Step 1 - Medicine 2014

The infectious diseases department of a hospital admitted a patient with nausea, liquid stool with mucus and blood streaks, fever, weakness. Dysentery was suspected. What method of laboratory diagnostics should be applied to confirm the diagnosis?

Mycological

Bacteriological

Protozoological

Microscopic

Serological

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Malaria is treated with structural analogs of vitamin B2 (riboflavin). These drugs disrupt the synthesis of the following enzymes in plasmodium:

NAD-dependent dehydrogenase

Aminotransferase

Peptidase

Cytochrome oxidase

FAD-dependent dehydrogenase

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A 6-year-old child with suspected active tuberculous process underwent the diagnostic Mantoux test. What immunobiological preparation was injected?

Tuberculin

Tularinum

BCG vaccine

Td vaccine

DTP vaccine

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In a young man during exercise, the minute oxygen uptake and carbon dioxide emission equalled to 1000 ml. What substrates are oxidized in the cells of his body?

Carbohydrates

Carbohydrates and fats

Proteins

Carbohydrates and proteins

Fats

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A sportsman spontaneously held breath for 40 seconds, which resulted in an increase in heart rate and systemic arterial pressure. Changes of these indicators are due to activation of the following regulatory mechanisms:

Conditioned sympathetic reflexes

Unconditioned parasympathetic reflexes

Conditioned parasympathetic reflexes

-

Unconditioned sympathetic reflexes

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A 53-year-old male patient is diagnosed with Paget’s disease. The concentration of oxyproline in daily urine is sharply increased, which primarily means intensified disintegration of:

Collagen

Albumin

Hemoglobin

Fibrinogen

Keratin

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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?

Papilloma

Polyp

Angiofibroma

Fibroma

Angioma

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During autopsy approximately 2,0 liters of pus have been found in the abdominal cavity of the corpse. Peritoneum is lustreless and has grayish shade, serous tunic of intestines has grayishcolored coating that is easily removable. Specify the most likely type of peritonitis in the patient:

Hemorrhagic peritonitis

Tuberculous peritonitis

Fibrinopurulent peritonitis

-

Serous peritonitis

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Autopsy of a dead 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?

Chronic myelogenous leukemia

Multiple myeloma

Hodgkin’s disease

Polycythemia vera

Chronic lymphocytic leukemia

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Autopsy of the dead patient who died from pulmonary edema revealed a large yellow-grey nidus in the myocardium, and a fresh thrombus in the coronary artery. What is the most likely diagnosis?

Cardiosclerosis

Amyloidosis

Myocardial infarction

Cardiomyopathy

Myocarditis

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An animal experiment is aimed at studying the cardiac cycle. All the heart valves are closed. What phase of the cycle is characterized by this status?

Protodiastolic period

Asynchronous contraction

Reduced filling

Rapid filling

Isometric contraction

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Cyanide is a poison that causes instant death of the organism. What enzymes found in mitochondria are affected by cyanide?

Flavin enzymes

Cytochrome B5

Cytochrome oxidase (aa3)

NAD+-dependent dehydrogenase

Cytochrome P-450

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Increased HDL levels decrease the risk of atherosclerosis. What is the mechanism of HDL antiatherogenic action?

They are involved in the breakdown of cholesterol

They promote absorption of cholesterol in the intestine

They supply tissues with cholesterol

They remove cholesterol from tissues

They activate the conversion of cholesterol to bile acids

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It has been found out that one of a pesticide components is sodium arsenate that blocks lipoic acid. Which enzyme activity is impaired by this pesticide?

Pyruvate dehydrogenase complex

Microsomal oxidation

Glutathione peroxidase

Methemoglobin reductase

Glutathione reductase

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Stool culture test revealed in a 6-month-old bottle-fed baby the strain of intestinal rod-shaped bacteria of antigen structure 0-111. What diagnosis can be made?

Colienteritis

Gastroenteritis

Dysentery-like disease

Choleriform disease

Food poisoning

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A boy referred to a genetics clinic was found to have 1 drumstick in blood neutrophils. The boy is likely to have the following syndrome:

Down’s

Klinefelter’s

Edwards’

Trisomy X

Turner’s

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A drycleaner’s worker has been found to have hepatic steatosis. This pathology can be caused by the disruption of synthesis of the following substance:

Phosphatidylcholine

Urea

Phosphatidic acid

Cholic acid

Tristearin

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Ascarid eggs have been detected during stool analysis. What drug should be prescribed?

Furazolidone

Nystatin

Tetracycline

Mebendazole

Chloramphenicol

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Bacteriological examination of the urine of the patient with pyelonephritis revealed microorganisms that produced yellow-green pigment and a characteristic odor in meatpeptone agar. What are they called?

Escherichia

Pseudomonas

Proteas

Azotobacter

Klebsiella

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Feces of a patient contain high amount of undissociated fats and have grayish-white color. Specify the cause of this phenomenon:

Enteritis

Obturation of bile duct

Irritation of intestinal epithelium

Hypovitaminosis

Hypoactivation of pepsin by hydrochloric acid

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A 46-year-old female patient consulted a doctor about pain in the small joints of the upper and lower limbs. The joints are enlarged and shaped like thickened nodes. Serum test revealed an increase in urate concentration. This might be caused by a disorder in metabolism of:

Amino acids

Pyrimidines

Lipids

Purines

Carbohydrates

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A 26-year-old female consulted a doctor about having stool with white flat moving organisms resembling noodles. Laboratory analysis revealed proglottids with the following characteristics: long, narrow, with a longitudinal channel of the uterus with 17-35 lateral branches on each side. What kind of intestinal parasite was found?

Taeniarhynchus saginatus

Taenia solium

Diphyllobothrium latum

Hymenolepis nana

Echinococcus granulosus

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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 havi- ng 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?

Syphilis

Tuberculosis

Actinomycosis

Hodgkin’s disease

Tumor metastasis

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A biochemical urine analysis has been performed for a patient with progressive muscular dystrophy. In the given case muscle disease can be confirmed by the high content of the following substance in urine:

Creatinine

Porphyrin

Urea

Hippuric acid

Creatine

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While examining foot blood supply a doctor checks the pulsation of a large artery running in the separate fibrous channel in front of articulatio talocruralis between the tendons of long extensor muscles of hallux and toes. What artery is it?

A. tarsea medialis

A. tibialis anterior

A. fibularis

A. tarsea lateralis

A. dorsalis pedis

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A patient with chronic heart failure with edema has increased level of blood aldosterone. What diuretic would be most effective in this case?

Spironolactone

Furosemide

Triamterene

Hydrochlorothiazide

Acetazolamide

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During autopsy the following has been revealed: the meninges of the upper cerebral hemispheres are extremely plethoric, of yellow-green color and are soaked with purulent effluent. What kind of meningitis is characterised by such clinical presentations?

