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Step 1 - Medicine 2019
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The mother’s karyotype has 45 chromosomes. It was determined that translocation of chromosome 21 to chromosome 14 had occurred. What disorder is likely to be observed in the child of this woman if the father’s karyotype is normal
Down syndrome
Klinefelter syndrome
Patau syndrome
Edwards syndrome
Morris syndrome (androgen insensitivity)
3 із 144
During regular examination of schoolchildren, a scrape from the perianal folds of a 10-year-old girl shows asymmetrical oval eggs with larvae inside. What diagnosis can be made
Enterobiasis
Amebiasis
Trichuriasis
Ascariasis
Ancylostomiasis
4 із 144
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 140х70 micron in size, with a terminal spike. What diagnosis can be made by the infectious diseases specialist?
Schistosomiasis
Paragonimiasis
Fascioliasis
Opisthorchiasis
Dicroceliasis
5 із 144
Cells of a person working in the Chornobyl Exclusion Zone have undergone a mutation in DNA molecule. However, with time the damaged interval of DNA molecule restored ist initial structure with a specific enzyme. In this case the following occurred:
Repair
Reverse transcription
Replication
Transcription
Translation
6 із 144
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
Transcription
Repair
Translation
Replication
7 із 144
The parents with normal hearing have two daughters and a son, who are congenitally deaf. Their other 5 children are healthy. What is the pattern of deafness inheritance in this case
Autosomal recessive
Autosomal dominant
X-linked recessive
Y-linked
X-linked dominant
8 із 144
Ingestion of plants and mushrooms that grow along highways is dangerous due to risk of lead poisoning. What is the main source of environmental pollution with this chemical element
Exhaust fumes
Herbicides
Sewage
Acid rains
Chemical fertilizers
9 із 144
Long-term taking of medicines can affect cells of the liver. Particularly, it can cause marked hypertrophy of agranular endoplasmic reticulum due to the following function of this organelle:
Detoxication of harmful substances
Formation of maturation spindle
Nucleic acid synthesis
Intracellular digestion
Protein synthesis
10 із 144
Dwellers of a village located in the taiga make a living by harvesting berries. Lately the occurrence of alveococcosis in the village population has increased. What is the source of invasion in this case
Foxes
Sick people
Fish
Birds
Rodents
11 із 144
A patient with severe poisoning was brought into the intensive care unit. In the course of complex treatment the subclavian vein needs to be catheterized for medicine administration. This vein is located in the following topographic structure:
Spatium antesсalenum
Spatium interscalenum
Trigonum omotrapezoideum
Spatium retrosternocleidomastoideus
Spatium interaрoneuroticum suprasternale
12 із 144
A 52-year-old woman came to the neurologist with complaints of loss of skin sensitivity on the right half of her face in the area of the lower eyelid, nasal arch, and upper lip. What branch of what nerve is damaged in this patient
Maxillary branch of the trigeminal nerve
Ophthalmic branch of the trigeminal nerve
Greater petrosal nerve branching from the facial nerve
Chorda tympani branching from the facial nerve
Mandibular branch of the trigeminal nerve
13 із 144
A patient with periodontitis of the lower molar came to the doctor. It was determined that the inflammatory process spread to the lymph nodes. What lymph nodes were the first to be affected by the inflammatory process
Submandibular
Anterior cervical
Facial
Submental
Lateral cervical
14 із 144
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 mediale
Segmentum apicale (superius) et segmentum basale mediale
Segmentum anterius et segmentum apicale
Segmentum lingualare superius et inferius
Segmentum basale anterius et posterius
15 із 144
A 30-year-old man with an incised wound on the plantar surface of the left foot was brought to the traumatology department. Lifting of the lateral side of the foot is limited. What muscle is likely to be functionally disturbed
Peroneus longus muscle
Flexor hallucis longus muscle
Triceps muscle of calf
Anterior tibial muscle
Soleus muscle
16 із 144
ovarian tumor was detected in a woman. She is prescribed a surgery. What ligament should be severed by the surgeon to separate the patient’s ovary from the uterus
Proper ovarian ligament
Broad ligament of the uterus
Round ligament of the uterus
Lateral umbilical ligament
Suspensory ligament of the ovary
17 із 144
A 45-year-old woman presents with breast cancer. Metastases can spread in this case to the following regional lymph nodes:
Axillary, parasternal
Abdominal, cervical
Cervical, parasternal
Parasternal, bronchomediastinal
Aortic, bronchomediastinal
18 із 144
A 35-year-old man with a hand injury came to the traumatology department. Examination revealed an incised wound on the palmar surface of the left hand; middle phalanges of digits II-IV cannot be flexed. What muscles are damaged
Flexor digitorum superficialis
Lumbrical muscles
Flexor digitorum profundus
Dorsal interossei
Palmar interossei
19 із 144
Clinical course of urolithiasis was complicated by the passage of a renal calculus. Where in the ureter is it most likely to stop
At the border between the abdominal and pelvic segments
2 cm above the entrance to the urinary bladder
In the middle of the abdominal segment
5 cm above the pelvic segment
In the renal pelvis
20 із 144
The surgeon noticed aggregated lymphoid nodules (Peyer’s patches) on the intestinal mucosa. What portion of the intestine is it
Ileum
Rectum
Jejunum
Duodenum
Cecum
21 із 144
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
Celiac trunk
Splenic artery
Middle colic artery
Superior mesenteric artery
22 із 144
A patient presents with an inner ear inflammation. On examination the doctor states that the 1st neurons of the auditory analyzer are affected. Where are these neurons located
G. spirale
G. trigeminale
G. geniculi
G. ciliare
G. vestibulare
23 із 144
A victim has received a deep incised stab wound to the upper posterior surface of the shoulder. Extension of elbow, hand, and digits is impaired; skin sensitivity of the posterior surface of the shoulder and forearm is lost. What nerve is damaged in this case
N. radialis
N. musculocutaneus
N. cutaneus brachii medialis
N. medianus
N. ulnaris
24 із 144
During an invasive operation the surgeon needs to access the omental bursa of the peritoneal cavity via the omental foramen (foramen of Winslow). What anatomical structure makes up the anterior border of this foramen
Hepatoduodenal ligament
Visceral surface of liver
Hepatorenal ligament
Superior part of duodenum
Greater omentum
25 із 144
Histone protein synthesis is artificially blocked in a cell. What cell structure will be damaged as a result
Nuclear chromatin
Golgi apparatus
Nuclear membrane
Nucleolus
Cell membrane
26 із 144
Some diseases of large intestine lead to the changes in the quantitative ratio between mucosal epithelial cells. What cell types are normally predominant in the cryptal epithelium of the large intestine
Goblet cells
Endocrine cells
Ciliated columnar epithelial cells
Cells with acidophilic granules
Poorly differentiated cells
27 із 144
Examination of a surgically excised adrenal gland shows large cells that can be impregnated with a potassium dichromate solution. What hormone is being synthesized by these cells
Adrenaline
Thyroxine
Secretin
Cholecystokinin
Aldosterone
28 із 144
inflammation can be characterized by hemocapillary dilation in the affected area, decreased blood circulation, and increased vessel wall permeability. What cells play the key role in this process
Tissue basophils
Eosinophils
Macrophages
Fibroblasts
Plasma cells
29 із 144
A histological specimen demonstrates a vessel with the wall that consists of endothelium, basement membrane, and loose connective tissue. This vessel belongs to the following type:
Non-muscular vein
Lymph capillary
Artery
Hemocapillary
Muscular vein
30 із 144
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
Sympathetic ganglion
Nerve trunk
Spinal cord
Intramural ganglion
31 із 144
A histological specimen shows significant amount of mucous connective tissue (Wharton’s jelly), vessels, as well as remnants of yolk sac stalk and allantois. Name this organ:
Umbilical cord
Esophagus
Vermiform appendix
Urethra
Ureter
32 із 144
A 40-year-old woman on examination presents with intensified basal metabolic rate. What hormone present in excess leads to such condition
Triiodothyronine
Somatostatin
Glucagon
Aldosterone
Thyrocalcitonin
33 із 144
Toxic damage to hepatic cells resulted in disruption of the patient’s liver function and the patient developed edemas. What changes of blood plasma are the main cause of edema development
Decrease of albumin content
Increase of albumin content
Increase of globulin content
Decrease of fibrinogen content
Decrease of globulin content
34 із 144
isolated heart was used to study excitation conduction velocity in different areas of the heart. What area had the lowest velocity of excitation conduction
Atrioventricular node
Purkinje fibers
Atrial myocardium
Ventricular myocardium
His bundle
35 із 144
A 40-year-old person developed elevated blood pressure after an emotional excitement. What is the likely cause of this effect
Increased sympathetic nervous system tone
Increased parasympathetic nervous system tone
Decreased cardiac contraction frequency
Hyperpolarization of cardiomyocytes
Arteriolar dilation
36 із 144
A patient has elevated blood pressure due to increased vascular tone. To lower the blood pressure in this case it is necessary to prescribe the blockers of:
alpha-adrenoceptors
Muscarinic acetylcholine receptors
alpha- and beta-adrenoceptors
beta-adrenoceptors
Histamine H1 receptors
37 із 144
ABO blood group is being determined. Erythrocyte agglutination occurred when standard sera of group I and group II were introduced into the blood being analyzed, while group III serum caused no agglutination. What agglutinogens do these erythrocytes have
B
C
D and C
A
A and B
38 із 144
What changes can be expected to occur in the isolated heart of a toad, if excessive amount of calcium chloride is introduced into its perfusate
Increased cardiac contraction force and frequency
Decreased cardiac contraction force
Diastolic cardiac arrest
Increased cardiac contraction force
Increased cardiac contraction frequency
39 із 144
After hyperventilation an athlete developed a brief respiratory arrest. It occurred due to the following changes in the blood:
Decrease of CO2 pressure
Increase of CO2 and O2 pressure
Increase of CO2 pressure
Decrease of O2 pressure
Decrease of pH
40 із 144
A person has increased pulmonary ventilation due to physical exertion. What indicator of external respiration will be significantly increased compared to the resting state
Respiratory volume
Inspiratory reserve volume
Vital lung capacity
Expiratory reserve volume
Total lung capacity
