MINISTRY OF PUBLIC HEALTH OF UKRAINE

Zaporozhye State Medical University

Department of propedeutics of internal diseases

COLLECTION

of final tests for the students of the thirds course of the medical faculty
on model 2: “Basic symptoms and syndromes of internal organs' diseases”

(for complex examination)

Speciality: General medicine

7.110101

Zaporozhye, 2011
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UDK 616.1 / 4-07(075.8)

Authors: Doctor of medical science, professor - Sivolap V.V.; assistant-professor - Oleynik A.I.;
assistant c.m.s. Avramenko N.F.; assistant c.m.s. Likhasenko I.V.

Collection of final tests for the students of the third course of the medical faculty on model 1:
“Basic symptoms and syndromes of internal organs' diseases” (for complex examination) -
Zaporozhye, 2011.

The Collection is devoted to the preparation of students of the third course for complex
examination

Reviewers:
Sivolap V.D. - Doctor of medical science, professor, the Head of department of internal
medicine 1 ZSMU
Visir V.A. - Doctor of medical science, professor, the Head of department of internal medicine 2
ZSMU
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Contens

Respyratory system………………………………………………………………..4

Cardiovascular system…………………………………………………………….11

Dygestive system…………………………………………………………………20

Nephrology………………………………………………………………………..30

Blood system……………………………………………………………………...38

Endocrine system………………………………………………………………….49

Literature……………………………………………………………………….....59
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Respyratory system

What clinical attribute is not characteristic for spontaneous pneumothorax?

1. Knife-like chest pain
2. Mixed dyspnea
3. Diffuse cyanosis
4. Dull sound over affected side
5. Forced posture of the patient

What clinical sing is the most typical for spontaneous pneumothorax?

1. Not sudden dyspnea
2. Sharp stabbing chest pain
3. Productive cough
4. Hemoptysis
5. Headache

The main etiologic factor of the acute bronchitis:

1. Genetic factors
2. Smoking
3. Viral infections
4. Abusing alcohol
5. Overeating

The acute obstructive bronchitis is characterized:

1. Moist rals
2. Glass-like sputum
3. Sibilant and sonorous dry rales
4. Lengthening a phase of inspiration
5. Paralytic chest

Duration of the acute bronchitis promotes except:

1. Infringement of bronchial passage
2. Irrational application of antibiotic
3. Decrease in resistency of the organism
4. Old age patients
5. Absence in diet of enough of carbohydrates

What are diagnostic criteria of the acute bronchitis?

1. Clinical sings
2. Clinical blood analysis
3. X-ray
4. Sputum analysis
5. All is higher listed

What is characterized for obstructive bronchitis?

1. Expiratory dyspnea
2. Inspiratory dyspnea
3. Chest pain
4. Bloody sputum
5. Test of ventilatory function is normal
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Occurrence of the dyspnea at the chronic obstructive bronchitis is caused by lesions of:
1. Trachea
2. Large bronchial tubes
3. Bronchial tubes of average caliber
4. Fine bronchial tubes
5. Bronchioles

What sputum is characterized at the chronic bronchitis?

1. Change rheological properties of sputum
2. Increased viscosity
3. Decreased elasticity
4. Increased cryoproteines
5. Increased quantity

Diagnostics of a degree of the chronic obstructive pulmonary diseases is based on:

1. Clinical sings
2. Clinical blood analysis
3. X-ray
4. Test of ventilatory function
5. Angiography of the lungs

Primary emphysema (type А) characterized

1. Increase in volume of a thorax
2. Decrease respiratory abilities of the lungs
3. Increase of the residual lung capacity
4. Increase of the transparencyсy lungs

A secondary emphysema with a chronic obstructive bronchitis characterized except

1. Clinical attributes of the pulmonary heart
2. Decrease diffusive abilities of the lungs
3. Increase of the residual lung capacity
4. Hypoxemia. and hypercapnia in the rest
5. Pneumosclerosis on the roentgenogram

Located emphysema is not

1. Vicarious emphysema
2. Senile emphysema
3. Periscar emphysema
4. Congenital lobe emphysema
5. Congenital unilateral emphysema

Vicarious emphysema develops from

1. A chronic bronchitis
2. The main bronchial tube
3. Narrowing trachea
4. Atelectasis of the lung
5. A bronchiectasis

What is caused of lobar pneumonias?

1. Inhalation of toxic substances
2. Stresses
3. Hyperthyroidism
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4. Streptococcus pneumonia
5. Liver diseases

What is often clinical symptom of the pleuropneumonia?

1. Ecchymosis
2. Nonsonorous fine moist rales
3. Pleural friction rub
4. Coarse moist rales
5. Completely absent of voice resonance

What is often extrapulmonary complication of the acute lobar pneumonia?

1. Hyperthyroidism
2. Hyperglycemia
3. Septic shock
4. Acute hepatitis
5. Meningitis

Changes, present always at bronchial asthma:

1. Changes hematopoietic systems
2. The changed reactance of bronchial tubes
3. Changes of function of vegetative nervous system
4. Changes of function endocrine systems
5. A sensitization of an organism respiratory allergens

What is often inflammatory factor at the acute lobar pneumonia?

1. Carbohydrates consumption
2. Fats consumption
3. Flu
4. Overheating on the Sun
5. Hypodynamic

What is often clinical symptom of the acute lobar pneumonia?

1. Fine sonorous rales
2. Echimoses
3. Erythema
4. Skin itch
5. Coarse rales

What is often complication of Staphylococcal pneumonia?

1. Diabetes
2. Formation of lung abscess
3. Pericarditis
4. Nephritis
5. Hypothyroidism

What is reason of upward displacement of the upper border of the lungs?

1. Abscess of the lung
2. Bronchopneumonia
3. Lung emphysema
4. Atelectasis of the lung
5. Chronic bronchitis
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What is symptom of pleural effusion?

1. Damuaso’s line
2. Increased voice resonance
3. Dry rales
4. Crepitation
5. Pressing pain behind sternum

What pulmonary disease is characterized eosinophilia in clinical blood analysis?

1. Chronic bronchitis
2. Tuberculosis of the lung
3. Acute pneumonia
4. Bronchial asthma
5. Abscess of the lung

What is the most typical clinical symptom at massive pleural effusion?

1. High temperature
2. Cough
3. A pain in chest
4. Severe dyspnea
5. Hemoptysis

What is the most important factor development of the lung emphysema?

1. Chronic obstructive pulmonary diseases
2. Acute pneumonia
3. Acute bronchitis
4. Repeated overcooling
5. Pneumoconiosis

What is often complaint at acute lobar pneumonia?

1. Polyphagia
2. Sternalgia
3. Polydypsia
4. Hemoptysis
5. Cough

What can you hear over large cavity with liquid secretion (abscess) in pulmonary tissue?
1. Dry rales
2. Fine sonorous rales
3. Fine nonsonorous rales
4. Coarse rales
5. Crepitation

What type of respiration can you hear over empty lung abscess communicated with large
bronchus?
1. Vesicular respiration
2. Increased of vesicular respiration
3. Harsh respiration
4. Bronchial respiration
5. Weakened of vesicular respiration

What are different between attacks of Bronchial asthma and Cardiac asthma?
1. Sudden development of attack
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2. Forced position of the patient

3. Duration of attack
4. Difficulty inspiration
5. Difficulty expiration

What is heard during attack of bronchial asthma?

1. Fine rales
2. Wheeze
3. Coarse rales
4. Moist rales
5. Crepitation

What is the main symptom of dry pleurisy?

1. Compressing pain in precardial area
2. Increased voice resonance
3. Chest pain in affected side
4. Amphoric respiration
5. Dyspnea

Pain at dry pleurisy is increased:

1. Lie on the affected side
2. During deep inspiration or coughing
3. In the morning
4. In the afternoon
5. At reduction in temperature

What pathology is characterized with harsh respiration?

1. Lungs emphysema
2. Bronchitis
3. Lobar pneumonia
4. Dry pleurisy
5. Pleural effusion

What respiration type is heard during attack of bronchial asthma?

1. Pathological bronchial respiration
2. Weakened vesicular respiration with long expiration
3. Amphoric respiration
4. Harsh respiration
5. Puerile respiration

What percussion sound is heard in second stage of acute lobar pneumonia?

1. Dull sound
2. Tympanic sound
3. Bell sound
4. Bandbox sound
5. Metallic sound

What is heard at bronchopneumonia?

1. Crepitation
2. Fine sonorous rales
3. Dry rales
4. Harsh respiration
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5. All is higher listed

What is change of the chest at lobar pneumonia?

1. Enlargement of affected side
2. Diminution of affected side
3. The affected side delays in the act of respiration
4. Emphysemic chest
5. Supraclavicular fossae are not seen

What is heard in second stage of acute lobar pneumonia?

1. Crepitation
2. Bronchial respiration
3. Harsh respiration
4. Weakening of vesicular respiration
5. Harsh respiration

What is heard over small and medium bronchiectasis (bronchial tubes which are filled with
liquid pus)?
1. Weakened vesicular respiration
2. Bronchial breath
3. Different moist rales
4. Amphoric breath sound
5. Harsh respiration

What disease is characterized with Charcot-Leyden crystals found in sputum?

1. Lobar pneumonia
2. Bronhiectasis
3. Bronchitis
4. Bronchial asthma
5. Lung abscess

Which Lung functional test is characterized obstructive type of respiratory disorder?

1. Forced expiratory volume in 1 second
2. Vital capacity
3. Residual volume
4. Total lung capacity
5. Functional residual capacity

What character does sputum have at tumors of the lung?

1. Mucous
2. Purulent
3. Putrefactive
4. Bloody
5. Serous

Which factors are developments of tumors of the lung?

1. Chronic bronchitis
2. Smoking and a dust content of the atmosphere
3. The ionized radiation
4. Hereditary predisposition
5. All is higher listed
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What is main diagnostic method of tumor of the lung?

1. Bronchoscopy
2. The general blood analysis
3. X-ray
4. Fluorography
5. Sputum analysis

Occurrence of pain during deep breath and cough at patients with lobar pneumonia the most
frequently testifies about:
1. Involving mediastinum lymph nodes in pathological process
2. Involving paratracheal and parabronchial lymph nodes in process
3. Involving pleura in process
4. Connection of the obstructive bronchitis
5. Development of the accompanying bronchitis

What is observed at lobar pneumonia, which is located in the lower lobe of the lung?
1. Mobility of the lower border is increased
2. Mobility of the lower border is reduced
3. Displacement of the upper border
4. Tympanic sound appears
5. Dry rales

What is the basic symptom of dry pleurisy?