Grippal meningitis

Meningococcal meningitis

Epidemic typhus-induced

Tuberculous meningitis

Anthrax-induced

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A 41-year-old male patient has a history of recurrent attacks of heartbeats (paroxysms), profuse sweating, headaches. Examination revealed hypertension, hyperglycemia, increased basal metabolic rate, and tachycardia. These clinical presentations are typical for the following adrenal pathology:

Hypofunction of the medulla

Primary aldosteronism

Hyperfunction of the adrenal cortex

Hyperfunction of the medulla

Hypofunction of the adrenal cortex

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A comminuted fracture of infraglenoid tubercle caused by shoulder joint injury has been detected during X-ray examination of a patient. What muscle tendon attached at this site has been damaged?

Long head of m. triceps brachii

Long head of m. biceps brachii

Short head of m. biceps brachii

Lateral head of m. triceps brachii

Medial head of m. triceps brachii

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A patient has increased thickness of alveolar-capillary membrane caused by a pathologic process. The direct consequence will be reduction of the following value:

Diffusing lung capacity

Oxygen capacity of blood

Respiratory minute volume

Alveolar ventilation of lungs

Expiratory reserve volume

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What drug will be most appropriate for the patient who has chronic gastritis with increased secretion?

Pepsin

Chlorphentermine

Pancreatine

Pirenzepine

Aprotinin

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As a result of careless handling of an iron, a 34-year-old female patient has got acute pain, redness, swelling of her right index finger. A few minutes later, there appeared a blister filled with a transparent liquid of straw-yellow color. The described changes are a manifestation of the following pathological process:

Alternative inflammation

Vacuolar degeneration

Exudative inflammation

Traumatic edema

Proliferative inflammation

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A 42-year-old male with a lesion of the ulnar nerve is unable to flex the II and V fingers to the midline. Which muscle function is impaired in this case?

Dorsal interosseous muscle

Short palmar muscle

Abductor muscle of little finger

Fidicinales

Palmar interosseous muscles

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A smear from the tonsillar coating of a patient with suspected diphtheria was found to contain blue bacilli with a thickening at the poles. What method of smear staining was used?

Neisser

Gram

Burri

Leffler

Hins

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A child was born asphyxiated. What drug must be administered to the newborn to stimulate breathing?

Prazosin

Aethimizolum

Proserine

Atropine

Lobeline

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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?

Purulent abscess

Acute osteomyelitis

Chronic osteomyelitis

Chronic fibrous periostitis

Parodontome

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Human red blood cells do not contain mitochondria. What is the main pathway for ATP production in these cells?

Creatine kinase reaction

Anaerobic glycolysis

Cyclase reaction

Oxidative phosphorylation

Aerobic glycolysis

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A 40-year-old female patient 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 stroma. Diagnose the thyroid gland disease:

Riedel’s thyroiditis

Basedow’s disease

De Quervain’s disease

Hashimoto’s thyroiditis

Nodular goiter

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A 43-year-old-patient has arterial hypertension caused by an increase in cardiac output and general peripheral resistance. Specify the variant of hemodynamic development of arterial hypertension in the given case:

-

Eukinetic

Hypokinetic

Hyperkinetic

Combined

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A patient has been hospitalised 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?

Bordet-Gengou test

Antigen-binding assay

Radioimmunoassay technique

Immune-enzyme analysis

Immunofluorescence test

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A patient has been hospitalised with provisional diagnosis of botulism. What serological reaction should be used to reveal botulinum toxin?

Bordet-Gengou test

Agglutination reaction

Precipitation reaction

Neutralization reaction

Immunofluorescence test

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Examination of a 52-year-old female patient has revealed a decrease in the amount of red blood cells and an increase in free hemoglobin in the blood plasma (hemoglobinemia). Color index is 0,85. What type of anemia is being observed in the patient?

Chronic hemorrhagic

Acquired hemolytic

Acute hemorrhagic

Anemia due to diminished erythropoiesis

Hereditary hemolytic

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The processes of heat transfer in a naked person at room temperature have been studied. It was revealed that under these conditions the greatest amount of heat is transferred by:

Heat radiation

Heat conduction

Convection

-

Evaporation

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Urine analysis has shown high levels of protein and erythrocytes in urine. This can be caused by the following:

Hydrostatic blood pressure in glomerular capillaries

Effective filter pressure

Renal filter permeability

Hydrostatic primary urine pressure in capsule

Oncotic pressure of blood plasma

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The development of both immune and allergic reactions is based upon the same mechanisms of the immune system response to an antigen. What is the main difference between the immune and allergic reactions?

Development of tissue lesion

Hereditary predisposition

Amount of released antigen

Routes by which antigens are delivered into the body

Antigen structure

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After a craniocerebral injury a patient is unable to recognize objects by touch. What part of brain has been damaged?

Postcentral gyrus

Temporal lobe

Occipital lobe

Precentral gyrus

Cerebellum

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A patient complaining of rapid pulse, dyspnea and bluish color of mucosa has been admitted to the cardiological department. The objective symptoms are as follows: edema of lower extremities, ascites. Which of the given medicines should be prescribed for intravenous administration to improve the patient’s general state?

Cordiamin

Digitoxin

Drotaverine

Corglyconum

Adrenalin hydrochloride

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As a result of a continuous chronic encephalopathy, a patient has developed spontaneous motions and a disorder of torso muscle tone. These are the symptoms of the disorder of the following conduction tract:

Tractus rubrospinalis

Tractus corticospinalis

Tractus spinothalamicus

Tractus tectospinalis

Tractus corticonuclearis

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A 10-year-old child has painful swallowing, neck edema, temperature rise up to 39,0oC, the whole body is covered with bright-red petechial rash. Back of the throat and tonsils are hyperemic, the tongue is crimson- colored. Tonsillar surface is covered with isolated grayishcolored necrosis nidi. What disease is it?

Influenza

Diphtheria

Measles

Meningococcal nasopharyngitis

Scarlet fever

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In a patient elevation of body temperature takes turns with drops down to normal levels during the day. The rise in temperature is observed periodically once in four days. Specify the type of temperature curve:

Febris reccurens

Febris remitens

Febris internuttens

Febris continua

Febris hectica

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

Posterior central gyrus

Anterior central gyrus

Occipital region

Frontal cortex

Cingulate gyrus

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Diabetic nephropathy with uremia has developed in a patient with pancreatic diabetes. The velocity of glomerular filtration is 9 ml/min. What mechanism of a decrease in glomerular filtration velocity and chronic renal failure development is most likely in the case of this patient?

