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Partly to unstring a plait

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Partly to unstring a plait.

D.	To unstring a plait to the moment of appearance of bleeding and impose it below previous place
E.	To unstring a plait to the moment of appearance of bleeding and impose it higher previous place
55.	You began the grant of help to the grown man suffering in place of event. At a primary review you found out, that suffering without consciousness, breathes, arterial bleeding from a wound on a thigh. you stopped bleeding. What measures you will carry out farther to arrival of fast.
A.	To watch after vital sparks, wash down hands.
B.	To carry out a transport immobilization of the damaged thigh, wash down hands.
C.	Carry a victim in more safe place, to wash down hands
D.	Lay a victim on the back, to heave up feet, to cover a blanket or overcoat, to watch after vital sparks, wash down hands.
E. *	To cover a victim a blanket or overcoat, to watch after vital sparks, wash down hands.
56.	You began the grant of help to the grown man suffering in place of event. At a primary review you found out, that suffering without consciousness, breathes, intensive bleeding in middle third of shin. A medicine chest of the first aid is not. Specify Your actions.
A.	To heave up a leg higher level of heart
B.	To impose a plait-rollup in middle third of thigh
C.	To impose a plait-rollup in lower third of thigh.
D. *	Densely to pin the piece of fabric against a wound the hand
E.	To impose a plait-rollup in overhead third of shin.
57.	In place of event found out a victim with entangled consciousness, pale, by moisture by touch by a skin, feeling of anxiety, thirst, weakness, frequent low pulse, frequent breathing, signs of irritation of peritoneum. Are there your actions to arrival of fast?
A.	To give to a victim an alcohol and much to drink
B.	To accept antishock measures, give to a victim much to drink.
C.	To control the state suffering.
D.	To give an alcohol to a victim.
E. *	To accept antishock measures, control the state suffering.
58.	You began the grant of help to the grown man suffering in place of event. When will you engage in determination of presence of damages of locomotorium?
A.	In the case of presence of complaints on pain in the area of bones of skeleton
B.	During a primary review.
C. *	During the second review.
D.	Appear by chance
E.	None of resulted.
59.	You began a review suffering in place of event. During the review of the left thigh you found out an edema and hemorrhage in fabrics. What additional information is needed for the exposure of diagnosis break of thigh-bone?
A.	Local pain.
B. *	Shortening of extremity.
C.	Deformation of extremity.
D.	Absence of active motions.

E.	All from transferred.
60.	You began the examination of suffering at the place of event. During the palpation bones of shins was found the crepitation. What is the most credible diagnosis in this case?
A.	Trauma of knee-joint
B.	Coalface of shin
C.	Overtension connection of ankle joint.
D. *	Fracture of bones of shin.
E.	All from above-mentioned.
61.	You began the grant of help for the grown injured man at the place of event. He is without consciousness and lies on a stomach. During the examination you found out the fracture of shin. In what case will you conduct a transport immobilization?
A.	When you will be sure in the rightness of a transport immobilization
B.	Always
C. *	When the ambulance will arrive too late
D.	When there is no bleeding
E.	All from the above-mentioned.
62.	You began the grant of help to the grown man suffering in place of event. At a review you found out the break of collar-bone. How to conduct a transport immobilization?
A. *	To fix a hand from the staggered side maximally arcuated in an elbow joint to the trunk.
B.	A transport immobilization is not conducted.
C.	To fix a hand to the trunk, unbanded in an elbow joint.
D.	To impose an impromptu tire on a forearm
E.	To impose an impromptu tire on a forearm and shoulder.
63.	You began the grant of help to the grown man suffering in place of event. At a review you found out the break of humeral bone. How to conduct a transport immobilization?
A. *	To fix a hand to the trunk, unbended in an elbow joint.
B.	A transport immobilization is not conducted.
C.	To fix a hand from the staggered side maximally arcuated in an elbow joint to the trunk.
D.	To impose an impromptu tire on a forearm
E.	To impose an impromptu tire on a forearm and shoulder.
64.	You began the grant of help to the grown man suffering in place of event. At a review you found out the break of bones of forearm. How to conduct a transport immobilization?
A.	To impose an impromptu tire on a forearm
B.	A transport immobilization is not conducted.
C.	To fix a hand to the trunk, un-bended in an elbow joint.
D. *	To impose on a forearm an impromptu tire and to fix a hand arcuated in an elbow joint to the trunk.
E.	To impose an impromptu tire on a forearm and shoulder.
65.	You began the grant of help to the grown man suffering in place of event. At a review you found out the presence of pain in the area of neck. How to conduct immobilization of the staggered segment?
A.	It is forbidden to conduct immobilization
B.	To lay a victim on a shield and not fix.
C.	To leave a victim on earth, underlaying a roller under a neck
D. *	Lay a victim on a shield, to fix to him, underlaying a roller under a neck.
E.	Does not need immobilization.
66.	You began the grant of help to suffering in place of event. He without consciousness and lies on a stomach. you inverted him on the back. A victim breathes, bleeding is not. Your actions farther.
A.	To check up the presence of pulse in a victim.
B. *	To cause first-aid.

C.	To translate a victim in stable position
D.	To call the surrounding witnesses of event for help.
E.	To take away a victim from the place of event.
67.	You began the grant of help to suffering in place of event. He without consciousness and lies on a stomach. you inverted him on the back. A victim does not breathe. you provided communicating of overhead respiratory tracts and did 2 unsuccessful insufflation. Your actions farther.
A.	To check up in a victim the presence of pulse and to translate a victim in stable position.
B.	To call for help the surrounding witnesses of event and to cause first-aid.
C. *	To improve communicating of respiratory tracts and repeat 2 insufflations.
D.	To improve communicating of overhead respiratory tracts and check up the presence of pulse in a victim.
E.	To improve communicating of overhead respiratory tracts and do 4 insufflations.
68.	You began the grant of help to the suffering expectant mother in place of event. It without consciousness and loafs. A victim does not breathe. you inverted it on the back, provided communicating of overhead respiratory tracts and did 2 unsuccessful insufflation. you improved communicating of respiratory tracts and repeated 2 insufflations. They appeared unsuccessful. Your actions farther.
A.	To begin artificial ventilation of lights.
B.	To call for help the surrounding witnesses of event and to cause first-aid.
C.	To carry out 4-5 energetic pressures on a stomach higher belly-button and to translate a victim in stable position.
D.	To improve communicating of overhead respiratory tracts and check up in a victim the presence of pulse during 10 sec.
E. *	To carry out 4-5 energetic pressures on a thorax.
69.	You began the grant of help in place of event to the child by age 6 years. It without consciousness and lies on a stomach. you inverted it on the back. Breathing absents, a pulse is. you began artificial ventilation of lights. With what frequency and in depth you will blow air in lights suffering.
A.	12 /min of incomplete insufflations
B. *	20 /min of incomplete insufflations
C.	18 /min of easy insufflations
D.	12 /min of complete insufflations
E.	22 /min of easy insufflations
70.	In place of event found out a victim with entangled consciousness, pale, by moisture by touch by a skin, feeling of anxiety, thirst, weakness, frequent low pulse, frequent breathing, scratch in the area of right hypochondrium. Are there your actions to arrival of fast?
A.	To heave up to a victim feet, to give much to drink.
B.	To heave up to a victim feet, to cover a blanket, to control his state.
C. *	To control the state suffering.
D.	To give an alcohol to a victim.
E.	You began the grant of help to the grown man suffering in place of event.
71.	At a primary review you found out, that suffering at consciousness, breathes, he closed a wound a handkerchief in middle third of right shin, from which blood follows intensively. A medicine chest of the first aid is not. You press a right femoral artery on 10 min. Bleeding stopped. Specify Your actions.
A.	To impose a plait-rollup in middle third of thigh
B.	To accept antishock measures
C. *	Impose a plait-rollup in lower third of thigh, to accept antishock measures
D.	To impose a tight bandage on a wound, to heave up a leg higher level of heart
E.	To impose a plait-rollup in overhead third of right shin.

72.	You began the grant of help to the grown man suffering in place of event. At a primary review you found out, that suffering without consciousness, breathes, intensive bleeding in middle third of right shoulder. A medicine chest of the first aid is not. Specify Your actions.
A.	To impose a plait-rollup in lower third of right shoulder.
B.	To impose a plait-rollup in middle third of right shoulder
C. *	Densely to pin the piece of fabric against a wound the hand
D.	To heave up a hand higher level of heart
E.	To impose a plait-rollup in overhead third of right forearm.
73.	You expect arrival of fast and control the state suffering after the stop of bleeding from a humeral artery by imposition of plait. Suffering at consciousness. Snow, frost, falls in the street - 5 оС. Passed 35 minutes from the moment of imposition of plait. Specify Your actions.
A.	To socialize with a victim, calm him.
B.	Additionally to conceal a victim.
C. *	To unstring a plait to the moment of appearance of bleeding and impose it higher previous place
D.	To heave up a right arm higher level of heart.
E.	To control the state suffering.
74.	You began the grant of help to the grown man suffering in place of event. At a primary review you found out, that suffering at consciousness, breathes, phleborrhagia from a wound on a thigh. you stopped bleeding. What measures you will carry out farther to arrival of fast.
A.	Suffering it follows to lay on the back, impose a plait higher wounds, to heave up a leg.
B.	Suffering it follows to lay on the back, impose a plait below wounds, to heave up a leg.
C.	To impose a tight bandage, begin the second review.
D.	Suffering it follows to lay on the back, heave up a leg.
E. *	To cover a victim a blanket or overcoat, to watch after vital sparks.
75.	You expect arrival of EMT and control the state suffering after the stop of bleeding from a humeral artery by imposition of plait. In the street +20 оС. Passed 35 minutes from the moment of imposition of plait. Specify Your actions.
A.	To unstring a plait to the moment of appearance of bleeding and impose it higher previous place
B. *	To socialize with a victim, calm him.
C.	To unstring a plait and impose a tight bandage.
D.	To unstring a plait to the moment of appearance of bleeding and impose it below previous place
E.	None of the named
76.	In place of event found out a victim with the penetrable wound of thorax. you rendered the first aid to him, placed in half-sitting position, caused a fast and began the second review. That must you find out at questioning?
A.	Does a victim take medicine?
B.	What did happen and why?
C.	What complaints?
D.	Is there an allergy on anything?
E. *	All from the given.
77.	You began the grant of help to the grown man suffering in place of event. At a review you found out the presence of pain in the area of pectoral department of spine. How to conduct immobilization of the staggered segment?
A. *	To lay a victim on a shield the back downward, to fix to him, underlaying a roller under a neck and small of back.
B.	To lay a victim on soft loads the back downward and to fix.
C.	To put a victim on a load, not changing position of body
D.	It is forbidden to conduct immobilization
E.	None of the named

78.	You began a review suffering in place of event. During palpation of bones a forearm found out crepitus. What most credible diagnosis can be put in this case.
A.	Coalface of forearm
B. *	Break of bones of forearm.
C.	Overtension of connection of forearm
D.	Break ray-wrist joint
E.	Spasm of muscles of forearm
79.	You began the grant of help to the grown man suffering in place of event. He without consciousness and lies on a stomach. At a review you found out the break of shoulder. What case will you conduct a transport immobilization in?
A. *	When a „fast” will arrive too late
B.	Always.
C.	When sure in the rightness of a transport immobilization
D.	When a break is
E.	All from the given
80.	You began a review suffering in place of event. During the review of the left shin you found out an edema and hemorrhage in fabrics. What additional information is needed for the exposure of diagnosis break of bones of shin?
A.	Local pain.
B. *	Curvature of extremity is for axes.
C.	Bleeding is from extremity.
D.	All from transferred.
E.	None of transferred.
81.	In place of event you found out a grown man victim without consciousness in position on a stomach. What must Your actions be farther?
A.	To cause medical first-aid.
B.	To explain, circumferential, that prepare to do, to begin a review after the method of AVS.
C.	To call the surrounding witnesses of event for help.
D.	To explain circumferential, that to pass the course of the first aid, to say, that prepare to do.
E. *	To begin a primary review after the method of AVS.
82.	In place of event you found out a victim which is at consciousness. What does ground to give you the first aid him?
A.	Absence of other witnesses of accident.
B.	Bleeding presence.
C.	Presence of the opened break of extremity.
D. *	Permission suffering.
E.	All from the given
83.	You began the grant of help to suffering in place of event. He without consciousness and lies on a stomach. What actions will you execute above all things?
A.	To find out, whether there is not bleeding
B.	To find out, whether there are not breaks.
C. *	To find out, whether a victim breathes.
D.	To check up the presence of pulse.
E.	To define the presence of signs of irritation of peritoneum.
84.	You began the grant of help to suffering in place of event. What case do you invert a victim in on the back?
A.	Presence of the opened break.
B.	At the receipt of permission for the surrounding witnesses of event.

C. *	Absence of breathing.
D.	Absence of other witnesses of accident.
E.	All from transferred.
85.	You began the grant of help to suffering in place of event. He without consciousness and lies on a stomach. you inverted him on the back. Your actions farther.
A.	To check up in a victim the presence of pulse during 10 s.
B.	To call for help the surrounding witnesses of event and to cause first-aid.
C. *	To find out or a victim breathes during 10 s.
D.	To provide communicating of overhead respiratory tracts.
E.	To translate a victim in stable position
86.	You began the grant of help to suffering in place of event. He without consciousness and lies on a stomach. you inverted him on the back. A victim does not breathe. you provided communicating of overhead respiratory tracts and did 2 insufflations. Your actions farther.
A.	To improve communicating of overhead respiratory tracts and do 2 insufflations yet.
B.	To call for help the surrounding witnesses of event and to cause first-aid.
C.	To translate a victim in stable position.
D.	To improve communicating of overhead respiratory tracts and check up in a victim the presence of pulse during 10 с.
E. *	To check up the presence of pulse during 10 sec.
87.	You began the grant of help to suffering in place of event. He without consciousness and lies on a stomach. you inverted him on the back. A victim does not breathe. you provided communicating of overhead respiratory tracts and did 2 insufflations. Checked, that a pulse was present. Your actions farther.
A. *	To conduct artificial ventilation of lights.
B.	To call for help the surrounding witnesses of event and to cause first-aid.
C.	To carry out 4-5 energetic pressures on a stomach higher belly-button and to translate a victim in stable position.
D.	To improve communicating of overhead respiratory tracts and check up in a victim the presence of pulse during 10 с.
E.	To carry out 4-5 energetic pressures on a thorax and translate a victim in stable position.
88.	You began the grant of help in place of event to the child by age 9 months. It without consciousness and lies on a stomach. you inverted it on the back. Breathing absents. you began artificial ventilation of lights. With what frequency and in depth you will blow air in lights suffering.
A. *	20 /min of easy insufflations
B.	12 /min of incomplete insufflations
C.	18 /min of easy insufflations
D.	12 /min of complete insufflations
E.	22 /min of easy insufflations
89.	In place of event found out a victim with entangled consciousness, pale, by moisture by touch by a skin, feeling of anxiety, thirst, weakness, frequent low pulse, frequent breathing. Are there your actions to arrival of fast?
A. *	To accept antishock measures, control the state suffering.
B.	To accept antishock measures, give to a victim much to drink.
C.	To control the state suffering.
D.	To give an alcohol to a victim.
E.	To give to a victim an alcohol and much to drink

90.	You began the grant of help to the grown man suffering in place of event. At a primary review you found out, that suffering at consciousness, breathes, he closed a wound a handkerchief in middle third of right shoulder, from which blood follows intensively. A medicine chest of the first aid is not. You press a right humeral artery on 10 min. Bleeding stopped. Specify Your actions.
A. *	To impose a plait-rollup in middle third of shoulder
B.	To accept antishock measures
C.	Impose a plait-rollup in lower third of shoulder, to accept протишокові measures
D.	To impose a tight bandage on a wound, to heave up a hand higher level of heart
E.	To impose a plait-rollup in overhead third of right forearm.
91.	You began the grant of help to suffering in place of event. During the second review found out the break of both thighs. What actions does it follow to accomplish to arrival of "fast"?
A.	To translate a victim in stable position.
B.	To conduct transport to immobilization of both staggered extremities, to provide rest.
C.	Lay a victim on a shield, to provide rest.
D.	Lay a victim on soft loads, to provide rest.
E. *	To provide rest, conceal a victim, give warm drink.
92.	You began the grant of help to the grown man suffering in place of event. He without consciousness, breathes and lies on a stomach. Among visible damages you found out the break of shin. What case will you conduct a transport immobilization in?
A. *	When personally it will be to transport in medical establishment
B.	At presence of near relation suffering
C.	When sure in the rightness of a transport immobilization
D.	At presence of helpers
E.	All from the given.
93.	You began the grant of help to the grown man suffering in place of event. He without consciousness and lies on a stomach. At a review you found out the break of shin. What case will you conduct a transport immobilization in?
A.	When sure in the rightness of a transport immobilization
B.	Always.
C. *	When a „fast” will arrive too late
D.	When bleeding is not
E.	All from transferred.
94.	In place of event you found out a grown man victim at consciousness in position on a stomach. What must Your actions be farther?
A. *	To appear, to explain that passed the course of the first aid, to offer a help, explain that prepare to do.
B.	To cause medical first-aid.
C.	To find out, is not there bleeding?
D.	To begin a review after the method of ABC.
E.	To call the surrounding witnesses of event for help.
95.	In place of event you found out a suffering child unescorted. What must Your actions be farther?
A.	To find out, whether there is not bleeding.
B.	To cause medical first-aid.
C.	To begin a review after the method of ABC.
D. *	To appear, to explain circumferential, that passed the course of the first aid, to offer a help, explain that prepare to do.
E.	To call parents and surrounding witnesses of event for help.
96.	In place of event you found out a suffering child which is at consciousness unescorted parents. What does ground to give you the first aid him?

A.	State of suffering child.
B.	Permission of surrounding witnesses of event.
C. *	Presence of external factors which threaten to life of child.
D.	Absence of other witnesses of accident.
E.	All from the given
97.	A 56-year-old male with a history of heavy alcohol use presents to the ED complaining of vomiting blood for several hours. Vital signs are BP of 90/60, pulse of 110, respiratory rate of 16, and temperature of 98°F. Primary resuscitative measures are begun, and placement of an NGT shows active bright red bleeding. Which of the following is the treatment of choice?
A.	Tamponade with a Sengstaken-Blakemore tube
B. *	Therapeutic upper GI endoscopy
C.	Octreotide infusion
D.	Vasopressin infusion
E.	Immediate referral for surgical intervention
98.	A 25-year-old male presents to the ED with abdominal pain. His pain is vague, periumbilical, and associated with anorexia and nausea. He is afebrile with normal vital signs. Physical examination is normal except for mild umbilical discomfort, without guarding or rebound. Initial work-up includes a normal CBC and urinalysis. Which one of the following would be the LEAST appropriate course of action?
A.	Abdominal computed tomography (CT) to evaluate for appendicitis.
B.	Abdominal ultrasound to evaluate for appendicitis.
C. *	Coverage with broad-spectrum antibiotics for acute appendicitis.
D.	Observation with surgical consultation if symptoms progress.
E.	Observation and discharge home with close follow-up if symptoms resolve.
99.	A healthy 25-year-old male complains of constant throbbing rectal pain that worsens immediately before defecation. Examination is remarkable for a temperature of 101.5°F and a tender, fluctuant, erythematous mass in the perianal region. Fullness and induration are appreciated on rectal examination. What would be the MOST appropriate course of action?
A.	Discharge home with instructions for sitz baths and bulk laxatives.
B.	Discharge home with instructions for sitz baths and topical steroid cream.
C.	Incision and drainage in the ED using local anesthetic.
D.	Anoscopy to evaluate for internal hemorrhoids or cryptitis.
E. *	Surgical consultation for incision and drainage in the operating room.
100.	A 40-year-old female with known gallstones presents with colicky right upper quadrant pain and vomiting. She has a history of similar episodes that usually resolve after 3 to 4 h. Vital signs are BP of 110/60, pulse of 78, respiratory rate of 16, and temperature of 98.4°F. Physical examination shows a mildly tender right upper quadrant without signs of peritonitis. Which one of the following would be LEAST appropriate in her ED management?
A.	Intravenous fluid administration.
B.	Pain control with opiate analgesics.
C.	Pain control with ketorolac.
D.	Antiemetic administration.
E. *	Immediate surgical consultation.
101.	A 35-year-old male who was exposed to hepatitis A presents with new-onset jaundice and vomiting. Vital signs are normal, and physical examination shows mild hepatomegaly with right upper quadrant tenderness. Laboratory studies show an ALT of 300 U/L; total bilirubin of 9 mg/dL; prothrombin time of 16.0 s (normal = 10.0-12.0 s), and glucose of 75 mg/dL. After intravenous fluid administration, vomiting resolves, and he is able to tolerate oral hydration. Which of the following would indicate that the patient should be admitted to the hospital?
A.	Elevated ALT, indicating hepatocellular damage.

B.	Hyperglycemia.
C.	Symptomatic vomiting.
D. *	Prolonged prothrombin time.
E.	Age > 30 years.
102.	A 75-year-old male is brought to the ED by his son-in-law for evaluation of altered level of consciousness. The patient has reportedly been bedridden for 2 days. Examination shows advanced sacral decubitus ulcers and bilateral ecchymoses of the upper arms. The son-in-law and the daughter both live with the patient. The son-in-law reports that the patient has been increasingly paranoid in recent weeks, with delusions of poisoning. What is the MOST likely diagnosis?
A.	Urosepsis.
B. *	Elder abuse.
C.	Dementia.
D.	Alcohol withdrawal.
E.	Medication side effect.
103.	An 80-year-old male is brought by ambulance from church for evaluation of a syncopal episode. The patient denies chest pain or palpitations and has no history of cardiac or cerebrovascular disease. Witnesses report no seizure activity. They loosened his shirt and tie immediately after the event, and the patient regained consciousness quickly. The patient has had several previous similar episodes for which he did not seek medical attention. One occurred while shaving and another occurred while dressing for church. Of the following, what is the MOST likely diagnosis?
A.	Gastrointestinal hemorrhage.
B.	Psychogenic syncope.
C. *	Carotid sinus hypersensitivity.
D.	Transient ischemic attack (TIA).
E.	Pulmonary embolism.
104.	A suicidal 28-year-old male ingested a handful of rodenticide pellets containing brodifacoum 30 min before ED presentation. Paramedics administered 1 mg/kg of activated charcoal en route to the hospital. The patient is awake and alert, with normal vital signs. There is no evidence of mucosal bleeding, skin bruising, or abdominal pain. A test for occult fecal blood is negative. Laboratory examinations for prothrombin time (PT), partial thromboplastin time (PTT), complete blood count (CBC), and platelets are all normal. What is the MOST appropriate action?
A.	Give additional charcoal, observe for 2 h, and discharge to psychiatry if stable.
B.	Admit and request urgent psychiatric consultation.
C.	Administer vitamin K 1 mg intravenously, observe for 2 h, and discharge to psychiatry if stable.
D.	Administer vitamin K 5 mg subcutaneously, observe for 4 h, and discharge to psychiatry if stable.
E. *	Admit, mobilize pharmacy resources to assess vitamin K inventory, and obtain psychiatric consultation.
105.	A 50-year-old male presents with a crush injury to the left lower extremity. He underwent a 45-min extrication after an accident at a construction site. Peripheral pulses are intact, but sensorimotor function is diminished. He is hemodynamically stable after standard resuscitation, but the wound site continues to bleed despite a pressure dressing. Available laboratory results include hemoglobin of 12, hematocrit of 32, platelet count of 45,000/µL, PT of 18, and fibrinogen of 80 mg/dL. The surgical team has been called to treat the wound. While awaiting their arrival, all of the following are appropriate interventions EXCEPT:
A.	Give 2 units of FFP.
B.	Type and screen 2 units of packed red blood cells.
C.	Give cryoprecipitate, 10 bags.
D.	Give platelets, 6 packs.
E. *	Give low-molecular-weight heparin.
106.	A 15-year-old male with hemophilia A presents with hoarseness, stridor, and anterior neck swelling after an assault in which he sustained a "karate chop" to the throat. What is MOST appropriate sequence of actions?

A. *	Endotracheal intubation, factor VIII replacement, neck CT.
B.	Factor VIII replacement, lateral soft-tissue film of the neck.
C.	Factor VIII replacement, neck CT, close observation for need to intubate.
D.	Check PTT and factor VIII assay, neck CT, close observation for need to intubate.
E.	Surgical airway, check factor VIII levels.
107.	A 22-year-old female with sickle cell anemia (Hb SS) presents with a 2-day history of pleuritic chest pain and mild dyspnea. Vital signs are: temperature 38°C, pulse 90, blood pressure of 126/80 mm Hg, respiration rate of 24 breaths per minute, and room air pulse oximetry of 92 percent. Chest x-ray and electrocardiography are unremarkable. Which one of the following is the LEAST appropriate action?
A.	Give empiric antibiotics, such as cefuroxime and erythromycin.
B. *	Hydrate the patient with normal saline at 200 cc/h.
C.	Treat pain with morphine sulfate boluses of 4 to 6 mg intravenously.
D.	Obtain a baseline arterial blood gas and arrange a V./Q. scan or spiral CT.
E.	Give supplemental oxygen.
108.	A 62-year-old African-American male who received TMP-SMX and pyridium for a urinary tract infection 2 days previously at an outside clinic presents to the ED complaining of dark urine. He denies fever or low back pain. Urinalysis shows a dark yellow urine, positive for blood, leukocytes, nitrites, bilirubin, and urobilinogen and negative for ketones, glucose, and protein. Microscopy shows red blood cells, white blood cells, and bacteria. What is the MOST likely diagnosis?
A.	Rhabdomyolysis.
B.	Side effect of pyridium.
C.	Gallbladder obstruction.
D. *	G6PD deficiency.
E.	Hepatitis.
109.	A 60-year-old female presents to the ED with a fever of 37.8°C, mild confusion, and headache for the past 2 days. The patient is awake with no nuchal rigidity or lateralizing neurologic signs. CT is negative for mass effect or intracranial bleed. Laboratory findings show a platelet count of 20,000/µL, reticulocytosis, mild leukocytosis with a left shift, schistocytes on peripheral smear, and mild azotemia. Urinalysis shows proteinuria and hematuria. All of the following are appropriate actions EXCEPT:
A.	Administering FFP.
B.	Plasma exchange transfusion.
C.	Prednisone or methylprednisolone intravenously.
D. *	Platelet transfusion.
E.	ICU admission.
110.	A 50-year-old male with known malignancy complains of bilateral lower extremity weakness and acute urinary retention. Ambulation has become increasingly difficult over the past 2 days. Examination is remarkable for percussion tenderness at the thoracolumbar junction. Rectal sphincter tone is preserved. All of the following actions are appropriate EXCEPT:
A.	Giving decadron 10 mg intravenously.
B.	Giving solumedrol 30 mg/kg.
C.	Ordering CT of the thoracolumbar region.
D.	Calling for emergent neurosurgical consult.
E. *	Placing a Foley catheter with a leg bag and discharging with close urology follow-up.
111.	A 55-year-old female with previously documented metastatic breast cancer presents to the ED with an altered sensorium. She is afebrile, and there are no focal neurologic signs. Serum calcium is 15 mg/dL. Which of the following is the LEAST appropriate action?
A.	Oncology consultation followed by glucocorticoid administration.
B.	Intravenous saline infusion.
C.	Intravenous furosemide administration.

D.	Oral phosphate administration.
E. *	Intravenous inorganic phosphate bolus administration.
112.	A 25-year-old male with a history of recent unprotected sexual intercourse presents with a complaint of urethritis. Gram stain of a urethral smear shows intracellular gram-negative diplococci. All of the following actions are recommended EXCEPT:
A.	Administering a single oral dose of cefixime 400 mg.
B.	Administering a single oral dose of azithromycin 1 g.
C.	Obtaining a serologic test for syphilis.
D.	Advising the patient to obtain HIV testing.
E. *	Administering a single oral dose of metronidazole 2 g.
113.	A 19-year-old female presents with painful pustular lesions on the vulva. She recalls having unprotected sexual intercourse approximately 10 days before with a male partner who had a single small lesion on the penis. She also reports dysuria that began when she noticed the lesions. All of the following statements are TRUE regarding the diagnosis EXCEPT:
A.	Although direct viral culture is more sensitive for detecting the organism, a smear of these lesions may show large intranuclear inclusions.
B.	Infection occurs by direct contact with mucosal surfaces or nonintact skin.
C. *	Systemic symptoms including fever, headache, and myalgias are uncommon.
D.	Appropriate initial therapy consists of antiviral drugs including acyclovir, famciclovir, or valacyclovir.
E.	Recurrent outbreaks of these lesions occur in 60 to 90 percent of patients.
114.	The diagnosis of toxic shock syndrome requires a temperature above 38.9°C (102°F), a systolic blood pressure (BP) below 90 mm Hg, an orthostatic decrease of systolic BP by 15 mm Hg or syncope, a rash with subsequent desquamation, and involvement of at least three organ systems. Which of the following systems is NOT considered in the diagnosis?
A.	Hematologic: thrombocytopenia < 100,000 platelets/µL.
B.	Renal: increase in BUN and creatinine two times normal level; pyuria without evidence of infection.
C.	CNS: disorientation without focal neurologic signs.
D. *	Respiratory: respiratory rate > 28 breaths per minute, evidence of bilateral alveolar infiltrates on chest x-ray.
E.	Gastrointestinal: vomiting, profuse diarrhea.
115.	An HIV-positive patient presents to the ED complaining of shortness of breath and nonproductive cough. Chest x-ray shows diffuse interstitial infiltrates, and O2 saturation is 85 percent on room air. All of the following statements regarding this patient's probable diagnosis are TRUE EXCEPT:
A.	Pneumocystis carinii pneumonia (PCP) is the most common opportunistic infection in AIDS patients.
B.	Pentamidine isothionate is an effective alternate therapy to TMP-SMX.
C. *	A normal chest x-ray rules out acute PCP infection.
D.	65 percent of patients relapse within 18 months.
E.	Oral steroid therapy should be started in patients with a Pao2 < 70 mm Hg, or an alveolar-arterial gradient > 35.
116.	A patient who fell down a cliff while backpacking is brought to the ED after a prolonged rescue 8 h after falling. The patient sustained multiple lacerations and abrasions that are covered by dirt and grass. The patient is a 45-year-old U.S. native who cannot remember the last time she received tetanus prophylaxis. Which of the following represents the BEST management?
A.	Adult tetanus toxoid (Td) 0.5 mL intramuscularly.
B.	Human tetanus immune globulin (TIG) 250 U intramuscularly.
C. *	Td 0.5 mL intramuscularly and TIG 250 U intramuscularly in the opposite extremity.
D.	No prophylaxis is necessary because the patient is a U.S. native who received primary immunization as a child.
E.	Td 0.5 mL intramuscularly and TIG 250 U intramuscularly, followed by additional doses of Td at 1 month and 6 months.

117.	A colleague seeks your advice regarding travel immunizations. He is leaving in 2 weeks to be part of a medical missionary team in remote areas of Africa and Southeast Asia and plans to take malaria prophylaxis. Which of the following statements is LEAST correct regarding rabies prophylaxis in this case?
A.	Preexposure prophylaxis is recommended because the areas being visited are known to be endemic.
B.	Prophylaxis with HDCV 1 mL intramuscularly should be administered in three doses at days 0, 7, and 21 or 28.
C.	Active immunity to rabies persists for at least 2 years in most vaccine recipients.
D. *	There is no need to check rabies antibody titers after immunization has been completed.
E.	If an exposure occurs, immediate treatment consists of cleaning wounds with soap, debriding devitalized tissue, copious irrigation with sterile saline or water, and avoidance of suturing.
118.	A 40-year-old male who immigrated 6 months previously to the United States from Guatemala presents to the ED with complaints of fever, chills, malaise, and abdominal pain. He reports having had similar symptoms just before immigrating and received treatment with an unknown medicine from a Guatemalan clinic. A Giemsa-stained blood smear confirms the presence of malarial parasites. Which of the following regimens is recommended in adults for the treatment of uncomplicated malaria caused by Plasmodium vivax?
A.	Quinine sulfate 650 mg orally three times a day for 5 to 7 days.
B.	Quinine sulfate 650 mg orally three times a day for 5 to 7 days, plus doxycycline 100 mg orally two times a day for 7 days.
C.	Chloroquine phosphate 1-g load, followed by 500 mg in 6 h, and then 500 mg/day for 2 days.
D.	Quinidine gluconate 10 mg/kg intravenous load and then 0.02 mg/kg/min infusion for 48 h plus doxycycline 100 mg intravenously every 12 h for 48 h.
E. *	Chloroquine phosphate 1-g load, followed by 500 mg in 6 h, and then 500 mg/day for 2 days, plus primaquine phosphate 26.3-mg load per day for 14 days upon completion of chloroquine therapy.
119.	A frequent traveler reports previously taking chloroquine for malaria prophylaxis while visiting India. The patient is now planning an extended trip to Sub-Saharan Africa and would like another supply of chloroquine. All of the following are TRUE regarding this patient's upcoming travel EXCEPT:
A. *	300 mg chloroquine base orally every week is recommended, with continuation of prophylaxis for 4 weeks after the last exposure.
B.	The patient should remain in well-screened areas between dusk and dawn, use mosquito nets, and wear long-sleeved clothing.
C.	A pyrethrum-containing insect spray should be used in the evening and insect repellant containing DEET should be applied to exposed skin.
D.	Malaria can be contracted even if chemoprophylaxis is taken and personal protection recommendations are followed.
E.	The patient should receive prophylaxis for chloroquine-resistant P. falciparum with mefloquine 228 mg base orally every week.
120.	A 37-year-old male arrives at the ED at 9:00 a.m. complaining of diarrhea that began at 5:00 a.m. The patient felt fine the night before after eating dinner at 8:00 p.m. at a local seafood restaurant. His dinner companion reportedly also developed copious diarrhea the same morning and is going to meet the patient at the ED. Which of the following organisms is MOST likely responsible for the food-borne illness?
A.	S. aureus
B.	Norwalk virus
C.	Enterotoxigenic E. coli
D. *	Vibrio parahaemolyticus
E.	Campylobacter
121.	Gas-forming soft tissue infections are life threatening and must be diagnosed early and treated aggressively. Which one of the following symptoms or findings is LEAST likely to be seen with these infections?

A. *	Increasing symptoms over 7 to 10 days
B.	Pain out of proportion to physical findings
C.	Brawny edema with crepitance on palpation
D.	Bullae or malodorous serosanguinous discharge
E.	Low-grade fever, with tachycardia out of proportion to the fever
122.	Universal precautions were recommended in 1987 by the CDC to protect healthcare workers from the potential hazards of exposure to blood and other body fluids. All of the following practices are part of the recommended universal precautions EXCEPT:
A. *	Wear puncture-proof gloves when handling needles or sharp instruments with the potential for puncturing skin
B.	Mask and eye protection are indicated if mucous membranes of the mouth, nose, and eyes may be exposed to drops of blood or other body fluids
C.	Do not recap or bend needles
D.	Use a bag-valve mask to prevent the need for mouth-to-mouth resuscitation
E.	Healthcare workers with weeping dermatitis should avoid direct patient care until the condition resolves
123.	A 22-year-old female presents to the ED comatose after a seizure, with a blood pressure of 80/40 and a pulse of 148. QRS duration is 280 ms. She has been depressed and began taking nortriptyline 2 weeks ago. What is the MOST appropriate initial therapeutic intervention?
A.	Intravenous access and sodium bicarbonate at a dose of 1 to 2 mEq/kg
B.	Intravenous access, gastric lavage, and diazepam to control seizures
C.	Airway control, intravenous access, and activated charcoal per nasogastric tube
D. *	Airway control and mechanical ventilation, intravenous access, and sodium bicarbonate at a dose of 1 to 2 mEq/kg
E.	Physostigmine, 0.5 to 2.0 mg intravenously, diluted in 10 mL saline and given over 5 min
124.	A doctor inspected a patient at a receipt on stationary treatment and found out sharp poslablenie of the vocal shaking and dulling of perkutornogo sound below than corner of levoy shoulder-blade. About what pathological state is it possible to think ?
A. *	A presence of liquid is in a pleura cavity.
B.	Presence of tumour of pleura.
C.	Obturatsiya of road clearance of bronchial tube.
D.	Presence of all above enumerated pathological states.
E.	A presence of air is in a pleura cavity.
125.	A victim is withdrawn from under the obstruction of house in the area of earthquake. Objectively: pritomniy, pain in the lumbar-pectoral department of spine, skin covers of purpose. Motions are absent in feet, the function of pelvic organs is broken. Lower extremities fillings out, hot by touch, AO-130/80 of mm of рт.ст., Рs-48/min. What most reliable diagnosis?
A.	A. The heavy is combined vertebral-skeletal trauma.
B.	Pain shock.
C.	Traumatic shock.
D. *	The trauma of spine and spinal cord, spinal'niy shock, is closed.
E.	The trauma of spine and spinal cord is opened.
126.	At patient of 25 years tetraplegiya appeared after a dive, violation of functions of pelvic organs, loss of all types of sensitiveness. What most reliable diagnosis?
A.	Break of pectoral department of spine.
B. *	B. Break of neck department of spine with the damage of spinal cord.
C.	Break of neck department of spine without the damage of spinal cord.
D.	Zaboy of cerebrum.
E.	Break of lumbar department of spine.

127.	A female patient reports a recent sexual contact with a partner who has just been treated for a suspected STD. During the examination, a urine test for pregnancy is found to be positive. Which of the following antibiotics is safe to prescribe before referring the patient to an obstetrician for prenatal care?
A.	Acyclovir.
B.	Azithromycin.
C.	Cefixime.
D.	Metronidazole.
E. *	All of the above.
128.	Near transformer unit the old man is found unconscious. Objectively: pulse on a carotid and respiratory motions of thorax are absent. What will your actions be in this case?
A.	Tracheotomy
B.	To do nothing
C.	Artificial ventilation of lungs and indirect massage of heart
D. *	To call an ambulance
E.	Endocardiac injection of adrenalin
129.	The uncle in drunken state pushed away his 8 years old nephew from a bridge 7 meters high. Rescuers took out a victim in 5 minutes. Clinically: sharp pallor of skin covers, absence of liquid discharges from respiratory tracts, breathlessness and absence of palpitation. What type of drowning can be suspected?
A. *	Syncopal
B.	True
C.	Asphyxial
D.	Mechanical
E.	Hydratational
130.	In the rural district of the Autonomous republic of Crimea an earthquake happened force to 5 points. 2 men perished, 30 people got damages of different severity degree and need urgent medical aid. Specify the optimum term of giving the first medical aid:
A. *	30 minutes
B.	1 hour
C.	2-3 hours
D.	4-6 hours
E.	8-12 hours
131.	You are conducting the primary reanimation measures (indirect massage of heart and "mouth-to-mouth ventilation") in out of hospital conditions. What time is necessary to conduct such measures in case of absence of cardiac activity reduction and function of Central nervous system?
A.	45 minutes
B.	15 minutes
C. *	Before arrival of specialized brigade of ambulance
D.	30 minutes
E.	60 minutes
132.	10 years old child fell into cold water and was dragged out in 10 minutes. Objectively: expressed pallor of skin; from upper respiratory tracts foamy liquid is not discharged. What is the most probable diagnosis?
A.	Real drowning
B.	"Dark blue" drowned man
C. *	Syncopal type of drowning
D.	Asphyxial type of drowning
E.	"Dry" drowning

133.	Artificial ventilation of lungs is conducted to the 4th month’s child in the regimen of normoventilation because of sharp respiratory insufficiency which is caused by the development of sharp bronchiolitis. One of the elements of controlling the efficiency of AVL is monitoring free passage of endotracheal tube. Which mentioned symptoms do testify its impassability?
A.	Cyanosis
B.	Cough
C.	Tachicardia
D.	Decrease of pressure on breath
E. *	Increase of pressure on breath
134.	18 years old girl diving into water, hit her head at the bottom of the river. She marks weakness in upper extremities, sharp pain in cervical department of spine. Objectively: forced position – a head is to the right. Sharp local pain is at the level of osteoid outgrowth of VІ-VІІ vertebrae. Sensitiveness is disordered; mobile sphere is without any special features. What urgent medical aid must be given to a sick?
A. *	To introduce anesthetic preparations, to the collar of Shants, to transport to the specialized department on hard stretchers
B.	To put a patient on soft stretchers, put a pillow under a head and neck and transport to the hospital
C.	To introduce cardiac and respiratory analeptics and lay on hard stretchers with a bolster under shoulder-blades
D.	To introduce analgetics and transport to the hospital in semisitting position
E.	Under the local anesthesia to make taxis of cervical vertebra and immobilize by a gypsum thoracocranioplastic bandage
135.	12 years old girl was dragged from water in 3 minutes after drowning in the river. Reanimation measures were conducted by parents to the arrival of ambulance. They succeeded to obtain spontaneous, not frequent heart contractions, but breathing did not restore. What must doctor do immediately?
A.	"triple maneuver" after P. Safar
B. *	Intubation of trachea, sanitation of respiratory tracts, AVL
C.	Indirect massage of heart
D.	To introduce adrenalin intracardiac
E.	To introduce sulfate of atropine intracardiac
136.	For the conduction of intensive infusion therapy in a patient with sharp respiratory insufficiency, the cannulation of subclavian vein after Seldinger was done. After introduction of 600 ml infusion liquid the state of patient became worse sharply, tachypnea increased from 26 to 40 per minute, at auscultation of breathing on the right it is sharply weak, peructorical flatness. What is your diagnosis?
A.	Edema of lungs
B.	Edema of brain
C. *	Hydrothorax
D.	Tromboembolism of pulmonary artery
E.	Sharp cardiac insufficiency.
137.	For artificial respiration, a doctor found out that head throwing of patient is almost impossible because of little mobility of cervical spine. What additional actions must be done under these circumstances?
A. *	To lift the lower jaw of patient up and open his mouth, at the moderate deviation of head
B.	To turn the throwing head of patient aside and open to his mouth
C.	To put a pillow under patient’s head
D.	To make an additional strain for the maximal throwing of patient’s head
E.	To put a pillow or fold towel under patient’s shoulders
138.	58 years old patient was urgently hospitalized to the hospital in the terminal state: unconscious, pale cyanotic skin, does not breathe, tones of heart are hardly heard, tachycardia. Pulse and BP are not determined. What are primary and exigent measures in this case?
A.	Introduction of adrenalin

B.	Introduction of respiratory analeptics
C.	Introduction of 4% solution of sodium hydrocarbonate intravenously
D.	External cardiac massage
E. *	Artificial ventilation of lungs
139.	8th months girl was hospitalized to the reanimation department. Objectively: consciousness and breathing are absent; papillary response to light is negative, peripheral pulse on main vessels is not determined. What reanimation extra measure must be applied first of all in this situation?
A.	External cardiac massage
B. *	Liberation of respiratory tracts
C.	Ventilation of lungs
D.	Intravenous introduction of adrenalin
E.	Defibrillation of heart
140.	66 years old patient was delivered to reanimation department: unconscious, pulse on carotids is not determined, breathing at auscultation of lungs is not heard to, dilated pupils and there is no papillary response to light, skin covers pale. On electrocardiogram (ECG) big wave fibrillation of ventricles is registered. What is extra action?
A.	To combine AVL with external cardiac massage
B.	Intravenous introduction of adrenalin
C.	Intravenous introduction of atropine
D.	To do external cardiac massage
E. *	Electric defibrillation
141.	27 years old electrician got electrotrauma, touching by a hand to the bare electric wiring. There was blood circulation and respiratory arrest. Reanimation measures provided the restoration of cardiac activity in 5 min. What is the most possible complication in a few hours or even days after damage by electric current?
A. *	Blood circulation arrest
B.	Respiratory arrest
C.	Sharp hepatic insufficiency
D.	Sharp kidney insufficiency
E.	Edema of lungs
142.	32 years old woman used defective electric device. Suddenly she fell, losing consciousness, there were cramps. What violations of cardiac rhythm will be marked on electrocardiogram?
A.	Asystole
B.	B. Paroxysmal tachycardia
C.	Atrioventricular block
D. *	Fibrillation of ventricles
E.	Mechanical electro-dissociation of ventricles
143.	52 years old woman was hospitalized to the department of first aid with an epileptic attack. The first action while giving first medical aid is:
A.	To introduce intravenously 5 mg diazepam with next introduction of fenitoin
B.	To fix the tongue
C.	To introduce intravenously stream of 50% dextrose’s solution
D. *	To make sure of respiratory tracts passage and sufficient oxygenation of patient
E.	To cause medicinal pentobarbital coma
144.	64 years old woman with unstable stenocardia fell down suddenly during the walk. A doctor established fainting, absence of pulsation on A. саrotis and heart tones, constricted pupils and not frequent, shallow breathing. From what, in this case, is it necessary to begin reanimation measures?
A. *	Intravenous introduction of atropine
B.	To hit breastbone with a fist

C.	To conduct transesophageal cardio stimulation
D.	Intubation and AVL
E.	Intravenous introduction of adrenalin
145.	64 years old woman with unstable stenocardia fell down suddenly during the walk. A doctor established fainting, absence of pulsation on A. саrotis and heart tones, constricted pupils and not frequent, shallow breathing. What is the most reliable diagnosis?
A.	Faintness
B.	Collapse
C.	Heat stroke
D.	Asphyxia
E. *	Sudden blood circulation arrest
146.	3 years old child with sharply hard breathing, cyanosis of skin covers, salivation, absence of swallowing was delivered to the domestic doctor from a remote rural district. From anamnesis it is known that a child swallowed a bee. Objectively: edema of larynx, examination of glottis is impossible. In this case for providing the free passage of respiratory tracts it was decided to do crycothyreotomia. What is the essence of this operation?
A. *	In the transversal section of fabrics between cricoid and shield-like cartilages
B.	In the longitudinal section of cricoid and partly shield-like cartilage with excision a part from them and forming a channel
C.	In the longitudinal section shield-like and partly cricoid cartilages
D.	In the longitudinal section of shield-like cartilage
E.	In the longitudinal section of cricoid cartilage
147.	A doctor introduced an antibiotic to the patient, as a result there was anaphylactic shock and patient died. How can we characterize actions of doctor?
A.	As murder because of carelessness.
B.	As violation of storage rules and use of poisonous, drastic and narcotic matters.
C.	As illegal experiment on human being.
D. *	As careless hard bodily harm.
E.	As violation of professional duties.
148.	Suddenly an old man lost consciousness in the street, he continues to breathe independently. What is the primary measure?
A.	To conduct the massage of heart
B.	To take out from a mouth dentures and other extraneous bodies
C.	C. To lay on a floor, lift up lower extremities
D. *	To inflict pericardial blow
E.	To conduct artificial ventilation of lungs
149.	A young fellow struck his head at a bottom diving from a height in a small depth. Immediately he was dragged to the shore by holiday-makers. He is in a state of clinical death and with the signs of spine trauma in a cervical department. What are the specialties of reanimation measures in this situation?
A.	To conduct artificial respiration after the method of Sylvester
B.	To conduct artificial respiration after the method of Khogera-Nilsena
C. *	Not to conduct the maximal throwing of victim head back
D.	Not to open a mouth of a victim, but conduct artificial respiration “mouth-to-nose”
E.	Not to take out the lower jaw of a victim up and forward
150.	A young girl was dragged out from a lake in 3 minutes after drowning. Unconscious. Breathing absents, from a mouth grey suds are selected. Skin is violet-cyanotic color. Pulsation above carotid is not determined. Specify the order of reanimation help.
A. *	To clean the mouth and throat cavity by a finger, to conduct AVL "mouth-to-mouth", closed massage of heart;

B.	To turn a victim’s head down, to press a thorax for the taking out of water, to conduct AVL "mouth-to-mouth";
C.	To do pericardial stroke immediately, conduct AVL and closed massage of heart;
D.	To release respiratory tracts from water, to conduct AVL after Sylvester;
E.	To call an ambulance immediately, to its arrival - to conduct AVL after Sylvester and closed massage of heart.
151.	In the street an old woman fell down suddenly. Objectively: on a carotid pulse absents, by no visual breathing, dilated pupils, irresponsive on light. What must be done first of all?
A.	Dactylar revision of mouth cavity and upper respiratory tracts passage, artificial ventilation of lungs
B.	Knock in a pericardial area, to check up the reaction of pupils
C.	To observe if there are respiratory motions of thorax, dactilar revision of mouth cavity and upper respiratory tracts passage
D.	To do ECG, dactilar revision of mouth cavity and upper respiratory tracts passage
E. *	Knock in a pericardial area, dactilar revision of mouth cavity and upper respiratory tracts passage
152.	In the morning a mother found 5 months boy in bed already dead with cadaveric lividity, face down. Before that a child was healthy. What is the most probable reason of child’s?
A.	Meningoencephalitis
B. *	Syndrome of sudden death
C.	Aspiration by the vomit masses
D.	Epileptic status
E.	Cardiogenic shock
153.	A patient was delivered to the waiting department unconscious after car accident. BP - 60/0 mm, pulse – 140 per minute. Objectively: fracture of thigh in the medium third area. Internal hemorrhage. Computer tomography of brain – hemorrhagic trauma of frontal lobe. When osteosynthesis of thigh can be done?
A. *	After taking out of shock and arrest of internal hemorrhage
B.	immediately after the end of diagnostic process
C.	After taking the patient out of shock, not late than third day
D.	After arrest of internal hemorrhage
E.	After taking the patient out of shock
154.	A patient was appealed to the traumatic department with an incised wound on palm's surface of lower third of forearm from an elbow side. After the removal of bandage there is expressed arterial bleeding. Violation of which of the following arteries can cause bleeding?
A. *	Ulnar artery
B.	Reverse elbow artery
C.	radial artery
D.	Interbone
E.	lower ulunar collateral
155.	A public-call message was received by a waiting room of hospital that soon a patient will be delivered by an ambulance who was withdrawn from blazing home in unconscious state. What damages are most probable in a victim:
A.	Burns of skin and respiratory tracts, sharp poisoning of CO2
B. *	Burns of skin, burn shock
C.	Burns of respiratory tracts, burn shock
D.	Poisoning of CO2
E.	Sharp respiratory insufficiency
156.	56 years old woman was strucked by car. She complaints about pain in the area of right iliac bone. She is not able to stand on a right foot. Objectively: there is a hematoma in the right half of pelvis, raws, bleeding, extremity is shortened, external rotary press of thigh, positive syndrome of “sticking” heel. Your diagnosis:

A. *	Fracture of femoral neck of thigh-bone
B.	Dislocation in a thigh joint
C.	Fracture of thigh of iliac bone
D.	trauma of a hip area
E.	Breaking sacro-iliac connection
157.	A public-call message was received by a waiting room of the hospital, that soon a patient will be delivered by an ambulance which was withdrawn from blazing home in unconscious state. What damages of a victim are the most probable:
A.	Burns of skin and respiratory tracts, sharp poisoning of CO2
B.	Burns of skin, burn shock
C.	Burns of respiratory tracts, burn shock
D.	Poisoning of CO2
E. *	Sharp respiratory insufficiency
158.	A patient was acted to the induction centre after DTP with the plural breaks of lower extremities. A patient is pale, put on the brakes; a skin is covered sticky then. On overhead third of thigh a plait is imposed on the left, at the removal of which a bandage intensively gets wet blood. A pulsation on a popliteal artery on the left is absent. What most reliable diagnosis?
A.	Traumatic damage of femoral artery.
B.	B. Traumatic damage of femoral vein.
C.	Traumatic damage of popliteal vein.
D.	Trauma of soft fabrics.
E. *	Traumatic damage of popliteal artery.
159.	A patient, during his work on a circular saw, injured a left forearm. During a review was detected on the internal surface of left forearm wound 7x2 cm. The bottom of wound are the damaged muscles. From the depth of wound there is a pulsating stream of bright red blood. What first aid does need to be rendered a patient?
A.	Imposition of plait on a forearm.
B.	Imposition of squeezing bandage.
C. *	Imposition of plait on a shoulder.
D.	Position of extremity is promoted.
E.	Introduction of vikasolu and chlorous calcium.
160.	Victim, as a result of accident, get the wound of forearm is lacerated with the abundant pulsating bleeding bright red blood from a wound. What measures must be conducted above all things?
A.	To impose burn on extremity.
B.	To impose a squeezing bandage.
C. *	To carry out the finger pinning of humeral artery.
D.	To provide intravenous infusion of liquid.
E.	To give the promoted position of extremity
161.	A victim has been taken from under the debris of the destroyed house after he/she was in wreckage for 6 hours. After examination the following symptoms became evident: syndrome of prolonged compression of both limbs, II degree noncompensated ischemia. The complex intensive therapy is being held. What combinations of infusions are the most appropriate in the pre-hospital period?
A.	Physiological solution, soda.
B. *	Ringer’s solution, "Laktosol".
C.	10% glucose solution.
D.	Fresh frozen plasma.
E.	Gelatinolum, albumin.

162.	On the 4th day after transfusion of incompatible blood group a patient has reduced diuresis, developed anury, worsening of general condition and increased ABP. Lab tests showed: plasma creatinine - 680 mmol/L, urea plasma - 24 mmol/L. Which disease can be suspected in the first place?
A.	Hemotransfusion acute renal failure, anury.
B. *	Anaphylactic shock, acute renal failure, anury.
C.	Hemotransfusion shock, acute renal failure, anury.
D.	Postgemorragical acute renal failure, anury.
E.	Acute interstitial nephritis, obturative anury.
163.	A 30 year old person has been drawn from the building of fire. Examination revealed that III-A, III-B thermal burns make 20% of the total skin. AP - 110/70 mmHg., HR - 120/min. Which transfusion means are the most appropriate for the blind infusion correction during transportation?
A.	Saline solutions.
B. *	Polyglucinum.
C.	10% glucose solution.
D.	Fresh frozen plasma.
E.	Albumin.
164.	A patient was given native plasma blood transfusion. At the end of infusion the condition of the woman patient worsened: she was disoriented and restless. She had cyanosis and hypersalivation. Breathing rate - 36 /1 min., AP - 70/40 mmHg., exhale was difficult, she had sibilant dry rale. Which of the following medicines must be administered first?
A.	Adrenaline.
B.	Euphyllinum.
C. *	Suprastin.
D.	Noradrenaline.
E.	Prednisolone.
165.	After a road accident a patient was diagnosed with the fracture of pelvis, blunt trauma of abdomen, broken shoulder and forearm. AP- 80/60 mm/hg, Рs-120/min. Blood test shows\: er.- 2,2 ¦ 1012/L, Нb- 76 g/L, Hi- 0.24. What must the blood renovation start from?
A. *	Whole blood.
B.	Erythrocytic mass.
C.	Fresh frozen plasma.
D.	Albumin.
E.	Crystalloids.
166.	A 68 year old patient was delivered to the hospital with nasal hemorrhage. From the medical history: hypertensive disease for 15 years, untreated. Occasional nasal hemorrhage observed for several years. Physical examination: ABP – 210/120 mmHg, blood clots discovered in nasal cavity by anterior rhinoscopy, eupnea. What therapeutic approach shall the doctor choose?
A.	Anterior nasal packing with vasoconstrictor core, blood pressure control.
B.	Posterior nasal packing.
C.	Application of silver nitrate solution or vagotil to nasal mucous membrane.
D.	Lamination of mucous nasal membrane.
E. *	Carotid ligation on the part of hemorrhage.
167.	A 32 year old patient diagnosed with polytrauma – a closed head and chest injury. Closed fracture of the right femora. ABP – 100/60 mmHg, cardiac rate – 124 bpm, respiratory rate – 28 / min. After a 2 hour skeletal traction with the application of lidocaine local anesthesia an acute deterioration was observed – cyanosis on the face and neck, ABP – 60/40 mmHg, cardiac rate – 160 bpm, respiratory rate – 44 / min. What complication is most likely to have increased the polytrauma severity?
A. *	Fat embolism of pulmonary artery.
B.	Myocardial infarction, cardiogenic shock.

C.	Pain shock.
D.	Pulmonary artery thrombembolia.
E.	Acute anemia.
168.	A 27 year old patient suffered a road accident. The lower third of left tibia suffered deformation, pathological mobility of bone segments, a 5x3 centimeter wound effusing dark blood in a non-pulsating trickle. What is the optimal method of hemorrhage arrest?
A.	Tourniquet above the wound and limb immobilization.
B.	Tourniquet below the wound and limb immobilization.
C. *	Compressing aseptic dressing.
D.	Aseptic dressing and limb immobilization.
E.	Compressing aseptic dressing and limb immobilization.
169.	A 1- year old boy suffered an incised wound of the forearm anterior surface. The wound is trickling with dark blood. Which method of temporal blood arrest is to be applied?
A.	Application of compression band.
B.	Finger pressing of brachial artery.
C. *	Tourniquet application below the wound.
D.	Tourniquet application above the wound.
E.	Application of limb hyperextension method.
170.	In the course of house demolition man`s lower limbs had been jammed for 12 hours. The man`s condition immediately deteriorated upon release. Acute pain, swelling in damaged areas, chills, tachycardia with 140 bpm cardiac rate, reduced ABP at 70/30 mmHg, anxiety. What is most likely to have caused the deterioration of condition?
A. *	Toxico-infectious shock.
B.	Acute blood loss, hypovolemic shock.
C.	Acute renal failure.
D.	Acute left ventricular failure.
E.	Disseminated intravascular coagulation syndrome.
171.	When boarding on a suburban electric train a 42 year old man injured his right lower limb. Objectively: the right foot hanging on soft-tissue flap, continuous bleeding, the pulse is not felt. What emergency measures are to be undertaken?
A.	Antishock therapy.
B.	Hemorrhage arrest, anesthetic administration, immobilization by immediate transportation to a specialized department.
C.	Hemorrhage arrest, immobilization.
D.	anesthetic administration, immobilization.
E. *	Hemorrhage arrest, anesthetic administration, immobilization by immediate transportation to a specialized department, infusion therapy.
172.	A patient hospitalized after a traffic accident presents with pelvic bone fracture, blunt abdominal trauma, upper arm and forearm fracture. Physical examination: AP – 80/60 mm Hg, HR -120/min. Blood testing: Hb-76 g/l, Ht -0.24, RBC – 2.2*1012/l. Which of the following is the first aid measure to restore CBV?
A.	Fresh frozen plasma.
B.	Packed red blood cells.
C.	Whole blood.
D. *	Albumin.
E.	Crystalloids.
173.	After a manual reduction of fracture and application of plaster longuette in a patient with forearm fractures, hand and fingers swelling, pain, sensitivity disorders appeared. Which of the following is the most appropriate tactics of the doctor?

A.	Cut off the gauze fixing the longuette.
B.	Prescribe analgetics and diuretics.
C.	Remove the plaster bandage.
D.	This is a natural phenomen, the swelling will lessen by itself in one day.
E. *	Repeat reduction procedure.
174.	A patient with a gunshot wound to the abdomen. Mild wound bleeding. Findings at the medical exam: skin pallor, clammy sweat, confusional state. AP 40/0 mm Hg, filiform pulse. Percussion gives a dull note in dependent areas of the abdomen. Which of the following is the most likely diagnosis?
A.	Massive intraabdominal hemorrhage, severe blood loss.
B.	Gut injury.
C. *	Bladder injury.
D.	Liver injury.
E.	Superficial soft-tissue injury of the abdomen.
175.	An injured with burns to the back, buttocks, thighs, perineum and genitals was admitted to the evacuation department of emergency medical care unit. Distributing doctor, by using the “rule of nines”, estimated the total burned surface area as:
A.	18%
B.	36%
C.	21%
D. *	28%
E.	19%
176.	Patient K, age 25, is diagnosed with femora open fracture after the road accident. The wound is pulsing with blood of scarlet coloring. Conscious. Pale skin. What kind of hemorrhage may be implied in this case?
A.	Venous hemorrhage .
B. *	Arterial hemorrhage.
C.	Capillary hemorrhage.
D.	Lower limb varicosity hemorrhage.
E.	Hemorrhage type is difficult to define.
177.	A patient was diagnosed with acute hemorrhagic syndrome with 15% deficit of circulating blood volume (CBV). Which extent of blood loss is it necessary to start transfusion of blood components at?
A.	More than 30 % of CBV.
B.	More than 10 % of CBV.
C.	More than 50 % of CBV.
D. *	More than 35 % of CBV.
E.	More than 20 % of CBV.
178.	A 50 year old patient was hospitalized upon release from debris. The injured lower limb swelled and became cold in two hours. The patient`s condition deteriorated, blood pressure – 90/40 mmHg. No urine. The doctor suspected positional compression syndrome. What is the pathogenic development mechanism of this condition?
A.	Endogenous intoxication.
B.	Vascular spasm due to pain syndrome.
C.	Cardiovascular system intoxication.
D. *	Necrosis of convoluted tubules of kidney.
E.	Adipose degeneration of liver cells.
179.	You began the grant of help to the grown man suffering in the place of event. He is unconscious and lies on a stomach. At a primary review you found out traumatic amputation in middle third of right forearm. You have a medicine chest of the first aid. What’s your action?
A.	To wash a wound, impose a tight bandage

B.	In overhead third of right shoulder to impose a plait
C.	To impose a tight bandage on a wound
D. *	In lower third of right shoulder to impose a plait
E.	To impose a plait at once higher places of amputation.
180.	You began the grant of help to the grown man suffering in place of event. He is unconscious and lies on a stomach. At a primary review you found out traumatic amputation in middle third of right thigh. You do not have a medicine chest of the first aid. What’s your action?
A. *	In overhead third of right thigh to impose a plait-rollup
B.	In lower third of right thigh to impose a plait-rollup
C.	To impose a tight bandage on a wound
D.	To wash a wound, impose a tight bandage
E.	To impose a plait-rollup at once higher places of amputation.
181.	You began the grant of help for the grown injured man at the place of event. He is without consciousness and lies on a stomach. At a primary review you found out traumatic amputation in middle third of right thigh. You do not have a medicine chest for the first aid. What are your father actions?
A. *	In overhead third of right thigh to impose a plait-rollup
B.	In lower third of right thigh to impose a plait-rollup
C.	To impose a tight bandage on a wound
D.	To wash a wound, impose a tight bandage
E.	To impose a plait-rollup at once higher places of amputation.
182.	You began the grant of help for the grown injured man at the place of event. When will you determine the damages of locomotor system?
A.	In the case of presence of complaints on the pain in the area of bones of skeleton
B.	During a primary examination
C. *	During the secondary examination
D.	Appear by chance
E.	None of the above.
183.	You began the grant of help for the grown suffering at the place of event. During the examination you found out the break of collar-bone. How to conduct a transport immobilization?
A. *	To fix a hand from the staggered side maximally arcuated in an elbow joint to the trunk.
B.	A transport immobilization is not conducted.
C.	To fix a hand to the trunk, unbanded in an elbow joint.
D.	To impose an impromptu tire on a forearm
E.	To impose an impromptu tire on a forearm and shoulder.
184.	You began the grant of help for the grown injured man at the place of event. During the examination you found out the break of humeral bone. How to conduct a transport immobilization?
A. *	To fix a hand to the trunk, unbend in an elbow joint.
B.	A transport immobilization is not conducted.
C.	To fix a hand from the staggered side maximally arcuated in an elbow joint to the trunk.
D.	To impose an impromptu tire on a forearm
E.	To impose an impromptu tire on a forearm and shoulder.
185.	You began the grant of help for the grown suffering at the place of event. During the examination you found out the break of bones of forearm. How to conduct a transport immobilization?
A.	To impose an impromptu tire on a forearm
B.	A transport immobilization is not conducted.
C.	To fix a hand to the trunk, unbend in an elbow joint.
D. *	To impose on a forearm an impromptu tire and to fix a hand arcuated in an elbow joint to the trunk.
E.	To impose an impromptu tire on a forearm and shoulder.

186.	You began the grant of help for the grown suffering at the place of event. He is without consciousness and lies on a stomach. During the primary examination you found out the traumatic amputation in the middle third of the right forearm. You have a medicine chest for the first aid. What are your father actions?
A.	To wash a wound, impose a tight bandage
B.	In overhead third of right shoulder to impose a plait
C.	To impose a tight bandage on a wound
D. *	In the lower third of right shoulder to impose a plait
E.	To impose a plait at once higher places of amputation.
187.	In the morning, 75 years old woman getting out of bed stumbled and fell down. She can’t get up on the left leg because of the pain in a thigh joint. During transportation to the clinic a leg was led and rotated outside, there was an axial load causes pain, the symptom of “stick heel” was positive. Most probable clinical diagnosis is:
A. *	Medial fracture of femoral neck of thigh
B.	Dislocation of thigh
C.	Fracture of head of thigh
D.	Lateral fracture of femoral neck of thigh
E.	Tearing away of large swivel
188.	56 years old woman was struck by car. She complaints on pain in the area of right iliac bone. She is not able to stand on a right foot. Objectively: there is a hematoma in the right half of pelvis, raws, bleeding, extremity is shortened, external rotary press of thigh, positive syndrome of “sticking” heel. Your diagnosis:
A. *	Fracture of femoral neck of thigh-bone
B.	Dislocation in a thigh joint
C.	Fracture of thigh of iliac bone
D.	Trauma of a hip area
E.	Breaking sacro-iliac and bosom connection
189.	An ambulance arrived at a scene where a 40 year old man suffered from stab wounds in the left shoulder blade area. Objectively: patient is in critical condition, conscious, euphoric; BP - 90/50 mmHg, weak pulse- 120 beats/min. Superficial breathing, respiratory rate - 34/min. Wound is soaked in blood. What should paramedics do?
A.	Infusion therapy
B.	Tracheal intubation, artificial lung ventilation
C. *	C. Urgent transport to the surgical department
D.	Inject sympatomimmetics
E.	Infuse polyglucin intravenously
190.	As a result of patient being hit by a truck in the region of upper third of the left thigh, patient suffered from sharp pain of a continuous character which increases upon movement. Patient is unable to move freely. During examination hemorrhage is noted “Galliffet” type deformity, Sharp pain during upper third palpation of the left thigh, left extremely is shorter. What is the diagnosis?
A. *	Bone fracture of the thigh
B.	Blow of the soft tissues
C.	Hematoma of the thigh
D.	Sprain of the thigh
E.	Injury of the quadriceps muscle

191.	One hour ago the patient fell down and hit the head at sidewalk. He was unconscious for 10-15 min. During the examination: pale skin, regular calm breathing. Pulse - 54 beats/min, BP- 110/60 mmHg. Patient is lethargic, emotionally excited, and unable to evaluate the severity of his condition. Was observed the insignificant anisocoria, compression of the right basal fold, tip of the tongue was deviated to the right. Muscle strength in right arm decreased, increased muscle reflexes, no sensory or coordination disturbances. What is the kind of injury in this case?
A.	Compression of the brain.
B.	Concussion of the brain
C. *	Blow to the brain.
D.	Psychotic shock.
E.	Intracranial hemorrhage.
192.	The ambulance arrived to a motor vehicle accident and discovered a 34 year old patient. Objectively: critical condition, conscious, bilaterally dilated pupils, active photoreaction, superficial breathing, respiratory rate- 28/min. Pale skin covered with sticky sweat, acrocyanosis. BP- 60/40 mmHg., unable to determine pulse. Heart rate - 130 beats/min. Closed fracture of the pelvis, right thigh, and both shins, traumatic shock. What should be done first?
A.	Infusion therapy, hormone therapy
B. *	Analgesia, intravenous infusion of colloid solutions
C.	Immobilization of extremities, infusion therapy
D.	Infusion of analeptics and hormones
E.	Intravenous infusion of colloid and crystalloid solutions
193.	A patient was admitted with the pelvic pain. Two hours ago he was hited by a car. Objectively: moaning from the pain, BP- 70/40 mmHg, heart rate- 115/min, deformed pelvis, shortened right lower of extremity, no signs of internal demage of organs. How should his pain syndrome be managed?
A.	Intrapelvic anaesthesia
B.	Interosseous anaesthesia
C.	Non-narcotic analgesic
D.	Conductive anaesthesia
E. *	Narcotic analgesic
194.	An ambulance team transported the patient 83yo with complaints: on his right leg after falling on the right side. On examination, the patient lies on the hospital bed, the right lower limb rotated outwards, the outer side of the foot touches the bed. Positive symptom "attached five." Your possible diagnosis?
A.	Fracture of femur diaphysis.
B.	Hip dislocation.
C. *	Fracture of the femoral neck.
D.	Bruise of the hip joint.
E.	Fracture of the acetabulum.
195.	In admission department was delivered victim from the accident,currently without consciousness. SC - 60 / 0 mm Hg. century., pulse - 140/hv. Objectively: hip fracture in the middle third. Intraperitoneal bleeding. CT of the brain - frontal lobe hemorrhagic slaughter. When you can perform osteosynthesis of the hip?
A. *	After withdrawal from shock and intra-abdominal bleeding stops.
B.	Immediately after the diagnostic process.
C.	After the withdrawal of a patient with shock, not later than the third day.
D.	After stopping intra bleeding.
E.	After the withdrawal of a patient with shock.

