Caudate nucleus atrophy-huntingtons

U L
UK
I C M
E D
Microspherocytosis (abnormal spectrum,

M membrane defect
anchrin and band cells )
Mechanism-
Pregnant female having pneumonia,
allergic to penicillin - what drug should be
recommended to the patient?
A.fluoroqunolone
B.cephalosporin
C.Tetracycle
4.macrolide
5.treptomycin

U L
Drug for Lobar Pneumonia ?

UK
M
Azithromycin

D I C
E
Strepomycin

Mmore
Ciprofloxacin
something

Some history given..after that ecg showed

wide qrs(.13), reflex methods fails..what
drug to choose?
Amlodipine
Amiodarone
lidocaine
Strophantin etc)

Multiple sclerosis Treatment

U L
- steroid

UK
I C M
E D
Q. About M
WPW,

pt had some palpitation, then taken ecg

showed extended QRS with slight deviation
in begning of R wave. what is tx?
surgical ablation
lidocine
digoxin
steophantin
etc
Q. Patient gets smell of something then

L
suddenly bite tongue,involuntary urinates-

KU
U
Hysterical fits

I CM
D
Epileptic fits

E
M shape hematoma, cerebrall
Q. Biconvex
bleeding-
Ans. Epidural
Q. uterine contaction frm lower to upper-
Discordinated labor
Q.38 week preg, 2 weeks before had
covid..now fetal movements dx
option
Antenatal
Intranatal

L
Early peritnatal

KU
U
late perinatal

I CM
E D
M
chest pain radiating to left, st drepression in
some leads- options
STemi,
Nstemi,
angina
etc

> p wave absent, irreguglar rhythm, f waves-

*Atrial Fibrillation*

L
> p absent, regular rhythm, F waves- *Atrial

K U
U
Flutter*

I C M
acess kidneyE fnD
M
History of glomerulonephritis,high BP ,to
which indicator we will use

Ans - Creatinine

Ques .chicken pox child how many days to

isolate
Options
5days from rash,
10 days from contact,
21 days from start of rash
(Confusing questions start with rash ,end

L
with rash)

KU
U
If you get option like 5 days after the

I C M
appearance of Rash, mark that

E D
M

Q. History given + on ecg complete

dissociation of p and QRS, HR 44, what is
diagnosis?
2nd degree av block
3rd degree complete proximal
3rd degree complete distal

L
1st degree av block

KU
U
heart failur

I C M
E D
M

dressler syndrome- after mi,3weeks, pericardial

friction rub
There were many common ques like post step
tonsilits, rheumatic fever the usual ones
a little bit history was added with the ques to
confuse..thats all
femoral neck fracture was there..ext rotation,
shortening
For passing it was there..not copy paste but if

U L
you know the correct keywords you can get

UK
(around 80-85 questions)

I C M
E D
M

Symptoms of basal skull frac-

a) meningitis,kernigs,headache
b) nausea vomiting etc
*c) rhinorhea,racoon eyes,spectacular symptom
Child having occational dyspnea cyanosis,dx?
asthma
bronchitis
TOF
VSD

U L
U K
M
ICand mustache area.
A young man has made an appointment with

facial rash in theD

E
the dermatologist. He complains of a painful

M
beard
This condition has been persisting for several
weaks already. After shaving,the
patient‘s condition aggravates. The diagnosis
of sycosis is made. What primary
morphological elements
can be observed in the rash in this case? (2019)
1. Phlyctenae, maculae

2. Pustules, papulae

3. Nodes, nodules

U L
UK
4. Maculae, nodes

I C M
E D
M
5. Pustules, bumps

(Similar Question came in exam )

Q.During appointment with the doctor a man

complains of painful itching rashes that
appeared on his skin under the beard and
moustache one year ago, with frequent
exacerbations occurring throughout the year.
Objectively the skin of the facial hair growth
areas is bluish-purple, thickened, with pustules,
erosions, and scabs covering its moist
surface.The fistulous tracts are surrounded by
the area of loose pink-red granulation and
discharge pus. The skin resembles mulberry in
appearance. Make the diagnosis: (2018)

U L
UK
M
1. Deep trichophytosis

3. Acne rosacea DI C
E
2. Lupus erythematosus

4. SycosisM
5. Tuberculous lupus

Q. Child having occational dyspnea cyanosis,dx?

asthma
bronchitis
TOF
VSD

> 2 questions on Marfan and ehler danlos. One

L
was about long arms,blue sclera and other

KU
mentioned about lenticonus

M U
D I C
M E
 U L
UK
I C M
E D
M
Questions on Intensive & Extensive Index
A study of the structure of death causes in the
urban population revealed that cardiovascular
diseases
accounted for 55,0% of all deaths. What
statistic value represents these data? (2014)
1. Intensive index
2. Index of evidence
3. Extensive index
4. Index of correlation
5. Correspondence index

U L
UK
>.In a city with population 400000 people 5600

I C M
fatal cases were recorded, including 3300

E D
cases because of blood circulation diseases,

M
730 – because of tumors.
What index will allow to characterize mortality
from blood circulation diseases in this city?
(2006)
1. Visuality index
2. Relative intensity index
3. Intensive index
4. Extensive index
5. Correlation index
>A city‘s population is 400000 inhabitants in
2005 there were registered 5600 deaths,
including 3300 cases caused by cardiovascular
diseases, 730 – by tumours. Which of the
following indicators allows to characterize the

L
share of the circulatory system diseases as the

KU
cause of death in the city? (2012)

M U
D I C
E
1. Intensive index

Mindex
2. Index of relative intensity
3. Extensive
4. Ratio
5. Demonstrativeness index
 U L
UK
I C M
Drug to control atrial fibrillation - Beta blockers & Calcium Channel

E D
Blockers

M
Myocardial infarction+ left ventricular failure = electrical
stimulation

Pain around eye ,etc. light trigger headache releives after

sleeping - Cluster Headache

Blombwrg sign positive -Pelvi peritonitis

A 26-year-old male patient complains of
piercing pain during breathing,
cough,dyspnea. Objectively: to- 37,3oC,
respiration rate - 19/min, heart rate = Ps-
92/min; AP- 120/80 mm Hg. Vesicular
respiration. In the inferolateral parts of

U L
chest auscultation in both inspiration

UK
M
and expiration phase revealed noise that

D I C
was getting stronger at phonendoscope

M E
pressing and can be still heard after
cough. ECG showed no pathological
changes. What is the most likely
giagnosis?
A. Acute pleuritis
B. Intercostal neuralgia
C. Subcutaneous emphysema
D. Spontaneous pneumothorax
E. Pericarditis sicca
(Similar Question asked about exudative
pleuritis)

U L
K
> To prevent respiratory distress in

Ans. Dexamethasone U
M
newborn.

D C
I at 32weeks of
gestation M
E
Ques. A pregnant woman
with the risk of preterm labor
undergoes a treatment to prevent fetal
respiratory distress syndrome. What medicine
was she prescribed? (2020,21)
1. Dexamethasone
2. Misoprostol
3. Gynipral ( hexoprenaline)
4. Oxytocin
5. Progesterone

Pt with mi, now in emergency, not responding only mourns, eyes

not open active,on passive opening fixed to r8 side, right hand
moving to pain side,left hand no movement..access Glasgow
coma scale value and severity

U L
UK
I C M
E D
M
 U L
UK
I CM
ED
M
Discoordinated labor ac�vity (new)
Primary uterine iner�a (new)
Secondary uterine iner�a (new)
Hashimoto thyroidi�s (new)
Typhus (new)
Typhoid (new)
Takayasu s disease disease (oblitera�ng aortoarteri�s):
• Females < 40 years old
• Pulseless disease (weak upper extremity pulses).
Ankylosing spondyloarthri�s ( new ) -bilateral sacroilei�s
Beta-hemoly�c streptococcus (new)
Lead (new) – red blood cells with basophilic aggrega�ons
Atrial fibrilla�on- no p wave, f-wave
Ventricular fibrilla�on - Electrical defibrilla�on in emergency,
Dressler syndrome (new)
To check effec�veness of l-tyroxine treatment in pa�ent with hypothyroidism – check TSH level
Chronic salpimgoophri�s (new )
Myocardial infarc�on - STEMI
Ulcera�ve coli�s – surgery, colon enlargement
Intes�nal obstruc�on (new) – adhesions
Glomerulonephri�s – glucocor�costeroids

11. A 9 y.o. girl has an average height and harmonic growth development. She was ill with acute
respiratory infec�on for five �mes. Define the group of her health.
A. 2nd group*
B. 1st group
C. 3rd group
D. 4th group
E. 5th group

A youth, aged 15, from childhood suffers from atopic derma��s and allergy to the shellfish. In
the last 3 months a�er acquiring aquarium fish, rhini�s, conjunc�vi�s, itching in the nose
developed. What level of immunologic index should be defined in this case?
A. IgE*
B. IgJ
C. IgM
D. IgA
E. Circula�ng immunocomplexes
A 38 y.o. woman complains of a purulent discharge from the le� nostril. The body temperature
is 37,50C. The pa�ent is ill during a week and associates her illness with common cold. Pain
on palpa�on of her le� cheek reveals tenderness. The mucous membrane in the le� nasal
cavity is red and turgescent. The purulent exudates is seen in the middle meatus in maxillary.
What is the most probable diagnosis?
A. Acute purulent maxillary sinusi�s*
B. Acute purulent fron��s
C. Acute purulent ethmoidi�s
D. Acute purulent sphenoidi�s
E. –

A 37 y.o. primigravida woman has been having labor ac�vity for 10 hours. Labor pains last for
20-25 seconds every 6-7 minutes. The fetus lies in longitude, presenta�on is cephalic, head is
pressed upon the entrance to the small pelvis. Vaginal examina�on results: cervix of uterus is
up to 1 cm long, lets 2 transverse fingers in. Fetal bladder is absent. What is the most probable
diagnosis?
A. Primary uterine iner�a*
B. Secondary uterine iner�a
C. Normal labor ac�vity
D. Discoordinated labor ac�vity
E. Pathological preliminary period

An 8-year-old child with a 3-year history of diabetes was hospitalized in hyperglycemic

coma. Specify the ini�al dose of insulin to be administered:
A. 0,1-0,2 U/kg of body weight per hour
B. 0,05 U/kg of body weight per hour
C. 0,2-0,3 U/kg of body weight per hour
D. 0,3-0,4 U/kg of body weight per hour
E. 0,4-0,5 U/kg of body weight per hour

During appointment with the doctor a man complains of painful itching rashes that appeared on his skin
under the beard and moustache one year ago, with frequent exacerba�ons occurring throughout the year.
Objec�vely the skin of the facial hair growth areas is bluish-purple, thickened, with pustules, erosions, and
scabs covering its moist surface. The fistulous tracts are surrounded by the area of loose pink-red granula�on
and discharge pus. The skin resembles mulberry in appearance. Make the diagnosis:
A. Sycosis
B. Acne rosacea
C. Lupus erythematosus
D. Deep trichophytosis
E. Tuberculous lupus

There is a dynamic growth of number of congenital abnormali�es such as central paralysis,

newborns blindness, idiocy among the popula�on that lives near to pes�cides produc�on
enterprise. Compounds of which pollutant can cause the development of this pathology?
A. Mercury*
B. Stron�um
C. Cadmium
D. Iron
E. Chrome

A 4 month old child fell seriously ill: body temperature rose up to 38,5oC, the child became
inert and had a single vomi�ng. 10 hours later there appeared rash over the butocks and
lower limbs in form of petechiae, spots and papules. Some haemorrhagic elements have
necrosis in the centre. What is the most probable disease?
A. Meningococcemia*
B. Rubella
C. Influenza
D. Haemorrhagic vasculi�s
E. Scarlet fever

On the 6th day of life a child got mul�ple vesicles filled with seropurulent fluid in the region of
occiput, neck and butocks. General condi�on of the child is normal. What disease should be
suspected?
A. Vesiculopustulosis*
B. Impe�go neonatorum
C. Miliaria
D. Impe�go
E. Epidermolysis bullosa

A pa�ent’s X-ray image (anteroposterior projec�on) shows deforma�on of lung patern, pneumofibrosis,
re�cular (honeycomb) lung patern of lower pulmonary segments, cylindric and fusiform lumps. The most
likely diagnosis is:
A. Mul�ple bronchiectasis
B. Right lung abscess
C. Non-hospital-acquired pneumonia
D. Lungs maldevelopment
E. Diffuse pulmonary fibrosis

A man was undergoing treatment for a myocardial infarc�on. On day 13, his chest pain
increased and he developed shortness of breath. Objec�vely, the following is observed:
temperature-38.2° C, pulse respira�on rate 112 / min.,26 / min., fine bubbling crackles can be
heard under the right shoulder blade. On day 15, he was diagnosed with rightsided exuda�ve
pleurisy. Complete blood count shows the following: leukocytes – 8.9*109/L, eosinophils-8 %.
ESR-24 mm/hour. What complica�on of myocardial infarc�on occurred in this pa�ent?
A. Recurrent myocardial infarc�on
B. Dressler syndrome
C. Pneumonia
D. Pulmonary embolism
E. Cardiac asthma

38. A 59-year-old woman complains of pain and edema in the small joints of her hands,
shortness of breath, weakness. This condi�on lasts for 8 years already. Objec�vely, her body
temperature is 37.8 ° C, she has fine punctate hemorrhages on her torso and limbs, ulnar
devia�on of the hands is observed. The borders of the heart are shi�ed to the le�, a systolic
murmur can be detected over the apex. Her pulse is 96 / min. Her blood pressure is 170/100
mm Hg. Complete blood count shows the following: erythrocytes-3.2 10¹2 / L, Hb-108 g / L,
leukocytes-6.8 10 % / L, platelets-220-10 / L, ESR-48 mm / hour, C-reac�ve protein (+++).
General urinalysis shows the following: specific gravity-1016, protein-2.8 g / L, leukocytes 10-12
in the vision field, erythrocytes-2-4 in the vision field. What is the most likely diagnosis in this
case?
A. Chronic glomerulonephri�s
B. Thrombocytopenic purpura
C. Systemic lupus erythematosus
D. Rheumatoid arthri�s
E. Rheuma�sm

An 8-day-old boy was delivered to the hospital on the second day a�er the onset of the disease.
His parents complain of his fussiness, regurgita�on, body temperature up to 38.5 C, red skin
with infiltra�on in the lumbar area. His medical history has no peculiari�es. The child is in the
severe condi�on, inert, pale, suckles poorly. In the lumbar area, on the sacrum and butocks
there is a tense infiltra�on with hyperemic and cyano�c areas and with a so� spot 8×7 cm in its
center. the stool is 10 �mes in 24 hours, with green and mucous admixtures. What is the most
likely diagnosis?
A. Erysipelas
B. Congenital so�-�ssue tumor
C. Phlegmon of the newborn
D. Adiponecrosis
E. Hemangioma
A man complains of red and sore skin on his right calf. Objec�vely, his body temperature is
38.5°C; his inguinal lymph nodes on the right are enlarged and painful; the skin is red, with clear
boundaries between the redness and healthy skin; edema is observed; there are vesicles filled
with a dark liquid; palpa�on is painful. What is the provisional diagnosis in this case?
A. Herpe�c infec�on
B. Phlegmon of the leg
C. Varicella
D. Erysipelas
E. Cutaneous anthrax

A person has been hospitalized with the diagnosis of trichinellosis. What food product is the
likely cause of this helminthiasis?
A. Rabbit
B. Poultry
C. Beef
D. Muton
E. Pork

During coke produc�on, the concentra�on of dust in the air of the working area has been for
many years exceeding the maximum permissible concentra�on by 4-8 �mes. What disease is
most likely to develop among the workers in this industry as a result?
A. Anthracosis
B. Byssinosis
C. Asbestosis
D. Silicosis
E. Siderosis

A 36-year-old pa�ent complains of suffoca�on atacks with predominantly problema�c

exhala�on. The atacks occur up to 2-3 �mes a day and can be relieved by inhala�on of 2-
adrenomime�cs. This condi�on lasts for 10 years already. Objec�vely, the chest is expanded,
percussion detects a bandbox resonance over the lungs, ausculta�on detects harsh respira�on
with prolonged exhala�on. Laboratory analysis of sputum detects numerous eosinophils,
Charcot-Leyden crystals, and Curschmann spirals. What is the provisional diagnosis in this case?
A. Spontaneous pneumothorax
B. Chronic obstruc�ve bronchi�s
C. Bronchial asthma
D. Cardiac asthma
E. Carcinoid syndrome

A 36 y.o. pa�ent is diagnosed with right sided pneumothorax. What method of treatment is
indicated to the pa�ent?
A. Surgical drainage of the pleural cavity*
B. An�inflamma�on therapy
C. Symptoma�c therapy
D. Pleural puncture
E. Thoracotomy

The pa�ent has developed pain in the axillary area, rise of temperature developed 10 hours
ago. On examina�on: shaky gait is marked, the tongue is coated by white coa�ng. The pulse is
frequent. The painful lympha�c nodules are determined in the axillary area. The skin is
erythematous and glistering over the lympha�c nodules. What is the most probable diagnosis?
A. Bubonic plague*
B. Acute purulent lymphadeni�s
C. Lymphogranulomatosis
D. Anthrax
E. Tularemia
chicken pox incuba�on
calcium (convulsion)
fluorine
psoriasis
bladder exstrophy
epidemic typhus ( petechia)
batery = lead
secondary syphilis = painless ulcer and then rash

A 3-year-old boy has been hospitalized with severe edemas. Objectively, the boy is pale, his
blood pressure is 90/60 mm Hg, he has oliguria. General urinalysis shows the following: color ---
yellow, specific gravity --- 1020, protein levels --- 3.5 g/L, erythrocytes --- leached, 4--5 in the
vision field, leukocytes --- 2--3 in the vision field, 24-hour proteinuria --- 6.6 g. The cholesterol
levels are 9.8 mmol/L. What next step in the patient's management would be optimal?
Question 77Answer
a.
Kidney biopsy
b.
Nechiporenko urine test
c.
Monitoring throughout the next week
d.
Computed tomography without contrast
e.
Zimnitsky test
Feedback
The correct answer is: Kidney biopsy

A 17-year-old girl complains of a pain and swelling of her second finger on the right hand.
Three days ago she made a manicure. The pain developed on the second day after that.
Objectively, her nail fold is swolen, hyperemic, overhangs the nail plate, and is painful on
palpation. What is the most likely diagnosis in this case?
Question 73Answer
a.
Cutaneous panaritium
b.
Erysipeloid
c.
Paronychia
d.
Subcutaneous panaritium
e.
Subungual panaritium
 Feedback
The correct answer is: Paronychia

Within several days, a person developed a reduction in the peripheral vision, resembling a flap,
on the outer side. The patient does not know the cause of this condition. The eye is calm, the
optical media are transparent. On the nasal side of eye, ophthalmoscopy detects a gray "sail"
with vessels that wavers during eye movements. The optic disc and blood vessels are without
changes. What is the most likely diagnosis in this case?
Question 71Answer
a.
Vascular pathology of the retina
b.
Retinal detachment
c.
Lens subluxation
d.
Initial signs of glaucoma
e.
Hemianopsia with a neurological pathology
Feedback
The correct answer is: Retinal detachment

A 27-year-old woman, gravida 1, para 1, was hospitalized into the maternity ward. She had a 3-
year-long history of primary infertility. Contractions started 9 hours ago, occur every 4--5
minutes, and last 20--25 seconds. The waters broke 2.5 hours ago. The fetal heartbeat is
136/min. The small segment of the fetal head lies in the plane of the inlet into the lesser pelvis.
The cervix is smoothed out, its opening is 4 cm. The amniotic sac is absent. What complication
occurred during the childbirth?
Question 143Answer
a.
Primary weakness of labor activity
b.
Discoordinated labor activity
c.
Secondary weakness of labor activity
d.
Normal labor activity
e.
Pathological preliminary period
Feedback
The correct answer is: Primary weakness of labor activity

A 64-year-old man is undergoing outpatient treatment for ischemic heart disease, diffuse
cardiosclerosis, persistent atrial fibrillation, and functional class III heart failure. The
pharmacotherapy consists of cordarone (amiodarone) twice a day, torasemide every other day,
and trimetazidine twice a day. The family physician recommended taking warfarin (3 mg per
day) to prevent thrombus formation. What parameter should be measured in this case for
optimal control of the effectiveness and safety of the anticoagulant therapy?
Question 105Answer
a.
Platelet count
b.
Fibrinogen levels
c.
Erythrocyte sedimentation rate
d.
Lee-White clotting time
e.
International normalized ratio
Feedback
The correct answer is: International normalized ratio

A 72-year-old patient suffering from acute myocardial infarction, ECG monitoring revealed
paroxysmal ventricular tachycardia. At the same time he developed an acute ventricular failure.
BP - 80/40 mm Hg. What is the most effective and safe ay to treat the patiet?
Question 64Answer
a.
Amiodarone
b.
Mexitil
c.
Lidocaine
d.
Novocainamid
e.
Electrical stimulation
Feedback
The correct answer is: Electrical stimulation

In recent months, a 29-year-old woman developed complaints of pain in her right iliac region,
diarrhea with mucus and pus, pain in the hip joints, and periodic increases in body temperature.
The abdomen during palpation is soft, with tenderness in the right iliac region. Irrigography
shows that the mucosa resembles a "cobblestone pavement", the ileocecal junction is narrowed.
What disease can be suspected in this case?
Question 107Answer
a.
Gluten enteropathy (celiac disease)
b.
Tuberculous ileotyphlitis
c.
Crohn's disease
d.
Whipple's disease
e.
Pseudomembranous enterocolitis
Feedback
The correct answer is: Crohn's disease

A 30-year-old man has received second-degree burns that cover 40% of his body. On the
fourth day after the injury, his general condition acutely deteriorated. He developed
inspiratory dyspnea, frequent cough with frothy sputum, and cyanotic skin. Auscultation
detects numerous wet crackles in the lungs. His blood pressure is 110/60 mm Hg, heart
rate -- 100/min., respiration rate -- 32/min., central venous pressure -- 100 mm H₂O, total
protein -- 50 g/L, Ht -- 30%, Hb -- 90 g/L. ECG shows sinus tachycardia. What mechanism
of pulmonary edema pathogenesis is the main one in this case?
Question 123Answer
a.
Decreased plasma osmotic pressure
b.
Decreased contractility of the myocardium
c.
Pulmonary hypoventilation
d.
Surfactant dysfunction
e.
Hypervolemia of the pulmonary circulation
Feedback
The correct answer is: Decreased plasma osmotic pressure

In the computer lab of the research sector at a polytechnic institute, the workstations of
laboratory technicians are located close in front of the screens. Throughout their whole working
day, the technicians are exposed to the electromagnetic waves of ultra high frequencies.
Exposure to intense electromagnetic waves of such frequency is especially dangerous for the:
Question 132Answer
a.
Hearing analyzer
b.
Visual analyzer
c.
Sensory sensitivity
d.
Pain sensitivity
e.
Tactile sensitivity
Feedback
The correct answer is: Visual analyzer

A 26-year-old pregnant woman was hospitalized into the intensive care unit at 36 weeks of her
pregnancy with complaints of an intense headache in the frontal region. Physical examination
detected the following: blood pressure --- 170/90 mm Hg, pulse --- 85/min., respiratory rate ---
15/min., body temperature --- 36.9°C, edema of the limbs, fetal heart rate --- 159/min. During
the examination, the woman developed an attack of generalized tonic-clonic seizures. What
drug must be administered first in this case?
Question 110Answer
a.
Diazepam
b.
Sodium valproate
c.
Magnesium sulfate
d.
Lamotrigine
e.
Phenytoin
Feedback
The correct answer is: Magnesium sulfate

A 55-year-old woman complains of deformed finger joints and pain in them during movements.
Objectively, there are small bony formations on the lateral surfaces of the distal interphalangeal
joints. The formations are slightly painful to palpation. What are they called?
Question 115Answer
a.
Bouchard's nodes
b.
Rheumatoid nodules
c.
Erythema nodosum
d.
Heberden's nodes
e.
Tophi
Feedback
The correct answer is: Heberden's nodes

A 37-year-old man complains of chills, headache in the frontal region and temples, pain in
the muscles, pain during eye movement, photophobia, and extreme weakness. His
oropharyngeal mucosa is hyperemic. Scleritis is observed in the patient. Auscultation
detects isolated dry crackles and weakened heart sounds. Heart rate --- 98/min., blood
pressure --- 130/70 mm Hg, body temperature --- 39.8°C) What is the optimal way of
preventing this disease in the contact persons?
Question 104Answer
a.
Administration of intranasal interferons
b.
Antibiotic prophylaxis
c.
Vaccination
d.
Wearing a face mask
e.
Administration of oxolin ointment
Feedback
The correct answer is: Vaccination

A full-term girl with chronic fetoplacental insufficiency was born from the second pregnancy that
risked termination at 25--27 weeks. During the childbirth, the umbilical cord was revealed to be
wrapped once around the neck of the baby, the extraction of the shoulders was difficult. After
the birth, the Apgar scale was used to evaluate the baby's condition at the first minute of life: no
breathing, the heart rate of 50/min., total cyanosis, atony, areflexia. What would be the Apgar
score in this case?
Question 54Answer
a.
2 points
b.
0 points
c.
3 points
d.
4 points
e.
1 point
Feedback
The correct answer is: 1 point

A 32-year-old man complains of pain in his legs that intensifies during walking, intermittent
claudication, numbness of his toes, extremity
coldness, and inability to walk more that 100 meters. When he sleeps, his leg usually hangs
down. The patient has been smoking since he
was 16. He drinks alcohol in excess. The left leg is colder than the right one; the skin of the
extremities is dry. No pulse can be detected on
the pedal arteries, while pulsation of the femoral arteries is retained. What is the most likely
diagnosis?
a. Raynaud disease
b. Leriche syndrome (aortoiliac occlusive disease)
c. Deep thrombophlebitis
d. Obliterating endarteritis ✓
e. Diabetic angiopathy
The correct answer is: Obliterating endarteritis (nafs el idea)

A patient was hospitalized into the neurosurgery department with a closed craniocerebral injury,
a fracture of the right temporal bone. Five hours later, the patient's condition sharply
deteriorated, he developed respiratory disorders, periodical tonic seizures, and anisocoria
(dilation of the right pupil). What complication can be suspected in this case?
Question 39Answer
a.
Brain abscess
b.
Characteristics associated with the course of concussion
c.
Ischemic stroke in the area of the right cerebral peduncle
d.
Subarachnoid hemorrhage
e.
Epidural hematoma
Feedback
The correct answer is: Epidural hematoma

A premature newborn boy (pregnancy 5, birth 1, gestation term --- 27 weeks) has irregular
respiration of <30/min. after birth and $SpO_2$ of 70 %. Retractions of the pliable areas of the
chest and expiratory groaning are observed. Without oxygen support, generalized cyanosis
occurs. Auscultation reveals crepitus in the basal segments. There are no data on the prevention
of respiratory distress syndrome in the baby. What treatment tactics must be chosen in this
case?
Question 6Answer
a.
Provide artificial pulmonary ventilation with an Ambu bag and a mask
b.
Administer the surfactant preparation intratracheally within the first 15 minutes after birth
c.
Provide oxygen therapy using an oxygen tent
d.
Prescribe an antibacterial therapy
e.
Administer the surfactant preparation intratracheally 2 hours after birth
Feedback
The correct answer is: Administer the surfactant preparation intratracheally within the first 15
minutes after birth

The condition of a full-term newborn deteriorated on the first day of life. The baby was born
from the third pregnancy, during the second half of which gestosis was observed. The mother's
blood group is 0(I) Rh(-). Examination shows that the baby is inert and has icteric skin and
mucosa; baby's urine and stool are of normal color. Blood serum bilirubin is 248 mcmol/L,
because of indirect bilirubin levels. What is the most likely cause of this pathologic condition?
Question 9Answer
a.
Rh incompatibility
b.
ABO incompatibility
c.
Biliary atresia
d.
Fetal hepatitis
e.
Physiological jaundice
Feedback
The correct answer is: Rh incompatibility

A 65-year-old man has an over 17-year-long history of chronic obstructive bronchitis. He

complains of dyspnea with difficult inspiration, heaviness in his right subcostal region,
and edema of feet and shins. Auscultation detects rough respiration and dry crackles over
the lungs and an accentuated split second heart sound in the second intercostal region.
What changes can be expected on the ECG?
Question 14Answer
a.
Right ventricular myocardial hypertrophy
b.
Ciliary arrhythmia
c.
Deviation of the electrical axis of the heart to the left
d.
Left atrial hypertrophy
e.
Extrasystole
Feedback
The correct answer is: Right ventricular myocardial hypertrophy

A 35-year-old man was found dead in his own garage. Forensic examination detects the
following: horizontal closed strangulation mark, petechial hemorrhages on the skin of the head
and neck, facial cyanosis, marked livor mortis, and multiple Tardieu spots. What indicates that
the man did not die by hanging?
Question 55Answer
a.
Petechial hemorrhages on the skin
b.
Facial cyanosis
c.
Multiple Tardieu spots
d.
Marked livor mortis
e.
Horizontal strangulation mark
Feedback
The correct answer is: Horizontal strangulation mark

A 49-year-old man complains of angina pectoris attacks that occur when he walks up to 500 m.
He has a many-year-long history of chronic bronchitis. Examination detects a small number of
dry diffuse crackles in the lungs, the respiratory rate is 18/min. The borders of the heart are
expanded to the left, the heart sounds are muffled, the heart rate=PS=86/min., the blood
pressure is 160/100 mm Hg. Complete blood count shows the following: Hb --- 160 g/L,
leukocytes --- $6.4 · 10^9$/L, ESR --- 7 mm/hour. ECG shows hypertrophy of the left ventricle.
What group of drugs is contraindicated in this case, taking into account the concomitant
pathology?
Question 62Answer
a.
Long-acting nitrates
b.
Antiplatelet drugs
c.
Calcium antagonists
d.
Beta blockers
e.
Angioprotectors
Feedback
The correct answer is: Beta blockers

A 73-year-old man has a 5-year-long history of benign prostatic hyperplasia. One morning he
developed an acute urinary retention. Catheterization of his bladder is impossible. What urgent
aid must be provided for this man?
Question 64Answer
a.
Antispasmodics and analgesics
b.
Thermal procedures
c.
Diuretics
d.
Suprapubic bladder tap
e.
Adrenergic blockers
Feedback
The correct answer is: Suprapubic bladder tap

One week ago, a 68-year-old woman suddenly developed pain in the left half of her chest and
shortness of breath. Objectively, the following is observed: cyanosis, distended neck veins, pulse
--- 100/min., blood pressure --- 110/70 mm Hg, respiratory rate --- 28/min., liver +4 cm, the left
lower leg is edematous and sharply painful to palpation. Auscultation detects a dull lung sound
on the left, below the scapula; sonorous moist fine vesicular crackles are present; the borders of
the heart are expanded on the right; the II heart sound is accentuated over the pulmonary
artery. ECG shows deep S waves in leads I and aVL, as well as deep Q waves in leads III and aVF,
and a negative T wave in leads III and aVF. What is the most likely diagnosis in this case?
Question 80Answer
a.
Pleurisy
b.
Myocardial infarction
c.
Croupous pneumonia
d.
Thromboembolism of pulmonary artery branches
e.
Pericarditis
Feedback
The correct answer is: Thromboembolism of pulmonary artery branches

A man, who one day ago returned from a trip to Africa, presents with a sharply painful cluster of
lymph nodes in his armpit. The skin over the lymph node cluster is hyperemic. Bubonic plague is
suspected. What must the contact persons use for urgent prevention of this disease?
Question 95Answer
a.
Praziquantel
b.
Homologous immunoglobulin
c.
Heterologous serum
d.
Doxycycline
e.
Fluconazole
Feedback
The correct answer is: Doxycycline

A 55-year-old woman complains of deformed finger joints and pain in them during movements.
Objectively, there are small bony formations on the lateral surfaces of the distal interphalangeal
joints. The formations are slightly painful to palpation. What are they called?
Question 115Answer
a.
Bouchard's nodes
b.
Rheumatoid nodules
c.
Erythema nodosum
d.
Heberden's nodes
e.
Tophi
Feedback
The correct answer is: Heberden's nodes

A 35-year-old man was hospitalized with signs of surgical sepsis that has likely been caused by a
large carbuncle in his scapular region. Examination detected secondary purulent foci in the liver
and right lung. What stage of surgical sepsis is it?
Question 118Answer
a.
Terminal stage
b.
Septicemia
c.
Purulent resorptive fever
d.
Septicopyemia
e.
Toxemia
Feedback
The correct answer is: Septicopyemia

A 72-year-old patient came to a doctor with complaints of hand tremors, stiffness, slowness of
walking and speech, and difficulties in performing routine household chores. Physical
examination detects general bradykinesia, hypomimia, emprosthotonus, "shuffling" gait, hand
tremors at rest, D>S, plastic type of increased muscle tone, the "cogwheel rigidity"
phenomenon, and marked postural instability. What medicines must be a primary part of the
treatment regimen for this patient?
Question 147Answer
a.
Anticholinergic agents
b.
Medicines containing levodopa
c.
Antidepressants
d.
Anticholinesterase drugs
e.
Medicines that improve microcirculation
Feedback
The correct answer is: Medicines containing levodopa

A 74-year-old woman came to a doctor complaining of a pain in her right inguinal region. The
signs appeared suddenly, approximately 2 hours ago. The woman notes that she already had
these signs 3 weeks ago, but back then they disappeared on their own after she lay down.
Objectively, palpation detects below the Poupart's ligament a sharply painful, dense, and tense
formation 3.5 cm in diameter. The Dejerine sign (aggravation on coughing) is negative. What is
the most likely diagnosis in this case?
Question 101Answer
a.
Acquired strangulated inguinal hernia
b.
Inguinal lymphadenitis
c.
Acquired strangulated femoral hernia
d.
Acquired incarcerated femoral hernia
e.
Acquired incarcerated inguinal hernia
Feedback
The correct answer is: Acquired strangulated femoral hernia

In a 70-year-old woman, chest fluorography shows a shadow of a heterogeneous structure over

the left dome of the diaphragm. X-ray with contrast detects the abdominal segment of the
esophagus in the chest cavity. What is the most likely diagnosis in this case?
Question 150Answer
a.
Esophagitis
b.
Achalasia cardia
c.
Esophageal diverticulum
d.
Benign esophageal tumor
e.
Hiatal hernia
Feedback
The correct answer is: Hiatal hernia

A boy suffering from bronchial asthma started to experience suffocation attacks several times a
day. During the last attack, inhalation of astmopent (orciprenaline) had no effect. Intensive
therapy was unable to stop the attack. The child was transferred into the intensive care unit with
the diagnosis of II degree status asthmaticus. What was the leading mechanism of the
development of this condition in the child?
a. Complete refractoriness (blockade) of beta-2-adrenoceptors
b. Edema of the bronchial mucosa
c. Increased secretion of bioactive substances by mast cells
d. Inflammation of the bronchial mucosa
e. Spasm of the bronchial smooth muscles
The correct answer is: Complete refractoriness (blockade) of beta-2-adrenoceptors

A newborn with hemolytic disease according to Rh - factor have a О (I) Rh (+) blood group, in
mother А (II) Rh(-). What blood shoul be transfused during replacement blood transfusion&
Question 123Answer
a.
A (II) Rh(+)
b.
О (I) Rh (-)
c.
A (II) Rh (-)
d.
O (I) Rh (+)
e.
В (III) Rh(-)
Feedback
The correct answer is: О (I) Rh (-)

A 67-year-old man complains of dyspnea on exertion, attacks of retrosternal pain, dizziness. He

has no history of rheumatism. Objectively: pale skin, acrocyanosis. There are crackles in the lower
lungs. There is systolic thrill in the II intercostal space on the right, coarse systolic murmur
conducted to the vessels of neck. BP- 130/90 mm Hg, heart rate - 90/min., regular rhythm. The
liver extends 5 cm from under the edge of costal arch, shin edemas are present. Specify the
suspected valvular defect:
Question 74Answer
a.
Pulmonary artery stenosis
b.
Tricuspid regurgitation
c.
Ventricular septal defect
d.
Mitral insufficiency
e.
Aortic stenosis
Feedback
The correct answer is: Aortic stenosis

A 35-year-old forestry officer was delivered to the hospital on the 7th day after the onset of the
disease. He complains of chills, elevated body temperature up to 40.0°C, sharp headache, and
myalgias. On examination his face is puffy and hyperemic, the tongue is dry, ''chalk-dusted''. In
the left inguinal area, a sharply painful conglomeration of enlarged lymph nodes can be
palpated. The skin over the conglomeration is hyperemic and tense. What etiotropic therapy
should be prescribed to this patient?
Question 132Answer
a.
Ketoconazole
b.
Administration of heterologous serum
c.
Ribavirin
d.
Human immunoglobulin intravenously
e.
Streptomycin
Feedback
The correct answer is: Streptomycin

A 58-year-old man had a moderate ischemic stroke in the right hemisphere of the brain 10 days
ago. At the time of hospitalization, the deficit score on the NIHSS scale was 9 points. He suffers
from moderate arterial hypertension, atrial fibrillation, urolithiasis, and gout (remission). What
must be prescribed to the patient for secondary prevention of stroke?
Question 58Answer
a.
Oral anticoagulants (warfarin or NOACs --- dabigatran, rivaroxaban, apixaban)
b.
Drugs that improve cerebral blood flow
c.
High doses of lipid-lowering agents (e.g., atorvastatin --- 80 mg per day)
d.
Clopidogrel, 75 mg per day
e.
Aspirin, 100 mg per day
Feedback
The correct answer is: Oral anticoagulants (warfarin or NOACs --- dabigatran, rivaroxaban,
apixaban)

A woman complains of frequent and copious foamy stools without pathological admixtures,
cramp-like pain in her periumbilical region, rumbling in the stomach, and fever. From her
history, it is known that she was eating soft-boiled duck eggs. What is the most likely causative
agent of her condition?
Question 93Answer
a.
Salmonella typhi
b.
Escherichia coli
c.
Shigella sonnei
d.
V. cholerae
e.
Salmonella enteritidis
Feedback
The correct answer is: Salmonella enteritidis

A 19-year-old patient complains of a dry cough, muscle pain, and a fever of 39°C) A sore throat
and subfebrile body temperature were observed for the last week. Objectively, the respiration is
harsh. Complete blood count shows the following: leukocytes --- $10.0 · 10^9$/L, leukocyte left
shift, ESR --- 26 mm/hour. Chest X-ray shows an intensified pulmonary pattern, low-intensity
focal shadows in the lower segments of the right lung. What medicines should be prescribed in
this case?
Question 129Answer
a.
Sulfanilamides
b.
Aminoglycosides
c.
Second or third generation cephalosporins
d.
Penicillin antibiotics
e.
Macrolides
Feedback
The correct answer is: Penicillin antibiotics

On examination a man presents with the following signs: progressing weakness, loss of working
ability, rapid physical and mental fatigability, sensations of cold and hunger, and weight loss.
What type of alimentary disorder is it?
Question 63Answer
a.
Vitamin deficiency
b.
Dietary fiber deficiency
c.
Mineral deficiency
d.
Protein-energy undernutrition
e.
Polyunsaturated fatty acid deficiency
Feedback
The correct answer is: Protein-energy undernutrition

A 20-year-old woman is being treated for anemia (hemoglobin --- 72 g/L). A year and a half
ago, she had an involuntary miscarriage with a significant blood loss at 16 weeks of pregnancy,
after which the woman developed memory deterioration, fatigability, loss of appetite, dry skin,
brittle nails, and irregular menstrual cycles. Objectively, the following is observed: blood
pressure --- 80/55 mm Hg, pulse --- 54/min., height --- 168 cm, weight --- 48 kg, genital
hypoplasia. What medicine would be the optimal choice for this patient?
Question 10Answer
a.
Hydrocortisone
b.
Methotrexate
c.
Hydroxychloroquine
d.
Infliximab
e.
Human normal immunoglobulin
Feedback
The correct answer is: Hydrocortisone

