A worker who undergoes regular medical check-up for duodenal ulcer received a subsidized 24day sanatorium voucher from his plant. The term of annual leave of a worker is 24 calender days, it will take 4 days more to get to the sanatorium and back home. What is the procedure of obtaining a 4-day sick-leave?

During a regular medical examination at a metallurgical plant 20¥% of workers were found overweight (body weight was 5-14¥% higher than normal), and had early signs of obesity (grade I-II) with Quetelet index from 26 to 30. What products share must be reduced in the diet of this group of people in the first place in order to normalize their body weight?

District physician was charged with plan drafting concerning medical and preventive measures among the population in the area he is assigned to. What measures must he include in this plan as regards primary prevention of illness?

A patient undergoes inpatient treatment with the diagnosis of acute pancreatitis. To spare pancreas as much as possible the doctor prescribed for him starvation for 1-3 days. What products is the patient allowed to eat during recovery period after cancelling of starvation?

Clinic of a research instutute for occupational diseases examined a worker who works at a concentration plant and diagnosed him with chronic dust bronchitis. The case is investigated by a commission including the representatives of: the plant, clinic, territorial SES, department of Social Insurance Fund, trade union. According to the "regulation on investigation of…", the commission should be headed by the representative of the following authority:

Head of a department and a trade-union group have appealed to the head of a hospital about dismissal of the senior nurse who has 17-year record of service. The facts of charge were confirmed and recognized by the nurse herself. The nurse lives with a daughter (who is divorced and unemployed) and a 9-month-old grandson. Make an administrative decision:

A district doctor was commisioned with a task to work out a plan of treatment-and-prophylaxis actions for the population of his district. What actions of secendary prophylaxis must he include into this plan?

A plot of land with total area of 2,0 hectare was intended for building of a hospital. The maximal capacity of the hospital will be:

At's planned to construct multifield a new hospital in one of the cental city districts. What building type is the most appropriate in this case?

In the current year general practitioners of the municipal polyclinic have referred 11 patients with coronary artery disease to the in-patient hospital. In 3 cases the diagnosis wasn't confirmed. What managerial decision shoud be made in such case?

350 workers of a metalurgical plant had to undergo a yearly preventive examination. A territorial polyclinic carried out preventive examination of 325 workers. As a result of it, 1 worker was recognized as temporarily disabled, 15 workers underwent further rehabilitation at an after-work sanatorium, 10 workers were provided with diet meal. What index characterizing the preventive work of the polyclinic should be applied in this case?

The head of prenatal care department intends to complete expert evaluation of compliance with medical and technological standards of pregnancy follow-up. What documents must be verified for this purpose?

It is planned to make complete isolation boxes in the infectious department in order to prevent nosocomial airborne infections. The boxes consist of a tambour, a ward and a lock chamber. What structure should be also included in a complete isolation box?

Public nurseries are designed as a single or several one- or two-storey buildings linked by covered walkways. Planning the structure of preschool instiutions is based upon the following principle:

A 46-year-old patient once took part in elimination of breakdown at an atomic power plant. Currently he is being treated at an in-patient hospital. He was diagnosed with progressing vegetative insufficiency. This disease relates to the following group of ionizing radiation effects:

25 children at the age of 2-3 years who don't attend any child welfare institutions should be observed by a district pediatrician within the current year. How many initial visits of this group of children should be planned?

What guarantees against the preconceived attitude to the physician in cases of professional law violations do you know?

At the radiological unit of the hospital , gamma-devices of radiotherapy of "Agat" type and other closed sources of ionizing radiation are used for treatment of malignant neoplasms. What are the measures to be taken to protect personnel at the time of work with radioactive sources of such type?

A patient consulted a doctor about acure respiratory viral infection. The patient was acknowledged to be off work. The doctor issued him a medical certificate for 5 days. The patient is not recovering. What measures should the doctor take in order to legalize the further disability of patient?

A patient who has been consuming refined foodstuffs for a long time complains about headache, fatiguability, depression, insomnia, irritability. Objectively: muscle asthenia, pain and cramps in the gastrocnemius muscles, during walking the patient lands onto his heel first, then on the external edge of foot. Cardiovascular system exhibits tachycardia, hypoxia, dystrophic changes of myocardium. There are also gastrointestinal disorders. What is the most likely diagnosis?

The institutions which take part in carrying out medical examinations can be prevention and treatment facilities, medical board of Ministry of Defense, medical board of Ministry of Home Affairs, medico-social expert commissions, forensic medical boards etc. What institutions are responsible for temporary disability examination?

A student lives in the modern house in the flat with a complete set of sanitary equipment (WC, bath, shower, local water heater). How much water consumption has he got?

In a forest summer camp children have variable procedures to harden their organisms. What procedure has the most hardening power?

Among the inhabitants of a workmen's settlement located near an industrial plant the cases of nervous and endocrine system diseases as well as renal diseases became more frequent. Blood analyses revealed a decrease in sulfhydryl groups. These pathologies might have been caused by the following substance released into the environment:

Preventive examination of an 11 year old boy helped to determine his habitus type. It was established that the child's shoulders were deviated and brought forward, with forward flexion of head, the thorax was flattened, abdomen was convex. The child's backbone had signs of deepened cervical and lumbar curvatures. What habitus is it?

A 33 y.o. patient, works as a secretary. Her diet contains 150 g of protein (including 100 g of animal protein), 200 g of fat, 600 g of carbohydrates. What pathology can result from this diet?

Analysis of organization of medical care in a regional centre has shown that every year about 12¥% of patients receive inpatient care for diseases that don't require round-the-clock monitoring and intensive care. What are the most appropriate organizational changes required to address this problem?

It is required to analyze the level of daylight illumination in a ward of therapeutics unit. What device should be applied to estimate the level of daylight illumination?

According to results of medical and pedagogical observation during the gymnastics lesson in the 9th grade there was plotted a phisiological curve characterized by gradual increasing of pulse rate during the opening part of lesson, 80% increase during the main part; the curve has 4 waves. How can the lesson's structure be assessed?

A mother who is on partially paid maternity leave got sick and was hospitalized. What document is to be issued to a working father who will be taking care of a child during his mother's illness?

An employee had an abortion by medical indications on the 6.03.2001 and she stayed in a hospital till 17.03.2001. What term is the medical sick-list issued for?

During hygienic examination of a hospital it was established that the area for each bed in a double ward was: in the infectious department for children - 7 м2, in the infectious department for adults - 8м2, in the burns department - 9 м2, in the radiological department - 10 м2, in the critical care department - 13 м2. In which wards the area for each bed doesn't correspond with hygienic requirements?

A 15 year old adolescent was taken to the hospital with complaints of poor night vision. Objectively: increased darkness adaptation time, Bitot's spots on conjuctiva. The patient's skin is dry, scales off, folliculitis signs of the face skin are present. What is the cause of this disease?

Clinical and statistical study was devoted to the effect of a new pharmacological medication upon the patients with coronary heart disease. What parametric criterion (coefficient) can be used for estimation of results validity?

As a result of prophylactic medical examination a 35 year old woman was diagnosed with alimentary and constitutive obesity of the III degree. It is known from her anamnesis that the patient doesn't observe rules of rational nutrition: she often overeats, the last food intake is usually 10-15 minutes before going to bed, prefers fattening and rich in carbohydrates food. What is the main alimentary risk factor of obesity development?

During the periodic medical examination an assembly fitter (works on soldering details) didn't report any health problems. Closer examination revealed signs of asthenic-vegetative syndrome. Blood included red blood cells with basophilic aggregations and a somewhat higher number of reticulocytes, urine had a high concentration of delta-aminolevulinic acid. The complex of symptoms indicates the initial stage of chronic intoxication with:

Head of a department and a trade-union group have appealed to the head of a hospital about dismissal of the senior nurse who has 17 year record of service. The facts of charge were confirmed and recognized by the nurse herself. This nurse lives with a daughter (who is divorced and unemployed) and a 9-month-old grandson. Make an administrative decision:

In treatment and prevention establishments, regardless of their organisational and proprietary form, the rights of patients should be observed. Which of these rights is the most significant?

A patient is on the sick leave for 4 months continuously from the date of injury. The treatment is going to last for 1-2 months. Who has the right to extend the duration of medical certificate for this patient?

A 2 year old child has been ill with acute respiratory viral infection of upper thrice a year - in February, in April and in December. How should these occurences be recorded?

A factory's sectorial doctor selects a group of persons who often fall ill for thorough monitoring. At the same time he takes into consideration the number of etiologically related cases with temporary disability in each of the employees over the last year. An employee falls into this group if the number of sickness cases is:

The amount of ultraviolet radiation dose was measured in minutes. What device was applied for measurement of the biodose?

A 46-year-old patient was issued a 10-day sick list because of exacerbation of chronic cholecystitis. The patient's general condition got better, but the clinical manifestations of the disease are still present. What authority is entitled to extend the sick list?

A 37 year old patient applied to a local therapeutist. As a result of exacerbation of chronic obstructive bronchitis the patient had been temporarily disabled for 117 days within 1 year. What tactics will be legally correct?

A military unit stopped for 3-day's rest in an inhabited locality after a long march. The sanitary-epidemiological reconnaissance found several water sources. It is necessary to choose the source complying with the hygienic standards for drinking water in the field conditions:

There is a dynamic growth of number of congenital abnormalities such as central paralysis, newborns blindness, idiocy among the population that lives near to pesticides production enterprise. Compounds of which pollutant can cause the development of this pathology?

A pupil of the 8th form after trauma has acute atrophy of the left arm muscles, tonus of which is distinctly decreased, active movements are only in the left joint, pupil's foot is deformed. Function of support of the left leg is absent, support function of the right leg is preserved. The boy wears an orthopedic footwear. What group of physical training does the boy belong to?

In terms of megacalorie (1000 kcal = 4184 kJ) the ration of an adult includes 30 g of proteins, 37 g of fats, 137 g of carbohydrates, 15 mg of vitamin C, 0,6 mg of thiamine (vitamin B1). The ration is UNBALANCED as to the contents of:

In a rural health district a child died in the first month of life. In order to analyze this situation it was necessary to complete expert evaluation of medical records. Which medical document was analyzed in the first place?

A laboratory obtained a milk sample sent for analysis. Analysis gave the following data: color - whitish, smell - has no pecularities, taste - typical for milk, density - 1,038, acidity - Turner's 350 , fat - 3,2%. What is the quality level of this milk?

Maximum permissible concentration of carbon dioxide in the air is considered to be a sanitary index of air purity in a classroom. What concentration of carbon dioxide in the air is accepted as maximum permissible?

Study of actual diet of an adult revealed the following: proteins make up 16% of energy value of daily ration, fats - 25%, carbohydrates - 59%. Evaluate compliance of protein, fat and carbohydrate share in the energy value of daily ration with the recommended shares of these nutrients?

Basing upon the data of laboratory assessment of sanitary state of soil in a certain territory, the soil was found to be low-contaminated according to the sanitary indicative value; contaminated according to the coli titer; low-contaminated according to the anaerobe titer (Cl. Perfringens). This is indicative of:

An employee of a private company was ill with acute respiratory viral infection. Consulted a district doctor, who determined the fact of temporary loss of working ability, but refused to issue a sicklist, arguing that the patient worked in the private and not state-owned company. Should the sicklist be issued to the employees of private companies?

At the radiological unit of a hospital gamma-devices of radiotherapy of "Agat" type and other closed sources of ionizing radiation are used for treatment of malignant neoplasms. What measures are to be taken to protect personnel during working with radioactive sources of such type?

A general practitioner visited a 2-year-old child and diagnosed him with measles. The child attends a nursery, has a 5-year-old sister. What document must be filled in for the effective antiepidemic measures in the given health locality?

A 5 tons milk batch was sampled. The lab analysis revealed: fat content 2%, specific density - 1,04 g/cm3, acidity - 210Т, reductase probe - weak-positive. What way is the product to be used in?