196.	As result of truck impact to the area of the upper third of the left thigh patient felt a sharp pain of permanent nature, which is greatly enhanced when attempting movement, could not move independently. During clinical examination determined hemorrhage, deformation of type "riding breeches" sharp pain on palpation in the upper third of the left hip, shortening of the lower extremity. Preliminary diagnosis?
A. *	Fracture of the femur.
B.	Bruising of soft tissues.
C.	Damage 4 headed thigh muscle.
D.	Hip dislocation.
E.	Hematoma of the hip.
197.	19 years, diving into the water, hit his head on the ground. Felt a crunch and a sharp pain in the cervical spine. Rescue team delivered him to the emergency hospital. Objectively: head tilted forward, chin touching the sternum. Because of severe pain sufferer supports head in his hands. Neural outgrowth fifth cervical vertebra will hold back above. The act of swallowing difficult. Disorders of sensitivity, paresis, paralysis there. Movements in the cervical spine sharply limited painful. The most likely diagnosis?
A. *	Twist of 5th vertebra;
B.	Bruise of the cervical spine;
C.	Fracture of the body of the 5th cervical vertebra;
D.	Fracture-dislocation of the 5th vertebra;
E.	Fracture of spinous processes.
198.	Children fell on his left hand. Objectively: deformity, abnormal mobility and crepitation of bone fragments in the region of the left clavicle. Under the skin is determined by palpation sharp end of the fragment, which threatened perforation of the skin. What are doctors tactics?
A. *	Dispatched to the polling station clinic.
B.	Put antiseptic bandage on the area of fracture, be pain.
C.	Trauma call home.
D.	Try to fix the pieces.
E.	Immobilization immediately sent to the trauma department.
199.	Female 18 years, while diving into the water of the river, hit her head on the bottom. In the upper extremity weakness, marks a sharp pain in the cervical spine. An emergency position - head brought to the right. A sharp local pain at UI-UII spinous processes of vertebrae. Sensitivity is not broken. Moving sphere without singularities. What kind of medical emergency aid should be given to the injured?
A.	Enter pain and transported to the hospital in half-sitting position.
B.	Under local anesthesia to reposition subluxation of the cervical vertebra and thorax+cranial plaster bandage.
C.	Put the collar trenches, anesthesia, transport on hard stretchers.
D.	Enter the cardiac and respiratory analeptics and put on a stretcher with a hard roller blades under.
E. *	Put the patient on soft couches, and in head and neck, put a pillow and transported to the hospital.
200.	To affected 34 years on the scene of accidents caused by crew of ambulance. Objectively: state of heavy, conscious, dramatically slowed, pupils dilated, equal, photoreactions living, breathing shallow, CHDR-28/hv. Skin pale, covered with sticky sweat, pronounced acrocyanosis. AT-60/40 mmHg, pulse of the radial artery is not defined. CHSS-130/hv. Suspected closed fractures of the pelvis, right femur and bones of both legs, traumatic shock. What are the primary measures in place an accident?
A.	infusion of colloid and crystalloid solutions.
B.	Introduction analeptics, hormones.
C. *	Immobilization of limbs, infusion therapy.
D.	Anesthesia, in / infusion of crystalloid solutions.
E.	Infusion therapy, hormone therapy.

201.	To admissions department hospitalized child 14 years old, who lost in the woods during a snowstorm, found in a day. Objectively \: pale skin dramatically, to-32oC, raves, threadlike pulse, breathing shallow, decreased muscle tone. What degree of overcooling corresponds to this clinical picture?
A.	Hard.
B.	Very heavy.
C.	Terminal.
D. *	Easy.
E.	Moderate.
202.	To admissions department transported the victim complaining of pain in the pelvis. Two hours ago, the explosion was oppression vehicle that overturned. OBJECTIVE: moaning in pain. AT-70/40 mmHg CHSS-115/hv. Shortening the right lower extremity. Abdominal organs without pathology. Choose the best way to eliminate pain:
A.	Narcotic analgesics.
B. *	Regional anesthesia.
C.	intrapelvic anesthesia.
D.	Non-narcotic analgesics.
E.	Intraosseous anesthesia in a wing of the ilium.
203.	To the hospital admissions department received a telephone message that the machine will soon be delivered SHMD victim with severe injury. From history we know that a patient's lower limb was pressed reinforced concrete slabs weighing 2t for 30 minutes. What type of damage most likely in the present opinion of the victim?
A. *	Long-term crushing syndrome (WBS) and multiple fractures of the limbs.
B.	SDR limb.
C.	Multiple fractures of the limbs.
D.	Acute traumatic thrombosis limb.
E.	Traumatic paresis of nerve endings.
204.	To admissions department 2 hours after chest trauma admitted victim 37 years of age. Diagnosis: subtotal nearside hemothorax. Initiation complex of antishock measures. Due to delay surgery for urgent indications doctor performed puncture of pleural cavity in VII intercostal space and states that received the blood clot formed in. Evidence of that is this test?
A. *	Ongoing bleeding.
B.	The presence of purulent process in the pleural cavity.
C.	Cardiac tamponade.
D.	Beginning with disseminated intravascular coagulation.
E.	The threat of pulmonary edema.
205.	Do reception rooms received a patient with a closed brain injury. Level of consciousness - coma. Skin pale, marked acrocyanosis. Significant tachypnea, CHDR-45/hv., AT-190/110 mmHg, heart rate-124/hv. To eliminate respiratory failure in this case, you must:
A. *	Enter respiratory analeptics.
B.	Add morphine to slow respiratory rate.
C.	Put traheostomy.
D.	Start a ventilator.
E.	Start inhalation of oxygen.
206.	To traumatology department entered the victim in '46 with an open fracture right tibia and femur in 8 hours after injury. When surgical treatment of wounds revealed contamination of wounds the earth, the presence of nonviable tissue in wounds. Thorough surgical treatment of wounds, but doctors can not exclude the possibility of gas gangrene. What should be done for specific prevention of gas gangrene?
A.	Enter 30000 AO antigangrene polyvalent serum.
B.	Enter specific serum in a dose of 3000 AO Bezredko.

C.	Enter a polyvalent serum in a dose of 10 000 AO on Bezredko.
D. *	Enter antigangrene polyvalent serum in the amount of 15 ml.
E.	Conduct washing wounds 6% solution of hydrogen peroxide.
207.	Female 49 years twisted left leg, felt a sharp pain in the ankle joint, crunching, inability to stand on his left leg. What is the immobilization of limbs taken on first aid?
A. *	Commit the patient to a healthy limb.
B.	Put Diterihsa transport bus.
C.	Fixing plaster tire.
D.	Fixing the limb by using Cramer's tires, or shifts.
E.	Put 8-like bandage.
208.	Female 25 years 2 hours ago fell in the street. Objectively \: right hand is assigned, bent at the elbow, the patient maintains her healthy hand. Concave form observed in the region of the deltoid muscle. Head of humerus determined under great pectoral muscle. Active movements are impossible. Passive motion meet elastic resistance. What is the most likely diagnosis?
A.	Contusion of the right shoulder joint.
B.	Fracture of the clavicle.
C.	Fracture of head of right humerus.
D. *	Right shoulder dislocation.
E.	Fracture of surgical neck of right humerus.
209.	Female 43 years marks a sharp pain in the shoulder joint. 2 hours ago fell into the hands of the street. Objectively \: right limb allocated, "bent at the elbow. Hallow observed in the region of the deltoid muscle. Active movements are not possible, passive - elastic. What is the most likely diagnosis?
A.	Large tubercle fracture humerus.
B.	Fracture of the clavicle.
C.	Fracture of surgical neck of humerus.
D. *	Fracture of head of humerus.
E.	Shoulder dislocation.
210.	Female 45 years injured in road accidents. Condition of the injured moderately. PS-88/hv, AT-120/80 mmHg In the area of the left lower leg swelling of soft tissue deformation in the upper and middle third, rvanozabiyna wound up to 5 cm in the middle third. In the wound are the bone fragments. What first aid should be given in this case?
A.	Immobilization, as soon as transport to hospital.
B.	Immobilization, anesthesia, aseptic dressing.
C.	Primary debridement, immobilization.
D.	Anesthesia places the fracture, aseptic dressing.
E. *	Overlay plaster bandages.
211.	Female 47 years we fell on outstretched right hand, felt a crunch and a sharp pain in the lower third of the forearm, which were deformed and swollen. What first aid should be given?
A.	Immediately deliver to emergency hospital.
B. *	Enter painkillers, transport immobilization.
C.	To conclude the finiteness of kosynochnu bandage.
D.	Make a local anesthetic to try to fix fracture, immobilization staircase tire.
E.	Make improvised immobilization and deliver to emergency hospital.
212.	Female 52 years admitted to the emergency department with seizures. The first action when providing medical care in this case are:
A.	Type in / bolus 50% dextrose solution.
B. *	Lock tongue.
C.	Make sure in the airway and adequate oxygenation of the patient.

D.	Call a drug pentobarbituturate coma.
E.	Enter / in 5 mg diazepam, followed by the introduction of phenytoin.
213.	Female 65 years suffered a heavy emphasis on hand. Complained of pain in the wrist joint. What kind of damage most likely mechanism for this injury?
A.	Fracture of radial and ulnar diaphyses of bones.
B.	Fracture of radius and ulna head dislocation.
C.	Fracture of the distal radius metaepifisis.
D.	Dislocation brush.
E. *	Scaphoid fracture.
214.	Woman '69 fell from a chair to the side of the floor. Can not get up because of pain in the hip joint. Lower limb shortened and rotated outward. The patient can not raise straighten the knee joint in the lower limbs. Briana triangle on the side of injury disrupted, a large swivel palpated above the line Rozera - Nelatona, palpation during pupartovoyu ligament is painful. Diagnosis?
A.	Overfishing of large displacement of the swivel.
B.	Fracture of the bottom of the acetabulum.
C. *	Fracture of the roof of the acetabulum with posterior hip dislocation.
D.	above hip dislocation.
E.	Fracture of neck of femur with displacement.
F.	Cardiac weakened, accent II tone of the pulmonary artery, heart rate-110/hv.
215.	The lower edge of the liver 3 cm below the costal arch. What is the most likely diagnosis?
A.	Exacerbation of bronchitis.
B.	Dry pleurisy.
C.	Neuralgia intercostal nerves.
D.	Right-sided pneumonia.
E. *	Spontaneous pneumothorax.
216.	Female 72 years old, two hours ago fell on the left side. House felt a sharp pain in left hip area. Self could not climb. Physician after review suggested fractured neck of left femur. In which department should send the patient?
A. *	To study trauma clinic.
B.	To orthopedic and traumatology ward.
C.	In the surgical ward.
D.	By emergency hospital
E.	Treat at home.
217.	Female 75 years as a result of side impact passenger car, fell from a height of personal growth on the left side, felt a sharp pain in left hip alone was unable to get up. What additional methods of examination undertaken for the diagnosis?
A.	CT hip
B.	Electrocardiography
C.	X-ray left hip joint in two projections
D. *	Nuclear magnetic resonance imaging of the hip
E.	Radiography hip
218.	Female of 75 in the morning, rising from bed, and fell. Stand alone on the left leg was not able to because of pain in the hip joint. With revenues of the foot clinic assigned and rotated outward, axial load pain symptom "stuck five" positive. What is the most likely clinical diagnosis?
A.	Medial fracture of the neck of femur
B.	Hip dislocation
C. *	Fracture of femoral head
D.	The lateral cervical hip fracture

E.	Large gap
219.	A woman aged '56 hit a car. Complaints of pain in the right iliac bone section. Cant stand on the right leg. Objectively \: in the right half of the pelvis the hematoma, abrasions, bleeding, observed shortening of the limbs, external rotation of hip, positive syndrome "attached" heel. Your diagnosis:
A. *	Fracture of neck of femur
B.	Dislocation of the hip joint
C.	Hip fracture iliac bone
D.	Slaying hip area
E.	Sacro-iliac rupture
220.	Three year old girl,taking off her sweater,and have sharply pulled her by the wrist, then the child began to cry in pain. Indicates a pain in the elbow joint. When trying to active and passive movements supination girl reveals concern. What kind of damage does the child most likely have?
A.	Dislocation of the head of radius
B.	Dislocation of forearm
C.	Traumatic radial nerve neuritis
D. *	Stretching bursal-ligamentous apparatus of the knee joint
E.	Epifizioliz distal humerus
221.	Cardiac weakened, accent II tone of the pulmonary artery, heart rate-110/hv. The lower edge of the liver 3 cm below the costal arch. What is the most likely diagnosis?
A.	Aggravation of bronchitis
B.	Dry pleurisy
C.	Neuralgia intercostal nerves
D.	Right-sided pneumonia
E. *	Spontaneous pneumothorax
222.	The doctor examined the patient at admission to inpatient treatment and found a sharp weakening voice trembling and blunting percussion sound below the angle of the left scapula. On a pathological condition can think of?
A.	The presence of fluid in the pleural cavity.
B.	The presence of pleural tumors.
C.	Obturation lumen of the bronchus
D.	The presence of all the above mentioned pathologies
E. *	The presence of air in the pleural cavity.
223.	Elbow joint is swollen, with bruises from bleeding in the tissue, its smooth contours. Palpation is determined by local pain, cleft in the area of the olecranon. Passive movements sharply increase the pain, and active extension is limited and painful. What is the most likely diagnosis?
A.	Contusion of elbow joint.
B.	Arthritis of the knee joint.
C.	Fracture of the radial head.
D. *	Fracture of the olecranon.
E.	Dislocation forearm.
224.	Summer '78 women diagnosed extensive fracture of radius in a typical location. What are the optimal methods of treatment?
A. *	End-stage reposition.
B.	Metal osteosyntesis
C.	Bone extract.
D.	Endoprosthesis.
E.	Bone grafting.

