Archive for March 2019

A patient with peritonitis has water-electrolyte exchange disturbances. Clinical signs of cellular dehydration. Which liquid infusion will you not use for starting correction of water-electrolyte disbalance?

A patient with peritonitis has water-electrolyte exchange disturbances. Clinical signs of cellular dehydration. Which liquid infusion will you not use for starting correction of water-electrolyte disbalance? 


A. Darrova liquid
B. 0,3% KCl liquid
C. 5% glucose liquid
D. Reopolyglucin
E. 10% mannitol liquid


Answer: E. 10% mannitol liquid

Typical radical operations of stomach cancer are all. except:

Typical radical operations of stomach cancer are all. except: 


A. Wedgetype resection of stomach
B. Subtotal resection of stomach
C. Gastrectomy
D. Proximal resection of stomach
E. ¾ resection of stomach


Answer: A. Wedgetype resection of stomach

X-ray symptoms, which prove the malignization of polyps are all, except:

X-ray symptoms, which prove the malignization of polyps are all, except: 


A. Enlargement of polyps
B. Contours of polyps are not clear
C. Loss of peristalses
D. Ulceration of polyps
E. Faster evacuation of stomach content


Answer: E. Faster evacuation of stomach content

X-ray signs of stomach cancer are all, except:

X-ray signs of stomach cancer are all, except: 


A. Defect of filling
B. Absence of peristalses
C. Interruption of mucous crinkle
D. Open pylorus
E. Not clear contours of filling defect


Answer: D. Open pylorus


Factors, which conduce development of stomach cancer are all, except:

Factors, which conduce development of stomach cancer are all, except: 


A. Eating of hot, chilly food
B. Smoking
C. Not good heredity
D. Hard physical work
E. Long time chronic inflammation processes in stomach


Answer: D. Hard physical work

Precancerous diseases of stomach are all, except:

Precancerous diseases of stomach are all, except: 


A. Scarring processes in the stomach wall
B. Chronic gastritis
C. Chronic colitis
D. Poliposis of stomach
E. Ulcer disease of stomach


Answer: C. Chronic colitis

Operations, which are used in surgical treatment of duodenal ulcer are all, except:

Operations, which are used in surgical treatment of duodenal ulcer are all, except: 


A. Resection of stomach
B. Gastroenterostomy
C. Vagotomy and antrumectomy
D. Truncular vagotomy, suturing of bleeding blood vessel, pyloroplasty
E. Selective vagotomy, suturing of bleeding blood vessel, pyloroplasty


Answer: B. Gastroenterostomy

Symptoms of ulcer penetration to pancreas are all, except:

Symptoms of ulcer penetration to pancreas are all, except: 


A. Pain irradiation to spine
B. Constant pains
C. Increasing of diastase level in blood
D. Positive "splattering" symptom
E. Positive Meyo - Robson symptom


Answer: D. Positive "splattering" symptom

Malignization signs of ulcer are all, except:

Malignization signs of ulcer are all, except: 


A. Change of pain character
B. Big "niche" with infiltration around it
C. Increasing of stomach acidity
D. Loss of weight, nausea
E. Persistent pain


Answer: C. Increasing of stomach acidity

The signs of stomach bleeding are all, except:

The signs of stomach bleeding are all, except: 


A. Tachicardia, hypotonia
B. Vomiting with "cofee ground"
C. Melena
D. Resistance of abdominal wall
E. Pale skin


Answer: D. Resistance of abdominal wall

Typical symptoms of ulcer perforation are all, except:

Typical symptoms of ulcer perforation are all, except: 


A. Sharp pain in the abdomen
B. Loss of liver damping
C. Mild melena
D. Resistance of abdominal muscles
E. In X-ray free air in the abdomen can be detected


Answer: C. Mild melena

The objective symptoms of pyloric stenosis are all, except:

The objective symptoms of pyloric stenosis are all, except: 


A. Loss of weight
B. Open pylorus
C. Bad smell from mouth
D. Vomiting with previously eaten substances
E. During X-ray examination stomach is enlarged, 24 hours after examination can be found Barium substances


Answer: B. Open pylorus

X-ray symptoms of ulcer are all, except:

X-ray symptoms of ulcer are all, except: 


A. "Niche"
B. Convergence of mucosa crinkles
C. Rough relief of mucosa crinkles with "niche"
D. "Finger" symptom
E. Duodenostenosis


Answer: E. Duodenostenosis

Arteries which supply stomach with blood are all, except:

Arteries which supply stomach with blood are all, except: 


A. a. gastrica sinistra
B. a. gastrica dextra
C. a. mesenterica inferior
D. a. gastroepiploica sinistra
E. a. gastroepiploica dextra


Answer: C. a. mesenterica inferior

Incarceration symptoms of hernia are all, except:

Incarceration symptoms of hernia are all, except: 


A. Sharp pains during palpation of hernia
B. Hernia is irreparable
C. Positive "cough" symptom
D. Hernia is dense and resistant
E. Dysfunction of intestines


Answer: C. Positive "cough" symptom

A 26-year-old patient complains about inconvenient urination with and burning pains, feeling of hardness in the lower part of abdomen, pulsation pains in perineum, increasing of temperature up to 40°C with fever, headaches, feeling of dryness in the mouth, asthenia. The illness started acutely 10 days ago with cold. Which physical examination methods are the most important?

A 26-year-old patient complains about inconvenient urination with and burning pains, feeling of hardness in the lower part of abdomen, pulsation pains in perineum, increasing of temperature up to 40°C with fever, headaches, feeling of dryness in the mouth, asthenia. The illness started acutely 10 days ago with cold. Which physical examination methods are the most important? 


A. Percussion of urinary bladder
B. Examination of penis
C. Digital examination per rectum
D. Palpation of testis and epididymis
E. Palpation of the kidneys


Answer: C. Digital examination per rectum

Clinical peculiarities of direct inguinal hernia are all, except:

Clinical peculiarities of direct inguinal hernia are all, except: 


A. It has round form
B. Localized laterally from funiculus spermaticus
C. More often can be bilateral
D. Practically never goes down in scrotum
E. Weak back wall of canalis inguinalis


Answer: B. Localized laterally from funiculus spermaticus

Clinical pecularities of oblique inguinal hernia are all, except:

Clinical pecularities of oblique inguinal hernia are all, except: 


A. Elongate form
B. Goes together with funiculus spermaticus
C. Often goes down in scrotum
D. More often can be bilateral
E. Can be congenital


Answer: D. More often can be bilateral

Indications for using a tampon in the abdominal cavity in case of acute appendicitis are all except:

Indications for using a tampon in the abdominal cavity in case of acute appendicitis are all except: 


A. Appendix lies in medial position
B. Retrocaecal phlegmona in case of retrocaecal position of appendix
C. Bleeding from small blood vessels and lesions
D. Abscessus periappendicularis
E. Little piece of appendix left in lesions after appendectomy


Answer: A. Appendix lies in medial position

Local peritonitis can be in cases of the following diseases, except:

Local peritonitis can be in cases of the following diseases, except: 


A. Incarcerated hernia
B. Appedicular infiltrate in stage of abscedation
C. Pyelonephritis
D. Inflammation of Meccel diverticul
E. Acute appendicitis


Answer: C. Pyelonephritis

The symptoms of acute appendicitis are all, except:

The symptoms of acute appendicitis are all, except: 


A. Pains in the right ileocaecal region
B. Resistance of muscles
C. Rouzing symptom
D. Scotkin - Blumberg symptom
E. Meyo - Robson symptom


Answer: E. Meyo - Robson symptom

In case of esophagus cancer palliative operations are all, except:

In case of esophagus cancer palliative operations are all, except: 


A. Gastrostomy
B. Esophagofundanastomosis
C. Endoprotesation of esophagus
D. Gastroenteroanastomosis
E. Esophagojejunoanastomosis


Answer: D. Gastroenteroanastomosis

The methods of esophagus cancer treatment are all, except:

The methods of esophagus cancer treatment are all, except: 


A. X-ray therapy
B. Chemotherapy
C. Resection of esophagus in Torec modification
D. Endoprotesation of esophagus
E. Hormone therapy


Answer: E. Hormone therapy

Metastases of esophagus cancer are everywhere, except:

Metastases of esophagus cancer are everywhere, except: 


A. Neck lymph nodes
B. In bifurcacion place and paratracheal lymph nodes
C. In retroperitoneal lymph nodes
D. In liver
E. In thyroid gland


Answer: E. In thyroid gland

Diagnostic methods of esophagus cancer are all, except:

Diagnostic methods of esophagus cancer are all, except: 


A. Contrast investigation of esophagus
B. Esophagoscopy
C. Mediastinoscopy
D. Cytologic investigation of esophagus washing
E. Biopsy from tumor during endoscopy


Answer: C. Mediastinoscopy

The late symptoms of esophagus cancer are all, except:

The late symptoms of esophagus cancer are all, except: 


A. Cough, when eating liquid food
B. Voice hoarseness
C. Tight lymph nodes in the neck region
D. Not stable dysphagia
E. Full food obstruction in esophagus


Answer: D. Not stable dysphagia

The early symptoms of esophagus cancer are all, except:

The early symptoms of esophagus cancer are all, except: 


A. Difficulties swallowing
B. Scraping feeling during swallowing
C. Cough during eating liquid food
D. Sensation of having a foreign body in esophagus
E. Bad feeling behind sternum during swallowing


Answer: C. Cough during eating liquid food

Factors, which cause cancer of esophagus are all, except:

Factors, which cause cancer of esophagus are all, except: 


A. Prolonged use of too hot food
B. Prolonged use of rough food
C. Reflux - esophagitis
D. Too much alcohol consumption
E. Chronic tonsilitis


Answer: E. Chronic tonsilitis

On the second day after planned cholecystectomy the patient complains about pains in epigastric with belt like radiation, higher amylase in urine. The most probable cause of pancreatitis can be:

On the second day after planned cholecystectomy the patient complains about pains in epigastric with belt like radiation, higher amylase in urine. The most probable cause of pancreatitis can be: 


A. Reaction on narcosis
B. Hypovolemia
C. "Forgave" concrement in ductus choledochus
D. In postoperative period omnopone was used as a painkiller


Answer: C. "Forgave" concrement in ductus choledochus

Lung cancer develops from the following elements, except:

Lung cancer develops from the following elements, except: 




A. Epithelium of big bronchs
B. Epithelium of bronchiols
C. Epithelium of bronch mucose cells
D. Lymph nodes of lung radix
E. Epithelium of trachea


Answer: D. Lymph nodes of lung radix

The coefficient factors of breast cancer are all, except:

The coefficient factors of breast cancer are all, except: 


A. Age (40-50 years)
B. Dyshormonal disturbances of genitals
C. Heritablity
D. Smoking
E. Diseases of glandula mammae (fibroadenoma, mastitis, mastopathia etc.)


Answer: D. Smoking

What symptoms are characteristic for the beginning stage of peritonitis?

What symptoms are characteristic for the beginning stage of peritonitis?


1) Resistence of the muscles of frontal abdominal wall
2) In case
3) Tendency of tachicardia
4) Tendency of leucocythosis
5) Pain in the abdomen during movement

The correct answer is:


A. 1.,3.
B. 4.,5.
C. 1.,3.,4.
D. 3.,4.
E. All answers correct


Answer: E. All answers correct

Symptoms of low intestinal obturation are all, except:

Symptoms of low intestinal obturation are all, except: 


A. Bloating of abdomen in first hours
B. Loss of serum electrolytes
C. "Washing" in all abdomen
D. Attack like pains in the abdomen
E. Absence of stool


Answer: A. Bloating of abdomen in first hours

Claudicatio intermittens (Endarteritis occlusion of femur blood vessels - II or III stage after Fonten) can be decreased with lumbar sympathectomy, because extirpation of sympathetic ganglion of L2-5 increases blood flow and widens blood vessels in the skin of the extremity:

Claudicatio intermittens (Endarteritis occlusion of femur blood vessels - II or III stage after Fonten) can be decreased with lumbar sympathectomy, because extirpation of sympathetic ganglion of L2-5 increases blood flow and widens blood vessels in the skin of the extremity: 


A. Correct
B. Not correct


Answer: A. Correct

A 65-year-old woman complains about attack like pains in the abdomen and bloating. There was no stool for 24 hours, retention of gases. "Cloiber cups" in X-ray of abdomen. 2 laparotomies in anamnesis. The most possible diagnosis is:

A 65-year-old woman complains about attack like pains in the abdomen and bloating. There was no stool for 24 hours, retention of gases. "Cloiber cups" in X-ray of abdomen. 2 laparotomies in anamnesis. The most possible diagnosis is: 


A. Thrombosis of mesenterial blood vessels
B. Accretion ileus
C. Intestinal volvulus
D. Invagination


Answer: B. Accretion ileus

What is characteristic for deep venous insufficiency syndrome of lower extremities:

What is characteristic for deep venous insufficiency syndrome of lower extremities:


1) Skin pigmentation
2) Lipodermatoclerosis
3) Atrophy of skin
4) Marmorization of skin
5) Secundary varicosity of veins

The correct answer is:


A. 2.
B. 4
C. 1.,2.,3.
D. 1.,2.,3.,5.
E. 2.,3.,4.,5.


Answer: D. 1.,2.,3.,5.

A 33-year-old man complains about cough for several years. In spring and autumn he had pneumonia, which was treated very well. Objective: haemoptoe, bad smell from mouth, sputum, divided in three levels. During auscultation middle and high level wet murmur in lower part of the right lung. Temperature 37,2°C. Little cyanosis of lips, bungvalisu ???? fingers. Your diagnosis is:

A 33-year-old man complains about cough for several years. In spring and autumn he had pneumonia, which was treated very well. Objective: haemoptoe, bad smell from mouth, sputum, divided in three levels. During auscultation middle and high level wet murmur in lower part of the right lung. Temperature 37,2°C. Little cyanosis of lips, bungvalisu ???? fingers. Your diagnosis is: 


 A. Bronchoneoplasma 
B. Bronchectases 
C. Tbc bronchopneumonia 
D. Chronic bronchitis 
E. Abscessus of the lung

 Answer: B. Bronchectases

For direct inguinal hernia the points are characteristic, except:

For direct inguinal hernia the points are characteristic, except: 


A. It often is bilateral
B. Incarceration is rarer than in case of oblique hernia
C. Always acquired
D. More common in elderly people
E. It goes through lacuna vasorum


Answer: E. It goes through lacuna vasorum

A 55-year-old man was hospitalized with massive vomiting with blood. During examination you find ascites, "liver stars", on thorax wall. In gastroscopy you can see quick collecting of blood in distal part of oesophagus. Which can be the cause of bleeding?

A 55-year-old man was hospitalized with massive vomiting with blood. During examination you find ascites, "liver stars", on thorax wall. In gastroscopy you can see quick collecting of blood in distal part of oesophagus. Which can be the cause of bleeding? 


A. Obstruction of pylorus
B. Rupture of varicose veins in oesophagus
C. Gastric ulcer
D. Cancer of oesophagus


Answer: B. Rupture of varicose veins in oesophagus

During the operation of incarcerated hernia, at first you must open sac of hernia and then dissect angle of incarceration, because you must avoid "loosing" of incarcerated intestine cord after dissection of angle:

During the operation of incarcerated hernia, at first you must open sac of hernia and then dissect angle of incarceration, because you must avoid "loosing" of incarcerated intestine cord after dissection of angle: 


A. Correct
B. Not correct


Answer: A. Correct

X-ray symptoms of high ileus are:

X-ray symptoms of high ileus are:


1) "Cloiber cups" in first part of intestines
2) Bloated colon
3) Liquid under diaphragm
4) Bloated intestines in ileocaecal region
5) Lack of gas in stomach

The correct answer is:


A. 1.,3.,4.,5.
B. 1.,5.
C. 2.,3.,5.
D. 1.,2.,4.
E. All answers correct


Answer: B. 1.,5.

With terms "local" and "diffuse" or "total" peritonitis one can describe:

With terms "local" and "diffuse" or "total" peritonitis one can describe: 


A. Cause of peritonitis
B. Length of illness
C. Virulence of infection
D. Process localization in one or more anatomical regions
E. Kind of exudate


Answer: D. Process localization in one or more anatomical regions

Following statements must be included in treatment of mechanical bowel obstruction:

Following statements must be included in treatment of mechanical bowel obstruction:


1) Gastric intubation before operation
2) Radical treatment of the cause of obstruction
3) Water - electrolyte balance correction
4) Decompression of gastrointestinal tract
5) Stimulation of the gastrointestinal tract with medication for liquidation of ileus during postoperative period

Choose the right answer:


A. 2.,3.,5.
B. 1.,2.
C. 1.,3.,4.
D. 2.,5.
E. 1.,2.,3.,4.,5.


Answer: E. 1.,2.,3.,4.,5.

On the basis of conservative treatment of spastic dynamic ileus are:

On the basis of conservative treatment of spastic dynamic ileus are:


1) Correction of water-electrolyte balance
2) Stimulation of intestinal tract
3) Spasmolytics
4) Decompresion of intestinal tract through the nasogastral tube
5) Analgetics

The correct answer is:


A. 1.,2.,3.,4.
B. 1.,2.,3.
C. 3.,4.,5.
D. 1.,3.,5.
E. All answers correct


Answer: D. 1.,3.,5.

During treatment of peritonitis you must envisage:

During treatment of peritonitis you must envisage:


1) Correction of water-electrolyte balance
2) Antibiotic therapy
3) Sanatio of abdominal cavity
4) Steroide hormones
5) Eliminate the cause of peritonitis during operation

The correct answer is:


A. 1.,4.,5.
B. 1.,2.,3.,4.
C. 1.,2.
D. 1.,2.,3.,5.
E. All answers correct


Answer: D. 1.,2.,3.,5.

The basic symptom of peritonitis is:

The basic symptom of peritonitis is: 


A. Symptom Voskresensk
B. Pains during rectal and vaginal examination
C. Blumberg symptom
D. Decreasing of peristalsis


Answer: C. Blumberg symptom

Which of following descriptions is characteristic for Obrazcova - Melcer symptom?

Which of following descriptions is characteristic for Obrazcova - Melcer symptom? 


A. Increasing of pain in ileocaecal region, after turning the patient to the left side
B. Push like palpation in the left lower quadrant of the abdomen is felt sharp pain in the ileocaecal region
C. The pain attack starts in epigastrium or paraumbilical region and then goes down to ileocaecal region
D. Increasing of pain during palpation of ileocaecal region together with moving up patient's right leg
E. The pain increases during palpation of the ileocaecal region, when leg is elevated


Answer: D. Increasing of pain during palpation of ileocaecal region together with moving up patient's right leg

The symptoms of breast cancer sarcoma are all, except:

The symptoms of breast cancer sarcoma are all, except: 


A. Quick growth
B. No metastasis in regional lymph nodes
C. Big size tumor
D. Early tissue distraction
E. Early metastasis in lungs


Answer: B. No metastasis in regional lymph nodes

The characteristic symptoms of Peget cancer are all, except:

The characteristic symptoms of Peget cancer are all, except: 


A. Redness of areola and mamilla, with bleeding discharges
B. "Eczema" of mamilla
C. Enlarged regional lymph nodes
D. Immovable, dense, scabrous tumor in lateral quadrant
E. Smocking of mamilla


Answer: D. Immovable, dense, scabrous tumor in lateral quadrant

A 65-year-old man with diverticulosis of colon, entered the department with complains about intensive, diffuse pains in all abdomen which started suddenly. During palpation abdominal wall is resistant, no peristalsis, no percutore liver dullness, positive Blumberg symptom. What happened to the patient?

A 65-year-old man with diverticulosis of colon, entered the department with complains about intensive, diffuse pains in all abdomen which started suddenly. During palpation abdominal wall is resistant, no peristalsis, no percutore liver dullness, positive Blumberg symptom. What happened to the patient? 


A. Ileus
B. Bleeding in abdominal cavity
C. Intestinal ischaemia
D. Perforation of a hollow organ


Answer: D. Perforation of a hollow organ

In which of the following situations the character of pains is showed correctly?

In which of the following situations the character of pains is showed correctly? 


A. In case of ileus pains are constant, pulling, localized in mesogastrium
B. In case of acute pancreatitis pains are localized in epigastrium, belt like, radiating to spine
C. In case of retrocaecal appendicitis pains are attack like, localized in right side of abdomen
D. In case of ovary cyst rupture - attack like pains in ileocaecal region
E. In case of ulcer perforation attack like pains under right rib angle, radiating to the right shoulder


Answer: B. In case of acute pancreatitis pains are localized in epigastrium, belt like, radiating to spine

The coefficient factors of breast cancer are all, except:

The coefficient factors of breast cancer are all, except: 


A. Age (40-50 years)
B. Early menopause
C. Dishormonal disorders of genitals
D. Early menarche
E. Diseases of glandula mammae( fibroadenoma, mastopathia etc.)


Answer: B. Early menopause

A 56-year-old man during colonoscopy underwent extirpation of colon sigmoideum polypus. Polypus was localized 40 cm from margo ani. During hystological investigation there was found cancer on the apex of it, which infiltrates submucose tissue. In the basis of polypus no malignancy was found. Your tactics will be:

A 56-year-old man during colonoscopy underwent extirpation of colon sigmoideum polypus. Polypus was localized 40 cm from margo ani. During hystological investigation there was found cancer on the apex of it, which infiltrates submucose tissue. In the basis of polypus no malignancy was found. Your tactics will be: 


A. Telegamma therapy
B. Chemotherapy
C. Radical operative treatment
D. Dispanserization and control colonoscopy after each 3 months
E. Observation in policlinics


Answer: D. Dispanserization and control colonoscopy after each 3 months

A patient, 72 hours after laparoscopic cholecystectomy, started to feel pains in all over the abdomen, nausea, vomiting. General situation - medium severe. Skin is pale, pulse 110x min., temperature 38,2°C. Abdomen little bloated, painful. Blumberg symptom positive, no peristalsis. Your diagnosis?

A patient, 72 hours after laparoscopic cholecystectomy, started to feel pains in all over the abdomen, nausea, vomiting. General situation - medium severe. Skin is pale, pulse 110x min., temperature 38,2°C. Abdomen little bloated, painful. Blumberg symptom positive, no peristalsis. Your diagnosis? 


A. Postoperative intestinal paresis
B. Acute ileus
C. Bile peritonitis
D. Acute basal pneumonia
E. Ulcer perforation


Answer: C. Bile peritonitis

The symptoms characteristic for acute pancreatitis:

The symptoms characteristic for acute pancreatitis:


1) Ortner
2) Mysi
3) Certe
4) Meyo-Robson
5) Turner

The correct answer is:


A. 1.,2.,3.
B. 2.,4.,5.
C. 3.,4.,5.
D. 2.,3.,5.
E. All answers correct


Answer: E. All answers correct

In case of pancreas head cancer, the palliative operations are:

In case of pancreas head cancer, the palliative operations are:


1) Gastrojejunostomy
2) Biliodigestive anastomosis
3) Pancreatoduodenal resection
4) Distal resection of pancreas
5) Pancreatectomy

The correct answer is:


A. 2.,3.,4.
B. 1.,2.
C. 2.,5.
D. 3.,4.,5.
E. 1.,5.


Answer: B. 1.,2.

The main role in diagnosis of acute pancreatitis is:

The main role in diagnosis of acute pancreatitis is: 


A. X-ray investigation
B. Blood test
C. Determining of diastsis in urine
D. Determining of sugar level in blood
E. Clinics


Answer: E. Clinics

In case of pancreatitis with positive peritoneal symptoms, if you operate the patient, the operation will be:

In case of pancreatitis with positive peritoneal symptoms, if you operate the patient, the operation will be:


1) Necrectomy of necrotic tissue
2) Eliminate bile congestion, in case it is
3) Sanatio of abdominal cavity, bursa omentalis and drenage of retroperitoneal tissue
4) Pancreatoduodenal resection
5) Pancreatojejunostomy

The correct answer is:


A. 1.,2.,4.
B. 1.,4.
C. 4.,5.
D. 1.,2.,3.
E. 1.,2.,3.,4.,5.


Answer: D. 1.,2.,3.

A 44-year-old man complains about pain inside the thorax, feeling of asthenia, dyspnoe. 8 hours ago he had thorax wound with knife. In left 8. Intercostal region along medial axillary line we can see a wound 1 x 0,5 cm. Haemodynamics stable. In thorax X-ray little liquid in sinus. Breezing in left lung decreased. Your tactics:

A 44-year-old man complains about pain inside the thorax, feeling of asthenia, dyspnoe. 8 hours ago he had thorax wound with knife. In left 8. Intercostal region along medial axillary line we can see a wound 1 x 0,5 cm. Haemodynamics stable. In thorax X-ray little liquid in sinus. Breezing in left lung decreased. Your tactics: 


A. Observation of the patient in surgical department
B. Sanatio of wound and puncture of pleura cavity
C. Repeat X-ray of thorax after 2 hours
D. Thoracotomy


Answer: B. Sanatio of wound and puncture of pleura cavity

For acute pancreatitis is characteristic:

For acute pancreatitis is characteristic:


1) Hyperamilazemia
2) Hyperglycemia
3) Leucocytosis
4) Hyperdiastasuria
5) Hypocalcemia

The correct answer is:


A. 3.,4.,5.
B. 3.,5.
C. 1.,3.,4.
D. 1.,2.
E. All answers correct


Answer: E. All answers correct

Stones of gall-bladder can be determined with:

Stones of gall-bladder can be determined with:


1) X-ray of abdomen
2) Peroral cholecystography
3) I/v cholecystography
4) CT
5) US

The correct answer is:


A. 2.,3.,4.
B. 3.,4.,5.
C. 1.,2.,3.
D. 1.,2.,3.,5.
E. 1.,2.,3.,4.,5.


Answer: E. 1.,2.,3.,4.,5.

For determining pathogenesis of mechanical icterus you can use such methods:

For determining pathogenesis of mechanical icterus you can use such methods:


1) I/v cholangiography
2) Retrograde cholangiography
3) X-ray for gall-bladder region
4) Percutane transliver cholangiography
5) Peroral cholecystography

The correct answer is:


A. 2.,3.,4.
B. 1.,2.,4.,5.
C. 1.,3.,5.
D. 1.,2.,3.
E. 1.,2.,3.,4.,5.


Answer: A. 2.,3.,4.

A 52-year-old woman complains about pains under the right rib, which appear after eating fat food and which disappear after using spasmolytics. In US there was found one big Stone (30 mm). Your tactics:

A 52-year-old woman complains about pains under the right rib, which appear after eating fat food and which disappear after using spasmolytics. In US there was found one big Stone (30 mm). Your tactics: 


A. Ambulatory observation of the patient till next attack
B. Dissolvation of the stone with medicine
C. Extracorporal lytotrypsy
D. Conventional cholecystectomy
E. Laparoscopic cholecystectomy


Answer: E. Laparoscopic cholecystectomy

For chronic calculous cholecystitis is characteristic everything, except:

For chronic calculous cholecystitis is characteristic everything, except: 


A. I/v cholegraphy can give a picture of unlocked gall-blader
B. Always indicated operative treatment
C. Often find in women
D. Never connected with gall-bladder cancer
E. Peroral cholecystography can not give shadow


Answer: D. Never connected with gall-bladder cancer

Ultrasonography is the simplest and most informative method in case of attack of acute cholecystitis to determine stones, because if you make i/v or peroral cholecystography the patient must be specially prepared:

Ultrasonography is the simplest and most informative method in case of attack of acute cholecystitis to determine stones, because if you make i/v or peroral cholecystography the patient must be specially prepared: 


A. Correct
B. Not correct


Answer: A. Correct

Stenosis of the lower part of the stomach is characterized by:

Stenosis of the lower part of the stomach is characterized by:


1) It is followed by vomiting with old food, which gives alleviation
2) In X-ray you can see delay of barium evacuation and ectasy of stomach
3) It is followed by water-electrolyte exchange disturbances
4) Burning behind sternum
5) Operative treatment is obligatory

The correct answer is:


A. 1.,2.,3.
B. 1.,4.
C. 2.,3.,4.
D. 2.,5.
E. 1.,2.,3.,4.,5.


Answer: E. 1.,2.,3.,4.,5.

During home visit a 20- year-old woman has complaints in the right lower part of the abdomen, nausea, dizziness. These complaints appeared 6 hours ago after physical activity. Objective: moderate pains in the lower part of the abdomen, slight positive peritoneum irritation symptoms, TA 95/65 mm Hg.st.. Pulse 100x'. Your tactic in this case:

During home visit a 20- year-old woman has complaints in the right lower part of the abdomen, nausea, dizziness. These complaints appeared 6 hours ago after physical activity. Objective: moderate pains in the lower part of the abdomen, slight positive peritoneum irritation symptoms, TA 95/65 mm Hg.st.. Pulse 100x'. Your tactic in this case: 


A. Refer to a surgeon in an out-patient clinic
B. Hospitalize in surgery department for observation
C. Refer to gynecologist consultation
D. Hospitalize in surgery department for diagnostic laparoscopy
E. Send for treatment to internist



Answer: D. Hospitalize in surgery department for diagnostic laparoscopy

In a 55-year-old healthy woman during prophylactic examination hypercalcaemia was found. The most possible reason can be:

In a 55-year-old healthy woman during prophylactic examination hypercalcaemia was found. The most possible reason can be: 


A. Too much Ca in food
B. Metastases of breast cancer
C. Using of diuretics in anamnesis
D. Benign gl. parathyreoidea adenoma with hyperparatyreosis


Answer: D. Benign gl. parathyreoidea adenoma with hyperparatyreosis

In case of claudicatio intermittens everything is correct, except:

In case of claudicatio intermittens everything is correct, except: 


A. Pains in legs
B. Pains begin after physical activity
C. Pains pass after a few-minute rest
D. Pains arise after long time sitting in one position
E. Reduced pulse on both extremities


Answer: D. Pains arise after long time sitting in one position

Which of the operations has the most rare complication of dumping-syndrome?

Which of the operations has the most rare complication of dumping-syndrome? 


A. Truncular vagotomy with pyloroplasty
B. Selective proximal vagotomy
C. Vagotomy with antrumectomy
D. Subtotal stomach resection
E. Gastrectomy


Answer: B. Selective proximal vagotomy

Hartmann operation is indicated in the following cases:

Hartmann operation is indicated in the following cases:


1) Cancer of appendix
2) Cancer of colon sigmoideum with obstruction
3) Colon transversum cancer
4) Cancer of rectosigmoidal part of rectum
5) Patients over age 75, with rectosigmidal part cancer and adiposity

The correct answer is:


A. All answers correct
B. 1.,2.,3.
C. 2.,3.,4.
D. 3.,4.,5.
E. 2.,4.,5.


Answer: E. 2.,4.,5.

