surgery181

 181. Question

Survey radiograph of chest of a 62 year old smoker who often suffers from “pneumonias” showed a triangle shadow in the right lung, its vertex is pointing towards the lung root. It also showed deviation of heart and mediastinum shadows towards the lesion. What is the most probable diagnosis?

    1. Lung abscess
    2. Lung cyst
    --3. Cenral cancer of lung
    4. Peripheral cancer of lung
    5. Atelectasis
 182. Question

A childrens surgical unit admitted a 1-month-old boy who had been prenatally diagnosed with the left-sided pyelectasis. Such studies as drip infusion urography, cystography and USI allowed to reveal initial hydronephrosis. There is no information confirming the secondary pyelonephritis. What tactics of this patient management is most advisable?

    ---1. 6-month surveillance
    2. Antibacterial therapy
    3. Anderson-Hynes operation
    4. Urgent nephrostomy
    5. There is no need in further surveillance and treatment
 183. Question

A 38 y.o. woman was hospitalized to the surgical unit with vomiting and acute abdominal pain irradiating to the spine. On laparocentesis hemmorhagic fluid is obtained. What disease should be suspected?

    1. Acute appendicitis
    2. Perforated gastric ulcer
    3. Renal colic
    4. Acute enterocolitis
    ---5. Acute pancreatitis
 184. Question

During investigation for chronic, severe, epigastric pain, a 40 year old alcoholic man is found to have multiple areas of narrowing alternating with dilatation (“chain of lakes” appearance) of the main pancreatic duct. The operation of choice is:

    1. Sphincterotomy
    2. Distal pancreaticojejunostomy
    ---3. Lateral pancreaticojejunostomy
    4. Total pancreatectomy
    5. Distal pancreatectomy
 185. Question

A 9 y.o. child with diagnosis “chronic tonsillitis” stands dispanserization control. Within 1 year of observation there was one exacerbation of disease. Physical condition is satisfactory. The general state is not infringed. Define group of health:

    ---1. III (a)
    2. I-st
    3. III (b)
    4. III (c)
    5. II-d
 186. Question

A 30 year old patient undergoes treatment because of Werlhofs disease. Objectively: the patient is pale, there are petechial haemorrhages on the extension surfaces of forearms. Ps is 92 bpm, AP is 100/60 mm Hg. The lower edge of spleen is at a level with umbilicus. Blood count: erythrocytes: 2.8;1012/l, Hb – 90 g/l, Ht – 0.38, thrombocytes – 30;109/l. The patient is being prepared for splenectomy. What transfusion medium should be chosen in the first place for the preoperational preparation?

    1. Stored blood
    2. Erythrocytic suspension
    3. Native erythrocytic mass
    4. Washed erythrocytes
    ---5. Thrombocytic mass
 187. Question

A 19 y.o. man was admitted to the reception department in 20 minutes after being wounded with the knife to the left chest. The patient is confused. The heart rate is 96 bpm and BP- 80/60 mm Hg. There are the dilated neck veins, sharply diminished apical beat and evident heart enlargement What kind of penetrative chest wound complications has developed in patient?

    1. Massive hemothorax
    2. Valve-likes pneumothorax
    3. Closed pneumothorax
    ---4. Pericardium tamponade
    5. Open pneumothorax
 188. Question

A 48-year-old male patient complains of pain in the lower extremities, especially when walking, intermittent claudication, numbness in the fingers, cold extremities, inability to walk more than 100 meters. Sleeps with his leg lowered. The patient has been a smoker since he was 16, abuses alcohol, has a history of CHD. The left lower extremity is colder than the right one, the skin of extremities is dry, pedal pulse cannot be palpated, femoral pulse is preserved. What is the most likely diagnosis?

    ---1. Obliterating endarteritis
    2. Diabetic angiopathy
    3. Raynauds disease
    4. Leriche syndrome
    5. Deep thrombophlebitis
 189. Question

A 24 y.o. male patient was transferred to the chest surgery department from general surgical department with acute post-traumatic empyema of pleura. On the X-ray: wide level horizontal of fluid on the right. What method of treatment should be prescribed?

    1. Decortication of pleura
    2. Lobectomy
    ---3. Punction and drainage of pleural cavity
    4. Pneumoectomy
    5. Thoracoplasty
 190. Question

A 36-year-old woman applied to doctor with complaints of the enlargement of the right mammary gland. On physical exam: the right mammary gland is enlarged, hardened; nipple with areola is pasty and hydropic, looks like “lemon peel”. There palpates a lymph node in the right axilla, 1.5 cm in diameter, dense consistence, not mobile. What is the most probable diagnosis?

    1. Erysipelatouslike cancer of the mammary gland
    ---2. Hydropic and infiltrative cancer of the mammary gland
    3. Pagets cancer
    4. Diffusive mastopathy
    5. Acute mastitis