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1.
An esophagogastroduodenoscopy is generally not indicated for evaluating:
A. Asymptomatic or uncomplicated sliding hiatal hernia
B. Pain in the upper abdomen
C. Nausea
D. Vomiting
E. Gastroesophageal reflux disease (GERD)
ANSWER:A
2.
An esophagogastroduodenoscopy is generally not indicated for evaluating:
A. Asymptomatic or uncomplicated sliding hiatal hernia
B. Nausea
C. Vomiting
D. Gastroesophageal reflux disease (GERD)
E. Difficulty swallowing (dysphagia)
ANSWER:A
3.
The most-common symptom of GERD is
A. Heartburn
B. Pain with swallowing (odynophagia)
C. Regurgitation
D. Nausea
E. Chest pain
ANSWER:A
4.
Extraesophageal manifestations of GERD are all of the following except
A. Diverticulutis
B. Laryngitis (hoarseness, throat clearing)
C. Asthma
D. Erosion of dental enamel
E. Sinusitis
ANSWER:A
5.
An esophagogastroduodenoscopy is indicated in all following conditions except:
A. Asymptomatic or uncomplicated sliding hiatal hernia
B. Pain in the upper abdomen
C. Vomiting
D. Gastroesophageal reflux disease (GERD)
E. Difficulty swallowing (dysphagia)
ANSWER:A
6. The most common cause of esophagitis is
A. Gastroesophageal reflux disease
B. Viral esophagitis
C. Herpes simplex (Herpetiform esophagitis)
D. Ingestion of acid solution
E. Radiation therapy
ANSWER:A
7. What is true regarding congenital hypertrophic pyloric stenosis:
A. Hypochloremic alkalosis
B. More common in girls
C. Hellers myotomy is the procedure of choice.
D. Most often manifests at birth
E. None mentioned
ANSWER:С
8. In a case of hypertrophic pyloric stenosis, the metabolic disturbance is
A. Metabolic alkalosis with paradoxical aciduria
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis with alkaline urine
E. Hyperkalemia
ANSWER:С
9.
Common sites for cushing ulcers include all of the following except:
A. Esophagus
B. Stomach
C. Is1 part of duodenum
D. Jejunum
E. Distal duodenum
ANSWER:E
10.
Commonest site of peptic ulcer is:
A. Middle part of duodenum
B. Distal 1/3 of stomach
C. Pylorus of the stomach
D. Fundal localisation
E. E1st part of Duodenum
ANSWER:E
11.
Deep ulcerations in ulcerative colitis can appear as
A.
"collar-button" ulcers
B.
deeper
C.
occasionally connected to one another
D.
forming serpiginous.
E.
forming linear ulcers
ANSWER:A
12.
CT findings in Crohn’s disease include all of the following except
A.
absence of small bowel thickening
B.
mural thickening >2 cm
C.
homogeneous wall density
D.
mural thickening of small bowe
E.
mesenteric fat stranding
ANSWER:A
13.
CT findings in ulcerative colitis include
A.
target appearance of the rectum
B.
mural thickening >2 cm
C.
mural thickening of small bowe
D.
mesenteric fat stranding
E.
perianal disease
ANSWER:A
14. Which of the following is the most likely explanation for a 25-year-old man with a 7-year history of ulcerative colitis
and insidious onset of progressive fatigue, pruritus, and jaundice?
A. Bile duct tumor
B. Choledocholithiasis
C. Congenital polycystic liver
D. Primary biliary cirrhosis
E. Primary sclerosing cholangitis
ANSWER:E
15. What extrabowel sing of ulcerative colitis may be in patient if insidious onset of progressive fatigue, pruritus, and
jaundice have developed?
A. Bile duct tumor
B. Choledocholithiasis
C. Congenital polycystic liver
D. Primary biliary cirrhosis
E. Primary sclerosing cholangitis
ANSWER:E
16. There are following diagnostic tests for chronic hepatitis B except:
A. HDV RNA
B. IgG anti-HBc,
C. HBeAg,
D. Hepatitis B surface antibody (anti-HBs)
E. HBsAg,
ANSWER:A
17. Which of the following statements regarding liver cirrhosis isn’t true?
A. caused by alcoholism
B. caused by viral hepatitis A
C. treatment focuses on preventing progression and complications
D. caused by fatty liver disease
E. is generally irreversible condition
ANSWER:B
18. Signs of liver cirrhosis are all of the following except
A. Erythema nodosum
B. Spider angiomata
C. Palmar erythema
D. Nail changes
E. Hypertrophic osteoarthropathy
ANSWER:A
19. Causes of Cirrhosis and/or Chronic Liver Disease are all of the following except:
A. Viral hepatitis C,
B. Autoimmune,
C. Viral hepatitis A
D. Viral Hepatitis B
E. Viral Hepatitis B with hepatitis D
ANSWER:C
20. Complications of liver cirrhosis are all of the following except
A. Hyperuricemia
B. Bruising and bleeding
C. Jaundice due to decreased processing of bilirubin
D. Itching (pruritus)
E. Sensitivity to medication
ANSWER:A
21.