In an eight-month-old child, tonic tension of facial muscles, carpopedal spasm, and laryngospasm are
noted, followed by generalized clonic convulsions with loss of consciousness for several minutes. Posi�ve
symptoms of Khvostek, Trousseau, Lust. What emergency condi�on is observed in the child? Ques�on
28Answer
a. Epilep�c atack
b. Choking and cyano�c atack
c. Hypocalcemic (tetanic) convulsions
d. Affec�ve respiratory convulsions
e. Febrile convulsions
Feedback The correct answer is: Hypocalcemic (tetanic) convulsions

A 38-year-old pa�ent turned to the doctor with complaints of pain and discomfort behind the sternum,
which have lasted for the past 4 hours, the symptoms appeared a�er dinner. The pain some�mes
intensifies, then subsides, irradia�on in the le� scapula and hand is not noted. It is known from the
anamnesis that the pa�ent's father died at the age of 55 due to an acute myocardial infarc�on.
Objec�vely observed: body temperature 37.3°C, blood pressure --- 138/85 mm Hg. st., pulse --- 115/min,
BH --- 16/min. During ausculta�on, vesicular breathing is determined. ECG revealed: sinus tachycardia.
Previously, the pa�ent took 3 tablets of nitroglycerin with an interval of 5 minutes and aspirin, which
improved his condi�on. What are the further tac�cs in the management of this pa�ent? Ques�on
135Answer
a. Conduct a physical exercise test
b. Determina�on of cardiac biomarkers (CFC-MV, troponin I, N-terminal pep�de of natriure�c hormone)
c. Chest CT and FGDS
d. X-ray with barium mixture
e. Give the pa�ent a pain reliever
Feedback The correct answer is: Determina�on of cardiac biomarkers (CFC-MV, troponin I, N-terminal
pep�de of natriure�c hormone)

A 36-year-old woman consulted a doctor with complaints of general weakness, abdominal pain, and
yellowness of the skin. These complaints gradually increased during the last 3 months. The pa�ent
denies drug use and unprotected sex. During the physical examina�on: icteric sclera and yellowness
of the skin, pain upon palpa�on of the right subcostal region is observed. During the laboratory
examina�on of blood serum, the following were found: total bilirubin -- 6_4_._5_ _μm_o_l_/_l_,_
_d_i_r_e_c_t_ _--- 2_2_._7_ _μm_o_l_/_l_,_ _A_S_T_ _--- 822 U/l, ALT --- 1237 U/l, HBsAg - --
posi�ve, HBeAg --- posi�ve. What is the most appropriate treatment strategy for this pa�ent?
Ques�on 97Answer
a. Human immunoglobulin is normal
b. Prednisone and ribavirin
c. Specific immunoglobulin against hepa��s B virus
d. Hepa��s B vaccine and lamivudine
e. PEG-interferon alpha-2a
Feedback The correct answer is: PEG-interferon alfa-2a

The child is 1 year old, hospitalized on the 4th day of illness with complaints of an increase in body
temperature to 39°C, shortness of breath. Objec�vely: cyanosis of the nasolabial triangle, during
ausculta�on of the lungs on the right, breathing is sharply weakened, wet crepitus. Standard
an�bacterial therapy during the first three days of treatment is ineffec�ve. A staphylococcal e�ology
of pneumonia is assumed. What an�bacterial therapy is most appropriate in this case? Ques�on
146Select one:
A. Ampicillin
B. Penicillin
C. Azithromycin
D. Vancomycin
E. Erythromycin
Feedback The correct answer is: Vancomycin

The mother of a 12-year-old girl turned to the gynecologist to vaccinate the child against highly
oncogenic types of the human papilloma virus. From what age is it advisable to vaccinate? Ques�on
4Answer
a. 20--21 years
b. 16--17 years old
c. 14--15 years old
d. 12--13 years old
e. 18--19 years old
Feedback The correct answer is: 12--13 years

1. A 28-year-old woman came to a gynecologist with complaints of infertility for

the last 3 years. Her menstrual function is normal. She has a history of one
artificial abortion and chronic salpingo-oophoritis. She uses no contraception. The
spermogram of her husband is normal. What method should be used first to
determine the cause of this woman's infertility?
A. Hysteroscopy
B. Hysterosalpingography
C. Laparoscopy
D. Diagnostic uterine curettage
E. Hormone testing

3. A 28-year-old woman complains of weakness, dizziness, nosebleeds, and

hemorrhages on her torso. The condition onset was 4 months ago. Objectively, her
condition is of moderate severity. There are multicolored painless hemorrhages 1-2
cm in size on her back and abdomen. The peripheral lymph nodes are not enlarged.
The liver is (-), the spleen is (+). Blood test shows the following: Hb - 120 g/L,
erythrocytes - 3.4 × 1012/L, color index - 0.9, reticulocytes - 0.9%, serum iron -
15.01 mcmol/L, leukocytes - 4.2 × 109/L, eosinophils - 2%, basophils - 0%, band
neutrophils - 7%, segmented neutrophils - 40%, monocytes - 6%, lymphocytes
45%, platelets 47.1 × 109/L, ESR – 27 mm/hour. What is the most likely diagnosis
in this case?
A. Idiopathic thrombocytopenic purpura
B. Chronic lymphocytic leukemia
C. Hemolytic anemia
D. Chronic iron-deficiency anemia

10. A 32-year-old man has a closed cerebrocranial trauma, a closed chest trauma,
and a closed right femoral fracture. His blood pressure was 100/60 mm Hg, pulse -
124/min., respiration - 28/min. Two hours after the skeletal traction was performed
under topical lidocaine anesthesia, the patient's condition suddenly became worse.
His face and neck became cyanotic, blood pressure - 60/40 mm Hg. heart rate -
160/min., respiration rate - 44/min. What complication has likely developed in this
case?
A. Pain shock
B. Fat pulmonary embolism
C. Myocardial infarction, cardiogenic shock
D. Pulmonary embolism
E. Acute posthemorrhagic anemia

11. A 51-year-old man after an overexposure to cold has developed acute pain in
his lower abdomen and a burning pain that occurs at the end of urination. Urination
occurs up to 15 times per 24 hours. The urine is turbid and contains blood. Clinical
urinalysis shows leukocytes the whole vision field and isolated erythrocytes. What
provisional diagnosis can be made?
A. Acute pyelonephritis
B. Acute urethritis
C. Acute cystitis
D. Acute glomerulonephritis
E. Urolithiasis

16. A 45-year-old woman complains of general weakness, dyspnea, and dizziness.

Within one year her hair became gray, her nails started peeling, and she developed
gustatory disorders. For the last 5 years she has been registered for regular check-
ups with a gynecologist for uterine fibromyoma. Her blood test shows the
following: erythrocytes - 3.0 × 1012/L, Hb - 76 g/L, color index - 0.7, reticulocytes
0.7%, platelets - 160 × 109/L, leukocytes - 5.0 × 109/L, eosinophils - 2%, band
neutrophils - 3%, segmented neutrophils 63%, lymphocytes - 28%, monocytes -
4%, aniso- and microcytosis, ESR - 30 mm/hour. What type of anemia can be
suspected in this case?
A. Hypoplastic anemia
B. Minkowski-Chauffard syndrome
C. Autoimmune hemolytic anemia
D. Iron-deficiency anemia
E. B12-deficiency anemia

22. On examination a man presents with the following signs: progressing

weakness, loss of working ability, rapid physical and mental fatigability, sensations
of cold and hunger, and weight loss. What type of alimentary disorder is it?
A. Vitamin deficiency
B. Mineral deficiency
C. Protein-energy undernutrition
D. Dietary fiber deficiency
E. Polyunsaturated fatty acid deficiency

25. A 57-year-old man complains of cough with profuse mucopurulent sputum (up
to 150 mL per 24 hours). Objectively, he has drumstick fingers with watch-glass
nails. Percussion produces a shortened sound over the lungs. Auscultation detects
moderate and large bubbling crackles. Complete blood count shows leukocytosis
and a left shift in the leukogram. Chest X ray shows intensified pulmonary pattern
and ring-like shadows. Bronchography detects multiple cylindrical thickenings of
the bronchi with clear margins. Make the provisional diagnosis: empyema
A. Pulmonary gangrene
B. Pulmonary echinococcosis
C. Chronic pleural empyema
D. Bronchiectasis

27. A 35-year-old woman, a polisher, complains of chills, cold bluish fingertips,

low mobility of her hand joints, and a contracted sensation in the skin of her face
and hands. Examination detects anemia. pouch-like pursing of the mouth,
thickened skin of checks and hands, pale and cold fingertips. A bandbox resonance
and isolated fine inspiratory crackles can be heard over the lungs. Blood test shows
the following: erythrocytes - 3.8*1012/L, leukocytes-4.8-109/L, ESR-45 mm/hour.
CRP++. What is the most likely diagnosis in this case?
A. Vibration disease
B. Systemic scleroderma
C. Obliterating endarteritis of the extremities
D. Raynaud's disease
E. Myxedema

28. A 59-year-old man for a month has been presenting with short-term periodical
loss of strength in his limbs on the left. Later he developed a persistent morning
weakness in the affected limbs after wakening. Objectively, he is conscious and
has central paresis of the VII and XII pairs of his cranial nerves on the left. Central
hemiparesis and hemihypersthesia are observed on the left side. What are the drugs
of choice for treatment of this man?
A. Anticoagulants
B. Hemostatics
C. Hypotensive agents
D. Diuretics
E. Corticosteroids

32. An 18-year-old young man during hospitalization complains of general

weakness, body temperature of 37.5°C, loss of appetite, nausea, heaviness in the
right subcostal region, and discolored stool and urine. The disease onset was 5 days
ago. Objectively, his skin and sclerae are slightly icteric. The liver protrudes by 3
cm and is tender to palpation. Patient's urine is dark brown, while his stool is light-
colored. He usually drinks water from a tap. What is the most likely diagnosis in
this case?
A. Viral hepatitis B
B. Leptospirosis
C. Viral hepatitis A
D. Typhoid fever
E. Malaria
4. A 30-year-old man, a cable presser, complains of inertness, memory problems,
and pain in his limbs. Objectively, he presents with skin pallor, anemia,
reticulocytosis, basophilic stippling of erythrocytes, and high levels of porphyrin in
urine. This man has the signs of the following disease:
A. Saturnism
B. Mercurialism
C. Asbestosis
D. Berylliosis
E. Siderosis

45. A 45-year-old man, provisionally diagnosed with a transient ischemic attack,

was brought by an ambulance from an aniline-producing factory. Objectively, his
skin and mucosa are cyanotic. His speech is dysarthric. The man is disoriented in
space. His blood test shows the following: erythrocytes - 4.6 × 1012/L, Hb - 143
g/L, color index - 0.9, leukocytes - 5.6 × 109/L, Heinz bodies - 14%, reticulocytes -
18%, methemoglobin - 36%, ESR – 5 mm/hour. The patient was diagnosed with a
moderately severe acute aniline intoxication. What antidote agent will be the most
effective in this case?
A. Desferal (Deferoxamine)
B. Pentacin (Calcium trisodium pentetate)
C. Methylene blue
D. Succimer
E. Sodium thiosulfate

73. A 7-year-old boy after playing with a cat suddenly developed problems with
breathing. Objectively, the boy is pale, frightened, and sits, leaning onto his arms.
His body temperature is 36.6°C, heart rate - 120/min., respiration rate 42/min.,
speaks in syllables. The exhale is long and accompanied by wheezing. Percussion
detects a bandbox resonance over the lungs. An inhalation of ventolin (salbutamol)
solution was started via a nebulizer. What can help assess the child's need for
oxygen therapy in this case?
A. Chest X-ray
B. Assessment of accessory muscles involvement
C. Spirometry
D. Pneumotachometry
E. Pulse oximetry

75. A pregnant woman at 32 weeks of gestation with the risk of preterm labor
undergoes a treatment to prevent fetal respiratory distress syndrome. What
medicine was she prescribed?
A. Gynipral (hexoprenaline)
B. Misoprostol
C. Oxytocin
D. Dexamethasone
E. Progesterone

76. A 25-year-old parturient woman is hospitalized with contractions that have

been occurring for 12 hours already. The contractions last 25 seconds, while the
intervals between them last 3-4-7 minutes. The contractions are irregular and
sharply painful, with pain spreading upwards from the lower uterine segment. The
baby is in the cephalic presentation, the head is pressed to the entrance into the
lesser pelvis. Uterine hypertonus is observed. Internal obstetric examination shows
that the cervix is smoothed and the opening of the external orifice uterus is 3 cm.
The amniotic sac is intact. Make the provisional diagnosis:
A. Discoordinated labor activity
B. Physiological course of the labor
C. Cervical dystocia
D. Primary weakness of the labor activity
E. Secondary weakness of the labor activity

79. A 36-year-old woman complains of nausea, belching, liquid stool, and a pain in
the epigastrium after meals. For the last 2 years the disease has been slowly
progressing. Objectively, her skin is pale and dry, her tongue is coated, moist, and
has imprints of the teeth on its edges. Abdominal palpation detects a diffuse pain in
the epigastrium. What test will be the most informative in this case and should be
conducted next?
A. Comprehensive complete blood count
B. Gastrointestinal X-ray
C. Fractional analysis of gastric secretion
D. Fibrogastroscopy with biopsy of the gastric mucosa
E. Abdominal CT scan

114. A 56-year-old woman has been working as a disinfector for 19 years. She
complains of general weakness, nausea, bitter taste in her mouth, heavy sensation
in her right subcostal area, and rapid fatigability. Objectively, her body
temperature is 37.1°C, the sclerae are icteric, and the liver is enlarged. Total
bilirubin is 40 mcmol/L. What is the likely diagnosis?
A. Acute cholecystitis
B. Biliary dyskinesia
C. Chronic pancreatitis
D. Chronic cholecystitis
E. Occupational toxic hepatitis

92. A 20-year-old man was hospitalized on the 9th day of the disease. He attributes
his disease to eating of insufficiently thermally processed pork. At its onset this
condition manifested in periorbital edemas and fever. Objectively, his body
temperature is 38.5°C. The face is puffy and the eyelids are markedly swollen.
Palpation of gastrocnemius muscles is sharply painful. Blood test shows hyper -
eosinophilia. What is the etiology of this disease?
A. Echinococci
B. Trichuris
C. Ascarididae
D. Trichinella
E. Leptospira
97. A man complains of a heaviness behind his sternum, periodical sensation of
food retention, and dysphagia. During X-ray the barium contrast reveals a single
pouch-like protrusion in the right anterior wall of the esophagus. The protrusion
has clear margins and a clearly defined neck. What is the most likely diagnosis in
this case?
A. Esophageal carcinoma
B. Esophageal diverticulum
C. Hiatal hernia
D. Varicose veins of the esophagus
E. Esophageal polyp

137. A 25-year-old woman was hospitalized into the gynecological department

with complaints of pain in her lower abdomen and high temperature of 39.7°C.
Objectively, her blood pressure is 120/80 mm Hg, pulse- 108/min., of satisfactory
strength and volume. The abdomen is moderately distended and sharply painful in
its lower segments. The Bloomberg's sign is positive in the hypogastrium. During
vaginal examination, the uterus and its appendages cannot be palpated because of
anterior abdominal wall rigidity. The posterior vaginal fornix is overhanging and
sharply painful. What is the most likely diagnosis in this case?
A. Acute adnexitis
B. Acute endometritis
C. Ectopic pregnancy
D. Ovarian apoplexy
E. Pelvioperitonitis

1. Human body receives from atmosphere a number of chemicals. What type the of
ac�on results in the combined effect that is less than the sum of isolated effects of these
chemicals on the body?
A. Synergis�c ac�on
B. Complex ac�on
C. Isolated ac�on
D. *Antagonism
E. Poten�a�on

A three-year-old boy has been suffering from stool retention since birth. Every 3--4 days, the
mother gives her child enemas. The boy lags behind his peers in physical development.
Objectively, he has pale skin and distended abdomen. What disease can be suspected in this
child?
a. Intestinal tumor
b. Peritonitis
c. Helminthiasis
d. Hirschsprung's disease
e. Coprostasis
The correct answer is: Hirschsprung's disease

A 64-year-old man came to the emergency department with complaints of swelling of the lower
extremities, lower back, and anterior abdominal wall. There is a history of chronic bronchitis with
bronchiectasis. During physical examination, body temperature is 37.2°C, blood pressure is 110/75
mm Hg, pulse is 82/min., respiratory rate is 19/min. During the laboratory examination in the general
analysis of urine (ZAS): specific gravity - 1025, protein - 9.9 g/l, leukocytes - 2-3 in the field of
vision, erythrocytes - 1-2 in the field of vision, cylinders - no. Daily proteinuria - 11.4 g/day. In the
biochemical blood analysis, total protein is 52 g/l, albumin is 30 g/l, and cholesterol is 9.6 mmol/l.
What type of kidney damage is most likely in this patient?
Question 9Select one:
A. Diabetic nephropathy, nephritic syndrome
B. AA amyloidosis, nephrotic syndrome
C. Pyelonephritis, urinary syndrome
D. Glomerulonephritis, nephritic syndrome
E. Tubulo-interstitial nephritis, nephrotic syndrome
Feedback The correct answer is: AA amyloidosis, nephrotic syndrome
 20 june krok 2 abroad
1. Gumma syphilis- Tertiary syphilis
2. Mucovisidosis
3. Diptheria- grey and white coating + tonsillitis
4.Gorbachev biodosimeter- UV radiation
5. Eclampsia- convulsions + Raised bp in pregnant women
6. Congenital Rubella syndrome
7. Bladder exstrophy- urination from two holes
8. Keshan syndrome
9. Doxycycline- purulent discharge from vagina
10. Down syndrome : Trisomy 21
11. Hemophilia B – factor 9
12. Aortic stenosis
13. Gout- nodules waxy on ears and elbow
14. Catatonic stupor ( Schizophrenia)
15. Hypoplastic anemia- Pancytopenia
16. To tell about lie and position- role of 2nd leopold maneuver
17. Torasemide- pulmonary edema
18. Skin prick test
19. Colonoscopy- Crohn's disease
20. Dopamine agonists- Hyperprolactinemia
21. Bulimia nervosa- eating very less, fear of getting obese
22. Myocarditis- Tonsillitis
23. Gaucher's disease- wrinkled tissue paper appearance
24. C section- burst amniotic water 5 hours ago
25. Normal vaginal delivery- heart rate of fetus- 156bpm
26. Ruptured tubal pregnancy
27. Dilated cardiomyopathy- Alcoholic person, party last night
28. Cystic fibrosis- salty cheeks of baby
29. Parkinsonism- Manganese
30. Echocardiogram- systolic murmur
31. Mobitz type II heart block
32. Bacillus cereus- eating fried rice, chinese food
33. Creatinine levels- Glomerulonephritis
34. Dermatomyositis – violet erythema around eyes
35. Frost bite 4th degree- Amputation required after old exposure
36. Lens subluxation
37. Folic acid- Neural tube defect
38. Congestive heart failure
39. Lung abscess- 125 ml foul smelling sputum, shadow on Xray
40. Peripartum Cardiomyopathy- resolves after 6 months of pregnancy
41. Anencephaly- absent skull
42. Ulcerative colitis- lead pipe appearance
43. Atrial fibrillation- absent P waves
44. Arsenic poisoning- Hyperkeratosis, blindness, kidney and liver cancer
45. Biotin- Alopecia, dermatitis, paraesthesias
46. Uterine hypotonus
47. Menopausal syndrome- hot flashes
48. Android type obesity
49. Wernicke's encephalopathy- after binge drinking
50. Correlation studies estimate
51. Reiter's diseases- urethritis, pain in small joints, discharge from eyes
52. Klumpe's palsy- inferior distal paralysis grasp sign absent
53. Prothrombin time
54. Primary healthcare- vaccination
55. Anti rabies serum- dog bite age 25 year old boy
56. Prizmetal angina pectoris- retrosternal chest pain and elevated ST
57. Second generation cephalosporins- lung infection
58. Kidney transplantation
59. Congenital diaphragmatic hernia- bowel loops in the chest
60. Hypertrophic cardiomyopathy- banana shaped cavity of heart
61. Pheochromocytoma- palpitations and hypertension
62. Duodenal atresia- vomiting with bile
64. Subcutaneous varicose veins- receptionist who does standing work
65. Anxious disorder (depressive episode)
66. Hartman's operation- colon cancer
67. Ehler danlos syndrome- Rubber man
68. Uncontrolled maternal diabetes- sacral agensis
69. Angiography- pulmonary embolism
70. Femur length- 3rd trimester fetal age estimate
71. 9 months child- first measles dose 7 months age
72. Vulvur cancer- lichen planus
73. Antinuclear antibody- systemic scleroderma
74. Hemolytic jaundice- takes amoxicillin tablet
75. Bagassosis- worker in sugarcane mill
76. Pneumocystis jiroveci- HIV with pneumonia
77. Ebv infection- Downey bodies
78. C section- fetal bradycardia and 6 cm open external os
79. Parvovirus b19- Slapped cheek appearance
80. Contraction ring- Threatened uterine rupture
81. Caudal regression syndrome
82. Immediate laparoscopy- uterine perforations
83. Antacid- GERD
84. Bacterial vaginosis – fish like smell
85. Infantile hemangioma- at birth lesions
86. Water fluorination
87. Lead intoxication- reticulocytosis and basophilic rbcs
88. ESR estimation- rheumatoid arthritis
1. A 14-year-old girl is being examined by a pediatrician. Objectively found: a girl of tall
growth, asthenic physique, scoliotic abdominal striae, blue sclera. posture, chest deformation
were

diagnosed on the skin. Joint hypermobility, long ngers and hands are noted. Mitral valve
prolapse is visualized on

ultrasound of the heart. Which of the following is the most likely reason for her high growth?

