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1. Near transformer unit the old man is found unconscious. Objectively: pulse on a carotid and
respiratory motions of thorax are absent. What will your actions be in this case?
A. Tracheotomy
B. To do nothing
C. Artificial ventilation of lungs and indirect massage of heart
D. To call an ambulance *
E. Endocardiac injection of adrenalin
2. In the rural district of the Autonomous republic of Crimea an earthquake happened force to
5 points. 2 men perished, 30 people got damages of different severity degree and need
urgent medical aid. Specify the optimum term of giving the first medical aid:
A. 30 minutes *
B. 1 hour
C. 2-3 hours
D. 4-6 hours
E. 8-12 hours
3. You are conducting the primary reanimation measures (indirect massage of heart and
"mouth-to-mouth ventilation") in out of hospital conditions. What time is necessary to
conduct such measures in case of absence of cardiac activity reduction and function of
Central nervous system?
A. 45 minutes
B. 15 minutes
C. Before arrival of specialized brigade of ambulance *
D. 30 minutes
E. 60 minutes
4. Determine a correct ratio between the number of thorax compressions and number of
inhalations of air during the cardio-lungs reanimation:
A. 6:1
B. 7:1
C. 30:2 *
D. 5:1
E. 4:1
5. Dragging out a victim from water to the shore, before the beginning of reanimation you
need:
A. To clean oral cavity *
B. To unbutton a belt
C. To turn a person down and wait till the water pours from respiratory tracts
D. To wrap with warm clothes in order to avoid supercooling
E. To find out papillary response to light
6. Specify the type of drowning, which develops on the hospital stage:
A. Primary
B. Asphyxial
C. “Cryoshock”
D. Secondary *
E. Syncopal
7. Specify the most frequent type of drowning:
A. Primary *
B. Asphyxial
C. “Cryoshock”
D. Secondary
E. Syncopal
8. In the morning a mother found 5 months boy in bed already dead with cadaveric lividity,
face down. Before that a child was healthy. What is the most probable reason of child’s?
A. Meningoencephalitis
B. Syndrome of sudden death *
C. Aspiration by the vomit masses
D. Epileptic status
E. Cardiogenic shock
9. Hypoxia in the secondary turn results the changes in:
A. Heart
B. Liver
C. Kidneys
D. Brain
E. Adrenals *
10. Which is the main condition of possibility of transporting a patient in a state of clinical death
after giving him aid?
A. Intravenous access
B. Successful intubation
C. Restoration of independent cardiac activity
D. Presence of transport vehicle
E. Constricted pupil (miosis) *
11. 10 years old child fell into cold water and was dragged out in 10 minutes. Objectively:
expressed pallor of skin; from upper respiratory tracts foamy liquid is not discharged. What
is the most probable diagnosis?
A. Real drowning
B. "Dark blue" drowned man
C. Syncopal type of drowning *
D. Asphyxial type of drowning
E. "Dry" drowning
12. For restoration of cardiac activity it is more expedient to use:
A. Adrenalin hydrochloride *
B. Noradrenalin hydrotartat
C. Isadrin
D. Atropine sulfate
E. Calcium chloride
13. For endocardiac introduction of medications a needle is pricked:
A. In the 5th intercostals, the point of projection is apex of heart
B. In the 3rd intercostals, on the left of breast bone *
C. On the lower edge of the 4th rib, on the left of breast bone
D. In the 4th intercostals, 1.5 cm on the left of breast bone
E. In the place of projection of cardiac impulse
14. For artificial respiration, a doctor found out that head throwing of patient is almost
impossible because of little mobility of cervical spine. What additional actions must be done
under these circumstances?
A. To lift the lower jaw of patient up and open his mouth, at the moderate deviation of head
*
B. To turn the throwing head of patient aside and open to his mouth
C. To put a pillow under patient’s head
D. To make an additional strain for the maximal throwing of patient’s head
E. To put a pillow or fold towel under patient’s shoulders
15. To terminal states belong:
A. Pre-agony, terminal pause, agony, clinical death *
B. Agony, clinical and biological death
C. Comas, agony, clinical death
D. Pre-agony, agony, clinical, social death
E. Decrease of Blood Pressure to 80, comas, clinical death
16. Reliable sign of cardiac arrest is:
A. Isoline is on ECG *
B. loss of consciousness
C. Expressed cyanosis of skin and mucus
D. Pulse above radial artery is not palpated
E. Absence of BP
17. 32 years old woman used defective electric device. Suddenly she fell, losing consciousness,
there were cramps. What violations of cardiac rhythm will be marked on electrocardiogram?
A. Asystole
B. Paroxysmal tachycardia
C. Atrioventricular block
D. Fibrillation of ventricles *
E. Mechanical electro-dissociation of ventricles
18. 52 years old woman was hospitalized to the department of first aid with an epileptic attack.
The first action while giving first medical aid is:
A. To introduce intravenously 5 mg diazepam with next introduction of fenitoin
B. To fix the tongue
C. To introduce intravenously stream of 50% dextrose’s solution
D. To make sure of respiratory tracts passage and sufficient oxygenation of patient *
E. To cause medicinal pentobarbital coma
19. Protecting the brain from hypoxia can be attained by:
A. Hypothermia
B. Oxybutirat of sodium 100 mg/kg *
C. Hydrocortisone 15 mg/kg
D. Barbiturates 0,5 mg/kg
E. Atropine
20. Measures which are not used on prehospital stage while giving aid to a drown man:
A. CPR
B. Obligatory taking out of water from lower respiratory tracts *
C. Taking out of water from a stomach
D. Poliglukine intravenously
E. Fixing a tongue by a pin
21. Decrease of BP, tachycardia, spasm of peripheral vessels, increase of CVP, is characteristic
for shock in cases of:
A. Hard burns
B. Hard trauma
C. Massive bleeding
D. Sharp pancreatitis
E. Heart attack of myocardium *
22. Respiratory arrest is determined by the followings signs:
A. Pale color of skin and nasal mucosa
B. Absence of respiratory motions of thorax
C. Absence of respiratory motions of epigastrium area
D. Absence of air motion on expiration from respiratory tracts *
E. Bluish color of skin
23. Clinical death lasts in normothermal conditions:
A. 7-12 minutes
B. 1-3 minutes
C. 4-5 minutes *
D. 5-7 minutes
E. to 10 minutes
24. A doctor introduced an antibiotic to the patient, as a result there was anaphylactic shock and
patient died. How can we characterize actions of doctor?
A. As murder because of carelessness.
B. As violation of storage rules and use of poisonous, drastic and narcotic matters.
C. As illegal experiment on human being.
D. As careless hard bodily harm. *
E. As violation of professional duties.
25. Suddenly an old man lost consciousness in the street, he continues to breathe independently.
What is the primary measure?
A. To conduct the massage of heart
B. To take out from a mouth dentures and other extraneous bodies
C. To lay on a floor, lift up lower extremities
D. To inflict pericardial blow *
E. To conduct artificial ventilation of lungs
26. Maximally prolonged break in conducting an external massage of heart at CPR for the other
measures is:
A. 2-3 min.
B. 1-2 min.
C. 5-10 secs *
D. 15-30 secs
E. 30-60 secs
27. Medical worker refused to give a patient medical care, knowing about the grave condition of
patient, without any important reason. How can the actions of medical worker be
characterized, what article from a criminal code is it necessary to apply?
A. Careless attitude to the professional duties, article 144. *
B. Criminal not giving of medical care, article 124.
C. It is not my business, I have day off today.
D. Illegal experiment on human being, article 118.
E. Violation of deontology of medical worker, article 58.
28. Possible reasons of stomach blowing at AVL the method “mouth-to-mouth” is, except:
A. Excessive mass of patient *
B. An obstacle on an entrance to trachea
C. Excessive volume and breathing frequency
D. Wrong position of patient’s head
E. Unfilled stomach
29. Baby was born premature. While examination asymmetry of skin folds on thighs, limitation
of taken extremities, insignificant hypotrophy of cluneal muscles on the left were found out.
What is the most probable inborn pathology?
A. Dysplasia of the left thigh joint *
B. Congenital dislocation of thigh
C. Varus deformation of femoral necks of thigh
D. Fracture of femoral neck of thigh
E. Dysplasia of the right thigh joint
30. You began the grant of help to the grown man suffering in the place of event. He is
unconscious and lies on a stomach. At a primary review you found out traumatic amputation
in middle third of right forearm. You have a medicine chest of the first aid. What’s your
action?
A. To wash a wound, impose a tight bandage
B. In overhead third of right shoulder to impose a plait
C. To impose a tight bandage on a wound
D. In lower third of right shoulder to impose a plait *
E. To impose a plait at once higher places of amputation.
31. You began the grant of help to the grown man suffering in place of event. He is unconscious
and lies on a stomach. At a primary review you found out traumatic amputation in middle
third of right thigh. You do not have a medicine chest of the first aid. What’s your action?
A. In overhead third of right thigh to impose a plait-rollup *
B. In lower third of right thigh to impose a plait-rollup
C. To impose a tight bandage on a wound
D. To wash a wound, impose a tight bandage
E. To impose a plait-rollup at once higher places of amputation.
32. Main sign of death of extremity after prolonged compression is:
A. Areflexia
B. Absence of sensitiveness
C. Absence of passive motions
D. Absence of active motions
E. Absence of elastic motions *
33. Main sign of preservation of extremities after prolonged compression is:
A. Presence of dermographism
B. Presence of active motions
C. Presence of algetic sensitiveness *
D. Presence of tactile sensation
E. Presence of thermoanesthesia
34. At approaching to the place of event you found out a grown man victim at consciousness in
position on the abdomen. What are your next actions?
A. To begin a review after the algorhythm of ABC.
B. To appear, to explain that you come to give the first aid, to offer a help, explain that
prepare to do. *
C. To call medical first-aid.
D. To find out safeness for you is a place of event?
E. To find out, is there a medicine chest of the first aid?
35. You began the grant of help for the grown injured man at the place of event. When will you
determine the damages of locomotor system?
A. In the case of presence of complaints on the pain in the area of bones of skeleton
B. During a primary examination
C. During the secondary examination *
D. Appear by chance
E. None of the above.
36. You began the examination of suffering at the place of event. During the palpation bones of
shins was found the crepitation. What is the most credible diagnosis in this case?
A. Trauma of knee-joint
B. Coalface of shin
C. Overtension connection of ankle joint
D. Fracture of bones of shin. *
E. All from the above-mentioned.
37. You began the grant of help for the grown injured man at the place of event. He is without
consciousness and lies on a stomach. During the examination you found out the fracture of
shin. In what case will you conduct a transport immobilization?