1. Chest pain, cough with sputum
2. Dry cough, chest pain which is increased during deep breath and cough
3. Cough with sputum, high temperature
4. Chest pain with irradiation in the left hand
5. Stupid pain in the chest

What data of auscultation is typical for dry pleurisy?

1. Increased vesicular respiration
2. Bronchial respiration
3. Moist rales
4. Pleural friction sound
5. Crepitation

What is different between chronic obstructive pulmonary disease and bronchial asthma?
1. Long exhalation phase
2. Lung emphysema
3. Wheeze during forced exhalation
4. Dry rales
5. Absence of bronchial attacks

What is heard at chronic obstructive pulmonary disease?

1. Harsh respiration and dry rales
2. Absence of respiratory noise
3. Crepitation
4. Pleural friction sound
5. Pericardium friction sound
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Cardiovascular system

What is the best recommendation of diet for patient with cardiac insufficiency?
1. Don’t change any food habits
2. Extend the level of carbohydrates
3. Reduce the level of potassium, extend the level of natrium
4. Extend the level of potassium, reduce the level of natrium
5. Extend the level of calcium, reduce the level of potassium

Aortic stenosis accompanies all diseases, except:

1. Chronic rheumatic disease
2. Syphilis
3. Myocarditis
4. Bacterial endocarditis
5. Atherosclerosis

“Cor pulmonale” isn’t complication of:

1. Emphysema
2. Bronchial asthma
3. Pulmonary tuberculosis
4. Kyphoscoliatic chest
5. Atherosclerosis

What is not typical for stable angina?

1. Pain appears during physical activity
2. Pain can be reducted by nitroglycerine
3. Pain can not be reducted by validol
4. Pain may radiate in the arm to the wrist and fingers
5. Pain is not more than 15min

Pathognomonic and the most typical skin changes during acute rheumatic fever are:
1. Nettle-rash
2. Roseola
3. Annular erythema
4. Hemorrhages
5. Petechias

What sign is not characteristic for acute rheumatic fever?

1. Starts at children and youths
2. Chronological connection with non-streptococcic infection
3. Acute beginning
4. Polyartritis
5. Carditis

What is carditis during acute rheumatic fever?

1. Infectious disease induced with streptococcus
2. Slow hyperergic reaction on streptococcus antigen
3. Disease induced with virus
4. Disease induced with protozoa
5. Disease induced with fungi

Symptoms of what desease are carditis, polyarthritis, and erythema:

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1. Bacterial endocarditis
2. Acute rheumatic fever
3. Pericarditis
4. Cardiomyopathy
5. Myocarditis

Man, 48 years old. Suffers from stable angina pectoris appeared during walking one or two
blocks on the level, sometimes at rest. What method of examination is the most important?
1. Scintigraphy of myocardium
2. Echocardiography
3. Holter’s monitoring
4. Bicycle ergometer
5. Coronary angiography

What is the main clinical symptom of acute rheumatic fever?

1. Weakness
2. Osteoporosis
3. Pain in right hypochondria
4. Leg edema
5. Carditis

What is clinical symptom of diffuse myocarditis?

1. Heart failure
2. Hemorrhages
3. Splenomegaly
4. Diastolic murmur
5. Accentuated S II over aorta

What kind of pain happens at cardiac region in the presence of myocarditis?

1. Ache
2. Shooting-pain
3. Pressing
4. Constricting pain
5. Pinching

What is the main diagnostic criterion of acute rheumatic fever?

1. Hemarthrosis
2. Low grade fever
3. Chorea
4. Nasal hemorrhages
5. Heart pain

Direct symptom of mitral stenosis is:

1. Weakening S1 at the heart apex
2. Intensification S1 at the heart apex
3. Systolic murmur at the heart apex
4. Systolic murmur over aorta
5. Accentuated S2 over pulmonary artery

What is complication of mitral stenosis?

1. Pneumonia
2. Atrial fibrillation or atrial flutter
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3. Pleurisy
4. Bronchitis
5. Hepatitis

What is direct symptom of mitral regurgitation?

1. Decreased S2 over aorta
2. Accentuated S2 over pulmonary artery
3. Systolic murmur at the xiphoid process
4. Systolic murmur at the heart apex transmitted in the left axillary region
5. Diastolic murmur at the Botkin’s point

What is physical symptom of mitral regurgitation?

1. Displacement of the relative cardiac dullness upward and to the left
2. Increased S I at the heart apex
3. Diastolic murmur at the heart apex
4. Systolic thrill
5. Displacement of the relative cardiac dullness upward and to the right

There are vascular symptoms of aortic regurgitation, except:

1. Decreased systolic pressure
2. Pulsation of the peripheral arteries
3. Traube’s tone
4. Duroziez’s murmur
5. Quincke’s pulse

Direct symptom of aortic stenosis is:

1. Systolic murmur at II intercostal space to the left from sternum
2. Diastolic murmur at the heart apex
3. Intensification S1 at the heart apex
4. Systolic murmur at the xiphoid process
5. Rough systolic murmur at II intercostal space to the right from sternum

Symptom of tricuspid regurgitation is:

1. Diastolic murmur
2. Systolic thrill
3. Systolic murmur over xiphoid process
4. Accentuated S2 over aorta
5. Accentuated S2 over pulmonary artery

Upper border of normal blood pressure at adults is:

1. 120/70 mm Hg
2. 130/80 mm Hg
3. 135/85 mm Hg
4. 139/89 mm Hg
5. 140/95 mm Hg

The S1 intensifies in presence of:

1. Thyrotoxicosis
2. Mitral stenosis
3. Stable angina
4. Myocarditis
5. Aortic stenosis
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Pericardial friction rub is auscultated during:

1. Systole
2. Diastole
3. Systole and diastole
4. Presystole
5. Middiastole

What kind of pain is characteristic for stable angina?

1. Ache
2. Knife-like pain
3. Pressing
4. Shooting-pain
5. Pinching

What is the most typical variant of myocardial infarction?

1. Asymptomatic (painless)
2. Anemic
3. Cerebral
4. Status anginous
5. Hemorrhagic

Postinfarction period after myocardial infarction lasts:

1. From 30 min till 2 h from the beginning of the pain
2. From 1 till 10 days
3. From 10 days till 5th week
4. From 1 till 2 months
5. From 2 till 6 months from myocardial scarring

What foodstuff has to be limited at nutrition of myocardial infarction patient?

1. Water
2. Sugar
3. Salt
4. Spices
5. All correct

What is the main diagnostic criterion of essential hypertension of І stage?

1. Focal narrowing of retinal arteries
2. Large pulse pressure
3. Blood pressure to 160/99
4. Left ventricle hypertrophy
5. Abdominal vascular murmur

What is the basic pressor humoral factor of pathogenesis of early stages of essential
hypertension?
1. Angiotensin II
2. Aldosterone
3. Vasopressin
4. Catecholamines
5. Natrium delay

The most frequent complaint of patient with diffusive myocarditis:

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1. Arthralgia
2. Headache
3. Pain at cardiac region
4. Breathlessness
5. Low diuresis

Atrial fibrillation waves are characterized with:

1. Irregularity
2. Variety of forms
3. Variety of amplitudes
4. All features
5. During fibrillation atrial waves are lacking

Morgany-Adams-Stocks’es attack can be registered at:

1. III degree of AV block
2. Atrial flutter
3. Ventricular paroxysmal tachycardia
4. Atrial fibrillation
5. All abnormalities

What clinical symptom is less characteristic for aortic stenosis?

1. Stable angina
2. Giddiness
3. Sudden death
4. Pulsation of the carotid arteries
5. Left ventricle heart failure

What is ethyologyc factor of aortic regurgitation?

1. Dissecting aortic aneurysm
2. Atherosclerosis
3. Bacterial endocarditis
4. Essential hypertension
5. All causes

The most frequent reason of heart failure at aged people (after 75) is:
1. IHD, cardiosclerosis
2. Amyloidosis
3. Aortic stenosis
4. Arterial hypertension
5. Calcification of mitral valve

What is the first symptom of mitral stenosis?

1. Peripheral edema
2. Heaviness in right hypohondrium
3. Palpitation
4. Dyspnea
5. Orthopnea

The most frequent arrhythmia at patients with mitral stenosis is:

1. Paroxysmal atrial tachycardia
2. Atrial flutter
3. Atrial fibrillation
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4. Ventricular premature beats

5. Supraventricular premature beats

Patient, 19 years old, complaints of exceptional dyspnea. He has suffered for two weeks. After
quinsy appeared pain in joints, temperature rised to 37,8 0С. Provisional diagnosis:
1. Acute rheumatic fever
2. Myocarditis
3. Acute myocardial infarction
4. Bacterial endocarditis
5. Atherosclerosis

Patient, 68 years old, has suffered from constricting pain in mid part of sternum by walking one
block on the level during 3 years. Attack usually lasts 10 min. He had a treatment on account of
IHD. Systolic murmur can be auscultated over aorta. ECG: ST – segment and T – wave
depressed in leads III, aVF. Provisional diagnosis:
1. Acute myocardial infarction
2. Stable angina, class III
3. Dissecting aortic aneurysm
4. Unstable angina
5. Atherosclerosis of aorta

Woman, 37 years old, complaints of palpitation, giddiness, breathlessness, ache at cardiac

region. She has been ill during 3 months. At first attacks appeared 1-2 times per month, stopped
after breath-holding. Latest time they become more frequent. Objective data: skin is moist, tones
are clear, rhythmic. Heart rate 80/min., blood pressure - 140/90 mm Hg. ECG: during attack -
heart rate 160/min., QRS without changes, T is combened with P. What type of tachycardia does
she have:
1. Atrial flutter
2. Paroxysmal atrial fibrillation
3. Paroxysmal supraventricular tachycardia
4. Paroxysmal ventricular tachycardia
5. Sinus tachycardia

Woman, 30 years old, suffers from breathlessness after the slightest physical activity, cough with
blood streaks. Anamnes morbid: frequent quinsies, an episode of fever with pain in joints.
Objective data: pulsation in the epigastric region, S I is loud and diastolic murmur at the heart
apex. Heart rate 120/min., rhytm is irregular, the lungs are determined moist rales. Liver is 3 cm
below the costal margin, moderately painful. Probable heart trouble:
1. Mitral stenosis
2. Mitral regurgitation
3. Tricuspid stenosis
4. Aortic regurgitation
5. Interventricular septum defect

