1) Which of the following is the most typical lesion of the cardiovascular system in systemic scle- roderma? a) mitral stenosis b) aortic insufficiency c) exudative pericarditis d) macrofocal cardiosclerosis e) sterile wart-like endocarditis 2) Eyelid damage is one of the criteria for diagnosing one of the following: a) rheumatism b) systemic lupus erythematosus c) dermatomyositis d) polymyalgia rheumatica e) systemic scleroderma 3) In diffuse systemic scleroderma, the skin of the following body areas is affected: a) face, fingers, and toes b) torso, face, and limbs c) mostly torso d) mostly face e) mostly fingers 4) The drug of choice for true scleroderma kidney is: a) beta-blockers b) angiotensin converting enzyme inhibitor c) native plasma d) glucocorticoids e) cytostatic drugs 5) The pathognomonic manifestation of dermatomyositis is: a) periorbital edema with heliotrope rash on the upper eyelid and Gottron syndrome (rash over the metacarpophalangeal joints) b) erythema on exposed skin c) poikiloderma d) alopecia e) Raynaud's syndrome 6) In systemic scleroderma, the following blood vessels are predominantly affected: a) arterioles and capillaries b) medium caliber vessels c) vessels of any caliber d) large vessels e) veins 7) Which of the following laboratory tests has the greatest information value to confirm the diag- nosis of polymyositis? a) ESR b) antinuclear factor c) rheumatoid factor d) antibodies to muscle antigens e) increased blood levels of creatine kinase 8) The first phase of Raynaud's syndrome is manifested by: a) reactive hyperemia of the skin of the fingers and toes b) cyanosis of the distal extremities c) whiteness of the fingers and toes due to vasoconstriction d) paresthesia throughout the arm, leg 9) Which of the following symptoms characterizes Raynaud's syndrome a) weak pulse or absence of pulse in the medium caliber arteries of the limbs b) unilateral discoloration of fingers and toes c) development of necrotic lesions in the area of the fingers and toes d) absence of visceral lesions 10) Which skin lesion is not typical of systemic scleroderma? a) erythematous rash b) isolated foci of fibrosis c) telangiectasia d) skin calcification e) fibrosis of the skin proximal to the joints, including the neck, trunk 11) Which of the following statements is true for systemic lupus erythematosus a) development of erosive arthritis is typical b) dysphagia often occurs c) high disease severity is characterized by leukocytosis d) glomerulonephritis is a prognostically unfavorable organ lesion 12) Which of the following is not a diagnostic criterion (APA, 1987) for systemic lupus erythema- tosus? a) erosive arthritis b) polyserositis c) photosensitivity d) lesions of the central nervous system e) oral ulcers 13) True LE cells are: a) segmented neutrophils containing fragments of nuclei of other cells b) monocytes containing nuclei of other cells c) hematoxylin bodies d) monocytes forming rosettes with red blood cells 14) Which of the following does not contribute to the development of polyarteritis nodosa? a) persistence of hepatitis B virus b) increased antistreptococcal antibody titers c) drug intolerance d) increased sensitivity to cold and sunlight 15) The combination of unilateral Raynaud’s syndrome with the absence of pulse in the radial ar- tery of the arm on the same side and increased blood pressure in the legs suggests a) atherosclerosis b) thromboangitis obliterans (Buerger disease) c) Takayasu arteritis d) Horton's disease e) coarctation of the aorta 16) Which of the following is typically affected in Horton's disease a) aorta b) coronary arteries c) renal arteries d) temporal arteries e) pulmonary artery 17) Which of the following is not a cardiovascular symptom in polyarteritis nodosa? a) acute myocardial infarction b) diffuse heart muscle injuries c) mural endocarditis d) arterial hypertension 18) Granulomatous arteritis includes all of the conditions below, except for: a) polyarteritis nodosa b) eosinophilic granulomatosis with polyangiitis c) temporal arteritis d) nonspecific aortoarteritis e) granulomatosis with polyangiitis (Wegener's granulomatosis) 19) Arthritis in systemic lupus erythematosus is characterized by all of the following, except for: a) similarities with rheumatoid arthritis, with symmetrical damage to the proximal interphalangeal joints b) development of destructive changes in the joints c) regression under the influence of therapy with non-steroidal anti-inflammatory drugs d) joint subluxation 20) The optimal glucocorticoid for long-term therapy of systemic lupus erythematosus is: a) triamcinolone b) hydrocortisone c) dexamethasone d) methylprednisolone e) betamethasone 21) What are diseases of the joints, which include rheumatoid arthritis? a) inflammatory b) degenerative c) metabolic d) reactive e) combined with spondyloarthritis 22) Which joints does rheumatoid arthritis most often affect? a) of the spine b) of the knee c) proximal interphalangeal d) sacroiliac e) distal interphalangeal 23) For which complication of rheumatoid arthritis is urine analysis an informative test a) Hamman – Rich syndrome b) pericarditis c) amyloidosis d) digital vasculitis 24) Laboratory signs of rheumatoid arthritis are: a) increased CRP levels b) acceleration of ESR c) increased LDH levels d) leukocytosis e) ASO titer 25) Pannus is a) aggressive granulation tissue b) morning stiffness for more than 1 hour c) increased ALT d) Heberden's node e) high ASO titer 26) Leading pathogenetic mechanism of osteoarthritis progression is: a) synovitis b) articular cartilage degeneration c) protrusion of calcium hydroxyapatite crystals into the joint cavity d) bone remodeling e) atrophy of adjacent muscle groups 27) . Limitation of mobility in the affected joint in osteoarthritis is not associated with the presence of: a) muscle spasm b) subluxations c) bony ankylosis d) fibrosis and shrinkage of the joint capsule e) presence of large osteophytes 28) The most informative diagnostic method for osteoarthritis is: a) synovial biopsy b) synovial fluid examination c) radiography of joints d) complete blood count and blood biochemistry e) ultrasound 29) Bouchard’s nodes are bony enlargements in: a) metacarpophalangeal joints b) distal interphalangeal joints of the hand c) metatarsophalangeal joints d) proximal interphalangeal joints of the hand e) proximal interphalangeal joints of the foot 30) In which localization of osteoarthritis is the hand function most affected? a) distal interphalangeal joints b) first carpometacarpal joint c) proximal interphalangeal joints d) metacarpophalangeal joints 31) At which concentration of uric acid in the blood serum is hyperuricemia diagnosed in men? a) more than 0.460 mmol / l b) more than 0.420 mmol / l c) more than 0.400 mmol / l d) more than 0.360 mmol / l 32) Monoarthritis usually occurs in: a) gout b) SLE c) systemic scleroderma d) RA e) ankylosing spondylitis 33) Which of the following can be used to treat gout a) rituximab b) golimumab c) canakinumab d) adalimumab 34) Which of the following is characteristic of gout? a) asymmetrical damage to the joints of the feet at the onset b) symmetrical damage to the joints of the hands c) damage to the hip joints d) damage to the shoulder joint 35) Ankylosing spondylitis most often affects: a) young men b) elderly people c) little children d) middle-aged women 36) Ankylosing spondylitis excludes: a) bilateral sacroiliitis b) enthesopathies c) Heberden's nodes d) night pain in the lumbar region 37) Which joints are the first to be affected in ankylosing spondylitis? a) of the spine b) root joints c) distal joints d) proximal joints 38) In patients with ankylosing spondylitis, the first-line drug is: a) methotrexate b) sulfasalazine c) NSAIDs d) TNFα inhibitor 39) Radiologic signs of ankylosing spondylitis include: a) asymmetric sacroilitis b) erosion of small joints of the hands c) unilateral sacroiliitis d) bilateral sacroiliitis 40) Pathognomonic clinical signs of Crohn's disease are: a) constipation, bloating, fever b) diarrhea, pain in the joints c) constant bleeding from the rectum, nausea, fever d) abdominal pain, diarrhea, blood and pus in the stool e) presence of infiltrates in the abdomen, damage to the skin, eyes and joints 41) A radiologic sign not characteristic of Crohn’s disease is: a) the presence of strictures along the affected areas of the intestine b) multiple protrusions of the colonic wall c) the presence of identical lesions in both the large and small intestines d) the presence of spicules along the intestinal contour e) the presence of internal and external intestinal fistulas 42) Select the most characteristic area of intestinal damage in ulcerative colitis a) rectum b) terminal ileum c) any segment of the large intestine d) the entire colon e) anal and perianal area 43) Select the most characteristic morphological sign of Crohn’s disease during an endoscopic ex- amination: a) ulcers are slit-like structures comparable to cobblestone pavement b) increased vascular pattern of the mucosa c) multiple polyps d) fibrin plaques e) hyperemia and swelling of the mucous membrane 44) In which disease do intestinal strictures most often form? a) ulcerative colitis b) Crohn's disease c) diverticulosis d) ischemic colitis e) Hirschsprung's disease 45) Specify a disease in which inflammation is localized primarily in the mucous membrane: a) ischemic colitis b) Crohn's disease c) diverticulosis d) ulcerative colitis e) Hirschsprung's disease 46) Which study is the most informative for the diagnosis of ulcerative colitis? a) scatology b) stool culture for microbial flora c) colonoscopy d) X-ray of the small intestine e) fibrogastroscopy 47) When the tail is affected in patients with pancreatitis, the pain is localized: a) in the left hypochondrium or to the left of the navel b) in the epigastrium c) in the right hypochondrium d) has a girdling nature e) in the upper abdomen radiating like a belt 48) A characteristic clinical sign of chronic pancreatitis is: a) development of diabetes mellitus b) decreased function of external secretion c) jaundice d) increased transaminase activity e) hepatomegaly 49) Which of the following is not typical of chronic pancreatitis? a) girdling pain in the epigastrium b) pain in the left hypochondrium radiating to the back c) diarrhea d) vomiting for relief e) decreased appetite or lack of appetite 50) Which of the following are used to suppress the activity of pancreatic enzymes? a) antacids b) anticholinergics c) H2 blockers d) sandostatin e) beta-blockers 51) Which of the following are not etiological factors for the development of chronic pancreatitis? a) biliary tract diseases b) alcohol abuse c) immunological factors d) food allergies 52) Which of the following is not typical of chronic pancreatitis? a) abdominal pain b) steatorrhea c) creatorrhea d) watery diarrhea e) diabetes 53) Which of the following is the method of choice in the treatment of chronic calculous cholecys- titis? a) dissolution of stones with litholytic drugs b) micro-laparoscopic cholecystostomy c) extracorporeal shock wave lithotripsy d) cholecystectomy e) complex conservative therapy 54) The most informative method of research for intense long-term jaundice is: a) intravenous infusion cholangiography b) endoscopic retrograde cholangiopancreatography c) percutaneous transhepatic cholangiography d) ultrasound examination of the liver and biliary tract e) oral cholecysto-cholangiography 55) The most informative method for the diagnosis of calculous cholecystitis is a) oral cholecysto-cholangiography b) laparoscopy c) plain abdominal X-ray d) ultrasound examination of the liver and biliary tract e) endoscopic retrograde cholangiopancreatography 56) Which of the following is used in the treatment of hyperkinetic biliary dyskinesia? a) antispasmodics b) H2 blockers c) tubeless methods d) sucralfate and its analogues e) surgery 57) Under normal conditions, the gallbladder is located: a) at the intersection of the outer edge of the right rectus abdominis muscle and the costal arch b) at the intersection of the anterior axillary line on the right and the costal arch c) at the intersection of the midclavicular line and the costal arch d) 5 cm below the above point e) To the right of the navel 58) A positive Murphy’s sign is pathognomonic for: a) duodenal ulcer b) cholecystitis c) pancreatitis d) gastritis e) duodenitis 59) The normal thickness of the gallbladder wall according to ultrasound findings is: a) 1–2 mm b) 3–4 mm c) 5–6 mm d) 7–8 mm e) 9–10 mm 60) For the exacerbation phase of chronic cholecystitis, the most typical syndrome combination is: a) pain, cholestasis, portal hypertension b) pain, dyspepsia, inflammation c) asthenic vegetative syndrome, dyspepsia, general dystrophy d) dyspepsia, cholestasis, cytolytic hepatitis e) dyspepsia, asthenic vegetative syndrome, anemia 61) Liver cirrhosis is not characterized by the presence of: a) ascites b) splenomegaly c) varicose veins of the stomach d) dilatation of the abdominal superficial veins in the shape of a jellyfish head e) hyperalbuminemia 62) The most informative method for diagnosing liver cirrhosis is: a) bromsulphalein test b) determination of bilirubin and aminotransferase levels c) thymol test d) ultrasound examination of the liver and biliary tract e) morphological examination of liver biopsy 63) Ascites in liver cirrhosis is formed due to: a) secondary hyperaldosteronism b) hypoalbuminemia c) portal hypertension d) all of the above e) none of the above 64) The essential grounds for the diagnosis of chronic hepatitis are: a) past viral hepatitis