A. When you will be sure in the rightness of a transport immobilization
B. Always
C. When the ambulance will arrive too late *
D. When there is no bleeding
E. All from the above-mentioned.
38. You began the grant of help for the grown suffering at the place of event. During the
examination you found out the break of collar-bone. How to conduct a transport
immobilization?
A. To fix a hand from the staggered side maximally arcuated in an elbow joint to the trunk.
*
B. A transport immobilization is not conducted.
C. To fix a hand to the trunk, unbanded in an elbow joint.
D. To impose an impromptu tire on a forearm
E. To impose an impromptu tire on a forearm and shoulder.
39. You began the grant of help for the grown injured man at the place of event. During the
examination you found out the break of humeral bone. How to conduct a transport
immobilization?
A. To fix a hand to the trunk, unbend in an elbow joint. *
B. A transport immobilization is not conducted.
C. To fix a hand from the staggered side maximally arcuated in an elbow joint to the trunk.
D. To impose an impromptu tire on a forearm
E. To impose an impromptu tire on a forearm and shoulder.
40. You began the grant of help for the grown suffering at the place of event. During the
examination you found out the break of bones of forearm. How to conduct a transport
immobilization?
A. To impose an impromptu tire on a forearm
B. A transport immobilization is not conducted.
C. To fix a hand to the trunk, unbend in an elbow joint.
D. To impose on a forearm an impromptu tire and to fix a hand arcuated in an elbow joint
to the trunk. *
E. To impose an impromptu tire on a forearm and shoulder.
41. You began the grant of help for the grown suffering at the place of event. He is without
consciousness and lies on a stomach. During the primary examination you found out the
traumatic amputation in the middle third of the right forearm. You have a medicine chest for
the first aid. What are your father actions?
A. To wash a wound, impose a tight bandage
B. In overhead third of right shoulder to impose a plait
C. To impose a tight bandage on a wound
D. In the lower third of right shoulder to impose a plait *
E. To impose a plait at once higher places of amputation.
42. What is the first aid in patients with open pneumothorax?
A. primary wound cleansing.
B. Pleural puncture.
C. Thoractomy and assessment of the internal organs of the chest.
D. Apply occlusive dressing. *
E. Bronchoscopy.
43. What are the main complications of the intracranial trauma?
A. Psychiatric shock.
B. Meningitis.
C. Encephalitis.
D. Increased sensitivity to atmospheric pressure.
E. Increasing of intracranial pressure. *
44. Complications of nasal trauma include all of the following EXCEPT:
A. Avascular necrosis of the nasal septum.
B. Extraocular movement dysfunction. *
C. Fracture of the cribriform plate.
D. Saddle deformity.
E. Septal hematoma.
45. Specify the clinical signs of open pneumothorax:
A. Serious state of the patient.
B. Subdermal emphysema.
C. Forced position.
D. Escape of air and blood bubbles from the wound with a characteristic sound during
respiration. *
E. Chest pain.
46. Signs and symptoms associated with mandibular fractures include all of the following
EXCEPT:
A. Deformity of the dental arch.
B. Limited range of motion.
C. Mental nerve anesthesia.
D. Subconjunctival hemorrhage. *
E. Sublingual hematoma.
47. Which area of the mandible is MOST commonly fractured?
A. Angle. *
B. Condyle.
C. Molar.
D. Mental.
E. Symphysis.
48. Shock infusion therapy should start with intravenous input:
A. Gemodez.
B. Isotonic solution of sodium chloride. *
C. Polihlyukina.
D. Hypertonic glucose solutions.
E. 5% glucose solution.
49. Construction worker 27 y.o during work was pressed to the wall at home lorries. Complains
of pain in the pelvic area, inability to raise the direct lower limbs, weakness, dizziness. What
additional diagnostic method is necessary?
A. X-ray of the pelvis.
B. CT of the pelvis.
C. YAMRT pelvis.
D. Plain radiography of the pelvis. *
E. YAMRT, CT, Survey radiography of the pelvis.
50. What is the first aid to patients with open pneumothorax?
A. Bronchoscopy.
B. Pleural puncture.
C. Primary treatment of wounds.
D. Revision of the chest.
E. Overlay of oclusion bandages. *
51. What extent of infusion therapy conducted in the derivation of the victim with burn shock?
A. 30 ml / hr. *
B. 20 ml / hr.
C. 45 ml / hr.
D. 15 ml / hr.
E. 50 ml / hr.
52. Severity of state at blood loss depends on:
A. Speed reduction BCC. *
B. Volume of bloodstream.
C. From the shortage of BCC.
D. Initial state of the organism.
E. Index hematocrit.
53. Due to explosion wave patient got blind splinters wounded right thigh and right buttock
wound debris Saperno handle shovels. In the operating room held Pho wounds. What linked
feature Pho gunshot wounds:
A. Zone of secondary necrosis *
B. Irregular shape wound channel
C. Input and output openings
D. Areas of primary necrosis
E. Presence of wound channel
54. Identify the main complication in the case of brain injury:
A. Increased sensitivity to atmospheric conditions.
B. Encephalitis.
C. Meningitis.
D. Increasing intracranial pressure. *
E. Psychic shock.
55. Determine typical clinical signs of an open pneumothorax:
A. Bad general condition of the patient.
B. An emergency situation.
C. Subcutaneous emphysema.
D. Isolation air bubbles and blood from the wound with a characteristic sound during
breathing. *
E. Chest pain.
56. Determine valve mechanism of formation of pneumothorax.
A. The air is obtained from the wound during breathing.
B. Air gets into the wound when person is breathing.
C. Air gets into the wound does not work when person is breathing *
D. There is a valve that does not produce air.
E. Air enters through the bronchus, and goes through a wound.
57. Determine minimum volume of blood loss, which manifested clinical shock
A. 5% of BCC.
B. 10% of BCC.
C. 20% of BCC. *
D. 30% of BCC.
E. 40% of BCC.
58. Indicate term within which under conditions of cold conservation possible replantation of
upper extremities:
A. 1-2 hours. *
B. 2-4 hours.
C. 4-6 hours.
D. 6-8 hours.
E. To 24 hours.
59. Indicate the main manifestations of syndrome of prolonged compression of tissues:
A. Acute renal and liver insufficiency, anemia.
B. Hipovolemic shock acute renal insufficiensy + + anemia.
C. Acute renal and liver insufficiensy + edema of the lungs.
D. Anemia pulmonary edema + + hipovolemic shock. *
E. Impaired consciousness + anemia.
60. Indicate most possible way wounded estimation of blood loss:
A. Definition TSVT.
B. Definition systolic of arterial pressure. *
C. Determination of heart rate.
D. Defining characteristics of the objects' circulating blood volume.
E. Determination of respiratory rate.
61. Main sign of loss of limbs after prolonged compression:
A. Areflexia.
B. Lack of sensitivity.
C. Lack of passive movements.
D. The absence of active movements. *
E. Lack of elastic movements.
62. Main sign of preservation of limbs after prolonged compression:
A. Availability dermographism.
B. The presence of active movements
C. The presence of pain sensitivity. *
D. Availability tapping sensitivity.
E. The presence of temperature sensitivity.
63. Main importance in the mechanism of pathological disorders of the syndrome has long
squash tissues:
A. Miohlobinemiya.
B. Hyperkalemia *.
C. Hyperphosphatemia.
D. Hiperfermentemiya.
E. The volume of damage and duration rapture of tissues.
64. Main therapeutic measures for the removal of the victim with burn shock are:
A. Effective analgesia and infusion therapy. *
B. Effective analgesia and cooling section of the body with burns.
C. Effective analgesia and putting glucocorticoids.
D. Effective analgesia and the introduction of cardiac glycosides.
E. Effective analgesia and transport immobilization.
65. Clinical signs of shock, First degree:
A. Blood pressure above 90 mm Hg. Article
B. Blood loss up to 1 liters
C. Psychoemotional stress
D. Poliuriya *
E. Bradykardiya
66. Clinical signs of shock II degree:
A. Blood pressure above 100 mm Hg. Century *
B. Blood loss up to 1 liters
C. Loss of consciousness
D. Anuriya
E. Perypheral spasm of blood vessels
67. Clinical signs of shock III degree:
A. Violation of consciousness *
B. Hiporeflection
C. Anuriya
D. Bradykardiya
E. Blood loss more than 2.5 l
68. Cardiac weakened, accent II tone of the pulmonary artery, heart rate-110/hv. The lower edge
of the liver 3 cm below the costal arch. What is the most likely diagnosis?
A. Aggravation of bronchitis
B. Dry pleurisy
C. Neuralgia intercostal nerves
D. Right-sided pneumonia
E. Spontaneous pneumothorax *
69. The doctor examined the patient at admission to inpatient treatment and found a sharp
weakening voice trembling and blunting percussion sound below the angle of the left
scapula. On a pathological condition can think of?
A. The presence of fluid in the pleural cavity.
B. The presence of pleural tumors.
C. Obturation lumen of the bronchus
D. The presence of all the above mentioned pathologies
E. The presence of air in the pleural cavity. *
70. At the level of hip external rotation and shortening of limbs up to 3 cm, positive symptom
"attached heel." Indicate the most likely presumptive diagnosis.
A. Fracture of neck of femur. *
B. Slaughter of the hip joint.
C. Hip dislocation.
D. Fracture of ischium bone.
E. Pelvic fracture type "butterfly."
71. Premature infant was born. The examination revealed asymmetry of skin folds on the thighs,
restriction removal of limbs, slight malnutrition gluteal muscles on the left. What is likely
congenital pathology?
A. Left hip dysplasia *
B. Congenital hip sprain
C. Varusna demormatsiya hip
D. Fracture of neck of femur
E. Right hip dysplasia
72. Lower extremity in the area of the upper third of right thigh was wood heel. The patient,
despite therapy, began to deteriorate. There were clinical signs of shock. What kind of
complications you think?
A. Fat embolism.
B. Traumatic toxicosis. *
C. Thrombosis of small pulmonary artery branches.
D. Myocardial infarction.
E. Hip fracture.
73. Patient after an accident, his doctor diagnosed a closed head injuries. What are the main
forms are distinguished in the clinical course of a closed head injury?
A. Concussion.
B. The slaying of the brain;
C. Compression of the brain;
D. All the above listed.
E. All the above listed and skull fracture.*
74. Patient after the accident, doctor found his closed head injuries. What is most characteristic
of a closed head injury?
A. Damage to the brain without violating the integrity of the head cover. *
B.
C.
D.
E.
Damage to the brain without a skull fracture.
Damage to cover intact without prejudice to the head and skull fracture.
