Step 1 - Medicine 2005

A 35-year-old man has been delivered into a surgical ward with a suppurating wound in the neck, anterior to the trachea (previsceral space). If a surgical operation is not performed urgently, there is a risk of infection spreading to the:

Interaponeurotic suprasternal space

Retrovisceral space

Thoracic cavity - middle mediastinum

Thoracic cavity - posterior mediastinum

Thoracic cavity - anterior mediastinum

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In the life cycle of a cell during mitosis a natural change in the amount of genetic material occurs. The DNA doubles at the following stage:

Telophase

Metaphase

Prophase

Interphase

Anaphase

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A woman with seasonal vasomotor rhinitis, who works as a train dispatcher and is an outpatient, should be prescribed an antihi-staminic drug that does not suppress central nervous system. Name this drug:

Diprazine (Promethazine)

Tavegyl (Clemastine)

Suprastin (Chloropyramine)

Loratadine

Dimedrol (Diphenhydramine)

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During sanitary and bacteriological testing of water with the membrane filter technique there were revealed two red colonies on the membrane filter (Endo medium) through which 500 ml of water was filtered. Calculate the coli index and coli titer of this water:

4 and 250

250 and 4

500 and 2

2 and 500

250 and 2

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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:

Oligo-1,6-glucosidase

Collagenase

Lysozyme

Alpha-amylase

Beta-glucuronidase

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What kind of muscle contraction occurs in an upper limb during an attempt to lift a load beyond one’s strength?

Isotonic

Single

Isometric

Phasic

Auxotonic

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The patient’s pyramids of the medulla oblongata are damaged by tumor growth. As a result the conduction of nervous impulses will be impaired in the following pathway:

Tr. spinocerebellaris

Tr. corticonuclearis

Tr. corticospinalis

Tr. dentatorubralis

Tr. corticopontinus

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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

Jejunum

Ileum

Sigmoid colon

Duodenum

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After inoculation of investigated material (feces) on 1% alkaline peptone water and 8-hour-long incubation in the thermostat under 37°C there is growth of pale bluish film observed. Such cultural properties are characteristic of the agent of the following disease:

Dysentery

Typhoid fever

Plague

Paratyphoid A fever

Cholera

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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:

Glandular endometrial polyp

Atypical endometrial hyperplasia

Endometrial cystic glandular hyperplasia

Endometrial adenocarcinoma

Placental polyp

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A pregnant woman with several miscarriages in anamnesis is prescribed a therapy that includes vitamin preparations. What vitamin facilitates carrying of a pregnancy?

Alpha-tocopherol

Rutin

Pyridoxal phosphate

Cyanocobalamin

Folic acid

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A patient has decreased concentration of magnesium ions that are required for ribosomes connection to granular endoplasmic reticulum. This condition is known to disturb the process of protein biosynthesis. Disturbance occurs at the following stage:

Transcription

Replication

Amino acids activation

Translation

Processing

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A patient with chronic heart failure presents with increased blood viscosity. Capillaroscopy detected damage to the vessel walls of the microcirculation system. What disorder is possible in the given case?

Embolism

Arterial hyperemia

Blood ”sludge” phenomenon

Thrombosis

Venous hyperemia

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A 3-year-old boy with pronounced hemorrhagic syndrome has no antihemophilic globulin A ( factor VIII) in the blood plasma. Hemostasis has been impaired at the following stage :

Internal mechanism of prothrombinase activation

External mechanism of prothrombinase activation

Conversion of prothrombin to thrombin

Conversion of fibrinogen to fibrin

Blood clot retraction

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Paronychia of the patient’s little finger was complicated with phlegmon of the hand and forearm. In this case the suppuration had spread through the:

Vagina synovialis communis mm. flexorum

Canalis carpalis

Interfascial compartments

Vagina tendinis m. flexor carpi radialis

Vagina tendinis m. flexor pollicis longi

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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

Ramus sinister a. hepatica propria

А. pancreato-duodenalis sup

А. gasro-duodenalis

А. hepatica communis

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During treatment with bismuth preparations a patient with syphilis developed gray spots' on his oral mucosa and nephropathy symptoms. What drug is used as an antidote to bismuth preparations poisoning?

Naloxone

Bemegride

Unithiol

Methylene blue

Nalorphine

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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?

Lateral cervical

Facial

Submental

Submandibular

Anterior cervical

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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?

Promotion

-

Transformation

Initiation

Progression

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A person is in a room with air temperature of 38oC and relative air humidity of 50%. What type of heat transfer ensures maintenance of constant body core temperature under these conditions?

Conduction and convection

-

Convection

Evaporation

Radiation

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A patient has hoarseness of voice. During laryngoscopy a gray-white larynx tumor with papillary surface has been detected. Microscopic investigation has shown the following: growth of connective tissue covered with multilayer, strongly keratinized pavement epithelium, no cellular atypia. What is the most likely diagnosis?

Fibroma

Polyp

Papilloma

Angiofibroma

Angioma

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A shepherd, who tended to the flock of sheep with his dogs, gradually developed pain in the chest and bloody expectorations. X-ray revealed spheric helminth larvae in the patient’s lungs. Specify the helminth that could be the causative agent of this disease:

Diphylobotrium latum

Echinococcus

Taenia solium

Hymenolepis nana

Fasciola hepatica

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A 67-year-old patient with clinical diagnosis of chronic bronchitis, pneumosclerosis, and cardiopulmonary decompensation has the biopsy material taken from the suspicious area in his right bronchus mucosa. Cellular and tissue atypism along with pearly bodies can be histologically detected. What pathologic process is characterized by the described histological changes?

Squamous cell carcinoma of bronchus with keratinization

Squamous cell metaplasia of bronchial mucosa

Bronchiectasis

Polypoid chronic bronchitis

Acute bronchitis

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A child with point mutation presents with absence of glucose 6-phosphatase, hypoglycemia, and hepatomegaly. What pathology are these signs characteristic of?

Addison’s disease (Primary adrenal insufficiency)

McArdle’s disease (Glycogen storage disease type V)

Parkinson’s disease

Von Gierke’s disease (Glycogen storage disease type I)

Cori’s disease (Glycogen storage disease type III)

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At the 2-3 day after the gastric resection the patient’s intestinal peristalsis failed to restore. What should the patient be prescribed to stimulate the function of his gastrointestinal tract?

Dithyline (Suxamethonium chloride)

Platyphyllin

Cyclodol (Trihexyphenidyl)

Atropine

Proserin

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Examination of the patient with traumatic brain injury revealed that he has lost the ability to discern the movement of an object on the skin. What part of the cerebral cortex is damaged?

Parietal lobe

Frontal lobe

Occipital lobe

Anterior central gyrus

Posterior central gyrus

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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:

Heart

Kidneys

Liver

Spleen

Lungs

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Section shows significant enlargement of the patient’s right kidney. There is a nephrolith at the place of incision. Renal pelvic lumen is distended with accumulating urine. Renal parenchyma is acutely thinned out. What is the most correct diagnosis?

