Internal disease

Zolinger –Ellison Syndrome is:

a) gastric acid hyper secretion and gastrinoma

b) ulcerative colitis

c) systemic lupus erythematosus.

d) radiation damage

127. 
     Drug therapy of acute glomerulonephritis:
     

a) NSAIDs, corticosteroids;

b) cytostatics, glucocorticosteroids;

c) statins, heparin

d) all true

127. 
     The group of antibiotics has the nephrotoxicity:
     

1. Penicillin

2. Cephalosporins

3. * Aminoglycosides

4. Macrolides

127. 
     Which of the following is the most accurate statement regarding H pylori infection?
     

A. It is more common in developed than underdeveloped countries.

B. It is associated with the development of colon cancer.

C. It is believed to be the cause of nonulcer dyspepsia.

D. It is believed to be a common cause of both duodenal and gastric ulcers.

127. 
     Season-dependent pains in the epigastric region are typical of:
     

1. 
   Crohn's disease
   
2. 
   gastric cancer
   
3. 
   -pyloric ulcer
   
4. 
   exacerbation of chronic gastritis
   

127. 
     The most common manifestations of hypersplenism in liver diseases are:
     

1. 
   anemia
   
2. 
   leucopenia
   
3. 
   thrombocytopenia
   
4. 
   -anemia, leucopenia, thrombocytopenia, splenomegaly
   

127. 
     What drugs are required for treatment of gastritis associated with Helicobacter?
     

1. 
   Vicaline, antacids, metoclopramide
   
2. 
   histamine receptors H2-blockers
   
3. 
   almagel, metoclopramide
   
4. 
   -de-nol,–metronidasole,-amoxicilline
   

127. 
     Which of the listed below indices is the most informative for the diagnosis of acute pancreatitis?
     

1. 
   leukocytosis
   
2. 
   blood sugar
   
3. 
   alkaline phosphatase
   
4. 
   -amylase of blood and/or urine
   

127. 
     What drugs are indicated for patients with irritable bowel syndrome suffering from diarrhea?
     

1. 
   steamed wheat bran
   
2. 
   mucofalc
   
3. 
   -immodium
   
4. 
   forlax
   

127. 
     Which one of the following patients should be promptly referred for endoscopy?
     

1. 
   A 65-year-old man with new onset of epigastric pain and weight loss
   
2. 
   A 32-year-old patient whose symptoms are not relieved with ranitidine
   
3. 
   A 29-year-old H pylori-positive patient with dyspeptic symptoms
   
4. 
   A 49-year-old woman with intermittent right-upper quadrant pain following
   

meals

127. 
     Gastrin is prodused
     

1. 
   H-cells;
   
2. 
   М-cells;
   
3. 
   G-cells; *
   
4. 
   Р-cells;
   

127. 
     A 42-year-old overweight but otherwise healthy woman presents with sudden
     

onset of right-upper abdominal colicky pain 45 minutes after a meal of fried

chicken. The pain is associated with nausea and vomiting, and any attempt to eat

since has caused increased pain. Which of the following is the most likely cause?

1. 
   Gastric ulcer
   
2. 
   Cholelithiasis
   
3. 
   Duodenal ulcer
   
4. 
   Acute hepatitis
   

127. 
     A 45-year-old man was brought to the ER after vomiting bright red blood. He has a blood pressure of 88/46 mm Hg and heart rate of 120 bpm. Which of the following is the best next step?
     

1. 
   Intravenous fluid resuscitation and preparation for a transfusion
   
2. 
   Administration of a proton-pump inhibitor
   
3. 
   Guaiac test of the stool
   
4. 
   Treatment for H pylori
   

127. 
     Diagnostic methods for H.pylori verification are:
     

a. histologycal; * ureas test; *

b. microbiological blood test on H. Pylori;

c. microbiological stool test on H. Pylori;

d. all the criteria can be used

127. 
     Main diagnostic method for chronic gastritis is:
     

1. 
   coprogram;
   
2. 
   pH-metria of gastric juice;
   
3. 
   stomach X-ray with barium meal;
   
4. 
   gastroscopy with results of histological investigation. *
   

127. 
     A 15-year-old adolescent female has elevated liver enzymes and a positive
     

antinuclear antibody (ANA). Choose the one cause (A-G) that is probably

responsible for the patient’s presentation.

A. Alcohol-induced hepatitis

B. Viral hepatitis

C. Primary biliary cirrhosis

D. Autoimmune hepatitis

127. 
     Typical localisation of chronic gastritis type A is:
     

1. antral part of the stomach;

2. gastroesophageal part of the stomach;

3. cardia;

4. body of the stomach; *

127. 
     Characteristic of pain in chronic gastritis:
     

1. localisation in mesogastrium beginnig in night ;

2. localisation in right hypochandrium with irradiation in right shoulder;

3. localisation in epigastrium which is began after meal; *

4. localisation in epigastrium which is redused after meal;

127. 
     Localisaton of process in chronic gastritis В is:
     

1. antral part of the stomach; *

2. gastroesophageal part of the stomach;

3. cardia;

4. body of the stomach.

