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Last update: PALACKAJ (31.07.2019)
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Last update: PALACKAJ (31.07.2019)
For obtaining credit the student must fulfil following criteria:
The objects of Internal Medicine I, Internal Medicine II and Internal Medicine III are finished by state exam – practical and theoretical part. |
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Last update: Bc. Daniela Polanecká (08.07.2020)
INTERNAL MEDICINE III.: Andreoli, T. E.: Cecil essentials of medicine : W. B. Saunders company, 2010 (B) (available as ebook) And basic literature for the 5th year |
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Last update: Dita Strnadová (10.01.2024)
Questions for the test – 6th year
1. Where is the ischemic chest pain (angina pectoris) located? 2. Patients suffering from stenocardia will describe their pain in which ways? (using at least three adjectives) 3. What are the upper limits of normal blood pressure? 4. What is a typical clinical symptom of acute left-sided heart failure? 5. Which basic medications are used for the treatment of acute heart failure? 6. What are typical symptoms of acute myocardial infarction? 7. What are the three typical directions of stenocardia (angina pectoris) radiation ? 8. Which valvular heart defect should be considered in a young person who experienced syncope during exertion? 9. List at least two the most common causes of atrial fibrillation. 10. What long-term therapeutic measures should be instituted in patient with chronic atrial fibrillation? 11. List 4 basic medications which should be used as a secondary prevention in a patient after an acute myocardial infarction. 12. Is ventricular tachycardia life-threatening? 13. What is the first therapeutic approach in a patient with ventricular fibrillation? 14. What is the basic and first therapeutic approach in a patient with asystolia (cardiac arrest)? 15. Which severe side-effect can occur during opiates therapy? 16. Which group of medications is currently considered as a basic pharmacological intervention in hypercholesterolemia? 17. Which is the therapy of choice in a patient with acute myocardial infarction and elevated ST? 18. What are the acute forms of ischemic heart disease? 19. Which two pathological phenomena characterize the morphology of the left heart chamber in mitral insuficiency. 20. The laboratory marker, whose negativity excludes the presence of pulmonary embolism is: 21. How long lasts the permanent ventricular tachycardia? More than... 22. The pulmonary hypertension is characterized by elevated pulmonary artery pressure upper than: 23. Which two groups of medication significantly improve the prognosis of patients with congestive heart failure? 24. What are the indications for initiation of the cardiopulmonary resuscitation? 25. How long after a cardiac arrest is the patient unconscious? 26. How long after a cardiac arrest does the patient develop a mydriasis? 27. The first used test (except of resting ecg) in differential diagnosis of chest pain in non-emergent patient should be: 28. Which proportion (in percentage) of myocardial wall must be destroyed by necrosis to develop a cardiogenic shock? 29. What is the most specific laboratory test used to confirm the myocardial necrosis? 30. What is the most serious arrythmia in the course of myocard infarction? 31. ECG record: The hulking ST elevation which blends with the T-wave is called: 32. What is the consequence of (what follows after) a myocardial free wall rupture? 33. How many patients (in percentage) have an asymptomatic course of myocard infarction (silent ischemia)? 34. How many patients (in percentage) have a secondary cause of hypertension? 35. What is the laboratory marker of the congestive heart failure? 36. Which adverse effect is the most common during the ACEi treatment? 37. Which adverse effect is the most commonly observed when we treat a patient by furosemide? 38. So called Corrigan pulse ("water-hammer" pulse) is characteristic for...? 39. Which imaging method is the best for infective endocarditis diagnosis? 40. In how many adult patients (in percentage) persist patent foramen ovale? 41. Holosystolic murmur heard over the apex is typical for which valvular heart defect? 42. The systolic murmur heard at the second right intercostal space parasternally is typical for a valvular heart defect - which one? 43. What disease (from the rank of internal medicine) is nycturia typical for? 44. What dose of furosemide do you choose for treatment of acute heart failure in diuretic naive patient? 45. Which antiarrytmic drugs do we use for pharmacological version of atrial fibrilation? 46. What is the "in-hospital" mortality rate in patients suffering from myocardial infarction treated by PCI? 47. What is the most common pathophysiology and underlying cause of acute myocardial infarction? 48. What is the first choice treatment in patient suffering from ST elevation myocardial infarction? 49. List at least two contraindications for administration of digoxin 50. Which types of pacing we can use in cardiology? 51. What drug is used as "the first aid" in patients with significant A-V blockade? 52. List the two most common causes of development of aortic stenosis nowadays. 53. What is the basic treatment of aortic stenosis? (2) 54. List the most common cause of development of mitral stenosis. 55. Which valve could we expect to be affected in most cases by infective endocarditis in i.v. drug users? 56. Which disease do we find Osler´s nodes in? 57. What auscultation site is used for systolic murmur in patient with ventricular septal defect? 58. What is the usual daily dose of penicilin in treatment of infective endocarditis? 59. What disease are betablockers contraindicated in? 60. What kind of diuretics could we use in the treatment of hypertension? (List at least two.) 61. What drug is "the first choice" for treatment of hypertension during pregnancy? 62. In which disorder hypertension limited to the upper half of the body is usually observed? 63. Which disorder is characterized by paroxysmal hypertension? 64. Which is the typical finding during physical examination in the case of acute pericarditis sicca? (without effusion)? 65. Which cardiomyopathy is genetically determined? 66. Which imaging method is the best one for cardiac tamponade diagnosis? 67. Which two diagnostic methods are used to prove left ventricle hypertrophy in daily practice? 68. Which congenital heart disease is the most commonly diagnosed in adulthood? 69. What is the typical auscultation finding in the patient with atrial septal defect? 70. List five most common causes of pericardial effusion: 71. Which imaging method helps us to distinguish left ventricular dysfunction present in dilated cardiomyopathy and coronary heart disease? 72. What is the typical clinical presentation of cardiac tamponade? 73. Do calcium channel blockers belong among the preferred drugs for treatment of heart failure? 74. What kind of change could we observe on ECG record in patient with hyperkalemia? 75. What is the shape of P pulmonale on an ECG record? 76. What changes do we find on ECG record in patient with acute cor pulmonale? 77. List three symptoms associated with aortic stenosis? 78. What diseases cause left ventricle hypertrophy? 79. In which leads do we observe changes on ECG record in patient with inferior myocardial infarction? 80. What situation should we assume in patients with pathological Q wave and persistant ST elevation in leads monitoring anterior myocardial wal? 81. What is the first symptom of valvular regurgitant defects? 82. List at least three causes for development of mitral insufficiency. 83. In patient suffering from obstruction of calf arterial bed where is claudicatory pain localized? 84. In patient suffering from obstruction of superficial femoral artery where is claudicatory pain localized? 85. In patient suffering from obstruction of iliac arteries where is claudicatory pain localized? 86. What kind of pain does the patient with ischemic pain in lower limbs in rest describe? 87. What kind of complaints does the patient with claudicatory pain describe? 88. At what time do we observe filling of dorsal veins during the performance of modified Ratschow´s test? 89. What value of ankle-brachial index (ABI) do we consider as diagnostic for periphery artery disease? 90. What is necessary to take into the consideration in patient with proven PAD? What other diagnostic angiological procedures do you recommend? 91. List at least three measures belonging to non-pharmacological intervention in patients with PAD? 92. What is the most common cause of acute arterial occlusion in extremities? 93. Which clinical stage of PAD do we consider angiography in? 94. What is the most common cause of aortic dissection? 95. What does the term "abdominal angina" mean? 96. What is predisposig factor for development of thrombangiitis obliterans? 97. List the components of Wirchov-Rokitanski triad? 98. List at least three inborn hypercoagulable states? 99. List at least three acquired hypercoagulable states? 100. What examinations are considered as "gold-standard" in suspicion for deep venous thrombosis? 101. What basic therapeutic measures do we institute in patient with recently proven DVT in calf venous bed? 102. What does paradoxic embolism mean? 103. List at least four symptoms of pulmonary embolism. 104. What basic therapeutic measures do we institute in patient with recently proven thromboflebitis? 105. What kind of patients use the ortopnoeic position? 106. What is astma cardiale? 107. List signs of digitalis overdose. 108. List at least 5 causes of pulmonary hypertension. 109. List 3 diagnostic procedures that are necessary to diagnose infectious endocarditis. 110. How is possible to recognize the atrio-ventricular pacing at the ecg? 111. Which inborn valvular disease is prone to development of infectious endocarditis? 112. Which disease is suspicious in a patient with spleen infarction? 113. Describe the absolute indication for surgery in patient with infectious endocarditis. 114. Describe the typical finding at ecg in a patient with exsudative pericarditis. 115. Which disease could cause restrictive cardiomyopathy? 116. What is P wave at ecg - what does it mean? 117. What is the normal value of QTc interval at ecg ? 118. Describe the complication of long QT interval. 119. How do we call syndrome of preexcitation? 120. What is characteristic for the W-P-W syndrome at ecg? 121. Are we able to recognise ischemic changes at the ecg in a patient with cardiac pacing? 122. Describe the AV blockade of 1st degree at the ecg. 123. Which arrhytmia is the most frequent in old people? 124. Describe RBBB at the ecg. 125. How do we call the combination of RBBB+LAH at the ecg and how we recognize it? 126. Describe the Ebstein´s anomaly. 127. List 4 parts of Fallot´s tetralogy. 128. List 2 most frequent indications for heart transplant. 129. List 3 most frequent complications after heart transplant. 130. Could be fresh LBBB an expression of acute myocard infarction? 131. Which examination is indicated to confirm the diagnose of vaso-vagal syncope? 132. What is the normal value of QRS at the ecg? 133. List signs of right ventricle overload at the ecg. 134. What medication contains dual antiplatelet therapy? 135. When we use dual antiplatelet therapy? 136. Can we use aspirin treatment in patients with deep venous thrombosis? 137. Which new treatment can we use in patients with familiar hypercholesterolemia? 138. Which diabetic treatment could we use in patient with the heart failure? 139. STEMI of the lateral wall - describe the ecg finding. 140. Which coronary artery supplies the inferior waal of left ventricle? 141. What is the normal efficiency of the left ventricle? 142. Which treatment is used in a patient treated by warfarin who must undergo acute surgery? 143. List risk factors of aortic dissection. 144. What is the warning sign in a patient with aortic aneurysm (imminent rupture)? 145. What procedures are used to recognize the proximal type of aortic dissection? 146. List 5 basic groups of antihypertensive therapy 147. List the new classification of heart failure (2016). 148. List 3 causes of cardiac syncope. 149. Describe first aid in a patient with vaso-vagal syncope. 150. Which therapy is recommended in a pattient with massive, life-threatening pulmonary embolism? 151. In case of mitral stenosis we listen to "mitral triad" - what is it? 152. What are we able to listen in patient with aortic stenosis? 153. What is the difference between listening in patient with organic mitral regurgitation and a patient with mitral valve prolaps? 154. What is the treatment of thoracic empyema? List at least two methods. 155. What is the definition of nosocomial pneumonia? 156. List the two most frequent locations of the extra-thoracic tuberculosis, occured in the Czech Republic 157. What way of drug administration is preffered in the astma bronchiale treatment? 158. How long (how many months) should the patient have a productive cought to consider such disorder to be chronic? 159. What is the main risk factor for development of chronic bronchitis? 160. What kind of obstructive ventilation disorder is typical of astma bronchiale? 161. What oxygen concentrations could be administered during acute astma bronchiale treatment? 162. What kind of obstructive ventilation disorder is typical for COPD? 163. What is the change of ventilation pattern in a patient with acute exacerbation of COPD? 164. List at least two groups of drugs using in the treatment of patients with COPD. 165. Define parameters of sufficient oxygenation (SaO2, paO2) in a patient with COPD exacerbation. 166. Which type of ventilation change is typically present in idiopathic pulmonary fibrosis? 167. Define the possible sources of nosocomial infection. List at least two possible causes. 168. What is multiresistant tuberculosis? 169. Define the indication of corticosteroids in the treatment of extrapulmonary tuberculosis 170. What is the consequence of inadequate ADH secretion? 171. Which are the two basic histological types of pulmonary carcinoma? 172. Specify the neurological disease which is frequently observed in patients suffering from thymoma (in 30-50%). 173. Specify the auscultation findings in pneumothorax. 174. What is the most common cause of secondary pneumothorax? 175. Define changes in blood gases caused by alveolar hypoventilation 176. What is the most frequent cause of transsudate in pleural cavity? 177. Which biochemical parameter do we have to examine in young adults with severe form of COPD? 178. What is the term for lean dyspnoic patients with emphysema and no cyanosis? 179. What class of drugs is overused in the highest level in patients with COPD? 180. What does the abbreviation "LTOT" mean? 181. Which indication for lung transplant is associated with the best postoperative prognosis of the patients? 182. What hemodynamic parameter precludes the possibility of unilateral lung transplant? 183. What is the name for class of drugs used for treatment of unproductive (irritating) cough? 184. What is the name for class of drugs used for treatment of productive cough and expectoration of viscous mucus? 185. What disease is the cause for chronic cough in most cases? 186. What is the name of disease characterised by increased resistance in upper respiratory tract and periods of apnea during sleep? 187. What extent of pneumothorax (given by distance between the thoracic wall and lung) could be considered as a small rim PNO? 188. When performing drainage of pleural cavity by active suction, what is the range of negative pressures used? 189. What countries do we find the highest rate of tuberculosis? 190. What does the term "incidence of TBC" mean? 191. What is the incidence of TBC in Czech Republic in recent years and what is the trend of this parameter? 192. What does the term "primary TBC" mean? 193. What does the term "postprimary TBC" mean? 194. What does the term "latent TBC" (LTB) mean? 195. What are the tests for "latent TBC" (LTB)? 196. What is the evaluation of Mantoux II test? 197. What factors increase risk for the transition of "latent TBC" into active form? 198. What examinations is it necessary to perform before the treatment with anti-TNF alfa agents? 199. What is time is required to perform cultivation of M. tuberculosis? 200. What are the disadvantages of using PCR to diagnose M. tuberculosis when compared with classic cultivation tes? 201. What material is examined in cases when the patient is unable to expectorate sputum? 202. What is the course of chemoprophylactic treatment of TBC in CR? 203. When is the chemoprophylactic treatment of TBC indicated? 204. List all five basic antituberculotic drugs. 205. Which antituberculotic drugs are used in the initial treatment and how long does the initial phase last? 206. Which antituberculotic drugs are used in the continual treatment and for how long? 207. What does the abbrevation " MDR" mean in relation to TBC? 208. List at least 2 of some antituberculotic drugs used for the treatment of MDR tuberculosis? 209. What is the justification for TBC vaccination? 210. Which groups of population are currently vaccinated against TBC in CR? 211. Is the phrase "There is a steady increase of lung cancer incidence in CR in both men and women" true? Please justify. 212. What is the difference between pneumonia and bronchopneumonia? 213. What is the definition of "community acquired" pneumonia? 214. What is the definition of nosocomial pneumonia? 215. What is the most common pathogen causing pneumonia? 216. What pathogens cause so-called "atypical" pneumonia? 217. In walking patient where is the aspiration pneumonia localised? 218. In lying patient (for example ventilated) where is the aspiration pneumonia localised? 219. What pathogens cause aspiration pneumonia? 220. What is the detection rate of disease causing pathogens in sputum? 221. Finding of Gramm positive diplococci in sputum is suspective of what pathogen? 222. Which bacterial antigens are commonly examined in a urine sample? 223. Which class of immunoglobulins is important for diagnosis of acute M. pneumonii and Ch. pneumonii infections? 224. List at least 2 groups of antibiotics used for the empirical treatment of community acquired pneumonia? 225. List at least 2 groups of antibiotics used for the treatment of atypical pneumonia? 226. Which groups of patients are at increased risk of nosocomial pneumonia? 227. What is the most common pathogen causing nosocomial pneumonia? 228. List at least 2 groups of antibiotics used for the empirical treatment of nosocomial pneumonia? 229. List at least two of the most common complications of pneumonia? 230. What is the most common etiology of pneumonia in immunocompromised patients? 231. What is the most common pathogen causing pneumonia in AIDS patients? 232. What is a first typical symptom of rheumatoid arthritis manifestation? 233. Where is polymyalgia rheumatica pain typically localized? 234. What is the basic medication for the treatment of polymyalgia rheumatica? 235. What is the usual range (min-max dose) of the dose in chronic prednisone therapy? 236. Which part of the musculoskeletal system is affected in Bechterew's disease (ankylosing spondylitis)? 237. Which extra-articular symptoms in a young man might signalize a presence of Bechterew's disease? 238. What are the most characteristic deformities in rheumatoid arthritis? 239. What is rheumatoid factor? 240. What are rheumatoid nodules? 241. What is the combination of clinical presentation consisting of rheumatoid artritis, splenomegaly and leukopenia called? 242. List at least two of the most common complications of Felty´s syndrome? 243. Anti-citrullinated protein antibody are characteristic for which disease? 244. What are the clinical manifestations of gout? 245. What is the examination used for detection of urate crystals? 246. Which joint is most commonly affected by hydroxyapatite artritis? 247. Which disease is characterised by gross bridgeing of interverebral spaces by oseous process, especially in obese patients with DM older than 50years of age? 248. What are diagnostic features (clinical + lab and ancillary procedures) for polymyositis? 249. List at least two skin signs of dermatomyositis. 250. List at least two antibodies associated with myositis. 