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2014_wiosna
|
2014
|
spring
| 1
|
A 64-year-old obese man comes to the office because of knee joint stiffness. It is most noticeable when he wakes up in the morning or after a period of inactivity. The symptoms have started several years ago and have worsened since then. The serum uric acid concentration is increased. He has never had kidney stones or an acute attack of gout. Indicate the least appropriate next step in this case:
A. start treatment with allopurinol.
B. recommend low purine diet.
C. administer nonsteroidal anti-inflammatory drugs.
D. suggest physical therapy.
E. advise weight loss.
|
A
|
2014_wiosna
|
2014
|
spring
| 36
|
Tumor lysis syndrome:
A. refers to metabolic disorders in terminally ill patients.
B. includes hypercalcemia and hyponatremia.
C. includes hyperuricemia and hyperkalemia, hyperphosphatemia and hypocalcemia.
D. is typical complication of gastrointestinal tract tumors.
E. A and B are true.
|
C
|
2014_wiosna
|
2014
|
spring
| 159
|
Symptoms indicating a stroke should be first differentiated from:
A. hypokalemia.
B. pulmonary embolism.
C. hypoglycemia.
D. myocardial infarction.
E. pneumonia.
|
C
|
2014_wiosna
|
2014
|
spring
| 61
|
The most common cause of chest pain in children is:
A. musculoskeletal cause.
B. gastrointestinal cause.
C. cardiac cause.
D. respiratory cause.
E. zoster.
|
A
|
2014_wiosna
|
2014
|
spring
| 122
|
A patient, who had removed a tick from his arm the previous day, has visited his/her GP. Which of the following do describe the correct doctor’s approach?
A. observation for possible Lyme disease symptoms.
B. single oral application of 100 mg doxycycline.
C. recommendation to take doxycycline 100 mg twice daily for 14-21 days.
D. recommendation to take amoxicillin 500 mg three times per day for 14-21 days.
E. recommendation to take azithromycin 500 mg once daily for 14-21 days.
|
A
|
2014_wiosna
|
2014
|
spring
| 175
|
Glucagon is a drug used, among others, in:
A. hyperglycemia.
B. hyperkalemia.
C. beta-blockers intoxication.
D. amanita phalloides poisoning.
E. hyperkalcemia.
|
C
|
2014_wiosna
|
2014
|
spring
| 163
|
Pulse oximeter readings may be wrongly underestimated in the case of:
A. cyanide poisoning.
B. hypovolemic shock.
C. carbon monoxide poisoning.
D. jaundice.
E. all the above answers are true.
|
B
|
2014_wiosna
|
2014
|
spring
| 134
|
Abnormal health conditions are considered vaccination-associated reactions (except after BCG vaccine) when occur within:
A. 4 weeks after the vaccination.
B. 6 weeks after the vaccination.
C. 8 weeks after the vaccination.
D. 3 months after the vaccination.
E. 6 months after the vaccination.
|
A
|
2014_wiosna
|
2014
|
spring
| 94
|
The most frequent causes of acute pancreatitis:1) alcoholic hepatic cirrhosis;2) vitamin A deficiency;3) alcohol ingestion;4) excess carbohydrates in food;5) choledocholithiasis.The correct answer is:
A. 1,2.
B. 2,3.
C. 1,3.
D. 4,5.
E. 3,5.
|
E
|
2014_wiosna
|
2014
|
spring
| 143
|
Cannabinoids act in the brain mainly through:
A. enhancement of dopamine release.
B. reduction of dopamine release.
C. enhancement of serotonine release.
D. reduction of serotonine release.
E. enhancement of noradrenaline release.
|
A
|
2014_wiosna
|
2014
|
spring
| 114
|
Which of the following can inhibit uterus contractions?
A. progesterone.
B. ACTH.
C. prostaglandins.
D. A, B are true.
E. A, B and C are true.
|
D
|
2014_wiosna
|
2014
|
spring
| 102
|
According to Modified White Classification of Diabetes the onset of the disease at the age of 20 or older and/or the duration of less than 10 years is class:
A. A.
B. B.
C. C.
D. D.
E. R.
|
B
|
2014_wiosna
|
2014
|
spring
| 82
|
Nutritional treatment should be started:
A. in critically ill patients when planned starvation is going to last more than 5 days.
B. when there is no effective oral nutrition for 7-10 days.
C. in patients with cachexia when oral nutrition is not possible or it does not cover daily requirements.
D. true answers: A and C.
E. true answers: A, B, C.
|
E
|
2014_wiosna
|
2014
|
spring
| 155
|
A 30-years old man who - because of love affair - has treaten to commit suicide and has begun the preparation for it has been brought by the police to the Emergency Room of a psychiatric hospital. The man has not been previously treated because of mental problems and does not give his consent for admission to the psychiatric hospital. What should be the correct decision of the physician from the Emergency Room (according to Polish Mental Health Act)?
