1. Which of the following is the most characteristic clinical sign of ANAL FISSURE?

A. prolonged spasm of the sphincter

B. deformation of the perineum
C. itching in the anus
D. weakening of the sphincter tone with an empty ampoule
E. feeling of a foreign body in the anal canal.

2. Which of these methods of examination is the most informative in difficult diagnostic situations to
clarify the diagnosis of ACUTE APPENDICITIS?

A. laparoscopy
B. irrigoscopy
C. ERCP
D. FGDs
E. laparocentesis

3. What laboratory test suspects liver echinococcosis?

A. general blood analysis

B. coagulogram
C. RW blood test
D. Katsoni test
E. blood sowing

4. What is the most informative diagnostic method for varicose veins of the lower extremities?

A. march test
B. Doppler ultrasound
C. phlebography
D. CT scan
E. selective angiography

5. Which of the following is the most REMOTE COMPLICATION OF ACUTE PANCREATITIS?

A. hypovolemic shock
B. abscess gland bags
C. pancreatic cyst
D. pancreatogenic peritonitis
E. pancreatic abscess

6. In a patient with suspected perforated ulcer ("dagger" pain, ulcerative history, défense musculaire of
abdomen), there is no pneumoperitoneum on an overview radiograph of the abdominal cavity.

What additional research method IS most justified in this case?

A. pneumogastrography
B. endoscopic retrograde cholangiography
C. computer tomography
D. duodenoscopy
E. EGD

7. A man, 35 years old, was admitted with a clinical picture of gastrointestinal bleeding. What research
method IS most justified to establish the source of bleeding?

A. overview radiography of the abdominal cavity

 B. rectal examination
C. Abdominal ultrasound
D. fibrogastroduodenoscopy
E. transillumination

8. The man, 60, has been suffering from duodenal ulcer for about 15 years. During the last 6 months
have lost a lot of weight, worried about unmotivated fatigue and weakness. What method of research is
the MOST reasonably confirms the malignancy of an ulcer?

A. EGD with biopsy

B. endoscopic retrograde cholangiography
C. computer tomography
D. pneumocystography
E. duodenoscopy

9. The man, 63 years old, periodic vomiting of food eaten the day before, which brings relief. Ulcer
history for 10 years. On examination, the abdomen is determined by splashing noise. For what
complication of peptic ulcer disease is the most characteristic splash noise?

A. for ulcerative bleeding

B. for pyloroduodenal stenosis
C. for malignancy
D. for penetration
E. for perforation

10. A 67-year-old male was admitted with a right-sided inguinal hernia.

Which of the following is THE most likely diagnostic technique determined during the examination?

A. shirts
B. falling drops
C. cough symptoms
D. splash noise
E. hepatic dullness

11. The patient admitted to the clinic of acute intestinal obstruction, during the cleansing enema failed
to enter no more than 500 ml of water.

In this case, the most likely symptom is?

A. Obukhiv hospital
B. Schiemann-Dance
C. Zoege von Manteuffel
D. Spasokukotsky
E. Valya

12. The patient is 40 years old, 6 hours after the infringement of the inguinal hernia, its spontaneous
reduction occurred. The patient was herniated. The next day, the patient's condition worsened, there
were signs of peritonitis.

The most likely cause of peritonitis is?

A. bleeding from the vessels of the spermatic cord

B. early commissural ileus
C. thrombosis of mesenteric vessels
D. necrotic bowel loop
 E. pylephlebitis

13. A man of 47 years, came with complaints of bleeding and severe pain in the anus after defecation.
On examination, pronounced spasm of the sphincter.

Which of the following is the most likely preliminary diagnosis?

A. acute hemorrhoids
B. acute paraproctitis
C. stricture of the anal canal
D. acute anal fissure
E. thrombosis of hemorrhoids

14. Woman 57 years old complains of purulent discharge from the wound in the perineum. When
viewed in the perineum, the wound is determined by the size of 0, 3x0, 3 cm, from where pus is
released when pressed, the skin around is macerated. Which of these preliminary diagnoses is MOST
likely?

A. chronic hemorrhoids
B. chronic paraproctitis
C. stricture of the anal canal
D. chronic anal fissure
E. thrombosis of hemorrhoids

15. What research method is the most informative in Crohn's disease:

A. ultrasound, x-ray
B. endoscopy, computed tomography
C. magnetic resonance imaging, x-ray
D. x-ray examination, endoscopy
E. ultrasound, endoscopy

16. A patient suffering from lung abscess increased body temperature to 390s, weakness increased,
shortness of breath appeared. On an ultrasound pleural cavity, an inhomogeneous fluid is determined. A
preliminary diagnosis of Pyothorax on the left.

Which of the following methods is MOST informative for confirming pyothorax?

A. blood chemistry
B. puncture of the pleural cavity
C. CT scan
D. bronchoscopy
E. biopsy

17. A boy of 16 years old, was admitted with complaints of pain in the right half of the chest, shortness
of breath, general weakness. A chest x-ray was performed, where the collapse of the right lung is
determined. Diagnosed with Spontaneous pneumothorax. Which treatment method is most
appropriate?

A. pleural puncture with aspiration of air

B. conservative therapy
C. drainage of the pleural cavity with active aspiration of air
D. thoracotomy
E. observation

18. With what diseases it is necessary to conduct differential diagnosis in varicose veins?
 A. femoral hernia
B. Leriche's syndrome
C. lymphangitis
D. lymphostasis
E. diabetic angiopathy of the lower extremities

19. Which of the following is THE most likely contraindication for sclerotherapy in varicose veins of the
lower extremity?

A. loose type of lesion

B. soft, easily falling varicose veins
C. deep vein obstruction
D. relapse after surgical treatment
E. acute thrombophlebitis of subcutaneous veins of medical history

20. The patient was admitted a day later with complaints-severe pain in the right lower limb, numbness
and cold. The patient underwent a coronary angiography during the day.

Which of the following is the most likely disease to be suspected?

A. thrombosis
B. embolism
C. heart attack
D. sciatica
E. peripheral spasm

21. A man of 60 years turned to the hospital with complaints of frequent urges to defecate, blood and
mucus in the feces, General weakness. These complaints are disturbing for 4 months. In rectal
examination: perianal area without features, sphincter is toned, at a distance of 7-8 cm from the
perianal skin there is a tumor on the posterior-left wall with a fine-edged surface. Which preliminary
diagnosis of the following is most likely?

A. cancer of the upper rectum

B. cancer of the lower rectum
C. cancer of the rectosigmoid colon
D. cancer of the middle-ampullary rectum
E. cancer of the anal canal

22 The earliest recognition of cancer of the stomach provides:

A. abdominal overview x-ray

B. search for "small signs" syndrome
C. gastroscopy
D. radiography of the stomach
E. laparoscopy

23. Which of the following is the most likely cause of early spread of esophageal tumors to the
mediastinum?

A. with a thin layer of mucosa

B. with weak vascularization
C. lack of a serous cover
D. with weak muscle layer
E. lack of submucosal layer
24. The most correct name of the operation in which the stomach and regional lymph nodes are
completely removed from all areas of metastasis?

A. resection of 1\2 of the stomach

B. gastrectomy
C. imposition of gastrostomy
D. distal Subtotal resection
E. proximal Subtotal resection

25. A 42-year-old patient was hospitalized for surgical treatment for diffuse thyrotoxic goiter.
Preoperative preparation is carried out in the surgical Department. What group of drugs is used to
prevent adrenal insufficiency?

A. electrolytes
B. anticoagulants
C. antihistamine drug
D. corticosteroids
E. thyrostatic drugs

26. A 35-year-old patient underwent surgery for thyrotoxic goiter. Later, postoperative hypothyroidism
developed. The appointment of which drug is most appropriate?