Arteriolar spasm

Obstruction of nephron tubules with hyaline casts

Decrease in systemic arterial pressure

Tissue acidosis

Reduction of active nephron mass

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A 40-year-old patient has ulcer perforation in the posterior wall of stomach. What anatomical structure will blood and stomach content leak to?

Bursa praegastrica

Left lateral channel (canalis lateralis sinister)

Right lateral channel (canalis lateralis dexter)

Bursa omentalis

Bursa hepatica

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A patient is diagnosed with hereditary coagulopathy that is characterised by factor VIII deficiency. Specify the phase of blood clotting during which coagulation will be disrupted in the given case:

Thrombin formation

Fibrin formation

Clot retraction

Thromboplastin formation

-

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Angiocardiography of a 60-year-old male patient revealed constriction of a vessel located in the left coronary sulcus of the heart. What is the pathological vessel called?

Ramus circumflexus

Ramus interventricularis posterior

A. coronaria dextra

Ramus interventricularis anterior

V. cordis parva

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Those organisms which in the process of evolution failed to develop protection from H2O2 can exist only in anaerobic conditions. Which of the following enzymes can break hydrogen peroxide down?

Flavin-dependent oxidase

Oxygenase and catalase

Oxygenase and hydroxylase

Peroxidase and catalase

Cytochrome oxidase, cytochrome B5

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

Colon transversum

Caecum

Colon descendens

Colon sigmoideum

Colon ascendens

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

Epicritic

Phantom

Radiating

Visceral

Protopathic

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A patient has a critical impairment of protein, fat and hydrocarbon digestion. Most likely it has been caused by low secretion of the following digestive juice:

Bile

Saliva

Pancreatic juice

Intestinal juice

Gastric juice

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A female patient has facial neuritis that has caused mimetic paralysis and hearing impairment. Hearing impairment results from the paralysis of the following muscle:

Superior auricular muscle

Nasal muscle

Anterior auricular muscle

Posterior auricular muscle

Stapedius muscle

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A 22-year-old female student consulted a physician about fever up to 38oC, weakness, sore throat. Objectively: there is white coating of the tongue. What histological structures of the tongue are involved in the formation of this coating?

Epithelium of the fungiform papillae

Epithelium of the filiform papillae

Epithelium of the foliate papillae

Connective-tissue base of all the lingual papillae

Epithelium of the circumvallate papillae

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A patient has a traumatic injury of sternocleidomastoid muscle. This has resulted in a decrease in the following value:

Respiratory volume

Expiratory reserve volume

Residual volume

Functional residual lung capacity

Inspiratory reserve volume

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The receptors under study provide transfer of information to the cortex without thalamic involvement. Specify these receptors:

Gustatory

Visual

Olfactory

Auditory

Tactile

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Prolonged fasting causes hypoglycemia which is amplified by alcohol consumption, as the following process is inhibited:

Lipolysis

Glycogenolysis

Gluconeogenesis

Proteolysis

Glycolysis

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A 39-year-old female patient with a history of diabetes was hospitalized in a precomatose state for diabetic ketoacidosis. This condition had been caused by an increase in the following metabolite level:

Acetoacetate

Citrate

Aspartate

Alpha-ketoglutarate

Malonate

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A 37-year-old female patient complains of headache, vertigo, troubled sleep, numbness of limbs. For the last 6 years she has been working at the gas-discharge lamp-producing factory in the lead-processing shop. Blood test findings: low hemoglobin and RBC level, serum iron concentration exceeds the norm by several times. Specify the type of anemia:

Iron-deficiency anemia

Metaplastic anemia

Minkowsky-Shauffard disease

Iron refractory anemia

Hypoplastic anemia

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During an animal experiment, surgical damage of certain brain structures has caused deep prolonged sleep. What structure is most likely to cause such condition, if damaged?

Red nuclei

Cerebral cortex

Hippocampus

Basal ganglion

Reticular formation

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A patient takes cholagogues. What other process besides biliary excretion will be stimulated?

Gastric juice secretion

Water absorption

Intestinal motility

Pancreatic juice secretion

Gastric motor activity

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A 3-year-old child with meningeal symptoms died. Postmortem macroscopy of the pia matter revealed miliary nodules which were microscopically represented by a focus of caseous necrosis with masses of epithelioid and lymphoid cells with some crescent-shaped large cells inbetween having peripheral nuclei. Specify the type of meningitis in the child:

Tuberculous

Syphilitic

Grippal

Meningococcal

Brucellar

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A patient with homogentisuria has signs of arthritis, ochronosis. In this case, the pain in the joints is associated with the deposition of:

Oxalates

Carbonates

Homogentisates

Phosphates

Urates

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A patient with hereditary hyperammonemia due to a disorder of ornithine cycle has developed secondary orotaciduria. The increased synthesis of orotic acid is caused by an increase in the following metabolite of ornithine cycle:

Argininosuccinate

Ornithine

Urea

Citrulline

Carbamoyl phosphate

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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?

Patau syndrome

Turner’s syndrome

Klinefelter syndrome

Trisomy X

Down’s syndrome

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A 49-year-old male patient with acute pancreatitis was likely to develop pancreatic necrosis, while active pancreatic proteases were absorbed into the blood stream and tissue proteins broke up. What protective factors of the body can inhibit these processes?

Immunoglobulin

Cryoglobulin, interferon

«2-macroglobulin, ai-antitrypsin

Ceruloplasmin, transferrin

Hemoplexin, haptoglobin

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A 16-year-old female patient has fainted after quickly changing her body position from horizontal to vertical one. Which process from the ones listed below has caused the loss of consciousness in the first place?

Decreasing oncotic pressure of blood plasma

Increasing central venous pressure

Increasing venous return

Increasing arterial pressure

Decreasing venous return

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A 53-year-old male patient complains of acute pain in the right hypochondrium. Objective examination revealed scleral icterus. Laboratory tests revealed increased ALT activity, and stercobilin was not detected in the stool. What disease is characterized by these symptoms?

Hepatitis

Cholelithiasis

Chronic gastritis

Hemolytic jaundice

Chronic colitis

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A child patient has dry cough. What non-narcotic antitussive drug will relieve the patient’s condition?

Althaea officinalis root extract

Potassium iodide

Glaucine hydrochloride

Codeine phosphate

Morphine hydrochloride

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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 semilunaris

Linea inguinalis

Linea transversa

Linea terminalis

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When measuring total muscle action potential it was revealed that it was subject to the powerlaw relationship. The reason for this is that individual muscle fibers differ in:

Critical level of depolarization

Depolarization threshold

Resting potential

Diameter

Conduction velocity

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A patient has insufficient blood supply to the kidneys, which has caused the development of pressor effect due to the constriction of arterial resistance vessels. This is the result of the vessels being greately affected by the following substance:

Catecholamines

Angiotensin II

Norepinephrine

Angiotensinogen

Renin

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A patient is diagnosed with iron- deficiency sideroachrestic anemia, progression of which is characterised by skin hyperpigmentation, pigmentary cirrhosis, heart and pancreas affection. Iron level in the blood serum is increased. What disorder of iron metabolism causes this disease?

Increased iron assimilation by body

Excessive iron intake with food

-

Failure to assimilate iron leading to iron accumulation in tissues

Disorder of iron absorption in bowels

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In a village, a case of anthrax had been registered. Medical services began epidemiologically indicated specific prophylaxis of population against anthrax. What preparation was used for this purpose?

Chemical vaccine

Inactivated vaccine

Genetically engineered vaccine

Live vaccine

Anatoxin

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

Potassium ion exit

Potassium ion entry

Calcium ion entry

Calcium and potassium ion exit

Calcium ion exit

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According to the results of glucose tolerance test, the patient has no disorder of carbohydrate tolerance. Despite that, glucose is detected in the patients’s urine (5 mmol/l). The patient has been diagnosed with renal diabetes. What renal changes cause glucosuria in this case?

Increased glucose secretion

Exceeded glucose reabsorption threshold

Increased activity of glucose reabsorption enzymes

Decreased activity of glucose reabsorption enzymes

Increased glucose filtration

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

Atresia of tubus medullaris

Atresia of the fourth ventricle foramina

Closure of left interventricular foramen

Closure of right interventricular foramen

Atresia of sylvian aqueduct

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Parents of 5-year-old child report him o have frequent colds that develop into pneumonias, presence of purulent rashes on the skin. Laboratory tests have revealed the following: absence of immunoglobulins of any type, and naked cells are absent from the lymph nodes punctate. What kind of immune disorder is it?

Autosomal recessive agammaglobulinaemia (Swiss type)

X-linked hypogammaglobulinemia (Bruton type agammaglobulinemia)

Louis-Barr syndrome

Agranulocytosis

Hypoplastic anemia

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A 3-year-old child has continuous fever, lymph nodes are enlarged, the amount of lymphocytes in blood is significantly increased. Enzyme-linked immunosorbent assay (ELISA) revealed antigen of Epstein-Barr virus. What diagnosis can be made based on the information given above?

Generalized infection caused by herpes-zoster

Herpetic lymphadenopathy

Cytomegalovirus infection

Infectious mononucleosis

Burkitt’s lymphoma

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A microslide contains the preparation of a gland composed of several secretory saccule-shaped parts that open in the common excretory duct. What gland is it?

Simple branched tubular gland

Compound branched alveolar gland

Compound unbranched alveolar gland

Simple branched alveolar gland

Simple unbranched alveolar gland

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A patient intending to undergo a gender reassignment surgery has been admitted to a specialised clinic. In the course of examination both male and female gonades have been revealed, with male structure of external genitals. What kind of genital maldevelopment has the patient?

Ectopia of testis

Accessory ovary

Male pseudohermaphroditism

Female pseudohermaphroditism

True hermaphroditism

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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?

Pleiotropy

Multiple allelism

Complementarity

Incomplete dominance

Codominance

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In case of alkaptonuria, homogenti-sic acid is excreted in urine in large amounts. The development of this disease is associated with a disorder of metabolism of the following amino acid:

Methionine

Asparagine

Phenylalanine

Tyrosine

Alanine

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A male patient complains of skin insensitivity of inferior eyelid, external lateral surface of nose and upper lip. A doctor in the course of examination has revealed inflammation of the second branch of trigeminal nerve. What cranial foramen does this branch go through?

Superior orbital fissure

Oval

Lacerum

Spinosum

Supraorbital

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An patient with insomnia induced by allergic rash and itch has been prescribed the drug that has antihistamine and hypnotic effect. Specify this drug:

Benadryl

Loratadine

Analgin

Prednisolone

Acetylsalicylic acid

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In a cat with decerebrate rigidity the muscle tone is to be decreased. This can be achieved by:

Stimulation of the vestibular nuclei of Deiters

Destruction of the vestibular nuclei of Deiters

Stimulation of the otolithic vestibular receptors

Stimulation of the ampullar vestibular receptors

Stimulation of the vestibulocochlear nerve

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When studying the signs of pulmonary ventilation, reduction of forced expiratory volume has been detected. What is the likely causeof this phenomenon?

Increase of inspiratory reserve volume

Obstructive pulmonary disease

Increase of pulmonary residual volume

Increase of functional residual lung capacity

Increase of respiratory volume

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X-ray examination of a patient allowed to diagnose a tumor in the superior lobe of the right lung. There is a probability of metastases spread to the following lymph nodes:

Anterior mediastinum

Deep lateral cervical

Axillary

Sternal

Inferior mediastinum

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A 55-year-old patient with a characteristic rash, fever, dizziness has been admitted to a hospital. He has been provisionally diagnosed with typhus. No similar cases have been reported. In his youth (15 years old) the patient suffered typhus in a boarding school. What disease is it?

Brill’s disease

Rubella

Typhoid fever

Cholera

Measles

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A young woman suddenly developed fever up to 39oC accompanied by a strong headache. Examination revealed marked nuchal rigidity. Spinal puncture was performed. Gram-stained smear of cerebrospinal fluid contained many neutrophils and Gram-positive diplococci. What bacteria could be the cause of this disease?

Neisseria meningitidis

Haemophilus influenzae

Streptococcus pneumonia

Staphylococcus aureus

Pseudomonas aeruginosa

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In the course of an experiment adenohypophysis of an animal has been removed. The resulting atrophy of thyroid gland and adrenal cortex has been caused by deficiency of the following hormone:

Cortisol

Somatotropin

Thyroxin

Thyroid hormones

Tropic hormones

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Degenerative changes in posterior and lateral columns of spinal cord (funicular myelosis) caused by methylmalonic acid accumulation occur in patients with B12 -deficiency anemia. This results in synthesis disruption of the following substance:

Serotonin

Dopamine

Acetylcholine

Norepinephrine

Myelin

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A patient with suspected tumor of lung had been admitted to the oncological department. Examination revealed localised pathology in the inferior lobe of the left lung. How many bronchopulmonary segments does this lobe have?

4

3

2

5

6

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During local anesthetization the patient has gone into anaphylactic shock. What drug must be administered to the patient?

Epinephrine hydrochloride

Atropine sulfate

Diazepam

Nitroglycerin

Propranolol

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As a result of an injury, the integrity of the anterior spinal cord root was broken. Specify the neurons and their processes that had been damaged:

Motor neuron dendrites

Dendrites of association neurons

Axons of motor neurons

Dendrites of sensory neurons

Axons of sensory neurons

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A patient who had been taking diclofenac sodium for arthritis of mandibular joint developed an acute condition of gastric ulcer. Such side effect of this medicine is caused by inhibition of the following enzyme:

Phosphodiesterase

Lipoxygenase

Cyclooxygenase-2 (COX-2)

Monoamine oxidase

Cyclooxygenase-1 (COX-1)

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

Trichinosis

Taeniarhynchosis

Alveococcosis

Teniasis

Echinococcosis

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A female patient saught medical-genetic consultation. Physical examination revealed pterygium colli deformity (webbed neck), broad chest, underdeveloped breasts. Study of buccal epithelium cells revealed no X-chromatin in the nuclei. This indicates that the patient has the following syndrome:

Down’s

Edwards’

Turner’s

Klinefelter’s

Patau’s

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During blood transfusion a patient has developed intravascular erythrocyte hemolysis. What kind of hypersensitivity does the patient have?

IV type (granulomatosis)

IV type (cellular cytotoxicity)

I type (anaphylactic)

III type (immune complex)

II type (antibody-dependent)

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Patients with erythropoietic porphyria (Gunther’s disease) have teeth that fluoresce with bright red color when subjected to ultraviolet radiation; their skin is light-sensitive, urine is red-colored. What enzyme can cause this disease, when it is deficient?

Uroporphyrinogen decarboxylase

Ferrochelatase

Delta-aminolevulinate synthase

Uroporphyrinogen I synthase

Uroporphyrinogen III cosynthase

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During the air and bone conduction tests it was revealed that in the left ear the tones were louder by bone conduction. This might be associated with the disease of:

Right inner ear

Left inner ear

Right external ear

Right middle ear

Left middle ear

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In course of invasive abdominal surgery a surgeon has to locate the origin of the mesenteric root. Where is it normally localized?

Sigmoid colon

Left flexure of colon

Duodenojejunal flexure

Right mesenteric sinus

Right flexure of colon

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A 55-year-old male had been delivered to the resuscitation unit unconscious. Relatives reported him to have mistakenly drunk an alcoholic solution of unknown origin. On examination the patient was diagnosed with methanol intoxication. What antidote should be used in this case?

Ethanol

Acetylcysteine

Protamine sulfate

Teturamum

Naloxone

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

Secretion and filtration

Reabsorption

Secretion

Filtration

Reabsorption and secretion

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As a result of a road accident a 37-year-old female victim developed urinary incontinence. What segments of the spinal cord had been damaged?

Li — L2

S2 - S4

Thi — Li

Thi — Th5

Th2 — Th5

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An 8-week-pregnant woman with acute respiratory disease and temperature rise up to 39,0oC has called in a doctor. The doctor insisted on her avoiding taking paracetamol, because in this period of pregnancy there is a risk of its:

Teratogenicity

Allergenicity

Hepatotoxicity

Embryotoxicity

Fetotoxicity

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

Symptomatic

Pathogenetic

Etiotropic

Antimicrobial

Immunomodulatory

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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:

BCG vaccine

Interferon

Doxycycline

Dexamethasone

Ambroxol

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When defining blood group according to the AB0 system, using salt solutions of monoclonal antibodies, agglutination didn’t occur with any of the solutions. What blood group is it?

-

B (III)

AB (IV)

0 (I)

A (II)

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Examination of a 56-year-old female patient 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?

Increase in the oncotic pressure in the blood plasma

Increased proteolysis

Albuminosis

Increase in low-density lipoprotein level

Decrease in the concentration of amino acids in blood

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Symptoms of pellagra (vitamin PP deficiency) is particularly pronounced in patients with low protein diet, because nicotinamide precursor in humans is one of the essential amino acids, namely:

Tryptophan

Histidine

Lysine

Threonine

Arginine

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A 68-year-old patient consults a cardiologist, complaining of high arterial blood pressure, pain in the heart egion, intermittent pulse. Prescribe the (3\ -adrenoreceptor blocker for the treatment of the described pathology:

Metoprolol

Nootropil

Morphine hydrochloride

Fenoterol

Benzylpenicillin

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A female suffered rubella during pregnancy. The child was born with developmental abnormalities, namely cleft lip and palate. The child’s genotype is normal. These malformations are a manifestation of:

Polyploidy

Modification variability

Combinative variability

Aneuploidy

Chromosomal mutation

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An electron micrograph shows a cell-to-cell adhesion consisting, in each cell, of an attachment plaque. The intercellular space is filled with electron-dense substance including transmembrane fibrillar structures. Specify this adhesion:

Nexus

Adherens junction

Desmosome

Synapse

Tight junction

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For biochemical diagnostics of myocardial infarction it is necessary to measure activity of a number of enzymes and their isoenzymes. What enzymatic test is considered to be the best to prove or disprove the diagnosis of infarction in the early period after the chest pain is detected?

Aspartate aminotransferase cytoplasmic isoenzyme

Creatine kinase isoenzyme CK-MM

LDH2 lactate dehydrogenase isoenzyme

LDH1 lactate dehydrogenase isoenzyme

Creatine kinase isoenzyme CK-MB

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A patient complains of pain in the heart area during acute attack of gastric ulcer. What vegetative reflex can cause this painful feeling?

Viscerodermal reflex

Viscerovisceral reflex

Visceromotor reflex

Motor-visceral reflex

Dermatovisceral reflex

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A patient is diagnosed with acute morphine hydrochloride intoxication. Prescribe an oxidizing agent for gastric lavage:

Chloramine

Potassium permanganate

Sulfocamphocainum (Procaine + Sulfocamphoric acid)

Cerigel

Chlorhexidine (bi)gluconate

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In the course of puncture biopsy of transplanted kidney the following has been revealed: diffuse infiltration of stroma by lymphocytes and plasmocytes and necrotic arteritis. What pathological process has developed in the transplant?

Pyelonephritis

Glomerulonephritis

Immune rejection

Tubular necrosis

Ischemic kidney failure

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During cell division, DNA replication occurs by a signal from the cytoplasm, and a certain portion of the DNA helix unwinds and splits into two individual strains. What enzyme facilitates this process?

RNA polymerase

Ligase

Helicase

Restrictase

DNA polymerase

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A female patient, having visited the factory premises with lots of dust in the air for the first time, has got cough and burning pain in the throat. What respiratory receptors, when irritated, cause this kind of reaction?

Juxtacapillary (J) receptors

Stretch receptors of lungs

Thermoreceptors

Irritant receptors

Proprioceptors of respiratory muscles

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Since a patient has had myocardial infarction, his atria and ventricles contract independently from each other with a frequency of 60-70 and 3540 per minute. Specify the type of heart block in this case:

Complete atrioventricular

Intraventricular

Sino-atrial

Partial atrioventricular

Intra-atrial

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A 35-year-old female patient has been hospitalised with acute intoxication caused by salts of high-density metals (lead, most probably). As a part of complex therapy the antidote that contains two active sulfhydric groups has been prescribed. Specify this antidote:

Dimercaprol

Mannitol

Calcium chloride

Metamizole

Nalorphine hydrochloride

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A 60-year-old male patient has type II diabetes. A doctor has prescribed him synthetic hypoglycemic long-acting drug that is sulfonylurea derivative. What drug is it?

Acarbose

Butamide

Metformin

Glibenclamide

Actrapid (soluble insulin)

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A patient has been given atropine sulfate for rapid relief of spastic colon symptoms. The use of this drug is contraindicated during the followng disease:

Bradycardia

Bronchial asthma

Hypotension

Gastric ulcer

Glaucoma

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As an example of specific human parasites one can name Plasmodium falciparum, human pinworm and some others. The source of parasite invasion is always a human. Such specific human parasites cause the diseases that are called:

Infections

Anthroponoses

Zoonoses

Anthropozoonoses

Multifactorial diseases

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In an experiment a dog had been conditioned to salivate at the sight of food and a flash of light. After conditioning the reflex, the light was then paired with the bell. The dog didn’t start to salivate. What type of inhibition was observed?

Persistent

External

Protective

Extinctive

Differential

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A newborn baby has numerous hemorrhages. Blood coagulation tests reveal increased prothrombin time. The child is most likely to have a disorder of the following biochemical process:

Hydroxylation of proline

Conversion of methylmalonyl CoA to succinyl CoA

Production of gamma-carboxyglutamate

Conversion of homocysteine to methionine

Degradation of glutathione

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A 63-year-old male patient with bladder atony had been prescribed a medication, which he had been arbitrarily taking at a higher dose. The patient developed hypehydration, salivation, diarrhea, muscle spasms. The prescribed drug relates to the following group:

Tocolytics

Ganglionic blockers

Adrenergc blockers

Cholinomimetics

Cholinesterase reactivators

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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 I

Hyperlipoproteinemia type IIb

Hyperlipoproteinemia type IIa

Cholesterol, hyperlipoproteinemia

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Tissue sampling of a 37-year-old male patient with chronic renal disease has revealed the following: sclerosis, lymphocytic and plasmocytic infiltration of renal pelvis and calices walls, dystrophy and atrophy of tubules. Remaining tubules are enlarged and stretched with colloid masses, epithelium is flattened out ('scutiform' or 'shield-shaped' kidney). What is the most likely diagnosis?

Acute pyelonephritis

Glomerulonephritis

Tubular interstitial nephritis

Nephrosclerosis

Chronic pyelonephritis

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During the hystological study of cortical shaft, basophilic cells with developed synthesis organelles can be seen on the bone surface under the layer of fibers. These cells take part in bone tissue regeneration. What shaft layer are they located in?

Inner lamellae of compact bone tissue

Osteon layer

Periosteum

Outer lamellae of compact bone tissue

Bone

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Autopsy of a 50-year-old male who had tuberculosis revealed a dense gray-white nidus in form of a nodule 2 cm in diameter in the subpleural portion of the upper right lobe. The pleura in this region was thickened, in the pleural cavity there was a small amount of serous hemorrhagic fluid. Histological study of the region revealed some glandular structures with signs of cellular atypia and abnormal mitoses, which were found within the fibrous connective tissue. What other pathology had developed in the lungs?

Fibrosarcoma

Adenoma

Squamous cell carcinoma

Adenocarcinoma

Fibroma

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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+ and Cl

K+ and ClC. K + and Na+

Ca2+

Na+

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Hepatitis B is diagnosed through laboratory tests that determine the presence of HBA-DNA in blood serum of the patient. What reference method is applied for this purpose?

Hybridization signal amplification method

ELISA diagnostic method

Hybridization method

Ligase chain reaction method

Polymerase chain reaction

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On the 24th day since the onset of disease, a male patient diagnosed with typhoid fever and undergoing treatment in an infectious diseases hospital has suddenly developed clinical presentations of acute abdomen leading to the death of the patient. During autopsy peritonitis has been revealed, with numerous ulcers covering the colon mucosa and reaching as deep as muscular and, in places, serous tunic. The ulcers have smooth edges and even floor. The intestinal wall is perforated. What stage of typhoid fever has the lethal complication arisen at?

Medullary swelling

Regeneration

Dirty ulcer

Necrosis

Clean ulcer

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An HIV-positive patient’s cause of death is acute pulmonary insufficiency resulting from pneumonia. Pathohistological investigation of lungs has revealed interstitial pneumonia, alveolocyte desquamation and their methamorphoses: alveolocyte enlargement, large intranuclear inclusions surrounded by lightly-colored areas. Transformed cells resemble owl’s eye. Name the pneumonia causative agent:

Influenza virus

Toxoplasma

Cytomegalovirus

Candida fungi

Pneumococcus

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The organisms to be identified have a nucleus surrounded by a nuclear membrane. Genetic material is concentrated predominantly in the chromosomes which consist of DNA strands and protein molecules. These cells divide mitotically. Identify these organisms:

Bacteriophages

Bacteria

Viruses

Prokaryotes

Eukaryotes

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A 37-year-old male patient developed pseudoarthrosis after a closed fracture of the femur. Specify the type of regeneration in the patient:

Pathological hyper-regeneration

Reparative

-

Physiological

Pathological hypo-regeneration

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Nucleolar organizers of the 13-15, 21, 22 human chromosomes contain about 200 cluster genes that synthesize RNA. These regions of chromosomes bear the information on the following type of RNA:

snRNA

tRNA + rRNA

tRNA

rRNA

mRNA

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The resuscitation unit has admitted a patient in grave condition. It is known that he had mistakenly taken sodium fluoride which blocks cytochrome oxidase. What type of hypoxia developed in the patient?

Respiratory

Cardiovascular

Hypoxic

Tissue

Hemic

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Steatosis is caused by the accumulation of triacylglycerols in hepatocytes. One of the mechanisms of this disease development is a decrease in the utilization of VLDL neutral fat. What lipotropics prevent the development of steatosis?

Alanine, B1, PP

Arginine, ^ B3

Methionine, B6, B12

Valine, B3, B2

Isoleucine, B1, B2

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A 2-year-old boy is diagnosed with Down syndrome. What chromosomal changes may be the cause of this disease?

Trisomy 21

Monosomy X

Trisomy 13

Trisomy 18

Trisomy X

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A patient who has recently arrived 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 prove or to disprove the diagnosis of malaria?

Study of lymph node punctate

Study of cerebrospinal fluid

Microscopy of blood smears

Microscopy of bone marrow punctate

Urinalysis

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A patient has severe blood loss caused by an injury. What kind of dehydration will be observed in this particular case?