A. to admit the patient because he is “mentally ill”.
B. to refuse the admission because the patient is not “mentally ill”.
C. to admit the patient in order to clarify whether he is “mentally ill”.
D. to refer the patient to the out-patient psychiatric care.
E. to ask for the advice of another physician because the involuntary admission to the psychiatric hospital requires the decision of two psychiatrists.
|
C
|
2014_wiosna
|
2014
|
spring
| 16
|
A 40-year-old woman has edema, RR 170/100 mmHg, proteinuria>3.5 g/24h, hypoalbuminemia, hypercholesterolemia and microscopic hematuria. What is the diagnosis?
A. acute interstitial nephritis.
B. nephritic syndrome.
C. nephrotic syndrome.
D. rapidly progressive glomerulonephritis.
E. hypertensive nephropathy.
|
C
|
2014_wiosna
|
2014
|
spring
| 41
|
Gottron's sign is found in:
A. localized morphea.
B. atopic dermatitis.
C. dermatomyositis.
D. generalized morphea.
E. Schönlein-Henoch purpura.
|
C
|
2014_wiosna
|
2014
|
spring
| 179
|
Does the Polish Code of Medical Ethics include an article concerning human cloning?
A. yes, the Code recommends that the doctor should do it.
B. no, the Code does not regulate this issue.
C. yes, the Code allows therapeutic cloning.
D. yes, the Code allows cloning for reproductive purposes.
E. yes, the Code prohibits the doctor from cloning humans.
|
E
|
2014_wiosna
|
2014
|
spring
| 196
|
Which of the following are the examples of practical measures in health promotion implemented internationally and initiated by the World Health Organization?
A. Project Healthy Cities.
B. Health Promoting Schools.
C. Health Promoting Hospitals.
D. Health Promotion at Workplace.
E. all the above.
|
E
|
2014_wiosna
|
2014
|
spring
| 57
|
Factors predisposing to thrombosis are:
A. polycythemia.
B. steroid therapy.
C. hipofibrynogenemia.
D. correct answer is A,B.
E. correct answer is A,B,C.
|
D
|
2014_wiosna
|
2014
|
spring
| 180
|
In what circumstances, according to the Polish Code of Medical Ethics, the doctor should sustain the functioning of cells, tissues and organs after the declaration of brain death?
A. if they are to be examined.
B. if they are to be transplanted.
C. if they are not to be transplanted.
D. if required by the CPR.
E. after the CPR.
|
B
|
2014_wiosna
|
2014
|
spring
| 138
|
Risk factor for chronic venous insufficiency is:
A. female gender.
B. pregnancy.
C. obesity.
D. standing or sitting position during working hours.
E. all the above.
|
E
|
2014_wiosna
|
2014
|
spring
| 139
|
Which of the following is recommended in a patient on chronic vitamin K antagonist (VKA) therapy with INR > 4.5 but < 6.0, and no bleeding signs?
A. VKA withdrawal till INR drops to 2.0-3.0 (usually 1-2 days).
B. VKA withdrawal for 5-10 days and 2 mg of oral vitamin K.
C. VKA withdrawal for 5-10 days and 5-10 mg of oral vitamin K.
D. VKA withdrawal for 5-10 days and slow drip of 5-10 mg of vitamin K.
E. maintain the existing dose of VKA and give orally 5 mg of vitamin K till INR reaches 2.0-3.0.
|
A
|
2014_wiosna
|
2014
|
spring
| 181
|
The Law on medical activity provides for the possibility of requiring a doctor to perform co-called telephone duty, or standby to provide health services:1) only specialists can be committed for such duty;2) duration of such duty shall not exceed three hours for 24 hours;3) for each hour of such duty a doctor is entitled to remuneration in the amount of 50% of hourly basic salary;4) order to perform such duty can be issued only in the event of natural disasters;5) employees with higher education who perform medical profession, and are employed in the hospital can be committed for such duty.The correct answer is:
A. 3,4.
B. 1,3.
C. 2,3.
D. 3,5.
E. 4,5.
|
D
|
2014_wiosna
|
2014
|
spring
| 56
|
Neutropenia is not characteristic of:
A. Evans syndrome.
B. Diamond-Shwachman syndrome.
C. primary immune neutropenia.
D. Kawasaki disease.
E. Kostmann disease.
|
D
|
2014_wiosna
|
2014
|
spring
| 178
|
Polish Code of Medical Ethics regulating the behaviour of doctors in the modern world directly relates to:
A. internet.
B. social portal.
C. therapeutic cloning.
D. answers A,B,C are true.
E. answers A,B,C are false.
|
C
|
2014_wiosna
|
2014
|
spring
| 197
|
What conditions should diagnostic screening test meet?1) simplicity, ease of conduct and unambiguous interpretation;2) acceptance by the subjects;3) social significance of pathology for which the test is directed;4) important economic and ethical aspect of the results of the diagnosis.The correct answer is:
A. all the above.
B. 1,2,3.
C. 1,2.
D. only 1.
E. none of the above.
|
A
|
2014_wiosna
|
2014
|
spring
| 40
|
Revised Jones criteria are used in the diagnosis for the rheumatic fever in children. Which of the following is not a major criterion?
