Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №1 The 20 year old patient was hospitalized in a surgery unit. He complains to the insignificant pain in right ileac area. He has been sick for 3 days. His general state is satisfactory. Тhe body temperature is 37,3 С, pulse is 82 pulse beats /min. Precise located painful neoplasmic formation, which merges with a wing of a ileac bone and motionless could be palpated in the right ileac area. The blood analysis shows: leukocytes - 12х10109/l, ESR 32mm/hour. What diagnosis does the patient have? A. Infiltrate of the abdominal cavity. B. Appendicular infiltrate. C. Pelvis infiltrate. D. Blind intestine cancer. E. Abdominal cavity infected cyst. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №2 The patient is 28 years old. Weakness, faints appeared in 8 hours' time after the appendectomy. Skin covers are pale, pulse is 120 pulse beats /min. Тhe body temperature is 36,8 С, AT is 90/60 mm of the column of mercury. The stomach is soft, painless while palping at places there is a flatness of percussion sound while percussion. What complication after appendectomy operation is observed at the patient? A. Acute spread peritonitis. B. Thrombosis of mesenterial vessels. C. Pilephlebitis. D. Intestinal paresis. E. Internal bleeding. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №3 Person of the 38 weeks of pregnancy complains on acutely begun intensive pain in right ileac fossa, nausea. Тhe body temperature is 37,9 С. The uterus fundus is higher than the umbilicus. In the right half of a stomach, more in the bottom there is a sharp morbidity at palpation and expressed muscles pressure, positive symptoms of Shchetkin-Blumberg, Razdolsky, Bartomye-Mikhelson. In the blood analysis : leukocytes - 14х109/l. There are protein traces in the urine analysis, L - 3-4 in a field of a sight. What pathology takes place at the patient? A. Threat of interruption of pregnancy. B. Pyelonephritis gravidarum. C. Acute appendicitis. D. Torsion of cystic ovary. E. Lamination of placenta. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №4
Appendix have functions, except one of named below. A. Peristaltic. B. Blood-forming. C. Immune. D. Exocrine. E. Detoxication. The head of the department, professor
V.I. Bondarev
deal
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №5
deal
In the time of Mak-Burney approach in the right iliac region gradually are cuting 8 anatomical layer: 1.skin, 2. abdominal internal oblique muscle, 3. transverse muscle of abdomen, 4. proper external fascia, 5. subcutaneous fat, 6. peritoneum 7. transverse fascia of abdomen, 8. aponeurosis abdominal external oblique muscle. Locate them gradually from skin to peritoneum. A. 1,5,4,2,8,7,3,6. B. 1,5,8,4,3,2,7,6. C. 1,4,5,3,8,2,7,6. D. 1,5,4,8,2,3,7,6. E. 1,5,3,8,7,2,4,6. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №6
deal
Among association causative agents purulent infection, which are predetermine inflammatory process in acute appendicitis most often is found: A. Staphylococcus. B. Collibacillus. C. Streptococci. D. Enterococcus. E. Nonclostridial anaerobe. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №7
deal
Acute appendicitis is occur in any age, but statistically most often: A. Before 10 years B. from 10 till 40 years . C. from 40 till 60 years. D. Later on 60 years E. All variants. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №8
deal
During operation concerning an acute appendicitis is revealed: a appendix is hydropic, peritoneum of an appendix and its mesentery bloodshots, places of stratification of a fibrin. At a section of the removed process in its lumen pus, on a mucosa by places necrosises. To what pathomorphologic form it is necessary to relate this case of an acute appendicitis? A. Appendicular colic. B. Phlegmonous appendicitis. C. Gangrenous appendicitis. D. Catarrhal an appendicitis. E. Ruptured an appendicitis. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №9
deal
The patient 25 years complains of a pain in dextral ileal region which has appeared 1,5 hours ago. Sphygmus - 78 beats per minute., Т of a body - 36,8 С. At a palpation of a abdomen - a pain in a right ileal fossa, the signs of a irritation of a peritoneum are absent, L-6,8 109/л without changes in the formula. What is the most probable diagnosis? A. Right-hand renal colic. B. Helminthic invasion. C. Spastic colitis. D. Appendicular Colic. E. Psoitis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №10
deal
To the patient 35 years determinated the diagnosis of an appendicular colic. Which should be medical tactics? A. Treatment there is no need. B. Spasmolytics and antibiotics in the outpatient setting. C. Spasmolytics and antibiotics in conditions of a surgical hospital. D. Spasmolytics in conditions of a surgical hospital. E. Antibiotics in the outpatient setting. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №11
deal
Sick person 28 years old complains of a pain in dextral ileal range of constant character, nausea, parturition- 2, abortions - 3. The duration of disease 6 hours, at first pain was localized in epigastric region, and after 3 hours has moved to dextral ileal region. Objectiveli: Т of the body - 37,8 C, BP - 120/80 m.Hg, sphygmus - 88 beats per minute. Are positive signs: Rovsing, Sitkovsky, Bartomie - Michelson, signs of a irritation of the peritoneum in dextral ileal region. In analysis of a blood - leucocytes - 11,0 109/л, neutrocytosis, shift to the left. What diagnosis does the patient have? A. Acute coloenteritis. B. Acute Appendicitis. C. Acute cholecystitis. D. Acute right-hand adnexitis. E. Appendicular colic. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №12
deal
Sick person 28 years old complains of a pain in dextral ileal range of constant character, nausea, parturition- 2, abortions - 3. The duration of disease 6 hours, at first pain was localized in epigastric region, and after 3 hours has moved to dextral ileal region. Objectiveli: Т of the body - 37,8 C, BP - 120/80 m.Hg, sphygmus - 88 beats per minute. Are positive signs: Rovsing, Sitkovsky, Bartomie - Michelson, signs of a irritation of the peritoneum in dextral ileal region. In analysis of a blood - leucocytes - 11,0 109/л, neutrocytosis, shift to the left. What diagnosis does the patient have? What should be medical tactics? A. Antibiotic therapy, spasmolytics. B. Spasmolytics, cold on dextral ileal region. C. Antibiotic therapy, at an inefficiency of treatment - operation appendectomy. D. Antibiotic therapy, physiotherapy. E. Immediate operation - appendectomy. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №13 Sick person 28 years old complains of a pain in dextral ileal range of constant character, nausea, parturition- 2, abortions - 3. The duration of disease 6 hours, at first pain was localized in epigastric region, and after 3 hours has moved to dextral ileal region. Objectiveli: Т of the body - 37,8 C, BP - 120/80 m.Hg, sphygmus - 88 beats per minute. Are positive signs: Rovsing, Sitkovsky, Bartomie - Michelson, signs of a irritation of the peritoneum in dextral ileal region. In analysis of a blood - leucocytes - 11,0 109/л, neutrocytosis, shift to the left. What method of an anesthesia most expedient in this case? A. Local infiltration anaesthesia 0,25 % by solution of novocainum. B. Endotracheal narcosis - with artificial ventilation. C. Intravenous narcosis. D. Peridural anaesthesia. E. All variants are probable. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №14 Sick person 28 years old complains of a pain in dextral ileal range of constant character, nausea, parturition- 2, abortions - 3. The duration of disease 6 hours, at first pain was localized in epigastric region, and after 3 hours has moved to dextral ileal region. Objectiveli: Т of the body - 37,8 C, BP - 120/80 m.Hg, sphygmus - 88 beats per minute. Are positive signs: Rovsing, Sitkovsky, Bartomie - Michelson, signs of a irritation of the peritoneum in dextral ileal region. In analysis of a blood - leucocytes - 11,0х109/л, neutrocytosis, shift to the left. What access should be chosen for an operative treatment? A. Right pararectal (Lenander). B. Volkovich - Diakonov. C. Lekser. D. Middle - median laparotomy. E. Low- median laparotomy. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №15 At the patient 42 years with the distinct expressed clinic of an acute appendicitis, which waited for an operative treatment sudden pain in the right ileac fossa has increased sharply. What complication of an acute appendicitis can be assumed in the patient? A. Gangrene of the appendix. B. Thrombosis of ileocecal ileo-colic arteria. C. Formation of an appendicular infiltrate. D. Perforation of the appendix. E. Pylephlebitis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №16
deal
The patient 20 years, which was hospitalized in surgical department, complain of an insignificant pain in right ileal range. Т of a body - 37,8 With, sphygmus - 88 bit/mines. In a dextral ileaс fossa the painful tumorous formation is revealed distinct circumscribed which merges with a wing of an ileaс bone, immovable. In analysis of the blood: a leukocytosis 12х109/л, ESR - 32. What should be tactics of treatment? A. Immediate appendectomy. B. Antibiotic therapy. C. Antibiotic therapy, resorptional therapy. D. Antibiotic therapy, resorptional therapy, up to a complete resorption of an infiltrate and appendectomy. E. Antibiotic therapy, resorptional therapy up to a resorption, scheduled appendectomy after 3 months. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №17
deal
To the patient with the appendicular infiltrate prescribe conservative therapy. What complication most dangerously and probably can arise from conservative treatment? A. Allergic responses from antibiotics. B. Periappendicular abscess. C. Abscess of the Duglas pouch . D. Adhesive intestinal obstruction. E. Intestinal fistulas. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №18 The patient 33 years complains of a pain in the in the lower region of abdomen, nausea, weakness. Was ill 20 hours ago. The pains at first were localized in a dextral ileal fossa, and last 2 hours of had become more intense and are localized in the lower region of abdomen. Body temperature - 38,9. Sphygmus - 108. The palpation of the abdomen, in the inferior third is sharply morbid, signs of a irritation of the peritoneum here are clearly expressed: a strain of the muscles of abdomen. Symptoms Shetkin - Blumberg, Razdolski are positive. At digital research of the rectum is revealed morbid overhang of the Duglas pouch. In analysis of the blood: a leukocytosis - 16х109/л, . What diagnosis most probable? A. Acute appendicitis. B. Acute mesadenitis. C. Peritonitis appendicular etiology. D. Abscess of the Duglas pouch. E. Illness of the Cron. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №19
deal
Pilephlebitis, as an acute appendicitis complication is: A. Inflammation of lymphatic vessels and and lymphatic nodes of peritonium сavity. B. Thrombophlebitis of mesentery of vermiform process. C. Septic thrombophlebitis of ileac and colic vein. D. Septic thrombophlebitis of the portal vein system. E. Septic thrombophlebitis of hepatic veins. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №20
deal
The patient is 8 years old. On the 10th day of a follicular quinsy the acute appendicitis symptoms appeared. Which way of the infection penetration in vermiform appendix is the most proba-ble in this case? A. Hematogenous. B. Enterogenous. C. Lymphogenous. D. Enterogenous and Lymphogenous. E. Mixed. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №21
deal
On the 5-th day after appendectomy concerning the flegmon Appendicitis the patient felt the pains in the bottom of a sto-mach, in perinium with irradiation to the rectum, frequent de-sires to defecation, blood and slime appeared in feces. Тhe body temperature was 38,2 С. About which complication of the pa-tient’s acute appendicitis is it necessary to think first of all? A. Acute spread peritonitis. B. Early acute adhesion intestinal obstruction. C. Acute proctosigmoiditis. D. Enterogenous and Lymphogenous. E. Douglas pocket abscess. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №22
deal
When the patient was examined concerning the acute appendicitis it was proved , that he(she) had pains in the right ileac fossa, when he(she) laid on the left side. Which of the below listed symptoms are revealed to be the positive one? A. Bartomye-Mikhelson symptom. B. Voskresensky symptom. C. Coupe symptom. D. Sitkovsky symptom. E. Rovzing symptom. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №23
deal
When the patient was examined concerning the acute appendicitis it was proved , that while palping the pain is more intensive in the right ileac fossa, when the patient laid on the left side, than on a back. Which positive symptom does the patient have? A. Voskresensky symptom. B. Bartomye-Mikhelson symptom. C. Coupe symptom. D. Sitkovsky symptom. E. Rovzing symptom. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №24
deal
When the patient was examined concerning the acute appendicitis it was proved , that the pain was intensifying while palping sliding through a shirt from epigastrium area up to the right ileac fossa. Which positive symptom does the patient have? A. Obraztsov symptom. B. Ivanov symptom. C. Sitkovsky symptom. D. Rovzing symptom. E. Voskresensky symptom. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №25
deal
At the patient of 34 years of age you suspect an abscess of Douglas spaces. What method of research is preferable to diagnostics: A. Rectoromanoscopy. B. Digital research of rectum. C. Laparoscopy. D. Percusion and auscultation of a stomach. E. R-scopy of abdominal cavity. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №26
The lethality from an acute appendicitis on the average is amount : A. 0,6 % B. 0,5 % C. 0,4 % D. 0,3 % E. 0,2 % The head of the department, professor
V.I. Bondarev
deal
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №27
deal
28 years old patient presented with history of 14 hours constant pain in right iliac fossa.In last 2 hours the pain has decreased. Objectively: Local guarding of abdominal muscles. Diagnosed as acute appendicitis. What histological form of acute appendicitis could result in reduction of intensity of a pain of a stomach? A. Gangrenous. B. Cataral. C. Phlegmonic. D. Empyema of the appendix. E. Аppendicular infiltrate The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №28
deal
Diarrhea is not typical but still often symptom of acute appendicitis in children. In what case diarrhea is exact sign of appendix inflammation: A. in case of peritonitis. B. in infants and early aged children. C. in case of pelvic appendices location. D. in case of retrocecal appendicitis. E. when acute appendicitis is secondary to acute enterocolitis The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №41
deal
During the urgent diagnostic laparoscopy in the patient’s abdominal cavity some swollen loops of the small intestine near the intense gall-bladder covered with fibrin fur are detected. What disease should we think of? A. Acute pancreatitis B. Acute intestinal obstruction C. Acute cholecystitis. D. Mesenteric ischemia. E. Perforative ulcer. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №42
deal
The patient’s pain is defined by pressing between the peduncles right m. sternoklaidomastoideus in the area of its attachment to sternum and clavicle. Which symptom is that? A. Ortner. B. Moussy - Georgievsky. C. Murphy. D. Мeyo-robson. E. Kerr. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №43
deal
The patient’s pain is defined by tapping a palm edge on the right costal arch. Which acute cholecystitis syndrome is detected as a positive one? A. Moussy - Georgievsky. B. Murphy. C. Ortner. D. Мeyo-robson. E. Kerr. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №44
deal
The first aid doctor diagnosed a acute cholecystitis. What tactics should the doctor use? A. Bring in spasmolytics to the sick person. B. Invite the surgeon for the consultation. C. Bring in spasmolytics and not narcotic analgesic to the patient. D. Deliver the patient to the urgent surgical unit . E. Send the patient to the polyclinic gastroenterologist. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №45
deal
The major factors of the gall-stones appearing in the gall bladder are: A. Disorder of the gall outflow and infection occurrence in the gall ducts. B. Disorder of the blood circulation in the gall bladder. C. Infection occurrence in the gall ducts. D. Disorder of the gall outflow. E. Lymph node inflammation in the Kalo triangle. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №46
deal
The 46-year-old woman after the first attack of the acute cholecystitis, which was reserved by the conservative measures, during the ultrasonic research concretions were found . Is the operative treatment necessary? A. It is necessary, if the frequency of attacks is more than 5-6 a year. B. It is necessary when the ultrasonic concretions smashing is inefficient. C. It is necessary when the sanatorium treatment is inefficient. D. It is necessary. E. It is not necessary. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №47
deal
A patient was hospitalized in the casualty ward with the complaints to a pain in the right subcost, vomit, the body temperature was 39°С. The ultrasound research showed concretion in the gall-bladder. Which diagnosis could be tested? A. Acute intestine obstruction . B. Acute pancreatittis. C. Peptic ulcer of a stomach. D. Acute cholecystitis. E. Acute appendicitis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №48
deal
The acute calculous cholecystitis patient was decided to be operated on. What intraoperational research is the most informative? A. Intraoperational measurement of choledoch. B. Intravenous cholangeography. C. Liver ultrasonic research . D. Cholangeomanometry. E. Intraoperational cholangeography. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №49
deal
The patient has a diagnosis: an acute cholecystitis. On the second day after hospitalization the patient felt the pain in the epigastrium area, where infiltration is defined palpably. In the urine analysis the parameters of amylase attract attention - 1024 units. Which acute cholecystitis complication is it possible to talk about? A. Subliver abscess. B. Acute pancreatittis. C. Interintestine abscess. D. Local peritonitis. E. Perforative ulcer of duodenum. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №50
deal
A sick person was hospitalized in the surgical unit with the preliminary diagnosis: acute cholecystitis. Next day the patient’s pain became more expressed in subcostal, character. Ectericity of scleras skin chills, profuse hidrosis appeared. The temperature has a hectic character. Which acute cholecystitis complication is it possible to talk about? A. Acute cholecystopancreatittis. B. Fistula of the general bile-duct. C. Purulent cholangitis . D. Subliver abscess. E. Peritonitis. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №51
deal
A patient with gangrene cholecystitis and local peritonitis should have: A. Emergency operation. B. Conservative treatment. C. Deferred operation. D. The acceptance of the decision depends on age of the patient. E. Operate if there is no effect from conservative therapy. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №52
deal
At what disease can these positive symptoms of Ourtner, Boase, Murphy, Kerr be met? A. Acute pancreatittis B. Acute cholecystitis. C. Acute intestinal obstruction. D. Mesentery thrombosis. E. Perforative ulcer. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №53
deal
A 45-year-old woman, mother of four children, comes to the emergency room complaining of the sudden onset of the epigastric and right upper quadrant pain, radiating to the back, associated with vomiting. On examination, tenderness is elicited in the right upper quadrant, bowel sounds are decreased, and laboratory data shows leukocytosis, normal serum levels of amylase, lipase, and bilirubin. The most likely diagnosis is: A. Acute pancreatittis B. Perforative ulcer. C. Sigmoid diverticulus. D. Myocardial infarction. E. Acute cholecystitis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №54
deal
Which of the following are absolute indications for common bile duct exploration without preliminary cholangiography? A. Acute pancreatittis B. Toxic cholangitis. C. Bilirubinate stones in the gallbladder. D. Multiple small stones in the gallbladder. E. Dilated common bile duct. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №55
deal
A 60 year old woman mother of 6 children developed sudden onset of upper abdominal pain radiating to back, associated with nausea, vomiting, fever and chills. She noticed yellow discoloration of her sclera and skin. On physical examination the patient was found to be febril with temperature of 38.9C, along with right upper quadrant tenderness. Which nature of the jaundice is it possible to talk about? A. Infectious hepatitis . B. Hemoytic jaundice. C. Choledocholithiasis . D. Choledochal cyst. E. Ascariasis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №56
deal
A 75 year old man who had developed diabetes within last 6 months was found to be jaundiced. He has remained asymptomatic, expect for weight loss about 10 pounds in 6 months. On physical examination he is found to have a non- tender, globular, right upper quadrant mass that moves with respiration. A CT scan shows enlargement of the head of the pancreas, with no filling defects in the liver. Which of diagnosis among the following is true? A. Carcinoma of the head of the pancreas. B. Metastatic disease of the liver. C. Pancreatitis. D. Choledocholithiasis. E. Hemolytic jaundice. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №57
deal
Patient L., 38 years. Complaints about dull, aching pains in area of right hypochondria, permanent or arising up in 1-3 hours after the reception of abundant and especially fat food and fried dishes. Pain radiates upwards, in the region of right shoulder and neck. In addition, often disturbs feeling of bitter taste and metallic taste into the mouth, belch with air, flatulence. At palpation of abdomen tenderness in area of projection of gall bladder. A liver is not enlarged, a spleen not palpate. Your preliminary diagnosis: A. Acute cholecystitis. B. Chronic hepatitis. C. Cirrhosis of liver. D. Chronic cholecystitis. E. Acute hepatitis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №58
deal
A 70 years old woman had had a planned laparoscopic cholecystectomy done according biliary calculi. Six months later the patient again has attacks of severe pains in the right hypochondrium accompanied by jaundice and dark urine and stool discoloration. The total serum bilirubin is increased up to 60 mcmol/l, direct 40 mcmol/l. What disease does the patient have? A. Papillostenosis. B. Tumour of the pancreas head. C. Residual choledocholithiasis. D. Tumour of the large duodenal papilla. E. Choledochus stricture. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №59
deal
A 60 years old woman has been ill with chronic calculous cholecystitis for 10 years. During the treatment in sanatorium the patient had had a hepatic colic with jaundice. Ultra sound investigation revealed a lot of calculi sized 5-6 mm in the gallbladder. Choledochus is widened to 15 mm and contains concrements up to 6 mm in diameter in the distal part. What method of treatment is the most adequate and current? A. Cholecystectomy, choledochojejunostomy. B. Cholecystectomy, choledochoduodenostomy. C. Cholecystectomy, transduodenal papillosphincterotomy. D. Endoscopic papillosphincterotomy, laporoscopic cholecystectomy . E. Cholecystectomy, choledocholithotomy, external choledochus drainage according to Kerr. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №60
deal
A 58 years old woman with overweight night before has had an attack of right hypochondrium pain and jaundice with dark urine and stool discoloration appeared. On clinical examination the abdomen is distended and painful on palpation in the right hypochondrium, The mild liver enlargement there is. In blood the total bilirubin is 90 mkmol/l, direct (conjugated) 60 mkmol/l . What investigation is the most informative to clarify the diagnosis? A. Retrograde cholangiopancreatography . B. Intravenous cholegraphy. C. Infusional cholegraphy. D. Intracutaneous intrahepatic cholegraphy. E. Ultrasound investigation of the hepatopancreatobiliary zone. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №61
deal
A 62 years old woman complains of severe constant pain in the right hypochondrium, jaundice, discoloration of stool and dark urine, mild fever up to 37,5о С. Above mentioned complaints were appeared after an attack of severe abdomen pain connected with fatty food intake. On clinical examination the abdomen is soft. A painful enlarged gall bladder is palpated. The Orthner, Kerr’s symptoms are positive. What is the probable diagnosis? A. Liver cancer. B. Infectious hepatitis. C. Acute cholecystitis, choledochus calculi and obstructive jaundice. D. Liver abscess. E. Liver cirrhosis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №62
deal
A 45 years old woman was operated because of biliary calculi and obstructive jaundice. A two months later after operation there is continuing bile discharge up to 500,0-600,0 ml per day through the Kerr`s external choledochus drainage. On fistulography using the drainage in the distal part of the choledochus “a forgotten stount” up to 8 mm in diameter was identified. The choledochus is dilated up to 16 mm. The most correct surgeon treatment in this case is: A. Choledocholithotomy and drainage of the choledochus. B. Choledocholithotomy choledochojejunostomy. C. Choledocholithotomy choledochoduodenostomy. D. Choledocholithotomy with close seam on choledochus. E. Endoscopic papillosphincterotomy and removing a concrement from choledochus. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №63
deal
Patient Н, 44 years old, is hospitalized in surgical department with the diagnosis – of postcholecystectomic syndrome, residual choledocholithiasis, cholangitis, and mechanical jaundice. Operated 8 months back, done cholecystectomy, choledocholithotomy, drainage of abdomen according to Keru. What from of below-mentioned procedure would be appropriate to avoid occurrence of postcholecystectomic syndrome? A. Echography. B. Per oral Cholecystography. C. Intravenous Cholecystocholangiography D. X-ray of Abdomen. E. Intraoperative cholagiogrpahy. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №81
deal
The clinical picture of the patient who has the peptic ulcer of the duodenum in anamnesis has changed: the pains occur after meals, irradiate to the back, do not mix by atropine. Has had lost 6 kg of his body weight in half a year. The endoscopy detected the ulcer of the back duodenum bulb wall with dense margins, bulb deformation. Which factors can explain the patient’s changes in clinical course of the disease? A. Duodenostasis on the background of accompanying duodenitis. B. Ulcer perforation. C. Malignant change. D. Ulcer penetration. E. Pylorus stenosis. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №82 The 30 year old patient has been taking the intensive antiulcer therapy for 2 months concerning the firstly detected the peptic ulcer of the duodenum, but, despite that the ulcer defect has no the tendency to healing. What is the further treatment tactics? A. Continuation of conservative treatment. B. Bilrott I stomach resection. C. Selective proximal vagotomy. D. Bilrott II stomach resection. E. Trunk vagotomy with ulcer resection and pyloroplasty. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №83
deal
The 27 year old patient notices hungry pains in epigastrium and pains in 2 hours after eating, periodic nausea, loss of body weight for 6 months. The objective examination detected the preliminary diagnosis which is the peptic ulcer of the duodenum. Which is the most authentic method of research in this case? A. Reviewing roentgenography of the abdominal cavity. B. Fibrogastroduodenoscopy. C. Contrast roentgenoscopy of the gastrointestinal tract. D. Laparoscopy. E. Gastric juice analysis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №84
deal
The patient with a clinical picture of perforating ulcer of duodenum was hospitalized in the surgery unit. Which characteristic signs can be detected while doing the reviewing roentgenography of the abdominal cavity organs? A. Cloyber cups. B. Large intestine pneumothosis . C. Small intestine pneumothosis . D. Free gas under the diaphragm dome. E. Kerking folds. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №85 The 32-year-old patient with suspicion to perforating ulcer of duodenum was hospitalized in the surgery unit. He has never had an ulcer disease. It was impossible to prove or reject the perforation diagnosis with the help of roentgenological methods and gastroscopy. Which additional method of research is necessary to make? A. Computer tomography . B. Ultrasonic research of peritoneum cavity. C. Diagnostic laparotomy. D. Laparoscopy. E. Diagnostics with the help of thermovision camera. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №86
deal
The 32-year-old patient with perforating ulcer of duodenum was hospitalized. On operation it has been detected that the chronic ulcer of the anterior duodenum bulb wall perforates. Two hours have passed with the perforation moment. Which optimum operative intervention is necessary to do? A. Bilyot I stomach resection. B. Bilyot II stomach resection. C. Ulcer excision with pyloroplasty and vagotomy. D. Сlosure of the perforative ulcer. E. Ulcer excision with pyloroplasty. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №87
deal
The gastric secretion of the 50 year old patient was with suspicion on duodenum ulcer was researched with the help of maximal histamine test. The following results were received: ВАО - 21 m/h/l, МАО - 60 m/h/, рН - 0,5. What disease is characterized with these parameters? A. Stomach ulcer. B. Zollinger-Ellison syndrome. C. Duodenum ulcer . D. Ulcer –cancer of the stomach. E. Normal parameters of the gastric secretion. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №88
deal
The 42-year-old patient suffers from the duodenum peptic ulcer for 10 years. The character the disease case changed for the last 3 months. Some symptoms appeared: the feeling of weight in the stomach after meal, heartburn, often vomit, belch with a rotten smell, considerable weakness and loss of weight. Which complication is it possible to thought of? A. Stricture formation. B. Preforation. C. Malignization. D. Penetration. E. Bleeding. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №90
deal
The 65-year-old patient has been suffering from the peptic stomach ulcer for 10 years. The character of the disease case changed for the last half of the year. The pain syndrome decreased considerably, it is not connected with meals, no appetite, weakness appeared, and he lost his weight for 12-15 kg. the blood analysis shows: Нв-80 g/l, ESR -25 mm / hour. Which complication is it possible to thought of? A. Perforation. B. Malignization. C. Penetration. D. Bleeding. E. Stricture formation. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №91
deal
The 36-year-old patient with the duodenum peptic was hospitalized because of worse state of health. He complaints about vomit. Roentgenological research showed the stomach contrast delay up to 6 hours. What pylorostenosis stage is observed? A. Stenosis data are not presented. B. Subcompensation stage. C. Decompensation stage. D. A stage of relative compensation. E. Compensating stage. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №92
deal
The 45-year-old patient suffers from the duodenum peptic ulcer. He was hospitalized with getting worse state of health: weakness appearing, belch with a rotten smell, vomit. Roentgenological research showed the stomach contrast delay which is 14 hours. Which pylorostenosis stage is observed? A. Stenosis data are not presented. B. Compensating stage. C. Subcompensation stage. D. Decompensation stage. E. A stage of relative compensation. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №93
deal
The 40-year-old patient has been suffering from the duodenum peptic ulcer more than 5 years. He was hospitalized with getting worse state of health: weakness appearing, emaciation, constant nausea, vomit. Roentgenological research showed the stomach contrast delay, which is 25 hours. Which pylorostenosis stage is observed? A. Stenosis data are not presented. B. Compensating stage. C. Decompensation stage. D. Subcompensation stage. E. Stage of relative compensation. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №94
deal
A 50-year-old man comes to the emergency room with a history of vomiting of 3 days’ duration. His past history reveals that for approximately 20 years, he has been getting epigasric pain, lasting for 2 to 3 weeks, during early spring and autumn. He remembers getting relief from pain by taking milk and antacids. Physical examination showed a fullness in the epigastric area with visible peristalsis, absence of tenderness, and normal active bowel sounds. The most likely diagnosis is: A. Small bowel obstruction. B. Volvulus of the colon. C. Cancer of the stomach. D. Incarcerated umbilical hernia. E. Gastric outlet obstruction. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №95
deal
The 36-year-old patient with perforating ulcer of stomach was hospitalized. On operation it has been detected that the chronic ulcer of the lesser curvature of stomach perforates. Two hours have passed with the perforation moment. Which optimum operative intervention is necessary to do? A. Bilyot I stomach resection. B. Bilyot II stomach resection. C. Ulcer excision with pyloroplasty and vagotomy. D. Сlosure of the perforative ulcer. E. Ulcer excision. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №96
deal
The 36-year-old patient with perforating ulcer of stomach was hospitalized. On examination in a semisitting position the liver dullness disappears in the mid clavicular line.Which symptom of perforating ulcer is positive ? A. Spigarnogo. B. Dzubanovsky. C. Bernshtein. D. Mendels. E. Kylenkampha. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №97
deal
In patient with clinical presentation of peptic ulcer, by percussion is defined zone tenderness under xiphoid process. Which name of this symptom? A. Bernshtein. B. Mendels. C Dzubanovsky. D. Spigarnogo. E. Kylenkampha. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №98
deal
Which after the operative treatments on stomach more often have meet pathological syndromes? A. Bilyot I stomach resection. B. Bilyot II stomach resection. C. Big partial distal gastrectomy D. Different kinds vagal section. E. Stomach drainch operations. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №99
deal
Which of the listed below opertion are not done in cases of perforative duodenal ulcers ? A. Suturing of the ulcer. B. Vagotomy + resection of the ulcer. C. Vagotomy + Pyloroantrumectomy D. Resection of 2/3 - 3/4 of the stomach. E. Gastrostomy. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №100
deal
What from the listed operations in treatment of ulcer of stomach and duodenum is carried out only under emergency indications? A. Resection of stomach by Bilrot I. B. Resection of stomach by Bilrot II. C. Sewing up perforative ulcer. D. Selective proximal vagotomy E. Truncal vagotomy with pyloroplastic. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №101
deal
Patient P., 45 y.o. was delivered by an ambulance with complaints of pain in the epigastrium, vomit at the height of pain with impurity of blood; heartburn, weakness, dizziness, “black” stool in the morning. He has been ill for 10 years, nutrition is irregular. What complication has developed in the patient? A. Thrombocytopenia. B. Bleeding from hemorrhoidal veins. C. Bleeding from esophageal veins. D. Gastric bleeding. E. Intestinal bleeding. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №102
deal
For objective characteristics of degree severity of the dumping syndrome are possible to use: A. Measure pulse, BP, volume of blood circulation, time reaction period. B. Underweight body, ability to work, anamnesis, complaint. C. ECG, spirogram, blood sugar. D. Character undergo surgery. E. Рroteins of blood serum, сoagulogram, electrolytes of blood serum. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №103
deal
A sick man, who is 43, started to complain to his therapeutist about the heaviness in the stomach after a meal, bad belch, vomiting with food, he had eaten the day before. He has suffered from ulcer of duodenum for 10 years. He has applied to the doctor (therapeutist) two times but he started to feel worse last month. What pathology must it be? A. Gullet cancer. B. Ulcerous stenosis of the exit part of the gullet. C. Stomach cancer. D. Ahalaziya of the gullet. E. Reactive pancreatitis. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №104
deal
The 52 years old patient has been admitted to the hospital. He complains of vomiting, soft black repeated stools (melena) during the day. Such cases have never been before. The pulse rate is 96 beats per minute, the blood pressure 100/70 mm Hg. On finger examination of the rectum there was found black feces. The appropriate examining is: A. Roentgenoscopy of the stomac. B. Rectoromanoscopy. C. Irrigoscopy. D. Esophagogastroduodenoscopy. E. Laparoscopy. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №105
deal
Patient K, 42 years old, is hospitalized in surgical department with complaints of acute sharp pain in the stomach, vomiting. Suffering from a duodenal ulcer for last 8 years. Suspected as a Duodenal Perforation, however free gas in abdominal cavity is not revealed. The ulcer is suspected as covered perforation. What method of diagnosis should be applied for correct diagnosis? A. Fibrogastroscopy. B. Contrast (dye) investigation of stomach and duodenum. C. Laparosynthesis. D. Pneumogastrography. E. Pneumoperitoneum. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №106
deal
Patient B. 74 years old is hospitalized in surgical department with the diagnosis of perforated stomach ulcer. In the anamnesis heart attack of a myocardium, diabetes, Hypertension. The patient was advised for operation, which patient categorically refused. How to treat the patient? A. Antibacterial therapy B. Taylor’s Method. C. Infusion therapy. D. Start antiulcer Therapy. E. Discharge the patient. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №107
deal
65 years old patient had been on observation for 5 years concerning an ulcer of antral part of a stomach. Patient refused operation. Since last 6 months patient is having constant pain in the epigastric region. Disgust to meat products has appeared. Working capacity has decreased. The patient has become thin. In contrast examination of the stomach circular form of defect of a mucous membrane up to 5 sm. in diameter and aperistaltic zone is revealed. What is an effective method of verification of the diagnosis? A. Fibrogastroduedenoscopy with biopsy B. Ultra sonogram. C. Pneumoperitoneum. D. Roentgenoscopy of Stomach. E. ERCP. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №108
deal
38 years old man suffering form duodenal ulcer for long time, patient start feeling constant heaviness in a stomach after meal, regurgitation, vomiting food contains which he had in the evening of the previous day, weight loss. Objectively: Relatively satisfactory condition of the patient, appetite not changed, Turgor of skin is reduced. On palpation the stomach is soft, symptoms of irritation of abdomen is not present, “noise of splash “in epigastria region. Urinations normal. Stool once in 3 days. What complication has occurred in the patient? A. The covered perforation of an ulcer. B. Cancer of a stomach. C. Achalasia, esophagitis. D. Acute pancreatitis. E. An ulcerative stenosis of pyloric canal. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №121
deal
A patient with the complaints on stroking pain in the stomach, nausea, constipation was hospitalized in the unit. What disease does the patient have? A. Acute intestinal obstruction. B. Acute pancreatittis. C. Acute appendicitis D. Perforative ulcer. E. Acute cholecystitis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №122
deal
The lumen of the large intestine is closed with fecal stone. What kind of intestinal obstruction is that? A. Mixed. B. Paralytical. C. Strangulational. D. Spastic. E. Obturational. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №123 Volvulus. What kind of obstruction is that?
deal
A. Obturational. B. Mixed. C. Paralytical. D. Strangulational. E. Spastic. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №124
Peritoneal commissures. What kind of obstruction is that? A. Obturational. B. Mixed. C. Paralytical. D. Strangulational. E. Spastic. The head of the department, professor
V.I. Bondarev
deal
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №125
deal
A 75-year-old patient was operated concerning the acute intestine obstruction. The incarcerated loop of the jejunum of a dark blue colour was founded while revising the intestine. There is no peristalsis, the vessels pulsation of mesentery is absent. What does the surgeon have to do? A. Finish the operation. B. Drainage the peritoneum cavity. C. Resect a part of the small intestine. D. Carry out the inturbation of the small intestine. E. Take in the peritoneum cavity tightly. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №126
deal
Choose correct tactics at the patient of 53 years of age at the initial stage of obturative intestinal obstruction A. Nasogastral intubation. B. Scheduled operation. C. Emergency operation. D. Only conservative treatment. E. Operative treatment at an inefficiency of conservative actions. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №127
deal
Classical X-ray image of intestinal obstrustion is: A. Filling defect. B. Gas and horizontal levels. C. High positioned diaphragm. D. Reactive pleuritis. E. Pneumatosis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №128
deal
The patient, 43 years old is hospitalized with complaints of repeated vomiting, spasmodic pain in the abdomen, delay in passes of gases and stool. History of the patient - appendectomy. Objectively: Position of the patient -lying, pale skin. Pulse 90/ minutes. Blood Pressure 110/80 mm. Hg, t - 37, 2 oc Moderately distended abdomen, asymmetric, rigidity on the lower part of the abdomen. Increased peristalsis. Rebound tenderness- negative (Shetkina- Blumberg). Manual per rectum analysis of rectum- empty ampoule. Your diagnosis? A. Hepatic Colic. B. Acute pancreatitis. C. Hepatic Colic. D. Acute intestinal obstruction. E. Food poisoning. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №129 Hospitalized patients with complaints of colicky abdominal pain, nausea, repeated vomiting. Has a history of three operations on the abdominal organs. What is the cause of the disease? A Adhesive process in the abdominal cavity. B Tumor intestine. C Helminthic invasion. D Intussusception. E Ulcerative colitis. The head of the department, professor V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №130
deal
In ward is hospitalized a patient with complaints of colicky abdominal pain, nausea and repeated vomiting. At the Review of X-Ray of the abdominal cavity in a patient are seen cups of Kloyber . What is the diagnosis in a patient? A Acute pancreatitis. B Acute appendicitis. C Acute peritonitis. D Acute cholecystitis. E Acute intestinal obstruction. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №131 In the surgical department is hospitalized a patient complaining of constant abdominal pain, nausea and no passing of flatus and stool. On examination, attention is drawn to a large oblique abdomen. In the rectum is placed not more than 400,0 ml of liquid during enema. Which symptom is positive in the patient? A Symptom Obukhovskii hospital. B Symptom Obraztsova. C Symptom "falling drop". D Symptom Tsege-Manteuffel. E Symptom Bartome-Michelson. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №132
deal
In the ward is hospitalized patient with complaints of persistent pain in abdomen, regularly increasing, nausea, repeated vomiting. Has a history of three operations on the abdominal organs. Palpation defines dilatated loops of intestine over which is auscultated splashing sound. What kind of context we are talking about? A Strangulated obstruction. B Spasmodic obstruction. C Acute adhesive intestinal obstruction. D Paralytic obstruction. E Obstructive obstruction. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I
deal
Educational discipline TASK №133
surgery
In the ward hospitalized patient with complaints of persistent pain in abdomen, regularly increasing, nausea and repeated vomiting. In the history of three operations on the abdominal organs. Palpation is determined by the dilatated loop of intestine over which is auscultated splashing sound. Which symptom is positive in the patient? A Symptom Obraztsova. B Symptom Sklyarov. C Symptom Obukhovskii hospital. D Symptom Bartome-Michelson. E Symptom "falling drop". The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №134
deal
Elderly patient operated on for acute intestinal obstruction. On the audit is found strangulated intestinal jejunal loop of dark blue colour, no peristalsis, pulsation in vessels of mesentery is absent. Gut defined nonviable, name the proximal limits of resection? A 15-20 cm from the visible border of necrosis. B 20-25 cm from the visible border of necrosis. C 30-40 cm from the visible border of necrosis. D 50-70 cm from the visible border of necrosis. E 40-60 cm from the visible border of necrosis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №135
deal
Elderly patient operated on for acute intestinal obstruction. When the audit found subnormal intestinal jejunal loop in dark blue, no peristalsis, pulsation in vessels of mesentery is absent. Gut defined nonviable; tell the distal limits of resection? A 15-20 cm from the visible border of necrosis. B 10-15 cm from the visible border of necrosis. C 20-25 cm from the visible border of necrosis. D 40-60 cm from the visible border of necrosis. E 50-70 cm from the visible border of necrosis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №136
deal
The patient made an X-ray overview of abdominal cavity which defines the cups of Kloyber low and wide. Which disease it resembles? A Invagination B Large intestinal obstruction. C Small-Large intestinal obstruction. D Small Intestinal obstruction. E Acute peritonitis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №137
deal
In the ward is hospitalized a patient with complaints of persistent pain in his stomach periodically increasing, nausea and repeated vomiting. An objective examination is determined by the asymmetry, oblique abdomen. What is the symptom is positive in the patient?
A Symptom Bayer. B Symptom Obraztsova. C Symptom "falling drop". D Symptom Obukhovskii hospital. E Symptom Sklyarov. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №138
deal
Patient, who was hospitalized with a diagnosis of AIO notes rapid weight loss (12 kg for 2 months), weakness, and the periodicity of blood in the stool. What cause should the surgeon consider? A Peritoneal commissures B Helminthic invasion. C Tumor of intestine. D Non-specific ulcerative colitis. E Fecalith. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №139
deal
The patient, who was hospitalized with a diagnosis of AIO suspected tumor of the colon. What is a more informative study should be conducted to clarify the diagnosis? A Irrigography. B Ultrasound C Scan intestine.
D Selective angiography. E Intestinography. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №140
deal
Patient 15 years old, complained of cramping abdominal pain, nausea and vomiting. During PR is found bleeding secretion. What context we are talking about? A Wrapping sigmoid B Acute intussusception. C Acute peritonitis. D Acute appendicitis. E Acute destructive pancreatitis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №141
deal
The patient had had a resection of the small intestine following the adhesive intestinal obstruction. What method of intubation is the most appropriate? A Caeco enterostomy. B Enterotomy with a single decompression. C Apendeco-caeco enterostomy. D Gastroenterostomy. E Naso-gastrointestinal. The head of the department,
professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №142
deal
The patient complains of blurred constant abdominal pain, nausea, and frequent vomiting , absence of flatus and stools. Has a history of abdominal trauma. On objective examination is determined a uniform distension with absent peristalsis. On X-Ray is seen the distention of whole intestine that contains a lot of gas. What context we are talking? A Acute adhesive intestinal obstruction. B Paralytic obstruction. C Spasmodic obstruction. D Strangulated obstruction. E Obstructive ileus. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №143
deal
What treatment strategy should select the treatment of paralytic intestinal obstruction? A Decompression of the stomach, ganglioplegic, infusion therapy, anticholinergic drugs. B Decompression of the stomach, analgesics, infusion therapy, perirenal blockage and prompt intervention. C Decompression of the stomach, infusion therapy, urgent surgical interventions. D Decompression of the stomach, infusion therapy and scheduled surgery. E Decompression of the stomach, analgesics, infusion therapy, spasmolytics. The head of the department, professor V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №144
deal
The patient complains of sharp colicky abdominal pain, repeated vomiting, absence of stools and flatus. Has a history of abdominal trauma. On objective examination is determined by a soft belly, not distended, hyper peristalsis. In overview radiography no cups of Kloyber are seen. What context we are talking? A Paralytic obstruction. B Acute adhesive intestinal obstruction. C Strangulated obstruction. D Spasmodic obstruction. E Obstructive ileus. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №145
deal
What treatment strategy should we choose in the treatment of spastic intestinal obstruction? A Decompression of the stomach, analgesics, infusion therapy, spasmolytics. B Decompression of the stomach, ganglioplegic, infusion therapy, anticholinergic drugs. C Decompression of the stomach, infusion therapy, urgent surgical interventions. D Decompression of the stomach, infusion therapy and scheduled surgery. E Decompression of the stomach, analgesics, infusion therapy, perirenal blockage and prompt intervention. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №146
deal
In the development of the pathological process of acute intestinal obstruction for VP Petrov and AN Eryuhinim distinguished the first stage, which is called? A Stage of acute intestinal disorders intraluminal hemo-circulation. B Stage of peritonitis. C Stage of acute violations in intestinal passage. D Stage of an imaginary being. E Stage of shock. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №147
deal
In the development of the pathological process of acute intestinal obstruction for VP Petrov and AN Eryuhinim allocate the second stage, which is called? A Stage of an imaginary being. B Stage of peritonitis. C Stage of acute violations in intestinal passage. D Stage of acute intestinal disorders intraluminal hemo-circulation. E Stage of shock. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University
Faculty
medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №148
deal
In the development of the pathological process of acute intestinal obstruction for VP Petrov and AN Eryuhinim emit the third stage, which is called? A Stage of peritonitis B Stage of acute intestinal disorders intraluminal hemo-circulation. C Stage of acute violations in intestinal passage. D Stage of an imaginary being. E Stage of shock. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №149
deal
The most important and typical symptoms of mechanical intestinal obstruction is? A Headache, nausea, thirst, repeated vomiting, a delay of stool and gas. B Thirst, repeated vomiting, headache. C The nausea, thirst, repeated vomiting, delayed stool feces and gas. D Dry mouth, colicky pain, thirst, abdominal distension. E Colicky pain, delay of stool and gas, bloating distention. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University
Faculty
medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №161
deal
A nonalcoholic 45-year-old woman presents with an asymptomatic, septated 10-cm cystic mass in the body of the pancreas. She should be advised that: A. Drainage by Roux-en-Y jejunostomy is indicated. B. Complete excision of the lesion is indicated. C. The lesion is probably benign and requires observation only. D. It is cancerous and she will likely die from it in 12 months. E. Total pancreatectomy is the preferred surgical management. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №162
deal
A 24-year-old law student is brought into the emergency room complaining of severe abdominal pain of 6-8 hours duration. He had been to a party the night before. The pain is in the epigastrium radiating to the back and is associated with nausea. Clinical examination reveals an anxious, acutely ill youth with a regular pulse rate of 100/min, blood pressure og 100/70 mm Hg. The most likely diagnosis is: ? A. Acute cholecystitis. B. Acute pancreatitis. C. Acute appendicitis. D. Mesenteric adenitis. E. Acute diverticulitis. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University
Faculty
medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №163
deal
Аt the time of emergency diagnostic laparoscopy in the patient in abdominal cavity revealed serosanguineous liquid, plaques on the greater omentum. About what disease should be think? A. Acute cholecystitis. B. Acute appendicitis. C. Mesenteric adenitis. D. Acute pancreatitis. E. Acute diverticulitis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №164
deal
Patient complains of the persistent ache in the abdomen by type "surrounding belt pain ", nausea, vomiting. About which disease this is speaking? A. Acute cholecystitis. B. Acute pancreatitis. C. Acute appendicitis. D. Myocardial infarction. E. Acute intestinal obstruction. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №165
deal
In patient there is tenderness in the left costovertebral angle. Is this symptom of? A. Chyhrienko. B. Muyssi-Georgievsky. C. Kerte. D. Meyo-Robson. E. Kera. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №166
deal
A 38 years old woman was hospitalized to the surgical unit with acute abdominal pain irradiating to the spine and vomiting. On laparocentesis hemmorhagic fluid is obtained. What disease is suspected? A. Acute cholecystitis. B. Renal colic. C. Perforative gastric ulcer . D. Acute pancreatitis. E. Acute appendicitis. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №167
deal
In the patient with acute pancreatitis has determinated diagnosis of the fermentative peritonitis. Which measures it needs to do? A. Emergency laparotomy. B. Laparoscopy, drainage of the abdominal cavity C. Case monitoring. D. Laparocentesis. E. Peritoneal tap The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №168
Contraindications for operation in acute pancreatitis are: A. Functional insufficiency of the parenchymatous organs. B. Purulent and septic complications. C. Peritonitis. D. Erosive bleeding. E. Hemodynamic unstability and pancreatogenic shock. The head of the department, professor
V.I. Bondarev
deal
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №169
deal
The patient, who was hospitalized in a surgical clinic, there are following changes in laboratory parameters: L - 14 x 109 / l, R - 8%, with S -74%, ESR - 22 mm / h, bilirubin - 32 mmol / L, amylase - 36 g / ghl. Urine: specific gravity - 1024, L - 2-4 in the view, protein 0,033 g / l, amylase - 256 g / l. Which disease indicate these changes? A Acute cholecystitis. B Acute pancreatitis. C Acute intestinal obstruction. D Perforated ulcer KDP. E Acute hepatitis. The head of the department, professor V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №170
deal
In the surgical clinic is hospitalized patients, whose index level of trypsin in the blood was 62 ng / ml. What kind of disease indicates this figure? A Acute cholecystitis. B Acute pancreatitis. C Acute intestinal obstruction. D Myocardial infarction. E Acute hepatitis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I
deal
Educational discipline TASK №171
surgery
In the ward is admitted a patient 58 years of age with intense epigastric pain and mesogastrium. Level of serum calcium was 1.8 mmol / liter. What kind of disease is shown? A Acute cholecystitis. B Acute myocardial infarction. C Acute intestinal obstruction. D Acute pancreatitis. E Mesenteric thrombosis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №172
deal
During emergency diagnostic laparoscopy in a patient in the abdominal cavity revealed serous-hemorrhagic fluid, petechial lesions on the greater omentum. What kind of disease should think? A Acute pancreatitis. B Acute intestinal obstruction. C Mesenteric thrombosis. D Perforated ulcer. E Acute cholecystitis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №173
deal
The patient was diagnosed: acute pancreatitis. Which of narcotic analgesics you prefer? A Morphine. B Omnopon. C Promedol. D No-pen. E Dihydrocodeine. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №174
deal
The patient operated on for acute destructive pancreatitis two days ago suddenly came and collapsed, the fall of hemodynamics. P - 110 per minute. BP= 90/60 mm Hg Hp - 90 g / liter.E: 2,8 x 109 / l, L,T - 0,28. What complication arose? A Perforation of the stomach. B Myocardial infarction. C Cardiac intestine. D Erosive bleeding. E Thromboembolism ventral trunk. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №175 In the surgical department of hospitalized patients with acute
deal
pancreatitis. What steps need to be taken in the first place? A Drainage stomach (SD). B SD + Urinary bladder drainage (DUB) +CV Line C LH + DUB + enema. D CV Line + SD + DUB + enema. E SD + enema. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №176
deal
Patient with acute pancreatitis is developing thromboembolic predisposition. What protease inhibitors is contraindicated ? A Contrical. B 5-fluorouracil. C Trasylol. D Asprin E Tselol. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №177
deal
The patient complains of constant pain in the abdomen of type "surrounding belt pain ", nausea, vomiting. What kind of disease does it mean? A Acute cholecystitis.
B Acute pancreatitis. C Perforated ulcer. D Myocardial infarction. E Acute intestinal obstruction. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №178
deal
The patient has developed pain in the left edge of costa-vertebral angle. This is a symptom? A Chuhrienko. B Musset-Georgievskogo. C Kurt D Mayo-Robson. E Kera. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №179
deal
When seen radiography of the abdominal cavity identified: swelling of the transverse colon, the absence of the contour of the left lumbar, reducing the mobility of the left dome of the diaphragm. What kind of disease showed these signs? A Acute intestinal obstruction. B Perforated ulcer. C Acute pancreatitis.
D Mesenteric thrombosis. E Acute cholecystitis. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №180
deal
In a patient during laparotomy was found edematous acute pancreatitis. What kind of intervention on the pancreas need to perform? A Resection of the pancreas. B Omento pancreatopecsia. C Abdominisation of the pancreas. D Operation on the pancreas. E Marsupialization. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №181
deal
At laparotomy was found purulent pancreatitis. What access to the pancreas, is the most optimal? A Through the back of small omentum. B Through Winslow's foramen. C Through mesentery of the colon. D From gastrocolic. E From lumbotomy.
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №182
deal
The patient on the operation was found caudal fat necrosis. What kind of surgery should be? A Necrectomy. B Sequestrectomy. C Drainage of necrosed space. D Resection of the tail of the pancreas. E Marsupialization. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №183
A Patient with acute pancreatitis is diagnosed with enzymatic peritonitis. What steps need to be done? A Emergency laparotomy. B Dynamic observation. C Laparoscopy, drainage of the abdominal cavity. D Celiocentesis. E Punctured the abdominal cavity.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №201
deal
Mammary glands settle down at which level? A. From 1 to 5 rib B. From 2 to 5 ribs. C. From 2 to 4 ribs. D. From 3 to 6 ribs. E. From 3 to 4 ribs. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №202
The lactation after partus begins under the influence of hormones: A. Lactation hormone and Oxytocin. B. Progesterone and FSH. C. Cortisone and lactation hormone. D. Cortisone. E. progesterone.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №203
deal
The polythelia is: A.Partial absence of the gland. B. Full absence of the gland. C. Aplasia of one gland and hyperplasia of other gland. D. Increase of the quantities of nipples. E. Increase of the quantity of mammary glands. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №204
Surgical treatment of an acute mastitis is shown in a development phase: A. Serous. B. Infiltrative. C. Abscessed. D. Phlegmonous. E. Serous and infiltrative.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №205
deal
The most informative method of diagnostics of a cancer of a mammary gland is: A. Computer tomography. B. Mammography. C. Paracentetic biopsy. D. Clinical survey. E. Nuclear magnetic resonance. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №206
Systematic condition when chronic mastitis: A. Satisfactory. B. Middle severity. C. Severe D. Extremely severe. E. The agonal.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №207
deal
Character of an infiltrate at the chronic mastitis: A. Hard, little pain. B. Hard, sharp pain. C. Softened or soft. D. Separate ramollissements in an infiltrate. E. Softened, sharp pain. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №208
The polymastia is: A. Unilateral absence of mammary glands. B. Full absence of glands. C. Increase of quantity of papillas. D. Enlarge of the size of glands. E. Increase quantities of mammary glands.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №209
deal
The chronic nonspecific mastitis is: A. Natural consequence of an acute mastitis. B. Сonsequence of unsatisfactory treatment of acute process C. The special form of a mastitis. D. Does not exist as disease. E. Endocrinologic disease. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №210
The major method of treatment of an acute purulent mastitis is: A. Decantation of milk. B. Incision and abscess drainage. C. Antibiotic Therapy. D. Physiotherapeutic procedures. E. Symptomatic treatment.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №211
deal
Body temperature characteristic for the acute infiltrative mastitis: A. The normal. B. Subfebrile. C. High, the temperature curve of Hectic type. D. The febrile. E. The hyperpyrexial. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №212
deal
Colour of the skin over an infiltrate characteristic for the acute infiltrative mastitis. A. White-green colours. B. Hyperemia. C. Hyperemia with a cyanochronic shade. D. Normal colours. E. Pink colour.
The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №213 Each mammary gland develops from:
deal
A 1-5 lobes. B 5-10 lobes. C 15-20 a lobe. D 25-30 lobes. E 30-40 lobes. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №214
deal
Benign tumours and malignant tumours of the mammary gland most commonly are developing in: A Additional mammary glands. B Underdeveloped mammary glands. C Hypertrophy of the mammary glands. D All the above listed. E None of the above case
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №215
deal
Incise the subcutaneous abscess of the mammary gland: A Arched. B Radial. B Under the mammary gland. C Oval. D Similar to «V»shape. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №216
Gynecomastia it is: A Dishormonal disease of the mammary glands of the women. B Dishormonal disease of the mammary glands of the men. C Tumours of the mammary glands. D Disease of closed glands. E Purulent inflammation of mammary glands.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №217
deal
Body temperature characteristic for an acute abscessing mastitis: A Normal. B Subfebrile. C Febrile. D All listed. E High, the temperature curve of hectic type. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №218
deal
Colour of the skin over an infiltrate characteristic for an abscessing mastitis: A The normal. B Hyperemia. C Acyanotically - green. D Hyperemia with a cyanochroic tint. E As the geographical map.
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №219
deal
How many ducts the mammary gland lobe has? A 1 ducts. B 2 ducts. C 3 ducts. D 4 ducts. E 5 ducts. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №220
Hypomastia it is: A Descent of mammary glands. B Absence of mammary glands. C Enlargement of mammary glands. D Excalation of the mammary glands. E The separate form of the mastitis.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №221
deal
Cut when retromammary position of the mammary gland abscess: A The radial. B The arched. C Under the mammary. D V-like. E The oval. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №222
Benign tumor of the mammary gland: A Fibroadenoma B Adenoma C Papilloma D Lipoma E All of the above.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №223
deal
Body temperature characteristic for a phlegmonous stage of the mastitis: A Normal. B Subfebrile. C Febrile. D High, a temperature curve of the constant type. E High, the temperature curve of hectic type. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №224
Colour of a skin over an infiltrate at the phlegmonous stage of the mastitis: A Normal. B Hyperemia. C Hyperemia with a cyanochroic shade. D Acyanotically - green colour. E Acyanotic colour.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №225
deal
Lobar milk ducts are opened: A Directly on nipples apex. B In central ducts of the gland basis. C In central ducts in the middle part of the duct. D In segmentary ducts. E In central ducts on each side glands. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №226
The main tracks of a lymph drainage from the mammary gland: A Axillary. B Parasternal. C Subclavial. D Supraclavicular. E All of the above.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №227
deal
Mastoptosis it is: A Underdevelopment of the mammary glands. B Descent of the mammary glands. C Enlargement of the mammary glands. D Tumour of mammary glands. E Absence of mammary glands. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №228
Incesion for periareolar and a subareolar abscess of the mammary gland: A Radial. B Arched on areola edge. C Under the mammary gland. D V-like. E Oval.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №229
deal
Clinical signs of an acute mastitis: A Large stippling of the mammary gland. B Skin in a kind of "a orange crust" over tumorous formation. C Sharply painful infiltrate in the mammary gland with a dermahemia. D Presence tumorous formation with accurate contours. E Presence tumorous formation with indistinct contours. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №230
Choose precancerous disease of the mammary gland: A Fibrosing adenosis. B Hypomastia. C Polythelia. D Acute milk fever. E Cystic disease.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №231
deal
Body temperature, characteristic for the acute gangrenous mastitis: A Normal. B Subfebrile. C High, the temperature curve of constant type. D High, the temperature curve of pyretic type. E None of the above. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №232
Color skin over the infiltrate when the acute gangrenous mastitis: A Normal. B Hyperemia. C Hyperemia with a cyanochroic shade. D Pale - green colour. E Acyanotic colour.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №233
deal
Hypermastia is: A Underdevelopment of the mammary glands. B Enlargement of the mammary glands. C Ptosis of the mammary glands. D Augmentation of quantity of mammary glands. E Absence of mammary glands. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №234
Incesion when retromammary mastitis: A Arched subareolar. B Under the mammary gland. C Radial. D V-like. E The oval.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №235
deal
Treatment of the acute milk fever: A Sectoral resection of a mammary gland. B Mastectomy. C Roentgenotherapy, chemotherapy. D Drain of abscess E Conservative. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №236
Body temperature, characteristic for the chronic mastitis: A Normal. B Subfebrile. C Febrile. D High, a temperature curve of the constant type. E High, a temperature curve pyretic type.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №237
deal
Color of the skin over an infiltrate, characteristic for the chronic mastitis: A Unchanged. B Hyperemia. C Hyperemia with a cyanochroic shade. D Acyanotically - green colour. E None of the above. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №238
The basic function of a mammary gland: A Synthesis and milk secretion. B Synthesis and resorption of the milk. C Synthesis and milk reabsorption. D Milk secretion. E Secretion and milk reabsorption.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №239
deal
Special investigation of the mammary gland concern: A Mammography. B Thermography. C Ultrasound investigation. D The cytologic research of a punctate or abjections. E Аll the above listed. The head of the department, professor
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №240
Additional mammary glands are subject to treatment: A Medicamental. B Harmonal. C Radial therapy. D Surgical. E All listed.
V.I. Bondarev
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №241
deal
The anterior lobe of pituitary secreates which hormone: A Progesterone and Folliculinum. B Thyreoidinum and hydrocortisone. C Follicular stimulating hormone and luteinizing hormone D Progesterone and hydrocortisone. E Thyreoidinum and Foliculinum. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №242
Amastia it is: A Partial absence of the gland. B Full absence of the glands. C Aplasia of one gland and hyperplasia of the second. D Increase of the quantity of the mammary glands. E Descent of the mammary glands.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №243
deal
Mastitis it is: A Mammary gland damage. B Tumoral disease of the mammary gland. C Inflammatory disease of the mammary gland. D Anomaly of development. E There are not true answer. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №244
Monomastia it is: A Unilateral absence of glands. B Full absence of glands. C Aplasia of one gland and hyperplasia of other gland. D Increase of quantity of nipples. E Ptosis of mammary glands.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №245
deal
The milk fever arises more often: A During pregnancy. B At the time of labour. C In lactation period. D On not feeding women. E All the above listed. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №246
The mammary gland is enlarged, swells: A In period before menses. B In period after menses. C During both processes. D Does not variate in connection with a menses. E In the climacteric period.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №251
deal
The patient during laparotomy is found with perforated appendicitis, acute spilled peritonitis. How we should drain the abdominal cavity? A Through a single point. B Through two points. C Through four points. D Through three points. E Should not drain. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №252
deal
A 65 year old patient with diffused purulent peritonitis during laparotomy revealed perforation of a chronic duodenal ulcer. What kind of operation in terms of peritonitis should be? A Excision of ulcer, pyloroplasty. B Suturing of ulcer. C Excision of ulcer, pyloroplasty, TAV (Truncal abdominal vagotomy). D Excision of ulcer, pyloroplasty, STV (selective total vagotomy). E Excision of ulcer, pyloroplasty, HSV ((Highly selective vagotomy). The head of the department, professor V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №253
deal
The patient diagnosed with acute diffuse peritonitis, the stage of multiorgan failure. What changes will occur among the globulins? A Increased beta levels and reduction of gamma fractions. B Reduction of beta and gamma fractions. C Reduction of beta but increase of gamma fractions. D Increase of both beta and gamma fractions. E No changes will be noticed. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №254
deal
The patient under peridural anesthesia during laparotomy found perforated appendicitis; acute poured peritonitis .which sequence of actions should be taken? A Removal of exudate and the source of peritonitis, sanitation of abdominal cavity, decompression of intestine, drainage of the abdominal cavity. B Removal of exudate and the source of peritonitis, decompression of intestine, drainage of the abdominal cavity. C Removal of exudate and the source of peritonitis, mesenteric novocaine blockade of the intestine, sanitation of abdominal cavity, decompression of intestine, drainage of the abdominal cavity. D Removal of exudate and the source of peritonitis, drainage of the abdominal cavity. E Remove the source of peritonitis, sanitation and drainage of the abdominal cavity. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №255
deal
In ward is brought a patient in toxic stage of acute peritonitis. How much by time duration is a toxic phase? A Up to 6 hours. B Up to 12 hours. C Up to 24 hours. D 25 - 48 hours. E More than 48 hours. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №256
deal
The patient diagnosed with acute diffuse peritonitis, in the stage of multiple organ failure, with negative CVP (central venous pressure), with CBV (central blood volume) deficit of 25%. Where is the liquid moving? A Interstitial tissue space. B In the cell. C In Intestine. D In the intercellular space. E In the abdominal cavity. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №257
deal
In patient 75 years old with the presence of cardio-pulmonary disease is diagnosed with acute diffuse peritonitis, toxic phase. What kind of intubation of the intestine should not be done? A Thru gastrostomy. B Thru ileostomy. C Nasogastric. D Thru colostomy. E Thru the rectum. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №258
deal
The patient is diagnosed with acute diffuse peritonitis, in the stage of multiple organ failure. What changes will occur among the CIC (circulating immuno complex)? A A significant increase in CIC. B A slight increase in CIC. C No changes will be seen. D A slight decrease in the CIC. E A significant reduction in the CIC. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №259
deal
In patient 75 years with the presence of cardio-pulmonary disease diagnosed with acute diffuse peritonitis, toxic phase. Tell the contraindications to nasogastric intubation? A. Cardio-pulmonary insufficiency. # Hepatic failure. # Adrenal insufficiency. # Renal failure. # Multiple organ failure. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №259
deal
In patient 75 years with the presence of cardio-pulmonary disease diagnosed with acute diffuse peritonitis, toxic phase. Tell the contraindications to nasogastric intubation? A Cardio-pulmonary insufficiency. B Hepatic failure. C Adrenal insufficiency. D Renal failure. E Multiple organ failure. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №260
deal
The patient operated on for acute diffuse peritonitis, the postoperative period was al right. What is the indication to remove the endotracheal tube?
A Reduced blood leukocytes. B Normalization of body temperature. C Reduction in tachycardia. D Normalization of BP. E Normalization of bowel sounds. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №261
deal
Patient with acute diffuse peritonitis should conduct antibacterial therapy. In what means the introduction of the antibiotic will be most prolonged effect? A Intravenously. B Intraabdominal. C Endolymphatic. D Intros. E Intraarterial. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №262
deal
The patient may be diagnosed after laparotomy: primary peritonitis. In what percentage of total cases, primary peritonitis occurs? A 1%
B 2 - 5% C 6 - 10% D 11 - 15% E 16 - 20% The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №263
deal
The patient is aged 35, diagnosed with diffuse peritonitis at laparotomy revealed perforation of a chronic duodenal ulcer. What kind of operation in these circumstances we need to do? A Suturing of ulcer. B Excision of ulcer, pyloroplasty. C Excision of ulcer, pyloroplasty, TAV (Truncal abdominal vagotomy). D Excision of ulcer, pyloroplasty, STV (selective total vagotomy). E Excision of ulcer, pyloroplasty, HSV (Highly selective vagotomy). The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №264 The total area of the peritoneum in a human is: A 1000 cm2. B 1500 cm2. C The area of the skin. D 500 cm2. E 700 cm2.
deal
The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №265
deal
The patient after appendectomy for 9 days abscess. With what access should the diagnosed pelvic abscess should be opened? A Inferior midline laparotomy. B By Pfannenstiel. C By Pirogov. D Through the rectum. E Through access by Volkovych - Diakonov. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №266
deal
In the ward is brought a patient who is in the reactive phase of acute peritonitis. How much is the duration time of reactive phase? A Up to 6 hours. B Up to 12 hours. C Up to 24 hours. D 25 - 48 hours. E More than 48 hours. The head of the department,
professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №267 The patient was diagnosed: acute diffuse peritonitis, toxic phase. Which vein should be cannulized for infusion therapy? A V.subclavia. B V.basilica. C V.cephalica. D V.saphena magna. E V.jugularis. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №268 The patient diagnosed with acute diffuse peritonitis, in the stage of multiple organ failure. What will happen incase of increased activity of the sympathic - adrenal system? A Increased blood leukocytes. B Neutrocytosis. C Inhibition of peristaltic activity of intestine. D Hyperthermia. E Tachypnea. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №269 The patient is diagnosed with aseptic peritonitis. What can cause aseptic peritonitis? A Intestinal contents. B Gastric juice. C Colonic contents. D Duodenal content. E Pancreatic juice. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №270 The patient is diagnosed: acute appendicitis. What are the indications for the med line laparotomy? A Pored peritonitis. B Appendicular infiltration. C Appendicular abscess. D Local peritonitis. E The presence of peritonitis. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №271 The patient is diagnosed with diffuse peritonitis. How is the operation done? A Sutured tightly. B Laparostomy. C Planned laparotomy. D Drainage. E Peritoneal lavage. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №272 The patient is diagnosed: acute gangrenous peritonitis. How do we need to drain the abdominal cavity? A Thru counterpuncture around the wound. B Do not drain. C Thru the wound. D Put a tampon. E Thru counterpuncture in the inguinal areas. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №273
deal
All are the representatives of gram-positive anaerobic rods except? A Eubacterium. B Propionic bacterium. C Arachnia. D Veillonella parvula. E Actinomius. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №274 In patient 35 years old is diagnosed with acute diffuse peritonitis, toxic phase. How should the intubation of intestine be done? A Thru gastrostomy. B Thru ileostomy. C Nasogastric. D Thru colostomy. E Thru the rectum. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №275
deal
The patient was diagnosed abscessed appendicular infiltration. How we need to continue treatment? A Change the antibiotic. B Expand abscess access to Volkovitch - Diakonov. C Endolymphatic therapy phis procedure. D Conservative therapy. E Expand abscess ileoappendicular access. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №276
deal
Causative agents of acute peritonitis among many gram-negative aerobic pathogens are listed below. Which for your understanding should not be associated among listed below? A Gonococcus. B Pneumococcus. C Meningococcus. D Streptococcus. E Rods of blue-green manure. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №277
deal
The patient during laparotomy is diagnosed with perforated appendicitis, acute diffuse purulent peritonitis, terminal phase. How we must carry the operation? A Drainage with one point. B Drainage with two points. C Drainage with four points. D Drainage with three points. E Laparostomy. The head of the department, professor
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University Faculty medical Specialty medical deal Course IV Semester V I I – V I I I Educational discipline surgery TASK №278 The patient before peridural anesthesia during laparotomy is diagnosed with perforated appendicitis, acute pored peritonitis. Which action is not needed? A Decompression of the intestine. B Removal of the exudate. C Drainage of the abdominal cavity. D Sanitization of abdominal cavity. E The blockade of bowel mesentery. The head of the department, professor
V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №279
deal
In ward is brought a patient in the terminal stage of acute peritonitis. What is the duration time of the terminal phase? A Up to 6 hours. B Up to 12 hours. C Up to 24 hours. D 25 - 48 hours. E More than 48 hours. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №291
Hernia. Specify the factor that distinguishes the sliding hernia with the ordinary? A Hernial fluid. B Hernial hiatus. C Hernial contents. D Signs of inflammation of the membranes. E Walls of hernial sac, formed by parietal peritoneum and the hollow body. The head of the department, professor V.I. Bondarev
deal
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №292
deal
What is the most certain method of instrumental diagnosis of uncomplicated hernia? A Laparoscopy. B Ultrasound. C Peritoneography. D Cystography. E Scan. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №293
What hernia doesn’t have hernial hiatus? A Congenital. B Acquired. C Recurrent. D Neuropathic. E Postoperative. The head of the department, professor
V.I. Bondarev
deal
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №294
deal
Specify the factor of decisive importance of separating the groin hernias into, straight, congenital, recurrent, acquired, encysted? A Theoretical. B The difference in clinical manifestations. C Defines the selection mode of operation. D Defines the type of anesthesia. E Specifies tactics after the operation. The head of the department, professor V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №295
deal
key principle of the pathogenetic surgery indirect and direct inguinal hernias? A Removal of insolvent posterior inguinal canal wall. B Operative correction of weakened aponeurosis, the external oblique abdominal muscles .. C Elimination of extended deep inguinal ring. D Suturing the underdeveloped vaginal process of peritoneum. E The restriction to the normal size of the external (superficial) inguinal ring. The head of the department, professor V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №296
deal
The patient was 70 years old, diagnosed as: relapse of direct inguinal hernia. No other associated diseases , no contraindication to the operation. Point out the best means of operation? A Bassini. B Kukudzhanova. C Shouldice. D Mac-Wei. E Pastempskogo. The head of the department, professor V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №297
deal
The patient was 30 years. Diagnosis - indirect acquired reducible inguinal hernia. Associated diseases not found. Point out the optimal way of operation? A According to Girard. B According to Girard-Spasokukotsky. C According to Girard-Spasokukotskimzi with Kimbarovskogo sutures. D By Bassini. E According to Martynov. The head of the department, professor V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №298
Specify the type of femoral hernia occurs most frequently? A The medial femoral hernia. B Lateral (side) Femoral hernia. C Vasculo-lacunar femoral hernia. D Musculo-lacunar femoral hernia. EA Hernias of lacunar ligament. The head of the department, professor
Faculty
deal
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №299
Select the most correct definition of "the crown of death"? A Exit femoral hernia between the femoral artery and vein. B Anomalous care of the lower epigastric artery. C Carefully see closing of the lower epigastric artery. D Carefully see closing of the internal iliac artery. E Hernial sac is placed under the crural arch over the femoral artery and vein. The head of the department, professor V.I. Bondarev
deal
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №300
deal
What is the Bassini operation in femoral hernia? A Suturing broad femoral fascia to Poupart’s ligament. B Suturing Poupart’s ligament and Cooper's ligaments. C Suturing lacunar and Coopers ligament. D Suturing Gimbernat ligament with Poupart’s. E Closing the outer ring of femoral canal with a piece of aponeurosis of external oblique abdominal muscles. The head of the department, professor V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №301
Indicate the probability of recreance after surgery for a umbilical hernia? A Less than 3%. B 3 - 10%. C 10 -15%. D 15 - 25%. E 30 - 40%. The head of the department, professor V.I. Bondarev
deal
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №302
deal
The patient was 45 years old, manual worker. In the area of the umbilicus tere is hernia protrusion of 4 x 3 cm, in the supine position hernia freely reduces. Diagnosis - acquired reducible umbilical hernia. Indicate the optimal way of operation? A Method Mayo. B Method Sapezhko. C Method Leksnera. D Method Grekova. E How the Resurrection. The head of the department, professor V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №303
Indicate the most life-threatening complications of hernia? A Irreducibility. B Strangulation. C Coprostasis. D Injury. E Inflammation. The head of the department, professor
V.I. Bondarev
deal
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №304
What type of strangulation most often occurs in practice? A Elastic. B Retrograde. C Calovius. D Hernia Richter’s. E Appendicocele. The head of the department, professor
Faculty
deal
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №305
deal
Indicate the optimal length of the resection of the proximal loop of small intestine due to strangulation leading to full necrosis? A The length of the proximal segment to 40-50 cm B The length of the proximal segment to 30-40 cm C Within sight of strangulated sulcus. D The length of the segment 15-20 cm E The length of the proximal segment to 10 cm The head of the department, professor V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University
Faculty
medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №306
Choose a reliable (main) early sign of strangulated hernia? A Irreducible hernia. B Irreducibility and pain. C Positive symptom cough shock. D Violations of bowel function. E Positive symptom Barashnikova. The head of the department, professor
Faculty
deal
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №307
deal
Patient 57 year old brought to the reception ward with a diagnosis - strangulated inguinal hernia within 6 hours. During your examination hernia corrected on its own. What is your tactic? A Writing recommendations and discharge home. B Observation in the reception chamber for 2 hours. C Hospitalize in the surgical department and urgently operate. D Hospitalize in the surgical department for observation. E Hospitalize in the therapy department. The head of the department, professor V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №308
deal
Patient 65 years obesity 3rd stage. Brought by the ambulance with strangulated umbilical hernia. Refuses from operation. Insists on the reduction/correction of hernia. Why its not indicated to correct strangulated hernia? A There is a painful shock. B Seeming reposition. C Perforation of strangulated organ. D Develop peritonitis. E Intraintestinal bleeding. The head of the department, professor V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №309
deal
Patient 30 years. Two years ago, operated on for inguinal hernia. At present time comes with - a huge indirect recurrent inguinal hernia. Other associated diseases are not present. Point out the optimal way of operation. A According to Girard - Spasokukotsky. B According to Girard - Spasokukotsky with Kimbarovsky sutures. C By Bassini. D By Kukudzhanovim. E According to Martynov. The head of the department, professor V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №310
deal
Male 60 years old without any severe ongoing pathology. Diagnosis - direct reducible inguinal hernia. Point out the optimal way of operation.
A According to Girard - Spasokukotsky seamed Kimbarovsky. B According to Martynov. C By Bassini - Postempskim. D By Ruddi. E According to Roo - Oppel. The head of the department, professor V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №311
deal
A 40 year old patient, operated on for giant ventral hernia after post previous laparotomy due to peritonitis. At the 5 th day of the operation the patients condition deteriorated, during the dressing the surgeon noticed in the subcutaneous tissue a loop of small intestine. Your diagnosis? A Recurrent ventral hernia. B Prolapse. C Eventration D Postoperative hernia. E Traumatic hernia. The head of the department, professor V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №312
deal
What is the main in the pathogenesis of inguinal hernias. A The failure of the posterior wall of due to disorder of collagen synthesis and collagen lysis in the transverse fascia.
B Increased intra-abdominal pressure. C High inguinal gap. D Under developed vaginal processes of peritoneum. E Reducing aponeurosis of external oblique muscle. The head of the department, professor
Faculty
V.I. Bondarev
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №313
deal
Abdominal organs go into the scrotum through the inguinal canal on changing body position. Which is this hernia? A Internal inguinal hernia. B Congenital inguinal hernia. C Acquired inguinal hernia. D Acquired reducible inguinal hernia. E Hernia Brock. The head of the department, professor V.I. Bondarev
Faculty
Ministry of Healthcare in Ukraine Lugansk State Medical University medical Specialty medical Course IV Semester V I I – V I I I Educational discipline surgery TASK №314
Indicate the most important factor in the etiopathogenesis of acquired hernias. A Profession. B Congenital. C Favorable. D Trauma. E Operation.
deal
The head of the department, professor
V.I. Bondarev