1.

А 30 у.о. patient has got multiple body skin rash C. Chronic obstructive emphysema
consisting of small paired elements that are D. Pulmonary neoplasm
scattered on the skin diorderly and mostly focally, E. Disseminated pulmonary tuberculosis
they are accompanied by itch. The rash appeared a
few days after attending sport centre and sauna. 5. A 19 y.o. boy was admitted to the hospital
What is the most probable diagnosis? with closed abdominal trauma. In course of operation
A. Neurodermitis multiple ruptures of spleen and small intestine were
B. Eczema revealed. AP is falling rapidly, it is necessary
C. Allergic dermatitis to perform hemotransfusion. Who can determine the
D. Contact dermatitis patient's blood group and rhesus compatibility?
E. Scab A. A surgeon
B. An anaesthesilogist
2. Patient 27 y.o. was hospitalized to the С. A doctor of any speciality
psychiatric hospital for the 4-th time during 2 years. D. A traumatologist
Heard voices commenting on his actions, had E. A laboratory physician
delusions of persecution (was sure that the
Mafia wanted to kill him). After a course of 6. A patient has got pain in the axillary area, rise
treatment with neuroleptics was discharged from of temperature developed 10 hours ago. On
hospital with the diagnosis of schizophrenia, state examination: shaky gait is evident, the tongue is
of remission. The secondary prevention of the coated with white coating. The pulse is frequent. The
relapses of schizophrenia requires: painful lymphatic nodes are revealed in the
A. Long-term hospitalization axillary area. The skin is erythematous and
B. Psychiatric observation glistering over the lymphatic nodes. What is the most
С. Supportive treatment with neuroleptics of probable diagnosis?
prolonged action A. Bubonic plague
D. Participation in a self-help group B. Acute purulent lymphadenitis
E. Psychoanalytic treatment C. Tularemia
D. Anthrax
3. A 35 y.o. patient was admitted to the local E. Lymphogranulomatosis
hospital a week after a road accident with
clinical picture of clotted hemothorax. What is the 7. A patient complains of nycturia, constant boring
most appropriate treatment tactic for prevention pain in perineum and suprapubic region, weak
of acute pleural empyema? urine jet, frequent, obstructed and painful
A. Passive drainage of pleural cavity urination. He has been ill for several months,
B. Complex conservative therapy pain in perineum appeared after getting problems
С. Treatment by pleural punctions with urination. Rectal examination revealed that
D. Active drainage of pleural cavity prostate is enlarged (mostly owing to the right
E. Surgical removal of clotted hemothorax lobe), dense, asymmetric, its central sulcus is
flattened, the right lobe is dense, painless, tuberous.
4. A 30 y.o. man presents with a history of What disease can it be?
recurrent pneumonias and a chronic cough A. Chronic congestive prostatitis
production of foul smelling, pirulent B. Cancer of prostate
sputum, ocassionally glood tinged, which is C. Urolithiasis, stone of the right lobe of prostate
worse in the morning and on lying down. On D. Prostate sclerosis
physical examination, the patient appears E. Prostate tuberculosis
chronically ill with clubbing of fingers, inspiratory
rales at the base of lungs posteriorly. Most likely 8. A 52 y.o. patient fell from 3 m height on the flat
diagnosis: ground with the right lumbar area. He complains of
A. Bronchoectasis pain in this area. There is microhematuria in the
B. Chronic bronchitis urea. Excretory urography revealed that kidney's
1
functioning is satisfactory. What is the most changes of mucous membrane. In blood: WBC- 9,8
probable diagnosis? •109/L, RBC- 3,0 • 1012/L, sedimentation rate - 52
A. Kidney's abruption mm/hour. What medication provides pathogenetic
B. Multiple kidney's ruptures treatment of this patient?
С. Kidney's contusion A. Linex
D. Subcapsular kidney's rupture B. Kreon
E. Paranephral hematoma C. Motilium
D. Sulfosalasine
9. А 7 у.о. boy has crampy abdominal pain and a E. Vikasolum
rash on the back of his legs and buttocks as well as
on the extensor surfaces of his forearms. 13. A 25 y.o. man who has been suffering from
Laboratory analysis reveals proteinuria and disseminated sclerosis for 4 years complains of
microhematuria. He is most likely to be affected by: increasing unsteadyness, weakness of his lower
A. Polyarteritis nodosa extremities, urinary retention. Objectively: central
B. Systemic lupus erythematosus tetra-paresis. Cerebellar ataxia. Disturbed function
С. Poststreptococcal glomerulonephritis of pelvic organs. What is the most appropriate therapy
D. Dermatomyositis in this case?
E. Anaphylactoid purpura A. Glucocorticoids
B. Desensitizing medications
10. A child is 1 y.o. Within the last months after the C. Nootropics
begining of supplemental feeding the child has D. Vitamins
appetite loss, diarrhea with massive defecation, E. Antibiotics
sometimes vomiting. Objectively: body temperature
is normal. Body weight is 7 kg. Evident pallor 14. A 50 y.o. woman for 1 year complained of attacks
of skin, leg edemata, enlarged abdomen. of right subcostal pain after fatty meal. Last week the
Coprogram shows a lot of fatty acids and soaps. attacks have repeated every day and become more
The child was diagnosed with celiac disease and painful. What diagnostic study would you
prescribed gluten-free diet. What shoul be excluded recommend?
from the dietary intake in this case? A. X-ray examination of the gastrointestinal tract
A. Fruit B. Liver function tests
B. Animal protein С. Ultrasound study of the pancreas
C. Cereals - wheat, oats D. Ultrasound examination of the gall-bladder
D. Digestible carbohydrates E. Blood cell count
E. Milk and dairy produce
15. An 8 y.o. boy complains of constant cough
11. A 10 y.o. child who is at oligoanuretic stage of along with discharge of greenish sputum,
acute renal insufficiency has got sensations of dyspnea during physical activities. At the age of
pricking in the mucous 1 year and 8 months he fell ill for the first time
membrane of oral cavity and tongue, extremities with bilateral pneumonia that had protracted
numbness, reduced reflexes, respiratory course. Later on there were recurrences of the
disturbance, arrhythmia. What are these symptoms disease 5-6 times a year, during the remission
caused by? periods there was constant productive cough. What
A. Acidosis examination results will be the most important for
B. Hyperkaliemia making a final diagnosis?
С. Hyponatremia A. Bronchoscopy
D. Alkalosis B. Spirography
E. Hyperazotemia C. Bacterial inoculation of sputum
D. Roentgenography of thorax organs
12. A 41 y.o. woman has suffered from nonspecific E. Bronchography
ulcerative colitis for 5 years. On
rectoromanoscopy: evident inflammatory process 16. A 41 y.o. woman complains of weakness,
of lower intestinal parts, pseudopolyposive fatigue, fever up to 38°C, rash on the face skin,
2
pain in the wrists and the elbows. On physical E. Gastrointestinal tract
examination: erythematous rash on the cheeks
with "butterfly"look, the wrists and elbow joints 20. A patient who has been contacting with
are involved symmetrically, swollen, sensitive, benzol for 6 years has a nonevident leukopenia,
friction rub over the lungs, the heart sounds are moderate reticulocytosis, gingival hemorrhage,
weak, regular, HR- 88/min, BP- 160/95 mm Hg. dizziness, asthenovegetative syndrome. What a
Hematology shows anemia, leucopenia, severity degree of chronic intoxication with
lymphopenia; on urinalysis: proteinuria, benzol corresponds with described symptoms?
leukocyturia, casts. What is the main mechanism of A. Minor
disease development? B. Severe
A. Production of myosin antibodies C. Disease is not connected with work
B. Production of antibodies to double- stranded conditions
DNA D. Moderate
C. Production of antibodies to endothelial cells E. -
D. Production of antimitochondrial antibodies
E. Production of myocytes antibodies 21. A 28 y.o. patient who has no permanent residence
was admitted to the hospital with preliminary
17. An 8 y.o. child presents with low-grade fever, diagnosis "influenza", on the 5-th day of disease
arthritis, colicky abdominal pain, and a purpuric there are appeared maculopapular and petechial
rash limited to the lower extremities, laboratory rash on his body and internal surfaces of his
studies reveal a guaiac-positive stool, a urinalysis extremities. Body temperature is 41°C, euphoria,
with red blood cell (RBC) casts and mild hyperemic face, scleras reddening, tongue tremor,
proteinuria, and a normal platelet count. The tachycardia, splenomegaly, excitement. What is
most likely diagnosis is: the most probable diagnosis?
A. Idiopathic thrombocytopenic purpura A. Typhoid fever
B. Systemic lupus erythematosus (SLE) B. Delirium alcoholicum
С. Henoch-Schonlein's vasculitis C. Spotted fever
D. Poststreptococcal glomerulonephritis D. Leptospirosis
E. Rocky Mountain spotted fever E. Measles

18. For the persons who live in a hot area after an 22. The highest risk of congenital anomalies probably
accident at a nuclear object, the greatest risk occurs when human embryos or fetuses are exposed
within the first decade is represented by cancer to ionizing radiation. During which part of
of: gestational period does it occur?
A. Thyroid gland A. 18-45 days after conception
B. Reproduction system organs B. 90-120 days after conception
C. Lungs С. 10-14 days after conception
D. Breast D. The third trimester
E. Skin E. The first 7 days

