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2014_wiosna
|
2014
|
spring
| 9
|
A 66-year-old man with paroxysmal atrial fibrillation and his 30-year-old daughter in the 8th week of pregnancy have the same results: TSH = 0.1 mlU/L and FT4 and FT3 normal. Thiamazole treatment is justified:
A. in both patients.
B. only in the case of the father.
C. only in the case of the daughter.
D. in neither of them.
E. depending on the level of antithyroid antibodies.
|
B
|
2014_wiosna
|
2014
|
spring
| 110
|
The mechanism of labor comprises four maneuvers of the fetus, which it performs in order to adapt to the space conditions during its way out through the birth canal. The third head maneuver is the following one:
A. head rotation from the transverse dimension into the straight conjugate.
B. head flexion.
C. head rotation toward one of the woman’s thigh.
D. head extension.
E. active descent through the birth canal.
|
D
|
2014_wiosna
|
2014
|
spring
| 28
|
Autoimmune pancreatitis should be suspected in a patient with:1) inflammatory bowel disease;2) primary biliary cirrhosis;3) gastric ulcer;4) Sjögren’s syndrome;5) choledocholithiasis.The correct answer is:
A. 1,2.
B. 1,2,4.
C. 1,3,4.
D. 2,3,4.
E. all the above.
|
B
|
2014_wiosna
|
2014
|
spring
| 147
|
The mood disorders characteristic for depression have two aspects. The first aspect is the feeling of sadness and gloom. Which is the second aspect?
A. inability to concentrate.
B. inability to enjoy life.
C. lack of motivation.
D. loss of libido.
E. anxiety.
|
B
|
2014_wiosna
|
2014
|
spring
| 90
|
Perforation of gastric or duodenal ulcer:1) causes hematemesis;2) gives peritonitis symptoms;3) needs urgent surgery;4) occurs most frequently in men;5) is diagnosed with the gastric endoscopy.The correct answer is:
A. 1,2,3.
B. 2,3.
C. 3,4.
D. 1,3.
E. 1,5.
|
B
|
2014_wiosna
|
2014
|
spring
| 130
|
Which of the following is recommended for the rhythm control in atrial fibrillation with concomitant heart failure?
A. beta blockers.
B. digoxin.
C. verapamil.
D. A, B are true.
E. A, B and C are true.
|
D
|
2014_wiosna
|
2014
|
spring
| 188
|
The insured person is entitled to appeal to SIF (ZUS) medical board against the ruling of SIF (ZUS) certifying doctor within the following period of the receipt of the decision:
A. 30 days.
B. 14 days.
C. 7 days.
D. 5 days.
E. 3 days.
|
B
|
2014_wiosna
|
2014
|
spring
| 167
|
One of the indications for orotracheal intubation is to get on the Glasgow scale which of the following number of points:
A. 9 points.
B. 10 points.
C. 8 points.
D. 12 points.
E. necessity for intubation is not connected with the number of points on Glasgow scale.
|
D
|
2014_wiosna
|
2014
|
spring
| 49
|
Hypoglycemia cannot be caused by:
A. physical strain.
B. malnutrition.
C. insulin overdose.
D. additive meal.
E. stress.
|
D
|
2014_wiosna
|
2014
|
spring
| 171
|
Etomidate is intravenous anesthetic indicated when necessary in the following patients:
A. with hypotonia.
B. pregnant.
C. with increased intracranial pressure.
D. with arterial hypertension.
E. none of the answers is correct.
|
A
|
2014_wiosna
|
2014
|
spring
| 126
|
Which of the following parameters is not included in SCORE scale?
A. age.
B. gender.
C. total cholesterol level.
D. glucose level.
E. systolic blood pressure.
|
D
|
2014_wiosna
|
2014
|
spring
| 65
|
Choose the false statement concerning juvenile idiopathic arthritis:
A. diagnosis of JIA can be established if symptoms occure in child before the age of 16 years.
B. JIA is a heterogeneous disease, with three basic types of onset: polyarticular, oligoarticular and systemic.
C. in the course of JIA "acute phase" reactants could be elevated or normal.
D. the diagnosis of JIA is a contraindication to swimming in a pool.
E. the JIA etiology is unknown and the treatment symptomatic.
|
D
|
2014_wiosna
|
2014
|
spring
| 32
|
A 50-year-old woman who is overweight (BMI = 28 kg/m2) complains of severe right and middle abdominal pain that began a few hours after abundant and “fat” dinner. Additionally: nausea and food vomiting twice. She had similar symptoms 2 years ago, during a wedding reception. Ultrasound performed at that time revealed a few small gallstones in the gallbladder. Gastric endoscopy performed at the same time demonstrated only bile in the stomach. She has recently been taking ibuprofen because of a knee pain and 75 mg of aspirin daily (the latter was recommended by her cardiologist). Her temperature is 38.3 Celsius. Her blood pressure is normal. Her pulse is slightly increased. On examination the right upper abdomen is painful on palpation and the pain increases on shaking. No peritoneal symptoms. Normal intestinal motility. Indicate the most probable diagnosis:
A. biliary gastritis.
B. acute pancreatitis.
C. acute gastric ulcer.
D. colon diverticulitis.
E. acute cholecystitis.
|
E
|
2014_wiosna
|
2014
|
spring
| 5
|
A 75-year-old man comes to the emergency department because of bleeding from the nose. He takes drugs because of permanent atrial fibrillation, but he is not able to recall their names. His blood pressure is 130/80 mmHg. Which of the following tests is the most appropriate one to explain the cause of bleeding?
