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LEKEXAM / 2011 spring

Question distribution — 2011 spring session

Share of each category in the latest available session.

Internal medicinePediatricsSurgeryGynecology and obstetricsFamily medicineEmergency medicine, AnaesthesiologyPsychiatryMedical law and bioethicsPublic healthMedical certification

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Question 1

All the following are absolute contraindications to thrombolytic therapy in acute myocardial infarction except:

Apast history of hemorrhagic stroke
Bgastrointestinal bleeding during the past month
Cbleeding diathesis
Daortic dissection
Eblood pressure 200/100 mmHg

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Question 2

Cardiovascular risk SCORE calculator includes the following factors except:

Aage.
Btriglyceride level.
Ctotal cholesterol level.
Dgender.
Esmoking.

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Question 3

Prinzmetal’s angina is a variant of ischemic heart disease. Which of the following statements regarding this disease is false?

Ait is provoked by coronary vasospasm.
BECG recorded during chest pain shows ST elevation.
Csmoking is prohibited.
Dfirst line pharmacology includes calcium channel blockers.
Eif calcium channel blockers are ineffective beta blockers should be added.

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Question 4

Which of the following statements regarding aortic stenosis (AS) is false?

AAS is characterized by long lasting asymptomatic clinical course.
Bpalpitations and chest pain are typical symptoms of AS.
Csystolic murmur in the aortic area radiating to the carotic arteries may be found on physical examination.
DAS is characterized by wide and fast pulse pressure.
EECG shows left ventricular hypertrophy and strain.

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Question 5

Urinary tract infections are the most common disorders of the urinary tract. The most common microorganism is Escherichia coli. They could be cultured using the standard media. However, there are certain microorganisms which could not be cultured using the standard media. This atypical microorganisms can also be relatively common causes of urinary tract infections. The microorganisms that cause urinary tract infections but they cannot be cultured using the standard media are the following except:

AChlamydia trachomatis.
BNeisseria gonorrhoeae.
CProteus mirabilis.
DMycoplasma hominis.
EUreaplasma urealyticum.

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Question 6

Adult polycystic kidney disease is one of the most common hereditary kidney diseases. The clinical feature of this disease is the presence of cysts in kidneys and other lesions in many other organs. The incorrect answer concerning the clinical feature of adult polycystic kidney disease is:

Aliver cysts are very common.
Bpancreas cysts could be present.
Cintracranial aneurysms could be present.
Ddiverticulosis could be also found.
Elung cysts are very common.

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Question 7

The difficulty with diagnosing the acute coronary syndrome in patients with chronic kidney disease may result from the following:

Asilent acute coronary syndrome is relatively common in chronic kidney disease.
Bother causes of chest pain are also frequent in chronic kidney disease.
Cother changes in ECG falsely suggestive of the acute coronary syndrome are also relatively common.
Dmarkers of myocardial injury are elevated in chronic kidney disease.
Eall the answers are correct.

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Question 8

A 75-year-old male with long-term history of simple renal cysts (2 cysts in the left kidney) suffered from a single episode of hematuria. In sonography of the kidneys, renal mass was found in the cyst in the left kidney. In cystoscopy a source of hematuria was not found. The next step in identifying the possible cause of hematuria should be:

Akidney biopsy.
Bnext sonography in 3 months.
Cnext cystoscopy should be performed in the case of the next episode of hematuria.
Dcomputed tomography.
Ethere is no need for further examination.

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Question 9

A 65-year-old male was admitted to the ward due to anuria. Laboratory results revealed: serum creatinine 7.8 mg/dl, urea 145 mg/dl, potassium 5.3 mmol/l. On ultrasonography bilateral hydronephrosis, without urine in the bladder. Which strategy should be implemented first?

Aurine culture
Bpyelography
Cstart dialysis therapy
Dadminister high dose of loop diuretics (i.e. 15 vials of furosemide)
Eurology consultation and an attempt to remove the obstruction of urine flow

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Question 10

The most typical laboratory presentation of renal colic is the following:

Aleukocyturia.
Bproteinuria.
Celevated serum creatinine.
Derythrocyturia.
Epyuria.

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Question 11

In prerenal acute renal failure the most important strategy is the following:

Astart with renal replacement therapy.
Badministration of loop diuretic.
Cadequate hydration.
Dlow sodium diet.
Enephroprotective therapy including ACE inhibitor.

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Question 12

Sterile pyuria- inability to culture microorganisms on the standard media in a patient with leukocyturia may be suggestive of:

Amycobacterium tuberculosis infection.
Banaerobic bacterial infection.
Cinterstitial nephritis due to phenacetin (analgesic) abuse.
Dcorrect answers are A and B.
Ecorrect answers are A, B and C.

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Question 13

Which of the following disorders does not belong to connective tissue diseases?

Asystemic lupus erythematosus (SLE).
BSjögren’s disease.
Crheumatoid arthritis (RA).
Dosteoarthritis (OA).
Epolymyositis (PM).

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Question 14

A 28-year-old female had two miscarriages in her history and recently was admitted to hospital because of an ischemic stroke caused by CNS (central nervous system) vessel thrombosis. Laboratory testing revealed: HGB 12.5 g/dl, WBC 6.8 G/l, PLT 80 G/l, APTT 58 s. Which of the following autoantibodies are most likely in the serum of this patient?

Aanti-SS-A (Ro), anti-SS-B (La).
Bantibodies against citrullinated antigens (ACPA).
Canti Scl-70.
Drheumatoid factor (RF).
Eantiphospholipid antibodies (APLA).

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Question 15

Raynaud’s phenomenon can occur as an isolated sign or accompany another disease, for example a connective tissue disease. Which of the testing given below is the imaging of choice enabling discrimination between functional nature of Raynaud’s phenomenon and the fixed vascular lesions (organic character of the sign)?

Acapillaroscopy.
Bangiography.
Cultrasonography with Doppler function.
Dthermography.
Eangio-CT.

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Question 16

Rheumatoid arthritis (RA) typically involves the following joints:
1) joints of the wrist;
2) metacarpophalangeal joints (MCP);
3) distal interphalangeal joints (DIP);
4) atlanto-axial joint;
5) sacroiliac joints.
The correct answer is:

A1,2,4.
B2,4,5.
C2,3.
D1,5.
E1,3,4.

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Question 17

Which of the features given below does not correspond to the clinical picture of systemic sclerosis?

ARaynaud’s phenomenon.
Bdyspnoea due to interstitial lung disease.
Cmask-like-face with microstomy.
Dswallowing disorders and gastroesophageal reflux.
Eenthesitis of Achilles tendon.

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Question 18

A 42-year-old female is treated by an ophthalmologist because of keratoconjunctivitis sicca symptoms. She is suffering from advanced dental caries and for some time her cervical and axillary lymph nodes have been enlarged. Polyclonal hypergammaglobulinaemia was revealed in serum protein electrophoresis. Which of the following is the most likely diagnosis in this case?

Asystemic sclerosis.
Bpolymyalgia rheumatica.
CSjögren’s syndrome.
DWegener’s granulomatosis.
EB-cell lymphoma.

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Question 19

A dose of glucocorticosteroids which is considered safe on account of the risk of developing osteoporosis is (expressed in prednisone):

A5 mg.
B7.5 mg.
C10 mg.
Dglucocorticoid therapy is safe if its duration does not exceed 3 months, irrespective of the daily doses.
Ethe safe dose with regard to this risk cannot be determined.

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Question 20

A 30-year-old woman with a childlike face and cold and dry skin does not menstruate. The low concentration of FSH, TSH and prolactin suggests:

Ahyperthyroidism.
Bpregnancy.
Chypopituitarism.
Dpremature ovarian failure syndrome.
Eall the answers are correct.

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Question 21

The increased concentration of prolactin rarely occurs in:

Apregnant women
Bpatients with controlled hypothyroidism
Cpatients with advanced renal failure
Dpatients with liver failure
Eall the answers are correct

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Question 22

Asymptomatic bacteriuria in pregnancy:

Aoccurs 2-3 times more frequently than in non-pregnant women.
Bdoes not require any treatment.
Cis most frequently caused by type B streptococcus.
Dincreases the risk of premature birth.
Eall the answers are correct.

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Question 23

Which of the following agents inhibit platelet aggregation?
1) acetylsalicylic acid;
2) clopidogrel;
3) carvedilol;
4) enoxaparin;
5) acenocoumarin.
The correct answer is:

A1,2.
B1,3.
C1,2,3.
D1,3,4,5.
E2,3,5.

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Question 24

A harsh systolic murmur with gradually increasing and then decreasing intensity (crescendo-decrescendo), away from the first heart sound, best heard in the second right intercostal space at the sternum, transmitting to the carotid arteries is typical of:

Amitral regurgitation.
Bvalvular pulmonary stenosis.
Cventricular septal defect.
Daortic stenosis.
Emitral stenosis.

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Question 25

Cardiovascular risk factors include:
1) diabetes mellitus;
2) tobacco smoking; concentration;
3) increased LDL cholesterol concentration;
4) decreased HDL cholesterol;
5) arterial hypertension.
The correct answer is:

A1,2,3,4.
B1,2,3,5.
C2,3,4,5.
D1,2,4,5.
Eall of the above.

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Question 26

Which of the following expressions related to acute coronary syndrome with ST segment elevation (STEMI) are correct?

1) differential diagnosis of chest pain should include pulmonary embolism and aortic dissection;

2) within 12 hours of symptom onset reperfusion by primary percutaneous coronary angioplasty (PTCA) or fibrinolysis is the key hospital management of all patients with STEMI;

3) the potential complication is interventricular septal rupture;

4) accompanying diabetes mellitus does not influence the prognosis.

The correct answer is:

A1,2.
B1,2,3.
C2,3.
D2,3,4.
Eall of the above.

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Question 27

Which of the following expressions related to atrial fibrillation are correct?
1) arterial hypertension is a common cardiovascular cause of atrial fibrillation;
2) it is associated with clinical manifestation of acquired valvular disease, especially mitral stenosis;
3) hyperthyroidism is a potential causative factor;
4) it increases the risk of thromboembolic complications, especially ischaemic cerebrovascular stroke.
The correct answer is:

A1,2.
B1,2,3.
C2,3.
D2,3,4.
Eall of the above.

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Question 28

(1) With regard to cardiological prevention regular physical activity demonstrates beneficial effect by decreasing cardiovascular risk through weight loss, blood pressure reduction and insulin resistance decline. (2) In secondary prevention in the case of patients with previous myocardial infarction physical training is contraindicated regardless of its intensity level.

Aexpression 1 is correct, 2 incorrect.
Bexpression 1 is incorrect, 2 correct.
Cboth expressions are correct.
Dboth expressions are incorrect.
Eexpression 2 excludes expression 1.

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Question 29

Pharmacological treatment with beta-adrenergic blocking agents (beta blockers) is contraindicated in the following conditions:

Adiabetes mellitus.
Bcompensated chronic heart failure.
Csymptomatic bradycardia.
Dold age.
Eall of the above.

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Question 30

Mechanical complications of myocardial infarction include:

1) acute left ventricle free wall rupture;

2) pulmonary oedema;

3) cardiogenic shock;

4) acute septal rupture;

5) acute mitral valve regurgitation.

The correct answer is:

Aall the above.
B1,2,3.
C1,4,5.
D2,3.
E4,5.

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Question 31

A patient after ST elevation myocardial infarction, treated with primary PCI, with moderate left ventricle systolic dysfunction requires chronic therapy of:
1) beta blockers;
2) clopidogrel for 1 month;
3) statin;
4) ACE inhibitor;
5) clopidogrel for 12 months.
The correct answer is:

A1,3,4,5.
B1,2,3.
C1,3,5.
D2,4,5.
E4,5.

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Question 32

The risk factors linked to poor prognosis in patients with infective endocarditis (IE) include:
1) IE in artificial valve;
2) renal failure;
3) stroke;
4) IE of fungal aetiology;
5) low left ventricle ejection fraction (EF).
The correct answer is:

Aall the above.
B1,2,3,4.
C1,3,5.
D2,3,5.
E4,5.

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Question 33

A 58-year-old man has visited his physician complaining of painful sausagelike swelling of two digits of the right foot. The pain troubles him while walking. On the examination the physician finds also: oedema of the distal interphalangeal joints in the third and fourth fingers of the right hand with nail discoloration and scaly erythematous plaque in the gluteal cleft. Laboratory findings reveal: CRP 35 mg/l, L 10.8 G/l, rheumatoid factor test is negative. Indicate the most probable diagnosis:

ALyme disease (borreliosis).
Brheumatoid arthritis.
Cgout.
DReiter’s syndrome.
Epsoriatic arthritis.

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Question 34

The autoantibodies specific to systemic scleroderma are:

Arheumatoid factor.
Banti-dsDNA antibodies.
Canti-cyclic citrullinated protein (CCP) antibodies.
Danti-SSA, anti-SSB autoantibodies.
Eanti-topoisomerase I antibodies (anty-Scl70).

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Question 35

The rapid occurrence of polyuria of more than 12 l per day with urine specific gravity of 1001 indicates:

Adecompensated diabetes mellitus.
Bpolyuria due to renal failure.
Cdiabetes insipidus due to vasopressin deficiency.
Dinherited nephrogenic diabetes insipidus.
Enone of the above.

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Question 36

Typical symptoms of adrenal insufficiency are the following except:

Atanning of skin and mucosa.
Borthostatic hypotension.
Chypokalemia.
Dhyponatremia.
Eweight loss.

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Question 37

Hypothyroidism is associated with the following symptoms except:

Acold intolerance.
Bfatigue and general slowdown.
Cpersistent constipation.
Dpale and cold skin.
Elow serum cholesterol.

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Question 38

Which of the following clinical factors isn’t used in Pediatric Crohn's Disease Activity Index (including Ryżko modifications)?

Aabdominal pain.
Bpatient functioning/activity.
Cappetite.
Dstools per day.
Eperirectal disease.

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Question 39

The first-line antibiotic treatment of pertussis in children is:

Afirst-generation cephalosporin.
Bpenicillin.
Csecond-generation cephalosporin.
Dmacrolide.
Ethird-generation cephalosporin.

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Question 40

A 4-month infant with anxiety, irritation and loss of appetite. In the last several hours a child had had diarrhoea and vomited frequently with milk. Microbiological examination of the stool showed the evidence of rotavirus infection. What will you apply in the treatment?

Aamoxicillin with clavulanic acid.
Bnifuroxazide.
Camoxicillin.
Dco-trimoxazole.
Ejust symptomatic treatment.

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Question 41

Crede’s treatment is used in prevention of gonococcal conjunctivitis in newborns. What solution, according to this treatment, should be applied to the conjuctival sac?

Aphysiological salt
Bsilver nitrate
Cgold nitrite
Dsilver nitrite
Egold nitrate

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Question 42

Which of the following symptoms are alarming symptoms in gastroesophageal reflux disease in children?

Adysphagia.
Bloss of weight.
Canaemia.
Dnight cough or dyspnoea.
Eall the answers are correct.

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Question 43

Which of the following is not a clinical indication that children with acute renal failure should be dialyzed?

Acerebral oedema.
Bpulmonary oedema.
Chypertension.
Dcardiac insufficiency.
Eanaemia.

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Question 44

Which of the following is not an absolute contraindication to stomach wash in children?

Acaustic substances.
Bhaemorrhagic diathesis.
Cpatient’s agitation and the lack of cooperation.
Desophageal varices.
Epast esophageal surgeries.

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Question 45

Which of the following is not a contraindication to intramuscular injection in children?

Askin rash.
Bintramuscular fibrosis.
Canticoagulant treatment.
Dshock.
Ehigh fever.

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Question 46

If you need to collect newborn arterial blood, the artery of choice is:

Aradial artery.
Bulnar artery.
Caorta.
Dfemoral artery.
Etibial artery.

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Question 47

The first-line treatment of lambliasis in a 10-year-old girl is:

Aamoxicillin.
Bcefuroxime.
Cnifuroxazide.
Dclarithromycin.
Emetronidazole.

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Question 48

What is the proper dose of vitamin D3 in healthy infants?

A100 units a day.
B200 units a day.
C400 units a day.
D600 units a day.
E800 units a day.

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Question 49

The following are the characteristic symptoms ofbacterial tonsillitis, except for:

Ahigh fever (38,5-40ºC).
Bsevere throat ache.
Cabdominal pains with vomiting.
Dsudden onset of symptoms.
Egradual onset of symptoms.

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Question 50

Choose the right answer concerning Quincke’s oedema:
1) it is a familial, hereditary type of vasomotor oedema;
2) it is connected with inherited defect of complement;
3) stress could intensify the symptoms;
4) acute abdomen symptoms could be observed.
The correct answer is:

Aonly 1.
B1,2.
C2,3.
D1,2,3.
Eall the above.

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Question 51

Vasomotor oedema is caused by food allergens, rarely by pollen allergens, but it could also be caused by:

Aphysical effort.
Bdrugs.
Cinsect bites.
Dinfection.
Eall the above.

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Question 52

The main cause of urinary tract infection in children is:

AEscherichia coli.
BKlebsiella.
CHaemophilus influenzae.
DPseudomonas.
EProteus mirabilis.

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Question 53

According to the current vaccination program in Poland, tuberculosis vaccination is obligatory:

1) in the newborn within 24 hours after the delivery;

2) after premature newborns reach 2000 g of their body weight;

3) before discharging newborns from hospital;

4) after birth with the first injection of the hepatitis B vaccine;

5) for the first year medical students if tuberculin skin test is negative.

The correct answer is:

A1,2,3.
B1,2,3,4.
Call of the above.
D2 ,3.
E2,3,4.

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Question 54

Streptococcus pneumonia vaccination is obligatory (and given at the expense of the state budget) for:

1) 2-year-old child with idiopathic thrombocytopenia;

2) HIV-positive 1.5-year-old child;

3) 4-year-old child with primary immunodeficiency;

4) 8-year-old child with the cochlear implant;

5) 13-year-old patient after splenectomy.

The correct answer is:

A1,2.
B1,2,3.
Call of the above.
D2,3,4,5.
E2,3,5.

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Question 55

An 8-year-old boy suffered the injury on the playground (foot stab wound). The wound was cleansed within 3 hours after the trauma. The analysis of the boy’s vaccination history reveals that he received all the obligatory vaccines according to the Polish Vaccination Program. Indicate what kind of tetanus prophylaxis should be administered in this patient:

Athere is no need for tetanus anatoxin administration.
Bone dose of tetanus anatoxin should be administered.
Cone dose of tetanus anatoxin and one of specific antitoxin should be administered.
Dtwo doses, obtained 4 weeks apart, of tetanus anatoxin should be administered.
Eone dose of tetanus-diphteria (DT) vaccine should be administered.

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Question 56

A 6-year-old child has had a fever for 2 days, and complains of sore throat and pain when swallowing. On examination you can see inflamed pharynx, enlarged palate tonsils covered with fibrinous effusion. The fast throat swab test is positive for Streptococci. Choose the correct medications:

Aonly local treatment – rinse the throat with antiseptics.
Bpenicillin orally 50,000 – 100,000 units/kg of body weight/day administered three times a day.
Cdoxycycline 100 mg once daily.
Dtrimethoprim-sulfamethoxazole 24-36 mg/kg b.w./day given orally.
Eciprofloxacin 10 mg/kg b.w./day every 8 hours.

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Question 57

The parents brought their 5-week old infant to the outpatient clinic. They report jaundice lasting for 2 weeks. It is breast-fed only. The stools are yellow and loose. Laboratory findings: total bilirubin – 8.2 mg%, conjugated bilirubin – 0.8 mg%. On ultrasonography the biliary ducts and gall bladder normal. When considering further proceedings you state that the most probable cause of the symptoms is:

Aphysiological jaundice.
Bobstruction of the extrahepatic biliary ducts.
Cobstruction of the intrahepatic biliary ducts.
Djaundice of breast-fed infants.
Eprogressive familial intrahepatic cholestasis.

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Question 58

One day after the labor a woman was diagnosed with chickenpox. What kind of prophylaxis should be administered in the newborn?

Aimmediate administration of varicella vaccine.
Bimmediate administration of varicella vaccine and specific immunoglobulin.
Cimmediate administration of specific immunoglobulin.
Dadministration of acyclovir intravenously for 7 days, beginning on the day of the chickenpox diagnosis in the woman.
Ethe newborn does not need vaccine or immunoglobulin administration; you must monitor the newborn and start the treatment when chickenpox symptoms appear

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Question 59

Which products contain gluten?
1) durum wheat;
2) rye;
3) corn/maize;
4) barley;
5) rice;
6) potato flour.
The correct answer is:

A1,2,3.
B2,3.
C1,2,4,6.
D1,2,5.
E1,2,4.

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Question 60

The indications for celiac disease screening test are:
1) diabetes mellitus type 1;
2) exocrine pancreatic insufficiency;
3) selective IgA deficiency;
4) autoimmune thyroiditis;
5) amelogenesis imperfecta.
The correct answer is:

A1,2.
B2,4.
C2,3,4,5.
D1,2,4.
E1,3,4,5.

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Question 61

During a physical examination in a 6-year-old boy, high blood pressure in the upper limbs and weak pulse in the femoral arteries were observed. The above symptoms are typical of congenital heart defect:

Atetralogy of Fallot.
Bpulmonary stenosis.
Cpatent ductus arteriosus.
Daortic coarctation.
Eaortic stenosis.

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Question 62

Chest pain in children is a common symptom. The causes of chest pain in children are not usually connected with heart disorders. Which of the following is not a cardiac cause of chest pain:

Aanomalies of coronary arteries.
Binfectious heart diseases.
Cmyocardial infraction.
Dcardiac arrhythmias.
Ehypertension.

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Question 63

Sinus arrhythmia is one of the reasons for sending children to the Cardiological Outpatient Department. Which of the following statements concerning sinus arrhythmia in children is false?

Asinus arrhythmia in children is physiological if the heart rhythm is within norm according to age.
Bsinus arrhythmia is diagnosed when, in electrocardiography, differences between following R-R segment interval are longer than 0.08 sec.
Csinus arrhythmia is connected with respiratory phase.
Dthe cause of sinus arrhythmia is a decrease in intra-chest pressure during inspiration, which results in an increase in blood volume flowing to the right atrium.
Eincrease in the heart rate during expiration and a decrease during inspiration is typical of sinus arrhythmia.

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Question 64

Most of the heart murmurs in children are harmless. Which of the following statements concerning heart harmless murmurs is false?

Aharmless heart murmurs occur in normal heart without any anatomical defect.
Bharmless heart murmurs are usually silent and have small range of radiation.
Cintensity and radiation of harmless heart murmurs decrease during fever and after physical effort.
Dharmless heart murmurs change according to body positioning.
Eone of the causes of harmless heart murmurs is the presence of a tendinous chord in left ventricle.

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Question 65

Patent ductus arteriosus (PDA) constitutes 10% of all congenital heart defects. Which of the following statements referring to PDA in children is false?

Ain the majority of full-term newborns in the first 24 hours the functional closure of the ductus arteriosus is observed.
Bin the first 3 weeks of life in newborns the total anatomical closure of the ductus arteriosus is observed.
Cfrequency and persistence of patent ductus arteriosus are dependent mainly on prematurity, hydratation status and lung immaturity as well as the intensity of lung changes.
Din older children a typical symptom of patent ductus arteriosus is a continuous murmur above the pulmonary artery.
EE1 prostaglandin is the drug causing the closure of the ductus arteriosus in newborns.

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Question 66

The first Leopold’s maneuver is used for:

Apalpating of the uterine fundus and finding out which fetal part occupies the fundus.
Bfinding out which fetal parts there are on both sides of the abdomen.
Cdetermining of the presenting part.
Dassessing the fetal descent.
Enone of the above.

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Question 67

The factors that predispose to breech presentation include:

Apreterm delivery, low birthweight.
Babnormalities of pregnancy implantation in the cases of uterine congenital malformations.
Cfetal anomalies, oligo- and polyhydramnios, multiple gestation.
Danswers A and C are correct.
Eanswers A,B,C are correct.

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Question 68

The interspinous distance, used for pelvis assessment, is defined as:

Adistance between anterior superior iliac spines.
Bdistance between the upper margin of the symphysis and the promontory of the sacrum.
Cdistance between anterior inferior iliac spines.
Ddistance between ischial spines.
Enone of the above.

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Question 69

Intrauterine growth restriction caused by placental insufficiency occurs in:

1) Rh-immunization;

2) pregnancy hypertension;

3) hypothyroidism;

4) diabetes mellitus type F according to White;

5) diabetes mellitus type R according to White.

The correct answer is:

A1,3,5.
B1,4,5.
C2,3,4.
D2,4,5.
E1,2,5.

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Question 70

Which of the following tocolytic agents is an oxytocin antagonist?

Amagnesium sulfate.
Britodrine.
Catosiban.
Dnifedipine.
Eclenbuterol.

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Question 71

Frequently used tocolytic agents include:

Abeta-adrenergic drugs.
Bcalcium channel blockers.
Cspasmolytics.
Dnitric oxide donors.
Eall the above.

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Question 72

The management of preterm delivery is based on:

Ainhibition of uterine contractions.
Bstimulation of fetal lung maturation.
Cdetermination of a delivery mode.
Dneonatal intensive care.
Eall the above.

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Question 73

The pathomechanism of preterm birth includes:

Aactivation of maternal or fetal hypothalamic-pituitary-adrenal (HPA) axis.
Bdecidual-chorioamniotic or systemic inflammation.
Cdecidual hemorrhage.
Dpatologic distension of the uterus.
Eall the above.

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Question 74

The secondary prophylaxis of deep venous thrombosis (DVT) in pregnancy include low-molecular-weight heparin administration. The optimal dose of Clexane is:

A0.01 mg/kg.
B0.1 mg/kg.
C1.0 mg/kg.
D1.5 mg/kg.
E2.0 mg/kg.

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Question 75

Which of the following diseases is not included in the differential diagnosis of deep venous thrombosis (DVT) in pregnancy?

Alymphatic edema.
Berysipelas.
Cgerman measles.
Dsciatica.
Elymphangitis.

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Question 76

In which of the following complications of pregnancy low level of placental lactogen is not observed?

Ahypertension.
Bintrauterine growth restriction.
Cinfection of the urine bladder.
Dfetal intrauterine demise.
Ebleeding in the second half of pregnancy.

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Question 77

Placental lactogen (hPL) is a polypeptide produced and secreted by syncytiotrophoblast cells. At which gestational age is the highest hPL level detected?

A8 weeks.
B18 weeks.
C24 weeks.
D38 weeks.
E40 weeks.

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Question 78

The rarest cause of congenital malformations among live newborns is/are:

Amaternal diseases.
Bintrauterine infections.
Cchemical and physical teratogens.
Dmutation in a single gene.
Echromosomal abnormalities.

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Question 79

The side effects of β-mimetics include:
1) hyperglycemia
2) tachycardia
3) hypoglycemia
4) pulmonary edema
5) hypercalcemia
The correct answer is:

A1, 2, 3
B1, 2, 4
C1, 3, 4
D2, 4, 5
E3 ,4, 5

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Question 80

During the labor, the border line between active and passive uterine segment is:

Ainternal cervical os.
Bexternal cervical os.
CBandl's contraction ring.
Duterine isthmus.
Euterine horns.

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Question 81

In the luteal phase of the menstrual cycle, progesterone is secreted by:

Aovarian follicle.
Bcorpus luteum.
Cendometrial glands.
Dovarian hilus cells.
Eendometrium.

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Question 82

The risk factors for ectopic pregnancy are:
1) previous ectopic pregnancy;
2) infertility therapy;
3) history of pelvic inflammatory disease (PID);
4) history of tubal surgery;
5) alcohol abuse.
The correct answer is:

A1,2,3.
B1,2,3,4.
C2,3,4.
D3,4,5.
Eall the above.

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Question 83

Which of the following symptoms discovered in a 34-year-old woman is the least suggestive of endometriosis?

Anodularity of the uterosacral ligaments.
Btenderness of the retroverted uterus during palpation.
Ctenderness in the cicatrix post cesarean section.
Dbilateral enlargement of the inguinal lymph nodes.
Etender, enlarge and fixed left ovary.

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Question 84

Choose the main risk factors for cervical cancer:

AHPV 16/18 infection, multiple sexual partners, multiparity.
BHPV 16/18 infection, CMV infection, low socioeconomic status.
Chistory of CIN-2, vaginal infection caused by Chlamydia trachomatis, low antioxidant diet.
Dcigarette smoking, history of CIN-1, EBV infection.
Eoral contraceptive use, HSV-2 infection, early sexual initiation.

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Question 85

Choose the HPV types of high oncogenic potential:

A16,18,39,45.
B16,6,11,34.
C16,18,6,11.
D6,11,34,42.
E16,11,34,44.

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Question 86

The risk factors for endometrial cancer include:

Acigarette smoking, hypertension, obesity.
Bdiabetes mellitus, hypertension, obesity.
Coral contraceptive usage, hypertension, obesity.
Dtalc exposition, cigarette smoking, obesity.
Emutation in BRCA 1 and BRCA 2 genes, diabetes mellitus, obesity.

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Question 87

The basic therapy in the management of vaginal cancer includes:

A5-fuorouracil chemotherapy
Bcisplatin chemotherapy
Cradiotherapy
Dsurgical therapy
Echemotherapy

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Question 88

A 35-year-old patient complains of profuse menses. Ultrasound examination revealed an intrauterine focal lesion that could be an endometrial polyp. Recommend the next step:

Atotal hysterectomy without adnexa.
Bhysteroscopy and the excision of the polyp (if the initial diagnosis is confirmed).
Cfurther observation.
Doral contraceptive in a continuous scheme.
Etherapy with GnRH analog.

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Question 89

Angiotensin converting enzyme (ACE) Inhibitors:
1) block conversion of angiotensin I into angiotensin II;
2) block calcium channels;
3) are the drug of choice in the therapy of gestational hypertension (PIH);
4) are the drug of choice in the therapy of hypertension in non-pregnant women;
5) are contraindicated in pregnancy.
The correct answer is:

A1,3.
B2,3.
C1,4,5.
D2,5.
E1,4.

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Question 90

If one dizygotic twin dies early in I trimester of pregnancy which is diagnosed by routine ultrasound examination, the management of choice is:

Aamnioreduction and the evacuation of the dead fetus.
Bthe same as in the case of high risk pregnancy.
Cprenatal diagnosis implementation.
Dbiochemical diagnosis for trophoblastic disease.
Ediagnosis for disseminated intravascular coagulation.

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Question 91

The most frequent chromosomal abnormality in live male newborns is:

ADown syndrome.
BTurner syndrome.
CKlinefelter syndrome.
DEdwards syndrome.
Ecri-du-chat syndrome.

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Question 92

The first group of drugs used in psychiatry were:

Abenzodiazepines.
Bbarbiturates.
Cbutyrophenones.
Dphenothiazines.
Ethioxanthenes.

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Question 93

Which of the following is not a characteristic feature of delusions?

Areaction to external stimuli.
Bfalseness.
Cthe co-existence of other psychopathological symptoms.
Dimpossibility to correct.
Estrong sense of obviousness.

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Question 94

Stereotypic movements are one of the disturbances of:

Aconsciousness.
Borientation.
Cemotions.
Dmovement expression.
Eattention.

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Question 95

Which of the following does not belong to the typical symptoms of delirium:

Aillusions
Bhallucinations
Cdisorientation
Dworsening of symptoms in the evening and at night
Edelusions

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Question 96

Which of the following is not included in the ICD-10 classification of dementias?

AGanser’s syndrome.
BAlzheimer’s dementia.
Cvascular dementia.
Dorganic amnestic syndrome.
Edementia not otherwise specified.

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Question 97

The gene responsible for the development of amyloid in the plaques of Alzheimer’s disease is located in chromosome:

A12.
B15.
C17.
D21.
E22.

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Question 98

The most common mental dysfunction in AIDS patients is:

Adepression.
Bparanoia.
Ccognitive dysfunction.
Dobsessive-compulsive syndrome.
Egeneralized anxiety disorders.

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Question 99

The number of alcohol-dependent people in Poland is:

A100 000 – 200 000.
B250 000.
C300 000 – 350 000.
D600 000 – 800 000.
Eabout 1 000 000.

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Question 100

What do you call when an individual, being under the influence of psychoactive substance, undertakes activities potentially dangerous to his/her health orlife?

Adependence.
Brisky use.
Cabstinence.
Dsocial use.
Ethis state does not belong to the pathology.

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Question 101

The name “schizophrenia” was introduced by:

AKraepelin.
BAlzheimer.
CBohnhoffer.
DParkinson.
EBleuler.

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Question 102

Which statement is not included in the program called „The 10 theses” and aimed at the popularization of problems caused by schizophrenia in the society:

Aschizophrenia is a disease.
Bschizophrenia is a heritable disease.
Cschizophrenia is not an incurable disease.
Dthere are no schizophrenics, there is schizophrenia.
Epatients with schizophrenia do not constitute more danger to others than people without schizophrenia.

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Question 103

Which of the following mental disturbances is characterized by the imitation of various somatic symptoms, sometimes with a symbolic character?

Adissociation disorders.
Bobsessive-compulsive disorders.
Cpseudodementia.
Damnestic syndrome.
Ehebephrenic schizophrenia.

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Question 104

The gender identity disorders (according to the ICD-10) are one of:

Amood disorders (F 30 - 39).
Bneurotic disorders (F40 – 48).
Cbehavioral syndromes associated with physiological disturbances and physical factors (F 50 – 59).
Ddisorders of adult personality and behaviour (F 60 – 69).
Ethe ICD-10 classification does not include category: “gender identity disorders”.

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Question 105

The main mechanism of action of benzodiazepine derivates (anxiolytic drugs) is the following receptor antagonism:

ABDZ
BNMDA
C5HT1A
DD2
EΑ1

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Question 106

Which of the following is not a risk factor for postoperative wound dehiscence?

Aage (more than 30).
Bdiabetes mellitus.
Cjaundice.
Dincreased abdominal pressure.
Eall of the above are the risk factors.

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Question 107

Dyspnoea and decreased saturation occurred half an hour after subclavian vein catheterization. What is the meaning of these symptoms?

Ait is a normal situation after the procedure associated with chemokin release; standard conservative therapy is sufficient (oxygen).
Bair embolism. Urgent diagnostics (echocardiogram) and intensive conservative treatment are essential.
Cpneumoedema. Urgent diagnostics (chest x-ray), immediate pleurocentesis and/or chest drainage are essential.
Danswers B,C are correct.
Enone of the answers explains the described symptoms.

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Question 108

The surgeon performed an incision one finger above suprasternal notch, and after the preparation of isthmus of thyroid gland and incision of two cartilage rings of the trachea, the tube was introduced and fixed with skin sutures. The procedure was performed without anesthesia. What is the name of the procedure?

Aplanned coniotomy.
Burgent coniotomy.
Cplanned tracheostomy.
Durgent tracheostomy.
Ebronchostomy.

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Question 109

During the operation when the resection of the rectum was performed, the intestinal perforation and the fecal leakage to peritoneum occurred. What would be the qualification of the wound?

Aclean wound
Bclean-contaminated wound
Ccontaminated wound
Ddirty-infected wound
Eoperational wound

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Question 110

Injuries in multiple body injuries are most common in the region of:

Ahead.
Bchest.
Cabdomen.
Dpelvis.
Elimbs.

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Question 111

Kocher reposition of luxation of the glenohumeral joint is performed in 4 phases in the sequence:

Aabduction, internal rotation, adduction to the chest, external rotation.
Babduction, external rotation, abduction from the chest, internal rotation.
Cabduction, external rotation, adduction to the chest, internal rotation.
Dabduction, internal rotation, abduction from the chest, external rotation.
Eabduction, external rotation, adduction to the chest, external rotation.

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Question 112

Which of the following symptoms is not a part of hypercalcemic crisis?

Aoliguria.
Bpolydipsia.
Cnausea and vomiting.
Dsomnolence and coma.
Ehypotension.

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Question 113

A Sengstaken-Blakemore tube should not be kept in place more than:

A12 hours.
B24 hours.
C48 hours.
D36 hours.
Ethere is no time limit established to keep the tube in place.

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Question 114

Which of the arteries are part of pancreatic vasculature?

Aupper pancreatico-duodenal artery.
Blower pancreatico-duodenal artery.
Csplenic artery.
Dcorrect answers are A and B.
Ecorrect answers are A, B and C.

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Question 115

Which of the statements concerning disorders of potassium homeostasis is correct?
1) potassium is the predominant extracellular cation;
2) excessive excretion because of diarrhea is one of the causes of hypokalemia;
3) 20% glucose solution and short-acting insulin are used for the treatment of hypokalemia;
4) acute and chronic renal failure impair potassium excretion and lead to hyperkalemia;
5) cardiac asystole results from hyperkalemia.
The correct answer is:

A1,2,3.
B2,4,5.
C1,4,5.
D2,3,5.
E1,3,4.

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Question 116

Which of the statements concerning fluid therapy is correct?
1) colloids are used to fill in the vessels;
2) crystalloids are used to fill in the extracellular space;
3) average arterial blood pressure, heart rate and central venous pressure are used for monitoring the level of patient’s hydration;
4) Ringer’s solution is an example of colloids;
5) dextran and gelatine are crystalloids.
The correct answer is:

A1,2,3.
B2,4,5.
C1,4,5.
D2,3,5.
E1,3,4.

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Question 117

Which of the statements concerning the infection treated with surgery is true?
1) whitlow is an acute inflammation of the dorsal surface of the fingers
2) carbuncle is most often located in the nape of the neck
3) paronychia is an inflammation of the tissues surrounding the fingernail or toenail
4) in the era of antibiotics all the infections are treated conservatively, and the surgical intervention is used only for the treatment of complications
5) abscess is the limited inflammation of soft tissues with necrosis and the presence of pus
The correct answer is:

A1, 2, 3
B2, 4, 5
C1, 4, 5
D2, 3, 5
E1, 3, 4

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Question 118

Which of the statements concerning the basic surgical procedures is correct?
1) venflon is an intravenous cannula
2) venesection is the procedure aimed to expose the peripheral vein
3) unconscious patient should have been intubated before the introduction of a gastric probe
4) nausea and vomits are contraindications to the introduction of gastric probe
5) urethral injuries are contraindications to a suprapubic bladder puncture
The correct answer is:

A1, 2, 3
B2, 4, 5.
C1, 4, 5
D2, 3, 5
E1, 3, 4

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Question 119

Which of the statements concerning the disorders of hemostasis is correct?
1) Virchow triad relates to the formation of venous blood clots;
2) thrombogenesis is the process of blood clots dissolving;
3) DIC coagulopathy is the result of disseminated intravascular coagulation;
4) fibrinolysis, which is the process of braking down intravascular fibrin clots, counterbalances the process of coagulation;
5) decrease in blood flow inhibits the formation of blood clots.
The correct answer is:

A1,2,3.
B2,4,5.
C1,4,5.
D2,3,5.
E1,3,4.

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Question 120

The most common malignancy in the world is:

Abreast cancer.
Bgastric cancer.
Ccervical cancer.
Dlung cancer.
Ecolon cancer.

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Question 121

The Intensive Care Units (ICU) patients should undergo preventive procedures against stress ulcers. The most important procedure is:

Aadministration of proton pump inhibitors.
Binduction of pharmacological coma in these patients in order to decrease the stress.
Cexamination of gastric acidity.
Deradication of Helicobacter pylori infection.
Eperforming the test for HP infection and its eradication when positive.

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Question 122

The only trustworthy method to diagnose breast cancer is:

Aultrasonography.
Bmammography.
Ccytology.
Dhistopathology.
Egenetic testing.

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Question 123

The cause of primary spontaneous pneumothorax is:

Aruptured, subpleural bubble (bleb).
Btuberculosis.
Clung cancer.
Dbullous emphysema.
Ebronchial asthma.

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Question 124

The most common cause of esophageal perforation is:

Aswallowed foreign body.
Bendoscopy.
Cspontaneous rupture (Boerhaave’s syndrome).
Dcervical spine surgery.
Epost traumatic rupture.

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Question 125

A 45-year-old patient was admitted to the emergency unit (EU) with a calf injury. Around 7 hours earlier, while cleaning up the garage, the lateral surface of his calf was torn by a piece of sheet metal. The length of the wound is approx. 6 cm, the depth approx. 1.5-2 cm. The wound has torn edges and you can see the redness around it. The patient had tetanus vaccination in the army (26 years before). Which of the following is the most appropriate procedure?

Awound irrigation, dressing, antibiotics.
Bsurgical wound cleaning, human tetanus antitoxin, anatoxin.
Csurgical cleaning, anatoxin, antibiotics.
Dsurgical cleaning, human tetanus antitoxin, antibiotics.
Eantiseptic dressing, antibiotics, secondary wound suturing after cleaning.

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Question 126

The recommended procedure in a patient with symptoms of distal gastrointestinal bleeding is:

Acomputed tomography with a contrast.
Bbarium X-ray.
Ccolonoscopy.
Dselective angiography.
Edigital subtraction angiography (DSA).

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Question 127

A 65-year-old patient called the emergency service because of the heavy pain of the right lower extremity. The pain is located down the knee and the patient is unable to move the foot. Physical examination reveals cold skin in this area and paresthesias. The patient’s medical history is positive for ischemic heart disease and atrial fibrillation. What is the most probable diagnosis in your opinion?

Aarterial embolus.
Bacute venous insufficiency.
Csciatica.
Dleg compartment syndrome.
Eleg phlegmon.

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Question 128

Whipple’s triad is the symptom of:

Aacute pancreatitis.
Bpancreas tumor – insulinoma.
Cperforated duodenal ulcer.
Dupper gastrointestinal bleeding.
Ebowel obstruction.

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Question 129

Which part of the colon is the most common localization of colon cancer?

Aascending colon.
Brectum.
Cdescending colon.
Dtransverse colon.
Eall of them equally.

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Question 130

Courvoisier’s sign is defined as:

Apalpable tumor and tenderness above the right lower abdominal quadrant.
Bpalpable and painless enlargement of the gall bladder.
Clocal excessive intestine movements that can be seen while watching the abdomen.
Dpalpable enlargement of the liver (hepatomegaly).
Epalpable enlargement of the liver and spleen (hepato- and splenomegaly).

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Question 131

Paraesophageal hiatal hernia is defined as the displacement of:

Athe whole stomach with the cardia into the mediastinum.
Bfundus and greater curvature of the stomach without the cardia.
Csmall intestine.
Dstomach with the cardia and liver.
Ecardia and upper part of the stomach.

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Question 132

Contraindication to the upper gastrointestinal endoscopy is/are:

Ableeding esophageal varices.
Bpyloric stenosis.
Cperforated gastric ulcer.
Djaundice.
Ecolon cancer.

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Question 133

A patient with biliary colic attack should not be given morphine because it causes the contraction of the hepatopancreatic ampulla sphincter.

Aboth sentences are true and there is a causal relationship between them.
Bboth sentences are true but there is no causal relationship between them.
Cthe first sentence is true but the second is false.
Dthe first sentence is false and the second is true.
Eboth sentences are false.

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Question 134

When orally administrating paracetamol to children the maximum dosing (per kg body weight) is:

A150 mg every 4 hours.
B15 mg every 4 hours.
C5 mg every 4 hours.
D150 mg every 12 hours.
E15 mg every 12 hours.

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Question 135

Because untreated streptococcal tonsillitis may cause serious complications, in any case of this disease a physician has to report this fact to a district sanitary inspector.

Aboth sentences are true and there is a causal relationship between them.
Bboth sentences are true but there is no causal relationship between them.
Cthe first sentence is true but the second is false.
Dthe first sentence is false and the second is true.
Eboth sentences are false.

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Question 136

Itching of the anus and perineum, insomnia, nervousness and anorexia may be the symptoms of:

Aenterobiasis.
Bascariasis.
Ctrichuriasis.
Dtaeniasis.
Etoxocariasis.

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Question 137

A physician suspecting his patient of suicidal tendencies should directly ask him about it, because the majority of people who committed suicide had suicidal thoughts in the preceding period.

Aboth sentences are true and there is a causal relationship between them.
Bboth sentences are true but there is no causal relationship between them.
Cthe first sentence is true but the second is false.
Dthe first sentence is false and the second is true.
Eboth sentences are false.

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Question 138

The following speaks against the diagnosis of community-acquired pneumonia:

Ano tachycardia with a rate above 100/min
Bno tachypnoe higher than 24/min
Cno temperature higher than 38°C
Danswers A and B are correct
Eanswers A, B and C are correct

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Question 139

The duration of the treatment of non-complicated community-acquired pneumonia with a light and moderately severe course should be as follows:

Aapproximately 5 days.
Bapproximately 5 days, or about 2 days after obtaining stabilization of the clinical status.
Capproximately 7 days, or about 3 days after obtaining stabilization of the clinical status.
D10 days.
E14 days.

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Question 140

The following speaks for viral etiology and against bacterial etiology of acute pharyngitis:

Acough.
Bhigh fever.
Crapid onset.
Dnausea and vomiting.
Epatient age 5-15.

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Question 141

The immediate application of an antibiotic in acute otitis media is recommended in children from risk groups and in severe infections:

Ain children aged under 6 months.
Bin children aged under 2 years with bilateral otitis media.
Cin children with high fever and vomiting.
Din patients with otorrhoea.
Ein all the above-mentioned cases.

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Question 142

Basic treatment in streptococcal pharyngitis consists in the application of the following:

Acefadroxil orally at a dose of 30 mg/kg/daily in 1-2 doses for 10 days.
Bphenoxymethylpenicillin orally at a dose of 100,000 to 200,000 units kg/daily in 2 doses for 10 days.
Camoxycyclin and clavulonic acid at a dose of 90/6.5 mg/kg daily in 2 doses for 5 days.
Dcefuroxime orally at a dose of 30 mg/kg/daily in 2 doses for 5 days.
Eceftriaxone at a dose of 50 mg/kg once per day for 3 days.

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Question 143

A drug of choice in the ambulatory treatment of the infectious aggravations of COPD is:

Aclarithromycin.
Bamoxicillin.
Cdoxycycline.
Dcefuroxime.
Eceftriaxone.

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Question 144

According to WHO, examination for diabetes mellitus should be performed once a year in the following patients:

Awith overweight and obesity.
Bwith polycystic ovary syndrome.
Cwith dislipidaemia.
Dwith cardiovascular diseases.
Ein all the above-mentioned cases.

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Question 145

The recommended frequency of performing glycemia self-control in patients with type 2 diabetes taking oral anti-diabetic drugs or GLP-1 analogues is the following:

Aonce a month an abbreviated glycemic profile
Bonce a week an abbreviated glycemic profile
Cdaily 1 measurements of glycemia; in addition once a week an abbreviated glycemic profile
Dmultiple glycemia measurements daily according to established principles
Emultiple glycemia measurements daily according to established principles, and additionally measurements in the case of malaise

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Question 146

What is the estimated weight of a 5-month-old infant with a birth weight of 3500 g:

A6 kg.
B7 kg.
C8 kg.
D9 kg.
E10 kg.

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Question 147

A 2-month-old breast-fed baby should have the following supplementation of vitamin(s):

AD.
BE.
CK.
DD and E.
ED and K.

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Question 148

What is the resistance of the neck on passive forward flexion, preventing from the chin touching the sternum, called:

ABrudzinski’s contralateral reflex sign.
BBrudzinski’s neck sign.
CKernig’s sign.
Dnuchal rigidity.
EAmos’s sign.

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Question 149

Which of the following concerning paracetamol is true?

Awhen administered rectally it has lower bioavailability than when given orally.
Bit is antipyretic.
Cit is anti-inflammatory.
Danswers A and B are correct.
Eanswers A, B, C are correct.

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Question 150

Which of the following are the characteristic symptoms of scarlet fever?
1) Koplik’s spots;
2) Filatow’s triangle;
3) Pastia’s lines;
4) nuchal and occipital lymphadenopathy;
5) rough-textured, confluent rush.
The correct answer is:

A1,2.
B2,3.
C1,3,5.
D2,3,4,5.
Eall the above.

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Question 151

What would you consider in a 2-year-old child with 6 loose stools for the last 24 hours, without vomiting, fever, or dehydration?

Aadmit to hospital.
Badministration of co-trimoxazole.
Cfluids orally.
Dantibiotics.
Eadministration of metronidazole.

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Question 152

Among the drugs used in the treatment of postoperative pain:

Ametamizole also has a spasmolytic effect.
Bmetamizole is the longest acting non-opioide analgesic.
Cparacetamol may produce red-colored urine.
Dmorphine can be administered to patients with hepatic porphyria.
Ediclofenac may be administered intravenously.

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Question 153

Dry drowning is a term that characterizes the phase of drowning when the following actions take place:

Avocal cord contraction and apnea independent of the will.
Bapnea dependent of the will.
Cflooding the lungs with water.
Dlaryngospasm regression and respiratory movements.
Eit is a phenomenon characteristic of drowning in salty water.

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Question 154

The resuscitation of patients with accidental hypothermia should be continued until their core temperature rises to:

A24°C
B26°C
C28°C
D30°C
E35°C

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Question 155

Which of the following concerning mixed venous oxygen saturation is false?

Ain sepsis, the values may be elevated.
Bdifficulty with interpretation in the case of intracardiac shunts.
Cthe correct value is ≈ 70 mmHg.
Dthe values may increase with an increase in hemoglobin levels at constant oxygen consumption
Eusually increases in general anesthesia.

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Question 156

Which are the parts of „death triad”?

Aacidosis, hypoxemia, hypocapnia.
Bhypoxemia, hypercapnia, hypothermia.
Cacidosis, coagulopathy, hyperthermia.
Dcoagulopathy, hypoxemia, hypocapnia.
Eacidosis, coagulopathy, hypothermia.

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Question 157

What does the term Damage Control mean?

Ainitial stabilization of the patient’s health condition.
Bseizures treatment, warming up the patient.
Cfluid therapy, antibiotic therapy.
Ddiagnosis of injuries and hemodynamic stabilization.
Epermissive hypotension and oxygen therapy.

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Question 158

In what kind of the following accidents first aid can be delivered only to some extent?

Aaviation.
Btrain.
Csea.
Dmultiple.
Emassive.

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Question 159

The only reliable sign of death of the patient in profound hypothermia is:

Alack of reflexes.
Bunsuccessful resuscitation despite warming the patient up.
Cno response to defibrillation.
Dwide, not reacting to light pupils.
Elack of spontaneous breathing.

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Question 160

Which of the following can cause the death of a patient suffering from hemoptysis?

Amassive blood loss.
Bintravascular clotting.
Csevere coagulopathy from the use of coagulation factors.
Dsevere respiratory failure.
Esevere circulatory failure.

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Question 161

The most important disturbances in electrolyte balance concern:

Amagnesium.
Bsodium.
Ccalcium.
Dpotassium.
Echloride.

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Question 162

In which of the following life-threatening situations rhabdomyolysis does not occur?

Acocaine intoxication
Bburns
Cbenzodiazepines intoxications
Dcrush syndrome
Eintoxication with seizures

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Question 163

In a patient with severe dyspnea, the first steps should be:

Aperform an ECG test
Bperform a chest X-ray
Cperform blood gas analysis
Dgive oxygen
Einsert an intravenous line

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Question 164

Which of the following lab tests should be performed as the first choice in unconscious patient admitted to ER?

Ahemoglobin, hematocrit.
Bblood gasometry.
Clevel of urea and creatinine.
Dcardiac markers.
Eglucose level.

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Question 165

The first aid for burns from boiling water in the upper limb of an adult male aged about 50 consists in:

Acovering the burnt with a clean and dry sheet.
Bwaiting for the arrival of the ambulance while leaving the victim in peace.
Cputting a wet dressing on the burnt and waiting for the arrival of the ambulance.
Dcooling the limb by immersing it in cold water for 10-15 minutes.
Ecooling the limb with cold running water or using a hydrogel dressing.

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Question 166

What percentage of a 10-year-old child’s body surface is the burn of the groin, the left leg and the front surface of the torso?

A18%.
B28%.
C30%.
D33%.
E38%.

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Question 167

Hypokalemia may manifest itself in the form of:

Aextrasystoles, sometimes ventricular fibrillation.
Bhypersensitivity to cardiac glycosides.
Cmuscle weakness, sometimes rhabdomyolysis.
Dparesthesias, nervous hypersensitivity or apathia.
Eall the answers are correct.

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Question 168

The Hippocratic oath prohibits:

Ain vitro fertilization.
Babortion.
Ccontraception.
Danswers A,B,C are true.
Eanswers A,B,C are false.

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Question 169

The only chance for treatment of an unconscious 18-year-old patient is his participation in a medical experiment. In accordance with legal regulations:

Ahe has to die.
Bin this situation, not the Polish regulations but the Oviedo Convention applies.
Cthe doctor may decide himself after consulting the Regional Medical Chamber.
Dconsent may be given by his mother.
Econsent may be given by the guardianship court.

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Question 170

Does the Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine contain provisions on creating human embryos for research purposes?

Ano.
Brecommends creating embryos for research purposes.
Cit prohibits creating embryos for research purposes.
Dit leaves the decision to researchers.
Eit leaves the decision to parents.

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Question 171

Which document describes tasks, principles and organizations of the chambers of physicians and dentists and rights and obligations of their members?

Adeclaration on medical self-government.
Bact on Chambers of Physicians and Dentists.
Cregulations on Chambers of Physicians and Dentists.
Dconstitution of the Republic of Poland
Eact on Trade Unions.

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Question 172

When no contraindications are found during a medical examination before a mandatory vaccination, it should be carried out within a reasonable period after this examination. This period is maximum:

A12 hours.
B24 hours.
C36 hours.
D48 hours.
E60 hours.

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Question 173

Medical duty is understood in Polish law as physician’s professional activities performed:
1) in normal working time;
2) in a healthcare institution designed for patients requiring twenty-four hour health care services;
3) in overtime;
4) in time outside normal working hours, but calculated as working time;
5) and paid with the addition of 200% of the hourly rate calculated of the minimum wage.
The correct answer is:

A1,5.
B2,3.
C2,4.
D3,5.
E4,5.

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Question 174

A doctor confirming death is obliged to:
1) determine (if possible) the identity of remains;
2) consult the documents concerning the health status of the deceased in the period prior to his death;
3) issue “Akt zgonu” (a Death Certificate);
4) notify a relevant prosecutor or police if he suspects the death was caused by a crime;
5) perform an autopsy.
The correct answer is:

A1,2,3.
B2,4,5.
C1,2,4
D3,4,5.
E2,3,5.

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Question 175

A legally capacitated adult patient who is in a pharmacological coma is treated in a hospital ward. Previously, he has not authorized physicians to provide information to any third parties. In this case, his doctor may release information about patient’s health to:
1) his spouse;
2) his parents-in-law;
3) a person remaining with him in cohabitation;
4) a journalist;
5) his legal representative.
The correct answer is:

A1,2,3.
B1,2,4.
C1,2,5.
D1,3,5.
E2,3,5.

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Question 176

A criminal court punishing a physician who has committed a criminal offense in connection with his professional activity may set an additional penalty in the form of:
1) 1-10 year professional activity ban;
2) withdrawal of his right to practice profession for life;
3) confiscation of the objects used to commit the crime;
4) reprimand with an entry in the register of the regional chamber of physicians and dentists;
5) liability for damages.
The correct answer is:

A1,2,4.
B2,3,4.
C1,3,5.
D2,4,5.
E3,4,5.

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Question 177

A training pension is granted to a person with a relevant period of insurance and who was stated to be appropriate for professional retraining due to incapacity to continue their current occupation. The total period of paying a training pension cannot exceed:

A12 months.
B18 months.
C18 months.
D30 months.
E36 months.

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Question 178

Which of the following is not included in the Minister of Labour and Social Policy Regulations dated 1 February 2002 on the criteria for assessing disability in people under 16 years as a medical condition necessitating constant care or assistance:

Apsychosis and psychotic syndromes.
Bautism.
Cfrequent respiratory infections.
Depilepsy with frequent seizures or explicit psychoneurological consequences.
Emental retardation.

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Question 179

The basic period of receiving the benefit from social insurance for farmers is 180 days. If, after this period, the insured is still unable to work but as a result of further treatment and rehabilitation may regain their capacity for work then the benefit period is extended but not more than:

A60 days.
B120 days.
C180 days.
D240 days.
E360 days.

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Question 180

The SIF (ZUS) certifying doctors while considering incapacity to work do not have to take into account one of the following:

AState Sanitary Inspection (PIS) decisions stating an occupational disease.
Bgovernor’s findings that there are not professional retraining opportunities.
Clegally abiding arrangements for the recognition of events as accidents at work.
Doccupational doctors’ rulings.
Emilitary medical boards’ rulings for establishing a link between identified injuries and war and between illnesses and military service.

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Question 181

A person who is under 20 years of age fulfils the condition of the required contributory and non-contributory period for granting a pension due to incapacity to work if this total period is at least:

A1 year.
B2 years.
C3 years.
D4 years.
E5 years.

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Question 182

Employees’ social insurance does not include:

Atemporary incapacity to work due to illness.
Blong-term incapacity to work due to illness.
Cinability to live independently.
Dlong-term incapacity to work due to occupational disease.
Elong-term incapacity to work due to an accident on the way to and from work.

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Question 183

A medical certificate of temporary incapacity to work due to illness or the necessity of personal care for an employee’s sick family member is issued:

Aafter physical examination of the insured or their sick family member.
Bbased on the information card from the hospital.
Cbased on the certificate from a specialist.
Dbased on the certificate from the ambulance service.
Ebased on the information card from the sanatorium.

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Question 184

Which statement concerning average life expectancy in the first decade of 21st century is true?

ABulgaria and Greece enjoy the greatest life expectancy among European countries.
Baverage life expectancy in Poland over the last 20 years has not changed significantly.
Cat present the average life expectancy for Polish women is about 85 years and it means that our country is among European populations with the greatest life expectancy.
Dat present the average lifespan for males in Poland is about 71 years and for women 80 years.
Eat present the average lifespan for males in Poland is about 75 years and for women 83 years.

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Question 185

Which statements concerning the most important causes of mortality in Poland over the last 20 years are false?

1) there have been no significant changes in the total number of deaths;

2) decline in mortality due to cancer has been significantly greater than from cardiovascular diseases;

3) the most important reason for the reduction of the total number of deaths has been a significant decrease in deaths from cardiovascular diseases;

4) cardiovascular diseases and tumours are the reason for over 70% of all deaths at present;

5) cardiovascular mortality among women is higher than men.

The correct answer is

A1,5.
B1,2.
C1,3,4.
D1,2,5.
E1,3,4,5.

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Question 186

Cardioverter–defibrillator implantation in a patient after successful resuscitation following cardiac arrest could be classified as the activity in the frame of:

Ahealth promotion.
Bprimary prevention.
Csecondary prevention.
Dambulatory cardiac rehabilitation.
ENational Health Program 2010-2025.

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Question 187

According to WHO experts’ prognoses the most prevalent reasons for mortality in European countries with high and medium level of economic development (including Poland) in 2030 will be:

Atuberculosis and AIDS.
Binjuries, suicides and road injuries.
Cdiabetes, metabolic syndrome and obesity.
DAlzheimer disease and other dementias of vascular origin.
Eall the answers are false.

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Question 188

Which statement or statements concerning health promotion is or are false?

1) health promotion is a process enabling people to improve control over their own health;

2) health promotion is addressed mainly to high risk individuals or sick persons;

3) intersectorial activity is an important feature of health promotion e.g. cooperation between various ministries, scientific societies and social organizations in order to propagate healthy nutrition and physical activity;

4) developing health promoting policy is an important component of health promotion;

5) habitat approach to health promotion means practically that health promoting activities could be performed in schools, hospitals, sports clubs and prisons.

The correct answer is:

Aonly 2.
B2,5.
C2,3,5.
D2,3,4,5.
Enone of the above.

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Question 189

Among the main factors responsible for significant decrease in mortality due to coronary heart disease in Poland over the last 20 years are:
1) reduction in smoking among males;
2) beneficial reduction in fat consumption i.e. increase in vegetable oil consumption and reduction in butter consumption;
3) reduction of obesity prevalence in children, youth and adults;
4) more frequent use of statins and aspirin in secondary prevention;
5) better availability of angiography and invasive cardiological procedures (PCI, CABG) for patients with acute coronary syndromes.
The correct answer is:

Aonly 5.
B1,3,5.
C2,3,4,5.
D1,2,4,5.
Eall the above.

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Question 190

Among screening procedures recommended in early detection of socially important chronic diseases by international and national experts are:

1) screening in order to diagnose early cervical cancers;

2) screening in order to diagnose early prostate and lung cancers;

3) screening in order to diagnose early diabetes;

4) screening in order to diagnose early breast cancers;

5) screening in order to diagnose early oesophagus and liver cancers.

The correct answer is:

A1,4.
B1,2,4.
C1,2,3.
D1,3,4.
E1,2,4,5.

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Question 191

The primary objectives of health care include:
1) prevention of socially important infectious and non-infectious diseases;
2) assurance of universal and equal access to health care;
3) monitoring the health of the population;
4) promoting healthy lifestyle;
5) public health legislation.
The correct answer is:

A1,2.
B1,2,4.
C1,3,5.
D1,2,3,4.
Eall the above.

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Question 192

In a 55-year-old male after spinal injury with permanent catheter in the bladder, asymptomatic bacteriuria was found. The following strategy should be implemented:

Aantibiotic therapy for 7 days.
Bchange of the catheter after each episode of asymptomatic bacteriuria.
Cantibiotic therapy for at least 6 months.
Dtherapy with antibiotics/chemotherapeutics only in the presence of the signs and symptoms of urinary tract infection.
Ethere is no need to treat such patients.

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Question 193

Which of the following hepatotropic virus infections are spreading through fecal-oral transmission?
1) HAV;
2) HCV;
3) HBV;
4) HDV;
5) HEV.
The correct answer is:

A1,2.
B3,4.
C1,4.
D1,5.
E2,5.

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Question 194

The first-line antibiotic treatment of pertussis in children is:

Afirst-generation cephalosporin.
Bpenicillin.
Csecond-generation cephalosporin.
Dmacrolide.
Ethird-generation cephalosporin.

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Question 195

Choose the correct sentence concerning rubella prophylaxis:

Apregnant women may receive the vaccine by the end of I trimester only.
Brubella in patient’s past medical history is a contraindication to vaccination.
Crubella vaccination is obligatory for every girl in Poland.
Drubella vaccination is obligatory in the first year of life.
Eall the above sentences are false.

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Question 196

Intravascular volume replacement with the colloid fluids requires supply:

Aas much as is the volume deficit.
B1,5 times as much as is the volume deficit.
C3 times as much as is the volume deficit.
D4 times as much as is the volume deficit.
E7 times as much as is the volume deficit.

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Question 197

One of the causes of prerenal acute renal failure can be:

Anephritis.
Bnephrolithiasis.
Cembolism of renal vessels.
Dsepsis.
Ehypertrophy of the prostate.

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Question 198

The common signs in pulmonary embolism are:

AECG changes
Bdyspnea and hemoptysis
Cpain in the chest and coughing
Dsuppression of a vesicular murmur and hollow heart tones
Ehypoxia and hypercapnia

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Question 199

A patient after a head injury has her/his eyes closed. Under the influence of pain stimulus he/she opens them, locates the pain and responds to questions but uses the wrong words. The level of consciousness on the Glasgow Coma Scale (GSC) should be estimated at:

A10 pt.
B11 pt.
C12 pt.
D13 pt.
Esuch a case cannot be estimated with GSC.

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Question 200

The validity of a prescription after the date of its issuing does not exceed:

1) 7 days for pharmacy-made drugs;

2) 14 days for antibiotics and in the case of prescriptions issued by emergency care institutions;

3) 30 days generally;

4) 90 days for immunological drugs prepared for individual patients;

5) 150 days for drugs and medical devices imported from abroad for individual users.

The correct answer is:

A1,3,5.
B2,4,5.
C2,3,4.
D3,4,5.
E2,3,5.

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