A pregnant woman at 32 weeks of gestation with the risk of preterm labor undergoes a treatment to prevent fetal respiratory

distress syndrome. What medicine was she prescribed?

a. Misoprostol
b. Dexamethasone ✓
c. Gynipral (hexoprenaline)
d. Oxytocin
e. Progesterone
The correct answer is: Dexamethasone

A 28-year-old man was hospitalized on the ninth day of illness with complaints of fever of 39^oC, headache, general weakness,
constipation, and disturbed sleep. Objectively, on the skin of his abdomen there are isolated roseolas, his pulse is 78/min., the liver
is enlarged by 2 cm. Make the diagnosis:
a. Leptospirosis
b. Typhoid fever ✓
c. Epidemic typhus
d. Sepsis
e. Brucellosis
The correct answer is: Typhoid fever

A 28-year-old man without the permanent place of residence was hospitalized with the provisional diagnosis of influenza. On day 5
after the onset of the disease, a roseolar petechial rash appeared on his trunk and on the inner surfaces of the limbs. Objectively,
the patient presents with the body temperature of 40^oС, euphoria, facial hyperemia, redness of the sclera, tremor of the tongue,
tachycardia, splenomegaly, and agitation. What is the most likely diagnosis in this case?
a. Leptospirosis
b. Delirium tremens
c. Epidemic typhus
d. Typhoid fever
e. Measles
The correct answer is: Epidemic typhus

In a pediatric clinic, located in a rural area, there are 9 children, who simultaneously fell ill. The following signs were detected: low
physical activity, acrocyanosis of the nasolabial triangle and fingertips, mucosal cyanosis, tachycardia, dyspnea. It was determined
that all the sick children were fed with a formula that was dissolved in the water taken from a dug well. Laboratory analysis
revealed high levels of methemoglobin in the blood of the children. These signs can be caused by increased content of a certain
element in the water. Name this element:
a. Nitrates ✓
b. Methylmercury
c. Sulfates
d. Selenium
e. Lead
The correct answer is: Nitrates
After playing with ''mosaics'', a 2-year-old child suddenly developed cough, stridorous respirations, urges to vomit, and cyanosis
against the background of relative somatic health. What should the doctor suspect first when examining this child?
a. Pneumonia
b. Pertussis
c. Acute obstructive bronchitis
d. Acute laryngotracheitis
e. Foreign body aspiration ✓
The correct answer is: Foreign body aspiration

A 45-year-old man complains of an intense retrosternal pain that radiates into the lower jaw and occurs at rest, at night, several
times for 10--15 minutes. During a pain attack, an elevation of the ST segment can be recorded on the ECG in leads V 3--4. What
is the provisional diagnosis in this case?
a. Stable angina pectoris, functional class II
b. Progressive angina pectoris
c. Myocardial infarction
d. Prinzmetal angina pectoris ✓
e. Stable angina pectoris, functional class IV
The correct answer is: Prinzmetal angina pectoris

A 40-year-old man complains of a rash all over his body and slight itching. He has been ill for 3 months and associates his rash
with a neuropsychiatric trauma. Objectively, he has multiple pink papules covered with silvery scales on the skin of his torso, scalp,
and extensor surfaces of the limbs. What will be the provisional diagnosis in this case?
a. Seborrheic dermatitis
b. Pityriasis rosea Gibert
c. Papular syphilide
d. Lichen ruber planus
e. Disseminated psoriasis ✓
The correct answer is: Disseminated psoriasis

: A 40-year-old woman after an unsuccessful treatment by a neurologist was referred to a gynecologist. She complains of swollen
breasts, depression intermittent with agression, weakness, tearfulness, numb arms, and meteorism that appear 2--3 days before a
menstruation and disappear after the menstruation is over. She considers herself ill for the last 2 years. Gynecological examination
detects no pathologic changes in her genitals. She was diagnosed with premenstrual syndrome. What clinical form of premenstrual
syndrome is the most likely in this case?
a. Mixed
b. Neuropsychic ✓
c. Crisis
d. Edematous
e. Cephalgic
A newborn child has been diagnosed with physiological jaundice. What symptom is characteristic of this health condition?
a. Yellow color of the skin, appearing on day 2-3 of life ✓
b. Colorless feces
c. A recurrent increase in the intensity of jaundice
d. Jaundice that lasts more than 10 days
e. Jaundice, appearing within the first 24 hours of life
The correct answer is: Yellow color of the skin, appearing on day 2-3 of life

10-year-old boy came to the polyclinic with complaints of stuffy nose. It is known that these signs occur in the child periodically (in
spring and autumn). He has a history of atopic dermatitis. The father of the child has bronchial asthma. Objectively, the boy's face
is pale and slightly swollen. Respirations are 22/min. Auscultation detects vesicular respiration over the lungs. Rhinoscopy shows
swollen and pale nasal mucosa. What disease can be suspected?
a. Acute adenoiditis
b. Allergic rhinitis ✓
c. Acute maxillary sinusitis
d. Recurrent respiratory disease
e. Acute rhinitis
The correct answer is: Allergic rhinitis

: A family doctor needs to prepare a plan for carrying out a complex of treatment and prevention measures among the population.
What secondary prevention measures must be included in this plan?
a. Elimination of causative factors
b. Implementation of rehabilitation measures
c. Improvement of living conditions
d. Prevention of disease occurrence
e. Prevention of disease complications ✓
The correct answer is: Prevention of disease complications

A 17-year-old boy has been diagnosed with Prasad's syndrome. It is characterized by short stature, sexual underdevelopment,
enlargement of the liver and spleen, and iron-deficiency anemia. This health condition is caused by the insufficient content of a
certain microelement in the diet. Name this microelement.
A.Zinc ✔️
B. Iron
C. Copper
D. Selenium
E. Iodine
A 33-year-old woman came to a maternity clinic with complaints of infertility for the last 5 years. The patient has a history of
gonorrhea. Examination detects no deviations from the norm in the development of the patient's genitals. The basal temperature
throughout three cycles is biphasic. What is the most likely cause of infertility in this case?
a. Structural abnormalities of the genitals
b. Endometriosis
c. Immunological infertility
d. Impaired patency of the fallopian tubes ✓
e. Endocrine pathology
The correct answer is: Impaired patency of the fallopian tubes

A 70-year-old man with coronary artery disease and post-infarction cardiosclerosis suddenly a palpitation attack appeared. Heart
rate - 140/min, weak. Blood pressure - 100/60 mm Hg. Art. The ECG revealed - widening of the QRS complex (0.13 sec) and
negative T waves in classical leads. Reflex techniques, which are used to relieve palpitations, did not work. What medicine is most
appropriate to use in this case?
a. Lidocaine ✓
b. Strophanthin
c. Norepinephrine
d. Digitoxin
e. Verapamil
The correct answer is: Lidocaine