Pyelectasis

Hydronephrosis

Nephroblastoma

Hydroureteronephrosis

Renal cyst

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A patient demonstrates sharp decrease of pulmonary surfactant activity. This condition can result in:

Decreased airways resistance

Increased pulmonary ventilation

Alveolar tendency to recede

Decreased work of expiratory muscles

Hyperoxemia

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After a case of cold the patient developed a lacrimation disorder. This disorder was caused by functional disturbance of the following autonomic ganglion:

Sublingual

Ciliary

Otic

Pterygopalatine

Submandibular

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A patient is diagnosed with diabetic coma. Blood sugar is 18,44 mmol/l. What glucoseregulating drug should be prescribed in the given case?

Biguanide

Long-acting insulin

Rapid-acting insulin

Sulfonylurea derivative

Intermediate-acting insulin

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A man came into the admission room with complaints of edemas, rapid heart rate, dyspnea, and cyanotic mucosal tunics. He was diagnosed with chronic heart failure. What drug should be prescribed to improve the patient’s general state?

Mesaton (Phenylephrine)

Cordiamin

Digoxin

Papaverine hydrochloride

Nitroglycerine

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Exposure to colchicine resulted in metaphase plate of a human containing 23 chromosomes more than it is normal. Name this mutation:

Translocation

Polyteny

Inversion

Aneuploidy

Polyploidy

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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 blood pressure

Hypoproteinemia

Decreased resorption of pleural fluid

Increased permeability of the vessel wall

Erythrocyte aggregation

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A 46-year-old woman suffering from cholelithiasis developed jaundice. Her urine became dark yellow, while feces are light-colored. What substance will be the most increased in concentration in the blood serum in this case?

Biliverdine

Urobilinogen

Unconjugated bilirubin

Mesobilirubin

Conjugated bilirubin

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A traumatology unit received a patient with crushed muscular tissue. What biochemical indicator of urine will be raised in this case?

Glucose

Uric acid

Total lipids

Creatinine

Mineral salts

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A 30-year-old woman first developed pain, swelling, and skin redness in the area of joints about a year ago. Provisional diagnosis is rheumatoid arthritis. One of the likely causes of this disease is change in the structure of the following connective tissue protein:

Mucin

Collagen

Troponin

Myosin

Ovalbumin

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A 15-year-old teenager complains of lack of air, general weakness, palpitations. Heart rate is 130 /min., BP is 100/60 mm Hg. ECG: QRS complex has normal shape and duration. The number of P waves and ventricular complexes is equal, T wave merges with P wave. What type of cardiac arrhythmia is observed in the teenager?

Sinus tachycardia

Atrial thrill

Atrial fibrillation

Sinus extrasystole

Paroxysmal atrial tachycardia

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A patient complaining of dizziness, thirst, difficult swallowing, and impaired vision of close objects has addressed a doctor. 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:

Aminazine

Caffeine

Ephedrine

Atropine

Morphine

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On autopsy of a 40-year-old woman, who had been suffering from rheumatoid arthritis, her liver is found to be dense and enlarged. On dissection its tissue is red-brown colored, with enlarged follicles resembling semi-transparent grayish-white granules. What is the most likely pathological process?

Sugar-coated spleen

Porphyry spleen

Sago spleen

Splenic hyalinosis

Lardaceous spleen

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On autopsy the dissector determined that the lungs are enlarged, pale, soft, do not deflate, crunch when cut. Microscopically there are dilated alveolar ducts, alveolar septa are thin, and signs of intracapillary sclerosis are observed. What pulmonary disorder are these presentations characteristic of?

Pneumonia

Pneumothorax

Pneumosclerosis

Atelectasis

Emphysema

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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?

Hyponatremia

Hypophosphatemia

Hyperkalemia

Hypocalcemia

Hyperchlorhydria

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On examination the patient presents with hirsutism, moon-shaped face, stretch marks on the abdomen. BP is 190/100 mm Hg, blood glucose is 17,6 mmol/l. What pathology is such clinical presentation characteristic of?

Hyperthyroidism

Adrenocortical hyperfunction

Hyperfunction of the insular apparatus

Hypothyroidism

Gonadal hypofunction

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Histological specimen of the ovary shows large hollow structures. Primary oocyte within these structures is surrounded with transparent membrane and radiating crown and is situated in the cumulus oophorus, the wall is made of follicular cell layer and theca. What ovarian structure can be characterized by these morphological features?

Primary follicle

Corpus atreticum

Corpus luteum

Mature (tertiary) follicle

Primordial follicle

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Histological specimen demonstrates a parenchymal organ with cortical and medullary substances. The cortical substance is composed of bands of epithelial cells with capillary blood vessels between them. The bands form three zones. The medullary substance consists of chromaffin cells and venous sinusoids. What organ can be characterized by these morphological features?

Thyroid gland

Kidney

Adrenal gland

Lymph node

Thymus

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A child with suspected colienteritis was delivered to the infectious diseases hospital. Colibacillus was obtained from the child’s feces. How to determine whether this bacillus is of pathogenic variety?

Based on its biochemical properties

By means of bacteriophage typing

Based on the nature of its growth in Endo medium

Agglutination reaction with serum 0

Microscopy of stained smears

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A patient ungergoes right-sided pulmonectomy due to lung cancer. Name the anatomical structures of the right lung radix (downward order):

Veins, artery, bronchus

Bronchus, artery, veins

Veins, bronchus, artery

Artery, veins, bronchus

Artery, bronchus, veins

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In a township there was registered an outbreak of hepatitis, which was attributed to water supply. What hepatitis virus could be the cause of the outbreak in this township?

Hepatitis C virus

Hepatitis B virus

Hepatitis D virus

Hepatitis G virus

Hepatitis E virus

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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

Cerebellum

Reticular formation

Red nuclei

Thalamus

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Due to prolonged taking of a drug the patient can develop osteoporosis, gastric mucosal erosions, hypokalemia, sodium and water retention, and decreased blood content of corticotropine. Specify this drug:

Indometacin

Digoxin

Hydrochlorothiazide

Prednisolone

Reserpine

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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:

Urease

Aspartate aminotransferase

Pepsin

Carbamoyl phosphate synthetase

Amylase

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After pancreatic surgery the patient developed hemorrhagic syndrome with disturbed 3rd stage of blood clotting. What will be the most likely mechanism of the hemostatic disorder?

Decrease of fibrinogen synthesis

Fibrin-stabilizing factor deficiency

Qualitative abnormalities of fibri-nogenesis

Fibrinolysis activation

Decrease of prothrombin synthesis

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A patient with jaundice has high total bilirubin that is mainly indirect (unconjugated), high concentration of stercobilin in the feces and urine. The level of direct (conjugated) bilirubin in the blood plasma is normal. What type of jaundice can be suspected?

Gilbert’s disease

Parenchymal (hepatic)

Neonatal

Mechanical

Hemolytic

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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?

Red bone marrow

Spleen

Thymus

Tonsil

Lymph node

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During fibergastroscopy of a patient with ulcer disease of the stomach, the mucosal biopsy material is taken from the area of an ulcer. Impression smear is prepared from the biopsy material and stained by Gram method; the rest of the biopsy material is tested for urease activity. Microscopy of the impression smear revealed gram-negative spiral-shaped microorganisms, urease activity test is positive. What bacteria were detected?