Man, 59 years old, has chronic obstructive lung desease, emphysema, respiratory failure II st.
Complaints of recurring pain at cardiac region. Objective data: pulsation in the epigastric region,
decreased loudness of heart sounds, rhythmic, accentuated S 2 over pulmonary artery. Liver is 5 cm
below the costal margin, edema of the legs. What complication has he got?
1. IHD
2. Cor pulmonale
3. Myocarditis
4. Pneumosclerosis
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5. Dry pleurisy

Patient, 28 years old, had adenovirus infection two weeks ago. He has pain at cardiac region,
breathlessness, palpitation. Patient is pale, acrocyanosis, heart rate 92/min., filiform, blood
pressure - 90/60 mm Hg. Heart borders are displaced to the left and to the right for 2 cm. Heart
sounds are diminished, tachycardia, gallops rhythm. ECG: complete left bundle-branch block,
low voltage. What desease characterized by such symptoms?
1. Exudative pericarditis
2. Myocarditis
3. Acute rheumatic fever
4. Bacterial endocarditis
5. Dilated cardiomyopathy

Man, 67 years old, complaints of headache, giddiness, image flicker. It happens periodically
once in 4 years. At the same time blood pressure - 200/100 mm Hg. Heart borders are diminished
to the left for 1 cm. increased of S1 loudness at the heart apex, rhythmic, accentuated S II over
aorta, lungs and liver without features. Provisional diagnosis:
1. Atherosclerosis
2. Myocarditis
3. Dilated cardiomyopathy
4. Heart failure
5. Essential hypertension

Woman, 53 years old, complaints of headache, giddiness, constricting pain at cardiac region
during rest. She has suffered for 5 years. Blood pressure - 180/100 mm Hg. Objective data: heart
borders are diminished to the left for 1,5 cm, increased of S I loudness at the heart apex,
rhythmic, accentuated S2 Iover aorta.
Provisional diagnosis:
1. Essential hypertension
2. Myocardial infarction
3. Myocarditis
4. IHD, stable angina
5. Cushing's syndrome

Man, 57 years old, complaints of breathlessness, dry cough, pain at left half of chest with
irradiation to left scapula heaviness in right hypochondrium. Objective data: the patients
condition is grave, fine moist rales in lower lobes of lungs, decreased loudness of S I at the heart
apex, systolic murmur over the heart apex, heart rate 100/min., arrhythmic, blood pressure -
115/75 mm Hg. Liver is enlarged, painful. What degree of heart failure is it?
1. І degree
2. ІІА degree
3. ІІB degree
4. ІІІ degree
5. Lack

Man, 72 years old, had three times short loss of consciousness. Objective data: heart rate
42/min., blood pressure - 140/70 mm Hg. ECG: P-P – 80/min., R-R - 40/min, rhytm is regular.
What disorder of conduction does he have?
1. Sinoauricular block I degree
2. III degree AV-block
3. II degree AV-block
4. I degree AV-block
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5. Stroke

Woman, 57 years old, admitted to cardiology department. She suffers from pressing pain behind
the sternum, which irradiates to the left hand. Pain appeared 8 hours ago, its strength slowly
increased. Objective data: the patients condition is grave, cyanosis, decreased loudness of S I at
the heart apex. Heart rate 88/min, blood pressure - 110/60 mm Hg. ECG: abnormal Q wave, ST
segment elevation, positive T at I, aVL, V4-V6. What is localization of myocardial infarction?
1. Anterior wall infarction
2. Inferior wall infarction
3. Lateral wall infarction
4. Anterior lateral wall infarction
5. Inferior lateral wall infarction

Man, 62 years old, complains of severe squeezing pain behind the sternum. Has essential
hypertension for 7 years. Objective data: the patient’s condition is grave. Heart borders are
diminished to the left, decreased loudness of S1 at the heart apex. Heart rate 72/min., blood
pressure - 150/90 mm Hg. ECG ST segment is depressed; T wave is negative at V2–V6.
Provisional diagnosis:
1. Acute Q-wave myocardial infarction
2. Acute non Q-wave myocardial infarction
3. Stable angina
4. Essential hypertension
5. Myocarditis

Man, 48 years old, has constricting pain in the low part of the sternum during walking on 150-
200m and climbing 1 flight of stairs. Pain disappears during rest. Heart rate 62/min., blood
pressure - 120/70 mm Hg. ECG: regular sinus rhythm. What is the class of stable angina?
1. IHD, unstable angina
2. IHD, stable angina, class II
3. IHD, stable angina, class III
4. IHD, stable angina, class IV
5. IHD, vasospastic angina

Man, 56 years old, scientist, has constricting pain in the low part of the sternum several times a
day during walking uphill for 10min. Relive pain by nitroglycerine. Objective data: heart borders
is normal, heart rate 78/min., rhythmical, blood pressure - 130/80 mm Hg. ECG - T wave
elevated in V4-V5. Provisional diagnosis:
1. IHD, unstable angina
2. IHD, stable angina, class I
3. IHD, stable angina, class II
4. IHD, stable angina, class III
5. IHD, stable angina, class IV

Female patient, 25 years, suffers from ache at cardiac region, palpitation, breathlessness.
Chronic rheumatic heart disease, mitral regurgitation in anamnesis. Objective data: joints
unchanged, acrocyanosis. Heart rate 96/min., blood pressure - 105/70 mm Hg. Heart borders
dilated. S1 on the heart apex is weak, long systolic murmur transmitted to the left axillary region.
Accentuated S2 over the pulmonary artery. What changes of echocardiogram are typical for this
condition?
1. Dilatation of the left atrium and left ventricle
2. Dilatation of the right ventricle
3. Dilatation of the left and right atriums
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4. Dilatation of the right atrium

5. Dilatation of the left atrium and right ventricle

Man, 52 years old, suffers from pain at cardiac region during physical activity, giddiness.
Frequent cases of tonsillitis. Objective data: paleness, blood pressure - 120/90 mm Hg, heart rate
60/min., rhythmic, pulse small, slow and rare. Apical thrust strong, localized in 6 intercostal
space 1cm left from midclavicular line. S1 on the heart apex is weak, accentuated S2 over
pulmonary artery. In the 2 right intercostal space auscultated rough systolic murmur, conducted
on the a. carotis. Choose heart desease:
1. Coarctation of aorta
2. Atherosclerosis of aorta
3. Aortic stenosis
4. Tricuspid stenosis
5. Atrial septal defect

Female patient, 16 years, suffers from pain in large joints. Recovered from tonsillitis 2 weeks
ago. Objective data: heart borders are normal, S I at the heart apex is weak, systolic murmur at
the heart apex, heart rate 100/min., blood pressure 120/70 mm Hg, ESR 30 mm/h. Provisional
diagnosis:
1. Cardiomyopathy
2. Pericarditis
3. Viral myocarditis
4. Bacterial endocarditis
5. Acute rheumatic fever
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Dygestive system

For what kind of the chronic gastritis is typically: localization mainly in the body of the stomach,
prevalence of atrophic changes in mucous membrane, reduced acidity of gastric juice and
presence of antibodies to parietal cells?
1. Gastritis of type A
2. Gastritis of type B
3. Chemical gastritis
4. Radiating gastritis
5. Lymphocytary gastritis

For what kind of the chronic gastritis is typically: localization mainly in pyloric part of the
stomach, prevalence inflammation in mucous membrane, increased acidity of gastric juice and
presence Helicobacter pylori in stomach mucous membrane?
1. Gastritis of type A
2. Gastritis of type B
3. Chemical gastritis
4. Radiating gastritis
5. Lymphocytary gastritis

High figures of acidity are the most typical for localization of ulcer:
1. Gastric ulcer
2. Duodenal ulcer
3. Chemical gastritis
4. Radiating gastritis
5. Lymphocytary gastritis

Presence of the portal hypertension is the most typical for:

1. Acute hepatitis
2. Chronic hepatitis
3. Liver cirrhosis
4. Stomach ulcer
5. Duodenal ulcer

What called symptom not typical for distal colitis?

1. Blood in a stool
2. Watery diarrhea
3. Tenesmus
4. Spasmodic sigmoid gut
5. Pain syndrome

The main cause of development of the acute pancreatitis is:

1. Trauma of abdomen
2. Smoking
3. Cholelithiasis
4. Abusing sweet food
5. Duodenal ulcer

The main cause of development of the chronic pancreatitis is:

1. Trauma of abdomen
2. Smoking
 21

3. Alcohol abuse
4. Sweet stuff abuse
5. Duodenal ulcer

What is typical for hemolytic jaundice?

1. Pain syndrome
2. Excessive hemolysis of erythrocytes
3. Infringement of intestinal digestion
4. Portal hypertension syndrome
5. Liver impairment

What ulcers localization is characterized late and night pains?

1. Ulcerative esophagitis
2. Ulcer of small curvature of stomach
3. Ulcer of a bottom of stomach
4. Ulcer of the big curvature
5. Ulcer of a bulb of duodenum

What symptom is basic of gastric ulcer?

1. Nausea
2. Pain
3. Vomiting
4. Diarrhea
5. Weight loss

Where is the pain mostly felt at patients with duodenal ulcer?

1. In a zone of xiphoid process
2. In paraumbilical area
3. In right hypochondrium
4. In pyloroduodenal area
5. In left hypochondrium

What method of diagnostics is the most informative for gastric ulcer?

1. The general blood analysis
2. The analysis stool on the latent blood
3. Radiological
4. Esophagogastroduodenoscopy
5. Research of gastric secretion

Presence of melena is typical for:

1. Bleeding hemorrhoids
2. Ulcerative colitis
3. Gastric bleeding
4. Cracks of the anus
5. Cancer of sigma particle

What basic etiological factor is recognized in development of the chronic hepatitis?

1. Alcohol
2. Illnesses of metabolism and accumulation
3. Chemical influences
4. Viral hepatitis
5. Medicines
 22

What method of diagnostics is the most reliable for the chronic gastritis?
1. Laparoscopy
2. Ultrasound (US)
3. Biopsy the mucous membrane of the stomach
4. Cholangiography
5. X-ray of the stomach

Syndrome hypersplenism is contain:

1. Presence of anemia
2. Enlargement of the spleen
3. Presence of anemia, leukocytopenia, thrombocytopenia
4. Presence of thrombocytopenia
5. Presence of leukocytopenia

The portal hypertension is characterized by all symptoms, except one:

1. Varicous expanded veins of an esophagus and stomach
2. Varicous expanded of the veins on the forward abdomen wall
3. Enlargement of the spleen
4. Hypertension crisis (attack)
5. Ascites

What is the principal cause of bleedings from varicous veins of the esophagus in patients with
liver cirrhosis?
1. Decrease of prothrombin
2. Decrease of proconvertin
3. The portal hypertension
4. Reduction of thrombocytes
5. Reduction of fibrinolysis

One of the following groups covers “early” symptoms of cancer of the stomach:
1. Causeless weakness, decrease in work capacity, apathy
2. Absence of appetite, disgust for food
3. The phenomena of gastric discomfort
4. Unmotivated weight loss
5. All mentioned above symptoms

Which disease is characterized unacidic reaction pH?

1. Chronic superficial gastritis
2. Chronic atrophic gastritis
3. Chronic colitis
4. Duodenal ulcer
5. Stenosis of the pylorus

The most often cancer of stomach is situated:

1. Antral part of stomach
2. Small curvature of stomach
3. Big curvature of stomach
4. Cardiac part of stomach
5. Body of stomach

The most often histological form of stomach cancer is:

 23

1. Adenocarcinoma
2. Scirrhous carcinoma
3. Solid cancer
4. Epidermoid cancer
5. Not differentiated cancer

To precancer diseases of the stomach concerns:

1. Ulcer of a bulb of a duodenal gut
2. Retrobulb ulcer of a duodenal gut
3. Stomach ulcer
4. Chronic atrophic gastritis
5. Acute gastritis

Choose symptom that doesn’t characterize for portal hypertension:

1. Bleeding from the expanded veins of esophagus
2. Varicous expanded of the veins on the forward abdomen wall
3. Enlargement of spleen
4. Rise in temperature
5. Ascites

Complaints: pain in the right hypochondrium is intensive, colic like, provoked after improper
feeding, alcohol, nausea, bitterness in the mouth, etc. What form of the dysfunctional bile tract
disorders has patient?
1. Hyperkinetic form of the gall bladder or/and bile ducts dysfunction
2. Hypokinetic form of the gall bladder or/and bile ducts dysfunction
3. Insufficiency of function of a pancreas
4. Hypochlorhydria
5. Hyperchlorhydria

Complaints: on long, constant, dull holding pains or heavy feeling in the right hypochondrium;
nausea, bitterness in the mouth, etc. What form of the dysfunctional bile tract disorders has
patient?
1. Hyperkinetic form of the gall bladder or/and bile ducts dysfunction
2. Hypokinetic form of the gall bladder or/and bile ducts dysfunction
3. Insufficiency of function of a pancreas
4. Hypochlorhydria
5. Hyperchlorhydria

The attribute of bleeding from gastric ulcer is:

1. Strengthening of a previous pain
2. Vomiting by "coffee grounds"
3. Irradiating (eccentric) pain in a back
4. Heartburn and sour smack in a mouth
5. Constipation

Its following forms concern to 1-st clinical stage of the stomach cancer:
1. The growth of tumor limited to the muscular membrane
2. The growth of tumor limited mucous and submucous membranes
3. The growth of tumor limited to serous layer
4. Growth, within the limits of all wall of the stomach without metastasizes
5. Growth, within the limits of all wall of the stomach with metastasizes
 24

Its following forms concern to 4-th clinical stage of a cancer of a stomach:

1. The growth of tumor limited mucous and submucous membranes
2. Growth within the limits of all wall of stomach with metastasizes in regional nodes
3. Growth within the limits of all wall of stomach without metastasizes in regional nodes
4. Growth of tumor with germination in the next organs
5. The tumor of any sizes with the remote metastasis

What disease is complicated as pyloric stenosis?

1. Chronic superficial gastritis
2. Duodenal ulcer
3. Stomach cancer
4. Gastric ulcer
5. Chronic atrophic gastritis

What attributes of disease are characterized for stenosis of the pylorus?

1. Black stool
2. Bloody vomiting
3. Profuse morning vomiting with food that was ingested several days ago
4. Vomiting by "coffee grounds "
5. Suddenly developed sharp epigastric pain

Duodenal ulcer is characterized the following symptoms, except one:

1. Heartburn
2. Pain
3. Increase of acidity of gastric juice
4. Decrease of acidity of gastric juice
5. Constipation

Obstructive (subhepatic) jaundice is characterized:

1. Increase of total bilirubin due to the indirect one
2. Increase of total bilirubin due to the direct one
3. Increase of the thymol test
4. Increase scale of globulins
5. Enlargement of spleen

Attributes of the chronic pancreatitis are below-mentioned, except for one:

1. Localization of the in epigastric areas at the left
2. Diarrhea
3. Amplification (strengthening) of the pain after meal
4. Portal hypertension
5. Vomiting

What is the basic radiological attribute of the gastric ulcer?

1. Presence of ulcer "niche"
2. Presence of deformation of a stomach
3. Hypersecretion
4. Cicatricial deformation of a bulb
5. Convergence plications of stomach

For type B of gastritis all below-mentioned symptoms are characterized, except for one:
1. Presence Helicobacter pylori in a mucous membrane of a stomach
2. Localization mainly in antral part
 25

3. Hyperacid condition
4. Prevalence of inflammatory changes
5. Progressive atrophies of the secretory epithelium

What type of gastritis is precede gastric ulcer:

1. Rigid
2. Polypous
3. Atrophic
4. Antral
5. Radiating

Where is the pain localization in patient with ulcer of cardial part of the stomach?
1. Under xiphoid process
2. In periumbilical areas
3. In epigastric areas at the left
4. In piloroduodenal areas
5. In epigastric areas on the right

What is contributing factor in development of the chronic cholecystitis?

1. Sensitization
2. Gall bladder or/and bile ducts dysfunction
3. Insufficiency of function of a pancreas
4. Hypochlorhydria
5. Hyperchlorhydria

What virus is caused by chronic hepatitis?

1. Virus hepatitis A
2. Virus hepatitis B
3. Virus hepatitis E
4. Virus hepatitis D
5. Anyone

What complex of biochemical tests are specific for cholestatic syndrome?

1. Increasing of transferases, sorbitol dehydrogenase
2. Increasing of alkaline phosphatase, cholesterol, direct bilirubin
3. Decreasing of albumin, cholinesterase
4. Occurrence of rheumatoid factor
5. Decreasing in the blood of amount of erythrocytes, leukocytes, thrombocytes

Precancer disease of the stomach is not:

1. Chronic gastritis type A
2. Lymphocytary gastritis
3. Gastric ulcer
4. Duodenal ulcer

Occurrence of disgust for meat food the most typical complaint of the patient:
1. Аtrophic gastritis
2. Gastric ulcer
3. Duodenal ulcer
4. Cancer of a stomach
5. Chronic gastritis type B
 26

Early pain in epigastrium at the gastric ulcer arise:

1. 1,5 hours after meals
2. Occurring 30 - 40 minutes after meals
3. Early in the morning on an empty stomach
4. Nocturnal pain
5. Hunger pain

Palpation of ascending and descending colons are spent:

1. One right hand
2. One left hand
3. Bimanual palpation
4. Double hand
5. Slanting palpation

The most typical features of a pain at the chronic gastritis type A:

1. Sharp
2. Colicky pain
3. Painful symptom is not characterized
4. Nocturnal pain
5. Hunger pain

What part of the stomach is mainly struck at the chronic gastritis type B?
1. Fundus
2. Antral
3. Diffuse
4. Isolation
5. Cardiac part

What is main symptom at the chronic cholangitis?

1. Vomiting
2. Sialorrhea
3. Colicky pain in right upper quadrant
4. Diarrheas
5. Hectic fever

What is main clinical symptom of the cancer of cardial part of the stomach?
1. Gastric discomfort
2. Absence of appetite
3. Weight loss
4. Heaviness in abdomen after the meal
5. Dysphagia

Which disease of digestive system is more typical for the seasonal pain?
1. Cholecystitis
2. Cholelithiasis
3. Duodenal ulcer
4. Colitis
5. Hepatitis

Which disease of digestive system is characterized nocturnal, hunger pain?

1. Cholecystitis
2. Cholelithiasis
 27

3. Duodenal ulcer
4. Colitis
5. Hepatitis

What disorder of appetite is characterized for patients with not complicated duodenal
ulcer?
1. Perverted
2. Reduced
3. Increased
4. Disgust for meat food
5. Normal

Regurgitation with odor of rotten eggs is characterized for:

1. Not complicated gastric ulcer
2. Liver cirrhosis
3. Chronic pancreatitis
4. Pyloric stenosis
5. Chronic hepatitis

What is the character of vomit in patients with pyloric stenosis?

1. Vomiting with bile
2. Vomiting with blood
3. Vomiting by "coffee grounds "
4. Vomiting occurs 10-15 minutes after meals
5. Profuse morning vomiting with food that was ingested several days ago with odor of rotten
eggs

Heartburn is based on:

1. An atrophy of the mucous membrane of the stomach
2. Hypochlorhydria
3. Achlorhydria
4. Gastroduodenal reflux
5. Gastroesophageal reflux

Vomiting by “coffee grounds “ is characterized for:

1. Pylorostenosis
2. Jaundice
3. Gastric bleeding
4. Achlorhydria
5. Colitis

Melena is characterized for:

1. Nasal bleeding
2. Bleeding from sigmoid colon
3. Gastrointestinal bleeding
4. Bleeding from hemorrhoid veins
5. Haemoptysis

What is the character of feces in patients with gastric bleeding?

1. The blood is in feces of pink color
2. Feces of green color
3. Feces of black color
 28

4. Colorless
5. Normal

What kind of stool do patients have with the increased acidity of the gastric juice?
1. Constipation
2. Diarrhea
3. Alternation of locks with diarrheas
4. Feces with an impurity of not digested food
5. Normal

What attribute is the most typical for pyloric stenosis?

1. Retraction of the stomach in epigastric part
2. Swelling of the abdomen
3. Asymmetry of the abdomen
4. Visible peristalsis of the stomach
5. Resistance of the anterior abdominal wall

What is main reason of ascites at patients with liver cirrhosis?

1. Increase of bilirubin content in the blood
2. Increased of the spleen
3. Increased of the liver
4. Portal hypertension
5. Increased of arterial pressure

What is typical symptom for portal hypertension?

1. Constipations
2. Diarrheas
3. Ascites
4. Jaundice
5. Skin itch

What is Kurvuazje sign?

1. Tenderness in the point of projection of sigmoid colon
2. Tenderness in pyloroduodenal region
3. Tenderness in epigastric region
4. Palpation increased and painful gall-bladder
5. Palpation of pylorus of the stomach

What symptom is typical for the chronic cholecystitis?

