TESTS

Test 1.A girl of 7 years old complains of irritability, headache, and attack-like pain in the right hypochondrium which appear after intake of oily food. Temperature is normal; there are no pathologic changes in blood analysis. Hyperkinetic dyskinesia of gall bladder is diagnosed. What from mentioned below is necessary to include in complex therapy with caution?A. Duodenal intubationB. Physiotherapy of sedative typeC. CholespasmolyticsD. PhytotherapyE. Mineral water of low mineralization

Test 2.A boy of 14 years old complains of acute pains at right hypochondrium, which appeared after intake of fatty food. Objectively: painfulness at palpation of right hypochondrium and positive symptoms of Ker, Merphy and Ortner. At ultrasound examination of gallbladder 2 concretions of 4 mm in diameter were revealed. Which diet is indicated to a patient?A. N5B. N1C. N7D. N4E. N15

Test 3.Chronic cholecystitis has been diagnosed in a child of 12 years old 3 years ago. Clinical-laboratory remission is seen during last 2 years. Which group of health he must be related to?A. IB. IIC. IIID. IVE. V

Test 4.The girl of 12 years old was examined for dyskinesia of gall bladder. Hyperkinetic type of dyskinesia was confirmed with the help of ultrasound investigation taking into account that hyperkinetic dyskinesia of gall bladder is characterized with its retraction after choleretic meal for:

A. 85% of its primary volume B. 55% of its primary volume C. 40% of its primary volume D. 30% of its primary volume

E. 60% of its primary volume

Test 5.A boy of 12 years old entered the hospital with complaints of piercing pains at right hypochondrium, appearance of icteric tint of sclera and skin and nausea. Objectively: painfulness at palpation of right hypochondrium, sharp painfulness at Ker’s point and positive Merphy’s symptom. At ultrasound examination of liver and gallbladder concretions in gallbladder and bile duct were revealed. What is the diagnosis?A. Viral hepatitis BB. Chronic cholecystitisC. Dyskinesia of bile ductsD. CholelithiasisE. Acute cholecystittis

Test 6.

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Chronic lamblious cholecystitis is diagnosed in a boy of 12 years old. Which ethiotropic therapy is it necessary to prescribe?A. RovamicinB. AmpioxC. FuradoninD. MetronidasolE. Cefazolin

Test 7.Dyskinesia of bile ducts of hypertonic type is diagnosed in a boy of 8 years old. Where is it necessary to treat a patient?A. At infectious departmentB. At homeC. At gastroenterological departmentD. At day-time gastroenterological hospitalE. At surgical department

Test 8.A boy of 7 years old complains of fatiguability, heart beating and pains in epigastrium which appear after physical exertion. Hyperkinetic dyskinesia of gall bladder was supposed. What character of pain is the most typical for this type of dyskinesia?A. Attack-like painB. Boring painC. Piercing painD. Dull painE. Belt-like pain

Test 9.A girl of 13 years old complains of acute pains in the right hypochondrium and nausea, which appeared after intake of fatty food. Objectively: scleras are icteric, palpation of right hypochondrium is painful, “gallbladder” symptoms are positive and liver is not enlarged. At duodenal intubation prolongation of portion “B” phase was revealed. Which mostly informative examinations will confirm the diagnosis?A. Blood and urine testB. Biochemical examination of bileC. Ultrasound examination of liver and gallbladderD. Proteinogram, blood amylaseE. Functional liver tests, fibrogastroduodenoscopy

Test 10.A girl of 12 years old complains of pain at right hypochondrium, which appeared after physical exertion, and nausea. At duodenal intubation time of portion B excretion was 45 minutes. AT ultrasound examination: thickness of gallbladder wall – 3mm, concretion of 5 mm in diameter. Which predispositions to appearance of cholelithiasis exist in this case?A. Physical exertionB. Infectious factorC. Nutritional faultsD. Bile’s stagnationE. Psychical load

Test 11.A boy of 8 years old complains of boring pain at right hypochondrium, decrease of appetite and subfebrile temperature. Objectively: slight pallor of skin, abdomen is painful in right subcostal region, symptoms of Ker and Merphy are positive. Which examination is it necessary to prescribe to a patient?A. Full blood test, duodenal intubation, ultrasound examination of liver and gall bladderB. Fibrogastroduodenoscopy, urine test, functional liver testsC. Fractional gastric intubation, amylase of blood, proteinogramD. Full blood test, urine test, functional liver test

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E. Coprogram, full blood test, ultrasound examination of kidneys and urine bladder

Test 12.A girl of 13 years old complains of dull pain at right hypochondrium. Objectively: painfulness at palpation of right hypochondrium and positive “gallbladder: symptoms. At duodenal intubation time of the 4th phase is prolongated, volume of gallbladder bile is 70ml, rate of portion B excretion is 0,8ml/min. Patient’s mother has cholelithiasis. Which drugs are indicated to a patient in order to prevent cholelithiasis?A. HydrocholereticsB. SorbitC. CholosasD. AllocholE. Nicodin