19. A 32 y.o. patient has been suffering from 23. A 16 y.o. female presents with abdominal pain and
systematic scleroderma for 14 years. She was purpuric spots on the skin. Laboratory
repeatedly exposed to treatment in the in-patient investigations reveals a normal platelet count,
department. Complains of periodical dull cardiac with haematuria and proteinuria.The most likely
pain, dyspnea, headache, eyelid edemata, weight diagnosis:
loss, pain and deformation of extremities joints. A. Thrombotic thrombocytopenic purpura
What organ's lesion deteriorates the prognosis for B. Haemolytic uraemic syndrome
the disease? C. Sub acute bacterial endocarditis
A. Lungs D. Heavy metal poisoning
B. Skin and joints E. Schonlein-Henoch purpura
C. Kidneys
D. Heart
3
24. The patient with acute respiratory viral carbon oxides that have negative influence
infection (3-rd day of disease) has complaints upon the inhabitants' health. The effct of these
on pain in lumbar region, nausea, dysuria, oliguria. hazards can be characterized as:
Urinalysis - hematuria (100-200 RBC in eyeshot spot), A. Complex
specific gravity -1002. The blood creatinin B. Combined
level is 0,18 mmol/L, potassium level - 6,4 mmol/L. C. Adjacent
Make the diagnosis: D. Mixed
A. Acute glomerylonephritis E. Associated
B. Acute interstitial nephritis
C. Acute cystitis 29. A 30 y.o. man was always reserved by
D. Acute renal colic nature. He never consulted psychiatri sts. He
E. Acute renal failure complains of headache, sensation "as if
something bursts, moves, bubbles under his
25. A triad of symptoms ("stearing spot", skin". Objectively: no pathology was revealed.
"terminal film", "blood dew") have been What is the most probable psychopathologic
revealed on examination of a patient. What symptom in this case?
disease should you think about? A. Hallucination
A. Ritter's disease B. Paresthesia
B. Psoriasis C. Cenestopathy
C. Lichen ruber planus D. Hypersthesia
D. Vasculitis E. Dysmorphopsia
E. Seborrhea
30. An aircraft factory processes materials with
26. A 3 т.о. child fell seriously ill, body use of lasers. It is determined that the device
temperature rised up to 37,8°C, there is radiates in the light spectrum and that levels
semicough. On the 3-rd day the cough grew of laser radiation at the workplaces exceed the
worse, dyspnea appeared. On percussion: alarm level. Speci fy, what organs will be affected
tympanic sound above lungs, on auscultation: a in the first place?
lot of fine moist and wheezing rales during A. Eyes
expiration. What is the most probable diagnosis? B. Skin
A. Acute respiratory viral infection, bronchiolitis C. Liver
B. Acute respiratory viral infection, focal D. Spleen
pneumonia E. Kidneys
C. Acute respiratory viral infection, bronchitis
with asthmatic component 31. A patient with a history of coronary artery
D. Acute respiratory viral infection, bronchitis disease and atrial fibrillation has the onset of
E. Acute respiratory viral infection, sudden pain and weakness of the left leg.
bronchopneumonia Examination reveals a cool, pale extremity with
absent pulses below the groin and normal
27. 6 т.о. infant was born with body's mass 3 contralateral leg. The most likely diagnosis is:
kg and length 50 cm. He is given natural A. Acute thrombophlebitis
feeding. How many times per day the infant B. Arterial thrombosis
should be fed? С. Dissecting aortic aneurysm
A. 5 D. Cerebrovascular accident
B. 7 E. Arterial embolism
С. 8
D. 4 32. Fluorography of a 45 y.o. man revealed some
E. 6 little intensive foci with indistinct outlines on
the top of his right lung for the first time. The
28. Atmospheric air of an industrial centre is patient doesn't feel worse. He has been
polluted with the following wastes of smoking for many years. Objectively:
metallurgical plants: sulphuric, nitric, metal, pulmonary sound above lungs on percussion,
4
respiration is vesi cular, no rales. Blood count is B. Too long intake of saturating dose
unchanged. What is the most probable diagnosis? С Disturbed metabolism of digoxin in liver
A. Focal pulmonary tuberculosis D. Exceeding daily saturating dose
B. Bronchopneumonia E. Disturbed elimination of the medication by
C. Eosinophilic pneumonia kidneys
D. Disseminated pulmonary tuberculosis
E. Peripheral cancer of lung 37. A 43 y.o. patient complains of periodical pain
attacks in the right half of her face. The attack is
33. Name a statistical observation unit for characterized by spasm of mimetic muscles of the
determination of influence amount of right face's half, reddening of skin on this side.
bloodsugar on the healing of wound's surface in Blood has no pathologies. She was diagnosed
a postoperative period: with right-sided trifacial neuralgia. What medication
A. The patient who has a wound surface should be prescribed?
B. An amount of bloodsugar A. Analgine
C. The patient in a postoperative period B. Indometacin
D. The patient who was discharged on an after- C. Prednisolone
care D. Actovegine
E. Blood analysis E. Finlepsin

34. The total area of ground intended for 38. A 4 y.o. boy was admitted to the hospital with
building of a regional hospital is 2,0 hectare. What is complaints of dyspnea, rapid fatigability. His
the highest possible capacity of the in-patient anamnesis registers frequent respiratory diseases. On
hospital that can be built upon this ground? percussion: heart borders are dilatated to the left
A. 200 beds and upwards. On auscultation: amplification of
B. 100 beds the SII above pulmonary artery, a harsh
C. 400 beds systolodyastolic "machine"murmur is auscultated
D. Over 1000 beds between the II and the III rib to the left of breast
E. 800 beds bone, this murmur is conducted to all other points
including back. AP is 100/20 mm Hg. What is the
35. A 25 y.o. patient complains of pain in the I most probable diagnosis?
finger on the right hand. On examination: the A. Opened arterial duct
finger is homogeneously hydropic, in bent position. B. Interatrial septal defect
On attempt to unbend the finger the pain is getting С. Valvar aortic stenosis
worse. Acute pain appears during the probe in D. Isolated stenosis of pulmonary arterial orifice
ligament projection. What decease is the most E. Interventricular septal defect
likely?
A. Thecal whitlow (ligament panaritium) 39. A patient complains of feeling heaviness
B. Paronychia behind his breast bone, periodical sensation of
C. Bone panaritium food stoppage, dysphagy. During the X-ray
D. Subcutaneous panaritium examination barium contrast revealed a single
E. Articular (joint) panaritium saccular' outpouching of anterodextral
esophagus wall with regular contours and
36. A 75 y.o. man with IHD (atherosclerotic rigidly outlined neck. What is the most probable
cardiosclerosis, atrial fibrillation, cardiac diagnosis?
insufficiensy stage 2 B; chronic pyelonephritis) was A. Esophageal polyp
prescribed digoxin. During the first 6 days the B. Hiatal hernia
digoxin dose amounted 0,25 mg twice per day that let С. Varix dilatation of esophageal veins
to abatement of dyspnea, edemata and cyanosis. D. Cancer of esophagus
But on the 7-th day the patient developed E. Esophageal diverticulum
nausea and bradycardia. What is the most
probable cause of digoxin intoxication? 40. A 58 y.o. patient complains of weakness, leg
A. Treatment complex doesn't include unitiole edemata, dyspnea, anorexia. He has been suffering
5
from chronic bronchitis for many years. During the 44. The 10 y.o. boy has complains on headache,
last 5 years he has been noting intensified discharge weakness, fever 40°C, vomiting, expressed dyspnea,
of sputum that is often purulent. Objectively: RR- pale skin with flush on right cheek, lag of right
80/min, AP- 120/80 mm Hg. Disseminated hemithorax respiratory movement, dullness on
edemata, skin is dry and pale, low turgor. In percussion over low lobe of right lung, weakness
urine: intense proteinuria, cylindruria. Specify the of vesicular respiration in this zone. The abdomen
most probable pathological process in kidneys: is painless and soft at palpation. Which disease lead
A. Interstitial nephritis to these symptoms and signs?
B. Acute glomerulonephritis A. Pneumonia croupousa
С. Chronic pyelonephritis B. Flu
D. Chronic glomerulonephritis C. Acute cholecystitis
E. Renal amyloidosis D. Intestinal infection
E. Acute appendicitis
41. A 56 y.o. patient ill with cholecystectomy
suddenly had an intense hemorrhage. She needs 45. A young man has painful indurations in the
blood transfusion. Her blood group is AB(IV)Rh-. peripapillary regions of both mammary glands.
Hemotransfusion station doesn't dispose of this The most reasonable action will be:
group. What group of donors can be involved? A. To administer steroids locally
A. Donors of rare blood groups B. To remove them
B. Emergency donors C. To cut and drain them
C. Relatives D. To leave these indurations untouched
D. Donors of active group E. To take an aspirate for bacterial inoculation and
E. Reserve donors cytology

42. A doctor of the general practice has registered 46. A 19 y.o. girl was admitted to Emergency
the following death causes for the previous year: the Department: unconsionsness state, cyanosis,
first place was taken by cardiovascular diseases myotic pupil, superficial breathing - 12/min. BP-
(60%), the second - by tumors (18%), then – traumas 90/60 mm Hg, Ps- 78/min. Choose the action
(8,3%) etc. What diagrams will provide the most corresponding to this clinical situation:
substantial information about the registered A. Cordiamine injection
ocurrences? B. Caffeine injection
A. Pie diagram С. Controlled respiration
B. Cartogram D. Gastric lavage
C. Circle diagram E. Oxygen inhalation
D. Line diagram
E. Column diagram 47. A patient with nosocomial pneumonia presents
signs of collapse. Which of the following
43. A 21 y.o. man complains of having morning pneumonia complications is most likely to be
pains in his back for the last three months. The pain accompanied with collapse?
can be relieved during the day and after physical A. Exudative pleuritis
exercises. Physical examination revealed reduced B. Emphysema
mobility in the lumbar part of his spine, increase of C. Septic shock
muscle tonus in the lumbar area and sluch during D. Toxic hepatitis
moving. X-ray pattern of spine revealed bilateral E. Bronchial obstruction
sclerotic changes in the sacrolumbal part. What test
will be the most necessary for confirming a diagnosis? 48. A 38 y.o. woman was hospitalized to the
A. Rheumatoid factor surgical unit with acute abdominal pain
B. ESR irradiating to the spine and vomiting. On
С. Uric acid in blood plasma laparocentesis hemmorhagic fluid is obtained. What
D. HLA-B27 disease is suspected?
E. Antinuclear antibodies A. Acute pancreatitis
B. Renal colic
6
C. Acute appendicitis E. Administering an instravenous bolus of 50%
D. Acute enterocolitis dextrose
E. Perforative gastric ulcer
53. A 39 y.o. woman complaines of squeezed
49. A full-term newborn child has a diagnosis epigastric pain 1 hour after meal and heartburn.
newborn's Rh-factor hemolytic disease. Bilirubin rate She had been ill for 2 years. On palpation,
is critical. The child's blood group is В (III), his there was moderate tenderness in
mother's blood group — A(II). The child has pyloroduodenal area. Antral gastritis was revealed
indication for hemotransfusion. What donor blood on gastroscopy. What study can establish
must be chosen? genesis of the disease?
A. Blood group O(I)Rh+ A. Detection of autoantibodies in the serum
B. Blood group B(III)Rh- B. Examination of stomach secretion
C. Blood group A(II)Rh- C. Revealing of Helicobacter infection in gastric
D. Blood group A(II)Rh + mucosa
E. Blood group B(III)Rh + D. Gastrin level in blood
E. Examination of stomach motor function
50. A 28 y.o. man fell seriously ill, he feels chill, has
got a fever, body temperature raised up to 54. A 30 y.o. victim of fire has thermal burns
38,5°C, paroxysmal pain in the left iliac region, of III-A and III-B degree that amount 20% of
frequent defecation in form of fluid bloody and total skin coverlet. AP is 110/70 mm Hg,
mucous mass. Abdomen palpation reveals HR- 120/min. What transfusion means shoul be
painfulness in its left half, sigmoid colon is used for blind infusion correction during
spasmed. What is the most probable diagnosis? transportation?
A. Amebiasis A. Polyglucine
B. Colibacillosis B. Salines
C. Acute dysentery C. Fresh frozen plasma
D. Nonspecific ulcerative colitis D. Albumin
E. Malignant tumors of large intestine E. 10% glucose solution