251. In rheumatology what does the term "DAS" mean? 252. What is "antiphospholipid syndrome"? 253. What is a fatal complication in patients with systemic sclerosis? 254. Which substance is used in the basic treatment of polymyositis and dermatomyositis and what is the dosing of this drug? 255. List at least three major causes of clinically significant hypergammaglobulinemia. 256. What is the characteristic feature of diffuse idiopathic skeletal hyperostosis? 257. List at least five adverse effects of corticosteroid treatment. 258. What is the recommended concurrent pharmacotherapy in patients undergoing long-term corticosteroid treatment? 259. List at least five adverse effects of NSAID treatment. 260. Which disease is strongly associated with antigen HLA-B27? 261. Which antibodies are typically present in SLE? 262. Name the basic disease-modulating drug in reumatoid artritis. 263. Name at least 3 biological, disease-modulating drugs and list their extracelullar targets. 264. What is rituximab? 265. Occupational diseases in the Czech Republic can be acknowledged solely by 266. The most frequent occupational disease due to vibrations nad overload of upper extremities is 267. What malignancy can be caused by benzene? 268. What cancers can develop in uranium miners (list at least 2) 269. What occupational diseases are most frequent in the healthcare workers (list at least 2)? 270. What type of skin tests (and where applied) are used to diagnose contact allergic dermatitis? 271. What examinations are used to diagnose vibrations-induced Raynaud syndrome (at least 2)? 272. Which examination can prove vibrations-induced or overload-induced peripheral neuropathy? 273. What antidote is used to treat internal contamination by iodine radionuclide? 274. What is the correct first aid after ingestion of acids or alkalis? How much? 275. What examination after ingestion of corrosives is considered the gold standard to diagnose the damage and to decide further steps ? 276. Which antidotes are used to treat poisoning with lead or mercury - group name + generic names/abbreviations? 277. What antidote can treat intoxication with methemoglobinaemia (at least 1)? 278. What are the clinical symptoms of methemogloginaemia (2 signs at least)? 279. What is the typical sound on auscultation in asbestosis and extrinsic allergic alveolitis? 280. What is the treatment of silicosis and asbestosis? 281. What examination is crucial for the diagnosis of silicosis/ asbestosis? 282. What tumours may be caused by asbestos (at least 2 types) 283. What is the common effect of organic solvents? 284. To diagnose occupational asthma, following examinations are crucial (at least 2): 285. Most important information in Material Safety Data Sheet (MSDS) of a chemical product is its formula. Where can it be found (at least 1 possibility)? 286. What shape have the opacities on the chest radiograph in silicotic patients? 287. What organ damage in addition to neurotoxicity causes ethylene glycol (antifreeze, brake fluids) 288. What typical damage (besides CNS effect) causes methylalcohol? 289. What antidotes are used after ingestion of ethylene glycol and methanol? 290. After petroleum distillates ingestion (gasoline, naphta) following procedures are contraindicated in the pre-hospital and hospital care (2 examples) 291. Poisoning with Amanita phalloides can be treated with following drugs - "antidotes" 292. The latency from ingestion to first symptoms of poisoning with Amanita phalloides is typically 293. Intoxication with morphine and its derivatives can be treated with 294. Decision concerning antidote treatment in paracetamol ingestion is based on (at least 1 option) 295. Antidote indication in benzodiazepines or morphine derivates poisoning is based on 296. Can chronic low-back pain due to long-term physical overload be compensated in the Czech Rep? 297. Can a healthcare worker be compensated for covid-19? 298. What characteristics (exposure criteria) of the job must be fulfilled for occupational carpal tunnel syndrom due to overload? (at least 2) 299. Who verifies working condition in suspected occupational disease in the patient (at least 1) 300. What type of noise-induced hearing loss can be compensated as an occupational disease? 301. What are two main causes leading to acute pancreatitis? 302. Which hepatotropic viruses spread mainly by the orofaecal route? 303. Characterise the typical and general course of hepatitis C acute phase? 304. Which viral hepatitides never become chronic? 305. Which antigen is always present in the blood of patients with chronic hepatitis B? 306. Which laboratory parameter indicates the seriousness of hepatic encephalopathy? 307. Which tumour marker is typical of hepatocellular carcinoma? 308. What are two basic types of ileus? 309. What beam orientation should be applied during X-ray examination in recumbent position of patient to diagnose ileus? 310. What is a typical sign of ileus in X-ray examination (plain films of the abdomen)? 311. List two main causes of hepatic cirrhosis. 312. Which kind of disorder could we assume in patients with prolonged protrombin time and cirrhosis of liver. 313. What is the causal treatment of fulminant liver failure in cases when the complex non-specific treatment fails? 314. Which pharmacological group do we use in treatment of chronic portal hypertension? 315. What does hepatorenal syndrome mean? 316. Which test serves as a preventitive screening for colon cancer? 317. Which patients with cholecystolithiasis are not indicated for cholecystectomy? 318. What parameters (and what arbitrary value of them) signalize that the patient with acute gastrointenstinal bleeding is hemodynamically unstable? 319. What two test are important to provide the diagnosis of gastroesophageal reflux disease? 320. Which gastric neoplasma is the most frequently observed? 321. What is the definition of diarrhoea? 322. What are three characteristic features of the gastrointestinal lesions occured in patients with Crohn disease? 323. What is the time-course and associated characteristics of a colic? 324. What is the time-course of pain due to imflammation? 325. Which laboratory parameter indicates a serious bleeding into gastrointestinal tract at the earliest? 326. What changes (in laboratory parameters) could we expect in a serious bleeding into gastrointestinal tract? List at least three. 327. What parameter and signs do we look for during ultrasound examination in patient with suspected cholestasis? 328. What is the cause of pseudomembranous enterocolitis? 329. Which disease is caused by Tropheryma Whipplei? 330. What diagnostic method do we use in oder to prove achalasia? 331. What is the crucial difference between ERCP and MRCP? 332. What diagnostic method do we use in oder to prove chronic pancreatitis? 333. What should we perform during the diagnostic process for functional disorders of GI tract? 334. What diet should be instituted in a patient with acute exacerbation of idiopathic proctocolitis? 335. What are the risk factors for transformation of IBD into CRC? 336. What acute disease could imitate "a new case" of Crohn´s disease? 337. What kind of drugs is considered as a therapy of choice in a patient with acute exacerbation of idiopathic proctocolitis? 338. Which kind of polyp in large intestine is associated with hypokalemia? 339. In which parts of GI tract could we find gastrinoma? List at least two organs. 340. What are pharmacological options for the treatment of pseudomembranous enterocolitis? Be specific. 341. What characteristics of antibiotics are considered necessary for succesful treatment of cholangitis? 342. List drugs used for eradication of Helicobacter pylori. 343. List three unequivocal indications for eradication of Helicobacter pylori. 344. What diagnostic method do we use in oder to evaluate compliance of a patient treated for celiac disease? 345. What diagnostic method do we use in oder to evaluate compliance of a patient treated for celiac disease? 346. What diagnostic method do we use in oder to prove unequivocally celiac disease? 347. What is the basic energetic need of a healthy young person not extremely burdened physically? 348. What is the basic need for liquids in an uncomplicated recumbent patient in ml/kg/day? 349. What is the basic need for full-value proteins for a healthy person? 350. What means BMI? 351. What is definition of obesity (using BMI value)? 352. What is the upper limit of normal body weight expressed by BMI? 353. What does the term "all-in-one parenteral nutrition" mean? 354. What is the effect of the prolonged shock to diuresis? 355. What is the reason for insertion of nasojejunal tube? 356. What does antidote mean in toxicology? 357. Which organ is severely affected and often fails in paracetamol poisoning? 358. What is the definition of sepsis? 359. What amount of muscular mass could be catabolised in severe acute critical state per day? 360. What is plasmapheresis? 361. List all branched essential aminoacids. 362. List at least five trace elements. 363. In which medium are vitamins D and K soluble? 364. List micronutrients administered for their antioxidative properties. 365. What purpose does the indirect calorimetry serve? 366. What is the first aid for a patient who is unconscious due to hypoglycemia? 367. What is a typical clinical sign of diabetes sensitive polyneuropathy in lower extremities? 368. What is the most significant clinical sign of periphery artery disease? 369. What is characteristic laboratory finding in incipient diabetic nephropathy? 370. What value of fasting glycemia is diagnostic of diabetes? (measured in venous plasma) 371. List at least three basic symptoms of hypoglycemia 372. Which medication is used as a basic treatment for a patient with newly diagnosed type 2 diabetes mellitus? 373. What is the basic therapetic measure in patient with type 1 diabetes mellitus? 374. Which two pathophysiological causes determine the development of type 2 diabetes mellitus? 375. What has to be corrected first in patient with hyperosmolar hyerglycemic state? 376. Which severe disorder can be caused by extremely high level of serum triglycerides? 377. Which external factor causes the diabetic foot ulcer in most cases? 378. What is the most important contra-indication of metformine in type 2 diabetic patients? 379. List at least three symptoms of hyperglycemia. 380. What examinations should be performed at least annualy in patients with diabetes? List at least three. 381. What tests are used to evaluate metabolic control and overall health status of patients treated for diabetes? Name at least seven of them. 382. What is the normal range of HbA1c in healthy subjects according to IFCC calibration? 383. What does the term " impaired fasting glucose" mean? 384. What kind of drugs used in treatment of DM can cause hypoglycemia? 385. What three features characterize diabetic dyslipidemia? 386. What waist circumeference (in cm) is diagnostic for metabolic syndrome according to IDF guidelines? 387. When during the day is the highest cortisol level in plasma? 388. What is an usual hydrocortison dose (range) used for substituion in a patient suffering from Addison's disease? 389. What is the typical laboratory finding in patients with hyperaldosteronism (Conn's syndrome)? 390. In a patient with Addison's crisis one can expect hypertension, hypotension or a patient is normotensive? 391. Define the common therapeutic dose of intravenous hydrocortisone administred during an acute situation. In which acute situation this treatment should be applied? 392. What means tetany? 393. What are typical symptoms of thyreotoxicosis? 394. What are typical symptoms of hypothyroidism? 395. What does the term "goitre" mean? 396. List two main causes of hypercalcemia 397. Which laboratory parameter is the most useful in patient with hypercalcemia and why? 398. What are the most common signs of primary hyperparathyroidism? 399. What signs and symptoms could inform us about possible hypocalcemia? 400. Which hormonal deficit is the most important in pituitary insufficiency and why? 401. How can we differentiate polyuria caused by diabetes insipidus from polyuria in diabetes mellitus or due to hyperparathyroidism? 402. What is the leading sign in an adult patient with elevated growth hormone production? 403. Why is abrupt interruption of long-term corticosteroid treament (with medium or high doses) dangerous? 404. What are clinical signs of hyperaldosteronism? 405. What symptoms could tell us about possible pheochromocytoma? 406. What treatment should be instituted in a patient with adrenal (Addisonian) crisis? 407. List other endocrine diseases associated with type 1 diabetes. (at least one) 408. What are clinical signs and symptoms telling us about suddenly developed anemia? 409. What is the most common cause underlying development of microcytic anaemia? 410. Which morphologic characteristic is important for differentiation of anemias? 411. What is the most frequent and wide-spread type of anemia? 412. What is the most serious complication of pernicious anemia? 413. What is the most notable symptom of haemolytic anemia? 414. Which laboratory test do we use for confirmation of autoimmune hemolytic anemia? 415. There is a necessity to treat a patient with autoimmune hemolytic anemia by blood transfusions. What kind of transfusion preparation would you prefer? 416. Is hemolytic anemia possible to be observed in a patient after a cardiac surgery (using extracorporal circulation)? 417. What is a typical finding in blood count in a patient who suffers from aplastic anemia? 418. Which examination is necessary to perform in differential diagnosis of aplastic anemia? 419. What is the most frequent complication of chronic lymphocytic leukemia? 420. Is the primary focus of non-hodgkin lymphoma located always in a lymph-node? 421. What is the consequence of the Bence-Jones protein production? 422. What is the typical X-ray finding in Kahler´s disease? 423. What lab test do you use for monitoring the efficacy of low-molecular weight heparin treatment? 424. Which preparation is the most effective to normalize protrombin test in a patient who is overdosed by warfarin? 425. Which preparation is essential to treat a trombocytopenic patient when an emergent surgery is required? 426. Which test do we use for monitoring of efficacy during warfarin treatment? 427. Which imaging method should be performed to prove the intracerebral haemorrhage? 428. Which imaging method should be performed in patients with stroke before initiation of low-molecular weight heparin treatment? 429. Can brain arteries atherosclerosis lead to the cerebral atrophy? 430. What is the upper limit of normal size of lymph node? 431. What is the most frequent underlying cause of lymphadenopathy? 432. Which imaging method could be used for evaluation of the size of lymph nodes. 433. What does sentinel lymph node mean? 434. Is lymphadenopathy present in a patient with Whipple´s disease? 435. At what size of a lymph node do we consider lymphadenectomy? 436. What antidote do we use in a serious heparin overdosing? 437. Is disseminated intaravascular coagulation a dynamic disorder? 438. Could reaction antigen–antibody trigger disseminated intravascular coagulation? 439. What are the most frequent complications after bone marrow transplantation? 440. At what concentration of hemoglobin do we administer blood transfusion? 441. At what concentration of hemoglobin do we administer blood transfusion in cardiac patients? 442. What is the most frequent type of anemia in pregnant women? 443. At what site do we perform confirmatory determination of blood groups of a patient and PRBC? 444. List class of drugs used for treatment of immune-mediated adverse reaction to blood transfusion? 445. What is the first therapeutic measure in case of adverse reaction to blood transfusion? 446. What is mycosis fungoides? 447. Which disease is associated with Pel-Ebstein fever with? 448. What is Walderstrom´s disease? 449. Describe the mechanism of vitamin B12 absorption 450. Which conditions support the development of macrocytic anemie - what could cause lack of folic acid and vitamin B12? 451. Describe the typical finding in blood cell count and biochemistry lab in irondeficiency anemia 452. Describe the typical finding in blood cell count and biochemistry lab in anemia of chronic disease 453. Describe the typical finding in blood cell count and biochemistry lab in pernicious anemia 454. List the classification of anemias according to their development mechanism 455. List basic groups of anticoagulation drugs according to their effect mechanism (4) 456. What is the mechanism of warfarin effect? 457. Define uremic syndrome ? 458. What laboratory parameter is most important for classification of chronic kidney diseases ? 459. Could we evaluate glomerular filtration rate without performing any clearance methods (clearance of creatinin, inulin, DTPA )? 460. We are able to classify chronic kidney disease (CKD) according to calculated GFR and albuminuria. How the CKD stages are marked ? 461. Explane CKD stage G4A3 462. What clinical and laboratory parameters are specific for urinary tract infecions? 463. What is asymptomatic bacteriuira and in which cases do we treat it? 464. What does the term "complicated infection of urinary tract" mean? 465. Define chronic kidney disease 466. We are able to classify acute kidney injury. What parameter are used ? 467. What factors contribute very often to lithogenesis? List at least two of them. 468. What does the term "ischemic kidney disease" mean? 469. What is the most frequent form of vascular nephropathy in population? 470. What are predisposing factors for vascular nephropathy? 471. What is the definition of microalbuminuria? 472. What is the definition of selective glomerular proteinuria? 473. What does the term preglomerular ("overflow") proteinuria" mean? 474. What does the term "tubular proteinuria" mean? 475. What is the definition of non-selective glomerular proteinuria? 476. What is the definition of nephrotic proteinuria? 477. What detection method is used to find out microhematuria? What is reference value ? 478. What morphological abnormality of erythrocyte in urinary sediment is typical of glomerular lesion? 479. What is the clinicaly definition of rapidly progressive glomerulonephritis? 480. What method, used in evaluation of bioptic renal sample, is important for differential diagnosis of rapidly progressive glomerulonephritis. 481. Which imaging method informs about morphology of kidney, ureters and urinary bladder ? 482. What extra benefit gives the examination by scintigraphy in comparison to other imaging method ? 483. Use of iodinated contrast media in patients suffering from chronic nephropathy is associated with a risk. Define this risk. 484. What examination is considered as the most important in patients presented with unidentified cause of renal failure ? 485. What is the definition of nephrotic syndrome? 486. What criterion is used forclassification of metabolic acidoses ? 487. How to calculate anion gap ? 488. List at least three causes for metabolic acidosis with anion gap. 489. What does the term "Bence-Jones protein" mean? 490. What is the most frequent cause of dehydration associated with lab abnormalities: hypokalemia, hypochloremia and metabolic alkalosis? 491. What laboratory abnormalities are typical of secondary hyperparathyreoidism ? 492. What is the laboratory definition of parathyreoid gland adenoma ? 493. List at least three therapeutic measures used for correction of hyperphosphatemia. 494. What is the sodium deficit in patient with body weight=74kg and serum concentration of Na=115mmol/l.? 495. What is volume (in litres) of the total body water in a patient whose body weight is 75kg. 496. What is the definition of polyuria? 497. What is the definition of oliguria? 498. How we classify polyuria ? 499. What is the formula for calculation of base deficit? 500. How many liters ECT has a person weighing 70 kg ? 501. What EFNa is in patient with renal failure of prerenal etiology? 502. List risk factors that are examinated during complex geriatri examination 503. What is ADL in geriatrics and what does it mean? 504. List tests that are used for diagnostics of demetia and depression in geriatrics. 505. What is geriatric frailty syndrom? List the most important changes in this syndrom.
STATE EXAM QUESTIONS – 6TH YEAR – INTERNATIONAL STUDENTS (valid from October 1st, 2023)
1. Acute heart failure 2. Chronic heart failure – etiopathogenesis and symptomatology 3. Chronic heart failure – diagnostics and complex therapy 4. Aortic valvular disorders 5. Mitral valvular disorders 6. Coronary artery disease – acute forms 7. Chronic coronary artery disease – classification, ethiology, symptomatology 8. Chronic coronary artery disease - diagnostics, therapy 9. Acute myocardial infarction 10. Complications of myocardial infarction 11. Shock 12. Arterial hypertension 13. Secondary hypertension 14. Pulmonary embolism 15. Congenital heart defects in adults 16. Inflammatory disorders of the heart (myocarditis, pericarditis…) 17. Infective endocarditis 18. Cardiomyopathies 19. Cardiac tamponade 20. Supraventricular arrhythmias 21. Ventricular arrhythmias 22. Atrial fibrillation – symptomatology, diagnosis, and therapy 23. Cor pulmonale 24. Circulatory and breathing arrest, cardiopulmonary resuscitation 25. Disorders of aorta 26. Disorders of brain arteries, stroke 27. Acute disorders of peripheral arteries 28. Chronic disorders of peripheral arteries 29. Acute disorders of peripheral veins 30. Chronic disorders of peripheral veins 31. Vasculitis-related kidney disease – affections of kidney caused by connective tissue diseases and vasculitis 32. Vasculitis 33. Nephrotic syndrome (definition and differential diagnosis) 34. Serious affections of kidneys in relation to internal diseases (diabetes mellitus, hypertension, poisoning, malignancies) 35. Urinary tract infections 36. Urolithiasis 37. Acute and rapidly progressive glomerulonephritis 38. Chronic glomerulonephritis 39. Acute and chronic interstitial nephritis. Autosomal dominant polycystic kidney disease 40. Staging of chronic nephropathies (regardless of etiology) 41. Acute kidney failure (classification and differential diagnostics) 42. Chronic kidney failure 43. Acid-base balance and it´s disturbances 44. Disturbances of fluid balance with preserved isotonicity of extracellular fluid (isotonic dehydration/hypovolemia) 45. The most frequently observed disturbances of electrolyte balance. Disturbances of fluid balance with increased and decreased tonicity of extracellular fluid (hypertonic and hypotonic dehydration) 46. Disturbances in potassium metabolism 47. Organ transplantation. Elimination methods. 48. Vascular nephropathy 49. Benign disorders of the thyroid gland (including inflammatory); goiter 50. Hyperthyroidism and it´s complications 51. Hypothyroidism and it´s complications 52. Tumors of the thyroid gland 53. Parathyroid gland disorders 54. Basic hypothalamic and pituitary disorders 55. Hypofunction of adrenal cortex, diagnostics, treatment, significance 56. Hyperfunction of adrenal cortex, diagnostics, treatment, significance 57. Primary hyperaldosteronism, diagnostics, treatment, significance 58. Treatment by corticosteroids (acute and chronic), indication and complications 59. Disorders of adrenal medulla 60. Type 1 Diabetes mellitus – pathophysiology, clinical presentation, diagnostics 61. Type 2 Diabetes mellitus - pathophysiology, clinical presentation, diagnostics 62. Basic treatment principles of type 1 diabetes 63. Basic treatment principles of type 2 diabetes 64. Acute complications of diabetes mellitus 65. Chronic complications of diabetes mellitus 66. Obesity 67. Syndrome of insulin resistance 68. Autoimmune polyglandular syndrome 69. Disturbances of lipid metabolism 70. Atherosclerosis 71. Parenteral nutrition – basic principles 72. Enteral nutrition – basic principles 73. Community-acquired pneumonia 74. Hospital-acquired pneumonia 75. Pulmonary tuberculosis 76. Extrapulmonary tuberculosis 77. Bronchial asthma – stable stadium 78. Acute bronchial asthma 79. Chronic bronchitis, bronchiectasis 80. Chronic obstructive pulmonary disease (COPD) – stable stadium 81. Acute exacerbation of the chronic obstructive pulmonary disease 82. Idiopathic pulmonary fibrosis 83. Lung cancer 84. Pleural effusions 85. Acute and chronic respiratory insufficiency 86. Diseases of mediastinum 87. Pneumothorax 88. Anemia – classification, ethiology, symptomatology 89. Principles of transfusion medicine 90. Iron deficiency anemia 91. Megaloblastic anemia 92. Hemolytic anemia and anemia of chronic disease 93. Myelodysplastic syndrome 94. Myeloproliferative disorders 95. Plasmacytoma and plasma cell disorders 96. Disturbances in coagulation – bleeding disorders 97. Disturbances in coagulation – hypercoagulation state 98. Disseminated intravascular coagulopathy 99. Degenerative disorders of joints and spine 100. Chronic inflammatory arthropathies; rheumatoid arthritis 101. Acute rheumatic fever 102. Ankylosing spondylitis and spondyloarthropathies 103. Systemic rheumatic disease (scleroderma, polymyositis, dermatomyositis) 104. Systemic lupus erythematosus 105. Osteoporosis and osteomalatia 106. Uric acid, hyperuricemia and gout 107. Porphyrias 108. Gastrointestinal bleeding 109. Disorders of esophagus 110. Peptic ulcer disease 111. Tumors of stomach 112. Inflammatory bowel disease 113. Colonic polyps and colorectal cancer 114. Non-neoplastic disorders of bowel – diverticulosis, diverticulitis 115. Functional gastrointestinal disorders 116. Malabsorption syndrome and coeliac disease 117. Cholelithiasis and its complication 118. Acute pancreatitis 119. Chronic pancreatitis 120. Acute hepatitis 121. Chronic hepatitis 122. Liver cirrhosis 123. Portal hypertension – classification, complication, therapy, and prognosis 124. Acute and chronic liver failure 125. Tumors of liver, bile duct, gallbladder, and pancreas 126. Differences in the course, clinical presentation, diagnostics, and therapy of internal diseases in elderly 127. Complex geriatric examination 128. Geriatric frailty syndrome 129. Geriatric syndromes (except of frailty syndrome) 130. Sarcopenia in the elderly 131. Rational pharmacotherapy in elderly
OCCUPATIONAL DISEASES AND TOXICOLOGY
1. Occupational diseases, endangerment by occupational disease, list of occupational diseases, social-legal aspects, and compensation of occupational diseases 2. Occupational bronchial asthma and allergic rhinitis 3. Occupational extrinsic allergic alveolitis – acute and chronic form 4. Diseases caused by asbestos (malignant and non-malignant) 5. Silicosis 6. Coal-workers´ pneumoconiosis 7. Inhalation damage or the airways and lungs due to irritant gases and toxic chemicals: chlorine, nitrogen oxides, metal fume fewer 8. Intoxication with lead 9. Intoxication with mercury 10. Intoxication with pesticides (organophosphorus and carbamate insecticides, warfarin rodenticides) 11. Intoxication with methyl alcohol, ethylene glycol and ethyl alcohol 12. Intoxication with organic solvents (general features, gasoline, toluene, trichloroethylene, benzene, carbon tetrachloride) 13 Intoxication with carbon monoxide, hydrogen cyanide and cyanides. 14. Intoxication with methemoglobinizing agents (aniline, nitrobenzene, pharmaceuticals) 15. Intoxication with mushrooms (A. phalloides, A. pantherina, Psilocybe, Cortinarius orellanus) 16. Intoxication with pharmaceuticals (general management, poisoning with benzodiazepines, paracetamol, morphine, antidepressants) 17. First aid and treatment of acute poisonings – general measures, the importance of charcoal. Ingestion of acids and alkalis. Toxic household products. Poison Information Centers. 18. Damage due to ionizing radiation (acute radiation disease, dermatitis, cataract, fertility damage, tumors). Diagnostics, dose evaluation and treatment. 19. Occupational carcinogens (chemical and physical factors, IARC classification, diagnostic criteria for occupational cancer in the Czech Republic) 20. Diseases of nerves, vessels, and musculoskeletal system of upper extremities due to vibrations 21. Occupational diseases of nerves, tendons, bursae and joints due to long-lasting overload of extremities. Diagnostics, clinical and hygienic criteria. 22. Occupational diseases of the skin – allergic and non-allergic; diagnostics. 23. Noise-induced occupational hearing loss
DIFFERENTIAL DIAGNOSTICS:
1. Differential diagnostics of chest pain 2. Differential diagnostics of syncope 3. Differential diagnostics of hypertension 4. Differential diagnostics of systolic heart murmurs 5. Differential diagnostics of diastolic heart murmurs 6. Differential diagnostics of hematuria 7. Differential diagnostics of proteinuria 8. Differential diagnostics of limb edemas 9. Differential diagnostics of dehydration 10. Differential diagnostics of dyspnea 11. Differential diagnostics of cough 12. Differential diagnostics of hemoptysis 13. Differential diagnostics of interstitial lung processes 14. Differential diagnostics of pleural effusions 15. Differential diagnostics of disease with bronchial obstruction 16. Differential diagnostics of loss of consciousness 17. Differential diagnostics of dyslipidemias 18. Differential diagnostics of anemias 19. Differential diagnostics of hepatosplenomegaly 20. Differential diagnostics of lymphadenopathies 21. Differential diagnostics of bleeding disorders 22. Differential diagnostics of abdominal pain 23. Differential diagnostics of vomiting 24. Differential diagnostics of enterorrhagia 25. Differential diagnostics of jaundice 26. Differential diagnostics of focal liver processes 27. Differential diagnostics of bowel inflammations 28. Differential diagnostics of ascites 29. Differential diagnostics of fever 30. Differential diagnostics of joint pain 31. Differential diagnostics of pain in the extremities 32. Differential diagnostics of hypoglycemia 33. Differential diagnostics of ileus 34. Differential diagnostics of left-sided heart failure 35. Differential diagnostics of right-sided heart failure 36. Differential diagnostics of pulmonary hypertension 37. Differential diagnostics of pericardial effusion 38. Differential diagnostics of unexpected body weight change 39. Differential diagnostics of localized pulmonary lesions 40. Differential diagnostics of diarrhea
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Last update: Dita Strnadová (10.01.2024)
Syllabus of 2-week specialized lectures and clinical practicals: 1/ Occupational diseases and toxicology Lectures and clinical practice in the subject of professional diseases take place at the Clinic of Professional diseases of 1st Faculty of Medicine, Charles University, Na Bojišti 1, Prague 2 – lecture hall on the ground floor – 8.00–12.00 a.m. every day. Phone Nr.: secretary 22496 4537.
1. Occupational diseases. List of occupational disease, law, definition, etiopathogenesis, clinical presentation, diagnostics, and therapy. 2. The most frequent occupational diseases in Czech Republic 3. Preventive measures. Entrance and preventive examinations. 4. Occupational skin diseases. Definition, etiopathogenesis, clinical presentation, diagnostics, and therapy. 5. Disorders due to vibrations. Definition, etiopathogenesis, clinical presentation, diagnostics, and therapy. 6. Disorders due to overload. Definition, etiopathogenesis, clinical presentation, diagnostics, and therapy. 7. Disorders due to ionizing radiation. Definition, etiopathogenesis, clinical presentation, diagnostics, and therapy. 8. Occupational diseases of respiratory tract. Definition, etiopathogenesis, clinical presentation, diagnostics, and therapy: allergic occupational diseases (allergic rhinitis, asthma bronchiale), occupat. interstitial fibrosis, silicosis, diseases due to asbestos inhalation, acute respiratory injury. 9. Intoxication. Definition, etiopathogenesis, clinical presentation, diagnostics, and therapy: organic solvents, metals, pesticides, CO, poisonings with pharms and mushrooms, injury caused by corrosives. First aid.
10. Occupational cancer. Definition, etiopathogenesis, clinical presentation, diagnostics, and therapy. 2/ Pulmology:
Training in pulmonology takes place at the Pneumological Clinic of Faculty Hospital Motol. Students shall meet on the ground floor of this building at 8.00 a.m. Phone Nr: secretary 22443 6601. 1. Occupational allergic diseases. Definition, etiopathogenesis, clinical presentation, diagnostics, and therapy. Allergic alveolitis, asthma, rhinitis.
2. Occupational interstitial fibrosis. Definition, etiopathogenesis, clinical presentation, diagnostics, and therapy. 3. Lung transplantation. History, indications, diagnostic and therapeutical measures in patients underwent lung transplantation.
4. Extrapulmonary tuberculosis. Definition, etiopathogenesis, clinical presentation, diagnostics, and therapy.
5. Respiratory injury. Definition, etiopathogenesis, clinical presentation, diagnostics, and therapy. 3/ Nephrology Training in nephrology takes place in Internal Clinic of Teaching Hospital Motol. Phone Nr. secretary 22443 4001. Students are informed about new diagnostic and therapeutical methods in nephrology. Acute and chronic kidney failure, nephrolithiasis, elimination methods, kidney transplantation. 4/ Diabetology Clinical practice in diabetology takes place in IKEM (Institute for Clinical and Experimental Medicine) at Vídeňská 1958/9 , Prague 4. Students shall meet at the reception of this building at 9.00 a.m. and call secretary, line 4100 (phone nr. 25136 4100).
Students are informed about new diagnostic and therapeutical methods in diabetology. Type 1 and 2 diabetes, diabetic foot syndrome, diabetic neuropathy, nephropathy, retinopathy, transplantation in diabetic patients. 5/ ECG practicals The lecture is run in library of Internal clinic. 6/ Differential diagnostics. The lecture is run in library of Internal clinic.
Head supervisor of teaching of Internal Medicine III is: prof. MUDr. Keil Radan, Ph. D.
Responsible person: MUDr. Pavlína Piťhová, Ph.D., tel. 22443 4014, 4067
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