41 із 144
A patient developed punctate hemorrhages after a tourniquet had been applied. It occurred due to functional disturbance of the following blood corpuscles:
Platelets
Neutrophils
Monocytes
Lymphocytes
Eosinophils
42 із 144
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
43 із 144
After a certain CNS structure had been destroyed in a test animal, this animal lost its orienting reflexes. What structure had been destroyed
Corpora quadrigemina
Medial reticular nuclei
Red nuclei
Lateral vestibular nuclei
Substantia nigra
44 із 144
On examination the patient was determined to have a strong, balanced, inert type of higher nervous activity according to Pavlov’s classification. What temperament according to Hippocrates is it
Phlegmatic
Melancholic
-
Sanguine
Choleric
45 із 144
A 45-year-old woman presents with insufficient secretion of enterokinase enzyme. Enterokinase deficiency can cause disturbance of the following digestive function:
Protein hydrolysis
Vitamin absorption
Carbohydrate hydrolysis
Lipid hydrolysis
Lipid absorption
46 із 144
Systemic blood pressure of a person equals 120/65 mm Hg. Blood ejection into aorta occurs when left ventricular pressure exceeds:
65 mm Hg
120 mm Hg
100 mm Hg
90 mm Hg
10 mm Hg
47 із 144
Prolonged vomiting resulted in dehydration of the patient’s body. Under these conditons, water retention in the body is ensured primarily due to increased secretion of the following hormone:
Vasopressin
Calcitonin
Natriuretic hormone
Aldosterone
Adrenaline
48 із 144
KCl concentration in a solution that surrounds an isolated cell was increased. How will resting membrane potential (RMP) and cell excitability change in this case
RMP decreases, excitability increases
RMP decreases, excitability remains unchanged
RMP increases, excitability increases
RMP and excitability remain unchanged
RMP increases, excitability decreases
49 із 144
Human brain produces endogenous peptides that are similar to morphine and can reduce pain perception. Name these peptides:
Endorphins
Liberins
Oxytocin
Vasopressin
Statins
50 із 144
I.M. Siechenov has proven that a tired limb restores its working capacity faster if during its period of rest another limb works. It became a basis for the concept of:
Active rest
Optimum
Parabiosis
Pessimum
Fatigue
51 із 144
Domestic accident has resulted in a significant blood loss in the patient, which was accompanied by a drop in blood pressure. What hormones ensure quick restoration of the blood pressure caused by a blood loss
Adrenaline, vasopressin
Aldosterone
Cortisol
Reproductive hormones
Oxytocin
52 із 144
An experiment was conducted to measure the skin sensitivity threshold. What patches of skin have the highest sensitivity threshold
Back
Dorsal surface of the hand
Shin
Shoulder
Face
53 із 144
A student, whose educational achievements throughout the semester were poor, feels emotionally tense during the final test. What is the primary cause that induced the leading mechanism of emotional tension in this case
Lack of information
Lack of time and energy
Lack of energy and information
Lack of energy
Lack of time
54 із 144
After a trauma the patient has developed right-sided paralyses and disturbed pain sensitivity. On the left side no paralyses are observed, but pain and thermal sensitivity is disturbed. What is the cause of this condition
Unilateral right-side spinal cord injuiry
Midbrain injury
Motor cortex injury
Brainstem injury
Cerebellar injury
55 із 144
A 3-year-old child with elevated body temperature has taken aspirin and developed increased hemolysis of erythrocytes. In this case hemolytic anemia can be caused by congenital deficiency of the following enzyme:
Glucose 6-phosphate dehydrogenase
Glucose 6-phosphatase
Glycerol-phosphate dehydrogenase
Glycogen phosphorylase
Gamma-glutamyl transferase
56 із 144
Collagenosis patients typically present with the processes of connective tissue destruction. The presence of these processes can be confirmed by the increase in:
Blood oxyproline and oxylysine
Blood urates
Transaminase activity in the blood
Blood creatine and creatinine
LDH-isoenzyme activity in the blood
57 із 144
During diabetes mellitus and starvation, the number of acetone bodies in blood increases. These bodies are used as a source of energy and are synthesized from the following substance:
Acetyl-CoA
Citrate
Malate
Ketoglutarate
Succinyl-CoA
58 із 144
Blood test of the patient revealed albumine content of 20 g/L and increased activity of lactate dehydrogenase isoenzyme 5 (LDH5). These results indicate disorder of the following organ:
Liver
Kidneys
Heart
Spleen
Lungs
59 із 144
A patient presents with an 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
Starch granules
Connective tissue
Positive reaction to stercobilin
60 із 144
A patient with diabetes mellitus after an insulin injection lost his consciousness and developed convulsions. What will be the result of a biochemical test for blood glucose level in this case
2.5 mmol/L
5.5 mmol/L
8.0 mmol/L
3.3 mmol/L
10 mmol/L
61 із 144
A 27-year-old patient presents with pathologic changes in the liver and brain. Blood plasma exhibits acute decrease in copper levels, while urine copper levels are elevated. The patient is diagnosed with Wilson disease. To confirm this diagnosis it is necessary to measure activity of the following enzyme in the patient’s blood serum:
Ceruloplasmin
Carbonic anhydrase
Alcohol dehydrogenase
Leucine aminopeptidase
Xanthine oxidase
62 із 144
The Gerontology Institute recommends older people to take vitamin complexes that contain vitamin E. What is the main function of this vitamin
Antioxidant
Antineuritic
Antihemorrhagic
Antiscorbutic
Antidermatitic
63 із 144
Ammonia is extremely toxic for human CNS. What is the main way of ammonia neutralization in the nervous tissue
Glutamine synthesis
Ammonium salts synthesis
Transamination
Urea synthesis
Formation of paired compounds
64 із 144
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
Accumulation of creatinine in muscles
Increased content of ADP in muscles
Decreased content of lipids in muscles
Intensive breakdown of muscle proteins
65 із 144
Human genetic apparatus consists of approximately 30 thousand of genes, while the number of antibody variants can be as high as millions. What mechanism leads to formation of new genes that ensure the synthesis of such a number of antibodies
Genetic recombination
Gene amplification
DNA repair
Formation of Okazaki fragments
DNA replication
66 із 144
Chronic overdose of glucocorticoids leads to the development of hyperglycemia in a patient. Name the process of carbohydrate metabolism that results in elevated blood glucose levels:
Gluconeogenesis
Glycogenolysis
Aerobic glycolysis
Glycogenesis
Pentose-phosphate pathway
67 із 144
A patient for a long time was on an imbalanced diet low in proteins, which resulted in hepatic fatty infiltration. This condition is likely to develop if a certain substance is absent in a person’s diet. Name this substance:
Methionine
Biotin
Cholesterol
Acetic acid
Alanine
68 із 144
A patient, who has been subsisting exclusively on polished rice, has developed polyneuritis due to thiamine deficiency. What substance is an indicator of such avitaminosis, when it is excreted with urine
Pyruvic acid
Uric acid
Methylmalonic acid
Malate
Phenyl pyruvate
69 із 144
A 40-year-old man with pulmonary tuberculosis was prescribed isoniazid. Prolonged taking of this drug can result in development of the following vitamin deficiency:
Pyridoxine
Biotin
Cobalamin
Folic acid
Thiamine
70 із 144
Disturbed activity of trypsin and chymotrypsin leads to disturbed protein breakup in the small intestine. Activity of these enzymes depends on the presence of the following factor:
Enterokinase
N a+ salts
Bile acids
Pepsin
Hydrochloric acid
71 із 144
A newborn presents with weak suckling, frequent vomiting, and hypotonia. Blood and urine citrulline are very high. What metabolic process is disturbed
Ornithine cycle
Gluconeogenesis
Cori cycle
Tricarboxylic acid cycle
Glycolysis
72 із 144
Patients with ischemic heart disease are usually prescribed small doses of aspirin. This drug inhibits synthesis of platelet aggregation activator, thromboxane A2. What substance is this activator synthesized from
Arachidonic acid
Glutamic acid
Acetic acid
Homogentisic acid
Malonic acid
73 із 144
A patient with myocardial infarction in the acute phase has been hospitalized into the cardiology unit. To induce platelet lysis in the patient’s coronary vessels during the early hours of infarction, the following enzyme should be used:
Streptokinase
Hyaluronidase
Trypsin
Lysozyme
Chymotrypsin
74 із 144
In the hematology unit a patient with leukemia was prescribed 5-Fluorouracil. This drug:
Inhibits DNA synthesis
Inhibits translation
Stimulates DNase
Catalyzes replication
Inhibits transcription
75 із 144
A 7-year-old boy is diagnosed with anemia. Laboratory analysis detects pyruvate kinase deficiency in his erythrocytes. What process is disturbed in this boy, playing the main role in anemia development in this case
Anaerobic glycolysis
Decarboxylation of amino acids
Gluconeogenesis
Deaminization of amino acids
Anaerobic glycogenolysis
76 із 144
Examination of a patient shows decreased leukocyte and erythrocyte count and low hemoglobin levels in peripheric blood, as well appearance of large cells (megaloblasts). What vitamin deficiency can cause these clinical presentations
Folic acid
Riboflavin
Biotin
Niacin
Ascorbic acid
77 із 144
Wernicke-Korsakoff syndrome often develops in chronic alcoholics, who have a low-vitamin diet. Decreased transketolase activity can be observed in the course of this disease. What vitamin deficiency causes this development
Thiamine
Riboflavin
Cobalamin
Niacin
Retinol
78 із 144
A patient was hospitalized in a comatose state. The patient has a 5-yearlong history of diabetes mellitus type 2. Objectively respiration is noisy, deep, with acetone breath odor. Blood glucose is 15.2 mmol/L, ketone bodies - 100 micromol/L. These signs are characteristic of the following diabetes complication:
Ketoacidotic coma
Hyperglycemic coma
Hyperosmolar coma
Hepatic coma
Hypoglycemic coma
79 із 144
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
Initiation
Promotion
-
Transformation
80 із 144
After a prolonged attack of severe headache the patient lost mobility in his left arm and leg. Muscle tone is decreased in the affected limbs, the muscles are spasmed, spinal tendon reflexes are acutely intensified, reflex zones are increased. What nervous system disorder can be observed in this patient
Central paralysis
Extrapyramidal paralysis
Peripheral paralysis
Flaccid paralysis
Reflex paralysis
81 із 144
Hematologic study shows the following pattern: erythrocytes - 2, 8 • 1012/L, Нb - 80 g/L, color index - 0.85, reticulocytes - 0,1%, platelets - 160 thousand per microliter, leukocytes - 60 • 109 /L. Basocytes - 2%, eosinophils - 8%, promyelocytes - 5%, myelocytes - 5%, juvenile - 16%, stab neutrophils - 20%, segmented neutrophils - 34%, lymphocytes - 5%, monocytes - 5%. This clinical presentation indicates the following blood pathology:
Chronic myeloleukemia
Undifferentiated leukemia
Hemolytic anemia
Hypoplastic anemia
Acute myeloleukemia
82 із 144
Antileukocytic antibodies are detected in the blood of a patient with leukopenia. What type of Coombs-Gell hypersensitivity reaction developed in this case
Cytotoxic
Delayed-type hypersensitivity
Anaphylactic
Immune complex-mediated
Stimulating
83 із 144
A patient with obliterating endarteritis has undergone a ganglionic sympathectomy. Positive therapeutic effect of this surgery is associated with development of arterial hyperemia of the lower limbs, which can be described as:
Neuroparalytic
Reactive
Metabolic
Working
Neurotonic
84 із 144
In an experiment a laboratory rat was subjected to a stress factor (electric current), which resulted in muscular hypotonia, arterial hypotension, hypothermia, and hypoglycemia in the animal. What period of general adaptation syndrome is it
Shock phase
Resistance stage
-
Exhaustion stage
Antishock phase
85 із 144
A 14-year-old adolescent has diphtheria. During the peak of the disease against the background of acute drop in body temperature and tachycardia the blood pressure is 70/50 mm Hg. What type of vascular tone disturbance is it
Acute hypotension
Somatoform autonomic dysfunction
-
Chronic hypotension
Essential hypotension
86 із 144
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
Deceleration of leukocyte migration to the tissues
Decreased leukocyte disintegration
Immunity activation
Leukocyte redistribution
87 із 144
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
Functional cardiac overload
Coronary artery thrombosis
Coronary atherosclerosis
Intravascular aggregation of blood cells
88 із 144
A 30-year-old person has been stung by a bee. The stung area exhibits edema, hyperemia, and elevated temperature. What is the initial pathogenetic factor of inflammatory edema in this case
Increase of microvascular permeability
Increase of capillary blood pressure
Disturbed lymphatic efflux
Decrease of oncotic blood pressure
Increase of osmotic pressure in the inflammation focus
89 із 144
A 30-year-old woman developed facial edemas. Examination detected proteinuria (5.87 g/L), hypoproteinemia, dysproteinemia, and hyperlipidemia. Such combination of signs is characteristic of:
Nephrotic syndrome
Chronic pyelonephritis
Chronic kidney failure
Nephritic syndrome
Acute kidney failure
90 із 144
An uconscious young man in the state of morphine intoxication has been brought into admission room. The patient’s respiration is slow and shallow due to suppression of the respiratory center. What kind of respiratory failure occurred in this case
Ventilatory disregulation
Perfusion
Ventilatory restriction
Diffusion
Ventilatory obstruction
91 із 144
A man has been working for a long time in oil processing. What type of carcinogens does he encounter at his workplace
Polycyclic aromatic hydrocarbons
Biological carcinogens
Nitrosamines
Amines
Amino-azo compounds
92 із 144
A patient has been suffering from bronchial asthma for 15 years. What changes in the patient’s leukogram can be expected in this case
Eosinophilia
Basophilia
Leukopenia
Left shift
Leukocytosis
93 із 144
A married couple came for a genetic counseling. The husband suffers from insulinindependent diabetes mellitus, while the wife is healthy. What is the probability of their child developing insulin-independent diabetes mellitus
Higher than in the population
Lower than in the population
The same as in the population
50 %
100 %
94 із 144
A laboratory rat with chronic kidney failure presents with osteoporosis, pathologic calcification of the internal organs, and arterial hypertension. These disturbances are associated with increased activity of the following hormone:
Parathyroid hormone
Adrenaline
Thyroxin
Calcitonin
Triiodothyronine
95 із 144
A patient is diagnosed with severe B12- deficiency anemia resulting in disturbed hematopoiesis and appearance of atypical erythrocytes in the blood. The patient has a history of total gastric resection. This diagnosis can be confirmed if the following cells are present in the peripheral blood:
Megalocytes
Normocytes
Microcytes
Elliptocytes
Anulocytes
96 із 144
A patient with asphyxia after a brief respiratory arrest developed single infrequent respirations with passive expiration, after which he stopped breathing completely. What type of respiration was observed in this case
Gasping respiration
Apneustic respiration
Cheyne-Stokes respiration
Biot respiration
Kussmaul respiration
97 із 144
A 3-year-old child has been brought by ambulance to the intensive care unit of the infectious diseases hospital. On examination the child is in severe condition, skin and mucosa are dry, tissue turgor is reduced. The patient’s history states that profuse diarrhea and recurrent vomiting were observed throughout the previous day after the child had eaten food products of poor quality. What type of salt and water imbalance is likely to have developed in the patient
Hypoosmolar dehydration
Isoosmolar hyperhydration
Isoosmolar dehydration
Hyperosmolar hyperhydration
Hypoosmolar hyperhydration
98 із 144
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
Intraatrial block
Second-degree atrioventricular block
First-degree atrioventricular block
Intraventricular block
99 із 144
A 40-year-old man with impaired venous patency in the lower limbs developed edemas. What mechanism plays the main role in the development of this disturbance
Elevated filtration pressure
Decreased gradient of osmotic pressure between blood and tissue
Hypoproteinemia
Positive fluid balance
Disturbed humoral regulation of watermineral balance
100 із 144
Autopsy of a 60-year-old woman, who for a long time had been suffering from essential hypertension, shows significantly diminished kidneys (weight of both kidneys is 80 g) with finely granular surface. Uniform renal cortical thinning can be observed on section. Name the described changes in the kidneys:
Primary contracted kidney
Secondary contracted kidney
Amyloid contracted kidney
Diabetic nephrosclerosis
Pyelonephritic contracted kidney
101 із 144
Autopsy of a 3-year-old child shows a tumor in the cerebellum. The tumor has no clear margins separating it from the surrounding tissues. Histologically it is made of small atypical cells with hyperchromic nuclei. This tumor is most likely a:
Medulloblastoma
Medullary sarcoma
Glioblastoma
Sarcoma metastasis
Cancer metastasis
102 із 144
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
Carneous degeneration
Atelectasis
Gangrene
Hemorrhage
103 із 144
Regional lymph nodes surrounding an infected wound are enlarged. Histological examination shows increased number of macrophages, lymphocytes, and lymphatic follicles in the cortical layer of the lymph nodes, as well as a large amount of plasma cells. What process in the lymph nodes is indicated by these histological changes
Antigen stimulation
Congenital deficiency of lymphoid tissue
Neoplastic aberration
Acquired deficiency of lymphoid tissue
Transplant rejection
104 із 144
A patient has gradually developed a skin plaque on his face. In the center of this plaque there are necrotic patch and ulcer. Histopathological analysis of the biopsy material reveals proliferation of atypical epithelial cells with large number of pathologic mitoses. What is the most likely diagnosis
Skin cancer
Sarcoma
Trophic ulcer
Fibroma
Papilloma
105 із 144
Histological analysis of a biopsy skin sample obtained from a 24-year-old patient detects caseous necrosis surrounded with cellular infiltrate consisting of lymphocytes, among which there are single giant cells; proliferation of connective tissue and endovasculites are observed. Characterize this pathologic process:
Proliferative granulomatous inflammation
Ichorous inflammation
Proliferative interstitial inflammation
Catarrhal inflammation
Abscess
106 із 144
Autopsy of a man, who had been suffering from mitral stenosis, reveals dense brown lungs. What pathologic process had occurred in the lungs
Hemosiderosis
Hemochromatosis
Jaundice
Hemomelanosis
Lipofuscinosis
107 із 144
A 63-year-old man, who has been suffering from chronic diffuse obstructive pulmonary emphysema for 15 years, died of progressive heart failure. Autopsy shows nutmeg liver cirrhosis, cyanotic induration of kidneys and spleen, ascites, and edemas of the lower limbs. What type of heart failure can be characterized by such changes in the internal organs
Chronic heart failure
Acute right ventricular failure
Acute left ventricular failure
Acute global heart failure
Chronic atrial failure
108 із 144
A 6-year-old girl presents with acute onset of a disease. She developed sore throat and high temperature that were later accompanied by a punctate skin rash. Oral examination reveals acute pharyngeal hyperemia, raspberry tongue, and enlarged bright red tonsils with dull gray and yellow foci that spread to the peritonsillar tissues. The submandibular lymph nodes are enlarged. What disease are these changes characteristic of
Scarlet fever
Pharyngeal diphtheria
Laryngeal diphtheria
Meningococcal nasopharyngitis
Measles
109 із 144
Autopsy of a man, who served on a nuclear submarine, revealed the following pathologies: bone marrow atrophy (panmyelophthisis), anemia, leukopenia, thrombocytopenia, lymphocytic disintegration in the lymph nodes, spleen, gastrointestinal lymphatic system, and hemorrhages into the adrenal glands. What disease had developed in this case
Acute radiation sickness
Vibration disease
Decompression sickness
Acute leukemia
Acute anemia
110 із 144
A 9-month-old child presents with delayed tooth eruption, improper sequence of tooth eruption, and horizontal maxillary configuration (high-arched palate). Microscopically enamel mineralization pattern is irregular, enamel columns are wrinkled, some of them are vacuolated, predentin zones are widened, single denticles can be observed. What disease is it
Early rickets
Late rickets
Osteomalacia
Gout
Hypervitaminosis D
111 із 144
Autopsy of a 58-year-old man, who for a long time has been drinking alcohol in large amounts and died at home, is being conducted. Macroscopically the right lung is dense and enlarged, its tissue is gray and homogeneous on section, its pleura is covered with grayish membranous deposits. Microscopically the alveolar cavities contain fibrin threads, neutrophils, and hemolysed erythrocytes. Make the diagnosis:
Croupous pneumonia
Caseous pneumonia
Focal pneumonia
Primary pulmonary tuberculosis
Interstitial pneumonia
112 із 144
Autopsy of a 49-year-old woman who died of chronic kidney failure shows small dense striated kidneys with areas of hemorrhages. Microscopically nuclei of epithelial channels contain hematoxylin bodies; glomerular capillaries resemble wire loops, have thickened basement membranes, and in places contain hyaline thrombi and foci of fibrinoid necrosis. What is the most likely diagnosis
Systemic lupus erythematosus
Atherosclerotic nephrosclerosis
Arteriolosclerotic nephrosclerosis
Rheumatism
Amyloidosis