51. X-ray pattern of thorax organs revealed a 55. A 2 y.o. girl has been ill for 3 days. Today
large intensive inhomogeneous opacity with she has low grade fever, severe catarrhal
indistinct outlines on the ri ght side at the level presentations, slight maculopapular rash on her
of the 4-th rib. In the centre of this opacity there buttocks and enlarged occipital lymph nodes.
is a horizontal level and clearing of lung What is your diagnosis?
tissue above it. What disease does this X-ray A. Pseudotuberculosis
pattern correspond with? B. Adenoviral infection
A. Tuberculoma of the right lung С. Scarlet fever
B. Peripheral cancer D. Measles
С.- E. Rubella
D. Abscess of the right lung
E. Right-sided pneumothorax 56. A 20 y.o. patient complains of amenorrhea.
Objectively: hirsutism, obesi ty with fat tissue
52. A 51 y.o. women was taken to the prevailing on the face, neck, upper part of
emergency department in convulsive status body. On the face there are acne vulgaris, on
epilepticus. The first means of medi cal the skin- - striae cutis distense. Psychological and
management should be: intellectual development is normal.
A. Ensuring that the airway is open and the Gynecological condition: external genitals are
patient is oxygenating moderately hairy, acute vaginal and uterine
B. Injecting 5 mg of diazepam followed by a hypoplasia. What diagnosis is the most
loading dose of phenytoin probable?
C. Inducing pentobarbital coma A. Shichan's syndrome
D. Inserting a tongue blade B. Turner's syndrome
7
C. Stein-Levental's syndrome
D. Babinski-Froehlich syndrome 61. A military unit stopped for 3-day's rest in
E. Itsenko-Cushing syndrome inhabited locality after a long march. The
sanitary-epidemiological reconnaissance found
57. A 30 y.o. primigravida woman has got intensive several water sources. It is necessary to choose the
labor pain every 1-2 minutes that lasts 50 seconds. source complying with the hygienic standards for
The disengagement has started. The perineum drinking water in the field conditions.
with the height of 4 cm has grown pale. What A. River water
actions are necessary in this situation? B. Artesian well water
A. Expectant management C. Spring water
B. Perineotomy D. Water from melted snow
C. Vacuum extraction of fetus E. Rain water
D. Episiotomy *
E. Perineum protection 62. A 43 y.o. patient had cholecystectomy 6 years
ago because of chronic calculous cholecystitis.
58. By the end of the 1st period of physiological Lately he has been suffering from pain in the right
labour the clear amniotic waters were given vent. subcostal area and recurrent jaundice. Jaundice
Contractions lasted 35-40 sec every 4-5 min. hasn't gone for the last 2 weeks. Stenoutic papillitis
Palpitation of the fetus is 100 bpm. The AP is 0,5 cm long has been revealed. What is the best
140/90 mm Hg. Di agnosis: way of treatment?
A. Hydramnion A. To perform endocsopic papillosphi- ncterotomy
B. Acute hypoxia of the fetus B. To treat conservatively: antibiotics, spasmolytics,
C. Back occipital presentation antiinflammatory drugs
D. Labors before term C. To perform external choledoch drainage
E. Premature detachment of normally posed D. To perform transduodenal papillosphi-
placenta ncterotomy
E. To perform choledochoduodenostomy
59. А 43 у. о. woman complains of contact
hemorrhages during the last 6 months. Bimanual 63. Which gestational age gives the most accurate
examination: cervix of the uterus is enlarged, its estimation of weeks of pregnancy by uterine size?
mobility is reduced. Mirrors showed the following: A. Between 31 and 40 weeks
cervix of the uterus is in the form of cauliflower. B. Less that 12 weeks -
Chrobak and Schiller tests are positive. What is the C. Between 12 and 20 weeks
most probable diagnosis? D. Between 21 and 30 weeks
A. Cancer of cervix of the uterus E. Over 40 weeks
B. Leukoplakia
C. Polypus of the cervis of the uterus 64. A 34 y.o. patient 3 hours ago was bitten by a
D. Cervical pregnancy dog. He has got a non-bleeding wound in his left
E. Nascent fibroid arm caused by the dog's bite. What surgical care
would you provide to the patient?
60. Laparotomy was performed to a 54 y.o. A. Complete suturing of the wound
woman on account of big formation in pelvis that B. Cream bandage
turned out to be one-sided ovarian tumor along C. Incomplete suturing of the wound
with considerable omental metastases. The most D. Aseptic bandage
appropriate intraoperative tactics involves: E. Wound bathing with detergent water and
A. Biopsy of omentum antiseptic application
B. Biopsy of an ovary
C. Ablation of an ovary and omental metastases 65. What guarantees against the preconceived
D. Ablation of omentum and both ovaries with attitude to the physician in cases of professional law
tubes violations do you know?
E. Ablation of omentum, uterus and both ovaries A. Conduct an inquiry by preliminary investigator
with tubes of police department
8
B. Draw up a statement about forensic medical 69. A full-term child survived antenatal and
examination intranatal hypoxia, it was born in asphyxia
of experts (2-5 points on Apgar score). After birth the child
C. Sanction of public prosecutor, inquiry by has progressing excitability, there are also vomiting,
preliminary investigator of prosecutor's office, nystagmus, spasms, strabismus, spontaneous Moro's
committee and Babinsky's reflexes. What localization of
D. Utilisation copy of medical documents intracranial hemorrhage is the most probable?
E. Conduct forensic medical examination by A. Periventricular hemorrhages
district forensic medicine expert B. Subarachnoid hemorrhage
С Small cerebral tissue hemorrhages
66. A 22 y.o. patient complains of having boring D. Hemorrhages into the brain ventricles
pain in the right iliac region for one week, E. Subdural hemorrhage
morning sickness, taste change. Delay of
menstruation is 3 weeks. Objectively: AP- 110/70 70. On the 4-th day of injections a 60 y.o.
mm Hg, Ps- 78/min, t°- 37,0°C. Bimanual patient felt pain and tissue induration in the left
examination revealed that uterus is a little buttock. Objectively: the skin in the
enlarged, soft, movable, painless. Appendages superexternal quadrant of the left buttock is red
palpation: a painful formation 3x4 cm large on the and hot, palpation reveals a painful infiltrate 6 x 6 cm
right, it is dense and elastic, moderately large with softening in the centre. Body
movable. What is the most probable diagnosis? temperature is 37,9°C. What action is necessary
A. Acute appendicitis to diagnose an abscess?
B. Progressing tubal pregnancy A. Punction
C. Interrupted tubal pregnancy B. X-ray investigation
D. Uterine pregnancy С. Biopsy
E. Cyst of the right ovary D. Ultrasonic examination
E. Clinical blood analysis
67. A 56 y.o. patient has worked at the
aluminium plant over 20 years. Within 3 last years 71. On the 15-th day after a minor trauma of the
he has got loosening of teeth, bone and joint right foot a patient felt malaise, fatigability,
pains, piercing pains in heart region, vomiting. irritability, headache, high body temperature, feeling
The provisional diagnosis is: of compression, tension and muscular twitching of his
A. Phosphorus intoxication right crus. What disease can it be?
B. Fluorine intoxication A. Anaerobic gas gangrene
C. Manganese intoxication B. Tetanus
D. Mercury intoxication С. Erysipelas
E. Lead intoxication D. Acute thrombophlebitis
E. Thromboembolism of popliteal artery
68. A 14 y.o. girl complains of profuse bloody
discharges from genital tracts during 10 days after 72. A 40 y.o. patient complains of yellowish
suppresion of menses for 1,5 month. Similiar discharges from the vagina. Bimanual examination:
bleedings recur since 12 years on the background of no pathological changes. The smear contains
disordered menstrual cycle. On rectal Trichomonas vaginalis and blended flora. Colposcopy:
examination: no pathology of the internal two hazy fields on the front labium, with a negative
genitalia. In blood: Hb- 70 g/L, RBC- 2,3 • 1012/L, Iodum test. Your tactics:
Ht- 20. What is the most probable diagnosis? A. Specific treatment of Trichomonas colpitis
A. Noncomplete spontaneous abortion B. Treatment of specific colpitis and with the
B. Polycyst ovarian syndrome subsequent biopsy
С. Werlholf 's disease C. Diathermocoagulation of the cervix of the
D. Juvenile bleeding, posthemorrhagic anemia uterus
E. Hormonoproductive ovary tumor D. Cervix ectomy
E. Cryolysis of cervix of the uterus

9
73. A 14 y.o. child suffers from vegetovascular What is the doctor's professional tactics in this
dystonia of pubertal period. He has got situation?
sympathoadrenal atack. What medicine should be A. The urgent hospitalization in to the
used for atack reduction? herapeutic department
A. Corglicone B. Aminocapronic acid intravenously
B. Amisyl C. Treatment at home
C. No-shpa D. Treatment at a day time hospital
D. Euphyline E. The urgent hospitalization in to the
E. Obsidan surgical department

