State Exam 2 - All Updated Final

1. Principles of management:

general.

psychological;

mixed;

political;

dynamic;

2. General cleaning in risk rooms in hospitals of various profiles is carried out:

1 time per day;

2 times a day;

1 time in 7 days.

2 times in 7 days;

3. Forms of protein deficiency:

Keshan's disease (alimentary cardiomyopathy);

Kwashiorkor;

nutritional iron deficiency anemia;

endemic goiter;

Desquamation of the epithelium, baldness.

4. Physical methods of water disinfection:

sedimentation, permanganate;

filtration, ozonation;

chlorination with preammonization;

sonication, UV rays.

5. Primary prevention is:

Prevention of the spread of diseases through early diagnosis and timely treatment

Prevention of the transition of chronic diseases to acute form

prevention (reduction) of the incidence by affecting its causes, conditions, risk factors.
 Creation of decent conditions for chronic patients

Rehabilitation of chronic patients

6. The concept of chemical thermoregulation:

biological processes for the absorption of heat by the body;

physiological processes of heat absorption by the body;

a complex of neurohumoral, biochemical and biophysical processes for the generation of thermal energy in the human body;

physiological process aimed at the accumulation of heat in the body;

metabolic processes for the assimilation of heat in the body.

7. Choose who belongs to the sources of infectious agents:

live infected human or animal organism;

contaminated environmental objects;

any object on which the pathogen is found;

carriers in which the pathogen multiplies;

carriers.

8. The daily diet is:

food allowance per day, distributed at three meals a day for breakfast, lunch and dinner;

the number of dishes and drinks (in grams) constituting a daily meal;

list of products (in grams) needed to prepare one portion of breakfast, lunch, dinner;

percentage distribution of caloric intake for breakfast, lunch and dinner;

Nutrition, which provides quantitative and qualitative requirements for it during the day.

9. Types of noise by sources of its formation:

household, friction, production;

transport, shock, production;

shock, friction, aerodynamic;

shock, unstressed, production;

aerodynamic, industrial, transport.

10. Epidemiological surveillance is:

monitoring and analysis system for infectious diseases;

 form of organization of anti-epidemic work;

a system that provides continuous collection of data on infectious morbidity, analysis and generalization of the received
materials;

a system of dynamic and integrated monitoring of the epidemic process of an infectious disease in order to develop
recommendations and improve the effectiveness of preventive and anti-epidemic measures.

11. Special methods for improving water quality:

double chlorination, ozonation, microwave treatment;

coagulation, iodination, exposure to gamma rays;

deodorization, iron removal, desalination.

disinfection, decontamination, sonication;

12. Occupational hearing loss is:

noise disease;

neuritis of the auditory nerve;

noise injury;

rupture of the eardrum,

deafness.

13. Explain what to do if, when opening a box with measles vaccine, it did not contain instructions for using the drug?

take advice from another doctor;

use the instructions from another box of the same series;

use the instructions from the box of another series;

ban the use of the vaccine;

look for instructions.

14. The essence of the methodology for the study of the visual-motor reaction, unit:

study of visual acuity using a special digital table, in units of processed information;

study of visual acuity using a special letter table, in units of processed information;

study of latent time of the visual-motor reaction using a chronoreflexometer in milliseconds.

study of visual acuity using a chronoreflexometer, in hertz;

15. Extensive indicators characterize:

the structure of the phenomenon;

 the frequency of the phenomenon;

averages;

difference of indicators;

prevalence of the phenomenon.

16. Combined disinfection is a combination of methods:

physical + mechanical;

physical + chemical;

mechanical + chemical;

mechanical+physical+chemical;

mechanical+biological.

17. Descriptive-evaluative analytical epidemiological studies include:

randomized controlled clinical trials;

cohort studies.

field trials;

math modeling;

18. Name the main areas of demography:

population size by different age and sex groups;

statics and dynamics of the population.

natural and mechanical movement of the population;

composition and migration of the population;

pendulum and internal migration;

19. The biosphere is:

the totality of the atmosphere, hydrosphere and lithosphere;

the most active layer of living matter of the Earth;

the Earth’s shell, to which human scientific and technological activity is distributed;

part of the atmosphere, hydrosphere and lithosphere of the Earth, inhabited by living organisms;

part of the environment, which determines the social and material conditions of man.

20. The generalizing method for studying physical development is:

 dynamic observation of the physical development of the child;

assessment of the physical development of the child by the method of sigmal deviations;

assessment of the physical development of the child on the regression scales;

a mass study of the physical development of a group of children.

21. Name the source of infection in rabies:

wolves.

snakes;

insects;

birds;

22. An epidemic outbreak is:

an epidemic process in which the usual number of cases of disease is noted in a given area and with a given infection;

group diseases that do not go beyond the family, collective, locality and are interconnected by a single source, ways and
factors of transmission.

morbidity that exceeds the usual level or occurs where it was not;

morbidity, inherent and highly tied to a given area, i.e. depending on natural, biological and social factors that affect the
epidemiological process in a particular place;

23. What activities should be carried out in the clinic during the epidemic rise in the incidence of influenza?

Isolation of the patient within the apartment

Deployment of additional reception for patients with influenza (with suspected influenza) with a separate entrance, dressing
room, reception, etc.; disinfection mode, mask mode, increase in personnel for home care, chemoprophylaxis for staff.

Mass vaccination of the population

Inspection of medical facilities for compliance with the disinfection and sterilization regime

Prohibit the use of the air conditioning system

24. The economic efficiency of health care is expressed:

in achieving the set goals in the field of disease prevention;

in improving the patient's condition;

in reducing the incidence rate;

in increasing life expectancy;

in the estimated contribution to the growth of labor productivity.

25. The main physiological values of carbon dioxide:

diluent oxygen in the atmosphere;

irritant of the respiratory center.

participation in the formation of the oxygen effect;

participation in the plastic processes of plants;

26. The general effect of noise on the human body is manifested:

neuritis of the auditory nerve;

professional hearing loss;

noise disease;

noise injury;

deafness.

27. The special intensive coefficient is:

the ratio of newborn boys and girls;

hospital mortality;

the average duration of a case of incapacity for work;

mortality in myocardial infarction;

the structure of mortality of the population.

28. What is the indicator of the capacity of the hospital?

number of beds.

the number of medical positions;

the average number of days of use of the bed;

bed turnover;

average length of stay in bed;

29. The strategy of general management of a healthcare organization is influenced by everything except:

state policy in relation to public health protection;

investment in the introduction of new treatment methods.

the purchasing power of patients;

provision of qualified personnel;

 nothing is affected;

30. Outbreaks that are realized by food transmission are characterized by ...

the occurrence of diseases along the chain;

pronounced seasonality;

short incubation period in infected.

connection with a water source;

31. Inverse correlation:

With an increase in factor intensity, the incidence rate of the population rises;

With an increase in the intensity of the factor, the level of health of the population stabilizes;

With a decrease in the intensity of the factor, the level of health of the population decreases;

with a decrease in the intensity of the factor, the level of public health rises.

32. Food hygiene is:

science of patterns and principles of rational (optimal) nutrition..

The science of the principles of the organization of preventive nutrition of a healthy person.

The science of studying the diet of a healthy and sick person.

The science of nutrition, which provides the minimum physiological level of intake of nutrients and energy in the body.

The science of the principles of nutrition in accordance with the recommended regimen.

33. Situations of Epidemiology Cases: In a children's recreation camp, from August 13 to 25, Flexner's dysentery 60 children and
12 attendants. In total, 320 children rested in the camp.aged 7 to 15 years. The total number of camp staff is 35 people. The
medical service of the camp was carried out by a paramedic and a nurse. In no intestinal diseases were observed during the 1st
and 2nd shifts in the camp. Employees catering facilities were permanent. The first two children fell ill on 13 August. The
disease began acutely fever up to 39.5 ° C, abdominal pain, nausea, vomiting. The next day, these children had multiple loose
stools. On August 20, three more fell ill children. Only eight children who fell ill on August 15, and three who fell ill on August 25,
dysentery proceeded severely with a pronounced clinical picture. 35 people the disease was mild. Dysentery in children has
been confirmed bacteriologically in 51.7% of cases, in personnel - in 46.4%. Question: What route of transmission caused the
infection of children?

contact way

waterway.

contact-household way

alimentary

34. The main methods of water disinfection:

bacteriological, biochemical;
 chemical, physical.

coagulation, chlorination;

filtration, sedimentation;

35. Sanitary and epidemiological well-being of the population is ...

a system of measures to prevent, reduce and eliminate infectious diseases;

the state of health of the population, the human environment, in which there is no harmful effect on the human body of
environmental factors and favorable conditions for his life are provided.

a set of objects, phenomena and environmental factors, determining the conditions of human life;

the state of health of the population, the human environment, in which there is no harmful effect on the human body of
environmental factors;

a set of measures to prevent, reduce the main non-communicable diseases;

36. When registering isolated cases of infectious diseases, the territory is assessed as:

prosperous.

emergency;

dysfunctiona;l

sustainable;

37. The lack of drinking water is caused, first of all:

greenhouse effect;

a decrease in groundwater;

pollution of water bodies;

soil erosion.

38. The effect of large concentrations of pollutants in a short period of time is called:

dangerous action.

chronic effect.

harmful effect.

acute effect

severe action.

39. Destruction of probably accumulated microorganisms in the absence of a visible source of infection is disinfection:

preventive.
 focal;

current;

final;

40. The power of the hospital is determined by:

population served;

number of beds.

the volume of medical services provided;

the number of working doctors;

volume of diagnostic equipment;

41. Optimal (comfortable) conditions of the hospital’s internal environment are necessary because:

medical personnel must be protected from the possibility of occupational diseases;

the patient is characterized by a decrease in the adaptive capacity of the body;

the hospital should not be dangerous to others;

modern hospitals are equipped with sophisticated medical equipment;

this allows you to maintain a high aesthetic level of the room.

42. Explain how hand sanitizer is applied:

before washing hands;

on hydrated skin;

on treated skin;

for dry skin.

43. The economic efficiency of health care is determined by:

as the ratio of the number of lost working days to the value of the annual national income;

as the ratio of the annual national income to health care costs;

as the ratio of expenses on disability benefits to the value of economic damage;

as the ratio of economic effect to costs.

as the ratio of the degree of change in demand to price change;

44. The chemical composition of atmospheric air:

N2. 37%, CO2. 12%, O2. 40%, inert gases. eleven%;

 N2. 70% CO2. 1%, O2. 19%, inert gases. ten%;

N2. fickle, CO2. 0.03%, O2. 20%, inert gases. 12.5%;

N2. 78%, CO2. 0.03-0.04%, O2. 21%, inert gases. 1%, water vapor.

45. Complete the sentence. Persons who have been attacked by ixodid ticks in natural foci of tick-borne encephalitis are
prescribed ...

gammaglobulin;

immunoglobulin.

poly serum;

toxoid;

46. The toxic sensitizing properties of the DTP vaccine depend on:

diphtheria component;

tetanus component;

pertussis component.

from adsorbent;

47. Vaccination against whooping cough is subject to children under the age of:

1 year;

3 years.

6 years;

9 years;

48. The ultimate goal of marketing activities is:

improving product quality;

making a profit.

meeting consumer demand;

increasing the influence of manufactured goods on the market;

improvement of intracorporate relations;

49. What does the tariff scale consist of?

a set of tariff rates and tariff coefficients divided by categories of wages.

the totality of the corrective coefficients divided by categories of wages;

 a set of tariff coefficients divided by categories of wages;

the totality of tariff rates divided by categories of wages rates;

the totality of tariff rates divided by categories of wages rates, tariff and adjustment coefficients;

50. The characteristics of the variation series are:

standard deviation and coefficient of variation;

average error and correlation coefficient;

ratio indicator and coordination coefficient;

visibility indicator and standardized coefficient;

growth rate and growth rate.

51. The most effective type of prevention is:

primary prevention

secondary prevention

Tertiary prevention

Quaternary prevention

all of the above.

52. Identify the main age groups at risk for viral hepatitis A (years):

1 – 14.

15 - 30 ;

31 - 45 ;

46 - 65 ;

53. The value of amino acids in food:

are not synthesized in the human body and must come with food;

part of the amino acids are not synthesized in the human body and must come with food;

water adsorption in the intestines;

main source of energy;

are a source of biologically valuable substances: phosphatides, sterols, tocopherols.

54. Illumination is:

power of light sources, which is determined in candela;

 spatial density of light radiation, the unit of which is lumen;

surface density of luminous flux in lm that is emitted (or reflected) from an area of 1 m2;

luminous intensity that is emitted or reflected from a unit area in m2 in a certain direction;

surface density of the light flux.

55. The main principles of the scientific organization of labor are not:

organization of the workplace;

unity of the information base;

rationing of labor operations;

cooperation and specialization of labor.

rational use of working time;

56. Preventive sanitary supervision is carried out in relation to:

new objects of industrial, housing and communal and cultural construction, during reconstruction, changing the profile and
technology of the production process.

sanitary and hygienic working conditions;

monitoring compliance with sanitary legislation in relation to the work of women and adolescents;

control over preventive examinations;

compliance with sanitary and hygienic standards during production, transportation, storage and sale of food products;

57. To determine the reliability of the differences between the average and relative values (t), in addition to the values of these
values, you need to know them:

standard deviation;

average error;

absolute growth;

the absolute value of one percent of the increase;

visibility indicator.

58. Anti-epidemic measures are a set of evidence-based recommendations that provide:

prevention of non-communicable diseases among certain population groups;

reduction in the incidence of infectious diseases in the general population;

reduction in the incidence of non-communicable diseases in the general population;

revealing the pathogenic properties of the pathogen;

 reduction in mortality.

59. Daily fluctuations in atmospheric pressure are measured:

barograph.

a barometer;

thermograph;

thermometer;

60. Select indicators of annual incidence dynamics:

periodicity;

seasonality;

trend;

cyclicality;

prevalence.

61. Sanitation is:

The science of the mechanisms of the development of diseases under the influence of environmental factors;

practical use of the developed hygiene standards, sanitary rules and recommendations.

The science of the predicted health status of the population under various hygienic conditions;

the development and implementation of the rules of a healthy lifestyle in society;

Prevention of the development of infectious diseases among the population;

62. To determine the relative humidity, you need:

thermometer;

thermograph;

hygrometer.

barometer;

63. The main work of the local general practitioner is focused on:

in the inpatient hospital;

in the clinic and at home.

in the prevention department of the polyclinic;

in the diagnostic rooms of the polyclinic;

 in the laboratory of the polyclinic;

64. Medical devices that do not contain viable microorganisms, but contain spores, are considered:

clean;

disinfected;

sterile;

disposable;

reusable.

65. Clinical epidemiology is understood ...

investigation of cases of infectious disease in a hospital;

anti-epidemic measures in the hospital;

branch of medicine based on rigorously proven scientific facts;

the science of hospital treatment;

a branch of medicine that studies a disease in a hospital setting.

66. Methods and means of primary prevention include:

taking medication;

adherence to the principles of a healthy lifestyle.

timely surgical treatment;

Seeking regular medical attention;

preventive hospitalization;

67. Features of catering under radiation exposure:

recommended diets with a high content of fiber and pectins;

Proteins, mainly animals, should make up 50% of the diet;

increase in caloric intake in addition to the norm corresponding to physical activity and age by 700 kcal;

diets with a high content of polyunsaturated fatty acids are recommended;

Recommended additional intake of vitamins B and C.

68. The most significant physical property of dust, which plays a role in the development of pneumoconiosis:

content of bound silica;

content of free silicon dioxide;

 solubility in water;

solubility in fats (lipoids).

69. The correlation coefficient equal to one indicates:

functional connection between phenomena.

weak connection between phenomena;

a strong connection between phenomena;

average connection between phenomena;

70. Indicators of the quality of the work of the polyclinic:

morbidity with temporary disability, percentage of hospitalized dispensary patients, timeliness of dispensary observation
coverage of newly identified patients;

activity of making visits to the doctor, percentage of hospitalized dispensary patients, timeliness of dispensary observation
coverage of newly identified patients;

morbidity with temporary disability, activity of making visits to the doctor, timeliness of dispensary observation coverage of
newly identified patients;

morbidity with temporary disability, activity of making visits to the doctor, percentage of hospitalized dispensary patients;

morbidity with temporary disability, activity of making visits to the doctor, percentage of hospitalized dispensary patients,
timeliness of dispensary observation coverage of newly identified patients.

71. The effect of carbon monoxide on the central nervous system is due to:

the formation of methemoglobin;

hypoxia and direct action;

the development of paralysis of the respiratory center;

damage to the region of the medulla oblongata.

72. Situations of Epidemiology Cases: Patient N., 78 years old, a resident of the city of Saratov, sought medical help 9 November
due to fever up to 39 ° C, chills. Primary diagnosis "malaria?". It is known from the anamnesis that patient N. did not travel to the
tropics. October 7th to 9th November was on inpatient treatment in one of the hospitals in the city of Saratov, where repeatedly
received blood transfusions. In the patient's blood rings and gametocytes of Pl. Falciparum. Tropical malaria diagnosis.
Question: Who or what became a possible source of malaria for this patient N.?

A possible source of malaria for this patient N. was a donor blood who had malaria or was a parasite carrier of Pl. Falciparum
during blood donation..

The source of three-day malaria for patient N was a donor – his a relative of A. who appears to be a carrier of pl.Vivax.

In this case, patient N contracted sexual way.

Infection with malaria occurred through household items is possible, especially through personal hygiene items.
73. What does not apply to the ways of protecting the rights of the patient in case of harm to the patient in case of harm to
health?

restoration of the situation that existed before the violation of the right, and suppression of actions that violate the right or
create a threat of its violation;

compensation for harm;

damages;

compensation for non-pecuniary damage;

protection by the patient of his own rights.

74. Physiological nutritional standards are:

evidence-based standards that fully cover the energy expenditure of the body;

standards to ensure the quality and safety of food;

standards for food supplies;

norms reflecting the optimal needs of the population;

Norms in line with the financial capabilities of citizens.

75. Medical-statistical research includes the following stages, except for:

collecting statistical material;

carrying out standardization.

analysis of statistical material;

development, grouping, summary of statistical material;

drawing up a program and plan of statistical research;

76. List the diseases that can be transmitted through water:

fluorosis;

protein-energy deficiency;

poliomyelitis.

pneumoconiosis;

77. Types of power:

official.

public;

formal;
 legitimate;

adaptive;

78. The destruction of probably accumulated microorganisms in the absence of a visible source of infection is disinfection:

preventive.

focal;

current;

final;

79. Preventive sanitary supervision does not include the following main elements:

hygienic study and control of the state of the air, water bodies, soil.

commissioning of the reconstructed facility;

approval of the allotment of a land plot for construction;

approval of the construction project of the facility;

approval of the object reconstruction project;

80. The indicator of the effectiveness of the work of the local general practitioner includes:

decrease in attendance;

decrease in mortality;

decrease in morbidity.

growth of injuries;

growth in the birth rate;

81. Methods of chlorinating water:

chlorination with double ozonation;

usual doses of chlorine, chlorination with pre-ammoniation.

triple chlorination;

chlorination with permanganate and ammonization;

82. Ecology is the science of:

the study of the effects of solar solar characteristics on biota;

the study of the effects of heliomineralogical properties of the planet on biota;

the relationship of plant and animal organisms with each other;

 the impact of environmental pollution on public health;

regularities in the relationship of human society with the environment.

83. The chemical composition of exhaled air:

O2. 15-16%, CO2. 3-4%, N. 78%, inert gases. 1%, water vapor is saturated.

O2. 21%, CO2. 0.03-0.04%, N. 78%, inert gases;

O2. 16-18%, CO2. 3%, N. 78%, water vapor. 3%;

O2. 21%, CO2. 0.03-0.04%, dust. 3 mg / l, water vapor. no;

84. Method for identifying the effects of environmental pollution on public health:

correlation analysis.

proofreading tests;

calculation of etiological indices;

rating nomogram;

Integration method;

85. Nutritional and biological value of milk and dairy products:

protein and fat of dairy products are in a ratio of 1: 1 - the international standard of balance;

calcium milk is in optimal proportion with phosphorus;

milk carbohydrate - lactose, breaking down into glucose and galactose, causes fermentation processes;

milk has a pronounced environmental effect, therefore it is used in diet food;

Dairy products have a normalizing effect on blood sugar.

86. The idea of eliminating infections was first put forward by

Robert Koch;

I.I. Mechnikov;

Louis Pasteur;

F.F. Erisman.

87. Choose the correct definition Science as Evidence-Based Medicine is...

evidence presented to the patient to justify the prescribed treatment;

selection of explanations for the adverse outcome of treatment;

medical practice on the use of treatment methods, the usefulness of which has been proven in benign studies.
 pathoanatomical conclusions submitted to the court;

88. Anti-epidemic measures aimed at the third link of the epidemic process ...

current disinfection;

personal hygiene;

isolation of patients;

health education.

89. The intake and elimination of carbon monoxide from the body:

enters and is excreted through the respiratory system in an unchanged form;

enters through the respiratory system and is not excreted from the body - turns into carboxyhemoglobin;

enters through the respiratory system and intact skin, is not excreted from the body;

enters through the respiratory system and undergoes detoxification in the liver, is not excreted;

enters through the respiratory system, excreted in the urine.

90. The biological effect of ultraviolet rays:

decay of rhodopsin;

general stimulating;

synthesis of vitamin B1;

strong thermal effect;

The synthesis of visual pigment.

91. The level of the mean error of the mean and relative magnitude is influenced by:

the composition of the compared populations;

number of observations.

the value of the growth rate;

coefficient of variation;

92. The following should first be placed in the box of the infection department:

with acute respiratory infection;

with a disease in a serious form;

with intestinal infections;

with airborne viral infections;

 with an unknown diagnosis.

93. To determine the absolute humidity it is necessary:

barometer;

thermometer;

psychrometer.

catatermometer;

94. Specify the primary risk factor for type I diabetes mellitus:

genetic predisposition.

infectious disease;

low physical activity;

the presence of bad habits;

95. A small purulent discharge from a pustule on the shoulder at the injection site of the BCG vaccine appeared in a newborn.
How to evaluate this phenomenon?

individual intolerance;

local allergic reaction;

normal course of the vaccination process;

consequence of improper administration of the vaccine;

genetic disease.

96. A healthy lifestyle is seen as:

medical, socio-economic, philosophical, pedagogical category, personal problem;

medical, socio-economic category, personal problem.

medical, socio-economic, pedagogical category, personal problem;

medical, socio-economic category;

philosophical, pedagogical category, personal problem;

97. Situations of Epidemiology Cases: Child S., 2 years old, attends a kindergarten, nursery group. On October 19, in the
evening, the mother discovered an increase in temperature to 37.5°C and small punctate rash on the child's body. When
contacting a pediatrician On October 20, the doctor made a preliminary diagnosis of measles. Epidemiological data: On October
10, the child with his parents visited cinema. The child's mother had measles in childhood, the father was not sick and was not
vaccinated. No cases of measles have been registered in the kindergarten in the last 2 months. Question: What measures
regarding contact should be carried out at the place of residence?

Vaccinate mother with live measles vaccine urgently according to epidemiological testimony.
 Vaccinate a child with a live measles vaccine urgently according to epidemiological testimony.

In the focus of measles, carry out wet cleaning and airing.

Vaccinate all family members with live measles vaccine urgently according to epidemiological testimony.

Vaccinate the father with a live measles vaccine urgently according to the epidemiological testimony..

98. What is not a source of additional health care financing

income from the commercial activities of healthcare organizations;

medical insurance funds;

means of the republican budget.

voluntary donations of individuals and legal entities;

medical tourism;

99. Chemical method of water purification:

coagulation.

chlorination;

use of gamma radiation;

ozonation;

100. Situations of Epidemiology Cases: A 37-year-old patient with chronic hepatitis B has been registered at the dispensary for
2 years (chronic hepatitis B with low replicative activity). He lives in a comfortable apartment with his wife's relatives. His wife
works in the biochemical laboratory of the city clinical hospital (laboratory assistant). Mother-in-law is a general practitioner;
currently working in the clinic of veterans of the Great Patriotic War. Father-in-law is an artist, works in the creative association
"Rainbow". Task: Make a plan of anti-epidemic measures.

Treatment of the patient, compliance with personal hygiene, current disinfection at the place of residence, observation of
contacts, examination.

Identification, serological examination and observation of contacts, emergency notification, isolation of patients at home (if it
is possible to comply with the anti-epidemic regimen), or to an infectious diseases hospital. Regime-restrictive measures, em

Isolation of the patient within the apartment; Room ventilation, UV irradiation, wet cleaning

All these options are correct

101. Features of management science:

scientific approach.

systemic orientation;

use of models;

hypothesis formulation;
 the formation of hypotheses;

102. In the structure of mortality of the population of economically developed countries, the leading place is taken by

infectious and parasitic diseases, diseases of the digestive system, mental illnesses;

diseases of the circulatory system; neoplasms; injury and poisoning.

neoplasms; trauma; respiratory diseases;

trauma and poisoning, diseases of the circulatory system, mental diseases;

neoplasms, diseases of the circulatory system, mental illness;

103. Repeated examination of patients with pediculosis after treatment is carried out through:

5 days;

after 1 month;

15-20 days;

25 days;

7 days.

104. The concept of local vibration:

oscillatory movements transmitted only to the shoulder girdle;

vibrational movements transmitted only to the lower extremities;

vibrational movements transmitted only to the chest;

oscillatory movements transmitted only to the forearm (hand);

vibrational movements transmitted to a limited area of the body.

105. What artificial lighting systems exist?

Incandescent and fluorescent lamps;

general, local, combined.

local and wall;

direct and reflected;

106. The pathogenetic sign of any pneumoconiosis is:

bronchitis, the formation of bronchiectasis;

development of the pulmonary heart;

the development of pulmonary fibrosis;

 the addition of tuberculosis.

107. What is the correct definition of the term "health care management"?

the science of the ability to use material, financial and human resources for the most efficient operation of the industry.

improving public health;

the most effective improvement of the quality of treatment and prevention measures and the use of health care resources;

activities aimed at making a profit;

managing the creation and implementation of certain services;

108. Situations of Epidemiology Cases: In July-August, 35 cases of leptospirosis were registered among residents of the K.
region. Of all those with leptospirosis, 65.7% (23) are children under the age of 14, and 34.3% (12) are adults. There are 23 men
(65.7%) among the sick, 12 women (34.3%). All patients had leptospirosis in an anicteric form. Moderate course was observed
in 15 (42.9%) patients and mild in 20 (57.1%) patients.In 28 (80%) patients, the diagnosis was confirmed by laboratory tests, the
Pomona serogroup was identified, and in 3 patients, the Sergoe serogroup was also identified.It was established that all the sick
people swam in the river. Dams were made in the bathing places, because of which the water stagnated.222 blood sera from
farm animals of the private and public sector were studied, 179 (80.6%) turned out to be positive: 61 sera with Pomona
serogroup leptospires, the remaining 118 with mixed serogroups Pomona, Tarassowi and Icterohaemorrhagiae.113 small wild
and 26 synanthropic rodents of various species were caught. Laboratory studies C yielded no results. erythrocyte diagnosticum
positive.Measures have been taken: swimming in the river is prohibited, house-to-house rounds have been organized and
carried out, medical supervision has been established for persons who are in the same conditions as those who are sick in
terms of the risk of infection (30 days), disinfection and deratization measures have been taken in the outbreak. Question:
Assess the completeness of the measures taken in the epidemic focus of leptospirosis.

Activities were carried out in full.

Activities were carried out in full and quality..

Activities were carried out efficiency.

109. Highlight the differences between a disinfectant and an antiseptic:

application area.

methods of conducting;

degree of decontamination;

deadline;

110. The plan of statistical research includes:

definition of types and methods of observation;

setting the goal and objectives of the study;

development of a statistical document;

determination of the observation unit;

development of an accounting document.

111. The concept of “decentralization” of health care management in the new conditions includes the following components,
except

reduction of measures of administrative and coercive influence vertically;

lack of a regulatory framework in healthcare.

decentralization of budget financing:

receipt of funds for compulsory health insurance at the territorial level;

expansion of the rights and powers of heads of medical institutions;

112. The basis for assessing the performance of the health care system in modern economic conditions is based on:

provision of the population with beds;

provision of the population with doctors;

the final result, taking into account the state of health of the population.

the amount of funding for health care per capita per year;

the total number of inpatient beds per 1000 population;

113. The main goal of secondary prevention:

prevention of the occurrence of the disease (effect on the mechanism of the disease);

preventing the occurrence of a disease by influencing risk factors;

prevention of overload of body systems in violation of the rules of a healthy lifestyle;

prevention of progression or exacerbation of the disease;

environmental health.

114. Carriers of blood infections are:

house and blow flies, cockroaches;

field mice, marmots, ground squirrels, muskrats;

rats, house mice;

ticks, horseflies, fleas, mosquitoes.

115. The rationalization of the labor process provides for:

full automation of production;

full mechanization of production;

the fight against occupational hazards;

a favorable rhythm of work.

116. Situations of Epidemiology Cases: Child S., 2 years old, attends a kindergarten, nursery group. On October 19, in the
evening, the mother discovered an increase in temperature to 37.5°C and small punctate rash on the child's body. When
contacting a pediatrician On October 20, the doctor made a preliminary diagnosis of measles. Epidemiological data: On October
10, the child with his parents visited cinema. The child's mother had measles in childhood, the father was not sick and was
notvaccinated. No cases of measles have been registered in the kindergarten in the last 2 months. Question: What activities
need to be carried out for contact persons in the children's garden?

Vaccinate all those who have not been vaccinated before this time;

Find out the immune status of children and team members; Vaccinate all those who have not been vaccinated before this time;

Assign observation of contacts and introduce quarantine for a period of 17 (21) days. Find out the immune status of children
and team members;

Find out the immune status of children and team members;Vaccinate all those who have not been vaccinated before this time;
Assign observation of contacts and introduce quarantine for a period of 17 (21) days.

117. The method of sigmal deviations allows you to evaluate a child:

development range;

the level of physical development according to individual anthropometric signs;

is the level of biological development;

level of functional performance;

level of body resistance.

118. Standardized ratios are used for:

determining the reliability of the difference between the compared indicators;

determining the nature and strength of the connection between phenomena;

comparison of intensive indicators obtained on populations that are not identical in composition;

comparison of groups on a qualitative basis;

analysis of population health indicators in dynamics.

119. Correlation is defined as a relationship:

in which any value of one of the signs corresponds to a strictly defined value of another sign interconnected with it;

characterizing the features of the distribution of two compared features;

in which the value of each value of one attribute corresponds to several values of another attribute interconnected with it;

in which any value of one of the features corresponds to a strictly defined value of another unrelated feature;

in which the value of each value of one attribute corresponds to several values of another attribute not related to it.

120. The greenhouse effect occurs as a result of accumulation in the atmosphere:

carbon monoxide;
 carbon dioxide;

nitrogen dioxide;

sulfur oxides.

121. Estimated indicators of capacity (capacity, throughput) of the hospital are:

number of beds.

number of visits per shift;

number of beds served;

number of positions of doctors;

population served;

122. The first epidemiological study, the purpose of which was to describe the disease, explain its causes and take measures to
eliminate it, was carried out by:

Robert Koch;

John Snow;

Danila Samoilovich;

L.V. Gromashevsky;

Louis Pasteur.

123. The classification of labor in terms of the severity of the labor process:

3 degrees: light, medium, heavy physical activity;

3 degrees: light, optimal, permissible physical activity;

4 degrees: light, medium, heavy І degrees, heavy ІІ degrees physical activity.

2 degrees: optimal and permissible physical activity;

124. Objectives of the meta-analysis ...

clarification of the diagnosis;

express diagnosis;

obtaining new drugs;

increasing the reliability of research results.

125. Indicate the main types of water supply sources:

seawater;
 groundwater.

melt water;

mineral water;

126. Situations of Epidemiology Cases: On December 7, the mother of a 7.5-month-old child turned to the children's polyclinic at
the place of registration with a complaint of swelling in the left axillary region, which she noticed about a month ago when
bathing the child. The swelling gradually increased in size, reaching the size of a bean by the time of treatment. Child R. is
registered in the city of A., unorganized, was not observed at the clinic at the place of registration, lives in the region where on
September 29 of the same year, the branch of the children's clinic was vaccinated with BCG-M. The child was examined: X-ray
examination dated December 11 without pathology, bacteriological examination was not performed, on December 24, a surgical
intervention was performed in the surgical department of the Children's Clinical Hospital (DCH), in fragments of the lymph node
tissue (dated December 29), morphological changes were most characteristic of tuberculous lymphadenitis. The child was
consulted in TKB. The diagnosis is "complicated course of vaccinal lymphadenitis". Held outpatient process, axillary left-sided
treatment. An extraordinary preliminary report was sent on a post-vaccination complication for inoculation with a tuberculosis
vaccine. An investigation has been ordered to determine its cause. Conclusion: the formation of axillary lymphadenitis after
BCG-M vaccination is presumably associated with the individual characteristics of the organism of the child R. against the
background of a weakened somatic state. Question: Name the possible causes of complications after vaccination against
tuberculosis.

The quality of the administered vaccine

Technical errors while getting vaccinated

The peculiarities of the reaction of the vaccinated organism

All of the above answers are correct.

127. Situations of Epidemiology Cases: Child 6 months old, aged 3 and 4.5 months. was vaccinated against polio. The second
vaccination was accompanied by neurological disorders Task: Doctor tactics

Сhange the timing of vaccination

Use another brand of vaccine

This is considered a normal reaction after vaccination no cause for concern

The child can get the vaccine at the age of majority

Post-vaccination complication. Further vaccination is contraindicated.

128. The indicators of the dynamic range are all, except:

absolute growth;

natural growth;

growth rate;

growth rate;

the absolute value of one percent increase.

129. One of the tasks of the public health department is:

 system analysis of data using modern information technologies;

identification of levels of risk to public health;

assessment and forecasting of the health status of the population;

increasing the level of hygienic culture and medical and social activity of the population by means and methods of hygienic
education and upbringing.

study of morbidity and injury;

130. For protection against beta radiation are used

Lead, Leaded glass

Plexiglass, Aluminum, Plastic.

Water, paraffin

Cadmium

Boron, Uranium

131. Personal prevention is aimed at:

mechanism for the development of diseases or risk factors;

preventing the progression of an existing disease;

prevention of violations of the human body systems in case of non-compliance with the rules of a healthy lifestyle;

prevention of exacerbation of a chronic disease;

environmental health.

132. What is the leading centralized water supply system:

remote;

ring;

pumping.

regional;

133. The incidence is considered epidemic when ...

does not exceed 1...100,000 population per year;

does not exceed the level usual for the area.

significantly exceeds the average annual level in the area;

uncharacteristic for this area;

higher than normal for the area;

134. Labor intensity is:

the load on the body during labor, requiring intensive brain work to coordinate the activity of the neuromuscular apparatus;

the load on the body during labor, requiring intensive brain work to obtain and analyze information;

the load on the body during labor, requiring intensive brain work to coordinate the activity of the cardiovascular system;

the load on the body during labor, requiring intensive brain work to coordinate the activities of the respiratory system;

the load on the body during labor, requiring intensive brain work forcoordination of the load on the circulatory system of the
body.

135. The physical method of disinfection is:

washing, airing;

wiping with disinfectants;

exposure to high temperature, steam, radiation;

use of antibiotics;

the use of chemical solutions.

136. The methods of obtaining primary information include everything, with the exception of:

direct observation;

copying data from primary medical documentation;

anamnestic method;

questionnaires;

random selection.

137. Recommended for protection against gamma rays.

organic glass

iron

aluminum

cadmium

lead, concrete.

138. Deratization is understood ...

a set of measures aimed at combating arthropods.

a set of measures aimed at combating rodents;

sanitary and veterinary measures;

 extermination of rodents mainly in natural conditions;

139. Chemical indicator of the effectiveness of ventilation:

room air exchange;

air speed;

air temperature;

CO2 content in the air.

140. The capacity of a polyclinic is measured:

staffing with medical workers;

the number of therapeutic sites;

morbidity of the population;

coverage of medical examination;

the number of visits per shift.

141. Situations of Epidemiology Cases: On August 1, he was transferred to the surgical department of the hospital in the city of
N. frompsychiatric hospital citizen K. 63 years old with complaints of acute abdominal pain,of being "stab with a dagger".
Objectively: there is no bloating, there is a sharp tension in the muscles of the abdominal wall ("board-shaped abdomen"),
positive Shchetkin-Blumberg symptom. K. was urgently operated on the day of admission.From the surgical department 3 days
after the operation, a patient with a diagnosis "typhoid fever?" transferred to the infectious diseases hospital, where, on the
basis of clinical and bacteriological data was diagnosed with typhoid fever.Sick 10th of June was involved in the distribution of
food in this ward. During bacteriological examination patients of the ward identified N. - typhoid carrier. Upon admission to the
hospital patient K. was twice examined for an intestinal group of infections with a negative result. According to relatives,
intestinal disorders were not observed. Sick was in the department for treatment for a year. Question: Where did the infection
occur?

In the hospital.

During the operation

At home

In the ward

142. Minimizing the risk of undesirable consequences of providing medical care is the next characteristic qualities:

Availability;

Efficiency;

Efficiency;

Security.

Convenience;
143. What does not apply to the initial data for calculating the standard and planned cost of medical care?

the planned volumes of medical care by types of its provision by a medical organization;

contracts for the supply of material resources, containing the conditions for their implementation and payment;

norms of workload, labor costs, calculations of the staffing level, terms of remuneration, determined in accordance with the
current legislation;

share of expenses for payment of certain medical services.

useful life (normative service life) of fixed assets and items included in current assets;

144. Situations of Epidemiology Cases: The district of D. is located on the territory enzootic for tick-borne viral encephalitis.
From 3 to 6 cases of tick-borne encephalitis per 100,000 population were annually registered in the region. The incidence of
tick-borne viral encephalitis is recorded from April to October. The peak incidence occurs in June-July and lags behind the
number of ixodid ticks (May-June) by one month. Annually 1200 calls are registered for tick bites. Ticks are tested for
pathogens by PCR. In nature, the virulence of ticks in recent years was -8.9% The village of U. is located on the territory of the
district, where at the end of May a case of tick-borne viral encephalitis was registered with a seasonal worker. Appeals about
the suction of ticks are recorded annually 30-40 cases. Only a part of them is sent for the detection of pathogens with
difficulties in delivery, the answer is received in 4-5 days. The antigen of the tick-borne encephalitis virus was found in 2 copies
of ticks, there is no information about vaccinations in patients. The inhabitants of the village are engaged in logging. Permanent
residents (450 people, 95 of them children) live in private houses, seasonal workers (210 people) in a hostel. Among seasonal
workers there is an annual change of up to 40%. When working in the forest, workers use overalls and chemicals for its
processing. Vaccinations against tick-borne viral encephalitis are carried out in late May and early June. Vaccination coverage
against tick-borne encephalitis of permanent residents is 69%, among seasonal workers 31%. Emergency specific prevention of
tick-borne encephalitis in the village was carried out for one victim. Question: Evaluate the quality of vaccination against tick-
borne viral encephalitis.

The quality of vaccine prevention is satisfactory.

The quality of vaccine prevention is unsatisfactory. Preventive vaccinations against TBE are carried out for the population
living in endemic territories and for the population traveling to endemic territories..

The quality of vaccine prevention is effective.

The quality of vaccine prevention meets the requirements in this situation.

145. Good nutrition is:

nutrition of a sick person aimed at the prevention of relapse of the disease;

nutrition of a healthy person, based on the specific action of food to prevent the occurrence of nutritional diseases;

Nutrition for workers in particularly harmful working conditions;

nutrition of residents of ecologically disadvantaged areas;

Nutrition of patients in health organizations.

146. Correlation analysis allows you to:

derive a regression equation and determine the predicted level of health depending on the intensity of the factors involved;

establish the influence of environmental factors;

establish the degree and nature of the influence of environmental factors.

 establish the objectivity of the influence of environmental factors;

147. The objectives of health economics include:

analysis of the effectiveness of the use of material, labor and financial resources of health care;

study of the profitability, economic efficiency of various forms of medical care;

the economic justification of the costs in health care for the provision of various types of medical care;

development of economic criteria for the effectiveness of health care;

everything is true.

148. Seasonal rise in incidence is:

epidemic rise in its level during the calendar year;

allowance to the level of year-round morbidity;

an increase in the incidence that occurs at the same time of the year following the activation or onset of actions of natural,
biological or social causes;

epidemic rise in morbidity caused by irregular, randomly acting causes of a social nature;

epidemic rise in its level during the month.

149. Environmental factors due to the presence of a person and the results of his labor activity are called

biotic

abiotic

climatic

anthropogenic.

carcinogenic

150. Physiometric studies include:

measurement of dead muscle strength.

measurement of body weight;

study of the shape of the chest;

determination of the proportionality of body parts;

151. What definition of the term "management" is correct?

management, a special type of activity for the professional leadership of people in different organizations.

the mental and physical process that leads to the fact that subordinates carry out the prescribed official instructions, solve
certain problems;
 activities aimed at making a profit by creating and selling certain products or services;

the ability to motivate the personnel of the organization;

152. Of the listed types of statistical tables, the best idea about the studied population is given by:

a simple table;

group table;

four-field table;

multi-field table;

combination table.

153. WHO does not function

act as the directing and coordinating body in the field of international health;

encourage and develop disease control and medical research;

provide technical assistance to governments at their request;

make decisions binding on its member states.

develop and disseminate international standards;

154. Requirements for the organization:

the presence of more than two people who consider themselves part of the group;

the presence of one common goal.

the presence of group members;

the presence of the administration;

the presence of a leader;

155. Vitamin Deficiency Disease:

kwashiorkor;

nutritional insanity;

rickets;

Calcification of soft tissues and arteries;

Cardiac beriberi.

156. A doctor who has diagnosed an infectious disease must ..

determine the boundary of the hearth;

 fill out an "emergency notice";

carry out the final disinfection;

organize measures to eliminate the outbreak;

. carry out deratization.

157. Food poisoning is:

diseases whose contagiousness is due to etiology;

diseases with weak contagiousness;

non-contagious diseases;

occurring only acutely diseases;

Acute diseases with obligatory gastrointestinal tract lesions.

158. Situations of Epidemiology Cases: At the end of summer, an outbreak of enterovirus infection occurred in the village of R.
in the region. The diagnosis of epterovirus diseases was confirmed by the isolation of the Coxsackie A virus from swabs of the
pharynx, feces, and cerebrospinal fluid. In some patients, parastation of the titer was determinedantibodies by 4 times or more.
36 patients aged from 4 months to 54 years were under observation. By age, the patients were distributed as follows: from 4 to
12 months 3 children, from 1 year to 3 years 5 children, from 3 years to 7 years 11, from 11 to 14 years 10 patients, six adult
patients from 19 to 26 years, one woman 54 years old. Patients were admitted from 2 to 10 August, mainly on the 1st and 3rd
days of illness. Only three patients were admitted on days 5-7 of illness. In 24 patients, localized forms of the disease were
determined, and in 12 children - combined syndromes of the disease. Among the localized form, serous meningitis prevailed in
21 patients (among them, seven adults from 19 to 54 years old, herpangina and diarrhea, respectively, in two and one child.
Combined forms of enterovirus infection were recorded in 12 children. Serous meningitis, herpangina, exanthema, and diarrhea
were observed in five children, serous meningitis and foot-and-mouth disease in one child, exanthema, herpangina, diarrhea in
six children. Question: Give a preliminary assessment of the epidemic situation.

An epidemic outbreak of an enterovirus infection occurred in the village of R..

An epidemic outbreak of a contact infection occurred in the village of R.

An epidemic outbreak of an airborne infection occurred in the village of R.

An epidemic outbreak of a transmissible infection occurred in the village of R.

159. Method for assessing the physical development of the child:

correlation;

is a combined method;

dispersion;

a method of estimation on regression scales.

160. Medical and preventive nutrition is:

nutrition of a sick person, aimed at the prevention of relapse of diseases or their transition into chronic forms;

nutrition of the population aimed at the prevention of nutritional diseases;

 nutrition of organized groups;

food for workers in particularly harmful working conditions;

Nutrition of patients in health organizations.

161. Select which parasitosis belongs to biohelminthiases:

ascariasis;

opisthorchiasis;

enterobiasis;

echinococcosis.

162. Which of the following is relevant to running an organization?

the ability of a leader to influence subordinates, a means of implementing the organization's mission;

the ability of subordinates to influence management;

the responsibility of the person for the results of activities, the ability of the leader to influence subordinates, the means of
implementing the mission of the organization.

a means of carrying out the mission of the organization;

control over the activities of subordinates;

163. Clinical examination is:

organizational form of screening;

method of active dynamic observation.

the main goal of medical and preventive care;

detection of acute diseases among the population;

detection of infectious diseases among the population;

164. Etiology of silicosis - the impact on the lung tissue of dust particles containing:

free carbon dioxide;

free silicon dioxide;

free aluminum dioxide (iron);

is bound silicon dioxide;

bound iron dioxide (aluminum).

165. What is a viral disease that can be transmitted through water:

 hepatitis A.

leptospirosis;

fluorosis;

dysentery;

166. Indicate the main climate-forming factors:

chemical composition of the soil, its geomagnetic properties;

geographical longitude and latitude, the nature of the underlying surface and its relief.

altitude;

the nature of the soil in the area;

167. A comprehensive science that studies the laws of human interaction with the environment, population issues, the
preservation and development of human health - these are

social hygiene

human ecology.

demography

human biology

anthropology

168. Situations of Epidemiology Cases: Patient K., aged 40, was admitted to the clinic of infectious diseases with a preliminary
diagnosed with tick-borne viral encephalitis. Sick for 3 days. The onset of the disease is acute: suddenly increased body
temperature up to 40 ° C, there was an intense headache, accompanied by vomiting, myalgia, paresthesia. Epidemiological
history: a month ago, traveled to a territory endemic in tick-borne encephalitis, and consumed raw goat's milk. Vaccination
history -completed an incomplete course of vaccinations against tick-borne encephalitis. Question: Who is the main carrier of
tick-borne encephalitis virus?

dogs ticks

ixodid ticks.

argasid ticks

gamasid ticks

anopheles mosquitoes

169. An epidemic is:

an epidemic process in which the usual number of cases of disease is noted in a given area and with a given infection;

group diseases that do not go beyond the family, collective, locality and are interconnected by a single source, ways and
factors of transmission;
 morbidity, inherent and highly tied to a given area, i.e. depending on natural, biological and social factors that affect the
epidemiological process in a particular place;

group diseases that do not go beyond the family.

170. Which method of analyzing economic efficiency is the effect expressed in QALY - years of quality life saved:

cost minimization analysis;

analysis of benefit - value;

cost-benefit analysis;

cost-effectiveness analysis;

cost-utility analysis.

171. What indicators are used to calculate the need for inpatient beds?

the level of referral (morbidity) per 1,000 population;

the percentage of hospitalization;

the average number of days of the patient's stay in the bed;

the planned number of days of use of the bed per year;

all indicators are used.

172. According to WHO experts, interventions to combat the increase in cardiovascular morbidity should focus on measures:

primary prevention.

secondary and tertiary prevention;

increasing investment in research and development on this issue;

bringing science to practice;

improving medical care for patients with cardiovascular diseases;

173. Sanitary-hygienic and anti-epidemic measures are carried out in order to:

timely provision of medical care to the population;

the distribution of the affected into groups in need of isolation and sanitization;

maintaining and strengthening the health of the population, as well as the prevention of infectious diseases and the
elimination of epidemic foci.

prevention of the emergence and spread of infectious disease in the population;

ensuring the sanitary well-being of the population and eliminating the adverse sanitary consequences of the use of weapons
by the enemy mass destruction;
174. Clinical epidemiology is understood ...

investigation of cases of infectious disease in a hospital;

anti-epidemic measures in the hospital;

branch of medicine based on rigorously proven scientific facts.

the science of hospital treatment;

175. A science that studies the community of organisms (biogeocenoses), interspecific relationships, energy flows and cycles
of substances - these are

endoecology;

demecology;

synecology;

global ecology;

geoecology.

176. Quality standards do not include:

the standard of the health status of the patient who completed the treatment;

examination standard;

number of outpatient visits per completed case.

standard of care;

all of the above;

177. Determine which disease is included in the structure of non-communicable diseases:

yersiniosis;

tuberculosis;

rickettsiosis;

schistosomiasis;

neurosis.

178. When is the epidemiological examination of the focus of infection carried out:

according to the schedule in a planned manner;

within 2 days after receiving an emergency notice;

at any free time at the discretion of the epidemiologist;

within 7 days after receiving an emergency notice.

179. Under the epizootic process is understood ...

the process of occurrence and spread of infectious diseases among the population;

the spread of diseases only among wild animals.

interaction of a pathogen and a susceptible organism, manifested by disease or carriage of the infectious agent;

spread of disease in animals;

180. Carbon monoxide is:

colorless gas with a sharp asphyxiating odor;

yellow-green gas, odorless;

odorless colorless gas;

gas yellow - green, with a pungent odor;

colorless gas with a faint, vague odor.

