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1. Fifth degree of MS characterised with: A. Patient can’t walk without help B. Patient can’t walk C. Patient has spastic-paretic gait, difficulty to walk and weakness on 200-300 m. D. Patient has difficulty to walk only after physical training E. Patient has difficulty to walk and weakness on 2-3 km. ANSWER: B 2. First degree of MS characterised with: A. Patient can’t walk without help B. Patient can’t walk C. Patiend blindness D. Patient has difficulty to walk only after physical training E. Patient has difficulty to walk and weakness on 2-3 km. ANSWER: D 3. Forth degree of MS characterised with: A. Patient can’t walk without help B. Patient can’t walk C. Patiend blindness D. Patient has difficulty to walk only after physical training E. Patient has difficulty to walk and weakness on 2-3 km. ANSWER: A 4. Signs of MS cerebellar ataxia includes all except: A. intention at coordinating tests B. decreasing of deep sense C. scanning speach D. nystagmus E. decreasing of muscules tones ANSWER: B 5. Signs of MS cerebellar ataxia includes all except: A. intention at coordinating tests B. scanning speach C. dizziness D. nystagmus E. decreasing of muscules tones ANSWER: C 6. The most accurate diagnostic method of MS is: A. CSF B. EEG C. CT D. MRI E. Angiography ANSWER: D 7. The most frequently appearing first symptoms of MS are: A. A. Transient visual disturbances, parasthesia, disorders of urination, decreased vibration sense B. B. Transient visual disturbances, legs paresis, micturition, decreased vibration sense C. C. Transient visual disturbances, lower paraparesis, absence of abdominal reflexes, parasthesia D. D. Transient parasthesia, decreased vibration sense, muscle hypotonia, absence of abdominal reflexes E. E. Hesitating at walking, absence of abdominal reflexes, urination disturbances, decreased visual acuity ANSWER: B 8. Third degree of MS characterised with: A. Patient can’t walk without help B. Patient can’t walk C. Patiend blindness D. Patient has difficulty to walk only after physical training E. Patient has difficulty to walk and weakness on 2-3 km. ANSWER: E 9. Typical optic sing of syphiliytic damage is A. myosis B. anizokoria C. paresis of vertical sight D. Vice verse Argil – Robertson symptom E. bilateral ptosis ANSWER: D 10. What are the clinical criteria of MS diagnosis? A. A. Multiple lesion of CNS, chronic course B. B. Acute infectious disease with lesion of all parts of NS C. C. Chronic disease with monosymptomatic lesion of pyramid pathways D. D. Acute stroke – like onset with gradual increasing of symptoms during the week E. E. Peripheral NS lesion, including optic nerves ANSWER: A 11. What clinical form of MS is the most frequent? A. A. Bulbar, cerebellar B. B. Brain stem – cerebellar – spinal 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. C. C. Optic – brain stem – cerebellar D. D. Spinal - brain stem – cerebellar E. E. Cerebellar – spinal ANSWER: B What dose of methylprednisolone has to be used in case of AMEM? A. 10-15 mg per kg i/v B. 15-25 mg per kg i/v C. 25-30 mg per kg i/v D. 5-10 mg per kg i/v E. 50-60 mg per kg i/v ANSWER: A What is maximal dose of methylprednisoloni at MS pulse – therapy? A. A. 500 mg per day B. B. 600 mg per day C. C. 750 mg per day D. D. 800 mg per day E. E. 1000 mg per day ANSWER: E What is the most frequent type of MS clinical course? A. A. Remittent B. B. Stationary C. C. Slow progressive D. D. Rapid progressive E. E. Regressive ANSWER: A What medicine should be used in case of exacerbation of MS? A. Betametason B. Betaferon C. Azatioprin D. Solu-medrolum E. Proserinum ANSWER: D At signs of compression on lumbar – sacral level for pain management usually is prescribed A. dehydration B. analgesics C. tranquilization D. nonsteroid anti – inflammatory E. vitamins of group B ANSWER: A For L5 radiculopathy is typical