Control Tests

DANYLO HALYTSKY LVIV NATIONAL MEDICAL UNIVERSITY
Department of Propedeutics to Internal Medicine №1
Discipline: Propedeutics to Internal Medicine
Methodological Guidelines ofself-preparation for the test control and

differential creditfor English-speaking Students of Medical Faculty
(3-d Year of Study)
Lviv-2019
Discussed and approved
at a methodical meeting of department of
propedeutic ofinternalmedicine №1
Protocol № __
from “___”_________2019 y.
Chief of the department
prof. R. J. Dutka
___________________________
Methodological Guidelines of self-preparation of discipline propaedeutics to internal

medicine, training of specialists of the second (master's) level of higher education,
branch of knowledge 22 “Health care” specialtiy 222 "Medicine", medical faculty, ІІІ
year of study,compiledby:
- MD.PhD,Assoc. Professor of department of propedeutic of internalmedicine
№1 Novosad A.B.,
- MD.PhD,Assoc. Professor ofdepartment of propedeutic ofinternalmedicine

№1 AbrahamovychK.J.
Edited by Head of the department of Propedeutics of Internal Medicine №1 - MD,

Prof. Dutka R.J.
2
CONTENT
1. CONTROL TESTS OF THEORETICAL KNOWLEDGE………4
2. SITUATIONAL TASKS ………………………………..…………106
3. LIST OF PRACTICAL SKILLS …………………………………114
3
CONTROL TESTS OF THEORETICAL KNOWLEDGE
1. Complicationsof mitral regurgitation:

a) chronic left ventricular and atrial failure, chronic right ventricular heart
failure and chronic total ventricular heart failure;
b) arterial or venous emboli with massive pulmonary, cerebral, peripheral
thromboembolism, chronic left atrial heart failure, right ventricle heart failure;
c) cardiac asthma, chronic heart failure due to the “mitralization" of aortic
regurgitation;
d) sudden cardiac death, cardiac asthma, pulmonary edema, heart failure due to
“mitralization” o f aortic stenosis.
2. Complicationsof aortic regurgitation:
a) chronic left ventricular and atrial failure, chronic right ventricular heart failure
and chronic total ventricular heart failure;
b) arterial or venous emboli with massive pulmonary, cerebral, peripheral
thromboembolism, chronic left atrial heart failure, right ventricle heart failure;
c) cardiac asthma, chronic heart failure due to the “mitralization" of aortic
regurgitation;
d) sudden cardiac death, cardiac asthma, pulmonary edema, heart failure due to
“mitralization” o f aortic stenosis.
3. Signs of mitral regurgitation:
a) patient feels fatigue, exhaustion, palpitations of the heart, cough,
exertional and nocturnal dyspnea;
b) exertional and nocturnal dyspnea, cough, palpitation, pain in the heart;
c) dizziness, headaches, syncope, cardiac asthma, low diastolic pressure in the
aorta;
d) pain in the heart (angina type pain), cardiac asthma and even pulmonary
edema.
4. Signs of aortic regurgitation:
a) patient feels fatigue, exhaustion, palpitations of the heart, cough, exertional and
nocturnal dyspnea;
b) exertional and nocturnal dyspnea, cough, palpitation, pain in the heart;
c) dizziness, headaches, syncope, cardiac asthma, low diastolic pressure in
the aorta;
d) pain in the heart (angina type pain), cardiac asthma and even pulmonary
edema.
5. Signs of mitral stenosis on X-ray examination:
a) disappearing of the heart waist, enlarged of the left atrium auricle,
enlarged of the right ventricle, protrusion of the pulmonary trunk;
b) smoothed of the left border due to protrusion of the left atrium auricle,
moderate enlarging of the pulmonary trunk, protrusion of the left low arch;
4
c) protrusion of the left ventricle arch, heart apex rounding, marked heart waist,
(heart configuration is duck-like), narrowing of the retrocardial space in the
second position;
d) shows hypertrophied left ventricle, “aortic” configuration of the heart and post-
stenotic dilatation of the ascending aorta, the cusps of the aortic valve are often
calcified on lateral view.
6. Signs of aortic stenosis during X-ray examination:
a) disappearing of lhe heart waist, enlarged of the left atrium auricle, enlarged of
the right ventricle, protrusion of the pulmonary trunk;
b) smoothed of the left border due to protrusion of the left atrium auricle,
moderate enlarging of the pulmonary trunk, protrusion of the left low arch;
c) protrusion of the left ventricle arch, heart apex rounding, marked heart waist,
(heart configuration is duck-like), narrowing of the retrocardial space in the
second position;
d) shows hypertrophied left ventricle, “aortic” configuration of the heart and
post-stenotic dilatation of the ascending aorta, the cusps of the aortic valve
are often calcified on lateral view.
7. Heart configuration as “duck-like” on X-ray is a sign of:
a) aortic stenosis;
b) aortic regurgitation;
c) mitral stenosis;
d) mitral regurgitation.
8. Systolic thrill (cat’s purr) is the sign of:
a) aortic stenosis;
c) mitral stenosis;
9. Asymmetrical (p. differens) pulse on the radial arteries is a sign of:
a) aortic stenosis;
c) mitral stenosis;
10.Blowing, decreasing murmur, which is heard at the heart apex and synchronous
with the first heart sound is the sign of:
a) aortic stenosis;
c) mitral stenosis;
11.Triple rhythm at the apex is the sign of:
a) aortic stenosis;
c) mitral stenosis;
12.Quincke’s pulse is the sign of:
a) aortic stenosis;
5
c) mitral stenosis;
13.“Pistol shot”is the sign of:
a) aortic stenosis;
c) mitral stenosis;
14.“Aortic”heart configuration is the sign of:
a) aortic stenosis;
c) mitral stenosis;
15.Small, slow and rare pulse is the sign of:
a) aortic stenosis;
c) mitral stenosis;
16.Fast, high large volume pulse is the sign of:
a) aortic stenosis;
c) mitral stenosis;
17.If systolic pressure increased and diastolic decreased is the sign of:
a) aortic stenosis;
c) mitral stenosis;
18.Spread pulsation in the III-IV intercostals space along left edge of sternum with
synchronous pulsation in the epigastric region are detected in case of:
a) aortic stenosis;
c) mitral stenosis;
19.Left ventricular failure corresponds with all listed, except:
a) increasing pressure in the left atrium;
b) increasing pressure in pulmonary veins ;
c) congestion in greater circulation;
d) increasing pressure in later pulmonary artery.
20.Clinical picture of congestion in lesser circulationis characterized by all listed,

except:
a) breathlessness;
b) enlarged liver;
c) orthopnea;
6
d) crepitation over the lung.
21.Clinical pictures of congestion in greater circulation are characterized by all listed,
except:
a) pain in the right hypochondrium;
b) paroxysmal nocturnal dyspnea;
c) edema on lower extremities;
d) enlarged liver.
22.Massive accumulation of fluid may cause all listed, except:
a) ascites;
b) pleural effusion;
c) dysphagia;
d) pericardial effusion.
23.Forced position of patient with cardiac asthma is:
a) sitting with legs hanging down from the bed or he stands up;
b) sitting with trunk slightly bent forward;
c) lying on the abdomen:
d) there is no forced position.
24.Forced position of patient withpulmonary edema is:
a) sitting with legs hanging down from the bed or he stands up;
b) sitting with trunk slightly bent forward;
c) lying on the abdomen;
d) there is no forced position.
25.Chronic left ventricular heart failure may be caused by:
a) cardiomyopathy;
b) bronchial asthma (status asthmaticus);
c) lobar pneumonia;
d) lung atelectasis.
26.Acute right ventricular heart failure may be caused by:
a) thromboembolism of the trunk of the pulmonary artery or its branches;
b) postinfarction cardiosclerosis;
c) cardiomyopathy;
d) arrhythmias.
27.Acute left ventricular failure may be caused by:
a) lobar pneumonia;
b) bronchial asthma (status asthmaticus);
c) myocarditis;
d) cardiomyopathy.
28.Chronic right ventricular heart failure may be caused by:
a) myocarditis;
b) tricuspid regurgitation;
c) cardiomyopathy;
d) aortic valve disease.
29.ECGsigns of chronic right ventricular heart failure:
a) hypertrophy of left ventricle, left bundle branch block;
b) hypertrophy of right ventricle, right bundle branch block;
7
c) P-pulmonale in II, III standard leads, signs of overloading of the right ventricle
in V 1-2;
d) signs of overloading of the left ventricle.
30.ECGsigns of Chronic left ventricular heart failure:
a) P-pulmonale in II, III standard leads, signs of overloading of the right ventricle
in V 1-2 ;
b) hypertrophy of left ventricle, left bundle branch block;
c) hypertrophy of right ventricle, right bundle branch block;
d) signs of overloading of the left ventricle.
31.I class of heart failure by NYHAis characterized by:
a) ordinary physical activity does not cause dyspnea (or fatigue, palpitation,
or anginal pain);
b) ordinary physical activity results in dyspnea (or fatigue, palpitation, or anginal
pain);
c) less than ordinary physical activity causes dyspnea (or fatigue, palpitation, or
anginal pain);
d) symptoms of dyspnea (or of angina) may be present even at rest.
32.III class of heart failure by NYHAis characterized by:
a) ordinary physical activity does not cause dyspnea (or fatigue, palpitation, or
anginal pain);
b) ordinary physical activity results in dyspnea (or fatigue, palpitation, or anginal
pain);
c) less than ordinary physical activity causes dyspnea (or fatigue, palpitation,
or anginal pain);
d) symptoms of dyspnea (or of angina) may be present even at rest.
33.II stage of Heart Failure by Classification according to N.D. Strazhesko and V.H.
Vasilenko is characterized by:
a) symptoms during physical exercises: dyspnea, palpitation;
b) symptoms and signs of heart failure not only durin physical exercises, but
at rest;
c) at rest pronounced cyanosis, swollen jugular veins, edema and ascites are
revealed;
d) hemodynamic disorders, irreversible morphological changes of all organs.
34.III stage of Heart Failure by Classification according to N.D. Strazhesko and V.H.
Vasilenko is characterized by:
a) symptoms and signs of heart failure not only durin physical exercises, but at
rest;
b) symptoms during physical exercises: dyspnea, palpitation;
c) hemodynamic disorders, irreversible morphological changes of all organs;
d) at rest pronounced cyanosis, swollen jugular veins, edema and ascites are
revealed.
35.Syncope it is:
a) acute vascular failure due to the affection of the vascular tone primary or
secondary origin;
b) a sudden transient loss of consciousness;
8
c) clinical syndrome that develops when there is critical impairment of tissue
perfusion to some organs
d) no correct answer.
36.Shock it is:
a) acute vascular failure due to the affection of the vascular tone primary or
secondary origin;
b) a sudden transient loss of consciousness;
c) clinical syndrome that develops when there is critical impairment of tissue
perfusion to some organs
37.Shock is characterised by:
a) weakness, nausea, darkening in the eyes, noise in the cars;
b) pallid skin, decreasing of body temperature, accelerated and superficial
respiration, decreased arterial and venous blood pressure;
c) tachycardia, rapid shallow respiration, cold clammy skin, hypotension;
d) sinus bradycardia or sinoatrial blocks or sinus pauses >3 s, atrioventricular
block, alternating left and right bundle branch block.
38.Syncope is characterised by:
a) oliguria, multi-organ failure, thready pulse;
b) pallid skin, decreasing of body temperature, accelerated and superficial
respiration, decreased arterial and venous blood pressure;
c) tachycardia, rapid shallow respiration, cold clammy skin, hypotension;
d) sinus bradycardia or sinoatrial blocks or sinus pauses >3 s,
atrioventricular block, alternating left and right bundle branch block.
39.On what level should be systolic arterial blood pressure (SBP) for establishing
arterial hypertension?
a) 200 mm Hg and higher;
b) 140 mm Hg and higher;
c) 120 mm Hg and higher;
d) 100 mm Hg and higher.
40.On what level should be diastolic arterial blood pressure (DBP) for establishing
arterial hypertension?
a) 70 mm Hg and higher;
b) 90 mm Hg and higher;
c) 120 mm Hg and higher;
d) 140 mm Hg and higher.
41.How many times should be measured blood pressure to establish arterial
hypertension?
a) 2-3 times in different days during 4 weeks;
b) 2-3 times in different days during 8 weeks;
c) 2-3 times in different days during 1 week;
d) 2-3 times in one day.
42.How many times should be measured blood pressure to establish arterial
hypertension?
a) 2-3 times in different days during 8 weeks;
9
b) 2-3 times in different days during 4 weeks;
c) 2-3 times in different days during 1 week;
d) 2-3 times in one day.
43.Normal BP established at the level:
a) 120-129 SBP (mm Hg) and/or 80-84 DBP (mm Hg);
b) 130-139 SBP (mm Hg) and/or 85-89 DBP (mm Hg);
c) 140-159 SBP (mm Hg) and/or 90-99 DBP (mm Hg);
d) 160-179 SBP (mm Hg) and/or 100-109 DBP (mm Hg).
44.High normal BP established at the level:
45.Grade I hypertension established at the level:
46.Grade II hypertension established at the level:
d) 180 SBP (mm Hg) and/or > 110 DBP (mm Hg).
47.Grade III hypertension established at the level:
d) 180 SBP (mm Hg) and/or > 110 DBP (mm Hg).
48. Isolated systolic hypertension established at the level:
a) 140 SBP (mm Hg) and < 90 DBP (mm Hg);
49. Stage I hypertension:
a) no objective signs of organic changes;
b) at least one sign of organ involvement without symptoms or dysfunction;
c) both symptoms and signs have appeared as result of organ damage;
d) signs of a absence of consciousness and / or failure of organs.
50. Stage III hypertension:
a) no objective signs of organic changes;
b) at least one sign of organ involvement without symptoms or dysfunction;
c) both symptoms and signs have appeared as result of organ damage;
d) signs of a absence of consciousness and / or failure of organs.
51. Damage of kidney on Stage III hypertension is established at the level of plasma
creatinine concentration:
10
a) more than 177 mmol/1;
b) more than 351 mmol/1;
c) more than 440 mmol/1;
d) less than 177 mmol/1.
52. What level of protein in the urine indicates the presence of Stage II hypertension?
a) less than 1,2 - 2,0 mg/dl;
b) 1,2 - 2,0 mg/dl;
c) more than 4,0 mg/dl;
d) more than10,0 mg/dl.
53. Increase level of what laboratory index is typical for Cushing`s
syndrome:
a) cortisol and 17-OKS is in blood;
b) aldosteron in blood and urine;
c) adrenalin, noradrenalin in blood;
d) renin in blood plasma.
54.Increase level of what laboratory index is typical forConn’s syndrome:
c) adrenalin, noradrenalinin blood;
55.Increase level of what laboratory index is typical forPhaeochromocytoma:
c) adrenalin, noradrenalinin blood;
56.Increase level of what laboratory index is typical for renovascular hypertension:
c) adrenalin, noradrenalin;
57.What provocative test is performed for establishing Phaeochromocytoma:
a) test with antibiotics;
b) test with histamine and alpha-adrenoblockers;
c) test for glucose tolerance;
d) test with veroshpiron.
58.What provocative test is performed for establishing Conn’s syndrome:
a) test with histamine and alpha-adrenoblockers;
b) test with antibiotics;
c) test for glucose tolerance;
d) test with veroshpiron.
59.Dyspnea at rest is typical for:
11
a) mild cours of myocarditis;
b) moderate cours of myocarditis;
c) sever cours of myocarditis;
d) not typical for myocarditis.
60.Pericardial friction of scraping character is typical for:
a) myocarditis;
b) dry pericarditis;
c) exudative pericarditis;
d) hypertension.
61.Swelling of neck veins that increased on inspiration is typical sign of:
c) dry pericarditis;
d) exudative pericarditis.
62.Cardiomegaly on X-ray is typical sign of:
c) sever cours of myocarditis;
d) exudative pericarditis.
63.Duration of subacute course of myocarditis is:
a) 1 – 3 months;
b) 3 – 6 months;
c) 6 – 9 months;
d) more than 9 months.
64.Duration of chronic course of myocarditis is:
a) 1 – 3 months;
12
b) 3 – 6 months;
c) 6 – 9 months;
d) more than 9 months.
65.Aseptic pericarditis can be caused by all, except:
a) diffuse pathology of connective tissue;
b) metabolic disorders - uremia, gout;
c) angina;
d) allergy.
66.Aseptic pericarditis can be caused by all, except:
a) the diseases o f blood;
b) treatment of steroids;
c) treatment with anticoagulants;
d) C hypovitaminosis.
67.Cause of hemorrhagic pericarditis is:
a) carcinoma of the breast;
b) septicaemia;
c) rheumatic fever;
68.Cause of purulent pericarditis is:
a) carcinoma of the breast;
b) septicaemia;
c) lymphoma;
69.Main cause of coronary heart diseases is:
a) atheroma and its complications;
b) hypoxia of the brain of any origin;

13
c) congenital heart disease;
d) arterial hypertension.
70.The main cause of coronary heart diseases is:
a) parenchymal and interstitial renal disease;
b) atheroma and its complications;
c) heart valves insufficiency;
d) arterial hypertension.
71.For differential diagnosis between myocardial infarction and angina should be

applied:
a) dobutamine;
b) nitroglycerin;
c) eufillin;
d) captopril.
72.For differential diagnosis between myocardial infarction and angina should be

applied:
a) dobutamine;
b) nitroglycerin;
c) adenosine;
d) dipyridamole.
73.Acute coronary syndrome includes:
a) Q-wave myocardial infarction;
b) unstable angina;
c) vasospastic angina;
d) cardiac arrhythmia.
74.Acute coronary syndrome includes:
a) stable angina;
14
b) Princmetala’s angina;
c) non-Q-wave myocardial infarction;
d) cardiac arrhythmia.
75.Characteristic feature of unstable angina is:
a) pain that radiates to left shoulder;
b) occurrence of pain attack at rest;
c) pain that occurs during exercise;
d) pain that lasts for several hours or days.
76. Attack of pain that lasts for several hours or days typical for:
a) stable angina;
b) unstable angina;
c) myocardial infarction;
d) arrhythmias.
77.In what period of myocardial infarction is formed myocardial scar?
a) very acute;
b) acute;
c) subacute;
d) recovery.
78.In what period of myocardial infarction is formed myocardial scar?
a) very acute;
b) acute;
c) subacute;
d) stabilization.
79.Intenstive pain in the epigastrium or in the right hypochondrium, which associated

with dyspeptic disorders are typical signs of:
a) abdominal type of myocardial infarction;
15
b) asthmatic type of myocardial infarction;
c) arrhythmic type of myocardial infarction;
d) cerebral type of myocardial infarction.
80. Complication of abdominal type of myocardial infarction can be:
a) relative mitral incompetence;
b) acute gastrointestinal lesion and ulcer;
c) cardiogenic shock with fall of blood pressure;
d) syncope and coma.
81.Severe difficulty in breathing, cough with a foamy pink sputum and small
intensity of chest pain are typical signs of:
82.Complication of asthmatic type of myocardial infarction can be:
a) acute gastrointestinal lesion and ulcer;
b) relative mitral incompetence;
83.Disorders of rhythm and cardiac conduction, with slightly pain syndrome are
typical signs of:
84. Complication of arrhythmic type of myocardial infarction can be:
16
85. Giddiness, syncope, cramps and even coma are typical signs of:
86. Complication of cerebral type of myocardial infarction can be:
87. What type of myocardial infarction can pass unrecognized and may reveal
afterwards during ECG recording or Echo-CG examination?
d) “silent” type of myocardial infarction.
88. What type of myocardial infarction can pass unrecognized and may reveal
afterwards during ECG recording or Echo-CG examination?
a) asthmatic type of myocardial infarction;
b) “silent”type of myocardial infarction;
17
89. In acute period of myocardial infarction may be all complications except:
a) cardiogenic shock;
b) ulcers of gastrointestinal tract;
c) Dressler’s syndrome;
d) pericarditis.
90. In subacute period of myocardial infarction may be observe all complications

except:
a) ulcers of gastrointestinal tract;
b) Dressler’s syndrome;
c) post-infarction remodeling;
d) post-infarction angina.
91. Dressler’s syndrome is characterized by all except:
a) persistent fever;
b) pericarditis;
c) peritonitis;
d) pleurisy.
92. The Dressler’s syndrome occurs:
a) immediately after the occurrence of myocardial infarction;
b) in two days after the occurrence of myocardial infarction;
c) a few weeks or even month after the myocardial infarction;
d) in half a year after the occurrence of myocardial infarction.
93. Aneurysm revealed during inspection of the heart region as:
a) pulsation in the epigastric region;
b) pulsation of neck veins;
c) weak restricted pulsation in the III-IV intercostals spaces somewhat

laterally from the left sternal edge;
18
d) protrusion in the fifth intercostal space on the left side of the chest.
94. Diagnostic signs of cardigenic shock all except:
a) fall systolic blood pressure less 90 mm Hg;
b) deranged consciousness;
c) rise diastolic blood pressure more 110 mm Hg;
d) decreased volume of urine less 20 ml/hour.
95. II classes of acute heart failure (classification by Killip) is characterized by:
a) presence of cardiac shock;
b) presence of rales in less 50 % of lung areas or gallop rhythm;
c) absence of pulmonary rales and gallop cardiac rhythm;
d) presence of rales in more 50 % of lung areas.
96. III classes of acute heart failure (classification by Killip) is characterized by:
a) presence of rales in less 50 % of lung areas or gallop rhythm;
b) presence of rales in more 50 % of lung areas associated with gallop

rhythm;
c) absence of pulmonary rales and gallop cardiac rhythm;
d) presence of cardiac shock.
97. Myocardial infarction is characterized by leukocytosis with mild nuclear shift to

the left that occurs:
a) in a few hours after onset of chest pain, reached the peak at 2-4 days and
normalized in a week;
b) at 2-3 days from onset of chest pain, reached maximal level till 2 week and
normalized at 3-4 weeks;
c) in 60-90 minutes after chest pain, every 12 hours 3 time;
d) in 12 hours after chest pain, one time and normalized in a week.
98. Myocardial infarction is characterized by accelerated ESR that observed:
a) at 2-3 days from onset of chest pain, reached maximal level till 2 week and
normalized at 3-4 weeks;
19
b) in a few hours after onset of chest pain, reached the peak at 2-4 days and
normalized in a week;
d) in 12 hours after chest pain, one time and normalized in a week.
99. Optimal time for estimation of myocardial marker of necrosis – myoglobin is:
a) in 1-2 hours after chest pain;
b) in every 12 hours 3 time;
d) in 12 hours after chest pain, one time.
100. Optimal time for estimation of myocardial marker of necrosis – creatine kinase
is:
b) after chest pain in every 12 hours 3 time;
101. Optimal time for estimation of myocardial marker of necrosis – creatine kinase
MB is:
102. Optimal time for estimation of myocardial marker of necrosis – lactate

dehydrogenase is:
20
103. Optimal time for estimation of myocardial marker of necrosis – troponin T is:

104. Optimal time for estimation of myocardial marker of necrosis – troponin I is:
105. Sudden cardiac death (SCD) is characterized by all except:
a) apnea;
b) difficulty in breathing, cough with a foamy pink sputum;
c) absence of heart sounds;
d) appearance of pale-grey tint of skin.
106. Sudden cardiac death (SCD) is characterized by all except:
a) absence of pulse on large arteries;
b) nausea and vomiting with intenstive pain in the epigastrium;
c) absence of heart sounds;
d) appearance of pale-grey tint of skin.
107. For syndrome of the pulmonary tissue consolidation typical character of

dyspnea is:
a) expiratory or mixed and increased during physical activity;
b) expiratory, gradually increased;
c) inspiratory or mixed;
d) mixed, rapidly increased and transmit to asphyxia.
108. For syndrome of increased airiness of the pulmonary tissue typical character of
dyspnea is:
21
a) inspiratory or mixed;
b) expiratory or mixed and increased during physical activity;
c) expiratory, gradually increased;
d) mixed, rapidly increased and transmit to asphyxia.
109. For bronchospastic syndrome typical character of cough is:
a) may be dry or with sputum discharge;
b) commonly dry and has reflex character;
c) moist with difficult sputum expectoration;
d) commonly dry whichturn to the moist with large amount.
110. For syndrome of the cavity in the lungs typical character of cough is:
a) dry or with sputum discharge;
b) commonly dry and has reflex character;
c) moist with difficult sputum expectoration;
d) dry whichturn to the moist with large amount (by “full mouth”).
111. For syndrome of air accumulation in pleural cavity (pneumothorax) typical

character of chest pain is:
a) pain is connected with the deep respiration;
b) accentuated by respiratory movement and coughing;
c) sharp and knife-like character, localized on the affected side;
d) chest pain is absent.
112. For syndrome of the pulmonary tissue consolidation typical character of chest
pain is:
a) pain is connected with the deep respiration;
b) accentuated by respiratory movement and coughing;
c) sharp and knife-like character, localized on the affected side;
d) chest pain is absent.
22
113. Fluid accumulation in pleural cavity also called:
a) pneumothorax;
b) hydrothorax;
c) hemothorax;
d) chylothorax.
114. Air accumulation in pleural cavity also called:
a) hydrothorax;
b) pneumothorax;
c) hemothorax;
d) chylothorax.
115. Bronchial breathing “metallic” is typical for:
a) hydrothorax;
b) syndrome of increased airiness of the pulmonary tissue;
c) pneumothorax;
d) syndrome of the pulmonary tissue consolidation.
116. In valve type of pneumothorax is typical:
a) bronchial breathing with determination of breathing only during exspiration;
b) bronchial breathing with determination of breathing only during

inspiration;
c) vesicular breathing with determination of breathing only during inspiration;
d) vesicular breathing with determination of breathing only during exspiration.
117. Facies pneumonica ischaracterized by:
a) one -sided blush on the same cheek as affected lung;
b) exhausted, pale face with blush localized on the cheeks, “burning eyes”, dry
lips;
c) edematous, pale, and yellowish face with a cyanotic hue;
23
d) round or “moon-like” face, plethora, red cheeks.
118. Facies tuberculous ischaracterized by:
a) one -sided blush on the same cheek as affected lung;
b) exhausted, pale face with blush localized on the cheeks, “burning eyes”,
dry lips;
c) edematous, pale, and yellowish face with a cyanotic hue;
d) round or “moon-like” face, plethora, red cheeks.
119. Moist cough with large amount (by “full mouth”) is typical for:
a) syndrome of the pulmonary tissue consolidation;
b) pneumothorax;
c) syndrome of increased airiness of the pulmonary tissue;
d) syndrome of the cavity in the lungs.
120. Hippocratic nails is typical for:
b) pneumothorax;
c) syndrome of increased airiness of the pulmonary tissue;
d) syndrome of the cavity in the lungs.
121. Sights of increased airiness of the pulmonary tissue during inspection of the
chest can be all, except:
a) emphysematous form of the chest;
b) horizontal direction of the ribs;
c) smoothed and narrow intercostals spaces;
d) asymmetrical chest with one half falls in the breathing act.
122. Syndrome of the pulmonary tissue consolidation is characterized by:
a) asymmetrical chest with one half falls in the breathing act;
b) emphysematous form of the chest;
24
c) asymmetric in the chest with one half lags in the breathing act;
d) symmetrical chest.
123. Glass-like or glass like with yellow traces color character of the sputum is
typical for:
c) syndrome of the cavity in the lungs;
d) pneumothorax.
124. Mucous-purulent or mucous-purulent bloody with unpleasant odor character of

the sputum is typical for:
c) syndrome of the cavity in the lungs;
d) pneumothorax.
125. X-ray sights ofhydrothorax:
a) consolidation of the pulmonary tissue, tumor,the signs of bronchium

obstruction;
b) signs of increased airiness of the pulmonary tissue, low diaphragm’s position;
c) augment and deformity of lung picture over increased in transparent lung

tissue;
d) homogenous darkening with horizontal or slating level.
126. X-ray sights of pneumothorax:
a) consolidation of the pulmonary tissue, tumor,the signs o f bronchium

obstmction;
b) signs of increased airiness of the pulmonary tissue, low diaphragm’s position;
c) augment and deformity of lung picture over increased in transparent lung

tissue;
25
d) large clear up space without lung’s depiction, comprehensible border of
the adhesives lung.
127. "P-pulmonale”, decreased R-wave in right leads is typical for:
a) pneumothorax;
b) pulmonary tissue consolidation;
c) cavity in the lungs;
d) hydrothorax.
128. Emphysematous form o f the chest is typical for:
a) increased airiness of the pulmonary tissue;
b) pulmonary tissue consolidation;
c) cavity in the lungs;
d) hydrothorax.
129. Inflammatory injury of bronchial tree is also called:
a) emphysema of the lungs;
b) bronchial asthma;
c) bronchitis;
d) pneumonia.
130. Disease characterized by pathologic alveoli dilation localized in terminal

bronchi is also called:
c) bronchitis;
d) pneumonia.
131. Bronchitis it is:
a) disease that leads to bronchial hyperreactivity;
b) inflammatory injury of bronchial tree;
26
c) disease accompanied by destructive changes of alveoli;
d) inflammatory disease with obligatory alveoli involvement.
132. Emphysema of the lungs it is:
a) inflammatory injury of bronchial tree;
b) disease accompanied by destructive changes of alveoli;
c) disease that leads to bronchial hyperreactivity;
d) inflammatory disease with obligatory alveoli involvement.
133. Hemoptysis is more typical for:
c) bronchitis;
d) bronchiectatic disease.
134. Central or diffuse cyanosis is typical sing of:
a) pneumonia;
b) dry pleurisy;
c) bronchiectatic disease;
d) acute bronchitis.
135. Degree I – Intermittent bronchial asthma characterized by:
a) short-term symptoms less than 1 time per month;
b) short-term symptoms less than 1 time per week;
c) symptoms appear every day;
d) symptoms frequent than 1 time per week but less than 1 time per day.
136. Degree II – Grave bronchi persistent asthma characterized by:
a) short-term symptoms less than 1 time per week;
b) symptoms appear every day;
c) constant symptoms of bronchial asthma;

27
d) symptoms frequent than 1 time per week but less than 1 time per day.
137. Complications of bronchiectatic disease all beside
a) lung bleeding;
b) renal amiloidosis;
c) hepatic coma;
d) metastatic brain abscesses.
138. Complications of bronchiectatic disease all beside
a) “cor pulmonale”;
b) hepatic coma;
c) renal amiloidosis;
d) metastatic brain abscesses.
139. Dyspnea that appears only during physical activity is typical sing of:
a) lungs emphysema;
c) acute bronchitis;
d) pneumonia.
140. Coarse and medium bubbling rales is typical sing of:
a) lungs emphysema;
c) chronic bronchitis;
141. Severity of asthmatic status is characterized by all listed, except:
a) degree of respiratory failure;
b) acidosis;
c) degree of renal failure;
d) hypercapnia.
28
142. Severity of asthmatic status is characterized by all listed, except:
a) degree of respiratory failure;
b) level of hypoxemic coma;
c) degree of renal failure;
d) respiratory center paralysis.
143. Formation of “dumb lung” is a manifestation of:
a) lungs emphysema;
144. Clinical manifestation of bronchial asthma attack is all listed, except:
a) feeling of difficulty breathing;
b) significant expiratory dyspnea;
c) shallow respiration;
d) cough with large amount of sputum.
145. Clinical manifestation of bronchial asthma attack is all listed, except:
a) noisy distant rales;
b) significant expiratory dyspnea ;
c) tachypnea;
d) cough with large amount of sputum.
146. X-ray sing of lung’s “amputation” is typical for:
a) lungs emphysema;
147. Horizontal position of the ribs is the X-ray sing of:

29
a) pneumonia;
148. 24-hours amount of sputum in patients with chronic bronchitis is usually:
a) 20-30 ml;
b) 50-70 ml;
c) 250-300 ml;
d) 1 L.
149. Intrahospital pneumonia means:
a) pneumonia that develops outside from hospital;
b) pneumonia, that was diagnosed on admission to hospital;
c) pneumonia that develops in first 48-72 hours after hospitalization;
d) pneumonia that develops in first 120 hours after hospitalization.
150. Nonhospital pneumonia means:
a) pneumonia that develops in first 48-72 hours after hospitalization;
b) pneumonia that develops outside from hospital;
c) pneumonia that develops in first 120 hours after hospitalization;
d) pneumonia, that was diagnosed on admission to hospital.
151. The main risk factors of pneumonia all, exept:
a) innate defects of bronchopulmonary system;
b) chronic infection in nosepharynx;
c) genetic factors;
d) long confinement to bed.
152. The main risk factors of pneumonia all, exept:
a) heart failure with congestion in lesser circulation;

30
b) the state of immunodeficiency and treatment with immune depressants;
c) genetic factors;
d) old age.
153. Pain in the chest in case of pneumonia is characterized by:
a) irradiation to left shoulder or arm;
b) sudden occurrence, increasing during deep inspiration or cough;
c) epigastrium pain during coughing;
d) not a typical sign of pneumonia.
154. Clinical signs of pneumonia ascough is characterized by:
a) dry cough throughout the disease;
b) cough with production of hardly expectorated tenacious sputum;
c) cough with blood clots;
d) paroxysmal coughing and patients take th e forced posture in form o f

orthopnea.
155. The posture of the patients with pneumonia is:
a) frequently active or may be forced (orthopnea);
b) forced (lie on the affected side in order to relieve the pain);
c) active;
d) forced (lie on the healthy side in order to relieve the pain).
156. The posture of the patients with pleurisy is:
a) frequently active or may be forced (orthopnea);
b) forced (lie on the affected side in order to relieve the pain);
c) active;
d) forced (lie on the healthy side in order to relieve the pain).
157. In auscultation of the lungs of patient with pleurisy can be heard:
a) dre rales;
31
b) pleural friction;
c) crepitation;
d) bubbling rales.
158. In auscultation of the lungs of patient with acute lobar pneumonia can be
heard:
a) dry rales;
b) pleural friction;
c) crepitation;
d) nothing is heard.
159. In lobar pneumonia the sputum is:
a) sticky, rusty initially, later mucopurulant, tenacious or tenacious thick

consistency, odorless;
b) mucopurulant, tenacious or tenacious thick consistency, glass-like with yellow

traces color, odorless;
c) large amount of mucopurulant, purulent or mucopurulent bloody strong smell

sputum;
d) mucous.
160. Sticky, rusty initially, later mucopurulant, tenacious or tenacious thick

consistency, odorless sputum is typical for:
a) lobar pneumonia;
b) focal pneumonia;
d) chronic bronchitis.
161. X-ray signs of focal pneumonia:
a) darkening limited by the lung’s lobe or several lobes;
b) darkening limited by the lung’s segment;
c) significant darkness with slanting upper border of the fluid;
d) poor bronchial picture in the peripheral zones.

32
162. X-ray signs of pleura affection:
a) darkening limited by the lung’s lobe or several lobes;
b) darkening limited by the lung’s segment;
c) significant darkness with slanting upper border of the fluid;
d) poor bronchial picture in the peripheral zones.
163. X-ray signs of significant darkness with slanting upper border of the fluid is
typical for:
a) focal pneumonia;
b) lobar pneumonia;
c) emphysema of the lungs;
d) exudative pleurisy.
164. X-ray signs of darkening limited by the lung’s lobe or several lobes is typical
for:
a) focal pneumonia;
b) lobar pneumonia;
c) emphysema of the lungs;
d) exudative pleurisy.
165. The color of the patient skin and visible mucosa with dry pleurisy is:
a) cyanotic;
b) pale;
c) red;
d) without changes.
166. The color of the patient skin and visible mucosa with exudative pleurisy is:
a) cyanotic;
b) pale;
c) red;
33
d) without changes.
167. One-side blush on the same cheek as affected lung, is typical sing of:
a) pneumonia;
b) bronchiectatic disease;
d) pleurisy.
168. Pain that can irradiate to the upper abdominal region or to the neck is typical
sing of:
a) pleurisy;
b) pneumonia;
d) chronic bronchitis.
169. Etiological factors of suprahepatic (hemolytic) jaundice all except:
a) hereditary hemolytic anemia;
b) acquired hemolytic anemia;
c) iIncreased erythrocytes hemolysis;
d) liver disease.
170. Etiological factors of hepatic (parenhimatous) jaundice all except:
a) liver cirrhosis;
b) talassemia;
c) gilber's syndrome;
d) metastatic affection of the liver.
171. Etiological factors of hepatic (parenhimatous) jaundice all except:
a) different types of hepatitis;
b) cancer of the extra hepatic bile ducts;
c) cholangitis;
34
d) toxico-allergic liver affection.
172. Etiological factors of subhepatic (mechanical) jaundice all except:
a) tumor of the liver;
b) cancer of the pancreas;
c) calculus cholecystitis;
d) cancer of the major duodenal papilla.
173. Suprahepatic jaundice characterized by:
a) orange-yellow tint;
b) lemon-yellow tint;
c) greenish- yellow tint;
d) pale tint.
174. Parenchymatous jaundice(hepatic jaundice) characterized by:
d) pale tint.
175. Obstructive jaundice (subhepatic jaundice) characterized by:
d) pale tint.
176. Hemolytic jaundicealso called:
a) suprahepatic jaundice;
b) hepatic jaundice;
c) subhepatic jaundice;
35
177. Parenchymatous jaundicealso called:
a) hemolytic jaundice;
178. Obstructive jaundicealso called:
179. Itching of the skin is the most typical symptom for:
a) syndrome of bile ducts dyskinesia;
b) syndrome of jaundice;
c) syndrome of gastrointerstitial bleeding;
d) syndrome of portal hypertension.
180. Increased of total bilimbin mainly due to the bound bilirubin is typical for:
a) subhepatic jaundice;
c) suprahepatic jaundice;
181. Increased of total bilirubin mainly due to the unbound bilirubin is typical for:
36
182. Increased of total bilirubin due to the unbound and bound fractions is typical
for:
183. Beerlike color of urine is typical for:
a) syndrome of jaundice;
b) syndrome of gastrointerstitial bleeding;
c) syndrome of portal hypertension;
d) syndrome of functional dyspepsia.
184. Increased γ-globulins level, hyperproteinemia, elevated thymol test and

immunoglobulins G and M contents are typical to:
a) immunoinflammatory syndrome;
b) cytolisis syndrome;
c) cholestatic syndrome;
d) hepatic-cellular failure syndrome.
185. Increased activity of alkaline phosphotase in combination with

hyperbilirubunemia, hypercholesterolemia, and β-lipoproteinemia is typical to:
186. Decreased albumins, cholesterol, protrombin contents in combination with

hyperbilirubinemia is typical for:
37
187. Increased activity of ALT, AST, alkaline phosphatase, lactate dehydrogenase,

cholinesterase, sorbitol dehydrogenase and hyperbilirubunemia with
predominance of bound fraction indicates:
188. Increasing albumin levels in the blood determin all except:
a) chronic hepatitis;
b) liver cirrhosis;
c) cholelitiasis;
d) liver cancer.
189. Chronic diseases of the liver, chronic infections, autoimmune hepatitis, liver
cirrhosis, chronic active hepatitis reflect increasing of:
a) α1-globulins;
b) α2-globulins;
c) β-globulins;
d) γ-globulins.
190. Primary and secondary hyperlipoproteinemia reflect increasing of:
a) α1-globulins;
b) α2-globulins;
c) β-globulins;
d) γ-globulins.
191. During what pathological condition observed acholic stool?
a) obstruction of common bile duct;

