Modul 2 Symptoms and syndromes in diseases of internal organs Text test

* Mitral stenosis;

Pneumosclerosis

Splitting of І heart sound is typical for:

1. 
   Atrioventricular block
   
2. 
   * Ventricular block of impulse conduction
   
3. 
   Acute bronchitis
   
4. 
   Mitral stenosis
   
5. 
   Angina pectoris
   

Splitting of ІІ heart sound at pulmonary artery is observed in

1. 
   Aortal incompetence
   
2. 
   Aortal stenosis
   
3. 
   Acute bronchitis
   
4. 
   * Mitral stenosis
   
5. 
   Rheumatic myocarditis
   

Normal value of electric axis of the heart (angle ά) is equal to:

1. 
   -30° to -60°;
   
2. 
   0° to -30°;
   
3. 
   0° to +30°;
   
4. 
   * +30° to +69°;
   
5. 
   +70° to +90°.
   

Weakening of 1 heart sound is typical for:

1. 
   Extrasystoly
   
2. 
   Synchronous systoly of atriums and ventricles, complete atrioventricular block;
   
3. 
   * Myocardiosclerosis
   
4. 
   Mitral stenosis;
   
5. 
   Coffeinomania
   

What ECG-signs of left atrial hyperthrophy do you know?

1. 
   Rising of amplitude of wave P.
   
2. 
   Rising of amplitude of wave R.
   
3. 
   Decreasing of amplitude of wave R.
   
4. 
   Duration of wave P is not changed.
   
5. 
   * Appearance of byphasic P wave.
   

What is the diffecence of pericardial friction murmur and organic systolic and diastolic murmurs?

1. 
   It is nit detectible by palpation;
   
2. 
   Intensifies if a patient bends backward;
   
3. 
   * Intensifies if a patient bends forward;
   
4. 
   Doesn’t coinside with systole and diastole;
   
5. 
   Weak; of low intensity
   

Where is Botkin-Erb’s point located?

1. 
   V interspace 1-1,5 cm medially from the left midclavicular line
   
2. 
   II interspace leftward of the sternum
   
3. 
   * III-IV interspaces leftward of the sternum
   
4. 
   At the xyphoid process
   
5. 
   II interspace rightward of the sternum
   

Which heart defect the organic systolic murmur is typial for?

1. 
   Stenosis of mitral orifice
   
2. 
   * Stenosis of aortic orifice
   
3. 
   Aortic incompetence
   
4. 
   Stenosis of pulmonary artery;
   
5. 
   Tricuspid valve incompetence.
   

Which among presented below murmurs are extracardial?

1. 
   Kumb’s, Flint’s and Grahaim-Steel’s murmurs
   
2. 
   Precardial, cardiopulmonic, pleuropericardial, Kumb’s, Flint’s and Grahaim-Steel’s murmurs
   
3. 
   Precardial, cardiopulmonic, pleuropericardial, Kumb’s murmurs
   
4. 
   * Pericardial and pleuropericardial friction murmurs
   
5. 
   Flint’s, precardial, cardiopulmonic murmurs
   

Which organic murmur at heart apex resembles sensation of a cat’s purr?

1. 
   Systolic murmur of the mitral valve inompetence
   
2. 
   * Diastolic murmur of mitral stenosis
   
3. 
   Systolic murmur of aortic stenosis
   
4. 
   Diastolic murmur of aortic incompetence
   
5. 
   Systolic murmur of stenosis of pulmonary artery
   

Which organic murmur gives the filling of “cat’s purr” at heart apex?

1. 
   Sytolic murmur in mitral incompetence
   
2. 
   * Diastolic murmur in mitral stenosis;
   
3. 
   Systolic murmur in aortal stenosis;
   
4. 
   Diastolic murmur in aortal incompetence;
   
5. 
   Systolic murmur in in anemia
   

Place of auscultation of murmur in aortic incompetence:

1. 
   Heart apex;
   
2. 
   * 2^nd intercostal space righwards from the sternum
   
3. 
   3^rd intercostal space righwards from the sternum
   
4. 
   3^rd intercostal space leftwards from the sternum
   
5. 
   Fifth intercostal space righwards from the sternum
   

Which organic murmur gives the filling of “cat’s purr” at basis of the heart?

1. 
   Systolic murmur in mitral incompetence
   
2. 
   Diastolic murmur in mitral stenosis;
   
3. 
   *Sstolic murmur in aortal stenosis;
   
4. 
   Diastolic murmur in aortal incompetence;
   
5. 
   Systolic murmur in in anemia
   

Which characteristics are typical for pain pattern in chronic hepatitis?

1. 
   Located in epigastrium, appears on empty stomach
   
2. 
   Night pain in epigastrium
   
3. 
   Girdling pain in 1-2 hours after meal
   
4. 
   Located in left hypochondrium, occurs in physical load
   
5. 
   *Location in right hypochondrium, occurs in physical load
   

A patient has peptic ulcer and pylorostenosis. Which character of vomiting masses will be in this case?

1. 
   Vomit with admixtions of bile
   
2. 
   Vomit with admixtions of blood
   
3. 
   Mucus and pus in vomiting masses
   
4. 
   Undigested food in vomiting masses
   
5. 
   * Vomiting with food used a day before
   

Which data among the follofing indicate on decreased liver detoxication function?:

1. 
   hyperbilirubinemia, hypoproteinemia, hypoazotemia
   
2. 
   hyperbilirubinemia, hypoproteinemia, hypophenolemia
   
3. 
   * hyperazotemia, hyperphenolemia, increased potassium concentration in the blood
   
4. 
   hypoazotemia, hyperphenolemia, decreased potassium concentration in the blood
   
5. 
   hypoazotemia, hypophenolemia, hyperammonemia
   

Accumulation of liquid in abdominal cavity is called:

1. 
   * Ascites
   
2. 
   Hydrothorax
   
3. 
   Pneumothorax
   
4. 
   Hydropericardium
   
5. 
   Exsudate
   

What pain pattern is typical for billiary colick?

1. 
   Discomfort in right subcostal area
   
2. 
   Epigastric pain on hunger or at night
   
3. 
   * Intensive, paroxysmal pain in right subcostal area
   
4. 
   Distension pain in the mesogastrium
   
5. 
   Discomfort in left subcostal area
   

What pain pattern is typical for chronic hepatitis?

1. 
   * Dull-boring or mild pressing pain in right subcostal area
   
2. 
   Epigastric pain on hunger or at night
   
3. 
   Intensive, paroxysmal pain in right subcostal area
   
4. 
   Distension pain in the mesogastrium
   
5. 
   Discomfort in left subcostal area
   

In diseases of a liver and gallbladder pain may develop due to all reasons except of:

1. 
   Distension of Glisson’s capsule
   
2. 
   Spastic contractions of a gallbladder
   
3. 
   Inflammation of Glisson’s capsule
   
4. 
   Inflammation and distension of gallbladder walls
   
5. 
   * Destruction of hepatocites
   

Select the proper appearance of xanthomas:

1. 
   They look like angiomas elevated above the skin
   
2. 
   * They look like yellow plaques
   
3. 
   They look like excoriations
   
4. 
   They look like hemorrhagic rash
   
5. 
   They look like nettle rash
   

Inflammatory diseases of the liver include:

1. 
   Wilson disease
   
2. 
   * Hepatitis
   
3. 
   Gilbert syndrome
   
4. 
   Hydatid disease of the liver
   
5. 
   Agenesis of the liver
   

Itching of the skin in liver diseases indicates on:

1. 
   Presence of duodenogastric reflux
   
2. 
   * Increased content of bile acids due to cholestasis
   
3. 
   Affected proteins production by a liver
   
4. 
   Deranged process of bilirubin conjugation
   
5. 
   Increase of detoxication function of a liver
   

Laboratory examination of feces for scant blood may be positive:

1. 
   In microbleeding from the ulcer of a stomach or intestine
   
2. 
   In microbleeding from a tumour of gastrointestinal tract
   
3. 
   In nonspecific ulcerous colitis
   
4. 
   In intake of meet during meals
   
5. 
   * All mentioned above
   

Which data among the follofing indicate on decreased synthetic function of a liver?

1. 
   * Hypoalbuminemia, decreased levels of fibrinogenum and prothrombin
   
2. 
   Hyperbilirubinemia, decreased levels of fibrinogenum and prothrombin
   
3. 
   Hypoalbuminemia, hypercholesterolemia, hyperazotemia
   
4. 
   Hyperbilirubinemia, hypercholesterolemia, hyperazotemia
   
5. 
   Hyperalbuminemia, decreased levels of fibrinogenum and prothrombin
   

Cholelithiasis is a violation of metabolism:

1. 
   Cholesterol
   
2. 
   Bilirubin
   
3. 
   Bile acids
   
4. 
   * All of the above
   
5. 
   Everything is wrong
   

Cholestasis is important in the development of:

1. 
   * Cholelithiasis
   
2. 
   Urolithiasis
   
3. 
   Gastric ulcer
   
4. 
   Obesity
   
5. 
   Carditis
   

Chronic cholecystocholangitis is the chronic inflammation of:

1. 
   Stomach and duodenum
   
2. 
   Stomach and gall bladder
   
3. 
   * A gallbladder and bile ducts
   
4. 
   A gallbladder and pancreas
   
5. 
   Stomach and bile ducts
   

Dilatation of anterior abdominal wall veins are typical for:

1. 
   Bile ducts dyskinesia
   
2. 
   * Cholecystocholangitis
   
3. 
   Gastritis
   
4. 
   Duodenitis
   
5. 
   Colitis
   

Enlargement of a liver is typical for:

1. 
   Bile ducts dyskinesia
   
2. 
   *Cholecystocholangitis
   
3. 
   Gastritis
   
4. 
   Pancreatitis
   
5. 
   Colitis
   

Factors contributing to the development of gallstone disease

1. 
   Genetic predisposition
   
2. 
   Metabolic changes
   
3. 
   bBle ducts dysfunction
   
4. 
   Cholestasis
   
5. 
   * All of the above
   

Factors contributing to the development of gallstone disease:

1. 
   Viral diseases
   
2. 
   * Obesity
   
3. 
   Prolonged hypothermia
   
4. 
   Insolation
   
5. 
   All of the above
   

What is typical for cholelythiasis?

1. 
   * Intensive, paroxysmal pain in right subcostal area
   
2. 
   Distension , permanent pain in the mesogastrium
   
3. 
   Dull, aching pain in right subcostal area
   
4. 
   Pain in right subcostal area on empty stomach
   
5. 
   Intensive, paroxysmal pain in left subcostal area
   

The next symptoms are typical for chronic cholecystitis:

1. 
   *Pain in the right hypochondrium after intake of fatty or fried food
   
2. 
   Pain in a stomach after the physical loading
   
3. 
   Pain in the right hypochondrium after asleep
   
4. 
   Pain in the right hypochondrium during urination
   
5. 
   Pain in the right hypochondrium before asleep
   

The next symptoms are typical for chronic hepatitis:

1. 
   * Pain in the right hypochondrium, hepatosplenomegaly
   
2. 
   Pain in the left hypochondrium
   
3. 
   Diarrhea, intoxication
   
4. 
   Splenomegaly, jaundice
   
5. 
   Pain in the stomach
   

What is typical for dyspepsic syndrome in diseases of a gallbladder?

1. 
   Diarrhea after the use of milk
   
2. 
   Diarrhea is frequent, profuse
   
3. 
   No changes
   
4. 
   * Periodical constipation
   
5. 
   Diarrhea before the use of milk
   

Gallstones are divided on:

1. 
   * Pigment and cholesterol
   
2. 
   Bilirubin and phosphorous
   
3. 
   Calcium and cholesterol
   
4. 
   Pigment and magnesium
   
5. 
   All of the above
   

Markers of chronic hepatitis B are:

1. 
   * HBe Ag, HBs Ag, HBV-DNA, anti-HBe Ig G, anti-HBs Ig G
   
2. 
   HAV-RNA, anti-HAV Ig M, anti-HAV Ig G
   
3. 
   HСV-RNA, anti-HСV Ig M
   
4. 
   HBs Ag, HDV-RNA, anti-HDV Ig M, anti-HBe Ig M
   
5. 
   HGV-RNA, anti-E2 HGV
   

Markers of chronic hepatitis D are:

1. 
   HBe Ag, HBs Ag, HBV-DNA, anti-HBe Ig G, anti-HBs Ig G
   
2. 
   HAV-RNA, anti-HAV Ig M, anti-HAV Ig G
   
3. 
   HСV-RNA, anti-HСV Ig M
   
4. 
   * HBs Ag, HDV-RNA, anti-HDV Ig M, anti-HBe Ig M
   
5. 
   HGV-RNA, anti-E2 HGV
   

Markers of chronic hepatitis G are:

1. 
   HBe Ag, HBs Ag, HBV-DNA, anti-HBe Ig G, anti-HBs Ig G
   
2. 
   HAV-RNA, anti-HAV Ig M, anti-HAV Ig G
   
3. 
   HСV-RNA, anti-HСV Ig M
   
4. 
   HBs Ag, HDV-RNA, anti-HDV Ig M, anti-HBe Ig M
   
5. 
   * HGV-RNA, anti-E2 HGV
   

Markers of chronic hepatitis С are:

1. 
   HBe Ag, HBs Ag, HBV-DNA, anti-HBe Ig G, anti-HBs Ig G
   
2. 
   HAV-RNA, anti-HAV Ig M, anti-HAV Ig G
   
3. 
   * HСV-RNA, anti-HСV Ig M
   
4. 
   HBs Ag, HDV-RNA, anti-HDV Ig M, anti-HBe Ig M
   
5. 
   HGV-RNA, anti-E2 HGV
   

Name basic clinical signs of cholestasis syndrome:

1. 
   * Jaundice, skin itching
   
2. 
   Jaundice, hepatosplenomegaly
   
3. 
   Pallor, jaundice, hepatosplenomegaly
   
4. 
   Stomach-aches, jaundice
   
5. 
   Pallor, skin itching
   

Name character of pain in perforation of stomach ulcer:

1. 
   Boring
   
2. 
   Burning
   
3. 
   Pressing
   
4. 
   * “Knife-like”
   
5. 
   Belting
   

Name typical signs of stomach cancer:

1. 
   Loss of appetite (disgust for meat)
   
2. 
   Marked loss of body weight for short period of time
   
3. 
   Pain in the upper andomen (sometimes very intensive)
   
4. 
   Periodical “unexplained” diarrhea
   
5. 
   * All mentioned
   

Pain in the inguinal area relates to:

1. 
   Presence of gastritis
   
2. 
   Presence of duodenitis
   
3. 
   * Presence of spastic colitis
   
4. 
   Presence of pancreatitis
   
5. 
   Normal finding
   

Positive Ortner’s sign is characteristic for:

1. 
   Gastritis
   
2. 
   Pancreatitis
   
3. 
   * Cholecystocholangitis, hepatitis
   
4. 
   Duodenitis
   
5. 
   Colitis
   

Positive thymol test is characteristic for:

1. 
   Gastritis
   
2. 
   Pancreatitis
   
3. 
   * Cholecystocholangitis, hepatitis
   
4. 
   Duodenitis
   
5. 
   Colitis
   

Presence of asterixis is characteristic for:

1. 
   Gastritis
   
2. 
   Duodenitis
   
3. 
   * Hepatic insufficiency
   
4. 
   Bile ducts dyskinesia
   
5. 
   Colitis
   

The main ethiologic factor of chronic hepatitis is:

1. 
   Bacteria
   
2. 
   Parasites
   
3. 
   * Virus
   
4. 
   Fungi
   
5. 
   Bile
   

The syndrome of "cholestasis" includes the increased levels of:

1. 
   * АsАТ, АlАТ, total bilirubin
   
2. 
   Cholesterol, direct bilirubin, alkaline phosphatase
   
3. 
   Cholesterol, indirect bilirubin, alkaline phosphatase
   
4. 
   General bilirubin, remaining nitrogen
   
5. 
   General bilirubin, АsАТ, АlАТ
   

The syndrome of "cytolysis" includes:

1. 
   * Increase of the АsАТ level, АlАТ, LDG, bilirubin
   
2. 
   Increase level of cholesterol, iron, LDG
   
3. 
   Decrease level of proteins, cholesterol, bilirubin, СRP
   
4. 
   Decrease level of СRP, remaining nitrogen, АsАТ, АlАТ
   
5. 
   Decrease of the АsАТ level, АlАТ, LDG, bilirubin
   

To the obvious biochemical researches for patients with the diseases of hepatobiliary system belong the folloving:

1. 
   General albumen, CRP, seromucoid, bilirubin
   
2. 
   * General protein and fractions, transaminases, bilirubin, cholesterol
   
3. 
   General protein and fractions, urea, creatinin, cholesterol
   
4. 
   General protein and fractions, CRP, seromucoid, urea
   
5. 
   General protein and fractions, CRP, cholesterol
   

What do cholesterol stones consist of?

1. 
   Bilirubin
   
2. 
   Proteins
   
3. 
   Lecithin
   
4. 
   Bile acids
   
5. 
   * All of the above
   

What are the signs of bile lithogenicity in biochemical blood analysis?

1. 
   Lower cholesterol, bilirubin, increased concentration of bile acids
   
2. 
   * Increased levels of cholesterol, bilirubin, reducing the concentration of bile acids
   
3. 
   Increased cholesterol levels, lower bilirubin, an increased concentration of bile acids
   
4. 
   Lower cholesterol, bilirubin, reducing the concentration of bile acids
   
5. 
   Everything is wrong
   

What are the signs of bile lithogenicity on microscopic examination of bile samples?

1. 
   Bacteria
   
2. 
   * Cholesterol crystals in large quantities
   
3. 
   Mucus
   
4. 
   All of the above
   
5. 
   Everything is wrong
   

What color of feces in case of viral hepatitis?

1. 
   Bright-yellow
   
2. 
   Dark-brown
   
3. 
   * Clays color
   
4. 
   Mud-color
   
5. 
   Black
   

What complex of investigations is needed for patients with the diseases of hepatobiliary system?

1. 
   РH-metry, ultrasonography, duodenal probing
   
2. 
   РH-metry, esophagogastroduodenoscopy, ultrasonography
   
3. 
   Esophagogastroduodenoscopy, ultrasonography, laparoscopy
   
4. 
   * cholecystography, ultrasonography, duodenal probing
   
5. 
   Esophagogastroduodenoscopy, laparoscopy
   

What does not belong for methods of preparation for gastroduodenoscopy?

1. 
   Psychological preparation
   
2. 
   Supper a day before at 18 o’clock
   
3. 
   * Cleansing enema on previous day at 20 o’clock
   
4. 
   Instruction of a patient to be on the fasten stomach in the morning
   
5. 
   Irrigation of a throat with 1-2 % dicaine solution ( 3-5 min before investigation)
   

What examination method is used for early diagnostics of cholelithiasis before formation of gallstones?

1. 
   Gallbladder ultrasound
   
2. 
   Cholecystography
   
3. 
   * Microscopy and biochemical study of bile
   
4. 
   Coprogram
   
5. 
   Esophagogastroduodenoscopy
   

What is necessary for investigation of stomach secretory function?

1. 
   A tray, a bottle
   
2. 
   30-50 ml of 33 % magnesium sulfate solution
   
3. 
   Syringies 2,0 and 20,0 ml capacity
   
4. 
   1 ml of 1% dimedrol solution
   
5. 
   * 0,1% histamine solution
   

What is normal location of liver lower border on anterior median line revealed by percussion?

1. 
   At costal arch
   
2. 
   * between the upper and medial thirds of the distance between the navel and xyphois process
   
3. 
   between the lower and medial thirds of the distance between the navel and xyphois process
   
4. 
   At the navel
   
5. 
   At costal arch
   

What is not necessary to prepare for abdominal puncture?

1. 
   Troacar with a stylet, a acalpel, a pincet
   
2. 
   Syringes, needles, surgical gur, a plaster
   
3. 
   Sterile peaces of gause, tubes
   
4. 
   0,5 % novocaine solution , 5 % iodinum solution
   
5. 
   * Bobrov’s apparatus
   

How is jaundice with occlusion of the common bile duct called?

1. 
   Physiological
   
2. 
   Hemolytic
   
3. 
   * Mechanical
   
4. 
   Parenchymatous
   
5. 
   Combined
   

What portion of bile in the duodenal contents is investigated in case of cholelithiasis?

1. 
   A.
   
2. 
   * B.
   
3. 
   C.
   
4. 
   D.
   
5. 
   E.
   

Where are formed gallstones?

1. 
   In the hepatic bile ducts
   
2. 
   In the common bile duct
   
3. 
   In the gall bladder
   
4. 
   * All of the above
   
5. 
   Everything is wrong
   

Where pain in a hepatic colic is conducted?

1. 
   In the left hypochondrium
   
2. 
   Epigastric
   
3. 
   * In the right hypochondrium
   
4. 
   In the right iliac region
   
5. 
   In the left iliac region
   

Where pain in the attack of biliary colic is conducted?

1. 
   To the right shoulder
   
2. 
   To the neck
   
3. 
   Under the right scapula
   
4. 
   * All of the above
   
5. 
   Everything is wrong
   

Which changes in coprogram are typical for chronic pancreatitis?

1. 
   Semiliquid feces with unpleasant smell
   
2. 
   Steatorrhea
   
3. 
   Creatorrhea
   
4. 
   Amylorrhea
   
5. 
   * All mentioned above
   

Which laboratory test is informative in diagnostics of chronic pancreatitis exacerbation?

1. 
   Complete blood count
   
2. 
   *Investigation of amylase, lipase, tripsin leves and their inhibitors
   
3. 
   Investigation of serum proteins
   
4. 
   Coprogram
   
5. 
   Duodenal probing
   

Which method is the most informative in differentiation of peptic ulcer and stomach cancer?

1. 
   * Esophagogastroduodenoscopy with biopsy
   
2. 
   Roentgenoscopy of the stomach
   
3. 
   Roentgenography of the stomach
   
4. 
   Examination of feces for scant blood
   
5. 
   Е. Investigation of stomach secretion
   

Which method of investigation of stomach lower border is the most informative?

1. 
   percussion
   
2. 
   Auscultation
   
3. 
   * Deep sliding palpation
   
4. 
   Percutory palpation (determination of splashing sound)
   
5. 
   Superficial palpation
   

Which pain is typical for chronic enteritis?

1. 
   Diffuse pain in all abdominal region
   
2. 
   In the left iliac region
   
3. 
   * In paraumbilical region
   
4. 
   In epigastrium
   
5. 
   in lower parts of abdomen
   

Which pathological condition should you suspect in the patient if he has disgust to meat?

1. 
   Peptic ulcer
   
2. 
   Chronic gastritis
   
3. 
   Hemorrhoids
   
4. 
   * Cancer of the intestine
   
5. 
   Enteritis
   

Which radiopaque preparation is necessary for X-ray examination of stomach and intestine?

1. 
   Cholevid
   
2. 
   * Barium sulphate
   
3. 
   Bilignost
   
4.