74. A 7 y.o. girl has mild form of varicella. Headache, 78. An infant is 2 d.o. It was full-term born with
weakness, vertigo, tremor of her limbs, ataxia, signs of intrauterine infection, that's why it was
then mental confusion appeared on the 5th day of prescribed antibiotics. Specify, why the gap
illness. Meningeal signs are negative. between antibiotic introductions to the new-born
Cerebrospinal fluid examination is normal. How can children is longer and dosage is smaller
you explain these signs? compared to the older children and adults?
A. Meningitis A. The newborns have a lower level of
B. Meningoencephalitis glomerular filtration
C. Myelitis B. The newborns have lower concentration of
D. Neurotoxic syndrome protein and albumins in blood
E. Encephalitis C. The newborns have reduced activity of
glucuronil transferase
75. A 34 y.o. woman in the 10-th week of D. The newborns have diminished blood PH
gestation (the second pregnancy) consulted a doctor E. The newborns have bigger hematocrit
of antenatal clinic with purpose of statement on the
dyspensary record. In the previous pregnancy 79. A 40 yo. woman has changes of
there took place hydramnion, the child's birth mammary gland. What are the most often
weight was 4086. What method of examination is symtomps that precede the malignization?
necessary for carrying out, first of all? A. Painless movable induration
A. Bacteriological investigation of di scharge from B. Pure discharges from the nipple
the vagina С. Painful movable induration
B. The test for tolerance to glucose D. Skin induration with inverted nipple
C. A cardiophonography of fetus E. Bloody discharges from the nipple
D. USI of the fetus
E. Determination of the contents of 80. A 9 y.o. child with diagnosis "chronic
fetoproteinum tonsillitis" stands dispanserization control. Within
1 year of observation there was one exacerbation of
76. At year-end hospital administration has disease. Physical conditi on is satisfactory. The
obtained the following data: annual number of general state is not infringed. Define group of
treated patients and average annual number of health:
beds used for patient's treatment. What index A. Ill (c)
of hospital work can be calculated based upon B. 1 st
this data? С. III (a)
A. Average annual bed occupancy D. Il-d
B. Average bed idle time E. Ill (b)
C. Bed resources of the hospital
D. Average duration of patients presence in the 81. A 44 y.o. man has acute disarthria, right-
hospital sided Horner's syndrome, hiccup, right-sided
E. Bed turnover ataxia, loss of pain sensation of his face to the
right and of his body to the left. The man is
77. The family doctor examined a pati ent and conscious. Computer tomography of brain is
diagnosed an acute bleeding of an intestine. normal. The most reasonable measure will be:
10
A. Surgical cerebral decompression
B. Endarterectomy of the left carotid artery 86. A 67 y.o. patient complains of dyspnea, breast
C. Endarterectomy of the right carotid artery pain, common weakness. He has been ill for
D. Introduction of direct coagulants and 5 months. Objectively: t°-37,3°C, Ps- 96/min.
observation Vocal tremor over the right lung cannot be
E. Out-patient observation determined, percussion sound is dull, breathing
cannot be auscultated. In sputum: blood
82. The parameter of infantile mortality for the diffusi vely mixed with mucus. What is the most
last year was -16,3, in present year -15,7. Name a probable diagnosis?
kind of the diagram that can be used for a graphic A. Focal pulmonary tuberculosis
representation of it: B. Exudative pleuritis
A. Intrastylar C. Macrofocal pneumonia
B. Linear D. Bronchoectatic disease
С. Stylar E. Lung cancer
D. Radial
E. Sector 87. An 18 y.o. woman consulted a gynecologist
about the pain in the lower part of abdomen,
83. The major repair of a hospital included renewal fever up to 37,5°C, considerable
of colour design of hospital premi ses because it is of mucopurulent discharges from the genital
great psychological and aesthetical importance; tracts, painful urinati on. Vaginal examination
and so the walls of patient wards will be painted with mirrors: the urethra is infiltrated, cervix of
under consi deration of: the uterus is hyperemic, erosive. The uterus is
A. Diseases of patients who will be staying in painful, ovaries are painful, thickened; forni xes
these wards are free. Bacterioscopy test revealed
B. Hospital profile diplococcus. What diagnosis is the most
С Wall reflection coefficient probable?
D. Creation of cozy atmosphere A. Chlamydiosis
E. Windows orientation B. Chronic gonorrhea
C. Candydomycosis
84. A 65 y.o. patient has acute pain, D. Trichomoniasis
paresthesia, paleness of his left extremi ty. Pulse E. Recent acute ascending gonorrhea
in the a. dorsalis pedis is absent. There is skin
coldness and paleness that gradually spreads 88. A number of viable fetuses per 1000 women
upwards. These symptoms are most likely to at the age between 15 and 44 is determined by:
be the evi dence of: A. Perinatal rate
A. Thrombophelebitis of deep veins B. Birth rate
B. Hernia of lumbar disc C. Genital index
С. Arterial occlusion D. Reproductive level
D. - E. Obstetric rate
E. Thrombophlebitis of superficial veins
89. A 38 y.o. patient lifted a heavy object that
85. The 7 т.о. infant is suffering from acute resulted in pain in the lumbar part of spine
pneumonia which was complicated by irradiating to the posterior surface of his left
cardiovascular insufficiency and respi ratory leg. The pain increases during changing body
failure of II degree. The accompani ed diagnosis is position and also in the upright position.
malnutrition of II degree. Choose the best Examination revealed positive symptoms of
variant of therapy: tension. What is the preliminary diagnosis?
A. Macropen and Penicillin A. Myelopathy
B. Ampiox and Amicacin B. Arachnomyelitis
C. Ampiox and Polymixin C. Spinal cord tumor
D. Gentamycin and Macropen D. Pathology of intercostal disks
E. Penicillin and Ampiox E. Polyneuritis
11
 of water column. The first step in further
90. Patient 22 y.o., was admitted to trauma center treatment of the patient will be:
with complains of pain in the left ankle joint, A. Continued parenteral introduction of fliud in
which increased while movements and order to raise AP
weight bearing. On the clinical examination it B. Introduction of peripheral vasodilatators in order
was found, that the patient had the closed to reduce CVP
fracture of medial malleolus without C. Introduction of loop diuretics in order to reduce
displacement. In which position the foot has to be CVP
fixed in plaster cast? D. Echocardiogram
A. In position of planter flexion of foot E. Catheterization of left pleural cavity while the
B. At right angle with varus positioning of the outer end of catheter is submerged in water
foot
C. In position of dorsal flexion of foot 94. A 58 y.o. man complaines of severe
D. In position of pronation inspiratory dyspnea and expectoration of frothy
E. In position of supination and blood-tinged sputum. He has
been suffering from essential hypertension and
91. A 25 y.o. woman complained of fatigue, hair loss ischemic heart disease. On examination: acrocyanosis,
and brittle nails. The examinati on revealed pallor "bubbling"breathing, Ps-30/min, BP- 230/130 mm
of skin, Ps- 94/min, BP- 110/70 mm Hg. On blood Hg, bilateral rales. Choose medicines for treatment.
count: Hb- 90 g/L, RBC- 3,5 • 10 12/L, C.I.- 0,7; A. Strophanthine, potassium chloride,
ESR- 20 mm/h. Serum iron level was 8,7 mcmol/1. plathyphylline
What treatment would you initiate? B. Morphine, furosemide, nitroprusside sodium
A. Vitamin B12 intramuscularly С. Albuterol, atropine, papaverine
B. Iron dextrin injections D. Cordiamine, isoproterenol
C. Blood transfusion E. Theophylline, prednisolon
D. Packed RBCs transfusion
E. Ferrous sulfate orally 95. A 19 y.o. patient was admitted to the hospital
with acute destructive appendicitis. He suffers
92. Medical examination of a 43 y.o. man revealed from hemophilia B-type. What antihemophilic
objectively pailness of skin and mucous medicine should be included in pre- and post-
membranes, smoothness of li ngual papillas, operative treatment plan?
transverse striation of nails, fissures in the mouth A. Fresh frozen blood
corners, tachycardia. Hemoglobin content amounts B. Fresh frozen plasma
90 g/1; there are anisocytosis, poikilocytosis. The C. Dried plasma
most probable causative agent of this D. Native plasma
condi tion is deficiency of the following E. Cryoprecipitate
microelement:
A. Zinc 96. A 65 y.o. man who has problems with urination
B. Copper as a result of benign prostate gland adenoma
C. Selenium dveloped fever and chill, hypotension, sinus
D. Iron tachycardia. Skin is warm and dry. Clinical blood
E. Magnesium analysis revealed absolute granulocytopenia. These
hemodynamic changes are most likely to be caused
93. А 20 у.о. man has a stab knife wound in the left by:
half of thorax close to nipple. AP is 90/60 mm Hg, A. Secondary endothelial changes as a result of
Ps- 130/min, BR- 32/min. During inspiration there bacterial lesion
is increase of pulse wave in the region of jugular B. Secondary reflex vasodilatation as a result of
vein, decrease of peripheral arterial pulse and lowered cardiac output
reduction of AP Respiratory murmurs are C. Endotoxemia with activation of complement
unchanged. X-ray pattern of thorax organs has no system
pecularities. After introduction of 2 1 of isotonic D. Reflex vagus stimulation with lowered cardiac
solution the AP stayed low, CVP raised up to 32 cm output
12
E. Secondary circulation insufficiency with retained D. Eczema
systolic function as a result of peripheral E. Erysipelas
vasoconstriction
101. 3 weeks ago a patient was ill with
97. A 23 y.o. woman who suffers from insulin- tonsillitis. Clinical examination reveals edema,
dependent diabetes was admitted to the acute care arterial hypertension, hematuria, proteinuria (1,8
department with mental confusion, inadequate g/per day), granular and erythrocital casts. What is
anxious behaviour, hyperhidrosis, excessive salivation, the preliminary diagnosis?
tachycardia. What examination will be a primary A. Pyelonephritis
task? B. Renal amyloidosis
A. Clinical blood analysis C. Intestinal nephritis
B. Blood urea and creatinine test D. Glomerulonephritis
С. Blood test for sugar E. Cystitis
D. Plasma electrolytes test
E. Gaseous composition of arterial blood 102. A 30 y.o. parturient woman was taken to the
maternity house with complaints of having acute,
98. In treatment and prevention establishments, regular labour pains that last 25-30 seconds every 1,5-
regardless of their organisational and proprietary 2 minutes. Labour activity began 6 hours ago.
form, the rights of patients should be observed. Uterus is in higher tonus, head of the fetus is
Which of these rights are the most significant? above the opening into the small pelvis. Fetal
A. The right to the information heartbeat is 136/min. PV: cervical dilatation is 4 cm,
B. The right to be heard uterine fauces is spasming at a height of
C. The right to the protection of the patient's parodynia. Head is level with opening into the
interests small pelvis, it is being pushed off. What is the
D. The right to the free choice most probable diagnosis?
E. The right to the protection from incompetence A. Normal labour activity
B. Discoordinated labour activity
99. A 54 y.o. woman complains of increasing fatigue C. Primary powerless labour activity
and easy bruising of 3 weeks' duration. Physical D. Pathological preliminary period
findings included pale, scattered ecchymoses and E. Secondary powerless labour activity
petechiae and mild hepatosplenomegaly. In blood:
RBC- 2,5 • 1012/L; Hb- 73 g/L; HCT- 20%; PLT- 23 • 103. A 63 y.o. patient was operated on account of
109/L; and WBC-162 • 109/L with 82% blasts, that big multinodular euthyroid goiter. Despite of techical
contained Auric rods; peroxi- dase stain was difficulties a forced subtotal resection of both
positive. What is the most probable diagnosis? parts of the thyroid gland was performed. On
A. Hemolytic anemia the 4-th day after the operation the woman had
B. Chronic leukemia cramps of face muscles and upper extremities,
C. Acute leukemia stomach ache. Positive Chvostek's and Trousseau's
D. Thrombocytopenia signs. What is the most
E. Megaloblastic anemia probable cause of such condition?
A. Tracheomalacia
100. A 43 y.o. patient was admitted to the hospital B. Insufficiency of parathyroid glands
with complaints of high temperature of the C. Injury of recurrent nerve
body and severe headache. On examination: D. Thyrotoxic crisis
carbuncle is revealed on the forearm. There E. Postoperative hypothyroidism
are intense edema around it, insignificant pain,
regional lymphadenitis. The patient is a worker of 104. After a long periode of subfebrility a patient
cattle-ranch. What disease is it necessary to think registered increase of dyspnea, pain in the right
about first? hypochondrium, leg edemata. Objectively: neck
A. Erysipeloid veins are edematic. Ps is 120 bpm, sometimes it
B. Carcinoma of skin disappears during inspiration. Heart sounds are very
С. Anthrax weakened. ECG showed low-voltage waves of
13
ventricular complex. A month ago there was raise of antibiotics for the period of exacerbation -
ST V1 — V4 segment. Cardiac silhouette is enlarged, gentamicin (80 mg 3 times a day) and biseptol
roundish. What is the most probable diagnosis? (960 mg twice a day). What consequences may be
A. Metabolic postinfection myocardi- opathy caused by such a combination of antibiotics?
B. Exudative pericarditis A. Acute renal insufficiency
C. Primary rheumatic carditis B. Acute suprarenal insufficiency
D. Small-focal myocardial infarction C. Chronic renal insufficiency
E. Postinfarction cardiosclerosis D. Antibiotic combination is optimal and
absolutely safe
105. A 35 y.o. patient experienced a strong nervous E. Glomerulosclerosis
stress that resulted in formation of reddened and
edematic areas on the back surface of her hands with 109. A w oman in her 39-th w eek o f
further formation of small inflammated nodules, pregnancy, the second labor, has regular birth
vesicles and then erosions accompanied by profuse activity. Uterine contractions take place every 3
discharge of serous liquid. The process is also minutes. What criteria describe the beginning of the II
accompanied by intense itching. What is the most labor stage the most precisely?
probable diagnosis? A. Duration of uterine contractions more than 30
A. Microbial eczema seconds
B. Allergic dermatitis B. Presenting part is in the lower region of small
C. Common eczema pelvis
D. Toxicodermia С. Rupture of membranes
E. Common contact dermatitis D. Cervical smoothing over 90%
E. Cervical dilatation no less than 4 cm
106. A 42 y.o. woman works at the factory on the
fabrication of mercury thermometers, complains of 110. A 7 d . o . b o y i s a d m i t t e d t o t h e hospital
the headache, swoons, reduction of memory, small for evaluation of
and frequent flutter of fingers of drawn hands, the vomiting and dehydration. Physical examination is
eyelids and the tongue, bleeding gums, gingivitis. otherwise normal except for minimal
What preparation is it nessesary to use for the hyperpigmentation of the nipples. Serum sodium
elimination of mercury from the organism? and potassium concentrations are 120 meq/L and 9
A. Pentoxil meq/L respectively. The most likely diagnosis is:
B. Magnesium sulphate A. Panhypopituitarism
C. Sodium hydrate of carbon B. Secondary hypothyroidism
D. Unithiol С. Congenital adrenal hyperplasia
E. Seduxen D. Pyloric stenosis
E. Hyperaldosteronism
107. A 32 y.o. woman consulted a gynecologist about
having abundant long menses within 3 months. 111. A 60 y.o. asthmatic man comes for a check up
Bimanual investigation: the body of the uterus is and complains that he is having some difficulty in
enlarged according to about 12 weeks of pregnancy, "starting to urinate". Physical examination
distorted, tuberous, of dense consistence. indicates that the man has blood pressure of
Appendages are not palpated. Histological test of 160/100 mm Hg, and a slight enlarged prostate.
the uterus body mucosa: adenocystous hyperplasia Which of the following medications would be
of endometrium. Optimal medical tactics: useful in treating both of these conditions:
A. Surgical treatment A. Propranolol
B. Phytotherapy B. Phetolamine
C. Phase by phase vitamin therapy C. Doxazosin
D. Radial therapy D. Labetalol
E. Hormonetherapy E. Isoproterenol