225.	A young woman fell on slippery surfaces by designated right hand, felt pain, turned to another doctor. On examination found \: pain localized in the right shoulder joint, the hand to bring the active movements in the joint is possible due to pain, lower acromial process shovels hallow soft tissue compared with the left shoulder joint, numbness of fingers, limbs symptom load on the negative axis. What is the most likely diagnosis?
A.	Fracture acromia end of the clavicle.
B. *	Traumatic dislocation of the shoulder.
C.	Damage to shoulder nerve plexus.
D.	Diaphysis fracture shoulder.
E.	Slaughter of the shoulder joint.
226.	At the level of hip external rotation and shortening of limbs up to 3 cm, positive symptom "attached heel." Indicate the most likely presumptive diagnosis.
A. *	Fracture of neck of femur.
B.	Slaughter of the hip joint.
C.	Hip dislocation.
D.	Fracture of ischium bone.
E.	Pelvic fracture type "butterfly."
227.	Premature infant was born. The examination revealed asymmetry of skin folds on the thighs, restriction removal of limbs, slight malnutrition gluteal muscles on the left. What is likely congenital pathology?
A. *	Left hip dysplasia
B.	Congenital hip sprain
C.	Varusna demormatsiya hip
D.	Fracture of neck of femur
E.	Right hip dysplasia
228.	Lower extremity in the area of the upper third of right thigh was wood heel. The patient, despite therapy, began to deteriorate. There were clinical signs of shock. What kind of complications you think?
A.	Fat embolism.
B. *	Traumatic toxicosis.
C.	Thrombosis of small pulmonary artery branches.
D.	Myocardial infarction.
E.	Hip fracture.
229.	Patient after an accident, his doctor diagnosed a closed head injuries. What are the main forms are distinguished in the clinical course of a closed head injury?
A.	Concussion.
B.	The slaying of the brain;
C.	Compression of the brain;
D.	All the above listed.
E. *	All the above listed and skull fracture.
230.	Patient after the accident, doctor found his closed head injuries. What is most characteristic of a closed head injury?
A. *	Damage to the brain without violating the integrity of the head cover.
B.	Damage to the brain without a skull fracture.
C.	Damage to cover intact without prejudice to the head and skull fracture.
D.	Damage to soft tissues of the head without skull fracture.
E.	Damage to soft tissues of the head, skull fracture without violating the integrity of the dura mater.
231.	Patient after the accident, doctor diagnosed his brain concussion. What are the main symptoms in this pathology?
A.	Short-term loss of consciousness.

B.	Retrograde amnesia (memory loss for events that preceded the injury).
C.	Bradycardia, nausea, vomiting.
D.	Pain during movement of eyeballs.
E. *	All the above listed symptoms.
232.	One of the builders at work was pressed to the wall at home lorries. Complains of pain in the pelvis, the inability to raise the direct lower limbs, weakness, dizziness. Previous diagnosis - closed fracture of pelvic bones. In which position should be transported the victim?
A.	In the stomach of the lower limbs rectified
B.	On the side of the abdomen bend to lower limbs
C. *	On the back of the bend in the knee and hip joints of lower limbs
D.	On the back of the lower limbs rectified
E.	Sitting
233.	Patients in '24 at the class cycling has fallen to the right side. During the fall of the right upper limb was in a position to bring. Complains of constant pain in the right upper arm area, which increases with movements in the shoulder joint. The right hand is in a forced position. Determine the edema, hemorrhage and deformation in the right-clavicular joint acromial, positive symptom "keys." Active and passive movements of the shoulder joint are possible but limited due to increasing pain. Put a preliminary diagnosis?
A. *	Dislocation acromial end of the right clavicle
B.	Bruising of soft tissue right upper part of arm
C.	Fracture of the outer third of the right clavicle
D.	Dislocations right shoulder
E.	Damage solely of the joint
234.	Patients 28 years old, entered the clinic with complaints of pain in right knee injury function. Indirect trauma, leaving skiing, at the time of braking and sudden stops, a rotation of the right tibia. On examination: the contours of the right knee joint are smoothed, joint increased in volume. Symptoms of "ballot nadkolinka", "fluctuations" positive. When passively bent leg pain occurs, the latter making the forward and backward. Preliminary diagnosis?
A. *	Damage to the anterior and posterior cruciate ligament
B.	Damage to the anterior cruciate ligament
C.	Damage to the posterior cruciate ligament
D.	Collateral damage relationship
E.	Damage miniskus
235.	Patients 32yo, he fell with a focus on the right knee joint. Leaning on a stick with a bent right shin, right shin actively straighten not able to outline the right knee, joint increased in volume. Palpation: local temperature of the joint, pain is present during any kind of manipulation. Prior diagnosis?
A. *	Fracture of left patella
B.	Damage to own bonds patella
C.	Damage rectus femor
D.	Damage tendon stretching
E.	Right patella luxation
236.	Patients in '42 fell to the elongated reserved and slightly rotated arm. I turned on the trauma point complaining of constant intense pain and shoulder joint area, which is greatly enhanced when you try to movements in the joint. On examination, the shoulder is somewhat taken away and rejected back, patient support hand in a forced position, as seen below acromial process hallow deltoid,flatness of subclavian fossa. Palpation is determined to strengthen local pain, stiffness of passive movements. Ask a preliminary diagnosis.
A. *	Anterior shoulder dislocation
B.	Bruising of soft tissue shoulder joint
C.	Fracture of surgical neck shoulder

D.	Clavicular dislocation
E.	Fracture of clavicle
237.	Patients 42yo, after falling to straighten the arm at the elbow felt intense constant pain in the left upper arm. On examination determined shortening and the omission of the left upper arm, flatness of the subclavian and pits, a bruise. The end is in a forced position - patient supports other hand elbow and forearm. Palpation is defined by a sharp local pain in the middle third clavicle. Put a previous diagnosis
A. *	Fracture of clavicle
B.	Bruising of soft tissue nadplichchya
C.	Rotary cuff shoulder injury
D.	Shoulder dislocation
E.	Dislocation-dislocation
238.	Patient 44yo, brought in orthopedic department and trauma hospital complaining of sudden intense pain in the right hip joint, which is greatly enhanced with small movements. Right hip joint deformed. Leg bent, present and rotated inward. Palpation felt displaced femoral head. Large swivel removed and its tip is defined above line Rozera-Nelatona. Heatedly symmetry line and triangle Shemahera Briana. Defined relative shortening the length of the lower extremity. Identify presumptive diagnosis
A. *	Top-posterior hip dislocation
B.	Front-top hip dislocation
C.	Front-bottom hip dislocation
D.	Lower-posterior hip dislocation
E.	Damage to the hip joint
239.	Patient 60 years old after the fall of allotted hand felt a sharp pain in right shoulder joint. On examination, marked swelling and deformation in the upper third of the shoulder, bleeding on the inside surface of the shoulder. Angle of the limbs is off. The patient support hand in a somewhat forced designated position. Active movements in the shoulder joint due to pain not possible, passive - sharply painful and limited. Palpation is determined by the maximum point of pain in the metaphyseal part of the humerus. Put a presumptive diagnosis
A. *	Abductive fracture surgical neck shoulder
B.	Shoulder dislocation
C.	Bruising of soft tissue shoulder joint
D.	Adductive fracture surgical neck shoulder
E.	Fracture of the humerus diaphysis
240.	Patient,68yo, after the fall felt pain in the left hip joint, inability to attack the left leg. On examination, determined by shortening the lower limb, external rotation of her. Above is a large swivel above the line Rozer-Nelatona. Active and passive movements in the hip joint is much limited due to pain. Determine the positive symptom "attached five.Preliminary diagnosis?
A. *	Fractured neck of femur
B.	Hip dislocation
C.	Bruising of soft tissue in the hip joint
D.	Fractured neck of femur
E.	Sprain fractured femur
241.	Patient, 40yo,fell on the outstretched hand, felt pain in right shoulder joint. After examination diagnosed right shoulder closed sprain. What symptoms are leading to this pathology?
A. *	Pain, shoulder joint deformity, a symptom of elastic fixing
B.	Deformation of the shoulder joint
C.	Violation of limb axis
D.	Bringing the limbs, lack of movement, deformation
E.	Hemorrhage in the area of the joint, swelling of hands

242.	During the explosion ball bomb victim was wounded in the stomach. Worryingly severe abdominal pain. With 0.5 cm diameter wound in the left abdomen bloody fluid secreted from intestinal smell. Do you think the damage which is characteristic of the abdomen in this case?
A.	Damage abdominal muscles
B. *	Through bowel injury
C.	Damage to the spleen
D.	Damage to pelvic bones
E.	Damage to the urethra
243.	During the earthquake in women 36 years of right lower extremity was the heel of the debris destroyed house. 6 hours free from compression. OBJECTIVE: state hard, excited, confused, AT-100/60 mmHg, PS-100/hv, right lower extremity swelling, skin on the thigh of blue-purple. Sensitivity sharply reduced, movements and pulse it missing. What is urgent medical care should be given to patient?
A.	Apply a tourniquet to the upper third of the thigh, the introduction of drug transport immobilization.
B.	Enter analgesics, immobilization aids.
C.	Immediately send to a specialized department.
D. *	Tight bandaging the right lower extremity, the introduction of anesthetics, transport immobilization, local, cold.
E.	Novocaine blockade of the lumbar incision, tourniquet, immobilization Diterihsa bus.
244.	During the demolition of the house people were curtailed within 12 hours of lower limbs. After clearing the victim's condition immediately worsened. Observed a sharp pain and swelling in damaged areas, chills, tachycardia with heart rate to 140/hv, lower blood pressure - 70/30 mmHg, anxiety. What is most likely due to the deterioration of the patient?
A. *	Toxic-infectious shock
B.	Acute blood loss, hypovolemic shock
C.	Acute renal failure
D.	Acute left ventricular failure
E.	Intravascular coagulation syndrome desiminated
245.	After manual reposition and plaster imposition of a patient with fractures of the forearm bones appeared meter and finger swelling, pain, sensory disturbances. What should be the tactics of a doctor.
A. *	Cut the bandage, which is fixed
B.	Assign analgesics and diuretics
C.	Remove the plaster cast
D.	This is a natural phenomenon, swelling and independently reduced by day
E.	Repeat reposition
246.	After chest trauma with rib fractures diagnosed a patient hemothorax suggested pleural puncture. In the most appropriate place to pleural puncture?
A.	In the second intercostal space in mid-clavicular line;
B.	In the fourth intercostal space in mid-clavicular line;
C. *	In VI-VIII-axillary intercostal space on the back or shoulder line;
D.	In V intercostal space on the middle axillary line;
E.	In the fourth intercostal space on the back axillary line.
247.	Bullet wounded in left hip. Can’t step, or move his leg. In lower front surface of distal left thigh wound measuring 1.5 x 1.5. Another wound - on rear inner thigh size 6 x 7. Wounds bleed moderately. Thigh in the lower third of the deformed, is abnormal mobility. What is the harm in this situation prevents traffic injuries.
A. *	Gunshot fracture of the femur
B.	Damage femoral nerve
C.	intra muscular hematoma
D.	Injuries parts of soft tissue

E.	Damage to the femoral artery

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