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Over the years the problem of gastroduodenal ulcers become less critical. Which of the following is believed to be the main reason for this situation?
According to the Polish vaccination calendar, tuberculosis vaccine is administered to healthy children:
The disorders associated with chronic kidney disease include all of the following except for:
A transudate with a low protein content and the low activity of lactate dehydrogenase (LDH) may accumulate in the pleural cavity in the course of:
1) pneumonia;
2) heart failure;
3) cirrhosis;
4) neoplastic disease;
5) gastrointestinal disorder.
The correct answer is:
Which of the following is the most common cause of hyperandrogenism in women
Which of the following can cause spurious hyperkalemia?
Which of the following parameters can be measured with spirometry?
1) vital capacity;
2) total lung capacity;
3) forced expiratory volume in 1 second;
4) inspiratory capacity;
5) residual volume.
The correct answer is:
How should a sudden attack of dyspnea be managed in a 25-year-old woman in 28th week of gestation, who was diagnosed with asthma at the age of 5-6, who has had no asthma attacks for at least 15 years, and has normal respiratory sounds and the heart rate 130/min?
Antinuclear antibodies (ANA), specifically reactive with Jo-1 antigen can be found mainly in patients with:
HLA B-27 antigen is characteristic of:
Which statement describing Gilbert’s syndrome is true?
The first-choice drug used in treatment of acute liver failure related to paracetamol (acetaminophen) overdose is:
Characteristic medical signs associated with cardiac tamponade include:
1) distended neck veins;
2) high arterial blood pressure;
3) low arterial blood pressure;
4) muffled heart sounds;
5) bradycardia;
6) tachycardia.
The correct answer is:
A 67-year-old woman with paroxysmal atrial fibrillation, hypertension and type 2 diabetes mellitus (CHA2DS2 -VASc score of 4) in the prevention of ischaemic stroke requires the treatment with:
In the acute phase of pulmonary embolism the following can be used except for:
Which of the following is not considered in the assessment of the thromboembolic complication risk in patients with non-valvular atrial fibrillation, according to CHA2DS2 VASc scale:
Which of the following medications can cause hypercalcemia?
1) calcimimetics;
2) thiazides;
3) lithium;
4) calcium receptor antagonists;
5) vitamin D.
The correct answer is:
Hypercalcemia does not occur in:
Which of the following is the least probable cause of the unilateral dilation of the renal pelvis and calyces:
Which pathogen is the most common cause of community-acquired urinary tract infections?
A 54-year-old women with diabetes mellitus t. 2 came to the emergency room because of a head injury, without any other symptoms. The urinalysis revealed proteinuria - 0.1 mg/dl, 50 WBC/HPF and numerous bacteria. You will order:
Indicate the false statement on Lynch syndrome:
What are the indications for corticosteroid treatment in tuberculosis? 1) adrenal insufficiency caused by adrenal tuberculosis; 2) caseous pneumonia; 3) acute pericarditis; 4) tuberculous meningoencephalitis with the signs of increased intracranial pressure; 5) tuberculous spondylitis. The correct answer is:
A simultaneous increase in prothrombin time (PT) and in activated partial thromboplastin time (APTT) is characteristic of:
Please indicate the results of arterial blood gases measurement corresponding to the exacerbation of chronic hypercapnic respiratory failure:
Indicate the false statement on vaccinations against influenza:
The treatment of choice in anaphylactic shock includes:
A 30-year-old male patient came to the ER because of fever 38 °C, pharyngitis, skin rash and generalized lymph node enlargement with lymphopenia. Numerous high risk sexual contacts and syphilis in his medical history. The diagnostic procedures should proceed towards:
Patient with the following set of viral markers: HBsAg plus, HBeAg plus, anti-HBc IgM minus, anti-HCV minus should be regarded as:
The cause of hypouricemia is not:
Indicate true statements on the pathogenesis and treatment of edemas in nephrotic syndrome:
1) in the majority of patients with albumin concentration of 2.0-3.0 g/l edemas occur with hypervolemia and are caused by sodium retention in renal tubules;
2) in some patients with hypoalbuminemia < 2.0 g/l edemas occur with hypovolemia;
3) regardless of an underlying pathomechanism in all patients 100 mL of 20% albumin should be infused before diuretic administration;
4) in patients with hypervolemia sodium supply should be limited to 3-6 g of NaCl daily;
5) increased doses of intravenous furosemide are recommended because of hypoalbuminemia.
The correct answer is:
Systolic „crescendo-decrescendo” murmurs, radiating to the carotid arteries and the clavicles are characteristic of:
Indicate the true statement on the treatment of first episode of mild pseudomembranous colitis:
A 68-year-old patient came to the Infectious Diseases Outpatient Clinic with a diagnosis of chronic hepatitis C, and F3 fibrosis confirmed in elastographic examination. He also suffers from ischemic heart disease. Indicate the adequate statement on the recommended treatment and prognosis:
Which of the following is an urgent indication for the initiation of chronic renal replacement therapy - dialysis?
A 57-year-old patients came to the emergency room due to strong pain in the lumbar region lasting for two days and radiating to the right groin, with nausea, vomiting, with no fever. The urinalysis revealed proteinuria - 0.1 mg/dl, haematuria, and 6-8 white blood cells in the field of view. The most likely cause of these symptoms is:
Which of the following disorders are causes of secondary arterial hypertension: 1) primary hyperaldosteronism; 2) renal artery stenosis; 3) obstructive sleep apnea; 4) hypo- or hyperthyroidism; 5) acromegaly; 6) coarctation of the aorta. The correct answer is:
Which of the following is the cytostatic of particularly high cardiotoxicity, which can lead to congestive heart failure?
Constricted pupils may be observed in:
A 5-year-old child has been admitted because of pain in the lumbar area, a high fever for 24h now and an unpleasant smell of urine. In the general urine test, leukocyturia and nitrites are shown. The correct procedure will be:
Which of the following are signs or symptoms of hypercortisolemia in children?
1) accelerated growth;
2) excessive weight gain;
3) delayed growth;
4) acne;
5) hyperpigmentation.
The correct answer is:
A 4-month-old girl was admitted to the hospital due to poor weight gain after a second episode of rectal prolapse. History of jaundice up to 5 weeks of age. Currently, an occasional cough. Except for dystrophy, no significant abnormalities on physical examination. Not yet diagnosed, not hospitalized. In basic research, lab. Serum Na concentration 128 mmol / L, Cl concentration 88 mmol / L. Which disease entity is the most likely?
Which of the following methods is deciding in the diagnosis of food allergy?
Indicate the false statement of hives:
A GP diagnosed pertussis in a mother of a 3-week-old neonate. What is the correct management in this case?
Within what time in the period of infectivity will an immunocompetent child display chickenpox signs after contacting an infectious patient (with chickenpox)?
Physical examination of a 4-month-old infant revealed signs of dyspnea, tachypnea 75/min and diffused rales on lung auscultation. The child was born at 28 hbd, with the birth weight of 820 g. Oxygen therapy was necessary for the first two months of life. Body temperature was 36.8 °C, CRP 1 mg/L. A chest X-ray showed diffused small infiltrations within the lungs. The most probable diagnosis is:
Absolute contraindications to childhood vaccination include:
An infant received the second dose of DTP vaccine 20 days after the first one. What is the proper management in this case?
The most common cause of hyperthyroidism in adolescents is:
Indicate the false statement concerning HHV6 virus infection:
Which of the following are characteristic of hemolytic-uremic syndrome?
1) thrombocytopenia;
2) elevated serum creatinine concentration;
3) thrombocytosis;
4) anemia;
5) presence of schistocytes in peripheral blood;
6) presence of lymphoblasts in peripheral blood.
The correct answer is:
Which of the following are observed in the course of iron deficiency anemia?
1) decreased total iron binding capacity;
2) decreased mean corpuscular hemoglobin concentration;
3) decreased percentage of the erythroblastic cells in marrow;
4) red cell poikilocytosis;
5) megaloblastic erythropoiesis in marrow.
The correct answer is:
A 14-year-old patient was admitted to the hospital because of hypertension, edemas, proteinuria and microscopic hematuria. The lab tests showed increased ASO titres, low levels of C3 complement, normal renal function. What is the most probable diagnosis?
In a child with a confirmed diagnosis of coeliac disease, i.e. permanent gluten intolerance, the following products should be totally eliminated from the diet:
1) wheat;
2) rye; 3) corn;
4) barley;
5) rice. T
he correct answer is:
Choose the correct statements regarding ITP (idiopathic thrombocytopenic purpura):
1. In 20% of severe cases, bleeding into the CNS occurs
2. in 50% of cases, the acute form goes into a chronic form
3. This is the most common haemorrhagic diathesis in children
4. It is necessary to identify antiplatelet antibodies for diagnosis
5. The amount of megakaryocytes is reduced in the bone marrow
Acute lymphoblastic leukemia (ALL) in a child population presents a relatively good prognosis compared with other neoplastic diseases. Which of the following is a prognostic high risk factor in ALL in children that urges intensive treatment and decreases chances of curing the disease?
Acute bronchitis in children is most commonly caused by:
Which of the following are secondary disturbances typical of nephrotic syndrome?
1) increased triglyceride and cholesterol serum concentrations;
2) vitamin D deficiency;
3) hyperthyroidism;
4) decreased fibrinogen concentration;
5) decreased immunoglobulin serum concentration.
Which of the following conditions are characterized by increased urine loss of phosphates?
1) Fanconi syndrome;
2) tumor lysis syndrome during chemotherapy;
3) hypophosphatemic rickets;
4) hyperparathyroidism;
5) hypoparathyroidism.
The correct answer is:
Indicate true statements concerning urinary tract infections in children:
1) Gram negative bacteria are the most common etiological factor;
2) clinical signs in neonates are not specific;
3) primary diagnostic procedure is voiding cystourethrography;
4) voiding disturbances are predisposing factors;
5) the duration of treatment depends on the severity of child condition.
The correct answer is:
Parents removed a tick from the skin of their 5-year-old child. After 10 days erythema occurred in the bite mark and it gradually increased. During physical examination the erythema has 7 cm in diameter and has a clearing in the central part. What is the proper management in this case?
The respiratory rate in a normal active 2-year-old child should not exceed:
Risk factors for urolithiasis do not include:
Fetal fibronectin is:
All of the following are features of Swyer syndrome, except from:
Which of the following markers should be used in the diagnosis of molar pregnancy?
Which of the following medicines is not indicated in endometriosis treatment?
Indicate the true sentence describing endometriosis:
In a 16-year-old girl with amenorrhea, vaginal hematoma (hematocolpos) was diagnosed during ultrasound examination. The most probable diagnosis is:
A 41-year-old patient came to gynecologist asking for advice on contraception during perimenopause. She has two children, and has diabetes mellitus type I diagnosed at the age of 4. The current level of glycated haemoglobin HbA C is 8.9%, urine albumin excretion - 40 mcg/mg creatinine, her blood pressure is about 130/80 mmHg, ophthalmoscopy showed pre-proliferative retinopathy. Which of the following methods is contraindicated in this patient?
Disulfiram-ethanol reaction may be expected in a patient with an infection of reproductive organs, who drank alcohol during the treatment with:
In female adolescents (15 years old) without signs of breast development gonadotropins should be measured in order to exclude:
In women using biphasic hormonal anticonception a typical menstrual period
Indicate the true sentences regarding screening for the neoplastic disorders of female genital organs:
1) screening for vaginal and vulvar cancer is not performed because of the low incidence of these tumours;
2) screening for endometrial cancer is not performer because its first symptoms, i.e. uterine bleeding, are easily noticed by women and reported to their doctors;
3) screening for non-epithelial tumours of the ovaries, the uterus and the vagina is not performed because of the low incidence of these tumours;
4) screening for endometrial cancer is performed and includes ultrasound imaging, the measurement of the markers: CA 125, HE 4 (human epididymis protein 4) and chorion gonadotropin;
5) screening for cervical cancer is performed and includes a cytological test, a test which sensitivity reaches 85-90% in leading centers. The correct answer is:
In a patient with Turner syndrome (karyotype 45,X), within sexual organs, one can observe:
Factors increasing the risk of emergency peripartum hysterectomy do not include:
Indicate the true sentences regarding ovarian reserve:
1) it is lower in Afro-Americans than in Caucasian women;
2) it is determined genetically;
3) it decreases after ovarian surgery;
4) it decreases as a consequence of ovarian disorders;
5) it increases with woman’s age;
6) it decreases after antibiotic treatment.
The correct answer is:
The normal age of menarche in Poland is defined as:
Which of the following heart diseases in a pregnant woman are absolute indications for cesarean delivery?
1) uncorrected ASD;
2) uncorrected VSD;
3) uncorrected coarctation of the aorta;
4) Marfan syndrome.
The correct answer is:
Intermittent amenorrhea denotes:
Untreated iron-deficiency anemia in a pregnant woman may lead to:
1) intrauterine growth retardation;
2) premature labour;
3) elongation of the pregnancy;
4) congenital anomalies;
5) prolonged labour.
The correct answer is:
Indicate findings present in normal cardiotocographic non-stress test (NST) in pregnancy:
1) baseline fetal heart rate - 100/min;
2) baseline fetal heart rate - 150/min;
3) marked variability of the fetal heart rate;
4) absence of accelerations;
5) absence of decelerations.
The correct answer is:
So called clue cells are typical of:
Indicate the true sentences regarding impending miscarriages:
1) painless vaginal bleeding is usually present;
2) gynecological examination shows cervical ripening;
3) gynecological examination shows the cervix dilated to 1-2 cm;
4) speculum examination shows the amniotic sac;
5) treatment of choice is conservative.
The correct answer is:
In patients with severe preeclampsia the treatment of choice, both for the cessation of seizures as well as for their prevention, includes:
Indicate the maneuver used in vaginal delivery of a baby in a longitudinal lie with breech presentation in order to release the child's shoulders:
The administration of short-acting GnRH analogues begins on the first day of the menstrual cycle and from the third day gonadotropins are added. This description regards controlled ovarian hyperstimulation with the use of:
Neoplastic ovarian tumours which produce steroid hormones include: 1) thecoma; 2) mature teratoma; 3) endometrioid carcinoma; 4) granulosa cell tumour. The correct answer is:
The examiner places his hands flat and parallel on both sides of the abdomen of a pregnant woman, at the level of the umbilicus. The described maneuver allows to determine the fetal position and is called:
Which of the following syndromes is an example of paranoid syndrome:
Which of the following perception disturbances is recognized by patients as unreal?
Which of the following is a mood-congruent delusion observed in depression?
Mutism is classified as a disorder of:
What is the incidence of depression in the general population and then subsequently female and male population:
An example of serotonin norepinephrine reuptake inhibitor (SNRI) is:
Late psychotic symptoms after consuming psychoactive substances may not appear earlier than:
Axial symptoms of schizophrenia as described by Bleuler do not include:
Catalepsy is a kind of:
Vitamin B1 deficiency is frequently observed in the course of:
The use of force by medical staff is regulated by:
The relationship with the father, competing for his favors with an emotionally unavailable mother, favors the development of personality disorder in women of the following type:
Medications used ad hoc in a panic attack include:
Screening tests useful in the diagnostics of cognitive disorders include:
Which of the following concerning carcinoma of the ampulla of Vater is false?
Which of the following is not an indication for the surgical treatment of chronic pancreatitis in every case?
Which of the following concerning pancreatic cancer is false?
Pulse palpation in clinical settings is possible on the following arteries, except for:
In the Forrest classification of hemorrhages the grade II denotes:
Which of the following is relative contraindication to conservative surgery in breast cancer?
Which of the following is not an indication for urgent exploratory laparotomy after abdomen trauma?
Pringle maneuver consists in the compression of:
The most common neuroendocrine pancreatic tumor is:
Which of the following concerning intestinal obstruction is false ?
Internal hernias do not include:
Which of the following concerning Meckel’s diverticulum is false?
A 27-year-old woman with severe abdominal pain was admitted to the ER. She had fainted at home. She complains of the pain of the whole abdomen, lasting for 2 hours. The pain had acute onset in the lower abdomen. She can’t remember the date of her last menstruation period, but she confirms no periods for more than a month. On palpation increase muscle tone and tenderness are observed. Other findings include pale skin, BP 80/60 mmHg, HR 120/min. Which condition should be excluded in the first place?
In the TNM classification of colon cancer T1 denotes infiltration of:
The ankle-brachial pressure index (ABPI) in healthy people is at least 1. ABPI score <0.5 indicates:
The proper management in the case of rectal perforation accompanied by fecal peritonitis is:
According to the rule of nines, a burning of both lower limbs and the scrotum in adult patients affects:
Positive Chvostek, Trousseau and Erb’s signs suggest:
Which of the following is recommended in the case of stage T3 cecum cancer?
To what organ do other organs' neoplastic tumors metastasize to most frequently?
Which of the following distinguish allergic rhinitis from a common cold:
1 - itchy nose
2 - watery nasal discharge
3 - sneezing
4 - cough
5 - fever
In children with birth weight lower than 2000 g the mandatory vaccination against viral hepatitis B:
The basic diagnostic method of identification of Giardia lamblia is:
According to the Program of vaccinations for year 2016a neonate should be vaccinated within 24 hours of birth against:
1) viral hepatitis B
2) viral hepatitis A
3) invasive infection with Neisseria meningitidis
4) invasive infection with Streptococcus pneumoniae
5) tuberculosis
The mother come to the GP office with her 7-day- old daughter worrying about a light mucous vaginal discharge in the child. What is the correct management?
A 2-year-old boy came with his mother for a due checkup visit. He is going to attend a nursery school in a few months. His vaccination has been performed according to the schedule. What recommendations for additional immunization should be given to the mother?
A healthy, full-term infant:
Indicate the false statement on oral glucose tolerance test (OGTT):
An accidentally aspirated foreign body most frequently goes to:
Complicated urinary tract infection (UTI) includes:
The first physical symptoms during puberty include:
The minimal anti- smoking intervention consists in:
Indicate the false statement on the treatment of type 2 diabetes:
Indicate the false statement:
Purulent inflammation in the area of the nail fold is called:
Fibromyalgia - a condition characterized by widespread pain in muscles and tendons- most frequently affects:
A 12-year-old girl came with her father to the GP’s office. She complains of vomiting, intensifying abdominal pain which focuses in the hypogastric region. Her body temperature is 37.5°C, she passed a single soft stool earlier this day. On physical examination peritoneal signs can be noted. Which of the following is the most probable diagnosis?
Which of the following is a "disease without pulse" most frequently affecting young women under 20 years of age?
Woman's milk excreted in the first 5 days after the delivery is called:
An aneurysm of the abdominal aorta is most frequently misdiagnosed as:
Which of the following is not used in patients with severe respiratory failure caused by status asthmaticus?
Specific antidotes do not include:
Hospitalization is recommended in the case of
Which of the following is used in the resuscitation of a patient with cardiac arrest and ventricular fibrillation?
A classic triad of symptoms in pulmonary embolism, occurring in 25% of patients, includes:
Levine's sign is:
Which of the following should be given to a patient with hyperkalemia at the level of 7 mmol/l, if the ECG shows toxic influence of potassium on the heart muscle?
Spurious hyponatremia occurs secondary to:
Which of the following is used in the resuscitation of a patient with cardiac arrest and asystole?
Which of the following is the proper management of a low-voltage VF?
When is the tourniquet used?
Which of the following is the most effective procedure that can lead to ventricular fibrillation or the return of normal rhythm in the case of asystole occurring directly after defibrillation?