Shigella flexneri

Helycobacter pylori

Campylobacter jeuni

Spirilla minor

Treponema pallidum

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A patient suffering from gout was prescribed allopurinol. What pharmacological property of allopurinol provides therapeutic effect in this case?

Competitive inhibition of xanthine oxidase

Acceleration of nucleic acids synthesis

Deceleration of pyrimidine nucleotides salvage

Acceleration of pyrimidine nucleotides catabolism

Acceleration of nitrogen-containing substances excretion

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A woman, who has been suffering from marked hypertension for 15 years, has lately developed dyspnea, palpitations, slightly decreased systolic pressure, while diastolic pressure remains the same. What is the main mechanism of heart failure development in this case?

Damage to the myocardium

Cardiac overload due to increased vascular resistance

Cardiac overload due to increased blood volume

Disorder of impulse conduction in the myocardium

Dysregulation of cardiac function

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Old burial ground for animal refuse, which has not been in use for the last 50 years, is planned to be given for housing development. However, the soil analysis detected viable spores of a causative agent of an extremely dangerous disease. What microorganism is the most likely to remain in the soil for such a long period of time?

Bacillus anthracis

Francisella tularensis

Mycobacterium bovis

Brucella abortus

Yersinia pestis

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Blood of the patients with diabetes mellitus shows increased content of free fatty acids. Name the most likely cause of this:

Decreased activity of plasma phosphatidylcholine-cholesterol-acyltransferase

Activation of ketone bodies utilization

Accumulation of palmitoyl-CoA in cytosol

Activation of apoА1, apoА2, and apoА4 apolipoprotein synthesis

Increased activity of adipose triglyceride lipase

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During autopsy of a man, who had been suffering from mitral stenosis, the lungs are revealed to be dense and brown-colored. What pathologic process had occurred in the lungs?

Hemosiderosis

Lipofuscinosis

Hemochromatosis

Jaundice

Hemomelanosis

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Examination of the coronary arteries revealed atherosclerotic plaques with calcinosis that close 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

Myocardial infarction

Postinfarction cardiosclerosis

Myocarditis

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T-lymphocytes are determined to be affected with HIV. In this case viral enzyme reverse transcriptase (RNA-dependent DNA-polymerase) catalyzes the synthesis of:

DNA based on the viral RNA matrix

Viral protein based on the viral RNA matrix

Viral DNA based on the DNA matrix

Viral RNA based on the DNA matrix

Informational RNA based on the viral protein matrix

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A woman with dense area in her mammary gland came to a surgeon. To minimize the trauma to the mammary gland lobule during the operation the surgeon should make the incision:

Arcuately

Radially

Transversely

Vertically

-

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Electrical activity of neurons is being measured. They fire prior to and at the beginning of inhalation. Where are these neurons situated?

Cerebral cortex

Spinal cord

Mesencephalon

Diencephalon

Medulla oblongata

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Investigation of an isolated cardiac myocyte determined that it does not generate excitation impulses automatically, which means this cardiac myocyte was obtained from the following cardiac structure:

Sinoatrial node

Purkinje’s fibers

His’ bundle

Ventricles

Atrioventricular node

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To lose some weight a woman has been limiting the amount of products in her diet. 3 months later she developed edemas and her diuresis increased. What dietary component deficiency is the cause of this?

Proteins

Carbohydrates

Vitamins

Fats

Minerals

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The patients with organic brain disorder can take the following drug to improve their memory:

Piracetam

Diazepam

Caffeine

Nitrazepam

Medazepam

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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:

Furuncle

Leprosy

Actinomycosis

Syphilis

Carbuncle

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In preparation for business trip abroad the doctor was prescribed a histoschi-zontocidal antimalarial drug as a personal means of disease prevention. What drug was given to the doctor?

Mefloquine

Chingamin

Biseptol (Co-trimoxazole)

Doxycycline

Quinine

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A patient, who has been suffering from bronchial asthma for a long time, developed acute respiratory failure. What is the main mechanism of pathology development in this case?

Decreased elasticity of the pulmonary tissue

Restrictive disorders of pulmonary ventilation

Pulmonary blood supply disturbance

Obstructive disorders of pulmonary ventilation

Pulmonary enzyme system disturbance

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A 40-year-old woman has undergone thyroidectomy. Histological study of thyroid gland found the follicles to be of different size and contain foamy colloid, follicle epithelium is high and forms papillae, there is focal lymphocytic infiltration in the stroma. Diagnose the thyroid gland disease:

Basedow’s disease

Hashimoto’s thyroiditis

De Quervain’s disease

Riedel’s thyroiditis

Nodular goiter

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A patient has been hospitalized with provisional diagnosis of virus B hepatitis. Serological reaction based on complementation of antigen with antibody chemically bound to peroxidase or alkaline phosphatase has been used for disease diagnostics. What is the name of the applied serological reaction?

Radioimmunoassay technique

Immobilization test

Enzyme-linked immunosorbent assay

Complement fixation test

Immunofluorescence test

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Due to blood loss the circulating blood volume of a patient decreased. How will it affect the blood pressure in this patient?

Systolic pressure will decrease, while diastolic will increase

Only systolic pressure will decrease

Only diastolic pressure will decrease

Systolic and diastolic pressure will decrease

Diastolic pressure will decrease, while systolic will increase

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A bacteriological laboratory tests canned meat for botulinum toxin. Extract of the tested material and ABE botulinum antitoxin serum was introduced into the test group of mice; the control group of mice received the extract without antibotulinic serum. What serological reaction was used?

Precipitation

Complement binding

Opsonophagocytic

Neutralization

Double immunodiffusion

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A 50-year-old man is diagnosed with ischemic heart disease and cardiosclerosis with hypertensive syndrome. What drug should be prescribed in this case?

Corglycon

Strophanthine

Metoprolol

Acetylsalicylic acid

Potassium chloride

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

Acute renal failure

Uremic coma

Pyelonephritis

Chronic renal failure

Glomerulonephritis

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Autopsy of a 9-year-old child shows numerous irregular defects of varying depth with uneven margins and gray-white films tightly attached to the underlying tissue on the rectal mucosa of the body. What disease can be suspected?

Typhoid fever

Amebiasis

Dysentery

Salmonellosis

Cholera

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A man presents with glomerular filtration rate of 180 ml/min., while norm is 125±25 ml/min. The likely cause of it is the decreased:

Hydrostatic blood pressure in the glomerular capillaries

Plasma oncotic pressure

Renal blood flow

Permeability of the renal filter

Effective filtration pressure

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A young man came to a hospital with complaints of disturbed urination. Examination of his external genitalia revealed the urethra to be split on the top, with urine flowing out of this opening. What type of external genitalia maldevelopment is observed in this case?

