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1.Which of the metastasis is not typical for gastric cancer? A. Krukenberg's metastasis B. Sorgius's metastasis C. Shnitsler's metastasis D. Virchov's metastasis E. Sister Joseph's metastasis ANSWER: B 2. What is localization of the Shnitsler’s metastasis? A. Umbilicus B. Ovaries C. Left supraclavicular area D. Douglas space E. Rectum ANSWER: D 3. What type of bone metastases has a breast cancer? A. Osteolytic B. Osteoblastic C. Retention D. Consolidating E. Mixed ANSWER: A 4. What type of bone metastases has a lung cancer? A. Osteolytic B. Osteoblastic C. Retention D. Consolidating E. Mixed ANSWER: A 5. What type of bone metastases has a prostate cancer? A. Osteolytic B. Osteoblastic C. Retention D. Consolidating E. Mixed ANSWER: B 6. What type of bone metastases has hypernephroma? A. Osteolytic B. Osteoblastic C. Retention D. Consolidating E. Mixed ANSWER: A 7. What type of bone metastases has a thyroid cancer? A. Osteolytic B. Osteoblastic C. Retention D. Consolidating E. Mixed ANSWER: A 8. Which malignant tumour has osteoblastic metastases? A. Hypernephroma B. Lung cancer C. Prostate cancer D. Thyroid cancer E. Breast cancer ANSWER: C 9. What is the most effective method of diagnosis of bone metastases in case of follicular thyroid carcinoma? A. Magnetic resonance imaging B. Computed tomography C. Digital radiography D. Scintigraphy by J-131 E. Thermography ANSWER: D 10. Which type of radiation therapy is preferred in case of multiple skeletal metastases? A. Gamma radiation B. X-ray C. Alpha-particles radiation D. Systemic radiotherapy E. Neutron radiation ANSWER: D 11. Which radiopharmaceutical radionuclide does not apply to therapy of bone metastases? A. Phosphorus-32 (32P) B. Strontium-89 chloride (89Sr) C. Colloidal gold-198 (198Au) D. Samarium-153 (153Sm) E. Rhenium-186 (186Re) ANSWER: C 12. What is the most effective method for early diagnosis of bone metastases? A. Radiography B. Radioisotope diagnosis (Bone Scan) C. Determination of tumor markers D. Immunohistochemistry E. Bone biopsy ANSWER: B 13. Which of the drugs most effective in adjuvant therapy of pain syndrome caused by bone metastases? A. Bisphosphonates B. Adrenergic agonist’s alpha2-receptor C. Calcium channel blockers D. Antagonists of exciting amino acids E. Spasmolytics ANSWER: A 14. Which of the drug does not belong to bisphosphonates? A. Nifedipin B. Bonefos C. Aredia D. Zometa E. Pamiredin ANSWER: A 15. Which of the drugs does not belong to a group of calcium channel blockers? A. Nifedipin B. Verapamil C. Izoptin D. Falikard E. Sirdalud ANSWER: E 16. Which of these diuretics is potassium sparing? A. Hypothiazid B. Diakarb C. Mannit D. Spironolactone E. Furosemide ANSWER: D 17. What drug is not used topically to stop bleeding from wounds or tumors? A. Tahokomb B. Beryplast C. Helaspon D. Vikasol E. Gelfoum ANSWER: D 18. Which drug is not antihemorrhagic? A. Etamzilat B. Tardiferon C. Vikasol D. Pamba E. Dicinon ANSWER: B 19. What way is mainly metastasizing skin cancer? A. Lymphogenous B. Hematogenous C. Implantation D. Retrograde E. Contact ANSWER: A 20. What is localization of the Krukenberg’s metastases? A. Umbilicus B. Ovaries C. Left supraclavicular area D. Douglas space E. Interpectoral spaces ANSWER: B 21. What is localization of the Virchov’s metastasis? A. Left supraclavicular area B. Interpectoral spaces C. Ovaries D. Rectum E. Douglas space ANSWER: A 22. Atelectasis as a complication is most common to following lung cancer: A. Central B. Peripheral C. Lung carcinomatosis D. Pancoast lung cancer E. Non-small lung cancer ANSWER: A 23. What is the cause of lung atelectasis? A. Compression of lungs outside the pleural fluid B. Depressurization pleural cavity C. Fibrosis of lung tissue D. Bronchial obstruction E. Lung tissue ischemia due