Damage to soft tissues of the head without skull fracture.
Damage to soft tissues of the head, skull fracture without violating the integrity of the
dura mater.
75. Patient after the accident, doctor diagnosed his brain concussion. What are the main
symptoms in this pathology?
A. Short-term loss of consciousness.
B. Retrograde amnesia (memory loss for events that preceded the injury).
C. Bradycardia, nausea, vomiting.
D. Pain during movement of eyeballs.
E. All the above listed symptoms. *
76. There are normochromnic anemia and insignificant (small) leucocytes. What is the most
probable diagnosis?
A. Scissure of anus
B. Gastroenteric bleeding from the lower departments
C. Gastroenteric bleeding from the upper departments *
D. Bleeding from hemorrhoid nodes of rectum
E. Cancer of rectum
77. Determine basic clinical symptom of the internal bleeding:
A. Deterioration of the state of patient
B. A general weakness, faintness, darkening in eyes *
C. Diminution of the amount of leucocytes
D. Diminution of the amount of leucocytes with the change of formula to the left
E. A presence of blood is in urine
78. Determine the minimal volume of blood loss which is manifested by the clinic of shock:
A. 5% VCB
B. 10% VCB
C. 20% VCB *
D. 30% VCB
E. 40% VCB
79. The left foot was torn off because of the explosion of personnel mine. Strong bleeding from
cult. A foot is contained on dermal flap. Wreckages of bones of shin and foot are seen in a
wound. Your actions:
A. To impose an arterial plait *
B. Immobilize extremity and foot
C. To amputate a foot by the improvised helpful facilities
D. To calm down a patient
E. To give anesthesia
80. Specify the most probable method of estimation of blood loss severity:
A. Determination of CVT
B. Determination of systolic arterial pressure
C. Determination of frequency of pulse
D. Determination of descriptions of the volume of circulatory blood *
E. Determination of respiration rate
81. A patient was appealed to the traumatic department with an incised wound on palm's surface
of lower third of forearm from an elbow side. After the removal of bandage there is
expressed arterial bleeding. Violation of which of the following arteries can cause bleeding?
A. Ulunar artery *
B. Reverse elbow artery
C. radial artery
D. Interbone
E. lower ulunar collateral
82. 42 year old patient was hospitalized to a surgical department with the closed fracture of
pelvis in the state of grave shock. What blood substitutes must be prescribed for the fluid
antishock management?
A. Reopoliglucin *
B. Intralipid
C. Hemodesum
D. Physiological salt solution
E. Plasma
83. The basic features of venous bleedings are:
A. Bright red color of blood
B. Bright red color of blood and pulsating character of bleeding
C. Dark color of blood
D. Comparatively slow character of bleeding
E. Dark color of blood with comparatively slow character of bleeding *
84. In which measure is fluid management held/conducted while removal a patient from a burn
shock:
A. 30 ml per hour *
B. 20 ml per hour
C. 45 ml per hour
D. 15 ml per hour
E. 50 ml per hour
85. The gravity of state because of blood loss depends on:
A. The speed of decreasing of VCB
B. Volume of blood bed *
C. Deficit of VCB
D. Onset state of organism
E. Index of hematocrit
86. Fluid management of shock must start from intravenous introduction of:
A. Hemodesis
B. Isotonic solution of sodium chloride
C. Poliglucin
D. Hypertonic solutions of glucose
E. 5% solution of glucose *
87. Specify the clinical signs of shock of the II degree:
A. BP higher 100 мм of mercury column
B. Blood loss to 1 liter
C. Loss of consciousness
D. Anuria
E. Spasm of peripheral vessels *
88. Main medical measures of the leading out a victim from burn shock will be:
A. Effective analgesia and infusion therapy *
B. Effective analgesia and cooling of areas of body with burns
C. Effective analgesia and introduction of glucocorticoids
D. Effective analgesia and introduction of cardiac glycosides
E. Effective analgesia and transport immobilization
89. A plait is applied correctly, if:
A. Skin covers of extremities below plait remain pink
B. Pulsation on vessels below plait is determined
C. Pulsation on vessels below plait is not determined and bleeding stopped from a wound
D. Bleeding proceeds from a wound, and pulsation on vessels below plait is absent
E. Pulsation on vessels below plait is determined, bleeding proceeds from a wound, but
intensity is diminished *
90. The ІV degree of burns is characterized by:
A. Charring of skin with surrounding fabrics
B. Hyperemia of skin, edema of fabrics
C. Presence of bladders with serous content, hyperemia of skin and its edema
D. A presence of necrosis of derma and bladders on skin *
E. Presence of necrosis of derma
91. A patient was appealed to the traumatic department with an incised wound on palm's surface
of lower third of forearm from an elbow side. After the removal of bandage there is
expressed arterial bleeding. Violation of which of the following arteries can cause bleeding?
A. Ulunar artery
B. Reverse elbow artery
C. radial artery
D. Interbone
E. lower ulunar collateral *
92. 42 year old patient was hospitalized to a surgical department with the closed fracture of
pelvis in the state of grave shock. What blood substitutes must be prescribed for the fluid
antishock management:
A. Reopoliglucin
B. Intralipid
C. Hemodesum
D. Physiological salt solution
E. Plasma *
93. Common for the most forms of shock is:
A. Pallor/paleness
B. Bradikardiya
C. Hypoperfusion of fabrics and hypoxia
D. Diminishing of cardiac output extras
E. Anemia *
94. Clinical signs of shock of I degree:
A. BP higher than 90 mm of mercury column
B. Blood loss to 1 litre
C. Psycho-emotional stress
D. Polyuria *
E. Bradycardia
95. Clinical signs of shock of II degree:
A. BP higher than 100 mm of mercury column *
B. Blood loss to 1 litre
C. Loss of consciousness
D. Anuria
E. Spasm of peripheral vessels
96. Which of the following is NOT a predisposing factor for epistaxis?
A. Cocaine use.
B. Hypertension.
C. Infection.
D. Peptic ulcer disease. *
E. Uremia.
97. All of the following are important questions to ask a patient with the acute epistaxis
EXCEPT:
A. Is there a history of drug use?
B. How long has there been bleeding?
C. Is there ear pain? *
D. Is there a history of liver disease?
E. Is there a sensation of blood in the back of the throat?
98. All of the following are accepted methods of controlling anterior epistaxis EXCEPT:
A. Direct cautery of a bleeding vessel.
B. Nasal packing.
C. Embolization. *
D. Direct pressure.
E. Application of vasoconstrictive agents.
99. Complications of epistaxis controlled with anterior nasal packing include all of the
following EXCEPT:
A. Anemia.
B. Dislodgment.
C. Sinusitis.
D. Toxic shock syndrome.
E. Vertigo *
100. A posterior source of epistaxis should be suspected in all of the following conditions
EXCEPT:
A. Bleeding from both nares.
B. Epistaxis with associated presyncope or syncope.
C. Presence of foreign body. *
D. No anterior source.
E. Sensation of blood down back of throat.
101. Clinical signs of shock of III degree:
A. Violation of consciousness
B. Hyporeflexion
C. Anuria
D. Bradycardia *
E. Blood loss more than 2,5 litres
102. The basic features of venous bleedings are:
A. Bright red color of blood
B. Bright red color of blood and pulsating character of bleeding
C. Dark color of blood
D. Comparatively slow character of bleeding *
E. Dark color of blood with comparatively slow character of bleeding
103. A public-call message was received by a waiting room of hospital that soon a patient
will be delivered by an ambulance who was withdrawn from blazing home in unconscious
state. What damages are most probable in a victim:
A. Burns of skin and respiratory tracts, sharp poisoning of CO2
B. Burns of skin, burn shock *
C. Burns of respiratory tracts, burn shock
D. Poisoning of CO2
E. Sharp respiratory insufficiency
104. Signs and symptoms associated with mandibular fractures include all of the following
EXCEPT:
A. Deformity of the dental arch.
B. Limited range of motion.
C. Mental nerve anesthesia.
D. Subconjunctival hemorrhage. *
E. Sublingual hematoma.
105. Reduced CBV is accompanied by:
A. Increased blood pressure. *
B. Reduction of MOS.
C. Increase of AC.
D. Reduction of blood circulation.
E. Increase of venous pressure.
106.
One can determine the conservation of capillary blood flow with the help of:
A. JSC.
B. Pulse rate.
C. The reaction was pale spots nail bed.
D. The state of consciousness. *
E. Hourly diuresis.
107.
The primary response in case of a hypovolemic shock is:
A. The use of sympathomimetics (dopamine).
B. Oxygen therapy. *
C. Restoration of blood volume.
D. Diuretics.
E. Transfusion.
108.
Severity of a patient’s state during blood loss depends on:
A. Speed of BCC reduction.
B. Three-dimensional bloodstream.
C. BCC deficit. *
D. Initial state of the organism.
E. Hematocrit index.
109.
Specify the primary means of assessing the degree of hypovolemia:
A. Temperature and skin coloring.
B. TSVT.
C. Hematocrit. *
D. Filling pulse and heart rate.
E. Hourly urine output, the level of protein in the urine.
110.
Distress syndrome is usually caused by:
A. Massive hemo transfusion. *
B. Small cardiac output.
C. Polytrauma.
D. Dehydration.
E. Aspiration of vomit.
111. The victim in a state of shock with a SC-70 mmHg pulse 140 min. Determine the
volume of blood loss:
A. 20%.
B. 30%.
C. 40%. *
D. 50%.
E. 60%.
112.
3rd degree hypovolemic shock corresponds to loss of blood volume:
A. 10-15% of BCC. *
B. 40-50% of BCC.
C. 50-60% of BCC.
D. 1.5-2 liters.
E. 2.5-3 liters.
113.
2nd degree hypovolemic shock corresponds to loss of blood volume:
A. 15-25% of BCC.
B. 30-40% of BCC.
C. 500 ml.
D. 0,8-1,2 liters.
E. 2.5-3 liters. *
114.
Antishock therapy determines pathophysiological mechanisms of shock:
A. Absolute or relative deficiency of BCC.
B. Disorder of the heart pumping function.
C. tissue hypoxia.
D. Violation of regulation of vascular tone. *
E. Metabolic alkalosis.
115.
Which of the following is an incorrect way of assessing a hypovolemic degree:
A. TSVT. *
B. The level of blood pressure.
C. Filling the pulse and heart rate.
D. Size hourly urine output.
E. The level of protein in the urine.
116. The victim is in a state of shock with a blood pressure - 90 mm Hg, pulse 120 min.,
determine the volume of blood loss:
A. 20%.
B. 30%.
C. 40%.
D. 50%. *
E. 60%.
117. Which of the following does not determine antishock therapy of pathophysiological
mechanisms of shock:
A. Absolute and relative CBV deficit.
B. Disorder of the heart pumping function.
C. Hypoxia of tissues and cells.
D. Violation of regulation of vascular tone. *
E. Hyperthermia.
118.
