rN @ eneutron.info PrrCoaee Cnn eae CO eee Recon} he lower third of his left thigh, which rtion. Possibility of trauma is denied by ormal; pastosity and pain can be detected with deep palpation ¢ mobilit d ay of distal femoral metaphysis shows an ar uction a »d test: immature cells, no signs of inflammatior nost likely 1.0 Chronic osteo 2.0 Osteogenic sarcoma 3.2 Osteitis fibros:Canad Gg Tue caters CeCe ee eRe ey Home Medical No Krok 2 - 2015 (General Medicine) Question 69 of 200 69. Question year-old boy has developed pain in the area of his left knee joint. Objectively: in the painful area are infiltratec joint function is reduced. X- is, with A15 thigh soft tissues ray: there is a focus of destruction in the left distal femoral metaphy: periosteum detachment and formation of Cod layer at the margin of the defec X-ray reveals numerous mierofocal metastases. What pathology is the most | Im iangle in the bone cortical to cause such presentation? 1.0 Juxtacortical sarc 2.0 Chondrosarc 3.©) Ewing's sarcoma 4.0 Osteogenic sarcoma 5. © Fibrosarcom: NEXT QUESTIOI——————————————_ BY Home MedicaP Note Ua ae Krok 2 - 2015 (General Me Question 118 of 200 118. Question A 60-year-old woman, moth abdominal pain radiatin and chills. Subsequently, she On physical exami-natior 38, 9° C, along with set of upper titing, fever lera and s ature ely diagnosisCee 3. Questic A 41-year-old patien th lisea! influenza. After that miting, diarrhea and he develoy nau. hypoglycemia. BP decreased content of corticosterone, ydro. c 17-oxycorticosteroids. What conditic fewer - Diabetes mellitus a{1.0 Internal hemorrhoids a Acute paraproctiting to with history osttingBe clian ne Question 14 of 200 14. Question A 30- ear-old woman complains of irregular copion irradiates to the rectum s painful menstruations, pain states 10-year-long infertility. On bimanual ze; uterine appendages on the both sides are corded, with rectricted mobility, painfu here are dense nodular painful growths detected in the posterior fornix. A doctor si Anamnes examination: uterus is of normal s spects endometriosis. What method allows to verify this diagnosis? 1. Hysterosco 2.2 Diagnostic curettage of uterine cavity 3.0 Laparoscopy 4 Paracentesis of posterior fornix 5. © Uterine probing NEXT QUESTIOIclon a Question 37 of 200 37. Question A patient with high temperature came to a first-aid post in the evening. The fact of temporary disability was established. Indicate the measure to be taken in this case: | 1. OThe sick list for up to 3 days should be issued 2.0 The night duty doctor should issue a medical certificate, which will be subsequently used _ forissuing a sick list from the date of the previous day 3.9 The sick list for 1 day should be issued 4...) No document should be issued 9-0 The sick list for 3 days should be i NEXT QUESTION.ow tone a Question 47 of 200 47. Question 6 hours) is 1-day-old, postmature; s performed by applying A newborn infant (the first labor, lasted for body weight is 3850 g; body length is 52 cm. Deli-very wa obstetrical forceps in sincipital presentation, Apgar score is 1/3. The face is bluish- pale. The head is thrown bac th trauma is present; the infant is excitable, shrill “cerebral scream”is present; the eyes are half-open; facial expression is attentive; hyperesthesia, hypersthenia and readiness for convulsions are present. Liquor has high content of erythrocytes, lymphocytic cytosis occurs. The most likely diagnosi: q severe bi is: 1. Intraventricular hi morrhage 2.) Intracerebral rhage [BO Subdural hemorrhage ‘4, Subarachnoid hemorrhage 5. © Epidu NEXT QUESTIO! al hemorrhageCoe Home Medical Notes year-old girl complains of general weakness, rise of body temperature up to ’ C, pain and swelling of knee joints, feeling of cardiac rhythm disruption. The child had tonsillitis 3 weeks ago. The knee joints are swollen, local raise of temperature is observed, mobility is reduced. Heart sounds are extrasystole is present; at the cardiac apex systolic no weakenei e can be auscultated, which is not conducted to the left axillary r¢ ESR is 38 mm/h. CRP 2+. Antistreptolysin-O titers are 400. The most likely disease is: Non-rheumaticPe tion, Home Medical Notes Question 63 of 200 63. Question A patient