Krok-1 2015 English

Front 1

Characteristic sign of glycogenosis ismuscle pain during physical work. Bloodexamination usually reveals hypoglycemia.This pathology is caused by congenital deficiencyof the following enzyme:

Back 1

Glycogen phosphorylase

Front 2

Histologic specimen of a kidneydemonstrates cells closely adjoined to therenal corpuscle in the distal convolutedtubule. Their basement membrane isextremely thin and has no folds. These cellssense the changes in sodium content of urineand influence renin secretion occurringin juxtaglomerular cells. Name these cells

Back 2

Macula densa cells

Front 3

A 46-year-old female patient has continuoushistory of progressive muscular(Duchenne’s) dystrophy. Which bloodenzyme changes will be of diagnostic valuein this case?

Back 3

Creatine phosphokinase

Front 4

A laboratory experiment on a dogwas used to study central parts of auditorysystem. One of the mesencephalonstructures was destroyed. The dog has lostthe orienting response to auditory signals.What structure was destroyed

Back 4

Inferior colliculi of corpora quadrigemina

Front 5

A patient has decreased concentrationof magnesium ions that are requiredfor ribosomes connection to granularendoplasmic reticulum. This condition isknown to disrupt the process of protein biosynthesis.Disruption occurs at the followingstage:

Back 5

Translation

Front 6

A 6-year-old child with suspected activetuberculous process has undergone diagnosticMantoux test. What immunobiologicalpreparation was injected?

Back 6

Tuberculin

Front 7

During postembryonal haemopoiesisin red bone marrow the cells of one ofthe cellular differons demonstrate gradualdecrease in cytoplasmic basophilia as wellas increase in oxyphilia, the nucleus is beingforced out. Such morphological changes aretypical for the following haemopoiesis type

Back 7

Erythropoiesis

Front 8

When taking exams students often havedry mouth. The mechanism that causes thisstate results from the following reflexe

Back 8

Conditioned sympathetic

Front 9

A 67-year-old patient with clinicaldiagnosis of chronic bronchitis,pneumosclerosis, and cardiopulmonarydecompensation has the biopsy materialtaken from the suspicious area in his rightbronchus mucosa. Cellular and tissue atypismalong with pearly bodies can be histologicallydetected. What pathologic process ischaracterized by the described histologicalchanges?

Back 9

Squamous cell carcinoma of bronchuswith keratinization

Front 10

A microspecimen of heart showsrectangular cells from50 to 120 micrometerslarge with central position of nucleusand developed myofibrils. The cells areconnected by intercalated discs. These cellsare responsible for the following function:

Back 10

Function of heart contractions

Front 11

Untrained people often have musclepain after sprints as a result of lactateaccumulation. This can be caused byintensification of the following biochemicalprocess:

Back 11

Glycolysis

Front 12

Poisoning caused by botulinum toxinthat prevents calcium ions from enteringaxone nerve endings of motoneurons is lifethreateningbecause it can lead to:

Back 12

Respiratory arrest

Front 13

Increased HDL levels decrease the riskof atherosclerosis.What is themechanism ofHDL anti-atherogenic action

Back 13

They remove cholesterol from tissues

Front 14

It has been found out that one of a pesticidecomponents is sodium arsenate thatblocks lipoic acid. Which enzyme activityis impaired by this pesticide?

Back 14

Pyruvate dehydrogenase complex

Front 15

drycleaner’s worker has been found tohave hepatic steatosis. This pathology canbe caused by the disruption of synthesis ofthe following substance

Back 15

Phosphatidylcholine

Front 16

A 35-year-old man with peptic ulcer diseasehas undergone antrectomy. After thesurgery secretion of the following gastrointestinalhormone will be disrupted themost:

Back 16

Gastrin

Front 17

Atretic bodies and developed yellowbody can be observed along with folliclesof various orders in an ovary specimen.What stage of ovarian and menstrual cycle ischaracterized by the described ovary condition?

Back 17

Premenstrual

Front 18

A 16-year-old adolescent is diagnosedwith hereditary UDP (uridine diphosphate)glucuronyltransferase deficiency.Laboratory tests revealed hyperbilirubinemiacaused mostly by increased bloodcontent of the following substance:

Back 18

Unconjugated bilirubin

Front 19

Prior to glucose utilization in cells it istransported inside cells from extracellularspace through plasmatic membrane. Thisprocess is stimulated by the followinghormone:

Back 19

Insulin

Front 20

After implantation of a cardiac valvea young man systematically takes indirectanticoagulants. His state was complicatedby hemorrhage.What substance content hasdecreased in blood?

Back 20

Prothrombin

Front 21

12-year-old patient has white nonpigmentedspots on the skin. The spotsappeared after the patient became 10 yearsold, and they constantly grow. This spotsappeared due to the lack of the followingskin cells:

Back 21

Melanocytes

Front 22

A group of Ukrainian tourists returningfrom Samarqand was bringing with themgerbils. During examination in customs officeulcers were detected on the skin of theanimals. What protozoa is the most likely tocause the disease in the animals, if mosquitosare the carriers?

Back 22

Leishmania tropica major

Front 23

A 5-year-old child has been diagnosedwith acute right distal pneumonia. Sputuminoculation revealed that the causativeagent is resistant to penicillin and senstiveto macrolides. What drug should be prescribed?

