1
2002
1. A 24-year-old man on the 5th day of acute
respiratory disease with high grade temperature
started having strong headaches, systemic dizziness,
sensation of double vision, paresis of mimic muscles
to the right, tickling by swallowing. Diagnosis: Acute
viral encephalitis. Determine the basic direction of
the emergent therapy.
A. Glucocorticoids
B. Hemodesis
C. Zovirax
D. Cephtriaxon
E. Lasix
2. A 29-year-old woman has had a surgical treatment
concerning the benign serous epithelial tumour of the
ovary. The postoperative period passed without
complications.What is necessary to prescribe in the
rehabilitational period?
A. No further observation
B. Antibacterial therapy and adaptogens
C. Magnetic therapy and vitamin therapy
D. Laser therapy and enzyme therapy
E. Hormone therapy and proteolytic enzymes
3. A 54-year-old patient applied with complaints of
acute pain in the shoulder-joint. 10 minutes earlier he
fell in the street with his arms stretched. Doctor of
the traumatological unit noticed an acute deformation
of the right shoulder-joint, the impossibilty of active
movement in the right extremity.
Roentgenologically: uncoincidence of articulating
surfaces. What is the most probable diagnosis?
A. Dislocation of the scapula
B. Contusion of the humerus
C. Dislocation of the humerus
D. Dislocation of the clavicle
E. Fracture of the humerus
4. A 19-year-old woman complains of pain in the
abdomen and joints, asks for more analgetics and
somnifacient injections. The patient was examined.
Gynecological and urological pathologies are absent.
There are signs of previous punctures along
superficial veins of the extremities. The patient does
not explain the origin of punctures. Tendon reflexes
of upper and lower extremities are the same, quick.
Photoreaction of the pupil of the eye is weak. The
tongue is grey coated. During communication the
patient in affectively not even-tempered. There is
diarrhea without pathologic inclusions. What tactics
is necessary to improve the condition of this patient?
A. Consultation of an expert in narcology
B. Additional consultation of surgeon
C. Prescription of medications the patient asks for.
D. Treatment with antibiotics
E. Consultation of infectious diseases doctor
5. A 52-year-old woman suffering from obesity
complains of bloody discharges from sexual paths
during 4 days. Last normal menses were 2 years ago.
Histological investigation of biopsy of the
endometrium has revealed adenomatous hyperplasia.
What reason from the mentioned below caused the
development of disease?
A. The increased contents of follicle-stimulating
hormone
B. Poor aromatization of preandrogens due to
hypothyroidism
C. Excessive transformation of preandrogens from
adipose tissues
D. Hypersecretion of estrogens by tissues of the
organism
E. Supersecretion of androgens by the cortex of
paranephroses
6. A patient with nosocomial pneumonia has signs of
collapse. Which of the following pneumonia
complication is the most likely to be accompanied
with collapse?
A. Toxic hepatitis
B. Bronchial obstruction
C. Septic shock
D. Emphysema
E. Exudative pleuritis
7. A 20-year-old woman is having timed labor
continued for 4 hours. Light amniotic fluid came off.
The fetus head is pressed to the orifice in the small
pelvis. The anticipated fetus mass is 4000,0g ±
200,0g. Heartbeat of the fetus is normal. Intrinsic
examination: cervix is absent, disclosure - 2 cm, the
fetal membranes are not present. The head is in 1-st
plane of the pelvis, a sagittal suture is in the left
slanting dimension. What is the purpose of glucose-
calcium-hormone - vitaminized background
conduction?
A. Fetus hypoxia prophylaxes
B. Antenatal preparation
C. Treatment of weakness of labor activity.
D. Prophylaxes of weakness of labor activity
E. Labor stimulation
8. A 7-year-old girl suddenly fell ill with fever,
headache, severe sore throat, vomiting. Minute bright
red rash appeared on her ablushed skin in 3 hours. It
is more intensive in axillas and groin. Mucous
membrane of oropharynx is hyperemic. Greyish
patches are on tonsills. Submaxillary glands are
enlarged and painful. What is your diagnosis?
A. Enteroviral infection
 2
B. Scarlet fever
C. Pseudotuberculosis
D. Rubella
E. Measles
9. A 58-year-old patient was diagnosed basal-cell
skin cancer, 1st stage. Tumor is up to 1 cm in size
and with up to 0,5 cm deep infiltration in tissues.
Tumor is localized in the right nasolabial area.
Choose the most optimal method of treatment.
A. Long-distance roentgenotherapy
B. Chemotherapy
C. Surgical treatment
D. Long-distance gamma therapy
E. Short-distance roentgenotherapy
10. Thrombosis of the coronary artery caused
myocardial infarction. What mechanisms of injury
will be the dominating ones in this disease?
A. Lipid mechanisms
B. Calcium mechanisms
C. Protein mechanisms
D. Acidotic mechanisms
E. Electrolytoosmotic mechanisms
11. A 28-year-old man was discharged from the
hospital after having an out-of-hospital pneumonia.
He has no complaints. On physical exam: his
temperature is — 36,6°C, RR-18/min, Ps — 78 bpm,
BP — 120/80 mm Hg. During ausculation there is
harsh respiration to the right of the lower part of the
lung. Roentgenologically: infiltrative changes are
absent, intensification of the pulmonary picture to the
right in the lower lobe. How long should the doctor
keep the patient under observation?
A. 1 month
B. 3 months
C. 12 months
D. Permanently
E. 6 months
12. A 55-year-old patient complains of bloating and
rumbling in the abdomen, increased outgoing of
gasesfoamy liquid stool of acid odor. Symptoms
appear after eating of milk products. What is the
name of such symptom complex?
A. Acid dyspepsia syndrome
B. Adipose dyspepsia syndrome
C. Dyskinesia syndrome
D. Decaying dyspepsia syndrome
E. Malabsorbtion syndrome
13. A 27-year-old patient was admitted to the
psychiatric hospital for the 4-th time during 2 years.
He heard voices commenting on his actions, had
delusions of persecution (was sure that mafia wanted
to kill him). He was discharged from hospital with
the diagnosis of schizophrenia, state of remission
after a course of treatment with neuroleptics. What is
necessary to do to prevent relapses of schizophrenia?
A. Psychiatric observation
B. Participation in a self-assistance group
C. Long-term hospitalization
D. Psychoanalytic treatment
E. Supportive treatment with neuroleptics of
prolonged action
14. A woman in the first half of pregnancy was
brought to clinic by an ambulance. Term of
pregnancy is 36 weeks. She complains of intensive
pain in the epigastrium, had vomiting for 2 times.
Pain started after the patient had eaten vinaigrette.
Swelling of lower extremities. BP — 140/100 mm
Hg. Urine became curd after boiling. What is the
most probable diagnosis?
A. Dropsy of pregnant women
B. Exacerbation of pyelonephritis
C. Nephropathy of the 3rd degree
D. Preeclampsia
E. Food toxicoinfection
15. A 2-months-old child after preventive
vaccination had a prolonged hemorrhage from the
vaccination place and due to those an intramuscular
hematoma. During examination of the child a
considerable rise of prothrombin consumption and a
significant prolongation of the activated partial
thromboplastic time were found. What is the most
probable diagnosis?
A. Hemophilia
B. Werlhof's disease
C. Henoch-Schoenlein disease
D. Hemorrhagic disease of the neonate
E. Inborn afibrinogenemia
16. District physician was charged with plan drafting
concerning medical and preventive measures among
the population in the area he is assigned to. What
measures must he include in this plan as regards
primary prevention of illness?
A. Referral of patients to sanatorium
B. Measures to improve patients' life conditions
C. Prevention of disease onset
D. Prevention of disease complications
E. Measures to increase patients' life quality
17. A 27-year-old patient was brought to clinic with a
crashed wound of the posterior surface of the right
shin in 2 hours after the accident happened. During
surgical treatment pieces of dirty clothes and gravel
were removed. What actions from the given below
are the decisive ones to prevent an anaerobic
 3
infection?
A. Radical surgical treatment
B. Introduction of the medical dose of the anti-
gangrene serum
C. Rational antibiotic therapy
D. Hyperbaric oxygenation
E. Introduction of the preventive dose of an anti-
gangrene serum
18. A pupil of the 8th form after trauma has acute
atrophy of the left arm muscles, tonus of which is
distinctly decreased, active movements are only in
the left joint, pupil's foot is deformed. Function of
support of the left leg is absent; support function of
the right leg is preserved. The boy wears orthopedic
footwear. What group of physical training does the
boy belong to?
A. Preparatory
B. Additional
C. Other
D Special
E. Basic
19. The woman from a group of risk (chronic
pyelonephritis in anamnesis) had labor through
natural birth canal. In one day after labor she started
complaining of fever and loin pains, often urodynia.
Establish the most probable complication.
A. Apostatis of stitches after episiotomy
B. Endometritis
C. Infected hematoma
D. Thrombophlebitis of veins of the pelvis
E. infection contamination of the urinary system
20. A 18-year-old patient had subtotal strumectomy
due to malignant capillary cystadenoma of the
thyroid gland. In 2 months there was a suspicion of
metastasis presence in the lungs. What
rontgenological method is to be used first?
A. Bronchoscopy
B. Angiopneumonography
C. Roentgenoscopy of lungs
D. Bronchography
E. Roentgenography of lungs
21. During a period of 1 year 11 600 diseases were
registered in the clinic. Among them are: influenza
and acute respiratory disease - 5800, blood
circulatory system diseases — 34 800, digestion
organs diseases — 1300 and others-1020. What
relative index can be calculated according to this
data?
A. Extensive
B. Intensive
C. Relative intensity
D. Visual graphic
E. Correlation
22. A 12-year-old girl applied to doctor with
complaints of swelling on the front part of the neck.
The doctor diagnosed hyperplasia of the thyroid
gland of the second degree, euthyroidism. Ultrasound
suspected autoimmune thyroiditis. Blood was taken
for titre of antibodies to thyroglobulin. What titre of
antibodies will be diagnostically important?
A. 1:50
B. 1:100
C. 1:150
D. 1:200
E. 1:250
23. A 10-year-old child complains of fever
(temperature is 39°C), frequent painful urination
[pollakiuria]. Urine test: proteinuria [0,066 g/L],
leukocytouria [entirely within eyeshot], bacteriuria
[105 colony forming units/mL]. What is the most
probable diagnosis?
A. Acute glomerulonephritis
B. Acute cystitis
C. Dysmetabolic nephropathy
D. Acute pyelonephritis
E. Urolithiasis
24. Define the basic registration document on the
profound study of rate of cases with temporary loss
of ability to work on the industrial enterprise.
A. A card of the personal account of rate of cases
B. An ambulatory medical card
C. Sick-leave
D. Report of temporary loss of ability to work
E. An inpatient medical card
25. By the end of the 1st period of physiological
labor clear amniotic fluid came off. Contractions
lasted 35-40 sec every 4-5min. Heartbeat of the fetus
was 100 bpm. The BP was 140/90 mm Hg. What is
the most probable diagnosis?