was delivered to a su closed tr gical department after a road accident with a auma of chest and right-sided rib fracture. The patient was diagnosed with right-sided pneumothorax; it is indicated to perform drainage of pleural cavity. Pleural puncture should be made: 1.O Inthe int of the dullness on percussion 2.2 In the 6th inter ostal space along the posteri-or axillary lin 3.0 Inthe 7th intercostal space alo! e scapular line 4. © Inthe projection of pleural sinusA pat patter segments Oem enac) g pattern of lower pulmonary ikely diagnosis is:Cea lon on Question 73 of 200 73. Que tion A 70-year-old patient consulted a doctor about arrhythmic cardiac activity, dyspnea. Objectively: BP - 150/90 mm Hg, extrasystole arrhythmia (10-12 beats per minute), left ventricular systolic dysfunction (ejection fraction at the rate of 42%). Which of anti-arrhythmic drugs should be administered as initial therapy in this case? 1, © Digoxin 2. Flecainide 4. Encainide 5. © Moracizine NEXT QUESTION.— ea hor, Question 85 of 200 85. Question A 23-year-old woman after weight loss, iner cons stress has developed thirst, polydipsia, polyuria, ater she developed nausea and somnolence, lost iousness and was hospitalised. Glycemia is sharply positive. _advisab easing fatigue mmol/l, acetone in urine is reatment for ketoacidotic coma was initiated. When would it be start preventive treatment of hypoglycemia by introduction of 5% glucose solution When patient b: es C ous mmol/l per hour glycemia dCoen re Question 88 of 200 88. Question Home Medical Notes A 34-year-old patient was de lower leg bones bur: livered to a first-aid center . Upon examination ble with open fracture of the » What actions should be stated: blood flows in pulsating of medical aid: eding is taken at this stage Provide immobil ization and deliver the patient to a hospital 2.0 Apply tourniquet to the thigh proximally to the place of hemorrhage and deliver the patient to operating room 3.2 Apply tourniquet to the thig righ distally to the place of hemorrhage and deliver the patient to operating room 4,2 Deliver the patie it to operating room 5. © Apply pressure dressing to stop hemorrhage and deliver the patient to operating room 5. © Apply pressure dressing to sto NEXT QUESTIO!Home Medical Notes -year-old boy during preventive examination was determined to have changes in his spine curvature in frontal plane: the right shoulder is lowered and flat, scapulae angles are of different height due to the right scapula being shifted down. Waist triangles are pronounced on the both sides; longitudinal muscles of the back form muscle cushion on the left. What type of posture is detected in the child? Kyphoti Stooping 4.2 Corrected Lordotic NEXT QUESTIOICea on a Question 104 of 200 104. Question A 25-year-old female patient complains of marked weakn blackouts, dizzine taste disorder. Objectively: the pati-ent has mark her mouth, peeling nails, sy: 10%/l, Hb- 70 g/l, colour index is the most lik , sleepiness, The patient has a history of menorrhagia. ed weakness, pale skin, cracks in the corners of olic apical murmur. Blood test results: RBC — 3, 4 « — 0,75, platelets — 140 - 109/l, WBC- 6, 2 - 10/1. What y diagnosis? disease 2.2 Acute posthemorrhagic an: 3. Acute leukem 4. .B12-def iency anemia SS .. = = + E S b— poor Coe Question 121 of 200 121. Quest 4 24-year-old patient complains of general weakness, dizziness body temperature Tise UP 10 37; 5° C, sore throat, neck edema, enlargement of submaxillary lymph nodes. Objectively: mucous membrane of oropharynx is edematic and cyanotic, tonsils are enlarged and covered with films that spread be yond the tonsils and Sent De easily removed. What is the leading mechanisn of this illness development? Action of b: Accumulaticculo a Question 122 of 200 122. Question 7-38 weeks complains of headache, nausea, is hydropie, there is A primagravida with pregnancy of 3 pain in epigastrium. Objectively: the skin is acyanotic. Fac: short fibrillar twitching of blepharons, muscles of the face and the inferior extremities. The stare is fixed. BP — 200/110 mm Hg; sphygmus is of 92 bpm, ation rate is 32/min. Heart activity is rhythmical. Appreciable: tremities are present. Urine is cloudy. What medication intense. Resp' edemas of the inferior should be administered? 