lep february 2012.pdf

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SED - 4 - VERSI ON I
February 2012
Nr 1. A 56-year-old man has been admitted to hospital because of vomiting. The
potassium blood serum is 2.4 mmol/l. The patient is not able to intake any foods.
Indicate the best way to treat hypokalemia:
A. fast intravenous injection of 40 mmol kalium chloride solution.
B. intravenous infusion of kalium chloride diluted in 0.9% saline solution with a speed
of 10 mmol KCl per minute.
C. intravenous infusion of kalium chloride diluted in 0.9% saline solution with short
acting insulin with a speed of 10 mmol KCl per minute.
D. intravenous infusion of kalium chloride in 10% glucose solution with short acting
insulin with a speed of 10 mmol KCl per minute.
E. intravenous infusion of kalium chloride in 10% glucose solution with short acting
insulin with a speed of 10 mmol KCl per hour.
Nr 2. A 87-year-old woman has been admitted to hospital because of dehydration, low
blood pressure and sinus tachycardia. Indicate the best way to treat tachycardia:
A. verapamil intravenous injection. D. metoprolol administered orally.
B. verapamil administered orally.
E. 0.9% sodium chloride intravenous infusion.
C. bisoprolol administered orally.
Nr 3. A 74-year-old woman has been admitted to hospital because of dehydration.
She takes ramipril 10 mg once a day. The serum creatinine concentration is 176
mol/l. The normal values of serum creatinine concentration have been observed
previously. Blood pressure is 90/60 mmHg. Which of the following treatment is correct?
A. stop ramipril and give thiazide diuretics.
B. stop ramipril and give loop diuretics.
C. stop ramipril and give aldosteron antagonist.
D. stop ramipril and start intravenous 0.9% NaCl infusion.
E. continue ramipril and start intravenous 0.9% NaCl infusion.
Nr 4. Which of the following antibiotics should be used as empiric first-line treatment
in a 30-year-old woman with bacterial urinary tract infection?
A. third-generation cephalosporin.
D. antibiotics from fluoroquinolone group.
B. second-generation cephalosporin.
E. antibiotics from aminoglycoside group.
C. first-generation cephalosporin.
Nr 5. 65-year-old man has been admitted to hospital because of nose bleeding. The
patient takes acenocoumarol 3 mg once a day because of permanent atrial fibrillation.
Indicate the best medical test to confirm the overdosing of acenocoumarol:
A. bleeding time.
B. prothrombin time.
C. vitamin K concentration in blood plasma.
D. factor VIII concentration in blood plasma.
E. activated partial thromboplastin time.
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SED - 5 - VERSI ON I
February 2012
Nr 6. Chronic Helicobacter pylori infection can lead to the development of:
1) gastric ulcer;
4) Barrett oesophagus;
2) vitamin B 12 deficiency;
5) gastric MALT lymphoma.
3) bacterial overgrowth syndrome;
The correct answer is:
A. all the above. B. 1,2,3,5.
C. 1,2,4.
D. 1,2,5.
E. 1,2,4,5.
Nr 7. The factors that trigger jaundice in the most common congenital
hyperbilirubinemia, i.e. Gilbert's syndrome, include:
1) stress;
4) alcohol consumption;
2) physical exercise;
5) febrile illness;
3) starvation;
6) premenstrual period in women.
The correct answer is:
A. 1,2,3,5.
B. 2,3,5,6.
C. all the above.
D. 1,2,4,5,6.
E. 1,2,3,4,5.
Nr 8. A 50-year-old male with chronic fatigue, itchy skin, weight loss, and a history of
ulcerative colitis. Physical examination reveals the yellowing of the skin and mucous
membranes, as well as numerous scratches on the skin; laboratory studies: increased
ALP and GGT (2-10 fold), AST and ALT (2-4 fold). The most likely diagnosis is:
A. primary sclerosing cholangitis.
B. autoimmune hepatitis.
C. primary biliary cirrhosis.
D. intrahepatic cholestasis.
E. chronic cholangitis.
Nr 9. Contraindications to the use of ursodeoxycholic acid (UDCA) in the treatment
of cholecystolithiasis are:
1) pigment stones;
4) multiple stones;
2) calcium stones;
5) pregnancy;
3) deposits with a diameter exceeding 15 mm;
6) obesity.
The correct answer is:
A. 1,2,3,5.
B. 4,5,6.
C. all the above.
D. none of the above.
E. only 5.
Nr 10. The common causes of acute pancreatitis are:
1) stones in the gallbladder and biliary tract;
2) alcohol;
3) endoscopic retrograde cholangiopancreatography;
4) some medications;
5) abdominal trauma;
6) bacterial infections.
The correct answer is:
A. 1,2,3.
B. 1,2,6.
C. 2,3,6.
D. 3,5,6.
E. all the above.
SED - 6 - VERSI ON I
February 2012
Nr 11. The complications of chronic pancreatitis include:
1) pancreatic cancer;
2) true pancreatic cyst;
3) pseudoaneurysm of the vessels in the vicinity of the pancreas;
4) narrowing or obstruction of the common bile duct or duodenum;
5) pancreatic ascites.
The correct answer is:
A. 1,2,3,4.
B. 1,2,4,5.
C. 1,2,3,5.
D. 1,3,4,5.
E. 2,3,4,5.
Nr 12. Risk factors for pancreatic cancer include:
1) smoking;
4) genetic predisposition;
2) chronic pancreatitis;
5) large intake of fat and meat;
3) acute pancreatitis;
6) diabetes.
The correct answer is:
A. all the above.
B. 1,3,5.
C. 1,4,5,6.
D. 1,2,3,4,5.
E. 1,2,4,5,6.
Nr 13. Hematuria is not a feature of:
A. renal carcinoma.
D. renal papillary necrosis.
B. interstitial nephritis.
E. glomerulonephritis.
C. hypocalciuria.
Nr 14. Chronic hepatitis C infection:
A. has renal manifestation in up to 30% of patients.
B. is a cause of mixed cryoglobulinemia.
C. may cause nephritic syndrome.
D. all the above statements are true.
E. B and C are true.
Nr 15. Pulmonary-renal syndrome is typical of:
A. Goodpasture syndrome.
D
. cryoglobulinemia.
B. ANCA-associated small-vessel vasculitis.
E. all the above.
C. lupus erythematosus.
Nr 16. Which of the following concerning IgA nephropathy is false ?
A. classically is characterized by episodic hematuria.
B. is associated with the deposition of IgA in the Bowman’s capsule.
C. is one of the most common forms of glomerulonephritis worldwide.
D. should be distinguished from Henoch-Sch nlein purpura.
E. may be familial.
Nr 17. Which of the following is not a risk factor for diabetic nephropathy?
A. hyperglycemia.
D. smoking.
B. normal blood pressure.
E. family history of diabetic nephropathy.
C. dyslipidemia.
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SED - 7 - VERSI ON I
February 2012
Nr 18. Which of the following concerning cholesterol emboli is false ?
A. is caused by the release of plague cholesterol crystals into the circulation.
B. most commonly follows endovascular procedure involving large arteries, such as
aorta.
C. should be treated with anticoagulants.
D. may manifest itself through cerebral transient ischemic attacks.
E. often livedo reticularis in the lower extremities is present.
Nr 19. Hypertensive nephropathy:
A. is arteriolosclerosis, chronic nephrosclerosis and interstitial fibrosis of the kidneys.
B. is 5 times more common in white race.
C. develops in most patients with hypertension.
D. should be confirmed by renal biopsy.
E. is characterized by nephrotic syndrome.
Nr 20. Impaired renal blood flow may be caused by:
A. non-steroidal anti-inflammatory drugs.
D. angiotensin receptor blockers.
B. ACE inhibitors.
E . all answers are correct.
C. cyclosporine.
Nr 21. Acute kidney injury:
A. is associated with significantly increased mortality.
B. may progress to end-stage renal disease in up to 10% of patients.
C. complete recovery is possible in some patients.
D. all the above are true.
E. A and C are true.
Nr 22. A 52-year-old patient with a history of hypertension and hyperlipidemia was
attended in the Emergency Room due to intense chest pain radiating to his back,
accompanied by dyspnoea. On physical examination asymmetry in radial pulse and a
diastolic murmur were found. Which is the most probable diagnosis?
A. acute mitral insufficiency.
D
. pulmonary embolism.
B. myocardial infarction.
E . pneumothorax.
C. aortic dissecting aneurysm.
Nr 23. A 75-year-old female patient with a two month history of stenokardia,
palpitations and dizziness. Physical examination reveals a crescendo-decrescendo
systolic murmur at the base of the heart radiating to the neck. Which is the most
probable valvular heart disease?
A. mitral stenosis.
D
. aortic regurgitation.
B. mitral regurgitation.
E . tricuspid regurgitation.
C. aortic stenosis.
Nr 24. Which of the following heart diseases can be treated with cardiac
resynchronization therapy (CRT)?
A. acute coronary syndrome.
D. atrial fibrillation.
B. hypertension.
E. aortic stenosis.
C. chronic heart failure.
SED - 8 - VERSI ON I
February 2012
Nr 25. Which of the following is the possible complication of coronary angiography?
A. cardiac arrest.
D
. haemotoma at the puncture site.
B. anaphylactic shock.
E . all the above.
C. contrast induced nephropathy.
Nr 26. Which is the best laboratory marker reflecting heart failure advancement?
A. CKMB.
B. troponin.
C. proBNP.
D. D-dimer.
E. haemoglobin.
Nr 27. Which of the following is not associated with right-sided heart failure?
A. peripheral oedemas.
D. positive hepatojugular reflex.
B. basal crepitations in the lungs.
E. ascites.
C. jugular vein distention.
Nr 28. Digoxin overdose may be associated with the following side effects:
A. paroxysmal atrial tachycardia with block.
D. second degree atrio-ventricular
B. increase in ventricular arrhythmia.
block.
C. sinus bradycardia.
E. all of the above.
Nr 29. Atrial fibrillation may be complicated with:
A. aggravation of heart failure symptoms. D. aggravation of stenocardia.
B. stroke.
E. all of the above.
C. decrease in the quality of life.
Nr 30. The photosensitivity is typical of:
A. systemic sclerosis.
D
. polymyositis.
B. rheumatoid arthritis.
E . none of the above.
C. systemic lupus erythematosus.
Nr 31. Ketoprofen is a nonsteroidal anti-inflammatory drug given as a therapy for
various types of arthritides. The maximal daily dose is:
A. 50 mg.
D. 1000 mg.
B. 100 mg.
E. ketoprofen is not a nonsteroidal anti-inflammatory drug.
C. 200 mg.
Nr 32. A 55-year-old obese male woke up in the early morning with a strong pain and
the swelling of the right toe. The skin in this region was red and warm. In laboratory
testing: uric acid 10 mg/dl. The reasonable therapeutic option in the presented acute
attack of the underlying disease is:
A. colchicine 1 mg each 6h during the first day.
D. tramadol.
B. acetylsalicylic acid 75 mg/d.
E . A and/or B are true.
C. acetaminophen.
Nr 33. Which of the following is not a risk factor for osteoporosis?
A. increased coffee intake.
D
. long-term steroid therapy.
B. advanced age.
E . vitamin D deficiency.
C. obesity.

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