A 73-year-old male presents with a complaint of fatigue. There is no history of alcohol abuse or liver disease; the
patient is on no medication. Scleral icterus is noted on physical exam. The patient is noted to have conjugated
hyperbilirubinema, with bilirubin detected in the urine. Serum bilirubin is 12 mg/dL, AST and ALT are in normal range,
and alkaline phosphatase is 300 U/L (3 times normal). The next step in evaluation is
A. Hepatitis profile
B. Ultrasound or CT scan
C. Reticulocyte count
D. Family history for hemochromatosis
E. Colonoscopy
ANSWER:B
22. Ultrasonography can provide important information in patients with all of the following except:
A. perforated duodenal ulcer
B. acute pancreatitis,
C. chronic pancreatitis,
D. pancreatic calcification,
E. pseudocyst.
ANSWER:A
23. In acute pancreatitis, the pancreas:
A. is characteristically enlarged
B. has scattered calcification
C. has ductal decompression
D. is replaced
E. no changes
ANSWER:A
24. Most lesions of pancreas on CT are characterized by all of the following except:
A. the presence of ductal decompression
B. enlargement of the pancreatic outline,
C. distortion of the pancreatic contoura
D. a fluid filling that has a different attenuation coefficient than normal pancreas
E. none of the listed
ANSWER:A
25. The differential diagnosis of chronic pancreatitis should include all of the following disorders except:
A. perforated peptic ulcer;
B. acute cholecystitis and biliary colic;
C. acute intestinal obstruction;
D. mesenteric vascular occlusion
E. paroxysmal atrium fibrillatium.
ANSWER:E
26. The differential diagnosis of chronic pancreatitis includes:
A. pneumonia
B. myocardial infarction;
C. dissecting aortic aneurysm;
D. All of the listed
E. peptic ulcer..
ANSWER:D
27. A 28 years old patient, complaints on cough with small amount of colourless sputum, pain in the right half of
thorax during breathing, shortness of breath, increase of temperature to 39 °С. Felt ill rapidly. Used aspirin.
Objectively: herpes on lips. In lower lobe of right lung there is dull percussion sound, bronchial breathing. X-ray:
there is homogeneous infiltration of right lower lobe. What is the most possible etiology of pneumonia?
A.
B.
C.
D.
E.
Pneumococcus
Staphylococcus
Mycoplasma
Legionella
Klebsiella
ANSWER: A
28.
A young woman complains of wheeze, dyspnoea and cough. She cannot sleep at night because of a chronic
cough. She and her mother love animals and together they have 14 cats. Her PEFR is normal but her CXR suggests
hyperinflation. What is the previous diagnosis?
A.
B.
C.
D.
E.
Bronchial asthma
Bronchogenic carcinoma
Emphysema
Respiratory failure
Bronchitis
ANSWER: A
29.
Female B., 44 years old, complains on cough with mucous sputum, increase of temperature to 39 °С, weakness,
dyspnea, sweating. Breathing rate - 26/min, skin is moist. Below left scapula there is shortening of percussion sound.
Breathing during auscultation is weakened, moist rales. Blood test: L - 11х109/l, ESR - 29 mm/h. Your previous
diagnosis?
A.
B.
C.
D.
E.
Left-side lower lobe pneumonia
Gangrene of lungs
Left-side exudative pleurisy
Cancer of left side lower lobe
Pulmonary abscess
ANSWER: A
30.
Man, 32 y.o., complaints on attack of expiratory dyspnea, which lasts for 48 hours, cough with small amount of
sputum. He is ill with bronchial asthma for 5 years, was treated with glucocorticosteroids, used inhalers. Objectively:
condition is severe, patient sits. Diffuse cyanosis, pulse -110/min, BP - 110/70. Tones of heart are weak, II tone is louder
above the pulmonary artery. During percussion in lungs there is “bang-box” sound, large amount of dry wheezes. In blood
there is eosinophylia - 18 %. What medicines are drugs of choice for this patient?