The correct answer is: Marfan syndrome

2. During the examination of the newborn girl, a hemorrhage on the head was found,
which does not go beyond one bone, does not pulsate, does not hurt. What condition has the
child developed?

and. Hydrocephalus of the brain

The correct answer is: Cephalohematoma

3. A three-year-old child has had stool

retention since birth. Every 3--4 days, the mother gives the child enemas. The boy lags behind his
peers in physical development.

Objectively observed: pallor of the skin, abdominal distension. What disease can be assumed in
the child?

The correct answer is: Hirschsprung's disease

4. The patient, a worker at a chemical plant, works in the village aggressive liquid,
accidentally spilled it on his overalls, got a chemical burn on his right thigh and shin. After
removing the clothes, it was found: on the front-inner surface of the right thigh and on the front
surface of the right shin, with a transition to the rear part of the foot, yellow-gray areas, fragments
of the epidermis in places, tactile and painful hypesthesia of the a ected skin areas are observed.

What kind of emergency care should be provided rst?

The correct answer is: washing with running water

5. In a 57-year-old patient, a right kidney formation was detected during a routine

ultrasound examination. Name the most informative method of diagnosis

Choose one answer:

Correct answer: Spiral computer tomography

6. A woman in labor has massive bleeding after giving birth to twins through natural
birth canals.

Children's place and birth canal are intact. The bottom of the uterus is higher than the navel, the
uterus is soft on palpation, does not respond to the introduction of uterotonics.

What is the most likely cause of bleeding?

The correct answer is: Atony of the uterus

7. Phenylketonuria was detected in a two-week-old newborn during a screening

examination. What treatment should be prescribed to the child to prevent serious complications in
the future?

The correct answer is: Special diet

8. A 25-year-old woman after giving birth has increased unsteadiness while walking
and weakness in her legs. He has been ill for 6 years, notes deterioration every hour in the fall.

Objectively observed: a euphoric woman, reduced criticality of her condition, horizontal

nystagmus, high tendon re exes, clonus of the feet, pathological foot re exes, abdominal re exes
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 absent, ataxia during Romberg's test, intentional tremor and failure to perform coordination tests.
Temporal pallor of optic nerve discs is observed on the fundus. What is the most likely diagnosis?

The correct answer is: Multiple sclerosis

9. A 52-year-old woman went to the doctor for an annual preventive examination. The
patient's father has a history of cardiovascular disease. Physical examination revealed: height 172
cm, weight - 77 kg, BMI 26 kg/m?, body temperature - 36.8°C, heart rate - 81/ min, respiratory
rate - 16/min, blood pressure 160/100 mm Hg . Art. on both hands. At ophthalmoscopy of the
fundus, narrowing of retinal vessels was found.

Laboratory indicators within the norm. Which appointment would be the most appropriate to
reduce the patient's risk of death from cardiac vascular diseases?

The correct answer is: Enalapril

10. A 14-year-old girl is being examined by a pediatrician. Objectively found: a girl of

tall growth, asthenic physique, scoliotic abdominal striae, blue sclera. posture, chest deformation
were

diagnosed on the skin. Joint hypermobility, long ngers and hands are noted. Mitral valve
prolapse is visualized on

ultrasound of the heart. Which of the following is the most likely reason for her high growth?

The correct answer is: Marfan syndrome

11) During the examination of the newborn girl, a hemorrhage on the head was found, which
does not go beyond one bone, does not pulsate, does not hurt. What condition has the child
developed?

The correct answer is: Cephalohematoma

12. A 72-vear-old patient turned to the doctor with complaints of hand tremors,
sti ness, slowness of gait and speech, and di culties in

performing usual housework. During the physical examination, the following are observed:

general bradvkinesia, hypomimia, emprostotonus, gait with a "wagging" gait, hand tremors at
rest, D>S, increased muscle tone of the plastic type, the "cogwheel" phenomenon, pronounced
postural instability. What drugs should be present in the treatment regimen of this patient in the
rst place?

The correct answer is: Preparations containing

13. For 12 hours, the lumberjack worked outdoors in windy weather at an air
temperature of +4-5°C Shoes squeezed the distal parts of the feet. He complains of stabbing,
burning pain in 1--3 toes of both feet, pain in the interphalangeal joints, decreased skin sensitivity
on

1--3 toes. During the examination, it was found that the toes are slightly swollen, the skin is
bluish, the movements in the interphalangeal joints are limited and painful, the sensitivity of the
skin is slightly reduced, the pulsation of the arteries on the back of the feet is preserved. What will
be the preliminary diagnosis?

The correct answer is: Frostbite of the rst degree

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 14. The patient, a worker at a chemical plant, works in the village aggressive liquid,
accidentally spilled it on his overalls, got a chemical burn on his right thigh and shin. After
removing the clothes, it was found: on the front-inner surface of the right thigh and on the front
surface of the right shin, with a transition to the rear part of the foot, yellow-gray areas, fragments
of the epidermis in places, tactile and painful hypesthesia of the a ected skin areas are observed.

What kind of emergency care should be provided rst?

The correct answer is: Rinsing with running water

15. On the 3rd day, the newborn was found to have deformation, swelling and
hematoma of soft tissues in the left supraclavicular region. The upper limb is brought to the trunk,
passive movements are accompanied by the child's restlessness. What is the likely diagnosis?

The correct answer is: Fracture of the left clavicle displacement of fragments

16. A child with a gestation period of 30 weeks was born with a body weight of 1100.0
g. 3 hours after birth, frequent apneas, gasps-like breathing appeared, heart rate - 98/min. The
rating on the Silverman scale is 9 points. Additional oxygenation did not improve the child's
condition. What are the next actions of the doctor?

The correct answer is: Arti cial lung ventilation with positive pressure

17. As a result of improper storage, sprouted or green potatoes have a bitter taste.

What poisonous substance contained in such a potato can cause food poisoning?

The correct answer is: solanin

18. Several chemical substances enter the human body from atmospheric air. What is
the name of the type of combined action, where the total e ect exceeds the sum of the e ects of
each individual substance included in the combination, in the case of its isolated e ect on the
body?

The correct answer is: Potentiation

19. A newborn baby developed a rash on his body.

The mother was not registered at the women's consultation. After birth, the child was assessed
on the Apgar scale at 7 and 9 points for 1 and 5 minutes, respectively. Physical examination
revealed: body temperature 37°C, pulse 145/min, respiratory rate 33/min, petechial rash on the
body. When auscultating the heart, a systolic-diastolic murmur is heard in the left subclavian
region. What is the most likely diagnosis?

The correct answer is: rubella

20. A 64-year-old man is undergoing outpatient treatment for ischemic heart disease,
di use cardiosclerosis, persistent atrial brillation, functional class III heart failure.
Pharmacotherapy consists of cordarone Twice a day, torasemide every other day, trimetazidine
twice a day.

The family doctor recommended taking warfarin (3 mg per day) in order to prevent thrombosis.
The measurement of which indicator in order to control the e ectiveness and safety of
anticoagulant therapy in this case would be the most expedient?

The correct answer is:

International normalized ratio

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 21. After the extraction of the second molar, the patient's body temperature increased,
there was pain in the pharynx on the left side, in ltration, hyperemia of the lower part of the
anterior palatal arch, displacement of the tonsils to the midline and upwards. Regional lymph
nodes are painful during palpation. The

otolaryngologist diagnosed <<paratonsilar abscess>>. What is the path of infection spread in this
case?

The correct answer is: Odontogenic

22. A 29-year-old woman complained of pain in the right iliac region, diarrhea with
impurities of mucus and pus, pain in the hip joints, and a periodic increase in body temperature
during the last few months. Abdomen on palpation is soft, sensitive in the right iliac region. During
irrigography, it was found: the relief of the mucous membrane resembles a "cobblestone

bridge", the ileocecal transition is narrow. What

disease can be assumed?

The correct answer is: Crohn's disease

24. A 27-year-old woman, pregnancy I, delivery 1, was hospitalized in the maternity

ward. It is known from the anamnesis: primary infertility for three years. Contractions occur every
4--5 minutes, 20--25 seconds each, duration 9 hours. 2.5 hours ago, the amniotic uid was
removed.

Fetal heart rate 136/min. The small segment of the head is located in the plane of the entrance to
the small pelvis. The cervix is smoothed, the opening

4 cm. The amniotic sac is absent. What complication occurred during childbirth?

The correct answer is: Primary weakness of

birth activity

25. A 42-year-old patient was hospitalized in the trauma department. X-ray revealed a
fracture of the pelvic bones.

Objectively observed: no spontaneous urination, urethrorrhagia. An enlarged bladder and painful

swelling in the perineum are palpated. What will be the preliminary diagnosis?

The correct answer is: Trauma to the urethra

26. To con rm the diagnosis of food poisoning, samples need to be sent to the
laboratory. What samples should be obtained for analysis? Ans.Vomit masses

27. A 22-year-old male went to the doctor with complaints of fever and cough with
yellow sputum. Symptoms are observed for seven days. Physical examination revealed:body
temperature 38.3°C,bloodpressure130/70mm HAgr.t., heart rate-79/min,respiratoryrate17/
min,Sp0295%.Onauscultation,rales are heard onhte left.Plain tsehc x-raryevealed consolidations
inhte olwer oble of the left l u n g . What i st h e most appropriate gurdt o prescribe t othe patient?
Correct answer: Azithromycin

30. The patient complains of back pain,weakness of the right foot, impairedwalking. On
examination, it was found: painful palpation of the lumbarparavertebral points, positive symptoms
of a cough shock andLasegue on the right at an angle of70°,thereis no Achilles re ex on the right,
weakness of the extensors of the right foot, poorly standing on the right heel. The patient was
diagnosed with sciatica with paresis of the foot on the right. What group of drugs should be
prescribed to him? A. Non-steroidal anti-in ammatory

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 31. A 54-year-old man was hospitalized with complaints of general weakness,fever up to
38.6°C, shortness of breath with signi cantphysicalexertion,frequentnasal

bleeding. Works in production plastics, where ti comes into contact with

aromatic compounds. Objectively revealed: the

skin is pale, dry. Aclinical blood test revealed: erythrocytes $2.1 10^{12$/I, Hb - - - 90

g/I, leukocytes $2.210^9$/1, --N - - 1 % , s t a b - - - 1 %, s e g m e n t e d

-*- 75%, lymphocytes - - 20%, myelocytes - - 3%, platelets $30-10^9$/1, --- ESR

32 mm/hour. What is the most likely

diagnosis?

A. Chronic intoxication with benzene

32. A 65-year-old patient with acute anterior myocardial infarction developed an

asthma attack. On examination:di use cyanosis. In the lungs there are a large number of wet rales
of various sizes. Heart rate - 100/min. BP- 160/100 mm Hg. What complication has developed in
the patient? Ans. pulmonary edema

33. A42-year-old patient was hospitalized

in the trauma department. X-ray revealed a fracture of the pelvic bones.

Objectively observed: no spontaneous

urination, urethrorhagia. Palpated enlarged bladder and painful

swelling in the perineum. What wil be the preliminary diagnosis?

Ans. urinary injury

34. A25-year-old woman had an increase in unsteadiness during walking and

weakness in her legs after childbirth. He has been il for 6 years,notes deterioration every year in
the fall. Objectively observed: the woman is euphoric, reduced criticality to her condition,
horizontal nystagmus, high tendon re exes, clonus of the feet, pathological foot re exes, no
abdominal re exes, ataxia during the Romberg test, intentional tremor and overshoot during the
performance of coordinating tests. In the fundus, temporal blanching of the optic discs is
observed. What is the most likely diagnosis? And. Multiple sclerosis

35. A 34-year-old woman consulted a doctor with

complaints of muscle weakness, thirst,increased urination at night, paresthesia, seizures.

Objectively revealed: the general condition is satisfactory, pastosity of the face and legs, Ps - - 80/
min, blood pressure - - - 200/110 mm Hg. Art.,accent I tone over the aorta. In a laboratory blood
test,itwasfound:K*_-31.mmol/,INa*--165 Immol / I.The ECG shows:T-wave inversion, S-T segment
depression. Ultrasound revealed hyperplasia of the right adrenal gland. What is the preliminary
diagnosis?

Ans. Primary hyperaldosteronism

36. A 25-year-old woman had an abortion six months

ago and complains of loss of appetite, weakness, and arthralgia. Two weeks later, black urine and
jaundice appeared, against which the general condition continues to deteriorate. Viral hepatitis is
suspected.

Which marker of viral hepatitis is likely to be positive in the patient?

Ans. Anti-HBc IgM

37. A59-year-old woman complains of pain and swelling of the small joints of the
hands,su ocation, and weakness. Sick for 8 years. Objectively observed: °t of

the body -- $37.8 OC$, punctate hemorrhages on the trunk and extremities, ulnar deviation of the
hands.

The boundaries of the heart are shifted to the left, systolic murmur over the apex. Pulse 96/min.
BP 170/100 mmHg Art. The general blood test revealed: erythrocytes $3.2 - 10^{12$/I, Hb - 108
g/1,leukocytes • $6.8 10^9$/I, platelets $220. --- 10

9 $ /1, ESR - - 48 mm / h, C-reactive protein +++.

In the general analysis of urine, ti was found: density - -

1016, protein - 2.8 g / I, leukocytes 10--12 in p / ---erythrocytes2-4 What is the most likely

Ans. Rheumatoid arthritis

38. A38-year-old patient is concerned about pain

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 in the metatarsophalangeal joints of 1-2 toes of the right foot. On examination, ti was found that
the skin over the a ected joints was purple-bluish in color, hot to the touch, in the area of the
auricles there were nodular formations covered with thin shiny skin. What drug for urate-lowering
therapy should be prescribed to the patient?

Ans. allopurinol

39. A45-year-old patient has been su ering from rheumatoid arthritis (RA) for 10 years and takes
methotrexate daily. Which statement about pneumococcal vaccination (23-valent vaccine) in this
case is consistent with the recommendations of the European Antirheumatic League ?

Ans. Vaccination recommended

40. The patient was hospitalized in the neurosurgical department for a closed craniocerebral
injury, a fracture of the temporal bone on the right. After 5 hours, his condition deteriorated
sharply, there were respiratory disorders, periodic tonic convulsions, anisocoria (dilation of the
right pupil). What complication can be expected in the patient?

Ans. Occurrenceo of epidural hematoma

41. A 32-year-old patient, looking at the pattern on the wallpaper, sees the lines begin to move,
forming the silhouettes of strange animals. Instead of a chandelier hanging from the ceiling, he
sees a giant octopus. Set psychopathological symptom.

Ans. Pareidolic Illusions

42. During the last months, a 29-year-old woman complained of pain in the

right iliac region, diarrhea with mucus and pus, pain ni the hip joints, periodic fever. The abdomen
is soft on palpation, sensitive in the right iliac region. When irrigography revealed: the relief of the
mucosa resembles <<cobblestone>>, the

ileocecal transition is narrowed. What disease

can be assumed?

Ans. cohns disease

43. A 46-year-old man went to the doctor with complaints of a rash on his hands that appeared a
week ago and was accompanied by severe itching. From the anamnesis it is known that the
patient su ers from bronchial asthma and seasonal

allergies. Physical examination revealed that the skin of the hands was dry, multiple erythematous
papules and vesicles with serous contents, areas of licheni cation and excoriation were found on
the back of both hands. What is the

most likely diagnosis?

Ans.eczema

44. A 10-year-old boy was treated in

the cardiology department for rheumatism, Tataka, active phase, I degree activity.

Discharged in a satisfactory condition. What drug

is most appropriate to prescribe for the prevention of secondary rheumatism?

