Krok-1 2014 English

Front 1

The infectious diseases departmentof a hospital admitted a patient withnausea, liquid stool with mucusand blood streaks, fever, weakness.Dysentery was suspected. Whatmethod of laboratory diagnosticsshould be applied to confirm the diagnosis

Back 1

Bacteriological

Front 2

Malaria is treated with structuralanalogs of vitamin B2 (riboflavin).These drugs disrupt the synthesis ofthe following enzymes in plasmodium

Back 2

FAD-dependent dehydrogenase

Front 3

A 6-year-old child with suspectedactive tuberculous process underwentthe diagnostic Mantoux test. Whatimmunobiological preparation wasinjected?

Back 3

Tuberculin

Front 4

In a young man during exercise, theminute oxygen uptake and carbon dioxideemission equalled to 1000 ml.What substrates are oxidized in thecells of his body?

Back 4

Carbohydrates

Front 5

sportsman spontaneously heldbreath for 40 seconds,which resulted inan increase in heart rate and systemicarterial pressure. Changes of theseindicators are due to activation of thefollowing regulatory mechanisms

Back 5

Unconditioned sympathetic reflexes

Front 6

A 53-year-old male patient is diagnosedwith Paget’s disease. Theconcentration of oxyproline in dailyurine is sharply increased, which primarilymeans intensified disintegrationof:

Back 6

Collagen

Front 7

A patient has hoarseness of voice.During laryngoscopy a gray-whitelarynx tumor with papillary surface hasbeen detected.Microscopic investigationhas shown the following: growth ofconnective tissue covered with multilayer,strongly keratinized pavementepithelium, no cellular atypia. What isthe most likely diagnosis?

Back 7

Papilloma

Front 8

During autopsy approximately 2,0liters of pus have been found in theabdominal cavity of the corpse. Peritoneumis lustreless and has grayishshade, serous tunic of intestines hasgrayish-colored coating that is easilyremovable. Specify themost likely typeof peritonitis in the patient:

Back 8

Fibrinopurulent peritonitis

Front 9

revealed bone marrow hyperplasiaof tubular and flat bones (pyoidmarrow), splenomegaly (6 kg) andhepatomegaly (5 kg), enlargement ofall lymph node groups. What disease are the identified changes typical for?

Back 9

Chronic myelogenous leukemia

Front 10

Autopsy of the dead patient whodied from pulmonary edema revealeda large yellow-grey nidus in themyocardium, and a fresh thrombus inthe coronary artery. What is the mostlikely diagnosis?

Back 10

Myocardial infarction

Front 11

An animal experiment is aimed atstudying the cardiac cycle.All the heartvalves are closed. What phase of thecycle is characterized by this status?

Back 11

Isometric contraction

Front 12

Cyanide is a poison that causesinstant death of the organism. Whatenzymes found in mitochondria areaffected by cyanide?

Back 12

Cytochrome oxidase (aa3)

Front 13

Increased HDL levels decrease therisk of atherosclerosis. What is themechanism of HDL anti-atherogenicaction?

Back 13

They remove cholesterol from tissues

Front 14

It has been found out that oneof a pesticide components is sodiumarsenate that blocks lipoic acid. Whichenzyme activity is impaired by thispesticide?

Back 14

Pyruvate dehydrogenase complex

Front 15

Stool culture test revealed in a 6-month-old bottle-fed baby the strain ofintestinal rod-shaped bacteria of antigenstructure 0-111. What diagnosiscan be made?

Back 15

Colienteritis

Front 16

A boy referred to a genetics clinicwas found to have 1 drumstick in bloodneutrophils. The boy is likely to havethe following syndrome:

Back 16

Klinefelter’s

Front 17

A drycleaner’s worker has beenfound to have hepatic steatosis. Thispathology can be caused by the disruptionof synthesis of the followingsubstance:

Back 17

Phosphatidylcholine

Front 18

Ascarid eggs have been detectedduring stool analysis. What drugshould be prescribed?

Back 18

Mebendazole

Front 19

Bacteriological examination of theurine of the patient with pyelonephritisrevealed microorganisms that produced yellow-green pigment anda characteristic odor in meat-peptoneagar.What are they called

Back 19

Pseudomonas

Front 20

Feces of a patient contain highamount of undissociated fats and havegrayish-white color. Specify the causeof this phenomenon:

Back 20

Obturation of bile duct

Front 21

A 46-year-old female patientconsulted a doctor about pain in thesmall joints of the upper and lowerlimbs. The joints are enlarged andshaped like thickened nodes. Serumtest revealed an increase in urateconcentration. This might be causedby a disorder in metabolism of:

Back 21

Purines

Front 22

26-year-old female consulted adoctor about having stool with whiteflat moving organisms resemblingnoodles. Laboratory analysisrevealed proglottids with the followingcharacteristics: long, narrow, with alongitudinal channel of the uterus with17-35 lateral branches on each side.What kind of intestinal parasite wasfound?

Back 22

Taeniarhynchus saginatus

Front 23

A male patient is 28 years old. Histologicalstudy of a cervical lymphnode revealed a change of its patterndue to the proliferation of epithelioid,lymphoid cells and macrophages havingnuclei in form of a horseshoe. Inthe center of some cell clusters therewere non-structured light-pink areaswith fragments of nuclei. What diseaseare these changes typical for?

Back 23

Tuberculosis

Front 24

A biochemical urine analysis hasbeen performed for a patient withprogressive muscular dystrophy. Inthe given case muscle disease can beconfirmed by the high content of thefollowing substance in urine:

Back 24

Creatine

Front 25

While examining foot blood supplya doctor checks the pulsation of alarge artery running in the separatefibrous channel in front of articulatiotalocruralis between the tendons oflong extensor muscles of hallux andtoes.What artery is it?

Back 25

A. dorsalis pedis

Front 26

patient with chronic heart failurewith edema has increased levelof blood aldosterone. What diureticwould be most effective in this case?

Back 26

Spironolactone

Front 27

During autopsy the followinghas been revealed: the meningesof the upper cerebral hemispheresare extremely plethoric, of yellowgreencolor and are soaked withpurulent effluent. What kind of meningitisis characterised by such clinicalpresentations?

Back 27

Meningococcal meningitis

Front 28

A 41-year-old male patienthas a history of recurrent attacksof heartbeats (paroxysms), profusesweating, headaches. Examinationrevealed hypertension, hyperglycemia,increased basal metabolic rate, andtachycardia. These clinical presentationsare typical for the followingadrenal pathology:

Back 28

Hyperfunction of the medulla

Front 29

A comminuted fracture ofinfraglenoid tubercle caused byshoulder joint injury has been detectedduring X-ray examination of a patient.What muscle tendon attached at thissite has been damaged?

Back 29

Long head of m. triceps brachii

Front 30

A patient has increased thicknessof alveolar-capillary membrane causedby a pathologic process. The directconsequence will be reduction of thefollowing value:

Back 30

Diffusing lung capacity

Front 31

What drug will be most appropriatefor the patient who has chronic gastritiswith increased secretion

Back 31

Pirenzepine

Front 32

As a result of careless handling ofan iron, a 34-year-old female patienthas got acute pain, redness, swellingof her right index finger. A few minuteslater, there appeared a blister filledwith a transparent liquid of strawyellowcolor. The described changesare a manifestation of the following pathological process

Back 32

Exudative inflammation

Front 33

42-year-old male with a lesion ofthe ulnar nerve is unable to flex theII and V fingers to the midline. Whichmuscle function is impaired in thiscase?

Back 33

Palmar interosseous muscles

Front 34

A smear from the tonsillar coatingof a patient with suspected diphtheriawas found to contain blue bacilli with athickening at the poles. What methodof smear staining was used?

Back 34

Leffler

Front 35

A child was born asphyxiated.What drug must be administered to thenewborn to stimulate breathing

Back 35

Aethimizolum

Front 36

A 40-year-old patient with theprogressing staphylococcal purulentperiodontitis developed purulentinflammation of bone marrow spacesof the alveolar process, and then ofthe body of mandible. Microscopyrevealed thinning of bone trabeculae,foci of necrosis, bone sequesterssurrounded by the connective tissuecapsule. What is the most likely diagnosis?

Back 36

Chronic osteomyelitis

Front 37

Human red blood cells do notcontain mitochondria. What is themain pathway for ATP production inthese cells?

Back 37

Anaerobic glycolysis

Front 38

A 40-year-old female patient hasundergone thyroidectomy. Histologicalstudy of thyroid gland found the folliclesto be of different size and containfoamy colloid, follicle epithelium is highand forms papillae, there is focallymphocytic infiltration in stroma. Diagnosethe thyroid gland disease

Back 38

Basedow’s disease

Front 39

A 43-year-old-patient has arterialhypertension caused by an increasein cardiac output and general peripheralresistance. Specify the variant ofhemodynamic development of arterialhypertension in the given case:

Back 39

Eukinetic

Front 40

A patient has been hospitalisedwith provisional diagnosis of virus Bhepatitis. Serological reaction basedon complementation of antigen withantibody chemically bound to peroxidaseor alkaline phosphatase has beenused for disease diagnostics. What isthe name of the applied serologicalreaction?

Back 40

Immune-enzyme analysis

Front 41

A patient has been hospitalised withprovisional diagnosis of botulism.What serological reaction should beused to reveal botulinum toxin?

Back 41

Neutralization reaction

Front 42

Examination of a 52-year-oldfemale patient has revealed a decreasein the amount of red blood cells andan increase in free hemoglobin inthe blood plasma (hemoglobinemia).Color index is 0,85. What type ofanemia is being observed in the patient?

Back 42

Acquired hemolytic

Front 43

The processes of heat transfer ina naked person at room temperaturehave been studied. It was revealed thatunder these conditions the greatestamount of heat is transferred by:

Back 43

Heat radiation

Front 44

Urine analysis has shown highlevels of protein and erythrocytesin urine. This can be caused by thefollowing:

Back 44

Renal filter permeability

Front 45

The development of both immune and allergic reactions is based uponthe same mechanisms of the immunesystem response to an antigen. Whatis the main difference between theimmune and allergic reactions?

Back 45

Development of tissue lesion

Front 46

After a craniocerebral injury a patientis unable to recognize objects bytouch. What part of brain has beendamaged?

Back 46

Postcentral gyrus

Front 47

A patient complaining of rapidpulse, dyspnea and bluish color ofmucosa has been admitted to the cardiologicaldepartment. The objectivesymptoms are as follows: edema oflower extremities, ascites. Which ofthe given medicines should be prescribedfor intravenous administration toimprove the patient’s general state?

Back 47

Corglyconum

Front 48

As a result of a continuouschronic encephalopathy, a patient hasdeveloped spontaneous motions anda disorder of torso muscle tone. Theseare the symptoms of the disorder of thefollowing conduction tract:

Back 48

Tractus rubrospinalis

Front 49

A 10-year-old child has painfulswallowing, neck edema, temperaturerise up to 39, 0oC, the whole bodyis covered with bright-red petechialrash. Back of the throat and tonsilsare hyperemic, the tongue is crimsoncolored.Tonsillar surface is coveredwith isolated grayish-colored necrosisnidi.What disease is it?

Back 49

Scarlet fever

Front 50

In a patient elevation of bodytemperature takes turns with dropsdown to normal levels during the day.The rise in temperature is observedperiodically once in four days. Specifythe type of temperature curve:

Back 50

Febris internuttens

Front 51

As a result of a craniocerebralinjury, a patient has a decreased skinsensitivity. What area of the cerebralcortex is likely to be damaged?

Back 51

Posterior central gyrus

Front 52

Diabetic nephropathy with uremiahas developed in a patient withpancreatic diabetes. The velocity ofglomerular filtration is 9 ml/min. Whatmechanism of a decrease in glomerularfiltration velocity and chronic renal failuredevelopment is most likely in thecase of this patient?

Back 52

Reduction of active nephron mass

Front 53

A 40-year-old patient has ulcerperforation in the posterior wall ofstomach. What anatomical structurewill blood and stomach content leakto?

Back 53

Bursa omentalis

Front 54

patient is diagnosed with hereditarycoagulopathy that is characterisedby factor VIII deficiency. Specify thephase of blood clotting during whichcoagulation will be disrupted in the givencase:

Back 54

Thromboplastin formation

Front 55

Angiocardiography of a 60-yearoldmale patient revealed constrictionof a vessel located in the leftcoronary sulcus of the heart. What isthe pathological vessel called?

Back 55

Ramus circumflexus

Front 56

Those organisms which in theprocess of evolution failed to developprotection from H2O2 can exist onlyin anaerobic conditions. Which of thefollowing enzymes can break hydrogenperoxide down?

Back 56

Peroxidase and catalase

Front 57

A patient complains of pain inthe right lateral abdomen. Palpationrevealed a dense, immobile, tumorlikeformation. A tumor is likely to befound in the following part of the digestivetube:

Back 57

Colon ascendens

Front 58

A patient complaining of pain inthe left shoulder-blade region has beendiagnosed with miocardial infarction.What kind of pain does the patienthave?

Back 58

Radiating

Front 59

A patient has a critical impairmentof protein, fat and hydrocarbon digestion.Most likely it has been caused bylow secretion of the following digestivejuice:

Back 59

Pancreatic juice

Front 60

female patient has facial neuritisthat has caused mimetic paralysis andhearing impairment. Hearing impairmentresults from the paralysis of thefollowing muscle

Back 60

Stapedius muscle

Front 61

A 22-year-old female studentconsulted a physician about fever up to38oC, weakness, sore throat. Objectively:there is white coating of thetongue. What histological structures ofthe tongue are involved in the formationof this coating?

Back 61

Epithelium of the filiform papillae

Front 62

A patient has a traumatic injury ofsternocleidomastoid muscle. This hasresulted in a decrease in the followingvalue:

Back 62

Inspiratory reserve volume

Front 63

The receptors under study providetransfer of information to the cortexwithout thalamic involvement. Specifythese receptors:

Back 63

Olfactory

Front 64

Prolonged fasting causeshypoglycemia which is amplified byalcohol consumption, as the followingprocess is inhibited:

Back 64

Gluconeogenesis

Front 65

A 39-year-old female patient witha history of diabetes was hospitalizedin a precomatose state for diabeticketoacidosis. This condition had beencaused by an increase in the followingmetabolite level:

Back 65

Acetoacetate

Front 66

A 37-year-old female patientcomplains of headache, vertigo,troubled sleep, numbness of limbs. Forthe last 6 years she has been workingat the gas-discharge lamp-producingfactory in the lead-processing shop.Blood test findings: low hemoglobinandRBC level, serum iron concentrationexceeds the norm by several times.Specify the type of anemia:

Back 66

Iron refractory anemia

Front 67

During an animal experiment,surgical damage of certain brainstructures has caused deep prolongedsleep. What structure is most likely tocause such condition, if damaged?

Back 67

Reticular formation

Front 68

A patient takes cholagogues. Whatother process besides biliary excretionwill be stimulated?

Back 68

Intestinal motility

Front 69

A 3-year-old child with meningealsymptoms died. Postmortemmacroscopy of the pia matter revealedmiliary nodules which were microscopicallyrepresented by a focusof caseous necrosis with masses of epithelioidand lymphoid cells with somecrescent-shaped large cells inbetweenhaving peripheral nuclei. Specify thetype of meningitis in the child:

Back 69

Tuberculous

Front 70

A patient with homogentisuria hassigns of arthritis, ochronosis. In thiscase, the pain in the joints is associatedwith the deposition of:

Back 70

Homogentisates

Front 71

A patient with hereditaryhyperammonemia due to a disorderof ornithine cycle has developedsecondary orotaciduria. The increasedsynthesis of orotic acid is caused by anincrease in the following metabolite ofornithine cycle:

Back 71

Carbamoyl phosphate

Front 72

Amniocentesis revealed two sexchromatin bodies (Barr bodies) in eachcell of the sample. What disease is thischaracter typical for?

Back 72

Trisomy X

Front 73

A 49-year-old male patient withacute pancreatitis was likely todevelop pancreatic necrosis, while activepancreatic proteases were absorbedinto the blood stream and tissue proteinsbroke up.What protective factors ofthe body can inhibit these processes?

Back 73

α2-macroglobulin, α1-antitrypsin

Front 74

A 16-year-old female patient hasfainted after quickly changing her bodyposition from horizontal to verticalone. Which process from the oneslisted below has caused the loss ofconsciousness in the first place?

Back 74

Decreasing venous return

Front 75

A 53-year-old male patientcomplains of acute pain in the righthypochondrium. Objective examinationrevealed scleral icterus. Laboratorytests revealed increased ALT activity,and stercobilin was not detected in thestool. What disease is characterized bythese symptoms?

Back 75

Cholelithiasis

Front 76

Achild patient has dry cough.Whatnon-narcotic antitussive drug will relievethe patient’s condition?

Back 76

Glaucine hydrochloride

Front 77

A patient complains of acute painattacks in the right lumbar region.During examination the nephrolithicobturation of the right ureter in theregion between its abdominal andpelvic segments has been detected.What anatomical boundary existsbetween those two segments?

Back 77

Linea terminalis

Front 78

When measuring total muscle actionpotential it was revealed that it wassubject to the power-law relationship.The reason for this is that individualmuscle fibers differ in

Back 78

Depolarization threshold

Front 79

A patient has insufficient bloodsupply to the kidneys, which hascaused the development of pressoreffect due to the constriction of arterialresistance vessels. This is the result ofthe vessels being greately affected bythe following substance:

Back 79

Angiotensin II

Front 80

A patient is diagnosed with irondeficiencysideroachrestic anemia, progression of which is characterisedby skin hyperpigmentation, pigmentarycirrhosis, heart and pancreasaffection. Iron level in the blood serumis increased. What disorder of ironmetabolism causes this disease?

Back 80

Failure to assimilate iron leading toiron accumulation in tissues

Front 81

In a village, a case of anthraxhad been registered. Medical servicesbegan epidemiologically indicatedspecific prophylaxis of population againstanthrax. What preparation wasused for this purpose?

Back 81

Live vaccine

Front 82

Experimental stimulation of thesympathetic nerve branches thatinnervate the heart caused an increasein force of heart contractions becausethe membrane of typical cardiomyocytespermitted an increase in:

Back 82

Calcium ion entry

Front 83

According to the results of glucosetolerance test, the patient has nodisorder of carbohydrate tolerance.Despite that, glucose is detected inthe patients’s urine (5 mmol/l). Thepatient has been diagnosed with renaldiabetes. What renal changes causeglucosuria in this case?

Back 83

Decreased activity of glucosereabsorption enzymes

Front 84

As a result of past encephalitis, amale patient has developed an increasein cerebrospinal fluid pressure in theright lateral ventricle. What can be thecause of this condition?

Back 84

Closure of right interventricularforamen

Front 85

Parents of 5-year-old child reporthim o have frequent colds that developinto pneumonias, presence of purulentrashes on the skin. Laboratory testshave revealed the following: absenceof immunoglobulins of any type, andnaked cells are absent from the lymphnodes punctate. What kind of immunedisorder is it?

Back 85

X-linked hypogammaglobulinemia(Bruton type agammaglobulinemia

Front 86

A 3-year-old child has continuousfever, lymph nodes are enlarged,the amount of lymphocytes in bloodis significantly increased. Enzymelinkedimmunosorbent assay (ELISA)revealed antigen of Epstein-Barr virus.What diagnosis can be made based onthe information given above?

Back 86

Infectious mononucleosis

Front 87

Amicroslide contains the preparationof a gland composed of severalsecretory saccule-shaped parts thatopen in the common excretory duct.What gland is it?

Back 87

Simple branched alveolar gland

Front 88

A patient intending to undergoa gender reassignment surgery hasbeen admitted to a specialised clinic.In the course of examinationboth male and female gonades havebeen revealed, with male structure ofexternal genitals. What kind of genitalmaldevelopment has the patient?

Back 88

True hermaphroditism

Front 89

An 18-year-old male hasbeen diagnosed with Marfansyndrome. Examination revealed adevelopmental disorder of connectivetissue and eye lens structure,abnormalities of the cardiovascularsystem, arachnodactylia. Whatgenetic phenomenon has caused thedevelopment of this disease?

Back 89

Pleiotropy

Front 90

In case of alkaptonuria, homogentisicacid is excreted in urine in largeamounts. The development of this diseaseis associated with a disorder ofmetabolism of the following aminoacid:

Back 90

Tyrosine

Front 91

A male patient complains of skininsensitivity of inferior eyelid, externallateral surface of nose and upper lip.A doctor in the course of examinationhas revealed inflammation of thesecond branch of trigeminal nerve.What cranial foramen does this branchgo through?

Back 91

Supraorbital

Front 92

An patient with insomnia inducedby allergic rash and itch has beenprescribed the drug that has antihistamineand hypnotic effect. Specifythis drug:

Back 92

Benadryl

Front 93

In a cat with decerebrate rigiditythemuscle tone is to be decreased. Thiscan be achieved by:

Back 93

Destruction of the vestibular nucleiof Deiters

Front 94

When studying the signs ofpulmonary ventilation, reduction offorced expiratory volume has beendetected.What is the likely causeof thisphenomenon?

Back 94

Obstructive pulmonary disease

Front 95

X-ray examination of a patientallowed to diagnose a tumor in thesuperior lobe of the right lung. Thereis a probability of metastases spread tothe following lymph nodes

Back 95

Sternal

Front 96

A 55-year-old patient with acharacteristic rash, fever, dizzinesshas been admitted to a hospital. Hehas been provisionally diagnosed withtyphus. No similar cases have beenreported. In his youth (15 years old)the patient suffered typhus in a boardingschool.What disease is it?

Back 96

Brill’s disease

Front 97

A young woman suddenlydeveloped fever up to 39oC accompaniedby a strong headache. Examinationrevealed marked nuchal rigidity.Spinal puncture was performed.Gram-stained smear of cerebrospinalfluid contained many neutrophilsand Gram-positive diplococci. Whatbacteria could be the cause of this disease?

Back 97

Neisseria meningitidis

Front 98

In the course of an experimentadenohypophysis of an animal hasbeen removed. The resulting atrophyof thyroid gland and adrenal cortexhas been caused by deficiency of thefollowing hormone:

Back 98

Tropic hormones

Front 99

Degenerative changes in posteriorand lateral columns of spinalcord (funicular myelosis) caused bymethylmalonic acid accumulationoccur in patients with B12-deficiencyanemia. This results in synthesis disruptionof the following substance

Back 99

Myelin

Front 100

patient with suspected tumorof lung had been admitted to theoncological department. Examinationrevealed localised pathology in theinferior lobe of the left lung. Howmany bronchopulmonary segmentsdoes this lobe have?

Back 100

5

Front 101

During local anesthetization thepatient has gone into anaphylacticshock. What drug must be administeredto the patient?

Back 101

Epinephrine hydrochloride

Front 102

As a result of an injury, the integrityof the anterior spinal cord root wasbroken. Specify the neurons and theirprocesses that had been damaged

Back 102

Axons of motor neurons

Front 103

A patient who had been taking diclofenacsodium for arthritis of mandibularjoint developed an acute conditionof gastric ulcer. Such side effect ofthis medicine is caused by inhibition ofthe following enzyme:

Back 103

Cyclooxygenase-1 (COX-1)

Front 104

In one of Polessye regions therewas an outbreak of helminthiasismanifestedby cramps and facial edmata. The developed preventive measuresin particular included ban for eatinginfested pork even after heat processing.What helminthiasis was the case?

Back 104

Trichinosis

Front 105

A female patient saught medicalgeneticconsultation. Physical examinationrevealed pterygium collideformity (webbed neck), broad chest,underdeveloped breasts. Study ofbuccal epithelium cells revealed noX-chromatin in the nuclei. This indicatesthat the patient has the followingsyndrome:

Back 105

Turner’s

Front 106

During blood transfusion apatient has developed intravascularerythrocyte hemolysis. What kind ofhypersensitivity does the patient have?

Back 106

II type (antibody-dependent)

Front 107

Patients with erythropoieticporphyria (Gunther’s disease) haveteeth that fluoresce with bright redcolor when subjected to ultravioletradiation; their skin is light-sensitive,urine is red-colored. What enzyme cancause this disease, when it is deficient?

Back 107

Uroporphyrinogen III cosynthase

Front 108

During the air and bone conductiontests it was revealed that in theleft ear the tones were louder by boneconduction. This might be associatedwith the disease of:

Back 108

Left middle ear

Front 109

In course of invasive abdominalsurgery a surgeon has to locate the originof the mesenteric root. Where is itnormally localized

Back 109

Duodenojejunal flexure

Front 110

A 55-year-old male had beendelivered to the resuscitation unitunconscious. Relatives reported himto have mistakenly drunk an alcoholicsolution of unknown origin. On examinationthe patient was diagnosed withmethanol intoxication. What antidoteshould be used in this case?

Back 110

Ethanol

Front 111

Due to the use of poorqualitymeasles vaccine for preventivevaccination, a 1-year-old childhas developed an autoimmunerenal injury. The urine was foundto contain macromolecular proteins.What process of urine formation hasbeen disturbed?

Back 111

Filtration

Front 112

As a result of a road accident a 37-year-old female victim developed urinaryincontinence. What segments ofthe spinal cord had been damaged

Back 112

S2 − S4

Front 113

An 8-week-pregnant woman with acute respiratory disease andtemperature rise up to 39, 0oC hascalled in a doctor. The doctor insistedon her avoiding taking paracetamol,because in this period of pregnancythere is a risk of its:

Back 113

Teratogenicity

Front 114

A pneumonia patient has beenadministered acetylcysteine as a partof complex therapy. What principleof therapy has been taken into considerationwhen applying this drug?

Back 114

Pathogenetic

Front 115

A 26-year-old female patient withbronchitis has been administered abroad spectrum antibiotic as a causaltreatment drug. Specify this drug:

Back 115

Doxycycline

Front 116

When defining blood groupaccording to the AB0 system, usingsalt solutions of monoclonal antibodies,agglutination didn’t occur with anyof the solutions. What blood group isit?

Back 116

0 (I)

Front 117

Examination of a 56-year-oldfemale patient with a history of type1 diabetes revealed a disorder ofprotein metabolism that is manifestedby aminoacidemia in the laboratoryblood test values, and clinically by thedelayed wound healing and decreasedsynthesis of antibodies. Which ofthe following mechanisms causes thedevelopment of aminoacidemia?

Back 117

Increased proteolysis

Front 118

Symptoms of pellagra (vitamin PPdeficiency) is particularly pronouncedin patients with low protein diet,because nicotinamide precursor inhumans is one of the essential aminoacids, namely:

Back 118

Tryptophan

Front 119

A 68-year-old patient consultsa cardiologist, complaining of higharterial blood pressure, pain in theheart egion, intermittent pulse. Prescribethe β1-adrenoreceptor blockerfor the treatment of the describedpathology:

Back 119

Metoprolol

Front 120

A female suffered rubella duringpregnancy. The child was bornwith developmental abnormalities,namely cleft lip and palate. The child’sgenotype is normal. These malformationsare a manifestation of

Back 120

Modification variability

Front 121

An electron micrograph showsa cell-to-cell adhesion consisting, ineach cell, of an attachment plaque.The intercellular space is filled withelectron-dense substance includingtransmembrane fibrillar structures.Specify this adhesion:

Back 121

Desmosome

Front 122

For biochemical diagnostics ofmyocardial infarction it is necessaryto measure activity of a number ofenzymes and their isoenzymes. Whatenzymatic test is considered to be thebest to prove or disprove the diagnosisof infarction in the early period afterthe chest pain is detected?

Back 122

Creatine kinase isoenzyme CK-MB

Front 123

A patient complains of pain inthe heart area during acute attack ofgastric ulcer. What vegetative reflexcan cause this painful feeling?

Back 123

Viscerovisceral reflex

Front 124

A patient is diagnosed with acutemorphine hydrochloride intoxication.Prescribe an oxidizing agent for gastriclavage:

Back 124

Potassium permanganate

Front 125

In the course of puncture biopsyof transplanted kidney the followinghas been revealed: diffuse infiltrationof stroma by lymphocytesand plasmocytes and necrotic arteritis.What pathological process hasdeveloped in the transplant?

Back 125

Immune rejection

Front 126

During cell division, DNA replicationoccurs by a signal from thecytoplasm, and a certain portion of theDNA helix unwinds and splits into twoindividual strains. What enzyme facilitatesthis process

Back 126

Helicase

Front 127

A female patient, having visitedthe factory premises with lots of dust inthe air for the first time, has got coughand burning pain in the throat. Whatrespiratory receptors, when irritated,cause this kind of reaction?

Back 127

Irritant receptors

Front 128

Since a patient has had myocardialinfarction, his atria and ventriclescontract independently from eachother with a frequency of 60-70 and 35-40 perminute. Specify the type of heartblock in this case:

Back 128

Complete atrioventricular

Front 129

A 35-year-old female patient hasbeen hospitalised with acute intoxicationcaused by salts of high-densitymetals (lead,most probably).As a partof complex therapy the antidote thatcontains two active sulfhydric groupshas been prescribed. Specify this antidote:

Back 129

Dimercaprol

Front 130

A 60-year-old male patient hastype II diabetes. A doctor has prescribedhim synthetic hypoglycemic longactingdrug that is sulfonylurea derivative.What drug is it?

Back 130

Glibenclamide

Front 131

A patient has been given atropinesulfate for rapid relief of spasticcolon symptoms. The use of this drugis contraindicated during the followngdisease:

Back 131

Glaucoma

Front 132

As an example of specific humanparasites one can name Plasmodiumfalciparum, human pinworm and someothers. The source of parasite invasionis always a human. Such specific humanparasites cause the diseases that arecalled:

Back 132

Anthroponoses

Front 133

In an experiment a dog had beenconditioned to salivate at the sight offood and a flash of light. After conditioningthe reflex, the light was then pairedwith the bell. The dog didn’t startto salivate.What type of inhibition wasobserved?

Back 133

External

Front 134

A newborn baby has numeroushemorrhages. Blood coagulation testsreveal increased prothrombin time.The child is most likely to have a disorderof the following biochemicalprocess:

Back 134

Production of gammacarboxyglutamate

Front 135

A 63-year-old male patient withbladder atony had been prescribed amedication, which he had been arbitrarilytaking at a higher dose. Thepatient developed hypehydration, salivation,diarrhea, muscle spasms. Theprescribed drug relates to the followinggroup:

Back 135

Cholinomimetics

Front 136

A 67-year-old male patientconsumes eggs, pork fat, butter, milkand meat. Blood test results:cholesterol - 12,3 mmol/l, total lipids- 8,2 g/l, increased low-density lipoproteinfraction (LDL). What typeof hyperlipoproteinemia is observed inthe patient?

Back 136

Hyperlipoproteinemia type IIa

Front 137

Tissue sampling of a 37-year-oldmale patient with chronic renal diseasehas revealed the following: sclerosis,lymphocytic and plasmocytic infiltrationof renal pelvis and calices walls,dystrophy and atrophy of tubules.Remaining tubules are enlarged andstretched with colloid masses, epitheliumis flattened out ("scutiform"or"shield-shaped"kidney). What is themost likely diagnosis?

Back 137

Chronic pyelonephritis

Front 138

During the hystological studyof cortical shaft, basophilic cells withdeveloped synthesis organelles canbe seen on the bone surface under thelayer of fibers. These cells take part inbone tissue regeneration. What shaftlayer are they located in?

Back 138

Periosteum

Front 139

had tuberculosis revealed a densegray-white nidus in form of a nodule2 cm in diameter in the subpleuralportion of the upper right lobe. Thepleura in this region was thickened,in the pleural cavity there was asmall amount of serous hemorrhagicfluid. Histological study of the regionrevealed some glandular structures withsigns of cellular atypia and abnormalmitoses, which were found within thefibrous connective tissue. What otherpathology had developed in the lungs?

Back 139

Adenocarcinoma

Front 140

In course of an experimentthere has been an increase in thenerve conduction velocity. This maybe caused by an increase in theconcentration of the following ionsthat are present in the solution aroundthe cell:

Back 140

Na+

Front 141

Hepatitis B is diagnosed throughlaboratory tests that determine thepresence of HBA-DNAin blood serumof the patient. What reference methodis applied for this purpose?

Back 141

Polymerase chain reaction

Front 142

On the 24th day since the onsetof disease, a male patient diagnosedwith typhoid fever and undergoingtreatment in an infectious diseaseshospital has suddenly developed clinicalpresentations of acute abdomenleading to the death of the patient.During autopsy peritonitis has beenrevealed, with numerous ulcers coveringthe colon mucosa and reaching asdeep as muscular and, in places, seroustunic. The ulcers have smooth edgesand even floor. The intestinal wallis perforated. What stage of typhoidfever has the lethal complication arisenat?

Back 142

Clean ulcer

Front 143

An HIV-positive patient’s causeof death is acute pulmonary insufficiencyresulting from pneumonia.Pathohistological investigation of lungshas revealed interstitial pneumonia,alveolocyte desquamation andtheir methamorphoses: alveolocyteenlargement, large intranuclearinclusions surrounded by lightlycoloredareas. Transformed cellsresemble owl’s eye. Name thepneumonia causative agent:

Back 143

Cytomegalovirus

Front 144

The organisms to be identifiedhave a nucleus surrounded by anuclear membrane. Genetic materialis concentrated predominantly in the chromosomes which consist of DNAstrands and protein molecules. Thesecells divide mitotically. Identify theseorganisms:

Back 144

Eukaryotes

Front 145

A 37-year-old male patientdeveloped pseudoarthrosis after aclosed fracture of the femur. Specifythe type of regeneration in the patient:

Back 145

Pathological hypo-regeneration

Front 146

Nucleolar organizers of the 13-15,21, 22 human chromosomes containabout 200 cluster genes that synthesizeRNA. These regions of chromosomesbear the information on the followingtype of RNA:

Back 146

rRNA

Front 147

The resuscitation unit has admitteda patient in grave condition.It is known that he had mistakenlytaken sodium fluoride which blockscytochrome oxidase. What type ofhypoxia developed in the patient?

Back 147

Tissue

Front 148

Steatosis is caused by theaccumulation of triacylglycerols inhepatocytes. One of the mechanismsof this disease development is adecrease in the utilization of VLDLneutral fat. What lipotropics preventthe development of steatosis

Back 148

Methionine, B6, B12

Front 149

A 2-year-old boy is diagnosed withDown syndrome. What chromosomalchanges may be the cause of this disease?

Back 149

Trisomy 21

Front 150

A patient who has recently arrivedfrom an endemic area presentswith elevated body temperature,headache, chills, malaise, that is withthe symptoms which are typical for acommon cold. What laboratory testsare necessary to prove or to disprovethe diagnosis of malaria?

Back 150

Microscopy of blood smears

Front 151

A patient has severe blood losscaused by an injury. What kind ofdehydration will be observed in thisparticular case?

