51). A 27 year old man complains of pains in epigastrium which are relieved by food intake.
EGDFS shows antral erosive gastritis, biopsy of antral mucous presents Hеlicobacter Pylori.
Diagnosis is:
A. Gastritis of type B
B. Gastritis of type A
C. Reflux-gastritis
D. Menetrier’s gastritis
E. Rigid antral gastritis
Mnemonic:
Autoimmune gastritis type A = Autoimmune (Atrophy)
Autoimmune gastritis type B = Bacteria (H. pylori)
Autoimmune gastritis type C = Chemical (Bile)
52). A 75 year old man who has been suffering from diabetes for the last six months was found
to be jaundiced. He was asymptomatic except for weight loss at the rate of 10 pounds in 6
months. Physical examination revealed a hard, globular, right upper quadrant mass that moves
during respiration. A CT scan shows enlargement of the head of the pancreas, with no filling
defects in the liver. The most likely diagnosis is:
A. Carcinoma of the head of the pancreas
B. Infectious hepatitis C. Haemolytic jaundice
D. Malignant biliary stricture
E. Metastatic disease of liver
Explanation: Elderly is risk factor. weight is alarm sign for cancer. On examination, hard, globular mass which move during respiration . CT scan shows enlargement of the head of the pancreas that indicate cancer.
53). A 22 year old woman complained of right subcostal aching pain, nausea, and decreased
appetite. She fell ill 2 months after appendectomy when jaundice appeared. She was treated in
an infectious hospital. 1 year later above mentioned symptoms developed. On exam: the
subicteric sclerae, enlarged fi- rm liver. Your preliminary diagnosis:
A. Chronic viral hepatitis
B. Calculous cholecystitis
C. Gilbert’s disease
D. Acute viral hepatitis
E. Chronic cholangitis
Explanation:Chronic hepatitis is inflammation of the liver that lasts at least 6 months. Common causes include hepatitis B and C viruses and certain drugs. Many people have no symptoms, but some have vague symptoms, such as a general feeling of illness, poor appetite, fatigue and sign of jaundice.
54). A male patient, 60 years old, tobacco smoker for 30 years, alcoholic, has dysphagia and
weight loss since 4 months. Suggested diagnosis?
A. Cancer of the esophagus
B. Esophageal achalasia
C. Hanter’s disease
D. Esophagitis
E. Esophageal diverticulum
Explanation: Elderly, tabacco, alcoholism is risk factor of developing cancer, dysphasia and weight loss is alarm sigh of esophageal cancer.
55). A healthy 75 year old woman who leads a moderately active way of life went through a
preventive examination that revealed serum concentration of common cholesterol at the rate
of 5,1 millimole/l and HDL (high-density lipoproteins) cholesterol at the rate of 70 mg/dl. ECG
reveals no pathology. What dietary recommendation is the most adequate?
A. Any dietary changes are necessary
B. Decrease of cholesterol consumption
C. Decrease of saturated fats consumption
D. Decrease of carbohydrates consumption
E. Increase of cellulose consumption
Explanation: Given condition everything is normal so Any dietary changes are necessary.
56). A 54 year old male patient complains about permanent dull pain in the mesogastral region,
weight loss, dark blood admixtures in the feces, constipations. He put off 10 kg within a year. In
blood: erythrocytes: 3, 5·1012/l, Hb- 87 g/l, leukocytes - 12, 6 · 109/l, stab neutrophil shift, ESR-
43 mm/h. What is the most probable diagnosis?
A. Cancer of transverse colon
B. Gastric ulcer
C. Chronic colitis
D. Chronic pancreatitis
E. Stomach cancer
Explanation: Mesogastral region is middle portion of stomach transverse colon located at that region. Weight loss and bleeding is alarm sign of cancer. elder patient more vulnerable to have cancer.
57). A 32 year old patient suffering from chronic viral hepatitis complains about dull pain in the
right subcostal area, nausea, dry mouth. Objectively: liver dimensions are 13-21-11 cm
(according to Kurlov), spleen is by 2 cm enlarged, aspartate aminotransferase is 3,2
micromole/l·h, alanine aminotransferase - 4,8 millimole/l·h. Serological study revealed HBeAg,
high concentration of DNA HBV . What drug should be chosen for treatment of this patient?
A. α-interferon
B. Acyclovir
C. Remantadinum
D. Arabinoside monophosphate
E. Essentiale-forte
Explanation: α-interferon is used to treat chronic viral hepatitis.
58). A 41 year old woman has suffered from nonspecific ulcerative colitis for 5 years. On
rectoromanoscopy: evident inflammatory process of lower intestinal parts, pseudopolyposive
changes of mucous membrane. In blood: WBC- 9, 8 · 109/l, RBC- 3, 0 · 1012/l, ESR - 52
mm/hour. What medication provides pathogenetic treatment of this patient?
A. Sulfosalasine
B. Motilium
C. Vikasolum
D. Linex
E. Kreon
Explanation: Drug of choice for nonspecific Ulcerative colitis is sulfasalizine.
59). A patient suffering from gastroesophageal reflux has taken from time to time a certain
drug that "reduces acidity"for 5 years. This drug was recommended by a pharmaceutist. The
following side effects are observed: osteoporosis, muscle weakness, indisposition. What drug
has such following effects?
A. Aluminium-bearing antacid
B. Inhibitor of proton pump
C. 2-blocker
D. Metoclopramide
E. Gastrozepin
Explanation: Antacid used to treat GERD. which neutralize gastric acid. osteoporosis, muscle asthenia, indisposition are side effect of Aluminium-bearing antacid.
60). A 20-year old woman has a 3-4 month history of bloody diarrhoea; stool examination
proved negative for ova and parasites; stool cultures negative for clostridium, campylobacter
and yersinia; normal small bowel series; edema, hyperemia and ulceration of the rectum and
sigmoid colon seen on sigmoidoscopic examination. Select the most likely diagnosis:
A. Ulcerative colitis
B. Gastroenteritis
C. Carcinoid syndrome
D. Zollinger-Ellison syndrome
E. Granulomatous colitis
Explanation: ulcerative colitis is a chronic inflammatory disease of the colon and rectum , which develops starting from the rectum. Symptoms include bloody diarrhoea, pain during defication , rectal and sigmoid colon ulceration.
part 7
EGDFS shows antral erosive gastritis, biopsy of antral mucous presents Hеlicobacter Pylori.
Diagnosis is:
A. Gastritis of type B
B. Gastritis of type A
C. Reflux-gastritis
D. Menetrier’s gastritis
E. Rigid antral gastritis
Mnemonic:
Autoimmune gastritis type A = Autoimmune (Atrophy)
Autoimmune gastritis type B = Bacteria (H. pylori)
Autoimmune gastritis type C = Chemical (Bile)
52). A 75 year old man who has been suffering from diabetes for the last six months was found
to be jaundiced. He was asymptomatic except for weight loss at the rate of 10 pounds in 6
months. Physical examination revealed a hard, globular, right upper quadrant mass that moves
during respiration. A CT scan shows enlargement of the head of the pancreas, with no filling
defects in the liver. The most likely diagnosis is:
A. Carcinoma of the head of the pancreas
B. Infectious hepatitis C. Haemolytic jaundice
D. Malignant biliary stricture
E. Metastatic disease of liver
Explanation: Elderly is risk factor. weight is alarm sign for cancer. On examination, hard, globular mass which move during respiration . CT scan shows enlargement of the head of the pancreas that indicate cancer.
53). A 22 year old woman complained of right subcostal aching pain, nausea, and decreased
appetite. She fell ill 2 months after appendectomy when jaundice appeared. She was treated in
an infectious hospital. 1 year later above mentioned symptoms developed. On exam: the
subicteric sclerae, enlarged fi- rm liver. Your preliminary diagnosis:
A. Chronic viral hepatitis
B. Calculous cholecystitis
C. Gilbert’s disease
D. Acute viral hepatitis
E. Chronic cholangitis
Explanation:Chronic hepatitis is inflammation of the liver that lasts at least 6 months. Common causes include hepatitis B and C viruses and certain drugs. Many people have no symptoms, but some have vague symptoms, such as a general feeling of illness, poor appetite, fatigue and sign of jaundice.54). A male patient, 60 years old, tobacco smoker for 30 years, alcoholic, has dysphagia and
weight loss since 4 months. Suggested diagnosis?
A. Cancer of the esophagus
B. Esophageal achalasia
C. Hanter’s disease
D. Esophagitis
E. Esophageal diverticulum
Explanation: Elderly, tabacco, alcoholism is risk factor of developing cancer, dysphasia and weight loss is alarm sigh of esophageal cancer.
55). A healthy 75 year old woman who leads a moderately active way of life went through a
preventive examination that revealed serum concentration of common cholesterol at the rate
of 5,1 millimole/l and HDL (high-density lipoproteins) cholesterol at the rate of 70 mg/dl. ECG
reveals no pathology. What dietary recommendation is the most adequate?
A. Any dietary changes are necessary
B. Decrease of cholesterol consumption
C. Decrease of saturated fats consumption
D. Decrease of carbohydrates consumption
E. Increase of cellulose consumption
Explanation: Given condition everything is normal so Any dietary changes are necessary.
56). A 54 year old male patient complains about permanent dull pain in the mesogastral region,
weight loss, dark blood admixtures in the feces, constipations. He put off 10 kg within a year. In
blood: erythrocytes: 3, 5·1012/l, Hb- 87 g/l, leukocytes - 12, 6 · 109/l, stab neutrophil shift, ESR-
43 mm/h. What is the most probable diagnosis?
A. Cancer of transverse colon
B. Gastric ulcer
C. Chronic colitis
D. Chronic pancreatitis
E. Stomach cancer
Explanation: Mesogastral region is middle portion of stomach transverse colon located at that region. Weight loss and bleeding is alarm sign of cancer. elder patient more vulnerable to have cancer.
57). A 32 year old patient suffering from chronic viral hepatitis complains about dull pain in the
right subcostal area, nausea, dry mouth. Objectively: liver dimensions are 13-21-11 cm
(according to Kurlov), spleen is by 2 cm enlarged, aspartate aminotransferase is 3,2
micromole/l·h, alanine aminotransferase - 4,8 millimole/l·h. Serological study revealed HBeAg,
high concentration of DNA HBV . What drug should be chosen for treatment of this patient?
A. α-interferon
B. Acyclovir
C. Remantadinum
D. Arabinoside monophosphate
E. Essentiale-forte
Explanation: α-interferon is used to treat chronic viral hepatitis.
58). A 41 year old woman has suffered from nonspecific ulcerative colitis for 5 years. On
rectoromanoscopy: evident inflammatory process of lower intestinal parts, pseudopolyposive
changes of mucous membrane. In blood: WBC- 9, 8 · 109/l, RBC- 3, 0 · 1012/l, ESR - 52
mm/hour. What medication provides pathogenetic treatment of this patient?
A. Sulfosalasine
B. Motilium
C. Vikasolum
D. Linex
E. Kreon
Explanation: Drug of choice for nonspecific Ulcerative colitis is sulfasalizine.
59). A patient suffering from gastroesophageal reflux has taken from time to time a certain
drug that "reduces acidity"for 5 years. This drug was recommended by a pharmaceutist. The
following side effects are observed: osteoporosis, muscle weakness, indisposition. What drug
has such following effects?
A. Aluminium-bearing antacid
B. Inhibitor of proton pump
C. 2-blocker
D. Metoclopramide
E. Gastrozepin
Explanation: Antacid used to treat GERD. which neutralize gastric acid. osteoporosis, muscle asthenia, indisposition are side effect of Aluminium-bearing antacid.
60). A 20-year old woman has a 3-4 month history of bloody diarrhoea; stool examination
proved negative for ova and parasites; stool cultures negative for clostridium, campylobacter
and yersinia; normal small bowel series; edema, hyperemia and ulceration of the rectum and
sigmoid colon seen on sigmoidoscopic examination. Select the most likely diagnosis:
A. Ulcerative colitis
B. Gastroenteritis
C. Carcinoid syndrome
D. Zollinger-Ellison syndrome
E. Granulomatous colitis
Explanation: ulcerative colitis is a chronic inflammatory disease of the colon and rectum , which develops starting from the rectum. Symptoms include bloody diarrhoea, pain during defication , rectal and sigmoid colon ulceration.
part 7
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