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:

Thoracic cavity - middle mediastinum

Retrovisceral space

Thoracic cavity - posterior mediastinum

Interaponeurotic suprasternal space

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:

Interphase

Anaphase

Prophase

Telophase

Metaphase

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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:

Loratadine

Dimedrol (Diphenhydramine)

Diprazine (Promethazine)

Tavegyl (Clemastine)

Suprastin (Chloropyramine)

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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:

250 and 4

2 and 500

250 and 2

500 and 2

4 and 250

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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

Beta-glucuronidase

Collagenase

Lysozyme

Alpha-amylase

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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?

Phasic

Auxotonic

Single

Isometric

Isotonic

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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. corticonuclearis

Tr. corticospinalis

Tr. spinocerebellaris

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?

Jejunum

Duodenum

Sigmoid colon

Transverse colon

Ileum

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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:

Plague

Dysentery

Cholera

Paratyphoid A fever

Typhoid fever

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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

Endometrial adenocarcinoma

Atypical endometrial hyperplasia

Placental polyp

Endometrial cystic glandular hyperplasia

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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?

Pyridoxal phosphate

Alpha-tocopherol

Cyanocobalamin

Folic acid

Rutin

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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:

Amino acids activation

Replication

Processing

Transcription

Translation

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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?

Venous hyperemia

Thrombosis

Blood ”sludge” phenomenon

Arterial hyperemia

Embolism

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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 :

Blood clot retraction

Conversion of fibrinogen to fibrin

Conversion of prothrombin to thrombin

External mechanism of prothrombinase activation

Internal mechanism of prothrombinase activation

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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 tendinis m. flexor pollicis longi

Vagina tendinis m. flexor carpi radialis

Interfascial compartments

Vagina synovialis communis mm. flexorum

Canalis carpalis

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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

А. gasro-duodenalis

А. hepatica communis

А. pancreato-duodenalis sup

Ramus sinister a. hepatica propria

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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?

Submental

Submandibular

Anterior cervical

Lateral cervical

Facial

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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?

Initiation

Promotion

Progression

-

Transformation

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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?

Convection

-

Conduction and convection

Radiation

Evaporation

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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?

Angioma

Papilloma

Angiofibroma

Polyp

Fibroma

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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:

Taenia solium

Diphylobotrium latum

Hymenolepis nana

Fasciola hepatica

Echinococcus

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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?

Acute bronchitis

Squamous cell metaplasia of bronchial mucosa

Bronchiectasis

Squamous cell carcinoma of bronchus with keratinization

Polypoid chronic 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?

Cori’s disease (Glycogen storage disease type III)

McArdle’s disease (Glycogen storage disease type V)

Addison’s disease (Primary adrenal insufficiency)

Parkinson’s disease

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

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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?

Cyclodol (Trihexyphenidyl)

Platyphyllin

Proserin

Dithyline (Suxamethonium chloride)

Atropine

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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?

Posterior central gyrus

Anterior central gyrus

Occipital lobe

Frontal lobe

Parietal lobe

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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

Lungs

Kidneys

Liver

Spleen

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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?

Hydroureteronephrosis

Pyelectasis

Nephroblastoma

Renal cyst

Hydronephrosis

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

Alveolar tendency to recede

Increased pulmonary ventilation

Decreased airways resistance

Hyperoxemia

Decreased work of expiratory muscles

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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:

Ciliary

Sublingual

Submandibular

Otic

Pterygopalatine

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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

Sulfonylurea derivative

Long-acting insulin

Intermediate-acting insulin

Rapid-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?

Digoxin

Mesaton (Phenylephrine)

Nitroglycerine

Cordiamin

Papaverine hydrochloride

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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:

Polyploidy

Inversion

Translocation

Aneuploidy

Polyteny

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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?

Decreased resorption of pleural fluid

Increased permeability of the vessel wall

Erythrocyte aggregation

Increased blood pressure

Hypoproteinemia

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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?