A. Baralginum
B. Contrical
C. Thyreoidinum
D. Mercazolil
E. Calcium gluconate

27. A man of 52 years, went to the clinic with complaints of a feeling of heaviness in the epigastrium,
rapid saturation, burp accompanied by a foul rotten egg smell, copious vomiting of food eaten the day
before, significant weight loss. From anamnesis: within 7 years suffers from peptic ulcer disease,
repeatedly received outpatient treatment. Objectively: depleted, skin dry, turgor reduced, determined
by the symptom of the tail, trusso. Belly soft, defined by the sound of splashing. What complication of
peptic ulcer disease can you think of?

A. bleeding
B. pyloroduodenal stenosis
C. malignization
D. perforation
E. penetration

28. Patient 68 years old, complaining of inguinal hernia on the left, difficulty urinating. A preliminary
diagnosis of a Sliding hernia of the bladder.

Which of these methods of examination IS the most reasonable for diagnosis?

A. Ultrasound
B. irrigoscopy
C. colonoscopy
D. x-ray
E. cystography

29. During the operation for acute intestinal obstruction, a dark-colored loop of the small intestine and
hemorrhagic fluid in the abdominal cavity were found. What surgical tactics are the most appropriate?
 A. the imposition of a bypass anastomosis
B. resection necrotic bowel
C. vagotomy
D. remove the colostomy
E. external drainage of the abdominal cavity

30. What tactics of the surgeon IS most expedient at nodulation?

A. emergency surgery
B. setting a siphon enema
C. operation in a planned manner
D. dynamic observation
E. the introduction of drugs that enhance intestinal peristalsis

31. A woman of 54 years, complained of itching, feeling of a foreign body in the anus, the allocation of
scarlet blood during defecation.

Which of the following is the most priority action against the patient?

A. external examination of the perianal area

B. anoscopy
C. irrigoscopy
D. proctosigmoidoscope
E. finger examination of the rectum

32. The patient, 38 years old, complains of loose stools with mucus and blood up to 6-8 times a day,
abdominal pain, more pain in the iliac region, subfebrile temperature, weight loss, weakness.
Objectively: pallor of the skin, tenderness during palpation of the abdomen in the course of the
descending colon. In the blood test: hemoglobin 90 g / l, leukocytes 10, ESR 30 mm/h. If barium enema -
flattening the relief of the mucosa of the descending division of the colon, lack of Australi. The most
appropriate indications for surgical treatment for complications of the disease ulcerative colitis?

A. diverticula abscesses, adhesions process

B. arrose blood vessel
C. intestinal perforation, toxic dilation
D. fistulas between the colon and other organs
E. rectal-vaginal atresia

33. Patient A., 43 years old, was admitted to the surgical Department. The patient was examined,
diagnosed with peritonitis.

Which of these therapeutic tactics is THE most appropriate?

A. outpatient treatment at the place of residence

B. emergency surgery
C. make additional surveys
D. conservative treatment
E. planned operation

34. A woman, 52 years old, has a suspected echinococcal liver cyst.

What is the most informative laboratory study should be prescribed to clarify the diagnosis?

A. the level of leukocyte

B. Mantoux reaction
C. sample of cough shock
 D. Casoni’s sample
E. red blood cell levels

35. A patient operated on for perforated appendicitis showed pain in the right upper abdomen and chills
in dynamics. In the blood test, leukocytosis is noted up to 18.0x109 / l, ESR - 28 mm / h. Ultrasound of
the abdominal cavity in the subphrenic space revealed fluid formation. Which of the following is the
MOST likely complication in the postoperative period?

A. pneumonia of the lower lobe of the right lung

B. acute cholecystitis
C. abscess
D. acute pancreatitis
E. perforation of a duodenal ulcer

36. Patient., 30 years old, underwent an appendectomy for gangrenous appendicitis. On the 4th day
after the operation, the condition worsened, pains appeared in the lower abdomen, tenesmus, noted an
increase in temperature to 39.00C in the evenings. The study of per rectum determines the overhang
and soreness of the anterior wall of the rectum. Which of the following preliminary diagnoses is MOST
probable?