Test 13.A child of 10 years old suffers from pains in right subcostal region, which is provoked by physical loads, fatty and fried food. Positive painful syndrome in point of Ker is revealed during palpation. At ultrasound investigation enlargement of gall bladder and increased density of its wall, without its thickening, is found. After intake of bile-expelling breakfast the gall bladder retracted for ¼ of its volume. Which cholagogue drug is it necessary to prescribe?A. AllocholB. Magnesium sulfasC. CholenzymeD. SorbitE. Cholosas

Test 14.Abdominal pains after intake of fatty food appeared in a girl of 10 years old. Objectively: general condition is satisfactory, pain during palpation of abdomen, positive symptom of Ker. Which examinations are necessary to prescribe for verification of diagnosis?A. Proteinogram, fractional gastric intubationB. Indices of acute phase, full blood testC. Duodenal intubation, ultrasound examination of liverD. Functional liver tests, urine test for bile pigmentsE. Fibrogastroscopy, pH-metry

Test 15.A girl of 8 years old was admitted to the hospital with complaints of pains in the right hypochondrium, fatigue, sweating, and irritability. Bile ducts dyskineia was suspected. What is the most frequent cause of bile ducts dyskinesia in children?A. Neuricirculatory dysfunctionB. Intake of super cooled or overheated foodC. Prolonged intake of salicylates and antibioticsD. Intake of rough, off-grade foodE. Physical overloading

Test 16.A girl of 8 years old complains of attack-like pains in right subcostal region and around umbilicus, which appear after physical load, and disposition to constipation. Objectively: skin is of normal color. There are carious teeth in mouth cavity. Abdomen is soft, painful in right hypochondrium. Liver is 2cm below the right ribs arch, elastic. AT duodenal intubation: failures at receiving of portion “B”, 2nd phase is prolonged, and bile of portions “A” and “C” is normal. What diagnosis is it possible to establish?A. Chronic cholecytocholangitis B. Dyskinesia of bile ducts of hypertonic-hyperkinetic typeC. Dyskinesia of bile ducts of hypertonic typeD. Chronic hepatitisE. Dyskinesia of bile ducts of hypotonic type

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Test 17.Dyskinesia of bile ducts of hypokinetic type is diagnosed in a girl of 10 years old. Which bile-expelling drugs are not recommended for her?A. SpasmolyticsB. SedativeC. CholekyneticsD. CholereticsE. Vitamins

Test 18.The girl of 12 years old was examined for dyskinesia of gall bladder. Hyperkinetic type of dyskinesia was confirmed with the help of ultrasound investigation taking into account that hyperkinetic dyskinesia of gall bladder is characterized with its retraction after choleretic meal for:A. 40% of its primary volumeB. 55% of its primary volumeC. 85% of its primary volumeD. 30% of its primary volumeE. 60% of its primary volume

Test 19.A girl of 9 years old has permanent boring aches in right subcostal region, which appear after intake of fatty food, and nausea. Which is your preliminary diagnosis?A. Dyskinesia of bile ducts of hyperkinetic typeB. Dyskinesia of bile ducts of hypokinetic typeC. Dyskinesia of bile ducts of hypertonic typeD. Dyskinesia of bile ducts of hypotonic typeE. Dyskinesia of bile ducts of hypertonic-hyperkinetic type

Test 20.In the girl of 14 years old the hypertonic type of biliary tracts dyskinesia was diagnosed after considering various clinical and laboratory signs namely all the mentioned signs are typical for hypertonic type of biliary tract's dyskinesia except:

A. "Night and hungry" pain B. Pains above umbilicus at the right part in 20-30 minutes after meal C. Liver's enlargement D. Peripheral subicterus of sclerotics E. Prolongation of closed sphincter Oddi's phase during duodenal intubation more than 10 minutes

Test 21.A boy of 8 years old suffered from hepatitis B a year ago. During last 2 months he complaints of fatigue, disorders of sleep, decrease of appetite, and nausea, especially in the morning. Skin is free of jaundice, liver and spleen are palpated 1 cm below the ribs’ arch, painless. ALT is 2,2mmol/l. This condition is considered to be:A) Development of chronic hepatitisB) Recurrence of viral hepatitis BC) Dyskinesia of bile ductsD) Residual effects of hepatitis BE) Development of hepatic cirrhosis

Test 22.In the girl of 14 years old the diagnosis of hepatitis was confirmed with the help of finding in the blood antihepatic antibodies. But preliminary diagnosis of autoimmune hepatitis was established on the base of clinical symptoms. In particularly chronic autoimmune hepatitis is probable if following signs are present:

A. All mentioned B. Hepatosplenomegaly C. Hypergammaglobulinemia

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D. Hypertransferasemia E. Hyperbilirubinemia

Test 23.Dyskinesia of bile ducts of hypotonic type is diagnosed in a girl of 7 years old. Which diet is it necessary to prescribe?A. Table N10B. Table N5C. Table N8D. Table N1E. Table N7

Test 24.A boy of 12 years old admitted to a hospital with complaints of abdominal pain, elevated temperature to 38 C, edema on face and shanks, decrease of urine’s quantity and change of urine’s color (“meat slops”). Objectively: pallor, edema on face and shanks, BP – 140/90mm Hg, CR – 92/min. Liver is +2,5cm below rib’s arch. There is free liquid in abdominal cavity. Which investigation is informative for evaluation of renal function:A. Urine test by Nechiporenko B. Urine testC. Test by ZimnitskyD. Determination of protein in urineTest by Addis-Kakovsky