A. partial thromboplastin time.
B. INR.
C. platelet count.
D. bleeding time test.
E. bone marrow test.
|
B
|
2014_wiosna
|
2014
|
spring
| 24
|
The urinalysis of a 30-year-old man is positive for erythrocytes and dismorphic RBCs. Please indicate the most probable diagnosis:
A. cystitis.
B. urolithiasis.
C. prostatitis.
D. chronic pyelonephritis.
E. glomerulonephritis.
|
E
|
2014_wiosna
|
2014
|
spring
| 73
|
The most common cause of the upper gastrointestinal tract hemorrhage is:
A. gastric ulcer.
B. esophageal varices.
C. duodenal ulcer.
D. gastric cancer.
E. Mallory - Weiss syndrome.
|
C
|
2014_wiosna
|
2014
|
spring
| 72
|
In patient with acute biliary pancreatitis the recommended treatment is:
A. first, conservative treatment. After 7 days performance of endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy and implantation of self-expanding prosthesis into the Wirsung 's duct.
B. emergency laparotomy, cholecystectomy with biliary revision.
C. percutaneous biliary drainage.
D. emergency or early (within 24 hours) endoscopic retrograde cholangiopancreatography with endoscopic sphincterotomy is the recommended treatment.
E. acute pancreatitis is always treated conservatively.
|
D
|
2014_wiosna
|
2014
|
spring
| 25
|
A 68-year-old man was admitted to hospital with the symptoms of congestive heart failure. On examination: blood pressure - 160/86 mmHg, Hb 10.2 g/dL, creatinine level - 2.5 mg/dL, eGFR - 28 mL/min, Na - 132 mmol/L, K - 4.9 mmol/L. Choose the appropriate treatment:
A. furosemide 40 mg i.v. (infusion pump), ramipril 2.5 mg, low sodium diet.
B. hemodialysis.
C. spironolactone 50 mg, furosemide 100 mg p.o.
D. hydrochlorothiazide 50 mg, ramipril 10 mg.
E. hydrochlorothiazide 25 mg, spironolactone 50 mg, ramipril 5 mg.
|
A
|
2014_wiosna
|
2014
|
spring
| 4
|
A 75-year-old man with diabetes comes to the office for a check-up. He has had diabetes for 5 years. He takes the maximal dose of metformin. His HbA1C is 7.1%. Indicate the diet tip which is not proper for the man:
A. choose high-fiber complex carbohydrates.
B. limit soda and candy.
C. eat regular small meals.
D. eat a lot of non-starchy vegetables.
E. eat more trans fats e.g. margarine.
|
E
|
2014_wiosna
|
2014
|
spring
| 33
|
A 40-year-old man underwent gastric endoscopy because of gastroesophageal reflux symptoms lasting for a few days. The urease test is positive. PMH: peptic ulcer disease - negative, anemia - negative, family gastric cancer - negative. He does not take NSAIDs, does not smoke cigarettes. He had Helicobacter pylori (Hp) eradication done. One month after the eradication he had serological test performed (finger blood test, on his own initiative) and this was positive for Helicobacter pylori. In this clinical situation one should:
A. repeat gastric endoscopy and Hp urease test.
B. perform breathing test to confirm Hp infection.
C. recommend Helicobacter pylori eradication with different drugs.
D. order the treatment with proton pump inhibitor (ex. omeprazole) for one month and repeat serological Hp test.
E. explain to the patient that Hp antibodies may appear positive on serological test for years and it is not equal to infection and does not always need treatment.
|
E
|
2014_wiosna
|
2014
|
spring
| 64
|
The characteristic symptoms of metabolic syndrome include, except for:
A. triglyceride above normal values and HDL below normal values.
B. lactose intolerance.
C. increase in blood pressure above normal.
D. fasting glucose above normal.
E. increased waist circumference or BMI above normal.
|
B
|
2014_wiosna
|
2014
|
spring
| 127
|
Which of the Lyme disease symptoms does not need laboratory confirmation of infection?
A. erythema migrans.
B. lymphocytic leukemia.
C. chronic atrophic dermatitis of extremities.
D. arthritis.
E. myocarditis.
|
A
|
2014_wiosna
|
2014
|
spring
| 170
|
Proven efficacy in CPR possesses:
A. adrenaline.
B. early defibrillation used in the appropriate mechanisms.
C. atropine.
D. early orotracheal intubation.
E. vasopressin.
|
B
|
2014_wiosna
|
2014
|
spring
| 48
|
In atypical pneumonia in children you will prescribe:
A. antibiotics are not needed.
B. penicyllins.
C. cefalosporins.
D. aminoglycozides.
E. macrolides.
|
E
|
2014_wiosna
|
2014
|
spring
| 189
|
In accordance with the Law on an old age and a disability pension from the Social Insurance Fund (ZUS) a person, who has suffered the impairment of the body, is considered unable to live independently if they require:
A. assistance in daily activities.
B. care in the acute phase of the disease.
C. assistance in dealing with administrative matters.
D. permanent or long term care of another person in meeting basic needs.
E. legal guardian appointed by the court.
|
D
|
2014_wiosna
|
2014
|
spring
| 166
|
40-years-old patient with cranio-cerebral damage presents flexion response to pain, does not open eyes and makes no sounds. How many points he/she gets on Glasgow scale:
A. 7 points.
B. 8 points.
C. 6 points.
D. 5 points.
E. 4 points.
|
D
|
2014_wiosna
|
2014
|
spring
| 131
|
Screening for gestational diabetes should be performed at:
A. 10th - 16th week of pregnancy.
B. 16th - 20th week of pregnancy.
C. 20th - 24th week of pregnancy.
D. 24th - 28th week of pregnancy.
E. 28th - 32nd week of pregnancy.
|
D
|
2014_wiosna
|
2014
|
spring
| 91
|
Sigmoid diverticulitis gives the following symptoms:1) pain in left lower quadrant;2) blood in the stool;3) painful resistance above the left lower quadrant;4) persistent diarrhea;5) narrow stools.The correct answer is:
A. 1,2.
B. 2,3.
C. 3,4.
D. 1,3.
E. 1,5.
|
D
|
2014_wiosna
|
2014
|
spring
| 146
|
For the diagnosis of paranoia is essential the presence of:
A. delusions and verbal hallucinations.
B. verbal imperative hallucinations.
C. the feeling of being persecuted.
D. systematized delusions.
E. delusional mood and anxiety.
|
D
|
2014_wiosna
|
2014
|
spring
| 29
|
Choledocholithiasis symptoms may mimic:1) perforated duodenal ulcer;2) myocardial infarction;3) acute pancreatitis from other causes;4) acute intermittent porphyria;5) right renal colic.The correct answer is:
A. 2,4.
B. 1,2,4.
C. 1,3,4.
D. 2,3,4.
E. all the above.
|
E
|
2014_wiosna
|
2014
|
spring
| 111
|
The most frequent causes of the first trimester spontaneous miscarriage include:
A. genetic causes.
B. corpus luteum insufficiency.
C. congenital uterus malformations.
D. autoimmune causes.
E. infections.
|
A
|
2014_wiosna
|
2014
|
spring
| 107
|
How much immunoglobulin-D will you give for an A Rh(-) woman who gave birth by caesarian section to an A Rh(+) child and hasn’t got immunity antibodies?
A. 50 µg.
B. 75 µg.
C. 100 µg.
D. 150 µg.
E. 300 µg.
|
E
|
2014_wiosna
|
2014
|
spring
| 8
|
In the renal ultrasound examination two cortical cysts of the right kidney were found in a 53-year-old woman. Their diameters are 1 cm and 2 cm. The patient complains of hot flashes and irritability; her father died of lung cancer at the age of 83 and mother of a stroke at the age of 77. RR 135/80 mmHg, creatinine 0.8 mg/dl, FSH 53 mlU/L. Urinalysis normal. The physician should:
A. recognize simple kidney cysts and recommend ultrasound checks in a year.
B. recognize congenital polycystic kidney and recommend genetic testing.
C. recognize acquired cystic kidney and perform the biopsy of the smaller cyst.
D. recognize acquired cystic kidney and perform the biopsy of the bigger cyst.
E. suspect ectopic secretion of FSH and perform the test for the inhibition with E3.
|
A
|
2014_wiosna
|
2014
|
spring
| 87
|
Symptoms of sigmoid cancer:1) blood in the stool;2) alternating constipation and diarrhea;3) anemia;4) cachexia;5) narrow stools.The correct answer is:
A. 1,2,4.
B. 1,2,3.
C. 2,3,5.
D. 1,2,5.
E. 2,3,4.
|
D
|
2014_wiosna
|
2014
|
spring
| 68
|
Medications used for treatment of constipation in children do not include:
A. lactulose.
B. macrogol.
C. bisacodyl.
D. metoclopramide.
E. paraffin.
|
D
|
2014_wiosna
|
2014
|
spring
| 150
|
Among alimentary deficiencies which may contribute to the presence of depression the most important is the deficiency of vitamin B12 and:
A. vitamin C.
B. vitamin D and E.
C. vitamin A and D.
D. vitamin B1.
E. folic acid.
|
E
|
2014_wiosna
|
2014
|
spring
| 13
|
A 27-year-old man suffering from type 1 diabetes for 2 years was diagnosed with the sudden onset of nephrotic syndrome. HbA1c 6.3%, creatinine 1.5 mg/dL, no signs of diabetic retinopathy and hypertension. The doctor should:
A. recognize diabetic nephropathy and intensify insulin treatment.
B. recognize diabetic nephropathy and include ACE inhibitors in the treatment.
C. recognize diabetic nephropathy and prepare the patient for dialysis.
D. refer the patient to a nephrologist for a possible kidney biopsy.
E. observe the patient and refer him to a nephrologist if creatinine exceeds 1.7 mg/dL.
|
D
|
2014_wiosna
|
2014
|
spring
| 44
|
A premature born infant with body weight 1200 g has:
A. extremely low birth weight.
B. low birth weight.
C. normal birth weight.
D. very low birth weight.
E. small birth weight.
|
D
|
2014_wiosna
|
2014
|
spring
| 193
|
According to UN experts the population exceeds the threshold of old age at a time when:
A. percentage of people aged 65 years is at 3%.
B. percentage of people aged 65 years is at 7%.
C. percentage of people aged 65 years is at 33%.
D. the number of people aged 60 years is more than 6 millions.
E. average life expectancy exceeds 60 years.
|
B
|
2014_wiosna
|
2014
|
spring
| 52
|
The following associations are characteristic of childchood malignancies, except:
A. acute myeloid leukemias and bleeding gums.
B. neuroblastoma and raised urinary catecholamines.
C. osteosarcoma and tumor in upper end of the femur.
D. hepatoblastoma and raised AFP (alpha- fetoprotein) in serum.
E. brain tumors and early morning vomiting.
|
C
|
2014_wiosna
|
2014
|
spring
| 185
|
A patient’s husband came to the doctor. He brought his wife’s results of the diagnostic tests and asked the doctor for prescription drugs and a certificate of temporary incapacity to work for his wife. What should the doctor do?
A. he is allowed to issue the prescription, but should refuse to issue the certificate without personal examination of the patient.
B. he is allowed to issue the prescription and certificate if he considers that the diagnostic test results were prepared by an authorized entity.
C. he is allowed to issue the prescription and certificate if the provision of the health care benefit is not financed from public resources.
D. he is not allowed to issue the prescription without personal examination of the patient, but he is allowed to issue the certificate.
E. he is not allowed to issue the prescription and certificate without personal examination of the patient.
|
E
|
2014_wiosna
|
2014
|
spring
| 136
|
Which of the following scales is used to assess the stage of puberty in children, youth and adults on the basis of morphological features, the genitals and breasts?
A. Tanner.
B. Apgar.
C. Glasgow.
D. Schmidt.
E. SCORE.
|
A
|
2014_wiosna
|
2014
|
spring
| 59
|
The least probable finding in megaloblastic anemia of childchood is:
A. folic acid and/or Vit. B12 defficiency.
B. hepatosplenomegaly.
C. thrombocytosis.
D. psychomotor developmental delay.
E. lack of appetite, diarrhoea.
|
C
|
2014_wiosna
|
2014
|
spring
| 161
|
The most frequent etiological pathogen of infectious endocarditis is:
A. streptococci, staphylococci, enterococci.
B. viruses.
C. rods, bacilli.
D. mycobacteria.
E. none of the above.
|
A
|
2014_wiosna
|
2014
|
spring
| 198
|
Which of the following concerning diagnostic test sensitivity is true?1) it is another term for diagnostic test specificity;2) it is characteristic feature of the diagnostic method (test);3) it is the number of test positive results among clinically confirmed diagnoses.The correct answer is:
A. 1,2.
B. 1,3.
C. 2,3.
D. all the above.
E. only 1.
|
C
|
2014_wiosna
|
2014
|
spring
| 177
|
The doctor received by one of the social networking sites symptoms, test results and the photos of skin 34 year old woman indicating the systemic lupus erythematosus. In accordance with the Polish Code of Medical Ethics he/she should:
A. communicate all suggestions on the portal.
B. communicate his/her opinion to this woman through the internet recommending a visit to the doctor.
C. communicate his/her opinion to this woman through the Internet and recommending the drugs an online pharmacy.
D. propose a visit to his/her office for two months.
E. refer the matter to the Patient Ombudsman.
|
B
|
2014_wiosna
|
2014
|
spring
| 18
|
A 40-year-old woman suffered from dysuria which began during journey, progressing weakness, temperature 38.5°C and pain in the right lumbar region. What drug should be chosen?
A. amoxicillin.
B. fosfomycin.
C. nitrofurantoin.
D. quinolone.
E. imipenem.
|
D
|
2014_wiosna
|
2014
|
spring
| 120
|
Endometriosis should be taken into consideration in the following states:1) pelvic pain syndrome;2) dyspareunia;3) ascites;4) decreased fertility;5) mixed urine incontinence.The correct answer is:
A. 1,2,3.
B. 2,3,4.
C. 3,4,5.
D. 1,3,5.
E. 1,2,4.
|
E
|
2014_wiosna
|
2014
|
spring
| 63
|
The cause of hypoglycaemia in children could be, except for:
A. growth hormone deficiency.
B. excess insulin.
C. excess glucagon.
D. hypothyroidism.
E. adrenocortical insufficiency.
|
C
|
2014_wiosna
|
2014
|
spring
| 34
|
A 50-year-old woman complains of skin itching in her trunk and extremities. It happens mainly after bathing in the evening. She has been using various ointments and “cooling” oils, and tried to take hydroxyzine at bedtime - to no avail. On exam: no signs except for excoriations of the arm and trunk skin. Lab tests: alkaline phosphatase and GGTP 1.5 times above upper limit, AST and ALT normal. Total cholesterol 260 mg%, bilirubin 1.0 mg%. Abdomen ultrasound shows no pathology. In this clinical situation you should first choose:
A. stool test for parasites and Giardia cysts.
B. skin tests for food allergy.
C. serum anti-mitochondrial antibodies test.
D. attempt to change washing powder and the kind of underwear used by the patient.
E. refer her to dermatologist.
|
C
|
2014_wiosna
|
2014
|
spring
| 3
|
A 70-year-old man comes to the office because of dry mouth and increased thirst. His fasting plasma glucose is 213 mg/dl. Which of the following is the most appropriate next step?
A. diagnose diabetes and start the pharmacological treatment of diabetes.
B. repeat fasting plasma glucose.
C. advise oral glucose tolerance test.
D. diagnose diabetes but do not start pharmacological treatment.
E. test HbA1C.
|
A
|
2014_wiosna
|
2014
|
spring
| 22
|
A patient hospitalized because of severe pneumonia and treated with a broad-spectrum antibiotic, complains of numerous loose stools, stomachache and fever. Laboratory tests revealed leukocytosis, electrolyte abnormalities and hypoalbuminemia. Colonoscopy revealed yellow plaques on the wall of the distal sigmoid colon and rectum. Faecal culture revealed Clostridium difficile, and additional tests were positive for toxins A and B. What is the diagnosis?
A. pseudomembranous colitis.
B. coeliac disease.
C. food allergy.
D. foodborne illness.
E. ulcerative colitis.
|
A
|
2014_wiosna
|
2014
|
spring
| 75
|
While examining electrocuted patient you should remember that:
A. extension of skin burns may tell us about degree of inner tissue damage.
B. tissue damage appear at the place where the current comes in.
C. the patient may develop acute kidney failure.
D. extra-low voltage does not cause cardiac arrhythmias.
E. damage caused by thermal burns are greater than the damage caused by electric shock.
|
C
|
2014_wiosna
|
2014
|
spring
| 182
|
The doctor fill out the death certificate of:
A. the deceased; at the request of their close persons within the meaning of the Act on Patients’ Rights and the Ombudsman for Patients’ Rights.
B. stillborn children, irrespective of the duration of gestation, in each case.
C. stillborn children, irrespective of the duration of gestation, on a proposal from the persons entitled to give the burial.
D. stillborn children if the gestation lasted at least 22 weeks.
E. the deceased; at the request of the registry office or cemetery administration.
|
C
|
2014_wiosna
|
2014
|
spring
| 55
|
Syndromes associated with Wilms tumor are:
A. WAGR.
B. Beckwith-Wiedemann.
C. Denys-Drash.
D. Perlman.
E. all answers are correct.
|
E
|
2014_wiosna
|
2014
|
spring
| 194
|
The basic functions of public health measures to the general population include all the following except for:
A. monitoring the health of the population and determining its health needs.
B. identifying and combating health risks in food, water as well as in learning, residence and work environment.
C. educating and training physicians and other staff.
D. ensuring full accessibility to protective vaccination.
E. monitoring the extend and quality of medical services.
|
D
|
2014_wiosna
|
2014
|
spring
| 43
|
For febrile convulsions the most characteristic features are:
A. more often in girls.
B. in children over 5 years.
C. in children under 5 years.
D. in children under 6 months.
E. more often complex convulsions.
|
C
|
2014_wiosna
|
2014
|
spring
| 14
|
A 30-year-old man with diabetes mellitus type 1 treated with insulin for about 6 months has hematuria and proteinuria 2 g/24 h, RR 155/95 mmHg and plasma creatinine steadily increasing to 5 mg/dl (442 µmol/l) for the last two weeks. The most probable diagnosis is:
A. hypertensive nephropathy.
B. diabetic nephropathy.
C. rapidly-progressive glomerulonephritis.
D. acute interstitial nephritis.
E. nephrotic syndrome.
|
C
|
2014_wiosna
|
2014
|
spring
| 157
|
In paroxysmal atrial fibrillation rhythm control therapy should not be implemented because of the embolic complications risk in the following situation:
A. if symptoms last more than 3 days.
B. if symptoms last more than 2 days.
C. if symptoms last more than 24 hours.
D. attempt for rhythm control restoration is always necessary in paroxysmal atrial fibrillation.
E. in patients age 60 and more there is low embolic complications risk.
|
B
|
2014_wiosna
|
2014
|
spring
| 80
|
What is the most common extratestinal manifestation of Crohn disease?
A. dermatitis.
B. eye disorders.
C. liver and bile ducts disorders.
D. arthritis.
E. pancreas disorders.
|
D
|
2014_wiosna
|
2014
|
spring
| 100
|
Which of the following is a symptom suggestive of Mayer-Rokitansky-Küster syndrome?
A. precocious puberty.
B. hirsutism.
C. primary amenorrhea.
D. absence of secondary sexual characteristics.
E. delayed puberty.
|
C
|
2014_wiosna
|
2014
|
spring
| 38
|
Chemotherapy in patients with non-small cell lung cancer (NSCLC):
A. is an adjuvant postoperative therapy in early stage cancer.
B. is used in combination therapy together with radiotherapy in locally advanced cancer.
C. is a palliative treatment in generalized cancer disease.
D. A and C are true.
E. A, B and C are true.
|
E
|
2014_wiosna
|
2014
|
spring
| 116
|
Which of the following concerning PCOS (polycystic ovary syndrome) is true?1) it is a risk factor for endometrial cancer;2) glucose disorders affect approx 40% of PCOS patients;3) fertility of PCOS patients is similar to the fertility of healthy women;4) elevated serum androgens and the clinical symptoms of androgen excess are characteristic features of PCOS;5) increased FSH to LH ratio is characteristic of PCOS.The correct answer is:
A. 4,5.
B. 3,4,5.
C. 1,2,3.
D. 1,2,4.
E. 1,2,4,5.
|
D
|
2014_wiosna
|
2014
|
spring
| 141
|
Which of the following drug is recommended for the indefinite anti-platelet therapy in patients after acute myocardial infarction, in case of aspirin intolerance or contraindications to its use?
A. clopidogrel.
B. prasugrel.
C. rivaroxaban.
D. dabigatran.
E. low weight heparin.
|
A
|
2014_wiosna
|
2014
|
spring
| 96
|
A 25-year-old woman in 34 weeks gestation comes to the doctor’s because of sudden, not very abundant and painless bleeding from the uterus which occurred at night. What procedure should the doctor perform?
A. internal pelvic examination in order to determine the cervical dilation.
B. speculum examination in order to locate the bleeding area and stop the bleeding.
C. abdominal ultrasonography in order to determine the location of the placenta.
D. transvaginal ultrasonography in order to measure the FHR (fetal heart rate).
E. internal pelvic examination and then abdominal ultrasonography in order to assess the risk of abortion.
|
C
|
2014_wiosna
|
2014
|
spring
| 79
|
Gastric cancer can by described by the following sentences:1) one of the most frequently occurring cancers in men;2) Lauren’s classification is used for clinical classification;3) most frequently located in the proximal part of the stomach;4) gastric polyps of diameter more than 2 cm are correlated with increased gastric cancer risk;5) there is an increased risk of gastric cancer in patients with pernicious anemia.The correct answer is:
A. 1,2,3.
B. 2,3,5.
C. 1,2,4,5.
D. 1,2,3,5.
E. all the above.
|
C
|
2014_wiosna
|
2014
|
spring
| 97
|
Which of the following is used to estimate gestational age?
A. FHR (fetal heart rate) measurement in transvaginal ultrasonography.
B. calculations based on the date of the last menstrual period.
C. CRL (crown-rump length) measurement after 12 weeks’ gestation.
D. evaluation of the placenta maturity grade.
E. B and C are true.
|
B
|
2014_wiosna
|
2014
|
spring
| 78
|
65-year old patients was admitted by a surgeon due to episodes of fresh blood in stool, weight loss and pencil-like stools. In DRE surgeon revealed infiltration in anal canal so he took biopsy and got endorectal ultrasound (ERUS) done. ERUS revealed infiltration through all layers of bowel wall but without infiltration of anal sphincters, in addition two metastatic lymph nodes were described in perirectal tissues. The histologic examination of biopsy specimen revealed adenocarcinoma. Choose the best treatment option for this patient:
A. radical radiochemotherapy.
B. neoadjuvant radiotherapy then surgery.
C. neoadjuvant chemotherapy then surgery.
D. surgery without preoperative treatment.
E. brachytherapy then chemotherapy.
|
B
|
2014_wiosna
|
2014
|
spring
| 140
|
Duration of amoxicillin treatment of uncomplicated acute otitis media in children under 2 years of age should be:
A. 3 days.
B. 5 days.
C. 7 days.
D. 10 days.
E. 14 days.
|
D
|
2014_wiosna
|
2014
|
spring
| 117
|
Which dose of folic acid is recommended in a woman who delivered a child with a neural tube defect in the past?
A. 0.4 mg daily.
B. 1.4 mg daily.
C. 4 mg daily.
D. 14 mg daily.
E. 40 mg daily.
|
C
|
2014_wiosna
|
2014
|
spring
| 39
|
The diagnosis of malignant mesothelioma is based on:
A. cytological analysis of exudative pleural fluid.
B. histological analysis of tissues obtained by means of video thoracoscopy.
C. chest CT scan.
D. PET-CT scan.
E. chest MRI scan.
|
B
|
2014_wiosna
|
2014
|
spring
| 101
|
Bizygotic twins are:
A. monochorionic monoamniotic pregnancy.
B. monochorionic diamniotic pregnancy.
C. dichorionic monoamniotic pregnancy.
D. dichorionic diamniotic pregnancy.
E. B or D are true.
|
D
|
2014_wiosna
|
2014
|
spring
| 81
|
Pharyngoesophageal diverticulum (Zenker’s diverticulum) is:1) the most frequent esophageal diverticulum;2) caused mainly by the disorder of relaxation of upper esophageal sphincter;3) may cause complete esophageal obstruction;4) may cause Mendelson’s syndrome;5) may cause hoarseness when large.The correct answer is:
A. 1,2,3.
B. 1,2,4.
C. 1,4,5.
D. 2,3,5.
E. all the above.
|
E
|
2014_wiosna
|
2014
|
spring
| 156
|
The gold standard for the treatment of ventricular tachycardia is:
A. fast application of antiarrhytmic drugs.
B. percutaneous stimulation.
C. the treatment of the underlying cause because most of tachyarrhytmias can accompany various pathological conditions.
D. cardioversion.
E. defibrillation.
|
C
|
2014_wiosna
|
2014
|
spring
| 15
|
A 50-year-old woman has been complaining of progressing weakness, ankle edema and resistant arterial hypertension for some years now. Serum creatinine concentration is 15 mg/dl (1326 µmol/l), urea 230 mg/dl (38 mmol/l). What is the most probable diagnosis?
A. nephrotic syndrome.
B. chronic kidney disease.
C. chronic pyelonephritis.
D. hypertensive nephropathy.
E. IgA nephropathy.
|
B
|
2014_wiosna
|
2014
|
spring
| 42
|
The most common cause of the arrhythmias in children is:
A. hipokalemia.
B. hipermagnesemia.
C. infections.
D. asphyxia.
E. malnutrition.
|
C
|
2014_wiosna
|
2014
|
spring
| 195
|
The following definition: “Therapeutic and rehabilitative activities undertaken at the time when the disease is already fully developed aiming at reducing its impact and the risk of its recurrence” concerns:
A. primary prevention.
B. secondary prevention.
C. tertiary prevention.
D. health promotion.
E. none of the above.
|
C
|
2014_wiosna
|
2014
|
spring
| 54
|
Most common tumors diagnosed in teenagers are:
A. osteosarcoma.
B. Hodgkin lymphoma.
C. neuroblastoma.
D. soft tissue sarcomas.
E. correct answer is A,B.
|
E
|
2014_wiosna
|
2014
|
spring
| 183
|
Doctor who want to make use of the conscience clause are required to:1) obtain the consent of their superiors;2) inform the Ombudsman for Patients’ Rights;3) indicate the real possibility of obtaining the same service from another physician;4) register and justify this fact in medical records;5) apply for authorization to the competent court.The correct answer is:
A. 1,2.
B. 1,3.
C. 3,4.
D. only 5.
E. 4,5.
|
C
|
2014_wiosna
|
2014
|
spring
| 74
|
Absolute indications for amputation - select the false sentence:
A. necrolysis in diabetic foot.
B. massive crushing limbs.
C. critical limb ischemia when other methods of treatment fail.
D. extensive purulent wounds.
E. gas gangrene when other treatments fail.
|
D
|
2014_wiosna
|
2014
|
spring
| 23
|
A 54-year-old man was admitted to hospital due to severe dyspnoea accompanied by chest pain which happened during physical exertion and lasted for approx. 1 hour. Physical examination revealed RR 180/95 mmHg, pulse 95, rales over more than half of the lungs. Which is the most possible diagnosis?
A. acute heart failure due to acute coronary syndrome.
B. chronic heart failure due to arrhythmia.
C. cardiogenic shock due to acute coronary syndrome.
D. isolated right heart failure.
E. high cardiac output syndrome.
|
A
|
2014_wiosna
|
2014
|
spring
| 2
|
A 78-year-old woman comes to the office to continue the treatment of hypertension. The urine test shows increased number of leukocytes in urine. The woman does not have any symptoms of urinary tract infection. She feels well. Which of the following is the most appropriate next step?
A. urine culture and then treatment with appropriate antibiotics.
B. start treatment with amoxicillin.
C. start treatment with amoxicillin with clavulanic acid.
D. start treatment with ciprofloxacin.
E. do not perform urine culture or treatment with antibiotics.
|
E
|
2014_wiosna
|
2014
|
spring
| 35
|
Which of the following possess the prognostic value in malignant neoplasms?
A. staging.
B. grading.
C. age at diagnosis.
D. A and B are true.
E. A, B and C are true.
|
E
|
2014_wiosna
|
2014
|
spring
| 62
|
Pharmacological treatment of primary hypertension in children and adolescents should begin in the case, with the exception of:
A. presence of organ damage.
B. symptomatic hypertension.
C. coexistence of other diseases that increase cardiovascular risk (diabetes, hyperlipidemia).
D. after 1-3 months of ineffective non-pharmacological treatment in children with hypertension I ° without organ damage.
E. after 3-6 months of ineffective non-pharmacological treatment in children with hypertension I ° without organ damage.
|
D
|
2014_wiosna
|
2014
|
spring
| 121
|
The differential diagnosis of ectopic pregnancy includes:1) acute pancreatitis;2) pneumonia;3) salpingitis;4) ovary tumor rupture;5) adnexal torsion.The correct answer is:
A. all the above.
B. 1,3,4.
C. 3,4,5.
D. 1,4,5.
E. 1,2,3.
|
C
|
2014_wiosna
|
2014
|
spring
| 19
|
A 50-year-old man has autosomal dominant polycystic kidney disease (ADPKD), a disease which his mother also had. Show the true statement concerning the disease:
A. USG has 100% sensitivity for subjects > 30 years with a positive family history.
B. in about 50% of patients liver cysts are present.
C. painful hematoma and the ruptures of the cysts may appear.
D. all the above are true.
E. true are A and C.
|
D
|
2014_wiosna
|
2014
|
spring
| 199
|
According to the definition health needs:1) are associated with the incidence of diseases and pathologies within the population;2) are objective states that are not human mental states;3) are equivalent to the demand for health care;4) require to take preventive and curative measures against possible loss of life or health.The correct answer is:
A. only 1.
B. 1,2,3.
C. 1,2,4.
D. 3,4.
E. only 3.
|
C
|
2014_wiosna
|
2014
|
spring
| 176
|
68 year old female patient diagnosed with paranoid schizophrenia and mild dementia turned to endocrinologist asking for transvaginal examination, because she will soon gibe birth, threatening suicide if they refuse. According to Polish Medical Ethics Code endocrinologist should:
A. perform the required examination.
B. propose a patient to increase the dose of antipsychotic medications.
C. refer patient to a psychiatric outpatient clinic.
D. immediately consult a psychiatrist.
E. refuse treatment if the patient does not have a endocrinological problem.
|
D
|
2014_wiosna
|
2014
|
spring
| 160
|
Please indicate true statement about Barlow syndrome:
A. it is a syndrome of the aortic valve prolapse.
B. it is a syndrome of mitral valve prolapsed.
C. uncomplicated Barlow syndrome does not need hospital admission.
D. on physical examination there is audible mid-systolic click with subsequent murmur best heard over the apex.
E. true statements are: B, C, D.
|
E
|
2014_wiosna
|
2014
|
spring
| 58
|
Acute life-threatening conditions that occur in pediatric oncology are:
A. tumor lysis syndrome.
B. leukostasis.
C. status epilepticus.
D. ileus.
E. all answers are correct.
|
E
|
2014_wiosna
|
2014
|
spring
| 137
|
Glycemic goal criteria in adults with type 1 diabetes and short-term type 2 diabetes (below 5 years of diabetes) comprise HbA1c level of:
A. ≤ 5.5%.
B. ≤ 6.0%.
C. ≤ 6.1%.
D. ≤ 6.5%.
E. ≤ 7.0%.
|
D
|
2020_wiosna
|
2020
|
spring
| 77
|
A patient complains of a dull, disturbing, diffuse, deep abdominal pain, which precise location he is unable to determine, but the pain is the strongest at the midline. The patient reports the pain resembles a pain that was accompanying the first symptoms of acute appendicitis 20 years ago. Such a pain is called:
A. phantom pain.
B. cluster pain.
C. somatic pain.
D. neuralgic pain.
E. visceral pain.
|
E
|
2020_wiosna
|
2020
|
spring
| 98
|
The relation of the long fetal axis to the long axis of the uterus and reproductive canal is called:
A. fetal lie.
B. position.
C. fetal location.
D. engagement.
E. presentation.
|
A
|
2020_wiosna
|
2020
|
spring
| 118
|
Which stage of endometriosis according to the classification of the American Society for Reproductive Medicine should be diagnosed in a patient with an endometrial cyst of the left ovary of 4 cm in diameter, partial obliteration of the recto-uterine pouch and superficial lesions of the peritoneal membrane of the diameter < 1 cm?
A. I.
B. II.
C. III.
D. IV.
E. V.
|
C
|
2020_wiosna
|
2020
|
spring
| 20
|
Which of the following signs and symptoms, occurring with variable intensity, may suggest acute tubulo-interstitial nephritis?1) dull lumbar pain;2) oliguria;3) maculopapular rash;4) hematuria;5) fever.The correct answer is:
A. all the above.
B. 1,2,4.
C. only 1.
D. 3,4,5.
E. 2,3.
|
A
|
2020_wiosna
|
2020
|
spring
| 1
|
A densitometric examination of a 78-year-old woman showed T-score equal to -2,8 and her calcium concentration was 13.0 mg/mL (normal range 8.5-10.5). The patient should be further diagnosed for:
A. primary hyperparathyroidism.
B. secondary hyperparathyroidism.
C. neoplastic lesions located in the bones.
D. A and C are true.
E. B and C are true.
|
D
|
2020_wiosna
|
2020
|
spring
| 36
|
Indicate the true statement concerning diffuse large B-cell lymphoma:
A. it is a potentially curable neoplasm.
B. the treatment of choice is monotherapy with a cytostatic agent, independently on the staging of the disease.
C. the progression is always slow.
D. allotransplantation of hematopoietic stem cells is a preferred method in the first-line treatment.
E. it is one the least common lymphomas.
|
A
|
2020_wiosna
|
2020
|
spring
| 159
|
The polymorphic ventricular tachycardia occurred in a patient intoxicated with tricyclic antidepressants. The treatment should include the administration of:
A. magnesium sulphate.
B. β-blocker.
C. digoxin.
D. amiodarone.
E. verapamil.
|
A
|
2020_wiosna
|
2020
|
spring
| 61
|
Which of the following is not used to diagnose obesity in children?
A. location on the BMI centile chart.
B. waist-to-hip ratio (WHR).
C. abdominal circumference chart.
D. Cole’s index.
E. crown-rump length (CRL).
|
E
|
2020_wiosna
|
2020
|
spring
| 122
|
An 18-year-old patient with a sore throat and body temperature 37.4 ºC presents pus-like exudate tonsils, enlarged cervical lymph nodes, spleen enlargement, and a maculopapular rash after amoxicillin administration. The most probable diagnosis is:
A. streptococcal pharyngitis.
B. infectious mononucleosis.
C. diphtheria.
D. scarlet fever.
E. herpangina.
|
B
|
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