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Question 21/100

The treatment of Fabry disease includes:

A. alpha-galactosidase A

B. acetylsalicylic acid

C. atorvastatin

D. penicillin

E. allopurinol

Question 22/100

In patients with plasmocytic myeloma, bacterial infections and viral infections are the most common causes of death and therefore, as a preventive measure, it is recommended that:

A.Vaccination of patients with plasmocytic myeloma is not warranted due to lack of response

B.Vaccination against Streptoccocus pneumoniae and Haemophilus influenzae

C.Vaccination against Streptoccocus pneumoniae and Haemophilus influenzae, annual influenza A vaccination, and prophylactic administration of acyclovir in patients treated with bortezomib (up to 6 weeks after withdrawal)

D.Prophylactic administration of acyclovir in patients treated with bortezomib (up to 6 weeks after withdrawal)

E.Annual influenza vaccination

Question 23/100

Pleural mesothelioma:

A. is a pleural reaction to lung cancer that develops subpleurally and infiltrates the visceral pleura

B. is a pleural neoplasm typically presenting with early formation of metastases to the lungs, liver, and central nervous system

C. is a pleural cancer that develops no more than 5 years after cessation of asbestos exposure

D. is a pleural cancer that develops even decades after cessation of asbestos exposure

E. is a slow, asymptomatic thickening of the pleura following exposure to inhaled asbestos particles

Question 24/100

The criteria for myocardial ischemia used in the definition of myocardial infarction are:

A. The presence of symptoms of myocardial ischemia

B. All of the following

C. Presence of new regional systolic dysfunction whose location is consistent with an ischemic etiology

D.Presence of new ischemic changes on the ECG

E.Detection of a thrombus in a coronary artery during coronary angiography

Question 25/100

Radiologic signs characteristic of psoriatic arthritis are:

A. Asymmetric sacroiliac joint inflammation

B.All of the following

C.Joint stenosis

D.Pencil-in-the-cup symptom

E.Periosteal stratification

Question 26/100

In former , long-term cigarette smokers:

A. the risk of lung cancer is the same as in current cigarette smokers

B. the risk of lung cancer decreases in the first five years after quitting smoking and stays the same thereafter

C. the risk of developing lung cancer even after several years will not be lower than in people who have never smoked

D.the risk of developing lung cancer initially increases in the first year after stopping smoking and then quickly decreases

E. risk of lung cancer decreases rapidly in the first year after smoking cessation

Question 27/100

Which of the following statements does not preclude the administration of alteplase in acute conditions?

A.Clinical observation suggestive of subarachnoid hemorrhage (SAH)

B.Minor or rapidly improving stroke symptoms

C.Oral anticoagulant use (e.g., Warfarin)

D.Previous stroke within 3 months

E.Systolic blood pressure less than 185 mm Hg or diastolic blood pressure less than 110 mm Hg at the time of treatment

Question 28/100

The standard duration of treatment for lower extremity deep vein thrombosis is

A. 3 months

B.24 months

C.6 months

D.1 month

E.12 months

Question 29/100

Positive inotropic drugs used to treat acute heart failure include:

A.Dobutamine, noradreanaline, levosimendan, dopamine 3-5 µg/kg/min, vasopressin, milrinone

B.Dobutamine, norepinephrine, levosimendan, dopamine (dose > 5 µg/kg/min), milrinone

C.Dobutamine, levosimendan, dopamine (dose 3-5 µg/kg/min), milrinone, isosorbitan dinitrate

D.Dobutamine, levosimendan, dopamine (dose >5 µg/kg/min), milrinone, vasopressin

E.Dobutamine, levosimendan, dopamine (dose 3-5 µg/kg/min), milrinone

Question 30/100

Characteristic of sarcoidosis is the formation of:

A. excess surfactant in the alveoli

B. both serous and non-serous granulomas are present in sarcoidosis

C. there are no granulomas in sarcoidosis

D. serous granulomas

E. noncaseating granulomas

Question 31/100

Acute diverticulitis:

A. is diagnosed by colonoscopy

B. does not tend to recur

C. the patient may present with fever, leukocytosis, and palpation of a lump in the left iliac fossa

D. requires surgery in most patients

E. occurs in 15% of patients with diverticulosis and always requires hospitalization

Question 32/100

All of the following factors are associated with a high risk of stroke in patients with atrial fibrillation, except:

HINT: CHA2DV2Sc Score

A. diabetes mellitus

B. age over 65 years

C. hypertension

D. congestive heart failure

E.hypercholesterolemia

Question 33/100

Sentence I) A low-energy fracture occurring in a person with osteopenia can be diagnosed as osteoporosis. Sentence II) Treatment should be instituted in this situation.

A.Both sentences are false.

B.Both sentences are true but there is no relationship between them.

C.The first sentence is false and the second is true.

D.The first sentence is true and the second sentence is false.

E.Both sentences are true and there is a relationship between them.

Question 34/100

Indicate the incorrect association of a heart rhythm disorder and its treatment:

A. narrow QRS complex tachycardia - adenosine

B. atrial fibrillation - digoxin

C. ventricular fibrillation - defibrillation

D. atrial flutter - ablation

E. postinfarction ventricular tachycardia – propafenone

Question 35/100

When a patient with acute chest pain is found by the emergency medical team at home to have ST-segment elevations in leads II, III, and aVF, the patient should be transported to a percutaneous coronary intervention (PCI) center at:

A.< 70 minutes

B.< 60 minutes

C.< 30 minutes

D.< 120 minutes

E.< 90 minutes

Question 36/100

A 67-year-old woman was admitted to the hospital with a femoral neck fracture after a fall. Which of the following regimens represents optimal venous thromboembolism prophylaxis for the patient?

A.Clopidogrel 600mg/day and subcutaneous unfractionated heparin

B.Subcutaneous low molecular weight heparin

C.Warfarin, with an international normalized ratio (INR) of 1.5 to 2.0

D.Subcutaneous unfractionated heparin

E.Clopidogrel 600mg / day

Question 37/100

Of the drugs used to treat type 2 diabetes, the insulin-dependent mechanism of action is characteristic of:

Keine Ahnung

A. PPAR gamma agonists

B. metformin

C. SGLT-2 inhibitors

D. GLP-1 analogues

E. sulfonylurea derivatives

Question 38/100

In psoriatic arthritis of the axial form with Achilles tendonitis, treatment should be initiated with:

>Choosen drug is first-line agent in psoriatic arthritis

A.Sulfasalazine

B.TNF alpha inhibitors

C.Methotrexate

D. IL-17 inhibitors

E.NSAIDS

Question 39/100

For rapidly increasing dyspnea in the setting of lymphoma-induced superior vena cava syndrome, the appropriate management is:

A.None of the above

B.Diuretics

C.Chemotherapy only

D.Urgent tumor removal

E.Dexamethasone to reduce bronchial obstruction and mucosal edema, plus oxygen and chemotherapy as soon as possible

Question 40/100

Which test would you use to diagnose primary hyperaldosteronism?

A. 0.9% NaCl inhibition test, test with captopril 50 mg p.o.

B. 10% NaCl inhibition test, test with fludrocortisone

C. perindopril 10 mg p.o., fludrocortisone test

D. captopril 25 mg p.o. test, perindopril 10 mg p.o. test

E. test with captopril 25 mg p.o., test with fludrocortisone

Question 41/100

Pneumonia caused by anaerobic bacteria:

A. follows a droplet infection

B. always takes the form of an acute lower respiratory tract infection

C. may develop following loss of consciousness or swallowing disorders

D. produces radiographic changes in the upper lobes, without disintegration

E. usually presents with a dry cough

Question 42/100

Scanty urine (oliguria), hematuria, eosinophilia, fever, and maculopapular-reddish osuta of various locations are the most typical symptoms of:

A. IgA nephropathy

B. Acute tubulointerstitial nephritis

C. Acute glomerulonephritis

D. urosepsis

E. rapidly progressive glomerulonephritis

Question 43/100

Noninvasive methods for assessing liver fibrosis in nonalcoholic steatohepatitis include:

A.FIB-4 index and liver elastography

B.All of the above

C.Liver elastography

D.FIB-4 index

E. Fine needle biopsy of the liver

Question 44/100

Typical symptoms of thrombotic thrombocytopenic purpura - TTP - do not include:

A. thrombocytopenia

B. hemolytic anemia with schistocytes present in the smear

C. CNS involvement

D. abdominal pain

E. vasculitis

Question 45/100

The following symptoms may occur in the course of empty saddle syndrome:

A. visual field loss

B. headache

C. headache and visual field loss

D. all answers are correct

E.moderate hyperprolactinemia

Question 46/100

Factors causing exacerbation or recurrence of ulcerative colitis include all of the following except?

A.Sudden death in the family

B. Use of NSAIDs

C.Antibiotic therapy

D.Iron supplementation

E.CMV infection

Question 47/100

The Virchow triad defines:

HINT: (1) venous stasis, (2) activation of blood coagulation aka hypercoagulobility, and (3) vein damage - aka endothelail injury

A.Risk factors for falls in the geriatric population

B. Risk factors for stroke

C. Risk factors for arterial thrombosis

D. Risk factors for venous thrombosis

E.Risk factors for myocardial infarction

Question 48/100

IgA nephropathy is diagnosed by:

A. albuminemia and proteinemia in the presence of proteinuria >3.5 g/24h

B. Proteinuria, hematuria, edema

C. Histopathological picture of the kidney specimen

D. presence of nephrotic syndrome

E. decrease in eGFR below 30 ml/min

Question 49/100

The most common physical signs of pulmonary embolism are:

A. overt protrusion

B. attenuation of alveolar murmur

C. tachypnoea and tachycardia

D. Wheezes and flurries

E. crackles

Question 50/100

Which medications can cause acute tubulointerstitial nephritis?

A.Antibiotics such as ciprofloxacin

B.Proton pump inhibitors e.g. omeprazole

C.Non-steroidal anti-inflammatory drugs e.g. ibuprofen

D.Antituberculosis drugs e.g. rifampicin

E.All of the above medications

Question 51/100

A patient with unstable tachycardia requires:

A.None of the given answers.

B.All of those given.

C.Administration of antiarrhythmic drugs intravenously

D.Perform synchronized cardioversion

E.Administering antiarrhythmic medications orally

Question 52/100

In dual antiplatelet therapy, we use acetylsalicylic acid at a dose of:

A.150 mg twice daily

B.300 mg once daily

C.75 mg once a day

D.150 mg once a day

E.75 mg twice a day

Question 53/100

Small cell carcinoma of the lung:

A. is less associated with smoking than large cell carcinoma

B. unlike adenocarcinoma, rarely causes endocrine paraneoplastic symptoms

C. often at the time of diagnosis blood and lymph node metastases are found

D. typically metastasizes to distant organs (e.g., brain or liver) but rarely to mediastinal nodes

E. manifests aggressive growth and because of its high rate of cellular proliferation is usually a giant lung tumor at the time of diagnosis even before mediastinal metastases have occurred

Question 54/100

Idarucizumab is a drug that reverses the effects (antidote) of:

A. apixaban

B. fondaparinux

C.edoxaban

D.dabigatran

E. rivaroxaban

Question 55/100

The INR index increases during treatment with vitamin K antagonists and novel anticoagulants. The INR index can be used to assess the anticoagulation effect during treatment with: 1/ acenocoumarol; 2/ warfarin; 3/ dabigatran; 4/rivaroxaban; 5/apixaban

The correct answer is:

A.1,2,3,4,5

B.1,2,3

C.1

D.1,2,3,4

E.1,2

Question 56/100

The probability that the daughter of a hemophilia A patient will be a carrier is:

A.25%

B.75%

C.0%

D.100%

E.50%

Question 57/100

In a 66-year-old man with a body mass index of 32 kg/m2 with hypertension who has a fasting blood glucose of 132 mg/dL on periodic testing, you should:

A.Repeat the fasting blood glucose determination after a 7-day low-carbohydrate diet

B.Determine insulin levels after a 75 g glucose load

C.Recognize abnormal fasting blood glucose and recommend dietary treatment and increased physical activity

D.Perform an oral glucose load test

E.Recognize type 2 diabetes and initiate nonpharmacologic treatment and use metformin in increasing doses

Question 58/100

Indicate the correct sentence regarding osteoarthritis of the knee:

A.It is usually more painful to climb stairs than to descend

B.There is morning joint stiffness about 60 minutes

C. There is rarely joint stiffness

D.The outlines of the joint become thickened and deformed

E.There is secondary hypertrophy of the quadriceps muscle of the thigh

Question 59/100

Lynch syndrome:

A. is diagnosed based on the Rome criteria

B. is associated with a mutation in the APC gene

C. is characterized by the presence of hundreds of adenomas in the colon

D. is accompanied by osteosarcomas and soft tissue tumors

E. is the most common cause of genetically determined colorectal cancer

Question 60/100

Conditions that exclude the diagnosis of primary Sjögren's syndrome, according to the 2016 ACR/EULAR classification criteria, include:

> Lymphoma, HBV &HCV infection - causes for 2ndary Sjögrens

A.Lymphoma

B.HBV infection

C. History of HCV infection

D. All of the following conditions are exclusion criteria for the diagnosis of Sjögren's syndrome

E.Previous irradiation of the head and neck region

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