A. paresis of foot extensors B. paresis of foot flexors C. decreased Achielle reflex D. hypotrophy of calf muscles E. hypoesthesia on anterior surface of hip ANSWER: A For S1 radiculopathy is typical A. paresis of foot extensors, hypotrophy of anterior surface of calf B. paresis of foot flexors, hypotrophy of calf muscles C. paresis of foot flexors, steppage-gait D. hypotrophy of quadriceps femoris, anesthesia on anterior surface of hip E. paresis of foot flexors, hypotrophy of anterior surface of calf ANSWER: B Increased low back pain after bending head forward is called A. Laseg sign B. Degerina sign C. Siquar sign D. Wasserman sign E. Neri sign ANSWER: E Increasing pain on anterior surface of hip after leg flexion in knee joint in patient lying on abdomen is called A. Laseg sign B. Matskevych sign C. Siquar sign D. Wasserman sign E. Neri sign ANSWER: B Low back pain at coughing, sneezing is called A. Laseg sign B. Degerina sign C. Siquar sign D. Wasserman sign E. Neri sign ANSWER: B 22. What are the most common signs of compressive-radicular syndrome at cervical osteochondrosis? A. pain and paresthesia in certain dermatome B. segmental hyper or hypoesthesia C. decreased reflexes D. absent reflexes E. domination of sensory disorders over the motor ones ANSWER: C 23. What are the most important methods of cervical radiculopathy investigation? A. MRI B. CT-scan C. Spondilography D. Myelography E. Angiography ANSWER: A 24. What are the signs of L2 radix lesion A. Calf muscles hypotrophy B. Decreased knee reflex C. Decreased Achielle reflex D. Decreased plantar reflex E. Hypoesthesia on external surface of hip, calf and foot ANSWER: B 25. What are the signs of L3 radix lesion A. difficulties at leg flexion in knee joint B. difficulties at foot extension C. difficulties at leg extension in knee joint D. difficulties at foot flexion E. decreased Achielle reflex ANSWER: C 26. What changes on X – ray prove that the patient has III stage of osteochondrosis? A. Horizontal osteophits B. Vertical osteophits C. slightly expressed lordosis D. sclerosis of closing plate E. Decreased height of intervertebral disc ANSWER: D 27. What changes on X – ray prove that the patient has II stage of osteochondrosis? A. Horizontal osteophits B. Vertical osteophits C. slightly expressed lordosis D. sclerosis of closing plate E. Decreased height of intervertebral disc ANSWER: E 28. What structures are involved at ALS? A. A. pyramidal pathways B. B. Spino – muscular pathways C. C. Anterior horns of the spinal cord D. D. Cortico – muscular pathways E. E. Cortico – nuclear pathways ANSWER: D 29. What sign is not typical for algic stage of shoulder-hand syndrome? A. severe pain in hand, arm B. hand edema C. cyanotic hand D. local osteoporosis E. severe limitation of arm movements ANSWER: D 30. What roots are usually damaged at vertebral compression on lumbar level? A. radix L5-S1 B. radix S1- S2 C. radix L4- L5 D. radix L3- L4 E. radix L1- L 2 ANSWER: A 31. To decrease progression of degenerative changes in between vertebral discs it is necessary to use A. non steroid anti-inflammatory drugs B. vitamins of group B C. dehydration D. chondroprotectors E. biostimulants ANSWER: D 32. What clinical form is typical for alcoholic polineuropathy? A. sensory B. motor C. sensory-motor 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. D. autonomic E. sensitive ANSWER: E What complains more informative for diagnostic of subarachnoid hemorrhage? A. Seizures B. Loss of consciousness C. Sudden headache D. Focal headache E. Felling like a stroke on a head ANSWER: C Which structures of spinal cord are usually involved at atactic stage of tabes dorsalis? A. posterior columns B. posterior horns C. posterior roots D. lateral columns E. anterior horns ANSWER: A Which of the following clinical forms are the most often for acute disseminated encephalomyelitis? A. A. Encephalomyelopoliradiculoneuritis B. B. Polioencephalomyelitis C. C. Opticomyelitis D. D. Disseminated myelitis E. E. Myasthenic syndrome ANSWER: A Which of the following is differential diagnosis of encephalomyelitis? A. A. Multiple sclerosis B. B. Tick’s encephalitis C. C. ALS D. D. para infectious encephalitis E. E. Spinal tumor ANSWER: A What could possible cause appearing of focal symptoms in the patients with subarachnoid hemorrhage A. Spasm of vessels B. Recedive C. Occlusion hydrocephalus D. Presence of aneurysm E. Increasing of intracranial pressure ANSWER: A What is medication of choice at trigeminal neuralgia? A. Suprastini B. Pentalgini C. Karbamasepini D. Baralgini E. Dyclophenac ANSWER: C What is neurodystrophic syndrome of cervicobrachialgia? A. Coccygodynia B. shoulder –hand syndrome C. Syndrome of musculus pectoralis minor D. Scalenus –syndrome E. Piriformis syndrome ANSWER: B What is neurodystrophic syndrome of cervicobrachialgia? A. coccygodynia B. epicondilosis C. Musculus pectoralis minor syndrome D. Scalenus syndrome E. Piriformis syndrome ANSWER: B What is the absolute direction for the operative treatment of intervertebral disc hernia? A. severe pain phenomena B. Huge hernia C. Acute compression of horse tail D. Well expressed static-dynamic disorders E. Acute radiculopathy ANSWER: C What is the absolute direction for the operative treatment of intervertebral disc hernia? A. severe pain phenomena during 1 month B. size of hernia 5-6 mm C. Acute compression of radiculo-medullar artery D. Well expressed static-dynamic disorders E. Acute radiculopathy ANSWER: C What is the early sign of diabetic polineuropathy? 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. A. lost deep reflexes B. paresis of feet flexors C. paresis of feet extensors D. Lost deep sensation E. Sensitive ataxia ANSWER: A What is the most common cause of pain syndrome on lumbar level? A. Spondilitis B. oseochondrosis C. tumors D. Myeloma disease E. trauma ANSWER: B What is the most common cause of radicular pain on lumbar –sacral level? A. hernia of intervertebral disc B. Spondilolisthesis C. Primary tumors D. Metastatic tumors E. Spinal arachnoiditis ANSWER: A What is the most frequent etiologic factor of SH? A. Atherosclerotic B. Blastomatose C. Traumatic D. Hypertensive E. Aneurysmatic ANSWER: E What is the most important complication of facial nerve neuropathy? A. Conjunctivitis B. Contracture C. Pain D. Synkinesis E. Fasciculation ANSWER: B What is the peculiarity of botulism polineuropathy development? A. incubation period 12-24 days B. normal temperature C. diplopia and photophobia D. headache E. mimic muscles paralysis ANSWER: C What is the sign of distal symmetric diabetic polineuropathy? A. well expressed sensitive ataxia B. severe trophic disorders C. flaccid paresis in distal parts of extremities D. Atrophy of calf muscles E. Steppage gait ANSWER: B What medication is antidote at PhOS poisoning? A. Unitiolum B. Ca tetacini C. D-penicylamini D. Reosorbilact E. Isonitrazid ANSWER: E ?What medication is prescribed in first row of treatment of cholinergic crisis? A. lasix B. Atropini C. Dipiroxim D. Prednisoloni E. KCl ANSWER: B What medication should be prescribed at PhOS poisoning? A. Proserini B. Nerviplex C. Gangleroni D. Atropini E. Anaprilini ANSWER: D What medicine is better to use for preventing spasm of vessels and ischemia of brain in case of subarachnoid hemorrhage? A. Nimodipini B. Lidokaini C. Euphyllini 54. 55. 56. 57. 58. 59. 60. 61. 62. 63. 64. D. Papaverini E. Naniprus ANSWER: A What pathogenetic group of medication is primary one at facial nerve neuropathy in acute period? A. desensibilization B. dehydration C. rheological D. desintoxication E. non steroid anti-inflammatory drugs ANSWER: B What sign is not typical for lumbalgia? A. straining of paravertebral muscles B. painful palpation of paravertebral points C. Deformation of lumbar lordosis D. Stretch phenomena E. Signs of vertebral column instability ANSWER: D What signs are developed at extracranial lesion of facial nerve? A. Prosoplegia, kserophthalmia, hyperakusis, ageysia B. Prosoplegia, hyperakusis, ageysia C. Palsy of all mimic muscles, lacrimation, retroauricular pain D. Palsy of lower mimic muscles, lacrimation, retroauricular pain E. Prosoplegia, hyperlacrimation, hyperakusis ANSWER: C Anterior cerebral artery is occluded, main signs are: A. Paresis of distal part of lower extremity, symptoms of oral automatism, psychiatric disorders B. Paresis of distal part of lower extremity, retention of urine, apraxia C. Paresis of distal part of lower extremity, retention of urine, symptoms of oral automatism D. Paresis of distal part of lower extremity, psychiatric disorders E. Paresis of distal part of lower extremity, retention of urine, symptoms of oral automatism, psychiatric disorders ANSWER: A If the internal carotid artery is occlu ded before ophthalmic artery: A. Hemiplegia, hemianesthesia, gaze paresis, speech disorders B. Apraxia, astereognosia, autotopagnosia, pseudomelia C. Hemianopsia with senso-motor aphasia, apraxia D. Alternal optic – hemiplegic syndrome E. Hemiplegia, hemianesthesia, homonymic hemianopsia ANSWER: D If the left middle cerebral artery main trunk is occluded: A. Hemiplegia, hemianesthesia, gaze paresis, speech disorders B. Agnostic syndrome C. Apraxia, astereognosia, autotopagnosia, pseudomelia D. Alternal optic – hemiplegic syndrome E. Hemiplegia, hemianesthesia, homonymic hemianopsia ANSWER: A Infarction in the region of the posterior cerebral artery: A. Hemiplegia, hemianesthesia, well expressed general cerebral symptoms B. Hemiplegia, hemianesthesia, homonymic hemianopsia C. Apraxia, astereognosia, autotopagnosia, pseudomelia D. Visual agnosia, hemianopsia, hyperpathia, disorientation in space and time E. Hemianopsia with senso-motor aphasia, apraxia ANSWER: D Infarction in the region of vertebral artery: A. Hemiplegia, hemianesthesia, well expressed general cerebral symptoms B. Drop-attacks”, equilibrium disorders and paresis with sensory disturbances C. Apraxia, astereognosia, autotopagnosia, pseudomelia D. Systemic dizziness, vestibular disorders, senso-motor aphasia, apraxia E. Visual agnosia, hemianopsia, hyperpathia, disorientation in space and time ANSWER: B Ischemic stroke with gradual growth of focal symptoms needed to be differentiated with: A. Hemorrhage stroke B. Brain tumor* C. Brain abscess D. Encephalitis E. Dyscirculative encephalopathy ANSWER: B Most effective method in treatment of atherothrombotic brain infarction in first 3 hours is: A. To renew blood circulation in zone of ischemia (Actilaza) B. Using anticoagulative therapy (Heparini, Fraxiparini) C. Using antiagregants (Aspirini, Ticlid) D. To improve perfusion using Cavinton, Penthoxiphyllini, Euphyllini. E. Using cell protection (Sermioni, Aktovegini, Instenoni) ANSWER: A 65. Most important element in pathogenesis of atherothrombotic stroke is: A. Occlusion or stenosis MAH B. Disturbance of rheologic blood properties C. Increasing of adhesion and aggregation in blood cells D. Disturbance of self-regulation of brain blood circulation with unstable blood pressure E. Disturbance of brain blood circulation ANSWER: A 66. Most important reason that cause cardioembolic stroke is: A. Atherosclerosis B. Septic endocarditis C. Artificial valves of heart D. Arrhythmia E. Rheuimatizm ANSWER: D 67. Most important sign of beginning atherothrombotic brain infarction is: A. Focal symptoms developed during some ours and days B. Prevalence of focal symptoms over the general cerebral once C. Precursors D. Developing at night or in the morning time E. Pale face ANSWER: D 68. Posterior cerebral artery is occluded, main signs are: A. Hemianesthesia, hyperpathia, hemianopsia B. Lower qudrantive hemianopsia