Back 23

Azithromycin

Front 24

To an emergency ward a 7-year-oldchild was delivered in the condition ofallergic shock caused by a bee sting. Highconcentration of histamine is observed inblood. Production of this amine is the resultof the following reaction:

Back 24

Decarboxylation

Front 25

A 65-year-old man suffering from goutcomplains of pain in his kidneys. Ultrasonicexamination revealed kidney stones. Acertain substance in increased concentrationcan cause kidney stones formation. Namethis substance:

Back 25

Uric acid

Front 26

Sex chromatin was detected duringexamination of a man’s buccal epithelium.It is characteristic of the followingchromosome disease:

Back 26

A. Klinefelter’s syndrome

Front 27

Pure culture of microorganisms wasobtained from pharynx of a child withsuspected diphtheria.Morphologic, tinctorial,cultural, and biochemical propertiesof the microorganisms were studied andrevealed to be characteristic of diphtheriaagents. What investigation should be additionallyperformed to make a conclusion,that these microorganisms are pathogenicdiphtheria bacilli

Back 27

Determine toxigenic properties

Front 28

Autopsy of a man who had tuberculosisrevealed a 3x2 cm large cavity in the superiorlobe of the right lung. The cavity wasinterconnected with a bronchus, its wallwas dense and consisted of three layers: theinternal layer was pyogenic, themiddle layerwas made of tuberculous granulation tissueand the external one was made of connectivetissue.What is the most likely diagnosis

Back 28

Fibrous cavernous tuberculosis

Front 29

A 7-year-old child has acute onset of disease:temperature rise up to 38oC, rhinitis,cough, lacrimation, and large-spot rash onthe skin. Pharyngeal mucosa is edematous,hyperemic, with whitish spots in the buccalarea. What kind of inflammation causes thechanges in the buccal mucosa?

Back 29

Catarrhal inflammation

Front 30

Analysis of sputum taken from a patientwith suspected pneumonia revealed slightlyelongated gram-positive diplococci with pointedopposite ends. What microorganismswere revealed in the sputum

Back 30

Streptococcus pneumoniae

Front 31

Serological diagnostics of infectious diseases is based upon specific interaction withantigenes. Specify the serological reactionthat underlies adhesion of microorganismswhen they are affected by specific antibodiesin presence of an electrolyte:

Back 31

Agglutination reaction

Front 32

A 4-year-old child was admitted to anorthopaedic department with displaced shinfracture. Bone fragments reposition requiresanalgesia. What drug should be chosen?

Back 32

Promedol

Front 33

Doctors make mostly radial incisionsduring mammary gland surgery. What particularsof anatomical organizationmake suchsurgical technique preferable?

Back 33

Lobe apexes converge towards nipples

Front 34

A 41-year-old man has a history ofrecurrent attacks of heartbeats (paroxysms),profuse sweating, headaches. Examinationrevealed hypertension, hyperglycemia,increased basal metabolic rate, andtachycardia. These clinical presentations aretypical for the following adrenal pathology:

Back 34

Hyperfunction of the medulla

Front 35

A 12-year-old child has developednephritic syndrome (proteinuria, hematuria,cylindruria) 2 weeks after the case of tonsillitis,which is a sign of affected glomerularbasement membrane in the kidneys. Whatmechanism is the most likely to cause thebasement membrane damage?

Back 35

Immune complex

Front 36

Several minutes after a dentist administerednovocaine for local anaesthesia ofa patient’s tooth, the following symptomssharply developed in the patient: fatigue,skin itching. Objectively the following canbe observed: skin hyperemia, tachycardia,BP dropped down to 70/40 mm Hg. Whatkind of allergic reaction is this pathology?

Back 36

Anaphylactic

Front 37

A patient with probable liver abscesswas delivered to a surgical department. Thepatient for a long time had been on anassignment in an African country and hadrecurrent cases of acute gastrointestinal disturbance.What protozoan disease can itbe?

Back 37

Amebiasis

Front 38

Work in a mine is known to causeinhalation of large amounts of coal dust.Inhaled coal dust can be detected in thefollowing pulmonary cells:

Back 38

Alveolar macrophages

Front 39

Electrical activity of neurons is beingmeasured. They fire prior to and at thebeginning of inhalation. Where are theseneurons situated?

Back 39

Medulla oblongata

Front 40

Electrocardiogramanalysis demonstratesthat cardiac cycle of a human equals 1second. It means that heart rate per minuteequals:

Back 40

60

Front 41

Glomerular filtration of a person, whohas been starving for a long time, hasincreased by 20%. The most likely cause offiltration changes in the given conditions is:

Back 41

Decrease of blood plasma oncoticpressure

Front 42

Cells of healthy liver actively synthesizeglycogen and proteins. What organelles arethe most developed in them?

Back 42

Granular and agranular endoplasmicreticulum

Front 43

Atria of an experimental animal weresuperdistended with blood, which resultedin decreased reabsorption of Na+ and waterin renal tubules. This can be explained bythe influence of the following factor on kidneys:

Back 43

Natriuretic hormone

Front 44

A patient with hypertensic crisis hasincreased content of angiotensin II in blood.Angiotensin pressor effect is based on:

Back 44

Contraction of arteriole muscles

Front 45

A 43-year-old-patient has arterialhypertension caused by increase in cardiacoutput and general peripheral resistance.Specify the variant of hemodynamicdevelopment of arterial hypertension in thegiven case:

Back 45

Eukinetic

Front 46

A patient has been hospitalisedwith provisional diagnosis of virus Bhepatitis. Serological reaction based oncomplementation of antigen with antibodychemically bound to peroxidase or alkalinephosphatase has been used for disease diagnostics.Name this serological reaction:

Back 46

Immune-enzyme analysis

Front 47

A surgeon has to find the commonhepatic duct during operative interventionfor treatment of concrements in the gallducts. The common hepatic duct is locatedbetween the leaves of:

Back 47

Hepatoduodenal ligament

Front 48

It is known that the gene responsible fordevelopment of blood groups according toAB0 system has three allele variants. Existenceof the IV blood group can be explainedby the following variability form

Back 48

Combinative

Front 49

When measuring power inputs of aperson by the method of indirect calorimetrythe following results were obtained:oxygen consumption is 1000 ml andcarbon dioxide production is 800 ml per minute.The person under examination has thefollowing respiratory coefficient:

Back 49

0,8

Front 50

On examination of a newborn boy’sexternal genitalia a fissure in the urethraopening on the inferior surface of his penisis detected.What maldevelopment is it?

