Клиническая фармакология
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96
1 курс
📅 13 мая 2026
👀 9
1
A 29-year-old woman. Secondary amenorrhea for 8 months. BMI — 18. Stress, intense training. FSH ↓, LH ↓, estradiol ↓, prolactin — normal. The MOST likely diagnosis:2
A 38-year-old woman complains of heavy and prolonged menstruation for 6 months and reports weakness. Ultrasound shows endometrial thickness of 16 mm with heterogeneous structure. Pregnancy is excluded. Which diagnostic method is MOST appropriate to clarify the nature of endometrial pathology?3
A 16-year-old girl is evaluated for primary amenorrhea. Findings: sex chromatin absent, karyotype 46,XY (male karyotype). Which of the following preliminary diagnoses is MOST likely?4
A 25-year-old woman presents with severe lower abdominal pain, weakness, and dizziness. Blood pressure is 90/60 mmHg, pulse rate is 110 bpm. Pelvic ultrasound shows a significant amount of free fluid in the abdominal cavity. Ovarian apoplexy with intra-abdominal bleeding is suspected. What is the most appropriate management?5
A 47-year-old woman undergoes a preventive examination. She has no complaints. Her periods are irregular. Her body mass index is 28 kg/m². Which of the following is the MOST mandatory part of a preventive examination for a woman 45+?6
The 2nd observation group in gynecology includes women:7
A 26-year-old woman presents with pain in the left labium majus, swelling, and fever up to 38°C. On examination: hyperemia and a painful, round mass measuring 3 cm in the lower third of the labium majus; fluctuation is positive. What is the most likely diagnosis?8
A patient with acute PID. Antibiotics for 72 hours without effect. Ultrasound: tubo-ovarian abscess 7 cm. Next step:9
A 27-year-old female patient presented to an antenatal clinic complaining of a three-year infertility. She is married. Menstruation is irregular, occurring every 34-45 days, lasting 4-5 days, and is moderate. Bimanual examination reveals no abnormalities. Basal thermometry is monophasic (36.2-36.6°C). What is the MOST appropriate scope of evaluation?10
A 29-year-old female patient complains of irregular menstruation with delays of up to 9 months and secondary infertility for 7 years. She has a history of one birth. Objectively: obesity grade II, developed after childbirth; normosthenic body type; secondary sexual characteristics are normal. CT scan of the brain revealed a pituitary microadenoma. Which investigation is MOST appropriate as the first step?11
A 42-year-old woman was brought by ambulance with complaints of heavy bloody discharge from the genital tract, general weakness. Over the past year notes heavy prolonged menstruation. This bleeding from the first day of expected menstruation lasts for 16 days. Vaginally: cervix cylindrical, os closed. Uterus enlarged to 8–9 weeks of pregnancy, dense, mobile, painless, smooth. Appendages not palpable. Fornices deep. The MOST likely diagnosis:12
Which indicator most objectively reflects the quality of antenatal care provided by a women’s health clinic?13
A 47-year-old woman. Complaints of heavy menstruation and a feeling of pressure in the pelvis. Ultrasound: uterus enlarged to 12 weeks, myometrium heterogeneous, no clear capsule of the nodes, diffuse thickening of the posterior wall. The MOST likely diagnosis:14
A 36-year-old patient. Secondary infertility for 6 years. Menstruation is regular, painful. Pain intensifies before menstruation and during defecation. Ultrasound shows ovarian cysts with fine-dispersed content, fixed. The uterus has limited mobility. The most likely leading pathogenetic mechanism of the disease:15
A 30-year-old patient, ovulatory menstrual cycle, complains of rusty-brown discharge 3 days before menstruation. Type of menstrual cycle disorder:16
A 6-year-old girl presents with early breast development and the appearance of pubic hair. Growth is accelerated. Menstruation has not occurred. Hormonal evaluation reveals elevated LH and FSH levels, while estrogen levels are within the normal range. What is the most likely type of precocious puberty?17
A 37-year-old patient presents with periodic severe deterioration of well-being, including depression, fatigue, and joint pain. She also reports cramping abdominal pain, edema of the face, hands, and legs, and frequent urination. One year ago, she underwent total oophorectomy. What is the MOST appropriate treatment strategy?18
A 49-year-old woman presented with complaints of itching, swelling and redness of the external genitalia, dryness and decreased sensitivity of the clitoris, labia majora and vaginal introitus. History: frequent inflammatory diseases of the uterine appendages. Menopause for 2 years. On examination: scratch marks, microcracks of the vulva, skin dry, wrinkled, thickening in the vulvar area of yellow color, vulvar folds wrinkled. Histology result — hyperplastic dystrophy without atypia. The MOST likely diagnosis:19
Patient N., 30 years old, presented to a women’s clinic with complaints of severe itching, burning, watery foamy vaginal discharge. From history: unprotected casual sexual contact one week ago. On speculum examination: hyperemia, edema of the vagina, discharge watery, foamy. Your preliminary diagnosis:20
A 35-year-old married woman with three children is under follow-up for varicose veins of the lower extremities. Her mother had a stroke at age 52. Which contraceptive method is MOST contraindicated?