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Free Practice Questions for Russia Primary Medical Accreditation — General Medicine

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Key Facts: Russia Primary Medical Accreditation — General Medicine Exam

80 Questions

Testing stage length

Methodological Center (fmza.ru)

60 Minutes

Testing time limit

Methodological Center (fmza.ru)

70%

Pass mark for each stage

Minzdrav Order No. 709n

3 Stages

Testing, OSCE stations, situational tasks

Minzdrav Order No. 709n

No Fee

Accreditation is free of charge

Minzdrav Russia

Primary accreditation in «Лечебное дело» has three pass/fail stages under Minzdrav Order No. 709n: 80 test items in 60 minutes (pass ≥70%), 5 OSCE stations (≥70% on each) and 2 situational tasks of 12 questions (≥70%). It is free and held in Russian.

Sample Russia Primary Medical Accreditation — General Medicine Practice Questions

Try these sample questions to review concepts for the Russia Primary Medical Accreditation — General Medicine exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 105+ question experience with AI tutoring.

1A 54-year-old male with newly diagnosed essential arterial hypertension (stage II, grade 2, high cardiovascular risk) has an office blood pressure of 165/102 mmHg. According to current Russian clinical guidelines, what is the recommended initial antihypertensive pharmacotherapy?
A.Monotherapy with a thiazide-like diuretic, titrated to the maximum dose before adding anything else
B.Monotherapy with a long-acting dihydropyridine calcium channel blocker, adding a second drug after 3 months
C.A single-pill combination of an ACE inhibitor or ARB with a calcium channel blocker or a thiazide-like diuretic
D.Triple therapy with an ACE inhibitor, a beta-blocker and a loop diuretic from the first visit
Explanation: The Russian clinical guidelines on arterial hypertension in adults (Russian Society of Cardiology, 2024) recommend starting most patients on a two-drug combination, preferably as a single pill: a RAAS blocker (ACE inhibitor or ARB) plus a calcium channel blocker or a thiazide/thiazide-like diuretic such as indapamide. Monotherapy is reserved for low-risk grade 1 hypertension, patients aged 80 or older and frail patients. A man with grade 2 hypertension and high cardiovascular risk therefore starts on a combination.
2What is the primary target blood pressure level for a 48-year-old patient with uncomplicated arterial hypertension, provided that the medication is well tolerated, according to Russian clinical guidelines?
A.<140/90 mmHg, without any further reduction
B.<130/80 mmHg, but not lower than 120/70 mmHg
C.<120/70 mmHg, aiming as low as tolerated
D.<150/90 mmHg for all working-age adults
Explanation: Russian clinical guidelines (2024) set <140/90 mmHg as the first target for all treated patients and, if treatment is well tolerated, <130/80 mmHg. For patients under 65 the systolic target is 120–130 mmHg, and diastolic pressure is lowered to 70–79 mmHg in all patients. Pressures below about 120/70 mmHg are not pursued because of the risk of hypoperfusion (the J-curve).
3A 62-year-old male with chronic heart failure and reduced ejection fraction (HFrEF, LVEF 32%, NYHA class II) is already receiving optimal doses of an ACE inhibitor, bisoprolol, and eplerenone. He remains mildly symptomatic. Which class of medication should be added to complete foundational guideline-directed medical therapy?
A.A loop diuretic at a fixed high dose despite no signs of congestion
B.Immediate-release nifedipine to unload the left ventricle
C.Ivabradine, regardless of the rhythm or resting heart rate
D.An SGLT2 inhibitor such as dapagliflozin or empagliflozin
Explanation: Modern clinical guidelines for HFrEF (both Russian Society of Cardiology and international ESC guidelines) mandate 'quadruple foundational therapy': an ARNI or ACEi, an evidence-based beta-blocker, a mineralocorticoid receptor antagonist (MRA), and an SGLT2 inhibitor (dapagliflozin or empagliflozin). SGLT2 inhibitors significantly reduce cardiovascular death and heart failure hospitalizations regardless of diabetes status.
4Which electrocardiographic pattern is diagnostic of an acute transmural ST-segment elevation myocardial infarction (STEMI) of the anterior left ventricular wall?
A.ST elevation in V1–V4 with reciprocal ST depression in III and aVF
B.Horizontal ST depression of 1 mm in V5–V6 with flattened T waves
C.Diffuse concave ST elevation in most leads with PR-segment depression
D.A short PR interval with a delta wave in leads II, III and aVF
Explanation: Anterior STEMI shows new ST elevation in contiguous anterior precordial leads (V1–V4), reflecting occlusion of the left anterior descending artery, often with reciprocal ST depression in the inferior leads. Under the universal definition of myocardial infarction, the threshold in V2–V3 is ≥2 mm in men aged 40 or older, ≥2.5 mm in men under 40 and ≥1.5 mm in women, and ≥1 mm in the other leads.
5A 58-year-old patient with paroxysmal non-valvular atrial fibrillation has a history of hypertension, type 2 diabetes mellitus, and a prior ischemic stroke 2 years ago. According to the CHA2DS2-VASc risk score, what is the patient's score and recommended stroke prevention strategy?