After being stung by a bee, an 18-year-old patient feels hot and presents with dyspnea and edema of her lip, face, and neck. The
patient's breathing is difficult and noisy, the patient has cough. The skin is pale and cold to the touch. Blood pressure - 75/50 mm
Hg. Pulse - 98/min., thready. Tachycardia is observed, the heart sounds are muffled and rhythmic. What is the most likely diagnosis
in this case?
a. Quincke's edema
b. Urticaria
c. Status asthmaticus
d. Anaphylactic shock ✓
e. Hypotonic crisis
The correct answer is: Anaphylactic shock

A district center is being supplied with water from an interlayer water-bearing stratum with high levels of calcium and magnesium
salts. What is the optimal method of water treatment that should be applied before pumping the water into the distribution network?
a. Decontamination
b. Softening ✓
c. Sedimentation
d. Ozonation
e. Desalination
The correct answer is: Softening
: A 62-year-old woman undergoes treatment for bilateral gonarthrosis and has been regularly taking diclofenac sodium for 2 years.
During the last six months she notes clevations of her blood pressure to 160/100 mm Hg. X-ray of the knee joints shows decreased
height of the intra-articular space, marginal growths on the articular surfaces, and epiphyseal osteoporosis. General urinalysis
shows the following specific gravity1010, erythrocytes - 5-6 in sight, leukocytes -10-12 in sight, casts (cylinders) - 0-1 in sight,
glucose not detected, protein-0.22 g/L. Fasting plasma glucose-6.3 mmol/L What is the most likely cause of the changes observed
in the general urinalysis?
A. Tubulointerstitial nephritis✔️
B. Diabetic nephropathy
C. Hypertensive nephropathy
D. Urolithiasis
E. Chronic glomerulonephritis

A 30-year-old woman complains of sudden reddening of her right eye. photophobia, a feeling of sand in the eye. and lacrimation
that appeared 3 days ago, as well as rhinitisand a fever of 38°C. Objectively, she has marked edema of the eyelids, hyperemia of
the conjunctiva of transitional folds, and fine punctate hemorrhages in the conjunctiva of the upper eyelid. A small amount of
mucopurulent secretion is observed. What is the most likely diagnosis in this case?
A. Bacterial conjunctivitis of the right eye✔️
B. Adenoviral conjunctivitis of the right eye
C. Herpetic conjunctivitis of the right eye
D. Allergic conjunctivitis of the right eye
E. Tuberculous conjunctivitis of the right eye

A 70-year-old patient has undergone a surgery for the removal of a traumatic cataract of the right eye. Objectively, in the right eye
emphVisus=0.8 with the correction of +10.0 D sph, while in the left eye emphVisus=0.6 without correction. What means of
correction would
be most advisable for this patient?
a. No correction is needed
b. Glasses: OD +10.0 D sph; OS planum
c. Glasses: both lenses +10.0 D sph
d. Cylindrical lenses
e. OD intraocular correction

Q: A room with 23C , Humidity 48%, air velocity 0.1

Answers :
Comfortable ✔️probably
Non-comfortable, Cooling
Non-comfortable, Increased air velocity
Non-Comfortable, High humidity
Objectively, a 22-year-old patient has numerous non-inflammatory yellowish- brown and pale pink spots on the skin of the chest,
neck, shoulders, and the sides of the torso. When the spots are scratched, the sign of "shavings" is observed. The disease onset
was 2 years ago, the rashes were first noticed after a summer vacation by the sea. What is the most likely diagnosis in this case?
A. Pityriasis rosea Gibert
B. Erythrasma
C. Streptodermia
D. Tinea versicolor (Pityriasis versicolor)✔️
E. Syphilitic roseola

A 20-year-old patient came to a doctor with complaints of à rash that appeared on the skin. Objectively, on the skin of the trunk,
arms, and the back of the neck, there is a macular rash with light brown spots 1-3 cm in size that in some places merge together.
The results of the Balzer test are positive. What is the most likely diagnosis in this case?
A. Secondary syphilis
B. Pityriasis rosea
C. Parapsoriasis
D. Microbial eczema
E. Tinea versicolor (Pityriasis versicolor)✔️

A 32-year-old woman complains of paresthesias and weakness in the upper limbs, dizziness, impaired vision, periodic loss of
consciousness. Got sick a few years ago when weakness appeared in the hands, a decrease in blood pressure in the hands to
80/50 mm Hg, an increase body temperature Objectively observed: condition satisfactory, body temperature - 37.1°C) Blood
pressure and pulse on the upper limbs are not determined. A systolic murmur is heard above carotid arteries, more to the right and
above the aorta. Blood pressure on the lower extremities - 230/120 mm Hg. A general blood test revealed: anemia, accelerated
ESR. Specify the probable diagnosis.
a. Coarctation of the aorta
b. Takayasu's disease ✓
c. Obliterating thromboangiitis
d. Syphilitic aortitis
e. Nodular periarteritis
The correct answer is: Takayasu's disease

A 32-year-old patient complains of reddening, burning, and sensation of a foreign body in the right eye. The disease is acute. On
examination: visual acuity of the both eyes is 1,0. In the right eye there are hyperemy and swelling of the conjunctiva, superficial
injection. There is purulent discharge in the conjunctival sac. The cornea is clear. The color and pattern of the iris are uncanged,
the pupil is mobile. What diagnosis is most likely?
a. Foreign body of the cornea
b. Acute conjunctivitis ✓
c. Acute iridocyclitis
d. Acute attack of glaucoma
e. Acute dacryocystitis
The correct answer is: Acute conjunctivitis
A 23-year-old woman without visible cause developed a conflicting behavior at her workplace. She accused the management of
underestimating her, claimed that she can be a deputy director, because she speaks four languages, is very attractive, and can
make useful connections for the company. She has been dressing extravagantly, flirting with her colleagues, and singing loudly in
her office. In fact, she has only the training of a computer operator and speaks no foreign languages. What is the likely clinical
diagnosis?
Select one:
A. Schizophrenia
B. Manic episode ✓
C. Mild mental retardation
D. Epilepsy
E. Depressive disorder
The correct answer is: Manic episode

A patient complains of a fever of 39^oС, chills, headache, difficulty sleeping, and poor appetite. Objectively, on the back surface of
the neck, there is a large, purple-cyanotic, sharply painful, dense infiltrate. In the center of the infiltrate, there are several openings,
through which thick yellow-green pus is being discharged. What is the most likely diagnosis in this case?
a. Furuncle
b. Erysipelas
c. Abscess
d. Hidradenitis
e. Carbuncle ✓
The correct answer is: Carbuncle

A 32-year-old woman complains of marked shortness of breath, dry cough, a fever of 39^oС, and excessive sweating.
Bacterioscopy of her sputum detected acid-fast bacteria [+]. Mantoux test with 2 tuberculin units resulted in a papule 21 mm in
size. X-ray visualizes numerous symmetrically located focal shadows 1-2 mm in size in both lungs. The shadows are low-intensity
and have blurry contours. What is the most likely diagnosis in this case?
a. Miliary pulmonary tuberculosis
b. Sarcoidosis
c. Chronic disseminated pulmonary tuberculosis
d. Focal tuberculosis
e. Caseous pneumonia
The correct answer is: Miliary pulmonary tubercul