Mesobilirubin

Unconjugated bilirubin

Conjugated bilirubin

Urobilinogen

Biliverdine

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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?

Creatinine

Uric acid

Total lipids

Glucose

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:

Troponin

Mucin

Collagen

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?

Atrial fibrillation

Sinus tachycardia

Sinus extrasystole

Paroxysmal atrial tachycardia

Atrial thrill

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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:

Atropine

Caffeine

Morphine

Ephedrine

Aminazine

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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

Lardaceous spleen

Sago spleen

Porphyry spleen

Splenic hyalinosis

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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?

Emphysema

Pneumonia

Pneumosclerosis

Atelectasis

Pneumothorax

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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?

Hypophosphatemia

Hyperkalemia

Hypocalcemia

Hyponatremia

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?

Hyperfunction of the insular apparatus

Hypothyroidism

Gonadal hypofunction

Hyperthyroidism

Adrenocortical hyperfunction

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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?

Corpus atreticum

Mature (tertiary) follicle

Corpus luteum

Primordial follicle

Primary 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?

Lymph node

Adrenal gland

Thymus

Thyroid gland

Kidney

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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?

Agglutination reaction with serum 0

By means of bacteriophage typing

Based on its biochemical properties

Based on the nature of its growth in Endo medium

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):

Bronchus, artery, veins

Veins, bronchus, artery

Artery, bronchus, veins

Artery, veins, bronchus

Veins, artery, bronchus

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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 G virus

Hepatitis B virus

Hepatitis D virus

Hepatitis C 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?

Red nuclei

Substantia nigra

Cerebellum

Thalamus

Reticular formation

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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:

Digoxin

Hydrochlorothiazide

Indometacin

Reserpine

Prednisolone

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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?

Qualitative abnormalities of fibri-nogenesis

Fibrinolysis activation

Decrease of fibrinogen synthesis

Decrease of prothrombin synthesis

Fibrin-stabilizing factor deficiency

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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?

Hemolytic

Neonatal

Mechanical

Gilbert’s disease

Parenchymal (hepatic)

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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?

Spleen

Red bone marrow

Thymus

Lymph node

Tonsil

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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?

Helycobacter pylori

Treponema pallidum

Shigella flexneri

Spirilla minor

Campylobacter jeuni

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

Deceleration of pyrimidine nucleotides salvage

Acceleration of nitrogen-containing substances excretion

Acceleration of pyrimidine nucleotides catabolism

Acceleration of nucleic acids synthesis

Competitive inhibition of xanthine oxidase

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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?

Disorder of impulse conduction in the myocardium

Dysregulation of cardiac function

Cardiac overload due to increased blood volume

Damage to the myocardium

Cardiac overload due to increased vascular resistance

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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?

Brucella abortus

Francisella tularensis

Mycobacterium bovis

Yersinia pestis

Bacillus anthracis

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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:

Activation of ketone bodies utilization

Decreased activity of plasma phosphatidylcholine-cholesterol-acyltransferase

Accumulation of palmitoyl-CoA in cytosol

Increased activity of adipose triglyceride lipase

Activation of apoА1, apoА2, and apoА4 apolipoprotein synthesis

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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?

Hemochromatosis

Hemomelanosis

Hemosiderosis

Lipofuscinosis

Jaundice

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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:

Myocarditis

Tiger heart

Postinfarction cardiosclerosis

Diffuse cardiosclerosis

Myocardial infarction

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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 RNA based on the DNA matrix

Informational RNA based on the viral protein matrix

Viral DNA based on the DNA matrix

Viral protein based on the viral RNA 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:

Vertically

Radially

-

Transversely

Arcuately

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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?

Diencephalon

Spinal cord

Medulla oblongata

Mesencephalon

Cerebral cortex

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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:

Ventricles

Purkinje’s fibers

Atrioventricular node

His’ bundle

Sinoatrial 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

Fats

Vitamins

Minerals

Carbohydrates

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

Diazepam

Caffeine

Medazepam

Nitrazepam

Piracetam

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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

Actinomycosis

Syphilis

Leprosy

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?

