Step 1 - Medicine 2013

A patient diagnosed with focal tuberculosis of the upper lobe of the right lung had been taking isoniazid as a part of combination therapy. After some time, the patient reported of muscle weakness, decreased skin sensitivity, blurred vision, impaired motor coordination. Which vitamin preparation should be used to address these phenomena?

Vitamin C

Vitamin A

Vitamin D

Vitamin B6

Vitamin B12

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A 60-year-old male patient has a 9-year history of diabetes and takes insulin Semi-lente for the correction of hyperglycemia. 10 days ago he began taking anaprilin for hypertension. One hour after administration of the antihypertensive drug the patient developed hypoglycemic coma. What is the mechanism of hypoglycemia in case of anaprilin use?

Reduction of glucagon half-life

Increase of insulin Semilente half-life

Inhibition of glycogenolysis

Increase of bioavailability of insulin Semilente

Decrease in glucose absorption

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Pterin derivatives (aminopterin and methotrexate) are the inhibitors of dihydrofolate reductase, so that they inhibit the regeneration of tetrahydrofolic acid from dihydrofolate. These drugs inhibit the intermolecular tranfer of monocarbon groups, thus suppressing the synthesis of the following polymer:

Protein

Homopolysaccharides

Gangliosides

Glycosaminoglycans

DNA

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A child with suspected tuberculosis was given Mantoux test. After 24 hours the site of the allergen injection got swollen, hyperemic and painful. What are the main components that determine such response of the body?

Mononuclear cells, T-lymphocytes and lymphokines

Granulocytes, T-lymphocytes and IgG

Plasma cells, T-lymphocytes and lymphokines

Macrophages, B-lymphocytes and monocytes

B-lymphocytes, IgM

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Hemoglobin catabolism results in release of iron which is transported to the bone marrow by a certain transfer protein and used again for the synthesis of hemoglobin. Specify this transfer protein:

Haptoglobin

Albumin

Transferrin (siderophilin)

Transcobalamin

Ceruloplasmin

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A 12-year-old boy has been hospitalized for suspected food poisoning. The fecal samples were inoculated on the Endo agar, which resulted in growth of a large number of colorless colonies. What microorganism is most likely to be EXCLUDED from the list of possible causative agents of the disease?

Escherichia coli

Yersinia enterocolitica

Proteus vulgaris

Pseudomonas aeruginosa

Salmonella enteritidis

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A 23-year-old patient has been admitted to a hospital with a craniocerebral injury. The patient is in a grave condition. Respiration is characterized by prolonged convulsive inspiration followed by a short expiration. What kind of respiration is it typical for?

Cheyne-Stokes

Gasping breath

Biot’s

Apneustic

Kussmaul’s

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It has been experimentally proven that the excitation of the motor neurons of flexor muscles is accompanied by the inhibition of the motor neurons of extensor muscles. What type of inhibition underlies this phenomenon?

Inhibition after excitation

Lateral

Reciprocal

Feedback

Pessimal

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A 3-year-old boy with pronounced hemorrhagic syndrome doesn’t have antihemophilic globulin A (factor VIII) in the blood plasma. Hemostasis has been impaired at the following stage:

Conversion of prothrombin to thrombin

Conversion of fibrinogen to fibrin

External mechanism of prothrombinase activation

Blood clot retraction

Internal mechanism of prothrombinase activation

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A patient got a gunshot wound of hip which damaged the sciatic nerve. Any impact on the affected limb causes severe, excruciating pain. What mechanism of pain is most likely in this case?

Causalgic

Reflex

Enkephalin hypofunction

Endorphin hypofunction

Phantom

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A 60-year-old patient with a long history of stenocardia takes coronarodilator agents. He has also been administered acetylsalicylic acid to reduce platelet aggregation. What is the mechanism of antiplatelet action of acetylsalicylic acid?

It has membrane stabilizing effect

It reduces the activity of phosphodiesterase

It enhances the synthesis of prostacyclin

It reduces the activity of cyclooxygenase

It enhances the activity of platelet adenylate cyclase

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A patient with bronchial asthma has developed acute respiratory failure. What kind of respiratory failure occurs in this case?

Dysregulation of alveolar ventilation

Perfusion

Obstructive disturbance of alveolar ventilation

Restrictive ventilatory defect

Diffusion

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On the fifth day after the acute blood loss a patient has been diagnosed with hypochromic anemia. What is the main mechanism of hypochromia development?

Release of immature red blood cells from the bone marrow

Impaired iron absorption in the intestines

Increased destruction of red blood cells in the spleen

Increased excretion of body iron

Impaired globin synthesis

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A patient with diabetes developed a diabetic coma due to the acid-base imbalance. Specify the kind of this imbalance:

Respiratory acidosis

Non-gaseous alkalosis

Metabolic acidosis

Gaseous alkalosis

Metabolic alkalosis

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A girl receives antibiotics of the penicillin group for acute bronchitis. On the third day of treatment she developed allergic dermatitis. Which drug should be administered?

Cromolyn sodium

Ephedrine hydrochloride

Loratadine

Beclomethasone

Levamisole

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A female patient has been diagnosed with cervical erosion, which is a precancerous pathology. What defense mechanism can prevent the development of a tumor?

Simplification of the antigenic structure of tissues

High-dose immunological tolerance

Increase in natural killer level (NK-cells)

Low-dose immunological tolerance

Increase in the activity of lysosomal enzymes

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Microscopy of the coronary artery of a dead 53-year-old patient revealed luminal occlusion due to a fibrous plaque with some lipids. The most likely form of atherosclerosis in this case is:

Lipidosis

Atheromatosis

Ulceration

Liposclerosis

Prelipid stage

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Autopsy of the patient revealed bone marrow hyperplasia of tubular and flat bones (pyoid marrow), splenomegaly (6 kg) and hepatomegaly (5 kg), enlargement of all lymph node groups. What disease are the identified changes typical for?

Polycythemia vera

Multiple myeloma

Chronic myelogenous leukemia

Hodgkin’s disease

Chronic lymphocytic leukemia

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As a result of an injury a patient cannot extend his arm at the elbow. This may cause abnormal functioning of the following muscle:

Musculus levator scapulae

Musculus infraspinatus

Musculus triceps brachii

Musculus subscapularis

Musculus teres major

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A man sitting with his eyes closed, undergoes electroencephalography. What rhythm will be recorded on the EEG if there is an audible signal?

Alpha rhythm

Gamma rhythm

Theta rhythm

Beta rhythm

Delta rhythm

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Electrophoretic study of a blood serum sample, taken from the patient with pneumonia, revealed an increase in one of the protein fractions. Specify this fraction:

a2-globulins

y-globulins

3- globulins

Albumins

a1-globulins

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Examination of an 18-year-old girl revealed the following features: hypoplasia of the ovaries, broad shoulders, narrow pelvis, shortening of the lower extremities, 'sphinx neck'. Mental development is normal. The girl was diagnosed with Turner’s syndrome. What kind of chromosome abnormality is it?

Monosomy X

Nullisomy X

Trisomy 13

Trisomy18

Trisomy X

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Hypertrichosis is the Y-linked character. The father has hypertrichosis, and the mother is healthy. In this family, the probability of having a child with hypertrichosis is:

0,5

1

0, 25

0,125

0,625

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A casualty has a fracture in the region of the inner surface of the left ankle. What is the most likely site for the fracture?

Medial malleolus

Lateral malleolus

Calcaneus

Astragalus

Lower third of the fibula

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Some infectious diseases caused by bacteria are treated with sulfanilamides which block the synthesis of bacteria growth factor. What is the mechanism of their action?

They inhibit the absorption of folic acid

They are allosteric enzyme inhibitors

They are antivitamins of para-amino benzoic acid

They are involved in redox processes

They are allosteric enzymes

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A 42-year-old male patient with gout has an increased blood uric acid concentration. In order to reduce the level of uric acid the doctor administered him allopurinol. Allopurinol is the competitive inhibitor of the following enzyme:

Adenine phosphoribosyltransferase

Guanine deaminase

Hypoxanthine-phosphoribosyltransferase

Adenosine deaminase

Xanthine oxidase

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A 40-year-old female patient diagnosed with acute pancreatitis has been delivered to the admission department of a regional hospital. What drug should be administered the patient in the first place?

Contrycal

Metacin

Platyphyllin

Atropine

Pirenzepine

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A patient consulted a doctor about being unable to abduct his right arm after a past trauma. Examination revealed that the passive movements were not limited. The patient was found to have the atrophy of the deltoid muscle. What nerve is damaged?

Ulnar

Axillary

Radial

Median

Suprascapular

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After a trauma of the upper third of the anterior forearm a patient exhibits difficult pronation, weakening of palmar flexor muscles and impaired skin sensitivity of 1-3 fingers. Which nerve has been damaged?

n. radialis

n. musculocutaneus

n. medianus

n. cutaneus antebrachii medialis

n. ulnaris

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A 38-year-old female patient complains of general weakness, cardiac pain, increased appetite, no menstruation. Objectively: the height is 166 cm, weight 108 kg, the patient has moonshaped face, subcutaneous fat is deposited mainly in the upper body, torso and hips. There are also blood-red streaks. Ps- 62/min, AP-160/105 mm Hg. Which of the following diseases is the described pattern of obesity most typical for?

Babinski-Frohlich syndrome

Alimentary obesity

Myxedema

Cushing pituitary basophilism

Insulinoma

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A 60-year-old patient with a long history of atherosclerosis and a previous myocardial infarction developed an attack of retrosternal pain. 3 days later the patient was hospitalized and then died of progressive cardiovascular insufficiency. At autopsy a white fibrous depressed area about 3 cm in diameter with clear boundaries was found in the posterior wall of the left ventricle and interventricular septum. The dissector evaluated these changes as:

Myocardial infarction

Focal cardiosclerosis

Myocarditis

Myocardial degeneration

Myocardial ischemia

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Measurements of the arterial pCO2 and pO2 during an attack of bronchial asthma revealed hypercapnia and hypoxemia respectively. What kind of hypoxia occurred in this case?

Circulatory

Hemic

Respiratory

Histotoxic

Tissue

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A female patient with bronchial asthma had taken prednisolone tablets (1 tablet 3 times a day) for 2 months. Due to a significant improvement of her condition the patient suddenly stopped taking it. What complication is likely to develop in this case?

Cushing’s syndrome

Upper body obesity

Withdrawal syndrome

Hypotension

Gastrorrhagia

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A patient with suspected dysentery has been admitted to the infectious diseases hospital. Which basic method of laboratory diagnosis must be applied in the first place?

Bacteriological

Microscopic

Allergic

Serological

Biological

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During a surgery with the use of hygronium the patient had an abrupt fall in blood pressure. Blood pressure can be normalized by the representatives of the following drug group:

M-cholinergic agents

o-adrenergic agonists

Ganglionic blockers

N-cholinergic agents

o-blockers

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A patient with respiratory failure has blood pH of 7,35. pCO2 test revealed hypercapnia. Urine pH test revealed an increase in the urine acidity. What form of acid-base imbalance is the case?

Compensated respiratory acidosis

Decompensated respiratory alkalosis

Compensated respiratory alkalosis

Compensated metabolic acidosis

Decompensated metabolic acidosis

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On examination a patient was found to have medial strabismus, the inward deviation of the eyeball and inability to abduct the eyeball outwards. What nerve is damaged?

Oculomotor

Ocular

Trochlear

Abducent

Visual

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A patient with a dislocated shoulder had been admitted to a hospital. With the purpose of skeletal muscle relaxation he was given an injection of relaxant dithylinum acting normally 5-7 minutes. However, the effect of dithylinum in this patient lasted up to 8 hours. What is the most likely cause of the prolonged effect of dithylinum in this patient?

Reduced drug excretion

Material accumulation of the drug

Genetic deficiency of blood cholinesterase

Potentiation by another drug

Reduced activity of microsomal liver enzymes

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As a result of an injury of the knee joint a patient shows a drawer sign, that is the anterior and posterior displacement of the tibia relative to the femur. What ligaments are damaged?

Interosseous membrane

Cruciate ligaments

Oblique popliteal ligament

Arcuate popliteal ligaments

Collateral ligaments

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The neurosurgical department has admitted a 54-year-old male complaining of no sensitivity in the lower eyelid skin, lateral surface of nose, upper lip. On examination the physician revealed the inflammation of the second branch of the trigeminal nerve. This branch comes out of the skull through the following foramen:

Round foramen

Superior orbital fissure

Oval foramen

Lacerated foramen

Spinous foramen

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Bacteriological examination of purulent discharges from the urethra revealed some gramnegative beanshaped bacteria located in the leukocytes. They can be identified as the causative agent of the following disease:

Syphilis

Venereal lymphogranulomatosis

Chancroid

Trichomoniasis

Gonorrhea

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A male patient is 28 years old. Histological study of a cervical lymph node revealed a change of its pattern due to the proliferation of epithelioid, lymphoid cells and macrophages having nuclei in form of a horseshoe. In the center of some cell clusters there were non-structured light-pink areas with fragments of nuclei. What disease are these changes typical for?

Hodgkin’s disease

Tuberculosis

Tumor metastasis

Syphilis

Actinomycosis

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A 35-year-old male patient has been referred by an andrologist for the genetic counselling for the deviations of physical and mental development. Objectively: the patient is tall, has asthenic constitution, gynecomastia, mental retardation. Microscopy of the oral mucosa cells revealed sex chromatin (single Barr body) in 30% of cells. What is the most likely diagnosis?

DiGeorge syndrome

Klinefelter syndrome

Cushing pituitary basophilism

Recklinghausen’s disease

Down syndrome

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

Mechanical

Hemolytic

Neonatal jaundice

Parenchymal (hepatic)

Gilbert’s disease

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A male with a lesion of one of the CNS parts has asthenia, muscular dystonia, balance disorder. Which CNS part has been affected?

Reticular formation

Vestibular nuclei

Cerebellum

Red nuclei

Black substance

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A 50-year-old patient has been administered laevomycetin for the treatment of typhoid fever, but on the next day the patient’s condition worsened, the temperature rose to 39,60C. The deterioration of the patient’s condition can be explained by:

Insensitivity of the pathogen to laevomycetin

Re-infection

Allergic reaction

Effects of endotoxins of the causative agent

Secondary infection

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A 12-year-old patient has been admitted to a hospital for hemarthrosis of the knee joint. From early childhood he suffers from frequent bleedings. Diagnose the boy’s disease:

Hemophilia

B12 (folic acid)-deficiency anemia

Hemolytic anemia

Thrombocytopenic purpura

Hemorrhagic vasculitis

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Examination of a patient with ischemic heart disease revealed the impaired venous blood flow in the territory of the cardiac vein running in the anterior interventricular sulcus of heart. What vein is it?