Paraphimosis

Epispadia

Phimosis

Hypospadias

Hermaphroditism

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A 10-year-old child had cut his leg with a glass shard, when playing, and was delivered to the outpatient department to receive antitetanus serum. To prevent development of anaphylactic shock the serum was introduced by Bezredka method. This method of organism hyposensitization is based on the following mechanism:

Stimulation of immune tolerance to antigen

Binding of mast cell-fixed IgE

Stimulation of antigen-specific IgG2

Blocking of mast cell mediators synthesis

Stabilization of mast cell membranes

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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?

Ischemic damage to the tubules

Morbid affection of the urinary tracts

Autoimmune damage to the nephrons

Increased blood proteins

Inflammatory damage to the nephrons

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During experiment a part of the brain was extracted, which resulted in asynergy and dysmetria development in the test animal. What part of the brain was extracted in the animal?

Parietal lobe

Mesencephalon

Cerebellum

Frontal lobe

Reticulum

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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?

Diabetes mellitus

Bronchial asthma

Ischemic heart disease

Ulcer disease

Essential hypertension

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Histologic preparation stained with orcein demonstrates from 40 to 60 fenestrated elastic membranes within the middle coat of the vessel. Name this vessel:

Elastic artery

Muscular artery

Muscular vein

Nonmuscular vein

Mixed type artery

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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 are likely in the father?

I (0), Rh (-)

I (0), Rh (+)

III (B), Rh (+)

II (А), Rh (+)

II (A), Rh (-)

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A 40-year-old woman with Cushing’s disease presents with steroid diabetes. On biochemical examination she has hyperglycemia and hypochloremia. What process activates in the first place in such patients?

Gluconeogenesis

Glycogenolysis

Glycolysis

Glucose transportation into a cell

Glucose reabsorption

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A 40-year-old prisoner died of tuberculosis in the corrective labor camp. Autopsy of the body revealed deformation and diminishing of both lung apices; in the both upper lobes there are multiple cavities with dense walls 2-3 mm thick; in the lower lung lobes there are disseminated foci of caseous necrosis varying from 5 mm to 2 cm in diameter. Diagnose the type of tuberculosis:

Secondary cirrhotic tuberculosis

Hematogenous macrofocal pulmonary tuberculosis

Secondary fibro-cavitary tuberculosis

Primary tuberculosis, primary affect development

Secondary fibrous-focal tuberculosis

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A 7-year-old boy died of acute posthemorrhagic anemia caused by profuse hemorrhage in the gastrointestinal tract. Postmortem study revealed the following: macroscopically there were acutely enlarged various groups of the lymph nodes, thymomegaly, hepatosplenomegaly, and bright red bone marrow; microscopically there was hypercellular bone marrow with monomorphic infiltrations composed of blasts and diffuse-focal tumor infiltrations in the liver, spleen, lymph nodes, brain substance and tunics. Make the diagnosis:

Acute monoblastic leukemia

Acute myeloblastic leukemia

Acute lymphoblastic leukemia

Acute plasmablastic leukemia

Acute undifferentiated leukemia

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Autopsy of a man, who served on a nuclear submarine, revealed the following pathologies: bone marrow atrophy (panmyelophthisis), anemia, leukopenia, thrombocytopenia, lymphocytes disintegration in the lymph nodes, spleen, gastrointestinal lymphatic system, and hemorrhages into the adrenal glands. What disease had developed in this case?

Vibration disease

Decompression sickness

Acute anemia

Acute leukemia

Acute radiation sickness

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After sensitization a test animal received subcutaneously a dose of antigen. At the site of injection a fibrinous inflammation developed with alteration of vessel walls, basal substance, and fibrous structures of connective tissue. The inflammation took form of mucoid and fibrinoid degeneration, fibrinoid necrosis. What immune response occurred in the test animal?

Immediate hypersensitivity

Delayed hypersensitivity

Transplantation immune reaction

Granulomatosis

Normergic reaction

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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?

Aminocapronic acid

Phenylin (Phenindione)

Vicasol (Menadione)

Thrombin

Contrykal (Aprotinin)

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A patient complaining of pain in the left shoulder-blade region has been diagnosed with miocardial infarction. What kind of pain does the patient have?

Epicritic

Radiating

Protopathic

Visceral

Phantom

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During regular check-up a child is determined to have interrupted mineralization of the bones. What vitamin deficiency can be the cause?

Calciferol

Riboflavin

Folic acid

Cobalamin

Tocopherol

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On examination the patient was determined to have strong, balanced, inert type of higher nervous activity according to Pavlov’s classification. What temperament according to Hippocrates is it?

Melancholic

Phlegmatic

-

Sanguine

Choleric

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A specimen shows an organ covered with connective tissue capsule with trabeculae radiating inward the organ. The organ’s cortex contains lymph nodules; there are medullary cords made of lymphoid cells. What organ is under study?

Red bone marrow

Spleen

Lymph node

Tonsils

Thymus

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Brain autopsy revealed an edema, hyperemia, and small hemorrhages in the medulla oblongata. Microscopically chromatolysis, hydropia and nerve cell necrosis are observed; within the cytoplasm of hippocampal nerve cells there are eosinophilic structures (Negri bodies) detected. What diagnosis corresponds with the described morphological signs?

Encephalomyelitis

Encephalitis

Brucellosis

Rabies

Meningococcal meningitis

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A married couple came for a genetic counseling. The husband suffers from insulin-independent diabetes mellitus, while the wife is healthy. What is the probability of their child developing insulin-independent diabetes mellitus?

50 %

The same as in the population

Higher than in the population

100 %

Lower than in the population

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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)

Prednisolone

Paracetamol

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Electron micrograph of the kidney shows fenestrated endothelium lying on the basement membrane; the external surface of the membrane has adjacent dendritic epithelial cells. What do these structures form in the kidney?

Distal nephron

Henle’s loop

Filtration barrier

Proximal nephron

Juxtaglomerular apparatus

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A worker of an agricultural enterprise had been suffering from an acute disease with aggravating intoxication signs, which resulted in his death. On autopsy: the spleen is enlarged, flaccid, dark cherry-red on section, yields excessive pulp scrape. Soft meninges of the fornix and base of the brain are edematous and saturated with blood (’’cardinal’s cap”). Microscopically: serous-hemorrhagic inflammation of meninges and cerebral tissues. Make the diagnosis:

Brucellosis

Cholera

Anthrax

Tularemia

Plague

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A woman suffers from tonsillitis complicated with retropharyngeal abscess that is localized in the spatium retrovi-scerale. In this case the suppurative process can spread to the:

Spatium interaponeuroticum suprasternale

Mediastinum posterius

Mediastinum anterius

Spatium pretracheale

Spatium interscalenum

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A patient with chronic bronchitis was prescribed a drug with mucolytic action. Name this drug:

Magnesium sulfate

Atropine sulfate

Paracetamol

Anaprilin (Propranolol)

Ambroxol

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A patient suffers from acute cardiopulmonary failure with pulmonary edema. What diuretic should be prescribed in the given case?

Dichlothiazidum (Hydrochlorothiazide)

Diacarb (Acetazolamide)

Furosemide

Spironolactone

Triamterene

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Therapeutics unit of a hospital received a man suffering from ulcer disease of the stomach with hyperacidity. Which of the listed group of drugs must be used as a part of the complex therapy of this patient?

