Step 1 - Medicine 2018

A 40-year-old woman on examination presents with intensified basal metabolic rate. What hormone present in excess leads to such condition?

Thyrocalcitonin

Aldosterone

Somatostatin

Triiodothyronine

Glucagon

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Autopsy of a woman revealed the following morphologic changes: stenosis of the atrioventricular opening, mitral insufficiency. Histologically there are focal cardiosclerosis and ’’blooming” Aschoff nodules in the myocardium. What is the most likely diagnosis?

Polyarteritis nodosa

Dermatomyositis

Systemic lupus erythematosus

Scleroderma

Rheumatism

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After a case of sepsis a 27-year-old woman developed ’bronzed” skin discoloration characteristic of Addison’s disease. Hyperpigmentation mechanism in this case is based on increased secretion of:

Melanocyte-stimulating hormone

Gonadotropin

Thyroid-stimulating hormone

в-lipotropin

Somatotropin

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A 16-year-old girl presents with no hair on the pubis and in the armpits, her mammary glands are underdeveloped, no menstruations. What hormone imbalance can it be indicative of?

Pancreatic islet failure

Adrenal medulla hyperfunction

Hyperthyroidism

Hypothyroidism

Ovarian failure

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From the feces of a patient with acute gastroenteritis a pure culture of microorganisms was obtained. The microorganisms are small mobile slightly curved gram-negative bacilli that within 6 hours grow into a light blue film on the 1% alkaline peptone water. Such properties are characteristic of the following microorganism:

Spirilla

Bacillus

Clostridium

Spirochaete

Vibrio

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A patient was brought into the infecti- onal diseases hospital on the 8th day since the disease onset. The patient complains of headache, malaise, and weakness. A sample of blood was taken for the serological test. Widal agglutination test results with blood sample diluted 1:200 and typhoid fever O-diagnosticum were positive. What diagnosis can be made based on the results of this test?

Cholera

Typhoid fever

Leptospirosis

Dysentery

Tuberculosis

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

Oligo-1,6-glucosidase

Collagenase

Lysozyme

в-glucuronidase

a-amylase

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In the process of hemoglobin catabolism iron is released and then as a part of special transport protein is returned to the bone marrow, to be used again for hemoglobin synthesis. Name this transport protein:

Transferrin

Transcobalamin

Albumin

Ceruloplasmin

Haptoglobin

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The first-aid center has received a victim of a traffic accident diagnosed with closed displaced fracture of the middle third of the thigh. For repositioning of bone fragments the patient received 10 ml of 2% dithylinum solution intravenously, which resulted in prolonged period of apnoea and muscle relaxation. What enzyme is deficient, resulting in such pharmacogenetic enzymopathy?

Uridine diphosphate glucuronyltransferase

N-acetyltransferase

Glucose 6-phosphate dehydrogenase

Methemoglobin reductase

Pseudocholinesterase

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An 18-year-old student presents with enlarged thyroid gland accompanied by accelerated metabolism and increased heart rate. These signs can be observed during hypersecretion of thyroxin. What organelles of thyroid cells are primarily responsible for hormone production and secretion?

Centrosomes

Lysosomes

Golgi apparatus

Mitochondria

Ribosomes

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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?

Ileum

Duodenum

Transverse colon

Sigmoid colon

Jejunum

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A laboratory experiment on a dog was used to study central parts of auditory system. One of the mesencephalon structures was destroyed. The dog has lost the orienting response to auditory signals. What structure was destroyed?

Reticular formation nuclei

Substantia nigra

Inferior colliculi of corpora quadrigemina

Red nucleus

Superior colliculi of corpora quadrigemi-na

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

Glandular endometrial polyp

Endometrial cystic glandular hyperplasia

Endometrial adenocarcinoma

Placental polyp

Atypical endometrial hyperplasia

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A 45-year-old man diagnosed with hepatic cirrhosis and ascites underwent drainage of 5 liters of fluid from his abdominal cavity, which resulted in development of syncopal state due to insufficient blood supply to the brain. What circulatory disorder occurred in the abdominal cavity in this case?

Embolism

Arterial hyperemia

Venous hyperemia

Ischemia

Thrombosis

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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. hepatica communis

А. pancreato-duodenalis sup

А. gasro-duodenalis

Ramus sinister a. hepatica propria

Ramus dexter a. hepatica propria

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Microscopy of the puncture sample obtained from the inflammation focus of the patient with cutaneous abscess revealed numerous blood cells of different types. What cells are the first to transfer from vessels to tissues during inflammation?

Eosinophils

Neutrophils

Monocytes

Lymphocytes

Basocytes

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During the first year of life an infant presents with disturbed process of breast milk curdling. What cells of the proper gastric glands are functionally disturbed?

Cervical mucous cells

Exocrinocytes

Parietal exocrinocytes

Main exocrinocytes

Accessory mucous cells

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A lab rat has subcutaneously received mercury(II) chloride in the amount of 5 mg/kg. 24 hours later the plasma creatinine concentration increased several times. What mechanism of retention azotemia is observed in this case?

Increased glomerular filtration

Increased creatinine reabsorption

Decreased glomerular filtration

Increased creatinine production in the muscles

Increased creatinine production in the renal tubules

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Collagenosis patients typically present with connective tissue destruction processes. The presence of these processes can be confirmed by the increase in:

Blood urates

LDH-isoenzyme activity in the blood

Transaminase activity in the blood

Blood creatine and creatinine

Blood oxyproline and oxylysine

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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

Initiation

Progression

Transformation

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After an X-ray examination of the tuberculosis clinic patient, he was diagnosed with tumor of the right lung. During operation the surgeon removed the middle lobe of the patient’s right lung. This lobe includes:

Segmentum basale anterius et posterius

Segmentum laterale et segmentum mediate

Segmentum apicale (superius) et segmentum basale mediale

Segmentum lingualare superius et inferius

Segmentum anterius et segmentum apicale

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A 2-year-old child presents with physical retardation and frequent pneumonias. The child was diagnosed with non-closure of the arterial canal. Hemodynamics disturbance in this case is caused by communication between the:

Pulmonary trunk and pulmonary veins

Superior vena cava and aorta

Aorta and pulmonary trunk

Aorta and pulmonary veins

Superior vena cava and pulmonary trunk

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A child diagnosed with purulent inflammation of the middle ear was brought to the otolaryngology department. The disease started with the inflammation of the nasopharynx. It was determined that the infection had reached the tympanic cavity through the eustachian tube that is located in the:

Canalis musculotubarius

Сanaliculus chordae tympani

Сanaliculus tympanicus

Сanaliculi carotim tympanici

Сanalis caroticus

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During the prestart period an athlete develops increased frequency and force of cardiac contractions. These changes are caused by intensification of the following reflex responces:

Parasympathetic conditioned

Sympathetic conditioned

Peripheral

Sympathetic unconditioned

Parasympathetic unconditioned

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Due to trauma the patient has lost 25% of circulating blood volume. Name the emergency compensatory mechanism against blood loss:

Interstitial fluid inflow to the vessels

Restoration of erythrocyte number

Increase of reticulocyte number

Erythropoiesis activation

Restoration of blood protein composition

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ECG analysis of the patient shows that the T waves are positive in the second standard limb lead and their amplitude and duration is normal. The conclusion can be made that the following process occurs normally in the patient’s ventricles:

Excitation

Relaxation

Contraction

Repolarization

Depolarization

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

Increased pulmonary ventilation

Alveolar tendency to recede

Decreased work of expiratory muscles

Decreased airways resistance

Hyperoxemia

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After a case of common cold the patient developed numbness of the right side of the face. Examination revealed disturbed pain and thermal sensitivity in the right half of the face. What nerve was damaged?

Hypoglossal

Vagus

Glossopharyngeal

Trigeminal

Facial

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X-ray exmination of a 57-year-old man indicates local areas of hard bone tissue resorption in some of the patient’s bones. These changes can be associated with increased activity of:

Chondrocytes

Osteocytes

Chondroblasts

Osteoclasts

Osteoblasts

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A patient presents with acute attack of cholelithiasis. Laboratory examination of the patient’s feces will show the following in this case:

Connective tissue

Partially digested cellulose

Positive reaction to stercobilin

Negative reaction to stercobilin

Starch granules

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During autopsy of a 34-year-old man, who died of chronic kidney failure due to renal amyloidosis, in the lungs (mainly in the lower lobes) the pathologist detected multiple bronchial dilations filled with purulent masses accumulated in the bronchial lumen. Surface of the lungs section has fine-meshed pattern and resembles a honeycomb. Histologically there is a chronic inflammation detected in the bronchial wall, muscle fibers are replaced with connective tissue. These changes in the lungs can be defined as:

Chronic pneumonia

Bronchopneumonia

Chronic bronchitis

Lung abscesses

Bronchiectases

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Initial inoculation of water in 1% peptone water resulted in growth of a thin film on the medium surface in 6 hours. Such cultural properties are characteristic of causative agent of the following disease:

Tuberculosis

Pseudotuberculosis

Cholera

Dysentery

Plague

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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?

Hypoproteinemia

Decreased resorption of pleural fluid

Increased permeability of the vessel wall

Increased blood pressure

Erythrocyte aggregation

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A 42-year-old man with gout presents with high content of uric acid in blood. The patient was prescribed allopurinol to lower the concentration of uric acid. Allopurinol is a competitive inhibitor of the following enzyme:

Adenine phosphoribosyltransferase

Guanine deaminase

Adenosine deaminase

Hypoxanthine phosphoribosyltransferase

Xanthine oxidase

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Autopsy revealed a large wedge-shaped patch of a dense dark red tissue with clear margins in the upper lobe of the right lung. Histological examination detected there necrosis of the alveolar walls; the alveolar lumen is tightly packed with erythrocytes. What process occurred in the lungs?

Hemorrhagic infarction

Hemorrhage

Atelectasis

Carneous degeneration

Gangrene

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A patient complains of dizziness, thirst, difficult swallowing, and impaired vision of close objects. 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

Morphine

Ephedrine

Atropine

Aminazine

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A patient presents with indigestion, stomachaches, and excessive salivation. Similar simptoms had already been observed in this patient previously. Laboratory analysis detected oval eggs covered with lumpy capsules in the patient’s feces. What is the most likely cause of the patient’s disorder?

Diphyllobothriasis

Enterobiasis

Ascariasis

Fascioliasis

Trichocephaliasis

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Regional lymph nodes surrounding an infected wound are enlarged. Histological examination shows increased number of macrophages, lymphocytes, and lymphatic follicles, as well as a large amount of plasma cells, in the cortical layer of the lymph nodes. What process in the lymph nodes is indicated by these histologic changes?

Neoplastic aberration

Acquired deficiency of lymphoid tissue

Antigen stimulation

Congenital deficiency of lymphoid tissue

Transplant rejection

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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?

Hyperchlorhydria

Hyperkalemia

Hypocalcemia

Hyponatremia

Hypophosphatemia

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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 176 mmol/L. What pathology is such clinical presentation characteristic of?

Hyperfunction of the insular apparatus

Hyperthyroidism

Adrenocortical hyperfunction

Gonadal hypofunction

Hypothyroidism

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A 45-year-old woman presents with breast cancer. Metastases can spread in this case to the following regional lymph nodes:

Abdominal, cervical

Axillary, parasternal

Cervical, parasternal

Aortic, mediastinal

Parasternal, mediastinal

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A 40-year-old pregnant woman underwent amniocentesis. Examination determined the fetal karyotype to be 47, XY+21. What fetal pathology was detected?

Klinefelter syndrome

Down syndrome

Patau syndrome

Phenylketonuria

Turner syndrome

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A patient used an indirect-acting adrenergic agonist to treat rhinitis. After the patient has been putting in the nose drops for several days, the vasoconstrictive effect of the drug gradually diminished. Name this phenomenon:

Allergy

Cumulation

Tachyphylaxis

Teratogenicity

Idiosyncrasy

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

Hepatitis B virus

Hepatitis E virus

Hepatitis G virus

Hepatitis C virus

Hepatitis D virus

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A medical student was hospitalized into the infectious diseases unit on the 2nd day after the disease onset; the patient is suspected to have infectious mononucleosis. What results of laboratory analysis can confirm this diagnosis immediately on the day of the hospitalization?

Fourfold increase in number of antibodies to Epstein-Barr virus was detected

IgM antibodies to Epstein-Barr virus were detected

Herpesvirus was isolated

IgM antibodies to herpes simplex virus were detected

Cytomegalovirus antibodies were detected

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

Red nuclei

Thalamus

Reticular formation

Cerebellum

Substantia nigra

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A 20-year-old young man with tall stature, asthenic body type, signs of hypogonadism and gynecomastia, and low sperm count (azoospermia) has karyotype 48. XXY. What hereditary syndrome can be characterized by this chromosomal anomaly?

Klinefelter syndrome

Down syndrome

Wiskott-Aldrich syndrome

Turner syndrome

Louis-Bar syndrome (ataxia-telangiectasia)

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Pathogenic staphylococcus was obtained from the purulent wound of the patient. Its antibiotic sensitivity was determined to be as follows: penicillin growth inhibition zone - 8 mm; oxacillin 9 mm, ampicillin - 10 mm, gentamicin - 22 mm, lincomycin - 11 mm. What antibiotic should be chosen for treatment in this case?

Gentamicin

Penicillin

Ampicillin

Oxacillin

Lincomycin

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A patient presents with dilated blood vessels of the anterior medial surface of the lower leg. This condition resulted from the dilation of the following blood vessel:

V. poplitea

V saphena magna

А. tibialis anterior

А. tibialis posterior

V saphena parva

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A patient, who had received a thermal burn, developed painful boils filled with turbid liquid on the skin. What morphological type of inflammation has developed in the patient?

Croupous

Proliferative

Diphtheritic

Serous

Granulomatous

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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:

Aspartate aminotransferase

Carbamoyl phosphate synthetase

Urease

Amylase

Pepsin

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Coronary artery thrombosis resulted in development of myocardial infarction. What mechanisms of cell damage are leading in this disease?

Protein

Lipid

Calcium

Electroosmotic

Acidotic

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People, who for a long time remained in hypodynamic state, develop intense pain in the muscles after a physical exertion. What is the most likely cause of this pain?

Decreased content of lipids in muscles

Intensive breakdown of muscle proteins

Accumulation of creatinine in muscles

Accumulation of lactic acid in muscles

Increased content of ADP in muscles

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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?

Tonsil

Spleen

Red bone marrow

Thymus

Lymph node

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A 25-year-old woman complains of visual impairment. Examination revealed disturbed eye accommodation, the pupil is dilated and unresponsive to light. What muscles are functionally disturbed in this case?

Iris sphincter muscle, ciliary muscle

Iris sphincter and iris dilator muscles

Lateral rectus muscle, iris sphincter muscle

Iris dilator muscle, ciliary muscle

Superior oblique muscle, ciliary muscle

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A patient with hypochromic anemia has hair with split ends and suffers from hair loss. The nails are brittle. Gustatory sensations are affected. What is the mechanism of development of these symptoms?

Low production of thyroid hormones

Vitamin B12 deficiency

Low production of parathyroid hormone

Iron enzymes deficiency

Vitamin A deficiency

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A patient suffers from hepatic cirrhosis. What substance excreted in urine should be analyzed to characterize the antitoxic function of liver?

Ammonium salts

Hippuric acid

Uric acid

Amino acids

Creatinine

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A 65-year-old woman, who had been suffering from deep vein thrombophlebitis of the lower leg, suddenly died when awaiting her appointment with the doctor. Autopsy revealed loose friable red masses with corrugated dull surface in the main pulmonary artery and its bifurcation. What pathologic process was discovered by the pathologist in the pulmonary artery?

Thrombosis

Thromboembolism

Tissue embolism

Foreign body embolism

Fat embolism

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

Decreased activity of plasma phosphatidylcholine-cholesterol-acyltransferase

Activation of ketone bodies utilization

Activation of apoА1, apoА2, and apoА4 apolipoprotein synthesis

Increased activity of adipose triglyceride lipase

Accumulation of palmitoyl-CoA in cytosol

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Representatives of a certain human population can be characterized by elongated body, height variability, decreased volume of muscle mass, increased length of limbs, decreased size and volume of rib cage, increased perspiration, decreased indices of base metabolism and fat synthesis. What type of adaptive evolution is it?

Mountain

Intermediate

Moderate

Tropical

Arctic

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A 56-year-old man complains of thirst and frequent urination. The endocrinologist diagnosed this patient with diabetes melli-tus and prescribed him glibenclamide. What mechanism of action does this drug have?

Facilitates glucose transport through cell membranes

Inhibits glucose absorption in the intestine

Suppression of а-cells of islets of Langerhans

Stimulation of в-cells of islets of Langerhans

Facilitates glucose uptake by the tissues

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Patients with bile duct obstruction typically present with inhibited blood clotting and develop hemorrhages due to insufficient assimilation of vitamin:

A

K

E

D

C

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A test animal receives electrical impulses that irritate the sympathetic nerve that innervates blood vessels of the skin. What reaction will it cause in the blood vessels?

Arterial and venous dilation

Arterial dilation

Arterial and venous constriction

Venous dilation

No reaction

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

Tiger heart

Postinfarction cardiosclerosis

Myocarditis

Myocardial infarction

Diffuse cardiosclerosis

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A person has increased pulmonary ventilation due to physical exertion. What indicator of external respiration will be significantly increased compared to the resti- ng state?

Total lung capacity

Vital lung capacity

Respiratory volume

Inspiratory reserve volume

Expiratory reserve volume

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The carotid bodies on both sides were removed in a test animal. Which of the listed factors WILL NOT be able to cause hyperventilation in the test animal?

Acidosis

Hypercapnia

Increase of core body temperature

Hypoxemia

Physical exertion

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Due to prolonged stay in the mountains at the altitude of 3000 m above the sea level, a person developed increased oxygen capacity of blood, which was directly caused by intensified production of:

2 ,3-bisphosphoglycerate

Catecholamines

Carbaminohemoglobin

Leukopoietins

Erythropoietins

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

Fats

Vitamins

Carbohydrates

Proteins

Minerals

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A microslide of the lung tissue sample taken from a patient with pneumonia shows damage to the cells that carry out respiratory function. What cells of the alveolar wall are damaged?

Lymphocytes

Club cells

Macrophages

Type 2 alveolar cells

Type 1 alveolar cells

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After a psychic trauma a woman developed periodical increases in her blood pressure accompanied by headache, palpitations, and general weakness. What mechanism of hypertension development does this woman have?

Increased arteriolar tone

Tachycardia

Decreased cardiac output

Venoconstriction

Increased circulating blood volume

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An electron micrograph of a nephron segment shows cuboidal cells with ciliated lining on their apical surfaces; their basal surfaces have basal striation with mitochondria located between the cytolemma invaginations. Name the described nephron segment:

Glomerular capsule

Proximal tubule

Collecting ducts

Distal tubule

Thin limbs of Henle’s loop

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A patient has been taking bisacodyl for a long time to treat chronic constipation. However, several weeks later the aperient effect of the drug diminished. What is the possible cause of this?

Sensitization

Functional cumulation

Drug dependence

Material cumulation

Acquired tolerance

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A force generated by the muscle is not enough to lift a load. What type of muscle contraction occurs in this case?

Isometric

Isotonic

Concentric

Tetanic

Eccentric

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Condition of a patient with diabetes mellitus sharply deteriorated after a regular injection of insulin. The patient became anxious and broke out in cold sweat; tremor of the extremities, general weakness, and dizziness appeared. What medicine can remove these symptoms?

Adrenaline

Glibutid (Buformin)

Caffeine

Noradrenaline

Tolbutamide

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Microscopy of the myocardium of a girl, who died of diphtheria due to heart failure, shows fatty degeneration, multiple foci of cardiomyocytes necrosis, and small foci of cellular infiltrates in the interstitium. What type of myocarditis is it?

Diffuse exudative

Granulomatous

Focal exudative

Interstitial

Alterative

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A schizophrenia patient was prescribed aminazine. What pharmacodynamic action of this drug is the grounds for its prescription in this case?

Hypothermic

Antipsychotic

Muscle relaxant

Hypotensive

Antiemetic

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

Furuncle

Syphilis

Carbuncle

Leprosy

Actinomycosis

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A patient was hospitalized into the infectious diseases unit on the 11th day since the disease onset and provisionally diagnosed with typhoid fever. What biological material should be collected from the patient for the analyzes at this stage?

Urine

Roseola secretion

Bile

Feces

Blood serum

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A man with ischemic heart disease has been taking his medicine too often throughout a day, which resulted in poisoning. Examination detects cyanosis of skin and mucosa, sharp drop of blood pressure, tachycardia, and respiratory depression. Blood methemoglobin is high. What type of medicine did the patient overdose on?

Myotropic antispasmodics

Calcium channel blockers

Organic nitrates

a-adrenergic blockers

Adenosine-based drugs

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General structure of eukaryotic genes is as follows: exon-intron-exon. Such functional structure of a gene leads to certain specifics of the transcription process. What sequence will correspond with precursor mRNA (immature)?

Exon-intron

Intron-exon

Exon-intron-exon

Exon-exon

Exon-exon-intron

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Atria of a test animal were superdi-stended with blood, which resulted in decreased reabsorption of Na+ and water in renal tubules. This can be explained by the effect of the following factor on the kidneys:

Vasopressin

Angiotensin

Renin

Natriuretic hormone

Aldosterone

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A patient with clinical signs of a primary immunodeficiency has functionally disturbed mechanism of antigen-presentation to the immunocompetent cells. What cells are likely to have structural defects?

Macrophages, monocytes

T-lymphocyte

Fibroblasts

B-lymphocyte

O-lymphocytes

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During intensive muscle work there is a large amount of ammonia produced in the muscles. What amino acid plays the main role in the transportation of ammonia to the liver and participates in gluconeogenesis reactions?

Alanine

Lysine

Arginine

Ornithine

Aspartate

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Encephalopathy has developed in a child with hemolytic disease of the newborn. What substance had increased in the child’s blood, resulting in damage to the CNS?

Unconjugated bilirubin

Bile acids

Bilirubin-albumin complex

Bilirubin glucuronide

Verdohemoglobin

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Renal examination shows the kidney to be swollen and plethoric, with easily removable capsule. Renal pelvis and calyces are dilated and filled with turbid urine; their mucosa is dull and has hemorrhagic foci. On section the renal tissue is variegated, there are yellow-gray areas surrounded with plethoric and hemorrhagic zone. What di- sease can be characterized by such results of macroscopic examination?

Renal amyloidosis

Nephrolithiasis

Polycystic kidney

Acute pyelonephritis

Acute glomerulonephritis

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A 54-year-old man complains of general weakness, frequent colds, and bruises constantly appearing on his body. Blood test: erythrocytes - 2.5 • 1012/L; Hb- 80 g/L; color index - 0.9; reticulocytes - absent; platelets - 50 • 109/L; leukocytes - 58 • 109/L; leukogram: basocytes 5%, eosinophils -15%, myeloblasts - 6%, myelocytes - 10%, juvenile - 18%, stab neutrophils 26 %, segmented neutrophils - 10%, lymphocytes - 8%, monocytes - 2%, ESR - 40 mm/hour. What hematologic conclusion can be made?

Leukemoid response

Myeloblastic leukemia

Chronic lymphocytic leukemia

Chronic myelogenous leukemia

Basophilic eosinophilic leukocytosis

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A mutation has occurred in a cell in the first exon of the structural gene. The number of nucleotide pairs changed from 290 to 250. Name this type of mutation:

Translocation

Nullisomy

Deletion

Duplication

Inversion

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The dorsal root of the spinal nerve of a test animal was severed. What changes will occur in the innervation area?

Loss of sensitivity and motor function

Increased muscle tone

Decreased muscle tone

Loss of sensitivity

Loss of motor function

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Due to destruction of certain structures of the brainstem a test animal has lost its orientation reflexes in response to strong light stimuli. What structures were destroyed?

Posterior quadrigeminal bodies

Red nuclei

Vestibular nuclei

Substantia nigra

Anterior quadrigeminal bodies

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A toxin neutralized with 0.4% formaldehyde under 37-40oC for 4 weeks is used for vaccination. This preparation was first used by Gaston Ramon for diphtheria prevention. Name this preparation:

Adjuvant

Anatoxin

Antitoxic serum

Immunoglobulin

Inactivated vaccine

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24 hours after an appendectomy the patient’s blood test shows neutrophilic leukocytosis with a regenerative shift. What is the most likely mechanism of absolute leukocytosis development in the patient’s peripheral blood?

Decreased leukocyte disintegration

Deceleration of leukocyte migration to the tissues

Intensification of leukopoiesis

Immunity activation

Leukocyte redistribution

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The right leg of a 40-year-old woman measured at the shin level is by 2 cm smaller in the diameter than the left leg. Ankle-jerk (Achilles) and knee-jerk reflexes are absent on the right. What is the most likely mechanism of hyporeflexia development during peripheral paralysis?

Disturbed synaptic impulse transmission

Activation of excitatory impulses from the CNS

Disturbed conduction of stimulation

Disturbed perception of stimulation

Inhibition of pyramidal motoneuron

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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

Increased blood proteins

Morbid affection of the urinary tracts

Ischemic damage to the tubules

Inflammatory damage to the nephrons

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A 59-year-old man, a business manager, developed intense burning retrosternal pain that irradiates to the left arm. The pain occurred in the evening after the tax audit. 15 minutes later the patient’s condition normalized. What mechanism of angina pectoris development is leading in this patient?

Functional cardiac overload

Coronary artery thrombosis

Increased level of blood catecholamines

Intravascular aggregation of blood cells

Coronary atherosclerosis

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A 25-year-old woman at her third pregnancy with impending miscarriage was brought to the hospital. What combination of Rh-factor of the mother and the fetus can be the cause of this condition?

Mother Rh (+), fetus Rh (+)

Mother Rh (-), fetus Rh (-)

-

Mother Rh (+), fetus Rh (-)

Mother Rh (-), fetus Rh (+)

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A specimen of a 10-day-old human embryo shows two interconnected sacs (amniotic and yolk sacs). Name the structure located in the place where these two sacs connect:

Embryonic shield

Amniotic stalk

Extraembryonic mesoderm

Floor of the amniotic sac

Roof of the amniotic sac

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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 does the father have?

II (A), Rh (-)

II (А), Rh (+)

I (0), Rh (+)

III (B), Rh (+)

I (0), Rh (-)

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

Glycogenolysis

Gluconeogenesis

Glycolysis

Glucose transport to the cells

Glucose reabsorption

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A patient with a chemical burn has developed esophageal stenosis. The patient presents with acute weight loss due to problematic food intake. Blood test: erythrocytes - 3.0 • 1012/L, Hb-106 g/L, total protein - 57 g/L. What type of starvation does this patient suffer from?

Complete starvation

Protein starvation

Absolute starvation

Incomplete starvation

Water starvation

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Autopsy of the body of a man, who for a long time had been working at the factory with high content of silicon dioxide in the air, revealed enlarged dense lungs with numerous round and oval sclerotic foci. The foci were miliary and larger in size and colored gray or gray-black. What is the most likely diagnosis?

Asbestosis

Diffuse sclerotic silicosis

Anthracosilicosis

Nodular silicosis

Silicoanthracosis

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Autopsy of the body of a 50-year-old man, who had been suffering from tuberculosis and died of cardiopulmonary decompensation, shows lobar affection of the lungs: the upper lobe of the right lung is enlarged, dense, yellow on section, crumbling, with pleural fibrin deposition. What type of secondary tuberculosis can be characterized by this pathology?

Tuberculoma

Caseous pneumonia

Fibrous focal tuberculosis

Infiltrative tuberculosis

Acute focal tuberculosis

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A woman has come to the hospital with complaints of general weakness, dizziness, and dyspnea. Resently she has been taking levomycetin (chloramphenicol) for prevention of enteric infection. Blood test: erythrocytes - 1.9 • 1012/L, hemoglobin - 58 g/L, color index - 0.9, leukocytes - 2.2 G/L, reticulocytes - 0.3%. What type of anemia is it indicative of?

Iron-deficiency

Aplastic

Metaplastic

Hemolytic

Hypoplastic

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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?

Vicasol (Menadione)

Phenylin (Phenindione)

Thrombin

Contrykal (Aprotinin)

Aminocapronic acid

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A patient with streptococcal infection of the gingiva was prescribed a drug with в-lactam ring in its structure. What drug of those listed below belongs to this pharmacological group?

Erythromycin

Levomycetin (Chloramphenicol)

Streptomycin sulfate

Benzylpenicillin

Rifampicin

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A microslide of the skin sample taken from the finger of a child shows that epidermis is insufficiently developed. What germ layer was damaged in the process of embryo development?

Endoderm

Ectoderm

Mesenchyme

Mesoderm

Ectomesenchyme

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Neutralization of xenobiotics and active endogenous metabolites often occurs via introduction of an oxygen atom into the substrate molecule. What process occurs as the result?

Phosphorilation

Decarboxylation

Deaminization

Hydroxylation

Transamination

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In the process of an experiment, vascular resistance to the blood flow was measured in the different areas of circulatory system. The highest resistance was detected in the:

Venules

Arteries

Arterioles

Capillaries

Veins

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A 34-year-old man died in a comatose state. According to his family after a business trip to an African country he developed periodical jaundice attacks. Autopsy shows the following: dense enlarged spleen with slate-black pulp; enlarged plethoric liver, gray-black on section; cerebral gray matter is brown-gray; cerebral white matter contains numerous small hemorrhages. What infectious disease can be suspected?

Generalized herpetic infection

Generalized cryptococcosis

Prion infection

Meningococcemia

Malaria

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What diagnostic method should be used in industry to test the raw leather for presence of B. antracis?

Microscopy with Burry-Gins stain

Serological test

Bacteriological analysis

Microscopy with Aujeszky stain

Ascoli’s thermo precipitation test

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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)

Paracetamol

Prednisolone

Celecoxib

Analgin (Metamizole)

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A patient with myocardial infarction has acute heart failure. Among the drugs that increase the force of heart contractions the least dangerous in this case will be:

Caffeine

Adrenaline

Euphyllin (Aminophylline)

Dobutamine

Isadrinum (Isoprenaline)

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During intensive physical exertion, one of the energy sources for the working muscles is glucose produced as the result of gluconeogenesis. This process is the most intensive in the following organ:

Liver

Brain

Stomach

Lungs

Muscles

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During inflienza epidemic, morbidity in the schoolchildren, who did not participate in sports, was 40%, while in the schoolchildren, who engaged in regular physical aci-vities, morbidity did not exceed 20%. What adaptation mechanism ensured low morbidity in the physically active schoolchildren?

Genetic adaptation

Physiological adaptation

Specific adaptation

Cross-adaptation

Biochemical adaptation

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Monoamine oxidase inhibitors are widely used as psychopharmacological drugs. They change the level of nearly all neurotransmitters in synapses, with the following neurotransmitter being the exception:

Acetylcholine

Dopamine

Adrenaline

Noradrenaline

Serotonin

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A 17-year-old girl suffers from periodical palpitations that last several minutes. Her heart rate is 200/min., rhythmic. What heart rhythm disorder developed in this patient?

Paroxysmal tachycardia

Extrasystole

Atrioventricular block

Sinus bradycardia

Sinus tachycardia

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Kidney X-ray image obtained by means of pyelography shows that the minor calyces converge to form 2 major calyces that adjoin to the renal pelvis, from which the ureter exits. What type of urinary tract is it?

Embryonic

Bicornuate

Mature

Fetal

Cystic

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A patient has been brought into a surgical ward with an incised wound of the anterior surface of the shoulder in its lower one-third. Flexing function was disturbed in the shoulder and elbow joints, which is caused by the damage to the:

Anconeus muscle

Deltoid muscle

Biceps muscle of the arm

Coracobrachial muscle

Triceps muscle of the arm

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

Acetazolamide (Diacarb)

Triamterene

Spironolactone

Furosemide

Hydrochlorothiazide (Dichlothiazidum)

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Ketosis develops in the patients with diabetes mellitus, as the result of activation of fatty acids oxidation processes. What acid-base imbalance can result from accumulation of excessive ketone bodies in the blood?

Metabolic alkalosis

Respiratory acidosis

No imbalance occurs

Respiratory alkalosis

Metabolic acidosis

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A 5-year-old child is diagnosed with Bruton syndrome (X-linked agammaglobulinemia) that manifests itself as 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 IgD, IgE

No changes

Decreased IgA, IgM

Increased IgD, IgE

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During the skill-building session in microbiology the students need to stain the prepared and fixed sputum smears obtained form a tuberculosis patient. What staining technique should be used in this case?

Giemsa

Ziehl-Neelsen

Gins

Gram

Burry

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A woman with hypophyseal diabetes insipidus developed a water-mineral imbalance. What type of water-mineral imbalance develops in such cases?

Hypoosmolar dehydration

Hyperosmolar dehydration

Hypoosmolar hyperhydration

Isoosmolar dehydration

Hyperosmolar hyperhydration

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First-year schoolchildren have received tuberculin skin Mantoux test) at the school nurse’s office. The purpose of this test was:

To measure immunity stress toward diphtheria

To measure allergization rate toward rickettsia

To preventively vaccinate against tuberculosis

To determine the children that need to receive BCG vaccination

To detect parotitis in the schoolchildren

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In an experiment it is necessary to assess neuromotor and muscle excitability. What value shoud be measured to make the assessment?

Action potential duration

Resting potential

Action potential amplitude

Threshold potential

Sensory threshold

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Vestibular receptors of semicircular canals of a test animal have been destroyed. What reflexes will disappear as a result?

Statokinetic reflex during movements with angular acceleration

Body-righting reflex

Primary orienting reflex

Statokinetic reflex during movements with linear acceleration

Head-righting reflex

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Acute renal impairment caused death of a patient with hemorrhage. Autopsy revealed enlarged kidneys with broad pale pink cortical layer expressively demarcated from dark red renal pyramids. Macroscopic examination revealed lack of epithelial nuclei of the convoluted tubules, tubulorrhexis, phlebostasis. The cell nuclei of the choroid glomus and straight tubules were present. What pathology is it?

Necronephrosis

Pyelonephritis

Infarction

Glomerulonephritis

Nephrosis

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A boxer had sustained a blow to the left parotid area, after which he developed paralysis of the facial muscles on this side. What nerve had been damaged?

Facial

Mandibular

Lesser petrosal

Maxillary

Ophthalmic

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A patient has an open facial wound with undermined edges; tissue necrosis with gradually developing partial gangrene that nearly reaches the bone tissue is observed. On close examination the wound contains live larvae. The patient is diagnosed with tissue myiasis. What Diptera larvae are the causative agents of this disease?

Phlebotomus pappatachi

Glossina palpalis

Musca domestica

Wohlfahrtia magnifica

Stomoxys calcitrans

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A hereditary disease - homocystinuria - is caused by disturbed transformation of homocysteine into methionine. Accumulated homocysteine forms its dimer (homocystine) that can be found in urine. What vitamin preparation can decrease homocysteine production?

Vitamin B6

Vitamin B12

Vitamin C

Vitamin PP

Vitamin B2

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During hypersensitivity skin test a patient received an allergen subcutaneously, after which the patient developed skin redness, edema, and pain due to histamine action. This biogenic amine is produced as the result of the following transformation of histidine amino acid:

Deaminization

Decarboxylation

Methylation

Phosphorilation

Isomerization

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During the fight a man has received a strong blow to the upper anterior abdominal wall, which resulted in the cardiac arrest. What mechanism has led to the cardiac arrest in this case?

Parasympathetic conditioned

Sympathetic conditioned

Sympathetic unconditioned

Parasympathetic unconditioned

Peripheral

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A woman has lost a lot of blood during the childbirth. Her blood group needs to be determined. Erythrocyte agglutination occurred with standard serums 0 (I) and А (II) and did not occur with standard serum B (III). What blood group does this woman have?

А (II)

-

0 (I )

B (III)

АВ (IV)

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A 60-year-old man diagnosed with chronic heart failure was brought to the hospital. After a long course of treatment the patient developed signs of intoxication: dyspnea, extrasystole, nausea, and disturbed perception of colors. What medicine has caused such side-effects?

Drotaverine

Digoxin

Furosemide

Anaprilin (Propranolol)

Nitroglycerine

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A patient with exacerbated peptic ulcer disease of the stomach has made an appointment with the doctor. What type of drugs should be included in the complex therapy of this patient?

^-adrenergic antagonists

a-adrenergic agonists

a-adrenergic antagonists

H1 antagonists

H2 antagonists

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Autopsy of the body revealed waxy degeneration of the rectus abdominis muscles. In the terminal segment of the small intestine there are ulcers 3-5 cm in diameter. The ulcer walls are covered in a crumbling grayish-white substance. The ulcer edges are markedly raised above the mucosa. Widal test is positive. Make the diagnosis:

Crohn’s disease

Relapsing fever

Typhoid fever

Nonspecific ulcerative colitis

Dysentery

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Genealogical analysis of a child with myotonic dystrophy determined that this disease is present in every generation, equally presented by the relatives of both genders, the risk of inheriting this disease is equal no matter which parent is affected. If one of the parents is heterozygous for this disease and the other parent is healthy, the risk of them giving birth to a sick child is 50%. What type of disease inheritance is it?

Y-linked

X-linked dominant

Autosomal recessive

Autosomal dominant

X-linked recessive

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A 30-year-old man has undergone surgical removal of a thyroid tumor. Histologically the tumor is made up of papillary structures varying in size that emerge from the inner surface of dilated cystic follicles and are covered with atypical epithelium. What is the most likely diagnosis?

Papillary carcinoma

Medullary carcinoma

Colloid nodular goiter

Macrofollicular adenoma

Follicular carcinoma

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A young woman, a foreign student from Tehran, has made an appointment with the urologist. She complains of the sensation of heaviness in her lower abdomen and a small amount of blood being excreted with urine at the end of each urination. Microscopy of urine detects the presence of parasite eggs, approximately 140x70 micron in size, with a terminal spike. What diagnosis can be made by the infectious diseases specialist?

Schistosomiasis

Fascioliasis

Dicroceliasis

Opisthorchiasis

Paragonimiasis

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Various biological preparations can be used for poliomyelitis prevention. What drug induces the type of local intestinal mucosal immunity that lasts the longest?

Oral vaccination with live vaccine

Parenteral vaccination with inactivated vaccine

Oral introduction of poliovirus-specific immunoglobulin

Parenteral introduction of normal human immunoglobulin

Parenteral vaccination with live vaccine

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Histological analysis of a removed skin tumor shows clusters and bands composed of atypical stratified squamous epithelium cells that penetrate into the underlying tissue. What preliminary diagnosis can be made?

Adenoma

Non-keratinizing squamous cell carcinoma

Carcinoma in situ

Papilloma

Solid cancer

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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 yellowish-white liquid. What complication of the patient’s pneumonia had developed?

Granuloma

Abscess

Gangrene

Tuberculoma

Sequestrum

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A patient with parkinsonism was prescribed levodopa, which led to rapid improvement of the patient’s condition. What is the mechanism of action of this drug?

Muscarinic acetylcholine receptor stimulation

Anticholinesterase action

Stimulation of dopamine receptors

Stimulation of dopamine synthesis

Muscarinic acetylcholine receptor blockade

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A sick child presents with high content of phenyl pyruvate in urine (normally it is practically absent). Blood phenylalanine level is 350 mg/L (norm -15 mg/L). What disease are these symptoms characteristic of?

Alkaptonuria

Gout

Phenylketonuria

Tyrosinosis

Albinism

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An oncology patient is to undergo a surgery on the descending colon. Name the main source of blood supply to this organ:

Middle colic artery

Celiac trunk

Splenic artery

Superior mesenteric artery

Inferior mesenteric artery

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A patient presents with enlarged cervical lymph nodes. Other lymph nodes and internal organs are without changes. Peripheral blood test results are normal. Histological examination of biopsy material taken from the cervical lymph node shows smoothed-out pattern, absent follicles, homogeneous cell composition represented by lymphoblasts. The cells penetrate into the lymph node capsule. What diagnosis can be made?

Myeloblastic leukemia

Erythroblastic leukemia

Sezary disease

Burkitt lymphoma

Lymphoblastic leukemia

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

Increase of inspiratory reserve volume

Increase of pulmonary residual volume

Increase of respiratory volume

Obstructive pulmonary disease

Increase of functional residual lung capacity

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A man is a carrier of HIV that is an RNA virus. The cells of this patient synthesize viral DNA. This process is based on:

Replication

Repair

Transcription

Reverse transcription

Translation

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Sanitary assessment of a pond, where the children from a recreation summer camp take their swims, detected there oval cysts 50-60 micron in diameter, with 2 nuclei visible in their cytoplasm (macronucleus and micronucleus). What protozoa do these cysts belong to?

Balantidium

Amoeba

Lamblia

Toxoplasma

Euglena

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A hospital has received a 24-year-old man, who had received a penetrating wound to the eye, which has caused the vitreous body to run out. As the result of this, retinal detachment occurred. What retinal layer was tightly adherent to the vascular tunic of the eye and did not detach?

Ganglion cell layer

Layer of rods and cones

Retinal pigment epithelium

Inner nuclear layer

Outer nuclear layer

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A newborn presents with weak suckling, frequent vomiting, and hypotonia. Blood and urine citrulline are very high. What metabolic process is disturbed?

Cori cycle

Ornithine cycle

Glycolysis

Gluconeogenesis

Tricarboxylic acid cycle

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Stool test detects in the patients feces a large amount of undigested fats.This patient is the most likely to have disturbed secretion of the following enzymes:

Gastric protease

Pancreatic lipases

Pancreatic proteases

Bile lipase

Pancreatic amylase

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A 19-year-old young man was examined in the nephrology clinic. High calcium was detected in his secondary urine. What hormone is likely to cause such change, if it is produced in excess?

Oxytocin

Glucagon

Adrenaline

Testosterone

Aldosterone

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A young woman presents with a tumor along the auditory nerve. The tumor is node-shaped, 3 cm in diameter, soft and elastic, pink-white colored, and has homogeneous structure. Microscopically the tumor contains bundles of cells with oval nuclei. These cellular fibrous bundles form regular structures made up of parallel rows of regularly oriented cells arranged in the form of a palisade with acellular homogeneous area in between (Verocay bodies). Name this type of tumor:

Neuroblastoma

Ganglioneuroma

Neurinoma

Ganglioneuroblastoma

Malignant neurinoma

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A patient has undergone surgical removal of the pylorus. Decreased secretion of the following hormone can be expected:

Gastrin

Histamine

Gastric inhibitory polypeptide

Cholecystokinin

Secretin

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An electron micrograph shows a small vessel with endothelial layer but without basement membrane and pericytes; anchoring fibrils are present. Name this vessel:

Arteriole

Venule

Visceral hemocapillary

Lymph capillary

Sinusoid hemocapillary

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One of the causes of pernicious anemia is disturbed synthesis of transcorrin -Castle’s intrinsic factor - by the parietal cells of the stomach. What substance is called Castle’s extrinsic factor?

Folic acid

Biotin

Riboflavin

Pyridoxine

Cobalamin

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A patient with contact dermatitis needs to be prescribed an antihistamine drug without somnolescent effect. Select this drug from the list:

Dimedrol (Benadryl)

Ranitidine

Suprastin (Chloropyramine)

Loratadine

Diprazine (Promethazine)

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Congenital pyruvate carboxylase deficiency causes physical and mental retardation in children and leads to early death. It is characterized by lactic acidemia, lactaci-duria, and a number of metabolic disorders. Among others, inhibition of the following occurs:

Glycolysis and glycogenolysis

Pentose-phosphate pathway and glycolysis

Lipolysis and lipogenesis

Glycogenesis and glycogenolysis

Citric acid cycle and gluconeogenesis

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A woman with enteritis accompanied by severe diarrhea presents with loss of water in the extracellular space, increased water content in the cells, and decreasing blood osmolarity. Name this type of water-electrolyte imbalance:

Isoosmolar hypohydration

Hypoosmolar hypohydration

Hyperosmolar hyperhydration

Hypoosmolar hyperhydration

Hyperosmolar hypohydration

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To stimulate the labor activity a parturient woman was prescribed a drug - a posterior pituitary hormone that does not affect the blood pressure. As the pregnancy progresses, the sensitivity to this hormone increases. Name the prescribed drug:

Ergotal

Pituitrin

Dinoprostone

Dinoprost

Oxytocin

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

Sodium

Potassium

Potassium and sodium

Calcium

Potassium and calcium

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

Formation of maturation spindle

Intensive protein synthesis

Intensive energy production

Restoration of cytoplasmic membrane

Partial or complete cell destruction

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A patient is diagnosed with glucocerebroside lipidosis (Gaucher’s disease) that manifests as splenomegaly, liver enlargement, affected bone tissue, and neuropathies. What enzyme of complex lipid catabolism is deficient, thus causing this disease?

Sphingomyelinase

Hyaluronidase

Glucocerebrosidase

в-galactosidase

Hexosaminidase

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A 3-year-old girl with mental retardation has been diagnosed with sphingomyelin lipidosis ( Niemann-Pick disease). In this condition the synthesis of the following substance is disturbed :

Glycosyltransferase

Sphingomyelinase

Sphingosine

Ceramides

Gangliosides

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A traumatology unit has received a patient with a wrist trauma and a clinical presentation of the damage to the nerve that passes through the carpal tunnel. Name this nerve:

N. radialis

N. axillaris

N. ulnaris

N. musculocutaneus

N. medianus

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A patient, who has been taking ft-adrenergic blockers, developed a bronchial spasm. What group of bronchodilators should be chosen to stop the bronchial spasm?

в-adrenergic blockers

Indirect adrenergic agonists

Myotropic antispasmodics

Cholinesterase inhibitors

Muscarinic cholinomimetic agents

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A man has an inguinal hernia. The hernial sac exits through the following opening:

Anulus superficialis canalis inguinalis

Linea alba

Anulus profundus canalis inguinalis

Foramen suprapiriforme

Anulus femoralis

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After a nephrectomy the patient developed enteroparesis. What cholinergic agent with anticholinesterase action should be prescribed in this case?

Aceclidine

Pilocarpine

Acetylcholine

Proserin

Carbacholine

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Parenchyma of an organ is composed of pseudounipolar neurons localized under the capsule of connective tissue. Central place belongs to nerve fibers. Name this organ:

Intramural ganglion

Nerve trunk

Sympathetic ganglion

Spinal ganglion

Spinal cord

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An obstetrician-gynecologist measures pelvis size of a pregnant woman. A caliper was used to measure the distance between the two iliac crests. What measurement of large pelvis was made?

Conjugata vera

Distantia throchanterica

Distantia spinarum

Conjugata anatomica

Distantia cristarum

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Genetic recombination is achieved via several mechanisms. One such mechanism is crossingover. It occurs at the following stage of prophase in the first meiotic division:

Diakinesis

Pachynema

Zygonema

Diplonema

Leptonema

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ECG of the patient shows increased duration of the QRS complex. What is the most likely cause?

Increased atrial and ventricular excitability

Disturbed conduction in the atrioventricular node

Increased period of atrial excitation

Increased atrial excitability

Increased period of ventricular excitation

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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:

Renal disorder

Essential hypertension

Diabetes insipidus

Pellagra

Myxedema

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A 40-year-old woman was diagnosed with glomerulonephritis based on her clinical symptoms and the results of urine analysis. Anamnesis states chronic tonsillitis. What microorganisms are the most likely cause for her kidney damage?