127. 
     H. pylory is localisated
     

1. in adventicia;

2. in muscular layer of the stomach;

3. under the layer of mucin; *

4. in mucose of the stomach.

127. 
     Ussually H. pylory is localisated
     

1. antrum; bulbus of the duodenum;

2. cardia of the stomach;

3. esophagus;

4. body of the stomach.

127. 
     Creatorea is symptom of
     

1. pancreas excretory insuffisiency; *

2. reflux-esophagit;

3. chronic cholecistitis.

4. chronic duodenitis;

127. 
     Second line drugs for H. Pylori eradication are
     

1. amoxicillin;

2. clarithromicin; sumamed;

3. sumamed;

4. tetracyclin; * tinidasol. *

127. 
     Parietal cells of stomach mucous produse
     

1. gastrin;

2. natria hydrocarbonat;

3. pepsinigen;

4. prostaglandins;

5. chloric acid. *

127. 
     A 35-year-old woman has chronic crampy abdominal pain and intermittent
     

constipation and diarrhea, but no weight loss or gastrointestinal bleeding. Her

abdominal pain is usually relieved with defection. Colonoscopy and upper

endoscopy with biopsies are normal, and stool cultures are negative. Which of

the following is the most likely diagnosis?

A. Infectious colitis

B. Irritable bowel syndrome

C. Crohn disease

D. Ulcerative colitis

127. 
     Medication which is decreased synthesis of hydrochloric acid:
     

1. almagel;

2. amoxicillin;

3. omeprasol;*

4. venter;

127. 
     “Aggressive” factors in pathogenesis of ulcer disease are:
     

1. pepsin; * hydrochloric acid; *

2. alcalotic reaction of the saliva.

3. mucous stomach cells proliferation;

4. hydrochloric acid

127. 
     Drug depended ulcer is induced
     

1. streptokinase.

2. metoprolol;

3. prednisolon;*

4. salmeterol;

127. 
     Main clinical symptom in duodenum ulcer disease is:
     

1. pain on empty stomach; *

2. diarrhoea;

3. eructation;

4. early pain after meal;

127. 
     Penetration of ulcer into the pancreas lead to increasing of
     

1. amylase; *

2. lipase;

3. alkaline phophotase

4. ALT;

127. 
     Cytolic syndrom is characterised high level of
     

1. γ-glutamintranspeptidas (-GT);

2. alkalitphosphotas;

3. ALT;* AST;* lactatdegidrogenas;*

4. direct bilirubin.

127. 
     Symptoms of cyrrhotic stage of chronic hepatitis are
     

1. ascites, varicose esophagus veins;*

2. high level of WBC;

3. high tempriture.

4. high level of albumin;

127. 
     Replicative phase of HBV-infection is characterized
     

1. HBV DNA in plasma;* HBe Ag in plasma;*

2. HBs Ag in plasma; HBcor Ag in plasma;

3. Hbe-Ab in plasma.

4. HBcor Ag in plasma;

127. 
     Integrative phase of HBV-infection is characterized
     

1. HBV DNA in plasma;

2. HBs Ag in plasma;* HBe-Ab in plasma.*

3. HBe Ag in plasma;

4. HBcor Ag in plasma; HBV DNA in plasma;

127. 
     Mesenchimal inflamation sindrom are characterised
     

1. high level of γ-globulin;* high timol test. * high ESR;*

2. high level of bilirubin; high level of WBC;

3. low level of protrombin;

4. high level of WBC;

127. 
     “Gold standart” treatment in chronic hepatitis C is
     

1. monotherapy of recombinant interferon;

2. monotherapy of lamivudin;

3. combination of interferon and antivirus medication (ribavirin);*

4. combination of interferon and lamivudin.

127. 
     241) Duration of antiviral course in chronic viral hepatitis
     

1. 3 monthes;

2. 6-12 monthes; *

3. 24 monthes;

4. 36 monthes.

127. 
     Indications to paracentesis in liver cirrhosis are
     

1. high level of bilirubin (more than 100 mkmol/l);

2. refractive to treatment ascites;*

3. bacterial peritonitis;

4. ascites which induses pulmonary failure.*

127. 
     Clinical signs of the portal hypertension are:
     

1. ascites; * esophageal and hemorrhoid varicose veins; *

2. gynecomastia;

3. itch of the skin;

4. coma.

127. 
     Kera’s symptom is
     

1. painfull in tape on right costal arch;

2. painfull in palpation of gall bladder region;*

3. painfull in palpation between legs of right musculus sterno-cleudo-mostoideus;

4. patient stops breath in palpation of gall bladder region.

127. 
     Ortner’s symptom is
     

1. painfull in tape on right costal arch; *

2. painfull in palpation of gall bladder region;

3. painfull in palpation between legs of right musculus sterno-cleudo-mostoideus;

4. patient stops breath in palpation of gall bladder region.

127. 
     Merphy’s symptom is
     

1. painfull in tape on right costal arch;

2. painfull in palpation of gall bladder region;

3. painfull in palpation between legs of right musculus sterno-cleudo-mostoideus;

4. patient stops breath in palpation of gall bladder region. *

127. 
     Mussy’s symptom is
     

1. painfull in tape on right costal arch;

2. painfull in palpation of gall bladder region;

3. painfull in palpation between legs of right musculus sterno-cleudo-mostoideus; *

4. patient stops breath in palpation of gall bladder region.

127. 
     Cirrhotic stage of chronic hepatitis is characterised
     

1. limphoid inflamatory infiltration;

2. changing morphological structure of liver; fibrose 4-th degree;*

3. high level of WBC;

4. hig degree of hepatocite distrophia;

127. 
     Clinical signs of the portal hypertension are:
     

1. ascites; * esophageal and hemorrhoid varicose veins; *

2. coma.

3. gynecomastia;

4. itch of the skin;

127. 
     Etiological treatment of chronic hepatitis:
     

1. diuretics;

2. sandostatin.

3. ursodesoxycholic acid drugs;

4. recombinant interferon ; *

127. 
     Treatment decreasing of high ammonia level in the blood in portal encephalopathy:
     

1. vitamin C;

2. hepa-merc; * dufalac; *

3. essential, ursodesoxycholic acid drugs;

4. ursofalk;

127. 
     Clinical feature of chronic pancreatitis in acute stage is characterized:
     

1. diarrhea more than 10 time per day with mucus in stool;

2. girdle pain in hypogastric area;

3. girdle pain in epigastric area; * nausea. * meteorism; *

4. reflux esophagitis;

127. 
     Level of α-amylase in blood is increased in
     

1. Irritable bowel syndrome

2. attack of chronic pancreatitis; *

3. peritonitis;

4. reflux esophagitis;

127. 
     The type gall stones which can dissolve in result of ursodesoxycholic acid administration is:
     

1. calcii-bilirubinate;

2. cholesterol; *

3. “black pigment”;

4. any stones.

127. 
     Cholesterin gallstone is diagnosticated after:
     

1. abdomen ultrasound;

2. abdomen X-ray; *

3. isotopic cholecistography;

4. retrograd cholecistopancreatoduodenography.

127. 
     For the basic treatment of rheumatoid arthritis include:
     

      a) dimexide

b) prednisone

      c) Indomethacin

      d) methotrexate *

127. 
     Specify the most frequent side effect of NSAIDs:
     

a) hepatotoxicity

b) an increase in blood pressure

c) dermatitis

g) gastropathy *

127. 
     What hematologic changes are typical for SLE?
     

a) polycythemia

b) eosinophilia

c) leukocytosis

g) leukopenia *

127. 
     The best drug of treating SLE is –
     

1. Aspirin

2. Indomethacin

3. Phenylbutazone

4. Steroids *

127. 
     What are the tophi?
     

1. osteophytes

2. deposition of urate in the tissues

3. inflamed granulomas

4. induration subcutaneous tissue

127. 
     Acute gout attack can be triggered by:
     

1. hypothermia

2. mild trauma

3. The abuse of alcohol and meat foods

4. The long walking

127. 
     During which of the following periods in a woman’s life is the most bone mass
     

accumulated?

A. Ages 15-25

B. Ages 25-35

C. Ages 35-45

D. Ages 45-55

127. 
     Heberden's nodes for the most typical:
     

A) gout

s) osteoarthritis

C) Rheumatoid Arthritis

D) periarteritis nodosa

127. 
     Which of the following indicators most informative in the differential diagnosis of rheumatoid arthritis and systemic lupus erythematosus?
     

A) ESR acceleration

B) increase in IgG, IgM, IgA

c) the presence of LE cells in blood

D) increase in C-reactive protein

127. 
     Which of the following patients is most likely to be a candidate for bone
     

mineral density screening?

A. A 65-year-old, thin, white woman who smokes and is 15 years

postmenopausal

B. A 40-year-old white woman who exercises daily and still menstruates

C. A healthy 55-year-old white man

D. A 50-year-old overweight African American woman

127. 
     Basic drugs for the treatment of osteoarthritis include:
     

a) prednisolone;

b) chondroitin sulfate;

c) movalis;

g) aloe extract;

d) indomethacin.