1.2 Pentaminum of 5% - 4,0 ml 2. DHexenalum of 1% - 2,0 ml 4. © Papaverine hydrochloride of 2% - 4,0 ml 5.) Dibazolum (Bendazole hydrochloride) of 1% - 6,0 ml NEXT QUESTION.aA Question 124 of 200 124. Question A 68-year-old patient complains of pain, slight swelling and creaking in the distal joints of her fingers and knee joints. She has been suffering from this condition for 4 years, Objectively: thickening of knee and interphalangeal joints, restricted mobi 4 - 10%/l, ESR — 12, mm/h, fibrinogen — 3,5 g/l; Rheumatoid factor ~ 1:3: treptolysin O — 160 unit ) units.; CRP+. What mechanism of development is likely for this ity of these joints. Blood test: leukocytes seromucoid — 6 condition? 4.0 Glycosaminoglycanes synthesis disruption 2.0 Increased uric SI Immune reaction to strepto >: 4, Native DNA antibodies hyperprod 5, OQ Rheumatoid factor development NEXT QUESTION.s Q re eyclon, a Question 139 of 200 139. Question A 24-year-old primipara was hospitalised with complaints of discharge of the amniotic waters. The uterus is tonic on palpation. The position of the fetus is longitudinal, it is pressed with the head to pelvic outlet. Palpitation of the fetus is rhythmical, 140 bpm, auscultated on the left below the navel, Internal examination: cervix of the uterus is 2 5 cm long, dense, the external opening is closed, light amniotic waters are discharged. Point out the correct component of the diagnos 1.0 Antenatal discharge of the amniotic waters 2. © Pathological preterm labour 3. The end of the 1st stage of labour of labour 4. © The beginning of the 1st stag Early discharge of the amniotic waters wv@ eneutron info uw Home Medical Notes Question 165 of 200 165. Question A 60-year-old woman has been suffering from arterial hypertension for 15 years. After recurrent stroke she started complaini-ng about unmotivated bad mood, problems with attention concentration; she forgets to close the entrance door, cannot recall events of the past day. Computer tomography shows areas of postinfarction changes in the cortical postfrontal areas. What is the most probable diagnosi: Pick’s disease Dissociative amnesia 1 2. 3. Alzheimer’s disease 4. Huntington's disease ‘5.0 Vascular dementia Io amel cate}@ eneutron.info Home edical Notes Cnulron Question 169 of 200 169. Question opulation groups mortality has been studied for a long tim: resulting changes in mortality territorial trends are Various p distribution of population and considered, What statstical method can be applied? 4. D Analysis of relative values 2. © Assessment of parameter difference reliabilit 3.0 Correlation and regression analysis 5.) Standardized NEXT QUESTION. io analysisQuestion 184 of 200 184. Question A 54-year-old patient has been suffering | diet being his only treatment. Within the last half a year he lost 7 kg of body weight, complai-ns of th vertigo when raising from bed, decrease of erectile function, frequent stool, especially at night. Objectively: malnutrition, dry skin. BP in luina po: 160/90 mm Hg; BP in standing position is 170/85 mm Hg. No edemas. Fasting plasma glucose level 1s 12 mmoi/t. Glycated hemoglobin accounts for 11%. Albumin excreted with urine is diagnosi: m diabetes mellitus for 5 years, with 2 mg per day. The most likely is: 1.0 Diabetes mellitus type 2 with visceral neuropathy 2. Diabetes mellitus type 1 with ketoacidosis Diabetes mellitus type 2 with nephropathy Diabetes mellitus type 2 with polyneuropathy yok © Diabetes mellitus type 4-with ence; ait phalomyelopathyCSN coaNa Ce) Ce att c Cent Home Medical Notes Krok 2 - 2015 (General Medicine) Krok 2 Tele ram Channel Question 187 of 200 187. Question ostal area. s urticaria and skin A 41-year-old patient, a hunter, complains of heaviness in the right sub No other complaints recorded. Anamnesis states causel itching that occurred 1 year ago. Objectively: liver margin is rounded, painless, and can be palpated 3 cm below the costal arch. No other pathology was detected during physical examination of the patient. Body temperature is normal. X-ray reveals a hemisph e diaphragm. What rical protrusion in the right cupula oj ease can be suspected in the given case? 1, Subdiaphragn ic € 2. Liver abscess 3. Metastatic tumor '4.