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Step 1 - Medicine 2013
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A 60-year-old male patient has a 9-year history of diabetes and takes insulin Semi-lente for the correction of hyperglycemia. 10 days ago he began taking anaprilin for hypertension. One hour after administration of the antihypertensive drug the patient developed hypoglycemic coma. What is the mechanism of hypoglycemia in case of anaprilin use?
Inhibition of glycogenolysis
Increase of insulin Semilente half-life
Decrease in glucose absorption
Reduction of glucagon half-life
Increase of bioavailability of insulin Semilente
3 із 200
Pterin derivatives (aminopterin and methotrexate) are the inhibitors of dihydrofolate reductase, so that they inhibit the regeneration of tetrahydrofolic acid from dihydrofolate. These drugs inhibit the intermolecular tranfer of monocarbon groups, thus suppressing the synthesis of the following polymer:
DNA
Protein
Homopolysaccharides
Glycosaminoglycans
Gangliosides
4 із 200
A child with suspected tuberculosis was given Mantoux test. After 24 hours the site of the allergen injection got swollen, hyperemic and painful. What are the main components that determine such response of the body?
Mononuclear cells, T-lymphocytes and lymphokines
B-lymphocytes, IgM
Macrophages, B-lymphocytes and monocytes
Granulocytes, T-lymphocytes and IgG
Plasma cells, T-lymphocytes and lymphokines
5 із 200
Hemoglobin catabolism results in release of iron which is transported to the bone marrow by a certain transfer protein and used again for the synthesis of hemoglobin. Specify this transfer protein:
Transferrin (siderophilin)
Transcobalamin
Albumin
Ceruloplasmin
Haptoglobin
6 із 200
A 12-year-old boy has been hospitalized for suspected food poisoning. The fecal samples were inoculated on the Endo agar, which resulted in growth of a large number of colorless colonies. What microorganism is most likely to be EXCLUDED from the list of possible causative agents of the disease?
Escherichia coli
Proteus vulgaris
Pseudomonas aeruginosa
Salmonella enteritidis
Yersinia enterocolitica
7 із 200
A 23-year-old patient has been admitted to a hospital with a craniocerebral injury. The patient is in a grave condition. Respiration is characterized by prolonged convulsive inspiration followed by a short expiration. What kind of respiration is it typical for?
Apneustic
Gasping breath
Biot’s
Kussmaul’s
Cheyne-Stokes
8 із 200
It has been experimentally proven that the excitation of the motor neurons of flexor muscles is accompanied by the inhibition of the motor neurons of extensor muscles. What type of inhibition underlies this phenomenon?
Reciprocal
Feedback
Pessimal
Lateral
Inhibition after excitation
9 із 200
A 3-year-old boy with pronounced hemorrhagic syndrome doesn’t have antihemophilic globulin A (factor VIII) in the blood plasma. Hemostasis has been impaired at the following stage:
Internal mechanism of prothrombinase activation
External mechanism of prothrombinase activation
Conversion of prothrombin to thrombin
Blood clot retraction
Conversion of fibrinogen to fibrin
10 із 200
A patient got a gunshot wound of hip which damaged the sciatic nerve. Any impact on the affected limb causes severe, excruciating pain. What mechanism of pain is most likely in this case?
Causalgic
Endorphin hypofunction
Phantom
Enkephalin hypofunction
Reflex
11 із 200
A 60-year-old patient with a long history of stenocardia takes coronarodilator agents. He has also been administered acetylsalicylic acid to reduce platelet aggregation. What is the mechanism of antiplatelet action of acetylsalicylic acid?
It reduces the activity of cyclooxygenase
It enhances the activity of platelet adenylate cyclase
It has membrane stabilizing effect
It reduces the activity of phosphodiesterase
It enhances the synthesis of prostacyclin
12 із 200
A patient with bronchial asthma has developed acute respiratory failure. What kind of respiratory failure occurs in this case?
Obstructive disturbance of alveolar ventilation
Restrictive ventilatory defect
Dysregulation of alveolar ventilation
Perfusion
Diffusion
13 із 200
On the fifth day after the acute blood loss a patient has been diagnosed with hypochromic anemia. What is the main mechanism of hypochromia development?
Release of immature red blood cells from the bone marrow
Impaired globin synthesis
Impaired iron absorption in the intestines
Increased destruction of red blood cells in the spleen
Increased excretion of body iron
14 із 200
A patient with diabetes developed a diabetic coma due to the acid-base imbalance. Specify the kind of this imbalance:
Metabolic acidosis
Respiratory acidosis
Metabolic alkalosis
Gaseous alkalosis
Non-gaseous alkalosis
15 із 200
A girl receives antibiotics of the penicillin group for acute bronchitis. On the third day of treatment she developed allergic dermatitis. Which drug should be administered?
Loratadine
Beclomethasone
Ephedrine hydrochloride
Levamisole
Cromolyn sodium
16 із 200
A female patient has been diagnosed with cervical erosion, which is a precancerous pathology. What defense mechanism can prevent the development of a tumor?
Increase in natural killer level (NK-cells)
Simplification of the antigenic structure of tissues
Low-dose immunological tolerance
Increase in the activity of lysosomal enzymes
High-dose immunological tolerance
17 із 200
Microscopy of the coronary artery of a dead 53-year-old patient revealed luminal occlusion due to a fibrous plaque with some lipids. The most likely form of atherosclerosis in this case is:
Liposclerosis
Prelipid stage
Ulceration
Lipidosis
Atheromatosis
18 із 200
Autopsy of the patient revealed bone marrow hyperplasia of tubular and flat bones (pyoid marrow), splenomegaly (6 kg) and hepatomegaly (5 kg), enlargement of all lymph node groups. What disease are the identified changes typical for?
Chronic myelogenous leukemia
Multiple myeloma
Chronic lymphocytic leukemia
Hodgkin’s disease
Polycythemia vera
19 із 200
As a result of an injury a patient cannot extend his arm at the elbow. This may cause abnormal functioning of the following muscle:
Musculus triceps brachii
Musculus teres major
Musculus subscapularis
Musculus infraspinatus
Musculus levator scapulae
20 із 200
A man sitting with his eyes closed, undergoes electroencephalography. What rhythm will be recorded on the EEG if there is an audible signal?
Beta rhythm
Gamma rhythm
Theta rhythm
Alpha rhythm
Delta rhythm
21 із 200
Electrophoretic study of a blood serum sample, taken from the patient with pneumonia, revealed an increase in one of the protein fractions. Specify this fraction:
y-globulins
a1-globulins
a2-globulins
Albumins
3- globulins
22 із 200
Examination of an 18-year-old girl revealed the following features: hypoplasia of the ovaries, broad shoulders, narrow pelvis, shortening of the lower extremities, 'sphinx neck'. Mental development is normal. The girl was diagnosed with Turner’s syndrome. What kind of chromosome abnormality is it?
Monosomy X
Trisomy 13
Trisomy X
Trisomy18
Nullisomy X
23 із 200
Hypertrichosis is the Y-linked character. The father has hypertrichosis, and the mother is healthy. In this family, the probability of having a child with hypertrichosis is:
0,5
1
0,625
0,125
0, 25
24 із 200
A casualty has a fracture in the region of the inner surface of the left ankle. What is the most likely site for the fracture?
Medial malleolus
Astragalus
Calcaneus
Lateral malleolus
Lower third of the fibula
25 із 200
Some infectious diseases caused by bacteria are treated with sulfanilamides which block the synthesis of bacteria growth factor. What is the mechanism of their action?
They are antivitamins of para-amino benzoic acid
They are allosteric enzymes
They inhibit the absorption of folic acid
They are involved in redox processes
They are allosteric enzyme inhibitors
26 із 200
A 42-year-old male patient with gout has an increased blood uric acid concentration. In order to reduce the level of uric acid the doctor administered him allopurinol. Allopurinol is the competitive inhibitor of the following enzyme:
Xanthine oxidase
Hypoxanthine-phosphoribosyltransferase
Adenine phosphoribosyltransferase
Guanine deaminase
Adenosine deaminase
27 із 200
A 40-year-old female patient diagnosed with acute pancreatitis has been delivered to the admission department of a regional hospital. What drug should be administered the patient in the first place?
Contrycal
Pirenzepine
Platyphyllin
Atropine
Metacin
28 із 200
A patient consulted a doctor about being unable to abduct his right arm after a past trauma. Examination revealed that the passive movements were not limited. The patient was found to have the atrophy of the deltoid muscle. What nerve is damaged?
Axillary
Ulnar
Median
Radial
Suprascapular
29 із 200
After a trauma of the upper third of the anterior forearm a patient exhibits difficult pronation, weakening of palmar flexor muscles and impaired skin sensitivity of 1-3 fingers. Which nerve has been damaged?
n. medianus
n. cutaneus antebrachii medialis
n. radialis
n. musculocutaneus
n. ulnaris
30 із 200
A 38-year-old female patient complains of general weakness, cardiac pain, increased appetite, no menstruation. Objectively: the height is 166 cm, weight 108 kg, the patient has moonshaped face, subcutaneous fat is deposited mainly in the upper body, torso and hips. There are also blood-red streaks. Ps- 62/min, AP-160/105 mm Hg. Which of the following diseases is the described pattern of obesity most typical for?
Cushing pituitary basophilism
Insulinoma
Babinski-Frohlich syndrome
Myxedema
Alimentary obesity
31 із 200
A 60-year-old patient with a long history of atherosclerosis and a previous myocardial infarction developed an attack of retrosternal pain. 3 days later the patient was hospitalized and then died of progressive cardiovascular insufficiency. At autopsy a white fibrous depressed area about 3 cm in diameter with clear boundaries was found in the posterior wall of the left ventricle and interventricular septum. The dissector evaluated these changes as:
Focal cardiosclerosis
Myocarditis
Myocardial infarction
Myocardial degeneration
Myocardial ischemia
32 із 200
Measurements of the arterial pCO2 and pO2 during an attack of bronchial asthma revealed hypercapnia and hypoxemia respectively. What kind of hypoxia occurred in this case?
Respiratory
Circulatory
Hemic
Tissue
Histotoxic
33 із 200
A female patient with bronchial asthma had taken prednisolone tablets (1 tablet 3 times a day) for 2 months. Due to a significant improvement of her condition the patient suddenly stopped taking it. What complication is likely to develop in this case?
Withdrawal syndrome
Upper body obesity
Hypotension
Gastrorrhagia
Cushing’s syndrome
34 із 200
A patient with suspected dysentery has been admitted to the infectious diseases hospital. Which basic method of laboratory diagnosis must be applied in the first place?
Bacteriological
Allergic
Biological
Microscopic
Serological
35 із 200
During a surgery with the use of hygronium the patient had an abrupt fall in blood pressure. Blood pressure can be normalized by the representatives of the following drug group:
o-adrenergic agonists
M-cholinergic agents
Ganglionic blockers
o-blockers
N-cholinergic agents
36 із 200
A patient with respiratory failure has blood pH of 7,35. pCO2 test revealed hypercapnia. Urine pH test revealed an increase in the urine acidity. What form of acid-base imbalance is the case?
Compensated respiratory acidosis
Compensated metabolic acidosis
Decompensated respiratory alkalosis
Compensated respiratory alkalosis
Decompensated metabolic acidosis
37 із 200
On examination a patient was found to have medial strabismus, the inward deviation of the eyeball and inability to abduct the eyeball outwards. What nerve is damaged?
Abducent
Visual
Trochlear
Ocular
Oculomotor
38 із 200
A patient with a dislocated shoulder had been admitted to a hospital. With the purpose of skeletal muscle relaxation he was given an injection of relaxant dithylinum acting normally 5-7 minutes. However, the effect of dithylinum in this patient lasted up to 8 hours. What is the most likely cause of the prolonged effect of dithylinum in this patient?
Genetic deficiency of blood cholinesterase
Potentiation by another drug
Reduced activity of microsomal liver enzymes
Material accumulation of the drug
Reduced drug excretion
39 із 200
As a result of an injury of the knee joint a patient shows a drawer sign, that is the anterior and posterior displacement of the tibia relative to the femur. What ligaments are damaged?
Cruciate ligaments
Arcuate popliteal ligaments
Collateral ligaments
Oblique popliteal ligament
Interosseous membrane
40 із 200
The neurosurgical department has admitted a 54-year-old male complaining of no sensitivity in the lower eyelid skin, lateral surface of nose, upper lip. On examination the physician revealed the inflammation of the second branch of the trigeminal nerve. This branch comes out of the skull through the following foramen:
Round foramen
Oval foramen
Lacerated foramen
Spinous foramen
Superior orbital fissure
41 із 200
Bacteriological examination of purulent discharges from the urethra revealed some gramnegative beanshaped bacteria located in the leukocytes. They can be identified as the causative agent of the following disease:
Gonorrhea
Trichomoniasis
Venereal lymphogranulomatosis
Chancroid
Syphilis
42 із 200
A male patient is 28 years old. Histological study of a cervical lymph node revealed a change of its pattern due to the proliferation of epithelioid, lymphoid cells and macrophages having nuclei in form of a horseshoe. In the center of some cell clusters there were non-structured light-pink areas with fragments of nuclei. What disease are these changes typical for?
Tuberculosis
Tumor metastasis
Actinomycosis
Syphilis
Hodgkin’s disease
43 із 200
A 35-year-old male patient has been referred by an andrologist for the genetic counselling for the deviations of physical and mental development. Objectively: the patient is tall, has asthenic constitution, gynecomastia, mental retardation. Microscopy of the oral mucosa cells revealed sex chromatin (single Barr body) in 30% of cells. What is the most likely diagnosis?
Klinefelter syndrome
Cushing pituitary basophilism
DiGeorge syndrome
Down syndrome
Recklinghausen’s disease
44 із 200
A patient with jaundice has high total bilirubin that is mainly indirect (unconjugated), high concentration of stercobilin in the stool and urine. The level of direct (conjugated) bilirubin in the blood plasma is normal. What kind of jaundice can you think of?
Hemolytic
Mechanical
Neonatal jaundice
Gilbert’s disease
Parenchymal (hepatic)
45 із 200
A male with a lesion of one of the CNS parts has asthenia, muscular dystonia, balance disorder. Which CNS part has been affected?
Cerebellum
Black substance
Red nuclei
Vestibular nuclei
Reticular formation
46 із 200
A 50-year-old patient has been administered laevomycetin for the treatment of typhoid fever, but on the next day the patient’s condition worsened, the temperature rose to 39,60C. The deterioration of the patient’s condition can be explained by:
Effects of endotoxins of the causative agent
Re-infection
Insensitivity of the pathogen to laevomycetin
Secondary infection
Allergic reaction
47 із 200
A 12-year-old patient has been admitted to a hospital for hemarthrosis of the knee joint. From early childhood he suffers from frequent bleedings. Diagnose the boy’s disease:
Hemophilia
Hemolytic anemia
Hemorrhagic vasculitis
Thrombocytopenic purpura
B12 (folic acid)-deficiency anemia
48 із 200
Examination of a patient with ischemic heart disease revealed the impaired venous blood flow in the territory of the cardiac vein running in the anterior interventricular sulcus of heart. What vein is it?
