1. A 25-year-old pregnant woman was hospitalized in connection with uterine bleeding.

General
bloodloss = 250 ml. After a thorough examination, it was established: pregnancy 10-11 weeks,
spontaneous abortion in progress. Specify treatment tactics in this case

A. Carry out hemotransfusion in Prescribe uterotonic drugs

C. Prescribe antispasmodics

D.Carry out the removal of the fetal egg

E. Strict bed rest

2. A 52-year-old man complained of periodic pains behind the sternum, a violation of the passage of
the dura and 5 kg in 3 weeks. During fibroesophago-gastroscopy, it was found: free passage
esophagus to the level of 37.5-38 cm from the edge of the upper incisors, where the upper pole of
the exophytic formation is determined, which narrows the lumen to 1/2 of the norm. According to
the biopsy results: adenocarcinoma. What precancerous disease is most likely in the patient?

A. Esophageal polyp

B. Esophageal diverticulum

S. Barrett's esophagus

D. Esophageal lipoma

E. State after a burn of the esophagus

3. Air samples were taken for laboratory analysis in the operating room during monitoring of
compliance with the sanitary and hygienic regime. The following results were obtained: the total
number of microorganisms in 1 m° of air - 490, in particular hemolytic streptococcus - was not
detected. Set the degree of air cleanliness in the operating room.

A. Moderately polluted

B. Very clean

C. Clean

D. Heavily polluted

E. Contaminated

4. Under organization time sanatorium resort meals for persons affected by the Chernobyl disaster fi,
it was proposed to provide in the sions contain a regulated amount of nutrients that enter into a
competitive relationship with radionuclides and prevent their absorption in the gastrointestinal tract.
Which nutrients are of priority importance for ensuring such a biological effect of food?

A. Potassium, calcium, dietary fiber

B. Fat-soluble vitamins, animal proteins

1. A 25-year-old pregnant woman was hospitalized in connection with uterine bleeding. General
bloodloss = 250 ml. After a thorough examination, it was established: pregnancy 10-11 weeks,
spontaneous abortion in progress. Specify treatment tactics in this case

A. Carry out hemotransfusion in Prescribe uterotonic drugs

C. Prescribe antispasmodics

D.Carry out the removal of the fetal egg Ddc

E. Strict bed rest

2. A 52-year-old man complained of periodic pains behind the sternum, a violation of the passage of
the dura and 5 kg in 3 weeks. During fibroesophago-gastroscopy, it was found: free passage
esophagus to the level of 37.5-38 cm from the edge of the upper incisors, where the upper pole of
the exophytic formation is determined, which narrows the lumen to 1/2 of the norm. According to
the biopsy results: adenocarcinoma. What precancerous disease is most likely in the patient?

esophagus
A. Esophageal polyp

B. Esophageal diverticulum Barret's

to
S. Barrett's esophagus
predisposing
D. Esophageal lipoma

E. State after a burn of the esophagus esophageal adenocarcinoma

3. Air samples were taken for laboratory analysis in the operating room during monitoring of
compliance with the sanitary and hygienic regime. The following results were obtained: the total
number of microorganisms in 1 m° of air - 490, in particular hemolytic streptococcus - was not
detected. Set the degree of air cleanliness in the operating room.

A. Moderately polluted

B. Very clean 2500

C. Clean clean
D. Heavily polluted

E. Contaminated

4. Under organization time sanatorium resort meals for persons affected by the Chernobyl disaster fi,
it was proposed to provide in the sions contain a regulated amount of nutrients that enter into a
competitive relationship with radionuclides and prevent their absorption in the gastrointestinal tract.
Which nutrients are of priority importance for ensuring such a biological effect of food?

fibers needed
pottaesiumorhhod
A. Potassium, calcium, dietary fiber

B. Fat-soluble vitamins, animal proteins

Agnes
C. Magnesium, phosphorus, vegetable proteins

D. Vegetable fats, dietary fibers

E. Iron, zinc, easily digestible carbohydrates.

5. A 45-year-old man was hospitalized. In the patient's anamnesis, there is a paracoccal dilatation of
the veins of the lower extremities - approx. He suddenly felt a pain in his chest " is warned: buy-pale
neck veins, cyanosis. On the ECG of the nannybut: Mc-Gin-White sign (O!I-SI), Ppulmonalc, tilting of
the electrical axis of the heart this is to the right, signs of right-hand overturning spread hearts.
Determination of the level of which substance in blood sugar should be carried out to confirm the

putfhfnfmb.co embolism
diagnosis?

A. Creatine phosphokinase

B. Alanine aminotransferases

C. Cardiac troponin

D. Aspartate aminotransferases

E. D-dimer

6. A 65-year-old woman is being treated in the surgical department for phlegmon of the buttocks.
During the microbiological examination of the wound, non-clostridial anaerobes were found to be
the causative agent of the surgical infection - proteus and bacteroids. What therapeutic tactics
should be applied first of all in the treatment of this infection?

D. Washing the purulent cavity with antisebirds

E. Radical excision of affected tissues

7. In a 36-year-old patient, after drinking alcohol and fatty food the day before, at night there was an
attack of acute arthritis of the 1st moldphalanx joint of the right foot. During the examination, the
following is observed: the first finger is numb, the skin is bluish, hot to the touch. In the general
blood test, it was found. LE 12.0 - 1012/l, shift to the left, ESR - 42 mm/h. Choose an option for
starting therapy

A. NSAIDs

B. Ointment with NSAIDs locally

C. Colchicine
gout
D. Prednisolone

E. Diprospan intra-articularly

8. A 54-year-old woman turned to the doctor with complaints of general weakness lasting 2 months,
noise in the head, hoarseness of voice. It is known from the anamnesis that at the age of 34 there
was a subtotal resection of the stomach due to peptic ulcer disease. Physical examination without
features. In general the following blood test is observed: Hb – 58 g/l, erythrocytes - 1.2 - 1012/l,
leukocytes - 2.8 • 10°, platelets - 140 • 10°/l, fasterythrocyte sedimentation rate - 17 mm/h,
anisocytosis, poikilocytosis (++). Which of the following diagnostic methods is the most appropriate
to prescribe to the patient?
anemia
A. Fibrogastroscoliosis

B. Indirect Coombs test

Pernicious
C. Determination of the level of liver enzymes in the blood

D. Direct Coomb test

E. Determination of blood cyanocobalamin level

9. A 32-year-old woman complains of bilateral pain in her hands and swelling of her fingers, a feeling
of stiffness for several hours after waking up, and fatigue. Objectively observed: swelling of the
second and third metacarpal-phalangeal and proximal interphalangeal joints, positive symptoms of
transverse compression of the hand. What type of arthritis does the patient have?

A. Rheumatic

B. Gout

C. Osteoarthritis

D. Rheumatoid

E. Reactive

10. A 76-year-old patient complains of episodes of memory loss and dizziness. 3 anamnesis shows
that two years ago he suffered an acute myocardial infarction. Objectively observed: heart rate =
pulse = 32/min, Blood pressure - 160/90 mm Hg. Art. The ECG revealed: AV-blockade of the III
degree. What should be are you the doctor's next tactic?

A. Assign the patient a permanent not atropic

B. Observation of the patient once a month constantly

C. Implantation of an electric pacemaker

D. Place the patient on constant reception of isadrin

E. Assign to the patient acceptance

F-adrenoblockers constantly

11. The patient complains of redness, burning, feeling of a foreign body in the right eye. I fell ill
suddenly. During the examination, it was found that the visual acuity of the right and left eyes was
1.0. In the right eye - hyperemia and swelling of the conjunctiva, superficial injection. Purulent
discharge in the conjunctival sac. The cornea is transparent, the color and pattern of the iris are
unchanged, the pupil is mobile. What is the most likely diagnosis?

A. Acute dacryocystitis

B. Acute conjunctivitis

C. Foreign body of the cornea

D. Acute attack of glaucoma

E. Acute iridocyclitis

12. A 47-year-old patient turned to a neurologist with complaints of pain in the lumbar region. A
preliminary diagnosis was established: sciatica, and a course of physiotherapeutic treatment was
carried out. However, the patient's condition did not improve. An X-ray of the spine and pelvis
revealed osteoporosis and significant bone defects. In the general blood analysis, normochromic
anemia is observed, the total protein is 107 g/l. For results a general urine analysis revealed protein.
ryu - 4.0 g/l. What research must be done to establish the final effect. agnosia?

A. Radioisotope examination of the kidneys → multiple

Diagnosis
myeloma
B. Ultrasound of abdominal organs

?_?
-
C. Sternal puncture

Blood cancer
D. Cytochemical study of blood cells

E. Comprehensive blood analysis

Orang
13. The patient complains of an increase in body temperature to 38°С during the last 2 days.
Objectively observed: a positive Pasternatsky symptom on the left. General analysis of urine: specific
gravity. protein - 0.99 g/l, erythrocytes- 1015, 6 8 in n/3, leukocytes - 30-32 in p/z. What is the
previous diagnosis?

A. Acute cystitis

B. Renal amyloidosis

C. Acute pyelonephritis

14. In a 34-year-old woman with previously normal menstrual function, the times became irregular,
according to the of functional diagnostics - innovative. Mammary glands are painful to palpation,
milk is secreted (galactorrhoea). What research is recommended for the patient first of all?

Psolactineinia
A. Progesterone test

B. Determination of the level of gonadotropins

C. Computed tomography of the head brain

D. Determination of prolactin level

E. Ultrasound examination of mapelvis logo

15. A 62-year-old woman complains of a feeling of interruptions in the work of the heart, periodic
heart palpitations, reduced work capacity sti, general frailty. Deterioration of the condition has been
noted in recent months. She consulted a doctor after dizziness in the head with a brief loss of
consciousness the day before. Objectively observed: pulse - 52/min, arrhythmic. No noises were
detected during auscultation. The ECG shows: sinus rhythm, irregular, PO interval _ 0.20 sec. ORS =
0.08 ceK. A gradual decrease in the RR interval with. the next fall of PORST. What is the most likely
cause of the patient's condition?

A. Atrioventricular blockade of the III degree

B. Atrioventricular block II degree

C. Trifascicular blockade of the bundle legs Fic

D. Atrioventricular blockade of the 1st degree

E. Sinoauricular blockade

16. For the organization of water supply for the inhabitants of the village, a water source with the
content of sulfates, chlorides, nitrates, and iron was selected, which meets hygienic requirements,
but with a high fluoride content (3 mg/dm?). To disthe course of which the disease can lead use of
water with such a chemical composition?

A. Fluorosis normal till 0.7

B. Urolithiasis

C. Kapiecy

D. Gallstone disease

E. Gout

17. A 28-year-old man during the regular medical examination of the complaint lived on periodic
attacks palpitation. Objectively observed: blood pressure - 130/80 mm Hg art., pulse - 65/min. For
results The ECG records a shortening of the P-Q interval, the appearance of an additional excitation
wave in the QRS complex, deformation of the complex ORS and negative wave P. About which patho

abnormal
The patient's complaints and changes in EKG?