Back 50

Hypospadias

Front 51

Poisoning caused by mercury (II) chloride(corrosive sublimate) occurred in theresult of safety rules violation. In 2 daysthe patient’s diurnal diuresis became 620ml. The patient developed headache, vomiting,convulsions, dyspnea; moist crackles areobserved in the lungs. Name this pathology:

Back 51

Acute renal failure

Front 52

For people adapted to high externaltemperatures profuse sweating is notaccompanied by loss of large volumes ofsodium chloride. This is caused by the effectthe following hormone has on the perspiratoryglands:

Back 52

Aldosterone

Front 53

Along with normal hemoglobin typesthere can be pathological ones in the organismof an adult. Name one of them

Back 53

HbS

Front 54

Emotional stress causes activation ofhormon-sensitive triglyceride lipase in theadipocytes. What secondary mediator takespart in this process?

Back 54

Cyclic adenosine monophosphate

Front 55

A patient has been diagnosed withalkaptonuria. Choose an enzyme that cancause this pathology when deficient

Back 55

Homogentisic acid oxidase

Front 56

As a result of a continuous chronicencephalopathy a patient has developedspontaneous motions and disorder of torsomuscle tone. These are the symptoms of thedisorder of the following conduction tract

Back 56

Tractus rubrospinalis

Front 57

A child is 10 years old. The followingpresentations have developed: sharppain during swallowing, swollen neck, bodytemperature rise up to 39, 0oC, bright-red finelypapular rash all over the body. Pharynxand tonsils are sharply hyperemic ("flamingpharynx"), "crimson tongue". On the tonsilssurface there are isolated greyish necrosisfocuses.What disease it might be?

Back 57

Scarlet fever

Front 58

A patient suffers from intermittentfevers and normalizations of bodytemperature that occur during the day. Thetemperature rise is observed regularly everyfourth day. Specify the type of temperaturecurve:

Back 58

Febris internuttens

Front 59

A woman with the III (В), Rh- bloodgroup gave birth to a child with the II (А)blood group. The child is diagnosed withhemolytic disease of newborn caused byrhesus incompatibility. What blood groupand Rh can the father have?

Back 59

II (А), Rh+

Front 60

patient is diagnosed with hereditarycoagulopathy that is characterised by factorVIII deficiency. Specify the phase of bloodclotting during which coagulation will be disruptedin the given case:

Back 60

Thromboplastin formation

Front 61

Angiocardiography of a 60-year-old manrevealed constriction of the vessel located inthe left coronary sulcus of his heart. Namethis pathological vessel:

Back 61

Ramus circumflexus

Front 62

A patient complains of pain in the rightlateral abdomen. Palpation revealed adense, immobile, tumor-like formation. Thetumor is likely to be found in the followingpart of the digestive tube:

Back 62

Colon ascendens

Front 63

During regular check-up a child isdetected with interrupted mineralization ofthe bones. What vitamin deficiency can bethe cause?

Back 63

Calciferol

Front 64

During hystological analysis of thelymph node situated in the posteriorneck triangle of an 18-year-old patienta morphologist detected a clusterof cells including the following: isolatedmultinucleate Reed-Sternberg cells, largeand small Hodgkin’s cells and numerouslymphocytes, isolated plasma cells, eosinophils.What disease has developed in thepatient?

Back 64

Lymphogranulomatosis

Front 65

An infant has pylorospasm, weakness,hypodynamia, convulsions as a result offrequent vomiting. What kind of acid-basedisbalance is it?

Back 65

Excretory alkalosis

Front 66

A 39-year-old man who had beenoperated for the stomach ulcer died 7days after the surgery. Autopsy revealedthat peritoneal leaves were dull, plephoric,covered with massive yellow-greenish films,the peritoneal cavity contained about 300ml of thick yellow-greenish liquid. Whatpathologic process was revealed in the peritonealcavity?

Back 66

Fibrinous suppurative peritonitis

Front 67

Monoamine oxidase inhibitors arewidely used as psychopharmacologicaldrugs. They change the level of nearlyall neurotransmitters in synapses, withthe following neurotransmitter being theexception:

Back 67

Acetylcholine

Front 68

A patient with urolithiasis has developedsevere pain attacks. For pain shock preventionhe was administered an antispasmodicnarcotic analgesic along with atropine.Name this drug:

Back 68

Promedol

Front 69

A patient with acute myocardial infarctionhas been administered heparin as a partof complex therapy. Some time after heparininjection the patient developed hematuria.What heparin antagonist should be injectedto remove the complication?

Back 69

Protamine sulfate

Front 70

A 37-year-old woman complains ofheadache, vertigo, troubled sleep, numbnessof limbs. For the last 6 years she has beenworking at a gas-discharge lamp-producingfactory in a lead-processing shop. Blood testfindings: low hemoglobin and RBC level,serum iron concentration exceeds the normby several times. Specify the type of anemia:

Back 70

Iron refractory anemia

Front 71

Despite the administration of cardiotonicsand thiazide diuretic a patient withchronic heart failure has persistent edemasand the risk of ascites arose.What medicationshould be administered to enhance thediuretic effect of the administered drugs

Back 71

Spironolactone

Front 72

Acute renal impairment caused deathof a patient with hemorrhage. Autopsyrevealed enlarged kidneys with broad palepinkcortical layer expressively demarcatedfrom dark-red renal pyramids. Macroscopicexamination revealed lack of epithelial nuclei of convoluted tubules, tubulorrhexis,phlebostasis. The cell nuclei of choroidglomus and straight tubules were present.What pathology is it?

Back 72

Necronephrosis

Front 73

A 3-year-old child with meningealsymptoms died. Postmortem macroscopyof the pia matter revealed miliary noduleswhich were microscopically represented bya focus of caseous necrosis with masses ofepithelioid and lymphoid cells with largecells containing crescent-shaped peripheralnuclei situated between them. Specify thetype of meningitis in the child:

Back 73

Tuberculous

Front 74

A 66-year-old woman had intravenousinjection of magnesium sulfate solutionto stop hypertensive crisis. However herarterial pressure did not decrease andafter repeated introduction of the samepreparation she developed sluggishness,slow response to stimuli; the patient isunconsciousness and her respiration is inhibited.What preparation is antagonist ofmagnesium sulfate and can remove thesymptoms of its overdose?