b) data from a histological examination of the liver c) detection of the Australia antigen in the blood serum d) recurrent low-grade fever, icterus, pain in the right hypochondrium, moderate hepatomegaly e) detection of alpha fetoprotein in the blood serum 65) . A characteristic histologic sign of chronic active hepatitis is: a) inflammatory infiltrate in the portal tracts b) dilatation of bile canaliculi c) hepatic necrosis d) presence of hyaline inclusions (Mallory bodies) e) decrease in the number of stellate reticulum endothelial cells (Kupffer cells) 66) Cholestasis syndrome is characterized by an increase in: a) parameters of bromsulphalein test b) level of gamma globulins c) alkaline phosphatase level d) acid phosphatase level e) aminotransferase level 67) Mesenchymal inflammation is characterized by an increase in: a) level of gamma globulins b) cholesterol levels c) alkaline phosphatase activity d) bilirubin level e) albumin level 68) Primary biliary cholangitis is characterized by the following symptom complex: a) jaundice, pruritus, xanthomas, hepatosplenomegaly, high alkaline phosphatase and cholesterol levels b) jaundice, anorexia, nausea, soft liver, high transaminase level, and normal alkaline phosphatase level c) jaundice, hepatosplenomegaly, moderately elevated transaminase, hypergammaglobulinemia, positive anti-smooth muscle antibodies d) jaundice, pain in the right upper quadrant of the abdomen, hepatomegaly, leukocytosis 69) Autoimmune hepatitis is characterized by the following symptom complex a) jaundice, pruritus, xanthomas, hepatosplenomegaly, high alkaline phosphatase and cholesterol levels b) jaundice, anorexia, nausea, soft liver, high transaminase level, and normal alkaline phosphatase level c) jaundice, hepatosplenomegaly, moderately elevated transaminase, hypergammaglobulinemia, positive anti-smooth muscle antibodies d) jaundice, pain in the right upper quadrant of the abdomen, hepatomegaly, leukocytosis 70) For mild and moderate ascites, it is advisable to carry out all of the below measures, except for a) diet containing up to 2 g of table salt per day b) limiting daily fluid intake to 1 liter c) spironolactone 100 mg or more per day orally d) paracentesis with removal of ascitic fluid e) furosemide (40–120 mg per day) or torasemide (5–15 mg per day) 71) The most common cause of chronic diffuse liver disease is: a) hepatotropic viruses b) alcohol c) hereditary diseases – storage disease d) toxic hepatotropic agents 72) The most informative method for the diagnosis of chronic gastritis is: a) ultrasound examination of the abdomen b) esophagogastroduodenoscopy with a morphological examination of biopsy samples of gastric mucosa c) study of gastric juice d) X-ray of the stomach 73) . The reference method for the primary diagnosis of H. pylori is: a) 13C-urea breath test b) bacteriological test c) cytology d) determination of antibodies to H. Pylori in blood 74) Which of the following are essential drugs for the treatment of epigastric pain syndrome in functional dyspepsia? a) antisecretory drugs b) antacids c) antispasmodics d) prokinetic agents e) enzymes 75) Essential drugs for the treatment of postprandial distress syndrome in functional dyspepsia are: a) antisecretory drugs b) antacids c) antispasmodics d) prokinetic agents e) enzymes 76) The standard first-line triple therapy regimen for H. pylori eradication is: a) proton pump inhibitors + prokinetic agent + metronidazole b) amoxicillin + clarithromycin + levofloxacin c) proton pump inhibitors + amoxicillin + clarithromycin d) proton pump inhibitors + bismuth tripotassium dicitrate + tetracycline e) bismuth tripotassium dicitrate + tetracycline + metronidazole 77) Which of the following is used to increase the effectiveness of H. pylori eradication therapy? a) increasing the duration of therapy to 30 days b) adding tripotassium dicitrate to standard bismuth therapy c) prescribing a double dose of amoxicillin and clarithromycin d) r eplacing proton pump inhibitors with H2 blockers 78) The effectiveness of H. pylori eradication is monitored: a) the timing of monitoring does not matter b) during the first week after completion of eradication therapy c) 2 weeks after the end of eradication therapy d) 4 weeks after the end of eradication therapy e) 8 weeks after the end of eradication therapy 79) Duodenal ulcer is characterized by: a) pain 0.5–1 hour after eating b) pain in the right hypochondrium c) pain on an empty stomach and at night d) pain immediately after eating 80) Which of the following