surgery51

Äìèòðèé Ñàâðàöêèé
 51. Question

A 10-year-old child has been admitted to a hospital with a closed craniocerebral injury with suspected cerebral edema. The patient is in grave condition, unconscious. The dyspnea, tachycardia, hypertension are present. Muscle tone is increased, there is nystagmus, pupillary and oculomotor reactions are disturbed. The mandatory component of intensive care is dehydration. What diuretic is adequate in this case?

    1. Mannitol
    2. Spironolactone
    3. Moduretic
    4. Hydrochlorthiazide
    --5. Furosemide
 52. Question

A 75-year-old male patient complains of slight pain in the right iliac region. The abdominal pain arose 6 days ago and was accompanied by nausea. Surgical examination revealed moist tongue, Ps- 76 bpm. AP- 130/80 mm Hg. Abdomen was soft, slightly painful in the right iliac region on deep palpation, the symptoms of the peritoneum irritation were doubtful. In blood: RBCs – 4;1012/l, Hb- 135 g/l, WBCs – 9;109/l, stab neutrophils – 5%, segmentonuclear – 52%, lymphocytes – 38%, monocytes – 5%, ESR – 20 mm/h. Specify the doctors further tactics:

    1. Refer the patient to a district therapist
    --2. Emergency operation for acute appendicitis
    3. Administration of additional examination: abdominal ultrasound, x-ray contrast study of the gastrointestinal tract
    4. Send the patient home
    5. Hospitalization, dynamic surveillance
 53. Question

A patient complains of impaired far vision. Previously his eyes often turned red and hurt. Objectively: the eyes are not irritated, the cornea is transparent, anterior chambers are median deep, their liquid is transparent. The iris of the right eye has not changed in colour, its pattern is unchanged. The pupil is of irregular shape, scalloped. Biomicroscopy of the crystalline lens reveals the areas of opacity and vacuoles. Make a diagnosis:

    1. Tetanic cataract of the right eye
    2. Radiation cataract of the right eye
    ---3. Complicated cataract of the right eye
    4. Senile cataract of the right eye
    5. Diabetic cataract of the right eye
 54. Question

A 26-year-old patient consulted a doctor abut sore throat, fever up to 38.2°C. A week ago, the patient had angina, didn’t follow medical recommendations. On examination, the patient had forced position of his head, trismus of chewing muscles. Left peritonsillar region is markedly hyperemic, swollen. What is the provisional diagnosis?

    1. Meningitis
    ---2. Left-sided peritonsillar abscess
    3. Phlegmonous angina
    4. Tonsil tumour
    5. Diphtheria of the pharynx
 55. Question

A 15 year old patient suffers from headache, nasal haemorrhages, sense of lower extremity coldness. Objectively: muscles of shoulder girdle are developed, lower extremities are hypotrophied. Pulsation on the pedal and femoral arteries is sharply dampened. AP is 150/90 mm Hg, 90/60 on the legs. Systolic murmur can be auscultated above carotid arteries. What is the most probable diagnosis?

    1. Aortal insufficiency
    2. Coarctation of pulmonary artery
    3. Aorta aneurism
    --4. Aorta coarctation
    5. Aortal stenosis

 56. Question

To replace the blood loss replacement 1000 ml of the same group of Rhesus-compatible donated blood was transfused to the patient. The blood was conserved by sodium citrate. At the end of hemotransfusion there appeared excitement, pale skin, tachycardia, muscles cramps in the patient. What complication should be suspected?

    1. Anaphylactic shock
    --2. Citrate intoxication
    3. Citrate shock
    4. Allergic reaction
    5. Pyrogenous reaction
 57. Question

A 77-year-old male patient complains of inability to urinate, bursting pain above the pubis. The patient developed acute condition 12 hours before. Objectively: full urinary bladder is palpable above the pubis. Rectal prostate is enlarged, dense and elastic, well-defined, with no nodes. Interlobular sulcus is distinct. Ultrasonography results: prostate volume is 120 cm3, it projects into the bladder cavity, has homogeneous parenchyma. Prostate-specific antigen rate is of 5 mg/ml. What is the most likely disease that caused acute urinary retention?

    ---1. Prostatic hyperplasia
    2. Acute prostatitis
    3. Tuberculosis of the prostate
    4. Prostate carcinoma
    5. Sclerosis of the prostate
 58. Question

What developes most often after accidental intake of Hydrochloric acid?

    1. Cushings syndrome
    2. Acute pancreatitis
    --3. Cardiac insufficiency
    4. Deyladss syndrome
    5. Kutlings syndrome

 59. Question

Examination of the corpse of a man who died from hanging reveals: death spots disappear when pressed upon and restore after 50 seconds, rigor mortis is moderately expressed only in the masticatory muscles as well as neck and finger muscles, body temperature is of 31°C. The time of death:

    1. 16-24 hours ago
    2. 10-18 hours ago
    3. 8-10 hours ago
    --4. 6-7 hours ago
    5. 1-2 hours ago
 60. Question

Forensic medical expertise of corpse of a newborn revealed: body weight 3500 g, body length 50 cm, the umbilical cord was smooth, moist, glossy, without any signs of drying. Hydrostatic tests were positive. The test results are the evidence of:

    1. Secondary atelectasis
    2. Primary atelectasis
    3. Stillbirth
    --4. Live birth
    5. Hyaline membrane disease