Quinine

Doxycycline

Biseptol (Co-trimoxazole)

Chingamin

Mefloquine

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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?

Pulmonary blood supply disturbance

Pulmonary enzyme system disturbance

Restrictive disorders of pulmonary ventilation

Decreased elasticity of the pulmonary tissue

Obstructive disorders of pulmonary ventilation

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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?

Immunofluorescence test

Immobilization test

Radioimmunoassay technique

Complement fixation test

Enzyme-linked immunosorbent assay

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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

Systolic and diastolic pressure will decrease

Only diastolic pressure will decrease

Only systolic 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?

Double immunodiffusion

Precipitation

Neutralization

Complement binding

Opsonophagocytic

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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

Acetylsalicylic acid

Potassium chloride

Metoprolol

Strophanthine

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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:

Uremic coma

Chronic renal failure

Pyelonephritis

Acute 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?

Salmonellosis

Cholera

Dysentery

Typhoid fever

Amebiasis

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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:

Plasma oncotic pressure

Hydrostatic blood pressure in the glomerular capillaries

Permeability of the renal filter

Effective filtration pressure

Renal blood flow

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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?

Hermaphroditism

Paraphimosis

Hypospadias

Phimosis

Epispadia

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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:

Binding of mast cell-fixed IgE

Blocking of mast cell mediators synthesis

Stabilization of mast cell membranes

Stimulation of antigen-specific IgG2

Stimulation of immune tolerance to antigen

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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

Increased blood proteins

Inflammatory damage to the nephrons

Morbid affection of the urinary tracts

Autoimmune 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?

Reticulum

Mesencephalon

Frontal lobe

Parietal lobe

Cerebellum

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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?

Essential hypertension

Ulcer disease

Bronchial asthma

Ischemic heart disease

Diabetes mellitus

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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:

Muscular vein

Mixed type artery

Nonmuscular vein

Muscular artery

Elastic 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?

III (B), Rh (+)

I (0), Rh (+)

II (А), Rh (+)

II (A), Rh (-)

I (0), 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?

Glycolysis

Glucose transportation into a cell

Gluconeogenesis

Glycogenolysis

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 fibro-cavitary tuberculosis

Secondary cirrhotic tuberculosis

Hematogenous macrofocal pulmonary 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 undifferentiated leukemia

Acute lymphoblastic leukemia

Acute plasmablastic leukemia

Acute monoblastic leukemia

Acute myeloblastic 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?

Acute radiation sickness

Decompression sickness

Acute leukemia

Vibration disease

Acute anemia

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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?

Granulomatosis

Normergic reaction

Transplantation immune reaction

Delayed hypersensitivity

Immediate hypersensitivity

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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?

Phenylin (Phenindione)

Aminocapronic acid

Vicasol (Menadione)

Contrykal (Aprotinin)

Thrombin

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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?

Visceral

Radiating

Epicritic

Protopathic

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?

Tocopherol

Folic acid

Calciferol

Riboflavin

Cobalamin

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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?

Sanguine

Choleric

-

Melancholic

Phlegmatic

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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

Thymus

Spleen

Lymph node

Tonsils

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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?

Brucellosis

Rabies

Encephalitis

Meningococcal meningitis

Encephalomyelitis

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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?

The same as in the population

50 %

100 %

Lower than in the population

Higher 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?

Promedol (Trimeperidine)

Prednisolone

Celecoxib

Paracetamol

Analgin (Metamizole)

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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?

Juxtaglomerular apparatus

Distal nephron

Filtration barrier

Henle’s loop

Proximal nephron

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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:

Tularemia

Anthrax

Brucellosis

Cholera

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:

Mediastinum anterius

Spatium pretracheale

Spatium interaponeuroticum suprasternale

Mediastinum posterius

Spatium interscalenum

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

Paracetamol

Anaprilin (Propranolol)

Atropine sulfate

Ambroxol

Magnesium sulfate

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

Triamterene

Furosemide

Dichlothiazidum (Hydrochlorothiazide)

Spironolactone

Diacarb (Acetazolamide)

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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?

Steroidal antiinflammatory drugs

Histamine Hi-receptor antagonists

Calcium channel blockers

Histamine H2-receptor antagonists

Nonsteroidal 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?

Turner

Down

DiGeorge

Kleinfelter

Patau

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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?

Hemagglutination inhibition assay (HAI)

Direct and indirect enzyme-linked immunosorbent assay (ELISA)

Direct and indirect immunofluorescence (IF)

Radioimmunoassay (RIA)

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?

Decreased IgD, IgE

No changes

Increased IgA, IgM

Increased IgD, IgE

Decreased IgA, IgM

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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?

Abscess

Hemorrhagic infarction

Ischemic stroke

Cyst

Tumor

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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 volume receptors

Vascular baroreceptors

Hypothalamic thermoreceptors

Proprioceptors of the working muscles

Vascular chemoreceptors

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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?

Muscle contracture

Incomplete tetanus

Smooth tetanus

Asynchronous tetanus

Series of single contractions

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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:

D -amino acid oxidase

Diamine oxidase

Phenylalanine 4-monooxygenase

Monoamine oxidase

L-amino acids 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?

Sphingomyelinase deficiency

Glucose 6-phosphatase deficiency

Xanthine oxidase deficiency

Amylo-1,6-glucosidase deficiency

Acid lipase 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, ХХХ

48, XXXY

46, XX

48, XXYY

47, XXY

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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?

Teniasis

Opisthorchiasis

Beef tapeworm infection

Echinococcosis

Diphyllobothriasis

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

Carbohydrates

Amylase

Chymotrypsin

Bile acids

Tripsin

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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?

Cytochrome splicing

Cytochrome synthesis

Adenosine triphosphate synthesis

Transfer of reduced equivalents to ubiquinone

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 venous return

Increased venous return

Increased central venous pressure

Decreased oncotic plasma pressure

Increased arterial 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

Histamine

Glutamine

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 arcuata

Linea terminalis

Linea transversa

Linea semilunaris

Linea inguinalis

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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:

Hepatolenticular degeneration

Acute productive hepatitis

Fatty hepatosis

Massive progressive necrosis

Acute exudative hepatitis

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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:

Lymphopoiesis

Granulocytopoiesis

Leukopoiesis

Immunogenesis

Erythropoiesis

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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

Potassium ion exit

Calcium ion entry

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?

Closure of the right interventricular foramen

Atresia of the fourth ventricle foramina

Atresia of the tubus medullaris

Closure of the left interventricular foramen

Atresia of the sylvian aqueduct

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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?

Monocytes

Eosinophils

Neutrophils

Endotheliocytes

Fibroblasts

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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?

Interspinal ligament

Posterior longitudinal ligament

Yellow ligament

Anterior 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?

Clostridium botulinum

Escherichia coli

Pseudomonas aeruginosa

Staphylococcus aureus

Clostridium perfringens

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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:

Repolarization

Depolarization

Contraction

Relaxation

Activation

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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?

Tuberculoma

Sequestrum

Gangrene

Granuloma

Abscess

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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?

Malate

Methylmalonic acid

Pyruvic acid

Uric acid

Phenyl pyruvate

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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?

Oxidation of glucose into lactate

Activation of microsomal oxidation

Increase of lipid peroxidation

Neutralization of xenobiotics

Counteraction to lipid peroxidation

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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

Sympathetic unconditioned reflex

Sympathetic conditioned reflex

Metasympathetic reflex

Parasympathetic 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:

Epithelial cells

Endocrine cells

Exocrine chief cells

Mucous cells

Exocrine parietal 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:

Urea

Glycosaminoglycans

Amino acids

Glucose

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?