181. One of the main signs of vibrational disease (with local exposure):

deformation of the feet and hands;

softening of bones (osteomalacia);

brittle bones (osteoporosis);

decrease in pain sensitivity.

182. What is the intermediate host for teniosis?

wild carnivores;

domestic pigs;

cattle;

human.

183. The concept of physical thermoregulation:

a complex of neurohumoral, biochemical, physiological processes aimed at the transfer of heat by the body to the
environment.

a set of neurohumoral, physical, chemical, physiological processes for the formation of heat in the body;

Intensity and orientation of the main metabolism in the body;

a number of functional changes in the body that regulate the intensity of neurohumoral processes;

184. Methods of hygienic education are:

 information-receptive, problem statement method, heuristic;

information-receptive, analytical, problem method presentation, heuristic;

information-receptive, statistical, method of problem presentation;

information-receptive, reproductive, sociological, heuristic;

information-receptive, reproductive, problem presentation method, heuristic.

185. BCG vaccine is administered:

Skin;

Intradermal.

subcutaneously;

through the mouth;

186. The direction of communication in the correlation analysis can be:

direct and reverse.

irrational and rational;

positive and negative;

indirect and direct;

187. The physiology of labor studies:

Effect of severity of labor on the human body

The effect of labor stress on the human body

Effect of severity and harmfulness on the human body

The effect of severity and tension on the human body.

188. The degree of variation of the variation series is determined by calculating:

growth rate;

the visibility indicator;

the average error of the mean;

standard deviation;

the coefficient of reliability of the difference in mean values.

189. A device for measuring vibration parameters is:

vibration amplitude meter;

 vibration frequency meter;

vibrometer;

vibroammeter;

pallestesiometer.

190. The organizational form of clinical examination is:

medical examination.

screening;

consultation;

observation;

hospitalization;

191. Number of current cases(new and old) of specified disease identified over a given time interval from estimated population
at mid interval is called;

Prevalence

Period Prevalence.

Point Prevalence

Disease Prevalence

Incidence

192. Situations of Epidemiology Cases: A patient came to the emergency room of the hospital for medical help. From the
anamnesis it became known that the patient is infected with HIV. Task: Name the elements of special clothing for medical
personnel working in the mode of possible contact with the patient's blood and other biological fluids.

All manipulations in which contact with the patient's biological fluids can occur are carried out in a personal protective
equipment that includes a medical suit, shoes and gloves

All manipulations in which contact with the patient's biological fluids can occur are carried out in a disposable medical gown,
cap, shoes, goggles and gloves

There is no need to wear personal protective equipment except for a medical gown, mask and gloves

All manipulations in which contact with the patient's biological fluids can occur are carried out in a surgical gown, rubber
gloves, a hat, and removable shoes; if there is a risk of splashing, use a mask, goggles, a protective screen, oilcloth or rubber.

193. Highlight the infections of which body system are most often associated with the provision of medical care:

respiratory;

intestinal;

nervous;
 urinary;

circulatory.

194. Epidemiological studies according to the purpose of conducting are divided into:

descriptive and analytical.

analytical and observational;

routine and relative;

observational and descriptive;

195. A variation that halves the variation series is called:

fashion;

standard deviation;

arithmetic mean;

median;

limit.

196. Management methods:

organizational;

economic.

social;

political;

mathematical;

197. Data required to determine the average error (m) of the relative value (P):

intensive indicator and total number of observations;

fashion and total number of observations;

median and total number of observations;

arithmetic mean and total number of observations;

standard deviation and total number of observations.

198. Transmission factors are:

elements of the external environment that ensure the transfer of the pathogen from one organism to another;

biotic environmental factors in which the pathogen accumulates;

 abiotic environmental factors in which the pathogen accumulates;

the natural habitat of the pathogen;

biotic and abiotic environmental factors in which the pathogen accumulates.

199. The structure of morbidity is determined:

list of nosological forms;

distribution of incidence among different population groups;

pathogenesis of a specific nosological form;

the duration of the main phases of the disease;

seasonal patterns of morbidity.

200. Situations of Epidemiology Cases: Patient K., aged 40, was admitted to the clinic of infectious diseases with a preliminary
diagnosed with tick-borne viral encephalitis. I considered myself sick for 3 days. The onset of the disease is acute: suddenly
increased body temperature up to 40 ° C, there was an intense headache, accompanied by vomiting, myalgia, paresthesia.
Clinical picture: body temperature - 39°C; hyperemia of the skin of the face, neck and mucous membranes, injection of vessels
of the sclera. Meningeal symptoms are noted - neck stiffness, Kernig's and Brudzinsky's symptoms are positive.Epidemiological
data: traveled to a territory endemic for tick-borne encephalitis, and consumed raw goat's milk. Vaccination history - completed
an incomplete course of vaccinations against tick-borne encephalitis. Question: How did the patient become infected?

did not comply with security measures

ate food with dirty hands

completed an incomplete course of vaccinations against tick-borne encephalitis.

did not seek medical attention in time

201. Overwork is:

transcendental inhibition in brain cells, associated with the performance of uninteresting, not creative work;

subjective expression of the process of fatigue (of any degree);

high degree of fatigue, characterized by a mismatch between the expended and restored energy;

subjective sensation of a very high degree of fatigue;

objective process associated with overstrain of the cardiovascular system.

202. Disinfection methods include:

general and ongoing cleaning;

physical and chemical;

preventive and focal;

current and final;

 general and final.

203. Not classified as a motivational factor:

interest in work;

recognition and success;

promotion;

increase in load.

growth and development;

204. Living organisms protect against harsh ultraviolet radiation:

oxygen layer;

hydrosphere;

ozone layer;

lithosphere.

205. Public health is viewed studied as:

a one-factor problem, which includes goals and objectives for the study of public health and influencing environmental factors;

a multifactorial problem, which includes goals and objectives for the study of general morbidity, without taking into account
the influence of environmental factors;

a multifactorial problem that includes goals and objectives for the study of public health and influencing environmental
factors.

assessment of indicators of the natural movement of the population;

assessment of indicators of general mortality and disability;

206. How should the hospital budget be planned?

with an excess of the expenditure side over the income;

with an excess of the revenue side over the expenditure side.

expenses must correspond to income;

does not matter;

with the possibility of creating reserves for the next year;

207. To measure and record air temperature readings in dynamics, you need:

thermometer;

thermograph.
 psychrometer;

catheter;

208. Situations of Epidemiology Cases: At the end of summer, an outbreak of enterovirus infection occurred in the village of R.
in the region. The diagnosis of epterovirus diseases was confirmed by the isolation of the Coxsackie A virus from swabs of the
pharynx, feces, and cerebrospinal fluid. In some patients, parastation of the titer was determinedantibodies by 4 times or more.
36 patients aged from 4 months to 54 years were under observation. By age, the patients were distributed as follows: from 4 to
12 months 3 children, from 1 year to 3 years 5 children, from 3 years to 7 years 11, from 11 to 14 years 10 patients, six adult
patients from 19 to 26 years, one woman 54 years old. Patients were admitted from 2 to 10 August, mainly on the 1st and 3rd
days of illness. Only three patients were admitted on days 5-7 of illness. In 24 patients, localized forms of the disease were
determined, and in 12 children - combined syndromes of the disease. Among the localized form, serous meningitis prevailed in
21 patients (among them, seven adults from 19 to 54 years old, herpangina and diarrhea, respectively, in two and one child.
Combined forms of enterovirus infection were recorded in 12 children. Serous meningitis, herpangina, exanthema, and diarrhea
were observed in five children, serous meningitis and foot-and-mouth disease in one child, exanthema, herpangina, diarrhea in
six children. Question: Give a preliminary assessment of the epidemic situation.

An epidemic outbreak of an enterovirus infection occurred in the village of R..

An epidemic outbreak of a contact infection occurred in the village of R.

An epidemic outbreak of an airborne infection occurred in the village of R.

An epidemic outbreak of a transmissible infection occurred in the village of R.

209. During pre-sterilization cleaning of medical devices:

remove various contaminants.

destroy vegetative forms of microorganisms;

destroy vegetative and spore forms of microbes;

neutralize the source of infection;

210. The main reporting form of the city clinic:

report on the causes of temporary disability;

report on the activities of healthcare organizations providing medical care in a hospital;

report on the activities of healthcare organizations providing medical care on an outpatient basis.

information about the incidence of acute coronary syndromes, the effectiveness of diagnostic and therapeutic and
rehabilitation measures;

report on the work of the prevention room of the outpatient healthcare organization;

211. What are the diseases that are caused by the chemical composition of water:

diseases that are caused by high or low water hardness.

hypovitaminosis;

protozoal diseases;
 diseases caused by violation of the drinking water intake regimen;

212. Which principle does not apply to the basic principles of radiation protection:

protection by the amount (dose) of radiation,

protection by distance from the radiation source,

concentration protection,

protection by time,

Screen protection.

213. Sanitary-hygienic and anti-epidemic measures are carried out in order to:

timely provision of medical care to the population;

the distribution of the affected into groups of need for isolation and sanitization;

preservation and strengthening of public health, as well as the prevention of infectious diseases and the elimination of
epidemic foci.

prevention of the emergence and spread of infectious diseases among the population;

214. The main goal of tertiary prevention:

prevention of possible complications of the disease.

prevention of the progression of a chronic disease;

prevention of overload of body systems in violation of the rules of a healthy lifestyle;

improvement of the working environment, prevention of occupational diseases;

environmental health;

215. What degree of probability corresponds to the confidence interval М ± m:

68.3%;

95.5%;

95.7%;

99.7%;

99.9%.

216. Outbreaks realized by water transmission are characterized by ...

illness in children under 1 year of age;

the occurrence of diseases along the chain;

 short incubation period in infected;

connection with a water source.

217. The severity of labor is:

load on the body during labor, requiring muscle effort and appropriate energy support;

load on the body during labor activity, manifested in functional changes primarily of the cardiovascular system;

is the load on the body during labor activity, manifested in functional changes primarily of the central nervous system of the
respiratory system;

the load on the body during labor activity, manifested in functional changes primarily of the respiratory system;

load on the body during labor activity, manifested in functional changes primarily of the peripheral nervous system.

218. Which of the following relates to the principle of motivation?

use of the motives of people's behavior to achieve the goal.

participation of all employees in management;

creation of a multi-stage management structure;

awarding with diplomas;

encouragement with prizes;

219. Hygiene is the science of:

mechanisms of the development of the disease under the influence of environmental factors;

the practical use of sanitary norms and rules;

society and government measures to structure it;

pathological conditions of the body under the influence of a technogenic environment;

maintaining and strengthening public and individual health through preventive measures.

220. The functional duties of the head of a medical institution do not include

staffing;

definition of goals and objectives of the activities of units;

organization of activities of departments.

implementation of internal and external communication links;

control of joint and individual actions;

221. Chemical methods of water disinfection:

 UV rays, boiling;

chlorination, ozonation.

ozonation, x-rays;

magnetic field, iodination;

222. What should be done in case of turbidity of the immunoglobulin in the ampoule:

let settle;

can be used;

prohibit the use.

dispose of;

223. The effectiveness of clinical examination is assessed by the number of persons removed from the dispensary registration
due to:

Retirement;

Exit to disability;

Recovery.

Change of residence;

Refusal of the patient from dispensary observation;

224. The quality of diagnostics of polyclinic doctors can be assessed by the following indicators:

the frequency of coincidence of pathoanatomical and polyclinic diagnoses;

the percentage of refusals in hospitalization due to the unreasonable direction of patients from the polyclinic to the hospital;

the frequency of coincidence of clinical and pathoanatomical diagnosis;

percentage of misdiagnosis.

the percentage of undiagnosed (viewed) diagnoses of polyclinic doctors;

225. Classification of environmental factors by origin:

etiological, environmental, biological;

etiological factors and risk factors;

social, biotic, and abiotic;

chemical, physical, biological and social;

Entomological, geographical and ethnographic.

226. Select the indicator used to study the epidemiological significance of morbidity:

absolute indicator;

intensive indicator;

absolute and visibility indicator;

visibility indicator;

extensive indicator.

227. In health care management there are:

subject of management.

participants in management;

management environment;

health care institutions;

subordinate organizations;

228. Name the immunobiological drugs used to create active immunity:

anatoxin;

bacteriophage;

homologous serum;

killed vaccine;

live vaccine.

229. Line diagrams are used to illustrate:

dynamics of the phenomenon;

phenomena in a closed cycle of time;

extensive indicators;

morbidity structure;

seasonality of morbidity.

230. The main measure of sanitary protection of the soil:

sanitary and entomological;

sanitary-chemical;

sanitary statistics;
 technological;

therapeutic and prophylactic.

231. Storage of chlorine-containing substances occurs ...

exposed to light in a closed container;

in the dark in a closed container.

exposed to light in an open container;

in the dark in an open container;

232. Time series alignment is carried out if it consists of:

absolute values;

sharply fluctuating values;

inhomogeneous quantities;

intensive indicators;

extensive indicators.

233. Daily fluctuations in air humidity are measured:

a barographer;

a barometer;

thermograph;

thermometer;

hygrograph.

234. Public prevention includes:

creation of favorable living, working, leisure and food conditions with the help of state legislation and norms;

prevention of overload of body systems in violation of the rules of a healthy lifestyle;

the study of the mechanisms of the development of diseases under the influence of environmental factors;

the development and implementation of types and systems of hardening of the body, physical education;

development of recommendations on the hygienic content of the skin, hair, oral cavity and teeth.

235. Compulsory medical insurance funds in the territory of the region (region) are formed at the expense of: everything is
correct, except

income from paying;

 federal budget funds;

budget funds of subjects;

income from the placement of temporarily free funds.

personal funds of citizens;

236. Drawing up a plan and research program is:

the first stage of statistical research;

the second stage of statistical research;

the third stage of statistical research;

the fourth stage of statistical research;

the fifth stage of statistical research.

237. Fatigue is:

is the subjective expression of the objective processes occurring in the body under the influence of labor activity;

is an objective process characterized by a decrease in working capacity;

deterioration of the central nervous system under the influence of intensive labor activity;

deterioration of the cardiovascular system under the influence of intensive labor;

deterioration of the indicators of the neuromuscular apparatus under the influence of intensive labor activity.

238. The indicator of the effectiveness of the work of the local general practitioner includes:

decrease in attendance;

decrease in mortality;

decrease in morbidity.

growth of injuries;

growth in the birth rate;

239. Select the incidence rate (incident):

number of deaths;

the number of newly and previously diagnosed diseases;

number of newly diagnosed diseases;

number of previously identified patients;

the number of newly diagnosed and dead.

240. Dietary nutrition is:

nutrition of a sick person, based on the pharmacological action of food restore disturbed homeostasis;

nutrition of a healthy person, aimed at the prevention of nutritional, cardiovascular, gastrointestinal, allergic and other
diseases;

Nutrition for workers in particularly harmful working conditions;

nutrition of residents of ecologically disadvantaged areas;

Nutrition based on the non-specific action of food and aimed at preventing the occurrence of noncommunicable diseases.

241. About the identification of what diseases is reported by the registration statistical form No. 090 / y?

about newly diagnosed infectious disease;

about newly diagnosed pulmonary tuberculosis;

on newly diagnosed mental illness;

about newly diagnosed malignant neoplasm.

about newly diagnosed venereal disease;

242. The parametric criteria for assessing the statistical significance of research results include the t-criterion of reliability:

Kruskela - Wallis;

Student's t;

Manna - Whitney;

Kolmogorov - Smirnova;

Wilcoxon.

243. The classification of labor in terms of intensity of the labor process:

4 degrees: light, medium, hard work of the 1st degree, hard work of the 2nd degree.

4 degrees: light, optimal, permissible, unacceptable load;

3 degrees: very light, medium degree, maximum permissible load;

4 degrees: hard, hard work of the 1st degree, hard work of the 2nd degree, load;

244. Occupational health studies:

the impact of the labor process, harmful occupational factors on the body of a working person.

the impact of the nutrition process on the body of working people

The impact of the process of labor stress on the body of working people
245. A small number of observations (small sample). is the number of observations:

less than 50;

less than 30.

less than 100;

less than 200;

246. What instrument is needed to measure atmospheric pressure?

light meter;

thermometer;

catatermometer;

barometer.

247. Ways of intake of sulfur dioxide in the body:

intact skin;

upper respiratory tract;

with milk (tropism);

the gastrointestinal tract;

any of the above.

248. Vaccination against hepatitis B is carried out:

once;

three times according to the scheme of 0.1.6 months.

four times according to the scheme 0,1,2,12 months;

twice according to the scheme of 0.6 months;

249. The collection program includes:

the choice of the object of research;

copying of information;

quality control of registration;

development of an accounting document.

determination of the sample size;

250. The level of confidence coefficient (t) for mean and relative values in most medical and statistical studies should be at
least:

1;

2.

4;

251. The concept of water disinfection:

release of water from toxic impurities;

release of water from pathogenic microbes and viruses.

release of water from radioactive substances;

release of water from suspended solids;

252. To abiotic factors include

parasitism

commensalism

sexual selection

climatic.

artificial

253. The main requirement for the sample:

representativeness;

objectivity;

conjugation;

selectivity;

discreteness.

254. The ratio characterizes:

the change in the phenomenon over time;

the ratio of two independent aggregates;

the distribution of the whole into parts;

the ratio of two dependent populations;

the relationship of the parts of the whole to each other.

255. Organizational measures to combat noise:

 automation and mechanization of production;

damping of equipment (soundproof foundations);

personal protective equipment (antiphons);

change in the process;

noise reduction by means of sound insulation.

256. Health promotion is:

Application of hardening and training methods to enhance individual health

a process that allows people to increase control over their health in order to improve health.

a set of measures aimed at reducing the level of environmental pressure.

a set of measures aimed at achieving an acceptable risk of health problems.

257. Determine which contingent is the risk group for diphtheria:

weakened adults;

unvaccinated children.

over-ill adolescents;

infants;

258. The spectral characteristic of vibration is:

distribution of the level of vibration velocity (vibration acceleration) over frequencies;

combination of vibrations with different frequencies;

combination of vibrations with different intensities;

distribution of the levels of the period of oscillation and amplitude over frequencies.

259. Sanitary norms and rules are ...

acts regulating the system of observation and forecasting of the state of human health depending on the quality of the human
environment;

documents regulating the methods of control of human environment factors.

acts regulating the system of observation, analysis, evaluation and forecasting of the state of people's health;

regulatory legal acts that establish sanitary and epidemiological requirements, the non-observance of which poses a threat to
the life and health of the population;

260. Choose the mode of administration of live polio vaccine:

intravenously;
 intradermally;

intramuscularly;

orally;

subcutaneously.

261. The ratio of the ratio according to the calculation method is close to the ratio:

clarity;

extensive;

intensive;

coordination;

likelihood.

262. Types of control:

initial; final;

preliminary, warning, current.

current;

final;

operational;

263. The main indicator of the degree of fecal contamination of water in reservoirs is:

amount of floating impurities;

percentage of non-canalized houses at the nearest water use point;

smell and taste of water;

amount of pathogenic intestinal microflora;

amount of fecal coliform bacteria.

264. The role of hygienic optimization of the hospital environment:

reduction of economic costs for the construction and operation of the hospital;

organization of effective dispensary monitoring of the state of public health;

the creation of optimal hygienic conditions for the treatment process and the speedy recovery of the patient.

the creation of specialized medical care for the population;

265. One of the options for the “aftereffects” of industrial poisons in chronic occupational poisoning:
 imbalance in metabolic processes;

inhibition of cellular immunity;

violation of detoxification function of the liver;

violation of the genitourinary system;

cumulation.

266. What is not a source of additional financing for health care?

income from commercial activities of healthcare organizations;

medical insurance funds;

funds of the republican budget.

voluntary donations from individuals and legal entities;

medical tourism;

267. Select the leading route of transmission of aerosol infections:

aerosol;

airborne.

transmissible;

food;

268. Type of pneumoconiosis:

actinomycosis;

silicatosis.

aspergillosis;

bronchitis (tracheitis);

269. The toxic effect of industrial poisons on the body depends on:

the degree of ionization of the air of the working area;

chemical structure of the poison;

features of the process;

electrical state of the air of the working area;

radiation background air of the working area.

270. The frequency of vibrational vibrations is:

 is the number of oscillations per unit time;

is the energy of the oscillatory process;

is the number of vibrations per unit area;

is the amplitude of oscillations in an elastic medium;

is a sequence of oscillations per unit time.

271. The prevention department does not include:

anamnestic;

functional and instrumental research methods;

day hospital.

examination room for women;

cabinet for the formation of a healthy lifestyle;

272. Natural passive immunity is developed as a result of:

serum injections;

bacteriocarrier;

administration of gamma globulin;

transplacental transfer of antibodies from mother to fetus;

all options are correct.

273. What are the limits of possible random fluctuations of the average value (M) with a probability of 99.7%:

M ± m;

M ± 2m;

M ± 3m;

M ± 2m;

M ± 3m.

274. The vertical transmission mechanism takes place ...

in hemorrhagic fever with renal syndrome;

with congenital syphilis.

with typhoid fever;

with staphylococci;
275. Prevention is:

a system of measures to prevent disease, maintain health and prolong human life

prevention of the spread of mass noncommunicable diseases.

a set of measures to reduce environmental pollution.

a set of measures aimed at identifying and timely treatment of diseases.

health-improving complex of events.

276. The structure of the phenomenon under study is characterized by the coefficient:

intensive;

extensive;

clarity;

ratios;

coordination.

277. Choose what the final stage of epidemiological diagnostics includes:

organization of meetings and planning of scientific and practical conferences;

planning of anti-epidemic and preventive measures;

planning preventive measures;

planning of preventive and veterinary measures;

drawing up a report on the results of scientific and practical conferences.

278. The essence of a prospective study:

comparison of the health status of the population in groups in the presence and absence of the influence of the studied
environmental factor;

comparing the health status of the population in groups in the presence of different levels of influence of the studied factor;

establishing the level of health literacy of the population;

mathematical modeling and forecasting of public health in relation to the state of the environment;

comparison of health status in groups of patients and healthy people.

279. Which medical instruments are classified as "semi-critical" according to the Spalding classification:

catheters;

bronchoscopes.

implants;
 needles;

280. The main value of atmospheric oxygen:

respiration processes of living organisms.

carbon dioxide diluent;

participation in air exchange processes;

physiological pathogen of the respiratory center;

281. What is called the weather?

averaged long-term condition of meteorological factors of a given area;

a set of average daily meteorological and geomagnetic factors of a given territory at a given time.

the state of the chemical properties of air in a given territory at a given time;

electromagnetic state of the atmosphere characteristic of the area;

282. What method of cost-benefit analysis is used to compare different treatment alternatives in terms of cost and disease
outcome?

cost minimization analysis;

analysis of benefit - value.

cost-benefit analysis;

cost-effectiveness analysis;

cost-utility analysis;

283. Specify the organoleptic norm of drinking water quality:

transparency not less than 30 cm.

transparency of at least 50 cm;

smell more than 2 points;

taste more than 2 points;

284. Situations of Epidemiology Cases: Patient N., 78 years old, a resident of the city of Saratov, sought medical help 9
November due to fever up to 39 ° C, chills. Primary diagnosis "malaria?". It is known from the anamnesis that patient N. did not
travel to the tropics. October 7th to 9th November was on inpatient treatment in one of the hospitals in the city of Saratov, where
repeatedly received blood transfusions. In the patient's blood rings and gametocytes of Pl. Falciparum. Tropical malaria
diagnosis. Question: How did patient N. contract malaria in this case?

Patient N. got infected with endemic area through mosquitoes.

The source of three-day malaria for patient N. was a donor – his a relative of A. who appears to be a carrier of pl.Vivax.
 In this case, patient N. was infected with tropical malaria transfusion of infected blood (parenteral route of transmission)..

The source of tropical malaria for patient N was a nurse from another patient diagnosed with malaria.

The source of tropical malaria for patient N was relatives who had traveled to tropical countries.

285. One of the main signs of vibrational disease (with local exposure):

softening of bones (osteomalacia);

increased fragility of bones (osteoporosis);

deformation of the feet and hands;

increase in vibration sensitivity;

spasm and stasis of capillaries.

286. What degree of probability corresponds to the confidence interval P ± 3m:

68.3%;

95.5%;

95.7%;

99.7%;

99.9%.

287. Indicate the main type of water supply sources:

distilled water;

atmospheric water.

melt water;

mineral water;

288. Physical method of clarifying water:

coagulation;

filtering.

application of UVI;

ozonation;

289. The content of the current sanitary supervision does not include:

implementation of systematic control over functioning facilities;

organization and control over the conduct of preventive medical examinations;

 carrying out systematic sanitary control over the construction of facilities.

control over the observance of sanitary norms and rules during the transportation of food products;

290. Choose how often you need to change the catheter for the sanitation of the endotracheal tube:

once a day;

change as needed;

use a new one every time.

change at the discretion of the doctor;

291. Sanitary and epidemiological well-being is not ensured:

implementation of republican and local programs to strengthen public health and improvement of the human environment;

the definition of a disability group, long-term working in harmful working conditions.

carrying out anti-epidemic and sanitary-hygienic measures;

the application of medical liability for offenses in the field of sanitary and epidemiological welfare of the population;

compliance with sanitary norms and rules:

292. Experimental epidemiological studies include:

case-control study;

cohort study;

randomized controlled clinical trials;

screening study;

retrospective studies.

293. Types of thermoregulation:

chemical and physical.

biochemical and neurohumoral;

ontogenetic and phylogenetic;

systemic and cellular;

294. What is a zooanthroponic disease that can be transmitted through water:

fluorosis;

dysentery;

leptospirosis.
 tuberculosis;

295. Morbidity is considered as an outbreak, epidemic, pandemic on the basis of the following ...

according to the rate of spread of infection;

according to the severity of the disease;

by the number of identified carriers;

by the number of detected cases.

296. Explain how the destruction of unused opened ampoules containing the remnants of live vaccines is carried out:

autoclaving with subsequent disposal;

pouring them with disinfectants, with subsequent disposal;

pouring boiling water with subsequent disposal;

boiling with subsequent disposal;

only disposal.

297. An epidemic focus is:

the location of the source of infection with the territory surrounding it to the extent that it is capable of transmitting the
infectious agent to others in this particular situation with this infection.

the territory in which the process of interaction between the parasite population and the host population is carried out;

territory in which, after the absence of cases of infectious diseases during the maximum incubation period, a new case of an
infectious disease is detected;

area in which cases of an infectious disease are constantly detected;

298. The main measure of sanitary protection of the soil:

architectural and planning;

sanitary-chemical;

sanitary statistics;

application of individual protective measures;

therapeutic and prophylactic.

299. Classification of food poisoning, they are divided:

into three groups: microbial, non-microbial, and unknown etiology;

into three groups: toxicoinfection, toxicosis and poisoning of unknown etiology;

into four groups: animal origin, plant origin, mixed (mixed etiology), and unknown etiology;
 into three groups: permanently toxic products, temporarily toxic products, and an unknown etiology;

into four groups: toxicoinfection, intoxication (toxicosis), mycotoxicosis and unknown etiology.

300. What are the sanitary protection zones of water sources:

research area;

zone of heavy duty.

control zone;

business area;

301. Situations of Epidemiology Cases: In the city of K., which is free from typhoid fever, 6 cases of the disease were registered.
The population of the city of K. is relatively small, the water supply is partially centralized, pumps are used in most parts of the
city. Multi-storey houses are only in the center of the city. The first cases were identified on June 16. In the future, one or two
and less often three patients a day from different families were hospitalized. In the Sh. family, consisting of four people, on
June 16, a girl M. 12 years old and a boy T. 17 years old fell ill. In the family of V., on June 16, the girl T., 6 years old, and on June
18, the girl Yu., 11 years old, fell ill. In R.'s family, a 3-year-old girl G. and a 5-year-old boy S. fell ill on the same day, June 19.
Families live in neighboring one-story houses that lack running water and sewerage. Water is used from the nearest pump,
which is used by residents of five more houses. Families are friendly with each other. On June 1, the birthday of a 6-year-old girl
T. from the family of V was celebrated. In 70% of patients, the disease proceeded in a severe form. Question: What is the route
of infection transmission and your preliminary diagnosis?

Presumably, the epidemic outbreak is due to the airborne route. Epidemic flu outbreak in the city.

Presumably, the epidemic outbreak is due to the food route. Epidemic hepatitis A outbreak in the city.

Presumably, the epidemic outbreak is due to the food route. Epidemic outbreak in the city typhoid fever..

Presumably, the epidemic outbreak is due to the airborne route. Epidemic measles outbreak in the city.

302. Standardized odds are applied solely for the purpose of:

comparisons.

studying the intensity of the phenomena;

assessing the reliability of differences;

determining the limits of possible fluctuations of sample indicators for a given number of observations;

303. The functions of social standards in healthcare are not performed by:

per capita norms of budgetary security of expenditures;

average salary.

standard of provision with primary care physicians;

availability of pharmacies;

availability of beds;
304. The main methodological approach for solving problems in the field of healthcare organization is:

statistical analysis of the health status of the population.

the study of public opinion;

solving personnel issues;

system management approach;

solving financial issues;

305. Noise is:

only disturbing sounds;

intense sound stimuli;

sounds arising in a limited space;

a chaotic pile of sounds of various physical properties that adversely affect the body;

repeatedly reflected sounds.

306. The specific effect of local vibration on the body manifests itself in the form of:

increased sensitivity to high temperature (positive reaction to heat);

increased tactile sensitivity;

paresthesia;

increased sensitivity to light and sound stimuli;

increasing auditory sensitivity.

307. Situations of Epidemiology Cases: On August 1, he was transferred to the surgical department of the hospital in the city of
N. frompsychiatric hospital citizen K. 63 years old with complaints of acute abdominal pain,of being "stab with a dagger".
Objectively: there is no bloating, there is a sharp tension in the muscles of the abdominal wall ("board-shaped abdomen"),
positive Shchetkin-Blumberg symptom. K. was urgently operated on the day of admission.From the surgical department 3 days
after the operation, a patient with a diagnosis "typhoid fever?" transferred to the infectious diseases hospital, where, on the
basis of clinical and bacteriological data was diagnosed with typhoid fever.Sick 10th of June was involved in the distribution of
food in this ward. During bacteriological examination patients of the ward identified N. - typhoid carrier. Upon admission to the
hospital patient K. was twice examined for an intestinal group of infections with a negative result. According to relatives,
intestinal disorders were not observed. Sick was in the department for treatment for a year. Question: Specify the activities
aimed at the source of infection in this outbreak

stop accepting new patients.

check all new patients

check all staff

To do nothing

308. The specific effect of local vibration on the body manifests itself in the form of:
 hypersensitivity to light and sound stimuli;

hypersensitivity to the cold factor (positive cold test);

increased auditory sensitivity;

changes (increase) in tactile sensitivity;

increased sensitivity to high temperature (positive test for heat).

309. Who is subject to compulsory health insurance:

children;

disabled people;

unemployed population;

the entire population.

working population;

310. Average values include:

standard deviation;

the average error of the mean;

arithmetic mean;

amplitude;

limit.

311. The fourth stage of statistical research includes:

analysis of the data obtained;

the formation of combination tables;

graphic images;

control of the collected statistical material;

grouping of statistical material.

312. What is not related to sources of health financing?

funds of the republican and (or) local budgets;

gratuitous (sponsor) assistance of legal entities and (or) individual entrepreneurs;

fines for violations of sanitary norms and rules;

income from paid services of the population;

 income of leasing companies.

313. The epidemiological method is:

statistical method for studying epidemiological patterns;

a specific set of techniques and methods that provide analysis and synthesis of information about the epidemic process;

epidemiological observations and mathematical modeling of the epidemic process;

experimental epidemiological studies ;

mathematical modeling of the epidemic process.

314. What are the sanitary protection zones of water sources:

research area;

zone of restrictions.

control zone;

engineering zone;

315. What are the limits of possible random fluctuations of the average value (M) with a probability of 95.5%:

M ± m;

M ± 2m;

M ± 3m;

M ± 2m;

M ± 3m.

316. General and special coefficients can be:

extensive;

intensive;

coordination;

likelihood;

clarity.

317. Factors contributing to the development of meteotropic reactions:

increase in radiation background;

gradual change in atmospheric pressure;

excess ultraviolet radiation;

 a sharp change in air temperature, humidity, air velocity, atmospheric pressure.

318. Select the most common helminthiasis among children:

ascariasis;

hyminolepidosis;

opisthorchiasis;

enterobiasis;

giardia.

319. Situations of Epidemiology Cases: There are 26 students in the 1st grade of school No. 5 in the city of O. 25 people were
vaccinated against tuberculosis in the maternity hospital, the unvaccinated was issued a refusal to vaccinate. The Mantoux test
was performed annually for all children. In September, before revaccination, a Mantoux test was performed. The results were
evaluated after 72 hours, it was found: - in 17 children the test is negative, 2 days after reading the Mantoux reaction examined,
temperature taken, no contraindications revealed, revaccination with BCG vaccine was carried out: - Mantoux reaction was
positive in 9 children: in this case, the size of the infiltrate in 6 children was 5-6 mm (a positive reaction persists from the
moment of vaccination), one of them suffers from diabetes mellitus, revaccination of children was not carried out, for a
consultation with the phthisiatrician was not sent, the other three: one child has an infiltrate of 12 mm (an increase in infiltrate
by 7 mm compared to last year), the second child has an infiltrate of 17 mm, the same reaction was noted last year, after which
he was sent to the PTD for additional examination, a certificate of passage examination was not provided to the school, a
positive Mantoux test was detected for the first time in an unvaccinated person, an infiltrate of 6 mm (“tuberculin test bend”).
Question: Name the goals of mass tuberculin diagnostics.

Early diagnosis of tuberculosis in children

Identification of persons at risk of developing tuberculosis for follow up observation by a phthisiatrician and, if necessary,
preventive treatment (for the first time infected with MBT with a "turn" of tuberculin tests, with hyperergic and increasing rea

Selection of children for revaccination

Determination of epidemiological indicators on tuberculosis (infection of the population, annual risk of infection)

All of the above goals are correct.

320. Distinguish Leadership Styles:

autocratic, adaptive, democratic.

convincing, democratic;

adaptive, capitalist;

democratic, capitalist;

capitalist, convincing;

321. A healthy lifestyle is

physical education and sports.

list of activities aimed at promoting and maintaining health

 an individual system of behavior aimed at maintaining and promoting health.

health-improving complex of measures.

322. The purpose of hygienic examination of food products is to clarify the properties characterizing:

nutritional value and harmlessness of products for human health;

shelf life of products that ensure their suitability for nutrition;

lack of signs of food spoilage;

compliance with their organoleptic requirements;

Lack of falsification of products.

323. Situations of Epidemiology Cases: In the village of M. in April, as a result of the flood, a partial flooding of the village. A few
days after the flooding of the populated point to the district hospital began to receive patients (12 people) from the flood zone
with complaints of weakness, headache, fever up to 39.4°C, cramping pains in the abdomen. Stool up to 15 times a day, stools
mucus and blood. All patients before the disease consumed raw water from a local well. Was delivered preliminary diagnosis of
acute intestinal infection. Question: What laboratory tests should be carried out to establish the final diagnosis?

it is necessary to conduct a general analysis of blood and feces

it is necessary to conduct a general blood test and gastroscopy

it is necessary to carry out bacteriological culture of feces

stool culture and serological examination with paired sera should be done.

324. Choose the most significant route of transmission in meningococcal Infections:

water;

airborne.

contact household;

dusty;

325. Situations of Epidemiology Cases: In a children's combine in one of the 7 functioning groups, 5 out of 18 children aged 6-7
years who were in them fell ill. The first 4 children fell ill with AII on the same day directly in the children's institution for a
relatively short period of time from 12.00 to 17.00. The diseases proceeded according to the type of food intoxication
(temperature up to 38-40o, vomiting, loose stools up to 5 times with streaks of blood and mucus in some children). All four
patients were diagnosed with gastroenteritis. In the fifth victim, the disease occurred on the same day as in other children, but
not in a children's institution, but only after returning home (from 19.00) and proceeded much easier (single vomiting, single
liquid stool without impurities, normal temperature). Task: How can one explain the occurrence of the fifth disease in a relatively
late period (only after returning home from the kindergarten)?

The occurrence of the fifth disease in a relatively late period (after returning home) is explained that the child has strong
immune system

Maybe the child has another form of food poisoning

This indicates an unknown intestinal disease, otherwise all children would get sick at the same time
 The occurrence of the fifth disease in a relatively late period (after returning home) is explained by the relatively small dose of
the pathogen received by this child (a very small amount of the infected product was consumed).

The occurrence of the fifth disease in a relatively late period (after returning home) is explained that the child ate other food

326. The role of hygienic optimization of the hospital environment:

prevention of the spread of nosocomial infection;

the creation of specialized medical care for the population;

organization of effective dispensary monitoring of the state of public health;

reduction of economic costs for the construction and operation of the hospital;

creating the necessary conditions for student learning.

327. The intensive coefficient is:

growth rate;

provision of the population with doctors;

the proportion of diseases of the circulatory system among all causes of death of the population;

infant mortality;

absolute growth.

328. The essence of cross-sectional epidemiological research:

comparison of the health status of the population in groups in the presence and absence of the influence of the studied factor;

comparison of the health status of the population in groups in the presence of different levels of influence of the studied
factor;

long-term dynamic observation of a certain contingent of people in the observation area;

mathematical modeling and forecasting of public health in connection with the state of the environment;

comparison of health status in groups of patients and healthy people in the observation area.

329. What is an infectious disease of a bacterial nature that can be transmitted through water:

endemic goiter;

tuberculosis;

typhoid fever.

poliomyelitis;

330. Situations of Epidemiology Cases: Patient K., aged 40, was admitted to the clinic of infectious diseases with a preliminary
diagnosed with tick-borne viral encephalitis. Sick for 3 days. The onset of the disease is acute: suddenly increased body
temperature up to 40 ° C, there was an intense headache, accompanied by vomiting, myalgia, paresthesia. Epidemiological
history: a month ago, traveled to a territory endemic in tick-borne encephalitis, and consumed raw goat's milk. Vaccination
history - completed an incomplete course of vaccinations against tick-borne encephalitis. Question: Ways of transmission of
the causative agent of tick-borne encephalitis sick K.

aerogenic

contact

food.

blood contact

331. Choose the family of the causative agent of coronavirus infection:

Adenoviridae;

Coronaviridae.

Paramyxoviridae;

Picornoviridae;

332. Sources of ionizing radiation are divided:

open, closed..

complete, incomplete.

harmful, harmless.

dangerous, harmful.

general, local.

333. Analysis of the annual dynamics of incidence determines:

trend and dynamics of the incidence of the population;

the quality of the anti-epidemic measures taken;

leading factors in the transmission of infectious diseases;

the quality of preventive and anti-epidemic measures taken;

the level of interseasonal morbidity of the population.

334. Which of the following risk factors are genetic?

untimely medical assistance;

water pollution;

drug use;

blood grouping;

Psychogenic.
335. Occupational hygiene - a section of hygiene that studies:

the impact on the body of working conditions and the prevention of occupational diseases;

prevalence of endemic diseases among workers;

prevalence of occupational diseases among workers;

the impact on children of occupational diseases of their parents;

the study of sources and factors of environmental pollution.

336. What to do if there are severe reactions in more than 4% of cases with one series of vaccine?

administer a higher dose of the vaccine;

administer the vaccine at a lower dose;

stop using;

continue vaccinations;

stop not for long.

337. Indices of indoor microclimate:

temperature, relative humidity, air velocity.

temperature and air velocity;

temperature, radiation temperature, air velocity;

absolute humidity and air velocity;

338. Epidemiological examination of foci of infectious diseases is an integral part of:

retrospective analysis;

operational analysis.

prospective observation;

organizational stage of epidemiological research;

339. What is the main function that water performs in a person’s life:

pathophysiological;

physiological.

compensatory;

regulatory;

340. Severe reactions to inactivated vaccines appear after vaccination:

 not earlier than 4-5 days;

no later than 2 days.

from 5 to 12 days;

from 1 to 3 days;

341. Highlight at what stages there is the greatest danger of violation of the temperature regime of storage of vaccine
preparations:

at the workplace of the vaccinator;

at the manufacturer's warehouse;

at the territorial storage warehouse;

when transported in a thermal container;

at the doctor's workplace.

342. Sterilization is understood...

Destruction of spore forms of the pathogen;

Destruction of vegetative forms;

Destruction of pathogenic and vegetative forms of pathogens;

Destruction of pathogenic pathogens in the environment;

Destruction of pathogenic, non-pathogenic and opportunistic pathogens, spore and vegetative forms.

343. The physical development of children and adolescents is:

a set of indicators characterizing the school maturity of the child;

a complex of indicators characterizing the psychological state of the child;

a complex of morphological and functional properties of the body, characterizing the state of health of the child;

the results of functional tests characterizing the state of the central nervous system.

344. What is used to reflect the state of health of the population in official statistics?

case-control studies;

morbidity rate;

survey results;

screening studies;

cohort studies.
345. Which of the following situations can be considered nosocomial infections: 1) typhoid fever was diagnosed by serological
tests on the 10th day of hospitalization in the therapeutic department in a patient with a primary diagnosis of pneumonia; 2)
salmonellosis was diagnosed on the 10th day of hospitalization in a patient with cholecystitis; 3) pneumonia in a patient with
influenza was detected in the hospital on the 2nd day of hospitalization; 4) measles (Filatov's spots) was detected on the 5th
day of hospitalization in a patient with pneumonia.

Case 1

Case 2

Case 2 and 4

Case 1 and 3

All situations can be considered as nosocomial infections.

346. Situations of Epidemiology Cases: Patient K., aged 40, was admitted to the clinic of infectious diseases with a preliminary
diagnosed with tick-borne viral encephalitis. I considered myself sick for 3 days. The onset of the disease is acute: suddenly
increased body temperature up to 40 ° C, there was an intense headache, accompanied by vomiting, myalgia, paresthesia.
Clinical picture: body temperature - 39°C; hyperemia of the skin of the face, neck and mucous membranes, injection of vessels
of the sclera. Meningeal symptoms are noted - neck stiffness, Kernig's and Brudzinsky's symptoms are positive.
Epidemiological data: traveled to a territory endemic for tick-borne encephalitis, and consumed raw goat's milk. Vaccination
history - completed an incomplete course of vaccinations against tick-borne encephalitis. Question: Who is the main carrier of
tick-borne encephalitis virus?

ixodid ticks.

ordinary tick

viral mite

insects

347. By "epidemic morbidity" is meant diseases ...

single diseases;

above the average level of long-term morbidity.

not typical for the area;

characteristic of a given locality;

uncharacteristic for the area;

348. The frequency of the phenomenon in a given environment is characterized by the coefficient:

intensive;

extensive;

clarity;

ratios;

coordination.
349. The purpose of studying the physical development of children and adolescents:

assessment of the professional suitability of the child;

preservation and strengthening of children's health;

assessment of the mental state of the child;

assessment of the regimen of the day of the child;

development of hygiene requirements for child care facilities.

350. What are the quality indicators of drinking water:

organoleptic.

hydrobiological;

physical;

biochemical;

351. A significant difference between the mean and relative values can be recognized at the level of the Student's coefficient (t):

> 1;

> 2;

> 3;

> 4;

> 5.

352. The Goal of Healthcare Management:

reduction of losses to society from morbidity, disability and mortality of the population with the rational use of resources.

an increase in the salary of medical workers;

creation of new methods of diagnosis and treatment;

rational use of finance;

solving the assigned tasks;

353. Sanitary and epidemic well-being is not ensured:

implementation of republican and local programs to promote health, improve the human environment;

determination of the disability group for long-term workers in hazardous conditions.

carrying out sanitary-hygienic and anti-epidemic measures;

the application of medical liability for offenses in the field of sanitary and epidemic welfare of the population;
 compliance with sanitary norms and rules;

354. The main therapeutic and preventive measures to combat noise pathology:

conducting preliminary and periodic medical examinations of workers;

medical examination of patients with occupational hearing loss, with manifestations of "noise disease";

spa treatment and rehabilitation in dispensaries;

rational nutrition;

measures to increase the protective forces (reactivity) of the body of workers.

355. What is called an etiological factor?

additional effect on the body, contributing to the onset of the disease, not being its immediate cause;

additional effects on the body contributing to death, not being its direct cause;

cause of the pathological process in the body;

cause of the functional process;

circumstances and conditions leading to the loss of a person's ability to work or his disability.

356. What is not related to the expenditure side of the budget?

financing of the non-production sphere;

fines and sanctions.

public administration;

subsidies and transfers to the population;

servicing the public debt;

357. The qualitative indicators of the polyclinic activity do not include:

general morbidity in the population;

infectious morbidity;

number of people removed from dispensary registration due to change of place of residence.

initial disability access;

mortality;

358. Point out the wrong methods of implementing regional health policy

the development of the principle of federalism and the implementation of regionalization and decentralization on its basis;

conciliation - contractual procedures ensuring the interests of regional development;

 selective support of depressive regional systems;

directive planning and distribution of resources by the federal center.

federal and regional intervention;

359. Management style:

behavioral;

authoritarian.

psychological;

statistical;

stochastic;

360. The value of atmospheric nitrogen:

participation in photosynthesis;

diluent oxygen in the atmosphere.

dissolution in soil bio-media;

physiological pathogen of the respiratory center;

361. When analyzing the work of the polyclinic, the following indicators are used:

complete coverage of the population by dispensary observation;

volume of medical care at home, percentage of hospitalized dispensary patients, complete coverage of the population by
dispensary observation;

average number of visits to doctors per inhabitant per year, volume of medical care at home, complete coverage of the
population by dispensary observation;

average number of visits to doctors per inhabitant per year, volume of medical care at home, percentage of hospitalized
dispensary patients, complete coverage of the population by dispensary observation.

average number of visits to doctors per inhabitant per year, percentage of hospitalized dispensary patients, complete coverage
of the population by dispensary observation;

362. The methods of hygienic education are:

information-receptive, problem statement method, heuristic;

information-receptive, analytical, problem statement method, heuristic;

information-receptive, statistical, problem statement method;

information-receptive, reproductive, sociological, heuristic;

information-receptive, reproductive, problem presentation method, heuristic.

363. The method of chemical deratization is used ...

in living quarters;

in hospitals;

at food enterprises;

for handling ships, railway wagons, warehouses.

364. Special methods for improving water quality:

fluoridation, defluorination.

chlorination with preammonization;

coagulation followed by filtration;

double chlorination;

365. What is acclimatization?

a complex of physiological changes in the body in connection with a changed climate.

A special case of the body's response to climate change;

a set of physiological changes aimed at maintaining a constant body temperature;

shift in physical and chemical thermoregulation under the influence of the environment;

366. Under the epidemic process is understood ...

the process of occurrence and spread of infectious diseases among the population..

interaction of a pathogen and a susceptible organism, manifested by disease or carriage of the infectious agent;

increased incidence in a limited area;

interaction of populations of parasites and people united by a common territory, domestic, natural and other conditions of
existence;

interaction of a pathogen and a susceptible organism;

367. The simultaneous effect on the body of several industrial poisons (combination) may be accompanied by:

impaired hematopoietic function;

hyperthermic reaction;

the effect of functional cumulation;

the effect of potentiation;

the effect of material cumulation.

368. Determining the degree of epidemiological significance of a group is primarily expressed ...

the value of the intensive indicator;

the value of the extensive indicator;

simultaneously the value of intensive and extensive indicators.

the absolute number of cases;

369. Potentially hazardous factors that increase the likelihood of developing diseases, their progression and adverse outcome
are called:

transmission factors.

etiological factors.

economic factors.

risk factors

370. In the direction of communication, the correlation can be direct and:

reverse.

conjugate;

unpaired;

straightforward;

371. The acute clinical form of acute general action of the heating microclimate:

heat stroke.

infrared cataract;

sunstroke;

ultraviolet erythema;

372. Sulfur dioxide (sulfur dioxide) is:

gray-yellow gas;

gas without color and odor;

colorless gas with a sharp asphyxiating odor;

odorless gray-yellow gas;

yellow gas with a faint odor.

373. Public health is seen as:

 a one-factor problem, which includes goals and objectives for the study of public health and influencing environmental factors;

a multifactorial problem, including goals and objectives for the study of general morbidity, without taking into account the
influence of environmental factors;

a multifactorial problem, including goals and objectives for the study of public health and influencing environmental factors.

assessment of indicators of the natural movement of the population;

assessment of indicators of general mortality and disability;

374. The concentration of alcohol as a disinfectant...

50 %

70%.

96%

40%

95%

375. Hygienic standard for air temperature in a residential building:

16 –18 ° C;

16-24 ° C;

18 - 20 ° C;

20 - 22 ° C.

376. Nutritional and biological value of meat and meat products:

meat of animals and poultry contains all the essential amino acids that favorably balanced;

the ratio of amino acids of tryptophan and oxyproline determines the usefulness of meat protein, while oxyproline
characterizes the content of high-grade proteins, and tryptophan - inferior;

Collagen and elastin proteins have the highest biological and nutritional value, as they are the main sources of extractive
substances;

meat practically does not contain extractive substances;

Goose and duck meat is more lean and dietary than chicken and turkey meat.

377. The organizational and preparatory stage of a statistical study includes everything except:

setting the goal of the study;

setting the research objectives;

determining the scientific and practical significance of the research;

choosing a research topic;

 encryption of the material.

378. The science of the interaction of organisms between themselves and with the environment is

biology;

ecology;

histology;

ornithology;

Botany.

379. With direct correlation:

with increasing factor intensity, the incidence of the population increases.

with an increase in the intensity of the factor, the level of health of the population worsens;

With a decrease in the intensity of the factor, the level of health of the population stabilizes;

With a decrease in the intensity of the factor, the level of public health rises;

380. The property of a disinfectant that ensures the destruction of fungi:

bactericidal;

virulent ;

fungicidal.

bacteriostatic;

381. The most “sensitive” indicator of the effectiveness of clinical examination of patients with chronic diseases is:

decrease in morbidity with temporary disability;

improvement in health status (reduction in the frequency of exacerbations).

decrease in the percentage of hospitalized;

reduction of access to primary disability;

reduction in overall mortality;

382. Outcome model performance indicators do not include:

the prevalence of individual diseases;

the level of quality of treatment;

The average duration of the case of the disease;

provision of the population with doctors.

 the level of quality of medical examination;

383. Sanitary-hygienic and anti-epidemic measures are carried out in order to:

timely provision of medical care to the population;

the distribution of the affected into groups of need for isolation and sanitization;

preservation and strengthening of public health, as well as the prevention of infectious diseases and the elimination of
epidemic foci..

prevention of the emergence and spread of infectious diseases among the population;

ensuring the sanitary well-being of the population and eliminating the unfavorable sanitary consequences of the use of
weapons of mass destruction by the enemy;

384. Risk factors for the disease can be:

climatogeographic, environmental, industrial, psychogenic, genetic;

urbanized, social, environmental;

natural, artificial, mixed;

subjective, objective and mixed;

lifestyle, genetic, environmental and medical.

385. What device is needed to determine the amount of supply air in the room?

katatermometr;

pressure gauge;

anemometer.

psychrometer;

386. Explain the purpose of medical examination of personnel in medical institutions:

identifying people with genetic diseases;

identification of the source of infectious diseases;

increased resistance to infections;

disruption of infectious disease transmission routes;

for prevention.

387. One of the main signs of vibrational disease (with local exposure):

peeling of the skin;

inflammation of the hair follicles;

 hair loss;

osteomalacia and osteoporosis.

388. Humus is:

Earth's hard shell, formed under the influence of climate;

maternal rock of the earth's crust;

fertile soil layer;

loose, surface layer of the earth's crust;

The layer of the earth's crust, on which human activities extend.

389. Situations of Epidemiology Cases: 10 cases of rotavirus infection were registered in the surgical department of the
pediatric hospital. Age of patients from 3 to 5 years, clinical course disease in 3 patients of moderate severity, in the rest of the
lungs. Child K was the first to fall ill. He was admitted to the hospital on January 25, then weeks, the rest of the children fell ill,
one or two cases a day were recorded. All patients after elective surgery. In the department, in addition to the sick, there are 15
more children who are scheduled operations. There are 5-6 patients in the wards. Question: What is the route of transmission of
infection in this situation?

An enterovirus infection.

A contact infection..

An airborne infection.

A transmissible infection.

390. Water purification is:

improvement of organoleptic properties.

elimination of toxic substances;

elimination of excess salts;

elimination of microflora;

391. Features of the internal layout of the maternity hospital:

the presence of 4 ward sections in the departments;

instead of chambers there should be only boxes;

the presence of departments: physiological, observational, pathology of pregnancy;

the dining room is located in the neutral zone of the department;

the presence of a prenatal and postpartum section in the department.

392. What payments do not apply to the payroll of employees of a healthcare organization?
 wages of key personnel;

remuneration of personnel of paraclinical institutions;

remuneration of personnel of auxiliary units;

wages of administrative, economic and managerial personnel;

payment of benefits for temporary disability.

393. Which of the options does not apply to the stages of financial planning for health care?

calculation of financial standards;

determination of the real needs of the population in various types of medical care;

determination of the real needs of health care in financial resources;

comparison of the financial resources actually allocated by the state with the real need for them in health care;

formation of investments.

394. The extension coefficient is:

the average life expectancy;

mortality of the population;

proportion of girls among newborns;

provision of the population with beds;

natural growth.

395. Disease associated with exposure to dust containing bound silicon dioxide:

silicosis;

anthracosis;

siderosis;

talcosis;

aluminos.

396. Name the factor of transmission of hepatitis C virus:

air;

feces;

blood.

vomit;
397. The main characteristics of the organization:

finance;

external environment;

the initial division of labor;

vertical division of labor.

working capital;

398. Which of the following risk factors are environmental?

socially. living conditions;

pollution of air, water, soil.

poor quality of care;

smoking;

malnutrition;

399. The mean error is directly proportional to:

the number of observations;

a change in the attribute;

standard deviation;

the coefficient of variation;

the correlation coefficient.

400. Medical ecology is a science that studies:

the impact of industrial pollution on the functioning of various ecosystem components;

the possibility of creating non-waste technologies;

the impact of industrial production on human health;

The mutual influence of natural ecosystems and industrial production facilities;

environmental impact on human health.

401. Method for identifying the effects of environmental pollution on human health:

method of average values;

proofreading method;

method of multivariate mathematical analysis;

 According to standard tables;

The method of probabilistic statistics.

402. Specify methods of sterilization:

thermal, chemical, cold;

chamber, biological, gas;

chemical, chamber, physical;

cold, mechanical;

chemical, biological.

403. A method for studying the physical development of children and adolescents:

moment observations;

anthropometric;

psycho-hygienic;

hygienic;

is functional.

404. The following types of ionizing radiation are distinguished:

Alpha radiation. Beta radiation.

Neutron radiation.

Gamma and X-rays.

A.C.

A.В.C..

405. Situations of Epidemiology Cases: In the village of M. in April, as a result of the flood, a partial flooding of the village. A few
days after the flooding of the populated point to the district hospital began to receive patients (12 people) from the flood zone
with complaints of weakness, headache, fever up to 39.4°C, cramping pains in the abdomen. Stool up to 15 times a day, stools
mucus and blood. All patients before the disease consumed raw water from a local well. Was delivered preliminary diagnosis of
acute intestinal infection. Question: How can one assess the epidemic situation of acute intestinal infections in a locality?

The epidemiological situation in the settlement can be assessed as an outbreak, possibly water given flooding, which could
lead to deterioration water quality..

The epidemiological situation in the settlement can be assessed as outbreak, possibly due to high contagiousness with ticks.
It is possible that encephalitis ticks contributed to the infection.

The epidemiological situation in the settlement can be assessed as outbreak, possibly due to high contagiousness with
domestic animals.
 The epidemiological situation in the settlement can be assessed as an outbreak, possibly a food one, given the flooding, which
could lead to a deterioration water quality.

406. Biotic factors include

ultraviolet radiation

parasitism

oxygen content in the medium

climatic

Chemical.

407. What guarantees does compulsory health insurance provide?

receiving minimal medical care;

the receipt by all citizens of medical care of a certain volume and level.

free high-tech expensive medical care for citizens;

payment of benefits in case of temporary disability;

payment of benefits;

408. Preventive measures aimed at the first link of the epidemic process include ...

detection of bacteria carriers;

personal hygiene;

drinking good quality water;

health education;

immunoprophylaxis.

409. The individualizing method of studying physical development is:

assessment of the physical development of the child - by the method of sigma deviations;

dynamic observation of the physical development of the child;

assessment of the physical development of the child on the regression scales;

a mass study of the physical development of a group of children;

assessment of the physical development of the children's team.

410. Select the official name of the causative agent of a new coronavirus infection:

2019-nCoV;
 MERS-CoV;

SARS-CoV;

SARS-CoV-2.

411. Situations of Epidemiology Cases: Hepatitis B was diagnosed in a 32-year-old woman who was in a surgical hospital 5
months ago due to a severe injury, where she was repeatedly transfused with blood and blood substitutes. There are 3 more
people in the family: husband is a technician, mother is a pensioner, son, 3 years old, does not attend kindergarten. The patient
and her husband are personnel donors. Task: Make a plan of anti-epidemic measures.

Inspection of medical facilities for compliance with the disinfection and sterilization regime.

Isolation of the patient within the apartment; Room ventilation, UV irradiation, wet cleaning.

Examination of the patient, treatment in the infectious department, examination of medical facilities for compliance with the
disinfection and sterilization regime, examination of contacts, dynamic observation for 6 months..

Emergency notification, isolation in an infectious diseases hospital, identification, serological examination and observation of
contacts. Regime-restrictive measures, emergency prevention. San lumen work.

412. Types of ventilation:

fortochny and artificial;

window and door;

natural and artificial.

aeration and infiltration;

413. When using a bacteriological weapon containing a pathogen of a particularly dangerous infection, the territory is assessed
as:

sustainable;

emergency.

dysfunctional;

prosperous;

414. Noise disease:

identical to the term “occupational hearing loss”;

identical to the concept of “auditory nerve neuritis”;

represents the specific (local) and non-specific (general) effects of noise on the body;

is a manifestation of a specific (local) effect of noise;

is a manifestation of only the nonspecific (general) effect of noise on the body.

415. The doctor of the Health Center provides counseling on rationalizing nutrition and explaining to the patient the following
principles of healthy eating:

qualitative, quantitative characteristics, nutritional balance, diet, safety and digestibility of food.

quality, characteristics, nutritional balance, diet, safety and digestibility of food;

qualitative, quantitative characteristics, nutritional balance, diet, food safety;

qualitative, quantitative characteristics, diet, safety and digestibility of food;

qualitative, quantitative characteristics, nutritional balance, safety and digestibility of food;

416. Hospital hygiene studies:

the influence of environmental factors on medical personnel to optimize the conditions for the treatment of patients and the
creation of favorable working conditions for medical workers.

the influence of factors of the hospital environment on patients and medical personnel to optimize the conditions for the
treatment of patients and the creation of favorable working conditions for medical workers..

the influence of environmental factors on the health of patients and medical personnel for the prevention of exposure to
harmful and dangerous factors.

the influence of factors of the hospital environment on patients to optimize working conditions, recreation and treatment of
patients in hospitals.

the influence of environmental factors on patients to optimize working conditions, recreation and treatment of patients in
hospitals.

417. What is not a revenue part of the country's budget?

taxes and agricultural profits;

taxes from the population;

personal funds of the population.

taxes of non-governmental organizations;

taxes and industry profits;

418. Cardiovascular diseases are the leading cause of morbidity and mortality:

in all WHO member countries;

in poor countries;

in all countries of the world.

in developing countries;

in the countries of the European Region;

419. Definition of the concept of "health" (individual):

high level of compensatory-adaptive mechanisms of the body;

 a certain level of morbidity;

a certain level of pathological affliction of the population;

state of complete physical, mental and social well-being in the absence of disease;

The absence of disease in humans.

420. In which departments (hospitals) are separate isolated rooms (locks) needed:

gastroenterological, pulmonological;

specialized, infectious, obstetric;

ambulance hospital, dermatological department;

ophthalmic, rehabilitation treatment;

intensive care unit, infectious diseases hospital.

421. WHO is:

private, not commercial;

non-governmental;

government.

philanthropic;

commercial;

422. Symptoms of hypervitaminosis D:

calcification of soft tissues and arteries;

headache, dizziness, diplopia;

desquamation of the epithelium, baldness;

vomiting;

Rickets.

423. The staff of the Public Health Department are:

valeologist, paramedic valeologist (instructor);

valeologist, psychologist;

valeologist, sociologist, editor;

valeologist, psychologist, sociologist, editor;

valeologist doctor, paramedic valeologist (instructor), psychologist, sociologist, editor.

424. Types of meteotropic reactions in weather-dependent people:

exacerbation of chronic diseases.

amnesia;

hypertension;

allergic skin rashes;

425. How to manage hospitalized influenza patient care to reduce the spread of the infectious agent?

Isolation of the patient within the apartment

Room ventilation, UV irradiation, wet cleaning

Mask mode

Personal hygiene

All these options are correct.

426. What properties of dust are most important in the development of pneumoconiosis?

dispersion and shape;

dispersion and consistency;

dispersion and electric charge;

dispersion and chemical composition;

dispersion and solubility (in fats or water).

427. The scope of what relationships include the norms and principles of medical ethics and deontology:

doctor-patient relationship, the relationship between the doctor and the patient's relatives, relationships in the medical team,
relationship between medical workers and society.

doctor-patient relationship, relationships in the medical team, relationship between medical workers and society;

the relationship between the doctor and the patient's relatives, relationships in the medical team, relationship between medical
workers and society;

doctor-patient relationship, the relationship between the doctor and the patient's relatives, relationship between medical
workers and society;

doctor-patient relationship, the relationship between the doctor and the patient's relatives, relationships in the medical team;

428. What is Compulsory Health Insurance?

one of the types of social insurance, universal mass.

a system aimed at increasing the wages of medical workers;

the same as accident insurance;

 the same as social insurance;

accident insurance and social insurance;

429. Differences between observational epidemiological studies in relation to experimental ones are that ...

study and control groups may be different in size;

experimental studies are only cohort;

observational studies are only prospective;

experimental studies involve intervention in the natural course of events, the epidemic process in particular;

observational studies are only retrospective.

430. Situations of Epidemiology Cases: A 25-year-old patient was admitted to the clinic of infectious diseases with a
preliminary diagnosed with food poisoning. Clinical data: body temperature - 39.5 ° C, headache, chills, aches in body, nausea,
repeated vomiting, diarrhea. Epidemiological data: the day before the disease, she consumed cakes with cream. Within 2 days,
4 more similar cases were registered in the region. During an epidemiological survey of a cafe where the sick people used
cakes, a panaritium was found on the confectioner's finger. Question: State a hypothesis about the way of transmission of
pathogens of food poisoning in this situation.

aerogenic

contact

food.

blood contact

431. Vibration is:

oscillatory process in any environment;

all kinds of interfering vibrations;

is an oscillatory process carried out in time and space;

oscillatory motion of solid mechanical bodies;

vibrational movements in which the body goes through a position of stable equilibrium.

432. Sections of the epidemiological analysis:

field and retrospective;

transverse and field;

retrospective and operational;

continuous and retrospective;

field and operational.

433. What budget items are not related to current expenses?

wages;

business trips and business trips;

purchase of supplies and consumables;

overhaul.

payment for transport services;

434. Hygienic standard for relative indoor air humidity:

20-28%;

20-40%;

30-90%;

30-60%.

435. Epidemiological diagnostics is:

section of epidemiology, representing a system of methods for studying epidemic phenomena and parameters in order to
prevent diseases;

section of epidemiology, representing a system of methods for studying the epidemic process in order to establish the causes
and conditions for its development;

section of epidemiology, aimed at the system of conducting epidemic research in order to establish the causes and conditions
for the development of diseases;

branch of medicine that studies the epidemiology of infectious diseases in order to carry out anti-epidemic measures;

branch of medicine that studies the epidemiology of noncommunicable diseases.

436. Who approves the estimate of the healthcare institution?

the head of the institution;

the head of the health department.

the chairman of the regional executive committee;

chief accountant of the institution;

the chairman of the regional council of deputies;

437. Data required to determine the mean error (m) of the mean (M):

intensive indicator and total number of observations;

fashion and total number of observations;

median and total number of observations;

 arithmetic mean and total number of observations;

standard deviation and total number of observations.

438. The main pathogenetic sign in acute intoxication with carbon monoxide:

violation of the activity of enzymes (primarily respiratory);

the formation of methemoglobin (hypoxia);

formation of carboxyhemoglobin (hypoxemia).

paralysis of the centers of the medulla oblongata;

439. The simultaneous effect on the body of several industrial poisons (combined effect) may be accompanied by:

hyperthermic reaction;

violation of hematopoietic function;

the effect of material cumulation;

the effect of summation;

the effect of functional cumulation.

440. Identify who is responsible for compliance with infection control requirements and implementation of measures to prevent
nosocomial infection:

doctor of the organizational and methodological department;

deputy chief medical officer;

statistics department specialist;

paramedical worker.

medical assistant;

441. What is the main factor determining the choice of water supply source:

landscape conditions;

chemical composition of atmospheric air;

availability of water source.

ease of transport;

442. What financial plan reflects the estimate?

income;

expenses.
 income and expenses;

there is no correct answer;

receipt of funds to the budget;

443. What is somatoscopy?

study of the functional state;

anthropometric measurements;

psychophysiological studies;

collection of medical history;

physical examination.

444. Choose the duration of post-infectious immunity in viral hepatitis A:

temporary;

long-term;

short-term;

lifetime.

445. Anti-epidemic measures aimed at the second link of the epidemic process include ...

detection of bacteria carriers;

final disinfection.

immunoprophylaxis;

hospitalization of patients;

446. A functional link is a link in which each value of one attribute corresponds to:

several values of another attribute, interconnected with it;

one value of another attribute, interconnected with it;

one meaning of another, unrelated attribute;

several meanings of another, unrelated attribute;

none of the values of another attribute, interconnected with it.

447. Select who is the final owner in echinococcosis:

cattle;

small cattle;
 dog.

human;

448. Situations of Epidemiology Cases: In a children's combine in one of the 7 functioning groups, 5 out of 18 children aged 6-7
years who were in them fell ill. The first 4 children fell ill with AII on the same day directly in the children's institution for a
relatively short period of time from 12.00 to 17.00. The diseases proceeded according to the type of food intoxication
(temperature up to 38-40o, vomiting, loose stools up to 5 times with streaks of blood and mucus in some children). All four
patients were diagnosed with gastroenteritis. In the fifth victim, the disease occurred on the same day as in other children, but
not in a children's institution, but only after returning home (from 19.00) and proceeded much easier (single vomiting, single
liquid stool without impurities, normal temperature). Task: Why did only a small part of the children in the group get sick (5 out
of 18)?

It is obvious that not all children in the group consumed the infected product, but only the sick ones..

There was not enough dose of the toxin in the food to cause poisoning in all the children.

This cannot be determined without further analysis.

It is possible that other children will show symptoms in a few days as the toxin has a slow effect.

449. Recommended for protection against alpha radiation.

organic glass

cardboard, paper.

aluminum

cadmium

lead

450. What family does HIV belong to according to the taxonomic classification of viruses?

adenoviruses;

retroviruses.

rotaviruses;

togoviruses;

451. Leading methods of epidemiological diagnostics are:

prognostic and retrospective epidemiological analysis;

cohort and experimental studies;

retrospective and operational epidemiological analysis;

experimental and empirical analysis;

retrospective epidemiological analysis.

452. The essence of the retrospective study:

a synthesis of all the data obtained, an integrated assessment of the state of health;

distribution of the population by health groups simultaneously in several areas of observation;

establishing the level of health literacy of the population;

mathematical modeling and forecasting of public health in relation to the state of the environment;

comparison of the state of health in groups of sick and healthy people in the areas of observation.

453. Which of the following risk factors belongs to the “lifestyle” group?

physical inactivity;

soil pollution;

ineffective preventive measures;

blood affiliation;

heredity.

454. The standard deviation is calculated to determine:

errors of representativeness;

the degree of variation of the variation series;

the reliability of the difference in average values;

the reliability of the difference in relative values;

the predicted level of the phenomenon.

455. Diseases associated with an unfavorable microclimate:

heat and sunstroke.

urticaria and allergies;

snow blindness;

ultraviolet erythema;

456. Specify the definition of the concept of "infection control" - measures to prevent the occurrence and spread of infectious
diseases in ...

military structures;

preschool institutions;

healthcare organizations..

educational system;
457. Select which parasitosis refers to contact:

ascariasis;

opisthorchiasis;

taeniasis;

enterobiasis.

458. The term "exotic diseases" defines:

infectious and non-infectious human diseases characteristic of the territory;

any infectious diseases characteristic of the area;

any zoonotic infections that are not typical for the area;

infectious human disease that is not typical for the area.

459. Situations of Epidemiology Cases: A 25-year-old patient was admitted to the clinic of infectious diseases with a
preliminary diagnosed with food poisoning. Clinical data: body temperature - 39.5 ° C, headache, chills, aches in body, nausea,
repeated vomiting, diarrhea. Epidemiological data: the day before the disease, she consumed cakes with cream. Within 2 days,
4 more similar cases were registered in the region. During an epidemiological survey of a cafe where the sick people used
cakes, a panaritium was found on the confectioner's finger. Question: What microorganisms could cause food poisoning in this
situation toxic infection?

Considering panaritium in a confectioner, most likely, infection of a confectionery Staphylococcus aureus products.

Considering panaritium in a confectioner, most likely, infection of a confectionery Salmonella products

Considering panaritium in a confectioner, most likely, infection of a confectionery Escherichia coli products

Considering panaritium in a confectioner, most likely, infection of a confectionery Mycobacterium tuberculosis products

Considering panaritium in a confectioner, most likely, infection of a confectionery Clostridium botulinum

460. A condition for calculating average values is the construction:

interval series;

variation series;

time series;

moment series;

group table.

461. Primary medical care for the city population is provided by:

outpatient health care organizations.

hospices;

city hospitals;
 psychiatric hospitals;

hygiene, epidemiology and public health centers;

462. The main goal of primary prevention:

prevention of exacerbation of chronic diseases;

prevention of the occurrence of diseases (effect on the mechanism of development of the disease or on risk factors);

prevention of overload of body systems in violation of the rules of a healthy lifestyle;

environmental health;

Prevention of the progression of an existing disease.

463. The epidemiology of infectious diseases is a science:

about epidemics;

about the mechanism of transmission of the pathogen;

on the causes, conditions and mechanisms of the formation of morbidity in the population;

about the patterns of occurrence, development and termination of the epidemic process, ways of its prevention and
elimination;

about epidemics, pandemics, exotics diseases.

464. Situations of Epidemiology Cases: In a children's combine in one of the 7 functioning groups, 5 out of 18 children aged 6-7
years who were in them fell ill. The first 4 children fell ill with AII on the same day directly in the children's institution for a
relatively short period of time from 12.00 to 17.00. The diseases proceeded according to the type of food intoxication
(temperature up to 38-40o, vomiting, loose stools up to 5 times with streaks of blood and mucus in some children). All four
patients were diagnosed with gastroenteritis. In the fifth victim, the disease occurred on the same day as in other children, but
not in a children's institution, but only after returning home (from 19.00) and proceeded much easier (single vomiting, single
liquid stool without impurities, normal temperature). Task: How did the infection spread in the group?

Since in kindergarten children are in close contact with each other, we can say about contact household transmission of
infection

There is definitely a fecal-oral route of transmission

Given the simultaneous onset of diseases, the same type of clinical picture according to the type of food intoxication , we can
say that there is a food way of infection transmission.

It is difficult to draw epidemiological conclusions because we do not have enough data on the situation

We can suspect the contamination of the water that the children used

465. Nosocomial infections are

digestive system infections that are not present in the patient at the time of admission to the hospital, but develop during his
stay in the hospital.

infections that are present in the patient at the time of admission to the hospital, and develop during their stay in the hospital.
 infections that are present in medical personnel at the time of admission to the hospital, and develop during their stay in the
hospital.

infections that are absent in the patient at the time of admission to the hospital, but develop during his stay in the hospital..

respiratory tract infections that are present in patients at the time of admission to the hospital and develop during their stay in
the hospital.

466. The results of a retrospective epidemiological analysis are the basis for:

determining indicators of infestation;

selection of strategic measures to combat infections;

elimination of epidemic foci that have arisen in the territory;

outbreak investigation and control;

determining incidence rates.

467. Soil is:

Earth's hard shell containing water;

maternal breed of the earth's crust, prevailing in the area;

soil containing organic matter;

the layer of the earth's crust, on which human activity extends;

independent natural-historical body, formed as a result of the influence of soil-forming factors and the total activity of man.

468. Current sanitary supervision provides for:

systematic observation of already existing objects with the purpose of ensuring compliance with approved sanitary and
hygienic norms and rules.

construction supervision;

examination of regulatory and technical documentation for raw materials, products, technological processes;

protection of atmospheric air, water, soil;

accounting for all industrial and domestic sources of pollution;

469. Epidemiology (modern view) is:

science that determines the patterns of occurrence and spread of infectious diseases;

a science that determines the patterns of occurrence and spread of non-communicable diseases in order to develop anti-
epidemic and preventive measures;

a science representing a system of methods for studying epidemic diagnostics in order to establish the causes and conditions
for its development.
470. Comprehensive examination of citizens is carried out:

once in the reporting year.

2 times in the reporting year;

3 times in the reporting year;

quarterly;

monthly;

471. Nutritional and biological value of plant products:

at the expense of plant products creates at least 50% of the daily energy value of food rations;

vegetable proteins provide at least 40% of the daily protein requirement, contain all the essential amino acids in the optimal
proportion;

vegetable fats do not contain polyunsaturated fatty acids and tocopherols;

vegetable fats contain all fat-soluble vitamins;

fiber is the main carbohydrate of plants and creates the main calorie content of plant products.

472. The role of hygienic optimization of the hospital environment:

creation of conditions for the training of medical personnel;

the creation of specialized medical care for the population;

organization of effective dispensary monitoring of the state of public health;

reduction of economic costs for the construction and operation of the hospital;

the creation of the necessary working conditions for medical staff.

473. In a village, it is advisable to locate an obstetric hospital in the zone:

residential (residential).

industrial;

communal warehouse;

suburban;

green;

474. Select the causative agent of whooping cough:

Bordetella pertussis.

Corynebacterium diphtheria;

herpes zoster;
 Mycobacterium tuberculosis;

475. What are the hygiene requirements for drinking water:

water should not contain saprophytic microorganisms;

water should have impeccable organoleptic and physical properties.

water should have a certain temperature;

water must be hard;

476. Situations of Epidemiology Cases: A case of tick-borne encephalitis was registered in a 3-year-old child. She fell ill on
June 5 while on vacation in the countryside. Hospitalized. The parents deny that the child sucked a tick and visited the forest,
but noted her consumption of raw goat's milk, bought from the mistress of the house in which they live. Parents and the second
child of 5 years did not drink milk. The owner has 2 goats grazing in the pasture in the undergrowth. When collecting
epidemiological anamnesis, it was found that on June 3, the father of the child, while fishing on a forest lake, found a stuck tick,
which he removed on his own and threw it away. The patient was asked to conduct a study of blood or a biopsy from the site of
tick bite by PCR. Question: Indicate the most probable way of infection with tick-borne viral encephalitis in a 3-year-old child,
justify the decision.

TBE infection is possible when swimming in the lake.

TBE infection is possible when a tick is bitten, crushed when removed, and as well as the use of raw goat's milk. Since the
parents deny visiting the forest and sucking on the tick, the most likely infection remains through the use of raw goat's milk..

TBE infection is possible when on a walk in the forest and with a tick bite.

TBE infection is possible when got infected from pets while playing.

477. What are the types of groundwater:

interstratal pressure water.

infiltration water;

siphon water;

interstratal mixed water;

478. The effect of small concentrations of pollutants over a long period of time is called:

dangerous action.

chronic effect

harmful effect.

acute effect.

severe action.

479. Biological function of fatty acids:

in saturated macromolecular acids - antisclerotic;

 are not synthesized in the human body and must come with food;

in polyunsaturated fatty acids (linoleic, lenolenic, arachidonic) - anti-sclerotic activity and the ability to change the permeability
of the vascular wall;

in polyunsaturated fatty acids (linoleic, lenolenic, arachidonic);

With an excess of polyunsaturated fatty acids in the diet, the negative effect of fats on liver function is associated.

480. The content of the current sanitary supervision does not include:

systematic monitoring of the functioning objects;

organization and control of preventive medical examinations;

carrying out systematic sanitary control over the construction of facilities.

control over compliance with sanitary norms and rules during the transportation of food products;

control over compliance with sanitary standards and rules during storage and sale of food products;

481. The essence of the antirachitic effect of ultraviolet radiation on the body:

thermal effect due to the amplification of vibrational and rotational movements of molecules;

due to the formation of physiologically active substances (histamine-like, choline, acetylcholine), the sympathetic-adrenal
system, metabolic and trophic processes are activated;

education in the surface layers of the skin of cholecalciferol;

increased formation of melanin in the epidermis;

The effect of radiation on the nucleic compounds of a microbial cell with its subsequent death.

482. What indicator is used to describe the structure of morbidity:

intensive;

visibility;

ratios;

extensive.

483. The main measure of sanitary protection of the soil:

organizational and administrative;

sanitary-chemical;

sanitary statistics;

application of individual protective measures;

therapeutic and prophylactic.

484. One of the symptoms of chronic sulfur dioxide poisoning:

changes in the morphological composition of the blood (often anemia);

changes in the morphological composition of the blood (often leukopenia);

dyspeptic phenomena;

toxic pneumonia;

blistering on the skin (bullous form).

485. Statistical method to exclude the influence of the unequal composition of the compared groups:

correlation;

assessment of the reliability of the differences in indicators;

standardization;

analysis of variance;

regression analysis.

486. Specify the primary risk factor for the development of type I diabetes mellitus:

genetic predisposition.

infection;

little physical activity;

having bad habits;

487. The most reliable result is obtained by the standardization method:

straight.

indirect;

reverse;

Kerridge;

488. To determine the effectiveness of clinical examination, indicators are not used:

Movement from one dispensary group to another;

Morbidity with temporary disability;

Dynamics of fertility.

Relapse rate and sustained remission;

Changing the disability group;

489. Methods of chlorinating water:

double chlorination, rechlorination.

triple chlorination, rezonation;

permanganation with pre-chlorination;

chlorination with preliminary ozonation;

490. Control levels:

strategic, operational, district;

strategic, tactical, operational;

strategic, tactical, district;

tactical, operational, district;

strategic, tactical, operational, district.

491. Healthcare is as decentralized as possible

in the UK;

in Japan;

in Russia;

in Australia;

in the USA.

492. Organizational measures to combat noise:

noise reduction by means of sound insulation;

automation and mechanization of the labor regime;

rationalization of the labor regime;

installation of soundproof foundations.

493. The manifestation of training in mental work:

optimization of excitation processes;

improvement of all indicators of the cardiovascular system;

vision improvement;

improvement of all indicators of the respiratory and neuromuscular systems;

increased attention.
494. Choose what is the transmission factor of intestinal infections:

dirty hands.

distilled water;

infected air;

blood components;

495. The science that studies ecosystems such as population and species, as well as the processes that occur in them, are

endoecology;

demecology;

geoecology;

synecology;

demography.

496. Method for assessing the physical development of the child:

correlation;

is a combined method;

dispersion;

by nomograms.

497. Select when to measure the temperature of the vaccine refrigerator:

at the end of the working day;

at the beginning of the working day;

every time you open the fridge;

in the morning and in the evening;

during the day.

498. A method for studying the physical development of children and adolescents:

moment observations;

physiometric.

psycho-hygienic;

hygienic;

499. Nutritional and biological value of eggs:

 The caloric content of 100 g of whole egg exceeds the calorie content of other products animal origin;

protein and egg fat are in a ratio of 1: 2 - the international standard of balance;

calcium in the egg is in optimal proportion with phosphorus;

the ratio of cholesterol to lecithin neutralizes the atherogenic properties of cholesterol;

The ratio of cholesterol to lecithin gives atherogenic properties to eggs.

500. Regarding transmission of HIV to infant from infected HIV mother, which statement is/are true:

Start zidovudine during labour; 25% chance of vertical transmission; Avoid breast feeding; Cesarean section cause less
transmission

Vaccinate infant with OPV and MMR

501. Gestational diabetes is usually diagnosed at:

I trimester

II trimester and III trimester beginning.

At time of delivery

Perinatal period

502. A 23-year-old woman (gravida 1, para 0), approximately 6 weeks pregnant, comes to your clinic for treatment. A home
pregnancy test was positive 1 ½ weeks ago. She has developed bleeding over the past 2 days. What is the most likely cause of
the bleeding?

Hydatidiform mole

Abruptio placentae

Ectopic pregnancy

Abortion

503. A pregnant lady had no complaints but mild cervical lymphadenophathy in first trimester. She was prescribed spiramycin
but she was non-compliant. Baby was born with hydrocephalous and intracerebral calcification. Which of these is likely cause?:

Toxoplasmosis

CMV

Cryptococcus

Rubella

504. True about cervical incompetence is all except:

1st trimester abortion.

Hegar’s dilator can be passed in non pregnant state

 History of trauma can precede

2nd trimester abortion

505. Cause of oligohydramnios is:

Oesophageal atresia

Duodenal atresia

Renal agenesis

Diabetes

506. Cholestasis of pregnancy is characterized by:

Commonly occur in 1st trimester of pregnancy

Increased maternal mortality

Increased perinatal mortality; Recurrence in subsequent pregnancy; Generalised pruritis

507. Which one of the following is the best drug of choice for treatment of bacterial vaginosis during pregnancy:

Clindamycin

Metronidazole

Erythromycin

Rivamycin

508. Which of the following is not seen in a pregnant lady with hypothyroidism:

Puerperal depression

Neonatal thyrotoxicosis

Mental retardation

Congenital anomalies are seen

509. Which of the following ovarian tumour is most prone to undergo torsion during pregnancy?

Serous cystadenoma

Mucinous cystadenoma

Dermoid cyst

Theca lutein cyst

510. Basanti, a 28 yrs aged female with a history of 6 weeks of amenorrhea presents with pain in abdomen; USG shows fluid in
pouch of Douglas. Aspiration yields dark color blood that fails to clot. Most probable diagnosis is:
 Ruptured ovarian cyst

Ruptured ectopic pregnancy.

Red degeneration of fibroid

Pelvic abscess

511. MTP is not done in:

Case of rape

Baby with congenital disease

Mother at risk

Family is poor.

512. Most deaths involving placenta previa result from:

Infection

Toxemia

Hemorrhage.

Thrombophlebitis

Traumatic rupture of uterus

513. Screening test for gestational diabetes is:

GCT

Fasting blood sugar

HB1AC

Random blood sugar

514. All of the following are used in first trimester MTP except:

Dilatation and evacuation

RU-486

Suction and evacuation

Extra-amniotic ethacridine.

515. Cesarean section is preferred in:

Toxoplasmosis

Herpes
 CMV

Varicella zoster virus

516. Complication of diabetes in pregnancy includes al except:

Macrosomia

Shoulder dystocia

Hyperglycemia in newborn

IUGR

Caudal regression

517. Indication of anti-D immunoglobulin is/are:

Vaginal bleeding

ECV

Mid trimester abortion

After amniocentesis

All a, b, c, d.

518. Amniocentesis is done at weeks:

10-12

14-20

20-25

25-30

519. The most common cause of hyperprolactinemia:

Pituitary tumor

Pituitary trauma

Postovariectomic synddrome

Sheehans syndrome

520. Polyhydramnios is not associated with:

Renal agenesis

Anencephaly

Open spina bifida

 Tracheo esophageal fistula

521. Multiple pregnancies occur most commonly with:

T. Clomiphene

T. Clomiphene and dexamethasone

T. Dexamethasone

Pulsatile GnRH therapy.

522. Important factor for discordant growth between twins is:

Anemia

Twin-twin transfusion.

Compression

All

523. Polyhydramnios is associated with all except:

Diabetes

Open spina bifida

Multiple pregnancy

Renal agenesis

524. Indication of amnioinfusion is:

Oligohydramnios; Suspected renal anomalies; In case of fetal distress

To facilitate labour

525. Bad prognostic markers of choriocarcinoma treatment are:

Liver metastasis. High hCG titre. Chemotherapy started 12 months after pregnancy.

Lung metastasis

Previous H. mole

526. All of the following are used for induction of labor, except:

PG F2 a tablet.

PG E1 tablet

PG E2 gel
 Misoprostol

527. Complication of manual removal of placenta is/are:

Subinvolution

Inversion of uterus

Incomplete removal of placents

All of the above.

528. Which of the following is not normally in urine of a pregnant woman in 3rd trimester:

Glucose

Fructose

Galactose

Lactose

529. Expectant management of placenta previa includes all except:

Anti D

Cervical cerclage.

Blood transfusion

Steroids

530. A 32 weeks pregnant women presents with mild uterine contraction and on examination her vitals are stable and placenta
previa type III is present. Best management is:

Bed rest + Dexamethasone

Bed rest + Nifedipine and Dexamethasone.

Bed rest + Sedation

Immediate caesarean section

531. Antipituitary antibodies will form in:

Premenstrual syndrome

Hyperprolactinemia syndrome

Postovariectomic synddrome

Sheehans syndrome

532. A pregnant female presents with fever. On lab investigation her Hb was decreased (7 mg%), TLC was normal and platelet
count was also decreased. Peripheral smear shows fragmented RBCs. Which is least probable diagnosis?

DIC

TTP

HELLP syndrome

Evans syndrome

533. A 23 years old primigravida comes in labour room for induction of labour. Cervix is closed and 3 cm long. Which of the
following medicine will be given to her for cervical ripening?

Methergin.

Salbutamol.

Prostaglandin E 2.

Methyldopa.

534. In Erythroblastosis fetalis, the first child is spared because:

Immune response in second exposure is fast

Sensitization of Rh-negative mothers by a Rhpositive fetus generally occurs at birth

Small amounts of fetal blood leak into the ma ternal circulation at the time of delivery

Mothers develop significant titers of anti-Rh ag glutinins during the postpartum period.

535. Incidence of preterm delivery in twin pregnancy is:

25%

50%.

75%

100%

536. A 32-year-old G0P0 patient presents complaining of secondary dysmenorrhea that is increasing in severity. The pain is
triggered by deep thrusting with coitus. Which of the following is the most common cause of deep thrust dyspareunia?

Endometriosis

Depression

Vaginismus

Vestibulitis

537. Following antibiotics are safe to treat UTI in pregnancy:

Aminoglycosides
 Penicillin; Cephalosporins

Cotrmoxazole

Ciprofloxacin

538. Condition characterized by hypopituitarism due to necrosis of the pituitary gland is:

Premenstrual syndrome

Hyperprolactinemia syndrome

Postovariectomic synddrome

Sheehans syndrome

539. Diamniotic-dichorionic twin will result if the fertilized egg divides:

within 3 days.

between 4th to 8th day

After 8th day

after 15th day

540. A female presents with leaking and meconum stained liquior at 32 weaks. She is infected with

CMV

Listeria

Toxoplasma

Herpes

541. Heart disease with worst prognosis in Pregnancy is?

Aortic Stenosis

Pulmonary Hypertension

Uncorrected fallot

Marfan’s syndrome with normal aorta.

542. Neurological defect pathogomonic of fetus of diabetic mothers is:

Caudal regression

Closed Neural tube defects

Spina Bifida

All of the above

543. In a case of vesicular mole, all of following are high risk factors for the development of choriocarcinoma except:

Serum hCG levels > 100000 miu/ml

Uterus size larger than 16 week

Features of thyrotoxicosis.

Presence of bilateral theca lutein cysts of ovary

544. Indicator of severe pre-eclampsia:

IUGR; Diastolic BP>110 mm of Hg

Oliguria

Pulmonary Edema

Systolic BP> 160

All a, b, c, d

545. All can be used to lower mother to child HIV spread except:

Elective CS

Omitting ergometrine

ART

Intrapartum nevirapine.

546. All are prognostic indicators of pregnancy induced hypertension, EXCEPT:

Low platelets

Serum Na

Elevated liver enzymesm

Serum uric acid

547. The cause of fetal death in ectopic pregnancy is postulated as:

Vascular accident.

Nutritional adequacy

Endocrine insufficiency

Immune response to mother

548. For an HIV +ve pregnant woman true is:

CS elective will decrease transmission to baby; Start ART & continue throughout pregnancy ART is safe for gestation
 If she hasn’t received prophylaxis, leave her alone for vaginal delivery

Vaginal delivery will decrease risk for baby

549. Surfactant appears in amniotic fluid at the gestational age of:

20 weeks

32 weeks

36 weeks

28 weeks

550. A diabetic female at 40 wks of gestation delivered a baby by elective cesarean section. Soon after birth the baby developed
respiratory distress. The diagnosis is:

Transient tachypnea of the new born.

Congenital diaphragmatic hernia

Tracheo oesophageal fistula

Hyaline membrane disease

551. Causes of Hydramnios are all except:

Anencephaly

Oesophageal atresia

Posterior urethral value

Twins

552. Commonest type of ectopic pregnancy with rupture is:

Isthmic.

Ampulla

Interstitial

Infundibular

553. Oligohydramnios is associated with all, except:

Sacral Agenesis

Polycystic kidney disease

Renal agenesis

Anal Atresia
554. The treatment of choice for hydatiform mole with a uterine size of 28 weeks is:

Suction evacuation.

Intra–amniotic saline followed by oxytocin

Evacuation by misoprostol and mifepristone

Methotrexate administration

555. Savita is 32 weeks pregnant presents in causality and diagnosed as a case of APH. Vitals are unstable with BP 80/60
which of the following is next step in management:

Careful observation

Blood transfusion.

Medical induction of labour

Immediate cesarean section

556. All of the following are known causes of recurrent abortion except:

TORCH infections.

SLE

Rh incompatibility

Syphilis

557. Baby doesn’t need drugs (PGI Dec 09) Transmission of HIV from mother to child is prevented by all the following except:

Oral zidovudine to mother at 3rd trimester along with oral zidovudine to infant for 6 weeks

Vitamin A prophylaxis to mother

Vaginal delivery

Stopping breast feed

558. The placenta is anchored to the myometrium partially or completely without any intervening decidua is called:

Placenta accreta

Placenta increta

Placenta succenturiate

Placenta percreta

559. A pregnant woman developed idiopathic choletatic jaundice. The following condition is not associated:

Intense itching
 SGOT, SGPT less than 60 IU

Serum bilirubin > 5 mg/dl

Markedly increased levels of alkaline phosphatise

560. In which of the following heart disease is maternal mortality during pregnancy found to be the highest?

Coarctation of aorta

Eisenmenger syndrome.

AS

MS

561. All of the following conditions are risk factor for urinary tract infections in pregnancy except:

Diabetes

Hypertension

Sickle cell anemia

Vesicoureteral reflux

562. Indications for caesarean section in pregnancy are all except:

Eisenmenger syndrome.

Aortic stenosis

MR

Aortic regurgitation

563. Defenitive treatment of preeclampsia is:

Anti hypertensive

Anti epileptic

Magnesium sulphate

Delivery of fetus

564. A female has history of 6 weeks amenorrhea, USG shows empty sac, serum β hCG 6500IU/L. What would be next
management:

Medical management.

Repeat hCG after 48 hrs

Repeat hCG after 1week

 Surgical management

565. A case of 35 week pregnancy with hydramnios and marked respiratory distress is best treated by:

Intravenous frusemide

Saline infusion

Amniocentesis

Artificial rupture of membranes

566. Antepartum hemorrhage occurs after how many weeks:

12 weeks

18 weeks

20 weeks

28 weeks.

567. Malaria in pregnancy not causeds

HELLP syndrome

IUGR

IUFD

Preterm

568. Not true about ectopic pregnancy:

Previous ectopic is greatest risk. Increased risk with pelvic infections. Increased risk with IVF. IUCD use increases the risk.

Pregesterone only pills doesn’t increase risk

Testosterone only pills doesn’t increase risk

Ferrum doesn’t increase risk

569. During first trimester of pregnancy risk of fetal malformation in a pregnant woman with insulin dependent diabetes is best
predicted by:

Blood sugar values

Glycosylated haemoglobin levels.

Serum alpha fetoprotein levels

Serum unconjugated estriol levels

570. In which stage of peritonitis the symptoms of the central nervous system predominate:
 Reactive

Toxic

Terminal

Vascular

571. Modern diagnostic aid to diagnose ectopic pregnancy:

hCG

Transvaginal USG.

AFP

Gravindex

572. Ampullary pregnancy usually outcome is:

Tubal abortion

Tubal rupture

Hematosalpinx

Pelvic hematocele

573. Late hyperglycemia in pregnancy is associated with:

Macrosomia

IUGR

Postmaturity

Congenital malformation

574. Prostaglandin used for cervical ripening:

PG E1

PG E2.

PG F2-α

Oral oxytocin

575. During IVF can be compication as:

Premenstrual syndrome

Ovarian hyperstimulation syndrome

Postovariectomic synddrome
 Sheehans syndrome

576. 23 years old primigravida presents to you at fourteen weeks of gestation. She is concerned about normality of fetus. At
what time you will advise her detailed fetal anomaly scan:

14-16 weeks.

18-22 weeks.

22-24 weeks.

24-28 weeks.

577. What is marker of global tissue perfusion disorder in sepsis:

Creatinine

Glucose

Lactate

Bilirubin

578. All are true about gestational diabetes except:

Chances of recurrence in next pregnancy

One third cases become permanent

Congenital malformation is common.

Insulin is treatment of choice

579. The drug of choice for prevention of seizues in a patient with severe preeclampsia is:

Phenytoin

Magnesium sulphate

Diazepam

Nifedipine

580. Signs of heart disease in pregnancy:

Diastolic murmur; Dyspnea on exertion; Nervousness or syncope on exertion.

Systolic murmur

Tachycardia

581. In an uncomplicated twin pregnancy normal delivery should be attempted in the following situation:

First baby – Vertex and second baby transverse lie

 Both babies are breech presentation

First baby transverse lie and second longitudinal lie

First baby transverse lie and second frank breech

582. A pregnant woman presents with red degeneration of fibroid; Management is:

Myomectomy

Conservative

Hysterectomy

Termination of pregnancy

583. Fulminant hepatitis is caused by

Hepatitis A

Hepatitis B

Hepatitis D

Hepatitis E

584. If the process covers from 2 to 5 anatomical areas of the abdominal cavity it is:

Local unlimited peritonitis

Local limited peritonitis

Diffuse peritonitis

Common peritonitis

585. Treatment of choice in placenta accreta:

Manual removal

Hysterotomy

Hysterectomy.

Wait and watch

586. 35-year-old female with choriocarcinoma treatment of choice is:

Dilatation and evacuation

Radiotherapy

Hysterectomy

Chemotherapy.
587. Highest transmission of hepatitis B from mother to fetus occurs if the mother is infected during:

Ist trimester

IInd trimester

IIIrd trimester

At the time of implantation

588. Which one of the following methods for induction of labor should not be used in patients with previous lower segment
cesarean section:

Prostaglandin

Prostaglandin tablet.

Stripping of the membrane

Oxytocin drip

589. Not an indicator for blood transfusion:

Severe anemia at 36 weeks

Moderate anemia at 24-30 weeks.

Blood loss anemia

Refractory anemia

590. Drugs used for treatment of ectopic pregnancy are:

MTX, Actinomycin-D, RU-486, KCI.

HCG

Oxytocin

Progesteron

591. Induction at term is not done in:

Hypertension

DM

Heart disease.

Renal disease

592. Glucosuria during routine investigation of antenatal visit indicates that there is need for:

Gestational diabetes treatment

 Dietary control

Insulin treatment

Glucose tolerance test.

593. Which one of the following is not associated with diabetes in pregnancy?

Sacral agenesis of the fetus

Advanced placental grading.

Baby weight > 3.5 kg

Hydramnios

594. Benign vulvar tumor that originates from apocrine sweat glands of the inner surface of the labia majora is:

Bartholin cyst

Hydradenoma

Lipoma

Papilloma

595. If you find that a 24 –year- old patient with amenorrhea of 18 weeks duration had an elevated serum hCG, and absent fetal
heart & movement and uterine size 28 weeks which of the following would be the most likely diagnosis ?

Normal pregnancy

Hydatiform mole

Twin pregnancy

Missed abortion

596. True statement regarding twin delivery is:

First twin has more chances of asphyxia

Second twin has more chances of developing polycythemia.

Second twin has more chances of developing hyaline membrane disease

Increased mortality in first twin

597. Following are more common in multipara woman than primipara except:

Anemia

Placenta previa

PIH
 None of the above

Pregnancy in Rh negative women

598. Choriocarcinoma commonly metastasize to:

Brain

Lung, Vagina.

Cervix

Ovary

599. Diagnosis of ectopic pregnancy can be made with predicted b-hCG levels of more than:

1000 m IU/mL

1500 m IU/ mL.

2000 m IU/mL

2500 m IU/ mL

600. In placenta previa conservative treatment is not done in case of:

Active labour. Anencephaly. Dead baby.

Severe placenta previa

Premature fetus

601. At what gestational age should be pregnancy with cholestasis of pregnancy be terminated.

39 wks

36 wks

38 wks

40 wks

602. HRT is indicated in:

Premenstrual syndrome

Ovarian hyperstimulation syndrome

Postovariectomic synddrome

Sheehans syndrome

603. Best endometrial reaction in ectopic pregnancy is:

 Arias stella reaction

Secretory phase

Decidual reaction without chorionic villi.

Decidual reaction with chorionic villi

604. The following complications during pregnancy increase the risk of postpartum hemorrhage (PPH) except:

Hypertension.

Macrosomia

Twin pregnancy

Hydramnios

605. Vaginal delivery is allowed in all except:

Monochorionic monoamniotic twins.

First twin cephalic and second breech

Extended breech

Mento anterior

606. At what period does the tuberculosis flare up most commonly in a pregnant patient?

First trimester

Second trimester

Third trimester

Puerperium

607. A 26 years old lady presented with secondary amenorrhea and FSH and LH are found to be high, your diagnosis will be?

Sheehan syndrome

Asherman syndrome

Premature ovarian failure

Imperforated hymen

608. Tocolytic of choice in heart disease is:

Alcohol

Atosiban

MgS04.
 Nifedipine

609. To say twin discordance the differences in the two twins should be:

15% with the larger twin as index

15% with the smaller twin as index

25% with the larger twin as index.

25% with the smaller twin as index

610. The gold standard test for uterine fibroids is:

Ultrasound

Hysteroscopy

Biopsy

Laparoscopy

611. In a nulliparous woman, the treatment of choice in ruptured ectopic pregnancy is:

Salpingectomy and end-to-end anastomosis.

Salpingo-oophorectomy

Wait and watch

Linear salpingostomy

612. For which syndrome is characteristic vegetovascular pathologies (“hot flashes”, arrhythmia, hyperhidrosis, pain in the
region of the heart, tachycardia)?

Premenstrual syndrome

Ovarian hyperstimulation syndrome

Postovariectomic synddrome

Sheehans syndrome

613. Contraindication of induction of labor:

PIH

Bad obstetrical history

Diabetes

Heart disease.

614. Maximum incidences of congenital malformation are seen during pregnancy with:
 Toxoplasmosis

Rubella

Syphilis

CMV

615. Which of the following is seen in the infant of a diabetic mother:

Hyperkalemia

Hypercalcemia

Macrocytic anemia

Polycythemia.

616. True about complete hydatidiform mole is:

Chromosome pattern is XX. Enlarged ovarian cyst occurs. Associated with preeclampsia.

It is of maternal origin

It is common in developed countries

617. Best diagnostic test for cholestasis of pregnancy:

Serum bilirubin

Bile acid

Serum alkaline phosphatase

Serum transaminase

618. A female presents with 8 weeks amenorrhea with pain left lower abdomen. On USG, there was thick endometrium with
mass in lateral adnexa. Most probable diagnosis:

Ectopic pregnancy.

Torsion of dermoid cyst

Tubo-ovarian mass

Hydrosalpinx

619. Most common gestational trophoblastic disease following H. mole is:

Invasive mole.

Choriocarcinoma

Placental site trophoblastic tumor

 Placental nodule

620. Dopamine agonist therapy is indicated in:

Premenstrual syndrome

Hyperprolactinemia syndrome

Postovariectomic synddrome

Sheehans syndrome

621. Which of the following seen in preeclampsia:

Hypertension; Proteinuria

Pedal edema

Convulsions

622. Treatment of Red degeneration of fibroid in pregnancy:

Analgesics

Laparotomy

Termination of pregnancy

Removal at cesarean section

623. “Twin peak” sign is seen in:

Dichorionic-diamniotic twins.

Monochorionic monoamniotic twins

Discordant twins

Conjoined twins

624. True about H. mole:

Complete mole seen in human only

Trophoblastic proliferation.

Hydropic degeneration

Villus pattern absent

625. A pregnant woman with fibroid uterus develops acute painin abdomen with low grade fever and mild leucocytosis at 28
weeks. The most likely diagnosis is:

Preterm labour
 Torsion of fibroid

Red degeneration of fibroid

Infection in fibroid

626. Which of the following is an absolute indication for caesarean section in pregnancy associated with heart disease?

Pulmonary stenosis

Coarctation of aorta.

Eisenmenger syndrome

Ebstein’s anomaly

627. Nonimmune hydrops foetalis is seen in all except:

a-Thalassemia

Parvovirus-19

Rh-incompatibility

Chromosomal anomaly

628. All of the following drugs are effective for cervical ripening during pregnancy except:

Prostaglandin E2

Oxytocin

Progesterone.

Misoprostol

629. In tuboovarian abscess is performed:

Posterior colpotomy

D&C

Laparotomy

Hysterectomy

630. All of the following are acquired factors of ectopic pregnancy, except:

Inflammatory

Tubal hypoplasia

Endometriosis

Surgical
631. Fluid resuscitation in severe sepsis:

30mL/kg crystalloid solution

20ml/kg colloid solution

10mL/kg crystalloid solution

30ml/kg colloid solution

632. What is the treatment of choice of unruptured tubal pergnancy with serum b-hCG titre 2000 IU/mL:

Single dose of methotrexate.

Vairable dose of methotrexate

Expectant management

Laparoscopic salpingostomy

633. A 6 week pregnant lady is diagnosed with sputum positive TB. Best management is:

Wait for 2nd trimester to start ATT

Start category IATT in first trimester

Start category II ATT in first trimester

Start category III ATT in second trimester

634. True statement regarding Heart disease in pregnancy:

Epidural anaesthesia is used.

Cesarean section is preferred

Forceps is contraindicated

Ergometrine given

635. A 9 month old pregnant lady presents with jaundice and distension, pedal edema after delivering normal baby. Her clinical
condition deteriorates with increasing abdominal distension and severe ascites. Her bilirubin is 5 mg/dl, S. alkaline
phosphatase was 450u/L and ALT (345lu). There is tender hepatomegaly 6cm below costal margin and ascetic fluid show
protein less than 2 mg% Diagnosis is:

Acute fatty liver of pregnancy

HELLP syndrome

Acute fulminant, liver failure

Budd chiari syndrome

636. For medical termination of pregnancy, consent should be obtained from?

 The male partner

The male as well as the female partner

The female partner.

Consent is not required

637. Which of the following is not used in postpartum hemorrhage:

PGF2

PGE2.

PGE1

Ergometrine

638. In pregnancy, the most common cause of transient-diabetes insipidus is:

Severe preeclampsia

Hydramnios

Multiple pregnancy

IUGR

Tuberculosis and Asthma in pregnancy

639. In cervical incompetence, cerclage operation done are:

Mc Donald operation, Shirodkar operation.

Abdominal sling operation

Purandare’s operation

Khanna’s sling operation

640. Which is the safest contraceptive method for a woman with sickle-cell anemia?

Intrauterine device

Low dose progesterone pill

Condom or diaphragm.

Low dose oestrogen-progesterone

641. The test used to differentiate between maternal and fetal blood in a gives sample is:

Kleihauer-Betke test

Apt test
 Osmotic fragility test

Bubbling test

642. Termination of pregnancy in placenta previa is indicated in:

Active bleeding. Active labour. Fetal malformation

Unstable lie

Gestational age > 34 weeks with live fetus

643. 26-year-old female suffers from PPH on her second postnatal day. Her APTT and PTT are prolonged while BT, PT and
platelet counts are normal. Likely diagnosis is:

Acquired hemophilia

Lupus anticoagulant

DIC

Inherited congenital hemophilia.

644. Mifepristone is not used in:

Threatened abortion.

Fibroid

Ectopic pregnancy

Molar pregnancy

645. True about complete mole:

Presence of fetal parts and cardiac activity

Normal uterine size (only in 15-20%). Preeclampsia at <24 weeks. Per vaginal bleeding is commonest presentation.

Beta hCG doubling time is 7-10 days

646. If infection localized to uterus in septic abortion it is:

Grade 1

Grade 2

Grade 3

Grade 4

647. According to MTP Act, 2 doctors opinion is required when pregnancy is:

10 weeks
 6 weeks

> 12 weeks.

> 20 weeks

8 weeks

648. 18 years old P 1 presents in outpatient department ten days after delivery with tender hot painful swelling in right breast.
She also complains of fever with rigors. What will be the most likely management:

Antibiotics.

Analgesics.

Incision & drainage.

Conservative management.

649. Zidovudine given for HIV in pregnancy because:

Decreases chance of vertical transmission

Decrease severity of infection

Decrease severity of infection in mother

Cause no benefit

Gynecological disorders in pregnancy

650. The patient complains intensive itching, on vulva it was founded thickened elevated white patches. It is:

Bartholin cyst

Hydradenoma

Lipoma

Leukoplakia

651. Correct statement about establishing the chorionicity in twin pregnancy is:

Same sex rule out dichorionicity.

b. + Twin peak in dichorionicity

Thick membrane is present in monochorionic

Best detected after 16 weeks

652. True statement regarding ectopic pregnancy:

Pregnancy test positive. hCG levels should be >1000 mlU/mL for earliest detection of gestational sac by TVS. Methotrexate is
used.
 hCG levels should be <1000 mlU/mL for earliest detection of gestational sac by TVS

hCG levels should be <2000 mlU/mL for earliest detection of gestational sac by TVS

653. Commonest complication of diabetes, complicating pregnancy is:

VSD.

ASD

Sacral agenesis

Anencephaly

654. In Bishop score, all are included except:

Effacement of cervix

Dilatation of cervix

Station of head

Interspinal diameter.

655. Prophylactic chemotherapy is indicated after evacuation of H. Mole in all except:

Initial level of urine hCG is 40000 IU after 6 weeks of evacuation

Increase in hCG titre 24000 IU after 10 week of evacuation

Metastasis

Nulliparous lady.

656. A 32 years old G3P2 at 28 weeks of gestation presents with severe pain in the right flank radiating to her groin. She also
complaints of rigors and chills. Urine analysis reveals numerous pus cells. The most likely diagnosis is:

Appendicitis.

Pyelonephritis.

Round ligament torsion.

Meckel’s diverticulum.

657. A pregnant diabetic on oral sulphonylureas therapy isshifted to insulin. All of the followings are true regarding this, except:

Oral hypoglycaemics cause PIH

Insulin does not cross placenta

Cross placenta and deplete foetal insulin

During pregnancy insulin requirement increases and cannot be met with sulphonylureas
658. An obese 63-year-old woman presents with a 3-month history of continuous scanty vaginal bleeding. She denies the use of
hormone replacement therapy. Adequate history and physical examination in the office reveal no other abnormalities. A Pap
smear is negative. Which of the following is the next most appropriate step in her management?

Begin estrogen replacement therapy

Sample the endometrium

Perform colposcopic evaluation of the cervix

Obtain random biopsies of the cervix

659. Most common cause of intrauterine infection:

Rubella

Toxoplasma

Hepatitis

Cytomegalovirus

660. Which female genital malignancy is most common in pregnancy ?

Ovarina cancer

Vaginal vulvar cancer

Endometrial cancer

Cervical cancer

661. 20 years old primigravida comes in emergency at 32 weeks of gestation. She is complaining of blurring of vision, gross
edema. On examination her B.P is 170/115 mm Hg. What is the most likely diagnosis?

Hypertension.

Renal disease.

Eclampsia.

Preeclampsia.

662. The drug used for medical management of ectopic pregnancy is:

Methotrexate.

Misoprostol

Mifepristone

Methyl ergometrine

663. A 25-year-old female was diagnosed to have choriocarcinoma, management is:

 Chemotherapy.

Radiotherapy

Hysterectomy

Hysterectomy and then radiotherapy

664. In the evaluation of a 26-year-old patient with 4 months of secondary amenorrhea, you order serum prolactin and β-hCG
assays. The β-hCG test is positive, and the prolactin level is 100 ng/mL (normal is < 25 ng/mL in nonpregnant women in this
assay). This patient requires which of the following?

Routine obstetric care

Computed tomography (CT) scan of her sella turcica to rule out pituitary adenoma

Repeat measurements of serum prolactin to ensure that values do not increase more than 300 ng/mL

Bromocriptine to suppress prolactin

665. Karyotype of complete mole is:

46 XX.

46 XXY

69XXX

69 XY

666. Which of the following is not associated with diabetes in pregnancy?

Sacral agenesis of the foetus

Advanced placental grading

Baby weight > 3.5 kg

Hydramnios

667. A 27-year-old woman presents to your office complaining of mood swings, depression, irritability, and breast pain each
month in the week prior to her menstrual period. She often calls in sick at work because she cannot function when she has the
symptoms. Which of the following medications is the best option for treating the patient’s problem?

Progesterone

A short-acting benzodiazepine

Selective serotonin reuptake inhibitors (SSRIs)

A nonsteroidal anti-inflammatory drug (NSAID)

668. The risk factors for placental abruption include the following except:

History of placental abruption in previous previous pregnancy

 Hypertension

Diabetes mellitus.

Preterm rupture of membranes

669. Abruption of placenta occurs in all except:

Smokers

Folic acid deficiency

Alcoholics.

PIH

670. What is most common site of ectopic pregnancy:

Ovarian

Tubal

Abdominal

Cervical

671. Congenital infection in which fetus has minimal teratogenic risk is:

HIV

Rubella

Varicella

CMV

672. Rh-isoimmunization in pregnancy can cause all except:

Antepartum hemorrhage

Postpartum hemorrhage

Pregnancy induced hypertension

Oligohydramnios

673. In modern era, the only indication for internal podalic version is:

Delivery of second baby of twins.

Oblique lie

Transverse lie

Breech presentation
674. Ovarian cyst in postpartum patient, treatment is:

Immediate removal

Removal after 2weeks

Removal after 6 weeks

Removal after 3 months

675. 14 weeks pregnant woman had abor0on and she was told that it is a complete abortion. This is true regarding complete
abortion:

Uterus is usually bigger than date

Cervical OS is opened with tissue inside the cervix

Need to have evacuation of the uterus

After complete abortion there is minimal or no pain and minimal or no bleeding

676. Commonest site of metastasis of choriocarcinoma is:

Liver

Lung.

Brain

Cervical lymph nodes

677. All are seen in non immune hydrops foetalis except:

Pericardial effusion

Large placenta

Skin edema

Ascites

678. Since the workup of an elevated PRL level can be expensive, it is recommended that PRL levels are drawn when the lowest
values are to be expected. Which of the following is true about PRL levels?

Decrease after exercise

Decrease shortly after sleep

Decrease after a breast examination

Increase during stress

679. Spontaneous abortion in 1st trimester is caused by:

Trisomy 21, Monosomy.

 Rh-incompatibility

Trauma

680. A 30-year-old woman para 6 delivers vaginally following normal labour with spontaneous delivery of an intact placenta.
Excessive bleeding continues, despite manual exploration, bimanual massage, intravenous oxytocin and administration of 0.2
mg methergin IV, which one of the following would be the next step in the management of this patient:

Packing the uterus

Immediate hysterectomy

Bilateral internal iliac ligation

Injection of PGF 2α.

681. Most common site of ectopic pregnancy is ampulla because:

Fertilisation takes place here.

It is the widest part

Chloroquine

It has less propulsive activity

682. Parameters assessed prior to induction of labor are all except:

Fetal gestation age

Fetal weight estimation

Fetal part palpable.

Ensure fetal presentation and lie

683. Indications for posterior colpotomy:

Pelvic abscess

Retained products

Injury to uterus

Suspected injury to gut

684. All of the following may be used in pregnancy associated hypertension except:

Nifedipine

Captopril

Methyldopa

Hydralazine
685. Glucose tolerance test is indicated in pregnancy because of:

Big baby; Previous GDM; H/O diabetes in maternal uncle

Eclampsia

anemia

pielonefritis

686. A women at 8 months of pregnancy complains of abdominal pain and slight vaginal bleed. On examination the uterine size
is above the expected date with absent fetal heart sounds. The diagnosis:

Hydramnios

Concealed hemorrhage.

Active labour

Uterine rupture

687. You see five postmenopausal patients in the clinic. Each patient hasone of the conditions listed, and each patient wishes to
begin hormone replacement therapy today. Which one of the following patients would you start on therapy at the time of this
visit?

Mild essential hypertension

Liver disease with abnormal liver function tests

Malignant melanoma

Undiagnosed genital tract bleeding

688. In pregnancy amount of glucose used on GTT:

50 gm

75 gm

100 gm.

125 gm

689. A para II poorly compensated cardiac patient has delivered 2 days back. You will advice her to:

Undergo sterilization (tubectomy) after 1 week

Undergo sterilization after 6 weeks

Suggest her husband to undergo vasectomy.

Take oral contraceptive pills after 6 months

690. All are the causes of antepartum hemorrhage (APH) except:

 Placenta previa

Abruptio placenta

Circumvallate placenta

Battledore placenta.

691. Internationally accepted definition of abortion is the expulsion of the products of conception:

Before 28th week of gestation or 1 kg weight of fetus

Before 24th week of gestation or 750 gms weight of fetus

Before 20 weeks of gestation or 750 gms weight of fetus

Before 20th week of gestation or 500 gms weight of fetus.

None of the above statements is correct

692. If patient complains for fishy odor and vaginal discharge. What is possible diagnosis?

Gonorrhea

Chlamidiosis

Bacterial vaginosis

Trichomoniasis

693. Abdominal ectopic pregnancy treatment is:

Laparotomy

Salpingectomy

Salpingotomy

Methotrexate

694. Which of the following conditions is associated with polyhydramnios?:

Posterior urethral valve

Cleft palate

Congenital diaphragmatic hernia

Bladder exostrophy

695. Drug of first choice for treatment of hyperthyroidism during pregnancy is:

Propranolol

Carbimazole
 Methimazole

Propylthiouracil

696. A female of 36 weeks gestation presents with hypertension, blurring of vision and headache. Her blood pressure reading
was 180/120 mm Hg and 174/110 mm Hg after 20 minutes. How will you manage the patient?

Admit the patient and observe

Admit the patient, start antihypertensives and continue pregnancy till term.

Admit the patient, start antihypertensives, MgSO4 and terminate the pregnancy

Admit oral antihypertensives and follow up in outpatient department.

697. Intrahepatic cholestasis treatment in pregnancy is:

Cholestyramine

Ursodiol

Steroids

Antihistamines

698. Maximum strain of parturient heart occurs during:

At term

Immediate postpartum.

Ist trimester

IInd trimester

699. A patient presents with amenorrhea and galactorrhea. Her PRL levels are elevated. She is not and has never been
pregnant. In addition to evaluating her for a prolactinoma, one also needs to evaluate for other causes that would increase PRL
such as elevated level of which of the following?

Corticotropin-releasing hormone (CRH)

Dopamine

Gamma-aminobutyric acid (GABA)

Thyrotropin-releasing hormone (TRH)

700. Following renal disorder is associated with worst pregnancy outcome:

Systemic lupus erythrmatosus

IgA nephropathy

Autosomal dominant polycystic kidney disease

 Scleroderma

701. Benign invasion of endometrium into the myometrium is :

Endometrioma

Adenomyosis

Appoplexy

Chocolate cyst

702. Most common cause of maternal anaemia in pregnancy:

Acute blood loss

Iron deficiency state.

GI blood loss

Hemolytic anaemia

Thalassemia

703. A 21-year-old woman has amenorrhea, mild vaginal spotting, pelvic pain, and left shoulder pain. Her vital signs are blood
pressure, 90/50 mm Hg; pulse, 110 bpm; and temperature, 98.6°F. Abdominal examination shows left lower quadrant
tenderness with rebound. Pelvic examination demonstrates a painful 4-cm left adnexal mass. A serum pregnancy test is
positive. A hematocrit is 22% (normal, 35% to 45%). Which of the following is the best next step?

Observation

Progesterone therapy

Methotrexate therapy

Surgery

704. False about partial mole

Caused by triploidy

Can be diagnosed very early by USG

Can present as missed abortion

Rarely causes persistent GTD.

705. Which of the following predisposes to placenta previa?

Primigravida

Singleton pregnancy

Diabetes mellitus
 Past caesarean pregnancy.

706. Which of the following drug is not used for medical management of ectopic pregnancy:

Potassium Chloride

Methotrexate

Actinomycin D

Misoprostol.

707. True about H mole:

Always associated with raised uterine size for gestational age

Raised hCG. Hysterectomy in selected cases. Thyrotoxicosis rare.

Chemotherapy is the treatment of choice

708. In which of the following heart diseases maternal mortality is found to be highest?

Eisenmenger’s complex.

Coarctation of aorta

Mitral stenosis

Aortic stenosis

709. Antiprogesterone compound RU-486 is effective for inducing abortion if the duration of pregnancy is:

63 days.

72 days

88 days

120 days

710. A patient has secondary dysmenorrheal and a fixed pelvis. At laparoscopy, lesions are biopsied that are thought to
represent endometriosis. The diagnosis of endometriosis is confirmed histologically by identifying extragenital implants
containing which of the following?

Endometrial glands and stroma

Hypertrophic smooth muscle

Hemorrhage and iron pigment deposits

Fibrosis

711. In extraamniotic 2nd trimester medicolegal termination of pregnancy, which of the following are ethacridine used:
 Ethacridine lactate.

Prostaglandin

Hypertonic saline

Glucose

712. Treatment of choice of 28 weeks size H mole in 40 years parous woman is:

Vacuum extraction

Hysterectomy.

Hysterotomy

Vaginal delivery

713. A 33-year-old woman who underwent normal puberty describes an 18-month history of secondary amenorrhea and hot
flashes. A pregnancy test was negative. A progesterone withdrawal challenge test revealed no bleeding. Her FSH was 94
mlU/mL, and her LH level was 68 mlU/mL. She desires to be pregnant with her current partner. Which of the following is the
most appropriate next step in the management of this individual?

Karyotype

Measurement of serum prolactin

Gonadotropin stimulation therapy

Estrogen replacement therapy

714. Elements of the Bishop score used for assessment of inducibility include the following except:

Station

Fetal movements.

Cervical dilatation

Cervical position

715. Oligohydramnios is/are associated with:

Neural tube defect

Renal agenesis

Postmature birth

Premature birth

716. Which is not transmitted to the baby at delivery:

Toxoplasmosis
 Gonococcus

Herpes simplex type II

Hepatitis-B

717. A lady with 37 weeks pregnancy, presented with bleeding per vagina. Investigation shows severe degree of placenta previa.
The treatment is: (AI 01)

Immediate CS.

Blood transfusion

Conservative

Medical induction of labour

718. Mifepristone is used in:

Early medical abortion.

Sarcoma botryoides

Molar pregnancy

Habitual abortion

719. Medical treatment of ectopic pregnancy should be offered to those patients whose hCG level is less than:

10,000 IU and the size of the mass is less than < 4 cms.

5,000 IU and the size of the mass is less than 5 cm

7,500 IU and the size of the mass is less than 3 cm

2,000 IU and the size of the mass is less than 3 cm

720. In a case of recurrent spontaneous abortion, following investigation is unwanted:

Hysteroscopy

Testing antiphospholipid antibodies

Testing for TORCH infections.

Thyroid function tests

721. RU-486 is used in all of the following, except:

Postcoital contraception

Cervical ripening

Induction of labor.
 MTP

722. Placenta previa is characterized by all except:

Painless bleeding

Causeless bleeding

Recurrent bleeding

Presents after first trimester.

723. Most useful investigation in the first trimester to identify risk of fetal malformation in a fetus of a diabetic mother is:

Glycosylated Hb.

Ultrasound

MSAFP

Amniocentesis

724. All of the following are indications for termination of pregnancy in APH patient except:

37 weeks

IUD

Transverse lie.

Continuous bleeding

725. Prognosis of gestational trophoblastic disease depends on all except:

Number of living children.

Blood group

Parity

Previous hCG titre

726. Theca luteal cysts are found in association with raised:

HCG levels

AFP levels

Estradiol levels

Progesterone levels

727. A woman presents with amenorrhea of 2 months duration; lower abdominal pain, facial pallor, fainting and shock.
Diagnosis is:
 Ruptured ovarian cyst

Ruptured ectopic pregnancy.

Threatened abortion

Septic abortion

728. About ectopic pregnancy true statements are:

Rising titre of HCG. Common after tubal surgery. Seen in patients taking GnRH therapy.

Negative pregnancy test excludes the diagnosis

Common in patients taking OCP

729. Commonest site of ectopic pregnancy is:

Uterus

Cervix

Abdomen

Tubes.

730. For antenatal fetal monitoring in a diabetic pregnancy all of the following are useful except:

Non-stress test

Biophysical profile

Doppler flow study.

Fetal kick count

731. Treatment of endometrial hyperplasia with atypia in postmenopausal women:

Surgery

LNG-IUS

Total hysterectomy with BSO

Observation alone

732. A 45-year-old woman is found to have a 4-cm adnexal mass, ascites, and bilateral pleural effusions. Which of the
aforementioned options is the most likely diagnosis?

Leiomyomata

Endometrioma

Corpus luteum cyst

 Fibroma

733. Gestational trophoblastic disease with jaundice, best drug is:

Methotrexate

Adriamycin

Actinomycin-D.

Cyclophosphamide

734. True about tubal pregnancy:

Prior h/o tubal surgery

Prior tubal pregnancy. Prior h/o PID/Chlamydia infection. IUCD predisposes.

OCP predisposes

735. The kleihauer test for detecting fetal erythrocytes is based on the fact that:

Adult erythrocytes are larger than those of foetus

hbA has higher O2 affinity than hbF

hbF is more resistant to acid elution

hbA takes erythromycin stain less than hbF

736. Which one of the following is not an operation for uterine inversion:

O sullivan

Haultain

spincelli

Fentoni.

737. Most common type of twin pregnancy is:

Vertex + transverse

Both vertex.

Vertex + breech

Both breech

738. Which drug is given to prevent HIV transmission from mother to child:

Nevirapine
 Lamivudine

Stavudine

Abacavir

739. All of the following drugs have been used for medical abortion except:

Mifepristone

Misoprostol

Methotrexate

Atosiban.

740. In PIH an impending sign of eclampsia is:

Visual disturbance; Severe proteinuria

Wt. gain of 2 lb per week

Pedal edema

741. Twin peak sign seen in:

Monochorionic diamniotic

Dichorionic monoamniotic

Conjoined twins

Diamniotic dichorionic.

None of the above

742. Hypothyroidism in pregnancy is least likely associated with:

Recurrent abortions

Polyhydramnios

PIH

Preterm labour

743. Supine hypotension is characteristic of:

First trimester of pregnancy

2nd trimester of pregnancy

3rd trimester of pregnancy

Twin pregnancy
744. A primigravida at 37 week of gestation reported to labour room with central placenta previa with heavy bleeding per
vaginum. The fetal heart rate was normal at the time of examination. The best management option for her is:

Expectant management

Cesarean section.

Induction and vaginal delivery

Induction and forceps delivery

745. In non immune hydrops which of the following is NOT seen:

Skin oedema

Ascites

Large placenta

Cardiomegaly

746. Commonest cause of postpartum hemorrhage in multipara is:

Fibroid

Retained placenta

Uterine atony.

Uterine perforation

747. All are true about placenta previa except:

Bright red blood loss

Painless vaginal bleeding

Increased uterine tone.

Malpresentations frequent

748. A 37 years multipara construction labourer has a blood picture showing hypochromic anisocytosis. This is most likely
indicative of:

Iron deficiency

Folic acid deficiency

Malnutrition

Combined iron and folic acid deficiency.

749. During pregnancy HIV transmission occurs mostly during:

Ist trimester
 2nd trimester

3rd trimester

During labour

750. Common cause of “Sepsis syndrome” in obstetrics includes

Antepartum pyelonephritis

Puerperal infection

Chorioamnionitis

All of the above

751. First line of treatment of endometrial hyperplasia without atypia:

Surgery

LNG-IUS

Total hysterectomy

Observation alone

752. Suganti Devi is 30 weeks pregnant with idiopathic cholestasis, is likely to present with following features except:

Serum bilirubin of 2 mg/dl

Serum alkaline phosphatase of 30 KAV

SGPT of 200 units

Prolongation of prothrombin time

753. True statement regarding cholestasis in pregnancy:

Recurrs in subsequent pregnancy; Mild jaundice occurs in majority of patients

Ursodeoxyholic acid relieves pruritus

Pruritus may precedes laboratory findings

Serum alkaline phosphatase is most sensitive indicator

754. A 33-year-old patient has been diagnosed as having adenomyosis. Which of the following symptoms is most consistent
with this diagnosis?

Dyspareunia

Mood swings

Painful defecation
 Secondary dysmenorrhea

755. The current imaging technique of choice for the diagnosis of hydatidiform mole is:

Computed tomography

Ultrasonography

Plain X-ray abdomen

Magnetic resonance imaging

756. pH of amniotic fluid at later weeks of gestation:

4.5

6.5

7.2

757. In superfecundation which of the following is seen:

Fertilization of 2 ova released at same time, by sperms released at intercourse on 2 different occasions.

Fertilization of 2 ova released at same time by sperms released at single intercourse

Both

None

758. All are true about gestational trophoblastic disease except:

Complete mole genome is triploidy.

Choriocarcinoma rarely follows full term pregnancy

Suction and curettage remove most of hydatidiform mole

Snow storm appearance on USG

759. The best way to diagnose the degree of placenta previa is:

Transvaginal sonography.

Double set-up examination

Observation during C.S

Examination of placenta after delivery

760. Hydatidiform mole is characterized histologically by:

 Hyaline membrane degeneration

Hydropic degeneration of the villous stroma.

Non proliferation of cytotrophoblast

Non proliferation of syncytiotrophoblast

761. The screening test for gestational diabetes mellitus that has highest sensitivity is:

Glycosylated Hb

Blood fructosamine

50gms glucose challenge test.

Random blood sugar

762. A primipara presents one week after delivery. She is tearful, has spells of cry and lack of appetite and sleep. What is the
most likely diagnosis?

Anaemia.

Post-natal depression.

Schizophrenia.

Maniac disorders.

763. Causes of hydramnios:

Anencephaly; Oesophageal atresia; Twins

Posterior urethral valve

Renal agenesis

764. A woman in early pregnancy is worried because of some recent discomfort in her left breast. On examination, her skin
appears normal, she has no axillary or clavicular adenopathy, but you palpate a smooth, nontender, 2-cm mass. Your immediate
management should be which of the following?

Breast ultrasound

Needle aspiration of the mass

Excisional biopsies of the mass

Mammography

765. All are prophylactic for atonic PPH except:

125 microgram carboprost IM at delivery of anterior.

Methergine IV at a delivery of anterior shoulder

 controlled cord traction at delivery of anterior shoulder

10 units Oxytocin within mins after delivery

766. In a pregnant woman with heart disease, all of the following are to be done except:

IV methergin after delivery.

Prophylactic antibiotic

IV frusemide postpartum

Cut short 2nd stage of labour

767. A 28 years old female with a history of 8 weeks amenorrhea complains of vaginal bleeding and lower abdominal pain. On
USG examination there is gestational sac with absent fetal parts. The diagnosis is:

Ectopic pregnancy

Incarcerated abortion.

Threatened abortion

Corpus luteum cyst

768. Which of the following antihypertensives is not safe in pregnancy:

Clonidine

ACE inhibitors/Enalapril

a-Methyldopa

Amlodipine

769. Tablets supplied by government of india contain:

60 mg elemental iron +500 mcg of folic acid

200 mg elemental iron +1 mg of folic acid

100 mg elemental iron +500 mcg of folic acid.

100 mg elemental iron +5 mg of folic acid

770. True about indications for prevention of Rh isoimmunization:

Given to the newborn within 72 hrs of birth; Required when baby is Rh+ and mother Rh; Can be given upto one month of age of
baby

Can be helpful in ABO incompatibility

771. While evaluating a 30-year-old woman for infertility, you diagnosed a bicornuate uterus. You explain that additional testing
is necessary because of the woman's increased risk of congenital anomalies in which system?
 Skeletal.

Hematopoietic.

Urinary.

Central nervous.

772. Conservative management is contraindicated in a case of placenta previa under the following situations, except:

Evidence of fetal distress

Fetal malformations

Mother in a hemodynamically stable condition.

Women in labour

773. A 23 year old lady pregnant in 1st trimester came complaining of lower abdominal pain, in examination a mass continued
with the uterus was found. What is the diagnosis:

Red degeneration of fibroid

Ectopic pregnancy

Uterine rupture

Rupture placenta

774. A young woman with six weeks amenorrhea presents with mass in abdomen. USG shows empty uterus. Diagnosis is:

Ovarian cyst

Ectopic pregnancy.

Complete abortion

None of the above

775. A 35-year-old accountant complains of episodic bloating, breast tenderness, dyspareunia, irritability, and depression,
which leave her with “only 1 good week a month.” She is currently using condoms and foam for birth control because she “felt
terrible” on OCs. Pelvic examination is normal. What is diagnosis:

Climacteric syndrome

Premenstrual syndrome

Sheehans syndrome

Ashermans syndrome

776. Commonest site of ectopic pregnancy is:

Isthmic
 Ampulla.

Intestitial

Infundibular

777. A 47-year-old woman complains of postcoital bleeding, nearly as heavy as menses. Which of the following is the most
likely origin of her bleeding?

Cervical polyps

Cervical ectropion

Cervical carcinoma

Cervical nabothian cysts

778. Pregnant women in 1st trimester is given spiramycin that she does not stick to. Baby born with hydrocephalus infection
was by:

HSV

Treponema pallidum

Toxoplasma

CMV

779. Which is the Drug of Choice for Severe Preeclampsia?

Labetalol

Metaprolol

A-methyldopa

Nifidipine

780. Which steps in D&C is correct:

Uterine sounding,curretage,dilation,anesthesia

Anesthesia, uterine sounding,dilation,curretage

Curretage,dilation,anesthesia,uterine sounding

Dilation,anesthesia,uterine sounding

781. Causes of 1st trimester abortion are all except:

Rubella

Syphilis

Defective germplasm
 Trauma

None.

782. All are true about pre eclampsia except:

Cerebral hemorrhage

Pulmonary edema

ARF

DVT

783. Secondary prevention of septic abortion is:

Access to effective and acceptable contraception

Access to safe, legal abortion

Appropriate medical management of abortion

Prompt diagnosis and effective treatment of endometritis

784. Massive ovarian enlargement with multiple cysts, hemoconcentration, and the third-space accumulation of fluid is
characteristic for:

Premenstrual syndrome

Ovarian hyperstimulation syndrome

Postovariectomic synddrome

Sheehans syndrome

785. Drugs Supplied by NACO For Prevention of Mother to Child transmission

Nevirapine

Zidovudine

Nevirapine + Zidovudine

Nevirapine + Zidovudine + 3tc

786. HIV Positive Primi Near Term, Advice Given is

Treatment should be started before labour; Avoid mixing of blood intrapartam; Ceaserian section would be decrease
transmission of HIV to baby

Vaginal delivery preferred

787. Normal pregnancy can be continued in:

 Primary pulmonary hypertension

Wolf-Parkinson-White syndrome.

Eisenmenger syndrome

Marfan syndfome with dilated aortic root

788. If the process is localized in one of the pockets of the peritoneum it is:

Local unlimited peritonitis

Local limited peritonitis

Diffuse peritonitis

Common peritonitis

789. Endometrial biopsy in postmenopausal women is recommended if ET is:

4 mm

6 mm

8 mm

7 mm

790. What is the pH range of amniotic fluid:

5.5 - 6.0

6.0 - 6.5

6.5 - 7.0

7.0 - 7.5

791. Which is not a feature of HELLP syndrome:

Thrombocytopenia

Eosinophilia

Raised liver enzyme

Hemolytic anemia

792. Which of the following tests is most sensitive for the detection of iron depletion in pregnancy?

Serum iron

Serum ferritin.

Serum transferrin
 Serum iron binding capacity

793. All are associated with hydramnios except:

Premature labour

Gestational diabetes

Renal agenesis

Increased amniotic fluid

794. During examination of patient with PID the cervix was erythematous with characteristic “strawberry” appearance. What is
diagnosis:

Gonorrhea

Chlamidiosis

Siphylis

Trichomoniasis

795. M/C cause of spontaneous first trimester abortion is:

Uterine malformation

Chromosomal abberation.

Infection

Genetic cause

796. Large placenta is seen in all of the following except:

IUGR

Syphilis

CMV

Rubella

797. MTP at 8 weeks is done by:

Suction evacuation.

Intramuscular oxytocin

Dilatation and curettage

Intrauterine prostaglandins

798. According FIGO classification leiomyoma Type 4 is:

 Submucosal

Intramural

Subserosal

Pedunculated

799. Chicken pox in Pregnancy A pregnant lady develops chicken pox. During which part of her pregnancy will it lead to highest
chance of neonatal infection:

Last 5 days

12-16 week

8-12 week

16-20 week

800. The highest incidence of gestational trophoblastic disease is in:

Australia

Asia.

North America

Western Europe

801. A positive “Stallworthy’s sign” is suggestive of which of the following conditions:

Twin pregnancy

Breech presentation

Vesicular mole

Low lying placenta.

Pregnancy induced hypertension

802. Which of the following features indicates the presence of heart disease in pregnancy and which is not seen in normal
pregnancy?

Exertional dyspnea

Distended neck veins.

Synstemic hypotension

Pedal edema

803. Formula used for estimation of the total iron requirement is:

4 x body weight (kg) x Hb deficit (g/dl)

 4.4 x body weight (kg) x Hb deficit (g/dl).

0.3 x body weight (kg) x Hb deficit (g/dl)

3.3 x body weight (kg) x Hb deficit (g/dl)

804. A multipara with 34 weeks pregnancy tachycardia, fever hepatosplenomegaly, pallor has:

Malaria

Iron deficiency anemia

Physiological anemia

Megaloblastic anemia

805. Risk factor for pre-eclampsia includes:

Age >35yr; Obesity; Previous h/o preeclampsia; Antiphospholipid syndrome

Multigravida

Smoking

Acohol

806. The consequences of Rh incompatibility are not serious during first pregnancy because:

Antibodies are not able to cross placenta

Antibody titer is very low during primary immune response

IgG generated is ineffective against fetal red cells

Massive hemolysis is compensated by increased erythropoiesis

807. A 42 year-old woman complains of menorrhagia and dysmenorrhea that progressed gradually, the most likely diagnosis is:

Endometrial cancer.

Adenomyosis.

Cervical cancer.

Ovarian cyst.

808. During the evaluation of secondary amenorrhea in a 24-year-old woman, hyperprolactinemia is diagnosed. Which of the
following conditions could cause increased circulating prolactin concentration and amenorrhea in this patient?

Stress

Primary hyperthyroidism

Anorexia nervosa
 Congenital adrenal hyperplasia

809. A woman with h/o recurrent abortions presents with isolated increase in APTT. Most likely cause is:

Lupus anticoagulant.

Factor VII

Von Willebrand’s disease

Hemophilia A

810. A lady with 12 wks of pregnancy having fasting blood glucose 170 mg/dl, the antidiabetic drug of choice is:

Insulin

Metformin

Glipizide

Glibenclamide

811. A women is pregnant now, she had lost 3 fetuses in (2 at age 32 and one at age of 18 weeks of gestation):

G4 P2+1

G4 P3+0

G4 P0+3

P2+1

812. Which of the following endocrinological condition may be associated with hydatidiform mole?

Hypothyroidism

Hyperthyroidism.

Diabetes

Hyperprolactinemia

813. Methotrexate can be used if ectopic pregnancy size:

< 3.5 cm

< 4.5 cm

< 5.5 cm

< 2.5 cm

814. Worst prognosis is seen in pregnant women with cardiac lesion is:
 Mitral stenosis

Co-arctation of aorta

Eisenmenger syndrome.

Tetralogy of fallot’s

815. Oligohydramnios is seen in:

Oesophageal atresia

Spina bifida

Cholangioma of placenta

Posterior Urethral valves

816. Which type of delivery is safest in maternal heart disease?

Vaginal

Cesarean section

Outlet forceps.

Mid-cavity forceps

817. In which stage of peritonitis peristalsis of the intestine is absent, the abdomen is swollen:

Reactive

Toxic

Terminal

Vascular

818. At 28 weeks gestation, amniocentesis reveals a OD 450 of 0.20 which is at the top of third zone of the liley curve. The most
appropriate management of such a case is:

Immediate delivery

Intrauterine transfusion

Repeat Amniocentesis after 1 week

Plasmapheresis

819. A 28 years old female presented with the history of recurrent abortions, pain in calves for 4 years. Patient is suffering from
congenital deficiency of:

Protein C.

Thrombin
 Plasmin

Factor XIII

820. A primipara presented at 10 weeks of gestation with lower abdominal pain. On examination there was pallor and lower
abdominal tenderness. What is the likely possibility?

Ruptured ectopic.

Twisted ovarian cyst

Red degeneration

Acute appendicitis

821. A case of gestational trophoblastic neoplasia is detectez to have lung metastasis. She should be staged as:

Stage – I

Stage – II

Stage – III.

Stage – IV

822. Amniocentesis is best diagnostic if done in ………………weeks:

8-10

12-14

16-18

20-22

823. The DOC for treatment of thyrol oxicosis during pregnancy is:

Carbimazole

Iodine therapy

Propylthiouracil

Methimazole

Hypertensive disorders in pregnancy

824. “Clue cells” are characteristic for:

Gonorrhea

Chlamidiosis

Bacterial vaginosis
 Trichomoniasis

825. Which one differentiates choriocarcinoma from invasive mole?

Hemorrhage and necrosis

Absence of villi on histology.

Presence of cannonball metastases

High Level of chorionic gonadotropins

826. A female having 6 weeks amenorrhea presents with ovarian cyst. The proper management is:

Immediate ovariotomy

Ovariotomy at IInd trimester

Ovariotomy 24 hours after delivery

Ovariotomy with caesarean

827. Critical obstetrics conjugate for trial of labour is:

8.5 cm

9.0 cm.

9.5 cm

10.0 cm

828. Causes of antepartum hemorrhage are all except:

Placenta previa

Atonic uterus.

Abruptio placenta

Circumvallate placenta

829. The amniotic fluid is in balance by:

Excretion by fetal kidneys; Maternal hemostasis

Fetal membrane absorption

Fetal intestinal absorption

Fetal sweating

830. Acute pyelonephritis in pregnancy all of the following are true except:
 Left kidney is involved in 50% of patients

Most common isolate is E. coli

More common in later ½ of pregnancy

Responds to amino glycosides

831. A primagravida is on the antenatal care with the physiological duration of pregnancy. Her first day of last menstrual period
was on May 15. Determine the estimated date of delivery.

February 8

February 15

February 19

February 22

832. True regarding PPH:

Type B lynch suture used; With new advances both atonic and traumatic PPH can be reduced; More common in multipara;
Associated with polyhydramnios.

Mifepristone used

Misoprostol used

833. Amount of amniotic fluid at 12 weeks of pregnancy is:

50 ml

100 ml

200 ml

400 ml

834. In which stage of peritonitis the compensatory mechanisms are preserved:

Reactive

Toxic

Terminal

Vascular

835. During delivery, the risk of transmission of maternal infection to the foetus is the highest in:

Rubella

Cytomegalo virus

Herpes simplex virus

 Human papilloma virus

836. The following complications are likely to increase in a case of severe anemia during the pregnancy except:

Pre-eclampsia

Intercurrent infection

Heart failure

Preterm labour

Subinvolution.

837. All of the following include in Sofa score, except:

Creatinine

Glucose

Hypotention

Bilirubin

838. True about is/are:

MS surgery better avoided in pregnancy; MR with PHT-definite indication for termination of pregnancy; Aortic stenosis in young
age is due to Bicuspid valve.

Isolated TR always due to infective endocarditis

MS with pressure gradient 10mm Hg-indication for surgery

839. The MTP Act was passed in the year:

1971.

1976

1982

1988

840. True about diabetes in pergnancy are all except:

Glucose challenge test is done between 24-28 weeks

50 gm of sugar is given for screening test

Insulin resistance improves with pregnancy

Diabetes control before conception is important to prevent malformation

841. Clinical signs of hydramnios can be demonstrated when fluid collection is more than:
 1 ltr.

2 ltr.

3 ltr.

4 ltr.

842. Indications of medical management in ectopic pregnancy:

Presence of fetal heart activity

Size <4cms.

Gestation <6weeks

a-hCG >1500

b-hCG <15000.

843. The amniotic fluid is completely replaced in every:

3 hours

6 hours

9 hours

12 hours

844. The serum tumor markers for dysgerminoma is:

LDH

β-hCG

α-fetoprotein

Ca-125

845. All of the following drugs are used in the management of postpartum hemorrhage except:

Ergometrine

Methergine

Prostaglandin

Mifeprestone.

846. Massive PPH may warrant following interventions:

Hysterectomy; Internal iliac A. ligation; Balloon tamponade; Uterine artery embolism.

Thermal Endometrial ablation

 Laparoscopy

Hysteroscopy

847. If division of fertilized egg occurs at 4-8th day what kind of monozygotic twin pregnancy will it give rise to:

Diamnionic dichroionic

Diamnionic monochorionic.

Monoamnionic monochorionic

Conjoined twins

848. All of the following drugs are used for urinary tract infections in pregnancy except:

Nitrofurantoin

Ampicillin

Cephalosporin

Quinolones

849. A patient went into shock immediately after normal delivery, likely cause:

Amniotic fluid embolism

PPH

Uterine inversion.

Eclampsia

850. In heart patient the worst prognosis during pregnancy is seen in:

Mitral regurgitation

Mitral valve prolapse

Aortic stenosis.

Pulmonary stenosis

851. A primigravida is in second stage of labor for the past two hours. Fetal head is at +1 station. Inspite of effective uterine
contractions, mother is unable to push as she is exhausted. What will be the next step in her management?

Wait for another one hour.

Give sedation to the mother.

Shift her for emergency section.

Instrumental delivery.
852. Feature of diabetes mellitus in pregnancy:

Postdatism

Hydramnios; congenital defect; PPH.

Neonatal hyperglycemia

853. The percentage of water in liquor amnii is:

42%

64%

76%

99%

854. Malignant progression risk is greatest for:

CIN I

CIN II

CIN III

CIN IV

855. Complete H. Mole are:

Triploid

Diploid. Increased b-hCG.

2% cases may convert to carcinoma

Chance of malignant conversion less than partial mole

856. Most valuable diagnostic test in a case of suspected ectopic pregnancy:

Serial b-hCG levels

Transvaginal USG.

Prosgesterone measurement

Culdocentesis

857. A hypertensive pregnant woman at 34 weeks comes with history of pain in abdomen, bleeding per vaginum and loss of
fetal movements. On examination the uterus is contracted with increased uterine tone. Fetal heart sounds are absent. The most
likely diagnosis is:

Placenta previa

Hydramnios
 Premature labour

Abruptio placenta.

858. Treatment of lutein cyst in hydatidiform mole is

Ovarian cystectomy

Ovariectomy

Suction evacuation.

Ovariotomy

859. The dose of anti D gamma globulin given after term delivery for a Rh negative mother and Rh positive baby is:

50 micro gram

200 micro gram

300 micro gram

100 micro gram

All of the above doses are incorrect

860. Drug used to decrease PPH is:

Oxytocin

Mathergine.

Progesterone

Prostaglandins

861. Young lady presents with acute abdominal pain and history of 1½ months amenorrhoea, on USG examination there is
collection of fluid in the pouch of Douglas and empty gestational sac. Diagnosis is:

Ectopic pregnancy.

Pelvic hematocele

Threatened abortion

Twisted ovarian cyst

862. Most common type of Eclampsia is

Intercurrent

Antepartum

Intrapartum
 Postpartum

863. All of the following are indications for medical management of unruptured tubal pregnancy, except:

Serum human gonadotroph in < 2000 IU/L

Size of the mass 6 cm.

Haemodynamically stable

No intra-abdominal hemorrhage

864. Oligohydramnios is seen in all except:

Renal agenesis

Rh incompatibility

IUGR

Postmaturity

865. A double headed monster is known as a:

Diplopagus

Dicephalus.

Craniopagus

Heteropagus

866. Intraheptaic cholestasis, ideal time for termination of pregnancy:

28 weeks

36 weeks

38 weeks

40 weeks

867. In diabetic pregnancy least common is:

Caudal regression syndrome.

Anencephaly

VSD

Spina bifida

868. Placenta accreta is associated with:

 Placenta previa in present pregnancy

Uterine scar

Multiple pregnancy

Multipara.

Uterine malformation

869. Induction of labor is done in all except:

Heart disease.

Preeclampsia

Abruptio placenta hemorrhage

Chronic polyhydramnios

870. Recurrent spontaneous abortions are seen in all except:

TORCH infection, Herpes infection.

Uterine pathology

Balanced paternal translocation

None

871. Hypothyroidism is associated with the following clinical problems, except:

Menorrhagia

Early abortions

Galactorrhoea

Thromboembolism.

872. In which of the following conditions, the medical treatment of ectopic pregnancy is contraindicated:

Sac size is 3 cm

Blood in pelvis is 70 mL

Presence of fetal heart activity.