Test 25.Edema of face and lower extremities, elevation of temperature to 37,5 C, headache, vomit and abdominal pain appeared in a child of 9 years old. There are elements of streptodermia on skin during 2 weeks. BP is 130/80 mm Hg. Urine test: color of “meat slops”, protein – 2g/l, leukocytes – 4-6 in field of sight, erythrocytes – ¼ of field of sight. Total blood protein – 62,4g/l, cholesterine – 4,3mmol/l. What is your provisional diagnosis?A. Acute glomerulonephritis with nephrotic syndromeB. Acute glomerulonephritis with nephritic syndromeC. Acute glomerulonephritis with nephrotic syndrome, hematuria and hypertensionD. Acute pyelonephritisE. Acute interstitial nephritis

Test 26.A 4-year-old male developed an upper respiratory tract infection that was followed in 2 weeks by general edema. His blood pressure is normal. Urinalysis reveals 2 to 5 red blood cells per high-power field and 4+{plus} protein. His BUN is 19 mg/dL, creatinine 0.6 mg/dL, cholesterol 402 mg/dL, serum albumin 0.9 g/dL, antistreptolysin O titer is increased.The most likely diagnosis would beA. poststreptococcal glomerulonephritisB. membranous glomerulonephritisC. minimal lesion nephrotic syndromeD. membranoproliferative glomerulonephritisE. focal sclerosis

Test 27.The diagnosis of acute glomerulonephritis with nephritic syndrome is established in a child of 10 years old. Daily diuresis is decreased to 50%. Diuresis restored gradually in 4 weeks after hospitalization and receiving of strict bed rest regimen. Which mechanism provoked oliguria in this case?A. Increase of intravascular coagulationB. Increase of permeability of basal membranesC. Decrease of glomerular filtration and increase of reabsorptionD. Increase of angiotensin II secretionE. Increase of aldosterone production

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Test 28.A boy of 5 years old was admitted to the hospital with complaints of edemas, rare urinations, paleness, weakness. Which of above mentioned signs is the most typical for nephrotic syndrome of acute glomerulonephritis?A. Massive peripheral and cavitary edemasB. Symptoms of intoxicationC. Decrease of visual acuityD. Low specific gravity of urineE. Leukocituria

Test 29.A girl of 7 years old was admitted to the hospital with complaints of pain in the back, weakness, high fever, frequent and painful micturitions. Temperature was 38,5 C. Pasternatsky's test was positive. Acute pyelonephritis was established after clinical and laboratory examination. Pyelonephritis is necessary to differentiate with all diseases except:A. VulvovaginitisB. Renal tuberculosisC. Renal tumorD. Hepatitis E. Glomerulonephritis

Test 30.A girl of 13 months is conveyed by her parents to a hospital with complaints of refusal to eat, vomit, total pallor, darkening and sharp decrease of urine during last day and slight general edema. It is known from anamnesis that during last 2 days green, watery stool 10-12 times a day has been seen. Which syndrome most likely determines severity of child’s condition?A. Septic shockB. Toxicosis with exicosisC. Disseminated intravascular blood coagulationD. Acute renal failureE. Acute respiratory failure

Test 31.Azotemic stage of chronic renal failure is diagnosed in a patient of 13 years old. There is decreased level of calcium in blood serum and increased level of alkaline phosphatase and on X-ray of forearm and hand – signs of osteoporosis. Which of mentioned drugs are necessary to use for treatment and prevention of osteopathies in this patient?A. Calcium without vitamin DB. Vitamin D and calciumC. Phosphorus and vitamin B1D. Zinc and molybdenumE. Polyvitamins and manganese

Test 32.Criteria of reflux-nephropathy’s diagnostics are:A. Disorders of tubular-interstitial functionsB. Steady proteinuriaC. Decrease of glomerular filtrationD. HypertensionE. All mentioned

Test 33.A child of 4 years old staying in reanimation department with diagnosis: Acute renal failure, oligoanuric stage. At ECG high wave T, enlargement of QRS-complex, displacement of interval S-T lower than isoline. What disorder of electrolytic balance is it possible to think of:

A. Hyperkaliemia B. Hypocalcemia

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C. Hypokaliemia D. Hypercalcemia E. Hyperphosphatemia

Test 34.Severe headache, diplopia and amaurosis appeared after 48 hours from the onset of the disease in a child of 10 years old suffering from acute glomerulonephritis with nephritic syndrome. BP is 180/120mm Hg. What complication developed in a child:A. Ischemic insultA. Hypertonic crisisB. Hypertonic encephalopathyC. Acute renal insufficiencyD. Chronic renal failure

Test 35.A child of 3 years old admitted to a hospital due to decrease of urine’s quantity to 200ml during day, peripheral and cavitary edemas. BP is normal. Proteinuria in urine test is 3,3g/l. What is your provisional diagnosis:A. Infection of urinary tractB. Acute glomerulonephritis with nephritic syndromeC. Interstitial nephritisD. Acute glomerulonephritis with nephrotic syndromeE.Chronic glomerulonephritis

Test 36.Which of the following statements is correct?A. Renal metabolic diseases are the most frequent causes of end-stage renal disease (ESRD) in children.B. The congenital nephrotic syndrome (minimal change nephropathy) is the most frequent cause of ESRD in young children.C. Causes of ESRD in children vary with age.D. Congenital and obstructive processes are the most frequent causes of ESRD in 13- to 17-year-old children.E. The glomerulonephritides produce ESRD most frequently in children younger than 5 years.

