Step 1 - Medicine 2017

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

Thoracic cavity - anterior mediastinum

Interaponeurotic suprasternal space

Thoracic cavity - posterior mediastinum

Retrovisceral space

Thoracic cavity - middle mediastinum

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

Interphase

Prophase

Telophase

Anaphase

Metaphase

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

Loratadine

Dimedrol (Diphenhydramine)

Suprastin (Chloropyramine)

Diprazine (Promethazine)

Tavegyl (Clemastine)

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

4 and 250

250 and 2

250 and 4

500 and 2

2 and 500

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Protective function of saliva is based on several mechanisms, including the presence of enzyme that has bactericidal action and causes lysis of complex capsular polysaccharides of staphylococci and streptococci. Name this enzyme:

Beta-glucuronidase

Collagenase

Alpha-amylase

Lysozyme

Oligo-1,6-glucosidase

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

Isometric

Auxotonic

Phasic

Single

Isotonic

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

Tr. spinocerebellaris

Tr. corticopontinus

Tr. corticonuclearis

Tr. corticospinalis

Tr. dentatorubralis

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A patient complains of pain in the upper umbilical region. On palpation there is a mobile painful intestine. What intestine is being palpated by the doctor?

Duodenum

Sigmoid colon

Jejunum

Transverse colon

Ileum

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

Paratyphoid A fever

Plague

Cholera

Typhoid fever

Dysentery

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Histological investigation of the uterine scrape of the 45-year-old woman with disturbed ovarian menstrual cycle revealed increased number of endometrial glands, some of which are serrated, while others are dilated and cyst-like. Make the diagnosis:

Endometrial cystic glandular hyperplasia

Atypical endometrial hyperplasia

Placental polyp

Glandular endometrial polyp

Endometrial adenocarcinoma

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

Cyanocobalamin

Alpha-tocopherol

Folic acid

Pyridoxal phosphate

Rutin

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

Amino acids activation

Translation

Replication

Transcription

Processing

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

Blood ”sludge” phenomenon

Thrombosis

Venous hyperemia

Embolism

Arterial hyperemia

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

External mechanism of prothrombinase activation

Blood clot retraction

Internal mechanism of prothrombinase activation

Conversion of prothrombin to thrombin

Conversion of fibrinogen to fibrin

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

Canalis carpalis

Vagina tendinis m. flexor pollicis longi

Interfascial compartments

Vagina tendinis m. flexor carpi radialis

Vagina synovialis communis mm. flexorum

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During cholecystectomy besides a. cystyca another artery was pulled into the ligature. Ligation of this artery resulted in right-sided necrosis of the liver which led to the death of the patient. What artery was mistakenly ligated along with a. cystyca?

А. pancreato-duodenalis sup

Ramus sinister a. hepatica propria

Ramus dexter a. hepatica propria

А. gasro-duodenalis

А. hepatica communis

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

Bemegride

Methylene blue

Unithiol

Naloxone

Nalorphine

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A patient with periodontitis of the lower molar came to the doctor. It was determined that the inflammatory process spread to the lymph nodes. What lymph nodes were the first to be affected by the inflammatory process?

Anterior cervical

Submandibular

Submental

Facial

Lateral cervical

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A 63-year-old man suffers from esophageal carcinoma, presents with metastases into the mediastinal lymph nodes and cancerous cachexia. What pathogenetic stage of neoplastic process is observed in the patient?

Promotion

Progression

Initiation

-

Transformation

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

Convection

Conduction and convection

Evaporation

Radiation

-

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

Papilloma

Fibroma

Angioma

Angiofibroma

Polyp

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

Echinococcus

Taenia solium

Fasciola hepatica

Hymenolepis nana

Diphylobotrium latum

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

Acute bronchitis

Bronchiectasis

Squamous cell carcinoma of bronchus with keratinization

Squamous cell metaplasia of bronchial mucosa

Polypoid chronic bronchitis

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

Parkinson’s disease

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

Cori’s disease (Glycogen storage disease type III)

McArdle’s disease (Glycogen storage disease type V)

Addison’s disease (Primary adrenal insufficiency)

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

Platyphyllin

Dithyline (Suxamethonium chloride)

Cyclodol (Trihexyphenidyl)

Atropine

Proserin

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

Occipital lobe

Anterior central gyrus

Parietal lobe

Frontal lobe

Posterior central gyrus

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Blood test of the patient revealed albumine content of 20 g/l and increased activity of lactate dehydrogenase isoenzyme 5 (LDH5). These results indicate disorder of the following organ:

Spleen

Liver

Heart

Kidneys

Lungs

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

Nephroblastoma

Hydronephrosis

Pyelectasis

Hydroureteronephrosis

Renal cyst

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

Alveolar tendency to recede

Decreased work of expiratory muscles

Increased pulmonary ventilation

Decreased airways resistance

Hyperoxemia

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

Ciliary

Sublingual

Otic

Submandibular

Pterygopalatine

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

Long-acting insulin

Intermediate-acting insulin

Biguanide

Sulfonylurea derivative

Rapid-acting insulin

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

Digoxin

Papaverine hydrochloride

Cordiamin

Nitroglycerine

Mesaton (Phenylephrine)

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

Polyploidy

Aneuploidy

Translocation

Polyteny

Inversion

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A 30-year-old man complains of suffocation, heaviness in the chest on the right, general weakness. Body temperature is 38,9oC. Objectively the right side of the chest lags behind the left side during respiration. Pleurocentesis yielded exudate. What is the leading factor of exudation in the patient?

Increased blood pressure

Hypoproteinemia

Erythrocyte aggregation

Increased permeability of the vessel wall

Decreased resorption of pleural fluid

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

Conjugated bilirubin

Unconjugated bilirubin

Urobilinogen

Mesobilirubin

Biliverdine

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

Uric acid

Total lipids

Mineral salts

Creatinine

Glucose

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

Myosin

Mucin

Ovalbumin

Collagen

Troponin

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

Atrial fibrillation

Sinus extrasystole

Paroxysmal atrial tachycardia

Atrial thrill

Sinus tachycardia

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A patient complaining of dizziness, thirst, difficult swallowing, and impaired vision of close objects has addressed a doctor. Objectively: respiratory rate is increased, pupils are dilated, general agitation, talkativeness, though the speech is indistinct. BP is 110/70 mm Hg, heart rate is 110/min. Given symptoms can indicate overdosage of the following drug:

Caffeine

Atropine

Aminazine

Ephedrine

Morphine

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

Sago spleen

Splenic hyalinosis

Lardaceous spleen

Porphyry spleen

Sugar-coated spleen

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

Atelectasis

Pneumosclerosis

Emphysema

Pneumonia

Pneumothorax

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During removal of the hyperplastic thyroid gland of a 47-year-old woman, the parathyroid gland was damaged. One month after the surgery the patient developed signs of hypoparathyroidism: frequent convulsions, hyperreflexia, laryngospasm. What is the most likely cause of the patient’s condition?

Hypophosphatemia

Hyponatremia

Hyperchlorhydria

Hypocalcemia

Hyperkalemia

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

Gonadal hypofunction

Adrenocortical hyperfunction

Hyperthyroidism

Hypothyroidism

Hyperfunction of the insular apparatus

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

Primordial follicle

Mature (tertiary) follicle

Corpus atreticum

Corpus luteum

Primary follicle

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

Kidney

Lymph node

Adrenal gland

Thymus

Thyroid gland

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

Agglutination reaction with serum 0

Microscopy of stained smears

Based on its biochemical properties

By means of bacteriophage typing

Based on the nature of its growth in Endo medium

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

Bronchus, artery, veins

Artery, veins, bronchus

Artery, bronchus, veins

Veins, bronchus, artery

Veins, artery, bronchus

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

Hepatitis G virus

Hepatitis D virus

Hepatitis C virus

Hepatitis E virus

Hepatitis B virus

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A 64-year-old woman presents with disturbed fine motor function of her fingers, marked muscle rigidity, and tremor. The neurologist diagnosed her with Parkinson’s disease. What brain structures are damaged resulting in this disease?