is indicated in case of refractory stomach ulcer? a) repeated X-ray of the stomach b) a course of hyperbaric oxygen therapy c) repeated endoscopy with tissue biopsy from the edges of the ulcer d) continuation of the course of antiulcer therapy 81) Which of the following is typical of a peptic ulcer localized in the pyloric region? a) presence of early pain b) rare relapses of the disease c) heartburn d) short and rare remissions with frequent complications, such as bleeding and obstruction of the gastric outlet e) all of the above are true 82) What pain is characteristic of duodenal ulcer? a) dull, pressing pain in the epigastric region, aggravated by eating b) cramp-like pain in the right hypochondrium radiating to the right shoulder when eating fatty foods c) constant dull pain in the epigastrium not associated with eating d) pain in the epigastric region that occurs on an empty stomach and 2–3 hours after eating e) pressing pain in the left hypochondrium, intensifying after eating and radiating to the back 83) Complaints of sulfur burps and vomiting food taken the day before in a patient with an exacer- bation of gastric ulcer indicates the development of a) penetration b) bleeding c) perforations d) malignant ulcer e) pyloric stenosis 84) Iron deficiency anemia is characterized by: a) hyperchromia, macrocytosis b) hypochromia, macrocytosis c) hypochromia, microcytosis d) hyperchromia, microcytosis 85) Which of the following can be detected in chronic lymphocytic leukemia? a) Botkin – Gumprecht shadows b) the Ph chromosome c) LE cells d) Howell – Jolly bodies e) cabot rings 86) The most informative method for confirming myeloproliferative disease in chronic myeloid leukemia is: a) calculation of the leukocyte formula b) bone marrow trephine biopsy c) lymph node puncture d) liver puncture e) sternal puncture 87) B12 deficiency anemia is characterized by: a) hyperchromia, macrocytosis b) hypochromia, macrocytosis c) hypochromia, microcytosis d) hyperchromia, microcytosis 88) The most informative method for confirming lymphoproliferative syndrome in chronic lym- phocytic leukemia is: a) calculation of the leukocyte formula b) bone marrow trephine biopsy c) lymph node puncture d) liver puncture e) sternal puncture 89) Acute and chronic leukemia differ from each other by: a) severity of clinical manifestations b) degree of tumor cell differentiation c) duration of the disease d) spread of the disease 90) In order to monitor the effectiveness and safety of warfarin therapy, it is necessary to deter- mine: a) D-dimer b) APTT c) PTI d) INR 91) Which additional study is carried out to clarify the diagnosis if megaloblastic anemia is detected a) serum ferritin levels b) TIBC c) serum vitamin B12 and folate levels d) Coombs test 92) One of the criteria for diagnosing multiple myeloma is: a) detection of 10% or more plasma cells in the bone marrow b) eosinophil – basophil association c) increase in the number of blasts in the bone marrow by more than 30% d) increase in the number of lymphocytes in the myelogram by more than 30% 93) A change in the myelogram characteristic of chronic myeloid leukemia is detection of: a) Botkin – Gumprecht shadows b) Ph chromosome c) LE cells d) Howell – Jolly bodies e) cabot rings 94) Factor VII deficiency is characterized by: a) prolonged APTT and PT b) prolonged PT, normal APTT c) prolonged APTT, normal PT d) normal PT and APTT 95) . Development of plethora syndrome is characteristic of: a) acute leukemia b) chronic myeloid leukemia c) chronic lymphocytic leukemia d) B12 deficiency anemia e) erythremia 96) Hiatus leukemicus is characteristic of a) acute leukemia b) chronic myeloid leukemia c) chronic lymphocytic leukemia d) multiple myeloma 97) According to the WHO classification, severe anemia is diagnosed when the hemoglobin con- centration decreases to less than: a) 60 g/l b) 66 g/l c) 70 g/l d) 80 g/l 98) The concentration of which should be determined to identify latent iron deficiency? a) ferritin b) hemoglobin c) iron d) transferrin 99) The background of hereditary microspherocytosis is: a) impaired glucose-6-phosphate dehydrogenase activity b) red cell membrane defect c) formation of autoantibodies to body’s own red blood cells d) defect in globin chain synthesis 100) Idiopathic thrombocytopenic purpura is characterized by the following type of bleeding: a) macular petechial hemorrhage b) hematoma c) mixed microcirculatory hematoma and hemorrhage in vasculitis d) hemorrhage in angiomas

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