Question 121 of 209
121. Question
A 65-year-old patient complains of dull pain in the rectum during and after defecation, discharge of mucus and small amount of blood mixed up with mucus and faeces. The discharged blood is of dark red color, sometimes with small amount of clots. The patient is sick for 8 months, has lost some weight. On digital examination, there is a round constriction of the rectum with infiltrate at a height of 4-5 cm from the anus. What is the most probable diagnosis?
---1. Cancer of the medium-ampullar section of the rectum
2. Cicatricial stenosis of the rectum
3. Crohns disease
4. Non-specific ulcer colitis
5. Chronic paraproctitis
122. Question
A patient aged 18 with a cranial injury was in comatose state during several hours. In post-comatose period gets tired quickly, non-productive in dialog – in the beginning answers 2-3 questions, then gets tired and can not understand the point of the question. Which psychotropic should be given to the patient to prevent psychoorganic syndrome?
1. Neuroleptics
--2. Nootropics
3. Tranquillisers
4. Antidepressants
5. Stimulators
123. Question
On the 4th day after recovering from a cold a patient was hospitalized with complaints of solitary spittings of mucoid sputum. On the 2nd day there was a single discharge of about 250 ml of purulent blood-streaked sputum. Objectively: the patients condition is moderately severe. Respiratory rate – 28-30/min, Ps- 96 bpm, AP- 110/70 mm Hg. Respiration above the left lung is vesicular, weak above the right lung. There are moist rales of different types above the lower lobe and amphoric breath near the angle of scapula. What is the most likely diagnosis?
--1. Acute pulmonary abscess
2. Pyopneumothorax
3. Acute focal pneumonia
4. Pleural empyema
5. Exudative pleuritis
124. Question
A 47-year-old patient complains about cough with purulent sputum, pain in the lower part of the left chest, periodical body temperature rise. She has been suffering from these presentations for about 10 years. Objectively: “drumstick” distal phalanges. What examination would be the most informative for making a diagnosis?
1. Survey radiograph of lungs
2. Bronchoscopy
3. Bacteriological analysis of sputum
4. Pleural puncture
--5. Bronchography
125. Question
A patient has a stab wound on his right foot. On the fourth day after injury the patients body temperature rose up to 38°C, inguinal lymph nodes became enlarged and painful, skin over them reddened. What complication might be suspected?
--1. Lymphadenitis
2. Phlegmon
3. Lymphangitis
4. Erysipelas
5. Tetanus
Question 126 of 209
126. Question
A 37-year-old male patient has a history of diabetes of moderate severity. On the left side of face the patient has a carbuncle. What severe complication might have occurred in the patient?
1. Thrombophlebitis
2. Endarteritis
3. Lymphangitis
4. Thromboembolism
--5. Cavernous sinus thrombosis
127. Question
A 65 y.o. man who has problems with urination as a result of benign prostate gland adenoma developed fever and chill, hypotension, sinus tachycardia. Skin is warm and dry. Clinical blood analysis revealed absolute granulocytopenia. These hemodynamic changes are most likely to be caused by:
1. Secondary endothelial changes as a result of bacterial lesion
2. Secondary circulation insufficiency with retained systolic function as a result of peripheral vasoconstriction
3. Reflex vagus stimulation with lowered cardiac output
---4. Endotoxemia with activation of complement system
5. Secondary reflex vasodilatation as a result of lowered cardiac output
128. Question
X-ray picture of chest shows a density and an abrupt decrease in the upper lobe of the right lung. The middle and lower lobe of the right lung exhibit significant pneumatization. The right pulmonary hilum comes up to the dense lobe. In the upper and middle parts of the left pulmonary field there are multiple focal shadows. In the basal region of the left pulmonary field there are clear outlines of two annular shadows with quite thick and irregular walls. What disease is this X-ray pattern typical for?
1. Pancoast tumour
2. Atelectasis of the right upper lobe
--3. Fibro-cavernous pulmonary tuberculosis
4. Abscessing pneumonia
5. Peripheral cancer
129. Question
A 28-year-old female patient has been admitted to a hospital. She states to be ill for 12 years. On examination she has been diagnosed with bronchiectasis with affection of the left lower lobe of lung. What is the optimal treatment tactics for this patient?
1. Bronchopulmonary lavage
--2. Left lower lobectomy
3. Antibiotic therpy
4. Active drainage of the left pleural cavity
5. Left-sided pneumoectomy
130. Question
A 17-year-old patient complains of pain in the area of the left knee joint. Soft tissues of thigh in the affected region are infiltrated, joint function is limited. X-ray picture of the distal metaepiphysis of the left femur shows a destruction focus with periosteum detachment and Codmans triangle found at the defect border in the bone cortex. X-ray of chest reveals multiple small focal metastases. What treatment is indicated?
1. Distance gamma-ray therapy
2. Amputation of the lower extremity
3. Disarticulation of the lower extremity
--4. Palliative chemotherapy
5. Radioiodine therapy