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Step 1 - Medicine 2018
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Autopsy of a woman revealed the following morphologic changes: stenosis of the atrioventricular opening, mitral insufficiency. Histologically there are focal cardiosclerosis and ’’blooming” Aschoff nodules in the myocardium. What is the most likely diagnosis?
Rheumatism
Systemic lupus erythematosus
Dermatomyositis
Polyarteritis nodosa
Scleroderma
3 із 200
After a case of sepsis a 27-year-old woman developed ’bronzed” skin discoloration characteristic of Addison’s disease. Hyperpigmentation mechanism in this case is based on increased secretion of:
Melanocyte-stimulating hormone
Gonadotropin
в-lipotropin
Thyroid-stimulating hormone
Somatotropin
4 із 200
A 16-year-old girl presents with no hair on the pubis and in the armpits, her mammary glands are underdeveloped, no menstruations. What hormone imbalance can it be indicative of?
Ovarian failure
Adrenal medulla hyperfunction
Hyperthyroidism
Hypothyroidism
Pancreatic islet failure
5 із 200
From the feces of a patient with acute gastroenteritis a pure culture of microorganisms was obtained. The microorganisms are small mobile slightly curved gram-negative bacilli that within 6 hours grow into a light blue film on the 1% alkaline peptone water. Such properties are characteristic of the following microorganism:
Vibrio
Clostridium
Spirochaete
Spirilla
Bacillus
6 із 200
A patient was brought into the infecti- onal diseases hospital on the 8th day since the disease onset. The patient complains of headache, malaise, and weakness. A sample of blood was taken for the serological test. Widal agglutination test results with blood sample diluted 1:200 and typhoid fever O-diagnosticum were positive. What diagnosis can be made based on the results of this test?
Typhoid fever
Cholera
Tuberculosis
Dysentery
Leptospirosis
7 із 200
Protective function of saliva is based on several mechanisms, including the presence of enzyme that has bactericidal action and causes lysis of complex capsular polysaccharides of staphylococci and streptococci. Name this enzyme:
Lysozyme
Collagenase
a-amylase
в-glucuronidase
Oligo-1,6-glucosidase
8 із 200
In the process of hemoglobin catabolism iron is released and then as a part of special transport protein is returned to the bone marrow, to be used again for hemoglobin synthesis. Name this transport protein:
Transferrin
Haptoglobin
Ceruloplasmin
Albumin
Transcobalamin
9 із 200
The first-aid center has received a victim of a traffic accident diagnosed with closed displaced fracture of the middle third of the thigh. For repositioning of bone fragments the patient received 10 ml of 2% dithylinum solution intravenously, which resulted in prolonged period of apnoea and muscle relaxation. What enzyme is deficient, resulting in such pharmacogenetic enzymopathy?
Pseudocholinesterase
Glucose 6-phosphate dehydrogenase
N-acetyltransferase
Uridine diphosphate glucuronyltransferase
Methemoglobin reductase
10 із 200
An 18-year-old student presents with enlarged thyroid gland accompanied by accelerated metabolism and increased heart rate. These signs can be observed during hypersecretion of thyroxin. What organelles of thyroid cells are primarily responsible for hormone production and secretion?
Golgi apparatus
Mitochondria
Centrosomes
Lysosomes
Ribosomes
11 із 200
A patient complains of pain in the upper umbilical region. On palpation there is a mobile painful intestine. What intestine is being palpated by the doctor?
Transverse colon
Duodenum
Ileum
Sigmoid colon
Jejunum
12 із 200
A laboratory experiment on a dog was used to study central parts of auditory system. One of the mesencephalon structures was destroyed. The dog has lost the orienting response to auditory signals. What structure was destroyed?
Inferior colliculi of corpora quadrigemina
Substantia nigra
Reticular formation nuclei
Superior colliculi of corpora quadrigemi-na
Red nucleus
13 із 200
Histological investigation of the uterine scrape of the 45-year-old woman with disturbed ovarian menstrual cycle revealed increased number of endometrial glands, some of which are serrated, while others are dilated and cyst-like. Make the diagnosis:
Endometrial cystic glandular hyperplasia
Atypical endometrial hyperplasia
Placental polyp
Glandular endometrial polyp
Endometrial adenocarcinoma
14 із 200
A 45-year-old man diagnosed with hepatic cirrhosis and ascites underwent drainage of 5 liters of fluid from his abdominal cavity, which resulted in development of syncopal state due to insufficient blood supply to the brain. What circulatory disorder occurred in the abdominal cavity in this case?
Arterial hyperemia
Thrombosis
Ischemia
Embolism
Venous hyperemia
15 із 200
During cholecystectomy besides a. cystyca another artery was pulled into the ligature. Ligation of this artery resulted in right-sided necrosis of the liver which led to the death of the patient. What artery was mistakenly ligated along with a. cystyca?
Ramus dexter a. hepatica propria
А. gasro-duodenalis
А. pancreato-duodenalis sup
А. hepatica communis
Ramus sinister a. hepatica propria
16 із 200
Microscopy of the puncture sample obtained from the inflammation focus of the patient with cutaneous abscess revealed numerous blood cells of different types. What cells are the first to transfer from vessels to tissues during inflammation?
Neutrophils
Monocytes
Basocytes
Eosinophils
Lymphocytes
17 із 200
During the first year of life an infant presents with disturbed process of breast milk curdling. What cells of the proper gastric glands are functionally disturbed?
Main exocrinocytes
Accessory mucous cells
Cervical mucous cells
Parietal exocrinocytes
Exocrinocytes
18 із 200
A lab rat has subcutaneously received mercury(II) chloride in the amount of 5 mg/kg. 24 hours later the plasma creatinine concentration increased several times. What mechanism of retention azotemia is observed in this case?
Decreased glomerular filtration
Increased creatinine production in the muscles
Increased creatinine production in the renal tubules
Increased glomerular filtration
Increased creatinine reabsorption
19 із 200
Collagenosis patients typically present with connective tissue destruction processes. The presence of these processes can be confirmed by the increase in:
Blood oxyproline and oxylysine
LDH-isoenzyme activity in the blood
Blood urates
Transaminase activity in the blood
Blood creatine and creatinine
20 із 200
A 63-year-old man suffers from esophageal carcinoma, presents with metastases into the mediastinal lymph nodes and cancerous cachexia. What pathogenetic stage of neoplastic process is observed in the patient?
Progression
Promotion
Transformation
-
Initiation
21 із 200
After an X-ray examination of the tuberculosis clinic patient, he was diagnosed with tumor of the right lung. During operation the surgeon removed the middle lobe of the patient’s right lung. This lobe includes:
Segmentum laterale et segmentum mediate
Segmentum lingualare superius et inferius
Segmentum apicale (superius) et segmentum basale mediale
Segmentum anterius et segmentum apicale
Segmentum basale anterius et posterius
22 із 200
A 2-year-old child presents with physical retardation and frequent pneumonias. The child was diagnosed with non-closure of the arterial canal. Hemodynamics disturbance in this case is caused by communication between the:
Aorta and pulmonary trunk
Superior vena cava and pulmonary trunk
Pulmonary trunk and pulmonary veins
Aorta and pulmonary veins
Superior vena cava and aorta
23 із 200
A child diagnosed with purulent inflammation of the middle ear was brought to the otolaryngology department. The disease started with the inflammation of the nasopharynx. It was determined that the infection had reached the tympanic cavity through the eustachian tube that is located in the:
Canalis musculotubarius
Сanaliculus tympanicus
Сanaliculi carotim tympanici
Сanalis caroticus
Сanaliculus chordae tympani
24 із 200
During the prestart period an athlete develops increased frequency and force of cardiac contractions. These changes are caused by intensification of the following reflex responces:
Sympathetic conditioned
Parasympathetic unconditioned
Peripheral
Parasympathetic conditioned
Sympathetic unconditioned
25 із 200
Due to trauma the patient has lost 25% of circulating blood volume. Name the emergency compensatory mechanism against blood loss:
Interstitial fluid inflow to the vessels
Erythropoiesis activation
Restoration of erythrocyte number
Increase of reticulocyte number
Restoration of blood protein composition
26 із 200
ECG analysis of the patient shows that the T waves are positive in the second standard limb lead and their amplitude and duration is normal. The conclusion can be made that the following process occurs normally in the patient’s ventricles:
Repolarization
Depolarization
Relaxation
Contraction
Excitation
27 із 200
A patient demonstrates sharp decrease of pulmonary surfactant activity. This condition can result in:
Alveolar tendency to recede
Increased pulmonary ventilation
Decreased airways resistance
Decreased work of expiratory muscles
Hyperoxemia
28 із 200
After a case of common cold the patient developed numbness of the right side of the face. Examination revealed disturbed pain and thermal sensitivity in the right half of the face. What nerve was damaged?
Trigeminal
Hypoglossal
Glossopharyngeal
Vagus
Facial
29 із 200
X-ray exmination of a 57-year-old man indicates local areas of hard bone tissue resorption in some of the patient’s bones. These changes can be associated with increased activity of:
Osteoclasts
Chondrocytes
Osteoblasts
Chondroblasts
Osteocytes
30 із 200
A patient presents with acute attack of cholelithiasis. Laboratory examination of the patient’s feces will show the following in this case:
Negative reaction to stercobilin
Partially digested cellulose
Positive reaction to stercobilin
Starch granules
Connective tissue
31 із 200
During autopsy of a 34-year-old man, who died of chronic kidney failure due to renal amyloidosis, in the lungs (mainly in the lower lobes) the pathologist detected multiple bronchial dilations filled with purulent masses accumulated in the bronchial lumen. Surface of the lungs section has fine-meshed pattern and resembles a honeycomb. Histologically there is a chronic inflammation detected in the bronchial wall, muscle fibers are replaced with connective tissue. These changes in the lungs can be defined as:
Bronchiectases
Lung abscesses
Bronchopneumonia
Chronic pneumonia
Chronic bronchitis
32 із 200
Initial inoculation of water in 1% peptone water resulted in growth of a thin film on the medium surface in 6 hours. Such cultural properties are characteristic of causative agent of the following disease:
Cholera
Pseudotuberculosis
Plague
Dysentery
Tuberculosis
33 із 200
A 30-year-old man complains of suffocation, heaviness in the chest on the right, general weakness. Body temperature is 38.9oC. Objectively the right side of the chest lags behind the left side during respiration. Pleurocentesis yielded exudate. What is the leading factor of exudation in the patient?
Increased permeability of the vessel wall
Hypoproteinemia
Erythrocyte aggregation
Increased blood pressure
Decreased resorption of pleural fluid
34 із 200
A 42-year-old man with gout presents with high content of uric acid in blood. The patient was prescribed allopurinol to lower the concentration of uric acid. Allopurinol is a competitive inhibitor of the following enzyme:
Xanthine oxidase
Adenosine deaminase
Hypoxanthine phosphoribosyltransferase
Adenine phosphoribosyltransferase
Guanine deaminase
35 із 200
Autopsy revealed a large wedge-shaped patch of a dense dark red tissue with clear margins in the upper lobe of the right lung. Histological examination detected there necrosis of the alveolar walls; the alveolar lumen is tightly packed with erythrocytes. What process occurred in the lungs?
Hemorrhagic infarction
Hemorrhage
Gangrene
Atelectasis
Carneous degeneration
36 із 200
A patient complains of dizziness, thirst, difficult swallowing, and impaired vision of close objects. Objectively: respiratory rate is increased, pupils are dilated, general agitation, talkativeness, though the speech is indistinct. BP is 110/70 mm Hg, heart rate is 110/min. Given symptoms can indicate overdosage of the following drug:
Atropine
Aminazine
Caffeine
Ephedrine
Morphine
37 із 200
A patient presents with indigestion, stomachaches, and excessive salivation. Similar simptoms had already been observed in this patient previously. Laboratory analysis detected oval eggs covered with lumpy capsules in the patient’s feces. What is the most likely cause of the patient’s disorder?
Ascariasis
Diphyllobothriasis
Fascioliasis
Trichocephaliasis
Enterobiasis
38 із 200
Regional lymph nodes surrounding an infected wound are enlarged. Histological examination shows increased number of macrophages, lymphocytes, and lymphatic follicles, as well as a large amount of plasma cells, in the cortical layer of the lymph nodes. What process in the lymph nodes is indicated by these histologic changes?
Antigen stimulation
Transplant rejection
Acquired deficiency of lymphoid tissue
Neoplastic aberration
Congenital deficiency of lymphoid tissue
39 із 200
During removal of the hyperplastic thyroid gland of a 47-year-old woman, the parathyroid gland was damaged. One month after the surgery the patient developed signs of hypoparathyroidism: frequent convulsions, hyperreflexia, laryngospasm. What is the most likely cause of the patient’s condition?
Hypocalcemia
Hyponatremia
Hyperchlorhydria
Hypophosphatemia
Hyperkalemia
40 із 200
On examination the patient presents with hirsutism, moon-shaped face, stretch marks on the abdomen. BP is 190/100 mm Hg, blood glucose is 176 mmol/L. What pathology is such clinical presentation characteristic of?
Adrenocortical hyperfunction
Hypothyroidism
Hyperthyroidism
Hyperfunction of the insular apparatus
Gonadal hypofunction
41 із 200
A 45-year-old woman presents with breast cancer. Metastases can spread in this case to the following regional lymph nodes:
Axillary, parasternal
Aortic, mediastinal
Cervical, parasternal
Parasternal, mediastinal
Abdominal, cervical
42 із 200
A 40-year-old pregnant woman underwent amniocentesis. Examination determined the fetal karyotype to be 47, XY+21. What fetal pathology was detected?
Down syndrome
Klinefelter syndrome
Phenylketonuria
Turner syndrome
Patau syndrome
43 із 200
A patient used an indirect-acting adrenergic agonist to treat rhinitis. After the patient has been putting in the nose drops for several days, the vasoconstrictive effect of the drug gradually diminished. Name this phenomenon:
Tachyphylaxis
Cumulation
Idiosyncrasy
Teratogenicity
Allergy
44 із 200
In a township there was registered an outbreak of hepatitis, which had supposedly spread through the water supply. What hepatitis virus could be the cause of the outbreak in this township?
Hepatitis E virus
Hepatitis G virus
Hepatitis C virus
Hepatitis D virus
Hepatitis B virus
45 із 200
A medical student was hospitalized into the infectious diseases unit on the 2nd day after the disease onset; the patient is suspected to have infectious mononucleosis. What results of laboratory analysis can confirm this diagnosis immediately on the day of the hospitalization?
IgM antibodies to Epstein-Barr virus were detected
IgM antibodies to herpes simplex virus were detected
Cytomegalovirus antibodies were detected
Fourfold increase in number of antibodies to Epstein-Barr virus was detected
Herpesvirus was isolated
46 із 200
A 64-year-old woman presents with disturbed fine motor function of her fingers, marked muscle rigidity, and tremor. The neurologist diagnosed her with Parkinson’s disease. What brain structures are damaged resulting in this disease?
Substantia nigra
Thalamus
Reticular formation
Cerebellum
Red nuclei
47 із 200
A 20-year-old young man with tall stature, asthenic body type, signs of hypogonadism and gynecomastia, and low sperm count (azoospermia) has karyotype 48. XXY. What hereditary syndrome can be characterized by this chromosomal anomaly?
Klinefelter syndrome
Turner syndrome
Down syndrome
Louis-Bar syndrome (ataxia-telangiectasia)
Wiskott-Aldrich syndrome
48 із 200
Pathogenic staphylococcus was obtained from the purulent wound of the patient. Its antibiotic sensitivity was determined to be as follows: penicillin growth inhibition zone - 8 mm; oxacillin 9 mm, ampicillin - 10 mm, gentamicin - 22 mm, lincomycin - 11 mm. What antibiotic should be chosen for treatment in this case?