Back 74

Calcium chloride

Front 75

A patient working at a pig farm complainsof paroxysmal abdominal pain, liquidfeces with mucus and blood, headache,weakness, fever. Examination of largeintestine revealed ulcers from 1 mm up toseveral cm in diameter, feces contained ovalunicellular organisms with cilia. What diseasecan be suspected?

Back 75

Balantidiasis

Front 76

An unconscious patient was deliveredby ambulance to the hospital. On objectiveexamination the patient was found topresent no reflexes, periodical convulsions,irregular breathing. After laboratoryexamination the patient was diagnosed withhepatic coma. Disorders of the centralnervous system develop due to accumulationof the following metabolite:

Back 76

Ammonia

Front 77

When playing a child received a hit to thepresternum region.As a result of this traumaan organ located behind the presternumwasdamaged. Name this organ

Back 77

Thymus

Front 78

A child suffers from dry cough. Whatnon-narcotic antitussive drug will relieve thepatient’s condition?

Back 78

Glaucine hydrochloride

Front 79

Apatient complains of acute pain attacksin the right lumbar region. During examinationa nephrolithic obturation of the rightureter in the region between its abdominaland pelvic segments has been detected.What anatomical boundary exists betweenthose two segments?

Back 79

Linea terminalis

Front 80

A patient has insufficient blood supplyto the kidneys, which has caused thedevelopment of pressor effect due toconstriction of arterial resistance vessels.This condition results from the vessels beingstrongly affected by the following substance:

Back 80

Angiotensin II

Front 81

In a village a case of anthrax has beenregistered. Medical services began epidemiologicallyindicated specific prophylaxis ofpopulation against anthrax.What preparationwas used for this purpose?

Back 81

Live vaccine

Front 82

Experimental stimulation of thesympathetic nerve branches that innervatethe heart caused an increase in the force ofheart contractions because the membraneof typical cardiomyocytes permitted anincrease in:

Back 82

Calcium ion entry

Front 83

According to the results of glucosetolerance test a patient has no disorderof carbohydrate tolerance. Despite thatglucose is detected in the patients’s urine (5mmol/l). The patient has been diagnosed withrenal diabetes. What renal changes causeglucosuria in this case?

Back 83

Decreased activity of glucose reabsorptionenzymes

Front 84

Alveolar space of acinus was invaded bybacteria that interacted with the surfactant.This led to the activation of the cells thatare localized in the alveolar walls and on thesurface. Name these cells:

Back 84

Alveolar macrophages

Front 85

Parents of a 5-year-old boy report himto have frequent colds that develop intopneumonias, presence of purulent rasheson the skin. Laboratory tests have revealedthe following: absence of immunoglobulinsof any type, and naked cells are absentfrom the lymph nodes punctate. What kindof immune disorder is it?

Back 85

X-linked hypogammaglobulinemia(Bruton type agammaglobulinemia)

Front 86

Examination of a 42-year-old patientrevealed a tumour of adenohypophysis.Objectively: the patient’s weight is 117kg, he has moon-like hyperemic face, redbluestriae of skin distension on his belly.Osteoporosis and muscle dystrophy arepresent. AP is 210/140 mm Hg. What is themost probable diagnosis?

Back 86

Cushing’s disease

Front 87

2 days after labour a woman developedshock along with DIC syndrome thatcaused her death. Autopsy revealedpurulent endomyometritis, regionalpurulent lymphangitis, lymphadenitis andpurulent thrombophlebitis. There werealso dystrophic alterations and interstitialinflammation of parenchymal organs. Whatis the most likely diagnosis?

Back 87

Septicemia

Front 88

In case of alkaptonuria, homogentisicacid is excreted in urine in large amounts.The development of this disease is associatedwith metabolic disorder of the followingamino acid:

Back 88

Tyrosine

Front 89

When blood circulation in the damagedtissue is restored, lactate accumulation stopsand glucose consumption decelerates. Thesemetabolic changes are caused by activationof the following process:

Back 89

Aerobic glycolysis

Front 90

Adoctor examined a patient, studied theblood analyses, and reached a conclusion,that peripheral immunogenesis organs areaffected. What organs are the most likely tobe affected?

Back 90

Tonsils

Front 91

doctor asked a patient to make a deepexhalation after a normal inhalation. What muscles contract during such exhalation?

Back 91

Abdominal muscles

Front 92

A 4-year-old child with hereditaryrenal lesion has signs of rickets; vitaminD concentration in blood is normal. Whatis the most probable cause of ricketsdevelopment?

Back 92

Impaired synthesis of calcitriol

Front 93

In a cat with decerebrate rigidity themuscle tone is to be decreased. This can beachieved by:

Back 93

Destruction of the vestibular nuclei ofDeiters

Front 94

Autopsy of a 5-year-old child revealedin the area of vermis of cerebellum a softgreyish-pink node 2 cm in diameter withblurred margins and areas of haemorrhage.Histologically this tumour consisted ofatypical monomorphous small round cellswith large polymorphous nuclei. Whattumour is it?

Back 94

Medulloblastoma

Front 95

Surface with an intact toad on it wasinclined to the right. Tone of extensormuscles became reflectory higher due to theactivation of the following receptors

Back 95

Vestibuloreceptors of utricle and saccule

Front 96

A patient with high-titer antinuclearantibodies died from progressing renalimpairment. Autopsy revealed mesangioproliferativeglomerulonephritis andabacterial polypous endocarditis. Periarterialbulbar sclerosis was detected in spleenand productive proliferative vasculitis inskin.What is the most likely diagnosis?

Back 96

Systemic lupus erythematosus

Front 97

When studying the signs of pulmonaryventilation, reduction of forced expiratoryvolume has been detected. What is the likelycause of this phenomenon?

Back 97

Obstructive pulmonary disease

Front 98

specimen of a parenchymal organshows poorly delineated hexagonal lobulessurrounding a central vein, and theinterlobular connective tissue containsembedded triads (an artery, a vein and anexcretory duct).What organ is it?

Back 98

Liver

Front 99

patient had a trauma that causeddysfunction of motor centres regulatingactivity of head muscles. In what parts ofcerebral cortex can the respective centrenormally be located?

Back 99

Inferior part of precentral gyrus

Front 100

During intravenous saline transfusiona patient’s condition deteriorated drastically,and the patient died from asphyxiation.Autopsy revealed acute venous congestionof internal organs with sharp right heartdilatation. When the right ventricle waspunctured underwater, the bubbles escaped.What pathological process occurred in thepatient?

Back 100

Air embolism

Front 101

Diseases of respiratory system and circulatorydisorders impair the transport ofoxygen, thus causing hypoxia. Under theseconditions the energy metabolism is carriedout by anaerobic glycolysis. As a result, the following substance is generated andaccumulated in blood:

Back 101

Lactic acid

Front 102

Examination of a 6-month-old childrevealed a delay in closure of the occipitalfontanelle.When should it normally close

Back 102

Before 3 months

Front 103

Sex chromosomes of a woman didn’tseparate and move to the opposite polesof a cell during gametogenesis (meiosis).The ovum was impregnated with a normalspermatozoon.Which chromosomal diseasecan be found in her child?

Back 103

Turner’s syndrome

Front 104

A patient was prescribed loratadine totreat allergic cheilitis. What is the mechanismof action of this drug?

Back 104

Blockade of H1-histamine receptors

Front 105

During introduction of local anesthesiaa patient has gone into anaphylactic shock.What drug must be administered to the patient?

Back 105

Epinephrine hydrochloride

Front 106

patient has been diagnosed withinfluenza. His condition drasticallyworsened after taking antipyretic drugs. Heis unconscious, AP is 80/50 mm Hg, Ps is140/m, body temperature dropped down to35, 8oC. What complication developed inthis patient?

Back 106

Collapse

Front 107

An alcoholic has alcoholic psychosiswith evident psychomotor agitation. Whatneuroleptic drug should be administered foremergency aid?

Back 107

Aminazine

Front 108

During blood transfusion a patienthas developed intravascular erythrocytehemolysis. What kind of hypersensitivitydoes the patient have?

Back 108

II type (antibody-dependent)

Front 109

In the course of an experimentthalamocortical tracts of an animal were cut.What type of sensory perception remainedintact?

Back 109

Olfactory

Front 110

A 4-year-old child presents withgeneral weakness, sore throat and deglutitiveproblem. After his examination a doctorsuspected diphtheria and sent the materialto a bacteriological laboratory. To determinethe diphtheria causative agent the materialshould be inoculated into the following differentialdiagnostic medium:

Back 110

Blood tellurite agar

Front 111

When treating a patient withchronic cardiac failure a doctor detectedbradycardia and deterioration of the patient’sgeneral state. Such condition is causedby cumulative effect of a drug. Which drugof those listed below has cumulative action?

Back 111

Digoxin

Front 112

A doctor was addressed by a 30-yearoldman.There is a probability of the patientbeing HIV-positive. To clarify the diagnosisthe doctor proposed to perform polymerasechain reaction. The basic process in this kind of investigation is:

Back 112

Gene amplification

Front 113

Due to the use of poor-quality measlesvaccine for preventive vaccination, a 1-year-old child developed an autoimmunerenal injury. The urine was found to containmacromolecular proteins. What process ofurine formation was disturbed?

Back 113

Filtration

Front 114

A 26-year-old female patient withbronchitis has been administered a broadspectrum antibiotic as a causal treatmentdrug. Specify this drug

Back 114

Doxycycline

Front 115

A 65-year-old man suddenly lost visionin one eye due to the retinal detachment.The patient underwent enucleation. Histologicalexamination of the removed eyeretina and choroid revealed clusters of atypicalcells with marked polymorphism of cellsand nuclei, with a moderate number of mitosesincluding the pathological ones. Thecell cytoplasm and intercellular mediumcontained brown pigment resulting in positiveDOPA reaction. Perls’ reaction wasnegative. What is the most likely diagnosis?

Back 115

Melanoma

Front 116

During determining the blood groupaccording to the AB0 systemwith salt solutionsof monoclonal antibodies agglutinationdid not occur with any of the solutions.Whatblood group is it?

Back 116

0 (I)

Front 117

One of the factors that cause obesity isinhibition of fatty acids oxidation due to:

Back 117

Low level of carnitine

Front 118

During ventricular systole the cardiacmuscle does not respond to additional stimulationbecause it is in the phase of:

Back 118

Absolute refractoriness

Front 119

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

Back 119

Potassium permanganate

Front 120

During cell division DNA replicationoccurs after a signal is received from thecytoplasm, then a certain portion of theDNA helix unwinds and splits into two individualstrains. What enzyme facilitates thisprocess?

Back 120

Helicase

Front 121

A patient has been given atropinesulfate for rapid relief of spastic colonsymptoms. The use of this drug is contraindicatedduring the followng disease

Back 121

Glaucoma

Front 122

As an example of specific human parasitesone can name Plasmodium falciparum,human pinworm and some others. Thesource of parasite invasion in these cases isalways a human. Such specific human parasitescause the diseases that are called

Back 122

Anthroponoses

Front 123

In the course of an experiment therehas been increase in nerve conduction velocity. This may be caused by increase inconcentration of the following ions that arepresent in the solution around the cell:

Back 123

Na+

Front 124

An HIV-positive patient’s cause ofdeath is acute pulmonary insufficiencyresulting frompneumonia. Pathohistologicalinvestigation of lungs has revealed interstitialpneumonia, alveolocyte desquamationand methamorphoses: alveolocyteenlargement, large intranuclear inclusionssurrounded by lightly-coloured areas.Transformed cells resemble owl’s eye. Namethe causative agent of pneumonia:

Back 124

Cytomegalovirus

Front 125

The organisms to be identified have anucleus surrounded by a nuclear membrane.Genetic material is concentrated predominantlyin the chromosomes that consistof DNA strands and protein molecules.These cells divide mitotically. Identify theseorganisms:

Back 125

Eukaryotes

Front 126

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

Back 126

Trisomy 21

Front 127

After a road accident a victim hastachycardia, arterial blood pressure 130/90mm Hg, tachypnoe, the skin is pale anddry, excitation of central nervous system isobserved. What shock stage is the patientmost likely in?

Back 127

Erectile

Front 128

As a result of a mechanical injury anover 10 cm long portion of a peripheralnerve was damaged. This caused an impairmentof the upper limb activity. The patientwas offered nerve transplantation.What glialcells will participate in regeneration andprovide the trophism of the injured limb?

Back 128

Schwann cells

Front 129

A 47-year-old man developed intestinalcolic against the background of essentialhypertension. In this situation it would bemost efficient to arrest the colic by administeringdrugs of the following group:

Back 129

Myotropic antispasmodics

Front 130

Microscopy of a female patient’s swabsmade from vaginal secretion revealed gramnegativebean-shaped diplococci. Whatprovisional diagnosis can be made

Back 130

Gonorrhoea

Front 131

A 54-year-old woman was brought to acasualty department after a car accident. Atraumatologist diagnosed her with multiplefractures of the lower extremities. What kindof embolism is most likely to develop inthis case?

Back 131

Adipose

Front 132

A therapeutist has an appointmentwith a 40-year-old patient complaining ofrecurrent pain attacks in his hallux jointsand their swelling. Urine analysis revealedits marked acidity and pink colour. Whatsubstances can cause such changes in theurine?

Back 132

Uric acid salt

Front 133

A 30-year-old man with diabetesmellitus type I was hospitalised. Thepatient is comatose. Laboratory testsrevealed hyperglycemia and ketonemia.What metabolic disorder can be detectedin this patient?

Back 133

Metabolic acidosis

Front 134

A 15-year-old patient has fastingplasma glucose level 4,8 mmol/l, one hourafter glucose challenge it becomes 9,0mmol/l, in 2 hours it is 7,0 mmol/l, in 3hours it is 4,8 mmol/l. Such parameters arecharacteristic of:

Back 134

Subclinical diabetes mellitus

Front 135

A patient has undergone surgicalremoval of a cavitary liver lesion 2 cmin diameter. It was revealed that thecavity wall was formed by dense fibrousconnective tissue; the cavity containedmurky thick yellowish-green fluid with anunpleasant odor. Microscopically the fluidconsisted mainly of polymorphonuclearleukocytes. What pathological process arethese morphological changes typical for?

Back 135

Chronic abscess

Front 136

A patient consulted a physician aboutchest pain, cough, fever. Roentgenographyof lungs revealed eosinophilic infiltrateswhich were found to contain the larvae.What kind of helminthiasis are thesepresentations typical for?

Back 136

Ascariasis

Front 137

During appendectomy a patient hadthe a. appendicularis ligated. This vesselbranches from the following artery

Back 137

A. Ileocolica

Front 138

A 28-year-old patient undergoingtreatment in a pulmonological departmenthas been diagnosed with pulmonaryemphysema caused by splitting of alveolarseptum by tissular tripsin. The disease iscaused by the congenital deficiency of the following protein:

Back 138

α1-proteinase inhibitor

Front 139

A patient, who has been suffering fora long time from intestine disbacteriosis,has increased hemorrhaging caused by disruptionof posttranslationalmodification ofblood-coagulation factors II, VII, IХ, and Хin the liver. What vitamin deficiency is thecause of this condition?

Back 139

К

Front 140

During a surgery for femoral hernia asurgeon operates within the boundaries offemoral trigone. What structure makes upits upper margin?

Back 140

Lig. inguinale

Front 141

An obstetrician-gynecologist measurespelvis size of a pregnant woman. A caliperwas used to measure the distance betweenthe two iliac crests. What measurement oflarge pelvis was made?

Back 141

Distantia cristarum

Front 142

A patient has arterial hypertension.What long-acting drug from the group ofcalcium channel blockers should be prescribed?

Back 142

Amlodipine

Front 143

A patient has been diagnosedwith URTI. Blood serum containsimmunoglobulin M. What stage of infectionis it?

Back 143

Acute

Front 144

A43-year-old patient suffers fromacutepancreatitis with disrupted common bileduct patency. What condition can developin this case?

Back 144

Mechanical jaundice

Front 145

A patient has a tumor of the eyesockettissues behind the eyeball. Disruption ofaccomodation and pupil constriction isobserved. What anatomical structure isdamaged?

Back 145

Ganglion ciliare

Front 146

Lymphocytes and other cells of ourbody synthesize universal antiviral agentsas a response to viral invasion. Name theseprotein factors

Back 146

Interferon

Front 147

A patient consulted a dentist aboutrestricted mouth opening (trismus).Anamnesis states a stab wound of the lowerextremity. What infection may cause thesesymptoms?

Back 147

Tetanus

Front 148

A patient has damaged spinal cord whitematter in the middle area of the posteriorwhite column, disrupted proprioceptivesensibility of the lower limb joints andmuscles.What fibers are affected?

Back 148

Fasciculus gracilis

Front 149

In an elderly person the change in heartforce and vessels physical properties weredetected; they can be clearly observed ongraphic recording of carotid pulse waves.What method was applied?

Back 149

Sphygmography

Front 150

A patient has developed paroxysmalventricular tachycardia against thebackground of cardiac infarction.What antiarrhythmicdrug should be chosen to avoidlowering cardiac output?