Indicate the lowest systolic blood pressure allowing to find the carotid pulse:
Which of the following is not recommended in the management of a patient with irregular narrow QRS-complex tachyarrhythmia (without symptoms of heart failure):
Indicate the true statement concerning the use of automated external defibrillator (AED):
Which of the following may be considered in the case of recurrent arrhythmia with a high heart rate, when electrical cardioversion and amiodarone are ineffective?
Which of the following are signs or symptoms observed in subarachnoid hemorrhage?
1) strong headache;
2) focal neurological deficits;
3) vomiting;
4) meningism.
The correct answer is:
The QT interval in the following ECG (speed 25 mm/s) should be classified as:
Is the doctor allowed to give medical advice at a distance?
Does the Code of Medical Ethics refer to euthanasia?
Are legally incapacitated people entitled to object to being admitted to the hospital? ?
A patient dissatisfied with the way he has been treated demands the doctor hold a consultation. The patient, other doctors, a priest and a homeopath healer who has been “curing” the patient’s family for years should take part in the consultation. According to the Code of Medical Ethics the doctor should:
Brain death was confirmed in a 25-year-old patient who did not want to become an organ donor, a fact that was noted in the Central Register of Objections. According to the Code of Medical Ethics the attending doctor should:
A doctor is to transfer a nucleus of the ovum to the cytoplasm of the ovum of another woman. As a result of this in vitro fertilization a child free of the defects associated with mitochondrial inheritance is going to be born. According to the Code of Medical Ethics such an act is:
Is it a doctor’s duty to turn the attention of society, authorities and patients to the importance of health care?
In accordance with the Act on Patients’ Rights and the Ombudsman for Patients’ Rights the doctor providing the patient with medical services is allowed to object to the presence of patient’s beloved one while performing those services:
In the Polish law medical secrecy covers:
What does the term “therapeutic privilege” mean?
In accordance with the law on old age and disability pensions paid from Social Insurance Fund, an insured person with the required period of insurance and holding a medical ruling on the purposefulness of occupational retraining issued by the certifying doctor is entitled to:
A. resultant disability pension.
B. training pension.
C. carer’s benefit.
D. sickness benefit.
E. disability pension resulting from incapacity for work.
SIF (ZUS) certifying doctors and SIF (ZUS) medical boards issue rulings on the entitlement for benefits paid from Social Insurance Fund but they do not issue rulings on:
In accordance with the law on old age and disability pensions paid from Social Insurance Fund, who is entitled to submit an application for the disability pension resulting from incapacity for work to SIF?
In accordance with the law on old age and disability pensions paid from SIF, an insured person who does not agree with the SIF certifying doctor’s ruling is allowed to appeal within 14 days of the date of receiving the ruling to:
In accordance with the law on old age and disability pensions paid from SIF, insured persons are entitled to the disability pension resulting from incapacity for work if they have the required contributory and non-contributory period and hold the medical ruling on:
Pension for incapacity for work for a person under 20 may be granted if the contributory and non-contributory period is at least:
According to the World Health Organization infections associated with health care occur in about:
The Haddon matrix should be used for analyzing the factors which prevent:
Which denominator number is used for calculating the mortality rate of the disease?
The general real (rough) death rate in Poland in 2014 was 970/100 000. In a small developing country in the same year it was 810/100 000. Which of the following best describes that situation?
What kind of prophylaxis is a mass screening test according to Bogdan Kleczkowski?
Let us assume that a new screening test was prepared to detect ovarian cancer. The chart below shows the frequency of its results. Which of the following is true if we take as a referential value the result of 0-30 μg/dL?
Syphilis treatment is an action in the area of:
Right hemiparesis for 3 hours, 95% stenosis of left carotid artery in the ultrasound, normal CT image of the head. Choose the right procedure:
The features of hemolytic-uremic syndrome include:
1) hemolytic anemia;
2) thrombocytosis;
3) thrombocytopenia;
4) acute kidney injury with oliguria;
5) splenomegalia.
The correct answer is: