- •2.0 Нормальна анатомія
- •In course of laparotomy a surgeon revealed gangrenous lesion of descending colon. It was
- •2/3 Of his tongue. Which nerve must have been damaged?
- •Volume is 700 ml. What is the patient's dead space ventilation?
- •Is utilized in gluconeogenesis first of all in this case:
- •Victim has elbow joint trauma with avulsion of medial epicondyle of humerus. What nerve can be
- •Inflammation of the tympanic cavity (purulent otitis media) was complicated by inflammation of
- •It is necessary to take the cerebrospinal fluid from a patient with suspected inflammation of
- •Venous net and edema of the soft tissues of face, neck, upper part of the trunk and upper
- •Vegetative abnormalities in the sleep, heat regulation, all kinds of metabolism, diabetes insipidus
- •Injured?
- •Injury. The escaped blood will be assembled in the following anatomic formation:
- •In the specimen of one of the parts of respiratory system a tubular organ was found. It has low
- •Inserted?
- •It is necessary to press the carotid artery to the tubercle of a cervical vertebra. Which vertebra
- •Interventricular branch of the right coronary artery. What heart parts are affected?
- •In stomach). Examination revealed a tumour of initial part of duodenum. Specify localization of
- •Inflammatory process of modified subserous layer around cervix of the uterus caused an
- •Intensive pain syndrome. In what region of genitals does the pathological process take place?
- •In course of an operation surgeon removed a part of a lung that was ventilated by a tertiary
- •In case of a penetrating wound of the anterior abdominal wall the wound tract went above the
- •Induce such changes in the spine curvature?
- •Vessel surrounded by fascicles of brachial plexus. What artery is it?
- •Inferior mesenteric artery. What bowel segment is damaged?
- •In order to prevent massive haemorrhage in the region of oral cavity floor it is required to ligate
- •Inside the genu of internal capsule. What conduction tract is damaged?
- •Interaponeurotic suprasternal space. What anatomic structure localized in this space is
- •In course of a small pelvis operation it became necessary to ligate an ovarian artery. What
- •Isdamaged?
- •Vessels drain directly into the thoracic duct. Specify this organ:
- •Intestines was revealed. Whatsubstances that are created in the intestines can cause
- •Increased amount of free fat acids is observed in the blood of the patients with diabetes
- •In case of enterobiasis acrihine - the structural analogue of vitamin b2 - is administered.
- •Isolated from the same enzyme?
- •Insects have been found in his flat. Which of them may be a carrier of the pathogen of epidemic
- •Increased level of valine, isoleucine, leucine is in the blood and urine. Urine has specific smell.
- •Increased breaking of vessels, enamel and dentine destruction in scurvy patients are caused by
- •Increased production of thyroidal hormones t3 and t4, weight loss, tachycardia,
- •12 Hours after an accute attack of retrosternal pain a patient presented a jump of aspartate
- •Is tachycardia and smell of acetone from the mouth. Analysis results: blood glucose - 20,1
- •Is activated most of all with help of carnitine?
- •Injection of insulin. What is the result of biochemical blood analysis for concentration of the
- •Intestinal wall. What vitamin will stimulate this process?
- •Values level could be helpful in proving diagnosis?
- •Impairment. What is the probable cause of metabolic disorder?
- •Is the main pathogenetic mechanism of obesity?
- •Vitamin a together with specific cytoreceptors penetrates through the nuclear membranes,
- •Induces transcription processes that stimulate growth and differentiation of cells. This biological
- •In patients with the biliary tract obstruction the blood coagulation is inhibited; the patients have
- •In course of histidine catabolism a biogenic amin is formed that has powerful vasodilatating
- •Vitamin b1 deficiency results in disturbance of oxidative decarboxylation of
- •Index of pH of the blood changed and became 7,3 in the patient with diabetus mellitus. Detecting
- •In blood?
- •Vitamin:
- •47,Хху. Such phenomenon of cell inhomogeneity is called:
- •Isoleucine and their ketoderivatives in blood and urine. Urine smelt of maple syrup. This disease
- •Is characterized by the deficit of the following enzyme:
- •It was found out that some compounds, for instance fungi toxins and some antibiotics can inhibit
- •Inhibition. What substance is it?
- •In clinical practice tuberculosis is treated with izoniazid preparation - that is an antivitamin able
- •Irradiating to the neck. The pain arose 2 hours ago. Objectively: the patient’s condition is grave,
- •Inhibit the intermolecular tranfer of monocarbon groups, thus suppressing the synthesis of the
- •Inhibitor of the following enzyme:
- •Vitamin is one of cofactors of these enzymes?
- •Increased degradation. Which of the following compounds is the product of this process?
- •It is known that the monoamine oxidase (mao) enzyme plays an important part in the
- •1.0 Біологія
- •Inheritance?
- •It was proved that a molecule of immature mRna (precursor mRna) contained more triplets
- •16*109L, Platelets 450*109l Blood picture: anizocytosis, poikilocytosis, reticulocytes-
- •3,8%. What anemia does this patient have?
- •In mucousa moistening?
- •In some regions of South Africa there is a spread sickle-shaped cell anemia, in which
- •If strong oxidizers get into the bloodstream, a methemoglobin is formed. It is a compound, where
- •Iron (II) becomes iron (III). What has to be done to save the patient?
- •Investigation should be used for the exact diagnosis?
- •In the ovary specimen colored with hematoxylin-eosin, follicle is determined where
- •In the perianal folds of a 5-year-old girl her mother has found some white "worms" that caused
- •Itch and anxiety in the child. The "worms" were sent to the laboratory. During examination the
- •46 Chromosomes were revealed on karyotype examination of the 5-year-old girl. One of the
- •15Th pair of chromosomes is longer than usual due to connected chromosome from the 21 pair.
- •Intelligence quotient. Which karyotype corresponds with this disease?
- •It was revealed that t-lymphocytes were affected by hiv. Virus enzyme - reverse transcriptase
- •Into dna in mycobacteria?
- •It is known that the gene responsible for development of blood groups according to ab0 system
- •Variability form:
- •In course of practical training students studied a stained blood smear of a mouse with bacteria
- •Is diagnosed with hemolytic disease of newborn as a result of rhesus incompatibility. What
- •Invasive diseases can be transmitted by the dog if it is the source of invasion?
- •Inflammatory hyperemia and cutaneous edema. Histologic examination of tissue sampling from
- •46 Хy in some cells, but most cells have karyotype of Klinefelter's syndrome - 47 ххy. Such cell heterogenity is called:
- •Inheritance is it?
- •Insects up to 3 mm long on the child's clothing. Specify the parasite:
- •3.0 Гістологія
- •Volume of what elements is increased in this case?
- •In the blood of a 26-year-old man it was revealed 18% of erythrocytes of the spherical,
- •In the microspecimen of red bone marrow there were revealed multiple capillares through the
- •In a histological specimen parenchyma of an organ is represented by lymphoid tissue that forms
- •In course of an experiment a big number of stem cells of red bone marrow was in some way
- •Inhibited?
- •In course of indirect histogenesis of tubular bone tissue a plate is formed between epiphyseal
- •Infiltration. What is the most likely diagnosis?
- •Vitamin a deficit results in the impairment of twilight vision. Name the cells that have the
- •Is the most probable reason of their development?
- •In form of a saccule openining into the duct. How is this gland called according to the
- •In course of a conditional experiment the development of mesenchyma cells was completely
- •Inhibited. Development of the following muscular tissue will be disturbed:
- •8.0 Мікробіологія
- •It is planned to use the territory of an old cattle burial ground (which is not used for more than
- •50 Years) for building houses. But ground analysis revealed presence of the pathogen of the
- •Very dangerous illness. Which of the indicated microorgonisms is likely to remain in the ground
- •In a patient with clinical signs of immunodeficiency the number and functional activity of t and b
- •Immunocompetent cells was found during investigation on the molecule level. Defect of what
- •In order to speed up healing of a wound of oral mucosa a patient was prescribed a drug that is a
- •Is known that this protein is a factor of natural resistance of an organism. What is it called?
- •In this patient?
- •Is oxidase- and catalase-positive, ferments mannitol and synthesizes plasmocoagulase. What
- •Isolated. Their morphological, tinctorial, cultural and biochemical properties appeared to be
- •In order to determine toxigenicity of diphtheria bacilli a strip of filter paper impregnated with
- •In order to estimate toxigenity of diphtheria agents obtained from patients the cultures were
- •Inoculated on Petri dish with nutrient agar on either side of a filter paper strip that was put into
- •Introducted to a group of mice under examination; a control group of mice got the extract without
- •In the surgical department of a hospital there was an outbreak of hospital infection that showed
- •Itself in often postoperative wound abscesses. Bacteriological examination of pus revealed
- •Indicative of?
- •Vomiting matters of a patient suspected of having cholera were delivered to the bacteriological
- •Inoculum from pharynx of a patient ill with angina was inoculated into blood-tellurite agar. It
- •Important role in tuberculosis prevention. In this case the following vaccine is applied:
- •Inoculated into the following differential diagnostic medium:
- •Inoculated on the Endo agar, which resulted in growth of a large number of colorless colonies.
- •Vaccine must be given to prevent rabies?
- •7.0 Патологічна анатомія
- •Immunocomplex glomerulonephritis, ulcers on the edges of the aortic valves, covered with
- •Is plethoric, it is of yellowish-green color, soaked with purulent and fibrose exudate, it lookes like
- •Ventricle. Liver is enlarged, its surface is smooth, incision revealed that it was plethoric, with
- •6 Months after delivery a woman had uterine bleeding. Gynecological examination revealed in
- •Infiltration of appendix wall along with necrosis and defect of mucous membrane with affection of
- •Its muscle plate. What appendicitis form was developed?
- •48 Hours after performing tuberculin test (Mantoux test) to a child a 10 mm papule appeared on
- •Is hyperemic, edematic, its surface was covered with grey-and-green coats. Name the
- •Interstitial myocarditis. What diagnosis corresponds with the described picture?
- •Inflammation that affected the marrow, haversian canals and periosteum. Under the periosteum
- •Inflammation. What pathological process was described?
- •1 Mm thick closely adhering to the subjacent tissues. What pathological process are these
- •In the glomerules proliferation of capsule nephrothelium as well as of podocytes and phagocytes
- •Immature fibroblast-like cells with multiple mitosis, which grow through the muscles. What is the
- •Into the pulmonary parenchyma, acute abscesses and atelectases. Internal organs have
- •2 Days after labour a woman developed shock along with dic syndrome that caused her death.
- •2 Hours after a skeletal extension was performed to a 27 year old patient with multiple traumas
- •Vessel lumen. What complication of polytrauma was developed?
- •In course of severe respiratory viral infection there appeared clinical signs of progressing
- •Is the most probable diagnosis?
- •In the area of the right lung apex revealed a cavity 5 cm in diameter communicating with lumen
- •Infiltration composed of lymphocytes, epithelioid cells (mainly plasmocytes). What is the most
- •Interventricular septum. The dissector evaluated these changes as:
- •Its pattern due to the proliferation of epithelioid, lymphoid cells and macrophages having nuclei in
- •14 Days after quinsy a 15-year-old child presented with morning facial swelling, high blood
- •9.0 Фармакологія
- •In patient with marked peripheral edema. Increased amount of aldosterone is in the blood.
- •Indicate the medicine to be prescribed.
- •60 Microgram/kilogram of phenylin. Because of presentations of convulsive disorder
- •Insufficiency. What medicine should be prescribed first of all?
- •Indometacin. With what activity of the drug can this complication be connected?
- •Vomiting, diarrhea, bradycardia, hypotention, weakness, dehydration of the organism. What
- •Industry. What medicine should be used?
- •Introduction of a pharmaceutical substance to an experimental animal resulted in reduction of
- •Intense inhibition of central nervous system. What may it be connected with?
- •Irregularly taking antibiotics for an infectious disease. Examination of the child revealed incisor
- •Intake of an antianginal drug the pain behind the breast bone disappeared, but the patient
- •In tolerance to its effect, and this phenomenon is called:
- •Intestinal peristalsis and tonus of urinary bladder. What drug is it?
- •Vomiting that occurs all of a sudden. What medication should be prescribed?
- •Inhibition of consciousness and respiration. What preparation is antagonist of magnesium
- •In order to prevent cardiogenic shock?
- •Is a sulphonyl urease derivate of the second generation. It improves microcirculation and is
- •Impairment of psychic, somatic and vegetative functions. Name the syndrome of different
- •It was decided to potentiate fentanyl action with a neuroleptic. Which of the following
- •In order to accelerate healing of a radiation ulcer a vitamin drug was administered. What drug is it?
- •Intravenously with an antihypertensive drug - salt of an alkaline-earth metal. What drug was
- •Injected?
- •Isoniazid as a part of combination therapy. After some time, the patient reported of muscle
- •Vitamin preparation should be used to address these phenomena?
- •It is known that individuals with genetically caused deficiency of glucose-6-phosphate
- •In order to stimulate breathing in a child born with asphyxia, the doctor gave him a drug injection
- •Into the umbilical vein. What drug might have been injected?
- •6.0 Патологічна фізіологія
- •Vitamin deficiency can be the reason of this change:
- •Inflamation is characterised by increasing penetration of vessels of microcirculation stream,
- •Increasing of their fluid dynamic blood pressure. Increasing of the osmotic concentration and
- •In this case?
- •Interval from complex to complex; fallout of some ventricular complexes; р waves and qrst
- •Inheritance of this disease?
- •In result of the damage of one of the Atomic Power Plant reacttor the run-out of radioelements
- •Ventricle insufficiency. What is the most typical for this state?
- •In the blood 50mmol/l). What mechanism is prevalent in the development of the coma?
- •Irradiation doze of 500 roentgen. He complains of headache, nausea, dizziness. What changes
- •In leukocytes quantity can be expected 10 hours after irradiation?
- •Isosthenuria, proteinuria. What is the leading factor in the pathogenesis of these symptoms
- •Ventricular qrst complex is wide, r-wave is double-peak or two-phase. What form of
- •2 Years ago a patient underwent resection of pyloric part of stomach. He complains of
- •Inflammation of a patient's eye was accompanied by accumulation of turbid liquid with high
- •In diastole. What is the most probable mechanism of cardiac arrest in diastole?
- •Ventilation. What is the main mechanism of this disturbance?
- •37,9OC. Which of the following substances is the most likely cause of temperature rise?
- •Inflammation accompanied by hyperemia, infiltration and painfulness. What type of allergic
- •Violation of safety rules resulted in calomel intoxication. Two days later the daily diuresis was
- •620 Ml. A patient experienced headache, vomiting, convulsions, dyspnea, moist rales in lungs.
- •24 Hours after appendectomy blood of a patient presents neutrophilic leukocytosis with
- •Inflammatory processes cause synthesis of protein of acute phase in an organism. What
- •Intensification at the beginning of polyuria stage of acute renal insufficiency is caused by:
- •Insulin-dependant diabetes, the wife is healthy. What is the probability that this couple will have
- •1,50C higher than on the opposite intact side. What of the following is the most probable
- •Is 16*109/l. Leukocyte formula: basophils - 0, eosinophils - 2%, juvenile forms - 2%,
- •Insult to cells which contributes to the pathology development. What processes are stimulated by
- •In course of a preventive examination of a miner a doctor revealed changes of cardiovascular
- •Is reduction of the following index:
- •Infections for a long time. A month later the child's condition changed for the worse. Blood
- •7,18. These abnormalities were caused by the development of:
- •Insufficiency - limb edema, lymph node enlargement. What form of lymphatic circulation
- •Insufficiency is it?
- •3,2*109/L. What is the leading mechanism of leukopenia development?
- •In a grave condition. Respiration is characterized by prolonged convulsive inspiration followed
- •4.0 Нормальна фізіологія
- •In 6 hours temperature rapidly increased up to 400c with shiver. Muscle pains have
- •In the experiment on the animal the part of the cerebral cortex hemispheres was removed. It
- •Inhibition of alpha-motoneuron of the extensor muscles was noticed after stimulation of
- •Isolated muscle of a frog is rhythmically irritated with electric impulses. Every next impulse is in a
- •In course of an experiment a skeletal muscle is being stimulated by a series of electric impulses.
- •Intrapleural pressure is being measured in a person. In what phase has a person hold his breath
- •If the pressure is - 25 cm h2o?
- •Volume is 50 mL. What is the frequency of cardiac contraction?
- •In a healthy adult speed of the excitement conduction through the atrioventricular node is
- •Indices of the external respiration is much higher than in a state of rest?
- •In the small intestine cavity:
- •Inhabitants of territories with cold climate have high content of an adaptive thermoregulatory
- •Injected a medication for short-acting narcosis. 1 minute later the patient being under
- •In plasma was 40 g/l. What influence will be exerted on the transcapillary water exchange?
- •In course of an experiment a skeletal muscle is being stimulated by a series of electric impulses.
- •Vagus branches that innervate heart are being stimulated in course of an experiment. As a
- •If a man has an attack of bronchiospasm it is necessary to reduce the effect of vagus on
- •5,4 L, hematocrit makes up 50%, whole blood protein is 80 g/l. These blood characteristics are
- •In response to a change in body position from horizontal to vertical blood circulation system
- •Introduction of a big dose of histamine to an experimental animal caused abrupt drop of arterial
- •Vagus branches that innervate heart are being stimulated during an experiment. This caused
- •In course of an experiment a peripheral section of vagus of an expiremental animal is being
- •Voluntary breath-holding caused increase of respiration depth and frequency. The main factor
- •In course of an experiment a toad's right labyrinth was destroyed. It will cause amyotonia of the
- •Vagi of an experimental animal were cut on both sides. What respiration changes will be
- •Varnishes had a bronchospasm. This reflex was caused by irritation of the following receptors:
- •It was established that agglutination of the recipient’s blood erythrocytes had been caused by
- •In course of an experiment thalamocortical tracts of an animal were cut. What type of sensory
- •It has been experimentally proven that the excitation of the motor neurons of flexor muscles is
- •Information transmission to the motoneurons of the spinal cord through the following descending
- •78 Decreased blood supply to the organs causes hypoxia that activates fibroblasts function. Volume of what elements is increased in this case?
- •79 From the defecation of a 6-year-old ill child, who has artificial feeding, the intestinal bacillus with antigen structure 0-111 is excreted. What is the diagnosis?
- •102 On autopsy it was revealed: large (1-2 cm) brownish-red, easy crumbling formations covering ulcerative defects on the external surface of the aortic valve. What is the most likely diagnosis?
- •121 Due to cranial trauma the patient developed the symptoms: intention tremor, dysmetry, adiadochokinesis, dysarthria. What structure of the brain is injured?
- •126 Person has stable hr, not more than 40 bpm. What is the pacemaker of the heart rhythm in this person?
- •138 Where should the cathetor for evacuation of the lymph from the thoracic lymph duct be inserted?
- •10. Synthesis of phospholipids is disordered due to fat infiltration of liver. Indicate which of the presented substances can enhance the process of methylation during phospholipids synthesis?
- •21. A patient because of pathological process has thickened alveolar membrane. What will be reduced directly as a result this?
- •118. Genetic structure of eukaryote is "exon-intron-exon". This structure-functional organization of gene caused transcription peculiarities. What will be pro-I-rna according to the scheme?
- •121. Shock and signs of acute renal failure (arf) developed in the patient due to severe injury. What is the leading cause of development of arf in the case?
- •129. A patient with iron deficiency anemia has been treated at the in-patient hematological department of the regional children's hospital during 13 years. What hypoxia type does this patient have?
- •130. Decreased blood supply to the organs causes hypoxia that activates fibroblasts function. Volume of what elements is increased in this case?
- •157. A man in a quiet condition has increased activity of the muscles, responsible for the inspiration. What from the belowmentioned can cause this?
- •161. A child, suffering from pylorostenosis accompanied by frequent vomiting, developed signs of dehydration. What form of acid-base disbalance can develop in this case?
- •195. Where should the cathetor for evacuation of the lymph from the thoracic lymph duct be inserted?
- •198. A patient has a suspected pneumonia. In his sputum there were revealed grampositive diplococci, prolonged with the slightly pointed opposite ands. What microorganisms are revealed in the sputum?
- •199. A patient has tissue ischemia lower the knee joint, accompanied with "intermittent claudication". Which artery is occluded in this case?
- •26 Objective examination of a patient revealed: slender figure, big skull, highly developed frontal region of face, short extremities. What constitutional type is it characteristic for?
- •27 An isolated muscle of a frog is rhythmically irritated with electric impulses. Every next impulse is in a period of relaxation from the previus contraction. What contraction of the muscle occurs?
- •65 Necrosis focus appeared in the area of hyperemia and skin edema in few hours after burn. What mechanism strengthens destructive effect in the inflammation area?
- •77 A patient with diabetes mellitus experienced loss of consciousness and convulsions after injection of insulin. What is the result of biochemical blood analysis for concentration of the sugar?
- •79 Examination of a newborn boy's genitals revealed a cleft of urethra that opens on the inferior surface of his penis. What developmental anomaly is meant?
- •81 Decreased blood supply to the organs causes hypoxia that activates fibroblasts function. Volume of what elements is increased in this case?
- •108 A child has inhaled a button. Where is it likely to be?
- •109 Microscopic examination of the sputum of a patient with pneumonia occasionally revealed some larvae. Eosinophiles were detected on blood examination. What helminthiasis can be diagnosed?
- •110 Concentration of pyruvate is increased in the patient's blood, the most of which is excreted with urine. What avitaminosis has the patient?
- •116 A child has got galactosemia. Concentration of glucose in blood has not considerably changed. Deficiency of what enzyme caused this illness?
- •119 Diabetes mellitus causes ketosis as a result of activated oxidation of fatty acids. What disorders of acid-base equilibrium may be caused by excessive accumulation of ketone bodies in blood?
- •123 Cerebral trauma caused increase of ammonia formation. What aminoacid takes part in removal of ammonia from cerebral tissue?
- •136 Synthesis of phospholipids is disturbed as a result fatty infiltration of liver. Indicate which of the following substances can enhance the process of methylation during phospholipids synthesis?
- •156 While preparing a patient to the operation the heart chambers' pressure was measured. In one of them the pressure changed during one heart cycle from 0 to 120 mm Hg. What chamber of heart was it?
- •26 Objective examination of a patient revealed: slender figure, big skull, highly developed frontal region of face, short extremities. What constitutional type is it characteristic for?
- •27 An isolated muscle of a frog is rhythmically irritated with electric impulses. Every next impulse is in a period of relaxation from the previus contraction. What contraction of the muscle occurs?
- •65 Necrosis focus appeared in the area of hyperemia and skin edema in few hours after burn. What mechanism strengthens destructive effect in the inflammation area?
- •77 A patient with diabetes mellitus experienced loss of consciousness and convulsions after injection of insulin. What is the result of biochemical blood analysis for concentration of the sugar?
- •79 Examination of a newborn boy's genitals revealed a cleft of urethra that opens on the inferior surface of his penis. What developmental anomaly is meant?
- •81 Decreased blood supply to the organs causes hypoxia that activates fibroblasts function. Volume of what elements is increased in this case?
- •108 A child has inhaled a button. Where is it likely to be?
- •109 Microscopic examination of the sputum of a patient with pneumonia occasionally revealed some larvae. Eosinophiles were detected on blood examination. What helminthiasis can be diagnosed?
- •110 Concentration of pyruvate is increased in the patient's blood, the most of which is excreted with urine. What avitaminosis has the patient?
- •116 A child has got galactosemia. Concentration of glucose in blood has not considerably changed. Deficiency of what enzyme caused this illness?
- •119 Diabetes mellitus causes ketosis as a result of activated oxidation of fatty acids. What disorders of acid-base equilibrium may be caused by excessive accumulation of ketone bodies in blood?
- •123 Cerebral trauma caused increase of ammonia formation. What aminoacid takes part in removal of ammonia from cerebral tissue?
- •136 Synthesis of phospholipids is disturbed as a result fatty infiltration of liver. Indicate which of the following substances can enhance the process of methylation during phospholipids synthesis?
- •156 While preparing a patient to the operation the heart chambers' pressure was measured. In one of them the pressure changed during one heart cycle from 0 to 120 mm Hg. What chamber of heart was it?
- •11 After an immunoassay a child was diagnosed with immunodeficiency of humoral immunity. What is the reason for the primary immunodeficiency development in the child?
- •93 A weightlifter has a disruption of thoracic lymphatic duct as a result of lifting a weight. Choose the most likely site of injury:
- •95 A patient with massive burns developed acute renal insufficiency characterized by a significant and rapid deceleration of glomerular filtration. What is the mechanism of its development?
- •147 As a result of continuous starvation the glomerular filtration rate has increased by 20%. The most probable cause of the glomerular filtration alteration under the mentioned conditions is:
- •158 A child suffers from drug idiosyncrasy. What is the cause of such reaction?
- •173 Lung ventilation in a person is increased as a result of physical activity. Which of the following indices of the external respiration is much higher than in a state of rest?
- •174 A patient has been given high doses of hydrocortisone for a long time. This caused atrophy of one of the adrenal cortex zones. Which zone is it?
- •177 A victim of an accident has bleeding from the soft tissues anteriad the mandibular angle. Which vessel should be ligated for the bleeding arrest?
- •178 A coprological survey revealed light-colored feces containing drops of neutral fat. The most likely reason for this condition is the disorder of:
156 While preparing a patient to the operation the heart chambers' pressure was measured. In one of them the pressure changed during one heart cycle from 0 to 120 mm Hg. What chamber of heart was it?
A. Left ventricle
B. -
C. Right atrium
D. Right ventricle
E. Left atrium
157 A 10-year-old girl often experiences acute respiratory infections with multiple punctate haemorrages in the places of clothes friction. Hypovitaminosis of what vitamin has the girl?
A. В2
B. В6
C. В1
D. А
E. С
158 Analysis of amniotic fluid that was obtained as a result of amniocentesis (puncture of amniotic sac) revealed cells the nuclei of which contain sex chromatin (Barr's body). What can it be evidence of?
A. Development of male fetus
B. Genetic disorders of fetus development
C. Development of female fetus
D. Trisomy
E. Polyploidy
159 A 68-year-old woman can't move her upper and lower right extremities due to the stroke. Muscle tone of these extremities and their reflexes are increased. There are pathological reflexes. What form of paralysis is it?
A. Tetraplegia
B. Paraplegia
C. Dissociation
D. Monoplegia
E. Hemiplegia
160 A 17-year-old boy fell seriously ill, body temperature rose up to 38,50С, there is cough, rhinitis, lacrimation, nasal discharges. What kind of inflammation is it?
A. Fibrinous inflammation
B. Hemorrhagic inflammation
C. Suppurative inflammation
D. Catarrhal inflammation
E. Serous inflammation
161 Nowadays about 50 minor bases have been found in the t-RNA structure besides the main four nitrogenous bases. Choose the minor nitrogenous base:
A. Uracil
B. Dihydrouracil
C. Cytosine
D. Cysteine
E. Adenine
162 The energy inputs of a healthy man have been measured. In what state was the patient if his energy inputs were less than the main exchange?
A. Nervous exertion
B. Calmness
C. Rest
D. Easy work
E. Sleep
163 A patient, who suffers from congenital erythropoietic porphyria, has skin photosensitivity. The accumulation of what compound in the skin cells can cause it?
A. Coproporphyrinogen 3
B. Uroporphyrinogen 2
C. Uroporphyrinogen 1
D. Protoporphyrin
E. Heme
164 A woman with 0 (I) bllod group has born a child with AB blood group. This woman's husband has A blood group. What genetic interaction explains this phenomenon?
A. Recessive epistasis
B. Codominance
C. Polymery
D. Incomplete dominance
E. Complementation
165 The donor who didn't donate the blood for a long time was investigated with IFA method. Anti-HBs antibodies were revealed. What does positive result of IFA in this case mean?
A. Chronic hepatitis С
B. Previous hepatitis B
C. Acute hepatitis B
D. Acute hepatitis C
E. Chronic hepatitis В
166 The effect of electric current on the exitable cell caused depolarization of its membrane. Movement of what ions through the membrane caused depolarisation?
A. НСО3-
B. Na+
C. К+
D. Сl-
E. Са2+
167 A patient with clinical signs of immunodeficiency has no changes of the number and functional activity of T- and B- lymphocytes. Defect with disfunction of antigen-presentation to the immunocompetent cells was found during examinatio on the molecule level. Defect of what cells is the most probable?
A. Macrophages, monocytes
B. Т-lymphocytes, В-lymphocytes
C. NK-cells
D. Fibroblasts, Т-lymphocytes, В-lymphocytes
E. 0-lymphocytes
168 A patient with encephalopathy was admitted to the neurological in-patient department. There was revealed a correlation between increasing of encephalopathy and substances absorbed by the bloodstream from the intestines. What substances that are formed in the intestines can cause endotoxemia?
A. Butyrate
B. Ornithine
C. Acetacetate
D. Biotin
E. Indole
169 A 1-year-old child with symptoms of muscle involvement was admitted to the hospital. Examination revealed carnitine deficiency in his muscles. What process disturbance is the biochemical basis of this pathology?
A. Lactic acid utilization
B. Substrate phosphorylation
C. Transporting of fatty acids to mitochodrions
D. Actin and myosin synthesis
E. Regulation of Ca2+ level in mitochondrions
170 A 44-year-old woman complains of common weakness, heart pain, considerable increase of body weigt. Objectively: moon-like face, hirsutism, AP- 165/100 mm Hg, height - 164 cm, weight - 103 kg; fat is mostly accumulated in the region of neck, upper shoulder girdle, stomach. What is the main pathogenetic mechanism of obesity?
A. Decreased production of glucagon
B. Increased production of glucocorticoids
C. Increased production of mineralocorticoids
D. Increased production of insulin
E. Decreased production of thyroidal hormones
171 Examination of initial molecular structure revealed substitution of the glutamic acid by valine. What inherited pathology is it typical for?
A. Hemoglobinosis
B. Favism
C. Sickle-cell anemia
D. Thalassemia
E. Minkowsky-Shauffard disease
172 A patient with serious damage of muscular tissue was admitted to the traumatological department. What biochemical urine index will be increased in this case?
A. Glucose
B. Creatinine
C. Uric acid
D. Common lipids
E. Mineral salts
173 Increased fragility of vessels, enamel and dentine destruction resulting from scurvy are caused by disorder of collagen maturation. What stage of procollagen modification is disturbed under this avitaminosis?
A. Formation of polypeptide chains
B. Detaching of N-ended peptide
C. Hydroxylation of proline
D. Glycosylation of hydroxylysine residues
E. Removal of C-ended peptide from procollagen
174 After a serious viral infection a 3-year-old child has repeated vomiting, loss of consciousness, convulsions. Examination revealed hyperammoniemia. What may have caused changes of biochemical blood indices of this child?
A. Disorder of biogenic amines neutralization
B. Activated processes of aminoacids decarboxylation
C. Increased purtefaction of proteins in intestines
D. Disorder of ammonia neutralization in ornithinic cycle
E. Inhibited activity of transamination enzymes
175 When a patient with traumatic impairment of the brain was examined, it was discovered that he had stopped to distinguish displacement of an object on the skin. What part of the brain was damaged?
A. Occipital zone of the cortex
B. Posterior central gurus
C. Parietal zone of the cortex
D. Frontal central gurus
E. Frontal zone
176 A 7-year-old girl has signs of anemia. Laboratory examination revealed pyruvate kinase deficiency in erythrocytes. What process disturbance plays the main role in anemia development?
A. Tissue respiration
B. Peroxide decomposition
C. Anaerobic glycolysis
D. Aminoacids desamination
E. Oxidative phosphorylation
177 A pregnant woman had been having toxicosis with severe repeated vomiting for 24 hours. In the end of the day there appeared tetanic convulsions and fluid loss. What shift of acid-base state caused these changes?
A. Gaseous acidosis
B. Metabolic acidosis
C. Excretory alkalosis
D. Gaseous alkalosis
E. Excretory acidosis
178 A 55-year-old patient with continuing ventricular arrhythmias was admitted to the hospital. The patient is taking timolol drops for glaucoma, daily insulin injections for diabetes mellitus, and an ACE inhibitor for hypertension. You have decided to use phenytoin instead of procainamide. What is the reason?
A. The hypertensive effects of procainamide would aggravate the hypertension
B. The anticholinergic effect of procainamide would aggravate glaucoma
C. The cholinergic effects of procainamide would aggravate the diabetes
D. The local anesthetic effect of procainamide would aggravate the hypertension
E. The local anesthetic effect of procainamide would potentiate diabetes
179 A businessman came to India from South America. On examination the physician found that the patient was suffering from sleeping-sickness. What was the way of invasion?
A. After contact with sick dogs
B. As a result of mosquito's bites
C. Through dirty hands
D. As a result of bug's bites
E. With contaminated fruits and vegetables
180 A young man has a painlessl formation without marked borders in the soft tissues of his thigh. On the tissue bioptate the formation looks like flesh of fish and consists of immature fibroblast-like cells with multiple mitosis growing through the muscles. What is the most likely diagnosis?
A. Fibrosarcoma
B. Fibroma
C. Myoma
D. Myosarcoma
E. Cancer
181 A person has steady HR not exceeding 40 bpm. What is the pacemaker of this person's heart rhythm?
A. Atrioventricular node
B. His' bundle
C. Purkinje's fibers
D. Sinoatrial node
E. Branches of His' bundle
182 Live vaccine was injected into the human body. Increasing activity of what connective tissue cells can be expected?
A. Fibroblasts and labrocytes
B. Macrophages and fibroblasts
C. Pigmentocytes and pericytes
D. Plasmocytes and lymphocytes
E. Adipocytes and adventitious cells
183 RNA-polymerase B(II) is blocked due to amanitine poisoning (poison of death-cup). It disturbs:
A. Reverse transcription
B. Synthesis of m-RNA
C. Maturation of m-RNA
D. Synthesis of t-RNA
E. Primers synthesis
184 An isolated cell of human heart automatically generates excitation impulses with frequency 60 times pro minute. What structure does this cell belong to?
A. Ventricle
B. Atrioventricular node
C. His' bundle
D. Sinoatrial node
E. Atrium
185 Autopsy revealed that right lung is enlarged, solid, there are fibrin layers on the pleura. Lung tissue is light grey color on incision with muddy liqued exudates. What lung disease are these symptoms typical for?
A. Fibrosing alveolitis
B. Croupous pneumonia
C. Interstitial pneumonia
D. Bronchopneumonia
E. Pulmonary gangrene
186 Testosterone and it's analogs increase the mass of skeletal muscles that allows to use them for treatment of dystrophy. Due to interaction of the hormone with what cell substrate is this action caused?
A. Membrane receptors
B. Ribosomes
C. Nuclear receptors
D. Proteins-activators of transcription
E. Chromatin
187 An autopsy revealed large (1-2 cm) brownish-red, easy crumbling formations covering ulcerative defects on the external surface of the aortic valve. What is the most likely diagnosis?
A. Diffusive endocarditis
B. Recurrent warty endocarditis
C. Polypous-ulcerative endocarditis
D. Acute verrucous endocarditis
E. Fibroplastic endocarditis
188 A 50-year-old man has felt vague abdominal discomfort within past 4 months. Physical examination revealed no lymphadenopathy, and no abdominal masses or organomegaly at palpation. Bowel sounds are heard. An abdominal CT scan shows a 20 cm retroperitoneal soft tissue mass obscuring the left psoas muscle. A stool specimen tested for occult blood is negative. Which of the following neoplasms is this man most likely to have?
A. Lipoma
B. Adenocarcinoma
C. Hamartoma
D. Melanoma
E. Lymphoma
189 A patient had been taking glucocorticoids for a long time. When the preparation was withdrawn he developed the symptoms of disease aggravation, decreased blood pressure and weakness. What is the reason of this condition?
A. Sensibilization
B. Cumulation
C. Habituation
D. Appearance of adrenal insufficiency
E. Hyperproduction of ACTH
190 While shifting the gaze to the closely situated object the refracting power of eye's optical mediums will increase by 10 diopters. It results from changing of such eye structure:
A. Cornea
B. Muscle that dilatates pupil
C. Lens
D. Vitreous body
E. Liquid of the anterior chamber of eye
191 Parents with an ill child consulted an infectionist. They had been working in one of Asian countries for a long time. The child has sallow skin, loss of appetite, laxity, enlarged liver, spleen, peripheral lymph nodes. What protozoal illness can be suspected?
A. Amebiasis
B. Visceral leishmaniasis
C. Balantidiasis
D. Lambliasis
E. Toxoplasmosis
192 A person felt thirsty after staying under the conditions of hot weather for a long time. Signals of what receptors caused it first of all?
A. Osmoreceptors of hypothalamus
B. Baroreceptors of aortic arch
C. Glucoreceptors of hypothalamus
D. Osmoreceptors of liver
E. Sodium receptors of hypothalamus
193 Blood analysis of a patient showed signs of HIV infection (human immunodeficiency virus). Which cells does HIV-virus primarily affect?
A. Cells that contain receptor T4 (T-helpers)
B. Cells that contain receptor IgM (B-lymphocytes)
C. Specialized nervous cells (neurons)
D. Proliferating cells (stem hematoplastic cells)
E. Mast cells
194 Blood sampling for the haematology is recommended to carry out on an empty stomach and in the morning. What changes in blood formula are possible if blood sampling was carried out after food intake?
A. Increase of leukocyte number
B. Increase of erythrocyte number
C. Increase of plasm proteins
D. Decrease of erythrocyte number
E. Decrease of thrombocyte number
195 Part of the DNA chain turned 180 degree as a result of gamma radiation. What type of mutation took place in the DNA chain?
A. Inversion
B. Doubling
C. Replication
D. Translocation
E. Deletion
196 A patient has got a spasm of smooth muscles of bronchi. Activators of what membrane cytoreceptors are phisiologically reasoned to stop an attack?
A. в-adrenoreceptors
B. б- and в -аdrenoreceptors
C. Н-cholinoreceptors
D. б -аdrenoreceptors
E. М-cholinoreceptors
197 A patient with hypochromic anemia has splitting hair and loss of hair, increased nail brittling and taste alteration. What is the mechanism of the development of these symptoms?
A. Deficiency of vitamin А
B. Decreased production of parathyrin
C. Deficiency of iron-containing enzymes
D. Deficiency of vitamin В12
E. Decreased production of thyroid hormones
198 A 22-year-old patient was admitted to the hospital with complaints of heavy nasal breathing. During the examination of her nasal cavity the doctors found thickened mucous membrane, a lot of mucus and nodular infiltrates without erosions in the nose.The nasal rhinoscleroma was diagnosed. The biopsy was taken. What typical morphological changes may be found?
A. Granulomas with Langhan's cells
B. Granulomas with foreign body cells
C. Interstitial inflammation
D. Granulomas with Virchow's cells
E. Granulomas with Mikulicz's cells
199 The alternate usage of dichlotiazide, etacrin acid and lasex did not influence diuretically upon the patient with marked peripheral edemata. The aldosterone rate in the blood is increased. Indicate which medicine should be prescribed:
A. Urea
B. Amilorid
C. Spironolacton
D. Mannit
E. Clopamid
200 Slime, blood and protozoa 30-200 microns long have been revealed in a man's feces. The body is covered with cilias and has correct oval form with a little bit narrowed anterior and wide round shaped posterior end. At the anterior end a mouth is visible. In cytoplasm there are two nucleui and two short vacuoles. What are the described features typical for?
A. Lamblia
B. Balantidium
C. Trichomonas
D. Dysenteric amoeba
E. Intestinal amoeba
Kroc 1_ 2008
1. A human body cools in water much faster that in the air. What way of heat emission in water is much more efficient?
C. *Heat conduction
2. A driver who got a trauma in a road accident and is shocked has reduction of daily urinary output down to 300 ml. What is the main pathogenetic factor of such dieresis change?
A. *Drop of arterial pressure
3. Myocyte cytoplasm contains a big number of dissolved metabolites of glucose oxidation. Name one of them that turn directly into a lactate:
A. *Pyruvate
4. Continuous taking of some drugs foregoing the pregnancy increase the risk of giving birth to a child with genetic defects. What is this effect called?
A. *Mutagenic effect
5. A patient has yellow skin colour, dark urine, and dark-yellow feces. What substance will have strengthened concentration in the blood serum?
D. *Unconjugated bilirubin
6. Examination of an ovary specimen stained by hematoxylin-eosine revealed a follicle in which follicular epithelium consisted of 1-2 layers of cubic cells. There was also a bright red membrane around the ovocyte. What follicle is it?
E. *Primary
7. 2 hours after a skeletal extension was performed to a 27 year old patient with multiple traumas (closed injury of chest, closed fracture of right thigh) his condition abruptly became worse and the patient died from acute cardiopulmonary decompensation. Histological examination of pulmonary and cerebral vessels stained with Sudan III revealed orange drops occluding the vessel lumen. What complication of polytrauma was developed?
C. *Fat embolism
8. A patient complains of frequent diarrheas, especially after consumption of rich food, weight loss. Laboratory examination revealed steatorrhea; his feces were hypocholic. What might have caused such condition?
B. *Obturation of biliary tracts
9. A 12 year old child has intolerance to some foodstuffs. Their consumption causes an allergic reaction in form of itching skin eruptions. What antihistaminic drug should be admistered so that the child could attend school?
A. *Loratadine
10. Labelled amino acids alanine and tryptophane were injected to a mouse in order to study localization of protein synthesis in its cells. The labelled amino acids will be accumulated near the following
organellas:
B. *Ribosomes
11. As a result of prophylactic medical examination a 7 year old boy was diagnosed with Lesch-Nyhan syndrome (only boys’ fall ill with it). The boy's parents are healthy but his grandfather by his mother's side suffers from the same disease. What type of disease inheritance is it?
B. *Recessive, sex-linked
12. A patient ill with chronic cardiac insufficiency was prescribed an average therapeutic dose of digoxin. Two weeks after begin of its taking there appeared symptoms of drug intoxication (bradycardia, extrasystole, nausea). Name the phenomenon that caused accumulation of the drug in the organism?
A. *Material cumulation
13. Bacterioscopic examination of a smear from the pharynx of a diphtheria suspect revealed bacilli with volutine granules. What etiotropic drug should be chosen in this case?
B. *Antidiphtheritic antitoxic serum
14. A culture of monkey cells (Vero) and a group of mouse sucklings were infected with an inoculum taken from a child with provisional diagnosis "enterovirus infection". There was no cytopathic effect on the cell culture but mouse sucklings died. What enteric viruses might have caused disease of this child?
B. *Coxsackie A
15. A patient ill with neurodermatitis has been taking prednisolone for a long time. Examination revealed high rate of sugar in his blood. This complication is caused by the drug influence upon the following link of carbohydrate metabolism:
C. *Gluconeogenesis activation
16. A man with a stab wound in the area of quadrilateral foramen applied to a doctor. Examination revealed that the patient was unable to draw his arm aside from his body. What nerve is most probably damaged?
A. *N.axillaris
17. Ultramicroscopical examination of "dark" hepatocyte population in the cell cytoplasm detected a developed granular endoplasmic reticulum. What function has this organella in these cells?
E. *Synthesis of blood plasma proteins
18. A 17 year old boy fell seriously ill, the body temperature rose up to 38, 5°C, there appeared cough, rhinitis, lacrimation, nasal discharges. What inflammation is it?
D. *Catarrhal
19. Researchers isolated 5 isoenzymic forms of lactate dehydrogenase from the human blood serum and studied their properties. What property indicates that the isoenzymic forms were isolated from the same enzyme?
E. *Catalyzation of the same reaction
20. A 60 year old patient has impaired perception of high-frequency sounds. These changes were caused by damage of the following auditory analyzer structures:
B. *Main cochlea membrane near the oval window
21. ECG of a patient with hyperfunction of thyroid gland showed heart hurry It is indicated by depression of the following ECG element:
B. *R - R interval
22. A patient taking clonidine for essential hypertension treatment was using alcohol that caused intense inhibition of central nervous system. What may it be connected with?
D. *Effect potentiating
23. A patient is ill with diabetes mellitus accompanied by hyperglycemia on an empty stomach (7, 2 millimole/1). The hyperglycemia rate can be retrospectively estimated (over the last 4-8 weeks before the examination) on the ground of the rate of the following blood plasma protein:
D. *Glycated hemoglobin
24. 6 months after labour a woman had uterine hemorrhage. Gynaecological examination of uterine cavity revealed a dark-red tissue with multiple cavities resembling of a "sponge". Microscopic examination of a tumour revealed in blood lacunas atypic light epithelial Langhans cells and giant cells of syncytiotrophoblast. What tumour is it?
D. *Chorioepithelioma
25. A 3 year old child with symptoms of stomatitis, gingivitis and dermatitis of open skin areas was delivered to a hospital. Examination revealed inherited disturbance of neutral amino acid transporting in the bowels. These symptoms were caused by the deficiency of the following vitamin:
A. *Niacin
26. A patient ill with essential hypertension was recommended a drug that prevents thrombosis. It is to be taken parenterally. What drug is it?
C. *Heparin
27. A 38 year old patient suffers from rheumatism in its active phase. What laboratory characteristic of blood serum is of diagnostic importance in case of this pathology?
C. *C-reactive protein
28. A 28 year old man had a gunshot wound of shin that resulted in an ulcer from the si de of the injury. What is the main factor of neurodystrophy pathogenesis in this case?
E. *Traumatization of peripheral nerve
29. A 26 year old man is in the torpid shock phase as a result of a car accident. In blood: 3,2 • 109/1. What is the leading mechanism of leukopenia development?
B. *Redistribution of leukocytes in bloodstream
30. Parents of a 3 year old child have been giving him antibiotics with purpose of preventing enteric infections for a long time. A month later the child's condition changed for the worse. Blood examination revealed apparent leukopenia and granulocytopenia. What is the most probable mechanism of blood changes?
B. *Myelotoxic
31. Examination of a 12 year old boy with developmental lag revealed achondroplasia: disproportional constitution with evident shortening of upper and lower limbs as a result of growth disorder of epiphyseal cartilages of long tubal bones. This disease is:
B. *Inherited, dominant
32. Hartnup disease is caused by point mutation of only one gene which results in disturbance of tryptophane absorption in the bowels and its resorption in the renal tubules. It is the reason for disorder of both digestive and urination systems. What genetic phenomenon is observed in this case?
C. *Pleiotropy
33. A 46 year old patient applied to a doctor complaining about joint pain that becomes stronger the day before weather changes. Blood examination revealed strengthened concentration of uric acid. The most probable cause of the disease is the intensified disintegration of the following substance:
D. *Adenosine monophosphate
34. A 28 year old patient had high arterial pressure, hematuria and facial edemata. In spite of treatment renal insufficiency was progressing. 6 months later the patient died from uremia. Microscopic examination of his kidneys and their glomerules revealed proliferation of capsule nephrothelium and of podocytes with "demilune" formation, sclerosis and hyalinosis of glomerules. What disease corresponds with the described picture?
B. *Subacute glomerulonephritis
35. A 35 year old man with a trauma of his left hand was admitted to the traumatology department. Objectively: cut wound of palmar surface of left hand; middle phalanxes of II-V fingers don't bend. What muscles are damaged?
E. *Superficial finger flexor
36. A 65 year old man suffering from gout complains of kidney pain. Ultrasound examination revealed renal calculi. The most probable cause of calculi formation is the strengthened concentration of the following substance:
A. *Uric acid
37. A patient with frequent attacks of stenocardia was prescribed sustak-forte to be taken one tablet twice a day. At first the effect was positive but on the second day stenocardia attacks resumed. What can explain inefficiency of the prescribed drug?
A. *Tachyphylaxis
38. An aged man had raise of arterial pressure under a stress. It was caused by activation of:
B. *Sympathoadrenal system
39. A cerebral trauma caused increased ammonia generation. What amino acid participates in the excretion of ammonia from the cerebral tissue?
A. *Glutamic
40. As a result of posttranslative modifications some proteins taking part in blood coagulation, particularly prothrombin, become capable of calcium binding. The following vitamin takes part in this process:
E. *K
41. A student takes notes of a lecture. Quality of his notes became significantly worse when his neighbours began talking. What type of conditional reflex inhibition was the cause of it?
C. *External
42. A 7 year old child is ill with bronchitis. It is necessary to administer him an antibacterial drug. What drug of fluoroquinolone group is CONTRA-INDICATED at this age?
A. *Cyprofloxacin
43. A patient is ill with hepatocirrhosis. State of antitoxic liver function can be characterized by examination of the following substance exreted by urine:
B. *Hippuric acid
44. A patient suffering from chronic cardiac insufficiency was recommended to undergo a prophylactic course of treatment with a cardiological drug from the group of cardiac glycosides that is to be taken enterally. What drug was recommended?
E. *Digoxin
45. 48 hours after tuberculine test (Mantoux test) a child had a papule 10 mm in diameter on the spot of tuberculine injection. What hypersensitivity mechanism underlies these changes?
D. *Cellular cytotoxicity
46. While palpating mammary gland of a patient a doctor revealed an induration in form of a node in the inferior medial quadrant. Metastases may extend to the following lymph nodes:
E. *Parasternal
47. A gynaecologist was examining a patient and revealed symptoms of genital tract inflammation. A smear from vagina contains pyriform protozoa with a spine, flagella at their front; there is also an undulating membrane. What disease can be suspected?
D. *Urogenital trichomoniasis
48. In course of an experiment a big number of stem cells of red bone marrow were in some way destructed. Regeneration of which cell populations in the loose connective tissue will be inhibited?
E. *Of macrophags
49. A pregnant woman had her blood group identified. Reaction of erythrocyte agglutination with standard serums of 0aβ (I), Bα (III) groups didn't proceed with standard serum of Aβ (II) group. The blood group under examination is:
A. *Aβ (II)
50. Prophylactic medical examination of a 36 year old driver revealed that his AP was 150/90 mm Hg. At the end of working day he usually hears ear noise, feels slight indisposition that passes after some rest. He was diagnosed with essential hypertension. What is the leading pathogenetic mechanism in this case?
A. *Neurogenetic
51. A histological specimen of spleen shows a vessel with a wall consisting of endothelium and subendothelial layer, median membrane is absent, exterior membrane inosculates with the layers of spleen connective tissue. What vessel is it?
E. *Vein of non-muscular type
52. It was revealed that T-lymphocytes were affected by HIV Virus enzyme - reverse transcriptase (RNA-dependent DNA polymerase) - catalyzes the synthesis of:
D. *DNA on the matrix of virus mRNA
53. Planned mass vaccination of all newborn 5-7 day old children against tuberulosis plays an important role in tuberculosis prevention. In this case the following vaccine is applied:
A. *BCG
54. Life cycle of a cell includes the process of DNA autoreduplication. As a result of it monochromatid chromosomes turn into bichromatid ones. What period of cell cycle does this phenomenon fall into?
D. *S
55. Rest potential of a cell equals —80 mV. At what stage of action potential did the membrane potential equal +30 mV?
C. *Reverse polarization
56. A patient with suspected diagnosis "progressing muscular dystrophy" got his urine tested. What compound will confirm this diagnosis if found in urine?
A. *Kreatine
57. While playing volleyball a sportsman made a jump and landed on the outside edge of his foot. He felt acute pain in the talocrural joint, active movements are limited, passive movements are unlimited but painful. A bit later there appeared a swelling in the area of external ankle; the skin became red and warm. What type of peripheral circulation disturbance is the case?
A. *Arterial hyperemia
58. Autopsy of a man who had been working as a miner for many years and died from cardiopulmonary decompensation revealed that his lungs were airless, sclerosed, their apexex had emphysematous changes, the lung surface was greyish-black, and the incised lung tissue was coal-black. What disease caused death?
C. *Anthracosis
59. Examination of a 55 year old woman revealed under the skin of submandibular area a movable slowly growing pasty formation with distinct borders 1, 0 x0,7 cm large. Histological examination revealed lipocytes that form segments of diffrent forms and sizes separated from each other by thin layers of connective tissue with vessels. What is the most probable diagnosis?
A. *Lipoma
60. A patient is 44 years old. Laboratory examination of his blood revealed that content of proteins in plasma was 40 g/1. What influence will be exerted on the transcapillary water exchange?
B. *Filtration will be increased, reabsorption - decreased
61. A 30 year old woman has face edemata. Examination revealed proteinuria (5, 87 g/1), hypoproteinemia, dysproteinemia, hyperlipidemia. What condition is the set of these symptoms typical for?
C. *Nephrotic syndrome
62. Vitamin B1 deficiency results in disturbance of oxidative decarboxylation of a-ketoglutaric acid. This will disturb synthesis of the following coenzyme:
D. *Thiamine pyrophosphate
63. Skin of a man who died from cardiac insufficiency has an eruption in form of spots and specks. There are also bedsores in the area of sacrum and spinous vertebral processes. Microscopical examination of CNS, skin, adrenal glands revealed in the vessels of microcirculatory bed and in small arteries destructiveproliferative endothrombovasculitis with Popov's granulomas; interstitial myocarditis. What diagnosis corresponds with the described picture?
A. *Spotted fever
64. A man with an injury of the dorsal area of his neck was admitted to the resuscitation department. What muscle occupies this area?
A. *M.trapezius
65. A patient with a knife wound in the left lumbal part was delivered to the emergency hospital. In course of operation a surgeon found that internal organs were not damaged but the knife injured one of muscles of renal pelvis. What muscle is it?
D. *Greater psoas muscle
66. A 56 year old patient came to a hospital with complaints about general weakness, tongue pain and burning, sensation of limb numbness. In the past he underwent resection of forestomach. In blood: Hb - 80
B. *B12-folate deficient
67. A patient ill with thrombophlebitis of his lower limbs had chest pain, blood spitting, progressing respiratory insufficiency that led to his death. Autopsy diagnosed multiple lung infarctions. What is the most probable cause of their development?
A. *Thromboembolism of pulmonary artery branches
68. A concentrated solution of sodium chloride was intravenously injected to an animal. This caused decreased reabsorption of sodium ions in the renal tubules. It is the result of the following changes of hormonal secretion:
D. *Aldosterone reduction
69. A patient had hemorrhagic stroke. Blood examination revealed strengthened kinin concentration.The patient was prescribed contrical. It was administered in order to inhibit the following proteinase:
E. *Kallikrein
70. Packed cell volume of a man was 40% before the trauma. What packed cell volume will be observed 24 hours after blood loss of 750 ml?
B. *30%
71. On the 2-3rd day after stomach resection intestinal peristalsis wasn't restored. What is to be administered for stimulation of gastrointestinal tract?
D. *Proserin
72. An ophthalmologist used a 1 % mesaton solution for the diagnostic purpose (pupil dilation for eye-ground examination). What is the cause of mydriasis induced by the drug?
A. *Activation of a1 adrenoreceptors
73. A patient with disturbed cerebral circulation has problems with deglutition. What part of brain was damaged?
D. *Brainstem
74. A 16 year old boy after an illness has diminished function of protein synthesis in liver as a result of vitamin K deficiency It will cause disturbance of:
A. *Blood coagulation
75. An isolated cell of human heart automatically generates excitement impulses with frequency of 60 times per minute. This cell was taken from the following heart structure:
B. *Sinoatrial node
76. Examination of coronary arteries revealed atherosclerotic calcified plaques closing vessel lumen by 1/3. The muscle has multiple whitish layers of connective tissue. What process was revealed in the myocardium?
C. *Diffusive cardiosclerosis
77. A patient with cholelithiasis fell ill with mechanic jaundice. Examination revealed that the stone was in the common bile duct. What bile-excreting ducts make up the obturated duct?
C. *Ductus hepaticus communis et ductus cysticus
78. 2 years ago a patient underwent resection of pyloric part of stomach. He complains of weakness, periodical dark shadows beneath his eyes, dyspnea. In blood: Hb – 70 g/1, erythrocytes - 3,0∙1012//, colour index - 0,7. What changes of erythrocytes in blood smears are the most typical for this condition?
E. *Microcytes
79. A 6 year old child was delivered to a hospital. Examination revealed that the child couldn't fix his eyes, didn't keep his eyes on toys, eye ground had the cherry-red spot sign. Laboratory analyses showed that brain, liver and spleen had high rate of ganglioside glycometide. What congenital disease is the child ill with?
D. *Tay-Sachs disease
80. In course of an experiment a peripheral section of vagus of an expiremental animal is being stimulated. What changes will be observed?
A. *Heart rate fall
81. A patient with bacterial pneumonia was prescribed benzylpenicillin. What is the mechanism of its antibacterial effect?
C. *Inhibition of synthesis of microorganism wall
82. Blood minute volume of a 30 year old woman at rest is 5 I/m. What blood volume is pumped through the pulmonary vessels per minute?
E. *5 1
83. In course of an experiment a toad's right labyrinth was destroyed. It will cause amyotonia of the following muscles:
B. *Right extensors
84. A patient died from cardiopulmonary decompensation. Histological examination revealed diffused pulmonary lesion together with interstitial edema, infiltration of tissue by limphocytes, macrophages, plasmocytes; pulmonary fibrosis, panacinar emphysema. What disease corresponds with the described picture?
C. *Fibrosing alveolitis
85. In order to accelerate healing of a radiation ulcer a vitamin drug was administered. What drug is it?
B. *Retinol acetate
86. A stomatologist injected a patient with a certain drug in order to reduce salivation during tooth filling. What drug is it?
C. *Atropine sulfate
87. Vagus branches that innervate heart are being stimulated in course of an experiment. As a result of it the excitement conduction from atria to the ventricles was brought to a stop. It is caused by electrophysical changes in the following structures:
C. *Atrioventricular node
88. A doctor examined a child and revealed symptoms of rachitis. Development of this desease was caused
D. *1,25 [OH]-dichydroxycholecalciferol
89. Histological examination of a skin tissue sampling revealed granulomas consisting of macrophagal nodules with lymphocytes and plasmatic cells. There are also some big macrophages with fatty vacuoles containing causative agents of a disease packed up in form of spheres (Virchow's cells). Granulation tissue is well vascularized. What disease is this granuloma typical for?
C. *Lepra
90. A patient consulted a stomatologist about purulent inflammation of his gums. What drug will be the most effective if it is suspected that a causative agent is an anaerobe?
E. *Metronidazole
91. Microscopy of stained (Ziehl-Neelsen staining) smears taken from the sputum of a patient with chronic pulmonary disease revealed red bacilli. What property of tuberculous bacillus was shown up?
A. *Acid resistance
92. The upper lobe of the right lung is enlarged, grey and airless, the inscision surface is dripping with turbid liquid, the pleura has many fibrinogenous films; microscopical examination of alveolus revealed exudate containing neutrophils, desquamated alveolocytes and fibrin fibers. The bronchus wall is intact. What is the most probable diagnosis?
D. *Croupous pneumonia
93. A patient has a decreased vasopressin synthesis that causes polyuria and as a result of it evident organism dehydratation. What is the mechanism of polyuria development?
D. *Reduced tubular reabsorption of water
94. A patient of surgical department complains about- pain in the small of her back and in the lower part of her belly; painful and frequent urination. Bacteriological examination of urine revealed gram-negative oxidase-positive rod-like bacteria forming greenish mucoid colonies with specific smell. What causative agent can it be?
C. *Pseudomonas aeruginosa
95. A patient has acne on his face. Microspcopic examination of scrapings from the affected areas revealed living porrect vermiform arthropoda 0, 2-0,5 mm large with four pairs of short extremities in the front part of their bodies. What is the laboratory diagnosis?
D. *Demodicosis
96. Examination of a patient with pustular skin lesions allowed to isolate a causative agent that forms in the blood agar roundish yellow middle-sized colonies surrounded by haemolysis zone. Smears from the colonies
contain irregular-shaped clusters of grampositive cocci. The culture is oxidase- and catalase-positive, ferments mannitol and synthesizes plasmocoagulase. What causative agent was isolated?
B. *Staphylococcus aureus
97. Inoculum from pharynx of a patient ill with angina was inoculated into bloodtellurite agar. It resulted in growth of grey, radially striated (in form of rosettes) colonies 4-5 mm in diameter. Gram-positive bacilli with clublike thickenings on their ends placed in form of spread wide apart fingers are visible by microscope. What microorganisms are these?
C. *Diphtheria corynebacteria
98. A man with a wound of his limb that had been suppurating for a long time died from intioxication. Autopsy revealed extreme emaciation, dehydration, brown atrophy of liver, myocardium, spleen and cross-striated muscles as well as renal amyloidosis. What diagnosis corresponds with the described picture?
A. *Chroniosepsis
99. In course of severe respiratory viral infection there appeared clinical signs of progressing cardiac insufficiency that caused death of a patient in the 2nd week of disease. Autopsy revealed that the heart was sluggish, with significant cavity dilatation. Histological examination of myocardium revealed plephora of microvessels and diffuse infiltration of stroma by lymphocytes and histiocytes. What disease corresponds with the described picture?
E. *Myocarditis
100. A patient consulted a doctor about symmetric dermatitis of open skin areas. It was found out that the patient lived mostly on cereals and ate too little meat, milk and eggs. What vitamin deficiency is the most evident?
A. *Nicotinamide
101. A patient with clinical signs of encephalitis was delivered to the infectious diseases hospital. Anamnesis registers a tick bite. Hemagglutination-inhibition reaction helped to reveal antibodies to the causative agent of tick-borne encephalitis in the dilution 1:20 which is not diagnostic. What actions should the doctor take after he had got such result?
B. *To repeat the examination with serum taken 10 days later
102. Parents of a 10 year old boy consulted a doctor about extension of hair-covering, growth of beard and moustache, low voice. Intensified secretion of which hormone must be assumed?
A. *Of testosterone
103. An animal with aortic valve insufficiency got hypertrophy of its left heart ventricle. Some of its parts have local contractures. What substance accumulated in the myocardiocytes caused these contractures?
E. *Calcium
104. An unconscious young man with signs of morphine poisoning entered admission office. His respiration is shallow and infrequent which is caused by inhibition of respiratory centre. What type of respiratory failure is it?
D. *Ventilative dysregulatory
105. A patient being treated for viral hepatitis type B got symptoms of hepatic insufficiency. What blood changes indicative of protein metabolism disorder will be observed in this case?
C. *Absolute hypoalbuminemia
106. A patient ill with essential arterial hypertension had a hypertensic crisis that resulted in an attack of cardiac asthma. What is the leading mechanism of cardiac insufficiency in this case?
C. *Heart overload caused by high pressure
107. Surgical removal of a part of stomach resulted in disturbed absorption of vitamin B12, it is excreted with feces. The patient was diagnosed with anemia. What factor is necessary for absorption of this vitamin?
A. *Gastromucoprotein
108. A 45 year old man consulted a doctor about a plaque-like formation on his neck. Histological examination of a skin bioptate revealed clusters of round and oval tumour cells with a narrow border of basophilic cytoplasm resembling of cells of basal epidermal layer. What tumour is it?
D. *Basal cell carcinoma
109. A 45 year old woman is ill with breast cancer. Her left arm has symptoms of lymphatic system insufficiency - limb edema, lymph node enlargement. What form of lymphatic circulation insufficiency is it?
A. *Mechanic insufficiency
110. Mother of a 2 year old child consulted a stomatologist. In the period of pregnancy she was irregularly taking antibiotics for an infectious disease. Examination of the child revealed incisor destruction, yellow enamel, and brown rim around the dental cervix. What drug has apparent teratogenic effect?
D. *Doxacycline
111. A man who has been taking a drug for a long time cannot withhold it because this causes impairment of psychic, somatic and vegetative functions. Name the syndrome of different disturbances caused by drug discontinuation:
D. *Abstinence
112. A chemical burn caused esophagus stenosis. Difficulty of ingestion led to the abrupt loss of weight. In blood: 3,0 • 1012/1, Hb - 106 g/1, crude protein - 57 g/1. What type of starvation is it?
B. *Incomplete
113. As a result of long-term starvation the glomerular filtration of a man was accelerated by 20%. The most probable cause of filtration changes under such conditions is:
A. *Fall of oncotic pressure of blood plasma
114. The territory of an old burial ground for animal refuse that hasn't been used for over 50 years is meant for house building. But soil investigation showed the presence of viable spores of a causative agent causing a very dangerous disease. What microorganism might have been preserved in soil for such a long period of time?
A. *Bacillus anthracis
115. During starvation muscle proteins break up into free amino acids. These compounds will be the most probably involved into the following process:
D. *Gluconeogenesis in liver
116. A 62 year woman complains of frequent pain attacks in the area of her chest and backbone, rib fractures. Her doctor suspected myeloma (plasmocytoma). What of the following laboratory characteristics will be of the greatest diagnostic importance?
D. *Paraproteinemia
117. The cerebrospinal fluid is being examined for the purpose of differential meningitis diagnostics. At what site is the lumbal puncture safe?
D. *L III-L IV
118. Power inputs of a man were measured. In what state was this man if his power inputs were lower than basal metabolism?
B. *Sleep
119. Vagi of an experimental animal were cut on both sides. What respiration changes will be observed?
D. *It will become deep and infrequent
120. Pharmacological effects of antidepressants are connected with inhibition of an enzyme catalyzing biogenic amines noradrenaline and serotonine in the mitochondrions of cerebral neurons. What enzyme participates in this process?
B. *Monoamine oxidase
121. A pathological process in bronchi resulted in epithelium desquamation. What cells will regenerate bronchial epithelium?
D. *Basal
122. Examination of a man who had been working hard under higher temperature of the environment revealed abnormal quantity of blood plasma proteins. What phenomenon is the case?
C. *Relative hyperproteinemia
123. A 70 year old man is ill with vascular atherosclerosis of lower extremities and coronary heart disease. Examination revealed disturbance of lipidic blood composition. The main factor of atherosclerosis pathogenesis is the excess of the following lipoproteins:
A. *Low-density lipoproteins
124. For the purpose of myocardium infarction treatment a patient was injected with embryonal stem cells derived from this very patient by means of therapeutic cloning. What transplantation type is it?
A. *Autotransplantation
125. A 40 year old man noticed a reddening and an edema of skin in the area of his neck that later developed into a small abscess. The incised focus is dense, yellowish-green. The pus contains white granules. Histological examination revealed drusen of a fungus, plasmatic and xanthome cells, macrophages. What type of mycosis is the most probable?
B. *Actinomycosis
126. An embryo displays disturbed process of dorsal mesoderm segmentation and somite formation. What part of skin will have developmental abnormalities?
B. *Derma
127. In course of a conditional experiment the development of mesenchyma cells was completely inhibited. Development of the following muscular tissue will be disturbed:
B. *Smooth muscular tissue
128. A girl is diagnosed with adrenogenital syndrome (pseudohermaphroditism). This pathology was caused by hypersecretion of the following adrenal hormone:
D. *Androgen
129. Golgi complex exports substances from a cell due to the fusion of the membrane saccule with the cell membrane. The saccule contents flows out. What process is it?
A. *Exocytosis
130. An oncological patient was prescribed methotrexate. With the lapse of time target cells of the tumour lost susceptibility to this drug. There is change of gene expression of the folowing enzyme:
C. *Dehydrofolate reductase
131. An infant has apparent diarrhea resulting from improper feeding. One of the main diarrhea effects is plentiful excretion of sodium bicarbonate. What form of acid-base balance disorder is the case?
A. Metabolic alkalosis
E. *Metabolic acidosis
132. Workers of a hothouse farm work under conditions of unfavourable microclimate: air temperature is +37°C, relative humidity is 90%, air speed is 0,2 m/s. The way of heat emission under these conditions will be:
E. *Evaporation
133. Examination of a 70 year old patient rrevealed insulin-dependent diabetes. What drug should be administered?
A. *Glibenclamid
134. A 59 year old patient is a plant manager. After the tax inspection of his plant he felt intense pain behind his breastbone irradiating to his left arm. 15 minutes later his condition came to normal. Which of the possible mechanisms of stenocardia development is the leading in this case?
A. *High catecholamine concentration in blood
135. A 44 year old woman complains of general weakness, heart pain, significant increase of body weight. Objectively: moon face, hirsutism, AP is 165/100 mm Hg, height - 164 cm, weight - 103 kg; the fat is mostly accumulated on her neck, thoracic girdle, belly. What is the main pathogenetic mechanism of obesity?
A. *Increased production of glucocorticoids
136. A 20 year old patient died from intoxication 8 days after artificial illegal abortion performed in her 14-15th week of pregnancy. Autopsy of the corpse revealed yellowish colour of eye sclera and of skin, necrotic suppurative endometritis, multiple pulmonary abscesses, spleen hyperplasia with a big number of neutrophils in its sinuses. What complication after abortion was developed?
C. *Septicopyemia
137. There are several groups of molecular mechanisms playing important part in pathogenesis of insult to cells which contributes to the pathology development. What processes are stimulated by proteinic damage mechanisms?
C. *Enzyme inhibition
138. A patient takes digoxin for treatment of cardiac insufficiency. What diuretic may increase digoxin toxicity due to the intensified excretion of K+ ions?
E. *Hydrochlorothiazide
139. A patient ill with amebiasis was prescribed a certain drug. The use of alcohol together with this drug is contra-indicated because the drug inhibits metabolism of ethyl alcohol. What drug is it?
B. *Metronidazole
140. While performing an operation in the area of axillary crease a surgeon has to define an arterial vessel surrounded by fascicles of brachial plexus. What artery is it?
A. *A.axillaris
141. A patient with nephrotic syndrome has massive edemata of his face and limbs. What is the leading pathogenetic mechanism of edemata development?
E. *Drop of oncotic blood pressure
142. A patient underwent an operation on account of gall bladder excision that resulted in obstruction of Ca absorption through the bowels wall. What vitamin will stimulate this process?
C. *D3
143. While studying maximally spiralized chromosomes of human karyotype the process of cell division was stopped in the following phase:
D. *Metaphase
144. A patient ill with tuberculosis died from progressing cardiopulmonary decompensation. Autopsy in the area of the right lung apex revealed a cavity 5 cm in diameter communicating with lumen of a segmental bronchus. On the inside cavity walls are covered with caseous masses with epithelioid and Langhans cells beneath them. What morphological form of tuberculosis is it?
D. *Acute cavernous tuberculosis
145. A patient recovered from Sonne dysentery and was once more infected with the same causative agent. What is such infection form called?
E. *Reinfection
146. A 30 year old woman has applied a lipstick with a fluorescent substance for a long time. Then she got a limited erythema and slight peeling on her lip border, later there appeared transversal striae and cracks. Special methods of microscopic examination of the affected area helped to reveal sensibilized lymphocytes and macrophages in the connective tissue; cytolysis. What type of immunological hypersensitivity was developed?)
C. *IV type (cellular cytotoxicity)
147. Autopsy of a man who died from the sepsis in his femoral bone revealed phlegmonous inflammation that affected the marrow, haversian canals and periosteum. Under the periosteum there are multiple abscesses, adjoining soft tissues of thigh also have signs of phlegmonous inflammation. What pathological process was described?
D. *Acute hematogenous osteomyelitis
148. A patient was diagnosed with autoimmune hemolitic cytotoxic anemia. What substances are antigens in II type allergic reactions?
D. *Modified receptors of cell membranes
149. Rats being under stress have muscular hypertonia and high arterial pressure, high glucose concentration in blood and intensified secretion of corticotropin and corticosteroids. In what stress phase are these animals?
C. *Antishock phase
150. It was proved that a molecule of immature mRNA (precursor mRNA) contained more triplets than amino acids found in the synthesized protein. The reason for that is that translation is normally preceded by:
A. *Processing
151. A patient who has been treated in a neural clinic and has been taking a sedative for a long time got the following complication: cough, rhinitis, epiphora. What drug caused these disturbances?
A. *Sodium bromide
152. Examination of a newborn boy's genitalia revealed a urethral hiatus that opens on the undersite of his penis. What malformation is it?
E. *Hypospadias
153. A patient that entered the admission office had the following signs of acute cardiac insufficiency: paleness, acrocyanosis, frequent shallow respiration. What drug is indicated in this case?
A. *Corglycon
154. In order to speed up healing of a wound of oral mucosa a patient was prescribed a drug that is a thermostable protein occurring in tears, saliva, and mother’s milk as well as in a new-laid hen's egg. It is known that this protein is a factor of natural resistance of an organism. What is it called?
E. *Lysozyme
155. A 38 year old patient with full-blown jaundice, small cutaneous hemorrhages, general weakness and loss of appetite underwent puncture biopsy of liver. Histological examination revealed disseminated dystrophy, hepatocyte necrosis, Councilman's bodies. Lobule periphery has signs of significant infiltration by lymphocytes, there are also individual multinuclear hepatocytes. What is the most probable diagnosis?
C. *Acute viral hepatitis
156. A patient with acute morphine poisoning was delivered to a hospital. What specific narcotic antagonist should be chosen in this case?
C. *Digoxin
157. Autopsy of a man ill with severe hypothyroidism revealed that connective tissue, organ stroma, adipose and cartilaginous tissues were swollen, semitransparent, and mucus-like. Microscopic examination of tissues revealed stellate cells having processes with mucus between them. What type of dystrophy is it?
A. *Stromal-vascular carbohydrate
158. In order to estimate toxigenity of diphtheria agents obtained from patients the cultures were inoculated on Petri dish with nutrient agar on either side of a filter paper strip that was put into the centre and moistened with antidiphtheric antitoxic serum. After incubation of inoculations in agar the strip-like areas of medium turbidity were found between separate cultures and the strip of filter paper. What immunological reaction was conducted?
C. *Precipitation gel reaction
159. A patient ill with enteritis accompanied by massive diarrhea has low water rate in the extracellular space, high water rate inside the cells and low blood osmolarity. What is such disturbance of water-electrolytic metabolism called?
E. *Hypo-osmolar hypohydration
160. In course of a preventive examination of a miner a doctor revealed changes of cardiovascular fitness which was indicative of cardiac insufficiency at the compensation stage. What is the main proof of cardiac compensation?
A. *Myocardium hypertrophy
161. It was found out that some compounds, for instance fungi toxins and some antibiotics can inhibit activity of .RAM-polymerase. What process will be disturbed in a cell in case of inhibition of this enzyme?
C. *Transcription
162. As a result of destruction of certain brainstem structures an animal has lost its orientative reflexes in response to strong photic stimuli. What structures were destroyed?
B. *Anterior tubercles of quadrigeminal plate
163. Inflammation of the tympanic cavity (purulent otitis media) was complicated by inflammation of mammillary process sockets. What wall of tympanic cavity did the pus penetrate into the sockets through?
D. *Posterior
164. A 35 year old man got an injury that caused complete disruption of spinal cord at the level of the first cervical segment. What respiration changes will be observed?
A. No changes will be observed
B. It will become infrequent and deep
C. Thoracic respiration will be maintained, diaphragmal respiration will disappear
D. *It will come to a standstill
E. Diaphragmal respiration will be maintained, thoracic respiration will disappear
165. Systemic arterial pressure of an adult dropped from 120/70 to 90/50 mm Hg that led to reflectory vasoconstriction. The vasoconstriction will be maximal in the following organ:
A. *Bowels
166. A pregnant woman was registered in an antenatal clinic and underwent complex examination for a number of infections. Blood serum contained IgM to the rubella virus. What is this result indicative of?
E. *Of primary infection
167. A boy found a spider with the following morphological characteristics: it is 2 cm long, has roundish black abdomen with two rows of red spots on its dorsal side; four pairs of jointed limbs are covered with small black hairs. What arthropod is it?
C. *Karakurt spider
168. Examination of a young woman revealed a node-like, soft and elastic homogenous tumor of pinkish-white colour along the acoustic nerve. The tumor contains cell bundles with oval nuclei. Cellular fibrous bundles form rhythmic structures made up by parallel rows of regularly oriented cells arranged in form of a palisade with cell-free homogenous zone (Verocay bodies) between them. What tumor is it?
A. *Neurinoma
169. Two hours after an exam a student had a blood count done and it was revealed that he had leukocytosis without significant leukogram modifications. What is the most probable mechanism of leukocytosis development?
A. *Redistribution of leukocytes in the organism
170. If a man has an attack of bronchiospasm it is necessary to reduce the effect of vagus on smooth muscles of bronchi. What membrane cytoreceptors should be blocked for this purpose?
A. *M-cholinoreceptors
171. Plasmic factors of blood coagulation are exposed to post-translational modification with the participation of vitamin K. It is necessary as a cofactor in the enzyme system of 7-carboxylation of protein factors of blood coagulation due to the increased affinity of their molecules with calcium ions. What amino acid is carboxylated in these proteins?
D. *Glutamic
173. An endocrinal gland with parenchyma consisting of epithelium and neural tissue is under morphological examination. Epithelial trabecules have two types of cells: chromophilic and chromophobe. Identify this organ:
B. *Adrenal glands
174. A patient came to the hospital complaining about quick fatigability and apparent muscle weakness. Examination revealed an autoimmune disease that causes disorder of functional receptor condition in neuromuscular synapses. What transmitter will be blocked?
C. *Glycine
175. Microscopic examination of a Gramstained scrape from patient's tongue revealed oval, round, elongated chains of dark-violet gemmating cells. What disease can be caused by this causative agent?
E. *Candidosis
176. A patient ill with chronic gastritis went for endogastric pH-metry that allowed to reveal decreased acidity of gastric juice. It is indicative of diminished function of the following cells:
A. *Parietal exocrinocytes
177. Examination of a 60 year old patient revealed hyperglycemia and glucosuria. A doctor administered him a medication for internal use. What medication is it?
D. *Glibenclamid
178. A 6 month old baby ill with bronchitis was taken for an X-ray of chest. Apart of changes associated with bronchi the X-ray film showed a shadow of thymus gland. What might have caused such changes?
D. *The above-mentioned condition is a normal variant for this age
179. A 20 year old patient complains of general weakness, dizziness, quick fatigability. Blood analysis results: Hb- 80 g/1. Microscopical examination results: erythrocytes are of modified form. This condition might be caused by:
C. *Sickle-cell anemia
180. In course of laparotomy a surgeon revealed gangrenous lesion of descending colon. It was caused by thrombosis of the following artery:
D. *Sinister colic
181. In course of a small pelvis operation it became necessary to ligate an ovarian artery. What formation may be accidentally ligated together with it?
E. *Ureter
182. A patient has a deep cut wound on the posterior surface of his shoulder in its middle third. What muscle might be injured?
E. *Triceps muscle of arm
183. A patient was admitted to the surgical department with suspected inflammation of Meckel's diverticulum. What part of bowels should be examined in order to discover the diverticulum in course of an operation?
A. *Ileum
184. A 35 year old patient applied to a doctor with complaints about having intense rhinitis and loss of sense of smell for a week. Objectively: nasal cavity contains a lot of mucus that covers mucous membrane and blocks olfactory receptors. In what part of nasal cavity are these receptors situated?
E. *Superior nasal turbinate
185. A cardiac electric stimulator was implanted to a 75 year old man with heart rate of 40 bpm. Thereafter the heart rate rose up to 70 bpm. The electric stimulator has undertaken the function of the following heart part:
B. *Sinoatrial node
186. Blood of a patient with presumable sepsis was inoculated into sugar broth. There appeared bottom sediment. Repeated inoculation into blood agar caused growth of small transparent round colonies surrounded by hemolysis zone. Examination of a smear from the sediment revealed gram-positive cocci in form of long chains. What microorganisms are present in blood of this patient?
A. *Streptococci
187. A patient has low rate of magnesium ions that are necessary for affixion of ribosomes to the endoplasmic reticulum. It is known that it causes disturbance of protein biosynthesis. At what stage is protein biosynthesis impaired?
B. *Translation
188. A patient with hypertensic crisis was admitted to the cardiological department, he was injected intravenously with an antihypertensive drug - salt of an alkaline-earth metal. What drug was injected?
D. *Magnesium sulfate
189. Examination of a 35 year old patient revealed high acidity of gastric juice. What receptors should be blocked in order to reduce it?
E. *Histamine
190. While performing an inguinal canal operation on account of hernia a surgeon damaged the canal's contents. What exactly was damaged?
A. *Funiculus spermaticus
191. A 3 year old child with fever was given aspirin. It resulted in intensified erythrocyte haemolysis. Hemolytic anemia might have been caused by congenital insufficiency of the following enzyme:
B. *Glucose 6-phosphate dehydrogenase
192. After consumption of rich food a patient has nausea and heartburn, steatorrhea. This condition might be caused by:
B. *Bile acid deficiency
193. A patient complains of dizziness and hearing loss. What nerve is damaged?
A. *Vestibulocochlear
194. A child was born with cleft palate. Examination revealed aorta defects and reduced number of T-lymphocytes in blood. What immunodeficient syndrome is it?
E. *DiGeorge
195. A woman suffering from osteochondrosis felt acute pain in her humeral articulation that became stronger when she abducted her shoulder. These symptoms might be caused by damage of the following nerve:
B. *Axillary nerve
196. A boy has I (I°I°) blood group and his sister has IV (IAIB) blood group. What blood groups do their parents have?
C. *II (IAI°) and III (IBI°)
197. A patient has a cluster of matted together dense lymph nodes on his neck. Histological examination of a removed lymph node revealed proliferation of reticular cells, presence of Reed-Sternberg cells. What disease is meant?
B. *Lymphogranulomatosis
198. A woman underwent an operation on account of extrauterine (tubal) pregnancy. In course of the operation the surgeon should ligate the branches of the following arteries:
cystic
D. *Uterine and ovarian
199. A specimen stained by Ozheshko method contains rod-like microorganisms stained blue with round terminal components stained red. What are these components called?
D. *Spores
200. A 37 year old patient suffering from obliterating vascular endarteritis of lower limbs takes daily 60 microgram/kilogram of phenylin. Because of presentations of convulsive disorder (craniocerebral trauma in anamnesis) he was prescribed phenobarbital. Withholding this drug caused nasal hemorhage. What is this complication connected with?
C. *Induction of enzymes of microsomal oxidation in liver caused by phenobarbital
Krok 1/2009
1. Before tooth extraction a patient was advised to take a certain drug for haemorrhage prevention. What drug was advised?
D. *Vicasolum
2. Autopsy of a man who died from influenza revealed that the heart was slightly enlarged and pastose. The surface of the incision of myocardium appeared to be pale, with specks. Microscopic examination revealed signs of parenchymatous adipose and hydropic degeneration, edematic stroma with scant lymphocytic and macrophage infiltration; plethoric vessels; perivascular petechial haemorrhages. What type of myocarditis is it?
C. *Serous diffuse
3. Examination of a patient revealed autoi mmune haemolytic anaemia (cytotoxic type). What substances act as antigens in the II-type allergic reactions?
E. *Modified receptors of cell membranes
4. Medical examination at the military regi stration and enlistment office revealed that a 15-year-old boy was high, with eunuchoid body proportions, gynecomastia, female pattern of pubic hair distribution. The boy had also fat deposits on the thighs, no facial hair, high voice, subnormal intelligence quotient. Which karyotype corresponds with this disease?
A. *47, XXY
5. Study of bacteriological sputum specimens stained by the Ziel-Neelsen method revealed some bright-red acid-resistant bacilli that were found in groups or singularly. When inoculated onto the nutrient media, the signs of their growth show up on the 10-15 day. These bacteria relate to the following family:
C. *Micobacterium tuberculosis
6. A 1,5-year-old child presents with both mental and physical lag, decolorizing of skin and hair, decrease in catecholamine concentration in blood. When a few drops of 5% solution of trichloroacetic iron had been added to the child's urine it turned olive green. Such alteration is typical for the following pathology of the amino acid metabolism:
C. *Phenylketonuria
7. A patient's organism has decreased concentration of magnesium ions that are necessary for attachment of ribosomes to the granular endoplasmatic reticulum. It is known that this causes protein biosynthesis disturbance. What stage of protein biosynthesis will be disturbed?
E. *Translation
8. The minute blood volume in a patient with transplanted heart has increased as a result of physical activity. What regulative mechanism is responsible for these changes?
C. *Catecholamines
9. A patient has been given high doses of hydrocortisone for a long time. This caused atrophy of one of the adrenal cortex zones. Which zone is it?
D. *Fascial
10. Autopsy of a man with a malignant stomach tumour who had died from cancer intoxication revealed in the posteroinferior lung fields some dense, grayish-red irregular foci protruding above the section surface: Microscopic examination revealed exudates containing a large amount of neutrophils in the lumen and walls of small bronchi and alveoles. Such pulmonary alterations indicate the following disease:
E. *Acute purulent bronchopneumonia
11. An injured person was delivered to the hospital with a penetrating wound in the left lateral region of abdomen. What part of the large intestine is most likely damaged?
B. *Colon descendens
12. A 49-year-old patient consulted a doctor about increased fatigability and dyspnea provoked by physical activity. ECG results: heart rate — 50/min, PQ-interval is prolonged, QRS-complex is unchanged, the number of P-waves exceeds the number of QRS-complexes. What type of arrhythmia is it?
E. *Atrioventricular block
13. Colonoscopy of a patient with dysentery revealed that the mucous membrane of the large intestine was hyperemic, edematic, and its surface was covered with grey-and-green layerings. What morphological form of dysenteric colitis is it?
B. *Fibrinous
14. A histological specimen of a kidney shows a part of the distal tubule going between the afferent and efferent arteriole. The cells building the tubule wall have dense nuclei; basal membrane is absent. Such structural formation is called:
D. *Macula densa
15. An elderly female patient suffers from the type 2 diabetes mellitus accompanied by obesity, atherosclerosis, coronary artery disease. Basal hyperinsulinemia is also present. What treatment would be the most appropriate?
D. *Glibenclamid
16. After a serious psycho-emotional stress a 45-year-old patient suddenly felt constricting heart pain irradiating to the left arm, neck and left scapula. His face turned pale, the cold sweat stood out on it. The pain attack was stopped with nitroglycerine. What process has developed in this patient?
D. *Stenocardia
17. Examination of a patient revealed a dense, movable skin tumour that is standing out distinctly from the surrounding tissues. Its section is found to be white and composed of fibrous tissue. Microscopic examination revealed interlacing collagen fibers and few cells. What tumour is it?
A. *Fibroma
18. Continuous use of a certain drug may cause osteoporosis, erosions of stomach mucosa, hypokaliemia, retention of sodium and water in the organism, decreased concentration of corticotropin in blood. What drug is it?
E. *Prednisolone
19. A female patient consulted a physician about digestive disorder, extended abdominal pain. Examination revealed drastic decrease in hemoglobin concentration. It is known from the anamnesis that while living in the Far East the patient used to eat freshlysalted caviar. Some relatives living with her had the similar condition. What is the most likely diagnosis?
B. *Diphyllobothriasis
20. Examination of a patient with frequent haemorrhages from the internal organs and mucous membranes revealed proline and lysine within the collagen fibers. Disorder of their hydroxylation is caused by lack of the following vitamin:
D. *Vitamin C
21. A patient underwent a surgery for excision of a cyst on pancreas. After this he developed haemorrhagic syndrome with apparent disorder of blood coagulation. Development of this complication can be explained by:
C. *Activation of fibrinolytic system
22. A patient with android-type obesity had been suffering from arterial hypertension, hyperglycemia, glycosuria for a long time and died from the cerebral haemorrhage. Pathologic examination revealed pituitary basophil adenoma, adrenal cortex hyperplasia. What is the most likely diagnosis?
C. *Itsenko-Cushing's syndrome
23. During an experiment the myotatic reflex has been studied in frogs. After extension in a skeletal muscle its reflectory contraction was absent. The reason for it might be a dysfunction of the following receptors:
B. *Muscle spindles
24. The greater amount of nitrogen is excreted from the organism in form of urea. Inhibition of urea synthesis and accumulation of ammonia in blood and tissues are induced by the decreased activity of the following liver enzyme:
A. *Carbamoyl phosphate synthesize
25. A pathology-histology laboratory received a vermiform appendix up to 2,0 cm thick. Its serous membrane was pale, thick and covered with yellowish-green films. The wall was flaccid, of grayish-red colour. The appendix lumen was dilated and filled with yellowish-green substance. Histological examination revealed that the appendix wall was infiltrated with neutrophils. Specify the appendix disease:
D. *Acute phlegmonous appendicitis
26. Gynecological examination of the uterine cervix in a 30-year-old woman revealed some bright-red lustrous spots that easily bleed when touched. Biopsy showed that a part of the uterine cervix was covered with cylindrical epithelium with papillary outgrowths; in the depth of tissue the growth of glands was present. What pathology of the uterine cervix was revealed?
C. *Pseudoerosion
27. After a craniocerebral trauma a patient lost the ability to execute learned purposeful movements (apraxia). The injury is most likely localized in the following region of the cerebral cortex:
D. *Gyrus supramarginalis
28. On the ground of clinical presentations a patient was prescribed pyridoxal phosphate. This medication is recommended for correction of the following processes:
B. *Transamination and decarboxylation of amino acids
29. In patients with the biliary tract obstruction the blood coagulation is inhibited; the patients have frequent haemorrhages caused by the subnormal assimilation of the following vitamin:
E. *K
30. A patient with coronary artery disease was admitted to the cardiological department. For stenocardia prevention a drug from the group of -adrenoceptor blockers was administered. What drug is it?
A. *Metoprolol
31. A man has normal sensitivity of his finger skin; however he doesn't sense his wedding ring around the finger. What process induced by wearing of the ring has caused this phenomenon?
B. *Receptor adaptation
32. A man suffering from osteochondrosis got acute pain in the abdominal muscles (lateral and anterior). During objective examination a physician diagnosticated increased pain sensitivity of skin in the hypogastric region. This pain might be caused by affection of the following nerve:
E. *Iliohypogastric
33. An 8-year-old child was admitted to the infectious department with fever (up to 38°C) and punctuate bright-red skin rash. The child was diagnosed as having scarlet fever. Objectively: mucous membrane of pharynx is apparently hyperaemic and edematic, the tonsils are enlarged and have dull yellowish-grey foci with some black areas. What inflammation is the reason for the pharynx alterations?
C. *Purulent necrotic
34. Examination of a patient suffering from chronic hepatitis revealed a significant decrease in the synthesis and secretion of bile acids. What process will be mainly disturbed in the patient's bowels?
B. *Fat emulsification
35. In response to a change in body position from horizontal to vertical blood circulation system develops reflectory pressor reaction. Which of the following is its compulsory component?
D. *Systemic constriction of the venous vessels
36. A newborn develops dyspepsia after the milk feeding. When the milk is substituted by the glucose solution the dyspepsia symptoms disappear. The newborn has the subnormal activity of the following enzyme:
E. *Lactase
37. Examination of a 2-year-old child revealed physical developmental lag, the child often has pneumonias. The child was diagnosed with nonclosure of ductus arteriosus. Haemodynamics disorder was caused by the intercommunication of the following vessels:
C. *Aorta and pulmonary trunk
38. A patient with massive burns developed acute renal insufficiency characterized by a significant and rapid deceleration of glomerular filtration. What is the mechanism of its development?
D. *Reduction of renal blood flow
39. Vagus nerves of an experimental animal have been cut on the both sides. What respiratory changes will result from this?
C. *Respiration will become deep and infrequent
40. Life cycle of a cell includes a process of DNA autoreduplication. As a result of this process monochromatid chromosomes become bichromatid. This phenomenon is observed within the following period of the cell cycle:
A. *S
41. You are studying functioning of a bacteria operon. The operator gene has been released from the repressor gene. Immediately after this the following process will start in the cell:
B. *Transcription
42. A patient presents with icteritiousness of skin, scleras and mucous membranes. Blood plasma the total bilirubin is increased, stercobilin is increased in feces, urobilin is increased in urine. What type of jaundice is it?
D. *Haemolytic
43. In a histological specimen parenchyma of an organ is represented by lymphoid tissue that forms lymph nodes; the latter are arranged in a diffuse manner and enclose a central artery. What anatomic formation has such morphological structure?
E. *Spleen
44. Autopsy of a man who died from sepsis revealed a phlegmonous inflammation in the femoral bone of lower extremity. The inflammation was seen in the bone marrow, haversian canals and periosteum. There were also multiple abscesses underneath the periosteum; the surrounding soft tissues of the thigh were also affected by the phlegmonous inflammation. What pathological process is it?
B. *Acute haematogenous osteomyelitis
45. Retrospective diagnostics of bacterial dysentery involved serological analysis of blood serum intended for determination of Shigella antibody titre. Which of the following reactions should be applied for this purpose?
D. *Passive haemagglutination
46. A 65-year-old man has purulent abscess on his neck. Analyses revealed a culture of gram-positive cocci with plasmocoagulase activity. This culture relates most likely to:
D. *Staphylococcus aureus
47. After a disease a 16-year-old boy is presenting with decreased function of protein synthesis in the liver as a result of vitamin K deficiency. This may cause disorder of:
B. *Blood coagulation
48. A patient has a transversal laceration in the spinal cord. What respiratory changes will result from this?
B. *Respiration will present no significant changes
;
49. A patient has lost skin sensitivity in the region of the medial surface of his shoulder. This is the result of dysfunction of the following nerve:
A. *Medial brachial cutaneous nerve
50. Examination of a patient admitted to the surgical department with symptoms of acute appendicitis revealed the following changes in the white blood cells: the total count of leukocytes is 16 • 109/1. Leukocyte formula: basophils - 0, eosinophils - 2%, juvenile forms - 2%, stabnuclear - 8%, segmentonuclear - 59%, lymphocytes - 25%, monocytes - 4%. The described changes can be classified as:
A. *Neutrophilia with regenerative left shift
51. A 28-year-old female patient consulted a gynecologist about sterility. Examination revealed underdeveloped ovaries and uterus, irregular menstrual cycle. Analysis of the sex chromatin revealed 2 Barr's bodies in most somatic cells. What chromosome disease is most likely?
B. *Triple X syndrome
52. A 46-year-old patient suffering from the diffuse toxic goiter underwent resection of the thyroid gland. After the surgery the patient presents with appetite loss, dyspepsia, increased neuromuscular excitement. The body weight remained unchanged. Body temperature is normal. Which of the following has caused such a condition in this patient?
E. *Reduced production of parathormone
53. While examining a patient an otolaryngologist noticed hyperaemia and significantly edematous tonsils with a grayish film upon them. Microscopical examination of this film revealed some gram-positive bacilli placed at an angle with each other. What disease might be suspected?
E. *Diphtheria
54. After inoculation of the material obtained from the pharynx of an angina patient onto the blood-tellurite agar, grey colonies could be observed. They were 4-5 mm in diameter, radially striated (in form of rosettes). Microscopical examination revealed grampositive bacilli with clavate swollen ends arranged in form of wide-spread fingers. Identify these microorganisms:
E. *Diphtheria corynebacteria
55. Which muscle contraction will be observed in the upper extremity during holding (not moving) a load in a certain position?
D. *Isometric
56. After taking poor-quality food a patient developed repeated episodes of diarrhea. On the next day he presented with decreased arterial pressure, tachycardia, extrasystole. Blood pH is 7,18. These abnormalities were caused by the development of:
D. *Nongaseous acidosis
57. During an experiment the dorsal roots of the spinal cord of an animal have been cut. What changes will be observed in the innervation zone?
D. *Sensitivity loss
58. ECG study showed that the T-waves were positive in the standard extremity leads, their amplitude and duration was normal. The right conclusion would be that the following process runs normally in the heart ventricles:
E. *Repolarization
59. A female patient consulted a doctor about pain and limited movements in the knee joints. Which of the following nonsteroid anti inflammatory drugs should be administered taking into consideration that the patient has a history of chronic gastroduodenitis?
D. *Celecoxib
60. A patient consulted a physician about muscle rigidity, constrained movements, permanent arm tremor. The patient was diagnosed with Parkinson's disease. What preparation should be administered?
A. *Levodopa
61. A married couple came to the genetic counseling. The husband suffers from the insulin-dependent diabetes, the wife is healthy. What is the probability that this couple will have an insulin-dependent child?
D. *Higher than throughout the population
62. Following exposure to radiation a lot of mutant cells appeared in a patient. Sometime later most of them were detected and destroyed by the following cells of the immune system:
A. *T-lymphocytes-killers
63. A man suffering from a hereditary disease married a healthy woman. They got 5 children, three girls and two boys. All the girls inherited their father's disease. What is the type of the disease inheritance?
D. *Dominant, X-linked
64. A 70-year-old patient suffers from atherosclerosis complicated by the lower limb thrombosis that has caused gangrene on his left toes. What is the most likely cause of the thrombosis origin?
E. *Thrombocyte adhesion
65. As a result of a road accident a driver has gotten a trauma. Now he is in shock condition and presents with a decrease in daily diuresis down to 300 ml. What is the main pathogenetic factor of such alteration in the diuresis?
A. *Arterial pressure drop
66. A patient with myocardial infarction was admitted to the cardiological department. For pain relief it was decided to potentiate fentanyl action with a neuroleptic. Which of the following neuroleptics is the most sui- table for neuroleptanalgesia?
A. *Droperidol
67. Bacteriological examination of purulent discharges from the urethra revealed gramnegative bacteria looking like coffee beans. They were localized in the leukocytes and could decompose glucose and maltose to acid. These are the causative agents of the following disease:
A. *Gonorrhoea
68. A patient suffering from syphilis has been treated with bismuth preparations. As a result of it some grey spots turned up on the mucous membrane of the oral cavity; nephropathy symptoms were also present. What drug should be used for treatment of bismuth intoxication?
D. *Unithiol
69. In spite of treatment with cardiotonics and thiazide diuretic a patient suffering from chronic cardiac failure still presents with edemata and faces a risk of ascites. What medication should be administered in order to increase the diuretic effect of the above mentioned drugs?
B. *Spironolactone
70. A newborn child was found to have reduced intensity of sucking, frequent vomiting, hypotonia. Urine and blood exhibit increased concentration of citrulline. What metabolic process is disturbed?
B. *Ornithinic cycle
71. After the prior sensibilization an experi mental animal was given a subcutaneous injection of an antigen. The place of injection exhibited a fibrinous inflammation with alteration of the vessel walls, basal substance and fibrous structures of the connective tissue in form of mucoid and fibrinoid swelling and necrosis. What immunological reaction is it?
C. *Immediate hypersensitivity
72. Autopsy of a 49-year-old woman who died from chronic renal insufficiency, revealed: kidneys were dense, reduced, multicoloured, with haemorrhagic areas. Microscopic examination revealed some hematoxylin bodies in the nuclei of the renal tubule epithelium; "wire-loop" thickening of the glomerular capillary basement membrane; here and there in the capillaries some hyaline thrombi and foci of fibrinoid necrosis were present. What is the most likely diagnosis?
E. *Systemic lupus erythematosus
73. After transfusion of 200 ml of blood a patient presented with body temperature rise up to 37,9°C. Which of the following substances is the most likely cause of temperature rise?
E. *Interleukin-1
74. In an embryo the process of dorsal mesoderm segmentation and somite formation is disturbed. What part of skin will probably have developmental abnormalities?
D. *Dermis
75. A patient has osmotic pressure of blood plasma at the rate of 350 mOsmol/1 (norm is 300 mOsmol/1). This will cause hypersecretion of the following hormone:
A. *Vasopressin
76. A patient suffering from myasthenia has been administered proserin. After its administration the patient has got nausea, diarrhea, twitch of tongue and skeletal muscles. What drug would help to eliminate the intoxication?
D. *Atropine sulfate
77. Vitamin B deficiency causes disturbance of oxidative decarboxylation of aketoglutaric acid. This leads to the impaired synthesis of the following coenzyme:
C. *Thiamine pyrophosphate
A. Flavine adenine dinucleotide
B. Lipoic acid
D. Coenzyme A
E. Nicotinamide adenine dinucleotide
78. A 53-year-old female patient was diagnosed with liver rupture resulting from a blunt abdominal injury. The escaped blood will be assembled in the following anatomic formation:
E. *Rectouterine pouch
79. After a sprint an untrained person develops muscle hypoxia. This leads to the accumulation of the following metabolite in muscles:
A. *Lactate
80. Microscopical examination of an enlarged cervical lymph node revealed blurring of its structure, absence of lymphoid follicles; all the microscopic fields showed cells with roundish nuclei and thin limbus of basophil cytoplasm. It is known from the clinical data that other groups of lymph nodes are also enlarged as well as spleen and liver. What disease might be suspected?
A. *Lymphoid leukosis
81. Examination of the anterior abdominal wall of a pregnant woman revealed a tumourlike formation that arose on the spot of a tumour that was removed two years ago. The neoplasm was well-defined, dense, 2x1 cm large. Histological examination revealed that the tumour was composed of differentiated connective tissue with prevailing collagen fibres. What tumour might be suspected?
A. *Desmoid
82. A patient has pellagra. Interrogation revealed that he had lived mostly on maize for a long time and eaten little meat. This disease had been caused by the deficit of the following substance in the maize:
B. *Tryptophan
83. Quite often the cause of secondary immunodeficiency is an infection involvement, when the causative agents propagate directly in the cells of immune system and destroy it. The following diseases are characterized by:
D. *Infectious mononucleosis, AIDS
84. A 32-year-old patient consulted a doctor about the absence of lactation after parturition. Such disorder might be explained by the deficit of the following hormone:
E. *Prolactin
85. To prevent the transplant rejection after organ transplantation it is required to administer hormonotherapy for the purpose of immunosuppression. What hormones are used for this purpose?
A. *Glucocorticoids
86. A patient suffering from chronic bronchitis takes a synthetic mucolytic drug that facilitates the sputum thinning. What drug is it?
A. *Acetylcysteine
87. A 62-year-old female patient has developed a cataract (lenticular opacity) secondary to the diabetes mellitus. What type of protein modification is observed in case of diabetic cataract?
D. *Glycosylation
88. As a result of durative antibiotic therapy a 37-year old patient developed intestinal dysbacteriosis. What type of drugs should be used in order to normalize intestinal microflora?
D. *Eubiotics
89. A patient with high rate of obesity was advised to use carnitine as a food additive in order to enhance "fat burning". What is the role of carnitine in the process of fat oxidation?
B. *Transport of FFA (free fatty acids) from cytosol to the mitochondria
90. While studying a microslide obtained from the punctuate of a regional lymph node and stained by Romanovsky-Giemsa method a physician revealed some light-pink thin microorganisms with 12-14 regular spiral coils and pointed ends, up to 10-13 micrometer long. This might be the causative agent of the following disease:
D. *Syphilis
91. As a result of continuous starvation the glomerular filtration rate has increased by 20%. The most probable cause of the glomerular filtration alteration under the mentioned conditions is:
D. *Decrease in the oncotic pressure of blood plasma
92. A female patient suffering from bronchial asthma had got a viral infection that provoked status asthmaticus with fatal outcome. Histological examination of lungs revealed spasm and edema of bronchi oles, apparent infiltration of their walls with lymphocytes, eosinophils and other leukocytes; labrocyte degranulation. What mechanism of hypersensitivity underlies the described alterations?
C. *Reagin reaction
93. A 63-year-old patient with collapse presentations was delivered to the emergency hospital. A physician has chosen noradrenalin against hypotension. What is its mechanism of action?
B. *Activation of a1-adrenoreceptors
94. A patient complains about dyspnea provoked by the physical activity. Clinical examination revealed anaemia and presence of the paraprotein in the zone of gamma globulins. To confirm the myeloma diagnosis it is necessary to determine the following index in the patient's urine:
A. *Bence Jones protein
95. Examination of a young woman revealed a tumour up to 3 cm in diameter in form of a knot localized along the acoustic nerve. The tumour is homogenous, soft and elastic, of pink-and-white colour. Microscopically the tumour contains clusters of cells with oval nuclei. Fibrous cell clusters form regular structures made up by parallel rows of regularly oriented cells arranged in form of a palisade. Zones between the rows of cells are acellular and homogenous (Verocai bodies). What tumour is it?
E. *Neurinoma
96. A 38-year-old patient came to a traumatology centre and complained about an injury of his right hand. Objectively: the patient has a cut wound in the region of the thenar eminence on the right hand; distal phalanx of the I finger cannot be flexed. What muscle was injured?
E. *Long flexor muscle of thumb
97. An oncological patient was administered methotrexate. With the lapse of time the target cells of the tumour lost sensitivity to this preparation. We can observe changes in the gene expression of the following enzyme:
D. *Dihydrofolate reductase
98. A 35-year-old patient complains about having severe rhinitis and loss of sense of smell for a week. Objectively: the nasal cavity contains a lot of mucus covering the mucous membrane and blocking olfactory receptors. In what region of the nasal cavity are these receptors located?
B. *Superior nasal concha
99. A 38-year-old patient with a uterine haemorrhage lasting for 2 days was delivered to the admission ward. Which of the following will be revealed in the patient's blood?
C. *Decrease in the haematocrite index
100. Autopsy of a 1, 5-year-old child revealed haemorrhagic skin rash, moderate hyperaemia and edema of nasopharyngeal mucous membrane, small haemorrhages in the mucous membranes and internal organs; dramatic dystrophic alterations in liver and myocardium; acute necrotic nephrosis; massive haemorrhages in the adrenal glands. What disease are these alterations the most typical for?
B. *Meningococcal infection
101. Treatment course of bacterial pneumonia included benzylpenicillin sodium salt. What is the mechanism of its antimicrobial action?
A. *Inhibition of cell wall synthesis of the microorganism
102. In the perianal folds of a 5-year-old girl her mother has found some white "worms" that caused itch and anxiety in the child. The "worms" were sent to the laboratory. During examination the physician saw white filiform helminths 0, 5-1 cm long, with pointed ends, some helminths had twisted ends. What is the most likely diagnosis?
E. *Enterobiasis
103. A young man complains about urination disorder. Examination of the external genitals revealed that the urethra was split and urine could flow out of this orifice. What anomaly of the external genitals development is it?
A. *Epispadia
104. A 12-year-old teenager has significantly put off weight within 3 months; glucose concentration rose up to 50 millimolel. He fell into a coma. What is the main mechanism of its development?
D. *Hyperosmolar
105. During the regular sanitaryepidemiological inspection of a pharmacy, the bacteriological analysis of air was performed. The air was found to have bacilli, yeast fungi, hemolytic streptococci, micrococci. Which of the detected microorganisms indicate the direct epidemic danger?
B. *Haemolytic streptococci
106. A 9-month-old infant is fed with artificial formulas with unbalanced vitamin B6 concentration. The infant presents with .pellagral dermatitis, convulsions, anemia. Convulsion development might be caused by the disturbed formation of:
A. *GABA
107. A 10-year-old child had the mantoux tuberculin test administered. 48 hours later a papule up to 8 mm in diameter appeared on the site of the injection. What type of hypersensitivity reaction developed after the tuberculin injection?
E. *Type IV hypersensitivity reaction
108. A patient suffering from chronic hyperacidic gastritis takes an antacid drug for heartburn elimination. After its ingestion the patient feels better but at the same time he has a sensation of stomach swelling. Which of the following drugs might be the cause of such side effect?
A. *Magnesium oxide
109. Two weeks after lacunar tonsillitis a 20-year-old man started complaining about general weakness, lower eyelid edemata. After examination the patient was diagnosed with acute glomerulonephritis. What are the most likely pathological changes in the urine formula?
B. *Proteinuria
110. A man died from an acute infectious disease accompanied by fever, jaundice, haemorrhagic rash on the skin and mucous membranes as well as by acute renal insufficiency. Histological examination of renal tissue (stained by Romanovsky-Giemsa method) revealed some convoluted bacteria looking like C und S letters. What bacteria were revealed?
E. *Leptospira
111. A bacteriological laboratory has received smears from the sputum of a patient with a chronic pulmonary disease. Microscopical examination of the smears stained by the Ziehl-Neelsen technique revealed red bacilli. What property of the tuberculosis bacillus has shown itself?
E. *Acid resistance
112. The temperature of the ambient environment is 38° C and relative air humidity is 50%. What ways of heat emission provide maintaining a constant temperature of the human body?
A. *Evaporation
113. Nappies of a newborn have dark spots being the evidence of homogentisic acid formation. This is caused by the metabolic disorder of the following substance:
D. *Tyrosine
114. An electronic microphotograph shows a macrophagic cell with erythrocytes at different stages of differentiation located along its processes. This is the cell of the following organ:
E. *Red bone marrow
115. A histological specimen presents a receptor zone of a sensoepithelial sense organ. Cells of this zone are placed upon the basal membrane and include the following types: external and internal receptor cells, external and internal phalangeal cell, stem cells, external limiting cells and external supporting cell. The described receptor zone belongs to the following sense organ:
D. *Acoustic organ
116. A man who is riding the carousel presents with increased heart rate, sweating, nausea. This condition is caused primarily by the stimulation of the following receptors:
E. *Vestibular ampullar
117. A patient has a massive haemorrhage caused by damage of the dorsal lingual artery by cancer of tongue back. What vessel should be ligated for the haemorrhage arrest?
E. *Lingual artery
118. As a result of a trauma a patient has developed traumatic shock that led to the following disorders: AP is 140/90 mm Hg, Ps is 120 bpm. The patient is fussy, talkative, and pale. Such state relates to the following shock phase:
A. *Erectile
119. A 12-year-old adolescent suffering from bronchial asthma has a severe attack of asthma: he presents with marked expiratory dyspnea, skin pallor. What type of alveolar ventilation disorder is observed?
C. *Obstructive
120. Cytoplasm of the myocytes contains a lot of dissolved metabolites resulting from glucose oxidation. Name the metabolite that turns directly into lactate:
D. *Pyruvate
121. Autopsy of a 50-year-old man revealed the following changes: his right lung was moderately compact in all parts, the dissected tissue was found to be airless, fine-grained, dryish. Visceral pleura had grayish-brown layers of fibrin. What is the most likely diagnosis?
E. *Croupous pneumonia
122. After a hypertonic crisis a patient presents with lacking spontaneous movements in his right arm and leg, muscle tone of these extremities is increased. What type of motor dysfunction has developed in this case?
A. *Central paralysis
123. Pyeloureterography X-ray photo showed a renal pelvis with minor calyces only (major calyces were absent). What form of urinary tracts of a kidney was revealed?
C. *Embryonal
124. An experimental animal has lost orientative reflexes as a result of destruction of certain brainstem structures. What structures had been destroyed?
E. *Quadrigeminal plate
125. In a healthy adult speed of the excitement conduction through the atrioventricular node is 0, 02-0, 05 m/sec. Atrioventricular delay enables:
A. *Sequence of atrial and ventricular contractions
126. Products of some proteins hydrolysis and modification are the biologically active substances called hormones. Lipotropin, corticotropin, melanotropin and endorphins are synthesized in the hypophysis of the following protein:
B. *Proopiomelanocortin (POMC)
127. In a 2-year-old child with catarrhal presentations and skin rash a pediatrician suspected scarlet fever. The child was given intracutaneously a small dose of serum antibody to the streptococcal erythrogenic toxin; on the site of injection the rash disappeared. What do the reaction results mean?
C. *The clinical diagnosis was confirmed
128. Stimulation of an excitable cell by the electric current has led to the depolarization of its membrane. The depolarization has been caused mainly by the following ions penetrating into the cell through its membrane:
E. *Na+
129. While determining power inputs of a patient's organism it was established that the respiratory coefficient equaled 1, 0. This means that in the cells of the patient the following substances are mainly oxidized:
C. *Carbohydrates
130. A 48-year-old patient was admitted to the hospital with complaints about weakness, irritability, sleep disturbance. Objectively: skin and scleras are of yellow colour. In blood: increased concentration of total bilirubin with prevailing direct bilirubin. The feces are acholic. The urine is dark (contains bile pigments). What type of jaundice is it?
A. *Mechanic
131. Examination of a 27-year-old patient revealed pathological changes in liver and brain. Blood plasma analysis revealed an abrupt decrease in the copper concentration, urine analysis revealed an increased' copper concentration. The patient was diagnosed with Wilson's degeneration. To confirm the diagnosis it is necessary to'study the activity of the following enzyme in blood serum:
E. *Ceruloplasmin
132. Cooling of the human body in water is much faster than in the air. What way of heat emission in water is much more effective?
E. *Heat conduction
133. Depressions and emotional insanities result from the deficit of noradrenalin, serotonin and other biogenic amines in the brain. Their concentration in the synapses can be increased by means of the antidepressants that inhibit the following enzyme:
E. *Monoamine oxidase
134. During a prophylactic medical examination a 7-year-old boy was diagnosed with daltonism. His parents are healthy and have normal colour vision, but his grandfather on his mother's side has the same abnormality. What is the type of the abnormality inheritance?
C. *Recessive, sex-linked
135. A student came to see a doctor and asked to administer him a drug for treatment of allergic rhinitis that occurs in the period of linden flowering. What drug may be used?
B. *Loratadine
136. A mother consulted a doctor about her 5-year-old child who develops erythemas, vesicular rash and skin itch under the influence of sun. Laboratory studies revealed decreased iron concentration in the blood serum, increased uroporphyrinogen I excretion with the urine. What is the most likely inherited pathology in this child?
C. *Erythropoietic porphyria
137. A patient suffers from the haemorrhagic syndrome that shows itself in frequent nasal bleedings, posttraumatic and spontaneous intracutaneous and intraarticular haemorrhages. After a laboratory study a patient was diagnosed with the type B haemophilia. This disease is provoked by the deficit of the following factor of blood coagulation:
D. *IX
138. After a trauma a patient lost lability of elbow extension. This might have been caused by dysfunction of the following main muscle:
E. *m. triceps brachii
139. Preventive examination of a patient revealed an enlarged lymph node of metastatic origin on the medial wall of the left axillary crease. Specify the most likely localization of the primary tumor:
E. *Mammary gland
140. A 30-year-old patient complains about having abdominal pain and diarrhea for five days; body temperature rise up to 37, 5°C along with chills. The day before a patient had been in a forest and drunk from an open water reservoir. Laboratory analyses enabled to make the following diagnosis: amebic dysentery. What is the drug of choice for its treatment?
C. *Metronidazole
141. In clinical practice tuberculosis is treated with izoniazid preparation — that is an antivitamin able to penetrate into the tuberculosis bacillus. Tuberculostatic effect is induced by the interference with replication processes and oxidation-reduction reactions due to the buildup of pseudo-coenzyme:
A. *NAD
142. A patient complains about edemata of legs, skin cyanosis, and small ulcers on one side of the lateral condyle. Examination revealed a swelling, enlarged veins, formation of nodes. The pathological process has started in the following vein:
D. *V. saphena parva
143. A section of the left lung was found to have an area of dense red tissue. The area was cone-shaped, stood out distinctly from the healthy tissue, with its base directed to the pleura. The dissected tissue was granular, dark-red. What is the most likely diagnosis?
D. *Haemorrhagic infarction
144. A middle-aged man went to a foreign country because he had been offered a job there. However he had been unemployed for quite a long time. What endocrine glands were exhausted most of all in this man?
E. *Adrenal glands
145. A man has worked in an African country for 3 years. A month after his return to Ukraine he consulted an ophthalmologist and complained about eye ache, eyelid edema, lacrimation and temporary visual impairment. Underneath the eye conjunctiva the doctor revealed helminths 30-50 mm long with elongated filiform body. What diagnosis might be suspected?
C. *Filariasis
146. A girl has been diagnosed with adrenogenital syndrome (pseudohermaphroditism). This pathology is caused by hypersecretion of the following adrenal hormone:
D. *Androgens
147. A patient with severe course of respiratory viral infection presented with clinical signs of progressing heart failure that led to his death in the 2nd week of disease. Autopsy revealed that the heart cavities were significantly dilated, the heart was flabby. Histological examination of the myocardium revealed microvascular plethora and diffuse stroma infiltration with lymphocytes and histiocytes. What is the most likely diagnosis?
A. *Myocarditis
148. During examination of an 11-month-old infant a pediatrician revealed osteoectasia of the lower extremities and delayed mineralization of cranial bones. Such pathology is usually provoked by the deficit of the following vitamin:
B. *Cholecalciferol
149. A patient was admitted to the hospital with an asphyxia attack provoked by a spasm of smooth muscles of the respiratory tracts. This attack was mainly caused by alterations in the following parts of the airways:
C. *Small bronchi
150. A patient with a hypertensive crisis was admitted to the cardiological department. He was given an intravenous injection of an antihypertensive drug - alkali-earth metal salt. What drug was injected?
B. *Magnesium sulfate
151. A patient consulted an urologist about pain during urination. Analysis of his urine taken in the daytime revealed eggs with a characteristic sharp point. It is known from the anamnesis that the patient has recently returned from Australia. What is the most likely diagnosis?
B. *Urogenital schistosomiasis
152. Examination of a patient 24 hours after appendectomy revealed neutrophilic leukocytosis with a regenerative shift. What is the most likely mechanism of leukocytosis development?
C. *Intensification of leukopoiesis
153. A man with a stab wound in the region of the quadrilateral foramen consulted a doctor about it. Examination revealed that the injured couldn't abduct his arm from the body. What nerve is most likely damaged?
E. *n. axillaris
154. A 49-year-old driver complains about unbearable constricting pain behind the breastbone irradiating to the neck. The pain arose 2 hours ago. Objectively: the patient's condition is grave, he is pale, heart tones are decreased. Laboratory studies revealed high activity of creatine kinase and LDH\. What disease are these symptoms typical for?
A. *Acute myocardial infarction
155. An animal has an increased tonus of extensor muscles. This result of intensified information transmission to the motoneurons of the spinal cord through the following descending pathways:
D. *Vestibulospinal
156. It is necessary to take the cerebrospinal fluid from a patient with suspected inflammation of brain tunics. Diagnostic puncture was performed between the arches of the lumbar vertebras. During the puncture the needle went through the following ligament:
A. *Yellow (naval)
157. A microspecimen of the submandibular salivary gland shows some basket-shaped cells concentrated around the acines and excretory ducts. These cells surround bases of the serous cells and are called myoepitheliocytes. These cells relate to the following tissue:
D. *Muscular tissue
158. While on holiday in the countryside a boy found a spider with the following morphological peculiarities: body length of 2 cm, round black abdomen with two rows of red dots on its dorsal surface, four pairs of segmented extremities covered with tiny black hairs. Identify this arthropod:
D. *Karakurt spider
159. Lung ventilation in a person is increased as a result of physical activity. Which of the following indices of the external respiration is much higher than in a state of rest?
A. *Respiratory volume
160. A married couple consulted a specialist at the genetic consultation about probability of having children with hemophilia. Both spouses are healthy, but the wife's father has hemophilia. In this family hemophilia may be passed to:
D. *Half of sons
161. Autopsy of a man, who had been suffering from the multiple bronchiectasis for 5 years and died from chronic renal insufficiency, revealed that kidneys were dense and enlarged, with thickened cortical layer of white colour with greasy lustre. What renal disease might be suspected?
D. *Secondary amyloidosis
162. While playing volleyball a sportsman jumped and then landed across the external edge of his foot. This caused acute pain in the talocrural articulation, active movements became limited, passive movements remained unlimited but painful. In the region of the external ankle a swelling appeared, the skin turned red and became warmer to the touch. What type of peripheral circulation disorder has developed in this case?
A. *Arterial hyperaemia
163. An 18-year-old man was delivered to the hospital after a road accident. Examination at the traumatological department revealed multiple injuries of soft tissues of face in the region of the medial eye angle. The injuries caused massive haemorrhage. What arterial anastomosis might have been damaged in this region?
B. *a. carotis externa et a. carotis interna
164. A patient suffering from stomach ulcer has been treated with an antacid drug almagel. For acute bronchitis treatment he was prescribed the antibiotic methacycline. However within next 5 days the fever didn't fall, cough and sputum nature remained unchanged. A physician came to the conclusion that the drugs were incompatible. What type of drug incompatibility is the case?
E. *Pharmacokinetic, absorption stage
165. ECG of a 44-year-old patient shows signs of hypertrophy of both ventricles and the right atrium. The patient was diagnosed with the tricuspid valve insufficiency. What pathogenetic variant of cardiac dysfunction is usually observed in case of such insufficiency?
E. *Heart overload by volume
166. While examining the oral cavity a stomatologist revealed inflammation of papillae on the border of the median and posterior third of the back of tongue. What papillae are inflamed?
C. *Papillae vallatae
167. Examination of a patient revealed overgrowth of facial bones and soft tissues, tongue enlargement, wide interdental spaces in the enlarged dental arch. What changes of the hormonal secretion are the most likely?
E. *Hypersecretion of the somatotropic hormone
168. As a result of increased permeability of the erythrocyte membrane in a patient with microspherocytic anaemia (Minkowsky-Shauffard disease) cells receive sodium ions and water. - Erythrocytes take form of spherocytes and can be easily broken down. What is the leading mechanism of erythrocyte damage in this case?
A. *Electrolytic osmotic
169. A 58-year-old patient suffers from the cerebral atherosclerosis. Examination revealed hyperlipoidemia. What class of lipoproteins will most probably show increase in concentration in this patient's blood serum?
C. *Low-density lipoproteins
170. A patient who has been taking a drug for a long time cannot abruptly stop its use, because this may lead to psychic and somatic dysfunctions. Name the syndrome of different disorders caused by a drug withdrawal:
A. *Abstinence
171. A woman delivered a dead child with multiple developmental defects. What protozoan disease might have caused the intrauterine death?
B. *Toxoplasmosis
172. A man presents with increased heart rate, mydriatic pupils, and dry mouth. This condition results from the activation of the following system of function regulation:
D. *Sympathetic
173. Autopsy of a 73-year-old man who had been suffering from the coronary heart disease along with cardiac insufficiency for a long time revealed: nutmeg liver, brown induration of lungs, cyanotic induration of kidneys and spleen. What kind of circulation disorder was the cause of such effects?
B. *General chronic venous congestion
174. After a surgery a 36-year-old woman was given an intravenous injection of concentrated albumin solution. This has induced intensified water movement in the following direction:
E. *From the intercellular fluid to the capillaries
175. Proserin increases skeletal muscle tone when given systematically. Halothane induces relaxation of skeletal muscles and reduces proserin effects. What is the nature of proserin and halothane interaction?
A. *Indirect functional antagonism
176. A man with an injury in the nuchal region (regio nuchae) was admitted to the resuscitation department. What muscle occupies this region?
A. *m. trapezius
177. A patient suffering from coronary artery disease had taken a certain drug many times a day in order to arrest stenocardia attacks. Overdose of this drug finally caused intoxication. Objectively: cyanotic skin and mucous membranes, dramatic fall in the arterial pressure, tachycardia, and respiration inhibition. Blood has increased concentration of methemoglobin. The drug the patient had taken relates to the following group:
B. *Organic nitrates
178. A stillborn child was found to have thickened skin resembling of the tortoise shell, underdeveloped auricles. Histological examination of skin revealed hyperkeratosis, atrophy of the granular epidermis layer; inflammatory changes were not present. What is the most likely diagnosis?
A. *Ichthyosis
179. A patient who had myocardial infarction was administered 75 mg of acetylsalicinic acid a day. What is the purpose of this administration?
B. *Reduction of thrombocyte aggregation
180. Sanitary bacteriological research on water by the membrane filter method revealed two red colonies on a membrane filter (Endo agar) through which 500 ml of analyzed water were passed. Calculate the coli index and coli titer of the analyzed water:
A. *4 and 250
181. A histological specimen shows a blood vessel. Its inner coat is composed by endothelium, subendothelium and internal elastic membrane. The middle coat is enriched with smooth myocytes. Such morphological characteristics are typical for the following vessel:
E. *Muscular-type artery
182. A 45-year-old patient suffers from neurosis characterized by irritability, sleeplessness, motiveless anxiety. What drug would eliminate all the symptoms?
C. *Diazepam
183. A man had worked in a coal mine for over 20 years. After his death autopsy revealed that his lungs were dense, grayishblack and had large areas of neogenic connective tissue containing a lot of microphages with black pigment in the cytoplasm. What is the most likely diagnosis?
C. *Anthracosis
184. A baby refuses the breast, he is anxious, presents with arrhythmic respiration. The urine smells of "brewer's yeast "or "maple syrup". This pathology was caused by the inherited defect of the following enzyme:
A. *Dehydrogenase of branched-chain alpha-keto acids
185. A patient with drug intoxication presented with the dryness of oral mucous membrane and mydriatic pupils. Such action of this drug is associated with the following effect:
E. *Muscarinic cholinoreceptor block
186. A 62-year-old female patient complains about frequent pains in the region of thorax and vertebral column, rib fractures. A physician suspected myelomatosis (plasmocytoma). Which of the following laboratory indices will be of the greatest diagnostic importance?
C. *Paraproteinemia
187. After a road accident a driver was delivered to the hospital with an injury of the medial epicondyle of humerus. What nerve might be damaged in this case?
D. *n. ulnaris
188. During an experiment vagus branches that innervate heart are being stimulated. This has stopped conduction of excitement from the atria to the ventricles. The reason for it are electrophysical changes in the following structures:
B. *Atrioventricular node
189. A patient with a limb fracture must be administered a depolarizing drug from the myorelaxant group for the purpose of a shorttime surgery. What drug is it?
D. *Dithylinum
190. It was established that agglutination of the recipient's blood erythrocytes had been caused by the standard sera from the I and II groups. Serum from the III group as well as anti-Rh serum hadn't provoked any agglutination. Which blood group and rhesus is allowed to be transfused this recipient?
D. *B, a (III) Rh—
191. A worker of a cattle farm fell acutely ill and then died from the progressing intoxication. Autopsy revealed enlarged, hyposthenic spleen of dark-cherry colour when dissected; excessive pulp scraping. At the base and fornix of brain pia maters are edematous, soaked with blood, dark-red ("scarlet hat"). Microscopic examination revealed serous haemorrhagic inflammation of brain tissues and tunics along with destruction of small vessel walls. What is the most likely diagnosis?
C. *Anthrax
192. Pharmacological effects of antidepressants are based upon blocking (inhibiting) the enzyme that acts as a catalyst for the breakdown of biogenic amines noradrenalin and serotonin in the mitochondria of cephalic neurons. What enzyme takes part in this process?
C. *Monoamine oxidase
193. A patient with clinical presentations of immunodeficiency has undergone immunological tests. They revealed significant decrease in number of cells that form rosettes with sheep erythrocytes. What conclusion can be drowning on the ground of the analysis data?
E. *Decrease in T-lymphocyte level
194. A 50-year-old patient complains about general weakness, appetite loss and cardiac arrhythmia. The patient presents with muscle hypotonia, flaccid paralyses, weakened peristaltic activity of the bowels. Such condition might be caused by:
A. *Hypokaliemia
195. A 60-year-old patient presents with weakened peristaltic activity of the bowels. Which of the following foodstuffs would stimulate peristalsis most of all?
A. *Brown bread
196. A patient has an increased pyruvate concentration in blood. A large amount of it is excreted with the urine. What vitamin is lacking in this patient?
A. *B1
197. A patient presents with twilight vision impairment. Which of the following vitamins should be administered?
C. *Retinol acetate
198. ECG of a patient shows such alterations: F-wave is normal, P — Q-interval is short, ventricular QRST complex is wide, .R-wave is double-peak or two-phase. What form of arrhythmia is it?
C. *WPW syndrome (Wolff-Parkinson-White)
199. In the pubertal period cells of the male sexual glands start producing the male sexual hormone testosterone that is responsible for formation of the secondary sexual characters. What cells of the male sexual glands produce this hormone?
A. *Leidig cells
200. While eating a child choked on food and aspirated it. The child has severe cough, cyanotic skin and mucous membranes, rapid pulse, infrequent respiration, prolonged expiration. The child has developed the following disorder of the external respiration:
C. *Expiratory dyspnea under asphyxia
Krok 1. Medicine-2010
1 Two hours after an exam a student had a blood count done and it was revealed that he had leukocytosis without significant leukogram modifications. What is the most probable mechanism of leukocytosis development?
A. Leukopoiesis intensification and deceleration of leukocyte lysis
B. Redistribution of leukocytes in the organism
C. Deceleration of leukocyte migration to the tissues
D. Deceleration of leukocyte lysis
E. Leukopoiesis intensification
2 A patient was stung by a be E. Examination revealed that his left hand was hot, pink, edematic, there was a big red blister on the site of sting. What is the leading mechanism of edema development?
A. Reduced vessel filling
B. Drop of osmotic pressure in tissue
C. Increased vessel permeability
D. Injury of vessels caused by the sting
E. Drop of oncotic pressure in tissue
3 A patient caught a cold after which there appeared facial expression disorder. He cannot close his eyes, raise his eyebrows, bare his teeth. What nerve is damaged?
A. Glossopharyngeal
B. Trigeminus
C. Vagus
D. Infraorbital
E. Facial
4 A newborn child has convulsions that have been observed after prescription of vitamin B6. This most probable cause of this effect is that vitamin B6 is a componet of the following enzyme:
A. Netoglubarate dehydromine
B. Pyruvate dehydrostase
C. Glutamate decarboxylase
D. Aminolevulinate synthase
E. Glycogen phosphorylase
5 Bacterioscopic examination of a smear from the pharynx of a diphtheria suspect revealed bacilli with volutine granules. What etiotropic drug should be chosen in this case?
A. Diphtheritic anatoxin
B. Interferon
C. Bacteriophage
D. Antidiphtheritic antitoxic serum
E. Eubiotic
6 A patient has a decreased vasopressin synthesis that causes polyuria and as a result of it evident organism dehydratation. What is the mechanism of polyuria development?
A. Reduced tubular reabsorption of protein
B. Acceleration of glomerular filtration
C. Reduced tubular reabsorption of $Na$ ions
D. Reduced tubular reabsorption of water
E. Reduced glucose reabsorption
7 A 62 year old patient who previously worked as stoker was admitted to a hospital with complaints about general weakness, abrupt weight loss, hoarse voice, dyspnea, dry cough. Laryngoscopy revealed a tumour in the pharynx that invaded vocal cords and epiglottis. What is the most probable cause of tumour development?
A. Nitrosamines
B. Polycyclic aromatic carbohydrates
C. Retroviruses
D. Ionizing radiation
E. Aromatic amines and amides
8 Patients who suffer from severe diabetes and don't receive insulin have metabolic acidosis. This is caused by increased concentration of the following metabolites:
A. Unsaturated fatty acids
B. Fatty acids
C. Triacylglycerols
D. Ketone bodies
E. Cholesterol
9 A 62 year woman complains of frequent pain attacks in the area of her chest and backbone, rib fractures. Her doctor suspected myeloma (plasmocytoma). What of the following laboratory characteristics will be of the greatest diagnostic importance?
A. Hypoglobulinemia
B. Proteinuria
C. Hyperalbuminemia
D. Hypoproteinemia
E. Paraproteinemia
10 A 2 year old child had acute respiratory viral infection and died from cardiopulmonary decompensation. Autopsy revealed that his right lung was hyperemic; in the 2nd, 6th and 10th segments and on the incision there were airless yellowish foci of irregular form, from several mm up to 1 cm larg E. Microscopical examination revealed exudate consisting mainly of neutrophils in the given areas of pulmonary tissue in the alveoles, bronchioles and bronchial tubes. What is the most probable diagnosis?
A. Acute bronchitis
B. Interstitial pneumonia
C. Focal pneumonia
D. Croupous pneumonia
E. Pulmonary abscess
11 Autopsy of a 17 year old girl who died from pulmonary failure revealed a small area of caseous necrosis in the inferior lobe of the right lung, and occurences of caseous necrosis in the bronchopulmonary, bronchial and bifurcational lymph nodes. What is the most probable postmortem diagnosis?
A. Hematogenous progression of primary tuberculosis
B. Hematogenous tuberculosis with predominant lung affection
C. Caseous pneumonia under secondary tuberculosis
D. Tuberculoma
E. Primary tuberculosis
12 People adapted to high external temperatures have such pecularity: profuse sweating isn't accompanied by loss of large volumes of sodium chlorid E. This is caused by the effect of the following hormone upon the perspiratory glands:
A. Aldosterone
B. Natriuretic
C. Cortisol
D. Tgyroxin
E. Vasopressin
13 An experimantal animal that was kept on protein-free diet developed fatty liver infiltration, in particular as a result of deficiency of methylating agents. This is caused by disturbed generation of the following metabolite:
A. Acetoacetate
B. Cholesterol
C. DOPA
D. Choline
E. Linoleic acid
14 A man weighs 80 kg, after long physical activity his circulating blood volume is reduced down to 5,4 l, hematocrit makes up 50%, whole blood protein is 80 g/l. These blood characteristics are determined first of all by:
A. Water loss with sweat
B. Increased diuresis
C. Increased number of erythrocytes
D. Increased circulating blood volume
E. Increased protein concentration in plasm
15 Examination of a patient with impaired blood coagulation revealed thrombosis of a branch of inferior mesenteric artery. What bowel segment is damaged?
A. Colon transversum
B. Colon sigmoideum
C. Caecum
D. Ileum
E. Colon ascendens
16 A 42 year old woman with neuralgia of trifacial nerve complains about periodical reddening of the right part of her face and neck, sense of warmth gush, increased skin sensitivity. These effects can be explained by the following type of arterial hyperemia:
A. Reactive
B. Functional
C. Metabolic
D. Neuroparalytic
E. Neurotonic
17 A 7 year old child often suffers from streprococcic angin A. Doctor suspected development of rheumatism and administered serological examination. The provisional diagnosis will be most probably confirmed by presence of antibodies to the following streptococcic antigen:
A. M-protein
B. Capsular polysaccharide
C. C-carbohydrate
D. O-streptolysin
E. Erythrogenic toxin
18 Clinical diagnosis of a female patient was gonorrhoe A. What examination method can be applied for confirmation of this diagnosis?
A. Test with bacteriophage
B. Immobilization reaction
C. Hemagglutination reaction
D. Infection of laboratory animals
E. Microscopy of pathological material
19 A patient staggers and walks astraddl E. He has hypomyotonia of arm and leg muscles, staccato speech. In what brain section is this affection localized?
A. Cerebellum
B. Red nucleus
C. Caudate nucleus
D. Motor cortex
E. Putamen
20 A bacteriological laboratory received sputum sample of a patient suffering from tuberculosis. Bacterioscopic examination of smears and detection of tuberculosis bacillus can be realized by one of enrichment methods that involves processing of sputum only with solution of caustic sod A. What is this method called?
A. Inactivation
B. Neutralization
C. Homogenization
D. Flotation
E. Filtration
21 Examination of an ovary specimen stained by hematoxylin-eosine revealed a follicle in which follicular epithelium consisted of 1-2 layers of cubic cells. There was also a bright red membrane around the ovocyt E. What follicle is it?
A. Mature
B. Primary
C. Secondary
D. Atretic
E. Primordial
22 Laboratory examination of a child revealed increased concentration of leucine, valine, isoleucine and their ketoderivatives in blood and urin E. Urine smelt of maple syrup. This disease is characterized by the deficit of the following enzyme:
A. Dehydrogenase of branched amino acids
B. Phosphofructomutase
C. Aminotransferase
D. Glucose-6-phosphatase
E. Phosphofructokinase
23 Autopsy of a man who died from burn disease revealed brain edema, liver enlargement as well as enlargement of kidneys with wide light-grey cortical layer and plethoric medullary are A. Microscopic examination revealed necrosis of tubules of main segments along with destruction of basal membranes, intersticium edema with leukocytic infiltration and haemorrhages. What is the most probable postmortem diagnosis?
A. Pyelonephritis
B. Tubulointerstitial nephritis
C. Necrotic nephrosis
D. Gouty kidney
E. Myeloma kidney
24 A couple had a child with Down's diseas E. Mother is 42 years ol D. This disease is most probably caused by the following impairment of prenatal development:
A. Blastopathy
B. Gametopathy
C. Embryopathy
D. Non-specific fetopathy
E. Specific fetopathy
25 A patient suffering from pheochromocytoma complains of thirst, dry mouth, hunger. Blood test for sugar revealed hyperglycemi A. What type of hyperglycemia is it?
A. Adrenal
B. Alimentary
C. Hypercorticoid
D. Somatotropic
E. Hypoinsulinemic
26 Examination of a newborn boy's genitalia revealed an urethral hiatus that opens on the undersite of his penis. What malformation is it?
A. Cryptorhidism
B. Monorchism
C. Epispadia
D. Hermaphroditism
E. Hypospadias
27 Blood of a 12 year old boy presents low concentration of uric acid and accumulation of xanthine and hypoxanthin E. This child has genetic defect of the following enzyme:
A. Ornithine carbamoyltransferase
B. Arginase
C. Xanthine oxidase
D. Glycerylkinase
E. Urease
28 Cytogenetic examination of a patient with reproductive dysfunction revealed normal karyotype 46 ХY in some cells, but most cells have karyotype of Klinefelter's syndrome - 47 ХХY. Such cell heterogenity is called:
A. Mosaicism
B. Duplication
C. Inversion
D. Monomorphism
E. Transposition
29 A patient got an injury of spinal marrow in a road accident that caused loss of tactile sensation, posture sense, vibration sens E. What conduction tracts are damaged?
A. Anterior spinocerebellar tract
B. Tectospinal tract
C. Fascicle of Goll and cuneate fascicle
D. Rubrospinal tract
E. Reticulospinal tract
30 A 15 year old girl has pale skin, glossitis, gingivitis. Blood count: erythrocytes - 3,3*1012/l, hemoglobin - 70 g/l, colour index - 0,5. Examination of blood smear revealed hypochromia, microcytosis, poikilocytosis. What type of anemia is it?
A. Sickle-cell
B. Thalassemia
C. B12-folic acid-deficient
D. Hemolytic
E. Iron-deficient
31 Blood group of a 30 year old man was specified before an operation. His blood is Rh-positiv E. Reaction of erythrocyte agglutination was absent with standard sera of 0a\b (I), Аb (II), Вa (III) groups. The blood under examination is of the following group:
A. Аb (II)
B. 0a\b (I)
C. АВ (IV)
D. Вa (III)
E. -
32 A female patient underwent liver transplantation. 1,5 month after it her condition became worse because of reaction of transplant rejection. What factor of immune system plays the leading part in this reaction?
A. T-killers
B. B-lymphocytes
C. T-helpers
D. Interleukin-1
E. Natural killers
33 A patient was admitted to the surgical department with inguinal herni A. During the operation the surgeon performs plastic surgery on posterior wall of inguinal canal. What structure forms this wall?
A. Aponeurosis of abdominal external oblique muscle
B. Loose inferior edge of transverse abdominal muscle
C. Peritoneum
D. Inguinal ligament
E. Transverse fascia
34 A patient suffers from pulmonary tuberculosis. During treatment neuritis of visual nerve aros E. What drug has caused this by-effect?
A. Rifampicin
B. Streptomycin
C. Kanamycin
D. Ethambutol
E. Isoniazid
35 A patient with chronic cardiac insufficiency has been taking foxglove (Digitalis) preparations for a long tim E. Due to the violation of intake schedule the woman got symptoms of intoxication. These symptoms result from:
A. Material cumulation
B. Antagonism
C. Tachyphylaxis
D. Sensibilization
E. Idiosyncrasy
36 A patient had been suffering from profuse diarrhea and vomiting for 2 days. He died from acute dehydration. Autopsy revealed that the intestinal wall was edematic and hyperemic, with multiple haemorrhages in the mucous membran E. Intestine lumen contains whitish fluid resembling of rice water. What disease caused death?
A. Enterocolitis
B. Dysentery
C. Salmonellosis
D. Cholera
E. Typhoid fever
37 A 30 year old man had been suffering from acute respiratory disease and died from cardiopulmonary decompensation. Autopsy revealed fibrinous-haemorrhagic inflammation in the mucous membrane of larynx and trachea, destructive panbronchitis, enlarged lungs that look black due to the multiple abcesses, haemorrhages, necrosis. What is the most probable postmortem diagnosis?
A. Parainfluenza
B. Measles
C. Adenoviral infection
D. Influenza
E. Respiratory syncytial infection
38 A patient was diagnosed with bartholinitis (inflammation of greater vulvovaginal glands). In which organ of urogenital system are these glands localized?
A. Clitoris
B. Small lips of pudendum
C. Uterus
D. Vagina
E. Large lips of pudendum
39 Examination of a patient revealed typical presentations of collagenosis. This pathology is characterized by increase of the following urine index:
A. Arginine
B. Hydroxyproline
C. Glucose
D. Mineral salts
E. Ammonium salts
40 After destruction of CNS structures an animal lost orientative reflexes. What structure was destroyed?
A. Medial reticular nuclei
B. Black substance
C. Lateral vestibular nuclei
D. Quadrigeminal plate
E. Red nucleus
41 A patient has been syffering from diarrhea for 5 day. On the fith day colonoscopy revealed that membrane of rectum was inflamed, there were greyish-green films closely adhering to the subjacent tissu E. What is the most probable diagnosis?
A. Typhoid fever
B. Crohn's disease
C. Nonspecific ulcerous colitis
D. Dysentery
E. Salmonellosis
42 A cerebral trauma caused increased ammonia generation. What amino acid participates in the excretion of ammonia from the cerebral tissue?
A. Lysine
B. Tryptophan
C. Valine
D. Tyrosine
E. Glutamic
43 A patient suffers from diabetes melitus. After the regular insulin injection his condition grew worse: there appeared anxiety, cold sweat, tremor of limbs, general weakness, dizziness. What preparation can eliminate these symptoms?
A. Noradrenaline
B. Caffeine
C. Glibutide
D. Adrenaline hydrochloride
E. Butamide
44 Examination of a child who frequently suffers from infectious diseases revealed that IgG concentration in blood serum was 10 times less than normal, IgA and IgM concentration was also significantly reduce D. Analysis showed also lack of B-lymphocytes and plasmocytes. What disease are these symptoms typical for?
A. Swiss-type agammaglobulinemia
B. Louis-Bar syndrome
C. Dysimmunoglobulinemia
D. Di George syndrome
E. Bruton's disease
45 A patient suffering from stenocardia was taking nitroglycerine which caused restoration of blood supply of myocardium and relieved pain in the cardiac are A. What intracellular mechanism provides restoration of energy supply of insulted cells?
A. Intensification of RNA generation
B. Intensification of ATP resynthesis
C. Intensification of oxygen transporting into the cell
D. Increased permeability of membranes
E. Reduction of ATP resynthesis
46 A 66 year old female patient got intravenous injection of magnesium sulfate solution for the purpose of elimination of hypertensive crisis. But arterial pressure didn't go down and after repeated introduction of the same preparation there appered sluggishness, slow response, inhibition of consciousness and respiration. What preparation is antagonist of magnesium sulfate and can eliminate symptoms of its overdose?
A. Potassium permanganate
B. Calcium chloride
C. Potassium chloride
D. Sodium chloride
E. Activated carbon
47 A 19 year old woman suffers from primary syphilis. Doctor administered her complex therapy that includes benzylpenicillin sodium salt. What is the mechanism of action of this drug?
A. It blocks synthesis of cytoplasm proteins
B. It blocks DNA synthesis
C. It blocks synthesis of peptidoglycan of microbal membrane
D. It blocks RNA synthesis
E. It blocks thiol enzymes
48 Students who are taking examinations often have dry mouth. The mechanism that causes this state is the realization of the following reflexes:
A. Unconditioned peripheral
B. Unconditioned sympathetic
C. Conditioned sympathetic
D. Unconditioned parasympathetic
E. Conditioned parasympathetic
49 A patient is 44 years ol D. Laboratory examination of his blood revealed that content of proteins in plasma was 40 g/l. What influence will be exerted on the transcapillary water exchange?
A. Filtration will be decreased, reabsorption - increased
B. Both filtration and reabsorption will be decreased
C. Both filtration and reabsorption will be increased
D. Exchange will stay unchanged
E. Filtration will be increased, reabsorption - decreased
50 A viral infection has damaged cells that form walls of bile capillaries. This stimulated conditions for inflow of bile into the blood of sinusoidal capillaries. What cells are damaged?
A. Pit-cells
B. Endotheliocytes
C. Kupffer's cells
D. Ito cells
E. Hepatocytes
51 A healthy man is in a region with high risk of catching malari A. What drug should be administered for individual chemoprophylaxis of malaria?
A. Biseptol
B. Sulfalen
C. Tetracycline
D. Metronidazole
E. Chingamin
52 A child is pale, pastose, muscular tissue is bad developed, lymph nodes are enlarge D. He often suffers from angina and pharyngitis, blood has signs of lymphocytosis. The child is also predisposed to autoallergic diseases. What type of diathesis can be presumed in this case?
A. Exudative
B. Gouty
C. Asthenic
D. Hemorrhagic
E. Lymphohypoplastic
53 Autopsy of a 5 year old child revealed in the area of vermis of cerebellum a soft greyish-pink node 2 cm in diameter with areas of haemorrhag E. Histologically this tumour consisted of atypical monomorphous small roundish cells with big polymorphous nuclei. What tumour is it?
A. Astrocytoma
B. Oligodendroglioma
C. Glioblastoma
D. Meningioma
E. Medulloblastoma
54 Surface with an intact toad on it was inclined to the right. Tone of extensor muscles became reflectory higher due to the activation of the following receptors:
A. Proprioreceptors
B. Photoreceptors of retina
C. Vestibuloreceptors of semicircular ducts
D. Mechanoreceptors of foot skin
E. Vestibuloreceptors of utricle and saccule
55 Lungs of a preterm infant have areas of atelectasis (pulmonary collapse). The main cause is:
A. Underdeveloped inspiration muscles
B. Diminished force of surface tension of lungs
C. Increased viscous resistance
D. Surfactant excess
E. Surfactant deficiency
56 A patient got a trauma that caused dysfunction of motor centres regulating activity of head muscles. In what parts of cerebral cortex is the respective centre normally localized?
A. Inferior part of precentral gyrus
B. Angular gyrus
C. Superior parietal lobule
D. Superior part of precentral gyrus
E. Supramarginal gyrus
57 A patient suffers from stenocardia and takes isosorbide mononitrat E. He was prescribed a complementary drug with disaggregating effect. What drug is it?
A. Propranolol
B. Nitroglycerine
C. Acetylsalicinic acid
D. Validol
E. Nifedipine
58 A patient in a transplantation centre underwent heart transplantation. The organ was taken from a donor who died in a road accident. Foreign heart can be rejected as a result of development of transplantation immunity. It is usually prevented by means of:
A. Immunosuppressors
B. X-ray therapy
C. Chemotherapy
D. Enzymes
E. Ultrasound
59 A woman was delivered to a hospital for trachea intubation. What of the following drugs should be applied in this case?
A. Metronidazole
B. Nitroglycerine
C. Dithylinum
D. Atropine sulfate
E. Gentamycin sulfate
60 A patient with skin mycosis has disorder of cellular immunity. The most typical characteristic of it is reduction of the following index:
A. T-lymphocytes
B. Immunoglobulin E
C. Immunoglobulin G
D. B-lymphocytes
E. Plasmocytes
61 Examination of a patient suffering from frequent haemorrhages in the inner organs and mucous membranes revealed proline and lysine being included in collagen fibers. Impairment of their hydroxylation is caused by lack of the following vitamin:
A. C
B. K
C. D
D. E
E. A
62 A patient complained about being unable to adduct and abduct fingers in the metacarpophalangeal articulations towards and away from the 3rd finger. Which muscles' function is impaired?
A. Long flexors of fingers
B. Interosseous muscles
C. Lumbrical muscles
D. Breviflexors of fingers
E. Extensors
63 A newborn child suffers from milk curdling in stomach, this means that soluble milk proteins (caseins) transform to insoluble proteins (paracaseins) by means of calcium ions and a certain enzym E. What enzyme takes part in this process?
A. Pepsin
B. Renin
C. Lipase
D. Secretin
E. Gastrin
64 During preparation of a patient to a heart surgery it was necessary to measure pressure in heart chambers. In one of them pressure varied from 0 mm Hg up to 120 mm Hg within one cardiac cycl E. What heart chamber is it?
A. Left ventricle
B. Left atrium
C. -
D. Right ventricle
E. Right atrium
65 A 50 year old patient underwent resection of tumour of large intestine wall. Microscopically it presents itself as fascicles of divergent collagen fibers of different thickness and form and some monomorphous fusiform cells that are irregularly distributed among the fibers. Cellular atypia is not evident. What tumour is it?
A. Fibromyoma
B. Fibrosarcoma
C. Soft fibroma
D. Hard fibroma
E. Desmoma
66 During regular examination of schoolchildren it was revealed that a 10 year old girl had asymmetric oval eggs with a larva in the scrape from her perianal folds. What diagnosis should be made?
A. Ascariasis
B. Trichocephalosis
C. Enterobiasis
D. Amebiasis
E. Ankylostomiasis
67 Examination of a man who had been working hard under higher temperature of the environment revealed abnormal quantity of blood plasma proteins. What phenomenon is the case?
A. Dysproteinemia
B. Paraproteinemia
C. Absolute hypoproteinemia
D. Relative hyperproteinemia
E. Absolute hyperproteinemia
68 A patient consumed a lot of reach in proteins food that caused increase of rate of proteolytic enzymes of pancreatic juic E. It is also accompanied by increase of rate of the following enzyme:
A. Pepsin
B. Gastricsin
C. Renin
D. Tripsin
E. Enterokinase
69 6 months after labour a woman had uterine hemorrhag E. Gynaecological examination of uterine cavity revealed a dark-red tissue with multiple cavities resembling of a "sponge". Microscopic examination of a tumour revealed in blood lacunas atypic light epithelial Langhans cells and giant cells of syncytiotrophoblast. What tumour is it?
A. Squamous cell nonkeratinous carcinoma
B. Chorioepithelioma
C. Fibromyoma
D. Cystic mole
E. Adenocarcinoma
70 A patient was diagnosed with paralysis of facial and masticatory muscles. The haematoma is inside the genu of internal capsul E. What conduction tract is damaged?
A. Tr. cortico-fronto-pontinus
B. Tr. cortico-thalamicus
C. Tr. cortico-temporo-parieto-occipito-pontinus
D. Tr. cortico-spinalis
E. Tr. cortico-nuclearis
71 A sportsman needs to improve his sporting results. He was recommended to take a preparation that contains carnitin E. What process is activated the most by this compound?
A. Vitamin K transporting
B. Glucose transporting
C. Fatty acids transporting
D. Amino acids transporting
E. Calcium ions transporting
72 An unconscious young man with signs of morphine poisoning entered admission offic E. His respiration is shallow and infrequent which is caused by inhibition of respiratory centr E. What type of respiratory failure is it?
A. Perfusive
B. Ventilative restrictive
C. Diffusive
D. Ventilative obstructive
E. Ventilative dysregulatory
73 A patient has delayed conduction of excitement through the atrioventricular nod E. What changes of ECG will be observed?
A. Prolongation of Q-T interval
B. S-T-segment displacement
C. Prolongation of P-Q interval
D. Negative T wave
E. Prolongation of Q-S interval
74 Roentgenological examination of skull base bones revealed enlargement of sellar cavity, thinning of anterior clinoid processes, destruction of different parts, destruction of different parts of sella turcic A. Such bone destruction might be caused by a tumour of the following wndocrinous gland:
A. Hypophysis
B. Thymus gland
C. Epiphysis
D. Thyroid gland
E. Adrenal glands
75 A 33 year old man died from uraemi A. Autopsy revealed enlarged kidneys weighing 500,0 each and consisting of multiple cavities 0,5-2 cm in diameter. The cavities were full of light-yellow transparent liqui D. Renal pelvis and ureters had no pecularities. What renal disease caused uraemia?
A. Renal tumour
B. Renal tuberculosis
C. Rapidly progressing glomerulonephritis
D. Bilateral polycystic renal disease
E. Chronic pyelonephritis
76 Inflammatory processes cause synthesis of protein of acute phase in an organism. What substances stumulate their synthesis?
A. Interleukin-1
B. Angiotensin
C. Interferons
D. Immunoglobulins
E. Biogenic amins
77 In order to determine toxigenicity of diphtheria bacilli a strip of filter paper impregnated with antitoxic diphtherial serum was put on the dense nutrient medium. There were also inoculated a microbal culture under examination and a strain that is known to be toxigeni C. If the microbal culture under examination produces exotoxin, this wil result in formation of:
A. Zones of lecithovitellinous activity
B. Precipitin lines
C. Zones of diffuse opacification
D. Haemolysis zones
E. Precipitin ring
78 A patient was admitted to the infectious department. His symptoms: dry skin, decreased skin turgor, rice-water stool. The patient was diagnosed with choler A. What disorder of water-electrolytic balance is most often observed in this disease?
A. Hyperosmotic hyperhydration
B. Hyperosmotic hypohydration
C. Hypoosmotic hypohydration
D. Hypoosmotic hyperhydration
E. Isoosmotic hypohydration
79 A patient has herpetic rash. What medication should be administered?
A. Benzylpenicillin sodium salt
B. Gentamycin
C. Biseptol
D. Clotrimazole
E. Acyclovir
80 Inflammation of the tympanic cavity (purulent otitis media) was complicated by inflammation of mammillary process sockets. What wall of tympanic cavity did the pus penetrate into the sockets through?
A. Lateral
B. Anterior
C. Medial
D. Posterior
E. Superior
81 ECG of a patient shows prolongation of T-wav E. This is caused by deceleration in ventricles of:
A. Depolarization and repolarization
B. Contraction
C. Depolarization
D. Relaxation
E. Repolarization
82 A patient suffers from chronic left-ventricular insufficiency. What medication should be administered?
A. Pyracetam
B. Vinpocetine
C. Bemegride
D. Digoxin
E. Etimizole
83 A patient suffering from infectious mononucleosis has been taking glucocorticosteroids for two weeks. This resulted in remission but the patient got exacerbation of chronic tonsillitis. This complication is induced by the following effect of glucocorticosteroids:
A. Anti-shock
B. Antitoxic
C. Antiallergenic
D. Immunosuppressive
E. Anti-inflammatory
84 An alcoholic woman has born a girl with mental and physical developmental lag. Doctors diagnosed the girl with fetal alcohol syndrom E. What effect is the cause of the girl's state?
A. Malignization
B. Carcinogenic
C. Mechanic
D. Teratogenic
E. Mutagenic
85 A patient complained about dizziness, memory impairment, periodical convulsions. It was revealed that these changes were caused by a product of decarboxylation of glutamic aci D. Name this product:
A. Pyridoxal phosphate
B. GABA
C. TDP
D. THFA
E. ATP
86 During an experiment a skeletal muscle is stimulated by a series of electric impulses. What type of muscle contraction will be observed provided that each subsequent impulse comes in the period of shortening of the previous single muscle contraction?
A. Holotetanus
B. A series of single contractures
C. Asynchronous tetanus
D. Partial tetanus
E. Muscle contracture
87 Vagus branches that innervate heart are being stimulated during an experiment. This caused reduction of heart rate due to the intensification of the following process (through the cell membrane of cardiac pacemaker):
A. Calcium ion yield
B. Calcium and potassium ion yield
C. Calcium ion entry
D. Potassium ion entry
E. Potassium ion yield
88 Untrained people often have muscle pain after sprints as a result of lactate accumulation. This might be caused by intensification of the following biochemical process:
A. Lipogenesis
B. Glycogenesis
C. Pentose phosphate pathway
D. Glycolysis
E. Gluconeogenesis
89 A patient complains of frequent diarrheas, especially after consumption of rich food, weight loss. Laboratory examination revealed steatorrhea; his feces were hypocholi C. What might have caused such condition?
A. Unbalanced diet
B. Lack of pancreatic phospholipase
C. Lack of pancreatic lipase
D. Inflammation of mucous membrane of small intestine
E. Obturation of biliary tracts
90 A 30 year old woman has face edemat A. Examination revealed proteinuria (5,87 g/l), hypoproteinemia, dysproteinemia, hyperlipidemi A. What condition is the set of these symptoms typical for?
A. Nephritic syndrome
B. Chronic pyelonephritis
C. Nephrotic syndrome
D. Acute renal failure
E. Chronic renal failure
91 A scheme presents an exocrinous gland that has unbranched excretory duct with a terminal part in form of a saccule openining into the duct. How is this gland called according to the morphological classification of exocrinous glands?
A. Compound unbranched alveolar tubular
B. Compound unbranched alveolar
C. Simple branched tubular
D. Simple unbranched alveolar
E. Compound branched alveolar
92 In course of laparotomy a surgeon revealed gangrenous lesion of descending colon. It was caused by thrombosis of the following artery:
A. Sinister colic
B. Ileocolic
C. Superior mesenteric artery
D. Median colic
E. Dexter colic
93 Brain tomography revealed a tumour in the region of red nucleus. What part of brain isdamaged?
A. Midbrain
B. Interbrain
C. Medulla oblongata
D. Cerebellum
E. Pons cerebelli
94 A patient has been suffering from elevated temperature and attacks of typical cough for 10 days. Doctor administered inoculation of mucus from the patient's nasopharynx on the agar. What microorganism is presumed?
A. Klebsiella
B. Pfeiffer's bacillus
C. Staphylococcus
D. Listeria
E. Pertussis bacillus
95 A 44 year old woman complains of general weakness, heart pain, significant increase of body weight. Objectively: moon face, hirsutism, AP is 165/100 mm Hg, height - 164 cm, weight - 103 kg; the fat is mostly accumulated on her neck, thoracic girdle, belly. What is the main pathogenetic mechanism of obesity?
A. Increased mineralocorticoid production
B. Increased production of glucocorticoids
C. Reduced production of thyroid hormones
D. Increased insulin production
E. Reduced glucagon production
96 A patient in postoperative period was prescribed an anticholinesterase drug for stimulation of intestinal peristalsis and tonus of urinary bladder. What drug is it?
A. Propanolol
B. Proserin
C. Dichlothiazide
D. Reserpine
E. Mannitol
97 A patient suffering from initial hypertension has been taking an antihypertensive preparation for a long tim E. Suddenly he stopped taking this preparation. After this his condition grew worse, this led to development of hypertensive crisis. This by-effect can be classified as:
A. Cumulation
B. Dependence
C. Sensibilization
D. Abstinence syndrome
E. Tolerance
98 Hepatitis has led to the development of hepatic failur E. Mechanism of edemata formation is activated by the impairment of the following liver function:
A. Chologenetic
B. Barrier
C. Protein-synthetic
D. Antitoxic
E. Glycogen-synthetic
99 A patient has acne on his fac E. Microspcopic examination of scrapings from the affected areas revealed living porrect vermiform arthropoda 0,2-0,5 mm large with four pairs of short extremities in the front part of their bodies. What is the laboratory diagnosis?
A. Myiasis
B. Scabies
C. Demodicosis
D. Pediculosis
E. Phthiriasis
100 A 64 year old woman has impairment of twilight vision (hemeralopy). What vitamin should be recommended in the first place?
A. Vitamin E
B. Vitamin A
C. Vitamin C
D. Vitamin B6
E. Vitamin B2
101 A patient has difficulties with hand movement. Examination revealed inflammation of common synovial sheath of flexor muscles. It is known from the patient's anamnesis that he got a stab wound of finger a week ago. Which finger was most probably damaged?
A. Digitus medius
B. Pollex
C. Digitus anularis
D. Digitus minimus
E. Index
102 A patient with obliterating atherosclerosis underwent sympathectomy of femoral artery in the region of femoral trigon E. What type of arterial hyperemia was induced by the operation?
A. Functional
B. Neurotonic
C. Metabolic
D. Neuroparalytic
E. Reactive
103 A 47 year old man with myocardium infarction was admitted to the cardiological department. What changes of cellular composition of peripheral blood are induced by necrotic changes in the myocardium?
A. Monocytosis
B. Eosinophilic leukocytosis
C. Neutrophilic leukocytosis
D. Lymphopenia
E. Thrombocytopenia
104 A 60 year old patient has impaired perception of high-frequency sounds. These changes were caused by damage of the following auditory analyzer structures:
A. Eustachian tube
B. Main cochlea membrane near the helicotrema
C. Tympanic membrane
D. Main cochlea membrane near the oval window
E. Middle ear muscles
105 Examination of a 42 year old patient revealed a tumour of adenohypophysis. Objectively: the patient's weight is 117 kg, he has moon-like hyperemic face, red-blue striae of skin distension on his belly. Osteoporosis and muscle dystrophy are present. AP is 210/140 mm Hg. What is the most probable diagnosis?
A. Cushing's syndrome
B. Conn's disease
C. Cushing's disease
D. Essential hypertension
E. Diabetes mellitus
106 A histological specimen presents an artery. One of the membranes of its wall has flat cells lying on the basal membran E. What type of cells is it?
A. Smooth myocytes
B. Macrophages
C. Mesothelium
D. Fibroblasts
E. Endothelium
107 A patient with hip fracture was prescribed a narcotic analgeti C. Its anesthetic action is determined by interaction with the following receptors:
A. Cholinoreceptors
B. Benzodiazepine receptors
C. Opiate receptors
D. Adrenoreceptors
E. GABA-ergic receptors
108 A 46 year old woman suffering from chololithiasis developed jaundic E. Her urine became dark-yellow and feces became colourless. Blood serum will have the highest concentration of the following substance:
A. Mesobilirubin
B. Urobilinogen
C. Biliverdin
D. Conjugated bilirubin
E. Unconjugated bilirubin
109 Normal, actively dividing cells of human red bone marrow are analyze D. What number of cells' chromosomes is typical for G1 period?
A. 46
B. 48
C. 23
D. 45
E. 47
110 A patient is ill with diabetes mellitus accompanied by hyperglycemia on an empty stomach (7,2 millimole/l). The hyperglycemia rate can be retrospectively estimated (over the last 4-8 weeks before the examination) on the ground of the rate of the following blood plasma protein:
A. Ceruloplasmin
B. Fibrinogen
C. C-reactive protein
D. Albumin
E. Glycated hemoglobin
111 When blood circulation in the damaged tissue is restored, then lactate accumulation comes to a stop and glucose consumption decelerates. These metabolic changes are caused by activation of the following process:
A. Gluconeogenesis
B. Aerobic glycolysis
C. Glycogen biosynthesis
D. Lipolysis
E. Anaerobic glycolysis
112 During influenza epidemic 40% of pupils who didn't go in for sports were affected by the disease, and among the pupils who regularly did physical exercises this index was only 20%. What adaptative mechanisms determined such a low sickness rate of pupils participating in the sports?
A. Specific adaptation
B. Biochemical adaptation
C. Physiological adaptation
D. Cross adaptation
E. Genetic adaptation
113 A 65 year old female patient suffers from chronic renal insufficiency accompanied by evident edemata caused by chronic glomerulonephritis. What diuretic should be administered for forced diuresis?
A. Cyclometazide
B. Acetazolamide
C. Hydrochlorothiazide
D. Chlorthalidone
E. Furosemide
114 A patient suffering from chronic cardiac insufficiency was recommended to undergo a prophylactic course of treatment with a cardiological drug from the group of cardiac glycosides that is to be taken enterally. What drug was recommended?
A. Cordarone
B. Strophanthine
C. Cordiamin
D. Corglycon
E. Digoxin
115 One of sections of central nervous system has layerwise arrangement of neurocytes. Among them there are cells of the following forms: stellate, fusiform, horizontal, pyramidal. What section of central nervous system is this structure typical for?
A. Cortex of cerebrum
B. Hypothalamus
C. Medulla oblongata
D. Spinal cord
E. Cerebellum
116 A 4 year old child complained of pain during deglutition, indisposition. Objectively: palatine arches and tonsils are moderately edematic and hyperemic, there are greyish-white films up to 1 mm thick closely adhering to the subjacent tissues. What pathological process are these changes typical for?
A. Dystrophy
B. Inflammation
C. Metaplasia
D. Organization
E. Necrosis
117 A foreign body (a button) closed space of the right superior lobar bronchus. What segments of the right lung won't be supplied with air?
A. Apical and posterior basal
B. Medial and lateral
C. Superior and inferior lingular
D. Apical, posterior, anterior
E. Apical and median basal
118 A patient ill with thrombophlebitis of his lower limbs had chest pain, blood spitting, progressing respiratory insufficiency that led to his death. Autopsy diagnosed multiple lung infarctions. What is the most probable cause of their development?
A. Thromboembolism of bronchial arteries
B. Thrombosis of pulmonary artery branches
C. Thrombosis of bronchial arteries
D. Thrombosis of pulmonary veins
E. Thromboembolism of pulmonary artery branches
119 A full-term newborn child has yellowish skin and mucous membranes. This might be probably caused by temporary deficiency of the following enzyme:
A. Biliverdin reductase
B. Heme synthetase
C. Uridine transferase
D. Heme oxygenase
E. UDPglucoronyltransferase
120 Ultrasonic examination of a patient revealed aneurism in the area of aortic arch that caused alteration of vocal function of larynx. What nerve was constricted?
A. Superior laryngeal
B. Mandibular
C. Recurrent laryngeal
D. Sublingual
E. Diaphragmatic
121 Atria of an experimental animal were superdistended by blood that resulted in decreased reabsorption of Na+ and water in renal tubules. This can be explained by the influence of the following factor upon kidneys:
A. Renin
B. Vasopressin
C. Angiotensin
D. Aldosterone
E. Natriuretic hormone
122 A patient suffers from hepatocirrhosis. State of antitoxic liver function can be characterized by examination of the following substance exreted by urine:
A. Amino acids
B. Ammonium salts
C. Hippuric acid
D. Uric acid
E. Creatinine
123 Dietary intake of a 30 year old nursing woman contains 1000 mg of calcium, 1300 mg of phosphorus and 20 mg of iron per day. It is necessary to change content of these mineral substances in the following way:
A. To increase calcium content
B. To reduce fluorine content
C. To reduce iron content
D. To increase iron content
E. To increase phosphorus content
124 A 25 year old patient was examined by a medical boar D. Examination revealed pathology of chest. Transverse dimensions were to small and the sternum was strongly protruding. What chest type is it?
A. Flat chest
B. Funnel chest
C. Keeled chest
D. Barrel chest
E. Cylindrical chest
125 A 50 year old patient has been taking treatment thrice for the last 6 months because of fractures caused by domestic accidents. Microscopical examination of bony tissue revealed foci of lacunar resolution, giant-cell granulomas in the tumour-like formations, cysts. Bony tissue was substituted by fibrous connective tissu E. Examination revealed also adenoma of parathyroid gland and hypercalcemi A. What is the most probable diagnosis?
A. Osteopetrosis
B. Parathyroid osteodystrophy
C. Paget's disease
D. Osteomyelitis
E. Myelomatosis
126 A young woman who entered a production department where it strongly smelt of paints and varnishes had a bronchospasm. This reflex was caused by irritation of the following receptors:
A. Central chemoreceptors
B. Peripheral chemoreceptors
C. Pleura receptors
D. Irritant
E. Juxtaglomerular
127 An isolated muscle fiber is under examination. It was established that the threshold of stimulation force became significantly lower. What is the cause of this phenomenon?
A. Inactivation of sodium channels of membrane
B. Inactivation of potassium channels of membrane
C. Block of energy production in the cell
D. Activation of potassium channels of membrane
E. Activation of sodium channels of membrane
128 Burned skin surface was treated with a certain preparation. Its antiseptic properties are provided by atomic oxygen that is formed in presence of organic substances. What preparation was applied?
A. Sodium hydrocarbonate
B. Alcoholic iodine solution
C. Potassium permanganate
D. Furacillin
E. Chlorhexidine bigluconate
129 Examination of a patient suffering from cancer of urinary bladder revealed high rate of serotonin and hydroxyanthranilic aci D. It is caused by excess of the following amino acid in the organism:
A. Alanine
B. Tyrosine
C. Tryptophan
D. Methionine
E. Histidine
130 A man was intoxicated with mushrooms. They contain muscarine that stimulates muscarinic cholinoreceptors. What symptoms signalize intoxication with inedible mushrooms?
A. Rise of arterial pressure
B. Bronchi dilatation
C. Increased heart rate
D. Mydriatic pupils
E. Myotic pupils
131 A patient who suffers from insomnia caused by emotional disorder was prescribed a hypnotic drug with tranquillizing effect. What hypnotic was prescribed?
A. Sodium ethaminal
B. Bromisoval
C. Phenobarbital
D. Nitrazepam
E. Chloral hydrate
132 Examination of a 66 year old patient revealed a lytic tumour in the locus of pathological rib fractur E. Histologically this tumour consists of atypical plasmoblasts. Further examination revealed osteoporosis in the bones of vertebral column and pelvis. These changes are typical for:
A. Myelomatosis
B. Metastatic lung cancer
C. Ewing's osteosarcoma
D. Neuroblastoma
E. Tuberculous osteomyelitis
133 A 46 year old patient who had been suffering from tuberculosis for 6 years died from massive pulmonary haemorrhag E. Autopsy revealed different-sixed foci of sclerosis and caseous necrosis in lungs, in the upper part of the right lung there was a cavity 5 cm in diameter with dense grey walls, the cavity contained liquid blood and blood clots. What type of tuberculosis is it?
A. Fibrocavernous
B. Acute cavernous
C. Acute focal
D. Fibrous focal
E. Infiltrative
134 During the repeated Widal's agglutination test it was noticed that the ratio of antibody titers and O-antigens S.typhi in the patient's serum had increased from 1:100 to 1:400. How would you interpret these results?
A. The patient is an acute carrier of typhoid microbes
B. The patient previously had typhoid fever
C. The patient has typhoid fever
D. The patient is a chronic carrier of typhoid microbs
E. The patient was previously vaccinated against typhoid fever
135 A patient complained about muscle rigidity, constrained motions, constant tremor of arms. On the grounds of examination his disease was diagnosed as Parkinson's diseas E. What drug should be administered?
A. Diphenylhydantoin
B. Diazepam
C. Phenobarbital
D. Ethosuximide
E. Levodopa
136 Labelled amino acids alanine and tryptophane were injected to a mouse in order to study localization of protein synthesis in its cells. The labelled amino acids will be accumulated near the following organellas:
A. Ribosomes
B. Smooth endoplasmic reticulum
C. Cell centre
D. Golgi apparatus
E. Lysosomes
137 A 56 year old patient suffering from cardiac insufficiency has edema of feet and shins, edematous skin is pale and col D. What is the leding mechanism of edema pathogenesis?
A. Increase of capillary permeability
B. Rise of hydrostatic pressure in venules
C. Drop of oncotic pessure in capillaries
D. Disorder of lymph outflow
E. Positive water balance
138 A 50 year old man who was referred to the hospital for treatment of cervical lymphadenitis underwent test for induvidual sensitivity to penicillin. 30 seconds after he went hot all over, AP dropped down to 0 mm Hg that led to cardiac arrest. Resuscitation was unsuccessful. Autopsy results: acute venous plethora of internal organs; histological examination of skin (from the site of injection) revealed degranulation of mast cells (tissue basophils). Degranulation was also revealed in myocardium and lungs. What type of hypersensitivity reaction is it?
A. Anaphylactic
B. -
C. Delayed-type hypersensitivity
D. Immunocomplex-mediated
E. Complement-mediated cytotoxic
139 During examination of a patient a dentist revealed a lot of "white spots" - zones of enamel demineralization. What microorganisms take part in the development of this process?
A. Streptococcus salivarius
B. Streptococcus mutans
C. Staphylococcus epidermidis
D. Veilonella parvula
E. Streptococcus pyogenes
140 A patient who has been abusing tobacco smoking for a long time has got cough accompanied by excretion of viscous mucus; weakness after minor physical stress, pale skin. The patient has also lost 12,0 kg of body weight. Endoscopic examination of biosy material his illness was diagnosed as squamous cell carcinom A. Name a pathological process that preceded formation of the tumour:
A. Metaplasia
B. Hyperplasia
C. Hypoplasia
D. Sclerosis
E. Necrosis
141 In course of an experiment thalamocortical tracts of an animal were cut. What type of sensory perception remained intact?
A. Visual
B. Olfactory
C. Auditory
D. Exteroreceptive
E. Nociceptive
142 Among junior children of an orphanage an outbreak of intestinal infection with signs of colienteritis was registere D. In order to identify isolated causative agent it is necessary to:
A. To study sensitivity to bacteriophages
B. To determine sensitivity to antibiotics
C. To study biochemical properties of the causative agent
D. Study antigenic properties of the causative agent
E. To study virulence of the causative agent
143 Vitamin A together with specific cytoreceptors penetrates through the nuclear membranes, induces transcription processes that stimulate growth and differentiation of cells. This biological function is realized by the following form of vitamin A:
A. Trans-retinal
B. Retinol
C. Carotin
D. Trans-retinoic acid
E. Cis-retinal
144 A 4 year old child with hereditary renal lesion has signs of rickets, vitamin D concentration in blood is normal. What is the most probable cause of rickets development?
A. Impaired synthesis of calcitriol
B. Lack of calcium in food
C. Hypofunction of parathyroid glands
D. Hyperfunction of parathyroid glands
E. Increased excretion of calcium
145 A 35 year old man consulted a dentist about reduced density of dental tissue, high fragility of teeth during eating solid foo D. This patient suffers the most probably from the deficiency of the following mineral element:
A. Iron
B. Potassium
C. Magnesium
D. Sodium
E. Calcium
146 A patient working at a pig farm complains about paroxysmal abdominal pain, liquid feces with admixtures of mucus and blood, headache, weakness, fever. Examination of large intestine revealed ulcers from 1 mm up to several cm large, feces contained oval unicellular organisms with cili A. What disease should be suspected?
A. Amebiasis
B. Lambliasis
C. Balantidiasis
D. Toxoplasmosis
E. Trichomoniasis
147 A 25 year old Palestinian woman complains of weakness, dizziness, dyspne A. In anamnesis: periodically exacerbating anemi A. In blood: Hb - 60 g/l, erythrocytes - 2,5*1012/l, reticulocytes - 35o/oo, anisocytosis and poikilocytosis of erythrocytes, a lot of target cells and polychromatophils. What type of anemia is it?
A. Sickle-cell anemia
B. Addison-Biermer disease
C. Glucose 6-phosphate dehydrogenase-deficient anemia
D. Minkowsky-Shauffard disease
E. Thalassemia
148 A woman works as railway traffic controller. She suffers from seasonal vasomotor rhinitis and gets treatment in the outpatient setting. She was prescribed an antihistamine that has no effect upon central nervous system. What drug is it?
A. Promethazine
B. Dimedrol
C. Tavegil
D. Suprastin
E. Loratadine
149 Examination of a patient with pustular skin lesions allowed to isolate a causative agent that forms in the blood agar roundish yellow middle-sized colonies surrounded by haemolysis zon E. Smears from the colonies contain irregular-shaped clusters of gram-positive cocci. The culture is oxidase- and catalase-positive, ferments mannitol and synthesizes plasmocoagulas E. What causative agent was isolated?
A. Staphylococcus saprophyticus
B. Staphylococcus epidermidis
C. Streptococcus pyogenes
D. Streptococcus agalactiae
E. Staphylococcus aureus
150 A patient complains about impaired evacuatory function of stomach (long-term retention of food in stomach). Examination revealed a tumour of initial part of duodenum. Specify localization of the tumour:
A. Pars inferior
B. Flexura duodeni inferior
C. Pars superior
D. Pars descendens
E. Pars ascendens
151 Histological examination of a 40 year old man's thymus revealed reduced share of parenchymatous elements, increased share of adipose and loose connective tissue, its enrichment with thymus bodies. The organ's mass was unchange D. What is this phenomenon called?
A. Age involution
B. Atrophy
C. Accidental involution
D. Hypotrophy
E. Dystrophy
152 An infectious disease caused contractive activity of muscles that contract and dilate eye pupil (paralytic state). What functional eye system was damaged?
A. Photosensory
B. Accomodative
C. Lacrimal apparatus
D. Dioptric
E. Ancillary
153 Study of conversion of a food colouring agent revealed that neutralization of this xenobiotic takes place only in one phase - microsomal oxydation. Name a component of this phase:
A. Cytochrome C
B. Cytochrome B
C. Cytochrome A
D. Cytochrome Р-450
E. Cytochrome oxidase
154 Study of fingerprints (dactylography) is used by criminalists for personal identification as well as for diagnostics of genetic abnormalities, particularly Dawn's diseas E. What layer of skin determines individuality of fingerprints?
A. Reticular
B. Horny
C. Dermopapillary
D. Clear (stratum lucidum epidermidis)
E. Basal
155 A 23 year old man has perforation of hard palat E. In the area of this perforation there was a compact well-defined formation. Microscopic examination of the resected formation revealed a large focus of caseous necrosis surrounded by granulation tissue with endovasculitis, cellular infiltration composed of lymphocytes, epithelioid cells (mainly plasmocytes). What is the most probable diagnosis?
A. Scleroma
B. Sarcoma
C. Tuberculosis
D. Syphilis
E. Leprosy
156 A clinic observes a 49 year old patient with significant prolongation of coagulation time, gastrointestinal haemorrhages, subcutaneous hematomas. These symptoms might be explained by the deficiency of the following vitamin:
A. E
B. H
C. B6
D. B1
E. K
157 A doctor revealed tissues injury on patient's scalp with localized suppurations and diagnosed his disease as myiasis. This infestation is caused by larvae of the following insect:
A. Malarial mosquito
B. Kissing bug
C. Wohlfahrt fly
D. Mosquito
E. Stable fly (Stomoxys calcitrans)
158 A 4 year old child was admitted to the orthopaedic department with shin fracture together with displacement. Bone fragments reposition requires preliminary analgesi A. What preparation should be chosen?
A. Morphine hydrochloride
B. Promedol
C. Panadol
D. Analgin
E. -
159 Emotional stress causes activation of hormon-sensitive triglyceride lipase in the adipocytes. What secondary mediator takes part in this process?
A. Diacylglycerol
B. Ions of Са2+
C. Cyclic guanosine monophosphate
D. Cyclic adenosine monophosphate
E. Adenosine monophosphate
160 A patient suffering from periodical attacks caused by inhalation of different flavoring substances was diagnosed with atopic bronchial asthm A. IgE level was increase D. This is typical for the following type of reactions:
A. Anaphylactic reactions
B. delayed-type hypersensitivity
C. Cytotoxic reactions
D. Immunocomplex reactions
E. Autoimmune reactions
161 Researchers of a bacteriological laboratory examine tinned meat for botulinic toxin. For this purpose a group of mice was injected with an extract of the material under examination and antitoxic antibotulinic serum of A, B, E types. A control group of mice was injected with the same extract but without antibotulinic serum. What serological reaction was applied?
A. Precipitation
B. Neutralization
C. Opsonocytophagic
D. Complement binding
E. Double immune diffusion
162 Cardinal symptoms of primary hyperparathyroidism are osteoporosis and renal lesion along with development of urolithiasis. What substance makes up the basis of these calculi in this disease?
A. Uric acid
B. Bilirubin
C. Cystine
D. Cholesterol
E. Calcium phosphate
163 A 45 year old man consulted a doctor about a plaque-like formation on his neck. Histological examination of a skin bioptate revealed clusters of round and oval tumour cells with a narrow border of basophilic cytoplasm resembling of cells of basal epidermal layer. What tumour is it?
A. Epidermal cancer
B. Basal cell carcinoma
C. Hydroadenoma
D. Syringoadenoma
E. Trichoepithelioma
164 A cell at the stage of mitosis anaphase was stimulated by colchicine that inhibits chromosome separation to the poles. What type of mutation will be caused?
A. Duplication
B. Inversion
C. Translocation
D. Polyploidy
E. Deletion
165 48 hours after tuberculine test (Mantoux test) a child had a papule 10 mm in diameter on the spot of tuberculine injection. What hypersensitivity mechanism underlies these changes?
A. Anaphylaxy
B. Granulomatosis
C. Cellular cytotoxicity
D. Immunocomplex cytotoxicity
E. Antibody-dependent cytotoxicity
166 Introduction of a big dose of histamine to an experimental animal caused abrupt drop of arterial pressure as a result of:
A. Constriction of resistance vessels
B. Dilatation of resistance vessels
C. Increase of heart rate
D. Decrease of heart rate
E. Decrease of heart rate and force
167 A patient died from acute cardiac insufficiency, among clinical presentations there was gastrointestinal haemorrhag E. Examination of mucous membrane of sromach revealed some defects reaching myenteron; their edges and bottom were mostly even and loose, some of them contained dark-red bloo D. What pathological process was revealed?
A. Thrombosis
B. Inflammation
C. Erosions
D. Chronic ulcers
E. Acute ulcers
168 Electronic microphotography of pulmonary alveole's wall presents a big cell. Its cytoplasm has a lot of mitochondria, developed Golgi apparatus, osmiophil lamellated corpuscles. What is the main function of this cell?
A. It is a component of blood-air barrier
B. It absorbs microorganisms
C. It warms the air
D. It purifies the air
E. It produces surfactant
169 A patient underwent an operation on account of gall bladder excision that resulted in obstruction of Ca absorption through the bowels wall. What vitamin wil stimulate this process?
A. D3
B. C
C. B12
D. K
E. PP
170 A 48 year old patient complained about intense pain, slight swelling and reddening of skin over the joints, temperature rise up to 38oC. Blood analysis revealed high concentration of urates. This condition might be caused by disturbed metabolism of:
A. Collagen
B. Pyrimidines
C. Cholesterol
D. Carbohydrates
E. Purines
171 A 17 year old boy fell seriously ill, the body temperature rose up to 38,5oC, there appeared cough, rhinitis, lacrimation, nasal discharges. What inflammation is it?
A. Serous
B. Fibrinous
C. Purulent
D. Catarrhal
E. Hemorrhagic
172 It is known that the gene responsible for development of blood groups according to AB0 system has three allele variants. If a man has IV blood group, it can be explained by the following variability form:
A. Phenocopy
B. Phenotypic
C. Genocopy
D. Mutational
E. Combinative
173 Characteristic sign of glycogenosis is muscle pain during physical work. Blood examination reveals usually hypoglycemi A. This pathology is caused by congenital deficiency of the following enzyme:
A. Glycogen phosphorylase
B. Lysosomal glycosidase
C. Gamma amylase
D. Glucose 6-phosphate dehydrogenase
E. Alpha amylase
174 A concentrated solution of sodium chloride was intravenously injected to an animal. This caused decreased reabsorption of sodium ions in the renal tubules. It is the result of the following changes of hormonal secretion:
A. Reduction of atrial natriuretic factor
B. Aldosterone increase
C. Aldosterone reduction
D. Vasopressin increase
E. Vasopressin reduction
175 An unconscious patient was delivered to the admission war D. Objectively: the patient's skin is cold, pupils are myotic, he has laboured Cheyne-Stokes respiration, arterial pressure is low, urinary bladder is full. What substance has caused intoxication?
A. Tranquilizers
B. Non-narcotic analgetics
C. -
D. Muscarinic receptor blockers
E. Narcotic analgetics
176 A 22 year old patient from the West Ukraine complains of laboured nasal breathing. Morphological examination of biopsy material of nasal mucous membrane revealed lymphoid, epithelioid, plasma cells as well as Mikulicz's cells. What is the most probable diagnosis?
A. Leprosy
B. Rhinoscleroma
C. Tuberculosis
D. Syphilis
E. Glanders
177 An isolated cell of human heart automatically generates excitement impulses with frequency of 60 times per minut E. This cell was taken from the following heart structure:
A. Atrioventricular node
B. Atrium
C. Ventricle
D. Sinoatrial node
E. His' bundle
178 Voluntary breath-holding caused increase of respiration depth and frequency. The main factor stimulating these changes of external respiration is:
A. Increased tension of CO2 in blood
B. Decreased tension of O2 in blood
C. Decreased concentration of H+ in blood
D. Increased tension of O2 in blood
E. Decreased tension of CO2 in blood
179 A patient has low rate of magnesium ions that are necessary for affixion of ribosomes to the endoplasmic reticulum. It is known that it causes disturbance of protein biosynthesis. At what stage is protein biosynthesis impaired?
A. Translation
B. Amino acid activation
C. Replication
D. Transcription
E. Termination
180 A 45 year old patient was admitted to the cardiological department. ECG data: negative P wave overlaps QRS complex, diastolic interval is prolonged after extrasystol E. What type of extrasystole is it?
A. Ventricular
B. Atrial
C. Atrioventricular
D. Sinus
E. Bundle-branch
181 A 5 year old child is ill with measles. Blood analysis revealed increase of total number of leukocytes up to 13*109/l. Leukogram: basophils - 0, eosinophils - 1, myelocytes - 0, juvenile neutrophils - 0, band neutrophils - 2, segmented neutrophils - 41, lymphocytes - 28, monocytes - 28. Name this phenomenon:
A. Lymphocytosis
B. Agranulocytosis
C. Eosinopenia
D. Monocytosis
E. Neutropenia
182 Surgical approach to the thyroid gland from the transverse (collar) approach involves opening of interaponeurotic suprasternal spac E. What anatomic structure localized in this space is dangerous to be damaged?
A. Subclavicular vein
B. External jugular vein
C. Jugular venous arch
D. Superior thyroid arthery
E. Inferior thyroid arthery
183 During an operation a patient got injection of muscle relaxant dithylinum. Relaxation of skeletal muscles and inhibition of respiration lasted two hours. This condition was caused by absence of the following enzyme in blood serum:
A. Glutathione peroxidase
B. Catalase
C. Acetylcholinesterase
D. Butyrylcholin esterase
E. Glucose 6-phosphatase
184 Microscopical examination of a microbal culture revealed fusiform spore-forming microorganisms that get violet-blue Gram's stain. What microorganisms were revealed?
A. Actinomycete
B. Streptococci
C. Clostridia
D. Diplococci
E. Spirochaete
185 A 63 year old male patient who had been suffering from chronic diffuse obstructive disease, pulmonary emphysema, for 15 years died from cardiac insufficiency. Autopsy revealed nutmeg liver cirrhosis, cyanotic induration of kidneys and spleen, ascites, edemata of lower limbs. These changes of internal organs are typical for the following disease:
A. General cardiac insufficiency
B. Acute left-ventricular insufficiency
C. Acute right-ventricular insufficiency
D. Chronic right-ventricular insufficiency
E. Chronic left-ventricular insufficiency
186 A patient staying in the pulmonological department was diagnosed with pulmonary emphysema accompanied by reduced elasticity of pulmonary tissu E. What type of respiration is observed?
A. Inspiratory dyspnea
B. Periodic respiration
C. Superficial respiration
D. Infrequent respiration
E. Expiratory dyspnea
187 A virological laboratory obtained pathological material (mucous discharges from nasal meatuses) taken from a patient with provisional diagnosis "influenza". What quick test will allow to reveal specific viral antigen in the material under examination?
A. Radioimmunoassay
B. -
C. Direct and indirect immunofluorescence test
D. Hemagglutination inhibition assay
E. Direct and indirect fluorescence immunoassay
188 A patient ill with neurodermatitis has been taking prednisolone for a long tim E. Examination revealed high rate of sugar in his bloo D. This complication is caused by the drug influence upon the following link of carbohydrate metabolism:
A. Intensification of glucose absorption in the bowels
B. Inhibition of glycogen synthesis
C. Gluconeogenesis activation
D. Glycogenogenesis activation
E. Activation of insulin decomposition
189 Examination of coronary arteries revealed atherosclerotic calcified plaques closing vessel lumen by 1/3. The muscle has multiple whitish layers of connective tissu E. What process was revealed in the myocardium?
A. Postinfarction cardiosclerosis
B. Myocarditis
C. Diffusive cardiosclerosis
D. Tiger heart
E. Myocardium infarction
190 A 34 year old woman was diagnosed with hereditary microspherocytic hemolytic anemia (Minkowsky-Shauffard disease). What mechanism caused haemolysis of erythrocytes?
A. Autoimmune disorder
B. Bone marrow hypoploasia
C. Enzymopathy
D. Membranopathy
E. Hemoglobinopathy
191 Examination of a patient revealed hypertrophy and inflammation of lymphoid tissue, edema of mucous membrane between palatine arches (acute tonsillitis). What tonsil is normally situated in this area?
A. Tonsilla tubaria
B. -
C. Tonsilla pharyngealis
D. Tonsilla lingualis
E. Tonsilla palatina
192 Material taken from a patient with provisional diagnosis "influenza" was referred to a laboratory. For virological examination the hemadsorption reaction was applie D. This reaction can be applied for detection of the following viruses:
A. All the complex viruses
B. Any viruses
C. DNA-genomic viruses
D. All the simple viruses
E. Viruses containing hemagglutinins
193 During hypersensitivity test a patient got subcutaneous injection of an antigen which caused reddening of skin, edema, pain as a result of histamine action. This biogenic amine is generated as a result of transformation of the following histidine amino acid:
A. Phosphorylation
B. Decarboxylation
C. Deaminization
D. Isomerization
E. Methylation
194 A patient with cholelithiasis fell ill with mechanic jaundic E. Examination revealed that the stone was in the common bile duct. What bile-excreting ducts make up the obturated duct?
A. Ductus hepaticus dexter et ductus cysticus
B. Ductus hepaticus communis et ductus cysticus
C. Ductus hepaticus dexter et sinister
D. Ductus hepaticus communis et ductus choledochus
E. Ductus hepaticus sinister et ductus cysticus
195 A 25 year old man has spent a long time in the sun under high air humidity. As a result of it his body temperature rose up to 39oC. What pathological process is it?
A. Noninfectious fever
B. Hyperthermia
C. Burn disease
D. Hypothermia
E. Infectious fever
196 A 70 year old female patient was diagnosed with fracture of left femoral neck accompanied by disruption of ligament of head of femur. The branch of the following artery is damaged:
A. Inferior gluteal
B. Obturator
C. Femoral
D. Internal pudendal
E. External iliac
197 Examination of a pregnant woman revealed twice as much concentration of fibrinogen in blood plasm. What ESR can this woman have?
A. 0-5 mm/h
B. 5-10 mm/h
C. 2-12 mm/h
D. 40-50 mm/h
E. 10-15 mm/h
198 A family of students who came from Africa got a child with anemia signs. The child died soon. Examination revealed that the child's erythrocytes have abnormal semilunar shap E. Specify genotypes of the child's parents:
A. аа х аа
B. Аа х аа
C. Аа х АА
D. АА х АА
E. Аа х Аа
199 According to the model of double DNA helix that was suggested by Watson and Creek, it was established that one of chains would not be lost during replication and the second chain would be synthesized complementary to the first on E. What way of replication is it?
A. Semiconservative
B. Analogous
C. Dispersed
D. Identical
E. Conservative
200 A patient underwent appendectomy. In the postoperative period he has been taking an antibioti C. The patient complains about hearing impairment and vestibular disorders. What group of antibiotics has such by-effects?
A. Cephalosporins
B. Tetracyclines
C. Macrolides
D. Aminoglycosides
E. Penicillins
Krok 1. Medicine-2011
1 A 2-year-old child with mental and physical retardation has been delivered to a hospital. He presents with frequent vomiting after having meals. There is phenylpyruvic acid in urine. Which metabolism abnormality is the reason for this pathology?
A. Phosphoric calcium metabolism
B. Water-salt metabolism
C. Amino-acid metabolism
D. Carbohydrate metabolism
E. Lipidic metabolism
2 When measuring power inputs of a man by the method of indirect calorimetry the following results were obtained: 1000 ml oxygen consumption and 800 ml carbon dioxide liberation per minute. The man under examination has the following respiratory coefficient:
A. 1,0
B. 0,9
C. 0,8
D. 1,25
E. 0,84
3 Microscopical examination of an enlarged cervical lymph node revealed blurring of its structure, absence of lymphoid follicles; all the microscopic fields showed cells with roundish nuclei and thin limbus of basophil cytoplasm. It is known from the clinical data that other groups of lymph nodes are also enlarged as well as spleen and liver. What disease might be suspected?
A. Myeloid leukosis
B. Multiple myeloma
C. Lymphosarcoma
D. Lymphoid leukosis
E. Lymphogranulomatosis
4 A student failed to answer all the questions of examination paper correctly. As a result he blushed, felt hot and lost confidence. What type of arterial hyperemia has developed in this case?
A. Postishemic hyperemia
B. Neurotonic hyperemia
C. Pathologic hyperemia
D. Metabolic hyperemia
E. Neuroparalytic hyperemia
5 Heart rate of a 30-year-old man under emotional stress reached 112 bpm. The reason for the heart rate increase is the altered condition of the following conducting system of heart:
A. Purkinje's fibers
B. Sinoatrial node
C. His' bundle branches
D. Atrioventricular node
E. His' bundle
6 During examination of a 6-year-old child a doctor revealed greyish films on the pharyngeal tonsils. Their removal provoked moderate haemorrhage. Bacterioscopy revealed gram-positive clublike bacteria. What symptoms will develop in this child within the next few days if no specific treatment is provided?
A. Strong paroxysmal cough
B. Intermittent fever
C. Pulmonary edema
D. Papulous skinrash
E. Toxic lesions of myocard, liver and kidney
7 A patient with coronary disease and arrhythmia has been administered a drug that blocks potassium channels and prolongs the action potential. What drug is it?
A. Amiodarone
B. Corglyconum
C. Dobutamine
D. Nitroglycerin
E. Lisinopril
8 A 45-year-old patient was admitted to the cardiological department. ECG data: negative P wave overlaps QRS complex, diastolic interval is prolonged after extrasystole. What type of extrasystole is it?
A. Sinus
B. Ventricular
C. Atrioventricular
D. Atrial
E. Bundle-branch
9 A patient consulted a doctor about a sensation of imbalance which appeared after a trauma. Which nerve is damaged?
A. Facial nerve
B. Vagus nerve
C. Intermediate nerve
D. Vestibulocochlear nerve
E. Trigeminal nerve
10 A 25-year-old man has spent a long time in the sun under high air humidity. As a result of it his body temperature rose up to 39oC. What pathological process is it?
A. Hyperthermia
B. Burn disease
C. Hypothermia
D. Infectious fever
E. Noninfectious fever