1 із 200
Step 1 - Medicine 2014
0%
1 із 200
00:00
2 із 200
Malaria is treated with structural analogs of vitamin B2 (riboflavin). These drugs disrupt the synthesis of the following enzymes in plasmodium:
FAD-dependent dehydrogenase
Peptidase
NAD-dependent dehydrogenase
Cytochrome oxidase
Aminotransferase
3 із 200
A 6-year-old child with suspected active tuberculous process underwent the diagnostic Mantoux test. What immunobiological preparation was injected?
Tuberculin
Td vaccine
Tularinum
BCG vaccine
DTP vaccine
4 із 200
In a young man during exercise, the minute oxygen uptake and carbon dioxide emission equalled to 1000 ml. What substrates are oxidized in the cells of his body?
Carbohydrates
Fats
Carbohydrates and proteins
Carbohydrates and fats
Proteins
5 із 200
A sportsman spontaneously held breath for 40 seconds, which resulted in an increase in heart rate and systemic arterial pressure. Changes of these indicators are due to activation of the following regulatory mechanisms:
Unconditioned sympathetic reflexes
-
Conditioned parasympathetic reflexes
Conditioned sympathetic reflexes
Unconditioned parasympathetic reflexes
6 із 200
A 53-year-old male patient is diagnosed with Paget’s disease. The concentration of oxyproline in daily urine is sharply increased, which primarily means intensified disintegration of:
Collagen
Fibrinogen
Hemoglobin
Albumin
Keratin
7 із 200
A patient has hoarseness of voice. During laryngoscopy a gray-white larynx tumor with papillary surface has been detected. Microscopic investigation has shown the following: growth of connective tissue covered with multilayer, strongly keratinized pavement epithelium, no cellular atypia. What is the most likely diagnosis?
Papilloma
Polyp
Angioma
Angiofibroma
Fibroma
8 із 200
During autopsy approximately 2,0 liters of pus have been found in the abdominal cavity of the corpse. Peritoneum is lustreless and has grayish shade, serous tunic of intestines has grayishcolored coating that is easily removable. Specify the most likely type of peritonitis in the patient:
Fibrinopurulent peritonitis
Tuberculous peritonitis
Hemorrhagic peritonitis
-
Serous peritonitis
9 із 200
Autopsy of a dead patient revealed bone marrow hyperplasia of tubular and flat bones (pyoid marrow), splenomegaly (6 kg) and hepatomegaly (5 kg), enlargement of all lymph node groups. What disease are the identified changes typical for?
Chronic myelogenous leukemia
Polycythemia vera
Multiple myeloma
Hodgkin’s disease
Chronic lymphocytic leukemia
10 із 200
Autopsy of the dead patient who died from pulmonary edema revealed a large yellow-grey nidus in the myocardium, and a fresh thrombus in the coronary artery. What is the most likely diagnosis?
Myocardial infarction
Myocarditis
Amyloidosis
Cardiosclerosis
Cardiomyopathy
11 із 200
An animal experiment is aimed at studying the cardiac cycle. All the heart valves are closed. What phase of the cycle is characterized by this status?
Isometric contraction
Asynchronous contraction
Rapid filling
Reduced filling
Protodiastolic period
12 із 200
Cyanide is a poison that causes instant death of the organism. What enzymes found in mitochondria are affected by cyanide?
Cytochrome oxidase (aa3)
Cytochrome B5
NAD+-dependent dehydrogenase
Flavin enzymes
Cytochrome P-450
13 із 200
Increased HDL levels decrease the risk of atherosclerosis. What is the mechanism of HDL antiatherogenic action?
They remove cholesterol from tissues
They supply tissues with cholesterol
They promote absorption of cholesterol in the intestine
They are involved in the breakdown of cholesterol
They activate the conversion of cholesterol to bile acids
14 із 200
It has been found out that one of a pesticide components is sodium arsenate that blocks lipoic acid. Which enzyme activity is impaired by this pesticide?
Pyruvate dehydrogenase complex
Microsomal oxidation
Glutathione peroxidase
Glutathione reductase
Methemoglobin reductase
15 із 200
Stool culture test revealed in a 6-month-old bottle-fed baby the strain of intestinal rod-shaped bacteria of antigen structure 0-111. What diagnosis can be made?
Colienteritis
Gastroenteritis
Choleriform disease
Dysentery-like disease
Food poisoning
16 із 200
A boy referred to a genetics clinic was found to have 1 drumstick in blood neutrophils. The boy is likely to have the following syndrome:
Klinefelter’s
Turner’s
Down’s
Trisomy X
Edwards’
17 із 200
A drycleaner’s worker has been found to have hepatic steatosis. This pathology can be caused by the disruption of synthesis of the following substance:
Phosphatidylcholine
Urea
Cholic acid
Tristearin
Phosphatidic acid
18 із 200
Ascarid eggs have been detected during stool analysis. What drug should be prescribed?
Mebendazole
Furazolidone
Nystatin
Chloramphenicol
Tetracycline
19 із 200
Bacteriological examination of the urine of the patient with pyelonephritis revealed microorganisms that produced yellow-green pigment and a characteristic odor in meatpeptone agar. What are they called?
Pseudomonas
Proteas
Azotobacter
Escherichia
Klebsiella
20 із 200
Feces of a patient contain high amount of undissociated fats and have grayish-white color. Specify the cause of this phenomenon:
Obturation of bile duct
Hypovitaminosis
Enteritis
Irritation of intestinal epithelium
Hypoactivation of pepsin by hydrochloric acid
21 із 200
A 46-year-old female patient consulted a doctor about pain in the small joints of the upper and lower limbs. The joints are enlarged and shaped like thickened nodes. Serum test revealed an increase in urate concentration. This might be caused by a disorder in metabolism of:
Purines
Pyrimidines
Carbohydrates
Lipids
Amino acids
22 із 200
A 26-year-old female consulted a doctor about having stool with white flat moving organisms resembling noodles. Laboratory analysis revealed proglottids with the following characteristics: long, narrow, with a longitudinal channel of the uterus with 17-35 lateral branches on each side. What kind of intestinal parasite was found?
Taeniarhynchus saginatus
Taenia solium
Hymenolepis nana
Diphyllobothrium latum
Echinococcus granulosus
23 із 200
A male patient is 28 years old. Histological study of a cervical lymph node revealed a change of its pattern due to the proliferation of epithelioid, lymphoid cells and macrophages havi- ng nuclei in form of a horseshoe. In the center of some cell clusters there were non-structured light-pink areas with fragments of nuclei. What disease are these changes typical for?
Tuberculosis
Actinomycosis
Hodgkin’s disease
Syphilis
Tumor metastasis
24 із 200
A biochemical urine analysis has been performed for a patient with progressive muscular dystrophy. In the given case muscle disease can be confirmed by the high content of the following substance in urine:
Creatine
Porphyrin
Urea
Creatinine
Hippuric acid
25 із 200
While examining foot blood supply a doctor checks the pulsation of a large artery running in the separate fibrous channel in front of articulatio talocruralis between the tendons of long extensor muscles of hallux and toes. What artery is it?
A. dorsalis pedis
A. tibialis anterior
A. tarsea medialis
A. fibularis
A. tarsea lateralis
26 із 200
A patient with chronic heart failure with edema has increased level of blood aldosterone. What diuretic would be most effective in this case?
Spironolactone
Triamterene
Furosemide
Acetazolamide
Hydrochlorothiazide
27 із 200
During autopsy the following has been revealed: the meninges of the upper cerebral hemispheres are extremely plethoric, of yellow-green color and are soaked with purulent effluent. What kind of meningitis is characterised by such clinical presentations?
Meningococcal meningitis
Grippal meningitis
Anthrax-induced
Epidemic typhus-induced
Tuberculous meningitis
28 із 200
A 41-year-old male patient has a history of recurrent attacks of heartbeats (paroxysms), profuse sweating, headaches. Examination revealed hypertension, hyperglycemia, increased basal metabolic rate, and tachycardia. These clinical presentations are typical for the following adrenal pathology:
Hyperfunction of the medulla
Hyperfunction of the adrenal cortex
Primary aldosteronism
Hypofunction of the adrenal cortex
Hypofunction of the medulla
29 із 200
A comminuted fracture of infraglenoid tubercle caused by shoulder joint injury has been detected during X-ray examination of a patient. What muscle tendon attached at this site has been damaged?
Long head of m. triceps brachii
Short head of m. biceps brachii
Medial head of m. triceps brachii
Long head of m. biceps brachii
Lateral head of m. triceps brachii
30 із 200
A patient has increased thickness of alveolar-capillary membrane caused by a pathologic process. The direct consequence will be reduction of the following value:
Diffusing lung capacity
Alveolar ventilation of lungs
Respiratory minute volume
Expiratory reserve volume
Oxygen capacity of blood
31 із 200
What drug will be most appropriate for the patient who has chronic gastritis with increased secretion?
Pirenzepine
Aprotinin
Pancreatine
Chlorphentermine
Pepsin
32 із 200
As a result of careless handling of an iron, a 34-year-old female patient has got acute pain, redness, swelling of her right index finger. A few minutes later, there appeared a blister filled with a transparent liquid of straw-yellow color. The described changes are a manifestation of the following pathological process:
Exudative inflammation
Vacuolar degeneration
Traumatic edema
Alternative inflammation
Proliferative inflammation
33 із 200
A 42-year-old male with a lesion of the ulnar nerve is unable to flex the II and V fingers to the midline. Which muscle function is impaired in this case?
Palmar interosseous muscles
Dorsal interosseous muscle
Abductor muscle of little finger
Fidicinales
Short palmar muscle
34 із 200
A smear from the tonsillar coating of a patient with suspected diphtheria was found to contain blue bacilli with a thickening at the poles. What method of smear staining was used?
Leffler
Gram
Burri
Hins
Neisser
35 із 200
A child was born asphyxiated. What drug must be administered to the newborn to stimulate breathing?
Aethimizolum
Atropine
Lobeline
Proserine
Prazosin
36 із 200
A 40-year-old patient with the progressing staphylococcal purulent periodontitis developed purulent inflammation of bone marrow spaces of the alveolar process, and then of the body of mandible. Microscopy revealed thinning of bone trabeculae, foci of necrosis, bone sequesters surrounded by the connective tissue capsule. What is the most likely diagnosis?
Chronic osteomyelitis
Acute osteomyelitis
Parodontome
Purulent abscess
Chronic fibrous periostitis
37 із 200
Human red blood cells do not contain mitochondria. What is the main pathway for ATP production in these cells?
Anaerobic glycolysis
Oxidative phosphorylation
Creatine kinase reaction
Aerobic glycolysis
Cyclase reaction
38 із 200
A 40-year-old female patient has undergone thyroidectomy. Histological study of thyroid gland found the follicles to be of different size and contain foamy colloid, follicle epithelium is high and forms papillae, there is focal lymphocytic infiltration in stroma. Diagnose the thyroid gland disease:
Basedow’s disease
Nodular goiter
Riedel’s thyroiditis
De Quervain’s disease
Hashimoto’s thyroiditis
39 із 200
A 43-year-old-patient has arterial hypertension caused by an increase in cardiac output and general peripheral resistance. Specify the variant of hemodynamic development of arterial hypertension in the given case:
Eukinetic
Hyperkinetic
Hypokinetic
-
Combined
40 із 200
A patient has been hospitalised with provisional diagnosis of virus B hepatitis. Serological reaction based on complementation of antigen with antibody chemically bound to peroxidase or alkaline phosphatase has been used for disease diagnostics. What is the name of the applied serological reaction?
Immune-enzyme analysis
Immunofluorescence test
Antigen-binding assay
Bordet-Gengou test
Radioimmunoassay technique
41 із 200
A patient has been hospitalised with provisional diagnosis of botulism. What serological reaction should be used to reveal botulinum toxin?
Neutralization reaction
Agglutination reaction
Precipitation reaction
Immunofluorescence test
Bordet-Gengou test
42 із 200
Examination of a 52-year-old female patient has revealed a decrease in the amount of red blood cells and an increase in free hemoglobin in the blood plasma (hemoglobinemia). Color index is 0,85. What type of anemia is being observed in the patient?
Acquired hemolytic
Hereditary hemolytic
Acute hemorrhagic
Anemia due to diminished erythropoiesis
Chronic hemorrhagic
43 із 200
The processes of heat transfer in a naked person at room temperature have been studied. It was revealed that under these conditions the greatest amount of heat is transferred by:
Heat radiation
Evaporation
-
Convection
Heat conduction
44 із 200
Urine analysis has shown high levels of protein and erythrocytes in urine. This can be caused by the following:
Renal filter permeability
Oncotic pressure of blood plasma
Hydrostatic primary urine pressure in capsule
Hydrostatic blood pressure in glomerular capillaries
Effective filter pressure
45 із 200
The development of both immune and allergic reactions is based upon the same mechanisms of the immune system response to an antigen. What is the main difference between the immune and allergic reactions?
Development of tissue lesion
Amount of released antigen
Hereditary predisposition
Antigen structure
Routes by which antigens are delivered into the body
46 із 200
After a craniocerebral injury a patient is unable to recognize objects by touch. What part of brain has been damaged?
Postcentral gyrus
Cerebellum
Precentral gyrus
Occipital lobe
Temporal lobe
47 із 200
A patient complaining of rapid pulse, dyspnea and bluish color of mucosa has been admitted to the cardiological department. The objective symptoms are as follows: edema of lower extremities, ascites. Which of the given medicines should be prescribed for intravenous administration to improve the patient’s general state?
Corglyconum
Drotaverine
Digitoxin
Adrenalin hydrochloride
Cordiamin
48 із 200
As a result of a continuous chronic encephalopathy, a patient has developed spontaneous motions and a disorder of torso muscle tone. These are the symptoms of the disorder of the following conduction tract:
Tractus rubrospinalis
Tractus corticospinalis
Tractus corticonuclearis
Tractus tectospinalis
Tractus spinothalamicus
49 із 200
A 10-year-old child has painful swallowing, neck edema, temperature rise up to 39,0oC, the whole body is covered with bright-red petechial rash. Back of the throat and tonsils are hyperemic, the tongue is crimson- colored. Tonsillar surface is covered with isolated grayishcolored necrosis nidi. What disease is it?
Scarlet fever
Meningococcal nasopharyngitis
Measles
Influenza
Diphtheria
50 із 200
In a patient elevation of body temperature takes turns with drops down to normal levels during the day. The rise in temperature is observed periodically once in four days. Specify the type of temperature curve:
Febris internuttens
Febris hectica
Febris reccurens
Febris continua
Febris remitens
51 із 200
As a result of a craniocerebral injury, a patient has a decreased skin sensitivity. What area of the cerebral cortex is likely to be damaged?
Posterior central gyrus
Cingulate gyrus
Occipital region
Frontal cortex
Anterior central gyrus
52 із 200
Diabetic nephropathy with uremia has developed in a patient with pancreatic diabetes. The velocity of glomerular filtration is 9 ml/min. What mechanism of a decrease in glomerular filtration velocity and chronic renal failure development is most likely in the case of this patient?
Reduction of active nephron mass
Tissue acidosis
Decrease in systemic arterial pressure
Obstruction of nephron tubules with hyaline casts
Arteriolar spasm
53 із 200
A 40-year-old patient has ulcer perforation in the posterior wall of stomach. What anatomical structure will blood and stomach content leak to?
Bursa omentalis
Bursa hepatica
Right lateral channel (canalis lateralis dexter)
Left lateral channel (canalis lateralis sinister)
Bursa praegastrica
54 із 200
A patient is diagnosed with hereditary coagulopathy that is characterised by factor VIII deficiency. Specify the phase of blood clotting during which coagulation will be disrupted in the given case:
Thromboplastin formation
-
Thrombin formation
Clot retraction
Fibrin formation
55 із 200
Angiocardiography of a 60-year-old male patient revealed constriction of a vessel located in the left coronary sulcus of the heart. What is the pathological vessel called?
Ramus circumflexus
V. cordis parva
Ramus interventricularis posterior
Ramus interventricularis anterior
A. coronaria dextra
56 із 200
Those organisms which in the process of evolution failed to develop protection from H2O2 can exist only in anaerobic conditions. Which of the following enzymes can break hydrogen peroxide down?
Peroxidase and catalase
Flavin-dependent oxidase
Oxygenase and hydroxylase
Oxygenase and catalase
Cytochrome oxidase, cytochrome B5
57 із 200
A patient complains of pain in the right lateral abdomen. Palpation revealed a dense, immobile, tumorlike formation. A tumor is likely to be found in the following part of the digestive tube:
Colon ascendens
Colon sigmoideum
Colon transversum
Caecum
Colon descendens
58 із 200
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
Epicritic
Phantom
Protopathic
Visceral
59 із 200
A patient has a critical impairment of protein, fat and hydrocarbon digestion. Most likely it has been caused by low secretion of the following digestive juice:
Pancreatic juice
Saliva
Gastric juice
Intestinal juice
Bile
60 із 200
A female patient has facial neuritis that has caused mimetic paralysis and hearing impairment. Hearing impairment results from the paralysis of the following muscle:
Stapedius muscle
Posterior auricular muscle
Superior auricular muscle
Nasal muscle
Anterior auricular muscle
61 із 200
A 22-year-old female student consulted a physician about fever up to 38oC, weakness, sore throat. Objectively: there is white coating of the tongue. What histological structures of the tongue are involved in the formation of this coating?
Epithelium of the filiform papillae
Epithelium of the foliate papillae
Epithelium of the circumvallate papillae
Epithelium of the fungiform papillae
Connective-tissue base of all the lingual papillae
62 із 200
A patient has a traumatic injury of sternocleidomastoid muscle. This has resulted in a decrease in the following value:
Inspiratory reserve volume
Functional residual lung capacity
Residual volume
Respiratory volume
Expiratory reserve volume
63 із 200
The receptors under study provide transfer of information to the cortex without thalamic involvement. Specify these receptors:
Olfactory
Visual
Auditory
Gustatory
Tactile
64 із 200
Prolonged fasting causes hypoglycemia which is amplified by alcohol consumption, as the following process is inhibited:
Gluconeogenesis
Glycogenolysis
Lipolysis
Proteolysis
Glycolysis
65 із 200
A 39-year-old female patient with a history of diabetes was hospitalized in a precomatose state for diabetic ketoacidosis. This condition had been caused by an increase in the following metabolite level:
Acetoacetate
Alpha-ketoglutarate
Citrate
Aspartate
Malonate
66 із 200
A 37-year-old female patient complains of headache, vertigo, troubled sleep, numbness of limbs. For the last 6 years she has been working at the gas-discharge lamp-producing factory in the lead-processing shop. Blood test findings: low hemoglobin and RBC level, serum iron concentration exceeds the norm by several times. Specify the type of anemia:
Iron refractory anemia
Minkowsky-Shauffard disease
Hypoplastic anemia
Metaplastic anemia
Iron-deficiency anemia
67 із 200
During an animal experiment, surgical damage of certain brain structures has caused deep prolonged sleep. What structure is most likely to cause such condition, if damaged?
Reticular formation
Hippocampus
Red nuclei
Cerebral cortex
Basal ganglion
68 із 200
A patient takes cholagogues. What other process besides biliary excretion will be stimulated?
Intestinal motility
Gastric motor activity
Water absorption
Pancreatic juice secretion
Gastric juice secretion
69 із 200
A 3-year-old child with meningeal symptoms died. Postmortem macroscopy of the pia matter revealed miliary nodules which were microscopically represented by a focus of caseous necrosis with masses of epithelioid and lymphoid cells with some crescent-shaped large cells inbetween having peripheral nuclei. Specify the type of meningitis in the child:
Tuberculous
Syphilitic
Meningococcal
Brucellar
Grippal
70 із 200
A patient with homogentisuria has signs of arthritis, ochronosis. In this case, the pain in the joints is associated with the deposition of:
Homogentisates
Carbonates
Oxalates
Urates
Phosphates
71 із 200
A patient with hereditary hyperammonemia due to a disorder of ornithine cycle has developed secondary orotaciduria. The increased synthesis of orotic acid is caused by an increase in the following metabolite of ornithine cycle:
Carbamoyl phosphate
Urea
Ornithine
Argininosuccinate
Citrulline
72 із 200
Amniocentesis revealed two sex chromatin bodies (Barr bodies) in each cell of the sample. What disease is this character typical for?
Trisomy X
Down’s syndrome
Patau syndrome
Turner’s syndrome
Klinefelter syndrome
73 із 200
A 49-year-old male patient with acute pancreatitis was likely to develop pancreatic necrosis, while active pancreatic proteases were absorbed into the blood stream and tissue proteins broke up. What protective factors of the body can inhibit these processes?
«2-macroglobulin, ai-antitrypsin
Cryoglobulin, interferon
Hemoplexin, haptoglobin
Ceruloplasmin, transferrin
Immunoglobulin
74 із 200
A 16-year-old female patient has fainted after quickly changing her body position from horizontal to vertical one. Which process from the ones listed below has caused the loss of consciousness in the first place?
Decreasing venous return
Increasing venous return
Decreasing oncotic pressure of blood plasma
Increasing arterial pressure
Increasing central venous pressure
75 із 200
A 53-year-old male patient complains of acute pain in the right hypochondrium. Objective examination revealed scleral icterus. Laboratory tests revealed increased ALT activity, and stercobilin was not detected in the stool. What disease is characterized by these symptoms?
Cholelithiasis
Hepatitis
Chronic gastritis
Hemolytic jaundice
Chronic colitis
76 із 200
A child patient has dry cough. What non-narcotic antitussive drug will relieve the patient’s condition?
Glaucine hydrochloride
Potassium iodide
Althaea officinalis root extract
Codeine phosphate
Morphine hydrochloride
77 із 200
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 semilunaris
Linea transversa
Linea arcuata
Linea inguinalis
78 із 200
When measuring total muscle action potential it was revealed that it was subject to the powerlaw relationship. The reason for this is that individual muscle fibers differ in:
Depolarization threshold
Conduction velocity
Critical level of depolarization
Resting potential
Diameter
79 із 200
A patient has insufficient blood supply to the kidneys, which has caused the development of pressor effect due to the constriction of arterial resistance vessels. This is the result of the vessels being greately affected by the following substance:
Angiotensin II
Angiotensinogen
Catecholamines
Norepinephrine
Renin
80 із 200
A patient is diagnosed with iron- deficiency sideroachrestic anemia, progression of which is characterised by skin hyperpigmentation, pigmentary cirrhosis, heart and pancreas affection. Iron level in the blood serum is increased. What disorder of iron metabolism causes this disease?
Failure to assimilate iron leading to iron accumulation in tissues
Increased iron assimilation by body
Disorder of iron absorption in bowels
-
Excessive iron intake with food
81 із 200
In a village, a case of anthrax had been registered. Medical services began epidemiologically indicated specific prophylaxis of population against anthrax. What preparation was used for this purpose?
Live vaccine
Inactivated vaccine
Anatoxin
Genetically engineered vaccine
Chemical vaccine
82 із 200
Experimental stimulation of the sympathetic nerve branches that innervate the heart caused an increase in force of heart contractions because the membrane of typical cardi-omyocytes permitted an increase in:
Calcium ion entry
Calcium and potassium ion exit
Potassium ion exit
Potassium ion entry
Calcium ion exit
83 із 200
According to the results of glucose tolerance test, the patient has no disorder of carbohydrate tolerance. Despite that, glucose is detected in the patients’s urine (5 mmol/l). The patient has been diagnosed with renal diabetes. What renal changes cause glucosuria in this case?
Decreased activity of glucose reabsorption enzymes
Exceeded glucose reabsorption threshold
Increased glucose filtration
Increased activity of glucose reabsorption enzymes
Increased glucose secretion
84 із 200
As a result of past encephalitis, a male patient has developed an increase in cerebrospinal fluid pressure in the right lateral ventricle. What can be the cause of this condition?
Closure of right interventricular foramen
Atresia of the fourth ventricle foramina
Atresia of tubus medullaris
Atresia of sylvian aqueduct
Closure of left interventricular foramen
85 із 200
Parents of 5-year-old child report him o have frequent colds that develop into pneumonias, presence of purulent rashes on the skin. Laboratory tests have revealed the following: absence of immunoglobulins of any type, and naked cells are absent from the lymph nodes punctate. What kind of immune disorder is it?
X-linked hypogammaglobulinemia (Bruton type agammaglobulinemia)
Louis-Barr syndrome
Hypoplastic anemia
Autosomal recessive agammaglobulinaemia (Swiss type)
Agranulocytosis
86 із 200
A 3-year-old child has continuous fever, lymph nodes are enlarged, the amount of lymphocytes in blood is significantly increased. Enzyme-linked immunosorbent assay (ELISA) revealed antigen of Epstein-Barr virus. What diagnosis can be made based on the information given above?
Infectious mononucleosis
Burkitt’s lymphoma
Herpetic lymphadenopathy
Generalized infection caused by herpes-zoster
Cytomegalovirus infection
87 із 200
A microslide contains the preparation of a gland composed of several secretory saccule-shaped parts that open in the common excretory duct. What gland is it?
Simple branched alveolar gland
Compound branched alveolar gland
Compound unbranched alveolar gland
Simple branched tubular gland
Simple unbranched alveolar gland
88 із 200
A patient intending to undergo a gender reassignment surgery has been admitted to a specialised clinic. In the course of examination both male and female gonades have been revealed, with male structure of external genitals. What kind of genital maldevelopment has the patient?
True hermaphroditism
Accessory ovary
Female pseudohermaphroditism
Ectopia of testis
Male pseudohermaphroditism
89 із 200
An 18-year-old male has been diagnosed with Marfan syndrome. Examination revealed a developmental disorder of connective tissue and eye lens structure, abnormalities of the cardiovascular system, arachnodactylia. What genetic phenomenon has caused the development of this disease?
Pleiotropy
Multiple allelism
Codominance
Incomplete dominance
Complementarity
90 із 200
In case of alkaptonuria, homogenti-sic acid is excreted in urine in large amounts. The development of this disease is associated with a disorder of metabolism of the following amino acid:
Tyrosine
Methionine
Alanine
Asparagine
Phenylalanine
91 із 200
A male patient complains of skin insensitivity of inferior eyelid, external lateral surface of nose and upper lip. A doctor in the course of examination has revealed inflammation of the second branch of trigeminal nerve. What cranial foramen does this branch go through?
Supraorbital
Superior orbital fissure
Lacerum
Spinosum
Oval
92 із 200
An patient with insomnia induced by allergic rash and itch has been prescribed the drug that has antihistamine and hypnotic effect. Specify this drug:
Benadryl
Prednisolone
Loratadine
Acetylsalicylic acid
Analgin
93 із 200
In a cat with decerebrate rigidity the muscle tone is to be decreased. This can be achieved by:
Destruction of the vestibular nuclei of Deiters
Stimulation of the otolithic vestibular receptors
Stimulation of the vestibulocochlear nerve
Stimulation of the ampullar vestibular receptors
Stimulation of the vestibular nuclei of Deiters
94 із 200
When studying the signs of pulmonary ventilation, reduction of forced expiratory volume has been detected. What is the likely causeof this phenomenon?
Obstructive pulmonary disease
Increase of respiratory volume
Increase of inspiratory reserve volume
Increase of pulmonary residual volume
Increase of functional residual lung capacity
95 із 200
X-ray examination of a patient allowed to diagnose a tumor in the superior lobe of the right lung. There is a probability of metastases spread to the following lymph nodes:
Sternal
Anterior mediastinum
Deep lateral cervical
Axillary
Inferior mediastinum
96 із 200
A 55-year-old patient with a characteristic rash, fever, dizziness has been admitted to a hospital. He has been provisionally diagnosed with typhus. No similar cases have been reported. In his youth (15 years old) the patient suffered typhus in a boarding school. What disease is it?
Brill’s disease
Cholera
Measles
Rubella
Typhoid fever
97 із 200
A young woman suddenly developed fever up to 39oC accompanied by a strong headache. Examination revealed marked nuchal rigidity. Spinal puncture was performed. Gram-stained smear of cerebrospinal fluid contained many neutrophils and Gram-positive diplococci. What bacteria could be the cause of this disease?
Streptococcus pneumonia
Staphylococcus aureus
Haemophilus influenzae
Pseudomonas aeruginosa
Neisseria meningitidis
98 із 200
In the course of an experiment adenohypophysis of an animal has been removed. The resulting atrophy of thyroid gland and adrenal cortex has been caused by deficiency of the following hormone:
Tropic hormones
Thyroxin
Somatotropin
Cortisol
Thyroid hormones
99 із 200
Degenerative changes in posterior and lateral columns of spinal cord (funicular myelosis) caused by methylmalonic acid accumulation occur in patients with B12 -deficiency anemia. This results in synthesis disruption of the following substance:
Myelin
Acetylcholine
Serotonin
Norepinephrine
Dopamine
100 із 200
A patient with suspected tumor of lung had been admitted to the oncological department. Examination revealed localised pathology in the inferior lobe of the left lung. How many bronchopulmonary segments does this lobe have?
5
3
2
6
4
101 із 200
During local anesthetization the patient has gone into anaphylactic shock. What drug must be administered to the patient?
Epinephrine hydrochloride
Nitroglycerin
Propranolol
Diazepam
Atropine sulfate
102 із 200
As a result of an injury, the integrity of the anterior spinal cord root was broken. Specify the neurons and their processes that had been damaged:
Axons of motor neurons
Dendrites of sensory neurons
Axons of sensory neurons
Motor neuron dendrites
Dendrites of association neurons
103 із 200
A patient who had been taking diclofenac sodium for arthritis of mandibular joint developed an acute condition of gastric ulcer. Such side effect of this medicine is caused by inhibition of the following enzyme:
Cyclooxygenase-1 (COX-1)
Phosphodiesterase
Monoamine oxidase
Lipoxygenase
Cyclooxygenase-2 (COX-2)
104 із 200
In one of Polessye regions there was an outbreak of helminthiasis manifested by cramps and facial edmata. The developed preventive measures in particular included ban for eating infested pork even after heat processing. What helminthiasis was the case?
Trichinosis
Alveococcosis
Teniasis
Taeniarhynchosis
Echinococcosis
105 із 200
A female patient saught medical-genetic consultation. Physical examination revealed pterygium colli deformity (webbed neck), broad chest, underdeveloped breasts. Study of buccal epithelium cells revealed no X-chromatin in the nuclei. This indicates that the patient has the following syndrome:
Turner’s
Klinefelter’s
Down’s
Patau’s
Edwards’
106 із 200
During blood transfusion a patient has developed intravascular erythrocyte hemolysis. What kind of hypersensitivity does the patient have?
II type (antibody-dependent)
IV type (granulomatosis)
I type (anaphylactic)
IV type (cellular cytotoxicity)
III type (immune complex)
107 із 200
Patients with erythropoietic porphyria (Gunther’s disease) have teeth that fluoresce with bright red color when subjected to ultraviolet radiation; their skin is light-sensitive, urine is red-colored. What enzyme can cause this disease, when it is deficient?
Uroporphyrinogen III cosynthase
Delta-aminolevulinate synthase
Uroporphyrinogen I synthase
Ferrochelatase
Uroporphyrinogen decarboxylase
108 із 200
During the air and bone conduction tests it was revealed that in the left ear the tones were louder by bone conduction. This might be associated with the disease of:
Left middle ear
Right external ear
Right inner ear
Left inner ear
Right middle ear
109 із 200
In course of invasive abdominal surgery a surgeon has to locate the origin of the mesenteric root. Where is it normally localized?
Duodenojejunal flexure
Sigmoid colon
Left flexure of colon
Right mesenteric sinus
Right flexure of colon
110 із 200
A 55-year-old male had been delivered to the resuscitation unit unconscious. Relatives reported him to have mistakenly drunk an alcoholic solution of unknown origin. On examination the patient was diagnosed with methanol intoxication. What antidote should be used in this case?
Ethanol
Acetylcysteine
Protamine sulfate
Teturamum
Naloxone
111 із 200
Due to the use of poor-quality measles vaccine for preventive vaccination, a 1-year-old child has developed an autoimmune renal injury. The urine was found to contain macromolecular proteins. What process of urine formation has been disturbed?
Filtration
Secretion and filtration
Secretion
Reabsorption and secretion
Reabsorption
112 із 200
As a result of a road accident a 37-year-old female victim developed urinary incontinence. What segments of the spinal cord had been damaged?
S2 - S4
Th2 — Th5
Thi — Li
Li — L2
Thi — Th5
113 із 200
An 8-week-pregnant woman with acute respiratory disease and temperature rise up to 39,0oC has called in a doctor. The doctor insisted on her avoiding taking paracetamol, because in this period of pregnancy there is a risk of its:
Teratogenicity
Embryotoxicity
Hepatotoxicity
Fetotoxicity
Allergenicity
114 із 200
A pneumonia patient has been administered acetylcysteine as a part of complex therapy. What principle of therapy has been taken into consideration when applying this drug?
Pathogenetic
Immunomodulatory
Etiotropic
Antimicrobial
Symptomatic
115 із 200
A 26-year-old female patient with bronchitis has been administered a broad spectrum antibiotic as a causal treatment drug. Specify this drug:
Doxycycline
BCG vaccine
Dexamethasone
Interferon
Ambroxol
116 із 200
When defining blood group according to the AB0 system, using salt solutions of monoclonal antibodies, agglutination didn’t occur with any of the solutions. What blood group is it?
0 (I)
AB (IV)
B (III)
-
A (II)
117 із 200
Examination of a 56-year-old female patient with a history of type 1 diabetes revealed a disorder of protein metabolism that is manifested by aminoacidemia in the laboratory blood test values, and clinically by the delayed wound healing and decreased synthesis of antibodies. Which of the following mechanisms causes the development of aminoacidemia?
Increased proteolysis
Decrease in the concentration of amino acids in blood
Albuminosis
Increase in low-density lipoprotein level
Increase in the oncotic pressure in the blood plasma
118 із 200
Symptoms of pellagra (vitamin PP deficiency) is particularly pronounced in patients with low protein diet, because nicotinamide precursor in humans is one of the essential amino acids, namely:
Tryptophan
Threonine
Arginine
Histidine
Lysine
119 із 200
A 68-year-old patient consults a cardiologist, complaining of high arterial blood pressure, pain in the heart egion, intermittent pulse. Prescribe the (3\ -adrenoreceptor blocker for the treatment of the described pathology:
Metoprolol
Nootropil
Fenoterol
Benzylpenicillin
Morphine hydrochloride
120 із 200
A female suffered rubella during pregnancy. The child was born with developmental abnormalities, namely cleft lip and palate. The child’s genotype is normal. These malformations are a manifestation of:
Modification variability
Combinative variability
Aneuploidy
Chromosomal mutation
Polyploidy
121 із 200
An electron micrograph shows a cell-to-cell adhesion consisting, in each cell, of an attachment plaque. The intercellular space is filled with electron-dense substance including transmembrane fibrillar structures. Specify this adhesion:
Desmosome
Tight junction
Adherens junction
Nexus
Synapse
122 із 200
For biochemical diagnostics of myocardial infarction it is necessary to measure activity of a number of enzymes and their isoenzymes. What enzymatic test is considered to be the best to prove or disprove the diagnosis of infarction in the early period after the chest pain is detected?
Creatine kinase isoenzyme CK-MB
LDH2 lactate dehydrogenase isoenzyme
LDH1 lactate dehydrogenase isoenzyme
Creatine kinase isoenzyme CK-MM
Aspartate aminotransferase cytoplasmic isoenzyme
123 із 200
A patient complains of pain in the heart area during acute attack of gastric ulcer. What vegetative reflex can cause this painful feeling?
Viscerovisceral reflex
Motor-visceral reflex
Viscerodermal reflex
Dermatovisceral reflex
Visceromotor reflex
124 із 200
A patient is diagnosed with acute morphine hydrochloride intoxication. Prescribe an oxidizing agent for gastric lavage:
Potassium permanganate
Sulfocamphocainum (Procaine + Sulfocamphoric acid)
Chloramine
Cerigel
Chlorhexidine (bi)gluconate
125 із 200
In the course of puncture biopsy of transplanted kidney the following has been revealed: diffuse infiltration of stroma by lymphocytes and plasmocytes and necrotic arteritis. What pathological process has developed in the transplant?
Immune rejection
Pyelonephritis
Glomerulonephritis
Tubular necrosis
Ischemic kidney failure
126 із 200
During cell division, DNA replication occurs by a signal from the cytoplasm, and a certain portion of the DNA helix unwinds and splits into two individual strains. What enzyme facilitates this process?
Helicase
Ligase
Restrictase
RNA polymerase
DNA polymerase
127 із 200
A female patient, having visited the factory premises with lots of dust in the air for the first time, has got cough and burning pain in the throat. What respiratory receptors, when irritated, cause this kind of reaction?
Irritant receptors
Thermoreceptors
Juxtacapillary (J) receptors
Stretch receptors of lungs
Proprioceptors of respiratory muscles
128 із 200
Since a patient has had myocardial infarction, his atria and ventricles contract independently from each other with a frequency of 60-70 and 3540 per minute. Specify the type of heart block in this case:
Complete atrioventricular
Partial atrioventricular
Sino-atrial
Intra-atrial
Intraventricular
129 із 200
A 35-year-old female patient has been hospitalised with acute intoxication caused by salts of high-density metals (lead, most probably). As a part of complex therapy the antidote that contains two active sulfhydric groups has been prescribed. Specify this antidote:
Dimercaprol
Mannitol
Nalorphine hydrochloride
Metamizole
Calcium chloride
130 із 200
A 60-year-old male patient has type II diabetes. A doctor has prescribed him synthetic hypoglycemic long-acting drug that is sulfonylurea derivative. What drug is it?
Glibenclamide
Butamide
Metformin
Actrapid (soluble insulin)
Acarbose
131 із 200
A patient has been given atropine sulfate for rapid relief of spastic colon symptoms. The use of this drug is contraindicated during the followng disease:
Glaucoma
Bradycardia
Hypotension
Gastric ulcer
Bronchial asthma
132 із 200
As an example of specific human parasites one can name Plasmodium falciparum, human pinworm and some others. The source of parasite invasion is always a human. Such specific human parasites cause the diseases that are called:
Anthroponoses
Zoonoses
Multifactorial diseases
Infections
Anthropozoonoses
133 із 200
In an experiment a dog had been conditioned to salivate at the sight of food and a flash of light. After conditioning the reflex, the light was then paired with the bell. The dog didn’t start to salivate. What type of inhibition was observed?
External
Protective
Persistent
Extinctive
Differential
134 із 200
A newborn baby has numerous hemorrhages. Blood coagulation tests reveal increased prothrombin time. The child is most likely to have a disorder of the following biochemical process:
Production of gamma-carboxyglutamate
Hydroxylation of proline
Conversion of homocysteine to methionine
Degradation of glutathione
Conversion of methylmalonyl CoA to succinyl CoA
135 із 200
A 63-year-old male patient with bladder atony had been prescribed a medication, which he had been arbitrarily taking at a higher dose. The patient developed hypehydration, salivation, diarrhea, muscle spasms. The prescribed drug relates to the following group:
Cholinomimetics
Cholinesterase reactivators
Adrenergc blockers
Ganglionic blockers
Tocolytics
136 із 200
A 67-year-old male patient consumes eggs, pork fat, butter, milk and meat. Blood test results: cholesterol - 12,3 mmol/l, total lipids - 8,2 g/l, increased low-density lipoprotein fraction (LDL). What type of hyperlipoproteinemia is observed in the patient?
Hyperlipoproteinemia type IIa
Hyperlipoproteinemia type IIb
Cholesterol, hyperlipoproteinemia
Hyperlipoproteinemia type IV
Hyperlipoproteinemia type I
137 із 200
Tissue sampling of a 37-year-old male patient with chronic renal disease has revealed the following: sclerosis, lymphocytic and plasmocytic infiltration of renal pelvis and calices walls, dystrophy and atrophy of tubules. Remaining tubules are enlarged and stretched with colloid masses, epithelium is flattened out ('scutiform' or 'shield-shaped' kidney). What is the most likely diagnosis?
Chronic pyelonephritis
Acute pyelonephritis
Tubular interstitial nephritis
Glomerulonephritis
Nephrosclerosis
138 із 200
During the hystological study of cortical shaft, basophilic cells with developed synthesis organelles can be seen on the bone surface under the layer of fibers. These cells take part in bone tissue regeneration. What shaft layer are they located in?
Periosteum
Osteon layer
Bone
Inner lamellae of compact bone tissue
Outer lamellae of compact bone tissue
139 із 200
Autopsy of a 50-year-old male who had tuberculosis revealed a dense gray-white nidus in form of a nodule 2 cm in diameter in the subpleural portion of the upper right lobe. The pleura in this region was thickened, in the pleural cavity there was a small amount of serous hemorrhagic fluid. Histological study of the region revealed some glandular structures with signs of cellular atypia and abnormal mitoses, which were found within the fibrous connective tissue. What other pathology had developed in the lungs?
Adenocarcinoma
Fibroma
Squamous cell carcinoma
Adenoma
Fibrosarcoma
140 із 200
In course of an experiment there has been an increase in the nerve conduction velocity. This may be caused by an increase in the concentration of the following ions that are present in the solution around the cell:
Na+
K+ and ClC. K + and Na+
Ca2+
Ca2+ and Cl
141 із 200
Hepatitis B is diagnosed through laboratory tests that determine the presence of HBA-DNA in blood serum of the patient. What reference method is applied for this purpose?
Polymerase chain reaction
Hybridization signal amplification method
Ligase chain reaction method
ELISA diagnostic method
Hybridization method
142 із 200
On the 24th day since the onset of disease, a male patient diagnosed with typhoid fever and undergoing treatment in an infectious diseases hospital has suddenly developed clinical presentations of acute abdomen leading to the death of the patient. During autopsy peritonitis has been revealed, with numerous ulcers covering the colon mucosa and reaching as deep as muscular and, in places, serous tunic. The ulcers have smooth edges and even floor. The intestinal wall is perforated. What stage of typhoid fever has the lethal complication arisen at?
Clean ulcer
Regeneration
Dirty ulcer
Medullary swelling
Necrosis
143 із 200
An HIV-positive patient’s cause of death is acute pulmonary insufficiency resulting from pneumonia. Pathohistological investigation of lungs has revealed interstitial pneumonia, alveolocyte desquamation and their methamorphoses: alveolocyte enlargement, large intranuclear inclusions surrounded by lightly-colored areas. Transformed cells resemble owl’s eye. Name the pneumonia causative agent:
Cytomegalovirus
Influenza virus
Toxoplasma
Pneumococcus
Candida fungi
144 із 200
The organisms to be identified have a nucleus surrounded by a nuclear membrane. Genetic material is concentrated predominantly in the chromosomes which consist of DNA strands and protein molecules. These cells divide mitotically. Identify these organisms:
Eukaryotes
Prokaryotes
Viruses
Bacteria
Bacteriophages
145 із 200
A 37-year-old male patient developed pseudoarthrosis after a closed fracture of the femur. Specify the type of regeneration in the patient:
Pathological hypo-regeneration
-
Pathological hyper-regeneration
Reparative
Physiological
146 із 200
Nucleolar organizers of the 13-15, 21, 22 human chromosomes contain about 200 cluster genes that synthesize RNA. These regions of chromosomes bear the information on the following type of RNA:
rRNA
tRNA
tRNA + rRNA
mRNA
snRNA
147 із 200
The resuscitation unit has admitted a patient in grave condition. It is known that he had mistakenly taken sodium fluoride which blocks cytochrome oxidase. What type of hypoxia developed in the patient?
Tissue
Respiratory
Hypoxic
Cardiovascular
Hemic
148 із 200
Steatosis is caused by the accumulation of triacylglycerols in hepatocytes. One of the mechanisms of this disease development is a decrease in the utilization of VLDL neutral fat. What lipotropics prevent the development of steatosis?
Methionine, B6, B12
Alanine, B1, PP
Valine, B3, B2
Isoleucine, B1, B2
Arginine, ^ B3
149 із 200
A 2-year-old boy is diagnosed with Down syndrome. What chromosomal changes may be the cause of this disease?
Trisomy 21
Trisomy 13
Monosomy X
Trisomy X
Trisomy 18
150 із 200
A patient who has recently arrived from an endemic area presents with elevated body temperature, headache, chills, malaise, that is with the symptoms which are typical for a common cold. What laboratory tests are necessary to prove or to disprove the diagnosis of malaria?
Microscopy of blood smears
Study of cerebrospinal fluid
Urinalysis
Study of lymph node punctate
Microscopy of bone marrow punctate
151 із 200
A patient has severe blood loss caused by an injury. What kind of dehydration will be observed in this particular case?
Iso-osmolar
Normosmolar
-
Hyposmolar
Hyperosmolar
152 із 200
A 30-year-old patient has dyspnea fits, mostly at night. He has been diagnosed with bronchial asthma. What type of allergic reaction according to the Gell-Coombs classification is most likely in this case?
Anaphylactic
Delayed-type hypersensitivity
Immune complex
Stimulating
Cytotoxic
153 із 200
Decarboxylation of glutamate induces production of gamma- aminobutyric acid (GABA ) neurotransmitter. After breakdown, GABA is converted into a metabolite of the citric acid cycle, that is:
Succinate
Fumarate
Malate
Citric acid
Oxaloacetate
154 із 200
An outbreak of an intestinal infection occurred in a kindergarten on the eve of New Year holidays. Bacteriological examination of patients’ faeces didn’t reveal any pathogenic bacteria. Electron microscopy revealed roundish structures with clear outer edges and a thick core resembling a wheel. Specify the most likely causative agent of this infection:
Rotavirus
Coxsacki-virus
Adenovirus
P.vulgaris
E.coli
155 із 200
A smear of streptobacillus preparation stained by Ozheshko method has been studied microscopically with oil immersion. What structural feature of the bacteria has been studied?
Spores
Inclusions
Flagella
Capsule
Structure of cell wall
156 із 200
After a road accident a victim has tachycardia, arterial blood pressure 130/90 mm Hg, tachypnoe, the skin is pale and dry, excitation of central nervous system is observed. What shock stage is the patient most likely in?
Erectile
Agony
Preshock (compensation stage)
Torpid
Terminal
157 із 200
Autopsy has revealed shrunken kidneys weighing 50 mg, with finegrained surface and uniformly thi- nned substance. Microscopic investigation has shown the thickening of arteriole walls due to accumulation of homogeneous anhistic pink-coloured masses in them. Glomerules were undersized, sclerotic, with atrophied tubules. What disease are these changes characteristic of?
Essential hypertension
Renal amyloidosis
Pyelonephritis with kidney shrinkage
Acute glomerulonephritis
Membranous nephropathy
158 із 200
A fixed-run taxi passenger has a sudden and expressed attack of tachycardia. A doctor travelling by the same taxi has managed to slow down his heart rate by pressing upon the eyeballs and thus causing the following reflex:
Dagnini-Aschner reflex
Bainbridge reflex
Hering-Breuer reflex
Frank-Starling mechanism
Holtz’s reflex
159 із 200
Histological examination of biopsy samples taken from the thickened edges of a gastric ulcer revealed small clusters of small, markedly atypical hyperchromatic epithelial cells that were localized in the overdeveloped stroma. Specify the tumor:
Scirrhous undifferentiated carcinoma
Adenocarcinoma
Undifferentiated sarcoma
Adenoma
Medullary carcinoma
160 із 200
A 10-year-old child was found to have a congenital hypoplasia of the left kidney. Ultrasound examination revealed that the right kidney was markedly enlarged and had regular shape. No functional disorders were revealed. Specify the process that developed in the right kidney:
Vicarious hypertrophy
Metaplasia
Working hypertrophy
Hypertrophic growth
Pseudohypertrophy
161 із 200
In allergic diseases, a dramaic increase in basophilic leukocyte number in patients’ blood is observed. This phenomenon is due to the following basophil function:
Participation of heparin and histamine in metabolism
Participation in blood clotting
Immunoglobulin synthesis
Phagocytosis of microorganisms and small particles
Phagocytosis of immune complexes
162 із 200
A 47-year-old male patient developed intestinal colic against the background of essential hypertension. In this situation it would be most efficient to arrest the colic by using drugs of the following group:
Myotropic antispasmodics
M-cholinomimetics
Adrenomimetics
Anticholinesterase agents
Sympathomimetics
163 із 200
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?
Increase of ALT, AST level
Hyperbilirubinemia
Urobilinuria
Bilirubinuria
Cholemia
164 із 200
An underage patient has signs of achondroplasia (dwarfism). It is known that this is a monogenic disease and the gene that is responsible for the development of such abnormalities is a dominant one. The development of that child’s brother is normal. Specify the genotype of the healthy child:
aa
AA
Aa
AaBb
AABB
165 із 200
A patient has acute bronchitis. The fever up to 38,5oC had lasted for a week, presently there is a decrease in temperature down to 37,0oC. Specify the leading mechanism in the 3rd stage of fever:
Peripheral vasodilation
Increased heat production
Increased respiratory rate
Development of chill
Increased diuresis
166 із 200
A 35-year-old female patient has undergone biopsy of the breast nodules. Histological examination has revealed enhanced proliferation of the small duct and acini epithelial cells, accompanied by the formation of glandular structures of various shapes and sizes, which were located in the fibrous stroma. What is the most likely diagnosis?
Fibroadenoma
Invasive ductal carcinoma
Adenocarcinoma
Cystic breast
Mastitis
167 із 200
At a bacteriological laboratory animal skins are analyzed by means of Ascoli precipitaion test. What is detected if the reaction is positive?
Anthrax agent antigens
Plague agent
Brucellosis agent
Yersinia surface antigen
Anaerobic infection toxin
168 із 200
Examination of the duodenal contents revealed some pear-shaped protozoa with two nuclei and four pairs of flagella. The organisms had also two axostyles between the nuclei and a ventral adhesive disc. What protozoan representative was found in the patient?
Lamblia
Intestinal trichomonad
Leishmania
Toxoplasma
Trypanosome
169 із 200
A 36-year-old female patient has a history of 52-hypovitaminosis. The most likely cause of specific symptoms (epithelial, mucosal, cutaneous, corneal lesions) is the defi- ciency of:
Flavin coenzymes
Cytochrome A1
Cytochrome C
Cytochrome B
Cytochrome oxidase
170 із 200
A 54-year-old female was brought to the casualty department after a car accident. A traumatologist diagnosed her with multiple fractures of the lower extremities. What kind of embolism is most likely to develop in this case?
Fat
Tissue
Thromboembolism
Gaseous
Air
171 із 200
A blood drop has been put into a test tube with 0,3% solution of NaCl. What will happen to erythrocytes?
Osmotic haemolysis
Mechanical haemolysis
Any changes will be observed
Shrinkage
Biological haemolysis
172 із 200
There are cortical and medullary substances separated by connective tissue layer in the endocrine gland specimen. Parenchyma cells make up three zones in cortical substance, with rounded masses in the superficial zone, parallel chords in the middle one, reticular structure of cell chords in the deep one. What gland is it?
Adrenal gland
Pituitary gland
Thyroid gland
Hypothalamus
Epiphysis
173 із 200
Histological specimen of a 10-day human embryo represents 2 contacting sacs (amniotic and yolk sacs). Specify the structure that separates the amni-otic cavity from the yolk sac:
Embryonic shield
Floor of the amniotic sac
Amniotic stalk
Roof of the yolk sac
Extraembryonic mesoderm
174 із 200
An electron micrograph shows a cell of neural origin. The terminal portion of the cell dendrite has cylindrical shape and consists of 1000 closed membrane disks. What cell is represented by the micrograph?
Rod receptor cell
Cone receptor cell
Neuron of the anterior horns of the spinal cord
Spinal node neuron
Neuron of the cerebral cortex
175 із 200
Disruption of nerve fiber myelinogenesis causes neurological disorders and mental retardation. These symptoms are typical for hereditary and acquired alterations in the metabolism of:
Sphingolipids
Cholesterol
Higher fatty acids
Phosphatidic acid
Neutral fats
176 із 200
A patient underwent surgical removal of a cavitary liver lesion 2 cm in diameter. It was revealed that the cavity wall was formed by dense fibrous connective tissue; the cavity contained muddy, thick, yellowish-greenish fluid with an unpleasant odor. Microscopically, the fluid consisted mainly of polymorphonuclear leukocytes. What pathological process are these morphological changes typical for?
Chronic abscess
-
Phlegmon
Acute abscess
Empyema
177 із 200
A patient complains of photoreception disorder and frequent acute viral diseases. He has been prescribed a vitamin that affects photoreception processes by producing rhodopsin, the photosensitive pigment. What vitamin is it?
Retinol acetate
Pyridoxine hydrochloride
Tocopherol acetate
Cyanocobalamin
Thiamine
178 із 200
A 7-year-old boy got ill with diphtheria. On the third day he died of asphyxiation. At autopsy the mucosa of the larynx, trachea and bronchi had thickened, edematous, lustreless appearance and was covered with gray films which could be easily removed. Specify the type of laryngeal inflammation:
Croupous
Diphtheritic
Intermediate
Catarrhal
Purulent
179 із 200
A child has a history of hepatomegaly, hypoglycemia, seizures, especially on an empty stomach and in stressful situations. The child is diagnosed with Gierke disease. This disease is caused by the genetic defect of the following enzyme:
Glycogen phosphorylase
Glucokinase
Glucose-6-phosphatase
Amyloid-1,6-glycosidase
Phosphoglucomutase
180 із 200
A public utility specialist went down into a sewer well without protection and after a while lost consciousness. Ambulance doctors diagnosed him with hydrogen sulfide intoxication. What type of hypoxia developed?
Hemic
Respiratory
Tissue
Overload
Circulatory
181 із 200
A child with a normal karyotype is diagnosed with cleft lip and hard palate, defects of the cardiovascular system, microcephaly. The child’s mother suffered rubella during pregnancy. This pathology in the child may be an example of:
Genocopy
Phenocopy
Trisomy
Monosomy
-
182 із 200
A 28-year-old patient undergoing treatment in the pulmonological department has been diagnosed with pulmonary emphysema caused by splitting of alveolar septum by tissular tripsin. The disease is cased by the congenital deficiency of the following protein:
a1-proteinase inhibitor
a2-macroglobulin
Haptoglobin
Cryoglobulin
Transferrin
183 із 200
A patient with signs of osteoporosis and urolithiasis has been admitted to the endocrinology department. Blood test has revealed hypercalcemia and hypophosphatemia. These changes are associated with abnormal synthesis of the following hormone:
Parathyroid hormone
Calcitriol
Calcitonin
Cortisol
Aldosterone
184 із 200
During a surgery for femoral hernia a surgeon operates within the boundaries of femoral trigone. What structure makes up its upper margin?
Lig.inguinale
Lig.lacunare
Fascia lata
Lig. pectinale
Arcus iliopectineus
185 із 200
A 19-year-old victim has been delivered to the casualty department with a cut wound of the trapezius muscle. Which of the cervical fasciae forms a sheath for this muscle?
Investing layer of cervical fascia
Carotid sheath of cervical fascia
Visceral part of the pretracheal layer of cervical fascia
Prevertebral layer of cervical fascia
Muscular part of the pretacheal layer of cervical fascia
186 із 200
A patient with acne has been prescribed doxycycline hydrochloride. What recommendations should be given to the patient, while he is taking this drug?
Avoid long stay in the sun
The course of treatment should not exceed 1 day
Do not take with vitamins
Take with large quantity of liquid, preferably milk
Take before meal
187 із 200
A 30-year-old patient with a past history of virus B hepatitis complains of prolonged nosebleeds. What drug will be most efficient in remedying this condition?
Vicasolum
Dipiridamol
Fraxiparine
Asparcam
Folic acid
188 із 200
A patient has arterial hypertension. What long-acting drug from the group of calcium channel blockers should be prescribed?
Amlodipine
Atenolol
Pyrroxanum
Reserpine
Octadine
189 із 200
A patient has been diagnosed with ARVI. Blood serum contains immunoglobulin M. What is the stage of infection in this case?
Acute
Carriage
Prodromal
Incubation
Reconvalescence
190 із 200
In a dysentery patient undergoing treatment in the contagious isolation ward, a significant increase in packed cell volume has been observed (60%). What other value will be affected by this change?
Increasing blood viscosity
Increasing erythrocyte sedimentation rate (ESR)
Increasing volume of blood circulation
Thrombocytopenia
Leukopenia
191 із 200
A patient complains of palpitation after stress. The pulse is 104 bpm, P-Q=0,12 seconds, there are no changes of QRS complex. What type of arrhythmia does the patient have?
Sinus tachycardia
Sinus bradycardia
Ciliary arrhythmia
Extrasystole
Sinus arrhythmia
192 із 200
A 30-year-old patient has undergone keratoplasty in the transplantation center, cornea has been taken fron a donor, who died in a road accident. What kind of transplantation was performed?
Allotransplantation
Autotransplantation
Xenotransplantation
Heterotransplantation
Explantation
193 із 200
A 29-year-old male with a knife wound of neck presents with bleeding. During the initial dbridement of the wound the surgeon revealed the injury of a vessel found along the lateral edge of the sternocleidomastoid muscle. Specify this vessel:
V jugularis externa
A. carotis interna
A. carotis externa
V jugularis interna
V jugularis anterior
194 із 200
A histologic specimen represents an organ with walls comprised of mucous, submucous, fibrous-cartilaginous and adventitial membranes. Epithelium is multirowed and ciliated, muscular layer of mucous membrane is absent, submucous membrane contai- ns serousmucous glands, hyaline cartilage forms open circles. What organ has the described morphological features?
Trachea
Secondary bronchi (lobar bronchi)
Larynx
Tertiary bronchi (segmental bronchi)
Terminal bronchiole
195 із 200
In cancer patients who have been continuously receiving methotrexate, the target cells of tumor with time become insensitive to this drug. In this case, gene amplification of the following enzyme is observed:
Dihydrofolate reductase
Thiaminase
Deaminase
-
Thioredoxin reductase
196 із 200
Pancreas is known as a mixed gland. Endocrine functions include production of insulin by beta cells. This hormone affects the metabolism of carbohydrates. What is its effect upon the activity of glycogen phosphorylase (GP) and glycogen synthase (GS)?
It inhibits GP and activates GS
It activates GP and inhibits GS
It inhibits both GP and GS
It does not affect the activity of GP and GS
It activates both GP and GS
197 із 200
A patient has the oxyhemoglobin dissociation curve shifted to the left. What blood changes induce this condition?
Alkalosis, hypocapnia, temperature drop
-
Acidosis, hypercapnia, temperature rise
Acidosis, hypocapnia, temperature rise
Acidosis, hypercapnia, temperature drop
198 із 200
Administration of doxycycline hydrochloride caused an imbalance of the symbiotic intestinal microflora. Specify the kind of imbalance caused by the antibiotic therapy:
Dysbacteriosis
Sensibilization
Idiosyncrasy
Bacteriosis
Superimposed infection
199 із 200
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
Supression of serotonergic neurotransmission
H1-histamine receptors stimulation
Inhibition of stimulating amino acids
200 із 200
A patient has been found to have a marked dilatation of saphenous veins in the region of anterior abdominal wall around the navel. This is symptomatic of pressure increase in the following vessel:
Vportae hepatis
V mesenterica inferior
V mesenterica superior
V cava superior
V cava inferior