A. WPW syndrome →extra

pathway -

B. Paroxysmal supraventricular tachycardia

between atria and
C. Ventricular extrasystole

D. Blockade of the leg of the bundle of His ventricles

E. Paroxysmal ventricular tachycardia
18. A 42-year-old man injured in a road accident was hospitalized with a diagnosis of 30m:
polytrauma, rupture of the spleen, fracture of the right hip. Objectively observed: slowed down, skin
covered with sticky cold sweat, pale. Breathing in upper, frequent. Pulse - 140/min, weak filling, AT -
65/40 mm Hg. art., TsVT - 0. Surgical intervention under intravenous anesthesia with artificial
ventilation of the lungs is planned. What anesthetic should be chosen for general anesthesia?

A. Isoflurane

B. Ketamine

C. Sodium thiopental

D. Sevoflurane

E. Propofol

19. A 17-year-old girl complains of pain in the knee and ankle joints, an increase in body temperature
to 39°C. 2 weeks ago she suffered acute tonsillitis. Objectively observed: swelling and sharp pain in
the joints, limitation of their movements. On the skin of the trunk and limbs, there are barely
noticeable ring-shaped pale pink spots we. Heart rate - 95/v, AT - 90/60 mm Hg. article, thenWe are
weakened, a soft systolic murmur over the top of the heart. Set the previous diagnostic

A. Reiter's disease

B. Erythema nodosum

C. Rheumatoid arthritis

D. Systemic scleroderma

E. Acute rheumatic fever

20. A pregnant woman was hospitalized at 38 weeks gestation, her second pregnancy. The first
pregnancy ended naturally childbirth, a boy weighing 3600 was born The woman was found to be
HIV-positive during her second pregnancy at 12 weeks of gestation. A woman receives AART from the
22nd week of pregnancy. The position of the fetus is elongated, main presentation Estimated weight
3200÷200 gr. The heartbeat of the fetus is sonorous, rhythmic 122-138/min. The viral load is 40 viral
copies/ml. What is the technique of childbirth in this case?

tem
section
A. Caesarean section at 38 weeks of pregnancy
as
-
B. Exclude the second period of childbirth
c-
C. Cesarean section at 40 weeks of pregnancy do
can
D. Induce labor at 38 weeks of pregnancy

E. To give birth conservatively

21. During the study of the average level and nature of the diversity of some laboratory indicators,
the following data were obtained: for total blood protein - mean square deviation of 14 g/l,
coefficient of variation- 6%; for erythrocyte sedimentation rate, respectively #2 mm/h, 23%. Which of
the signs being studied is the most diverse?

A. More research is needed to explore diversity 6

>
B. Erythrocyte sedimentation rate 23
C. Additional calculations are required to study diversity

D. Total serum protein

E. Differences in the variety of signs of THi

22. A 67-year-old patient complains of dizziness, general weakness, and twice lost consciousness. It is
known from the anamnesis that he suffered a myocardial infarction 4 years ago. Objectively
observed: condition of medium severity, skin and mucous membranes normal color, breathing in the
lungs Visicular, no wheezing. Heart sounds muffled, arrhythmic, heart rate - 62/min. AT 140/90 mm
Hg. Art. Abdomen is soft, painless. There is no peripheral edema. The ECG revealed: PO interval - 200
ms, ORS - 80 ms, sudden loss of the ORS complex without a previous increase in the PQ interval, with
periodicity - 3:1, 4:1. What kind of heart rhythm disorder did the patient have?

A. Complete AV blockade No bits I

→ p - o progressweb
B. AV blockade of the II degree, Mobitz II QRS
Increases .

C. AV blockade of the II degree, Mobitz I drop

same
D. CA blockade
interval
E. AB blockade of the first degree
Type2-1 p @
Qrs
drop
23. A 35-year-old man who is ill on epilepsy, developed a large convulsive attack lasting 4 minutes. 10
minutes after the attack, consciousness did not recover, repeated tonic-clonic seizures occurred.
What is the drug of choice in this choice ?

A. Carbamazepine

B. Haloperidol

C. Valproic acid

D. Diazepam

E. Amitryprilin

24. A 45-year-old woman complains of general weakness, drowsiness, a constant feeling of fatigue,
reduced work capacity, cramps, hair loss. 3 of the anamnesis, it is known that the patient underwent
resection of the thyroid gland a year ago due to multinodular goiter. Objectively observed: body
temperature - 36°C, dry, wrinkled skin, amenorrhea. What pathological condition did the patient
have?
A. Thyrotoxicosis

B. Climacteric syndrome

C. Chronic thyroiditis

D. Hypothyroidism

E. Hypoparathyroidism

25. On the 5th day after childbirth, a woman in labor complains of pain in the left mammary gland
and an increase in body temperature to 38.1°C. During the examination, the mammary gland is
enlarged, painful during palpation, there are cracks and swelling of the nipple, hyperemia of the
upper-external quadrant of the gland. What are the recommendations regarding the prevention of a
complication that occurred in a woman?

A. Feeding the child on demand, expressing residual milk, prevention of cracked nipples

B. Feeding no longer than 10 minutes after overlay, expressing residual milk

C. Constant pumping of mammary glands

D. Stop feeding the baby if cracks appear

E. Feeding the baby by the hour

26. A 55-year-old patient was hospitalized in an unconscious state to the intensive care unit.
Objectively observed: the condition is severe, the pupils are dilated, they react to light background,
noisy breathing, BH - 10/min, pulse on radial and carotid arteries does not determine TSYA, JSC -
40/20 mm Hg. Art. The ECG showed but: ventricular flutter with heart rate - 210/min. What
resuscitation measures should be carried out nasamperel?

A. Electropulse therapy

B. Intravenous administration of adrenaline with atropine

C. Intravenous administration of lidocaine

D. External heart massage

E. Intravenous administration of norepinephrine Well

27. On the fourth day after her arrival from India, a woman was hospitalized in the infectious
department with complaints of abdominal pain, stools of a rare consistency in small quantities, 7-8
times a day, containing a large amount of vitreous mucus and blood. inflammatory stam, zalov putiya
shikira bor should the remedy be prescribed to a woman?

A. Metronidazole
entamoeba histolytica

[ parasite Amoebic dysentery

B. Nifuroxazide

C. Loperamide
D. Ceftriaxone

E. Erythromycin

28. Give an assessment of the physical development of children. different height and height, if the
indicators of body weight and chest circumference are within t 1 sigma:

A. Medium

B. Low

C. Harmonious

D. Disharmonious

E. Vysoky

29. A 37-year-old patient was hospitalized 1 chagnozoma: chronic kidney disease, 1 Art. -
mesangioproliferative glomerulonephritis. The daily loss of protein in the urine is 5.1 g. In the clinical

§
analysis of blood: total protein - 48.2 g/l, urea 5.7 mmol/l, creatinine - 76.3 μmol/d, holesterin - 8.1
mmol/l. Blood pressure - 140/90 mm Hg. Art. What group of drugs should be prescribed to the
patient?

ghuoaod-iosknoids-erlomen.to
A. Nitrofurans

B. Antibiotics

C. Plukocorticosteroids nephritis
D. Nonsteroidal anti-inflammatory drugs

E. Sulfanilamides

30. A man came to the doctor complaining of pain in the lower jaw. Objectively observed: body
weight is reduced, skin is pale, bad breath, gums bleed. X-rays of the jaw showed signs of
osteoporosis. The patient worked at a chemical company for 30 years. For which pathological
condition are these symptoms characteristic?
↑
A. Chronic phosphorus poisoning
fwunne and
Skeletal
B. Potassium perchlorate poisoning

C. Chronic osteomyelitis of the lower jaw

D. Methidruttyu poisoning

E. Fluorosis
dental changes
31. A woman giving birth for the first time was hospitalized for the maternity ward with a
complaintwe are on irregular nature and bloody discharge from the genital tract. The gestation
period is 39 weeks. During an external obstetric examination, the establishment updated: the
position of the fetus is longitudinal, catch presentation. Hypertonus of the uterus is determined.
During the internal obstetric examination, the cervix is 1 cm long, the cervical canal is open for 2 cm.
The head is preterm the fetus, pressed against the entrance to the small pelvis. The discharge is
bloody, with clots. Ser-did the complication occur during childbirth? 024723 fetal heart rate
arrhythmias, 80-100 min. Yaks

placental
A. Rupture of the uterus

B. Rupture of the cervix. Complete placenta previa

called
C. Premature detachment of the placenta → also abruption
D. Marginal placenta previa

32. A 29-year-old mother in labor, in her third labor, gave birth to a boy weighing 1900 g, height 48
cm, with an Apgar score of 7-8 points at 40 weeks. In the 1st period of childbirth, a placenta was
born measuring 17816x1.5 cm, weighing 340 g; with multiple petrifications, shells of greenish color.
What pathology most likely caused the delay of intrauterine rofetus?

A. Premature detachment of a normally located placenta

B. Intrauterine infection of the fetus

IUGR
C. Placental insufficiency r. Fetal hypotrophy and moaning ←
D. Premature birth

33. A 47-year-old patient received flame burns on his upper limbs and trunk. During the hospital stay,
the stoso attacks are severe, consciousness is clouded, fever, blood pressure 80/50 mm Hg. art.,
pulse 118/min. Locally ШИ B degree burns in area were ascertained 20% What medical measures are
necessary lead first?

A. Prescribe antibacterial and detoxification therapy

B. Administer narcotic analgesics, start infusion therapy

C. Carry out necrotomy of the burn surface, hemotransfusion

D. Prescribe detoxification therapy

E. Carry out primary surgical treatment of the burn wound

34. A 40-year-old man complains of sharp weakness, pain in muscles and joints, temperature rise to
38.6°C, weight loss. He became acutely ill. 3 medical history, it is known that he had viral hepatitis 6
months ago. Objectively observed: the patient's condition is of moderate severity, heart rate -
80/min, BP - 175/95 mm Hg. Painful subcutaneous nodules up to 1 cm in size are palpated on the
inner surface of the forearm. On the upper extremities, sensitivity disorders of the "glove" type are
noted. According to the results of clinical blood analysis, moderate anemia, leukocygosis,
sosinophilia, accelerated ESR were revealed. Clinical analysis of urine shows moderate proteinuria
and microhematuria. Which disease is characterized by such clinical and laboratory indicators
disappeared?