© Hydatid disease of liver = 5. Hepatocellular carcinoma NEXT QUESTIO!PBC DPC cuuow Home Medical Notes Krok 2 - 2015 (General Medicine) am Channel Krok 2 Teleg) Question 192 of 200 192. Question A 26-year-old female patient has an 11-year history of rheumatism. Four years ago she suffered 2 rheumatic attacks. Over the last 6 months there have been paroxysms of atrial fibrillation every 2-3 months. What option of antiarrhythmic therapy or tactics should be proposed 1. Heparin administration 2.) Defibrillation 3. Immediate hospitalization 4, Lidocaine administratior 5.0 Prophylactic admi NEXT QUESTION. istration of cordaroneOr Merc unA) (J Centar eee eae Be Cac Home Medical Notes ram Channel r-old man had been drowning at sea, when he was found and evacuated to the shore. Objectively: unconscious, pale face, no breathing can be auscultated, save the man. What thready pulse. Resuscitation measures allowed to complication can develop in him in the nearest future? 1 Bronchial spasm 2. Encephalopathy 3.0 Respiratory arrest 4.0 Pulmonary edema 5.© Cardiac arrest NEXT QUESTION.Pea) x RU. 7 rn IM. Home Medical Notes = 4,© Staphylococcus 5.0 Enterovirus 39. Question A 14-year-old girl has been presenting with irritability and tearfulness for about a year. A year ago she was also found to have diffuse enlargement of the thyroid gland (II grade). This condition was regarded as a pubertal manifestation, the girl did not undergo any treatment. The girl’s irritability gradually gave place to a complete apathy. The girl got puffy face, soft tissues pastosity, bradycardia, constipations. Skin pallor and gland density progressed, the skin got a waxen hue. What disease may be assumed? Juvenile basop! Subacute thyroidit 3.0 Diffuse toxic goiter 4, Thyroid carcinoma Autoimmune thyroiditis 40. Question ‘A 60-year-old woman, mother of 6 children, developed a sudden onset of uppen abdominal pain radiating to the back, accompanied by nausea, vomiting, fever and chills. Subsequently, she noticed yellow discoloration of her sclera and § On physical exami-nation the patient was found to be febrile with temperature Of 38, 9° C, along with right upper quadrant tenderness. The most likely diagnosis i Choledochal cystal Ero nnd ace Cee Saker e CeCe Ey auliow a 4.Q Thyroid carcinoma Bt Autoimmune thyroiditis 40. Question A 60-year-old woman, mother of 6 children, developed a sudden onset of upper abdominal pain radiating to the back, accompanied by nausea, vomiting, fever and chills. Subsequently, she noticed yellow discoloration of her sclera and skin. On physical exami-nation the patient was found to be febrile with temperature of 38, 9° C, along with right upper quadrant tenderness. The most likely diagnosis is: Chol chal cyst 2.© Benign biliary strictu 3. Malignant biliary stric 4. Choledocholithiasis ‘5.0 Carcinoma of the head of the pancreas Mi 41. Question ear-old parturient woman has the I labor stage. The pregnancy is full-term: onds. Fetus presentation is polar, is 150/min, mouth A 20. Labors occur every 3 minutes and last for the head is pressed to the small pélvis entrance. Heart rate of the fetus distinct and rhythmic. Vagina examination: uterus cervix is smoothed ou' of the womb is 2 cm open; fetal bladder is intact; the head is presented over the I plane of small pelvis; moderate mucous-bloody discharge is observed. What phase of the I labor stageCenc) Home Medical Notes 5. © Esophageal chalasia 47. Question A newborn infant (the first labor, lasted for 26 hours) is 1-day-old, pos body weight is 3850 g; body length is 52 cin. Deli-very was performed by applying obstetrical forceps in sincipital presentation, Apgar score is 1/3. The face is bluish- Pale. The head is thrown back; severe birth trauma is present; the infant is excitable, shrill “cerebral scream”is present; the eyes are half-open; facial Meaan is attentive; hyperesthesia, hypersthenia und readiness for convulsions are present. Liquor has high content of erythrocytes, cytosis occurs. The most likely diagnosis is mature; lymphocytic 1.0 Intraventricular hemorrhage 2. Intracerebral hemorrhage 3.0 Subdural hemorrhage : 4. Subarachnoid hemorrhage 5.