A sample of milk was taken for testing from a 5 ton milk batch. Lab analysis showed the following: fat content 2%, specific density- 1,04 g/cm3 , acidity 210C, reductase probe – weak positive. What way the product is to be used in? What would you advise?

Patient with thyreotoxicosis is in the 2 beds hospital ward of therapeutic department. The area of the ward is 18 m2 , height 3 m, ventilation rate 2,5/hr. Air temperature - 200С, relative humidity - 45%, air movement velocity - 0,3 m/s, light coefficient - 1/5, noise level - 30 dB. Do hygienic evaluation of the conditions meet the standards?

In an urban settlement situated on the riverbank, an outbreak of hepatitis A was registered. The disease might have water origin. This assumption can be confirmed by growth of the following values of water quality:

A maternity hospital registered 616 live births, 1 stillbirth, 1 death on the 5th day of life over a 1 year period. What index allows the most precise estimation of this situation?

A factory worker has ARD complicated by acute bronchitis. He receives treatment in the outpatient setting. The attending doctor has issued him a medical certificate for 5 days and then extended its duration by 5 more days. Patient can't get down to work because of his health status. Who should extend the duration of medical certificate for this patient?

A children's health camp received a party of tinned food. External examination of the tins revealed that they had deep dents; formed a concavity when pressed and didn't immediately return to the initial state; rust was absent; the tins were greased with inedible fat. Specify the bloat type:

A painter working at a motorcar plant was diagnosed with acute intoxication with amide compounds of benzene, moderate severity grade. The in-patient treatment resulted in considerable health improvement. What expert decision should be made in this case?

What is the maximum duration of medical certificate in case of tuberculosis?

25 unorganized children in the age 2-3 year will be observed on a pediatric district it in the current year. What scheduled number of initial visitations will make to this group of children?

A patient who had eaten mushrooms in the morning was delivered to the infectious diseases hospital at night. The disease development was rapid. The patient presented with stomach pain, frequent diarrhea, intractable vomiting, burning thirst, headache and dizziness. He died on the third day. What mushrooms are most likely to have caused mycetismus?

The total area of a ward at the therapeutical department is 28 m2. What is the maximum number of beds that can be exploited in this ward?

While making sanitary examination of burn unit for adults it was stated that wards for 4 persons are of 28 m2 square. What should be the minimum ward area in this unit?

District doctor of rural medical department was called to a 42-year-old patient. While examining the patient, the doctor suspected the dysentery. What document must the doctor issue?

It is planned to organize a rural outpatient clinic. The patients will be able to visit the doctors of the following specialities:

Carpathian region is characterized by permanently high (over 80%) air humidity. In the cold season the population of this region feels very cold at moderately low temperatures. This is due to an increase in the heat transfer by:

The institutions which take part in medical examinations can be prevention and treatment facilities, medical board of Ministry of Defense, medical board of Ministry of Home Affairs, medico-social expert commissions, forensic medical boards etc. What institutions are responsible for temporary disability examination?

Over a current year among workers of an institution 10% haven't been ill a single time, 30% have been ill once, 15% - twice, 5% - 4 times, the rest - 5 and more times. What is the percentage of workers relating to the I health group?

An engineer-chemist at the age of 47 often fells ill with an occupational skin disease. Who makes a decision to transfer him to other job accepts?

On medical observation a doctor identified girl (162 cm tall and 59 kg weight) who complained loss of ability to see surrounding objects clearly in the evening. On examination: dry skin, hyperkeratosis. Her daily ration includes the following vitamines: vitamine А– 0,5 mg, vit.В1– 2,0 mg, vit.В2– 2,5 mg, vit.В6– 2 mg, vit.С– 70 mg. What is the hypovitaminosis type?

Working conditions of a building company worker are characterized by cooling microclimate effect, silica-containing dust, caustic alkali (quicklime) and noise. What medical expert should be the chief of the commission that periodically examines the workers of the mentioned category?

Thyreotoxicosis patient is in the two-place hospital ward of therapeutic department. The area of the ward is 18 m2 , height is 3 m, ventilation rate is 2,5/h. Air temperature is 200С, relative humidity is 45%, air movement velocity is 0,3 m/sec, light coefficient is 1/5, noise level constitutes 30 dB. Make a hygienic assessment of these conditions.

An employee has been diseased for 4 months, further treatment is necessary, the patient is incapacitated. Who is authorized to provide further disability examination of this patient?

A worker diagnosed with "acute dysentery" was sent to the infectious department by a doctor of aid post. What document should be used for registration of this disease?

The major repair of a hospital included renewal of colour design of hospital premises because it is of great psychological and aesthetical importance; and so the walls of patient wards will be painted under consideration of:

A mineshaft is situated on the territory of homestead land, it is 20 m away from the house, 10 m - from the toilet and 15 m - from the neighbour's house. What is the smallest distance that, according to the sanitary code, should be established between the well and the source of probable water pollution?

The outpatient department of a city hospital works also as a 60-bed day hospital for somatic patients. The department operates in a single-shift mode. What specialist selects patients for admission to the day hospital?

A patient with high temperature came to a first-aid post in the evening. The fact of temporary disability was established. Indicate the order of examination in this case:

A 50-year-old male suburbanite underwent treatment in rural outpatient clinic for pneumonia. The treatment didn't have effect and the disease got complicated by exudative pleuritis. What prevention and treatment facility should the patient be referred to for further aid?

An outbreak of food poisoning was recorded in an urban settlement. The illness was diagnosed as botulism on the grounds of clinical presentations. What foodstuffs should be chosen for analysis in the first place in order to confirm the diagnosis?

An employee has been invalid for 6 months as a result of a hip fracture. Who has the right to authorize the issue of the medical sick-list for the last 2 months?

A family lives in the town situated within the zone of radiation pollution. A 6-year-old child had been ill with ARVI for 19 days. The child was undergoing outpatient treatment and was nursed by his mother, a cafe worker. Specify the order of disability examination:

At first appointment with an obstetrician-gynaecologist a pregnant woman is referred to other medical specialists. She must be obligatory examined by the following specialists:

Indicate the registration medical document for the patient, who 21.02. was addressed to the doctor with diagnosis ARVD for the first time in this year:

In order to reduce weed growth on agricultural land, some herbicides have been used for a long time. In terms of environmental stability these herbicides are rated as stable. Specify the most likely route of their entry into the human body:

Chief physician of a polyclinic encharged a district doctor with a task to determine the pathological prevalence of disease N in his district. What document allows to estimate the disease prevalence in the population of a medical district?

A department chief of an in-patient hospital is going to inspect resident doctors as to observation of medical-technological standards of patient service. What documentation should be checked for this purpose?

A 42 year old metalworker has been working at the turning machine for production of heavy large-size parts for 5 years. His work requires using of hand and pedal levers that involves considerable physical force. What means for osteoarthrosis prevention should be recommended?

Workers of fishery are subjected to low temperatures of the air (from 5 till 150C). Diseases of what organs and systems are the most frequent among workers of such enterprises?

A worker was temporarily off work because of illness for 16 days, was under out-patient treatment. The doctor in charge issued a sick-list first for 5 days, then prolonged it for 10 days. Who can further prolong the sick-list of this patient?

The Transcarpathian region is characterized by constant high (over 80%) air moisture. Population of this region feels an intense cold in winter when the temperature is temperately low. What way of heat emission becomes more active?

A 59-year-old male patient with essential hypertension of stage II is registered with the dispensary department of a polyclinic. The patient regularly takes ACE inhibitors and calcium antagonists. How often should a therapeutist examine this patient (except for exacerbation periods)?

Bacterial analysis of air in a living space in winter period by means of Krotov's apparatus revealed that total number of microorganisms in 1m3 of air was 7200. What is the allowed number of microorganisms for the air to be characterized as "pure"?

A teacher of a secondary school was diagnosed with pulmonary tuberculosis. What is the maximum duration of his medical certificate?