108. A 50 y.o. woman who suffers from chronic 112. A 40 y.o. patient with rheumatic heart disease
pyelonephritis was prescribed a combination of complains of anorexia, weakness and loss of
14
weight, breathlessness and swelling of feet. The occupational hazard is the principal one under these
patient had tooth extraction one month ago. On conditions?
examination: t°- 39°C, Ps- 100/min. Auscultation: A. High level of noise
diastolic murmur in the mitral area. Petechial lesion B. Improper occupational microclimate
around the clavicle; spleen was palpable. С. Compelled working pose
A. Recurrence of rheumatic fever D. Air pollution with anesthetic
B. Subacute bacteria endocarditis E. Mental overfatigue
С. Mitral stenosis
D. Aortic stenosis 117. A 13 y.o. girl complains of having
E. Thrombocytopenia purpura temperature rises up to febrile figures for a month,
joint ache, periodical skin rash. Examination
113. After delivery and revision of placenta there revealed steady enhancing of ESR, LE-cells. What is
was found the defect of placental lobe. General the most probable diagnosis?
condition of woman is normal, uterus is firm, A. Systematic scleroderma
there is moderate bloody discharge. Inspection of B. Juvenile rheumatoid arthritis
birth canal with mirrors shows absence of C. Systematic lupus erythematosus
lacerations and raptures. What action is D. Rheumatics
nesessary? E. Acute lymphoblast leukosis
A. External massage of uterus
B. Urine drainage, cold on the lower abdomen 118. A patient suffers from chronic recurrent
C. Use of hemostatic medications pancreatitis with evident disturbance of
D. Use of uterine contracting agents exocrinous function. After intake of rich spicy
E. Manual exploration of the uterine cavity food and spirits his stool becomes fatty. Reduced
production of what factor is the most probable
114. Poorly refined wastes of an industrial plant are cause of steatorrhea?
usually thrown into the river that supplies drinking A. Acidity of gastric juice
water. It causes perishing of some microorganisms, B. Alkaline phosphatase
disturbs processes of water self-purification and C. Tripsin
worsens its quality that can have negative D. Amylase
influence upon people's health. How is this effect of E. Lipase
environmental factors called?
A. Complex 119. A 60 y.o. patient cpmplains of weakness,
B. Combined dizziness, heaviness in the upper part of
C. Associated abdomen, paresthesia of toes and fingers.
D. Indirect Objectively: skin icteritiousness, tongue is crimson,
E. Direct smooth. Hepatomegaly. In blood: Hb- 90 g/1,
erythrocytes — 2 , 3 - 1012/l, reticulocytes - 0,2%;
115. A 58 y.o. patient developed acute color index - 1,2, macrocytosis; Jolly's bodies,
myocardium infarction 4 hours ago, now he is in Cabot's ring bodies. What medication is the most
the acute care department. ECG registers short appropriate for treatment?
paroxysms of ventricular tachycardia. The most A. Vitamin Bi2
appropriate measure will be to introduct: B. Feroplex
A. Propafenone C. Dyspherol
B. Amyodaron D. Prednisolone
C. Flecainid E. Packed red blood cells
D. Lidocain
E. Veropamil 120. Prevalence of a disease in region N amounted
1156 occurences per 1000 of inhabitants. What
116. An anestesiologist gives narcosis to the patient, of the mentioned indices characterizes the disease
he uses a non-reversive contour. Anesthetic is prevalence?
halothane. Air temperature in the operation room A. Standardized
is 21°C, humidity 50%, level of noise 30 dB. What B. Intensive
15
С. Visual index
D. Ratio 125. A 39 y.o. patient complains of having dyspnea
E. Extensive during physical activity, crus edemata, palpitation,
heart intermissions. Objectively: HR is 150 bpm,
121. A district doctor keeps the record of atrial fibrillation. Heart is both ways enlarged. Heart
reconvalescents after infectious diseases, people sounds are muted. Liver is 6 cm below the costal
who are disposed to frequent and long-lasting margin. Echocardiogram reveals dilatation of heart
diseases, patients with chronic pathologies. What chambers (end diastolic volume of left ventricle is
category of patients should belong to the III health 6,8 cm) is 29% EF, valve apparatus is unchanged.
group? What is the most probable diagnosis?
A. People with chronic pathologies and disposed A. Dilated cardiomyopathy
to frequent and long-lasting diseases B. Exudative pericarditis
B. People disposed to frequent and long- lasting C. Restrictive cardiomyopathy
diseases D. Hypertrophic cardiomyopathy
C. All above mentioned categories E. Thyreotoxic cardiomyopathy
D. People with chronic diseases
E. Reconvalescents after infectious diseases and 126. A 33 y.o. woman survived two operations on
patients with chronic pathologies account of extrauterine pregnancy, both uterine
tubes were removed. She consulted a doctor
122. A 13 y.o. teenager who suffers from with a question about possibility of having a child.
hemophilia A was taken to the hospital after a What can be advised in this case?
fight at school. His diagnosis is right-sided A. Induction of ovulation
hemarthros of knee joint, retroperitoneal B. Artifical fertilization with donor's semen
hematoma. What should be primarily prescribed? C. Insemination with her husband's semen
A. Washed thrombocytes D. Extracorporal fertilization
B. Aminocapronic acid E. Substitutional maternity
C. Dry plasma
D. Placental albumin 127. A 74 y.o. patient complains of abdomen pain
E. Fresh frozen plasma and sweling, nausea. She suffers from ischemic
heart disease, postinfarction and atherosclerotic
123. A patient has been suffering from morning cardi- osclerosis. Objectively: the patient is in
cough accompanied by discharge of small amount of grave condition, abdomen is swollen, abdominal wall
sputum, dyspnea for 8 years. He has been smoking doesn't take active part in respiration. Laparoscopy
for 10 years. Objectively: cyanosis, prolonged revealed a small amount of muddy effusion in
expiration, dry rales. What is the most probable abdominal cavity, one of the loops of small
diagnosis? intestine is dark-cyan. What is the most probable
A. Multiple bronchiectasis diagnosis?
B. Chronic non-obstructive bronchitis A. Thrombosis of mesenteric vessels
С. Chronic obstructive bronchitis B. Twisted bowels
D. Bronchial asthma С. Erysipelas
E. Idiopatic fibrosing alveolitis D. Acute intestinal obstruction
E. Ischemic abdominal syndrome
124. A 62 y.o. patient suffers from DM- 2.
Diabetes is being compensated by diet and 128. A 2 т.о. child with birth weight 5100 g
Maninilum. Patient has to undergo an operation on has jaundice, hoarse cry, umbilical hernia,
inguinal hernia. What tactics of hypoglycemic physical development lag. Liver is +2 cm enlarged,
therapy should be used? spleen is not enlarged. In anamnesis: delayed
A. Prescribe long-acting insulin falling-away of umbilical cord rest. In blood: Hb-
B. Prescribe guanyl guanidines 120 g/L, erythrocytes - 4 , 5 — 1012/L, ESR- 3 mm/h.
C. Give Glurenorm in place of Maninilum Whole serum bilirubin is 28 mcmole/L, indirect - 20
D. Prescribe fast-acting insulin mcmole/L, direct - 8 mcmole/L. What is the most
E. Continue with the current therapy probable diagnosis?
16
A. Conjugated jaundice erythrocytes - 3 , 0 • 1012/L, Hb- 90 g/L, C.I.-
B. Congenital hepatitis 1,0, mi-crospherocytosis, reticulocytosis. Blood
C. Congenital hypothyreosis bilirubin - 56 mmole/L, indirect bilirubin -38
D. Hemolitic anemia mmole/L. Choose the way of treatment:
E. Cytomegalovirus infection A. Omentosplenopexy
B. Splenectomy
129. The patient was admitted to the hospital on C. Spleen transplantation
the 7-th day of the disease with complaints of high D. Portocaval anastomosis
temperature, headache, pain in the muscles, E. Omentohepatopexy
especially in calf muscles. The dermal
integuments and scleras are icteric. There is 133. A 33 y.o. patient was admitted to the hospital
hemorrhagic rash on the skin. Urine is bloody. The with stopped repeated ulcerati-ve bleeding. He
patient went fishing two weeks ago. What is the was pale and exhausted. Blood count: Hb- 77 g/1,
diagnosis? Ht- 0,25. In view of anemia there were made two
A. Yersiniosis attempts of blood transfusion of the same group
B. Brucellosis - A(lI)Rh +. In both cases the transfusion had to be
С. Trichinellosis stopped because of development of anaphylactic
D. Salmonellosis reaction. What transfusion medium would be
E. Leptospirosis advisable in this case?
130. A 74 y.o. patient has been suffering from A. Erythrocytic suspension
hypertension for 20 years. He complains of B. Erythrocytic mass (native)
frequent headache, dizziness, he takes enalapril. C. Fresh citrate blood
Objectively: accent of the SII above aorta, Ps- 84 D. Washed erythrocytes
bpm, rhythmic, AP- 180/120 mm Hg. What group E. Erythrocytic mass poor in leukocytes and
of hypotensive medications could be additionally thrombocytes
prescribed under consideration of the patient's age?
A. β-adrenoceptor blockers 134. A 42 y.o. woman complains of dyspnea, edema
B. α-adrenoceptor blockers of the legs, and tachycardia during small physical
C. Central sympatholytics exertion. Heart borders are displaced to the left and
D. Thiazi'de diuretics SI is accentuated, there is diastolic murmur on
E. Loop diuretics apex. The liver is enlarged by 5 cm. What is the
cause of heart failure?
131. A 42 y.o. patient complains of weakness, A. Aortic stenosis
heartbeat, nasal hemorrhages, cutaneous B. Mitral stenosis
hemorrhages. His condition has been worsening С. Tricuspid regurgitation
progressively for a month. Objectively: grave D. Mitral regurgitation
condition, the extremities and body skin has spotted E. Tricuspid stenosis
and petechial hemorrhages, lymph nodes are not
palpable, Ps- 116/min, liver is +2 cm enlarged, 135. A 28 y.o. woman comes to the Emergency Room
spleen is not palpable. Blood has evident with a slightly reddened, painful "knot", 8 cm
pancytopenia. What disease should you think about above the medial malleolus. Examination in the
first of all? standing position demonstrates a distended vein
A. Acute leukosis above and below the mass. There are no other
B. Acute agranulocytosis abnormalities on physical examination. The most
C. Hypoplastic anemia likely diagnosis is:
D. Hemorrhagic vasculitis A. Superficial venous thrombosis
E. Werlhof's disease B. Cellulitis
C. Early deep vein thrombosis
132. A 15 y.o. patient has developmental lag, D. Subcutaneous hematoma
periodical skin yellowing. Objectively: spleen is E. Insect bite
16x12x10 cm large, holecistoli-thiasis, skin ulcer
on the lower third of his left crus. Blood count:
17
136. An engineer-chemist at the age of 47 often fells post. What document should be used for
ill with an occupational skin disease. Who makes a registration of this disease?
decision to transfer A. Statistic coupon for registration of final diagnoses
him to other job accepts? B. Statistic card of the patient who left in-
A. DCC patient hospital
B. The chief of shop С. Urgent report on infectious disease
C. The attending physician D. Outpatient's card
D. A head physician E. Inpatient's card
E. MSEC
141. A 45 yo. man complains of having intensive
137. Mother of a newborn child suffers from pain in the epigastric region 1,5-2 hours later after
chronoc pyelonephritis. She survived acute food intake. He has been suffering from ulcer for 11
respiratory viral infection directly before labour. years. Objectively: t°- 36,5°C, RR- 16/min, Ps- 70
Delivery was at term, the period before discharge bpm, AP- 120/80 mm Hg. On palpation: local
of waters was prolonged. On the 2-nd day the painfulness in the right epigastric region. What
child got erythematous rash, later on - vesicles parameters of intragastric Ph-meter in the region of
about 1 cm large with seropurulent content. stomach body are the most
Nikolsky's symptom is positive. Dissection of typical for this patient's disease?
vesicles results in erosions. The child is inert, A. pH = 4,0-5,0
body temperature is subfebrile. What is the most B. pH = 1,0-2,0
probable diagnosis? С. pH = 5,0-6,0
A. Pseudofurunculosis D. pH = 3,0-4,0
B. Sepsis E. pH = 6,0-7,0
С. Ritter's dermatitis
D. Vesicular pustulosis 142. A girl 13 y.o. consulted the school doctor on
E. Impetigo neonatorum account of moderate bloody discharge from the
genital tracts, which appeared 2 days ago.
138. A 7 y.o. girl fell ill abruptly: fever, headache, Secondary sexual characters are developed.
severe sore throat, vomiting. Minute bright red rash What is the most probable cause of bloody
appear in her reddened skin in 3 hours. It is more discharge?
intensive in axillae and groin. Mucous membrane of A. Werlhof's disease
oropharynx is hyperemic. Greyish patches is on the B. Juvenile hemorrhage
tonsills. Submaxillary lymph nodes are enlarged C. Endometrium cancer
and painful. What is your diagnosis? D. Haemophilia
A. Enteroviral infection E. Menarche
B. Pseudotuberculosis
C. Scarlet fever 143. A child is 2 т.о. Inguinofemoral folds contain
D. Rubella acutely inflamed foci with distinct borders in form
E. Measles of spots that are slightly above the surrounding
areas due to skin edema. The rash has appeared
139. A patient who takes diuretics has during the week. Vesiculation and wetting are absent.
developed arrhythmia as a result of cardiac What is the most probable diagnosis?
glycoside overdose. What is the treatment tactics A. Complicated course of scabies
in this case? B. Dermatomycosis
A. Increased calcium level in blood C. Infantile eczema
B. Increased potassium concentration in blood D. Psoriasis
С. - E. Napkin-area dermatitis
D. Reduced magnesium concentration in blood
E. Increased sodium consentration in blood 144. A worker at a porcelain factory who has been
in service for 10 years complains of cough, dyspnea,
140. A worker diagnosed with "acute dysentery "was ache in his chest. What occupational disease are these
sent to the infectious department by a doctor of aid complaints most typical for?
18
A. Chronic dust bronchitis A. Strophanthine
B. Silicosis B. Nifedipine
C. Occupational bronchial asthma C. Lidocain
D. Chronic cor pulmonale D. Morphine
E. Multiple bronchiectasis E. Enalapril

145. A 30 y.o. woman has the 2-nd labour that has 149. A 30 y.o. man complains of sharp pain in
been lasting for 14 hours. Hearbeat of fetus is the right ear, hearing loss, high temperature
muffled, arrhythmic, 100/min. Vaginal for three days. Objectively: right ear whispering
examination: cervix of uterus is completely opened, language — 0,5 m, external ear is intact,
fetus head is level with outlet from small pelvis. otoscopically - eardrum protrusion, hyperemia and
Saggital suture is in the straight diameter, small swelling, loss of landmarks. What disease is it?
crown is near symphysis. What is the further A. Chronic purulent otitis media
tactics of handling the delivery? B. Chronic secretory otitis media
A. Cesarean section C. Eustachian tube disfunction
B. Use of obstetrical forceps D. Acute purulent otitis media
C. Stimulation of labour activity by oxytocin E. Acute mastoiditis
D. Cranio-cutaneous (Ivanov's) forceps
E. Use of cavity forceps 150. A patient is staying in the hospital with the
diagnosis of abdominal typhus. During the 3-d
146. A 10 y.o. boy with hemophilia has signs of acute week from the beginning of the disease the patient
respiratory viral infection with fever. What of the stopped keeping diet and confinement to bed. As a
mentioned antifebrile medications are result the body temperature and rapid pulse
contraindicated to this patient? decreased and melena appeared. What kind of
A. Acetylsalicylic acid complications should we think about first of all?
B. Panadol extra A. Intestinal haemorrhage
C. Paracetamol B. Nephroso-nephritis
D. Analgin С. Meningitis
E. Pipolphen D. Hepatite
E. Thrombophlebitis
147. The patient 25 yo. was admitted on the 1st
day of the disease with complaints of double vision in 151. A patient consulted a doctor about acure
the eyes, heavy breathing. The day before the patient respiratory viral infection. The patient was
ate homemade mushrooms. On objective acknowledged to be off work. The doctor issued him
examination: paleness, widened pupils, disorder of a medical certificate for 5 days. The patient is not
swallowing, bradycardia, constipation are marked. recovering. What measures should the doctor take
What is the diagnosis? in order to legalize the further disability of patient?
A. Botulism A. To send the patient to the medical social expert
B. Leptospirosis comission
C. Lambliasis B. To prolong the medical certificate at his own
D. Yersiniosis discretion but no more than for 10 days in total
E. Salmonellosis, gastrointestinal form C. To send the patient to the medical
consultative commission
148. A 7 y.o. boy was admitted to the hospital. He D. To prolong the medical certificate at his own
complains of unpleasant sensations in the heart discretion but no more than for 6 days in total
region, pain in the epigastrium, dizziness, E. To prolong the medical certificate together with
vomiting. Objectively: evident paleness of skin, department superintendent
dyspnea, jugular pulse. Heart borders are within
the normal range. Heart sounds are clear, HR- 152. The child has complains of the "night "and
170/min, small pulse. AP- 90/50 mm Hg. EKG "hungry"abdominal pains. At fibroscopy in area a
showed: paroxysm of ventricular tachycardia. The bulbus ofa duodenum the ulcerrative defect of 4
paroxysm can be suppressed by: mms diameter is found, the floor is obtected with a
19
fibrin, (H.p +). Administer the optimum schemes of
treatment: 156. A 22 y.o. man complains of acute throat
A. Omeprasole - Trichopolum - Claritromicin pain, increasing upon swallowing during 3 days.
B. Trichopolum Body temperature 38,3°C, neck lymph nodules are
С. Vicalinum - Ranitidin slightly enlarged and painful. Pharyngoscopically -
D. De-nol tonsilar hyperemia, enlargement and edema,
E. Maalox - Ranitidin tonsils are covered by round yellow fibrinous
patches around crypts openings. Beta-haemolytic
153. A 75 y.o. man has acute pain in the streptococcus in swab analysis. What is the
paraumbilical region accompanied by vomiting diagnosis?
and feeling of abdominal swelling in A. Acute follicular tonsilitis
approximately 30 minutes aftef meals. He lost 10 kg B. Infectious mononucleosis
during the last months because he doesn't eat in С. Acute membranous tonsilitis
order to avoid pain. Abdomen examination reveals D. Pharyngeal candidosis
no changes in the periods between pain attacks. E. Pharyngeal diphtheria
Above the right femoral artery a murmur can be
auscultated, peripheral pulsation in the lower 157. A 19 y.o. girl admitted to the hospital
extrimities is weak. X-ray examination of stomach complained of pain in the knee and fever of 38,6°C.
and colonoscopy reealed no changes. What is the She is ill for 2 weeks after acute tonsillitis. On exam,
leading factor of this pathogenesis? hyperemia and swelling of both knees, temperature
A. Psychogenic changes is 37,4°C, HR- 94/min, BP-120/80 mm Hg, and heart
B. Transient obstruction border is displaced to the left; SI is weak, systolic
С. Inflammation murmur is present. Total blood count shows the
D. Ischemia following: Hb- 120 g/L, WBC- 9,8 • 109/L, ESR of
E. Neoplastic process 30 mm/L. ECG findings: the rhythm is regular, PQ =
0,24 sec. What is a causative agent of the disease?
154. A 35 y.o. patient who suffers from chronic A. Staphylococci
glomerulonephritis and has been hemodialysis- B. Ricchetsia
dependent for the last three years developed C. Autoimmune disorder
intermissions of heart activity, hypotension, D. Viral-bacterial association
increasing weakness, dyspnea. ECG showed E. Beta-hemolytic streptococci
bradycardia, atrioventricular block type I, high
pointed waves T. The day before the flagrant 158. A child was born with body weight 3.250 g
violation of diet took place. What is the most and body length 52 cm. At the age of 1,5 month the
probable cause of these changes? actual weight is sufficient (4350 g), psychophysical
A. Hyperkaliemia development corresponds with the age. The
B. Hypokaliemia child is breast-fed, occasionally there are
C. Hypernatriemia regurgitations. What is the cause of regurgitations?
D. Hypocalciemia A. Acute gastroenteritis
E. Hyperhydratation B. Aerophagia
C. Pylorostenosis
155. A 38 y.o. patient has been treated in a hospital. A D. Esophageal atresia
fever of 39°C, chest pain which is worsened by E. Pylorospasm
breathing, cough, brownish sputum appeared on the
7-th day of the treatment. Chest X- ray shows left 159. A 34 y.o. woman in her 29-th week of
lower lobe infiltrate. Which of the following is pregnancy, that is her 4-th labor to come, was
the treatment of choice for this patient? admitted to the obstetric department with
A. Cephalosporins of the III generation complaints of sudden and painful bloody
B. Tetracycline discharges from vagina that appeared 2 hours
C. Streptomycin ago. The discharges are profuse and contain
D. Erythromycin grumes. Cardiac funnction of the fetus is rhytmic,
E. Penicillin 150 strokes in the minute, uterus tone is
20
normal. The most probable provisional diagnosis will C. IHD. Functional Class II angina
be: D. Myocardial dystrophy
A. Bloody discharges E. Myocarditis
B. Detachment of normally located placenta ,
C. Disseminated intravascular coagulation syndrome 164. A 70 y.o. man is ill with ischemic heart
D. Placental presentation disease. His mood is evidently depressed, anxious.
E. Vasa previa As a result of continious sleeplessness he has got
fears, suicidal thoughts. He would sit for a long time
160. A 40 weeks pregnant woman in intrinsic in the same pose, answer after a pause, in a low,
obstetric investigation: the cervix of a uterus is monotonous voice. His face has a look of
undeveloped. The oxytocin test is negative. Upon suffering, pain, fear. What is the main
inspection at 32 weeks it is revealed: AP- 140/90 psychopathologic syndrome?
mm Hg, protei- nuria 1 g/1, peripheric edemata. A. Phobic syndrome
Reflexes are normal. Choose the most correct tactics B. Obsessive syndrome
of guiding the pregnant: C. Asthenic syndrome
A. Complex therapy of gestosis for 7 days D. Depressive syndrome
B. Strict bed regimen for 1 month E. Paranoid syndrome
C. Cesarean section immediately
D. Complex therapy of gestosis for 2 days 165. A 24 y.o. patient 13 months after the first
E. Laborstimulation after preparation labour consulted a doctor about amenorrhea.
Pregnancy has concluded by a Cesarean section
161. A 49 y.o. female patient was admitted to the concerning to a premature detachment of
hospital with acute attacks of headache normally posed placenta hemorrhage has made
accompanied by pulsation in temples, AP rised low fidelity 2000 ml owing to breakdown of
up to 280/140 mm Hg. Pheochromocytoma is coagulability of blood. Choose the most suitable
suspected. What mechanism of hypertensive atack investigation:
does this patient have? A. USI of organs of a small pelvis
A. Increasing of ^plasma renin activity B. Determination of the contents of Testosteron-
B. Increasing of vasopressin excretion Depotum in Serum of blood
С. Increasing of catecholamines concentration С. Determination of the level of Gonadotropins
D. Increasing of aldosterone level in blood D. Computer tomography of the head
E. Increasing of thyroxine excretion E. Progesteron assay

