Question 31 of 209
31. Question
A 36-year-old injured has been taken to the emergency station with open tibial fractures. Examination reveals bleeding: pulsating blood spurts out of the wound. What medical manipulations are required at this stage of medical care?
1. Apply a tourniquet on the thigh distal to the source of bleeding and transport the patient to the operating room
--2. Apply a tourniquet on the thigh proximal to the source of bleeding and transport the patient to the operating room
3. Transport the patient to the operating room
4. Immobilize the fracture and transport the patient to the operating room
5. Stop the bleeding by a compressive bandage and transport the patient to the operating room
32. Question
Development of chronic venous insufficiency of lower extremities depends on the functional condition of so-called musculovenous pump. This term refers to the following group of muscles:
1. Thigh muscles
--2. Shin muscles
3. Abdominal wall muscles
4. Foot muscles
5. Buttock region muscles
33. Question
A patient undergoing treatment for the left-sided destructive pneumonia presents with deterioration of his general condition, progressing dyspnea, cyanosis. Objectively: the left side of chest is not involved in respiration, breathing sounds cannot be auscultated. Radiograph shows a shadow reaching the 5th rib with a horizontal fluid level and a radiolucency above it, the mediastinum is displaced to the right. What is the medical tactics?
1. Endotracheal intubation
2. Emergency bronchoscopy
3. Infusion and antibacterial therapy
--4. Thoracostomy
5. Open thoracotomy
Question 34 of 209
34. Question
The treatment of choice for duodenal obstruction caused by secondary duodenal hematoma that developed a few days after blunt abdominal injury is:
1. Immediate exploration
2. Retrocolic gastrojejunostomy
3. Tube duodenostomy
--4. Nasogastric decompression and parenteral alimentation
5. Duodenojejunostomy
35. Question
A 56-year-old patient was undergoing a surgery for suture repair of perforated ulcer. During the operation the cardiomonitor registered ventricular fibrillation. The first-priority measure should be:
1. Injection of calcium chloride
--2. Electrical defibrillation
3. Injection of lidocaine
4. Injection of atropine
5. Injection of adrenalin
36. Question
A 54-year-old female patient has been admitted to a hospital 12 days after the beginning of acute pancreatitis. Objectively: the patient is in grave condition. The body temperature is hectic. Ps – 112 bpm. The abdomen is swollen. Epigastrium palpation reveals a very painful infiltration falling in the localization of pancreas. Abdominal cavity contains fluid. There is an edema of the left lumbar region. In blood: WBCs – 18;109/l. What is the required tactics of the patients treatment?
1. Further conservative treatment
2. Peritoneal dialysis
3. Massive antibacterial therapy
--4. Surgical treatment
5. Increase in antienzymes
37. Question
A patient was delivered to a surgical department after a road accident with a closed trauma of chest and right-sided rib fracture. The patient was diagnosed with right-sided pneumothorax, it is indicated to perform drainage of pleural cavity. Pleural puncture should be made in:
---1. In the 2nd intercostal space along the middle clavicular line
2. In the point of the greatest dullness on percussion
3. In the 7th intercostal space along the scapular line
4. In the 6th intercostal space along the posterior axillary line
5. In the projection of pleural sinus
38. Question
A patient with frostbite of both feet was delivered to the admission ward. What actions should be taken?
1. To rub feet with snow
2. To administer cardiac medications
3. To apply an alcohol compress
4. To put feet into hot water
--5. To apply a bandage, to introduce vasodilating medications
39. Question
An emergency team has delivered to a hospital an unconscious patient found lying in the street in winter. Objectively: the patient is pale, with superficial respiration; bradycardia with heartrate 54/min, to- 35°C. AP- 100/60 mm Hg. Palpation of chest and abdomen revealed no peritoneal symptoms. There is a smell of alcohol from the patients mouth. What is the most likely diagnosis?
--1. Hypothermia
2. Apparent death
3. Acute cardiovascular insufficiency
4. Frostbite of trunk and extremities
40. Question
A 67 y.o. patient complains of dyspnea, breast pain, common weakness. He has been ill for 5 months. Objectively: to- 37.3°C, Ps- 96/min. Vocal tremor over the right lung cannot be determined, percussion sound is dull, breathing cannot be auscultated. In sputum: blood diffusively mixed with mucus. What is the most probable diagnosis?
--1. Lung cancer
2. Bronchoectatic disease
3. Focal pulmonary tuberculosis
4. Macrofocal pneumonia
5. Exudative pleuritis