Left lateral canal

Right lateral canal

Rectouterine pouch

Retrovesical pouch

Vesicouterine pouch

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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:

Inferior part of the precentral gyrus

Supramarginal gyrus

Angular gyrus

Superior part of the precentral gyrus

Superior parietal lobule

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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?

Phlegmonous gastritis

Catarrhal gastritis

Corrosive gastritis

Croupous gastritis

Diphtheritic 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?

Functional

Neurotonic

Metabolic

Neuroparalytic

Reactive

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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?

Undifferentiated small cell carcinoma

Squamous cell carcinoma

Adenocarcinoma

Undifferentiated large 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?

Posterior deep temporal artery

Lateral pterygoid artery

Middle meningeal artery

Anterior deep temporal artery

Superficial temporal 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?

Teniasis

Alveococcosis

Taeniarhynchosis

Echinococcosis

Trichinosis

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

Rod cells

Horizontal cells of retina

Bipolar neurons

Cone cells

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:

Pancreas

Parotid gland

Thyroid gland

Thymus

Parathyroid gland

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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:

Doxycycline

Interferon

BCG vaccine

Dexamethasone

Ambroxol

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

Reflex hyperpnea

Cough

Reflex dyspnea

Bronchial spasm

Reflex apnea

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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

Albuminosis

Increased proteolysis

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:

Low carnitine content

Lack of carbohydrates in the diet

Excessive consumption of fatty foods

Choline deficiency

Impaired phospholipid synthesis

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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:

Translation initiation in eucaryotes

Translation initiation in procaryotes

Replication initiation in procaryotes

Transcription initiation in procaryotes

Transcription initiation in eucaryotes

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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:

Conduction and convection

Radiation

Conduction

Evaporation

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?

Angiotensin-converting-enzyme inhibitors

Muscarinic agonists

Cholinesterase inhibitors

Calcium channel blockers

Muscarinic antagonists

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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 IV

Hyperlipoproteinemia type IIb

Hyperlipoproteinemia type IIa

Cholesterol, hyperlipoproteinemia

Hyperlipoproteinemia type I

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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:

Bijochinol (Quinine bismuth iodide)

Penicillin G Sodium Salt

Azithromycin

Streptomycin

Ciprofloxacin

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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:

Potassium and sodium

Calcium

Sodium

Potassium

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?

Formation of maturation spindle

Intensive energy production

Intensive protein synthesis

Partial or complete cell destruction

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:

Cellular cytotoxicity

Atopy (local anaphylaxis)

Antibody-dependent cell-mediated cytolysis

Systemic anaphylaxis

Immune complex hypersensitivity

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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 bromide

Sodium nucleotide

Albumin

Sodium chloride

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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?

Urobilinuria

Bilirubinuria

Hyperbilirubinemia

Increase of ALT, AST level

Cholemia

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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?

Fibroplastic endocarditis

Recurrent verrucous endocarditis

Acute verrucous endocarditis

Diffuse endocarditis

Ulcerative polypoid 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

Anaphase of the first division

Metaphase of the first division

Anaphase of the second division

Metaphase of the second 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?

Platyphyllin

Atropine

Salbutamol

Adrenaline

Ipratropium bromide

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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?

Phenobarbital

Chloral hydrate

Ethaminal sodium (Pentobarbital)

Nitrazepam

Barbamylum (Amobarbital)

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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?

Vital capacity

Maximal breathing capacity

Respiration rate

Functional residual capacity

Respiratory minute volume

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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?

Tsetse fly

Cockroach

Gnat

Mosquito

Triatomine bug

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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?

Tissue

Air

Gaseous

Thromboembolism

Adipose

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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 acidosis

Acid-base balance is normal

Respiratory alkalosis

Metabolic 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

Enterotoxin action

Pathogen adhesion to the enterocyte receptors

Activation of adenylate cyclase

Enterotoxic shock development

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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

Keto acids oxidative decarboxylation

Proline hydroxylation

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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?

