Internal disease

INTERNAL DISEASE-

VARIANT 1

1. 
   Specify the possible causes of chronic pancreatitis:
   

a) alcohol;

b) a chronic viral infection;

c) cholelithiasis;

d) overweight, hyperlipidemia;

2. 
   For acute uncomplicated peptic ulcer disease is characterized by:
   

a) "hungry" epigastric pain;

b) the therapeutic effect of antacids;

c) chronic antral gastritis associated with HP;

d) vomiting eaten food the day before.

3. 
   When penetration ulcers in the pancreas increases the level of:
   

a) Amylase;

b) lipase;

c) glucose;

d) alkaline phosphatase;

4. 
   Extra-intestinal (systemic) manifestations of ulcerative colitis:
   

a) erythemanodosum, acute arthritis affecting medium sized joints, conjunctivitis;

b) pyodermagangrenosum, sacroiliitis, iridocyclitis, acthma/

c) asthma, COPD

d) acute renal failure

5. 
   Normal liver functions are:
   

a)albumin synthesis, synthesis of coagulation proteins, gastrin synthesis.

b) bile acid formation, albumin synthesis, synthesis of coagulation proteins

c) bilirubin exertion, white blood cells synthesis, albumin synthesis,

d)hormone catabolism, white blood cells synthesis, bilirubin exertion

6. 
   Normal level AST:
   

a)Less than 35U/L

b)Less than 25U/L

c)Less than 45U/L

d)Less than 40U/L/

7. 
   Which of the interferons has mainly antiviral activity?
   

1) γ-IFN

2) α-IFN

3) β-IFN

4] t-IFN.

8. 
   Standard starting the treatment of chronic hepatitis C currently is:
   

a) monotherapy ribavirin (Rebetol);

b) monotherapy α-IFN;

c) combination therapy Rebetol with α-IFN.

d) cyclopheron

9. 
   The best combination for the treatment of portal hypertension in patients with liver cirrhosis are:
   

a) restriction of physical activity, reducing salt intake, assignment saluretikov;

b) Appointment of saluretikov in combination with β-blockers;

c) Appointment of a combined therapy with veroshpiron, restriction of salt intake, β-blockers.

d) geptral

10. 
    Indications for surgery in peptic ulcer:
    

a) perforation, hemorrhage

b) vomiting, pain, penetration,

c) dyspnea, dysphagoea.

d) abdominal pain

11. 
    Complication of PEPTIC ulcer;
    

a) Bleeding;

b) portal hypertension;

c) jaundice;

d) ascites;

12. 
    Factors mucosal protection are:
    

a) mukoproteids and bicarbonates;

b) hydrochloric acid;

c) H. pylori;

d) an antibody to parietal cells of the stomach

13. 
    Clinical manifestations of chronic gastritis:
    

a) cytolytic syndrome;

b) cholestatic syndrome;

c) syndrome of portal hypertension;

d) syndrome of gastric dyspepsia.

14. 
    Proton pomp ingibitor (PPI) are:
    

a. atenolol;

b. lantoprasol; *

c. methoprolol;

d. phamotidin.

15. 
    Parietal cells of stomach mucous produse:
    

a. gastrin;

b. natriahydrocarbonat;

c. pepsinigen;

d. chloric acid.

16. 
    . Gastrin is prodused
    

a. H-cells;

b. М-cells;

c. G-cells;

d. Р-cells;

e. parietal cells.

17. 
    Typical localization of chronic gastritis type A is:
    

a. antral part of the stomach;

b. gastroesophageal part of the stomach;

c. cardia;

d. body of the stomach;

18. 
    Characteristic of pain in chronic gastritis:
    

a. localization in mesogastrium beginnig at night ;

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

c. localisation in epigastrium which is began after meal;

d. localisation in epigastrium which is redused after meal;

19. 
    Localisaton of process in chronic gastritis В is:
    

a. antral part of the stomach;

b. gastroesophageal part of the stomach;

c. cardia;

d. body of the stomach.