A. arthritis.
B. Sydenham’s chorea.
C. erythema marginarum.
D. subcutaneous nodules.
E. fever.
|
E
|
2014_wiosna
|
2014
|
spring
| 17
|
A 25-year-old man has noticed the recurrent episodes of macroscopic hematuria appearing 1-2 times a year during or immediately following upper respiratory infections for the last two years. What is the most probable diagnosis?
A. IgA nephropathy.
B. nephrolithiasis.
C. Henoch-Schonlein syndrome.
D. asymptomatic microscopic hematuria.
E. hemolytic-uremic syndrome.
|
A
|
2014_wiosna
|
2014
|
spring
| 154
|
According to the Polish Mental Health Act (art. 23) the admission to the psychiatric hospital without patient’s consent is allowed only when the person (indicate the exact description):
A. has mental problems.
B. is mentally ill.
C. is adult.
D. does not give consent for the treatment.
E. is aggressive toward others.
|
B
|
2014_wiosna
|
2014
|
spring
| 83
|
Partial nail fold removal for the treatment of the first right toe paronychia should be performed:
A. in block anesthesia (Oberst’s method).
B. in local anesthesia - conduction anesthesia.
C. with locally applied ethyl chloride.
D. true answers: B and C.
E. anesthesia is not required.
|
A
|
2014_wiosna
|
2014
|
spring
| 103
|
Which of the following is the most common complication of sudden elevation of arterial blood pressure in a pregnant woman:
A. placental abruption .
B. pulmonary edema.
C. Mendelson’s syndrome.
D. postpartum uterine atony .
E. fetal cerebral edema.
|
A
|
2014_wiosna
|
2014
|
spring
| 115
|
Which of the following contraceptive methods has the lowest Pearl’s index?
A. condom.
B. calendar method.
C. combined oral contraceptive pill.
D. intrauterine device.
E. spermicides.
|
C
|
2014_wiosna
|
2014
|
spring
| 142
|
Syndrome including various somatic and psychiatric symptoms which appear a couple of hours after cessation of alcohol drinking, is called:
A. delirium.
B. amnestic syndrome.
C. abstinence syndrome.
D. delusional syndrome.
E. Otello’s syndrome.
|
C
|
2014_wiosna
|
2014
|
spring
| 95
|
In pancreatic head cancer:1) there is mechanical jaundice;2) empyema of gallbladder develops;3) coffee-grounds vomiting appears;4) intrahepatic and extrahepatic ducts are being expanded;5) portal hypertension occurs.The correct answer is:
A. 1,2.
B. 1,4.
C. 2,5.
D. 1,5.
E. 1,3.
|
B
|
2014_wiosna
|
2014
|
spring
| 135
|
Side effect typical of DTP vaccine (diphtheria, tetanus and pertussis) is:
A. thrombocytopenia.
B. orchitis.
C. inflammation of salivary glands.
D. arthritis (usually of small joints of hands and feet).
E. hypotonic-hyporesponsive episode.
|
E
|
2014_wiosna
|
2014
|
spring
| 162
|
Please indicate true statement about acute respiratory failure:
A. gas exchange disorder leads to hypoxemia, ventilation disorder leads to hypocapnia.
B. gas exchange disorder leads to hypercapnia, ventilation disorder leads to hypoxemia.
C. gas and ventilation disorder mean the same, and the hypercapnia develops secondary to hypoxemia.
D. hypoxemia is always associated with non-respiratory acidosis.
E. hypoxemia gives increased patient’s drowsiness until coma.
|
A
|
2014_wiosna
|
2014
|
spring
| 174
|
Indication for electrical cardioversion is:
A. hemodynamically unstable supraventricular tachycardia.
B. every ventricular tachycardia.
C. permanent atrial fibrillation.
D. third degree atrioventricular block.
E. ventricular tachycardia without a pulse.
|
A
|
2014_wiosna
|
2014
|
spring
| 123
|
Which of the following is not a risk factor for thromboembolic disease?
A. BMI 30 kg/m2.
B. malignancy.
C. pregnancy.
D. microcytic anemia.
E. airplane flight above 6 hours.
|
D
|
2014_wiosna
|
2014
|
spring
| 60
|
Isolated prolongation of INR in a child with bleeding diathesis in the skin, we suspect:
A. isolated factor VII deficiency.
B. factor VIII deficiency.
C. vitamin K deficiency.
D. plasma factor V deficiency.
E. von Willebrand factor deficiency.
|
A
|
2014_wiosna
|
2014
|
spring
| 158
|
Which of the following drugs are applied together with defibrillation in the treatment of ventricular fibrillation acc. to ALS?