Escherichia

Staphylococci

Streptococci

Meningococci

Mycoplasma

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A 7-year-old child presents with marked signs of hemolytic anemia. Biochemical analysis of erythrocytes determined low concentration of NADPH and reduced glutathione. What enzyme is deficient in this case leading to the biochemical changes and their clinical manifestations?

Pyruvate kinase

Fructokinase

Hexokinase

Lactate dehydrogenase

Glucose-6-phosphate dehydrogenase

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When examining a biopsy material obtained from the thyroid gland, the pathologist discovered lymphocyte infiltration of the thyroid tissues and destruction of the parenchymal elements. Diffuse lymphocyte infiltration with lymphoid follicles was detected in the stroma. What is the most likely diagnosis?

Papillary thyroid cancer

Graves’ disease (toxic diffuse goiter)

Solid adenoma of the thyroid

Undifferentiated thyroid carcinoma

Hashimoto’s thyroiditis (chronic lymphocytic thyroiditis)

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An 8-year-old girl presents with signs of disturbed twilight vision. This condition is caused by the deficiency of vitamin:

E

K

A

D

F

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A 25-year-old young man came to the doctor complaining of general weakness, rapid fatigability, irritability, reduced working ability, and bleeding gums. What vitamin is likely to be deficient in this case?

Retinol

Thiamine

Riboflavin

Folic acid

Ascorbic acid

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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?

Hyperaminoacidemia

Hyperuricemy

Argininosuccinic aciduria

Citrullinuria

Hyperazotemia

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A person with the fourth blood group (genotype IAIB) has in erythrocytes both antigen A controlled by allele IA and antigen B controlled by allele IB. This phenomenon is an example of the following gene interaction:

Polymery

Epistasis

Semidominance

Complementarity

Codominance

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Vascular endothelium is characterized by high metabolic activity and synthesizes vasoactive substances. Among these substances there is a potent vasodilator synthesized from L-arginine. Name this vasodilator:

Nitrogen oxide

Adrenaline

Histamine

Acetylcholine

Bradykinin

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A victim of a traffic accident was received by the intensive care unit. The patient is in a grave condition that can be characterized as a severe pathologic process that leads to exhaustion of vital functions and puts the patient into the marginal state between life and death due to critical reduction of capillary circulation in the affected organs. The patient is in the state of:

Agony

Coma

Shock

Preagony

Collapse

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A person becomes less receptive to pain in physically or emotionally straining situations due to activation of:

Antinociceptive system

Adrenal glands functions

Nociceptive system

Thyroid gland functions

Parasympathetic nervous system

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A patient suffers from posttraumatic hemorrhage that resulted in development of hemorrhagic shock. What volume of circulating blood was lost by the patient?

12-25 %

40-50 %

3-20 %

50-75 %

25-40%

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

Rifampicin

Tetracycline

Bactrim (Co-trimoxazole)

Furasolidone

Streptocide

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

Round ligament of the liver

Triangular ligament of the liver

Falciform ligament of the liver

Venous ligament of the liver

Coronary ligament of the liver

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A patient has disturbed blood supply to the anterior papillary muscle of the left ventricle. What cardiac artery supplies this muscle with blood?

Ramus marginalis

Ramus interventricularis posterior

Ramus interventricularis anterior

Ramus circumflexus

A. coronaria dextra

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Autopsy of the body of an elderly man revealed yellow spots' and streaks in the aortic intima and white-yellow protruding plaques in the area of aortic bifurcation. Microscopy (with hematoxylin and eosin staining) shows round cavities in the thickened aortic intima. The cavities color orange when stained with sudan 3 and are surrounded with overgrown connective tissue. What process developed in the aortic intima?

Local hyalinosis

Systemic hyalinosis

Metabolic disorder of cholesterol and cholesterol ethers

Metabolic disorder of neutral fat

Secondary amyloidosis

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An 18-year-old patient has developed candidiasis after the case of pneumonia treated with ^lactam antibiotic. What antimycotic agent should be prescribed?

Trimethoprim/sulfamethoxazole (Bi-septol)

Ampicillin

Fluconazole

Streptomycin

Phthalylsulfathiazole

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Preventive vaccination against poliomyelitis is made with inactivated vaccine introduced parenterally. What immunoglobulins create the postvaccinal immunity in this case?

IgM, IgG

Ig£, IgM

Serum ^А, IgM

IgM, secretory IgA

IgG, secretory IgA

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During pregnancy a woman has been taking an antiepileptic drug - sodium valproate. It resulted in her child developing a vertebral column malformation - spina bifida. Name the described effect of the drug:

Immunosuppressive effect

Sensitizing effect

Dependence

Teratogenic effect

Acquired tolerance

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A patient was prescribed atropine sulfate to treat intestinal colic. What concomitant disease can be a contraindication for this drug?

Sinus bradycardia

Hypotension

Bronchial asthma

Vertigo

Glaucoma

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A patient has developed status epilepti-cus. What medicine should be used in this case to stop the seizures?

Diazepam

Cyclodol (Trihexyphenidyl)

Diprazine (Promethazine)

Valerian extract

Sodium bromide

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A 48-year-old man is unconscious. He has a history of several syncopal episodes with convulsions. ECG shows deformed QRS complexes unconnected with P waves, atrial contractions are approximately 70/min., ventricular contractions -25-30/min. Name the type of arrhythmia in this case:

Intraventricular block

Intraatrial block

Second-degree atrioventricular block

Complete atrioventricular block

First-degree atrioventricular block

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In human organism significant blood loss leads to decreased blood pressure, tachycardia, and weakness. Eventually the sensation of thirst appears. What hormone participates in the development of this sensation?

Adrenalin

Serotonin

Dopamine

Angiotensin 2

Cortisol

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After a trauma the man has lost skin sensitivity on the lateral surface of his forearm. What nerve of the brachial plexus provides sensitivity of the affected area?

N. musculocutaneus

N. radialis

N. medianus

N. ulnaris

N. axillaris

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Autopsy of a 50-year-old woman, who had been suffering from systemic connective tissue disease, reveals small dense kidneys with lumpy surface. Microscopy of the renal glomeruli detects there foci of fibrinoid necrosis, hyaline thrombi, hematoxylin bodies, and so-called ”wire loop thickening” of the basement membranes. What disease can be characterized by such changes in the kidneys?

Scleroderma

Rheumatism

Rheumatoid arthritis

Dermatomyositis

Systemic lupus erythematosus

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A 4-year-old child presents with numerous carious cavities and yellow-colored teeth. The mother has a history of antibiotic treatment during her pregnancy. What antibiotic was the most likely taken by the child’s mother?

Doxycycline

Ampicillin

Cefazolin

Erythromycin

Streptomycin sulfate

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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?

Superinfection

Autoinfection

Relapse

Reinfection

Exogenous infection

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After a hand fracture the man has lost the ability to touch his little finger with the thumb on the affected hand. Examination of the palmar surface shows one of the palmar muscles to be atrophied. Name the affected muscle:

Mm. lumbricales

M. palmaris brevis

M. opponens policis

Mm. interossei

M. flexor digiti minimi

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