internal 3
問題一覧
1
316. A 56-year-old patient called a general practitioner at home, complaining of dagger pain in the epigastric region, radiating to the right shoulder and right shoulder blade. He has a history of stomach ulcer, worsening during the day. The position of the patient is forced - lying on his side with his legs pulled up to his stomach. On examination, the skin is pale, there is a cold sweat. The facial expression is pained, frightened. Heart sounds are muffled, bradycardia. On palpation of the abdomen - "board-like" tension of the muscles of the entire anterior wall. Symptoms of irritation of the peritoneum are sharply positive in all parts of the abdomen. Determine doctor's tactics:
• emergency hospitalization in the surgical department, surgical treatment
2
317. A 46-year-old man K. complains of vomiting with blood, severe weakness, black stools. A week ago, pain in the right hypochondrium began to disturb, jaundice developed. History: viral hepatitis B. On examination, the skin and sclera are icteric, telangiectasia, palmar erythema. The abdomen is swollen, enlarged due to ascites. Hepatosplenomegaly. What is the cause of the bleeding?
• Varicose veins of the esophagus
3
318. A 34-year-old man consulted a general practitioner with complaints of recurring nausea, “nightly” and “hungry” pains in the epigastrium during the last 3 weeks, sour belching. An FGDS study revealed for the first time an ulcerative defect of the mucous membrane of the posterior wall of the duodenum measuring 1.4 cm. Helicobacter pylori was found in the biopsy. Choose the correct treatment regimen for this disease:
• amoxicillin + clarithromycin + omeprazole
4
319. A 64–year-old man received tetracycline inside for 5 days due to coughing with copious mucous sputum, shortness of breath, and an increase in body temperature to 37.7°C, then replaced with ceftriaxone injections. On the 10th day of the disease, diarrhea occurred (7 times a day), blood in the stool, pain all over the abdomen, bloating, fever up to 39°C. The patient needs to carry out:
• colonoscopy
5
320. A 37-year-old patient went to the clinic complaining of general weakness and subictericity of the sclera. Objectively: moderate hepatomegaly. In blood tests: AST-14 U/l, ALT-30 U/l, hepatitis C-positive. To verify the diagnosis, the patient must perform:
• determination of HCV RNA
6
321. A 67-year-old man, who had been abusing alcohol for a long time, turned to a doctor with complaints of jaundice of the skin and sclera, an increase in abdominal size, insomnia at night and drowsiness during the day, impaired coordination. On examination: asterixis, "liver odor" from the mouth. Ultrasound of the abdominal cavity: signs of portal hypertension, hepatomegaly and splenomegaly, fluid in the abdominal cavity. A life-threatening complication, the manifestations of which are increasing in the patient, is:
• hepatic encephalopathy
7
322. Patient, 52 years old, after taking fatty foods, abdominal pain, repeated vomiting appeared. Palpation has moderate pain in the epigastric region. After the outpatient treatment, the condition improved – the pain became less, vomiting stopped, laboratory data were within normal limits. What is the outcome of the disease in this situation:
• remission
8
323. The young man I., 16 years old complains of pain in the knee, ankle, wrist joints, fever up to 38.0oC, palpitations, rash on the body. He had pharyngitis two weeks ago. Objectively: ring-shaped erythema on the skin. The joints are defigured, hot to the touch, sharply painful when moving. The boundaries of the heart are enlarged, the tones are deaf. Heart rate-58 in min. Blood test: Hb-135 g/l, RBC-5.2x1012/l, WBC-18.0x109/l, ESR -35 mm/h. Your conclusion:
• The patient has osteoarthritis, outpatient treatment
9
324. A patient, 47 years old, complains of acute pain in the area of the thumb of the left foot, swelling of the joint, redness of the skin of the back of the foot, an increase in body temperature to 39,0°C. Swelling of the first metatarsophalangeal joint of the left foot, restriction of movements. On the X-ray of the joint: the symptom of a "punch". Blood test: WBC-10.0x109/l, ESR-45 mm/h, urea-15 mmol/L. In the urine sample: specific gravity-1.014, erythrocytes – 5-7, urates. Which of the listed drugs is most appropriate to prescribe?
• allopurinol, as it inhibits the enzyme xanthine oxidase, suppressing the formation of urates in the blood serum
10
325. A 30-year-old patient complains of fatigue, shortness of breath during exercise, cough, swelling on the feet. As a child, she suffered a rheumatic attack. Objectively: the heart tones are muted, the rhythm is correct, systolic noise at the top, swelling on the feet. The appointment of which examination is most appropriate?
• Doppler Echocardiography
11
326. A 35-year-old woman works as a teacher. She complained of an increase in body temperature to 38.3°С, swelling, soreness and a local increase in temperature over the joints of the hands. Two weeks ago, she was on vacation at sea, according to the patient, she was in the sun for a long time. What was the provoking factor of deterioration?
• hyperinsolation
12
327. A patient with osteoarthritis, there is pain in the knee joints, ESR is 25 mm/h. Duration of illness 1 year, she has not been treated before. Select a treatment method:
• NSAIDs
13
328. A 42-year-old woman complains of body temperature up to 38-39°C, volatile pain, swelling and limitation of movement in the knee, ankle, wrist joints for 1 year, overall weakness, loss of body weight (9 kg in 7 months); On physical examination: lymphadenopathy. CBC: WBC-3.6x109/l, segmented neutrophils-35%, lymphocytes-53%, ESR-38 mm/h. Blood biochemistry: CRP-15 mg/l, positive SCL-70. Which of these medicines are most suitable for treatment?
• Prednisolone 60 mg/day
14
329. A 44-year-old female patient. Gottron’s papules, heliotrope rash, cutaneous ulcers, generalised weakness and pain, and weight loss with normal levels of creatine kinase. There was diffuse tenderness over most of her joints but no joint effusions. She had generalised weakness in all limbs with significant upper and lower limb muscle wasting and normal tone and reflexes. What instrumental diagnostic method would you choose?
• electromyography
15
330. Patient with complaints of distinctive skin rash on the face, eyelids, chest, nail cuticle areas, knuckles, knees, elbows. Muscle biopsy showed inflammation of muscle tissue. Choose the right treatment strategy:
• non-steroidal anti-inflammatory drugs
internal disease
internal disease
Abuhussin Alsaeed · 100問 · 1年前internal disease
internal disease
100問 • 1年前internal disease 2
internal disease 2
Abuhussin Alsaeed · 100問 · 1年前internal disease 2
internal disease 2
100問 • 1年前internal disease 3
internal disease 3
Abuhussin Alsaeed · 100問 · 1年前internal disease 3
internal disease 3
100問 • 1年前internal state 1
internal state 1
Abuhussin Alsaeed · 100問 · 1年前internal state 1
internal state 1
100問 • 1年前internal state 2
internal state 2
Abuhussin Alsaeed · 100問 · 1年前internal state 2
internal state 2
100問 • 1年前internal state 3
internal state 3
Abuhussin Alsaeed · 54問 · 1年前internal state 3
internal state 3
54問 • 1年前internal state 3
internal state 3
Abuhussin Alsaeed · 70問 · 1年前internal state 3
internal state 3
70問 • 1年前pediatric
pediatric
Abuhussin Alsaeed · 100問 · 1年前pediatric
pediatric
100問 • 1年前pediatric 2
pediatric 2
Abuhussin Alsaeed · 68問 · 1年前pediatric 2
pediatric 2
68問 • 1年前surgery 2
surgery 2
Abuhussin Alsaeed · 100問 · 1年前surgery 2
surgery 2
100問 • 1年前問題一覧
1
316. A 56-year-old patient called a general practitioner at home, complaining of dagger pain in the epigastric region, radiating to the right shoulder and right shoulder blade. He has a history of stomach ulcer, worsening during the day. The position of the patient is forced - lying on his side with his legs pulled up to his stomach. On examination, the skin is pale, there is a cold sweat. The facial expression is pained, frightened. Heart sounds are muffled, bradycardia. On palpation of the abdomen - "board-like" tension of the muscles of the entire anterior wall. Symptoms of irritation of the peritoneum are sharply positive in all parts of the abdomen. Determine doctor's tactics:
• emergency hospitalization in the surgical department, surgical treatment
2
317. A 46-year-old man K. complains of vomiting with blood, severe weakness, black stools. A week ago, pain in the right hypochondrium began to disturb, jaundice developed. History: viral hepatitis B. On examination, the skin and sclera are icteric, telangiectasia, palmar erythema. The abdomen is swollen, enlarged due to ascites. Hepatosplenomegaly. What is the cause of the bleeding?
• Varicose veins of the esophagus
3
318. A 34-year-old man consulted a general practitioner with complaints of recurring nausea, “nightly” and “hungry” pains in the epigastrium during the last 3 weeks, sour belching. An FGDS study revealed for the first time an ulcerative defect of the mucous membrane of the posterior wall of the duodenum measuring 1.4 cm. Helicobacter pylori was found in the biopsy. Choose the correct treatment regimen for this disease:
• amoxicillin + clarithromycin + omeprazole
4
319. A 64–year-old man received tetracycline inside for 5 days due to coughing with copious mucous sputum, shortness of breath, and an increase in body temperature to 37.7°C, then replaced with ceftriaxone injections. On the 10th day of the disease, diarrhea occurred (7 times a day), blood in the stool, pain all over the abdomen, bloating, fever up to 39°C. The patient needs to carry out:
• colonoscopy
5
320. A 37-year-old patient went to the clinic complaining of general weakness and subictericity of the sclera. Objectively: moderate hepatomegaly. In blood tests: AST-14 U/l, ALT-30 U/l, hepatitis C-positive. To verify the diagnosis, the patient must perform:
• determination of HCV RNA
6
321. A 67-year-old man, who had been abusing alcohol for a long time, turned to a doctor with complaints of jaundice of the skin and sclera, an increase in abdominal size, insomnia at night and drowsiness during the day, impaired coordination. On examination: asterixis, "liver odor" from the mouth. Ultrasound of the abdominal cavity: signs of portal hypertension, hepatomegaly and splenomegaly, fluid in the abdominal cavity. A life-threatening complication, the manifestations of which are increasing in the patient, is:
• hepatic encephalopathy
7
322. Patient, 52 years old, after taking fatty foods, abdominal pain, repeated vomiting appeared. Palpation has moderate pain in the epigastric region. After the outpatient treatment, the condition improved – the pain became less, vomiting stopped, laboratory data were within normal limits. What is the outcome of the disease in this situation:
• remission
8
323. The young man I., 16 years old complains of pain in the knee, ankle, wrist joints, fever up to 38.0oC, palpitations, rash on the body. He had pharyngitis two weeks ago. Objectively: ring-shaped erythema on the skin. The joints are defigured, hot to the touch, sharply painful when moving. The boundaries of the heart are enlarged, the tones are deaf. Heart rate-58 in min. Blood test: Hb-135 g/l, RBC-5.2x1012/l, WBC-18.0x109/l, ESR -35 mm/h. Your conclusion:
• The patient has osteoarthritis, outpatient treatment
9
324. A patient, 47 years old, complains of acute pain in the area of the thumb of the left foot, swelling of the joint, redness of the skin of the back of the foot, an increase in body temperature to 39,0°C. Swelling of the first metatarsophalangeal joint of the left foot, restriction of movements. On the X-ray of the joint: the symptom of a "punch". Blood test: WBC-10.0x109/l, ESR-45 mm/h, urea-15 mmol/L. In the urine sample: specific gravity-1.014, erythrocytes – 5-7, urates. Which of the listed drugs is most appropriate to prescribe?
• allopurinol, as it inhibits the enzyme xanthine oxidase, suppressing the formation of urates in the blood serum
10
325. A 30-year-old patient complains of fatigue, shortness of breath during exercise, cough, swelling on the feet. As a child, she suffered a rheumatic attack. Objectively: the heart tones are muted, the rhythm is correct, systolic noise at the top, swelling on the feet. The appointment of which examination is most appropriate?
• Doppler Echocardiography
11
326. A 35-year-old woman works as a teacher. She complained of an increase in body temperature to 38.3°С, swelling, soreness and a local increase in temperature over the joints of the hands. Two weeks ago, she was on vacation at sea, according to the patient, she was in the sun for a long time. What was the provoking factor of deterioration?
• hyperinsolation
12
327. A patient with osteoarthritis, there is pain in the knee joints, ESR is 25 mm/h. Duration of illness 1 year, she has not been treated before. Select a treatment method:
• NSAIDs
13
328. A 42-year-old woman complains of body temperature up to 38-39°C, volatile pain, swelling and limitation of movement in the knee, ankle, wrist joints for 1 year, overall weakness, loss of body weight (9 kg in 7 months); On physical examination: lymphadenopathy. CBC: WBC-3.6x109/l, segmented neutrophils-35%, lymphocytes-53%, ESR-38 mm/h. Blood biochemistry: CRP-15 mg/l, positive SCL-70. Which of these medicines are most suitable for treatment?
• Prednisolone 60 mg/day
14
329. A 44-year-old female patient. Gottron’s papules, heliotrope rash, cutaneous ulcers, generalised weakness and pain, and weight loss with normal levels of creatine kinase. There was diffuse tenderness over most of her joints but no joint effusions. She had generalised weakness in all limbs with significant upper and lower limb muscle wasting and normal tone and reflexes. What instrumental diagnostic method would you choose?
• electromyography
15
330. Patient with complaints of distinctive skin rash on the face, eyelids, chest, nail cuticle areas, knuckles, knees, elbows. Muscle biopsy showed inflammation of muscle tissue. Choose the right treatment strategy:
• non-steroidal anti-inflammatory drugs