Substantia nigra

Red nuclei

Cerebellum

Reticular formation

Thalamus

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

Digoxin

Hydrochlorothiazide

Indometacin

Prednisolone

Reserpine

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Nitrogen is being excreted from the body mainly as urea. When activity of a certain enzyme in the liver is low, it results in inhibition of urea synthesis and nitrogen accumulation in blood and tissues. Name this enzyme:

Urease

Amylase

Carbamoyl phosphate synthetase

Pepsin

Aspartate aminotransferase

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

Decrease of prothrombin synthesis

Decrease of fibrinogen synthesis

Qualitative abnormalities of fibri-nogenesis

Fibrinolysis activation

Fibrin-stabilizing factor deficiency

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

Gilbert’s disease

Parenchymal (hepatic)

Mechanical

Neonatal

Hemolytic

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Histological specimen shows organ parenchyma to consist of lymphoid tissue that forms lymph nodules; the nodules are located diffusely and have a central artery. What anatomical structure has such morphological characteristics?

Red bone marrow

Tonsil

Spleen

Thymus

Lymph node

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

Shigella flexneri

Treponema pallidum

Helycobacter pylori

Campylobacter jeuni

Spirilla minor

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

Acceleration of pyrimidine nucleotides catabolism

Acceleration of nucleic acids synthesis

Acceleration of nitrogen-containing substances excretion

Competitive inhibition of xanthine oxidase

Deceleration of pyrimidine nucleotides salvage

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

Damage to the myocardium

Cardiac overload due to increased vascular resistance

Cardiac overload due to increased blood volume

Disorder of impulse conduction in the myocardium

Dysregulation of cardiac function

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

Brucella abortus

Bacillus anthracis

Francisella tularensis

Mycobacterium bovis

Yersinia pestis

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

Decreased activity of plasma phosphatidylcholine-cholesterol-acyltransferase

Increased activity of adipose triglyceride lipase

Activation of apoА1, apoА2, and apoА4 apolipoprotein synthesis

Activation of ketone bodies utilization

Accumulation of palmitoyl-CoA in cytosol

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

Hemosiderosis

Lipofuscinosis

Jaundice

Hemomelanosis

Hemochromatosis

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Examination of the coronary arteries revealed atherosclerotic plaques with calcinosis that close the arterial opening by 1/3. In the muscle there are numerous whitish layers of connective tissue. Name the process detected in the myocardium:

Diffuse cardiosclerosis

Tiger heart

Postinfarction cardiosclerosis

Myocardial infarction

Myocarditis

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

DNA based on the viral RNA matrix

Informational RNA based on the viral protein matrix

Viral RNA based on the DNA matrix

Viral DNA based on the DNA matrix

Viral protein based on the viral RNA matrix

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

Radially

-

Vertically

Arcuately

Transversely

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

Diencephalon

Mesencephalon

Cerebral cortex

Medulla oblongata

Spinal cord

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

Purkinje’s fibers

Ventricles

His’ bundle

Atrioventricular node

Sinoatrial node

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

Proteins

Fats

Vitamins

Minerals

Carbohydrates

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

Nitrazepam

Caffeine

Diazepam

Medazepam

Piracetam

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A 40-year-old man developed skin redness and swelling in the neck area, where eventually a small abscess appeared. On section the focus is dense and yellow-green colored. In the purulent masses there are white granules. Histologically there are fungal druses, plasma and xanthome cells, and macrophages detected. Specify the most correct etiological name of this pathological process:

Actinomycosis

Carbuncle

Syphilis

Leprosy

Furuncle

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

Chingamin

Quinine

Mefloquine

Biseptol (Co-trimoxazole)

Doxycycline

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

Pulmonary enzyme system disturbance

Decreased elasticity of the pulmonary tissue

Obstructive disorders of pulmonary ventilation

Pulmonary blood supply disturbance

Restrictive disorders of pulmonary ventilation

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

Basedow’s disease

Riedel’s thyroiditis

Nodular goiter

De Quervain’s disease

Hashimoto’s thyroiditis

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

Radioimmunoassay technique

Immunofluorescence test

Enzyme-linked immunosorbent assay

Immobilization test

Complement fixation test

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

Systolic pressure will decrease, while diastolic will increase

Diastolic pressure will decrease, while systolic will increase

Only diastolic pressure will decrease

Systolic and diastolic pressure will decrease

Only systolic pressure will decrease

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

Complement binding

Double immunodiffusion

Opsonophagocytic

Neutralization

Precipitation

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

Strophanthine

Potassium chloride

Acetylsalicylic acid

Metoprolol

Corglycon

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

Pyelonephritis

Chronic renal failure

Glomerulonephritis

Acute renal failure

Uremic coma

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

Salmonellosis

Dysentery

Cholera

Typhoid fever

Amebiasis

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

Plasma oncotic pressure

Effective filtration pressure

Hydrostatic blood pressure in the glomerular capillaries

Renal blood flow

Permeability of the renal filter

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

Hermaphroditism

Epispadia

Paraphimosis

Phimosis

Hypospadias

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

Binding of mast cell-fixed IgE

Stimulation of immune tolerance to antigen

Stabilization of mast cell membranes

Stimulation of antigen-specific IgG2

Blocking of mast cell mediators synthesis

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A 38-year-old man, who has been suffering from systemic lupus erythematosus for 3 years, developed diffuse renal lesions accompanied by massive edemas, marked proteinuria, hyperlipidemia, and dysproteinemia. What is the most likely mechanism of proteinuria develoment in this case?

Autoimmune damage to the nephrons

Ischemic damage to the tubules

Morbid affection of the urinary tracts

Inflammatory damage to the nephrons

Increased blood proteins

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

Cerebellum

Frontal lobe

Reticulum

Parietal lobe

Mesencephalon

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A woman with polyarticular rheumatoid arthritis was prescribed a non-steroidal antiinflammatory drug - diclofenac sodium. After the patient has been taking it for some time, her concomitant disease exacerbated, which forced the doctor to cancel the prescription of this drug. What concomitant disease could necessitate cancellation of this drug prescription?

Diabetes mellitus

Essential hypertension

Ischemic heart disease

Ulcer disease

Bronchial asthma

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

Elastic artery

Muscular vein

Nonmuscular vein

Muscular artery

Mixed type artery

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A woman with the III (В), Rh (-) blood group gave birth to a child with the II (А) blood group. The child is diagnosed with hemolytic disease of newborn caused by rhesus incompatibility. What blood group and Rh are likely in the father?

II (A), Rh (-)

I (0), Rh (+)

III (B), Rh (+)

II (А), Rh (+)

I (0), Rh (-)

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

Glycolysis

Glycogenolysis

Glucose transportation into a cell

Gluconeogenesis

Glucose reabsorption

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

Primary tuberculosis, primary affect development

Secondary fibrous-focal tuberculosis

Hematogenous macrofocal pulmonary tuberculosis

Secondary fibro-cavitary tuberculosis

Secondary cirrhotic tuberculosis

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

Acute lymphoblastic leukemia

Acute plasmablastic leukemia

Acute monoblastic leukemia

Acute myeloblastic leukemia

Acute undifferentiated leukemia

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

Acute anemia

Decompression sickness

Acute leukemia

Vibration disease

Acute radiation sickness

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

Delayed hypersensitivity

Transplantation immune reaction

Normergic reaction

Immediate hypersensitivity

Granulomatosis

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Preoperative examination revealed prothrombin deficiency in the blood of the patient. What drug should be preliminarily prescribed to mitigate blood loss in the patient during the surgery?

