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Krok2 – 2014 Base(Surgery)

‘Foundation Course’ for FMGE Preparation

    Question 11 of 209
    11. Question

    A 60 y.o. man complains of significant pain in the right eye, photophobia, lacrimation, reduced vision of this eye, headache of the right part of the head. Pain occured 2 days ago. On examination: Vis OD- 0.03, congested injection of the eye ball, significant cornea edema, front chamber is deep, pupil is narrow, athrophic iris, there is optic nerve excavation on the eye fundus, intraocular pressure- 38 mm Hg. Vis OS- 0.8 unadjustable. The eye is calm, healthy. Intraoccular pressure- 22 mm Hg. What is the most probable diagnosis?
        1. Eye nerves neuritis
        2. Right eyes uveitis
        3. Maculodystrophy
        4. Right eyes keratitis
        ---5. Acute glaucoma attack
 Question 12 of 209
12. Question

After a car accident a 37-year-old patient has an acute pain and bleeding in the middle third of his right thigh. Objectively: there is a wound on the anterior surface of the right thigh with massive bleeding, abnormal mobility at the level of the middle third of the thigh. The first aid is to be started with:

    --1. Digital occlusion of the femoral artery
    2. Venipuncture and intravenous infusion of polyglycine
    3. Tourniquet application
    4. Immobilization of the extremity with a transportation splint
    5. Injection of pain-killers

 Question 13 of 209
13. Question

A patient with acute purulent otitis media complicated by mastoiditis was admitted to a hospital. Roentgenogram of mastoid processes showed the shadiowing of the cellular system on the lesion, absence of bone septa was present. What are the necessary therapeutic actions at the second stage of mastoiditis?

    --1. Mastoidotomy
    2. Paracentesis of the drum
    3. Tympanoplasty
    4. Cateterization of the Eustachian tube
    5. Radical operation on the middle ear
 Question 14 of 209
14. Question

A 42-year-old patient with acute haemorrhage and class III blood loss underwent blood transfusion and got 1.8 l of preserved blood and erythromass of the same group and Rh. After the transfusion the patient complained of unpleasant retrosternal sensations, his arterial pressure dropped to 100/60 mm Hg, there appeared convulsions. Blood serum calcium was at the rate of 1.7 millimole/liter. What is the mechanism of this complication development?

    --1. Citrate binds calcium ions, hypocalcemia impairs myocardial function
    2. Citrate causes the development of metabolic acidosis
    3. Citrate binds potassium causing severe hypokalemia
    4. The increased citrate rate causes convulsions
    5. Citrate is cardiotoxic and nephrotoxic

 15. Question

A 38-year-old patient has suddenly developed pain in the left side of his chest, suffocation. Objectively: moderately grave condition, Ps- 100/min, AP- 90/60 mm Hg, breath sounds on the left cannot be auscultated. Chest radiography shows the collapse of the left lung up to 1/2. What kind of treatment should be administered?

   -- 1. Passive thoracostomy
    2. Operative therapy
    3. Rest, resolution therapy
    4. Active thoracostomy
    5. Pleural puncture

 16. Question

A child is being discharged from the surgical department after conservative treatment of invagination. What recommendations should doctor give to mother to prevent this disease recurrence?

    1. Hardening of the child
    2. Feces observation
    ---3. Strict following of feeding regimen
    4. Common cold prophilaxis
    5. Gastro-intestinal disease prevention

 17. Question

A 40-year-old woman with acute gastrointestinal hemorrhage was transfused 400 ml of the preserved blood after having conducted all compatibility tests. After hemotransfusion the condition of the patient became worse. She started having headache, muscles pain, her temperature has risen up to 38.8°C. What is the reason for such condition of the patient?

    1. Allergic reaction
    2. Air embolism
    3. Hemotransfusional shock development
    --4. Pyrogenic reaction of medium severity
    5. Bacterial and toxic shock development

 18. Question

A 9-year-old boy fell from a tree and hit the occipital region, there was a momentary loss of consciousness. Objectively: the childs condition is satisfactory, he complains of the headache and dizziness. The X-ray of skull reveals a comminuted depressed fracture of occipital bone in the region of inion. What treatment is indicated for the patient?

    1. Therapeutic lumbar punctures
    2. Hemostatic therapy
    3. Anti-inflammatory therapy
    ---4. Surgical intervention
    5. Complex conservative treatment
 19. Question

A 57 year old patient abruptly lost the sight of one eye. Examination revealed that his sight made up 0.02 excentrically, eye fundus has haemorrhages of different forms and sizes (“squashed tomato” symptom). Disc of optic nerve is hyperemic. In anamnesis general vascular pathology is recorded. Direct-acting anticoagulants were administered. What is the most probable diagnosis?

    1. Diabetic retinopathy
    2. Hypertensive angiopathy
    3. Embolism of central artery of retina
    --4. Thrombosis of central vein of retina
    5. Hypertensive angioneuropathy


    20. Question

    A 47-year-old female patient complains of leg heaviness, fatigue when standing and walking. This feeling disappears when she takes a horizontal position. Objectively: dilatation of the superficial veins of the left shin and thigh with pigmentation and trophic skin disorders. What functional test should the examination be started with?
        1. Sheinis test
        2. Pratt test 2
        --3. Trendelenburgs test
        4. Perthes test
        5. Pratt test 1