Test 37.The most frequent cause of graft loss in pediatric renal transplant recipients isA. trauma to the graftB. recurrence of the original renal disease in the graftC. technical difficultiesD. infectionE. rejection reaction

Test 38.A girl of 8 years old suffers from acute glomerulonephritis. The level of protein in diurnal urine is 3g/l, in urine test – 4,7g/l; total protein in biochemical blood test is 48g/l, urea – 5,2mmol/l, creatinine – 0,1mmol/l, cholesterin – 9,4mmol/l. Which pathogenetic drug is it necessary to prescribe?A. SandimunB. PrednisoloneC. CyclophosphanD. Delagil

E. Azatioprin

Test 39.A girl of 6 years old complains of general weakness, decrease of appetite, vomits 2 times, headache and lumbar pain. She suffered from angina 12 days ago. Objectively: pallor of skin, slight edema of face, symptom of Pasternatsky is positive. Blood test: normochromic anemia, ESR – 15mm/h, neutrophilic

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leucocytosis. Urine test: protein – 1,5g/l, leached erythrocytes – to 20 in a field of sight, hyaline casts – 5 in field of sight. What is your diagnosis?A. Acute glomerulonephritisB. Acute pyelonephritisC. Chronic pyelonephritisD. Chronic glomerulonephritisE. Subacute malignant glomerulonephritis

Test 40.Condition of 14 years old boy suffering from nephritic variant of acute glomerulonephritis worsened abruptly – headache, vomit, loss of vision and recurring convulsions appeared. What complication arose?A. Pulmonary edemaB. Intracranial hemorrhageC. Acute renal insufficiencyD. UremiaE. Angiospastic encephalopathy

Test 41.Osteodystrophy is diagnosed in a boy of 12 years old with chronic renal failure. Prolonged use of calcium and vitamin D metabolites was ineffective. Progressive renal osteopathy is an indication for which operation:A. ThymoectomyB. ThyroidectomyC. CryohypophysectomyD. AdrenalectomyE. Parathyroidectomy

Test 42.Chronic pyelonephritis has been diagnosed 3 years ago in a child of 8 years old. During prophylactic examinations periodically moderate leucocyturia is seen in urine test at the background of clinical health. Which health group he may be related to?A. IB. IIC. IIID. IVE. V

Test 43.Anemic syndrome continues to progress in a patient of 14 years old on a background of renal failure. Indicate a drug of choice for pathogenetic treatment of this syndrome.A. Erythrocyte massB. Ferrum-LekC. CyanocobalamineD. ErythropoetinE. Folic acid

Test 44.A girl of 5 years old was admitted to the hospital with complaints of frequent and painful micturitions with a little amount of urine. Temperature was 36,5 C. Pasternatsky's test was negative. Acute cystitis was established after examination. Treatment of acute cystitis includes everything except:A. Electrophoresis on urinary bladder B. Antibacterial therapyC. NitrofuransD. GlucocorticoidsE. Phytotherapy

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Test 45.A girl of 12 years old is staying at hospital with diagnosis of acute glomerulonephritis with nephritic syndrome, initial stage with disorders of renal function. Vomit, disturbances of vision, unconsciousness and convulsions appeared on the background of severe headache. Indicate the main method of prevention of this condition.A. CalciumB. CardiotonicsC. CorticosteroidsD. AnticonvulsantsE. Hypotensive drugs

Test 46.A boy of 7 years old entered the hospital with complaints of lumbar pain, edema of face and red color of urine. Symptoms of intoxication are marked (decrease of appetite, vomit and pallor of skin). Symptom of Pasternatsky is positive. Urine analysis: color – brown, specific density – 1018, protein – 0,66g/l, erythrocytes – ½ of field of vision, hyaline casts – 3-4 in field of vision. Priority prescription is:A. Benzantinpenicillin GB. PrednisolonC. MetindolD. AmikacinE. Leukeran

Test 47.A child of 7 years old was treated in nephrological department with a diagnosis: Acute glomerulonephritis with nephrotic syndrome, period of clinical-laboratory remission, without disorders of renal function. He is under dispensary supervision at polyclinics. Indicate the period of dispensary observation for this child.A. 5 yearsB. 3 yearsC. 1 yearD. 6 months2 years

