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The presence of multiple adenomatous polyps on endoscopic examination of the digestive tract and co-existing soft tissue fibromas on the arms and the shanks give rise to a suspicion of
In the case of the mother being a carrier of the mutated gene, the risk that her son will be ill with haemophilia A is:
In patients with acute tumor lysis syndrome laboratory abnormalities include:
In a 75-year-old woman in a check-up a serum sodium of 132 mmol/l has been found. The woman does not complain about any symptoms and does not take any drugs. Indicate the proper way of treatment:
Bone marrow aplasia is characterized by:
What drug is used for the treatment of juvenile idiopathic arthritis?
The most common cause of food allergy in infants is:
Pathological changes within the temporal and parietal cortex and in the limbic system, variable severity of cognitive impairment, perception disorders, parkinsonism, collapses, fainting, depressive syndrome, hypersensitivity to neuroleptics. Which of the following dementias does this description refer to?
Which of the following should you suspect in a female patient complaining of cyclic regular hypogastric pain occurring for a longer time and rectal bleeding that accompanies menstruation?
A 31-year-old female working at a social care unit has reported to a family doctor complaining about the itchy abdomen skin, escalating during the night and a rash. In physical examination skin lesions in the form of papules and nodules, excoriations and single crusts were found. How should the doctor proceed?
Neuroborreliosis can manifest itself as:
1. lymphocytic meningitis,
2. encephalitis,
3. spinal cord inflammation;
4. cranial nerve palsy,
5. chronic encephalopathy,
6. impaired concentration;
7. increased nerve excitability
The correct answer is:
The doctor stating death is obliged to immediately notify the police or the prosecutor if:
1) they are unable to determine the cause of death;
2) the deceased does not have a next of kin within the meaning of Article 3 of the Act on
Patients’ Rights and the Ombudsman for Patients' Rights;
3) they have a justified suspicion that a crime was the cause of death;
4) they have a justified suspicion that suicide was the cause of death;
5) they are unable to establish the identity of the deceased;
The correct answer is:
Medical Rescue Team with the doctor was called to a 32-year-old man who was under the influence of designer drugs. These drugs caused the patient to react aggressively. What are the conditions under which it is possible to apply direct coercion in this patient?
1) it can be applied only if the doctor diagnoses the patient with mental illness;
2) doctor is allowed to apply it if they obtain consent from a medical specialist in psychiatry appointed by the province governor;
3) patient’s behavior poses a threat to his life or health;
4) it is only possible to hold the patient down and to immobilize him. However, the doctor is not allowed to force the patient to take medication;
5) before applying direct coercion the doctor should warn the patient.
The correct answer is:
The HLY indicator means:
Cancer staging:
Bronchoscopy in a patient with a suspicion of lung cancer:
1) is one of the basic diagnostic examinations;
2) should be applied to peripheral lesions only;
3) may include tissue sampling for histologic examination;
4) provides cellular material sampling for cytological examination;
5) may be performed only in patients with the normal values of respiratory function tests.
The correct answer is:
A 51-year-old man with bronchial asthma presents at GP because of recurrent episodes of food impaction, pyrosis, and chest pain increased after meals, and not associated with physical activity. The clinical picture suggests that the first strategy should be:
Macroscopic haematuria occurs in a 65-year old smoking man with no accompanying pain, and the ultrasound shows a solid tumour with a diameter above 4 cm located in the pole of the left kidney. What should be done next?
1) follow-up of the tumour with ultrasound every 6 months;
2) urine analysis and urine cytology;
3) kidney function analysis, whole blood count, alkaline phosphatase, calcium level;
4) abdomen, pelvis and chest CT scan to establish the stage of the neoplastic disease;
5) partial or total (radical) nephrectomy depending on the stage of the disease.
The correct answer is:
Which of the following symptoms, apart from decreased mood, are among the basic symptoms of depressive syndrome?
1) attention disorder;
2) decreased energy or increased fatigue;
3) anhedonia or a loss of interest;
4) sleeping and eating disorders;
5) anxiety;
6) unwarranted guilt;
7) cancellation or suicidal thoughts.
The correct answer is:
Treatment of an episode of depression in the course of bipolar disorder should be initiated with the administration of:
Which of the following syndromes is the most frequent cause of genetically determined intellectual disability in human population?
A doctor is going to do some experiment on animals. Before launching it they should obtain the approval of:
An employer turns to his doctor employee, who works on the contract of employment, to sign a contract including the so-called non-compete clause. What should the doctor do?
A homeless with clear symptoms of peritonitis was taken to a private hospital admission room. The hospital is able to help the patient but it does not have the contract signed with the National Health Fund (NFZ) for this type of medical services. How should the doctors proceed?
In patients with severe preeclampsia the treatment of choice, both for the cessation of seizures as well as for their prevention, includes:
Pringle maneuver consists in the compression of:
Which of the following is recommended in the case of stage T3 cecum cancer?
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?
When is the tourniquet used?
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:
A 19-year-old man comes to the office because of yellowish whites of his eyes. Serum bilirubin concentration was 2.9 mg/dL (50 µmol/L). Following tests were normal: abdominal ultrasound, blood count, urine test, LDH, ALT, AST, GGT, ALP, HBS antigen and anti-HCV antibodies. The patient complains of stress associated with his oncoming secondary school-leaving examination. What should be the next step in diagnosis and treatment?
Subacute sclerosing panencephalitis (SSPE) occurs with higher rate in children suffering in the early childhood (under 2 years of age) from:
Which procedure is necessary for the diagnosis of Wilms’ tumour?
A patient with measles is contagious for:
I-metaiodobenzylguanidine (MIBG) scintigraphy is a method used in children for the diagnosis of:
“This tumor can develop before puberty but the peak incidence is observed in women of reproductive age. It easily ruptures which may lead to peritoneal signs and symptoms demanding urgent surgery. In postmenopausal women it may cause abnormal bleeding from the reproductive tract. Surgical excision does not guarantee full recovery as this tumor recurrence may be observed as many as 30 years after the initial diagnosis”. The above is a characteristic of:
Which of the following indicates a complete mole at ultrasound examination?
1) “snow-storm” image;
2) no fetus;
3) presence of theca lutein cysts;
4) presence of fetal echo with a visible heart action;
5) presence of the gestational sac with amniotic fluid.
The correct answer is:
A patient with her husband come to the gynaecologist’s office. The husband wants to be present at the examination. What should the doctor do?
1) they should allow the husband to be present at the examination because husband as a close person has the right to be present at the provision of health services;
2) if the patient does not give her clear consent to her husband’s presence, they should ask him to leave;
3) they may not allow the husband to be present at the provision of health services to his wife if they decide that the patient’s health safety is at stake;
4) they should let the husband assist because her silence should be interpreted as implicit consent;
5) regardless of circumstances and the patient’s will they should ask the husband to leave because the examination may violate the patient’s right to intimacy.
The correct answer is:
In accordance with the Act on Therapeutic Activities autopsy in principle is carried out after at least:
The doctor while giving medical services to his patient finds out that they suffer from infectious, sexually transmitted disease. What should he do?
1) he should immediately pass on the information to the appropriate voivode, who can take a decision to isolate the patient;
2) he should force the patient to stay in place and immediately call the sanitary services;
3) he should inform the patient about the means that prevent the disease from spreading;
4) he has the duty to inform the patient of the necessity that their sexual partner consult a doctor;
5) he must immediately let all the people closely associated with the patient know and warn them about the threat.
The correct answer is:
Beckwith-Wiedemann syndrome is associated with an increased risk of developing:
Complete blood count: WBC 126,2 G/L, LY 33,61 G/L, MO 82,95 G/L, NE 9,62 G/L, RBC 3,82 T/L, Hgb 10,8 g/dL, MCV 84,6 fl, PLT 48 G/L suggests the diagnosis of:
The most common symptom reported by patients with vulvar cancer:
Assessment of the location of the fundal height is an important part of obstetrical examination. The fundus of the uterus at 24 week of gestation is normally located:
Negative symptoms of schizophrenia include:
In accordance with the Law on cash benefits from social insurance in the case of disease and maternity, medical rulings on temporary incapacity for work can be issued for the period not longer than three days prior to the day of the examination of the insured if the results indicate that the insured was undoubtedly unable to work in that period. Who can issue the medical ruling for the period longer than three days prior to the day of the examination?
Epidemiology as a science deals with the assessment of:
The characteristic feature of myelodysplastic syndromes is:
Which of the following are important for selection of chemotherapy in pulmonary cancer?
1) general condition of the patient;
2) stage of the disease;
3) organ damages;
4) histological type of the cancer;
5) familial history of cancer.
The correct answer is:
A 16-year-old patient complaining of persistent pruritus for 3 months uses immunosuppressive treatment in the form of ointments and creams, prescribed by a dermatologist, with no result. In the patient's relation her neck has recently ‘swelled’, and she reports also weakness and reduced exercise tolerance. On the examination, tachypnea, a bundle of enlarged lymph nodes (the largest with a diameter of 3 cm) in the region of the sternocleidomastoid muscle and the supraclavicular area on the same side were noted. An increased vascularization of the chest skin is visible. The patient should be referred to:
Which of the following does not suggest the development of malignant melanoma from a nevus?
The signs of Jaworski, Rovsing and Blumberg are typical signs of:
Which of the following is the most successful method to obtain hemostasis in the case of the bleeding from esophageal varices which could not be stopped endoscopically or when urgent endoscopy is not available?
Which of the following is the primary medication used for the long-term antihypertensive therapy in pregnancy?
The clinical features of HELLP syndrome include:
1) elevated liver enzymes;
2) low platelet count;
3) hemolysis;
4) thrombocytosis;
5) decreased concentration of indirect bilirubin.
The correct answer is:
Which of the following statements concerning cold water cooling of the patient suffering from burns is true?
Which of the following is not a cause of arterial hypertension in neonates?
Colorectal cancer is most commonly located in:
An umbilical cord prolapse during the second stage of the labor in a cephalic presentation with a longitudinal lie:
Which of the following is not a biological effect of progesterone?
Which of the statements regarding stress urinary incontinence is true?
A 65-year-old patient in good medical condition, with arterial hypertension and type 2 diabetes mellitus treated with oral therapy, comes to the gynecologist because of the moderate hemorrhage from the reproductive tract. Her body weight is 87 kg and the height is 163 cm. The result of the endometrial biopsy is: endometrial adenocarcinoma G1. Transvaginal ultrasound imaging suggests minimal invasion of the endometrium, CT imaging shows no intra-abdominal dissemination nor pathological pelvic or paraaortic lymph nodes. Indicate the optimal treatment for this patient:
Endocrine hypertension occurs in the course of:
Indicate the false statement:
Which of the following medications is used in the therapy of Alzheimer’s disease?
The actual carer of an adult unconscious patient is allowed to express their consent for:
Morbidity rate reaches higher values if:
Which type of esophageal cancer is a consequence of achalasia:
The diagnosis of iron deficiency anemia in an otherwise asymptomatic 75-year-old male should suggest the need to exclude:
Which of the following foreign bodies should be immediately removed endoscopically from the gastrointestinal tract?
1) coins;
2) buttons;
3) batteries;
4) foreign bodies stuck in the esophagus, not passing to the stomach;
5) needles.
The correct answer is:
Which of the following is more common among teenagers than pre-school children?
Choriocarcinoma is one of the rarest but most aggressive malignant tumors in women. Its diagnosis is based on:
Fetal bradycardia is defined as a decrease of the basic fetal heart rate:
The diagnosis of endometriosis should be considered in a patient with the following symptoms:
1) periodic pain, beginning just before the menstrual period lasting throughout the whole time of menstruation;
2) the temperature during the menstrual period > 39°C;
3) dyspareunia (pain related to sexual intercourse);
4) pain during defecation or micturition;
5) a stinking discharge from the vagina, occurring cyclically after menstruation.
The correct answer is:
A 58-year-old patient complains of vaginal dryness and postcoital bleedings. The gynecological examination reveals atrophic lesions in the vagina and normal uterus and uterine appendages. The cytological smear of the cervix is normal. The local vaginal estrogen therapy has been recommended and thus the patient should:
To control the decision on temporary incapacity to work a SIF (ZUS) certifying doctor cannot:
In a population of 1.000.000 inhabitants 1.000 persons suffer from pancreatic cancer and in this population there were 200 deaths from that disease in one calendar year. Which of the following is the best overall measure of the described epidemiological situation with regard to pancreatic cancer?
The cerebrospinal fluid test performed in a 15-year-old child showed: cell count 420 /µL, 86% lymphocytes, erythrocytes 3/µL, glucose concentration 61 mg/dL, protein concentration 46 mg/dL, chloride ion concentration 122 mmol/L. The result is characteristic of:
Cafe-au-lait spots are typical of:
Kehr's drain is used in:
A 56-year-old patient was subjected to total thyroidectomy because of Grave’s disease. Immediately after the removal of the tracheal tube the symptoms of acute respiratory failure occurred including stridor and dyspnea. The most probable reason for such symptoms is:
The complications of fetal diabetes include:
A 25-year-old woman reported at 20th week of her pregnancy for a prenatal examination. Her arterial pressure was measured to be 170/100 mmHg. Which of the following medications should be advised?
A 25-year-old man was referred for a psychiatric examination after an abuse of drugs and alcohol. The examination revealed that his behavior is characterized by: emotional instability, feeling of inner desolation, tendency towards self-destructive actions, unstable emotional relations. These features correspond with the diagnostic criteria for:
A doctor, after recognizing or suspecting the occurrence of vaccine adverse event, is obliged to report this fact to the state country sanitary inspector not later than within:
A 58- year-old woman came by the family doctor office and complains od constant fatigue, weakness, sleepiness, feeling cold and constipation. The symptoms last for about 3 months. She gained 6 kg in 2 months in spite of a stable diet. The pysical examination revealed dry, rough skin and swollen lower eyelids. The blood pressure was 110/60 mmHg, the heart rate was regular, 58/min, with quiet normal heart sounds. The respitaroty sounds were normal bilaterally. No other abnormalities were noted. The most probable diagnosis is:
The data on the number of the cases of X disease obtained in surveys carried out during health festivities is of little value as far as epidemiology and the disease spreading are concerned because:
The monoclonal protein (M protein) in multiple myeloma is usually an immunoglobulin of the class:
Which of the following is responsible for inflammation of the edges of the eyelids in the elderly?
What medication should be used to start treatment for newly diagnosed diabetes with polydipsia and polyuria?
Jaundice, low hemoglobin levels, high reticulocyte count, elevated indirect bilirubin levels, negative direct antiglobulin test, decreased erythrocyte osmotic resistance and abnormal EMA test result point to:
Indicate clinical situations in which chronic tubulointerstitial nephritis develops:
1) hyperuricemia;
2) chronic lithium treatment;
3) primary Sjögren’s syndrome;
4) hypercalcemic nephropathy;
5) hypokalemic nephropathy.
The correct answer is:
The Poviat Disability Adjudication Team decides on the degree of disability:
Indicate the true statement concerning vulvar cancer:
A 28-year-old woman who fainted again at home reported to the obstetrics and gynecology ER. On admission she presented pale, sweaty face, rapid heart rate, body temperature 36.6˚C. Despite inserting a contraceptive intrauterine device a year ago, she had her last period 8 weeks ago. Preliminary gynecological examination showed: slight vaginal bleeding, slightly enlarged uterus, painful resistance in the projection of the left uterine appendages and doughy tumor in the pouch of Douglas. These symptoms are indicative of diagnosis:
Which of the following medications is not used in a manic episode?
Superficial vesicular and purulent eruptions, with honey colored crusts over dried lesions, usually located in the lip area are characteristic of:
The doctor determines that the prognosis for the patient is unfavourable and that passing on this information to them may harm the good of the patient. What in light of the law may the doctor do?
Complete androgen insensitivity syndrome is characterized by:
Uterine leiomyomas are the most frequent benign neoplasms of the uterus. Indicate the false statement concerning their symptoms:
Which of the following is not a risk factor for endometrial cancer?
In accordance with the Law on cash benefits from social insurance in the case of disease and maternity, an insured person is entitled to rehabilitation cash benefit if they fulfill, among others, the following:
In accordance with the Law on old-age and disability pensions paid out from the Social Insurance Fund the statement issued by an SIF certifying doctor and medical board about partial or complete incapacity for work is the basis for the pension granting institution to grant:
Which of the following is used for the prophylaxis or the treatment of bleeding in von Willebrand disease?
Meckel's diverticulum consists of:
In contrast to older children and teenagers, the most common neoplastic diseases among children under 5 years of age include:
A 15-year-old boy came to the primary care unit because of fever (>38.0 C), fatigue, lack of appetite, profuse night sweats and losing weight. Physical examination confirmed weight loss (> 10% over last six months), painless cervical and supraclavicular lymphadenopathy. Indicate the most probable diagnosis:
Mounting scientific evidence supports the hypothesis that the postal code is a better health predicting factor than the genetic code. This hypothesis refers to:
A screening test in diabetic kidney disease is:
A 70-year-old male patient experienced palpitations and chest pain, his arterial blood pressure was 70/50 mmHg. The ECG showed atrial fibrillation with ventricular function 180/min. The appropriate management was to:
In the case of multiorgan injuries in pregnant women:
In the case of a ruptured abdominal aorta anurysm the symptom triad includes:
The diseases that can imitate the so called ”acute abdomen” include:
The indications for hospitalization of patients suffering from pyelonephritis do not include:
Indicate the false statement concerning tetanus:
Which of the statements below is true about determining the right to a retirement and disability pensions and calculating their amounts:
Which of the following is the document stipulating the rules of health promotion actions in the fight against the epidemic accumulation of diseases of affluence and defining health promotion as ”the process of enabling people to increase control over the factors affecting their lives”?
The first international treaty on evidence-based public health, accepted by over 170 United Nations countries is:
The letter ‘I’ in the AT-MIST acronym refers to:
The primary trauma examination (ABCDE) according to ATLS comprises all of the following elements, except for:
How many levels does the Verbal Rating Scale (VRS) contain?
The letter S in the SAMPLE acronym refers to:
A 34-year-old male without any medical history has been brought to hospital by the medical rescue team due to disorders of consciousness. The patient opens his eyes in response to pain and produces incomprehensible sounds. A decerebrate response is also observed. How many points will the patient score according to Glasgow Coma Scale?
A 62-year-old male patient with a gastroscopy-confirmed gastric cancer located in the stomach body region without distant metastases (T2N0M0) who received cycles of neoadjuvant chemotherapy was admitted to the general surgery ward for surgical management. Select the correct management:
Which surgical treatment can be used in patients with a diagnosis of a perianal fistula?
Select the indication for elective surgery in a patient with diverticular disease of the sigmoid colon:
A symptomatic (documented) cholelithiasis is an indication for cholecystectomy (gallbladder removal). Elective cholecystectomy should be performed in the case of asymptomatic cholelithiasis in patients with:
Which of the following is used for the patient’s general performance status assessment?
Anal fistula should be differentiated with all of the below except for:
A 65-year-old man had an ischemic stroke with hemiparesis and speech disturbances. At discharge for outpatient treatment, the physician entered into the medical history report that the patient has been classified as Cerebral Performance Category (CPC) category 3, which refers to:
The Injury Severity Score (ISS) defines 6 body regions. How many body regions are used to calculate the final ISS score?
Which of the following is a false statement regarding trauma centres (CU) and the format for collecting medical data by the emergency medical team (ZRM) for a trauma centre according to the AT-MIST scheme:
A 53-year-old man fell from a tree. He rates his pain as 7 on the NRS scale. Select the optimal pain management in this case:
A 63-year-old conscious man with tachycardia, GCS=15 and hemodynamic instability requires:
Calculate the basic daily fluid requirements for a 27-kg healthy child using the Holliday-Segar formula:
Trauma can result in intraperitoneal haemorrhage. Which of the following is the most frequent cause of intraperitoneal haemorrhage?
In the Child-Pugh scale, decompensated cirrhosis is diagnosed from at least:
A 38-year-old female was administered intravenous ciprofloxacin infusion due to acute pyelonephritis. Shortly after the infusion start, the patient complained of heat sensation and scratchy throat. Physical examination revealed stridor, blood pressure of 70/58 mmHg and then below detection limits. Aside from withholding the infusion, first of all the patient should be administered:
Indicate true statements regarding acute viral rhinosinusitis in adults:
1) it usually lasts <10 days;
2) it is primarily caused by coronaviruses;
3) deterioration after 5 days indicates bacterial superinfection;
4) no improvement after 72 hours indicates the need for antibiotic therapy.
The correct answer is:
Indicate true statements regarding spontaneous bacterial peritonitis:
1) diagnostic peritoneocentesis is indicated;
2) diagnosis requires WBC count >250 in ascitic fluid;
3) empirical antibiotic therapy includes macrolides and aminoglycosides;
4) prophylaxis includes norfloxacin.
The correct answer is:
Screening for type 2 diabetes is indicated once every 3 years in individuals who:
In a patient presenting with Charcot’s triad, imaging studies revealed choledocholithiasis with bile duct dilation. Indicate antibiotic of choice:
In a male with heart failure and left ventricular ejection fraction of 35%, the use of angiotensin-converting enzyme (ACE) inhibitors is indicated. Once introduced of ACE, we need to monitor kidney function after:
A 58-year-old female, during diagnostics for abnormal blood glucose levels, reported noticing a substantial increase in her shoe size. Upon further questioning she admitted that her family noticed a change in her facial features. In this case we need to determine the level of:
A 64-year-old male presented at the Emergency Department due to a stabbing chest pain, accompanied by fever up to 38 degrees Celsius and a dry cough. The ECG revealed generalised ST-segment elevation with simultaneous PQ-segment depression. Indicate the first-line treatment:
Weight loss, poor heat tolerance, psychomotor agitation, diarrhoea and heart palpitations are typical symptoms of:
A 40-year-old male complains of colic-type pain located in his right lumbar region radiating to the right inguinal region, accompanied with microhematuria (erythrocyturia) found in laboratory tests. The imaging study of choice is:
A 62-year-old male was admitted to the Internal Medicine Department due to acute kidney injury and hypercalcaemia. Diagnostics revealed nephrotic proteinuria, diffuse mediastinal and abdominal lymphadenopathy and numerous osteolytic lesions in bones. The patient requires urgent consultation with:
A 62-year-old male presented at the Emergency Department due to jaundice, which appeared few days after an episode of diarrhoea. Laboratory tests revealed decreased kidney function with creatinine level of 4.34 mg/dL (N 0.52-1.2 mg/dL), thrombocytopaenia 34 G/L (N 150-400 G/L) and anaemia. Indicate the most likely diagnosis:
A 75-year-old female with atrial fibrillation treated with apixaban, underwent percutaneous coronary intervention with stent implantation of the left anterior descending (LAD) artery due to myocardial infarction. Dual antiplatelet therapy with acetylsalicylic acid (ASA) and clopidogrel was implemented. In this case, after 7 days you should:
The severity of obstruction in COPD patients is graded according to the GOLD score, which is based on the following parameter:
A 25-year-old female presented to her General Practitioner due to a fever up to 39 degrees Celsius and persistent cough. On physical examination the patient was alert and oriented, with a tachypnea (24 breaths per minute) and auscultation findings consistent with inflammation over her left lung. Blood pressure was 105/63 mmHg. The patient has no concomitant diseases. Indicate the correct management:
In elderly patients with somatic delirium quetiapine may be used, which is administered:
In a 45-year-old male with no history of chronic disease treatment, who underwent an arthroscopy complicated with a week-long hospital stay, lower leg deep vein thrombosis occurred. Primary anticoagulation therapy with rivaroxaban should be continued for:
In a 82-year-old female with history of rheumatoid arthritis diagnosed at the age of 20 years, severe peripheral pitting oedema appeared. Due to proteinuria found in a spot urine sample, 24-hour urine collection was ordered, which revealed proteinuria of 32 grams per day. In this situation you should suspect:
Signs and symptoms of superior vena cava syndrome may be seen in the course of:
The typical management of acute tumour lysis syndrome includes:
Indicate true statement(s) regarding pre-excitation syndromes:
1) a pre-excitation syndrome is a premature activation of the ventricles through an accessory pathway connecting the atrium and ventricle;
2) WPW (Wolff-Parkinson-White) syndrome features prolonged PR interval and QRS complex widened by the delta wave;
3) LGL (Lown-Ganong-Levine) syndrome features shortened PR interval and QRS complex widened by the delta wave;
4) digoxin is the medication of choice in the treatment of WPW syndrome;
5) clinical symptoms of pre-excitation syndromes occur during bradycardia;
6) from around the age of 5, ablation of the abnormal conduction pathway is a possible management option.
The correct answer is:
A 4-month-old infant was brought to the paediatric Emergency Department by his father due to watery nasal discharge. The parent, after reading information online, suspects acute sinusitis. Indicate true statement:
Indicate false statement(s) regarding coagulopathies:
1) haemophilia type A is inherited in an autosomal recessive manner;
2) haemophilia type A results from a deficiency of factor VIII;
3) haemophilia type B is inherited in an autosomal dominant manner;
4) in 80% of cases there is a positive family history, while sporadic cases are caused by new mutations;
5) haemophilia types A and B occur mainly in boys; females are carriers, although the disease may also occur in girls;
6) typical manifestations of haemophilia include intra-articular and intra-muscular bleeding;
7) the severe form of haemophilia type B is diagnosed when factor VIII activity is below 1%.
The correct answer is:
According to the 2026 vaccination schedule, the mandatory vaccinations administered during the first year of life include:
(BCG - vaccination against tuberculosis, DTP - vaccination against diphtheria, tetanus, and pertussis, IPV - intramuscular vaccine against poliomyelitis, OPV - oral poliomyelitis vaccine, PCV - vaccination against pneumococcal infection, RV - vaccination against rotavirus infection, HBV - vaccination against hepatitis B, Hib - vaccination against Haemophilus influenzae type B, MMR - vaccination against measles, mumps, and rubella)
Indicate false statement regarding the congenital autoinflammatory syndrome PFAPA in children:
Indicate true statement regarding the treatment of osteosarcoma in children:
Hemorrhagic disease of the newborn can be caused by vitamin K deficiency. This leads to the decreased levels of several coagulation factors, primarily those belonging to the prothrombin complex. Indicate the correct set of factors affected with level decrease:
Indicate true statement regarding NEC (necrotizing enterocolitis):
According to the 2026 vaccination schedule, the recommended (non-mandatory) vaccinations for children include immunization against:
1) influenza;
2) hepatitis A;
3) meningococcal infection;
4) pneumococcal infection;
5) human papillomavirus (HPV);
6) COVID-19;
7) chickenpox (varicella).
The correct answer is:
A 52-year-old female presents at the outpatient unit for a routine check-up. She reports no complaints and has no chronic diseases in her medical history. Which cancer screening tests should the patient undergo, according to current recommendations?
A 68-year-old male presents at the outpatient unit due to jaundice, dark urine, skin itching, and 8 kg weight loss over 2 months. He also complains of epigastric pain radiating to his back. Laboratory tests revealed elevated total bilirubin and cholestatic enzymes levels. Abdominal CT revealed a tumour in the head of the pancreas of 3.5 cm in diameter without distant metastases. Indicate the appropriate management:
A 58-year-old male presents at the outpatient unit due to focal lesion of 3 cm in diameter in the left liver lobe, accidentally detected during abdominal ultrasound. In history: chronic hepatitis B, moderate alcohol consumption, no systemic symptoms. Laboratory tests revealed normal ALT/AST and elevated AFP (alpha-fetoprotein) levels. Indicate the appropriate management:
A 61-year-old male presents at the outpatient unit due to gradually worsening difficulty swallowing, initially solids, then also liquids. Additionally, he reports 6 kg weight loss over 3 months and weakness. In history: smoking (20 pack-years), moderate alcohol consumption. Physical examination is unremarkable. Indicate the appropriate management:
A 35-year-old woman presents at the endocrinology clinic due to a thyroid tumour. Ultrasound revealed a solid, hypoechoic tumour with uneven outline and microcalcifications in the right thyroid lobe. Fine-needle aspiration biopsy diagnoses papillary thyroid carcinoma. No distant metastases or cervical lymphadenopathy were found. Indicate the appropriate management:
A 72-year-old male attends a doctor due to weakness, weight loss of about 8 kg over 3 months, and recurrent abdominal pain. In history: alternating periods of constipation and diarrhoea; the patient denies presence of blood in the stool. Laboratory tests revealed microcytic anaemia. Indicate the appropriate management:
A 65-year-old male presents at the Emergency Department due to 10 kg weight loss over 3 months, loss of appetite, and fullness sensation after small meals. Gastroscopy revealed an ulcerated tumour in the prepyloric part of the stomach; histopathology examination confirmed adenocarcinoma. Abdominal CT revealed no distant metastases; endosonography (EUS) revealed that the tumour infiltrated the submucosa and partially the muscle layer, regional lymph nodes are suspicious (cN1). Indicate the appropriate management:
A 48-year-old male presents at the Emergency Department due to severe epigastric pain radiating to his back, nausea, and vomiting of food contents. The symptoms persist for a dozen or so hours. In history: cholelithiasis. Physical examination revealed yellow sclera, epigastric tenderness, and no bowel sounds. Laboratory tests revealed elevated inflammatory markers (WBC, CRP), elevated cholestatic markers, and high serum amylase and lipase levels. Abdominal ultrasound revealed gallbladder deposits and dilatation of the common bile duct; the pancreas was visible partially, with inflammatory infiltration. Indicate the appropriate management:
A 64-year-old female presents at the Emergency Department due to sudden pain in her right groin, which appeared after lifting heavy groceries. On physical examination, a painful, hard lump below the inguinal ligament is found, which cannot be reduced into the abdominal cavity. In this clinical situation, what should be suspected?
A symptom that often occurs in patients with acute cholecystitis and features pain intensification during deep inhalation or limitation of respiratory movements during palpation of the upper quadrant of the abdomen is:
Which of the following tests is not recommended to be performed up to the 10th week of gestation (or when a pregnant woman first attends a doctor) in the course of a normal pregnancy?
By definition, benign polyhydramnios is recognised when the largest single pocket of amniotic fluid (MVP, maximum vertical pocket) is:
According to the recommendations for the diagnostics of recurrent miscarriages, it is not recommended to perform the following routine examinations at the first stage of diagnostic process:
Indicate true statements regarding thrombocytopenia in pregnant women:
1) it usually appears in the third trimester, and the platelet count does not fall below 70,000/μL;
2) it occurs together with arterial hypertension and proteinuria;
3) it requires differentiation from immune thrombocytopenia;
4) it may lead to neonatal thrombocytopenia;
5) it requires no treatment and resolves within a few weeks after delivery.
The correct answer is:
Due to the presence of risk factors for gestational diabetes, the patient underwent a 75-gram oral glucose tolerance test in the 10th week of gestation. The results of the test are as follows: fasting glucose: 96 mg/dL, after 1 hour: 177 mg/dL, and after 2 hours: 157 mg/dL. Based on the results, indicate which of the following statements are true:
1) the results are normal, the patient is healthy;
2) gestational diabetes is diagnosed;
3) fasting blood glucose level fulfils the criterion for diagnosing gestational diabetes;
4) glucose level after 1 hour fulfils the criterion for diagnosing gestational diabetes;
5) glucose level after 2 hours fulfils the criterion for diagnosing gestational diabetes.
The correct answer is:
Indicate true statements regarding anaemia in pregnancy:
1) anaemia in pregnancy is defined as haemoglobin level of <12 g/dL in the first and third trimesters and <11 g/dL in the second trimester;
2) the most common cause of anaemia in pregnant women is iron deficiency;
3) prophylactic iron supplementation should be routinely implemented in every pregnant woman from the first trimester;
4) in the case of suspected iron deficiency anaemia, ferritin level determination is helpful in diagnostics;
5) physiological anaemia in pregnant women is mainly due to an increase in plasma volume.
The correct answer is:
Pancreatic cancer should be considered in patient with:
Indicate false statement regarding small-cell lung carcinoma:
The most common symptom of upper urinary tract cancer is:
The primary diagnostic method of identifying urinary bladder carcinoma is:
Which features of thyroid focal lesions indicate a high risk of thyroid cancer?
Management of the gastro-esophageal reflux disease (GERD) in an adult, without alarm symptoms and outside of flare-ups, involves:
Rabies virus cannot be contracted:
The most frequent cause of non-complicated cystitis is the bacteria:
The medication of last choice for treating an episode of depression in a patient with a history of seizures is:
In a patient with depression and significant psychomotor retardation, the most effective medication may be:
Long-acting benzodiazepines include:
Which of the following medications will provide the most rapid onset of hypnotic effect?
Which of the following medications carries the highest teratogenic risk during pregnancy?
Which of the personality disorders according to DSM-5 belongs to cluster B?
Worsening or loss of visual acuity in optic chiasm injury may manifest itself as colour vision disturbances, affecting mostly the following colour:
In the case of eyeball dislocation, you should, as first aid measure:
Which of the following statements regarding intraocular foreign body is false?