162. The patients has sustained blunt trauma to the 166. A male, 50 y.o., has a black flat mole on the skin
chest. Which of the following would most likely be of the leg for 10 years. Since 4 months ago the shapes
the cause of acute of the mole become irregular. What diagnostic
cardiopulmonary collapse? methods should be used?
A. Acute adult respiratory distress syndrome A. Incision biopsy
(ARDS) B. Thermography
B. Hemothorax C. Excision biopsy
C. Pneumothorax D. Fine needle biopsy
D. Pulmonary contusion E. Smear for microscopic examination
E. Rib fractures
167. A 10 y.o. child has average indices of body
163. A 52 y.o. patient with previously functional length and her chest circumference exceeds
Class II angina complains of 5 days of intensified average , indices, body weight index is
and prolonged retrosternal pains, decreased heightened due to lipopexia. Functional
exercise tolerance. Angina is less responsive to characteristics of physical development are below
Nitroglycerinum. Which of the following diagnosis is average. Physical development of this child can be
most likely? estimated as:
A. IHD. Unstable angina A. Deeply disharmonic
B. Cardialgia due to spine problem B. Harmonic
21
C. Disharmonic A. In common bile duct
D. Below average B. In pancreas
E. Average C. In gallbladder
D. In liver
168. A 2 y.о. child was delivered in time with E. In duodenum
weight 3.500 g and was on the mixed feeding.
Current weight is 4900 g. Evaluate the current 172. A 42 y.o. patient lifted a heavy object that
weight of the child: resulted in acute pain in the right half of his
A. Corresponding to the age chest, increased dyspnea. The patient's condition
B. Hypotrophy of the II grade is grave: cyanosis of lips and mucous
С. Hypotrophy of the I grade membranes, RR is 28 pm, Ps- 122 bpm. On
D. 150 g less than necessary percussion there is tympanitis above the right half of
E. Paratrophy of the I grade chest, on auscultation - stongly diminished breath
sounds; accent of the II heart sound above the
169. A patient with hepatic cirrhosis drank some pulmonary artery. AP is 80/40 mm Hg. What is the
spirits that resulted in headache, vomiting, main emergency action at the pre-admission stage?
aversion to food, insomnia, jaundice, fetor hepaticus, A. Aminophylline introduction
abdominal swelling. What complication of hepatic B. Adrenaline introduction
cirrhosis is meant? С. Calling a cardiological brigade
A. Acute stomach ulcer D. Oxygen inhalation
B. Hemorrhage from varicosely dilatated veins of E. Air aspiration from the pleural cavity
esophagus
С. Thrombosis of mesenteric vessels 173. A 56 y.o. woman has an acute onset of fever up to
D. Hepatocellular insufficiency 39°C with chills, cough, and pain on respiration
E. Portal hypertension in the right side of her chest. On physical
examination: HR-90/min, BP- 95/60 mm Hg, RR-
170. A healthy 75 y.o. woman who leads a 26/min. There is dullness over the right lung on
moderately active way of life went through a percussion. On X-ray: infiltrate in the right middle
preventive examination that revealed serum lobe of the lung. What is the diagnosis?
concentration of common cholesterol at the A. Acute lung abscess
rate of 5,1mmol/1 and HDL (high-density B. Acute pleurisy
lipoprotei-ns) cholesterol at the rate of 70 mg/dl. C. Community-acquired bronchopneumonia
ECG reveals no pathology. What dietary D. Community-acquired lobar pneumonia with
recommendation is the most adequate? moderate severity
A. Decrease of saturated fats consumption E. Hospital-acquired lobar pneumonia
B. Any dietary changes are necessary
С. Increase of cellulose consumption 174. A newborn child has purulent discharges
D. Decrease of cholesterol consumption from the umbilical wound, skin around the
E. Decrease of carbohydrates consumption umbilicus is swollen. Objectively: the child's skin
is pale, of yellow- greyish colour, generalized
171. A patient is 65 y.o. He has been a smoker hemorrhagic rash. Body temperature is of hectic
for 40 years. Hew has lost 10 kg during the n'ature.
last 3 months. Complains of pain in the What is the most probable diagnosis?
epigastric area after taking meals, diarrhea, A. Thrombocytopathy
jaundice. Physical examination revealed enlarged, B. Hemolytic disease of newborn
painless gallbladder. Feces are light-coloured and C. Sepsis
clay-like. Blood analysis revealed increased level of D. Hemorrhagic disease of newborn
whole and direct bili-rubin, alkaline phosphotase and E. Omphalitis
glutami-nepyruvate transferase. Clinical urine
analysis showed positive bilirubin reaction and 175. Medical examination of a man revealed
negative urobilinogene reaction. Where is the initial "geographic tongue". This microsymptom is the
process that caused these changes? evidence of the following vitamin deficiency:
22
A. Vitamin D opening. There are no evident injuries. What is the
B. Vitamin PP provisional diagnosis?
C. Vitamin С A. Long QT syndrome
D. Vitamins of В group B. Sympathicotonic collapse
E. Vitamin A C. Vagotonic syncope
D. Epilepsy
176. A woman had the rise of temperature up to E. Hysteric syncope
39°C on the first day after labour. Tlie rupture of
fetal membranes took place 36 hours before 180. A 75 y.o. woman with coronary heart disease
labour. The investigation of the bacterial flora of constantly takes warfarin. She was taken to the
cervix of the uterus revealed hemocatheretic acute care department with complaints of
streptococcus of group A. The uterus body is soft, sudden sensation of weakness in the left half of
tender. Discharges are bloody, mixed with pus. her body and eyeball deviation to the left. What
Specify the most probable postnatal complication: examination of the patient will be a primary
A. Infected hematoma task?
B. Metroendometritis A. Computer tomography of brain
C. Infection of the urinary system B. Spinal punction
D. Apostatis of junctures after the episiotomy С. Electroencephalogram
E. Thrombophlebitis of pelvic veins D. Magnetic resonance tomography of brain
E. Ultrasonic examination of carotid arteries
177. A woman was hospitalised with full-term
pregnancy. In survey: the uterus is morbid, the 181. A patient of 32 y.o. complains of severe
abdomen is tense, heart sounds of the fetus are weakness, tremor of extremities. Objective
not auscultated. What is the most probable examination: body weight loss,
complication of pregnancy? wet and warm skin. The thyroid gland is enlarged
A. Premature detachment of the normally posed up to the 3-rd degree, painless, elastic. Ps-
placenta 108/min. BP- 160/55 mm Hg. There are no other
B. Preterm labour abnormalties. The diagnosis is:
C. Hydramnion average degree
D. Back occipital presentation A. Chronic autoimmune thyroiditis, hypertrophic
E. Acute hypoxia of a fetus type
B. Diffuse euthyroid goiter of the 3-rd degree
178. A 70 y.o. patient complains of weakness, C. Diffuse toxic goiter of the 3-rd degree,
dizziness, short periods of unconsciousness, pain in thyrotoxic6sis of the D. Chronic fibrous thyroiditis
the cardiac area. Objectively: HR- 40 bpm, heart E. Toxif erous adenoma of the thyroid gland
sounds are rhythmic, the SI is dull, periodically
amplified. AP is 180/90 mm Hg. What is the most 182. Heart auscultation of a 16 y.o. boy without
probable cause of hemodynamic disturbances? clinical symptoms revealed accent of the S II
A. Bradysystolic form of ciliary arrhythmia and systolic murmur above the pulmonary
B. Complete left bandle-branch block artery. Heart sounds are resonant, rhythmic.
C. Atrioventricular block type I What is the most probable diagnosis?
D. Atrioventricular block type III A. Functional murmur
E. Sinus bradycardia B. Insufficiency of pulmonary artery valve
C. Stenosis of pulmonary artery valve
179. A 14 y.o. girl got a bad mark at-the lesson of D. Defection of interatrial septum
math as well as teacher's reprimand that made her E. Nonclosure of Botallo's duct
cry for a long time. At the end of the lesson she
suddenly lost consciousness and fell down. 183. A 41 y.o. patient was admitted to the
Objectively: skin is of pale pink colour, Ps- 100 intensive care unit with hemorrhagic shock due to
bpm, satisfactory, AP- 110/70 mm Hg. Eyelids are gastric bleeding. He has a history of hepatitis В during
closed and don't give away to the tries of their the last 5 years. The source of bleeding are esophageal

23
veins. What is the most effective method for control 187. A 3 y.o. child with weight defficiency suffers
of the bleeding? from permanent moist cough. In history there are
A. Intravenous administration of pituitrin some pneumonias with obstruction. On
B. Hemostatic therapy examination: distended chest, dullness on
C. Operation percussion over the lower parts of lungs. On
D. Administration of plasma auscultation: a great number of different rales.
E. Introduction of obturator nasogastric tube Level of sweat chloride is 80 mmol/L. What is the
most probable diagnosis?
184. In course of observation of sanitary conditions A. Bronchial asthma
of studying at the technical university it was necessary B. Mucoviscidosis (cystic fibrosis)
to evaluate the visual regimen of students, who study С Pulmonary hypoplasia
from 9 a.m to 3 p.m. What index of natural light will D. Recurrent bronchitis
be the most informative? E. Bronchiectasis
A. Natural light coefficient
B. Light coefficient 188. A 46 y.o. patient complains of colicky pain in
C. Time of the room insolation the right lumbar region that is irradiating to the
D. Presence of mixed (upper-lateral) light lower part of abdomen, nausea. She didn't have such
E. Depth of study room pains before. Survey radiograph of abdominal
cavity organs didn't reveal any pathological stains.
185. A 27 y.o. patient has been having for almost a Ultrasonic sonogram revealed in the enlarged
year fatigue, hyperhidrosis, heaviness in the left right renal pelvis a hyperechoic mass approximately
hypochondrium, especially after meals. 1,5 cm large that gives rise to an "ultrasonic track".
Objectively: spleen and liver enlargement. In What is the most probable diagnosis?
blood: erythrocytes —3,2 1012/l; Hb- 100 g/l, colour A. Benign tumor of kidney
index 0,87, leukocutes — 100 • 109/7, basophils - B. Renal calculus
7%, eosinophils - 5%, myelocytes 15%, C. Renal cyst
juveniles - 16%, stab neutrophils - 10%, D. Malignant tumor of kidney
segmentonuclear leukocytes - 45%, lymphocytes E. Renal tuberculosis
- 2%, monocytes - 0%, reticulocytes - 0,3%,
thrombocytes 400 • 109/l, ESR- 25 mm/h. What is 189. A 34 y.o. patient has been suffering from
the most probable diagnosis? pulmonary tuberculosis for 7 years; he complains of
A. Acute leukosis muscle feebleness, weight loss, diarrheas, increased
B. Chronic lympholeukosis frequency of urination. Objectively:
C. Hepatocirrhosis hyperpigmentation of skin, gums, internal cheek
D. Chronic myeloleukosis surfaces. AP is 90/58 mm Hg. Blood count:
E. Erythremia erythrocutes 3,1 • 1012/L, Hb- 95 g/L, C.I.- 0,92;
leukocytes - 9,4 109/L, eosinophils 7, segmentonuclear
186. A 38 y.o. woman is seriously ill. She complains leukocytes - 45, stab neutrophils - 1, lymphocytes
of frequent paroxysms of expiratory dyspnea. The - 40, monocytes - 7, Na+- 115 mmole/L, K+- 7,3
last paroxysm lasted over 12 hours and failed to mmole/L. What is the preliminary diagnosis?
respond to theophylline. The skin is palish gray, A. Congenital adrenal hyperplasia
moist, RR of 26/min. On auscultation, breath B. Diabetes insipidus
sounds are absent over some areas. Your C. Primary hyperaldosteronism
preliminary diagnosis? D. Primary insufficiency of adrenal cortex
A. Chronic obstructive bronchitis E. Pheochromocytoma
B. Bronchiectasis, respiratory failure of the II-III
degree 190. 10 years ago a patient had a fracture in the
C. Bronchial asthifta, status asthmaticus middle one-third of his left femoral bone, and
D. Ischemic heart disease, pulmonary edema during the last 7 years he has been having acute
E. Atopic bronchial asthma, respiratory failure of inflammation in the area of old fracture
the III degree accompanied by formation of a fistula through
which some pus with small fragments of bone tissue
24
is discharged. After a time the fistula closes. What weakness, malaise, nervousness, dark bloody
complication of the fracture is it? smears from vagina directly before and after
A. Soft tissue phlegmon menses. Bimanual examination revealed that
B. False joint uterus body is enlarged, appendages cannot be
C. Chronic osteomyelitis palpated, posterior fornix has tuberous surface.
D. Bone tuberculosis Laparoscopy revealed: ovaries, peritoneum of
E. Trophic ulcer rectouterine pouch and pararectal fat have
"cyanotic eyes". What is the most probable
191. The disease began acutely. The frequent watery diagnosis?
stool developed 6 hours ago. The body's A. Disseminated form of endometriosis
temperature is normal. Then the vomiting was B. Tuberculosis of genital organs
joined. On examination: his voice is hoarse, eyes are C. Ovarian cystoma
deeply sunken in the orbits. The pulse is frequent. D. Polycystic ovaries
Blood pressure is low. There is no urine. What is E. Chronic salpingitis
the preliminary diagnosis?
A. Salmonellosis 195. A woman consulted a doctor on the 14-
B. Toxic food-borne infection th day after labor about sudden pain, hyperemy
C. Dysentery and induration of the left mammary gland, body
D. Cholera temperature rise up to 39°C, headache, indisposition.
E. Typhoid fever Objectively: fissure of nipple, enlargement of the
left mammary gland, pain on palpation. What
192. A primigravida woman appealed to the pathology would you think about in this case?
antenatal clinic on the 22.03.03 with complaints A. Lacteal cyst with suppuration
of boring pain in the lower part of abdomen. B. Fibrous adenoma of the left mammary gland
Anamnesis registered that her last C. Phlegmon of mammary gland
menstruation was on the 4.01.03. Bimanual D. Lactational mastitis
examination revealed that uterine servix is intact, E. Breast cancer
external fauces is closed, uterus is enlarged up to
the 9-th week of pregnancy, movable, painless. 196. A 30 y.o. man complains of intense pain,
What complication can be suspected? reddening of skin, edema in the ankle-joint
A. Risk of abortion in the 9-th week of area, fever up to 39°C. There was acute onset of
pregnancy the illness. In the past there were similar attacks
B. Hysteromyoma lasting 5-6 days without residual changes in the
C. - joint. The skin over the joint is hyperemic without
D. Vesicular mole definite borders and without infiltrative bank on
E. Abortion that started in the 9-th week of the periphery. What is the most likely diagnosis?
pregnancy A. Rheumatoid arthritis
B. Osteoarthritis
193. At a machine-building plant the casts are C. Infectional arthritis
cleaned by means of abrasion machines that are a D. Gout
source of local vibration. What are the most E. Erysipelatous inflammation
efficient preventive measures for preventing
harmful effect of vibration on workers' organisms? 197. A 54 y.o. woman has been ill with
A. Hand massaging osteomyelitis of femoral bone for over 20
B. Giving sanitary instructions to the workers years. During the last month there appeared and
C. Preliminary and periodical medical examinations have been steadily increasing edemata of lower
D. Warm hand baths extremities. Urine analysis revealed: proteinuria -
E. Use of gloves that reduce vibration 6,6 g/1. Blood analysis: disproteinemia in form of
hypoalbuminemia, raise of a2- and 7-globulines,
194. A patient was admitted to the hospital with ESR- 50 mm/h. What is the most probable
complaints of periodical pain in the lower part diagnosis?
of abdomen that gets worse during menses, A. Chronic glomerulonephritis
25
B. Acute glomerulonephritis
C. Secondary renal amyloidosis
D. Systematic lupus erythematosus
E. Myelomatosis

198. Elderly people develop tumors more frequently.

One of the main causes is:
A. Increased disfunctioning of mitoses
B. Increased activity of cellular immunity
С. Decreased intensity of antibodies formation
D. Increased intensity of antibodies formation
E. Decreased activity of cellular immunity

199. A 37 y.o. patient complains of pain in the right

arm which increases during motion, raised body
temperature up to 39°C. In the right cubital fossa
there is a trace of injection, hyperemia and thickening
along the vein. Your diagnosis?
A. Abscess
B. Inflammation of lymph
C. Erysipelas
D. Phlegmon
E. Phlebit

200. A 5 tons milk batch was sampled. The lab

analysis revealed: fat content 2%, specific density
-1,04 g/cm3, acidity - 21°T, reductase probe - weak-
positive. What way is the product to be used in?
A. Sell but inform customers about milk quality
B. Do the product away
C. Sell without limitations
D. Discard for animal feeding
E. Technical utilization

26