1) For the diagnosis of gastroesophageal reflux disease, the primary study is: a) endoscopy b) X-ray c) histologic examination d) pH-metry 2) Endoscopic examination reveals gastroesophageal reflux disease in the form of: a) diffuse esophageal spasm b) Mallory – Weiss syndrome c) gastroesophageal reflux with esophagitis d) esophageal candidiasis 3) The gastric secretion is stimulated by: a) cholecystokinin b) secretin c) serotonin d) gastrin 4) Castle’s intrinsic factor is formed in: a) large intestine b) fundus of the stomach c) duodenum d) small intestine 5) The signs of endocrine pancreatic insufficiency in chronic pancreatitis include: a) hyperglycemia b) weight loss c) deficiency of fat-soluble vitamins d) steatorrhea 6) The drugs of choice in the treatment of patients with gastroesophageal reflux disease are a) proton pump inhibitors b) H2 antagonists c) aluminum-containing gastroprotectants d) dopamine receptor blockers 7) The most dangerous complication of ascites is: a) development of venous collaterals in the abdominal wal b) dyspnea c) umbilical hernia d) spontaneous bacterial ascites – peritonitis 8) The conservative therapy of chronic pancreatitis does not include: a) analgesics b) corticosteroids c) sandostatin d) enzyme preparations 9) A laboratory indicator of exacerbation of chronic pancreatitis is the level of: a) aminotransferase b) alkaline phosphatase c) amylase d) glucose 10) For abdominal pain, nausea, heartburn, belching, the patient should be prescribed: a) complete blood count b) computed tomography of the abdominal organs c) X-ray of the abdominal organs d) esogastroduodenoscopy 11) Proton pump inhibitors ensure intragastric pH levels of ___ or higher for more than 18 hours a day a) 3 b) 7.5 c) 7 d) 5 12) A study characterizing the endocrine function of the pancreas is: a) Gregersen test b) glucose profile test c) urine diastasis d) coprogram 13) A contraindication to fiber optic endoscopy of the upper digestive tract is: a) cardia cancer b) esophageal diverticulum c) asthmatic condition d) varicose veins of the esophagus 14) To assess the functional consequences of chronic pancreatitis, one should determine the blood levels of: a) iron and vitamin B12 after a test breakfast b) lipase and amylase after a test breakfast c) fasting cholesterol and triglycerides levels d) fasting glucose and insulin levels 15) The most informative method in diagnosing endoscopy-negative gastroesophageal reflux dis- ease is: a) 24-hour intraesophageal pH monitoring b) X-ray examination of the esophagus c) scintigraphy of the esophagus d) abdominal ultrasound 16) The risk of developing acute pancreatitis is high if there is a significant increase in _____ in blood plasma: a) VLDL b) LDL. c) HDL d) LP(a) 17) What is necessary in gastroesophageal reflux? a) prescription of apomorphine b) horizontal position after eating c) split meals d) restriction of animal fats 18) A risk factor for pancreatitis is: a) night shift work b) alcohol abuse c) dairy intolerance d) excessive physical activity 19) During ultrasound examination it is impossible to characterize ____ of the organs and struc- tures being studied a) macrostructure b) topographic and anatomical relationships c) microstructure d) macrostructure and topographic and anatomical relationships 20) The most significant symptom indicating the presence of duodenal reflux is: a. bile in vomit a) bile in vomit b) nausea c) belching air d) heaviness in the epigastrium 21) The primary mechanism playing a role in the pathogenesis of gastroesophageal reflux disease is: a) increased tone of the lower esophageal sphincter b) decreased tone of the lower esophageal sphincter c) hyposecretion of hydrochloric acid d) increased esophageal clearance 22) The most reliable indicator of pancreatitis is: a) hyperglycemia b) girdle pain c) high levels of amylase in blood (diastase in urine) d) steatorrhea 23) A common cause of pancreatitis is: a) infection b) obesity c) Helicobacter pylori d) gallbladder disease 24) It is used to suppress the activity of the pancreas: a) magnesium hydroxide + algeldrate b) aprotinin c) oxprenolol d) polymethylsiloxane polyhydrate 25) The early manifestations of exocrine pancreatic insufficiency include: a) polyfecalia b) cachexia c) diabetes mellitus d) pancreatic cholera syndrome 26) The main role in the treatment of gastroesophageal reflux disease is attributed to: a) antibiotics b) antacids c) proton pump inhibitors d) antispasmodics 27) The total amount of gastric juice (in liters) secreted in a person during a normal diet is: a) 1.5–2 b) 0.5–1 c) 2–2.5 d) 1–1.5 28) The symptom of heartburn is pronounced in: a) chronic pyelonephritis b) gastroesophageal reflux disease c) chronic pancreatitis d) chronic cholecystitis 29) A reliable indication of pyloric stenosis is: a) succussion splash 3-4 hours after eating b) visible peristalsis c) resonance underneath the Traube’s space d) vomiting bile 30) The synthesis of hydrochloric acid in the gastric glands is carried out by: a) neuroendocrine cells b) mucous cells c) parietal cells d) gastric chief cells 31) The dominant symptom of recurrent pancreatitis is: a) nausea b) abdominal pain c) bitter taste in the mouth d) stool softening 32) Which of the following is diagnostically significant for chronic pancreatitis? a) increased elastase activity in the stool b) a lot of fat in the stool c) decreased urinary diastase activity d) calcifications in the head of the pancreas 33) The most characteristic symptom of infectious esophagitis is: a) heartburn b) odynophagia (pain when swallowing) c) belching air d) hiccups 34) In chronic pancreatitis with exocrine insufficiency, the nature of the stool is: a) bulky, mushy, shiny b) liquid, mixed with red blood c) watery with flakes d) scanty, fragmented 35) Exacerbation of chronic pancreatitis is indicated by: a) increased echogenicity of the pancreas on ultrasound b) jaundice c) elevated levels of urinary diastase d) impaired glucose tolerance 36) The gallbladder contracts under the influence of a) cholecystokinin b) gastrin c) secretin d) pancreatic juice 37) A complication not typical for gastroesophageal reflux disease is: a) esophageal adenocarcinoma b) Barrett's esophagus c) polyposis of the esophagus d) appearance of esophageal strictures 38) For relieving pain due to esophagitis, the most effective medication is: a) rabeprazole b) drotaverine c) platyphylline d) metoclopramide 39) To assess the exocrine function of the pancreas, it is necessary to determine the activity of: a) fecal lipase b) fecal elastase c) lipase in blood d) elastase in blood 40) An absolute contraindication to colonoscopy is: a) decompensated heart failure b) bleeding hemorrhoids c) acute anal abscess (acute paraproctitis) d) severe form of ulcerative colitis 41) The cause of esophageal bleeding in liver cirrhosis is: a) jaundice b) increased pressure in the portal vein c) decrease in blood hemoglobin d) high viral load 42) The method of choice when determining the treatment strategy in patients with progressive hepatocellular failure of any origin is: a) massive corticosteroid therapy b) massive corticosteroid therapy in combination with cytostatics c) extensive interferon therapy d) liver transplantation 43) The most reliable method for differential diagnosis of hepatic and obstructive jaundice is: a) blood biochemistry for bilirubin and alkaline phosphatase levels b) endoscopic examination of the esophagus and the stomach c) abdominal ultrasound d) blood biochemistry for ALT and AAT levels 44) If chronic calculous cholecystitis is suspected, in order to clarify the diagnosis, it is necessary to conduct: a) abdominal ultrasound b) duodenal intubation c) plain radiography of the abdominal organs d) esophagogastroduodenoscopy (EGD) 45) Varicose veins in the esophagus and in the cardia of the stomach most often occur in: a) viral hepatitis b) Caroli disease c) liver cirrhosis d) metastatic liver disease 46) Positive Ker's symptom is a sign of: a) duodenal ulcer b) chronic cholecystitis c) cancer of the head of the pancreas d) chronic pancreatitis 47) Portal hypertension can be observed in: a) chronic hepatitis b) liver cirrhosis c) metastchronic pancreatitisatic liver cancer 48) The most common cause of portal hypertension is: a) intrahepatic block in hepatic steatosis b) Budd – Chiari syndrome c) intrahepatic block in hepatic steatosisintrahepatic block in liver cirrhosis d) extrahepatic block due to splenic vein thrombosis 49) A complication of peptic ulcer is: a) penetration b) renal colic c) portal hypertension d) cholelithiasis 50) Which of the following does not indicate penetration of the ulcer? a) decreased response to antacids b) melaena c) appearance of intractable pain d) change in the characteristic rhythm of pain 51) The normal healing time for a duodenal ulcer is: a) 1.5 months b) 6 months c) 3 months d) 1.5 weeks 52) An endoscopic sign of active Helicobacter pylori gastritis is: a) very pronounced rugae and a large amount of mucus b) pale mucosa (rugae appear less prominent) c) scar tissue changes in the gastric mucosa d) mucosal hyperemia with pinpoint hemorrhages (petechiae) 53) An X-ray detected a flat irregularly shaped niche in the antrum of the stomach. It is approxi- mately 2.5 cm in diameter and is surrounded by a wide area showing reduced or absent peristaltic activity. It is indicative of: a) acute stomach ulcer b) ulcerating cancer c) uncomplicated ulcer of the antrum 54) .In the differential diagnosis between peptic ulcer disease and stomach cancer, the most im- portant is: a) histologic examination b) histamine test of gastric secretion c) fibrogastroduodenoscopy 55) ___ stomach polyps are the most susceptible to malignancy a) juvenile b) hyperplasiogenic c) adenomatous d) hyperplastic 56) For a patient experiencing iron deficiency anemia and having a medical history of jejunum and partial ileum resection, the most optimal course of treatment will be: a) intramuscular administration of vitamin B12 b) oral administration of folic acid c) oral administration of Ferrum Lek d) intramuscular administration of Ferrum Lek 57) The indication for parenteral administration of iron supplements is resection of: a) small intestine b) colon c) right lung d) pancreas 58) The cause of thrombosis of the portal vein and its branches is deficiency in: a) vitamin K b) proteins C and S c) alcohol dehydrogenase d) immunoglobulin G 59) When using warfarin to prevent recurrence of pulmonary embolism, the target international normalized ratio is equal to: a) 2.0–3.0 b) 1.5–2.5 c) 2.5–3.5 d) 3.0–4.0 60) The recommended duration for the administration of apixaban at a dose of 10 mg twice a day for the treatment of acute venous thromboembolism is: a) 21days b) 28 days c) 7 days d) 14 days 61) D-dimer is a product of lysis of: a) factor X b) thrombin c) platelets d) fibrin 62) The duration of anticoagulant therapy after the first episode of venous thromboembolism (VTE) is at least (in months): a) 3 b) 6 c) 9 d) 12 63) The main factors predisposing to thrombosis are: a) thrombocytopenia, microcirculatory rarefaction, embolism b) vascular spasm, atherosclerosis, high plasma renin activity c) endothelial damage, turbulent blood flow, hypercoagulation d) atheromatous plaques, hemostasis, hypocoagulation 64) Osteoarthritis is characterized by: a) anemia b) leukocytosis c) normal blood counts d) thrombocytosis 65) In uncomplicated osteoarthritis CBC shows: a) leukocytosis b) thrombocytopenia c) no changes d) leukopenia 66) Intermittent joint locking is most characteristic of a) osteoarthritis b) rheumatoid arthritis (RA) c) gout d) psoriatic arthropathy 67) A Baker's cyst is: a) accumulation of fluid in the posterior part of the knee joint b) accumulation of fluid in the prepatellar bursa c) accumulation of fluid in the joint cavity d) periarticular cyst-like lucency of bone tissue on X-ray images 68) .The formation of liver abscesses is characteristic of: a) alveococcosis b) amoebiasis c) toxoplasmosis d) 6lechinococcosis 69) Bright hyperemia of the skin of irregular shape with clear borders in combination with fever is characteristic of: a) lichen planus b) phlegmon c) erysipelas d) abscess 70) A 40-year-old man received deep wounds when falling from a tractor. Tetanus antitoxin should not be administered if: a) tetanus toxoid was last administered 12 years ago b) he received a full course of immunization and was revaccinated 2 years ago c) he received 2 injections of tetanus toxoid during his life d) tetanus antitoxin was administered 5 years ago 71) Intestinal bleeding in typhoid fever is caused by a) ulcerative lesions of lymphoid structures in the ileum b) ulcerative necrosis of the duodenum c) universal destructive-proliferative endothrombovasculitis d) long-term bacteremia 72) .Ulcerative colitis is characterized by: a) segmental lesions b) relapse-free course c) development of transmural ulcers d) frequent bleeding 73) The complication most characteristic of Crohn's disease is: a) development of a toxic megacolon b) intestinal obstruction c) bleeding d) increased risk of malignancy 74) .The risk of thromboembolic complications in cardiac arrhythmias increases in: a) atrial tachycardia b) ventricular extrasystole c) atrial fibrillation d) atrial extrasystole 75) Multiple injuries, extensive surgical interventions, septic conditions, malignant tumors can cause the development of a) disseminated intravascular coagulation (DIC) b) Osler – Weber – Rendu syndrome (hereditary haemorrhagic telangiectasia) c) hemolytic anemia d) hemorrhagic vasculitis 76) .To stop bleeding in acute DIC, it is necessary to: a) transfuse at least 1 liter of warm donor blood b) transfuse sufficient volumes of fresh frozen plasma c) prescribe prothrombin complex concentrates d) perform plasmapheresis with a 1-liter exchange volume 77) A screening method for the diagnosis of colon cancer is: a) irrigoscopy b) fecal occult blood test c) ultrasound of the large intestine d) fibrocolonoscopy 78) .The most likely precursor of lung cancer is: a) alcoholism b) obesity c) drug addiction d) smoking 79) .The earliest symptom of cancer located in the cardiac part of the stomach is: a) dysphagia b) pain behind the sternum c) vomiting d) epigastric pain 80) Mammography for early detection of breast cancer is recommended for women aged from a) 40 years b) 18 years c) 50 years d) 30 years 81) The simplest and most informative method for early diagnosis of central lung cancer is a) bronchoscopy b) spirometry c) sputum cytology d) chest photofluorography 82) Stomach cancer is most often located in: a) the body b) the antrum c) the greater curvature d) the cardia 83) The earliest specific syndrome in patients with cancer of the biliopancreatic – duodenal zone is: a) mechanical (obstructive) jaundice b) frequent vomiting c) epigastric and back pain d) weight loss 84) A breast cancer screening method is: a) self-examination b) breast ultrasound c) examination by a mammologist d) mammography 85) Anorexia – cachexia syndrome is most pronounced in cancer of: a) skin b) stomach, pancreas c) cervix of the uterus d) kidneys, adrenal glands 86) In the differential diagnosis between peptic ulcer disease and stomach cancer, the most im- portant is a) fecal occult blood test b) X-ray c) endoscopic examination with biopsy d) gastric secretion test 87) Сancer located in the middle ampulla of the rectum can cause: a) tumor in the right iliac region b) pain in the right iliac region and above the pubic area c) constipation and diarrhea d) frequent tenesmus with the discharge of blood and mucus 88) Palliative care means: a) an approach to alleviate the suffering of the patient and improve the quality of life of terminal patients and their families b) a method of treatment that allows to completely cure the patient c) treatment of concomitant diseases d) measures aimed at preventing the development of serious diseases 89) .In patients with malignant pleural effusion (MPE), the pleural fluid is often: a) hemothorax b) transudate c) exudate d) chylothorax 90) The decisive role in the differential diagnosis of lung abscess from tuberculosis and cavitary lung cancer is attributed to: a) bronchoscopy b) biopsy c) clinical examination d) X-ray examination 91) Lung cancer frequently metastasizes to: a) submandibular lymph nodes b) axillary lymph nodes c) posterior cervical lymph nodes d) supraclavicular lymph nodes 92) The clinical symptom most characteristic of central lung cancer is: a) decreased vocal fremitus b) fetid sputum c) hemoptysis d) dull percussion sound 93) The recommended terms of temporary disability in exacerbation of chronic cholecystitis of moderate severity are: a) 10–14 days b) 21–42 days c) 7–10 days d) 14–21 days 94) The absolute contraindication to bronchoscopy is: a) stroke b) community-acquired pneumonia c) bronchogenic cancer with metastases d) a foreign body in the bronchi 95) .The differential diagnosis for a lung abscess should include: a) bronchial asthma b) chronic bronchitis c) cavernous pulmonary tuberculosis d) acute interstitial pneumonia (also known as Hamman – Rich syndrome) 96) Lung damage in sepsis most often manifests through: a) exudative pleurisy b) bilateral infiltrates on the X-ray c) pulmonary hypertension d) subtotal (extensive) lung tissue lesion 97) A patient with a rounded peripheral formation in the lung of unspecified etiology should under- go: a) anti-tuberculosis therapy b) hormone therapy c) continuous monitoring d) lung biopsy 98) The three-layer sputum is characteristic of: a) lung abscess and bronchiectases b) sarcoidosis c) chronic obstructive bronchitis d) extrinsic allergic alveolitis 99) The presence of this sign in sputum suggests destruction of the lung tissue: a) a large number of white blood cells b) a large number of red blood cells c) Charcot – Leiden crystals d) elastic fibers 100) The main diagnostic method for detecting a lung cyst is: a) radioisotope lung scanning b) bronchography c) X-ray and computed tomography of the lung d) bronchoscopy

FINAL EXAM 5

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