Back 151

Iso-osmolar

Front 152

A 30-year-old patient has dyspneafits, mostly at night. He has been diagnosedwith bronchial asthma. Whattype of allergic reaction according tothe Gell-Coombs classification is mostlikely in this case?

Back 152

Anaphylactic

Front 153

Decarboxylation of glutamateinduces production of gamma aminobutyric acid (GABA )neurotransmitter. After breakdown,GABA is converted into a metaboliteof the citric acid cycle, that is:

Back 153

Succinate

Front 154

An outbreak of an intestinalinfection occurred in a kindergarten onthe eve of New Year holidays. Bacteriologicalexamination of patients’faeces didn’t reveal any pathogenicbacteria. Electronmicroscopy revealedroundish structures with clear outeredges and a thick core resembling awheel. Specify the most likely causativeagent of this infection:

Back 154

Rotavirus

Front 155

A smear of streptobacilluspreparation stained by Ozheshkomethod has been studied microscopicallywith oil immersion. Whatstructural feature of the bacteria hasbeen studied?

Back 155

Spores

Front 156

After a road accident a victimhas tachycardia, arterial blood pressure130/90 mm Hg, tachypnoe, the skinis pale and dry, excitation of centralnervous system is observed. Whatshock stage is the patient most likelyin?

Back 156

Erectile

Front 157

Autopsy has revealed shrunkenkidneys weighing 50 mg, with finegrainedsurface and uniformly thinnedsubstance. Microscopic investigationhas shown the thickening ofarteriole walls due to accumulation ofhomogeneous anhistic pink-colouredmasses in them. Glomerules wereundersized, sclerotic, with atrophiedtubules. What disease are thesechanges characteristic of?

Back 157

Essential hypertension

Front 158

A fixed-run taxi passenger hasa sudden and expressed attack oftachycardia. A doctor travelling by thesame taxi has managed to slow downhis heart rate by pressing upon theeyeballs and thus causing the followingreflex:

Back 158

Dagnini-Aschner refle

Front 159

Histological examination of biopsysamples taken from the thickenededges of a gastric ulcer revealed smallclusters of small, markedly atypicalhyperchromatic epithelial cells thatwere localized in the overdevelopedstroma. Specify the tumor

Back 159

Scirrhous undifferentiated carcinoma

Front 160

A 10-year-old child was found tohave a congenital hypoplasia of theleft kidney. Ultrasound examinationrevealed that the right kidney wasmarkedly enlarged and had regularshape. No functional disorders wererevealed. Specify the process thatdeveloped in the right kidney:

Back 160

Vicarious hypertrophy

Front 161

In allergic diseases, a dramaicincrease in basophilic leukocytenumber in patients’ blood is observed.This phenomenon is due to the followingbasophil function

Back 161

Participation of heparin and histaminein metabolism

Front 162

A 47-year-old male patientdeveloped intestinal colic against thebackground of essential hypertension.In this situation it would be most efficientto arrest the colic by using drugsof the following group:

Back 162

Myotropic antispasmodics

Front 163

Apatient has been admitted to thecontagious isolation ward with signsof jaundice caused by hepatitis virus.Which of the symptoms given belowis strictly specific for hepatocellularjaundice?

Back 163

Increase of ALT, AST level

Front 164

An underage patient has signs ofachondroplasia (dwarfism). It is knownthat this is a monogenic disease andthe gene that is responsible for thedevelopment of such abnormalities isa dominant one. The development ofthat child’s brother is normal. Specifythe genotype of the healthy child

Back 164

aa

Front 165

A patient has acute bronchitis.The fever up to 38, 5oC had lasted for aweek, presently there is a decrease intemperature down to 37, 0oC. Specifythe leading mechanism in the 3rd stageof fever:

Back 165

Peripheral vasodilation

Front 166

A 35-year-old female patienthas undergone biopsy of the breastnodules. Histological examination hasrevealed enhanced proliferation ofthe small duct and acini epithelialcells, accompanied by the formation ofglandular structures of various shapesand sizes, which were located in the fibrousstroma. What is the most likelydiagnosis?

Back 166

Fibroadenoma

Front 167

At a bacteriological laboratoryanimal skins are analyzed by meansof Ascoli precipitaion test. What isdetected if the reaction is positive

Back 167

Anthrax agent antigens

Front 168

Examination of the duodenalcontents revealed some pear-shapedprotozoa with two nuclei and four pairsof flagella. The organisms had alsotwo axostyles between the nuclei and aventral adhesive disc. What protozoanrepresentative was found in the patient?

Back 168

Lamblia

Front 169

A 36-year-old female patienthas a history of B2-hypovitaminosis.The most likely cause of specificsymptoms (epithelial, mucosal,cutaneous, corneal lesions) is the deficiency of

Back 169

Flavin coenzymes

Front 170

A 54-year-old female was broughtto the casualty department after a caraccident. A traumatologist diagnosedher withmultiple fractures of the lowerextremities. What kind of embolism ismost likely to develop in this case?

Back 170

Fat

Front 171

A blood drop has been put into atest tube with 0,3% solution of NaCl.What will happen to erythrocytes?

Back 171

Osmotic haemolysis

Front 172

There are cortical and medullarysubstances separated by connectivetissue layer in the endocrine glandspecimen. Parenchyma cells make upthree zones in cortical substance, withrounded masses in the superficialzone, parallel chords in themiddle one,reticular structure of cell chords in thedeep one.What gland is it?

Back 172

Adrenal gland

Front 173

Histological specimen of a 10-dayhuman embryo represents 2 contactingsacs (amniotic and yolk sacs). Specifythe structure that separates the amnioticcavity from the yolk sac

Back 173

Embryonic shield

Front 174

An electron micrograph showsa cell of neural origin. The terminalportion of the cell dendrite has cylindricalshape and consists of 1000closed membrane disks. What cell isrepresented by the micrograph

Back 174

Rod receptor cell

Front 175

Disruption of nerve fiber myelinogenesiscauses neurological disordersand mental retardation. Thesesymptoms are typical for hereditaryand acquired alterations in themetabolism of:

Back 175

Sphingolipids

Front 176

A patient underwent surgicalremoval of a cavitary liver lesion 2cm in diameter. It was revealed thatthe cavity wall was formed by densefibrous connective tissue; the cavitycontained muddy, thick, yellowishgreenishfluid with an unpleasantodor. Microscopically, the fluid consistedmainly of polymorphonuclearleukocytes. What pathological processare these morphological changes typicalfor?