A.
B.
C.
D.
E.
Corticosteroids
β2-agonists
Theophyllin
Cholynolytics
Antihystamines
ANSWER: A
31.
Man, 39 y.o., 8 last years is ill with bronchial asthma. Rapidly during physical work he felt worsening of
breathing, cough, distance wheezes appeared and dyspnea began to increase. Medicine of what pharmacological group is
it better to recommend for the patient to remove such attacks of dyspnea?
A.
B.
Agonists of β2-adrenoreceptors
Metilxantines
C.
D.
E.
β2-adrenoblockers
Inhalated glucocorticoids
Oral glucocorticoids
ANSWER: A
32.
Patient J., 45 y.o., complaints on dyspnea during insignificant physical exertion, cough with minimal amount of
“glass-like” sputum, attacks of dyspnea up to 3 times a day, more often at night, sweating. She is ill for more than 5 years.
Has an allergy on dust, cockroaches. For treatment uses bekotid for near the year. Diagnosis?
A.
B.
C.
D.
E.
Bronchial asthma
Eosinophylic pulmonary infiltrate
COPD
Bronchiectasis with bronchial spasm
Pulmonary vasculitis (syndrome of Charg - Stross)
ANSWER: A
33.
Patient Y.,49 y.o., complaints on dyspnea, cough. Sputum is absent. Used many puffs of salbutamol, intal, but
without any efficacy. Objectively: sits, leaning on a table. Total cyanosis of the body. Peripheral edema is absent.
Breathing is superficial, dyspnea, during auscultation breathing cannot be heard in some areas of lungs; wheezes are
diffuse, expiration is considerably prolonged. Tones of heart are weak, tachycardia. Pulse - 112/min, BP - 110/70. Liver is
near the edge of costal arch. What is the previous diagnosis?
A.
B.
C.
D.
E.
Status asthmaticus
Bronchial asthma of moderate severity
COPD
Aspiration of foreign body
Heart asthma
ANSWER: A
34.
Patient J., 36 y.o., complains for fever (39 C), pain in the left part of the chest. Pleuropneumonia was diagnosed in
the patient. What onset is typical for pleuropneumonia?
A.
B.
C.
D.
E.
Acute
Latent
Fulminant
Gradual
None of the above
ANSWER: A
35.
Patient N., 45 y.o., complains for fever (38 C), sweating, dry caugh and general weakness. Bronchopneumonia
was diagnosed in the patient. What onset is typical for bronchopneumonia?
A.
B.
C.
D.
E.
Acute
Latent
Fulminant
Gradual
None of the above
ANSWER: D
36.
Patient of 54, complaints on dyspnea during insignificant physical exertion, cough with minimal amount of
sputum. Objectively: diffuse cyanosis. Thorax of emphysematous form. In lungs breathing is vesicular, weakened with
prolonged expiration, dry wheezes are heard. BP -140/80. Pulse - 92/min, rhythmic. Spirography: FVC – 72 %,
FEV1/FVC - 50 %. What is the type of respiratory failure in this patient?
A.
Obstructive
B.
C.
D.
E.
Mixed type with prevalence of obstruction
Restrictive
Mixed type with prevalence of restriction
Respiratory insufficiency is absent
ANSWER: A
37. What is the major difference in pathophysiology between asthma and COPD?
A. Asthma is a restrictive disorder and COPD is an obstructive disorder.
B. COPD results in permanent airflow obstruction and asthma is a condition of reversible airflow obstruction.
C. COPD is caused by chronic exposure to inhalation irritants and the major cause of asthma is cigarette smoking.
D. Asthma is the result of an inflammatory process and COPD is a result of inflammatory, infectious, and
hyperresponsiveness processes.
E. Non of above
ANSWER: B
38.
Which assessment finding should you expect in the patient with COPD?
A. Decreased vocal fremitus
B. Grossly bloody sputum
C. Loss of the gag reflex
D. Tracheal deviation
E. Non of above
ANSWER: A
40.
41.
42.
43.
39. Which disorder is an example of a "restrictive" pulmonary disease?
A. Asthma
B. Bronchitis
C. Lung cancer
D. Pulmonary fibrosis
E. Non of above
ANSWER: D
Which type of acid-base imbalance is most common among patients with COPD?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
E. Non of above
ANSWER: A
Which assessment finding in a patient with severe dyspnea indicates to you that the respiratory problem is chronic?
A. Wheezing on exhalation
B. Productive cough
C. Clubbed fingers
D. Cyanosis
E. None of above
ANSWER: C
What part of the pulmonary system is most affected by asthma?
A. Alveoli
B. Larynx
C. Pharynx
D. Airways
E. None of above
ANSWER: D
Which assessment finding should you expect in the patient with COPD?
A. Decreased vocal fremitus
B. Grossly bloody sputum
C. Loss of the gag reflex
D. Tracheal deviation
E. None of above
ANSWER: A
44. Patient V., a 24 years old barman, presents with a dry cough of sudden onset. He complains of a chest pain and rusty
sputum. He also has a very high fever, rapid breathing, cyanosis and crepitations. Pneumonia was suspected. What is the
most nesessary method of investigation?
A. Chest X-ray
B. Spirography
C. Analysis of sputum
D. General blood analysis
E. General urine analysis
ANSWER: A
45. All medicines listed below are used in bronchial asthma, except:
A. Morphine
B. Salbutamol
C. Aminophylline
D. Steroids
E. Ipratropium
ANSWER: A
46. Obstructive type of insufficiency of pulmonary ventilation is caused by:
A. Narrowing of bronchi
B. Decreasing of diaphragm mobility
C. Arrising of pleuritis
D. Decreasing of breathing muscles strength
E. Violation of perfusion
ANSWER: A
47. Cavity in case of lung abscess is:
A.
Separated from pulmonary tissue and connected with a bronchus
B.
Connected with a bronchus
C.
Not connected with a bronchus
D.
Connected with interstitium of lungs
E.
Not separated from pulmonary interstitium
ANSWER: A
48. Chronic abscess is a result of :
A. Incomplete treatment of acute abscess
B. Initial gangrene of lungs
C. Presence of chronic bronchitis
D. Initially chronic disease
E. Joining of chronic pneumonia
ANSWER: A
49. Complication of bronchiectasis are all except:
A. Bronchiogenic carcinoma
B. Cerebral abscess
C. Lung abscess
D. Amyloidosis
E. Nothing of the above
ANSWER: A
50. The most unlikely cause of pleural effusion is:
A. Thyroid tumors
B. Bronchial carcinoma
C. Carcinoma breast
D. Lymphoma
E. Nothing of the above
ANSWER: A
51. All the following may be the causes of hemorrhagic pleural effusion except:
A. Congestive heart failure
B. Pulmonary embolism
C. Lung cancer
D. Tuberculosis
E. Severe chest trauma
ANSWER: A
52. A 38 y.o. patient was urgently admitted to the hospital with complaints of sudden weakness, dizziness, loss of
consciousness, body weight loss, nausea, vomiting, severe pain in epigastric area, diarrhea, skin hyperpigmentation. What
is the most probable diagnosis?
A. Addisonic crisis
B. Acute gastroenteritis
C. Meningoencephalitis
D. Scleroderma
E. Pellagra
ANSWER: A
53. A 26 y.o. male patient with postoperative hypothyroidism take thyroxine 100 mg 2 times a day. He has developed
tachycardia, sweating, irritability, sleep disorder. Determine further treatment tactics.
A. To decrease thyroxine dosage
B. To increase thyroxine dosage
C. To administer betablockers
D. To add mercasolil to the treatment
E. To administer sedatives
ANSWER: A
54. A 54-year-old patient complains of weakness, weight loss despite the unchanged appetite, frequent urination, skin
itching for six months. Some time ago the patient underwent treatment for furunculosis. She hasn't been examined
recently. Objectively: malnutrition, dry skin with signs of scratching. Small lymph nodes can be palpated in the axillary
regions. Changes in the internal organs are absent. What testing must be administered in the first place?
A. Blood sugar test on an empty stomach
B. Complete blood count
C. Endoscopy of stomach
D. Lymph node biopsy
E. Blood sterility testing
ANSWER: A
55. A 32-year-old female complains of dizziness, headache, palpitation, tremor. For the last several months she has been
under outpatient observation for the increased arterial pressure. Since recently such attacks have become more frequent
and severe. Objectively: skin is covered with clammy sweat, tremor of the extremities is present. HR- 110/min, AP220/140 mm Hg. Heart sounds are muffled. Blood test results: WBCs - 9,8109/l, ESR - 22 mm/h. Blood glucose - 9,8
mmol/l. What disease is the most likely cause of this crisis?
A. Pheochromocytoma
B. Essential hypertension
C. Preeclampsia
D. Primary hyperaldosteronism
E. Diabetic glomerulosclerosis
ANSWER: A
56. A 47-year-old woman underwent a thyroid gland resection due to nodular euthyroid goiter. What preparations are
most likely to prevent the disease recurrence?