Phenylin (Phenindione)

Thrombin

Contrykal (Aprotinin)

Aminocapronic acid

Vicasol (Menadione)

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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?

Radiating

Protopathic

Epicritic

Visceral

Phantom

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

Calciferol

Riboflavin

Cobalamin

Tocopherol

Folic acid

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

Choleric

Sanguine

-

Melancholic

Phlegmatic

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

Red bone marrow

Lymph node

Spleen

Thymus

Tonsils

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

Encephalitis

Rabies

Encephalomyelitis

Brucellosis

Meningococcal meningitis

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

50 %

Higher than in the population

Lower than in the population

The same as in the population

100 %

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A 46-year-old patient suffering from ulcer disease of the stomach is diagnosed with rheumatoid arthritis. What antiinflammatory drug would be the most advisable in this case?

Promedol (Trimeperidine)

Celecoxib

Prednisolone

Analgin (Metamizole)

Paracetamol

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

Juxtaglomerular apparatus

Distal nephron

Filtration barrier

Proximal nephron

Henle’s loop

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

Anthrax

Brucellosis

Plague

Tularemia

Cholera

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

Mediastinum posterius

Spatium interaponeuroticum suprasternale

Mediastinum anterius

Spatium interscalenum

Spatium pretracheale

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

Magnesium sulfate

Paracetamol

Atropine sulfate

Anaprilin (Propranolol)

Ambroxol

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

Furosemide

Spironolactone

Dichlothiazidum (Hydrochlorothiazide)

Diacarb (Acetazolamide)

Triamterene

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

Calcium channel blockers

Nonsteroidal antiinflammatory drugs

Steroidal antiinflammatory drugs

Histamine Hi-receptor antagonists

Histamine H2-receptor antagonists

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

Kleinfelter

Down

Turner

DiGeorge

Patau

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

Hemagglutination inhibition assay (HAI)

Direct and indirect enzyme-linked immunosorbent assay (ELISA)

Reverse indirect haemagglutination (RI-HA)

Radioimmunoassay (RIA)

Direct and indirect immunofluorescence (IF)

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A 5-year-old child is diagnosed with Bruton syndrome (X-linked agammaglobulinemia) that manifests itself in severe clinical course of bacterial infections and absence of B lymphocytes and plasma cells. What changes of immunoglobulin content can be observed in blood serum of the child with immunodeficiency?

Increased IgA, IgM

Decreased IgA, IgM

No changes

Decreased IgD, IgE

Increased IgD, IgE

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

Abscess

Hemorrhagic infarction

Cyst

Tumor

Ischemic stroke

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

Vascular baroreceptors

Vascular volume receptors

Hypothalamic thermoreceptors

Vascular chemoreceptors

Proprioceptors of the working muscles

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

Muscle contracture

Smooth tetanus

Series of single contractions

Asynchronous tetanus

Incomplete tetanus

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

Phenylalanine 4-monooxygenase

D -amino acid oxidase

Diamine oxidase

L-amino acids oxidase

Monoamine oxidase

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

Sphingomyelinase deficiency

Amylo-1,6-glucosidase deficiency

Acid lipase deficiency

Xanthine oxidase deficiency

Glucose 6-phosphatase deficiency

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

47, XXY

46, XX

48, XXXY

48, XXYY

47, ХХХ

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

Diphyllobothriasis

Opisthorchiasis

Beef tapeworm infection

Echinococcosis

Teniasis

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

Amylase

Carbohydrates

Chymotrypsin

Tripsin

Bile acids

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

Transfer of reduced equivalents to molecular oxygen

Cytochrome splicing

Cytochrome synthesis

Transfer of reduced equivalents to ubiquinone

Adenosine triphosphate synthesis

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

Increased arterial pressure

Decreased oncotic plasma pressure

Decreased venous return

Increased central venous pressure

Increased venous return

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

Histamine

Urea

Ammonia

Bilirubin

Glutamine

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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 terminalis

Linea arcuata

Linea transversa

Linea inguinalis

Linea semilunaris

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

Acute productive hepatitis

Fatty hepatosis

Hepatolenticular degeneration

Massive progressive necrosis

Acute exudative hepatitis

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

Lymphopoiesis

Granulocytopoiesis

Erythropoiesis

Leukopoiesis

Immunogenesis

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

Calcium ion exit

Potassium ion entry

Potassium ion exit

Calcium and potassium ion exit

Calcium ion entry

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

Atresia of the sylvian aqueduct

Closure of the left interventricular foramen

Atresia of the fourth ventricle foramina

Closure of the right interventricular foramen

Atresia of the tubus medullaris

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

Endotheliocytes

Monocytes

Neutrophils

Fibroblasts

Eosinophils

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

Anterior longitudinal ligament

Yellow ligament

Iliolumbar ligament

Posterior longitudinal ligament

Interspinal ligament

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

Pseudomonas aeruginosa

Clostridium perfringens

Staphylococcus aureus

Escherichia coli

Clostridium botulinum

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

Contraction

Relaxation

Depolarization

Repolarization

Activation

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

Sequestrum

Abscess

Gangrene

Tuberculoma

Granuloma

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A patient, who has been subsisting exclusively on polished rice, has developed polyneuritis due to thiamine deficiency. What substance is an indicator of such avitaminosis, when it is excreted with urine?

Methylmalonic acid

Phenyl pyruvate

Malate

Pyruvic acid

Uric acid

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

Increase of lipid peroxidation

Neutralization of xenobiotics

Activation of microsomal oxidation

Oxidation of glucose into lactate

Counteraction to lipid peroxidation

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

Parasympathetic unconditioned reflex

Sympathetic conditioned reflex

Metasympathetic reflex

Sympathetic unconditioned reflex

Parasympathetic conditioned reflex

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

Mucous cells

Epithelial cells

Exocrine chief cells

Exocrine parietal cells

Endocrine cells

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

Glucose

Urea

Lipids

Glycosaminoglycans

Amino acids

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

Vesicouterine pouch

Retrovesical pouch

Rectouterine pouch

Right lateral canal

Left lateral canal

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

Superior part of the precentral gyrus

Inferior part of the precentral gyrus

Superior parietal lobule

Angular gyrus

Supramarginal gyrus

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

Corrosive gastritis

Phlegmonous gastritis

Catarrhal gastritis

Croupous gastritis

Diphtheritic gastritis

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

Epistasis

Complete dominance

Semidominance

Complementarity

Codominance

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

Neuroparalytic

Reactive

Metabolic

Neurotonic

Functional

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

Adenocarcinoma

Squamous cell carcinoma

Undifferentiated small cell carcinoma

Undifferentiated large cell carcinoma

Glandular squamous cell carcinoma

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

Superficial temporal artery

Posterior deep temporal artery

Anterior deep temporal artery

Middle meningeal artery

Lateral pterygoid artery

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

Echinococcosis

Teniasis

Alveococcosis

Trichinosis

Taeniarhynchosis

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

Rod cells

Cone cells

Bipolar neurons

Horizontal cells of retina

Ganglionic nerve cells

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

Thymus

Parathyroid gland

Pancreas

Thyroid gland

Parotid gland

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

Interferon

Ambroxol

BCG vaccine

Dexamethasone

Doxycycline

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

Reflex apnea

Reflex dyspnea

Cough

Bronchial spasm

Reflex hyperpnea

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

Increase in plasma oncotic pressure

Albuminosis

Increased proteolysis

Decrease in concentration of blood amino acids

Increase in low-density lipoproteins level

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

Choline deficiency

Impaired phospholipid synthesis

Excessive consumption of fatty foods

Lack of carbohydrates in the diet

Low carnitine content

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

Transcription initiation in procaryotes

Translation initiation in procaryotes

Replication initiation in procaryotes

Translation initiation in eucaryotes

Transcription initiation in eucaryotes

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

Radiation

Evaporation

Conduction and convection

Conduction

Convection

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During gastric resection the patient received mixed anesthesia with tubocurarin chloride muscle relaxant; to restore spontaneous respiration the patient received proserin. What pharmacological group does this drug belong to?

Muscarinic agonists

Muscarinic antagonists

Cholinesterase inhibitors

Angiotensin-converting-enzyme inhibitors

Calcium channel blockers

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

Hyperlipoproteinemia type IIb

Hyperlipoproteinemia type IIa

Hyperlipoproteinemia type I

Cholesterol, hyperlipoproteinemia

Hyperlipoproteinemia type IV

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

Ciprofloxacin

Bijochinol (Quinine bismuth iodide)

Streptomycin

Azithromycin

Penicillin G Sodium Salt

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

Calcium

Potassium

Sodium

Potassium and sodium

Potassium and calcium

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

Partial or complete cell destruction

Intensive protein synthesis

Restoration of cytoplasmic membrane

Formation of maturation spindle

Intensive energy production

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

Immune complex hypersensitivity

Cellular cytotoxicity

Atopy (local anaphylaxis)

Systemic anaphylaxis

Antibody-dependent cell-mediated cytolysis

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

Calcium chloride

Sodium nucleotide

Albumin

Sodium chloride

Sodium bromide

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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

Increase of ALT, AST level

Hyperbilirubinemia

Urobilinuria

Bilirubinuria

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

Diffuse endocarditis

Ulcerative polypoid endocarditis

Acute verrucous endocarditis

Fibroplastic endocarditis

Recurrent verrucous endocarditis

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

Prophase of the first division

Metaphase of the first division

Anaphase of the first division

Anaphase of the second division

Metaphase of the second division

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

Ipratropium bromide

Platyphyllin

Salbutamol

Atropine

Adrenaline

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

Phenobarbital

Nitrazepam

Barbamylum (Amobarbital)

Ethaminal sodium (Pentobarbital)

Chloral hydrate

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

Maximal breathing capacity

Respiratory minute volume

Respiration rate

Vital capacity

Functional residual capacity

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

Mosquito

Tsetse fly

Triatomine bug

Gnat

Cockroach

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

Tissue

Thromboembolism

Gaseous

Adipose

Air

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

Acid-base balance is normal

Respiratory alkalosis

Respiratory acidosis

Metabolic acidosis

Metabolic alkalosis

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

Exotoxin action

Pathogen adhesion to the enterocyte receptors

Activation of adenylate cyclase

Enterotoxin action

Enterotoxic shock development

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

Keto acids oxidative decarboxylation

Amino acids transamination

Amino acids decarboxylation

Redox reactions

Proline hydroxylation

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

Testosterone

Oxytocin

Estriol

Prolactin

Relaxin

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

Esophagus

Vermiform appendix

Ureter

Urethra

Umbilical cord

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

Localization of the causative agent within macrophages

Spores that exceed cells in diameter

Presence of the capsule

Polar placement of volutin granules

Fence-like position of the agent’s cells

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

Alteration of transcapillary exchange

Stimulation of sympathetic nerves

Ischemia of the central nervous system

Stimulation of parasympathetic nerves

Abrupt change in body fluid volume

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

Adrenaline

Glucocorticoids

Insulin

Mineralocorticoids

Vasopressin

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

Neoplastic erythroid hyperplasia

Iron-deficiency

S12-deficiency

Hypoxia

Acidosis

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

Complementary interaction

Polymery

Overdominance

Complete dominance

Epistasis

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

Corticoliberin

Thyroliberin

Somatoliberin

Somatostatin

Corticostatin

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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