© Epidural hemorrhage 48. Question A 2-year-old woman on a reduced dict, complaints of distorted s mouth. Objectively: What clin vegetarian, attended a hospital with nell and taste perception and lesions in the angles of her lera is distinctly blue. iron-deficiency anemia. al syndrome is expres. 1.0 Anemic 2.0 Sideropenic 3. Hemorrhagic@ eneutron info ison _—- SeSmEnyenrueyeseneugury 5. Exotoxin of a causative agent 62. Question A 43-year-old patient had right-sided deep vein thrombos Now he is suffering from the sense of heaviness, edema of the lower ectively: moderate edema of shin, brown induration of skin in ial shin veins are present. What of iliofemoral segment 3 years ago tremity. Oby right ¢ the lower third of shin, vari is the most probable diagnosis? dilatation of super, 1.0 Acute thrombophlebitis of superficial veins 2. © Acute thrombosis of ir 3.2 Parkes-Weber syr 4. Postthrombophlebitic syndrome, varicose form 5. Lymphedema of lower right extremit 63. Question A patient was delivered to_a surgical department after a road accident with a ed trauma of chest and right-sided rib fracture. The patient was diagnosed clos ded pneumothorax; it is indicated to perform drainage of pleural with right cavity. Pleural puncture should be made: 1.O Inthe point of the greatest dullness on percussion 2.0 Inthe 6th intercostal space along the posteri-or axillary line 3.0 Inthe 7th intercostal space along the scapular line Inthe projection of pleural sinus 4, ‘5.0 In the 2nd intercostal space along the middle clavicular line70. Question A months, hirsutism. Gynaecological examination revealed that the ovaries were enlarged, painless, compact, uterus had no pecularities. Pelvic ultra year-old woman complains of increased intermenstrual periods up to ound revealed that the ovaries were 4-5 em in diameter and had multiple enlarged Sollicles on periphery. X-ray of skull base showed that sellar region was dilated. What is the most probable diagnosis? dismenorrhea 2:0 Sheehan's syndrome al syndrome 4. Morgagni-Stewart syndrom 2: Stein-Leventhal syndrome (Polycystic ovary syndrome) 71. Question amination of placenta revealed a defect. An obstetrician performed manual inves igation of uterine cavity, uterine massage. Prophylaxis of endometritis in the postpartum period should involve the following action: 1. Intrauterine instillation of dioxine 2.2 Contracting agents 3.© Instrumental revision of uterine cavity 4.0 Antibacterial therapyCneulron 6. Question An unconscious 35-year-old intensive care unit present. patient has been delivered b pjectively: th an ambulance to the he patient is in semicon The reaction of pupils to light is reduced. verbal instructions. BP is150/100 mm Hg, tachycardia is preseni methanol. What antidote should be administe erate mydrias' s is is non-responsive to Blood contains 1. Ethanol Thiamine chlorid 4.0 Tave A 6-year-old girl-attended a general actitioner with her mother. The child complains of burning pain and itching in her external genitalia. The girl was taking antibiotics the day before due to her suffering fi e On from acute bronchi amination: external genitalia are swollen, hyperemic, there is white deposit accumulated in the folds. The most likely diagnos 4 Ba idol ceshemunoimiticras omplained of amenorrhea @ 24-year-old patient ¢ ietachment of of premature ¢ the rate of 2000 ml 13 months after the first labo Pregnancy ended in Caesarian normally positioned placenta which resulted in blood loss ¢ blood clotting. Choose the most suitable investigati section because ion: due to disturbance of (5. Estimation of ‘gonadotropin rate is a case of child dying during the first month of an expert assessment of uld be considered first In a rural health care-area ther his life. To analyse this situation among other measures, medical records is performed. What medical document sho:LOPrimary hypothyroidism 3.0 Hypopituitarism body mm organs from levels of evel of a itary r at the I rdia. formative ford skin are pale with ph nodes are not enlarged. anges of internal organs. anisocytosis, utrophiles — 12% 7%, ESR - 12 ditionally make a y nen tion ige of 18 menstruations are 17 elopment; when the mn gyr gical examinatio mination: prolactin level exceedsCo ‘ eadache, irritability, rapid fatiga ht occurred at the age of 14. Objectively: weig) ody built. Fatty tissue is distributec irks) on the thighs, abdomen and m pvisional diagnosis is: 5.0 Pubertate dyspituitarism When exam ing ii hool class wa: determin indow-to-floor arec ratio is What parame: t d-to-room-depth ratio is 2Bn cclicr 2e{Pnotoelectric opntnaimia 1. Bronchography 510 Bronchoscopy(F nC) aA Cee eee ee Cee Pech lion Microcephaly clinic with welfare Questio patient attended a maternity A 59-year-old female complains of bloody discharge from the genital tracts. Postm is 12 years. eveaied that external genital organs had signs of age ody discharge came Vaginal examinanon involution, uterus cervix was not erosive, small amount of bli from the cervical canal. Uterus is of normal size, uterine appendages are unpalpable. Fornices were deep and painless. What method should be applied for jon? the diagnosis specificat Culdoscopy 2.0 Laparoscopy 3.) Separated diagnosic curettage 3 Puncture skin is dry and hot face niration, there is also smell 180. Question During examination a patient! is unconscious, his hyperemia is present. The patient has Kussmaul’s re: eritoneum irritation are positive. Blood sugar should be taken? of acetone in the air. Symptoms of p' 3 millimole/l. What emergency action: is 3Cee ow 181. Questior 4 baby was born at 36 weeks of gestation. Delivery was normal, by natural way. The baby has a large cephalohematoma. The results of blood count are: Hb- 3, 5 - 10°*/l, total serum bilirubin 123 mmol/l, direct bilirubin — 11 112 mmol/l. What are the causes of hyperbilirubinemia in this 1209/1, E mmol/l, indirect case? 4.0 Mechanical obstruction of the bile outflow intravascular hemo! 5. Erythrocyte hemolysis 182. Question 4 52-year-old patient complains of pain in the right part of her c cough with a lot of albuminoid sputum emitting foul smell of “meat slop Objectively: the patient’s condition is grave, cyanosis is observed, breathing rate is 31/min, percussion sound above the right lung is shortened, auscultation les). What is the most probable diagnos revealed various moist rales (crac! 1.) Pleura empyema 2.2 Lung abscess 3. Multiple bronchiectasis ‘ ee 4.0) Lung gangrene 5. Chronic pneumonia 183. Questioncry an A aA Pe ee poner is vas hospitalised in an intensive care unit with a diagno ed with cold sweat. Pulse can be 24/min, A 30-year-old patient v of multiple bee stings. Skin is pale and cov palpated only at the carotid arteries and is 110/min; breating rate od. What drug must be administered immediately? rhytmical, weakene intrave 1. Prednisolon 2. © Adrenaline hydrochloride intramuscularly Adrenaline hydrochloride intravenously 3. Tavegyl (Clemastins opamine intrav 186. Question year-old patient complains about having pain attacks in the right subcostal fatty food. Over the last A 50 area for about a year. The pain arises mainly after taking fi week the attacks occurred daily and became more painful. On the 3rd day of F skin and seleras, hospitalization the patient presented with icteritiousness 0j and dark urine. In blood: neutrophilic leukocytosis — 13, 1 light-coloured fecPena Hore Medical Notes EC neulion 198. Question was an outbreak of hepatitis type A possibly ide urban community ther u : y can confirm this theory? In river- f spread by water. What indexes of ver water qualit 1 Fecal coliform bacteria index 2.) Coliphage number 316 Celibacillus index re 4,2 Oxidability Si Non-icteric leptospirosis age 199. Question 4 24-year-old patient visited a doctor complaining of enla submaxillary lymph nodes. Objectively: submaxillary, axillary and inguinal lymph nodes are enlarged. Chest X-ray shows: enlarged lymph nodes of mediastinum. Blood test: erythrocytes -3, 4 - 10'2/l, Hb- 100 g/l, blood colour index — 0,88, platelets — 190 - 10°/l, leucocytes neutrophi-les — 2%, segmented neutrophiles mm/h. What test must be prescribed to verify the caus: -gement of his — 8%, band - 109/1, eosinophiles 67%, lymphocytes of lymphadenopathy? Puncture biopsy of lymph nodes 1.) Open biopsy of lymph nodes - [3.0 Sternal puncture . & 4, © Ultrasonography of abdominal cavity 5 Mediastinum tomography 200. Question A patient has been hospital ed, The onset of the disease was gradual: nausea