Exam 1

Dyspepsia means: pain in the upper abdomen. “Heartburn". a common term for unpleasant sensations in the upper abdomen. regurgitation of gastric contents into the esophagus. a common term for all symptoms that result from inadequate excretion of pepsin.

A 60-year-old patient who comes to the doctor for dyspepsia. we have to do gastroscopy. First, in 14 days, we anticipate an antacid or H2 receptor blocker. first, prescribe eradication treatment for H. pylori. we perform gastroscopy in case of anemia. First, we prescribe an ulcer diet for 14 days.

Among the "signs of alarm" that justify immediate gastroscopy in dyspepsia are all listed except: weight loss. anemia. palpable tumor. pain for more than 2 weeks. pain before meal ("on an empty stomach").

The color of the coffee sediment of the vomit is the most characteristic for: ileus. alcohol poisoning. overdose of black coffee. bleeding from the upper gastrointestinal tract. bleeding from the lower gastrointestinal tract.

Odor of faeces of the vomit shows: ileus. poisoning with organophosphates. gastrointestinal haemorrhage. gallbladder disease. meteorism.

What is usually the first investigation with suspected intestinal perforation: ultrasound. abdominal x-ray. CT. lab.blood tests. rectal examination.

Colic (pain) is a typical example of: visceral pain. parietal pain. transferred pain. phantom pain. none of the above.

The visceral type of pain is characterized by: “defense musculaire” always accompanies the pain. accompanied by nausea and vomiting. unlike transferred pain, it is well localized. it gets worse when coughing, sneezing and moving. never spreads over the diaphragm.

The transferred pain is: well-localized. always proximal to the affected organ. always distal from the affected organ. worse on palpation of the dermatome, which belongs to the same spinal segment as the affected organ. synonymous with phantom pain.

If at percussion of the abdomen we find thympanism, most probable cause is the following: perforation of the hollow body. free fluid in the abdomen. free liquid retroperitoneal. ileus. pregnancy.

The pain in acute appendicitis is characterized by: worsens with movement and cough. radiates to the right shoulder. is a painful palpation of the Erb point. has a colic character, comes in attacks. no recurrent pain.

We suspect bowel infarction: with severe abdominal pain, followed by a strong bowel emptying. when the pain stops after 3-4 hours, when the whole ischemic area dies. with defense musculaire that arises already at the onset of pain. with the pain that occurs in the attacks. in young people with sudden severe abdominal pain.

Jaundice becomes visible at a concentration of bilirubin, which: exceeds the upper limit of the normal. exceeds the upper limit of the normal by 50%. exceeds the upper limit of the normal by 100%. exceeds the upper limit of the normal by 300%. it can also be in the normal range.

Bilirubin in urine is a sign: direct hyperbilirubinaemia. indirect hyperbilirubinaemia. prehepatic jaundice. kidney disease. Gilbert’s disease.

Direct hyperbilirubinaemia and an increase in alkaline phosphatase and gGT causes suspicion of: obstruction of bile ducts with gallstones. hemolytic anemia. Gilbert syndrome. resorption of blood from large hematomas. none of the above.

Indirect hyperbilirubinaemia can be found in: Gilbert syndrome. alcoholic liver disease. gallstones. primary biliary cirrhosis. bleeding into the gastrointestinal tract.

An enlarged and palpatory painful liver is most likely a sign of the following causes: cancer. acute cholecystitis. alcoholic liver cirrhosis. acute left-sided heart failure. viral hepatitis.

The strongly increased alkaline phosphatase concentration is most evident on: acute hepatitis. obstruction of the bile duct. alcoholic liver cirrhosis. poisoning with carbon monoxide. extravascular haemolysis.

When we find higher level of direct bilirubin, the first diagnostic approach is: ultrasound of the liver and bile ducts. CT abdomen. gastroscopy (and, if necessary, endoscopic ultrasound). puncture of the bone marrow. lumbar puncture.

The normalization of the prolonged prothrombin time in a patient with hyperbilirubinemia after three days of vitamin K is most likely due to the following diagnoses: Gilbert syndrome. alcoholic hepatitis. viral hepatitis. bile duct carcinoma. poisoning with paracetamol.

Diarrhea in ulcerative colitis. osmotic. secretory. exudative. motility. none of the above.

Osmotic diarrhea is differentiated from the secretory by: fasting test (not eating). hematesta of the feces. rectal examination. gastroscopy. autopsy.

A sixty-year-old chronic alcoholic comes to the doctor because of the 14-day-old swelling of the left lower limb distal to the knee. Among the causes most likely to be possible: heart failure (alcohol cardiomyopathy). hypoproteinemia due to inadequate nutrition. nephrotic syndrome. Local inflammation. liver cirrhosis.