Back 176

Chronic abscess

Front 177

A patient complains ofphotoreception disorder and frequentacute viral diseases. He has beenprescribed a vitamin that affectsphotoreception processes by producingrhodopsin, the photosensitive pigment.What vitamin is it?

Back 177

Retinol acetate

Front 178

A 7-year-old boy got ill with diphtheria.On the third day he diedof asphyxiation. At autopsy themucosa of the larynx, trachea andbronchi had thickened, edematous,lustreless appearance and was coveredwith gray films which could be easilyremoved. Specify the type of laryngealinflammation:

Back 178

Croupous

Front 179

A child has a history ofhepatomegaly, hypoglycemia, seizures,especially on an empty stomach andin stressful situations. The child is diagnosedwith Gierke disease. This diseaseis caused by the genetic defect ofthe following enzyme:

Back 179

Glucose-6-phosphatase

Front 180

A public utility specialist wentdown into a sewer well withoutprotection and after a while lostconsciousness. Ambulance doctors diagnosedhim with hydrogen sulfideintoxication. What type of hypoxiadeveloped?

Back 180

Hemic

Front 181

A child with a normal karyotypeis diagnosed with cleft lip andhard palate, defects of the cardiovascularsystem, microcephaly. Thechild’s mother suffered rubella duringpregnancy. This pathology in the childmay be an example of:

Back 181

Genocopy

Front 182

A 28-year-old patient undergoingtreatment in the pulmonologicaldepartment has been diagnosed withpulmonary emphysema caused bysplitting of alveolar septum by tissulartripsin. The disease is cased by thecongenital deficiency of the followingprotein:

Back 182

α1-proteinase inhibitor

Front 183

A patient with signs ofosteoporosis and urolithiasis hasbeen admitted to the endocrinologydepartment. Blood testhas revealed hypercalcemia andhypophosphatemia. These changes areassociated with abnormal synthesis ofthe following hormone

Back 183

Parathyroid hormone

Front 184

During a surgery for femoralhernia a surgeon operates within theboundaries of femoral trigone. Whatstructure makes up its upper margin

Back 184

Lig.inguinale

Front 185

A 19-year-old victim has beendelivered to the casualty departmentwith a cut wound of the trapeziusmuscle. Which of the cervical fasciaeforms a sheath for this muscle?

Back 185

Investing layer of cervical fascia

Front 186

A patient with acne has beenprescribed doxycycline hydrochloride.What recommendations should be givento the patient, while he is takingthis drug?

Back 186

Avoid long stay in the sun

Front 187

A 30-year-old patient with a pasthistory of virus B hepatitis complainsof prolonged nosebleeds. What drugwill be most efficient in remedying thiscondition?

Back 187

Vicasolum

Front 188

A patient has arterial hypertension.What long-acting drug from thegroup of calcium channel blockersshould be prescribed?

Back 188

Amlodipine

Front 189

A patient has been diagnosedwith ARVI. Blood serum containsimmunoglobulin M. What is the stageof infection in this case?

Back 189

Acute

Front 190

In a dysentery patient undergoingtreatment in the contagious isolationward, a significant increase in packedcell volume has been observed (60%).What other value will be affected bythis change?

Back 190

Increasing blood viscosity

Front 191

A patient complains of palpitationafter stress. The pulse is 104bpm, P-Q=0,12 seconds, there are nochanges of QRS complex. What typeof arrhythmia does the patient have?

Back 191

Sinus tachycardia

Front 192

A 30-year-old patient hasundergone keratoplasty in thetransplantation center, cornea has beentaken fron a donor, who died in a roadaccident. What kind of transplantationwas performed?

Back 192

Allotransplantation

Front 193

A 29-year-old male with a knifewound of neck presents with bleeding.During the initial d-bridement ofthe wound the surgeon revealed theinjury of a vessel found along thelateral edge of the sternocleidomastoidmuscle. Specify this vessel:

Back 193

V. jugularis externa

Front 194

A histologic specimen representsan organ with walls comprisedof mucous, submucous, fibrouscartilaginousand adventitial membranes.Epithelium is multirowed and ciliated,muscular layer of mucous membrane isabsent, submucous membrane contains serous-mucous glands, hyalinecartilage forms open circles. Whatorgan has the described morphologicalfeatures?

Back 194

Trachea

Front 195

In cancer patients who have beencontinuously receiving methotrexate,the target cells of tumor with timebecome insensitive to this drug. In thiscase, gene amplification of the followingenzyme is observed:

Back 195

Dihydrofolate reductase

Front 196

Pancreas is known as a mixedgland. Endocrine functions includeproduction of insulin by beta cells. Thishormone affects the metabolism ofcarbohydrates. What is its effect uponthe activity of glycogen phosphorylase(GP) and glycogen synthase (GS)?

Back 196

It inhibits GP and activates GS

Front 197

A patient has the oxyhemoglobindissociation curve shifted to the left.What blood changes induce this condition?

Back 197

lkalosis, hypocapnia, temperaturedrop

Front 198

Administration of doxycyclinehydrochloride caused an imbalanceof the symbiotic intestinal microflora.Specify the kind of imbalance causedby the antibiotic therapy

Back 198

Dysbacteriosis

Front 199

A patient with signs of emotionallability that result in troubled sleep hasbeen prescribed nitrazepam. Specifythe sleep-inducing mechanism of thisdrug:

Back 199

GABA-ergic system activation

Front 200

A patient has been found to havea marked dilatation of saphenous veinsin the region of anterior abdominalwall around the navel. This issymptomatic of pressure increase inthe following vessel:

Back 200

V. portae hepatis