Previous ectopic pregnancy

873. In complicated ectopic pregnancy treatment is:

Methotrexate

Surgical
 Mifepristone

Misoprostol

874. Which of the following is not an indication for antiphospholipid antibody testing?

3 or more consecutive first trimester pregnancy losses

Unexplained cerebrovascular accidents

Early onset sever preeclampsia

Gestational diabetes

875. Which of the following perinatal infections has the highest risk of fetal infection in the first trimester:

Hepatitis B virus

Syphilis

Toxoplasmosis

Rubella

876. A patient has entered spontaneous premature labor at 28 weeks’ gestation. During the vertex delivery, one should do which
of the following?

Perform an episiotomy

Use prophylactic forceps

Use vacuum extraction

Allow spontaneous vaginal birth

877. Commonly used grading for abruption placenta:

Page.

Johnson

Macafee

Apt

878. How is fetal blood differentiated from maternal blood:

Kleihauer test

Apt test

Bubble test

Lilly’s test
879. Drug of choice of eclampsia

MgSo4

Phenobarbitone

Methyldopa

Clonazepam

880. B-Lynch brace suture is applied for:

Atonic uterus in PPH.

cervix

Ovaries

Fallopian tube

881. Children borne to Diabetic mothers can develop all except:

Macrosmia

Caudal regression

Hypercalcemia

CVS Defects

882. Minimum duration between onset of symptoms and death is seen in:

APH

PPH.

Septicemia

Obstructed labor

883. A G 2P1 with previous cesarean section due to obstructed labor comes for first antenatal visit at 34 weeks of gestation.
She is seeking advice for home delivery this time. What will be the most dangerous complication in her case if we allow her to
deliver at home by untrained birth attendant?

Prolonged latent phase.

Arrest in second stage of labour.

Delayed progress in active phase of labour.

Rupture uterus.

884. A 26-year-old primigravida with juvenile myoclonic epilepsy comes to you at 4 months with concern regarding continuing
sodium-valproate treatment. Your advice is:
 Add lamotrigine to sodium valproate

Taper sodium valproate and add lamotrigine

Switch on to carbamazepine

Continue sodium valproate with regular monitoring of serum levels

Disorders of Amniotic fluid volume

885. Snow storm appearance on USG is seen in:

H. mole.

Invasive mole

Twin pregnancy

Ectopic pregnancy

Choriocarcinoma

886. The commonest complication of twin pregnancy delivery includes:

Interlocking

Abruptio placentae

Postpartum hemorrhage.

Obstructed labour

887. Indication of methotrexate in molar pregnancy:

Fetal heart activity

Size <4 cm

b-hCG 4000 MIU/ml

Evidence of metastasis. Age 50 years.

888. Which of the following is associated with incarcerated retroverted gravid uterus?

Abortion

Anterior Sacculation

Urinary retention

All of the above

889. The hormone responsible for the decidual and Arias stella reaction of ectopic pregnancy is:

hCG
 Progesterone.

Estrogen

HPL

890. Pregnant lady presenting with IgG antibodies of rubella, means that:

She is already immune to infection

Susceptible

She is infective

None

891. Most important factor in management of precclampsia:

Severtiy of hypertension

Proteinuria

892. A 38 year old woman is seen for the evaluation of a swelling in her right vulva. She has also noted pain in this area when
walking and during coitus. On examination a mildly tender fluctuant mass was noticed just outside the introits in the right vulva.
What the most likely diagnosis?

Bartholin's abscess.

Lymphogranuloma venerum.

Chancroid.

Vulva carcinoma.

893. For inducing therapeutic abortion, mifepristone is most effective when given within ________ days of pregnancy:

120

88

72

63.

894. Most common cause of first trimester abortion is:

Chromosomal abnormalities.

Syphilis

Rhesus isoimmunization

Cervical incompetence
895. Highest transmission of hepatits B from mother to fetus occurs if the mother is infected during

Ist trimester

IInd trimester

IIIrd trimester

At the time of implanation

896. Most common cause of abortion:

Ovofetal factor.

Maternal hypoxia

Uterine fibroid

Cervical incompetence

897. D/D of acute abdomen in pregnancy are all except:

Cystitis; Appendicitis; Ruptured ectopic

Threatened abortion

Cervical incompetence

898. Criteria of Systemic Inflammatory Response Syndrome, except:

Body temperature < 36oC or > 38oC

Heart rate > 90 beats per minute

WBC > 12,000/mm3

Endometritis

899. A 48-year-woman who had two normal pregnancies 13 and 15 years ago presents with the complaint of amenorrhea for 7
months. She expresses the desire to become pregnant again. After exclusion of pregnancy, which of the following tests is next
indicated in the evaluation of this patient's amenorrhea?

Hysterosalpingogram.

Endometrial biopsy.

Thyroid function test.

LH and FSH levels.

900. A prosthetic valve patient switch to heparin at which time of pregnancy:

28 weeks

32 weeks
 36 weeks.

Postpartum

901. A hemodynamically stable nulliparous patient with ectopic pregnancy has adnexal mass of 2.5 x 3 cms and b-hCG titer of
1500 mIU/mL. What modality of treatment is suitable for her:

Conservative management

Medical management.

Laparoscopic surgery

Laparotomy

902. A 28 years old P2 comes to emergency, after home delivery with heavy bleeding per vaginum. After evaluation and
emergency resuscitation she is diagnosed as a case of uterine atony. What is the appropriate medicine in the management of
this case:

Oxytocin.

Salbutamol.

Beta blockers.

Magnesium sulphate.

903. The pH of amniotic fluid is:

6.8 to 6.9

7.1 to 7.3

7.4 to 7.6

6.7 to 6.8

904. Which one of the following statements is false regarding “partial hydatidiform mole” ?

Chance of choriocarcinoma < 5%

Demonstrates diploid karyotype.

May contain fetus

Has milder elevation of hCG

905. With reference to syndromic approach in reproductive tract infections, consider the following statements:

Singel drug can be used for treatment

The diagnosis of exact disease is not relevant

The management is disease specific

 This is an important part of family health Aware ness compaign

906. Following is used in Ist trimester MTP:

Mifepristone

Misoprostol

Mifepristone and misoprostol, Laminaria tent.

907. Which is not a common cause of placenta accreta?

Previous LSCS

Previous currettage

Previous myomectomy

Previous placenta previa/abrupto placenta.

908. The drug of choice in treatment of typhoid fever in pregnancy is:

Ampicillin

Chloramphenicol

Ciprofloxacin

Ceftriaxone

909. Indications for termination of pregnancy includes:

Aortic stenosis

Eisenmenger’s syndrome, NYHA grade 4 heart disease with history of decompensation in the previous pregnancy.

Tricuspid stenosis

Severe mitral stenosis + NYHA grade II

910. Pregnancy should be strongly discouraged in women with:

Mitral stenosis

ASD

VSD

Eisenmenger’s syndrome.

911. In which part of fallopian tube ectopic pregnancy will have longest survival:

Isthmus
 Ampulla

Cornua

Interstitium.

912. Anaemia of foetus in Rh isoimmunization can be estimated by all except

USG of placenta

Increased middle cerebral artery blood flow/NST

Cordocentesis

Sinusoidal pattern in carditocography

913. Increased capillary permeability and ovary enlargement are the principal characteristics of:

Premenstrual syndrome

Ovarian hyperstimulation syndrome

Climacteric syndrome

Sheehans syndrome

914. Total amount of iron needed by the fetus during entire pregnancy is:

500 mg

1000 mg

800 mg

300 mg.

915. Hypothyroidism in pregnancy is least likely associated with:

Recurrent abortions

Polyhydramnios

PIH

Preterm labour

916. Anti-D prophylaxis should be given in all of the following conditions except:

Medical abortion for 63 days pregnancy

Amniocentesis at 16 weeks

Intrauterine transfusion at 28 weeks

Manual removal of Placenta

917. Anti tubercular drug contraindicated in pregnancy:

Streptomycin

Refampicin

INH

Ethambutol

Pyrazinamide

918. Amount of liquor is maximum at:

32-34 weeks

36-38 weeks

34-36 weeks

38-40 weeks

919. In a patient with heart disease, which of the following should not be used to control PPH:

Methyergometrine.

Oxytocin

Misoprostol

Carboprost

920. Feto maternal transfusion is detected by:

Kleihauer test

Spectrophotometry

Benzidine test

None of the above

921. Prostaglandins can be used for medical termination of pregnancy by all routes except:

Intravenous.

Intramuscular

Extra-amniotic

Intra-amniotic

922. A lady with previous CS presents in labor. Trials of labor is contraindicated in:

Breech presentation
 The fact of knowing that the previous CS was due to CPD

Previous classical CS.

No previous vaginal delivery

923. Twin pregnancy predisposes to:

Hydramnios

Pregnancy induced hypertension

Malpresentation

All of the above.

924. Criteria for pelvic peritonitis is:

Presence of free fluid in the cavity of the small pelvis, mainly in the Douglas space

Presence of free fluid in intestine

Subhepatic abscess

Echonegative content in appendix

925. In which infection vaginal discharge is caseous and white?

Gonorrhea

Chlamidiosis

Siphylis

Candidosis

926. All of the following drugs have been used for medical abortion except:

Mifepristone

Misoprostol

Methotrexate

Atosiban.

927. Preeclampsia is not predisposed by:

Molar pregnancy

Oligohydraminos

Diabetes

Multiple pregnancy
928. Regarding idiopathic cholestasis of pregnancy correct is:

Deep jaundice is present

Pruritus is the first symptom; Maximum incidence during III trimester; Increased liver transaminase

Hepatic necrosis present

929. A 32-year-old woman with two live children was brought to emergency with the history of missed period for 15 days,
spotting since 7 days and pain abdomen since 6hrs. Her pulse was 120/min, pallor ++, systolic BP 80 mmHg. There was fullness
and tenderness on per abdomen examination. Cu-T thread was seen through external os on P/S examination On P/V
examination, cervical movements were tender, uterus was bulky and soft. There was fullness in pouch of Douglas. She is most
likely suffering from:

Pelvic inflammatory disease

Missed abortion with infection

Ruptured ectopic pregnancy.

Threatened abortion

930. A 24 years old G 3P2 presents to you at 32 weeks of gestation with preterm prelabour rupture of membranes for ten days.
She is complaining of pain in lower abdomen, fever with rigors and chills and purulent vaginal discharge. What is her diagnosis?

Pyrexia of unknown origin.

Puerperal pyrexia.

Preterm labour.

Chorioamnionitis.

931. Commonest cause of postpartum hemorrhage is:

Atonic uterus.

Traumatic

Combination of atonic and traumatic

Blood coagulation disorders

932. Risk factor for preeclampsia:

Chronic hypertension; Obesity

Smoking

Placenta previa

Multiparity

933. True about diabetes in pregnancy:

 Macrosomia; Congenital anomalies.

IUGR

Oligohydramnios

Placenta previa

934. A 27-year-old primigravida presents with pregnancy induced hypertension with blood pressure of 150/100 mm/ Hg at 32
weeks of gestation with no other complications. Subsequently, her blood pressure is controlled on treatment. If there are no
complications, the pregnancy should be best terminated at:

40 completed weeks

37 completed weeks

35 completed weeks

34 completed weeks

935. As Per ACOG – 2001 criteria to diagnose “gestational diabetes” using GTT is plasma glucose at 2 hr more than
_______mg/dL:

180

155

140

126

936. Test not useful in case of tubal pregnancy:

Pelvic examination

USG

hCG

Hysterosalpingography.

937. Sulfonylurea is shifted to insulin in pregnant lady because:

Sulphonylurea causes PIH

Increases demands during pregnancy not compensated by sulfonyl urea alone

Insulin does not cross placenta.

Sulfonylurea depletes insulin from fetus-beta cell of pancreas

938. B Lynch suture is applied on:

Cervix
 Uterus.

Fallopian tube

Ovaries

939. Doppler USG in twins is used for:

Twin to twin transfusion

b. Conjoined twin

Diagnosis of twins.

All of the above

940. The commonest congenital anomaly seen in pregnancy with diabetes mellitus is:

Multicystic kidneys

Oesophageal atresia

Neural tube defect

Duodenal atresia

941. Procedure of choice in a woman with 12 weeks pregnancy and atypical pap smear is:

Cone biopsy

MTP with cone biopsy

Hysterectomy

Colposcopy

942. A 26-year-old pregnant woman has been detected to have a diastolic murmur in mitral area. Echocardiography reveals
mitral valve orifice to be 0.8 cm2. The cause of her murmur is

Mild mitral stenosis

Severe mitral stenosis.

Functional murmur

Transmitted murmur from the congenital heart disease of the foetus

943. Kalindi 25 years female admitted as a case of septic abortion with tricuspid valve endocarditis. Vegetation from the valve
likely to affect is:

Liver

Spleen

Brain
 Lung.

944. Placenta previa true are:

Incidence increases by two fold after LSCS.

More common in primipara

Most common in developed countries

1 per 1000 pregnancies

Most common cause of PPH

945. A 27 years primigravida presents with pregnancy inducedhypertension with blood pressure of 150/ 100 mm of Hg at 32
weeks of gestation with no other complications. Subsequently, her blood pressure is controlled on treatment. If there are no
complications, the pregnancy should be terminated at:

40 completed weeks

37 completed weeks

35 completed weeks

34 completed weeks

946. All are seen in gestational diabetes except:

Previous macrosomic baby

Obesity

Malformations

Polyhydramnios

947. Phosphatidyl glycerol appears in amniotic fluid at:

20 weeks

28 weeks

35 weeks

38 weeks

948. All are used in treatment for PPH except:

Oxytocin

Carboprost

Ergometrine

Ritodrine.
949. Miladevi is a diagnosed case of ectopic gestation, which of the following will be the most reliable indicator:

Arias stella reaction

Culdocentesis showing blood in the posterior cul-de-sac

Absence of the normal doubling of hCG levels

No gestational sac in USG.

950. A 26-year-old woman is first seen at 28 weeks’ gestation. Her history and physical are normal except for the presence of a
2-cm posterior cervical leiomyoma. The patient is relatively asymptomatic. Which of the following is the best management for
this patient?

Myomectomy at 36 weeks

Myomectomy now with steroids and tocolysis

Elective cesarean delivery at term

Watchful waiting

951. Amount of amniotic fluid at 12 weeks of pregnancy is:

50 mL

100 mL

200 mL

400 mL

952. Which of the following histories is not an indication to perform oral glucose tolerance test to diagnose gestational diabetes
mellitus?

Previous Eclampsia

Previous Congenital anomalies in the fetus

Previous Unexplained fetal loss

Polyhydramnios

953. Commonest intrauterine infection in pregnancy is:

Toxoplasmosis

CMV

Herpes

Rubella

954. Gynecologic peritonitis results from all of the following, EXCEPT:

 Melting of the wall of pyosalpinx

Intestinal ulcer perforation

Various gynecological operations

Criminal abortions

955. Which vitamin deficiency is most commonly seen in a pregnant mother who is on phenytoin therapy for epilepsy:

Vitamin B6

Vitamin B12

Vitamin A

Folic acid

956. A gravida 3 female with h/o 2 previous 2nd trimester abortion presents at 22 weeks of gestation with funneling of cervix.
Most appropriate management would be:

Administer dinoprostone and bed rest

Administer misoprostol and bed rest

Apply Fothergill stitch

Apply McDonald stitch.

957. The most consistent sign in disturbed ectopic pregnancy is:

Pain

Vaginal bleeding.

Fainting

Vomiting

958. Ectopic pregnancy is most commonly associated with:

Endometriosis

Congenital tubal anomalies

Tuberculosis

Tubal inflammatory diseases.

Retroverted uterus

959. A 55-year-old woman presents to your office for consultation regarding her symptoms of menopause. She stopped having
periods 8 months ago and is having severe hot flushes. The hot flushes are causing her considerable stress. What should you
tell her regarding the psychological symptoms of the climacteric?
 They are not related to her changing levels of estrogen and progesterone.

They commonly include insomnia, irritability, frustration, and malaise.

They are related to a drop in gonadotropin levels.

They are not affected by environmental factors.

960. Common cause of retained placenta:

Atonic uterus.

Constriction ring

Placenta accreta

Poor voluntary expulsive effort

961. Management of unruptured tubal pregnancy includes:

Methotrexate, Laparoscopic salpingostomy.

Prostaglandins

Hysterectomy

Salpingectomy

962. A primigravida presents to casualty at 32 weeks gestation with acute pain abdomen for 2 hours, vaginal bleeding and
decreased fetal movements. She should be managed by:

Immediate cesarean section

Immediate induction of labour.

Tocolytic therapy

Magnesium sulphate therapy

963. A 21-year-old athletic woman with diabetes on a low-dose oral contraceptive comes to your clinic with irregular menses
and bilateral breast discharge. On examination, the discharge is expressed and galactorrhea is confirmed with fat globules seen
microscopically. She currently takes metoclopramide(Reglan) for delayed gastric emptying. A random serum prolactin level is
65 ng/mL. Which of the following is most likely responsible for her hyperprolactinemia?

Metoclopramide

Pregnancy

Oral contraceptive

Pituitary adenoma

964. All of the following are true about the lupus anticoagulants except:

Increase in APTT
 Recurrent second trimester abortion in pregnant females

Can occur without other symptoms of antiphospholipid antibody syndrome

Severe life threatening hemorrhage.

965. Decidual casts bleeding per vaginum are suggestive of:

Inevitable abortion

Threatened abortion

Tubal abortion.

None

966. A case of gestational trophoblastic neoplasia belongs to high risk group if disease develops after:

Hydatidiform mole

Full term pregnancy.

Spontaneous abortion

Ectopic pregnancy

967. Which of the following statements is incorrect in relation to pregnant women with epilepsy:

The rate of congenital malformation is increased in the offspring of women with epilepsy

Seizure frequency increases in approximately 70% of women

Breast feeding is safe with most anticonvulsants

Folic acid supplementation may reduce the risk of neural tube defect

968. All of the following are associated with GDM except:

Previous H/O macrosomic baby

Oligohydraminos.

Malformations

Infections

969. All of the following can cause DIC during pregnancy except:

a.+ Diabetes mellitus

Amniotic fluid embolism

Intrauterine death

Abruptio placentae.
970. Partial mole is:

Haploid

Diploid

Triploid.

Polyploid

971. A young girl presents with abdominal distention and a mass. Ultrasound and serum tumor markers confirm a neoplastic
origin to her ovarian mass. Childhood neoplastic ovarian masses most commonly originate from which of the following?

Gonadal epithelium

Gonadal stroma

Germ cells

Sex cords

972. In valvular heart disease complicating pregnancy the following statements are true except:

A closed mitral valvotomy can be carried out if symptoms of mitral stenosis are severe

Open heart surgery is associated with a reduction in fetal loss.

Mitral regurgitation is usually well tolerated

A maternal mortality of 15% has been reported in women with critical aortic stenosis

It is mandatory to continue full anticoagulation in patients with mechanical valvular prosthesis

973. A 16-year-old G0P0 patient reports delayed onset of menses, the sudden onset of severe pain, and syncope. A serum
pregnancy test is negative. Her CBC reveals an Hct of 42% and a WBC of 8,000. Which of the following is the most likely
diagnosis?

Ectopic pregnancy

PID

Appendicitis

Ruptured corpus luteum cyst of the ovary

974. True about diabetic mother is:

Hyperglycemia occurs in all infants of diabetic mothers

High incidence of congenital heart anomalies is common; Beta agonist drugs are CI during delivery.

Small baby

975. DIC is common with:

 Placenta previa

Abruptio placenta.

Placenta accerta

Battledore placenta

976. In which of the following heart diseases is maternal mortality during pregnancy found to be the highest:

Coarctation of aorta

Eisenmenger syndrome.

AS

MS

977. Syphilis is transmitted in which week of pregnancy:

4th week

8th week

16th week

28th week

978. Which of the following is true about vasa previa except?

Incidence is 1: 1500

Mortality rate of 20% with undiagnosed case.

Associated with low lying placenta

Cesarean section is indicated

979. Hydrops fetalis is caused by:

Parvovirus infection

HZ virus infection

Down syndrome

Toxoplasma

All a, b, c, d.

980. The method most suitable for MTP in 3rd month of pregnancy is:

Dilatation and curettage

Extra-amniotic ethacridine
 Hysterectomy

Suction and evacuation.

981. A pregnant lady is diagnosed to be HBs Ag positive. Which of the following is the best way to prevent infection to the child:

Hepatitis vaccine to the child

Full course of Hepatitis B vaccine and immunoglobulin to the child

Hepatitis B immunoglobulin to the mother

Hepatitis B immunization to mother

982. Characteristics of severe sepsis:

Body temperature < 36oC or > 38oC

Heart rate > 90 beats per minute

WBC > 12,000/mm3

Lactate (> 2)

983. Immediate cord ligation is done in:

Pre-term babies

Rh incompatibility

Both a and b

None of the above

984. Asymptomatic UTI in pregnancy, true is:

Most are usually asymptomatic in pregnancy; If untreated, progresses to pyelonephritis; Increase chance of premature infant;
Increase risk of chronic renal lesion.

Early and prompt treatment prevents abnormali

985. The most common type of conjoined twins?

Craniophagus

Thoracophagus.

Ischiophagus

Abdominophagus

986. A 25-year-old woman is having a severe intrapartum hemorrhage with hypovolumic shock. Which of the following
symptoms is evidence of pituitary infarction?
 Infrequent urination

Diarrhea

Easy bruisability

Lactation failure

987. Ectopic pregnancy: most common feature is:

Abdominal pain.

Amenorrhea

Fainting attack

Bleeding P.V

988. A patient at 8 weeks pregnancy is diagnosed to have dermoid cyst it should be removed at:

Immediately

At 14-16 weeks

Only when it undergoes torsion

At term along with LSCS

989. Galactorrhea can be seen in:

Premenstrual syndrome

Hyperprolactinemia syndrome

Postovariectomic synddrome

Sheehans syndrome

990. Risk of amniotic fluid embolism is greatest in:

First trimester of pregnancy

Second trimester of pregnancy

During labour

In puerperal period

Epilepsy in pregnancy

991. Uterine artery embolisation is done by using:

Thrombin

Polyvinyl alcohol.
 Vitamin K

Iodine

992. Molar pregnancy is diagnosed in:

I trimester.

II trimester

III trimester

All of the above

993. Most common cardiac lesion seen in pregnancy:

Mitral regurgitation

Mitral stenosis.

Tetralogy of fallots

Patent ductus arteriosus

994. True about fatty liver of pregnancy:

Common in third trimester; Microvesicular fatty changes

Recurrence is very common

Lysosomal injury is the cause

Alcohol is the main cause

995. A female presents with significant blood loss due to postpartum hemorrhage (PPH). What would be the shock index
(HR/systolic BP)?

0.9-05

0.5-0.7

0.9-1.5

0.9-1.1.

996. Oncogenic HPV types are:

16,18

6,11

42,43

12,13
997. Recurrence of gestational trophoblastic tumor can be associated with all except:

Enlarged uterus

Persistent lutein cysts in ovaries

Plateau of hCG.

Sub urethral nodule

998. True about congenital diseases in diabetes mellitus is all except:

Results due to free radical injury

6-10% cases are associated with major congenital abnormality.

1-2% of newborns are associated with single umbilical artery

Insulin can be given

999. With oral iron therapy, rise in Hb% can be seen after:

1 week

3 weeks

4 weeks

6 weeks

1000. Which of the following types of viral hepatitis infection in pregnancy, the maternal mortality is the highest?

Hepatitis-A

Hepatitis -B

Hepatitis- C

Hepatitis –E

Renal disorders in pregnancy

1001. Blood chimerism is maintained by:

Monochorinonic dizygotic twins.

Dichorionic dizygotic twins

Vanishing twins

Singleton pregnancy

1002. Amniotic fluid volume in polyhydramnios is more than?

500 mL
 1000 mL

1500 mL

3:1

1003. A lady with 8 wks pregnancy presented with random blood glucose of 177mg/dl. The treatment is:

Phenformin

Sulfonylurea

Insulin

Glipizide

1004. Couvelaire uterus is present:

Placenta previa

Abruptio placenta.

Vasa previa

All of the above

1005. Infants of diabetic mothers are likely to have the following cardiac anomaly:

Coarctation of aorta

Fallot’s tetralogy

Ebstein’s anomaly

Transposition of great arteries

1006. Maximum transmission of HIV from mother to fetus occurs during which period

Prenatal vertical transmission

Intrapartum during delivery

Postpartum during breast feeding

Equal in all stages

1007. Most common cause of secondary PPH is:

Uterine inertia

Retained placenta.

Episiotomy

Cervical tear
1008. A twenty years old woman has been brought to casualty with BP 70/40 mm Hg, pulse rate 120/min. and a positive urine
pregnancy test. She should be managed by:

Immediate laparotomy.

Laparoscopy

Culdocentesis

Resuscitation and medical management

1009. Risk factors for preeclampsia:

Chronic hypertenstion; Obesity; Placental ischaemia; Antiphospholipid syndrome

Anemia

Bleeding

Multigravida

1010. Not a histological marker for choriocarcinoma:

Vill.

Cytotrophoblast

Syncytiotrophoblast

Bizarre nuclei

1011. Transplacental transmission of toxoplasmosis occur maximally when:

Infection to mother occurs within 6 months before pregnancy

Infection to mother occurs beyond 6 months before pregnancy

In 1st trimester

In last trimester

1012. The dermoid cyst, diagnosed at 6 weeks of pregnancy, Best treatment modalities:

Removal LSCS along with removal of cyst

Removal only when it undergoes torsion

Remove immediately

At 14-16 weeks of pregnancy

DIC in pregnancy, Amniotic fluid embolism shock

1013. A mother is HbsAg positive and anti HBe Ag positive. Risk of transmission of hepatitis B in child is:
 20%

50%

0%

90%

1014. A pregnant woman is found to have excessive accumulation of amniotic fluid. Such polyhydramnios is likely to be
associated with all of the following conditions except:

Twinning

Microencephaly

Oesophageal atresia

Bilateral renal agenesis

1015. In case of twining true statement is:

After embryonic disc fusion, conjoint twin is formed.

Incidence of monozygotic twin varies with race

Incidence of dizygotic twin is constant

The frequency of monozygosity and dizygosity is same

1016. A 21 year old primigravida is admitted at 39 weeks gestation with painless antepartum hemorrhage. On examination
uterus is soft non-tender and head engaged. The management for her would be:

Blood transfusion and sedatives

A speculum examination

Pelvic examination in OT.

Tocolysis and sedatives

1017. Ultrasound of a 36 year of gravida reveals small grapelike cystic structures without the evidence of a developing embryo.
A diagnosis of complete most likely reveal that the:

Genotype of the mole is a 46XXX and is completely paternal in origin.

Genotype of the mole is triploid

hCG levels are markedly decreased

Serum levels of alpha-fetoprotein are elevated

1018. Which of the following statements concerning hepatitis infection in pregnancy is true?:

Hepatitis B core antigen status is the most sensitive indicator of positive vertical transmission of disease
 Hepatitis B is the most common form of hepatitis after blood transfusion

The proper treatment of infants born to infected mothers includes the administration of hepatitis B immune globulin as well as
vaccine

Patients who develop chronic active hepatitis should undergo MTP

1019. In diabetes, which can occur in the fetus:

Pre-eclampsia

Polyhydramnios

Fetal anomalies.

Abruptio placentae

1020. Abortion is defined as “expulsion of fetus” less than ......... gms:

500.

800

900

1000

1021. The effects of diabetic mother on infants is/are:

Brain enlargement as a part of macrosomia

Hyperglycemia in infant

First trimester abortion; Unexplained fetal death; Caudal regression.

1022. Snow storm appearance on USG is seen in:

Hydatidiform mole.

Ectopic pregnancy

Anencephaly

None of the above

1023. Which of the drug is not commonly used in PPH ?

Mifepristone.

Misoprostol

Oxytocin

Ergotamine
1024. True about ectopic pregnancy:

Transvaginal USG-first imaging test of choice. Associated with decidual reaction. In ectopic, interstitial ring sign is seen.

hCG level is sufficient for diagnosis

Doppler is of no significance

1025. Highest risk of ectopic pregnancy is associated with:

Pelvic inflammatory disease.

Tubal endometriosis

Intrauterine contraceptive device

Broad ligament tumours

1026. A patient has failed to have any further dilation after achieving 6 cm. As possible reasons for this secondary arrest of
dilation are explored, you place an intrauterine catheter to calculate the intensity of her contractions which are measured in
Montevideo units. Which of the following is a Montevideo unit?

Number of contractions in 10 minutes

Number of contractions per minute times their intensity

Intensity of any 10 contractions times the time it took for them to occur

Number of contractions in 10 minutes times their average intensity

1027. Which of the following is not a criterion for antenatal diagnosis of Twin-Twin transfusion syndrome?

Oligohydramnios in donor fetus

Dichorionicity.

Hemoglobin difference of >5 g/dL between the two fetuses

Weight difference of >20% between the two fetuses

1028. 26 years old lady with H/o recurrent abortion which of the following investigations you will do to confirm the diagnosis:

PT

BT

Anti Russel viper venom antibodies.

Clot solubility test

1029. Regimen followed in expectant management of placenta previa:

Liley’s method

Crede’s method
 Macafee and Johnson regime.

Brandt-Andrews Method

1030. Recurrent abortion in Ist trimester, investigation of choice:

Karyotyping.

SLE Ab

HIV

TORCH infection

1031. Mc cause of perinatal mortality in twins:

Single fetal demise

Twin-twin transfusion syndrome

Prematurity.

IUGR

1032. The most common association of renal failure in obstetrics is?

PIH

Sepsis

Abruptio placentae

HELLP syndrome

1033. A lady presented to your clinic with a history of recurrent early pregnancy loss. What are the investigations to be ordered:

VDRL

Toxoplasma serology

Hemogram/blood grouping, Blood Sugars.

Rubella screening

1034. Conservative treatments for tubal pregnancy include the following except:

Salpingostomy

Salpingotomy

Salpingectomy.

Resection and anastomosis

1035. 30-year-old primi with 36 weeks of pregnancy with blood pressure 160/110 & urinary albumin is 3+ & platelet count
80000/mm3. What will be the management?

Betamethasone; Labetalol; Urgent LSCS; Labour induction

MgSO4

Salbutamol

indometacyn

1036. Which one of the following casues the greatest risk of ecotpic pregnancy:

Pelvic inflamatory disease

IUD use

Previous ectopic pergnancy.

Previous MTP

1037. Which of the following tumors is not commonly known toincrease size during in pregnancy ?

Glioma

Pituitary adenoma

Meningioma

Neurofibroma

1038. The following test may be abnormal in disseminated intravascular coagulation except:

Prothrombin

Activated partial thromboplastin time

D-timer levels

Clot solubility

1039. Monochorionic monoamniotic twin occurs if division occurs:

Before 24 hours

1-4 days

4-8 days

> 8 days.

1040. If division of fertilized egg takes place in between 5 and 8 days. It would rise to which kind of twin pregnancy:

Monochorionic/monoamniotic
 Monochorionic/diamniotic.

Dichorionic/monoamniotic

Siamese twins

1041. Diagnostic factor for choriocarcinoma is:

Lung metastasis

Hypoplastic trophoblasts

hCG Levels less than 35,000 Miu/mL.

None

1042. Which one of the following is an indication for vaginal delivery in twin pregnancy:

First twin breech and Second twin vertex

First twin vertex and second twin breech; First twin vertex and second twin in transverse lie.

First twin in transverse lie and second twin breech

1043. Which drug is given to prevent HIV transmission from mother to child?

Nevirapine

Lamivudine

Stavudine

Abacavir

1044. According to Hellin’s law chances of twins in pregnancy are:

1 in 60

1 in 70

1 in 80.

1 in 90

1 in 100

1045. Lady with abortus in uterus and dilated open os, is suggestive of:

Missed abortion

Threatened abortion

Complete abortion

Inevitable abortion.
1046. Most characteristic anomaly in infant of a diabetic mother:

Caudal regression.

VSD

Spina bifida

Anencephaly

1047. A G2 P1+0+0 diabetic mother present at 32 weeks pregnancy, there is history of full term fetal demise in last pregnancy.
Her vitals are stable, sugar is controlled and fetus is stable. Which among the following will be the most appropriate
management ?

To induce at 38 weeks

To induce at 40 weeks

Cesarean section at 38 weeks

To wait for spontaneous delivery

1048. The following conditions are associated with molar pregnancy except:

Pregnancy induced hypertension

Thyrotoxicosis

Gestational diabetes.

Hyperemesis gravidarum

1049. Common cause of death in inversion of uterus:

Neurogenic shock

Hemorrhage.

Pulmonary embolism

Infection

1050. A gravida 2 patient with previous LSCS comes at 37 weeks, has BP= 150/100 mm of hg. And on pervaginal examination,
cervix is 50% effaced station-3, os is closed and pelvis is adequate. Protein uria is +1, Most appropriate step at the moment
would be:

Antihypertensive regime and wait for spontaneous labor

Wait and watch

Induce labour

Caesarean section

1051. Most severely affected child in Rh-isoimmunisation patients:

 Rh negative mother with Rh positive in 2nd child

Rh positive mother with Rh negative in 2nd child

Rh positive mother with Rh negative in 1st child

Rh positive mother with Rh positive in 2nd child

1052. Highest risk of ectopic is with:

Progastasert.

Tubectomy

Condoms

CuT

1053. The major contribution of the amniotic fluid after 20 weeks of gestation:

Ultrafiltrate and maternal plasma

Fetal urine

Fetal lung fluid

Fetal skin

1054. The separation of normally situated placenta in a case of multiple pregnancy may be due to the following except:

Increased incidence of toxemia

Sudden escape of liquor following rupture of membranes

Deficiency of vitamin B12

Deficiency of folic acid.

Sudden shrinkage of the uterus following delivery of the first baby

1055. All of the following are risk factors for endometrial hyperplasia, except:

Increased body mass index

Polycystic ovary syndrome

Pregnancy

Immunosupression

1056. A pregnant lady acquires chicken pox 3 days prior to delivey. She delivers by normal vaginal route which of the following
statements is true ?

Both mother and baby are safe

 Give antiviral treatment to mother before delivery

Give antiviral treatment to baby

Baby will develop neonatal varicella syndrome

1057. Most common congenital defect in diabetic mother

Spina bifida

Caudal regression

VSD

Renal agencies

1058. Twin pregnancy predisposes to all except:

Hydramnios

Pregnancy induced hypertension

Malpresentation

Polycythemia

1059. Recurrent abortion seen in all except:

Syphilis

TORCH.

Rh incompatibility

Chromosomal abnormality

1060. Amniotic fluid at 38 weeks in normal pregnancy is:

800 cc

1100 cc

1500 cc

1800 cc

1061. Non-immune hydrops fetalis is due to all except:

Chromosome defect

Alpha thalassemia major

Parvo B – 19 virus

ABO incompatibility
1062. For the treatment of Toxoplasma infection during pregnancy, drug of choice is:

Sulphadiazine

Spiramycin

Pyrimethamine

Clindamycin

1063. What is second stage of peritonitis:

Reactive

Toxic

Terminal

Vascular

1064. Causes of polyhydraminos include:

a.+ Diabetes mellitus; Esophageal atresia; Anencephaly

Preeclampsia

Renal agenesis

1065. Villous pattern is lost in:

Invasive mole

Tubal mole

Hydatidiform mole

Choriocarcinoma.

1066. Mother’s blood grp is Rh-ve. Indirect Coomb’s is +e. The following will be seen in baby:

Anemia; Hydrops fetails

Abnormal umbilical artery waveform deceleration

IUGR

Oligohydramnics

1067. Cervical incompetence is characterized by:

1st trimester abortion

2nd trimester abortion, Premature rupture of membrane, Cerclage operation done.

3 trimester abortion
1068. Stenosis of the left atrioventricular orifice can develop as a result of:

rheumatism

myocardial infarction

chest trauma

infective endocarditis

1069. The width of the common bile duct is normally equal to:

Up to 0.5 cm

0.6-1.0 cm

1.1-1.5cm

1.6-2.0cm

1070. The most common symptom of acute pancreatitis is:

nausea and vomiting

hyperthermia

jaundice

bloating

1071. Conservative treatment of acute intestinal obstruction without surgery is possible with:

inversion

nodulation

obstructive intestinal obstruction

dynamic obstruction

1072. In primary peritonitis, infection of the peritoneum occurs:

with perforation of gastric ulcer

with perforation of the appendix

with adnexitis

by hematogenous route

1073. The fulminant form of sepsis develops in terms of:

1-2 hours

12-24 hours
 1-2 days

5-7 days

1074. In case of occlusion of the abdominal aorta, blood pressure in the legs:

not defined

normal

elevated

reduced

1075. Which factor is most conducive to the development of strangulation obstruction:

eating spicy food

adhesive process in the abdominal cavity

dolichosigma

alcohol intake

1076. Protodiastolic murmur in mitral stenosis occurs due to:

active atrial systole

appearance of atrial fibrillation

increase in pressure gradient "left atrium - left ventricle"

mitral regurgitation

1077. Not typical for peritonitis:

abdominal muscle tension

symptom of Courvoisier

increased heart rate

gas delay

1078. Morphological forms of thyroid cancer are dominated by:

follicular cancer

papillary cancer

adenocarcinoma

1079. What infusion therapy will you prescribe to the patient first of all peritonitis with dehydration?
 10% mannitol solution

reopoliglyukin, polyionic solution

5% glucose solution

0.3% potassium chloride solution

1080. Which is the most common cause of obstructive jaundice?

Cicatricial strictures of the extrahepatic biliary tract

Choledocholithiasis

Cancer of the head of the pancreas

Echinococcus liver

1081. For the diagnosis of acute appendicitis do not apply:

Palpation of the abdominal wall

Clinical blood test

Digital rectal examination

Irrigoscopy

1082. Conservative treatment of acute intestinal obstruction is used only for:

inversion

knotting

intussusceptions

Dynamic obstruction

1083. A manifestation of thyrotoxicosis is not:

Greffe and Mоbius symptom

tachycardia

exophthalmos

enlargement of the thyroid gland

1084. Which imagine is the most informative for the diagnosis of calculous cholecystitis?

Oral cholecystocholangiography

Laparoscopy

Plain x-ray of the abdomen

 Ultrasound

1085. The most common localization of invaginacin is:

Caecum

Ileocecal segment

Ileo-ileal (ilio-iliac) segment

Sigmoid colon

1086. Colonic mechanical obstruction is most often caused by:

Foreign bodies

Gallstones

Malignant tumors

Abdominal adhesions

1087. Which is not a sign of thyrotoxic heart?

atrial fibrillation

cardiodilation

low systolic pressure

high systolic pressure

1088. Which is the main treatment for thyroid cancer?

Х - ray

surgical

chemotherapeutic

immunotherapy

1089. To reduce pressure in the pulmonary circulation, you can use all of the listed drugs, except:

nitroglycerin

pentamin

prednisolone

lasix

1090. What is observed in thyrotoxicosis?

 decrease in pulse pressure

pathological muscle weakness

photophobia

pathological thirst

1091. Which research method will help confirm the diagnosis of acute intestinal obstruction?

X - ray of the abdominal cavity

Laparoscopy

Gastroduodenoscopy

Ultrasound scan of the abdomen

1092. A 19-year-old patient was referred for examination with a presumptive diagnosis of mitral heart disease. Examination
revealed a systolic murmur at the apex of the heart. What method of examination is the most informative for confirming or
excluding the diagnosis of heart disease?

electrocardiography

echocardiography

chest x-ray

blood test for antistreptococcal antibody titers

1093. Which method would you choose to diagnose Douglas abscess space?

Sigmoidoscopy

Laparoscopy

Percussion and auscultation of the abdomen

Digital examination of the rectum

1094. Which of the following congenital heart defects is characterized by systolic murmur throughout the anterior chest wall
with epicenter in the 3rd-4th intercostal space?

atrial septal defect

ventricular septal defect

open ductus arteriosus

aortic coarctation

1095. A patient with diffuse purulent peritonitis was admitted 36 hours after the onset of the disease, his condition is serious.
BP 7O/5O mm Hg. What is your tactic?

emergency operation
 conservative therapy

emergency surgery after 2-6 hours of preparation

carrying out measures to clarify the source of peritonitis and after that urgent operation

1096. What symptom is pathognomonic for left ventricular failure?

swelling of the neck veins

ascites

liver enlargement

orthopnea

1097. Which of the following drugs is a direct positive inotropic agent?

digoxin

sodium nitroprusside

furosemide

verospiron

nifedipine

1098. Peritonitis may be due to the following diseases, except:

perforation of Meckel's diverticulum

Crohn's disease

stenosis of the major duodenal papilla

Richter infringement hernia

1099. Which is the most informative research method for acute intestinal obstruction:

X -ray of the abdominal cavity

fibrocolonoscopy

gastroscopy

angiography

1100. Obstructive intestinal obstruction most often develops with the localization of the tumor:

In the caecum

In the rectum

In the middle third of the transverse colon

 In the sigmoid colon

1101. A 42-year-old patient has a significant shift of the boundaries of relative dullness of the heart to the left, increased apex
beat, a pronounced symptom of systolic trembling in the 2nd intercostal space to the right of the sternum and there same
weakening of the 2nd tone. Which of the following auscultatory phenomen must certainly occur in this patient:

systolic murmur at the apex

diastolic murmur at the apex

systolic murmur over the aorta

diastolic murmur over the pulmonary artery

1102. Which is the most common clinical manifestation of thyrotoxic goiter?

decreased production of thyroid hormone

increased production of thyroid hormone

increased production of pituitary hormones

decreased production of pituitary hormones

1103. All of the following are characteristic of the late stage of peritonitis, except:

Bloating

Hypovolemia

Disappearance of intestinal noises

Increased peristalsis

1104. Since childhood, a 22-year-old man has noticed systolic murmur at the base of hearts. Аrterial pressure 150/100 mmHg.
Chest x-ray: left ventricular enlargement, uneven, jagged lower edges of 5-7 ribs on both sides. Reduced pulsation in the legs.
Diagnosis?

aortic stenosis

atrial septal defect

aortic coarctation

ventricular septal defect

1105. Which of the following factors are the main, determining course of acute peritonitis?

the state of the immune status of the patient and the degree of virulence of microbes

the time of year when the disease occurred

the nature and amount of food consumed by the patient

patient's age
1106. For peritonitis is not typical:

tachycardia

dry tongue

muscle tension in the anterior abdominal wall

diarrhea

1107. What passes in the inguinal canal in men:

The spermatic cord

femoral artery

femoral vein

ilioinguinal nerve

1108. The reactive stage of peritonitis continues:

4-6 hours

24 hours

48 hours

72 hours

1109. Infection of the gallbladder in the development of acute cholecystitis happens in the following way:

Hematogenous

Lymphogenic

Contact

Invasive

1110. An "early" symptom of thyroid cancer?

hardening and enlargement of the gland

pain when swallowing

dysphagia

hoarseness

1111. In which organs are the most common distant metastases of cancer rectum?

in the kidneys

in the lungs
 in the peritoneum

in the liver

1112. Diastolic murmur in mitral stenosis:

radiates to the left axillary region

better auscultated in the position on the right side

better auscultated in the interscapular space

better auscultated in the position on the left side in the exhalation phase

1113. Colon obturation obstruction is most often caused by:

foreign bodies

gallstones

malignant tumors

abdominal adhesions

1114. Intussusception refers to obstruction:

spastic

paralytic

obstructive

strangulation

1115. Feature of the pulse in aortic insufficiency:

extrasystole

atrial fibrillation

small slow

high ambulance

1116. The most reliable sign of stenosis of the left atrioventricular holes is:

enlargement of the left border of the heart

Facies mitrales

the presence of atrial fibrillation

the presence of an "opening click" of the mitral valve

1117. Metastasis is most typical for thyroid cancer:

into the brain

in cervical lymph nodes

to the liver

into the lungs

1118. Which complication is not typical for operations on the thyroid gland?

bleeding

air embolism

fat embolism

tracheal injury

1119. Weakening of the 1st tone is observed, as a rule, with the following defects hearts:

mitral valve insufficiency

tricuspid valve insufficiency

ventricular septal defect

stenosis of the left atrioventricular orifice

1120. The development of the pathological process in acute appendicitis begins:

From the serous cover of the appendix

From the mucosa of the appendix

From the muscle layer of the appendix

From the mucous membrane of the dome of the caecum

1121. The most common cause of peritonitis is:

acute appendicitis

perforated ulcer

salpingitis

strangulation of the small intestine

1122. A 32-year-old patient has a clinic of diffuse purulent peritonitis. He was admitted to the hospital 3 hours after the onset of
the disease. Hemodynamic parameters satisfactory on admission. What is your tactic?

carrying out measures to clarify the source of peritonitis and after that urgent operation
 emergency operation

conservative treatment

emergency surgery after 2-6 hours of preparation

1123. The most typical hemodynamic disorders in mitral stenosis:

increase in end diastolic volume of the left ventricle

increase in cardiac output

increased pressure in the pulmonary capillaries, increased pressure in the left atria

curettage of the uterine cavity

1124. What is the murmur in aortic stenosis?

holosystolic

protosystolic

mesosystolic

presystolic

1125. What myocardial lesion is combined with signs similar to aortic stenosis?

hypertrophic obstructive cardiomyopathy

dilated cardiomyopathy

restrictive cardiomyopathy

Abramov-Fiedler idiopathic myocarditis

1126. The most dangerous complication of acute destructive cholecystitis is:

cirrhosis of the liver.

diffuse peritonitis.

acute pancreatitis.

cicatricial stricture of the common bile duct.

1127. Most often stomach cancer metastasizes to:

lungs

liver

ovaries

bones
1128. With an abscess of the Douglas space, it is shown:

puncture through the abdominal wall

therapeutic enemas

opening through the abdominal wall

puncture, opening and drainage through the rectum

1129. Blood circulation in the mesentery of the intestine is not disturbed in case of:

inversion

obturation

nodulation

invaginations

1130. The operation "appendectomy" in acute appendicitis is contraindicated:

With appendicular infiltrate

Acute myocardial infarction

Pregnancy 36-40 weeks

Nocaine intolerance

Violation of blood clotting

1131. The most common cause of small bowel mechanical obstruction is:

Foreign bodies of the intestinal tract

Gallstones

Tumors of the intestine

Abdominal adhesions

1132. What sign is not typical for aortic insufficiency?

pupillary pulsation

decrease in pulse pressure

fast and high heart rate

high systolic blood pressure

1133. 1. What is not typical for bleeding from the veins of the esophagus and cardia of the stomach:

bloody vomiting
 melena

bradycardia

anemia

1134. Specify the method of the most reliable confirmation of the diagnosis "cancer thyroid gland".

anamnesis

palpation

fine needle biopsy

scanning

1135. Which method is the most informative in the diagnosis of acute appendicitis:

Colonoscopy

Puncture through the posterior fornix of the vagina

ultrasound

Laparoscopy

1136. All signs are characteristic of mitral insufficiency, except:

flapping first tone at the top

systolic murmur at the apex

enlargement of the borders of the heart to the left

decrease in cardiac output

1137. The most informative method for diagnosing perforated ulcers is:

esophagogastroduodenoscopy

Ultrasound

laparocentesis

laparoscopy

1138. Which of the following signs is typical for mitral stenosis?

systolic murmur at the apex of the heart

weakened 1st tone at the top

protodiastolic murmur in the 2nd intercostal space on the right

presystolic murmur at the apex

1139. Choledocholithiasis can lead to the following complications:

Empyema of the gallbladder

Gangrene of the gallbladder

Budd-Chiari Syndrome

Cholangitis, jaundice

1140. Which is the most common complication of strumectomy?

recurrent nerve injury

recurrence of thyrotoxicosis

tetany

hypothyroidism

1141. In case of cardiac tamponade, it is indicated:

pericardial puncture

blood transfusion

diuretics

hemostatic therapy

1142. Which of the symptoms of acute appendicitis is rare in humans advanced age?

Slight pain in the right iliac region

High body temperature

Muscle tension in the right iliac region

Delayed stool

1143. Clinical picture of acute cholangitis is not typical for:

High temperature

Jaundice

Leukocytosis

Unstable loose stools

1144. Which is a radical operation for calculous cholecystitis:

cholecystectomy

Cholecystostomy
 removal of stones from the gallbladder

Internal drainage of the common bile duct

1145. Median laparotomy should be performed in case of:

diffuse peritonitis

local unrestricted peritonitis

Douglas pouch abscess

appendicular infiltrate

1146. How does blood pressure change in aortic insufficiency?

does not change

only systolic rises

only diastolic rises

systolic blood pressure rises and diastolic blood pressure falls

1147. Risk factors for infective endocarditis are all of the following except one:

tooth extraction

venous catheterization

primary pulmonary hypertension

curettage of the uterine cavity

1148. The most common localization of the tumor accompanied by the development acute intestinal obstruction is:

splenic flexure

transverse colon

hepatic flexure

sigmoid colon

1149. A 42-year-old patient suffering from mitral heart disease developed atrial extrasystoles after tonsillitis. What threatens
this violation rhythm?

development of circulatory failure

the appearance of atrial fibrillation

occurrence of coronary insufficiency

all of the above

1150. Pylephlebitis is usually a complication of:

Perforated stomach ulcer

Volvulus of the small intestine

Infarction of the small intestine due to embolism of the superior mesenteric artery

Destructive appendicitis

1151. Volvulus of the small intestine refers to one of the following types of intestinal obstruction:

Obstructive

strangulation

Spastic

Dynamic

1152. Contraindication to emergency appendectomy is:

Appendicular infiltrate

Myocardial infarction

Second half of pregnancy

Diffuse peritonitis

1153. With paralytic ileus, treatment is carried out:

Only conservative

Only operational

Operative in the absence of the effect of conservative

Laparoscopic ileostomy

1154. The most common histological form of cancer:

adenocarcinoma

undifferentiated cancer

squamous cell carcinoma

adenoacanthoma

1155. Invagination refers to obstruction:

spastic

paralytic
 obstructive

mixed

1156. Which is done for stage 2 thyroid cancer?

hemistrumectomy with resection of the isthmus, followed by administration of thyroidin

subtotal resection of the thyroid gland

Crile's operation

extracapsular total strumectomy

1157. Specify the early clinical manifestations of infringement of the small intestine in internal hernias:

diarrhea

collapse

cramping abdominal pain, gas retention

symptoms of peritoneal irritation

1158. Positive venous pulse is:

with aortic stenosis

with mitral valve insufficiency

in pulmonary hypertension of any origin

with tricuspid valve insufficiency

1159. What is not typical for thyrotoxic crisis?

loss of consciousness

Chvostek's symptom

hyperthermia

tachycardia

1160. Which is the main method for diagnosing thyroid cancer?

physical

x-ray

morphological

radioisotope
1161. An 18-year-old patient was sent for examination by the military registration and enlistment office. Developed normally.
Above the base of the heart, a rough systolic noise with an epicenter in the 2 m intercostal space at the right edge of the
sternum, is carried out on carotid arteries. The second tone over the aorta is weakened. Pulse 64 per minute, rhythmic. Hell of
the brachial artery 95/75 mm Hg, on the femoral artery hell 110/90 mmHg. What is your diagnosis?

aortic stenosis

concomitant heart disease

aortic coarctation

ventricular septal defect

1162. The most dangerous manifestation of portal hypertension is:

ascites

bleeding from varicose veins of the esophagus

splenomegaly

hemorrhoids 3-4 stage.

1163. To detect malignant tumors of the thyroid gland is not used:

trial excision

puncture biopsy with a thick needle

trepanbiopsy

determination of the titer of antibodies to the thyroid gland

1164. The main symptoms of peritonitis are everything except:

vomit

stomach ache

bloody stool

stool and gas retention

1165. The complication of choledocholithiasis is:

dropsy of the gallbladder

empyema of the gallbladder

jaundice, cholangitis

chronic active hepatitis

1166. In what type of acute intestinal obstruction are bloody discharges from the rectum observed:
 volvulus of the small intestine

spastic obstruction

intussusception

paralytic ileus

1167. The most common causes of occlusive diseases of the abdominal aorta are:

atherosclerosis

past trauma to the aorta

dysplasia of the walls of the aorta

bacterial endocarditis

1168. To patient with gangrenous cholecystitis is shown:

emergency surgery.

Delayed operation.

conservative treatment.

Operation in the absence of the effect of conservative therapy.

1169. In case of clinical diagnosis of melanoma without morphological verification, it can be started:

surgical treatment.

chemotherapy treatment

radiation treatment

symptomatic

1170. The most useful circulating marker for patients with hepatocellular carcinoma is:

CA 50

Levels of vitamin B 12

CEA

AFP.

1171. Urgent histological examination during surgery for breast neoplasms may not be performed if the diagnosis is confirmed:

clinical data

mammography

morphological cytological examination D ultrasound of the mammary glands.

1172. Effects of interaction of X-ray radiation with atoms of matter:

nuclear reactions

the formation of electron-positron pairs

the formation of recoil protons

electron scattering.

1173. The incidence of squamous cell skin cancer on the background of# the disease (Bowen) is:

almost 100%.

about 50%

15 - 20%

30%

1174. What is the main treatment for breast cancer?

surgical

chemotherapy

radiation therapy

complex treatment.

1175. Which of the following symptoms is not typical for breast cancer?

umbilication

lemon peel

nipple retraction

hyperpigmentation.

1176. Most often, breast cancer metastases to:

bones.

stomach

liver

brain

1177. Which of the following statements relating to adenoviruses is/are correct?

Adenoviral infection is a common cause of upper respiratory tract infection

Adenoviral genetic material consists of double-stranded DNA

 Adenovirus can be produced in large quantity and easily purified

all of above.

1178. Melanoma of the skin refers to tumors:

neuroectodermal nature.

ectodermal nature

mesenchymal nature

mixed nature

1179. Complications of radiation therapy:

local and general.

general

local

baldness

1180. The term "operability" most of all corresponds:

the patient's condition, allowing the operation.

the condition of the patient, allowing you to perform a radical operation

the ability to perform a radical operation

there is no right answer

1181. Breast cancer screening tests include:

self-examination once a month

ultrasound of the mammary glands

mammography.

examination by a mammologist once every 6 months

1182. Morphological verification of malignant neoplasms is:

fluoroscopy

histological examination of the tumor.

ultrasound

CT
1183. Tissue radiosensitivity depends:

on the type of radiation

on the degree of tissue differentiation.

on the time of radiation

from the depth of the tumor

1184. The high incidence of hepatitis B infection in Africa and parts of Asia is thought to be causally associated with increased
incidence of which of the following malignancies?

Hepatocellular carcinoma.

Esophageal cancer

Burkitt’s lymphoma

Gastric carcinoma

1185. The main goal of radical radiation therapy:

summing up the maximum possible dose of radiation

a decrease in the biological activity of tumor cells

induce the death of the most sensitive tumor cells

achieving complete tumor regression.

1186. The primary or local symptoms of lung cancer can include all of the above, except:

cough

hemoptysis

increase in body temperature.

dysphonia

1187. A new marker that has possible utility in the management of patients with non–small-cell lung cancer (NSCLC) is:

Calcitonin

Neuron-specific enolase

CYFRA 21-1.

Glucagon

Chromogranin A.

1188. Which of the following variables best predicts prognosis for patients with a recent diagnosis of cutaneous melanoma and
no clinical evidence of metastatic disease?
 Breslow thickness..

Clark’s level.

Ulceration.

Gender.

Celtic complexion.

1189. The defeat of the papillary layer of the skin in melanoma corresponds to the degree of invasion according to Clark:

II.

III

IV

1190. The most objective information about the local prevalence of the tumor process (stage of the disease) can be obtained:

during the clinical examination of the patient

during X-ray examination

when using endoscopic methods

with pathomorphological examination of a resected (removed) organ with regional lymphatic apparatus.

1191. The basic principle of radiation therapy for malignant neoplasms:

maximum destruction of the tumor

the use of the highest possible doses of radiation with the maximum destruction of the tumor without damaging healthy
tissues

maximum destruction of the tumor with minimal damage to the surrounding healthy tissue.

destruction of the tumor and irradiation of the surrounding tissue to prevent recurrence

1192. For what disease can close-focus X-ray therapy be used?

lung cancer

breast cancer

skin cancer.

prostate cancer

1193. The term "symptomatic therapy" means:

therapy aimed at eliminating the most painful manifestations of the diseaseassociated with neoplasms and complications of
specific therapy.
 therapy aimed at reducing primary tumors

therapy aimed at reducing distant metastases

there is no right answer

1194. Radioactive iodine is used to diagnose tumors:

pancreas

stomach

thyroid.

all answers are correct

1195. Radiotherapy interval is:

the time between courses of tumor irradiation

the difference between the sensitivity of the tumor and the surrounding tissues to ionizing radiation.

the relationship between the sensitivity of surrounding tissues and the tumor to ionizing radiation

the sum of the sensitivity of the surrounding tissues and the tumor to ionizing radiation

1196. Which of the following statements regarding retroviruses is/are correct?

The genetic material contained within a retrovirus is

Retroviruses can be used to transfect both replicating and non-replicating cells

all of Above.

1197. . Intraductal papillomas of the mammary gland can be detected when:

non-contrast mammography

ductography.

large-frame fluorography

ultrasound of the mammary glands

1198. What is commonly understood as the term "single metastases" in metastatic lung lesions - the presence:

one metastasis

from 2 to 4 metastases.

6 to 10 metastases

bargaining chip syndrome

1199. The phenomenon of obstruction in colon cancer is manifested:

intestinal bleeding

persistent abdominal pain

an increase in temperature

intestinal obstruction.

1200. Compliance with the principles of zoning and casing when performing oncological operations is aimed at:

to provide antiblastic

to ensure ablastic.

to maximize the preservation of organ function

ensuring maximum volume

1201. A number of clinical factors have been noted to decrease sensitivity of tumors to the effects of ionizing radiation. Which
of the following is most important in this regard?

Increased tissue vascularity

High tumor mitotic rate

Tissue hypoxia.

Subcutaneous tumor location

1202. Who is not at risk for lung cancer?

villagers.

long-term smokers

patients with COPD

men over the age of 40

1203. Which of the following represent obstacles to the use of retroviruses in therapeutic gene transfer?

Viral receptors may not be present on target cell membranes

For integration, the host cell must undergo mitosis

Virus particles are labile

All of above.

1204. Previous clinical studies with cancer vaccines have:

Clearly demonstrated induction of tumor-specific immune response.

 Repeatedly demonstrated clinical response to large tumor burden.

Not clearly demonstrated induction of tumor-specific immune response..

Not been performed to date.

1205. When bronchoscopy performed in a patient with central lung cancer, you can see a tumor or indirect signs of it:

narrowing

rigidity

looseness of the bronchial wall

all answers are correct.

1206. The Lynch Syndrome is also known as hereditary non-polyposis colorectal cancer. Which of the following is/are features
of this syndrome?

Left sided colon cancers

Autosomal dominant inheritance.

Multiple polyps beginning in adolescence

Multiple cutaneous nevi

1207. Tissue radiosensitivity depends:

on the type of radiation

on the degree of tissue differentiation.

on the time of radiation

from the depth of the tumor

1208. A 65-year-old man is seen two years following right hemicolectomy for a Duke’s B-2 carcinoma of the cecum. Although
asymptomatic, the CEA level has risen four-fold from a value obtained six months previously. Computed tomography reveals a
single, 3 cm lesion in the right hepatic lobe. There is no evidence of extra-hepatic metastatic disease and the patient undergoes
right hepatic lobectomy. Which of the following correctly represents the chance of overall 5 year survival?

15%

33%.

50%

66%

1209. Which serum markers are useful in the management of patients with testicular cancer?

hCG

AFP
 CA 15-3

Two of the above.

None of the above

1210. What morphological forms of lung cancer are distinguished?

squamous cell (45%) - the result of long-term atrophy and anaplasia of the bronchial epithelium

small-celled (20 - 25%) - the most aggressive. It is characterized by rapid metastasis. Often occurs in young people

adenocarcinoma (20-25%) - more common in women and younger patients

all answers are correct.

1211. A marker for the diagnosis of pancreatic cancer is:

CA 15-3.

CA 19-9..

Alphafetoprotein (AFP).

Carcinoembryonic antigen (CEA).

CYFRA 21-1.

1212. It has the least effect on long-term results of surgical treatment of malignant diseases.

type of tumor growth:

the presence of metastases in regional lymph nodes

the presence of distant metastases

the patient's age.

1213. The main method for diagnosing central benign lung tumors is:

fibrobronchoscopy with biopsy.

tomography

radiography

bronchography

1214. The decisive role in the increase in the incidence of lung cancer belongs to

smoking:.

occupational hazards

air pollution
 increased life expectancy

1215. Patient H., 49 years old, underwent surgery: oophorectomy for ovarian tumor. The conclusion of the histological study:
the metastatic nature of the tumor. What cancers most often metastasize to the ovaries?

stomach cancer

pancreatic cancer

breast cancer

1) and 3) are true.

1216. A risk factor for breast cancer is:

the presence of breast cancer in a cousin

mastalgia

the presence of a gene mutation BRCA-1 / BRCA-2 *.

early onset of menopause

1217. Education in the mammary gland is round, mobile, dense, painless with clear, even edges. What kind of education is being
described?

malignant tumor of the breast

breast cyst

focal adenosis

fibroadenoma.

1218. In patients with colorectal cancer the serum CEA level is a clinically useful measure for all reasons except:

Prognosis

Detection of recurrence

Guiding second-look operations

Following treatment response

Early diagnosis.

1219. Early radiation reactions occur:

only during the course of radiation therapy

only after the end of radiation therapy within 100 days

only for radioresistant tumors

during the course of radiation therapy and within 90 days after its completion.
1220. The presence of satellites on the skin around the melanoma indicates:

local extent of the tumor

the presence of additional nevoid formations

tumor recurrence

for dissemination of the tumor process.

1221. A circulating marker that may be useful in the management of patients with any neuroendocrine tumor is:

Chromogranin A

Neuron-specific enolase

hCG

Two of the above.

None of the above

1222. Which of the following statements is/are true of the epidemiology and etiology of melanoma?

Most patients are diagnosed after age 60 years

Skin color has no association with risk of melanoma

Sun exposure is the only risk factor for melanoma

The per capita incidence of melanoma is highest in Australia.

1223. Primary diagnosis of cancer at the level of the general health care network provides:

establishing the presence of a malignant tumor.

morphological verification

assessment of the stage of the disease

assessment of the prevalence of the process according to the TNM system

1224. Resistance of tumors to multiple chemotherapeutic agents is often due to the MDR gene. This gene encodes a protein
that acts by which of the following mechanisms?

As a transmembrane efflux pump for chemotherapeutic agents.

As a DNA repair molecule

As an isoform of superoxide dismutase

As a membrane stabilizer

1225. Ways (method) of obtaining material for morphological confirmation of the diagnosis in bronchological examination are:
 washout and aspirate from the bronchus

smears-prints

punctate

all of the above.

1226. Bronchography is most appropriate in patients:

peripheral benign lung tumors.

central benign lung tumors

in all cases

with atypical forms of lung cancer

1227. What disease should be used for differential diagnosis in case of suspected breast cancer?

acute mastitis

nodular mastopathy.

breast tuberculosis

intercostal neuralgia

1228. All listed organs and tissues have a high degree of radiosensitivity, except:

lymphoid tissue

skin.

thymus

ovaries and testes

bone marrow

1229. Chemotherapy refers to:

systemic methods of exposure to the body.

regional methods of exposure to the body

local methods of exposure to the body

all answers are correct

1230. Workers exposed to asbestos are at increased risk for which of the following tumors?

Thoracic mesothelioma

Bladder carcinoma
 Laryngeal carcinoma

All of above.

1231. Hemophilia B has been treated in a pre-clinical model by gene transfer for which deficient clotting factor?

Factor II

Factor VII

Factor IX.

Factor X

1232. Which of the following tumors may cause elevated CEA levels?

Breast cancer

Colorectal cancer

Gastric cancer

Lung cancer

All of the above.

1233. The surgical method refers to:

systemic methods of exposure to the body

regional methods of exposure to the body

local methods of exposure to the body.

all answers are correct

1234. The leading treatment for skin melanoma is:

surgical treatment.

radiation therapy

combined treatment

chemotherapy

1235. The palliative course of radiation therapy has the main goal:

prolong the life of the patient.

heal the patient

relieve severe symptoms of the disease

for preoperative preparation

1236. The most common complication that requires alteration of planned chemotherapy regimens is which of the following?

Pulmonary fibrosis

Gastrointestinal ulceration

Hematologic suppression.

Hepatotoxicity

1237. Ionization of an atom is called:

the transition of an electron to another shell

hard collision with another atom

emission of ionizing radiation by it

snatching out one or more electrons.

1238. The basic principle of radiation therapy for malignant neoplasms:

maximum destruction of the tumor

the use of the highest possible doses of radiation with the maximum destruction of the tumor without damaging healthy
tissues

maximum destruction of the tumor with minimal damage to the surrounding healthy tissue.

destruction of the tumor and irradiation of the surrounding tissue to prevent recurrence

1239. Determination of hormonal receptors is necessary:

for typing the histological nature of the tumor

to determine the level of hormones in the body

to determine the appropriateness of hormone therapy.

all answers are correct

1240. Basal cell carcinoma is most often localized on the skin:

Face.

upper limbs

lower limbs D torso

1241. The operation to remove the parasternal lymph nodes is indicated when the tumor is located in:

upper-outer quadrant

upper-inner quadrant
 lower-inner quadrant

the correct answers are 2 and 4.

1242. What examination is more expedient to perform in case of bloody discharge from the mammary gland in the first place?

histological examination

cytological examination of the discharge.

mammography

trepan biopsy

1243. Which tumor marker is useful for the management of patients with breast cancer?

CA 125

Inhibin

CA 19-9

CA 15-3.

CEA

1244. Radiomodifying agents are agents that:

increase the damage to the tumor

weaken tumor damage

weaken radiation responses of healthy cells.

enhance radiation responses of healthy cells

1245. Radioisotope research in clinical oncology is used:

to visualize the primary tumor

to determine the prevalence of a malignant process

to assess the functional state of some internal organs

all answers are correct.

1246. Which of the following statements regarding alpha-1-antitrypsin deficiency is/are correct?

Alpha-1-antitrypsin is a plasma elastase inhibitor

Most homozygous patients develop chronic obstructive pulmonary

Intracellular accumulation of abnormal protein occurs in hepatocytes

all of Above.
1247. Cytotoxic T cells (CTL) are capable of recognizing:

Peptide antigens associated with major histocompatibility complex (MHC) molecules

Membrane-bound antigens

Cytoplasmic antigens

Nuclear antigens

All of the above.

1248. For what disease can close-focus X-ray therapy be used:

lung cancer

breast cancer

skin cancer.

prostate cancer

1249. Radioresistant are all listed organs and tissues, except:

small intestine.

muscle tissue

bone tissue in adults

liver

1250. The main radiobiological paradox is:

the correspondence between the amount of absorbed energy and the degree of reactions of a biological object B attachment
of non-ionizing radiation

different radiosensitivity of tissues

a large discrepancy between the insignificant amount of absorbed energy and the extreme severity of the reactions of a
biological object.

1251. Which of the following is NOT typical for breast cancer?

bloody nipple discharge

the symptom of "lemon peel"

the "site" symptom

a mobile formation in the mammary gland with a clear, even contour.

1252. The presence of which marker is a significant poor prognosis variable for patients with breast cancer:

CEA
 C-erb B-2.

AFP

Human chorionic gonadotropin (hCG)

1253. Prolonged and intense sun exposure can lead to:

skin cancer.

lung cancer

stomach cancer

breast cancer

1254. Patients that have acquired immunodeficiency syndrome are at increased risk for which of the following neoplasms?

Colorectal cancer

Meningioma

Kaposi’s sarcoma.

Hepatocellular carcinoma

Esophageal carcinoma

1255. Favorite localization of skin cancer:

on the limbs

on the torso.

on the periorbital zone

at the sites of transition of the skin into the mucous membrane #

1256. Clinical signs of skin melanoma:

hyperpigmentation

asymmetry of nevoid formation

hair loss with hairy nevus

all of the above.

1257. The main goal of symptomatic surgery is:

removal of the organ affected by the tumor

removal of regional lymphatic tumor metastases

elimination of complications that can lead the patient to death.

 all answers are correct

1258. DNA viruses have been implicated as etiologic agents in several human tumors. Evidence for a causative role exists for
which of the following neoplasms?

Burkitt’s lymphoma.

Testicular carcinoma

Osteogenci sarcoma

Esophageal carcinoma

1259. Radical course of radiation therapy pursues the main goal:

prolong the life of the patient

heal the patient.

relieve severe symptoms of the disease

electron scattering

1260. Adoptive immunotherapy with lymphokine activated killer cells (LAK) and tumor infiltrate (TIL) cells are characterized by:

Nonspecific stimulation of effector cells.

Expansion ex vivo of large numbers of lymphocytes.

Infusion with interleukin 2 (IL-2).

Significant toxicity at high doses.

All of the above..

1261. The patient has itching in the area of the age spot. A spot of intense black color, 0.3 × 0.5 cm in size, rises under the skin.
Weeping on the surface. Your tactics:

dynamic observation

puncture biopsy

taking fingerprints.

complete removal

1262. Complications of radiation therapy:

local and general.

general

local

baldness
1263. When a chemotherapeutic agent is stated to have caused a partial response this implies what degree of reduction in
measurable tumor volume?

0–9%

10–29%

30–49%

50–99%.

1264. The combined method of radiation therapy includes:

two or more types of radiation treatment.

radiation and drug treatment

radiation and surgical treatment

improve wound healing

1265. Brachytherapy involves the delivery of radiation therapy locally via specially designed catheters placed in direct
apposition to the treated tissue. The most common radioisotope used in this application is which of the following?

125I.

14C

3H

34P

1266. Transformation of a pigmented nevus into malignant melanoma may appear:

an uneven zone of hyperemia around the nevus

increased or uneven pigmentation

ulceration, bleeding, enlargement

all of the above.

1267. The most serious long-term side effect of bleomycin therapy is which of the following?

Pulmonary fibrosis.

Cataract formation

Cardiomyopathy

Aplastic anemia

1268. The goals of preoperative radiation therapy by conventional fractionation are all of the above, except:

destruction of poorly differentiated tumor cells

 transfer of the tumor from an inoperable state to an operable one C causing lethal damage to subclinical foci of tumor growth

improve wound healing.

1269. Early radiation reactions occur:

only during the course of radiation therapy

only after the end of radiation therapy within 100 days C only for radioresistant tumors.

during the course of radiation therapy and within 90 days after its completion.

1270. Mask use in operation theatre:

Protects patient from getting infection

Protects the doctor.

Protects both doctor and patient

None is protected

Should not be used

1271. What are the main advantages of endotracheal anesthesia over mask anesthesia:

reducing the toxic effect of the anesthetic

ease of control of the depth of anesthesia

prevention of language sinking.

prevention of aspiration

1272. What is the duration of the treatment of the surgeon's hands with 0.5% alcohol solution of chlorhexidine digluconate?

1 min

2-3 minutes.

4-5 min

6-7 minutes

1273. What stage of ether anesthesia is divided into levels?

stage 1

stage 2

stage 3.

all stages
1274. Methods for cold sterilization of medical devices include:

autoclaving

immersion of the product in a 6% solution of hydrogen peroxide.

immersion of the product in a 5% sodium chloride solution

exposure of the product to -radiation

1275. Choose from the following methods of local anesthesia:

anesthesia with cooling

infiltration anesthesia.

anesthesia with fluorothane

anesthesia using muscle relaxants

1276. Which of the following is the correct sequential order of the phases of healing?

Remodeling, inflammation, hemostasis, and repair

Inflammation, hemostasis, proliferation, and maturation

Hemostasis, inflammation, repair, and remodeling.

Inflammation, maturation, proliferation, and hemostasis

1277. What is sterilization?

destruction of pathogens of infectious diseases

destruction of pathogens of purulent infection

treatment of medical equipment by wiping twice with a solution of a drug with an antimicrobial effect

complete destruction of microflora on medical products.

1278. Permitted shelf life of sterile dressings in bix?

12 hours

24 hours

36 hours

48 hours.

1279. Which of the listed antibiotics are aminoglycosides?

ampicillin

gentamicin
 kefzol.

vibramycin

1280. Identify which of the following terms does not describe a type of wound?

Infused.

Incised

Confused

Puncture

1281. For sterilization of instruments, all of the listed methods can be used except:

autoclaving

immersion in 6% hydrogen peroxide solution

immersion in 1% deoxone-1 solution

boiling.

1282. For what stage of ether anesthesia are facial reddening, dilated pupils, increased respiration, increased blood pressure,
increased muscle tone typical?

stage 1

stage 2.

stage 3

stage 4

1283. Synthetic suture material in a medical institution can be sterilized:

boiling

immersion in 96% ethyl alcohol

immersion in a chloramine solution

in an air sterilizer.

1284. What is Bakkal processing of the surgical field?

treatment of the operating field with 96% ethyl alcohol

treatment of the operating field with demicide

treatment of the operating field with brilliant green.

treatment of the operating field with an aqueous solution of chlorhexidine bigluconate

1285. Select the complications possible with mask anesthesia:

a sharp drop in blood pressure

vomiting

tongue sinking

regurgitation.

1286. Choose ways to deal with clinical death (as a complication of anesthesia):

the introduction of cardiac glycosides

the introduction of hormones

artificial ventilation of the lungs

electrical defibrillation of the heart.

1287. A man suffered much injures from a road traffic accident. The process that is important in minimizing his blood loss when
various injured body structures is called

Homeostasis

Hemostasis.

Hemolysis

Erythropoiesis

1288. Which of the following activities can be attributed to mechanical antiseptics?

performing surgical debridement.

drainage of the wound with double-lumen drainage

washing the wound with sodium hypochlorite solution

the use of ultrasonic cavitation

1289. Ditilin belongs to the group:

sedatives

analgesics

antipsychotics

muscle relaxants.

1290. Nonionizing radiation and ionizing radiation are sterilization methods mainly used in hospitals. Ultraviolet radiation is one
example of nonionizing radiation, name the ionizing radiation?

Infrared
 X-rays and gamma rays.

Halogens

Ethylene oxide

1291. What is the correct sequence of actions for sterilizing catgut according to Sitkovsky?

washing, defatting in ether, soaking in a solution of potassium iodide, hanging in a jar, holding for 3-5 days

washing, defatting in ether, wiping with mercuric chloride, twisting into rings, hanging in a jar with crystalline iodine at the
bottom, holding for 3-5 days

washing, defatting in ether, wiping with mercuric chloride, soaking in a solution of potassium iodide, twisting into rings,
hanging in a jar with crystalline iodine at the bottom, holding for 3-5 days

washing, defatting in ether, wiping with mercuric chloride, soaking in a solution of potassium iodide, twisting into rings,
hanging in a jar with crystalline iodine at the bottom, holding for 3-5. days, bacteriological control.

1292. Which of the listed biological antiseptic drugs are immunostimulating?

staphylococcal toxoid.

lysozyme

polyvalent bacteriophage

sandoglobulin

1293. Which of the following options for treating the surgeon's hands can be qualified as the classic Spasokukotsky-Kochergin
method?

washing hands under a tap with soap with a sterile napkin, treatment with 0.5% alcohol solution of chlorhexidine bigluconate

washing hands under the tap with soap for 3 minutes, drying with a sterile swab, processing with 96% alcohol solution for 10
minutes, lubricating the nail beds and folds of the skin of the fingers with 5% tincture of iodine

washing hands with running water and soap for 1 minute, drying with a sterile napkin, processing in a basin with a solution of
first-rate solution for 1 minute

washing hands with a 0.5% solution of ammonia in two basins for 3 minutes, drying with a sterile napkin, processing with a
96% alcohol solution for 5 minutes, lubricating the nail beds and folds of the skin of the fingers with 5% tincture of iodine.

1294. Basic anesthesia is used:

for quick entry into anesthesia.

to eliminate emotional reactions before the operation

for muscle relaxation

to control vital body functions during surgery

1295. Which of the following products can be used both as antiseptics and as disinfectants?
 hydrogen peroxide.

sodium benzoate

chloramine

chlorocine

1296. What type of antiseptic is the enzymatic removal of necrotic tissue from a wound?

mechanical antiseptic

biological antiseptic.

chemical antiseptic

physical antiseptic

1297. Highlight acceptable methods of sterilizing metal staples:

boiling for 30 minutes

sterilization in a steam sterilizer

sterilization in a dry heat sterilizer

immersion for 2 hours in a 2% chloramine solution.

1298. In surgical profession, a patient has been infected by HIV positive doctor during which procedure:

Endoscopy

Dental extraction.

Abdominal surgery

Cardiac transplant

Renal transplant

1299. What complications are possible with endotracheal anesthesia?

a sharp decrease in blood pressure

regurgitation.

tongue sinking

aspiration of foreign bodies

1300. Which of the following methods of controlling the sterility of the dressing (instruments) and the sterilization regime in an
autoclave are direct ones?

the use of substances with a specific melting point

 the use of paper tape impregnated with a substance that changes color upon reaching a certain temperature

bacterial sowing from dressings and linen.

thermometry

1301. The most effective and least toxic means of reducing the risk of wound infection is:

Cephalexin 50-75 mg/kg/d

Normal saline irrigation 50-100 ml/cm of wound.

Hydrogen peroxide skin preparation

Povidone-iodine scrub

1302. For what purpose is the airway used during anesthesia?

prevention of aspiration of foreign bodies

prevention of laryngospasm

prevention of language sinking

prevention of bronchospasm.

1303. Which of the following are used for intravenous anesthesia?

ketamine

kefzol

relanium

lidocaine.

1304. The two major layers of the skin are:

Epidermis and subdermis

Epidermis and dermis.

Dermis and subcutaneous

Dermal and fatty layer

1305. Which of the named scientists is the founder of antiseptics?

Bergman

Pasteur

Lister.

Pelekhin
1306. Which of the following ''water purification'' methods is most common in the rural parts of the countries like India, Nepal,
and Africa that is also a simple, reliable, and economical method?

Solar disinfection.

Chlorination

Advanced purifiers

Salt

1307. What method of using antimicrobial drugs is a surface antiseptic?

intravenous administration

injecting tissue around the wound

application to the wound.

intramuscular administration

1308. Anti-thrombin III inactivates which coagulation factor?

XIIa

Xa

IIa

IXa

All of the above.

1309. The means of biological antiseptics include:

sodium chloride

vicasol

aminocaproic acid.

tetanus toxoid

1310. Shaving hair on the skin in the area of the operating field should be done:

on the day of surgery.

upon admission of the patient to the surgical department

in the evening, on the eve of the operation

24 hours before surgery

1311. Specialized surgical intervention is most likely to be needed for lacerations involving:
 The vermilion border

Fingertip/nailbed with suspected phalangeal fracture

Large forehead flap

Medial portion of eyelid margin.

1312. How to properly treat a surgeon's hands with a first round?

washing with soap and water (without a brush), washing with a first wash in a basin with napkins for 1 min, drying with a
sterile napkin.

washing with soap and water, wiping dry, washing with a first wash in a basin for 3 minutes

first wash in a basin for 1 min, wash with soap and water, wipe dry

washing with soap and water, wiping dry, wiping with a napkin with first wash 1 min

1313. Muscle relaxants include:

arduan

ditilin

listenone

sombrevin.

1314. In order to enhance local anesthesia and its prolongation, add to the novocaine solution:

adrenaline.

muscle relaxants

antibiotics

polyglucin

1315. Which of the following best describes the process of 'Disinfection'?

The elimination of all forms of microorganisms and bacterial spores

The elimination of all forms of bacterial spores

The reduction or elimination of microorganisms and bacterial spores

The reduction or elimination of many microorganisms and some bacterial spores.

1316. Epinephrine-containing anesthetics are contraindicated in:

Vermilion border

Extensive scalp laceration with active bleeding

 Narrow flap from pinna.

Thigh laceration

1317. Which of the listed substances are suitable for the treatment of the surgical field?

iodonate.

iodopyrone

hydrogen peroxide

mercuric chloride

1318. What drugs are more often used for induction of anesthesia?

thiopental sodium

hexenal

ether

fentanyl.

1319. What is the skin pretreatment before an emergency surgery?

washing the skin with soap and water

in shaving hair

in wrapping the site of the upcoming operation with a sterile diaper

in the treatment of leather with a 0.5% solution of ammonia.

1320. Methods for sterilization of medical instruments and products that are not subject to heat treatment:

sterilization with formalin vapor.

gas sterilization

immersion in sodium bicarbonate solution

immersion in the first round

1321. Introductory anesthesia is used:

for muscle relaxation

to prevent hypotension

to enhance the effect of maintenance anesthesia

for quick lulling of the patient without arousal stage.

1322. Muscle relaxants for anesthesia are used:

to create arterial hypotension

to relax the skeletal muscles

to relax smooth muscles.

to prevent aspiration

1323. Permissible shelf life of sterile dressings in bags?

12 hours

24 hours.

36 hours

72 hours

1324. What means are used for neuroleptoanalgesia?

droperidol

sibazon

chlorpromazine.

ditylin

1325. Chemical antiseptics used to treat the hands of a surgeon must have the following properties:

have a strong antiseptic effect

be harmless to the surgeon's skin

have anti-inflammatory properties

have a local antiallergic effect.

1326. Which of the following will NOT decrease the pain of anesthetic infiltration?:

Counter-irritation

Alkalinization of lidocaine with addition of 8.4% sodium bicarbonate in 1:9 ratio bicarb:lido)

Chilling anesthetic fluids.

Subdermal (vs. intrademal) infiltration

1327. When should a surgeon wear sterile gloves in preparation for surgery?

before hand treatment

after hand treatment

 after putting on the robe.

before putting on the robe

1328. Name the chemical in a 'bleach' (a disinfectant) used to eliminate bacteria, fungi, and viruses?

Sodium chloride

Ethylene oxide

Sodium hypochlorite.

Ethyl alcohol

1329. Longest phase of wound healing

Inflamatory

Haemostasis

Regeneration

Remodeling.

1330. Synthetic suture material in a hospital setting is usually sterilized:

boiling

in a steam sterilizer at a temperature of 110 ° C

in a steam sterilizer at a temperature of 120 ° C.

in a steam sterilizer at a temperature of 132 ° C

1331. Which of the following activities are required when preparing a patient for surgery and anesthesia?

the appointment of hormonal drugs

the appointment of sedative therapy

emptying the gastrointestinal tract

the appointment of cardiac funds.

1332. What sample is used to control the complete removal of blood from instruments that have undergone pre-sterilization
treatment?

phenolphthaleic

benzidine.

biological

orthostatic
1333. For what stage of ether anesthesia is the complication in the form of vomiting typical?

1 stage

2 stages.

3 stages

all stages

1334. All the products below are made of heat-sensitive materials, except for:

silicone drainage for draining the abdominal cavity

reusable rubber gloves

Billroth's hemostatic forceps.

Safar air duct

1335. Which of the listed substances are local anesthetics?

propanidide

novocaine

calypsol

trimecaine.

1336. Who first used nitrous oxide for pain relief?

Morton

Jackson

Simpson

Wells.

1337. What is the correct meaning of the term known as the 'terminal sterilization process?

The initial sterilization of the raw materials for the product

The final sterilization of the healthcare products and medical devices.

The decontamination of the environmental bioburden

The aseptic technique used during the manufacturing process of the product

1338. Determine the correct sequence of actions when performing endotracheal anesthesia:

the introduction of muscle relaxants

induction anesthesia
 the use of ganglion blockers

the use of maintenance anesthesia.

1339. Which of the following substances are used to test sterility in dry heat sterilization?

magnesium sulfate

chloramphenicol

sulfur

benzoic acid.

1340. What temperature conditions are recommended for dry heat sterilization?

150 ° C

160 ° C

170 ° C

180 ° C.

1341. For anesthesia with a face mask, you can use:

fentanyl

ditilin

fluorothane

ketamine (calypsol).

1342. An implantation infection in the operation area develops when microbes enter the wound:

through the hands of the surgeon

from tweezers when dressing

with gauze turunda

from the staples of the stapler.

1343. Dry bandage is done:

to stop blood flow.

in order to stop

to apply pressure to the wound

to prevent wound
1344. What is the duration of the first treatment of the surgeon's hands?

1 min.

2 minutes

3 minutes

4 minutes

1345. Which of the following drugs can be used to process hands of the surgeon?

chlorhexidine bigluconate

sodium bicarbonate

degmin

eurocept.

1346. What method of using antimicrobial drugs is a surface antiseptic?

intravenous administration

injecting tissue around the wound

application to the wound.

intramuscular administration

1347. List the goals (all) that are pursued in preparing the surgeon's hands for the operation:

removing dirt from the skin of the hands

removing bacteria from the skin of the hands

the destruction of bacteria on the skin of the hands

protection of the skin of the hands from microtraumas.

1348. What drugs can be used to prevent candidiasis that develops as a result of prolonged use of antibiotics?

furazolido

levorin

sulfalene

metronidazole.

1349. Identify the temperature and time period commonly used for the hot air oven while sterilizing glassware in the laboratory

180 degrees Celcius for 30 mins

63 degrees Celcius for 30 mins

 121 degrees Celcius for 15 mins

160 degrees Celcius for 45 mins.

1350. What gases are used to sterilize medical devices?

carbon monoxide

carbon dioxide combined with carbon monoxide

acetylene

ethylene oxide.

1351. What modern additional methods of physical antiseptics are advisable to use during the surgical treatment of a purulent
wound?

wound treatment with 3% hydrogen peroxide

washing the wound with a 5% aqueous solution of chlorhexidine

ultrasonic cavitation.

excision of the infiltrate at the bottom of the wound

1352. ______ is an injury that results from heat, chemical agents or radioarion.

Wound

Burn.

Fit

Heart attack

1353. What temperature conditions are recommended for sterilization with steam under pressure?

100 ° C

110 ° C

120 ° C.

128 ° C

1354. Select from the following agents those recommended for chemical sterilization of instruments:

ethyl alcohol

6% hydrogen peroxide solution

0.5% potassium permanganate solution.

1% deoxone-1 solution
1355. What is the correct sequence for processing individual parts of the surgeon's hands?

palmar, dorsum, nail beds of each finger, interdigital spaces of one hand, then the other, palms and back of the hands,
forearms.

forearms, hands, fingers with interdigital spaces

hands, fingers with interdigital spaces, forearms

the back, palmar surfaces of each finger, interdigital spaces, the upper third of the forearm, the lower two-thirds of the forearm,
wrists from the back and palmar surfaces

palmar surfaces of each finger, palms, back surfaces of each finger, back of the hands, forearms

1356. Joseph Lister first introduced the use of antiseptics in hospitals, what is the name of the chemical he used for the
antisepsis process?

Ethyl alcohol

Carbolic acid.

Hydrogen peroxide

Chlorohexidine

1357. At what stage of ether anesthesia is analgesia first noted?

stage 1.

stage 2

stage 3

stage 4

1358. Which of the listed methods of treating the surgeon's hands are modern?

Brun's method

the Furbringer method

treatment with pervomur (preparation C-4).

treatment with a solution of chlorhexidine bigluconate

1359. What is disinfection?

destruction of spore-forming bacteria

destruction of viruses, bacteria and protozoa

destruction of anaerobic bacteria

destruction of pathogenic microflora.

1360. What is it called when a child gets an injury from a fall while running and her injury is external?

scratch.

twitch

breach

sprain

1361. Which of the following activities are required when carrying out preliminary preparation of the operating field?

general hygienic bath

transfer of the patient to the intensive care unit.

change of linen

skin treatment with a 5% alcohol solution of iodine with the imposition of a sterile diaper

1362. After primary survey excludes life/limb-threatening injury, the initial management priority for a wound requiring suture
repair is:

Sterile prep

Radiographic evaluation

Local anesthesia.

Irrigation

1363. In a patient receiving 24 units of blood over 2 hours, the complication most likely to be seen would be:

hypercalcaemia

increased oxygen uptake in the lungs

coagulopathy.

hypokalaemia

1364. Chemical burns are caused by____.

Heat

Solids

Acids.

Nitrogen gas

1365. Post-translational modification occurs with:

factor V
 von Willebrand factor

factor XII

protein C Post-translational modification – think of Vit K.

1366. The most appropriate location for a non-absorbable suture (such as nylon or polypropylene) is:

Forehead of a vigorous toddler

Dermal (buried) layer of complex facial laceration

Intraoral repair in 4-year-old child

Scalp laceration in adolescent.

1367. All the following are considered toxic to wounded tissues EXCEPT:

Hydrogen peroxide

Isopropyl (rubbing) alcohol

Chlorhexidine

Povidone-iodine solution.

1368. Which of the following is the recommended heat temperature and time period for the moist heat sterilization method
used in an autoclave?

180 c for 5 minutes

121 c for 15 minutes.

126 c for 3 minutes

160 c for 45 minutes

1369. A 45-year-old woman comes to the physician because of right foot pain for 3 months. She has a burning sensation in the
plantar area between the third and fourth metatarsals that radiates to the third and fourth digits. She is an account executive
and wears high heels to work every day. Vital signs are within normal limits. Examination of the right lower extremity shows
intact skin. The posterior tibial and dorsalis pedis pulses are palpable. When pressure is applied to the sole of the foot between
the metatarsal heads the patient feels pain and there is an audible click. Tapping on the affected area causes pain that shoots
into the third and fourth digits. Which of the following is the most likely diagnosis?

First metatarsophalangeal joint sprain

Third metatarsal stress fracture

Metatarsal osteochondrosis

Intermetatarsal neuroma.

Ganglion cyst

1370. A 53-year-old woman comes to the physician because of a 3-month history of intermittent severe left neck, shoulder, and
arm pain and paresthesias of the left hand. The pain radiates to the radial aspect of her left forearm, thumb, and index finger.
She first noticed her symptoms after helping a friend set up a canopy tent. There is no family history of serious illness. She
appears healthy. Vital signs are within normal limits. When the patient extends and rotates her head to the left and downward
pressure is applied, she reports paresthesias along the radial aspect of her left forearm and thumb. There is weakness when
extending the left wrist against resistance. The brachioradialis reflex is 1+ on the left and 2+ on the right. The radial pulse is
palpable bilaterally. The remainder of the examination shows no abnormalities. Which of the following is the most likely
diagnosis?

Carpal tunnel syndrome

C3-C4 spondylosis

Syringomyelia

Thoracic outlet syndrome

C5-C6 disk herniation.

1371. A 21-year-old woman is brought to the emergency department following a motor vehicle collision. She has significant
pain and weakness in her right arm and hand. Physical examination shows multiple ecchymoses and tenderness in the right
upper extremity. She is able to make a fist, but there is marked decrease in grip strength. An x-ray of the right upper extremity
shows a midshaft humerus fracture. Which of the following structures is most likely injured?

Median nerve

Radial nerve.

Radial artery

Brachial artery

Ulnar nerve

1372. A 23-year-old man is brought to the emergency department 30 minutes after being tackled while playing football. He has
severe right shoulder pain and is unable to move the shoulder. He also reports nausea but has not vomited. There is no personal
or family history of serious illness. His only medication is a multivitamin. On physical examination, the right upper extremity is
externally rotated and slightly abducted. Palpation of the right shoulder joint shows tenderness and an empty glenoid fossa. The
right humeral head is palpated below the coracoid process. The left upper extremity appears normal. Radial pulses are palpable
bilaterally. An x-ray of the right shoulder is performed. The physician administers analgesia and obtains informed consent for
closed reduction. This patient is at greatest risk for which of the following complications?

Paralysis of the wrist flexors and intrinsic hand muscles

Decreased sensation of the dorsum of thumb, index, and middle fingers

Decreased sensation of the lateral upper arm.

Inability to flex the thumb, index, and middle fingers

Decreased sensation of the lateral lower arm

1373. A 13-year-old boy is brought to the emergency department by his mother because of a 2-hour history of ankle pain after
tripping during basketball practice. He is not able to walk or put weight on his left foot. Medical history is unremarkable. He
takes no medications. His mother has a history of early-onset osteoporosis. The patient appears to be in distress. His
temperature is 37.0°C (98.6°F), pulse is 98/min, respirations are 12/min, and blood pressure is 130/68 mm Hg. Physical
examination of the left lower extremity shows marked swelling of the left ankle. There is severe tenderness to palpation over
the left medial malleolus. Movement of the left ankle is limited by pain. Posterior tibial and dorsalis pedis pulses are palpable.
Neurologic examination shows no abnormalities. A plain anteroposterior x-ray of the left ankle is shown. This patient is at
greatest risk of developing which of the following complications?
 Limb-length discrepancy.

Superficial peroneal nerve injury

Complex regional pain syndrome

Osteomyelitis

Recurrent fracture

1374. A 45-year-old man is brought to the emergency department following a motor vehicle collision. He reports right hip pain
and numbness along the right thigh. Physical examination shows decreased sensation to light touch over a small area of the
medial thigh. X-rays of the pelvis show a displaced pelvic ring fracture. Further evaluation of this patient is most likely to show
which of the following findings?

Sensory deficit of the dorsal foot

Impaired hip extension

Impaired dorsiflexion of the foot

Impaired extension of the knee

Impaired adduction of the hip.

1375. A 42-year-old woman comes to the physician because of pain in her left ankle for 2 days. The pain is worse at night and
with exercise. Five days ago, the patient was diagnosed with Salmonella gastroenteritis and started on ciprofloxacin. She has
ulcerative colitis, hypertension, and hypercholesterolemia. She has smoked two packs of cigarettes daily for 25 ears and drinks
two to three beers daily. Current medications include mesalamine, hydrochlorothiazide, and simvastatin. She is 158 cm (5 ft 2
in) tall and weighs 74 kg (164 lb); BMI is 30 kg/m?. Her temperature is 36.7°C (98°F), pulse is 75/min, and blood pressure is
138/85 mm Hg. There is tenderness above the left posterior calcaneus and mild swelling. There is normal range of motion of
the left ankle with both active and passive movement. Calf squeeze does not elicit plantar flexion. Which of the following is the
most likely underlying mechanism for this patient's symptoms?

Adverse medication effect.

Recent bacterial gastroenteritis

Underlying inflammatory bowel disease

Crystal formation within the joint

Bacterial seeding of the joint

1376. A 46-year-old woman is brought to the emergency department because of pain and swelling in her right ankle after falling
from her horse. She did not lose consciousness. She appears to be in acute distress. Her temperature is 36.7°C (98°F), pulse is
80/min, and blood pressure is 138/76 mm Hg. She is oriented to person, place, and time. The pupils are equal and reactive to
light. Examination shows an abrasion on the left knee. The right ankle is swollen and tender; range of motion is limited by pain.
Peripheral pulses and sensation are intact over the right foot. A lateral x-ray of the right ankle shows a fracture of the posterior
malleolus. An anteroposterior x-ray of the right ankle is shown. In addition to analgesia, which of the following is the most
appropriate management?

Closed reduction and casting

Bed rest and cooling

Limited weight bearing with use of crutches

 Closed reduction and percutaneous pinning

Open reduction and internal fixation.

1377. A 23-year-old man is brought to the physician because of increasing pain and swelling of the left knee for 2 months. The
pain has awoken him from his sleep on multiple occasions. He tried ibuprofen but has had no relief of his symptoms. There is
no family or personal history of serious illness. Vital signs are within normal limits. On examination, the left knee is mildly
swollen and tender; range of motion is limited by pain. An x-ray of the left knee is shown. Which of the following is the most
likely diagnosis?

Osteosarcoma

Chondrosarcoma

Fibrous dysplasia

Enchondroma

Osteoclastoma.

1378. A 44-year-old woman comes to the physician for the evaluation of right knee pain for 1 week. The pain began after the
patient twisted her knee during basketball practice. At the time of the injury, she felt a popping sensation and her knee became
swollen over the next few hours. The pain is exacerbated by walking up or down stairs and worsens throughout the day. She also
reports occasional locking of the knee. She has been taking acetaminophen during the past week, but the pain is worse today.
Her mother has rheumatoid arthritis. The patient is 155 cm (4 ft 11 in) tall and weighs 75 kg (165 lb); BMI is 33 kg/m2. Vital
signs are within normal limits. Examination shows effusion of the right knee; range of motion is limited by pain. There is medial
joint line tenderness. Knee extension with rotation results in an audible snap. Further evaluation is most likely to show which of
the following?

Joint space narrowing and sclerotic changes on x-ray

Hyperintense line in the meniscus on MRI.

Medial joint laxity on examination

Anterior tibial translation on examination

Erosions and synovial hyperplasia on MRI

1379. A 15-year-old boy is brought to the emergency department 30 minutes after the sudden onset of left groin pain. The pain
started when he rotated his upper body to throw his opponent on the ground during a wrestling competition at school. He has no
history of hip or knee injuries. His past medical history is significant for asthma, for which he takes daily inhaled
corticosteroids. He does not smoke cigarettes but reports occasionally drinking beer and smoking marijuana with some of his
friends after school. He is at the 65th percentile for height, 90th percentile for weight, and 69th percentile for BMI. On physical
examination, the left leg is slightly flexed at the hip and externally rotated. Range of motion of the left hip is decreased. There is
tenderness over the groin and medial aspect of the upper thigh that worsens with hip flexion and rotation. An x-ray of the hip is
shown. Which of the following is the most likely diagnosis?

Fracture of trochanter minor.

Avascular necrosis of the femoral head

Femoral neck fracture

Adductor strain

Slipped capital femoral epiphysis

1380. An 18-year-old woman is brought to the emergency department by her coach 30 minutes after injuring her left knee while
playing field hockey. She was tackled from the left side and has been unable to bear weight on her left leg since the accident.
She fears the left knee may be unstable upon standing. There is no personal or family history of serious illness. The patient
appears uncomfortable. Vital signs are within normal limits. Examination shows a swollen and tender left knee; range of motion
is limited by pain. The medial joint line is tender to touch. The patient's hip is slightly flexed and abducted, and the knee is
slightly flexed while the patient is in the supine position. Gentle valgus stress is applied across the left knee and medial joint
laxity is noted. The remainder of the examination shows no further abnormalities. Which of the following is the most likely
diagnosis?