38
b) erythrocytes hemolysis (anemia);
c) pancreatitis;
d) hepatic coma.
192. During what pathological condition observed increase stercobilin content in the
stool?
a) obstruction of common bile duct;
b) erythrocytes hemolysis (anemia);
c) pancreatitis;
d) hepatic coma.
193. Tenderness in Ker`s point is typical for:
a) syndrome of jaundice;
b) syndrome of gastrointerstitial bleeding;
c) syndrome of bile ducts dyskinesia;
d) syndrome of functional dyspepsia.
194. Shock frequently ensues when blood loss is:
a) 5 to 15 per cent of blood volume;
b) 15 to 25 per cent of blood volume;
c) 25 to 40 per cent of blood volume;
d) 40 to 50 per cent of blood volume.
195. Causes of upper gastrointestinal hemorrhage all except:
a) duodenal ulcer;
b) varices or portal hypertensive gastropathy;
c) diverticulosis;
d) erosive gastropathy.
196. Causes of lower gastrointestinal hemorrhage all except:
a) hemorrhoids;
39
b) diverticulosis;
c) erosive gastropathy;
d) enterocolitic.
197. Hematomesis is:
a) black and tarry stools due to the presence of blood;
b) vomiting of blood;
c) passage of red blood per rectum;
198. Hematochezia is:
199. Melena is:
200. Acholic stool it is:
a) absence of stercobilin in the stools;
b) blood in the stools;
c) increase stercobilin content in the stool;
201. Suprahepatic causes of syndrome of portal hypertension all except:
a) hepatic veins thrombosis;
b) liver cirrhosis;
40
c) hepatic veins compression;
d) vena cava inferior thrombosis.
202. Intrahepatic causes of syndrome of portal hypertension all except:
a) chronic hepatitis;
b) liver cirrhosis;
c) congenital anomaly of vena porta;
d) metastatic liver damage.
203. Subhepatic causes of syndrome of portal hypertension all except:
a) congenital anomaly of vena porta;
b) compression of a portal collector by a tumor;
c) hepatic veins thrombosis;
d) spasms.
204. Positive fluctuation symptoms typical for:
a) Syndrome of jaundice;
b) Syndrome of gastrointerstitial bleeding;
c) Syndrome of portal hypertension;
d) Syndrome of functional dyspepsia.
205. Hydrothorax syndrome can be observed in case of:
a) Syndrome of jaundice;
b) Syndrome of gastrointerstitial bleeding;
c) Syndrome of portal hypertension;
d) Syndrome of functional dyspepsia.
206. Causes of syndrome of functional dyspepsia all except:
a) bad habits;
b) cholelitiasis;
c) psychological stresses;
41
d) infectious of a stomach mucous by Helicobacter pilory.
207. Causes of syndrome of functional dyspepsia all except:
a) alimentary faults;
b) pancreatitis;
c) reception of medicines;
d) infectious of a stomach mucous by Helicobacter pilory.
208. For functional dyspepsia specific constant or recurrent dyspepsia which

duration is:
a) not less than 2 weeks;
b) not less than 12 weeks for last 12 months;
c) not less than 12 weeks for last 24 months;
d) it does not matter.
209. Ulcer-like type of dyspepsia characterized by all except:
a) feeling of early saturation, weight, overflow;
b) periodic pain in epigastria, without irradiation;
c) pain arising on an empty stomach (hungry pains) or at night;
d) pain relieved after reception of food and/or antacids.
210. Dysmotonic type of dyspepsia characterized by all except:
a) feeling of early saturation, weight, overflow;
b) sensation of discomfort after meal, nausea, sometimes vomiting;
c) periodic pain in epigastria, without irradiation;
d) decrease in appetite.
211. Teleangioectasia it is:
a) hemorrhages in the lower extremities;
b) dark-red spots on the skin and mucosa;
c) hemorrhages in the eye;
42
d) brown spots on the entire body.
212. Pain in epigastrium, connected with food reception is typical for:
a) Chronic virus hepatitis;
b) Gastroduodenitis;
c) Liver cirrhosis;
d) Calculus cholecistitis.
213. Signs dysbacteriosis in coprology study is typical for:
a) Gastroduodenitis;
b) Chronic virus hepatitis;
c) Ulcer disease;
214. Early revealing mucous membrane dysplasia is typical for:
b) Liver cirrhosis;
c) Gastroduodenitis;
215. Ferric deficiency anemia, leucocytosis, reticulocytosis in clinical blood

analysis are signs of:
a) Ulcer disease;
c) Chronic virus hepatitis;
d) Cholecistitis.
216. Complications of ulcer disease all except:
a) perforation;
b) stenosis;
c) hemorrhoids;
43
d) malignization.
217. Complications of ulcer disease all except:
a) gastrointestinal bleeding
b) perforation;
c) ascites;
d) penetration.
218. Seasonal (in spring or autumn) pain is typical for:
c) Ulcer disease;
d) Cholecistitis.
219. Nocturnal, hunger pain, which is abated after taking food is typical for:
c) Ulcer disease;
d) Cholecistitis.
220. Taking soda is relieving factor for:
a) Virus hepatitis;
c) Ulcer disease;
d) Cholecistitis.
221. Vomiting and warmly is relieving factor for:
a) Virus hepatitis;
c) Ulcer disease;
d) Cholecistitis.
44
222. Vomiting by “coffee grounds” is a sign of:
a) Virus hepatitis;
c) Ulcer disease;
d) Cirrhosis.
223. Melena is a sign of:
a) Virus hepatitis;
c) Ulcer disease;
d) Cirrhosis.
224. Increase amylase level in biochemical blood analysis is signs of:
a) Ulcer disease;
d) Cholecistitis.
225. Decrease in the maintenance of blood coagulating system factorsis signs of:
a) Ulcer disease;
d) Cholecistitis.
226. What Instrumental method of examination is most informative in the diagnosis

of ulcer disease?
a) Stomach chromendoscopia;
b) Fibroesophagogastroduodenoscopia;
c) Ultrasound examination;
d) Colonoscopia.
45
227. What Instrumental method of examination is most informative in the diagnosis
of ulcer disease?
a) Stomach chromendoscopia;
b) Ultrasound examination;
c) Fibroesophagogastroduodenoscopia;
d) Rentgenoscopy of the stomach and duodenum.
228. What instrumental method of examination is most informative in the diagnosis

of cholecistitis?
a) Endoscopic study;
b) Ultrasound examination;
c) Fibroesophagogastroduodenoscopia;
d) Rentgenoscopy of the stomach and duodenum.
229. What instrumental method of examination is most informative in the diagnosis

of cholecistitis?
a) Cholecyctography;
b) Endoscopic study;
c) Survey roentgenography examination o f the belly cavity;
d) Computed tomography.
230. Etiological factors of cholecistitis all except:
a) metabolic dysbalance;
b) hypodinamia;
c) an irrational nutrition;
d) viral lesions.
231. Etiological factors of cholecistitis all except:
a) metabolic dysbalance;
b) hypodinamia;
c) an irrational nutrition;
46
d) helicobacter pylori.
232. Pain characterized by rapid onset over a few minutes and lasts one to several
hours is typical for:
a) Ulcer disease;
d) Cholecistitis.
233. Aching pain that arises in right upper quadrant or upper abdominal, which may
radiate to the right scapular area is typical for:
a) Ulcer disease;
d) Cholecistitis.
234. Tenderness in Ker point typical for:
a) Ulcer disease;
c) Pancreatitis;
d) Cholecistitis.
235. Positive Kerras’, Murphys’, Ortners’ and Mussis’ symptoms typical for:
a) Ulcer disease;
c) Pancreatitis;
d) Cholecistitis.
236. Presence of bilious pigments in clinical urine analysis typical for:
a) Ulcer disease;
47
c) Liver cirrhosis;
d) Cholecistitis.
237. Increase maintenance of fat acids incoprologicul study typical for:
a) Ulcer disease;
c) Liver cirrhosis;
d) Cholecistitis.
238. Extra hepatic displays of virus hepatitis include all except:
a) Myocarditis;
b) Pericarditis;
c) Pancreatitis;
d) Cholecystitis.
239. Extra hepatic displays of virus hepatitis include all except:
a) Shegren syndrome;
b) Vasculitis;
c) Reino syndrome;
d) Conn's syndrome.
240. In the anamnesiscause of virus hepatitis can be all except:
a) Hemotransfusions
b) Stomatologic manipulations
c) Sexual contacts
d) Disturbances in nutrition
241. In the anamnesiscause of virus hepatitis can be all except:
a) Use of drugs
b) Intravenous manipulations
c) Sexual contacts
48
d) Genetic predisposition
242. Enlargement or decline of the liver sizesis typical for:
b) Ulcer disease;
243. In palpation of the liver and spleenin the presence of virus hepatitis can be
found:
a) Liver is non-palpable;
b) Changes of liver lower edge, surface, consistency;
c) Hepatosplenomegaly;
d) Lower liver border and spleen are not accessible for palpation.
244. Increased activity of alkaline phosphotase in combination with

hyperbilirubunemia for account of both fraction is typical for:
a) Ulcer disease;
d) Cholecistitis.
245. HBs Ag, Hbe Ag, anti-Hbe are typical markers for:
a) CVH B
b) CVH C
c) CVH D
d) CVH F
246. NS, NS4, PCR-RNA are typical markers for:
a) CVH B
b) CVH C
49
c) CVH D
d) CVH F
247. Leukopenia, thrombocytopenia, anemia in clinical blood analysis are signs of:
a) Ulcer disease;
d) Cholecistitis.
248. The liver cirrhosis allocates all following clinical syndromes except:
a) the syndrome of portal hypertension;
b) syndrome of cardiovascular failure;
c) hepatic encephalopathy;
d) hepatolienal syndrome.
249. The liver cirrhosis allocates all following clinical syndromes except:
a) the syndrome of hepato-cellular insufficiency;
b) hepatic encephalopathy;
c) nephrotic syndrome;
d) hepatolienal syndrome.
250. Complications of liver cirrhosis all except:
a) Hepatorenal syndrome;
b) Bacterial peritonitis;
c) Bleeding from varicous expanded veins;
d) Pericarditis.
251. Complications of liver cirrhosis all except:
a) Encephalopathy;
b) Portal hypertension;
c) Bacterial peritonitis;
50
d) Myocarditis.
252. Jaundice, expansion of the veins on the forward abdomen wall, palmary
erythema are typical signs of:
a) Ulcer disease;
c) Liver cirrhosis;
d) Cholecistitis.
253. Jaundice, hynecomastia at men, traces of scratches on all body are typical signs
of:
a) Ulcer disease;
c) Liver cirrhosis;
d) Cholecistitis.
254. Edematous ascitic syndrome even anasarca typical for:
a) Ulcer disease;
b) Liver cirrhosis;
d) Cholecistitis.
255. Cachexia and enlargement of abdomen in sizes typical for:
a) Ulcer disease;
b) Liver cirrhosis;
d) Cholecistitis.
256. Proteinuria and bacteriouria in clinical urine analysisare signs of:
a) Liver cirrhosis;
b) Ulcer disease;
51
d) Cholecistitis.
257. Red color blood on the stool surfacein coprology study may be detected in case
of:
a) Liver cirrhosis;
b) Ulcer disease;
d) Cholecistitis.
258. A positive test for occult bleeding is typical signs of:
a) Liver cirrhosis;
b) Ulcer disease;
d) Cholecistitis.
259. Revealing o f varicous expanded veins of an esophagus and stomach can be

detected in the presence of:
b) Ulcer disease;
c) Cholecistitis;
d) Liver cirrhosis.
260. Varicous dilated veins of rectal textures can be detected in the presence of:
b) Ulcer disease;
c) Cholecistitis;
d) Liver cirrhosis.
261. “Facies nephritica” is typical sign of:
a) urinary syndrome;
52
b) nephritic syndrome;
c) urethrical syndrome;
d) none of the listed.
262. Nephritic syndrome includes all except:
a) Proteinuria;
b) Microhematuria;
c) Hypoproteinemia;
d) Hyperlipidemia.
263. Edema in patients with nephritic syndrome characterized by all except:
a) symmetrical localization;
b) arises on the face in the morning;
c) has descending character;
d) has ascending character.
264. In Clinical blood analysis for nephritic syndrome is typical all except:
a) Anemia;
b) Erythropenia;
c) Leukocytosis;
d) Increased ERS.
265. In Clinical urine analysis for nephritic syndrome is typical all except:
a) High specific gravity;
b) Proteinuria (≥3g/24h);
c) Macrohematuria;
d) Large amount of cylinders.
266. In three glasses test detecting erythrocytes in last portion is typical for:
a) Cystitis;
b) Pyelonephritis;
53
c) Glomerulonephritis;
d) Acute renal failure.
267. Suprarenal cause of acute renal failure:
a) Inflammatory renal diseases;
b) Urinary tract obstruction;
c) Overdose of diuretics;
d) Renal vessels occlusion.
268. Renal cause of acute renal failure:
a) Urinary tract obstruction;
b) Inflammatory renal diseases;
c) Diarrhea and vomiting;
d) Overdose of diuretics.
269. “Meat slops” it is:
a) red-yellow color of urine;
b) dark yellow color of urine;
c) white color of urine;
d) transparent color of urine.
270. Anuria is typical sign of :
d) renal failure syndrome.
271. Indicate GFR typical for Stage III Chronic Renal Diseases:
a) more than 90 ml/min;
b) 60-89 ml/min;
c) 30-59 ml/min;
54
d) 15-29 ml/min.
272. Indicate GFR typical for Stage IV Chronic Renal Diseases:
a) 60-89 ml/min;
b) 30-59 ml/min;
c) 15-29 ml/min;
d) less than 15 ml/min.
273. For glomerulonephritis are typical next changes in urinalysis:
a) polyuria, nocturia, isuria and hypostenuria, low specific gravity (less than
1.018);
b) proteinuria (≥3g/24h), hematuria, large amount of cylinders and

leucocytes (nonconstant);
c) large amount of leucocytes, pyuria, cylindruria, bacteriuria;
d) large amount of salt crystals in the urine.
274. For pyelonephritis are typical next changes in urinalysis:
a) polyuria, nocturia, isuria and hypostenuria, low specific gravity (less than
1.018);
b) proteinuria (≥3g/24h), hematuria, large amount of cylinders and leucocytes

(nonconstant);
c) large amount of leucocytes, non-concstant microhematuria, pyuria,

cylindruria, bacteriuria;
d) large amount of salt crystals in the urine.
275. Increase in creatinine level is a typical feature for:
276. Combination of hypoproteinemia and hypercholisterinemia in biochemical

blood analysis is a typical feature for:
55
277. Outcomes of fast advance glomerulonephritis:
a) fast progression with poor prognosis, renal failure and death;
b) complete recovery, transformation to the chronic form;
c) the duration is persistence or continuously progressive;
d) duration with period of remission and progression, prognosis – satisfactory.
278. Outcomes of acute glomerulonephritis:
a) fast progression with poor prognosis, renal failure and death;
b) complete recovery, transformation to the chronic form;
c) the duration is persistence or continuously progressive;
d) duration with period of remission and progression, prognosis – satisfactory.
279. Positive Pasternatsky’s symptom is typical for:
a) fast advance glomerulonephritis;
b) acute glomerulonephritis;
c) acute pyelonephritis;
d) not typical for these diseases.
280. Pyuria in Clinical urine analysis is typical for:
a) chronic glomerulonephritis;
c) acute pyelonephritis;
d) not typical for these diseases.
281. Renal abscess is typical complication for:
56
c) pyelonephritis;
d) not typical of these diseases.
282. Paranephritis is typical complication for:
c) pyelonephritis;
d) not typical of these diseases.
283. Physical examination includes all listed except:
a) complaints:
b) palpation;
c) percussion;
d) ausculation.
284. Instrumental examination includes all listed except:
a) ECG;
b) Radiography;
c) Sputum analysis;
d) Endoscopy.
285. Laboratory examination includes all listed except:
a) ECG;
b) Blood analysis;
c) Urine analysis;
d) Sputum analysis.
286. Inquiry includes all listed except:
a) complaints;
b) palpation;
57
c) anamnesis morbi;
d) anamnesis vitae.
287. Prapedeutics to internal discases is:
a) the science atbout methods of clinical examination of the patient and

diagnosis basing;
b) the study of the physical structure of organisms;
c) the study of the normal functioning of the body and the underlying regulatory
mechanisms;
d) the study of disease—the causes, course, progression and resolution thereof.
288. Clinical diagnosis is based on all listed except:
a) subjective examination;
b) objective examination;
c) treatment;
d) present complaints.
289. Preliminarydiagnosisis based on all listed except:
a) present complaints;
b) history of the patient disease;
c) objective examination;
d) physical examination.
290. Preliminarydiagnosis is based on
a) the patient`s present complaints the anamnesis morbi, anamnesis vitae,

and physical examination;
b) the subjective examination of the patient, and objective examination;
c) the subjective, objective examination, and treatment.
291. Clinical diagnosis is based on:
a) the patient`s present complaints the anamnesis morbi, anamnesis vitae, and
physical examination;
58
c) the subjective, objective examination, and treatment.
292. Final diagnosis is based on:
a) the patient`s present complaints the anamnesis morbi, anamnesis vitae, and
physical examination;
c) the subjective, objective examination and treatment.
293. Diagnosis has the following structure:
a) main disease, complication of the main disease, concomitant (concurrent)

disease;
b) complication of the main disease, concomitant (concurrent) disease , main

disease;
c) concomitant (concurrent) disease, main disease, complication of the main

disease.
294. Syndrome is:
a) combination of symptoms that are interrelated and give rise to one

another;
b) abnormal phenomena as pain, dizziness, nausea, vomiting, etc, occurring in
c) sick persons;
d) summarize clinical examinations.
295. Symptoms is:
a) combination of symptoms that are interrelated and give rise to one another;
b) abnormal phenomena as pain, dizziness, nausea, vomiting, etc, occurring

in
c) sick persons;
d) summarize clinical examinations.
296. Subjective symptoms are those:
59
a) that cannot be found on examination of the patient - pain, dizziness,
nausea, etc.;
b) that can be found on examination of the patient - cyanosis, jaundice, enlarged

internal organs, tachycardia, etc;
c) that reflects the history of the disease and the patient's life.
297. Objective symptoms are those:
a) that cannot be found on examination of the patient - pain, dizziness, nausea,

etc.;
b) that can be found on examination of the patient - cyanosis, jaundice,

enlarged internal organs, tachycardia, etc..;
c) that reflects the history of the disease and the patient's life.
298. Deontology – is:
a) the study of human social behavior and its origins, development, organizations,
and institutions;
b) the systematic and rational study of concepts of God and of the nature of
religious truths;
c) theories that place special emphasis on the relationship between duty and
the morality of human actions;
d) the study of general and fundamental problems, such as those connected

with reality, existence, knowledge, values, reason, mind, and language.
299. Anamnesis morbi or history of the present disease includes obtaining of

following information except:
a) family history;
b) the time of disease onset (acute or gradual);
c) the first symptoms and their character;
d) previous examination and results (if any);
e) treatment and results (if any).
300. The past history involves all listed except:
a) habits;
60
b) history of present disease;
c) family history;
d) social history;
e) allergological history.
301. Palpation is:
a) the method of clinical examination, which is used to determine elasticity

and dryness of the skin, to assess condition of the subcutaneous fat, to
detect edema. Is very important in examination of the abdominal organs:
intestine, liver, gall bladder, spleen;
b) method of physical examination, which helps to determine whether the

underlying tissues are air-filled, fluid-filled, or solid;
c) method of physical examination which means listening the sound inside the
body.
302. Percussion is:
a) the method of clinical examination, which is used to determine elasticity and

dryness of the skin, to assess condition of the subcutaneous fat, to detect
edema. Is very important in examination of the abdominal organs: intestine,
liver, gall bladder, spleen;

c) method of physical examination which means listening the sound inside the
body.
303. Auscultation is:
a) the method of clinical examination, which is used to determine elasticity and

dryness of the skin, to assess condition of the subcutaneous fat, to detect
edema. Is very important in examination of the abdominal organs: intestine,
liver, gall bladder, spleen;

c) method of physical examination which means listening the sound inside

the body.
61
304. Satisfactory patient ’s condition(status morboacili) is characterized by
a) clear consciousness, active or active with restriction posture, free or

partial deranged (specific) gait, sensible facial expression, and adequate
mental reaction;
b) deranged consciousness, alteration of facial expression and posture (forced),

uncertain gait, partial deranged mental state and may be observed in patients
with recurrence of chronic disease, acute diseases, or due to the traumas and
poisoning;
c) disorders of practically all clinical features: deranged consciousness, changed

facial expression (fear, suffer, hopelessness, indifference). The patients have
forced or passive posture, loss of weight, edema, and inadequate mental state;
d) unconsciousness, passive posture, and indifferent facial expression and

observes in the patient with coma, shock, and agony.
305. Moderate condition(status ingravescens) is characterized by
a) clear consciousness, active or active with restriction posture, free or partial

deranged (specific) gait, sensible facial expression, and adequate mental
reaction;
b) deranged consciousness, alteration of facial expression and posture

(forced), uncertain gait, partial deranged mental state and may be
observed in patients with recurrence of chronic disease, acute diseases, or
due to the traumas and poisoning;

forced or passive posture, loss o f weight, edema, and inadequate mental state;

306. Grave condition(status morbogravi) is characterized by

reaction;

62
poisoning;
c) disorders of practically all clinical features: deranged consciousness,

changed facial expression (fear, suffer, hopelessness, indifference). The
patients have forced or passive posture, loss o f weight, edema, and
inadequate mental state;

307. Extremely grave condition(status gravissimus) is characterized by

reaction;

poisoning;

forced or passive posture, loss o f weight, edema, and inadequate mental state;

308. Condition that may be observed in patients with infections and oncological
diseases, heart failure, disorders of renal, liver functions, abnormalities of nervous
and endocrine systems, after operations, traumas is called:
a) Good patient’s condition;
b) Satisfactory patient ’s condition (status morboacili);
c) Moderate condition (status ingravescens);
d) Grave condition (status morbogravi);
e) Extremely grave condition (status gravissimus).
309. Condition that may be observes in the patient with coma, shock, and agony is
called:
63
310. Condition that may occur in patients with remission of chronic disease
favorable course of a disease, or during recovery is called:
311. Cloudiness is:
a) Disorientation in space, surroundings, the answers inadequate and delayed,

reflexes are present;
b) Disorientation in space, indifferent, the answers adequate, but delayed,

c) Disorientation in time, space, surroundings, own personality. Pathological deep

sleep from which patient wake up only for short periods of time when called
loudly or roused by an external stimulus, reflexes are present, but delayed;
d) Unconsciousness with absence of response to external stimuli, absence of

reflexes, deranged vital function.
312. Sopor is:
a) Disorientation in space, surroundings, the answers inadequate and delayed,

b) Disorientation in space, indifferent, the answers adequate, but delayed, reflexes

are present;
c) Disorientation in time, space, surroundings, own personality. Pathological

deep sleep from which patient wake up only for short periods of time
64
when called loudly or roused by an external stimulus, reflexes are present,
but delayed;
d) Unconsciousness with absence of response to external stimuli, absence of

313. Disorientation in space, indifferent, the answers adequate, but delayed, reflexes
are present it is:
a) Cloudiness;
b) Stupor;
c) Sopor;
d) Coma.
314. Unconsciousness with absence of response to external stimuli, absence of

reflexes, deranged vital function it is:
a) Cloudiness;
b) Stupor;
c) Sopor;
d) Coma.
315. Twilight state is characterized by:
a) disorientation in surroundings, loss of memory (amnesia), patient is exited,

has pathologically high spirits, is anxious, sometimes even aggressive;
b) visual and acoustic hallucinations, inadequacy of emotions, anxiety,

intermittent thinking;
c) disorientation in space, indifferent, the answers adequate, but delayed, reflexes

are present;
d) unconsciousness with absence of response to external stimuli, absence of

316. Delirium is characterized by:
a) disorientation in surroundings, loss of memory (amnesia), patient is exited, has

pathologically high spirits, is anxious, sometimes even aggressive;
65
b) visual and acoustic hallucinations, inadequacy of emotions, anxiety,
intermittent thinking;
c) disorientation in space, indifferent, the answers adequate, but delayed, reflexes

are present;
d) unconsciousness with absence of response to external stimuli, absence of

317. Disorientation in surroundings, loss of memory (amnesia), patient is exited, has

pathologically high spirits, is anxious, sometimes even aggressive, all that is
signs of:
a) Twilight state;
b) Delirium;
c) Stupor;
d) Coma.
318. Visual and acoustic hallucinations, inadequacy of emotions, anxiety,

intermittent thinking all that is signs of:
a) Twilight state;
b) Delirium;
c) Stupor;
d) Coma.
319. Specify the name of the patient's posture that is typical for states listed below –
attacks of bronchial asthma, cardiac asthma, spasm of bronchi; lung tumor,
pneumothorax:
a) standing upright position;
b) orthopnea;
c) supine posture;
d) position lying on the side
e) prone position.
66
320. Specify the name of the patient's posture that is typical for states listed below –
tumor of pancreas, acute thrombosis of lien vein, trauma and tuberculosis of
spine:
a) standing upright position;
b) orthopnea;
c) supine posture;
d) position lying on the side;
e) prone position.
321. Gait as “a duck” - is characterized by:
a) small, slow step with compensatory inclination trunk to the opposite side
due to the hypotonia of pelvis muscle;
b) putting trunk backward for support balance;
c) high rising of climb, reach the floor, limb continue to search fulcrum;
d) abundance (superfluous) leg draw aside and the arm from the same side bond
to the trunk due to the increased muscle tone.
322. “Proud” gait is characterized by:
a) small, slow step with compensatory inclination trunk to the opposite side due
to the hypotonia of pelvis muscle
b) putting trunk backward for support balance
c) high rising of climb, reach the floor, limb continue to search fulcrum
d) abundance (superfluous) leg draw aside and the arm from the same side bond
to the trunk due to the increased muscle tone
323. For patients with Parkinsonism is typical:
a) Gait as “a duck”
b) “Proud” gait
c) Dolls/puppet gait
d) paretic gait
324. For a pregnant woman is typical

67
a) Gait as “a duck”
b) “Proud” gait
c) Dolls/puppet gait
d) paretic gait
325. Facies as a “wax-doll” is characterized by:
a) face is edematous, pale, and yellowish with a cyanotic hue. The mouth is
always half open, the lips are cyanotic, the yeas are dull;
b) very pale with yellowish tint and seemingly translucent skin;
c) round or “moon-like” face, plethora, red cheeks;
d) sunken eyes, pinched nose, deadly livid and cyanotic skin, which is sometimes
covered with large drops of cold sweat.
326. Facies Hyppocratica is characterized by:
a) face is edematous, pale, and yellowish with a cyanotic hue. The mouth is
always half open, the lips are cyanotic, the yeas are dull;
b) very pale with yellowish tint and seemingly translucent skin;
c) round or “moon-like” face, plethora, red cheeks;
d) sunken eyes, pinched nose, deadly livid and cyanotic skin, which is
sometimes covered with large drops of cold sweat.
327. Round or “moon-like” face, plethora, red cheeks is also called:
a) facies in patients with Cushing’s syndrome ;
b) facies Hyppocratica;
c) facies as a “wax-doll”;
d) facies Corvisara;
e) facies acromegalica.
328. Enlarged superciliary arches, zygomatic bones, ears, auricles nose, lips, tongue,
growth and putting forward of low jaw (prognotism) is also called:
a) facies in patients with Cushing’s syndrome ;
b) facies Hyppocratica;
68
c) facies as a “wax-doll”;
d) facies Corvisara;
e) facies acromegalica.
329. Vitiligo is:
a) symmetrical white spots on the face, trunk, limbs;
b) the redness located on checks;
c) cyanotic color of the skin;
d) yellow color of the skin.
330. Pale color of the skin (cutis pallide) is connected with:
a) anemia;
b) fever;
c) bilirubinemia;
d) Addison’s disease;
e) administration the silver drug for a long time.
331. Red color of the skin (cutis rubra s. erythema) is connected with:
a) anemia;
b) fever;
c) bilirubinemia;
332. Yellow skin and mucosa (cutis icterica, s. icterus) is connected with:
a) anemia;
b) fever;
c) bilirubinemia;

69
333. Pathological brown or bronze color of the skin is connected with:
a) anemia;
b) fever;
c) bilirubinemia;
334. Grayish (“dirty”) color of the skin is connected with:
a) anemia;
b) fever;
c) bilirubinemia;
335. Peripheral or acrocyanosis is observed in patients with:
a) chronic lung diseases;
b) congenital heart disease;
c) congestive heart failure;
d) thrombosis of artery or vein.
336. Local cyanosis (cyanosis localis) is observed in patients with:
c) congestive heart failure;
337. Central or diffuse cyanosis (cyanosis diffuse) is observed in all cases except:
c) poisoning of the hemolytic substances;

70
338. Hemolytic or suprahepatic jaundice (icterus colore citricoluteo s. icterus

suprahepatica) is characterized by:
a) lemon-yellow tint of the skin;
b) orange-yellow tint of the skin;
c) greenish-yellow tint of the skin;
d) red tint of the skin.
339. Parenchymatous or hepatic jaundice (icterus colore ruhiginoso s. icterus

hepatica) is characterized by:
340. Obstructive or subhepatic jaundice (icterus colore luteoviridi s. icterus

infrahepatica) is characterized by:
341. If the patient has acute or chronic hepatitis is often observed:
a) Obstructive or subhepatic jaundice;
b) Parenchymatous or hepatic jaundice;
c) Hemolytic or suprahepatic jaundice.
342. If the patient has partial or complete obstruction of the common bile duct is
often observed:
a) Obstructive or subhepatic jaundice;
b) Parenchymatous or hepatic jaundice;
71
c) Hemolytic or suprahepatic jaundice.
343. Pathological reasons of dry skin (xeroderma) is:
a) Myxedema;
b) Syncope;
c) Acute leukemia;
d) Thyrotoxicosis.
344. Pathological reasons of moist skin (hyperhydrosis) is
a) Cholera;
b) Thyrotoxicosis;
c) toxicity of pregnancy;
d) Myxedema.
345. Petechia is:
a) small pointed hemorrhages;
b) large black and blue spots;
c) red spots of different size;
d) a swelling from gross bleeding.
346. Purpura (hemopurpura) is:
a) small pointed hemorrhages;
b) large black and blue spots;
c) red spots of different size;
d) a swelling from gross bleeding.
347. Stria it is:
a) necrosis of the soft tissues due to the ischemia
b) the result of healing, in which normal structure are permanently replaced by

fibrous tissue
c) is damage of the skin and subcutaneous tissue with retarded healing process
72
d) a streak-like, linear, atrophic, pink, purple or white lesions of the skin due
to change in the connective tissue.
348. Teleangioectasia is:
a) dark-red spots on the skin and mucosa;
b) streak-like, linear, atrophic, pink, purple or white lesions of the skin due to
change in the connective tissue;
c) necrosis of the soft tissues due to the ischemia;
d) rash-like eruption of 2-3 mm patches.
349. Roseola is a:
a) rash-like eruption of 2-3 mm patches;
b) large red spot with distinctly outlined margins slightly elevated under skin;
c) damage of the skin and subcutaneous tissue with retarded healing process;
d) a localized collection of pus in the cavity more than 1 cm in diameter.
350. Erythema:
a) rash-like eruption of 2-3 mm patches;
b) large red spot with distinctly outlined margins slightly elevated under
skin;
c) damage of the skin and subcutaneous tissue with retarded healing process;
d) a localized collection of pus in the cavity more than 1 cm in diameter.
351. Pustula is:
a) a visible accumulation of the pus in the skin;
b) a localized collection of pus in the cavity more than 1 cm in diameter;
c) lesions, which are limited to the face, shoulders, upper chest and back;
d) necrosis of the soft tissues due to the ischemia.
352. Abscess is:
a) a visible accumulation of the pus in the skin;
b) a localized collection of pus in the cavity more than 1 cm in diameter;

73
c) lesions, which are limited to the face, shoulders, upper chest and back;
d) necrosis of the soft tissues due to the ischemia.
353. Nails in a form of “watch glass” (Hippocratic nails) looks like:
a) altered forms as curved inside with marked transverse folds;
b) as a bulbous swelling of the tip of the linger or toe , the normal angle
between the proximal part of the nail and the skin is lost;
c) flattened and thickened in acromegaly;
d) white proximally and red-brown distally.
354. Spoon-shaped nails (koilonychia) looks like:
a) as a bulbous swelling of the tip of the linger or toe , the normal angle between
the proximal part of the nail and the skin is lost;
b) flattened and thickened in acromegaly;
c) altered forms as curved inside with marked transverse folds;
d) white proximally and red-brown distally.
355. Generalized fluid accumulate in the abdomen is called:
a) Ascitis;
b) Hydrothorax;
c) Hydropericardium;
d) Anasarca.
356. Generalized fluid accumulate in pleural cavity is called:
a) Ascitis;
b) Hydrothorax;
c) Hydropericardium;
d) Anasarca.
357. In normosthenic person size of subcutaneous fat is:
a) 1.5-2 cm;
74
b) more than 2 cm;
c) less than 1.5 cm;
d) less than 0.5 cm.
358. Cachexia observed if the thickness of subcutaneous fat is:
a) 1.5-2 cm;
b) more than 2 cm;
c) less than 1.5 cm;
d) less than 0.5 cm.
359. Ginoid type of obesity is characterized by:
a) uniformly fat distribution with more pronounced accumulation at the

buttock and hip;
b) accumulation of fat mainly at the upper part of the body, abdomen, and
completely absence of fat at the butock and legs;
c) no change in subcutaneous fat in abdomen.
360. Aneroid type of obesity is characterized by:
a) uniformly fat distribution with more pronounced accumulation at the buttock

and hip;
b) accumulation of fat mainly at the upper part of the body, abdomen, and
completely absence of fat at the butock and legs;
c) no change in subcutaneous fat in abdomen.
361. Chronic tonsillitis, tuberculosis, infectious mononucleosis, chronic

lympholeucosis, lymphogranulomatosis, lymphosarcoma may lead to increased:
a) Occipital lymph nodes;
b) Cervical lymph nodes;
c) Axillary lymph nodes;
d) Cubital (local) lymph nodes.
362. Purulent process at the hands, cancer of the breast may lead to increased:
a) Occipital lymph nodes;

75
b) Cervical lymph nodes;
c) Axillary lymph nodes;
d) Cubital (local) lymph nodes.
363. Short stature is caused by all listed except:
a) Cherechewski-Tumer syndrome;
b) Cretinism;
c) Marfan’s syndrome ;
d) Chrohn’s disease.
364. High stature is caused by all listed except:
a) Acromegaly;
b) Marfan’s syndrome;
c) Kleinefelter’s syndrome;
d) Cushing’s syndrome.
365. Rheumatoid arthritisis characterized by:
a) damage commonly knee in a form of monoarthritis;
b) transient and migratory or a more persistent polyarthritis;
c) affecting the distal interphalangeal joints;
d) pain on movement of joints, morning stiffness and symmetrical swelling of

small joints of the fingers and the toes;
e) symmetrical lesions of large joints with acute painful inflammation.
366. Arthritis of rheumatic fever is characterized by:
a) pain on movement of joints, morning stiffness and symmetrical swelling of

small joints of the fingers and the toes;
b) damage commonly knee in a form of monoarthritis;
c) symmetrical lesions of large joints with acute painful inflammation;
d) transient and migratory or a more persistent polyarthritis;
76
e) affecting the distal interphalangeal joints.
367. Blue sclera or syndrome of “blue eyes” may observed at:
a) Jaundice;
b) Rieger syndrome;
c) Bacterial endocarditis;
d) Typhus;
e) Addison’s disease.
368. Yellow sclera is early sign of:
a) Jaundice;
b) Rieger syndrome;
c) Bacterial endocarditis;
d) Typhus;
369. Red “as a rabbit” conjunctivae may observe at:
a) Jaundice;
b) Rieger syndrome;
c) Epilepsy;
d) Typhus;
370. Single brown spot at conjunctiva may observe at:
a) Jaundice;
b) Rieger syndrome;
c) Epilepsy;
d) Typhus;
371. Myosis is:

77
a) papillary constriction;
b) papillary dilation;
c) asymmetrical pupils;
d) pulsation of the pupil in synchronism with the cardiac beat.
372. Mydriasis is:
a) papillary dilation;
b) papillary constriction;
c) asymmetrical pupils;
d) pulsation of the pupil in synchronism with the cardiac beat.
373. Cyanotic color of the lips is observed in:
a) high temperature;
b) chronic bleeding;
c) mitral stenosis;
d) leukemia.
374. Pale lips occur in:
a) high temperature;
b) chronic bleeding;
c) mitral stenosis;
d) heart failure.
375. White-gray fur on the tongue observe at:
a) gastritis, virus hepatitis, and some infections;
b) typhus, pneumonia and peritonitis;
c) rheumatic polyarthritis;
d) those who smoke excessively.
376. White-blue fur on the tongue observe at:
a) gastritis, virus hepatitis, and some infections;

78
b) typhus, pneumonia and peritonitis;
c) rheumatic polyarthritis;
d) those who smoke excessively.
377. Crimson-red (strawberry/raspberry) tongue observe in
a) scarlet fever;
b) typhoid fever;
c) stomatitis;
d) anxiety.
378. Coated in the center and at the base but clear the tip and margins of the tongue
is typical to:
a) scarlet fever;
b) typhoid fever;
c) stomatitis;
d) anxiety.
379. The left lung is divided into:
a) two lobes;
b) three lobes;
c) four lobes;
d) five lobes.
380. The right lung is divided into:
a) two lobes;
b) three lobes;
c) four lobes;
d) five lobes.
381. Upper respiratory tract includes all except:
a) nose;
79
b) trachea;
c) larynx;
d) pharynx.
382. Lower respiratory tract includes all except:
a) lungs;
b) larynx;
c) bronchi;
d) trachea.
383. The pharynx is a muscular tube about:
a) 3 cm long;
b) 7 cm long;
c) 12 cm long;
d) 15 cm long.
384. Trachea (windpipe)is a muscular tube about:
a) 5 cm long;
b) 10 cm long;
c) 15 cm long;
d) 20 cm long.
385. Inferior angel of the scapula usually lies at the level of the:
a) 2th rib or interspace;
b) 5th rib or interspace;
c) 7th rib or interspace;
d) 10th rib or interspace.
386. Floating ribs are:
a) 9th and 10th ribs;
b) 11th and 12th ribs;

80
c) 13th and 14th ribs;
d) the is no floating ribs.
387. Posteriorly the lover border of the lung lies at about the level of the
a) 5th thoracic spinous process at the paraspinal line;
b) 2th rib at the midclavicular line and 5th rib at the midaxillary line;
c) 11th thoracic spinous process at the paraspinal line;
d) 6th rib at the midclavicular line and 8th rib at the midaxillary line.
388. Anteriorly the lover border of the lung passes the:
a) 2th rib at the midclavicular line and 5th rib at the midaxillary line;
b) 11th thoracic spinous process at the paraspinal line;
c) 6th rib at the midclavicular line and 8th rib at the midaxillary line;
d) 6th thoracic spinous process at the paraspinal line.
389. Acute dyspnea may be:
a) over minutes;
b) over hours;
c) over weeks;
d) episodic breathlessness.
390. Dramatically sudden dyspnea, all except:
a) Pneumothorax;
b) Pneumonia;
c) Pulmonary embolism;
d) Pulmonary edema.
391. Acute dyspnea, all except:
a) Pneumonia;
b) Pulmonary embolism;
c) Asthma;
81
d) Left ventricular failure.
392. Subacute dyspnea may be:
a) over month or years;
b) over hours;
c) over weeks;
d) episodic breathlessness.
393. Scoliosis is the:
a) backward curvature of the spine with formation of the gibbus;
b) lateral curvature of the spine;
c) combination of the lateral and backward curvature of the spine;
d) forward curvature of the spine, generally in the lumber region.
394. Kyphosis is the:
a) lateral curvature of the spine;
b) backward curvature of the spine with formation of the gibbus;
c) combination of the lateral and backward curvature of the spine;
d) forward curvature of the spine, generally in the lumber region.
395. Heavy dyspnea with very difficult inspiration is typical for:
a) Bronchial asthma;
b) Cardiac asthma;
c) Pleural effusion;
d) Laryngitis.
396. Heavy dyspnea with very difficult expiration is typical for:
a) Cardiac asthma;
b) Left ventricular failure;
c) Bronchial asthma;
d) Anemia.
82
397. What medicines can cause cough?
a) calcium channel blockers;
b) β-blockers;
c) statins;
d) some antibiotics.
398. What medicines can cause cough?
a) calcium channel blockers;
b) statins;
c) angiotensin converting enzyme inhibitors;
d) some antibiotics.
399. Chronic bronchitis is characterized by increase of cough:
a) in themorning – “morning cough”
b) in the evening – “evening cough”
c) in night – “night cough”
d) cough is homogeneous throughout the day
400. Tuberculosis is characterized by increase of cough:
a) in the morning – “morning cough”
b) in the evening – “evening cough”
c) in night – “night cough”
d) cough homogeneous throughout the day
401. Dry cough with irritative barking quality is typical for all listed except:
a) inflammatory conditions of pharynx;
b) lung abscess;
c) tracheobronchitis;
d) early pneumonia.
402. Cough with expectoration of sputum is typical for all listed except:
83
a) early pneumonia;
b) bronchiectasis:
c) lung abscess;
d) cavernous tuberculosis of the lungs.
403. Daily amount of sputum may vary:
a) from 10-15 ml to 2 liters;
b) from 200-500 ml 2 liters;
c) from 1000 ml to 4 liters;
404. Daily amount of sputum may vary:
a) from 10 ml to 200-500 ml;
b) from 10-15 ml to 2 liters;
c) from 1000 ml to 4 liters;
405. What kind of blood is typical for hemoptysis?
a) bright red
b) dark brown
c) black
d) with the content of food
406. Bronchial contents should be:
a) alkaline;
b) weakly acidic;
c) neutral;
d) acid.
407. Heamoptysis following the acute onset of chest pain and dyspnea is typical for:
a) bronchitis;
84
b) bronchiectasis;
c) pulmonary embolism;
d) pneumonia.
408. “Rusty” staining of mucoid sputum is typical for:
a) pneumococcalpneumonia;
b) bronchiectasis;
c) bronchitis;
d) tracheobronchitis.
409. Narrow and slightly expressed interspaces, epigastric angle exceeds 90° typical
for:
a) normosthenic chest;
b) hypersthenic chest;
c) asthenic chest;
d) there is no correct answer.
410. Wide and pronounced interspaces, epigastric angle is less than 90° typical for:
c) asthenic chest;
411. Barrel chestalso called:
a) paralytic;
b) emphysematous;
c) rachitic;
d) funnel.
412. Pigeon chest also called:
a) emphysematous;
85
b) paralytic;
c) rachitic;
d) funnel.
413. Barrel chest is typical for:
a) emphysema;
b) rheumatoid arthritis;
c) pneumosclerosis;
d) rachitis.
414. Paralytic chest is typical for:
a) pneumosclerosis;
c) emphysema;
d) rachitis.
415. For women most typical:
a) thoracic (costal) respiration;
b) abdominal respiration;
c) mixed respiration;
416. For men most typical:
a) abdominal respiration;
b) thoracic (costal) respiration;
c) mixed respiration;
417. Noiseless shallow respiration quickly deepens is called:
a) Grocco’s respiration
b) Cheyne-Stokes respiration.
86
c) Biot’s respiration
418. Deep rhythmic respiration that alternate with apnea is called:
a) Cheyne-Stokes respiration.
b) Grocco’s respiration
c) Biot’s respiration
419. Moderate expressed visible interspaces, epigastric angle near 90° typical for:
c) asthenic chest;
420. “Cobbler chest” also called:
a) emphysematous;
b) paralytic;
c) rachitic;
d) funnel.
421. Pigeon chest is typical for:
c) pneumosclerosis;
d) rachitis.
422. Increased vocal fremitus typical for all except:
a) lobar pneumonia;
b) lungs infarction;
c) compressive atelectasis;
87
d) significant amount of air accumulated in the pleural cavity.
423. Decreased vocal fremitus typical for all except:
a) pleural thickening ;
b) obstructive atelectasis;
c) very thick chest wall;
d) lobar pneumonia.
424. Absent vocal fremitus typical for:
a) significant amount of fluid accumulated in the pleural cavity;
b) very thick chest wall;
c) lungs infarction;
d) compressive atelectasis.
425. Patients with grave diseases should be percussed in:
a) standing position;
b) sitting position;
c) lying position;
d) does not matter.
426. For comparative percussion of the lungs is used:
a) loud percussion;
b) light percussion;
c) lightest percussion;
d) does not matter.
427. On the left side percussion is carried out only to the:
a) 1st interspace;
b) 3rd interspace;
c) 6rd interspace;
d) 8rd interspace.
88
428. Sound over airiness organs:
a) soft;
b) loud;
c) hard;
429. Sound over airless organs:
a) loud;
b) hard;
c) soft;
430. Softer and shorterpercussion sounds over 2nd and 3rd interspaces to the left of
the sternum caused by:
a) close location of the heart;
b) smaller amount of pulmonary tissue;
c) close location of the liver;
d) resonant effect of the stomach.
431. Softer and shorterpercussion sounds over right axillary region as compared
with left one caused by:
a) close location of the heart;
b) smaller amount of pulmonary tissue;
c) close location of the liver;
d) resonant effect of the stomach.
432. Clear pulmonary percussion sound mast be:
a) softer,higher,shorter;
b) loud,low,long;
c) very loud,lower,longer;
89
d) soft (medium), high (medium), short.
433. Bandbox (hyperresonance) percussion sound mast be:
a) loud, low, long;
b) softer, higher, shorter;
c) very loud, lower, longer;
434. Tympany percussion sound mast be:
a) softer, higher, shorter;
b) loud, high (with music tembre), long;
c) very loud, lower, longer;
435. Increased airiness of the pulmonary tissue characterized by:
a) tympany percussion sound ;
b) clear pulmonary percussion sound;
c) bandbox percussion sound;
d) metallic percussion sound.
436. Large pneumothorax characterized by:
a) metallic percussion sound;
b) bandbox percussion sound;
c) clear pulmonary percussion sound;
d) tympany percussion sound.
437. Intermediate sound can be coursed by all except:
a) obstructive atelectasis;
b) pneumosclerosis,;
c) pulmonary edema;
d) pleural accumulation of pus (empyema).

90
438. Dullness sound can be coursed by all except:
a) pulmonary tumor (airless tissue);
b) when fluid occupies the pleural space (over fluid):
c) pleural accumulation of serous blood (hemothorax)
d) compressive atelectasis.
439. Metallic percussion sound can be coursed by:
a) pulmonary edema;
b) large (6-8 cm in diameter) air-filled bulla in the lungs;
c) obstructive atelectasis;
d) when fluid occupies the pleural space (over fluid).
440. Cracked-pot percussion sound can be coursed by:
a) large superficial cavity communicated with the bronchus;
b) pulmonary edema;
c) obstructive atelectasis;
d) when fluid occupies the pleural space (over fluid).
441. Anteriorly upper level of the lung localized at;
a) 1—1,5 cm above clavicle;
b) the level of the 7th cervical vertebra (C7);
c) 3—4 cm above clavicle;
d) the level of the 10th cervical vertebra (C10).
442. Posteriorly upper level of the lungs localized at:
a) 1—1,5 cm above clavicle;
b) the level of the 7th cervical vertebra (C7);
c) 3—4 cm above clavicle;
d) the level of the 10th cervical vertebra (C10).
443. Lower border of the right lung by parasternal line localized:

91
a) 5th interspace;
b) 6th interspace;
c) 7th interspace;
d) 8th interspace.
444. Lower border of the right lung by midclavicular line localized:
a) 5th interspace;
b) 6th interspace;
c) 7th interspace;
d) 8th interspace.
445. Lower border of the left lung by scapular line localized:
a) 10th interspace;
b) 8th interspace;
c) 7th interspace;
d) 6th interspace.
446. Lower borders of the left lung by midaxillary line localized:
a) 5h interspace;
b) 7th interspace;
c) 8th interspace;
d) 10th interspace.
447. Respiratory excursion o f the lower border of right lung by middavicular line:
a) 1 – 2 cm;
b) 2 – 3 cm;
c) 4 – 6 cm;
d) 6 – 8 cm.
448. Respiratory excursion of the lower border of leftt lung by midaxillar line:
a) 1 – 2 cm;
92
b) 2 – 3 cm;
c) 4 – 6 cm;
d) 6 – 8 cm.
449. Respiratory mobility of the lower border of the lungs is decreased in all except:
a) emphysema;
b) asthenic persons;
c) pleural effusion;
d) adhesion or obstruction.
450. Respiratory mobility of the lower border of the lungs is decreased in all except:
a) pleural effusion;
b) hypersthenic persons;
c) emphysema;
d) adhesion or obstruction.
451. Bilateral lowering of the lower lungs edges is observed in all except:
a) asthenic persons;
b) in acute dilation of the lungs;
c) hemiparesis of the diaphragm;
d) еmphysema.
452. Unilateral lowering of the lower lung edge is observed in all except:
a) pleural effusion;
b) emphysema;
c) hydrothorax;
d) pneumothorax.
453. Bilateral elevation of the lower lungs edges is observed in all except:
a) in hypersthenic persons;
b) compressive atelectasis;
93
c) ascitis;
d) meteorism.
454. Unilateral elevation of the lower lung edge is observed in all except:
a) pneumosclerosis;
c) temporary in late pregnancy;
d) marked enlargement of the spleen.
455. Which is correct about vesicular breath sounds?

a) inspiratory sounds last longer than expiratory ones;
b) inspiratory and expiratory sounds are about equal;
c) expiratory sounds last longer than inspiratory ones;
d) inspiratory and expiratory sounds are indistinguishable.
456. How also called vesicular breathing:
a) bronchial;
b) amphoric;
c) alveolar;
d) laryngotracheal;
e) metallic.
457. In which case vesicular breathing pathologically decreased:
a) children with a thin chest wall;
b) lung abscess;
c) emphysema;
d) the attack of bronchial asthma;
e) "puerile respiration".
458. "Puerile” breathing:
a) physiological intensification of vesicular breathing
b) pathologically decreased vesicular respiration;
c) physiological intensification of bronchial breathing;
d) pathologically decreased bronchial breathing;
e) stenotic respiration.
459. Bronchial breath sounds are normally heard all over the place except:
a) over most of both lungs.

b) between the scapulae.
c) over the manubrium.
d) over the trachea in the neck.
460. In which case vesicular breathing pathologically increased:
a) children with a thin chest wall;
b) lung abscess;
c) emphysema;
94
d) the attack of bronchial asthma;
e) "puerile respiration".
461. Harsh breathing:
a) short jerky inspiration efforts interrupted by short pauses between them: the
expiration is usually normal;
b) deeper vesicular breathing during which the inspiration and

expiration phases are intensified;
c) inspiratory sounds last longer than expiratory ones.
462. How also called bronchial breathing:
a) bronchial;
b) amphoric;
c) alveolar;
d) laryngotracheal;
e) metallic.
463. What lung pathology is characterized by hard breathing:
a) dry pleurisy;
b) emphysema;
c) bronchitis;
d) pneumonia;
e) lung abscess.
464. Normal breath sounds heard over most of both lungs are described as
being:
a) loud;
b) intermediate;
c) very loud;
d) soft.
465. What lung pathology is characterized by dry rales:
a) dry pleurisy;
b) emphysema;
c) bronchitis;
d) pneumonia;
e) the attack of bronchial asthma.
466. In patients with inflammatory infiltration voice trembling:
a) increased;
b) decreased;
c) not altered;
d) missing;
e) slightly decreased.
467. What lung pathology is characterized by harsh breathing:
a) dry pleurisy;
b) emphysema;
c) bronchitis;
d) pneumonia;
95
e) lung abscess.
468. What lung pathology is characterized by coarse bubbling rales:
a) dry pleurisy;
b) emphysema;
c) bronchitis;
d) pneumonia;
e) cavern.
469. In patients with pneumothorax voice trembling and bronhofoniya:
a) increased;
b) decreased;
c) not altered;
d) missing;
470. On which phase of respiration occurs crepitation:
a) on inspiration;
b) on expiration;
c) on inspiration and on expiration;
d) on breath-hold.
471. Where arise rales:
a) in the alveoles;
b) in the bronchi;
c) in the pleural cavity;
d) in the larynx;
e) during the passage of air through the glottis.
472. How also called bronchial breathing:
a) bronchial;
b) amphoric;
c) alveolar;
d) laryngotracheal;
e) metallic.
473. High-pitched breath sounds are best heard by using
a) the diaphragm of the stethoscope;
b) the bell of the stethoscope;
c) both the bell and the diaphragm of the stethoscope;
d) a stethoscope with tubing at least 20" (50 cm) in length.
474. What can be heard in patients with dry pleurisy:
a) crackling;
b) dry rales;
c) pleural friction rub;
d) moist rales.
475. In patients with emphysema voice trembling and bronhofoniya:
a) increased;
b) decreased;
c) not altered;
d) missing;
96
476. Where appears crepitation:
a) in the small bronchi:
b) in the large bronchiin;
c) in the alveoli;
d) in the pleural cavity.
477. What lung pathology is characterized by dry rales:
a) dry pleurisy;
b) emphysema;
c) bronchitis;
d) pneumonia;
e) the attack of bronchial asthma.
478. Main respiratory (breath) sounds:
a) rales;
b) bronchial (laryngotracheal) breath sounds;
c) crepitation;
d) pleural friction sounds.
479. Adventitious (added) sounds all except:
a) rales;
b) bronchial (laryngotracheal) breath sounds;
c) crepitation;
d) pleural friction sounds.
480. Decreased vesicular breathing appears in the case of:
a) thin chest wall because of underdeveloped muscles;
b) thin chest wall because of subcutaneous fat;
c) thick chest wall because of excessively developed muscles;
d) exercising.
481. Increased vesicular breathing appears in all cases except:
a) thin chest wall because of underdeveloped muscles;
b) thin chest wall because of subcutaneous fat;
c) occurs in children;
97
d) thick chest wall because of subcutaneous fat.
482. Pathologically decreased vesicular breathing observes in all cases except:
a) initial stage of acute lobar pneumonia;
c) compressive atelectasis;
d) inflammatory edema of the mucosa.
483. Pathologically increased vesicular breathing occurs in all cases except:
a) bronchospasm;
b) bronchitis;
c) bronchial asthma;
d) pulmonary emphysema.
484. Dry rales can be:
a) Coarse bubbling
b) Medium bubbling
c) Sibilant
d) Fine bubbling
485. Fine bubbling rales:
a) soft, high-pitched, and very brief;
b) somewhat louder, and not so brief;
c) loud, lowpitched, and longer;
d) relatively low pitched, sonoring sounds.
486. Coarse bubbling rales:
a) loud, lowpitched, and longer;
b) relatively low pitched, sonoring sounds;
c) soft, high-pitched, and very brief;
d) somewhat louder, and not so brief.

98
487. Wheezes also called:
a) Sonorous rales;
b) Sibilant rales;
c) Medium bubbling rales;
d) Coarse bubbling rales.
488. Rhonchi also called:
a) Sibilant rales;
b) Sonorous rales;
c) Medium bubbling rales;
d) Coarse bubbling rales.
489. Fine bubbling rales:
a) generate in small bronchi and bronchioles;
b) originate in bronchi of medium caliber;
c) produce in bronchi of large caliber.
490. Coarse bubbling rales
a) generate in small bronchi and bronchioles;
b) originate in bronchi of medium caliber;
c) produce in bronchi of large caliber.
491. The most common causes of the moist rales include all except:
a) bronchopneumonia;
b) cavity in the lungs;
c) tumor of bronchus;
d) pulmonary edema.
492. Sibilant rales signify obstruction in small bronchi in all except:
a) bronchial asthma;
b) tuberculosis;
99
c) tumor of bronchus;
d) bronchiectasis.
493. For acute lobar pneumonia most typical:
a) moist rales;
b) pleural rub;
c) crepitation;
d) dry rales.
494. Dry rales:
a) Best heardduringexpiration;
b) Heard at the end of inspiration;
c) Best heard during inspiration;
d) Heard throughout respiratory cycle.
495. Moist rales:
a) Best heard during inspiration;
c) Best heard during expiration;
d) Heard throughout respiratory cycle.
496. Crepitation:
a) Heard at the end of inspiration;
b) Best heard during expiration;
c) Heard throughout respiratory cycle;
d) Best heard during inspiration.
497. Pleural friction sound:
a) Heard throughout respiratory cycle;
c) Best heard during inspiration;

100
d) Best heard during expiration.
498. Only this sound is heard during Breathing movement with close nose and
mouth:
a) Dry rales;
b) Moistrales;
c) Crepitation;
d) Pleuralfrictionsound.
499. Pressure with the stethoscope causes Increase of:
a) Dry rales;
b) Moistrales;
c) Crepitation;
500. Decrease or disappears during cough:
a) Dry rales;
b) Moistrales;
c) Crepitation;
501. Decrease or change character during cough:
a) Dry rales;
b) Moistrales;
c) Crepitation;
502. Instrumental methods of investigation used to examine the patients with

disorders of the respiratory system include all except:
a) Roentgenoscopy
b) Fibrogastroscopy
101
c) Roentgenography (radiography)
d) Fluorography
503. Instrumental methods of investigation used to examine the patients with

disorders of the respiratory system include all except:
a) Computed tomography
b) Fibrogastroscopy
c) Magnetic resonance imaging
d) Bronchography
504. Method (technique) of obtaining biological samples in patients with respiratory

diseases is:
a) Roentgenoscopy
b) Bronchography
c) Fluorography
d) Bronchoscopy
505. Method (technique) of obtaining biological samples in patients with respiratory

diseases is:
a) Roentgenoscopy
b) Roentgenography
c) Fluorography
d) Collection of the sputum
506. Macroscopic study of sputum examination includes all except:
a) amount of sputum
b) cellular elements of sputum
c) character of sputum
d) color of sputum
507. Microscopic study of Sputum examination includes all except:
a) cellular elements of sputum

102
b) consistence of sputum
c) fibrous elements of sputum
d) crystal formations of sputum
508. Anasarca - is:
a) edema on the legs;
b) edema on the lower back;
c) edema on the neck;
d) abdominal hydrops;
e) edema of the all body.
509. Whenhappens pathological displacement of the apical impulse in left:
a) left ventricular hypertrophy;
b) ascites;
c) flatulence;
d) emphysema;
e) pneumosclerosis.
510. When the pulse of carotid arteries ("dance carotid") is increased:
a) mitral stenosis;
b) insufficiency of the mitral valve;
c) aortic stenosis;
d) insufficiency of the aortic valve;
e) insufficiency of the tricuspid valve.
511. When and where there is determined systolic trembling ("cat purring"):
a) mitral stenosis, on apex of the heart;
b) aortic stenosis, in the II-nd right intercostal space;
c) insufficiency of the aortic valve, in the II-nd right intercostal space;
d) dry pericarditis, at the apex of the heart;

103
e) dry pericarditis, in the area of absolute cardiac dullness.
512. Area of extended apical beat:
a) 1-2 cm2;
b) less than 1 cm2;
c) less than 2 cm2;
d) more than 2 cm2.
513. Resistant apical beat indicates:
a) insufficiency of the mitral valve;
b) aortic insufficiency;
c) aortic stenosis;
d) left ventricular hypertrophy;
e) dilated left ventricular cavity.
514. When and where there is determined systolic trembling ("cat purring"):
a) mitral stenosis, on apex of the heart;
b) aortic stenosis, in the II-nd right intercostal space;
c) insufficiency of the aortic valve, in the II-nd right intercostal space;
d) dry pericarditis, at the apex of the heart;
e) dry pericarditis, in the area of absolute cardiac dullness.
515. Pulsation of the liver can occur when:
b) aortic valve insufficiency;
c) tricuspid valve insufficiency;
d) lack of contractile function and left ventricle;
e) mitral stenosis.
516. Character of cyanosis in cardiovascular disease:
a) diffuse;
104
b) on the face;
c) acrocyanosis;
d) in the lower extremities;
e) in some parts of the body.
517. Edema in patients with cardiovascular failure occurs on:
a) lower extremities;
b) the face;
c) back;
d) the eyelids;
e) the upper extremities.
c) aortic stenosis;
519. What is the orthopnea:
a) hemoptysis;
b) cough;
c) cold extremities;
d) feeling of pulsation in the body;
e) forced sitting position.
520. When the pulse of carotid arteries ("dance carotid") is increased:
a) mitral stenosis;
b) insufficiency of the mitral valve;
c) aortic stenosis;
105
d) insufficiency of the aortic valve;
e) insufficiency of the tricuspid valve.
521. Pulsation jugular veins – is a symptom of:
a) insufficiency the aortic valve;
b) insufficiency of mitral valve;
c) tricuspid valve insufficiency;
d) exudative pericarditis;
e) stenosis of right atrioventricular valve.
522. Whenhappens pathological displacement of the apical impulse in left:
a) left ventricular hypertrophy;
b) ascites;
c) flatulence;
d) emphysema;
e) pneumosclerosis.
523. What is the cardialgia:
a) pain in the liver;
b) pain in the heart;
c) feeling of "disruptions" in the heart;
d) muscle pain;
e) heartbeat.
524. Epigastric pulsation, growing on inspiration is stated, indicates:
a) atherosclerosis of the aorta;
b) left ventricular hypertrophy;
c) hypertrophy of the right ventricle;
d) aneurysm of the aorta;
e) vascular tumor of the liver (hemangioma).

106
525. Cardiac impulse - is:
a) pulse to the left of the sternum over a large area;
b) ripple in the II-nd right intercostal space;
c) ripple in the II-nd left intercostal space;
d) epigastric pulsation;
e) pulsation in the axillary fossa.
c) aortic stenosis;
527. Displacement left border of cardiac dullness to the left can occur in case of:
a) hypertrophy of the right atrium;
b) hypertrophy of the left atrium;
c) hypertrophy of the right and left atrium;
d) hypertrophy and dilatation of left ventricular;
e) mitral valve stenosis.
528. Increasing area of absolute cardiac dullness observed in:
a) left-sided pneumothorax;
b) emphysema;
c) attack of bronchial asthma;
d) pneumopericarditis;
e) hydropericarditis.
529. The upper border of absolute cardiac dullness is located:
a) the lower edge of III- th rib on the left midclavicular line;

107
b) the lower edge of the IV-th rib on the left parasternal line;
c) the lower edge of the V- th rib on the left midclavicular line;
d) the top edge of the III-th rib on the left parasternal line;
e) the top edge of the IV-th rib on the left midclavicular line.
530. The upper border of absolute cardiac dullness is located:
a) the lower edge of III- th rib on the left midclavicular line;
b) the lower edge of the IV-th rib on the left parasternal line;
c) the lower edge of the V- th rib on the left midclavicular line;
d) the top edge of the III-th rib on the left parasternal line;
e) the top edge of the IV-th rib on the left midclavicular line.
531. S1 occurs during:
a) ventricular systole;
b) ventricular diastole;
c) auricular systole;
d) auricular diastole;
e) dilatation of the left ventricle.
532. S2 occurs during:
a) ventricular systole;
b) ventricular diastole;
c) auricular systole;
d) auricular diastole;
e) ventricular dilatation.
533. S1consists of:
a) one component;
b) two components;
c) three components;
108
d) four components;
e) five components.
534. S2 consists of:
a) one component;
b) two components;
c) three components;
d) four components;
e) five components.
535. Tension of myocardial ventricular, closure of atrioventricular valves, atrial

contraction, vibrations in the initial part of the aorta and pulmonary trunk form:
a) S1;
b) S2;
c) S3;
d) S4;
e) pericardial knock.
536. The simultaneous closure of aortic and pulmonary trunk form:
a) S1;
b) S2;
c) sound of mitral valve opening;
d) S3;
e) S4.
537. During the auscultation the patient must breathe
a) quietly;
b) deeply;
c) often;
d) hold breath on the inspiratory phase;
109
e) hold breath on the expiratory phase.
538. Listening point of left atrioventricular valve located in:
a) heart apex;
b) 2nd intercostal space to the right of the sternum;
c) to the left of the sternum at the 3rd costosternal articulation;
d) 2nd intercostal space to the left of the sternum;
e) base of the xiphoid process.
539. Listening point of right atrioventricular valve located in:
a) heart apex;
b) on the sternum midway between 3rd left and 5th right costosternal articulation;
c) 2nd intercostal space to the right of the sternum;
d) base of the xiphoid process;
e) 2nd intercostal space to the left of the sternum.
540. Listening point of pulmonary valve located in:
a) in the 2nd intercostal space 1-1,5cm to the left of the sternum;
b) heart apex;
c) 2nd intercostal space to the right of the sternum;
541. Listening point of aortic valve located in:
a) heart apex;
b) 2nd intercostal space to the right of the sternum;
c) in the middle of the sternum at the level of the 3rd costosternal articulation;
542. Fifth listening point located in:

110
a) base of the xiphoid process;
b) to the left of the sternum at the 3rd and 4th costosternal articulation;
c) 2nd intercostal space to the left of the sternum;
d) 2nd intercostal space to the right of the sternum;
e) heart apex.
543. Decreasing of both heart sounds typical for
a) aortic heart defects;
b) mitral heart defects;
c) myocarditis;
d) hypertension;
e) thyrotoxicosis.
544. Increased both heart sounds typical for:
a) pulmonary emphysema;
b) pleural effusion on the left;
c) excess of subcutaneous fat;
d) anemia;
e) myocardial infarction.
545. Decrease S1 at the apex of the heart typical for:
a) myocarditis;
b) insufficiency of the left atrioventricular valve;
c) thyrotoxicosis;
d) emphysema;
e) hard physical exertion.
546. Decrease S2 at the aortic valve typical for:
a) atherosclerosis of the aorta;
b) aortic defects;
111
c) syphilitic mezoartryt;
d) hypertension;
e) hyperthyroidism.
547. When the ECG rhythm is called the right:
a) R-R intervals are different more than 10%;
b) R-R intervals are different not more than 0.1 s;
c) R-R intervals are different more than 0.1 s;
d) R-R intervals are different more than 0.2 s;
e) R-R intervals are different more than 0.3 s?
548. Sinus rhythm is called right (normal) if:
a) P wave is negative and present before each complex QRS;
b) P wave is positive and present before each complex QRS;
c) P wave before each complex QRS - not equal in amplitude and shape;
d) P wave is not present before each QRS complex, PQ interval is 0.25 - 0.35.
549. In what node of the heart conduction system normally occurs excitation
impulse:
a) in the atrioventricular node;
b) in the sinus node;
c) in the left leg of bundle branch;
d) in the right leg of bundle branch;
e) in the Purkinje fibers.
550. What ECG interval used to determine heart rate:
a) P-Q;
b) QRS;
c) QRST;
d) R-R.
112
551. What is normal heart rate:
a) 40 - 60 per 1 min;
b) 90 - 120 per 1 min;
c) 60 - 80 per 1 min;
d) 120-240 per 1 min;
e) 30 - 40 per 1 min.
552. P wave on the ECG is:
a) ventricular excitation;
b) excitation of interventricular septum;
c) atrial excitation;
d) ventricular repolarization;
e) excitation atrio-ventricular node.
553. QRS complex on the ECG is:
554. T wave on the ECG is:
555. Normal duration of P wave is:
a) ≤ 0,10 s;
113
b) ≤ 0,03 s
c) 0,06 – 0,08 s;
d) 0,1 – 0,25;
e) ≤ 0,45 s.
556. Normal duration of QRS complex is:
a) ≤ 0,10 s;
b) ≤ 0,03 s
c) 0,06 – 0,08 s;
d) 0,1 – 0,25;
e) ≤ 0,45 s.
557. Normal duration of S wave is:
a) ≤ 0,10 s;
b) ≤ 0,03 s
c) 0,06 – 0,08 s;
d) 0,1 – 0,25;
e) ≤ 0,04 s.
558. In what lead T wave is always normally negative:
a) I standard lead;
b) II standard lead;
c) III standard lead;
d) AVR;
e) AVF.
559. Electrical axis of the heart is not rejected if:
a) in the I standard lead is highest R wave, in the III standard lead is deepest S
wave;
114
b) in the III standard lead is highest R wave, in the I standard lead is deepest S
wave;
c) the highest R wave in the II standard lead;
d) the highest R wave in the III standard lead;
e) the highest R wave in the I standard lead.
560. Electrical axis of the heart is vertical when:
a) in the I standard lead is highest R wave, in the III standard lead is deepest S
wave;
b) in the III standard lead is highest R wave, in the I standard lead is deepest S
wave;
c) the highest R wave in the II standard lead;
d) the highest R wave in the III standard lead;
e) the highest R wave in the I standard lead.
561. If an ECG is recirded at speed of 50 mm/s, one small box (1 mm) represents
a) 0,04 ms
b) 0,01 ms
c) 0,02 ms
d) 0,05 ms
562. The standard bipolar limb leads are:
a) Leads I, II and III
b) Leads aVF, aVR, aVL
c) Leads V1-V6
d) all of the above
563. In horizontal position of heart electrical axis voltage of R is:
a) RI>RII>RIII
b) RII>RI>RIII
c) RIII>RII>RI
d) RI=RIII
564. The normal PQ-interval duration is:

115
a) 0,08-0,10 sec.
b) 0,12-0,2 sec.
c) 0,06-1 sec.
d) 0,35-0,04 sec.
565. The normal Q wave characteristics are:
a) amplitude not more than 1/4 of the R wave
b) its duration is 0,03 sec.
c) may be deep and wide in the aVR lead
d) all of the above
566. The cause of heart rate less than 40 beats per minute may be:
a) ventricular rhythm;
b) sinus baradycardia;
c) heart sick syndrome;
d) all of the above.
567. Wave P is hidden in QRS in
a) sinus premature contraction;
b) an upper nodal extrasystole;
c) an midnodal extrasystole;
d) an lower nodal extrasystole.
568. Does P-wave precede to QRS-complex in case of ventricular premature

contraction?
a) yes, always;
b) no;
c) if ventricular premature contraction generates in upper part of ventricular

septum.
569. Sings of wandering pacemaker are:
116
a) changes of P-wave configuration from cycle to cycle;
b) PQ-interval duration is not constant, depend on the site of pacemaker;
c) the morphology of QRS-complex is normal;
d) all of the above.
570. Brady-tachy syndrome is typical to
a) idioventricular rhythm;
b) sinus arrhythmia;
c) sick sinus syndrome;
d) heart blockades.
571. Specify the basic characteristic signs of damage the esophagus:
a) pain, weight loss, diarrhea, steatorrhea;
b) dysphagia, odynophagia, heartburn, chest pain, hematemesis/melena;
c) nausea and vomiting, epigastric pain, hematemesis/melena, early satiety;
d) pain, nausea/ vomiting, nematemesis;
e) pain urgency, hematochezia, tenderness, pruritus.
572. Specify the basic characteristic signs of damage the stomach:
a) dysphagia, odynophagia, heartburn, chest pain, hematemesis/melena;
b) pain, weight loss, diarrhea, steatorrhea;
573. Specify the basic characteristic signs of damage the duodenum:

117
574. Specify the basic characteristic signs of damage the rectum:
575. Vomiting that arose through 10-15 minutes after eating is a consequence of:
a) ulcer or cancer of cardiac part of the stomach;
b) ulcer or cancer of the stomach body;
c) ulcer of the pylorus or duodenum.
576. Vomiting that arose through 2-3 hours after eating is a consequence of:
a) ulcer or cancer of cardiac part of the stomach acute gastritis;
577. Vomiting that arose through 4-6 hours after eating is a consequence of:
a) ulcer or cancer of cardiac part of the stomach acute gastritis;
578. Main features of pain in peptic ulcer:
a) is epigastric, may radiate to the back, and is of variable quality: gnawing,

burning, boring, aching, pressing, or hunger like;
b) is epigastric, and of variable quality. The pain is persistent and slowly

progressive;
c) is epigastric, may radiate to the back or other parts of the abdomen or may be
poorly localized. The quality of the pain is usually steady;
118
d) is steady, deep epigastric pain, radiating through to the back. Pain is chronic or
of recurrent course;
e) is epigastric and in either upper quadrant steady and deep pain that often
radiates to the back. The pain is persistent, and can relieve in leaning forward
with trunk flexed.
579. Main features of the stomachcancer pain:


progressive;
with trunk flexed.
580. Dysphagia is:
a) as a sensation of “sticking” or obstruction of the passage of food through

the mouth, pharynx, or esophagus;
b) a specific burning sensation behind the sternum associated with regurgitation

of gastric contents into the inferior portion of the esophagus;
c) return of the part of swallowed food into the mouth due to backward movement
of esophagus and stomach with open cardia without contraction of diaphragm
and abdominal muscles;
d) reflex act associated with irritation of the vagus nerve;
e) the forceful oral expulsion of gastric contents.
581. Heartburn(pyrosis) is
a) as a sensation of “sticking” or obstruction of the passage of food through the

mouth, pharynx, or esophagus;
119
b) a specific burning sensation behind the sternum associated with
regurgitation of gastric contents into the inferior portion of the esophagus;
582. Regurgitation (crutio, ructus) is


c) return of the part of swallowed food into the mouth due to backward
movement of esophagus and stomach with open cardia without
contraction of diaphragm and abdominal muscles;
583. Nauseais:


584. Vomiting(emesis) is:

120
585. Melena may indicate:
a) Botkin's disease;
b) hemorrhoids;
c) chronic pancreatitis;
d) cirrhosis complicated;
e) bleeding from the veins of the esophagus;
f) tumor of the bladder.
586. When can be observed ‘melena’:
a) in case of bleeding into the abdominal cavity;
b) in the case of intestinal bleeding;
c) in case of stomach bleeding;
d) in case of hemolytic jaundice;
e) in case of parenchymatous jaundice?
587. Vomiting with food that was consumed 1 - 2 days ago, is typical for:
a) stenosis of the goal;
b) gastric cancer;
c) a stomach ulcer;
d) duodenal ulcer;
e) atrophic gastritis.
588. In case of what disease most often observed fresh blood in feces:
121
a) colitis;
b) duodenal ulcer disease;
c) a stomach ulcer;
d) gastric cancer;
e) hemorrhoids?
589. The abdomen has the “frog” form in the case of:
a) meteorism;
b) ascites;
c) pregnancy;
d) obesity;
e) peritonitis.
590. Due to what method can be determine the presence of free fluid in the
abdomen:
a) probing;
b) percussion;
c) review;
d) gastroscopy;
e) auscultation?
591. Symptom of muscular protection (defence musculaire) is typical for:
a) inflammation of the abdominal cavity;
b) inflammation of the peritoneum;
c) a stomach ulcer;
d) duodenal ulcer disease;
e) pyloric stenosis.
592. From what of the intestines segment begins deep palpation by Obraztsov-
Strazhesko:
122
a) cecum;
b) the transverse colon;
c) appendix cecum;
d) the sigmoid colon;
e) ascending colon?
593. Transverse colon is:
a) at the umbilicus;
b) 1 - 2 cm above the umbilicus;
c) 2-3 cm above the umbilicus;
d) 2-3 cm below the umbilicus;
e) 2-3 cm below the great curvature of the stomach.
594. Where in the norm is lower border of the stomach:
a) 2 - 3 cm below the umbilicus;
b) 2 - 3 cm above the umbilicus;
c) at the umbilicus;
d) 3-4 cm above the umbilicus;
e) 3-4 cm below the umbilicus?
595. The pain in the epigastric region, which has zoster nature and irradiates to the
back indicates:
a) gastritis or peptic ulcer disease of the stomach;
b) duodenitis or duodenal ulcer;
c) pancreatitis;
d) cholecystitis;
e) irritation of abdominal plexus due to illness of the stomach, duodenal intestine,

gall bladder and pancreas.
596. What is the difference between gastric vomiting and vomiting that appeared
because of other reasons:
123
a) is not associated with meals;
b) are clearly associated with eating;
c) lots of vomiting with acid content;
d) vomiting on an empty stomach?
597. For the diagnosis of peptic ulcer disease primarily used:
a) Duodenal intubation;
b) X-rays;
c) Fractional study of gastric contents;
d) Fibrogastroscopy?
598. What method of investigation in suspected peptic ulcer disease should be used
to study fractional gastric contents:
a) Fibrogastroscopy;
b) X-rays;
c) Examination of stool for occult blood;
d) Ultrasound?
599. Which of these methods of analysis is the most accurate in the diagnosis of
gastritis:
a) X-ray;
b) The study of gastric secretion;
c) Palpation;
d) Percussion?
600. Using which examinations can detect the presence of Helicobacter pylory:
a) Fecal and gall;
b) Analysis of bile, feces, urine;
c) Analysis of bile, gastric juice and saliva;
d) Analyzing the contents of the duodenum and saliva;
124
e) Respiratory (urease) test, serological examination of blood, biopsies of gastric
mucosa smear?
601. For what disease is typical an admixture of mucus in the stool?
a) Colitis;
b) Enteritis;
c) Hemorrhoids;
d) Gastric ulcer and duodenal ulcer?
602. Which of the test breakfasts now prefer during the test of gastric secretion:
a) alcohol (Ermanno)
b) cabbage (Leporskogo);
c) beef broth (Zimnitskiy);
d) histamine?
603. What is the strongest stimulus of gastric secretion:
a) cabbage juice;
b) alcohol;
c) coffee;
d) insulin;
e) histamine?
604. For what disease is most common hypersecretion:
a) gastritis;
b) gastric cancer;
c) duodenal ulcer;
d) cholecystitis?
605. How do we call low content of free hydrochloric acid in gastric juice:
a) achlorhydria;
b) hypoacidity;
125
c) normoacidity;
d) hyperacidity?
606. H do we call high content of free hydrochloric acid in gastric juice:
a) hypoacidity;
b) hyperacidity;
c) normoacidity;
d) achlorhydria?
607. How do we call absence of free hydrochloric acid in gastric juice:
a) hyperacidity;
b) hypoacidity;
c) achlorhydria?
608. What acidity is most commonly seen in patients with duodenal ulcer:
a) normoacidity;
b) hypoacidity;
c) hyperacidity;
d) achlorhydria.
609. For what disease is most common hyperacidity:
a) cholecystitis;
b) duodenal ulcer;
c) gastritis;
d) gastric cancer?
610. What means the large number of red blood cells in the gastric contents
a) duodenal ulcer;
b) gastritis;
c) stenosis;
d) gastric cancer?
126
611. What kind of complications of peptic ulcer evidenced by the appearance in the
gastric content of starch grains:
a) acute pancreatitis;
b) chronic cholecystitis;
c) pyloric stenosis;
d) malignancy ulcers;
e) ulcer bleeding?
612. What is the pH of basal secretion typical for chronic gastritis with increased
secretion of the stomach:
a) pH less than 1.5;
b) a pH more than 2.0;
c) a pH more than 2.5;
d) pH more than 3.0;
e) pH more than 4.5?
613. What is the pH in case of maximal histamine stimulation typical for chronic
gastritis with decreased secretion of stomach:
a) pH more than 4.5;
b) pH more than 2.5;
c) pH less than 2.1;
d) pH less than 5.4;
e) pH more than 5.0?
614. By what method can be most accurately determine lower border of the liver:
a) percussion;
b) palpation;
c) auscultation;
d) X-ray?
615. Where is is the lower border of the liver at medium clavicular line:
127
a) at the right costal arc;
b) 1 cm above the right costal arch;
c) 2 cm below the right costal arch;
d) at the umbilicus;
e) 2 cm below the umbilicus?
616. What method is usually used to determine the upper border of the liver:
a) auscultation;
b) palpation;
c) percussion;
d) review?
617. Sizes of the liver by Kurlov normally (in cm):
a) 10-7, 8-6, 9-5;
b) 12-9, 11-8 , 10-7;
c) 11-9, 10-8, 9-7;
d) 8-6, 7-5, 6-4.
618. For what disease typical enlarged, painful liver:
a) severe cardiac decompensation;
b) liver cirrhosis;
c) pancreatitis;
d) leukemia?
619. For what disease typical reduce size of liver:
a) liver cirrhosis;
b) subacute macular degeneration
c) liver;
d) acute hepatitis;
e) chronic hepatitis;
128
f) persistent hepatitis?
620. For chronic cholecystitis is typical:
a) Ker`s symptom;
b) Shchetkin-Blumberg symptom;
c) pain in the zone of Chauffard;
d) tenderness at the Desjardin`s point.
621. What is a Ker`s symptom:
a) pain at the point of projection of gallbladder during palpation, especially on

inspiration;
b) pain during tapping by hand on the right costal arch;
c) pain in the zone of Chauffard;
d) tenderness at the Desjardin`s point?
622. Normall level of bilirubin in blood:
a) bound;
b) 75% unbound of the total;
c) 75% bound of the total;
d) absent;
e) 25% unbound of the total?
623. The presence of bilirubin in urine in norm:
a) appears periodically;
b) absent;
c) there are traces;
d) there is lots of it.
624. What function of the liver can be determined during the examination of
bilirubin levels:
a) forming a protein;
129
b) pigment;
c) carbohydrate;
d) antitoxic?
625. For what disease the most typical increase serum globulins:
a) hepatitis;
b) duodenitis;
c) cholecystitis;
d) cancer?
626. What of enzymes belonging to the organ liver enzymes:
a) aldolase;
b) acid phosphatase;
c) alkaline phosphatase;
d) sorbitol dehydrogenase?
627. What means change in the activity of alkaline phosphatase:
a) Mechanical jaundice;
b) Violation of carbohydrate function of the liver;
c) Violation of the antitoxic function of the liver;
d) Violation of protein forming function of the liver;
e) Regulation of protein metabolism due to liver disease?
628. By using what method learned participation of liver in fat metabolism:
a) sediment samples;
b) determine the level of cholesterol in the blood;
c) determination of enzyme levels;
d) determination of protein fractions of blood?
629. What method of examination has the greatest value in diagnosis of gallstone
disease:
130
a) questioning;
b) palpation;
c) cholecystography;
d) irrigoscopy;
e) duodenal intubation?
630. Scanning of the liver - is examination by:
a) radioactive isotopes;
b) X-rays;
c) laparoscopy;
d) biopsy;
e) pneumoperitoneum.
631. By using what method can be examine in vivo the morphology of the liver:
a) scan;
b) biopsy;
c) laparoscopy;
d) splenoporto graphy?
632. How denoted the hepatitis A virus:
a) HAAg;
b) anti-HAV;
c) HBsAg;
d) HAV;
e) Anti- HAV, Ig M?
633. How denoted the hepatitis B virus:
a) HbsAg;
b) HBV;
c) anti-HBs;
131
d) HBeAg;
e) Anti- HBc?
634. How denoted the hepatitis C virus:
a) HCAg;
b) HCV;
c) anti-HCV;
d) HBV-RVA;
e) HBV-DNA?
635. How denoted the hepatitis D virus:
a) HDV;
b) HDAg;
c) anti-HDV;
d) anti-HDV, Ig M?
636. How denoted the hepatitis E virus:
a) HDV;
b) anti-HBs;
c) HEV;
d) anti-HBc?
637. How we indicate antibody against virus of hepatitis A:
a) anti-HAV;
b) HAAg;
c) HBeAg;
d) Anti- HAV, anti- HBV?
638. How we indicate antibody against hepatitis A virus in the acute phase of
infection:
a) anti-HAV;
132
b) HAAg;
c) HBeAg;
d) Anti- HAV, Ig M?
639. How we indicate antibody against the protein of hepatitis C virus:
a) HCV;
b) HCAg;
c) anti-HCV;
d) HCV-RVA?
640. How we indicate antibody against the virus of hepatitis D in the acute phase of
infection:
a) HDV;
b) HDVAg;
c) anti-HDV, Ig G;
d) anti-HDV, Ig M?
641. What virus - agents of hepatitis are known at this time:
a) A i B;
b) A, B, anti-A, anti-B;
c) A, B, C, D, E, F, G;
d) A, B, C;
e) A, B, C, D, E?
642. Specify the basic characteristic signs of damage the pancreas:
133
643. Main features of pain in acute pancreatitis:


progressive;
c) is epigastric, may radiate to the back or other parts of the abdomen or

may be poorly localized. The quality of the pain is usually steady;
with trunk flexed.
644. How called feces with the large amount of fat:
a) steatorrhea;
b) melena;
c) acholic stool;
d) sheep feces?
645. Tendency to diarrhea typical for:
a) duodenal ulcer disease intestine;
b) erosive duodenitis;
c) chronic pancreatitis;
d) chronic gastritis with increased gastric acidity juice.
646. Main features of pain in chronic pancreatitis:


progressive;
134
d) is steady, deep epigastric pain, radiating through to the back. Pain is
chronic or of recurrent course;
with trunk flexed.
647. What is early sign of pancreatic insufficiency:
a) The presence stercobilin in the stool;
b) Steatorrhea;
c) Black feces;
d) The presence of urobilin in the stool;
e) The normal color of stool?
648. Main features of the cancer of the pancreas:


progressive;
radiates to the back. The pain is persistent, and can relieve in leaning
forward with trunk flexed.
649. Where the primary urine is formed:
a) in glomerulus;
b) in the proximal tubules;
c) in the distal tubules;
d) in the loop of the nephron;
e) in glomerulus and proximal tubule?

135
650. What are the mechanisms of formation urine performed at the level of tubules:
a) Filtration;
b) filtration and reabsorption;
c) reabsorption and secretion;
d) filtration and secretion?
651. Excretory anuria:
a) violation of urine formation by kidneys;
b) lack of urine because of constraints in the urinary tract;
c) daily urine output less than 500 ml;
d) urinary excretion of acetone.
652. Where in the kidney occurs complete adsorption of glucose:
a) in glomerulus;
b) in the proximal tubules;
c) in the distal tubules;
d) in the loop of the nephron;
e) in the glomeruli and nephron loop?
653. What are the mechanisms of formation of urine done at the level of the
glomeruli:
a) filtration and reabsorption;
b) filtration;
c) secretion;
d) filtration and secretion;
e) secretion and reabsorption?
654. What typical for edema in patients with acute nephritis:
a) appear in the evening;
b) first appear in lower extremities;
136
c) first appear in upper extremities;
d) appear on the face in the morning;
e) immediately appears anasarca?
655. What is the nocturia:
a) increased urine specific gravity;
b) night urine output;
c) the presence of glucose in urine;
d) violation of urine caused by kidneys;
e) inability to emptying urinary bladder as a result of compression or damage to

the spinal brain?
656. What syndrome characterized by presence of the following symptoms: edema,

high proteinuria, hypoproteinemia,, hypercholesterolemia:
a) uric;
b) nephrotic;
c) hypertensive;
d) mixed;
e) hypertonic and uric?
657. For what disease typical positive Pasternatsky symptom:
a) glomerulonephritis;
b) pyelonephritis;
c) liver disease;
d) cystitis?
658. What is the dysuria:
a) reduced specific gravity of urine;
b) urinary excretion mainly at night;
c) disorders of urination;
137
d) the presence of glucose in urine;
e) frequent urination?
659. Pollakiuria typical for:
a) nephrotic syndrome;
b) pyelonephritis;
c) glomerulonephritis;
d) cystitis.
660. The main symptom of uremia:
a) the presence of edema;
b) itchy skin;
c) azotemia;
d) reduction in body temperature.
661. Complete termination of excretion of urine is called:
a) oliguria;
b) polyuria;
c) anuria;
d) nocturia.
662. State of mind in terminal stage of uremia:
a) sopor;
b) stupor;
c) coma;
d) clear conscience.
663. Indicate whether are palpated kidneys in a healthy person:
a) palpable in a position on the left or right side;
b) palpable in a position on the back;
c) is not palpable;
138
d) palpable just right kidney?
664. For what disease typical prolonged polyuria with high specific gravity of urine
a) heart failure;
b) renal insufficiency;
c) diabetes;
d) pyelonephritis;
e) poisoning nephrotoxic substances?
665. What is the name of reduction of daily urine output:
a) oliguria;
b) anuria;
c) nocturia;
d) polakiuriya?
666. Polyuria:
a) daily urine output is less than 1 l;
b) daytime urine output is less than 2 L;
c) nocturnal urine output more than 1 l;
d) daily urine output is less than 2 L;
e) daily urine output more than 2 liters.
667. What could indicate progressive increase of edema:
a) a decrease in urine output;
b) an increase in urine output;
c) reduction in body weight of the patient;
d) increase in body weight of the patient?
668. What is the secretory anuria:
a) violation of urine output as a result of constraints in the urinary ways;
b) violation urine output caused by kidneys;

139
c) violation urine output from the bladder as a result of spinal cord injury;
d) daily urine output is less than 500 ml;
e) daytime urine output is less than 500 ml?
669. Content of what substance in the urine significantly increases its specific
gravity:
a) urates;
b) protein;
c) bilious pigments;
d) glucose;
e) uric acid?
670. Expressed bilirubinuria typical for:
b) obstructive jaundice;
c) nephrolithiasis;
d) myocardial kidneys;
e) chronic glomerulonephritis.
671. For what disease the most typical leucocyturia:
a) pyelonephritis;
b) paranephritis;
c) acute glomerulonephritis;
d) renal amyloidosis;
e) urinary bladder cancer?
672. When patient have acute glomerulonephritis, what changes will be in urine:
a) proteinuria and hematuria;
b) leucocyturia and hematuria;
c) leucocyturia and cylindruria;
140
d) leucocyturia and proteinuria.
673. What changes in urine are typical for chronic pyelonephritis:
a) hematuria and cylindruria;
b) leucocyturiaand proteinuria;
c) cylindruria;
d) hematuria and bacteriuria;
e) hematuria, cylindruria, proteinuria?
674. Specific gravity of urine depends of:
a) amount of food you eat;
b) nature of the food;
c) amount of salt in the urine;
d) amount of excreted urine and amount of solid substances in the urine;
e) temperature of the body?
675. What conditions must be followed during the test by Zimnitsky:
a) constant bed rest;
b) standardized water regime;
c) collecting urine in a sterile vessel;
d) mast be used catheter for urine collecting;
e) patient mast receive a large number of fluid?
676. Expressed urobilinogenuria typical for:
a) obstructive jaundice;
b) hemolytic anemia;
c) nephrolithiasis;
d) myocardial kidneys;
e) chronic glomerulonephritis?
677. Cylinders in urine it is:

141
a) mucus that changed its consistency in acidic urine;
b) protein copies of tubules of the kidneys;
c) accumulation of bacteria;
d) pressed platelets;
e) pressed salt?
678. Urobilinogen in urine:
a) absent in a healthy person;
b) appears in the case of kidneys disease;
c) appears in the case of pancreas disease;
d) appears in the case of mechanical jaundice.
679. Leucocyturia - the presence of large amounts in urine of:
a) cylinders;
b) epithelial cells;
c) leucocytes;
d) erythrocytes.
680. Albuminuria it is:
a) increased glucose in the urine;
b) the lack of protein in the urine;
c) the presence of protein in the urine;
d) the presence of sediment in the urine.
681. The appearance of urobilinogen in the urine indicates:
a) disease of the kidneys;
b) diseases of the pancreas gland;
c) liver disease;
d) obstructive jaundice.
682. The appearance of fresh red blood cells in urine typical for:
142
a) pyelonephritis;
b) nephrotic syndrome;
c) glomerulonephritis;
d) urethritis.
683. Cylindruria typical for:
a) pyelonephritis;
b) urethritis;
c) nephrotic syndrome;
d) paranephritis.
684. Specific gravity of urine of healthy person is:
a) 1,000-1,005;
b) less than 1,015;
c) higher than 1,030;
d) 1,015-1,030.
685. Bilirubinuria typical for:
a) healthy person;
b) hemolytic jaundice;
c) only for obstructive jaundice;
d) mechanical and parenchymatous jaundice.
686. The content of leucocytes in urine sediment of healthy individual (in vision
area):
a) till 40-60;
b) not contained;
c) 1-2;
d) 100 and more.
687. Unaltered erythrocytes in the sediment of urine appear in the following cases:
143
a) bladder stones;
b) cystitis;
c) tuberculosis urinary bladder;
d) glomerulonephritis.
688. Altered erythrocytes in the sediment of urine appear in the following cases:
a) pyelonephritis;
b) cystitis;
c) renal tuberculosis;
689. Ketonuria - the presence in urine of:
a) acetoacetic acid;
b) glucose;
c) acetone, acetoacetic acid;
d) protein.
690. Glycosuria is often typical for:
a) misuse of sweet food;
b) emotional turmoil;
c) diabetes;
691. Normal values of erythrocytes count in men:
a) 5.5±1.0 x 1012/1;
b) 10,8±1.0 x 1012/1;
c) 15,5±1.0 x 1012/1;
d) 20,0±1.0 x 1012/1.
692. Normal values of erythrocytes count in women:
a) 3.8±1.0 x 1012/1;
144
b) 4.8±1.0 x 1012/1;
c) 6.8±1.0 x 1012/1;
d) 8.8±1.0 x 1012/1.
693. Increasing of erythrocytes number is classified as:
a) erythrocytosis;
b) erythrocytopenia;
c) oligochromemia;
d) hyperchromemia.
694. Increased concentration of hemoglobin in the blood:
a) erythrocytosis;
b) erythrocytopenia;
c) oligochromemia;
d) hyperchromemia.
695. Normal values of hemoglobin in men:
a) 10.5±2.5 g/dl;
b) 2.5±2.5 g/dl ;
c) 5.5±2.5 g/dl;
d) 15.5±2.5 g/dl.
696. Normal values of hemoglobin in women:
a) 10.0±2.5 g/dl;
b) 12.0±2.5 g/dl;
c) 14.0±2.5 g/dl;
d) 16.0±2.5 g/dl.
697. What values of color index can be characteristic for vitamin B12 deficiency
anemia:
a) less than 0.8;
145
b) 1.2-1.5;
c) more than 1.1;
d) 0.85-1.1.
698. What color index values indicate the normochromia:
a) less than 0.8;
b) 1.2-1.5;
c) more than 1.1;
d) 0.85-1.1.
699. Normal values of leucocytes:
a) 1.0-9.0 × 109/1;
b) 4.0-9.0 × 109/1;
c) 7.0-9.0 × 109/1;
d) 9.0-9.0 × 109/1.
700. Normal value of Basophils:
a) 0.02-0.3 x 109 /l (0.5-5 %);
b) 0-0.065 x 109 /l (0-1 %);
c) 1.2-3.0 x 109 /l (19-37%);
d) 0.09-0.60 x 109 /l (3-11 %).
701. Normal value of Eosinophils:
a) 0.02-0.3 x 109 /1(0.5-5 %);
b) 0-0.065 x 109 /1 (0-1 %);
c) 1.2-3.0 x 109 /1(19-37%);
d) 0.09-0.60 x 109 /1 (3-11 %).
702. Normal value of Lymphocytes:
a) 0.02-0.3 x 109 /1(0.5-5 %);
b) 0-0.065 x 109 /1 (0-1 %);

146
c) 1.2-3.0 x 109 /1(19-37%);
d) 0.09-0.60 x 109 /1 (3-11 %).
703. Normal value of Monocytes:
a) 0.02-0.3 x 109 /l(0.5-5 %);
b) 0-0.065 x 109 /l (0-1 %);
c) 1.2-3.0 x 109/l (19-37%);
d) 0.09-0.60 x 109/l (3-11 %).
704. Normal number of thrombocytes (platelets) is:
a) 100.0-220.0 x 109/l ( 180000-320000 per 1 µl);
b) 120.0-320.0 x 109/l ( 180000-320000 per 1 µl);
c) 180.0-320.0 x 109/l ( 180000-320000 per 1 µl);
d) 200.0-420.0 x 109/l (180000-320000 per 1 µl).
705. Normal rate of erythrocyte sedimentation rate in adult males:
a) 1 to 20 mm/hr;
b) 5 to15 mm/hr;
c) 0,5 to 5 mm/hr;
d) 1 to 10 mm/hr.
706. Normal rate of erythrocyte sedimentation rate in females:
a) 1 to 20 mm/hr;
b) 5 to15 mm/hr;
c) 0,5 to 5 mm/hr;
d) 2 to 15 mm/hr.
147
SITUATIONAL TASKS
1. Patient Mordik M. came to the doctor with complaints on the attacks of severe
dyspnea, with more difficulty inspiration, which often arises during night sleep.
During objective examination detected pallid and cyanotic skin, acrocyanosis and
cold sweat. The accessory muscles take part in the breating, tachypnea - 35 per
minute. Vocal fremicus is increased over the low regions of the both sides of
lungs. Over the lungs – dull tympanic sound. Harsh respiration and crepitation in
the posterior part of the lungs are heard. The apex beat displaced to the left. The
heart sounds are decreased at the apex, accentuated second heart sound over the
pulmonary artery, gallop rhythm. Heart rate – 110 b.p.m., frequent, arrhythmic.
Blood pressure –110/70 mmHg.
a) Name the leading syndrome.
b) Indicate additional methods of examination that are necessary for diagnosis and
confirmation of this syndrome.
2. Patient Titov J. came to the doctor with complaints on severe acute pain in the
chest, cough, hemoptysis and dyspnea. During objective examination detected
diffuse cyanosis, pallid skin, cold sweat. Swollen neck veins, edema on legs and
epigastric pulsation observed. During percussion revealed displacement to the
148
right from the sternum right border of the relative heart dullness. During
auscultation revealed diminution of heart sound and splitting of the second sound
over the pulmonary artery. Heart rate – 110 b.p.m. Blood pressure –100/60
mmHg. In palpation of abdomen is detected the enlarged liver.On ECG in II, III
standard leads - P-pulmonale, in V 1-2 - signs of overloading of the right ventricle.
c) Name the leading syndrome.
d) Indicate additional methods of examination that are necessary for diagnosis and
3. Patient Kurc J. came to the doctor with complaints on severe breathlessness,

cough with expectoration of sputum, heaviness in the heart. During objective
examination detected forced posture - sitting with trunk slightly bent forward, the
skin pall, cyanosis with grey tint and cold sweet. Respiration is rattling and heard
at the distance. Sputum which released during coughing is foaming with traces of
blood (pink or red). Over the lungs in the posterior inferior parts of the chest – dull
sound. Over entire surface of the lungs moist rails of various calibers are heard.
The heart sounds are weakened, protodiastolic gallop rhythm auscultated. Heart
rate – 110 b.p.m. Blood pressure –110/70 mmHg.
4. Patient Redas J. came to the doctor with complaints on heaviness in right

hypochondrium, thirst, loss of appetite, nausea, vomiting and edema at the low
extremities. During objective examination detected slightly yellow color of the
skin, swallowing of the neck veins, pulsation of the vena jugulars, anasarca,
cardiac beat and epigastric pulsation which increased in deep inspiration. During
percussion revealed displacement to the right the right border of the relative
cardiac dullness and over left lung is determined dullness. During auscultation
revealed at apex decrease heart sounds, second sound over the pulmonary artery is
accentuated and pathological reduction of vesicular breathing. During palpation of
the abdomen revealed ascites.Clinical urine analysis: oliguria, proteinuria,
cylindruria. ECG - hypertrophy of right ventricle, right bundle branch block.
5. On reception at the doctor patient Turks G. felt a sharp dizziness, blackout

(darkening in the eyes), tinnitus (noise in the ears), weakness and as a result lost
consciousness. During objective examination detected pallid skin with a marble
shade, cold sweat and cold limbs. Blood pressure – 90/50 mmHg. Heart rate – 120
b.p.m. During auscultation revealed decreased heart sounds.
149
6. Patient Kesop L. came to the doctor with complaints on pain at the heart,
palpitation, headache, dizziness, disorder of vision. During objective examination
detected hyperemic skin, the patient is overweight. Apex beat displaced to the left
and downwards, diffuse, high. Also observed displacement of the left border of
the relative cardiac dullness to the left. Increased loudness of the first heart sound
at the heart apex and accentuated second heart sound over aorta are heard. Blood
pressure – 160/100 mmHg. During ophthalmoscopy revealed angioretinopathy.
7. Patient Lilof N. came to the doctor with complaints on dyspnea, faintness, pain in
lower part of sternum that radiate in arm to the wrist and fingers. The duration of
the pain is brief, not more than 10 min. Pain usually occurs after rapid stair
climbing. During objective examination detected displacement of apex beat to the
outside. The left border of relative cardiac dullness displaced. Both heart sounds
are decreased. Also observed abnormal carotid pulse and decreased peripheral
pulse. On biochemical analysis: elevated level of cholesterol, triglycerides,
decreased high density lipoprotein cholesterol and increase low density lipoprotein
cholesterol.
8. Patient Moony F. came to the doctor with complaints on pain in the chest that
appeared about a day ago, radiating to the left shoulder. Also, the patient has a
fear of death. During objective examination detected cold peripheries,
acrocyanosis. During auscultation is heard lung crepitation, decreased first heart
sound and presystolic and protodiastolic gallop rhythms. Blood pressure –
140/100 mmHg. In clinical blood analysis revealed leukocytosis and elevated
ESR.
150
9. Patient Moony F. came to the doctor with complaints on epigastric pain associated
with nausea and vomiting, which appeared about a day ago. Also, the patient has a
fear of death. During objective examination detected cold peripheries,
ESR.
10.Patient Moony F. came to the doctor with complaints on difficulty while

breathing, cough, minor chest pain that appeared about a day ago. Also, the patient
has a fear of death. During objective examination detected cold peripheries,
ESR.
11.Patient Deret S. came to the doctor with complaints on moist cough, general
weakness, perspiration and dyspnea.Cough is commonly periodic, moist with
difficult sputum expectoration. Sputum is mucous, glass-like. During objective
examination detected emphysematous form of the chest with accessory respiratory
muscles participation in the breathing act. During auscultation is heard medium
bubbling rales. In clinical blood analysis revealed leukocytosis and elevated ESR.
12.Patient Kooter S. came to the doctor with complaints on cough, hemoptysis,

dyspnea that occurs frequently during increased physical activity, pain in the
chest, hyperthermia, general weakness, loss of ability to work and appetite. Cough
is commonly moist, periodic with purulent greenish-yellow strong smell sputum
discharge. During objective examination detected symmetrical chest. In
auscultation of the lungs over the pathologically increased vesicular breathing
identify different moist rales decreased after cough and sputum discharge.
151
13.Patient Mozek S. came to the doctor with complaints on attack of dyspnea,

asphyxia, episodic breathlessness, cough, headache and weakness. These
symptoms frequent than 1 time per week but less than 1 time per day, often occur
at night. During objective examination detected respiration rate – 30 per min and
noisy distant rales. The form of the chest is emphysematous with accessory
muscles participate in the breathing act, also observed decreased excursion of the
chest. The vocal fremitus is badly transmitted and generalized bandbox sound
assessed over the lungs during percussion.
14.Patient Ludik S. came to the doctor with complaints on dyspnea that appears only
during physical activity than takes permanent disposition, has expiratory character
and dry cough. During objective examination detected diffuse cyanosis, barrel-like
(emphysematous) form of the chest with protruded supra- and subclavicular
fosses, horizontal direction of the ribs, smoothed and narrow intercostals spaces.
The vocal fremitus is badly transmitted and generalized bandbox sound assessed
over the lungs during percussion.
15.Patient Boblik Z. came to the doctor with complaints on hyperthermia (38,5 °C),
cough with hardly expectorated tenacious sputum, pain in the chest, dyspnea,
general weakness, lost of ability to work, perspiration, loss of appetite, headache,
pain in the muscles, joints. During objective examination detected pale skin, blush
on the left cheek, respiration rate – 25 per min, vocal fremitus is increased on the
left side. During percussion revealed dull sound on the left side. During
auscultation is heard crepitation (loud, crackling sound) on the left side.
16.Patient Rodzig H. came to the doctor with complaints on moist cough, mixed
dyspnea, pain and feeling o f heaviness in the chest, general weakness,
hyperthemia, loss of appetite and perspiration. During objective examination
152
detected diffuse cyanosis, respiration rate – 22 per min. During percussion
revealed dull sound on the right side. During auscultation is heard pleural friction
sound with decreased vesicular breathing in the lower part of right lung.
17.Complete blood count: (man) Hemoglobin – 12,3±2,5 g/dl; erythrocytes –

4,3×1012/l; color index – 0,7; leukocytes – 5,7×109/l.Leukocytogramma: band
neutrophils – 4%;polymorphonuclear neutrophils – 56%; basophils – 1%;
eosinophils –2%; lymphocytes –31%; monocyte – 6%; thrombocytes (platelets) –
200,0×109/l; erythrocyte sedimentation rate (ESR) – 5 mm/hr.
Evaluate the following analysis (install the changes in the analysis and specify
syndrome that is suitable for this analysis).
18.Complete blood count: (woman) Hemoglobin –10,0±2,5 g/dl; erythrocytes –

3,8±1,0×1012/l; color index – 0,7; leukocytes – 6,7×109/l.Leukocytogramma: band
19.Complete blood count: (woman) Hemoglobin –11,3±2,5 g/dl; erythrocytes –

4,0±1,0×1012/l; color index – 0,7; leukocytes – 6,7×109/l.Leukocytogramma: band
syndrome that is suitable for this analysis)

153
22.Complete blood count: (woman) Hemoglobin – 14,0±2,5 g/dl; erythrocytes –


eosinophils – 2%; lymphocytes – 21%; monocyte – 10%; thrombocytes (platelets)
– 150,0×109/l; erythrocyte sedimentation rate (ESR) – 4 mm/hr.
24.Complete blood count: (woman) Hemoglobin – 14,0±2,5 g/dl; erythrocytes –

eosinophils – 2%; lymphocytes – 21%; monocyte – 10%; thrombocytes (platelets)
– 148,0×109/l; erythrocyte sedimentation rate (ESR) – 5 mm/hr.
25.Urinalysis: (woman)color – straw yellow; specific gravity – 1018; reaction of

urine feebly acid; protein – 35 mg/24h; leukocytes – 15-20 in vision area;
erythrocytes – 1-2 in vision area.
154
26.Urinalysis: (man)color – straw yellow; specific gravity – 1018; reaction of urine

feebly acid; protein – 35 mg/24h; leukocytes – 13-18 in vision area; erythrocytes –
1-2 in vision area.
27.Urinalysis: (man)color – straw yellow; clarity – clear; specific gravity – 1017;

reaction of urine – feebly acid; protein – 140 mg/24h; leukocytes – 1-2 in vision
area; erythrocytes – 1-2 in vision.

area; erythrocytes – 1-2 in vision area.
29.Urinalysis: (woman) color – straw yellow; clarity – clear; specific gravity – 1017;
area; erythrocytes – 1-2 in vision area.

area; erythrocytes altered – 12-18in vision area.
155
31.Urinalysis: (woman) color – straw yellow; clarity – clear; specific gravity – 1017;
area; erythrocytesaltered – 19-20in vision area.
32.Urinalysis: (woman) color – red; specific gravity – 1017; reaction of urine –acid;
protein – 80 mg/24h; leukocytes – 1-2 in vision area; erythrocytesunaltered – 25-
30in vision area.
33.Bloodchemistry: cholesterol –4,2mmol/L; β- lipoproteins – 3,9mmol/L; total

protein – 70 g/l; total bilirubin – 34 mkmol/l; aspartate aminotransferase(АSТ) –
0,67 mmol/h×l; alanine aminotransferase (АLТ) – 0,80 mmol/h×l; lactate
dehydrogenase (LDG) – 6,2 mkmol/s×l; sorbitol dehydrogenase (SDG)– 8,7
nmol/s×l; alkalayn phosphatase –1,3 mmol/h×l.
34.Bloodchemistry: cholesterol – 5,1mmol/L; β- lipoproteins – 4,7mmol/L; total

nmol/s×l; alkalayn phosphatase –1,3 mmol/h×l.

0,35 mmol/h×l; alanine aminotransferase (АLТ) –0,48 mmol/h×l; lactate
nmol/s×l; alkalayn phosphatase – 4,3 mmol/h×l.
156
nmol/s×l; alkalayn phosphatase – 5,5 mmol/h×l.
157
РRACTICAL SKILLS
1. Conduct questioning of the patient. Make conclusion about the received

information.
2. Conduct general overview of exemplary patient. Identify the major symptoms.
3. Conduct comparative percussion and determine the clinical significance of
symptoms.
4. Conduct topographic percussion and determine diagnostic value of symptoms.
5. General inspection of head and neck. Specify basic signs that you need to pay
attention during general inspection. Identify changes that are possible to detect
during general inspection.
6. General inspection of skin and subcutaneous tissue. Specify basic signs that you
need to pay attention during general inspection. Identify changes that are possible
to detect during general inspection.
7. General inspection of the oral cavity and eyes. Specify basic signs that you need to
pay attention during general inspection. Identify changes that are possible to
detect during general inspection.
8. Conduct inspection of body, legs and hands of exemplary patient. Identify the
clinical significance of symptoms.
9. Conduct palpation of the thyroid gland to evaluate the findings.
10.Palpation of lymph nodes. Specify main lymph nodes. Determine signs of lymph
nodes that need to be determined during palpation and pathological causes leading
to enlarged lymph nodes.
11.Conduct questioning of patients with disorders of respiratory system. Identify the
main complaints.
12.Conduct inspection of the chest of patient with pathology of the respiratory
system. Identify the main symptoms and signs that are established during static
inspection.
13.Conduct inspection of the chest of a patient with pathology of the respiratory
system, Identify the main symptoms and signs that are established during dynamic
inspection.
14.Palpation of the chest. Indicate three basic key points that are established by
palpation of the chest, and the method of their determination.
15.Comparative percussion of the lungs. Indicate main tasks of this method and show
the technique of its performance.
16.Topographic percussion of the lungs. Indicate main tasks of this method and show
the technique of its performance.
158
17. Determine the active mobility of the lower edge of the lungs, evaluate diagnostic
value of symptoms.
18.Auscultation of the lungs. Show the technique of auscultation (anterior view,
posterior view, axillary regions). Tell about the main respiratory sounds (breath
sounds).
posterior view, axillary regions). Tell about the main respiratory sounds (breath
sounds) namely about vesicular (alveolar) breath sounds.
posterior view, axillary regions). Tell about the adventitious (added) sounds
namely about bronchial (laryngotraheal) breath sounds.
21.Conduct questioning of patients with disorders of the cardiovascular system.
Identify the main (specific) complaints.
22.Conduct questioning of patients with disorders of the cardiovascular system.
Identify the nonspecific complaints.
23.Conduct inspection of the heart region. Determine examination plan, specify the
clinical symptoms.
24.Conduct palpation of the heart region. Determine examination plan, show the
technique of palpation the apex beat. Specify the basic signs of pathological
changes of the heart region.
25.Percussion of the heart: specify examination plan of percussion. Show the
percussion technique to determine the relative cardiac dullness of the heart.
Identify normal borders of the relative cardiac dullness.
26.Percussion of the heart: specify examination plan of percussion. Show the
percussion technique to determine the absolute cardiac dullness of the heart.
Identify normal borders of the absolute cardiac dullness.
27.Determine by percussion the vascular bundle, evaluate findings.
28.Determine by percussion configuration of the heart. Identify normal configuration
of the heart.
29.Conduct auscultation of arteries to determine the diagnostic value of symptoms.
30.Auscultation of the heart: specify examination plan of auscultation. Show the
technique of auscultation (five standard listening points of the heart). Tell about
the normal heart sounds (heart tones) and their changes.
the three-sound rhythms (additional heart sounds).
the heart murmurs.
33.Palpation of the pulse. Show the technique of palpation. Identify the main
characteristics of pulse and their normal manifestations.
34.Blood pressure measurements. Specify examination plan of blood pressure
measurement. Identify normal findings of blood pressure.
35.Blood pressure measurements. Specify examination plan of blood pressure
measurement. Identify common abnormalities of blood pressure.
159
36.Conduct questioning of patients with disorders of digestive system. Identify the
main complaints.
37.Conduct inspection of abdomen. Determine examination plan, specify signs of
abdomen in the normal conditions and pathological causes that lead to abdomen
changes.
38.Superficial palpation of the abdomen. Show the technique of palpation. Indicate
main signs that are defined during superficial palpation of the abdomen.
39.Penetrative palpation of the abdomen. Indicate main points that are determined
during penetrative palpation of the abdomen.
40.Deep sliding palpation of the abdomen (by Obraztsov-Strazhesko). Indicate
recommended sequence of the examination. Show the technique of deep sliding
palpation of the sigmoid colon.
palpation of the caecum colon.
palpation of the ascending colon.
palpation of the descending colon.
palpation of the transverse colon.
palpation of the stomach.
46.Palpation of the liver. Show the technique of palpation. Identify the main basic
signs that are determined during palpation of the liver.
47.Percussion of the liver (by M.G. Kurlov). Show the percussion technique to
determine the liver borders. Identify normal sizes of the liver. Indicate
pathological causes that lead to liver borders changes.
48.Palpation of the spleen. Show the technique of palpation. Identify the main basic
signs that are determined during palpation of the spleen.
49.Conduct questioning of patients with disorders of urinary system. Identify the
main complaints.
50.Palpation (by Obraztsov-Strazhesko) and percussion (Pasternatsky`s symptom) of
the kidneys. Identify the basic signs that are determined during palpation and
percussion of the kidneys.
51.Conduct physical examination of the patient with heart failure. Identify the main
symptoms and syndromes, establish functional class of the patient.
52.Conduct physical examination of a patient with mitral valve disease. Identify
major symptoms and syndromes.
53.Conduct physical examination of a patient with aortic valve disease. Identify
160
54.Conduct physical examination of the patient with arterial hypertension.Identify
55.Conduct physical examination of a patient with myocarditis. Identify major
symptoms and syndromes.
56.Conduct physical examination of a patient with dry pericarditis. Identify major
symptoms and syndromes.
57.Conduct physical examination of a patient with exudative pericarditis. Identify
58.Conduct questioning of patients with Ischemicheart disease. Install dominant
disease.Identify the main (specific) complaints.
59.Conduct physical examination of the patient with stable angina.Identify major
symptoms and syndromes, Define functional class.
60.Conduct physical examination of the patient with мyocardial infarction.Identify
61.Analyze the ECGof patient with мyocardial infarction. Determine character and
localization of heart muscle affection.
62.Conduct questioning, inspection and objective examination of the patient with
Syndrome of the pulmonary tissue consolidation and set the typical complaints
and symptoms.
Syndrome o f increased airiness of the pulmonary tissue and set the typical
complaints and symptoms.
syndrome of bronchium obstruction (bronchospastic syndrome) and set the typical
syndrome of fluid accumulation in pleural cavity (hydrothorax) and set the typical
syndrome of air accumulation in pleural cavity (pneumothorax) and set the typical
syndrome of the cavity in the lungs and set the typical complaints and symptoms.
68.Conduct questioning and examination of the patient with obstructive lung disease.
Identify the main symptoms and syndromes, lesion data spirograph set the stage of
the disease.
69.Perform palpation, percussion of the chest and auscultation of the lungs of patients
with obstructive lung disease. Identify the main symptoms and syndromes.
70.Conduct questioning and objective examination of the patient with bronchitis.
Identify the main symptoms and syndromes.
71.Conduct questioning and objective examination of the patient with bronchiectatic
disease. Identify the main symptoms and syndromes.
72.Conduct questioning and objective examination of the patient with bronchial
asthma. Identify the periodof disease, main symptoms and syndromes.
161
73.Conduct questioning and objective examination of the patient with emphysema of
the lungs. Identify the main symptoms and syndromes. Evaluate radiological signs
of emphysema.
74.Conduct questioning and physical examination of the patient with pneumonia.
Identify the main symptoms and syndromes.
75.Conduct questioning and physical examination of a patient with pleurisy. Identify
the nature of pleurisy, the main symptoms and syndromes.
syndrome of jaundice and set the typical complaints and symptoms.
syndrome of bile ducts dyskinesia (dysfunctional bile tract disorders) and set the
typical complain ts and symptoms.
syndrome of gastrointerstitial bleeding and set the typical complaints and
symptoms.
syndrome of portal hypertension and set the typical complaints and symptoms.
syndrome of functional dyspepsia and set the typical complaints and symptoms.
81.Conduct questioning of the patient, inspection and palpation of its abdomen in a
patient with chronic gastritis. Identify the major syndromes.
82.Analyze the results of a study of gastric contents in patients with chronic gastritis.
Determine the state of gastric secretion and estimate its acid-formingfunction.
83.Conduct questioning, inspection and palpation of the abdomen in patient with
peptic ulcer disease. Identify the major syndromes, identify possible localization
of ulcers.
84.Conduct questioning, inspection and palpation of the abdomen in a patient with
chronic cholecystitis. Check the main symptomstypical for affection of
gallbladder. Identify the major syndromes.
85.Evaluate the results of duodenal intubation of patients with diseases of the stone in
biliary tract. Identify the main symptoms and localization of lesions.
86.Conduct questioning and examination of the patient with hepatitis. Identify the
main symptoms and syndromes.
87.Conduct questioning and examination of the patient with liver cirrhosis. Identify
the main symptoms and syndromes.
88.Conduct physical examination of the patient with hepatitis. Identify the major
syndromes based on the results of biochemical blood tests and urinalysis.
89.Conduct physical examination of the patient with cirrhosis. Identify the major
syndromes based on the results of biochemical blood tests and urinalysis.
nephritic syndrome and set the typical complaints and symptoms.
urinary syndrome and set the typical complaints and symptoms.
92.Conduct physical examination of a patient with kidney disease
(glomerulonephritis or pyelonephritis). Identify the major syndromes.
162
93.Analyse urinalysis of a patient with kidney disease. Identify the main symptoms
and syndromes. Make a conclusion about the nature of kidney damage.
Suggested Reading:
Propaedeutics to Internal Medicine: Diagnosics; textbook for English learning
Students of higher medical schools; Part 1.; Ed. 2 / O.N. Kovalyova, T.V.
Ashcheulova – Vinnytsya: Nova Knyha publishers, 2011. – 424 p.
163

Control Tests

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Control Tests

Uploaded by

Copyright:

Available Formats

DANYLO HALYTSKY LVIV NATIONAL MEDICAL UNIVERSITY

Department of Propedeutics to Internal Medicine №1

Discipline: Propedeutics to Internal Medicine

Methodological Guidelines ofself-preparation for the test control and

Methodological Guidelines of self-preparation of discipline propaedeutics to internal

- MD.PhD,Assoc. Professor ofdepartment of propedeutic ofinternalmedicine

Edited by Head of the department of Propedeutics of Internal Medicine №1 - MD,

1. CONTROL TESTS OF THEORETICAL KNOWLEDGE………4

2. SITUATIONAL TASKS ………………………………..…………106

3. LIST OF PRACTICAL SKILLS …………………………………114

1. Complicationsof mitral regurgitation:

20.Clinical picture of congestion in lesser circulationis characterized by all listed,

a) test with histamine and alpha-adrenoblockers;

b) test with antibiotics;

c) test for glucose tolerance;

d) test with veroshpiron.

59.Dyspnea at rest is typical for:

b) moderate cours of myocarditis;

c) sever cours of myocarditis;

d) not typical for myocarditis.

60.Pericardial friction of scraping character is typical for:

61.Swelling of neck veins that increased on inspiration is typical sign of:

a) mild cours of myocarditis;

b) moderate cours of myocarditis;

62.Cardiomegaly on X-ray is typical sign of:

a) mild cours of myocarditis;

b) moderate cours of myocarditis;

c) sever cours of myocarditis;

63.Duration of subacute course of myocarditis is:

d) more than 9 months.

64.Duration of chronic course of myocarditis is:

d) more than 9 months.

65.Aseptic pericarditis can be caused by all, except:

a) diffuse pathology of connective tissue;

b) metabolic disorders - uremia, gout;

66.Aseptic pericarditis can be caused by all, except:

a) the diseases o f blood;

c) treatment with anticoagulants;

67.Cause of hemorrhagic pericarditis is:

a) carcinoma of the breast;

68.Cause of purulent pericarditis is:

a) carcinoma of the breast;

69.Main cause of coronary heart diseases is:

a) atheroma and its complications;

b) hypoxia of the brain of any origin;

70.The main cause of coronary heart diseases is:

a) parenchymal and interstitial renal disease;

b) atheroma and its complications;

c) heart valves insufficiency;

71.For differential diagnosis between myocardial infarction and angina should be

72.For differential diagnosis between myocardial infarction and angina should be

73.Acute coronary syndrome includes:

a) Q-wave myocardial infarction;

74.Acute coronary syndrome includes:

c) non-Q-wave myocardial infarction;

75.Characteristic feature of unstable angina is:

a) pain that radiates to left shoulder;

b) occurrence of pain attack at rest;

c) pain that occurs during exercise;

d) pain that lasts for several hours or days.

77.In what period of myocardial infarction is formed myocardial scar?

78.In what period of myocardial infarction is formed myocardial scar?

79.Intenstive pain in the epigastrium or in the right hypochondrium, which associated

a) abdominal type of myocardial infarction;