Histamine Hi-receptor antagonists

Histamine H2-receptor antagonists

Calcium channel blockers

Nonsteroidal antiinflammatory drugs

Steroidal antiinflammatory drugs

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A 45-year-old woman gave birth to a boy with cleft maxilla (cleft lip and palate). On additional examination there are significant disturbances of the boy’s nervous, cardiovascular, and visual systems. Karyotype investigation allowed diagnosing the patient with trisomy 13. What syndrome is present in the boy?

Patau

Turner

DiGeorge

Down

Kleinfelter

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Pathologic material (mucosal excretion from the nasal passages) obtained from a patient provisionally diagnosed with influenza was delivered to the virological laboratory. What quick test allows detecting specific viral antigen in the investigated material?

Direct and indirect immunofluorescence (IF)

Direct and indirect enzyme-linked immunosorbent assay (ELISA)

Radioimmunoassay (RIA)

Hemagglutination inhibition assay (HAI)

Reverse indirect haemagglutination (RI-HA)

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A 5-year-old child is diagnosed with Bruton syndrome (X-linked agammaglobulinemia) that manifests itself in 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?

Increased IgD, IgE

Increased IgA, IgM

No changes

Decreased IgA, IgM

Decreased IgD, IgE

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A 37-year-old man, who was working in a caisson, after being lifted to the surface suddenly developed signs of acute cerebral circulation disturbance and loss of consciousness. Several days later he died. On autopsy in the left cerebral hemisphere there was detected a gray soft irregular focus 5х6х3,5 cm in size. What process had occurred in the brain?

Ischemic stroke

Tumor

Hemorrhagic infarction

Abscess

Cyst

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A short-term physical load resulted in reflex increase of heart rate and systemic arterial pressure in a person. What receptor activation was the most contributory to inducing the pressor reflex?

Vascular baroreceptors

Vascular volume receptors

Vascular chemoreceptors

Proprioceptors of the working muscles

Hypothalamic thermoreceptors

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During experiment a skeletal muscle is being stimulated with a series of electrical impulses. What type of muscular contraction will develop, if each following impulse occurs within the relaxation period after the previous single contraction of the muscle?

Asynchronous tetanus

Muscle contracture

Incomplete tetanus

Series of single contractions

Smooth tetanus

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Depression and emotional disturbances result from the lack of noradrenaline, serotonin, and other biogenic amines in the brain. Their content in the synapses can be increased through administration of antidepressants that inhibit the following enzyme:

Monoamine oxidase

Phenylalanine 4-monooxygenase

D -amino acid oxidase

L-amino acids oxidase

Diamine oxidase

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A 2-year-old child presents with acute psychomotor retardation, vision and hearing impairment, sharp enlargement of the liver and spleen. The child is diagnosed with hereditary Niemann-Pick disease. What genetic defect is the cause of this disease?

Xanthine oxidase deficiency

Glucose 6-phosphatase deficiency

Acid lipase deficiency

Sphingomyelinase deficiency

Amylo-1,6-glucosidase deficiency

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Clinical presentations of a woman allowed provisionally diagnosing her with X polysomy Cytogenetic method is applied to clarify the diagnosis. The diagnosis will be confirmed if the patient’s karyotype is:

47, XXY

46, XX

48, XXXY

48, XXYY

47, ХХХ

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During dehelmintization there was a 3,5-meter-long tapeworm produced from the patient’s intestine.There are 4 suckers and hooks on the tapeworm’s scolex. Mature segments of the tapeworm are immobile and have up to 12 uterine branches. What disease is it?

Opisthorchiasis

Teniasis

Beef tapeworm infection

Diphyllobothriasis

Echinococcosis

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A patient presents with steatorrhea. This disorder can be linked to disturbed supply of the intestine with the following substances:

Bile acids

Chymotrypsin

Amylase

Tripsin

Carbohydrates

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Cytochrome oxidase is a hemeprotein that is an end component of the mitochondrial respiratory chain. What reaction is catalyzed with this enzyme?

Transfer of reduced equivalents to ubiquinone

Cytochrome synthesis

Adenosine triphosphate synthesis

Cytochrome splicing

Transfer of reduced equivalents to molecular oxygen

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A 16-year-old girl fainted when she tried to quickly change her position from hori-sontal to vertical. What caused the loss of consciousness in the girl?

Decreased oncotic plasma pressure

Increased venous return

Increased arterial pressure

Decreased venous return

Increased central venous pressure

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An unconscious patient was delivered by ambulance to the hospital. On objective examination the patient was found to have no reflexes, periodical convulsions, irregular breathing. After laboratory examination the patient was diagnosed with hepatic coma. Disorders of the central nervous system develop due to the accumulation of the following metabolite:

Bilirubin

Glutamine

Histamine

Ammonia

Urea

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A patient complains of acute pain attacks in the right lumbar region. During examination the nephrolithic obturation of the right ureter in the region between its abdominal and pelvic segments has been detected. What anatomical boundary exists between those two segments?

Linea transversa

Linea semilunaris

Linea arcuata

Linea inguinalis

Linea terminalis

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After mushroom poisoning the patient developed signs of acute hepatic failure leading to his death. On autopsy the liver is diminished, flaccid; the capsule is wrinkled; the tissue is ochreyellow on section. Microscopically: fatty degeneration of hepatocytes, necrotic central segments of the hepatic lobes. These changes are characteristic of:

Acute exudative hepatitis

Acute productive hepatitis

Massive progressive necrosis

Fatty hepatosis

Hepatolenticular degeneration

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Blood test of an athlete shows the following: erythrocytes - 5,5 • 1012/l, hemoglobin - 180 g/l, leukocytes - 7 • 109/l, neutrophils - 64%, basophils - 0,5%, eosinophils - 0,5%, monocytes - 8%, lymphocytes - 27%. These values primarily indicate the stimulation of:

Immunogenesis

Lymphopoiesis

Granulocytopoiesis

Erythropoiesis

Leukopoiesis

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Experimental stimulation of the sympathetic nerve branches that innervate the heart caused an increase in the force of heart contractions because the membrane of typical cardiomyocytes permitted an increase in:

Calcium ion exit

Calcium ion entry

Potassium ion exit

Calcium and potassium ion exit

Potassium ion entry

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As a result of past encephalitis, a man has developed an increase in cerebrospinal fluid pressure in the right lateral ventricle. What can be the cause of this condition?

Atresia of the fourth ventricle foramina

Closure of the right interventricular foramen

Atresia of the sylvian aqueduct

Closure of the left interventricular foramen

Atresia of the tubus medullaris

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A patient with pneumonia has body temperature of 39,2oC. What cells are the main producers of endogenous pyrogen that had caused such temperature rise?

Fibroblasts

Monocytes

Endotheliocytes

Eosinophils

Neutrophils

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A patient is diagnosed with compression fracture of the lumbar vertebra. The patient presents with acutely increased lumbar lordosis. What ligament was damaged in this patient resulting in such deformation of vertebral column curvature?

Anterior longitudinal ligament

Yellow ligament

Interspinal ligament

Posterior longitudinal ligament

Iliolumbar ligament

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Gram-positive spore-forming bacilli were extracted in anoxic environment from the patient’s wound contaminated with soil. Cultivation on a blood-glucose agar resulted in growth of the colonies surrounded with hemolysis zone. What agent was extracted from the wound?

Staphylococcus aureus

Clostridium perfringens

Escherichia coli

Clostridium botulinum

Pseudomonas aeruginosa

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The patient’s ECG shows that in the second standard lead from the extremities the P waves are positive, their amplitude is 0,1 mV (norm is 0,05-0,25 mV), duration -0,1 seconds (norm is 0,07-0,10 seconds). It can be concluded that the following process occurs normally in the cardiac atria:

Depolarization

Relaxation

Activation

Repolarization

Contraction

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Autopsy of a patient, who died of bilateral bronchopneumonia, shows in the left lung lower lobe a cavity 5 cm in diameter, filled with liquid yellowish-white substance. What complication of the patient’s pneumonia had developed?

Sequestrum

Abscess

Tuberculoma

Granuloma

Gangrene

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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

Phenyl pyruvate

Methylmalonic acid

Malate

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It is known that pentose-phosphate pathway actively functions in the erythrocytes. What is the main function of this metabolic pathway in the erythrocytes?

Counteraction to lipid peroxidation

Oxidation of glucose into lactate

Neutralization of xenobiotics

Increase of lipid peroxidation

Activation of microsomal oxidation

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Pupil dilation occurs when a person steps from a light room into a dark one. What reflex causes such a reaction?

Parasympathetic conditioned reflex

Parasympathetic unconditioned reflex

Sympathetic conditioned reflex

Metasympathetic reflex

Sympathetic unconditioned reflex

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A patient complaining of heartburn has undergone biopsy of the gastric mucosa. In the sample there are numerous cells with oxyphilic cytoplasm in the glandular epithelium. Name these cells:

Exocrine parietal cells

Exocrine chief cells

Epithelial cells

Endocrine cells

Mucous cells

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Inherited diseases, such as mucopolysaccharidoses, manifest in metabolic disorders of connective tissue, bone and joint pathologies. The sign of this disease is the excessive urinary excretion of the following substance:

Glucose

Amino acids

Urea

Glycosaminoglycans

Lipids

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A woman was delivered to a gynecological unit with signs of acute abdomen and suspected extrauterine pregnancy with oviduct rupture. Where will the blood accumulate in this case?

Vesicouterine pouch

Retrovesical pouch

Right lateral canal

Rectouterine pouch

Left lateral canal

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A patient had a trauma that caused dysfunction of motor centers regulating activity of head muscles. These centers can normally be located in the following area of the cerebral cortex:

Supramarginal gyrus

Inferior part of the precentral gyrus

Superior part of the precentral gyrus

Superior parietal lobule

Angular gyrus

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At the post-mortem examination the stomach of a patient with renal failure was found to have a yellow-brown coating on the thickened mucosa. The coating was firmly adhering to its surface and had significant thickness. Microscopy revealed congestion and necrosis of mucosal and submucosal layers, fibrin presence. What is the most likely diagnosis?

Corrosive gastritis

Croupous gastritis

Diphtheritic gastritis

Catarrhal gastritis

Phlegmonous gastritis

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Cystinuria manifests itself in a human as cystine stones in the kidneys (homozygous individuals) or increased cystine content in the urine (heterozygous individuals). Cystinuria is a monogenic disorder. Determine the type of interaction between the genes of cystinuria and normal urine cystine excretion:

Epistasis

Semidominance

Codominance

Complementarity

Complete dominance

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A patient with obliterating atherosclerosis has undergone sympathectomy of the femoral artery in the area of femoral triangle. What type of arterial hyperemia was developed in the patient due to this surgery?

Neuroparalytic

Functional

Reactive

Neurotonic

Metabolic

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On bronchoscopy there is a polypoid growth 1,0 cm in diameter with ulcer in its center in the upper lobe of the right lung. Histological investigation revealed a tumor composed of lymphocyte-like cells with hyperchromic nuclei, the cells form layers and bands. What is the most likely tumor type?

Squamous cell carcinoma

Undifferentiated large cell carcinoma

Adenocarcinoma

Undifferentiated small cell carcinoma

Glandular squamous cell carcinoma

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The brain trauma unit received a patient with damaged greater wing of the sphenoid bone. The fracture line crosses the spinous foramen of the sphenoid. What vessel was damaged?

Superficial temporal artery

Middle meningeal artery

Posterior deep temporal artery

Anterior deep temporal artery

Lateral pterygoid artery

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In one of Polessye regions there was an outbreak of helminthiasis manifested by cramps and facial edemas. The developed preventive measures in particular included ban for eating infested pork even after heat processing. What helminthiasis was the case?

Taeniarhynchosis

Teniasis

Echinococcosis

Trichinosis

Alveococcosis

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A person with vitamin A deficiency develops twilight vision disturbance. Name the cells that fulfill this photoreceptor function:

Rod cells

Cone cells

Horizontal cells of retina

Bipolar neurons

Ganglionic nerve cells

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Presented is the biopsy material of an organ consisting of saccule-shaped rounded structures of varying size. Inside these structures there is a gel-like non-cellular substance - colloid; structure walls are composed of one layer of cuboidal cells that lay on the basement membrane. Between the saccules there is connective tissue with vessels. Name this organ:

Thymus

Parotid gland

Parathyroid gland

Thyroid gland

Pancreas

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A 26-year-old woman with bronchitis has been administered a broad spectrum antibiotic as a causal treatment drug. Specify this drug:

Ambroxol

BCG vaccine

Interferon

Dexamethasone

Doxycycline

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Water affects the mucosa of lower nasal passages resulting in diving reflex. This responce manifests itself as:

Reflex dyspnea

Cough

Bronchial spasm

Reflex apnea

Reflex hyperpnea

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Examination of a 56-year-old woman with a history of type 1 diabetes revealed a disorder of protein metabolism that is manifested by aminoacidemia in the laboratory blood test values, and clinically by the delayed wound healing and decreased synthesis of antibodies. Which of the following mechanisms causes the development of aminoacidemia?

Decrease in concentration of blood amino acids

Increased proteolysis

Albuminosis

Increase in low-density lipoproteins level

Increase in plasma oncotic pressure

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

Impaired phospholipid synthesis

Lack of carbohydrates in the diet

Low carnitine content

Excessive consumption of fatty foods

Choline deficiency

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Streptomycin and other aminoglycosides prevent the joining of formyl-methionyl-tRNA by bonding with the 30S ribosomal subunit. This effect leads to disruption of the following process:

Transcription initiation in procaryotes

Replication initiation in procaryotes

Transcription initiation in eucaryotes

Translation initiation in eucaryotes

Translation initiation in procaryotes

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In hot weather ventilators are often used to normalize the microclimate in the heated rooms. It leads to intensified heat transfer from the human body by means of:

Evaporation

Radiation

Conduction

Conduction and convection

Convection

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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?