A. Thyroid hormones
B. Mercazolil
C. Thyrotropin
D. Antistruminum (potassium iodide)
E. Radioactive iodine
ANSWER: A
57. A 38-year-old woman experiences episodic increases of arterial pressure up to 240/120 mm Hg, which is
accompanied by nausea, vomiting, tachycardia, increased sweating, hyperglycemia. The attack is usually followed by the
excessive urination. Renal sonography reveals an additional formation adjacent to the upper pole of the right kidney and
possibly belonging to the adrenal gland. What laboratory test will allow to clarify the diagnosis?
A. Determination of urinary excretion of metanephrines
B. Blood test for insulin and C-peptide
C. Estimation of glomerular filtration rate by creatinine clearance
D. Blood test for free thyroxine and thyrotrophic hormone (TSH)
E. Blood test for renin level
ANSWER: A
58. A 58-year-old patient has a 3-year history diabetes mellitus type II. He has been keeping to a diet and regularly taking
glibenclamide. He has been delivered to a hospital on an emergency basis for acute abdomen. Objectively: the patient is
of overnutrition type. The skin is dry. In the lungs vesicular breathing can be auscultated. Heart sounds are regular,
90/min. BP- 130/70 mm Hg. The symptom of "wooden belly" is visible. Blood sugar - 9,8 mmol/l. The patients has
indication for laparotomy. What is the most appropriate way of further treatment of diabetes?
A. To administer rapid insulin
B. To continue taking glibenclamide
C. To administer pre-mixed insulin in the morning and in the evening
D. To administer 1 tablet (500 mg) of metformin three times a day
E. To administer 1 tablet of glibenclamide three times a day
ANSWER: A
59. A 40-year-old female patient complains of headache, dizziness, muscle weakness, occasional cramps in the
extremities. She has been taking antihypertensive medications for 10 years. BP- 180/100 mm Hg. Blood potassium - 1,8
mmol/l, sodium - 4,8 mmol/l. In urine: alkaline reaction, the specific gravity - 1012, protein and sugar are not found,
WBCs - 3-4 in the field of vision, RBCs - 1-2 in the field of vision. Conn's syndrome is suspected. Which drug should be
chosen for the treatment of arterial hypertension?
A. Spironolactone
B. Propanolol
C. Enalapril
D. Hydrochlorothiazide
E. Clonidine
ANSWER: A
60. A 18-year-old patient had subtotal strumectomy due to malignant capillary cystadenoma of the thyroid gland. In 2
months there was a suspicion of metastasis presence in the lungs. What method is to be used first?
A. Roentgenography of lungs
B. Scintigraphy with iodine 131
C. Angiopneumonography
D. Bronchography
E. Bronchoscopy
ANSWER: B
61. Which manifestation of Graves’ disease is unaffected by medical treatment for the hyperthyroidism?
A. Weight loss
B. Thinning hair
C. Exophthalmus
D. Tachycardia
E. Non of above
ANSWER: C
62. Which arterial blood gas values indicate to the physician that the patient is experiencing metabolic ketoacidosis?
A. pH 7.38, HCO3– 22 mEq/L, PCO2 38 mm Hg, PO2 98 mm Hg
B. pH 7.28, HCO3– 18 mEq/L, PCO2 28 mm Hg, PO2 98 mm Hg
C. pH 7.48, HCO3– 28 mEq/L, PCO2 38 mm Hg, PO2 98 mm Hg
D. pH 7.28, HCO3– 22 mEq/L, PCO2 58 mm Hg, PO2 88 mm Hg
E. Non of above
ANSWER: B
63. Which of these hormones is not produced by adrenal cortex:
A. Hydrocortisone.
B. Aldosterone.
C. Epinephrine.
D. Dehydroisoandrosterone.
E. None above them
ANSWER: C
64. Which of the following is not an indicator of a hypoglycemic condition?
A. Fatigue
B. Poor appetite
C. Tachycardia
D. Confusion
E. None above them
ANSWER: B
65. Which product is not synthesized in thyroid gland:
A. Thyroxine (T4)
B. Triiodothyronine (T3)
C. Thyrotropin
D. Thyroglobulin
E. Thyroid peroxidase
ANSWER: C
66. Sign that is typical for diabetes insipidus is:
A. Hyperglycemia
B. Hypoglycemia
C. Polydipsia
D. High urine osmolality
E. Low serum osmolality
ANSWER: C
67. Which of the following is the most specific test to diagnose acromegaly?
A. Magnetic resonance imaging of the pituitary gland
B. Measurement of growth hormone (GH) levels during an oral glucose tolerance test
C. Measurement of insulin-like growth factor I and growth hormone (GH) serum levels
D. Measurement of random GH blood levels
E. An octreotide scan
ANSWER: C
68. The prominent feature of Cushing’s disease is:
A. Hypertension
B. Hypokalemia
C. Weight gain
D. Hypernatremia
E. All of them
ANSWER: C
69. Which clinical manifestations alert the physician to the possibility of anterior pituitary hyperfunction?
A. Enlarged hands and feet, heat intolerance
B. Non of above
C. Bradycardia, hypotension, and somnolence
D. Chronic constipation and darkening of the skin
E. Hyponatremia, hyperkalemia, and hypercalcemia
ANSWER: A
70. A 20-yr-old woman presents with a 4 cm solid mass in the left thyroid lob. FNA reveals papillary carcinoma. Choose
the most likely management.
A. Total thyroid lobectomy
B. Ablative dose of radioactive iodine
C. External beam radiation
D. Propranolol
E. Total thyroidectomy and removal of central group of lymph nodes
ANSWER: E
71. A 27-yr-old woman presents with fever, sore throat and dysphagia. On examination she has a fine tremor and a
diffusely tender thyroid. Radioisotope scan shows no uptake. Choose the most likely diagnosis
A. Thyroglossal cyst
B. De Quervain's thyroiditis
C. Hypothyroidism
D. Lymphoma
E. Endemic goiter
ANSWER: B
72. A 20 y.o. patient complains of amenorrhea. Objective examination: hirsutism, obesity with fat tissue prevailing on the
face, neck, upper part of body. On the face there are acne vulgaris, on the skin - striae cutis distense. Psychological and
intellectual development is normal. Gynecological condition: external genitalia are moderately hairy, vaginal and uterine
hypoplasia. What diagnosis is the most probable?
A. Polycystic ovary syndrome
B. Sheehan's syndrome
C. Cushing’s syndrome
D. Babinski-Froehlich syndrome
E. Turner's syndrome
ANSWER: C
73. A 60-year-old man with type 2 diabetes mellitus develops progressive weakness and confusion over a 10-day period.
In the emergency department, he is found to have dry skin and mucous membranes, and low blood pressure (100/60 mm
Hg). Serum glucose is very high (950 mg/dL), but blood pH is normal (7.38), and his serum is negative for ketones.
Serum osmolality is 335 mOsm/kg. The first priority in management is
A. intravenous insulin
B. intravenous pressor agents
C. fluid replacement
D. computed tomographic scan of the head
E. search for a precipitating cause
ANSWER: C
74. A 61-yr-old woman presents with stiff joints, myopathy and constipation. Plain radiographs reveal a right calculus and
evidence of osteitis fibrosa. Choose the most likely diagnosis.
A. Parathyroid adenoma
B. Parathyroid hyperplasia
C. Prolactinoma
D. Insulinoma
E. Phaeochromocytoma
ANSWER: A
75. A 29 year-old woman was found to have hemoglobin level 7.8 g/dl, with a reticulocyte count of 0.8%. The peripheral
blood smear showed microcytic hypochromic anemia, The serum iron was low and the total iron binding capacity was
high. The most likely cause of anemia is
A. Iron deficiency anemia.
B. Beta-thalassemia minor.
C. Sideroblastic anemia.
D. Anemia due to chronic infection.
E. Porphyria
ANSWER: A
76.
65 year-old male was passing large voluminous foul smelling stools for 4-6 days; over last 3 months he has
developed anemic. Most likely etiology of anemia is:
A.
Vitamin B12 deficiency
B.
Iron deficiency
C.
Folic acid deficiency
D.
Pyridoxin deficiency
E.
Sideroblastic
ANSWER: B
77.
25-year-old-girl, presents with complaints of fever and weakness. On examination there is splenomegaly of 3
cm below the costal margin. Hb is 6 g/dL, WBC is 2.0 x 109/L, platelets count is 60 x 109/L. Which of the following is the
least likely diagnosis?
A.
Acute lymphocytic leukemia
B.
Anemia of chronic disease
C.
Aplastic anemia
D.
Megaloblastic anemia
E.
Sideroblastic
ANSWER: C
78.
A 36-year-old patient complains of fatigue, weakness, anorexia and weight loss, easy bruising, and fever.