-

Iso-osmolar

Normosmolar

Hyperosmolar

Hyposmolar

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A 30-year-old patient has dyspnea fits, mostly at night. He has been diagnosed with bronchial asthma. What type of allergic reaction according to the Gell-Coombs classification is most likely in this case?

Anaphylactic

Immune complex

Stimulating

Cytotoxic

Delayed-type hypersensitivity

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Decarboxylation of glutamate induces production of gamma- aminobutyric acid (GABA ) neurotransmitter. After breakdown, GABA is converted into a metabolite of the citric acid cycle, that is:

Succinate

Malate

Fumarate

Oxaloacetate

Citric acid

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An outbreak of an intestinal infection occurred in a kindergarten on the eve of New Year holidays. Bacteriological examination of patients’ faeces didn’t reveal any pathogenic bacteria. Electron microscopy revealed roundish structures with clear outer edges and a thick core resembling a wheel. Specify the most likely causative agent of this infection:

P.vulgaris

E.coli

Rotavirus

Adenovirus

Coxsacki-virus

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A smear of streptobacillus preparation stained by Ozheshko method has been studied microscopically with oil immersion. What structural feature of the bacteria has been studied?

Inclusions

Capsule

Spores

Structure of cell wall

Flagella

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After a road accident a victim has tachycardia, arterial blood pressure 130/90 mm Hg, tachypnoe, the skin is pale and dry, excitation of central nervous system is observed. What shock stage is the patient most likely in?

Terminal

Agony

Preshock (compensation stage)

Erectile

Torpid

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Autopsy has revealed shrunken kidneys weighing 50 mg, with finegrained surface and uniformly thi- nned substance. Microscopic investigation has shown the thickening of arteriole walls due to accumulation of homogeneous anhistic pink-coloured masses in them. Glomerules were undersized, sclerotic, with atrophied tubules. What disease are these changes characteristic of?

Acute glomerulonephritis

Renal amyloidosis

Pyelonephritis with kidney shrinkage

Membranous nephropathy

Essential hypertension

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A fixed-run taxi passenger has a sudden and expressed attack of tachycardia. A doctor travelling by the same taxi has managed to slow down his heart rate by pressing upon the eyeballs and thus causing the following reflex:

Dagnini-Aschner reflex

Hering-Breuer reflex

Holtz’s reflex

Bainbridge reflex

Frank-Starling mechanism

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Histological examination of biopsy samples taken from the thickened edges of a gastric ulcer revealed small clusters of small, markedly atypical hyperchromatic epithelial cells that were localized in the overdeveloped stroma. Specify the tumor:

Scirrhous undifferentiated carcinoma

Adenocarcinoma

Adenoma

Medullary carcinoma

Undifferentiated sarcoma

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A 10-year-old child was found to have a congenital hypoplasia of the left kidney. Ultrasound examination revealed that the right kidney was markedly enlarged and had regular shape. No functional disorders were revealed. Specify the process that developed in the right kidney:

Vicarious hypertrophy

Working hypertrophy

Pseudohypertrophy

Hypertrophic growth

Metaplasia

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In allergic diseases, a dramaic increase in basophilic leukocyte number in patients’ blood is observed. This phenomenon is due to the following basophil function:

Participation in blood clotting

Participation of heparin and histamine in metabolism

Phagocytosis of immune complexes

Immunoglobulin synthesis

Phagocytosis of microorganisms and small particles

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A 47-year-old male patient developed intestinal colic against the background of essential hypertension. In this situation it would be most efficient to arrest the colic by using drugs of the following group:

Sympathomimetics

Anticholinesterase agents

Adrenomimetics

M-cholinomimetics

Myotropic antispasmodics

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

Cholemia

Hyperbilirubinemia

Bilirubinuria

Increase of ALT, AST level

Urobilinuria

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An underage patient has signs of achondroplasia (dwarfism). It is known that this is a monogenic disease and the gene that is responsible for the development of such abnormalities is a dominant one. The development of that child’s brother is normal. Specify the genotype of the healthy child:

AA

AABB

aa

AaBb

Aa

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A patient has acute bronchitis. The fever up to 38,5oC had lasted for a week, presently there is a decrease in temperature down to 37,0oC. Specify the leading mechanism in the 3rd stage of fever:

Increased respiratory rate

Development of chill

Increased diuresis

Increased heat production

Peripheral vasodilation

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A 35-year-old female patient has undergone biopsy of the breast nodules. Histological examination has revealed enhanced proliferation of the small duct and acini epithelial cells, 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?

Cystic breast

Fibroadenoma

Adenocarcinoma

Mastitis

Invasive ductal carcinoma

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At a bacteriological laboratory animal skins are analyzed by means of Ascoli precipitaion test. What is detected if the reaction is positive?

Yersinia surface antigen

Anaerobic infection toxin

Anthrax agent antigens

Plague agent

Brucellosis agent

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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?

Lamblia

Trypanosome

Toxoplasma

Leishmania

Intestinal trichomonad

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A 36-year-old female patient has a history of 52-hypovitaminosis. The most likely cause of specific symptoms (epithelial, mucosal, cutaneous, corneal lesions) is the defi- ciency of:

Flavin coenzymes

Cytochrome B

Cytochrome C

Cytochrome oxidase

Cytochrome A1

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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?

Fat

Tissue

Thromboembolism

Gaseous

Air

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A blood drop has been put into a test tube with 0,3% solution of NaCl. What will happen to erythrocytes?

Any changes will be observed

Mechanical haemolysis

Shrinkage

Biological haemolysis

Osmotic haemolysis

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There are cortical and medullary substances separated by connective tissue layer in the endocrine gland specimen. Parenchyma cells make up three zones in cortical substance, with rounded masses in the superficial zone, parallel chords in the middle one, reticular structure of cell chords in the deep one. What gland is it?

Hypothalamus

Pituitary gland

Thyroid gland

Epiphysis

Adrenal gland

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Histological specimen of a 10-day human embryo represents 2 contacting sacs (amniotic and yolk sacs). Specify the structure that separates the amni-otic cavity from the yolk sac:

Floor of the amniotic sac

Amniotic stalk

Embryonic shield

Roof of the yolk sac

Extraembryonic mesoderm

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An electron micrograph shows a cell of neural origin. The terminal portion of the cell dendrite has cylindrical shape and consists of 1000 closed membrane disks. What cell is represented by the micrograph?

Spinal node neuron

Neuron of the anterior horns of the spinal cord

Neuron of the cerebral cortex

Rod receptor cell

Cone receptor cell

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Disruption of nerve fiber myelinogenesis causes neurological disorders and mental retardation. These symptoms are typical for hereditary and acquired alterations in the metabolism of:

Higher fatty acids

Sphingolipids

Neutral fats

Cholesterol

Phosphatidic acid

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A patient underwent surgical removal of a cavitary liver lesion 2 cm in diameter. It was revealed that the cavity wall was formed by dense fibrous connective tissue; the cavity contained muddy, thick, yellowish-greenish fluid with an unpleasant odor. Microscopically, the fluid consisted mainly of polymorphonuclear leukocytes. What pathological process are these morphological changes typical for?