A. subphrenic abscess
B. periappendicular abscess
C. diffuse peritonitis
D. pelvic abscess
E. subhepatic abscess

37. A woman is 53 years old, when she contacts a surgeon in a polyclinic, a tumor-like formation in the
epigastric region is determined. Latex agglutination reaction within 1:64. On the CT scan of the
abdominal organs there is a rounded formation in the left lobe of the liver with a calcified wall.

Which of the following diagnoses is MOST probable?

A. solitary cyst of the liver

B. echinococcal liver cyst
C. liver abscess
D. pancreatic cyst
E. stomach cancer

38. A woman, 44 years old, was admitted to the clinic with complaints of feelings of heaviness in the
right hypochondrium. In the blood test, eosinophilia, accelerated ESR, is noted. On the survey
radiograph of the abdominal cavity there is a high standing of the right dome of the diaphragm. On
ultrasound, two cavity formations with clear edges and homogeneous contents are determined.

Which of the following diagnoses is MOST probable in this case?

A. liver cancer
B. liver hemangioma
C. liver echinococcosis
D. solitary cyst of the liver
E. lung alveococcosis

39. A man, 45 years old, was admitted with complaints of pain in the left half of the chest during
breathing, general weakness, and profuse purulent sputum. The patient notes an improvement after a
profuse discharge of fetid, purulent sputum up to 300 ml. Auscultatory in the left chest, amphoric
breathing is heard.
Which of the following changes is MOST likely to be a radiograph:

A. a cavity with a liquid level without perifocal infiltration

B. cavity with fluid level and perifocal infiltration
C. lung tissue infiltration site without clear boundaries
D. extensive dimming in the lung without clear boundaries
E. cavity destruction with foci of seeding

40. Plays an important role in the comparative diagnosis of obliterating atherosclerosis and endarteritis?

A. Sample Oppel
B. Reovasographic data
C. Data on aortic arteriography
D. Data on radonuclides in Te99 pellophosphate (technology)
E. Sample Samuels

41. Which of the following is the most informative to assess the prevalence of esophageal cancer
stenosis process?

A. respiratory and esophageal radiography

B. radiometry of the esophagus
C. Ultrasound of the esophagus
D. x-ray examination with liquid barium solution
E. bronchoscopy

42. A man 61-year-old was diagnosed with a tumor of the caecum according to irrigography. According
to the additional survey, there are no data for distant metastases. Clinical diagnosis: cancer of the
caecum St III, T3NXM0.

Which operation of the following IS most appropriate for this localization of the tumor?

A. right-sided hemicolectomy
B. workaround retransliteration
C. Subtotal colectomy
D. cecumectomy
E. ileostomy

43. A woman 58-year-old after a comprehensive examination was clinically diagnosed with сancer of the
upper ampullary rectum St III, T3NXM0. Which operation of the following is most acceptable in this
localization of the tumor?

A. overlay sigmoscopy
B. abdominal-perineal extirpation of the rectum
C. abdominal-anal resection of the rectum with colostomy
D. abdominal-anal resection of the rectum with relegation
E. anterior resection of the rectum

44. A 45-year-old patient underwent Subtotal strumectomy for thyrotoxic goiter. In the early
postoperative period, a thyrotoxic crisis developed. Which of the following plays a major pathogenetic
role in the development of the crisis?

A. iatrogenic damage to the recurrent nerve

B. insufficiency of thyroid function
C. degenerative changes in the tracheal rings and their thinning
D. growth of thyroid parenchyma by connective tissue
 E. insufficiency of adrenal cortex function

45. An absolute contraindication to lumbar puncture is:

A. meningitis
B. displacement of the median structures of the brain.
C. meningoencephalitis
D. staphylococcal destruction of the lungs
E. birth traumatic brain injury

46. Prevention of cicatricial stenosis of the esophagus for burns is:

A. esophagoscopy
B. bougieurage.
C. antibiotics
D. antispasmodics
E. absorbable means

47. For the diagnosis of posterior urethral valve, the most informative ofX-ray contrast studies consider:

A. retrograde urethrography
B. excretory urography
C. mikitsionny cystourethrography
D. infusion urography
E. pneumocystography

48. Please provide the correct answers. Cardiac tonus reduction occurs at: 1) chalazicardia 2)
diaphragmatic pleural hernia 3) congenital stenosis of the esophagus 4) congenital short esophagus
5) hiatal hernia 6) achalasiacardia Answers:

A. 3,4,5
B. 1,4,5
C. 1,3,6
D. 1,4,6
E. 2,3,4

49. Please provide the correct answers. For differential diagnosis peptic esophageal stenosis with
congenital short esophagus and hiatal hernia:

A. fibroeophagogastroscopy
B. a biopsy of the mucous membrane of the lower third of the esophagus
C. pH measurement of the esophagus
D. radioisotope research.
E. radiopaque examination of the esophagus and stomach

50 Please provide the correct answers. The foreign body of the esophagus is manifested symptoms: 1)
vomiting 2) refusal of food 3) salivation 4) shortness of breath 5) hyperthermia 6) difficulty
swallowing 7) chest pain Answers:

A. 1,2,3
B. 4,5,6
C. 1,3,7
D. 2,3,6
E. 2,4,7

51. Determine the most rational surgical treatment for acute pyopneumotorox in a 2-year-old child:
 A. pleural puncture
B. drainage with active aspiration.
C. thoracotomy with closure of the bronchial fistula
D. thoracotomy with removal of the affected lobe
E. passive suction drainage

52. What treatment is preferred for elimination atelectasis in the postoperative period in patients with
bronchiectasis:

A. bronchoscopy
B. percutaneous drainage of the trachea
C. tracheal catheterization.
D. antibiotic therapy
E. postural drainage

53. Define lung hypoplasia:

A. congenital maldevelopment of the lung

B. underdevelopment of all structural elements of lung units.
C. congenital underdevelopment of the trachea and bronchi
D. congenital maldevelopment of the pulmonary circulation
E. congenital development of lung parenchyma

54. All diagnostic measures are correct for detecting atresia.esophagus, except:

A. radiography of the esophagus with iodolipol

B. esaphagoscopy
C. tracheobronchoscopy.
D. radiography
E. the introduction of air into the esophagus through the catheter located in it

55. What is the method of radiological diagnosis of bronchiectasis:

A. fluoroscopy
B. radiography
C. bronchoscopy
D. bronchography.
E. angiopulmonography

56. Specify a method of treatment for tense bull with a brochiolar fistula:

A. bronchoscopy
B. intensive care without intervention in the focus
C. bulla drainage
D. puncture bulla.
E. bronchial catheterization

57. Specify a method of treatment of purulent cloisonne pleurisy:

A. intensive care without intervention in the focus

B. Bulau drainage of the pleural cavity.
C. puncture of the pleural cavity
D. drainage of the pleural cavity with active aspiration
E. bronchoscopy

58. What are the signs of bladder tuberculosis with cystoscopy:

 A. mucosal trabecularity
B. narrowing of the openings of the ureter
C. the presence of tubercles around the openings of the ureters
D. vein expansion
E. trigonite

59. What is the instrumental research conducted to establish source of hematuria:

A. bladder catheterization
B. cystoscopy
C. survey radiography
D. excretory urography
E. cystography

60. With intraperitoneal ruptures of the bladder, as a diagnostic method is not carried out:

A. excretory urography
B. descending cystography
C. ultrasound of the bladder
D. ascending cystography
E. bladder catheterization

61. Indicate the most frequent localization of malignant tumors of the bladder:

A. front wall
B. side wall
C. the tip of the bladder
D. back wall
E. Lieto triangle

62. Highlight the most characteristic symptom of renal colic:

A. rise in blood pressure

B. low-grade fever
C. sudden onset, pain in the lumbar region and in the hypochondrium
D. forced situation
E. painless hematuria

63. What is the main method used to diagnose bladder stones:

A. uroflowmetry
B. antiography
C. ultrasound
D. sedimentary cystography
E. cystotonometry

64. Diagnosis of the diverticulum of the urethra:

A. cystoscopy
B. urethrography + urethroscopy
C. cystography
D. ultrasound of the bladder
E. bladder catheterization

65. What is the radiological symptom that is not characteristic of the primary chronic pyelonephritis:
 A. changes in the size and contours of the kidneys
B. slowing down the release of contrast
C. a change in the renal cortical index
D. the "shadow" of calculus
E. deformation of the pelvis-cup system

66. For cystoscopy is not a contraindication:

A. urethral stricture
B. acute cystitis
C. microcystis
D. terminal macrohematuria
E. acute prostatitis

67. What is the characteristic triad of symptoms of acute pyelonephritis:

A. lower back pain, changes in urine, anuria

B. high fever, anuria, low back pain
C. fever, lower back pain, changes in urine
D. high temperature, changes in urine, anuria
E. changes in urine lower back pain, ischuria

68. The most common causative agents of paranephritis are:

A. pneumococcus
B. Mycobacterium tuberculosis
C. a stick of blue-green pus and enterococcus
D. staphylococcus and E. coli
E. viruses

69. The most effective diagnostic method for paranephral abscess is:

A. ultrasound examination
B. survey radiography of the urinary tract
C. excretory urography
D. isotopic renography
E. infusion urography

70. A traumatic dislocation is:

A. the complete displacement of the articular ends of the bones, in which the contact of the
articular surfaces in the joint area is lost.
B. fracture dislocation
C. incomplete displacement of the articular ends of the bones, in which the contact of the articular
surfaces in the joint area is lost.
D. a partial displacement of the articular ends of the bones, in which contact of the articular
surfaces in the joint area is lost.
E. fracture

71. When is a dislocation considered inveterate?

A. after 3-4 weeks

B. up to 4.5 weeks
C. up to 2 weeks
D. up to 3 weeks
 E. up to a week

72. What is the most COMMON COMPLICATION of external abdominal hernia?

A. inflammation of the hernial sac

B. hernia sac phlegmon
C. incarceration
D. inviolability
E. coprostasis

73. Which of the following is the most common complication of HEMORRHOIDS?

A. rectocele
B. hemorrhoid thrombosis
C. anal fissure
D. pararectal abscess
E. abscess of the epithelial-coccygeal course

74. What type of intestinal obstruction is most often characterized by a bloody discharge from the anus
in the form of "raspberry jelly"?

A. obstructive obstruction
B. inversion of the small intestine
C. paralytic obstruction
D. spastic obstruction
E. intussusception

75. A change in what indicator of a general blood test is taken into account in the diagnosis of HEPATIC
ECHINOCOCCOSIS?

A. leukocytosis
B. leukopenia
C. thrombocytopenia
D. eosinophilia
E. nytrophyllosis

76. WHICH COMPLICATION IS THE MOST POSSIBLE WITH LOWER EXTREMITATION VASCULAR
ATHEROSCLEROSIS?

A. gangrene of the limb

B. phlegmon limbs
C. pulmonary embolism.
D. acute cerebrovascular accident
E. acute violation of mesenteric circulation

77. WHICH DISEASE most often develops after Pancreatic necrosis?

A. diabetes
B. thyrotoxic goiter
C. Lerish syndrome
D. bilio-cardial syndrome
E. Mallory-Weiss syndrome

78. A man, 22 years old, who was admitted with a clinical picture of a perforated ulcer, was assigned a
review x-ray of the abdominal cavity.
What x-ray sign IS most characteristic of a perforated ulcer?

A. intestinal pneumatosis
B. Bowl Kloyber
C. pneumothorax
D. intestinal arch
E. pneumoperitoneum

79. A 28-year-old man was hospitalized for ulcerative bleeding. On examination, the skin is pale, covered
with cold sweat. AD-50 / 20mm. RT.in the blood test: erythrocytes – 1, 8h1012/l,hemoglobin – 62 g/l.

What complication IS most likely in this patient?

A. hypovolemic shock
B. hemorrhagic shock
C. anaphylactic shock
D. toxic shock
E. septic shock

80. A 39-year-old male reported clinical signs of pyloroduodenal stenosis.

What method of research is THE most informative?

A. pneumogastrography
B. computer tomography
C. stomach x-ray
D. EGD
E. Ultrasound investigations

81. A 50-year-old patient with a right-sided inguinal hernia was admitted to the surgery Department.
With palpation of hernial protrusion, the formation of a soft consistency of the lobular structure is felt,
with percussion, the dulling of the percussion sound is determined.

Which of the following is THE most likely contents of the hernia SAC?

A. greater omentum
B. loops of the small intestine
C. pancreas
D. sigmoid colon
E. caecum

82. The patient is 72 years old, after cholecystectomy there is an exacerbation of chronic bronchitis and
secondary healing of the postoperative wound. Which of the following is MOST likely to develop in the
postoperative period?

A. postoperative hernia
B. flatulence
C. coprostasis
D. intestinal paresis
E. intestinal obstruction

83. In a patient admitted with acute intestinal obstruction, a survey x-ray of the abdominal cavity
revealed Kloyber bowls and Kerckring folds. These radiological signs ARE most likely when?

A. colonic obstruction
B. volvulus of the sigmoid colon
 C. small bowel obstruction
D. intussusceptions
E. perforation of the hollow organ

84. On the sixth day after the appendectomy, the patient had cramping pain, bloating, delayed stool and
gas. In the dynamics of the notes vomiting.

A. The most likely complication developed in the early postoperative period?

B. bleeding from the appendicular artery
C. thrombosis of mesenteric vessels
D. adhesive intestinal obstruction
E. Douglas space abscess
F. failure of sutures

85. A man of 37 years, complains of periodic itching in the anus, the allocation of scarlet blood after
defecation.

Which of these preliminary diagnoses is MOST likely?

A. paraproctitis
B. anal fissure
C. tumor of the rectum
D. syphilitic granuloma
E. hemorrhoids

86. Which of the following clinical signs of Crohn's disease is most common?

A. fever, cough, dizziness, abdominal pain

B. diarrhea, fever, colic, vomiting
C. abdominal pain, nausea, vomiting, colic
D. fever, diarrhea, abdominal pain, weight loss
E. weight loss, vomiting, colic, fever

87. A 43-year-old man is diagnosed with suppuration of an echinococcal liver cyst. Which of the
treatment tactics is MOST acceptable?

A. conservative therapy
B. puncture of an echinococcal cyst
C. surgical treatment as planned
D. surgical treatment in an emergency
E. percutaneous cholecystostomy under ultrasound control

88. Which of the following is the MOST acceptable method for the treatment of chronic lung abscesses?

A. complex conservative treatment in a hospital

B. Spa treatment
C. dispensary observation
D. radical operation
E. ambulatory treatment

89. Men 26 years old, turned to the emergency room of surgery with complaints of pain in the right side
of the chest, shortness of breath, general weakness. After examination, a preliminary diagnosis was
made: spontaneous nonspecific pneumothorax.

What research method is the most appropriate for clarifying the diagnosis?
 A. chest x-ray
B. pleural puncture
C. lung scan
D. bronchoscopy
E. thoracoscopy

90. The patient underwent sclerotherapy. After 3 hours, the patient had swelling of the left lower limb,
bursting pain in the limb, skin cyanotic color, cold to the touch. The most likely complication?

A. deep vein thrombosis

B. thrombosis of the popliteal artery
C. phlegmon
D. lymphostasis
E. thrombophlebitis

91. The patient is 65 years old, suffers from intermittent lameness for 2 years, but has never sought
medical help or been treated. 9 hours before admission to the emergency Department, the patient had
a cold snap, numbness and pain in the right lower limb. On examination, the right lower limb is pale,
cold, the subcutaneous veins are asleep, active movements and sensitivity are reduced, the pulse below
the right inguinal fold is absent. Which of the following diagnoses is the most likely?

A. thrombosis of iliac artery

B. thrombosis of the iliac vein
C. iliac artery embolism
D. sciatica
E. neuromuscular syndrome

92. A man of 62 years complains of General weakness, decreased ability to work, dizziness, weight loss,
subfebrile temperature, periodically liquid stool up to 2-3 times a day, without impurities, rumbling in
the stomach before the appearance of the urge to chair. sick for 4 months. the doctor turned for the
first time. in his youth, put "colitis", was treated at the resorts. the last 10 years, there were no
exacerbations. on examination: pallor of the skin, a slight decrease in turgor of the skin, the abdomen is
somewhat swollen, painless on palpation, in the General history of blood-anemia, poikilocytosis,
anisocytosis. Which preliminary diagnosis of the following is most likely?

A. cancer of the sigmoid colon

B. exacerbation of chronic colitis
C. cancer of the cecum
D. an infection of the intestines
E. cancer of the descending colon

93. A man of 62 years complains of the presence of impurity of blood of dark color and mucus to the
feces for 2 months, frequent urges to the act of defecation. The General condition is satisfactory. He was
treated with decoctions of herbs-without effect. Which of the following is the most likely clinical
diagnosis?

A. infectious disease of the colon

B. tuberculosis of the intestine
C. ulcerative colitis
D. cancer of the ampullary rectum
E. hemorrhoids

94. The most informative method of examination in the detection of dysplasia of the stomach
epithelium:
 A. examination of the mucosa through a gastroscope
B. histological examination
C. x-ray examination
D. Ultrasound of the stomach
E. MRI

95. Due to the high incidence of colorectal cancer, many countries have developed a screening program
for the early diagnosis of this pathology. At the same time, the main and most rational method of
screening used at the population level is?

A. proctosigmoidoscope
B. fibrocolonoscopy
C. fecal occult blood test
D. irrigoscopy+graphy
E. finger examination of the rectum

96. The most informative method for diagnosing the presence of metastases of gastric cancer in the
parietal peritoneum:

A. laboratory test
B. laparoscopies
C. manual method of abdominal examination
D. overview radiography of the abdominal cavity
E. radiography of the stomach on the background of double contrast

97. A 44-year-old patient underwent Subtotal strumectomy for thyrotoxic goiter. In the postoperative
period, there is an increase in body temperature to 39.60 C, tachycardia to 140-145 beats per 1 minute,
as well as increased mental excitability. What is the most expected complication developed in the
postoperative period?

A. the discovered tracheal stenosis

B. thyrotoxic crisis
C. postoperative hypothyroidism
D. suppuration of the postoperative wound
E. iatrogenic damage to the recurrent nerve

98. A 55-year-old man was taken to the emergency Department with complaints of sharp pain in the
epigastric region. Suffers from peptic ulcer disease. Suddenly felt a sharp intense pain in the upper
abdomen. Under inspection lies on right side with reduced to stomach with their feet. On palpation, the
abdomen is sharply tense and painful in the epigastrium. Hepatic dullness is not defined.

What method of research allows to establish the diagnosis?

A. overview radiography of the abdominal cavity

B. MRI of abdomen
C. Abdominal CT scan
D. ERCP
E. EGD

99. A 40-year-old Man was taken to the surgery's emergency room with complaints of severe pain in the
epigastrium and right area, radiating into the back, nausea. From anamnesis: periodically disturb night
"hungry" pain, the Man stops them with a solution of baking soda, notes the seasonal nature. On
examination, the skin of normal color, the belly of the usual form, soft, painful in the epigastrium and
right hypochondrium. Ultrasound of the abdominal cavity: there is no free fluid, the gallbladder is
without features, the pancreas is not enlarged, the contours are clear. Diastasis is normal. What is the
most likely diagnosis?

A. perforated duodenal ulcer

B. acute pancreatitis
C. malignancy of the ulcer
D. penetration of gastric ulcer
E. gastritis

100. Ambulance delivered a man with a strangulated inguinal hernia. During transportation, the hernia
spontaneously ruptured.

What further tactics of the surgeon IS most expedient?

A. perform diagnostic laparoscopy

B. perform diagnostic laparotomy
C. put a cleansing enema
D. observation in hospital
E. outpatient observation