The reduction of capillary perfusion causes:
A. Metabolic acidosis.
B. Reduction of blood coagulation.
C. Withdrawal of plasma from the vessels. *
D. Blood viscosity reduction.
E. Microthrombosis.
119. All of the following factors belong to multiple organ failure due to prolonged tissue
compression, except:
A. Microthrombosis
B. Acidosis.
C. Mioglobinemia.
D. Hypovolemia.
E. Bilirubinemia. *
120. All of the following are included in the list of intensive care procedures due to prolonged
compression of tissue during prehospital stage, except:
A. Restoration of BCC.
B. Early creation of meadows of the body.
C. The use of antihypertensive agents. *
D. Pain relief.
E. Transport immobilization.
121.
After prolonged limb compression, you must:
A. Apply a tourniquet and leave it for 2 hours.
B. Unfasten the tourniquet every 2-30 minutes.
C. Remove the tourniquet immediately.
D. Leave the limb for 3 hours.
E. None of the answers are correct. *
122.
The main feature of saving limbs after prolonged compression:
A. Dermographism . *
B. The presence of active movements.
C. The presence of pain sensitivity.
D. Availability tapping sensitivity.
E. All the answers are not correct.
123.
The main sign of loss of limbs after prolonged compression:
A. No reflex.
B. Lack of sensitivity.
C. Lack of passive movements.
D. The absence of active movements.
E. All the answers are not correct. *
124.
After a compression tourniquet should be removed from which limb:
A. Bleeding.
B. Plowed. *
C. Saved.
D. Gangrenous.
E. All the answers are not correct.
125.
Determine the minimum amount of blood loss, which manifests itself as clinical shock:
A. 10% of BCC.
B. 20% of BCC.
C. 30% of BCC. *
D. 40% of BCC.
E. 25% of BCC.
126. Blood pressure, tachycardia, peripheral vascular spasm, and an increase of TSVT is
typical shock, in cases of:
A. Severe burns.
B. Serious injury.
C. Massive bleeding. *
D. Acute pancreatitis.
E. Myocardial infarction.
127. What is the first thing that needs to be done in case of a hypovolemic shock due to blood
loss?
A. Quick hemostasis and a restoration of BCC.
B. Apply b-blockers.
C. Administer a solution of glucose.
D. Administer a hypertonic solution of sodium chloride and reopoliglukine.
E. Administer spasmodicals. *
128. The hospital is about to receive a patient via the ambulance that has been saved from the
rubble of a burning building. What are the expected traumas?
A. Burns skin and respiratory tract, acute CO poisoning.
B. Burns the skin, burn shock.
C. respiratory burns, burn shock.
D. CO poisoning.
E. Acute respiratory failure. *
129. A patient with a lacerated hand, in the palmar region, extending to his elbow had his
bandages removed. After removal of the bandage, the wound started bleeding. Which artery
has been affected?
A. ulnar.
B. Reverse ulnar.
C. Radiation. *
D. Interosseous.
E. Lower ulnar collateral.
130.
A 42 year old patient has been hospitalized with a closed pelvic fracture. Which blood
substitute should be administered for infusion therapy?
A. Reopoliglukin.
B. Intralipid.
C. Hemodez
D. Normal saline solution.
E. Plasma. *
131. After 4 days of incompatible blood transfusion, the patient’s dieresis has dropped
dramatically. His overall state has debilitated, alongside with an increase in arterial pressure
and anuresis. Upon laboratory inspection: plasma creatinine – 680 mmol/l, urea plasma – 24
mmol/l. These signs are typical for which disease and which stage?
A. Hemotransfusion acute renal failure, anuria.
B. Anaphylactic shock, acute renal failure, anuria.
C. Hemotransfusion shock postrenalna acute renal failure, anuria. *
D. Posthemorrhagic acute renal failure, anuria.
E. Acute interstitial nephritis, obstructive anuria.
132.
In the event of chemical burns it is necessary to:
A. Apply an aseptic bandage.
B. Treat the burnt area with a 3 % solution of H2O2.
C. Treat the burnt area urgently with the great amount of water, neutralize the remains of
acid with a 2 % sodium hydrocarbonate solution and in case of alkali burns treat the
burnt with a 2% acetic acid solution or citric acid. *
D. Apply ointment bandages.
E. Cleanse the burnt area with a 0.5 % novocaine solution.
133.
II degree hypovolemic shock corresponds to the blood loss in the amount of:
A. 15-25% of circulating blood volume
B. 30-40% of circulating blood volume *
C. 500 ml.
D. 0,8-1,2 L.
E. 2,5-3 L.
134.
On the basis of the tissue damage depths one can assess:
A. Area of burns.
B. Degree of burns.
C. Type of burns.
D. Affection of internals. *
E. Availability of a burn disease.
135.
The most common symptoms for most types of shock are:
A. Paleness.
B. Bradycardia.
C. Inadequate perfusion of tissues and hypoxia.
D. Decrease in heart beat. *
E. Anaemia.
136. All of the following are TRUE regarding the evaluation of a patient with acute
abdominal pain EXCEPT:
A. The onset, location, and severity of pain are useful differentiating factors.
B. The most important physical examination modality is palpation.
C. The WBC may be normal even in inflammatory conditions such as appendicitis.
D. Ultrasonography is a valuable imaging tool increasingly available to emergency
physicians.
E. Analgetic medications should be withheld until a surgeon evaluates the patient because
they may obscure the diagnosis. *
137.
A.
B.
C.
D.
E.
Which of the following is the MOST common cause of upper GI bleeding?
Esophageal varices.
Mallory-Weiss year.
PUD. *
Erosive gastritis.
Arteriovenous malformations.
138. A patient presents with what appears to be massive lower GI hemorrhage. Which one of
the following is the LEAST likely etiology?
A. Diverticulosis.
B. Angiodysplasia.
C. Gastric varices.
D. Duodenal ulcer.
E. Hemorrhoids. *
139.
A.
B.
C.
Which of the following is a mechanical or obstructive cause of dysphagia?
Aortic aneurysm *
Candida esophagitis
Multiple sclerosis
D. Scleroderma
E. Gastroesophageal reflux
140.
A.
B.
C.
Which one of the following statements regarding esophageal trauma is TRUE?
Ingestion of lye causes a partial-thickness burn to the mucosa.
Contrast studies are contraindicated if a perforation is suspected.
Swallowed foreign bodies may cause a partial-thickness laceration that leads to severe
bleeding.
D. Mallory-Weiss syndrome involves a laceration of the otherwise normal esophagus after
repeated emesis.
E. Boerhaave's syndrome is a full-thickness perforation, usually leading to severe
mediastinitis. *
141. Which one of the following patients who swallowed a foreign body is MOST likely to
require endoscopy or surgery for definitive treatment?
A. An asymptomatic child with a button battery shown to be in the stomach on x-ray.
B. A 34-year-old male with an impacted piece of steak, who is tolerating his secretions
well.
C. A 6-year-old male who swallowed a penny that appears to be in the esophagus on x-ray.
D. An adult psychiatric patient who swallowed a razor blade. *
E. A 22-year-old male who swallowed heavily wrapped cocaine that appears to have passed
the pylorus.
142. Which of the following is TRUE regarding meat impaction in the esophagus?
A. Endoscopy should be performed within 6 h, even in patients who are handling their own
secretions.
B. Esophageal pathology is present in up to 50 percent of patients.
C. Glucagon, nifedipine, and meat tenderizer should all be tried before endoscopy.
D. After the patient feels the bolus has passed, a barium swallow should be performed. *
E. Patients without airway compromise can be observed as outpatients and scheduled for a
24-h follow-up.
143. In a young, otherwise healthy patient with a newly suspected diagnosis of PUD, what
would be the MOST appropriate course of action in the ED?
A. Begin symptomatic and therapeutic treatment with cimetidine. *
B. Immediate referral for endoscopy.
C. Begin empiric treatment of H. pylori with a triple antibiotic regimen.
D. Begin combination therapy with an H2 receptor antagonist, proton pump inhibitor, and
antacids.
E. Begin therapy with sucralfate and order an H. pylori breath test.
144. In a patient with PUD, all of the following clinical signs or symptoms should raise
concern of a complication EXCEPT:
A. Passage of melanotic stool.
B. Burning epigastric pain occurring every night. *
C. Abrupt onset of mid-back pain.
D. Repeated episodes of vomiting over the previous 12 h.
E. Severe, diffuse abdominal pain.
145.
Which of the following scenarios may represent acute appendicitis?
A.
B.
C.
D.
E.
146.
A.
B.
C.
D.
E.
A 4-year-old male with vomiting and lethargy.
A 75-year-old female with fever and abdominal pain.
A 26-year-old female who is 32 weeks pregnant with right upper quadrant pain.
A 45-year-old male with AIDS and who has vomiting and diarrhea.
All of the above. *
What is the MOST common cause of large bowel obstruction?
Adhesions.
Incarcerated hernia.
Diverticulitis.
Neoplasm. *
Sigmoid volvulus.
147.
A.
B.
C.
D.
E.
Which of the following is TRUE regarding small bowel obstruction?
It is rarely associated with abdominal pain.
It usually presents with clear, nonbilious vomiting.
Diffuse, severe abdominal tenderness indicates secondary peritonitis. *
X-ray shows air-filled bowel with prominent haustrae.
Nasogastric tube decompression is generally ineffective.
148.
A.
B.
C.
D.
Which of the following is MOST accurate regarding hernias in children?
All umbilical hernias should be referred for immediate surgical repair.
Inguinal hernias usually resolve spontaneously.
Umbilical hernias are highly prone to incarceration.
Indirect inguinal hernias are caused by congenital failure of the processus vaginalis to
close. *
E. Umbilical hernias are caused by congenital weakness of the linea albus of the rectus
sheath.
149. All of the following statements are TRUE regarding hernias EXCEPT:
A. Indirect inguinal hernias result from congenital defects and frequently incarcerate.
B. Direct inguinal hernias result from acquired defects in the transversalis fascia and rarely
incarcerate.
C. Femoral hernias occur more commonly in males and frequently incarcerate. *
D. Acquired umbilical hernias are associated with obesity and pregnancy and frequently
incarcerate.
E. Pelvic hernias are extremely rare but may occur through the sciatic and obturator
foramina.