1. Shchetkin-Blumberg symptom
2. Kerras’ symptom
3. Pasternatsky’s symptom
4. Mendel’s symptom
5. Fluctuation symptom

Which jaundice is typical elevation of total bilirubin?

1. Mechanical jaundice
2. Hemolytic jaundice
3. Parenchymatous jaundice
4. All kinds of jaundices
 29

Increasing of bound bilirubin can be caused by:

1. Hemolytic jaundice
2. Iron-deficiency anemia
3. Subhepatic jaundice
4. Aplastic anemia
5. Pernicious anemia

Increasing of unbound bilirubin can be caused by:

1. Hemolytic jaundice
2. Iron-deficiency anemia
3. Mechanical jaundice
4. Aplastic anemia
5. Chronic gastritis

What viruses are caused chronic hepatitis?

1. A, Е
2. B, C, D
3. A, B, C, D, Е
4. A, D
5. A, C
 30

Nephrology

What is normal specific gravity of the urine?

1. 11,001 – 1,048
2. 1,010 – 1,028
3. 1,001 – 1,010
4. 1,025 – 1,048
5. 1,010 – 1,048

Leucocyturia is characterized for:

1. Pyelonephritis
2. Nephrotic syndrome
3. Acute nephritis
4. Renal amyloidosis
5. Cancer of the bladder

What is normal urine volume?

1. 0 – 200 ml
2. 500 – 1000 ml
3. 1000 – 1800 ml
4. 2000 – 3000 ml
5. 3000 – 4000 ml

What is nocturia?
1. Less than 500 ml of urine/24 h
2. 1000 – 1800 ml of urine/24 h
3. Exceed volume of urine at night than at day
4. Exceed volume of urine at day than at night
5. Exceed 2000 ml of urine/24 h

Albuminuria is:
1. Increased glucose level of urine
2. Absence of protein of urine
3. Presence of protein of urine
4. Presence of setting of urine
5. Presence of urobilin of urine

Glucosuria is characterized for:

Abuse of spicy food
Emotional distress
Diabetes mellitus
Glomerulonephritis
Ulcer disease

What test does determin erythrocytes' presence in the urine?

1. Zimnitsky’s test
2. Rehberg’s test
3. Nechiporenko’s metod
4. Three - glasses test
5. Gregersen’s test

What results of Zimnitsky’s test show decreased of renal concentrating ability?

 31

1. The exceed volume of urine at day than at night

2. The volume of urine - 1000-2000 ml/24 h
3. Big difference of the urine specific gravity in individual servings
4. Low specific gravity of urine in all portions
5. The high specific gravity of urine

What substances are increased the specific gravity of the urine?

Urate
Proteins
Bile pigments
Glucose
Uric acid

Expressed urobilinogenuria is characteristic for:

1. Obstructive jaundice
2. Hemolytic jaundice
3. Nephrolithiasis
4. Renal Infarction
5. Chronic glomerulonephritis

Expressed bilirubinuria is characteristic for:

1. Obstructive jaundice
2. Hemolytic jaundice
3. Nephrolithiasis
4. Renal infarction
5. Chronic glomerulonephritis

Cylinders of urine characterized:

1. Slime changes its consistency in acidic urine
2. Protein copies of tubules of the kidneys
3. Accumulation of bacteria
4. Pressed bars of platelets
5. Salt stoppers

What urine pH makes the predominance of vegetable diet?

1. Acid
2. Slightly acid
3. Alkaline
4. Neutral
5. Strong acid

The altered erythrocytes in urine appear in:

1. Acute nephritis
2. Urolithiasis
3. Acute cystitis
4. Tuberculosis of urinary bladder
5. Hypertrophy of prostate

What protein level in urine syndrome?

1. To 3,5 g / 24 h
2. To 4,5 g / 24 h
3. To 5,5 g / 24 h
 32

4. To 6,5 g / 24 h
5. To 9,5 g / 24 h

Leucocyturia is presence in urine of large quantities of:

1. Cylinders
2. Urate
3. Leukocytes
4. Erythrocytes
5. Phosphates

Uraturia is presence in the urine:

1. Oxalic acid
2. Uric acid
3. Phosphoric acid
4. Hippuric acid
5. Nitric Acid

The unmodified erythrocytes in the urine are characterized:

1. Pyelonephritis
2. Nephrotic syndrome
3. Glomerulonephritis
4. Renal amyloidosis
5. Urolithiasis

What normal content of leukocytes in the sediment of urine (in sight)?

1. 40-50
2. 30-40
3. 20-30
4. To 2-4
5. 100 and more

Crystals in urine sediment, painted in pink, are:

1. Carbonates
2. Phosphates
3. Oxalates
4. Urates
5. Uric acid

Leached erythrocytes in urine sediment appear at:

1. Urolithiasis
2. Cystitis
3. Pyelonephritis
4. Glomerulonephritis
5. Renal amyloidosis

What is ketonuria?
1. Acetoacetic acid in the urine
2. Glucose in the urine
3. Acetone in the urine
4. Protein in the urine
5. Bile pigments in the urine
 33

The concentration of creatinine in the blood is:

1. 1,107 – 2,096 mmol/l
2. 0,176 – 0,297 mmol/l
3. 0,088 – 0,176 mmol/l
4. 0,044 – 0,088 mmol/l
5. More than 2,096 mmol/l

What is Nechiporenko’s method?

1. Counting number of leucocytes, erythrocytes, cylinders in urine in 24 h
2. Counting number of leucocytes, erythrocytes, cylinders in urine in 1 h
3. Counting number of leucocytes, erythrocytes, cylinders in urine in 1 minute
4. Counting number of leucocytes, erythrocytes, cylinders in 1 ml of the urine
5. Counting quantity of urine in 1 minute

What is Addis – Kakovsky’s method?

1. Counting number of leucocytes, erythrocytes, cylinders in urine in 24 h
2. Counting number of leucocytes, erythrocytes, cylinders in urine in 1 h
3. Counting number of leucocytes, erythrocytes, cylinders in 1l of urine
4. Counting number of leucocytes, erythrocytes, cylinders in urine in 1 minute
5. Counting number of leucocytes, erythrocytes, cylinders in 1 ml of urine

The normal maximum number of leukocytes in 1 ml of urine is:

1. 1000
2. 2000
3. 3000
4. 4000
5. 5000

The normal number of erythrocytes in Nechiporenko’s method is:

1. 10
2. 100
3. 1000
4. 1500
5. 2000

What is normal glomerular filtration rate?

1. 50-75 ml/min
2. 80-120 ml/min
3. 125-145 ml/min
4. 150-170 ml/min
5. 180-200 ml/min

What symptom is not characterized for chronic renal disease?

1. Arterial hypertension
2. Pain in the lumbar region
3. Delay of the urine (oliguria)
4. Arterial hypotension
5. Edema

What symptom is characterized for edema in acute nephritis?

1. Arises at evening
 34

2. At first arises on lower extremities

3. At first arises on upper extremities
4. Arises at morning on the face
5. Immediately appears an anasarca

Urine changes in acute nephritis are characterized:

1. Proteinuria, hematuria, cylinduria
2. Leucocyturia, hematuria
3. Leucocyturia, cylinduria
4. Leucocyturia, hematuria, cylinduria
5. Proteinuria, leucocyturia

What is the mechanism of kidney swelling?

1. Decreased glomerular filtration and increased reabsorption of sodium
2. Increased secretion of aldosterone and antidiuretic hormone
3. Increased permeability of vascular wall
4. Decreased oncotic pressure of plasma
5. All the above listed

What is direction of irradiation of pain in renal colic?

1. Up and left
2. Up and right
3. Lower abdomen
4. On the back of the thigh
5. Substernal

What are pathological changes determine nephrotic syndrome?

1. Increased blood pressure
2. The presence of red blood cells and cylinders in urine
3. Proteinuria, hypoproteinemia, hyperlipidemia, and edema
4. Edema of the lower extremities
5. Hyperbilirubinemia and hepatomegaly

Proteinuria, leucocyturia and bacteriuria are characteristics for?

1. Nephrotic syndrome
2. Acute glomerulonephritis
3. Acute pyelonephritis
4. Bladder Cancer
5. Renal amyloidosis

What changes in chronic pyelonephritis urine are characterized of?

1. Hematuria, cylindruria
2. Leucocyturia, cylindruria, proteinuria
3. Bacteriuria, cylindruria
4. Hematuria, bacteriuria
5. Hematuria, cylindruria, proteinuria

What is characterized in the urine in diabetic coma?

1. Albuminuria
2. Acetonuria
3. Hypostenuria
4. Hyperstenuria
 35

5. Leucocyturia

What syndrome is characterized by massive albuminuria?

1. Cystitis
2. Pyelonephritis
3. Nephrotic syndrome
4. Glomerulonephritis
5. Urolithiasis

What levels of the specific gravity of urine are characteristic for the uremia syndrome?
1. 1,030 – 1,040
2. 1,009 – 1,011
3. 1,015 – 1,020
4. 1,020 – 1,030
5. 1,040 and more

Glomerulonephritis is characterized by:

1. Proteinuria
2. Leucocyturia
3. Bacteriuria
4. Glucosuria
5. Acetonuria

Renal amyloidosis is characterized by:

1. Proteinuria 1g / 24h
2. Proteinuria more than 3-5g / 24h
3. Hematuria
4. Gipoproteinuria
5. Leucocyturia

What is the most reliable sign of chronic renal failure?

1. Hypercholesterolemia
2. Hyperpotassemia
3. Increased creatinine level in blood
4. Oliguria
5. Proteinuria

What renal pathology is characterized in diabetes mellitus?

1. Glomerulonephritis
2. Glomerulosclerosis
3. Pyelonephritis
4. Renal amyloidosis
5. Renal abscesses

What is necessary to restrict the diet in chronic renal failure?

1. Liquid
2. Proteins
3. Carbohydrates
4. Fats
5. Salt

What heart pathology is characterized in chronic renal failure?

 36

1. Cardiac asthma
2. Myocarditis
3. Dry pericarditis
4. Endocarditis
5. Myocardial infarction

What is the reason for anemia in uremia?

1. Bleeding
2. Iron deficiency
3. Hemolysis
4. B12 Deficiency
5. Deficiency of erythropoietin

Hemorrhagic syndrome in uremia is characterized by:

1. Thrombocytopenia
2. Increased permeability of vascular wall
3. Prothrombin deficiency
4. Coagulation factor - VIII deficiency
5. Coagulation factor - IX deficiency

Gastritis in uremia is:

1. Endogenous toxic
2. Exogenous toxic
3. Bacterial
4. H. Pylori
5. Atrophic

Aphonia in uremia is characterized:

1. Paresis of the vocal cords
2. Dehydratation
3. Hyperuricemia
4. Ketoacidosis
5. Creatininemia

What is caused pleural frictions rub in uremia?

1. Dehydratation
2. Pleural tuberculosis
3. Dry pleurisy
4. Mezoepitelioma of the pleura
5. Hyperuricemia

What level of hyperketonemia dangerous to the patient's life?

1. 3,8-5,2 mmol/L
2. 6,5 mmol/L
3. 7,0 mmol/L
4. 9,0-10,0 mmol/l
5. 3,8 and less mg/dL

What is caused the chronic renal failure?

1. Chronic pyelonephritis
2. Chronic glomerulonephritis
3. Arterial hypertension
 37

4. Koch’s disease
5. Diabetes mellitus

What kind of complaints is observed in the second stage of chronic renal failure?
1. Loss of appetite
2. Fatigue
3. Unpleasant taste in the mouth
4. Dyspeptic syndrome
5. Cough
 38

Blood system

What face is in patients with Addison-Biermer’s anemia?

1. Facies anemic
2. Face of “wax doll”
3. Facies leontina
4. Facies Hyppocratica
5. Facies ammimi

What skin color is in patients with erythremia?

1. Icteric
2. Pale
3. Purple-red
4. Cyanotic
5. Earth-like

What skin color is in patients with chronic leukemia?

1. Pale
2. Pink
3. Purple
4. Earth-like
5. Icteric

Cutis icterica is characteristic of:

1. Iron deficiency anemia
2. Acute leukemia
3. Chronic lymphocytic leukemia
4. Hemolytic anemia
5. Multiple myeloma

Itchy skin is characteristic of:

1. Limfogranulomatosis (Hodgkin’s disease)
2. Hemophilia
3. Iron-deficiency anemia
4. Werlhoff’s disease
5. Splenomegaly

Itching after bathing is typical for:

1. Hemophilia
2. Erythremia
3. Werlhoff’s disease
4. Iron deficiency anemia
5. Acute leukemia

Increased bleeding is characteristic of:

1. Limfogranulomatosis (Hodgkin’s disease)
2. Chronic lymphocytic leukemia
3. Iron deficiency anemia
4. Werlhoff’s disease
5. Multiple myeloma
 39

Burning the patient’s tongue is characteristic of:

1. Addison-Biermer’s anemia
2. Chronic lymphocytic leukemia
3. Limfogranulomatosis (Hodgkin’s disease)
4. Chronic myelocytic leukemia
5. Thrombocytopenia

What kind of tongue a patient with Addison-Biermer’s anemia is characterized?

1. Papillae expressed pale
2. Papillae flattened, pink
3. Papillae expressed, covered with gray fur
4. Papillae flattened, covered with white fur
5. Dry tongue

Glassy tongue is characteristic of:

1. Iron deficiency anemia
2. Vitamin B12 deficiency anemia
3. Werlhoff’s disease
4. Hemophilia
5. Thrombocytopenia

Periodically elevation of temperature is characteristic of:

1. Iron deficiency anemia
2. Acute leukemia
3. Limfogranulomatosis (Hodgkin’s disease)
4. Chronic myelocytic leukemia
5. Hemophilia

Pain in right upper quadrant of abdomen is characteristic of:

1. Hemolytic anemia
2. Iron deficiency anemia
3. Hemophilia
4. Vitamin B12 deficiency anemia
5. Thrombocytopenia

Sternalgia and osalgia is characteristic:

1. Limfogranulomatosis (Hodgkin’s disease)
2. Hemophilia
3. Acute leukemia
4. Iron deficiency anemia
5. Thrombocytopenia

What factors are the most important in blood disorders?

1. Infections
2. Violation of diet
3. Emotional stress
4. Radiation effects
5. Seasonal effects

Pain in bones during tapping occurs in patients with:

1. Tuberculosis
 40

2. Chronic lymphocytic leukemia

3. Erythremia
4. Anemia
5. Thrombocytopenia

What kinds of lymph nodes are enlarged in blood disease?

1. Only axillaries
2. Axillaries and mandibular
3 Occipital
4. Inguinal
5. All sites are available for palpation

What disease is characterized by enlarged, enormous, of lymph nodes?

1. Tuberculosis of lymph nodes
2. Acute leukemia
3. Chronic lymphocytic leukemia
4. Hemophilia
5. Hemolytic anemia.

Enlarged lymph nodes (3-5 cm in diameter) firm consistency is characteristic of:

1. Lymph node tuberculosis
2. Limfogranulomatosis (Hodgkin’s disease)
3. Chronic lymphocytic leukemia
4. Chronic myelocytic leukemia
5. Anemia

Pyosis of lymph nodes and the formation of fistula occur in patients with:
1. Limfogranulomatosis (Hodgkin’s disease)
2. Chronic lymphocytic leukemia
3. Lymph node tuberculosis
4. Chronic myelocytic leukemia
5. Anemia

What organ of the abdominal cavity is often increased in the case of diseases of blood system?
1. Pancreas
2. Spleen
3. Stomach
4. The left kidney
5. The right kidney

What method is determined size of the spleen in the healthy person?

1. Palpation
2. Auscultation
3. Inspection
4. Percussion
5. X-ray

Where is normal location of the spleen?

1. At the level of the left costal
2. 2 cm below the costal
3. Not palpable
4. At the level of the umbilicus
 41

5. At the level of the right costal

What rib by is determined the length of spleen by the percussion?

1. VIII
2. IX
3. X
4. XI
5. XII

What normal length of the spleen?

1. 6-8cm
2. 4-6 cm
3. 2-3 cm
4. 10 cm
5. 12 cm

What is normal width of the spleen?

1. 6-4 cm
2. 2-3 cm
3. 10 cm
4. 6-8 cm
5. 10-12 cm

What is splenomegaly?
1. Increasing the number of leukocytes
2. Liver enlargement
3. Spleen enlargement
4. Lymph nodes enlargement
5. Increasing spleen function

Splenomegaly is characteristic for:

1. Iron deficiency anemia
2. Chronic myelcytes leukemia
3. Hemophilia
4. Vitamin B12 deficiency anemia
5. Tuberculosis

What is hypersplenism?
1. Spleen enlargement
2. Lymph nodes enlargement
3. Increasing spleen function
4 Spleen reducing
5. Decreasing spleen function

What is hepatomegaly?
1. Spleen enlargement
2. Liver enlargement
3. Spleen reducing
4. Liver reducing
5. Increasing liver function
 42

Hepatolienal syndrome is characterized by:

1. Liver enlargement
2. Enlarged spleen and reduced liver
3. Enlarged liver and reduced spleen
4. Enlarged both liver and spleen
5. Reduced both liver and spleen

What bones are puncture to obtain bone marrow?

1. Frontal
2. Tibia
3. IV thoracic vertebrae
4. Sternum
5. Ribs

What is named of value of the cellular elements in bone marrow?

1. Leucogram
2. Myelogram
3. Normogram
4. Lymphogram
5. Spyrogram

Where erythrocytes are produced?

1. Bone marrow
2. Liver
3. Spleen
4. Lymph nodes
5. Stomach

Where are platelets produced?

1. Bone marrow
2. Liver
3. Spleen
4. Lymph nodes
5. Kidneys

Where are leucocytes produced?

1. Bone marrow
2. Liver
3. Spleen
4. Lymph nodes
5. Kidneys

Prothrombin and fibrinogen are produced in:

1. Bone marrow
2. Spleen
3. Lymph nodes
4. Liver
5. Kidneys

Normal values of hemoglobin:

1. 120-160 g/l
2. 100-120 g/l
 43

3. 160-190 g/l
4. 80-100 g/l
5. 200 g/l.

Normal values of erythrocytes:

1. 2,0-3,0 ×1012/l
2. 3,9-5,0 × 1012/l
3. 5,0-6,0 ×1012/l
4. 3,0-3,9 × 1012/l
5. 1,5-2,0 ×1012/l

Normal values of leukocytes:

1. 2,0-4,0 × 109/l
2. 4,0-5,0 ×109/ l
3. 4,0-9,0 ×109/l
4. 4,0-9,0 × 10І2/l
5. 3,0-4,0 × 109/l

What is leukocyte formula:

1. Increased of leukocytes number
2. Increased of lymphocytes number
3. Increased of band neutrophils and appearance of young neutrophils
4. Percentage of separate forms of leucocytes
5. Decreased of leukocytes number

Shift of the leukocyte formula to the left is charactrized:

1. Increased of leukocytes number in the peripheral blood
2. Increased of lymphocytes number in the peripheral blood
3. Decreased of leukocytes number in the peripheral blood
4. Increased of band neutrophils and appearance of young neutrophils (in percentage) in
peripheral blood

Normal value of lymphocytes:

1. 10-15%
2. 5-10%
3. 25-35%
4. 35-60%
5. 80%

Normal value of color index:

1. 0,5-0,6
2. 0,9-1,0
3. 1,2-1,5
4. 0,7-0,8
5. 1,1 – 1,2

Normal value of osmotic fragility:

1. 0,16-0,30
2. 0,34-0,48
3. 0,10-0,20
4. 0,55-0,70
 44

5. 0,28-0,34

How is color index change in iron-deficiency anemia?

1. Hypochromia
2. Hyperchromia
3. Normochromia
4. Polychromasia
5. Dischromia

What is hemolysis indicator?

1. Increased of leukocytes number in peripheral blood
2. Increased plasma unconjugated bilirubin
3. Reduced of leukocytes number in peripheral blood
4. Accelerated ESR
5. Increasing the number of basophils

What is typical for hemolytic anemia?

1. Increased plasma unconjugated bilirubin
2. Increased plasma conjugated bilirubin
3. Leukocytosis
4. Accelerated ESR
5. Decreased plasma unconjugated bilirubin

What is specific sign of hemolytic anemia?

1. Increased plasma conjugated bilirubin
2. Accelerated ESR
3. Liver enlargement
4. Spleen enlargement
5. Decreased plasma unconjugated bilirubin

What is hemolysis indicator?

1. Leukocytosis
2. Leukopenia
3. Accelerated ESR
4. Reticulocytosis
5. Eosinophilia

Reticulocytosis in the peripheral blood may indicate:

1. Chronic myelocytic leukemia
2. Hemophilia
3. Hemolytic anemia
4. Werlhoff’s disease
5. Multiple myeloma

What are leucocytes number in patients with acute leukemia?