to occlusion of arteries ANSWER: D 24. What is the main difference between atelectasis and lung collapse? A. Collapse captures the whole of lung and atelectasis may develop in some parts B. Atelectasis resulting from bronchial obstruction and collapse – no C. Atelectasis develops gradually, and the collapse – a sudden D. Atelectasis has tumor aetiology, and collapse – the inflammatory E. The basis of atelectasis is organic changes, and collapse – functional ANSWER: B 25. Which of the following tumours often leads to pneumothorax? A. Central lung cancer B. Peripheral lung cancer C. Mediastinal form of lung cancer D. Pleural mesothelioma E. Mediastinal tumor ANSWER: B 26. Which types of pneumothorax is the most dangerous to the patient's life? A. Open B. Closed C. Valvular D. Combined E. All are equally dangerous ANSWER: C 27. Which symptom does not occur with pneumothorax? A. Absent of breath on the side of lesion B. Dyspnea C. Pulsion of intercostal spaces D. Bandbox percussion sound on the side of lesion E. Dull percussion sound on the side of lesion ANSWER: E 28. Specify the location of pleural puncture in case of pneumothorax. A. 2nd intercostals space by mid-clavicular line B. 4th intercostals space by the anterior axilla line C. 6th intercostals space by the mid axilla line D. 8th intercostals space by the posterior axilla line E. 9th intercostals space by the scapular line ANSWER: A 29. Which of the following symptoms are not found in patient with pleural effusion? A. Dyspnea B. Cough C. Absence or weakening of breathing on the side of lesion D. Bandbox percussion sound on the side of lesion E. Dull percussion sound on the side of lesion ANSWER: D 30. What cancer may cause pleural effusion at least? A. Breast cancer B. Cancer of lower lip C. Lung cancer D. Ovarian cancer E. Malignant lymphoma ANSWER: B 31. Specify the location of pleural puncture in case of pleural effusion. A. 2nd intercostals space by mid-clavicular line B. 4th intercostals space by the anterior axilla line C. 6th intercostals space by the mid axilla line D. 7-9th intercostals space by the posterior axilla line E. 10th intercostals space by the scapular line ANSWER: D 32. What treatment is preferable in case of malignant pleural effusion? A. Surgical B. Radiation C. Cytostatic D. Hormonal E. Photodynamic laser therapy ANSWER: C 33. What clinical sign not included in the superior vena cava syndrome? A. Cyanosis scalp and neck B. Dyspnea C. Descent of angle of mouth D. Dilatation of subcutaneous veins of the neck and chest E. Dizziness ANSWER: C 34. What sign is not part of the superior vena cava syndrome? A. Swelling of the face and neck B. Dyspnea C. Dilatation neck and chest veins D. Varicose veins of oesophagus E. Dizziness ANSWER: D 35. What sign is not part of the superior vena cava syndrome? A. Cough B. Dyspnea C. Increased blood pressure D. Neck veins E. Drowsiness ANSWER: C 36. What sign is not part of the superior vena cava syndrome? A. Cough B. Dyspnea C. Compensatory vein’s dilatation of the lower torso D. Hypotension E. Swelling face ANSWER: C 37. What tumor frequently cause superior vena cava syndrome? A. Thyroid gland cancer B. Larynx cancer C. Oesophagus cancer D. Lungs cancer E. Liver cancer ANSWER: D 38. What medications are not used in symptomatic treatment of superior vena cava syndrome? A. Bronchodilatators B. Hypotensive C. Cardiac glycosides D. Diuretics E. Corticosteroids ANSWER: B 39. What specific treatment should be applied first in the case of superior vena cava syndrome? A. Surgical B. Chemotherapy or radiation therapy C. Immunotherapy D. Photodynamic therapy E. Symptomatic treatment ANSWER: B 40. When should be special treatment of patient with superior vena cava syndrome? A. Preceding to symptomatic treatment B. After successful symptomatic treatment C. In parallel with the symptomatic treatment D. Not indicated due to high risk of complications E. Only after morphological confirmation of malignant tumor ANSWER: C 41. What clinical symptoms not typical for cardiac tamponade? A. Dyspnea B. Acrocyanosis C. Pale skin D. Reducing blood pressure E. Increased blood pressure ANSWER: E 42. What changes in instrumental diagnostics do not indicate cardiac tamponade? A. Reduced P-wave on ECG B. Reducing the height of QRS-T on ECG C. Increased central venous pressure to 120-140 mm water column D. Increased heart shadow on chest X-ray E. Presence of liquid level in the pericardial cavity ANSWER: C 43. Where is the most common localization of primary thrombi which cause the pulmonary embolism? A. Pulmonary vein B. Veins of the pelvis and lower extremities C. Pulmonary artery D. Veins of the upper half of body E. Heart ventricles ANSWER: B 44. Which of the listed pathologies not increase the risk of pulmonary artery embolism? A. Varicose disease B. Obliterating endarteritis C. Malignant tumor D. Diabetes E. Adiposity ANSWER: B 45. Which clinical forms of pulmonary artery embolism cause the developing of infarct-pneumonia? A. Fulminant B. Acute C. Subacute D. Chronic E. Syncopal ANSWER: C 46. How long does the acute form of pulmonary artery embolism last? A. 1-10 min B. Several hours C. 3-5 days D. 7 days E. Several weeks ANSWER: B 47. How long last the fulminant form of pulmonary artery embolism? A. 1-10 min B. Several hours C. 1 day D. 3-5 days E. Several weeks ANSWER: A 48. How long last the subacute form of pulmonary artery embolism? A. 1-10 min B. Several hours C. 1 day D. 3-5 days E. Several weeks ANSWER: D 49. What clinical symptom is not typical for pulmonary artery embolism? A. Chest pain B. Dyspnea C. Hypotension D. Increased blood pressure E. Tachycardia ANSWER: D 50. What symptom is not typical for pulmonary artery embolism? A. Haemoptysis B. Pericardial rubbing sound C. Noise pleural friction D. Swelling of neck veins E. Increased venous pressure ANSWER: B 51. What sign is not typical for pulmonary artery embolism? A. Expanding the right border of heart B. Triple (gallop) cardiac rhythm C. Collapse D. Pale cyanosis E. Reduction of alveolar-arterial pCO2 gradient ANSWER: E 52. What auscultation sign is typical for pulmonary artery embolism? A. Systolic noise over the aorta B. Diastolic noise over the tip of heart C. Accent of 2nd tone over the aorta D. Diastolic noise over the pulmonary artery E. Accent of 2nd tone over the pulmonary artery ANSWER: E 53. What ECG sign is not typical for pulmonary artery embolism? A. Wide negative T-wave in the 1-4 chest positions B. Deep S-wave in the first chest position C. Increase Q-wave in the third chest position D. Displacement of interval S-T E. Narrow negative T-wave ANSWER: E 54. What is not typical radiological sign of pulmonary artery embolism? A. Increased pulmonary vascular network on the side of lesion B. Dilatation of right heart C. Elevation dome of diaphragm on the side of lesion D. Depleted pulmonary vascular network on the side of lesion E. Triangular shadow in the lung ANSWER: A 55. Which of these drugs effectively reduces intracranial pressure? A. Furosemide B. Spironolactone C. Hipothiazyd D. Mannitol E. Acid etakryn ANSWER: D 56. Which of these diuretics is refers as potassium sparing? A. Hipotiazyd B. Diakarb C. Mannitol D. Spironolactone E. Furosemide ANSWER: D 57. Which of these symptoms is not specific for spinal cord compression? A. Pain B. Paraplegia C. Vestibular ataxia D. Quadriplegia E. Paresthesia ANSWER: C 58. Which of these methods is effective in specific treatment of spinal cord compression caused by metastatic vertebral destruction? A. Photodynamic therapy B. Radiation therapy C. Cytostatic therapy D. Hormonal therapy E. Symptomatic treatment (narcotic analgesics, corticosteroids, bisphosphonates) ANSWER: B 59. Identify complications of bone metastases. A. Pain B. Dysfunction of adjacent joints C. Presence of tumor in the area of bone destruction D. Change of the bone structure of beams E. Fever ANSWER: B 60. Which of the pathological processes is not a complication of bone metastases? A. Pain B. Dysfunction of adjacent joints C. Intoxication D. Hypercalcemia E. Pathological fracture ANSWER: A 61. What is origin of the Shnitsler’s metastasis? A. Hematogenous B. Lymphogenous C. Implantation D. Contact E. Retrograde ANSWER: C 62. What is origin of the Sorgius metastasis? A. Hematogenous B. Lymphogenous C. Implantation D. Contact E. Retrograde ANSWER: B 63. What mechanism of action of bisphosphonates is not typical? A. Cytostatic effect B. Inhibition of osteoclast activity C. Prevention of pathological fractures D. Stabilization of calcium content in blood E. Inhibition of osteoblast’s resorption ANSWER: A 64 What is Karnofsky index (quality of life) in patient who stays in bed more than 50 % of daily time? A. 90-100 % B. 70-80 % C. 50-60 % D. 30-40 % E. 10-20 % ANSWER: C 65. What is Karnofsky index (quality of life) in patient who stays in bed less than 50 % of daily time? A. 90-100 % B. 70-80 % C. 50-60 % D. 30-40 % E. 10-20 % ANSWER: B 66. Which metastatic way is more often for the follicular thyroid cancer? A. Lymphogenous B. Hematogenous C. Implantation D. Retrograde E. Perineural ANSWER: B 67. Which metastatic way is more often for the papillary thyroid cancer? A. Lymphogenous B. Hematogenous C. Implantation D. Retrograde E. Perineural ANSWER: A 68. What is the basic metastatic way of endometrial cancer? A. Hematogenous B. Lymphogenous C. Implantation D. Dissemination to peritoneum E. Retrograde ANSWER: B 69. What is the primary metastatic way of the gastric cancer? A. Hematogenous B. Lymphogenous C. Implantation D. Dissemination to peritoneum E. Retrograde ANSWER: B 70. What is the primary metastatic way of oesophageal cancer? A. Hematogenous B. Lymphogenous C. Implantation D. Dissemination of pleura E. Retrograde ANSWER: B 71. What is the primary metastatic way of colon cancer? A. Hematogenous B. Lymphogenous C. Implantation D. Dissemination to peritoneum E. Retrograde ANSWER: B 72. What is the primary metastatic way of colorectal cancer? A. Hematogenous B. Lymphogenous C. Implantation D. Dissemination to peritoneum E. Retrograde ANSWER: B 73. What is the primary metastatic way of rectal cancer? A. Hematogenous B. Lymphogenous C. Implantation D. Dissemination to peritoneum E. Retrograde ANSWER: B 74. Which way is most metastasizing ovarian cancer? A. Hematogenous B. Lymphogenous C. Dissemination within peritoneum D. Implantation E. Retrograde ANSWER: C 75. What is the preferred metastatic way of chorionepithelioma? A. Hematogenous B. Lymphogenous C. Contact D. Implantation E. Perineural ANSWER: A 76. What is the preferred metastatic way of soft tissue sarcoma? A. Hematogenous B. Lymphogenous C. Perineural D. Implantation E. Retrograde ANSWER: A 77. What is the preferred metastatic way of osteogenic sarcoma? A. Hematogenous B. Lymphogenous C. Perineural D. Implantation E. Retrograde ANSWER: A 78. What is the preferred metastatic way of Ewing's sarcoma? A. Hematogenous B. Lymphogenous C. Perineural D. Implantation E. Retrograde ANSWER: A 79. What is the preferred metastatic way of laryngeal cancer? A. Hematogenous B. Lymphogenous C. Perineural D. Implantation E. Retrograde ANSWER: B 80. Cancer of what part of larynx has a highest metastatic rate? A. Supraglottis B. Glottis C. Subglottis D. Anterior commissure E. Posterior commissure ANSWER: A 81. Cancer of what part of larynx has a lowest metastatic rate? A. Supraglottis B. Glottis C. Subglottis D. Ventricular bands E. Infrahyoid epiglottis ANSWER: B 82. Satellite metastasis is: A. Metastasis in adjacent organs B. Metastasis within 2 cm of the primary tumour C. Metastasis in symmetrical areas of the body D. Regional lymph node metastasis E. Metastases which locate more than 2 cm from the primary tumour ANSWER: B 83. What is the preferable method of treatment of neck lymph node metastases? A. Surgical B. Radiation therapy C. Chemotherapy D. Immunotherapy E. Photodynamic therapy ANSWER: A 84. What operation is used in case when metastatic lymph nodes on the neck extending beyond the fascial sheath or invades the internal jugular vein? A. Radical neck dissection (Crile operation) B. Supraomohyoid selective neck dissection C. Modified radical neck dissection D. Lateral selective neck dissection E. Sentinel lymph node biopsy ANSWER: A 85. What operation is used in case when metastatic lymph nodes on the neck not extending beyond the fascial sheaths? A. Radical neck dissection (Crile operation) B. Supraomohyoid selective neck dissection C. Modified radical neck dissection D. Lateral selective neck dissection E. Sentinel lymph node biopsy ANSWER: C 86. What operation is used when melanoma metastases present in inguinal lymph nodes? A. Superficial groin dissection B. Radical ilioinguinal dissection C. Crile operation D. Axillary dissection E. Sentinel lymph node biopsy ANSWER: B 87. What is the name by author the submandibular lymphadenectomy? A. Madden operation B. Crile operation C. Vanakh operation D. Billroth operation E. Halstead operation ANSWER: C 88. What anatomical structures are subject to removal at radical neck dissection (Crile operation)? A. Lymph nodes and neck fatty tissue within the fascial space B. Lymph nodes, fatty tissue, sternocleidomastoid muscle, internal jugular vein, and accessory nerve C. Lymph nodes, ligation of external carotid artery and resection of hyoid bone D. Lymph nodes and resection of lower lip E. Cervical lymphadenectomy and resection of thyroid gland ANSWER: B 89. What is localization of the Sorgius metastasis? A. Left supraclavicular area B. Navel C. Ovaries D. Lymph node at the lateral border of pectoralis major E. Douglas space ANSWER: D 90. What is localization of Sister Joseph’s metastasis? A. Left supraclavicular area B. Umbilicus C. Ovaries D. Interpectoral spaces E. Douglas space ANSWER: B 91. What is localization of the Rotter’s metastasis? A. Left supraclavicular area B. Umbilicus C. Ovaries D. Interpectoral spaces E. Douglas space ANSWER: D 92. Where is most often location of colon cancer’s hematogenous metastases? A. In pelvic bone B. In brain C. In liver D. In regional lymph nodes E. In lung ANSWER: C 93. Where is most often location of hematogenous metastases of rectal cancer (lower third of rectum)? A. In pelvic bone B. In brain C. In liver D. In the regional lymph nodes E. In lung ANSWER: E 94. Where is most often hematogenous metastatic way of the rectal cancer of upper rectum? A. In pelvic bone B. In brain C. In liver D. In the regional lymph nodes E. In lung ANSWER: C 95. What is name by author the metastatic ovarian cancer? A. Krukenberg metastasis B. Sorgius metastasis C. Shnitsler metastasis D. Virchov metastasis E. Sister Joseph metastasis ANSWER: A 96. Where most developing chorionepithelioma metastases? A. Bones B. Lungs C. Liver D. Cerebrum E. Regional lymph nodes ANSWER: B 97. Where most developing hematogenous metastasis of prostate cancer? A. Bones B. Lungs C. Liver D. Cerebrum E. Regional lymph nodes ANSWER: A 98. Where most developing lymphogenous metastasis of prostate cancer? A. Bones B. Lungs C. Liver D. Cerebrum E. Regional lymph nodes ANSWER: E 99. Where most metastasizing cancer of the cervix? A. Bones B. Lungs C. Liver D. Cerebrum E. Regional lymph nodes ANSWER: E 100. What is the origin of Virchov’s metastasis? A. Hematogenous B. Lymphogenous C. Implantation D. Contact E. Retrograde ANSWER: B