Ans. bicillin 5

45. a57-year-old patient, aplanned ultrasound examination revealed avolumetric heterogeneous

formation of the right kidney. Name the most informative method for diagnosing a kidney tumor:

Ans.spiral CT

46. cancer of stomach- gastrectomy

47. Tonslogenic

48. Scarlet fever

49. Acute pyelonephritis

50. Mushroom- botulism

51. Eat mashroom - deadly amanita

52. Manic syndrome

53. Fantaziaz- hallucination

54. Pain in right illiac- ultrasound

55. Azithromycin

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 56. Secondary rhumetism- erythromycin

57. Mask face- scleroderma

58. Epilepsy- diazepam, lorazepam, idofonin

59. Cervix smooth out, 4 nger - normal labour

60. Rubella - termination pregnancy

61. Old women- self breast test

62. 3 y o with malabsorption- sweet test

63. Multiple bod rash, itchy - eczema

64. Fracture in his head- epidural hematoma

65. On tree, damage right faical nerve- skull fractures

66. Syphilis

67. Sigmoidoscopy

68. Sound with tempinitis- right tension pnuemothorax - ray

69. Butter y- sle

70. Raynauds phenomenon

71. Bandbox sound- bronchial asthma

72. Holter monitering

73. Hand pronated and torso- erd duschne palsy

74. Frequent diarrhea, nacklash appearance - pallegra

75. Pneumonia (long question) -300ml

76. Micro climate

77. High protein in urine - amyloid nephrotic

78. Hashimoto

79. Three medicine in question- universal

80. Long answer nished with proton pump inhibitors

81. About baby delivery in hospitals- perinatal

82. Dysentery

83. In question ketone- ketoacidosis

84. Urgent c senction

85. Thiazide

86. Delivery through the natural birth canal

87. Encephalitis

88. Carbon monoxide

89. Calculation of relative value

90. Hemodialysis

91. Women cant walk - multiple sclerosis

92. Hashimoto thyroditis

93. Hemodialysis

94. System of RA - methotrexate

95. Child was alive when he was born - forensic medical examination

96. Aldosteroma

97. Gastroduodenoscopy

98. Lead poisoning

99. Hyperprolactemia

100. 3 degree atrioventricular heart block

101. Chronic myelogenous leukemia ( myoblast 13%)

102. Phlegmon

103. Broncoscopy

104. Normal correct diet for chlid

105. Reactive arthritis

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 Topic you must
study before attempting
the PYQ

Subject -
Medicine KROK-2

Cardiology Endocrinology
Acute
coronary syndrome Diabetes
-
-

Pericarditis
Acute & DKA
·
HHS
Augina
-

Hypoglycemia
·
-

Aortic
Regurgitation ·
TrDM
- Aortic stenosis
·
T2DM
-
Atrial Fibrillation
-

Acromegaly
-
Cardiac
Physiology -

Addison's disease
-

Electro Physiology Cushing'ssyndrome

-

Heartfailure
Hyperthyrodiom
-

Hypertension Hypothyroidism
-
-

Infective Endocarditis MEN

syndromes
-

Cardiomyopathy
-

Primary Aldosteroniom
-
SIADH
-
Thyroid Physiology
GAstro -

GERD
-

Physiology of
Basic Gil
System
-
Lower G Bluding
Barrett's
oesophagus Lynch Syndrome
·
-

- celiac disease
-
Crohn's disease
-

Esophageal Cancer
-

Peptic ulcer disease

-

Eosinophilic oesophagitis -
ulcerative colitis
-Gantric cancer
-

upper GV Bleeding.
Narratology Hepatology
liver failure
Acute
X-Thalassuia
-
-

-
Anaemia
-

Alcoholic Hepatitis
-

B- Thalassemia
-
X-1 Antitrypsin deficiency
·
chronic liver disease
Chronic leukemia
lymphocytic
-

Hepatis A&E
-

Deep vein Thrombosis

-

Paracetamol Overdosage
-

Haematopoiesis ·
disease
Wilson's
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Hamolytic Anemia Infections

Hodgkin lymphoma cellulitis

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Clostridium defficile
Macrocytic Anemia
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Gram-Negative infections
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Multiple mydoma -

Gram-positive infection
Malaria
Non-Hodgkin lymphoma
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-

.
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sickle cell disease -

Meningitis
erology Oncology
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Algleimer's disease
- Lord
compression
MalignantHypercalcami
A

Palsy
-

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Bell's
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Neutropenic sepsis
Epilepsy
-

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SVCG
Multiple Sclerosis
lysis
-

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Trou
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Myasthenia Gravis
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Parkinson's disease
- Status Epilepticus
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Stroke
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TIA
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vascular dementia
Nephrology Respiratory
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Acute
kidney Injury Asthma
-

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ABPKD -
COPD

Anti GBM disease

lung cancer
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-

Chronic
kidney disease lung function test
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Glomerulopathies -

Muscles
of Respiration
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Granulomatosiswith -Pneumonia
Pulmonary Embolism
Polyangitis
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Sarcoidosis
Microscopic Polyangitis
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WTI
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Spontaneous Preumothorax
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Tuberculosis
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Ventication

matology
~

Eosinophilic granulomatosis
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Giantcell asteritis

Gout
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ofeo arthorities
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osteoporosis
rheumatica
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Polymyalgia
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pseudogout
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Rheumatoid arthritis
⑧N
Nutrient Deficiency Symptoms

Poor vision in low light, dry eyes, increased susceptibility to

Vitamin A Night blindness infections

Vitamin B1
(Thiamine) Beriberi Muscle weakness, loss of appetite, fatigue, nerve damage

Vitamin B2
(Riboflavin) Ariboflavinosis Cracked lips, sore throat, inflamed tongue, skin disorders

Dermatitis, diarrhea, dementia, inflamed mucous

Vitamin B3 (Niacin) Pellagra membranes

Vitamin B9 (Folate) Megaloblastic anemia Fatigue, weakness, shortness of breath, pale skin

Fatigue, weakness, tingling and numbness in extremities,

Vitamin B12 Pernicious anemia memory loss

Vitamin C Scurvy Weakness, swollen and bleeding gums, poor wound healing

Rickets (in children) and osteomalacia (in

Vitamin D adults) Bone pain, muscle weakness, increased risk of fractures

Vitamin E Neuromuscular disorders Muscle weakness, coordination difficulties, vision problems

Vitamin K Bleeding disorders Easy bruising, excessive bleeding, prolonged clotting time

Iron Iron-deficiency anemia Fatigue, weakness, pale skin, shortness of breath

Calcium Osteoporosis Weak bones, increased risk of fractures

Iodine Iodine deficiency disorders Goiter (enlarged thyroid gland), impaired mental function

Growth retardation, impaired immune

Zinc function Delayed growth and development, frequent infections

Magnesium Hypomagnesemia Muscle spasms, irregular heartbeat, fatigue

Potassium Hypokalemia Weakness, muscle cramps, abnormal heart rhythm

Sodium Hyponatremia Nausea, headache, confusion, seizures

Fluoride Dental cavities Increased susceptibility to tooth decay

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Type of
Abortion Symptoms and Signs

Threatened - Vaginal bleeding, which may be light or heavy. - Mild to moderate abdominal pain or cramping. - No
Abortion cervical dilation or tissue passage. - Fetal heartbeat may be present.

Imminent - Vaginal bleeding, which may be heavy and include passage of clots or tissue. - Severe abdominal
Abortion pain or cramping. - Cervical dilation may be present. - Fetal heartbeat may or may not be present.

Incomplete - Vaginal bleeding, which may be heavy and include passage of clots or tissue. - Severe abdominal
Abortion pain or cramping. - Cervical dilation is present. - Some fetal or placental tissue remains in the uterus.

Complete - Vaginal bleeding, which may be light or moderate. - Mild abdominal pain or cramping. - Cervical
Abortion dilation is present initially but closes after expulsion of all fetal and placental tissue.

Missed - Absence of fetal heartbeat on ultrasound. - Vaginal bleeding may be absent or minimal. - No uterine
Abortion contractions or cervical dilation. - Absence of fetal growth or development.

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Rheumatological Disorder Main Characteristic Feature Main Diagnostic Test

Symmetrical joint involvement, morning Rheumatoid factor (RF) and anti-cyclic

stiffness lasting at least one hour, joint citrullinated peptide (anti-CCP) antibody
Rheumatoid Arthritis deformities tests

Systemic Lupus Butterfly rash on the face, joint pain and

Erythematosus (SLE) swelling, photosensitivity, fatigue Antinuclear antibody (ANA) test

Anti-SSA (Ro) and anti-SSB (La) antibody

Sjögren's Syndrome Dry eyes, dry mouth, fatigue, joint pain tests, Schirmer's test

Chronic back pain and stiffness, limited

spinal mobility, inflammation of sacroiliac HLA-B27 genetic test, imaging studies (X-
Ankylosing Spondylitis joints rays, MRI)

Joint pain and swelling associated with Clinical evaluation, imaging studies, blood
psoriasis, nail changes, sausage-like tests (e.g., erythrocyte sedimentation rate,
Psoriatic Arthritis swelling of fingers or toes C-reactive protein)

Acute joint pain, usually affecting the big Joint fluid analysis, blood test for uric acid
Gout toe, swelling, redness, high uric acid levels levels

Muscle pain and stiffness, primarily Erythrocyte sedimentation rate (ESR), C-

Polymyalgia Rheumatica affecting the shoulders and hips, fatigue reactive protein (CRP) test

Thickening and hardening of the skin,

Systemic Sclerosis Raynaud's phenomenon, internal organ Clinical evaluation, antibody tests (e.g., anti-
(Scleroderma) involvement centromere antibody, anti-Scl-70 antibody)

Polymyositis and Muscle weakness, skin rash (in Creatine kinase (CK) blood test,
Dermatomyositis dermatomyositis), difficulty swallowing electromyography (EMG), muscle biopsy

Vasculitis (e.g., Giant Cell

Arteritis, Takayasu's Inflammation of blood vessels, headache, Biopsy of affected blood vessels, blood tests
Arteritis) vision changes, limb pain, reduced pulses (e.g., erythrocyte sedimentation rate)

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Rheumatological Disorder Main Characteristic Feature Main Diagnostic Test

Joint pain and stiffness, typically

affecting weight-bearing joints, joint
Osteoarthritis deformities Clinical evaluation, X-rays

Widespread musculoskeletal pain,

fatigue, sleep disturbances, tender Clinical evaluation, exclusion of other
Fibromyalgia points conditions

Oral and genital ulcers, skin lesions, Clinical evaluation, international

Behçet's Disease eye inflammation, joint pain diagnostic criteria

Joint inflammation following an

infection, commonly affecting knees, Clinical evaluation, exclusion of other
Reactive Arthritis ankles, and feet causes

Systemic Vasculitis (e.g., Inflammation of blood vessels, Biopsy of affected tissues, blood
Wegener's Granulomatosis, respiratory symptoms, kidney tests (e.g., antineutrophil
Churg-Strauss Syndrome) involvement cytoplasmic antibodies)

Overlap of features from different

connective tissue diseases, such as Clinical evaluation, antibody tests
Mixed Connective Tissue Disease SLE, scleroderma, polymyositis (e.g., anti-U1RNP antibody)

Inflammation of cartilage, ear and

nose deformities, respiratory Clinical evaluation, imaging studies,
Polychondritis symptoms biopsy

Recurrent blood clots, pregnancy Blood tests for antiphospholipid

complications, positive antibodies (e.g., lupus anticoagulant,
Antiphospholipid Syndrome antiphospholipid antibodies anticardiolipin antibodies)

Chronic arthritis in children, joint pain Clinical evaluation, exclusion of other

Juvenile Idiopathic Arthritis and swelling, growth problems causes, specific criteria for subtypes

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Skin Condition Main Characteristic Features Etiology

Genetic predisposition, immune system

True eczema Itchy, red, and inflamed skin patches dysfunction, environmental triggers

Eczema with bacterial or fungal

Microbial eczema superinfection Bacterial or fungal infection of the skin

Skin eruption caused by exposure to toxins

Toxicoderma or medications Reaction to drugs, chemicals, or toxins

Simple contact Red, itchy rash caused by direct contact Contact with irritants, such as soaps, detergents,
dermatitis with irritants or chemicals

Rash triggered by an allergic reaction to Allergic reaction to allergens, such as certain

Allergic dermatitis specific substances foods, medications, or environmental allergens

Autoimmune disorders, medication reactions,

Bullous dermatitis Formation of fluid-filled blisters on the skin infections

Autoimmune blistering disease affecting Autoimmune response targeting proteins

Pemphigus vulgaris mucous membranes and skin involved in cell adhesion

Acute epidermal Severe skin reaction characterized by

necrolysis widespread blistering and skin detachment Severe drug reaction, often to medications

Erythema multiforme Target-shaped skin lesions, usually triggered Infections (e.g., herpes simplex virus),
exudativum by infections or medications medications, autoimmune response

Duhring dermatitis Chronic, itchy skin rash with grouped Autoimmune response to gluten ingestion
herpetiformis blisters (associated with celiac disease)

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Skin Condition Main Characteristic Features Etiology

Psoriasis Red, scaly patches of skin Autoimmune disorder, genetic predisposition

Papules, pustules, and comedones on Excess sebum production, clogged hair follicles,
Acne vulgaris the skin bacterial infection

Facial flushing, persistent redness, Genetic predisposition, environmental triggers,

Rosacea visible blood vessels vascular abnormalities

Loss of skin pigmentation, leading to

Vitiligo white patches Autoimmune destruction of melanocytes

Urticaria (Hives) Itchy, raised wheals on the skin Allergic reactions, autoimmune disorders, infections

Atopic Dermatitis Genetic predisposition, immune system dysfunction,

(Eczema) Itchy, dry, and inflamed skin patches environmental triggers

Blisters or sores that ooze and form a Bacterial infection, commonly caused by
Impetigo honey-colored crust Staphylococcus aureus or Streptococcus pyogenes

Red, circular patches with raised edges

Tinea (Ringworm) and clear centers Fungal infection, commonly caused by dermatophytes

Intense itching and rash, especially in

Scabies skin folds Infestation by the Sarcoptes scabiei mite

Molluscum Small, raised, pink or flesh-colored Viral infection, caused by the molluscum contagiosum
Contagiosum bumps with a central dimple virus

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Skin Condition Main Characteristic Features Etiology

Slow-growing, shiny, raised nodules Exposure to ultraviolet (UV) radiation, genetic

Basal Cell Carcinoma or lesions predisposition

Squamous Cell Chronic sun exposure, exposure to carcinogens,

Carcinoma Firm, red nodules or scaly patches weakened immune system

Asymmetric, irregularly shaped Excessive UV exposure, genetic predisposition, family

Melanoma moles or lesions history

Painful blisters and erosions, often Herpes simplex virus infection, particularly in
Eczema Herpeticum with fever individuals with pre-existing eczema

Oval-shaped, pink or red patches Viral infection, possibly triggered by human

Pityriasis Rosea with a scaly border herpesvirus-6 or 7

Pruritic, flat-topped, purple papules Autoimmune disorder, certain medications, viral

Lichen Planus or plaques infections

Painful, recurrent abscesses or Chronic inflammation of the hair follicles and sweat
Hidradenitis Suppurativa nodules in skin folds glands

Cutaneous Lupus Butterfly-shaped rash on the face, Autoimmune disorder, often associated with systemic
Erythematosus photosensitivity lupus erythematosus

Painful ulcers with undermined Autoimmune disorder, often associated with

Pyoderma Gangrenosum borders underlying systemic diseases

Stevens-Johnson Widespread rash, blistering, and skin

Syndrome detachment Severe adverse reaction to medications or infections

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Lung Sound Formation Reason Associated Diseases

Normal breath
sounds Normal airflow through the airways N/A

Narrowing of airways due to inflammation or Asthma, chronic obstructive pulmonary disease

Wheezes constriction (COPD), bronchitis

Rhonchi Secretions or mucus in the larger airways Chronic bronchitis, pneumonia, bronchiectasis

Opening of closed airways or movement Pneumonia, heart failure, interstitial lung

Crackles (Rales) through fluid-filled airways disease

Stridor Obstruction or narrowing of the upper airway Croup, epiglottitis, foreign body inhalation

Pleural friction rub Inflammation of the pleural lining Pleurisy, pleural effusion, pneumonia

Diminished breath Atelectasis, pneumothorax, severe asthma

sounds Reduced airflow or consolidation of lung tissue attack

Absent breath
sounds Lack of airflow or air entry Pneumothorax, hemothorax, lung collapse

Bronchial breath Abnormal transmission of breath sounds from

sounds larger airways Consolidation (e.g., pneumonia), lung tumors

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Percussion
Sound Characteristics Clinical Significance

Resonant Low-pitched, hollow sound Heard over healthy lung tissue

Louder and lower-pitched than Heard in conditions with increased lung air trapping (e.g.,
Hyperresonant resonant sound emphysema)

Thud-like, medium-pitched
Dull sound Heard over areas of lung consolidation (e.g., pneumonia, tumor)

Stony dullness Very dull sound Heard over areas of pleural effusion or hemothorax

Heard over large air-filled spaces (e.g., pneumothorax, large

Tympanic Drum-like, high-pitched sound bullae)

Heard over areas of complete lung collapse or massive pleural

Flat Very dull, high-pitched sound effusion

High-pitched, wooden-box-like Heard in conditions with increased air-filled lung volume (e.g.,
Bandbox sound bronchial asthma, chronic obstructive pulmonary disease)

Resonant sound with a metallic,

Cracked pot tinkling quality Suggestive of pneumothorax or bronchopleural fistula

Skodaic Increased resonance at the

resonance upper lung border Indicative of lung consolidation (e.g., lobar pneumonia)

Increased resonance with a nasal Suggestive of lung consolidation (e.g., pneumonia) or pleural
Egophony or bleating quality effusion

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Vasculitis Type Special Features Common Causes

Affects medium and large arteries, Exact cause unknown; autoimmune

Giant Cell (Temporal) Arteritis particularly the temporal arteries and genetic factors implicated

Affects large arteries, particularly the aorta Autoimmune disease, often with
Takayasu Arteritis and its branches unknown triggers

Involves medium and small arteries, forming Autoimmune disease, possibly

Polyarteritis Nodosa nodules and aneurysms triggered by viral infections

Affects small and medium-sized blood

Granulomatosis with Polyangiitis vessels, typically involving the upper Autoimmune disease, possibly
(Wegener's Granulomatosis) respiratory tract and kidneys triggered by infections

Eosinophilic Granulomatosis with Involves small and medium-sized blood

Polyangiitis (Churg-Strauss vessels, often associated with eosinophilia Autoimmune disease, often with
Syndrome) and asthma allergic or environmental triggers

Affects small blood vessels, including

capillaries, leading to inflammation and Autoimmune disease, possibly
Microscopic Polyangiitis damage triggered by infections

Primarily affects children, involves Exact cause unknown; likely involves

inflammation of medium-sized blood an abnormal immune response to an
Kawasaki Disease vessels, particularly coronary arteries infection

Multisystem vasculitis, involving both Autoimmune disease, often

arteries and veins, with recurrent oral and associated with HLA-B51 genetic
Behçet's Disease genital ulcers marker

Primarily affects small blood vessels,

characterized by purpura (skin rash) and Exact cause unknown; often follows
Henoch-Schönlein Purpura joint pain an upper respiratory tract infection

Associated with cryoglobulins, immune

complexes that precipitate and cause Often associated with hepatitis C
Cryoglobulinemic Vasculitis inflammation infection

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Stage/Sub- Cervical
stage Signs and Symptoms Duration Frequency of Contractions Dilation

Stage 1: Early
Labor

Irregular contractions, mild discomfort Contractions may be 5-30

or cramping, backache, nesting instinct, Variable, can minutes apart, lasting around
- Latent Phase bloody show last for days 30-45 seconds 0-3 cm

Regular contractions, increasing Contractions occur every 3-5

intensity and frequency, intensified 4-8 hours on minutes, lasting around 45-60
- Active Phase back pain average seconds 4-7 cm

Strong, frequent contractions, intense

pain, exhaustion, pressure in the lower Contractions are very close
- Transition back and rectum, complete dilation (10 30 minutes together, around 2-3 minutes 8-10 cm (full
Phase cm) to 2 hours apart, lasting 60-90 seconds dilation)

Stage 2:
Pushing and
Delivery

Strong urge to push, pressure in the Variable, Contractions are strong and
- Pushing and rectum, baby moving down the birth typically 1-3 powerful, lasting around 60-90 Fully dilated
Descending canal hours seconds (10 cm)

Stage 3:
Placental
Delivery

Mild contractions, decreased bleeding, Few minutes Contractions may continue but
- Expulsion of placenta separates from the uterine to 30 are usually milder and less N/A (Placenta
Placenta wall minutes frequent is delivered)

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Condition Etiology Distinctive Features Distinctive Lab Tests

Heavy proteinuria (>3.5 g/day), Urine protein-to-creatinine ratio,

Nephrotic hypoalbuminemia, generalized serum albumin levels, lipid profile,
Syndrome Primary: Idiopathic edema renal biopsy

Secondary: Systemic Hyperlipidemia, increased risk

diseases (e.g., diabetes) of thrombosis

Hematuria, mild proteinuria, Urinalysis (hematuria, red cell

Post-infectious hypertension, edema, renal casts), elevated anti-streptolysin O
Nephritic Syndrome glomerulonephritis insufficiency titers, complement levels

Recurrent episodes of gross

IgA nephropathy (Berger's hematuria, often after
disease) respiratory infections

Fever, flank pain, dysuria, Urinalysis (pyuria, bacteriuria),

Bacterial infection (most urinary frequency, positive urine culture, complete blood count
Pyelonephritis commonly E. coli) urine culture (leukocytosis)

Hematuria, proteinuria, Urinalysis (hematuria, proteinuria,

Autoimmune disorders hypertension, edema, renal red cell casts), antinuclear antibody
Glomerulonephritis (e.g., lupus) insufficiency test, renal biopsy

Urinalysis (hematuria, crystal

Formation of urinary Severe flank pain radiating to analysis), imaging studies (CT scan,
Urolithiasis stones the groin, hematuria ultrasound)

Severe intermittent pain in the

flank or lower abdomen, Clinical presentation, imaging
Renal Colic Passage of kidney stones hematuria studies (CT scan, ultrasound)

Sudden decrease in kidney

Various causes, e.g., acute function, oliguria or anuria, fluid Serum creatinine levels, blood urea
Acute Kidney Injury tubular necrosis overload nitrogen (BUN) levels, urine output

Gradual loss of kidney function, Estimated glomerular filtration rate

Chronic Kidney Diabetes, hypertension, proteinuria, electrolyte (eGFR), serum creatinine levels,
Disease glomerulonephritis, etc. imbalances urine albumin-to-creatinine ratio

Type of Leukemia Special Features CBC Values Other Relevant Lab Tests

Chronic Philadelphia Increased WBC

Bone marrow biopsy to confirm
Myeloid Leukemia chromosome (BCR- count (usually
diagnosis and assess disease
(CML) ABL fusion gene) >100,000/μL); increased
progression; cytogenetic
present in >95% of neutrophils, basophils,

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Type of Leukemia Special Features CBC Values Other Relevant Lab Tests

cases; usually and eosinophils; may analysis to detect Philadelphia

asymptomatic in have anemia and chromosome
early stages thrombocytopenia

Increased WBC count

Most common type
(usually >20,000/μL); Flow cytometry to confirm
Chronic of adult leukemia;
increased lymphocytes diagnosis and assess disease
Lymphocytic slow-growing and
(clonal B-cells); may have progression; immunoglobulin
Leukemia (CLL) often asymptomatic
anemia and gene rearrangement analysis
in early stages
thrombocytopenia

Increased or decreased
Bone marrow biopsy to confirm
Rapid onset; often WBC count; may have
diagnosis and assess disease
presents with anemia and
Acute Myeloid subtype; cytogenetic analysis to
symptoms such as thrombocytopenia;
Leukemia (AML) detect specific genetic
fatigue, fever, and presence of >20% blasts
abnormalities; flow cytometry to
bleeding in bone marrow or
detect surface markers on blasts
peripheralblood

Increased or decreased
Most common type
WBC count; may have Bone marrow biopsy to confirm
of childhood
anemia and diagnosis and assess disease
Acute leukemia; rapid
thrombocytopenia; subtype; cytogenetic analysis to
Lymphoblastic onset with
presence of >20% detect specific genetic
Leukemia (ALL) symptoms such as
lymphoblasts in bone abnormalities; flow cytometry to
fatigue, fever, and
marrow or peripheral detect surface markers on blasts
bleeding
blood

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Heart Murmur Location Description Associated Conditions

Systolic Murmurs

Second right Harsh, crescendo-decrescendo

Aortic valve calcification,
Aortic stenosis intercostal murmur that radiates to
bicuspid aortic valve
space carotids

Second left
Harsh, crescendo-decrescendo Congenital heart defects,
Pulmonic stenosis intercostal
murmur that radiates to back rheumatic fever
space

Mitral valve
Apex of the High-pitched, blowing murmur
Mitral regurgitation prolapse, rheumatic
heart that radiates to axilla
heart disease

Tricuspid Left lower Holosystolic, blowing murmur Rheumatic heart disease,

regurgitation sternal border that increases with inspiration infective endocarditis

Harsh, crescendo-decrescendo
Hypertrophic Left lower Genetic disorder, familial
murmur that increases with
cardiomyopathy sternal border inheritance
Valsalva maneuver

Diastolic Murmurs

Second right
High-pitched, blowing murmur Aortic valve insufficiency,
Aortic regurgitation intercostal
that increases with expiration endocarditis
space

Second left
Pulmonic High-pitched, blowing murmur Pulmonary hypertension,
intercostal
regurgitation that increases with inspiration congenital heart defects
space

Apex of the Low-pitched, rumbling murmur

Mitral stenosis Rheumatic heart disease
heart that increases with expiration

Left lower Low-pitched, rumbling murmur Rheumatic heart disease,

Tricuspid stenosis
sternal border that increases with inspiration carcinoid syndrome

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Finding Potential Causes Meaning

Increased lung volumes due to air trapping and

Chronic
hyperinflation, may indicate obstructive lung disease.
Hyperinflation obstructive pulmonary
In COPD, hyperinflation may result from destruction of
disease (COPD), asthma
alveolar walls and loss of lung tissue.

Decreased lung volumes due to partial or complete collapse

Airway obstruction, lung of lung tissue, may indicate obstructive or restrictive lung
Atelectasis
collapse disease. Atelectasis may also be caused by compression of
the lung tissue or pleural effusion.

Dense opacification of lung tissue due to the filling of alveoli

with fluid or pus, may indicate infection or
Consolidation Pneumonia, lung cancer
malignancy. Consolidation may also be seen in acute
respiratory distress syndrome (ARDS).

Fluid accumulation in the pleural space, may indicate an

Heart failure, underlying disease. The presence of pleural effusion may
Pleural effusion
pneumonia, cancer cause compression of the lung tissue and lead to atelectasis
or consolidation.

Air in the pleural space, may indicate lung collapse or injury.

Pneumothorax may be causedby trauma, lung disease, or as
Pneumothorax Trauma, lung disease a complication of medical procedures. A large
pneumothorax can cause significant respiratory distress and
requires urgent medical attention.

Fine, linear opacities in the lung fields due to thickening of

Interstitial lung
Interstitial the interstitium (the space between alveoli), may indicate
disease, pulmonary
infiltrates chronic lung disease. Interstitial infiltrates can also be seen
fibrosis
in pulmonary edema, viral infections, or pneumonitis.

Rounded opacities in the lung fields, may indicate

malignancy or infection. Lung nodules can have various
Nodules or
Lung cancer, metastases causes, including benign or malignant tumors, granulomas,
masses
or infections. The size, shape, and location of the nodule can
help determine the underlying cause.

Formation of a cavity or hollow space in lung tissue, may

indicate infection. Cavitation is most commonly seen in
Tuberculosis, lung
Cavitation tuberculosis and lung abscesses. A cavity may form when
abscess
lung tissue is destroyed by infection, resulting in a hollow
space.

Increased fluid in the lung tissue, may indicate heart or

Pulmonary Heart failure, fluid kidney disease. Pulmonary edema may be seen in acute
edema overload or chronic heart failure, as well as in other conditions that
cause fluid overload, such as kidney failure or liver disease.

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 Blockage of a pulmonary artery, may indicate a potentially
life-threatening condition. A pulmonary embolism occurs
Pulmonary when a blood clot travels to the lungs from another part of
Blood clotsin the lungs
embolism the body, such as the legs, and blocks blood flow. This can
lead to shortness of breath, chest pain, and other serious
complications.

Enlargement of the mediastinum (the area between the

lungs), may indicate aortic pathology or
Mediastinal Aortic aneurysm, malignancy. Mediastinal widening can be caused by various
widening lymphoma conditions, including aortic aneurysm, lymphoma, or other
tumors. CT scans or MRI may be necessary to further
evaluate the mediastinum.

Thickening of the pleural lining, may indicate chronic lung

disease or malignancy. Pleural thickening can be caused by
Pleural Asbestosis, various conditions, including asbestos exposure, chronic
thickening mesothelioma inflammation, or malignancy (e.g., mesothelioma). Pleural
thickening may cause pleural effusion and lead to
respiratory symptoms.

Inflammation of the pleural lining, may indicate an

underlying inflammatory condition. Pleurisy can be caused
Viral or bacterial
by various conditions, including viral or bacterial
Pleurisy infection, autoimmune
infections, autoimmune diseases (e.g., lupus), or pulmonary
disease
embolism. Pleurisy may cause chest pain ordiscomfort,
coughing, and difficulty breathing.

Enlargement of the heart, may indicate underlying heart

disease. Cardiomegaly can be caused by various conditions,
Heart failure, including heart failure, cardiomyopathy, or valve disease.
Cardiomegaly
cardiomyopathy Cardiomegaly may lead to respiratory symptoms and can
increase the risk of heart failure or other cardiovascular
complications.

Dilatation of the thoracic aorta, may indicate aortic

pathology. Thoracic aortic aneurysms can be caused by
Thoracic aortic various conditions, including connective tissue disorders,
Aortic aneurysm
aneurysm atherosclerosis, or genetic predisposition. Aortic aneurysms
can be life-threatening if they rupture or dissect and require
close monitoring and treatment.

Idiopathic pulmonary Scarring and thickening of lung tissue, may indicate chronic
Lung fibrosis fibrosis, occupational lung disease. Lung fibrosis can be caused by various
lung disease conditions, including idiopathic pulmonary fibrosis,
occupational lung disease, or autoimmune diseases. Lung

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 fibrosis can lead to respiratory symptoms, such as shortness
of breath, coughing, and decreased exercise tolerance.

Small, rounded opacities in the lung fields, may indicate

malignancy or infection. Lung nodules can have various
causes, including benign or malignant tumors,granulomas,
Benign or malignant
Lung nodules or infections. The size, shape, and location of the nodule
tumors, granulomas
can help determine the underlying cause. Follow-up imaging
and biopsy may be necessary to further evaluate the nodule
and determine if it is cancerous.

Heart
Location Description Associated Conditions
Sound

Mitral and "Lub" sound heard at the

S1 Normal heart sounds
tricuspid areas beginning of systole

Aortic and "Dub" sound heard at the

S2 Normal heart sounds
pulmonic areas end of systole

Low-pitched "gallop"
Apex of the
S3 sound heard in early Heart failure, volume overload
heart
diastole

Low-pitched "gallop"
Apex of the
S4 sound heard in late Hypertension, hypertrophic cardiomyopathy
heart
diastole

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 Abnormal sounds heard Various heart conditions, such as valve
Murmurs between normal heart stenosis or regurgitation, septal defects,
sounds or abnormal blood flow

Condition Description Distinctive Features Diagnostic Features

Fever, cough with Consolidation on chest X-

Infection of the lung
Pneumonia purulent sputum, chest ray, positive sputum culture,
tissue
pain, dyspnea elevated inflammatory markers

Chronic cough with

Normal chest X-ray, normal
Inflammation of the mucus production,
Bronchitis pulmonary function tests, elevated
bronchial tubes wheezing, chest
inflammatory markers
tightness

Cough, Mass or nodule on chest X-ray

Malignant tumor in
Lung cancer hemoptysis, weight or CT scan, biopsy or imaging
the lung tissue
loss, chest pain, dyspnea consistent with malignancy

Positive tuberculin skin test or

Infection caused Cough, fever, night interferon-gamma release assay,
Tuberculosis by Mycobacterium sweats, weight loss, chest X-ray with infiltrates or
tuberculosis hemoptysis cavitation, acid-fast bacilli on
sputum microscopy

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Condition Description Distinctive Features Diagnostic Features

Positive D-dimer test, CT

Blockage of a Sudden onset of
Pulmonary angiography or ventilation/perfusion
pulmonary artery by a dyspnea, chest pain,
embolism scan,elevated troponin or B-type
blood clot cough, hemoptysis
natriuretic peptide (BNP) levels

Normal chest X-ray, positive viral

Inflammation of the Wheezing, cough, test (e.g., respiratory syncytial
Bronchiolitis
bronchioles dyspnea, fever virus), elevated inflammatory
markers

Condition Description Distinctive Features Diagnostic Features

Recurrent
Chronic episodes of Reversibility on pulmonary function
Asthma inflammation of the wheezing, coughing, tests, elevated eosinophils in blood
airways dyspnea, chest or sputum
tightness

Chronic cough, Reduced airflow on pulmonary

Chronic obstructive
COPD sputum production, function tests, history of smoking
lung disease
dyspnea, wheezing or exposure to lung irritants

Chronic inflammation Interstitial infiltrates on chest X-ray

Interstitial Dyspnea, dry cough,
and scarring of the lung or CT scan, reduced lung volumes
lung disease fatigue, weight loss
tissue on pulmonary function tests

Interstitial infiltrates and

Chronic scarring and honeycombing on chest X-ray or CT
Pulmonary Dyspnea, dry cough,
thickening of the lung scan, reduced lung volumes and
fibrosis fatigue, weight loss
tissue decreased diffusion capacity on
pulmonary function tests

Autoimmune
Sarcoidosis Dyspnea, cough, Noncaseating granulomas on
disease that causes
fatigue, weight biopsy of involved organ, elevated
granulomas in various

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Condition Description Distinctive Features Diagnostic Features

organs, including the loss, erythema angiotensin-converting enzyme

lungs nodosum (ACE) levels

Idiopathic
pulmonary Elevated pulmonary artery
High blood pressure in Dyspnea, fatigue,
arterial pressure on echocardiography
the pulmonary arteries chest pain, syncope
hypertension or right heart catheterization
(IPAH)

High blood pressure in Elevated pulmonary artery

Pulmonary
the pulmonary arteries Dyspnea, fatigue, pressure on echocardiography or
hypertension due
due to underlying lung chest pain, syncope right heart catheterization,
to lung disease
disease underlying lung disease

Acute lung injury Bilateral infiltrates on chest X-ray

Acute respiratory Dyspnea, cough,
caused by various or CT scan, decreased lung
distress tachypnea,
factors, such as compliance and oxygenation on
syndrome (ARDS) hypoxemia
infection or trauma pulmonary function tests

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Condition Description Distinctive Features Diagnostic Tests

Fatigue,
Adrenal insufficiency due Low cortisol and
weakness, weight loss,
Addison's disease to adrenal gland damage aldosterone levels,
hypotension,
or dysfunction high ACTH levels
hyperpigmentation

Weight gain, central

Excess cortisol
obesity, moon Elevated cortisol levels,
Cushing's syndrome production, often caused
facies, muscle weakness, low ACTH levels
by a tumor
hypertension

Primary
Hypertension, weakness,
hyperaldosteronism due Elevated aldosterone
Conn's syndrome muscle cramps, polyuria,
to an aldosterone- levels, low renin levels
polydipsia
producing tumor

Paroxysmal
Adrenal gland tumor that Elevated urinary
hypertension, headache,
Pheochromocytoma produces excess catecholamines and
palpitations, sweating,
catecholamines metanephrines
anxiety

Hormonal evaluation
(cortisol, aldosterone,
Unintentionally Often asymptomatic, but
Adrenal androgens,
discovered adrenal gland can cause hypertension
incidentaloma catecholamines) and
mass or hormonal imbalances
imaging studies (CT, MRI,
or PET)

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Condition Description Distinctive Features Diagnostic Tests

A group of genetic
Ambiguous genitalia in Elevated plasma 17-
disorders that affect
Congenital adrenal females, early-onset hydroxyprogesterone, low
the adrenal glands'
hyperplasia (CAH) puberty, salt wasting, cortisol and aldosterone levels,
ability to produce
virilization in females genetic testing
hormones

Life-threatening
Hypotension, shock, Low serum cortisol levels,
condition caused
Adrenal crisis fever, abdominal pain, elevated ACTH levels,
by acute adrenal
confusion electrolyte abnormalities
insufficiency

Often asymptomatic, Hormonal evaluation (cortisol,

Benign tumor of the
but can cause aldosterone, androgens),
adrenal gland that can
Adrenal adenoma hypertension imaging studies (CT, MRI, or
cause hormonal
or hormonal PET), biopsy or surgical
imbalances
imbalances exploration

Elevated plasma cortisol,

Abdominal
aldosterone, and/or
Adrenocortical Rare malignant tumor pain, weight loss,
androgens, imaging
carcinoma of the adrenal cortex hypertension,
studies (CT, MRI, or PET),
hormonal imbalances
biopsy or surgical exploration

Adrenal insufficiency Fatigue, weakness, Low cortisol levels, low or

Secondary adrenal due to pituitary weight loss, normal ACTH levels, imaging
insufficiency or hypothalamic hypotension, lack of studies (MRI or CT) of the
dysfunction appetite pituitary gland

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Condition Description Distinctive Features Diagnostic Tests

Hormonal disorder causing Irregular periods, acne, Blood tests (elevated

Polycystic ovary
enlarged ovaries hirsutism, weight gain, androgens, LH:FSH ratio),
syndrome (PCOS)
and multiple cysts infertility pelvic ultrasound

Condition
Pelvic pain, painful
where endometrial Pelvic exam, ultrasound,
Endometriosis periods, pain during sex,
tissue grows outside the laparoscopy
infertility
uterus

Heavy menstrual
Noncancerous growths in bleeding, pelvic pain, Pelvic exam, ultrasound,
Uterine fibroids
the uterus pressure on the bladder MRI
or rectum

Pain or discomfort in the

Fluid-filled sacs that form on
Ovarian cysts pelvis, bloating, irregular Pelvic exam, ultrasound
the ovaries
periods

Abnormal vaginal
Cancer that develops in the Pap smear, HPV testing,
Cervical cancer bleeding, pelvic pain,
cervix colposcopy
pain during sex

Pelvic exam, biopsy,

Burning, stinging, or
Chronic pain or discomfort swabs to rule out
Vulvodynia rawness in the vulva,
in the vulva infection or other
pain during sex
conditions

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Condition Description Distinctive Features Diagnostic Tests

Polycystic ovary Hormonal disorder causing Irregular periods, acne, Blood tests (elevated
syndrome enlarged ovaries hirsutism, weight gain, androgens, LH:FSH ratio),
(PCOS) and multiple cysts infertility pelvic ultrasound

Condition
Pelvic pain, painful
where endometrial Pelvic exam, ultrasound,
Endometriosis periods, pain during
tissue grows outside the laparoscopy
sex, infertility
uterus

Noncancerous growths in
Uterine fibroids
the uterus
Heavy menstrual
bleeding, pelvic pain,
Pelvic exam, ultrasound, MRI
pressure on the
bladder or rectum

Pain or discomfort in
Fluid-filled sacs that form the pelvis,
Ovarian cysts Pelvic exam, ultrasound
on the ovaries bloating, irregular
periods

Abnormal vaginal
Cancer that develops in the Pap smear, HPV testing,
Cervical cancer bleeding, pelvic pain,
cervix colposcopy
pain during sex

Burning, stinging, or
Chronic pain or discomfort Pelvic inflammatory
Vulvodynia rawness in the vulva,
in the vulva disease (PID)
pain during sex

Abdominal bloating,
Cancer that develops in the pelvic pain, difficulty Pelvic exam, imaging studies
Ovarian cancer
ovaries eating or feeling full (ultrasound, CT, MRI), biopsy
quickly

Pelvic exam, microscopic

Vaginal yeast Fungal infection of the Vaginal itching,
examination of vaginal
infection vagina burning, and discharge
discharge

Vaginal discharge with Pelvic exam, microscopic

Bacterial Bacterial overgrowth in the
a fishy odor, itching or examination of vaginal
vaginosis vagina
burning discharge

Prolonged or heavy
Pelvic exam, blood tests (to
Menorrhagia Heavy menstrual bleeding menstrual periods,
check for anemia), ultrasound
passing blood clots

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Condition Description Distinctive Features Diagnostic Tests

Absence of menstrual No menstrual periods Blood tests (to check

Amenorrhea
periods for 3 months or longer hormone levels), ultrasound

Blood tests (low levels of

Fatigue, weakness,
pituitary hormones, including
Hormonal deficiencies due inability to breastfeed,
follicle-stimulating hormone,
Sheehan's to pituitary gland damage loss of pubic and
luteinizing hormone, thyroid-
syndrome after severe postpartum underarm hair,
stimulating hormone, and
hemorrhage irregular periods,
growth hormone), MRI of the
hypothyroidism
pituitary gland

Electrolyte
Description Distinctive Features Associated Diseases
Imbalance

Low sodium Fatigue, nausea, vomiting, Heart failure, liver disease, kidney
Hyponatremia levels in the headache, confusion, disease, SIADH, medications (e.g.
blood seizures, coma diuretics), excessive water intake

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Electrolyte
Description Distinctive Features Associated Diseases
Imbalance

High sodium Thirst, dry mouth, muscle

Dehydration, diabetes insipidus,
Hypernatremia levels in the weakness, confusion,
Cushing's syndrome, kidney disease
blood seizures, coma

Low potassium Weakness, fatigue, muscle

Diuretic use, vomiting, diarrhea,
Hypokalemia levels in the cramps, constipation,
renal disease, hyperaldosteronism
blood arrhythmias

High potassium Kidney disease, Addison's

Muscle weakness, paralysis,
Hyperkalemia levels in the disease, ACE inhibitors, potassium-
arrhythmias, cardiac arrest
blood sparing diuretics

Muscle cramps,
Low calcium
numbness/tingling in hands Hypoparathyroidism, chronic renal
Hypocalcemia levels in the
and feet, seizures, failure, vitamin D deficiency
blood
arrhythmias

Highcalcium Hyperparathyroidism, cancer (e.g.