A. Systemic lupus erythematosus

B. Rheumatism

C. Nodular polyarteritis

D. Dermatomasitis

E. Hemorrhagic pasculitis

35. A 15-year-old boy is ill for week Complains of fever, which with subfebrile in the first days
increased to 39-40°С in the next 2 days, general weakness, decreased appetite, periodic nausea, pain
in the stomach, muscles, joints. Manifestations of pharyngitis are observed, the tongue is bright with
swollen papillae, scleral injection, a spotted-patulous rash on the skin with thickening around the
joints, hyperemia and swelling of the hands and feet. Pulse - 110/min. During ultrasound,
hepatosplenomegaly and mesadenitis were detected. Physiological stools in the feed. In the general
blood analysis - neutrophilic leukocytosis. Make a preliminary diagnosis.
antic
→ my
adi nits lymphadenitis
A. Pseudotuberculosis, severe form

mes✓
B. Infectious mononucleosis

C. Kawasaki disease

D. Scarlet fever, severe form

E. Leptospirosis, severe form

36. A 35-year-old female patient complains of pain in the right lower leg, which worsens when
walking. Objectively observed: the skin is red, hot to the touch on the right lower leg along the
course of the varicose small saphenous vein, during palpation, an oblong, 3×2 cm painful induration
is detected in the upper third of the lower leg. What complication did the patient experience?

A. Lymphangitis

Superficial
B. Boil
aeon
C. Thrombophlebitis

D. Thrombosis of deep veins

E. Lymphadenitis

37. A 28-year-old man consulted a doctor about a formation on the skin of the 4th finger of the right
hand. Objectively observed barks: on the back surface of the 4th finger, warty growths, in size 3-8
mm, do not hurt, the surface is dry, soft of an elastic consistency, soldered to the underlying tissues,
there is no healing of the skin on the periphery of growths. What pathology is observed in the
patient?
A. Infectious mollusk

B. Common warts

C. Vegetative pyoderma

D. Warty tuberculosis

E. Occupational dermatitis

38. An eleven-year-old girl complains of pain in the joints, an increase in body temperature up to
38°С, weakness. I got sick 5 days ago. Objectively observed: a spotted-papular rash on the bridge of
the nose and face, the joints have not changed, the heart sounds are weakened. Blood pressure -
100/80 mm Hg. Art. In the general blood analysis: erythrocytes - 2.6 t/l, leukocytes - 3.7 g/l, platelets
- 12 g/l, ESR – 45 mm/h. CRP (+++). In general in the urine analysis: protein - 0.063 g/l, erythrocytes
you - 15-20 in p/z, leukocytes - 10 14 in p/z. Specify the probable diagnosis.

A. Systemic lupus erythematosus

B. Nodular periarteritis

C. Dermatomyositis

D. Acute rheumatic fever

E. Hemorrhagic vasculitis

39. What documentation needs to be checked in order to carry out an expert assessment of the
fulfillment of medical and technological standards of patient care by resident doctors?

A. Maps of medical appointments

B. Medical charts of inpatients

C. Annual report of treatment and prevention institution

D. Statistical maps of patients who were discharged from the hospital

E. Logbook of operative interventions

40. A 55-year-old man consulted a family doctor with complaints of weakness bone, thirst, dry
mouth, increased blood pressure. Objectively observed: IMT - 35.6 kg/m?, blood pressure - 140/90
mm Hg. st., the skin is dry, the subcutaneous fat is distributed according to the abdominal type.
Fasting pykemia - 6.0 mmol/l, postprandial 11.4 mmol/l, H6A1s - 6.8%. What a tactic treatment
should be chosen?

A. Assign sulfonylurea derivatives

B. Prescribe metformin

C. Insulinoteatyu ⑦ 6- 5
to normal
close
D. Diet therapy and exercise

E. Prescribe statins

41. 2 months after surgery for paraproctitis, a 53-year-old woman turned to the doctor with a
complaintwe for perianal discomfort, tenesmus, muco-purulent secretions. During the rectal
examination, an external fistula opening is noted, upon pressing on which pus comes out, along the
course of the hole, a cord-like compaction is noted in the direction of the rectum. During analgesia, it
is established: the mucous membrane of the intestine on the silence of bru-kivka. What is the
patient's probable diagnosis?

A. Incomplete internal pararectal canal THIS

B. Rectal cancer

C. Acute paraproctitis

D. Nonspecific ulcerative colitis

E. Crohn's disease, pararectal fistula

42. During the examination, a twelve-year-old girl was found to have compaction and slight swelling
in the area of the left mammary gland, there is no hyperemia. Specify further recommendations
dacia

A. UHF on the breast gland

B. Antibiotic terania

C. Radial section above the swelling with naB. paraareolar incision with drainage foot drainage

D. Dynamic observation without treatment

43. A 24-year-old woman was hospitalized with vomiting according to the type of "coffee

complaints about thickets", dizziness, general weakness. during the objective examination, it was
established: the patient is conscious, the skin is pale, dry, over the lungs on auscultation - harsh
breathing. ChD - 20/min, AG - 100/80 mm mercury century, pulse - 100/min. The abdomen is soft,
painless. Peritoneal symptoms are negative. The stool is liquid, black. Diuresis is preserved. Clinical
blood analysis revealed: Hb - 95 g/l, erythrocytes - 3.1 g/l, leukocytes - 9.8 g/l. What an indicator of
shock Algover index in this patient?

;:÷. ÷÷
A. 1.25

B. 0.85
" .
C. 1.5

D. 2

E. 1
44. In a hospital with an average annual number of beds of 330, 4,250 patients were treated, 4,540
patients were discharged, and 42 patients died in the hospital. What indicator is possible calculate?

A. The frequency of discordant diagnoses

B. Daily mortality

C. The average number of days of operation of a bed per year

D. Total mortality

E. Hospital mortality

45. A premature baby at the 32nd week of gestation developed respiratory disorders within an hour
after birth, which are estimated at 6 points on the Dovnes scale. Auscultatively over the lungs,
weakened breath-unweakened breathing, scattered crackling wheezes are heard. ChD - 66/min. An
xray of the chest cavity revealed: a decrease in the transparency of the lung tissue due to a diffuse
meshgranular pattern. Make a preliminary diagnosis.

A. Tracheoesophageal fistula

B. Diaphragmatic hernia

C. Respiratory distress syndrome newly discovered born

D. Edema-hemorrhagic syndrome

E. Congenital pneumonia

46. Detection of which structures during a patho-morphological examination is pathognomonic for

rabies?

A. Vuzlykiv Ashofa
Bodies
B. Taurus Negi

C. Crystals of Charcot-Leyden
Negri
D. Tilets Talalaev

E. Tilets Guarneri

47. An eight-month-old child has tonic tension of the muscles, carpo-psdal spasm, laryngospasm.
After that, sneralized clonal cells develop. houses with loss of consciousness for a few minutes.
Positive symptoms of Khvostek, Trus-so, Lust. What emergency condition is observed in the child)

A. Hypocalcemic (tetanic) convulsions in Febrile convulsions

B. Affective respiratory convulsions

C. Suffocation-tsanotic attack
D. An emleptic attack

48. A 56-year-old woman has been working as a disinfectant for 19 years. Complains of general
weakness, nausea, bitterness in the mouth, heaviness in the right hypochondrium, fast fatigue
Objectively watchingts: body temperature - 371°С, icterus of the sclera, enlarged liver, Total bilirubin
- 40 μmol/l. What is the likely diagnosis?

A. Chronic cholecystitis

B. Chronic pancreatitis

C. Acute cholecystitis

D. Dyskinesia of biliary tract

E. Toxic occupational hepatitis

49. A 35-year-old man complains of periodic epigastric pain at night. A duodenal bulb ulcer was
diagnosed. What a non-invasive method diagnosis of Helicobacter pylori infection has the highest
sensitivity and specificity, must be prescribed to the patient first of all?

A. 13C-urea breath test

B. Determination of fecal antigen

C. Determination of IgG, IgM in blood serum

D. Determination of IgA, IgM in saliva

E. Gastroscopy with biopsy

50. A 51-year-old patient was hospitalized with complaints of burning pains behind the sternum
lasting about 2 hours. The ECG shows: elevation of the ST segment in II, III, aVF leads. Blood pressure
150/90 mm Hg. st., pulse - 90/min. Which of the following drugs refers to the pathogenic therapy of
this patient huh?

like → given in
stroke
thrombi
A. Metronidazole

B. Alteplaza IschemicMI
C. Preductal
acute Thromboembolism
pulmonary
D. Omeprazole

E. Mildronate

51. Long-term use of drinking water with high hardness (20 mg-eq/dm) has a negative effect on the
health of the population. Which of the following pathologies is not related to the hardness of
drinking water?
A. Calcinosis

B. Gallbladders have a disease

C. Systemic phenomena

D. Dermatitis

E. Urinary tract disease

52. A 25-year-old woman developed a temple on the right side of her face, neck pain in the joints.
Physically observed: the condition is severe, erythema of the face in the form of a "butterfly", dark
body texture_ 38.7°C, joints radiocarpal joints the horns of the sernia are inflamed, systolic noise at
the apex of the sernia. Heart rate = 102/min. A pleural friction murmur is heard in the lower parts of
the lungs. In the general analysis of sschi, swelling was revealed - 036 gl. Determination of the level
of which indicator is most informative for the purpose of verification

A. Antibody to double-helical DIK

-3 dna
antibodies
B. C-reactive protein DNA SLE
C. Levels of immunoglobulins A, M, G, E

D. Levels of circulating immune complexes

E. Total protein and protein fractions of blood

53. A ten-year-old child complains of lethargy and decreased appetite. During the e- • Lustful
oestination revealed: lactone oiliness, jaundice mark, sclera subilericity, glossitis. Moderate
hepatochegolio 3 history is known about surgical intervention - resection of a part of the thin
cartilage. general blood analysis revealed: erythrocytes - 3.0: 1012 /l, hemoglobin - 90 g/l, color
index - 1.15, platelets - 180 • 10°/l, leukodytes - 45, 3 • 10°/l, palychnonuclear 4%, segmentonuclear
36%, eosinophils 3%, lymphocytes 52%, monocytes 5%, HYD 4 mm/h, macrodytosis, anisocytotoz,
pokkiocytosis. Set imoviocopy

A. Posthemorrhagic anemia

B. Iron deficiency anemia

C. Apastina anemia

D. Hemolytic anemia

E. B1 - folic acid deficiency anemia

54. A 27-year-old man complains of a cough with purulent sputum, pain in the chest during
breathing, an increase in body temperature to 38.6°C. He became acutely ill due to hypothermia. He
was admitted to a hospital. After laboratory and X-ray examination, he was diagnosed with
community-acquired pneumonia. 3 Which antibiotic is more appropriate to start treatment with?

A. Amoxicillin clavulanate
B. Vancomycin

C. Tetracycline hydrochloride

D. Tentamycin sulfate

E. Lincomycin

55. A 56-year-old woman turned to the doctor with complaints of an increase in temperature body
temperature up to 38.5°C, night sweats and increased lymph nodes in the left axillary and left
supraclavicular areas. During the physical examination, enlarged, painless, dense lymph nodes are
palpable in these areas. During the X-ray examination of the organs of the chest cavity, it was
revealed: expansion of the mediastinal shadow due to enlarged lymph nodes. After an excisional
biopsy of the supraclavicular lymph node, atypical multinucleated Reed-Sternberg cells were
detected. 3 family anamnesis is known: the patient's grandmother - breast cancer. For what disease
are these symptoms characteristic ptoms?

A. Bronchogenic carcinoma

B. Hodgkin's lymphomas

C. Tuberculosis

D. Infectious mononucleosis

E. Breast cancer metastasis

56. In a 29-year-old woman, the disease began suddenly with a rise in body temperature to 39°С, the
appearance of dark lilac-colored rashes on the skin of the face, forehead, around the eyes, neck and
front surface of the chest. Skeletal muscles are weak, painful on palpation, strength they have a
reduced He notes difficulty in swallowing. Laboratory revealed: sharply positive acute phase
indicators, ESR – 39 ml/h, erythro- these _ 2.9: 1012, N - 72 g/l. Definition level of which enzyme will
be most important for verifying the diagnosis?

Dermot myosins
A. Transferrin

B. Copper oxidases

C. Alkaline phosphatase

D. Creatine phosphokinase

E. Transaminases

57. Bradycardia was detected in a 30-year-old woman in labor in the first period of labor during
auscultation of fetal heart sounds. During the examination of the woman's cardiotocogram, a
decrease in heart rate to 90/min was found, the variability was monotonous (2 and less), late
decelerations with an amplitude of up to 50/min. Establish a diagnosis and determine obstetric
tactics in this case.

A. Fetal distress. Carrying out breeding

B. Normal state of the fetus. Further vethe day of childbirth through the natural genital tract

C. Fetal distress. Vacuum extraction of the fetus

D. Fetal distress. Urgent childbirth by caesarean section

E. Fetal distress. Operation of applying cavity obstetric forceps

58. Due to a violation of safety techniques while working with sources of ionizing radiation, the
worker was exposed to general radiation at a dose of about 8 Gy for an hour. What clinical form of

intestinal
radiation sickness will he develop? 024723

A. Acute promspev disease, intestinal form

B. acute radiation sickness, cerebral

36
C. radiation sickness, bone cancer: cerebral form

D. acute radiation sickness, toxemic form

E. chronic radiation sickness, bonecerebral form

59. A 16-year-old patient suddenly developed pain in the occipital region for the first time, flickering
"flies", one-time vomiting, which did not bring relief. Objectively - 160/110 mm Hg. art., pulse -
122/min, tense. Tendon reflexes are uniform. Angina tension. Accent I1 tone above the aorta. What
drug should be prescribed for the treatment of this patient?

A. 2% solution of Euphilin 3 mg/kg in 100 ml of isotonic sodium chloride solution IV

B. 1% Dibazol solution 0.1 ml/year of life in an isotonic solution of sodium chloride IV

C. Propranolol 2 mg IV drip in an isotonic solution of sodium chloride

D. 25% solution of magnesium sulfate 02 ml/kg in/m crisis

E. Nifedipine 20 mg sublingually
hypertensive
60. During the examination of the man who died at the scene of the accident, the doctor found on
the entire surface of his th of the back and partly on the side surfaces purple-purple spots on the
body, which fade when pressed and gradually regain their color after 5 minutes. What phenomenon
does the doctor observe?

A. Corpse cooling

B. Autolysis
cadaver spots
C. Corpse spots

D. Corpse incantation

E. Deadly drying
 In term
TndxatiM
61. A 28-year-old man complains of pain in the left lower limb for 6 months, intermittent lameness
that appears after walking 50-100 m, periodic night pains in the limb. During the examination, the
limb is pale, cold, arterial pulsation from the patient? essence on the shin. What is the probable
diagnosis in

A. Takayasu's disease

B. Raynaud's syndrome

C. Obliterating atherosclerosis

D. Femoral artery embolism

E. Obliterating endarteritis

62. The height of a ten-year-old boy is 129 cm, which is in the group below the average values of the
regression scale, body weight - 30.8 kg and OGK - 60.5 cm correspond to height. The number of
permanent teeth is 14 per socket. we are 1813. Annual height increase - 3 cm according to norms 4

i
6, VLDL - 1800 ml, muscular right hand strength - 16.5 and lazy – 024723 15.5 kg sons and daughters
Over the past year, perox ischevmonium. Assess the child's physical development if he is suffering
from chronic brosis

got"" A. Biological age lags behind the calendar age, physical development is low, harmonious, 4 load of
health physical

B. Biological age lags behind the calendar, monic, 3rd health group below-average development,
good

C. Biological age precedes the calendar, physical development is average, harmonious, 2 health group

D. Biological age corresponds to the calendar, physical development is low, disharmony , 4 health
group

E. Biological age according to the calendar, physical development below average, disharmonious, 3 rd
health group

63. A 32-year-old female patient works as a primary school teacher and undergoes a mandatory
preventive medical examination. It is known that there is an outbreak of measles in the region of
residence. The woman feels healthy. According to the preventive vaccination card, the patient has no
calendar violations, she received all the necessary vaccinations as a child. Her last vaccination against
diphtheria and tetanus was given at the age of 26, the last HAGI test - at 30 years old, without
reskinny During the physical examination, the following was found: body temperature - 37.2°С, pulse
- 80/min, blood pressure - 130/80 mm Hg. What a tactic in relation to this patient, it is advisable to
apply you?

A. Vaccination and screening are not required

B. Take a test for the human papilloma virus (HPV test)

C. Administer the ADS-M vaccine

D. Send for mammography

E. Determine the level of IgG to the measles virus

64. A 39-year-old patient complains of periodic headache, pulsating in nature, always on the left side,
more often before menstruation. What groups of drugs should be prescribed first?

A. Dexamethasone

B. Paracetamol

C. Valerian migraine
→ tiptars triplan
D. Antidepressants

E. Triptans
gunna
65. The mother of a twelve-year-old girl turned to a gynecologist to vaccinate the child against highly
oncogenic types of the human papilloma virus. 3 at what age is it advisable to perform this
vaccination!

A. 12-13 years old

B. 16-17 years old

C. 14-15 years old

D. 18-19 years old

E. 20-21 years

66. A 23-year-old patient has objectively. observed: skin is jaundiced, sclera is icteric, pulse

bbV. AT - 120180 mm rg. art., ALT, AST, thymolova the sample is the norm. Total bilirubin • μmolyl
due to indirect. For what pathology are these simitomas characteristic?

bilirubin
A. Chronic cryptogenic hepatitis

B. Cholestasis syndrome

C. Gilbert's syndrome ↑ unonyugaled

D. Liver cirrhosis

E. Chronic viral hepatitis C

67. The parents of an eight-year-old boy turned to the doctor with complaints about the child's
growth retardation. 3 history is known: born full-term, weighing 3100 g, body length 50 cm. Parents
of normal height. At the time of the boy's examination, the ratio of height to age = -3, weight is also
in the range < -2. "Bone age" is about 5 years old. Pathology from other organs and systems was not
detected. What research should be prescribed to the child to clarify the diagnosis?

A. Determination of the level of thyroid-stimulating hormone Well

 hormone
B. Determination of the level of somatotropic hormone

C. Determination of the level of gonadotropic hormone Well

growth
D. Determination of the level of luteinizing hormone Well

E. Determination of the level of adrenocorticotropic hormone

68. A 35-year-old woman complains that after SARS, heart failure, weight loss, pain in the front
surface of the skin began. Objectively observed: pulse 110/min, blood pressure - 130/60 mm Hg. st.,
thyroid the gonad is slightly enlarged, painful on palpation. Laboratory established: SHOV - 40 mm/h,
TSH - 0.05 mU/l, T4 34.3 pmol/l. What is the most likely diagnosis?

A. Subacute thyroiditis viral disease

B. Hashimoto's thyroiditis era
C. Acute thyroiditis

D. Diffuse toxic 30b

E. Paroxysmal tachycardia

69. A 48-year-old man complains of squeezing pain behind the sternum, which first appeared 1.5
hours after physical exertion and is not relieved by taking nitroglycerin. Objectively observed: HR -
75/min, BH - 16/min, BP 140/80 mm Hg. Art. During the ECG study, it was found that the ST segment
is shifted downward from the isoline by 1-2 mm in leads V4-V6. Determining the level of which
indicator will help diagnose the patient?

A. D-dimer

B. Sodium uretic peptide

C. Troponin
M1
D. KFC

70. A 31-year-old man was periodically treated for radiculitis of the lumbosacral spine for several
years. Over the past 2 years, pain has appeared in the joints of the upper and lower limbs, which
intensifies in the second half of the night. Objectively revealed: swelling of the knee joints,
tenderness during palpation of the lumbosacral spine, limitation of chest mobility during deep
breathing. In connection with the suspicion of ankylosing spondylitis, an X-ray of the spine and pelvic
bones was prescribed. What are the most likely changes on the x-ray genogram?

A. Narrowing of the joint space, osteophytosis

B. Bilateral sacroiliitis

C. Numerous brush-like enlightenments

D. Expansion of joint spaces, subchondral sclerosis

E. Osteoporosis, wear of the articular surface

71. The workplace of the proofreader is equipped with a desk and a chair with adjustable seat and
back parameters. His working day is 8 hours, the level of 96% of the working day. The development
of which occupational disease is possible in corector?

A. Varicose veins
→ Proofreader ↑
C. Mionii →
myopia
B. Coordinator neurosis

screen
time
D. Osteochondrosis

E. Ischemic heart disease

72. A 67-year-old woman turned to the doctor with complaints about a neoplasm in the upper part
of the left mammary gland, which she discovered by accident. The patient was referred for
mammography and ultrasound of the mammary glands. During mammography, a high-density
formation with heavy contours and polymorphic microcalcifications was detected in the upper-outer
quadrant of the gland. During the ultrasound, hyperechoic formation of vertical orientation with
uneven, indistinct contours and a 2.5 cm axillary lymph node with a structural violation were
revealed. Make a diagnosis.

A. Benign tumor with lesion of lymph fovezla

B. A malignant tumor with a metastatic lymph node

C. Hamartoma with lymph node damage

D. Fibroadenoma with attenuation

E. Oleogranuloma

73. A 25-year-old pregnant woman was sent to the inpatient department for treatment. In the
anamnesis - 2 spontaneous miscarriages. During the examination, a pregnancy of 14 15 weeks was
detected. 10 024723 Univ. It is observed vaginally: the cervix is shortened, with a prop. mak tip of the
finger, edoslannost, magno: skaiko-cervical insufficiency. Which one doctor's tick in this case?

A. Place a circular suture on the cervix

B. Do not wait for spontaneous abortion to occur, administer uterotonic drugs

C. to carry out hormonal treatment

D. Perform an amniocentesis and terminate the pregnancy

E. Bed rest with the appointment of sedatives

74. A 45-year-old man consulted a doctor after reporting a case active tuberculosis in a colleague
with whom he works in one office space. There are no complaints. After a tubercle test, the size of
the papule is 14 mm. There is no data on the result of the previous test. What doctor's tactics are the
most appropriate in this case?