V cordis magna
V obliqua atrii sinistri
V posterior ventriculi sinistri
V. cordis media
V. cordis parva
49 із 200
For the direct injection of medications into the liver surgeons use the round ligament of liver. This manipulation involves bougienage (lumen dilatation) of the following vessel:
V umbilicalis
A. hepatica propria
V. porta
Ductus venosus
A. umbilicalis
50 із 200
A patient with lobar pneumonia has had body temperature of 39oC with daily temperature fluctuation of no more than 1oC for 9 days. This fever can be characterized by the following temperature curve:
Persistent
Recurrent
Hyperpyretic
Remittent
Hectic
51 із 200
The temperature in a production room is 36oC. Relative air humidity is 80%. Under these conditions the human body transfers heat mainly through:
Sweat evaporation
Convection
Heat conduction
-
Radiation
52 із 200
A hospitalized patient bitten by a rabid animal has an avulsive wound of shin. What kind of vaccine must be given to prevent rabies?
Anti-rabies vaccine
Td
DTaP
BCG
TABte
53 із 200
At autopsy the occipital lobe of brain was found to have a cavity 2,5x1,5 cm large filled with a transparent liquid. The cavity had smooth brownish walls. What process had developed in the brain?
Cyst on the site of a hemorrhage
Paracephalia
A cyst on the site of the softening of the cerebrocortical grey matter
Brain abscess
Softening of the cerebrocortical grey matter
54 із 200
A child entering the school for the first time was given Mantoux test in order to determine if there was a need for revaccination. The reaction was negative. What is the meaning of this test result?
No cell-mediated immunity to tuberculosis
Availability of cell-mediated immunity to tuberculosis
No antibodies to the tuberculosis bacteria
No anti-toxic immunity to tuberculosis
Presence of antibodies to the tuberculosis bacteria
55 із 200
Study of the biopsy material revealed a granuloma consisting of lymphocytes, plasma cells, macrophages with foamy cytoplasm (Mikulicz cells), many hyaline globules. What disease can you think of?
Rhinoscleroma
Actinomycosis
Leprosy
Tuberculosis
Syphilis
56 із 200
Autopsy of a 78-year-old patient revealed that retroperitoneal tissue was soaked with blood, the abdominal aorta had a sacciform protrusion including a defect with irregular edges. The wall of the aorta was here and there of stone-like density. This is the complication of the following disease:
Atherosclerosis
Essential hypertension
Visceral syphilis
Marfan syndrome
Systemic vasculitis
57 із 200
Glycogen polysaccharide is synthesized from the active form of glucose. The immediate donor of glucose residues during the glycogenesis is:
UDP-glucose
Glucose-6-phosphate
ADP-glucose
Glucose-1-phosphate
Glucose-3-phosphate
58 із 200
After the diagnostic tests a 40-year-old male has been referred for the lymphography of the thoracic cavity. The surgeon revealed that the tumor had affected an organ whose lymphatic vessels drain directly into the thoracic duct. Specify this organ:
Esophagus
Pericardium
Trachea
Heart
Left main bronchus
59 із 200
A patient with biliary dyskinesia and constipations has been prescribed a cholagogue having also a laxative effect. What drug has been administered?
Magnesium sulfate
Allochol
Cholosas
Nicodinum
Cholenzyme
60 із 200
It is known that individuals with genetically caused deficiency of glucose-6-phosphate dehydrogenase may develop RBC hemolysis in response to the administration of some antimalarial drugs. Mani- festation of adverse reactions to drugs is called:
Idiosyncrasy
Allergy
Tachyphylaxis
Sensibilization
Tolerance
61 із 200
A 40-year-old patient with the progressing staphylococcal purulent periodontitis developed purulent inflammation of bone marrow spaces of the alveolar process, and then of the body of mandible. Microscopy revealed thinning of bone trabeculae, foci of necrosis, bone sequesters surrounded by the connective tissue capsule. What is the most likely diagnosis?
Chronic osteomyelitis
Chronic fibrous periostitis
Parodontome
Purulent abscess
Acute osteomyelitis
62 із 200
Curariform substances introduced into a human body cause the relaxation of all skeletal muscles. What changes in the neuromuscular synapse cause this phenomenon?
Blockade of N-cholinergic receptors of the synaptic membrane
Impaired acetylcholine release
Impaired cholinesterase synthesis
Depolarization of the postsynaptic membrane
Blockade of Ca2+ channels of the presynaptic membrane
63 із 200
A number of diseases can be diagnosed by evaluating activity of blood transaminases. What vitamin is one of cofactors of these enzymes?
B6
B2
B5
Bi
B8
64 із 200
After a car accident a 23-year-old male presented to the hospital with a cut wound of the anteromedial region of shoulder and arterial bleeding. Which artery was damaged?
A. brachialis
A. radialis
A. axillaris
A. profunda brachii
A. subscapularis
65 із 200
During the operation on the small intestine the surgeon revealed an area of the mucous membrane with a single longitudinal fold among the circular folds. Which portion of the small intestine is this structure typical for?
Pars descendens duodeni
Distal ileum
Pars ascendens duodeni
Pars horizontalis duodeni
jejunum
66 із 200
14 days after quinsy a 15-year-old child presented with morning facial swelling, high blood pressure, 'meat slops' urine. Immunohistological study of a renal biopsy sample revealed deposition of immune complexes on the basement membranes of the capillaries and in the glomerular mesangium. What disease developed in the patient?
Acute glomerulonephritis
Necrotizing nephrosis
Acute interstitial nephritis
Acute pyelonephritis
Lipoid nephrosis
67 із 200
A diseased child has a high fever, sore throat, swelling of submandibular lymph nodes. Objectively: pharyngeal mucosa is edematous, moderately hyperemic, the tonsils are enlarged, covered with grayish membrane tightly adhering to the tissues above. Attempts to remove the membrane produce the bleeding defects. What disease are these presentations typical for?
Diphtheria
Meningococcal disease
Scarlet fever
Catarrhal tonsillitis
Measles
68 із 200
Study of the biopsy material of an embryo revealed a zone of developmental abnormality in a somite. The zone was located close to the endoderm and the notochord. What formations may have abnormal development in case of pregnancy continuation?
Skeletal tissues
Genito-urinary system
Cardiac striated muscle tissue
Skeletal striated muscle tissue
Fibrous connective tissue of skin
69 із 200
A smear of sputum from the patient with suspected lobar pneumonia was stained with the use of the following stains and reagents: solution of gentian violet, Lugol’s solution, 96° alcohol, water magenta. What staining method was applied in this case?
Gram
Neisser
Leffler
Romanovsky
Ziehl-Nielsen
70 із 200
A patient has normally coloured stool including a large amount of free fatty acids. The reason for this is a disturbance of the following process:
Fat absorption
Fat hydrolysis
Lipase secretion
Choleresis
Biliary excretion
71 із 200
Examination of the removed stomach revealed a deep roundish defect with regular edges at the lesser curvature of the antrum. The defect reached the muscular tunic and was 1,5 cm in diameter. Within the defect floor there was a translucent dense area resembling of a hyaline cartilage. What process had developed in the floor of the stomach defect?
Local hyalinosis
Mucoid swelling
General hyalinosis
Amyloidosis
Fibrinoid alterations
72 із 200
By the decarboxylation of glutamate in the CNS an inhibitory mediator is formed. Name it:
GABA
Glutathione
Histamine
Asparagine
Serotonin
73 із 200
Thermometry revealed that the temperature of the exposed skin is by 11,5° lower than the temperature of the adjacent areas covered with clothing from natural fabrics. The reason for this is that the clothes reduce the heat loss through:
Convection
Evaporation
Radiation
Conduction
-
74 із 200
A specimen of pia mater includes a vessel whose wall doesn’t have the tunica media, the tunica externa is adherent to the surrounding tissues, the intima is composed of a basement membrane and endothelium. What vessel is it?
Nonmuscular vein
Muscular vein with underdeveloped muscular elements
Muscular artery
Artery of mixed type
Arteriole
75 із 200
A patient with extensive burns of torso skin exhibits signs of severe intoxication. What stage of the burn disease is this typical for?
Burn toxemia
Burn emaciation
Burn infection
Burn shock
Terminal
76 із 200
As a result of a craniocerebral injury a patient has a decreased skin sensitivity. What area of the cerebral cortex may be damaged?
Posterior central gyrus
Cingulate gyrus
Anterior central gyrus
Frontal cortex
Occipital region
77 із 200
A histological specimen of the eyeball shows a biconvex structure connected to the ciliary body by the fibers of the Zinn’s zonule and covered with a transparent capsule. Name this structure:
Crystalline lens
Vitreous body
Ciliary body
Cornea
Sclera
78 із 200
A comatose patient was taken to the hospital. He has a history of diabetes mellitus. Objectively: Kussmaul breathing, low blood pressure, acetone odor of breath. After the emergency treatment the patient’s condition improved. What drug had been administered to the patient?
Insulin
Glibenclamide
Adrenaline
Isadrinum
Furosemide
79 із 200
In order to stimulate breathing in a child born with asphyxia, the doctor gave him a drug injection into the umbilical vein. What drug might have been injected?
Aethimizolum
Coffeinum
Sulfocamphocainum
Corazolum
Cordiaminum
80 із 200
A patient complains of pain in the right lateral abdomen. Palpation revealed a dense, immobile, tumor-like formation. A tumor is likely to be found in the following part of the digestive tube:
Colon ascendens
Caecum
Colon sigmoideum
Colon transversum
Colon descendens
81 із 200
A patient underwent biopsy of the soft palate arches for a suspected tumor (macroscopy revealed an ulcer with a dense floor). Study of the biopsy material revealed mucosal necrosis with infiltration of lymphocytes, epithelioid cells, plasma cells, single neutrophils in the submucosa. There were also apparent signs of endovasculitis and perivasculitis. The described changes are typical for:
Primary syphilis
Necrotizing ulcerative Vincent stomatitis
Aphthous stomatitis
Pharyngeal diphtheria
Ulcerative stomatitis
82 із 200
Healthy parents with unremarkable family history have the child with multiple developmental defects. Cytogenetic analysis revealed the trisomy 13 in the somatic cells (Patau syndrome). What phenomenon has caused the defects?
Abnormal gametogenesis
Chromosomal mutation
Dominant mutation
Somatic mutation
Recessive mutation
83 із 200
A specimen shows an organ covered with the connective tissue capsule with trabeculae radiating inward the organ. There is also cortex containing some lymph nodules, and medullary cords made of lymphoid cells. What organ is under study?
Lymph node
Thymus
Red bone marrow
Tonsils
Spleen
84 із 200
A 25-year-old patient consulted a doctor about dysmenorrhea and infertility. Examination revealed that the patient was 145 cm high and had underdeveloped secondary sex characteristics, alar folds on the neck. Cytological study didn’t reveal any Barr bodies in the somatic cells. What diagnosis was made?
Turner’s syndrome
Morris syndrome
-
Klinefelter syndrome
Trisomy X syndrome
85 із 200
To prevent attacks of acute pancreatitis a doctor prescribed the patient trasylol (contrycal, gordox), which is an inhibitor of:
Trypsin
Elastase
Gastricsin
Carboxypeptidase
Chymotrypsin
86 із 200
A patient died from progressive heart failure. Autopsy revealed that the heart was enlarged in diameter, flabby. The muscle section exhibited irregular blood supply. Histological study of myocardium revealed hyperemia, the stroma was found to have lymphohistiocytic infiltrates with degeneration of cardiomyocytes. The revealed morphological changes are indicative of:
Non-purulent interstitial myocarditis
Venous plethora
Cardiosclerosis
Myocardial infarction
Cardiomyoliposis
87 із 200
A 13-year-old teenager underwent X-ray examination of the hip joint. Examination revealed a 3 mm wide radiolucent zone between the head and the shaft of femur. This situation should be evaluated as:
Normal (incomplete process of ossification)
Radiographic film artifact
Fissured fracture of the femoral neck
Dislocation of the femoral head
Fracture of the femoral neck
88 із 200
A surgeon examined the patient and found the injury of the upper third of the kidney. Considering the syntopy of the left kidney, the intactness of the following organ should be checked at the same time:
Stomach
Transverse colon
Small intestine
Descending colon
Liver
89 із 200
A patient with urolithiasis has unbearable spasmodic pain. To prevent pain shock, he has been given an injection of atropine along with a narcotic analgesic having antispasmodic effect. What drug was it?
Promedol
Tramadol
Nalorphine
Ethylmorphine hydrochloride
Morphine hydrochloride
90 із 200
Despite the administration of cardiotonics and a thiazide diuretic a patient with chronic heart failure has persistent edemata, there is a risk of ascites. What medication should be administered in order to enhance the diuretic effect of the drugs used?
Spironolactone
Clopamide
Manithol
Amiloride
Furosemide
91 із 200
A patient with a pathology of the cardiovascular system developed edemata of the lower extremities. What is the mechanism of cardiac edema development?
Increased hydrostatic pressure at the venous end of the capillary
Increased hydrostatic pressure at the arterial end of the capillary
Reduced osmotic pressure
Increased oncotic pressure
Lymph efflux disorder
92 із 200
During the fight, a man had a cardiac arrest due to the strong blow to the upper region of the anterior abdominal wall. Which of the following mechanisms has led to the cardiac arrest?
Parasympathetic unconditioned reflexes
Peripheral reflexes
Sympathetic unconditioned reflexes
Sympathetic conditioned reflexes
Parasympathetic conditioned reflexes
93 із 200
A pregnant woman underwent AB0 blood typing. Red blood cells were agglutinated with standard sera of the I and II blood groups, and were not agglutinated with the III group serum. What is the patient’s blood group?
B(III)
0( I )
-
AB(IV)
A(II)
94 із 200
Amniocentesis revealed two sex chromatin bodies (Barr bodies) in each cell of the sample. What disease is this character typical for?
Trisomy X
Turner’s syndrome
Patau syndrome
Klinefelter syndrome
Down’s syndrome
95 із 200
A hospital has admitetd a patient complaining of abdominal bloating, diarrhea, flatulence after eating protein foods. These signs are indicative of the impaired digestion of proteins and their increased degradation. Which of the following compounds is the product of this process?
Indole
Agmatine
Putrescine
Bilirubin
Cadaverine
96 із 200
An attack of tachycardia that occurred in a patient was stopped by pressing on his eyeballs. Which of the following reflexes underlies this phenomenon?
Aschner
Bernard’s
Hering
Goltz
Bainbridge
97 із 200
A male patient has been diagnosed with acute post-streptococcal glomerulonephritis. It is most likely that the lesion of the basement membrane of renal corpuscles was caused by the following allergic reaction:
Immune complex
Anaphylactic
Delayed
Cytotoxic
Stimulating
98 із 200
An unconscious patient was taken by ambulance to the hospital. On objective examination the patient was found to have no reflexes, periodical convulsions, irregular breathing. After laboratory examination the patient was diagnosed with hepatic coma. Disorders of the central nervous system develop due to the accumulation of the following metabolite:
Ammonia
Bilirubin
Glutamine
Histamine
Urea
99 із 200
A 20-year-old male patient complains of general weakness, rapid fatigability, irritability, decreased performance, bleeding gums, petechiae on the skin. What vitamin deficiency may be a cause of these changes?
Ascorbic acid
Thiamine
Folic acid
Riboflavin
Retinol
100 із 200
It is known that the monoamine oxidase (MAO) enzyme plays an important part in the metabolism of catecholamine neurotransmitters. In what way does the enzyme inactivate these neurotransmitters (norepinephrine, epinephrine, dopamine)?