A.Score 2; aspirin 75–100 mg daily is sufficient
B.Score 3; anticoagulate only if the score rises above 4
C.Score 4; long-term oral anticoagulation, preferably a DOAC
D.Score 4; aspirin plus clopidogrel instead of an anticoagulant
Explanation: In CHA2DS2-VASc scoring: Prior stroke/TIA gives 2 points; Hypertension gives 1 point; Diabetes mellitus gives 1 point; Age 58 is <65 (0 points). Total score is 4 (high risk). In males with score ≥2 (females ≥3), oral anticoagulation is strongly recommended (Class I, Level A). Direct oral anticoagulants (apixaban, rivaroxaban, dabigatran) are preferred over vitamin K antagonists. Antiplatelet monotherapy (aspirin) is ineffective for stroke prevention in AF and is not recommended.
6A 42-year-old previously healthy female presents to the outpatient clinic with productive cough, fever of 38.6°C, pleuritic right-sided chest pain, and localized crackles at the right lung base. Chest radiograph confirms right lower lobe consolidation. Her respiratory rate is 18/min, BP is 120/78 mmHg, and she is fully oriented (CURB-65 = 0). What is the first-line empirical antibiotic treatment?
A.Oral ciprofloxacin
B.Oral levofloxacin as the routine first choice
C.Intravenous ceftriaxone in a day hospital
D.Oral amoxicillin
Explanation: According to Russian Clinical Guidelines for Community-Acquired Pneumonia (Minzdrav Russia / Russian Respiratory Society), previously healthy outpatients under 65 years with mild pneumonia (CURB-65 = 0) and without risk factors for resistant pathogens should receive oral amoxicillin as first-line monotherapy, targeting Streptococcus pneumoniae. In patients with significant comorbidities or recent antibiotic use, amoxicillin/clavulanate is preferred.
7Which spirometric criterion confirms persistent, non-fully reversible airflow limitation diagnostic of Chronic Obstructive Pulmonary Disease (COPD)?
A.Post-bronchodilator FEV1 increase of more than 12% and 200 mL
B.Post-bronchodilator FEV1/FVC ratio below 0.70
C.Reduced FVC with a normal or high FEV1/FVC ratio
D.Peak expiratory flow variability above 20% over two weeks
Explanation: Per GOLD guidelines and Russian respiratory guidelines, a post-bronchodilator fixed ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) less than 0.70 (or below the lower limit of normal) in a clinical context of dyspnea, chronic cough, and tobacco exposure confirms persistent airflow limitation diagnostic of COPD.
8A 28-year-old female presents with recurrent episodes of nocturnal wheezing, chest tightness, and dry cough provoked by cold air. Spirometry shows FEV1 of 72% predicted, which increases by 16% (and 260 mL) 15 minutes after inhaling 400 mcg of salbutamol. What is the diagnosis and recommended initial controller therapy per GINA / Russian guidelines?
A.Bronchial asthma; low-dose inhaled corticosteroid–formoterol
B.COPD; long-acting muscarinic antagonist monotherapy
C.Bronchial asthma; as-needed salbutamol alone
D.Acute bronchitis; a 5-day course of azithromycin
Explanation: A significant bronchodilator response (FEV1 increase ≥12% and ≥200 mL) combined with episodic wheezing and nocturnal symptoms confirms the diagnosis of bronchial asthma. Modern guidelines (GINA Track 1 and Russian clinical guidelines) recommend low-dose ICS-formoterol as the preferred controller and reliever strategy (SMART/MART) to prevent severe exacerbations from the earliest treatment steps, avoiding SABA-only monotherapy.
9A 45-year-old male with confirmed Helicobacter pylori-positive duodenal ulcer disease has no known drug allergies. What is the standard first-line eradication regimen recommended by Russian gastroenterology guidelines (based on the Maastricht VI consensus)?
A.PPI monotherapy for 4–8 weeks, then on-demand antacids
B.Amoxicillin plus metronidazole for 5 days without acid suppression
C.A PPI with levofloxacin and amoxicillin as routine first-line therapy for 7 days
D.A PPI, amoxicillin, clarithromycin and bismuth for 14 days
Explanation: Russian Gastroenterological Association guidelines, which draw on the Maastricht VI consensus, give 14-day first-line regimens: standard triple therapy (PPI + clarithromycin + amoxicillin), the same triple therapy with bismuth tripotassium dicitrate added, or classic bismuth quadruple therapy (PPI + bismuth + metronidazole + tetracycline). Of the options offered, only the bismuth-enhanced triple regimen is a recommended first-line choice. Adding bismuth helps overcome clarithromycin resistance.
10A 52-year-old patient with alcoholic liver cirrhosis presents with mild ascites and confusion. Laboratory evaluation demonstrates: total serum bilirubin 48 µmol/L, serum albumin 26 g/L, and INR 1.9. Which scoring system is officially used to classify the clinical severity and prognosis of cirrhosis based on these parameters plus ascites and encephalopathy?
A.MELD (Model for End-Stage Liver Disease) score
B.Ranson criteria
C.Child–Pugh score
D.Glasgow–Blatchford score
Explanation: The Child-Pugh classification grades the severity of cirrhosis into classes A, B, or C using five parameters: total bilirubin, serum albumin, INR (or prothrombin time), severity of ascites, and degree of hepatic encephalopathy. Each is scored 1 to 3 points, with class A (5–6 points), class B (7–9 points), and class C (10–15 points).

About the Russia Primary Medical Accreditation — General Medicine Exam

Free independent practice by OpenExamPrep for Russia's primary accreditation in General Medicine (первичная аккредитация по специальности «Лечебное дело»). Graduates of 31.05.01 programmes must pass it under Minzdrav Order No. 709n to work as doctors, for example as a district therapist, or to enter residency. Questions cover internal medicine, emergency care, surgery, obstetrics, pediatrics, infectious diseases, prevention and Russian healthcare law. The real accreditation is taken in Russian and also includes OSCE stations and situational tasks. This bank is an English-language MCQ study adaptation, not an official translation or a simulation of those stages, and is not affiliated with Minzdrav or fmza.ru.

Exam sponsor: Accreditation commissions of the Ministry of Health of the Russian Federation (Минздрав России), supported by the Federal Accreditation Centers (ФАЦ) and the Methodological Center for Accreditation of Specialists (fmza.ru). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Stage 1: computer testing with 80 items in 60 minutes; pass ≥70%. Stage 2: 5 OSCE stations, 10 minutes each; pass ≥70% on every station. Stage 3: 2 computer-based situational tasks, 12 questions each and 30 minutes per task; pass ≥70% of answers. Each stage is pass/fail and must be passed before the next.

Time Limit

60 minutes (testing stage)

Passing Score

70% per stage

Exam / Certification Fees

No fee (free of charge)

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

Not published

Internal Medicine & Outpatient Therapy

Cardiology (hypertension, coronary disease, heart failure, arrhythmias), pulmonology (pneumonia, COPD, asthma), gastroenterology, nephrology, endocrinology, rheumatology and haematology in primary care.

Not published

Emergency Medical Aid & Resuscitation

Adult basic life support and airway obstruction, shockable rhythms, anaphylaxis, acute coronary syndromes, pulmonary oedema, hypertensive emergencies, comas, poisonings and environmental emergencies.

Not published

General Surgery & Traumatology

Acute abdomen (appendicitis, cholecystitis, pancreatitis, perforated ulcer, obstruction, strangulated hernia), gastrointestinal bleeding, trauma, burns, transport immobilisation and chest injuries.

Not published

Obstetrics & Gynecology

Antenatal screening, gestational diabetes, preeclampsia and eclampsia, HELLP, postpartum haemorrhage, ectopic pregnancy, ovarian torsion and pelvic inflammatory disease.

Not published

Pediatrics & Neonatology

Apgar scoring, neonatal resuscitation, infant feeding, rickets prophylaxis, croup, bronchiolitis, dehydration, febrile seizures and the Russian National Immunization Calendar (Order No. 1122n).

Not published

Infectious Diseases & Epidemiology

Viral hepatitis serology, HIV diagnosis (SanPiN 3.3686-21) and opportunistic infections, influenza, intestinal infections, cholera, tick-borne encephalitis, Lyme borreliosis and meningococcal infection.

Not published

Preventive Medicine & Dispanserization

Preventive medical examinations and dispanserization under Order No. 404n: frequency by age, cancer screening tests and health groups.

Not published

Healthcare Law, Medical Ethics & Pharmacovigilance

Federal Law No. 323-FZ (informed consent, medical secrecy, right to practise), certificates of incapacity for work (Order No. 1089n) and adverse-reaction reporting to Roszdravnadzor.

Preparing for the Russia Primary Medical Accreditation — General Medicine Exam

What You Need to Know

  • Passing score: 70% per stage
  • Assessment: Stage 1: computer testing with 80 items in 60 minutes; pass ≥70%. Stage 2: 5 OSCE stations, 10 minutes each; pass ≥70% on every station. Stage 3: 2 computer-based situational tasks, 12 questions each and 30 minutes per task; pass ≥70% of answers. Each stage is pass/fail and must be passed before the next.
  • Time limit: 60 minutes (testing stage)
  • Exam / certification fees: No fee (free of charge) Official sources

Using Our Practice Resources

  • Work through all 105 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
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Russia Primary Medical Accreditation — General Medicine: Suggested Study Strategy

1Master Russian National Clinical Guidelines (Клинические рекомендации Минздрава России) for hypertension, CAD, asthma, and pneumonia, which form the exact key criteria for test items.
2Memorize first-line emergency dosages: epinephrine (adrenaline) 0.3–0.5 mg IM into the anterolateral thigh for anaphylaxis; magnesium sulfate IV 4 g loading dose for severe preeclampsia/eclampsia.
3Review the 30:2 compression-to-ventilation ratio and 100–120 bpm rate for adult basic cardiopulmonary resuscitation (СЛР) per official resuscitation protocols.
4Understand the legal boundaries of Federal Law No. 323-FZ: exceptions to informed consent in emergencies, medical confidentiality rules (врачебная тайна), and the role of the medical commission (ВК).
5Know the Russian National Immunization Calendar (Order No. 1122n): hepatitis B within 24 hours of birth, BCG on days 3–7, DTP and polio from 3 months, and measles–rubella–mumps at 12 months with revaccination at 6 years.
6Practise the OSCE stations from the official station passports on fmza.ru. For example, the adult BLS checklist requires assessing breathing for 7–10 seconds before calling for help and starting 30:2 CPR.

Frequently Asked Questions

What is Russia's Primary Medical Accreditation in General Medicine?

It is the accreditation that graduates of a specialist degree in General Medicine (31.05.01 «Лечебное дело») must pass under Minzdrav Order No. 709n before practising. Passing gives the right to work in positions such as district therapist (врач-терапевт участковый). Passing is recorded in the unified state health information system (ЕГИСЗ), and the testing result is also used in admission to residency (ординатура).

What is the format, question count, and passing score of the testing stage?

The first stage is computer testing of 80 single-best-answer items with four options, compiled automatically from the unified assessment database maintained by the Methodological Center (fmza.ru). Candidates have 60 minutes. The stage is passed with at least 70% correct answers, that is, 56 or more of 80.

What are the three stages of the primary accreditation examination?

Under Order No. 709n the stages are taken in sequence, and each is pass/fail. (1) Testing: 80 items in 60 minutes, pass ≥70%. (2) Practical skills: 5 OSCE stations of 10 minutes each (adult basic life support, emergency care, intravenous injection, physical examination, and dispanserization or history-taking), with ≥70% needed on every station. (3) Situational tasks: 2 computer-based cases of 12 questions each, 30 minutes per case, pass ≥70% of answers.

Is there an examination fee for primary medical accreditation?

No. Minzdrav states that accreditation of specialists is conducted free of charge.

In what language is the official exam administered, and how does this practice bank differ?

The accreditation is conducted in Russian (Order No. 709n, para. 69) at accreditation centres. This bank is independent English-language practice: its four-option MCQs resemble the testing stage, but it is not an official translation. It also does not simulate the OSCE stations or situational tasks, which have to be practised separately, for example with the official station passports and rehearsal exam.