Blockade of opiate receptors

H1-histamine receptors stimulation

Supression of serotonergic neurotransmission

Inhibition of stimulating amino acids

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A 50-year-old inpatient during examination presents with glucosuria and blood glucose of 3,0 mmol/l, which are the most likely to be caused by:

Diabetes insipidus

Pellagra

Essential hypertension

Renal disorder

Myxedema

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

Colienteritis

Shigellosis

Pseudotuberculosis

Typhoid fever

Cholera

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

Indicate recent infection

Have the largest molecular weight

Are associated with anaphylactic reactions

Penetrate placental barrier

Are the main factor of antiviral protection

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

Low-density lipoproteins

High-density lipoproteins

Intermediate-density lipoproteins

Very low-density lipoproteins

Chylomicrons

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

Increase sex hormones synthesis

Decrease hormone synthesis in the adrenal medulla

Decrease insulin synthesis

Decrease adrenocorticotropic hormones synthesis

Increase thyroid hormones synthesis

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

Corpora quadrigemina

Hypothalamus

Globus pallidus

Red nuclei

Substantia nigra

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

IV (АВ) Rh (+)

II (А) Rh (+)

IV (АВ) Rh (-)

I (0) Rh (+)

III (В) Rh (-)

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

Increased activity of anticoagulation system

Decrease of fibrinogen content in blood

Hypocalcemia

Decrease of albumine content in blood

Thrombocytopenia

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

Increase of CO2 partial pressure

Increase of nitrogen content in air

Increase of blood pH

Decrease of O2 partial pressure

Increase of air humidity

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

Ergocalciferol

Streptokinase

Pentoxyl

Hirudine

Calcium chloride

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

Tight time

Lack of energy

Ttight time and lack of energy

Lack of energy and information

Lack of information

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

Genetic recombination

Gene amplification

Nucleotide deletion

Transduction

Missense mutation

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A 52-year-old man presents with fever and pain in the joints. Both of his first metatarsophalangeal articulations are deformed, swollen, and reddened. Blood urea is high. The patient is diagnosed with gout. What is the main developmental factor in the pathogenesis of this disease?

Citrullinuria

Hyperazotemia

Hyperuricemy

Hyperaminoacidemia

Argininosuccinic aciduria

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

Tachycardia

Fibrillation

Flutter

Extrasystole

Bradycardia

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

Furosemide

Phenazepam

Dopamine

Triamterene

Sodium bromide

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

Rifampicin

Bactrim (Co-trimoxazole)

Furasolidone

Tetracycline

Streptocide

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

Triangular ligament of the liver

Falciform ligament of the liver

Venous ligament of the liver

Coronary ligament of the liver

Round ligament of the liver

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

Allergy diagnostics

Prevention

Treatment evaluation

Treatment

Prognosis for the disease

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

Increased pulmonary ventilation

Increased renal reabsorption of bicarbonate

Decreased pulmonary ventilation

-

Increased renal reabsorption of ammonia

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

DiGeorge syndrome

Wiskott-Aldrich syndrome

Severe combined immunodeficiency (Swiss type)

Chediak-Higashi syndrome

Louis-Bar syndrome (Ataxia-telangiectasia)

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

Neurotonic

Postischemic

Metabolic

Neuroparalytic

Pathologic

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

V jugularis externa

A. carotis externa

V jugularis interna

V jugularis anterior

A. thyroidea superior

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

N. auricularis minor

N. auricularis major

N. petrosus minor

N. petrosus profundus

N. petrosus major

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A patient developed pyoinflammatory process of periodontal tissues caused by activation of the microorganisms inherent in the body, which are a part of oral mucosal microflora. What type of infection is it?

Autoinfection

Exogenous infection

Superinfection

Relapse

Reinfection

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