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Крок 1 - Медицина 2025
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2 із 295
The most important mediator of the central nervous system is gamma-aminobutyric acid. When decarboxylated, which of the amino acids is this biogenic amine formed?
Glutamate
Lysine
Tryptophan
Tyrosine
Histidine
3 із 295
A patient with femoral neck fracture, who for a long time had to remain in bed in a forced (supine) position, has developed dark-brown lesions along the backbone; soft tissues are swollen, in the areas of maceration there is a foul-smelling liquid. Name the clinicopathologic type of necrosis:
Bedsore
Infarction
Coagulation necrosis
Dry gangrene
Sequestrum
4 із 295
Examination shows that the patient's sternocleidomastoid muscle and the upper edge of the trapezius muscle suffer from atrophy. Turning the head into the opposite direction is problematic. What nerve is affected in this case?
Accessory nerve
Brachial plexus
Hypoglossal nerve
Intercostal nerve
Vagus nerve
5 із 295
During the examination of a child, the doctor noticed symmetrical roughness of the child's cheeks, diarrhea, and nervous disorders. What nutritional factors are deficient in this case, causing this condition in the child?
Nicotinic acid, tryptophan
Phenylalanine, pangamic acid
Lysine, ascorbic acid
Methionine, lipoic acid
Threonine, pantothenic acid
6 із 295
The frog's CNS structure was destroyed, causing the animal to lean towards destruction due to a significant decrease in extensor tone. What CNS structure was damaged?
Vestibular nucleus of Deiters
Pale Ball
Black matter
Red core
Quadrangular body
7 із 295
A 38-year-old woman presents for evaluation to a clinic with painful ulceration in her right breast for the last 2 months. She is worried because the ulcer is increasing in size. On further questioning, she says that she has a discharge from her right nipple as well. Her mother and aunt died of breast cancer at 60 and 54 years of age, respectively. Her right breast is enlarged and firm, with thickened skin, diffuse erythema, and an ulcer measuring 3x3 cm. Mammography is ordered that shows a mass with a large area of parenchymal distortion, and extensive soft tissue and trabecular thickening in the affected breast. The patient subsequently undergoes core needle and full-thickness skin punch biopsies. The pathology report states a clear dermal lymphatic invasion. Which of the following is the most common site for metastatic disease in this pathology?
Axillary, supraclavicular lymph nodes
Parasternal, tracheobronchial lymph nodes
Preaortic, tracheobronchial lymph nodes
Deep lateral cervical, superior diaphragmatic lymph nodes
Deep anterior cervical, abdominal lymph nodes
8 із 295
A histological specimen demonstrates a parenchymal organ, the structural and functional unit of which is a follicle. The wall of the follicle is formed by cuboidal cells. The cavity of the follicle is filled with a colloid. What organ is being demonstrated in the specimen?
Thyroid gland
Testicle
Pituitary gland
Salivary gland
Ovary
9 із 295
A patient with hyperthyroidism has high body temperature. What energy metabolism disorder is the leading one in the rise of the body temperature in this case?
Separation of oxidation and oxidative phosphorylation
Increased lipolysis
Enzyme activation in the Krebs cycle
Increased glycogen breakdown
Enzyme activation in the respiratory chain
10 із 295
Genealogical analysis of a family with a hereditary pathology of optic nerve atrophy has determined that this medical condition is passed on only by the mothers, both girls and boys can be affected, and the sick father does not pass on the disease to his daughters or sons. What type of hereditary disease is it?
Mitochondrial
Autosomal recessive
Autosomal dominant
X-linked recessive
X-linked dominant
11 із 295
A man was hospitalized in a comatose state. His medical history states that he has been suffering from type II diabetes mellitus for 5 years. Objectively, his respiration is noisy and deep. His blood glucose is 15.2 mmol/L, ketone bodies - 100 µmol/L. What complication of diabetes mellitus can be characterized by such findings?
Ketoacidotic coma
Hypoglycemic coma
Hyperosmolar coma
Hyperglycemic coma
Hepatic coma
12 із 295
Кілька правильних варіантів A patient presents with smoothed out right nasolabial fold and dilated right palpebral fissure (it cannot be closed during squinting, because the eyelids do not close). The patient has problems with talking and eating (food stuck between the cheek and teeth). What nerve is damaged in this case?
N. facialis dexter
Right facial nerve
N. trigeminus dexter
N. abducens right
N. vagus dexter
13 із 295
Examination of a patient detected accumulation of sphingomyelins in the cell lysosomes of the patient's liver, spleen, lungs, bone marrow, and brain, caused by the lack of sphingomyelinase enzyme. What pathology is most likely in this patient?
Niemann-Pick disease
Tay-Sachs disease
Gaucher disease
Sandhoff disease
Krabbe disease
14 із 295
In cases of fatty infiltration of the liver, the synthesis of phospholipids becomes disrupted. In such cases, the patients are advised to eat more cottage cheese, because it contains a certain substance that can promote the methylation process in the synthesis of phospholipids. Name this substance.
Methionine
Ethanolamine
Glycerine
Cysteine
Calcium
15 із 295
A patient diagnosed with chronic bronchitis underwent a biopsy of the main bronchus. The patient has a 30-year-long history of smoking. Histology of the biopsy material revealed stratified squamous epithelium. What pathological process in the main bronchus does it indicate?
Metaplasia
Dysplasia
Physiological regeneration
Reparative regeneration
Hyperplasia
16 із 295
Autopsy of the body of a 40-year-old man, who died of odontogenic sepsis, revealed sharp thickening of poorly mobile semilunar aortic valves. The tissue of the valve is whitish and opaque. Its outer surface has thrombotic deposits 1×1.5 cm in size. What type of endocarditis is it?
Ulcerative polypoid endocarditis
Fibroplastic endocarditis
Acute verrucous endocarditis
Recurrent verrucous endocarditis
Diffuse endocarditis
17 із 295
A patient with chronic glomerulonephritis has impaired renal endocrine function. What blood cell deficiencies are observed in this pathological condition?
Red blood cells
Leukocytes and platelets
Platelets
Leukocytes
Red blood cells and white blood cells
18 із 295
In the removed uterus of a 55-year-old woman, a pathologist has found a dense node in the thickness of the myometrium. The node is 5 cm in diameter and has clear boundaries. On section, its tissues are gray-pink and fibrous. Microscopically, the tumor consists of smooth muscle cells that form bundles of varying thickness, and of layers of connective tissue, hyalinized in some places. What tumor has developed in the patient?
Fibromyoma
Fibrosarcoma
Myosarcoma
Fibroma
Rhabdomyoma
19 із 295
A patient was prescribed an adrenomimetic drug to stop an attack of bronchial asthma. Select this drug from the list.
Salbutamol
Rheopolyglucin (Dextran)
Nitrosorbide (Isosorbide dinitrate)
Cerucal (Metoclopramide)
Asparcam (Potassium and magnesium aspartate)
20 із 295
A 38-year-old woman, who was diagnosed with systemic lupus erythematosus (SLE) 3 years ago, comes to her physician with a complaint of facial swelling and decreased urination that she first noticed 2 weeks ago. She currently takes azathioprine and corticosteroid. Her vital signs show blood pressure 150/90 mm Hg, pulse 91/min, temperature 36.8 °C, respiratory rate 15/min. On physical examination, the doctor notices erythematous rash on her face. The laboratory studies reveal hypercholesterolemia, hypertriglyceridemia. Which of the following is the most likely mechanism of renal injury in this patient?