Chronic abscess

-

Acute abscess

Phlegmon

Empyema

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A patient complains of photoreception disorder and frequent acute viral diseases. He has been prescribed a vitamin that affects photoreception processes by producing rhodopsin, the photosensitive pigment. What vitamin is it?

Pyridoxine hydrochloride

Tocopherol acetate

Retinol acetate

Thiamine

Cyanocobalamin

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A 7-year-old boy got ill with diphtheria. On the third day he died of asphyxiation. At autopsy the mucosa of the larynx, trachea and bronchi had thickened, edematous, lustreless appearance and was covered with gray films which could be easily removed. Specify the type of laryngeal inflammation:

Purulent

Diphtheritic

Croupous

Catarrhal

Intermediate

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A child has a history of hepatomegaly, hypoglycemia, seizures, especially on an empty stomach and in stressful situations. The child is diagnosed with Gierke disease. This disease is caused by the genetic defect of the following enzyme:

Glucose-6-phosphatase

Amyloid-1,6-glycosidase

Glycogen phosphorylase

Glucokinase

Phosphoglucomutase

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A public utility specialist went down into a sewer well without protection and after a while lost consciousness. Ambulance doctors diagnosed him with hydrogen sulfide intoxication. What type of hypoxia developed?

Respiratory

Overload

Hemic

Circulatory

Tissue

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A child with a normal karyotype is diagnosed with cleft lip and hard palate, defects of the cardiovascular system, microcephaly. The child’s mother suffered rubella during pregnancy. This pathology in the child may be an example of:

Trisomy

Phenocopy

Monosomy

Genocopy

-

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A 28-year-old patient undergoing treatment in the pulmonological department has been diagnosed with pulmonary emphysema caused by splitting of alveolar septum by tissular tripsin. The disease is cased by the congenital deficiency of the following protein:

a1-proteinase inhibitor

Transferrin

Haptoglobin

a2-macroglobulin

Cryoglobulin

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

Calcitriol

Aldosterone

Calcitonin

Cortisol

Parathyroid hormone

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During a surgery for femoral hernia a surgeon operates within the boundaries of femoral trigone. What structure makes up its upper margin?

Lig.inguinale

Lig.lacunare

Fascia lata

Lig. pectinale

Arcus iliopectineus

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A 19-year-old victim has been delivered to the casualty department with a cut wound of the trapezius muscle. Which of the cervical fasciae forms a sheath for this muscle?

Carotid sheath of cervical fascia

Prevertebral layer of cervical fascia

Visceral part of the pretracheal layer of cervical fascia

Muscular part of the pretacheal layer of cervical fascia

Investing layer of cervical fascia

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A patient with acne has been prescribed doxycycline hydrochloride. What recommendations should be given to the patient, while he is taking this drug?

Take with large quantity of liquid, preferably milk

Avoid long stay in the sun

Take before meal

Do not take with vitamins

The course of treatment should not exceed 1 day

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A 30-year-old patient with a past history of virus B hepatitis complains of prolonged nosebleeds. What drug will be most efficient in remedying this condition?

Fraxiparine

Dipiridamol

Folic acid

Vicasolum

Asparcam

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

Atenolol

Reserpine

Octadine

Amlodipine

Pyrroxanum

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A patient has been diagnosed with ARVI. Blood serum contains immunoglobulin M. What is the stage of infection in this case?

Prodromal

Acute

Incubation

Carriage

Reconvalescence

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In a dysentery patient undergoing treatment in the contagious isolation ward, a significant increase in packed cell volume has been observed (60%). What other value will be affected by this change?

Leukopenia

Increasing erythrocyte sedimentation rate (ESR)

Increasing blood viscosity

Increasing volume of blood circulation

Thrombocytopenia

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A patient complains of palpitation after stress. The pulse is 104 bpm, P-Q=0,12 seconds, there are no changes of QRS complex. What type of arrhythmia does the patient have?

Sinus tachycardia

Sinus bradycardia

Ciliary arrhythmia

Sinus arrhythmia

Extrasystole

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A 30-year-old patient has undergone keratoplasty in the transplantation center, cornea has been taken fron a donor, who died in a road accident. What kind of transplantation was performed?

Xenotransplantation

Heterotransplantation

Autotransplantation

Explantation

Allotransplantation

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A 29-year-old male with a knife wound of neck presents with bleeding. During the initial dbridement of the wound the surgeon revealed the injury of a vessel found along the lateral edge of the sternocleidomastoid muscle. Specify this vessel:

V jugularis externa

V jugularis anterior

V jugularis interna

A. carotis interna

A. carotis externa

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A histologic specimen represents an organ with walls comprised of mucous, submucous, fibrous-cartilaginous and adventitial membranes. Epithelium is multirowed and ciliated, muscular layer of mucous membrane is absent, submucous membrane contai- ns serousmucous glands, hyaline cartilage forms open circles. What organ has the described morphological features?

Secondary bronchi (lobar bronchi)

Terminal bronchiole

Tertiary bronchi (segmental bronchi)

Larynx

Trachea

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In cancer patients who have been continuously receiving methotrexate, the target cells of tumor with time become insensitive to this drug. In this case, gene amplification of the following enzyme is observed:

Dihydrofolate reductase

Thiaminase

Deaminase

Thioredoxin reductase

-

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Pancreas is known as a mixed gland. Endocrine functions include production of insulin by beta cells. This hormone affects the metabolism of carbohydrates. What is its effect upon the activity of glycogen phosphorylase (GP) and glycogen synthase (GS)?

It activates GP and inhibits GS

It activates both GP and GS

It inhibits GP and activates GS

It inhibits both GP and GS

It does not affect the activity of GP and GS

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A patient has the oxyhemoglobin dissociation curve shifted to the left. What blood changes induce this condition?

Acidosis, hypocapnia, temperature rise

Alkalosis, hypocapnia, temperature drop

-

Acidosis, hypercapnia, temperature rise

Acidosis, hypercapnia, temperature drop

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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

Idiosyncrasy

Bacteriosis

Sensibilization

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

GABA-ergic system activation

H1-histamine receptors stimulation

Inhibition of stimulating amino acids

Blockade of opiate receptors

Supression of serotonergic neurotransmission

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A patient has been found to have a marked dilatation of saphenous veins in the region of anterior abdominal wall around the navel. This is symptomatic of pressure increase in the following vessel:

V mesenterica superior

V mesenterica inferior

V cava inferior

V cava superior

Vportae hepatis

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