Family medicine question Variant 1

1. A 8 months old child. Complains of frequent watery stools upto 5-6 times a day, vomiting for 2
days, on examination the baby is lethargic, eyes are sunken, cannot drink, skin pinch goes down
very slowly. Classify the childs condition and tactics of treatment.
1. Moderate dehydration, treatment plan B
2. Severe dehydration, treatment plan C and immediate hospitalization
3. No dehydration treat child at home
4. Dysentry, treat with antibacterial drugs for 5 days
5. Severe dehydration treatment plan C

2. Baby is 1.5yrs old, with high temp 38.5,duration of 5 days, which is measured regularly.
Objectively: rigidity of occipital muscles, signs of measles are absent. The baby was not sick with
measles for the last 3 months. Classify the condition of the baby and your tactics.
1. Immediate hospitalization, with first dose of amoxicillin 250mg, and fist dose of paracetamol
500mg 1/4 of tablet.
2. High fever, give first dose of paracetamol in out patient
3. Treat the child in polyclinic
4. Give vit A and next visit after 2 days
5. Give paracetamol and next visit after 2 days

3. A child is 3yrs old, she weighs 10kgs, temperature is 38degrees, she has cough since 2 days with
generalized rash, breath rate-42/min, stridor and indrawing of chest are absent. She has red eyes, no
pus discharge from eyes and darkening of mucosa. Classify the condition of the child.
1. Pneumonia
2. Severe pneumonia
3. Measles and fever
4. Measles with complications

4. Baby was born with wt 3400gms ht 52cms, has come for control examination at 4 months of age,
determine the corresponding ht and wt
1. 4500gms, ht 60cms
2. 5900gms, ht 59cms
3. 6600gms, ht 63cms
4. 6350gms, ht 63cms
5. 5000gms, ht 58cms

5. A pregnant woman with regular menstrual cycle of 28 days had last menstruation at 06/february.
Calculate the date of delivery
1. 7 November
2. 13 November
3. 12 November
4. 24 November

6. To the family doctor came a54yrs old woman with complains in the chest, irregular in character,
increases during deep inhalation, dyspnoea at rest. On ECG right bundle block, high sharp P in III
and aVF leads, pathological Q in III and aVf. In anamnesis: thrombophlebitis in deep vein of
lower extremities. Your diagnosis, plan of treatment.
 Variant-2

1. Child, 1.5 years old, have diarrhea during 3 days, child is irritable, drinks normally, the skin
pinch goes back immediately.
Classify condition of a child-
1. There is no dehydration, persistent diarrhea.
2. Acute diarrhea, no dehydration.
3. Acute diarrhea, moderate dehydration.
4. Acute diarrhea, severe dehydration.
5. Persistent diarrhea.

2. Child 2 years, according to mother words hot to touch during 2 days. Objectively- child is quiet,
temperature 37.5; other signs of any disease are not present. Classify condition of child.
1. Very severe febrile diseases, give the first dose of an antibiotic and paracetamol.
2. Persistent fever, to direct on inspection in polyclinic, to give the first dose of paracetamol
3. The possible bacterial infection, to give anti-biotic
4. Non complicated fever, the subsequent visit in 2 days if the fever remains.

3. At the child 3.5 years generalize rash, running nose, cough during 3 days. Purulent discharges
from eyes. Respiration 38 in a minute, a body temperature 37.8. In month ulcers are not present.
Classify condition and define treatment-
1. Measles with complication of eyes.
2. Measles complicated with pneumonia.
3. Give the first dose of vitamin A 200000 ME in polyclinic and the second dose at home next day.
4. Treatment of eyes by tetracycline eye ointment.
5. Cleaning oral cavity by gencyan violet.
4. Healthy child 6 months on reception at FD, factual weight of child 7500 gm, length of is 66 cm,
weight and length at birth is 3200gm, 50cm respectively. Define compatibility of figures of factual
and proper weight and length of the child.
1. The weight and height of the child corresponds to normal indicator.
2. Lagging in weight and height
3. The over weight of body is marked.
4. Over height of the child is marked.
5. True signs of pregnancy are-
1. Increase of uterus.
2. Positive biological test on pregnancy.
3. The termination of menses.
4. Determination parts of the fetus.
5. Pigmentation of the big sexual lips.

6. The patient 67 years, has addressed to the local therapist with complains on the pain which have
arisen during physical activity at chest., after physical activity an indisposition, unmotivated
weakness remain. Your diagnosis tactics of conducting the patient.
 Variant 3

1. A child, 2 yrs. Complains on watery stools 5 times a day. On physical exam the child is irritable,
restless, sunken eyes, very thirsty, skin pinch goes back slowly. Diagnose the condition of the child
and treat.
1. Severe dehydration, treatment plan C
2. Moderate dehydration, treatment plan B
3. No dehydration, treatment plan A
4. Dysentery, treatment with ampicillin
5. Cholera, prescribe erythromycin

2. Child 2yrs with severe fever, temp 38 degrees, on examination there are ulcers in the mouth and
pus discharge from the eyes. Diagnose and treatment.
1. Severe complicated measles
2. Measles with complications of eyes and mouth
3. Non complicated measles
4. Give vit A, tetracycline ointment to be applied 3 times a day in eyes, clean mouth ulcers with
gentian violet. Advice next visit after 2 days
5. Hospitalization in the infectious disease hospital

3.A mother has brought 2yr old child with complaints small maculated rash on unchanged skin,
rash first developed on the face then all over the body, the rash stayed for 2 days, running nose and
slight cough, breath rate is 37/min, temp is 38.5 degrees, enlargement of occipital lymph nodes.
1. Measles, complicated by pneumonia
2. Measles
3. German measles
4. Scarlet fever
5. Chicken pox

4. Wt and ht at birth of child is 3200gms, 50cms. Determine the correlation the factual and proper
wt & ht of the child
1. Ht and wt are under normal parameters
2. The child is of small ht and wt
3. Excess body mass
4. Excess ht of the new born

5. Puerperant complains of high temp up to 39degrees on 5th day after labor. Objectively:
hyperemia of the upper lateral quadrant of the left breast with dense infiltration 5x6cms, painful on
palpation, with cracks on the left nipple rt breast is normal
1. Lactative serous mastitis
2. Cracks of nipples
3. Tumor of breast
4. Abscess of breast
6. Patient A, 45yrs old. He has come to the polyclinic with complains on intensive pressing pain
behind sternum and in epigastria region, ECG examination shows Q II, III, aVF >1/3 of R, ST
elevation. Your diagnosis and treatment tactics.

Variant 4

1. Child, 1.5yrs with frequent watery stools, vomiting. Baby sick during 1 day. On examination - baby
is irritable, eyes are not sunken, normally drinks, skin pinch goes down quickly.
Classify and treat.
1. no dehydration, treatment plan A
2. 50-100ml liquid after every watery stool
3. after vomiting wait 10-15 minutes and continue giving liquids
4. moderate dehydration, treatment plan B
5. Immediately infuse of saline solution iv

2. A child, 3 yrs old, has high fever 39 degrees, on examination painfull on pressing ear tragus,
on otoscopy - left tympanic drum is hyperemic, swollen, movement is low,
light conus is unclear. Classify and treat.
1. very severe febrile disease
2. possible bacterial infection (acute infection of ear)
3. give amoxicillin 250mg 1 tab 3 times a day for 5 days, paracetamol 500mg 1/2tab
4. possible bacterial infection (acute infection of ear), needs hospitalization
5. give amoxicillin 250mg 1/2 tab 3 times a day for 5 days and paracetamol 500mg 1/2 tablet.

3. A baby, 4 yr old, is unconscious with high temperature, was diagnosed severe

pneumonia. Baby cannot drink and take oral antibiotics. Your prescription?
1. Give chloramphenicol 2.5ml intramuscularly
2. Give chloramphenicol 3.5ml intramuscularly
3. Give chloramphenicol 1.5ml intramuscularly
4. Immediate hospitalisation
5. After injections of chloramphenicol treat in outpatient clinic

4. How with according graphics you prescribe low dosated COC (30-35mg) for emergency
contraception.
1. 2 tabs in first 72hrs, then 2 tabs after 12 hrs
2. 4 tabs in first 72 hrs, then 4tabs after 12 hrs
3. 6 tabs in first 72 hrs, then 4 tabs after 12hrs
4. 2 tabs every 4 hrs for duration of 24 hrs

5. Baby, 6 month, is examined by family doctor; factual wt is 4200gms, ht is 65cms. Wt at birth

was 3200gms, ht 50cms, evaluate physical growth of the baby
1. Ht and wt of the baby are under normal parameters
2. Hypotrophy 1st degree
3. Hypotrophy 2nd degree
4. Hypotrophy 3rd degree

6. The family doctor was visited by 34 yr old patient G. Complains are prolonged pressing
pain in the chest, without irradiation, in decreases in the sitting position, sub febrile temperature
dry cough. On ECG - ST elevation in all standard leads. Disease occurred after overcooling.
Diagnosis and treatment tactics.
 Variant 5

1. A child of 1yr has frequent watery stools 4 times a day for 15 days, temperature is normal, signs
of dehydration are absent. Evaluate the condition of the child and your tactics
1. Severe persistent diarrhea, immediate hospitalization
2. Persistent diarrhea, give ampicillin 0.25 g 1.5tab 4 times a day for 5 days
3. Persistent diarrhea, give ampicillin 0.25 g 1 tab 4 times a day for 5 days
4. Acute diarrhea, moderate dehydration, treatment plan B
5. Acute diarrhea, no signs of dehydration, gives ampicillin 0.5g 1 tab 4 times a day

2. Child of 1 yr.o. Fever 38degrees, on examination clouding of cornea, month ago had the
measles. Classify and prescribe treatment.
1. Severe complicated measles
2. Measles with complication of mouth and eyes
3. Non complicated measles
4. Give vi tA, tetracycline ointment apply in the eyes 3 times a day, next visit after 2 days
5. Hospitalization in the infectious diseases hospital
6. Give amoxicillin 250mg 1 tab 3times a day

3. A baby, 2 weeks old. Mother complains of redness of the umbilical cord and surrounding tissue,
baby has high fever 38.2 degrees, crepitations in breathing. Evaluate and classify the condition of
the baby, prescribe the next tactics
1. Local bacterial infection
2. Possible serious bacterial infection
3. Give the first dose of antibiotics intramuscular
4. Immediate hospitalization
5. Give antibiotics and treat in outpatient department

4. Baby, 5 month old. He is taken to the family doctor, factual wt of the baby is 7800gms, height is
63 cms; wt at birth was 3200gms, ht-50cms. Evaluate the physical parameters of the baby.
1. The wt and ht of the baby come under normal parameters
2. Paratrophy 1st degree
3. Paratrophy 2nd degree
4. Paratrophy 3rd degree

5. A woman on regular check up by FD on 12 July 1998 had positive pregnancy test. She has a
regular 21 day cycle; last menstruation was from 1st to 4th April 1998. Calculate weeks of the
pregnancy.
1.10-11 weeks
2.15-16 weeks
3.14-15 weeks
4.19-20 weeks
5. 7-8 weeks

6.On a visit to the family doctor, 50yr old woman complained of pain in the precardial area not
connected with physical activity, pain increases after emotional stress, accompanied with shivering,
quivering of muscles of the entire body, profuse sweating. On ECG negative T waves in V1-V4.
What would be your diagnosis? Differential diagnosis and tactics of treatment.

Variant 6
1. Baby 3 yrs old, has liquid stool with blood from 2 days.
Physical examination: child has irritability, sunken eyes, drinks eagerly, thirsty, skin fold move
down slowly.
Classification of disease and treatment;
1. Diarrhea, severe dehydration.
2. Acute diarrhea, moderate dehydration, treatment plan A.
3. Acute diarrhea, without dehydration, treatment plan A.
4. Dysentery, moderate dehydration.
5. Ampicillin 250 mg in 1.5 tab 4 times.
2. Mother comes for routine checkup of baby 3 yrs old, before 2 days baby had classification not
pneumonia, asthamic dyspnoea. Now mother complains baby has bad appetite and drink, difficulty
in breathing.problem .What is tactics for this patient.
1. Give first dose of salbutamol aerosol.
2. Direct to hospital .
3. Give first dose of salbutamol aerosol.and admit in hospital.
4. Give only oral antibiotics.
3. Child age 9 month. At control examination of family doctor fontanel sizes. 2.0 cm x 2.0 cm
and circumference of head 52 cm. After birth circumference of head 39 cm. Sweating .Loosing hair
as crown. Estimate condition of child .
1. Rickets in swing stage
2. Give Vit.D dose 2000ME.
3. Rickets in initial stage.
4. Give Vit.D 500 ME from October to May.
4. Lady visited doctor 12 June 1996 yrs, and she had pregnancy test positive. She had regular
menstrual cycle of 35 days; last menstrual cycle was 1-4 April 1996 yrs. Determine the delivery
date.
1. 1st January 1997.
2. 8th January 1997.
3. 15th January 1997.
4. 22nd January 1997.
5. 29th January 1997.
5. New born, 10 days old. Objectively on mucous mouth revealed white plaques. Estimate the baby
condition and learn mother to treat local infection.
1. Baby has candidosis
2. Baby has candidosis with ulcers in mouth.
3. Clean mouth with dressing dumped with saline solution
4. Clean mouth with gentcyan violet solution diluted with water 1:1
5. Wash hands.
6.Adolscent , 15 yrs old , visited FD with complaints pain in heart area, palpitation , duration of
pain 1- 1.5 hrs , pain appeared after physical exertion ( karate). One time pain lost consciousness.
Objectively systolic murmur on apex with irradiation on aorta. ECG-depression ST with inversion
T wave.
 Variant 7

1. Child 3 yr. old mother complains frequent watery stool with blood during 2 days .On physical
exam- irritable, sunken eyes, drinks fluid eagerly, thirsty, skin pinch goes back slowly. Classify
child's condition and treatment?
1. Diarrhea, severe dehydration
2. Acute diarrhea, some dehydration, treat as plan A
3. Acute diarrhea, no dehydration treat as plan A
4. Dysentery, some dehydration
5. Give ampicillin-250mg 1.5 tab - 4 times
2. Child 2 yrs old, high temperature, 38C, on physical exam oral ulcers, purulent discharge from
eyes, Classify and treat-
1. Severe complicated measles
2. Measles with complication of eyes and mouth
3. Uncomplicated measles
4. Give vit-A, tetracycline cream-apply on eyes -3 times /day; clean the mouth ulcer with
gancianviolet and net visit after 2 days
3. Child 4 yrs old, fever 39. Unable to drink, On physical exam enlargement of neck lymph nodes,
uvula bended to right, Classify condition-
1. Streptococcal pharyngitis
2. Tonsillar abscess
3. Non streptococcal pharyngitis
4. Bicillin 1-600000IU IM
5. Urgent hospitalization, give first dose of paracetamol.
4. Child 5 years. Yesterday evening mother observed vesicular rash in ear and area of
hair. In morning there was running nose, body temperature 37.5c.
Your diagnosis
1. Scarlet
2. Chicken Pox
3. Measles
4. Pseudo tuberculosis
5. Allergic rash
5. A woman with the pregnancy period of 26 weeks has pathological weight gain with edema of
lower extremities, arterial pressure 140/90 mmHg, sp. Gravity of urine 1010 1012, proteinuria
0.33 g/l, your diagnosis is:
1. Chronic pyelonephritis
2. Severe preeclampsia
3. Mild pre-eclampsia
4. Glomerulonephritis
5. Mild pre-eclampsia due to chronic pyelonephritis

6. The patient 65 years old, during 10 years suffers with HBP, hypotensive medications not
regularly accept, in last 4 years it is revealed moderate severity DM. He has addressed on reception
to FD because last 2-3 weeks heart attack have become frequent and severe. Pain has irradiation to
the left shoulder, its duration 3-5 min. Pain arise at phy activity, patient can not walk 200mts.
Yours diagnosis and treatment.
Variant 8

1. A child with acute diarrhea, severe dehydration. Prescribe treatment.

1. Iv ringer 30ml/kg of wt within 1hr then 70ml/kg within 2.5hrs
2. Iv ringer lactate 30ml/kg of wt within 30 mins then 70ml/kg within 2.5 hrs
3. Repeatedly check the condition of child every 3 hrs
4. If the child can drink give ORS 900-1400ml

2. Prescribe the treatment of child 5yrs old with pneumonia.

1. Amoxicillin 250mg 1 tab 3 times a day for 5 days
2. Soothe the throat and treat cough with safe drugs
3. Give oral salbutamol
4. Give paracetamol if temp >37.5 degrees
5. Amoxicillin 250mg 1/2 tab 3 times a day for 5 days

3. On physical evaluation of a 8 month old baby wt was 7300gms ht-68cms, baby was born with
wt 3200gms ht 50cms, was breastfed till 4 months, later was given additional foods. From
5.5months of age was fed once on porridge (semolina), from 6.5 months vegetable purre, from 7
months was fed meat. Till 5 months the baby grew according to age then put on very low wt 80-
100gms and after 7 months lost weight. Stool 2-3 times a day, periodically up to 5 times. Your
diagnosis.
1. Mucovyscidosis
2. Celiakia
3. Galactosamia
4. lactase insufficiency
5. Sucrose insufficiency

4. Principle sign of intrauterine paratrophy 1st degree is-

1. Increased ht of body 10-20%
2. Increased wt of body 10-20%
3. Increased wt of body 20-30%
4. Increased wt of body 30-39%
5. Increased wt of body more than 40%

5. Which one of these is most important in diagnosing gestose?

1. Weekly wt gain 300-400gms in the second half of pregnancy
2. Level of arterial pulse 25mmHg
3. Vomiting
4. Anemia
5. 1+2

6. Patient S is 48yrs old is a carpenter. Complains of feeling the heart beating, subsides by itself,
pressing pain in the chest, duration for 5 mins, occurs after walking 300-500mtrs, pain disappears
after nitroglycerine within first 5mins. At the moment is situated in the hospital for the duration of 1
month with the diagnosis of myocardial infarction, from 5th January of this yr. Cor-tones are loud.
PS=82, rhythmic. BP 130/80mmHg, on ECG sinus rhythm, focal changes in the posterior wall of
the left ventricle. Patient is sent to the Medical Social Expert Commission. Formulate the diagnosis
and evaluate the work capacity of the patient.

Variant 9

1. A 4yr old child has blood in stool, prescribe treatment.

1. Ampicillin 250mg 1.5 tab 4 times a day for 5 days
2. Erythromycin 250mg 1 tab 4 times a day for 3 days
3. Ampicillin 250mg 1 tab 4 times a day for 5 days
4. Nalidixic acid 250mg 1 tab 4 times a day for 5 days

2. You classified the condition of a child with cough/cold. At appearance of what signs mother must
return immediately
1. Fast breathing
2. Difficult breathing
3. Cannot drink or breastfeed
4. At temp >37.5degrees

3. When a woman for the first time takes combined oral contraceptives(COC), she has to start the
medications at-
1. The first day of menstrual cycle
2. The first 7 days of menstrual cycle
3. Immediately after the completion of menstrual cycle
4. Any convenient time

4. In out patient, a 2yr old child. Came for the diagnostic test MANTO, on examination-rhinorrhea,
temp 37degrees, tonsils are hyperamic, no white vegitation, rest is normal. Your tactics.
1. Do the probe MANTO
2. First treat then apply the probe MANTO
3. Do the probe MANTO,prescribe treatment
4. No need to do anything

5. In outpatient came a 30 yr old woman. 2nd time pregnant, 8th pregnancy on counting, duration
26 weeks, an hour ago at home she had sharp pain in lower abdomen which continued for 2-3 mins
then stopped after that she had little blood discharge with small clots of brown color.she possibly
has-
1. Late painful miscarriage
2. Painful injury of uterus
3. Comming out of placenta
4. Immature delivery of normal placenta
5. Cutting (injury) of uterus

6. Patient is 57yrs old. Working as an editor. Complains of uncomfortable and pressing pain after
walkin 500mtrs, duration from3 to 10 mins. The painful feeling subsides after taking nitroglycerine.
Objectively:pale face, sweating, heart border increased at left side, heart tones are muffled, rhythmic
systolic murmur at apex, heart beats 86/min. BP 130/80mmHg. On ECG- during attack depression
of ST 1.5mm in V2-V6. Your diagnosis and plan of treatment.

Variant -10
1. On reception the child 2 years with a liquid and frequent stool to 5 times a day. Objectively
irritable, painful, sunken eyes, the offered liquid drinks eagely, skin pinch goes back slowly.
Classify condition of child.
1. Heavy dehydration, to treat to plan C.
2. Heavy dehydration, to treat according plans B.
3. No dehydration, to treat according plan A.
4. Dysentery, to prescribe Ampicillin.
5. Cholera, to prescribe Erythromycin.
2. The child of 5 years complains on cough during 3 days. Body temperature 37.2, appetite is kept.
Objectively- not indrawing of chest & stridor at rest. Respiration 38 in minute. Classify condition.
1. Severe pneumonia.
2. Pneumonia.
3. Pneumonia absent, cough and cold.
4. Pneumonia absent, asthmatics breath.
5. Bronchiolitis.
3. Who from is listed below have the highest risk of development of serious complication at use the
contraceptive COC?
1. Sexually active teenager.
2. Smoking women at age of 25-35 years.
3. Smoking women are more senior 35 years.
4. The women suffering with diabetes(without vascular complication and lasting less than 20
years)
4. Estimate physical development of the child of 6 months with weight 8200 gm, length 67 cm,
circumference of head 45 cm, chest circumference 45 cm.. WT at birth 3200 gm, length 52 cm.
1. Physical development corresponding to age.
2. Deficiency of weight of body.
3. Surplus of weight of body and length.
4. Surplus of weight of body.
5. Microcephaly.
5. At the women at visiting of the doctor on July 12, 1998.the test of pregnancy the positive. She
has regular 21 day cycle, last menses was on 1 - 4 April 1998.
Determine data of pregnancy.
1. 10-11 weeks.
2. 15-16 weeks.
3. 14-15 weeks.
4. 19-20 weeks
5. 7-8 weeks.
6. The patient 65 years old, during 10 years suffers with HBP, hypotensive medications not
regularly accept, in last 4 years it is revealed moderate severity DM. He has addressed on reception
to FD because last 2-3 weeks heart attack have become frequent and severe. Pain has irradiation to
the left shoulder, its duration 3-5 min. Pain arise at phy activity, patient can not walk 200mts.
Yours diagnosis and treatment.

Variant 11
1. In the out patient department, child 11 months is admitted his mother. Complains diffuse
diarrhea and large amount of stool, temperature is 38 degrees. Physical exam - the child is
lethargic with sunken eyes, unable to drink, skin pinch goes down slowly. Classify the
condition and your tactic.
1. Severe dehydration-shift to the emergency department in the hospital
2. Moderate dehydration, treatment plan B
3. No dehydration, treatment plan A
4. Dysentery, treat with cotrimoxasole for 5 days
5. None of the above
2. Child, 5 years, has pus discharge from his ear since 10 days, body temperature is normal.
Diagnose and treat
1. Acute ear infection
2. Mastoiditis
3. Chronic ear infection
4. Emergency hospitalization, give paracetamol and appropriate antibiotics
5. Treat in out patient department, prescribe amoxicillin 250mg 1 tab three times a day, clean ear
with ear buds, advice mother for next visit after two days

3. A child 1.5 yrs, is admitted with complaints on frequent watery stools, vomiting, suffers
since 1 day. Physical examination - the child is irritable, eyes are not sunken, drinking is
normal, skin pinch goes back quickly. Diagnose and treat.
1. No dehydration, treatment with plan A
2. Give 50-100 ml of fluid after every watery stool
3. After vomit wait 10-15 min and continue to give fluid
4. Moderate dehydration, treat with plan B
5. Give iv infusion of saline solution immediately

4. If women forget to take 2 or more contraceptives tablets, she should do -

1. Stop taking the tablets and start again when her menses starts
2. Throw out the missed tablets and continue to take the remaining tablets as per schedule
3. Continue taking two tablets until going into previous regime
4. Use another method of contraception

5. After two hours of vaccination DPT 4 month old baby has high temperature 38.3 degrees,
has general irritability, later in the evening the child got better. What should be the doctors
tactic at 6th month vaccination?
1. Postpone vaccination for 1 month
2. Give half dose of the regular vaccine DPT
3. Stop all vaccines till 12 months of age
 4. Do the DPT vaccination, recommended preventive treatment for avoiding hypothermic reaction.
5. Postpone vaccination DPT for 3 month
6. 60 yr old patient is suffering from COPD since many yrs, during gardening he felt sudden
acute pain in chest, breathlessness and was taken to the polyclinic. On physical examination the
patients condition is very bad. Tachypnoea, superficial breathing, difficulty in breathing, bulging
the right side of the chest, cyanosis, tympanic sound on the right side, on the left side is box sound,
auscultation of lungs- weak vesicular breathing on right side.
Diagnose, differential diagnosis and the tactics of the doctor.
Variant 12
1. Child, 1.5yrs, with high temperature, during 5 days which is noted everyday. Objectively: rigidity of
occipital muscles. Signs of measles are absent. Child was not infected with measles previous 3 months.
Classify the condition of the baby and your tactics.
1. Immediate hospitalization, give first dose of amoxicillin 250mg, and first dose of paracetamol
500mg 1/4 tab
2. Persistent fever, give first dose of paracetamol in outpatient clinic
3. Examine and treat child in polyclinic
4. Give vit A, next visit after 2 days
5. Give paracetamol, next visit after 2 days

2 Baby, 7 months, wt 8.5 kg, temp 39 degree. Has cough since 3 days, the baby is able to drink
liquids, can suckle breast. Convulsions, vomits after food are absent, indrawing of chest and stridor
are absent at rest, breath rate 55/min.
Your diagnosis and tactics.
1. Severe pneumonia, immediate hospitalization
2. Pneumonia is absent, cold/flu treat in outpatient
3. Pneumonia is absent, asthmatic breathing
4. Pneumonia
5. Treat in outpatient with syrup amoxicillin 5ml 3 times a day

3. Child, 1yr old, has watery frequent stool up to 4 times day, duration of 15 days.
Body temp is normal, signs of dehydration are absent. Classify the condition of the
baby and your tactics.
1. Severe persistent diarrhea, needs immediate hospitalization
2. Persistent diarrhea, give ampicillin 0.25mg 1tab 4 times a day for 5 days
3. Persistent diarrhea, give ampicillin 0.25mg 1 tab 4 times a day for 5 days
4. Acute diarrhea with mild dehydration, treatment plan B
5. Acute diarrhea, dehydration is absent, give ampicillin 0.5mg 4 times a day

4. Which one of these is the typical side effect of COC -

1. Jaundice and decreased vision
2. Nausea, and painful mammary glands
3. Severe pain in the chest and dispnoea
4. Infarct and insult
5. First time pregnant woman, 24yrs old. At 32-33 weeks of pregnancy she had
high blood pressure 160/90mmHg, running nose, stuffiness of nose, headache,
worsening of condition, in urine analysis-protein 3.3gms/l.Your expected diagnosis-
1. Acute respiratory infection
2. Eclumpsia
3. Preeclumpsia
4. Pregestose
5. Hypertensive crisis
6. Patient, 52yrs old. Long time suffering from hypertonic diseases, felt sharp pain in the chest
which increased in intensity, accompanied by weakness, darkness in e eyes,
pain is irradiated to the vertebral column. Objectively: condition very bad, pale skin, vesicular
breathing, heart borders are normal, tones are low in intensity, II tone on aorta is weak, diastolic murmur
on aorta, heart rate 100beats/min.BP-180/100mmhg. Rheumatism in anamnesis is absent. Diagnosis,
differential diagnosis, and your tactics.

Variant 13

1. A child of 4 yrs. Complains of high temperature 39 degrees, is not able to drink, on physical
examination enlargement of cervical lymph nodes, uvula is deflected to the right. Diagnose and
prescribe treatment
1. Streptococcal pharingitis
2. Abscess of pharynx
3. Nonstreptococcal pharyngitis
4. Bicillin 1 600,000 U one dose intra muscular
5. Immediate hospitalisation and give first dose of paracetamol

2. A baby 3 months old. Weight-5300, temperature 38.5 degrees and cough since 4 day. He does
not show any signs of danger on examination, not indrawing chest, and breath rate 53 per minute,
asthamic breathing. Your tactics:
1. Give amoxicillin 5ml 3 times a day
2. Give 1 dose of aerosol salbutamol plus salbutamol oral for 5 days, next visit after 5 days
3. Next visit after 5 days
4. Sooth the throat and relief the cough with safe remedy.

3. A baby, 11 months old. With acute diarrhea, severe dehydration, weight 9kgs. Select proper
treatment
1. I/v Ringer lactate in duration of 1 hr 30 ml/kg weight then 70ml/kg for duration of 5 hrs
2. I/v Ringer lactate for duration 30 mins 30ml/kg, then 70ml/kg in 2.5hrs
3. Repeatedly check the childs condition every 3 hrs
4. If the child can drink give ORS 5ml/kg/hr

4. Woman is taking COC; she has to immediately return to the doctor if she has:
1. Pain in the lower part of the stomach
2. Severe headache, dizziness, general weakness
3. Severe pain in the lower extremities
4. All of the above

5. A lady was consulted by doctor on 7th July 1998 and she had a positive pregnancy test. She had
regular menses cycle as 21 days .The last cycle was 1-4 march 1998. Determine the pregnancy date:
1. 10-11 weeks
2. 15-16 weeks
3. 14-15 weeks
4. 19-20 weeks
5. 20-21 weeks
6. A 60 yr old women complains of acute squeezing, pressing chest pain, the acute attack occurred
during work in the garden, the pain is periodic occurring during 1 month, sometimes occurs at night,
sometimes burning, sometimes acute but is never severe. Patient wakes up with cough, mild stridor
and difficulty in breathing. She does not smoke, takes alcohol sometimes, has an active lifestyle.
Does exercise irregularly only sporadic. Have excessive weight 20kg. Your diagnosis and
differential diagnosis.

Variant:14
1.Child 4 yrs, he has increasing temperature 39 C, he cant drink .
Physical examination: enlargement of cervical lymph nodes and right deviation of little tongue.
Classify the disease and treatment.
1. Streptococcal pharyngitis.
2. Abscess of pharynx.
Non streptococcal pharyngitis.
3. Bicillin 1.600000ME I/M single dose.
4. Send to emergency department and give him 1st dose of paracetamol.

2. Baby, 3 months, with weight is 5300 gm, temp 38. 5 C.

Complaints: cough during 4 days. He has not had dangerous symptoms.
Examinations: not indrawing chest, breath rate 53 per minute, asthamic breathing.Your tactics:
1. Give Amoxicillin 5 ml 3 times a day.
2. Give aerosol Salbutamol + oral salbutamol for 5 days.
3. Visit to hospital after 5 days.
4. Sooth the throat and relief the cough with safe remedy.
5.
3. Child, 12 month, with acute diarrhea and moderate dehydration. Weight 11 kg. Calculate the
ORS for ORT.
1. 700-900 ORS.
2. 200-400 ORS.
3. 100-200 ORS.
4. 900-1400 ORS.
5. 50-10 ORS.
4. A lady was consulted by doctor on 7th July 1998 and she had a positive pregnancy test. She had
regular menses cycle as 28 days .The last cycle was 1-4 march 1998. Determine the pregnancy date:
1. 10-11 week.
2. 15-16 week.
3. 14-15 week.
4. 19-20 week.
5. 20-21 week.

5.Typical side effects of progestin contraceptives is :

1. Jaundice and liver function disorder
2. Severe headache
3. High BP
4. Changing in menstrual cycle
6. Patient 56 years old .Complaints: pain in right and left side of chest .Pain occur in time of rest
after intensive work and pain also after movement. He is smoking cigarette 1.5 packet in a day and
drinking alcohol 200-300 ml 2 times a week .Mild arterial hypertonia. In anamnesis increase of
cholesterol .
Differential diagnosis and diagnosis of patient.

Variant 15

1. A child is 3yrs old, measured with high temp 38degrees, pain in the throat, on examination,
increased lymph nodes of the neck, pea sized hyperamic glands. Classify and treatment
1. Streptococcal pharyngitis
2. Abscess of throat
3. Non streptococcal pharyngitis
4. Amoxicillin 250mg 1 tab 3 times a day for 10 days
5. Immediate hospitalisation,with first dose of paracetamol
6. Soothe the throat with warm milk

2. A child is 5yrs old, complains of cough since 3 days, temp is 37.2 degrees, appetite is normal. On
objective examination there is no inward pulling of the chest and stridor in rest. Breath rate 38/min.
Classify the condition as:--
1. Severe pneumonia
2. Pneumonia
3. Pneumonia is absent, maybe cough or cold
4. Pneumonia is absent, asthmatic breathing
5. Bronchiolitis

3. A child of 4yrs has blood in stools, prescribe treatment

1. Ampicillin 250mg 1.5tabs 4 times a day for 5 days
2. Erythromycin 250mg,1 tab 4 times for 3 days
3. Ampicillin 250mg,1 tab 4 times a day for 5 days
4. Nalidixic acid 250mg,1 tab 4 times a day for 5 days

4. At what time is intake of DEPOPROVERA not recommended, choose from below

1. First 7 days of the menstrual cycle
2. Immediatly or within 7 days after abortion
3. For the first 6 weeks after birth, if breast feeding, but must not use methods of lactational
amenorrhea
4. After 6 months of giving birth, if taking MLA
5. A woman on regular visit to the gyenacologist on 14 august 1998 had a +ve pregnancy test, she
has a regular 30day cycle, last menstruation was from 1st -4th march. Calculate the duration of the
pregnancy.
1. 10-11weeks
2. 15-16weeks
3. 14-15weeks
 4. 19-20weeks
5. 27-28weeks
6. A patient 28yrs old complains of pain in the lower third of the chest, pain irradiates to the left
shoulder, increases after eating. First time sick, irregular diet, smokes 1 pack of cigarettes/day
mother of patient had hypertonic disease, condition of patient is satisfactory, skin and mucous
membrane are clear, in lungs there is vesicular breathing, heart borders are normal, tones normal
rhythmic, heart contraction 64beats/min. Stomach tender, mild pain in the epigastric region. Your
diagnosis and treatment.

Family Medicine Quiz test

Ques. 1 2 3 4 5 6
1. 2 1 13 4 2 Thromboemboly of branches of lung
artery. Acute cor pulmonale.
Thromboflebitis of artery of low
extremities. Hospitalization.
2. 2 4 134 1 4 AMI. ECG, hospitalizatuion.
3. 2 2 4 3 1 12 Diaphragmal AMI. Hospitalization
4. 123 23 24 2 4 Acute pericarditis. Treatment in In-Patient
Clinic.
5. 2 146 234 1 3 Climacteric cardiopathy. HRT.
6. 45 12 12 3 1 3 4 5 Prolapse of MV. BAB.
7. 1 123 235 1 2 ARF. Active phase.1 level activity. Primary
pheumocarditis.
8. 134 12 2 2 4 CHD. Angina. FC III. Postinfarct
cardiosclerosis. HF. FC I. Social
rhabilitation.
9. 14 123 24 2 4 CHD. Angina. FC III. BAB, CaB,
antiplatelets.
10. 2 3 3 1 1 CHD. Angina. FC III. EH III. Severe. High
risc. HF FC III. ACE blockers, BAB,
diuretics.
11. 1 15 123 3 4 Pneumothorax. Surgery aid.
12. 1 45 2 5 3 Ruptured AA. ECG, ultrasound,
hospitalization in cardiovascular surgery.
13. 245 124 134 3 2 GERD. H1-blockers, antacids.
14. 245 5 1 2 4 Myositis. ECG, X-ray.
15. 36 3 14 23 5 Ulcer of stomach. Eradicational therapy.