Cardiopulmohematogastronephro PDF

PRASHNA 1 Which of the following symptoms is the main one in gastroesophageal reflux disease? Vomiting Cough Heartburn Nausea Arrhythmias PRASHNA 2 What are the most common of the listed causes of chronic gastritis? Yersinia Chlamydia Streptococcus Staphylococci Helicobacteria PRASHNA 3 Which...

PRASHNA 1 Which of the following symptoms is the main one in gastroesophageal reflux disease? Vomiting Cough Heartburn Nausea Arrhythmias PRASHNA 2 What are the most common of the listed causes of chronic gastritis? Yersinia Chlamydia Streptococcus Staphylococci Helicobacteria PRASHNA 3 Which of the following laboratory changes is characteristic of cholestasis syndrome? Increased alkaline phosphatase Increased serum iron Lower cholesterol Increased transaminase levels Increases myoglobin levels PRASHNA 4 What factors are leading in the onset and development of acute or chronic gallbladder inflammation? stagnation of bile chronic hepatitis chronic pancreatitis sedentary lifestyle high fat diet PRASHNA 1 A 42-year-old man complains of heartburn, feeling of lump behind his sternum, a sour reflux for a long time. Heartburn, feeling of lump is significantly reduced after taking almagel. He smokes, often drinks alcohol. On examination: in the lungs vesicular breathing. Heart sounds are clear, blood pressure 120/70 mm Hg. The abdomen is soft, painless. Analyzes of blood and ECG – are normal.Which of the following diagnoses is MOST possible? IHD, progressive angina Chronic galloping cholecystitis Gastroesophageal reflux disease HP - associated chronic gastritis Peptic ulcer disease of the duodenum PRASHNA 2 A 59-year-old man complains of a feeling of heaviness in the epigastrium after eating, reflux with eaten food, muscle weakness, rapid fatigue, hair loss. On examination: skin is pale, dry. A coated white tongue. The abdomen is soft, painful in epigastrium. CBC: erythrocytes 2,6х10¹² / l, Hemoglobin 79 g / l, Colour index 0,9. EGD (esophagogastroduodenoscopy): mucosal atrophy in the area of ​ ​ the body of the stomach.Which of the following diagnoses is MOST possible? Chronic duodenitis Stomach ulcer Chronic autoimmune gastritis Chronic non-atrophic gastritis Gigantic hypertrophic gastritis PRASHNA 3 A 32-year-old woman complains of a feeling of heaviness in the epigastrium after eating, belching with eaten food, poor appetite, unstable stools, weakness, rapid fatigue. On examination: skin is pale, dry, angular cheilitis, white coated tongue. The abdomen is soft, painful in epigastrium. In the blood: hyperchromic anemia. EGD (esophagogastroduodenoscopy): foci of atrophy in the area of ​ ​ the body, the fundus of the stomach.Which of the following diagnoses is MOST possible? Chronic duodenitis Chronic pancreatitis Stomach ulcer Chronic autoimmune gastritis Chronic non-atrophic gastritis PRASHNA 4 A 32-year-old man complains of "hungry" and night pains in epigastrium, which relieve after eating; heartburn, sour belching, constipation. These complaints have bothered her for 2 years. On examination: the tongue is clean, moist. The abdomen is soft, painful in the epigastrium on the right. EGD (esophagogastroduodenoscopy): hyperemia of the mucous membrane of the antral part of the stomach. Cytological examination of biopsy material and positive express urease test for Helicobacter pylori infection. Which of the following diagnoses is MOST possible? Stomach ulcer Reactive reflux - gastritis Chronic atrophic gastritis Chronic eosinophilic gastritis Chronic non-atrophic gastritis PRASHNA 5 A 40-year-old man complains of epigastric pain several hours after eating, on an empty stomach, at night. Sick for 1,5 - 2 years. He smokes. On examination: In the lungs vesicular breathing, respiratory rate 17 per minute. Heart sounds are rhythmic, heart rate 76 per min. Blood pressure 120/80 mm Hg The abdomen is soft, painful in epigastrium. Costovertebral angle tenderness (Pasternacki’s sign) negative.Which of the following diagnoses is MOST possible? Chronic gastritis Chronic pancreatitis Chronic cholecystitis Biliary dyskinesia Gastroesophageal reflux disease PRASHNA 6 A 40-year-old man complains of a prolonged burning sensation behind the sternum after a meal, which increases with leaning forward, a feeling of lump behind the sternum, sour reflux. On examination: Excessive nutrition. In the lungs, vesicular breathing. The heart sounds are clear, the rhythm is correct, blood pressure 130/80 mm Hg. The abdomen is soft, painless. ECG at the time of "burning" behind the sternum is normal.Which of the following diagnoses is MOST possible? IHD, progressive angina Chronic galloping cholecystitis Gastroesophageal reflux disease HP - associated chronic gastritis Peptic ulcer disease of the duodenum PRASHNA 7 Which of the following is the diagnosis of exception? Crohn's disease Colon cancer Pollyposis of the intestine Nonspecific ulcerative colitis Irritable Bowel Syndrome PRASHNA 8 A 55-year-old woman complained of a periodic bloating, growling, problems wit stool. She has had these complaints for several years. Which of the listed clinical syndromes is most likely in this case? Cytolytic Sideropenic Intestinal dyspepsia Gastric indigestion Functional dyspepsia PRASHNA 9 Which of the following medications causes constipation? Antibiotics Iron preparations Enzyme preparations Preparations of bile acids Preparations of magnesium sulfate PRASHNA 10 Which of the following conditions is contraindicated in irrigoscopy? Pain in the anus Stool disorders, constipation, diarrhea Acute anal fissure Mucous or purulent discharge from the anus Suspicion of rectum and sigmoid colon disease PRASHNA 11 Which of the following symptoms is the most probable in irritable bowel syndrome? Eructation of air Retrosternal pain during heartburn Heaviness in the right hypochondrium Pain in the epigastrium after eating Feeling of incomplete defecation PRASHNA 12 What is the most important in differential diagnosis of irritable bowel syndrome and chronic pancreatitis? Anemia Leucotytosis Elevation of transaminases Steatorrhea, Creatorrhea, Amylorrhea Positive fecal occult blood test PRASHNA 13 What is most frequently seen in functional diarhea? Anemia Leucocyturia Elevation of transaminases Steatorhea, Creatorrhea, Amylorrhea Associated vegetative disturbances PRASHNA 14 Indicate from the listed frequency of defecation per day for functional diarrhea? 2-4 times more than 5 times more than 10 times more than 15 times irrelevant PRASHNA 15 Which of the following is the most optimal drug for treatment of irritable bowel syndrome with constipation in elderly and old people? Smecta Dufalac Senna Castor oil Magnesia sulfate PRASHNA 16 Indicate what of the above is most important for the purpose of differential diagnosis between irritable bowel syndrome and dilation of hemorrhoidal veins: Thrombocytosis Leukocyturia Increase of transaminases Blood in the stool at the end of defecation Certain findings in colonoscopy PRASHNA 17 A 39-year-old man complains of frequent profuse fatty stools, bloating, weight loss. Abusing alcohol, sick for 10 years. On examination: reduced nutrition. On the skin of the trunk, "ruby drops", the stomach is bloated. Coprogram: pieces of food, muscle fibers.What is the preliminary diagnosis MOST POSSIBLE? Chronic colitis Chronic duodenitis Chronic cholecystitis Chronic pancreatitis Chronic reflux gastritis PRASHNA 18 A woman of 55 years complains of pain attacks in the right hypochondrium after eating fatty foods, nausea, sometimes vomiting. A year ago, a cholecystectomy for cholelithiasis was made. On examination: visible mucous membranes and skin are subicteric. On palpation, an area of tenderness is observed above the navel to the right of the middle line. In the blood: increased activity of glutamate dehydrogenase, aminotransferases, total bilirubin-39 μmol / l. EGD (esophagogastroduodenoscopy): an increase in the duodenal papilla to 1.2 cm on the background of hyperemic and edematous mucosa. Which of the following preliminary diagnoses is MOST possible? Chronic cholangitis, exacerbation Postcholecystectomy syndrome Chronic gastritis of type B, exacerbation Chronic duodenitis in the acute phase Chronic cholestatic hepatitis, exacerbation PRASHNA 19 A 33-year-old woman came to clinic complaining of pain in the right upper quadrant, more often after fatty foods, nausea, bitterness in her mouth. Sick for 5 years. Upon examination, the root of the tongue is yellow, the abdomen is slightly painful at the point of projection of the gallbladder.Which of the following diagnostic methods is needed to confirm the diagnosis? Recto-manoscopy Excretory urography US of kidneys, adrenals Gastric Ph test Ultrasound of the liver and gallbladder PRASHNA 20 The patient 51 years of age, for a long time there are pain and a feeling of heaviness in the right hypochondrium. On examination: upon palpation - pain at the point of projection of the gallbladder. Cholecystography: enlarged bladder of oblong shape with delayed emptying. What is the most probable preliminary diagnosis? Dyskinesia of the intestine Chronic cholangitis Chronic autoimmune hepatitis Chronic cholestatic hepatitis Chronic calculous cholecystitis PRASHNA 1 A patient of 32 years old has pain in the right hypochondrium after consuming fatty, fried foods. On examination: upon palpation - pain at the point of projection of the gallbladder. Ultrasonography of the gallbladder: thickening of the wall, concrements in the cavity of the gallbladder.What is the Most likely preliminary diagnosis? Dyskinesia of the intestine Chronic cholangitis Chronic autoimmune hepatitis Chronic cholestatic hepatitis Chronic calculous cholecystitis PRASHNA 2 A 65-year-old woman complains of epigastric pain attacks after consuming fatty foods, nausea, sometimes heartburn. 2 years ago, a cholecystectomy was made for cholelithiasis. On examination: visible mucous membranes and the skin are subicteric. On palpation - tenderness above the navel to the right of the middle line. In the blood: ESR 26 mm / h, total bilirubin-39 μmol / l. EGD ( esophagogastroduodenoscopy): an increase in the duodenal papilla to 1.2 cm on the background of hyperemic and edematous mucosa.Which of the following preliminary diagnoses is MOST possible? Chronic cholangitis, exacerbation Postcholecystectomy syndrome Chronic gastritis of type B, exacerbation Chronic duodenitis in the acute phase Chronic viral hepatitis, exacerbation PRASHNA 3 A 51-year-old man complained of epigastric pain, a feeling of epigastric heaviness after eating, a feeling of rapid saturation, belching. These complaints have been a concern for the past year.What syndrome should the therapy be directed to in this case? Malabsorption Cholestatic Intestinal dyspepsia Fermentation dyspepsia Gastric indigestion PRASHNA 4 A 29-year-old woman came to polyclinic with complaints of heartburn, which has been worrying for the past 2 months. Pregnancy is 29-30 weeks. Blood tests, ECG are normal, serological tests for Helicobacter pylori infection are negative.Which of the following most likely causes heartburn? Atony of the sphincter of Oddi Increased acidity Reduction of intra-abdominal pressure Increased intra-abdominal pressure Decreased pressure in the duodenum PRASHNA 5 A 43-year-old man complained of prolonged burning pains behind the sternum, diminishing or passing after eating. Pain worries for the last 2 months. ECG at the time of burning pain behind the sternum is normal.What study MUST be done to confirm the diagnosis? Esophagogastroduodenoscopy Echocardiography Ultrasound of the pancreas Duodenal sounding Retrograde cholangiography PRASHNA 6 A man of 48 years, complains of epigastric pain for several months. In the anamnesis rheumatoid arthritis, in occasion for which takes methotrexate, prednisolone 40 mg. On examination: In the lungs, vesicular breathing, respiratory rate 17 per min. The heart sounds clear, the rhythm is correct, heart rate is 76 min. Blood pressure 120/80 mm Hg The abdomen is soft, painful in epigastrium. Pastenacki’s sign ( costovertebral angle tenderness) is negative. EGD (esophagogastroduodenoscopy): ulcerative defect in pyloric part.Which of the following factors of stomach ulcer development is most likely in this case? Chemical Alimentary Autoimmune Helicobacter pylori Medication PRASHNA 7 A 40-year-old man complains of a prolonged burning sensation behind the sternum after a meal, which increases with leaning forward, feeling of a lump behind the sternum, sour reflux. On examination: Excessive nutrition. In the lungs, vesicular breathing. The heart sounds are clear, the rhythm is correct, blood pressure 130/80 mm Hg. The abdomen is soft, painless. ECG at the time of "burning" behind the sternum is normal.Which of the following diagnoses is MOST possible? IHD, progressive angina Chronic galloping cholecystitis Gastroesophageal reflux disease HP - associated chronic gastritis Peptic ulcer disease of the duodenum PRASHNA 8 A 43-year-old man complained of prolonged burning pains behind the sternum, diminishing or passing after eating. Pain worries for the last 2 months. ECG at the time of burning pain behind the sternum is normal.What kind of research is needed to confirm the diagnosis? Fibrogastroduodenoscopy Echocardiography Ultrasound of the pancreas Duodenal sounding Retrograde cholangiography PRASHNA 9 A woman of 25 years complains of epigastric pain after eating, at night, belching, constipation. Complaints worry for a long time, outpatient treatment for chronic gastritis. On examination: the tongue is moist, the root of the tongue is covered with white coating. The abdomen is soft, painful in epigastrium.What is needed to confirm exacerbation of chronic gastritis and identify Helicobacter pylori infection? Duodenal sounding Fecal occult blood test EGD with targeted biopsy Contrastive radiography of the stomach 24-hour Stomach ph test PRASHNA 10 A man of 29 years is suffering from chronic gastritis. On EGD (esophagogastroduodenoscopy): hyperemia of mucosa of the antral part of the stomach. PCR biopsy material found Helicobacter pylori infection.Which therapy is the main one in this case? Eradication Antiviral Spasmolytic Gastroprotective Detoxification PRASHNA 11 A 26-year-old man, complained of dizziness, tinnitus, thirst, severe weakness. In the anamnesis a peptic ulcer. Since yesterday, notes tarry stool. On examination: pallor of skin, sticky sweat. Pulse of weak filling and tension. BP 80/60 mm Hg. CBC: erythrocytes 2,9х1012 / l, Нв - 90 g / l, Colour index 0,9, leukocytes 9,0 thousands.Which of the listed complications of peptic ulcer developed in this case? Penetration Perforation Bleeding Maligination Stenosis PRASHNA 12 A male 33 years old with discomfort in the abdomen, constipation, developed a decrease in potency. When examining no abnormalities were found. What is the most likely diagnosis? Crohn's disease Chronic prostatitis Chronic pancreatitis Nonspecific ulcerative colitis Irritable Bowel Syndrome PRASHNA 13 A woman of 30 years with discomfort in the abdomen, alternating constipation and diarrhea, developed a violation of the menstrual cycle. When examining no abnormalities were found. What is the most likely diagnosis? Crohn's disease Chronic pancreatitis Chronic Salpingitis Nonspecific ulcerative colitis Irritable Bowel Syndrome PRASHNA 14 In a man of 50 years with complaints of blood in feces, a dense formation in the left ileal area of ​ ​ 5 sm in diameter, the cancer of the sigmoid intestine is suspected.What method of research from the listed is most likely to confirm a preliminary diagnosis? Ultrasound of the pelvic organs Rectal examination Colonoscopy with biopsy Ultrasound of the abdominal cavity organs Study of feces for occult blood PRASHNA 15 A man of 50 years, complained of blood in the stool for 3 months. Before this, about for about a year he had constipation, pain in the left iliac area. On examination: moderate nutrition., in the lungs - without pathology. Heart rate of 76 beats per minute. BP140/90 mm Hg, the tongue is wet, the abdomen is soft, painful in the left iliac region, where a dense formation of 5 cm in diameter is palpated. The liver along the edge of the costal arch. On rectal examination - without pathology.What is the most likely diagnosis? Sigmoid cancer Chronic cholecystitis Nonspecific ulcerative colitis Peptic ulcer disease of the duodenum Irritable Bowel SyndromeA 28-year-old woman complains about constipation, abdominal discomfort, prolonged aching pain in the region of the heart for 4 months. On examination: the blood analysis, a feces - within the limits of norm or rate. EFGDS, colonoscopy, ultrasound of the abdominal cavity, ECG, EchoCG - without pathological changes. What is the most likely diagnosis? Non-rheumatic myocarditis Nonspecific ulcerative colitis Peptic ulcer of duodenum Irritable Bowel Syndrome Gastroesophageal reflux disease PRASHNA 16 A man of 48 years old, turned to a general practitioner with complaints of frequent profuse fatty stools, bloating, weight loss. Abusing alcohol, sick for 10 years. On examination: reduced nutrition. On the skin of the trunk, "ruby drops", the stomach is bloated. In the coprogram - pieces of food, muscle fibers, steatorrhoea. Diagnosed: chronic pancreatitis, exocrine insufficiencyWhich therapy is the MOST recommended to the patient? Holospazmolytics ursodeoxycholic acid peripheral M-cholinolytics; drugs containing bile acids drugs containing pancreatic enzymes PRASHNA 17 A 52-year-old woman complains about pain in the right hypochondrium, chills, fever, weakness, itching skin. The patient had a cholecystectomy 3 years ago associated with gall stones disease. Objectively: skin and sclera jaundice, traces of scratching. The liver protrudes from under the edge of the costal arch by 5 cm, dense, the edge is pointed. Biochemistry of blood: blood bilirubin - 63.8 μmol / l, cholesterol - 7.9 mmol / l, alkaline phosphatase - 8 μmol / l. Retrograde cholangiography showed signs of obstruction of the common bile duct.Which of the following preliminary diagnoses would be the MOST appropriate? Chronic autoimmune hepatitis Primary biliary cirrhosis of the liver Secondary biliary cirrhosis of the liver Postcholecystectomy syndrome Chronic calculous cholangitis PRASHNA 18 A 33-year-old woman complains about pain in the right hypochondrium, weakness, drowsiness, decreased appetite, itchy skin, and periodic nasal bleedings within a month. From the anamnesis: he receives a TB treatment. Objectively: the skin and sclera icteric, traces of scratching. The liver protrudes from under the edge of the costal arch to 5-6 cm, painful. Moderate splenomegaly. Blood tests: bilirubin -118.6 μmol / l, ALT-2.8 μmol / l, thymol test-11 units, alkaline phosphatase-9.3 μmol / l. Which of the following preliminary diagnoses would be the MOST appropriate? Chronic hepatitis Drug-induced Hepatitis Autoimmune hepatitis Biliary cirrhosis Acute viral hepatitis PRASHNA 1 Which of the following diagnostic criteria is Iron Deficiency Anemia the main? hyperchromia normochromia hyperproteinemia decrease in ferritin levels increased ferritin levels PRASHNA 2 Which of the following reasons is fundamental to the development of Iron Deficiency Anemia? helminthic invasion overweight hemorrhoids alcoholism smoking PRASHNA 3 What syndrome is manifested by dry skin, brittle nails, hair loss and early graying, perversion of taste and smell? hemorrhagic hyperplastic intoxication sideropenic circulatory-hypoxic PRASHNA 1 For what type of anemia the following laboratory data: erythrocytes of 2.9 million, Hg - 78 g / l, CP-0.8, lei-you-4.0 thousand, tr-you-200 thousand would be the most characteristic to? hemolytic B12-scarce hypoplastic iron deficiency Sidero-asrhristic PRASHNA 2 A 28-year woman complains about of weakness, shortness of breath, palpitations, menorrhagia in the last six months. Objectively: the skin and visible mucous membranes are pale, transverse striation of the nails. Systolic murmur at the apex, tachycardia. In the blood: er-you 3.2 million, HB - 86 g / l, leuc. - 4,0tys, ESR-15 mm / h, anisocytosis ++, poikilocytosis ++. In the myelogram of sideroblasts, 12%. Serum iron is 7.0 μmol / l. What is the most likely diagnosis? B12-deficiency anemia hypoplastic anemia iron deficiency anemia sickle cell anemia autoimmune hemolytic anemia PRASHNA 3 A 25 –year woman applied to the GP with complaints of shortness of breath, palpitation, dizziness, noise in the ears, distortion of taste (eating chalk, flour), poor appetite, weakness. It is sick for 2 years, in the last 1.5 years, hyperpolymorrhoea. Objectively: reduced nutrition, skin and visible mucous membranes are pale, nails deformed. Lungs and heart – with no special features, the liver and spleen are not enlarged. Blood test: er-2.9 million, HB-72 g / l, CP-0.7, leukemia 4.0 thousand, ESR-26mm / h, anisocytosis ++, poikilocytosis +.Which method of investigation will be the MOST informative for the verification of a diagnosis? Hema test Kumbsa test immunogram blood proteinogram blood on serum iron PRASHNA 4 A 78-year-old woman complained about general weakness, shortness of breath, epigastric severity after taking food, a feeling of creeping "goose bumps" in the right lower limb. From anamnesis: Two years ago, a stomach resection was performed in connection with a pronounced cicatricial deformity. Objectively : the skin is pale yellow, subicteric sclera. The tongue is bright red, the cracks in the corners of the mouth. Tones of the heart are cramped, the rhythm is correct, heart rate 90 per minute, blood pressure 110/70 mm Hg. Moderate hepatomegaly. In blood tests: the erythrocytes are 2.5 million, HB is 80 g / l, CP-1.3, leuk.-3.5 thousand, tr-thou is 150 thousand, vol. bilirubin-45 μmol / l. What is the most appropriate treatment tactics? Administration of cyanoblamine in a dose of 200-400 mcg per day The introduction of cyanoblamine in a dose of 1000-1200 mcg per day Inward cyanocobalamin at a dose of 1000-1200 mcg per day Transfusion of erythromass Inside ascorbic acid in a dose of 1000-1200 mg per day PRASHNA 5 A 45-year-old man complains of weakness, sweating, weight loss, dull pain in the left hypochondrium. Objectively: the skin is pale, moist. Lymph nodes are not enlarged. The liver protrudes from under the costal arch to 3 cm, the spleen is at the level of the navel, pliable, painless. In the blood: the eras are 3.0 million, the leukemia is 96 thousand, the myeloblasts 2%, promyelocytes 4%, metamyelocytes 8%, fal. - 12%, segm-52%, eos.