surgery 191

191. Question

A 62-year-old patient has been delivered to the surgical department with complaints of sudden pain in the umbilical region irradiating to the back and groin, which was accompanied by a syncope. Objectively: the patient is in grave condition, umbilical region is tender on palpation, bowel sounds are diminished. AP drop is present. USI reveals: free fluid in the abdomen, thickening of the wall of the abdominal aorta. The most likely diagnosis is:

    1. Peritonitis
    2. Acute pancreatitis
    --3. Rupture of abdominal aortic aneurism
    4. Acute appendicitis
    5. Stomach ulcer perforation
 192. Question

A 4 y.o. child attends the kindergarten. Complains of poor appetite, fatigue. Objective examination: skin and mucous membrane are pale, child is asthenic. In the hemogram: hypochromatic anemia 1st, leucomoide reaction of the eosinophile type. What pathology must be excluded first of all?

    1. Atrophic gastritis
    ---2. Helminthic invasion
    3. Hypoplastic anemia
    4. Duodenal ulcer
    5. Lymphoprolipherative process
193. Question

A 22 year old patient was admitted to trauma center with complaints of pain in the left ankle joint that was getting worse during moving and weight bearing. On the clinical examination it was found that the patient had the closed fracture of medial malleolus without displacement. In which position should the foot be fixed in plaster cast?

    ---1. At right angle with varus positioning of the foot
    2. In position of supination
    3. In position of planter flexion of foot
    4. In position of dorsal flexion of foot
    5. In position of pronation
 194. Question

30 y.o. woman, had mild trauma of 5th finger of the left hand 15 days ago. She has treated her self at home. She presents to the hospital due to deterioration of the condition and temperature rise. Objectively: hyperemia and swelling on the ventral surface of finger. Restricted movements of the finger. X-ray of the left hand: an early stage of osteomyolitis of the fifth finger could not be excluded. The diagnosis: panaris of 5th finger of the left hand. What form of panaris has occurred in the patient?

    1. Tendon type
    2. Joints type
    ---3. Bony
    4. Paronychia
    5. Hypodermic
 195. Question

A 45-year-old woman, mother of four children, comes to the emergency room complaining of a sudden onset of the epigastric and right upper quadrant pain, radiating to the back, accompanied by vomiting. On examination, tenderness is elicited in the right upper quadrant, bowel sounds are decreased, and laboratory data shows leukocytosis, normal serum levels of amylase, lipase, and bilirubin. The most likely diagnosis is:

    1. Acute pancreatitis
    2. Perforated peptic ulcer disease
    3. Sigmoid diverticulitis
    --4. Acute cholecystitis
    5. Myocardial infarction
 196. Question

A 20-year-old patient was delivered to the hospital in summer from the street with haemorrage from the brachial artery. First medical aid involved application of a tourniquet for provisional arrest of bleeding. What is the maximal exposure of the tourniquet?

    1. 60 minutes
    2. 180 minutes
    3. 15 minutes
    4. 30 minutes
    --5. 120 minutes
 197. Question

A 32-year-old patient lives in an area endemic for echinococcosis. In the last 6 months he reports of pain in the right subcostal area, fever. He is suspected to have liver echinococcosis. What study would be the most informative in this case?

    --1. USI
    2. Biochemical laboratory examination
    3. Liver scanning
    4. Survey radiography of abdominal cavity
    5. Angiography
 198. Question

A 40 year old woman has a self-detected hard breast mass. The procedure of choice for confirming the diagnosis is:

    ---1. Excision biopsy
    2. Thermography
    3. Aspiration biopsy with cytology
    4. Ultrasonography
    5. Mammography
 199. Question

A 36 y.o. patient is diagnosed with right sided pneumothorax. What method of treatment is indicated to the patient?

    1. Pleural puncture
    --2. Surgical drainage of the pleural cavity
    3. Symptomatic therapy
    4. Antiinflammation therapy
    5. Thoracotomy
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