Back 150

Lidocaine hydrochloride

Front 151

Electrocardiogram of a young manreveals deviation of his electrical axis ofheart to the left. This phenomenon can becaused by:

Back 151

Hypersthenic body type

Front 152

A 6-year-old child suffers from delayedgrowth, disrupted ossification processes,decalcification of the teeth.What can be thecause?

Back 152

Vitamin D deficiency

Front 153

A 30-year-old patient’s blood testrevealed the following: erythrocyte countis 6 · 1012/l, hemoglobin is 10,55ммоль/l.Vaquez’s disease was diagnosed. Name theleading part of pathogenesis:

Back 153

Neoplastic erythroid hyperplasia

Front 154

A 25-year-old patient complains ofincreasing pain in his leg muscles occurringduring walking and forcing him to makefrequent stops. Objectively: skin of legsis pale, no hair-covering, toenails are withtrophic changes, no pulsation of pedalarteries. The most probable cause of thesechanges is:

Back 154

Ischemia

Front 155

This year influenza epidemic ischaracterised by patients’ body temperaturevarying from 36, 9oC to 37, 9oC. Such feveris called:

Back 155

Subfebrile

Front 156

A woman complains of visual impairment.Examination revealed obesity in thepatient and her fasting plasma glucose levelis hyperglycemic. What diabetes complicationcan cause visual impairment/blindness?

Back 156

Microangiopathy

Front 157

Prolonged treatment of hypothyroidismhas caused general dystrophy, dental caries,tachycardia, tremor of extremities. Whatdrug is the cause of these side effects?

Back 157

L-thyroxin

Front 158

A 3-year-old child has eaten somestrawberries. Soon he developed a rashand itching. What was found in the child’sleukogram?

Back 158

Eosinophilia

Front 159

A patient has been found to have amarked dilatation of the saphenous veinsin the region of anterior abdominal wallaround the navel. This is symptomatic ofpressure increase in the following vessel

Back 159

V. portae hepatis

Front 160

Cholesterol content in blood serumof a 12-year-old boy is 25 mmol/l.Anamnesis states hereditary familialhypercholesterolemia caused by synthesisdisruption of receptor-related proteins for:

Back 160

Low-density lipoproteins

Front 161

Obesity is a common disease. Theaim of its treatment is to lower contentof neutral fats in the body. What hormonsensitiveenzyme is the most important forintracellular lipolysis?

Back 161

Triacylglycerol lipase

Front 162

40-year-old woman was diagnosedwith glomerulonephritis based on her clinicalsymptoms and the results of urineanalysis. Anamnesis states chronic tonsillitis.What microorganisms are the most likelycause for her kidney damage?

Back 162

Streptococci

Front 163

A man is suffering from diarrhea. Insummer he spent his vacation in the southat the sea coast. Bacteria with the followingproperties were detected in his feces: gramnegativecurved mobile monotrichous bacillithat do not produce spores or capsules.They are undemanding to nutrient mediumbut require alkaline reaction (рН 8,5-09,5).Described are the agents of the followingenteric infection:

Back 163

Cholera

Front 164

A patient is diagnosed with chronicatrophic gastritis attended by deficiency ofCastle’s intrinsic factor.What type of anemiadoes the patient have?

Back 164

B12-deficiency anemia

Front 165

A pregnant woman was detected withIgM to rubella virus. An obstetriciangynecologistrecommended therapeuticabortion due to the high risk of teratogenicaffection of the fetus. Detection of IgM wasof great importance as it is these specificimmunoglobulins that:

Back 165

Indicate recent infection

Front 166

A patient is diagnosed with cardiacinfarction. Blood test for cardiospecificenzymes activity was performed. Which ofthe enzymes has three isoforms?

Back 166

Creatine kinase

Front 167

A 50-year-old man, who has beensuffering from chronic hepatic failure forseveral years, has developed ascites. Whatis the main mechanism of this disorderdevelopment?

Back 167

Increased pressure in portal vein system

Front 168

A 30-year-old man has sustained aninjury to his thorax in a traffic incident, whichcaused disruption of his external respiration.What type of ventilatory difficultycan be observed in the given case?

Back 168

Restrictive extrapulmonary ventilatoryimpairment

Front 169

A 53-year-old man suffering from diabetesmellitus has developed a painfulconical induration, bluish-red with yellowcenter, on the skin of his neck. Such changesare characteristic of:

Back 169

Furuncle

Front 170

Biochemical analysis of an infant’serythrocytes revealed evident glutathioneperoxidase deficiency and low concentrationof reduced glutathione. What pathologicalcondition can develop in this infant?

Back 170

Hemolytic anemia

Front 171

In winter a 3-year-old child hassharp rise of body temperature up to40oC. Hemorrhagic rash is observed onthe skin and mucosa. Bean-shaped gramnegativemicroorganisms situated in pairsare detected in the blood. What provisionaldiagnosis can be made?

Back 171

Meningococcosis

Front 172

Microelectrode analysis of nerve fiberbiolectrical activity revealed, that itsmembrane potential equals 90 mV. Its initialrest potential was 85 mV. What processoccurs in this case?

Back 172

Hyperpolarization

Front 173

Parkinson’s disease is caused by disruptionof dopamine synthesis. What brainstructure synthesizes this neurotransmitter?

Back 173

Substantia nigra

Front 174

Determining a patient’s blood group withmonoclonal test-reagents revealed positiveagglutination reaction to anti-A and anti-B reagents, and negative reaction to anti-D.What blood group does this patient have

Back 174

IV (АВ) Rh−

Front 175

A patient visited a dentist to extract atooth. After the tooth had been extracted,bleeding from the tooth socket continuedfor 15 minutes. Anamnesis states that thepatient suffers from active chronic hepatitis.What phenomenon can extend the time ofhemorrhage?