A. atropine, sodium bicarbonate.
B. adrenaline, amiodarone, magnesium sulfate.
C. atropine, sodium bicarbonate, magnesium sulfate.
D. atropine, amiodarone, hydrocortisone.
E. adrenaline, calcium chloride, vasopressin.
|
B
|
2014_wiosna
|
2014
|
spring
| 37
|
In a 65-year-old man with hypochromic anemia and an increased serum CEA level you should suspect:
A. gastric cancer.
B. pancreatic cancer.
C. colon cancer.
D. liver cancer.
E. A and B are true.
|
C
|
2014_wiosna
|
2014
|
spring
| 119
|
The fetus position means:
A. orientation of fetus parts relative to the pelvis of the mother.
B. ratio of the long axis of the fetus and the long axis of the pelvis of the mother.
C. orientation between fetus parts.
D. ratio of the fetus head and trunk.
E. orientation of the presenting fetus part relative to interspinous distance.
|
A
|
2014_wiosna
|
2014
|
spring
| 76
|
Femoral neck fracture in the elderly may be life threatening due to the complications of immobility such as:1) thrombosis; 2) pulmonary embolism;3) urinary tract infection;4) cardiac arrhythmias;5) ascites.The correct answer is:
A. 1,2,3.
B. 3,4.
C. 1,2.
D. all the above.
E. 1,2,4.
|
A
|
2014_wiosna
|
2014
|
spring
| 99
|
In pregnant patients vaginal and rectal swabs for Streptococcus agalactiae (GBS) screening should be taken:
A. in 8 weeks gestation.
B. between 11 and 14 weeks gestation.
C. in 20 weeks gestation.
D. between 24 and 28 weeks gestation.
E. between 35 and 37 weeks gestation.
|
E
|
2014_wiosna
|
2014
|
spring
| 92
|
Felon:1) is an infection located on the palmar surface of fingers and metacarpus;2) is an infection located on the plantar surface of a foot;3) its treatment is based on antibiotics and immobilization;4) its treatment is based on incision, drainage and immobilization;5) it is caused by trauma.The correct answer is:
A. 1,3,5.
B. 1,4,5.
C. 2,3,5.
D. 2,4,5.
E. 2,4.
|
B
|
2014_wiosna
|
2014
|
spring
| 112
|
Which of the following is the most accurate method of pregnancy assessment?
A. Naegele’s rule.
B. CRL measurement during ultrasound performed between the week 7th and 11th.
C. ultrasound measurement of four parameters, independent of gestational age.
D. palpation of the uterus fundus height.
E. measurement of the beta-hCG serum level.
|
B
|
2014_wiosna
|
2014
|
spring
| 104
|
A 24-year-old woman complains on irregular vaginal bleeding 3 months after parturition. The examination shows the body of the uterus of normal size and painless, the vaginal part of the cervix is formed, the canal is closed. Which of the following examinations should be first performed?
A. FSH and LH concentrations.
B. β-hCG concentration.
C. D&C (dilation and curettage).
D. Doppler spectrum of uterine arteries.
E. progesterone concentration.
|
B
|
2014_wiosna
|
2014
|
spring
| 84
|
Cholecystolithiasis may cause obstruction of gastrointestinal tract because the large gallstone can get through the fistula into the small intestine and stop at the ileocecal valve (Bauhin’s valve).
A. theorem is true, rationale is false.
B. theorem is false, rationale is true.
C. both theorem and rationale are false.
D. both theorem and rationale are true, but there is no cause-effect relationship.
E. both theorem and rationale is true, and there is a cause-effect relationship.
|
E
|
2014_wiosna
|
2014
|
spring
| 153
|
Which of the following is not the absolute contraindication for the electroconvulsive therapy?
A. severe cardio-vascular disease.
B. intense suicidal thoughts and tendencies.
C. intracranial aneurism.
D. recent brain infarct.
E. decompensated diabetes.
|
B
|
2014_wiosna
|
2014
|
spring
| 10
|
A 52 year-old-man with his 42-year-old wife who is in 6th week of pregnancy have slightly elevated levels of TSH (5.6 mUl/l), with normal FT3 and FT4 concentrations. They do not have any clinical signs of hypothyroidism. Who should be promptly treated with thyroxine:
A. husband and wife.
B. only wife.
C. only husband.
D. neither husband nor wife.
E. husband or wife depending on the test result of TSH after TRH.
|
B
|
2014_wiosna
|
2014
|
spring
| 128
|
Indicate which of the following statements is false:
A. Epstein Barr virus is an etiological factor of infectious mononucleosis.
B. facial nerve paralysis can be a complication of shingles.
C. rubella gives a lifelong immunity in most cases.
D. mumps is symptomless in 20-30% of cases.
E. patient with measles can be infectious to the others from the moment of the rash occurrence till its disappearance.
|
E
|
2014_wiosna
|
2014
|
spring
| 47
|
You will advice parents who have a child with gastroesophageal reflux:
A. AR milk.
B. HA milk.
C. only breast feeding.
D. aminoacid mixtures.
E. soya milk.
|
A
|
2014_wiosna
|
2014
|
spring
| 190
|
In accordance with the Law on an old age and a disability pension from the Social Insurance Fund (ZUS), incapacity to work for the pension purposes is ruled for the period not longer than:
A. 1 year.
B. 2 years.
C. 3 years.
D. 4 years.
E. 5 years.
|
E
|
2014_wiosna
|
2014
|
spring
| 51
|
The most common malignant solid tumor occuring in infants is:
A. neuroblastoma.
B. retinoblastoma.
C. osteosarcoma.
D. hepatoblastoma.
E. nephroblastoma.
|
A
|
2014_wiosna
|
2014
|
spring
| 169
|
Cardiopulmonary resuscitation should not be attempted if:
A. justified decision to discontinue resuscitation was made before cardiac arrest happened.
B. bringing the patient back to life is not possible due to patient’s condition and presence of comorbidities.
C. cancer disease is diagnosed in a patient.
D. true answers: A, B, C.
E. true answers: A and B.
|
E
|
2014_wiosna
|
2014
|
spring
| 186
|
Social pension is not granted if total incapacity to work resulted from the impairment of the body occurred:
A. before the age of 18 years.
B. during high school or university period before the age of 25 years.
C. during employment.
D. during doctoral studies.
E. during scientific postgraduate studies.
|
C
|
2014_wiosna
|
2014
|
spring
| 149
|
The most frequent factor predicting the suicide is the presence of:
A. alcohol abuse.
B. mental disorders.
C. abuse of stimulant substances.
D. suicide in patients’ family.
E. loneliness.
|
B
|
2014_wiosna
|
2014
|
spring
| 71
|
In order to assess the capacity and patency of the deep and superficial veins of the lower limbs we can do:1) Trendelenburg test;2) Perthes test;3) Adson test;4) compression ultrasonography;5) venography.The correct answer is:
A. 1,2.
B. 1,2,4,5.
C. 3,4,5.
D. 1,4,5.
E. all above.
|
B
|
2014_wiosna
|
2014
|
spring
| 26
|
A 50-year-old man with chronic kidney disease (eGFR 26 mL/min) was diagnosed with dyslipidemia: total cholesterol 280 mg/dL, triglycerides 380 mg/dL. Choose the appropriate treatment:
A. lifestyle modification + atorvastatin.
B. gemfibrozil + rosuvastatin.
C. gemfibrozil.
D. lifestyle modification + gemfibrozil.
E. lifestyle modification.
|
A
|
2014_wiosna
|
2014
|
spring
| 7
|
A 72-year old man has been brought to the emergency department because of acute tetany. Two weeks ago thyroidectomy was performed in this patients because of a retrosternal goiter. Which of the following is the most appropriate next step:
A. give calcium gluconate infusion intravenously.
B. give 0.9% NaCl infusion intravenously.
C. give KCl infusion intravenously.
D. give 5% glucose infusion intravenously.
E. give calcium blocker.
|
A
|
2014_wiosna
|
2014
|
spring
| 108
|
Which of the following are the risk factors for endometrium cancer:1) obesity;2) PCOS;3) diabetes;4) hypertension;5) nulliparity;6) late menopause.The correct answer is:
A. 1,2,3,5.
B. 1,3,4,5.
C. 1,3,4,5,6.
D. 2,4,5,6.
E. all the above.
|
E
|
2014_wiosna
|
2014
|
spring
| 30
|
A 24-year-old woman with no PMH had laparoscopic cholecystectomy because of numerous small gallstones in her gallbladder. Two weeks later at night she had pain in her middle upper abdomen. The next day laboratory exams showed: AST 300 IU/L, ALT 260 IU/L, serum bilirubin 2.4 mg/dL, serum and urine amylase negative. Ultrasound showed no changes in the liver, biliary ducts and pancreas. The patient’s eyes are slightly yellow and urine is dark. The most probable diagnosis is:
A. acute viral hepatitis.
B. acute pancreatitis.
C. choledocholithiasis.
D. iatrogenic injury - the possibility of bile duct ligation.
E. liver cirrhosis.
|
C
|
2014_wiosna
|
2014
|
spring
| 88
|
Mechanical ileus:1) most frequently is caused by colon cancer;2) starts with frequent urge to defecate;3) gives slow heartbeat;4) most frequently is caused by peritoneal adhesions;5) most frequently refers to small intestine.The correct answer is:
A. 1,2.
B. 2,3.
C. 4,5.
D. 2,4.
E. 2,5.
|
C
|
2014_wiosna
|
2014
|
spring
| 124
|
In the community acquired pneumonia of adults, the outpatient drug of first choice is:
A. amoxicillin.
B. amoxicillin with clavulanic acid.
C. cephalosporin.
D. macrolide.
E. benzylpenicillin.
|
A
|
2014_wiosna
|
2014
|
spring
| 173
|
Complications of CPR comprise:
A. rib fractures.
B. sternum fractures.
C. hemorrhage into the pericardium.
D. stomach rupture.
E. all the answers are true.
|
E
|
2014_wiosna
|
2014
|
spring
| 165
|
Immediate treatment of tension pneumothorax comprises cannula puncture in the following chest area:
A. IV intercostal space (above rib V) in midclavicular line.
B. IV intercostal space (below rib V) in midaxillary line.
C. II intercostal space (above rib II) in anterior axillary line.
D. III intercostal space (below rib III) in midclavicular line.
E. II intercostal space (above rib III) in midclavicular line.
|
E
|
2014_wiosna
|
2014
|
spring
| 132
|
Orthostatic hypotension can be diagnosed when during a 3-minutes tilting test:
A. at least 20 mmHg drop of systolic blood pressure is noted.
B. at least 20 mmHg drop of diastolic blood pressure is noted.
C. systolic blood pressure drops below 90 mmHg.
D. A, B are true.
E. A, B and C are true.
|
E
|
2014_wiosna
|
2014
|
spring
| 133
|
Which of the following interventions in COPD patients can reduce the risk for disease development and partially stop its progression?
A. smoking cessation.
B. regular physical activity.
C. regular sanatorium treatment.
D. annual flu vaccination.
E. all the above.
|
A
|
2014_wiosna
|
2014
|
spring
| 164
|
Pulmonary hemorrhage means:
A. expectoration of more than 100 ml of blood hourly or over 300-500 ml daily.
B. expectoration of approx. 50 ml of blood hourly or approx. 100-200 ml daily.
C. single expectoration of 500 ml of blood.
D. hemoptysis at least 10 times daily.
E. none of the answers is true.
|
A
|
2014_wiosna
|
2014
|
spring
| 125
|
Physical exam of the patient reveals over the lung deadened tone on percussion, fremitus more pronounced, rales. These symptoms may suggest:
A. obstructive atelectasis.
B. lung fibrosis.
C. lung infiltration.
D. pneumothorax.
E. airways obstruction.
|
C
|
2014_wiosna
|
2014
|
spring
| 66
|
Choose the false statement concerning scarlet fever:
A. rash is caused by streptococcal pyrogenic exotoxin.
B. it is related to the Group A beta-hemolytic streptococcal infection.
C. the most intense lesions are found in the area around the mounth and naso-labial folds (Filatov triangle).
D. the rash forms the classic red streaks known as Pastia lines.
E. form the second week desquamation (flakes peeling) appears.
|
C
|
2014_wiosna
|
2014
|
spring
| 89
|
Acute appendicitis:1) can occur at any age;2) can be treated with laparoscopic surgery;3) starts with heavy vomiting;4) is caused by E. coli infection;5) accompanies upper respiratory tract infections.The correct answer is:
A. 1,2.
B. 2,3.
C. 2,4.
D. 1,4.
E. 2,5.
|
A
|
2014_wiosna
|
2014
|
spring
| 31
|
A 48-year-old man, healthy so far, has abnormal liver tests: ALT 118 IU/L, AST 64 IU/L (performed on a regular check-up). He is abstinent, BMI is normal; he does not take any medicines or dietary supplements. Family history is negative for liver disease. During childhood he underwent three abdominal surgeries because of purulent appendicitis and adhesive bowel obstruction. Indicate an additional test which should be performed in this patient first:
A. serum iron level.
B. serum ceruloplasmin and copper levels.
C. blood alfa-1 antitrypsin level.
D. hepatic viruses markers - HBsAg and anti-HCV.
E. no tests are needed, except for ALT and AST follow-up in 2-3 months.
|
D
|
2014_wiosna
|
2014
|
spring
| 6
|
A 72-year-old woman is brought to the emergency department because of dehydration caused by vomiting. She has tachycardia and her arterial blood pressure is 90/60 mmHg. Indicate the least appropriate next step in this case:
A. 0.9% NaCl intravenous infusion.
B. start intravenous infusion of verapamil.
C. intravenous KCl infusion in glucose solution.
D. check serum creatinine concentration.
E. check blood glucose concentration.
|
B
|
2014_wiosna
|
2014
|
spring
| 109
|
Delayed puberty in girls is diagnosed when no somatic and hormonal changes occur after the age of:
A. 10.
B. 13.
C. 15.
D. 17.
E. 18.
|
B
|
2014_wiosna
|
2014
|
spring
| 27
|
A 56-year-old man reports increasing severe lower abdominal and left iliac fossa pain lasting for the last three days. These are accompanied by dysuria, a variable mode of defecation and fever up to 39°C. He has not been treated because of chronic diseases. The most probable diagnosis is:
A. left renal colic.
B. sigmoid diverticulitis.
C. ischemic colitis.
D. cystitis.
E. infectious colitis.
|
B
|
2014_wiosna
|
2014
|
spring
| 70
|
There are following symptoms of acute abdomen:
A. stomachache.
B. nausea and vomiting.
C. coprostasis and retention of gases.
D. all among above.
E. only A and B answers.
|
D
|
2014_wiosna
|
2014
|
spring
| 148
|
For the diagnosis of bipolar affective disorder it is mandatory to diagnose in the course of the disorder:
A. multiple depressive episodes.
B. one depressive episode during the antipsychotic treatment.
C. manic episode.
D. multiple manic episodes.
E. all of above.
|
C
|
2014_wiosna
|
2014
|
spring
| 168
|
30-years-old patient admitted to the ER after traffic accident presents rapid breathing, prolonged capillary return, pale skin, pulse 110/minute, arterial blood pressure 110/80 mmHg with decreased pulse amplitude. You should diagnose:
A. class I of hypovolemic shock.
B. class II of hypovolemic shock.
C. class III of hypovolemic shock.
D. class IV of hypovolemic shock.
E. normal status - shock is not suspected.
|
B
|
2014_wiosna
|
2014
|
spring
| 187
|
The rulings on disability and the degree of disability are issued by:
A. SIF (ZUS) certifying doctors and SIF (ZUS) medical boards.
B. ASIF (KRUS) certifying doctors and ASIF (KRUS) medical boards.
C. district and provincial Disability Adjudication Boards.
D. military medical boards.
E. Ministry of Internal Affairs (MSW) medical boards.
|
C
|
2014_wiosna
|
2014
|
spring
| 191
|
The medical ruling on temporary incapacity to work is issued with two copies. The doctor issuing the ruling provides its first copy for:
A. local branch of SIF (ZUS).
B. headquarters of SIF (ZUS).
C. insured person.
D. National Health Fund (NFZ).
E. employer.
|
C
|
2014_wiosna
|
2014
|
spring
| 46
|
Rubella infection in pregnant woman after 16 weeks of pregnancy may cause in newborn:
A. eye malformations.
B. malformations of urinary tract.
C. hearing loss.
D. cataracta.
E. teeth abnormalities.
|
C
|
2014_wiosna
|
2014
|
spring
| 129
|
Eosinophilia > 1500/µl on peripheral blood count can be caused by:
A. allergy.
B. parasitic diseases.
C. Hodgkin’s disease.
D. A, B are true.
E. A, B and C are true.
|
E
|
2014_wiosna
|
2014
|
spring
| 200
|
According to the World Health Organization statistics concerning the causes of death in the world Chronic Obstructive Pulmonary Disease is fourth in the ranking. The risk factors for this disease include:1) environmental pollution;2) smoking;3) physical inactivity.The correct answer is:
A. only 1.
B. only 2.
C. only 3.
D. 1,3.
E. all the above.
|
E
|
2014_wiosna
|
2014
|
spring
| 11
|
The blood glucose of a 57-year-old obese male is: fasting 121 mg/dL, after one hour oral glucose tolerance test 257 mg/dl and after two hours 195 mg/dl. The physician should:
A. recognize diabetes and start insulin treatment.
B. recognize diabetes and start treatment with metformin.
C. recognize diabetes and recommend lifestyle modification.
D. not recognize diabetes, but consider lifestyle modification.
E. not recognize diabetes or give any special recommendation.
|
D
|
2014_wiosna
|
2014
|
spring
| 152
|
Anxiolytic use of hydroxizine is limited because of its:
A. dependence potential.
B. lack of sedation.
C. affinity to the H1 receptor causing drowsiness.
D. answers A and B are correct.
E. answers A,B and C are correct.
|
C
|
2014_wiosna
|
2014
|
spring
| 85
|
Please choose the set of features characterizing Crohn’s disease:1) pathological changes may occur in every part of the gastrointestinal tract;2) the changes are limited to the mucous and submucous membranes;3) perianal fistulae occur frequently;4) sparing surgery is a gold-standard procedure;5) total colectomy is performed in this disease.The correct answer is:
A. 1,2,4.
B. 2,5.
C. 2,3,5.
D. 1,3,4.
E. 1,2,3,4.
|
D
|
2014_wiosna
|
2014
|
spring
| 105
|
Which of the following is used in the prophylaxis of neural tube defects:
A. vitamin A.
B. vitamin E.
C. vitamin D.
D. vitamin K.
E. folic acid.
|
E
|
2014_wiosna
|
2014
|
spring
| 113
|
The most common neoplastic marker characteristic of ovarian cancer is CA 125. An increased CA 125 level occurs also in:
A. pancreatic cancer.
B. endometriosis.
C. adnexitis.
D. uterine leiomyomas.
E. all the above.
|
E
|
2014_wiosna
|
2014
|
spring
| 144
|
The diagnosis of schizophrenia is made mainly on the basis of presence og “4 A” symptoms, which include:
A. ambi (-valence, -sentence, -tendence) and automatism.
B. autism and automatism.
C. automatism and association.
D. ambi (-valence, -sentence, -tendence) and autism.
E. ambi (-valence, -sentence, -tendence).
|
D
|
2014_wiosna
|
2014
|
spring
| 93
|
Hernias in surgical scar:1) are the result of an abscess located in surgical incision;2) should be treated with hernia belt;3) can become a place of bowel incarceration;4) should be treated with tension-free surgical repair;5) can frequently cause gastrointestinal bleeding.The correct answer is:
A. 1,2,5.
B. 1,3,4.
C. 1,4,5.
D. 1,3,5.
E. 1,2,3.
|
B
|
2014_wiosna
|
2014
|
spring
| 184
|
During an operation on a patient under general anesthesia a new circumstance occurs, namely a need to expand the operating field. Before the operation the patient, who is of legal age and capacitation, expressed neither his consent nor objection to that. Such an operation is permissible if:1) doctor obtains consent of the legal representative of the patient;2) patient’s close person expresses their consent;3) excluding this new circumstance would threaten patient’s life, cause severe body injury or health dysfunction;4) doctor, if possible, consults another doctor of the same as far as possible specialty;5) only if there is a direct threat to the life of the patient.The correct answer is:
A. 1,2.
B. 3,4.
C. 2,4.
D. 4,5.
E. 1,5.
|
B
|
2014_wiosna
|
2014
|
spring
| 53
|
In a 2 year old child with viral infection of the nasopharynx platelet counts is 770 thousands/ul:
A. platelet count is within normal values and does not require investigation.
B. this is reactive throbocytosis and does not require investigation.
C. it is an indication for urgent haematological investigation.
D. antiplatelets drugs should be used.
E. all answers are false.
|
B
|
2014_wiosna
|
2014
|
spring
| 192
|
The doctor issuing a ruling on temporary incapacity to work is required to store its second copy for:
A. 7 years.
B. 5 years.
C. 3 years.
D. 1 year.
E. half a year.
|
C
|
2014_wiosna
|
2014
|
spring
| 45
|
The most often pathogenic agent in pyelonephritis in infants is:
A. Escherichia coli.
B. Pseudomonas aeruginosa.
C. Klebsiella pneumoniae.
D. Streptococcus pneumoniae.
E. Rotavirus.
|
A
|
2014_wiosna
|
2014
|
spring
| 12
|
Which of the following speak in favour of diagnosis of polymyalgia rheumatica in a male patients with muscle pains of the shoulder girdle, the pelvic girdle and the neck:1) age > 50;2) absence of morning stiffness;3) ESR <10 mm after one hour;4) persistence of the symptoms despite the treatment with prednisone in a dose of 20 mg/day for two weeks.The correct answer is:
A. only 1.
B. 1,2.
C. 2,3.
D. 1,3,4.
E. all the above.
|
A
|
2014_wiosna
|
2014
|
spring
| 151
|
The antipsychotic treatment of schizophrenic pregnant women is:
A. the treatment of choice in chronic schizophrenia.
B. the last option in the case of the failure of other therapeutic methods.
C. the treatment of choice in the presence of catatonic symptoms.
D. harmless to the fetus.
E. absolutely contraindicated.
|
B
|
2014_wiosna
|
2014
|
spring
| 86
|
Current recommendation for the surgical treatment of inguinal hernia include the implementation of alloplasty with the use of synthetic mesh, because this tension-free repair is characterized by a smaller number of infectious complications.
A. theorem is true, rationale is false.
B. theorem is false, rationale is true.
C. both theorem and rationale are false.
D. both theorem and rationale are true, but there is no cause-effect relationship.
E. both theorem and rationale are true and there is a cause-effect relationship.
|
A
|
2014_wiosna
|
2014
|
spring
| 69
|
Before large surgery on gastrointestinal tract the prophylaxis of thromboembolism and the antimicrobial prophylaxis are indicated, because the risk of thromboembolism is increased and the operations field become contaminated.
A. the first and the second sentences are true and there is logical sense.
B. the first and the second sentences are true but there is not logical sense.
C. the first sentence is true and the second sentence is false.
D. the first sentence is true and the second sentence is false.
E. both sentences are false.
|
B
|
2014_wiosna
|
2014
|
spring
| 106
|
Gregg’s triad represents the syndrome of congenital defects associated with viral intrauterine infection caused by:
A. cytomegaly.
B. rubella.
C. chickenpox.
D. measles.
E. mumps.
|
B
|
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