family medicine 4

Indicate the true statements concerning acute epiglottitis: 1) it is usually caused by viruses (RS, influenza, parain- fluenza, adenovirus); 2) it is caused by bacteria (H. influenzae, S. pneumo- niae, S. pyogenes); 3) it develops within several days; 4) it develops within several hours; 5) it leads to respiratory distress; 6) it has a mild course and is treated symptomatical- ly. The correct answer is: A. 1,4,6. B. 2,3,6. C. 2,4,5. D. 1,3,5. E. 1,3,6.

Indicate false sentence regarding acute otitis media (AOM): A. viruses are the most frequent etiological factor of AOM. B. adenoid hypertrophy contributes to the develop- ment of AOM. C. passive smoking increases the risk of AOM. D. age under 2 is always an indication for antibiotic therapy in the case of AOM diagnosis.E. intratemporal complications of AOM include mas- toiditis.

Which of the following Helicobacter pylori eradication protocols is preferred in Poland? A. triple therapy: PPI + amoxicillin + clarithromycin. B. triple therapy: PPI + amoxicillin + metronidazole. C. triple therapy: PPI + amoxicillin + levofloxacin. D. quadruple therapy: PPI + bismuth + metronidazole + tetracycline. E. quadruple therapy: PPI + amoxicillin + clar- ithromycin + metronidazole.

Indicate the false sentence about vaccines: A. vaccines against measles, rubella, mumps, varicel- la, and rotaviruses are alive. B. vaccines against Meningococcus, Pneumococcus, and Haemophilus influenzae typeB are dead. C. vaccines against rotaviruses are administered oral- ly. D. monovalent vaccine contains antigens of a single microorganism. E. polyvalent vaccine contains antigens of at least two different species of microorganisms.

Which of the following medications should be pre- scribed for a patient with diabetes mellitus type 2 as a first choice drug? A. bisoprolol. B. amlodipine. C. indapamid. D. ramipril. E. doxazosin.

186. Which of the following is the target value of LDL-cho- lesterol in a patient with a very high risk of cardiovascular death? A. below 160 mg/dL. B. below 130 mg/dL. C. below 100 mg/dL. D. below 70 mg/dL. E. LDL-cholesterol level is irrelevant in such a patient.

Lalonde's concept of health "fields" identifies major factors which influence the health of the population. The health care system affects the popu- lation's health in about: A. 50%. B. 40%. C. 30%. D. 20%. E. 10%.

In children with birth weight lower than 2000 g the mandatory vaccination against viral hepatitis B: A. is performed according to a 3-dose schedule: 0; 1; 2 month. B. is performed according to a 3-dose schedule: 0; 1; 6 month and a booster dose at the age of 5. C. is performed according to a 4-dose schedule: 0; 1; 2; 12 month. D. is performed according to a 4-dose schedule: 0; 1;; 12 month and a booster dose at the age of 5. E. should not be performed.

Indicate the false statement on oral glucose toler- ance test (OGTT): A. it is performed at least 8 hours after the last meal. B. it is performed after 3 days of consuming an aver- age diet with a normal carbohydrate content. C. in pregnant women a 2-stage test is performed, which starts from a screening test with 50 g of glucose. D. glycemia should be determined while fasting and 120 minutes after glucose solution intake. E. glycemia should be determined in the plasma of venous blood.

Indicate the true statement concerning the use of antibiotics in the case of a tick bite: A. antibiotic should be used when specific antibodies were detected in spite of a lack of clinical symptoms. B. therapy with antibiotics lasting several months nei- ther brings any medical advantage or improves the patient's quality of life. C. post-exposure prophylaxis (single 200 mg dose of doxycycline) should be performed in every person within 48 hours of the bite. D. A,B are correct. E. A,B,C are correct.