20. 
    Diagnostic methods for H.pylori verification are:
    

a. histologycal;

b. ureas test;

c. microbiological blood test on H. Pylori;

d. microbiological stool test on H. Pylori;

21. 
    Creatorea is symptom of :
    

a. pancreas excretory insuffisiency; *

b. reflux-esophagit;

c. chronic gastritis A;

d. chronicduodenitis;

22. 
    First line drugs for H. Pylori eradication are:
    

a. amoxicillin;

b. furazolidone.

c. metronidazole;

d. sumamed;

23. 
    Main diagnostic method for chronic gastritis is:
    

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

24. 
    “Aggressive” factors in pathogenesis of ulcer disease are:
    

a. pepsin; * bile acid regurgitation; * hydrochloric acid; *

b. bile acid regurgitation; * alcalotic reaction of the saliva.

c. mucous stomach cells proliferation; hydrochloric acid; *

d. hydrochloric acid; * alcalotic reaction of the saliva.

25. 
    “Protective” factors in pathogenesis of ulcer disease are:
    

a. mucous stomach cells regeneration; chloric acid, pepsin;

b. pepsin; mucus secretion; chloric acid.

c. prostaglandins; mucous stomach cells regeneration; mucus secretion;

d. mucus secretion; chloric acid, bile acid regurgitation;

26. 
    Drug depended ulcer is induced:
    

a. aspirin; metoprolol;

b. metoprolol; prednisolon;

c. prednisolon; aspirin;

d. salmeterol; streptokinase.

27. 
    Pain in epigastrium after meal is symptom ulcer disease of :
    

a. stomach;

b. distal part of esophagus;

c. duodenum.

d) ileum

28. 
    Main clinical symptom in duodenum ulcer disease is:
    

a. pain on empty stomach; *

b. diarrhoea;

c. eructation;

d. early pain after meal;

29. 
    Penetration of ulcer into the pancreas lead to increasing of
    

a. amylase; *

b. lipase;

c. alkalinephophotase

d. ALT;

30. 
    How much bile is produced by liver /day?
    

a. 100-300 ml

b. 300-500 ml

c. 500-1200 ml

d. 500-1000ml

31. 
    Which hepatitis is most dangerous in pregnancy?
    

a. Hepatitis A

b. Hepatitis B

c. Hepatitis C

d. Hepatitis E

32. 
    Gastric Ulcer is caused due to:
    

a. Bile acid reflux

b. Recurrent herb

c. Hyperacidity

d. Decreased mucosal resistance

33. 
    Treatment of drug-induced gastritis:
    

a. Mesoprostol

b. H₂ receptor blockers

c. Antacids

d. Aspirin

34. 
    Progressive dysphagia is seen in connection with:
    

a. Carcinoma esophagus

b. Globus hystericus

c. Achalasia

d. Chalasia

35. 
    Specific test for malabsorption:
    

a. D-xylose test

b. Schilling test

c. Fecal fatestimation

d. X-xylose test

36. 
    Indications of colonscopy:
    

a. rectal bleeding, anemia, suspected inflammatory bowel disease

b. suspected inflammatory bowel disease, severe shock.

c. severe respiratory disease

d. cardiac arrhythmia.

37. 
    Contraindications of colonoscopy:
    

a. rectal bleeding, anemia, suspected inflammatory bowel disease

b. suspected inflammatory bowel disease,

c. severe respiratory disease, severe shock.

d. suspected inflammatory bowel disease

38. 
    . Normal serum bilirubin level is:
    

a. less than 1mg\dl,

b. less than 2mg\dl,

c. less than 3mg\dl,

d. less than 4mg\dl,

39. 
    Pick characteristic: for Almagelum preparation:
    

a. H2 blocker gistaminoretseptorov

b. The total anticholinergic action

c. anticholinergic topical

d. antacid

40. 
    Pick response to the drug atropine:
    

a. H2 blocker gistaminoretseptorov

b. The total anticholinergic action

c. anticholinergic topical

d. antacid

e. miotonik.

41. 
    What sign confirms perforation stomach ulcer?
    

a. abdominal pain

b. hematemesis

c. The free gas in the abdomen

d. abdominal distension

42. 
    Pick response to the drug Reglan:
    

a. H2 blocker gistaminoretseptorov

b. The total anticholinergic action

c. anticholinergic topical

d. miotonik

43. 
    . Ascites in liver cirrhosis is formed as a result of:
    

a. secondary hyperlipiemia

b. hyperalbuminemia

c. Portal Hypertension, hypoalbumiemia

d. hyperglicemia

44. 
    For preparation gastrotsepin pick up his characterization:
    

a. H2 blocker gistaminoretseptorov

b. The total anticholinergic action

c. anticholinergic topical

d. antacid

45. 
    Decrease acid-secretory function occurs more frequently:
    

a. in chronic superficial gastritis

b. in chronic gastritis, antrum

c. in chronic atrophic gastritis

d. with hypertrophic gastriti

46. 
    The ranitidine is:
    

a. blocker of H2-histamine receptors

b. total anticholinergic action

c. anticholinergic topical

d. antacid

47. 
    The leading cause of irritable bowel syndrome - is:
    

a. Infection.

b. Immunological disorders.

c. neurovascular disorders.

d. Increased sensitivity to certain types of food

e. Malignant degeneration

48. 
    Choose sulfanilamide drug that acts only in the lumen of the intestine:
    

a. Urosulfan

b. Sulfapiridazin

c. sodium Sulfatsil

d. Ftalazol

49. 
    The method of diagnosing the cause and localization of bleeding from the upper gastrointestinal tract is:
    

a. Radiography

b. Portomanometriya

c. Laparoscopy

d. gastroduodenoscopy

50. 
    The incubation period of hepatitis B:
    

a. 60-180 days

b. 120-160 days

c. 60-80 days

d. 30-90 days

51. 
    The incubation period for hepatitis A is:
    

a. 3-8 days

b. 1-2 weeks

c. 8-10 weeks

d. 1month

52. 
    Specify the characteristic sign of increased hemolysis:
    

a. hypochromic anemia

b. The increase in direct bilirubin

c. The rich color of urine

d. High reticulocytosis

53. 
    A man 29 years, 6 months - diarrhea 6-8 times a day, fatigue, fever. Pe-periodically - pain and tension in the lower right quadrant of the abdomen. The most likely diagnosis is:
    

a. carcinoid syndrome

b. Crohn's disease

c. Irritable Bowel Syndrome

d. pancreas insufficiency

e. amoebiasis

54. 
    A man 21 years, weight loss and occasionally diarrhea with blood.
    

Colonoscopy revealed inflammation and bleeding of mucous contact from the rectum to the middle of the transverse colon. Biopsy: acute and chronic inflammation, limited-stop mucus membrane. The most likely diagnosis is:

a. amoebiasis

b. Crohn's disease

c. Salmonella enterocolitis

d. ulcerative colitis

55. 
    A patient with an ulcer upper part of the duodenum there was bleeding. Which artery it is most likely eroded?
    

a. gastroduodenal

b. liver

c. The right gastric

d. The right gastro-mesenteric

56. 
    Clinical manifestations of pyloric stenosis following:
    

a. vomiting, dehydration, tetany

b. bleeding , tetany

c. nausea,

d. diarrhea

57. 
    Which of the following drugs is indicated for chronic atrophic gastritis with secretory deficiency?
    

a. atropine

b. natural gastric acid

c. Almagelum

d. cimetidine

58. 
    Characteristic signs of alcoholic cirrhosis are:
    

a. The early development of jaundice and later - portal hypertension

b. Early CNS involvement

c. The early development of portal hypertension later - jaundice and liver, insufficient accuracy

d. The presence of mitochondrial antibodies and an increase in the activity of alkaline phosphatase-basins

59. 
    Which of the following drugs should appoint patients with chronic gastritis type B?
    

a. betatsid

b. panzinorm

c. ranitidine

d. prednisolone

e. natural gastric acid

60. 
    Diarrhea may be due to injury :
    

a. stomach

b. spleen

c. The small intestine

d. liver

61. 
    Characteristic of chronic gastritis type B:
    

a. vomiting with food residues

b. diarrhea

c. convoluted folds thickened mucous

d. biopsy - atrophy of the glands

62. 
    A characteristic of hemochromatosis:
    

a. The early development of jaundice and later - portal hypertension

b. Early CNS involvement

c. The early development of portal hypertension and later - jaundice and liver, insufficient accuracy

d. skin pigmentation and increased iron levels in the blood.

63. 
    To exclude the malignancy of gastric ulcer should be used:
    

a. X-ray examination

b. endoscopy with biopsy

c. study of fecal occult blood

d. Study of gastric juice by histamine

64. 
    A woman of 45 years - alternating constipation and diarrhea, bloating, feeling hot flashes, abdominal pain with defecation, lack of menstruation. Stool with mucus. depressing. Abdomen soft, sensitive along the large intestine. Full clinical and laboratory examination revealed no pathological changes. A presumptive diagnosis?
    

a. chronic pancreatitis

b. ulcerative colitis

c. Crohn's disease

d. Irritable Bowel Syndrome

65. 
    Chronic atrophic gastritis is caused by:
    

a. Antibody response to the G cells of the stomach, which reduces the production of gastrin leads to achlorhydria;

  b. mucosal atrophy in patients with atherosclerosis;

  c. long-term use of glucocorticoids;

  d. NSAIDs.

66. 
    Complications of duodenal ulcer;
    

a. Bleeding;

b. portal hypertension;

c. jaundice;

d. ascites;

67. 
    Clinical manifestations of chronic cholecystitis is considered to be the following syndromes:
    

a. cytolytic;

b. hepatorenal;

c. pain; asthenovegetative;

d. hepatocellular insufficiency.

68. 
    Morphological changes of colonic mucosa in acute ulcerative colitis:
    

a. swelling, redness;

b. The narrowing of the intestinal lumen;

c. Disappearance haustrum.

d. erosion, ulcers;.

69. 
    What are the etiological factors of autoimmune hepatitis:
    

a. The defeat of the endothelium of the liver vessels;

b. Hepatitis B;

c. Hepatitis C virus;

d. Non known;

70. 
    DRUG-INDUCED CHRONIC HEPATITIS may be caused by:
    

a. omeprozol

b. Isoniazid

c. geptral

d. vitamins

71. 
    Chronic hepatitis is characterized by next clinical syndromes
    

a. Cholestatic, Hepatomegaly

b. Dispeptic

c. Portal hypertension

d. biopsy - atrophy of the glands

72. 
    Which hepatitis is most dangerous in pregnancy?
    

a. Hepatitis A

b. Hepatitis B

c. Hepatitis C+D

d. Hepatitis E

73. 
    Drug of choice in Zollinger Ellison syndrome is:
    

a. B-blocker

b. Ranitidine

c. Antacids

d. Omeprazole

74. 
    For Primary biliary cirrhosis select the circulating antibodies with which it is most closely associated:
    

a. antibodies to mitochondria

b. antibodies to native DNA

c. antibodies to smooth muscle cells;

d. antibodies to parietal cells;

75. 
    Characteristic of pain in chronic gastritis:
    

a. localisation in mesogastriumbeginnig in night ;

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

c. localisation in epigastrium which is began after meal;

d. localisation in epigastrium which is redused after meal;

76. 
    Localisaton of process in chronic gastritis В is:
    

a. antral part of the stomach;

b. gastroesophageal part of the stomach;

c. cardia;

d. body of the stomach

77. 
    Ussually H. pylory islocalisated:
    

a. antrum; bulbus of the duodenum;

b. cardia of the stomach;

c. body of the stomach.

d. esophagus; antrum.

78. 
    Creatorea is symptom of :
    

a. pancreas excretory insuffisiency;

b. reflux-esophagit;

c. chroniccholecistitis.

d. chronicduodenitis;

79. 
    The presence of the triad symptoms - persistent increase in gastric acid secretion, gastrointestinal ulceration, diarrhea - indicates:
    

a. Zollinger-Ellison syndrome;

b. peptic ulcer disease with localization in the stomach;

c. ulcerative colitis;

d. ulcer with localization in Postbulbarnye department;

80. 
    For the clinic of chronic gastritis is characterized by:
    

a. subfebrile temperature;

b. moderate leukocytosis;

c. dyspeptic syndrome;

d. diarrhea;

81. 
    The presence of erosions in the antral stomach is typical for:
    

a. acute gastritis;

b. autoimmune gastritis;

c. granulomatous gastritis;

d. H. pylori infection.

82. 
    The total amount of gastric acid excreted in normal human food mode:
    

a. 0.5-1.0 l;

b. 1.0-1.5 l;

c. 1.5-2.0 l;

d. 2.0-2.5 l;

83. 
    Kreatoreya typical for:
    

a. chronic pancreatitis;

b. Crohn's disease;

c. ischemic colitis;

d. irritable bowel syndrome;

c. gallbladder dyskinesia.

84. 
    A sign of perforation of ulcer is:
    

a. fever;

b. vomiting;

c. heartburn;

d. the rigidity of the anterior abdominal wall;

85. 
    Gastric secretion decreases:
    

a. famotidine;

b. solkoseril;

c. Cytotec;

d. Venter;

86. 
    Omeprazole belongs to the group of drugs:
    

a. blockers;

b. M-holinoblokatory;

c. blockers of histamine H1-receptor antagonists;

d.proton pump blockers.

87. 
    It stimulates the activity of pancreatic enzymes:
    

a. somatostatin;

b. glucagon;

c. histamine;

d. motilin;

e. vasoactive intestinal peptide.

88. 
    In humans, per day of pancreatic juice is produced:
    

a. to 0.5 liters;

b. 0.5-1.0 l;

c. 1.0-1.5 l;

d. 1.5-2.0 l;

e. 2.0-2.5 liters.

89. 
    Which one is the most authentic test for the diagnosis of malabsorption syndrome?
    

a. test D-xylose;

b. test for tolerance to lactose;

c. X-ray of the gastrointestinal tract;

d. The study of gastric secretion.

90. 
    Indication for emergency surgery therapy of peptic ulcer:
    

a. bleeding

b. penetration

c. perforation

d. carcinoma

91. 
    The duration of antiviral course of chronic viral hepatitis
    

a. 3 months

b. 6-36 months

c. 48 months

d. life

92. 
    The drug of choice for treatment of hepatic encephalopathy
    

a. reaferon

b. Duspatalin

c. essentiale

d. Hepa-Merz *

93. 
    The drug of choice for primary biliary cirrhosis
    

a. thistle

b. Heptral

c. gepabene

d. ursofalk

94. 
    Antibodies detected with polymyositis:
    

a. alcoholic steatosis;

b. Wilson's disease;

c. acute hepatitis A;

d. primary biliary cirrhosis.

95. 
    Conjugated (linked) bilirubin produced in liver cells by the enzyme
    

a. ACE;

b. glyukoroniltransferazy;

c. acidic phosphatase;

d. leytsinaminotransferazy;

96. 
    Etiological treatment with interferon in chronic viral hepatitis are beginning to phase: