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Mari State University

2021

Mari State University

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general medicine medical student exam anatomy physiology

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This is a set of multiple-choice questions (MCQs) from a pre-Goss exam at Mari State University in 2021, covering topics in general medicine. The questions cover topics including anatomy, physiology and infectious diseases.

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MINISTRY OF EDUCATION AND SCIENCE OF THE RUSSIAN FEDERATION FSBEI HE Mari State University APPROVE Director of the Medical Institute ____ prof. G....

MINISTRY OF EDUCATION AND SCIENCE OF THE RUSSIAN FEDERATION FSBEI HE Mari State University APPROVE Director of the Medical Institute ____ prof. G. Yu. Struchko “26” April 2021 STATE FINAL CERTIFICATION STATE INTERDISCIPLINARY EXAMINATION IN THE FIELD OF STUDY 31.05.01 GENERAL MEDICINE VARIANT 1 YOSHKAR-OLA, 2021 CHOOSE ONLY ONE CORRECT ANSWER 001. Mitosis provides: 1) genetic diversity; 2) maintaining the constancy of the genetic material; 3) crossing-over; 4) reduction of the chromosome set. 002. What anatomical formation forms the posterior wall of the inguinal canal? 1) lig. inguinale; 2) fascia transversalis; 3) aponeurosis m. obliquus externus abdominis; 4) mm. obliquus externus et transversus abdominis; 5) m. obliquus internus abdominis. 003. With endoscopy of the small intestine, a longitudinal fold is visible on the mucous membrane among the circular folds, and there is an Ampulla of Vaters on it. Which part and of which intestine does the doctor see? 1) the upper part (bulb) of the duodenum; 2) the horizontal part of the duodenum; 3) the descending part of the duodenum; 4) the initial part of the jejunum; 5) the final section of the ileum. 004. Choose the definition of neurosis that most fully corresponds to that from the standpoint of the theory of I.P. Pavlov about HNA (higher nervous activity): 1) any states of violation of the power law relations’ implementation by the centers (neurons); 2) only a violation of the development of conditioned reflexes of higher orders; 3) both answers, 1) and 2) are correct; 4) both answers 1) and 2) are incorrect. 005. Choose a selective M1-anticholinergic antagonist from the following drugs: 1) atropine; 2) pirenzepine; 3) trigegsyphenidyl. 4) tropicamide; 006. Select a possible unwanted side reaction of the body to the administration of ipratropium bromide from the following: 1) arterial hypotension; 2) bradycardia; 3) salivation; 4) dry mouth. 007. Choose the correct statement: 1) atropine is contraindicated in glaucoma; 2) hydrochlorothiazide is contraindicated in hypertension; 3) propranolol is a highly selective β1-adrenergic blocker; 4) formoterol increases the tonus of the bronchi. 008. The most common opportunistic infection in AIDS: 1) staphylococcal pneumonia; 2) pneumococcal pneumonia; 3) Friedlander's pneumonia; 4) Pneumocystis pneumonia. 009. The formation of granulomas from large macrophages in Peyer's patches in typhoid fever is observed at the stage of: 2 1) healing; 2) cerebral swelling; 3) the formation of ulcers; 4) cleansing of ulcers. 010. Deficiency of which hormone can cause polyuria? 1) somatotrophic hormone; 2) vasopressin; 3) adrenaline; 4) oxytocin; 5) testosterone. 011. Where is the renal corpuscle of juxtamedullary nephrons located? 1) in the renal cortex; 2) in the external renal medulla; 3) in the internal renal medulla; 4) on the border of the cortical and medullary substances; 5) in the medullary substance, at the tops of the pyramids. 012. Loose fibrous connective tissue includes the following types of cells: 1) fibroblasts, macrophages, mast cells, pericytes, plasma cells; 2) osteoblasts, osteocytes, osteoclasts; 3) astrocytes, epindymocytes, pigmentocytes, macrophages; 4) all of the above. 013. Dysfunction of which nerve can lead to aspiration of food masses? 1) lingual; 2) glossopharyngeal; 3) sublingual; 4) upper laryngeal; 5) vagus. 014. Specify microorganisms dominating in the distal parts of the intestine. 1) types of Bacteroides; 2) types of Clostridium; 3) types of Candida; 4) types of Streptococcus; 5) types of Lactobacillus; 6) types of Enterobacter. 015. Pellagra disease is associated with a deficiency of: 1) ascorbic acid; 2) vitamin PP; 3) retinol; 4) calciferol. 016. Conventionalism understands truth as: 1) the announcement of scientists at the choice of the most expedient and convenient scientific theory in use; 2) correspondence of knowledge of objective reality; 3) non-contradiction, self-consistency of knowledge; 4) knowledge useful to humans. 017. The emergence of modern medical sexology is associated with: 1) the spread of ethical nihilism, vulgar Freudianism; 2) the distribution of contraceptives and other products of pharmacists; 3) the spread of the porn and sex industries; 4) the scientific and technological revolution; 5) all of the above factors. 018. As a result of the Battle of Kulikovo, 3 1) Russia defended its independence in the fight against the crusaders; 2) Russia finally fell into dependence on the Golden Horde; 3) the role of Moscow as a center for the unification of Russian lands has increased; 4) Russia has conquered access to the Black Sea. 019. After graduation, the future Indian healer said: 1) an oath; 2) a vow; 3) a prayer; 4) a preaching; 5) did nothing. 020. In the names of anthelmintics, there are frequency segments: 1) -vir-, -andr-; 2) -press-, -tens-; 3) -verm-, -helm-; 4) -ang(i)-, -vas-. 021. The main condition for the appearance of a resting potential is the presence of a concentration difference outside and inside the cell, mainly ions of: 1) Na+, K+ and Cа2+; 2) Na+ and Cl-; 3) K+ and Cl-; 4) Na+, K+ and Cl-. 022. Metalloprotein is: 1) inulin; 2) cellulose; 3) hemoglobin; 4) hyaluronate; 5) ribonuclease. 023. What does not participate in protein biosynthesis? 1) glycine; 2) ornithine; 3) leucine; 4) arginine; 5) tryptophan. 024. The value of the correlation coefficient ranges: 1) from 0 to 1; 2) from 0 to 2; 3) from 0.5 to 1; 4) from -1 to +1; 5) from -10% to + 10%. 025. The International Classification of Diseases, 10th Edition is divided into: 1) 18 classes; 2) 19 classes; 3) 20 classes; 4) 21 classes; 5) 22 classes. 026. Infectious diseases are divided into anthroponoses, zoonoses and saprophytes according to the following characteristics: 1) reservoir of infection; 2) source of the infection; 3) tmechanism of pathogen transmission. 027. Preventive measures are carried out: 1) regardless of the presence of infectious diseases cases; 4 2) in isolated infectious diseases cases; 3) in multiple infectious diseases cases. 028. Which of the following stages of the eczematous process is the most valuable for confirming the diagnosis of eczema? 1) vesicular; 2) cortical; 3) oozing lesion; 4) squamous; 5) erythematous. 029. What disease is characterized by rashes on the skin of the palms and soles: 1) herpes; 2) gonorrhea; 3) mycoplasmosis; 4) syphilis; 5) soft chancre. 030. Early diagnosis of lesions of the nervous system in AIDS is facilitated by the detection in the cerebrospinal fluid of: 1) an increase in the titer of HIV antibodies; 2) high lymphocytic pleocytosis; 3) increasing the content of immunoglobulin G; 4) 1 and 3 are true; 5) 1 and 2 are true. 031. In classic trigeminal neuralgia, there is: 1) permanent pain syndrome; 2) hypalgesia on the face in the area of innervation of the II and III branches of the trigeminal nerve; 3) trigger areas on the face; 4) psychomotor agitation during an attack; 5) 2 and 3 are true. 032. Borderline mental disorders are characterized by: 1) delirium, hallucinations, confusion; 2) withdrawal syndrome; 3) personality degradation; 4) neurotic and personality disorders; 5) impairment of memory and intelligence. 033. Alcohol degradation includes all of the above, except: 1) persistent changes in memory and intelligence; 2) ignoring ethical norms; 3) thought disorder in the form of disruption; 4) psychopathic manifestations; 5) loss of a critical attitude towards alcohol abuse and their condition. 034. From what part of the nasal cavity bleeding is most often caused? 1) from the inferior turbinate; 2) from the middle turbinate; 3) from the osseous part of the nasal septum; 4) from the cartilaginous part of the nasal septum; 5) from the cavernous venous plexus. 5 035. At what age do adenoid vegetations most often occur in children? 1) up to one year; 2) from 1 to 2 years; 3) from 3 to 7 years; 4) from 8 to 12 years; 5) over 12 years. 036. In the differential diagnosis of an acute attack of glaucoma and acute iridocyclitis, the following are important: 1) complaints, medical history; 2) the state of the anterior chamber, gonioscopy data; 3) the presence of precipitates, posterior synechiae, pupil diameter; 4) the presence of pain syndrome. 037. Progressive axial myopia in children must be differentiated from: 1) congenital glaucoma; 2) congenital cataract; 3) pigmentary retinal degeneration; 4) atrophy of the optic nerve. 038. Direction of inertial displacement of the body in the passenger compartment in a frontal collision is: 1) forward; 2) back. 039. Harmful and hazardous production factors are divided into: 1) leading to accidents and occupational diseases; 2) general poisonous, asphyxiant, neurotoxic; 3) ergonomic, biological, anthropomorphological; 4) physical, chemical, biological, psychophysiological; 5) everything is wrong; 6) everything is correct. 040. Acute disseminated intravascular coagulation syndrome in patients with septic shock occurs due to: 1) the release of a large amount of tissue thromboplastin into the systemic circulation; 2) spasm of peripheral vessels and centralization of blood circulation; 3) release of antithrombin III by bacterial cells into the systemic circulation; 4) depression of the formation of fibrinogen; 5) a pronounced decrease in platelet aggregation. 041. Diastolic murmur: 1) is heard after I tone; 2) coincides with the apical impulse; 3) coincides with the pulse on the carotid artery; 4) is heard in a long pause between tones. 042. An increase in the daily amount of urine over 2 liters is: 1) polyuria; 2) pollakiuria; 3) stranguria; 4) ishuria; 5) anuria. 043. Д The malignant course of arterial hypertension is characterized by: 1) damage to the retinal arteries; 2) atherosclerosis of the vessels of the lower extremities; 6 3) heart rhythm disturbances; 4) the appearance of heart blockages. 044For Prinzmetal's angina pectoris, all of the listed symptoms are characteristic, except: 1) the cyclical character; 2) the occurrence of pain at rest at night; 3) rise of the ST segment above the isoline during an attack; 4) the appearance of pain during exercise; 5) equality of the period of increase in pain to the period of its disappearance. 045. Examination of the fundus of eye in patients with infective endocarditis sometimes reveals: 1) Osler nodules; 2) narrowing of the arteries; 3) edema of the papilla of the optic nerve; 4) petechiae; 5) all of the above. 046. What drugs reactivate cholinesterase in acute intoxication with organophosphorus compounds? 1) dipiroxime; 2) glucose; 3) O2 inhalation; 4) vitamin B1; 5) cocarboxylase. 047. After the flu, a 17-year-old girl had thirst, polyuria, general weakness, blood sugar level - 16 mmol / l, glucosuria, acetone in urine - ++. The type of diabetes in the patient is: 1) type 2 diabetes mellitus; 2) type 2 diabetes mellitus in young people (MODY); 3) secondary diabetes mellitus; 4) type 1 diabetes mellitus. 048. In case of detection of endemic goiter and normal levels of thyroid hormones, the following is prescribed: 1) potassium iodide 200 mcg; 2) levothyroxine; 3) thiamazole; 4) potassium iodide 100 mcg. 049. Note the drug of choice for the treatment of hypertension in a pregnant woman: 1) atenolol; 2) valsartan; 3) methyldopa; 4) ramipril. 050. It may cause hypergastrinemia and withdrawal symptoms: 1) atropine; 2) omeprazole; 3) pirenzepine; 4) ranitidine. 051. What signs make it possible to distinguish chronic glomerulonephritis from chronic pyelonephritis: A) fever with chills; B) asymmetry of kidney damage; C) the absence of 7 asymmetry of kidney damage; D) high proteinuria in combination with hematuria and cilindruria; E) high leukocyturia, bacteriuria. 1) C, D; 2) A, B, E; 3) A, C; 4) A, C, D; 5) A, C, D, E. 052. What the classic triad of symptoms of acute glomerulonephritis includes: A) edema; B) shortness of breath; C) hypertension; D) hematuria; E) heartbeat. 1) A, C, D; 2) C, D, E; 3) A, D, E; 4) A, B, C; 5) A, C, E. 053. What dietary measures are indicated for acute glomerulonephritis? 1) limiting sodium chloride to 1.5 g / day; 2) increased consumption of sodium chloride; 3) an increase in the amount of fluid consumed; 4) increased consumption of K + -containing products. 054. What drugs should be prescribed to a patient with chronic bronchitis and pulmonary hypertension? a) nitrosorbide; b) captopril; c) nifedipine; d) cardiac glycosides; e) long-term oxygen therapy. Choose the right combination: 1) b, d; 2) b, c, d; 3) a, c, e; 4) all answers are correct; 5) d, e. 055. Pleural friction rub is 1) heard more often at inspiratory height 2) heard during inhalation and exhalation 3) weakened after coughing 4) not change after coughing 5) 2 and 4 together 056. Select the clinical signs that are characteristic of dermatomyositis: A) periorbital swelling and "lilac" color of the skin around the eyes, B) hand of a "mechanic", C) face erythema of the "butterfly" type, D) Gottron's erythema, E) induration of the skin, F ) distal muscle weakness: 1) A, C, D, E; 2) A, B, D, F; 3) B, D, E, F; 4) A, B, D; 5) A, C, F. 057. Which of the following makes the diagnosis of ankylosing spondylitis unlikely? 1) alternating pain in the buttocks; 2) prolonged morning stiffness in the lower back; 3) limitation of mobility in the lumbar spine in the sagittal and frontal planes; 4) lack of reflexes on the foot and anesthesia of the outer side of the foot; 5) increased pain in the lower back at rest. 058. What basic anti-inflammatory drug is prescribed first for psoriatic arthritis? 1) leflunomide; 2) methotrexate; 3) mycophenolate mofetil; 8 4) sulfasalazine; 5) cyclosporine. 059. What ECG changes are specific for myocardial infarction? 1) low voltage of the P wave in standard leads 2) the width of the QRS complex ≥0.12 sec 3) pathological Q wave 4) concordant elevation of the ST segment 5) AB dissociation 060. For the relief of paroxysmal nodular tachycardia in Wolff Parkinson White syndrome, the drug of choice is: 1) digoxin; 2) anaprilin; 3) verapamil; 4) lidocaine; 5) amiodarone. 061. A 68-year-old patient was hospitalized with a diagnosis of acute coronary syndrome without ST segment elevation. During the examination, he complained of a sudden rapid heartbeat, covered with a cold sweat. The condition is serious, the skin is pale, cold. Heart sounds are muffled, rhythmic. Heart rate = 180 bpm. BP = 90/60 mm Hg. ECG shows wide ventricular complexes up to 0.18 s. What is the complication of myocardial infarction? 1) ventricular fibrillation; 2) ventricular tachycardia; 3) ventricular premature beats; 4) nodal tachycardia; 5) complete atrioventricular block. 062. What diameter an ulcer defect of the stomach or 12 duodenum is considered average of? 1) up to 0.5cm; 2) 0.6-1.9cm; 3) 2.0-3.0 cm; 4) more than 3.0cm. 063. For the treatment of nonspecific ulcerative colitis, the following drugs are used, except: 1) mesalazine; 2) sulfasalazine; 3) prednisone; 4) ibuprofen; 5) infliximab. 064. Which symptom or syndrome from the following is not typical for liver cirrhosis: 1) portal hypertension; 2) hemorrhagic; 3) edematous-ascitic; 4) cytolytic; 5) acute pain. 065. The leading mechanism for the development of the disease in botulism is the defeat of: 1) the mucous membrane of the small intestine; 2) the lymphatic apparatus of the small intestine; 3) motoneurons of the medulla oblongata and spinal cord; 4) the respiratory tract; 5) severe general intoxication 066. Hemorrhagic fever with renal syndrome's transmission path is: 1) nonpercutaneous ; 2) air-dust; 9 3) transmissive; 4) alimentary; 5) all of the above. 067. In which of the following examples, the patient correctly collected sputum for microscopy: 1) before going to the doctor, the patient independently collected sputum in household dishes and brought it to the appointment; 2) the patient collected the first sample during the first visit to the health facility under the supervision of medical personnel into a sterile container, received an instruction and a sterile tube for the second sample, and collected sputum in it during the second visit to the doctor after 5 days; 3) the patient collected the first sample during the first visit to the health facility under the supervision of medical personnel into sterile dishes, received instructions and a sterile test tube for the second sample, which was collected by him in the morning after brushing the teeth, the next day before visiting the doctor. He passed the third sample after going to a doctor for medical supervision in a special cough room. 068. When does the local BCG vaccination reaction appear and how long does it take? 1) after 72 hours, within a week. 2) 4-5 weeks after vaccination, up to 3-4 months. 3) one week after vaccination, up to two weeks. 069. The maximum allowable period in which the primary ITU transmits the application of a disabled person who does not agree with its decision to the higher ITU is: 1) up to 3 days; 2) up to 10 days; 3) up to 20 days; 4) up to 30 days. 070. A 54-year-old patient, a house painter, was sent to the ITU 15.03 for the first time as a chronically ailing. The documents were accepted and registered with the expert commission on March, 16. Examination takes place only on March, 25, where the patient is recognized as a disabled person of the III group. Indicate with what number and with what wording the medical institution closes the sickness certificate: 1) start working from 15.03; 2) recognized as a disabled person of the group III according to ITU 16.03; 3) recognized as a disabled person of the group III according to ITU 25.03; 4) start working from 25.03. 071. Carrying out decurarisation is advisable under the following conditions: 1) with incomplete restoration of neuromuscular conduction and the appearance of spontaneous breathing; 2) with complete blockade of neuromuscular conduction; 3) after 20 minutes in the absence of spontaneous ventilation; 4) immediately after the end of anesthesia, regardless of the degree of restoration of spontaneous breathing. 072. What is the least toxic anesthesia for a patient during a 2-3-hour surgery on the abdominal organs? 1) ether-oxygen mixture (mask); 2) halothane-oxygen mixture (mask); 3) endotracheal anesthesia with halothane-oxygen mixture; 10 4) NLA (neuroleptanalgesia); 5) fractional intravenous anesthesia with ketamine. 073. It is not true for acute appendicitis that: 1) the rigidity of the abdominal wall may be absent in the retrocecal position; 2) there may be no rigidity in the pelvic position; 3) vomiting always precedes pain; 4) pain may begin in the navel region; 5) pain often begins in the epigastric region. 074. The disappearance of pain and the appearance of "melena" with a duodenal ulcer is typical for: 1) pyloroduodenal stenosis; 2) perforation of the ulcer; 3) malignancy of the ulcer; 4) bleeding; 5) penetration into the pancreas. 075.In the diagnosis of neuromuscular dysplasia of the ureter of the listed methods, the most informative is: 1) dynamic nephroscintigraphy; 2) aortography; 3) venacavography; 4) cystography; 5) urocinematography. 076. A 35-year-old patient has chronic prostatitis (latent course), sclerosis of the bladder neck. Residual urine - 100 ml. He needs: 1) cystostomy; 2) prostatectomy; 3) transurethral electroresection of the bladder neck; 4) puncture cystostomy; 5) sanatorium-resort therapy, resorption therapy. 077. If you have diagnosed acute pancreatitis at home, what will you do: 1) prescribe a cold on the stomach, a cleansing enema, a second call the next day; 2) arrange hospitalization in a surgical hospital; 3) administer i/ v 50,000 units of trasilol, 1.0% solution of atropine, repeated call the next day; 4) prescribe a diet, antibiotics, re-call every other day; 5) prescribe rest, diet, antibiotics, a cleansing enema, re-call if there is no improvement. 078. If treatment is not started in a timely manner, the reactive phase will be shorter if peritonitis is caused by: 1) hemorrhagic pancreatitis; 2) perforation of the duodenal ulcer; 3) acute cholecystitis; 4) intestinal obstruction; 11 5) phlegmon of the colon. 079. Emergency care for valvular pneumothorax begins: 1) from the drainage of the pleural cavity; 2) with tracheostomy; 3) with blockade of intercostal nerves; 4) with immobilization of the chest; 5) with blockade of the phrenic nerve. 080. External drainage of the pancreatic cyst is indicated: 1) with malignancy; 2) with suppuration of the cyst; 3) with obstructive jaundice; 4) with bleeding into the lumen of the cyst; 5) there is no indication for this surgery. 081. The classic signs of acute cholangitis are: A) pain in the right subcostal area, B) fever, C) jaundice, D) a positive Ortner's symptom. 1) A; 2) A, C; 3) A, D; 4) A, B, C, D. 082. How does the dental pulp react to thermal stimuli in uncomplicated caries? 1) the pain in the tooth disappears immediately after the removal of the stimulus; 2) the pain in the tooth does not disappear immediately after the removal of the stimulus; 3) under the influence of cold, an attack of acute pain occurs; 4) the pain subsides under cold; 5) no pain occurs under the influence of cold. 083. Combined injury with mechanical damage is understood as: 1) fractures of the thigh and lower leg from one or both sides; 2) fractures of the bones of the extremities, spine or pelvis with simultaneous damage to internal organs; 3) fractures of the upper and lower extremities (for example, shoulder and thigh, forearm and lower leg, etc.); 4) damage to the hollow and parenchymal organs in blunt trauma to the abdomen; 5) damage to the great vessels and nerves in one anatomical area. 12 084. Contraindications to the use of compression-distraction osteosynthesis are: 1) multi-fragment fractures of long tubular bones; 2) comminuted fractures of the proximal metaepiphysis of long tubular bones with displacement; 3) subperiosteal fractures of the "green branch" type of the diaphysis of tubular bones; 4) multi-fragment fractures of the distal metaepiphysis of long tubular bones; 5) periarticular fractures with displacement of fragments. 085. What infectious disease in the acute phase is a medical indication for artificial termination of pregnancy? 1) salmonellosis; 2) giardiasis; 3) rubella; 4) dysentery. 086. In the treatment of which disease, metronidazole is most effective: 1) endometriosis; 2) anovulatory infertility; 3) threatening miscarriage; 4) trichomonas colpitis. 087. In the 2nd stage of labor, it is necessary to control: 1) fetal heartbeat; 2) body temperature; 3) intestinal peristalsis; 4) diuresis. 088. At what time between rupture and delivery does the likelihood of the occurrence of purulent-septic diseases of the mother increase? 1) up to 6 hours; 2) from 6 to 12 hours; 3) more than 12 hours; 4) more than 24 hours. 089. Which of the following may not be a risk factor for the development of juvenile rheumatoid arthritis in children? 1) a history of exudative-catarrhal diathesis; 2) frequent ARVI; 3) reaction to vaccination; 4) an increase in temperature with ARVI; 5) joint injury. 090. Which of the following is not typical for neuro-arthritic diathesis in children? 1) acetonemic vomiting; 2) urolithiasis; 3) arthralgia; 4) frequent ARVI; 5) accelerated psychomotor development. 091. What laboratory tests will help establish the diagnosis of hemorrhagic vasculitis? 