A. Repeated tuberculin test in a week

B. X-ray of chest organs

C. Sputum sampling for the detection of tuberculosis mycobacteria

D. Appointment of isoniazid, rifampicin and stanbutol

E. Quarantine for 3 months

75. 2 days after eating cold food, the man complained of a sharp pain in the throat and throat.
Breathing is noisy, BH - 26/min, body temperature 39°С. According to the results of laryngoscopy: the
glottis cannot be seen, it is covered by swollen tissues. What urgent medical measures should be
taken You?

A. Administration of antispasmodics

B. Artificial oxygen ventilation

C. Detoxification therapy

D. Tracheostomy

E. Intravenous administration of hormones

76. An eight-year-old girl complains of pain in the peri-umbilical region, which appears in the
morning on an empty stomach. Gastroduodenitis associated with N. plori was diagnosed. What drugs
are part of H. pylori eradication therapy?

A. Pantoprazole, clarithromycin, metronidzOl

B. Aluminum phosphate, famotidine, metronidazole

C. Colloidal bismuth subcitrate, prifinia bromide, azithromycin

D. Mebeverin, furazolidone, omeprazole

E. Trimebutin, roxithromycin, ranitidine

77. A woman with coronary artery disease has weekly attacks of palpitation, shortness of breath,
peworkers in the work of the heart. On the ECG during the attack "it is observed that the R-R
intervals have different durations, P waves are absent, hoils [, aub-ts have different amplitudes. B -
38% was found on echocardiography. The prescribed treatment regimen (amiodarone, warfarin).
Which of the following indicators in this case requires constant monitoring?

A. The level of platelets in. Fibrinogen level

B. Hemoglobin

C. Prothrombin index

D. International normalized ratio shen

78. A pregnant woman (20 weeks pregnant) who was diagnosed with acute gonorrhea turned to a
gynecologist. Which drug from the following pennies? should be used for the treatment of this pa

A. Biseptol

B. Streptomycin

C. Treatment with antibiotics should be carried out after gave birth

sale during pregnancy

D. Benzylpenipilin -

E. Tetracycline

79. A 34-year-old man was referred to the neurology department with complaints of intense
headache, diplopia when looking straight ahead, photophobia. Got sick acutely, the attack occurred
during sleep hey Objectively observed: deafness, moderate divergent strabismus, diplonia. Positive
Kernig symptoms on both sides. There are no paresis. Liquor is hemorrhagic. What medicine should
be prescribed for first?

A. Heparin

B. Nicotinic acid

C. Plutamic acid

D. Acetylsalicylic acid

E. is-aminocaproic acid
anticoagulant
80. A 58-year-old man is bothered by frequent dizziness, weakness, lost 14 kg in 2 months. 3 history
is known about transferred tuberculosis. Objectively established: increased skin pigmentation, body
weight deficit - 10 kg, blood pressure - 90/55 mm Hg. Art. In the general blood analysis, it was
revealed but: Not - 117 mmol/l, K+ _ 64 mmol/1, CI- - 116 mmol/l, [HCO5] - 27 meq/l, glucose 2.9
mmol/l. What is the likely diagnosis?

A. Chronic kidney failure

B. Thrombosis of renal veins

C. Adrenal insufficiency

D. Goodnascher's syndrome

E. ACTH-secreting tumor
81. A patient suffering from chronic kidney disease complained of rapid fatigue, sleep disturbances,
nausea, itching during the last month skin Objectively observed: consciousness is inhibited, the skin
is pale, the face is puffy. During auscultation of the heart, the following are observed: arrhythmic,
dull sounds, heart rate - 105/min, blood pressure - 170/100 mm Hg. Art. During the auscultation of
the lungs, he observes the 4-point crisis: but: creatinine - 0.65 mmol/l. What level of glomerular
filtration rate is an indication for replacement therapy?

A. 35 ml/min

disease
renal
B. 20 ml/min

C. 25 ml/min
stage CKD
D. 30 ml/min
→ End 5
E. 15 ml/min
stage
82. The general condition of a three-year-old child against the background of purulent otu-tu has
sharply worsened, the body temperature is 38.5°С. The left lower limb is brought to the trunk, there
are no active movements, the lower third of the thigh and the knee joint are thickened, hyperemic.
Axial load causes sharp restlessness. Establish the most likely diagnosis.

A. Fracture of the left hip

B. Left-sided epiphyseal osteomyelitis

C. Osteogenic sarcoma

D. Hygroma of the popliteal fossa

E. Rheumatoid arthritis

83. A 52-year-old man complained of difficulty in walking, sudden weakness and numbness in the left
limbs. Objectively, left-sided hemiplegia and mild hemiparesis were noted. After 4 hours, the man's
condition normalized, focal symptoms regressed, the patient was able to not enough to walk Blood
pressure - 120/80 mm Hg. Art. Which probable diagnosis?

A. Transient ischemic attack

B. Hertensive crisis

C. Ischemic stroke

D. Associated migraine

E. Hemorrhagic stroke

84. A 27-year-old woman in labor at 38-39 weeks of pregnancy was hospitalized in the post-hospital
department due to bloody discharge from the genital tract, which appeared with the onset of labor.
Blood loss was 90 ml. The general condition of the patient is satisfactory, blood pressure - 110/70
mm Hg. Art. During the vaginal examination, the following is observed: the neck of the baby is
rotated to 0.5 cm, open the diameter of the cervix is 3 cm, in front and to the right of the presenting
head, spongy tissue with an uneven surface is defined, which reaches the inner eye of the cervix. The
amniotic sac is intact. After the examination, the bleeding became more intense. What is the most
likely diagnosis?

A. Lateral placenta previa

B. Exfoliation normally located placenta

C. Corners of varicose veins of the vagina

D. Marginal placenta previa

E. Central placenta previa

85. A 50-year-old woman was hospitalized with complaints of palpitations, interruptions in work
heart, dizziness, shortness of breath, causing in the morning During the examination, the following is
observed: the condition is severe, the skin is pale, the extremities are cold. Pulse - 150/min, small
filled blood pressure - 80/50 mm Hg. Art. Tones of the heart sent bleni, arrhythmia. The ECG
revealed: the P wave is absent, f-waves, R-R intervals are different. Which one heart rhythm
- -

disturbance developed in pashanties?

A. Extrasystole

B. Ventricular tachycardia

C. Ventricular fibrillation

D. Atrial fibrillation

E. Supraventricular tachycardia

86. A six-year-old child with anemic and hemorrhagic syndromes According to the results of general
analysis blood lysis is observed: Hb - 80 g/l. CP - 0.9. reticulopites - 2 oo, Leukocytes 1.0-10°/l,
thrombocytes - 10:10°/l. For which Are the following research results characteristic of the disease?

A. Thrombocytoses in Iron deficiency anemia

B. Lymphoblastic leukemia
cells ↓
C. Thrombocytolenic purpura

D. Aplastic anemia
all
87. A 38-year-old man consulted a doctor with complaints of pain and disc fort behind the sternum,
which last for hum of the last 4 hours. The symptoms appeared after dinner, the pain sometimes
increases and then subsides, the patient does not note the irradiation in the left shoulder blade and
hand. 3, it is known from the anamnesis that the patient's father died at the age of 55 due to an
acute myocardial infarction. Objectively observed: body temperature 373°C, blood pressure - 138/85
mm Hg: st., pulse - 115/min, BH 16/min. During auscultation, the vezicular breathing. An ECG
revealed a sonowl tachycardia. Previously, the patient took 3 tablets of nitroglycerin with an interval
of 5 minutes and aspirin, which improved his condition. What are the further tactics in the
management of this patient?

A. Carry out a test with physical load yum

B. Determination of cardiac biomarkers (CFC-MV, troponin I, N-terminal sodium peptide rhetic

hormone)

MI
C. Give the patient a pain reliever

D. Chest CT and FIDS E. X-ray with barium mixture

88. A 27-year-old patient for 5 years was treated for NVC. Cholonik zvsrnur-sky complaints of
pronounced pain live. n, which appeared 3 hours ago, the gas does not go away. holing Objectively
observed: dry honk, stomach does not participate in the act of breathing, positive symptoms of
peritoneal irritation. Pulse - 120/min. Set the probable diagnosis.

A. Acute gastrointestinal bleeding

B. Intussusception of the colon

C. Mechanical intestinal obstruction

D. Perforation of the colon. Peritonitis

E. Acute appendicitis

89. A 25-year-old woman was prescribed an antibiotic due to bacterial tonsillitis, which she did not
take. After 2 weeks, swelling of the face, oliguria appeared, blood pressure rose Laboratory revealed:
blood creatinine - 340 μmol/l, urea - 42 mmol/l. Which one Has the patient developed a
complication?

A. Acute glomerulonephritis, nephrotic

B. Acute homerulonephritis, arterial hypertension

C. Chronic glomerulonephritis, chronic kidney failure

D. Acute glomerulonephritis, nephritic syndrome

E. Acute glomerulonephritis, acute renal insufficiency

90. What is the name of this type of combined action, in which the combined effect is less than the
sum of the effects of each of the substances included in the combination, in the case of their isolated
action on the organism?

A. Complex action

B. Combined action

C. Potentiation
D. Antagonism

E. Isolated action

91. The mother of an eight-month-old boy complains of abdominal distension in the child, abundant,
foamy stools 3-4 times a day with an unpleasant smell, weight loss. During the examination, the
child's skin is pale and dry, an increase in the volume of the stomach, hepatomegaly is determined.
Anemia in the general blood test. In the biochemical study of the blood - hypoproteinemia,
hypoalbuminemia, a decrease in cholesterol, total lipids and a-lipoproteins. Establish a diagnosis
based on the results of the study.

A. Crohn's disease

B. Intestinal form of cystic fibrosis

iifngst digestive-1 Hepatomegaly system

C. Ulcerative enteritis

D. Lactose deficiency
malabsorption
E. Celiac disease

92. A 20-year-old woman is being treated for anemia (hemoglobin - 72 g/l). 3 anamnesis is known to
be due one and a half years ago At 16 weeks of pregnancy, she had an involuntary miscarriage and
significant blood loss. The patient notes that after this she observes a decrease in memory, fatigue,
loss of appetite, dry skin, brittle nails, fatigue, menstrual dysfunction. Objectively established: BP =
80/55 mm Hg century, pulse - 54/min, height = 168 cm, weight 48 kg, genital hypoplasia. Which of
the following drugs should be prescribed for this patient?