Estriol

Testosterone

Oxytocin

Prolactin

Relaxin

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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:

Esophagus

Vermiform appendix

Umbilical cord

Urethra

Ureter

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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?

Spores that exceed cells in diameter

Fence-like position of the agent’s cells

Polar placement of volutin granules

Localization of the causative agent within macrophages

Presence of the capsule

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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?

Ischemia of the central nervous system

Alteration of transcapillary exchange

Abrupt change in body fluid volume

Stimulation of parasympathetic nerves

Stimulation of sympathetic nerves

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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:

Mineralocorticoids

Adrenaline

Vasopressin

Glucocorticoids

Insulin

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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:

Iron-deficiency

Neoplastic erythroid hyperplasia

S12-deficiency

Acidosis

Hypoxia

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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:

Overdominance

Polymery

Complete dominance

Epistasis

Complementary interaction

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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

Somatoliberin

Somatostatin

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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:

Inhibition of stimulating amino acids

GABA-ergic system activation

Supression of serotonergic neurotransmission

H1-histamine receptors stimulation

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:

Pellagra

Essential hypertension

Diabetes insipidus

Renal disorder

Myxedema

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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:

Typhoid fever

Pseudotuberculosis

Cholera

Colienteritis

Shigellosis

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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:

Have the largest molecular weight

Are the main factor of antiviral protection

Indicate recent infection

Are associated with anaphylactic reactions

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?

High-density lipoproteins

Chylomicrons

Very low-density lipoproteins

Intermediate-density lipoproteins

Low-density lipoproteins

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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 adrenocorticotropic hormones synthesis

Decrease hormone synthesis in the adrenal medulla

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

Red nuclei

Hypothalamus

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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 (+)

III (В) Rh (-)

IV (АВ) Rh (-)

II (А) Rh (+)

I (0) 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?

Thrombocytopenia

Hypocalcemia

Decrease of albumine content in blood

Decrease of fibrinogen content in blood

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?

Decrease of O2 partial pressure

Increase of air humidity

Increase of blood pH

Increase of nitrogen content in air

Increase of CO2 partial pressure

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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:

Calcium chloride

Pentoxyl

Ergocalciferol

Streptokinase

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?

Lack of energy

Tight time

Ttight time and lack of energy

Lack of energy and information

Lack of 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:

Gene amplification

Missense mutation

Genetic recombination

Transduction

Nucleotide deletion

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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?

Citrullinuria

Hyperaminoacidemia

Argininosuccinic aciduria

Hyperazotemia

Hyperuricemy

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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:

Tachycardia

Bradycardia

Extrasystole

Fibrillation

Flutter

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

Dopamine

Furosemide

Triamterene

Sodium bromide

Phenazepam

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

Bactrim (Co-trimoxazole)

Tetracycline

Streptocide

Furasolidone

Rifampicin

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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

Coronary ligament of the liver

Triangular ligament of the liver

Round ligament of the liver

Falciform 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

Treatment evaluation

Prevention

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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?

Decreased pulmonary ventilation

Increased renal reabsorption of bicarbonate

-

Increased renal reabsorption of ammonia

Increased pulmonary ventilation

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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?

Louis-Bar syndrome (Ataxia-telangiectasia)

Wiskott-Aldrich syndrome

Chediak-Higashi syndrome

Severe combined immunodeficiency (Swiss type)

DiGeorge 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?

Neurotonic

Neuroparalytic

Pathologic

Postischemic

Metabolic

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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

A. thyroidea superior

V jugularis externa

V jugularis anterior

V jugularis interna

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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. auricularis minor

N. petrosus major

N. petrosus profundus

N. petrosus 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?

Reinfection

Superinfection

Exogenous infection

Relapse

Autoinfection

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