Gentamicin
Penicillin
Lincomycin
Oxacillin
Ampicillin
49 із 200
A patient presents with dilated blood vessels of the anterior medial surface of the lower leg. This condition resulted from the dilation of the following blood vessel:
V saphena magna
V. poplitea
А. tibialis posterior
V saphena parva
А. tibialis anterior
50 із 200
A patient, who had received a thermal burn, developed painful boils filled with turbid liquid on the skin. What morphological type of inflammation has developed in the patient?
Serous
Diphtheritic
Croupous
Proliferative
Granulomatous
51 із 200
Nitrogen is being excreted from the body mainly as urea. When activity of a certain enzyme in the liver is low, it results in inhibition of urea synthesis and nitrogen accumulation in blood and tissues. Name this enzyme:
Carbamoyl phosphate synthetase
Amylase
Aspartate aminotransferase
Urease
Pepsin
52 із 200
Coronary artery thrombosis resulted in development of myocardial infarction. What mechanisms of cell damage are leading in this disease?
Calcium
Lipid
Protein
Electroosmotic
Acidotic
53 із 200
People, who for a long time remained in hypodynamic state, develop intense pain in the muscles after a physical exertion. What is the most likely cause of this pain?
Accumulation of lactic acid in muscles
Increased content of ADP in muscles
Decreased content of lipids in muscles
Intensive breakdown of muscle proteins
Accumulation of creatinine in muscles
54 із 200
Histological specimen shows organ parenchyma to consist of lymphoid tissue that forms lymph nodules; the nodules are located diffusely and have a central artery. What anatomical structure has such morphological characteristics?
Spleen
Red bone marrow
Thymus
Lymph node
Tonsil
55 із 200
A 25-year-old woman complains of visual impairment. Examination revealed disturbed eye accommodation, the pupil is dilated and unresponsive to light. What muscles are functionally disturbed in this case?
Iris sphincter muscle, ciliary muscle
Iris sphincter and iris dilator muscles
Iris dilator muscle, ciliary muscle
Lateral rectus muscle, iris sphincter muscle
Superior oblique muscle, ciliary muscle
56 із 200
A patient with hypochromic anemia has hair with split ends and suffers from hair loss. The nails are brittle. Gustatory sensations are affected. What is the mechanism of development of these symptoms?
Iron enzymes deficiency
Vitamin B12 deficiency
Low production of thyroid hormones
Vitamin A deficiency
Low production of parathyroid hormone
57 із 200
A patient suffers from hepatic cirrhosis. What substance excreted in urine should be analyzed to characterize the antitoxic function of liver?
Hippuric acid
Creatinine
Uric acid
Amino acids
Ammonium salts
58 із 200
A 65-year-old woman, who had been suffering from deep vein thrombophlebitis of the lower leg, suddenly died when awaiting her appointment with the doctor. Autopsy revealed loose friable red masses with corrugated dull surface in the main pulmonary artery and its bifurcation. What pathologic process was discovered by the pathologist in the pulmonary artery?
Thromboembolism
Foreign body embolism
Fat embolism
Thrombosis
Tissue embolism
59 із 200
Blood of the patients with diabetes mellitus shows increased content of free fatty acids. Name the most likely cause of this:
Increased activity of adipose triglyceride lipase
Activation of ketone bodies utilization
Activation of apoА1, apoА2, and apoА4 apolipoprotein synthesis
Decreased activity of plasma phosphatidylcholine-cholesterol-acyltransferase
Accumulation of palmitoyl-CoA in cytosol
60 із 200
Representatives of a certain human population can be characterized by elongated body, height variability, decreased volume of muscle mass, increased length of limbs, decreased size and volume of rib cage, increased perspiration, decreased indices of base metabolism and fat synthesis. What type of adaptive evolution is it?
Tropical
Mountain
Intermediate
Moderate
Arctic
61 із 200
A 56-year-old man complains of thirst and frequent urination. The endocrinologist diagnosed this patient with diabetes melli-tus and prescribed him glibenclamide. What mechanism of action does this drug have?
Stimulation of в-cells of islets of Langerhans
Suppression of а-cells of islets of Langerhans
Inhibits glucose absorption in the intestine
Facilitates glucose transport through cell membranes
Facilitates glucose uptake by the tissues
62 із 200
Patients with bile duct obstruction typically present with inhibited blood clotting and develop hemorrhages due to insufficient assimilation of vitamin:
K
E
A
D
C
63 із 200
A test animal receives electrical impulses that irritate the sympathetic nerve that innervates blood vessels of the skin. What reaction will it cause in the blood vessels?
Arterial and venous constriction
Arterial dilation
Venous dilation
Arterial and venous dilation
No reaction
64 із 200
Examination of the coronary arteries revealed atherosclerotic plaques with calcinosis that narrow the arterial opening by 1/3. In the muscle there are numerous whitish layers of connective tissue. Name the process detected in the myocardium:
Diffuse cardiosclerosis
Tiger heart
Postinfarction cardiosclerosis
Myocardial infarction
Myocarditis
65 із 200
A person has increased pulmonary ventilation due to physical exertion. What indicator of external respiration will be significantly increased compared to the resti- ng state?
Respiratory volume
Expiratory reserve volume
Total lung capacity
Inspiratory reserve volume
Vital lung capacity
66 із 200
The carotid bodies on both sides were removed in a test animal. Which of the listed factors WILL NOT be able to cause hyperventilation in the test animal?
Hypoxemia
Acidosis
Hypercapnia
Physical exertion
Increase of core body temperature
67 із 200
Due to prolonged stay in the mountains at the altitude of 3000 m above the sea level, a person developed increased oxygen capacity of blood, which was directly caused by intensified production of:
Erythropoietins
2 ,3-bisphosphoglycerate
Leukopoietins
Carbaminohemoglobin
Catecholamines
68 із 200
A woman has been limiting the amount of products in her diet to lose some weight. 3 months later she developed edemas and her diuresis increased. What dietary component deficiency is the cause of this?
Proteins
Fats
Vitamins
Minerals
Carbohydrates
69 із 200
A microslide of the lung tissue sample taken from a patient with pneumonia shows damage to the cells that carry out respiratory function. What cells of the alveolar wall are damaged?
Type 2 alveolar cells
Club cells
Lymphocytes
Macrophages
Type 1 alveolar cells
70 із 200
After a psychic trauma a woman developed periodical increases in her blood pressure accompanied by headache, palpitations, and general weakness. What mechanism of hypertension development does this woman have?
Increased arteriolar tone
Decreased cardiac output
Venoconstriction
Increased circulating blood volume
Tachycardia
71 із 200
An electron micrograph of a nephron segment shows cuboidal cells with ciliated lining on their apical surfaces; their basal surfaces have basal striation with mitochondria located between the cytolemma invaginations. Name the described nephron segment:
Proximal tubule
Glomerular capsule
Thin limbs of Henle’s loop
Distal tubule
Collecting ducts
72 із 200
A patient has been taking bisacodyl for a long time to treat chronic constipation. However, several weeks later the aperient effect of the drug diminished. What is the possible cause of this?
Acquired tolerance
Sensitization
Functional cumulation
Drug dependence
Material cumulation
73 із 200
A force generated by the muscle is not enough to lift a load. What type of muscle contraction occurs in this case?
Isometric
Concentric
Eccentric
Tetanic
Isotonic
74 із 200
Condition of a patient with diabetes mellitus sharply deteriorated after a regular injection of insulin. The patient became anxious and broke out in cold sweat; tremor of the extremities, general weakness, and dizziness appeared. What medicine can remove these symptoms?
Adrenaline
Noradrenaline
Glibutid (Buformin)
Tolbutamide
Caffeine
75 із 200
Microscopy of the myocardium of a girl, who died of diphtheria due to heart failure, shows fatty degeneration, multiple foci of cardiomyocytes necrosis, and small foci of cellular infiltrates in the interstitium. What type of myocarditis is it?
Alterative
Focal exudative
Interstitial
Granulomatous
Diffuse exudative
76 із 200
A schizophrenia patient was prescribed aminazine. What pharmacodynamic action of this drug is the grounds for its prescription in this case?
Antipsychotic
Muscle relaxant
Hypotensive
Antiemetic
Hypothermic
77 із 200
A 40-year-old man developed skin redness and swelling in the neck area, where eventually a small abscess appeared. On section the focus is dense and yellow-green colored. In the purulent masses there are white granules. Histologically there are fungal druses, plasma and xanthome cells, and macrophages detected. Specify the most correct etiological name of this pathological process:
Actinomycosis
Syphilis
Furuncle
Carbuncle
Leprosy
78 із 200
A patient was hospitalized into the infectious diseases unit on the 11th day since the disease onset and provisionally diagnosed with typhoid fever. What biological material should be collected from the patient for the analyzes at this stage?
Blood serum
Bile
Feces
Urine
Roseola secretion
79 із 200
A man with ischemic heart disease has been taking his medicine too often throughout a day, which resulted in poisoning. Examination detects cyanosis of skin and mucosa, sharp drop of blood pressure, tachycardia, and respiratory depression. Blood methemoglobin is high. What type of medicine did the patient overdose on?
Organic nitrates
Myotropic antispasmodics
a-adrenergic blockers
Adenosine-based drugs
Calcium channel blockers
80 із 200
General structure of eukaryotic genes is as follows: exon-intron-exon. Such functional structure of a gene leads to certain specifics of the transcription process. What sequence will correspond with precursor mRNA (immature)?
Exon-intron-exon
Exon-exon
Exon-intron
Intron-exon
Exon-exon-intron
81 із 200
Atria of a test animal were superdi-stended with blood, which resulted in decreased reabsorption of Na+ and water in renal tubules. This can be explained by the effect of the following factor on the kidneys:
Natriuretic hormone
Renin
Angiotensin
Vasopressin
Aldosterone
82 із 200
A patient with clinical signs of a primary immunodeficiency has functionally disturbed mechanism of antigen-presentation to the immunocompetent cells. What cells are likely to have structural defects?
Macrophages, monocytes
B-lymphocyte
Fibroblasts
O-lymphocytes
T-lymphocyte
83 із 200
During intensive muscle work there is a large amount of ammonia produced in the muscles. What amino acid plays the main role in the transportation of ammonia to the liver and participates in gluconeogenesis reactions?
Alanine
Arginine
Ornithine
Aspartate
Lysine
84 із 200
Encephalopathy has developed in a child with hemolytic disease of the newborn. What substance had increased in the child’s blood, resulting in damage to the CNS?
Unconjugated bilirubin
Verdohemoglobin
Bile acids
Bilirubin glucuronide
Bilirubin-albumin complex
85 із 200
Renal examination shows the kidney to be swollen and plethoric, with easily removable capsule. Renal pelvis and calyces are dilated and filled with turbid urine; their mucosa is dull and has hemorrhagic foci. On section the renal tissue is variegated, there are yellow-gray areas surrounded with plethoric and hemorrhagic zone. What di- sease can be characterized by such results of macroscopic examination?
Acute pyelonephritis
Acute glomerulonephritis
Renal amyloidosis
Nephrolithiasis
Polycystic kidney
86 із 200
A 54-year-old man complains of general weakness, frequent colds, and bruises constantly appearing on his body. Blood test: erythrocytes - 2.5 • 1012/L; Hb- 80 g/L; color index - 0.9; reticulocytes - absent; platelets - 50 • 109/L; leukocytes - 58 • 109/L; leukogram: basocytes 5%, eosinophils -15%, myeloblasts - 6%, myelocytes - 10%, juvenile - 18%, stab neutrophils 26 %, segmented neutrophils - 10%, lymphocytes - 8%, monocytes - 2%, ESR - 40 mm/hour. What hematologic conclusion can be made?
Chronic myelogenous leukemia
Basophilic eosinophilic leukocytosis
Myeloblastic leukemia
Leukemoid response
Chronic lymphocytic leukemia
87 із 200
A mutation has occurred in a cell in the first exon of the structural gene. The number of nucleotide pairs changed from 290 to 250. Name this type of mutation:
Deletion
Inversion
Nullisomy
Translocation
Duplication
88 із 200
The dorsal root of the spinal nerve of a test animal was severed. What changes will occur in the innervation area?
Loss of sensitivity
Loss of motor function
Loss of sensitivity and motor function
Increased muscle tone
Decreased muscle tone
89 із 200
Due to destruction of certain structures of the brainstem a test animal has lost its orientation reflexes in response to strong light stimuli. What structures were destroyed?
Anterior quadrigeminal bodies
Posterior quadrigeminal bodies
Vestibular nuclei
Substantia nigra
Red nuclei
90 із 200
A toxin neutralized with 0.4% formaldehyde under 37-40oC for 4 weeks is used for vaccination. This preparation was first used by Gaston Ramon for diphtheria prevention. Name this preparation:
Anatoxin
Inactivated vaccine
Adjuvant
Immunoglobulin
Antitoxic serum
91 із 200
24 hours after an appendectomy the patient’s blood test shows neutrophilic leukocytosis with a regenerative shift. What is the most likely mechanism of absolute leukocytosis development in the patient’s peripheral blood?
Intensification of leukopoiesis
Decreased leukocyte disintegration
Immunity activation
Leukocyte redistribution
Deceleration of leukocyte migration to the tissues
92 із 200
The right leg of a 40-year-old woman measured at the shin level is by 2 cm smaller in the diameter than the left leg. Ankle-jerk (Achilles) and knee-jerk reflexes are absent on the right. What is the most likely mechanism of hyporeflexia development during peripheral paralysis?
Disturbed conduction of stimulation
Activation of excitatory impulses from the CNS
Inhibition of pyramidal motoneuron
Disturbed perception of stimulation
Disturbed synaptic impulse transmission
93 із 200
A 38-year-old man, who has been suffering from systemic lupus erythematosus for 3 years, developed diffuse renal lesions accompanied by massive edemas, marked proteinuria, hyperlipidemia, and dysproteinemia. What is the most likely mechanism of proteinuria develoment in this case?
Autoimmune damage to the nephrons
Morbid affection of the urinary tracts
Increased blood proteins
Ischemic damage to the tubules
Inflammatory damage to the nephrons
94 із 200
A 59-year-old man, a business manager, developed intense burning retrosternal pain that irradiates to the left arm. The pain occurred in the evening after the tax audit. 15 minutes later the patient’s condition normalized. What mechanism of angina pectoris development is leading in this patient?
Increased level of blood catecholamines
Coronary atherosclerosis
Coronary artery thrombosis
Functional cardiac overload
Intravascular aggregation of blood cells
95 із 200
A 25-year-old woman at her third pregnancy with impending miscarriage was brought to the hospital. What combination of Rh-factor of the mother and the fetus can be the cause of this condition?
Mother Rh (-), fetus Rh (+)
Mother Rh (+), fetus Rh (-)
-
Mother Rh (-), fetus Rh (-)
Mother Rh (+), fetus Rh (+)
96 із 200
A specimen of a 10-day-old human embryo shows two interconnected sacs (amniotic and yolk sacs). Name the structure located in the place where these two sacs connect:
Embryonic shield
Amniotic stalk
Roof of the amniotic sac
Extraembryonic mesoderm
Floor of the amniotic sac
97 із 200
A woman with the III (В), Rh (-) blood group gave birth to a child with the II (А) blood group. The child is diagnosed with hemolytic disease of newborn caused by rhesus incompatibility. What blood group and Rh does the father have?
II (А), Rh (+)
III (B), Rh (+)
I (0), Rh (-)
II (A), Rh (-)
I (0), Rh (+)
98 із 200
A 40-year-old woman suffers from Cushing’s disease - steroid diabetes. On biochemical examination she has hyperglycemia and hypochloremia. What process activates in the first place in such patients?
Gluconeogenesis
Glycogenolysis
Glucose reabsorption
Glycolysis
Glucose transport to the cells
99 із 200
A patient with a chemical burn has developed esophageal stenosis. The patient presents with acute weight loss due to problematic food intake. Blood test: erythrocytes - 3.0 • 1012/L, Hb-106 g/L, total protein - 57 g/L. What type of starvation does this patient suffer from?
Incomplete starvation
Protein starvation
Water starvation
Absolute starvation
Complete starvation
100 із 200
Autopsy of the body of a man, who for a long time had been working at the factory with high content of silicon dioxide in the air, revealed enlarged dense lungs with numerous round and oval sclerotic foci. The foci were miliary and larger in size and colored gray or gray-black. What is the most likely diagnosis?
Nodular silicosis
Asbestosis
Anthracosilicosis
Silicoanthracosis
Diffuse sclerotic silicosis
101 із 200
Autopsy of the body of a 50-year-old man, who had been suffering from tuberculosis and died of cardiopulmonary decompensation, shows lobar affection of the lungs: the upper lobe of the right lung is enlarged, dense, yellow on section, crumbling, with pleural fibrin deposition. What type of secondary tuberculosis can be characterized by this pathology?
Caseous pneumonia
Tuberculoma
Infiltrative tuberculosis
Fibrous focal tuberculosis
Acute focal tuberculosis
102 із 200
A woman has come to the hospital with complaints of general weakness, dizziness, and dyspnea. Resently she has been taking levomycetin (chloramphenicol) for prevention of enteric infection. Blood test: erythrocytes - 1.9 • 1012/L, hemoglobin - 58 g/L, color index - 0.9, leukocytes - 2.2 G/L, reticulocytes - 0.3%. What type of anemia is it indicative of?
Hypoplastic
Hemolytic
Iron-deficiency
Aplastic
Metaplastic
103 із 200
Preoperative examination revealed prothrombin deficiency in the blood of the patient. What drug should be preliminarily prescribed to mitigate blood loss in the patient during the surgery?
Vicasol (Menadione)
Contrykal (Aprotinin)
Phenylin (Phenindione)
Aminocapronic acid
Thrombin
104 із 200
A patient with streptococcal infection of the gingiva was prescribed a drug with в-lactam ring in its structure. What drug of those listed below belongs to this pharmacological group?
Benzylpenicillin
Levomycetin (Chloramphenicol)
Streptomycin sulfate
Erythromycin
Rifampicin
105 із 200
A microslide of the skin sample taken from the finger of a child shows that epidermis is insufficiently developed. What germ layer was damaged in the process of embryo development?
Ectoderm
Mesenchyme
Mesoderm
Endoderm
Ectomesenchyme
106 із 200
Neutralization of xenobiotics and active endogenous metabolites often occurs via introduction of an oxygen atom into the substrate molecule. What process occurs as the result?
Hydroxylation
Phosphorilation
Deaminization
Decarboxylation
Transamination
107 із 200
In the process of an experiment, vascular resistance to the blood flow was measured in the different areas of circulatory system. The highest resistance was detected in the:
Arterioles
Arteries
Capillaries
Veins
Venules
108 із 200
A 34-year-old man died in a comatose state. According to his family after a business trip to an African country he developed periodical jaundice attacks. Autopsy shows the following: dense enlarged spleen with slate-black pulp; enlarged plethoric liver, gray-black on section; cerebral gray matter is brown-gray; cerebral white matter contains numerous small hemorrhages. What infectious disease can be suspected?
Malaria
Generalized cryptococcosis
Prion infection
Meningococcemia
Generalized herpetic infection
109 із 200
What diagnostic method should be used in industry to test the raw leather for presence of B. antracis?
Ascoli’s thermo precipitation test
Microscopy with Burry-Gins stain
Bacteriological analysis
Microscopy with Aujeszky stain
Serological test
110 із 200
A 46-year-old patient suffering from ulcer disease of the stomach is diagnosed with rheumatoid arthritis. What antiinflammatory drug would be the most advisable in this case?
Celecoxib
Promedol (Trimeperidine)
Analgin (Metamizole)
Paracetamol
Prednisolone
111 із 200
A patient with myocardial infarction has acute heart failure. Among the drugs that increase the force of heart contractions the least dangerous in this case will be:
Dobutamine
Caffeine
Adrenaline
Isadrinum (Isoprenaline)
Euphyllin (Aminophylline)
112 із 200
During intensive physical exertion, one of the energy sources for the working muscles is glucose produced as the result of gluconeogenesis. This process is the most intensive in the following organ:
Liver
Stomach
Muscles
Lungs
Brain
113 із 200
During inflienza epidemic, morbidity in the schoolchildren, who did not participate in sports, was 40%, while in the schoolchildren, who engaged in regular physical aci-vities, morbidity did not exceed 20%. What adaptation mechanism ensured low morbidity in the physically active schoolchildren?
Cross-adaptation
Biochemical adaptation
Physiological adaptation
Specific adaptation
Genetic adaptation
114 із 200
Monoamine oxidase inhibitors are widely used as psychopharmacological drugs. They change the level of nearly all neurotransmitters in synapses, with the following neurotransmitter being the exception:
Acetylcholine
Dopamine
Serotonin
Adrenaline
Noradrenaline
115 із 200
A 17-year-old girl suffers from periodical palpitations that last several minutes. Her heart rate is 200/min., rhythmic. What heart rhythm disorder developed in this patient?
Paroxysmal tachycardia
Sinus tachycardia
Atrioventricular block
Sinus bradycardia
Extrasystole
116 із 200
Kidney X-ray image obtained by means of pyelography shows that the minor calyces converge to form 2 major calyces that adjoin to the renal pelvis, from which the ureter exits. What type of urinary tract is it?
Mature
Fetal
Embryonic
Bicornuate
Cystic
117 із 200
A patient has been brought into a surgical ward with an incised wound of the anterior surface of the shoulder in its lower one-third. Flexing function was disturbed in the shoulder and elbow joints, which is caused by the damage to the:
Biceps muscle of the arm
Coracobrachial muscle
Deltoid muscle
Anconeus muscle
Triceps muscle of the arm
118 із 200
A patient suffers from acute cardiopulmonary failure with pulmonary edema. What diuretic should be prescribed in the given case?
Furosemide
Hydrochlorothiazide (Dichlothiazidum)
Spironolactone
Acetazolamide (Diacarb)
Triamterene
119 із 200
Ketosis develops in the patients with diabetes mellitus, as the result of activation of fatty acids oxidation processes. What acid-base imbalance can result from accumulation of excessive ketone bodies in the blood?
Metabolic acidosis
Respiratory alkalosis
No imbalance occurs
Metabolic alkalosis
Respiratory acidosis
120 із 200
A 5-year-old child is diagnosed with Bruton syndrome (X-linked agammaglobulinemia) that manifests itself as severe clinical course of bacterial infections and absence of B lymphocytes and plasma cells. What changes of immunoglobulin content can be observed in blood serum of the child with immunodeficiency?
Decreased IgA, IgM
No changes
Increased IgD, IgE
Decreased IgD, IgE
Increased IgA, IgM
121 із 200
During the skill-building session in microbiology the students need to stain the prepared and fixed sputum smears obtained form a tuberculosis patient. What staining technique should be used in this case?
Ziehl-Neelsen
Gins
Gram
Burry
Giemsa
122 із 200
A woman with hypophyseal diabetes insipidus developed a water-mineral imbalance. What type of water-mineral imbalance develops in such cases?
Hyperosmolar dehydration
Hypoosmolar hyperhydration
Hypoosmolar dehydration
Hyperosmolar hyperhydration
Isoosmolar dehydration
123 із 200
First-year schoolchildren have received tuberculin skin Mantoux test) at the school nurse’s office. The purpose of this test was:
To determine the children that need to receive BCG vaccination
To detect parotitis in the schoolchildren
To measure allergization rate toward rickettsia
To measure immunity stress toward diphtheria
To preventively vaccinate against tuberculosis
124 із 200
In an experiment it is necessary to assess neuromotor and muscle excitability. What value shoud be measured to make the assessment?
Sensory threshold
Action potential amplitude
Action potential duration
Threshold potential
Resting potential
125 із 200
Vestibular receptors of semicircular canals of a test animal have been destroyed. What reflexes will disappear as a result?
Statokinetic reflex during movements with angular acceleration
Body-righting reflex
Statokinetic reflex during movements with linear acceleration
Primary orienting reflex
Head-righting reflex
126 із 200
Acute renal impairment caused death of a patient with hemorrhage. Autopsy revealed enlarged kidneys with broad pale pink cortical layer expressively demarcated from dark red renal pyramids. Macroscopic examination revealed lack of epithelial nuclei of the convoluted tubules, tubulorrhexis, phlebostasis. The cell nuclei of the choroid glomus and straight tubules were present. What pathology is it?
Necronephrosis
Nephrosis
Infarction
Pyelonephritis
Glomerulonephritis
127 із 200
A boxer had sustained a blow to the left parotid area, after which he developed paralysis of the facial muscles on this side. What nerve had been damaged?
Facial
Mandibular
Lesser petrosal
Maxillary
Ophthalmic
128 із 200
A patient has an open facial wound with undermined edges; tissue necrosis with gradually developing partial gangrene that nearly reaches the bone tissue is observed. On close examination the wound contains live larvae. The patient is diagnosed with tissue myiasis. What Diptera larvae are the causative agents of this disease?
Wohlfahrtia magnifica
Musca domestica
Stomoxys calcitrans
Glossina palpalis
Phlebotomus pappatachi
129 із 200
A hereditary disease - homocystinuria - is caused by disturbed transformation of homocysteine into methionine. Accumulated homocysteine forms its dimer (homocystine) that can be found in urine. What vitamin preparation can decrease homocysteine production?
Vitamin B12
Vitamin PP
Vitamin B2
Vitamin B6
Vitamin C
130 із 200
During hypersensitivity skin test a patient received an allergen subcutaneously, after which the patient developed skin redness, edema, and pain due to histamine action. This biogenic amine is produced as the result of the following transformation of histidine amino acid:
Decarboxylation
Phosphorilation
Methylation
Isomerization
Deaminization
131 із 200
During the fight a man has received a strong blow to the upper anterior abdominal wall, which resulted in the cardiac arrest. What mechanism has led to the cardiac arrest in this case?
Parasympathetic unconditioned
Peripheral
Parasympathetic conditioned
Sympathetic conditioned
Sympathetic unconditioned
132 із 200
A woman has lost a lot of blood during the childbirth. Her blood group needs to be determined. Erythrocyte agglutination occurred with standard serums 0 (I) and А (II) and did not occur with standard serum B (III). What blood group does this woman have?
B (III)
-
0 (I )
АВ (IV)
А (II)
133 із 200
A 60-year-old man diagnosed with chronic heart failure was brought to the hospital. After a long course of treatment the patient developed signs of intoxication: dyspnea, extrasystole, nausea, and disturbed perception of colors. What medicine has caused such side-effects?
Digoxin
Nitroglycerine
Furosemide
Drotaverine
Anaprilin (Propranolol)
134 із 200
A patient with exacerbated peptic ulcer disease of the stomach has made an appointment with the doctor. What type of drugs should be included in the complex therapy of this patient?
H2 antagonists
a-adrenergic agonists
a-adrenergic antagonists
^-adrenergic antagonists
H1 antagonists
135 із 200
Autopsy of the body revealed waxy degeneration of the rectus abdominis muscles. In the terminal segment of the small intestine there are ulcers 3-5 cm in diameter. The ulcer walls are covered in a crumbling grayish-white substance. The ulcer edges are markedly raised above the mucosa. Widal test is positive. Make the diagnosis:
Typhoid fever
Nonspecific ulcerative colitis
Dysentery
Relapsing fever
Crohn’s disease
136 із 200
Genealogical analysis of a child with myotonic dystrophy determined that this disease is present in every generation, equally presented by the relatives of both genders, the risk of inheriting this disease is equal no matter which parent is affected. If one of the parents is heterozygous for this disease and the other parent is healthy, the risk of them giving birth to a sick child is 50%. What type of disease inheritance is it?
Autosomal dominant
Y-linked
X-linked dominant
Autosomal recessive
X-linked recessive
137 із 200
A 30-year-old man has undergone surgical removal of a thyroid tumor. Histologically the tumor is made up of papillary structures varying in size that emerge from the inner surface of dilated cystic follicles and are covered with atypical epithelium. What is the most likely diagnosis?
Papillary carcinoma
Follicular carcinoma
Macrofollicular adenoma
Medullary carcinoma
Colloid nodular goiter
138 із 200
A young woman, a foreign student from Tehran, has made an appointment with the urologist. She complains of the sensation of heaviness in her lower abdomen and a small amount of blood being excreted with urine at the end of each urination. Microscopy of urine detects the presence of parasite eggs, approximately 140x70 micron in size, with a terminal spike. What diagnosis can be made by the infectious diseases specialist?
Schistosomiasis
Fascioliasis
Paragonimiasis
Opisthorchiasis
Dicroceliasis
139 із 200
Various biological preparations can be used for poliomyelitis prevention. What drug induces the type of local intestinal mucosal immunity that lasts the longest?
Oral vaccination with live vaccine
Parenteral vaccination with live vaccine
Parenteral vaccination with inactivated vaccine
Parenteral introduction of normal human immunoglobulin
Oral introduction of poliovirus-specific immunoglobulin
140 із 200
Histological analysis of a removed skin tumor shows clusters and bands composed of atypical stratified squamous epithelium cells that penetrate into the underlying tissue. What preliminary diagnosis can be made?
Non-keratinizing squamous cell carcinoma
Papilloma
Adenoma
Carcinoma in situ
Solid cancer
141 із 200
Autopsy of a patient, who died of bilateral bronchopneumonia, shows in the left lung lower lobe a cavity 5 cm in diameter, filled with yellowish-white liquid. What complication of the patient’s pneumonia had developed?
Abscess
Sequestrum
Gangrene
Granuloma
Tuberculoma
142 із 200
A patient with parkinsonism was prescribed levodopa, which led to rapid improvement of the patient’s condition. What is the mechanism of action of this drug?
Stimulation of dopamine synthesis
Stimulation of dopamine receptors
Anticholinesterase action
Muscarinic acetylcholine receptor blockade
Muscarinic acetylcholine receptor stimulation
143 із 200
A sick child presents with high content of phenyl pyruvate in urine (normally it is practically absent). Blood phenylalanine level is 350 mg/L (norm -15 mg/L). What disease are these symptoms characteristic of?
Phenylketonuria
Gout
Alkaptonuria
Tyrosinosis
Albinism
144 із 200
An oncology patient is to undergo a surgery on the descending colon. Name the main source of blood supply to this organ:
Inferior mesenteric artery
Splenic artery
Superior mesenteric artery
Middle colic artery
Celiac trunk
145 із 200
A patient presents with enlarged cervical lymph nodes. Other lymph nodes and internal organs are without changes. Peripheral blood test results are normal. Histological examination of biopsy material taken from the cervical lymph node shows smoothed-out pattern, absent follicles, homogeneous cell composition represented by lymphoblasts. The cells penetrate into the lymph node capsule. What diagnosis can be made?
Lymphoblastic leukemia
Myeloblastic leukemia
Erythroblastic leukemia
Burkitt lymphoma
Sezary disease
146 із 200
When studying the pulmonary ventilation values, the reduction of forced expiratory volume has been detected. What is the likely cause of this phenomenon?
Obstructive pulmonary disease
Increase of respiratory volume
Increase of functional residual lung capacity
Increase of inspiratory reserve volume
Increase of pulmonary residual volume
147 із 200
A man is a carrier of HIV that is an RNA virus. The cells of this patient synthesize viral DNA. This process is based on:
Reverse transcription
Replication
Repair
Translation
Transcription
148 із 200
Sanitary assessment of a pond, where the children from a recreation summer camp take their swims, detected there oval cysts 50-60 micron in diameter, with 2 nuclei visible in their cytoplasm (macronucleus and micronucleus). What protozoa do these cysts belong to?
Balantidium
Lamblia
Toxoplasma
Amoeba
Euglena
149 із 200
A hospital has received a 24-year-old man, who had received a penetrating wound to the eye, which has caused the vitreous body to run out. As the result of this, retinal detachment occurred. What retinal layer was tightly adherent to the vascular tunic of the eye and did not detach?
Retinal pigment epithelium
Inner nuclear layer
Outer nuclear layer
Layer of rods and cones
Ganglion cell layer
150 із 200
A newborn presents with weak suckling, frequent vomiting, and hypotonia. Blood and urine citrulline are very high. What metabolic process is disturbed?
Ornithine cycle
Tricarboxylic acid cycle
Glycolysis
Gluconeogenesis
Cori cycle
151 із 200
Stool test detects in the patients feces a large amount of undigested fats.This patient is the most likely to have disturbed secretion of the following enzymes:
Pancreatic lipases
Pancreatic amylase
Bile lipase
Pancreatic proteases
Gastric protease
152 із 200
A 19-year-old young man was examined in the nephrology clinic. High calcium was detected in his secondary urine. What hormone is likely to cause such change, if it is produced in excess?
Aldosterone
Adrenaline
Glucagon
Testosterone
Oxytocin
153 із 200
A young woman presents with a tumor along the auditory nerve. The tumor is node-shaped, 3 cm in diameter, soft and elastic, pink-white colored, and has homogeneous structure. Microscopically the tumor contains bundles of cells with oval nuclei. These cellular fibrous bundles form regular structures made up of parallel rows of regularly oriented cells arranged in the form of a palisade with acellular homogeneous area in between (Verocay bodies). Name this type of tumor:
Neurinoma
Ganglioneuroma
Malignant neurinoma
Ganglioneuroblastoma
Neuroblastoma
154 із 200
A patient has undergone surgical removal of the pylorus. Decreased secretion of the following hormone can be expected:
Gastrin
Histamine
Secretin
Gastric inhibitory polypeptide
Cholecystokinin
155 із 200
An electron micrograph shows a small vessel with endothelial layer but without basement membrane and pericytes; anchoring fibrils are present. Name this vessel:
Lymph capillary
Arteriole
Venule
Sinusoid hemocapillary
Visceral hemocapillary
156 із 200
One of the causes of pernicious anemia is disturbed synthesis of transcorrin -Castle’s intrinsic factor - by the parietal cells of the stomach. What substance is called Castle’s extrinsic factor?
Cobalamin
Pyridoxine
Riboflavin
Biotin
Folic acid
157 із 200
A patient with contact dermatitis needs to be prescribed an antihistamine drug without somnolescent effect. Select this drug from the list:
Loratadine
Ranitidine
Dimedrol (Benadryl)
Diprazine (Promethazine)
Suprastin (Chloropyramine)
158 із 200
Congenital pyruvate carboxylase deficiency causes physical and mental retardation in children and leads to early death. It is characterized by lactic acidemia, lactaci-duria, and a number of metabolic disorders. Among others, inhibition of the following occurs:
Citric acid cycle and gluconeogenesis
Glycogenesis and glycogenolysis
Glycolysis and glycogenolysis
Lipolysis and lipogenesis
Pentose-phosphate pathway and glycolysis
159 із 200
A woman with enteritis accompanied by severe diarrhea presents with loss of water in the extracellular space, increased water content in the cells, and decreasing blood osmolarity. Name this type of water-electrolyte imbalance:
Hypoosmolar hypohydration
Hypoosmolar hyperhydration
Hyperosmolar hypohydration
Hyperosmolar hyperhydration
Isoosmolar hypohydration
160 із 200
To stimulate the labor activity a parturient woman was prescribed a drug - a posterior pituitary hormone that does not affect the blood pressure. As the pregnancy progresses, the sensitivity to this hormone increases. Name the prescribed drug:
Oxytocin
Ergotal
Pituitrin
Dinoprost
Dinoprostone
161 із 200
Cell membrane rest potential changed from -85 to -90 mV It can be caused by activation of the following cell membrane channels:
Potassium
Sodium
Calcium
Potassium and sodium
Potassium and calcium
162 із 200
Ionizing radiation or vitamin E deficiency affect the cell by increasing lysosome membrane permeability. What are the possible consequences of this pathology?
Partial or complete cell destruction
Formation of maturation spindle
Intensive energy production
Intensive protein synthesis
Restoration of cytoplasmic membrane
163 із 200
A patient is diagnosed with glucocerebroside lipidosis (Gaucher’s disease) that manifests as splenomegaly, liver enlargement, affected bone tissue, and neuropathies. What enzyme of complex lipid catabolism is deficient, thus causing this disease?
Glucocerebrosidase
Hyaluronidase
в-galactosidase
Hexosaminidase
Sphingomyelinase
164 із 200
A 3-year-old girl with mental retardation has been diagnosed with sphingomyelin lipidosis ( Niemann-Pick disease). In this condition the synthesis of the following substance is disturbed :
Sphingomyelinase
Ceramides
Sphingosine
Glycosyltransferase
Gangliosides
165 із 200
A traumatology unit has received a patient with a wrist trauma and a clinical presentation of the damage to the nerve that passes through the carpal tunnel. Name this nerve:
N. medianus
N. radialis
N. axillaris
N. musculocutaneus
N. ulnaris
166 із 200
A patient, who has been taking ft-adrenergic blockers, developed a bronchial spasm. What group of bronchodilators should be chosen to stop the bronchial spasm?
Myotropic antispasmodics
Muscarinic cholinomimetic agents
Indirect adrenergic agonists
в-adrenergic blockers
Cholinesterase inhibitors
167 із 200
A man has an inguinal hernia. The hernial sac exits through the following opening:
Anulus superficialis canalis inguinalis
Foramen suprapiriforme
Anulus profundus canalis inguinalis
Linea alba
Anulus femoralis
168 із 200
After a nephrectomy the patient developed enteroparesis. What cholinergic agent with anticholinesterase action should be prescribed in this case?
Proserin
Pilocarpine
Acetylcholine
Aceclidine
Carbacholine
169 із 200
Parenchyma of an organ is composed of pseudounipolar neurons localized under the capsule of connective tissue. Central place belongs to nerve fibers. Name this organ:
Spinal ganglion
Intramural ganglion
Nerve trunk
Sympathetic ganglion
Spinal cord
170 із 200
An obstetrician-gynecologist measures pelvis size of a pregnant woman. A caliper was used to measure the distance between the two iliac crests. What measurement of large pelvis was made?
Distantia cristarum
Conjugata vera
Conjugata anatomica
Distantia spinarum
Distantia throchanterica
171 із 200
Genetic recombination is achieved via several mechanisms. One such mechanism is crossingover. It occurs at the following stage of prophase in the first meiotic division:
Pachynema
Diakinesis
Zygonema
Diplonema
Leptonema
172 із 200
ECG of the patient shows increased duration of the QRS complex. What is the most likely cause?
Increased period of ventricular excitation
Increased atrial excitability
Disturbed conduction in the atrioventricular node
Increased period of atrial excitation
Increased atrial and ventricular excitability
173 із 200
A 50-year-old inpatient during examination presents with glucosuria and blood glucose of 3.0 mmol/L, which are the most likely to be caused by:
Renal disorder
Essential hypertension
Myxedema
Diabetes insipidus
Pellagra
174 із 200
A 40-year-old woman was diagnosed with glomerulonephritis based on her clinical symptoms and the results of urine analysis. Anamnesis states chronic tonsillitis. What microorganisms are the most likely cause for her kidney damage?
Streptococci
Mycoplasma
Escherichia
Meningococci
Staphylococci
175 із 200
A 7-year-old child presents with marked signs of hemolytic anemia. Biochemical analysis of erythrocytes determined low concentration of NADPH and reduced glutathione. What enzyme is deficient in this case leading to the biochemical changes and their clinical manifestations?
Glucose-6-phosphate dehydrogenase
Lactate dehydrogenase
Pyruvate kinase
Fructokinase
Hexokinase
176 із 200
When examining a biopsy material obtained from the thyroid gland, the pathologist discovered lymphocyte infiltration of the thyroid tissues and destruction of the parenchymal elements. Diffuse lymphocyte infiltration with lymphoid follicles was detected in the stroma. What is the most likely diagnosis?
Hashimoto’s thyroiditis (chronic lymphocytic thyroiditis)
Graves’ disease (toxic diffuse goiter)
Papillary thyroid cancer
Solid adenoma of the thyroid
Undifferentiated thyroid carcinoma
177 із 200
An 8-year-old girl presents with signs of disturbed twilight vision. This condition is caused by the deficiency of vitamin:
A
E
D
K
F
178 із 200
A 25-year-old young man came to the doctor complaining of general weakness, rapid fatigability, irritability, reduced working ability, and bleeding gums. What vitamin is likely to be deficient in this case?
Ascorbic acid
Retinol
Thiamine
Riboflavin
Folic acid
179 із 200
A 52-year-old man presents with fever and pain in the joints. Both of his first metatarsophalangeal articulations are deformed, swollen, and reddened. Blood urea is high. The patient is diagnosed with gout. What is the main developmental factor in the pathogenesis of this disease?
Hyperuricemy
Hyperazotemia
Hyperaminoacidemia
Argininosuccinic aciduria
Citrullinuria
180 із 200
A person with the fourth blood group (genotype IAIB) has in erythrocytes both antigen A controlled by allele IA and antigen B controlled by allele IB. This phenomenon is an example of the following gene interaction:
Codominance
Complementarity
Epistasis
Polymery
Semidominance
181 із 200
Vascular endothelium is characterized by high metabolic activity and synthesizes vasoactive substances. Among these substances there is a potent vasodilator synthesized from L-arginine. Name this vasodilator:
Nitrogen oxide
Adrenaline
Acetylcholine
Bradykinin
Histamine
182 із 200
A victim of a traffic accident was received by the intensive care unit. The patient is in a grave condition that can be characterized as a severe pathologic process that leads to exhaustion of vital functions and puts the patient into the marginal state between life and death due to critical reduction of capillary circulation in the affected organs. The patient is in the state of:
Shock
Preagony
Coma
Collapse
Agony
183 із 200
A person becomes less receptive to pain in physically or emotionally straining situations due to activation of:
Antinociceptive system
Nociceptive system
Parasympathetic nervous system
Adrenal glands functions
Thyroid gland functions
184 із 200
A patient suffers from posttraumatic hemorrhage that resulted in development of hemorrhagic shock. What volume of circulating blood was lost by the patient?
25-40%
50-75 %
12-25 %
3-20 %
40-50 %
185 із 200
A patient with pulmonary tuberculosis is prescribed the most effective antituberculous antibiotic. Name this drug:
Rifampicin
Streptocide
Tetracycline
Bactrim (Co-trimoxazole)
Furasolidone
186 із 200
During surgery performed in abdominal cavity a surgeon located the ligament of liver stretching from the anterior abdominal wall (navel) to the inferior surface of liver. What ligament is it?
Round ligament of the liver
Triangular ligament of the liver
Falciform ligament of the liver
Venous ligament of the liver
Coronary ligament of the liver
187 із 200
A patient has disturbed blood supply to the anterior papillary muscle of the left ventricle. What cardiac artery supplies this muscle with blood?
Ramus interventricularis anterior
A. coronaria dextra
Ramus interventricularis posterior
Ramus marginalis
Ramus circumflexus
188 із 200
Autopsy of the body of an elderly man revealed yellow spots' and streaks in the aortic intima and white-yellow protruding plaques in the area of aortic bifurcation. Microscopy (with hematoxylin and eosin staining) shows round cavities in the thickened aortic intima. The cavities color orange when stained with sudan 3 and are surrounded with overgrown connective tissue. What process developed in the aortic intima?
Metabolic disorder of cholesterol and cholesterol ethers
Metabolic disorder of neutral fat
Secondary amyloidosis
Local hyalinosis
Systemic hyalinosis
189 із 200
An 18-year-old patient has developed candidiasis after the case of pneumonia treated with ^lactam antibiotic. What antimycotic agent should be prescribed?
Fluconazole
Phthalylsulfathiazole
Trimethoprim/sulfamethoxazole (Bi-septol)
Streptomycin
Ampicillin
190 із 200
Preventive vaccination against poliomyelitis is made with inactivated vaccine introduced parenterally. What immunoglobulins create the postvaccinal immunity in this case?
IgM, IgG
IgG, secretory IgA
IgM, secretory IgA
Serum ^А, IgM
Ig£, IgM
191 із 200
During pregnancy a woman has been taking an antiepileptic drug - sodium valproate. It resulted in her child developing a vertebral column malformation - spina bifida. Name the described effect of the drug:
Teratogenic effect
Sensitizing effect
Immunosuppressive effect
Acquired tolerance
Dependence
192 із 200
A patient was prescribed atropine sulfate to treat intestinal colic. What concomitant disease can be a contraindication for this drug?
Glaucoma
Sinus bradycardia
Bronchial asthma
Hypotension
Vertigo
193 із 200
A patient has developed status epilepti-cus. What medicine should be used in this case to stop the seizures?
Diazepam
Cyclodol (Trihexyphenidyl)
Sodium bromide
Valerian extract
Diprazine (Promethazine)
194 із 200
A 48-year-old man is unconscious. He has a history of several syncopal episodes with convulsions. ECG shows deformed QRS complexes unconnected with P waves, atrial contractions are approximately 70/min., ventricular contractions -25-30/min. Name the type of arrhythmia in this case:
Complete atrioventricular block
Second-degree atrioventricular block
First-degree atrioventricular block
Intraatrial block
Intraventricular block
195 із 200
In human organism significant blood loss leads to decreased blood pressure, tachycardia, and weakness. Eventually the sensation of thirst appears. What hormone participates in the development of this sensation?
Angiotensin 2
Adrenalin
Dopamine
Serotonin
Cortisol
196 із 200
After a trauma the man has lost skin sensitivity on the lateral surface of his forearm. What nerve of the brachial plexus provides sensitivity of the affected area?
N. musculocutaneus
N. axillaris
N. medianus
N. radialis
N. ulnaris
197 із 200
Autopsy of a 50-year-old woman, who had been suffering from systemic connective tissue disease, reveals small dense kidneys with lumpy surface. Microscopy of the renal glomeruli detects there foci of fibrinoid necrosis, hyaline thrombi, hematoxylin bodies, and so-called ”wire loop thickening” of the basement membranes. What disease can be characterized by such changes in the kidneys?
Systemic lupus erythematosus
Rheumatism
Scleroderma
Rheumatoid arthritis
Dermatomyositis
198 із 200
A 4-year-old child presents with numerous carious cavities and yellow-colored teeth. The mother has a history of antibiotic treatment during her pregnancy. What antibiotic was the most likely taken by the child’s mother?
Doxycycline
Cefazolin
Ampicillin
Erythromycin
Streptomycin sulfate
199 із 200
A patient developed pyoinflammatory process of periodontal tissues caused by activation of the microorganisms inherent in the body, which are a part of oral mucosal microflora. What type of infection is it?
Autoinfection
Exogenous infection
Reinfection
Superinfection
Relapse
200 із 200
After a hand fracture the man has lost the ability to touch his little finger with the thumb on the affected hand. Examination of the palmar surface shows one of the palmar muscles to be atrophied. Name the affected muscle:
M. opponens policis
M. palmaris brevis
M. flexor digiti minimi
Mm. interossei
Mm. lumbricales