A. Methotrexate

B. Human immunoglobulin is normal

C. Meropenem

D. Metronidazole

E. Hydrocortisone

93. A 25-year-old woman complains of weight loss, nausea, difficulty breathing, because lower
abdominal pain that occurred two months after medical termination of pregnancy. During the
bimanual examination, it was established: the uterus is slightly enlarged, dense, with limited
mobility, the appendages are unchanged. What hormones must be determined for differential
diagnosis?
disease
A. Testosterone

B. Thyroid hormones
gestational Trophoblast
C. Progesterone

D. Chorionic gonadotropin
E. Cortisol

94. The mother of a five-year-old child consulted a gynecologist about the girl's burning sensation in
the vagina and severe itching. 3. It is known from the anamnesis that the child took antibiotics for
the treatment of pneumonia. During the examination, it was found: hyperemia and swelling of the
vulva, thick, white, cheesy secretions odorless. What complication arose in girls?
Bad
A. Gonorrheal vulvovaginitis
antibiotics → good -1
a death
B. Trichomonas vulvovaginitis Baden
↓
C. Bacterial vulvovaginitis

D. Bacterial vaginosis
organisms
pathogenic growing
E. Candida vulvovaginitis

95. After a long stay in the sun, an eight-year-old girl developed heat stroke of moderate severity. The
child is objectively observed: severe throbbing headache, hyperthermia up to 37.5°С, blood pressure
- 110/65 mm Hg. art., hyperemia of the skin, profuse sweating, irritability. What are the tactics of
treating a child?

A. Oral rehydration

B. Administration of seduxen solution 0.5 mg/kg intravenously

C. Oxygenotherania

D. Administration of prednisone solution 2 mg/kg in/m

E. Administration of a 2% solution of papaverine 1 mg/kg intravenously

96. Control of the international normalized ratio (INR) needs to be 13 in patients with atrial
fibrillation who are taking a drug from the group of anti-thrombotic agents. Specify this prepair

A. Clopidogrel (platelet ADP receptor blocker)

B. Dabigatran (direct thrombin inhibitor)

C. Aspirin (an inhibitor of the enzyme cyclooxygenases)

D. Warfarin (vitamin K antagonist)

E. Rivaroxaban (factor Xa inhibitors)

97. A mother with a 3.5-year-old child turned to a pediatrician. The child is sick for the 4th day, fever
in the range of 38.7-392°C. The disease began acutely with a dry cough. On the second day, the
disease appeared: face rot, photophobia and purulent bilateral conjunctivitis. On the fourth day,
against the background of a body temperature of 394°C, spotted-papular rashes appeared behind
the ears and on the face. Breathing through the nose is difficult, there are small mucous secretions in
the lower nasal passages. The family has a younger brother aged 7 months. What protective
measures should the family doctor recommend for this child?

A. Prescribe vitamin A 100,000 IU

B. Vaccinate against measles, rubella, and mumps (MMC)

C. It does not need prevention because Dimina is protected transplacentally

D. Perform an intramuscular injection of 1.5 ml of anti-tick immunoglobulin

E. Carry out chemoprophylaxis

98. A six-year-old child suffering from an exanthem infection, on the 8th day of the disease, the body
temperature rose again to 39.6°С, a headache, vomiting appeared, a shaky gait, slurred speech were
observed. During the examination, residual elements of the rash (crusts), ataxia, disco-ordination of
movements, tremor of the limbs, horizontal nystagmus, instability in the Romberg position were
revealed. Specify the drug of choice for treatment the arrangement that arose in the child.

Post infectious
A. Adiclovir

B. Oseltamivir
tis
C. Zanamivir
cere beth
D. Varicella-zoster immunoglobulin

E. Ribavirin

99. A ten-year-old boy complains of pain and swelling of the knee joints, morning stiffness > 30
minutes, subfebrile body temperature, general weakness. During the examination, it was found: the
knee joints were deformed, warm to the touch, impaired motor activity of the affected joints.
Previous diagnosis: juvenile rheumatoid arthritis Specify the specific indicator of this condition illness

idiopathic
A. Halving of antibodies to modified citrullinated vimenchin (anti-MCV to SA-antigen)

B. Increase in the level of C-reactive protein Well

Juvenilearthritis
C. Dysproteinemia, decrease in albumin content, hyperglobulinemia

D. Increase in the level of rheumatoid factor

E. Increased content of circulating immune complexes (CIK)

100. A woman with complaints of sharp pains was hospitalized in a gynecological hospital lower
abdomen, dizziness. 3 anamnesis it is known: the last menstruation was 6 weeks ago. Objectively
observed: pale skin, blood pressure - 80/60 mm Hg. art., pulse 94/min. Symptom of peritoneal
irritation positive in the lower departments. It was established bimanually: the uterus is slightly
enlarged, the appendages are enlarged on the right, painful. Promtov's positive symptom. Establish a
probable diagnosis.

A. Torsion of the pedicle of the cyst of the right ovary

B. Ovarian apoplexy

C. Acute adnexitis

D. Violated ectopic pregnancy

E. Rupture of the cyst of the right ovary

101. The family doctor determines the presence of harmful factors in the patient and carries out
preventive work in relation to them. What kind of medical prevention is this?

A. Dolikarska

B. Tretinna

C. Social

D. Secondary

E. Primary

102. The patient complains of a sharp pain in the right throat radiating to the left ear, inability to
open the mouth, an increase in body temperature up to 40°C. Objectively observed: pronounced
trismus of masticatory muscles, asymmetry to the right, left palatine tonsil hyperemic, shifted to the
middle of the oropharynx, tongue shifted to the left. Bad breath. Hypersalivation. The maxillary
lymph nodes on the right are enlarged, painful during palpation. Rhinoscopic and otoscopic pictures
are normal. Make a diagnosis.

A. Right-sided paratonsillar abscess

B. Tumor of the right palatine tonsil

C. Subcleft lymphadenitis on the right

D. Right-sided parapharyngeal abscess

E. Right-sided sialoadenitis

103. A 35-year-old patient is in the intensive care unit for the fourth day after bleeding and
hemorrhagic shock. Daily diuresis - 50 ml. The second day is marked by vomiting. CVT -159 mm of
water Art., during auscultation in the lungs for the last 3 hours, isolated sounds are noted gentle
wheezing, BH - 32/kh. 30 szulchata. but laboratory analysis of blood revealed: 82 mmol/l, K* - 7
residual nitrogen o mmol/d, SG- - 78 mmol/l, Nat – 130 mmol/l, NI - 0.32, NH - 100g/l, blood
creatinine - 0.9 mmol/l. What are the complications? more likely developed in the patient?

A. Acute heart failure

B. Dehydration due to hypovolemia

C. Acute renal failure

D. Pneumonia
E. Acute adrenal insufficiency

104. An 18-year-old girl turned to her family doctor to choose a contraceptive method. Sexual
development corresponds to age. Height 150 cm, weight 75 kg. One sexual partner. Menarche from
the age of 14. Man. the jet cycle is not regular, there are delays of up to 3 months. The patient has
excessive growth of hair on the thighs, acne on the navel and forehead. What method of
contraception is most appropriate for this girl?

A. Fertility recognition methods based on the ovulation calendar

B. Intrauterine contraceptives

C. The method of lactational amenorrhea ✗

COS
D. Combined oral contraceptives (COOK)

E. Progestogen injectable contraceptives

105. An 18-month-old child has baldness on the back of the head, restless sleep, and increased
sweating. What disease is likely in the baby?

A. Chondrodystrophy

B. Phosphate-diabetes

C. Anemia

Rickets
D. Spasmophilia

E. Paxin

106. A boy suffering from hemophilia A developed pain in the knee joint 7 hours after the injury.
Objectively observed: the joint has increased in size, the skin over it is hyperemic, hot to the touch,
movements in the knee are sharply limited. What is needed appoint a boy first?

A. Puncture of the joint

B. Administration of cicinone

C. Introduction of E-ACC

D. Introduction of vikasol

E. Introduction of cryoprecipitate ^

107. On the second day after thyroidectomy, the patient developed convulsions. What treatment
does she need first of all?

A. Magnesium Ve+ potassium internally024723

B. Intravenous administration of 40% solution of glucose

6+2↓
Secondary Hypo parathyroids
sm →
 Thyroid fugeysoemoualofparathywidalo
C. Ketamine intravenously
commonly
D. Intravenous administration of 10% cal" Cion of chloride

E. Intravenous administration of potassium chloride

108. A 40-year-old patient was operated on for phlegmon of the lumbar di-foam. After the operation,
his body temperature rose sharply to 38°C, signs of intoxication appeared, and the number of
leukocytes in the blood increased. Pale granulations filled with purulent contents appeared in the
postoperative wound at the site of necrotic tissue. What complication did the patient have?

A. Repeated phlegmon

B. Putrefactive phlegmon

C. Allergic reaction

D. Sepsis

E. Besichov's inflammation

109. On the 8th day of a newborn's life a boy with a body weight of 3500 g had an elevated body
temperature and a rash. The mother reported that the child was healthy, did not take any
medication, but the day before, she became irritable and had a subfebrile temperature that gradually
increased. Objectively observed: body temperature - 38.9°C, blood pressure - 90/50 mm Hg. art.,
pulse - 160/min, BH - 17/min, Sp02 - 98% in room air. During the examination, a rash in the form of
blisters that burst easily was revealed. The rash occupies 60% of the body surface, is present around
the mouth, but not on the mucous membranes. Positive simit of Nikolsky. What is the likely
diagnosis?

A. Acute urticaria

B. Stevens-Johnson syndrome

É[ dermatitis
C. Congenital chicken pox

D. Ritter's syndrome → exlolalwe

E. Toxic epidermal necrolysis

110. A woman turned to a doctor with complaints of bloody discharge from the vagina, pain in the
lower back. The last menstruation was 2.5 months ago. During the objective examination, the
following is observed: the cervix is cyanotic, dilated, the external eye is located eccentrically, the
uterus is enlarged up to 5 weeks of pregnancy (hourglass), the appendages on both sides are not
palpable, the discharge from the cervical canal is bloody, insignificant. What pathology is likely in the
patient?

A. Cervical cancer

B. Cervical pregnancy
C. Myoma of the cervix

D. Polyp of the cervical canal

E. Submucosal myomatous node, What is born

111, a 55-year-old patient turned to the family doctor with complaints of a non-productive cough,
mainly in the morning. 3 anamit is not known that he has been smoking for 20 years. For the past 2-3
years, he has been experiencing shortness of breath during physical exertion. What spirometric
indicators found in the patient will confirm the diagnosis of chronic obstructive lung disease?

A. Reduction of FEV1 < 80% and reduction FEV1/FJEL < 0.7

B. Reduction of VL < 80% and reduction OfB1/FZHEL < 0.9

C. Magnification ZHEL and magnification FEV1/FJEL > 08

D. 3increase in FEV1 > 12% and/or ≤ 200 ml after taking a bronchodilator

E. Increase in FEV1 > 10% and/or < 150 ml after taking a bronchodilator

112. A 38-year-old patient has been working on a construction site with a jackhammer for 8 years.
Complains of sharp pain in the shoulder girdle, especially at night, numbness of the fingers in case of
cooling. Objectively established: the hands are swollen, cold, cynotic, sharply reduced all types of
sensitivity (pain, temperature, vibration). Under the time of the cold test is a symptom "dead
fingers". There is weakness in the adductor muscles of the V finger, the electrical excitability of the
muscles of the hands has changed. Dura-venous and periosteal reflexes are present. What is the
previous diagnosis?

→ limited to hands
A. Vibration disease of local effect

B. Vibrational polyneuropathy only

C. Nodular periarteritis

D. Vibration disease of the general tion

E. Raynaud's syndrome

113. A 48-year-old patient with arterial hypertension suddenly developed dizziness, pain in the
occipital region, nausea and photophobia. Objectively observed: sopor, facial hyperemia, AT -
190/100 mm Hg. st., pulse - 70/min, temperature body temperature 36.8°С. Horizontal no-stagm.
Tendon reflexes - without a clear difference of sides, strengthened. Rigidity of the occipital muscles -
4 transverse fingers, bilateral Kernig sign (+). What is the previous diagnosis?

A. Acute hypertensive encephalopathy

B. Subarachnoid hemorrhage

C. Brain abscess

D. Hypertensive stroke-hematoma
E. Subdural hematoma

114. The mother of a six-year-old boy complains of an increase in body temperature in the
temperatures up to 37.9°C, wet, unproductive cough, inspiratory shortness of breath during exercise,
general weakness. 3 in the anamnesis, it is known that he became acutely ill 3 days ago, after contact
with his sister, who was sick with GRI. During the examination, the pediatrician diagnosed out-of-
hospital bilateral focal pneumonia, PI degree of severity, acute course, uncomplicated form, DAYS of
knocking. What antibacterial agent should be prescribed to the child

A. Cephalosporins of the III generation

B. Cephalosporins of the II generation

C. Aminoglycosides

D. Amoxicillin

E. Makroltsi

115. During cleaning operations in the mine, the concentration of coal dust is 450 mg/m3 (PDA - 10
mg/m3). Development as What occupational disease of the respiratory organs is possible in the
miners of cleaning slaughter?

A. Anthracosis

B. Bisinosis

C. Allergic nasopharyngitis

D. Siderosis

E. Talkoza

116. A 56-year-old patient turned to a family doctor with complaints of general weakness, an
increase in body temperature to 38.5°C, cough with discharge of purulent sputum, slight shortness of
breath. Sick for three From the first day of clinical manifestations, he took amoxicillin-clavulanate,
but his condition did not improve. It is known from the anamnesis that the patient does not smoke,
has not taken antibiotics for the past six months, has been suffering from type 2 diabetes for five
years, and has been taking metformin. Objectively observed: blood pressure = 130/80 mm Hg. art.,
pulse - 85/min. B&H - 20/min. During the percussion of the lepercussive dulling was found sound in
the lower parts of the right lung, ausculatory over this area weakened vesicular breathing and fine
bubbling moist rales. 3 sides of other organs and systems were not identified by pathologists.
According to the results of the general blood analysis: neutrophilic leukocytosis with a shift of the
formula to the left. What are the next tactics of the family doctor?

A. Prescribe doxycycline

B. Send for consultation to an endocrinologist childbirth

C. Prescribe fluoroquinolone II-IV generation not

D. Prescribe first-generation cephalosporins

E. Increase dose amoxicillin clavulanate and add mucolytic agents

117. In a newborn on the fifth day life is marked by excessive bloating with contouring of intestinal
loops on the normal abdominal wall. Meconium passed after the enema. On the X-ray examination
of the abdominal organs, the expansion of the loops of the large intestine was revealed. What

invagination
developmental disability is likely in the child? 024723

Heo cecal
A. Portal hypertension

B. Intussusception of the intestine →

C. Stenosis of the ileum

118. A 27-year-old patient is stingy with a can of morning sickness for a sick guest the mother is
severely diagnosed with rheumatism, faculty high titer antenologically Rulikova: ka, in vimentin. Knee
erosions of the interphalangeal joints have been clinically detected. the bottom to appoint in this
case? days of initial basic treatment required

anti Rheumatic
modifying
A. Celecoxib

drugs
B. Xanthine oxidase inhibitors

C. Diclofenac
→ disease
D. Methotrexate DM ARD
119. A 17-year-old girl turned to a family doctor with complaints of frailty, constant fatigue,
irritability, excessive sleepiness, worsening of concentration, and worsening of twilight vision. He
considers his diet satisfactory, consumes bread and bakery, pasta and sausage products, canned
goods, sweets, coffee, non-alcoholic carbonated drinks. The daily diet actually does not contain hot
dishes, salads, fresh fruits and vegetables, natural fruit juices. During the examination of the girl, the
doctor drew attention to several bruises on the hands, knees, cyanosis of the nose, lips, nails, gums,
isolated petechial skin hemorrhages, paleness and dryness of the skin, pronounced hyperkeratosis of
the elbow joint, keratinization of hair follicles. What ingredients that caused the girl's complaints and
symptoms are lacking in the diet?

A. DiK vitamins

B. Bilkiv

C. CaiP

D. Vitamins A and C

E. Vitamins of group B
120. The daily diet of a 14-year-old girl contains vitamins: A - 1.5 mg Br I61.8 mg, B, - 2.0 mg, Vo = 2.0
mg; C - 20. E. During the medical examination, the following was observed: the body is of medium
weight, the physical development is normal, the biological age corresponds to that of the case, the
mucous membranes and the skin are free from the history of known, but often chlorinated,
respiratory and viral infections, after which there were small dot hemorrhages in the hair follicles.
eco (cuffs, rubber bands, belt). Symptoms How does hypovitaminosis persist in girls?

A. C-hypovitaminosis

B. B6 hypovitaminosis

C. A-hypovitaminosis

D. B, hypovitaminosis

E. V-hypovitaminosis

121. Women with a threat of premature birth At 32 weeks of pregnancy, prevention of respiratory
distress is carried out fetal syndrome. What drug is used in this case?

A. Progesterone

B. Ginipral village misoprostol

C. Dexamethasone

D. Oxytocin

122. A seven-month-old child was hospitalized for surgical removal 8 hours after the disease with
complaints of anxiety attacks, abdominal pain, and one-time vomiting. Objectively observed:
palpable tumor-like formation in the right half of the abdomen. During the rectal examination blood
was found in the form of "raspberry jelly". What disease can you assume?

A. Intussusception in. Aphid infestation

B. Enterocystoma

C. Abdominal tumor

D. Duplication of intestines

123. A 34-year-old female patient complains of severe headache and increased body temperature.
The disease arose acutely. Objectively observed: the eyelids are swollen, the skin on them is red, exo-
ophthalmos, restriction of eyeball movements. Set the previous diagosis.

A. Retrobulbar neuritis

B. Phlegmon of the orbit

C. Corneal ulcer

D. Eyelid abscess
oh
'YÑi→
E. Blepharitis

124. A three-month-old child with signs of rickets has Khvostek symptoms, Trousseau, Maslova. A day
ago, parents met watched for an attack of cyanosis, the child was not breathing, covered with sticky
sweat, but in one minute Lina exhaled loudly. After that, the condition normalized. What is the cause
of occurrence of the above symptoms of the disease child?

A. Increase in blood phosphorus level

B. An increase in the level of calcium in the blood

C. A decrease in the level of phosphorus in the blood

D. question of blood sodium level

E. Lowering the blood calcium level

125. The man has an above average body weight _ 29. Cory of the man's index of colon Indicate the
degree of obesity in the patient. 024723 17
overweight
25-30-5→ I
A. The third

B. Excess body weight

30-35 #
C. First

D. The fourth
to
→
→ HI
E. The second 3 5- -
above
yo
126. A 25-year-old woman was hospitalized in the gynecological department with complaints of an
increase in body temperature to 38.7°C, pain in the lower abdomen, purulent discharge from the
vagina. It is known from the anamnesis that you had an intrauterine spiral installed 6 years ago
During the vaginal examination, it was found: the cervix is cylindrical with signs of endocervicitis,
purulent discharge from the cervical canal, and the threads of the spiral are burning. The body of the
uterus is of normal size, painful. The appendages are painful on both sides. Parameters are free.
What is the most appropriate doctor's tactic in this case?
pelvic inflammatory
A. Hysteroscopy, antibiotic therapy DID →
B. Removal of the intrauterine spiral, antibiotic therapy
disease caused
C. Separate scraping of the uterus
of IUCD
D. Antibiotic terania Because
E. Analysis of vaginal secretions, antibiotics-cotherapy

127. A 45-year-old man was hospitalized in serious condition. It is known from the medical history
that he had pneumonia for 3 weeks before hospitalization. Objectively established: skin and mucous
 membranes of a dark earthy color, body temperature 38°C, shortness of breath at rest, breathing on
the left is sharply weakened. There is a cough with copious sputum. X-ray revealed darkening of the
left hemithorax. What is the most likely diagnosis?

A. Bronchitis

B. Pleural empyema

C. Lung tumor

D. Pneumonia

E. Pneumothorax

128. A family of three was hospitalized after consuming home-made canned fish. In patients with
manifested: impaired vision, fog before the eyes ma, inability to read small print. What is the
pathogenesis of nervous disorders is it safe for patients?

A. Development of hypocoagulation

Botulism
B. Increase in the release of acetylcholine synapse

C. Stimulation of adenylate cyclase synthesis

D. Blocking the release of acetylcholine in synapse

→
E. Demyelination of nerve fibers

129. In a three-year-old boy, the right half of the muscle increases during walking and running, which
decreases to normal sizes when lying down. Make a diagnosis.

A. Non-communicating hydrocele of the left testicle

B. Connective hydrocele of the right testicle

C. Phimosis of the right testicle

D. Paraphimosis

E. Orchiepididymitis

130. A 38-year-old woman developed clonic convulsions in the muscles of the right hand against the
background of clear consciousness, which spread to the right hand and lasted for several minutes.

r
During the examination of the patient after the attack, the following is observed: central right-sided
upper monoparesis. Specify the type of epileptic seizure will fall

A. Simple focal

B. Generalized absence

:&
aw C. Focal myoclonic

D. Focal motor with awareness (Jacksonian)

_
E. Generalized tonic-clonic

131. A man, a fisherman by profession, has been complaining of discomfort in the right
hypochondrium for the past few months, periodic episodes of diarrhea alternating with constipation,
and frequent rashes on the skin. Ultrasound of the abdominal organs revealed an increase in the
liver and head of the pancreas. Make a preliminary diagnosis.

A. Trichinellosis

B. Teniosis

C. Opisthorchosis

D. Ornithosis

E. Onchocerciasis

132. A six-month-old child's body temperature rose sharply to 39°C, vomiting, refusal to eat, and
shortterm tonic-clonic convulsions appeared. The child is tired, sleepy. Rigidity of the occiput
muscles, Kernig's symptoms, bursting of parietal tension were revealed. What laboratory-
instrumental examination should be carried out to verify the diagnosis?

