est questions for 3-course students of general medicine department

Propaedeutics of Internal Diseases test questions for students of general medicine

department

General questions

1. Subject and tasks of propaedeutics of Internal Diseases. Russian medical school

(G.A.Zaharin, S.P. Botkin, A.A. Ostroumov, N.D. Strazhesko, V.P. Obrazcov, V.H.
Vasilenko, E.M. Myasnikov).
2. The general methodology of diagnosis. Principles of diagnosis. Types and structure of the
diagnosis.
3. Methods of patients clinical examination (questioning, complaints, anamnesis). Physical
methods (general inspection, the facial expression of patients with internal diseases,
examination of separate parts of the body, derma body inspection, examination of
mucous membranes, lymphatic, muscular system, joints, limbs). Risk factors. Palpation
(types), percussion (types, variants of percussion sounds, the rules of percussion),
auscultation (the rules of auscultation). The concept of the general state of the patient.
4. The concept of additional research methods. The clinical significance of laboratory
diagnostics. Instrumental methods. Thermometry, technique, types of hyperthermia,
diagnostic value. Radiographic, radioisotope, ultrasound methods, magnetic resonance
imaging, endoscopy, needle biopsy, functional methods and their diagnostic value.
5. Medical records. The patient history as medical and legal document, its contents.
6. Medical ethics and deontology. Iatrogenic disease in internal medicine. The physician's
role in patient educating.
7. The order in reseption of the hospital. Responsibility of the junior and middle-level
medical personnel. Records of the reception.

Cardiovascular diseases

1. The examination of patients with CV pathology. Questioning and inspection. Heart

palpation. Percussion. The relative and absolute cardiac dullness. Characteristics of the
pulse. Vascular bundle. Methods of evaluation and clinical significance.
2. Heart auscultation. The cardiophony points. Heart tones, mechanisms of formation, their
characteristics. The concept of the splitting of the I and II tones. Diagnostic value.
3. Additional tones: tone of the mitral valve opening, the exile tones, systolic click, III and
IV heart sounds, rhythm "gallop" rhythm "quail", Strazhesko "gun-tone". Mechanisms of
formation, the point of listening, the clinical significance.
4. Intracardiac (organic and functional) and extracardiac cardiac murmurs. Formation
mechanisms and the clinical significance.
5. Blood pressure. Methods for measuring blood pressure (palpation, auscultatory). BP
monitoring. Classification of the normal levels of blood pressure (optimal, normal, high
normal).
6. Electrocardiography. Electrocardiographic leads (standard, enhanced, breast). The teeth
and normal ECG intervals. The general scheme of ECG interpretation. Load tests.
Holters ECG-monitoring, echocardiogram, their diagnostic value.
7. Cardiac arrhythmia. Sinus tachycardia, bradycardia, arrhythmia. The etiology,
pathogenesis, clinical manifestations. Atrial and ventricular fibrillation. ECG diagnosis of
arrhythmias. The concept of cardiac defibrillation.
8. Atrial fibrillation. Symptoms, ECG diagnosis.
9. Heart block. Sinoatrial, atrioventricular block, bundle-branch block. ECG diagnosis.
10. Acute rheumatic fever. Defining, common understanding of the etiology and
pathogenesis of rheumatic fever. The clinical manifestations, diagnosis (Kissel-Johnsons
criteria).
11. Acquired heart disease. Types of defects. Syndromes in heart defects.
12. The etiology of mitral stenosis. Hemodynamics, clinical diagnosis.
13. Mitral insufficiency. The etiology, hemodynamics, clinical diagnosis.
14. Mitral valve prolapse. The etiology, clinical features, diagnosis.
15. Aortic stenosis. The etiology, clinical features, diagnosis.
16. Insufficiency of the aortic valve. The etiology, clinical features, diagnosis.
17. Atherosclerosis. The concept of risk factors of atherosclerotic diseases. The basic
mechanisms of atherosclerosis. Clinical manifestations.
18. CHD. Definition, clinical variants. Myocardial infarction, definition, clinical
manifestations. Phase of MI. The main clinical syndromes and variants of MI.
19. Physical methods of patients examination and laboratory methods for the diagnosis of
MI. ECG diagnosis of MI. Functional tests. Complications of MI. Principles of
management and care of patients with myocardial infarction.
20. Stable angina. Definition. Clinical types of angina. ECG diagnosis.
21. Acute coronary syndrome. Definition. ECG diagnosis. Laboratory diagnosis.
22. The heart failure syndrome. Forms of heart failure. Acute heart failure. Cardiac asthma,
pulmonary edema. Cardiogenic shock. Clinical manifestations.
23. Chronic heart failure. Etiology and pathogenesis. Classification. Clinical manifestations.
Laboratory and instrument diagnostics.
24. Acute vascular insufficiency. Fainting (syncope), collapse. Shock. Reasons for
development.
25. Pericarditis. Definition. Types of pericarditis. Clinic of dry and exudative pericarditis.
Diagnostics (X-ray signs of pericarditis, ECG, echocardiogram).
26. Syndrome of heart muscle damage. Non-coronary heart disease. Myocarditis. The
etiology, clinical features, laboratory and instrumental diagnostics.
27. Cardiomyopathy. Definition. Clinical types of cardiomyopathies. Symptoms of
cardiomyopathies. Diagnosis.
28. Hypertensive heart disease. Definition. The etiology and pathogenesis. Classification.
The clinical features. The stratification of patients according to the degree of
cardiovascular risk. Laboratory and instrument diagnostics. Hypertensive crisis.

Diseases of the respiratory system

1. The examination of patients with pathology of the respiratory system. Questioning.

General and local inspection (cyanosis, abnormal shape of the chest). Palpation of the
chest (resistance, pain, voice trembling.) Percussion. Types of percussion. Methods of
determining, clinical significance. Types of pathological breath. Clinical significance.
Hemoptysis, chest pain, coughing, shortness of breath. The pathophysiology of
symptoms, their clinical significance.
2. Auscultation of the lungs. Souffles (basic and advanced). Bronhofoniya.
Pathophysiology, methods of determining and clinical significance.
3. Additional research methods, estimating respiratory system. Sputum, BAL fluid, pleural
effusion. Pleural puncture technique. Radiographic methods. Bronchoscopy. The study of
respiratory function (spirography, pneumatic, peak flow meters, blood gases). The
clinical significance of additional research methods.
4. Lung tissue sealing syndrome. Definition. Etiology. Symptoms in equity (segmental) and
focal sealing of lung tissue. The clinical significance.
5. Pulmonary atelectasis. Definition. Types of atelectasis (obturative, compression,
hypoventillation or functional). Clinical features. The role of bronchoscopy in the
diagnosis and treatment of atelectasis.
6. The syndrome of emphysema. Definition and types of emphysema. Etiology. Symptoms.
The clinical significance.
7. Bronchospastic syndrome. Definitions. Etiology. Symptoms. The clinical significance.
8. Pulmonary cavity syndrome. Causes. Symptoms. The clinical significance.
9. Syndrome of fluid accumulation in the pleural cavity (exudate, transudate). Causes.
Symptoms. The clinical significance.
10. Syndrome of air accumulation in the pleural cavity. Types of pneumothorax. Symptoms.
The clinical significance.
11. Respiratory failure syndrome. Definition. Classification and severity of RF.
Pathophysiological mechanisms of RF. Symptoms. Types of dyspnoea. The clinical
significance.
12. Pneumonia. Definition. Classification. The etiology of pneumonia. Nosocomial (hospital)
pneumonia. Common clinical manifestations. X-ray diagnostics.
13. Lobar pneumonia. Etiology. Pathomorphology. Symptoms of each stage. The criteria for
severe pneumonia. Laboratory and instrument diagnostics. Complications.
14. Lobular pneumonia. Etiology. The clinic, diagnostics.
15. Community-acquired atypical pneumonia. Etiology. Clinical features. Diagnostic
methods.
16. Lung abscess. Etiology and pathogenesis. Symptoms.
17. Chronic obstructive pulmonary disease (COPD). Definition. COPD risk factors. Clinical
variants (akin to bronchitis, emphysematous). Clinical features. Laboratory and
instrumental diagnosis of COPD. Complications.
18. Chronic pulmonary heart. Definition. Causes. Symptoms. Laboratory and instrument
diagnostics.
19. Pleural syndrome. The causes of pleural effusions. Pleurisy. Physiology of the pleural
cavity. Pathogenesis of exudate. Types of pleurisy (acute dry, swampy, purulent).
Features. Laboratory and Instrumental Diagnosis.
20. Bronchial asthma. Definition. Etiology. Risk factors. The pathophysiology of asthma.
Clinical types of asthma. Symptoms of asthma during an attack. Laboratory and
Instrumental Diagnosis.
21. Status asthmaticus. The clinic.
22. Acute bronchitis. The etiology of acute bronchitis, classification. Simpoms, diagnostics.
23. Chronic bronchitis. The etiology, risk factors of chronic bronchitis. Classification.
Chronic obstructive and non-obstructive bronchitis. Features.

Diseases of the digestive system

1. The examinaton of patients with digestive disorders. Questioning. General and local
examination of the abdomen. Deep and superficial palpation. Percussion. Auscultation.
Methodology, the clinical significance. Techniques for the detection of ascites.
2. Additional methods of the digestive system investigation. Physiology of gastric secretion.
The exam of the stomach functional state, methods of detecting Helicobacter pylori. The
study of duodenal contents, bile physiology. Stool examinations. Endoscopy, X-ray,
ultrasound, computer and morphological methods of research in gastroenterology. The
diagnostic value.
3. The syndrome of gastric dyspepsia. Definition. Etiology of dyspepsia. Organic and
functional dyspepsia. The sepsrste components of the syndrome. The diagnostic value.
4. Syndrome of intestinal absorption deficiency (malabsorption). Definition. Causes.
Symptoms. Additional methods.
5. Syndrome of digestion deficiency (maldigestion). Definition. Causes. Symptoms.
Additional methods.
6. Gastro-intestinal bleeding. Causes. The main clinical signs of bleeding from the upper
and lower gastrointestinal tract. Overall symptomatology of bleeding.
7. The syndrome of jaundice. Types of jaundice. Circulation of the bile pigments. The
diagnostic value.
8. Portal hypertension syndrome. Definition. Causes. Symptoms.
9. Banti's syndrome. Definition of "hypersplenism and splenomegaly." Causes.
Pathophysiology of hypersplenism.
10. Hepatic insufficiency syndrome. Definition. Hepatic encephalopathy, hepatic coma.
Causes.
11. Laboratory syndromes: cytolysis, cholestasis, hepatocellular failure, mesenchymal
inflammation. The diagnostic value.
12. Diarrhea and constipation. Definition. Etiology and risk factors of diarrhea and
constipation.
13. Gastroesophageal reflux disease. Definition. Causes. Symptoms. Additional methods.
14. Chronic gastritis. Definition. Etiology. Pathophysiology. Classification. Clinic.
Additional methods.
15. Peptic ulcer disease. Definition. Etiology. Pathophysiology. Clinical features of the
peptic ulcer of stomach and duodenum. Complications. Laboratory and Instrumental
methods.
16. Cancer of the stomach. Symptoms. Principles of diagnostics.
17. Chronic hepatitis. Definition. Medicinal and toxic liver damage. Viral hepatitis. The
etiology of viral hepatitis. High hepatitis B and C risk group. The symptoms and
syndromes of viral hepatitis.
18. Cirrhosis. Definition. The etiology of cirrhosis (liver). Symptoms and severity criteria of
cirrhosis. Laboratory and instrumental methods. Complications.
19. Cholelithiasis. Chronic cholecystitis. Definition. Physiology of the gall bladder.
Palpation of the gall bladder. Symptoms of chronic cholecystitis. Laboratory and
instrumental methods.
20. Functional disorders of the biliary system. Dyskinesia of the gallbladder and Oddis
sphincter. Examination plan.
21. Chronic pancreatitis. Definition. Etiology. The pathophysiology of chronic pancreatitis.
Symptoms of chronic pancreatitis. Palpation of pancreas. Laboratory and instrument
diagnostics.
22. Inflammatory and dystrophic diseases of the intestine. Physiology of the small and large
intestine. Chronic enteritis. The causes of enteritis.
23. Chronic colitis. Causes. Ulcerative colitis (nonspecific). The pathophysiology of UC.
Symptoms. Laboratory and instrument diagnostics.
24. Irritable bowel syndrome. Definition. Etiology. Clinical variants. The diagnostic criteria
for IBS methods.

Diseases of the urinary system

1. The examination of patients with urinary diseases. Questioning. Inspection of the

abdomen and lower back. Palpation of the kidneys. Percussion. Auscultation. Common
symptoms. Renal edema. Dysuric phenomena (oliguria, polyuria, pollakiuria, nocturia,
ischuria). The clinical significance.
2. Additional research methods, estimating urinary system. Urine examination. Microscopic
examination of the urinary sediment. Quantitative research methods of urinary sediment
(Nechiporenko's test). Assessment of renal function (Zimnitskys test, glomerular
 filtration rate and creatinine clearance). Instrumental methods (excretory urography, CT,
angiography, ultrasound, renal biopsy). The diagnostic value.
3. Urinary syndrome. Concept. The clinical significance.
4. Nephrotic syndrome. Etiology. Clinical manifestations. Diagnosis.
5. Hypertension syndrome (reno-parenchymatous arterial hypertension). The etiology and
pathophysiology of this syndrome. Symptoms.
6. Edema syndrome. Pathophysiology of edema. Symptoms. Methods for detection of latent
edema.
7. Nephritic (acute nephritic) syndrome. Characteristics. Causes. Diagnosis.
8. Syndrome of acute and chronic renal failure. Etiology. Clinical features in different
stages. Uremic coma.
9. Acute glomerulonephritis. Etiology, pathogenesis, symptoms. Principles of diagnostics.
10. Chronic glomerulonephritis. Etiology, pathogenesis, symptoms. Principles of diagnostics.
11. Urolithiasis. The etiology, clinical features. Examination technics.
12. Pyelonephritis (acute and chronic). The etiology, clinical features. The principles of
treatment.

Diseases of the blood

1. The examination of patients with pathology of the hematopoietic system. The theory of
hematopoiesis. Blood system examination methods. Questioning. General inspection.
Palpation (palpation of lymph nodes, liver, spleen). Percussion. Auscultation. The clinical
significance.
2. Investigation of the peripheral blood. The overall clinical analysis of blood, their
characteristics. Quantitative and qualitative changes of red blood cells shape and size.
Changing the content of white blood cells. The diagnostic value. Special research
methods in hematology, diagnostic value.
3. Anemia. The causes of anemia. Classification of anemia. Iron-deficiency anemia. Clinic.
Diagnosis.
4. Hemolytic syndrome. Causes. Diagnosis.
5. Hemorrhagic syndrome. Disseminated intravascular clotting. Causes. Symptoms.
Diagnosis.
6. Hematological malignancies. Contributing factors. Causes of death in leukemia. Acute
leukemia. Types of acute leukemia. Overall symptomatology. Laboratory diagnosis. The
value of clinical blood analysis (hiatus leukemicus).
7. Chronic myeloleukemia. Clinic. Diagnosis.
8. Chronic lymphocytic leukemia. The clinic, diagnostics.

Diseases of the endocrine system

1. The examination of patients with endocrine pathology. Questioning. General and local
examination. Palpation of the thyroid gland and testicles. Laboratory and instrumental
methods. Carbohydrate metabolism. Examination of blood and urine corticosteroids, thyroid
hormones, insulin. Instrumental methods of research in endocrinology.

2. Diabetes. Definition. Clinical variants of diabetes. The etiology of diabetes type 1and type
II. Symptoms in diabetes. Additional methods. Complications. Diabetic (ketoacidotic) coma.
Symptoms in coma.