1. Decreased
2. Increased
3. Normal
4. Increased the band neutrophils number
5. Decreased the band neutrophils number
 45

Acute leukemia is characterized all, except:

1. Leukocytosis
2. Accelerated ESR
3. Presence of blast cells
4. Hemoglobin concentration decreased
5. Increased count of eosinophils and basophils

Leukemoid reaction in the analysis of peripheral blood is characterized:

1. Infections
2. Chronic myelocytic leukemia
3. Chronic lymphocytic leukemia
4. Acute leukemia
5. Thrombocytopenia

Erythrocyte sedimentation rate (ESR) in patients with leukemia:

1. Sharp increased
2. Decreased
3. A slight increased
4. Not change
5. Normal

What cells are involved in hemostatic plug?

1. Erythrocytes
2. Lymphocytes
3. Eosinophils
4. Platelets
5. Basophils

What is measure the Duke test?

1. Leukocytes number
2. Platelet number
3. Erythrocytes number
4. ESR
5. Bleeding time test

Duration of normal times for theDuke test:

1. 1-3 min
2. 5-6 min
3. 20 sec
4. 10-14 min
5. 1 h

What analysis is specific for iron deficiency anemia?

1. ESR
2. Serum protein
3. Reticulocyte count
4. Osmotic fragility of erythrocytes
5. Serum iron level

What cells of the granulocytic series are mature and normally leave the bloodstream?
1. Blast cells
2. Myelocytes
 46

3. Metamyelocytes
4. Band cells
5. Polymorphonuclear neutrophils

What cell of 4 class is the parent of neutrophils?

1. Plazmoblast
2. Lymphoblast
3. Myeloblast
4. Megakarioblast
5. Monoblast

Symptoms of chronic myelocytic leukemia, except:

1. Liver enlargement
2. Hemorrhagic syndrome
3. Lymphadenopathy
4. Spleen enlargement
5. Anemia

At what disease occurs hemarthrosises?

1. Hemorrhagic vasculitis
2. Idiopathic thrombocytopenic purpura
3. Hemophilia
4. Cirrhosis
5. Diabetes mellitus

What leukogram in chronic myelocytic leukemia?

1. Lymphocytopenia
2. Basophilic-eosinophilic association
3. Shift to the left to myelocytes
4. Lymphocytosis
5. Monocytosis

What disease is characterized by increased count of basophils and eosinophils?

1. Acute lymphoblastic leukemia
2. Congenital anemia
3. Serum sickness
4. Chronic myelocytic leukemia
5. Melanosarcoma

Where leucocytes are formed?

1. In the liver
2. In the spleen
3. In the bone marrow
4. In the lymph nodes
5. In the thymus

Increased count of basophils and eosinophils is characteristic for:

1. Acute leukemia
2. Erythremia
3. Chronic myelocytic leukemia
4. Chronic lymphocytic leukemia
 47

5. Polycythemia vera

The most common clinical syndrome of idiopathic thrombocytopenic purpura:

1. Hemarthrosis
2. Ecchymosis
3. Necrosis
4. Angiopathy
5. Bleeding from mucosa

Which factor is absence in hemophilia A?

1. Hageman’s factor
2. Proaccelerin
3. Proconvertin (Kappa’s factor)
4. Prothrombin
5. Factor VIII

What method is the best for leukemia diagnostic?

1. General blood test
2. Myelogram
3. Biopsy of spleen
4. Biopsy of lymph nodes
5. Cytochemical methods

Where blood cells are formed?

1. In the liver
2. In the spleen
3. In the bone marrow
4. In the lymph nodes
5. In the thymus

Botkin-Gympreht shadowsare spesific for:

1. Acute lymphoblastic leukemia
2. Chronic erythromyelosis
3. Chronic lymphocytic leukemia
4. Chronic myelocytic leukemia
5. Erythremia

What symptom is typical for chronic lymphocytic leukemia?

1. Hepatomegaly
2. Fever
3. Anemia
4. Lymphadenopathy
5. Splenomegaly

Phyladelphia chromosome is characteristic for:

1. Acute leukemia
2. Erythremia
3. Chronic myelocytic leukemia
4. Chronic lymphocytic leukemia
5. Myeloma
 48

Folic acid deficiency (megaloblastic) anemia is characterized:

1. Neurological syndrome
2. Reduced vision
3. Anemia
4. Stomatitis
5. Headache

The most common clinical form of hemorrhagic vasculitis:

1. Cardiac
2. Cerebral
3. Simple
4. Articular
5. Abdominal

What anemia is more typical in pregnant women?

1. Hypoplastic
2. Hemolytic
3. Iron deficiency
4. Megaloblastic
5. Thalassemia
 49

Endocrine system

What is normal fasting plasma glucose?

1. 8,3-10,1 mmol/l
2. 6,2-9,3 mmol/l
3. 2,7-5,5 mmol/l
4. 3,8-6,7 mmol/l
5. 3,3-5,5 mmol/l

What is the resalt of OGTT 2h post-load plasma glucose in normal?

1. 8,43 mmol/l
2. 7,22 mmol/l
3. 9,6 mmol/l
4. Less 11,1 mmol/l
5. Less 7,8 mmol/l

What is basic criteria of diabetes mellitus?

1. Fasting plasma glucose ≥ 7,0 mmol/l
2. Glucocorticoid test
3. OGTT
4. Albuminuria
5. All enumerated

Severe forms of diabetes mellitus are characterized by all enumerated signs, except:
1. Ketoacidosis
2. Eruptive xanthomas
3. Presence of vascular complications (retinopathy, nephropathy, neuropathy)
4. Metabolic cataract
5. High doses of insulin

What is involvement of vision in diabetes?

1. Retinopathy
2. Blepharitis
3. Sty
4. Dystrophic cornea changes
5. All enumerated

First type diabetes mellitus is characterized by all enumerated signs, except:

1. Gradually onset of the disease
2. Young age
3. Acute form of clinical symptoms
4. Insulin dependence, B-cells affect
5. Obesity absence

Ketoacidotic coma is clinically manifested by all enumerated signs, except:

1. Pallor and dryness of skin
2. Normal temperature of body
3. Arterial hypotension
4. Arterial hypertension
5. Kussmaul’s breathing, acetone smell in the air breathed out

Hypoglycemic coma clinically manifested by all enumerated signs, except:

 50

1. Pallor and moistures of skin

2. Hyper tonus of muscles, convulsions
3. Blood pressure decreasing
4. Crepitation in lungs
5. Sudden onset

All enumerated alimentary factors contribute to obesity development, except:

1. Frequent high-caloric meals in small doses
2. Surplus use of vegetable food
3. Surplus use of carbohydrates
4. Surplus use of fats
5. Overeating

What symptoms of the following ones are characterized for hyperthyroidism?

1. Loos of weight
2. Constant palpitation
3. Increasd sweating
4. Trembling of extremities, muscle weakness
5. All enumerated

Hypothyroidism is characterized all enumerated, except:

1. Dryness of the skin
2. Constipation
3. Sleepiness
4. Bradicardia
5. Loss of body mass

What is important factor of insulin secretion regulation?

1. Lipids level in blood
2. Lactate level in blood
3. Pyruvate level in blood
4. Glycerin level in blood
5. Glucose level in blood

What is indication of insulin independent diabetes mellitus?

1. Acute disease onset
2. Diabetes frequency in relatives
3. Age older than 40 years at the onset of the disease
4. Decreased of insulin in blood
5. Severe course, inclination to ketoacidosis

What is the main symptom of diabetes mellitus?

1. Bradicardia
2. Exophtalmos
3. Polyuria
4. Pollakiuria
5. Loos of weight

What patients is the most frequently develop hyperosmolar coma?

1. Suffering from insulin dependent diabetes
2. Suffering from insulin independent diabetes
3. Suffering from diseases of pancreas (tumor)
 51

4. Suffering from congenital genetic syndromes

5. Suffering from pheohromocytoma

What is the cause of hyperglycemic coma?

1. Low dose of insulin
2. Overdose of insulin
3. Absence of meal after insulin injection
4. Introduction of excess liquid into the organism
5. Overeating

What is pathogenic factor of ketoacidosis development?

1. Insulin surplus
2. Insulin insufficiency
3. Insufficient of contrinsular hormones
4. Surplus of contrinsular hormones
5. Cellular dehydratation

What is the most dangerous thyrotoxic crisis complication?

Anemia
Hemorrhages
Acute disorder of brain circulation
Acute cardiovascular insufficiency
Acute hepatic insufficiency

What symptom occurs both in hypoglycemic coma and hypothyroid coma?

1. Slow onset
2. Slow soft pulse
3. Dilated pupils
4. Tendon reflexes are diminished
5. Abdominal pain

What is affected in diabetic retinopathy?

1. Cornea
2. Conjunctiva
3. Iris
4. Vitreous body
5. Blood vessels of retina

What organ is affected in diabetes mellitus?

1. Adrenal glands
2. Thyroid gland
3. Kidney
4. Stomach
5. Intestine

What is symptom of diabetes mellitus?

1. Polyarthralgias
2. Asphyxia
3. Skin and genital itch
4. Periodical thirst
5. Teeth loosening and dedentition
 52

What age diabetes mellitus type II is the most frequent?

1. Since 10 till 20 years
2. Since 20 till 30 years
3. Since 30 till 40 years
4. Since 40 till 50 years
5. Older than 50 years

What kind of coma is in diabetes mellitus?

1. Uremic
2. Hepatic
3. Anemic
4. Ketoacidotic
5. Thyrotoxic

What is characterized hyperosmolar coma?

1. Presence of ketoacidosis
2. Absence of ketoacidosis
3. Dehydration
4. Frequent oliguria
5. Frequent azotemia

What is the sign of hypoglycemic coma?

1. Flaccidity of muscles, absence of tendon reflexes
2. Rigidity of muscles, tremor of extremities, convulsions
3. Absence of appetite
4. Increased appetite
5. Proteinuria, cylindruria, glycosuria

What is Kocher’s symptom?

1. Rare blinking
2. Abnormally sparkling eyes
3. Pigmentation of eyelids
4. Some sclera is visible
5. Sensation of sand in the eyes

What is Ellinec' sign?

1. Rare blinking
2. Abnormally sparkling eyes
3. Pigmentation of eyelids
4. Some sclera is visible
5. Sensation of sand in the eyes

What is pretibial myxedema?

1. Eyelids edema
2. Face edema
3. Feet edema
4. Crus anterior surface skin lesion
5. Face skin lesion

What cardiac rhythm disturbance is in hyperthyroidism?