A 3-day-old full-term baby has the following blood test results: indirect bilirubin levels 345 mcmol/L, hourly increase 6.8 mcmol/L.
The child's condition is severe. Objectively, the child presents with decreased reflexes, muscle hypotonia, and limb tremor. The
blood of the child and the mother is Rh-incompatible. What would be the most effective method of treatment in this case?
A. Administration of phenobarbital
B. Hemosorption
C. Phototherapy
D. Corticosteroid therapy
E. Exchange blood transfusion✔️
. A 30-year-old woman on the fifth day after the physiological childbirth complained of swelling of her left breast, pain, reddened
skin, and a fever of 38°C. Objectively, her left mammary gland is enlarged, the skin there is red, with cyanosis in the upper-
outerquadrant. A sharply painful infiltrate without clear borders can be palpated. Expressing miIk does not bring relief. What is the
most likely diagnosis in this case?
A. Erysipelas
B. Infected breast cyst
C. Lactostasis
D. Breast cancer
E. Acute infiltrative mastitis✔️

A 32-year-old primipara woman developed intense contractions that last 55-60 seconds with an interval of 1-2 minutes between
them. Objectively, the disengagement of the fetal head begins. The perineum protrudes excessively and has the height of 4 cm.
The skin of the perineum is pale and tense. After a contraction stopped, a thin stream of blood appeared from the genital opening.
Specify the further tactics of managing the delivery.
a. Waiting tactics
b. Application of obstetrical forceps
c. Caesarean section
d. Vacuum extraction of the fetus
e. Episiotomy
The correct answer is: Episiotomy

A 34-year-old man fell ill 3 days ago after an overexposure to cold. He complains of a fever of $39.2^o$С, marked general
weakness, sweating, and cough. The cough was initially dry, but within the last 24 hours a small amount of "rusty" sputum was
produced. Objective examination detects herpes on the lips. Percussion reveals a dull sound in the lower pulmonary lobes.
Auscultation detects bronchial breathing and tachycardia. No changes were detected in the organs of the abdominal cavity. What is
the most likely diagnosis in this case?
a. Nosocomial pneumonia
b. Lung abscess
c. Exudative pleurisy
d. Community-acquired focal pneumonia
e. Croupous pneumonia ✓
The correct answer is: Croupous pneumonia

After semolina was introduced into the diet, a 1-year-old child for 2 months has been presenting with loss of appetite, irritability,
loss of body mass, and loss of previously learned skills. The feces are copious and foul-smelling. The skin is pale and dry, the hair
is brittle. The abdomen is distended, while the limbs are thin. Stool test shows high levels of fatty acids. What is the most likely
diagnosis?
a. Mucoviscidosis
b. Functional diarrhea
c. Irritable bowel syndrome
d. Celiac disease ✓
e. Lactase deficiency
The correct answer is: Celiac disease
A 64-year-old patient fell on his left side.Shortening of the left limb, external rotation of the hip, and the symptom of a stuck heel are
objectively observed. During palpation and tapping on the heel, the patient feels pain in the hip joint. What is the most likely
diagnosis?
A. Femoral neck fracture✔️
B. Fracture of the great werel
E. Hip dislocation
1. Fracture of the upper third of the femurBONES E. Contusion of the hip joint

A 30-year-old woman complains of menstruations missing for a year. She has a history of a massive postpartum hemorrhage.
Objectively, her secondary sex organs are normally developed, the hair growth pattern is of the female type. Bimanual examination
detects normal uterus and uterine appendages. What is a possible cause of amenorrhea in this case?
a. Pituitary necrosis ✓
b. Hypothalamic insufficiency
c. Thyroid disorder
d. Ovarian insufficiency
e. Adrenocortical necrosis
The correct answer is: Pituitary necrosis

A 30-year-old woman came to a doctor with complaints of milk discharge from her breasts and no menstruation for the last 5
months. She had one physiological childbirth four years ago. The development of her breasts is normal. Bimanual examination
detects a reduced in size uterus and normal size of the ovaries. MRI detects no cerebral pathology. Thyrotropin levels are within
the normal range, prolactin levels in blood serum are elevated. What is the most likely diagnosis in this case?
a. Sheehan syndrome
b. Hyperprolactinemia ✓
c. Hypothyroidism
d. Pituitary adenoma
e. Polycystic ovary syndrome
The correct answer is: Hyperprolactinemia

After falling and hitting the back of the head, a child lost hearing in the right ear and developed peripheral paralysis of the right
facial nerve, discharge of a clear fluid from the right auditory canal, and diffuse neurological symptoms. Make the provisional
diagnosis.
a. Meningoencephalitis
b. Post-traumatic meningoencephalitis
c. Cerebral contusion, subarachnoid hemorrhage
d. Cerebral contusion, basilar skull fracture ✓
e. Concussion
The correct answer is: Cerebral contusion, basilar skull fracture
A patient has developed a "raccoon eyes" sign ("spectacle hematoma") - blood has spread under the skin of the eyelids and
conjunctiva of both eyes. Isolated streak-like hemorrhages are visible on the fundus. What injury can cause such changes?
a. Subconjunctival scleral rupture
b. Concussion
c. Cerebral contusion
d. Eyeball contusion
e. Basilar skull fracture ✓
The correct answer is: Basilar skull fracture

A 29-year-old woman complains of a general weakness, increased fatigability, weight loss, and infrequent scanty periods. One year
ago she had a childbirth, complicated with a massive bleeding. Objectively, the woman is asthenic, her skin is pale and dry, the hair
cover is thin on her scalp and absent in her armpits. Her mammary glands and genitals are hypotrophic. Make the provisional
diagnosis:
a. Anorexia nervosa
b. Sheehan's syndrome ✓
c. Hypoplastic anemia
d. Asthenoneurotic syndrome
e. Pituitary tumor
The correct answer is: Sheehan's syndrome

An 18-year-old young man was hospitalized after a fight with signs of internal bleeding. Anamnesis states that he has hemophilia
A) He was diagnosed with an extraperitoneal hematoma. What must be prescribed to the patient first?
a. Packed platelets
b. Cryoprecipitate ✓
c. Fresh blood
d. Dried plasma
e. Aminocaproic acid
The correct answer is: Cryoprecipitate

An injured electrician in a state of clinical death is being resuscitated. ECG registers large-focal ventricular fibrillation. When,
according to the clinical practice guidelines for sudden circulatory arrest, must be medicines administered, namely, adrenaline
solution and amiodarone solution?
a. After the fourth defibrillation
b. After the second defibrillation
c. After the third defibrillation ✓
d. At the very beginning of the resuscitation measures
e. After the first defibrillation
The correct answer is: After the third defibrillation