Back 175

Decrease of fibrinogen content in blood

Front 176

Name the halogen-containing antisepticwith fungicidal properties, which is used totreat dermatomycosis

Back 176

Iodine solution

Front 177

Due to severe pain syndrome a patientwas prescribed a narcotic analgesic. Namethis drug:

Back 177

Morphine

Front 178

During pathomorphological kidneyinvestigation of a patient, who for a longtime had been suffering from osteomyelitisand died from progressing renal failure,the following was revealed: depositsof homogeneous eosinophilic massesin glomerular mesangium, arterial andarteriolar walls, and stroma, which becamered when stained with Congo red. Whatpathological process is this?

Back 178

Amyloidosis

Front 179

microslide presents a tissue withspherical cells, each of them containing alarge fat drop covered with thin cytoplasmlayer in its center. Nucleus is compressedand situated at the cell periphery. What tissueis it?

Back 179

White adipose tissue

Front 180

To treat rheumatoid arthritis a65-year-old woman was prescribed animmunosuppressive hormonal drug as a partof her complex therapy. Name this drug

Back 180

Prednisolone

Front 181

An experiment was aimed at testingflexor reflex in a spinal frog, which wasinitiated by simultaneous stimulation withisolated pre-threshold electrical impulses.The frequency of those impulses was such,that the reflex occurred.What process in thenerve centers can be observed during thisexperiment?

Back 181

Temporal summation

Front 182

A patient diagnosed with acutedysentery has been treated for 3 days in aninfectious diseases hospital. On admissionthere were complaints of high temperature,stomachache and fluid excrements withmucus as often as 8-10 times a day. Whatsample should be taken for analysis?

Back 182

Feces

Front 183

An 18-year-old woman has body disproportion,wing-like folds on the skin ofher neck, underdeveloped ovaries, nucleiof her buccal epithelium cells have no Barrbodies. Dermatoglyphics method revealedthat her adt angle is 66o. What provisionaldiagnosis can be made in this case?

Back 183

Turner’s syndrome

Front 184

A 27-year-old patient with injury tothe neck has lost approximately 30% ofthe blood volume. The patient’s condition issevere: blood pressure is 60/40 mmHg, heartrate is 140/min., respiratory rate is 30/min.,conscious. Characterize the condition of thepatient’s circulatory system:

Back 184

Hypovolemic shock

Front 185

A soldier with explosion-caused traumawas delivered to a hospital. Examinationrevealed his tympanic membrane to be intact. What defense reflex prevented thetympanic membrane from rupturing

Back 185

Contraction of m. tensor tympani

Front 186

A person with the fourth blood group(genotype IAIB) has in erythrocytes bothantigen A controlled by allele IA andantigen B controlled by allele IB. Thisphenomenon is an example of the followinggene interation:

Back 186

Codominance

Front 187

During narcosis a patient developed arisk of cerebral edema.What drug should beadministered in this case

Back 187

Furosemide

Front 188

During surgery performed in abdominalcavity a surgeon located ligament of liverstretching from anterior abdominal wall(navel) to inferior surface of liver. What ligamentis it?

Back 188

Round ligament of the liver

Front 189

9-year-old boy has acute onset of disease:sore throat, body temperature rise upto 39, 5oC; on the second day diffuse skinrash was detected all over his skin exept fornasolabial triangle. On examination of oralcavity: crimson tongue, "flaming pharynx",necrotic tonsillitis. What diagnosis is themost likely?

Back 189

Scarlet fever

Front 190

A 49-year-old man complains ofpain in his metatarsophalangeal jointsand joint deformation. In blood hyperuricemycan be observed. X-ray has revealedmetatarsophalangeal joint space narrowing,erosion, periarticular calcification ofthe both joints, osteoporosis. Microscopyhas revealed inflammatory granulomatousreaction surrounding necrotizing masses inthe area of the first metatarsophalangeal joint.Choose the most likely diagnosis:

Back 190

Gout (podagra)

Front 191

Granulomas containing lymphocytesand macrophages were detected duringanalysis of skin biopsy material. Amongmacrophages there are large cells with fatinclusions, which contain microorganismsin spheric packages (Virchow’s cells). Thefollowing disease is based on the describedtype of hypersensitivity:

Back 191

Leprosy

Front 192

A patient with suspected necrosis ofthe upper abdominal cavity organs was deliveredto a surgical department. This conditionis associated with acute circulatory disturbanceof the following vessel:

Back 192

Tuncus coeliacus

Front 193

Name the drug that inhibits excretoryfunction of pancreas during treatment ofacute pancreatitis

Back 193

Contrykal (Aprotinin

Front 194

An 18-year-old patient has developedcandidiasis after the case of pneumoniatreated with β-lactam antibiotic. What antimycoticagent should be prescribed

Back 194

Fluconazole

Front 195

During autopsy of a 9-month-old girl’sbody, who died due to severe pneumoniacomplicated with sepsis, lack of thymus isobserved. In the lymph nodes the lymphoidfollicles and cortical substance are absent;follicles of spleen are reduced in size with no light zones and plasma cells. What is thecause of such structural changes?

Back 195

Thymus agenesis

Front 196

A patient with femoral neck fracture,who for a long time had to remain in bedin a forced (supine) position, has developeddark-brown lesions along the backbone; softtissues are swollen, in the areas of macerationthere is a foul-smelling liquid. Name theclinicopathologic type of necrosis

Back 196

Bedsore

Front 197

A woman poisoned with unknownsubstance was hospitalised in a toxicologicaldepartment. What group of drugs canbe administered to decrease absorption andintroduction of the poison to her body?

Back 197

Adsorbents

Front 198

A patient after disrupted cerebral circulationhas developed paralysis. Choosethe anticholinesterase drug to be prescribedin this case:

Back 198

Proserin

Front 199

50-year-old woman is being treatedfor shingles in a neurology unit.What reactivatedvirus causes this disease

Back 199

Varicella zoster virus (chickenpox virus

Front 200

During examination of a patient adoctor should use anatomical division ofanterior abdominal wall into regions formore precise diagnostics. How many suchregions can abdomen be divided into?

Back 200

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