1) titer ASLO, ASG; 2) immunoglobulins; 3) blood platelets; 4) bleeding time; 5) none of the above. 092. What causes the pathogenesis of hemorrhagic syndrome in hemorrhagic vasculitis? 1) thrombocytopenia; 2) a decrease in the procoagulant activity of coagulation factors; 3) changes in the integrity of the vascular wall; 4) a decrease in the activity of 6-glucose phosphatesterase; 13 5) hemolysis of erythrocytes. 093. In a healthy person, the type of daily blood pressure profile: 1) dipper; 2) over-dipper; 3) non-dipper; 4) night-peaker. 094. The most informative ECG lead for bicycle ergometry for the diagnosis of ischemia is: 1) I; 2) II; 3) III; 4) V3; 5) V5. 095. The lengthening of the bleeding time is characteristic: 1) for thrombocytopenias of various origins; 2) for thrombocytopathies; 3) for disseminated intravascular coagulation; 4) when treated with heparin; 5) all of the above is true. 096. The reasons for the increase in plasma osmolarity are: 1) an increase in sodium; 2) hyperglycemia; 3) an increase in urea; 4) drinking alcohol; 5) all of the above is true. 097. Periostitis on the X-ray picture is: 1) calcification of paraosseous soft tissues; 2) the reaction of the periosteum in the form of various types of calcifications; 3) bone necrosis; 4) a decrease in bone transparency due to an increase in the number of bones' trabeculas per unit of bone volume. 098. Revealing fluid in the pleural cavity is most effective with the help of: 1) ultrasound; 2) thermal imaging; 3) X-ray examination; 4) percussion. 099. Small cell lung cancer often metastasizes: 1) into the skin; 2) into the bone; 3) into the brain; 4) into the adrenal glands; 5) into the liver. 100. Oncogenes are: 1) only RNA viruses; 2) only DNA viruses; 3) DNA and RNA viruses; 4) adenoviruses. MINISTRY OF EDUCATION AND SCIENCE OF THE RUSSIAN FEDERATION FSBEI HE Mari State University 14 APPROVE Director of the Medical Institute ____ prof. G. Yu. Struchko “26” April 2021 STATE FINAL CERTIFICATION STATE INTERDISCIPLINARY EXAMINATION IN THE FIELD OF STUDY 31.05.01 GENERAL MEDICINE VARIANT 2 YOSHKAR-OLA, 2021 CHOOSE ONLY ONE CORRECT ANSWER 001. What are emotions? 1) reflection of an actual need and the likelihood of its satisfaction by the cerebral cortex; 2) activation of engrams; 3) a sequence of neurons storing innate and acquired memory to satisfy a need; 4) all answers are correct. 002. Choose a neuromuscular relaxant with a depolarizing effect from the following drugs: 1) azamethonium; 2) atracurium; 3) vecuronium; 4) suxamethonium. 003. Select a feature of celecoxib from the following: 1) inhibits cyclooxygenase-1; 2) reduces the natriuretic effect of furosemide; 3) reduces platelet aggregation; 4) does not have antipyretic effects. 004Select a side effect specific to amlodipine: 15 1) arterial hypertension; 2) bronchospasm; 3) swelling of the legs and feet; 4) reflex bradycardia. 005. Lepric granulomas are characterized by: 1) Mikulicz cells; 2) Virchow's cell; 3) Berezovsky-Sternberg cell; 4) Clara cells. 006. In a tuberculous granuloma, the following predominate: 1) neutrophilic leukocytes; 2) plasma cells; 3) mast cells; 4) epithelioid cells. 007. Which compound has a toxic effect: 1) direct bilirubin (conjugated) 2) indirect bilirubin (unconjugated); 3) urobilinogen; 4) stercobilinogen; 5) albumin. 008. The scientific method formulated by K. Popper is called: 1) the principle of falsification; 2) the principle of historicism; 3) the principle of pragmatism; 4) the principle of incommensurability. 009. Which of the following does not apply to the ethical rules of the relationship between a healthcare professional and a patient? 1) the rule of truthfulness; 2) the rule of confidentiality; 3) the rule of choice freedom; 4) the rule of informed consent. 010. Which of the above is one of the reasons for the beginning of the Time of Troubles in the history of Russia in the late 16th and early 17th centuries? 1) the disintegration of the state into apanage principalities; 2) suppression of the Rurik dynasty; 3) the beginning of the convocation of Zemsky Sobor (Assembly of the Land); 4) coming to power of the heptarchy (consisting of seven prominent boyars). 011. Four signs of inflammation are described by: 1) Soran; 2) Celsus; 3) Asclepiades; 4) Galen. 012. Choose the correct translation "in tablets": 1) in tabulettis; 2) in tabulettas; 3) in tabulettae; 4) in tabulettarum 013. Human infrared radiation (thermal imaging) provides information: 1) about the human magnetic field; 2) electrical activity of internal organs; 3) the movement of blood through the capillaries of internal organs; 16 4) the temperature of the upper layers of the skin. 014. The mRNA precursor is: 1) hnRNA; 2) snRNA; 3) tRNA; 4) rRNA; 5) RNA primer. 015. Metabolic water is: 1) water supplied with food; 2) water formed in chemical reactions of the body; 3) radioactive water; 4) hydrated water; 5) well water. 016. When homozygous organisms with the same genotypes are crossed (genes interact according to the type of incomplete dominance), genotype splitting is observed in the offspring in the ratio: 1) 1:1; 2) 1:2:1; 3) 3:1; 4) no splitting is observed. 017. During the surgery, when the surgeon opened the lumen of the intestine, accumulations of lymphoid nodules (Peyer's patches) were found on the mucous membrane. Which section of the intestine was it? 1) the duodenum; 2) the jejunum; 3) the ileum; 4) the cecum; 5) the rectum. 018. The patient has a perforation of the ulcer of the posterior wall of the stomach. What anatomical formation do blood and stomach contents get into in this case? 1) saclesser omental sac; 2) pregastric sac; 3) the right lateral canal; 4) left lateral canal; 5) hepatic capsule. 019. In the period of small growth, the female reproductive cell is called 1) oocyte of the first order; 2) oocyte of the II order; 3) oogonium; 4) a mature egg; 5) polar cell. 020. Multi-row, highly prismatic ciliated epithelium lines: 1) esophagus, stomach, intestines; 2) nasal cavity, trachea, bronchi of large and medium caliber; 3) bladder, ureters, urethra; 4) body surface and serous membranes. 021. Where is the radial nerve (n. radialis) located in the lower third of the shoulder? 1) between the shoulder muscle (m. brachialis) and the biceps muscle of the shoulder (m. biceps brachii); 2) in the radial sulcus (sulcus n. Radialis); 3) between the brachial (m. brachialis) and brachioradial (m. brachioradialis) muscles; 17 4) in the humeromuscular canal (canalis humero-muscularis). 022. What is the main virulence factor of meningococcus: 1) LPS of endotoxin; 2) antiphagocytic properties of the capsule; 3) proteins of the cell wall; 4) the ability to survive inside the cell; 5) villi providing adhesion to the epithelium; 6) exotoxin. 023. Recommended orientation of surgical theater windows is: 1) southern; 2) northern; 3) eastern; 4) western. 024. What is the maximum period of time a medical commission can extend a work incapacity certificate of: 1) up to 2 months; 2) up to 3 months; 3) up to 6 months; 4) up to 10 months, and in some cases up to 12 months; 5) up to 4 months. 025. The recommended attached population in the therapeutic health locality is: 1) 100 people of the adult population aged 18 and over; 2) 1200 people of the adult and child population; 3) 1,500 adults aged 18 and over; 4) 1,700 adults aged 18 and over; 5) 2000 and more people of the adult and child population. 026. The term "iceberg phenomenon" in epidemiology means: 1) the registered incidence rate is lower than the true one; 2) slowly developing, difficult to recognize epidemics of infectious diseases. 027. Specify synonyms for the term "epidemiological study": 1) investigation of disease outbreaks; 2) epidemiological diagnostics; 3) epidemiological analysis. 028. White dermographism is most common in the following diseases: 1) allergic dermatitis; 2) atopic dermatitis; 3) true eczema; 4) urticaria; 5) psoriasis. 029. Which type of treponema is the causative agent of syphilis? 1) Тг. Balanitidis; 2)Тг. buccalis; 3)Тг. Dentenum; 4)Тг. Refrigens; 5)Тг. Pallidum 030. The method for the earliest diagnosis of ischemic stroke is: 1) classical electroencephalography; 2) rheoencephalography; 3) computed tomography; 4) magnetic resonance imaging; 5) positron emission tomography. 18 031. The diagnosis of neurosyphilis is confirmed by the following methods of examining the cerebrospinal fluid, with the exception of: 1) Wasserman reactions with three dilutions of cerebrospinal fluid; 2) colloidal Lange's test; 3) colloidal reaction Takata-Ara; 4) reactions of immobilization of pale treponema. 032. Patients with depression are characterized by: 1) hallucinations, confusion; 2) emotional dullness; 3) sleep disorders; 4) systematized delusions of persecution; 5) progressive amnesia. 033.For signs of an average degree of simple alcoholic intoxication, all of the above is characteristic, except: 1) functional disorders of motor skills; 2) slowing down and complications of the associative process; 3) dysarthric speech; 4) involuntary urination; 5) monotony of representations, difficulty in switching attention, inhibition. 034. On the basis of what symptoms can one suspect the development of acute purulent frontal sinusitis in a patient with ARVI? 1) bursting pain in the frontal region; 2) bursting pain in the occipital region; 3) bursting pain in the cheek region; 4) bursting pain in the parietal region; 5) bursting pain in the nose. 035. What is the surgical treatment of nasal septum abscess? 1) in the puncture of an abscess on one side; 2) in the puncture of the abscess on both sides; 3) in lancing of abscess on one side; 4) in lancing of abscess from both sides at the same level; 5) in lancing of abscess from two sides at different levels. 036. The motor apparatus of the eye consists of... extraocular muscles: 1) four; 2) five; 3) six; 4) seven; 5) eight. 037. With retinal detachment, patients complain of: 1) lacrimation and photophobia; 2) pressing pain in the eye; 3) the appearance of a "veil" in front of the eye; 4) pain during eye movement. 038. The mechanism of the formation of a tissue defect of the entrance gunshot wound is: 1) punchy; 2) contusion; 3) hydrodynamic; 4) discontinuous. 039. The principles of the modern system of medical and evacuation measures in emergency situations of peacetime are: 1) centralization, planning; 19 2) dismemberment (echelonment), continuity and timeliness; 3) the fastest return to work of the wounded, sick and injured; 4) continuity in the provision of the 1st medical aid; 5) teaching each citizen of the country in the techniques and methods of providing 1st medical care. 040. The indication for pleural puncture at the prehospital stage is: 1) open pneumothorax; 2) pleurisy with a lot of exudate; 3) closed pneumothorax; 4) middle hemothorax; 5) pressure tense pneumothorax. 041. Typical localization of pain in duodenal pathology is: 1) in the epigastric region above the navel; 2) around the navel; 3) in the upper third of the abdominal cavity of the encircling nature; 4) below the navel. 042. Choose from the diseases below those in which bronchophonia on the affected side will be enhanced: 1) focus of infiltration of lung tissue; 2) pulmonary emphysema; 3) unilateral hydrothorax; 4) unilateral artificial pneumothorax. 043. According to the risk stratification criteria, the main risk factors for hypertension include: 1) smoking; 2) drinking alcohol; 3) the level of total blood serum cholesterol is below 5.2 mmol / l; 4) the age of the man is less than 55 years old; 5) increased prothrombin index. 044. With a single sublingual intake of nitroglycerin, the following side effects most often occur: 1) headache; 2) ventricular extrasystole; 3) vomiting; 4) arterial hypertension; 5) difficulty in urinating. 045. The identification of Kerley lines on chest x-ray indicates: 1) hypertension in the pulmonary artery system; 2) hypovolemia of the pulmonary circulation; 3) inflammatory changes in the lungs; 4) venous stasis in the pulmonary circulation. 046. What are the factors that do not affect the development of noise sickness: 1) noise parameters; 2) work experience in noise conditions; 3) the duration of the noise during the working day; 4) humidity of the external environment; 5) individual sensitivity of the body. 047. Treatment of a ketoacidotic coma should begin with the introduction of: 1) strophanthin and insulin; 2) isotonic saline solution and insulin; 3) calcium salts; 20 4) norepinephrine; 5) potassium salts 6) nitroglycerin. 048. With thyrotoxicosis syndrome, the secretion of thyroid-stimulating hormone is: 1) normal; 2) depressed; 3) increased; 4) has no diagnostic value. 049. The side effect that occurs when using high doses of theophylline is: 1) AV block; 2) bradycardia; 3) convulsive states; 4) dry skin and dry mucous membranes. 050. Co-trimoxazole has the following properties: 1) causes hemolysis in individuals with deficiencies of glucose-6-phosphate dehydrogenase; 2) increases the synthesis of folates in the microbial cell; 3) practically does not bind to blood plasma proteins; 4) approved for use in pregnant women. 051. Indications for the appointment of corticosteroids in chronic glomerulonephritis are: A) high activity of the renal process; B) nephrotic syndrome without hypertension and hematuria; C) isolated proteinuria; D) isolated hematuria; E) hypertonic syndrome. 1) A, D; 2) A, E; 3) A, C; 4) D, E; 5) A, B. 052. Typical hemodynamic disorders in acute glomerulonephritis are: A) expansion of the heart cavities; B) accent of I tone over the aorta; B) low diastolic pressure; D) low pulse pressure; E) Graham Steell's murmur. 1) A, B; 2) A, C; 3) A, B, D; 4) A, B, C, D; 5) A, D, E. 053. Nephrotic syndrome is caused by: A) chronic glomerulonephritis, B) amyloidosis, C) pulmonary tuberculosis, D) renal vein thrombosis. 1) A, B; 2) A, B, C, D; 3) A, B, D; 4) C, D; 5) A, D. 054. The most informative criteria for right ventricular hypertrophy are: a) pronounced deviation of the QRS axis to the right; b) displacement of the transition zone to the right; c) displacement of the transition zone to the left; d) S-type of ECG. Choose the right combination: 1) A, B, D; 2) A, C, D; 3) B, D; 4) A, D; 5) A, C. 21 055 COPD risk factors are 1) tobacco smoking. 2) passive "smoking" in childhood. 3) production factors. 4) indoor and outdoor air pollution. 5) all of the above factors. 056. Which of the following signs is rare in psoriatic arthritis? 1) the presence of the HLA-B27 allele; 2) an increase in the C-reactive protein level; 3) detection of rheumatoid factor in blood serum; 4) sacroiliitis; 5) enthesitis. 057. Which of the following is not included in the classification criteria for polyarteritis nodosa? 1) livedo reticularis; 2) increased peripheral blood eosinophils by more than 10%; 3) an increase in diastolic pressure above 90 mm Hg; 4) an increase in the level of urea or creatinine in the blood; 5) detection of the surface antigen of the hepatitis B virus. 058. The big criteria for infective endocarditis does not include: 1) positive blood culture (pathogens typical of infective endocarditis isolated from two blood samples taken separately); 2) fresh vegetation; 3) newly formed valve regurgitation; 4) partial dehiscence of the valve prosthesis; 5) body temperature 38.0 ° C and above. 059. What treatment is most indicated in the first 90 minutes of Q wave myocardial infarction? 1) digitalization 2) calcium antagonist therapy 3) revascularization (thrombolytic therapy) 4) exercise therapy 5) revascularization (angioplasty with stenting) 6) antiarrhythmic therapy 060. Which of the following symptoms is characteristic of the auscultatory picture of mitral stenosis? 1) systolic murmur at the base of the heart 2) clapping I tone at the apex of the heart 3) protodiastolic murmur at Botkin's point 4) systolic murmur at the apex 5) "gallop" rhythm 061. … is ffective for asystole in cardiopulmonary resuscitation: A) atropine, B) adrenaline, C) amiodarone, D) lidocaine, E) endocardial stimulation. 1) A, C; 2) A, D; 3) C, E; 22 4) A, D; 5) B, E. 062. "Late", "hungry" and "night" pains in the epigastrium are characteristic for all localizations of the ulcer, except for: 1) ulcers of the duodenal bulb; 2) ulcers in the pyloric section; 3) ulcers in the upper stomach; 4) ulcers in the postbulbar part of the duodenum. 063. The conservative therapy of chronic pancreatitis does not include: 1) diet; 2) corticosteroids; 3) analgesics; 4) antispasmodics; 5) enzyme preparations. 064. Ascites in liver cirrhosis is formed due to: 1) secondary hyperaldosteronism; 2) hypoalbuminemia; 3) portal hypertension; 4) all of the above; 5) none of the above. 065. The stages of morphological changes in lymphoid elements in typhoid fever are as follows, except: 1) cerebral swelling; 2) necrosis; 3) the formation of ulcers; 4) the stage of "pure ulcers"; 5) stage of suppuration 066. The main morphological substrate for HFRS: 1) universal hemorrhagic vasculitis; 23 2) purulent meningoencephalitis; 3) catarrhal-hemorrhagic tracheobronchitis; 4) catarrhal-hemorrhagic proctosigmoiditis; 5) membranous-proliferative glomerulonephritis. 067. In clinical practice, the following pathway of MTB infection is most often observed: 1) air-dust; 2) aspiration; 3) alimentary; 4) nonpercutaneous; 5) transplacental; 6) transmission 068. What are your actions with a proven diagnosis of conversion of tubercular tests? 1) observation in the VI A-group of dispensary registration for 1-2 years, 3-month course of chemoprophylaxis according to the results of Diaskin test; 2) observation in the I B-group of dispensary registration and the main course of chemotherapy; 3) observation in group III A with the Mantoux test 2 times a year; 4) referral to a sanatorium for non-specific prophylaxis 069. Patient M., 43 years old, a loader, 7th grade education. Discharged from the hospital, where he had been for 3.5 months in connection with lung surgery, the postoperative course is smooth. Diagnosis: Absence of the lower lobe of the left lung, removed for bronchiectasis. Respiratory failure of the 1st degree. When sent to the ITU, the following decision is made: 1) temporarily disabled; 2) disabled person of group III; 3) disabled person of group II; 4) disabled person of group I. 070. The sickness certificate is issued to the patient when he is sent directly from the hospital to the employee organization sanatorium for the entire period of treatment, i.e. without deducting the duration of regular and additional vacations: 1) with tuberculosis; 2) with vibration disease; 3) with acute myocardial infarction; 4) with gonarthritis due to an occupational injury. 071. The amount of oxygen that binds 1 g of hemoglobin is: 1) 0.53 cm3; 2) 1.34 cm3; 3) 1.90 cm3; 4) 3.31 cm3; 5) 9.10 cm3. 072. A 50-year-old patient is being operated on for a hernia of the white line of the abdomen. Mask anesthesia with halothane-oxygen mixture. BP - 130/60 mm Hg., heart 24 rate - 78 per minute, respiratory rate - 18 per minute. Pupils - up to 2 mm, the reaction to light is sluggish, the corneal reflex is reduced. Determine the stage of anesthesia. 1) I; 2) II; 3) III1-2; 4) III3. 073. Contraindications to appendectomy are: 1) myocardial infarction; 2) pregnancy 30-40 weeks; 3) intolerance to novocaine; 4) appendicular infiltration; 5) violation of blood clotting. 074. The operation of choice for a perforated stomach ulcer in conditions of purulent peritonitis is: 1) resection of the stomach; 2) excision of the ulcer with stem vagotomy and pyloroplasty; 3) suturing the perforation; 4) selective proximal vagotomy with suturing of perforation; 5) true antrumectomy. 075. The stage of decompensation of neuromuscular dysplasia of the ureter is characterized by: 1) atrophy of the muscles of the ureter; 2) hypertrophy of the muscular layer of the ureter; 3) there are no pressure fluctuations in the ureter; 4) 1 and 3 are correct; 5) 2 and 3 are correct. 076. The patient has suppuration of the lumbar wound after pyelolithotomy. He needs: 1) increase the dose of antibiotics; 2) rinse the wound with an antibiotic solution; 3) open the wound with subsequent dressings 2 times a day, apply cotton swabs with a hypertonic solution of sodium chloride or magnesium sulfate; 4) apply tampons to the wound with Vishnevsky's ointment. 077. Name the arterial vessels that are involved in the blood supply to the stomach: 1) superior mesenteric artery; 2) splenic artery; 3) the left gastric artery; 4) common hepatic artery; 5) the lumbar artery. 078. The system for peritoneal dialysis (lavage) is used during: 1) 24 hours; 2) 48 hours; 3) 72 hours; 4) 4-5 days; 5) indefinitely until clinical improvement. 079. What complications can arise if fluid is quickly aspirated from the pleural cavity? 1) a sharp displacement of the mediastinum to the sick side; 2) the development of pleuropulmonary shock; 3) no changes will occur in the body; 4) the patient will feel a significant improvement; 25 5) nausea and vomiting may occur. 080. Blood circulation in the mesentery of the intestine is not disturbed when: 1) tortion; 2) obturation; 3) nodulation; 4) intussusception; 5) shrinkage. 081. What clinical symptoms are characteristic of hydropic gallbladder: A) Increased gallbladder, B) Pain in the right subcostal area, C) Jaundice, D) Increased ESR, eosinophilia, leukocytosis, E) R-logically rejected gallbladder. 1) A, B, C, D; 2) A, B, C, E; 3) A, С, D, E; 4) B, C, D, E; 5) A, B, D, E. 082. Deep caries is characterized by: 1) spontaneous pains, radiating, constant, increasing in intensity; the pain from the cold subsides, from the hot it intensifies; 2) paroxysmal, spontaneous pain; the intervals are long, the attacks are short; pain intensifies from irritants, localized within the affected tooth; 3) short-term pains from irritants, quickly disappear after elimination of the irritant, the carious cavity is deep, with softened dentin; 4) paroxysmal, radiating pains of a spontaneous nature, which are aggravated by cold; the intervals between attacks are short. 083. Non-gunshot open diaphyseal fractures are more common in the area of: 1) thigh; 2) shoulder; 3) clavicle; 4) lower leg; 5) forearm. 084. The clinical picture of acute blood loss is not characterized by: 1) weakness; 2) thirst; 3) dizziness; 4) bradycardia; 5) tachycardia. 085. The most informative method for diagnosing endometrial pathology is: 1) hysterosalpingography; 2) hysteroscopy; 3) histological examination of scrapings from the uterine cavity; 4) ultrasound examination of the pelvic organs; 5) cytological examination of aspirate from the uterine cavity. 086. For isthmic-cervical insufficiency, abortion is characteristic: 1) up to 12 weeks of pregnancy; 2) after 16 weeks of pregnancy; 3) at full term; 4) occurs regardless of the gestational age. 087. At what duration of regular sexual activity without contraception, if pregnancy has not occurred, the infertile couple is considered sterile: 1) 0.5 years; 26 2) 1 year; 3) 2 years; 4) 3 years. 088. The diagnosis of a clinically narrow pelvis can be made: 1) using pelviometry; 2) using ultrasound; 3) on clinical grounds; 4) using X-ray examination. 089. What symptom is not typical for the initial period of rickets? 1) violation of the sleep rhythm; 2) sweating; 3) baldness of the back of head; 4) hyperexcitability; 5) curvature of the legs. 090. The damage of which organ is not typical for tuberculosis in children? 1) lungs; 2) skin; 3) eyes; 4) kidneys; 5) liver. 091. Specify what does not apply to clinical syndromes of hemorrhagic vasculitis: 1) cutaneous; 2) damage to the cardiovascular system; 3) abdominal; 4) skin-articular; 5) renal. 092. When does bleeding occur after soft tissue injury in idiopathic thrombocytopenic purpura? 1) after 2 hours; 2) after 24 hours; 3) immediately after injury; 4) more than a day; 5) does not occur at all. 093. An increase in blood pressure at night is characteristic of the diurnal profile of the type: 1) non-dipper; 2) night-peaker; 3) dipper; 4) over-dipper. 094. Bicycle ergometry in order to diagnose ischemia is inappropriate when: 1) His bundle branch block; 2) the patient has a history of ventricular extrasystole; 3) atrial fibrillation; 4) all of the above is true. 095. An increase in LDH1-2 is observed when: 1) myocardial infarction; 2) hepatitis; 3) pancreatitis; 4) damage to skeletal muscles; 5) all of the above is true. 096. Fatty casts are most common for: 27 1) pyelonephritis; 2) nephrotic syndrome; 3) interstitial nephritis; 4) dysmetabolic nephropathy; 5) hypercholesterolemia. 097. Osteomalacia on a radiograph is: 1) softening of bone tissue due to a decrease in its mineralization; 2) destruction of bone tissue due to its replacement by a pathological substrate; 3) a decrease in the transparency of bone tissue due to an increase in the number of bone trabeculae per unit volume; 4) an increase in the transparency of bone tissue due to a decrease in the number of bone trabeculae per unit volume. 098. The advantage of digital X-ray fluorography over conventional fluorography is: 1) reducing the radiation exposure to the patient; 2) reduction of the time of image acquisition; 3) no need for X-ray film; 4) all the above factors. 099. Breast cancer is not characterized by metastases: 1) into the bone; 2) into the lungs; 3) into the brain; 4) into the liver; 5) into the navel. 100. What development do adenoviruses cause in humans? 1) papillomas; 2) tumors of the oropharynx; 3) molluscum contagiosum; 4) inflammatory diseases of the respiratory tract. MINISTRY OF EDUCATION AND SCIENCE OF THE RUSSIAN FEDERATION FSBEI HE Mari State University APPROVE Director of the Medical Institute ___ prof. G. Yu. Struchko “26” April 2021 STATE FINAL CERTIFICATION STATE INTERDISCIPLINARY EXAMINATION IN THE FIELD OF STUDY 31.05.01 GENERAL MEDICINE 28 VARIANT 3 YOSHKAR-OLA, 2021 CHOOSE ONLY ONE CORRECT ANSWER 001. Select a drug that is a prodrug: 1) dopamine; 2) isoprenaline; 3) labetolol; 4) methyldopa. 002. What antiarrhythmic drug belongs to class III? 1) amiodarone; 2) verapamil; 3) lidocaine; 4) procainamide. 003. This possess anti-atherogenic properties: 1) low density lipoproteins; 2) high density lipoproteins; 3) intermediate density lipoproteins; 4) -lipoproteins; 004. The most frequent mechanism of thanatogenesis in sudden cardiac death is: 1) heart rupture; 2) collapse; 3) asystole of the ventricular myocardium; 4) ventricular myocardial fibrillation. 005. What vitamin absorption worsens in acholia? 1) vitamin B1; 2) vitamin B12; 3) vitamin E; 4) vitamin B2; 5) folic acid. 006. The sense organs, which receptors are neurosensory cells, include: 1) the organ of smell and the organ of hearing; 2) organ of hearing and organ of vision; 3) the organ of balance and the organ of hearing; 4) the organ of smell and the organ of vision; 5) organ of taste and organ of balance. 007. The inner leaflet of the renal corpuscle capsule is formed by: 1) thyrocytes; 29 2) podocytes; 3) parathyrocytes; 4) nephrocytes. 008. What is sequestrectomy? 1) removal of eliminated bone tissue from the sequestral box; 2) dissection of the bone; 3) removal of a part of the bone; 4) removal of purulent contents from the medullary canal; 5) removal of non-viable tissue of the small intestine. 009. Indicate the morphological and tinctorial properties of Salmonella: 1) gram-negative immobile non-spore-forming capsular coccobacteria; 2) gram-negative mobile non-spore-forming bacilli without capsules; 3) gram-positive mobile spore-forming capsule bacilli; 4) gram-positive non-spore-forming bacteria of irregular shape; 5) gram-positive spore-forming cocci. 010. The main measures of primary prevention include: 1) systemic ecological and hygienic education of the population; 2) active identification of high-risk groups; 3) establishment and regulation of the main "starting" causal factor; 4) preventive treatment. 011. Medical assistance can be provided in the following conditions: 1) outside a medical organization (at the place where the ambulance team is called, including specialized ambulance, medical care, as well as in a vehicle during medical evacuation); 2) on an outpatient basis (in conditions that do not provide for round-the-clock medical supervision and treatment), including at home when a medical worker is called; 3) in a day hospital (in conditions providing for medical supervision and treatment during the day, but not requiring round-the-clock medical supervision and treatment); 4) on an inpatient basis (in conditions providing round-the-clock medical supervision and treatment); 5) all of the above is true. 012. In an explicit form, the idea of social progress was formulated in: 1) ancient philosophy; 2) the philosophy of the Enlightenment; 3) modern Western philosophy; 4) medieval philosophy. 013. Which of the following models of communication between a medical professional and a patient is the most optimal within the framework of the market form of healthcare organization? 1) engineering; 2) paternalistic; 3) collegial; 4) negotiable. 014. The work of this writer belongs to the "golden age" of Russian literature: 1) D.I. Fonvizin; 2) A.S. Pushkin; 3) A.P. Chekhov; 4) I.A. Bunin. 015. Outstanding medieval surgeon who created the doctrine of the treatment of gunshot wounds is: 1) Miguel Servet; 30 2) Paracelsus; 3) Guy de Choliak; 4) Ambroise Parй. 016. Specify the clinical term for "inflammation of the tonsils": 1) laryngitis; 2) pharyngitis; 3) glossitis; 4) tonsillitis. 017. The objective characteristics of sound are: 1) volume, intensity, frequency of sound; 2) intensity, pitch, wavelength; 3) intensity, timbre, wavelength; 4) average wave intensity, frequency. 018. Aerobic glycolysis is: 1) the process of cleavage of glycogen; 2) the process of protein cleavage; 3) the process of glucose cleavage; 4) the process of RNA cleavage; 5) the process of cleavage of amylopectin. 019. Oxidoreductases catalyze: 1) transfer of atoms or groups of atoms from one compound to another; 2) intramolecular transfer of atoms; 3) the formation or rupture of double bonds; 4) the formation of new bonds due to the energy of ATP; 5) redox reactions. 020. Gender-linked inheritance is: 1) inheritance of allelic genes in the male line; 2) inheritance of allelic genes in the female line; 3) inheritance of genes of sex chromosomes; 4) inheritance of mitochondrial genes. 021. The patient was admitted to the hospital complaining of a severe cough and shortness of breath. X-ray examination of the respiratory organs revealed the presence of an foreign body in the area of bifurcatio tracheae. At what level in relation to the spinal column is a foreign body found? 1) C4 – C6 2) C7 – Th1; 3) Th1 – Th2; 4) Th4 – Th5; 5) Th10 – Th11. 022. At the level of which rib lies the lower border of the lung along the mid-axillary line? 1) VI; 2) VII; 3) VIII; 4) IX; 5) X. 023. Indicate leukocyte signs of an allergic reaction or parasitic process: 1) leukocytosis with a moderate shift to the right with the appearance of immature forms, a significant increase in agranular phagocytes, eosinophils at the upper limit of the norm, calm lymphocytes; 2) leukocytosis with a shift to the left, eosino- and basophilia, monocytosis, calm lymphocytes; 31 3) leukopenia with a pronounced shift to the left, eosino- and basophilia; 4) a pronounced increase in eosinophils, moderate basophilia, lymphocytes at the upper limit of the norm or increased. 024. The mechanism of the antianginal action of metoprolol includes: 1) direct expansion of the coronary vessels; 2) a decrease in myocardial oxygen demand; 3) decreased oxygen delivery to the myocardium; 4) an increase in the work of the heart. 025. Effectiveness signs are: 1) signs included in the data collection program; 2) signs affecting other signs; 3) signs of the sample; 4) signs of the observation unit; 5) signs depending on other signs. 026. Quality criterion for anti-epidemic drugs: 1) compliance with the requirements of state and industry standards; 2) the brand and authority of the manufacturer; 3) low production cost; 4) consumer requirements. 027. In meningococcal infection, the aerosol transmission mechanism is implemented in the following way: 1) alimentary; 2) contact and household; 3) airborne. 028. In order to confirm the diagnosis of pemphigus the most important is: 1)severe thrombocytopenia; 2) pronounced leukocytosis in the peripheral blood; 3) detection of acantholytic cells in imprint smears; 4) detection of LE cells; 5) eosinophilia in erosions of vesical fluid. 029. Which is not the way of gonorrhea contamination: 1) by airborne droplets; 2) with genital-anal contacts; 3) during genital-genital contacts; 4) with genital-oral contacts; 5) when using common household items. 030. Intensive therapy for ischemic stroke has the main goal of correction of: 1) hypercholesterolemia; 2) hyperproteinemia; 3) cerebral edema; 4) water-electrolyte imbalance; 5) 1 and 2 are true; 6) 3 and 4 are true. 031. With the help of MRI, the focus of ischemic stroke of the brain is detected from the onset of the disease: 1) after 1 hour; 2) after 3 hours; 3) after 6 hours; 4) by the end of the first day. 032. The patient is 24 years old, lives with his parents. After leaving school, he changed several jobs, and did not stay for a long time anywhere. Currently unemployed. During the 32 last 6 months, he stopped meeting his friends, began to close himself in his room, does not want to take a shower (bath). Refuses to eat with his parents. Doesn't sleep at night and walks around the apartment. Being alone in his room, he talks as if there is someone else there. When the parents tried to discuss this behavior of their son, he whispered that he could not leave the house, as he was watching the neighbor. Parents are sure that their son does not take drugs, since he does not go anywhere and does not communicate with other people. What kind of mental disorder does the patient have? 1) schizophrenia; 2) neurosis; 3) drug addiction; 4) anorexia; 5) dysmorphomania. 033.Physical drug addiction syndrome includes all of the above except: 1) compulsive attraction; 2) the ability to achieve physical comfort in intoxication; 3) withdrawal symptoms; 4) loss of dose control; 5) the social consequences of drug addiction. 034. Which of the diseases is associated with chronic decompensated tonsillitis? 1) Wegener's disease; 2) Parkinson's disease; 3) Paget's disease; 4) Bekhterov's disease. 5) rheumatism; 035. What are the characteristics of the compensated form of chronic tonsillitis? 1) a history of tonsillitis once a year and the presence of local signs; 2) a history of tonsillitis 2-4 times a year; 3) a history of paratonsillar abscesses; 4) hypertrophy of the palatine tonsils of the 3rd degree; 5) a history of tonsillitis once a year and the patient has chronic pyelonephritis. 036. Corneal opacity, visible only by biomicroscopy, is called: 1) nebula; 2) macula; 3) spot (leukoma); 4) facet. 037. First aid in the polyclinic in case of a penetrating wound of the eyeball with the prolapse of the membranes consists in: 1) abundant rinsing with an antibiotic solution and local anesthesia; 2) repositioning of the fallen out mambranes; 3) excision of the fallen out membranes and sealing the wound; 4) the imposition of an aseptic dressing and urgent transportation to the ophthalmological department. 038. Cause of death in reflex (syncope) type of drowning: 1) acute pulmonary failure; 2) reflex cardiac arrest; 3) cardiac fibrillation and the development of acute heart failure. 039. The medical evacuation route is: 1) a system of measures aimed at the fastest and possibly complete return to work, the maximum reduction in mortality and disability of people who have received injuries or diseases; 2) the formation of a medical service, to which the wounded (injured) are evacuated; 33 3) this is the path along which the removal and transportation of the wounded (injured) and sick from the affected area to the suburban area is carried out; 4) a set of measures for the delivery of the wounded and sick from the area of occurrence of sanitary losses to medical centers and medical institutions for the timely and complete provision of medical care and treatment; 5) a set of evacuation routes and the stages of medical evacuation deployed on them and the sanitary vehicles used. 040. The onset of early pneumonia (in the first hours and days) is characteristic of injuries and wounds of the following anatomical areas: 1) shoulder-scapular; 2) maxillofacial; 3) pelvic; 4) lower limbs; 5) upper limbs. 041. The characteristic localization of pain in the pathology of the pancreas: 1) in the epigastric region above the navel; 2) around the navel; 3) in the upper third of the abdominal cavity, girdle type; 4) in the right upper quadrant of the abdomen. 042. Pain in the pathology of the large intestine is localized in: 1) in the epigastric region above the navel; 2) around the navel; 3) in the upper third of the abdominal cavity, girdle; 4) pain in the iliac regions. 043. Patients with arterial hypertension and angina pectoris should be prescribed: 1) calcium antagonists; 2) hydralazine (apressin); 3) agonists of imidazoline receptors; 4) furosemide; 5) raunatin. 044. Hospitalization of patients with new-onset angina pectoris: 1) recommended to all patients; 2) not recommended; 3) recommended in individual cases; 4) is decided individually. 045. Choose a beta blocker that is prescribed for CHF: 1) atenolol; 2) oxprenolol; 3) anaprilin; 4) pindalol; 5) bisoprolol. 046. The etiological factors contributing to the development of occupational diseases of the peripheral nerves and the musculoskeletal system include all of the above, except: 1) physical activity, 2) hypothermia, 3) neuropsychic stress, 4) vibrations, 5) forced working posture. 047. What indicator is the most reliable criterion for assessing the adequacy of diabetes mellitus treatment? 1) C-peptide; 34 2) average daily glycemia; 3) the level of contrainsular hormones in the blood; 4) the average amplitude of glycemic fluctuations; 5) glycated hemoglobin; 6) urine sugar level. 048. In primary hypothyroidism, the blood contains: 1) increased TSH levels; 2) decreased TSH levels; 3) normal TSH levels; 4) the analysis of TSH has no diagnostic value. 049. This does not cause bronchodilator effect: 1) propranolol; 2) salmeterol; 3) tiotropium bromide; 4) epinephrine. 050. Which drug increases the likelihood of amikacin nephrotoxicity? 1) amphotericin B; 2) vancomycin; 3) furosemide; 4) all of the above. 051. What signs carry information about the functional abilities of the kidney: A) the content of protein in the urine; b) isostenuria; c) decreased glomerular filtration; d) increase in urea; e) increased plasma creatinine. 1) А, C, D, E; 2) B, C, D, E; 3) А, B, C, D, E; 4) D, E; 5) C, D, E. 052. What signs are characteristic of acute glomerulonephritis: A) isostenuria; B) an increase in urine density; B) alkaline urine reaction; D) an increase in neutrophils in the urine; E) an increase in lymphocytes in the urine. 1) А, B; 2) А, C; 3) А, D; 4) B, C; 5) А, E. 053. Which of the following factors cause the development of acute glomerulonephritis? A) serum, B) vaccine, C) insect venom, D) medicinal substances, E) food. 1) А, B; 2) А, B, E; 3) А, D; 4) А, B, C, D, E; 5) C, D, E. 054. What auscultatory sign is characteristic of bronchial asthma? 1) wet wheezing; 2) dry wheezing on inspiration; 3) dry wheezing rales on exhalation. 4) crepitus 055. Prolonged hemoptysis with dry cough makes, first of all, suspect of: 1) bronchial cancer. 2) cavernous form of pulmonary tuberculosis. 35 3) bronchiectasis. 4) pneumoconiosis. 5) chronic obstructive pulmonary disease. 056. What combination of signs can be observed in the urogenital form of reactive arthritis: A) asymmetric oligoarthritis of the joints of the upper extremities, B) asymmetric oligoarthritis of the joints of the lower extremities, C) polyarthritis, D) acute conjunctivitis, E) acute anterior uveitis, E) cystitis, G) keratoderma? 1) А, D, F; 2) B, E, G; 3) B, D, G; 4) C, D, G; 5) B, F, G. 057. Which of the following non-steroidal anti-inflammatory drugs inhibit mainly cyclooxygenase-2, and therefore, less often cause gastrointestinal complications: A) aceclofenac, B) lornoxicam, C) meloxicam; D) naproxen; E) tenoxicam; E) celecoxib? 1) C, F; 2) А, C; 3) А, F; 4) B, C, E; 5) C, D, F. 058. Which of the following laboratory changes does not apply to the diagnostic criteria for systemic lupus erythematosus? 1) hemolytic anemia; 2) leukopenia below 4Ч109/ l; 3) lymphopenia below 1.5Ч109/ l; 4) thrombocytopenia below 100Ч109/ l; 5) increased ESR. 059. Specify the drug of choice for the relief of ventricular arrhythmias in acute myocardial infarction? 1) lidocaine; 2) amiodarone; 3) novocainamide; 4) verapamil; 5) potassium preparation. 060. Renoparenchymal hypertension is characterized by: 1) a history of kidney disease; 2) changes in urine tests; 3) a decrease in the glomerular filtration rate and an increase in creatinine; 4) everything is correct; 5) correct 1, 2. 061. Risk factors for atherosclerosis and CHD are all except: 1) arterial hypertension; 2) smoking; 3) dyslipidemia; 4) everything is correct; 5) chronic kidney disease 062. Four-component anti-Helicobacter pylori therapy includes: 1) omeprazole + amoxicillin + clarithromycin + pancreatin; 2) omeprazole + metoclopramide + amoxicillin + clarithromycin; 3) omeprazole + bismuth tripotassium dicitrate + pancreatin + clarithromycin; 4) omeprazole + amoxicillin + clarithromycin + bismuth tripotassium dicitrate. 36 063. Which of the diagnostic instrumental research methods is most preferable for the diagnosis of ulcerative colitis? 1) irrigoscopy; 2) esophagogastroduodenoscopy; 3) colonoscopy; 4) ultrasound examination of the intestine; 5) colonoscopy with targeted biopsy examination. 064. Which of the following is the most significant for the diagnosis of Wilson-Konovalov disease? 1) an increase in the level of alkaline phosphatase, cerulloplasmin, transaminases; 2) the presence of cytolysis syndrome; 3) increased urinary copper excretion, decreased cerruloplasmin levels, the presence of a Kaiser-Fleischer ring on the cornea when examined with a slit lamp, ATPaseR gene polymorphism; 4) an increase in the level of alkaline phosphatase, an increase in the level of serum copper, cholesterol and triglycerides; 5) none of the above. 065. An HIV-infected person is a source of infection: 1) only in periods of pronounced clinical manifestations; 2) only in the terminal stage; 3) only at the stage of asymptomatic infection (II B); 4) only in the stage of acute infection (II A); 5) for life; 6) only during seropositive periods. 066. The main route of transmission of dysentery is: 1) water; 2) alimentary; 3) contact and household; 4) airborne. 067. Which cells of the immune system are capable of recognizing macrophages that phagocytosed M. tuberculosis and killing them with perforin directly in the focus of the inflammatory reaction, producing cytokines - interferon-gamma (IFN-g) and TNF-a, synthesizing a number of peptides with pronounced toxic properties, (gran-winters or granulizin), accelerating the process of apoptosis of macrophages? 1) Th1 lymphocytes; 2) Th2 lymphocytes; 3) Tc-lymphocytes; 4) natural killers. 068. The modern pathomorphosis of tuberculosis is A) an increase in the proportion of severe forms of lung lesions with widespread caseous-necrotic changes; B) the predominance of exudative and necrotic inflammation, a decrease in the granulomatous tissue reaction and reactions of delimitation and reparation of foci of tuberculous inflammation; C) reduction of the population's incidence of tuberculosis; D) an increase in mortality from tuberculosis; E) the growth of drug-resistant tuberculosis; F) the growth of generalized forms against the background of the HIV epidemic; G) an increase in the number of cases of infiltrative tuberculosis. Correct: 1) АEDF 2) АCDG 3) АBEF 069. Persons leaving for Moscow on the call of the research institute, where they are observed as thematic patients, due to their absence from work 37 1) the sick leave of the Clinic & Expert Committee of the medical and prophylactic institution at the place of residence is issued; 2) a sick leave of the clinic of the Research Institute of Moscow is issued; 3) a certificate of arbitrary form is issued from a health facility at the place of residence; 4) no document is issued. 070. Not eligible for a certificate of incapacity for work: 1) temporary working retirees; 2) working disabled people; 3) citizens of the CIS working in the Russian Federation; 4) dismissed from work; 5) unemployed citizens registered with the labor and employment authorities. 071. When performing external heart massage, palms should be positioned: 1) on the upper third of the sternum; 2) on the border of the upper and middle third of the sternum; 3) on the border of the middle and lower third of the sternum; 4) on the mid-clavicular line on the left; 5) on the xiphoid process. 072. What prophylaxis of tongue retraction (mechanical asphyxia) is necessary for a patient in the early post-anesthetic period? 1) at the end of the operation, intravenously inject neostigmine methyl sulfate (a muscle relaxant antagonist); 2) put an air duct; 3) to introduce the patient with respiratory analeptics; 4) insert the tube into the stomach. 073. Malory-Weiss syndrome is: 1) varicose veins of the esophagus; 2) bleeding ulcer of Meckel's diverticulum; 3) bleeding from mucous membranes due to hemorrhagic angiomatosis (Randu-Osler disease); 4) cracks in the cardiac part of the stomach with bleeding; 5) hemorrhagic erosive gastroduodenitis. 074. Irreducibility of a hernia is a consequence of: 1) adhesions between the organs protruding into the hernial sac and the walls of the sac; 2) adhesions between the loops of the intestine that have come out into the hernial sac; 3) cicatricial process between the hernial sac and surrounding tissues; 4) inconsistency of the organs released into the hernial sac with the size of the hernial orifice; 5) all of the above. 075. Diagnosis of ureterocele is based on data of: 1) cystoscopy; 2) nephroscintigraphy; 3) artography; 4) only 1 and 2; 5) all of the above. 076. Diagnostics of kidney injury: 1) dynamic nephroscintigraphy; 2) radioisotope renography; 3) chromocystoscopy; 4) excretory urography; 38 5) pneumoren. 077. Among the complications of acute peritonitis are shock, sepsis, shock lung, pneumonia. What else can you attribute to typical complications? 1) renal-hepatic failure; 2) hypercoagulability; 3) dysproteinemia; 4) acute expansion of the stomach; 5) PATE. 078. The symptoms of appendicular infiltrate are all except: 1) subfebrile temperature; 2) Rovsing's symptom; 3) profuse diarrhea; 4) leukocytosis; 5) palpable tumor formation in the right iliac region. 079. The patient was admitted to the clinic with suspected acute pancreatitis. Indicate the most informative method for diagnosing the disease: 1) celiacography; 2) ultrasound examination; 3) laparocentesis; 4) thermography; 5) gastroduodenoscopy. 080. This contributes to the development of strangulated intestinal obstruction: 1) long narrow mesentery 2) adhesions of the abdominal cavity; 3) a sudden increase in intra-abdominal pressure; 4) overeating after prolonged fasting; 5) all of the above 081. The most typical complications of acute cholecystitis: A) Perivesical abscess, B) Intrahepatic cholelithiasis, C) Cholesterosis of the gallbladder, D) Biliary peritonitis, E) Empyema of the gallbladder. 1) А, C, D, E; 2) А, D, E; 3) B, C; 4) B, D. 082. In acute apical periodontitis, percussion response is: 1) sharply painful; 2) vertical and horizontal percussion causes pain; 3) slightly painful; 4) painless, sometimes unpleasant or mild pain; 5) painless. 083. The severity of an open non-ballistic fracture is determined: 1) the presence of a bone fragment protruding into the wound; 2) the presence of arterial, venous or mixed bleeding from the wound; 3) the severity and extent of soft tissue damage; 4) the comminuted nature of the fracture; 5) the time passed from the moment of injury till the admission of the victim to the hospital. 084. For fractures of the "Malgenya" type, treatment should be: 1) the position according to Volkovich; 2) coxite plaster cast; 3) skeletal traction; 4) osteosynthesis of the pelvic bones. 39 085. What symptoms are not typical for the clinic of preeclampsia? 1) arterial hypertension, proteinuria, edema; 2) soreness and increased frequency of urination; 3) hemolysis, increased activity of transaminases, thrombocytopenia; 4) tachycardia, headache, vision changes. 086. The most effective method for removing a submucous myomatous node on a thin base is: 1) scraping of the uterine cavity; 2) hysteroresectoscopy; 3) laparoscopy; 4) colposcopy. 087. Acute placental insufficiency occurs due to 1) polyhydramnios; 2) preeclampsia; 3) placental abruption; 4) a narrow pelvis. 088. Extended colposcopy is: 1) examination of the cervix using vaginal mirrors; 2) colposcopy with 10x magnification; 3) colposcopy with Schiller's test and acetoacetic test; 4) colposcopy with targeted biopsy. 089. Specify the evidence of bacteriuria: 1) 1 thousand microbial bodies in 1 ml of urine; 2) 5 thousand microbial bodies in 1 ml of urine; 3) 100 thousand microbial bodies in 1 ml of urine; 4) 10 thousand microbial bodies in 1 ml of urine; 5) 50 thousand microbial bodies in 1 ml of urine. 090. What manifestations are not typical for the pathogenesis of acute pneumonia in young children? 1) violation of bronchial patency; 2) the state of hypoxemia and hypercapnia; 3) insufficiency of enzymatic respiratory systems; 4) isoimmune antigen-antibody reaction; 5) microcirculation disorder. 091. After examining a 2-year-old child who had been coughing for 3 weeks, the doctor suspected whooping cough. What are the symptoms? 1) cyanosis of the nasolabial triangle; 2) manifestations of exudative diathesis on the skin; 3) temperature 39C; 4) scattered dry wheezing in the lungs; 5) hemorrhages in the sclera and an ulcer on the frenum of the tongue. 092. What are the clinical manifestations not typical for hemophilia: 1) hematomas; 2) bleeding in soft tissue injury; 3) hemarthrosis; 4) hemorrhagic petechial rash; 5) hemorrhages in internal organs. 093. The threshold heart rate for Holter ECG monitoring is: 1) heart rate, above which ECG signs of ischemia appear; 2) maximum heart rate during the observation period; 3) minimum heart rate during the observation period. 40 094. When conducting bicycle ergometry, the test is considered negative if: 1) there are no electrocardiographic and clinical signs of ischemia; 2) rhythm and conduction disturbances appeared; 3) there is an inversion of the T wave; 4) ischemic depression of the ST segment appeared. 095. Laboratory diagnosis of acute myocardial infarction includes the determination of the following indicators: 1) CPK; 2) LDH total, LDH1; 3) cardiospecific troponin T; 4) all of the above is true. 096. Hyperglycemia can be led by increased secretion of: 1) parathormone; 2) somatotropin; 3) estrogen; 4) aldosterone; 5) insulin. 097. Contraindications to excretory urography: 1) kidney injury; 2) intolerance to the contrast agent; 3) acute or chronic renal failure of 2-3 degrees; 4) prolapse of the kidneys. 098. X-rays are: 1) electromagnetic radiation emitted during radioactive decay of nuclei; 2) the flow of negatively charged particles; 3) electromagnetic radiation arising from the deceleration of particles (electrons) in the electric field of atoms; 4) electromagnetic radiation emitted by bodies whose temperature is above absolute zero. 099. An indication for chemotherapy is: 1) the presence of a malignant tumor; 2) the presence of metastases; 3) impossibility of carrying out radiation treatment; 4) impossibility of performing surgical treatment; 5) sensitivity of the tumor to cytostatics. 100. The main methods of diagnosing esophageal cancer are: 1) tomography of the mediastinum and esophagoscopy; 2) X-ray and esophagoscopy with biopsy; 3) pneumomediastinography and ultrasound; 4) radionucleide research; 5) ultrasound of the mediastinum and X-ray examination. MINISTRY OF EDUCATION AND SCIENCE OF THE RUSSIAN FEDERATION FSBEI HE Mari State University APPROVE Director of the Medical Institute ___ prof. G. Yu. Struchko “26” April 2021 41 STATE FINAL CERTIFICATION STATE INTERDISCIPLINARY EXAMINATION IN THE FIELD OF STUDY 31.05.01 GENERAL MEDICINE VARIANT 4 YOSHKAR-OLA, 2021 CHOOSE ONLY ONE CORRECT ANSWER 001. Indicate the boundaries of the carotid triangle of the neck: 1) trapezius muscle, scapular-hyoid muscle, sternocleidomastoid muscle; 2) the anterior belly of the digastric muscle, the scapular-hyoid muscle, the sternocleidomastoid muscle; 3) the anterior midline of the neck, scapular-hyoid muscle, sternocleidomastoid muscle; 4) the posterior belly of the digastric muscle, the scapular-hyoid muscle, the sternocleidomastoid muscle; 5) scapular-hyoid muscle, clavicle, sternocleidomastoid muscle. 002. Which muscle provides extension in the elbow joint: 1) biceps brachii; 2) brachial muscle; 3) triceps muscle of the shoulder; 4) brachioradialis muscle; 5) deltoid muscle. 003. Where can the center of the conditioned reflex be located? 1) only in the cerebral cortex; 2) in the cerebral cortex and in the higher subcortical structures; 3) in the cerebral cortex and any other parts of the central nervous system; 4) in the centers of the central nervous system. 004. Pilocarpine in glaucoma reduces intraocular pressure due to: 1) relaxation of the zinn ligament. 2) pupil dilation: 42 3) decrease in the secretion of intraocular fluid; 4) improve the outflow of intraocular fluid; 005. Contraindication for the appointment of metoprolol is: 1) arterial hypertension; 2) glaucoma; 3) ischemic heart disease; 4) cardiogenic shock. 006. Choose the route of administration of beclomethasone: 1) intravenous; 2) inhalation; 3) oral; 4) subcutaneous. 007. The source of pulmonary embolism can be: 1) portal vein; 2) deep veins of the legs; 3) subclavian vein; 4) femoral artery. 008. In cases of diphtheria, there may be development of this, in the heart: 1) purulent myocarditis; 2) toxic myocarditis; 3) granulomatous myocarditis; 4) fibrinous pericarditis. 009. Specify a characteristic feature in the peripheral blood in chronic lymphocytic leukemia: 1) the presence of at least 40% of lymphoblasts; 2) neutrophilia; 3) the presence of neutrophils with toxogenic granularity; 4) absolute and relative lymphocytosis; 5) erythrocytosis. 010. Select an elastic artery from the list provided: 1) aorta; 2) splenic artery; 3) the subclavian artery; 4) carotid artery; 5) femoral artery. 011. Which of the structural components of a eukaryotic cell has two membranes? 1) cell membrane; 2) cell center; 3) mitochondria; 4) Golgi complex. 012. The key problem of Russian philosophy in the 19th century was the search of: 1) the laws of dialectics; 2) ways of development of Russia; 3) methods of cognition; 4) directions of scientific and technological progress. 013. Types of euthanasia: 1) direct and indirect; 2) active and passive; 3) primary and secondary; 4) objective and subjective. 43 014. Who was the ruler of Kievan Rus? 1) Yaroslav the Wise; 2) Dmitry Donskoy; 3) Ivan Kalita; 4) Alexander Nevsky. 015. What method was used in ancient China for smallpox: 1) vaccination; 2) variolation; 3) surgical intervention; 4) bloodletting. 016. Complete the recipe line by choosing the correct endings: Rp: Tabulett… extract… Valerian… obduct… 0,02 N10 1) -ae, -i, -ae, -ae; 2) -as, -i, -ae, -as; 3) -ae, -i, -ae, -i; 4) -as, -i, -ae, -ae. 017. A liquid is called Newtonian, the viscosity of which depends on: 1) speed gradient; 2) pressure; 3) pressure and velocity gradient; 4) only from its nature and temperature. 018. Disruption in collagen synthesis occurs with this vitamin deficiency: 1) В1; 2) В2; 3) Б5; 4) С; 5) Е. 019. In the ornithine cycle, there is formation of: 1) creatinine; 2) urea; 3) ammonia; 4) betaine; 5) glycine. 020. Divergence of homologous chromosomes occurs during: 1) prophases; 2) anaphase of mitosis; 3) anaphase I of meiosis; 4) anaphase II of meiosis. 021. Indicate where, according to the Krenlein scheme, the trunk of the middle meningeal artery is projected: 1) at the intersection of the upper horizontal and rear vertical lines; 2) at the intersection of the upper horizontal and front vertical lines; 3) at the intersection of the upper horizontal and middle vertical lines; 4) at the intersection of the lower horizontal and front vertical lines; 5) at the intersection of the lower horizontal and middle vertical lines. 022. What types of clostridia cause the development of anaerobic gas infection: А) Clostridium tetani, B) Clostridium botulinum, C) Clostridium septicum, D) Clostridium perfringens, E) Clostridium histoliticum, F) Clostridium sordelli. 1) А, D, E, F; 2) C, D, E, F; 3) А, B, C,D; 44 4) А, C, E, F. 023. Relative humidity: 1) the percentage of absolute humidity to maximum; 2) the difference between the maximum and absolute types of humidity; 3) the elasticity of water vapor in the air at the time of measurement; 4) the ratio of absolute humidity to relative humidity, expressed as a percentage. 024. The average number of days a bed is operated per year is calculated as follows: 1) (number of bed-days actually spent by patients) / (number of days in a year); 2) (number of bed-days actually spent by patients) / (number of average annual beds); 3) (number of discharged patients) / (number of average annual beds); 4) (number of bed-days spent by patients) / (number of discharged patients). 025. A specialist that has the right to issue documents certifying temporary disability is: 1) a forensic expert; 2) the doctor of the balneary; 3) the doctor of the hospital department; 4) an ambulance doctor; 5) doctor of the blood transfusion station. 026. Specify synonyms for the term "epidemiological study": 1) investigation of disease outbreaks; 2) epidemiological diagnostics; 3) epidemiological analysis. 027. The main provisions of the doctrine of the epidemic process of L.V. Gramashevsky: 1) the correspondence of the transmission mechanism to the main localization of the pathogen in the host organism; 2) the phases of the development of the epidemic process; 3) etiological selectivity of the main (primary) routes of transmission of the causative agent of the infection, depending on its biological properties. 028. What is the most common complication of scabies? 1) allergic dermatitis; 2) secondary pyoderma; 3) cicatricial skin atrophy; 4) sepsis; 5) dry skin. 029. All of the above is characteristic for acute erythema nodosum, except: 1) localization of rashes on the legs; 2) only superficial vessels of the skin are affected; 3) an increase in body temperature up to 38-39 degrees; 4) is manifested by the formation of bright red painful nodes; 5) the nodes disappear without a trace within 2-3 weeks. 030. Typical complaints for patients with trigeminal neuralgia: 1) constant aching pains that capture half of the face; 2) short paroxysms of intense pain, provoked by a light touch on the face; 3) attacks of increasing intensity of pain in the area of the eye, jaw, teeth, accompanied by increased lacrimation and salivation; 4) for prolonged pain in the orbit, corner of the eye, accompanied by impaired visual acuity. 031. Alcoholic polyneuropathy is characterized by: 1) predominant lesion of the lower extremities; 2) predominant lesion of the upper limbs; 3) pain in the legs and feet; 4) pain in the forearms and hands; 5) 1 and 3 are true; 45 6) 2 and 4 are true. 032. Dementia is characterized by: 1) delirium, hallucinations, confusion; 2) withdrawal syndrome; 3) depersonalization and derealization; 4) neurotic and personality disorders; 5) impaired memory and intelligence. 033.In paranoid schizophrenia, the onset of the disease most often occurs in: 1) adolescence; 2) children's age; 3) mature age; 4) the period of involution; 5) advanced age. 034. What groups of drugs are used to treat allergic rhinitis: A) antihistamines, B) mucolytics, C) vitamins, D) topical glucocorticosteroids, E) decongestants, E) diuretics. 1) А, B; 2) C, D; 3) А, D; 4) E, F; 5) А, E. 035. What symptom in case of a fracture of the upper wall of the maxillary sinus is an indication for surgical treatment? 1) accumulation of blood in the maxillary sinus; 2) the appearance of purulent discharge from the nose; 3) subcutaneous emphysema in the lower eyelid; 4) subcutaneous hemorrhage in the lower eyelid; 5) diplopia. 036. In the fundus with a stagnant optic nerve head, there is: 1) gray optic nerve head with clear contours, narrowing of arterioles and venules; 2) waxy disc of the optic nerve with clear contours, significant narrowing of arterioles and venules, “bone bodies”; 3) the optic disc is hyperemic, its contours are indistinct, arterioles and venules are dilated; 4) the optic disc is not changed in color, it will protrude into the vitreous body, the contours are blurred, the venules are dilated, full-blooded, crimped. 037. What ophthalmoscopic symptom makes it possible to differentiate hypertension and symptomatic hypertension: 1) a symptom of arterio-venous crossover; 2) smoothness in the color of arterioles and venules; 3) the symptom of "cherry pits"; 4) the symptom of "crushed tomato"; 5) star shape. 038. The nature of the ends of the wound from double-edged objects (dagger, Finnish knife): 1) both ends are sharp; 2) one end is sharp, the other is rounded; 3) u-shaped. 039. The All-Russian Service for Disaster Medicine is a functional subsystem of: 1) The Ministry of Defense of Russia; 2) the Ministry of Internal Affairs of Russia; 3) Russian Emergency Service; 4) the Ministry of Health of the Russian Federation; 46 5) other ministries and departments. 040. With a burn of 3 "A" degree, pain sensitivity in the affected area is: 1) moderately reduced; 2) significantly reduced; 3) increased; 4) preserved; 5) absent. 041. Where is the upper limit of the relative dullness of the heart normally located?? 1) at the level of the II rib; 2) at the level of the II intercostal space; 3) at the level of the III rib; 4) at the level of IV rib. 042. In what disease is the cough dry? 1) acute bronchitis; 2) chronic bronchitis; 3) lung abscess; 4) bronchiectasis. 043. When measuring blood pressure by the method of N.S. Korotkov, the level of diastolic blood pressure is taken as the phase: 1) I; 2) II; 3) III; 4) IV; 5) V. 044. Pathognomonic sign for angina pectoris is: 1) chest pain not associated with physical activity without ECG changes; 2) ventricular premature beats after exercise; 3) chest pain and depression on the ECG of the S-T segment by 1 mm or more; 4) rise of the S-T segment by less than 1 mm; 5) an increase in the Q wave in the III standard and aVF leads. 045. The most common cause of death in a patient with infective endocarditis is: 1) myocardial abscesses; 2) renal failure; 3) thromboembolism of cerebral arteries; 4) intoxication; 5) congestive circulatory failure. 046. Gray hypoxemia with NO2 intoxication is manifested by the following symptoms, excluding: 1) ash gray complexion; 2) excitement; 3) lethargy; 4) a sharp drop in blood pressure; 5) low carbon dioxide content in arterial blood. 047. The main method of treatment and prevention of retinopathy is: 1) the use of antiplatelet agents; 2) laser coagulation of the retina; 3) the use of statins; 4) fasting. 048. List the possible causes of hypoglycemia: A) a large dose of insulin; B) insufficient amount of grain units in the diet; C) insufficient dose of insulin; D) alcohol intake; E) physical activity. Choose the right combination of answers: 47 1) А, B; 2) А, B, D, E; 3) B, C, D; 4) А, D, E; 5) B, C, E. 049. Specify the antiarrhythmic indicated for the relief of paroxysm of atrial fibrillation in the WPW syndrome: 1) digoxin; 2) diltiazem; 3) verapamil; 4) procainamide. 050. Note the mechanism of action of omeprazole: 1) blockade of H2-histamine receptors; 2) blockade of gastrin receptors; 3) blockade of the proton pump; 4) inactivation of hydrochloric acid. 051. Which variant of chronic glomerulonephritis may not be accompanied by the development of renal failure? 1) latent; 2) hematuric; 3) hypertensive; 4) nephrotic; 5) mixed. 052. Changes in biochemical parameters in chronic renal failure: 1) hyperalbuminemia; 2) dyslipidemia; 3) hypercreatininemia; 4) urobilinuria; 5) hyperbilirubinemia. 053. What are the indications for the appointment of glucocorticoids in acute glomerulonephritis: 1) edema; 2) the presence of nephrotic syndrome without severe hematuria and hypertension; 3) arterial hypertension; 4) macrohematuria. 054. What side effects develop with the use of inhaled glucocorticoids in usual doses? a) candidiasis of the oropharynx; b) ulcers of the gastrointestinal tract; c) dysphonia; d) steroid diabetes; e) frequent infections of the nasopharynx. Choose the right combination of answers: 1) а, c; 2) а, b, d, e; 3) all answers are corrent; 4) а, e; 5) а, b, e. 055. Which of the sputum elements reliably indicates the destruction of lung tissue: 1) Charcot-Leiden crystals 2) leukocytes 3) elastic fibers 4) Kurshman spirals 5) red blood cells 48 056. Systemic scleroderma is most characterized by the detection of antibodies in the blood serum: 1) to a cyclic citrullinated peptide; 2) to the cytoplasmic antigens of neutrophils; 3) topoisomerase; 4) to double-stranded DNA; 5) to the Smith antigen. 057. Periarticular osteoporosis is a characteristic radiographic sign of: 1) osteoarthritis; 2) gouty arthritis; 3) psoriatic arthritis; 4) rheumatoid arthritis; 5) septic (bacterial) arthritis. 058. Baker's cyst is: 1) periarticular cystic enlightenment of bone tissue on radiographs; 2) the accumulation of inflammatory fluid in the joint cavity; 3) accumulation of fluid in the posterior volvulus of the knee joint; 4) accumulation of fluid in the prepatellar bursa; 5) accumulation of fluid in the upper volvulus of the shoulder joint. 059. Signs of stable high functional class angina are: 1) an increase in the level of blood enzymes MV CPK and troponin T 2) drop in the ejection fraction 3) ECG signs of myocardial damage in the lateral wall 4) a decrease in the level of the threshold load with bicycle ergometry less than 50 W 5) lowering the level of the threshold load with bicycle ergometry below 125 W 060. What drug is indicated for the relief of paroxysmal ventricular tachycardia? 1) disopyramide; 2) lidocaine; 3) verapamil; 4) digoxin; 5) dronedarone. 061. In what kind of heart disease is the development of heart failure a consequence of a violation of the diastolic function of the myocardium? 1) myocardial infarction; 2) mitral stenosis; 3) dilated cardiomyopathy; 4) hypertrophic cardiomyopathy; 5) pulmonary stenosis. 062. Duration of anti-Helicobacter pylori therapy: 1) 15 days; 2) 10-14 days; 3) 15 days. 4) 21 days. 063. To relieve pain in chronic pancreatitis, do not use: 1) novocaine; 2) omeprazole; 3) analgin; 4) no-shpa; 5) morphine. 49 064. Determination of the severity of liver cirrhosis (Chyld-Pugh index) includes the following clinical and laboratory parameters, except for: 1) the presence of ascites; 2) stage of hepatic encephalopathy; 3) the level of albumin and bilirubin; 4) the number of platelets; 5) prothrombin time. 065. Main source of botulism: 1) a person; 2) warm-blooded herbivores; 3) carnivores; 4) birds. 066. The pathogenesis of HIV infection is based on: 1) damage to immunocompetent cells; 2) the development of oncopathology; 3) progressive dystrophy; 4) opportunistic infections; 5) severe metabolic disorders; 6) severe circulatory disorders. 067. To confirm tuberculosis of a particular organ, it is reliable to identify by the MTB method: 1) luminescence microscopy; 2) direct bacterioscopy; 3) culture test; 4) PCR method; 5) molecular genetic; 6) immunological. 068. For what purpose is the Mantoux reaction with 2 TU used in mass examinations?? 1) for the timely detection of infection and incidence of tuberculosis in children and adolescents; 2) for differential diagnosis of lung diseases; 3) for the timely detection of tuberculosis in adults. 069. "Supplementary" sick leave for temporary transfer to a facilitated work of a person in connection with an occupational disease and a patient with tuberculosis is drawn up as follows: 1) a new sick leave is issued every 10 days; 2) the sick leave is extended every 10 days; 3) sick leave is issued immediately for 2 months. 070. The final decision on the need to send the patient for a medical and social expertise is made by: 1) the attending physician; 2) the head of the department; 3) Deputy Chief Physician for medical expert board; 4) clinical expert commission; 5) chief physician. 071. GHB: 1) it is dangerous to use in case of hypokalemia; 2) causes a toxic effect; 3) when coming out of anesthesia, excitement is possible; 4) causes nausea and vomiting. 50 072. Which of the following complications is most common with external cardiac massage in elderly patients? 1) liver damage; 2) the appearance of signs of fat embolism; 3) fracture of the ribs; 4) subcutaneous emphysema; 5) fracture of the sternum and xiphoid process. 073. A symptom specific to acute appendicitis is: 1) Kocher - Volkovich; 2) Rovzing; 3) Sitkovsky; 4) all three symptoms; 5) none of them. 074. In the case of gallstone disease, emergency surgery is indicated for: 1) occlusion of the cystic duct; 2) cholecystopancreatitis; 3) perforated cholecystitis; 4) obstructive jaundice; 5) hepatic colic. 075. The stages of neuromuscular dysplasia are all, except: 1) achalasia; 2) hydrocalicosis and pisloectasia; 3) megaureter; 4) hydroureteronephrosis; 5) 2 and 4 are correct. 076. In case of a paraurethral cyst 5 cm in size without suppuration, it is necessary: 1) puncturing the cyst; 2) excision of the cyst transvaginally; 3) electrocoagulation of the cyst; 4) installation of a counting catheter-irrigator into the cyst; 5) discharge of the patient under the supervision of a urologist, gynecologist. 077. The symptom of the Obukhov hospital is detected in the following diseases: 1) acute intestinal obstruction; 2) acute pancreatitis; 3) perforated stomach ulcer; 4) acute cholecystitis; 5) restrained inguinal hernia. 078. The reactive stage of peritonitis continues: 1) 4-6 hours; 2) 24 hours; 51 3) 24-48 hours; 4) 48-72 hours; 5) over 72 hours. 079. In the case of treatment for acute thrombosis of hemorrhoids on an outpatient basis, it is most rational to: 1) prescribe laxatives (magnesium sulfate), lead lotions, orally - escuzan or aspirin, suppositories with belladonna; 2) make a novocaine blockade, reduce the nodes; 3) prescribe analgesics, lotions for the first 2-3 days, bed rest, dressings with heparin ointment, diet; 4) remove thrombosed nodes; 5) apply sclerotherapy. 080. Indications for forced intravenous diuresis in a patient with destructive pancreatitis: 1) pancreatogenic peritonitis; 2) polyuria; 3) intestinal paresis; 4) pain syndrome; 5) delirium. 081. The most common localization of intussusception is: 1) the cecum; 2) ileocecal segment; 3) ileo-ileal (iliac-iliac) segment; 4) sigmoid colon; 5) rectosigmoid department. 082. Caries course is subdivided into: 1) fissure, approximal, precervical, circular; 2) acute, progressive, arrested, chronic; 3) initial, superficial, medium, deep, perforated; 4) enamel, dentin, cement; 5) complicated, uncomplicated. 083. Polytrauma with mechanical damage to the skeleton is understood as: 1) multi-fragment bone fractures; 2) multiple, concomitant and combined trauma; 3) bone fractures and joint dislocations; 4) bone fractures complicated by damage to the great vessels; 5) bone fractures with extensive soft tissue damage. 084. Contraindications to bone osteosynthesis are: 1) osteoporosis of the bone; 2) open fractures with an extensive area of soft tissue damage; 3) infected fractures; 4) exte

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