_GEMATO

###TITLE### ТЕРАПИЯ ###THEMES### ТЕМА ГАСТРОЭНТЕРОЛОГИЯ ТЕМА ГЕМАТОЛОГИЯ ТЕМА ПУЛЬМОНОЛОГИЯ ##theme 2 ##score 1 ##type 1 ##time 00:01:00 Patient L. 50-year-old, has been admitted to the clinics with atrophic gastritis. In the blood test: erythrocytosis 3,8T\L, Hb 68g\l, c.i.l, macroanisocytosis. Poikilocytosis. There is a megaloblastic type of heamopoesis. A number of leucocytes, reticulocytes and thrombocytes is lowed. Which pathology is suspected? +B-12-deficiency anemia Irondeficiecy anemia Hemolytic anemia Post-hemoragic anemia Thalassaemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 32-year-old welder complaints of weakness and fever. His illness started as tonsillitis a month before. On exam, BT of 38,9◦C, RR of 24\min, HR of 100\min, BP of 100\70 mm HG, hemorrhages on the legs, enlargement of the lymph nodes. CBC shows Hb of 70 g\l, RBC of 2,2*1012\L, WBC of 3,0*109\L with 32%of blasts, 1%of eosinophiles, 3% of bands, 36% of segments. Establish the diagnosis.

Aplastic anemia Chronic lymphleukemia +Acute leukemia Vitamin-B12-deficiency anemia Chronic hemolytic anemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 54-year-old woman complaints of increasing fatigue and easy bruising of 3 weeks’ duration. Physical findings include pale, scattered ecchymoses and petechiae and mild hepatosplenomegaly. CBC; RBC- 2.550.000\mcL; Hb73 g\l; HTC20%; PLT-23.000\mcl; and WBC -162.000\mcl with 82%blasts, that contained Auric rods. Establish the diagnosis.

Chronic leulemia +Acute leukemia Thrombocytopenia Hemolytic anemia Megaloblastic anemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00

A 44-year-old woman complains of weakness, subfebrile fever, and pallor of the skin. Physical examination revealed the enlarged lymph nodes in the right supraclavicular area. On X-ray film, there was enlargement of bronchopulmonary and paratracheal lymph nodes. The liver was enlarged, with increased firmness. What is diagnosis?

Chronic myelocytic leukemia Tuberculosis Sarkoidosis Tumor metastases +Hodgkin’s desease ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A patient had stomach resection a year ago. He complaints of general weakness, giddiness. Blood count: Er-2,6 g\l; Hb -80g\l; C.ind. 0.7L-3,7g\l, reticulocytes 1%, segm 56%, lymph 34%, mon.6%. ESR 17 mm\hour.

Erythrocytes.are hypochronomic; there are anisocytosis & poikilocytosis. Fe of serum 5mkmol\L. Diagnosis is: Aplastic anemia B12-deficiency anemia Chronic myeloleukosis +Iron-deficiency anemia Chronic lymphoid leucosis ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 30 –year old woman complains of dizziness, weakness, increased nails fragility, alopecia and pica. On clinical examination body temperature is 36,7oC, the skin is pale , RR is 20 per min.; Ps 98, BP 100\60 mm of hg. In CBC erythrocytes are 2,8*1012g\l, Hb 85g\l; KP-0,9, reticulocytes 2%, WBC(leucocytes) 4,7*109g\l, eosinophils 2%, subneutrophils 3%, segmented neutrophils 62%, lymphocytes 26%, monocytes 5%. ESR 20 mm\hour.

Serum iron is 6,8 mkmol\l. What preparation is necessary to prescribe to a patient?

Fresh blood +Iron per os Erythrocal mass Iron pareuterally Vitamin B12-intramusculary ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A patient, aged 35 years, complains of dizziness, weakness, headache, palpitation, attacks of pain in umbilical, sacral areas, fever up to 38oC, urine discoloration resembled smoky brown and normal stool. The condition started after being sting. On clinical examination jaundice is noted. BP 100\60 mm of hg. Spleen is enlarged. RBC erythrocytes are 2,3*1012g\l, Hb 72g\l; K-0,9, reticulocytes 13,1%, WBC(leucocytes) 6,2*109g\l, ESR 25 mm\hour.

In urine urobilin reaction is strongly positive, bilirubin pigments are absent. The total bilirubin is 60 mkmol\l, indirect 40 mkmol\l. Serum iron is 20,4 mkmol\l. What clinical diagnosis is the most probable? +Aequired hemolytic anemia Acute liver insuffiency Iron-deficiency anemia B12-defiency anemia Viral hepatitis ##theme 2 ##score 1

##type 1 ##time 00:01:00 Woman, 56 years old, complaints about the skin itching, sweating, subfibrile fever with the periodic increases temperature to 38-39oC, loss of weight, heaviness in right and left hypochondria, dyspeptic disorders. Objectively: a skin is pale, some icteric. A liver palpate at the level of umbilicus, a spleen on 2cm is below than umbilicus, dense consistency. Common analysis of blood: RBC-3,0T\L, Hb-110g\l, C.I.-0,8; WBC-28 g\l, bas-4%, eos-5%, myel.6, St-8, segm.70%, L-5, M-3, tromb.180 g\l. Your diagnosis.

Chronic myeloleucosis (aleucemic form) Chronic myeloleucosis (leucemic form) +Chronic myeloleucosis (subleucemic form) Acute myeloblastic leucosis Chronic lympholeucosis ##theme 2 ##score 1 ##type 1 ##time 00:01:00 Woman 32 years old, during 2 years was treated by internist because of neurocyrculatory dystonya and by gynecologist because of mennorrhagia. Complaints about the promoted faitygability, muscular weakness, prediction for strong smells (petrol, ether), the desires eat chalk. Common analysis of blood: RBC-3,5 T\l, Hb-105g\l, C.i.0,8; hypochromia;anisocytosis; WBC.-6,8 g\l,, B-0%, E-2%, St-4%, S-60%, l-26%, M-8%, ESR-12 mm\hour. Whey iron 7-8 mkm\l. What is it necessary to appoint?

Vitamins of B-group +Peroral preparations of iron Folie acid Parenteral acid Vitamin C ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 42 years old man suddenly felt worsening of his general condition and complains of dizziness, weakness and appetite loss. From the clinical history it is know that the patient suffers from the duodenal ulcer disease within 15 years and it is written down in his individual medicine file. In CBC erythrocytes are 1,9*1012\l, Hb-57g\l, KP-0,9; reticulocytes 1%, thromb.2,1*109\l, WBC (leu 11,5*109\l, eosinophils-1%, St-10 %, Segm. - 65%, lymph-19%, mon 5%;, ESR-35mm\hour. What clinical diagnosis is the most probable?

Pernicious anemia hemolytic anemia Hypoplastic anemia DVS-syndrome +Post-hemorrhagic anemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 21 year-old patient with history of multiple pneumonias complaints of malaise, breathlessness, palpitation, filings of noisy ears and “flies” in front of eyes. The patient is ill within one month. On physical examination the skin is pale. In the mouth there is ulcerative necrotizing stomatitis. Also purpura in the femoral and abdominal skin areas is noted. The peripheral lymphatic nodes are not enlarged. CBC: RBC-1,8*1012\l, Hb-56g\l, KP-0,9, WBC 2,3*109\l, eosinophyls-2%, stub neutrophils3%, segm.neutrophils 65%, lymphocytes 22%, monocytes 8%, tromb.16*109\l, ESR-25 mm\h. In urine analysis the macrohaematuria is revealed. What clinical diagnosis is the most probable?

Hemolytic anemia +Aplastic anemia Iron-deficiency anemia

B12-difiency anemia Acquired hypoplastic anemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A patient aged 26 years, complains of the enlargement of cervical, subclavicular, grain, lymphatic nodes. Skin itching. Considerable sweating at night. Fever up to 39oIn CBC there are leukocytosis, lymphopenia, high ESR. What clinical diagnosis is the most probable? +Lymphogranulomatosis Chronic lymphatic leukemia Acute lymphoblastic leucosis Infectious mononucleosis Leukomoidal reaction ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 65years old patient was admitted in the hospital with a complains of fatigue, feeling of “cotton like” legs, loss of sensitivy of toes. On examination pale of the skin, subeccteric sclera. Heart sounds of low intensity, systolic murmur heard over the heart area, liver +2sm, painless, spleen not enlarged. Blood analysis: Hb-58g\l, E-1,3*10 12\l, color index – 1,3. reticulocytes 0,2%, ESR 30 mm\h, megaloblasts -2:100, macrocytosis. Jolly bodies, kebots ring, Most informative method of investigation is?

Osmotic resistence of erythrocytes Edoscopic examination of the stomach X-Ray of abdomen +Serum B12 and folic acid level Iron content of serum ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 42 y.o. patient complains of weakness, heartbeat, nasal hemorrhages, cutaneous hemorrhages. His condition has been worsening progressively for a month. Objectively: grave condition, the extremities and body skin has spotted and petechial hemorrhages, lymph nodes are not palpable. Ps-116\min, liver+2sm enlarged, spleen is not palpable.

Blood has evident pancytopnia. What disease should you think first of all? +Hypoplastic anemia Hemorrhagic vasculitis Acute agranulocytosis Werlhof’s disease Acute leucosis ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 54 years old woman complains of increasing fatigue and easy bruising of 3 weeks duration. Physcial findings included pale, scattered ecchymoses and petechiae and mild hepatosplenomegaly. In blood: RBC – 2,5* 10 12\l, Hb 73g\l, HCT- 20%, PLT – 23*10 9\l, and WBC 163*10 9\l with 82% blats stain was positive. What is the most probable diagnosis?

Hemolytic anemia Chronic leukemia

Thrombocytopenia +Acute leukemia Megaloblastic anemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 27 y.o. patient has been having for almost a year fatigue, hyperhidrosis, heaviness in the left hypochondrium, especially after meals. Objectively: spleen and liver enlargement. In blood: erythrocytes – 3,2* 10 12\l, Hb – 100 g\l, color index-0,87, leucocytes-100*10 9\l, basophils – 10%, eosinophils – 5%, myelocytes – 15%, juveniles – 16%, stab neutrophils 10%, segmentonuclear leucocytes -45%, lymphocytes – 2%, monocytes – 0%, reticulocytes – 0,3%, thrombocytes – 400*10 9\l, ESR – 25mm\h. what is the most probable diagnosis?

Hepatocirrhosis Acute leucosis Chronic lympholeucosis Erythremia +Chronic myeloleucosis ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 33 y.o. patient was admitted to the hospital with stopped repeated ulcerative bleeding. He was pale and exhausted.

Blood count: Hb- 77g\l, Ht-0,25. In view of anemia there was made two attempts of blood transfusion of the same group – A(II)Rh+. In the both cases the transfusion had to be stopped because of development of anaphylactic reaction. What transfusion medium would be advised in this case?

Fresh citrate blood +Washed erythrocytes Erythrocytic mass poor in leukocytes and thromocytes Erythrocytic suspension Erythrocytic mass ( nativ ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 35 y.o. woman is suspected of aplastic anemia. The bone marrow punction has been admitistered with the diagnostic purpose. What changes in the marrow punctatum are suggested?

Replacement of marrow elements with fibrous tissue. +Replacement of marrow elements with adipose tissue Absolute lymphocytosis Prevalence of megaloblasts Presence of blasts cells ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A man, aged 68 y.o, complains of tiredness, sweating, enlargement of cervical, submaxillary and axillary lymph nodes. Blood test: WBC – 34*10 9\l, lymphocytes -60%, Botkin and Gumprecht bodies, level of haemoglobin and quantity of thrombocytes. What is the most probable diagnosis?

Chronic myeloleucosis Lymphogranulomatosis +Chronic lympholeucosis

Acute leucosis Tuberculous lympholeucosis ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 58 y.o. male patient is examined by a physician and suffers from general weakness, fatigue, mild pain in the left subcostal area, sometimes frequent painful urination. Moderate splenomegaly has been revealed. Blood test: neurophilic leucocytosis with the progress to myelocyte; basophil – 2%; eosinophil-5%. There is a urate crystals in urine, erythrocytes 2-3 in the field of vision. What is the preliminary diagnosis?

Lymphogranulomatosis +Chronic myeloleucosis Urolithiasis Leukemoid reaction Hepar cirrhosis ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A man, 42 years old, died in a road accident after the hemorrhage on the spot, because of acute hemorrhagic anemia.

What minimum percent of the whole blood volume could result in death by acute hemorrhage? +10-14% 15-20% 25-30% 6-9% 35-50% ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 19 years old patient complains of long-term bleeding started after tooth extraction. It is known from the case history that he has had large haematomas in the childhood. His uncle from mother’s side died from bleeding.

What clinical diagnosis is the most probable? +Hemophilia Hemorrhagic vasculitis Iron deficiency anemia Aplastic anemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A man aged 32 yr notes general weakness, elevation of the body t°, pains in the throat while swallowing. He is ill 2 months and treated from tonsillitis by antibiotics without any effect. The main clinical features are body t° 38,4 °C, RR (respiratory rate) 22 per min; pulse 108, BP (blood pressure) 100/60 mm of Hg. The skin is pale. There are purpura (hemorrhagic rash) on extremities, systemic enlargement of lymphatic nodes and hepatosplenomegaly. In CBC RBC are 2,2*1012/l, Hb 70 g/l; WBC (leuc.) 13,5*109/l; atypical cells (blastocytes) 32\%; metamyelocytes 1\%; stab neutrophils 3\%; segm. neutr. – 35\%; lymph. – 20\%; monocytes – 8\%; thrombocytes 37*109/l; ESR – 30mm/hour. What clinical diagnosis is the most probable? +Acute leukosis Chronic lympholeukosis Chronic myeloleukemia

Aplastic anemia Thrombocytopenic purpura ##theme 2 ##score 1 ##type 1 ##time 00:01:00 The therapeutist must prescribe to patients primary prophylaxis iron deficiency anemia to prevent its development.

Whо is adminested this prophylaxis? +Pregnant women Patients after 60 All children Patients after operation Workers of industrial interprises. ##theme 2 ##score 1 ##type 1 ##time 00:01:00 The woman aged 30, is suffering from polycystic kidney. She was admitted to the hospital because of weakness thirst, nocturia. Diuresis was about 1800 ml per day. Blood pressure 200/100mm Hg. Blood test: erythrocytes: 1,8*109. Hg-68 g/l. Urine specific gravity is 1005, leucocytes- 50-60, erythrocytes in microscopic fild - 3-5, creatinine- 0,82 mmole/l, potassium – 6,5 mmole/l, provision urine filtration rate 10 ml/min. What’s the immediate task in the case treatment? +Hemodialysis antibacterial therapy sorbents blood transfusion Hypotensive therapy ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A patient K. aged 35 years complains of weakness, dizziness, headache, palpitation, attacks of pain in umbilical, sacral areas, fever up to 38,20C, urine discoloration resembled smoky brown and normal stool. The condition started after bee sting. On clinical examination the jaundice is noted. BP (blood pressure) is 100/60 mm of Hg, spleen is enlarged. RBC ( erythrocytes) are 2,3 * 1012/l, НB 72 g/l, K - 0,9, reticulocytes 13,1\%, WBC (leucocytes) 6,2 * 109/l, ESR -25 mm/hour. In urine urobilin reaction is strongly positive, bilirubin pigments are absent. The total bilirubin is 60 mkmol/l, indirect 40 mkmol/l. Serum iron is 20,4 mkmol/l. What clinical diagnosis is the most probable? +Acquired hemolytic anemia Acute liver insufficiency Iron-deficiency anemia В12- deficiency anemia Viral hepatitis ##theme 2 ##score 1 ##type 1 ##time 00:01:00 Patient L. 55 y.o., has been admitted to the clinics with chronic gastritis. In the blood test: erythrocytosis 3,8*10 12\L, Hb 70g\l, macro-anisocytosis, poikilocytosis. There is a megaloblastic type of hemopoesis. A number of leucocytes, reticulocytes and thrombocytes are lowed. Which pathology is suspected? +B12-deficiecy anemia

Iron-deficiency anemia Hemolytic anemia Post-hemorrhagic anemia Thalassaemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 32-year-old welder complaints of weakness and fever. His illness started as tonsillitis a month before. On exam, BT of 38,9◦C, RR of 24\min, HR of 100\min, BP of 100\70 mm HG, hemorrhages on the legs, enlargement of the lymph nodes. CBC shows Hb of 70 g\l, RBC of 2,2*1012\L, WBC of 3,0*109\L with 32%of blasts, 1%of eosinophiles, 3% of bands, 36% of segments. Establish the diagnosis.

Aplastic anemia Chronic lymphoblastic leukemia +Acute leukemia Vitamin-B12-deficiency anemia Chronic hemolytic anemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 54-year-old woman complaints of increasing fatigue and easy bruising of 3 weeks’ duration. Physical findings include pale, scattered ecchymoses and petechiae and mild hepatosplenomegaly. CBC; RBC- 2.550.000\mcL; Hb73 g\l; HTC20%; PLT-23.000\mcl; and WBC -162.000\mcl with 82%blasts that contained Auric rods. Establish the diagnosis.

Chronic leukemia +Acute leukemia Thrombocytopenia Hemolytic anemia Megaloblastic anemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 48-year-old woman complains of weakness, subfebrile fever, and pallor of the skin. Physical examination revealed the enlarged lymph nodes in the right supraclavicular area. On X-ray film, there was enlargement of bronchopulmonary lymph nodes. The liver was enlarged. What is the diagnosis?

Chronic myelocytic leukemia Tuberculosis Sarkoidosis Non-Hodgkin’s lymphoma +Hodgkin’s disease ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A patient had stomach resection a year ago. He complains of general weakness, giddiness. Blood count: Er-2,6 g\l; Hb -80g\l; C.ind. 0.7L-3,7g\l, reticulocytes 1%, segm 56%, lymph 34%, mon.6%. ESR 17 mm\hour. Erythrocytes are hypochromic; there are anisocytosis & poikilocytosis. Fe of serum 5mkmol\L. Diagnosis is: Aplastic anemia B12-deficiency anemia

Chronic myeloleukemia +Iron-deficiency anemia Chronic lymphoid leucosis ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 30–year-old woman complains of dizziness, weakness, increased nails fragility, alopecia and pica. On clinical examination body temperature is 36,7oC, the skin is pale, RR is 20 per min.; Ps 98, BP 100\60 mm of hg. In CBC erythrocytes are 2,8*1012g\l, Hb 85g\l; C.I.-0,9, reticulocytes 2%, WBC 4,7*10 9\l, eosiphils 2%, subneutrophils 3%, segmented neutrophils 62%, lymphocytes 26%, monocytes 5%. ESR 20 mm\hour. Serum iron is 6,8 mkmol\l. What preparation is necessary to prescribe to a patient?

Fresh blood +Iron per os Packed red Iron i\m, i\v Vitamin B12-intramusculary ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A patient, 35 years, complains of dizziness, weakness, headache, palpitation, attacks of pain in umbilical, sacral areas, fever up to 38oC, urine discoloration resembled smoky brown and normal stool. The condition started after being sting.

On clinical examination jaundice is noted. BP 100\60 mm of Hg. Spleen is enlarged. RBC are 2,3*10 12\l, Hb 72g\l; C.I.-0,9, reticulocytes 13,1%, WBC 6,2*109\l, ESR 25 mm\h. In urine urobilin reaction is strongly positive, bilirubin pigments are absent. The total bilirubin - 60 mkmol\l, indirect 40 mkmol\l. Serum iron - 20,4 mkmol\l. What clinical diagnosis is the most probable? +Acquired hemolytic anemia Acute liver insufficiency Iron-deficiency anemia B12-defiency anemia Viral hepatitis ##theme 2 ##score 1 ##type 1 ##time 00:01:00 Woman, 56 years old, complaints about the skin itching, sweating, subfebrile fever with the periodic increases temperature to 38-39oC, loss of weight, heaviness in right and left hypochondria, dyspeptic disorders. Objectively: a skin is pale, some icteric. A liver palpate at the level of umbilicus, a spleen on 2cm is below than umbilicus, dense consistency. Common analysis of blood: RBC-3,0*1012\\L, Hb-110g\l, C.I.-0,8; WBC-28 *109\l, bas. 4%, eos-5%, myel.6, St-8, segm.70%, L-5, M-3, tromb.180 g\l. Your diagnosis: Chronic myeloleukemia (aleukemic form) Chronic myeloleukemia (leukemic form) +Chronic myeloleukemia (subleukemic form) Acute myeloblastic leukemia Chronic lymphoblastic leukemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00

A 42 years old man suddenly felt worsening of his general condition and complains of dizziness, weakness and appetite loss. From the clinical history it is know that the patient suffers from the duodenal ulcer disease within 15 years and it is written down in his individual medicine file. In CBC - RBC are 1,9*1012\l, Hb-57g\l, C.I.-0,9; reticulocytes 1%, thromb.2,1*109\l, WBC - 11,5*109\l, eosinophiles 65%, lymph. - 19%, mon. - 5%, ESR35mm\hour. What clinical diagnosis is the most probable?

Pernicious anemia Hemolytic anemia Hypoplastic anemia DVS-syndrome +Post-hemorrhagic anemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 21 year-old patient with history of multiple pneumonias complaints of malaise, breathlessness, palpitation, filings of noisy ears and “flies” in front of eyes. The patient is ill within one month. On physical examination the skin is pale. In the mouth there is ulcerative necrotizing stomatitis. Also purpura in the femoral and abdominal skin areas is noted. The peripheral lymphatic nodes are not enlarged. CBC: RBC-1,8*10 12\l, Hb-56g\l, C.I.-0,9, WBC 2,3*109\l, eosinophyls-2%, stub 3%, segm. 65%, lymp. 22%, mon. 8%, tromb.16*10 9\l, ESR-25 mm\h. In urine analysis the macrohematuria is revealed. What clinical diagnosis is the most probable?

Hemolytic anemia +Aplastic anemia Iron-deficiency anemia B12-difiency anemia Acquired hypoplastic anemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 Another name of Rendu-Osler-Weber Syndrome is……. +Hemorrhagic telangiectasia Allergic purpura Hemophilia Rheumatic fever, Adhesive pericarditis ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What is bleeding disorder due to inherited deficiencies or abnormalities of coagulation factors VIII or IX? Allergic purpura Hemorrhagic telangiectasia +Hemophilia Hemorrhagic vasculitis Thrombocytopenia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What factor deficiency termed hemophilia A? VI

V I +VIII XI

##theme 2 ##score 1 ##type 1 ##time 00:01:00 What factor deficiencies, termed hemophilia C? +XI VI VII X IX ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What platelet disorders associated with other congenital defects are here?

Rendu-Osler-Weber Syndrome Henoch-Schonlein disease +Wiskott-Aldrich syndrome Von Willebrand's disease Klainfelter's syndrome ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A previously healthy 27-year-old woman is seen because of a petechial rash. She denies any recent bleeding and has had no recent illnesses. Hemoglobin, hematocrit, and white blood cell counts are normal. Examination of the peripheral blood smear reveals normal red and white blood cells and is remarkable only for a paucity of platelets.

The most likely diagnosis is: Aleukemic leukemia +Idiopathic thrombocytopenic purpura (ITP) Glanzmann's thrombasthenia Amegakaryocytic thrombocytopenia Drug-induced thrombocytopenia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 Essentials of diagnosis in Congenital Hemolytic Jaundice: +Malaise, abdominal discomfort, jaundice, anemia, splenomegaly, spherocytosis, increased osmotic fragility of red cells, negative Coombs test.

High reticulocytes count.

Serum iron low, total iron-binding capacity increased.

Lassitude, pallor, purpura, bleeding, pancytopenia, fatty bone marrow.

Persistent anemia and reticulocytosis, Coombs test usually positive.

##theme 2 ##score 1 ##type 1 ##time 00:01:00 What anemia does occur almost always due to blood loss? +Iron deficiency anemia.

Megaloblastic anemia.

Aplastic anemia.

Folic acid deficiency anemia.

B12 vitamin deficiency anemia. ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What is the most often clinical finding in anemia?

Fatigue. +Low platelets level.

Low white blood cells level.

High hemoglobin level.

Low hemoglobin level. ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What is the main preparation in the pernicious anemia administration?

Epinephrine.

Ferrum-Lek. Prednisolone. +Cyanocobalamin.

Penicillin ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What level of serum ferritin shows the iron deficiency anemia?

Below 24 ng/mL. Below 56 ng/mL. +Below 12 ng/mL. Below 120 ng/mL. Below 48 ng/mL. ##theme 2 ##score 1 ##type 1 ##time 00:01:00 How to treat the Aplastic anemia?

Marrow Transplant, Androgen Steroids.

Liver transplant, Androgen Steroids, +Bowel transplant, Hestagene Steroids.

Androgen Steroids, Penicillin.

Iron preparations. ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 60-year-old man complains of fever, significant weight loss, bone and joint pain, and bleeding gums. On examination - paleness, lymphadenopathy, hepato- and splenomegaly. CBC: WBC – 270*10 9/L with 13% lymphocytes, 1% monocytes, 21% basophiles, 29% neutrophils, 9% blasts, 12% promyelocytes, 12% myelocytes, 2% metamyelocytes, 1% eosinophiles. ESR – 22 mm/h. Name the drug for treatment. +Myelosan Prednisolone Cytosar Vinblastine Blood transfusion ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 54-year-old woman complains of increasing fatigue and easy bruising of 3 weeks’ duration. Physical findings included pale, scattered ecchymoses and petechiae and mild hepatosplenomegaly. CBC: RBC – 2.550.000/mcL; Hb – 73 g/L; HCT 20\%; PLT – 23.000/mcL; and WBC – 162.000/mcL with 82\% blasts, that contained Auric rods; peroxidase stain was positive; What is the most probable diagnosis?

Megaloblastic anemia Hemolytic anemia Thrombocytopenia Chronic leukemia +Acute leukemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 32 -year-old welder complains of weakness and fever. His illness started as tonsillitis a month before. On exam, BT of 38.9°C, RR of 24/min, HR of 100/min, BP of 100/70 mm Hg, hemorrhages on the legs, enlargement of the lymph nodes. CBC shows Hb of 70 g/L, RBC of 2.2*10 12/L, WBC of 3.0*109/L with 32% of blasts, 1% of eosinophiles, 3% of stab, 36% of segments, 20% of lymphocytes, and 8% of monocytes, ESR of 47 mm/h. What is the cause of anemia?

Chronic lymphoblastic leukemia +Acute leukemia Aplastic anemia Vitamin B12 deficiency anemia Chronic hemolytic anemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What is the Acute Lymphatic Leukemia? +Disorder of the blood-forming tissue (white cells) Disorder of the blood-forming tissue (red cells) Cardiac pain Increasing of blood pressure Decreasing of blood pressure

##theme 2 ##score 1 ##type 1 ##time 00:01:00 What is a level of platelets in the patient with Acute Lymphatic Leukemia?

Over 200.000/μL 150.000 – 200.000/μL +100.000 – 150.000/μL Below 100.000/μL Is not changed ##theme 2 ##score 1 ##type 1 ##time 00:01:00 In which patients the intracerebral hemorrhage occurs more frequently?

With low white cells counts +With high white cells counts (over 300.000/μL) Without any changes Increased level of erythrocytes Decreased level of erythrocyte ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What is the dosage of Vincristine during the treatment of acute lymphatic leukemia?

0,01 mg/kg intravenously once a week for 4 weeks. +0,05 mg/kg intravenously once a week for 4 weeks.

0,1 mg/kg intravenously once a week for 4 weeks.

0,5 mg/kg intravenously once a week for 4 weeks.

1 mg/kg intravenously once a week for 4 weeks. ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What is the aim of therapy in patient with chronic myelocytic leukemia? +Palliation of symptoms and correction of anemia To prevent the infiltration of organs by abnormal white cells Correction of anemia only To decrease the level of leukocytes To increase the level of thrombocytes ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What reason is thought to be the cause of complications in patient with chronic myelocytic leukemia?

Gum bleeding High white cells count Hypertension Leukemic infiltration of organs

+Cerebral ischemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 25-year-old patient complaints of weakness and fever. Her illness started as stomatitis a month before. On exam, BT of 39,9◦C, RR of 22\min, HR of 120\min, BP of 90\70 mm HG, hemorrhages on the legs, enlargement of the lymph nodes. CBC - Hb of 77 g\l, RBC of 2,1*1012\L, WBC of 2,7*109\L with 39%of blasts, 1%of eosinophiles, 3% of stab, 36% of segments. Establish the diagnosis.

Aplastic anemia Chronic lympholeukemia +Acute leukemia Vitamin-B12-deficiency anemia Chronic hemolytic anemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 44-year-old woman complained of weakness, subfebrile fever, and pallor of the skin. Physical examination revealed the enlarged lymph nodes in the right supraclavicular area. On X-ray film, there was enlargement of broncho-pulmonary and paratracheal lymph nodes. The liver was enlarged, with increased firmness. What is the diagnosis?

Tuberculosis. +Hodgkin’s disease.

Sarkoidosis.

Tumor metastases.

Chronic myelocytic leukemia. ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 25-year-old woman complained of fatigue, hair loss, and brittle nails. On exam, pallor of skin, PR of 94/min, BP of 110/70 mm Hg. On blood cell count, Hb of 90 g/L, RBC 3.5·1012/L, color index of 0.7, ESR of 20 mm/h. Serum iron level was 8.7 mcmol/L. what treatment would you initiate? +Ferrous sulfate orally Iron dextrin injections Vitamin B12 intramuscularly Blood transfusion Packed RBCs transfusion ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 62-year-old woman complains of increasing fatigue and easy bruising of 4 weeks’ duration. Physical findings included pale, scattered ecchymoses and hepatosplenomegaly. CBC: RBC – 2.250.000/mcL; Hb – 63 g/L; HCT 17\%; PLT – 18.000/mcL; and WBC – 128.000/mcL with 61\% blasts. What is the most probable diagnosis?

Megaloblastic anemia Chronic leukemia Thrombocytopenia Hemolytic anemia +Acute leukemia

##theme 2 ##score 1 ##type 1 ##time 00:01:00 A patient had stomach resection a year ago. He complains of general weakness, giddiness. Blood count: Er 2,6*1012/L, Hb 80 g/L, C.ind 0.7, L – 3.7 g/L, reticulocytes 1\%, segm. 56\%, lymp. 34\%, mon. 6\%, ESR 17 mm/hour. Erythrocytes are hypochromic; there are anisocytosis & poikilocytosis. Fe of serum 5 mkmol/L. Diagnosis is: Chronic myeloleukosis B12-deficiency anemia +Iron-deficiency anemia Aplastic anemia Chronic lymphoid leukemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 50 year old patient has been admitted to the clinics with atrophic gastritis. Blood count: erythrocytes - 3,8*10 12/l, Hb - 68 g/l, C.i. - 1, macro-anisocytosis, poikilocytosis. There is megaloblastic type of hemopoesis. A number of leukocytes, reticulocytes and thrombocytes are reduced. Which pathology is suspected?

Iron-deficiency anemia Post-hemorrhagic anemia Thalassaemia Hemolytic anemia +B12-deficiency anemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 60-year-old man complains of fever, significant weight loss, bone and joint pain, bleeding gums. Examination revealed paleness, lymphadenopathy, hepato- and splenomegaly. CBC: WBC – 270*10 9/l with 13% lymphocytes, 1% monocytes, 21% basophiles, 29% neutrophils, 9% blasts, 12% promyelocytes, 12% myelocytes, 2% metamyelocytes, 1% eosinophils. ESR - 22 mm/h. Name the drug for treatment: Vinblastine +Myelosan Prednisolone Cytosar Blood transfusion ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 25 year old patient complains about weakness, dizziness, appearance of hemorrhagic skin rash. She has been suffering from this for a month. Blood count: erythrocytes: 1,0*10 12/l, Hb- 37 g/l, color index - 0,9, leukocytes 1,2*109/l, thrombocytes – 42*109/l. What diagnostic method will be the most effective?

Liver biopsy Abdominal ultrasound +Sternal puncture Coagulogram Spleen biopsy

##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 68-year-old patient complains of tiredness, sweating, enlargement of cervical, submaxillary and axillary lymph nodes. Blood tests: leucocytes-35∗109/L, lymphocytes - 60%, Botkin and Gumprecht bodies, level of hemoglobin and quantity of thrombocytes is normal. Myelogram showed 40% of lymphocytes. What is the most probable diagnosis?

Acute leucosis +Lymphogranulomatosis Chronic myeloleucosis Tuberculosis lymphadenitis Chronic lympholeucosis ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A patient aged 26 years, complains of the enlargement of cervical, subclavicular, grain, lymphatic nodes. Skin itching. Considerable sweating at night. Fever up to 39 oIn CBC there is leukocytosis, lymphopenia, high ESR. What clinical diagnosis is the most probable? +Lymphogranulomatosis Chronic lymphatic leukemia Acute lymphoblastic leucosis Infectious mononucleosis Leukomoidal reaction ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 65-years-old patient was admitted in the hospital with complains of fatigue, feeling of “cotton like” legs, loss of sensitivity of toes. On examination - pale of the skin, subicteric sclera. Heart sounds of low intensity, systolic murmur heard over the heart area, liver +2sm, painless, spleen not enlarged. Blood analysis: Hb-58g\l, E к -1,3*1012\l, color index – 1,3. reticulocytes 0,2%, ESR 30 mm\h, megaloblasts -2:100, macrocytosis. Jolly bodies, Kebot's ring. Most informative method of investigation is?

Osmotic resistance of erythrocytes Endoscopic examination of the stomach X-Ray of abdomen +Serum B12 and folic acid level Iron content of serum ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 42 y.o. patient complains of weakness, heartbeat, nasal hemorrhages, cutaneous hemorrhages. His condition has been worsening progressively for a month. Objectively: grave condition, the extremities and body skin has spotted and petechial hemorrhages, lymph nodes are not palpable. Ps-116\min, liver +2сm enlarged, spleen is not palpable.

Blood has evident pancytopenia. What disease should you think first of all? +Hypoplastic anemia Hemorrhagic vasculitis Acute agranulocytosis Werlhof’s disease Acute leucosis

##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 54-years-old woman complains of increasing fatigue and easy bruising of 3 weeks duration. Physical findings included pale, scattered ecchymoses and petechiae and mild hepatosplenomegaly. In blood: RBC – 2,5* 10 12\l, Hb 73g\l, HCT- 20%, PLT – 23*10 9\l, and WBC 163*10 9\l with 82% blats. What is the most probable diagnosis?

Hemolytic anemia Chronic leukemia Thrombocytopenia +Acute leukemia Megaloblastic anemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 27 y.o. patient has been having for almost a year fatigue, hyperhydrosis, heaviness in the left hypochondria, especially after meals. Objectively: spleen and liver enlargement. In blood: erythrocytes – 3,2* 10 12\l, Hb – 100 g\l, color index-0,87, leucocytes - 100*10 9\l, basophiles – 10%, eosinophiles – 5%, myelocytes – 15%, juveniles – 16%, stab neutrophils 10%, segmentonuclear leucocytes -45%, lymphocytes – 2%, monocytes – 0%, reticulocytes – 0,3%, thrombocytes – 400*109\l, ESR – 25mm\h. what is the most probable diagnosis?

Liver cirrhosis Acute leucosis Chronic lympholeukemia Erythremia +Chronic myeloleukemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 33 y.o. patient was admitted to the hospital with stopped repeated ulcerative bleeding. He was pale and exhausted.

Blood count: Hb- 77g\l, Ht-0,25. In view of anemia there was made two attempts of blood transfusion of the same group – A(II) Rh+. In the both cases the transfusion had to be stopped because of development of anaphylactic reaction. What transfusion medium would be advised in this case?

Fresh citrate blood +Washed erythrocytes Packed red cells Erythrocyte suspension Packed red cells ( native) ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 35 y.o. woman is suspected of Aplastic anemia. The bone marrow aspiration has been administered with the diagnostic purpose. What changes in the marrow test are suggested?

Replacement of marrow elements with fibrous tissue. +Replacement of marrow elements with adipose tissue Absolute lymphocytosis Prevalence of megaloblasts Presence of blasts cells

##theme 2 ##score 1 ##type 1 ##time 00:01:00 A man, 68 y.o, complains of tiredness, sweating, enlargement of cervical, submaxillary and axillary lymph nodes.

Blood test: WBC – 34*10 9\l, lymphocytes -60%, Botkin's and Gumprecht's bodies, level of hemoglobin and quantity of thrombocytes are decreased. What is the most probable diagnosis?

Chronic myeloleucosis Lymphogranulomatosis +Chronic lympholeucosis Acute leucosis Non-Hodgkin’s lymphoma ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 58 y.o. male patient is examined by a physician and suffers from general weakness, fatigue, mild pain in the left subcostal area, sometimes frequent painful urination. Moderate splenomegaly has been revealed. Blood test: neurophilic leukocytosis with the progress to myelocytes; basophil – 2%; eosinophil-5%. There is a urate crystals in urine, erythrocytes 2-3 in the field of vision. What is the preliminary diagnosis?

Lymphogranulomatosis +Chronic myeloleucosis Kidney stones Leukemoid reaction Liver cirrhosis ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A man, 42 years old, died in a road accident after the hemorrhage on the spot, because of acute hemorrhagic anemia.

What minimum percent of the whole blood volume could result in death by acute hemorrhage? +10-14% 15-20% 25-30% 6-9% 35-50% ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 65-year-old woman is seen prior to cataract surgery. She has had no previous surgery except for a dental extraction, after which she bled for 10 days and required a 2-unit blood transfusion. One sibling died from postoperative hemorrhage during childhood, and there is a history of bleeding in a number of relatives, both male and female. Her partial thromboplastin time (PTT) is markedly prolonged, and the bleeding time is within normal limits. The most likely diagnosis is: Factor VIII deficiency +Factor XI deficiency Factor XII deficiency Fletcher factor deficiency Von Willebrand's disease ##theme 2

##score 1 ##type 1 ##time 00:01:00 What is a main syndrome of hemophilia? +Bleeding Lymphoproliferative Anemia Intoxication Infection ##theme 2 ##score 1 ##type 1 ##time 00:01:00 Another name of Henoch-Schonlein disease is………

Hemorrhagic telangiectasia Hemophilia +Allergic purpura Thrombocytopenia Hemorrhagic vasculitis ##theme 2 ##score 1 ##type 1 ##time 00:01:00 Management of thrombocytopenia requires administration of………….. +Platelet concentrates Crioglobulin Erythrocyte concentrates NaCl NaHCO3 ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What factor deficiencies termed hemophilia B? II VIII VII +IX XI ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What drug is useful in treatment of hemophilia?

Aspirin +Aminocapronic acid Meteospasmil Prednisolone Vitamin C

##theme 2 ##score 1 ##type 1 ##time 00:01:00 The functional systolic heart murmur is meet most frequently attached to: +Iron-deficiency anemia Hypothyroidism Diabetes Mellitus B12-defficiency anemia Pregnancy ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What changes in peripheral blood are observed by late post-hemorrhagic anemia? +Leukocytosis Leucopenia Erythropenia Thrombocytopenia Erythrocytosis ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What method of Addison-Biermer’s anemia treatment is basic?

Blood transfusion Reception В12 vitamin Reception iron medicine Phytotherapy +Iron reception with feeding products. ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What can one see in the general blood analysis by Addison-Biermer’s anemia?

Augment amount of thrombocytes Diminishing hemoglobin index Eosinophilia +Appear of megalocytes Lymphocytosis

##theme 2 ##score 1 ##type 1 ##time 00:01:00 What is the most often complaint in patients with anemia? +Arrhythmia Heart pain Headache Cough Giddiness ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What are the essentials of diagnosis of autoimmune hemolytic anemia? +Serum iron low, total iron-binding capacity increased.

Lassitude, pallor, purpura, bleeding, pancytopenia, fatty, bone marrow.

Persistent anemia and reticulocytosis, Coombs test usually positive.

Fever, jaundice.

High reticulocytes count. ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What genetic sign does indicate the chronic myelocytic leukemia? +Philadelphia chromosome in abnormal cells No sings XXX or XXY combination 3 chromosomes in the 21st pare Lack of chromosome 13 pare ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What are the main laboratory findings in patient with chronic lymphocyttic leukemia?

Thrombocytosis +Anemia and thrombocytopenia Thrombocytosis and lymphocytosis No findings Philadelphia chromosome in abnormal cells ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What drug is mostly used for the treatment of chronic lymphocyttic leukemia?

+Chlorambucil Prednisone Cyclophosphamide Myleran Penicillin ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 32 -year-old welder complains of weakness and fever. His illness started as tonsillitis a month before. On exam, BT of 38.9°C, RR of 24/min, HR of 100/min, BP of 100/70 mm Hg, hemorrhages on the legs, enlargement of the lymph nodes. CBC shows Hb of 70 g/L, RBC of 2.2*10 12/L, WBC of 3.0*109/L with 32% of blasts, 1% of eosinophiles, 3% of stab, 36% of segments, 20% of lymphocytes, and 8% of monocytes, ESR of 47 mm/h. What is the cause of anemia?

Chronic lympholeukemia +Acute leukemia Aplastic anemia Vitamin B12 deficiency anemia Chronic hemolytic anemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What is the Acute Lymphocyttic Leukemia? +Disorder of the blood-forming tissue (white cells) Disorder of the blood-forming tissue (red cells) Lymphatic tissue origin disorder Increasing of blood loss Decreasing of blood production ##theme 2 ##score 1 ##type 1 ##time 00:01:00 What reason is thought to be the cause of complications in patient with chronic myelocytic leukemia?

Gum bleeding High white cells count Hypertension Leukemic infiltration of organs +Cerebral ischemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 60-year-old man complains of fever, significant weight loss, bone and joint pain, and bleeding gums. On exam, paleness, lymphadenopathy, hepato- and splenomegaly. CBC: WBC – 270*10 9/L with 13% lymphocytes, 1% monocytes, 21% basophiles, 29% neutrophils, 9% blasts, 12% promyelocytes, 12% myelocytes, 2% metamyelocytes, 1% eosinophiles. ESR – 22 mm/h. Name the drug for treatment. +Myelosan Prednisolone Cytosar Vinblastine

Blood transfusion ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 54-year-old woman complains of increasing fatigue and easy bruising of 3 weeks duration. Physical findings included pale, scattered ecchymoses and petechiae and mild hepatosplenomegaly. CBC: RBC – 2.550.000/mcL; Hb – 73 g/L; HCT 20%; PLT – 23.000/mcL; and WBC – 162.000/mcL with 52% blasts, that contained Auric rods; peroxidase stain was positive. What is the most probable diagnosis?

Megaloblastic anemia Hemolytic anemia Thrombocytopenia Chronic leukemia +Acute leukemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 In which patients the intracerebral hemorrhage occurs more frequently?

With low white cells counts +With high white cells counts (over 300.000/μL) Without any changes Increased level of erythrocytes Decreased level of erythrocyte ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 48-years-old woman complains of increasingtiredness, fatigue and easy bruising of 5 weeks duration. Physical findings included pale skine, scattered petechiae and hepatosplenomegaly. In blood: RBC – 2,8* 10 12\l, Hb 78 g\l, HCT- 20%, PLT – 28*10 9\l, and WBC 178*10 9\l with 45% blats. What is the most probable diagnosis?

Hemolytic anemia Chronic leukemia Thrombocytopenia +Acute leukemia Megaloblastic anemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 30–year-old woman complains of dizziness, weakness, increased nails fragility, alopecia and pica. On clinical examination body temperature is 36,7oC, the skin is pale, RR is 20 per min.; Ps 98, BP 100\60 mm of hg. In CBC erythrocytes are 2,8*1012g\l, Hb 85g\l; C.I.-0,95, reticulocytes 2%, WBC 4,7*10 9\l, eosiphils 2%, subneutrophils 3%, segmented neutrophils 62%, lymphocytes 26%, monocytes 5%. ESR 20 mm\hour. Serum iron is 6,8 mkmol\l.

What preparation is necessary to prescribe to a patient?

Fresh blood Iron per os Packed red Iron i\m, i\v +Vitamin B12-intramusculary

##theme 2 ##score 1 ##type 1 ##time 00:01:00 A patient had stomach resection a year ago. He complains of general weakness, giddiness. Blood count: Er 2,6*1012/L, Hb 80 g/L, C.ind 0.7, L – 3.7*10 9/L, reticulocytes 1\%, segm. 56\%, lymp. 34\%, mon. 6\%, ESR 17 mm/hour. Erythrocytes are hypochromic; there are anisocytosis & poikilocytosis. Fe of serum 5 mkmol/L. Diagnosis is: +Iron-deficiency anemia B12-deficiency anemia Chronic myeloleucosis Aplastic anemia Chronic lymphoid leukemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 50-year-old patient has been admitted to the clinics with atrophic gastritis. Blood count: erythrocytes - 3,8*10 12/l, Hb - 68 g/l, C.i. - 1, macro-anisocytosis, poikilocytosis. There is megaloblastic type of hemopoesis. A number of leukocytes, reticulocytes and thrombocytes are reduced. Which pathology is suspected?

Iron-deficiency anemia Post-hemorrhagic anemia Thalassaemia Hemolytic anemia +B12-deficiency anemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 60-year-old man complains of fever, significant weight loss, bone and joint pain, bleeding gums. Examination revealed paleness, lymphadenopathy, hepato- and splenomegaly. CBC: WBC – 270*10 9/l with 13% lymphocytes, 1% monocytes, 21% basophiles, 29% neutrophils, 9% blasts, 12% promyelocytes, 12% myelocytes, 2% metamyelocytes, 1% eosinophiles. ESR - 22 mm/h. Name the drug for treatment: Iron-deficiency anemia +Chronic myeloleucosis B12-deficiency anemia Aplastic anemia Chronic lymphoid leukemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 25-year-old patient complains about weakness, dizziness, appearance of hemorrhagic skin rash. She has been suffering from this for a month. Blood count: erythrocytes: 1,0*10 12/l, Hb- 37 g/l, color index - 0,9, leukocytes 1,2*109/l, thrombocytes – 42*109/l. What diagnostic method will be the most effective?

Liver biopsy Abdominal ultrasound +Sternal puncture Coagulogram Spleen biopsy ##theme 2

##score 1 ##type 1 ##time 00:01:00 A 68-year-old patient complains of tiredness, sweating, enlargement of cervical, submaxillary and axillary lymph nodes. Blood tests: leucocytes-35∗109/L, lymphocytes - 60%, Botkin and Gumprecht bodies, level of hemoglobin and quantity of thrombocytes is normal. Myelogram showed 40% of lymphocytes. What is the most probable diagnosis?

Acute leucosis +Lymphogranulomatosis Chronic myeloleucosis Tuberculosis lymphadenitis Chronic lympholeucosis ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A 42-year-old man suddenly felt worsening of his general condition and complains of dizziness, weakness and appetite loss. From the clinical history it is known that the patient suffers from the duodenal ulcer disease within 15 years and it is written down in his individual medical file. In CBC - RBC are 1,9*10 12/l , Hb 57g/l , C.I. 0,9, reticulocytes 1\% , thromb. 2,1*109/l , WBC 11,5*109/l , eosinophils-1\%; stabneutrophils-10\%; seg.neutrophils65\%; lymph/-19\%; mon.-5\%; ESR-35 mm/hour. What clinical diagnosis is the most probable? +Pernicious anemia Hemolytic anemia Hypoplastic anemia DVC – syndrome Post-hemorrhagic anemia ##theme 2 ##score 1 ##type 1 ##time 00:01:00 A patient, 35 years, complains of weakness, dizziness, headache, palpitation, attacks of pain in umbilical, sacral areas, fever up to 38,20C, urine discoloration resembled smoky brown and normal stool. The condition started after bee sting. On clinical examination the jaundice is noted. BP (blood pressure) is 100/60 mm of Hg, spleen is enlarged. RBC are 2,3*1012/l, НB 72 g/l, K - 0,9, reticulocytes 13,1\%, WBC 6,2*10 9/l, ESR -25 mm/hour. In urine urobilin reaction is strongly positive, bilirubin pigments are absent. The total bilirubin is 60 mkmol/l, indirect 40 mkmol/l. Serum iron is 20,4 mkmol/l. What clinical diagnosis is the most probable?

Acquired hemolytic anemia Acute liver insufficiency Iron-deficiency anemia В12- deficiency anemia +Viral hepatitis