surgery141

Krok2 – 2014 Base(Surgery)

‘Foundation Course’ for FMGE Preparation

    Question 141 of 209
    141. Question

    Examination of a 38-year-old patient who had been hit with a blunt object on the left side of chest revealed a fracture of the X rib with fragments displacement, parietal pneumothorax. The patient complains of pain in the left subcostal area. Objectively: the patient is pale, AP- 80/40 mm Hg, Ps- 138/min, of poor volume. USI reveals fluid in the left abdomen. Splenic rupture is present. What treatment tactics should be chosen?
        1. Immediate upper median laparotomy followed by drainage of the left pleural cavity
        2. Left-sided thoracotomy immediately followed by laparotomy
        ---3. Drainage of the left pleural cavity followed by laparotomy
        4. Immediate laparotomy and alcohol-novocaine block of the X rib
        5. Anti-schock actions followed by laparotomy after the arterial pressure rise
 142. Question

In morgue there are dead bodies with the following causes of death: electrotrauma; rupture of the spleen with acute anemia. There is one unknown person; one ethyl alcohol poisoned person and one drowned man. What dead body should the blood group be determined for?

    --1. All dead bodies of the unknown persons
    2. Body of drowned man
    3. Body of person with a sudden death
    4. Body of poisoned person
    5. Body of person with internal hemorrhage
 143. Question

An unconscious victim in severe condition is brought to clinic. It is known that the patient touched the bare wire with his hand and during 5 minutes was under the influence of an alternating current with voltage of 220 V. Physical exam: skin is pale, cold by touch. Breath is weakened, BP – 90/50 mm Hg, Ps – 60 bpm, arrhythmical. There are fields of necrosis of the skin on the right hand and on the right foot. What is the preliminary diagnosis?

    1. Electrotrauma, acute cardiovascular failure
    2. High voltaged electroburn of the right foot and shank
    3. Vascular collapse due to electric current lesion
    ---4. Electroburn of the right foot and right hand
 144. Question

After the pneumatic dilatation of oesophageal structure a patient developed acute retrosternal pain getting worse when throwing the head back and swallowing. Objectively: dilatation of the neck veins, dropped beat pulse, signs of purulent intoxication, oliguria, emphysema of the upper portion of chest. What disease can be suspected?

    1. Spontaneous pneumothorax
    ---2. Suppurative mediastinitis
    3. Pleural empyema
    4. Acute myocardial infarction
    5. Thrombosis of the superior vena cava
 145. Question

A 45-year-old male patient with acute abscess of the left lung has suddenly developed acute chest pain and dyspnea while coughing, tachycardia has increased. The control Ro-gram shows left lung collapse, the air in the left pleural cavity and a horizontal fluid level. What is the mechanism of this complication?

    1. Bullae rupture of the left lung
    2. Atelectasis of the left lung
    --3. Abscess burst into the pleural cavity
    4. Inflammation spread to the visceral pleura
    5. Acute cardiovascular insufficiency
 146. Question

A patient complains of nycturia, constant boring pain in perineum and suprapubic region, weak urine jet, frequent, obstructed and painful urination. He has been ill for several months, pain in perineum appeared after getting problems with urination. Rectal examination revealed that prostate is enlarged (mostly owing to the right lobe), dense, asymmetric, its central sulcus is flattened, the right lobe is dense, painless, tuberous. What disease can it be?

    ---1. Cancer of prostate
    2. Chronic congestive prostatitis
    3. Urolithiasis, stone of the right lobe of prostate
    4. Prostate sclerosis
    5. Prostate tuberculosis

 147. Question

A patient complains of intense pressing pain in the pharynx, mainly to the right, impossibility to swallow even liquid food. The illness started 5 days ago. The patients condition is grave. Body temperature – 38.9°C, speech is difficult, voice is constrained, difficulties in opening the mouth. Submaxillary glands to the right are painful, enlarged. What is the most probable diagnosis?

    1. Pharyngeal tumour
    2. Diphtheria
    3. Vincents disease
    4. Phlegmonous tonsillitis
    --5. Peritonsillar abscess
 148. Question

A 49-year-old male patient who had been scheduled for a surgery for gastric cancer underwent preoperative infusion therapy. Up to 3.0 liters of liquid was introduced into the right cubital vein. The following day, he felt a dragging pain in the right shoulder. Objectively: on the inner surface of the shoulder there is a longitudinal hyperemic zone, edema of skin, a tender cord. What complication occurred in the patient?

    1. Venepuncture and edema of paravenous tissue
    ---2. Acute thrombophlebitis
    3. Acute lymphangitis
    4. Paravenous tissue phlegmon
    5. Paravenous tissue necrosis
 149. Question

A 29 y.o. patient was admitted to the hospital with acute girdle pain in epigastric area, vomiting in 1 hour after the meal. On examination: pale, acrocyanosis. Breathing is frequent, shallow. Abdominal muscles are tensed, positive Schotkin-Blumbergs symptom. What is the maximal term to make a diagnosis?

    1. In 3 hours
    2. In 6 hours
    ---3. In 2 hours
    4. In 0.5 hours
    5. In 1 hour
 150. Question

3 days ago a 29-year-old patient presented with pulsating pain in the region of rectum, fever, general weakness. Objectively: local tenderness in the anal region in the 6 O clock position. Digital investigation of rectum revealed a painful infiltration reaching the pectinate line. What is the most likely diagnosis?

    1. Acute prostatitis
    ---2. Acute periproctitis
    3. Acute haemorrhoids
    4. Rectum tumour
    5. Acute anal fissure