic pulse, frequent extrasystoles, blood pressure - 105/70 millimeters of mercury. Heart borders dilated. I tone on cardiac apex is weak, long systolic murmur. Accent of II tone upon pulmonary artery. Extrasystolic arrhythmia. Weak vesicular respiration. At lower parts – noteless, isolated rales. What changes of echocardiogram are most likely:

1

Dilatation of left auricle and left ventricle cavity

0

Dilatation of right ventricle cavity

0

Dilatation of left and right auricle cavity

0

Dilatation of right auricle cavity

0

Dilatation of left auricle and right ventricle cavity

#

Man, 52 years old. Suffers from pain at cardiac region during physical activity, giddiness. Frequent cases of quinsy. Objective data: paleness, blood pressure - 140/80 millimeters of mercury, heart rate 60/min., rhythmic, small, slow. Apical thrust strong, localized at 5 intercostal space 1cm left from linea medioclavicularis. I tone on cardiac apex is weak, small accent of II tone upon pulmonary artery. At 2 right intercostal space auscultated harsh systolic murmur, conducting to neck vessels. Choose heart desease:

0

Coarctation of aorta

0

Atherosclerosis of aorta

1

Aortic stenosis

0

Stenosis of right ventricular outflow

0

Atrial septal defect

#

Female patient, 23 years, suffers from painful hydropic joints. Recovered from quinsy 2 weeks ago. Objective data: cardiac dullness borders normal, I tone on cardiac apex is weak, systolic murmur, heart rate 100/min., blood pressure 120/70 millimeters of mercury, ESR 30 mm/h. Cronic decompensated tonsillitis. Provisional diagnosis:

0

Tonsillogenic cardiomyopathy

0

Myocardiodystrophy

0

Viral myocarditis

0

Bacterial endocarditis

1


#

Man, 32 years old, has been being under medical observation during 2 years on account of chronic rheumatic disease. A case of quinsy was diagnosed after overchilling. Choose optimal medicine:

0

Prednisolone

0

APP inhibitors

0

Beta-blockers

1

Benzylpenicillin

0

Vitamin C

#

Man, 52 years old. Suffers from morbus hypertonicus, II degree. Smoker. Doesn’ t take medicines routinely. Objective data: blood pressure - 175/105 millimeters of mercury, heart rate 92/min., vesicular respiration. Choose optimal antihypertensive agent:

0

Calcium antagonists

0

APP inhibitors

1

Beta-blockers

0

Adelphan

0

Clonidine

Documents

Int All Ques