Physical examination finds out splenomegaly, sternal tenderness, hemorrhage. Blood analysis shows normochromic
normocytic anemia, leukocytosis, blasts (23 %), thrombocytopenia. What is the diagnosis?
A.
Chronic myeloid leukemia
B.
Acute leukemia.
C.
Multiple myeloma
D.
Chronic lymphocytic leukemia
E.
Aplastic anemia
ANSWER: B
79.
A 63-year-old patient complains of pain in spine, head, fever, fatigue, weakness, weight loss. Physical and
laboratory examinations find out tender bones, normocytic and normochromic anemia, granulocytopenia and
thrombocytopenia. Bone x-ray examination of ribs shows lytic bone lesions. What is the possible diagnosis?
A.
Polycytemia rubra vera
B.
AML
C.
Multiple myeloma.
D.
CML
E.
CLL
ANSWER: C
80.
A 36-year-old man complains of weakness and fever. He had tonsillitis a month before. On exam, BT of 38,9 °,
RR of 24/min, HR of 100/min, BP – 90/60 mm Hg, hemorrhages on the legs, enlargement of the lymph nodes. CBC
shows Hb of 70 g/L, RBC – 2.2 x 1012/L, WBC – 3.0 x 109/L, with blasts – 32 %, eosinophiles – 1 %, bands – 3 %,
segments – 36 %, lymphocytes – 20 %, monocytes – 8 %, ESR – 47 mm/h. What is the case of anemia?
A.
Chronic lymphatic leukemia
B.
Aplastic anemia
C.
Vit. B12 deficiency anemia
D.
Acute leukemia
E.
Chronic hemolytic anemia
ANSWER: D
81.
A 65-year-old man complains of fever, significant weight loss, bleeding gums. On examination, paleness,
splenomegaly. CBC: WBC – 270 x 109/L, with 13 % lymphocytes, 1 % monocytes, 14 % basophiles, 33 % neutrophils, 9
% blasts, 15 % promyelocytes, 12 % myelocytes, 2 % metamyelocytes, 1 % eosinophils. ESR – 22 mm/h. Which drug
you can use for treatment?
A.
Myelosan
B.
Prednisolone
C.
Cytosar
D.
Vinblastine
E.
Blood transfusion
ANSWER: A
82.
A 25-year-old woman complains of increasing fatigue and easy bruising of 3 weeks’ duration. Physical findings
included pale, scattered ecchymosis and petechiae and mild hepatosplenomegaly. CBC: RBC – 2.5 x 1012/L ; Hb – 73
g/L; HCT 20%; PLT – 23 x 109/L; and WBC – 162 x 109/L with 72 % blasts, that contained Auric rods; peroxidase stain
was positive. What is the most probable diagnosis?
A.
Chronic leukemia
B.
Acute myeloid leukemia
C.
Thrombocytopenia
D.
Hemolytic anemia
E.
None of above
ANSWER: B
83.
A 38-yr-old woman presents with fever, sweats and weight loss. On examination he has an enlarged spleen.
Blood tests reveal a lymphocytosis and anaemia. The Philadelphia chromosome is negative. What is the diagnosis?
A.
ALL
B.
Multiple myeloma
C.
CLL
D.
Polycythemia rubra vera
E.
CML
ANSWER: C
84.
A 48-yr-old man presents with epistaxis. On examination he has enlarged nontender, symmetrical neck nodes.
His blood count reveals lymphocytosis, anaemia and thrombocytopenia. What is the most probable diagnosis?
A.
Multiple myeloma
B.
CLL
C.
CML
D.
AML
E.
Polycythemia vera
ANSWER: B
85.
A 75-yr-old man presents with malaise. He is noted to have gum hypertrophy and skin nodules. Investigations
reveal a pancytopenia and blasts. Blasts contain Auric rods; peroxidase stain is positive. What is the most probable
diagnosis?
A.
Multiple myeloma
B.
CML
C.
AML
D.
CLL
E.
None of above
ANSWER: C
86.
A 70-yr-old man presents with bone pain, anaemia and renal failure. His bone marrow reveals plasma cells 30
%. What is the most probable diagnosis?
A.
Myeloid metaplasia
B.
AML
C.
Multiple myeloma
D.
CLL
E.
Megaloblastic anaemia
ANSWER: C
87.
A 38-yr-old woman presents with anaemia. She is noted to have koilonychias and atrophic glossitis. Her blood
smear reveals microcytic, hypochromic blood cells, anysocytosis and poycilocytosis. What is the diagnosis?
A.
Sickle cell anaemia
B.