Posterior cruciate ligament injury

Medial meniscus injury

Anterior cruciate ligament injury

Lateral collateral ligament injury

Medial collateral ligament injury.

Lateral meniscus injury

1381. A 56-year-old man comes to the physician because of lower back pain for the past 2 weeks. The pain is stabbing and
shooting in quality and radiates down the backs of his legs. It began when he was lifting a bag of cement at work. The pain has
been getting worse, and he has started to notice occasional numbness and clumsiness while walking. He has hypertension and
peripheral artery disease. Medications include hydrochlorothiazide and aspirin. His temperature is 37°C (98.6°F), pulse is
82/min, and blood pressure is 133/92 mm Hg. Peripheral pulses are palpable in all four extremities. Neurological examination
shows 5/5 strength in the upper extremities and 3/5 strength in bilateral foot dorsiflexion. Sensation to light touch is diminished
bilaterally over the lateral thigh area and the inner side of the lower legs. Passive raising of either the right or left leg causes
pain radiating down the ipsilateral leg. Which of the following is the most appropriate next step in management?

X-ray of the lumbar spine

Erythrocyte sedimentation rate

MRI of the lumbar spine.

CT scan of the abdomen

Therapeutic exercise regimen

1382. A 29-year-old man comes to the physician because of a 3-day history of a swollen right knee. Over the past 6 weeks, he
has had painful episodes affecting the right knee and the left elbow. He previously had a rash, which subsided 2 months ago. He
lives in Connecticut and works as a landscaper. He is sexually active with one female partner and uses condoms consistently.
His temperature is 37.8°C (100.0°F), pulse is 90/min, respirations are 12/min, and blood pressure is 110/75 mm Hg. Physical
examination shows a tender and warm right knee; range of motion is limited by pain. The remainder of the examination shows
no abnormalities. His hematocrit is 44%, leukocyte count is 10,300/mm3, and platelet count is 145,000/mm3. Serum electrolyte
concentrations are within normal limits. Arthrocentesis of the right knee is performed and the synovial fluid appears cloudy.
Gram stain is negative. Analysis of the synovial fluid shows a leukocyte count of 27,000/mm3 and 80% neutrophils. Which of
the following is the most likely diagnosis?

Lyme arthritis.

Osteoarthritis

Rheumatoid arthritis

Gonococcal arthritis
1383. A 12-year-old girl is brought to the physician by her mother because of a 2-day history of high fever and swelling of the
left ankle and knee. She had a sore throat 3 weeks ago. There is no family history of serious illness. Her immunizations are up-
to-date. She developed an episode of breathlessness and generalized rash when she received dicloxacillin for a skin infection 2
years ago. She appears ill. Her temperature is 38.8°C (102.3°F), pulse is 87/min, and blood pressure is 98/62 mm Hg.
Examination shows swelling and tenderness of the left ankle and knee; range of motion is limited. Lungs are clear to
auscultation. A grade 3/6 holosystolic murmur is heard best at the apex. Abdominal examination shows no abnormalities.
Which of the following is the most appropriate pharmacotherapy?

Vancomycin

Clarithromycin.

High-dose glucocorticoids

Amoxicillin

Doxycycline

1384. A 52-vear-old woman comes to the office because of a 3-month history of worsening pain in her right knee. The pain is
exacerbated when she climbs the stairs to her apartment on the 4th floor. Treatment with ibuprofen has provided moderate pain
relief. Medical history is notable for type 2 diabetes mellitus controlled with metformin. She has smoked 4-5 cigarettes daily for
20 years. She is 165 cm (5 ft 4 in) tall and weighs 84 kg (185 Ib); BMI is 31 kg/m2. Vital signs are within normal limits.
Examination of the right knee shows tenderness to palpation on the right upper medial tibia; there is no swelling. Knee
extension with passive external rotation and valgus stress does not cause pain. There is no joint instability when gentle valgus
stress is applied across the knee. Examination of the left knee shows no abnormalities. X-ray of the right knee shows
osteophyte formation and narrowing of the joint space. Which of the following is the most appropriate next step in
management?

Bursal fluid aspiration

Quadriceps-strengthening exercises.

Glucocorticoid injections

MRI of the knee

Knee orthosis and crutches

1385. A 26-year-old medical student comes to the physician for a chest x-ray to rule out active pulmonary tuberculosis. He
needs a medical and radiological report before starting a medical internship in South Africa in 6 weeks. He says he feels well.
He has no history of serious illness. He has smoked 1 pack of cigarettes daily for the past 6 years. He does not drink alcohol. He
is 190 cm (6 ft 3 in) tall and weighs 75 kg (165 lbs); BMI is 20.8 kg/m7. His temperature is 37.0°C (98.6°F), pulse is 80/min,
respirations are 18/min, and blood pressure is 128/89 mm Hg. The lungs are clear to auscultation. Cardiac examination shows
no abnormalities. The x-ray of the chest shows a small pneumothorax (rim of < 2 cm) between the upper left lung margin and
the chest wall. Which of the following is the most appropriate next step in management of this patient?

Video-assisted thoracoscopic surgery

Emergent needle thoracostomy

Observation and follow-up x-ray.

Immediate intubation and assisted ventilation

CT of the chest

1386. A 35-year-old man comes to the physician because of a 3-month history of intermittent right lateral hip pain that radiates
to the thigh. Climbing stairs and lying on his right side aggravates the pain. Examination shows tenderness to palpation over the
upper lateral part of the right thigh. There is no swelling. When the patient is asked to resist passive adduction of the right leg,
tenderness is noted. An x-ray of the pelvis shows no abnormalities. Which of the following structures is the most likely source
of this patient's pain?

Iliotibial band

Acetabulum

Lateral femoral cutaneous nerve

Lumbar nerve roots

Greater trochanter.

1387. A 5-year-old boy is brought to the physician because of a 5-week history of pain in his left thigh. The mother reports that
her son fell from a ladder while playing with friends about a month and a half ago. He had a runny nose 3 weeks ago. He has no
history of serious illness. He has reached all developmental milestones for his age. His immunizations are up-to-date. His 7-
year-old brother has asthma. The patient is at 60th percentile for height and 65th percentile for weight. He appears healthy. His
temperature is 37.1°C (98.8°F), pulse is 88/min, respirations are 17/min, and blood pressure is 110/70 mm Hg. Examination
shows a mild left-sided antalgic gait. The left groin is tender to palpation; abduction and internal rotation are limited by pain.
The remainder of the physical examination shows no abnormalities. His hemoglobin concentration is 13.3 g/dL, leukocyte count
is 8,800/mm3, and platelet count is 230,000/mm3. An x-ray of the pelvis shows a left femoral epiphysis that is smaller than the
right with widening of the medial joint space on the left. The femoral head shows little discernible damage. Which of the
following is the most appropriate next step in management?

Femoral osteotomy

Casting and bracing

Femoral head pinning

Limited weight bearing and physical therapy.

1388. A 69-year-old woman comes to the emergency department because of a 3-hour history of pain in her left wrist. She was
cleaning a table when she slipped forward and fell onto a flexed hand. Medical history is remarkable for hypertension,
hypercholesterolemia, and osteoporosis. Current medications include perindopril, pitavastatin, and alendronate. She has
smoked one pack of cigarettes daily for 50 years. Examination shows warmth, tenderness, and edema of the left wrist. Range of
motion is decreased due to pain. An X-ray series of the left arm shows multiple fragmentations at the distal radioulnar joint and
an intraarticular oblique fracture with volar displacement of the distal fragment of the radius. Which of the following is the most
appropriate next step in management?

Internal fixation with intramedullary nailing

Sling and swathe splint

Closed reduction with percutaneous pinning

Open reduction internal fixation.

Hanging-arm cast

1389. A previously healthy 18-year-old army recruit is brought to a military treatment facility because of a 3-week history of
right foot pain. He recently started basic infantry training and has been running several kilometers daily. Initially, the pain only
occurred while running, but now it is also present at rest. The pain is located diffusely over the right forefoot. Vital signs are
within normal range. Examination shows mild swelling over the distal right forefoot. Pressing the metatarsal of the third right
toe results in pain. He walks with an antalgic gait. The remainder of the examination shows no abnormalities. An x-ray of the
right foot shows a slight loss of cortical density and callus formation at the third metatarsal shaft. Which of the following is the
most appropriate next step in management?
 Rest and acetaminophen.

Bone biopsy

Ultrasonography

Technetium bone scan

Cast immobilization

1390. A 25-year-old man comes to the emergency department because of acute onset left knee pain. The pain started while
playing basketball after suddenly hearing a popping sound. He has been unable to run since this incident. He has exercise-
induced asthma and allergic rhinitis. His only medication is a salbutamol inhaler. The patient appears healthy and well-
nourished. His temperature is 37°C (98.6°F), pulse is 67/min, and blood pressure is 120/80 mm Hg. Examination of the left knee
shows lateral joint line tenderness. Total knee extension is not possible and a clicking sound is heard when the knee is extended
and internally rotated. An x-ray of the left knee shows no abnormalities. Which of the following is the most appropriate next step
in management?

MRI scan of the knee.

Reassurance and follow-up

Open meniscal repair

Arthroscopy

Arthrocentesis

1391. A 24-year-old man is brought to the emergency department because of severe left shoulder pain following a fall onto his
left shoulder while skiing. He took 400 mg of ibuprofen on his way to the emergency department. He appears in acute distress.
His temperature is 37.0°C (98.6°F), pulse is 85/min, respirations are 14/min, and blood pressure is 115/78 mm Hg. Examination
of the left shoulder shows a visibly elevated left clavicle with tenderness and crepitus on palpation. Left shoulder active and
passive range of motion are limited by pain. The radial pulses are palpable, and there is no loss of sensation to light touch in the
left arm, hand, or shoulder. An x-ray of the left shoulder is shown. Which of the following is the most appropriate next step in the
management of this patient?

Bed rest, ice, and ibuprofen intake

CT scan of the chest and left shoulder

Physical therapy with restricted range of motion

Simple shoulder sling for 4-6 weeks

Open reduction and internal fixation.

1392. A 28-year-old woman comes to the physician because of numbness and weakness in her right hand for the past 4 weeks.
During this time, she has also had intermittent pain in her right arm for which treatment with ibuprofen has provided some relief.
She is a professional tennis player but has not been able to practice because her symptoms get worse when she swings the
racquet overhead. She does not smoke cigarettes, drink alcohol, or use illicit drugs. Her only medication is a vitamin
supplement. Her temperature is 37.0°C (98.6°F), pulse is 76/min, and blood pressure is 110/73 mm Hg. Physical examination of
the right hand shows decreased sensation to light touch in the 4th and 5th fingers. Repeated opening and closing of the hands
with the arms raised above the shoulder causes pain and a sensation of heaviness in the right arm. Percussion over the right
medial epicondyle of the humerus does not reproduce the symptoms. Which of the following is the most appropriate next step
in management?

Upper trunk decompression

 Epidural glucocorticoid injection

Elbow immobilization at night

Volar splinting

Physical therapy.

1393. A 27-year-old soldier stationed in Libya sustains a shrapnel injury during an attack, causing a traumatic above-elbow
amputation. The resulting arterial bleed is managed with a tourniquet prior to transport to the military treatment facility. On
arrival, he is alert and oriented to person, place, and time. His armor and clothing are removed. His pulse is 145/min,
respirations are 28/min, and blood pressure is 95/52 mm Hg. Pulmonary examination shows symmetric chest rise. The lungs
are clear to auscultation. Abdominal examination shows no abnormalities. There are multiple shrapnel wounds over the upper
and lower extremities. A tourniquet is in place around the right upper extremity; the right proximal forearm has been amputated.
One large-bore intravenous catheter is placed in the left antecubital fossa. Despite multiple attempts, medical staff is unable to
establish additional intravenous access. Which of the following is the most appropriate next step in management?

Irrigate the shrapnel wounds

Establish central venous access

Replace the tourniquet with a pressure dressing

Establish intraosseous access.

Perform endotracheal intubation

1394. A 52-year-old man comes to the physician because of right shoulder pain that began after he repainted his house 1 week
ago. Physical examination shows right subacromial tenderness. The pain is reproduced when the patient is asked to abduct the
shoulder against resistance with the arm flexed forward by 30° and the thumb pointing downwards. The tendon of which of the
following muscles is most likely to be injured in this patient?

Supraspinatus.

Subscapularis

Infraspinatus

Teres minor

Deltoid

1395. A 24-year-old man comes to the physician because of severe lower back pain for the past 2 days. The pain is constant
and nonradiating, and he describes it as 7 out of 10 in intensity. The pain began after he helped a friend move into a new
apartment. He has a history of intravenous heroin use. He takes no medications. His temperature is 37°C (98.6°F), pulse is
98/min, and blood pressure is 128/90 mm Hg. Examination shows old track marks on the cubital fossae bilaterally. His lumbar
paraspinal muscles are firm and tense on palpation. There is no midline spinal tenderness. Flexing the hip and extending the
knee while raising the leg to 70° does not cause any pain. Sensation is not impaired. Which of the following is the most
appropriate next step in management?

Epidural glucocorticoid injection

Bed rest only

Analgesia and regular activity.

MRI of the spine

 X-ray of the spine

1396. A 14-year-old boy is brought to the physician for the evaluation of back pain for the past 6 months. The pain is worse with
exercise and when reclining. He has not had any trauma to the back or any previous problems with his joints. He has no history
of serious illness. He attends high school and is on the swim team. He also states that he lifts weights on a regular basis. His
father has a disk herniation. Palpation of the spinous processes at the lumbosacral area shows that two adjacent vertebrae are
displaced and are at different levels. Muscle strength is normal. Sensation to pinprick and light touch is intact throughout. When
the patient is asked to walk, a waddling gait is noted. Passive raising of either the right or left leg causes pain radiating down
the ipsilateral leg. Which of the following is the most likely diagnosis?

Ankylosing spondylitis

Spondylolisthesis.

Scheuermann disease

Facet joint syndrome

Disk herniation

1397. A 22-year-old man who is on active duty in the US army sustains a stab wound to his chest during a military attack. He is
brought to the combat medic by his unit for a primary survey. The soldier reports shortness of breath. He is alert and oriented to
time, place, and person. His pulse is 99/min, respirations are 32/min, and blood pressure is 112/72 mm Hg. Examination shows
a 2-cm wound at the left fourth intercostal space at the midclavicular line. Bubbling of blood is seen with each respiration at the
wound site. There is no jugular venous distention. There is hyperresonance to percussion and decreased breath sounds on the
left side. The trachea is at the midline. Which of the following is the most appropriate next step in management?

Emergency thoracotomy

Partially occlusive dressing.

Emergency pericardiocentesis

Emergency echocardiography

Needle thoracostomy

1398. A 26-year-old woman comes to the physician because of increasing pain and swelling in her right foot for the past 2
weeks. Initially, the pain was intermittent but it is now constant and she describes it as 8 out of 10 in intensity. She has not had
any trauma to the foot or any previous problems with her joints. The pain has not allowed her to continue training for an
upcoming marathon. Her only medication is an oral contraceptive. She is a model and has to regularly wear stilettos for fashion
shows. She appears healthy. Vital signs are within normal limits. Examination shows swelling of the right forefoot. There is
tenderness to palpation over the fifth metatarsal shaft. Pushing the fifth toe inwards produces pain. The remainder of the
examination shows no abnormalities. Which of the following is the most likely diagnosis?

Turf toe

Morton's neuroma

Acute osteomyelitis

Stress fracture.

Plantar fasciitis

1399. A 35-year-old woman is brought to the emergency department 30 minutes after she was rescued from a burning
apartment. She was trapped in the apartment for about 20 minutes. On arrival, the patient is awake but confused. She has a
Glasgow Coma Score of 12. Her pulse is 116/min, respirations are 20/min, and blood pressure is 104/68 mm Hg. Pulse oximetry
on room air shows an oxygen saturation of 94%. Examination shows multiple partial-thickness burns over the chest, back, and
bilateral upper extremities, and full-thickness burns over the face. There is singeing of her nasal hair and eyebrows. Lungs are
clear to auscultation. The most appropriate next step in management is to decrease this patient's risk for which of the
following?

Carbon monoxide poisoning

Stress ulcer

Disseminated bacterial infection

Volume overload

Upper airway obstruction.

1400. A previously healthy 25-year-old man comes to the emergency department because of a 1-hour history of wrist pain. He
was playing football when he was tackled from behind and fell forward onto his outstretched right hand with his wrist extended.
Examination shows a tender, soft tissue swelling of his right hand; range of motion is limited by pain. An x-ray series of the right
arm is shown. Which of the following is the most likely diagnosis?

Galeazzi fracture

Colles fracture.

Boxer's fracture

Monteggia fracture

Scaphoid fracture

1401. A 34-year-old man comes to the physician because of increasing lower back and neck pain for the past 7 months. The
pain is worse in the morning and improves when he plays basketball. He has noticed shortness of breath while playing for the
past 2 months. He is sexually active with two female partners and uses condoms inconsistently. He appears lethargic. His vital
signs are within normal limits. Examination of the back shows tenderness over the sacroiliac joints. Range of motion is limited
by pain. The lungs are clear to auscultation. Chest expansion is decreased on full inspiration. His leukocyte count is
14,000/mm3 and erythrocyte sedimentation rate is 84 mm/h. An x-ray of the spine shows erosion and sclerosis of the sacroiliac
joints and loss of spinal lordosis. Further evaluation of this patient is most likely to show which of the following?

Paresthesia over the anterolateral part of the thigh

Hyperextension of the proximal interphalangeal joints with flexion of the distal inter-phalangeal joints

Nail pitting and separation of the nail from the nailbed

Tenderness at the Achilles tendon insertion site.

Ulnar deviation of the fingers bilaterally

1402. A 7-year-old boy is brought to the emergency department by his mother 1 hour after falling off his bike and landing head-
first on the pavement. His mother says that he did not lose consciousness but has been agitated and complaining about a
headache since the event. He has no history of serious illness and takes no medications. His temperature is 37.1°C (98.7°F),
pulse is 115/min, respirations are 20/min, and blood pressure is 100/65 mm Hg. There is a large bruise on the anterior scalp
and several superficial abrasions on both hands and knees. Examination, including neurologic examination, shows no other
abnormalities. A noncontrast CT scan of the head shows a nondepressed linear skull fracture with a 2-mm separation. Which of
the following is the most appropriate next step in management?

Inpatient observation.
 Discharge home

Contact child protective services

MRI of the brain

CT angiography

1403. A 16-year-old girl comes to the physician because of left wrist pain and swelling for 5 hours. She fell on an outstretched
hand while playing basketball. She ignored it initially as she thought it was just a bruise, but the pain and swelling worsened
throughout the day. The analgesic spray she used did not provide adequate relief. There is no family history of serious illness.
Her only medication is an oral contraceptive pill. Her immunizations are up-to-date. She appears anxious. Her temperature is
37.1°C (98.8°F), pulse is 88/min, and blood pressure is 118/72 mm Hg. Examination shows a swollen and tender left wrist;
range of motion is limited. The anatomical snuffbox is tender to palpation. The grip strength of the left hand is decreased. The
thumb can be opposed toward the other fingers. Finkelstein test is negative. X-rays of the wrist show no abnormalities. Which of
the following is the most appropriate next step in management?

Open reduction and internal fixation

Corticosteroid injections

Styloidectomy

Thumb spica cast and repeat x-ravs in 2 weeks.

Rest, ice, and repeat x-rays in 2 weeks

1404. An 11-year-old girl is brought to the emergency department 1 hour after falling from her bicycle. The girl was racing with
her cousin when she lost control and fell onto her right side. She has nausea and severe pain in the right shoulder. She is in
acute distress. Her temperature is 37.0°C (98.6°F), pulse is 85/min, respirations are 15/min, and blood pressure is 135/85 mm
Hg. Examination shows swelling and tenderness over the right clavicle and pain exacerbated by movement; range of motion is
limited. The skin over the clavicle is intact. The radial pulse in the right arm is intact. Sensory examination of the right upper
limb shows no abnormalities. An x-ray of the chest is shown. In addition to analgesia, which of the following is the most
appropriate next step in management for this patient's shoulder?

Perform tension banding

Apply a clavicular plate

Apply a shoulder spica cast

Apply a simple shoulder sling.

Obtain an MRI of the right shoulder

1405. A 4-year-old girl is brought to the emergency department after a fall from her bed on her outstretched hand 1 hour ago.
Her mother says that she has been inconsolable since. Vital signs are within normal limits. Examination of the left forearm
reveals a mild swelling distally. Her radial arm pulses are strong and symmetric. X-rays of the left forearm and wrist is shown.
Which of the following is the most appropriate next step in management?

Soft elastic bandage only

Percutaneous pinning and casting

Open reduction and internal fixation

Casting only.
 Closed reduction and splinting

1406. A 12-year-old boy is brought to the physician because of a 6-day history of gradually worsening right knee pain. The pain
is exacerbated by movement and kneeling. There is no pain at rest and no history of trauma to the knee. He is concerned
because his soccer tryouts are in a few days. Vital signs are within normal limits. Examination shows mild swelling and
tenderness to palpation of the right anterior, superior tibia. Extension of the right knee against resistance reproduces the knee
pain; flexion is limited by pain. There is no local erythema or effusion of the right knee. A lateral view of an x-ray of his right
knee is shown. Which of the following is the most likely underlying cause of this patient's symptoms?

Impingement of the infrapatellar fat pad

Inflammation of the infrapatellar bursa

Osteoid osteoma of the tibia

Chondromalacia patellae

Traction apophysitis of the tibial tubercle.

1407. An 8-year-old girl is brought to the physician for a well-child examination. Since the age of 2 years, she has had multiple
fractures after minor trauma. During the past year, she has fractured the left humerus and right clavicle after falls. Her father
also has a history of recurrent fractures. She is at the 5th percentile for height and 20th percentile for weight. Vital signs are
within normal limits. Physical examination shows increased convexity of the thoracic spine. Forward bend test demonstrates
asymmetry of the thoracolumbar region. There is a curvature of the tibias bilaterally, and the left leg is 2 cm longer than the
right. There is increased mobility of the joints of the upper and lower extremities. Which of the following is the most likely
additional finding?

Dislocated lens

Hearing impairment.

Widely spaced permanent teeth

Cerebral berry aneurysm

Prominence of the costochondral junctions

1408. Two weeks after undergoing below-knee amputation of the left leg, a 25-year-old woman comes to the physician because
of several episodes of sharp, shooting, and burning pain in her left lower leg for the past 3 days. She is in the military reserve
and was involved in active combat 2 weeks ago, during which she sustained multiple gunshot wounds to her left lower leg
resulting in irreversible limb ischemia. She is currently taking oral paracetamol, which has provided minimal pain relief. The
patient has a history of bronchial asthma for which she uses an albuterol inhaler. Temperature is 37.3°C (99.1°F), pulse is
78/min, and blood pressure is 123/75 mm Hg. Physical examination of the residual limb shows mild erythema and warmth of
the overlying skin with discrete, nonpurulent fluid draining from the suture, and mild tenderness to palpation. Muscle strength in
the hip and upper leg is normal bilaterally. Sensation to pain and temperature is normal in the left upper leg. Which of the
following is the most appropriate next step in management?

Surgical revision

Ibuprofen therapy

Spinal cord stimulation

Oxycodone therapy

Gabapentin therapy.
1409. A 42-year-old woman comes to the physician because of increasing pain in her right hip for 2 months. The pain is
intermittent, presenting at the lateral side of the hip and radiating towards the thigh. It is aggravated while climbing stairs or
lying on the right side. Two weeks ago, the patient was treated with a course of oral prednisone for exacerbation of asthma. Her
current medications include formoterol-budesonide and albuterol inhalers. Vital signs are within normal limits. Examination
shows tenderness to palpation over the upper lateral part of the right thigh. There is no swelling. The patient is placed in the left
lateral decubitus position. Abducting the extended right leg against the physician's resistance reproduces the pain. The
remainder of the examination shows no abnormalities. An x-ray of the pelvis shows no abnormalities. Which of the following is
the most likely diagnosis?

Greater trochanteric pain syndrome.

Femoroacetabular impingement

Meralgia paresthetica

Iliotibial band syndrome

Osteoarthritis of the hip

1410. A 51-year-old man comes to the physician because of a 3-day history of worsening right calf and heel pain. The pain
started suddenly during a run that was part of an exercise program for weight loss, which he started 4 weeks ago. Since the
onset of pain, he has mainly stayed at home to rest his leg. He has hypertension and chronic bacterial prostatitis. He drinks one
to two beers daily and does not smoke cigarettes. His medications are hydrochlorothiazide and levofloxacin. One week ago, he
returned from a business trip to Australia. He is 183 cm (6 ft 0 in) tall and weighs 100 kg (220 Ib); BMI is 30 kg/m?. Vital signs
are within normal limits. Physical examination of the right leg shows swelling and tenderness to palpation of the posterior distal
calf and the posterior heel. There is no plantar flexion when squeezing the calf while the patient is in the prone position.
Compression of the medial and lateral aspects of the heel does not elicit pain. Examination of the left leg shows no
abnormalities. Which of the following is the most likely diagnosis?

Retrocalcaneal bursitis

Deep vein thrombosis

Achilles tendon rupture.

Calcaneal apophysitis

1411. A 28-year-old man comes to the physician because of a 3-month history of pain in his left shoulder. He is physically
active and plays baseball twice a week. The pain is reproduced when the shoulder is externally rotated against resistance. Injury
of which of the following tendons is most likely in this patient?

Teres major

Pectoralis major

Infraspinatus.

Supraspinatus

Subscapularis

1412. A 49-year-old man comes to the physician because of severe, shooting pain in his lower back for the past 2 weeks. The
pain radiates down the back of both legs and started after he lifted a concrete manhole cover from the ground. Physical
examination shows decreased sensation to light touch bilaterally over the lateral thigh area and lateral calf. Patellar reflex is
decreased on both sides. The passive raising of either the right or left leg beyond 30 degrees triggers a shooting pain down the
leg past the knee. Which of the following is the most likely underlying cause of this patient's current condition?

Involuntary contraction of the paraspinal muscles

 Inflammatory degeneration of the spine

Compromised integrity of the vertebral body

Displacement of the nucleus pulposus.

Inflammatory reaction in the epidural space

1413. A 36-year-old woman comes to the physician because of new-onset limping. For the past 2 weeks, she has had a
tendency to trip over her left foot unless she lifts her left leg higher while walking. She has not had any trauma to the leg. She
works as a flight attendant and wears compression stockings to work. Her vital signs are within normal limits. Physical
examination shows weakness of left foot dorsiflexion against minimal resistance. There is reduced sensation to light touch over
the dorsum of the left foot, including the web space between the 1st and 2nd digit. Further evaluation is most likely to show
which of the following?

Decreased ankle jerk reflex

Normal foot eversion

Normal foot inversion.

Decreased patellar reflex

Weak knee flexion

1414. A 19-year-old man comes to the emergency department because of right wrist pain and swelling 2 hours after falling on
an outstretched hand while playing softball. The pain worsened when he attempted to pitch after the fall. He has eczema and
type 1 diabetes mellitus. Current medications include insulin and topical clobetasol. He appears uncomfortable. Examination
shows multiple lichenified lesions over his forearms. The right wrist is swollen and tender; range of motion is limited by pain.
There is tenderness to palpation in the area between the tendons of the abductor pollicis longus, extensor pollicis brevis, and
extensor pollicis longs muscle. The thumb can be opposed actively toward the other fingers. Muscle strength of the right hand
is decreased. Which of the following is the most likely diagnosis?

Colles fracture

Transscaphoid perilunate dislocation

Trapezium fracture

Scaphoid fracture.

De Ouervain tenosynovitis

1415. A 45-year-old man comes to the physician for evaluation of limited mobility of his right hand for 1 year. The patient states
he has had difficulty actively extending his right 4th and 5th fingers, and despite stretching exercises, his symptoms have
progressed. He has type 2 diabetes mellitus. He has been working as a mason for over 20 years. His father had similar
symptoms and was treated surgically. The patient has smoked one pack of cigarettes daily for 25 years and drinks 2-3 beers
every day after work. His only medication is metformin. Vital signs are within normal limits. Physical examination shows skin
puckering near the proximal flexor crease. There are several painless palmar nodules adjacent to the distal palmar crease.
Active and passive extension of the 4th and 5th digits of the right hand is limited. Which of the following is the most likely
underlying mechanism of this patient's symptoms?

Palmar fibromatosis.

Osteoarthritis

Ganglion cyst
 Ulnar nerve lesion

Tendon sheath tumor

1416. A 17-year-old boy is brought to the emergency department after being stabbed with a knife during an altercation.
Physical examination shows a 4-cm stab wound on the right lateral border of the T1 spinous process. An MRI of the spinal cord
shows damage to the area of the right lateral corticospinal tract at the level of T1. Further evaluation will most likely show which
of the following findings?

Absence of left-sided proprioception below T1

Absence of right-sided temperature sensation below T1

Presence of left-sided Babinski sign

Absence of left-sided fine touch sensation below T1

Absence of right-sided motor function below T1.

1417. A 15-year-old boy is brought to the physician by his mother because of a 2-month history of pain in his left hip. The pain
started suddenly and has worsened over the past 2 weeks. The pain radiates down the thigh and is aggravated by movement. He
had a fall while cycling around a month ago. He had a urinary tract infection 3 months ago that resolved with trimethoprim-
sulfamethoxazole. There is no family history of serious illness. His immunizations are up-to-date. He is 165 cm (5 ft 5 in) tall
and weighs 85 kg (187 lb); BMI is 31 kg/m2. His temperature is 37.5°C (99.5°F), pulse is 65/min, and blood pressure is 104/70
mm Hg. Examination shows an antalgic gait. The left groin is tender to palpation, and internal rotation is limited due to pain.
Flexing the hip causes external rotation and abduction. His leukocyte count is 9800/mm3, and his erythrocyte sedimentation
rate is 12 mm/h. An x-ray of the pelvis is shown. Which of the following is the most appropriate next step in management?

Conservative management

Long leg cast

Intravenous antibiotic therapy

Surgical pinning of femoral head.

Intraarticular lidocaine

1418. A 4670-g (10-Ib 5-oz) male newborn is delivered at term to a 26-year-old woman after prolonged labor. Apgar scores are
9 and 9 at 1 and 5 minutes. Examination in the delivery room shows swelling, tenderness, and crepitus over the left clavicle.
There is decreased movement of the left upper extremity. Movement of the hands and wrists is normal. Grasping reflex is
normal in both hands. An asymmetric Moro reflex is present. The remainder of the examination shows no abnormalities. An
anteroposterior x-ray confirms the diagnosis. Which of the following is the most appropriate next step in management?

Nerve conduction study

Surgical fixation

Physical therapy

Pin sleeve to the shirt.

Splinting of the arm

1419. A 15-year-old boy is brought to the physician because of progressive left leg pain for the past 2 months. The pain is
worse while running and at night. Examination of the left leg shows swelling and tenderness proximal to the knee. Laboratory
studies show an alkaline phosphatase level of 200 U/L. An x-ray of the left leg shows sclerosis, cortical destruction, and new
bone formation in the soft tissues around the distal femur. There are multiple spiculae radiating perpendicular to the bone. This
patient's malignancy is most likely derived from cells in which of the following structures?

Periosteum.

Bone marrow

Cartilage

Epiphyseal plate

Neural crest

1420. A 40-year-old sailor is brought to a military treatment facility 20 minutes after being involved in a navy ship collision. He
reports a sensation that he needs to urinate but is unable to void. He appears ill. Pulse is 140/min, respirations are 28/min, and
blood pressure is 104/70 mm Hg. Pelvic examination shows ecchymoses over the scrotum and perineum. There is tenderness
over the suprapubic region and blood at the urethral meatus. Digital rectal examination shows a high-riding prostate. Abdominal
ultrasound shows a moderately distended bladder. X-rays of the pelvis show fractures of all four pubic rami. Which of the
following is the most likely cause of this patient's symptoms?

Tearing of the anterior urethra

Blunt trauma to the prostate

Rupture of the corpus cavernosum

Rupture of the bladder

Tearing of the posterior urethra.

1421. A 21-year-old man comes to the military base physician for evaluation of progressive discomfort in his right shoulder for
the past 4 months. He joined the military 6 months ago and is part of a combat team. In anticipation of an upcoming
competition, he has been practicing rifle drills and firing exercises 8 hours a day. Physical examination shows tenderness to
palpation and a firm mass in the superior part of the right deltopectoral groove. Range of motion is limited by pain and stiffness.
Which of the following is the most likely diagnosis?

Osteoid osteoma

Lipoma

Acromioclavicular joint separation

Clavicle stress fracture

Myositis ossificans.

1422. A 53-year-old man comes to the emergency department for severe left knee pain for the past 8 hours. He describes it as
an unbearable, burning pain that woke him up from his sleep. He has been unable to walk since. He has not had any trauma to
the knee. Ten months ago, he had an episode of acute pain and swelling of the right big toe that improved with analgesics. He
has hypertension, type 2 diabetes mellitus, psoriasis, and hyperlipidemia. Current medications include topical betamethasone,
metformin, glipizide, losartan, and simvastatin. Two weeks ago, hydrochlorothiazide was added to his medication regimen to
improve blood pressure control. He drinks 1-2 beers daily. He is 170 cm (5 ft 7 in) tall and weighs 110 kg (242 Ib); BMI is 38
kg/m?. His temperature is 38.4°C (101.1°F). Examination shows multiple scaly plaques over his palms and soles. The left knee
is erythematous, swollen, and tender; range of motion is limited by pain. In addition to administering analgesics, which of the
following is the most appropriate next step in management?

Obtain blood cultures

 Measure serum uric acid levels

Perform arthrocentesis of the knee.

Measure serum anticitrullinated peptide antibodies

1423. A 33-year-old man who is on active duty in the US Army comes to the clinic because of a 1-day history of right shoulder
pain. The pain developed acutely during a lifting exercise, after which he took a break because he was unable to lift his arm. He
could not sleep last night because of the pain. Vital signs are within normal limits. Physical examination shows a mild swelling
over the right shoulder. The right deltoid and distal clavicular region are tender to palpation. Active abduction and external
rotation of the right shoulder are severely limited by pain. Passive external rotation is painful. An MRI of the right shoulder
shows a complete discontinuity of the supraspinatus tendon and mild effusion in the subacromial space. Which of the following
is the most appropriate next step in management?

Immobilization of the right shoulder

Arthrocentesis of the right shoulder

Surgical repair.

X-ray of the right shoulder

Reassurance

1424. A 27-year-old man comes to the physician because of pain and swelling in his right knee that began 3 days ago when he
fell during football practice. He fell on his flexed right knee as he dove to complete a pass. He felt some mild knee pain but
continued to practice. Over the next 2 days, the pain worsened and the knee began to swell. Today, the patient has an antalgic
gait. Examination shows a swollen and tender right knee; flexion is limited by pain. The right knee is flexed and pressure is
applied to proximal tibia; 8 mm of backward translation of the foreleg is observed. Which of the following is most likely injured?

Medial meniscus

Posterior cruciate ligament.

Anterior cruciate ligament

Medial collateral ligament

Lateral collateral ligament

1425. An 18-year-old man is brought to the emergency department 30 minutes after being stabbed in the chest during a fight.
He has no other injuries. His pulse is 120/min, blood pressure is 90/60 mm Hs, and respirations are 22/min. Examination shows
a 4-cm deep, straight stab wound in the 4th intercostal space 2 cm medial to the right midclavicular line. The knife most likely
passed through which of the following structures?

Pectoral fascia, transversus thoracis muscle, right lung.

Intercostal muscles, internal thoracic artery, right heart

Serratus anterior muscle, pleura, inferior vena cava

External oblique muscle, superior epigastric artery, azygos vein

Pectoralis minor muscle, dome of the diaphragm, right lobe of the liver

1426. A 19-year-old man is rushed to the emergency department 30 minutes after diving head-first into a shallow pool of water
from a cliff. He was placed on a spinal board and a rigid cervical collar was applied by the emergency medical technicians. On
arrival, he is unconscious and withdraws all extremities to pain. His temperature is 36.7°C (98.1°F), pulse is 70/min, respirations
are 8/min, and blood pressure is 102/70 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 96%. The pupils are
equal and react sluggishly to light. There is a 3-cm (1.2-in) laceration over the forehead. The lungs are clear to auscultation.
Cardiac examination shows no abnormalities. The abdomen is soft and nontender. There is a step-off palpated over the cervical
spine. Which of the following is the most appropriate next step in management?

CT scan of the spine

X-ray of the cervical spine

CT of the brain and spine

Rapid sequence intubation.

Laryngeal mask airway insertion

1427. A 44-year-old man is brought to the emergency department 25 minutes after falling off the roof of his house. He was
cleaning the roof when he slipped and fell. He did not lose consciousness and does not have any nausea. On arrival, he is alert
and oriented. He is placed on a backboard and has a cervical collar on his neck. His pulse is 96/min, respirations are 18/min,
and blood pressure is 118/78 mm Hg. Examination shows multiple bruises over the forehead and right cheek. The pupils are
equal and reactive to light. There is a 2-cm laceration below the right ear. Bilateral ear canals show no abnormalities. The right
wrist is swollen and tender; range of motion is limited by pain. The lungs are clear to auscultation. There is mild midline cervical
spine tenderness as well as tenderness along the 2nd and 3rd ribs on the right side. The abdomen is soft and nontender.
Neurologic examination shows no focal findings. Focused assessment with sonography for trauma (FAST) shows no free
intraperitoneal fluid. Two peripheral venous catheters are placed. Which of the following is the most appropriate next step in
management?

X-ray of the chest

CT scan of the abdomen

X-ray of the neck

MRI scan of the head

CT scan of the cervical spine.

1428. A 28-year-old man is scheduled for skin grafting of the right leg. Four weeks earlier, he underwent open reduction and
internal fixation of an open right tibial fracture. The postoperative period at that time was complicated by necrosis of the
overlying skin. In the operating room, he is placed on continuous hemodynamic monitoring and anesthetized with intrathecal
bupivacaine injected into the L3-L4 spinal interspace. Thirty minutes later, he has severe shortness of breath and
lightheadedness and loses consciousness. His temperature is 37.1°C (98.8°F), pulse is 38/min, respirations are 24/min, and
blood pressure is 82/50 mm Hg. Examination shows flushed skin. He withdraws the upper extremities to painful stimuli above
the navel. The lungs are clear to auscultation. Which of the following is the most likely underlying cause of this patient's
symptoms?

Loss of sympathetic vascular tone.

Bacterial toxin-induced vasodilation

Obstructive thrombus in the pulmonary artery

Intravascular volume depletion

Bone marrow embolism to the lungs

1429. A 36-year-old woman is brought to the emergency department 20 minutes after being involved in a high-speed motor
vehicle collision. On arrival, she is unconscious. Her pulse is 140/min, respirations are 12/min and shallow, and blood pressure
is 76/55 mm Hg. 0.9% saline infusion is begun. A focused assessment with sonography shows blood in the left upper quadrant
of the abdomen. Her hemoglobin concentration is 7.6 g/dL and hematocrit is 22%. The surgeon decides to move the patient to
the operating room for an emergency explorative laparotomy. Packed red blood cell transfusion is ordered prior to surgery. A
friend of the patient asks for the transfusion to be held as the patient is a Jehovah's Witness. The patient has no advance
directive and there is no documentation showing her refusal of blood transfusions. The patient's husband and children cannot
be contacted. Which of the following is the most appropriate next step in management?

Administer hydroxyethyl starch

Transfusion of packed red blood cells.

Consult hospital ethics committee

Administer high-dose iron dextran

Proceed to surgery without transfusion

1430. A 19-year-old man is brought to the emergency department because of severe right shoulder pain and inability to move
the shoulder after a fall while climbing outdoors. Examination shows the right upper extremity is externally rotated and slightly
abducted. There is loss of the normal rounded appearance of the shoulder. The right humeral head is palpated below the
coracoid process. Sensation to pinprick over which of the following skin areas is most likely to be reduced?

Medial aspect of the upper arm

Lateral aspect of the shoulder.

Hypothenar eminence and ulnar sided fingers

Thenar eminence and radial sided fingers

Skin above the clavicle

1431. A 32-year-old man is brought to a physician working alone at a small urban community health center after being stabbed
in the abdomen during an altercation. The patient has shortness of breath and abdominal pain and bleeding. He is alert and
active. He appears uncomfortable. His temperature is 37°C (98.6°F), pulse is 120/min, respirations are 20/min and shallow, and
blood pressure is 89/61 mm Hg. Examination shows a deep 4-cm wound at the right subcostal region with active bleeding.
Which of the following is the most appropriate initial action by the physician?

Perform bilateral tube thoracostomy

Establish IV access and administer intravenous fluids

Type and cross for transfusion of packed red blood cells

Perform rapid sequence intubation

Arrange for transport to the nearest trauma center.

1432. Three hours after undergoing left hip arthroplasty for chronic hip pain, a 62-year-old man has a prickling sensation in his
left anteromedial thigh and lower leg. He has never had these symptoms before. He has hyperlipidemia and coronary artery
disease. He has had recent right-sided gluteal and thigh pain with ambulation. Vital signs are within normal limits. On
neurologic examination, muscle strength is 3/5 on left hip flexion and 2/5 on left knee extension. Patellar reflex is decreased on
the left. Sensation to pinprick and light touch are decreased on the anteromedial left thigh and the medial lower leg. Dorsalis
pedis, popliteal, and femoral pulses are 2+ bilaterally. The surgical incision is without erythema or drainage. Which of the
following is the most likely underlying cause of this patient's symptoms?

Fibular nerve injury

L5 radiculopathy
 S1 radiculopathy

Obturator nerve injury

Femoral nerve injury.

1433. A 56-year-old woman comes to the emergency department because of worsening pain and swelling in her right knee for 3
days. She underwent a total knee arthroplasty of her right knee joint 5 months ago. The procedure and immediate aftermath
were uneventful. She has hypertension and osteoarthritis. Current medications include glucosamine, amlodipine, and
meloxicam. Her temperature is 37.9°C (100.2°F), pulse is 95/min, and blood pressure is 115/70 mm Hg. Examination shows a
tender, swollen right knee joint; range of motion is limited by pain. The remainder of the examination shows no abnormalities.
Arthrocentesis of the right knee is performed. Analysis of the synovial fluid shows: Appearance cloudy, Viscosity absent, WBC
count 78.000/mm3, Segmented neutrophils 94%, Lymphocytes 6%. Synovial fluid is sent for culture and antibiotic sensitivity.
Which of the following is the most likely causal pathogen?

Pseudomonas aeruginosa

Staphylococcus epidermidis.

Staphylococcus aureus

Escherichia coli

1434. A 52-year-old woman comes to the physician because of a 3-week history of pain in her right knee. The pain is worse at
the end of the day and when she walks. She says that it has become difficult for her to walk up the flight of stairs to reach her
apartment. She has hypertension. Her sister has rheumatoid arthritis. She drinks two to three beers daily. Current medications
include hydrochlorothiazide and a multivitamin. She appears anxious. She is 160 cm (5 ft 3 in) tall and weighs 92 kg (202 lb);
BMI is 36 kg/m2. Her temperature is 37.0°C (98.6°F), pulse is 87/min, and blood pressure is 135/83 mm Hg. Cardiopulmonary
examination shows no abnormalities. The right knee is not tender or erythematous; range of motion is limited. Crepitus is heard
on flexion and extension of the knee. Her hemoglobin concentration is 12.6 g/dL, leukocyte count is 9,000/mm3, and
erythrocyte sedimentation rate is 16 mm/h. An x-ray of the right knee is shown. Which of the following is the most appropriate
next step in the management of this patient?

Intraarticular glucocorticoid injections

Weight loss program.

Arthrocentesis of the right knee joint

Total joint replacement

Methotrexate therapy

1435. A 27-year-old man is brought to the emergency department because of pain and an inability to move his left shoulder for
the past 45 minutes. He says the symptoms started after he had a tonic-clonic seizure. He has autism spectrum disorder and
epilepsy. There is no family history of serious illness. His current medications include sodium valproate and levetiracetam. He
appears uncomfortable. Vital signs are within normal limits. Examination shows that the left arm is adducted and internally
rotated. The anterior left shoulder is flattened with prominence of the coracoid process. The right upper extremity shows no
abnormalities. Sensation over the lateral surface of both shoulders is normal. Radial pulses are palpable bilaterally.
Oropharyngeal examination shows a tongue laceration. An anteroposterior view x-ray of this patient's left shoulder and arm is
most likely to show which of the following?

Posterolateral depression fracture of the humeral head

Circular appearance of the humeral head.

Anteroinferior lesion of the glenoid labrum

 Midshaft humeral fracture

Superior subluxation of the humeral head

1436. A 13-year-old girl is brought to the emergency department 35 minutes after falling off a horse. Her mother reports that
she lost consciousness for fewer than 15 seconds. She reports pain in her left shoulder, left flank, and left hip. She has no
history of serious illness but had a sore throat, fatigue, and fever for the past week. She does not take any medications. Her
pulse is 105/min and blood pressure is 95/60 mm Hg. Physical examination shows abrasions on the left upper arm, but no signs
of fracture or dislocation. Passive and active range of motion of the shoulder, elbow, and wrist are intact. There is abdominal
tenderness and guarding in the left upper quadrant. Her hemoglobin concentration is 9.8 g/dL, leukocyte count is 5600/mm3,
and platelet count is 145,000/mm3. An abdominal ultrasound shows free intraabdominal fluid in the Douglas pouch. Which of
the following is the most likely cause of this patient's sonographic findings?

Small bowel perforation

Liver hematoma

Pancreatic laceration

Splenic rupture.

Kidney injury

1437. A 29-year-old man is brought to the emergency department 20 minutes after sustaining a gunshot wound to the
abdomen. On arrival, he is awake and oriented to person, place, and time. He appears agitated. His pulse is 102/min,
respirations are 20/min, and blood pressure is 115/70 mm Hg. The pupils are equal and reactive to light. Abdominal
examination shows an entrance wound in the right upper quadrant above the umbilicus. There is an exit wound on the right
lower back next to the lumbar spine. Breath sounds are normal bilaterally. There is diffuse mild tenderness to palpation with no
guarding or rebound. Cardiac examination shows no abnormalities. Intravenous fluid therapy is begun. Which of the following is
the most appropriate next step in management?

CT scan of the abdomen.

Close observation

Diagnostic laparoscopy

Immediate laparotomy

Diagnostic peritoneal lavage

1438. A 22-year-old man comes to the emergency department for pain and swelling of his left knee one day after injuring it
while playing soccer. While sprinting on the field, he slipped as he attempted to kick the ball and landed on the anterior aspect
of his knee. He underwent an appendectomy at the age of 16 years. His vital signs are within normal limits. Examination shows
a swollen and tender left knee; range of motion is limited by pain. The tibial tuberosity shows tenderness to palpation. The left
tibia is displaced posteriorly when force is applied to the proximal tibia after flexing the knee. The remainder of the examination
shows no abnormalities. An x-ray of the left knee joint shows an avulsion fracture of the tibial condyle. Which of the following is
the most likely diagnosis?

Anterior cruciate ligament injury

Lateral meniscus injury

Posterior cruciate ligament injury.

Lateral collateral ligament injury

Medial meniscus injury

1439. A 27-year-old woman comes to the emergency department because of severe left ankle pain after she fell over a rock
while hiking 2 hours ago. She took acetaminophen for the pain with only minimal relief. She has no history of serious illness and
takes no medications. She does not smoke cigarettes or drink alcohol. Vital signs are within normal limits. Examination shows
multiple abrasions on both legs. The left ankle is edematous and has a restricted range of motion due to pain; she is unable to
bear weight on the left foot. There is tenderness over the tip of the left medial malleolus. The pedal pulse is palpable.
Neurologic examination shows no abnormalities. The left foot is elevated, additional analgesia is given, and ice is applied to the
injured site. Which of the following is the most appropriate next step in management?

Place a semi-rigid ankle support

Obtain x-rays of the ankle.

Place a short-leg cast

Obtain an MRI of the ankle

1440. A 25-year-old woman is brought to the emergency department after being involved in a rear-end collision, in which she
was the restrained driver of the back car. On arrival, she is alert and active. She reports pain in both knees and severe pain over
the right groin. Temperature is 37°C (98.6°F), pulse is 116/min, respirations are 19/min, and blood pressure is 132/79 mm Hg.
Physical examination shows tenderness over both knee caps. The right groin is tender to palpation. The right leg is slightly
shortened, flexed, adducted, and internally rotated. The remainder of the examination shows no abnormalities. Which of the
following is the most likely diagnosis?

Femoral neck fracture

Anterior hip dislocation

Femoral shaft fracture

Posterior hip dislocation.

Pelvic fracture

1441. A 7-year-old boy is brought to the physician by his mother because of a limp for the last 3 weeks. He has also had right
hip pain during this period. The pain is aggravated when he runs. He had a runny nose and fever around a month ago that
resolved with over-the-counter medications. He has no history of serious illness. His development is adequate for his age. His
immunizations are up-to-date. He appears healthy. He is at the 60th percentile for height and at 65th percentile for weight. Vital
signs are within normal limits. Examination shows an antalgic gait. The right groin is tender to palpation. Internal rotation and
abduction of the right hip is limited by pain. The remainder of the examination shows no abnormalities. His hemoglobin
concentration is 13.6 g/dL, leukocyte count is 8,900/mm3, and platelet count is 170,000/mm3. An x-ray of the pelvis is shown.
Which of the following is the most likely cause of this patient's condition?

Unstable proximal femoral growth plate

Bacterial infection of the joint

Viral infection

Immune-mediated synovial inflammation

Avascular necrosis of the femoral head.

1442. A 32-year-old woman is brought to the emergency department for the evaluation of burn injuries that she sustained after
stumbling into a bonfire 1 hour ago. The patient has severe pain in her left leg and torso, and minimal pain in her right arm. She
does not smoke cigarettes. She takes no medications. She is tearful and in moderate distress. Her temperature is 37.2°C
(99.0°F), pulse is 88/min, respirations are 19/min, and blood pressure is 118/65 mm Hg. Her pulse oximetry is 98% on room air.
Cardiopulmonary examination shows no abnormalities. There are two tender, blanchable erythemas without blisters over a 5 x
6-cm area of the left abdomen and a 3 × 2-cm area of the left anterior thigh. There is also an area of white, leathery skin and
tissue necrosis encircling the right upper extremity just proximal to the elbow, which is dry and nontender. An ECG shows
normal sinus rhythm with no ST or T wave changes. Administration of intravenous fluids is begun. Which of the following is the
most appropriate next step in management?

Serial arterial blood gas analysis

Soft-tissue ultrasound

Intravenous ampicillin therapy

Monitoring of peripheral pulses and capillary filling.

X-ray of the chest

1443. A 35-year-old woman comes to the emergency department because of an open wound on her left knee after falling while
crossing a creek during a hike about 3 hours ago. She hit her knee on a rock and then had to crawl on the ground for several
meters until help arrived. She does not recall her immunization status. Her temperature is 36.7°C (98°F), pulse is 82/min, and
blood pressure is 116/72 mm Hg. Examination shows a swollen and tender left knee; range of motion is limited by pain. There is
a 5×3-cm (1.9×1.2-in) laceration just below the left kneecap; the skin is partly attached on the tibial side. The wound is covered
with dirt and soil; there is erythema around the wound margins. The wound is thoroughly irrigated and debrided. Which of the
following is the most appropriate next step in management?

Tension-free apposition of wound edges and administration of tetanus immunoglobulin

Surgical treatment with skin flap transfer and administration of tetanus immunoglobulin

Administration of tetanus vaccine only

Administration of tetanus immunoglobulin and tetanus vaccine.

Administration of oral antibiotics and tetanus vaccine

1444. A 27-year-old woman is brought to the emergency department after falling from her bicycle 1 hour ago. The patient was
on her way to work as she lost her balance, hitting her head on the sidewalk. She had an initial loss of consciousness for a
couple of minutes following the accident. She currently has nausea and a headache. She has vomited twice during the last 30
minutes. She has no history of a serious illness. The patient does not smoke or drink alcohol. She has never used illicit drugs.
She takes no medications. Her temperature is 37.0°C (98.6°F), pulse is 50/min, respirations are 10/min, and blood pressure is
160/90 mm Hg. She is oriented to person, place, and time. Her lungs are clear to auscultation. Cardiac examination shows
bradycardia but no murmurs, rubs, or gallops. The abdomen is soft and nontender. There is a bruise on the right temporal side
of the head. While the remainder of the physical examination is being performed, the patient starts having a seizure.
Intravenous lorazepam is administered and she is admitted to the intensive care unit. Which of the following is the most likely
diagnosis in this patient?

Ischemic stroke

Subdural hematoma

Intracerebral hemorrhage

Subarachnoidal hemorrhage

Epidural hematoma.

1445. A 28-year-old man comes to the emergency department because of pain in his right heel for the past month. Initially, the
pain was only present when he took his first steps in the morning or after running for a while, but now it is constant. He is
unable to put any weight on his right foot. He recently traveled and spent a lot of time walking to various tourist attractions over
the course of 6 weeks. He has no other history of serious illness and takes no medications. Vital signs are within normal limits.
Physical examination shows mild swelling of the right heel. There is tenderness to palpation on the medial and lateral aspects
of the posterior right heel; compressing the sides of the heel between the fingers elicits pain. The plantar surface of the heel is
only mildly tender to palpation. Sensation is normal. Which of the following is the most likely diagnosis?

Achilles tendinopathy

Plantar fasciitis

Calcaneal stress fracture.

Tarsal tunnel syndrome

Heel pad syndrome

1446. A 37-year-old man comes to the physician because of increasing swelling and pain of his right knee for the past month.
He has not had any trauma to the knee or previous problems with his joints. He has hypertension. His only medication is
hydrochlorothiazide. He works as a carpet installer. He drinks two to three beers daily. He is 170 cm (5 ft 7 in) tall and weighs 97
kg (214 lb); BMI is 34 kg/m?. His temperature is 37°C (98.6°F), pulse is 88/min, and blood pressure is 122/82 mm Hg.
Examination of the right knee shows swelling and erythema; there is fluctuant edema over the lower part of the patella. The
range of flexion is limited because of the pain. The skin over the site of his pain is not warm. There is tenderness on palpation of
the patella; there is no joint line tenderness. The remainder of the examination shows no abnormalities. Which of the following
is the most likely diagnosis?

Gout

Septic arthritis

Prepatellar bursitis.

Osteoarthritis

Osgood-Schlatter disease

1447. Five days after undergoing right knee arthroplasty for osteoarthritis, a 68-year-old man has severe pain in his right knee
preventing him from participating in physical therapy. On the third postoperative day when the dressing was changed, the
surgical wound appeared to be intact, slightly swollen, and had a clear secretion. He has a history of type 2 diabetes mellitus,
hyperlipidemia, and hypertension. Current medications include metformin, enalapril, and simvastatin. His temperature is 37.3°C
(99.1°F), pulse is 94/min, and blood pressure is 130/88 mm Hg. His right knee is swollen, erythematous, and tender to
palpation. There is pain on movement of the joint. The medial parapatellar skin incision appears superficially opened in its
proximal and distal part with yellow-green discharge. There is blackening of the skin on both sides of the incision. Which of the
following is the most appropriate next step in management?

Surgical debridement.

Nafcillin therapy

Skin grafting

Removal of prostheses

Antiseptic dressing

1448. A 19-year-old man is brought to the emergency department following a high-speed motor vehicle collision in which he
was a restrained passenger. He complains of pelvic pain and involuntary loss of urine, with constant dribbling. Examination
shows perineal bruising and there is pain with manual compression of the pelvis. Pelvic ultrasound shows a normal bladder.
Injury to which of the following structures is most likely responsible for this patient's urinary incontinence?

Pelvic splanchnic nerves.

 Genitofemoral nerve

Superior gluteal nerve

Ilioinguinal nerve

Obturator nerve

Femoral nerve

1449. A 22-year-old man comes to the physician because of a progressive swelling and pain in his right ring finger for the past
2 days. The pain began while playing football, when his finger got caught in the jersey of another player who forcefully pulled
away. Examination shows that the right ring finger is extended. There is pain and swelling at the distal interphalangeal joint.
When the patient is asked to make a fist, his right ring finger does not flex at the distal interphalangeal joint. There is no joint
laxity. Which of the following is the most likely diagnosis?

Rupture of the flexor digitorum profundus tendon at its point of insertion.

Closed fracture of the distal phalanx

Rupture of the extensor digitorum tendon at its point of insertion

Inflammation of the flexor digitorum profundus tendon sheath

Slipping of the central band of the extensor digitorum tendon

1450. A 37-year-old woman is brought to the emergency department 15 minutes after falling down a flight of stairs. On arrival,
she has shortness of breath, right-sided chest pain, right upper quadrant abdominal pain, and right shoulder pain. She is
otherwise healthy. She takes no medications. She appears pale. Her temperature is 37°C (98.6°F), pulse is 115/min, respirations
are 20/min, and blood pressure is 85/45 mm Hg. Examination shows several ecchymoses over the right chest. There is
tenderness to palpation over the right chest wall and right upper quadrant of the abdomen. Bowel sounds are normal.
Cardiopulmonary examination shows no abnormalities. Neck veins are flat. Which of the following is the most likely diagnosis?

Splenic laceration

Small bowel perforation

Pneumothorax

Liver hematoma.

Duodenal hematoma

1451. A 40-year-old man comes to the physician because of a 2-week history of progressively worsening pain on the outer side
of his right elbow. He does not recall any trauma to the area. The patient plays tennis recreationally and has recently gone from
playing weekly to playing daily in preparation for a local tournament. He has had some pain relief with ibuprofen. On physical
examination, there is tenderness over the lateral surface of the right distal humerus. The pain is reproduced by supinating the
forearm against resistance. The remainder of the examinations shows no abnormalities. Which of the following is the most
likely underlying cause of this patient's condition?

Nerve compression at the elbow

Bursal inflammation

Repeated wrist flexion

Excessive stress to bone

 Repeated wrist extension.

1452. A 28-year-old man is brought to the emergency department after being struck by a car while he was crossing the street
one hour ago. He did not lose consciousness. He has pain in his right arm, forehead, and pelvis. He also has an urge to urinate
but has been unable to do so since the accident. He appears uncomfortable. His temperature is 37.1°C (98.9°F), pulse is
72/min, respirations are 18/min, and blood pressure is 118/82 mm Hg. He is alert and oriented to person, place, and time. There
are abrasions over his scalp and face and a 1 × 3 cm area of ecchymosis above his right eye. His pupils are equal, round, and
reactive to light. Musculoskeletal examination shows tenderness and ecchymosis over the right distal forearm with intact
pulses, sensation, and capillary refill. There is no tenderness of the cervical spine. Abdominal examination shows suprapubic
tenderness. A scant amount of blood is present at the urethral meatus. A CT scan of the abdomen and pelvis shows a fracture
of both ipsilateral pubic rami. Which of the following is the most appropriate next step in management?

Retrograde urethrography.

Intravenous pyelography

Retrograde cystography

Foley catheterization

Retroperitoneal ultrasound

1453. A 21-month-old boy is brought to the physician for a well-child examination. His mother noticed deformities in both of his
legs since he started walking independently. He has been healthy apart from an upper respiratory tract infection 6 months ago.
He was delivered at 38 weeks' gestation. His 6-year-old sister was treated for developmental dysplasia of the hip. He can kick a
ball and say a 2-word phrase. He plays well with other children at his day care. His immunizations are up-to-date. He is at the
40th percentile for height and 50th percentile for weight. Vital signs are within normal limits. Examination shows closed anterior
and posterior fontanelles. The knees do not stay together when both the feet and ankles are placed together. The gait is
unremarkable. The mother is concerned that he has a growth disorder. Which of the following is the most appropriate next step
in management?

Vitamin D supplementation

Reassurance and follow-up.

Hip abduction brace

X-ray of the lower extremities

Bracing of the lower extremities

1454. A 16-year-old boy is brought to the physician because of a 2-month history of progressive right shoulder pain. He has had
many episodes of joint and bone pain in the past and as a child had recurrent painful swelling of the hands and feet. His brother
had a stroke at 6 years of age and now has an intellectual disability. The patient is at the 60th percentile for height and 55th
percentile for weight. His vital signs are within normal limits. Physical examination shows tenderness of the right anterior
humerus without noticeable swelling or skin changes. Active and passive range of motion of the right shoulder is decreased,
and there is pain with movement. Leukocyte count is 4600/mm3. An x-ray of the right shoulder shows subchondral lucency of
the humeral head with sclerosis and joint space narrowing. Which of the following is the most likely explanation for this patient's
symptoms?

Infection of the bone

Infection of the dermis and subcutaneous tissue

Infection of the joint space

Premature closure of the epiphysis

 Infarction of the bone trabeculae.

1455. A 28-year-old man comes to the physician because of a swollen, tender left knee for the past 4 days. During this period,
the patient has had pain with urination. He has no history of serious illness and takes no medications. He is sexually active with
two male partners and they use condoms inconsistently. His older sister has systemic lupus erythematosus. He is 180 cm (5 ft
11 in) tall and weighs 98 kg (216 lb); BMI is 30 kg/m2. His temperature is 37°C (98.6°F), pulse is 83/min, and blood pressure is
140/75 mm Hg. Examination shows conjunctivitis bilaterally. The left knee is warm, erythematous, and tender to touch; range of
motion is limited. Laboratory studies show an erythrocyte sedimentation rate of 62 mm/h. Urinalysis shows WBCs. Further
evaluation of this patient is most likely to show which of the following?

HLA-B27 positive genotype.

Hiking trip two months ago

Recent norovirus gastroenteritis

Positive anti-ds DNA antibodies

Chondrocalcinosis of the left knee

1456. A 19-year-old man is brought to the emergency department 2 hours after he sustained an injury to his right hand while
playing basketball. The ball hit his right index finger with force and he is now unable to lift the end of the finger. Examination
shows a right index finger flexed at the distal interphalangeal joint and inability to actively extend the distal phalanx; range of
motion is limited by pain. There is an extension deficit of 10°. The remainder of the examination shows no abnormalities. An x-
ray of the hand shows no fractures. Which of the following is the most appropriate next step in management?

Stack splint in hyperextension.

Kirschner wire fixation

Intraosseous suturing

Buddy tape to neighboring finger

Tendon suturing

1457. A 73-year-old woman is brought to the emergency department after she sustained a fall 3 hours ago. The patient was
walking down the stairs when she lost her balance and fell onto the right side of her body. She did not lose consciousness. She
has nausea, pain in her right hip, and has not been able to walk since the fall. She has hypertension, type 2 diabetes mellitus,
and osteoporosis. She lives with her daughter. She is independent in all of her activities of daily living and instrumental
activities of daily living. She walks 2 miles every other day. She smoked one pack of cigarettes daily for 30 years but quit 10
years ago. Current medications include atorvastatin, ramipril, metformin, and a multivitamin. She is 163 cm (5 ft 4 in) tall and
weighs 50 kg (110 Ib); BMI is 19 kg/m?. She appears pale. Vital signs are within normal limits. The right leg seems shorter than
the left and is rotated externally. Pulses are intact in both lower extremities. Palpation of the right hip causes severe pain and
the range of motion is limited. An x-ray of the right hip is shown. Which of the following is the most appropriate next step in
management?

Nonweightbearing for 6-8 weeks

External fixation

Intramedullary nail fixation.

Early weightbearing with physical therapy

Total hip replacement

1458. A 33-year-old woman is brought to the emergency department 15 minutes after being stabbed in the chest with a
screwdriver. Her pulse is 110/min, respirations are 22/min, and blood pressure is 90/65 mm Hg. Examination shows a 5-cm
deep stab wound at the upper border of the 8th rib in the left midaxillary line. Which of the following structures is most likely to
be injured in this patient?

Intercostal nerve

Left liver lobe

Spleen

Lower lung lobe.

Left ventricle

1459. A 45-year-old man comes to the physician because of progressively worsening pain in his left heel over the past 3
months. He says that the pain is worse in the morning when he gets up from the bed but decreases as he starts walking. Six
months ago, he was diagnosed with prediabetes. He started jogging daily and working out in an attempt to lose weight. He does
not take any medications. He drinks 3-4 beers on weekends but does not smoke or use illicit drugs. He is 188 cm (6 ft 2 in) tall
and weighs 109 kg (240 lb); BMI is 31 kg/m7. His vital signs are within normal limits. Physical examination shows tenderness
over the medial aspect of the left heel's inferior surface and worsening of the pain with passive dorsiflexion of the toes. The pain
is not reproduced upon squeezing the sides of the heel. An x-ray of the foot shows no abnormalities. Which of the following is
the most likely cause of this patient's symptoms?

Recurrent microtrauma to the Achilles tendon

Impingement of the S1 nerve root

Degeneration of the plantar aponeurosis.

Inflammation of the retrocalcaneal bursa

Impingement of the tibial nerve

1460. An 82-year-old man is brought to the emergency department by his daughter because of severe pain in his groin after a
fall. Two hours ago, he slipped on a wet rug and fell on his right side. The daughter says he "could not get up on his own" and
can hardly walk. There was no trauma to the head or upper limbs. Medical history is remarkable for hypothyroidism. His
medications are levothyroxine and a fish oil supplement. His temperature is 37.0°C (98.6°F), pulse is 72/min, and blood
pressure is 120/70 mm Hg. Physical examination shows a shortened right lower limb in external rotation; there are no visible
bruises. Range of motion of the right hip is severely limited due to pain. An x-ray of the pelvis is shown. Which of the following
is the most likely diagnosis?

Femoral neck fracture.

Posterior hip dislocation

Femoral head fracture

Pelvic fracture

Intertrochanteric fracture

1461. A 59-year-old man comes to the emergency department because of excruciating left knee pain for 4 days. He underwent
a total knee arthroplasty of his left knee joint 4 months ago. He has hypertension and osteoarthritis. Current medications
include glucosamine, amlodipine, and meloxicam. His temperature is 38.1°C (100.6°F), pulse is 97/min, and blood pressure is
118/71 mm Hg. Examination shows a tender, swollen left knee joint; range of motion is limited by pain. Analysis of the synovial
fluid confirms septic arthritis, and the prosthesis is removed. Which of the following is the most likely causal organism?
 Staphylococcus epidermidis.

Escherichia coli

Staphylococcus aureus

Pseudomonas aeruginosa

Group B Streptococcus

1462. A 22-year-old man is brought to the emergency department 30 minutes after being involved in a high-speed motor
vehicle collision in which he was an unrestrained driver. After extrication, he had severe upper back pain and was unable to
move his legs. On arrival, he is alert and fully oriented. His neck is immobilized in a cervical collar. His pulse is 58/min,
respirations are 17/min and regular, and blood pressure is 89/58 mm Hg. Pulse oximetry on room air shows an oxygen
saturation of 98%. He has flaccid paralysis and absent reflexes in the lower extremities. Sensory examination shows absent
sensation below the level of the nipples including absent sensation in the perianal region. Cardiopulmonary examination shows
no abnormalities. The abdomen is soft. Rectal examination discloses no discernable resting tone and squeezing of the glans
penis does not elicit anal sphincter contraction. The remainder of the examination, including a focused assessment with
sonography for trauma, shows no abnormalities. A whole-body CT scan reveals an isolated burst fracture of the T3 vertebra
with no evidence of facet injury. In addition to intravenous fluid therapy, which of the following is the most appropriate next step
in management?

Placement of Foley catheter.

Intravenous dexamethasone therapy

Surgical stabilization of the spine

Myelography

Phenylephrine therapy

1463. What is the name of the condition where there is an abnormal growth in the bladder?

Bladder cancer

Bladder diverticulum

Bladder polyp.

Bladder stone

1464. What is the name of the condition where there is an infection of the urethra caused by a sexually transmitted organism?

Gonorrhea.

Chlamydia

Trichomoniasis

Syphilis

1465. A patient with bladder outlet obstruction presents for evaluation. What is the most appropriate management plan?

Start alpha-blockers
 Start 5-alpha-reductase inhibitors

Start catheterization

Start surgery.

1466. What is the name of the condition where there is an abnormal growth in the urethra?

Urethral stricture

Urethral diverticulum

Urethral tumor.

Urethritis

1467. What is the name of the condition where there is an abnormal growth in the penis?

Peyronie's disease

Priapism

Penile tumor.

Penile fracture

1468. What is the name of the condition where the prostate gland becomes inflamed?

Prostatitis.

Prostate cancer

Benign prostatic hyperplasia

Erectile dysfunction

1469. What is the name of the condition where the kidneys are unable to filter waste products from the blood?

Chronic kidney disease

Acute kidney injury

End-stage renal disease.

Renal failure

1470. What is the name of the condition where there is an abnormal connection between the ureter and the bladder?

Ureterovesical fistula

Vesicoureteral reflux

Ureteropelvic junction obstruction

Ureterocele.
1471. What is the name of the condition where the testes fail to descend into the scrotum?

Testicular torsion

Epididymitis

Hydrocele

Cryptorchidism.

1472. What is the name of the condition where the kidneys become inflamed?

Pyelonephritis

Nephrotic syndrome

Glomerulonephritis.

Nephritis

1473. What is the name of the condition where there is an infection of the bladder that is caused by a sexually transmitted
infection?

Non-gonococcal urethritis

Gonococcal urethritis

Epididymitis

Nongonococcal cystitis.

1474. What is the name of the condition where there is an abnormal growth in the adrenal gland that is not cancerous?

Adrenal cancer

Adrenal adenoma.

Adrenal hyperplasia

Adrenal insufficiency

1475. What is the name of the condition where the bladder becomes inflamed and irritated?

Cystitis

Pyelonephritis

Interstitial cystitis

Urethritis.

1476. What is the name of the condition where there is a narrowing of the foreskin of the penis?

Phimosis.
 Paraphimosis

Priapism

Peyronie's disease

1477. What is the name of the condition where there is an infection of the prostate gland that is not caused by bacteria?

Chronic bacterial prostatitis

Acute bacterial prostatitis

Non-bacterial prostatitis.

Sexually transmitted prostatitis

1478. What is the name of the condition where there is an infection of the kidneys?

Pyelonephritis

Glomerulonephritis

Nephritis

Renal abscess.

1479. What is the name of the condition where there is an abnormal growth in the bladder that is cancerous?

Bladder cancer.

Bladder diverticulum

Bladder tumor

Bladder stone

1480. A patient with urinary incontinence presents for evaluation. What is the most appropriate initial management plan?

Start alpha-blockers

Start anticholinergics

Start pelvic floor exercises.

Start estrogen therapy

1481. What is the name of the condition where there is a blockage in the urethra due to an enlarged prostate?

Prostate cancer

Prostatitis

BPH

Urethral obstruction
1482. What is the name of the condition where there is an abnormal growth in the testicle?

Testicular torsion

Epididymitis

Testicular tumor.

Hydrocele

1483. A patient with recurrent urinary tract infections presents for evaluation. What is the most appropriate management plan?

Start prophylactic antibiotics.

Start urinary catheterization

Start bladder irrigation

Start surgery

1484. What is the name of the condition where there is an infection of the bladder caused by a sexually transmitted organism?

Chronic bacterial cystitis

Acute bacterial cystitis

Interstitial cystitis

Sexually transmitted cystitis.

1485. What is the name of the condition where there is an abnormal growth in the kidney that is not cancerous?

Kidney cancer

Kidney cyst

Renal adenoma.

Polycystic kidney disease

1486. What is the name of the condition where there is an infection of the testicle and the epididymis?

Orchitis

Epididymitis

Testicular torsion

Epididymo-orchitis.

1487. What is the name of the condition where there is an infection of the kidney, usually caused by bacteria?

Pyelitis

Glomerulonephritis
 Pyelonephritis.

Interstitial nephritis

1488. What is the name of the condition where there is an abnormal growth in the bladder that is not cancerous, but can cause
bladder outlet obstruction?

Bladder tumor

Bladder adenoma

Bladder neck obstruction.

Bladder diverticulum

1489. What is the name of the condition where there is an abnormal growth in the testicle?

Testicular cancer

Testicular torsion

Testicular varicocele

Testicular adenoma.

1490. What is the name of the condition where there is a blockage in the urethra due to an enlarged prostate gland?

Urethral stricture

Urethral obstruction

Urethral stenosis

Benign prostatic hyperplasia.

1491. A patient with urinary tract stones presents for evaluation. What is the most appropriate management plan?

Start hydration and observe

Start antibiotic therapy

Start surgery

Start lithotripsy.

1492. A patient with erectile dysfunction and a history of myocardial infarction presents for evaluation. What is the most
appropriate initial management plan?

Start oral medication

Refer to a cardiologist.

Start intracavernosal injection therapy

Start vacuum erection device therapy

1493. What is the name of the tube that carries urine from the bladder to the outside of the body?

Urethra

Ureter

Urinary meatus.

Renal pelvis

1494. What is the name of the condition where there is a blockage in the urethra due to scar tissue?

Urethral stricture

Urethral obstruction

Urethral stenosis.

Urethral diverticulum

1495. What is the name of the condition where there is an inflammation of the glans and foreskin of the penis?

Balanoposthitis

Phimosis

Paraphimosis

Balanitis.

1496. What is the name of the condition where there is an abnormal growth in the kidney that is cancerous?

Renal cell carcinoma.

Renal cyst

Renal adenoma

Renal stone

1497. What is the name of the condition where there is an abnormal growth in the ureter?

Ureteritis

Ureteral stricture

Ureteral tumor.

Ureteral calculus

1498. What is the name of the condition where there is an infection of the bladder?

Cystitis.

Pyelonephritis
 Interstitial cystitis

Urethritis

1499. A patient with benign prostatic hyperplasia presents with urinary symptoms. What is the most appropriate initial
management plan?

Start alpha-blockers.

Start anticholinergics

Start 5-alpha-reductase inhibitors

Start surgery

1500. What is the name of the condition where there is inflammation of the kidney?

Cystitis

Pyelonephritis.

Glomerulonephritis

Interstitial nephritis

1501. Which of the following is a common symptom of prostate cancer?

Painful urination

Blood in the urine

Erectile dysfunction

None of the above.

1502. What is the most common type of kidney stone?

Calcium oxalate.

Uric acid

Struvite

Cystine

1503. What is the name of the condition where there is an abnormal growth in the kidney?

Renal cell carcinoma

Renal cyst

Renal tumor.

Renal stone
1504. What is the name of the condition where there is inflammation of the epididymis?

Epididymal cyst

Epididymal abscess

Epididymitis.

Testicular torsion

1505. A patient with prostate cancer presents with bone metastasis. What is the most appropriate management plan?

Start chemotherapy

Start radiation therapy

Start androgen deprivation therapy.

Start immunotherapy

1506. A patient with testicular cancer presents for evaluation. What is the most appropriate initial management plan?

Start chemotherapy

Start radiation therapy

Start orchiectomy.

Start immunotherapy

1507. What is the name of the condition where there is an abnormal enlargement of the renal pelvis?

Renal cell carcinoma

Renal cyst

Hydronephrosis.

Renal stone

1508. What is the name of the condition where there is an abnormal growth in the urethra?

Urethral cancer

Urethral diverticulum

Urethral stricture

Urethral tumor.

1509. What is the name of the condition where there is an abnormal opening between the ureter and the bladder?

Ureterocele

Ureterovesical junction obstruction.

 Ureteropelvic junction obstruction

Urethral stricture

1510. What is the name of the surgical procedure used to remove a kidney?

Nephrostomy

Pyelolithotomy

Nephrectomy.

Cystectomy

1511. What is the name of the surgical procedure used to remove the entire prostate gland?

Vasectomy

Orchidectomy

Prostatectomy.

TURP

1512. What is the name of the condition where there is a buildup of calcium in the kidneys?

Nephrotic syndrome

Nephritis

Nephrolithiasis

Nephrocalcinosis.

1513. What is the name of the condition where there is an abnormal growth in the prostate gland that is not cancerous?

Prostate cancer

Benign prostatic hyperplasia

Prostatic adenoma.

Prostatitis

1514. What is the name of the condition where there is an abnormal connection between the bladder and the bowel?

Colovesical fistula

Enterovesical fistula.

Vesicorectal fistula

Rectovesical fistula
1515. What is the name of the condition where there is an infection of the bladder and the urethra?

Cystitis

Pyelonephritis

Urinary tract infection.

Glomerulonephritis

1516. What is the name of the surgical procedure used to remove the bladder?

Nephrectomy

Ureteroscopy

Cystectomy

Prostatectomy.

1517. What is the name of the condition where there is an abnormal connection between the bladder and the rectum?

Vesicorectal fistula

Urethral fistula

Ureteral fistula

Vesicorectovaginal fistula.

1518. What is the name of the condition where there is an infection of the prostate gland that is caused by a sexually
transmitted infection?

Chronic bacterial prostatitis

Acute bacterial prostatitis

Non-bacterial prostatitis

Sexually transmitted prostatitis.

1519. What is the name of the condition where there is an abnormal connection between the ureter and the intestine?

Ureterocolic fistula

Ureterenteric fistula.

Uretero

1520. What is the name of the condition where there is an abnormal growth in the bladder that is not cancerous, but can cause
bleeding and urinary tract infections?

Bladder polyp.

Bladder adenoma
 Bladder tumor

Bladder diverticulum

1521. A patient with testicular torsion presents for evaluation. What is the most appropriate management plan?

Start antibiotics

Start analgesics

Start surgical exploration.

Start observation

1522. What is the name of the condition where there is an abnormal growth in the kidney that is not cancerous?

Renal cell carcinoma

Renal cyst

Renal adenoma.

Renal stone

1523. A patient with a history of bladder cancer presents with recurrent disease. What is the most appropriate diagnostic test?

Magnetic resonance imaging (MRI) scan

Computed tomography (CT) scan

Cystoscopy.

Urinalysis

1524. Which of the following is a common cause of testicular cancer?

Obesity

Smoking

Physical inactivity

Cryptorchidism.

1525. What is the name of the condition where there is an abnormal opening between the bladder and the bowel?

Colovesical fistula

Rectovesical fistula

Vesicorectal fistula

Enterovesical fistula.
1526. What is the name of the condition where there is an excessive amount of protein in the urine?

Hematuria

Glycosuria

Pyuria

Proteinuria.

1527. What is the name of the condition where there is an abnormal growth in the bladder that protrudes into the urethra?

Bladder cancer

Bladder diverticulum

Bladder tumor.

Bladder stone

1528. What is the name of the condition where there is an abnormal enlargement of the prostate gland?

Prostate cancer

Benign prostatic hyperplasia.

Prostatitis

Erectile dysfunction

1529. What is the name of the condition where there is an abnormal growth in the bladder that is not cancerous?

Bladder cancer

Bladder diverticulum

Bladder adenoma.

Bladder tumor

1530. What is the name of the condition where the bladder sags or drops into the vagina?

Uterine prolapse

Cystocele

Rectocele

Vaginal prolapse.

1531. What is the name of the surgical procedure used to remove the urethra?

Ureterectomy

Urethrectomy
 Nephrectomy

Urethrotomy.

1532. A patient with urinary incontinence presents for evaluation. What is the most appropriate diagnostic test?

Urinalysis

Urodynamic testing.

Computed tomography (CT) scan

Magnetic resonance imaging (MRI) scan

1533. A patient with erectile dysfunction is not responding to oral medication. What is the most appropriate next step?

Start intracavernosal injection therapy.

Start vacuum erection device therapy

Refer to a psychologist

Refer to a urologist

1534. A patient with priapism presents for evaluation. What is the most appropriate management plan?

Start anticoagulants

Start alpha-blockers.

Start surgical intervention

Start observation

1535. What is the name of the condition where the bladder contracts involuntarily?

Urinary incontinence

Urinary retention

Overactive bladder.

Overflow incontinence

1536. A patient presents with urinary tract infection. What is the most appropriate initial management plan?

Start antibiotics empirically.

Start antifungal therapy

Start antiviral therapy

Start immunotherapy
1537. What is the name of the condition where there is a blockage in the urethra due to a stone?

Urethral stricture

Urethral obstruction

Urethral calculus.

Urethral stenosis

1538. What is the name of the condition where there is an abnormal growth in the adrenal gland?

Adrenal insufficiency

Adrenal hyperplasia

Adrenal tumor.

Adrenal adenoma

1539. Which of the following is a common cause of acute kidney injury?

Hypertension

Diabetes

Bladder cancer

Dehydration.

1540. What is the name of the condition where there is an abnormal growth in the adrenal gland that produces too much
cortisol?

Cushing's syndrome.

Addison's disease

Conn's syndrome

Adrenal hyperplasia

1541. What is the name of the condition where there is an abnormal growth in the bladder?

Bladder cancer

Bladder cyst

Bladder adenoma.

Bladder polyp

1542. What is the name of the condition where there is an abnormal accumulation of fluid in the scrotum?

Testicular cancer
 Testicular torsion

Hydrocele

Varicocele.

1543. What is the name of the condition where there is an infection of the prostate gland caused by a sexually transmitted
organism?

Chronic bacterial prostatitis

Acute bacterial prostatitis

Non-bacterial prostatitis

Sexually transmitted prostatitis.

1544. What is the name of the condition where there is an abnormal connection between the bladder and the uterus?

Vesicouterine fistula

Urethrovaginal fistula

Ureterouterine fistula

Vesicocervical fistula.

1545. A patient with prostate cancer presents with elevated prostate-specific antigen (PSA) levels. What is the most
appropriate next step?

Start androgen deprivation therapy

Start chemotherapy

Start radiation therapy

Perform biopsy.

1546. A patient with prostate cancer presents with bone pain. What is the most appropriate management strategy?

Start chemotherapy

Start radiation therapy

Start androgen deprivation therapy.

Start immunotherapy

1547. What is the name of the condition where there is an abnormal connection between the bladder and the urethra?

Urethral fistula

Vesicourethral fistula

Ureterourethral fistula
 Urethrovesical fistula.

1548. What is the name of the condition where there is an infection of the kidney and the ureter?

Pyelonephritis

Ureteritis

Cystitis

Upper urinary tract infection.

1549. A patient with renal cell carcinoma presents with metastasis to the lung. What is the most appropriate management plan?

Start radiation therapy

Start chemotherapy

Perform radical nephrectomy

Start targeted therapy.

1550. What is the name of the condition where there is an abnormal growth in the testicle?

Testicular cancer

Testicular adenoma.

Testicular cyst

Testicular torsion

1551. What is the name of the condition where there is an abnormal opening between the bladder and the vagina?

Ureterovaginal fistula

Urethrovaginal fistula

Vesicovaginal fistula.

Rectovaginal fistula

1552. What is the name of the condition where the bladder is unable to empty completely?

Urinary incontinence

Urinary retention

Urinary hesitancy.

Overflow incontinence

1553. What is the name of the condition where there is an abnormal growth in the ureter?
 Ureteral tumor

Ureteral stricture

Ureteral cancer

Ureteral polyp.

1554. What is the name of the condition where there is a blockage in the ureter due to a stone?

Ureteral stricture

Ureteral calculus.

Ureteral obstruction

Ureteral stenosis

1555. A patient with urinary tract obstruction presents for evaluation. What is the most appropriate diagnostic test?

Renal function tests

Ultrasound

Magnetic resonance imaging (MRI) scan

Computed tomography (CT) scan.

1556. What is the most common cause of erectile dysfunction?

Vascular disease.

Prostate cancer

Diabetes

Hypertension

1557. What is the name of the condition where there is a narrowing of the urethra due to scar tissue?

Ureteral stricture

Ureteral diverticulum

Ureteral caruncle

Urethral stricture.

1558. What is the name of the condition where the prostate gland becomes enlarged?

Prostate cancer

Prostatitis

Benign prostatic hyperplasia.

 Erectile dysfunction

1559. What is the name of the condition where there is inflammation of the bladder, urethra, and prostate gland?

Cystitis

Prostatitis

Urethritis.

Epididymitis

1560. What is the name of the condition where there is a blockage in the ureteropelvic junction?

Ureteropelvic obstruction

Ureteropelvic stricture

Ureteropelvic stenosis

Ureteropelvic junction obstruction.

1561. A patient with renal failure presents for evaluation. What is the most appropriate management plan?

Start dialysis.

Start blood transfusion

Start oral iron supplementation

Start intravenous iron supplementation

1562. What is the name of the condition where there is an abnormal connection between the urethra and the skin on the
underside of the penis?

Urethral stricture

Urethral diverticulum

Urethral cancer

Urethral fistula.

1563. What is the name of the condition where there is a blockage in the urethra due to scar tissue?

Urethral cancer

Urethral diverticulum

Urethral stricture.

Urethral obstruction

1564. What is the name of the condition where there is an inflammation of the epididymis?
 Epididymitis

Orchitis

Testicular torsion

Epididymal orchitis.

1565. What is the name of the condition where the kidneys are unable to remove excess acid from the blood?

Metabolic acidosis.

Metabolic alkalosis

Respiratory acidosis

Respiratory alkalosis

1566. What is the name of the condition where the urethra is abnormally narrowed?

Urethral stricture

Urethral diverticulum

Urethral caruncle

Urethritis.

1567. What is the name of the condition where there is an infection of the prostate gland that is caused by bacteria?

Chronic bacterial prostatitis

Acute bacterial prostatitis.

Non-bacterial prostatitis

Sexually transmitted prostatitis

1568. A patient with prostate cancer presents with high-grade disease on biopsy. What is the most appropriate management
plan?

Start radiation therapy

Start chemotherapy

Perform radical prostatectomy.

Start androgen deprivation therapy

1569. What is the name of the condition where there is inflammation of the prostate gland?

Prostatitis.

Prostate cancer
 Benign prostatic hyperplasia

Erectile dysfunction

1570. A patient with testicular microlithiasis presents for evaluation. What is the most appropriate management plan?

Start observation.

Start surgery

Start chemotherapy

Start radiation therapy

1571. A patient with a history of kidney stones presents with recurrent pain. What is the most appropriate management plan?

Start antibiotic therapy

Start thiazide diuretics

Start allopurinol

Start hydration and observe.

1572. A patient with urethral injury presents for evaluation. What is the most appropriate management plan?

Start antibiotics

Start urethral stent placement

Start dilatation therapy

Start surgical repair.

1573. A patient with renal calculi presents for evaluation. What is the most appropriate management plan?

Start antibiotics

Start hydration and observe

Start lithotripsy.

Start surgical intervention

1574. A patient with epididymitis presents for evaluation. What is the most appropriate management plan?

Start antibiotics.

Start analgesics

Start scrotal support

Start surgery
1575. What is the name of the condition where there is an abnormal growth in the ureter?

Ureteral cancer

Ureteral cyst

Ureteral adenoma.

Ureteral polyp

1576. What is the name of the condition where there is an infection of the testis?

Orchitis.

Epididymitis

Testicular cancer

Testicular torsion

1577. What is the name of the condition where there is an abnormal enlargement of the breast tissue in males?

Gynecomastia

Mastitis

Breast cancer

Breast adenoma.

1578. A patient with renal cysts presents for evaluation. What is the most appropriate diagnostic test?

Renal function tests

Ultrasound

Computed tomography (CT) scan.

Magnetic resonance imaging (MRI) scan

1579. What is the name of the condition where there is an infection of the kidney and the bladder?

Pyelonephritis

Cystitis

Urinary tract infection.

Glomerulonephritis

1580. What is the name of the condition where there is an abnormal growth in the bladder that protrudes through the wall?

Bladder cancer

Bladder diverticulum.
 Bladder tumor

Bladder stone

1581. What is the name of the condition where there is an abnormal growth in the epididymis?

Epididymal cancer

Epididymal cyst

Epididymal adenoma.

Epididymitis

1582. What is the name of the condition where there is a hernia in the scrotum?

Hydrocele

Varicocele

Inguinal hernia.

Femoral hernia

1583. What is the name of the condition where the kidneys are unable to filter waste products from the blood?

Renal failure.

Renal stenosis

Renal cell carcinoma

Renal cyst

1584. A patient with renal artery stenosis presents for evaluation. What is the most appropriate management plan?

Start antihypertensive therapy

Start antiplatelet therapy

Start anticoagulant therapy

Start surgical intervention.

1585. What is the name of the surgical procedure used to remove the testicles?

Orchiectomy

Vasectomy

TURP

Orchidectomy.
1586. What is the name of the condition where there is an abnormal growth in the bladder that is not cancerous?

Bladder cancer

Bladder cyst

Bladder adenoma.

Bladder polyp

1587. What is the name of the condition where there is a blockage in the ureteropelvic junction due to a stone?

Ureteropelvic obstruction

Ureteropelvic stricture

Ureteropelvic stenosis

Ureteropelvic calculus.

1588. A patient has been diagnosed with renal cell carcinoma. What is the most appropriate treatment option?

Nephrectomy.

Partial nephrectomy

Radiotherapy

Chemotherapy

1589. What is the name of the condition where there is an inflammation of the bladder?

Cystitis

Pyelonephritis

Glomerulonephritis

Interstitial cystitis.

1590. What is the name of the condition where there is a blockage in the urethra due to an enlarged prostate gland?

Benign prostatic hyperplasia.

Prostate cancer

Prostatitis

Erectile dysfunction

1591. A patient with interstitial cystitis presents for evaluation. What is the most appropriate management plan?

Start anticholinergics

Start alpha-blockers
 Start cystoscopy

Start diet modifications.

1592. What is the name of the condition where there is an inflammation of the prostate gland?

Prostate cancer

Benign prostatic hyperplasia

Prostatitis.

Prostatic adenoma

1593. What is the most common cause of chronic kidney disease?

Diabetes.

Hypertension

Glomerulonephritis

Polycystic kidney disease

1594. What is the most common type of bladder cancer?

Adenocarcinoma

Transitional cell carcinoma.

Squamous cell carcinoma

Small cell carcinoma

1595. A patient with bladder cancer presents with muscle invasion. What is the most appropriate management plan?

Start chemotherapy

Start radiation therapy

Start radical cystectomy.

Start immunotherapy

1596. Which of the following is a risk factor for bladder cancer?

Smoking

Obesity

Physical inactivity

All of the above.

1597. A patient with erectile dysfunction presents for evaluation. What is the most appropriate initial management plan?

Start phosphodiesterase type 5 inhibitors.

Start intracavernosal injections

Start testosterone replacement therapy

Start vacuum erection device therapy

1598. What is the name of the condition where there is a blockage in the ureter that prevents the flow of urine?

Ureteral stricture

Ureteral diverticulum

Ureteral caruncle

Ureteral obstruction.

1599. What is the name of the condition where the kidneys are unable to remove excess potassium from the blood?

Hypokalemia

Hypernatremia

Hyperkalemia.

Hyponatremia

1600. A patient presents with hematuria. What is the most appropriate diagnostic test?

Computed tomography (CT) scan.

Magnetic resonance imaging (MRI) scan

Ultrasound

X-ray

1601. What is the name of the condition where there is a blockage in the bladder neck that prevents the flow of urine?

Ureteral stricture

Ureteral diverticulum

Ureteral caruncle

Bladder neck obstruction.

1602. What is the name of the condition where there is an abnormal curvature of the penis?

Peyronie's disease

Priapism
 Phimosis

Paraphimosis.

1603. What is the name of the condition where there is an abnormal growth in the ureteropelvic junction?

Ureteropelvic cancer

Ureteropelvic adenoma.

Ureteropelvic cyst

Ureteropelvic polyp

1604. What is the name of the condition where there is inflammation of the bladder?

Cystitis.

Pyelonephritis

Glomerulonephritis

Interstitial cystitis

1605. What is the name of the condition where there is a blockage in the ureterovesical junction due to a stone?

Ureterovesical obstruction

Ureterovesical stricture

Ureterovesical stenosis

Ureterovesical calculus.

1606. A patient has been diagnosed with bladder cancer. What is the most appropriate surgical option?

Nephrectomy

Partial nephrectomy

Radical cystectomy.

Prostatectomy

1607. What is the name of the condition where there is an abnormal growth in the testis?

Testicular cancer

Testicular torsion

Testicular tumor.

Testicular abscess
1608. A patient presents with acute renal colic. What is the most appropriate initial management plan?

Start antibiotics

Start high dose steroids

Start diuretics

Administer analgesics and observe.

1609. What is the name of the condition where there is an abnormal growth in the urethra?

Urethral cancer

Urethral cyst

Urethral adenoma.

Urethral polyp

1610. What is the name of the condition where there is an abnormal growth in the bladder and the urethra?

Bladder tumor

Bladder adenoma

Bladder cancer

Urothelial carcinoma.

1611. What is the medical term for painful urination?

Dyspnea

Dysuria.

Dysphagia

Dyskinesia

1612. What is the name of the condition where there is an abnormal growth in the kidney?

Kidney cancer

Kidney cyst

Polycystic kidney disease

Renal adenoma.

1613. Whatbis the name of the condition where there is a blockage in the ureter due to a stone?

Ureteritis

Urethral stricture
 Ureteral calculus.

Ureterocele

1614. What is the name of the condition where there is a blockage in the urinary tract due to a stone?

Urolithiasis.

Ureteritis

Urethral stricture

Urethral diverticulum

1615. What is the name of the surgical procedure used to remove a kidney?

Nephrostomy

Nephrectomy

Pyeloplasty

Ureteroscopy.

1616. What is the name of the condition where the ureters become obstructed due to a congenital narrowing?

Ureteropelvic junction obstruction.

Hydronephrosis

Nephrotic syndrome

Pyelonephritis

1617. A patient with urethral stricture presents for evaluation. What is the most appropriate management plan?

Start alpha-blockers

Start dilatation therapy

Start urethral stent placement

Start surgery.

1618. What is the primary function of the kidneys?

To regulate blood pressure

To regulate blood sugar levels

To produce red blood cells

To filter waste products from the blood.

1619. What is the name of the condition where there is an abnormal growth in the ureter that can cause obstruction?

Ureteral tumor

Ureteral stricture

Ureteral polyp.

Ureteral diverticulum

1620. What is the name of the condition where the foreskin cannot be retracted from the head of the penis?

Peyronie's disease

Balanitis

Phimosis.

Priapism

1621. What is the name of the condition where the ureters are abnormally narrow?

Ureteral stricture

Ureteral diverticulum

Ureteral caruncle

Ureteral stenosis.

1622. What is the name of the condition where there is a protrusion of the urethra into the vagina?

Urethral stricture

Urethral diverticulum

Urethral prolapse.

Urethral cancer

1623. What is the name of the condition where there is a blockage in the ejaculatory duct due to a stone?

Ejaculatory duct obstruction

Ejaculatory duct stricture

Ejaculatory duct stenosis

Ejaculatory duct calculus.

1624. A patient with acute urinary retention presents for evaluation. What is the most appropriate initial management plan?

Start alpha-blockers

Start catheterization.
 Start analgesics

Start antibiotics

1625. A patient with a urethral stricture presents for evaluation. What is the most appropriate management plan?

Start urethral dilatation

Start urethral stent placement

Start surgery.

Start antibiotics

1626. A patient with bladder outlet obstruction presents for evaluation. What is the most appropriate diagnostic test?

Uroflowmetry.

Cystoscopy

Renal function tests

Urinalysis

1627. A patient with scrotal swelling presents for evaluation. What is the most appropriate initial management plan?

Start antibiotics

Start analgesics

Start scrotal support.

Start surgical exploration

1628. What is the name of the surgical procedure used to create an opening in the bladder for the purpose of emptying urine?

Ureteroscopy

Cystostomy.

Pyeloplasty

Prostatectomy

1629. Which of the following is a common symptom of a urinary tract infection?

Constipation

Frequent urination.

Chest pain

Headache
1630. What is the name of the condition where there is an abnormal growth in the penis?

Penile cancer

Penile adenoma.

Penile cyst

Penile polyp

1631. What is the name of the condition where there is an abnormal growth in the seminal vesicles?

Seminal vesicle cancer

Seminal vesicle cyst

Seminal vesicle adenoma.

Seminal vesiculitis

1632. What is the name of the condition where there is an infection of the urethra caused by a sexually transmitted infection?

Urethritis

Cystitis

Pyelonephritis

Gonococcal urethritis.

1633. A patient with bladder cancer presents for evaluation. What is the most appropriate staging test?

Magnetic resonance imaging (MRI) scan

Computed tomography (CT) scan.

Positron emission tomography (PET) scan

Ultrasound

1634. What is the name of the condition where there is a blockage in the urinary tract that prevents the flow of urine?

Ureteral stricture

Ureteral diverticulum

Ureteral caruncle

Urinary obstruction.

1635. What is the name of the condition where there is an abnormal enlargement of the lymph nodes in the groin area?

Inguinal lymphadenitis

Inguinal lymphadenopathy.
 Inguinal lymphoma

Inguinal lymphedema

1636. What is the name of the condition where there is a buildup of fluid in the kidney?

Renal abscess

Renal cyst

Renal tumor

Hydronephrosis.

1637. What is the name of the condition where there is an abnormal growth in the prostate gland?

Prostate cancer

Benign prostatic hyperplasia

Prostatic adenoma.

Prostatitis

1638. What is the name of the condition where there is an abnormal connection between the bladder and the vagina?

Vesicovaginal fistula

Urethrovaginal fistula

Ureterovaginal fistula

Cystourethrocele.

1639. What is the name of the condition where there is a blockage in the ureter due to a stone?

Ureteral stricture

Ureteral cancer

Ureteral obstruction

Ureteral stone.

1640. What is the name of the condition where there is an abnormal growth in the adrenal gland?

Adrenal cancer

Adrenal adenoma.

Adrenal hyperplasia

Adrenal insufficiency
Test System 2023