The kind of breast cancer in preoperative period can be determined with:

The kind of breast cancer in preoperative period can be determined with:


1) Palpation of breast
2) Termography
3) Puncture of the mass and hystological investigation
4) Mammography
5) Investigation of axillary lymph nodes

The correct answer is:


A. 1.,5.
B. 1.,4.
C. 1.,2.,3.
D. 2.,3.,4.,5.
E. All answers correct


Answer: E. All answers correct

Which methods of intensive therapy are used in treatment of diffuse purulent peritonitis?

Which methods of intensive therapy are used in treatment of diffuse purulent peritonitis?


1) Abdominal hypothermia
2) Peritoneal dialysis (lavage)
3) Forced diuresis
4) Infusion, desintoxication and antibacterial therapy

The correct answer is:


A. 1.,2.,3.
B. 1.,2.,4.
C. 1.,3.,4.
D. 2.,3.,4.
E. 2.,4.


Answer: D. 2.,3.,4.

The correct measuring method of lower extremity length is:

The correct measuring method of lower extremity length is: 


A. From trochanter major till 1. Finger of feet
B. From spina illiaca anterior till internal ankle
C. From symphisis till internal ankle
D. From spina illiaca anterior superior till ankle


Answer: D. From spina illiaca anterior superior till ankle

A 44-year-old woman complains about severe pain in the abdomen, which started 1 hour ago. The pains are localized in the right lower part of the abdomen. No vomiting and nausea. The patient is restless, can't sleep in a straight position, because of severe pain, the abdomen is bloated. Slight pain in perineum, often need for urination, but practically no urine. What must you do, to determine the diagnosis?

A 44-year-old woman complains about severe pain in the abdomen, which started 1 hour ago. The pains are localized in the right lower part of the abdomen. No vomiting and nausea. The patient is restless, can't sleep in a straight position, because of severe pain, the abdomen is bloated. Slight pain in perineum, often need for urination, but practically no urine. What must you do, to determine the diagnosis? 


A. Investigation of blood formula
B. Determining diastasis in urine
C. Kidney angiography
D. X-ray of urinary tract
E. I/v pyelography


Answer: E. I/v pyelography

A 32-year-old woman complains about dull pain in the right lumbar region, which increases during long walking and physical activity. She complains about higher blood pressure up to 180/120 mm Hg d.. She is ill for 5 years. Abdomen is unresistant. Kidneys are not palpable in horizontal position. Right kidney is palpable in vertical position - slightly painful, smooth, normal size. Urination is free, painless. What diagnosis can you suspect?

A 32-year-old woman complains about dull pain in the right lumbar region, which increases during long walking and physical activity. She complains about higher blood pressure up to 180/120 mm Hg d.. She is ill for 5 years. Abdomen is unresistant. Kidneys are not palpable in horizontal position. Right kidney is palpable in vertical position - slightly painful, smooth, normal size. Urination is free, painless. What diagnosis can you suspect? 


A. Kidney polycystosis
B. Nephroptosis
C. Kidney tumor
D. Hydronephrosis
E. Kidney cyst


Answer: B. Nephroptosis

How will you give first aid for a patient with torsio testis?

How will you give first aid for a patient with torsio testis? 


A. To put on suspensore
B. Compresses of spiritus aethylicus on the left side of scrotum
C. Operation - opening of funiculus spermaticus, fixation of testis in scrotum, or orchidectomy
D. Anticoagulants
E. Spasmolytic and antibacterial therapy


Answer: C. Operation - opening of funiculus spermaticus, fixation of testis in scrotum, or orchidectomy

A 15-year-old patient entered the emergency department with complains of severe pain in left scrotum and inguinal region, which started 2 hours ago after sudden physical activity. Patient is pale, covered with cold sweat. During examination the skin of scrotum is slightly oedematous, but there is no hyperemia. The left testis is a little bigger, with tension. The palpation of the left funiculus spermaticus is very painful. Your diagnosis is:

A 15-year-old patient entered the emergency department with complains of severe pain in left scrotum and inguinal region, which started 2 hours ago after sudden physical activity. Patient is pale, covered with cold sweat. During examination the skin of scrotum is slightly oedematous, but there is no hyperemia. The left testis is a little bigger, with tension. The palpation of the left funiculus spermaticus is very painful. Your diagnosis is: 


A. Acute orchitis
B. Venous thrombosis of funiculus spermaticus
C. Torsion of left testis
D. Varicocoele of the left side
E. Incarcerated left inguinal hernia


Answer: C. Torsion of left testis

During treatment of peritonitis, it is compulsory to use:

During treatment of peritonitis, it is compulsory to use:


1) Denying cause of peritonitis
2) Sanatio of abdominal cavity
3) Correction of water - electrolyte balance
4) Antibacterial treatment
5) Steroide hormones

The correct answer is:


A. 1.,3.,5.
B. 2.,3.,4.,5.
C. 3.,4.
D. 1.,2.,3.,4.
E. All answers correct


Answer: D. 1.,2.,3.,4.

Early symptom of venous mesenterial thrombosis is:

Early symptom of venous mesenterial thrombosis is: 


A. Suden increasing of temperature and fever
B. Often, mostly haemorrhagic diarrhea
C. Faeces like "boiled rice"
D. Bloating of abdomen
E. Resistence of anterior abdominal wall (abdomen like "board")


Answer: B. Often, mostly haemorrhagic diarrhea

In case of paralytic ileus You can find everything, except:

In case of paralytic ileus You can find everything, except: 


A. Colic pain
B. Absence of peristalsis
C. You can auscultate heart murmurs in the abdomen
D. High position of diaphragm
E. Meteorism during percutation


Answer: A. Colic pain

Which diagnostic examinations must be done, to prove the diagnosis of ileus?

Which diagnostic examinations must be done, to prove the diagnosis of ileus?


1) Determining the number of leucocytes
2) Inserting the stomach tube
3) Abdomen auscultation
4) X-ray of abdomen in vertical position
5) Abdomen palpation, examination per rectum

The correct answer is:


A. 1.,2.,3.
B. 3.,4.,5.
C. 1.,3.,4.
D. 1.,3.,4.,5.
E. 2.,3.,4.,5.


Answer: E. 2.,3.,4.,5.

Which diseases are accompanied with bleeding per rectum:

Which diseases are accompanied with bleeding per rectum:


1) Varices haemorrhoidi
2) Colon diverticulosis
3) Colon cancer
4) Irritation syndrom of colon
5) Non-specific ulcerose colitis

The correct answer is:


A. 1.,2.,3.
B. 1.,3.,4.,5.
C. 1.,2.,3.,5.
D. 1.,2.,4.,5.
E. All answers correct


Answer: C. 1.,2.,3.,5.

Factors, which conduce the development of ileus because of left side colon tumor ( comparing with right side):

Factors, which conduce the development of ileus because of left side colon tumor ( comparing with right side):


1) Smaller diameter of colon
2) Quicker growth
3) Big size of tumor
4) Dense content of intestines
5) Tumor is growing with stenosation

The correct answer is:


A. 1.,2.,3.
B. 2.,3.
C. 1.,4.,5.
D. 3.,4.,5.
E. All answers correct


Answer: C. 1.,4.,5.

The most characteristic complications of non-specific ulcer colitis are:

The most characteristic complications of non-specific ulcer colitis are:


1) Bleeding
2) Acute toxic dilatation of colon transversum
3) Peritonitis
4) Mechanical intestinal obstruction
5) Inside and outside intestinal fistulas

The correct answer is:


A. 1.,2.,3.
B. 2.,4.,5.
C. 1.,2.,4.
D. 2.,3.,5.
E. 1.,2.,3.,5.


Answer: E. 1.,2.,3.,5.

The main symptom during examination of a patient with suspected acute appendicitis is:

The main symptom during examination of a patient with suspected acute appendicitis is: 


A. Pain and resistancy of muscles in ileocaecal region
B. Palpation of adnexes per vaginam
C. Sitkovsy symptome
D. Loss of liver damping
E. Symptom Obrazcova


Answer: A. Pain and resistancy of muscles in ileocaecal region

For determining of viability of incarcerated intestines, you must look after such signs as:

For determining of viability of incarcerated intestines, you must look after such signs as:


1) The colour of intestine
2) Peristalsis
3) Pulse of mesenterial blood vessels
4) Discharge in hernia sac
5) Bloat incarcerated intestines

The correct answer is:


A. 1.,4.
B. 2.,3.,5.
C. 1.,2.,4.
D. 3.,4.,5.
E. 1.,2.,3.


Answer: E. 1.,2.,3.

Which objective finding is contraindication for radical surgical treatment of breast cancer:

Which objective finding is contraindication for radical surgical treatment of breast cancer:


1) Palpable supraclavicular lymph nodes
2) Oedema of hand in tumor side
3) Canceramatose pleuritis
4) Lymph Graphically proved enlarged lymph nodes along a. thoracica interna between 2. and 3. Ribs

The correct answer is:


A. 3.,4.
B. 2.,3.
C. 1.,2.,3.
D. 1.,4.
E. All answers are correct


Answer: E. All answers are correct

The reasons of lower extremities chronic venous insufficiency are:

The reasons of lower extremities chronic venous insufficiency are:


1) Insufficiency of the left atrium
2) Mechanical interference of blood reflow from lower extremities
3) Insufficiency of the right atrium
4) Insufficiency of valves of deep and subcutaneous veins of lower extremities
5) Insufficiency of perforant vein valves

The correct answer is:


A. 4.
B. 1.,4.
C. 2.,4.,5.
D. 2.,3.,4.,5.
E. All answers are correct


Answer: D. 2.,3.,4.,5.

Development of phlebothrombosis is promoted by:

Development of phlebothrombosis is promoted by:


1) Increasing of thrombocyte adhesion
2) Decreasing of blood flow
3) Hypercoagulation of blood
4) Lesion of blood vessel endothelium

The correct answer is:


A. 2.,3.
B. 2.,4.
C. 1.,3.,4.
D. 2.,3.,4.
E. All answers are correct


Answer: E. All answers are correct

The diagnosis of peripheral lung cancer best of all can be specified by:

The diagnosis of peripheral lung cancer best of all can be specified by: 


A. Fluorography
B. Lung X-ray in two projections
C. Tomography
D. Using physical examination methods
E. Transparietal punction biopsy of the mass


Answer: E. Transparietal punction biopsy of the mass

In case of not complicated chronic pleural empyema the lungs loose the possibility of expanding because of:

In case of not complicated chronic pleural empyema the lungs loose the possibility of expanding because of: 


A. Massive pleural delamination on parietal pleura
B. Massive pleural delamination on visceral pleura
C. Massive pleural delamination on diaphragmatic pleura
D. Decreasing of lung elasticity
E. Loss of chest elasticity


Answer: B. Massive pleural delamination on visceral pleura

The basic signs of bacterial - septic shock are:

The basic signs of bacterial - septic shock are:


1) High temperature
2) Bradicardia
3) Feeling of coldness, shiver
4) Decreasing of blood pressure
5)Dyspnoe

The correct answer is:


A. 1.,2.,3.
B. 1.,2.,3.,5
C. 1.,3.,4.,5.
D. 1.,3.,4.
E. All answers are correct


Answer: C. 1.,3.,4.,5.

Predisposing factors of extremity gangrene:

Predisposing factors of extremity gangrene:


1) Frostbite
2) Embolism of magistral artery
3) Diabetus mellitus
4) Injury of extremity artery
5) Ligation of superficial extremity veins

The correct answer is:


A. 1.,2.,4.,5.
B. 1.,2.,3.,4.
C. 2.,3.,5.
D. 1.,2.,3.,5.
E. All answers are correct


Answer: B. 1.,2.,3.,4.

The increasing of local temperature is not characteristic to following processes:

The increasing of local temperature is not characteristic to following processes: 


A. Infected wounds
B. Phlegmona of the front abdominal wall
C. Panaricium of the first palm finger
D. Tuberculosis of knee articulation (tuberculose gonitis)
E. Purulent bursitis of elbow articulation


Answer: D. Tuberculosis of knee articulation (tuberculose gonitis)

The symptoms of non - clostridial anaerobe infection are:

The symptoms of non - clostridial anaerobe infection are:


1) Oedema of skin
2) Unpleasant smell of exudation
3) Great amount of necrotic tissue in the wound
4) Muscles like "boiled meat"
5) Grey pus with addition of fat drops

The correct answer is:


A. 1.,2.,3.,4.
B. 2.,3.,5.
C. 3.,4.,5.
D. 2.,3.,4.,5.
E. All answers are correct


Answer: E. All answers are correct

Which microorganism causes furuncle most usually:

Which microorganism causes furuncle most usually: 


A. Staphilococus
B. Streptococus
C. Gonococus
D. Pseudomonas aeruginosa
E. Proteus vulgaris


Answer: A. Staphilococus

Paradoxical breezing can be noticed to the patients with:

Paradoxical breezing can be noticed to the patients with: 


A. Open pneumothorax
B. Chippy fractures of ribs
C. Simple fractures of several ribs
D. Valve pneumothorax


Answer: B. Chippy fractures of ribs

Which are the most characteristic clinical signs of haemorrhage?

Which are the most characteristic clinical signs of haemorrhage?


1) Dizziness
2) Feeling of coldness, shiver
3) Tachycardia
4) Thirst
5) Hypothensia

The correct answer is:


A. 1.,2.,3.,5.
B. 2.,3.,4.,5.
C. 1.,3.,4.,5.
D. 1.,3.,4.
E. All answers are correct


Answer: C. 1.,3.,4.,5.

Stomach resection operation because of cancer differs from operation in case of ulcer disease:

Stomach resection operation because of cancer differs from operation in case of ulcer disease:



1) Total resection of small curvature
2) Resection of omentum majus and minus
3) Ligation of a.gastrica sin. In the place, where it starts from truncus coeliacus
4) Stomach resection always at least subtotal
5) Performing of gastro-enteroanastamosis with stapler

The correct answer is:


A. 1.,2.
B. 2.,3.,4.
C. 1.,2.,3.
D. 2.,4.,5.
E. All answers are correct


Answer: B. 2.,3.,4.

What kind of pains are characteristic for early stage deformation arthrosis?

What kind of pains are characteristic for early stage deformation arthrosis?


1) Pain when starting to walk
2) Night pains
3) Pain after prolonged walking
4) Constant pulling pain in still position

The correct answer is:


A. 1.,2.,3.
B. 1.,3.
C. 2.,4.
D. 4.
E. All answers are correct


Answer: E. All answers are correct

Early signs of tetanus are:

Early signs of tetanus are:



1) Rigidity of occiput muscles
2) Insomnia
3) Trism of biting muscles
4) Fibrilation of muscles in wound region

The correct answer is:


A. 1.,2.,3.
B. 1.,3.
C. 2.,4.
D. 4.
E. All answers are correct


Answer: E. All answers are correct

A 17 years old patient was taken to the emergency department with complains of pain in glans penis. From childhood it was noticed that prepuce is very narrow and glans penis had never been opened. Six hours ago he opened it and could not remove back. During investigation glans penis and internal leaf of prepuce are tumefy, injected, painful. Your diagnosis is:

A 17 years old patient was taken to the emergency department with complains of pain in glans penis. From childhood it was noticed that prepuce is very narrow and glans penis had never been opened. Six hours ago he opened it and could not remove back. During investigation glans penis and internal leaf of prepuce are tumefy, injected, painful. Your diagnosis is: 


A. Incarceration of glans penis
B. Parafimosis
C. Haematoma of penis
D. Ruptura of penis cord


Answer: B. Parafimosis

The best method for sanitation of abdominal cavity in case of diffuse peritonitis is:

The best method for sanitation of abdominal cavity in case of diffuse peritonitis is: 


A. Irrigation of abdominal cavity with big amount of liquid and then aspiration with pump, drainage and lavage in postoperative period
B. Evacuation of discharge with tampons , tissues
C. A single infusion of antibiotic liquid
D. Aspiration of pus with pump
E. Irradiation of abdominal cavity with UVS


Answer: A. Irrigation of abdominal cavity with big amount of liquid and then aspiration with pump, drainage and lavage in postoperative period

A young woman complains about tingling and paleness of fingers of both hands, especially during raising up hands and predisposition to paronychia. These complains are observed in both upper extremities. Your diagnosis is:

A young woman complains about tingling and paleness of fingers of both hands, especially during raising up hands and predisposition to paronychia. These complains are observed in both upper extremities. Your diagnosis is: 


A. Syndrome Takajasi
B. Syndrome of upper aperture
C. Reaynaud disease
D. Syndrome Peget - Shreter
E. Tromboangitis obliterans


Answer: C. Reaynaud disease

Obligatory precancerous disease of colon transversum, which needs surgical treatment is:

Obligatory precancerous disease of colon transversum, which needs surgical treatment is:


1) Family poliposis
2) Solitare polypus
3) Villose adenoma
4) Crohn's disease
5) Non-specific ulcerative colitis

The correct answer is:


A. 1.,2.,3.,5.
B. 4.,5.
C. 2.,4.,5.
D. All answers are correct


Answer: A. 1.,2.,3.,5.

What are peculiarities for clinics of acute appendicitis if appendage lies in the small pelvis?

What are peculiarities for clinics of acute appendicitis if appendage lies in the small pelvis?


1) No pain in ileo-cecal region
2) Evidence of blood in faeces
3) Pain in frontal wall of the rectum during rectal investigation
4) Frequent problems of urination
5) Positive Pasternack symptom

The correct answer is:


A. 1.,2.,3.
B. 1.,3.,4.
C. 1.,3.,5.
D. 1.,2.,3.,5.
E. 2.,3.,5.


Answer: B. 1.,3.,4.

In case of bilirubin concentration in blood above 50 mmol/l in cholangiogram the bile ducts are not contrasting, because if bilirubine rate in blood is more than 50 mmol/l, liver can not excrete radiopaque:

In case of bilirubin concentration in blood above 50 mmol/l in cholangiogram the bile ducts are not contrasting, because if bilirubine rate in blood is more than 50 mmol/l, liver can not excrete radiopaque:


A. Correct
B. Incorrect


Answer: A. Correct

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