with preserved macular vision C. Upper qudrantive hemianopsia, alexia, semantic aphasia D. Metamorphopsia, hemianopsia, sensory aphasia, alexia E. Metamorphopsia, hemianesthesia, disappering hemiparesis ANSWER: D 69. Symptoms of extracranial lesion of vertebral artery are: A. Hemiplegia, hemianesthesia, well expressed general cerebral symptoms B. Drop-attacks”, equilibrium disorders and paresis with sensory disturbances C. Alternating syndromes of oblongate brain D. Visual agnosia, hemianopsia, hyperpathia, disorientation in space and time E. Hemianopsia with senso-motor aphasia, apraxia ANSWER: B 70. Symptoms of intracranial lesion of vertebral artery are: A. Hemiplegia, hemianesthesia, well expressed general cerebral symptoms B. “Drop-attacks”, equilibrium disorders and paresis with sensory disturbances C. Alternating syndromes of oblongate brain D. Visual agnosia, hemianopsia, hyperpathia, disorientation in space and time E. Hemianopsia with senso-motor aphasia, apraxia ANSWER: C 71. The main clinical features of cardioembolicl ischemic stroke is: A. Presents of precursors in anamnesis B. Slow development C. All symptoms of stroke are present in the beginning D. The main reason of this type of stroke is hypertensive disease. E. Well-expressed meningeal syndrom ANSWER: C 72. The main clinical features of haemorheological ischemic stroke is: A. Presents of precursors in anamnesis B. Patient has arrhythmia. C. Well-expressed general cerebral symptoms D. The most frequent localization is zone of contiguous blood circulation E. All symptoms are regressing during 1 week ANSWER: D 73. The main clinical features of hyperkinetic hypertensive crisis A. Slow development B. Often complicated with ischemic stroke C. Mainly diastolic blood pressure is increased D. Mainly systolic blood pressure is increased E. Often complicated with lung edema ANSWER: D 74. The main clinical features of hypokinetic hypertensive crisis A. Acute development B. Good responds to treatment C. Slow development, often complicated with ischemic stroke D. Mainly systolic blood pressure is increased E. Well-expressed autonomic disorders ANSWER: C 75. The main clinical features of lacuna ischemic stroke is: A. Presents of general cerebral symptoms B. Well-expressed focal symptoms 76. 77. 78. 79. 80. 81. 82. 83. 84. 85. C. Presents of meningeal syndrom D. Absent of general cerebral syndrome and disorders of mental function E. All symptoms are regressing during 1 week ANSWER: D The most common cause of secondary purulent meningitis A. Sepsis B. Cranial – cerebral trauma C. Purulent pulpitis D. Purulent sinusitis E. Abscess – pneumonia ANSWER: D The most common clinical signs of herpetic encephalitis are A. Fever, meningeal signs, epileptic attacks, focal signs B. Prodromal period during 2 – 3 weeks, fever, meningeal signs C. Fever, epileptic attacks, mono – hemiparesis D. Fever, hyperkinesis, lymphocytic pleocytosis in CSF up to hundreds cells in 1mcl. E. fever, Kernig sign, Jackson attack ANSWER: A The most common reason of secondary purulent meningitis A. Sepsis B. Cranial – cerebral trauma C. Purulent pulpitis D. Purulent otitis E. Abscess – pneumonia ANSWER: D The most common sign of general cerebral syndrome at secondary purulent meningitis is A. Headache B. Dizziness C. General hyperesthesia D. Nausea E. Vomiting ANSWER: A The most effective medications in the treatment of herpetic encephalitis are A. dehydration B. DNA- za, interferonum C. Interferonum, glucocorticoids D. Acyclovirum, virolex, zovirax, idoksiridinum, interferonum, glucocorticoids E. Immunomodulators (Ig, T – activinum, Timalinum, Timozinum). ANSWER: D Usually in debut of secondary purulent meningitis one can observe such meningeal sign as A. Neck stiffness B. Behterev phenomena C. Kernig sign D. Upper Brudzinski sign E. Lower Brudzinski sign ANSWER: A What alternative syndromes are typical for midbrain tumors? A. Weber, Benedict B. Fovihl, Myar-Hubler C. Jackson, Awellis, Schmidt D. Schmidt, Valenberg-Zaharchenko E. Myar-Hubler, Jackson ANSWER: A What alternative syndromes are typical for oblong brain tumors? A. Weber, Benedict B. Fovihl, Myar-Hubler C. Jackson, Awellis, Schmidt D. Schmidt, Valenberg-Zaharchenko, Jackson, Awellis E. Myar-Hubler, Jackson ANSWER: D What alternative syndromes are typical for Pons tumors? A. Weber, Benedict B. Fovihl, Myar-Hubler C. Jackson, Awellis, Schmidt D. Schmidt, Valenberg-Zaharchenko E. Myar-Hubler, Jackson ANSWER: B What arachnoiditis is associated with eye movements disorders? A. Convexital B. Basal C. Optic-chiasmal D. Ponto-cerebellaris E. Posterior cranial fosse ANSWER: B 86. What arachnoiditis is associated with seizures? A. Convexital B. Basal C. Optic-chiasmal D. Ponto-cerebellaris E. Posterior cranial fossa ANSWER: A 87. What are the criteria of refusing from antibiotics treatment at purulent meningitis? A. Cytosis less then 100 cells, 75 % of them are lymphocytes B. Cytosis less then 200 cells, 75 % of them are neutrophils C. Cytosis less then 150 cells, 25 % of them are lymphocytes D. Cytosis less then 10 cells, 50 % of them are neutrophils E. Cytosis less then 1000 cells, 15 % of them are lymphocytes ANSWER: A 88. What are the typical changes of CSF at meningococcal meningitis? A. Neutrophil pleocytosis B. Lymphocyte pleocytosis C. Fibrin plate D. Ksantochrome CSF E. Protein-cellular dissociation ANSWER: A 89. What are the typical changes of CSF at meningococcal meningitis? A. Bloody B. Ksantokhromic C. Purulent D. Opalescent E. Transparent ANSWER: C 90. What are the typical changes of CSF at tuberculosis meningitis? A. Purulent B. Ksantokhromic C. Bloody D. Opalescent E. Transparent ANSWER: D 91. What dose of Benzilpenicillinum is prescribed as etiotropic treatment for purulent meningitis? A. 300 000 Unites per kg B. 500 000 Unites per kg C. 100 000 Unites per kg D. 1000 000 Unites per kg E. 10 000 Unites per kg ANSWER: A 92. What is the most difficult complication for meningococcal meningitis? A. Lesion of cranial nerves B. Hydrocephalus C. Central paresis D. Meningococcemia E. Infectious-toxic shock ANSWER: E 93. What medication is being used for the treatment of tuberculoses meningitis? A. Riphampicinum B. Benzilpennicilinum C. Ampicillinum D. Gentamicinum E. Cyprofloksacinum ANSWER: A 94. What meningitis is associated with purulent changes of CSF? A. Tuberculosis B. Syphilitic C. Meningococcal D. Flu-associated E. Herpetic ANSWER: C 95. What meningitis is associated with serous changes of CSF? A. Meningococcal B. Staphylococcal C. Pneumococcal D. Tuberculosis E. Streptococcal ANSWER: D 96. What meningitis is characterized by decreased level of glucose and chlorides in CSF? A. Tuberculosis B. Syphilis C. Meningococcal D. Pneumococcal E. Herpetic ANSWER: A 97. What parts of nervous system suffer at herpetic encephalitis? A. Mediobasal structures of fronto-temporal lobe B. Subcortical nuclei C. Internal capsule D. Pons E. Oblong brain ANSWER: A 98. Which disease is usually differentiated with post encephalitic Parkinson disease? A. Sub cortical nodules tumor B. Sub cortical nodules hemorrhage C. Parkinson disease at CO poisoning D. Parkinson disease E. Hepatocerebral dystrophy ANSWER: D 99. Which encephalitis belongs to primary? A. Rheumatic B. Flu-associated C. Parainfectious D. Postvaccinal E. Tick encephalitis ANSWER: E F. 100. Which form belongs to the chronic stage of epidemic encephalitis Economo? A. Oculocephalgic B. Parkinson syndrome C. Abortive D. Flu-associated E. Lethargic ANSWER: B 101. What signs are typical for alcoholic polineuropathy A. hyperesthesia with hyperpathy in hands and feet B. sensory disorders according to the conductive type C. Pelvic disorders D. Proximal paresis of extremities E. Sensory disorders according to the segmental type ANSWER: A