150. All the following are TRUE regarding Crohn's disease EXCEPT:
A. Up to 50 percent of patients have involvement of both small bowel and colon.
B. Extraintestinal manifestations are common and include arthritis, uveitis, and liver
disease.
C. Abscesses and fistulas are frequent complications.
D. Up to 10 percent of patients develop perianal complications. *
E. Obstruction can occur as a result of stricture formation and bowel-wall edema.
151. Which of the following is TRUE regarding hemorrhoids?
A. Internal hemorrhoids are usually painful and associated with heavy bleeding.
B. External hemorrhoids are relatively painless and rarely thrombose.
C. Internal hemorrhoids are usually nonpalpable and best evaluated with anoscopy. *
D. Both internal and external hemorrhoids require prompt surgical referral for treatment.
E. Thrombosed internal hemorrhoids may be treated with excision of the clots in the ED.
152. Which of the following causes of constipation may NOT be safely managed on an
outpatient basis?
A. Hypothyroidism.
B. Fecal impaction.
C. Hyperparathyroidism.
D. Lead poisoning.
E. Sigmoid volvulus. *
153. Which of the following is the MOST common presentation of gallstones?
A. Acute pancreatitis.
B. Acute cholecystitis.
C. Biliary colic. *
D. Ascending cholangitis.
E. Gallbladder empyema.
154. All of the following are TRUE regarding acute rejection in liver transplant patients
EXCEPT:
A. Acute rejection is most commonly seen 7 to 14 days posttransplant.
B. Clinical presentation is easily differentiated from postoperative complications. *
C. It may be triggered at any time by tapering of immunosuppressive agents.
D. Diagnosis can only be made with certainty by ultrasound with biopsy.
E. Acute rejection is managed primarily by high-dose glucocorticoids.
155. All of the following are causes of unconjugated hyperbilirubinemia EXCEPT:
A. Acetaminophen poisoning. *
B. Hemolytic anemia.
C. Transfusion reaction.
D. Congestive heart failure.
E. Sickle cell anemia.
156. What is the MOST common cause of pancreatitis in an urban hospital setting?
A. Cholelithiasis.
B. Alcoholism. *
C. Abdominal trauma.
D. Penetrating peptic ulcer.
E. Salicylate poisoning.
157. Which of the following is NOT a complication of acute pancreatitis?
A. Adult respiratory distress syndrome (ARDS).
B. Myocardial depression.
C. Disseminated intravascular coagulopathy (DIC).
D. Malabsorption. *
E. Pancreatic pseudocyst.
158. A 55-year-old female presents to the ED with a fever 4 days after undergoing a
laparoscopic cholecystectomy. What is the MOST likely cause of the fever?
A. Pneumonia.
B. Thrombophlebitis.
C. Urinary tract infection. *
D. Wound infection.
E. Deep venous thrombosis.
159. A patient who has recently undergone gastrointestinal surgery presents to the ED with
abdominal pain and vomiting. Which of the following would be the LEAST likely surgical
complication?
A. Intestinal obstruction.
B. Intraabdominal abscess.
C. Pancreatitis.
D. Cholecystitis.
E. Pseudomembranous colitis. *
160. A patient with suspected cholelithiasis presents to the ED. What is the initial imaging
study of choice?
A. Abdominal plain film.
B. Abdominal ultrasound. *
C. Abdominal CT.
D. Radionuclide scan (HIDA).
E. Barium contrast radiography.
161. All of the following are true statements about falls in the elderly EXCEPT:
A. Most falls occur on steps or other uneven surfaces. *
B. Most falls result in isolated orthopedic injuries.
C. Decreased visual acuity and memory loss make it difficult for elderly patients to avoid
environmental hazards.
D. Syncope is a frequent cause of falls.
E. Falls are the most common accidental injury in patients older than 75 years.
162. Which of the following statements is MOST correct regarding abdominal pain in the
elderly?
A. Elderly patients are unlikely to have the problems of younger patients, such as
appendicitis or cholecystitis.
B. Given the same underlying diagnosis for an acute abdominal disorder, the elderly have
about the same mortality rate as younger patients.
C. The elderly exhibit less pain and tenderness than younger patients, but they are more
likely to have fever and leukocytosis than are younger patients.
D. Diagnostic delays and preexisting illnesses lead to a higher mortality in elderly patients
than in younger patients. *
E. The elderly are more likely than younger patients to seek early medical attention for
abdominal pain.
163. All of the following are true about elder abuse EXCEPT:
A. Physical abuse, neglect, and chronic verbal aggression are all forms of elder abuse.
B. The abuser is often dependent on the victim for financial and emotional support.
C. Dementia increases the risk of abuse.
D. Abuse correlates with personality problems of the caretaker.
E. A majority of abuse cases can be diagnosed by patient history alone. *
164. All of the following are true of lacerations and wound care in the elderly EXCEPT:
A. The elderly have about the same response to a tetanus toxoid booster as younger
patients. *
B.
C.
D.
E.
The incidence of tetanus increases with age.
Aging skin tears with minor friction.
In the elderly, skin tears usually present as epidermal flaps.
With aging, there is a decrease in cellular growth rate and a degeneration of collagen and
elastic fibers.
165. Which one of the following drugs is LEAST likely to result in thrombocytopenia?
A. Heparin.
B. Quinine.
C. Quinidine.
D. Estrogen. *
E. Heroin.
166. All of the following statements regarding platelet abnormalities are TRUE EXCEPT
A. bleeding complications may arise if platelets are < 50,000/µL.
B. patients are at risk for spontaneous bleeding if platelet counts are < 10,000/µL.
C. when platelets drop below 10,000/µL, the patient should receive a platelet transfusion.
D. patients with ITP respond well to platelet transfusion. *
E. each unit of platelets transfused should raise the platelet count by about 10,000/µL.
167. All of the following antibiotics are associated with drug-induced deficiencies of vitamin
K-dependent factors EXCEPT:
A. Cefotaxime.
B. Trimethoprim.
C. Cefoperazone.
D. Moxalactam.
E. Cefamandole. *
168. All of the following proteins require vitamin K to function properly EXCEPT:
A. Factor II (prothrombin).
B. Factor VII.
C. Factor IX.
D. Factor X.
E. Antithrombin III. *
169. All of the following statements regarding fresh frozen plasma (FFP) are TRUE
EXCEPT:
A. It contains all factors.
B. Intravenous administration can lead to volume overload.
C. Viral transmission is possible with transfusion.
D. It is a first-line treatment for uremic patients with bleeding. *
E. It is a first-line treatment for bleeding patients with a coagulopathy.
170. All of the following statements concerning heparin therapy are TRUE EXCEPT:
A. It facilitates antithrombin III binding to activated factors II, IX, XI, and XII.
B. The most common complication is bleeding.
C. One milligram of protamine sulfate neutralizes 1000 units of heparin. *
D. Thrombocytopenia is a common complication.
E. Co-use of cimetidine or NSAIDs increases bleeding risk.
171. All of the following statements regarding thrombocytopenia in the setting of heparin use
are TRUE EXCEPT:
A. The incidence is lower with low-molecular-weight heparin.
B. The most common form is transient and seldom lowers the platelet count below
100,000/µL.
C. The type with platelet antibody formation can be life threatening and may lower the
platelet count below 50,000/µL.
D. Arterial thromboses can occur in the more severe form.
E. Patients must have a previous exposure to heparin to develop anti-platelet antibodies. *
172. Which of the following TCAs is capable of causing status epilepticus without QRS
widening?
A. Nortriptyline
B. Amoxapine *
C. Maprotiline
D. Desipramine
E. Amitriptyline
173. If sodium bicarbonate therapy is ineffective, which of the following antidysrhythmics
may be used to treat ventricular dysrhythmias associated with TCA overdose?
A. R-blockers
B. Calcium channel blockers
C. Phenytoin
D. Lidocaine *
E. Class IA or IC antidysrhythmics
174. Which of the following statements about fluoxetine (Prozac) is FALSE?
A. It is the most frequently prescribed antidepressant in the United States
B. It is the most potent of the selective serotonin reuptake inhibitors (SSRIs) *
C. Seizures occur in approximately 0.2 percent of patients taking fluoxetine
D. Fluoxetine is the most potent inhibitor of P-450 hepatic drug metabolism and may
elevate TCA levels 2- to 10-fold
E. The most common symptoms seen in fluoxetine overdose are sinus tachycardia,
drowsiness, tremor, and nausea/vomiting
175. All of the following statements concerning serotonin syndrome are TRUE EXCEPT:
A. It is characterized by alterations in cognitive-behavioral ability, autonomic nervous
function, and neuromuscular activity
B. It is usually seen when monoamine oxidase inhibitors or selective serotonin reuptake
inhibitors are combined with other serotonergic drugs
C. Morphine and fentanyl are contraindicated for treatment *
D. Nneuromuscular symptoms are greatest in the lower extremities
E. Mandatory treatment includes discontinuation of all serotonergic medications
176. Which of the following drugs can be safely used in patients taking monoamine oxidase
inhibitors (MAOIs)?
A. Codeine
B. Dextromethorphan
C. Ketamine
D. Meperidine
E. Morphine *
177. Which of the following statements regarding adverse effects of neuroleptic medications
is INCORRECT?
A. Lower potency drugs such as chlorpromazine have greater anticholinergic,
antiadrenergic, and antihistaminic side effects, whereas the higher potency agents such
as haloperidol have mainly antidopaminergic side effects.
B. Dopamine antagonism accounts for adverse reactions, resulting in movement disorders.
C. Dystonic reactions are idiosyncratic, present early, and are seen more frequently in
females *
D. Akathisia and drug-induced parkinsonism are seen early and may be treated with
benztropine or amantadine.
E. Tardive dyskinesia is a late adverse effect and has no proven treatment
178. Which of the following organisms is the major cause of most travelers' diarrhea?
A. coli *
B. Campylobacter
C. Vibrio
D. Giardia
E. Shigella
179. Etiologic agents in tick-borne infections include bacterial, rickettsial, viral, and protozoal
organisms. All of the following infections can be acquired from a tick bite EXCEPT:
A. Rocky Mountain spotted fever
B. Q fever *
C. relapsing fever
D. tularemia
E. abesiosis
180. All of the following statements are TRUE regarding influenza EXCEPT:
A. influenza types A, B, and C may cause human infection
B. migrating aquatic fowl are thought to be the natural animal reservoir for influenza type
A
C. antiviral therapy with amantidine and rimantidine is effective against influenza types A,
B, and C *
D. annual influenza vaccination is recommended for healthcare workers
E. influenza pneumonia carries a high mortality rate, and more than 90 percent of deaths
occur in patients older than 70 years
181. Gas-forming soft tissue infections are life threatening and must be diagnosed early and
treated aggressively. Which one of the following symptoms or findings is LEAST likely to
be seen with these infections?
