100. Question
A 42-year-old builder consulted a doctor about a foot injury with a nail that he got in the morning of the same day. The wound was washed with water. Three years ago he was vaccinated against tetanus. Examination established satisfactory condition of the patient. The left foot was slightly edematic, there was a stab wound on the sole. In order to prevent tetanus it is primarily required to:
1. Administer a course of antibiotic therapy
--2. Give an intravenous injection of 0.5 ml of tetanus anatoxin
3. Give an intravenous injection of 3000 IU of antitetanus serum
4. Give an intravenous injection of 1 ml of tetanus anatoxin, 3000 IU of antitetanus serum
5. Treat the wound with suds
101. Question
Purulent mediastinitis is diagnosed at a 63-year-old patient. What diseases from the stated below CANNOT cause the purulent mediastinitis?
1. Deep neck phlegmon
2. Iatrogenic injury of the trachea
3. Perforation of the cervical part of the easophagus
4. Perforation of the thoracic part of the easophagus
--5. Cervical lymphadenitis
102. Question
A 20 y.o. patient suddely felt ill 12 hours ago. There was pain in epigactric area, nausea, sporadic vomiting. He had taken alcohol before. In few hours the pain localized in the right iliac area. On examination: positive rebound tenderness symptoms. WBC- 12.2;109/L. What is the most probable diagnosis?
--1. Acute appendicitis
2. Acute cholecystitis
3. Perforated ulcer
4. Acute pancreatitis
5. Rightside kidney colic
103. Question
A patient operated for acute paraproctitis undergoes antibacterial and detoxification therapy, the local course of the disease has the positive dynamics. Since the operation the patient has had chills, pyrexia, tachycardia, euphoria for five days. The doctor suspected sepsis. What study will confirm the diagnosis?
1. Determining the rate of average-weight molecules
--2. Blood culture for a pathogen
3. Liver ultrasound
4. X-ray of lungs
5. Determining the rate of microbial contamination of wound
104. Question
A 38 y.o. patient lifted a heavy object that resulted in pain in the lumbar part of spine irradiating to the posterior surface of his left leg. The pain increases during changing body position and also in the upright position. Examination revealed positive symptoms of tension. What is the preliminary diagnosis?
1. Myelopathy
2. Arachnomyelitis
3. Spinal cord tumor
4. Polyneuritis
--5. Pathology of intercostal disks
105. Question
A 55-year-old patient complains of severe itching, burning and pain in the eyes, skin redness in the outer corners of the palpebral fissure. Objectively: skin around the outer corners of the palpebral fissure is macerated, eczematous, there are single moist cracks. Palpebral conjunctiva is hyperemic, quaggy. There are minor discharges in form of stringing mucus. What is the most likely diagnosis?
---1. Chronic conjunctivitis
2. Blepharitis
3. Acute conjunctivitis
4. Sty
5. Atopic eyelid dermatitis
106. Question
3 hours ago a 65-year-old female patient felt sharp abdominal pain irradiating to the right scapula, there was a single vomiting. She has a history of rheumatoid arthritis. Objectively: pale skin, AP- 100/60 mm Hg, Ps- 60/min. Abdomen is significantly painful and tense in the epigastrium and right subcostal areat, there are positive symptoms of parietal peritoneum irritation over the right costal arch, that is tympanitis. What is the tactics of an emergency doctor?
1. To perform gastric lavage
--2. To take the patient to the surgical hospital
3. To inject spasmolytics
4. To take the patient to the rheumatological department
5. To inject pain-killers and watch the dynamics
107. Question
A 30-year-old patient has been admitted to the intensive care unit for multiple bee stings. The skin is covered with cold sweat. The pulse is felt just on the carotid arteries, 110 bpm, respiration is 24/min, rhythmic, weakened. Which drug should be given in the first place?
1. Adrenalin hydrochloride intramuscularly
2. Dopamine intravenously
3. Tavegil intravenously
4. Prednisolone intravenously
--5. Adrenalin hydrochloride intravenously
108. Question
A patient is staying in the hospital with the diagnosis of abdominal typhus. During the 3rd week from the beginning of the disease the patient stopped keeping diet and confinement to bed. As a result the body temperature and rapid pulse decreased and melena appeared. What kind of complications should we think about first of all?
--1. Intestinal haemorrhage
2. Meningitis
3. Hepatite
4. Thrombophlebitis
5. Nephroso-nephritis
109. Question
10 years ago a patient had a fracture in the middle one-third of his left femoral bone, and during the last 7 years he has been having acute inflammation in the area of old fracture accompanied by formation of a fistula through which some pus with small fragments of bone tissue is discharged. After a time the fistula closes. What complication of the fracture is it?
1. Soft tissue phlegmon
2. False joint
3. Trophic ulcer
4. Bone tuberculosis
--5. Chronic osteomyelitis
110. Question
A 52 year old patient complains about headache, weakness of his upper left extremity. Neurological symptoms become more intense during physical stress of the left extremity. Pulsation on the arteries of the left extremity is sharply dampened but it remains unchanged on the carotid arteries. What is the most probable diagnosis?
1. Raynauds syndrome
2. Thoracal outlet syndrome
--3. Occlusion of the left subclavicular artery, steal syndrome
4. Takayasus disease
5. Occlusion of brachiocephalic trunk