V. cordis parva

V cordis magna

V obliqua atrii sinistri

V. cordis media

V posterior ventriculi sinistri

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For the direct injection of medications into the liver surgeons use the round ligament of liver. This manipulation involves bougienage (lumen dilatation) of the following vessel:

V. porta

Ductus venosus

A. hepatica propria

V umbilicalis

A. umbilicalis

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A patient with lobar pneumonia has had body temperature of 39oC with daily temperature fluctuation of no more than 1oC for 9 days. This fever can be characterized by the following temperature curve:

Hyperpyretic

Hectic

Remittent

Persistent

Recurrent

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The temperature in a production room is 36oC. Relative air humidity is 80%. Under these conditions the human body transfers heat mainly through:

-

Heat conduction

Convection

Sweat evaporation

Radiation

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A hospitalized patient bitten by a rabid animal has an avulsive wound of shin. What kind of vaccine must be given to prevent rabies?

BCG

Anti-rabies vaccine

TABte

DTaP

Td

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At autopsy the occipital lobe of brain was found to have a cavity 2,5x1,5 cm large filled with a transparent liquid. The cavity had smooth brownish walls. What process had developed in the brain?

Cyst on the site of a hemorrhage

Softening of the cerebrocortical grey matter

Brain abscess

A cyst on the site of the softening of the cerebrocortical grey matter

Paracephalia

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A child entering the school for the first time was given Mantoux test in order to determine if there was a need for revaccination. The reaction was negative. What is the meaning of this test result?

Presence of antibodies to the tuberculosis bacteria

No anti-toxic immunity to tuberculosis

No cell-mediated immunity to tuberculosis

Availability of cell-mediated immunity to tuberculosis

No antibodies to the tuberculosis bacteria

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Study of the biopsy material revealed a granuloma consisting of lymphocytes, plasma cells, macrophages with foamy cytoplasm (Mikulicz cells), many hyaline globules. What disease can you think of?

Actinomycosis

Leprosy

Syphilis

Tuberculosis

Rhinoscleroma

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Autopsy of a 78-year-old patient revealed that retroperitoneal tissue was soaked with blood, the abdominal aorta had a sacciform protrusion including a defect with irregular edges. The wall of the aorta was here and there of stone-like density. This is the complication of the following disease:

Systemic vasculitis

Visceral syphilis

Atherosclerosis

Essential hypertension

Marfan syndrome

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Glycogen polysaccharide is synthesized from the active form of glucose. The immediate donor of glucose residues during the glycogenesis is:

Glucose-6-phosphate

UDP-glucose

ADP-glucose

Glucose-3-phosphate

Glucose-1-phosphate

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After the diagnostic tests a 40-year-old male has been referred for the lymphography of the thoracic cavity. The surgeon revealed that the tumor had affected an organ whose lymphatic vessels drain directly into the thoracic duct. Specify this organ:

Pericardium

Esophagus

Heart

Trachea

Left main bronchus

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A patient with biliary dyskinesia and constipations has been prescribed a cholagogue having also a laxative effect. What drug has been administered?

Magnesium sulfate

Cholosas

Nicodinum

Allochol

Cholenzyme

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It is known that individuals with genetically caused deficiency of glucose-6-phosphate dehydrogenase may develop RBC hemolysis in response to the administration of some antimalarial drugs. Mani- festation of adverse reactions to drugs is called:

Tachyphylaxis

Idiosyncrasy

Tolerance

Sensibilization

Allergy

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A 40-year-old patient with the progressing staphylococcal purulent periodontitis developed purulent inflammation of bone marrow spaces of the alveolar process, and then of the body of mandible. Microscopy revealed thinning of bone trabeculae, foci of necrosis, bone sequesters surrounded by the connective tissue capsule. What is the most likely diagnosis?

Parodontome

Acute osteomyelitis

Chronic osteomyelitis

Chronic fibrous periostitis

Purulent abscess

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Curariform substances introduced into a human body cause the relaxation of all skeletal muscles. What changes in the neuromuscular synapse cause this phenomenon?

Impaired cholinesterase synthesis

Blockade of Ca2+ channels of the presynaptic membrane

Impaired acetylcholine release

Blockade of N-cholinergic receptors of the synaptic membrane

Depolarization of the postsynaptic membrane

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A number of diseases can be diagnosed by evaluating activity of blood transaminases. What vitamin is one of cofactors of these enzymes?

Bi

B6

B5

B8

B2

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After a car accident a 23-year-old male presented to the hospital with a cut wound of the anteromedial region of shoulder and arterial bleeding. Which artery was damaged?

A. profunda brachii

A. subscapularis

A. axillaris

A. brachialis

A. radialis

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During the operation on the small intestine the surgeon revealed an area of the mucous membrane with a single longitudinal fold among the circular folds. Which portion of the small intestine is this structure typical for?

Pars horizontalis duodeni

Pars descendens duodeni

Pars ascendens duodeni

jejunum

Distal ileum

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14 days after quinsy a 15-year-old child presented with morning facial swelling, high blood pressure, 'meat slops' urine. Immunohistological study of a renal biopsy sample revealed deposition of immune complexes on the basement membranes of the capillaries and in the glomerular mesangium. What disease developed in the patient?

Acute pyelonephritis

Acute glomerulonephritis

Lipoid nephrosis

Necrotizing nephrosis

Acute interstitial nephritis

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A diseased child has a high fever, sore throat, swelling of submandibular lymph nodes. Objectively: pharyngeal mucosa is edematous, moderately hyperemic, the tonsils are enlarged, covered with grayish membrane tightly adhering to the tissues above. Attempts to remove the membrane produce the bleeding defects. What disease are these presentations typical for?

Meningococcal disease

Measles

Scarlet fever

Diphtheria

Catarrhal tonsillitis

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Study of the biopsy material of an embryo revealed a zone of developmental abnormality in a somite. The zone was located close to the endoderm and the notochord. What formations may have abnormal development in case of pregnancy continuation?

Skeletal striated muscle tissue

Genito-urinary system

Fibrous connective tissue of skin

Cardiac striated muscle tissue

Skeletal tissues

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A smear of sputum from the patient with suspected lobar pneumonia was stained with the use of the following stains and reagents: solution of gentian violet, Lugol’s solution, 96° alcohol, water magenta. What staining method was applied in this case?

Ziehl-Nielsen

Neisser

Gram

Romanovsky

Leffler

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A patient has normally coloured stool including a large amount of free fatty acids. The reason for this is a disturbance of the following process:

Fat hydrolysis

Fat absorption

Biliary excretion

Choleresis

Lipase secretion

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Examination of the removed stomach revealed a deep roundish defect with regular edges at the lesser curvature of the antrum. The defect reached the muscular tunic and was 1,5 cm in diameter. Within the defect floor there was a translucent dense area resembling of a hyaline cartilage. What process had developed in the floor of the stomach defect?

Local hyalinosis

Amyloidosis

Fibrinoid alterations

General hyalinosis

Mucoid swelling

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By the decarboxylation of glutamate in the CNS an inhibitory mediator is formed. Name it:

Asparagine

Histamine

Glutathione

GABA

Serotonin

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Thermometry revealed that the temperature of the exposed skin is by 11,5° lower than the temperature of the adjacent areas covered with clothing from natural fabrics. The reason for this is that the clothes reduce the heat loss through:

Convection

-

Radiation

Conduction

Evaporation

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A specimen of pia mater includes a vessel whose wall doesn’t have the tunica media, the tunica externa is adherent to the surrounding tissues, the intima is composed of a basement membrane and endothelium. What vessel is it?

Muscular artery

Nonmuscular vein

Arteriole

Artery of mixed type

Muscular vein with underdeveloped muscular elements

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A patient with extensive burns of torso skin exhibits signs of severe intoxication. What stage of the burn disease is this typical for?

Burn infection

Burn shock

Burn toxemia

Terminal

Burn emaciation

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As a result of a craniocerebral injury a patient has a decreased skin sensitivity. What area of the cerebral cortex may be damaged?

Occipital region

Cingulate gyrus

Frontal cortex

Anterior central gyrus

Posterior central gyrus

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A histological specimen of the eyeball shows a biconvex structure connected to the ciliary body by the fibers of the Zinn’s zonule and covered with a transparent capsule. Name this structure:

Cornea

Sclera

Ciliary body

Vitreous body

Crystalline lens

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A comatose patient was taken to the hospital. He has a history of diabetes mellitus. Objectively: Kussmaul breathing, low blood pressure, acetone odor of breath. After the emergency treatment the patient’s condition improved. What drug had been administered to the patient?

Glibenclamide

Adrenaline

Furosemide

Isadrinum

Insulin

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In order to stimulate breathing in a child born with asphyxia, the doctor gave him a drug injection into the umbilical vein. What drug might have been injected?

Cordiaminum

Sulfocamphocainum

Corazolum

Coffeinum

Aethimizolum

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A patient complains of pain in the right lateral abdomen. Palpation revealed a dense, immobile, tumor-like formation. A tumor is likely to be found in the following part of the digestive tube:

Caecum

Colon descendens

Colon transversum

Colon sigmoideum

Colon ascendens

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A patient underwent biopsy of the soft palate arches for a suspected tumor (macroscopy revealed an ulcer with a dense floor). Study of the biopsy material revealed mucosal necrosis with infiltration of lymphocytes, epithelioid cells, plasma cells, single neutrophils in the submucosa. There were also apparent signs of endovasculitis and perivasculitis. The described changes are typical for:

Necrotizing ulcerative Vincent stomatitis

Pharyngeal diphtheria

Ulcerative stomatitis

Primary syphilis

Aphthous stomatitis

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Healthy parents with unremarkable family history have the child with multiple developmental defects. Cytogenetic analysis revealed the trisomy 13 in the somatic cells (Patau syndrome). What phenomenon has caused the defects?

Recessive mutation

Abnormal gametogenesis

Dominant mutation

Chromosomal mutation

Somatic mutation

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A specimen shows an organ covered with the connective tissue capsule with trabeculae radiating inward the organ. There is also cortex containing some lymph nodules, and medullary cords made of lymphoid cells. What organ is under study?

Tonsils

Spleen

Red bone marrow

Thymus

Lymph node

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A 25-year-old patient consulted a doctor about dysmenorrhea and infertility. Examination revealed that the patient was 145 cm high and had underdeveloped secondary sex characteristics, alar folds on the neck. Cytological study didn’t reveal any Barr bodies in the somatic cells. What diagnosis was made?

-

Turner’s syndrome

Trisomy X syndrome

Klinefelter syndrome

Morris syndrome

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To prevent attacks of acute pancreatitis a doctor prescribed the patient trasylol (contrycal, gordox), which is an inhibitor of:

Gastricsin

Trypsin

Chymotrypsin

Carboxypeptidase

Elastase

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A patient died from progressive heart failure. Autopsy revealed that the heart was enlarged in diameter, flabby. The muscle section exhibited irregular blood supply. Histological study of myocardium revealed hyperemia, the stroma was found to have lymphohistiocytic infiltrates with degeneration of cardiomyocytes. The revealed morphological changes are indicative of:

Venous plethora

Myocardial infarction

Non-purulent interstitial myocarditis

Cardiomyoliposis

Cardiosclerosis

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A 13-year-old teenager underwent X-ray examination of the hip joint. Examination revealed a 3 mm wide radiolucent zone between the head and the shaft of femur. This situation should be evaluated as:

Fissured fracture of the femoral neck

Dislocation of the femoral head

Radiographic film artifact

Normal (incomplete process of ossification)

Fracture of the femoral neck

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A surgeon examined the patient and found the injury of the upper third of the kidney. Considering the syntopy of the left kidney, the intactness of the following organ should be checked at the same time:

Small intestine

Stomach

Liver

Descending colon

Transverse colon

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A patient with urolithiasis has unbearable spasmodic pain. To prevent pain shock, he has been given an injection of atropine along with a narcotic analgesic having antispasmodic effect. What drug was it?

Nalorphine

Tramadol

Morphine hydrochloride

Ethylmorphine hydrochloride

Promedol

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Despite the administration of cardiotonics and a thiazide diuretic a patient with chronic heart failure has persistent edemata, there is a risk of ascites. What medication should be administered in order to enhance the diuretic effect of the drugs used?

Clopamide

Spironolactone

Manithol

Amiloride

Furosemide

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A patient with a pathology of the cardiovascular system developed edemata of the lower extremities. What is the mechanism of cardiac edema development?

Reduced osmotic pressure

Increased hydrostatic pressure at the arterial end of the capillary

Increased hydrostatic pressure at the venous end of the capillary

Lymph efflux disorder

Increased oncotic pressure

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During the fight, a man had a cardiac arrest due to the strong blow to the upper region of the anterior abdominal wall. Which of the following mechanisms has led to the cardiac arrest?

Peripheral reflexes

Parasympathetic conditioned reflexes

Parasympathetic unconditioned reflexes

Sympathetic conditioned reflexes

Sympathetic unconditioned reflexes

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A pregnant woman underwent AB0 blood typing. Red blood cells were agglutinated with standard sera of the I and II blood groups, and were not agglutinated with the III group serum. What is the patient’s blood group?

B(III)

-

AB(IV)

0( I )

A(II)

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Amniocentesis revealed two sex chromatin bodies (Barr bodies) in each cell of the sample. What disease is this character typical for?

Turner’s syndrome

Trisomy X

Klinefelter syndrome

Patau syndrome

Down’s syndrome

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A hospital has admitetd a patient complaining of abdominal bloating, diarrhea, flatulence after eating protein foods. These signs are indicative of the impaired digestion of proteins and their increased degradation. Which of the following compounds is the product of this process?

Cadaverine

Indole

Bilirubin

Putrescine

Agmatine

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An attack of tachycardia that occurred in a patient was stopped by pressing on his eyeballs. Which of the following reflexes underlies this phenomenon?

Bernard’s

Aschner

Goltz

Bainbridge

Hering

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A male patient has been diagnosed with acute post-streptococcal glomerulonephritis. It is most likely that the lesion of the basement membrane of renal corpuscles was caused by the following allergic reaction:

Cytotoxic

Immune complex

Delayed

Stimulating

Anaphylactic

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

Glutamine

Urea

Bilirubin

Ammonia

Histamine

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A 20-year-old male patient complains of general weakness, rapid fatigability, irritability, decreased performance, bleeding gums, petechiae on the skin. What vitamin deficiency may be a cause of these changes?

Retinol

Thiamine

Folic acid

Ascorbic acid

Riboflavin

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It is known that the monoamine oxidase (MAO) enzyme plays an important part in the metabolism of catecholamine neurotransmitters. In what way does the enzyme inactivate these neurotransmitters (norepinephrine, epinephrine, dopamine)?

Hydrolysis

Removal of a methyl group

Addition of an amino group

Carboxylation

Oxidative deamination

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The cellular composition of exudate largely depends on the etiological factor of inflammation. What leukocytes are the first to get into the focus of inflammation caused by pyogenic bacteria?

Basophils

Myelocytes

Neutrophil granulocytes

Eosinophilic granulocytes

Monocytes

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At the end of the working day a worker of a hot work shop has been delivered to a hospital. The patient complains of a headache, dizziness, nausea, general weakness. Objectively: the patient is conscious, his skin is hyperemic, dry, hot to the touch. Heart rate is of 130/min. Respiration is rapid, superficial. What disorder of thermoregulation is most likely to have occurred in this patient?

Reduced heat production with no changes to the heat transfer

Increased heat transfer and heat production

Increased heat production with no changes to the heat transfer

Reduced heat transfer

Increased heat transfer and reduced heat production

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Alveolar space of the acinus was invaded by some bacteria which interacted with the surfactant. This led to the activation of the cells that are localized in the alveolar walls and on the surface. What cells are these?

Clara cells

Alveolocytes type I

Alveolar macrophages

Alveolocytes type II

Endothelial cells

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A 35-year-old male developed acute heart failure while running for a long time. What changes in the ionic composition can be observed in the cardiac muscle?

Accumulation of Na+ and Ca2+ ions in the myocardium cells

Reduction of Na+ and Ca2+ ions in the extracellular space

Accumulation of K + and Mg2+ ions in the myocardium cells

Reduction of K + and Mg2+ ions in the extracellular space

Reduction of Na+ and Ca2+ ions in the myocardium cells

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Workers of a conveyor workshop received recommendations for the effective organization of working time and higher working efficiency. What peculiarity of work in this workshop causes the greatest stress for the workers?

Social inefficiency of labor

Increased responsibility

State of 'operating rest'

Monotony of work

Increased intellectual component

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Mother of a boy who had recently returned from a summer camp found some small whitish insects up to 3 mm long on the child’s clothing. Specify the parasite:

Pulex irritans

Phtirus pubis

Blattella germanica

Pediculus humanus humanus

Cimex lectularius

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Histological examination of the removed skin neoplasm revealed clusters and cords of atypical cells of stratified squamous epithelium, growing into the underlying tissue. What diagnosis can be assumed?

Keratinizing squamous cell carcinoma

Carcinoma in situ

Adenoma

Non-keratinizing squamous cell carcinoma

Papilloma

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An 18-year-old male has been diagnosed with Marfan syndrome. Examination revealed a developmental disorder of connective tissue and eye lens structure, abnormalities of the cardiovascular system, arachnodactylia. What genetic phenomenon has caused the development of this disease?

Incomplete dominance

Codominance

Complementarity

Pleiotropy

Multiple allelism

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A patient has severe catarrhal symptoms. Material growth on Bordet-Gengou agar showed mercury-droplike colonies. Examination of the blood smears revealed some small ovoid grampositive bacilli sized 1-3 microns. What microorganisms were isolated?

Corynebacteria

Mycobacteria

Meningococcus

Bordetella

Brucella

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A 66-year-old patient with Parki- nson’s disease shows an improvement in locomotor activity after prolonged use of a certain drug which is converted to dopamine by the decarboxylation. What drug has the patient taken?

Naloxone

Droperidol

Chlorpromazine

Levodopa

Celecoxib

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Enzymatic jaundices are accompanied by abnormal activity of UDP-glucuronyl transferase. What compound is accumulated in blood serum in case of these pathologies?

Dehydrobilirubin

Conjugated bilrubin

Hydrobilirubin

Choleglobin

Unconjugated bilirubin

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For the study of serum proteins various physical and physicochemical methods can be used. In particular, serum albumins and globulins can be separated by this method:

Spectrography

Dialysis

Electrophoresis

Polarography

Refractometry

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Negative environmental factors have caused the dysfunction of myosatellite cells. What function of the whole muscle fibre is likely to be changed in this case?

Relaxation

Contractile thermogenesis

Contraction

Trophism

Regeneration

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The laboratory for especially dangerous infections conducts microscopic examination of pathological material from a patient with suspected plague. The sample was stained by BurriGins technique. What property of the causative agent can be identified by this technique?

Acid resistance

Alkali resistance

Spore formation

Capsule formation

Presence of volutin granules

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Autopsy of a 62-year-old woman revealed a dense well-circumscribed node of 6 cm in diameter in the cranial cavity. The node was attached to the dura mater and histologically consisted of clusters and micro-concentric structures of endothelial cells, psammoma bodies. What kind of tumor was found at autopsy?

Meningioma

Melanoma

Glioblastoma

Cancer metastasis

Medulloblastoma

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

Urea

Amino acids

Glucose

Glycosaminoglycans

Lipids

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An animal has an increased tonus of extensor muscles. This is the result of enhanced information transmission to the motoneurons of the spinal cord through the following descending pathways:

Reticulospinal

Vestibulospinal

Lateral corticospinal

Rubrospinal

Medial corticospinal

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A specimen of a parenchymal organ shows poorly delineated hexagonal lobules surrounding a central vein, and the interlobular connective tissue contains embedded triads (an 0artery, a vein and an excretory duct). What organ is it?

Thymus

Pancreas

Thyroid

Liver

Spleen

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A patient has been admitted to the infectious diseases department for malaise, fever up to 38 oC, jaundice. A few months ago, the patient underwent blood transfusion. The doctor suspected viral hepatitis B. What are the principal methods of laboratory diagnosis of hepatitis B?

Isolation of the virus in laboratory animals (neutralization reaction)

Isolation of the virus in chicken embryos

Detection of virions in blood by electron microscopy

Serological and gene diagnostics

Virus isolation in cell culture and its identification by the cytopathic effects

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After resection of the middle third of the femoral artery obliterated by a thrombus the limb is supplied with blood through the bypasses. What artery plays the main part in the restoration of the blood flow?

Superficial iliac circumflex artery

External pudendal artery

Descending genicular artery

Superficial epigastric artery

Deep femoral artery

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During the intravenous transfusion of the saline the patient’s condition deteriorated dramatically, and the patient died from asphyxiation. Autopsy revealed acute venous congestion of internal organs with the dramatic right heart dilatation. When the right ventricle was punctured underwater, the bubbles escaped. What pathological process occurred in the patient?

Air embolism

Thromboembolism

Tissue embolism

Gaseous embolism

Adipose embolism

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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?

Gastric abscess

Esogastritis

Fibrinous gastritis

Croupous gastritis

Corrosive gastritis

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Infectious diseases are treated with antibiotics (streptomycin, erythromycin, chloramphenicol). They inhibit the following stage of protein synthesis:

Replication

Translation

Transcription

Splicing

Processing

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Diseases of the respiratory system and circulatory disorders impair the transport of oxygen, thus leading to hypoxia. Under these conditions the energy metabolism is carried out by anaerobic glycolysis. As a result, the following substance is generated and accumulated in blood:

Lactic acid

Fumaric acid

Pyruvic acid

Glutamic acid

Citric acid

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A patient has been hospitalized for a suspected tumor of the prostate. During the surgery, it was revealed that the tumor invaded the bladder. Which part of the bladder was affected?

Bottom

-

Apex

Cervix

Body

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A casualty with an injury of the temporal region has been diagnosed with epidural hematoma. Which of the arteries is most likely to be damaged?

Medial cerebral artery

Posterior auricular artery

Superficial temporal artery

Anterior membranous artery

Medial membranous artery

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A 19-year-old male was found to have an elevated level of potassium in the secondary urine. These changes might have been caused by the increase in the following hormone level:

Glucagon

Aldosterone

Oxytocin

Adrenaline

Testosterone

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Analysis of the ECG revealed the missing of several PQRST cycles. The remaining waves and complexes are not changed. Specify the type of arrhythmia:

Atrial premature beat

Atrioventricular block

Intra-atrial block

Atrial fibrillation

Sinoatrial block

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ECG of a patient displays an abnormally long R wave (up to 0,18 s). This is caused by a decrease in the conduction velocity of the following heart structures:

Right ventricle

Ventricles

Left ventricle

Atrio-ventricular node

Atria

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6 hours after the myocardial infarction a patient was found to have elevated level of lactate dehydrogenase in blood. What isoenzyme should be expected in this case?

LDH1

LDH2

LDH4

LDH5

LDH3

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A 46-year-old female is scheduled for a maxillofacial surgery. It is known that the patient is prone to high blood coagulation. What natural anticoagulant can be used to prevent blood clotting?

None of the above-listed substances

Fibrinolysin

Heparin

Hirudin

Sodium citrate

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A 50-year-old patient with food poisoning is on a drip of 10% glucose solution. It not only provides the body with necessary energy, but also performs the function of detoxification by the production of a metabolite that participates in the following conjugation reaction:

Glucuronidation

Sulfation

Glycosylation

Hydroxylation

Methylation

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To assess the effectiveness of breathing in patients, the indicator of functional residual capacity is used. It includes the following volumes:

Inspiratory reserve volume and residual volume

Expiratory reserve volume and residual volume

Expiratory reserve volume and tidal volume

Inspiratory reserve volume, tidal volume, residual volume

Inspiratory reserve volume and tidal volume

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It is required to evaluate the level of tissue excitability. For this purpose one should determine:

Action potential amplitude

Depolarization threshold

Resting potential

Action potential duration

Critical level of depolarization

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Due to the use of poor-quality measles vaccine for preventive vaccination, a 1-year-old child developed an autoimmune renal injury. The urine was found to contain macromolecular proteins. What process of urine formation was disturbed?

Secretion

Secretion and filtration

Reabsorption

Reabsorption and secretion

Filtration

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A patient has been administered an anti-inflammatory drug that blocks the action of cyclooxygenase. Specify this anti-inflammatory agent:

Creatine

Aspirin

Allopurinol

Thiamin

Analgene

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A pneumonia patient has been administered acetylcysteine as a part of complex therapy. What principle of therapy was taken into consideration when applying this drug?

Antimicrobial

Etiotropic

Immunomodulatory

Pathogenetic

Symptomatic

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

Doxycycline

Ambroxol

Interferon

BCG vaccine

Dexamethasone

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A 65-year-old male suddenly lost the vision in one eye due to the retinal detachment. The patient underwent enucleation. Histological examination of the removed eye retina and choroid revealed clusters of atypical cells with marked polymorphism of cells and nuclei, with a moderate number of mitoses including the pathological ones. The cell cytoplasm and intercellular medium contained brown pigment giving a positive DOPA reaction. Perls’ reaction was negative. What is the most likely diagnosis?

Wilson’s disease

Cysticercosis

Melanoma

Pigmented mole

Hemorrhage

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A child cut his leg with a piece of glass while playing and was brought to the clinic for the injection of tetanus toxoid. In order to prevent the development of anaphylactic shock the serum was administered by Bezredka method. What mechanism underlies this method of desensitization of the body?

Stimulation of the synthesis of antigen-specific IgG

Binding of IgE receptors to the mast cells

Binding of IgE fixed to the mast cells

Stimulation of immune tolerance to the antigen

Blocking the mediator synthesis in the mast cells

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Microscopy of the myocardium of a patient who had died from heart failure revealed foci of fibrinoid necrosis located diffusely in the interstitial stroma, and often around the vessels. Such foci were surrounded by lymphocytes, macrophages, histiocytes. Pericardium was found to have signs of sero-fibrinous pericarditis. What is the most likely diagnosis?

Rheumatic heart disease

Cardiomyopathy

-

Myocardial infarction

Cardiosclerosis

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

Lack of carbohydrates in the diet

Impaired phospholipid synthesis

Excessive consumption of fatty foods

Low level of carnitine

Choline deficiency

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The genetic defect of pyruvate carboxylase deficiency is the cause of delayed physical and mental development and early death in children. This defect is characterized by lacticemia, lactaci-duria, disorder of a number of metabolic pathways. In particular, the following process is inhibited:

Glycogenesis and glycogenolysis

Pentose phosphate pathway and glycolysis

Glycolysis and glycogenolysis

Citric acid cycle and gluconeogenesis

Lipolysis and lipogenesis

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Deficiency of linoleic and linolenic acids in the body leads to the skin damage, hair loss, delayed wound healing, thrombocytopenia, low resistance to infections. These changes are most likely to be caused by the impaired synthesis of the following substances:

Eicosanoids

Interleukins

Catecholamines

Corticosteroids

Interferons

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During ventricular systole, the cardiac muscle does not respond to additional stimulation because it is in the phase of:

Subnormal excitability

Hyperexcitability

Absolute refractoriness

There is no correct answer

Relational refractoriness

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A mother had taken synthetic hormones during pregnancy. Her daughter was born with hirsutism formally resembling of adrenal syndrome. Such manifestation of variability is called:

Mutation

Phenocopy

Replication

Recombination

Heterosis

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Since a patient has had myocardial infarction, atria and ventricles contract independently from each other with a frequency of 60-70 and 35-40 per minute. Specify the type of heart block in this case:

Complete atrioventricular

Partial atrioventricular

Intra-atrial

Sino-atrial

Intraventricular

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

Hyperlipoproteinemia type IV

Hyperlipoproteinemia type IIb

Cholesterol, hyperlipoproteinemia

Hyperlipoproteinemia type I

Hyperlipoproteinemia type IIa

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A 12-year-old child has a viral infection complicated by obstructive bronchitis. Bronchospasm can be eliminated by inhalations of a drug from the following pharmacological group:

/32-agonists

N-cholinomimetics

M-anticholinergics

Analeptics

32- adrenergic blockers

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In course of an experiment there has been an increase in the nerve conduction velocity. This may be caused by an increase in the concentration of the following ions that are present in the solution around the cell:

Ca2+

Ca2+ and Cl

Na+

K+ and ClC. K + and Na+

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A male working as a blacksmith has been tested for auditory acuity. The tests revealed 50% hearing loss in the low-frequency range and a near-normal auditory acuity in the highfrequency range. This condition has been caused by the damage to the following structures of the auditory system:

Median part of the Corti’s organ

Corti’s organ - closer to helicotrema

Corti’s organ - closer to the oval foramen

Eardrum

Muscles of the middle ear

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In our country, routine preventive vaccinations against poliomyelitis ivolve using live vaccine that is administered orally. What immunoglobulins are responsible for the development of local post-vaccination immunity in this case?

Serum IgA

Secretory IgA

IgE

IgM

IgG

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An experiment proved that UV-irradiated skin cells of patients with xeroderma pigmentosum restore the native structure of DNA slower than the cells of healthy people due to the defect in repair enzyme. What enzyme takes part in this process?

RNA ligase

DNA gyrase

Primase

Endonuclease

DNA polymerase

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A patient who has recently come from an endemic area presents with elevated body temperature, headache, chills, malaise, that is with the symptoms which are typical for a common cold. What laboratory tests are necessary to confirm or to refute the diagnosis of malaria?

Microscopy of bone marrow punctate

Urinalysis

Microscopy of blood smears

Study of lymph node punctate

Study of cerebrospinal fluid

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What condition may develop 15-30 minutes after re-administration of the antigen as a result of the increased level of antibodies, mainly IgE, that are adsorbed on the surface of target cells, namely tissue basophils (mast cells) and blood basophils?

Serum sickness

Delayed-type hypersensitivity

Immune complex hyperresponsiveness

Antibody-dependent cytotoxicity

Anaphylaxis

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10 days after having quinsy caused by beta-hemolytic streptococcus a 6-year-old child exhibited symptoms of glomerulonephritis. What mechanism of glomerular lesion is most likely in this case?

Cellular cytotoxicity

Atopy

Immunocomplex

Anaphylaxis

Antibody-dependent cell-mediated cytolysis

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A 22-year-old woman ate some seafood. 5 hours later the trunk and the distal parts of limbs got covered with small itchy papules which were partially fused together. After one day, the rash disappeared spontaneously. Specify the hypersensitivity mechanism underlying these changes:

Systemic anaphylaxis

Immune complex hypersensitivity

Cellular cytotoxicity

Atopy (local anaphylaxis)

Antibody-dependent cell-mediated cytolysis

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A hypertensive patient had been keeping to a salt-free diet and taking antihypertensive drugs together with hydrochlorothiazide for a long time. This resulted in electrolyte imbalance. What disorder of the internal environment occurred in the patient?

Hypochloremic alkalosis

Hypermagnesemia

Increase in circulating blood volume

Metabolic acidosis

Hyperkalemia

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A miner consulted a physician about the appearance of body rash followed by a loss of appetite, bloating, duodenal pain, frequent bowel movements, dizziness. Ovoscopic probes of feces and duodenal contents revealed some eggs covered with a transparent membrane through which 4-8 germinal cells could be seen. What disease is likely to have occurred in the patient?

Enterobiasis

Trichocephaliasis

Strongyloidiasis

Hymenolepiasis

Ancylostomiasis

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Children with Lesch-Nyhan syndrome have a severe form of hyperuri- cemia accompanied by the formation of tophi, urate calculi in the urinary tracts, as well as serious neuro-psychiatric disorders. The cause of this disease is the reduced activity of the following enzyme:

Thymidylate synthase

Hypoxanthine-guanine phosphori-bosyltransferase

Karbamoyl phosphate synthetase

Xanthine oxidase

Dihydrofolate reductase

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In a car accident a man got injured and lost a lot of blood. What changes in peripheral blood are most likely to occur on the 2nd day after the injury?

Hypochromia

Microplania

Erythropenia

Significant reticulocytosis

Anisocytosis

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In the surgical ward, the dressing material was undergoing sterilization in an autoclave. Through an oversight of a nurse the mode of sterilization was changed and the temperature in the autoclave reached only 100oC instead of the due 120OC. What microorganisms can stay viable under these conditions?

Salmonella and klebsiella

Mold and yeast fungi

Corynebacteria and mycobacteria

Staphylococci and streptococci

Bacilli and clostridia

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As a result of a mechanical injury an over 10 cm long portion of a peripheral nerve was damaged. This led to the impairment of the upper limb activity. The patient was offered nerve transplantation. What glial cells will participate in regeneration and provide the trophism of the injured limb?

Fibrous cells

Ependymal cells

Schwann cells

Protoplasmic cells

Microglia

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A 26-year-old woman at 40 weeks pregnant has been delivered to the maternity ward. Objectively: the uterine cervix is opened, but the contractions are absent. The doctor has administered her a hormonal drug to stimulate the labor. Name this drug:

Hydrocortisone

Estrone

Testosterone

ACTH

Oxytocin

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A patient has recurrent attacks of epileptic seizures and stays unconscious between them. In order to stop convulsions the drugs of the following group should be used in the first place:

Tranquilizers

Sedatives

Neuroleptics

Muscle relaxants

Analeptics

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A patient with arthritis and varicose veins has been taking a non-steroidal antiinflammatory drug for a long time, which caused thrombosis of skin veins. Which of the following drugs might have caused this complication?

Phenylbutazone

Indomethacin

Ibuprofen

Aspirin

Celecoxib

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Students study the stages of gametogenesis. They analyze a cell having a haploid number of chromosomes, and each chromosome consists of two chromatids. The chromosomes are located in the equatorial plane of the cell. Such situation is typical for the following stage of meiosis:

Metaphase of the first division

Anaphase of the second division

Anaphase of the first division

Metaphase of the second division

Prophase of the first division

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A 35-year-old female patient underwent biopsy of the breast nodules. Histological examination revealed enhanced proliferation of the small duct epithelial cells and acini, accompanied by the formation of glandular structures of various shapes and sizes, which were located in the fibrous stroma. What is the most likely diagnosis?

Fibroadenoma

Adenocarcinoma

Cystic breast

Mastitis

Invasive ductal carcinoma

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Examination of the duodenal contents revealed some pear-shaped protozoa with two nuclei and four pairs of flagella. The organisms had also two axostyles between the nuclei and a ventral adhesive disc. What protozoan representative was found in the patient?

Trypanosome

Leishmania

Intestinal trichomonad

Lamblia

Toxoplasma

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A specimen of an onion rootlet includes a cell in which the fully condensed chromosomes are located in the equatorial plane making the monaster. What phase of the mitotic cycle is the cell in?

Metaphase

Interphase

Prophase

Late telophase

Early telophase

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When examining a patient, the doctor revealed a tumor of the bronchus which borders on the aorta. Which bronchus is affected?

Left principal

Middle lobar

Left upper lobar

Right principal

Right upper lobar

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

Tissue

Gaseous

Air

Thromboembolism

Adipose

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Microscopy of the bronchial wall revealed atrophy of the mucosa, metaplastic change from columnar to squamous epithelium, an increase in the number of goblet cells, diffuse infiltration of the bronchial wall with lymphoplasmacytic elements with a large number of neutrophilic granulocytes, pronounced sclerosis. Spesi-fy the morphological form of bronchitis:

Polypoid chronic bronchitis

Acute bronchitis

Chronic purulent bronchitis

Chronic bronchitis

Acute purulent bronchitis

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Due to the blockage of the common bile duct (which was radiographically confirmed), the biliary flow to the duodenum was stopped. We should expect the impairment of:

Carbohydrate hydrolysis

Fat emulsification

Protein absorption

Salivation inhibition

Secretion of hydrochloric acid

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

Enterotoxic shock development

Activation of adenylate cyclase

Enterotoxin effects

Exotoxin effects

Pathogen adhesion to the enterocyte receptors

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At the stage of translation in the rough endoplasmic reticulum, the ribosome moves along the mRNA. Amino acids are joined together by peptide bonds in a specific sequence, and thus polypeptide synthesis takes place. The sequence of amino acids in a polypeptide corresponds to the sequence of:

tRNA nucleotides

tRNA anticodons

rRNA nucleotides

rRNA anticodons

mRNA codons

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After the prolonged vomiting a pregnant 26-year-old woman was found to have the reduced volume of circulating blood. What change in the total blood volume can be the case?

Oligocythemic hypervolemia

Polycythemic hypervolemia

Oligocythemic hypovolemia

Polycythemic hypovolemia

Simple hypovolemia

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On allergological examination a patient has been diagnosed with pollinosis. Specific desensitization can be performed by:

Intermittent administration of allergen

Glucocorticoids

-

Antihistamines

Administration of saline

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A patient consulted a physician about chest pain, cough, fever. Roentgenography of lungs revealed eosinophilic infiltrates which were found to contain the larvae. What kind of helminthiasis are these presentations typical for?

Ascariasis

Fascioliasis

Trichinosis

Cysticercosis

Echinococcosis

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A patient with signs of osteoporosis and urolithiasis has been admitted to the endocrinology department. Blood test revealed hypercalcemia and hypophosphatemia. These changes are associated with abnormal synthesis of the following hormone:

Aldosterone

Parathyroid hormone

Cortisol

Calcitriol

Calcitonin

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Histological examination of the biopsy material obtained from the lower third of the esophagus of a 57-year-old male with the symptoms of continuous reflux revealed the change of the stratified squamous epithelium to the singlelayer columnar glandular epithelium with signs of mucus production. Specify the pathological process in the mucous membrane:

Metaplasia

Hypertrophy

Regeneration

Organization

Hyperplasia

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A 30-year-old female exhibits signs of virilism (growth of body hair, balding temples, menstrual disorders). This condition can be caused by the overproduction of the following hormone:

Oestriol

Relaxin

Oxytocin

Testosterone

Prolactin

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A patient with bacterial periodontitis has been administered iontophoresis with the use of iodine solution. Specify the mechanism of therapeutic action of this agent:

Albumin formation

Changing the surface tension of the bacterial cell membrane

Substitution of hydrogen atoms when the protein amino group contains a nitrogen atom

Reduction of the nitro group under the effect of nitroreductase

Inhibition of the cell wall formation

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A patient with extensive myocardial infarction has developed heart failure. What pathogenetic mechanism contributed to the development of heart failure in the patient?

Acute cardiac tamponade

Volume overload

Myocardial reperfusion injury

Reduction in the mass of functioning myocardiocytes

Pressure overload

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A patient who had been continuously taking drugs blocking the production of angiotensin II developed bradycardia and arrhythmia. A likely cause of these disorders is:

Hypokalemia

Hyperkalemia

Hypercalcemia

Hypernatremia

Hypocalcemia

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A patient has arterial hypertension. What long-acting drug from the group of calcium channel blockers should be prescribed?

Amlodipine

Atenolol

Pyrroxanum

Reserpine

Octadine

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Human skin has a high breaking strength. It is known that the skin consists of epithelial tissue and two kinds of connective tissue. Which of the following tissues provides the skin strength?

Single-layer epithelium

Stratified squamous epithelium

Transitional epithelium

Loose connective tissue

Unformed dense connective tissue

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As a result of a home injury, a patient suffered a significant blood loss, which led to a fall in blood pressure. Rapid blood pressure recovery after the blood loss is provided by the following hormones:

Cortisol

Adrenaline, vasopressin

Oxytocin

Sex hormones

Aldosterone

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A patient with constant headaches, pain in the occipital region, tinnitus, dizziness has been admitted to the cardiology department. Objectively: AP-180/110 mm Hg, heart rate - 95/min. Radiographically, there is a stenosis of one of the renal arteries. Hypertensive condition in this patient has been caused by the activation of the following system:

Kinin

Immune

Renin-angiotensin

Hemostatic

Sympathoadrenal

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A patient complains that at the bare mention of the tragic events that once occurred in his life he experiences tachycardia, dyspnea and an abrupt rise in blood pressure. What structures of the CNS are responsible for these cardiorespiratory reactions in this patient?

Specific thalamic nuclei

Cerebellum

Lateral hypothalamic nuclei

Quadrigemina of mesencephalon

Cerebral cortex

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A patient consulted a dentist about limited mouth opening (trismus). He has a history of a stab wound of the lower extremity. What infection may cause these symptoms?

Tularemia

Whooping cough

Wound anaerobic infection

Tetanus

Brucellosis

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Anatomical dead space is the portion of the air that is left in the airways after expiration. The reduction of the anatomical dead space is typical for the following situation:

Turning the lying patient on his left side

Breathing through the mouth

Forward flexion of head

Turning the lying patient on his right side

Tracheostomy

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Analysis of the experimental spirogram of a 55-year-old person revealed a decrease in tidal volume and respiratory amplitude compared to the situation of ten years ago. The change in these indicators is caused by:

Physical build of a person

Decreased force of respiratory muscle contraction

Body mass of a person

Gas composition of the air

Height of a person

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A patient underwent a course of treatment for atherosclerosis. Laboratory tests revealed an increase in the antiatherogenic lipoprotein fraction in the blood plasma. The treatment efficacy is confirmed by the increase in:

LDL

IDL

VLDL

Chylomicrons

HDL

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A 65-year-old female patient has chronic constipations due to the colon hypotonia. What drug should be chosen in this case?

Metoclopramide

Magnesium sulfate

Bisacodyl

Neostigmine methylsulfate

Castor oil

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A female patient complains of vision impairment. On examination she was found to have obesity, fasting hyperglycemia. What complication of diabetes can cause vision impairment?

Glomerulopathy

Macroangiopathy

Neuropathy

Atherosclerosis

Microangiopathy

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Analysis of the family history of children with Van der Woude syndrome revealed that in their families one of the parents had the typical for this syndrome defects (cleft lip and palate, lip pits regardless of gender). What is the type of inheritance of this syndrome?

X-linked recessive

X-linked dominant

Multifactorial

Autosomal recessive

Autosomal dominant

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Administration of doxycycline hydrochloride caused an imbalance of the symbiotic intestinal microflora. Specify the kind of imbalance caused by the antibiotic therapy:

Dysbacteriosis

Superimposed infection

Sensibilization

Idiosyncrasy

Bacteriosis

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A 3-year-old child had eaten some strawberries. Soon he developed a rash and itching. What was found in the child’s leukogram?

Eosinophilia

Monocytosis

Lymphocytosis

Neutrophilic leukocytosis

Hypolymphemia

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A 12-year-old patient was found to have blood serum cholesterol at the rate of 25 mmol/l. The boy has a history of hereditary familial hypercholesterolemia, which is caused by the impaired synthesis of the following protein receptors:

Very low density lipoproteins

High density lipoproteins

Intermediate density lipoproteins

Low density lipoproteins

Chylomicrons

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