Which of the following should be recommended for a 55-year-old female patient if her DXA examination showed T-score = -1.5? 1) calcium-rich diet; 2) supplementation of vitamin D 3) adequate physical activity; 4) cessation of smoking; 5) bisphosphates. The correct answer is: A. 1,2. B. 1,3. C. 1,2,4. D. 1,2,3,4. E. all the above.

Indicate the false statement concerning the manage- ment of streptococcal pharyngitis: A. there is no need to determine the susceptibility of Streptococcus pyogenes to Antibiotics. B. probability of Streptococcus pyogenes infection can be assessed with the use of Centor criteria. C. phenoxymethylpenicillin is the drug of choice in the treatment of streptococcal pharyngitis. D. doxycycline should be used in patients with hyper- sensitivity type I to penicillin. E. when in doubts whether the patient will take orally phenoxymethylpenicillin, benzathine benzylpenicillin should be administered in a single dose intramuscularly.

Indicate the true statement regarding ezetimibe: A. its hypolipidemic effect is weaker than that of statins. B. it should be used mainly in combination with statins, in patients with severe hypercholesterolemia. C. is the first-line treatment in the case of statin intol- erance. D. answers A and B are correct. E. answers A, B, C are correct.

Please indicate the false statement regarding typical anginal pain: A. it occurs in the retrosternal area. B. it radiates to the neck, mandible, left shoulder and left arm. C. it subsides within a few minutes at rest. D. it subsides within 5-10 min. from taking sublingual nitroglycerin. E. it can be evoked by physical effort or emotional stress.

The initiation of treatment to manage arterial hyper- tension with a single hypotensive agent (monotherapy) is justified in the case of: A. elderly patients with the frailty syndrome. B. patients with stage 2. hypertension and intermedi- ate overall cardiovascular risk. C. patients with stage 1. hypertension, regardless of the overall cardiovascular risk. D. answers A, C are correct. E. answers A, B, C are correct.

To manage mild forms of or compliment the treat- ment of gastro-oesophageal reflux disease (GERD), the family doctor may administer: 1) H2-blockers; 2) sucralfate; 3) itopride; 4) cisapride; 5) metoclopramide. The correct answer is: A. 1 only. B. 1,2. C. 1,2,3. D. 1,2,3,4. E. all of the above.

Five pregnant women were tested for gestational di- abetes using a 75 g glucose OGTT. Indicate normal results: A. 0 h - 97 mg/dl (5.3 mmol/l); 2 h - 129 mg/dl (7.1 mmol/l). B. 0 h - 104 mg/dl (5.7 mmol/l); 2 h - 161 mg/dl (8.9 mmol/l). C. 0 h - 90 mg/dl (5.0 mmol/l); 2 h - 156 mg/dl (8.6 mmol/l). D. 0 h - 128 mg/dl (7.0 mmol/l); 2 h - 201 mg/dl (11.1 mmol/l). E. 0 h - 87 mg/dl (4.8 mmol/l); 2 h - 150 mg/dl (8.3 mmol/l).

In type 2 diabetes, the first-line treatment in slim patients is: A. metformin. B. sulphonylurea derivative. C. gliptin. D. glitazone. E. flosine.

A professional organization for family physicians in Poland is: A. Polish Society of Internal and Paediatric Medicine. B. Polish Society of Paediatric, Internal and Family Medicine. C. Society of General Medicine Practitioners. D. Polish Society of Family Medicine. E. none of the above.

in the practice of family physicians, an essential struc- tured process for raising standards in patient care is: A. quality improvement cycle. B. external auditing. C. teamwork and problem solving. D. survey among medical staff and patients. E. none of the above.

The guaranteed health care services include, among others, the following activities of family physicians: A. analysis of the patient's health needs. B. patronage visits, routine health check-ups. C. health education. D. systematic periodic assessment of the patient's health status. E. all of the above.

The patients at high risk for venous thromboem- bolism who make longlasting journeys (> 4 hours' long) by plane, car, or bus, are recommended to take the following steps before the journey: 1) wearing graduated-compression knee-high socks; 2) preventive injection of a single dose of low-molec- ular-weight heparin; 3) taking novel oral anticoagulant (NOAC); 4) taking acetylsalicylic acid; 5) taking diosmin. The correct answer is: A. only 1. B. 1,2. C. 1,2,3. D. 1,2,3,4. E. all of the above.

To assess, in an outpatient care setting, the severity of community-acquired pneumonia (CRB-65 scale), the parameters specified below are used, ex- cept for: A. confusion. B. blood urea e 7 mmol/l. C. respiratory rate e 30/min. D. systolic blood pressure < 90 mmHg and diastolic blood pressure < 60 mmHg. E. age e 65 years.

A 58-year-old male visited his family doctor because of dyspnoea lasting for several weeks. The patient did not have any chronic conditions in the past. Medical interview revealed that the dyspnoea occurs when the patient is walking on flat ground, at his own pace, and it makes him stop and relax after walking a distance of about 200-300 m. Indicate dyspnoea grade according to modified Medical Research Council (mMRC) scale: A. 1. B. 2. C. 3. D. 4. E. 5.

A female patient, 65 years of age, came to see her family doctor because of severe abdominal pain which has become more intense for the last few days. Over the last few months she has had alternating constipation and diarrhoea. Presently, she has had no bowel movement for a few days. Medical history revealed iron-deficiency anaemia di- agnosed a few months before and arterial hypertension which has been poorly controlled as the patient is not fond of going to the doctor and she did not have any health complaints. On physical examination, the abdomen was distended and painful to touch, and increased intestinal peristalsis could be heard. Deep palpation was not possible due to abdominal tension. Indicate appro- priate measures to be taken: A. urgently refer the patient to hospital because of suspected intestinal obstruction. B. refer the patient to hospital for elective abdominal diagnostics. C. refer the patient to an ou.

A male patient, 70 years of age, came to see his family doctor to discuss the results of laboratory tests he made to check whether he may have osteo- porosis because he had had a radial bone fracture after a slight fall a few months before. Apart from that, he reports occasional lumbar pain and weakness which he thinks can be attributed to ageing. Laboratory tests showed blood calcium concentration 4 mmol/l (normal range: 2.1-2.6 mmol/l), creatinine 2.1 mg/dl (normal range: 0.6-1.3 mg/dl), and slight normocytic anaemia, with no other abnormalities. What is the most probable diagnosis? A. primary hyperparathyroidism. B. multiple myeloma. C. vitamin D deficiency. D. iron deficiency. E. primary osteoporosis.

A mother with her 5-year-old daughter came to see their family doctor. The daughter has been complaining of headache and she has occasionally vomited for some time. The symptoms usually occur in the morning hours. The doctor suspects a tumour of the central nervous system. However, the physical examination, including full neurological exam, did not reveal any abnormalities. The same refers to laboratory testing. What further mea- sures should be taken? A. paracetamol administration to control headache, at a dose based on kg body weight. B. recommendation to avoid eating late, in order to prevent morning vomiting. C. refer the patient to cancer centre for imagining diagnostics of the head. D. refer the patient to gastro ward for imaging diag- nostics of the abdomen. E. refer the patient to psychology clinic, as most prob- ably the child simulates the symptoms, which may be associated with impaired family relation- ships.

During a complex medical check-up for children at 3rd grade of primary school, the mother asks the doctor for a medical waiver to exempt her child from the physical education course. She claims that owing to obesity, the child has difficulty performing physical exercises and does not get such good grades as other children do. Which group of the phys- ical education course should the doctor classify the child into? A. group C, for a non-defined period of time, and ask the child to show up for regular control check-ups at the clinic. B. group C, for a month's time, and then make a re-assessment. C. group C1, as obesity is a serious disease which requires supplementary rehabilitation out of school. D. group B, considering the reason for the limitation and, possibly, providing guidelines to the teacher. E. group A, as the child should perform the same exercises as other pupils do, which will be beneficial to his/her hea.

Indicate the true criteria for positive bronchodilator response in asthma diagnostics in adults and children over 6 years of age: 1) FEV1 increase > 12% and >200 ml from baseline, in adults; 2) FEV1 increase > 12% or >200 ml from baseline, in adults; 3) FEV1 increase > 12% of baseline, in adults; 4) FEV1 increase > 12% and >200 ml from baseline, in children; 5) FEV1 increase > 12% or >200 ml from baseline, in children; 6) FEV1 increase >12% from baseline, in children. The correct answer is: A. 1,4. B. 1,5. C. 2,5. D. 3,5. E. 1,6.

1) Tinel-Hoffman sign 2) Phalen's sign; 3) Hashizume sign; (grading system) 4) Rumpel-Leede sign; 5) Thompson sign. (Achilles tendon rupture) The correct answer is: A. 1,2,3. B. 1,2,4. C. 1,2,5. D. 1,2,3,4. E. all of the above.

Which is the right treatment of acute viral diarrhoea in a patient with a negative history of other diseases? 1) hydration. 2) the use of electrolites. 3) the use of antidiarrhoeal drugs e.g. loperamide. 4) the use of probiotics. 5) the use of antibiotics. A. 1,2,3. B. 1,2,4. C. 1,2,5. D. 1,3,4. E. 1,3,5. The basis of the tr.

The basis of the treatment of inorganic sleep distur- bances is education on sleep hygiene. Which is the false recommendation? A. you should go to sleep and get up at a fixed time, regardles of the day of the week. B. you should avoid larger meals just before bed- time. C. you should not try to fall asleep at all costs. D. you should take a 20-30 - minute nap during the day. E. you should not drink large amounts of liquids be- fore bedtime.

In their everyday practice a general practitioner (GP) complies with evidence-based medicine (EBM) standards. The sources of knowledge are often guidelines and algorhythms. Taking into account the rules for selection and the features of good guide- lines, which of the following should the physician consult if they wanted to learn the up-to-date rules of treatment of disease X in Poland? A. the 1990 Polish guidelines for the treatment of disease X for General Practitioners. B. the 2020 European guidelines for the treatment of disease X for the outpatient care. C. the 2020 American guidelines for the treatment of disease X for ambulatory care. D. the 2020 European guidelines for the treatment of disease X for hospital care. E. EBM policy refers to hospital medicine only, so a general practitioner should rely on the local treatment policy and intuition.

the criteria for the metabolic syndrome do not in- clude: A. waist circumference >94 cm in men or >80 cm in women. B. triglyceride concentration >150 mg/dL or treat- ment with hypertriglycerides. C. concentration of LDL-C > 115 mg/dL or treatment of this form of dyslipidemia. D. systolic blood pressure >130 mmHg or diastolic blood pressure >85 mmHg or hypotensive treatment. E. fasting glucose concentration >100 mg/dL or phar- macological treatment of diabetes.

A mother with a two-year-old daughter who had been having symptoms of a cold for several days and had been treated independently at home, pre- sented to the general practitioner. The previous night there was also hoarseness, wheezing and the cough changed its character. The patient has difficulty in catching a breath, especially when crying. The mother noticed that when they came out, in the cold air, the symptoms quickly resolved. Which is the correct management in this patient? A. oral administration of dexamethasone 0.15-0.6 mg/kg of body weight. B. nebulization with 3% sodium chloride. C. intramuscular administration of ceftriaxone 50 mg/kg of body weight. D. oral administration of azitromycin10 mg/kg of body weight for 3 days. E. continuation of treatment of the cold and recom- mendation for spending more time outdoors.

Indicate the most common causes of lumbosacral pain in the patients below 30 years of age. A. seronegative spondyloartropathies. B. Paget's disease. C. congenital lumbar spinal stenosis. D. discopathy. E. bulging of the nucleus pulposus.

The damage to the recurrent laryngeal nerve as one of the causes of hoarseness may result from: 1) acute epiglottitis. 2) hypothyroidism. 3) gout. 4) lung cancers. 5) akromegalies. The correct answer is: A. all of the above. B. 2,3,4,5. C. 4,5. D. only 4. E. 2,3,4.

Acute infectious respiratory disease, caused by RNA viruses, in which the human being is the only reservoir of the virus, and infectivity to the environ- ment occurs 5 days prior to the onset of the rash and 3 days following its resolution is: A. infectious mononucleosis. B. rubella. C. roseola. D. hand, foot and mouth disease. E. measles.

Which of the parasites parasitizes only in the lumen of the human large intestine? 1) pinworm. 2) giardiasis. 3) ascaris lumbricoides. 4) armed tapeworm. 5) broad tapeworm. The correct answer is: A. only 1. B. 1,2. C. 1,2,3. D. 1,2,3,4. E. 2,3,4,5.

Which is the drug of choice in the treatment of acute uncomplicated bronchitis? A. amoxicillin. B. amoxicillin with clavulanic acid. C. clarithromycin. D. cefuroxime axetil. E. symptomatic treatment - without antibiotic thera- py.

A patient reported to the GP with temperature above 39° C, chills and severe pain, lasting from the evening hours of the previous day. The pain appeared several minutes after eating a heavy dinner, is located in the epigastrium and is radiating to the right shoulder. The patient reports a single incident of vomiting and nausea. Indicate the cause of the symptoms. A. gastric ulcer disease. B. appendicitis. C. right-sided renal colic. D. acute cholecystitis. E. abdominal aortic dissection.

Indcate the false statement concerning melanoma: A. a malignant neoplasm most commonly derived from cutaneous melanocytes that have undergone malignant transformation. B. a helpful tool facilitating the clinical diagnosis of melanoma is the ABCDE scale C. the prognosis depends on the stage of the dis- ease. D. the risk of developing another melanoma increas- es about 10-25 times in a person who has previously had this type of cancer. E. the best diagnostic method is a fine needle biopsy of a suspicious lesion.

In which neoplastic diseases does itching of the skin occur? 1) lung cancer. 2) breast cancer. 3) stomach cancer. 4) lymphogranuloma. 5) Sézary syndrome. The correctt answer is: A. only 1. B. 1,2. C. 1,2,3. D. 2,3,4. E. all of the above.

ndicate the vaccines that can be administered to pregnant women. 1) inactivated influenza vaccine. 2) hepatitis B vaccine. 3) pertussis, diphtheria and tetanus vaccine, Tdap type. 4) pertussis, diphtheria and tetanus DTPw vaccine; ??? 5) tuberculosis vaccine. The correct answer is:A. only 1. B. 1,2. C. 1,2,3. D. 1,2,3,4. E. 2,3,4,5.

A GP has been called for a home visit to an 80-year-old female patient, by her son who was concerned about the strange behavior of his mother: for the past 2 days the patient has not been able to speak, today she does not understand what she is being told, she does not follow the simplest commands, and also has problems with keeping balance. Indicate the cause of these symptoms. A. hypoglycaemia. B. stroke. C. brain tumour. D. decrease in blood pressure. E. Alzheimer's disease.

A 66-year-old male patient reported to his GP com- plaining of palpitations, impaired exercise tolerance and dizziness. On the assessment of the patient's ECG, the doctor found arrhythmias with irregular RR intervals, no visible P waves and regular electrical function of the atria in V1 lead. Indicate the cause. A. atrial flutter. B. paroxysmal atrial tachycardia. C. acute coronary syndrome D. paroxysmal atrial fibrillation. E. ventricular arrhythmias.

Indicate the true statements concerning erysipelas. 1) β-hemolytic streptococcosis is the pathogenic agent. 2) it may be a complication of ulcers in the course of venous insufficiency. 3) on the face, the infection usually affects the cheeks and nose, often taking the shape of a butterfly. 4) the treatment of choice is an antibiotic therapy with a gram-negative bacteria active drug. 5) acute glomerulonephritis is a very commonly ob- served complication of erysipelas. The correct answer is: A. only 1. B. 1,2. C. 1,2,3. D. 1,2,3,4. E. 2,3,4,5.

In which bacterial infection would you use amoxicillin as the first-line treatment? 1) bacterial pharyngitis and tonsilitis. ??? 2) bacterial sinusitis. 3) uncomplicated cystitis in women. 4) acute pyeolonephritis. 5) traveller's diarrhoea The correct answer is: A. only 1. B. only 2. C. 1,2. D. 2,4. E. all of the above.

The beginning of post-exposure management can be delayed until the confirmation of rabies in the animal, provided that the animal that exposed the person did not show any signs of the disease during the exposure and a 15-day veterinary obser- vation is possible. Indicate the statement to which the description refers. A. animals that have been vaccinated against rabies and have a documented vaccination. B. all domestic animals, i.e.: cats, dogs, rabbits, ham- sters, mice. C. only cats and dogs. D. the beginning of post-exposure management in the case of suspected rabies should be started immediately without unnecessary observation of the animal. E. such observation is possible in every animal only in the case of salivation of the damaged skin, slight bites and scratches.

immediate use of an antibiotic in acute otitis media is recommended in: 1) children under 6 months old. 2) children over 2 years old with bilateral otitis media. 3) children with high fever ( > 39o C ), severe pain and vomiting. 4) patients with purulent discharge from the ear. 5) patients with limited access to health care The correct answer is: A. all of the above. B. 1,3,4,5. C. 1,2,3,4. D. only 1. E. 1,4.

The condition of a 60-year-old female patient, suffer- ing from venous thromboembolism has suddenly deteriorated. Dyspnoea, tachycardia and tachypnoea have occurred. The patient is sygnificanly anxious. Indicate the cause: A. exacerbation of ischaemic heart disease. B. intercostal nerve neuralgia. C. pulmonary embolism. D. exacerbation of COPD. E. pneumonia.

A 7th grade primary school student presented to the GP for a balance test. When assessing sexual development, the doctor noted: the testes are grow- ing significantly and are of about 3.6 cm in size. The penis and scrotum are increasing/ enlarging. Pu- bic hair is still growing mainly around the back of the penis, but is becoming coarse and curly. The correct rating according to the Tanner scale is: A. G1,P1. B. G2, P3. C. G3, P3. D. G4, P4. E. G5, P5.

Normal urine sediment should not contain: 1) cystine crystals. 2) megnesium-amonium phosphate crystals. 3) uric acid crystals. 4) calcium oxalate crystals. 5) calcium phosphate crystals. The correct answer is: A. only 1. B. 1,2. C. 1,2,3. D. 1,2,3,4. E. 2,3,4,5.

Indicate the false statement concerning a medical patronage visit. A. a medical patronage visit to a healthy, full-term newborn baby should take place in the first four weeks of their life. B. a medical patronage visit to premature babies should take place within 7 days following the baby's discharge from the hospital. C. a medical patronage visit to a full-term newborn baby takes place at the newborn's home or in the healthcare facility. D. a medical patronage visit to premature baby al- ways takes place at the newborn's home. E. physical examination during a patronage visit should be carried out in the presence of the newborn's parents or guardians.

Indicate a feature that is not characteristic of COPD: A. progressive character. B. variability of symptoms during the day. C. chronic exposure to tobacco smoke. D. inspiratory chest position. E. loss of body weight.

A 21-day long antibiotic therapy will be used in the case of pneumonia caused by: A. Streptococcus pneumoniae. B. Legionella pneumophila. C. Mycoplasma pneumoniae. D. Chlamydia pneumoniae. E. Haemophilus influenzae.

A typical electrocardiographic image of acute my- ocardial infarction is: A. elevation of the ST segment at point J, in two adja- cent leads, by 2 mm in V1-V3 or by 1 mm in others. B. elevation of the ST segment at point J, in two adja- cent leads, by 2 mm in V4-V6 or by 1 mm in others. C. change in ST segment morphology at J ( depression or elevation ) D. recent right bundle branch block. E. the true answers are A i D.

Indicate the false statements concerning the values of complete blood count parameters. A. in peripheral blood smear test, in newborns lym- phocytes prevail. B. in peripheral blood smear test, in children neu- trophils prevail. c. the highest physiological values of leukocytes are observed in the newborn in the second week of life. D. the lowest hemoglobin and hematocrit values oc- cur in newborns. E. the highest platelet values occur in newborns.

In which of the following cases will the GP use a 3-dose vaccination schedule using tetanus prophylaxis? A. uncertainvaccination history, lack of documenta- tion, high risk of tetanus. B. uncertain vaccination history, lack of documenta- tion, low risk of tetanus. C. last dose of vaccine over 10 years ago, high risk of tetanus. D. last vaccination 5-10 years ago, high risk of tetanus. E. last vaccination dose 1-5 years ago, low risk of tetanus.

indicate the true statements concerningc plasma cell myeloma. 1) a typical symptom of plasma cell myeloma is bone pain, especially in the lumbar, costal regions; which responds well to nonsteroidal anti-inflamma- tory drugs. 2) three-digit ESR and the presence of M component in the serum and urine are typical for plasma cell myeloma. 3) increased percentage of monoclonal plasmacytes is typical for plasma cell myeloma in a punch biopsy. 4) patients with obesity during thalidomide therapy should receive prophylactic treatment against venous thromboembolism. 5) occurs mainly in young adults. The correct answer is: A. 1,2,3. B. 1,2,3,4. C. 2,3,4. D. 1,3. E. 1,2,4,5.

Indicate the false statement concernig neoplastic dis- eases. 1) daily intake of 10-20 grams of alcohol is a recog- nized risk factor for hepatocellular carcinoma and cholangiocrcinoma. 2) secondary prevention of colorectal cancer includes rectosigmoidoscopy every 10 years. 3) asymptomatic hypercalcaemia worsens the prog- nosis for a cancer patient. 4) the reasonableness of performing imaging exami- nations or blood tests in the prevention of cancer in asymptomatic patients is small. 5) the occurrence of fever in patients treated with cytostatics requires urgent complete blood count. The correct answer is: A. 1,2,3. B. 3,4,5. C. 1,4. D. 2,4. E. 3,4.

Indicate the true statements concerning a prolifera- tive blood disease: 1) Philadelphia chromosome presence is stated in 50% of chronic myelogenous leukaemia cases. 2) mediastinal tumor never causes upper vena cava syndrome. 3) the median diagnosis of acute myeloid leukemia is 57 years old. 4) outpatient complete blood count and abdominal ultrasound in a child with suspected acute myeloid leukaemia may delay diagnosis. 5) konieczne do rozpoznania ostrej białaczki szpikowej jest stwierdzenie minimum 20% komórek blastycznych w rozmazie krwi i/lub szpiku. (It is nec- essary to detect at least 20% of blast cells in the blood and/or bone marrow smear to diagnose acute myeloid leukemia.. ) The correct answer is: A. 1,4,5. B. 1,5. C. 1,3,5. D. 4,5. E. 2,3,4,5.

Indicate the symptoms that may accompany small cell lung cancer. 1) shoulder pain in Pancosta tumour. 2) Lambert-Eaton myasthenic syndrome. 3) Cushing's syndrome. 4) weight loss. 5) acanthosis nigricans The correct answer is: A. 1,4,5. B. 1,3,4. C. 1,2,4. D. 3,4,5. E. all of the above.

Grade III, on the TNM scale, in gastric cancer means. A. tumour infiltrating the submucosa, without distant metastases. B. tumour infiltrating the peritoneum with distant metastases. C. tumour infiltrating the muscle layer, without dis- tant metastases. D. tumour infiltrating the muscle layer, with distant metastases. E. tumour infiltrating the submucosa with the pres- ence of distant metastases.

Indicate the true statement concerning skin cancers. A. basal cell carcinoma usually develops before the age of 40. B. squamous cell carcinoma is the most common skin cancer C. basal cell carcinoma is characterized by rapid growth and ease of bleeding. D. patients with numerous moles and a history of a second-degree burn in the childhood are particularly vulnerable to the development of malig- nant melanoma. E. the most malignant form of melanoma is a form that develops from a malignant lentigo.

Indicate the true statement concerning small cell lung cancer. 1) an increase in the lactate dehydrogenase index is a bad prognostic indicator. 2) the occurrence of vomiting a few days after treat- ment is characteristic of chemotherapeutic agents used during the treatment of small cell lung cancer. 3) surgery is the preferred treatment method. 4) an X-ray is the most effective method of imaging responses to chemotherapy. 5) a tumor in the case of small cell lung cancer can be neuroendocrine active. The correct answer is: A. 1,2,3. B. 1,2. C. 2,3,4. D. 4,5. E. 1,2,5.

Indicate the true statements concerning breast fi- broadenoma. 1) the symptom that distinguishes fibroadenoma from abscess will be, for example, a fluctuation symptom typical of a purulent lesion. 2) breast tumour should be assessed according to the 5-point BI-RADS scale. 3) a negative FNAB result excludes the presence of cancer. 4) late menarche increases the risk of fibroadenoma. 5) clinically, difficult to be distinguished from phyl- lodes tumour. The correct answer is: A.1,2,5. B. 1,3,5. C. 1,5. D. 1,2,3,4. E. 2,3,4,5.

Indicate the true statements concerning cervical can- cer prevention. 1) Cervarix vaccine is reimbursed after the age of 9 years old. 2) adopting a single-dose schedule gives comparable effectiveness to a twodose schedule. 3) children over 15 years of age should adopt a 3-dose schedule. 4) in children between 9 and 14 years of age, if the interval between the 1st and 2nd dose has been shorter than 5 months, a 3rd dose should always be administered. 5) pregnant women should not be vaccinated with Cervix vaccine. The correct answer is: A. all of the above. B. 1,3,4,5. C. 1,4,5. D. 1,3,4. E. 2,3,4,5.

Indicate the true statements concerning pain and its possible cause. 1) night pain - cancer pain. 2) pain decreasing in a sitting and standing position, increasing in a lying position, with a feeling of tightness in the abdomen - compression fracture of the vertebral shaft. 3) pain increasing in a sitting position - spinal canal stenosis. 4) pain during coughing - hernia of the nucleus pul- posus. 5) pain decreasing in a sitting position - spinal canal stenosis. The correct answer is: A. 1,3,5. B. 1,4,5. C. 1,2,3. D. 1,3,4. E. 2,3,4,5.

Indicate the true statements concerning pinworm-in- duced parasitosis: 1) inflammatory lesions occur in the large intestine which may lead to appendicitis. 2) the most common symptoms are itching in the anus area, abdominal pain and excessive mobility. 3) in pharmacological treatment, pyrantel is used at a dose of 10 mg / kg bw at a single dose not exceeding the maximum dose of 2g. 4) infection occurs via the oral route by swallowing eggs floating in domestic dust 5) autoendoinfection may occur, especially in patients with constipation. The correct answer is: A. 1,2,4,5. B. 1,2,3,4. C. 1,2,4. D. 2,4,5. E. all of the above.