Oxidative deamination
Carboxylation
Hydrolysis
Removal of a methyl group
Addition of an amino group
101 із 200
The cellular composition of exudate largely depends on the etiological factor of inflammation. What leukocytes are the first to get into the focus of inflammation caused by pyogenic bacteria?
Neutrophil granulocytes
Eosinophilic granulocytes
Monocytes
Basophils
Myelocytes
102 із 200
At the end of the working day a worker of a hot work shop has been delivered to a hospital. The patient complains of a headache, dizziness, nausea, general weakness. Objectively: the patient is conscious, his skin is hyperemic, dry, hot to the touch. Heart rate is of 130/min. Respiration is rapid, superficial. What disorder of thermoregulation is most likely to have occurred in this patient?
Reduced heat transfer
Increased heat transfer and reduced heat production
Reduced heat production with no changes to the heat transfer
Increased heat production with no changes to the heat transfer
Increased heat transfer and heat production
103 із 200
Alveolar space of the acinus was invaded by some bacteria which interacted with the surfactant. This led to the activation of the cells that are localized in the alveolar walls and on the surface. What cells are these?
Alveolar macrophages
Alveolocytes type II
Endothelial cells
Clara cells
Alveolocytes type I
104 із 200
A 35-year-old male developed acute heart failure while running for a long time. What changes in the ionic composition can be observed in the cardiac muscle?
Accumulation of Na+ and Ca2+ ions in the myocardium cells
Accumulation of K + and Mg2+ ions in the myocardium cells
Reduction of Na+ and Ca2+ ions in the extracellular space
Reduction of K + and Mg2+ ions in the extracellular space
Reduction of Na+ and Ca2+ ions in the myocardium cells
105 із 200
Workers of a conveyor workshop received recommendations for the effective organization of working time and higher working efficiency. What peculiarity of work in this workshop causes the greatest stress for the workers?
Monotony of work
Increased responsibility
Increased intellectual component
State of 'operating rest'
Social inefficiency of labor
106 із 200
Mother of a boy who had recently returned from a summer camp found some small whitish insects up to 3 mm long on the child’s clothing. Specify the parasite:
Pediculus humanus humanus
Cimex lectularius
Pulex irritans
Blattella germanica
Phtirus pubis
107 із 200
Histological examination of the removed skin neoplasm revealed clusters and cords of atypical cells of stratified squamous epithelium, growing into the underlying tissue. What diagnosis can be assumed?
Non-keratinizing squamous cell carcinoma
Carcinoma in situ
Papilloma
Keratinizing squamous cell carcinoma
Adenoma
108 із 200
An 18-year-old male has been diagnosed with Marfan syndrome. Examination revealed a developmental disorder of connective tissue and eye lens structure, abnormalities of the cardiovascular system, arachnodactylia. What genetic phenomenon has caused the development of this disease?
Pleiotropy
Complementarity
Incomplete dominance
Multiple allelism
Codominance
109 із 200
A patient has severe catarrhal symptoms. Material growth on Bordet-Gengou agar showed mercury-droplike colonies. Examination of the blood smears revealed some small ovoid grampositive bacilli sized 1-3 microns. What microorganisms were isolated?
Bordetella
Brucella
Corynebacteria
Meningococcus
Mycobacteria
110 із 200
A 66-year-old patient with Parki- nson’s disease shows an improvement in locomotor activity after prolonged use of a certain drug which is converted to dopamine by the decarboxylation. What drug has the patient taken?
Levodopa
Naloxone
Celecoxib
Chlorpromazine
Droperidol
111 із 200
Enzymatic jaundices are accompanied by abnormal activity of UDP-glucuronyl transferase. What compound is accumulated in blood serum in case of these pathologies?
Unconjugated bilirubin
Conjugated bilrubin
Choleglobin
Hydrobilirubin
Dehydrobilirubin
112 із 200
For the study of serum proteins various physical and physicochemical methods can be used. In particular, serum albumins and globulins can be separated by this method:
Electrophoresis
Refractometry
Dialysis
Polarography
Spectrography
113 із 200
Negative environmental factors have caused the dysfunction of myosatellite cells. What function of the whole muscle fibre is likely to be changed in this case?
Regeneration
Contractile thermogenesis
Contraction
Trophism
Relaxation
114 із 200
The laboratory for especially dangerous infections conducts microscopic examination of pathological material from a patient with suspected plague. The sample was stained by BurriGins technique. What property of the causative agent can be identified by this technique?
Capsule formation
Alkali resistance
Acid resistance
Spore formation
Presence of volutin granules
115 із 200
Autopsy of a 62-year-old woman revealed a dense well-circumscribed node of 6 cm in diameter in the cranial cavity. The node was attached to the dura mater and histologically consisted of clusters and micro-concentric structures of endothelial cells, psammoma bodies. What kind of tumor was found at autopsy?
Meningioma
Melanoma
Cancer metastasis
Glioblastoma
Medulloblastoma
116 із 200
Inherited diseases, such as mucopolysaccharidoses, are manifested in metabolic disorders of connective tissue, bone and joint pathologies. The sign of this disease is the excessive urinary excretion of the following substance:
Glycosaminoglycans
Lipids
Urea
Glucose
Amino acids
117 із 200
An animal has an increased tonus of extensor muscles. This is the result of enhanced information transmission to the motoneurons of the spinal cord through the following descending pathways:
Vestibulospinal
Lateral corticospinal
Medial corticospinal
Rubrospinal
Reticulospinal
118 із 200
A specimen of a parenchymal organ shows poorly delineated hexagonal lobules surrounding a central vein, and the interlobular connective tissue contains embedded triads (an 0artery, a vein and an excretory duct). What organ is it?
Liver
Spleen
Pancreas
Thyroid
Thymus
119 із 200
A patient has been admitted to the infectious diseases department for malaise, fever up to 38 oC, jaundice. A few months ago, the patient underwent blood transfusion. The doctor suspected viral hepatitis B. What are the principal methods of laboratory diagnosis of hepatitis B?
Serological and gene diagnostics
Isolation of the virus in laboratory animals (neutralization reaction)
Isolation of the virus in chicken embryos
Virus isolation in cell culture and its identification by the cytopathic effects
Detection of virions in blood by electron microscopy
120 із 200
After resection of the middle third of the femoral artery obliterated by a thrombus the limb is supplied with blood through the bypasses. What artery plays the main part in the restoration of the blood flow?
Deep femoral artery
Superficial epigastric artery
External pudendal artery
Superficial iliac circumflex artery
Descending genicular artery
121 із 200
During the intravenous transfusion of the saline the patient’s condition deteriorated dramatically, and the patient died from asphyxiation. Autopsy revealed acute venous congestion of internal organs with the dramatic right heart dilatation. When the right ventricle was punctured underwater, the bubbles escaped. What pathological process occurred in the patient?
Air embolism
Tissue embolism
Gaseous embolism
Adipose embolism
Thromboembolism
122 із 200
At the post-mortem examination the stomach of a patient with renal failure was found to have a yellow-brown coating on the thickened mucosa. The coating was firmly adhering to its surface and had significant thickness. Microscopy revealed congestion and necrosis of mucosal and submucosal layers, fibrin presence. What is the most likely diagnosis?
Fibrinous gastritis
Croupous gastritis
Gastric abscess
Corrosive gastritis
Esogastritis
123 із 200
Infectious diseases are treated with antibiotics (streptomycin, erythromycin, chloramphenicol). They inhibit the following stage of protein synthesis:
Translation
Splicing
Replication
Processing
Transcription
124 із 200
Diseases of the respiratory system and circulatory disorders impair the transport of oxygen, thus leading to hypoxia. Under these conditions the energy metabolism is carried out by anaerobic glycolysis. As a result, the following substance is generated and accumulated in blood:
Lactic acid
Citric acid
Glutamic acid
Fumaric acid
Pyruvic acid
125 із 200
A patient has been hospitalized for a suspected tumor of the prostate. During the surgery, it was revealed that the tumor invaded the bladder. Which part of the bladder was affected?
Cervix
Bottom
Body
Apex
-
126 із 200
A casualty with an injury of the temporal region has been diagnosed with epidural hematoma. Which of the arteries is most likely to be damaged?
Medial membranous artery
Superficial temporal artery
Posterior auricular artery
Medial cerebral artery
Anterior membranous artery
127 із 200
A 19-year-old male was found to have an elevated level of potassium in the secondary urine. These changes might have been caused by the increase in the following hormone level:
Aldosterone
Adrenaline
Oxytocin
Testosterone
Glucagon
128 із 200
Analysis of the ECG revealed the missing of several PQRST cycles. The remaining waves and complexes are not changed. Specify the type of arrhythmia:
Sinoatrial block
Intra-atrial block
Atrioventricular block
Atrial fibrillation
Atrial premature beat
129 із 200
ECG of a patient displays an abnormally long R wave (up to 0,18 s). This is caused by a decrease in the conduction velocity of the following heart structures:
Ventricles
Left ventricle
Right ventricle
Atria
Atrio-ventricular node
130 із 200
6 hours after the myocardial infarction a patient was found to have elevated level of lactate dehydrogenase in blood. What isoenzyme should be expected in this case?
LDH1
LDH4
LDH2
LDH5
LDH3
131 із 200
A 46-year-old female is scheduled for a maxillofacial surgery. It is known that the patient is prone to high blood coagulation. What natural anticoagulant can be used to prevent blood clotting?
Heparin
Hirudin
Fibrinolysin
None of the above-listed substances
Sodium citrate
132 із 200
A 50-year-old patient with food poisoning is on a drip of 10% glucose solution. It not only provides the body with necessary energy, but also performs the function of detoxification by the production of a metabolite that participates in the following conjugation reaction:
Glucuronidation
Hydroxylation
Sulfation
Methylation
Glycosylation
133 із 200
To assess the effectiveness of breathing in patients, the indicator of functional residual capacity is used. It includes the following volumes:
Expiratory reserve volume and residual volume
Inspiratory reserve volume, tidal volume, residual volume
Inspiratory reserve volume and residual volume
Expiratory reserve volume and tidal volume
Inspiratory reserve volume and tidal volume
134 із 200
It is required to evaluate the level of tissue excitability. For this purpose one should determine:
Depolarization threshold
Action potential duration
Resting potential
Critical level of depolarization
Action potential amplitude
135 із 200
Due to the use of poor-quality measles vaccine for preventive vaccination, a 1-year-old child developed an autoimmune renal injury. The urine was found to contain macromolecular proteins. What process of urine formation was disturbed?
Filtration
Secretion
Secretion and filtration
Reabsorption
Reabsorption and secretion
136 із 200
A patient has been administered an anti-inflammatory drug that blocks the action of cyclooxygenase. Specify this anti-inflammatory agent:
Aspirin
Allopurinol
Thiamin
Analgene
Creatine
137 із 200
A pneumonia patient has been administered acetylcysteine as a part of complex therapy. What principle of therapy was taken into consideration when applying this drug?
Pathogenetic
Immunomodulatory
Symptomatic
Antimicrobial
Etiotropic
138 із 200
A 26-year-old female patient with bronchitis has been administered a broad spectrum antibiotic as a causal treatment drug. Specify this drug:
Doxycycline
Ambroxol
BCG vaccine
Dexamethasone
Interferon
139 із 200
A 65-year-old male suddenly lost the vision in one eye due to the retinal detachment. The patient underwent enucleation. Histological examination of the removed eye retina and choroid revealed clusters of atypical cells with marked polymorphism of cells and nuclei, with a moderate number of mitoses including the pathological ones. The cell cytoplasm and intercellular medium contained brown pigment giving a positive DOPA reaction. Perls’ reaction was negative. What is the most likely diagnosis?
Melanoma
Cysticercosis
Wilson’s disease
Hemorrhage
Pigmented mole
140 із 200
A child cut his leg with a piece of glass while playing and was brought to the clinic for the injection of tetanus toxoid. In order to prevent the development of anaphylactic shock the serum was administered by Bezredka method. What mechanism underlies this method of desensitization of the body?
Binding of IgE fixed to the mast cells
Stimulation of immune tolerance to the antigen
Stimulation of the synthesis of antigen-specific IgG
Binding of IgE receptors to the mast cells
Blocking the mediator synthesis in the mast cells
141 із 200
Microscopy of the myocardium of a patient who had died from heart failure revealed foci of fibrinoid necrosis located diffusely in the interstitial stroma, and often around the vessels. Such foci were surrounded by lymphocytes, macrophages, histiocytes. Pericardium was found to have signs of sero-fibrinous pericarditis. What is the most likely diagnosis?
Rheumatic heart disease
Cardiomyopathy
Myocardial infarction
Cardiosclerosis
-
142 із 200
One of the factors that cause obesity is the inhibition of fatty acids oxidation due to:
Low level of carnitine
Choline deficiency
Impaired phospholipid synthesis
Lack of carbohydrates in the diet
Excessive consumption of fatty foods
143 із 200
The genetic defect of pyruvate carboxylase deficiency is the cause of delayed physical and mental development and early death in children. This defect is characterized by lacticemia, lactaci-duria, disorder of a number of metabolic pathways. In particular, the following process is inhibited:
Citric acid cycle and gluconeogenesis
Lipolysis and lipogenesis
Glycolysis and glycogenolysis
Pentose phosphate pathway and glycolysis
Glycogenesis and glycogenolysis
144 із 200
Deficiency of linoleic and linolenic acids in the body leads to the skin damage, hair loss, delayed wound healing, thrombocytopenia, low resistance to infections. These changes are most likely to be caused by the impaired synthesis of the following substances:
Eicosanoids
Catecholamines
Interleukins
Corticosteroids
Interferons
145 із 200
During ventricular systole, the cardiac muscle does not respond to additional stimulation because it is in the phase of:
Absolute refractoriness
Relational refractoriness
There is no correct answer
Subnormal excitability
Hyperexcitability
146 із 200
A mother had taken synthetic hormones during pregnancy. Her daughter was born with hirsutism formally resembling of adrenal syndrome. Such manifestation of variability is called:
Phenocopy
Recombination
Replication
Mutation
Heterosis
147 із 200
Since a patient has had myocardial infarction, atria and ventricles contract independently from each other with a frequency of 60-70 and 35-40 per minute. Specify the type of heart block in this case:
Complete atrioventricular
Partial atrioventricular
Intra-atrial
Intraventricular
Sino-atrial
148 із 200
A 67-year-old male patient consumes eggs, pork fat, butter, milk and meat. Blood test results: cholesterol - 12,3 mmol/l, total lipids - 8,2 g/l, increased low-density lipoprotein fraction (LDL). What type of hyperlipoproteinemia is observed in the patient?
Hyperlipoproteinemia type IIa
Hyperlipoproteinemia type IV
Hyperlipoproteinemia type I
Cholesterol, hyperlipoproteinemia
Hyperlipoproteinemia type IIb
149 із 200
A 12-year-old child has a viral infection complicated by obstructive bronchitis. Bronchospasm can be eliminated by inhalations of a drug from the following pharmacological group:
/32-agonists
M-anticholinergics
Analeptics
N-cholinomimetics
32- adrenergic blockers
150 із 200
In course of an experiment there has been an increase in the nerve conduction velocity. This may be caused by an increase in the concentration of the following ions that are present in the solution around the cell:
Na+
Ca2+
K+ and ClC. K + and Na+
Ca2+ and Cl
151 із 200
A male working as a blacksmith has been tested for auditory acuity. The tests revealed 50% hearing loss in the low-frequency range and a near-normal auditory acuity in the highfrequency range. This condition has been caused by the damage to the following structures of the auditory system:
Corti’s organ - closer to helicotrema
Muscles of the middle ear
Eardrum
Median part of the Corti’s organ
Corti’s organ - closer to the oval foramen
152 із 200
In our country, routine preventive vaccinations against poliomyelitis ivolve using live vaccine that is administered orally. What immunoglobulins are responsible for the development of local post-vaccination immunity in this case?
Secretory IgA
IgM
Serum IgA
IgG
IgE
153 із 200
An experiment proved that UV-irradiated skin cells of patients with xeroderma pigmentosum restore the native structure of DNA slower than the cells of healthy people due to the defect in repair enzyme. What enzyme takes part in this process?
Endonuclease
Primase
DNA gyrase
RNA ligase
DNA polymerase
154 із 200
A patient who has recently come from an endemic area presents with elevated body temperature, headache, chills, malaise, that is with the symptoms which are typical for a common cold. What laboratory tests are necessary to confirm or to refute the diagnosis of malaria?
Microscopy of blood smears
Study of lymph node punctate
Urinalysis
Study of cerebrospinal fluid
Microscopy of bone marrow punctate
155 із 200
What condition may develop 15-30 minutes after re-administration of the antigen as a result of the increased level of antibodies, mainly IgE, that are adsorbed on the surface of target cells, namely tissue basophils (mast cells) and blood basophils?
Anaphylaxis
Antibody-dependent cytotoxicity
Immune complex hyperresponsiveness
Delayed-type hypersensitivity
Serum sickness
156 із 200
10 days after having quinsy caused by beta-hemolytic streptococcus a 6-year-old child exhibited symptoms of glomerulonephritis. What mechanism of glomerular lesion is most likely in this case?
Immunocomplex
Anaphylaxis
Cellular cytotoxicity
Atopy
Antibody-dependent cell-mediated cytolysis
157 із 200
A 22-year-old woman ate some seafood. 5 hours later the trunk and the distal parts of limbs got covered with small itchy papules which were partially fused together. After one day, the rash disappeared spontaneously. Specify the hypersensitivity mechanism underlying these changes:
Atopy (local anaphylaxis)
Antibody-dependent cell-mediated cytolysis
Systemic anaphylaxis
Immune complex hypersensitivity
Cellular cytotoxicity
158 із 200
A hypertensive patient had been keeping to a salt-free diet and taking antihypertensive drugs together with hydrochlorothiazide for a long time. This resulted in electrolyte imbalance. What disorder of the internal environment occurred in the patient?
Hypochloremic alkalosis
Metabolic acidosis
Hypermagnesemia
Hyperkalemia
Increase in circulating blood volume
159 із 200
A miner consulted a physician about the appearance of body rash followed by a loss of appetite, bloating, duodenal pain, frequent bowel movements, dizziness. Ovoscopic probes of feces and duodenal contents revealed some eggs covered with a transparent membrane through which 4-8 germinal cells could be seen. What disease is likely to have occurred in the patient?
Ancylostomiasis
Trichocephaliasis
Enterobiasis
Hymenolepiasis
Strongyloidiasis
160 із 200
Children with Lesch-Nyhan syndrome have a severe form of hyperuri- cemia accompanied by the formation of tophi, urate calculi in the urinary tracts, as well as serious neuro-psychiatric disorders. The cause of this disease is the reduced activity of the following enzyme:
Hypoxanthine-guanine phosphori-bosyltransferase
Thymidylate synthase
Xanthine oxidase
Dihydrofolate reductase
Karbamoyl phosphate synthetase
161 із 200
In a car accident a man got injured and lost a lot of blood. What changes in peripheral blood are most likely to occur on the 2nd day after the injury?
Erythropenia
Hypochromia
Anisocytosis
Microplania
Significant reticulocytosis
162 із 200
In the surgical ward, the dressing material was undergoing sterilization in an autoclave. Through an oversight of a nurse the mode of sterilization was changed and the temperature in the autoclave reached only 100oC instead of the due 120OC. What microorganisms can stay viable under these conditions?
Bacilli and clostridia
Corynebacteria and mycobacteria
Salmonella and klebsiella
Staphylococci and streptococci
Mold and yeast fungi
163 із 200
As a result of a mechanical injury an over 10 cm long portion of a peripheral nerve was damaged. This led to the impairment of the upper limb activity. The patient was offered nerve transplantation. What glial cells will participate in regeneration and provide the trophism of the injured limb?
Schwann cells
Ependymal cells
Microglia
Fibrous cells
Protoplasmic cells
164 із 200
A 26-year-old woman at 40 weeks pregnant has been delivered to the maternity ward. Objectively: the uterine cervix is opened, but the contractions are absent. The doctor has administered her a hormonal drug to stimulate the labor. Name this drug:
Oxytocin
Testosterone
Estrone
ACTH
Hydrocortisone
165 із 200
A patient has recurrent attacks of epileptic seizures and stays unconscious between them. In order to stop convulsions the drugs of the following group should be used in the first place:
Tranquilizers
Sedatives
Muscle relaxants
Neuroleptics
Analeptics
166 із 200
A patient with arthritis and varicose veins has been taking a non-steroidal antiinflammatory drug for a long time, which caused thrombosis of skin veins. Which of the following drugs might have caused this complication?
Celecoxib
Indomethacin
Aspirin
Phenylbutazone
Ibuprofen
167 із 200
Students study the stages of gametogenesis. They analyze a cell having a haploid number of chromosomes, and each chromosome consists of two chromatids. The chromosomes are located in the equatorial plane of the cell. Such situation is typical for the following stage of meiosis:
Metaphase of the second division
Anaphase of the first division
Prophase of the first division
Anaphase of the second division
Metaphase of the first division
168 із 200
A 35-year-old female patient underwent biopsy of the breast nodules. Histological examination revealed enhanced proliferation of the small duct epithelial cells and acini, accompanied by the formation of glandular structures of various shapes and sizes, which were located in the fibrous stroma. What is the most likely diagnosis?
Fibroadenoma
Adenocarcinoma
Mastitis
Invasive ductal carcinoma
Cystic breast
169 із 200
Examination of the duodenal contents revealed some pear-shaped protozoa with two nuclei and four pairs of flagella. The organisms had also two axostyles between the nuclei and a ventral adhesive disc. What protozoan representative was found in the patient?
Lamblia
Intestinal trichomonad
Toxoplasma
Trypanosome
Leishmania
170 із 200
A specimen of an onion rootlet includes a cell in which the fully condensed chromosomes are located in the equatorial plane making the monaster. What phase of the mitotic cycle is the cell in?
Metaphase
Late telophase
Early telophase
Prophase
Interphase
171 із 200
When examining a patient, the doctor revealed a tumor of the bronchus which borders on the aorta. Which bronchus is affected?
Left principal
Right principal
Right upper lobar
Left upper lobar
Middle lobar
172 із 200
A 54-year-old female was brought to the casualty department after a car accident. A traumatologist diagnosed her with multiple fractures of the lower extremities. What kind of embolism is most likely to develop in this case?
Adipose
Gaseous
Tissue
Air
Thromboembolism
173 із 200
Microscopy of the bronchial wall revealed atrophy of the mucosa, metaplastic change from columnar to squamous epithelium, an increase in the number of goblet cells, diffuse infiltration of the bronchial wall with lymphoplasmacytic elements with a large number of neutrophilic granulocytes, pronounced sclerosis. Spesi-fy the morphological form of bronchitis:
Chronic purulent bronchitis
Polypoid chronic bronchitis
Acute purulent bronchitis
Acute bronchitis
Chronic bronchitis
174 із 200
Due to the blockage of the common bile duct (which was radiographically confirmed), the biliary flow to the duodenum was stopped. We should expect the impairment of:
Fat emulsification
Protein absorption
Secretion of hydrochloric acid
Salivation inhibition
Carbohydrate hydrolysis
175 із 200
Typical manifestations of food poisoning caused by A. botulinum are double vision, abnormal functioning of the swallowing and breathing. These symptoms develop as a result of:
Exotoxin effects
Enterotoxin effects
Pathogen adhesion to the enterocyte receptors
Enterotoxic shock development
Activation of adenylate cyclase
176 із 200
At the stage of translation in the rough endoplasmic reticulum, the ribosome moves along the mRNA. Amino acids are joined together by peptide bonds in a specific sequence, and thus polypeptide synthesis takes place. The sequence of amino acids in a polypeptide corresponds to the sequence of:
mRNA codons
tRNA nucleotides
rRNA nucleotides
tRNA anticodons
rRNA anticodons
177 із 200
After the prolonged vomiting a pregnant 26-year-old woman was found to have the reduced volume of circulating blood. What change in the total blood volume can be the case?
Polycythemic hypovolemia
Oligocythemic hypovolemia
Polycythemic hypervolemia
Simple hypovolemia
Oligocythemic hypervolemia
178 із 200
On allergological examination a patient has been diagnosed with pollinosis. Specific desensitization can be performed by:
Intermittent administration of allergen
Antihistamines
-
Glucocorticoids
Administration of saline
179 із 200
A patient consulted a physician about chest pain, cough, fever. Roentgenography of lungs revealed eosinophilic infiltrates which were found to contain the larvae. What kind of helminthiasis are these presentations typical for?
Ascariasis
Trichinosis
Fascioliasis
Cysticercosis
Echinococcosis
180 із 200
A patient with signs of osteoporosis and urolithiasis has been admitted to the endocrinology department. Blood test revealed hypercalcemia and hypophosphatemia. These changes are associated with abnormal synthesis of the following hormone:
Parathyroid hormone
Calcitonin
Aldosterone
Calcitriol
Cortisol
181 із 200
Histological examination of the biopsy material obtained from the lower third of the esophagus of a 57-year-old male with the symptoms of continuous reflux revealed the change of the stratified squamous epithelium to the singlelayer columnar glandular epithelium with signs of mucus production. Specify the pathological process in the mucous membrane:
Metaplasia
Organization
Regeneration
Hypertrophy
Hyperplasia
182 із 200
A 30-year-old female exhibits signs of virilism (growth of body hair, balding temples, menstrual disorders). This condition can be caused by the overproduction of the following hormone:
Testosterone
Oestriol
Relaxin
Oxytocin
Prolactin
183 із 200
A patient with bacterial periodontitis has been administered iontophoresis with the use of iodine solution. Specify the mechanism of therapeutic action of this agent:
Inhibition of the cell wall formation
Albumin formation
Substitution of hydrogen atoms when the protein amino group contains a nitrogen atom
Changing the surface tension of the bacterial cell membrane
Reduction of the nitro group under the effect of nitroreductase
184 із 200
A patient with extensive myocardial infarction has developed heart failure. What pathogenetic mechanism contributed to the development of heart failure in the patient?
Reduction in the mass of functioning myocardiocytes
Pressure overload
Myocardial reperfusion injury
Volume overload
Acute cardiac tamponade
185 із 200
A patient who had been continuously taking drugs blocking the production of angiotensin II developed bradycardia and arrhythmia. A likely cause of these disorders is:
Hyperkalemia
Hypernatremia
Hypocalcemia
Hypercalcemia
Hypokalemia
186 із 200
A patient has arterial hypertension. What long-acting drug from the group of calcium channel blockers should be prescribed?
Amlodipine
Reserpine
Pyrroxanum
Octadine
Atenolol
187 із 200
Human skin has a high breaking strength. It is known that the skin consists of epithelial tissue and two kinds of connective tissue. Which of the following tissues provides the skin strength?
Unformed dense connective tissue
Transitional epithelium
Loose connective tissue
Stratified squamous epithelium
Single-layer epithelium
188 із 200
As a result of a home injury, a patient suffered a significant blood loss, which led to a fall in blood pressure. Rapid blood pressure recovery after the blood loss is provided by the following hormones:
Adrenaline, vasopressin
Aldosterone
Sex hormones
Cortisol
Oxytocin
189 із 200
A patient with constant headaches, pain in the occipital region, tinnitus, dizziness has been admitted to the cardiology department. Objectively: AP-180/110 mm Hg, heart rate - 95/min. Radiographically, there is a stenosis of one of the renal arteries. Hypertensive condition in this patient has been caused by the activation of the following system:
Renin-angiotensin
Immune
Sympathoadrenal
Hemostatic
Kinin
190 із 200
A patient complains that at the bare mention of the tragic events that once occurred in his life he experiences tachycardia, dyspnea and an abrupt rise in blood pressure. What structures of the CNS are responsible for these cardiorespiratory reactions in this patient?
Cerebral cortex
Quadrigemina of mesencephalon
Lateral hypothalamic nuclei
Specific thalamic nuclei
Cerebellum
191 із 200
A patient consulted a dentist about limited mouth opening (trismus). He has a history of a stab wound of the lower extremity. What infection may cause these symptoms?
Tetanus
Whooping cough
Brucellosis
Tularemia
Wound anaerobic infection
192 із 200
Anatomical dead space is the portion of the air that is left in the airways after expiration. The reduction of the anatomical dead space is typical for the following situation:
Tracheostomy
Turning the lying patient on his right side
Forward flexion of head
Turning the lying patient on his left side
Breathing through the mouth
193 із 200
Analysis of the experimental spirogram of a 55-year-old person revealed a decrease in tidal volume and respiratory amplitude compared to the situation of ten years ago. The change in these indicators is caused by:
Decreased force of respiratory muscle contraction
Physical build of a person
Height of a person
Body mass of a person
Gas composition of the air
194 із 200
A patient underwent a course of treatment for atherosclerosis. Laboratory tests revealed an increase in the antiatherogenic lipoprotein fraction in the blood plasma. The treatment efficacy is confirmed by the increase in:
HDL
LDL
VLDL
IDL
Chylomicrons
195 із 200
A 65-year-old female patient has chronic constipations due to the colon hypotonia. What drug should be chosen in this case?
Bisacodyl
Metoclopramide
Neostigmine methylsulfate
Castor oil
Magnesium sulfate
196 із 200
A female patient complains of vision impairment. On examination she was found to have obesity, fasting hyperglycemia. What complication of diabetes can cause vision impairment?
Microangiopathy
Glomerulopathy
Atherosclerosis
Macroangiopathy
Neuropathy
197 із 200
Analysis of the family history of children with Van der Woude syndrome revealed that in their families one of the parents had the typical for this syndrome defects (cleft lip and palate, lip pits regardless of gender). What is the type of inheritance of this syndrome?
Autosomal dominant
X-linked recessive
Autosomal recessive
X-linked dominant
Multifactorial
198 із 200
Administration of doxycycline hydrochloride caused an imbalance of the symbiotic intestinal microflora. Specify the kind of imbalance caused by the antibiotic therapy:
Dysbacteriosis
Sensibilization
Bacteriosis
Superimposed infection
Idiosyncrasy
199 із 200
A 3-year-old child had eaten some strawberries. Soon he developed a rash and itching. What was found in the child’s leukogram?
Eosinophilia
Neutrophilic leukocytosis
Monocytosis
Hypolymphemia
Lymphocytosis
200 із 200
A 12-year-old patient was found to have blood serum cholesterol at the rate of 25 mmol/l. The boy has a history of hereditary familial hypercholesterolemia, which is caused by the impaired synthesis of the following protein receptors:
Low density lipoproteins
Very low density lipoproteins
Chylomicrons
Intermediate density lipoproteins
High density lipoproteins