A. Hydramnion
B. Premature detachment of normally posed placenta
C. Acute hypoxia of the fetus
D. Back occipital presentation
E. Premature labor
26. A 22-year-old man with polyarthralgia and high-
grade fever has right-sided exudative pleuritis.
Roentgenological, down to the right of the 4th rib
there is a homogeneous dark cloud. To the left, in the
second segment — an isolated dense-focused
shadow. Mantoux test with 2 TU: 16 mm papula. The
protein content in the pleural fluid is increased,
Rivalt reaction is positive, increased amount of
leucocytes with lymphocyte predomination. What is
 4
the most probable etiology of pleuritis?
A. Cancerous
B. Tuberculous
C. Viral
D. Autoimmune
E. Staphylococcal
27. A 38-year-old woman was hospitalized to the
surgical unit with acute abdominal pain irradiating to
the spine and vomiting. On laparocentesis
hemorrhagic fluid is obtained. What disease is
meant?
A. Renal colic
B. Acute appendicitis
C. Perforative gastric ulcer
D. Acute pancreatitis
E. Acute enterocolitis
28. A 7-year-old child is sick for 2 weeks with
running nose, was taking nasal drops. The boy
suffers with alimentary allergy. He applied to doctor
due to suppurative and bloody discharges from nose,
maceration of ala nasi and upper lip. Rhinoscopy
results: there are whitish-greyish areas at nasal
septum. Mucous membrane of oropharynx is not
changed. What is the most probable disease?
A. Allergic rhinitis
B. Sinusitis (maxillar sinus))
C. Rhinovirus
D. Diphtheria of the nose
E. Adenovirus
29. In 13 months after the first labor a 24-year-old
woman complains of amenorrhea. Cesarian section
was conducted as a result of premature detachment of
normally posed placenta. Hemorrhage has made low
fidelity of 2000 ml due to breakdown of coagulation
of blood. Choose the most suitable investigation.
A. Determination of the contents of testosteron-
depotum in blood serum.
B. Computer tomography of the head
C. Ultrasound of organs of a small pelvis
D. Progesteron test
E. Determination of the level oi gonadotropin
30. What information gathering method is preferable
to study housing conditions of medical students
during training period?
A. Materials selection
B. Statistical
C. Directed selection method
D. Interviewing
E. Questionnaire
31. A 36-year-old woman applied to doctor with
complaints of the enlargement of the right mammary
gland. On physical exam: the right mammarj gland is
enlarged, hardened; nipple with areola is pasty and
hydropic, looks like "lemon peel". There palpates a
lymph node in the right axilla, 1,5 cm in diameter,
dense consistence, not mobile. What is the most
probable diagnosis?
A. Erysipelatouslike cancer of the mammary gland
B. Paget's cancer
C. Diffusive mastopathy
D. Acute mastitis
E. Hydropic and infiltrative cancer of the mammary
gland
32. At the radiological unit of the hospital, gamma-
devices of radiotherapy of "Agaf'type and other
closed sources of ionizing radiation are used for
treatment of malignant neoplasms. What are the
measures to be taken to protect personnel at the time
of work with radioactive sources of such type?
A. Shortening of working time and screening of the
source
B. Capsulation of devices and organization of room
ventilation
C. Systematical cleansing of surfaces from the
radioactive contamination and shortening of working
time
D. The increase of distance to the source and
individual hygiene compliance
E. Screening of the source and the use of means of
individual protection of respiration organs
33. A 16-year-old adolescent was vaccinated with
DTP. In eight days there was stiffness and pain in the
joints, subfebrile temperature, urticarial skin
eruption, enlargement of inguinal, cervical lymph
nodes and spleen. What kind of allergic reaction is
observed?
A. Hypersensitivity of delayed type
B. Cytoxic
C-
D. Immunocomplex
E. Hypersensitivity of immediate type
34. The adolescent of 15 years old was brought to the
hospital with complaints of poor night eyesight. On
physical exam: increased darkness adaptation time,
Bitot's spots on conjunctiva. The patient skin is dry,
scales off; folliculitis signs of the face skin are
present. What is a cause of this disease?
A. Thiamine deficit
B. Biotin deficit
C. Retinole deficit
D. Folic acid deficit
E. Napthtochynones deficit
35. A 75-year-old patient can not tell the month, date
 5
and season of the year. After long deliberations she
manages to tell her name. She is in irritable and
dissatisfied mood. She always carries a bundle with
belongings with her, hides a parcel with bread, shoes
in her underwear in her bosom as well as "invaluable
books". What is the most probable diagnosis?
A. Behavior disorder
B. Presenile melancholia
C. Atherosclerotic(lacunar) dementia
D. Senile dementia
E. Dissociated personality (psychopathy)
36. A 27-year-old woman was admitted to clinic with
complaints of pain in right ankle joint, impossibility
to stand on those extremity. Clinical examination: the
patient had a fracture of anterior part of distal
metaepiphisis of tibia [Pott-Desto's fracture]. What is
the mechanism of such injury?
A. Load along the axis with planter flexion of foot
B. Direct blow
C. Load along the axis with dorsal flexion of foot
D. Supination of the foot
E. Pronation of the foot
37. A 32-year-old in-patient with the diagnosis of
"acute abscess of the right lung "after cough had
developed sudden difficult breathing, cyanosis. There
is pain in the right half of thorax. What is the most
probable complication that is observed in the patient?
A. Embolic pneumonia
B. Pyopneumothorax
C. Perforation of the esophagus
D. Myocardial infarction
E. Exudative pleurisy
38. A 62-year-old patient is having NI-DDM.
Diabetes is being compensated by diet and
Maninilum. The patient has to be operated for
inguinal hernia. What is the tactics of hypoglycemic
therapy?
A. To prescribe Glurenorm instead of Maninilum.
B. To continue current therapy
C. To prescribe guanyl guanidines
D. To prescribe short-acting insulin
E. To prescribe long-acting insulin
39. A 58-year-old woman complains of
osteoarthrosis of knee-joint. For 2 weeks she had
been receiving an in-patient medical treatment. She
was discharged from the hospital in satisfactory
condition with complaints of minor pain after
prolonged static work. Local hyperemia and
exudative effects in the area of joints are absent.
What further tactics is the most expedient?
A. Orthopedist consultation
B. Refferral to MSEC
C. Outpatient treatment
D. Repeated in-patient treatment
E. Conducting arthroscopy
40. A woman is admitted to maternity home with
discontinued labor activity and slight bloody
discharges from vagina. The condition is severe, the
skin is pale, consciousness is confused. BP is 80/40
mm Hg. Heartbeat of the fetus is not heard. There
was a Cesarian section a year ago. Could you please
determine the diagnosis?
A. Premature expulsion of amniotic fluid
B. Placental presentation
C. Hysterorrhesis
D. Expulsion of the mucous plug from cervix uteri
E. Cord presentation
41. A 36-year-old woman is on the 12-th week of her
first pregnancy. In the past history she had undergone
treatment for infertility. Recently she visited guests
and contacted a child who developed rubella in 2
days after meeting. The woman doesn't remember
whether she was infected with rubella or not. What is
the adequate tactics?
A. Cyclovin administration
B. Immune globulin injection
C. Interruption of the pregnancy
D. Interferon administration
E. Monitoring of the specific Ig G Ig M with the
enzyme-linked immunosorbent assay (ELISA)
42. A 37-year-old patient was brought to
resuscitation unit. General condition of the patient is
very serious. Sopor. The skin is grey, moist. Turgor
is decreased. Pulse is rapid, intense. BP — 160/110
mm Hg, muscle tonus is increased. Hyperreflexia.
There is an ammonia odor in the air. What is the
presumptive diagnosis?
A. Hyperglycemic coma
B. Uraemic coma
C. Alcoholic coma
D. Hypoglycemic coma
E. Cerebral coma
43. A patient complains of pathological mass in the
right inguinal part during physical work. The mass is
round; about 4 cm in diameter, during palpation is of
soft and elastic consistence, located at the medial part
of the inguinal ligament. This mass is situated medial
to seminal funiculus. What is the preliminary
diagnosis?
A. Right-sided direct inguinal hernia
B. Right-sided femoral hernia
C. Lipoma of the right inguinal part
D. Varicose veins of the right thigh
E. Right-sided indirect inguinal hernia
 6
44. After a wasp-bite there was an itching of skin,
hoarse voice, barking cough, anxiety. On physical
exam: there is edema of lips, eyelids, cyanosis. What
medicine is to be taken first?
A. Prednisolone
B. Adrenalin
C. Euphylin
D. Lasix
E. Seduxen
45. A 75-year-old man who developed diabetes
within the last six months was found to be jaundiced.
He was an asymptomatic patient except weight loss
of 5 kg in 6 months. On physical examination,
nontender, globular, right upper quadrant mass that
moves with respiration. Abdominal computed
tomography (ACT) scan shows an enlargement of the
head of the pancreas, with no filling defects in the
liver. What can be diagnosed?
A. Carcinoma of the head of the pancreas
B. Metastatic disease of liver
C. Haemolytic jaundice
D. Malignant biliary stricture
E. Infectious hepatitis
46. A 42-year-old man died in a road accident after
the hemorrhage on the place due to acute
hemorrhagic shock. What minimum percent of all
blood volume could cause the death?
A. 35-50%
B. 25-30%
C. 6-9%
D. 15-20%
E. 10-14%
47. A 26-year-old woman gave birth to a child 6
months ago. She applied to gynecologist complaining
of menstruation absence. The child is breast-fed.
Vagina exam: uterus is of normal form, dense
consistence. What is the most probable diagnosis?
A. Physiological amenorrhea
B. Sheehan's syndrome
C. Pseudoamenorrhea
D. Gestation
E. Asherman's syndrome
48. District physician was charged with plan
preparation concerning the conducting of medical
and preventive measures among the population in the
area he is assigned to. What measures must he
include in this plan as regards secondary prevention
of illness?
A. Prevention of disease complications
B. Improvement of patients' life conditions
C. Prevention of disease onset
D. Elimination of causes of diseases onset
E. Conducting of rehabilitation measures
49. A 30-year-old man has a history of recurrent
pneumonias and chronic cough production of foul
smell, purulent sputum, ocassionally gloom tinged,
which becomes worse in the morning and in reclining
position. On physical examination, it is a chronic
patient with clubbing of fingers, wet inspiratory tract
at the root of lungs from behind. What is the most
probable diagnosis?
A. Bronchoectasis
B. Disseminated pulmonary tuberculosis
C. Pulmonary neoplasm
D. Chronic bronchitis
E. Chronic obstructive emphysema
50. A 34-year-old patient is hospitalized with
complaints of cervical and axillary lymph nodes
enlargement, subfebrile temperature during the last 2
months, increased sweating. There are Reed-
Sternberg (Berezovsky) cells in the punctation of
lymph nodes. What method of investigation is
expedient to use to study the extent of tumor
process?