Test 48.A child of 7 years old, who fell ill sharply with elevation of temperature up to 38C, complains of general weakness, nausea, and cough with expectoration of mucous sputum. Objectively: skin is pale with elements of urticarial allergic rash, peripheral lymph nodes are enlarged, liver and spleen are enlarged also to 1,5-2cm. Expiratory dyspnea, bilateral diffuse dry and bubbling rales in lungs, shortening of percussive sound at the right side below scapular angle is revealed. Infiltration of roundish shape are seen at lungs X-ray. There are 60% of eosinophils in cytology of sputum. In blood test: RBC - 3,5 x 10/12/l, Hb – 100g/l, WBC – 11 x 10/9/l, eosinophils – 20%, ESR – 12 mm/h. For which helminthes these changes are typical?A. AscariasisB. EnterobiasisC. TrichocephaliasisD. HymenolepiasisE. Echinococcosis

Test 49.Vermox (mebendazol) has been prescribed for treatment of 5-years-old child with enterobiasis. Which is the dose of this drug? (mg/kg)A. 2,5-5B. 7,5-10C. 12,5-15D. 15-17,5E. 10-20

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Test 50.4-years-old child receives medicamental treatment of enterobiasis. For prevention of recurrent infestation it’s necessary:A. To do disinsectionB. To exclude vegetables and fruits from dietC. To perform correct processing of meatD. To do deratization E. To keep personal hygiene

Test 51.A child of 10 years old complains of constant nausea, sialorrhea, bad appetite, abdominal pains, more often in right iliac region, frequent stool with admixture of mucus and blood, tenesmus and emaciation. Intestinal infections were exclude with the help of bacteriological examinations. Hyperemia of mucous membranes and helminthes, attached to the wall of sigmoid intestine and rectum and hanged over the lumen, were revealed. Their size was from 3 to 5,5cm with enlarged back end. Indicate the probable diagnosis.A. AnkilostomiasisB. EnterobiasisC. AscaridiasisD. HymenolepiasisE. Trichocephaliasis

Test 52.A child of 9 years old complains of attack-like character abdominal pains, which are localized in umbilical and right iliac region, and abdominal distention. He has frequent headaches, vertigo, disorders of sleeping, and syncope. Pinkish-white spindle-shaped helminthes of 30cm with straight pointed back end were revealed in emetic mass. Which helminthes this disease was provoked by?A. Hymenolepis nanaB. Trichuris trichiuraC. Enterobius vermicularisD. AscaridesE. Taenia solium

Test 53.A child is 5 years old. Ascariasis has been diagnosed and treatment with decaris (levamisol) has been prescribed. Which is the dose of this drug? (mg/kg)A. 2,5B. 5C. 7,5D. 10E. 12,5

Test 54.Eggs of Hymenolepis nana were revealed in coprogramm of 5-years-old child. There weren’t complaints and clinical features of the disease. In blood test: Hb – 128 g/l, RBC – 4,2 x 10/12/l, WBC – 6,8 x 10/9/l, eosinophils – 2%, stab neutrophils – 1%, segmented neutrophils – 44%, lymphocytes – 46%, monocytes – 7%, ESR – 6 mm/h. Which drug will you prescribe?A. Mebendazol (vermox)B. DecarisC. Pirviniy pamoatD. PhenasalE. Medicamental treatment isn’t indicated

Test 55.A child is 5 years old. He complains of periodical, not intensive abdominal pains accompanied by vomit and diarrhea. He has headaches, weakness, hysterical symptoms, periodical elevations of temperature to 37,5C. There is eosinophilia in blood test – 15%. Helminthes of 5cm, consisting of scolex with suckers

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and 24 small hooks as well as strobiles, consisting of 500 hermaphroditic segments, were found in stool. Distal segments contain mature eggs. What helminthes is it?A. Trichuris trichiuraB. AscaridesC. Hymenolepis nana D. Taenia soliumE. Taenia saginata

Test 56.A girl complains of itch in a vagina and perineum. Gynecologist repeatedly with diagnosis of vulvovaginitis cured her. She notes disorders of sleeping, irritability, headaches, increased fatigability, periodic abdominal pains, bad appetite and loss of weight. What diagnosis is mostly probable?A. AscariasisB. Trichocephaliasis C. EnterobiasisD. LambliasisE. Hymenolepiasis

Test 57.In the girl of 4 years old helminthoses was diagnosed after considering clinical and laboratory signs. Decaris (levamizol) is not used as antihelmintic drug in treatment of all mentioned helminthoses except:A. TrichosephaliasisB. EnterobiasisC. AscaridiasisD. HymenolepiasisE. Stronyloidiasis

Test 58.During preventive examination proglottides, having hermaphroditic structure of uterus with mature eggs, were revealed with the help of coproovoscopy in a child of 5 years old. For what helminthes is it typical?A. Taenia soliumB. AscaridesC. Trichuris trichiuraD. Hymenolepis nanaE. Taenia saginata

Test 59.7 years-old child complains of abdominal pains in umbilical region, bad appetite. Objectively: nutrition is decreased, skin is pale, and periorbital shades are seen. Scratching and skin hyperemia are present in perianal region. Eggs of Enterobius vermicularis are revealed at coproovoscopy. Which of mentioned drugs is the most active and well tolerated by children?A. CombantrinB. DecarisC. PiperasinD. VermoxE. Pirviniy pamoat

Test 60.A 9-year-old girl notices she has difficulty combing her hair and walking up stairs for approximately 1 month. Physical examination reveals a positive Gower sign and a faint maculopapular rash over the metacarpophalangeal joints. The most appropriate laboratory study to order isA. serum creatine phosphokinase B. erythrocyte sedimentation rateC. rheumatoid factorD. motor nerve conduction studyE. antinuclear antibodies

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Test 61.A 4-month-old infant is noted to have a grade 4 holosystolic murmur that is harsh over the left parasternal border. Results of both the chest radiograph and ECG are normal, and the child is otherwise asymptomatic. The most likely cause of this murmur isA. large VSD with 3:1 shuntB. an ASD secundum defectC. a small VSDD. pulmonic stenosisE. pink tetralogy of Fallot

Test 62.A previously well 3 1/2-month-old presents with poor feeding, diaphoresis during feeding, and poor growth. Vital signs reveal respirations of 70, pulse of 175, and blood pressure of 90/65 mm Hg in the upper and lower extremities. The cardiac examination reveals a palpable parasternal lift and a systolic thrill. A grade 4 holosystolic murmur and a middiastolic rumble are noted. The chest radiograph reveals cardiomegaly. The most likely diagnosis isA. cardiomyopathyB. myocarditisC. VSDD. coarctation of the aortaE. transposition of the great arteries

Test 63.A boy of 15 years was admitted to the hospital for examination of cardiovascular system. Pains in cardiac region, muffled first tone and apical systolic murmur appeared after severe pneumonia complicated with pleurisy. Differential diagnosis between myocardial dystrophy and myocarditis was made. All laboratory data are typical for myocardial dystrophy except:A. Arrhythmia at ECGB. Normal common blood testC. Marked dilation of left ventricle at X-ray D. Normal cardiac sizeE. Shortening of P-Q interval

Test 64.A boy of 12 years old is under dispensary observation of cardiorheumatologist with the diagnosis: Rheumatic fever, active phase, theumocarditis with affection of mitral valve. For how long is it necessary to provide secondary prevention of rheumatism with bicilin?A. 6 monthsB. 3 yearsC. 1 yearD. 1 monthE. 5 years

Test 65.An 18-month-old is noted to assume a squatting position frequently during play time at the daycare center. The mother also notices occasional episodes of perioral cyanosis during some of these squatting periods. The day of admission, the child becomes restless, hyperpneic, and deeply cyanotic. Within 10 minutes, the child becomes unresponsive. The most likely underlying lesion isA. cardiomyopathyB. anomalous coronary arteryC. tetralogy of FallotD. cystic fibrosisE. aspiration pneumonia

Test 66.

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Which of the following is the most important procedure in the diagnosis of subacute bacterial endocarditis?A. Complete blood countB. Urinalysis (microscopic)C. Erythrocyte sedimentation rateD. Blood cultureE. Electrocardiogram

Test 67.A child of 3 months old was discharged from a hospital where he received treatment of malnutrition of the 3rd degree. He is under dispensary observation at polyclinics. How frequently pediatrician must observe him?A. Once a monthB. Once a weekC. Twice a monthD. Once in 3 monthsE. Once in 6 months

Test 68.A boy of 14 years old is treated with complex of drugs because of stomach peptic ulcer. He complains of constipation during last week. Which of mentioned drugs may mostly provoke constipation?A. Vitamin UB. MetoclopramideC. Infusion of plantainD. RanitidinE. Almagel

Test 69.A boy of 12 years old is under dispensary supervision due to peptic ulcer of stomach. He has seasonal exacerbations in spring and autumn. What seasonal antirecurrent therapy is it necessary to prescribe?A. AntacidsB. VitaminsC. CholinoliticsD. MineralocorticoidsE. H2-blockers

Test 70.11-years-old boy complains of hungry abdominal pains; “moinihanian’s rhythm of pain is present. In anamnesis – chronic antral gastritis with increased secretory function of stomach is present from the age of 6 years. Which drug will you prescribe for prevention of peptic ulcer?A. CholenzymeB. No-spaC. PapaverinD. De-NolE. Essentiale

Test 71.A boy of 9 years old suffers from chronic gastritis with elevated secretory function of stomach during 2 years. What is the mechanism of abdominal pain syndrome in chronic gastritis?A. Stomach atoniaB. Increase of pressure in stomach and increase of its volumeC. Influence of aggressive factors on mucous membraneD. Presence of duodeno-gastral refluxE. Secondary affection of pancreas and its inflammation

Test 72.

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Such complaints as night hungry pains, heartburn and nausea appeared in 9-years-old child. Objectively: white fur on tongue and positive symptom of Mendel. At endoscopy: superficial widespread gastroduodenitis. Test for helicobacter infection is positive. Which antibacterial drug is it necessary to include conjointly with metronidazol and De-Nol for eradication of Helicobacter infection?A. ClarythromicinB. OleandomicinC. BiseptolD. ErythromicinE. Gentamicin

Test 73.A girl of 9 years old complains of pain in upper abdominal region after intake of rough and spicy food, heartburn and acid belching. She is ill during 1,5 years. Objectively: painfulness in epigastric region, the tongue is furred. Preliminary diagnosis: chronic gastritis. Which from mentioned methods will allow confirming this supposition for certain?A. Intragastral Ph-metryB. Fractional gastric intubationC. Contrast rentgenoscopy of inteastinal tractD. FibrogastroduodenoscopyE. Amylase in blood

Test 74.A child of 12 years old complains of dull pains in epigastrium after meals, nausea, and fatiguability. Diagnosis “chronic gastritis” was established after examination at a hospital. How frequently is it necessary to examine a child during the first year of supervision?A. Once in 3 monthsB. Once a monthC. Once in 6 monthsD. Once a yearE. Once in 2 years

Test 75.In the boy of 14 years old with acute pain in epigastrium after X-ray examination the diagnosis of peptic ulcer was established on the base of thesis that direct roentgenologic signs of peptic ulcer are:

A. Ulcer's "niche" B. Intensive motility of duodenum C. Hypersecretion D. Rapid barium's evacuation from the stomach

E. Bulbostasis

Test 76.A child of 11 years old is under dispensary observation due to peptic ulcer. There are seasonal exacerbations in autumn and spring. Which drug for antirecurrent therapy is it expedient to prescribe?A. MineralocorticoidsB. Reparative drugsC. CholinoliticsD. H2-blockersE. Antacids

Test 77.A patient of 12 years old complains of marked weakness, abdominal pains, sometimes vomit with “coffee grounds”, and tarry stool. There are pallor of skin and mucous membranes, tachycardia, BP 100/60 mm Hg. Abdomen is tensed and painful in epigastrium. Anemia is seen in blood test, time of blood coagulation is normal. Gregersen’s reaction is sharply positive. What diagnosis is mostly probable?A. Meckel’s diverticulum, bleedingB. Chronic ulcerous colitisC. Hemophilia, gastrointestinal bleeding

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D. Dysentery, hemocolitisE. Peptic ulcer of stomach, gastric bleeding

Test 78.Chronic gastritis with decreased secretory function has been diagnosed in a 10 years old patient. Which diet is it necessary to prescribe for this patient?A. N2B. N1C. N15D. N7E. N9

Test 79.A girl of 12 years old was admitted to the hospital with complaints of pains in epigastric region. At palpation painfulness was revealed in right half of epigastrium and around umbilicus. Clinical diagnosis of gastroduodenitis was confirmed at fibrodastroduodenoscopy. What examination is it necessary to provide for confirmation of Helicobacter presence?A. RheogastroscopyB. Urease respiratory test C. ElectrogastrographyD. Intragastral Ph-metryE. Fractional gastric intubation

Test 80.9-years-old boy suffers from peptic ulcer of stomach during 3 years. He was hospitalized due to worsening of his condition; inner bleeding has been diagnosed at a hospital. Which combinations of drugs are mostly expedient in this case?A. Vikasol, aminocapronic acidB. Calcium chloride, almagelC. De-Nol, clarythromicinD. Vikasol, almagelE. Adroxon, no-spa

Test 81.Helicobacter-associated form of peptic ulcer was diagnosed in a boy of 14 years old. First line variant (“triple” therapy) wasn’t effective.Which of mentioned drugs isn’t included in second line variant(“quadro” therapy)? A. ErythromicinB. De-NolC. ClarythromicinD. FamotidinE. Metronidazol

Test 82.A girl of 10 years old complains of persistent nausea, belching and heartburn. Night pains are present during 4 months. Mother notes irritability and disorders of sleep. Objectively: pain in epigastrium region with positive hammer symptom. Analysis of stool for occult blood is positive. What diagnosis is mostly probable?A. Chronic cholecystitisB. Chronic gastritisC. Peptic ulcer of stomachD. Chronic pancreatitisE. Chronic duodenitis

Test 83.

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A boy of 10 years old complains of dull pains in upper part of abdomen, feeling of heaviness, acidic belching, and heartburn. HE is ill during 6 months. Objectively: general condition is satisfactory; painfulness is revealed at palpation in epigastric and pyloroduodenal areas. Moderate enlargement of unchanged gastric folds due to spastic contractions is seen at fibrogastroscopy; folds are good expanded by air, there are neither erosions, nor ulcers. Mucous membrane of duodenum has no pathology. At intragastric Ph-metry – elevation of acidity. What is correct diagnosis?A. Functional gastric disorder with elevated secretionB. Chronic gastritis with elevated secretionC. Chronic gastroduodenitis with elevated secretionD. GastroptosisE. Reflux disease

Test 84.A child of 10 years old is under dispensary observation due to chronic hyperacid gastritis. During rehabilitation intake of mineral water has been prescribed. Which is the dose of mineral water for one intake per kilogram of body weight?A. 7-10 ml/kgB. 1-2 ml/kgC. 5-7 ml/kgD. 3-5 ml/kgE. 10-15 ml/kg

Test 85.Gastritis of B type is developed due to all mentioned causes except:A. Viral hepatitisB. Disorders of epithelium’s regenerationC. Persistence of Helicobacter in mucous membranes of pyloric part of stomachD. Prolonged drugs’ intakeE. Duodeno-gastric reflux

Test 86.For duodenal bulb’s ulcer all mentioned symptoms are typical except:A. Marked pains on an empty stomachB. Vomit in 2-3 hours after mealC. Regurgitation with acid tasteD. HeartburnE. Nausea in the morning

Test 87.A boy of 14 years old was admitted to the hospital with complaints of "night and hungry" pains in epigastric region. At palpation painfulness was revealed in epigastrium. His father suffers from peptic ulcer. All factors may be significant for peptic ulcer except:A. Intolerance of cow's milk proteinsB. Psycho-emotional stressC. Increase of acid-peptic factor's aggressionD. Decrease of natural resistance of mucous membraneE. Helicobacteriosis

Test 88.A girl of 10 years old is under dispensary observation at gastroenterological cabinet due to peptic ulcer of stomach and dyskinesia of bile ducts. Indicate the multiplicity of antirecurrent courses.A. Twice a yearB. Thrice a yearC. Once a yearD. Once in 2 months E. Once in 3 months

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Test 89.A girl of 15 years old is ill during a year. At endoscopic examination focal atrophic parts were revealed on mucous membrane of stomach. Histologically moderate degree of atrophy was found. Secretory gastric function is moderately decreased. Which of mentioned drugs is it expedient to use at such changes?A. Diluted hydrochloric acidB. Decoction of plantain (rib-grass)C. Decoction of motherwortD. Decoction of St.-John’s wortE. Mineral water 1-1,5 hours before meal

Test 90.A patient of 11 years old is observed with the diagnosis of chronic antral gastritis. At control examination duodenogastral reflux of II degree has been diagnoses. Which drug is it necessary to prescribe for correction of this pathology?A. PlatiphyllinB. No-spaC. MotiliumD. EuphyllinE. Atropin

Test 91.A girl of 5 years old falls ill with acute respiratory diseases and bronchitis 3-4 times a year during last year. She is under dispensary observation in a group of frequently ill children. ENT doctor revealed adenoids of II degree. What’s the most rationally to prescribe for prevention of development of recurrent bronchitis?A. Antihistaminic drugsB. Sanitation of chronic infectious focusC. ImmunomodulatorsD. Hardening of a childE. Antibacterial drugs

Test 92.A child of 6 years old, who hasn’t any chronic diseases, suffered from acute pneumonia 1 month ago. Which group of health he must be related to?A. IB. IIC. IIID. IVE. V

Test 93.A mother of 3-weeks child complains of regurgitation after feeding, periodic “fountain-like” vomit. These complaints appeared on the second week of life. The child is anxious, sucks the breast avidly, he has watery stool also. Objectively: turgor and elasticity of skin are decreased, visible “sand glass-like” peristalsis of stomach is seen. Which diagnosis is most probable?A. PylorospasmB. PylorostenosisC. Adrenogenital syndromeD. HypotrophyE. Diarrhea

Test 94.A child is 23 days old. On the second week of life regurgitation after each feeding appeared, which gradually changed to abundant vomit. There is no bile in vomit mass, quantity is more, than volume of previous feeding. The child is hungry, sucks the breast avidly. Stool is watery, volume of feces is small.

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Pylorostenosis was suspected. Which additional methods of examination is it necessary to provide for verification of diagnosis?

A. CoprogramB. Full blood testC. ProteinogramD. RentgenogastrographyE. Examination of sodium and potassium in blood serum

Test 95.The boy of 11 years old is treated at the gastroenterological department with diagnosis of ulcerative colitis. As for diet all the mentioned below products must be excluded except:

A. Apples B. Baked piquant, salt, smoked meals C. Fatty kinds of meat, fish D. Milk E. Fancy pastry, cakes

Test 96.Periodic vomit immediately after feeding is seen in a child of 4 days. Vomit isn’t plentiful. General condition of a child isn’t disturbed, skin is of usual color, turgor and elasticity of skin and physiological functions are normal. Radiographic examination of stomach didn’t reveal disorders of patency. What diagnosis is most probable?A. PylirostenosisB. PylorospasmC. DyspepsiaD. Adrenogenital syndromeE. Simple dyspepsia

Test 97.Pylorostenosis is diagnosed in a child of 20 days. The disease was characterized with abundant like fountain vomits, not after every feeding, hypotrophy, visible gastric peristalsis, under X-ray examination delay of contrast in the stomach up to 24 hours. Indicate the method of therapy of this disease:

A. Obligatory operative treatment B. Conservative treatment C. Diet D. Antibacterial therapy

E. Diet + antibacterial therapy

Test 98.Radiography of gastrointestinal tract with use of 5% barium suspension in woman’s milk has been performed in a boy of 10 days. Data of examination: marked folds of mucous membrane in pyloric channel, symptoms of “hangers” and “antral beak” are revealed. What is your provisional diagnosis?A. PylorospasmB. PylorostenosisC. Adrenogenital syndromeD. CardiospasmE. Gastritis

Test 99.A child of 11 years old suffers from severe bronchial asthma. He entered the hospital in period of attack. Which health group he may be related to?A. IB. IIC. IIID. IVE. V

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Test 100.A child of 7 months is under dispensary observation at polyclinics with a diagnosis: Rickets of II degree, flourishing period, subacute course. How frequently pediatrician must observe him?A. Once in 6 monthsB. Once a weekC. Once in 3 monthsD. Twice in 3 monthsE. Once a month

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