1.

When choosing the type of surgical aid for perforated stomach ulcers, they are usually guided by

a) the period from the moment of perforation

b) the degree of inflammatory changes in the peritoneum
c) the size of the perforated hole
d) the localization of perforated holes
e) the age of the patient

2. For diagnosis of bleeding ulcer of the stomach in the first thing you must do is

a) fecal occult blood

b) contrast x-ray of the stomach
c) analysis of gastric occult blood
d) fibrogastroscopy
e) determination of hemoglobin and hematocrit

3. In the early hours when started developing gastrointestinal bleeding can take place

a) melena
b) a symptom of muscle protection
c) vomiting, gastric contents color "coffee gut"
d) bradycardia
e) collapse

4. The most typical of acute ulcer 12 duodenal ulcer are

a) advanced age of the patient

b) has a history of taking aspirin or corticosteroids
C) strong seasonal paroxysmal pain in the epigastrium
d) vomiting of food, bringing relief
e) splashing in the stomach

5. The patient suffering from a bleeding stomach ulcer, after treatment removed from the shock.
However, conservative measures do not allow to achieve reliable hemostasis. In this case, it is
necessary

a) laparotomy and gastric resection

b) gastrostomy application
c) gastrostomy application
d) continue conservative therapy, including the use of the Meilengracht diet
e) laparotomy, gastroenteroanastomosis application, bleeding vessel pricking

6. In peptic ulcer disease complicated by bleeding, vomiting the contents of his stomach the color
of "coffee grounds" may occur when all the following localizations ulcers, in addition to

a) lesser curvature of the stomach

b) cardia of stomach
c) antrum
d) the lower esophagus
e) postbulbarnye of an of the duodenum

7. In the treatment of perforated ulcer 12 duodenal ulcer can be applied, as a rule, all these
methods of surgery, in addition to

1
a) excision of the ulcer
b) closure of the ulcer
c) resection of the stomach
d) pyloroplasty with a vagotomy
e) the imposition of gastroenteroanastomosis on a short loop

8. In perforated gastric ulcer it is necessary to conduct

a) immediate laparotomy depending on the condition of the peritoneum to solve the issue of the nature
of the transaction
b) the operation after intensive therapy, correction of protein and mineral metabolism
in
c) contrast and gastroscopic examination of the stomach, repeated gastric lavage with a solution of
hydrochloric acid
d) conservative therapy followed by surgery in the interval of 3-6 weeks

9. Complaints of the patient after resection of stomach heaviness in the epigastrium, weakness,
even to fainting after taking sweet or dairy food are signs

a) inculami pancreas
b) the syndrome resulting loops
c) peptic ulcer of the anastomosis
d) dumping syndrome
e) syndrome of small stomach

10. To post-resection syndromes does not apply

a) syndrome of small stomach

b) dumping syndrome
c) the syndrome resulting loops
d) biliary gastritis of the stump
e) diabetes mellitus

11. Secretin is formed

a) in the duodenum
b) in the liver
c) in the pancreas
d) in the distal small intestine
e) in the hypothalamus

12. The main stimulator of the release is secretin

a) hydrochloric acid
b) cleavage products of proteins
c) fats
d) carbohydrates
e) all of the above factors

13. Stimulant of hydrochloric acid by parietal cells of the stomach are

a) gastrin

2
b) histamine
c) the initiation of wandering nerve
d) increase the level of calcium in the blood
e) all of the above

14. Stenosis III. the pyloric part of the stomach needs

a) immediate laparotomy and resection of the stomach in all cases

b) operation after intensive parenteral therapy, correction of volemic disorders
c) contrast and endoscopic examination of the stomach, repeated gastric lavage with hydrochloric acid
solution, if malignancy is suspected - operation
d) immediate laparotomy, blood transfusion and plasma replacement solutions, use of antibiotics.
Depending on the condition of the peritoneum, decide on the nature of the operation
e) conservative therapy, surgical treatment is not indicated

15. the symptoms of a stenotic duodenal ulcer include all of the listed, except

a) vomiting
b) splashing on the projection of the stomach
c) the availability of bowls Kloybera
d) burping
e) weight loss

16. To prepare the patient for surgery for stenosis of the stomach ulcer origin, you must perform all
the following activities except

a) the appointment of hydrochloric acid with pepsin in large quantity

b) gastric lavage
c) introduction of electrolyte solutions
d) introduction of protein solutions
e) correction of acid-base state disorders

17. In a patient with duodenal ulcer, the study of gastric secretion revealed: high secretion and
acidity in the basal and cephalic phases and normal acidity in the gastric phase. The most rational
operation in this case is

a) Subtotal resection of the stomach

b) vagotomy with pyloroplasty
c) vagotomy without draining operation
d) resection to switch off
e) gastroenteroanastomosis

18. Resection to switch off can be performed

a) with a low postbulbar ulcer

b) when the ulcer penetrates into the hepatic-duodenal ligament
c) with dense inflammatory infiltrate in the area of the duodenum
d) in none of the above cases
e) in all of the above cases

19. The most informative in the differential diagnosis between gastric ulcer and ulcerated carcinoma
is

3
a) analysis of gastric juice
b) examination of feces for hidden blood
c) histamine test
d) positive effect on anti-ulcer treatment
e) esophagogastroscopy with biopsy

20. X-ray examination of the stomach revealed a stationary foreign body. In this case, you must

a) prescribe vaseline oil

b) prescribe mineral water
c) discharge the patient for outpatient observation
d) prescribe esophagogastroscopy
e) prescribe x-ray control

21. One of the early symptoms of acute expansion of the stomach after surgery is

a) hiccups
b) absence of bowel sounds
c) swelling in the epigastric region
d) tachycardia
e) vomiting

22. Acute expansion of the stomach can be quickly identified

a) a chest x-ray in the upright position

b) larapinta
c) nasogastric intubation
d) percussion of the abdominal wall
e) study of blood plasma on serotonin

23. A patient with acute gastric dilatation should not be used

a) nasogastric drainage of the stomach

b) infusion therapy
in) sedative therapy
d) antibiotic therapy
d) a continuous decompression of the stomach

24. The combination of alcohol intoxication with perforation of gastroduodenal ulcers, there are
certain diagnostic difficulties arising from

a) reduction of pain syndrome, which leads to the extinction of the reflexes from the anterior abdominal
wall
b) late uptake
c) possibility of psychosis
d) the possibility of suicide attempts
e) all of the above

25. Most reliable clinical signs of perforated ulcer are

a) vomiting
b) gastric bleeding
c) tension of the anterior abdominal wall, absence of hepatic dullness

4
d) frequent loose stools
e) hiccups

26. Malignant transformation is most often experienced

a) duodenal bulb ulcers

b) postbulbar ulcers
c) ulcers of small curvature of the stomach
d) ulcers of large curvature of the stomach
e) ulcers of all specified locations

27. absolute indications for surgical treatment of gastric ulcer are all listed, except

a) perforation
b) bleeding, not stopped by conservative methods
c) malignancy
d) large depth "niche" penetrating ulcers, detectable by x-ray
e) decompensated stenosis of the output division of stomach

28. The presence of perforation of a stomach ulcer or duodenum allows us to judge

a) a Board-shaped stomach
b) severe epigastric pain
C) pain in the lumbar region
d) increased leukocytosis up to 15,000
е) mild jaundice of the sclera and skin

29. Muscle tension in the right iliac fossa, often associated with a perforated duodenal ulcer can be
explained

a) leaking the contents on the right side of the channel

b) reflex connections through the spinal nerves
c) accumulation of air in abdominal cavity, particularly in the right iliac region
d) developing the poured peritonitis
e) the viscero-visceral reflex with the vermiform Appendix

30. Urgent surgical intervention is required when the following complications of peptic ulcer disease

a) stopped the GI bleeding

b) perforated ulcer
c) penetrating ulcer
d) the stenosis of target Department of a stomach
e) malosnezhnaja ulcer

31. Economical gastric resection that was performed for peptic ulcer disease, often leads to

a) dumping syndrome
b) hypoglycemic syndrome
c) syndrome of "small stomach"
d) peptic ulcer of the anastomosis
e) the syndrome resulting loops

32. Peptic ulcer of the duodenum must be differentiated from all the following diseases except

5
a) chronic cholecystitis
b) chronic colitis
c) chronic appendicitis
d) chronic pancreatitis
e) Mesoamerica

33. For chronic duodenal ulcer is a common complication

a) bleeding
b) malignancy
c) perforation
d) penetration into the pancreas
e) stenosis of the output part of the stomach

34. Relative indications for surgery for gastric ulcer are all listed, except for

a) large ulcers
b) ulcers of great depth (penetrating)
c) low acidity of gastric juice
d) failure of conservative treatment
e) callous ulcer

35. the characteristic signs of pyloric stenosis are all listed, except

a) jaundice
b) noise of splashing on an empty stomach
c) weight loss
d) belching " rotten"
e) pain in the epigastrium arching nature

36. Complaints characteristic for ulcer of the duodenum are all of these reasons except

a) pain in 1-1. 5 hours after a meal

b) jaundice
c) irradiation of pain in the lumbar region
d) night pain
e) vomiting

37. The most common localization of perforations in patients with peptic ulcer of the stomach and
duodenum is
a) duodenum
b) the pyloric part of the stomach.
c) a small curvature of the stomach
d) a large curvature of the stomach
e) cardiac region of stomach

38. For the syndrome Mallory Weiss syndrome characterized by the formation of cracks
a) in the abdominal esophagus
b) in the cardiac Department of the stomach
c) in the antrum of the stomach
d) in the pyloric stomach
e) in the body of the stomach

6
 39. For the dumping syndrome are not typical

a) muscle weakness
b) dizziness
c) tides
d) sweating
e) increased appetite

40. Conservative treatment of perforated gastric ulcer or duodenal ulcer according to Taylor consists

a) in the use of alkalis and agents that reduce gastric peristalsis

b) in periodic (every 4-5 hours) probing of the stomach, intravenous fluid infusion and pharmacological
blockage of the vagus nerve
c) in constant gastric lavage with chilled saline solution
d) in local hypothermia and intravenous fluid infusion
e) in constant aspiration of the stomach contents with intravenous fluids, the appointment of antibiotics

41. The most common cause of insolvency seams duodenal stump after gastric resection is

a) hypoproteinemia
b) hypotension during surgery
c) axial rotation of the small intestine
d) duodenitis
e) postoperative pancreatitis

42. Ways of distribution of gastrointestinal content in perforation of the stomach and duodenum
depend

a) the location of the stomach

b) localization of the holes perforated
c) from the anatomical structure of the lateral channels
d) the shape and arrangement of the transverse colon
e) all the above

43. Insolvency seams stump duodenum should be differentiated

a) insolvency of the seams of the gastroenteroanastomosis

b) with postoperative pancreatitis
c) with postoperative peritonitis
d) insolvency of the seams of the lesser curvature
e) all the above

44. Treatment for maintenance of anastomositis after resection of the stomach is

a) enzyme therapy
b) antibiotic therapy
c) nasogastric intubation
d) radiotherapy
e) all of the above

7
 45. 2 hours after gastric resection, blood flows from the stomach stump through a permanent
nasogastric probe. The rate of blood loss is about 500 ml per hour. Hemostatic and replacement
therapy is performed. In the absence of effect from it should

a) to continue local haemostatic therapy

b) to increase the pace of introduction of blood
c) to take urgent gastroscopy for the purpose of hemostasis
d) pour fibrin
e) urgently to operate the patient

46. At the time of perforation of gastric ulcer or duodenal ulcer is most common

a) tachycardia
b) cramping pain
c) localized, moderate pain
d) a sudden intense pain
e) loose stools

47. Covered perforation of ulcer of stomach or duodenum contribute

a) small diameter of the holes perforated

b) a slight filling of the stomach
c) topographic proximity of adjacent organs
d) the large diameter of the holes perforated
e) well-developed omentum

48. In perforated duodenal ulcer is more often used

a) resection of the stomach

b) different types of vagotomy in combination with sparing resection of stomach and other draining
operations
c) suturing perforated ulcer
d) closure of + the gastroenteroanastomosis
e) resection of stomach for a shutdown

49. Recurrence of gastroduodenal bleeding most likely

a) when quesnoy ulcer

b) penetrating ulcer
c) a superficial erosion of the mucosa
d) if trombirovanne vessel in the bottom of the ulcer with a diameter of more than 0. 1 cm
e) in resistant ulcers

50. Stomach cancer always metastasizes

a) in light
b) in the liver
c) in regional lymph nodes
d) bones
e) peritoneal

51. With high obturation of the bile ducts, all the following symptoms come to the fore, except

8
a) severe fever
b) the rapid onset of jaundice
c) quick weight loss
d) severe skin itching
e) dyspeptic disorders

52. Infiltrative form of cancer of major duodenal papilla may cause all of the above, except

a) extensive infiltration of the duodenal wall

b) deformation of the duodenum
c) stenosis of the duodenum
d) persistent paresis of the intestine
e) tumor invasion to the pancreas head

53. Surgical intervention in acute pancreatitis is indicated for all these conditions, except

a) growth of intoxication
b) complications of the purulent peritonitis
c) the failure of conservative therapy within 12-28 hours
d) combination with destructive form of cholecystitis
e) a sharp bloating

54. Causes of acute pancreatitis can be all of the following except

a) duodenostasis
b) stenosis of the sphincter of Oddi
c) Allergy
d) reflux of bile in pancreatic duct
e) infectious diseases (hepatitis)

55. Acute pancreatitis may occur under the influence of all of these factors, except

a) medications (diuretics, ACTH, aspargin)

b) pancreatic injuries
c) surgery on the large duodenal papilla
d) surgery on the abdominal organs
e) thyrotoxicosis

56. in acute pancreatitis, all these complications are possible, except

a) pancreatic abscess
b) retroperitoneal phlegmon
c) enzymatic peritonitis
d) acute heart failure
e) obturation intestinal obstruction

57. In the treatment of acute pancreatitis must not be used

a) the aspiration of stomach contents

b) the introduction of calcium gluconate
c) cholecystostomy
d) antispasmodics
e) preparations of opium

9
 58. The abdominization of the pancreas, produced in acute pancreatitis, contributes to all of the
above, except
a) limitations of the pathological process in the abdominal cavity
b) termination of admission of enzymes and degradation products in the retroperitoneal space
c) the cessation of revenues from enzymes and degradation products in the mesentery of the colon and
small intestine
d) improve blood supply to the gland
e) reducing the activity of proteolytic enzymes

59. The protease inhibitors

a) inhibit proteolytic activity of pancreatic enzymes

b) block autocatalysis activation of trypsinogen in the pancreas
c) inhibit the processes of kininogenesis and fibrinolysis in the blood
d) cropped the processes of kinins
e) all of the above

60. At deducing of the patient from pancreatogenic shock should be implemented all the actions
except

a) the need to stop pain

b) fill the exchange of circulating blood
c) the appointment of large doses of antibiotics
d) conducting of complexsocial
e) treatment of disorders of contractile myocardium function

61. In the remote period of the disease the outcome of acute pancreatitis can be all of these diseases
except

a) education false cysts

b) development of chronic pancreatitis
c) the emergence of diabetes
d) development of cystic fibrosis of the gland
e) the occurrence of insuloma

62. The efficacy of protease inhibitors in acute pancreatitis is characterized by all the above, except

a) decrease pain
b) disappearance of symptoms pancreatogenic toxemia
c) increasing the activity of the kallikrein-kinin system of blood
d) reduction of leukocytosis
e) reduce the degree of lymphocytopenia

63. In acute pancreatitis the greatest number of activated pancreatic enzymes contains

a) in the arterial blood

b) in venous blood
c) in the exudate of the abdominal cavity
d) lymph
e) in urine

64. The most common cause of acute pancreatitis in women can be

10
a) pregnancy
b) chronic cholecystitis
c) the alcoholism
d) abdominal trauma
e) the use of corticosteroids

65. The level of amylase in the urine is considered abnormal if it is

a) 16 units
b) 32 units
c) 64 units
d) 128 units
e) 256 units

66. For fat necrosis is characteristic of all of the above except

a) the formation of postnecrotic infiltrate in epigastric area and left upper quadrant
b) izolirovannogo transverse colon
c) the presence in large quantity of hemorrhagic fluid in the peritoneal cavity
d) positive Voskresensky symptom
e) involvement in the inflammatory process of the mesenteric gland and major vessels, stomach and
intestines

67. The most frequent complications of acute pancreatitis include all of the following except

a) abscess of the pancreas or the packing bags

b) abscesses of the retroperitoneal cellular spaces and the abdomen
c) phlegmon of retroperitoneal fat, greater omentum, and mediastinum
d) peritonitis
e) septic endocarditis

68. Urgent medical complex in acute pancreatitis should provide all of the above except

a) the relief of pain

b) removing the spasms of the sphincter of Oddi
c) accelerate the sequestration of pancreatic tissue
d) reduction of the secretory activity and swelling of the pancreas
e) inactivitate proteases in the blood and detoxification

69. In the pathogenesis of acute pancreatitis may play a role

a) surgical trauma
b) cholelithiasis
c) penetrating peptic ulcer
d) alcohol
e) all of the above factors

70. The most common cause of acute pancreatitis in men is

a) abdominal trauma
b) the use of corticosteroids
c) the alcoholism

11
d) chronic cholecystitis
e) cirrhosis of the liver

71. The development of toxemia in acute pancreatitis is due to these factors, in addition to

a) getting into the blood and lymph toksogennye polypeptides

b) getting into the blood and lymph toksogennye lipids
c) getting into the blood and lymph pancreatic enzymes and biogenic amines
d) activation of the kallikrein-kinin system and fibrinolysis system enzyme blood
e) presence of high leukocytosis and lymphocytopenia

72. Causes of development of fistula of the cecum after appendectomy are

a) the extent of inflammatory and destructive changes in the process

b) diagnostic errors
c) technical errors during the operation
d) errors in the tactics of treatment and management of the postoperative period
e) all of the above

73. Incomplete treatment of immature fistulas of the colon opening into the purulent cavity includes
-(1) opening and drainage of purulent streaks -(2) active aspiration of wound -(3) radical urgent
surgery(4) intensive therapy(5) disconnection of the fistula through the imposition of unnatural
anus

a) right 1, 2, 3 and 4
b) correct 2, 3, 4 and 5
c) correct 1, 3, 4 and 5
d) right 1, 2, 4 and 5
e) correct 1, 2, 3, and 5

74. Patients with peritonitis among these complications the most common

a) eventrate
b) the formation of intestinal fistula
c) pulmonary embolism
d) formation of abdominal ulcers
e) pneumonia

75. Leading in the treatment of patients with peritonitis is

a) surgical intervention
b) detoxification therapy
c) rational antibiotic therapy
d) suppression of intestinal paresis
e) the elimination of the causes leading to disruption of external respiration

76. Perforation of any hollow organ of the abdominal cavity is characterized by all of these
symptoms except

a) the appearance of a sharp pain

b) the tension in the muscles of the anterior abdominal wall
c) bradycardia
d) Frenikus-symptom

12
e) the Mayo - Robson symptom

77. The severity of peritonitis is most dependent on all these factors, except

a) body weight of the patient

b) the nature of the microflora
c) the severity of intoxication
d) hypovolemia
e) extent of the violation, protein, and electrolyte metabolism and acid-base balance

78. When sowing peritoneal exudate, growth is most often noted

a) Staphylococcus
b) Proteus
c) Escherichia coli
d) mixed flora
e) anaerobic flora

79. The immediate causes of the damage of the main bile duct can be all of these reasons except

a) congenital anomalies and variability of the topography ducts

b) inflammatory-infiltrative changes in the area of hepatoduodenal ligament
c) technical and tactical errors of surgeons
d) investigation of duct with probes, bougies, spoons and other tools
e) palpation of a study of the ducts in a patient with strangulated in the region of the papillae to provide
stone

80. Unnoticed injuries of the extrahepatic bile ducts may result in the postoperative period to all
these serious complications, except

a) limited or diffuse bile peritonitis

b) education subhepatic abscesses
c) development of external biliary fistula
d) thromboembolism of small branches of pulmonary artery
e) development of subphrenic abscess

81. To eliminate damage to the extrahepatic bile ducts is possible

a) usiv the injury of the duct sutures, atraumatic needle

b) staple the flow on a T-shaped drainage
c) staple the flow on an l-shaped drainage
d) imposing biliodigestive anastomosis
e) any of the following

82. For cholangitis is characteristic of

a) fever, often manifested by high fever hectic type

b) stunning chills
c) increase sweating, thirst, dry mouth
d) enlargement of the spleen
e) all of the above

83. The symptoms and signs of obstructive jaundice induced calculous cholecystitis, are all of these
reasons except

13
a) paroxysmal pain of biliary colic type
b) rapid development of jaundice after pain attack
c) the gall bladder is often not palpable, the area sharply painful
d) weight loss, severe weakness
e) non-intense itching of the skin

84. Patients with choledocholithiasis may have all of the following complications, except

a) cholangitis
b) obstructive jaundice
C) scarring of the duct
d) bedsores of the duct wall
e) gallbladder cancer

85. When sharpening a stone in the area of the large duodenal papilla

a) perform a duodenotomy, remove the stone and suture the intestine

b) apply a choledochoduodenostomy
c) after duodenotomy and extraction of the stone, drain the choledoch through the stump of the cystic
duct
d) open the choledoch and try to remove the stone; if this fails to perform a duodenotomy, remove the
stones, suture the duodenal wound and drain the common bile duct.
e) apply choledochoenterostomy

86. Rational treatment of cholelithiasis

a) food
b) medical
c) surgical
d) sanatorium- Spa treatment
e)mineral water treatment

87. Intermittent jaundice can be explainedby

a) cystic duct stone

b) gallstones with occlusion of the cystic Duct
c) wedge-shaped stone of the large duodenal nipple
d) ventilation stone of choledochus
e) tumor of extrahepatic bile ducts

88. When operating for acute cholecystitis complicated by pancreatitis (edematous form), the most
appropriate surgical tactics should be considered

a) typical cholecystectomy
b) after removal of the gallbladder, drain the choledoch through the stump of the cystic duct
c) after cholecystectomy, drain the common bile duct with a T-shaped drainage
d) after cholecystectomy, a drainage packing bag
e) apply a cholecystostomy

89. The Most common causes of acute biliary hypertension include

a) a tumor of the hepatopancreatoduodenal region

14
b) stenosis of the large papilla of the duodenum
c) choledocholithiasis as a complication of cholelithiasis and cholecystitis
d) duodenal hypertension
e) helminthic invasion

90. During the operation for cholelithiasis, a shrunken gallbladder was found, filled with stones and
expanded to 2.5 cm by the common bile duct. The patient should
a) perform a cholecystectomy
b) perform a cholecystectomy, then a cholangiography
c) directly perform a cholecystectomy and revision of the duct
d) apply a cholecystostomy
e) perform a duodenotomy with revision of the large duodenal papilla

91. Acute cholecystitis must be differentiated

a) perforated gastric ulcer

b) with a penetrating duodenalulcer
c) with right-sided basal pneumonia
d) in acute appendicitis with an atypical location of the Appendix
e) with all of the above

92. Acute destructive cholecystitis can lead to the following complications

a) spilled bile peritonitis

b) limited to abdominal ulcers (subhepatic, subhepatic, etc.), liver abscess
c) cholangitis
d)edema of the gallbladder
e) All of the above

93. A 50-year-old patient suffers from calculous cholecystitis, diabetes and angina. The most suitable for
her

a) diet therapy, the use of antispasmodics

b) Spa treatment
c) planned surgical treatment
d) treatment of diabetes and angina
e) surgical treatment only for vital indications

94. Jaundice in acute cholecystitis develops as a result of all of the above, with the exception
of

a) choledocholithiasis
b) obturation of the stone or mucous plug of the cystic duct
c) pancreatic head edema
d) cholangitis
e) helminthic infection of the common bile duct

95. Percutaneous transhepatic cholangiography is a method for diagnosing

a) liver abscess
b) intrahepatic vascular block
C) biliary cirrhosis of the liver
d) obstruction of the biliary tract in mechanical jaundice

15
d) chronic hepatitis

96. Recognition of the causes of obstructive jaundice was most promoted by

a) oral cholecystography
b) intravenous cholecystocholangiography
c) retrograde (ascending) cholangiography
d) liver scintigraphy
e) direct splenoportography

97. The occurrence of Purulent cholangitis is most often associated with

a) cholelithiasis
b) stenosis
c) reflux of intestinal contents through a previously imposed biliodigestive anastomosis
d) pseudotumor pancreatitis
e) pancreatic head tumor

98. The gallstone that caused obstructive intestinal obstruction enters the intestinal lumen most often
through the fistula between the gallbladder and

a) the caecum
b) slight curvature of the stomach
c) duodenum
d) jejunum
e) colon

99. The common bile duct should be evaluated in all patients

a) with mechanical jaundice

b) pancreatitis
c) when the common bile duct is dilated
d) with the choledocholithiasis clinic
e) in all of the above situations

100. Complications of gallstone disease include

a) gangrene and empyema of the gallbladder

b) acute pancreatitis
c) jaundice
d) cholangitis
e) All of the above

101. For the first time in medical practice, he performed

a) cholecystectomy.
b) Langenbuch K.
C) Monastyrsky N. D.
d) Fedorov S. P.
d) ker G.

102. Cicatricial stricture of extrahepatic bile ducts is accompanied by all of the above, with the exception
of

16
a) development of bile hypertension
b) stagnation of bile
c) formation of concretions and putty
d) development of mechanical jaundice
e) duodenostasis

103. Gallstones most often consist of

a) cholesterol
b) cystine
c) from oxalates
d) bile salts
e) uric acid

104. Gall bladder holsterol are most often combined

a) acute cholecystitis
b) for cholelithiasis
c) for malignant tumors of the gastrointestinal tract
d) gallbladder cancer
e) in chronic non-specific lung diseases

105. By the predisposing factors leading to the development of intestinal obstruction include all of these
except

a) congenital abnormalities of the intestinal tube (malattia, diverticulum of Mekele, the presence of
cracks, holes in the mesentery, etc.)
b) excessive mobility of the organs in congenital or acquired nature
c) presence of adhesions, bands, adhesions
d) change of motor function of the intestine with a predominance spasm or paresis
e) the presence of different formations in the lumen of the intestine, originating from its wall or
adjacent organs

106. which of these can cause a bowel obstruction

a. hernia
b. gout
c. diabetes
d. arthiritis

107. toxic megacolon is seen in

a. removal of pylorus
b. ulcerative colitis
c. ischemic colitis
d. subtotal gastrectomy

108. Overgrowth of the intestinal wall in acute intestinal obstruction is promoted by

a) digestive juices
b) food masses
c) gases
d) transudate
e) all of the above

109. the Main causes of hypernatremia in acute intestinal obstruction are all listed, except

17
a) loss of sodium with digestive juices
b) movement of sodium into cells (transmineralization)
c) decrease in sodium levels due to the development of metabolic alcolosis
d) excretion of sodium in the urine
e) insufficient intake of sodium in the body

110. Naso-gastro-intestinal intubation can cause all of the above, except

a) sinusitis and otitis

b) bronchitis and pneumonia
c) pulmonary artery thrombosis
d) esophageal and laryngeal stenosis
e) rupture of esophageal varicose veins

111. In acute intestinal obstruction, the following pathophysiological disorders occur

a) violation of blood supply in the intestinal wall and blood deposition in the intestinal wall
b) decrease in the volume of circulating blood
c) development of tissue hypoxia
d) violation of the cardiovascular system
e) all of the above

112. Increased intra-intestinal pressure and overstretching of the intestinal wall in acute intestinal
obstruction leads to all of the above changes, except for

a) deterioration of lung ventilation

b) additional fluid loss
c) additional loss of proteins and red blood cells
d) the occurrence of mesenteric thrombosis
e) the development of functional intestinal obstruction

113. The severity of the patient's condition with nodular formations is due to
a) intoxication
b) losses of fluid and electrolytes
c) shutting down of the circulation of large volumes of plasma
d) the exclusion from circulation of significant amounts of red blood
e) all of the above

114. In acute intestinal obstruction, vomit has all the listed features, except

a) mainly gastric contents

b) mainly small-intestinal contents
c) mainly large-intestinal contents
d) with a fecal smell
e) the color of coffee grounds

115. Pain in acute intestinal obstruction is characterized by all of the above, except

a) usually occurs suddenly, regardless of food intake, at any time of the day, without precursors
b) often has a paroxysmal character
c) has an increasing character throughout the entire period of the disease
d) there is no clear localization in any part of the abdominal cavity

18
e) it is permanent, not completely disappearing during the extra-paroxysmal period

116. Fluid Loss in acute intestinal obstruction occurs

a) with vomit
b) with exhaled air in the form of water vapor
c) with the skin surface in the form of sweat
d) with urine
e) all the ways listed

117. intussusception is most common in which age group

a. 5-10 months
b. 1-2 years
c. > 3 years
d. 18-25 years

118. which is best proven to mainstay remission in crohn’s diseases

a. salicylites
b. methotrexate
c. sulfadiane
d. glucocorticoids

119. comb sign is seen in ct

a. crohn’s disease
b. tuberculosis
c. gastroenterostomy
d. lymphoma

120. One of the early diagnostic symptoms of acute intestinal failure is a symptom of Val, which is
characterized by

a) "splashing", defined in a limited area or around the abdomen

b) breath sounds and heart sounds heard through abdominal wall
c) the presence of inflated intestinal loops, determined by bimanual, rectal and vaginal study
d) "empty" ileocecal region
e) clearly demarcated a stretch of the intestinal loop, which is determined by palpation of the abdomen

121. Radiological signs of acute intestinal obstruction are all of these reasons except

a) fluid in the intestinal loops dominates over gas

b) flatulence mild and usually refers to the part in which there is an obstacle
c) significant accumulation of fluid and gas in the stomach in connection with its expansion
d) the Cloibera bowls are clearly contoured and usually defined in large numbers
e) the diaphragm is located at the usual level and is well movable

122. Signs of non-viability of the intestine in acute intestinal obstruction may be

a) loss of intestinal tone and lack of peristalsis
b) cyanosis of the intestine
c) dullness of the peritoneal cover
d) lack of pulsation of the mesentery vessels
e) all of the above

123. To determine the viability of a cyanotic non-peristaltic colon that has lost its tone in acute intestinal
failure, the following methods are used

19
a) the heating of the intestine wipes moistened with hot saline solution and wait for 5 minutes
b) the introduction in the mesentery of 50-60 mm 0. A 25% solution of novocaine
c) the application of the serous covering of the intestine salt
d) all of the above
e) none of these methods are not suitable for determining the viability of the bowel

124. Necrobiotic changes in the wall of the intestine in strangulated intestinal obstruction start from the

a) serous cover
b) muscle layer
c) submucosal layer
d) mucus layer
e) from all layers simultaneously

125. The operation regarding the inversion of the sigmoid colon can be finished in any of the following
operational techniques, in addition to

a) datorii
b) signapex
c) matchmobile
d) resection of the sigmoid colon
e) removing nekrotizirovannah the sigmoid colon into the wound with the imposition of anastomosis
between the adductor and abductor knees

126. Treatment of volvulus of the sigmoid colon in the early stages of the disease without signs of
intoxication can be conservative and be

a) in the application of barium enema

b) stretching the twisted sigmoid colon with the help of a probe introduced through the proctoscope by
Brunsgaard
c) the smoothing of the inversion using the colonoscope
d) any method of the treatment options
e) none of the above methods of treatment

127. Surgical treatment of volvulus of the sigmoid colon currently includes the following methods except

a) one-stage resection a viable dolichosigma with anastomosis

b) simultaneously nekrotizirovannah resection of sigmoid intestine with anastomosis
c) resection of the sigmoid colon with the imposition of an unnatural anus with removal to the
abdominal wall, both the Central and peripheral ends of the sigmoid colon
d) Hartmann or Hartmann type operations
e) turning the dead sigmoid colon and removing it through the anus to the outside

128. Small violations of water-electrolyte and protein metabolism occur

a) with adhesive intestinal obstruction

b) with obturation intestinal obstruction
c) with strangulation intestinal obstruction
d) with a paralytic form of dynamic intestinal obstruction
e) with spastic form of dynamic intestinal obstruction

129. With high small bowel obstruction, the complex of therapeutic measures should begin

20
a) with surgery
b) with infusion therapy
c) with the introduction of a nasogastric probe
d) with antibiotic therapy
e) with the use of anticolinesterase drugs

130. In the treatment of pancreatic cysts, cystogastrostomy is used, frequent complications after this
operation are

a) esophagitis caused by trypsin ingestion

b) cyst recurrence
c) postoperative bleeding
d) infection
e) malignant degeneration

131. the Best treatment for a congenital pancreatic cyst is

a) medication
b) marsupialization
c) resection of the pancreatic body
d) radiation therapy
e) excision of the cyst

132. In the treatment of pancreatic cysts, the position of anastomoses with the gastrointestinal tract is
often practiced. The best of them is

a) cystogastrostomy
b) cystoejunostomy with an inter-intestinal anastomosis
c) cystoejunostomy on a disconnected loop
d) none of the listed anastomoses
e) all of the listed anastomoses

133. a pancreatic Tumor can be detected by the following indirect signs, except for

a) expansion of the bile ducts

b) an increase in the size of the gallbladder
c) an increase in retroperitoneal lymph nodes
d) the presence of liver metastases
e) an increase in the size of the kidneys

134. The practical meaning of the symptom Courvoisier is in all of the above, except

a) helps to identify the nature of jaundice

b) indicates with the greatest probability about the presence of the tumor and its localization in the
distal bile duct
c) provides assistance in establishing the diagnosis without using any additional research
d) provides assistance in determining the degree of liver function disorders
e) provides assistance in developing treatment tactics

135. With cancer of the pancreas and extrahepatic bile ducts, patients may experience all of the listed
complications, except

a) hepatic-renal failure

21
b) diabetes mellitus
c) ascites
d) adrenal insufficiency
e) bleeding from the gastrointestinal tract

136. Ascites in pancreatic cancer can be caused by all the listed causes, except

a) peritoneal carcinomatosis
b) portal circulation disorders due to cancer metastases to the liver
c) compression of the portal vein by a tumor
d) portal vein thrombosis
e) splenomegaly

137. In the areas of pancreatic tissue adjacent to the tumor, all these processes are observed, except for

a) sclerosis
b) atrophy of the gland
c) chronic inflammation
d) fat necrosis
e) the formation of many cysts

138. The clinical picture of cancer of the pancreatic head is not affected

a) the size of the tumor

b) from the tumor
c) from the relationship of the tumor to the common bile duct
d) the spread of the tumor to the duodenum
e) dissemination of the tumor in the splenic hilum

139. In pancreatic cancer, metastases can be found in any organ of the human body. This is due to all of
the above, except

a) the rich blood supply to the pancreas

b) the possibility of the tumor sprouting large vessels
c) the nature of the structure of the peritoneal lymphatic system, which consists in the presence of a
dense network of anastomoses of lymph nodes
d) the possibility of contact transfer of cancer cells along the peritoneum
e) the connection of the pancreas through the ducts with the gastrointestinal tract

140. in patients with pancreatic cancer, when the pancreatic duct is obturated by a tumor, all the listed
symptoms occur, except

a) pain in the upper abdomen

b) disorders of food digestion
c) intestinal disorders
d) weight loss
e) the disappearance of diabetes mellitus, if it occurred before the appearance of the tumor

141. The main symptoms encountered in cancer patients biliopancreatoduodenal zone in the pre-icteric
period, are all of these reasons except

a) weakness, fatigue
b) aparecio, nausea

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c) weight loss of diabetes
d) abdominal pain
e) development of renal failure

142. For tumors of the islet tissue of the pancreas is not typical

a) hypoglycemia 2 below. 8 mmol/l

b) disappearance of symptoms after intravenous glucose
c) brain disorders in the fasted state
d) nausea and vomiting in the fasted state
e) enlargement of the head of the pancreas

143. Acute appendicitis in the 1st phase is necessary to differentiate from:

a) gastric ulcer
b) pancreatitis
c) cholecystitis
d) intestinal obstruction
e) strangulated hernia

144. After appendectomy the patient stands out of bed on:

a) first day
b) second day
c) third day
d) fourth day
c) fifth day

145. After appendectomy to early postoperative complications belongs:

a) peritonitis
b) intestinal fistula
c) ventral hernia
d) ligature fistula
e) colitis

146. After appendectomy to late postoperative complications belongs:

a) intestinal fistula
b) appendicular infiltrate
c) pilephlebitis
d) peritonitis
e) colitis

147. Appendectomy after the treatment of appendicular infiltrate performed after:

a) 2-4 months
b) 1-2 weeks
c) 3-4 weeks
d) 1-2 months
e) 3-5 days

148. Appendectomy, as a rule, is performed under such anaesthesia:

23
a) intravenous anaesthesia
b) local anaesthesia
c) ether anaesthesia
d) conducting anaesthesia
e) endotracheal anaesthesia

149. Appendicular infiltrate appears after:

a) 3-5 days
b) 1-2 days
c) 5-6 days
d) 7-8 days
e) 8-10 days

150. Appendicular infiltrate is treated:

a) conservative therapy, then surgery

b) only conservative therapy
c) puncture
d) drainage
e) only surgical treatment

151. Appendicular infiltrate is treated:

a) antibiotics, paranephral blockade, detoxication therapy

b) antiseptics, analgesia, antibiotics, anti-inflammatory therapy
c) antibiotics, diuretics, antispasmodic, anti-inflammatory therapy
d) analgesia, antibiotics, diuretics, anti-inflammatory therapy
e) anti-inflammatory drugs, paranephral blockade, detoxication therapy

152. Bartomier’s sign is typical for:

a) acute appendicitis
b) acute cholecystitis
c) acute intestinal obstruction
d) food poisoning
e) acute pancreatitis

153. Black colour, fibrino-purulent fur, perforation are the signs of:

a) gangreno-perforative appendicitis
b) phlegmonous appendicitis
c) gangrenous appendicitis
d) catarrhal appendicitis
e) dystrophic appendicitis

154. Black colour, fibrino-purulent fur, pus in the lumen are the signs of:

a) gangrenous appendicitis
b) phlegmonous appendicitis
c) catarrhal appendicitis
d) gangreno-perforative appendicitis

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e) dystrophic appendicitis

155. Blumberg’s sign in Petit triangle is:

a) Gabay’s sign
b) Rovsing's sign
c) Sitkovsky's sign
d) Obrastsow's sign
e) Kulenkampf's sign

156. Blumberg’s sign is typical for:

a) acute appendicitis
b) acute thrombophlebitis
c) pneumothorax
d) food poisoning
e) bleeding ulcer

157. Causes of the appendicular infiltrate development:

a) late hospitalisation, misdiagnosed appendicitis

b) aggressive infection, impaired immunity
c) adhesions, increased immunity
d) peritonitis, abscessing
e) surgical trauma, infection

158. Characteristic changes in the general blood analysis in appendicitis:

a) neutrophil leucocytosis with deviation of the differential count to the left

b) neutrophil lymphocytosis with deviation of the differential count to the left
c) neutrophil eosonophilia with deviation of the differential count to the left
d) neutrophil leucocytosis with deviation of the differential count to the right
e) white cells neutrophilia with deviation of the differential count to the right

159. Chronic primary appendicitis - is the development of pathological changes in appendix after:

a) without the signs of acute appendicitis in anamnesis

b) acute appendicitis
c) appendicular infiltrate
d) appendicular abscess
e) pilephlebitis

160. Chronic residual appendicitis arises up after:

a) acute appendicitis
b) chronic appendicitis
c) colicks
d) recurrent appendicitis
e) primary chronic appendicitis

161. which is not true for emphysematous cholecystitis

a. associated with acalculuscholecystitis

25
b. common with diabetes
c. air is seen in lumen of gall bladder causing symptom of acute cholecystitis
d. clostridia is present

162. prophylactic cholecystectomy is not recommended for

a. heart transplant recipitents
b. diabetes mellitus
c. incidental gall stones on laparotomy
d. urea breath test

163. What volume of blood lost at a unspecific ulcerative colitis does consider complications?
a) 300 ml and more
b) 200-300 ml
c) 150-200 ml
d) 50-100 ml
e) To 50 ml
164. Which preparation is used for treatment of unspecific ulcerative colitis
a) ketanov
b) analgin
c) cerucal
d) fenolftaleine
f) sulfasalasine
g)
165. What part of intestine of most often is a pathological process localized in at Crohn disease?
a) Sigmoid bowel.
B
b) Lumbar part of colon bowel.
c) Ascending part of colon bowel.
d) Rectum.
e) Terminal part of small intestine.
f)
166. What operation is performed at the Crohn disease?
a) Application of colostomy.
b) Resection of large and small intestine.
c) Subtotal colectomy.
d) Proctocolonectomy.
e) A resection of bowel within the limits of healthy tissues.
167. What method of examination is used to confirm the diagnosis of Crohn disease?
a) Rectoscoopy
b) Sonography
c) Sciagraphy
d) CT
e) A biopsy is with histological examination

168. What medicines is used for treatment of unspecific ulcerative colitis?

a) Furazolidonum.
b) Aspirine.
c) Nospanum, papaverini.
26
d) Ampicillin.
e) Sulfasalazinum.
169. What layers of the bowel are damaged at Crohn disease
a) muscle
b) submucous
c) submucous and muscle
d) mucus
e) all of layers
170. What is the operation of choice at the unspecific ulcerative colitis?
a) Resection of colon.
b) Subtotal colectomy.
c) Bypassed loop anastomosis.
d) Proctocolonectomy with Ileostomy.
171. which is not found in ultrasound of acute cholecystitis
a. pericholecystic fluid
b. abscense of gall stones
c. anorexia
d.gall bladder thickness more than 6mm

172. What form of unspecific ulcerative colitis is most dangerous?

a) Recurrent.
b) Chronic continuous.
c) Chronic recurrent.
d) Acute.
e) Fulminating.
173. Roentgenological signs of unspecific ulcerative colitis
a) bowls of Kloyber
b) symptom of «roadway»
c) defect of filling
d) symptom of "niche"
e) symptom of "water-pipe"
174. Patient has diarrhea up to 25-30 times per days with blood, has weight lost, general weakness, periodic
a) stomach-ache.
Spastic colitis He is ill during 1,5 month. What diagnosis?
b) Diverticulosis
c) Pseudopoliposis
d) colitis
e) Unspecific ulcerative colitis
175. On irrigography is found the symptoms of «water-pipe», «shot through target». What is diagnosis?
a) Food toxicoinfection
b) Salmonellosis
c) Dysentery
d) Crohn disease
e) Unspecific ulcerative colitis

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176. At Crohn disease is damaged
a) only sigmoid bowel
b) only rectum
c) only colon
d) only small intestine
e) all parts of gastrointestinal truct
177. not an indication of cholecystectomy in gall bladder adenoma

a. associated gall stones

b. size more than 1 cm
c. age > 60 years
d. > 3 in number
178. Classification of unspecific ulcerative colitis by its distribution
a) easy, middle, heavy
b) left-side and total colitis
c) chronic continuous and relapse
d) acute, quick
e) proctitis, proctosygmoiditis, left-side and total colitis
179. Classification of unspecific ulcerative colitis by its clinical management
a) easy, heavy
b) easy, middle, heavy
c) left-side and total colitis
d) proctitis, proctosygmoiditis
e) acute, fulminating, chronic continuous and relapse
180. Characteristic complications of unspecific ulcerative colitis
a) peritonitis
b) perforation, penetration
c) adhesion
d) pancreatitis, cholecystitis
e) bleeding, perforation, toxic dilatation of bowels

181. For colic, caused by cholecystolithiasis, characterized by:

a) normal temperature
b) Mayo-Robson’s symptom
c) Spizharniy's symptom
d) bradycardia
e) Blumberg’s symptom
182. most common types of gall stones:
a. cholesterol stones
b. calcium bilirubinate
c. pigment stones
d. radiolucent
28
 183. true about pigment stoners are
a. black pigment stones are common in chronic hemolytic states
b. brown pigment stones due to secondary to chronic biliary infection
c. never single
d. all of the above

184. black pigment stones-true statement

a. chronic hemolysis
b. alchol abuse
c. not associated with infected bile
d. all of the above

185. Gallstones can cause all except:

a) cholangitis
b) obstructive intestinal obstruction
c) duodenostasis
d) obstructive jaundice
e) acute pancreatitis
186. Cholelithiasis dangerous:
a) possible obstructive jaundice
b) there is no right answer
c) secondary pancreatitis,
d) cancerous degeneration of the gall bladder,
e) development cirrhosis of the liver
187.Most common site of gallstone formation
a. gall bladder
b. cystic duct
c. hepatic duct
d. common bile duct

188. sign and symptoms of acute cholecystitis are except

a. RUQ pain
b. jaundice
c. elevated wbc
d. nausea vomiting

189. Cholecystectomy at cholelithiasis is indicated at:

a) more than five concretions on holetsistogramme
b) cholesterosis gallbladder
c) gallstones that cause diarrheal phenomenon
d) no right answer
e) absence of filling the gall bladder on cholangiogram

29
190. Which disease is most commonly differentiate chronic cholecystitis?
a) chronic pancreatitis
b) gastric ulcer,
c) chronic gastritis,
d) duodenal ulcer,
e) stomach cancer
191. Which disease is first necessary to differentiate acute peritonitis?
a) endotoxicosis
b) acute vascularpurpura
c) myelotoxic anemia
d) enterorrhagia
e) bronchitis
192. The most informative method of instrumental diagnosis of peritonitis is:
a) colonoscopy
b) gastroscopy
c) angiography
d) laparoscopy
e) abdominal X-ray
193. What should be done in the case of postoperative peritonitis?
a) perform laparotomy
b) perform laparoscopy
c) perform laparocentesis
d) appoint pain
e) antibiotics
194. Preferred noninvasive test to confirm H.pylori eradication is
a. stool antigen
b. whole blood antibody
c. serological detection
d. urea breath test

195.what is triple therapy for h.pylori

a. proton pump inhibitors plus 2 antibiotics
b. antibiotics of three types
c. gastroenterostomy
d. surgical removal

196. Symptom toxic "scissors" with peritonitis are:

a) increase in temperature and decrease in respiratory rate
b) increase in temperature and decrease heart rate
c) reduction of temperature and increase heart rate
d) decrease in temperature and pulse
e) increase in temperature and pulse
197. Symptom toxic "scissors" in peretonite this relationship:

30
a) respiratory rate and temperature
b) rectal temperature
c) blood pressure and temperature
d) blood pressure and pulse
e) Pulse and temperature

198. For some surgical pathology characteristic symptom of toxic "scissors"?

a) mesodenitis
b) peritonitis
c) pancreatitis
d) cholecystitis
e) appendicitis
199. Aseptic peritonitis may be caused by:
a) intestinal contents
b) abscess
c) pancreatic juice
d) staphylococci
e) coli
200. what is pyroloplasty
a. removal of pylorus
b. procedure to widen the pylorus without vagus stimulation
c. cut vagus nerve
d. subtotal gastrectomy

201.which statement is correct regarding formation of peptic ulcers

a. stress
b. increase in gastric acid is only sole cause
c. releases of prostaglandins cause stomach line to break
d. fromed when hcl penetrates mucosa of stomach this causes histamine to be released and send signal
to parietal for more acid
202. h.pylori can live in stomach because it secretes --- that neutralize acid
a. ammonia
b. urease
c. carbon dioxide
d. bicarbonate
203. Alarming symptoms for peptic ulcer endoscopy are
a. vomiting
b. dysphagia
c. anorexia
d. hematememis or melena
e. All of the above
204. A patient arrives at clinic with epigastric pain the pain is relieved by eating .in addition he reports
awakening in night with pain in stomach . based on the symptoms what type of ulcers do he have
a. gastric
b. esophageal
c. duodenal
d. refractory

31
205. a patient is recovering from a peptic ulcer . the dr. adviced the patient to eat solid foods . which
food the patient should avoid eating ?
a. banana
b. orange
c. milk
d. white rice
206.who is most likely to develop appendicitis
a. obese
b. alcoholic person
c. between 10-30 years
d. person with acid reflux
207. long term effect of appendectomy is
a. fatigue
b. bloating
c. weight loss
d.none
208. surgery is the only method to treat appendicitis
a. true
b. false
209. whatare symptoms of appendicitis
a. loss of appetite , abdominal tenderness
b. abdominal pain , fever , vomiting
c. both a and b
d. none
210. appendicitis can be fatal
A. true
b. false

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