A. MRI of the brain

B. Lumbar puncture

C. X-ray of the skull

D. Biochemical research of blood serum

E. Neurosonography

133. A 42-year-old man on the background of psychotraumatic circumstances (loss of job, wife's
illness), insomnia gradually appeared depression, depressed mood, decreased appetite. He lost
interest in everyday life, stopped coping with work, thoughts appeared about unwillingness to live.
What medicines should he be prescribed?

A. Anxiolytics

B. Neuroleptics

C. Antipsychotics

D. Antidepressants

E. Sleeping pills

134. A 19-year-old girl complains about 18 attacks of dysentery up to 4-5 times a week, no. chronic
attacks 1-2 times a week. 3 anamnesis is known about the presence of bronchi in the patient.
asthma, nasal polyposis, frequent sinusitis,He has been taking symbi for the past 5 years. court. It is
observed objectively: in-the leg. breathing is vesicular, weakened,isolated scattered dry whistling
rales. The addition of which of the following drugs can improve the control of the course of bronchial
asthma in this patient

+
napsdyposis
A. Montelukast

B. Desloratadine
→
asthma
C. Omalizumab

D. Delayed-release theophyllines

E. Systemic corticosteroids

135. A 45-year-old patient has been suffering from ankylosing spondylitis for 15 years. For the past
three years, he has noted pastiness of the face and swelling of the limbs. Objectively, it is observed:
the pose of a "beggar". According to the results of the x-ray examination, it was established: changes
in the thoracic and lumbar parts of the spine according to the "bamboo stick" type. During an
ultrasound of the heart, it was revealed: aortic regurgitation. In the general blood analysis, the
following is observed: No 106 g/l, leukocytes - 8.9 G/l, ESR 40 mm/hour Daily proteinuria - 9.6 g/d.

inflammatory
Blood creatinine - 230 μmol/l. What is the cause of the development of kidney failure?

A. Urinary stone disease

"
B. Pyelonephritis

C. Concomitant pathology of the heart

Chron ↓
D. Side effect of medicines

E. Kidney amyloidosis Amyloidosis

136. A 36-year-old woman consulted a doctor with complaints of general weakness, abdominal pain,
and jaundiced skin, which gradually increased over the past 3 months. The patient denies use Freser
noy area. During the laboratory examination of blood serum, it was found: total bilirubin - 64.5
μmol/l, direct - 22.7 μmol/d, AST - 822 units/l, ALT 1237 units/l, HBSAg - postoperatively, HBEAS.
positively. What tactics of treatment of this pa-puppy is the most appropriate? lamivudine

A. Vaccine for the prevention of hepatitis B

B. PEG-interferon a-2a

C. Specific immunoglobulin against the virus hepatitis B

D. The scrotum is normal in the family

137. A five-year-old girl was hospitalized after an electric shock. Child's condition It is extremely
difficult, the girl is unconscious. there is no independent breathing. During the test on the day of
cardiopulmonary resuscitation, waves of various shapes and amplitudes with a frequency of 320/min
are observed on the ECG, and the pulses on the peripheral and central arteries are abnormal. What is
the emergency treatment in this case?
A. Transfusion of crystalloids 10 mg/kg
ventricular
fibrillation
.

B.Electrical defibrillation

C. Administration of lidocaine solution 20 mg intravenously

D. Tracheal intubation

E. Direct heart massage

138. Child was born with a weight of 3800 g from the first physiological childbirth. A vesicle-head
appeared on the friend's side of the bed, the body temperature rose to 375°C, full of skin and hair.
The diagnosis was established: chicken pox. Until what age does a child chicken pox consideris it
congenital?

GPD
A. Until the 14th day

Ghat
B. Until 21 days

C. To b months

10h
D. Until the 30th day
day
&
E. Until 10 a.m

139. A 23-year-old female patient complains of dull pain in the right and left lumbar regions. During
the objective examination, there is a lump in the left hypochondrium and mesogastric area. there is a
painless, lumpy kidney of an elastic consistency, the right kidney is not palpable. During the
ultrasound, multiple clear hollow formations with schonenegative content in the parenchyma of the
right kidney, measuring from 1.2×1.7 cm to 2×2.5 cm, and similar formations in the parenchyma of
the left kidney, measuring 2.5×3.7 cm, were found, one of which is localized in the area of the lower
poles and has a size of 8.3x11.7 cm. Establish a probable diagnosis.

Bilaterofament
A. Multicystosis

B. Megacalycosis

C. Polycystic kidneys NO [
D. Solitary kidney cysts

E. Bilateral hydronephrosis

140. A 20-year-old female patient complains area, pain in the eyeballs, photophobia, muscle pain
and dry cough. Symptoms appeared 2 days ago. Objectively observed: the condition is severe, the
face is swollen, the mucous membrane of the oropharynx is hyperemo-vated, granular, the vessels
are dilated. Pulse 96/min, rhythmic, heart sounds are weak. On auscultation, scattered dry rales are
heard in the lungs. There are no meningeal symptoms. The general blood analysis revealed:
leukocytes - 3.10%, sosinophils - 1%, rod cells - 6%, segment cells - 51%, lymphocytes - 35%,
monocytes - 7%. Specify the probable diagnosis
A. Meningococcal infection

B. Pneumonia

C. Flu → influenza
D. Kio

E. Typhoid fever

141. During the preparation of the patient's treatment plan, a decision was made to use a medicinal
product with level of evidence A. What studies were used to obtain such evidence?

A. Description control" of research

B. Agreed opinions of experts

C. Based on the data of one large randomized clinical trial

D. Based on the data of many non-randomized studies

E. Based on the data of many randomized clinical trials

142. At 5 o'clock in the morning, a man had a the onset of severe pain behind the sternum, which
was driven by weakness and cold sweat. The ECG revealed: dome-shaped elevation of the ST
segment in leads II, III, avE, V5-V6. After the pain subsided, the ECG parameters returned to normal.
What is the probable diagnosis?

A. Acute myocardial infarction in the posterolateral area of the left ventricle

B. Pericarditis

C. Dilated cardiomyopathy

D. Myocarditis

E. Spontaneous angina of the Prinzmetal type

143. A 20-year-old woman in labor was hospitalized to the maternity hospital with regular social
activity. During the vaginal examination, the amniotic fluid was thickly stained with meconium. The
cervix is smoothed, opened up to 6 cm, the head of reaped to the entrance to the small pelvis,
heartbeat yes 190/min. What is the most likely diagnosis?

A. Weakness of labor activity

B. Fetal distress

C. Peeling of normally located placenta

D. Threat of uterine rupture

E. Excessive labor activity

144. A 64-year-old woman suffers from type 2 diabetes, receives hypoglycemic therapy: metformin
850 mg 3 times a day. Fasting pykemia - 7.8 mmol/l, two hours after eating - 10.5 mmol/l,
glycosylated hemoglobin - 8.7%. During the examination by an ophthalmologist, diabetic proliferative
retinopathy of the retina of both eyes was diagnosed. What are the further tactics of treatment?

A. Add glyClazid 160 mg per day

B. Add dapa-gliflozin 10 mg per day to hypoglycemic therapy

C. Transfer to insulin therapy

D. Do not change therapy

E. Increase the dose of metformin to 3,500 mg day

145. A 13-year-old girl complains of headache, dizziness, pulsation in the head, ringing in the ears,
periodic nosebleeds, palpitations, pain in the heart area, shortness of breath. During the
examination, the following is observed: pallor of the skin, weakening of the pulse on the femoral
arteries, blood pressure on the upper extremities - 125/60 mm Hg. st., on the lower ones - 110/60
mm Hg. Art. Auscultatively - loud systolic noise radiating in the carotid artery. What is the likely
diagnosis?

A. Defect of the interventricular membrane

B. Open ductus arteriosus

C. Stenosis of the aorta

D. Coarctation of the aorta

E. Stenosis of the mouth of the pulmonary artery

146. A 43-year-old patient was diagnosed with acute respiratory distress syndrome. Which indicator
should be focused on when assessing the degree of severity of this problem? illness?

A. Hemoglobin saturation arterial of blood

B. Displacement volume

C. Central venous pressure

D. Partial pressure of oxygen in arterial blood

E. Respiratory index

147. A 38-year-old man complains of spasm-like pains in the abdomen, nausea, belching, bloating,
flatulence, and no stool. From the anamnesis, it is known that the patient was recently operated on
for an abscess apenicitis Palpate stomach is painful in all departments, tense. There is a splashing
noise, vague symptoms of peritoneal irritation, hyperperistalsis. What is the previous diagnosis?
A. Zlukova intestinal obstruction

B. Gastric ulcer disease

C. Colon cancer

D. Diverticular colitis

E. Spilled peritonitis

148. A 67-year-old woman complains of weakness in her hands, a feeling of heaviness in her gah,
twitching in the muscles of the limbs. She fell ill about 10 months ago, when She noticed weakness in

pathological
her hands. Objectively observed: pronounced hypotrophy of the muscles of the upper limbs, diffuse
muscle fasciculations in the limbs, mainly in the hands. Decreased muscle strength in the upper limbs
up to 2 points. Muscle strength will be preserved in the legs. Deep reflexes on the limbs are
#
neurons
significantly increased, foot clonus on both sides. Pathological Babinski reflex on both sides.
Dysfunction of the pelvic organs, sensory and coordination disorders were not detected. Make a
diagnosis.

motor
neurodegenerati
affectingveweakness
A. Tuberculous meningitis

B. Syphilitic meningoencephalitis

C. Werdnig-Hoffman amyotrophy

D. Amyotrophic lateral sclerosis

→
disorder & hypertrophy
E. Myasthenia
mm +

149. A 35-year-old man turned to the doctor with complaints of a sharp weight gain of 27 kg over the
course of 2 years, weakness, hair loss on the head, and decreased potency. Objectively observed:
height - 174 cm, weight - 104 kg: Fat deposition mainly on the neck and trunk. The skin is dry, purple-
cyanotic in color. AT- 160/110 mm Hg. Art. An increase in the level of ACTH was detected during the
laboratory examination. On computer tomography -microadenoma hyphysical therapist What is the
most likely diagnosis?
npitelay → Cushing
A. Ishchenko-Cushing syndrome

B. Alimentary obesity
disease
C. Addison's disease

D. Hypertensive disease
adenoma→ Disease
E. Ishchenko-Cushing's disease

150. A 20-year-old patient complains of a headache, general weakness, and facial swelling in the
morning. 3 in the history it is known that 18 days ago he suffered acute tonsillitis. Objectively
observed: pale skin, swelling under the eyes, heart rate - 60/min, Blood pressure - 185/100 mm Hg.
Art. Pasternak's symptom Tskho is negative on both sides. The general analysis of urine revealed: the
-
color of "meat slops", protein =. 4.5 g/l, red blood cells neni - 40-45 in p/z, leukocytes - 5-6 in pz.
Daily diuresis is a common diagnosis.- 400 ml. Set the pop

A. Urinary stone disease

B. Systemic lupus erythematosus

C. Acute glomerulonephritis

D. Acute pyelonephritis

E. Amylosis of the kidneys