Megaloblastic anaemia
C.
Iron deficiency anaemia
D.
Aplastic anemia
E.
Hemolytic anemia
ANSWER: C
88.
A 28-year-old woman complains of fatigue, weakness, anorexia and weight loss, easy bruising, and fever.
Physical examination finds out splenomegaly, sternal tenderness, and hemorrhage. Blood analysis show normochromic
normocytic anemia, leukocytosis, blasts (23 %), thrombocytopenia. Blasts contain Auric rods; peroxidase stain is positive.
What is your diagnosis?
A.
Chronic myeloid leukemia
B.
Acute lymphocytic leukemia
C.
Chronic lymphocytic leukemia
D.
Acute myeloid leukemia
E.
Multiple myeloma
ANSWER: D
89.
Elevated serum ferritin, serum iron and percent transferrin saturation are most consistent with the diagnosis of:
A.
Hemochromatosis
B.
Lead poisoning
C.
Iron deficiency anemia
D.
Anemia of chronic disease
E.
Porphyria
ANSWER: A
90.
Which is not seen in Iron deficiency anaemia:
A.
Hyper-segmented neutrophils
B.MCHC<35 g/dL
C. Microcytosis
D. Hypochromia
E. MCV< 80 fL
ANSWER: A
91.
Most sensitive and specific test for diagnosis of iron deficiency anemia is:
A.
Serum iron level
B.
Serum ferritin level
C.
Serum transferrin receptor population
D.
Transferrin saturation
E.
Hb level
ANSWER: B
92.
The earliest sign of iron deficiency anaemia is:
A.
Decrease in transferrin level
B.
Decrease in transferrin level, increase in iron binding capacity
C.
Decrease in serum ferritin level
D.
Increase in iron binding capacity
E.
Increase in serum folic acid level
ANSWER: C
93.
Iron overload occurs in all, except:
A.
Anemia due to chronic infection
B.
Myelodysplastic syndrome
C.
Polycythemia vera
D.
Sideroblastic anaemia
E.
Thalassemia
ANSWER: C
94.
All are true regarding Anaemia of Chronic Diseases, except:
A.
Decreased serum ferritin level
B.
Normocytic anemia
C.
Low Total Fe Binding Capacity
D.
Increased Bone Marrow Fe
E.
Decreased serum Fe
ANSWER: A
95.
Anemia of chronic disease is characterized by all, except
A.
Increased total iron binding capacity
B.
Increased serum ferritin
C.
Increased macrophage iron in bone marrow
D.
Decreased serum iron
E.
Normocytic anemia
ANSWER: A
96.
Not present in Sideroblastic anaemia:
A.
Decreased serum iron
B.
High transferrin saturation
C.
Sideroblast cells in blood smear film
D.
Ineffective erythropoiesis
E.
Microcytic anaemia
ANSWER: A
97.
Which is not seen in a chronic case of Sickle cell anemia :
A.
Pulmonary hypertension
B.
Cardiomegaly
C.
Hepatomegaly
D.
Splenomegaly
E.
Structural orthopedic abnormalities
ANSWER: C
98.
All are true for sickle cell anemia, except
A.
Leukopenia
B.
Pulmonary arterial hypertension
C.
Fish vertebra
D.
Increased size of heart
E.
Gallstones
ANSWER: A
99. A 32 year-old woman was found to have hemoglobin level 7.8 g/dl, with a reticulocyte count of 0.8%. The peripheral
blood smear showed microcytic hypochromic anemia, The serum iron was low and the total iron binding capacity was
high. The most likely cause of anemia is
A. Iron deficiency anemia.
B. Beta-thalassemia minor.
C. Sideroblastic anemia.
D. Anemia due to chronic infection.
E. Porphyria
ANSWER: A
100. A 30-year-old man complains of weakness and fever. He had tonsillitis a month before. On exam, BT of 38,9 °, RR
of 24/min, HR of 100/min, BP – 90/60 mm Hg, hemorrhages on the legs, enlargement of the lymph nodes. CBC shows
Hb of 70 g/L, RBC – 2.2 x 1012/L, WBC – 3.0 x 109/L, with blasts – 32 %, eosinophiles – 1 %, bands – 3 %, segments –
36 %, lymphocytes – 20 %, monocytes – 8 %, ESR – 47 mm/h. What is the case of anemia?
A.
Chronic lymphatic leukemia
B.
Aplastic anemia
C.
Vit. B12 deficiency anemia
D.
Acute leukemia
E.
Chronic hemolytic anemia
ANSWER: D