1. Sinus bradycardia
2. Extrasystole
 53

3. Atrial fibrilation
4. Sinus tachycardia
5. Paroxysmal tachycardia

What scanning of thyroid gland do you know?

1. Scanning with gold preparations
2. Scanning with caesium
3. Scanning with strontium
4. Scanning with technetium
5. Scanning with radioactive iodine

Diabetes mellitus is characterized with:

1. Hyperglycemia
2. Albuminuria
3. Tachycardia
4. Cough
5. Jaundice

What is the cause of diabetes mellitus?

1. Psychic and physical injury
2. Infection
3. Heredity
4. Obesity
5. Hypothermia

What pancreatic cells are producing insulin?

1. Cells of excretory ducts
2. Acinus cells of pancreas
3. Alpha-cells of Langerhans’s islets
4. Beta-cells of Langerhans’s islets
5. Pancreas vessels and capillaries endothelium

What is Grefe’s symptom?

1. Rare blinking
2. Abnormally sparkling eyes
3. Pigmentation of eyelids
4. Some sclera is visible
5. Lid lag during fixing of slowly downward moving object

What is Shtelvag’s symptom?

1. Eyelid skin pigmentation
2. Abnormally sparkling eyes
3. Some sclera is visible
4. Rare blinking
5. Lid lag during fixing of slowly downward moving object

What is exophthalmos?
1. Eyeball pain
2. Sensation of sand in the eyes
3. Expelling of eyeball from the eye-socket
4. Sclera vessels injection
5. Eyelids edema
 54

What are the main complaints of patients with hyperthyroidism?

1. Excitability, anxiety
2. Loss of libido
3. Increased sweating, heat intolerancy
4. Palpitation, weight loss
5. All enumerated

What can be revealed on examination of patient with hyperthyroidism?

1. Anxious conduct, lots of unnecessary movements
2. Incompleteness of thoughts, quick distractibility
3. Eyelids, lips, tongue, head trembling, sometimes trembling of the whole body
4. Subcutaneous fatty tissue thinning, exophthalmos
5. All enumerated

What ophthalmic symptoms can be revealed in patient with hyperthyroidism?

1. Mebius's sign
2. Greffe' sign
3. Stelvag’ sign
4. Kraus' sign
5. All enumerated

What changes are typical during heart auscultation for hyperthyroidism?

1. The heart sounds are loud
2. Functional systolic murmur over the heart apex
3. Tachycardia
4. Pulse is high and fast
5. All enumerated

What ECG changes can be revealed in patient with hyperthyroidism?

1. Depresses ST-segment and inverted T wave
2. Sinus tachycardia
3. Extrasystole
4. Atrial fibrillation
5. All enumerated

What kind of pulse is typical for hyperthyroidism?

1. Pulse is high and fast
2. Bradycardia
3. Irregular
4. Deficient
5. All enumerated

What basic clinical manifestations are typical for thyrotoxical crisis?

1. Acute onset and lightning-fast course, coma in severe cases
2. Progressive rise of body temperature, uncontrollable vomiting, diarrhea
3. Abrupt excitement with delirium and hallucinations
4. Tachycardia 150-200 per minute, atrial fibrillation.
5. All enumerated

What kind of laboratory-instrumental methods of thyroid gland diagnoses are known?

1. Clinical blood analysis
 55

2. Serum total and free T4 and T3 concentration

3. Thyroid radioiodine
4. Ultrasound examination
5. All enumerated

What are the main complaints in patients with hypothyroidism?

1. General weakness, tiredness
2. General edema
3. Disoders of mental abilities, somnolence
4. Low-pitched hoarse voice, constipation
5. All enumerated

What skin changes are typical for hypothyroidism patient?

1. Dry skin, cold, scaly and thickened
2. Fragility and loss of hairs
3. Nails are thin and brittle
4. The periorbital edema
5. All enumerated

What neuropsychic sphere changes are observed in patients with hypothyroidism?

1. Acute psychologic slowing down, flaccid psychic functions, emotional poorness, apathy,
indifference to surroundings
2. Memory impairment
3. Hypersomnia
4. Mental deficiency right up to the development of dementia oligophrenia type
5. All enumerated

What cardiovascular system changes can be revealed in patient with hypothyroidism?

1. The apex beat is displaced to the left
2. Normal or slightly reduced blood pressure
3. Slow, weak pulse
4. Decreased loudness of both sounds
5. All enumerated

What electrocardiogram changes can reveal in patient with hypothyroidism?

1. Sinus bradycardia
2. Low amplitude P wave
3. Depressed ST-segment
4. P-Q interval is prolonged
5. All enumerated

What are the clinical manifestations of diabetes mellitus?

1. Thirst, expressed polyuria, polyphagia
2. Loosing weight, increasing weakness, dry mouth
3. Polyneuritis, furunculosis, parodontosis
4. Skin itch
5. All enumerated

What symptoms are characterized for diabetic nephropathy?

1. Low specific urine gravity
2. Albuminuria
3. Arterial hypertension
 56

4. Glucosuria
5. All enumerated

The characteristics of type I diabetes mellitus (insulin-dependent) are all enumerated, except:
1. Absolute insulin dependence may be observed
2. Severe course, susceptibility to ketoacidosis
3. Insulin level is abruptly reducted
4. Genetic defect of antiviral immunity
5. There are expressed morphological changes B-cells of islet of Langerhans

The characteristics of type II diabetes mellitus (insulin-independent) are all enumerated, except:
1. Gradually onset, usually at the age older than 40 years, often occurs in overweight
patient
2. Stable mild course, no susceptibility to ketoacidosis
3. At the onset there is no expressed damage of B-cells, in this connection sulfanilamide
glucose-reducing preparations are effective
4. Insulin blood level is slightly lowered, normal, or increased at the expense of combined
insulin
5. Insulin level is abruptly reduced

What clinical sign is observed in diabetic coma?

1. Gradual onset, deep, noisy breathing (Kussmaul's respiration), smell of acetone from
one's mouth
2. Rapid pulse, decreasing of arterial pressure
3. Glucose and acetone revealing in urine
4. Xeroderma, hypotonia of eyeballs
5. All enumerated

What clinical sign is observed in hypoglycemic coma?

1. Sudden development, usual respiration, no smell of acetone
2. Possible clonic and tonic convulsions
3. Blood pressure is normal or elevated, pulse is not rapid
4. Sweating is sharply expressed
5. All enumerated

What time blood glucose level is maximally elevated after carbohydrate load?
1. In 10-20 minutes
2. In 30-60 minutes
3. In 90 minutes
4. In 120 minutes
5. In 180 minutes

What arrhythmia is characteristic for thyroid heart?

1. Respiratory arrhythmia
2. Sinus bradycardia
3. Paroxysmal ventricular tachycardia
4. Atrial fibrillation
5. Ventricular flutter

What kind of respiration is observed in hypoglycemic coma?

1. Normal respiration
2. Chane-Stock’s respiration
 57

3. Biott’s respiration
4. Expiratory dyspnea
5. Kussmaul’s respiration

The symptoms of cardiovascular system damage in hypothyroidism are the following, except:
1. Bradycardia
2. Arterial hypotension
3. Pericarditis
4. Atrial fibrillation
5. Decreased waves amplitude on electrocardiogram

All of the following changes of cardiovascular system are characteristics for the hyperthyroidism,
except:
1. Systolic bloodl pressure is increased
2. Pulse pressure is increased
3. Tachycardia
4. Pulse is high and fast
5. Decreased loudness of both sounds

Insulin dependent diabetes mellitus is characterized by the following signs, except:

1. Disease occurs at young age
2. Acute onset
3. Decreased body mass
4. Stable course
5. Necessity insulin therapy

Insulin independent diabetes mellitus is characterized by the following signs, except:

1. Onset of disease at an elderly age
2. Gradual development of disease
3. Labile course
4. Obesity
5. Absence of susceptibility to ketoacidosis

What coma develops violently, beginning from anxiety, fear, hallucinations, headache and
locomotive excitation?
1. Hyperosmolar
2. Ketoacidotic
3. Hyperlactacidemic
4. Hypoglycemic
5. Any of the enumerated

The following factors promote to the development of ketoacidotic coma, except:

1. Unwarranted decrease of insulin dose
2. Physical and psychic traumas
3. Increased of food caloric value
4. Concomitant infectious diseases
5. All enumerated

Red-brown papulae is characteristic for:

1. Hypothyroidism
2. Obesity
3. Diabetes mellitus
 58

4. Hyperthyroidism
5. Acromegalia

Atrial fibrillation is characteristic for:

1. Diabetes mellitus
2. Hypothyroidism
3. Obesity
4. Acromegalia
5. Hyperthyroidism

At the 1-st degree obesity body mass exceeds the norm for:
1. 5-10℅
2. 20-30℅
3. 30-50℅
4. 50-100℅
5. More than for 100℅

In the 4 degree obesity body mass exceeds norm for:

1. 50-100℅
2. 5-10℅
3. More than for 100℅
4. 20-30℅
5. 30-50℅
 59

Literature

1. Vasilenko V., Grebenev A. Internal diseases an introductory course. - M.: Mir

Publishers, 1990. - 647 p.
2. Zh.D. Semidotskaya, O.S. Bilchenko, et al. Introduction to the course of internal
diseases. Book 1. Diagnosis: [Textbook/.].-Kharkiv: KSMU, 2005. -312p.
3. Kovalyova O.M., Shapovalova S.O., Nizhegorodtseva O.O. Propedeutic to internal
medicine. Part 2.– Vinnytsya: Nova knyha, 2007. – 264 p.
4. Syvolap V., Olejnik A., Lihkasenko I., Avramenko N. Electrocardiography for II-III
years students of the medical faculty: Manual for II-III-year students of the medical
universities (Zaporozhye State Medical University). Zaporozhye, 2006.- 45 c.
5. Syvolap V., Olejnik A., Lihkasenko I., Avramenko N. Clinical tasks in the propedeutics
of internal diseases for II-III years students of the medical faculty: Manual for II-III -
year students of the medical universities (Zaporozhye State Medical University).
Zaporozhye, 2006.-15c.
6.
Syvolap V., Olejnik A., Lihkasenko I., Avramenko N., Gerasko M. Methodical
recommendations on propedeutics of internal diseases (Book 2) (Zaporozhye State
Medical University). Zaporozhye, 2008.-164 p.
7. Harrison΄s principles off internal medicine / Fauci, Braunwald, Isselbacher and al.-XIV
edition. - Vol. 1 and 2. - International edition, 1998.