A. Increasing symptoms over 7 to 10 days *
B. Pain out of proportion to physical findings
C. Brawny edema with crepitance on palpation
D. Bullae or malodorous serosanguinous discharge
E. Low-grade fever, with tachycardia out of proportion to the fever
182. A doctor inspected a patient at a receipt on stationary treatment and found out sharp
poslablenie of the vocal shaking and dulling of perkutornogo sound below than corner of
levoy shoulder-blade. About what pathological state is it possible to think ?
A. A presence of liquid is in a pleura cavity. *
B. Presence of tumour of pleura.
C. Obturatsiya of road clearance of bronchial tube.
D. Presence of all above enumerated pathological states.
E. A presence of air is in a pleura cavity.
183. At patient of 25 years tetraplegiya appeared after a dive, violation of functions of pelvic
organs, loss of all types of sensitiveness. What most reliable diagnosis?
A. Break of pectoral department of spine.
B. Break of neck department of spine with the damage of spinal cord. *
C. Break of neck department of spine without the damage of spinal cord.
D. Zaboy of cerebrum.
E. Break of lumbar department of spine.
184.
A.
B.
C.
D.
E.
Which of the following is a mechanical or obstructive cause of dysphagia?
Aortic aneurysm *
Candida esophagitis
Multiple sclerosis
Scleroderma
Gastroesophageal reflux
185.
A.
B.
C.
Which one of the following statements regarding esophageal trauma is TRUE?
Ingestion of lye causes a partial-thickness burn to the mucosa.
Contrast studies are contraindicated if a perforation is suspected.
Swallowed foreign bodies may cause a partial-thickness laceration that leads to severe
bleeding.
D. Mallory-Weiss syndrome involves a laceration of the otherwise normal esophagus after
repeated emesis.
E. Boerhaave's syndrome is a full-thickness perforation, usually leading to severe
mediastinitis. *
186. Which one of the following patients who swallowed a foreign body is MOST likely to
require endoscopy or surgery for definitive treatment?
A. An asymptomatic child with a button battery shown to be in the stomach on x-ray.
B. A 34-year-old male with an impacted piece of steak, who is tolerating his secretions
well.
C. A 6-year-old male who swallowed a penny that appears to be in the esophagus on x-ray.
D. n adult psychiatric patient who swallowed a razor blade. *
E. A 22-year-old male who swallowed heavily wrapped cocaine that appears to have passed
the pylorus.
187. Which of the following is TRUE regarding meat impaction in the esophagus?
A. Endoscopy should be performed within 6 h, even in patients who are handling their own
secretions.
B. Esophageal pathology is present in up to 50 percent of patients.
C. Glucagon, nifedipine, and meat tenderizer should all be tried before endoscopy.
D. After the patient feels the bolus has passed, a barium swallow should be performed.
E. Patients without airway compromise can be observed as outpatients and scheduled for a
24-h follow-up. *
188. In a young, otherwise healthy patient with a newly suspected diagnosis of PUD, what
would be the MOST appropriate course of action in the ED?
A. Begin symptomatic and therapeutic treatment with cimetidine. *
B. Immediate referral for endoscopy.
C. Begin empiric treatment of H. pylori with a triple antibiotic regimen.
D. Begin combination therapy with an H2 receptor antagonist, proton pump inhibitor, and
antacids.
E. Begin therapy with sucralfate and order an H. pylori breath test.
189. In a patient with PUD, all of the following clinical signs or symptoms should raise
concern of a complication EXCEPT:
A. Passage of melanotic stool.
B. Burning epigastric pain occurring every night. *
C. Abrupt onset of mid-back pain.
D. Repeated episodes of vomiting over the previous 12 h.
E. Severe, diffuse abdominal pain.
190.
A.
B.
C.
D.
E.
191.
A.
B.
C.
D.
E.
Which of the following scenarios may represent acute appendicitis?
A 4-year-old male with vomiting and lethargy.
A 75-year-old female with fever and abdominal pain.
A 26-year-old female who is 32 weeks pregnant with right upper quadrant pain.
A 45-year-old male with AIDS and who has vomiting and diarrhea.
All of the above. *
What is the MOST common cause of large bowel obstruction?
Adhesions.
Incarcerated hernia.
Diverticulitis.
Neoplasm. *
Sigmoid volvulus.
192.
A.
B.
C.
D.
E.
Which of the following is TRUE regarding small bowel obstruction?
It is rarely associated with abdominal pain.
It usually presents with clear, nonbilious vomiting.
Diffuse, severe abdominal tenderness indicates secondary peritonitis. *
X-ray shows air-filled bowel with prominent haustrae.
Nasogastric tube decompression is generally ineffective.
193.
A.
B.
C.
D.
Which of the following is MOST accurate regarding hernias in children?
All umbilical hernias should be referred for immediate surgical repair.
Inguinal hernias usually resolve spontaneously.
Umbilical hernias are highly prone to incarceration.
Indirect inguinal hernias are caused by congenital failure of the processus vaginalis to
close. *
E. Umbilical hernias are caused by congenital weakness of the linea albus of the rectus
sheath.
194. All of the following statements are TRUE regarding hernias EXCEPT:
A. Indirect inguinal hernias result from congenital defects and frequently incarcerate.
B. Direct inguinal hernias result from acquired defects in the transversalis fascia and rarely
incarcerate.
C. Femoral hernias occur more commonly in males and frequently incarcerate. *
D. Acquired umbilical hernias are associated with obesity and pregnancy and frequently
incarcerate.
E. Pelvic hernias are extremely rare but may occur through the sciatic and obturator
foramina.
195. All the following are TRUE regarding Crohn's disease EXCEPT:
A. Up to 50 percent of patients have involvement of both small bowel and colon.
B. Extraintestinal manifestations are common and include arthritis, uveitis, and liver
disease.
C. Abscesses and fistulas are frequent complications.
D. Up to 10 percent of patients develop perianal complications. *
E. Obstruction can occur as a result of stricture formation and bowel-wall edema.
196. Which of the following is TRUE regarding hemorrhoids?
A. Internal hemorrhoids are usually painful and associated with heavy bleeding.
B. External hemorrhoids are relatively painless and rarely thrombose.
C. Internal hemorrhoids are usually nonpalpable and best evaluated with anoscopy. *
D. Both internal and external hemorrhoids require prompt surgical referral for treatment.
E. Thrombosed internal hemorrhoids may be treated with excision of the clots in the ED.
197. Which of the following causes of constipation may NOT be safely managed on an
outpatient basis?
A. Hypothyroidism.
B. Fecal impaction.
C. Hyperparathyroidism.
D. Lead poisoning.
E. Sigmoid volvulus. *
198. All of the following proteins require vitamin K to function properly EXCEPT:
A. Factor II (prothrombin).
B. Factor VII.
C. Factor IX.
D. Factor X.
E. Antithrombin III. *
199. All of the following statements regarding fresh frozen plasma (FFP) are TRUE
EXCEPT:
A. It contains all factors.
B. Intravenous administration can lead to volume overload.
C. Viral transmission is possible with transfusion.
D. It is a first-line treatment for uremic patients with bleeding. *
E. It is a first-line treatment for bleeding patients with a coagulopathy.
200. All of the following statements concerning heparin therapy are TRUE EXCEPT:
A. It facilitates antithrombin III binding to activated factors II, IX, XI, and XII.
B. The most common complication is bleeding.
C. One milligram of protamine sulfate neutralizes 1000 units of heparin. *
D. Thrombocytopenia is a common complication.
E. Co-use of cimetidine or NSAIDs increases bleeding risk.
201. All of the following statements regarding thrombocytopenia in the setting of heparin use
are TRUE EXCEPT:
A. The incidence is lower with low-molecular-weight heparin.
B. The most common form is transient and seldom lowers the platelet count below
100,000/µL.
C. The type with platelet antibody formation can be life threatening and may lower the
platelet count below 50,000/µL.
D. Arterial thromboses can occur in the more severe form.
E. Patients must have a previous exposure to heparin to develop anti-platelet antibodies. *
202. All of the following statements regarding thrombolytic drugs are TRUE EXCEPT:
A. They are contraindicated if the patient has a history of hemorrhagic stroke.
B. They cannot be used if the patient has active bleeding.
C. They must be avoided if aortic dissection is suspected.
D. They decrease pulmonary artery pressures, improve reperfusion, and increase survival
after massive pulmonary embolus. *
E. They are indicated for treatment of acute myocardial infarction.
203. Which one of the following is the LEAST common hematologic complication of HIV?
A. Thrombocytopenia.
B. Anemia.
C. ITP.
D. Thrombotic thrombocytopenic purpura (TTP). *
E. Acquired circulating antibodies.
204. All of the following statements regarding factor VIII inhibitors are TRUE EXCEPT:
A. PTT is normal, but the PT is prolonged. *
B. These inhibitors may develop in patients with previously normal hemostasis.
C. If present, mortality rate approaches 50 percent.
D. These inhibitors may develop in patients with underlying conditions such as pregnancy
and autoimmune or lymphoproliferative disorders.
E. These inhibitors can be seen in patients with congenital factor VIII deficiency
(hemophilia A).
205. All of the following statements regarding lupus anticoagulant are TRUE EXCEPT:
A. It is an antiphospholipid antibody that interferes with coagulation.
B. Most patients with lupus anticoagulant do not have lupus (SLE) or a clinical bleeding
disorder.
C. Affected patients are at risk for arterial and venous thrombosis.
D. Affected women may have recurrent fetal loss.
E. It is associated with a normal PTT. *
206. A 15-year-old male with hemophilia A presents with hoarseness, stridor, and anterior
neck swelling after an assault in which he sustained a "karate chop" to the throat. What is
MOST appropriate sequence of actions?
A. Endotracheal intubation, factor VIII replacement, neck CT. *
B. Factor VIII replacement, lateral soft-tissue film of the neck.
C. Factor VIII replacement, neck CT, close observation for need to intubate.
D. Check PTT and factor VIII assay, neck CT, close observation for need to intubate.
E. Surgical airway, check factor VIII levels.
207. All of the following statements regarding desmopressin (DDAVP) are TRUE EXCEPT:
A. It is a beneficial treatment for mild to moderate hemophilia A.
B. It can raise factor VIII activity up to threefold.
C. The usual dose is 0.3 µg/kg of body weight intravenous or subcutaneous every 12 h. *
D. A rise in factor VIII levels occurs between 4 and 6 h after administration.
E. Common side effects include headache and mild hyponatremia.
208.
A.
B.
C.
D.
E.
209.
A.
B.
C.
D.
E.
210.
A.
B.
C.
D.
E.
211.
A.
B.
C.
D.
E.
212.
A.
B.
C.
D.
E.
213.
A.
B.
C.
D.
E.
214.
A.
B.
C.
D.
E.
215.
A.
B.
C.
What is the amount of water in the body of adult human?
60% of body weight. *
80% of body weight.
55% of body weight.
85% of body weight.
75% of body weight.
What is the amount of intracellular water in the body?
45% of the body weight.
55% of the body weight.
35% of the body weight.
40% of the body weight. *
60% of the body weight.
What is the amount of extra cellular water in the body?
30% of the body weight.
40% of the body weight.
50% of the body weight.
20% of the body weight. *
15% of the body weight.
The reason of hypohydration might be everything, from the named below, except:
Diseases, which cause vomiting and diarrhea.
Burn disease.
Bleedings.
Hyperthermia.
Ascite, hydrothorax. *
Which way does the hematocrit change in case of hyperhydration?
Increases insignificantly.
Decreases.
Doesn’t change.
Increases greatly. *
All answers are correct.
What is the amount of water loss with urine (normally)?
1 ml/kg/hour. *
2 ml/kg/hour.
0,5 ml/kg/hour.
1,5 ml/kg/hour.
0,8 ml/kg/hour.
What is perspiration water loss?
Water loss with stool.
Water loss with urine.
Water loss through skin and breathing passages. *
All answers are correct.
All answers are incorrect.
What is normal perspiration water loss?
1 ml/kg/hour.
2 ml/kg/hour.
0,8 ml/kg/hour.
D. 1,5 ml/kg/hour.
E. 0,5 ml/kg/hour. *
216. What is endogen water?
A. Water, which is generated during protein catabolism.
B. Water, which is generated during fat catabolism.
C. Water, which is generated during fat, protein and carbohydrates catabolism. *
D. Intracellular water.
E. All answers are correct.
217. How does the water loss of patients with hyperthermia change?
A. Increase on 0,25 ml/kg/hour for every extra degree of temperature. *
B. Decrease on 0,25 ml/kg/hour for every extra degree of temperature.
C. Doesn’t change.
D. Increase on 0,5 ml/kg/hour for every extra degree of temperature.
E. Decrease on 0,25 ml/kg/hour for every extra degree of temperature.
218. What quantity of liquid should normally come to the body of healthy human every day?
A. 2-3 ml/kg/hour.
B. 3-4 ml/kg/hour.
C. C.1,5-1,7 ml/kg/hour. *
D. 2,7-2,9 ml/kg/hour.
E. 1,2-1,5 ml/kg/hour.
219. What type of dehydration is accompanied with hypernatremia?
A. Hypotonic.
B. Hypertonic. *
C. Isotonic.
D. All answers are correct.
E. All answers are incorrect.
220. What is normal molar concentration of plasma?
A. 240-260.
B. 260-280.
C. 285-310. *
D. 310-340.
E. 150-170.
221. What index from the listed below might be an evidence of low osmotic molarity of blood
plasma?
A. Hypernatremia.
B. Hyponatremia. *
C. Hyperglikemia.
D. Ketoacidosis.
E. Hypoglycaemia.
222. During aging relative amount of water in the body of human is:
A. Increasing.
B. Decreasing. *
C. Staying constant with small oscillations.
D. Staying constant and depends on the fat tissue content.
E. Staying constant and depends on sex.
223. Which statement does correctly describe changes in water amount in the bodies of
people with different amount of fat?
A. People with obesity have related content of water greater, than people with normal or
lowered nourishment. *
B. People with normal or lowered nourishment have greater water content, than people with
obesity.
C. People with normal nourishment have lower related and absolute water content than
people with obesity.
D. Absolute water content is almost equal in all mentioned cases.
E. All answers are incorrect.
224. The concentration of potassium in serum:
A. Increases in case of alkalosis.
B. Ecreases in case of acidosis.
C. Increases in case of acidosis. *
D. Decreases in case of alkalosis.
E. Doesn’t depend on acid-base balance.
225. The main intracellular cat ions are:
A. Na and Ca. *
B. Ca and Cl.
C. K and Mg.
D. K and Cl.
E. Mg and Cl.
226. ECG-signs of hypokaliemia are:
A. Ventricular tachycardia, extrasystolia.
B. Extensive (wide) QRS.
C. Prolongation of P-Q.
D. High, sharp T. *
E. All answers are incorrect.
227. In polarizing solution the best correlation of K and Mg for disorders correction should
be:
A. 1:20.
B. 20:1.
C. 1:8.
D. 8:1. *
E. All answers are incorrect.
228. Average daily maintenance of K for adult human is:
A. 10 mmol.
B. 90 mmol. *
C. 150 mmol.
D. 300 mmol.
E. 500 mmol.
229. Electrolytic compositions of interstitial and intravascular liquids mainly differ in amount
of:
A. K.
B. Na. *
C. Cl.
D. Ca.
E.
230.
A.
B.
C.
D.
E.
231.
A.
B.
C.
D.
E.
232.
A.
B.
C.
D.
E.
233.
A.
B.
C.
D.
E.
234.
A.
B.
C.
D.
E.
235.
A.
B.
C.
D.
E.
Protein.
During aging the content of water in the human body:
Increases.
Decreases. *
Stays constant with small oscillations.
Stays constant and depends on the fat tissue content.
Stays constant and depends on sex.
Normally the water amount in the body depends on:
the quantity of lipid tissue (it contains less water, than other tissues).
the quantity of lipid tissue (it contains more water, than other tissues).
level of Base Exchange.
the quantity of coming (consumed) liquid. *
climatic conditions.
Normally the correlation of extra and intracellular potassium is:
1:5.
1:30. *
30:1.
2:1.
7:1.
Choose incorrect statement considering potassium exchange:
Cells of different organs contain the same quantity of potassium.
Cells of different organs contain different quantity of potassium.
Intracellular concentration of potassium is greater than extra cellular.
Correlation between intracellular and extra cellular potassium is 30.
Brain and muscles have the greatest amounts of potassium. *
Which way will the loss of adrenal glands function influent the electrolytic balance?
Increases the rate of Na in the body. *
Increases the rate of K in cells.
Increases the rate of K in urine.
Doesn’t influent electrolytic exchange.
All answers are incorrect.
Daily maintenance of Ca for adult human is:
1 g. *
1 mg.
5 g.
10 g.
100 g
236.
A.
B.
C.
D.
E.
The most common reason of hypercalcemia is:
Primary and secondary hyperparathyreosis. *
Primary and secondary hypoparathyreosis.
Thyrotoxicosis.
Growth of blood plasma aldosterone rate.
Reduction of blood plasma aldosterone rate.
237. Name the most common reason of hypocalcaemia of adults:
A. Chronic renal insufficiency.
B.
C.
D.
E.
Destructive pancreatitis.
Hepatocirrhosis, alkalosis, hypomagnesaemia.
Surgical damage of parathyroid glands. *
Massive infusions of citrated blood.
238.
A.
B.
C.
D.
E.
The most common reasons of isotonic dehydration are all from the listed below except:
Extra inflow of Na. *
Bowel obstruction.
Bleeding.
Peritonitis.
Wound.
239.
A.
B.
C.
D.
E.
The concentration of ionic Ca increases in case of:
Acidosis.
Alkalosis.
Hypohydration.
Deficiency of Na. *
Acid-base balance doesn’t influence rate of Ca.
240.
A.
B.
C.
D.
E.
The reason of hypotonic dehydration might be everything from the listed below, except:
Insufficiencies of mineral corticoid function of adrenal glands.
Hyper function of adrenal glands.
Diarrhoea with hypertonic stool.
Diarrhoea with Na-poor stool. *
Diseases of kidneys, which damage electrolytes absorption.
241.
A.
B.
C.
D.
E.
In case of isotonic dehydration:
Osmotic pressure of blood plasma is increased. *
Osmotic pressure of blood plasma is decreased.
Osmotic pressure of blood plasma is normal.
CVP is increased.
All answers are correct.
242.
A.
B.
C.
D.
E.
243.
A.
B.
C.
D.
E.
For the correction of isotonic dehydration the best solutions are:
Colloid solutions.
Electrolytic solutions.
Colloid and electrolytic solutions. *
Hypertonic glucose solution.
Isotonic glucose solution
The reasons of hypertonic dehydration might be every, from the listed below, except:
Watery stool of patients with cholera or salmonellas disease.
Inadequate completing of perspiration loss. *
Excessive infusion of hypertonic solution of NaCl.
Osmotic diuresis.
Hypo and isostenuria of patients with kidney diseases.
244. In case of hypertonic dehydration:
A. The level of Na is above normal. *
B. The level of Na is below normal.
C. The level of Na is normal.
D. Osmotic pressure of blood plasma is normal.
E. All answers are correct.
245.
A.
B.
C.
D.
E.
246.
A.
B.
C.
D.
E.
247.
A.
B.
C.
D.
E.
In case of hypertonic dehydration first of all should be infused:
Hypertonic solution of glucose.
Hypertonic solution of NaCl.
Colloid solutions. *
Isotonic solutions of sorbitol, glucose.
All answers are incorrect.
Choose a wrong answer. For hypertensive dehydration the peculiar followings signs:
Thirst.
Turgidity.
Increase of VCB.
Decrease of VCB. *
Increase of concentration of sodium is in plasma of blood.
For gastric alkalosis tetaniya such changes are peculiar by a, for exception:
Normal to maintenance in plasma of blood of general calcium and decline ionized.
Hypochlorinemia.
Increase of content of parathironine is in plasma of blood.
Decrease of content of 1,25-dihydroxycalciumferol is in plasma of blood. *
Increase of PH and BE of blood
248.
A.
B.
C.
D.
E.
249.
A.
B.
C.
D.
E.
250.
A.
B.
C.
D.
E.
251.
A.
B.
C.
D.
E.
Development of metabolic alkalosis can be expected in cases:
of hyperaldosteronism, Kushing desease. *
diarrhea.
noncompensated of saccharine diabetes.
all of answer correct.
all of answer wrong.
What from the transferred violations of ABS are peculiar for myasthenia gravis:
respiratory alkalosis.
respiratory acidosis and metabolic acidosis. *
metabolic alkalosis.
respiratory alkalosis, metabolic alkalosis.
A,C.
What violations of ABS are most peculiar for cardiogenick shock:
respiratory acidosis.
metabolic alkalosis.
respiratory acidosis, metabolic alkalosis.
respiratory alkalosis.
respiratory alkalosis, metabolic acidosis. *
To trisaminum peculiar all except for:
synthetic containing sodium solution which creates a basic environment.
sodium hydrogen of carbonate well adjusts the intracellular acidosis. *
in time of hit in pair a venous cellulose is caused by necrosis of fabric.
with the rapid intravenous introduction represses breathing.
contraindicated at the parafunction of buds.
252. Results of laboratory researches: рСО2 – 50, рН – 7,12, HCO3 – 13. Your diagnosis:
A. compensated respirator acidosis.
B. noncompensated metabolic alkalosis.
C. respiratory alkalosis, metabolic acidosis.
D. metabolic acidosis respiratory acidosis. *
E. all of answer faithful.
253. A sharp respiratory alkalosis can not be investigated in the case of:
A. hemoragic shock.
B. embolism of pulmonary artery.
C. bakteriemia.
D. increase of рН of cerebrospinal liquid. *
E. all of answer correct.
254. At the increase of рН solution from 7,4 to a 8,4 concentration of hydrions:
A. increases in 2 times.
B. decreases in 10 times. *
C. decreases in 2 times.
D. increases in 10 times.
E. all of answer wrong.
255. What value of рН plasma of blood is answered by the concentration of hydrions of 40
nmol/l:
A. 7,0.
B. 7,35.
C. 7,4. *
D. 7,44.
E. 7,6.
256. Choose assertions which touch the buffer systems of organism:
A. hydrogen-carbonate system is contained only in plasma of blood.
B. Except for the hydrogen-carbonate system in plasma of blood there are protein and
phosphatic buffer systems. *
C. hydrogen-carbonate system there is only the buffer system of protein in plasma of blood.
D. in the intracellular liquid the main buffer system is hydrogen carbonate.
E. all of answer correct.
257. Name the drug, which is not used in case of hypercalcemia crises:
A. isotonic solution of NaCl.
B. glucocorticoids.
C. furosemid.
D. calcium gluconate. *
E. sodium salt of EDTA.
258. Electrolytic compositions of interstitial and intravascular liquids mainly differ in amount
of:
A. K.
B. Na. *
C. Cl.
D. Ca.
E. Protein.
259. Distribute water on the water sectors of organism for a man with mass 100 kg (general
water - intracellular - extracellular):
A. 60 - 40 - 20. *
B. 70 - 40 - 30.
C. 50 - 30 - 20.
D. 40 - 20 - 20.
E. 55 - 30 - 25.
260. Specify what norm of loss of water with urine for days for a man with mass 100 kg:
A. 2400 ml. *
B. 1200 of ml.
C. 1000 of ml.
D. 1500 of ml.
E. 1600 of ml.
261. Specify what norm of perspirations losses for a man with mass 100 kg:
A. 2400 of ml.
B. 1200 of ml. *
C. 1000 of ml.
D. 1500 of ml.
E. 1600 of ml.
262. Hematokrit 0,5, Sodium – 155 mmol/l. Specify the type of violation of homoeostasis:
A. hypertensive hypohydration. *
B. hypotonic hypohydration.
C. isotonic hypohydration.
D. hypertensive overhydratation.
E. hypotonic overhydratation.
263. Hematokrit 0,5, Sodium – 140 mmol/l. Specify the type of violation of homoeostasis:
A. hypertensive hypohydration.
B. hypotonic hypohydration.
C. isotonic hypohydration. *
D. hypertensive overhydratation.
E. hypotonic overhydratation.
264. Hematokrit 0,3, Sodium – 155 mmol/l. Specify the type of violation of homoeostasis:
A. hypertensive hypohydration.
B. hypotonic hypohydration.
C. isotonic hypohydration.
D. hypertensive to the overhydratation. *
E. hypotonic overhydratation.
265. Choose wrong position which touches sodium lactat:
A. Near 25 % in a norm appears in red corpuscles.
B. Basic place of formation is a liver. *
C. In a liver and in a bark substance of kidneys turns to glucose.
D. Formation diminishes in the case of acidosis.
E. All of answer correct.
266. The use of antiacid preparations can assist to development of acidosis in case:
A. stomach ulcer.
B. long use.
C. chronic nephritic insufficiency. *
D. carrying out of long ALV.
E. all of answer correct.
267. Surplus of bases appears in cases:
A. of the incessant vomiting. *
B. expressed sweaty state.
C. expressed overventilations.
D. fever.
E. all of answer correct.
268. In patient with metabolic alkalosis BE may be:
A. (–5). *
B. 0.
C. 1.
D. 2.
E. all of answer correct.
269. During aging relative amount of water in the body of human is:
A. Increasing.
B. Decreasing. *
C. Staying constant with small oscillations.
D. Staying constant and depends on the fat tissue content.
E. Staying constant and depends on sex.
270. Which statement does correctly describe changes in water amount in the bodies of
people with different amount of fat?
A. People with obesity have related content of water greater, than people with normal or
lowered nourishment. *
B. People with normal or lowered nourishment have greater water content, than people with
obesity.
C. People with normal nourishment have lower related and absolute water content than
people with obesity.
D. Absolute water content is almost equal in all mentioned cases.
E. All answers are incorrect.
271. The concentration of potassium in serum:
A. Increases in case of alkalosis.
B. Ecreases in case of acidosis.
C. Increases in case of acidosis. *
D. Decreases in case of alkalosis.
E. Doesn’t depend on acid-base balance.
272. The main intracellular cat ions are:
A. Na and Ca. *
B. Ca and Cl.
C. K and Mg.
D. K and Cl.
E. Mg and Cl.
273. ECG-signs of hypokaliemia are:
A. Ventricular tachycardia, extrasystolia.
B. Extensive (wide) QRS.
C. Prolongation of P-Q.
D. High, sharp T. *
E. All answers are incorrect.
274. In polarizing solution the best correlation of K and Mg for disorders correction should
be:
A. 1:20.
B. 20:1.
C. 1:8.
D. 8:1. *
E. All answers are incorrect.
275. What is the amount of water loss with urine (normally)?
A. 1 ml/kg/hour. *
B. 2 ml/kg/hour.
C. 0,5 ml/kg/hour.
D. 1,5 ml/kg/hour.
E. 0,8 ml/kg/hour.
276. What is perspiration water loss?
A. Water loss with stool.
B. Water loss with urine.
C. Water loss through skin and breathing passages. *
D. All answers are correct.
E. All answers are incorrect.
277. What is normal perspiration water loss?
A. 1 ml/kg/hour.
B. 2 ml/kg/hour.
C. 0,8 ml/kg/hour.
D. 1,5 ml/kg/hour.
E. 0,5 ml/kg/hour. *
278. What is endogen water?
A. Water, which is generated during protein catabolism.
B. Water, which is generated during fat catabolism.
C. Water, which is generated during fat, protein and carbohydrates catabolism.
D. Intracellular water.
E. All answers are correct. *
279. A sharp respiratory alkalosis can not be investigated in the case of:
A. hemoragic shock.
B. embolism of pulmonary artery.
C. bakteriemia.
D. increase of рН of cerebrospinal liquid. *
E. all of answer correct.
280. At the increase of рН solution from 7,4 to a 8,4 concentration of hydrions:
A. increases in 2 times.
B. decreases in 10 times. *
C. decreases in 2 times.
D. increases in 10 times.
E. all of answer wrong.
281. What value of рН plasma of blood is answered by the concentration of hydrions of 40
nmol/l:
A. 7,0.
B. 7,35.
C. 7,4. *
D. 7,44.
E. 7,6.
282. Choose assertions which touch the buffer systems of organism:
A. hydrogen-carbonate system is contained only in plasma of blood.
B. Except for the hydrogen-carbonate system in plasma of blood there are protein and
phosphatic buffer systems. *
C. hydrogen-carbonate system there is only the buffer system of protein in plasma of blood.
D. in the intracellular liquid the main buffer system is hydrogen carbonate.
E. all of answer correct.
283. Name the drug, which is not used in case of hypercalcemia crises:
A. isotonic solution of NaCl.
B. glucocorticoids.
C. furosemid.
D. calcium gluconate. *
E. sodium salt of EDTA.
284. Electrolytic compositions of interstitial and intravascular liquids mainly differ in amount
of:
A. K.
B. Na. *
C. Cl.
D. Ca.
E. Protein.
285.
A.
B.
C.
D.
E.
Name the most common reason of hypocalcaemia of adults:
Chronic renal insufficiency.
Destructive pancreatitis.
Hepatocirrhosis, alkalosis, hypomagnesaemia.
Surgical damage of parathyroid glands. *
Massive infusions of citrated blood.
286.
A.
B.
C.
D.
E.
The most common reasons of isotonic dehydration are all from the listed below except:
Extra inflow of Na. *
Bowel obstruction.
Bleeding.
Peritonitis.
Wound.
287.
A.
B.
C.
D.
E.
The concentration of ionic Ca increases in case of:
Acidosis.
Alkalosis.
Hypohydration.
Deficiency of Na. *
Acid-base balance doesn’t influence rate of Ca.
288.
A.
B.
C.
D.
E.
The reason of hypotonic dehydration might be everything from the listed below, except:
Insufficiencies of mineral corticoid function of adrenal glands.
Hyper function of adrenal glands.
Diarrhoea with hypertonic stool.
Diarrhoea with Na-poor stool. *
Diseases of kidneys, which damage electrolytes absorption.
289.
A.
B.
C.
D.
E.
In case of isotonic dehydration:
Osmotic pressure of blood plasma is increased. *
Osmotic pressure of blood plasma is decreased.
Osmotic pressure of blood plasma is normal.
CVP is increased.
All answers are correct.
290.
A.
B.
C.
D.
E.
291.
A.
B.
C.
D.
E.
For the correction of isotonic dehydration the best solutions are:
Colloid solutions.
Electrolytic solutions.
Colloid and electrolytic solutions. *
Hypertonic glucose solution.
Isotonic glucose solution
The reasons of hypertonic dehydration might be every, from the listed below, except:
Watery stool of patients with cholera or salmonellas disease.
Inadequate completing of perspiration loss. *
Excessive infusion of hypertonic solution of NaCl.
Osmotic diuresis.
Hypo and isostenuria of patients with kidney diseases.
292.
A.
B.
C.
D.
E.
In case of hypertonic dehydration:
The level of Na is above normal. *
The level of Na is below normal.
The level of Na is normal.
Osmotic pressure of blood plasma is normal.
All answers are correct.
293.
A.
B.
C.
D.
E.
In case of hypertonic dehydration first of all should be infused:
Hypertonic solution of glucose.
Hypertonic solution of NaCl.
Colloid solutions. *
Isotonic solutions of sorbitol, glucose.
All answers are incorrect.