-5%, basophore-5%, lymph-12%, tr-thou -200 thousand, ESR-60 mm / h. What is the most appropriate diagnosis? Erythremia Chronic lymphatic leukemia Chronic myelogenous leukemia Acute myeloblastic leukemia Leukemoid reaction of the myeloid type PRASHNA 6 A 53-year old man, veterinarian, arrived with severe splenomegaly. Blood sampling show; RBC 3,2 х1012/ l, Hb - 98 g / l, WBC 120x109/ l, promyelocytes - 12%, myelocytes - 10%, p / 12% s /% I-32, 19-limf. % baz. 7%, 8%, eoz., ESR-42 mm / h. Reaction Wright and Heddelsona- negative. What is the most likely diagnosis? erythema’s acute leukemias brucellosis with chronic current lympholeukosis by a chronic chronic myeloid leukemia PRASHNA 7 A 65 year old patient old with lymphadenopathy. Blood sampling showed - leukocytosis with an absolute lymphocytosis, shadows Botkin, basket cells. What of the preliminary diagnosis is the most likely? Acute an leukemia blood lymphosarcomas lymphogranulematosis lympholeukosis with a chronic current chronic lymphocytic leukemia PRASHNA 8 A 55-year woman had an enlarged lymph node and spleen, hemogram showed a leukocytosis with lymphocytosis. To what disease these changes are most typical to? Erythema Acute leukemia lymphogranulomatosis chronic myelogenous leukemia chronic lymphocytic leukemia PRASHNA 9 What type of anemia is characterized by hyperchromia and megaloblastic type of hematopoiesis? hemolytic B12-scarce hypoplastic iron deficiency Sidero-asrhristic PRASHNA 10 What is the most typical myelogram for hypoplastic anemia? 3-x-sprout hyperplasia bone marrow devastation depression of the megakaryocytic sprout decrease in the number of sideroblasts megaloblastic type of hematopoiesis PRASHNA 11 A 18 year old man has a fever, hemorrhagic and anemic syndrome. Hemogram showed 40% of blasts. What is the most likely diagnosis? agranulocytosis acute leukemia aplastic anemia chronic myelogenous leukemia chronic lymphocytic leukemia PRASHNA 12 A hemogram of an 18 year old girl showed pancytopenia and high blastosis. The reaction to myeloperoxidase is "negative". What is the most likely diagnosis? aplastic anemia acute lymphatic leukemia chronic myelogenous leukemia chronic lymphocytic leukemia PRASHNA 13 A 19 year old girl noted changes in the form of her nails a "washing board", the pallor of mucous membranes and skin. For which type of anemia the surface of nail plates like "washing board” would be most characteristic to? hemolytic B12-scarce hypoplastic iron deficiency Sidero-asrhristic PRASHNA 1 A 19 year old patient has a lymphadenopathy, prominent weakness. In the UAC: er-2.5 million, HB- 79 g / l, watering can. -6.1 thousand, blasts - 85%, tr-you-100 thousand. Cytochemistry for myeloperoxidase and lipids - negative, Chic-reaction - positive in the form of granules. When immunophenotyping: markers CD10 +, CD19 +, cIg-, sIg-. What is the most likely diagnosis? Erythema Myeloma disease Lymphogranulomatosis Acute myeloblastic leukemia Acute lymphoblastic leukemia PRASHNA 2 For what diseases glivec and hydrea are the first choice:? Acute myeloid leukemia acute lymphocytic leukemia aplastic anemia chronic lymphatic leukemia chronic myelogenous leukemia PRASHNA 3 A 15 year old teenager complains about general weakness, fatigue, hair loss, fragility of the nail plates, dyspnea, palpitations with physical exertion. From anamnesis: general weakness worries since childhood, heart auscultation revealed tachycardia, systolic murmur on the apex of the heart, blood pressure 110/80 mm Hg. hemoglobin-87 g / l, erythrocytes -3.5 x 10 12 / l, color index -0.6, trophocytes-185 x 10 9 / l, leukocytes -4.0 x 10 9 / l, ESR 16 mm / h. What of the following anemia is the MOST likely? aplastic megaloblastic B12 deficit iron deficiency hemolytic folic deficiency PRASHNA 4 A 35-year-old man complains about prominent general weakness, a slight increase of temperature up to 37.2 ° C, pain in the chest, unrelated to physical activity, mainly behind the sternum and under the shoulder blades, intensifying with deep inspiration, bruising with no obvious reasons , hemorrhagic eruptions on the skin of the legs, forearms, abdomen. On examination: single subcutaneous hemorrhage. Palpable cervical, axillary lymph nodes 3-5 cm in diameter, b / w, moderate density. BH - 22 per minute, pulse 84 in 1 min., Rhythmic. AD-120/70 mmHg. UAC: er. - 2.8 million / l, Hb - 90 g / l, reticulocytes - 20%, throm. - 30 thousand, a lake. - 28.0 thousand, neutrophils: p / y - 10%, seq. - 20%, lymphocytes - 60%, monocytes - 10%. ESR - 52 mm / h. The preparation contains the shadows of Botkin-Humprecht. Ultrasound examination: moderate enlargement of the liver and spleen. Radiography of OGC: an increase in broncho-pulmonary lymph nodes.What is the most likely diagnosis? Chronic myelogenous leukemia, terminal stage Chronic lymphatic leukemia, progressive form Chronic lymphocytic leukemia, benign form Erythremia, III stage Lymphogranulomatosis, III stage PRASHNA 5 Which of the following drugs would be MOST appropriate to prescribe in women with profuse and prolonged menstruation in order to prevent IDA? corticosteroids Folic acid Iron preparations for a week Iron preparations for 2 weeks iron preparations for 6 weeks What therapeutic tactics would be the most suitable for the prevention and treatment of neiroleukemia in acute leukemia? plasmapheresis forced diuresis antibacterial therapy head irradiation in a dose of 24 Gy transfusion of fresh whole blood PRASHNA 6 What period of acute leukemia is the most optimal for carrying out allogeneic bone marrow transplantation in patients? relapse first attack first remission Second remission terminal stage PRASHNA 7 A 53 year old male came to an appointment to the GP with complains about the feeling of heaviness in the left hypochondrium. On examination: expressed splenomegaly. Blood analysis: the ergs of 4.1 x 1012 / l, HB-120 g / l, leukemia-130x109 / l, promyelocytes - 3%, myelocytes - 5%, young - 9%, p / y-17%, s / i-48%, eos.7%, base-3%, lymph-8%, tr-ty-350x109 / l, ESR-28mm / h. What is the most likely diagnosis? Erythremia Acute leukemia osteomyelosclerosis chronic lymphocytic leukemia chronic myelogenous leukemia PRASHNA 8 What frequency and what kind of examination are prescribed to patients with iron deficiency anemia during dispensary observation in the polyclinic? Once a year, a sternal puncture 2 times a year, ultrasound of internal organs 2 times a year, biochemical analysis (liver tests) 2 times a year, general blood test and sternal puncture 2 times a year - a general blood test and serum iron composition PRASHNA 9 What is the most radical treatment for myelodysplastic syndrome? differentiating drugs cytostatic chemotherapy colony-stimulating factors Allogeneic bone marrow transplantation Transfusion of erythrocytic mass and thrombocytes PRASHNA 10 A 30-year-old man came to an appointment with complains about nasal, gingival hemorrhage, marked weakness, dyspnea. Objectively: the skin is pale, bruising all over the body. Peripheral lymph nodes are not enlarged. Heart sounds are muffled, systolic murmur at all points. HRC-100 in min. AD-100/70 mmHg. For the rest of the organs with no special features. Blood test: er. 2.0 million, HB-60 g / L, CP-0.9, leukemia-1.5 thousand, tr-thou-50 thousand. Trepanobiopsy showed the predominance of fatty bone marrow. What is the most likely diagnosis? Acute leukemia hemolytic anemia B12-deficiency anemia Iron-deficiency anemia hypoplastic anemia PRASHNA 11 A 27-year-old pregnant woman with gestational period of 10-11 weeks came to an appointment to the GP with complains about weakness, dizziness, palpitations when climbing to the 2nd floor, dry skin, brittle nails, hair loss.Objectively: Skin covers and visible mucous membranes are pale, dry. Hair is dull, nails are brittle. Tones of the heart are muffled, tachycardia, heart rate is 80 per min, AD - 100/70 mm Hg. Art. In the UAC: er. - 3.8 million / l, Hb - 90 g / l, watering can. - 5,2 thousand, ESR - 25 mm / h. What drug is the most appropriate for the pregnant women? haemophore Sorbifer ginotardiferon milgamma actinferrin PRASHNA 1 What biochemical index increase is characteristic for the development of atherosclerosis? creatinine myoglobin total protein triglycerides high density lipoproteins PRASHNA 2 What is the nature of pain with angina? cutting crushing stitching dagger shooting PRASHNA 3 What is the classic radiating pain for stenocardy/? right shoulder occipital region left hand right hand right hypochondrium PRASHNA 4 What disease increases the likelihood of developing coronary heart disease? Hypothyroidism Osteochondrosis Chronic gastritis Chronic pancreatitis Chronic cholecystitis PRASHNA 5 What disease often develops dyslipidemia? COPD Hepatitis Hypothyroidism Hyperthyroidism Reactive arthritis PRASHNA 6 Which of the following indicators refers to the manifestations of resorption-necrotic syndrome? Hyperglycemia Hypercoagulation Hyperenzymia Hypercholesterolemia Hyperbilirubinemia PRASHNA 7 What is the optimal concentration of total cholesterol in the blood for a healthy person? 2 mmol / l 5 mmol / l 6 mmol / l 7 mmol / l 8 mmol / l PRASHNA 1 A 66-year-old man, following a family conflict, felt a sharp pain behind the sternum, radiating to his left arm. He claims he took 2 tablets of nitroglycerin, but the pain did not dissappear. There was a growing weakness. He is on dispensary registration in occasion of a bronchial asthma. On the electrocardiogram: sinus tachycardia up to 95 per minute. The electric axis of the heart is horizontal. Elevation of the ST segment, in I, aVL; V2-V4 leads.Which of the following would be the cause of myocardial infarction? Bronchial asthma Psychogenic depression Intercostal neuralgia Atherosclerosis of the coronary arteries Osteochondrosis of the cervical spine PRASHNA 2 A 60-year-old man, after physical exertion in the garden, felt a sharp pain behind the sternum radiating to the left shoulder. Having a rest, taking isoket did not bring relief. There was a growing weakness, cold, sticky sweat, a sense of death fear. What of the following ECG signs are characteristic of Q myocardial infarction of the anterior wall? The emergence of QS V1-V4 Elevation of the ST segment V1-V2 Depression of the ST segment V5-V6 The appearance of a broadened wave Q V3-V4 The appearance of a broadened Q-wave in I, II standard leads PRASHNA 3 A 60-year old woman complains about compressive chest pain when walking for more than 500 meters, lasting for 2-3 minutes, stopped by nitrates intake. The pain behind the sternum appears when walking in cold and windy weather. Objectively: a pulse of 86 beats per minute, blood pressure of 140/90 mm Hg. Heart tones are muffled, the rhythm is correct. On the electrocardiogram: sinus rhythm, correct, heart rate 75 per minute. The electric axis of the heart is horizontal.What is the most likely diagnosis? Angina pectoris of stress FCI Angina of exertion FCII Angina of Strain FCIII Stenocardia of tension FC IV Vasospastic angina PRASHNA 4 What changes on the ECG are considered a prognostically unfavorable sign of coronary artery disease during exercise testing? P wave broadening Sinus bradycardia Atrial extrasystoles Single ventricular extrasystoles ST-segment depression in several leads PRASHNA 5 A 55-year-old man, a builder, smokes 2 packs of cigarettes a day, came to an appointment to the GP with complaints about pressing pain behind the sternum after emotional exertion (troubles at work). His bodyweight is 100 kg. BP 160/92 mm Hg. ECG with no changes. What would be a unmodified risk factor for IHD in this case? Age Smoking Hypothyroidism Excessive body weight Arterial hypertension PRASHNA 6 A 60 year-old man, was delivered to the cardiac center with complaints of strong, "dagger" pain of a tightening character behind the sternum. The pain appeared suddenly. He took isoket 2 times with no effect. There was weakness, cold, sticky sweat. On the electrocardiogram: sinus tachycardia up to 95 per minute. The electric axis of the heart is horizontal. In II, III, aVF, the deep and broadened Q wave. During the examination, changes in blood tests were revealed. What particular change would be characteristic for resorption-necrotic syndrome? Leukocytosis Hyperglycemia Hypercoagulation Hypercholesterolemia Hyperbilirubinemia PRASHNA 7 A 54-year-old man complains about chest compressive pain, radiating to under scapular region, disappearing within 10 minutes after taking nitroglycerin. The pain occurs throughout the year, 1-2 times a month in the morning. What changes on the ECG can be recorded at the pain onset? Inversion of the T wave ST segment depression Deformation of QRS complex Elevation of the ST segment above the contour line Syndrome of shortened PQ interval PRASHNA 8 A 47-year-old man, while walking, periodically notes a brief feeling of compression behind the sternum with hands becoming numb. Pain does not intensify when making a deep breath and relived by nitroglycerin. The patient has to slow down his walking speed during the pain attacks. The patient claims that these episodes started 3 weeks ago. What would be the most likely diagnosis? Variable angina pectoris Stable angina Firstly, established angina pectoris Hernia's esophageal aperture Osteochondrosis of the thoracic spine PRASHNA 9 A 50-year-old man, a smoker with frequent exacerbations of COPD, woke up at night from burning sensation behind the sternum, which lasted for 30 minutes? And that was not associated with breathing. Before the ambulance arrival, he experienced sharp weakness and cold, sticky sweat.What would be the most likely diagnosis? Pulmonary heart Lung infarction Myocardial infarction Cervical osteochondrosis Spontaneous pneumothorax PRASHNA 10 A 60 year woman complains about headaches, especially in the temporal region after awakening, flies before her eyes, tinnitus. Her height is 165, the body weight is 62 kg. She claims that her condtion has worsened within a week. During examination: an increase in the heart boundaries to the left, heart sounds are muffled. Heart rate is 88 per minute, blood pressure 150/85 mm Hg. Urine analysis and Complete blood count showed no pathology. Which of the following diagnosis is the MOST probable? Arterial hypertension I degree, risk 2 Arterial hypertension I, risk 3 Arterial hypertension II degree, risk 4 Arterial hypertension of the II degree, risk 3 Arterial hypertension, grade III, risk 4 PRASHNA 11 Select from the following in what cases ACE inhibitors would be the MOST preferred treatment of hypertension? Pregnancy LV dysfunction Hyperkalemia Lactation period Bilateral stenosis of the renal arteries PRASHNA 12 A 35 old woman came to an appointment to the GP concerning sudden BP fluctuations up to 200/110 Hg mm. These attacks last from 20 minutes to one hour. On ultrasound, the left adrenal gland is enlarged, and urinalysis is normal. What of the following diagnoses is MOST possible? Pheochromocytoma Hyperfenoid cancer Hypertension Primary aldosteronism Cardiopsychoneurosis PRASHNA 13 A 48-year-old woman, buider, complains about headaches, flickering of flies before the eyes (small dots in the field of view), and poor sleeping. She smokes, her height 164 and body weight 92 kg. The heart sounds are muffled, the rhythm is correct, the accent of the second tone is above the aorta. Blood pressure 174/104 mm Hg. Pulse 88 per minute, rhythmic, intense. What of the following diagnoses would MOST possible? Arterial hypertension II st, risk 2 Arterial hypertension II st, risk 3 Arterial hypertension IIIst, risk 2 Arterial hypertension IIIst, risk 3 Arterial hypertension IIIst, risk 4 PRASHNA 14 A 62-year-old man complains about headache, a noise in ears, poor sleeping, a decrease in working capacity. He says he suffers from increased blood pressure for 8 years. The heart sounds are muffled, the rhythm is correct. General blood pressure - 185/115 mm Hg. st., HR-85 in. in minutes. Blood and urine tests with not pathology. Biochemical blood test: total cholesterol - 8.0 mmol / l, LDL cholesterol - 4.0 mmol / l.What of the following diagnoses is MOST possible? Arterial hypertension of the II degree, risk 3 Arterial hypertension I degree, risk 4 Hypertension III degree, risk 4 Arterial hypertension of the II degree, risk 1 Arterial hypertension, grade II, risk 2 PRASHNA 15 A 58 year old man, complains about headaches, flickering flies before his eyes, fatigue, increased blood pressure to 160/100 mm Hg. He had MI 3 years ago. Height 164 weight 86 kg. The heart sounds are muffled, the accent is 2 tones above the aorta. Blood pressure 175/105 mm Hg. Pulse 68 U. in a minute, rhythmic, intense. On the ECG: a sinus rhythm, a heart rate of 70 U. in. Min., A horizontal position of EOS, hypertrophy of the left ventricle.What of the following diagnoses would be the most likely? Arterial hypertension II st, risk 2 Arterial hypertension II st, risk 4 Arterial hypertension IIIst, risk 2 Arterial hypertension IIIst, risk 3 Arterial hypertension IIIst, risk 4 PRASHNA 16 A 36-year-old man was hospitalized due to heart attacks, heart rate-200 beats per minute. From the anamnesis, the patient is an alcoholic. Echocardiogram showed normal sizes and functioning of the left and right ventricles of the heart, absence of valvular defect.What diagnosis is MOST likely? Sinus arrhythmia, due to alcohol intoxication Sinus tachycardia due to alcohol intoxication Atrial flutter, due to alcohol intoxication Atrial fibrillation due to alcohol intoxication Paroxysmal tachycardia due to alcohol intoxication PRASHNA 17 What kind of rhythm disturbance should be thought of if a sharp shortening of the R-R interval to 0.3-0.4 seconds is registered on the ECG, narrow QRS complexes (less than 0.1 sec), heart rate from 160 to 250 per min with the correct rhythm preserved? Sinus arrhythmia Sinus tachycardia Atrial extrasystole Paroxysmal tachycardia Ventricular extrasystole PRASHNA 18 A 42-year-old patient suffers for from palpitations which disappear by themselves. Recently, the frequency of palpitations increased, appearing almost daily, accompanied by pain in the heart. On examination, the condition is of medium severity, the skin is pale, cyanosis is not expressed, there is no peripheral edema. Heart rate 200 per minute, pulse 200 per minute of weak filling and tension. BP 110/70 mm Hg. On the ECG, the rhythm is correct, the P wave is not detected, the QRS complex is not changed.What is the most likely rhythm disorder in the patient? Sinus arrhythmia Sinus tachycardia Atrial flutter Atrial fibrillation Paroxysmal supraventricular tachycardia PRASHNA 19 The patient complains about the the cardiac disruptions which occurred for the first time. On the ECG: in all leads there is no P wave, registers f waves, QRS is not changed. Heart rate per minute is 152-124 times.What pathology most likely developed in the patient? Atrial flutter Sinus tachycardia Atrial fibrillation Ventricular fibrillation Atrial extrasystole PRASHNA 20 On the ECG, a complete block of the right leg of the bundle of His can be seen. Which electrocardiographic signs would be the most characteristic? Absence of QRS-complex The presence of F waves instead of the wave P Duration of the QRS complex Gradual increase in the width of the interval PQ The ventricle complex in V1-2 has an M-shaped look. PRASHNA 21 An ECG was performed on a patient with cardiac arrhythmia.What are the most likely electrocardiographic signs of atrial flutter? Absence of QRS-complex The appearance of f waves instead of the wave P Gradual increase in the width of the interval PQ The ventricle complex in V1-2 has an M-shaped look. The appearance of F waves with characteristic sawtooth shape PRASHNA 22 On the ECG, sinus rhythm, a heart rate of less than 60 per min while maintaining the sequence and shape of the wave P, QRS, T.What conclusion would be most correct in this case? Normal ECG Sinus arrhythmia Sinus bradycardia Sinus node weakness syndrome Ventricular extrasystole PRASHNA 23 When tachycardia with a frequency of excitation of the ventricles 160 per min and broadened QRS complexes. What should be assumed? paroxysm of atrial flutter paroxysm of atrial fibrillation paroxysm of ventricular tachycardia frequent ventricular extrasystole frequent supraventricular extrasystole PRASHNA 24 On the ECG, the duration of the P-Q interval is greater than 0.20 s, followed by a normal ventricular complex. To what pathology these changes would be most most characteristic? atrioventricular block of III degree atrioventricular block of the I degree incomplete block of the right bundle branch leg block of the left anterior branch of the bundle block of the left posterior branch of the bundle PRASHNA 25 The ECG noted a gradual increase in the P-Q interval, with further loss of the QRS complex, this cycle is repeated again. To what pathology these changes would be most characteristic? Atrioventricular block of II degree Mobitz 1 Atrioventricular block of II degree Mobitz 2 Atrioventricular block of II degree Mobitz 3 Atrioventricular block of the third degree Atrioventricular block of the I degree PRASHNA 26 On the patient's ECG: the P-Q interval is constant, equal to 0.22 s, the ratio of P to QRS is 3: 1. To what pathology these changes would be most characteristic? Atrioventricular block of the II degree Mobitz 1 Atrioventricular block of II degree Mobitz 2 Atrioventricular block of II degree Mobitz 3 Atrioventricular block of the I degree Atrioventricular block of the third degree PRASHNA 27 On the ECG: in the 2nd standard lead QRS is broadened more for than 0.12s, in the chest leads V1 -V2 there is a deformed QRS complex in the form of the letter "M", widening for 0.12 sec. To what pathology these changes would be most characteristic for? Incomplete block of the anterior branch of the left bundle branch leg Incomplete block of the posterior branch of the left bundle branch leg Complete block of the right bundle branch leg Incomplete block of the right bundle branch leg Complete block of the left bundle branch leg PRASHNA 28 Within half a year a 75-year-old patient suffering from coronary artery disease, angina pectoris, had attacks of tachyarrhythmia, which were suddenly replaced by bradycardia. Appart from clinical symptoms, ECG with no significant abnormalities. What is the most likely preliminary diagnosis? Brugada Romano-Warda Weaknesses of the sinus node Jervela-Lange-Nilsson Wolff-Parkinson-White PRASHNA 29 The patient has a 16 years’ history of suffocation, general weakness, palpitations. The heart rate is 130 beats per minute, the blood pressure is 100/60 mm Hg, the QRS complex is of normal shape and duration; the number of P waves and ventricular complexes is the same, T wave is fused with R wave.What type of arrhythmia is observed in the patient? Atrial flutter Sinus extrasystole Atrial fibrillation Atrial paroxysmal tachycardia Sinus tachycardia PRASHNA 30 The patient suddenly had palpitations (160 beats per minute), which a doctor stopped with a carotid sinus massage. What could cause the palpitations? Sinus tachycardia paroxysmal ciliary arrhythmia paroxysmal atrial flutter paroxysmal supraventricular tachycardia paroxysmal ventricular tachycardia PRASHNA 31 A 25-year old patient complains about palpitations, prickling pain in the heart region, weakness, dyspnea. Since childhood the patient suffers from CRHD. Objectively: the skin is pale, clean, mild edema of the feet. Heart boundaries are increased to the left. At the apex weakening of the I sound, systolic murmur, accent of the 2nd sound on the pulmonary artery. Blood pressure 100/70 mm Hg The heart rate is 96 beats per minute.What stages of the heart failure correspond to these symptoms? Chronic heart failure of Stage I Chronic heart failure III stage Chronic heart failure II A stage Chronic heart failure II B stage Chronic heart failure is absent PRASHNA 32 A 27 –year old woman complains about palpitations, interruptions and heart pain, general weakness, dizziness, dyspnea. Since childhood, suffers from chronic rheumatic heart disease. During objective examination: heart rate - 128 beats per minute, pulse - 82 per minute. Blood pressure 110/70 mm HgWhat possible rhythm disturbance can be detected in the patient? Sinus tachycardia Paroxysmal tachycardia Ventricular fibrillation Atrial fibrillation Syndrome of premature ejection of the ventricles PRASHNA 1 A 55-year old man came to appointment complaints about shortness of breath, edema of the lower limbs. On examination: heart borders increased to the right, weakening of the І sound, systolic murmur in the V point, and epigastric pulsation.Which of the following heart defects would be the MOST possible? Lutambash Syndrome Aortic insufficiency Mitral insufficiency Tricuspid insufficiency Defect of interventricular septum PRASHNA 2 A 45-year-old man, complains about headaches, flickering flies in eyes, decreased working capacity, poor sleeping, shortness of breath with habitual exercise. He is smoker, height is 164, weight is 92 kg. He suffers from type II diabetes for 5 years. The heart sounds are muffled, the rhythm is correct. Blood pressure 174/104 mm Hg. Pulse 88 per minute, intense. On the ECG: left ventricular hypertrophy. What is the most likely functional class of the heart failure in the patient? I-th functional class II-th functional class III-rd functional class IY-th functional class II and III functional class PRASHNA 3 A patient with acute myocardial infarction experiences painful attacks behind the sternum within 48 hours after the development of a heart attack.When preparing a therapy program, what does one think of in order to treat the patient? Enlargement of the necrosis zone Recurrent myocardial infarction Secondary myocardial infarction Complication of myocardial infarction Subacute period of myocardial infarction PRASHNA 4 A man of 45 years old, suddenly lost consciousness at work. Pulse is frequent, poor filling. Severe pallor. Heart sounds are deaf, the rhythm is correct. Blood pressure 80/60 mm. After 4 minutes became conscious. There was a sharp weakness. On the ECG taken in the medical center - focal changes in the myocardium. What are the characteristic (specific) changes on the ECG in myocardial infarction with a Q wave in this patient? Impaired heart rate Block of the left bundle branch leg ST segment elevation in several leads ST segment depression in several leads The appearance of the QS complex in two or more leads PRASHNA 5 On the ECG, a 55-year-old man with complaints of persistent burning pains in the left half of the chest that lasted for more than 30 minutes after taking several nitroglycerin tablets, revealed: QS and ST segment elevation in II, III, AVF leads.For which location of myocardial infarction is this ECG characteristic? Myocardial infarction of the septum Circulatory myocardial infarction Q myocardial infarction of the posterior wall of the left ventricle Myocardial infarction of the anterior wall of the left ventricle Myocardial infarction of the lateral wall of the left ventricle PRASHNA 6 A 63-year-old man suffers from ischemic heart disease, complaints of pain of compressive character, radiating to the scapula, passing within 5-6 minutes after taking isoket. The pain occurs when climbing 2 flights of stairs.What kind of treatment is needed for this patient? Beta-blockers Calcium antagonists Antiarrhythmic drugs Angiotensin receptor blockers Anti-inflammatory non-steroid drugs PRASHNA 7 A woman, 40 years old, suffers from AH II stage and metabolic syndrome.Which of the following hypotensive drugs is the drug of choice? Diuretics ACE inhibitors Calcium antagonists Imidazoline-type agonists Angiotensin I receptor blockers PRASHNA 8 A 45-year-old patient with hypertension was prescribed drugs. Which of the following hypotensive drugs could cause bradycardia and atrioventricular block? ACE inhibitors Loop diuretics Beta-blockers Angiotensin II receptor blockers Antagonists of the dihydropyridine series PRASHNA 9 A 62-year-old man receives treatment from a local therapist for arterial hypertension, ischemic heart disease complicated by chronic heart failure, and a 6.4-mmol / l potassium biochemical blood test.Which of the following drugs could cause changes in the blood? Beta-blockers Calcium antagonists Loop diuretics Thiazide diuretics Potassium-sparing diuretics PRASHNA 10 A man of 49 years has been suffering from COPD for more than 15 years. During the last 2 years, he noted an increase in blood pressure to 160/95 mm Hg. Art.Which of the following drugs is contraindicated for this patient? Diuretics ACE inhibitors β-adrenoblockers Calcium antagonists Imidazoline receptor agonists PRASHNA 11 A woman is 25 years old, pregnancy is 26-27 weeks, she does not have any complains. On examination: the heart sounds are clear, the rhythm is correct. AD 145/90 mm.rt. Art. On the ECG: a sinus rhythm, a heart rate of 73 per min., The normal position of the Electrical axis. Earlier, the increase in blood pressure was not observed, no diseases run in the family. Urine analysis: protein - traces, biochemical analysis without pathology.Which of the following antihypertensive drugs MOST appropriate to prescribe? Beta - blockers ACE inhibitors Calcium antagonists Angiotensin Receptor Blockers 1 Stimulators of central alpha2-adrenergic receptors PRASHNA 12 A young man of 17 years complains of a headache. On examination: weakening of the pulse on the arteries of the lower limbs, systolic murmur on the base of the heart and in the interscapular space on the left. Blood pressure 180/100 mm Hg. On the chest X-ray, lower edges of the ribs are seen.Which of the following treatments is MOST useful? Diuretics ACE inhibitors α-adrenoblockers Surgical treatment AT1 receptor blockade (ARB) PRASHNA 13 A 61-year-old man with postinfarction cardiosclerosis suddenly lost consciousness, which was accompanied by convulsions, involuntary urination and defecation. The heart sounds are deaf, the rhythm is wrong. Blood pressure 100/75 mm Hg. On the ECG, AV block of the II degree, Mobitz II with the Wenckebach-Samoilov periods.What complication most likely developed in this patient? Fainting Pulmonary edema Arrhythmic shock Cardiogenic shock Morgagni-Adams-Stokes Attack PRASHNA 14 A 55-year-old man complained about palpitations, shortnening of breath, general weakness. He considers himself to be sick for about 3 days, with a history of myocardial infarction. The P wave is not recorded on the ECG. There are atrial waves F with a frequency of 250 per minute, the same length, shape and height, are clearly visible in the leads II, III, avF, V1. The R-R intervals are the same. QRS complex is not changed.What is the likely rhythm disturbance in the patient? Sinus arrhythmia Atrial fibrillation Atrioventricular blockade of the I degree Atrioventricular blockade of degree II Atrial flutter, the correct form PRASHNA 15 A woman of 60 years old, seen by cardiologist with IHD, hypertension. On examination, blood pressure of 160/90 mm Hg, heart rate-115 per min, sinus tachycardia.Which of the following group of drugs should be prescribed first? Diuretics Beta blockers Cardiac glycosides Alpha-blockers Angiotensin II inhibitors PRASHNA 16 A man of 72 years, complains of shortness of breath, weakness, fatigue, swelling of the legs and feet. One year ago he suffered from a myocardial infarction. In the lower lungs, wet rales are heard. The liver is enlarged by 2 cm. On the ECG: sinus rhythm, heart rate of 88 per minute. There are signs of cicatricial damage to the myocardium. The condition is regarded as chronic heart failure II B, FC III.What therapy is most indicated to the patient? Antiarrhythmic ACE inhibitors Calcium antagonists Cardiac glycosides Aldosterone receptor antagonists PRASHNA 17 The man is 60 years old, suffering from coronary heart disease, takes nitrates. Palpitations and intensification of compressive pains in the chest, which radiate to the scapula, worsen during a period of 5-6 minutes after taking the isoket. Pain occurs when climbing two flights of stairs.What kind of treatment is needed for this patient? Beta-blockers Calcium antagonists Antiarrhythmic drugs Angiotensin receptor blockers Anti-inflammatory non-steroid drugs PRASHNA 18 A 60-year-old patient suffering from diabetes mellitus (receiving mannil) for a number of years is diagnosed with hypertension. Objectively: the skin is dry, traces of scratching. HR of 92 units per minute, BP 170/95 mm Hg, blood glucose 7.9 mm mol / l, proteinuria - 1 g / l. Echocardiography: dilatation of the cavity of the left ventricle, moderate hypertrophy.Which of the available drugs is the MOST acceptable for the treatment of hypertension? triampur Clonidine enalapril verapamil metoprolol PRASHNA 19 A woman of 60 years old has an increase in body weight, facial edema. Speech is slowed; the skin is dry, pale, with hyperkeratosis. Diffuse dense edema is defined. Heart rate - 50 per min. Blood pressure - 100/60 mm Hg In the analysis of blood: RBCs. - 3,45х1012 / l; Нemoglobin - 95 g / l; WBCs - 4.6x109 / l; glucose - 3.5 mmol / l.Which of the following is most likely recommended? Mercazolil Anaprilin L-thyroxine Bisoprolol Aldaron PRASHNA 20 A man of 29 years, complains of pricking pains in the region of the heart, fainting. Since childhood, he suffers from heart disease. Objectively: the pallor of the skin, pulsation of the cervical vessels, rhythmic swinging of the head. Upper percussion in the V intercostal space, systolic trembling. The heart rate is 80 beats per minute. The arterial pressure is 110/50 mm Hg.Which of the following group of drugs is the MOST accurate for this patient? Diuretics veroshpiron beta blockers ACE inhibitors calcium antagonists PRASHNA 21 A patient with hypertension is observed by the GP, takes prescribed drugs. On repeated admission the patient complains of nausea, headache. On the ECG - sinus bradycardia, heart rate 45 strokes per minute. Which therapy is the MOST accurate to the patient? nitates Diuretics preparations of potassium intravenous injection of euphyllinum discontinuation of the medication that reduces the heart rate PRASHNA 22 Male, 57 years old, teacher, 2 hours ago, while working in the garden, suddenly had a feeling of frequent irregular heartbeats, accompanied by weakness, unpleasant sensations in the heart. Similar sensations of palpitation, more often during a load, occur within half a year. These episodes were short and passed independently at rest. Over the past 2 years, there has been a marked increase in cholesterol levels (7.6 mmol / L - low-density lipoproteins predominate). Objectively: the skin is somewhat pale, hypersthenic body type. In the lungs, the breath is vesicular, there is no wheezing. The left border of the heart is on the mid-clavicular line. Blood pressure is 150/100 mm Hg. Art. Pulse on the radial arteries - frequent, arrhythmic, frequency - 102 bpm. Heart sounds at the apex have a variable sonority, are arrhythmic, heart rate is 112 beats per minute. The abdomen is soft, painless. The liver is not enlarged. Which test is most appropriate for clarifying the diagnosis? Hemostasiogram General clinical tests Biochemical blood test Daily ECG monitoring Electrophysiological examination of the heart PRASHNA 23 Male, 57 years old, teacher, 2 hours ago, while working in the garden, a sudden feeling of frequent, erratic heartbeat arose, accompanied by weakness and unpleasant sensations in the heart area. Similar sensations of heartbeat, more often during exercise, have been noted for six months. These episodes were short-lived and resolved spontaneously at rest. Data from preliminary records: over the past 2 years, cholesterol has been repeatedly elevated (7.6 mmol/l - low-density lipoproteins predominate). Objectively: the skin is somewhat pale, hypersthenic body type. In the lungs, the breath is vesicular, there is no wheezing. The left border of the heart is on the mid-clavicular line. Blood pressure is 150/100 mm Hg. Art. Pulse on the radial arteries - frequent, arrhythmic, frequency - 102 bpm. Heart sounds at the apex have a variable sonority, are arrhythmic, heart rate is 112 beats per minute. The abdomen is soft, painless. The liver is not enlarged.What is the most appropriate initial treatment strategy? cholesterol lowering drugs, diet anti-ischemic therapy, nitrates thrombolysis, antiaggregants and anticoagulants normalization of blood pressure, antihypertensive drugs remove paroxysm and restore sinus rhythm, antiarrhythmic PRASHNA 24 What changes are most likely to result from the simultaneous administration of ACE inhibitors (angiotensin-converting enzyme inhibitors) and potassium-sparing diuretics? reduction of cardiac output risk of developing hyperkalemia decreased efficiency of ACE inhibitors decrease in oxygen consumption in myocardium development of hypokalemia PRASHNA 25 A man of 60 years, complains of a headache, noise in the ears, poor sleeping, a decrease in working capacity and dyspnea. Increased blood pressure within six months. The heart sounds are muffled, the rhythm is correct. Blood pressure is 150/90 mm Hg. Art., Heart rate-80 miss. in min. Blood and urine tests without pathology. Biochemical blood test: total cholesterol 8.0 mmol / l, LDL cholesterol 4.0 mmol / l.Which therapy is the MOST accurate? Diuretics β-blockers ACE inhibitors cardiac glycosides angiotensin receptor antagonists PRASHNA 26 A man of 56 years, complains of headaches, flies before his eyes, fatigue. Three years ago he suffered from myocardial infarction. Height 164 weight 86 kg. The heart sounds are muffled, accent of the 2 sound above the aorta. Blood pressure 175/105 mm Hg. Pulse is 90 per second, rhythmic, intense. On the ECG: sinus rhythm, heart rate-92 beats per Min., Horizontal position of Electrical axis, hypertrophy of the left ventricle.Which therapy is recommended? Diuretics β-blockers ACE inhibitors cardiac glycosides angiotensin receptor antagonists PRASHNA 27 The man of 36 years, a long time has a rheumatic heart trouble. At objective survey: strengthened and poured a top push, increase in borders of heart to the left and up, easing І tone and systolic noise on a top, accent ІІ tone on a pulmonary artery. What therapy of heart failure is MOST shown the patient? diuretics β-blockers APF inhibitors antagonists of calcium antagonists of angiotenzinovy receptors PRASHNA 28 The patient takes warfarin after prosthetics of the mitral valve.What amount of INR should be maintained in the patient? less than 1.0 up to 2.0 2.0-2.5 3.0-3.5 more than 5.0 PRASHNA 29 A man of 60 years old, receives treatment from a local therapist for arterial hypertension, ischemic heart disease. Recently, shortness of breath, palpitations with little physical exertion, mild edema of feet. Hypotensive therapy was prescribed, which improved the state of health, but when checked biochemical blood test, potassium was 6.4 mmol / l.Which of the prescribed drugs could cause such changes in the blood? cardiac 10 mg Prestan 10/10 mg hypothiazide 12.5 mg / day veroshpiron 100 mg / day cardiogram 75 mg / day PRASHNA 30 A man with sudden complaints of tightening in the heart, headache, nausea, sweating. BP 165/95 mm Hg. The ECG recorded a sharp shortening of the R-R interval to 0.3-0.4 seconds, narrow QRS complexes (less than 0.1 seconds), a heart rate of 160 to 250 per min with the correct rhythm maintained.What violation of the rhythm is most likely in this case? Sinus arrhythmia Sinus tachycardia Atrial extrasystole Paroxysmal tachycardia Ventricular extrasystole PRASHNA 31 A man of 60 years, receives treatment from a local therapist for hypertension, ischemic heart disease, COPD. Recently, he noted shortness of breath, palpitations with little physical exertion, headache. Therapy was prescribed, which improved the state of health.Which therapy is MOST indicated for the patient? Diuretics β-blockers ACE inhibitors cardiac glycosides angiotensin receptor antagonists PRASHNA 32 A man of 57 years, with severe shortness of breath, with little physical exertion, blood pressure 100/70 mm Hg, with attacks of loss of consciousness. On ECG there is a complete dissociation between the P-wave and QRS complexes.What tactics of treatment is the most suitable? Assign cardioprotectors Assign calcium antagonists Assign beta blockers Combination of antiarrhythmic drugs Implantation of the pacemaker PRASHNA 1 Which of the listed agents is most common in urinary tract infection? proteas staphylococcus klebsiyella mycoplasma intestinal stick PRASHNA 2 Specify kidney topography? In small pelvis Retroperitoneally In the upper part of the abdominal cavity In the middle part of the abdominal cavity In the lateral abdominal canals PRASHNA 3 What is the most likely way of infection into the kidneys? contact hematogenic limfogenny urinogenic airborne PRASHNA 1 Patient M., 30 years old, 2 weeks after the angina, suddenly had swelling in the morning. Has a history of kidney disease. On examination: general condition of moderate severity, pallor and puffiness of the face, massive swelling of the legs, lower back, ascites, fluid in the pleural cavity. Auscultation of the lungs: respiration weakened in the lower lobes. Heart sounds are rhythmic, clear. Blood pressure is 190/120 mm Hg. Art. The abdomen is soft, painful on palpation in the area of ​ ​ the projection of the kidneys. Urine analysis: specific gravity- 1020, protein - 0.6 g / l, erythrocytes. - 50-60 in sp., Cylinders: hyaline, granular. CBC: Нemoglobin - 120 g / l, red blood cells - 4,6х10 / l, leucocytes - 8,3х10 / l, ESR - 20 mm / hour.What is the leading syndrome of the disease? Nephrotic uric acutely negative arterial hypertension Tubular disorders PRASHNA 2 For which of the listed pathologies development of the nephrotic syndrome is characteristic to? amyloidosis kidney tuberculosis Acute pyelonephritis infection of the urinary system interstitial nephritis PRASHNA 3 What of the following immunological indicators will be specific for the differential diagnosis of lupus nephritis? CRP RF ASL-O AT to Scl70 detection of antibodies to DNA PRASHNA 4 What of the following complications are most typical for urolithiasis? kidney tumor amyloidosis of the kidneys polycystic kidney disease glomerulonephritis urinary tract infection PRASHNA 5 A 18-year-old man complains of dysuria and fever. Previously, there were two episodes of urinary tract infection treated with oral antibiotics. Blood pressure 160/105 mm Hg. Art. Urine analysis: protein - 0.99 g / l, erythrocytes - 2-4, leucocytes-5-10 per p / sp. Serum creatinine is 90 μmol / l. On the completed urogram there is a bilateral vesicoureteral reflux.What is the MOST probable cause of this condition? reflux-nephropathy chronic pyelonephritis chronic glomerulonephritis Obstructiveuropathy at the prostate level chronic tubulointerstitial nephritis PRASHNA 6 Pregnant 12 weeks, with complaints of general weakness, aching pain in the lumbar region, associated with pregnancy, in 2 studies of urine analysis, taken in accordance with the rules of urine collection: specific gravity 1026-1028, white blood cells up to 30-40 in the field of vision, red blood cells 1- 2, bacteria +++, mucus ++.What drug is most suitable for the treatment? furagina gentamicin erythromycin Norfloxacin amoxicillin PRASHNA 7 Which form of chronic glomerulonephritis is most characteristic with symptoms as edema, proteinuria, hematuria? latent mixed hematological nephrotic hypertensive PRASHNA 8 What is the main mechanism in the pathogenesis of edematous syndrome? decreased secretion of ACTH acceleration of glomerular filtration Increased oncotic pressure decreased oncotic pressure decrease in the volume of circulating blood PRASHNA 9 Which of the following syndromes is the most common for urinary tract infections? dysuric Nephrotic nephritic Dyspeptic hypertensive PRASHNA 10 A man of 30 years after having angina , developed edema, hematuria, the BP has raised.What is the most likely diagnosis? acute glomerulonephritis Acute pyelonephritis CGN, exacerbation amyloidosis of the kidneys Nephrolithiasis PRASHNA 11 What is the most informative method of diagnosis of urinary tract infections? kidney biopsy general urine analysis kidney scintigraphy Zimnickiy urine test urine culture test PRASHNA 12 What level of glomerular filtration is most characteristic for the 3B stage of chronic kidney disease? 60-89 ml / min 45-59 ml / min 30-44 ml / min 15-29 ml / min less than 15 ml / min PRASHNA 13 What are the most typical signs of nephrotic syndrome in adolescents? mild edema, cyanosis, hyperlipidemia dense edema, cyanosis, hypoproteinemia swelling of lower legs, hyperalbuminaemia persistent swelling, pallor, hypoalbuminemia soft swelling, hypolipidemia PRASHNA 1 Teenager of 17 years complains of headaches, noise in the ears, edema of the face, urine color of "meat slops", BP increased up to 160/105 mm Hg. What is MOST probable cause of this condition? acute inflammation of the glomeruli increased fluid intake kidney ischemia increased osmotic pressure of blood plasma urolithiasis PRASHNA 2 A 42 year old man has in the analysis of urine: specific gravity - 1008, protein - 5.6 g / l, leukocytes 5-7 in the field of vision, erythrocytes 7-10, cylinders hyaline 1-2, granular - 8.What is the most typical disease for these changes? kidney cysts Acute pyelonephritis Urinary tract infections acute glomerulonephritis chronic glomerulonephritis PRASHNA 3 For what disease the following findings are the most characterisitic. Nechiporenko urine analysis: leukocytes-25,000, erythrocytes-600, cylinders-0? kidney tumors amyloidosis of the kidneys urinary tract infection acute glomerulonephritis chronic glomerulonephritis PRASHNA 4 A patient with diabetic nephropathy and impaired renal function developed a secondary pyelonephritis. Urine culture: E. Soli was found.Which of the following antibacterial drugs is most appropriate to prescribe in this situation? gentamicin amoxicillin with clavulanic acid tetracycline lincomycin erythromycin PRASHNA 5 Which of the following drugs are the basic anti-relapse drugs to treat urinary tract infections? NSAIDs Diuretics cytostatics antiaggregants antibacterial drugs, changing every month PRASHNA 6 What period of follow-up appointments is most appropriate after acute nephritis? 1 year 2 years 3 years 4 years 5 years PRASHNA 7 In a 32-year old woman with chronic renal failure anemia is found. Which of the following anemias is the most common in chronic kidney failure? В12 aplastic hyporegenerative folic-deficit autoimmune hemolytic PRASHNA 8 What is the period of dispensary observation in women after childbirth who had nephropathy of pregnancy? 5 years 1 year 2 year 3 years 6 months PRASHNA 9 A 39-year old woman complains of frequent urination, aching pain in the lumbar region, clouding of urine, general weakness. 5 years ago, after the birth, pain in the lower back, fever and dysuria. On examination: malnutrition. Temperature subfebrile - 37 degrees celcius. The heart sounds are muffled. Blood pressure 130/80 mm Hg, pulse -78 per min. Costovertebral angle tenderness (Pasternacki’s sign) is positive on both sides. CBC: Нв-112 g / l, leucocytes-7,8 thousand, ESR-25 mm / h. Nechiporenko urine analysis: leucocytes -20 000, erythrocytes-1000. After receiving a course of treatment the exacerbation of disease was stopped. Which of the following drugs do you recommend for anti-relapse treatment? NSAIDs Diuretics cytostatics antiaggregants antibacterial drugs, changing every month PRASHNA 10 A 35-year-old man complains of dull pains in the right lumbar region, painful urination, discharge of cloudy urine, malaise. Has beeb sick for about a year, when pains first appeared in the right lumbar region. He was treated in outpatient clinic, took furagin, antispasmodics. In urinalysis, leukocyturia, bacteriuria is constantly being detected.What is the most likely diagnosis? Acute pyelonephritis Acute glomerulonephritis Exacerbation of chronic pyelonephritis Exacerbation of chronic glomerulonephritis Chronic tubulointerstitial nephritis PRASHNA 11 For what disease the following findings in urine analysis is the most specific: specific gravity 1028, leukocytes to 50 in the field of vision, erythrocytes 1-2, bacteria +++, mucus +++ ? nephrolithiasis acute pyelonephritis acute glomerulonephritis chronic pyelonephritis chronic glomerulonephritis PRASHNA 12 Patient T., 35 years old, turned to the GP doctor with complaints of general weakness, nausea, periodic headaches. When examining the outpatient card, changes in urine tests in the form of proteinuria were revealed. When examined, the face is edematous, skin is pale, dry. Blood pressure - 170/110 mm Hg., auscultation of the heart: accent of the second sound over the aorta. In lungs without features. The abdomen is soft, painless on palpation, Pasternatcki’s sign is negative on both sides. The kidneys are not palpable. Complete blood count: erythrocytes - 3,0х10 / l, Нemoglobin - 100 g / l, colour index- 0,9, leucocytes - 7.8 thousands, ESR - 35 mm / hour. Urine analysis: specific gravity - 1002, protein - 1.0 g / l, leucocytes - 4-5, Erythrocytes - 5-8 , granular hyaline cylinders. Reberg's test: creatinine 250 μmol / l, glomerular filtration 28 ml / min, tubular reabsorption 97%. What is the most likely clinical diagnosis? bilateral chronic pyelonephritis, exacerbation, CKD IV stage chronic latent pyelonephritis, CKD IIIB stage chronic glomerulonephritis nephrotic form of exacerbation, CKD IV stage chronic glomerulonephritis mixed form of exacerbation, CKD IV stage chronic glomerulonephritis hypertensive form of exacerbation, CKD V stage PRASHNA 1 A statement of the fact of airway obstruction and its reversibility is possible when: Spirography Bronchoscopy Blood gas research X-ray of the lungs Angiopulmonography PRASHNA 2 What applies to selective β2-adrenostimulants? Isadrin Alupent Ephedrine Fenoterol Adrenaline PRASHNA 3 What are the side effects of inhaled glucocorticosteroids? Osteoporosis Diabetes Itsenko-Cushing's syndrome Arterial hypertension Candidiasis of the oral cavity PRASHNA 4 Which device is used to individually control the air flow rate? Evahaler Spirograph Nebulizer Handegler Peak flow meter PRASHNA 1 What clinical symptoms most likely indicate uncontrolled bronchial asthma? No symptoms at night No activity restriction Daily symptoms> 2 episodes a week Daytime symptoms ≤ 2 episodes a week The need for β2-agonists inhalations less than twice a week PRASHNA 2 A man smokes for 60 years from the age of 15, more than 1 pack of cigarettes a day. Symptoms of his disease was estimated on the MRC scale more than 2 points on the COPD assessment test scale at 20. What additional signs of chronic obstructive pulmonary disease will allow the patient to be classified as D? Symptoms NOT expressed More than 2 exacerbations per year Low risk of exacerbations Less than 1 exacerbation per year Degree of obstruction by GOLD 1-2 PRASHNA 3 A man smokes for 60 years from the age of 15, smokes more than 1 pack of cigarettes a day. Symptoms of his disease was estimated on the MRC scale more than 2 points on the COPD assessment test at 20.What additional signs of chronic obstructive pulmonary disease will allow the patient to be classified as D? Symptoms NOT expressed No exacerbation per year Low risk of exacerbations Less than 2 exacerbations per year Degree of obstruction by GOLD 3-4 PRASHNA 4 On an outpatient visit, a man of 50 years old, smokes from the age of 17, smokes 1 pack of cigarettes a day. Symptom of his illness was rated on the MRC scale by 1 point on the COPD assessment test scale in 9 points.What signs of chronic obstructive pulmonary disease will allow the patient to be classified as A? Symptoms expressed More than 1 exacerbation per year Less than 1 exacerbation per year High risk of exacerbations Degree of obstruction by GOLD 3-4 PRASHNA 5 A man of 60 years with a long history of smoking (more than 40 years) during the spirography (pulmonary function test) a severe degree of airflow speed limitation was identified.Which of these indicators are identified in the patient? FEV1 / FVC> 70% FEV1 FEV1 FEV1 ≥80% of the proper values FEV1 PRASHNA 6 The teenager of 17 years began to have a feeling of compression of the thorax, accompanied by audible in the distance wheezes. A similar state has been observed for the last 3 years from late summer to late autumn. On examination, pathological abnormalities in organs and systems have not been revealed. Which of the additional research methods will make it possible to verify the diagnosis? Electrocardiography Echocardiography Spirography Chest X-ray Bronchoscopy PRASHNA 7 A 22-year-old man came to an appointment to the GP with complaints of asthma attacks during fast walking, as well as night awakening from chest compressions and shortness of breath, cough in the morning with hard-to-remove viscous sputum, tears, runny nose. These symptoms have been observed mainly in the spring and autumn for 3-4 years. The examination was carried out, the syndrome of reversible bronchial obstruction was established on spirography, the volume of forced expiration was 70% of the required values.What is the pathomorphological basis of reversible obstruction? Cicatricial stenosis Peribronchial fibrosis Edema of the bronchial mucosa Bronchoscopic compression from the outside by a volumetric process Bronchial pressure from the outside with emphysema tissue PRASHNA 8 On admission, a teenager with complaints of wheezing in physical education classes, a feeling of nasal congestion. He has a runny nose, sneezing, tearing from May until the first snow falls. Objectively: the general condition is satisfactory. Skin is of normal color. The voice is nasal, profuse nasal mucous discharge. Percussion over the lungs revealed a pulmonary sound, on auscultation - vesicular breathing.What diagnosis is the most accurate for the patient? Bronchial asthma (BA) persistent remission BA intermittent, mild BA persistent, mild BA of persistent, moderate severity BA persistent, severe severity PRASHNA 9 A man of 60 years with a long history of smoking (more than 40 years) during the spirography a severe degree of airflow speed limitation was found.Which of these indicators are identified in the patient? FEV1 / FVC> 70% FEV1 FEV1 FEV1 ≥80% of the proper values FEV1 PRASHNA 10 At the reception, a 67-year-old man with complaints of dyspnea at rest, a persistent cough with scant sputum, poor sleeping. The patient can not leave the house on his own due to fear of deterioration. After the examination, the doctor asked to evaluate the symptoms of his illness on the basis of the COPD assessment test.What symptom is included in the scale of symptoms of chronic obstructive pulmonary disease COPD assessment test: Patient's body temperature assessment Doctor's assessment of spirography Patient evaluation of peakflowmetry The patient's assessment of the amount of sputum A doctor's assessment of radiological changes in the lungs PRASHNA 11 Female 35 years old. Complaints of cough with expectoration of sparse mucous sputum, dyspnea, chills, fever to 38.7 ° C, chest pain. She says the onset was acute, associated with hypothermia. 2 days ago there was a dry cough, a fever, the symptoms of intoxication began to increase. RR - 24 in 1 min. Auscultation of the lungs: weakened vesicular breathing, moist finely bubbly sonorous rattles in the lower parts of the right lung.What is your preliminary diagnosis? Acute pleurisy Acute bronchitis Bronchial asthma Community-acquired pneumonia Bronchoectatic disease PRASHNA 12 A patient who has been taking methotrexate for rheumatoid arthritis for many years had a fever, body temperature rose to 39.C, began to worry about a cough with scant sputum. On examination: RR 26 in 1 min, shortening of percussion sound on the right in subscapular region, weakened vesicular breathing, wet finely bubbling rales. These symptoms appeared after an acute respiratory viral infection. Which prospective pathogen is more likely to cause a developing pathological process? Legionella Pneumocystis Staphylococcus aureus E. coli Pseudomonas aeruginosa PRASHNA 13 A syndrome of bronchial obstruction is related to? Acute bronchitis Pulmonary tuberculosis Bronchial asthma Community-acquired pneumonia Nosocomial pneumonia PRASHNA 14 What is the main treatment for respiratory failure of grade III? Low-flow oxygen therapy Continuous use of euphyllinum Prolonged use of selective anticholinergics Prolonged administration of prolonged β2 agonists Use of inhaled glucocorticosteroids PRASHNA 15 What is the value of FEV1 with extremely severe airflow rate limitation in chronic obstructive pulmonary disease (COPD)? FEV1 FEV1 FEV1 ≥80% of the proper values 50% 30% PRASHNA 16 What symptom is included in the scale of symptoms of chronic obstructive pulmonary disease COPD assessment test? Patient's body temperature assessment Doctor's assessment of spirography Patient evaluation of peakflowmetry Doctor's assessment of radiological changes in the lungs Patient's assessment of exercise tolerance PRASHNA 17 What symptom is included in the scale of symptoms of chronic obstructive pulmonary disease COPD assessment test? Patient's body temperature assessment Doctor's assessment of spirography Patient evaluation of peakflowmetry The patient's assessment of the amount of sputum A doctor's assessment of radiological changes in the lungs PRASHNA 18 For what clinical situation is the physical symptom «crepitation» pathognomonic? Lung cancer Acute bronchitis Lobar pneumonia Bronchial asthma Chronic obstructive pulmonary disease PRASHNA 19 What complication of community-acquired pneumonia is the most dangerous for life? Abscess of the lung Gangrene lung Adhesive pleurisy Focal pneumonosclerosis Infectious-toxic shock PRASHNA 20 What antibiotics are prescribed for community-acquired pneumonia caused by an atypical microflora? Azithromycin (macrolides) Amoxicillin (betalactams) Gentamicin (aminoglycosides) Ceftriaxone (cephalosporins) Cefazolin (cephalosporins) PRASHNA 1 For what purpose do patients with bronchial asthma receive β2 agonists of short duration? With an expectorant For the purpose of liquefying phlegm With anti-inflammatory For the purpose of relieving attacks of suffocation In order to prevent attacks of suffocation PRASHNA 2 What is the basic treatment of bronchial asthma? β2 short-acting agonists Cholinolytics of short action Prolonged anticholinergics β2 long-acting agonists Inhaled glucocorticosteroids PRASHNA 3 A man of 55 years old has smoked from the age of 16, smokes 1 pack of cigarettes a day. In the history: exacerbation of the disease once per year. On the spirogram, the degree of obstruction by GOLD is 70% of the proper values. Symptoms of his illness were estimated on the scale MRC in 2 points on the COPD assessment test scale at 15.Which of the above should be prescribed to the patient as a basic therapy? Roflumilast Budesonide Fluticosone Tiotropium bromide Formoterol, if necessary PRASHNA 4 A woman smokes 60 years from the age of 14, smokes 1 pack of cigarettes a day. Difficulty coughing with sputum in the morning. Exacerbations of the disease 3 times a year. On the spirogram, the degree of obstruction by GOLD is 47% of the proper values. Symptoms of his illness were estimated on the scale MRC in 1 point on the COPD assessment test scale at 9.Which of the above should be prescribed to the patient as a basic therapy? Ventolin Berodual Atrovent Fluticasone + salmeterol Formoterol, if necessary PRASHNA 5 A man of 60 years with a history of smoking of more than 35 years, complained of a cough with mucopurulent sputum, shortness of breath with little physical exertion. On examination: RR - 34 in 1 min, diffuse cyanosis of the skin, nails in the form of hourglasses. The chest is barrel-shaped, the auxiliary muscles participate in the act of breathing. Percussion over lungs: boxy sound. On auscultation: weakened vesicular breathing, dry rales of different timbres.What additional assessment is needed to verify the diagnosis? Bronchoscopy, bronchography Sphyrography, determination of blood gases Determination of gases in the exhaled air Complete blood count, determination of IgE of blood General sputum analysis, sputum culture on flora PRASHNA 6 On an outpatient visit, a man of 49 years with complaints of a persistent cough with mucous expectoration, shortness of breath while walking. During inspection on a spirography the speed of an air stream of 80% of normal values was established, FEV1 / FVCL Prescribe treatment to this patient? Roflumilast Budesonide Fluticosone Ventolin if necessary Formoterol, if necessary PRASHNA 7 On an outpatient visit, a 65-year-old man with complaints of persistent cough with mucous sputum, dyspnea at rest, aggravated by walking. On spirography: the speed of an air stream of 45% from normal values was identified, FEV1 / FVCL Prescribe treatment to this patient? Ciclesonide Budesonide + formoterol Antibacterial preparation Indocaterol if necessary Formoterol, if necessary PRASHNA 8 At home, a 16-year-old teenager with complaints of pain in the epigastric region, increase in body temperature above 40 ° c was found by a doctor of the dispensary. Objectively: condition is severe: the temperature is 40.3 ° C, 35 bpm per minute. The right half of the chest lags behind in the act of breathing from the left, increased vocal jitter right below the angle of the scapula, there is a significant blunting of the pulmonary sound, on auscultation - bronchial breathing.What is the preliminary diagnosis of the patient? Pulmonary tuberculosis Exudative pleurisy Bronchoectatic disease Community-acquired pneumonia Aspiration pneumonia PRASHNA 9 A patient, who is on dispensary with a general practitioner for chronic obstructive pulmonary disease (COPD), has increased body temperature, chills, increased cough, sputum has become mucopurulent. Upon percussion: in the right subscapular region, dullness is determined. On auscultation: weakened vesicular breathing, shallow bubbling wet rales along with various dry in all fields.Which infectious agent is the most common in patients with COPD? Klebsiella Legionella Pneumococcus Haemophilus influenzae Pseudomonas aeruginosa PRASHNA 10 On admission, a teenager with complaints of wheezing in physical education classes, a feeling of nasal congestion. He has a runny nose, sneezing, tearing from May until the first snow falls. Objectively: the general condition is satisfactory. Skin is of normal color. The voice is nasal, abundantly detachable from the nose of the mucous nature. Upon percussion over the lungs: pulmonary sound, on auscultation - vesicular breathing.What diagnosis is the most accurate in this patient? Bronchial asthma (BA) persistent remission BA intermittent, mild BA persistent, mild BA of persistent, moderate severity BA persistent, severe severity PRASHNA 11 Woman of 33 years with complaints of paroxysmal cough with hard-to-separate sputum, chest tightness, the appearance of wheezing during fast walking. A similar condition is noted for 2 years in the summer-autumn period. On examination: the general condition is satisfactory. Skin is of normal color. RR at rest 20 in 1 min. Percussion of the lungs - pulmonary sound, on auscultation - vesicular breathing, disseminated dry wheezing. Heart: sounds of the right rhythm, clear. BP 110/70 mm Hg on both hands. The liver is palpable - at the edge of the costal arch. What kind of examination is required for the diagnosis in this clinical situation? Bronchoscopy Electrocardiography General clinical blood test Chest X-ray Spirography with bronchodilation test PRASHNA 12 A 37-year-old man turned to the general practitioner with complaints of asthma attacks, including at night, suppressed by ventolin injections up to 4-5 times a day. Suffers from allergic rhinitis all year round. In the anamnesis, bronchial asthma in childhood before he got 5 years old. There were no attacks of suffocation, a deterioration of the condition for more than a month. On examination, wheezing at a distance is audible. RR 22 in 1 min. Auscultation of the lungs: vesicular breathing, dry wheezing in all fields. Other organs without pathology.At the appointment, what drugs should be first prescribed to the patient? Mucolytic drugs Selective anticholinergics Antihistamines Antibacterial drugs Inhaled glucocorticosteroids PRASHNA 13 At home, a general practitioner examined a man of 49 years old, complaining of an attack of suffocation that occurred 2 hours ago at home, a cough with small separation of viscous glassy sputum. The condition is bad. The situation is forced: the patient sits in bed, leaning on it with his hands. The thorax is emphysematous. The number of respiratory movements is 30 per min., Exhalation is greatly restricted. Repeated use of berodual did not bring relief. There is marked diffuse cyanosis, swollen cervical veins. In the lungs, dry rattles of different timbres. Heart tones are muffled, right rhythm. Blood pressure 90/60 mm HgWhat is the diagnose of the patient? Status asthmaticus BA persistent severe A prolonged attack of bronchial asthma (BA) Chronic obstructive pulmonary disease, category C Chronic obstructive pulmonary disease, category D PRASHNA 14 A woman came to clinic complaining of asthma attacks, dosed with ventolin injections, cough with hard-to-remove viscous sputum. From the anamnesis: she was observed by the ENT doctor concerning a polyposis of the nose, marked intolerance to nonsteroid anti-inflammatory preparations.What drug should be prescribed firstly to the patient: Atrovent Ketotifen Montelukast Salmeterol Tiotropium bromide PRASHNA 15 A man of 39 years, the economist, from 18 years has been suffering from suffocation attacks with difficult exhalation. Attacks triggered by the smell of gasoline, cold air, accompanied by audible rattles in the distance, result in the release of a small amount of viscous sputum. When examined by a doctor the next day after an attack, the condition is satisfactory, body temperature is normal. Upon percussion: box sound, the borders of the lungs are lowered. On auscultation: weakened breathing, disseminated dry wheezes (buzzing and whistling) in all field of the lungs.Which diagnostic method is the MOST informative in this clinical situation? General clinical blood test Clinical analysis of sputum Computerized tomography of the lungs Radiography of the lungs in two planes Examination of function of external respiration PRASHNA 16 A 27-year-old woman turned to a general practitioner with complaints of a recurring feeling of chest tightness, which is accompanied by the appearance of wheezing during fast walking, with the inhalation of sharp odors. A similar condition has lasted for 2 years. These symptoms appear after infections of the upper respiratory tract. The doctor prescribed treatment: ciclesonide in a daily dose of 320 mcg per day in the form of inhalations. To stop the attacks of choking, use the bronchodilator salbutamol (ventolin).For what purpose did the doctor prescribe ciclesonide to the patient? With anti-inflammatory purpose Decreased tonus of the vagus nerve Blocking α-receptors of the bronchial tree Selective excitation of β2-adrenergic receptors of the bronchi Direct influence on the smooth muscles of the bronchi PRASHNA 17 A woman of 29 years has addressed with complaints: attacks of shortness of breath, cough with hardly detachable mucous sputum. In the anamnesis – allergic pollinosis. Objectively: BHD 26 in 1 min. Percussion of the lungs: pulmonary sound. Auscultation of the lungs: vesicular breathing, dry wheezing in all fields.What examination should be done to verify the diagnosis? Bronchoscopy Spirography Complete blood count With a reactive protein Blood gas examination PRASHNA 18 At admission, a teenager of 17 years with complaints of a runny nose in the spring-summer period for 4 years, is observed by allergist. During the last 2 years, had difficulty breathing, accompanied by wheezing during fast walking and running. On examination in the clinic, changes in respiratory volumes were not detected, in the lungs vesicular breathing. Heart: the sounds are clear, the right rhythm. Organs of the abdominal cavity without pathology.What disease was diagnosed by the doctor of the polyclinic? Chronic obstructive pulmonary disease, category A Bronchial asthma, persistent severe Bronchial asthma, persistent moderate severity Bronchial asthma, persistent with mild severity Bronchial asthma, intermittent to mild severity PRASHNA 19 A 32-year-old man suffers from asthma for long time. His disease was controlled by inhalation of 2 doses of ciclesonide (160 mg), β2 short-acting agonists used once a week during the day, at night for 3 months did not have to use them. Activity at home and outside home is not limited. In the lungs, vesicular breathing. What is the most likely diagnosis for this patient? BA, persistent moderate severity, complete control BA, intermittent light degree of severity, complete control BA, persistent with mild severity, uncontrolled course Bronchial asthma (BA), persistent severe, exacerbation BA, persistent with mild severity, complete control