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1. A patient 50-years-old, has been admitted to the clinics with atrophic gastritis. In the blood test: erythrocytosis 3,8T/L, Hb 68g/l, c.i.l, macroanisocytosis, poikilocytosis. There is a megaloblastic type of heamopoesis. A number of leucocytes, reticulocytes and thrombocytes is lowed. Which pathology is suspected?
+B-12-deficiency anemia
Irondeficiecy anemia
Hemolytic anemia
Post-hemoragic anemia
Thalassaemia
2. A 32-year-old welder complaints of weakness and fever. His illness started as tonsillitis a month before. On exam, BT of 38,9◦C, RR of 24/min, HR of 100/min, BP of 100/70 mm HG, hemorrhages on the legs, enlargement of the lymph nodes. CBC shows Hb of 70 g/l, RBC of 2,2*1012/L, WBC of 3,0*109/L with 32%of blasts, 1%of eosinophils, 3% of bands, 36% of segments. Establish the diagnosis.
Aplastic anemia
Chronic lymphleukemia
+Acute leukemia
Vitamin-B12-deficiency anemia
Chronic hemolytic anemia
3. A 54-year-old woman complaints of increasing fatigue and easy bruising of 3 weeks’duration. Physical findings include pale, scattered ecchymoses and petechiae and mild hepatosplenomegaly. CBC; RBC- 2.550.000/mcL; Hb- 73 g/l; HTC20%; PLT-23.000/mcl; and WBC -162.000/mcl with 82%blasts, that contained Auric rods. Establish the diagnosis.
Chronic leulemia
+Acute leukemia
Thrombocytopenia
Hemolytic anemia
Megaloblastic anemia
4. A 44-year-old woman complains of weakness, subfebrile fever, and pallor of the skin. Physical examination revealed the enlarged lymph nodes in the right supraclavicular area. On X-ray film, there was enlargement of bronchopulmonary and paratracheal lymph nodes. The liver was enlarged, with increased firmness. What is diagnosis?
Chronic myelocytic leukemia
Tuberculosis
Sarkoidosis
Tumor metastases
+Hodgkin’s desease
5. A patient had stomach resection a year ago. He complaints of general weakness, giddiness. Blood count: Er-2,6 g/l; Hb -80g/l; C.ind. 0.7L-3,7g/l, reticulocytes 1%, segm 56%, lymph 34%, mon.6%. ESR 17 mm/hour. Erythrocytes. are hypochronomic; there are anisocytosis & poikilocytosis. Fe of serum 5mkmol/L. Diagnosis is?
Aplastic anemia
B12-deficiency anemia
Chronic myeloleukosis
+Iron-deficiency anemia
Chronic lymphoid leucosis
6. A 30 –year old woman complains of dizziness, weakness, increased nails fragility, alopecia and pica. On clinical examination body temperature is 36,7oC, the skin is pale , RR is 20 per min.; Ps 98, BP 100/60 mm of Hg. In CBC erythrocytes are 2,8*1012g/l, Hb 85g/l; KP-0,9, reticulocytes 2%, WBC(leucocytes) 4,7*109g/l, eosinophils 2%, subneutrophils 3%, segmented neutrophils 62%, lymphocytes 26%, monocytes 5%. ESR 20 mm/hour. Serum iron is 6,8 mkmol/l. What preparation is necessary to prescribe to a patient?
Fresh blood
+Iron per os
Erythrocal mass
Iron pareuterally
Vitamin B12-intramusculary
7. A patient, aged 35 years, complains of dizziness, weakness, headache, palpitation, attacks of pain in umbilical, sacral areas, fever up to 38oC, urine discoloration resembled smoky brown and normal stool. The condition started after being sting. On clinical examination jaundice is noted. BP 100/60 mm of Hg. Spleen is enlarged. RBC erythrocytes are 2,3*1012g/l, Hb 72g/l; K-0,9, reticulocytes 13,1%, WBC(leucocytes) 6,2*109g/l, ESR 25 mm/hour. In urine urobilin reaction is strongly positive, bilirubin pigments are absent. The total bilirubin is 60 mkmol/l, indirect 40 mkmol/l. Serum iron is 20,4 mkmol/l. What clinical diagnosis is the most probable?
+Aequired hemolytic anemia
Acute liver insuffiency
Iron-deficiency anemia
B12-defiency anemia
Viral hepatitis
8. Woman, 56 years old, complaints about the skin itching, sweating, subfebrile fever with the periodic increases temperature to 38-39oC, loss of weight, heaviness in right and left hypochondrium, dyspeptic disorders. Objectively: a skin is pale, some icteric. Liver palpation at the level of umbilicus, a spleen on 2cm is below than umbilicus, dense consistency. Common analysis of blood: RBC-3,0T/L, Hb-110g/l, C.I.-0,8; WBC-28 g/l, bas-4%, eos-5%, myel. 6, St-8, segm.70%, L-5, M-3, tromb.180 g/l. Your diagnosis?
Chronic myeloleucosis (aleucemic form)
Chronic myeloleucosis (leucemic form)
+Chronic myeloleucosis (subleucemic form)
Acute myeloblastic leucosis
Chronic lympholeucosis
9. Woman 32 years old, during 2 years was treated by internist because of neurocirculatory dystonia and by gynecologist because of menorrhagia. Complaints about the promoted fatigability, muscular weakness, prediction for strong smells (petrol, ether), the desire to eat chalk. Common analysis of blood: RBC-3,5 T/l, Hb-105g/l, C.i.0,8; hypochromia; anisocytosis; WBC.-6,8 g/l,, B-0%, E-2%, St-4%, S-60%, l-26%, M-8%, ESR-12 mm/hour. Whey iron 7-8 mkm/l. What is it necessary to appoint?
Vitamins of B-group
+Peroral preparations of iron
Folic acid
Parenteral acid
Vitamin C
10. A 21 year-old patient with history of multiple pneumonias complaints of malaise, breathlessness, palpitation, feeling of noisy ears and “flies” in front of eyes. The patient is ill from one month. On physical examination the skin is pale. In the mouth there is ulcerative necrotizing stomatitis. Also purpura in the femoral and abdominal skin areas is noted. The peripheral lymphatic nodes are not enlarged. CBC: RBC-1,8*1012/l, Hb-56g/l, KP-0,9, WBC 2,3*109/l, eosinophyls-2%, stub neutrophils3%, segm.neutrophils 65%, lymphocytes 22%, monocytes 8%, tromb.16*109/l, ESR-25 mm/h. In urine analysis the macrohaematuria is revealed. What clinical diagnosis is the most probable?
Hemolytic anemia
+Aplastic anemia
Iron-deficiency anemia
B12-difiency anemia
Acquired hypoplastic anemia
11. A patient aged 26 years, complains of the enlargement of cervical, subclavicular, grain, lymphatic nodes, Skin itching, considerable sweating at night, fever up to 39o C .In CBC there are leukocytosis, lymphopenia, high ESR. What clinical diagnosis is the most probable?
+Lymphogranulomatosis
Chronic lymphatic leukemia
Acute lymphoblastic leucosis
Infectious mononucleosis
Leukomoidal reaction
12. A 65years old patient was admitted in the hospital with complains of fatigue, feeling of “cotton like” legs, loss of sensitivy of toes. On examination pale of the skin, subecteric sclera, heart sounds of low intensity, systolic murmur heard over the heart area, liver +2sm, painless, spleen not enlarged. Blood analysis: Hb-58g/l, E-1,3*10 12/l, color index – 1,3. reticulocytes 0,2%, ESR 30 mm/hr, megaloblasts -2:100, macrocytosis, Jolly bodies, kebots ring.Most informative method of investigation is?
Osmotic resistence of erythrocytes
Edoscopic examination of the stomach
X-Ray of abdomen
+Serum B12 and folic acid level
Iron content of serum
13. A 42 years old patient complains of weakness, palpitations, nasal hemorrhages, cutaneous hemorrhages. His condition has been worsening progressively for a month. Objectively: grave condition, the extremities and body skin has spotted and petechial hemorrhages, lymph nodes are not palpable. Ps-116/min, liver+2cm enlarged, spleen is not palpable. Blood has evident pancytopenia. What disease should you think first of all?
+Hypoplastic anemia
Hemorrhagic vasculitis
Acute agranulocytosis
Werlhof’s disease
Acute leucosis
14. A 54 years old woman complains of increasing fatigue and easy bruising of 3 weeks duration. Physcial findings included pale, scattered ecchymoses and petechiae and mild hepatosplenomegaly. In blood: RBC –,5* 10 12/l, Hb 73g/l, HCT- 20%, PLT –*10 9/l, and WBC 163*10 9/l with 82% blasts stain was positive. What is the most probable diagnosis?
Hemolytic anemia
Chronic leukemia
Thrombocytopenia
+Acute leukemia
Megaloblastic anemia
15. A 27 years old patient is having for almost a year fatigue, hyperhidrosis, heaviness in the left hypochondrium, especially after meals. Objectively: spleen and liver enlargement. In blood: erythrocytes –,2* 10 12/l, Hb –g*/l, color index-0,87, leucocytes-100*10 9/l, basophils – 10%, eosinophils –%, myelocytes –%, juveniles –%, stab neutrophils 10%, segmentonuclear leucocytes -45%, lymphocytes –%, monocytes –%, reticulocytes –,3%, thrombocytes –*10 9/l, ESR –mm/hr. What is the most probable diagnosis?
Hepatocirrhosis
Acute leucosis
Chronic lympholeucosis
Erythremia
+Chronic myeloleucosis
16. A 33 years old patient was admitted to the hospital with stopped repeated ulcerative bleeding. He was pale and exhausted. Blood count: Hb- 77g/l, Ht-0,25. In view of anemia there was made two attempts of blood transfusion of the same group – A(II)Rh+. In the both cases the transfusion had to be stopped because of development of anaphylactic reaction. What transfusion medium would be advised in this case?
Fresh citrate blood
+Washed erythrocytes
Erythrocytic mass poor in leukocytes and thromocytes
Erythrocytic suspension
Erythrocytic mass
17. A 35 years old woman is suspected of aplastic anemia. The bone marrow biopsy has been performed for the diagnostic purpose. What changes in the marrow biopsy are suggested?
Replacement of marrow elements with fibrous tissue.
+Replacement of marrow elements with adipose tissue
Absolute lymphocytosis
Prevalence of megaloblasts
Presence of blasts cells
18. A 58 years old male patient is examined by a physician and suffers from general weakness, fatigue, mild pain in the left subcostal area, sometimes frequent painful urination. Moderate splenomegaly has been revealed. Blood test: neurophilic leucocytosis with the progress to myelocyte; basophil –%; eosinophil-5%. There is a urate crystals in urine, erythrocytes 2-3 in the field of vision. What is the preliminary diagnosis?
Lymphogranulomatosis
+Chronic myeloleucosis
Urolithiasis
Leukemoid reaction
Hepar cirrhosis
19. A man, 42 years old, died on the spot in a road accident, because of acute hemorrhagic anemia. What minimum percent of the whole blood volume could result in death by acute hemorrhage?
+10-14%
-20%
-30%
-9%
-50%
20. A 19 years old patient complains of long-term bleeding started after tooth extraction. It is known from the case history that he has had large hematomas in the childhood. His uncle from mother’s side died from bleeding. What clinical diagnosis is the most probable?
+Hemophilia
Hemorrhagic vasculitis
Iron deficiency anemia
Aplastic anemia
B12-deficiecy anemia
21. A man aged 32 years notes general weakness, elevation of the body t°, pains in the throat while swallowing. He is ill from 2 months and treated from tonsillitis by antibiotics without any effect. The main clinical features are body t° 38,4 °C, RR (respiratory rate) 22 per min; pulse 108, BP (blood pressure) 100/60 mm of Hg. The skin is pale. There are purpura (hemorrhagic rash) on extremities, systemic enlargement of lymphatic nodes and hepatosplenomegaly. In CBC : RBC are 2,2*1012/l, Hb 70 g/l; WBC (leuc.) 13,5*109/l; atypical cells (blastocytes) 32%; metamyelocytes 1%; stab neutrophils 3%; segm. neutr. –%; lymph. –%; monocytes –%; thrombocytes 37*109/l; ESR – 30mm/hour. What clinical diagnosis is the most probable?
+Acute leukosis
Chronic lympholeukosis
Chronic myeloleukemia
Aplastic anemia
Thrombocytopenic purpura
22. The therapist must prescribe to patients primary prophylaxis iron deficiency anemia to prevent its development. Whо is administered with this prophylaxis?
+Pregnant women
Patients after 60
All children
Patients after operation
Workers of industrial interprises.
23. The woman aged 30, is suffering from polycystic kidney. She was admitted to the hospital because of weakness thirst, nocturia. Diuresis was about 1800 ml per day. Blood pressure 200/100mm Hg. Blood test: erythrocytes: 1,8*109. Hg-68 g/l. Urine specific gravity is 1005, leucocytes- 50-60, erythrocytes in microscopic field - 3-5, creatinine- 0,82 mmole/l, potassium – 6,5 mmole/l, provision urine filtration rate 10 ml/min. What’s the immediate task in the case treatment?
+Hemodialysis
Antibacterial therapy
Sorbents
Blood transfusion
Hypotensive therapy
24. Patient 55 years old has been admitted to the clinics with chronic gastritis. In the blood test: erythrocytosis 3,8*1012/L, Hb 70g/l, macro-anisocytosis, poikilocytosis. There is a megaloblastic type of hemopoesis. A number of leucocytes, reticulocytes and thrombocytes are lowed. Which pathology is suspected?
+B12-deficiecy anemia
Iron-deficiency anemia
Hemolytic anemia
Post-hemorrhagic anemia
Thalassaemia
25. Another name of Rendu-Osler-Weber Syndrome is?
+Hemorrhagic telangiectasia
Allergic purpura
Hemophilia
Rheumatic fever,
Adhesive pericarditis
26. What is bleeding disorder due to inherited deficiencies or abnormalities of coagulation factors VIII or IX?
Allergic purpura
Hemorrhagic telangiectasia
+Hemophilia
Hemorrhagic vasculitis
Thrombocytopenia
27. What factor deficiency termed hemophilia A?
VI
V
I
+VIII
XI
28. What factor deficiencies, termed hemophilia C?
+XI
VI
VII
X
IX
29. What platelet disorders associated with other congenital defects are here?
Rendu-Osler-Weber Syndrome
Henoch-Schonlein disease
+Wiskott-Aldrich syndrome
Von Willebrand's disease
Kleinfelter's syndrome
30. A previously healthy 27-years-old woman is seen because of a petechial rash. She denies any recent bleeding and has had no recent illnesses. Hemoglobin, hematocrit, and white blood cell counts are normal. Examination of the peripheral blood smear reveals normal red and white blood cells and is remarkable only for a paucity of platelets. The most likely diagnosis is?
Aleukemic leukemia
+Idiopathic thrombocytopenic purpura (ITP)
Glanzmann's thrombasthenia
A megakaryocytic thrombocytopenia
Drug-induced thrombocytopenia
31. Essentials of diagnosis in Congenital Hemolytic Jaundice:
+Malaise, abdominal discomfort, jaundice, anemia, splenomegaly, spherocytosis, increased osmotic fragility of red cells, negative Coombs test.
High reticulocytes count.
Serum iron low, total iron-binding capacity increased.
Lassitude, pallor, purpura, bleeding, pancytopenia, fatty bone marrow.
Persistent anemia and reticulocytosis, Coombs test usually positive.
32. What anemia does occur almost always due to blood loss?
+Iron deficiency anemia.
Megaloblastic anemia.
Aplastic anemia.
Folic acid deficiency anemia.
B12 vitamin deficiency anemia.
33. What is the most often clinical finding in anemia?
Fatigue.
Low platelets level.
Low white blood cells level.
High hemoglobin level.
+Low hemoglobin level.
34. What is the main preparation in the pernicious anemia administration?
Epinephrine.
Ferrum-Lek.
Prednisolone.
+Cyanocobalamin.
Penicillin
35. What level of serum ferritin shows the iron deficiency anemia?
Below 24 ng/mL.
Below 56 ng/mL.
+Below 12 ng/mL.
Below 120 ng/mL.
Below 48 ng/mL.
36. How to treat the Aplastic anemia?
+Marrow Transplant, Androgen Steroids.
Liver transplant, Androgen Steroids,
Bowel transplant, Hestagene Steroids.
Androgen Steroids, Penicillin.
Iron preparations.
37. A 60-year-old man complains of fever, significant weight loss, bone and joint pain, and bleeding gums. On examination - paleness, lymphadenopathy, hepato- and splenomegaly. CBC: WBC –*109/L with 13% lymphocytes, 1% monocytes, 21% basophiles, 29% neutrophils, 9% blasts, 12% promyelocytes, 12% myelocytes, 2% metamyelocytes, 1% eosinophiles. ESR –mm/h. Name the drug for treatment.
+Myelosan
Prednisolone
Cytosar
Vinblastine
Blood transfusion
38. A 32 -year-old welder complains of weakness and fever. His illness started as tonsillitis a month before. On exam, T of 38.9°C, RR of 24/min, HR of 100/min, BP of 100/70 mm Hg, hemorrhages on the legs, enlargement of the lymph nodes. CBC shows Hb of 70 g/L, RBC of 2.2*1012/L, WBC of 3.0*109/L with 32% of blasts, 1% of eosinophils, 3% of stab, 36% of segments, 20% of lymphocytes, and 8% of monocytes, ESR of 47 mm/hr. What is the cause of anemia?
Chronic lymphoblastic leukemia
+Acute leukemia
Aplastic anemia
Vitamin B12 deficiency anemia
Chronic hemolytic anemia
39. What is the Acute Lymphatic Leukemia?
+Disorder of the blood-forming tissue (white cells)
Disorder of the blood-forming tissue (red cells)
Cardiac pain
Increasing of blood pressure
Decreasing of blood pressure
40. What is a level of platelets in the patient with Acute Lymphatic Leukemia?
Over 200.000/μL
.000 –.000/μL
+100.000 –.000/μL
Below 100.000/μL
Is not changed
41. In which patients the intracerebral hemorrhage occurs more frequently?
With low white cells counts
+With high white cells counts (over 300.000/μL)
Without any changes
Increased level of erythrocytes
Decreased level of erythrocyte
42. What is the dosage of Vincristine during the treatment of acute lymphatic leukemia?
,01 mg/kg intravenously once a week for 4 weeks.
+0,05 mg/kg intravenously once a week for 4 weeks.
,1 mg/kg intravenously once a week for 4 weeks.
,5 mg/kg intravenously once a week for 4 weeks.
mg/kg intravenously once a week for 4 weeks.
43. What is the aim of therapy in patient with chronic myelocytic leukemia?
+Palliation of symptoms and correction of anemia
To prevent the infiltration of organs by abnormal white cells
Correction of anemia only
To decrease the level of leukocytes
To increase the level of thrombocytes
44. What reason is thought to be the cause of complications in patient with chronic myelocytic leukemia?
Gum bleeding
High white cells count
Hypertension
Leukemic infiltration of organs
+Cerebral ischemia
45. A 25-year-old patient complaints of weakness and fever. Her illness started as stomatitis a month before. On exam, BT of 39,9◦C, RR of 22/min, HR of 120/min, BP of 90/70 mm HG, hemorrhages on the legs, enlargement of the lymph nodes. CBC - Hb of 77 g/l, RBC of 2,1*1012/L, WBC of 2,7*109/L with 39%of blasts, 1%of eosinophiles, 3% of stab, 36% of segments. Establish the diagnosis.
Aplastic anemia
Chronic lympholeukemia
+Acute leukemia
Vitamin-B12-deficiency anemia
Chronic hemolytic anemia
46. A 44-year-old woman complained of weakness, subfebrile fever, and pallor of the skin. Physical examination revealed the enlarged lymph nodes in the right supraclavicular area. On X-ray film, there was enlargement of broncho-pulmonary and paratracheal lymph nodes. The liver was enlarged, with increased firmness. What is the diagnosis?
Tuberculosis.
+Hodgkin’s disease.
Sarkoidosis.
Tumor metastases.
Chronic myelocytic leukemia.
47. A 25-year-old woman complained of fatigue, hair loss, and brittle nails. On exam, pallor of skin, PR of 94/min, BP of 110/70 mm Hg. On blood cell count, Hb of 90 g/L, RBC 3.5·1012/L, color index of 0.7, ESR of 20 mm/hr. Serum iron level was 8.7 mcmol/L. what treatment would you initiate?
+Ferrous sulfate orally
Iron dextrin injections
Vitamin B12 intramuscularly
Blood transfusion
Packed RBCs transfusion
48. A 62-year-old woman complains of increasing fatigue and easy bruising of 4 weeks’duration. Physical findings included pale, scattered ecchymoses and hepatosplenomegaly. CBC: RBC –.250.000/mcL; Hb –g/L; HCT 17%; PLT –.000/mcL; and WBC –.000/mcL with 61% blasts. What is the most probable diagnosis?
Megaloblastic anemia
Chronic leukemia
Thrombocytopenia
Hemolytic anemia
+Acute leukemia
49. A 50 years old patient has been admitted to the clinics with atrophic gastritis. Blood count: erythrocytes - 3,8*1012/l, Hb - 68 g/l, C.I - 1, macro-anisocytosis, poikilocytosis. There is megaloblastic type of hemopoisis. A number of leukocytes, reticulocytes and thrombocytes are reduced. Which pathology is suspected?
Iron-deficiency anemia
Post-hemorrhagic anemia
Thalassaemia
Hemolytic anemia
+B12-deficiency anemia
50. A 25 years old patient complains about weakness, dizziness, appearance of hemorrhagic skin rash. She has been suffering from this for a month. Blood count: erythrocytes: 1,0*1012/l, Hb- 37 g/l, color index - 0,9, leukocytes - 1,2*109/l, thrombocytes –*109/l. What diagnostic method will be the most effective?
Liver biopsy
Abdominal ultrasound
+Sternal puncture
Coagulogram
Spleen biopsy
51. A 68-year-old patient complains of tiredness, sweating, enlargement of cervical, submaxillary and axillary lymph nodes. Blood tests: leucocytes-35∗109/L, lymphocytes - 60%, Botkin and Gumprecht bodies, level of hemoglobin and quantity of thrombocytes is normal. Myelogram showed 40% of lymphocytes. What is the most probable diagnosis?
Acute leucosis
Lymphogranulomatosis
Chronic myeloleucosis
Tuberculosis lymphadenitis
+Chronic lympholeucosis
52. A 27 y.o. patient has been having for almost a year fatigue, hyperhydrosis, heaviness in the left hypochondrium, especially after meals. Objectively: spleen and liver enlargement. In blood: erythrocytes –,2* 1012/l, Hb – 100 g/l, color index-0,87, leucocytes - 100*10 9/l, basophiles –%, eosinophiles –%, myelocytes –%, juveniles –%, stab neutrophils 10%, segmentonuclear leucocytes -45%, lymphocytes – 2%, monocytes –%, reticulocytes –,3%, thrombocytes –*109/l, ESR –mm\hr. what is the most probable diagnosis?
Liver cirrhosis
Acute leucosis
Chronic lympholeukemia
Erythremia
+Chronic myeloleukemia
53. Patient 45 years old, complains of sore throat, hyperthermia, fever, bones pain, weight loss, hypertrophy and bleeding of gums, ecchymosed on the skin, weakness, tiredness, bed feeling. He is ill during 1 month with rapid progression of condition. Objectively: pale skin and mucus membranes, ecchymosed on the skin, hypertrophy of gums, hepato –spleenomegaly. In blood: Hb-80 g\l, Er. –,5*1012\l, CI –,8, MCV –fl, reticulocytes –,1%, L- 4*109\l, blasts –%, myelocytes –%, metamyelocytes – 0%, stab neutrophils –%, segmented neutrophils –%, lymphocytes -12%, platelets - 100*109\l, ESR –mm\h. In mуelogramm: blasts 35% with positive myeloperoxidase test. What is the preliminary diagnosis?
+Acute Myeloid leukemia.
Chronic Myeloid leukemia.
Thrombocytopenic purpura.
Acute Lymphoid leukemia.
Aplastic anemia.
54. A 65-year-old woman is seen prior to cataract surgery. She has had no previous surgery except for a dental extraction, after which she bled for 10 days and required a 2-unit blood transfusion. One sibling died from postoperative hemorrhage during childhood, and there is a history of bleeding in a number of relatives, both male and female. Her partial thromboplastin time (PTT) is markedly prolonged, and the bleeding time is within normal limits. The most likely diagnosis is?
Factor VIII deficiency
+Factor XI deficiency
Factor XII deficiency
Fletcher factor deficiency
Von Willebrand's disease
55. What is a main syndrome of hemophilia?
+Bleeding
Lymphoproliferative
Anemia
Intoxication
Infection
56. Another name of Henoch-Schonlein disease is?
Hemorrhagic telangiectasia
Hemophilia
+Allergic purpura
Thrombocytopenia
Hemorrhagic vasculitis
57. Management of thrombocytopenia requires administration of?
+Platelet concentrates
Cryoglobulin
Erythrocyte concentrates
NaCl
NaHCO3
58. What factor deficiencies termed hemophilia B?
II
VIII
VII
+IX
XI
59. What drug is useful in treatment of hemophilia?
Aspirin
+Aminocapronic acid
Meteospasmil
Prednisolone
Vitamin C
60. The functional systolic heart murmur is meet most frequently attached to:
+Iron-deficiency anemia
Hypothyroidism
Diabetes Mellitus
B12-defficiency anemia
Pregnancy
61. What changes in peripheral blood are observed by late post-hemorrhagic anemia?
Leukocytosis
Leucopenia
+Erythropenia
Thrombocytopenia
Erythrocytosis
62. What method of Addison-Biermer’s anemia treatment is basic?
Blood transfusion
+Reception В12 vitamin
Reception iron medicine
Phytotherapy
Iron reception with feeding products.
63. What can one see in the general blood analysis by Addison-Biermer’s anemia?
Augment amount of thrombocytes
Diminishing hemoglobin index
Eosinophilia
+Appear of megalocytes
Lymphocytosis
64. What is the most often complaint in patients with anemia?
Arrhythmia
Heart pain
Headache
Cough
+Giddiness
65. What are the essentials of diagnosis of autoimmune hemolytic anemia?
Serum iron low, total iron-binding capacity increased.
Lassitude, pallor, purpura, bleeding, pancytopenia, fatty, bone marrow.
+Persistent anemia and reticulocytosis, Coombs test usually positive.
Fever, jaundice.
High reticulocytes count.
66. What genetic sign does indicate the chronic myelocytic leukemia?
+Philadelphia chromosome in abnormal cells
No sings
XXX or XXY combination
chromosomes in the 21st pare
Lack of chromosome 13 pare
67. What are the main laboratory findings in patient with chronic lymphocyttic leukemia?
Thrombocytosis
+Anemia and thrombocytopenia
Thrombocytosis and lymphocytosis
No findings
Philadelphia chromosome in abnormal cells
68. What drug is mostly used for the treatment of chronic lymphocyttic leukemia?
+Chlorambucil
Prednisone
Cyclophosphamide
Myleran
Penicillin
69. What is the Acute Lymphocyttic Leukemia?
+Disorder of the blood-forming tissue (white cells)
Disorder of the blood-forming tissue (red cells)
Lymphatic tissue origin disorder
Increasing of blood loss
Decreasing of blood production
70. A 48-years-old woman complains of increasing tiredness, fatigue and easy bruising of 5 weeks duration. Physical findings included pale skine, scattered petechiae and hepatosplenomegaly. In blood: RBC –,8* 1012/l, Hb 78 g/l, HCT- 20%, PLT –*10 9/l, and WBC 178*10 9/l with 45% blasts. What is the most probable diagnosis?
Hemolytic anemia
Chronic leukemia
Thrombocytopenia
+Acute leukemia
Megaloblastic anemia
71. A 60-year-old man complains of fever, significant weight loss, bone and joint pain, bleeding gums. Examination revealed paleness, lymphadenopathy, hepato- and splenomegaly. CBC: WBC –*109/l with 13% lymphocytes, 1% monocytes, 21% basophiles, 29% neutrophils, 9% blasts, 12% promyelocytes, 12% myelocytes, 2% metamyelocytes, 1% eosinophiles. ESR - 22 mm/hr. What is your diagnosis?
Iron-deficiency anemia
+Chronic myeloleucosis
B12-deficiency anemia
Aplastic anemia
Chronic lymphoid leukemia
72. A 42-year-old man suddenly felt worsening of his general condition and complains of dizziness, weakness and appetite loss. From the clinical history it is known that the patient suffers from the duodenal ulcer disease within 15 years and it is written down in his individual medical file. In CBC - RBC are 1,9*1012/l , Hb 57g/l, C.I. 0,9, reticulocytes 1% , thromb. 2,1*109/l , WBC 11,5*109/l , eosinophils-1%; stabneutrophils-10%; seg.neutrophils-65%; lymph-19%; mon.-5%; ESR-35 mm/hour. What clinical diagnosis is the most probable?
Pernicious anemia
Hemolytic anemia
Hypoplastic anemia
DVC –syndrome
+Post-hemorrhagic anemia
73. A patient, 35 years, complains of weakness, dizziness, headache, palpitation, attacks of pain in umbilical, sacral areas, fever up to 38,20C, urine discoloration resembled smoky brown and normal stool. The condition started after bee sting. On clinical examination the jaundice is noted. BP (blood pressure) is 100/60 mm of Hg, spleen is +enlarged. RBC are 2,3*1012/l, НB 72 g/l, K - 0,9, reticulocytes 13,1%, WBC 6,2*109/l, ESR -25 mm/hour. In urine urobilin reaction is strongly positive, bilirubin pigments are absent. The total bilirubin is 60 mkmol/l, indirect 40 mkmol/l. Serum iron is 20,4 mkmol/l. What clinical diagnosis is the most probable?
+Acquired hemolytic anemia
Acute liver insufficiency
Iron-deficiency anemia
В12- deficiency anemia
Post-hemorrhagic anemia
74. A 7 y.o. boy suddenly felt pain in his right knee, it became edematic. The day before he took part in a cross-country race. Family anamnesis has no data about hemophilia and bleeding sickness. Objectively: body temperature is 37,50С. The knee is painful, hot to the touch, edematic with local tissue tension over it. Blood count: Нb- 123 g/L, leukocytes - 5,6*109/L, thrombocytes - 354*109/L, prothrombin time - 12 seconds (normally 10-15 seconds), partly activated thromboplastin time - 72 seconds (normally 35-45 seconds). Hemorrhage time is normal, VIII:C factor is 5% of norm. What is the most probable diagnosis?
+Hemophilia A
Hemophilia B
Schoenlein-Henoch disease
Vitamin K deficiency
Thrombocytopenia
75. The physician must undertake measures for primary prophylaxis of iron deficiency anemia. Which of the following categories of patient are subject to such primary prophylactic measures?
+Pregnant women
Patients after 60
All children
Patients after operation
Workers of industrial enterprises
76. A 62-year-old patient complaining of enlargement of cervical, supraclavicular and axillary lymph nodes, subfebrile temperature for the last 3 months has been admitted to a hospital. In blood: WBCs - 64*109/l, lymphocytes - 72%. What method of study should be used to specify the diagnosis?
+Myelogram
Lymphography
Lymphoscintigraphy
X-rays
Thermography
77. A 42-year-old patient complains of back pain, darkened urine, general weakness, dizziness that occurred after treating a cold with aspirin and ampicillin. Objectively: the patient is pale, with subicteric sclera. HR - 98 bpm. Liver - +2 cm, spleen - +3 cm. In blood: RBCs - 2,6*1012/l, Hb - 60 g/l, CI - 0,9, WBCs - 9,4*109/l, basophils - 0,5%, eosinophils - 3%, stab neutrophils - 6% segmented neutrophils - 58%, lymphocytes - 25%, monocytes - 7%, ESR - 38 mm/hour, reticulocytes - 24%. Total bilirubin - 38 millimole/l. What complication occurred in the patient?
+Acquired hemolytic anemia
Toxic hepatitis
Cholelithiasis
Agranulocytosis
Paroxysmal nocturnal hemoglobinuria
78. A 16-year-old patient who has a history of intense bleedings from minor cuts and sores needs to have the roots of teeth extracted. Examination reveals an increase in volume of the right knee joint, limitation of its mobility. There are no other changes. Blood analysis shows an inclination to anemia (Hb- 120 g/l). Before the dental intervention it is required to prevent the bleeding by means of:
+Cryoprecipitate
Epsilon-aminocapronic acid
Fibrinogen
Dried blood plasma
Calcium chloride
79. An 18 y.o. girl complains of weakness, dizziness, loss of appetite, menorrhagia. There are many-coloured petechiae on the skin of the upper extremities. Blood test: Hb- 105 g/l; RBC- 3,2*1012/L; C.I.- 0,95; thromb.- 20*109/L. The sedimentation time according to Lee White is 5'; hemorrhagia duration according to Duke is 8', "pinch and tourniquet" test is positive. What is the most probable diagnosis?
+Idiopathic thrombocytopenic purpura
Hemophilia
Hemorrhagic diathesis
Iron deficiency anemia
Marchiafava-Micheli's disease
80. A 37-year-old woman complains of generalized fatigue, irritability, dysphagia, chalk hunger. On physical exam: t- 36,50C, respirations - 20/min, Ps - 96 bpm, BP - 110/70 mm Hg. Satisfactory nourishment. The skin and visible mucous membranes are pale. Blood test: Hb -70g/L, erythrocytes - 3,4*1012/L, CI - 0,7, reticulocytes - 2%, leucocytes - 4,7*109/L, eosinophilis. - 2%, band neutrophils - 3%, segmented neutrophils - 64%, lymphocytes - 26%, monocytes - 5%, ESR - 15 mm/min. Serum ferrum - 7,3 mmol/L, total protein - 70g/L. Deficit of what factor caused the development of the disease?
+Ferrum
Vitamin B6
Vitamin B12
Protein
Folic acid
81. A 27-year-old patient complains of nasal haemorrhages, multiple bruises on the anterior surface of the trunk and extremities, sudden weakness. In blood: Hb - 74 g/l, reticulocytes -16%, RBCs - 2,5*1012/l, platelets – 30*109/l, ESR- 25 mm/h. What is the most effective measure for the treatment of thrombocytopenia?
+Splenectomy
Iron preparations
Hemotransfusion
Cytostatics
Vitamin B12
82. A 38-year-old patient complains of inertness, subfebrile temperature, enlargement of lymph nodes, nasal haemorrhages, bone pain. Objectively: the patient's skin and mucous membranes are pale, palpation revealed enlarged painless lymph nodes; sternalgia; liver was enlarged by 2 cm, spleen - by 5 cm, painless. In blood: erythrocytes - 2,7*1012/l, Hb - 84 g/l, leukocytes - 58*109/l, eosinophils - 1%, stab neutrophils - 2%, segmented neutrophils - 12%, lymphocytes - 83%, lymphoblasts - 2%, smudge cells; ESR- 57 mm/h. What is the most likely diagnosis?
+Chronic lymphatic leukemia
Chronic myeloleukemia
Acute lymphatic leukemia
Acute myeloleukemia
Lymphogranulomatosis
83. A 22-year-old vegetarian patient with signs of malnutrition consulted a doctor about smell an taste distortion, angular stomatitis. Objectively: marked blue sclerae. The patient was diagnosed with iron deficiency anemia. What is the dominating clinical syndrome?
+Sideropenic
Anaemic
Haemologic
Haemolytic
Myelodysplastic
84. A 42-year-old female lives in the basement, is unemployed, undernourished. She complains of having general weakness, hair loss, brittle nails for six months, likes to eat chalk. Objectively: the patient is emaciated, pale, has dry skin. Peripheral lymph nodes are not enlarged. Liver is +1,5 cm. In blood: RBCs - 1,8*1012/l, Hb - 62 g/l, colour index - 0,78, reticulocytes - 0,5%, ESR- 18 mm/h. Leukogram exhibits no pathology. What is a provisional diagnosis?
+Nutritional iron deficiency anemia.
Chronic hepatitis.
B12-deficiency anemia.
Acquired hemolytic anemia.
Congenital hemolytic anemia.
85. A 14-year-old patient with signs of internal hemorrhage has been taken to a hospital after a fight. He has had hemophilia A since childhood. He has been diagnosed with retroperitoneal hematoma. What should be administered in the first place?
+Cryoprecipitate.
Aminocapronic acid.
Dried plasma.
Platelet concentrate.
Fresh blood.
86. A 43-year-old male patient undergoing treatment for peptic ulcer complains of weakness, dizziness, coffee-ground vomiting, melena. After administration of haemostatic’s the patient's condition has not improved, fresh blood has shown up in the vomit, skin bruises of different sizes have appeared. In blood: thrombocytes –*109/l, Lee-White clotting time - 35 minutes, APTT - 80 seconds. In this case it is most rational to administer the following preparation:
+Fresh frozen plasma.
Heparin.
Fibrinogen.
Rheopolyglucinum.
Vikasol.
87. Against the background of angina a patient has developed pain in tubular bones. Examination revealed generalized enlargement of lymph nodes, hepatolienal syndrome, sternalgia. In blood: RBCs - 3,6*1012/l, Hb - 87 g/l, thrombocytes –*109/l, WBCs - 13*109/l, blasts - 87%, stab neutrophils - 1%, segmented neutrophils - 7%, lymphocytes - 5%, ESR - 55 mm/h. What is the most likely diagnosis?
+Acute leukemia.
Erythremia.
Chronic lymphocytic leukemia.
Chronic myeloid leukemia.
Multiple myeloma.
88. A 52 y.o. woman complains of weakness, painful itching after washing and bathing, sensation of heaviness in the head. On examination: hyperemia of skin of face, neck, extremities. АP - 180/100 mm Hg. Spleen is 4 cm below the rib arch edge. What is the most probable diagnosis?
+Erythremia.
Essential hypertension.
Dermatomyositis.
Allergic dermatitis.
Systemic sclerodermia.
89. An 18-year-old patient since childhood suffers from bleeding disorder after minor injuries. His younger brother also has bleeding disorders with occasional hemarthrosis. Which laboratory test will be informative for diagnosis verification?
+Clotting time.
Fibrinogen rate.
Blood clot retraction.
Thrombocyte count.
Determination of prothrombin time.
90. Patient 60 years old, complains of bones pain, frequent fractures, polyuria, weakness, tiredness, periodic diarrhea. Patient has Diabetes Mellitus II type, Ischemic heart disease, Arterial hypertension. Objectively: hepato –spleenomegaly, Pasternatsky’s sing positive. In blood: Hb-100 g\l, Er. –,9*1012\l, L- 12*109\l, platelets - 100*109\l, ESR –mm\h. In serum: Ca –,8 mkg\l, glucose level –,8 mmol\l, total proteins –g\l, kreatinine –mcmol\l. In urine: hypercalceuria, glucoseuria, proteinuria. In mуelogramm: plasmacytoses. What is the preliminary diagnosis?
+Multiple Myeloma.
Chronic pyelonephritis.
Lymphoma.
Chronic Myeloid leukemia.
Iron deficiency anemia.
91. Young woman, 28 years old, complains of easy bruising, petechia, ecchymosed on the skin, menorrhagia, gums bleeding. She is ill during 2 weeks after viral infection. In blood: Hb-105 g\l, Er. –,8*1012\l, CI –,7, MCV –fl, L- 10*109\l, platelets - 50*109\l, ESR –mm\h. In serum: autoantibodies to platelets. What is the preliminary diagnosis?
+Thrombocytopenic purpura.
Acute Myeloid leukemia.
Lymphoma.
Chronic Myeloid leukemia.
Iron deficiency anemia.
92. Patient 55 years old, complains of weight loss, bones pain, abdominal pain in the right and left hypochondrial regions, easy bruising, petechia, ecchymosed on the skin , weakness, tiredness, dizziness, bed feeling. He is ill during 3 months with progression of condition. Objectively: pale skin and mucus membranes, petechia, ecchymosed on the skin, hepato –spleenomegaly. In blood: Hb-90 g\l, Er. –,5*1012\l, CI –,8, MCV –fl, reticulocytes – 0,1%, L- 70*109\l, myelocytes –%, metamyelocytes –%, stab neutrophils –%, segmented neutrophils –%, lymphocytes -15%, platelets - 100*109\l, ESR –mm\h. Philadelphia chromosome is positive. What is the preliminary diagnosis?
+Chronic Myeloid leukemia.
Thrombocytopenic purpura.
Acute Myeloid leukemia.
Lymphoma.
Aplastic anemia.