A. Antiography
B. Thermography
C. Lymphoscintigraphy
D. Roentgenological investigation
E. Lymphography
51. A 43-year-old patient complains of contact
hemorrhages during the last 6 months. Bimanual
examxervix of the uterus is enlarged, restricted in
mobility. Mirrors showed the following: cervix of the
uterus is in the form of cauliflower. Chrobak and
Schiller tests are positive. What is the most probable
diagnosis?
A. Leukoplakia
B. Cervical pregnancy
C. Cancer of cervix of the uterus
D. Nascent fibroid
E. Polypus of the cervix of the uterus
52. A 5-year-old child had strong headache,
vomiting, ataxy, dormancy, di-scoordination of
movements, tremor of the extremities on the 8th day
of the disease. It was followed by rise in body
temperature, vesiculosis rash mainly on the skin of
the body and the hairy part of the head. At the second
wave of the fever a diagnosis of encephalitis was
given. What disease complicated encephalitis in this
case?
A. Chicken pox
B. Measles
C. Herpetic infection
 7
D. Enterovirus ifection
E. German measles
53. A 26-year-old patient undergoes a course of
treatment due to chronic glomerulonephritis. The
treatment was successful, normalization of all the
characteristics was recorded. What sanitorium and
health resort treatment could be recommended?
A. Morshyn
B. Truskavets
C. The south coast of the Crimea
D. Myrhorod
E. Not recommended
54. A 1,5-year-old child has following symptoms:
chronic cough with purulent sputum discharge.
Dyspnea, physical retardation, large amount of stool.
Sweat chloride isl50 mEq/L. The child has been ill
since 2 month age. Diagnosis: cystic fibrosis. What is
the most suitable therapy?
A. Vitamins + mucolytics
B. H2-blockers + hepatoprotectors
C. Cholepoietic+adaptogenetic medicines
D. Vitamins+antibiotics
E. Enzymes + antibiotics
55. A 65-year-old patient complains of gradual
worsening of the left eye vision during 10 months.
On physical examination: acuty of vision of the left
eye is 0,01, not correctable. The eye is quiet, pupil of
the eye is grayish, reflex from the eye-ground is
absent. Intraocular pressure is 18 mm/Hg. What is
the most probable preliminary diagnosis?
A. Senile cataract
B. Open-angle glaucoma
C. Leukoma of the cornea
D. Disorder of blood circulation in retina vessels
E. Exfoliation of the retina
56. A 42-year-old patient applied to hospital with
complaints of pain behind the sternum with
irradiation to the left scapula. The pain appears
during significant physical work; this lasts for 5-10
minutes and is over on rest. The patient is sick for 3
weeks. What is the preliminary diagnosis?
A. IHD: First established angina pectoris
B. IHD: Variant angina pectoris (Prinzmetal's)
C. IHD: Stable angina pectoris of effort IV FC
D. IHD: Progressive angina pectoris
E. IHD: Stable angina pectoris of effort I FC
57. A 8-year-old boy has suffered from tonsillitis. In
2 weeks he started complaining of migratory joint
pain, edema of joints, restriction of movements,
fever. On examination, an acute rheumatic heart
disease, activity of the III-rd degree, primary
rheumocarditis, polyarthritis; acute course of disease,
cardiovascular failure IIA. What medication is to be
prescribed?
A. Prednisone
B. Erythromycin
C. Cefazolin
D. Diprazinum
E. Delagil
58. An anesthesiologist gives narcosis to the patient;
he uses a non-reversive contour. Anesthetic is
halothane. Air temperature in the operation room is
21°C, humidity 50%, and level of noise 30 dB. What
occupational hazard is the principal one in these
conditions?
A. Improper occupational microclimate
B. (Air pollution with anesthetic
C. Compelled working pose
D. High level of noise
E. Mental overfatigue
59. A 40-year-old woman complains of colic pains in
the lower part of abdomen and abundant bloody
discharges from genital tract. Last 2 years she had
menses for 15-16 days, abundant, with clots, painful.
Had 2 medical abortions. In bimanual investigation:
from the canal of the cervix uteri — a fibromatous
node, 3 cm in diameter, on the thin stem. Discharges
are bloody, moderate. Choose the correct tactics.
A. Hormonal hemostasis
B. Hysterectomy without ovaries
C. Operation: untwisting of born node
D. Phase by phase vitamin therapy
E. Supravaginal ablation of the uterus without
ovaries
60. Purulent mediastinitis is diagnosed at a 63-year-
old patient. What diseases from the stated below
CANNOT cause the purulent mediastinitis?
A. Deep neck phlegmon
B. Iatrogenic injury of the trachea
C. Perforation of the cervical part of the easophagus
D. Perforation of the thoracic part of the easophagus
E. Cervical lymphadenitis
61. At the gynaecological department there is a
patient of 32 years with the diagnosis: "acute
bartholinitis ".Body temperature is 38,2°C,
leucocytes count 10,4*109/£, the ESR is 24 mm/hour.
In the area of big gland of the vestibulum -the
dermahemia, the sign of the fluctuation, sharp
tenderness (pain). What is the most correct tactics of
the doctor?
A. Surgical dissecting, a drainage of an abscess of
the gland, antibiotics
B. Antibiotics, Sulfanilamidums
 8
C. Antibiotic therapy
D. Surgical dissection, drainage of the abscess of the
gland
E. Antibiotics, detoxication and biostimulants.
62. District doctor of rural medical department was
called to a 42-year-old patient. While examining the
patient, the doctor suspected the dysentery. What
document must the doctor issue?
A. Statistical coupon of final (precise) diagnosis
B. Abstract of outpatient medical card
C. Urgent notification of infectious disease
D. Infectious disease report
E. Report addressed to Head of the village
63. A 5-year-old child had an attack of palpitation
with nausea, dizziness, generalized fatigue. On ECG:
tachycardia with heartbeat rate of 220/min. Ventricle
complexes are deformed and widened. P wave is
absent. What medication is to be prescribed to
provide first aid?
A. Isoptin
B. Seduxen
C. Lydocain
D. Novocainamides
E. Strophantin
64. A 18-year-old patient applied to gynecologist
with complaints of the pain in the lower part of the
abdomen, rise in body temperature to 37,5°C,
considerable mucopurulent discharges from the
genital tract, colic by urinating. After mirror and
vagina exam the results are the following: the urethra
is infiltrated, cervix of the uterus is hyperemic,
erosive. The uterus is painful; ovaries are painful,
thickened, and free. Bacterioscopy test showed
diplococcus. What diagnosis is the most probable?
A. Chronic gonorrhea
B. Chlamydiosis
C. Trichomoniasis
D. Recent acute ascending gonorrhea
E. Candydomycosis
65. A 32-year-old woman complains of the pain in
the left epigastric area that appeared in 2 hours after
meal. She also complains of nausea, bloating of the
abdomen, tendency to diarrhea. On physical exam:
icteric scleras. The abdomen is painful by palpation
in the Gubergrits and Skulsky point. The liver is at
the ribs edge. Blood tests: amylase — 288 mmol/L,
total bilirubin - 20//mol/L. What are the most
probable diseases?
A. Chronic gastritis
B. Chronic pancreatitis
C. Chronic cholecystitis
D. Chronic hepatitis
E. Chronic enterocolitis
66. A man with a stab-wound of the right foot
applied to doctor. He stepped on the board with nail
two hours ago. In the patient medical chart it is stated
those 3 years ago he passed the whole course of
vaccination against tetanus. What is the tactics of
doctor to prevent tetanus in this case?
A. Administer 0,5 ml of tetanus toxoid
B. Administer 1 ml tetanus toxoid and 3000 U of
anti-tetanic serum
C. Administer 1,0 ml of tetanus toxoid
D. Administer 3000 U of anti-tetanic serum
E. Do not conduct specific prophylaxis
67. During the examination of the placenta which
was just born, the defect of 2 x 3 cm was found.
There is no hemorrhage. What is the most
appropriate tactics?
A. To prescribe uterotonic medications
B. External massage of the uterus
C. Observation of woman after labor
D. Instrumental revision of the uterine cavity
E. Hand revision of the uterine cavity
68. A 65-year-old patient complains of asphyxia,
cough with foamy red sputum, air deficiency, death
fear. On physical exam: the skin is pale,
acrocyanosis, cold sticky perspiration. Harsh
breathing, moist small and medium-vesicular rales
are in lower and hind parts on both sides. What is the
most probable presumptive diagnosis?
A. Edema of lung
B. Croupous pneumonia
C. Asthmatic status
D. Embolic pneumonia
E. Thromboembolism of pulmonary artery
69. A 9-year-old girl has an average height and
harmonic growth development. She was ill with
acute respiratory infection for five times. Define the
group of her health.
A. 4th group
B. 3rd group
C. 2nd group
D. 1st group
E. 5th group
70. A 65-year-old patient complains of dull pain in
the rectum during and after defecation, discharge of
mucus and small amount of blood mixed up with
mucus and faeces. The discharged blood is of dark
red color, sometimes with small amount of clots. The
patient is sick for 8 months, has lost some weight. On
digital examination, there is a round constriction of
the rectum with infiltrate at a height of 4-5 cm from
 9
the anus. What is the most probable diagnosis?
A. Cicatricial stenosis of the rectum
B. Crohn's disease
C. Non-specific ulcer colitis
D. Chronic paraproctitis
E. Cancer of the medium-ampullar section of the
rectum
71. A 4-year-old child on the 5th day of illness
complains of cough, rash on the skin. Temperature is
38,2°C, face is puffy, photophobia, conjunctivitis.
There is a bright papulomacular rash on the face,
neck, upper half of the thorax. Pharynx is
hyperemiated. There are serous and purulent
discharge from nose, dry rales in the lungs. What is
your preliminary diagnosis?
A. German measles
B. Enterovirus infection
C. Measles
D. Adenovirus infection
E. Scarlet fever
72. A 52-year-old patient has hypervolemic type of
essential hypertension. What medication is necessary
to prescribe either as monotherapy or in complex
with other antihypertensive remedies?
A. Dibazol
B. Niphedipin
C. Kapoten
D. Clophelin
E. Hypothiazid
73. A mother who is on partially paid maternity leave
got sick and was hospitalized. What document is to
be issued to a working father who will be taking care
of a child during his mother's illness?
A. Certificate of child's care necessity
B. Free-form certificate
C. Sick-leave
D. Extract from the medical card of out- or in-patient
E. Certificate of mother's illness
74. A 62-year-old patient complains of the pain
behind the sternum, bad passing of solid and liquid
food, bad breath, increased salivation weight, loss of
15 kg during the period of 2 months. Appetite is
retained. On physical exam: face features are
sharpened. The skin is pale, with sallow tint, its
turgor is decreased. The liver is not enlarged. Blood
Hb — 86g/L. Gregersen reaction is positive. What
kind of pathology caused the given clinical situation?
A. Benign growth of esophagus
B. Esophagus cancer
C. Cicatricial constriction of esophagus
D. Chronic non-specific esophagitis
E. Achalasia of esophagus
75. In the anamnesis of a 2-year-old girl there are
recurrent pneumonias with signs of obstruction.
There are heterogeneous moist and dry rales,
respiration is weakened. Dense, viscous secretion is
difficult to hawk. There are "drumsticks", physical
retardation. What is the most probable diagnosis?
A. Pulmonary tuberculosis
B. Bronchial asthma
C. Recidivating bronchitis
D. Mucoviscidosis, pulmonary form
E. Congenital pulmonary polycystosis
76. A 33-year-old woman works as the secretary. Her
diet contains 150 g of protein (including 100 g of
animal), 200 g of fat, 600 g of carbohydrates. What
pathology this diet can cause?
A. Paradontosis
B. Uterine fibromyoma
C. Obesity
D. Schizophrenia
E. Common cold
77. A 35-year-old man was operated on peptic ulcer
of the stomach. Mass deficit of the body is 10 kg.
The level of glucose after operation in the undiluted
cellular blood on an empty stomach is 6,7 mmol.
During repeated examination — 11,1 mmol (after
meal), level of HbAlc -10%. Could you please make
an interpretation of the given data?
A. Disordered tolerance to glucose
B. Diabetes mellitus risk group
C. Norm
D. Diabetes mellitus
E. Postoperative hyperinsulinemia
78. A 35-year-old woman was admitted to
resuscitation department in asthmatic status. What is
the most trustworthy criterion of breath
effectiveness?
A. Determination of "dead" space
B. Minute respiratory volume
C. Respiration rate
D. Respiratory volume
E. PaCO2 and PaO2
79. A 42-year-old woman who works at mercury
thermometers factory, complains of the headache,
syncopes, reduction of memory, small and frequent
flutter of fingers of stretched hands, eyelids and the
tongue, bleeding gums, gingivitis. What medication
is necessary to use for mercury elimination?
A. Unithiol
B. Sodium hydrate of carbon
C. Seduxen
D. Pentoxil
 10
E. Magnesium sulphate
80. In 30days, after accidental coitus a 25-year-old
patient developed ulcers on penis. On physical exam:
inside of prepuce there is painless round erosion, 1,5
cm in diameter, with dense bottom, with even edges,
without evident inflammatory changes. What is the
most probable diagnosis?
A. Primary syphilis (hard chancre)
B. Herpes simplex
C. Scabies complicated with pyococcuses
D. Chancriform pyoderma
E. Chancroid (soft chancre)
81. A 23-year-old patient wounded his left arm as a
result of gunfire. The bones of the arm are
undamaged. What appropriate surgical help must be
provided to this patient?
A. Suture wound and dries it
B. Aseptic dressing of the wound
C. Suture wound
D. Primary surgical processing with a flowing
suction
E. Dry wound with towel gauzes
82. A 10-year-old boy complains of a headache,
weakness, fever [temperature — 40° C], vomiting.
On physical examination: there is an expressed
dyspnea, pale skin with a flush on a right cheek, right
hemithorax respiratory movement delays, dullness on
percussion of the lower lobe of the right lung,
weakness of vesicular respiration in this region. The
abdomen is painless and soft by palpation. What
disease causes these symptoms and signs?
A. Pneumonia croupousa
B. Intestinal infection
C. Acute appendicitis
D. Acute cholecystitis
E. Influenza
83. While making a round, a doctor had noticed the
edema of the right shoulder of a 26-day-old child
with diagnosis of "umbilical sepsis". Active
movements in the shoulder joint were absent, right
hand was hanging down. Mother stated that her
child's condition had worsened for the last 24 hours
what resulted in child's refusal to be breast-fed,
restlessness, weeping while swaddling, rise in body
temperature up to 38,8°C. What is the most probable
preliminary diagnosis?
A. Fracture of the humerus
B. Traumatic brachioplexitis
C. Phlegmon of the shoulder
D. Epiphysial osteomyelitis of the humerus
E. Fracture of the clavicle
84. A 40-year-old woman with acute gastrointestinal
hemorrhage was transfused 400 ml of the preserved
blood after having conducted all compatibility tests.
After hemotransfusion the condition of the patient
became worse. She started having headache, muscles
pain, her temperature has risen up to 38,8° C. What is
the reason for such condition of the patient?
A. Allergic reaction
B. Pyrogenic reaction of medium severity
C. Air embolism
D. Hemotransfusional shock development
E. Bacterial and toxic shock development
85. A 5-year-old child with stigmas of
dysembryogenesis (small chin, thick lips, opened
mouth, hyperthelorismus) has systolic murmur in the
second intercostal to the right of the sternum. The
murmur passes to the neck and along the sternum left
edge. The pulse on the left brachial artery is
weakened. BP on the right arm is 110/60 mm Hg, on
the left -100/60 mm Hg. ECG results: hypertrophy of
the right ventricle. What defect is the most probable?
A. Open aortic duct
B. Aortic stenosis
C. Defect of interventricular septum
D. Defect of interatrial septum
E. Coarctation of the aorta
86. A 16-year-old woman complains of the
abdominal pain and purpuric spots on the skin.
Laboratory investigations revealed normal platelet
count with hematuria and proteinuria. What is the
most probable diagnosis?
A. Thrombotic thrombocytopenic purpura
B. Heavy metal poisoning
C. Henoch-Schoenlein purpura
D. Hemolytic uremic syndrome
E. Subacute bacterial endocarditis
87. A 38-year-old patient is under observation having
polyneuritic syndrome with considerable loss of
weight, fever, and rise in BP Blood test: considerable
inflammatory changes. What examination is the most
expedient to make the diagnosis?
A. Muscular biopsy with histological investigation of
the material
B. Blood culture
C. Determination of antinuclear antibodies
D. Electromyography
E. Determination of HLA antigens
88. A patient complains of an extremely intense pain
in epigastrium. He has peptic ulcer disease of
duodenum for 10 years. The patient is in the forced
position being on the right side with legs abducted to
stomach. Abdomen has acute tenderness in the
 11
epigastrium. Guarding contraction of the abdominal
wall muscles is observed. What is the preliminary
diagnosis?
A. Penetration of ulcer into pancreas
B. Acute pancreatitis
C. Acute condition of peptic ulcer disease
D. Perforation of ulcer
E. Thrombosis of mesenteric vessels
89. A 24-year-old man on the second day of the
disease with a sudden onset complains of a strong
headache in temples and in the area of orbits, dull
pain in the body, dry painful cough. His temperature
is 39°C. Adynamic. Mucous membrane of
oropharynx is "flaming", rales are not ausculated.
What is the most probable diagnosis?
A. Parainluenza
B. Meningococcus infection
C. Pneumonia
D. Influenza
E. Respiratory mycoplasmosis
90. Chest X-ray of the miner (with 24-year-length of
service; dust concentration on working place is 260
—280 mg/m3,15% of which is free silicon dioxide)
showed the signs that are typical of pneumoconiosis.
What kind of pneumoconiosis is this?
A. Silicosis
B. Carboconiosis
C. Anthraco-silicosis
D. Silicatosis
E. Anthraco-silicatosis
91. A 45-year-old woman complains of unbearable
crampy pain in the left half of face with 1-2 minutes
duration. Attacks are caused by mastication. The
patients fall ill two months ago after being in cold.
On physical exam: pain in exit points of trigeminal
nerve on the left. Touch near left ala nasi causes
attack with tonic convulsion of facial muscles. What
is the most probable diagnosis from the given below?
A. Arthritis of mandibular joint
B. Sinusitis (maxillaris)
C. Neuralgia of trigeminal nerve
D. Neuralgia of glossopharyngeal nerve
E. Facial migraine
92. A neonate was born from the 1st gestation on
term. The jaundice was revealed on the 2nd day of
life, and then it became more acute. The adynamia,
vomiting and hepatomegaly were observed. Indirect
bilirubin level was 275/imol/L, direct bilirubin level -
Sμ mol/L, Hb — 150 g/1. Mother's blood group -
0[I], Rh+, child's blood group- A[II], Rh+. What is
the most probable diagnosis?
A. Hemolytic disease of the neonate [ABO
incompatibility], icteric type
B. Physiological jaundice
C. Hepatitis
D. Hemolytic disease of the neonate [Rh
-incompatibility]
E. Jaundice due to conjugation disorder
93. A 28-year-old patient was admitted on the 9th
day of the disease to the clinic with complaints of
temperature up to 39,0°C, headache, weakness,
constipation. On physical examination, single
roseolas are on skin of the abdomen. Ps — 78 bpm.
The liver is enlarged by 2 cm. What is the probable
diagnosis?
A. Brucellosis
B. Typhoid fever
C. Malaria
D. Leptospirosis
E. Sepsis
94. A 38-year-old man is working for 15 years on the
slate producing factory. He complains of expiration
dyspnoe on exertion, dry cough. On physical exam:
dullness of the percutory sound in the interscapular
area, harsh respiration, dry diffused rales. There are
warts of grayish color on hands. The doctor of the
plant suspects asbestosis. What method is the most
informational to confirm the diagnosis?
A. Blood gases analysis
B. Chest X-ray exam
C. Bronchoscopy
D. Spirography
E. Bronchoalveolar lavage
95. A patient had disorder of nasal respiration,
mucopurulent discharges from nose, headache for 3
weeks. At anterior rhinoscopy in middle nasal
meathus the stria of pus, edema, hyperemia of the
mucosa of the nose have been determined. What
diagnostic method is necessary to administer first of
all?
A. General blood test
B. An X-ray of paranasal sinuses
C. CT of a skull
D. Bacteriology analysis of the mucous
E. Punction of the maxillar sinus nasal
96. A 35-year-old patient complains of BP rise,
headache, tinnitus, tachycardia. On physical
examination, Ps —100 bpm, rhythmical, intensive.
BP — 240/100 mm Hg. Left border of the relative
cardiac dullness is moved to the left for 1 cm, Sound
I on the apex is weakened, accent of the Sound Ilnd -
on aorta. Rough systolic murmur is ausculated on
each side of the umbilicus. What pathology could
cause this clinical picture?
 12
A. Stenosis of renal arteries
B. Essential hypertension
C. Chronic glomerulonephritis
D. Nephroptosis
E. Conn's syndrome
97. A 27-year-old man complains of pain in
epigastrium which is relieved by food intake. EGDFS
shows antral erosive gastritis, biopsy of antral
mucous presents Helicobacter Pylori. What can be
diagnosed in this case?
A. Reflux-gastritis
B. Gastritis of A type
C. Rigid antral gastritis
D. Menetrier's disease
E. Gastritis of type B
98. Thyreotoxicosis patient is in the two-place
hospital ward of therapeutic department. The area of
the ward is 18m2, height is 3 m, ventilation rate is
2,5/h. Air temperature is 20° C, relative humidity is
45%, air movement velocity is 0,3 m/sec, light
coefficient is 1/5, noise level constitutes 30 dB. Make
a hygienic assessment of these conditions.
