surgery 90

 90. Question

A 30 year old man complains of acute pain in his right ear, hearing loss, high temperature for three days. Objectively: right ear whispering language – 0.5 mm, external ear is intact, otoscopically – eardrum protrusion, hyperemia and swelling, loss of landmarks. What disease is it?

    1. Eustachian tube disfunction
    2. Chronic purulent otitis media
    --3. Acute purulent otitis media
    4. Chronic secretory otitis media
    5. Acute mastoiditis
 91. Question

On the 2nd day after a surgery for toxic mixed goiter IV a 35-year-old patient complains of heart pain. ECG shows prolonged QT intervals. Chvosteks and Trousseau symptoms cannot be clearly defined. The patient is provisionally diagnosed with latent tetany. What study will allow to confirm the diagnosis?

    1. Determination of thyroid hormones
    --2. Determination of blood calcium and phosphor
    3. Determination of potassim
    4. Determination of thyrotropic hormone
    5. Determination of sodium

 92. Question

A patient with suspicion of pelvic bones fraction is under examination conducted by the doctor who presses alae ilii in medial direction with his both hands. What causes painful syndrome of the patient?

    1. Traumatic injury of the intrapelvic organs
    2. Fracture of sciatic bones
    3. Retroperitoneal hematoma
    4. Fracture of the sacrum
    ---5. Disorder of continuity of the pelvic ring
 93. Question

A neonatologist examining a full-term mature baby revealed the shortening and external rotation of the newborns lower extremity. Clinical examination revealed positive Ortolani sign, symptom of non-vanishing pulse, additional skin folds on the internal surface of thigh. What is the most likely diagnosis?

    1. Femoral neck fracture
    2. Varus deformity of the femoral neck
    3. Fracture of the femoral shaft
    --4. Congenital hip dislocation
    5. Dysplasia of the hip joint
 94. Question

A 62-year-old male patient complains of intense pain in the left leg that suddenly arose three hours before, leg numbness and coldness. During the year there has been pain in the leg while walking, hypersensitivity to cooling. Objectively: the left foot and shin have marbled skin, subcutaneous veins are collapsed. The foot is cold, active movements of the foot and toes are preserved. Pulse is present only on the femoral artery. There is rough systolic murmur above the artery. Make a provisional diagnosis:

    1. Stenosis of the left popliteal artery
    2. Occlusive disease
    3. Acute thrombophlebitis
    4. Acute arterial thrombosis ileofemoralny
    --5. Acute occlusion of the left femoral artery
 95. Question

It is suspected that a 34 year old patient has an abscess of Douglas pouches. What diagnostic method is to be chosen?

    ---1. Digital examination of rectum
    2. Rectoromanoscopy
    3. R-scopy of abdominal cavity
    4. Laparoscopy
    5. Percussion and auscultation of stomach
 96. Question

A 27-year-old patient with a knife stomach wound has been delivered to a hospital 4 hours after injury. Objectively: the patient is in grave condition. Ps- 120 bpm, weak. AP- 70/40 mm Hg. Laparotomy revealed a lot of liquid blood in the abdominal cavity. The patient has been found to have bleeding from the mesenteric vessels of the small intestine. Damage to hollow organs has not been revealed. What is the best way to restore the blood loss?

    1. Transfusion of washed erythrocytes
    ---2. Autoblood reinfusiont
    3. Transfusion of fresh frozen plasma
    4. Rheopolyglucinum transfusion
    5. Erythromass transfusion
 97. Question

A patient with bilateral hydrothorax has repeatedly undergone pleural puncture on both sides. After a regular puncture the patients condition has become worse: he presents with fever, chest pain. The next day, the attending physician performing pleural puncture revealed some pus on the right. What is the mechanism of acute right-sided empyema development?

    1. Aerial
    2. Lymphogenous
    3. Hematogenous
    4. Implantation
    ---5. Contact-and-aspiration
 98. Question

Half an hour ago a 67-year-old patient with a hernia picked up a heavy object, which caused acute pain in the region of hernia protrusion, the hernia couldn’t be reduced. Objectively: the hernia in the right inguinal region is roundish, tight, moderately painful; during palpation it was reduced back to the cavity, the pain was gone. Specify the further medical tactics:

    --1. Inpatient surveillance
    2. Planned hernioplasty a month later
    3. Immediate hernioplasty
    4. Immediate laparotomy
    5. Planned hernioplasty a year later
 99. Question

During dynamic investigation of a patient the increase of central venous pressure is combined with the decrease of arterial pressure. What process is proved by such combination?

    1. Presence of hypervolemia
    --2. Developing of cardiac insufficiency
    3. Increase of bleeding speed
    4. Depositing of blood in venous channel
    5. Shunting