Наталья, тебе отдельное спасибо!
Выкладываю первые 10 вопросов. Дерзайте! (с)
1. A 21-year-old man comes to the clinic because he has become increasingly short of breath and has had a cough for the past week.
He appears dyspneic and has a temperature of 38.3EC (101.0EF). On physical examination he has bibasilar rales and generalized
lymphadenopathy (1 to 2 cm). Rectal examination shows multiple perianal contusions and a small amount of blood oozing from the
anal orifice. Chest x-ray film shows bilateral patchy alveolar infiltrates. The most appropriate course of action is to order blood tests
and to do which of the following?
(A) Admit him to the hospital and begin administration of trimethoprim-sulfamethoxazole, intravenously
(B) Admit him to the hospital and begin administration of penicillin and gentamicin, intravenously
(C) Begin administration of erythromycin, orally, and see him again the next day
(D) Prescribe isoniazid and rifampin, orally
(E) Recommend aspirin, fluids and rest at home
2. A 17-year-old white girl returns to the health center for a family planning follow-up visit. She gave birth to a healthy baby girl 8
months ago and does not want to become pregnant again. She is monogamous with the father of her baby but worries that he is not
monogamous with her. They live together and are not married. She is taking an oral contraceptive and "sometimes" uses condoms.
She says that she has great trouble remembering to take her pills and wants to discuss other contraceptive options. In addressing this
issue, which of the following is the most appropriate next step?
(A) Advise her to continue taking an oral contraceptive because it is one of the most effective methods of birth control
(B) Advise her that an intrauterine device would be a good contraceptive choice for her
(C) Discuss implantable or injection long-term progestational contraceptive agents
(D) Discuss the option of tubal ligation
(E) Fit the patient with a diaphragm and instruct her on proper use
3. A 19-year-old African-American college student comes to the student health center because of marked fatigue. Temperature is
38.3°C (101.0°F). Physical examination shows striking pallor of skin, nail beds and conjunctivae. There are petechial hemorrhages
in the skin of his legs. A soft, blowing systolic murmur is present over the precordium. No other abnormalities are present. Which
of the following is the most appropriate study at this time?
(A) Complete blood count
(B) Determination of bleeding and clotting time
(C) Examination of bone marrow aspirate
(D) Hemoglobin electrophoresis
(E) Serological testing for infectious mononucleosis
4. A 12-year-old girl is referred to the clinic by the school nurse for evaluation of scoliosis. The girl's scoliosis was detected during a
routine screening examination at the school, and it appears to be mild (curve less than 10 degrees). She is athletic and is otherwise
in good health. During the physical examination, particular attention should be given to which of the following?
(A) Arm length
(B) Blood pressure
(C) Body weight
(D) Cardiac examination
(E) Stage of pubertal development
5. A 10-month-old infant is brought to the health center by his mother because of eight watery bowel movements during the past
24 hours. On physical examination the infant is lethargic and somnolent. The mucous membranes are dry and the skin turgor is
poor. The anterior fontanel is sunken. At his last visit 2 weeks ago, he weighed 10 kg (22 lb); today his weight is 9 kg (20 lb). His
temperature is 37.2EC (99.0EF), pulse is 170/min and blood pressure is 100/60 mm Hg. Which of the following is the most
appropriate next step in management of this infant?
(A) Begin intravenous hydration with isotonic saline solution
(B) Educate the mother on how to recognize dehydration and worsening clinical symptoms in her infant
(C) Obtain serum electrolyte concentrations and begin oral rehydration therapy
(D) Obtain a stool culture and begin amoxicillin therapy
(E) Tell the mother to stop breast-feeding and have her give the infant a soy-based formula