Fatigue, weakness, confusion,
Hypercalcemia levels in the multiple myeloma), sarcoidosis,
constipation, kidney stones
blood excess vitamin D intake

Hematological
Description Distinctive Features Diagnostic Tests Peripheral Blood Smear
Condition

Blood tests (low

Anemia Fatigue, weakness,
Iron-deficiency hemoglobin and Microcytic, hypochromic
caused by a pallor, shortness of
anemia hematocrit, low red blood cells
lack of iron breath, brittle nails
serum ferritin)

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Hematological
Description Distinctive Features Diagnostic Tests Peripheral Blood Smear
Condition

Fatigue, weakness,
Anemia Blood tests (low
numbness/tingling
Vitamin B12 caused by a hemoglobin and Macrocytic red blood
in hands and feet,
deficiency anemia lack of hematocrit, low cells
difficulty walking,
vitamin B12 serum B12 levels)
smooth tongue

Blood tests (low

Anemia Fatigue, weakness, hemoglobin and
Folate deficiency Macrocytic red blood
caused by a pallor, shortness of hematocrit, low
anemia cells
lack of folate breath, diarrhea serum folate
levels)

Anemia
Blood tests
caused by Schistocytes,
Fatigue, weakness, (elevated bilirubin,
the spherocytes,
Hemolytic anemia pallor, low haptoglobin,
destruction polychromatophilic red
jaundice, dark urine high LDH, low
of red blood blood cells
haptoglobin)
cells

Fatigue, weakness, Blood tests

An inherited
pallor, pain crises, (hemoglobin
form of Sickle-shaped red blood
Sickle cell anemia jaundice, delayed electrophoresis to
hemolytic cells
growth and identify sickle cell
anemia
development trait or disease)

An inherited
Blood tests
form of Fatigue, weakness,
(hemoglobin
anemia that pallor, delayed
electrophoresis to Microcytic, hypochromic
Thalassemia affects the growth and
identify alpha or red blood cells
production development, bone
beta thalassemia
of deformities
trait or disease)
hemoglobin

Anemia
caused by Blood tests (low
the failure of Fatigue, weakness, levels of red blood Pancytopenia (reduced
the bone pallor, increased cells, white blood numbers of red blood
Aplastic anemia
marrow to risk of infections cells, and platelets; cells, white blood cells,
produce and bleeding bone marrow and platelets)
enough biopsy)
blood cells

A genetic Excessive bleeding Blood tests Normal peripheral blood

Hemophilia
bleeding or bruising, joint (measuring levels smear

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Hematological
Description Distinctive Features Diagnostic Tests Peripheral Blood Smear
Condition

disorder pain and swelling, of clotting factors

caused by a prolonged bleeding VIII or IX)
deficiency or after injury or
dysfunction surgery
of clotting
factors

A genetic
bleeding
Blood tests
disorder
Excessive bleeding (measuring levels
causedby a
Von Willebrand or bruising, of von Willebrand Normal peripheral blood
deficiency or
disease nosebleeds, heavy factor and factor smear
dysfunction
menstrual bleeding VIII, platelet
of von
function test)
Willebrand
factor

Swelling, pain,
Blood tests (D-
Blood clot warmth, redness in
dimer test to
that forms in the affected leg,
Deep vein detect fragments Normal peripheral blood
a deep vein, chest pain or
thrombosis (DVT) of blood clots, smear
usually in shortness of breath
ultrasound, CT
the leg if the clot travels to
scan)
the lungs

Chest pain, Blood tests (D-

Blood clot
Pulmonary shortness of breath, dimer test, CT Normal peripheral blood
that travels
embolism (PE) coughing up blood, scan, ventilation- smear
to the lungs
rapid heartbeat perfusion scan)

A genetic
mutation Blood tests
No symptoms, but
that (genetic testing for Normal peripheral blood
Factor V Leiden increased risk of
increases factor V Leiden smear
DVT or PE
the risk of mutation)
blood clots

An Blood tests
autoimmune Blood clots in veins (antiphospholipid
disorder or arteries, antibodies, lupus
Antiphospholipid Normal peripheral blood
that recurrent anticoagulant,
syndrome smear
increases miscarriages, low beta-2
the risk of platelet count glycoprotein 1
blood clots antibodies)

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Hematological
Description Distinctive Features Diagnostic Tests Peripheral Blood Smear
Condition

An
Bruising, petechiae Blood tests (low
autoimmune
Idiopathic (small red or purple platelet count,
disorder Decreased platelet
thrombocytopenic dots on the skin), ruling out other
that count, large platelets
purpura (ITP) bleeding from the causes of
destroys
gums or nose thrombocytopenia)
platelets

A rare blood
disorder Blood tests (low
Fatigue, weakness,
that causes platelet count,
fever, neurological
Thrombotic blood clots elevated LDH,
symptoms,
thrombocytopenic to form in decreased Schistocytes
petechiae or
purpura (TTP) small blood haptoglobin,
purpura, kidney
vessels schistocytes on
failure
throughout peripheral smear)
the body

Nosebleeds,
A genetic telangiectasias
Blood tests
Hereditary disorder (small, dilated
(genetic testing for
hemorrhagic that causes blood vessels on Normal peripheral blood
mutations in the
telangiectasia abnormal the skin or mucous smear
ENG, ACVRL1, or
(HHT) blood membranes),
SMAD4 genes)
vessels gastrointestinal
bleeding

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Malignant
Hematological Description Distinctive Features Diagnostic Tests
Condition

Enlarged lymph nodes Biopsy of an affected

A cancer of the lymphatic (especially in the neck, lymph node, blood tests
system that involves the armpit, or groin), (elevated erythrocyte
Hodgkin lymphoma
presence of Reed- fever, night sedimentation rate,
Sternberg cells sweats, weight loss, elevated C-reactive
pruritus (itching) protein)

Enlarged lymph nodes,

fever, night sweats,
A cancer of the lymphatic Biopsy of an affected
weight loss, pruritus
Non-Hodgkin system that does not lymph node or extranodal
(itching), involvement
lymphoma involve Reed-Sternberg site, blood tests (elevated
of extranodal sites (such
cells lactate dehydrogenase)
as the gastrointestinal
tract or skin)

Blood tests (elevated

Bone pain (especially in serum protein
the back or ribs), anemia, electrophoresis or
A cancer of plasma cells
Multiple myeloma fatigue, recurrent immunofixation, elevated
in the bone marrow
infections, kidney beta-2 microglobulin,
problems elevated calcium, low
albumin)

A rare cancer of
Blood tests (elevated
lymphoplasmacytic cells Weakness, fatigue, weight
Waldenström serum IgM, elevated
that produce large loss, bleeding, vision
macroglobulinemia viscosity, bone marrow
amounts of changes, neuropathy
biopsy)
immunoglobulin M (IgM)

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Malignant
Hematological Description Distinctive Features Diagnostic Tests
Condition

Blood tests (reduced

Fatigue, weakness,
numbers of red blood
A group of disorders in shortness of breath,
cells, white blood cells,
Myelodysplastic which the bone marrow increased risk of
and/or platelets,
syndromes (MDS) does not produce enough infections and bleeding,
abnormal morphology of
healthy blood cells anemia,
blood cells, bone marrow
thrombocytopenia
biopsy)

A disorder in which the

Headaches, dizziness,
bone marrow produces Blood tests (elevated
blurred vision, itching,
too many red blood cells, hemoglobin, hematocrit,
Polycythemia vera enlarged spleen,
leading to thickening of and red blood cell count,
increased risk of blood
the blood and increased low erythropoietin)
clots
risk of blood clots

A disorder in which the

Headaches, dizziness,
bone marrow produces Blood tests (elevated
Essential weakness, numbness or
too many platelets, platelet count, low
thrombocythemia tingling in the hands and
leading to increased risk erythropoietin)
feet, enlarged spleen
of blood clots or bleeding

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Cardiovascular Distinctive
Description Diagnostic Tests ECG Findings
Condition Features

A condition in ST segment
which the Chest pain or depression or T
arteries that discomfort wave inversion in
supply blood (angina) with leads that
to the heart exertion correspond to
Electrocardiogram (ECG), stress
Coronary artery become or emotional the
test, echocardiogram, coronary
disease (CAD) narrowed or stress, shortness affected coronary
angiography
blocked, of breath, artery, or no ECG
leading to fatigue, changes if the
reduced dizziness, obstruction is
blood flow to nausea mild or
the heart intermittent

Chest pain or
A blockage of discomfort
blood flow to (angina) that ST segment
the heart does not go elevation
muscle, away with rest or Q waves in
Myocardial infarction
leading or nitroglycerin, ECG, blood tests (troponin) leads that
(MI)
to heart shortness of correspond tothe
muscle breath, nausea affected area of
damage or or vomiting, the heart
death sweating,
dizziness

May show left

ventricular
Shortness of hypertrophy, ST
A condition in
breath, fatigue, segment
which the
swelling in the depression or T
heart is Electrocardiogram (ECG),
legs or ankles, wave inversion in
unable to echocardiogram, chest X-ray,
Heart failure (HF) rapid or leads that
pump blood tests (BNP, NT-proBNP),
irregular correspond to
enough blood cardiac MRI
heartbeat, the affected area
to meet the
coughing or of the heart, or
body's needs
wheezing no ECG changes if
the heart failure
is caused by

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Cardiovascular Distinctive
Description Diagnostic Tests ECG Findings
Condition Features

diastolic
dysfunction

A narrowing
Chest pain or Left ventricular
of the heart's
discomfort hypertrophy, ST
aortic valve,
(angina) with segment
which
exertion, Electrocardiogram depression or T
decreases
Aortic stenosis (AS) shortness of (ECG),echocardiogram, cardiac wave inversion in
blood flow
breath, fatigue, MRI leads that
from the
dizziness or correspond to
heart to the
fainting, heart the affected area
rest of the
palpitations of the heart
body

Left atrial
A leakage of enlargement, left
blood from ventricular
Shortness of
the heart's hypertrophy, ST
breath, fatigue,
mitral valve segment
Mitral regurgitation swelling in the Electrocardiogram (ECG),
back into the depression or T
(MR) legs or ankles, echocardiogram, cardiac MRI
left atrium, wave inversion in
heart
which can leads that
palpitations
lead to heart correspond to
failure the affected area
of the heart

33
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Cardiovascular Distinctive
Description Diagnostic Tests ECG Findings
Condition Features

Left ventricular
hypertrophy,
deep Q waves in
A condition in
leads that
which the
correspond to
heart muscle
the affected area
becomes Shortness of
of the heart,
abnormally breath, chest
abnormal Q
thick, leading pain, fainting, Electrocardiogram (ECG),
Hypertrophic waves in the
to reduced heart echocardiogram, cardiac MRI,
cardiomyopathy(HCM) lateral precordial
blood flow palpitations, genetic testing
leads, ST
out of the sudden cardiac
segment
heart and arrest
depression or T
increased risk
wave inversion in
of
leads that
arrhythmias
correspond to
the affected area
ofthe heart

A blockage of May show sinus

one or more Shortness of tachycardia, right
arteries in breath, chest ventricular strain
the lungs, pain (especially pattern (ST
typically with deep Electrocardiogram (ECG), chest segment
Pulmonary embolism
caused by a breathing or X-ray, CT angiography, blood elevation in leads
(PE)
blood clot coughing), rapid tests (D-dimer) V1-V4, and ST
that has heartbeat, depression in
traveled from coughing up leads II, III, and
another part blood aVF), or no ECG
of the body changes

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Cardiovascular Distinctive
Description Diagnostic Tests ECG Findings
Condition Features

May show left

A bulging or
ventricular
swelling in
hypertrophy, ST
the wall of
Chest or back segment
the aorta,
pain, shortness depression or T
which can Electrocardiogram (ECG),
Aortic aneurysm of breath, wave inversion in
lead to aortic echocardiogram, CT scan, MRI
coughing, leadsthat
rupture and
hoarseness correspond to
life-
the affected area
threatening
of the heart, or
bleeding
no ECG changes

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 ECG
Arrhythmia Description Signs and Symptoms Treatment Options
Findings

Medications: beta
Absent P blockers, calcium
A rapid and
Palpitations, shortness of waves, channel blockers,
irregular
Atrial fibrillation breath, fatigue, chest irregularly digoxin, amiodarone,
heartbeat
(AFib) discomfort, dizziness, irregular flecainide,
originating in
syncope ventricular propafenone; electrical
the atria
response cardioversion; catheter
ablation; pacemaker

Medications: beta
A rapid and blockers, calcium
Palpitations, shortness of Sawtooth-
regular channel blockers,
breath, fatigue, chest shaped
Atrial flutter heartbeat amiodarone, flecainide,
discomfort, dizziness, flutter
originating in propafenone; electrical
syncope waves
the atria cardioversion; catheter
ablation

A rapid and Vagal maneuvers;

regular Palpitations, shortness of medications: beta
Regular
Supraventricular heartbeat breath, lightheadedness blockers, calcium
narrow QRS
tachycardia (SVT) originating or dizziness, chest channel blockers,
complexes
above the discomfort, syncope adenosine, digoxin;
ventricles electrical cardioversion

Medications:
A rapid and Palpitations, chest Broad QRS
amiodarone, lidocaine,
regular or discomfort, complexes
procainamide, sotalol;
Ventricular irregular lightheadedness or with a
implantable
tachycardia (VT) heartbeat dizziness, regular or
cardioverter-
originating in fainting, sudden cardiac irregular
defibrillator (ICD);
the ventricles arrest pattern
catheter ablation

Immediate
A rapid and defibrillation;
Chaotic,
irregular medications:
Ventricular Sudden cardiac arrest, irregular
heartbeat epinephrine,
fibrillation (VFib) loss of consciousness ventricular
originating in amiodarone; advanced
activity
the ventricles cardiac life support
(ACLS)

A condition in
Wolff-Parkinson- which an extra Palpitations, shortness of Short PR Medications: beta
White (WPW) electrical breath, lightheadedness interval, blockers, calcium
syndrome pathway (the or dizziness, fainting delta waves channel
accessory

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 ECG
Arrhythmia Description Signs and Symptoms Treatment Options
Findings

pathway) blockers; catheter

connects the ablation
atria and
ventricles

Heart Block Description ECG Findings Treatment Options

No specific treatment
Delay in the conduction of
First-degree AV Prolonged PR interval (>200 needed; monitor for
electrical impulses from the
block ms) progression to
atria to the ventricles
higher-degree block

No specific treatment
Second-degree Progressive prolongation of Gradual lengthening of PR
needed; monitor for
AV block, Type I the PR interval followed by interval until a beat is
progression to
(Wenckebach) a dropped beat dropped
higher-degree block

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Heart Block Description ECG Findings Treatment Options

Intermittent failure of
Pacemaker,
conduction of electrical
Second-degree Prolonged PR interval with medications (e.g.,
impulses from the atria to the
AV block, Type II occasional dropped beats atropine,
ventricles, with some beats
isoproterenol)
not conducted

Atrial and ventricular

Complete block of conduction
rhythms are
Third-degree AV of electrical impulses from
dissociated; QRS
block (complete the atria to the ventricles, Pacemaker
complexes are wide and
heart block) resulting in independent
regular, with no relationship
rhythms in the two chambers
to P waves

Blood
Thyroid Characteristic Test and
Etiology Treatment
Disorder Features Imaging
Results

Fatigue,
weight gain,
Autoimmune disease, cold
Elevated TSH, Levothyroxine replacement
Hypothyroidism radiation therapy, intolerance,
low free T4 therapy
iodine deficiency constipation,
dry skin,
depression

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 Blood
Thyroid Characteristic Test and
Etiology Treatment
Disorder Features Imaging
Results

Weight loss, Low TSH,

heat high free T4, Anti-thyroid medications
Graves' disease, toxic intolerance, high (e.g., methimazole,
Hyperthyroidism nodular goiter, palpitations, radioactive propylthiouracil),
thyroiditis tremors, iodine uptake radioactive iodine therapy,
diarrhea, on thyroid surgery
anxiety scan

Thyroid
May be function
Benign or malignant asymptomatic tests, thyroid Observation,
Thyroid nodules growths in the or present as a ultrasound, surgery, radioactive iodine
thyroid gland palpable lump fine-needle therapy
in the neck aspiration
biopsy

Occupational
Mineral Characteristic Features Special Lab Findings
Disease

Elevated blood lead levels, basophilic

Abdominal pain,
stippling of red blood cells, increased
Lead Lead poisoning constipation, headaches,
urinary delta-aminolevulinic acid
irritability, memory loss
(ALA)

Tremors, memory loss, Elevated blood or urine mercury

irritability, depression, levels, proteinuria, elevated urinary
Mercury Mercury poisoning
anxiety, peripheral N-acetyl-beta-D-glucosaminidase
neuropathy (NAG)

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 Occupational
Mineral Characteristic Features Special Lab Findings
Disease

Tremors, bradykinesia,
Elevated blood or urine manganese
Manganese-induced postural instability, gait
Manganese levels, decreased serum
parkinsonism disturbance, cognitive
ceruloplasmin
impairment

Asbestos bodies in sputum or lung

Mesothelioma, lung Dyspnea, cough, chest pain,
Asbestos tissue, pleural thickening on chest X-
cancer, asbestosis pleural effusion
ray

Silica particles in lung tissue,

Dyspnea, cough, chest pain,
Silica Silicosis, lung cancer decreased forced expiratory volume
pulmonary fibrosis
(FEV1)

Dyspnea, cough, chest

Coal workers' Coal macules (black spots) in lung
Coal dust tightness, pulmonary
pneumoconiosis tissue, decreased FEV1
fibrosis

40
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 Characteristic Additional
Poison Specific Antidote Specific Blood Tests
Symptoms Findings

Nausea/vomitin Toxicity
Serum acetaminophen
g, abdominal N-acetylcysteine risk increased
Acetaminophen level, liver function
pain, jaundice, (NAC) with chronic
tests
liver failure alcohol use

Headache,
dizziness, Carboxyhemoglobi
weakness, Carboxyhemoglobin lev n levels may not
Carbon monoxide Oxygen therapy
confusion, el correlate with
nausea/vomitin clinical severity
g

Rapid breathing,
Hydroxocobalami
confusion, Arterial blood gas
Cyanide n, sodium Ethylene glycol
seizures, loss of (ABG), serum lactate
thiosulfate
consciousness

Nausea/vomitin
Formic acid may
g, abdominal
Fomepizole, accumulate and
Methanol pain, visual Serum methanol level
ethanol cause metabolic
disturbances,
acidosis
seizures

Nausea/vomitin
Symptoms may
g, abdominal
persist or recur
Organophosphate pain, muscle Atropine, Serum cholinesterase
with
s weakness, pralidoxime level
cholinesterase
respiratory
reactivation
distress

Abdominal pain,
Toxicity risk
vomiting,
increased with
Iron diarrhea, Deferoxamine Serum iron level
high-dose or
lethargy, liver
prolonged use
failure

Abdominal pain,
constipation, Toxicity risk
Lead anorexia, Chelation therapy Blood lead level increased with
fatigue, chronic exposure
headache

41
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 Characteristic Additional
Poison Specific Antidote Specific Blood Tests
Symptoms Findings

Toxicity risk
Nausea/vomitin
increased with
g, abdominal Blood or urine mercury
Mercury Chelation therapy exposure to
pain, tremors, level
certain types of
weakness
fish

Toxicity risk
Drowsiness,
increased with
confusion,
Benzodiazepines Flumazenil N/A concomitant use
respiratory
of other sedative
depression
drugs

Agitation, Chronic use can

confusion, Urine drug screen, lead to
Methamphetamin
hallucinations, Supportive care serum creatine kinase, neurotoxicity and
e
seizures, electrolytes psychiatric
tachycardia disorders

Respiratory Chronic use can

depression, lead to tolerance,
Opioids Naloxone Urine drug screen
pinpoint pupils, dependence, and
confusion, coma overdose

Agitation,
Chronic use can
hypertension,
Urine drug screen, lead to
Cocaine tachycardia, Supportive care
serum troponin cardiovascular
chest pain,
complications
seizures

Nausea/vomitin Chronic use can

g, confusion, lead to liver
Blood alcohol level,
Ethanol respiratory Supportive care damage and
serum electrolytes
depression, neurological
coma disorders

Agitation, Chronic use can

tachycardia, Urine drug screen, lead to
Amphetamine hypertension, Supportive care serum creatine kinase, neurotoxicity and
seizures, electrolytes psychiatric
hyperthermia disorders

Euphoria,
Marijuana Supportive care Urine drug screen Chronic use can
impaired
lead to respiratory
memory and

42
A Gift from Danish.
 Characteristic Additional
Poison Specific Antidote Specific Blood Tests
Symptoms Findings

concentration, and psychiatric

tachycardia disorders

Toxicity risk
Drowsiness,
increased with
respiratory
Barbiturates Supportive care Serum drug level concomitant use
depression,
of other sedative
coma
drugs

43
A Gift from Danish.
Translated from Ukrainian to English - www.onlinedoctranslator.com

The content structure of the integrated test exam STEP 2

for the specialty "Medicine"
Code 1 axis 2 1 6 0 Aplastic anemia
1 0 0 0 General questions 2 1 7 0 Methemoglobinemia
1 1 0 0 Features of children of different ages 2 2 0 0 Pathological bleeding
1 2 0 0 Features of youth 2 2 1 0 Hemophilia
1 3 0 0 Features of mature age 2 2 2 0 Hemorrhagic disease of newborns
1 4 0 0 Features of old age 2 2 3 0 Thrombocytopenic purpura
1 5 0 0 Medical ethics and jurisprudence 2 3 0 0 Neoplastic disorders
1 6 0 0 Applied biostatics and clinical 2 3 1 0 Lymphogranulomatosis
epidemiology; hygiene and occupational health and safety
2 3 2 0 Acute leukemia
1 6 1 0 Health is individual and public 2 4 2 0 Sepsis of newborns
1 6 2 0 Organization primary medical and sanitary
2 3 3 0 Chronic myeloid leukemia
assistance to the population
2 3 4 0 Chronic lymphocytic leukemia
1 6 3 0 Organization of various types of medical
care for adults and children (ambulatory 2 4 0 0 Sepsis
polyclinic, inpatient, specialized, sanatorium, 2 4 1 0 Surgical sepsis
emergency and emergency) 3 0 0 0 Mental and behavioral disorders
1 6 4 0 Health care management (main functions, 3 1 0 0 General psychopathology
organizational, economic, socio- 3 1 1 0 Bipolar affective disorder
psychological, legal and other aspects)
3 2 0 0 Private psychiatry
1 7 0 0 Thanatology
3 2 1 0 Schizophrenia
1 8 0 0 Environment and man
3 2 2 0 Epilepsy
2 0 0 0 Diseases of the blood and hematopoietic organs
4 0 0 0 Diseases of the nervous system and sense
2 1 0 0 Anemia
organs
2 1 1 0 Iron deficiency anemia 4 1 0 0 Eye diseases
2 1 2 0 Posthemorrhagic anemia 4 1 1 0 acute attack of glaucoma
2 1 3 0 Anemia with insufficient nutrition 4 1 2 0 Blepharitis
2 1 4 0 B-12 folate-dependent anemia
4 1 3 0 Conjunctivitis
2 1 5 0 Hemolytic anemia
4 1 4 0 Eye injuries
2 1 5 1 Hemolytic disease of the newborn
4 1 5 0 Foreign body of the eye
4 6 0 0 Emergency aid 5 2 4 0 Acute heart failure
4 5 0 0 Recommendations 5 2 5 0 Chronic heart failure
4 2 0 0 Diseases of the throat, ears, nose 5 3 0 0 Coronary heart disease
4 2 1 0 to swell 5 3 1 0 Angina
4 2 2 0 Laryngitis 5 3 2 0 Coronary insufficiency
4 2 3 0 Peritonsillar abscess 5 3 3 0 Myocardial infarction
4 2 4 0 Sinusitis 5 3 4 0 Postinfarction cardiosclerosis
4 2 5 0 Tonsillitis 5 4 0 0 Cardiomyopathies
4 3 0 0 Diseases of the nervous system 5 4 1 0 Congestive cardiomyopathy
4 3 1 0 Disorders of cerebral circulation 5 4 2 0 Hypertrophic cardiomyopathy
4 3 2 0 Radiculitis 5 4 3 0 Myocarditis
4 3 3 0 Chronic occupational injuries 5 4 4 0 Myocardiodystrophy
4 3 4 0 Vibration disease 5 5 0 0 Diseases of the pericardium

4 3 5 0 Coordinating neuroses (professional 5 5 1 0 Acute pericarditis

dyskinesia) 5 5 2 0 Constrictive pericarditis
4 4 0 0 Infections of the nervous system
5 5 3 0 Pericardial exudate
4 4 1 0 Meningitis 5 5 4 0 Pericardial tamponade
4 5 0 0 Intracranial trauma 5 6 0 0 Valvular heart disease
4 6 0 0 Obstetric lesions of the nervous system in 5 6 1 0 Acquired heart defects
newborns
5 6 2 0 Endocarditis
5 0 0 0 Diseases of the circulatory system
5 7 0 0 Congenital heart defects
5 1 0 0 Violation of heart rhythm
5 7 1 0 The ductus arteriosus is open
5 1 1 0 Extrasystole
5 7 2 0 Atrial septal defect
5 1 2 0 Fluttering and flickering of the atria
5 7 3 0 Interventricular membrane defect
5 1 3 0 Ventricular fibrillation
5 7 4 0 Tetrad of Fallot
5 1 4 0 Blockades
5 7 5 0 Coarctation of the aorta
5 2 0 0 Heart failure
5 7 6 0 Pulmonary artery stenosis
5 2 1 0 Diastolic dysfunction
5 8 0 0 Arterial hypertension
5 2 2 0 Systolic dysfunction
5 8 1 0 Essential arterial hypertension
5 2 3 0 Peripheral edema of cardiac origin
5 8 2 0 Secondary arterial hypertension 6 7 0 0 Neoplasms of the lungs and mediastinum
5 9 0 0 Venous diseases 6 7 1 0 Primary tumors
5 9 1 0 Phlebitis, thrombophlebitis, post-phlebitic 6 7 2 0 Metastatic tumors
syndrome 6 8 0 0 Congenital malformations of respiratory organs
5 9 2 0 Varicose veins of the lower extremities 6 9 0 0 Foreign body in the respiratory tract
5 10 0 0 Vegeto-vascular dystonias 7 0 0 0 Diseases of digestive organs
5 11 0 0 Thromboembolism of the pulmonary artery
7 1 0 0 Diseases of the esophagus
5 12 0 0 Pulmonary heart 7 1 1 0 Esophagitis
6 0 0 0 Respiratory diseases 7 1 2 0 Neoplasm of the esophagus
6 1 0 0 Pulmonary infections
7 1 3 0 Benign diseases of the esophagus
6 1 1 0 Bronchitis and bronchiolitis
7 2 0 0 Diseases of the stomach, small, large and rectal
6 1 2 0 Pneumonia intestines
6 1 3 0 Pulmonary tuberculosis 7 2 1 0 Gastritis, duodenitis
6 1 4 0 Lung abscess 7 2 2 0 Ulcer disease
6 1 5 0 Mediastenitis 7 2 3 0 Stenosis of the pylorus of the stomach

6 2 0 0 Obstructive pathology of the respiratory tract 7 2 4 0 Malabsorption syndrome

6 2 1 0 Bronchiectatic disease 7 2 5 0 Acute appendicitis
6 2 2 0 Bronchial asthma 7 2 6 0 Enteritis, colitis
6 2 3 0 Toxic lesions of the respiratory tract 7 2 7 0 Functional disorders of the stomach, gall
6 2 4 0 Chronic obstructive bronchitis bladder and biliary tract, intestines
6 2 5 0 Emphysema 7 2 8 0 Pinched and unpinched abdominal hernias
6 3 0 0 Chest injuries 7 2 9 0 Perforation of a hollow organ
6 4 0 0 Pneumoconiosis 7 2 10 0 Peritonitis
6 4 1 0 Asbestosis, silicosis, silicosis 7 2 11 0 Acute intestinal obstruction
6 4 2 0 Carboconiosis, metalloconiosis 7 2 12 0 Inflammatory diseases of the rectum
6 5 0 0 Respiratory failure 7 2 13 0 Gastrointestinal bleeding
6 6 0 0 Disorders involving the pleura 7 2 14 0 Neoplasm of the stomach
6 6 1 0 Pleurisy 7 2 15 0 Neoplasm of the large intestine
6 6 3 0 Pleural empyema 7 3 0 0 Diseases of the pancreas
7 3 1 0 Pancreatitis 9 1 2 0 Physiology of childbirth

7 3 2 0 Neoplasm of the pancreas 9 1 3 0 Physiology of the postpartum period

7 4 0 0 Diseases of the liver and biliary system 9 1 4 0 Gestosis of pregnant women

7 4 1 0 Chronic hepatitis 9 1 5 0 Premature, delayed pregnancy

7 4 2 0 Liver cirrhosis 9 1 6 0 Anomalies of labor activity
7 4 3 0 Functional disorders of the gallbladder and 9 1 7 0 injuries of the uterus and birth canal
biliary tract 9 1 8 0 Immunological conflict during pregnancy
7 4 4 0 Cholecystitis, gallstone disease 9 1 9 0 Fetal hypoxia
7 4 5 0 Cholangitis, blockage of the bile duct 9 1 10 0 Fetoplacental insufficiency
7 4 6 0 Liver failure 9 1 11 0 Bleeding in early pregnancy
7 4 7 0 Liver neoplasm 9 1 12 0 Childbirth bleeding
7 5 0 0 Abdominal injuries (superficial, open) 9 1 13 0 Postpartum sepsis
7 6 0 0 Congenital malformations of digestive organs 9 1 14 0 Ectopic pregnancy
8 0 0 0 Diseases of the genitourinary system 9 1 15 0 The course of pregnancy with extragenital
8 1 0 0 Pathology urinary bubble andsystems pathology
urine output 9 1 16 0 Placenta previa
8 1 1 0 Lower urinary tract infection, cystitis 9 1 17 0 Premature detachment of the placenta
8 1 2 0 Urinary stone disease 9 2 0 0 Gynecological diseases
8 2 0 0 Kidney pathology 9 2 1 0 Inflammatory diseases
8 2 1 0 Pyelonephritis (salpingitis, endometritis, salpingo-oophoritis,
8 2 2 0 Glomerulonephritis pelvioperitonitis, cervicitis)
9 2 2 0 Violation of the menstrual cycle
8 2 3 0 Chronic kidney failure
9 2 3 0 Sterility
8 2 4 0 Nephrotic syndrome
9 2 4 0 Endometriosis
8 2 5 0 Nephrotuberculosis
9 2 5 0 Malignant tumors of the uterus, ovaries
8 3 0 0 Neoplasm of the kidney
9 2 6 0 Benign neoplasms of the uterus and ovaries
8 4 0 0 Congenital malformations of the urinary system
9 3 0 0 Pathology of the mammary gland
9 0 0 0 Female reproductive system
9 3 1 0 Mastitis
9 1 0 0 Pregnancy, childbirth, postpartum period
9 3 2 0 Neoplasm of the mammary gland
9 1 1 0 Physiology of pregnancy
9 4 0 0 Neuroendocrine syndromes
10 0 0 0 Diseases of the skin and subcutaneous tissue 11 2 6 0 Systemic vasculitis (nodular polyarteritis,
10 1 0 0 Infections of the skin, subcutaneous tissue hemorrhagic vasculitis)
10 1 1 0 Pyoderma 11 2 7 0 Rheumatism

10 1 2 0 Scabies 11 2 8 0 Juvenile rheumatoid arthritis

10 1 3 0 Infectious diseases of the skin and 11 2 9 0 Reactive arthropathies
subcutaneous tissue 11 3 0 0 Bone tumors and osteochondropathy

10 1 4 0 Inflammatory diseases of fingers and bones 11 4 0 0 Other disorders of the musculoskeletal system

10 1 5 0 Purulent-inflammatory diseases in children 11 4 1 0 Polytrauma

10 1 6 0 Specific surgical infection (anaerobic 11 4 2 0 Typical fractures of the shoulder, forearm, hip, and
clostridial and non-clostridial) lower leg
11 4 3 0 Pelvis injury
10 2 0 0 Dermatitis, eczema
11 4 4 0 Damage to large joints
10 2 1 0 Allergic
11 4 5 0 Congenital malformations of the musculoskeletal
10 2 2 0 Professional
system
10 2 3 0 Infectious
11 4 6 0 Spine injury
10 3 0 0 Burns, frostbite
11 4 7 0 Birth trauma
10 4 0 0 Mycoses
12 0 0 0 Diseases endocrine systems and
10 5 0 0 Psoriasis
metabolic disorders
11 0 0 0 Diseases of the musculoskeletal system and 12 1 0 0 Pathology of the thyroid gland
connective tissue
12 1 1 0 Hypothyroidism
11 1 0 0 Infections of the musculoskeletal system 12 1 2 0 Thyrotoxicosis
11 1 1 0 Osteomyelitis 12 1 3 0 Thyroiditis
11 1 2 0 Tuberculosis of the bone system 12 2 0 0 Diabetes
11 2 0 0 Inflammatory and immunological disorders 12 2 1 0 Type I
11 2 1 0 Systemic scleroderma 12 2 2 0 Type II
11 2 2 0 Systemic lupus erythematosus 12 2 3 0 Ketoacidosis
11 2 3 0 Poliomyositis-dermatomyositis 12 2 5 0 Chronic complications
11 2 4 0 Rheumatoid arthritis 12 3 0 0 Adiposity
11 2 5 0 Ankylosing spondylitis
12 4 0 0 Adrenal gland pathology 13 2 4 2 Parotitis
12 4 1 0 Primary adrenocortical insufficiency 13 2 4 3 Whooping cough

12 5 0 0 Anomalies of the constitution 13 2 4 4 Measles

12 6 0 0 Hypotrophy, paratrophy 13 2 4 5 Rubella

12 7 0 0 Rickets, spasmophilia, hypervitaminosis 13 2 5 0 Infections caused by viruses of the herpes group
13 0 0 0 Infectious and parasitic diseases 13 2 5 1 Varicella
13 1 0 0 Mechanism transfers fecal-oral 13 2 5 2 Herpes zoster
(intestinal infections) 13 2 5 3 Infectious mononucleosis
13 1 1 0 Generalized intestinal infections
13 3 0 0 The transmission mechanism is transmissible (blood
13 1 1 1 Typhoid fever and paratyphoid fever infections)
13 1 1 2 Salmonellosis 13 3 1 0 Malaria
13 1 2 0 Intestinal infections that are accompanied
13 3 2 0 Typhus
acute diarrheal syndrome
13 4 0 0 The mechanism of transmission is wound (inoculation)
13 1 2 1 Gastrointestinal salmonellosis
13 4 1 0 Wound infections
13 1 2 2 Bacterial food poisoning
13 4 1 1 Viral hepatitis B, C, D
13 1 2 3 Shigellosis
13 4 1 2 HIV infection / AIDS
13 1 2 4 Cholera
13 4 2 0 Other wound infections
13 1 2 5 Botulism
13 4 2 1 Tetanus
13 1 3 0 Intestinal parasitic infections
13 4 2 2 Rabies
13 1 3 1 Giardiasis
13 4 2 3 Leptospirosis
13 1 3 2 Helminth infections
13 5 0 0 The transmission mechanism is multiple
13 1 4 0 Poliomyelitis
13 5 1 0 Plague
13 1 5 0 Viral hepatitis A
13 5 2 0 Anthrax
13 2 0 0 The transmission mechanism is air-droplet
13 6 0 0 Congenital infections of the newborn
13 2 1 0 Influenza and other acute respiratory viral
13 7 0 0 Infectious diseases, what are transmitted
infections
mostly sexually
13 2 2 0 Diphtheria
13 7 1 0 Gonococcal infection
13 2 3 0 Meningococcal infection
13 7 2 0 Syphilis
13 2 4 0 "Children's" droplet infections
13 2 4 1 Scarlet fever 13 7 3 0 Chlamydial infection
14 0 0 0 Emergency conditions 14 14 0 0 External bleeding
14 1 0 0 Asphyxia (including in newborns) 14 15 0 0 Stoppage of blood circulation and breathing
14 2 0 0 Hypertensive crisis 14 16 0 0 Collapse
14 3 0 0 Acute respiratory failure 14 17 0 0 Commies
14 4 0 0 Acute retention of urine 14 18 0 0 Swelling of the larynx
14 5 0 0 Acute adrenal insufficiency 14 19 0 0 Quincke's edema
14 6 0 0 Acute renal failure 14 20 0 0 Syncopal states (fainting)
14 7 0 0 Acute liver failure 14 21 0 0 Paroxysmal rhythm disturbances, including MES-
14 8 0 0 Acute vascular and heart failure syndrome
14 9 0 0 Acute poisoning, including combat poisonous 14 22 0 0 Hypothermia
substances 14 23 0 0 Seizure syndrome
14 10 0 0 Acute psychosis, incl. alcoholic delirium 14 24 0 0 Heat damage, including heatstroke
14 11 0 0 Acute radiation injuries 14 25 0 0 Drowning
14 12 0 0 Electric injury 14 26 0 0 Physiological childbirth

14 13 0 0 Epileptic status 14 27 0 0 Shocks

Code 2 axis 1 11 0 0 Radiology

1 0 0 0 Therapeutic profile 1 12 0 0 Clinical pharmacology
1 1 0 0 Therapy 1 13 0 0 Clinical immunology
1 2 0 0 Infectious diseases and epidemiology 2 0 0 0 Surgical profile
1 3 0 0 Endocrinology 2 1 0 0 General surgery
1 4 0 0 Occupational diseases 2 2 0 0 Oncology
1 5 0 0 Physiology 2 3 0 0 Urology
1 6 0 0 Emergency conditions, acute poisoning, injuries 2 4 0 0 Anesthesia and resuscitation
1 7 0 0 Radiation medicine 2 5 0 0 Orthopedics and traumatology
1 8 0 0 Psychiatry, behavioral sciences 2 6 0 0 ENT
1 9 0 0 Dermatovenerology 2 7 0 0 Ophthalmology
1 10 0 0 Neurology 2 8 0 0 Neurosurgery
2 9 0 0 Children's surgery Code 3 axis
2 10 0 0 Disaster medicine 1 0 0 0 Prevention
2 11 0 0 Forensic Medicine 1 1 0 0 Primary
3 0 0 0 Pediatric profile 1 2 0 0 Secondary
3 1 0 0 Pediatrics 2 0 0 0 Mechanisms of diseases
3 2 0 0 Children's infections 2 1 0 0 Etiology
3 3 0 0 Emergency conditions 2 2 0 0 Pathogenesis
3 4 0 0 Neonatology 3 0 0 0 Diagnostics
3 5 0 0 Medical genetics 3 1 0 0 The main disease
4 0 0 0 Obstetrics and gynecology 3 2 0 0 Complication of the disease
4 1 0 0 Obstetrics 3 6 0 0 Emergency condition
4 2 0 0 Gynecology 4 0 0 0 Management of the patient

4 3 0 0 Emergency conditions 4 1 0 0
Treatment, side effects of drugs, clinical
4 4 0 0 Infectious and venereal pharmacology
4 5 0 0 Extragenital pathology 4 2 0 0 Further examination
4 6 0 0 Gynecology and endocrinology 4 3 0 0 Tactics
5 0 0 0 Hygiene, OAZ 4 4 0 0 Rehabilitation
5 1 0 0 Hygiene 5 0 0 0 Health care organization
5 1 1 0 General hygiene
5 1 2 0 Communal hygiene
5 1 3 0 Food hygiene
5 1 4 0 Labor hygiene
5 1 5 0 Hygiene of children and adolescents
5 2 0 0 Health care organization
5 2 1 0 Social medicine
5 2 2 0 Economy