A 16-year-old boy developed dizziness. Heart rate --- 35/min., blood pressure --- 85/45 mm Hg. The boundaries of the heart are not
expanded, the tones of the heart are sonorous and pure. The ECG revealed: P waves are not associated with QRS complexes,
dissociation and different rhythm of the atria and ventricles is accompanied by a different location of the P wave in relation to the
QRST complex. Which pathology is characterized by this clinical picture?
a. Extrasystole
b. Atrioventricular block (2nd degree)
c. Atrioventricular dissociation
d. Sinus bradycardia
e. Complete atrioventricular block (3rd degree) ✓
The correct answer is: Complete atrioventricular block (3rd degree)
A 22-year-old pregnant woman was hospitalized in a severe condition. Throughout the past three days, she developed edemas,
headache, nausea, and one episode of vomiting. Objectively, her consciousness is clouded, her blood pressure is 160/130 mm Hg.
She presents with small fibrillar twitching of the facial muscles and problems with nasal breathing. During transportation, the
woman's arms started twitching, her body stretched out, her spine curved, her jaws tightly clenched, and she stopped breathing.
Then she developed clonic seizures and marked cyanosis. After that, the seizures stopped, a deep noisy inhale occurred, and
blood-stained foam appeared on the patient's lips. What is the most likely diagnosis in this case?
a. Hypertensive crisis
b. Eclampsia ✓
c. Epilepsy
d. Diabetic coma
e. Chorea
The correct answer is: Eclampsia

A 26-year-old pregnant woman was hospitalized in the intensive care unit during the 36th week of pregnancy with complaints of a
headache in the frontal area. During the physical examination: blood pressure --- 170/90 mm Hg., pulse --- 85/min. RR --- 115/min.
body temperature --- 36.9°C, swelling of the extremities. Fetal heartbeat --- 159/min. During the examination, the woman
developed an attack of generalized tonic-clonic convulsions. What drug should the doctor administer first?
a. Lamotrigine
b. Diazepam
c. Magnesium sulfate ✓
d. Phenytoin
e. Sodium valproate
The correct answer is: Magnesium sulfate

A 3-year-old child was hospitalized with generalized tonic-clonic seizures that last 50 minutes already and occurred against the
background of hyperthermic syndrome caused by influenza. The child was receiving no therapy. What aid must be provided for
urgent treatment of the seizure syndrome in this case?
a. Administer phenobarbital intramuscularly
b. Prescribe paracetamol in age-appropriate doses
c. Administer lorazepam intravenously ✓
d. Urgently apply cold compresses
e. Administer calcium gluconate intravenously
The correct answer is: Administer lorazepam intravenously

A 23-year-old woman with a history of taking injection drugs was registered at a maternity clinic due to her pregnancy (14 weeks of
gestation). Diagnosis: HIV infection, second clinical stage. The patient's general condition is satisfactory, she has no complaints.
The results of additional examinations are as follows: moderate anemia and leukopenia, CD4 lymphocyte count - 650 cells/mcL,
viral load - 2000 copies/mL. Is antiretroviral therapy indicated for this patient?
a. Mandatory prescription of antiretroviral therapy ✓
b. Antiretroviral therapy is prescribed at the third clinical stage of HIV infection
c. The start of antiretroviral therapy can be delayed because of the pregnancy
d. Antiretroviral therapy cannot be prescribed to pregnant women
e. Antiretroviral therapy can be prescribed only if CD4 lymphocyte count is less than 350 cells/mcL
The correct answer is: Mandatory prescription of antiretroviral therapy
A 24-year-old woman diagnosed with postoperative hypothyroidism came to a doctor with complaints of palpitations, irritability,
excessive sweating, and disturbed sleep. During the last month she has been undergoing treatment with levothyroxine in the dose
of 150 mcg once a day. What would be the further treatment tactics in this case?
a. Add Mercazolil (Thiamazole) to the treatment
b. Increase the dose of levothyroxine
c. Prescribe sulfonylurea drugs
d. Reduce the dose of levothyroxine ✓
e. Prescribe beta-blockers
The correct answer is: Reduce the dose of levothyroxine

A woman turned to a doctor with complaints that her husband, 47-year-old, has a behavior changes about 5 years ago. He became
irritable, anxious, began to make erratic, uncontrolable movements and during the last year ecame aggresive, incoordination
movements ad mke a grimace. During the examination: absent abstract thinking, moderate decrease in connitive functionns,
decreased muscle tone, ataxia,oooculoomotor apraxia re observed. An MRII examination of the brain revealed atrophy of the
corteex of the frontaa lobes and the caudate nucleus. Specify the probbable diagnosis.
a. Creutzfeldt-Jakob disease
b. Dyscirculatory atherosclerotic encelopathy
c. Parkinson`s disease
d. Hepatolenticular dystrophy
e. Huntington`s disease
The correct answer is: Huntington`s disease

: A patient with arterial hypertension had complaints: headache, dizziness, noise. y ears, changed language, which became
unintelligible. Objectively observed: horizontal nystagmus when looking to the sides, nasolabial asymmetry folds. After 3 hours, the
symptoms regressed. What is the most likely diagnosis?

A. Cardioembolic ischemic stroke

B. Subarachnoid hemorrhage

S. Transient ischemic attack✔️

D. Lacunar ischemic stroke

E. Atherothrombotic ischemic stroke

A 38-year-old man complains of a cough with purulent sputum (up to 60-80 mL per day) and a fever of 39°C. He associates his
condition with overexposure to cold. Objectively, his pulse is 96/min., rhythmic. Blood pressure 110/60 mm Hg. Examination
revealed that the right side was lagging behind in the process of breathing. Respiratory rate-30/min. Percussion detects local
dullness of the sound near the angle of the scapula. Auscultation detects heterogeneous wet crackles and amphoric breathing.
What is the most likely diagnosis in this case?
A. Acute bronchitis
B. Focal pneumonia
C. Acute lung abscess✔️
D. Bronchial asthma
E. Pleural empyema
A 45-year-old man diagnosed with acute pulmonary abscess suddenly developed sharp pain in his chest on the right and dyspnea
up to 30/min. Examination detects facial cyanosis and shallow rapid respirations. Auscultation reveals acutely weakened
respiration throughout the whole right lung; percussion reveals a vesiculotympanitic (bandbox) resonance at the lung apex and
dullness in the lower lobe. What complication developed in this patient?
a. Esophageal perforation
b. Pneumothorax
c. Acute mediastinitis
d. Pleuropneumonia
e. Pyopneumothorax ✓
The correct answer is: Pyopneumothorax

A 28-year-old man complains of nocturnal arthralgias and myalgias and lumbar pain that intensifies during trunk flexion and
extension. Examination detects increased ESR and C-reactive protein levels. X-ray shows bilateral sacroiliitis. Make the provisional
diagnosis.
a. Ankylosing spondylitis ✓
b. Bone tuberculosis
c. Polymyositis
d. Rheumatism
e. Osteochondrosis
The correct answer is: Ankylosing spondylitis

A newborn girl has Apgar score of 7-8 points at the 1-5 minutes after birth. During the labor there was a brief difficulty with
extraction of the shoulder girdle. After birth the baby presents with disturbed function of the proximal segment and forced position
of the right arm. The shoulder is rotated inwards, the elbow is extended, the forearm is pronated, and the whole upper limb
resembles an arm of a doll. What is the most likely clinical diagnosis in this case?
a. Erb-Duchenne palsy ✓
b. Thoracic spine trauma
c. Osteomyelitis of the right arm
d. Soft tissue injury of the right arm
e. Intracranial hemorrhage
The correct answer is: Erb-Duchenne palsy

A 3-year-old child has episodes accompani- ed by cyanosis, sudden anxiety, and squatti- ng. Objectively, the child has "drum- stick
deformation of the finger phalanges and nails that resemble a clock face. The cardi- ac dullness boundaries are shifted to the left
and right. A systolic tremor can be detected in the second intercostal space near the left edge of the sternum. A coarse systolic
murmur can be heard with p.max in the second intercostal space. The second heart sound is weakened over the base of the heart.
X-ray shows that the heart is in the form of a "wooden shoe", the pulmonary pattern is poorly visible. What is the most likely
diagnosis in this case?
A. Dilated cardiomyopathy
B. Atrial septal defect
C. Ventricular septal defect
D. Primary bacterial endocarditis
E. Tetralogy of Fallot✔️
A premature baby born at 34 weeks of gestation presents with the following at 4 hours after birth: tachypnea, respiration with a
seesaw motion, sternum depression, expiratory murmurs. Respiratory rate- 80/min. Auscultation detects weakened breathing with
non-constant heterogeneous crackles over the lungs. X-ray of the lungs shows air bronchogram and a nodose-reticular lung
pattern. What is the most likely diagnosis in this case?
A. Pulmonary atelectasis
B. Massive meconium aspiration syndrome
C. Hyaline membrane disease✔️
D. Birth injury
E. Neonatal pneumonia

A 42-year-old woman complains of morning stiffness in the joints of her hands, a feeling of tightness in the skin of her face, and
difficulty swallowing food. Objectively, she has facial amimia, her oral cavity has a "pouch-like" narrowing, and her fingertips are
pale and cold to the touch. Auscultation detects arrhythmic and weakened heart sounds and systolic murmur over the apex. Blood
test revealed the following: erythrocytes 3.2 10/L, leukocytes - 6.7 10/L, ESR 35 mm/hour. What is the most likely diagnosis in this
case?
A. Rheumatoid arthritis
B. Scleroderma✔️
C. Rheumatism
D. Systemic lupus erythematosus
E. Sjogren's syndrome

A patient suffering from scleroderma recently began to notice marked dryness in mouth, a feeling of "sand in the eyes" and redness
of the sclera. Parotid salivary glands increase in sizes, compacted to the touch. A manifestation of which complication are the
mentioned symptoms?

a.Sjogren's syndrome ✔️
b.Reiter's syndrome

c.Felty's syndrome

d.Shrgren's disease

e.Cystic fibrosis

An 18-year-old patient developed clinical signs of left-sided exudative pleurisy. After thoracentesis in the pleural effusion
determined: protein - 30 g/l, Rivalt's test is positive, 30 leukocytes in the field of vision, of which 100% are lymphocytes. What
genesis of the effusion should be thought about first of all?

a.Tuberculous ✔️
b.Parapneumonic

c.blastomny

d.Traumatic

e.Cardiogenic
A 14-year-old girl complains of a maculopapular rash along her body, a fever of 38.5°C, and a sore throat. Objectively, she has
enlarged cervical and submandibular lymph nodes and hyperemic oropharyngeal mucosa, her tongue and tonsils are coated with
white plaque. Palpation revealed hepato- and splenomegaly. What is the most likely diagnosis in this case?
A. Infectious mononucleosis ✔️
B. Enterovirus infection
C. Scarlet fever
D. Viral hepatitis A
E. Chronic myeloid leukemia

The industrial enterprise dicharges insufficiently treated industrial effluents into the river. Water from the river is used for domestic
water suplly. It causes death of some microorganisms, disruption of processes self-purification of water and deterioration of its
qulity, which can used to have a negative mpact on people`s health. How is called such action of enviromental factors?
a. Complex
b. Combined
c. Indirect
d. Direct
e. Linked
The correct answer is: Indirect

A 13-year-old girl was brought into the gynecological department with complaints of profuse bloody discharge from her genital
tracts for the last 10 days. Menarche was at the age of 11, the menstrual cycle is irregular. Rectoabdominal examination detects no
pathology. Make the provisional diagnosis:
a. Adenomyosis
b. External genital tract injury
c. Juvenile uterine bleeding ✓
d. Werlhof's disease (immune thrombocytopenic purpura)
e. Endometrial polyp
The correct answer is: Juvenile uterine bleeding

A 12-year-old girl has developed a panaritium (whitlow) on the fourth finger of her left hand. In this case, a reaction is most likely to
be detected in a certain group of lymph nodes. Name this group of lymph nodes.
a. Supraclavicular
b. Cubital ✓
c. Subclavian
d. Thoracic
e. Axillary
The correct answer is: Cubital

A 14-year-old girl complains of vaginal bleeding that lasts for 10 days and occurred after a three-month delay of menstruation. She
had menarche at the age of 13, her menstrual cycle is irregular. Complete blood count detects hemoglobin levels of 90 g/L. What is
the most likely diagnosis in this case?
a. Werlhof's disease
b. Uterine malformation
c. Cervical polyp
d. Juvenile uterine bleeding ✓
e. Hormone-producing uterine tumor
The correct answer is: Juvenile uterine bleeding
Two days after eating cold food, a 46-year-old man developed complaints of sharp pain in the throat and asphyxia. His respiration
is noisy, respiratory rate - 26/min., temperature - 39^oС. Laryngoscopically, the glottis is not visible and obscured by edematous
tissues. What urgent medical procedure must be performed in this case?
a. Nasal cannulas with the oxygen flow of 4 L/min
b. Administration of antispasmodics
c. Oxygen mask ventilation
d. Intravenous administration of hormones
e. Tracheostomy ✓
The correct answer is: Tracheostomy

A pregnant woman at 35 weeks of gestation has moderate preeclampsia. A decrease down to 3 points is detected in the
biophysical profile of the fetus. Dopplerometry reveals a reversal of the umbilical arterial flow. What would be the further tactics of
the attending doctor in this case?
a. Induction of labor by inserting a balloon device
b. Treatment of placental insufficiency with follow-up dopplerometry
c. Waiting tactics
d. Premature delivery via caesarean section ✓
e. Cordocentesis
The correct answer is: Premature delivery via caesarean section

A young woman says that she suddenly smells unpleasant odors for a few seconds, after which she does not remember what is
happening to her. At the same time, she bites her tongue, lets out urine, falls, bruises her body and head. Which condition is most
likely to occur in a woman?
a. Collapse
b. Epileptic syndrome ✓
c. Transient ischemic attack
d. Hysterical fit
e. Syncope
The correct answer is: Epileptic syndrome

: After giving birth, a 25-year-old woman developed increased weakness in her legs and unsteady walking. She has been suffering
from this condition for 6 years already. Every autumn, she notes a deterioration of her condition. Objectively, the woman is euphoric
and exhibits a reduced critical attitude towards her condition. She has horizontal nystagmus, high tendon reflexes, foot clonus,
pathological foot reflexes, no abdominal reflexes, ataxia during the Romberg test, and intentional tremor and missing during
coordination tests. Temporal pallor of the optic discs is observed on the eye fundus. What is the most likely diagnosis in this case?
a. Dyscirculatory encephalopathy
b. Myasthenia gravis
c. Acute disseminated encephalomyelitis
d. Multiple sclerosis ✓
e. Amyotrophic lateral sclerosis
The correct answer is: Multiple sclerosis
A 52-year-old man complains of periodic palpitation attacks that last 3-8 minutes and then stop on their own. Follow-up
examinations and ECG detected no rhythm disturbances. What special method of diagnosing rhythm disturbances must be
performed first in this case?
a. Transesophageal electric stimulation of the heart
b. Treadmill exercise stress test
c. Bicycle ergometry
d. Holter ECG monitoring ✓
e. Spirography
The correct answer is: Holter ECG monitoring

What is the type of joint action, where the overall effect on the human body is less than the sum of the individual effects of each
separate substance included in the combination?
a. Antagonism
b. Complex action
c. Isolated action
d. Combined action
e. Potentiation
The correct answer is: Antagonism

Several chemical substances enter the human body from atmospheric air. What is the type of joint action, where the overall effect
on the human body is more than the sum of the individual effects of each separate substance included in the combination?
a. Potentiation ✓
b. Antagonism
c. Complex action
d. Combined action
e. Isolated action
The correct answer is: Potentiation

Screening detected phenylketonuria in a two-week-old baby. What treatment must be prescribed for this child to prevent severe
complications in the future?
a. Hormone therapy
b. Antibiotic therapy
c. Vitamin therapy
d. Special diet ✓
e. Sunbathing
The correct answer is: Special diet

During the study of pulmonary tuberculosis morbidity, the data on socio-economic living conditions and harmful habits of the
patients were obtained. What method allows the assessment of the extent to which these factors influence the tuberculosis
morbidity?
a. Calculation of the regression coefficient
b. Calculation of the correlation coefficient ✓
c. Calculation of the agreement coefficient
d. Calculation of standardized indicators
e. Calculation of the confidence coefficient
The correct answer is: Calculation of the correlation coefficient
A certain statistical method can be used to study the relation between the duration of smoking and the frequency of malignant lung
neoplasms being detected. What method of statistical analysis should be used in this study?
A. Comprehensive health assessment
B. Dynamic analysis
C. Normalization of strongly intensive quantities
D. Correlation analysis✔️
E. Direct standardization

A 43-year-old patient, who had inhalation poisoning the day before, was diagnosed with acute respiratory distress syndrome. What
parameter must be used to assess the severity of the patient's illness?
a. Respiratory index (oxygenation index) ✓
b. Central venous pressure
c. Partial pressure of oxygen in arterial blood
d. Respiratory volume
e. Arterial oxygen saturation
The correct answer is: Respiratory index (oxygenation index)

Standardization is an important priority direction of modern healthcare development in the majority of economically developed
countries of the world. What normative document is systematically developed to assist practitioner and patient decisions about
appropriate health care for specific diseases and clinical circumstances?
a. Standard of medical care
b. Accreditation certificate
c. Clinical practice guidelines ✓
d. Medical care provision certificate
e. Certificate of conformity to established standards
The correct answer is: Clinical practice guidelines

A newborn girl was born from the second pregnancy with a complicated delivery (weak labor activity, shoulder dystocia). The Apgar
score is 6-8 points, the weight at birth is 4200 g. During examination, left-sided Erb–Duchenne palsy was diagnosed. At what level
is the spinal cord damaged in this case, as is characteristic of this disorder?
a. C5-C6 ✓
b. C7-Th1
c. C3-C4
d. C1-C3
e. Th1-Th2
The correct answer is: C5-C6

A 27-year-old woman complains of pain and morning stiffness in the small joints of her hands. Her condition is weather-dependent.
Objectively, she presents with swelling and deformation of her proximal interphalangeal joints and her second and third
metacarpophalangeal joints X-ray of the hands detects bone erosions (usurations) and signs of osteoporosis. What is the most
likely diagnosis in this case?
A. Rheumatoid arthritis✔️
B. Rheumatic polyarthritis
C. Psoriatic arthritis
D. Systemic scleroderma
E. Systemic lupus erythematosus
What clinical symptoms are characteristic during the initial phase of acute radiation sickness?
a. Hemorrhages in the skin, mucosa, gastrointestinal tract, brain, heart, and lungs (hemorrhagic syndrome), loss of appetite,
diarrhea (dyspeptic disorders)
b. Normalization of temperature, improvement of wellbeing, increased appetite, cessation of bleeding
c. Nausea, vomiting that intensifies after drinking fluids, loss of appetite, headache, general weakness, drowsiness ✓
d. Nausea, vomiting, increased body temperature, spastic abdominal pain, deterioration of wellbeing
e. Hair loss, neurological symptoms that gradually even out, sharp deterioration of wellbeing, increased body temperature
The correct answer is: Nausea, vomiting that intensifies after drinking fluids, loss of appetite, headache, general weakness,
drowsiness

A person fell from a ladder from the height of 2 m. An emergency medicine physician suspects a vertebral compression fracture at
the level of L1-L2. Objectively, the blood pressure is 100/60 mm Hg, the pulse is 104/min. What aid must be provided to the person
at the scene of the accident?
a. Analgesia, antishock therapy, transportation into the inpatient department
b. Analgesia, transportation into a hospital on hard stretchers ✓
c. Transportation into the inpatient department in the position lying on the side
d. Analgesics intramuscularly, transportation in a sitting position
e. Schneck's vertebral anesthesia, transportation into the inpatient department
The correct answer is: Analgesia, transportation into a hospital on hard stretchers

An emergency medical team arrived at the scene of an accident 4 minutes after the accident occurred and found 5 victims. Carry
out medical triage and determine the order in which the accident victims must be provided medical aid. Who must receive medical
aid first in this case?
a. The second passenger of the first car, a 6-year-old boy, has multiple facial lacerations
b. The driver of the first car, a 32-year-old man, hit the steering wheel and complains of chest pain
c. The passenger of the second car, a 57-year-old man, complains of pain in the area of his right thigh, medium-sized brown spots
appeared on the right leg of his pants, the spots do not increase in size
d. The driver of the second car, a 55-year-old man, hit the windshield and does not move, his condition is considered to be ✓
clinical death
e. The passenger of the first car, a 27-year-old pregnant woman, somewhat agitated, complains of pain in the area of her right
shoulder, other injuries not detected
The correct answer is: The driver of the second car, a 55-year-old man, hit the windshield and does not move, his condition is
considered to be clinical death

A girl with the weight of 3100 g was born at home from her mother's third pregnancy. On the third day, the mother noticed small
hemorrhages in the umbilical wound, as well as "red dots" on the sclera of the child's eyes. The mother was not registered for
prenatal care checkups. She is breastfeeding her baby as needed. Physical examination detects subconjunctival hemorrhages.
Laboratory testing revealed that the hemoglobin levels were 155 g/L, the mother's blood group was B(III) Rh-positive, while the
child's blood group was A(II) Rh-negative. What is the optimal tactics to prevent the progression of this condition in the child?
a. Transfusion of packed red blood cells
b. Transition to formula-feeding with iron-fortified formulas
c. Administration of vitamin K ✓
d. Administration of human antirhesus Rh0(D) immunoglobulin
e. Prescription of iron preparations to be taken orally
The correct answer is: Administration of vitamin K
A 44-year-old man was hospitalized with a perforated stomach ulcer 5 hours after the onset of the disease. The diagnosis was
confirmed by radiological pneumoperitoneum. Signs of diffuse peritonitis are increasing. The patient has a concomitant disease -
schizophrenia. The man absolutely refuses surgery. What would be the surgeon's next steps in this case?
a. Carry out conservative treatment using the Taylor's method
b. Notify the deputy chief physician and carry out conservative treatment until the patient consents to the surgery
c. Continue to persuade the patient until he consents to the surgery
d. Convene a council including the hospital administration and, based on the council's decision, immediately proceed with the ✓
patient's surgery
e. Refrain from surgical intervention and carry out comprehensive conservative treatment
The correct answer is: Convene a council including the hospital administration and, based on the council's decision, immediately
proceed with the patient's surgery

An 11-year-old girl has been immunized according to her age and in compliance with the calendar dates. What vaccinations should
the children receive at this age?
A. Diphtheria and tetanus✔️
B. TB
C. Hepatitis B
D. Pertussis
E. Polio

A 19-year-old girl complains of moderate itching and hair loss on her head. Objectively, on the skin of her occipital region there is a
single round erythematous focus 3 cm in diameter with clear margins. Asbestos-like scales can be observed on the surface of the
lesion. The hair in the focus of the lesion is broken off at the length of 6-8 mm. What is the most likely diagnosis?
a. Trichophytosis
b. Psoriasis
c. Microsporia ✓
d. Seborrhea
e. Scabies
The correct answer is: Microsporia

A 56-year-old patient complains of decreased appetite, weakness, palpitations, pain and a burning sensation in the tongue,
heaviness in the epigastric region, and numbness in the limbs. Objectively, the following is observed: pale skin with a lemon-
colored tint, Hunter's glossitis.charged liver and spleen. Complete blood count: erythrocytes - 2.8-101/L, hemoglobin- 100 g/L, color
index - 1.2, Erythrocytes are large, often oval, with Jolly bodies and Cabot rings. What is the most likely diagnosis in this case?
A. Chronic hepatitis
B. B12 and folate deficiency anemia✔️
C. Iron deficiency anemia
D. Hemolytic anemia
E. Aplastic anemia

A 63-year-old man came to a doctor with complaints of marked general weakness, poor appetite, weight loss, joint pain, and
heaviness in the right subcostal area. Complete blood count shows the following: erythrocytes --- $3.4 · 10^{12$/L, Hb --- 102 g/L,
color index --- 0.9, platelets --- $640 · 10^9$ /L, leukocytes --- $138 · 10^9$/L, blasts ---1 %, promyelocytes --- 2 %, myelocytes ---
13 %, juvenile --- 12 %, band neutrophils --- 16 %, segmented neutrophils --- 31 %, basophils --- 3 %, eosinophils --- 8 %,
lymphocytes --- 9 %, monocytes --- 5 %, ESR --- 30 mm/hour. What is the provisional diagnosis?
a. Erythremia (polycythemia vera)
b. Chronic lymphocytic leukemia
c. Leukemoid reaction
d. Acute leukemia
e. Chronic myeloid leukemia ✓
The correct answer is: Chronic myeloid leukemia
During the examination of a deceased person at the site of an accident, a doctor detected gray-yellow triangular areas in the
corners of the eye on the cornea. What phenomenon is observed by the doctor?
a. Louis sign (corneal clouding)
b. Larcher spots
c. Idiomuscular tumor
d. Kayser-Fleischer ring
e. Beloglazov sign ("cat's eye")
The correct answer is: Larcher spots

A 45-year-old woman complains of an induration in her left breast. Objectively, in the upper-outer quadrant of her left mammary
gland, she has a tumor-like formation approximately 2.5 cm in diameter without clear contours. The formation is mobile and
painless. The "lemon rind" sign is positive. In the left axillary region, there is a lymph node enlarged to 1.5 cm. What is the most
likely diagnosis in this case?
A. Breast fibroadenoma
B. Breast abscess
C. Lipogranuloma
D. Non-lactational mastitis
E. Breast cancer✔️

A 42-year-old patient complains of severe burning pains behind the sternum, which occurred approx an hour ago, after physical
overload, cold sweat, sharp general weakness. Objectively observed: the skin is clean, pale in color. Pulse - 72/min, blood
pressure - 190/100 mm Hg The boundaries of the heart have not changed. Tones are weakened, clean. The ECG determines:
sinus rhythm, correct. The amplitude of the Q wave in leads II, III, avF is equal to the amplitude of the R wave, duration 0.04
seconds. ST segment elevation 4 mm higher was registered in the same leads isolines Specify the previous diagnosis.
a. Subendocardial myocardial infarction
b. Posterior diaphragmatic myocardial infarction ✓
c. Anterior - lateral myocardial infarction
d. Circular myocardial infarction
e. Basal myocardial infarction
The correct answer is: Posterior diaphragmatic myocardial infarction

: A 35-year-old woman came to a doctor with complaints of shortness of breath, deteriorated vision ("a haze before her eyes"),
double vision, strabismus, nystagmus, markedly dry mouth, nasal voice, difficulty swallowing, muscle weakness, and abdominal
distension. According to her diet history, 20 hours ago she was eating canned meat and home-cooked fish. What is the most likely
diagnosis in this case?
A. Botulism ✔️
B. Foodborne toxicoinfection
C. Staphylococcal intoxication
D. Food poisoning of chemical origin
E. Foodborne mycotoxicosis
In medical business, the profit of a company must be included in the price of its medical services. What traditional criteria make up
the term "price"?
a. Cost price, profit, taxes ✓
b. Profitability, income, fixed costs
c. The sum of all production costs
d. Variable costs, cost price
e. Gross expenses, use value
The correct answer is: Cost price, profit, taxes

A 52-year-old woman came to a doctor for her annual preventive checkup. Her father has a history of cardiovascular disease.
Physical examination of the woman shows the following: height --- 172 cm, weight --- 77 kg, BMI --- 26 kg/m2, body temperature ---
36.8°C, pulse - -- 81/min., respiratory rate --- 16/min., blood pressure --- 160/100 mm Hg on both hands. Ophthalmoscopy of the
fundus detects narrowing of the retinal vessels. Laboratory values are within the normal range. What should be prescribed in this
case to reduce the patient's risk of death caused by cardiovascular diseases?
a. Enalapril
b. Nitroglycerin
c. Dipyridamole
d. Warfarin
e. Aspirin
The correct answer is: Enalapril

A 64-year-old patient with a tumor of the sigmoid colon and chronic thrombophlebitis of the deep veins of the right leg is scheduled
for a surgery. What is the optimal medicine for prevention of deep vein thrombosis in this patient?
a. Low-molecular-weight heparin ✓
b. Phenylinum (Phenindione)
c. Rheopolyglucin (Dextran)
d. Acetylsalicylic acid
e. Regular heparin
The correct answer is: Low-molecular-weight heparin

A 72-year-old patient turned to the doctor with complaints of burning pain behind the sternum, which was not decreases after
nitroglycerin and lasts more than 2 hours. The patient has been ill for a long time angina pectoris, hypertension and diabetes.
Blood pressure 150/95 mm Hg, heart rate 88/min. The ECG revealed: sinus rhythm, depression of the ST I segment, aVL, V5-V6,
negative T I, aVL, V5-V6. What is the most likely diagnosis?
a. Hypertensive crisis
b. Angina of tension 3 FC
c. Acute coronary syndrome without ST segment elevation ✓
d. Unstable angina
e. Acute coronary syndrome with ST segment elevation
The correct answer is: Acute coronary syndrome without ST segment elevation
Non st elevation, acute coronary syndrome

A 16-year-old boy developed dizziness. Heart rate --- 35/min., blood pressure --- 85/45 mm Hg. The boundaries of the heart are not
expanded, the tones of the heart are sonorous and pure. The ECG revealed: P waves are not associated with QRS complexes,
dissociation and different rhythm of the atria and ventricles is accompanied by a different location of the P wave in relation to the
QRST complex. Which pathology is characterized by this clinical picture?
a. Extrasystole
b. Atrioventricular block (2nd degree)
c. Atrioventricular dissociation
d. Sinus bradycardia
e. Complete atrioventricular block (3rd degree) ✓
The correct answer is: Complete atrioventricular block (3rd degree)
A 1.5-month-old girl, who was born prematurely and is being breastfed, was brought to a pediatrician. What daily dose of vitamin D
should the doctor prescribe for the prevention of rickets in this child?
a. 400 IU
b. 1000IU✓
c. 500 IU
d. 4000IU
e. 800 IU
The correct answer is: 1 000 IU

A child was born from the first pregnancy at the gestational age of 38 weeks via caesarean section with the weight of 3500 g. The
Apgar
score is 8-10 points. What procedure must be carried out for this baby during the first hours of life to prevent hemorrhagic disease
of the
newborn?
a. Vaccination
b. Oral administration of vitamin D
c. Instillation of erythromycin ointment into the conjunctival sac
d. Intramuscular administration of 1 mg of vitamin K ✓
e. Oral administration of vitamin C
The correct answer is: Intramuscular administration of 1 mg of vitamin K

The pregnancy is first, the term of gestation is 38 weeks. The fetus is in the longitudinal lie, the presentation is cephalic, with the
head pressed against the entrance to the lesser pelvis. The expected weight of the fetus is 3500.0 g. Contractions occur every 5
minutes and last for 25--30 seconds. The fetal heartbeat is 130/min., clear and rhythmic. Vaginal examination shows that the cervix
is shortened to 1 cm, the cervical canal allows inserting 1 finger width (2 cm). The amniotic sac is intact. What labor management
tactics should be chosen in this case?
a. Caesarean section
b. Tocolytic therapy
c. Stimulation of labor activity
d. Manage the birth through the natural birth canal ✓
e. Amniotomy
The correct answer is: Manage the birth through the natural birth canal

A man complains of unbearable cough with putrid-smelling chocolate-colored purulent sputum. The discharge of sputum reaches
600 mL per 24 hours. The patient's history states that the disease onset was acute, with irregular fever and the body temperature
reaching 39°C. X-ray shows a shadowed area with a cavity in its center that has irregular contours and a fluid level. What is the
most likely diagnosis in this case?
A. Bronchiectasis
B. Cavernous tuberculosis
C. Pulmonary gangrene✔️
D. Lung cancer with disintegration
E. Lung abscess
A 27-year-old woman at 17 weeks of her pregnancy has been hospitalized for treatment. She has a history of two spontaneous
miscarriages. Bimanual examination reveals that her uterus is enlarged to 17 weeks of pregnancy, the cervix is shortened, and the
opening allows inserting a fingertip. The woman was diagnosed with cervical-isthmic insufficiency. Specify the further tactics of
managing this patient
. A. Provide hormonal therapy
B. Provide tocolytic therapy
C. Apply cervical stitch✔️
B. Terminate the pregnancy
E. Perform amniocentesis
.

A 10-month-old boy is poorly gaining weight. His mother complains about his constant persistent cough. Sputum is thick and
viscous. The boy had pneumonia three times. His sweat chloride levels are over 80 mEq/L. What is the most likely diagnosis in this
case?
A. A foreign body in the bronchi
B. Mucoviscidosis cystic fibrosis) ✔️
C. Chronic bronchitis
D. Bronchial asthma.
E. Congenital lung abnormality

Periodic medical check-up revealed that a worker of chemical complex has malignant
tumor of the bladder. Contact with what industrial poison is the most probable cause of this
occupational disease?
1. Arsenic
2. Benzidine✔️
3. Asbestos
4. Carboxyl nickel
5. Vinilchloride
Pregnant week 39/38 , when she was 5year old she went ATRIAL SEPTAL DEFECT surgery , now no heart
problems every thing normal = normal delivery
Measles incubation period =q14 day

Second degree vertebral fracture = : surgery ..

Citrate intoxication - calcium chloride
Subarachnoid haemorrhage = nuchal rigidity+ kernigs positive
Hepatic cirrhosis + alcohol 6 uears + unpleasant smell from the mouth = liver failure
Pustule and papulae = sycosis
Amniotic sac intact and tense, haemorrhagic discharge, fetal heart beat not detected -
1 placental abruption, 2uterine rupture , 3complete placenta previa
= i choosed abruption
No Barr body , short neck -turner syndrome
Dense painfule formation on breast + pain increases before menistruation : breast fibroadenoma

new
Mass/formation 3*3cm behind the sternum= thymoma
Psa 24 + stone density = prostate cancer
Metaprolol = rvh
Bronchial asthma = special group

After diffuse toxic goiter surgery = thyrotoxicosis

Enlarged axillary lymph node and macupapuplar rash = infectious mononucleosis
Septic shock = meningitis symptoms sluggish ,80/40
Dressler syndrome = 3 weeks after myocardial infarction +weak respiration on the lung
Stool with mucus and blood 9/day , painful left iliac region , erosion +ulcer = non specific ulcerative colitis