113 із 144
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 herpetic infection
Prion infection
Generalized cryptococcosis
Meningococcemia
114 із 144
A 27-year-old woman has undergone a sector resection of mammary gland tissue. Macroscopy detects a dense white node, 4 cm in diameter, with clear margins in the excised tissue. Immediate histological analysis shows the tumor to consist of a large amount of fibrous stroma with stromal proliferation around the small canaliculi. Canalicular epithelium overlays the basement membrane and retains its polarity. Make the diagnosis:
Pericanalicular fibroadenoma
Sarcoma
Dyshormonal disorders
Adenocarcinoma
Cancer
115 із 144
In the course of an urgent surgery, the vermiform appendix of the patient was excised. The appendix was acutely distended and gray-black throughout its whole length. In the distal segment a defect of the appendix wall was detected, through which a foul-smelling gray-brown substance was being discharged from the appendix lumen. Histological analysis shows necrotization of the appendix wall with hemorrhagic foci; lumen of the mesenteric artery is filled with a trombus. What type of appendicitis is it
Acute gangrenous
Acute phlegmonous
Chronic
Acute superficial
Acute simple
116 із 144
A 39-year-old man underwent a surgery for peptic ulcer disease of the stomach. He died 7 days after the surgery. On autopsy the peritoneal layers are plethoric, dull, and covered with massive yellow-green membranous deposits. The peritoneal cavity contains approximately 300 mL of thick yellow-green fluid. What pathologic process was detected in the peritoneal cavity
Fibrinopurulent peritonitis
Serofibrinous peritonitis
Peritoneal commissures
Fibrinohemorrhagic peritonitis
Serous peritonitis
117 із 144
To test donor blood for hepatitis B antigens, it is necessary to use highly sensitive detection methods. What test should be used for this purpose
Solid-phase enzyme-linked immunosorbent assay
Immunoelectrophoresis
Indirect hemagglutination
Indirect immunofluorescence
Complement binding
118 із 144
The bacteriological laboratory has received for analysis a sample of dried fish from a focus of food poisoning outbreak. The bacteriologist inoculated the sample into a Kitt-Tarozzi medium, where growth of tennis racquetshaped microorganisms could be observed. These microorganisms are likely to be the causative agents of:
Botulism
Typhoid fever
Salmonellosis
Dysentery
Staphylococcal toxicoinfection
119 із 144
To determine toxigenicity of diphtheria causative agents obtained from patients, the cultures were inoculated in a Petri dish with nutrient agar, bilaterally to a strip of filter paper spotted with antidiphtheric antitoxic serum and situated in the center of the Petri dish. After incubation of the inoculated cultures in the agar, strip-like areas of medium turbidity formed between some of the cultures and the filter paper. What immunological test was conducted
Agar gel precipitation test
Coombs test
Agglutination test
Ring precipitin test
Opsonization test
120 із 144
The bacteriological laboratory needs to prepare for analysis of materials that are suspected to be contaminated with spores of anthrax causative agent. What diagnostic preparation allows for quick detection of these spores
Anti-anthrax fluorescent serum
Monoclonal antibodies to anthrax causative agent
Standard anthrax antigen
Anti-anthrax immunoglobulin
Enzyme-tagged immunoglobulin
121 із 144
A family has two children. The younger child is under a year. The child has developed spastic cough attacks. Similar clinical presentation was observed in the elder preschool child one month ago. The doctor suspects pertussis infection. What method enables retrospective diagnostics of this disease
Serological
Bacteriological
Molecular biological
Biological
Microscopy
122 із 144
What diagnostic method should be used in industry to test the raw leather for presence of antracis
Ascoli’s thermo precipitation test
Microscopy with Burry-Gins stain
Serological test
Bacteriological analysis
Microscopy with Aujeszky stain
123 із 144
Urinalysis of a patient with acute cystitis shows leukocytes and a large number of gramnegative bacilli. Inoculation has resulted in the growth of mucous colonies that produce a green soluble pigment. What microorganism is the most likely cause of the patient’s disorder
Pseudomonas aeruginosa
Proteus mirabilis
Salmonella enteritidis
Escherihia coli
Klebsiella pneumoniae
124 із 144
Pathologic material (mucosal excretion from the nasal passages) obtained from a patient provisionally diagnosed with influenza was sent to the virological laboratory. What quick test allows detecting specific viral antigen in the investigated material
Direct and indirect immunofluorescence (IF)
Reverse indirect hemagglutination (RIHA)
Hemagglutination inhibition assay (HAI)
Radioimmunoassay (RIA)
Direct and indirect enzyme-linked immunosorbent assay (ELISA)
125 із 144
First-year schoolchildren have received tuberculin skin test (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 measure allergization rate against rickettsia
To preventively vaccinate against tuberculosis
To detect parotitis in the schoolchildren
To measure immunity stress due to diphtheria
126 із 144
A 12-year-old boy with clinical presentation of influenza has developed respiratory mycoplasmosis. What type of infection has developed under these conditions
Mixed infection
Autoinfection
Relapse
Iatrogenic infection
Superinfection
127 із 144
A patient with peptic ulcer disease was prescribed famotidine. As a result his gastric juice acidity significantly decreased. What is the mechanism of action of this drug
Histamine H2 receptor blockade
Histamine H1 receptor blockade
Muscarinic M1 receptor blockade
Blockade of histamine receptors in the sympathetic ganglia
Inhibition of H+, K+-ATPase activity
128 із 144
A 33-year-old woman, who for a long time has been treated for chronic polyarthritis, complains of elevated blood pressure, changes in adipose tissue distribution, and disturbed menstrual cycle. What drug does this patient take
Prednisolone
Butadion (Phenylbutazone)
Indometacin
Beclometasone
Synaflan (Fluocinolone acetonide)
129 із 144
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 the bone fragments the patient received 10 mL of 2% dithylinum solution intravenously, which resulted in the prolonged period of apnoea and muscle relaxation. What enzyme is deficient, resulting in such pharmacogenetic enzymopathy
Pseudocholinesterase
Uridine diphosphate glucuronyltransferase
Glucose 6-phosphate dehydrogenase
N-acetyltransferase
Methemoglobin reductase
130 із 144
A patient with diabetes mellitus and allergic dermatitis was prescribed a certain fluorinated hormone drug in the ointment dosage form. When the patient asked, how this drug was better than the hydrocortisone ointment, the doctor explained that the prescribed medicine:
Had practically no resorptive effect
Was cheaper
Increased insulin synthesis
Had short-term action
Was less potent
131 із 144
A 45-year-old woman has an attack of cardiac fibrillation. She suffers from stage II essential hypertension. What is the drug of choice for stopping this attack
Anaprilin (Propranolol)
Lidocaine
Potassium chloride
Strophanthin
Sustac forte (Nitroglycerin)
132 із 144
A patient with inoperable lung cancer accompanied by unbearable pain was prescribed an analgesic. Against the background of analgesic therapy the patient developed signs of intestinal obstruction. What analgesic could have caused this complication
Morphine
Promedol (Trimeperidine)
Omnopon (Papaveretum)
Fentanyl
Analgin (Metamizole)
133 із 144
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
Material cumulation
Drug dependence
Functional cumulation
134 із 144
A 39-year-old man presents with hyperkeratosis, disturbed twilight vision, and high risk of infectious processes. What vitamin preparation should he be prescribed
Retinol acetate
Riboflavin
Ergocalciferol
Tocopherol acetate
Pyridoxine hydrochloride
135 із 144
The neurological department received a patient complaining of memory deterioration and loss of mental work capacity that developed after a head trauma. Recommend him a medicine for improvement in cerebral metabolism:
Piracetam (Nootropil)
Meridil (Methylphenidate)
Analgin (Metamizole)
Caffeine
Sydnocarb (Mesocarb)
136 із 144
A woman with polyarticular rheumatoid arthritis was prescribed a non-steroidal antiinflammatory drug - diclofenac sodium. After the patient has been taking it for some time, her concomitant disease exacerbated, which forced the doctor to cancel the prescription of this drug. What concomitant disease could necessitate cancellation of this drug prescription
Ulcer disease
Essential hypertension
Ischemic heart disease
Diabetes mellitus
Bronchial asthma
137 із 144
A patient with streptococcal infection of the gingiva was prescribed a drug with beta-lactam ring in its structure. What drug of those listed below belongs to this pharmacological group
Benzylpenicillin
Rifampicin
Erythromycin
Levomycetin (Chloramphenicol)
Streptomycin sulfate
138 із 144
A patient was administered a certain drug for relief of cardiac rhythm disturbance. This drug can be used as a local anesthetic as well. Name this drug:
Lidocaine hydrochloride
Dicain (Tetracaine)
Diphenine (Phenytoin)
Cocaine hydrochloride
Anaesthesin (Benzocaine)
139 із 144
A patient with arrhythmia was hospitalized into the cardiology unit. What antiarrhythmic drug should be prescribed
Amiodarone
Diclofenac sodium
Acetylsalicylic acid
Furacilin (Nitrofural)
Drotaverine hydrochloride
140 із 144
A woman with allergic neurodermatitis was prescribed a second-generation antihistamine without depressing effect on the CNS. Name this drug:
Loratadine
Diazolin (Mebhydrolin)
Dimedrol (Diphenhydramine)
Tavegyl (Clemastine)
Ketotifen
141 із 144
During gastric resection the patient received mixed anesthesia with tubocurarin chloride muscle relaxant; to restore spontaneous respiration the patient received proserin. What pharmacological group does this drug belong to
Cholinesterase inhibitors
Angiotensin-converting-enzyme inhibitors
Calcium channel blockers
Muscarinic agonists
Muscarinic antagonists
142 із 144
To treat the burns, a patient was prescribed a drug with antiseptic properties that are based on formation of atomic oxygen in the presence of organic substances. This drug has also an astringent (antiinflammatory) effect due to formation of albuminates. Name this drug:
Potassium permanganate
Ethyl alcohol
Sodium bicarbonate
Chlorhexidine digluconate
Hydrogen peroxide
143 із 144
Before a surgery the patient was prescribed a synthetic antiprotozoal drug for prevention of wound infection. The prescribed drug is highly effective against Helicobacter pylori. Name this drug:
Metronidazole
Aciclovir
Isoniazid
Chingamin (Chloroquine)
Doxycycline hydrochloride
144 із 144
A patient with essential hypertension was prescribed a drug that inhibits angiotensinconverting enzyme (ACE). What drug is it
Lisinopril
Losartan
Colestyramine
Carvedilol
Nifedipine