Muscarinic agonists

Muscarinic antagonists

Calcium channel blockers

Angiotensin-converting-enzyme inhibitors

Cholinesterase inhibitors

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A 67-year-old man consumes eggs, pork fat, butter, milk and meat. Blood test results: cholesterol - 12,3 mmol/l, total lipids - 8,2 g/l, increased low-density lipoprotein fraction (LDL). What type of hyperlipoproteinemia is observed in the patient?

Hyperlipoproteinemia type IIb

Hyperlipoproteinemia type IIa

Hyperlipoproteinemia type I

Cholesterol, hyperlipoproteinemia

Hyperlipoproteinemia type IV

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To treat bronchitis the patient was prescribed a beta-lactam antibiotic. Its mechanism of action is based on inhibition of murein production, which results in death of the causative agent. Name this drug:

Penicillin G Sodium Salt

Azithromycin

Bijochinol (Quinine bismuth iodide)

Ciprofloxacin

Streptomycin

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Cell membrane rest potential changed from -85 to -90 mV It can be caused by activation of the following cell membrane channels:

Sodium

Calcium

Potassium

Potassium and sodium

Potassium and calcium

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Ionizing radiation or vitamin E deficiency affect the cell by increasing lysosome membrane permeability. What are the possible consequences of this pathology?

Intensive protein synthesis

Partial or complete cell destruction

Formation of maturation spindle

Intensive energy production

Restoration of cytoplasmic membrane

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A 22-year-old woman ate some seafood. 5 hours later her torso and distal parts of her limbs developed small itchy papules which were partially fused together. One day later the rash disappeared spontaneously. Specify the hypersensitivity mechanism underlying these changes:

Atopy (local anaphylaxis)

Antibody-dependent cell-mediated cytolysis

Cellular cytotoxicity

Immune complex hypersensitivity

Systemic anaphylaxis

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During acute hemorrhage the body loses not only fluid but also electrolytes. What substance solution can be used as a simple blood substitute?

Calcium chloride

Sodium nucleotide

Sodium bromide

Sodium chloride

Albumin

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A patient has been admitted to the contagious isolation ward with signs of jaundice caused by hepatitis virus. Which of the symptoms given below is strictly specific for hepatocellular jaundice?

Cholemia

Bilirubinuria

Urobilinuria

Increase of ALT, AST level

Hyperbilirubinemia

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In a body of a 37-year-old woman, who died with signs of pulmonary edema, there was detected acute deformation of the aortic valve: it is shortened, thickened, ulcerated, has areas of stone-like density. On its external surface there are large, up to 2 cm in diameter, thrombotic plaques. Left ventricle wall is 2,2 cm thick. Cardiac muscle is dull, matt, and flaccid. What type of endocarditis corresponds with described alterations of the aortic valve?

Acute verrucous endocarditis

Ulcerative polypoid endocarditis

Fibroplastic endocarditis

Recurrent verrucous endocarditis

Diffuse endocarditis

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Students study the stages of gametogenesis. They analyze a cell with haploid number of chromosomes, whi-th each chromosome consisting of two chromatids. The chromosomes are located in the equatorial plane of the cell. Such situation is typical of the following stage of meiosis:

Prophase of the first division

Metaphase of the second division

Metaphase of the first division

Anaphase of the second division

Anaphase of the first division

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A 38-year-old woman developed a bronchial asthma attack. Which of the listed bronchial spasmolytics is effective for emergency aid and belongs to beta-2-adrenergic agonists?

Atropine

Platyphyllin

Ipratropium bromide

Adrenaline

Salbutamol

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After emotional upset a woman has been suffering from disturbed sleep for several days. What soporific drug would be preferable for this type of insomnia?

Nitrazepam

Phenobarbital

Barbamylum (Amobarbital)

Ethaminal sodium (Pentobarbital)

Chloral hydrate

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During training session in the laboratory the students were performing spirography on themselves. What indicator CANNOT be measured with this method?

Functional residual capacity

Vital capacity

Respiratory minute volume

Maximal breathing capacity

Respiration rate

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In the South and Central America there can be found a species of trypanosomes that is the causative agent of Chagas disease. What animal is the infection carrier specific to this disease?

Mosquito

Gnat

Cockroach

Triatomine bug

Tsetse fly

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A 54-year-old woman was brought to the emergency department after a car accident. A traumatologist diagnosed her with multiple fractures of the lower extremities. What kind of embolism is the most likely to develop in this case?

Adipose

Gaseous

Tissue

Thromboembolism

Air

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A 30-year-old man with diabetes mellitus type I was hospitalized. The patient is comatose. Laboratory tests revealed hyperglycemia and ketonemia. What metabolic disorder can be detected in this patient?

Metabolic alkalosis

Respiratory alkalosis

Metabolic acidosis

Acid-base balance is normal

Respiratory acidosis

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Typical manifestations of food poisoning caused by C. botulinum are double vision, abnormal functioning of the swallowing and breathing. These symptoms develop as the result of:

Exotoxin action

Pathogen adhesion to the enterocyte receptors

Enterotoxin action

Enterotoxic shock development

Activation of adenylate cyclase

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An infant, who was on synthetic formula feeding, developed signs of vitamin B\ deficiency. What reactions does this vitamin take part in?

Amino acids decarboxylation

Amino acids transamination

Redox reactions

Proline hydroxylation

Keto acids oxidative decarboxylation

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A 30-year-old woman developed the signs of virilism (body hair growth, balding temples, disturbed menstrual cycle). What hormone can cause this condition when hyperproduced?

Oxytocin

Estriol

Relaxin

Testosterone

Prolactin

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A histological specimen shows significant amount of mucous connective tissue (Wharton’s jelly), vessels, as well as residual yolk and allantois. Name this organ:

Urethra

Vermiform appendix

Umbilical cord

Ureter

Esophagus

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On examination of a 6-year-old child the doctor noticed grayish film on the child’s tonsils. Microscopy of the smears stained by Neisser method detected there Corynebacterium diphtheriae. What morphologic feature was the most indicative for determining the type of the agent?

Localization of the causative agent within macrophages

Presence of the capsule

Polar placement of volutin granules

Spores that exceed cells in diameter

Fence-like position of the agent’s cells

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During the sports competition a boxer received a strong blow to the abdomen, which caused a knockout due to a brief drop in blood pressure. What physiological mechanisms are the cause of this condition?

Alteration of transcapillary exchange

Stimulation of sympathetic nerves

Stimulation of parasympathetic nerves

Ischemia of the central nervous system

Abrupt change in body fluid volume

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After a severe stress the patient presents with eosinopenia in the blood test. In this case the decreased number of eosinophils can explain changes in the level of the following hormones:

Vasopressin

Insulin

Glucocorticoids

Adrenaline

Mineralocorticoids

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A 30-year-old patient’s blood test revealed the following: erythrocyte count is 6 • 1012/l, hemoglobin is 10,55 mmol/l. Vaquez’s disease was diagnosed. Name the leading part of pathogenesis in this case:

Hypoxia

Iron-deficiency

Acidosis

Neoplastic erythroid hyperplasia

S12-deficiency

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Deaf parents with genotypes DDee and ddEE gave birth to a child with normal hearing. Specify the interaction of D and E genes:

Complementary interaction

Overdominance

Epistasis

Complete dominance

Polymery

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Corticosteroid hormones regulate the adaptation processes of the body as a whole to environmental changes and ensure the maintenance of internal homeostasis. What hormone activates the hypothalamo-pituitary-adrenal axis?

Corticoliberin

Corticostatin

Thyroliberin

Somatostatin

Somatoliberin

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A patient with signs of emotional lability that result in troubled sleep has been prescribed nitrazepam. Specify the sleep-inducing mechanism of this drug:

GABA-ergic system activation

Supression of serotonergic neurotransmission

H1-histamine receptors stimulation

Inhibition of stimulating amino acids

Blockade of opiate receptors

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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:

Essential hypertension

Renal disorder

Myxedema

Diabetes insipidus

Pellagra

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A man is suffering from diarrhea. In summer he spent his vacation in the south at the sea coast. Bacteria with the following properties were detected in his feces: gramnegative curved mobile monotrichous bacilli that do not produce spores or capsules. They are undemanding to nutrient medium but require alkaline reaction (рН - 8,5-9,5). Described are the agents of the following enteric infection:

Shigellosis

Typhoid fever

Pseudotuberculosis

Cholera

Colienteritis

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A pregnant woman was detected to have IgM to rubella virus. An obstetrician-gynecologist recommended therapeutic abortion due to the high risk of teratogenic affection of the fetus. Detection of IgM was of great importance as it is these specific immunoglobulins that:

Are the main factor of antiviral protection

Are associated with anaphylactic reactions

Have the largest molecular weight

Indicate recent infection

Penetrate placental barrier

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During examination of a teenager with xanthomatosis the family history of hypercholesterolemia is revealed. What transportable lipids are increased in concentration in case of such a disease?

Low-density lipoproteins

Intermediate-density lipoproteins

High-density lipoproteins

Very low-density lipoproteins

Chylomicrons

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On examination the patient is found to have low production of adrenocorticotropic hormone. How would this affect production of the other hormones?

Increase thyroid hormones synthesis

Decrease insulin synthesis

Decrease hormone synthesis in the adrenal medulla

Decrease adrenocorticotropic hormones synthesis

Increase sex hormones synthesis

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Parkinson’s disease is caused by disturbance of dopamine synthesis. What brain structure synthesizes this neurotransmitter?

Globus pallidus

Corpora quadrigemina

Substantia nigra

Hypothalamus

Red nuclei

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Determining a patient’s blood group with monoclonal test-reagents revealed positive agglutination reaction to anti-A and anti-B reagents, and negative reaction to anti-D. What blood group does this patient have?

IV (АВ) Rh (+)

IV (АВ) Rh (-)

II (А) Rh (+)

I (0) Rh (+)

III (В) Rh (-)

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

Decrease of fibrinogen content in blood

Hypocalcemia

Decrease of albumine content in blood

Thrombocytopenia

Increased activity of anticoagulation system

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During ascent into mountains a person develops increased respiration rate and rapid heart rate. What is the cause of these changes?

Increase of CO2 partial pressure

Decrease of O2 partial pressure

Increase of blood pH

Increase of air humidity

Increase of nitrogen content in air

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To stop the bleeding the patient was prescribed a direct coagulant. During introduction of the solution the patient was complaining of pain along the vein, hot sensation, and palpitations. Name the drug that causes such symptoms:

Streptokinase

Pentoxyl

Ergocalciferol

Calcium chloride

Hirudine

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A student, whose educational achievements throughout the semester were poor, feels emotionally tense during the final test. What is the primary cause that induced leading mechanism of emotional tension in this case?

Ttight time and lack of energy

Lack of information

Tight time

Lack of energy

Lack of energy and information

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A young family came for a genetic counseling to identify the father of their child. The husband insists that the child does not resemble him at all and cannot possibly be his. Polymerase chain reaction method for person identification is based on the following:

Missense mutation

Genetic recombination

Gene amplification

Nucleotide deletion

Transduction

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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?

Argininosuccinic aciduria

Hyperuricemy

Hyperaminoacidemia

Hyperazotemia

Citrullinuria

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A 67-year-old man was delivered to the cardiology unit with complaints of periodical pain in the heart, dyspnea after even insignificant physical exertion, cyanosis, and edemas. ECG revealed additional contractions of the heart ventricles. Name this type of rhythm disturbance:

Flutter

Fibrillation

Tachycardia

Extrasystole

Bradycardia

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During narcosis the patient developed a risk of cerebral edema. What drug should be administered in this case?

Triamterene

Phenazepam

Furosemide

Sodium bromide

Dopamine

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A patient with pulmonary tuberculosis is prescribed the most effective antituberculous antibiotic. Name this drug:

Rifampicin

Bactrim (Co-trimoxazole)

Tetracycline

Furasolidone

Streptocide

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During surgery performed in the abdominal cavity a surgeon located ligament of liver stretching from anterior abdominal wall (navel) to inferior surface of liver. What ligament is it?

Venous ligament of the liver

Falciform ligament of the liver

Round ligament of the liver

Coronary ligament of the liver

Triangular ligament of the liver

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On examination of a patient with disease onset 5 days ago the doctor suspected tularemia and prescribed the patient tularin intracutaneously. What is the purpose of this drug administration in the patient?

Treatment

Allergy diagnostics

Prognosis for the disease

Prevention

Treatment evaluation

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A patient developed increased blood content of HCO- against the background of repeated and uncontrollable vomiting. What will be the leading mechanism in compensation of developed acid-base imbalance?

Increased pulmonary ventilation

Increased renal reabsorption of bicarbonate

Decreased pulmonary ventilation

-

Increased renal reabsorption of ammonia

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A 13-year-old boy presents with eczematous rashes on his shins and torso. Anamnesis states cases of otitis, pneumonia, and furuncles in the patient. Blood test: platelets - 70 • 109/l, low activity of T helper and T suppressor cells, low IgM, with normal IgA and IgG. What immunodeficient disease does this boy have?

DiGeorge syndrome

Wiskott-Aldrich syndrome

Severe combined immunodeficiency (Swiss type)

Louis-Bar syndrome (Ataxia-telangiectasia)

Chediak-Higashi syndrome

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During the exam a student was unable to correctly answer all the questions in his question card, which was accompanied by the reddening of his face and hot sensation. What type of arterial hyperemia did the student develop in this case?

Postischemic

Metabolic

Neuroparalytic

Neurotonic

Pathologic

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An injured person with wound of the anterior cervical region presents with hemorrhage. The outflowing blood is dark. What vessel is damaged?

A. carotis externa

V jugularis externa

V jugularis anterior

V jugularis interna

A. thyroidea superior

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Due to trauma the patient presents with disturbed function of the parotid gland. What nerve ensures its secretion function?

N. auricularis major

N. petrosus profundus

N. petrosus major

N. petrosus minor

N. auricularis minor

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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

Reinfection

Relapse

Exogenous infection

Superinfection

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