A. All conditions are OK
B. Non-effective ventilation
C. High level of noise
D. Discomfortable microclimate
E. Poor lighting
99. The diagnosis of a right-sided pneumothorax is
made to a 36-year-old patient. What method of
treatment is indicated to the patient?
A. Pleural puncture
B. Thoracotomy
C. Symptomatic therapy
D. Antiinflammation therapy
E. Drainage of the pleural cavity
100. A 35-year-old patient with alcohol abuse and
abnormal diet complains of pain in epigastrium that
occurs in 1-1,5 hours after having meal.
Fibrogastroduodenoscopy: marked hyperemia, small
defects, and easy appearance of sores on the mucous
membrane in the antral section of the stomach. What
is the most probable reason for this pathology?
A. Presence of antibodies to parietal cells
B. Nervous overstrain
C. Helicobacter pylori infection
D. Alimentary factor
E. Toxic action of alcohol
101. Melanoma diagnosis was made after
examination to a 16-year-old patient who complained
of frequent pain in the abdomen. Pigmentation of the
mucosa and skin, polyps in the stomach and large
intestine were found. It is known that mother of the
patient had an analogous pigmentation and was
treated often for anemia. What kind of disease is
meant?
A. Peutz - Eghers syndrome
B. Crohn's disease
C. Tuberculosis of the intestine
D. Hirschsprung's disease
E. Adolescent polyposis
102. A 40-year-old patient is sick for 8 years. He
complains of pain in the loin region during physical
work, in neck and thorax parts especially during
cough, pain in the right hip and joints. On physical
exam: body is fixed in the positon of incline forward
with the head pulled down, atrophy of the gluteus.
What is the most probable diagnosis?
A. Ancylosing spondyloarthritis
B. Spread osteochondrosis of the vertebral column
C. Tuberculous spondylitis
D. Spondyloarthropatia on the background of Reiter's
disease
E. Psoriatic spondyloarthropatia
103. A 57-year-old man complains of shortness of
breath, swelling on shanks, irregularity in cardiac
work, and pain in the left chest half with irradiation
to the left scapula. Treatment is ineffective. On
physical exam: heart's sounds are diminished, soft
systolic murmur on the apex. Ps — 100/min,
arrhythmical, BP - 115/75 mm Hg. The liver is +2
cm, painful. Roentgenoscopy: enlargement of heart
shadow to all sides, pulsation is weak.
Electrocardiogram (ECG): leftventricled
extrasystolia, decreased voltage. What method of
investigation is necessary to do to determine the
diagnosis?
A. Coronarography
B. X-ray kymography
C. Veloergometria
D. ECG in the dynamics
E. Echocardiography
104. During examination of a patient, masses in the
form of condyloma on a broad basis are found in the
area of the perineum. What is the tactics of the
doctor?
A. To send a woman into dermatological and
venerological centre
B. Antiviral treatment
C. Cryodestruction of condyloms
D. Chemical coagulator treatment
E. Surgical ablation of condyloms
105. To study physical development of children and
adolescents, anthropometric investigations are widely
 13
used. Choose a physiometric method of investigation 110. A 6-month-old infant was born with body mass
from the below given. of 3 kg and 50 cm length. He is breast-fed. How
A. Determination of vital capacity of lungs many times per day should the infant is fed?
B. Determination of vertebra form A. 8
C. Measurement of growth B. 4
D. Determination of thorax form C. 6
E. Determination of body weight D. 7
E. 5
106. Neonate is 5 days old. What vaccination dose of
bacillius Calmette-Guerin (bCG) vaccine is 111. An employee was disabled during 6 months as a
necessary for this child? result of a hip fracture. Who is entitled to sign the
A. 0.1 Mg sick-leave for the last 2 months?
B. 0.025 Mg A. MSEC
C. 0.075 Mg B. DCC together with the head physician of a
D. 0.2 Mg polyclinic
E. 0.05 Mg C. Deputy head physician of a working capacity
D. Doctoral controlling committee
107. In the structure of the population of N-region, E. Head physician of the polyclinic
person category of age from 0 till 14 yrs constituted
31%, for people from 50 yrs and older — 20%. 112. For persons who work in a zone of failure on
Estimate the population structure that characterizes nuclear object, the greatest risk of development
the given demographic situation in a most efficient within the first decade is represented by cancer. By
way. what cancer it is represented?
A. Migration of the population A. Lung
B. Progressive structure of the population B. Skin
C. Stationary structure of the population C. Breast
D. Regressive structure of the population D. Thyroid gland
E. Emigration of the population E. Reproduction system organs

108. A patient complains of intense pressing pain in
the pharynx, mainly to the right impossibility to
swallow even liquid food. The patient is sick for 5
days. His condition is severe. Body temperature is
38,9°C, it is difficult to talk, voice is constrained, it is
difficult to open the mouth. Submaxillary glands to
the right are painful, enlarged. What is the most
probable diagnosis?
A. Peritonsillar abscess
B. Diphtheria
C. Vincent's disease
D. Pharyngeal tumor
E. Phlegmonous tonsillitis
109. A woman while working in vegetable garden
developed severe pain in the loin. Lasague's and
Nery tension signs are obviously marked on the right.
Lumbar lordosis is smoothed, movements are harshly
restrained in lumbar part of the spine. Right ankle
(Achilles) reflex is absent. What kind of disease can
it be?
A. Hepatic colic
B. Neuritis of femoral nerve
C. Renal colic
D. Lumbalgia
E. Lumbar-sacral radiculitis
113. A 20-year-old patient complains of amenorrhea.
On physical exam: hirsutism, obesity with primarily
localization of adipose tissue on face, neck, upper
part of the body. There is an acne vulgaris on the
face, on the skin — striae cutis distensae. BP
-170/100 mm Hg. Mental development and intellect
are normal. Gynecological status: excessive hairiness
on external genitals, drastic hypoplasia of vagina and
uterus. What is the most probable diagnosis?
A. Itsenko-Cushing's syndrome
B. Stein-Leventhal syndrome
C. Pechranz-Babinsky and Frelich syndrome
D. Sheehan's syndrom
E. Shereshevsky-Turner syndrome
114. A 52-year-old man has recurrent transient
ischemic attacks. Auscultation of the carotid arteries
detects murmur. What diagnostic method is
necessary to apply first?
A. Cerebral angiography
B. Electroencephalography
C. CT of the brain
D. MRI of the brain.
E. Ultrasound dopplerography
115. A 42-year-old woman suffers from bronchial
asthma, has an acute attack of bronchial asthma.
 14
What medication from the listed below is
contraindicated to render a first aid?
A. Corazolum
B. Strophanthin hydrochloride
C. Morphinum hydrochloride
D. Izardin
E. Euphylinum
116. A 29-year-old patient complains of sterility.
Sexual life is for 4 years being married, does not use
contraception. There was no pregnancy before. On
physical examination, genitals are developed
normally. Uterine tubes are passable. Rectal
temperature during three menstrual cycles is
monophase. What is the most probable reason for
sterility?
A. Immunologic sterility
B. Genital endometriosis
C. Anomalies of genitals development
D. Anovulatory menstrual cycle
E. Chronic adnexitis
117. A 45-year-old man was brought to clinic with
complaints of the pain that started suddenly in the
left chest part and epigastric area, shortness of breath,
nausea, one-time vomiting. The acute pain started
after weight-lifting. On physical exam: shallow
breathing, RR - 38/min, left chest part is behind
during respiration, by percussion — tympanitic
sound, respiration is not ausculated. Ps — 110 bpm,
of weak filling. BP - 100/60 mm Hg, insignificant
displacement of heart to the right, sounds are dull.
What examination is the most expedient to do first?
A. Electrocardiography
B. Roentgenography
C. Esophagogastroscopy
D. Bronchoscopy
E. Ultrasound of the abdominal cavity
118. A 14-year-old victim was drawn out of the
water in winter after 15 minutes of being in the
water. The victim shows no vital signs. What
measures are to be taken?
A. To transport the victim to the nearest hospital to
carry out reanimation measures
B. To transport the victim to the nearest warm room
to carry out reanimation measures
C. Not to carry out reanimation measures
D. Not to waste time on the release of respiratory
tract from water, to take on cardiopulmonary
reanimation
E. To release respiratory tract from water, to create
drain position and to take on measures to restore
respiration and blood circulation
119. A patient was admitted to the hospital on the 7th
day of the disease with complaints of high
temperature, headache, pain in the muscles,
especially in calf muscles. Dermal integuments and
scleras are icteric. There is hemorrhagic rash on the
skin. Urine is bloody. The patient was fishing two
weeks ago. What is the most likely diagnosis?
A. Brucellosis
B. Salmonellosis
C. Yersiniosis
D. Trichinellosis
E. Leptospirosis
120. A 65-year-old patient complains of pain in the
right half of face, headache, and rise in temperature.
He is sick for 3 days, speaks of the disease due to
being in cold. On physical exam: in the right half of
forehead skin there is inflammatory hyperemia,
edema. Erosions with necrotic coating are on places
of vesicles. There are vesicles with inflammatory
hyperemia along the border of the nodes. What
pathology is meant in this case?
A. Eczema
B. Lichen planus erythematosus
C. Herpes zoster
D. Dermatitis
E. Erysipelas
121. A 37-year-old patient has sudden acute pain in
the right epigastric area after having fatty food. What
method of radiological investigation is to be used on
the first stage of examining the patient?
A. Radionuclide
B. Magnetic-resonance
C. Roentgenological
D. Thermographic
E. Ultrasonic
122. The student has got the following devices:
Geiger's counter, Ebert's counter, Krotov's apparatus,
Mischuk's device, Ebert's device. What device can he
use to assess germ pollution of the air?
A. Geiger's counter
B. Mischuk's device
C. Ebert's counter
D. Ebert's device
E. Krotov's apparatus
123. A victim of the car crash was brought to
neurosurgery due to craniocerebral trauma. During
examination symptoms of focused injury of the
cerebrum are found, cerebrum contusion is
suspected. What method of examination is to be
used?
A. Ultrasound examination of vessels of the
cerebrum
B. Antiography of vessels of the cerebrum
 15
C. X- ray of cranium bones
D. Eye-ground examination
E. Computed tomography of the cerebrum
124. In morgue there are dead bodies with the
following causes of death: electrotrauma; rupture of
the spleen with acute anemia. There is one unknown
person; one ethyl alcohol poisoned person and one
drowned man. What dead body should the blood
group is determined for?
with internal
A. Body of drowned man
B. Body of person hemorrhage
C. Body of person with a sudden death
D. All dead bodies of the unknown persons
E. Body of poisoned person
125. A 41-year-old patient was admitted to the
intensive care unit with hemorrhagic shock due to
gastric bleeding. He has a history of hepatitis B
during the last 5 years. The source of bleeding is
esophageal veins. What is the most effective method
for bleeding control?
A. Hemostatic therapy
B. Intravenous administration of pituitrin
C. Administration of plasma
D. Introduction of obturator nasogastric tube
E. Operation
126. A diagnosis of chronic arsenous intoxication
was defined at Y patient who is working as a night
man. What form of anemia is characteristic for this
disease?
A. Aplastic anemia
B. Hemolytic anemia
C. B12 - deficiency anemia
D. Hyper sideric anemia
E. Iron deficiency anemia
127. A 30-year-old patient who suffered from
headaches, while lifting a heavy subject up, felt an
intense headache in the form of the blow on his head.
There appeared nausea, vomiting, light dizziness. In
a day there was an objectively presented meningial
syndrome, t — 37,6°C. The doctor has suspected
subarachnoidal hemorrhage. What additional
examination is necessary to do to confirm the
diagnosis?
A. Rheoencephalography
B. Lumbar puncture with liquor examination
C. Computed tomography
D. Cerebral angiography
E. Roentgenography of the cranium
128. In the development of the inflammation
processes glucocorticoids reduce the level of certain
most important active enzyme. It results also in the
reducing of the synthesis of prostaglandins and
leucotrienes which have a key role in the
development of inflammation processes. What is the
exact name of this enzyme?
A. Arachidonic acid
B. Cyclooxygenase -1
C. Phospholipase A2
D. Lipoxygenase
E. Cyclooxygenase - 2
129. A 3-year-old boy suddenly fell ill with fever up
to 39°C, weakness, vomiting. Hemorrhagic rash of
various size appeared on his lower extremities in 5
hours. Meningococcemia with infective-toxic shock
of the 1st degree was diagnosed. What medications
should be prescribed?
A. Chloramphenicol succinate and interferon
B. Chloramphenicol succinate and prednisone
C. Penicillin and immunoglobulin
D. Penicillin and prednisone
E. Ampicillin and immunoglobulin
130. A patient with suspicion of pelvic bones fraction
is under examination conducted by the doctor who
presses alae ilii in medial direction with his both
hands. What causes painful syndrome of the patient?
A. Traumatic injury of the intrapelvic organs
B. Fracture of sciatic bones
C. Retroperitoneal hematoma
D. Disorder of continuity of the pelvic ring
E. Fracture of the sacrum
131. In the inhabited locality there is an increase of
diphtheria during the last 3 years with separate
outbursts in families. What measure can effectively
influence the epidemic process of diphtheria and
decrease the morbidity with diphtheria to single
cases?
A. Revelation of carriers
B. Early diagnostics
C. Immunization of the population
D. Hospitalization of patients
E. Disinfection in disease focus
132. In 2 weeks after pharyngitis a 25-year-old
patient started complaining of rise in temperature to
38° C, fatigue, shortness of breath during walking,
migrating joint intumescence and pain . On physical
exam: cyanosis of lips, pulse is weak, rhythmical,
100 bpm. The left heart border is moved outwards
from medi-aclavicular line for 1 cm. Sound I on the
apex is weakened, soft systolic murmur is ausculated.
What ethiological factor caused this pathological
process in the most probable way?
A. Beta hemolytic streptococcus
 16
B. Staphylococcus
C. Pneumococcus
D. Virus
E. Fungus
133. You suspect that a 34-year-old patient has got
an abscess of Douglas spaces. What method of
investigation is preferable to diagnostics?
A. Roentgenoscopy of abdominal cavity
B. Laparoscopy
C. Digital examination of rectum
D. Rectoromanoscopy
E. Percusion and auscultation of abdomen
134. Woman in childbirth, 25 years old, the second
period of labor. During internal obstetric
examination, opening of the uterine cervix is full.
Fetus membranes are absent. The head of the fetus is
represented, the head occupies sacral cavity. Sciatic
bones are undeterminable. During contractions
perineum is sticking out. Where is the head of the
fetus situated?
A. In the plane of the narrow part of minor pelvis
B. In the plane of the wide part of minor pelvis
C. By small segment in the plane of inlet into minor
pelvis
D. In the plane of outlet from the minor pelvis
E. Big segment in the plane of inlet into minor pelvis
135. A 19-year-old man has suffered from moderate
mental retardation since childhood. The patient is
illiterate, can take care of him, do simple household
work and other kinds of easy work under
supervision. What does his rehabilitation [tertiary
prevention] require?
A. Supervision of a social worker
B. Physical work under supervision
C. Supervision of relatives (if any)
D. 8All the above mentioned
E. None of the above mentioned
136. The child was born from the 5th pregnancy and
1st delivery. Mother's blood group — A[II] Rh-,
neonate's -A[II] Rh+. The level of indirect bilirubin
in umbilical blood was 58/µmol/L, hemoglobin - 40
g/L, RBC — 3,8* 1012/L. The level of indirect
bilirubin in 2 hours was 82µmol/l. The hemolytic
disease of the neonate [icteric-anemic type, Rh-
incompatibility] was diagnosed. Choose the
therapeutic tactics.
A. Symptomatic therapy
B. Hormonal therapy
C. 8Replacement blood transfusion
D. Plasma transfusion
E. Antibiotics
137. A 25-year-old man has focal shadowing of
small and medium intensity, unequal contours in 1st
and 2nd segments of the right lung revealed during
routine fluorography. What clinical form of
tuberculosis can be suspected in this patient?
A. Tuberculoma
B. Focal
C. Miliary
D. Disseminated
E. Fibro-cavernous
138. A 48-year-old patient complains of heaviness in
the right hypochondrium, itching of the skin. He had
been treated in infectious diseases hospital repeatedly
due to icterus and itch. On physical exam:
meteorism, ascitis, dilation of abdominal wall veins,
protruded umbilicus, spleen enlargement. What can
be diagnosed in this case?
A. Liver cirrhosis
B. Gallstones
C. Cancer of the liver
D. Cancer of the head of pancreas
E. Viral hepatitis B
139. A 4-year-old boy in 2 weeks after the tonsillitis
had edema, headache, vomiting three times per day.
On physical exam: rise of blood pressure, urine is of
meat slops color. What is the most probable
diagnosis?
A. Interstitial nephritis
B. Cystitis
C. Pyelonephritis
D. Urethritis
E. Glomerulonephritis
140. A 35-year-old woman was admitted to thoracic
surgery department with rise in body temperature up
to 40°C, onset of pain with deep breath inside, cough
with big quantity of purulent and bloody sputum with
bad smell. What disease is caused by these
symptoms?
A. Abscess of the lung
B. Bronchiectatic disease
C. Pulmonary tuberculosis
D. Actinomycosis of lungs
E. Complication of liver echinococcosis
141. Point out the unit for statistical observation for
the determination of blood sugar level influence on a
wound surface healing during postoperative period.
A. Blood sugar level
B. The patient who has a wound surface
C. The patient in a postoperative period
D. Blood test
E. The patient who was discharged to outpatient
treatment
 17
142. Parents of a 2-year-old boy applied to clinic
complaining of right testicle absence in the scrotum
of a boy. While examining the boy, hypoplasia of the
right half of the scrotum was revealed, absence of the
testicle. Testicle is miniaturized, it palpitates along
the inguinal canal but it could not be moved down to
scrotum. What is the most probable diagnosis?
A. Right-sided cryptorchism, abdominal form
B. Ectopia of the right testicle, pubic form
C. Left-sided monorchism
D. Right-sided cryptorchism, inguinal form
E. Retraction of the right testicle
(pseudocryptorchism)
143. A 26-year-old woman have been abusing of
alcohol for 7 years. She has psychological
dependence on alcohol, but no withdrawal syndrome.
Drinks are taken almost every day approximately 50-
100 g of wine. She is at her 4-th week of pregnancy.
What is necessary to do to prevent alcohol syndrome
of fetus?
A. Decrease of alcohol use
B. Gynecological observation
C. Medical abortion
D. Participation in the A-ANON group
E. Treatment of alcoholism and total abstinance from
alcohol during the whole period of pregnancy
144. Workers of fishery are subjected to low
temperatures of the air (from 5 till 15°C). Diseases of
what organs and systems are the most frequent
among workers of such enterprises?
A. Blood
B. Cardiovascular system
C. Gastrointestinal tract
D. Respiratory system
E. Liver
145. A 2-year-old girl has been ill for 3 days. Today
she has low-grade fever, severe catarrhal symptoms,
non-abundant maculopapular rash on her buttocks
and enlarged occipital glands. What is your
diagnosis?
A. Adenoviral infection
B. Measles
C. Pseudotuberculosis
D. Scarlet fever
E. Rubella
146. A 36-year-old alcoholic patient has cirrhosis and
pancreatic failure due to recurrent pancreatitis. His
complaints of nightblindness, decreased ability to
taste food, dry skin with hyperpigmentation. What
deficiency does these symptoms show?
A. Copper
B. Zinc
C. Chromium
D. Manganese
E. Selenium
147. A 10-year-old child is sick with chronic viral
hepatitis B with marked activity of the process. Total
bilirubin —70/^mol/L, direct - 26/xmol/L, indirect
— 44 µmol/L. AST — 6,2 mmoUL, ALT — 4,8
mmol/L. What mechanism underlies the
transaminase level increase of this patient?
A. Failure of bilirubin conjugation
B. Intrahepatic cholestasis
C. Hypersplenism
D. Cytolysis of hepatocytes
E. Failure of the synthetical function of the liver
148. Twenty-five unorganized toddlers (2-3 years
old) will be observed by district pediatrician current
year. What scheduled number of preventive
observations is to be made for this group of children?
A. 20
B. 100
C. 200
D. 50
E. 40
149. District pediatrician examines a healthy carried
1-month-old child. The child is breast-fed.
Prophylaxes of what disease will the doctor
recommend to do first?
A. Rachitis
B. Spasmophilia
C. Hypotrophia
D. Parathropy
E. Anemia
150. Choose the method of graphic representation of
monthly information about the number of registered
cases of acute intestinal infection in comparison to
the average monthly values, obtained for 5 previous
years.
A. The radial diagram
B. The figured diagram
C. Curvilinear
D. The sector diagram
E. The linear diagram
151. A 33-year-old woman was urgently brought to
clinic with complaints of the pain in the lower part of
the abdomen, mostly on the right, irradiating to
rectum, she also felt dizzy. The above mentioned
complaints developed acutely at night. Last menses
were 2 weeks ago. On physical exam: the skin is
pale, Ps — 92 bpm, t- 36,6°C, BP—100/60 mm Hg.
The abdomen is tense, slightly tender in lower parts,
 18
peritoneal symptoms are slightly positive. Hb — 98
g/L. What is the most probable diagnosis?
A. Apoplexy of the ovary
B. Renal colic
C. Intestinal obstruction
D. Abdominal pregnancy
E. Acute appendicitis
152. A sample of milk was taken for testing from a 5
ton milk batch. Lab analysis showed the following:
fat content 2%, specific density — 1,04 g/cm3,
acidity 21° C, reductase probe — weak positive.
What way the product is to be used in? What would
you advise?
A. Sell without limitations
B. Annihilate the product
C. Utilize technically
D. Write the product off for animal feeding
E. Sell but inform customers about milk quality
153. A 49-year-old patient complains of fever of
37,5°C, chest pain, dyspnea. On physical
examination, SI is clapping; S2 is accentuated in the
pulmonary artery, opening snap, presystolic murmurs
are auscultated. What is the most useful investigation
for valvular disorder assessment?
A. Phonocardiography
B. Electrocardiogram (ECG)
C. Echocardiography+dopplerechocardiography
D. Ballistocardiogram
E. Chest X-ray
154. A 37-year-old patient has come to clinic being
wounded in the area of umbilicus an hour ago. On
physical exam, there is a prick and cut painful wound
of about 0,5 x 1 cm around umbilicus on the
abdominal skin with slight bleeding.How would you
help this patient?
A. Laparotomy, abdominal cavity organs inspection.
Primary surgical processing of the wound
B. Suture on the wound
C. Aseptic bandage
D. Inspection of the wound with canal probe
E. Drainage of the wound with rubber strip
155. A 48-year-old man called for a district doctor
due to attack of cough with small amount of "rusty"
sputum, pain in the right side of the body during deep
respiration and cough. The patient has IDDM. On
physical exam, t — 39,2°C, Ps — 114 bpm, BP -
110/70 mm Hg, RR - 24/min. The skin is dry,
hyperemia of cheeks. During ausculation there are
moist sonorous crepitant rales in lower parts of the
lung. What are the doctor's actions?
A. Hospitalization to therapeutic unit
B. Hospitalization to endocrinology unit
C. Resuscitation
D. Referral to outpatient department
E. Prescription of out-patient treatment
156. A 40-year-old patient is being diagnosed: 1.
Medullar thyroid gland cancer. 2.
Pheochromocytoma. What operation should be made
first?
A. Operation concerning pheochromocytoma
B. Krail's operation
C. Subtotal resection of thyroid gland and fascicular
resection of limphatic nodes
D. Operation on thyroid gland
E. Vanach's operation
157. Rise in temperature up to 39°C was registered
the next day after a woman had labor. Fetal
membranes rupture took place 36 hours prior to
labors. The examination of the bacterial flora of
cervix uteri revealed the following: haemolytic
streptococcus of group A. The uterus tissue is soft,
tender. Discharges are bloody, with mixing of pus.
Establish the most probable postnatal complication.
A. Apostatis of stitches after the episiotomy
B. Infective contamination of the urinary system
C. Thrombophlebitis of veins of the pelvis
D. Metroendometritis
E. Infected hematoma
158. A 30-year-old man has suffered from traffic
accident. Consciousness is absent. Pulse on the
carotid artery is undeterminable, no respiration.
There is a wide leather belt on man's waist. What
measures are to be taken?
A. Put the victim with his back on the shield
B. Start immediate artificial ventilation of lungs and
closed-chest cardiac massage
C. Turn the victim to the right side
D. Do not touch the victim until the arrival of the
police
E. Conduct an artificial ventilation of lungs and
closed-chest cardiac massage after having released
from the belt
159. A 25-year-old man has facial edema, moderate
back pains. His temperature is 37,5°C, BP 180/100
mm Hg, hematuria up to 100 in v/f], proteinuria [2,0
g/L], hyaline casts — 10 in v/f., specific gravity —
1020. The onset of the disease is probably connected
with acute tonsillitis that started 2 weeks ago. What
is the most probable diagnosis?
A. Urolithiasis
B. Cancer of the kidney
C. Acute pyelonephritis
D. Chronic glomerulonephritis
E. Acute glomerulonephritis
 19
160. A patient undergoes inpatient treatment with the
diagnosis of acute pancreatitis. To spare pancreas as
much as possible the doctor prescribed for him
starvation for 1-3 days. What products is the patient
allowed to eat during recovery period after cancelling
of starvation?
A. Boiled meat
B. Broth
C. Potato and carrot mash
D. Milk
E. Grape juice
161. A 34-year-old patient was bitten by a dog 3
hours ago. There is a wound by dog teeth without
bleeding in the left arm. What surgical help would
you provide to this patient?
A. Clean wound with detergent water and apply anti-
septic
B. Complete suture of the wound
C. Aseptic bandage
D. Cream bandage
E. Incomplete suture of the wound
162. A 5-year-old girl with the transitory
immunodeficiency according to T-system has a
clinical picture of a right-sided pneumonia during 2
months. How pneumonia progress can be described?
A. Acute
B. Delaying
C. Reactivating
D. Chronic
E. Wavelike
163. A 37-year-old woman is sick with bronchial
asthma for 15 years. Recenlty asthmatic attacks occur
4-5 times per week, night attacks -2-3 times per
month. To stop attacks, the patient takes salbutamol.
On physical exam: condition is relatively
satisfactory. RR - 20/min, Ps is 76 bpm, BP -120/80
mm Hg. Respiration in lungs is vesicular. Cardiac
sounds are muted, rhythm is normal. What
medication should be prescribed to prevent attacks of
bronchial asthma on the first stage?
A. Tabletted corticosteroids
B. Regular dose of salbutamol
C. Injection of corticosteroids
D. Inhalation corticosteroids
E. Cromoglycat sodium
164. A patient suffers from suddenly arising crampy
pain in the right loin area. 2 hours after the pain had
started, hematuria took place. Loin X-ray: no
pathological shadows. Ultrasound: pyelocaliectasis
on the right, the left part is normal. What is the most
probable diagnosis?
A. Twist of the right ovary cyst
B. Intestine invagination
C. Stone of the right kidney, renal colic
D. Acute appendicitis
E. Tumour of the right kidney pelvis
165. A 20-year-old adolescent lives in the nidus of
tuberculous infection. The tuberculine Mantoux test
with 2 TU was determined as hyperergic. What signs
determine the hyperergic test of this adolescent?
A. 20 mm papula
B. 12 mm hyperemia
C. 4 mm papula
D. 24 mm hyperemia
E. 6 mm papula, necrosis
166. A 68-year-old patient complains of tiredness,
sweating, enlargement of cervical, submaxillary and
axillary lymph nodes. Blood tests: leucocytes — 35*
Itf/L, lymphocytes — 60%, Botkin and Gumprecht
bodies, level of hemoglobin and quantity of
thrombocytes is normal. Myelogram showed 40% of
lymphocytes. What is the most probable diagnosis?
A. Tuberculous lymphadenitis
B. Chronic myeloleucosis
C. Acute leucosis
D. Lymphogranulomatosis
E. Chronic lympholeucosis
167. In mental status of a 22-year-old patient there is
a stable pathological depressed mood. The patient is
sociable, replies briefly but to the point. The speech
is laconic, tempo is slowed, and movements are
constrained and inhibited. Speaks on the ideas of
self-accusation and self-humiliation. Medications of
what group are to be prescribed to this patient?
A. Hypnotics
B. Normotimics
C. Neuroleptics
D. Tranquilizers
E. Antidepressants
168. A 40-year-old man is ill with autoimmune
hepatitis. Blood test: A/G ratio 0,8, bilirubin —
42/imol/L, transaminase : ALT — 2,3 mmol g/L,
AST — 1,8 mmol g/L. What is the most effective
means in treatment from the given below?
A. Hepatoprotectors
B. Antibacterial medication
C. Glucocorticoids, cytostatics
D. Hemosorbtion, vitamin therapy
E. Antiviral medications
169. An unconscious victim in severe condition is
brought to clinic. It is known that the patient touched
the bare wire with his hand and during 5 minutes was
 20
under the influence of an alternating current with
voltage of 220 V Physical exam: skin is pale, cold by
touch. Breath is weakened, BP - 90/50 mm Hg, Ps —
60 bpm, arrhythmical. There are fields of necrosis of
the skin on the right hand and on the right foot. What
is the preliminary diagnosis?
A. Electrotrauma, acute cardiovascular failure
B. Electroburn of the right foot and right hand
C. High voltaged electroburn of the right foot and
shank
D. Electroburn of the right foot and right hand
E. Vascular collapse due to electric current lesion
170. A 3-month-old infant who is suffering from
acute segmental pneumonia reveals dyspnea
[respiration rate — 80 per minute], paradoxical
breathing, tachicardia, total cyanosis. Respiration-
pulse ratio is 1:2. The heart size is normal. What are
these signs indicative of?
A. Congenital heart disease
B. Respiratory failure of III degree
C. Respiratory failure of I degree
D. Respiratory failure of II degree
E. Myocarditis
171. A 4-day-old girl was born from a second desired
gestation, second delivery on the 39 week term. On
physical exam: characters of the pre-natal
retardation, aliform folds on the neck, lymphatic
edema of hands and feet that disappeared without
treatment during first 24 hours. What is your
assessment of the child?
A. Shereshevsky-Turner syndrome
B. Healthy child
C. Sclerema
D. Immature lymphatic system
E. Congenital hypothyreosis
172. Body temperature of a 12-year-old girl
increased up to 39 - 40°C in 4-5 hours after she had
taken 2 pills of aspirin. Complains of general
discomfort, dizziness, sudden appearance of red spots
on the skin with blister formation or exfoliation of
the epidermis with erosive surface. Lesions on the
skin looked like burns of II degree. Nikolsky
syndrome is positive. What is the most probable
diagnosis?
A. Acute epidermical necrolysis
B. Duhring's disease
C. Pemphigus vulgaris
D. Polymorphic exudative erythema
E. Bullous dermatitis
173. A 9-year-old girl has attacks of abdominal pain
after fried food. No fever. She has pain in Cera point.
The liver is not enlarged. Portion B [duodenal probe]
— 50 ml. What is your diagnosis?
A. Acute colitis
B. Hepatocirrhosis
C. Biliary tracts dyskinesia, hypotonic type
D. Peptic ulcer
E. Chronic duodenum
174. A 30-year-old patient complains of pain,
hyperemia along subcutaneous veins, rise in body
temperature. While examining the large shin
subcutaneous vein, there is hyperemia, pain by
pressing. Homanss and Luses's symptoms are
negative. What is the preliminary diagnosis?
A. Acute thrombophlebitis of subcutaneous veins
B. Embolism of aorta
C. Acute ileophemoral phlebothrombosis
D. Thrombosis of aorta
E. Lymphostasis
175. A woman was hospitalised with full-term
pregnancy. Examination: the uterus is tender, the
abdomen is tense, cardiac tones of the fetus are not
auscultated. What is the most probable complication
of pregnancy?
A. Back occipital presentation
B. Premature detachment of normally posed placenta
C. Hydramnion
D. Premature labor
E. Acute hypoxia of a fetus
176. During intramuscular DTP vacci nation in
clinic, a 3-month-old child developed signs of
laryngospasm, paleness of skin, cyanosis of lips,
"cock cry", stop of respiration, and tension of the
whole body with overturned backward head.
Allergological anamnesis of the child is not
complicated. What is the most probable diagnosis?
A. Anaphylactic shock, clonic spasms
B. Meningism, clonic and tonic spasms
C. Spasmophilia, tonic spasms
D. Meningoencephalitic reaction, clonic and tonic
spasms
E. Cerebral hemorrhage, tonic spasms
177. A 52-year-old patient with previously functional
Class II angina complains of intensive and prolonged
retrosternal pains, decreased exercise tolerance for 5
days. Angina is less responsive to Nitroglycerinum.
Which of the following diagnosis is the most
probable?
A. Myocarditis
B. Cardialgia due to spine problem
C. IHD. Unstable angina
D. Myocardial dystrophy
E. IHD. Functional Class II angina
 21
178. Mother with an infant visited the pediatrician.
Her baby was born with body mass of 3,2 kg and 50
cm length. He is 1 year old now. How many teeth the
baby should have?
A. 8
B. 10
C. 20
D. 6
E. 12
179. A 20-year-old woman with a 3-4 month history
of bloody diarrhea; stool examinationn is negative
for ova and parasites; stool cultures negative for
Clostridium, Campylobacter and yersinia; normal
small bowel series; edema, hyperemia and ulceration
of the rectum and sigmoid colon are seen on
sigmoidoscopic examination. Choose the most likely
diagnosis.
A. Granulomatous colitis
B. Zollinger-EUison syndrome
C. Carcinoid syndrome
D. Ulcerative colitis
E. Gastroenteritis
180. In 10 min after childbirth by a 22-year-old
woman, the placenta was spontaneousely delivered
and 100 ml of blood came out. Woman weight — 80
kg, infant weight — 4100 g, length — 53 cm. The
uterus contracted. In 10 minutes the hemorrhage
renewed and the amount of blood constitued 300 ml.
What amount of blood loss is permissible for this
woman?
A. 300 ml
B. 400 ml
C. 500 ml
D. 650 ml
E. 1000 ml
181. A 48-year-old woman complains of fatigue,
weight and appetite loss, headache. Suffered from
acute glomerulonephritis as adolescent. Suffers from
arterial hypertension since age 25. Has not
systematically undergone medical treatment, applied
to doctor very rarely. On laboratory investigation
signs of chronic renal failure first degree were found,
(creatinine — 0,23 mmol/L). What nutrition
recommendations are the most suitable for this
patient?
A. Ingestion with the increased content of the
"alkaline"
B. Fluid amount increase
C. Adipose control
D. Carbohydrate control
E. Protein control
182. A 68-year-old patient with long-term
hypertension complains of dizziness, difficulties by
swallowing, nasal voice, wobbly walking. These
symptoms appeared about three years ago and are
gradually progressing. What diagnosis of the given
below is the most probable?
A. Cerebral stem tumour
B. Ischemic attack
C. Discirculating encephalopathy
D. Stem encephalitis
E. Hemorrhagic attack
183. A 60-year-old man with unstable angina
pectoris fails to respond to heparin, nitroglycerin,
beta adrenegic blockers and calcium channel
antagonisst. What is the best treatment for this
patient?
A. Coronary artery bypasses grafting
B. Aspirin, orally
C. Intravenous strpetokinase
D. Excercise testing
E. Antihypertensive therapy
184. A young woman applied to gynecologist due to
her pregnancy of 4-5 weeks. The pregnancy is
desirable. Anamnesis stated that she had rheumatism
in the childhood. Now she has combined mitral heart
disease with the priority of mitral valve deficiency
When will she need the inpatient treatment (what
periods of pregnancy)?
A. 8-12 weeks, 28-32 weeks, 37 weeks
B. 12-16 weeks, 27-28 weeks, 37-38 weeks
C. 10-12 weeks, 24 weeks, 37-38 weeks
D. 6-7weeks, 16 weeks, 38 weeks
E. 16 weeks, 34 weeks, 39-40 weeks
185. A 24-year-old patient felt sick in 16 hours after
dried fish intake. There was nausea, vomiting,
weakness, flabbiness, double vision. On physical
exam, there was decrease of a muscle tone,
anisocoria, flaccid swallowing and tendon reflex.
What is the most probable diagnosis?
A. Food toxicoinfection
B. Botulism
C. Acute gastritis
D. Salmonellosis
E. Acute encephalitis
186. While making sanitary examination of burn unit
for adults it was stated that wards for 4 persons are of
28 m2 square. What should be the minimum ward
area in this unit?
A. 24 m2
B. 28 m2
C. 40 m2
D. 52 m2
E. 30 m2
 22
187. A 50-year-old patient was hospitalized in severe
condition with complaints of chills, high grade
temperature, dryness in the mouth, multiple
vomiting, pain in the epigastrium, frequent watery,
foamy, dirty green color stool of unpleasant odor.
The tongue and the skin are dry. BP — 80/40 mm
Hg. What first aid is necessary for the patient?
A. Hemosorbtion
B. Sympathomimetics
C. To prescribe polyglucin
D. Intravenous injection of sodium solutions
E. Fresh-frozen plasma transfusion
188. A 62-year-old patient complains of dyspnea on
rest, chest pain. 3 years ago he had myocardial
infarction. On physical examination, there is an
orthopnea, acrocyanosis, swollen cervical veins. Ps
— 92 bpm, total heart enlargement, the liver is
enlarged by 7 cm, shin edema. What is the stage of
chronic heart failure [CHF]?
A. CHF-1
B. CHF- 2 A
C. CHF-0
D. CHF-3
E. CHF-2 B
189. A 34-year-old woman with 10-week pregnancy
(the second pregnancy) has consulted gynaecologist
to make a record in patient chart. There was a
hydramnion previous pregnancy; the birth weight of
a child was 4086 g. What tests are necessary first of
all?
A. Ultrasound of the fetus
B. Determination of the contents of a fetoprotein
C. Bacteriological test of discharge from the vagina
D. Fetus cardiophonography
E. The test for tolerance to glucose
190. On the 20th of June a townsman was brought to
clinic. The disease broke out acutely, starting with
fever, rise in temperature to 38 — 39°C. There also
was weakness, acute headache, nausea, vomiting,
pain all over the body, sleep disorder. On physical
examination: hyperemia of skin of face, neck, thorax.
Meningeal signs are positive. 12 days ago the patient
returned from the Siberia, from the forest. What is
the most probable diagnosis?
A. Omsk hemorrhagic fever
B. Tick-borne encephalitis
C. Pseudotuberculosis
D. Epidemic typhus
E. Influenza
191. A 40-year-old woman complains of yellow
color discharges from the vagina. Bimanual
examination: no pathological changes. Smear test:
Trichomonas vaginalis and mixed flora. Colposcopy:
two hazy fields on the front labium, with a negative
Iodum probing. What is your tactics?
A. Cervix ectomy
B. Specific treatment of Trichomonas colpitis
C. Cryolysis of cervix uteri
D. Treatment of specific colpitis with the subsequent
biopsy
E. Diathermocoagulation of the cervix uteri
192. A 37-year-old woman complains of generalized
fatigue, irritability, dysphagia, chalk hunger. On
physical exam: t-36,5° C, respirations — 20/min, Ps
— 96 bpm, BP — 110/70 mm Hg. Satisfactory
nourishment. The skin and visible mucous
membranes are pale. Blood test: Hb —70g/L,
erythrocytes 3,4*1012/L, CI — 0,7, reticulocytes —
2%, leucocytes — 4,7*109/ L, eosinophilis. — 2%,
band neutrophils — 3%, segmented neutrophils —
64%, lymphocytes — 26%, monocytes - 5%, ESR —
15 mrn/min. Serum ferrum —7,3/µmol/L, total
protein — 70g/L. Deficit of what factor caused the
development of the disease?
A. Vitamin B12
B. Ferrum
C. Protein
D. Folic acid
E. Vitamin B6
193. In a man the disease started with acute onset.
Frequent watery stool developed 6 hours ago. The
body's temperature is normal. Then vomiting took
place. On physical examination: man's voice is
hoarse, eyes are deeply set in the orbits. The pulse is
frequent. Blood pressure is low. There is no urine.
What is the preliminary diagnosis?
A. Typhoid fever
B. Cholera
C. Toxic food-borne infection
D. Salmonellosis
E. Dysentery
194. A 32-year-old patient complains of severe
weakness, tremor of extremities. On physical
examination, there is loss of body weight, wet and
warm skin. The thyroid gland is enlarged up to the 3rd
degree, painless, elastic. Ps: 108 bpm. BP-160/55
mm Hg. The rest is in norm. What can be diagnosed?
A. Toxiferous adenoma of the thyroid gland
B. Chronic autoimmune thyroiditis, hypertrophic
type
C. Chronic fibrous thyroiditis
D. Diffuse toxic goitre of the 3rd degree,
thyrotoxicosis of the average degree
E. Diffuse euthyroid goitre of the 3rd degree
 23
A. Developing of cardiac insufficiency
195. A rounded shadow with well-defined outlines B. Depositing of blood in venous channel
was found at the costo-vertebral angle on a chest X- C. Presence of hypervolemia
ray of a healthy 9-year-old girl. Could you please D. Shunting
make the preliminary diagnosis? E. Increase of bleeding speed
A. Ganglionevroma
B. Sarcoma of the vertebra 200. A student lives in the modern house in the flat
C. Sympatoblastoma with a complete set of sanitary equipment (WC, bath,
D. Ganglioneuroblastoma shower, local water heater). How much water
E. Sympatogonioma consumption has he got?
A. 500 -600 L/day
196. A 14-year-old boy periodically complains of B. 160-200 L/day
pain in the epigastrium on an empty stomach, nausea C. 300-400 L/day
and heartburn during 3 years. Gastroduodenoscopy: D. 50-100 L/day
signs of gastroduodenitis and ulcer defect of the E. 10-15 L/day
mucous membrane of the duodenum. What is the
most effective medication to treat this child?
A. Almagel
B. Papaverin
C. De-nol
D. No-spa
E. Atropin

197. A 72-year-old patient after operation due to

holecystectomia was prescribed gentamicin (80 mg
every 8 hours) and cephalothin (2 g every 6 hours)
due to fever. In 10 days there was an increase of
creatinine up to 31(µmol/L. BP — 130/80 mm Hg,
daily quantity of the urine is 1200 mL. Urine tests are
without pathology. Ultrasound: the size of kidneys is
normal. What is the most probable reason for renal
failure?
A. Hepatorenal syndrome
B. Nephrotoxity of gentamicin
C. Cortical necrosis of kidneys
D. Acute glomerulonephritis
E. Unequal infusion of the liqiud

198. A neonate from gestation with severe gestosis of

the second half was born on the 41st week with 2400
g birth weight and 50cm long. On physical
examination: skin is flaccid, subcutaneous fatty
cellular tissue is thin, muscle hypotonia, new-born
period reflexes are decreased. Internal organs are
without pathological changes. How would you
estimate this child?
A. Term infant with normal body weight
B. Premature infant
C. Term infant with pre-natal growth retardation
D. Postmature infant
E. Immature infant

199. During dynamic investigation of a patient the

increase of central venous pressure is combined with
the decrease of arterial pressure. What process is
proved by such combination?