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Usubaliev Module 3

Famaily medicine - Usubaliev Module 3

Total questions: 40; Correctly answered: 39; Percentage of correct: 97.5% Skipped question: 0;

1. In primary health care, low back pain can be classi>ed into one of four categories. What causes low back pain is considered
the most serious?

Disease affecting the lumbar spine (eg, epidural abscess);

Problems outside the lumbar spine (such as kidney stones);

Low back pain accompanied by radicular pain (eg, associated with a herniated disc)

Non-speciMc low back pain.

2. The upper limit of the norm of analysis according to Nechiporenko

10,000 erythrocytes and 20,000 leukocytes

2000 erythrocytes and 1000 leukocytes

200 erythrocytes and 100 leukocytes

1000 erythrocytes and 4000 leukocytes

3. When the de>nition of Rheumatoid factor is most justi>ed. Rheumatoid factor to determine for:

ConMrmation of the diagnosis of rheumatoid arthritis in patients with polyarthritis

To assess prognosis in rheumatoid arthritis

To evaluate the effectiveness of rheumatoid arthritis therapy

For activity evaluation

4. In rheumatoid arthritis, the joints are the >rst to be affected.

Vertebrates

Sacroiliac

Proximal interphalangeal joints of the hands

Knee

5. Patients with lower back pain most often seek medical help ...

neuropathologists

general practitioners

Gynecologists

orthopedists

6. Criteria of Essential hypertension is:

Salt abuse

stenosis of renal artery

absence of symptomatic arterial hypertension

Left ventricular hypertrophy

7. De>ne the criteria for chronic bronchitis

Productive cough with sputum lasting more than six months for two consecutive years;

Productive cough with sputum lasting more than three months for two consecutive years;

Productive cough with sputum lasting more than two months for three consecutive years;

Cough with sputum lasting more than three months within one year.

8. Determine the most important indicator when evaluating the Zimnitsky test

Daily diuresis

Fluctuations in speciMc gravity

Maximum speciMc gravity

Assessment of excretory function of the kidneys

 9. For rheumatic polyarthritis, the most characteristic ...

Acute synovitis

Concomitant fever

"Wying" nature of joint damage

predominantly affecting small and medium joints

10. When is steroid therapy prescribed for COPD?

SigniMcant relief of bronchospasm was not achieved with inhaled drugs.

Courses of high doses of parenteral steroids are the basis of inpatient treatment

Corticosteroids are always prescribed during an exacerbation of the disease

inhaled corticosteroids are used to relieve bronchospasm

11. To suppress the activity of reactive synovitis in osteoarthritis, it is used

Uricosuric drugs

Chondroprotectors

NSAIDs

Cytostatics

12. All the following drugs most useful for treatment of hypertensive emergency with acute coronary syndrome:

Labetalol IV

Nitroglycerine IV

nitroprusside sodium IV

furosemide IV

13. Identify the most common cause of back pain in women of childbearing age

Pathology of the hip joint

Urinary tract infection (pyelonephritis)

Gynecological diseases

Pathology of the gastrointestinal tract (ulcer 12 duodenal ulcer)

:
 14. What scheme of bronchospasm relief provides sustainable relief of bronchospasm while minimizing adrenergic side effects

Higher doses of beta-agonists

One inhalation of each agent every six hours

Two inhalations of each agent every six hours

Use of zaMrlukast (Acolat),

15. After returning from a restaurant, a 53-year-old man developed sharp pains in the area of the big toe of the left foot at night,
the temperature rose to 38.3°C. Examination revealed swelling of the metatarsophalangeal joint, bright hyperemia of the skin
around it, touching the >nger causes a sharp increase in pain. Most likely diagnosis

Gouty arthritis

Rheumatoid arthritis

Reactive arthritis

Rheumatoid arthritis

16. How to treat acute lower back pain with medication? Which of these drugs is more effective in the treatment of nonspeci>c
low back pain?

NSAIDs

Muscle relaxants

Antispasmodics

opioid analgesics

17. The main biochemical indicator of kidney function

Urea

Uric acid

Blood creatinine

Blood protein
:
 18. Which of these methods is uninformative in the diagnosis of chronic bronchitis?

Spirometry

ECG

Airway biopsy

X-ray of the lungs

19. The patient is 40 years old. Complains of prolonged (more than 12 weeks) back pain. Identify the most characteristic
symptoms of spondyloarthritis.

. Mechanical rhythm of pain

Night pains, pain at rest

Morning pain decreases after physical activity

Arthritis, uveitis and psoriasis

20. A man went to a general practitioner with complaints of acute pain in the perineum, radiating to the sacrum and suprapubic
region. Body temperature 400 C, urination is di_cult, painful. Make a preliminary diagnosis

Acute prostatitis

Prostate adenoma

Prostate cancer

Bladder stone

21. The main purpose of the classi>cation and differential diagnosis of low back pain is ...

Identify patients with pathologies of the lumbar spine

Identify patients with non-speciMc low back pain as much as possible

Identify patients with pathologies of internal organs accompanied by back pain

.+IdentiMcation of patients who require urgent speciMc treatment)

:
 22. How to treat acute low back pain with non-drug methods? Which of these answers is the most correct regarding the tactics
of treating non-speci>c low back pain?

Sign giving advice to lead an active lifestyle

Manual therapy with the spine helps better

Massaging the lumbar region is most beneMcial

Patients improve regardless of treatment

23. Determine the most common cause of secondary arterial hypertension

Kidney pathology

Side effects of drugs

Endocrine disorders

Diseases of the lungs

24. Which of the following most clearly indicates the in`ammatory nature of joint pain

pain on movement

Crepitus

Proliferative deMguration of the joint

Pain at rest, nocturnal

25. Determine the criterion for SORD according to Spirometry data

FEV1/FVC less than 50%

FEV1/FVC = 70%

FEV1/FVC = 80%

FEV1/FVC = 90%

26. Select the symptom of rheumatoid arthritis that develops later than the rest

Morning stiffness

Swelling and deformity of the joints

Rheumatoid factor in serum

Subchondral osteoporosis
:
 27. According to the opinions of international experts, low back pain is considered acute if its duration is ...

More than 4 weeks

Less than 4 weeks

Less than 12 weeks

More than 12 weeks

28. The following indicators are typical for rheumatic fever

Moderate leukocytosis

Elevated titers of antistreptolysin O

Positive C-reactive protein

Increased Mbrinogen levels

29. Back pain. Determine the frequency of occurrence of serious diseases (cancer, infection, fracture).

About 90%

More than 10%

Less than 1%

More than 1%

30. What disease is characterized by morning stiffness for less than 30 minutes, pain of a mechanical nature, stiffness,
limitation of joint mobility, crepitus, narrowing of the joint space on X-ray examination, subchondral osteosclerosis, osteophytes

Rheumatoid arthritis

Gouty arthritis

Reactive arthritis

Deforming osteoarthritis

31. Which patients need diagnostic imaging (MRI, CT)?

if a serious, speciMc cause of the disease is suspected

In most cases, immediate diagnostic imaging is not required.

All patients should be directed not to miss the dangerous cause of pain

should send patients to specialists. They determine the indications for imaging
:
 32. Chondroprotectors include ...

Meloxicam

Chondroitin sulfate

Mydocalm

Diclofenac

33. The clinical triad of Reiter's syndrome includes

Urethritis, meningitis, conjunctivitis

Proctitis, prostatitis, cystitis

Urethritis, conjunctivitis, polyarthritis

urethritis, conjunctivitis, prostatitis

34. When it is not required to treat urgently.

Blood Pressure (BP) 200/110 mm/Hg

Blood Pressure (BP) 200/110 mm/Hg. and pulmonary oedema

Blood Pressure (BP) 230/130 mm/Hg at the pregnant woman convulsions

Blood Pressure (BP) 200/120 mm/Hg.Angina frequent attacks

35. The most reliable sign of chronic renal failure (CRF) is

Oliguria

Proteinuria

Arterial hypertension in combination with anemia

An increase in the level of creatinine in the blood

36. A 73-year-old female patient has dense bone growths in the area of the distal interphalangeal joints of the hands,
moderately painful, as they are called.

Rheumatoid nodules

Tophi

Heberden's nodules

Bouchard's nodules
:
 37. Determine the most effective drug for the relief of bronchial obstruction in COPD

Inhalation of ipratropium bromide;

Salbutamol inhalation

Theophylline

Prednisone tablets

38. Management of a patient with back pain. When not to refer a patient to a specialist.

If symptoms of «cauda equine» are present

Suspected metastatic disease

Non-speciMc back pain

Low back pain accompanied by signs of infection

39. A 40-year-old man consulted a general practitioner about an increase in blood pressure. The examination revealed: in the
analysis of urine, the speci>c gravity is 1012, the protein is 1.2 g/l, the erythrocytes are 10-15 in the p/c, ultrasound of the
kidneys revealed no pathology, the indicators of urea and creatinine in the blood are normal, the anamnesis data are without
features. What disease is most likely

Hypertension

Chronic pyelonephritis

Chronic glomerulonephritis

Gouty nephropathy

40. Reactive arthritis (Reiter's syndrome) can develop after

Urogenital infections

Salmonellosis

SARS

Rubella
: