1. What is active form of thyroid hormone?
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1. What is active form of thyroid hormone? A.
Triiodothyronine (T3)
B. Diiodothyronin (T2) C. Thyroxine (T4) D. TSH
E. Thyroid relizing hormone
2. Screening investigations for any newborn before hospital discharge include… A. Work up for TORCH-infections B. Work up for HIV-infection C. Investigation for PKU and hypothyreosis D. Investigation for Lues E. Investigation for diabetes mellitus
3. The following more commonly occurs in Crohn’s disease than ulcerative colitis: A. Erythema nodosum B. Pyoderma gangrenosum C. Uveitis D. Cholangiocarcinoma E. Ankylosing spondyloarthropathy with HLA B27
4. Which of the following factors leads to neonatal hyperbilirubinemia? A. Shortened neonatal red cell life span B. Impaired excretion of unconjugated bilirubin C. Limited conjugation of bilirubin in the liver D. Increased enterohepatic circulation E. All of the above
5. What therapy should be prescribed in the treatment of active phase of acute and chronic pyelonephritis? A. Complex (antibiotic and uroseptic) B. Monotherapy by antibiotics C. Monotherapy by uroseptic D. Phytotherapy E. Physiotherapy
6. A 3-day-old, 28-week-gestational-age infant was weaning from the respirator during the course of moderate to severe respiratory distress syndrome. Intravenous fluids had been increased to 175 ml/kg/24 hours. Today the infant developed mild hypoxia and hypercarbia necessitating higher ventilator settings to maintain normal blood gas values. On physical examination, the precordium is active, the pulse pressure is wide, and a grade 2/6 systolic ejection murmur is auscultated at the upper left sternal border with no radiation. After 24 hours of fluid restriction and diuretic therapy, the respiratory status has not improveD. The most appropriate diagnostic test is
A. Renal ultrasonography B. Echocardiography C. A renal perfusion scan D. An electrocardiogram E. Cardiac catheterization
7. What is the drug of choice to restore sinus rhythm in a patient with AV nodal reentry or orthodromic AV reentry? A. Adenosine B. Procainamide C. Lidocaine D. Digoxin E. Strophanthinum
8. Normal pulmonary function tests with a reduced DLCO (diffusion capacity) would be most suggestive of A. pulmonary emboli ? B. bronchial asthma C. COPD D. interstitial lung disease E. pneumonia
9. What is the feature of localized form of scleroderma? A. sclerodactyly B. telangiectasia C. absence of lesions of proximal extremities and trunk D. Raynaud's phenomenon E. calcinosis
10. Choose the correct order for the steps of hemostasis A. Blood coagulation, platelet plug formation, blood vessel spasm B. Platelet plug formation, blood coagulation, blood vessel spasm C. Blood vessel spasm, platelet plug formation, blood coagulation D. Blood vessel spasm, blood coagulation, platelet plug formation E. Blood coagulation, blood vessel spasm, platelet plug formation
11. Preterm newborns have higher risk of infections because: A. IgM begins to cross placenta after 30 wks. of pregnancy B. They are able to produce IgM at early stages of gestation C. Most IgG transfer occurs after 32 wks. of pregnancy D. Synthesis of IgA does not begin until 38 wks. E. All the above
12. Microbiologic studies are useful in evaluating patients with A. unexplained diarrhea B. abdominal pain C. suspected gastrointestinal infections D. all of the above E. none of the above
13. In the absence of a complicating bacterial infection, which of the following is the most appropriate approach to treating acute bronchitis? A. Prescribing broad-spectrum antibiotics B. Prescribing mucolytics C. Routinely recommending over-the-counter cough and cold preparations D. Providing symptomatic and supportive care E. Discouraging hydration and bed rest
14. Antimicrobial resistance to H. pylori is most likely to occur with which of the following agents? A. Metronidazole and clarithromycin B. Clarithromycin and tetracycline C. Metronidazole and amoxicillin D. Amoxicillin and tetracycline E. Amoxicillin and clarithromycin
15. What per hour increase of serum bilirubin indicates severe course of Rh haemolytic disease and determines the need for exchange transfusion? A. >1 micromol/L B. >3 micromol/L C. >4 micromol/L D. >8 micromol/L E. >17 micromol/L
16. All of the following pathogens are a likely cause of early-onset neonatal sepsis EXCEPT A. Group B streptococcus B. Listeria monocytogenes C. Escherichia coli D. Staphylococcus epidermidis E. Haemophilus influenzae F. Pneumococci
17. Inspection of the abdomen does not disclose signs of A. abdominal inflamation B. abdominal bulges C. abdominal scars D. gout
E. b and c only
18. All the lung volumes can be measured by spirometry except A. tidal volumes B. inspiratory reserve volume C. expiratory reserve volume D. residual volume E. b and c
19. What damage at systemic lupus erythematosus is the most severe for future disability and bad outcome? A. Dermatitis B. Arthritis C. Nephritis
D. Poliserositis E. Vasculitis
20. A 1700-g infant is born at 36 weeks' gestation complicated by severe oligohydramnios. The Apgar scores are 3 at 1 minute and 5 at 5 minutes. The infant requires endotracheal tube placement as part of the resuscitation and continued mechanical ventilation to improve the arterial blood gases. At 1 hour of age, the infant shows acute deterioration with cyanosis, bradycardia, and hypotension. The most likely diagnosis for this acute change is pneumothorax. Which data are the most important for this suspicion? A. Described clinical signs B. Infant’s BW and gestational age C. Endotracheal intubation in the delivery room D. History data and infant’s age E. Pregnancy complicated with severe oligohydramnios.
21. A 15 year old female presents following a sore throat with chest pain, fever, and a skin rash. Examination reveals a diastolic murmur. Her ASO titre is elevateD. Which of the following is a major criterion for the diagnosis of Rheumatic fever? A. Fever B. Raised ESR C. Migratory arthritis D. erythema multiforme E. Prolonged PR interval
22. In ulcerative colitis the diagnosis is confirmed by: A. Ileal involvement B. Crypt abscesses C. Skip lesion D. Granulomas
23. Which of the following test is most helpful in diagnosis of thalassemia? A. Serum iron B. Serum bilirubin C. Bone marrow biopsy D. Hemoglobin electrophoresis E. Serum vitamin B12
24. What are six common etiologies of membranous nephropathies? A. Idiopathic, syphilis, Hepatitis B, SLE, gold salts, and malignancy B. Idiopathic, chronic heart failure, Hepatitis B, SLE, gold salts, and malignancy C. Idiopathic, syphilis, Hepatitis A, SLE, gold salts, and malignancy D. Idiopathic, syphilis, Hepatitis B, SLE, NSAIDs, and malignancy E. Idiopathic, syphilis, Hepatitis B, SLE, gold salts, and bronchial asthma
25. What must be the tactics of the physician in identifying leukocyturia in girls? A. Observation of worms, exclusion vulvovaginitis B. Antibiotic therapy C. Urinoseptics D. Cystoscopy E. Excretory urography
26. CBC of term infant at the age of 12 hrs who was born after 20 hrs of membrane rupture: leukocytes– 14,5 х109/л; eosinophils- 6 %, basophils- 0 %, bands - 5 %, segs - 45 %, lymphocytes - 30 %, monocytes - 14 %. What is immature-to-total neutrophil ratio in this baby? A. 0,33
B. 0,25 C. 0,2
D. 0,1 E. 0,3
27. Which one is the main pathway for vertical transmission of HSV A. Transplacental (antenatal) B. With breast milk (postnatal) C. Air-born (postnatal) D. Contamination (intrapartum) E. Ascending (antenatal)
28. Which of the following is an indication that the endotracheal tube is correctly placed in the trachea and not in the esophagus? A. Continued cyanosis and bradycardia. B. CO2 detector indicates the presence of expired CO2. C. No vapor (mist) is detected in the endotracheal tube. D. Air is heard entering the stomach.
29. The following are known to cause bronchiolitis in infants except: A. Parainfluenza B. Chlamydia C. Mycoplasma D. Streptococcus pneumoniae E. Human metapneumovirus
30. A newborn female has a ventricular septal defect, cleft lip and palate, and imperforate anus. All of the following laboratory tests would be appropriate EXCEPT A. A karyotype analysis B. TORCH titer C. Renal ultrasonography D. Ultrasonography of the brain
31. Nonsteroidal anti-inflammatory drug-induced ulcers differ from H. pylori-associated ulcers in that patients. Are more likely to have with an nonsteroidal anti- inflammatory drug-induced ulcer A. a duodenal ulcer B. more severe upper gastrointestinal bleeding C. ulcer-related epigastric pain D. gastric cancer E. b and c only
32. A patient with lower abdominal pain, no weight loss and normal colonoscopy. The most likely diagnosis is: A. Colonic carcinoma. B. Crohn’s colitis. C. Ulcerative colitis. D. Irritable bowel syndrome
33.
A .Antibodies to foetal red blood cells are present in maternal circulation B. Antibodies to foetal red blood cells are present in newborn circulation C. Complexes antibody-red blood cell are present in newborn circulation D. Complexes antibody-red blood cell are present in maternal circulation E. Any antibodies are present in maternal circulation
34. The preterm newborn by definition is A. Born before completion of 38 weeks of gestation and has BW2500 g B. Born before completion of 37 weeks of gestation (less than 259 days) C. Born before completion of 37 weeks of gestation, has BW2500 g and BL45 cm D. Born before completion of 38 weeks of gestation (less than 267 days) E. Born alive before completion of 38 weeks of gestation (less than 267 days)
35. Community acquired pneumonia is most commonly associated with A. Staphylococcus B. Listeria C. Legionella D. Pneumococcus E. Pseudomonas
36. In the initial development of a disease management program for asthma in your managed-care organization, the primary focus should be A. the provision of an extensive patient education program B. to ensure that all patients do home monitoring of peak flows C. to ensure that your physicians only prescribe the least expensive inhaled corticosteroid D. to limit the frequency of patient consultation with specialists E. to limit using of salbutamol
37. A condition resulting from overstimulation of the blood-clotting mechanism in response to disease or injury. Results in generalized blood coagulation and consumption of coagulation factors. A. Disseminated intravascular coagulation B. Hemophilia A C. Hemophilia B D. von Willebrand’s disease E. Immune thrombocytopenia
38. Pulmonary vascularity is decreased in all of the following except: A. Tetralogy of Fallot B. Pulmonary atresia C. TAPVR D. Tricuspid atresia
39. Which of these is not secreted from the anterior hypophysis? A. Adrenocorticotropic hormone B. Thyroid stimulating hormone C. Oxytocin D. Follicular stimulating hormone E. Lutenising hormone
40. Severe haemophilia A is typically associated with what percentage of factor VIII in the plasma? A. Less than 1% B. 2-5% C. 6-20% D. 21-50% E. 51-70%
41. A baby has been suctioned, dried, and stimulated and still has not initiated breathing efforts. For apparent secondary apnea, what should be done next? A. Begin positive-pressure ventilation. B. Administer free-flow oxygen. C. Intubate and suction the trachea. D. Flick the baby's feet.
42. Which of the following statement best characterizes the current status of drug therapy in the prevention of stress-related mucosal bleeding? A. Large randomized, controlled trials confirm that an intravenous proton pump inhibitor is superior to an intravenous H2-receptor antagonist B. Antacids are the drugs of choice because they are effective and least costly C. Continuous infusion of an H2-receptor antagonist provides similar efficacy as intermittent intravenous administration D. Sucralfate is not effective E. Enzymes have a good clinical effect
43. What kidney structures are the most frequently affected at pyelonephritis? A. kidney glomerulus B. renal tubules C. ureters mucosa D. kidney capsule E. capillaries of the glomeruli
44. In contrast to term infants, the following statement is true regarding physiologic jaundice in the premature infant in the neonatal period: A. Has its onset later, reaches its peak later and has slower resolution B. Has its onset earlier, peaks earlier and has earlier resolution C. Has its onset earlier, peaks later and has slower resolution D. Has its onset later, reaches its peak earlier and has slower resolution E. Has its onset earlier, peaks earlier and has faster resolution
45. Which is the most important and effective action in a neonate requiring resuscitation? A. Provide oxygen B. Perform chest compressions C. Ventilate the lungs D. Give epinephrine
46. Which of the following are often associated with renal transplant rejection? A. Increased serum creatinine, increased urine output, increased tacrolimus concentration, decreased weight B. Increased serum creatinine, increased urine output, decreased cyclosporine concentration, decreased weight C. Increased serum creatinine, decreased urine output, increased cyclosporine concentration, decreased weight D. Increased serum creatinine, decreased urine output, decreased tacrolimus concentration, increased weight E. Increased serum creatinine, increased weight
47. A 42-week-gestational-age, 3600-g, breast-fed, white female is noted to have persistent hyperbilirubinemia at 2 weeks of age. On physical examination, the infant has not gained weight since birth and has decreased tone, an umbilical hernia, and an anterior fontanel measuring 4 x 6 cm. The most likely diagnosis is A. Crigler-Najjar syndrome B. Gilbert disease C. Biliary atresia D. Hypothyroidism E. Galactosemia
48. What symptom is characterized for tubulointerstitial nephritis? A. Bacteriuria B. Hipoizostenuriya C. Hypertension D. Dysuria E. Nocturia
49. What should we have to do firstly to diagnose pyelonephritis of pregnant 17-years old patient? A. Retrograde urography B. Excretory urography C. Cystoscopy D. Radiologic examination E. Chromocystoscopy
50. Which of the following signs and symptoms is unlikely to be associated with nausea? A. Joint pain B. Weight loss C. Diarrhea D. Fever E. B and c only
51. Which products should not be recommended at hyperoxaluria? A. apples, grapes, pears, apricots B. cooked meat, fish C. potatoes, cabbage, cucumber D. buckwheat, oats, wheat cereals E. sorrel, beans, cheese
52. Which medication should be avoided in thyroid storm? A. b-blockers B. Glucocorticosteroids C. Insulin D. Lugol’s solution E. ASA
A. Antibodies to foetal red blood cells are present in maternal circulation B. Antibodies to foetal red blood cells are present in newborn circulation C. Complexes antibody-red blood cell are present in newborn circulation D. Complexes antibody-red blood cell are present in maternal circulation E. Any antibodies are present in maternal circulation 54. W hich of the following nonpharmacologic therapies is not recommended for patients with
diastolic heart failure? A. isometric exercise B. judicious fluid restriction C. moderate sodium restriction D. low-fat diet E. all of the above
55. Reducing the volume of gallbladder bile two times after breakfast testifies: A. Dyskinesias by hypermotoric function B. Dyskinesias by hypomotoric function C. Normal tonus D. The inflammatory process in the gallbladder E. Cholangitis
56. W hich of the following is most true regarding renal transplantation? A. Renal transplantation is a reasonable option for all patients with end-stage renal disease B. Quality of life improves following renal transplantation C. HIV positivity is an absolute contraindication to renal transplantation D. Patients with polycystic kidney disease should be excluded from renal transplantation E. A and d only
57. W hich of the following agents reduces nausea and vomiting by increasing lower esophageal sphincter tone and improving gastric emptying? A. Diazepam B. Granisetron C. Diphenhydramine D. Metoclopramide E. Drotaverine
58. A 3-day-old, 28-week-gestational-age infant was weaning from the respirator during the course of moderate to severe respiratory distress syndrome. Intravenous fluids had been increased to 175 ml/kg/24 hours. Today the infant developed mild hypoxia and hypercarbia necessitating higher ventilator settings to maintain normal blood gas values. On physical examination, the precordium is active, the pulse pressure is wide, and a grade 2/6 systolic ejection murmur is auscultated at the upper left sternal border with no radiation. After 24 hours of fluid restriction and diuretic therapy, the respiratory status has not improveD. The most appropriate diagnostic test is
A. Renal ultrasonography B. Echocardiography C. A renal perfusion scan D. An electrocardiogram E. Cardiac catheterization
59. S elect the appropriate feeding method for the preterm baby with a corrected age of 29 wks in satisfactory condition A. Breastfeeding B. Feeding tube C. Bottle feeding D. Cup feeding E. Spoon feeding
60. I ndicate neonatal lung disease which is usually associated with perinatal asphyxia A. Pneumonia B. Transient tachypnea of newborn C. Meconium aspiration syndrome D. Pneumothorax E. Lung oedema
61. I n contrast to term infants, the following statement is true regarding physiologic jaundice in the premature infant in the neonatal period: A. Has its onset later, reaches its peak later and has slower resolution B. Has its onset earlier, peaks earlier and has earlier resolution C. Has its onset earlier, peaks later and has slower resolution D. Has its onset later, reaches its peak earlier and has slower resolution E. Has its onset earlier, peaks earlier and has faster resolution
62. P hototherapy effectiveness is based on A. Radiance energy B. Level of photooxidation C. Ability to convert indirect bilirubin into water-soluble forms D. Answers A,B,C E. Ability to stimulate glucuroniltransferase
63. W hich of the following agents reduces nausea and vomiting by increasing lower esophageal sphincter tone and improving gastric emptying? A. Diazepam B. Granisetron C. Diphenhydramine D. Metoclopramide E. Drotaverine
64. W hat non-specific tests are often abnormal for hypothyroidism? A. Anemia, increased cholesterol, triglycerides B. Anemia, increased urea, creatinine C. Anemia, decreased cholesterol, increased liver enzyme D. Anemia, increased glucose level E. Anemia, hyperproteinemia
65. T he most suggestive pulmonary function for neuromuscular disease is A. a reduction in the total lung capacity (TLC) B. a flat flow-volume loop C. a reduced force vital capacity (FVC) Yüklə 0,62 Mb. Dostları ilə paylaş:
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