Immune complex-mediated glomerular disease
---
Increased plasma oncotic pressure
Acute infection of the kidney
Decrease in renal blood flow (ischemic nephropathy)
21 із 295
An unidentified surgical specimen is received for histopathologic analysis. A portion of the specimen is cut and stained with hematoxylin and eosin. Light microscopy of the specimen reveals an organ with capsule and pulp. A capsule consists of dense connective tissue, which forms trabecular extensions and penetrates the parenchyma. The white pulp houses periarteriolar lymphoid sheaths (PALS), which are populated by T-cells and surround central arteries. Which of the following organs most likely complies with described histological findings?
Spleen
Tonsil
Red bone marrow
Lymph node
Thymus
22 із 295
A person with drug-induced poisoning is unconscious and presents with miosis and intensified spinal monosynaptic reflexes. What substance could be the cause of the poisoning in this case?
Morphine
Dimedrol (Diphenhydramine)
Ethaminal sodium
Diazepam
Aminazine (Chlorpromazine)
23 із 295
A patient has been diagnosed with a myocardial infarction. His blood was tested for the activity of cardiospecific enzymes. Which one among the detected enzymes has three isoforms?
Creatine kinase
Aspartate transaminase
Lactate dehydrogenase
Pyruvate kinase
Alanine transaminase
24 із 295
A parenchyma sample was taken from a hematopoietic organ of a patient for diagnostic purposes. The sample contains megakaryocytes. What hematopoietic organ is it?
Red bone marrow
Tonsil
Spleen
Lymph node
Thymus
25 із 295
A 64-year-old man presents with a tremor in his legs and arms. He says he has had the tremor for some time, but it has worsened in the last year. The tremor is more prominent at rest and almost disappears on movement. The patient is afebrile and vital signs are within normal limits. He is hunched over and his face is expressionless throughout examination. There is a prominent resting tremor that is accentuated when the patient is asked to clench the contralateral hand and alleviated by finger-nose testing. The patient has difficulty taking the first step, has a stooped posture and takes short rapid shuffling steps. A doctor initiates pharmacotherapy and the drug of first line, levodopa, is prescribed. Which of the following is the most likely mechanism of action of this drug?
Stimulation of dopamine production
---
Cholinesterase inhibition
Inhibition of M2-cholinergic receptors
Activation of M2-cholinergic receptors
26 із 295
The Wasserman reaction is markedly positive (++++) in a 30-year-old man. What infectious disease is diagnosed using the Wasserman reaction?
Syphilis
Brucellosis
Poliomyelitis
Influenza
Tuberculosis
27 із 295
A woman, who was undergoing treatment for insomnia, was found unconscious. Her respiration is inhibited, she is in a collaptoid state and presents with muscle hypotonia and absence of reflexes. Empty medicine packages were found at the site of the accident. What medicine could have caused such a condition in the patient?
Phenobarbital
Nialamide
Picamilon
Promedol (Trimeperidine)
Eleutherococcus tincture
28 із 295
During surgical intervention, an organ is removed from a 34-year-old patient and sent for histologic evaluation. The pathologist examines the slide. The organ is encased in a connective tissue capsule that extends septae into the organ's substance, which is portioned into cortex and medulla. It is richly vascularized and capsular blood vessels penetrate along with the septae. The medulla is fairly homogeneous and consists of chromaffin cells, but in the cortex, three concentric zones can be distinguished. Which of the following is the most likely organ?
Adrenal gland
Kidney
Thyroid gland
Lymph node
Thymus
29 із 295
A 26-year-old female patient with bronchitis has been administered a broad spectrum antibiotic as a causal treatment drug. Name this drug:
Amoxicillin
Interferon
Dexamethasone
Isoniazid
Vancomycin
30 із 295
A 3-year-old child has an acute intestinal infection with profuse diarrhea, followed by the development of anhydremic shock. What is the leading link in the development of this complication?
Hypovolemia
Reduced cardiac output per minute
Decreased arterial pressure
Hypoxia
Intoxication
31 із 295
Participation of a certain part of the central nervous system is mandatory for the formation of voluntary defecation in a child. What part of the central nervous system is it?
Cerebral cortex
Ventromedial nuclei of the hypothalamus
Coccygeal segments of the spinal cord
Medulla oblongata
Lateral nuclei of the hypothalamus
32 із 295
A patient undergoes right-sided pulmonectomy due to lung cancer. Name the anatomical structures of the right lung root (downward order):
Bronchus, artery, veins
Artery, bronchus, veins
Veins, bronchus, artery
Artery, veins, bronchus
Veins, artery, bronchus
33 із 295
In the course of an urgent surgery, the vermiform appendix of the patient was excised. The appendix was acutely distended and gray-black throughout its entire length. In the distal segment a defect of the appendix wall was detected, through which a foul-smelling gray-brown substance was being discharged from the appendix lumen. Histological analysis shows necrotization of the appendix wall with hemorrhagic foci; the lumen of the mesenteric artery is filled with a thrombus. What type of appendicitis is it?
Acute gangrenous
Chronic
Acute superficial
Acute phlegmonous
Acute simple
34 із 295
The bacteriological laboratory needs to prepare for analysis of the materials that are suspected to be contaminated with spores of anthrax causative agent. What diagnostic preparation allows for quick detection of these spores?
Anti-anthrax fluorescent serum
Monoclonal antibodies to anthrax causative agent
Enzyme-tagged immunoglobulin
Anti-anthrax immunoglobulin
Standard anthrax antigen
35 із 295
A surgeon suspects inflammation of the Meckel's diverticulum in a 10-year-old child. This condition requires a surgical intervention. What part of the intestine must be inspected to find the diverticulum?
1 meter of the ileum, starting from the place of its confluence with the large intestine
0.5 meters of jejunum, starting from the ligament of Treitz
Ascending colon
20 cm of the ileum, starting from the ileocecal angle
Descending colon
36 із 295
In a seven-year-old child, the disease began acutely with hyperthermia, catarrhal phenomena, and diarrhea. In the second week, respiratory disorders, flaccid paralysis of the lower extremities, and bilateral focal pneumonia were added on X-ray. During the autopsy, foci of glial reaction were found in the anterior horns of the spinal cord around dead neurons. What disease caused the child's death?
Poliomyelitis
Polyradiculoneuritis
Meningoencephalitis
Meningitis
Myelitis
37 із 295
A 65-year-old patient with a history of coronary artery disease presents to the doctor's office complaining of dizziness and sudden onset of redness of his skin. His blood pressure is 100/50 mm Hg, respiratory rate — 14/min. Which of the following medications did this patient most likely misuse?
Nitrovasodilator
Smooth muscle relaxant
α-adrenoreceptor antagonists
Adenosine
Calcium channel blockers
38 із 295
A 27-year-old parturient woman undergoes a complicated childbirth with impending cervical rupture. What pain relief medicine would be the safest in this case?
Promedol (Trimeperidine)
Analgin (Metamizole)
Fentanyl
Morphine hydrochloride
Diazepam
39 із 295
A 50-year-old patient has been hospitalized with signs of a hypertensive crisis. What is associated with a sharp increase in the blood pressure?
Spasm of arterioles
Endothelial desquamation
Hyalinosis of arterioles
Necrosis of arterioles
Endothelial dystrophy
40 із 295
When ascending to the top of Elbrus, a mountain climber experiences oxygen starvation, dyspnea, palpitations, and numbness of the extremities. What kind of hypoxia has developed in the mountain climber?
Hypoxic
Circulatory
Cardiac
Tissue
Hemic
41 із 295
The patient's ECG shows that the ST segment is displaced above the isoelectric line by 1 mm and the T wave duration is increased to 0.25 seconds. What process is disturbed in the patient, causing these changes on the ECG?
Ventricular repolarization
Atrioventricular conduction
Atrial repolarization
Atrial depolarization
Ventricular depolarization
42 із 295
One of the rules of surgery is to make incisions along the so-called Langer's lines (lines of skin tension). What tissue forms the strongest layer of the dermis — the reticular dermis?
Dense irregular connective tissue
Dense regular connective tissue
Epithelial tissue
Reticular connective tissue
Loose fibrous connective tissue
43 із 295
As a result of a stroke (hemorrhage in the brain), the patient cannot perform voluntary movements of the muscles in the head and neck. Brain examination using the NMR imaging revealed that the hematoma was located in the genu of the internal capsule. What conduction pathway is damaged in this patient?
Corticonuclear fibers
Thalamocortical fibers
Frontopontine fibers
Corticospinal fibers
Corticothalamic fibers
44 із 295
High molecular weight proteins were detected in the patient's urine. What is likely to be disturbed in the patient, causing this disorder?
Renal filter permeability
Value of effective filtration pressure
Secretion processes
Renal countercurrent system
Protein reabsorption
45 із 295
The plasma cell produces specific antibodies against a certain antigen. When the antigen is introduced into the body, the number of plasma cells increases. What blood cells increase in number in this case, resulting in increased total number of plasma cells?
B lymphocytes
T lymphocytes
Monocytes
Eosinophils
Basophils
46 із 295
A 72-year-old patient with hypertension was recommended a drug from the group of calcium channel blockers to lower blood pressure. What will be the effect of these drugs on the function of the ventricular myocardium?
Reducing the plateau phase
Increased contractility
Increased repolarization duration
Increased heart rate
There will be no effect
47 із 295
Histological microslide shows a vessel with the wall that consists of endothelium, basement membrane, and loose connective tissue. What type of vessel is it?
Non-muscular vein
Hemocapillary
Artery
Lymphocapillary
Muscular vein
48 із 295
The cytoskeleton of cells consists of microtubules, intermediate filaments, and microfilaments. What protein do microtubules contain?
Tubulin
Globulin
F-actin
Albumin
G-actin
49 із 295
A 42-year-old man died of acute anemia due to pulmonary hemorrhage. An irregularly-shaped round cavity 5–6 cm in size was detected in the second segment of the right lung. The cavity communicates with the bronchial lumen. The inner surface of the cavity is uneven and covered with a flabby, yellowish tissue. Its wall is thin and consists of compacted lung tissue alterations. Histology shows that the inner layer of the cavity consists of molten caseous masses with a large number of segmented leukocytes. What is indicated by the changes detected in the lungs of the deceased man?
Acute cavernous tuberculosis
Lung abscess
Disintegrating pulmonary carcinoma
Bronchoectatic cavern
Pulmonary infarction with septic disintegration
50 із 295
An increase in the circulating blood volume under the influence of aldosterone and antidiuretic hormone leads to the activation of secretion of a certain substance. What substance is it?
Atrial natriuretic peptide
Renin
Angiotensin II
Angiotensinogen
Melatonin
51 із 295
During an exam, the student's absolute pain threshold is higher than when the student is at rest. What system activates in the body, causing this phenomenon?
Antinociceptive system
Pituitary-adrenal system
Sympathoadrenal system
Sympathetic nervous system
Parasympathetic nervous system
52 із 295
A 28-year-old woman's blood test revealed hyperchromia of erythrocytes, megalocytes, and megaloblasts. What type of anemia does the patient have?
B12-folic acid deficiency
Hemolytic
Hypoplastic
Iron deficiency
Posthemorrhagic
53 із 295
A patient has an angina pectoris attack. What myotropic drug with resorptive action can be used to stop the attack?
Nitroglycerin
Anaprilin (Propranolol)
Validol (Menthyl isovalerate)
Nitrosorbide (Isosorbide dinitrate)
Menthol
54 із 295
What changes in the isolated heart can be expected after the introduction of adrenaline into the perfusion solution?
Increase in frequency and strength of contractions
Reduction in contraction strength
Increase in the frequency of cuts
Increase in contraction strength
Cardiac arrest in diastole
55 із 295
A 6-year-old child was diagnosed with a helminthic infestation. What changes in the child's leukogram should be expected in this case?
Increased eosinophil count
Increased lymphocyte count
Increased neutrophil count
Decreased eosinophil count
Increased monocyte count
56 із 295
A 35-year-old woman complains of pain in her joints and numbness of her fingers and toes. During examination, a doctor notes that the patient's face is amimic and has thickened skin. Biopsy of a cutaneous flap was performed for this patient. Histology detects disorganization of dermal connective tissue, mucoid and fibrinoid swelling, and foci of gross sclerosis and hyalinosis. Atrophy of integumental structures, sclerosis of vascular intima, and perivascular sclerosis are observed in the patient.
Systemic scleroderma
Rheumatism
Rheumatoid arthritis
Polyarteritis nodosa
Systemic lupus erythematosus
57 із 295
Material from a patient with a diagnosis of peritonitis was delivered to the bacteriological laboratory. Microscopic examination revealed gram-positive and gram-negative microorganisms. What morphological structure of a bacterial cell determines Gram staining?
Cell wall
Spores
Capsule
Cytoplasm
Flagella
58 із 295
A 30-year-old man was hospitalized with profuse diarrhea lasting for 12 hours. There was no vomiting. What changes can be observed in the patient's water-electrolyte balance and acid-base balance?
Non-gaseous acidosis with dehydration
Gaseous acidosis with dehydration
No changes in blood pH
Gaseous alkalosis with dehydration
Non-gaseous alkalosis with dehydration
59 із 295
A 65-year-old man with liver cirrhosis developed a significant decrease in blood pressure. What mechanism can be the cause of arterial hypotension in this case?
Reduced angiotensinogen synthesis in the liver
Increased urea synthesis in the liver
Reduced synthesis of transport proteins in the liver
Disturbed antitoxic function of the liver
Disturbed production of bile acids in the liver
60 із 295
Oxidation of carbohydrates and lipids produces a large amount of energy, the main portion of which is generated in the process of acetyl-CoA oxidation. How many ATP molecules are formed as a result of complete oxidation of one acetyl-CoA molecule?
12
36
38
8
24
61 із 295
After an intracerebral hemorrhage, the patient's speech became indistinct. Sound production in the larynx and movements of the lower jaw are retained. The nuclei of what nerves have been affected by the hemorrhage in this case?
Nuclei n. hypoglossi
Nuclei n. facialis
Nuclei n. vagi
Nuclei n. glossopharyngeus
Nuclei n. accessorii
62 із 295
A 56-year-old man presents for a checkup. The patient says he has to urinate quite frequently, but denies any dysuria or pain on urination. Past medical history is significant for diabetes mellitus type 2 and hypertension, both managed medically. Current medications are metformin, aspirin, captopril and furosemide. Laboratory findings are significant for the following: Glycated Hemoglobin (Hb A1c) — 8.0%, Fasting Blood Glucose — 12 mmol/L. His doctor decides to add glibenclamide to the therapy. Which of the following is the most likely mechanism of this drug's action?
Stimulation of insulin release
Facilitation of glucose absorption in the intestine
Inhibition of gluconeogenesis
Stimulation of glucose reuptake by the cell
Inhibition of insulin release
63 із 295
Under the action of which enzyme is arachidonic acid (a source of eicosanoid synthesis) released from the phospholipid bilayer of cell membranes?
Phospholipase A₂
Phospholipase C
Lipoxygenases
Phospholipase D
Cyclooxygenases
64 із 295
A 16-year-old girl has no hair on the pubis and in the armpits, her mammary glands are underdeveloped, she has no menstruation. What hormone imbalance is the likely cause of these symptoms?
Ovarian failure
Medulloadrenal hyperfunction
Hypothyroidism
Hyperfunction of pancreatic islet apparatus
Hyperthyroidism
65 із 295
In the experiment, the axons of the neurosecretory cells of the supraoptic nucleus of the hypothalamus were cut in an animal. The accumulation of which hormone will be disrupted in the pituitary gland?
Vasopressin
Lipotropin
Prolactin
Adrenocorticotropin
Somatotropin
66 із 295
Ionizing radiation or vitamin E deficiency affect the cell by increasing lysosome membrane permeability. What are the possible consequences of this pathology?
Partial or complete cell destruction
Restoration of cytoplasmic membrane
Formation of maturation spindle
Intensive energy production
Intensive protein synthesis
67 із 295
During a surgery with administration of an inhalation anesthetic and muscle relaxants, the anesthesiologist noticed a rapid increase in the patient's body temperature that reached 43 °C. What pathology did the patient develop?
Hyperthermic syndrome
Physical hyperthermia
Infection-induced fever
Traumatic shock
Overheating
68 із 295
Autopsy of the body of a 14-year-old child who died of pneumonia revealed the following: multiple punctate and spotty hemorrhages in the skin, mucosa, and serous membranes; an enlarged flaccid spleen that is red on section and yields only a small amount of material when scraped; enlarged pale gray mediastinal and retroperitoneal lymph nodes with a slightly pinkish tint on the cross-section; raspberry-red bone marrow in flat and tubular bones. What disease is indicated by the described changes?
Acute lymphoblastic leukemia
Chronic lymphoid leukemia
Chronic myeloid leukemia
Acute myeloblastic leukemia
Lymphogranulomatosis
69 із 295
A 37-year-old man is admitted to hospital with mental confusion and disorientation. His wife reports he became more irritable and forgetful in the past year. In addition, she notes that he became a vegan a year ago, and currently, his diet consists of starchy foods like potatoes, corn, and leafy vegetables. GI symptoms include anorexia, diarrhea and vomiting. He has glossitis and skin lesions that appear as vesicles over the extremities. Eczema-like lesions around the mouth, as well as desquamation and roughened skin over the hands are also present. Neurologic examination reveals symmetrical hypesthesia for all types of sensation in both upper and lower extremities in a 'glove and stocking' distribution. Deficiency in diet of which of the following amino acids is the most likely cause of this condition?
Tryptophan
Histidine
Arginine
Lysine
Threonine
70 із 295
The molecule of immature mRNA (pro-mRNA) contains more triplets than there are amino acids in the synthesized protein, because translation is normally preceded by:
Processing
Initiation
Repair
Replication
Mutation
71 із 295
A 48-year-old woman diagnosed with sciatica complains of severe pain. From the anamnesis, it is known that she is undergoing treatment for duodenal ulcer. Which selective COX-2 blocker should be prescribed to the patient?
Celecoxib
Aspirin
Diclofenac sodium
Indomethacin
Metamizole sodium
72 із 295
A woman, who complains of a constant feeling of fear and anxiety, has been diagnosed with neurosis and prescribed a drug with an anxiolytic effect. What drug is it?
Diazepam
Aminazine (Chlorpromazine)
Caffeine and sodium benzoate
Piracetam
Ginseng tincture
73 із 295
A child inhaled a button that was later removed from the right main bronchus using a bronchoscope. What bronchial epithelium is most likely to be damaged by such a foreign body?
Ciliated pseudostratified epithelium
Unstratified low prismatic epithelium
Transitional epithelium
Non-keratinized stratified epithelium
Unstratified squamous epithelium
74 із 295
Into what anatomical area does the frontal sinus orifice open through the ethmoid bone?
Middle nasal passage
Choanae
Lower nasal passage
Upper nasal passage
Infratemporal fossa
75 із 295
IgM to the rubella virus have been detected in a pregnant woman. Based on these findings, the obstetrician-gynecologist recommended terminating the pregnancy due to the high probability of teratogenic effects on the fetus. It is important that specifically IgM have been detected, because immunoglobulins of this class:
Are an indicator of recent infection
Can breach the placental barrier
Are the main factor of antiviral protection
Are associated with anaphylactic reactions
Have the largest molecular mass
76 із 295
A 47-year-old woman became blind due to chronic infection with Chlamydia trachomatis. A conjunctival scraping was prepared to detect cytoplasmic inclusions specific for this pathogen. Which of the following methods should be used to stain it?
Romanowski-Giemza
Leffler
Neisser
Gram
Burri-Gins
77 із 295
A 33-year-old woman has hepatocerebral dystrophy (Wilson's disease). Ceruloplasmin levels in her blood are decreased. Amino acid levels are sharply increased in her urine. These changes are primarily caused by the intensification of the following process:
Formation of copper complexes with amino acids
Reamination of amino acids
Gluconeogenesis
Urea synthesis
Breakdown of tissue proteins
78 із 295
A patient diagnosed with epidemic encephalitis has unilateral or bilateral ptosis (drooping eyelid), divergent strabismus, and accommodation disorders. The pupils are dilated. Which pair of cranial nerves are affected?
III
VI
IV
V
VII
79 із 295
During histological examination of autopsy material from a deceased pregnant woman, cells of the squamous epithelium of the embryonic skin, vellus hair, caseous grease, and mucins from the embryonic digestive tract were found in the microcirculatory bed of the lungs. Edema, diffuse damage to the alveoli, and systemic thrombosis with fibrin clots were also detected in the lungs. What type of embolism did the woman develop?
Amniotic
Air
Fat
Gas
Thromboembolism
80 із 295
During local anesthesia the patient has gone into anaphylactic shock. What drug must be administered to the patient?
Epinephrine hydrochloride
Atropine sulfate
Diazepam
Nitroglycerin
Propranolol
81 із 295
During microscopic examination of a preparation prepared from the peripheral area of the lung, a cross-section of a tubular formation was revealed, the wall of which consists of the mucous and adventitious membranes. The surface of the mucous membrane has numerous folds, and the muscular plate is formed by a continuous layer of smooth myocytes. What element of the airways is this?
Small bronchus
Alveolar duct
Large bronchus
Terminal bronchiole
Middle bronchus
82 із 295
Histones are small basic proteins, bound to DNA in chromatin. They contain numerous positively charged amino acid residues, which ensures their strong bond with the acidic groups of DNA. Name the most common amino acids in histones.
Lysine, arginine
Glutamic acid, glutamine
Serine, methionine
Aspartic acid, asparagine
Cystine, cysteine
83 із 295
In a 46-year-old man, laboratory blood tests revealed increased creatine phosphokinase activity. What pathological condition is most likely to have occurred in the patient?
Myocardial infarction
Pulmonary embolism
Kidney failure
Hemolytic anemia
Acute pancreatitis
84 із 295
A 20-year-old female comes to the clinic after missing her last 2 periods. Her cycles are usually regular, occurring at 28-30 day interval with moderate bleeding and some abdominal discomfort. Her doctor reveals loss of vision in the lateral halves of both eyes. Involvement of which of the following structures would you most likely expect to be the reason of bitemporal hemianopsia?
Optic chiasm
Right optic nerve
Left optic tract
Left optic nerve
Right optic tract
85 із 295
Bacteriological analysis of tap water shows the following: total bacterial count in 1.0 mL of water is 80, coli index is 3. What would be the conclusion?
The water is safe for consumption
The water quality is extremely dubious
The water is extremely polluted
The water quality is dubious
The water is polluted
86 із 295
A smear prepared from the duodenal content of a patient with maldigestion contained protozoa 10-18 mcm in size, with pear-shaped body, 4 pairs of flagella, and two symmetrically positioned nuclei in the widened front part of the body. What type of protozoa is the most likely in this case?
Lamblia
Entamoeba coli
Trichomonad
Balantidium
Entamoeba histolytica
87 із 295
A 32-year-old man was admitted to the hospital with an injury to his left hand. During the examination, a cut wound was found in the area of the thumb elevation and difficulty in flexing it. What muscle was damaged?
M. flexor pollicis brevis
M. adductor pollicis brevis
M. opponens pollicis brevis
M. flexor pollicis longus
M. abductor pollicis brevis
88 із 295
A 59-year-old man, a business manager, developed intense burning retrosternal pain with irradiation into 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?
Increased level of blood catecholamines
Intravascular aggregation of blood cells
Functional cardiac overload
Coronary artery thrombosis
Coronary atherosclerosis
89 із 295
A poisoning caused by sulema (mercury dichloride) has occurred at a factory. Two days later, the person, who had suffered from the sulema exposure, developed the 24-hour diuresis of 620 mL, headache, vomiting, convulsions, and dyspnea. What diagnosis can be made in this case?
Acute renal failure
Pyelonephritis
Uremic coma
Glomerulonephritis
Chronic renal failure
90 із 295
A man has an impairment of a certain part of his central nervous system, which manifests as asthenia, muscle dystonia, and a balance disorder. What part of the central nervous system is affected in this case?
Cerebellum
Red nuclei
Substantia nigra
Vestibular nuclei
Reticular formation
91 із 295
A woman came to a medical and genetic consultancy requesting to assess the risk of hemophilia in her children. Her husband has hemophilia. History-taking revealed that the woman's family had no cases of hemophilia. What is the risk of this couple giving birth to a child with this disease?
Absent
100%
50%
25%
75%
92 із 295
A 13-year-old girl was prescribed a drug for the treatment of megaloblastic anemia, which stimulates the transition from megaloblastic to normoblastic hematopoiesis and participates in the synthesis of purine and pyrimidine bases, activates the synthesis of protein and methionine. What drug was prescribed to the patient?
Cyanocobalamin
Hemostimulin
Ferrous sulfate
Erythropoietin
Rosehips
93 із 295
A 28-year-old patient has been hospitalized with complaints of abdominal pain, loose stools, weakness, fatigue, and shortness of breath. The patient has a history of a surgery for acute intestinal obstruction 2 years ago, with resection of 60 cm of the small intestine. At the time of the hospitalization, the patient's blood test results were as follows: erythrocytes - 2.4·10¹²/L, reticulocytes - 0.4%, hemoglobin - 80 g/L, color index - 1.25. The blood smear test detected macroanisocytes, poikilocytes, isolated megaloblasts, what pathology of the blood system can be characterized by such findings?
B₁₂-deficient anemia
Chronic posthemorrhagic anemia
Hypoplastic anemia
Hemolytic anemia
Iron deficient anemia
94 із 295
A newborn delivered at 33 weeks of gestation has a respiratory rate of 70/min and heart rate of 148/min 2 hours after birth. He is grunting and has intercostal and subcostal retractions. He has peripheral cyanosis as well. An immediate chest radiograph is taken which shows a fine reticular granulation on both lungs distress syndrome due to surfactant deficiency. Which of the following is the most likely mechanism of these clinical and imaging findings?
Tendency of alveoli to collapse
Decreased respiratory muscle work
Increased lung ventilation
—
Decreased airways resistance
95 із 295
During the surgery on the small intestine the surgeon revealed an area of the mucous membrane with a single longitudinal fold among the circular folds. Which portion of the small intestine is this structure typical for?
Descending part of the duodenum
Jejunum
Ascending part of the duodenum
Distal ileum
Pars horizontalis duodeni
96 із 295
A 60-year-old man with a history of hypertension, diabetes and hyperlipidemia had a sudden onset of right-sided weakness. By the time the ambulance arrived, he had difficulty speaking. Unfortunately, the patient died within the next 2 hours and an autopsy was performed immediately. The gross examination of the cerebral left hemisphere showed brain swelling, widened gyri and poorly demarcated gray-white junction. Which of the following is the most likely cause of this patient's death?
Ischemic stroke
Tumor
Intracerebral hemorrhage
Abscess
Cyst
97 із 295
Pathologies of lipid metabolism include sphingolipidoses that can be characterized by the accumulation of excess phospholipids and sphingolipids, mainly in the nervous tissue. What disease is associated with accumulation of GM₂ ganglioside in the body?
Tay-Sachs disease
Niemann-Pick disease
Krabbe disease
Fabry disease
Gaucher disease
98 із 295
A 40-year-old prisoner died of tuberculosis. Autopsy of the body revealed deformation and diminishing of both lung apices; in the both upper lobes there are multiple cavities with dense walls 2-3 mm thick; in the lower lung lobes there are disseminated foci of caseous necrosis varying from 5 mm to 2 cm in diameter. Diagnose the type of tuberculosis:
Secondary fibro-cavitary tuberculosis
Hematogenous macrofocal pulmonary tuberculosis
Primary tuberculosis, primary affect development
Secondary cirrhotic tuberculosis
Secondary fibrous-focal tuberculosis
99 із 295
A man died after a surgery for the perforation of the colon wall with signs of diffuse purulent peritonitis. Autopsy shows that the mucosa of the colon wall is thickened, covered in a fibrinous membrane, and has isolated ulcers that penetrate it to varying depths. Histology detects mucosal necrosis, the presence of fibrin, and leukocyte infiltration with hemorrhagic foci. What disease developed a complication in this case, causing the death of this man?
Dysentery
Nonspecific ulcerative colitis
Typhoid fever
Amoebiasis
Crohn's disease
100 із 295
The father and mother are healthy. Amniocentesis detects that the karyotype of the fetus is 45, X0. Make the diagnosis.
Turner syndrome
Trisomy X
Edwards syndrome
Cri-du-chat syndrome
Patau syndrome
101 із 295
A patient with frequent hemorrhages from the internal organs and mucous membranes has proline and lysine in the composition of collagen fibers. Their hydroxylation is impaired because of the following vitamin deficiency:
Vitamin C
Thiamine
Vitamin E
Vitamin K
Vitamin A
102 із 295
Five hours after eating seafood, a 22-year-old woman developed small itchy papules on the skin of her torso and distal parts of her limbs. The papules were partially merging with each other. 24 hours later, the rash spontaneously disappeared. What mechanism of hypersensitivity underlies these changes?
Atopy (local anaphylaxis)
Cell-mediated cytotoxicity
Antibody-dependent cell-mediated cytolysis
Systemic anaphylaxis
Immune complex-mediated hypersensitivity
103 із 295
A 24-year-old male decided to run a marathon after being untrained for a long period. The next day he visits his doctor with a chief complaint of severe pain in his thighs and shins. Which of the following is the most likely cause of this condition?
Lactic acid accumulation in the muscles
—
Creatinine accumulation in the muscles
Muscle proteins breakdown
Adenosine diphosphate accumulation in the muscles
104 із 295
What function do goblet cells of the single-layered multi-row ciliated epithelium of the bronchi perform?
Glandular
Reference
Suction
Short-lived
Exchange
105 із 295
Echo-planar imaging is a technique that uses gamma rays for MRI scans.
False
—
Not given
True
106 із 295
During the ascent into the mountains, a climber at an altitude of 6000 meters above sea level developed euphoria, inadequate assessment of the situation, and hallucinations. What is the leading cause in the development of these signs of mountain sickness?
Reduced partial pressure of oxygen in the air
Snow ophthalmia
Decreased atmospheric pressure
Air expansion in the frontal sinuses
Physical exertion
107 із 295
What is the mechanism of development of the analgesic effect of a narcotic analgesic?
Activation of opiate receptors
Inhibition of cholinergic receptors
Inhibition of histamine receptors
Activation of D₂ dopamine receptors
Inhibition of serotonin receptors
108 із 295
A patient with chronic heart failure developed signs of pulmonary edema. What diuretic must be prescribed to the patient for rapid correction of this complication?
Furosemide
Triamzid
Spironolactone
Clopamide
Diacarb (Acetazolamide)
109 із 295
During a pathological childbirth, separation of the pubic bones occurred in the woman. What type of bone junction was damaged in this case?
Symphysis
Syndesmosis
Synostosis
Diarthrosis
Synchondrosis
110 із 295
A 63-year-old man, who has been suffering from chronic fibrous-cavernous pulmonary tuberculosis for 24 years, has been delivered to a nephrology department with uremia. Intravital diagnostic test for amyloid in the kidneys was positive. What amyloidosis is it in this case?
Secondary systemic
Hereditary (genetic)
Primary systemic
Localized (focal)
Senile
111 із 295
A person with a head injury in the temporal region has been diagnosed with an epidural hematoma. What artery is most likely to be damaged in this case?
Middle meningeal artery
Anterior meningeal artery
Middle cerebral artery
Posterior auricular artery
Superficial temporal artery
112 із 295
A woman was hospitalized because of posterior wall myocardial infarction in the left ventricle. In this case, the circulation will be impaired in the following artery:
Posterior interventricular artery
Anterior interventricular artery
Left coronary artery
Thebesian vessels
Left circumflex artery
113 із 295
A patient is diagnosed with acute morphine hydrochloride intoxication. Prescribe an oxidizing agent for gastric lavage:
Potassium permanganate
Chlorhexidine (bi)gluconate
Sulfocamphocainum (Procaine + Sulfocamphoric acid)
Cerigel
Chloramine
114 із 295
During the healing of a wound, a scar made of connective tissue develops in the area of the tissue defect. What cells cause this process?
Fibroblasts
Melanocytes
Macrophages
Mast cells
Fibrocytes
115 із 295
A 35-year-old woman has come to her physician with a chief complaint of elevated blood pressure up to 180/100 mm Hg. She currently does not take any medication. During the physical examination, her blood pressure is 140/80 mm Hg and temperature is 36.8°C. She has a 'moon face', centripetal obesity, and striae on the skin with atrophy over the abdomen and thighs. Which of the following is the most likely cause of this patient's condition?
Cortisol-secreting adrenal adenoma
Pancreatic islet cells hyperfunction
Hypothyroidism
Hyperthyroidism
Ovarian insufficiency
116 із 295
Large cells containing numerous lysosomes, many nuclei, and a corrugated zone were found in the bone tissue. What are these cells called?
Osteoclasts
Semi-stem osteogenic cells
Osteocytes
Osteoblasts
Mesenchymal cells
117 із 295
During the lunch, a person ate salted herring and potatoes with pickles. After a while, this person became thirsty. This sensation has been caused by impulse from certain receptors. Name these receptors.
Osmoreceptors in the hypothalamus
Osmoreceptors in the liver
Volume receptors in the hypothalamus
Baroreceptors in the aortic arch
Volume receptors in the vena cava and atria
118 із 295
A patient has been fasting for 48 hours. What substances are used by muscle tissue as energy sources under these conditions?
Ketone bodies
Lactate
Amino acids
Glycerin
Pyruvate
119 із 295
Helicobacter pylori was detected in a patient with peptic ulcer disease of the stomach. What drug should be used in this case?
Metronidazole
Biseptol (Co-trimoxazole)
Levomycetin (Chloramphenicol)
Enteroseptol (Clioquinol)
Sulfadimethoxine
120 із 295
A patient presents with a disturbed process of urea synthesis. It indicates the pathology of the following organ:
Liver
Muscles
Brain
Kidneys
Bladder
121 із 295
Which group of organisms has nucleoids — circular DNA molecules that form chromosomes of simple structure (histones are absent)?
Bacteria
Viruses
Bacteriophages
The simplest
Mushrooms
122 із 295
A microslide demonstrates an organ with its wall consisting of three layers. The inner layer has tubular glands and undergoes cyclic changes. Name this organ:
Uterus
Urinary bladder
Ureter
Vagina
Esophagus
123 із 295
A 56-year-old woman complains of pain in the small joints of her hands and feet. She has been experiencing these symptoms for the last 12 years. Examination of her hands detects a subluxation of the metacarpophalangeal joints with fingers bent outwards ('walrus flippers'). There are high molecular weight immune complexes in the patient's blood. What diagnosis can be made in this case?
Rheumatoid arthritis
Gouty arthritis
Rheumatic polyarthritis
Systemic lupus erythematosus
Dermatomyositis
124 із 295
A patient with chronic bronchitis was prescribed a drug with mucolytic action. Name this drug:
Ambroxol
Atropine sulfate
Magnesium sulfate
Paracetamol
Anaprilin (Propranolol)
125 із 295
What eye function is impaired in case of damage to the ciliary body?
Accommodation
Protective
Photosensitive
Fiberglass
Trophic
126 із 295
Infectious diseases are treated with antibiotics (streptomycin, erythromycin, chloramphenicol). They inhibit the following stage of protein synthesis:
Translation
Splicing
Transcription
Processing
Replication
127 із 295
As a result of industrial exposure to chromium compounds, a woman has developed allergic dermatitis on both her hands. What skin cells are mainly involved in the manifestation of this disease?
Tissue basophils
Plasma cells
Macrophages
Lymphocytes
Neutrophils
128 із 295
In an experiment on an animal, the removal of a section of the cerebral cortex erased the previously developed conditioned reflexes in response to light stimulation. What section of the cortex was removed?
Occipital cortex
Precentral gyrus
Limbic cortex
Postcentral gyrus
Temporal lobe
129 із 295
In a patient with diabetes mellitus, regeneration processes are reduced and wounds do not heal for a long time. What metabolic changes cause this condition in the patient?
Inhibition of protein synthesis
Acidosis
Accumulation of ketone bodies
Reduced glucose supply to the cells
Lipid metabolism disorder
130 із 295
After delivery of a child by a pregnant woman, the midwife notices a defect in external genitalia of a newborn. The woman only had one prenatal ultrasound that reported a male fetus. On physical examination, the neonatologists notice a short, broad penis with an orifice in its dorsal aspect, both testicles are present in the scrotum. Which of the following is the most likely congenital abnormality?
Epispadias
Ovotesticular disorder of sex development
Phimosis
Hypospadias
Paraphimosis
131 із 295
Examination of a patient with a hearing impairment shows that the pathological process is localized at the level of the lateral lemniscus formation. At what level does it normally form in the brain?
Metencephalon (pons)
Thoracic spinal cord
Mesencephalon
Cervical spinal cord
Medulla oblongata
132 із 295
A 55-year-old woman has mitral valve insufficiency and had myocarditis 10 years ago. Currently she has no complaints. Her hemodynamics is within the normal range. What general nosology concept corresponds with this situation?
Pathological condition
Compensatory reaction
Pathological process
Typical pathological process
Pathological reaction
133 із 295
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
Extinctive
Persistent
Differential
134 із 295
Brain MRI shows a local dilation (aneurysm) of an artery in the lateral sulcus. What vessel has pathological changes in this case?
A. cerebri media
A. communicans anterior
A. communicans posterior
A. cerebri anterior
A. cerebri posterior
135 із 295
A large number of glucose oxidation metabolites are dissolved in the cytoplasm of myocytes. What metabolite can be directly converted into lactate?
Pyruvate
Fructose-6-phosphate
Oxaloacetate
Glucose-6-phosphate
Glycerophosphate
136 із 295
Deficiency of which blood clotting factor causes hemophilia B?
IX
VII
VIII
XI
V
137 із 295
In the body of a 37-year-old woman, who died with signs of pulmonary edema, there was detected an acute deformation of the aortic valve: it is shortened, thickened, has areas of stone-like density. On its external surface there are large, up to 2 cm in diameter, polypous thrombi. The left ventricle wall is dull and flaccid. What type of endocarditis corresponds with the described changes in the aortic valve?
Ulcerative polypoid endocarditis
Recurrent verrucous endocarditis
Acute verrucous endocarditis
Diffuse endocarditis
Fibroplastic endocarditis
138 із 295
A 45-year-old woman developed a pigmented nodule on her facial skin. Microscopically, the biopsy revealed fields of spindle-shaped and polymorphic cells containing brown pigment, with a large number of mitoses. What pathological condition did the patient have?
Melanoma
Cancer
Dermatofibroma
Pigmented nevus
Papilloma
139 із 295
A 39-year-old man comes to the doctor with complaints of chest pain and cough with occasional blood-streaked sputum. He does not have increased temperature or night sweating and his history is insignificant for smoking or alcohol abuse. However, he mentions visiting a relative who owns a sheep farm. Radiographic examination shows a cyst in the left lower lobe, and the serological test is positive. Which of the following organisms is the most likely cause of this patient's condition?
Echinococcus
Dwarf tapeworm
Pork tapeworm
Fish tapeworm
Liver fluke
140 із 295
What complication will arise in a patient diagnosed with liver cirrhosis and a significant decrease in serum albumin and globulin levels?
Swelling
Hemorrhagic syndrome
Encephalopathy
Aminoacids
Anemia
141 із 295
A 45-year-old woman comes to her physician with complaints of excessive fatigue and weakness. She says that these symptoms have been present for the past month. On further questioning, she admits having lost 3 kilograms in the last 2 weeks. On physical examination, she is a tired-appearing thin woman. Hyperpigmentation is present over many areas of her body, most prominently over the face, neck and back of hands (areas exposed to light). Increased production of which of the following hormones is the most likely cause of hyperpigmentation in this patient?
Melanocyte-stimulating hormone (MSH)
Thyroid-stimulating hormone (TSH)
Gonadotropins
Growth hormone (GH)
β-Lipotropin
142 із 295
A 70-year-old man has suffered a femoral fracture as a result of a fall. What is the most common fracture site in this bone at this age?
Neck
Middle part
Upper third
Lower third
Condyles
143 із 295
What is the form of acid-base imbalance in patients with accumulation of ketone bodies in the blood serum?
Metabolic acidosis
Respiratory acidosis
Metabolic alkalosis
Mixed alkalosis
Respiratory alkalosis
144 із 295
The cardiology department has received a patient with complaints of tachycardia, shortness of breath, and cyanotic mucosa. Examination detects leg edemas and ascites. What drug must be prescribed to the patient in this case?
Corglycon (Convallaria glycosides)
Cordiamine (Nikethamide)
Digitoxin
No-spa (Drotaverine)
Adrenaline hydrochloride
145 із 295
A patient was hospitalized with the following diagnosis: exacerbated peptic ulcer disease of the duodenum, duodenal bulb ulcer. Gastric juice analysis shows high secretory and acid-producing function of the stomach. What drug inhibits the secretory function of the gastric glands by blocking H₂ receptors?
Famotidine
Belladonna dry extract
Methacin
Platyphyllin
Atropine
146 із 295
A patient with liver cirrhosis has persistent arterial hypotension (blood pressure — 90/50 mm Hg). What causes the decrease in blood pressure in such a liver pathology?
Decreased angiotensinogen synthesis
Activation of the kinin-kallikrein system
Excessive vasopressin inactivation
Increased natriuretic hormone synthesis
Increased reflex effect of the receptor zone in the aortic arch
147 із 295
A 10-year-old child has painful swallowing, neck edema, temperature rise up to 39.0°C, 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 grayish-colored necrosis. What is the most likely diagnosis?
Scarlet fever
Measles
Meningococcal nasopharyngitis
Influenza
Diphtheria
148 із 295
A 37-year-old woman presents to the emergency department complaining of palpitations, dry cough, and shortness of breath. She is a nonsmoker. Her blood pressure 100/65 mm Hg, pulse — 76/min., respiratory rate — 23/min. Her physical exam is significant for bibasilar lung crackles and a low-pitched, mid-diastolic rumbling murmur best heard at the apical region without radiation. She has jugular vein distention and bilateral pitting edema. Despite considerable efforts in the emergency department, she dies from sudden cardiac death at night. The patient's heart shows a mitral stenosis. Histologic examination reveals increased connective tissue in the myocardium and Ashoff-Talalaev's granulomas. Which of the following is the most likely diagnosis?
Rheumatic heart disease
Polyarteritis nodosa
Systemic scleroderma
Systemic lupus erythematosus
Dermatomyositis
149 із 295
When the stimulation frequency of an isolated heart of a rabbit increases, incomplete relaxation of the ventricles of the heart can be observed because of:
Accumulation of calcium in cardiomyocytes
Increased potassium levels in the interstitium
Increased potassium levels in cardiomyocytes
Increased sodium levels in cardiomyocytes
Inhibition of the sodium–potassium pump
150 із 295
A geneticist examined a pregnant woman and determined that she has monozygotic twins. What process has resulted in the development of twins?
Polyembryony
Fragmentation
Budding
Schizogony
Endogony
151 із 295
A woman complains of leg edema, cyanotic skin, and small ulcers on the side of the lateral malleolus. Examination detects swelling, enlarged veins, and formation of nodes. What vein is involved in the pathology in this case?
V. saphena parva
V. profunda femoris
V. saphena magna
V. femoralis
V. jugularis externa
152 із 295
A patient with acute appendicitis has been hospitalized into the surgical department. An appendectomy under local anesthesia was initially recommended to the patient. However, it was later discovered that the patient had a history of frequent allergic reactions to medicines. Select from the list the drug that would be the optimal choice for infiltration anesthesia in this case.
Xylocaine (Lidocaine)
Novocaine (Procaine)
Anesthesine (Benzocaine)
Cocaine
Dicaine (Tetracaine)
153 із 295
A 14-year old girl presents to the emergency department for evaluation. She states there is no history of trauma but mentions she had a history of sickle cell disease. On physical examination, her upper part of right shin is very painful, red, swollen and hot. Her temperature is 39.2°C. An X-ray shows focal bony lysis and loss of trabecular architecture metaphysis of right tibia. Increased activity of which of the following cells is the most likely cause of bone reabsorption in this patient?
Osteoclasts
Chondroblasts
Chondrocytes
Osteocytes
Osteoblasts
154 із 295
RNA of human immunodeficiency virus (HIV) has penetrated the leukocyte and stimulated the cell to synthesize viral DNA using the revertase enzyme. Name this process:
Reverse transcription
Reverse translation
Operon depression
Convariant replication
Operon repression
155 із 295
A histological specimen of an eyeball shows a biconvex structure, connected to the ciliary body with the fibrous strands of the ciliary zonule and covered on top with a transparent capsule. What structure is it?
Crystalline lens
Cornea
Vitreous body
Ciliary body
Sclera
156 із 295
At the post-mortem examination, the stomach of a patient with renal failure was found to have a yellow-brown coating on the thickened mucosa. The coating was firmly adhering to its surface and had significant thickness. Microscopy revealed congestion and necrosis of mucosal and submucosal layers. What is the most likely diagnosis?
Fibrinous gastritis
Croupous gastritis
Gastric abscess
Esogastritis
Corrosive gastritis
157 із 295
A patient at the oncology department has undergone radiation therapy. After that, morphology detected a significant disruption in the process of regeneration of the epithelial layer in the small intestine mucosa. What cells of the epithelial membrane are damaged in this case?
Columnar epitheliocytes without a brush border, located in the crypts
Exocrinocytes with acidophilic granulation (Paneth cells)
Columnar epitheliocytes with a brush border
Goblet exocrinocytes
Endocrine cells
158 із 295
After a hemorrhage into the left hemisphere of the brain, the patient has lost the ability to speak. In this case, thrombosis occurred in the basin of:
Middle cerebral artery
Anterior communicating artery
Posterior communicating artery
Posterior cerebral artery
Anterior cerebral artery
159 із 295
A 48-year-old woman has been diagnosed with Raynaud syndrome (a spasm of peripheral blood vessels) and prescribed an adrenotropic agent. What group does this drug belong to?
Alpha-blockers
Alpha/beta-adrenergic agonists
Beta-2-blockers
Beta-1-adrenergic agonists
Beta-1-blockers
160 із 295
A patient with pleurisy has a foul-smelling fluid, containing biogenic amines and gases, in the pleural cavity. What type of inflammation is observed in this case?
Putrefactive
Fibrinous
Purulent
Catarrhal
Alternative
161 із 295
A patient with signs of jaundice has been hospitalized into the surgical department. Normally, bile does not enter the blood stream from the bile capillaries. What ultrastructural features of the hepatocyte structure contribute to this phenomenon?
Close contacts between hepatocytes
Microvilli on the surface of the capillaries
Polygonal shape of hepatocytes
No proper wall in bile capillaries
Biliary surface in hepatocytes
162 із 295
Autopsy of the body of a 72-year-old woman with rheumatoid arthritis, who died of uremia, revealed enlarged dense pale gray kidneys with shiny sebaceous surface on section. What pathology can be suspected, based on the revealed changes?
Renal amyloidosis
Chronic glomerulonephritis
Contracted granular kidneys
Chronic pyelonephritis
Atherosclerotic nephrosclerosis
163 із 295
Elevated blood homocysteine is a risk factor for cardiovascular pathology. This amino acid is formed in the body from:
Methionine
Alanine
Cysteine
Cystine
Folic acid
164 із 295
A 35-year-old woman has come to her physician with chief complaint of elevated blood pressure up to 180/100 mm Hg. She currently does not take any medication. During the physical examination, her blood pressure is 140/80 mm Hg, heart rate is 65/min. and temperature is 36.8°C. She has a 'moon face', hirsutism, centripetal obesity, and striae on the skin with atrophy over the abdomen and thighs. Which of the following is the most likely cause of this patient's condition?
Cortisol-secreting adrenal adenoma
Pancreatic islet cells hyperfunction
Hypothyroidism
Ovarian insufficiency
Hyperthyroidism
165 із 295
An 18-year-old girl comes to her physician with concern about her health because she has not achieved menarche. She denies any significant weight loss, changes in mood, or changes in her appetite. She mentions that her mother told her about mild birth defects. Past medical history and family history are benign. On physical examination, the patient is short in stature and webbed neck and wide chest. Staining of buccal smear reveals absence of Barr bodies in the nucleus of epithelial cells. Which of the following genetic disorders is the most likely cause of this patient's condition?
Turner syndrome
Patau syndrome
Cri du chat (cat cry) syndrome
Klinefelter syndrome
Edwards syndrome
166 із 295
X-ray of the skull base bones revealed enlarged sella turcica cavity, thinned out anterior clinoid processes, and destruction of various sella turcica regions. This type of bone destruction can be caused by a tumor of the following endocrine gland:
Hypophysis
Thymus
Epiphysis
Adrenal glands
Thyroid
167 із 295
Zoliclons (monoclonal antibodies) were used to determine the person's blood group according to the ABO system. Erythrocyte agglutination did not occur with any of the zoliclons. What blood type does this person have?
0 (I)
B (III)
---
A (II)
AB (IV)
168 із 295
During smoking, cigarette smoke exits out of the patient's auricle. What structure of the auditory organ is damaged?
Tympanic membrane
Membranous labyrinth
External acoustic meatus
Organ of Corti
Bone labyrinth
169 із 295
A man has convergent strabismus. What muscle of the eyeball is damaged in this case?
Lateral rectus muscle of the eye
Superior oblique muscle of the eye
Medial rectus muscle of the eye
Superior rectus muscle of the eye
Inferior rectus muscle of the eye
170 із 295
The patient's systolic blood pressure is 90 mm Hg, diastolic - 70 mm Hg. Such systolic blood pressure is caused by the decrease of the following factor:
Pumping ability of the left heart
Total peripheral resistance
Pumping ability of the right heart
Vascular tone
Aortic compliance
171 із 295
A patient with scurvy presents with disturbed processes of proline and lysine hydroxylation in the collagen. What biochemical process is inhibited in this case, causing this disorder?
Microsomal oxidation
Peroxidase oxidation of fats
Oxidative phosphorylation
Tissue respiration
Lipid peroxidation
172 із 295
A patient suffers from acute cardiopulmonary failure with pulmonary edema. What diuretic should be prescribed in the given case?
Furosemide
Spironolactone
Hydrochlorothiazide (Dichlothiazidum)
Acetazolamide (Diacarb)
Triamterene
173 із 295
It has been found out that one of the pesticide components is sodium arsenate that blocks lipoic acid. Which enzyme activity is impaired by this pesticide?
Pyruvate dehydrogenase complex
Microsomal oxidation
Glutathione reductase
Methemoglobin reductase
Glutathione peroxidase
174 із 295
After starting treatment for pulmonary tuberculosis, the patient consulted a doctor with complaints of red tears and urine. What drug caused these changes?
Rifampicin
Biseptol-480
Benzylpenicillin sodium salt
Cefazolin
Benzylpenicillin potassium salt
175 із 295
Examination of a patient revealed a reduced immunoglobulin count. What cells of the patient's immune system are likely to have an impaired function, causing this condition?
Plasma cells
Plasmablasts
T-killers
T-helpers
T-suppressors
176 із 295
A blood smear of an allergic person contains a large number of round cells with a segmented nucleus and large bright pink granules in the cytoplasm. Name these blood cells.
Eosinophilic granulocytes
Neutrophilic granulocytes
Lymphocytes
Erythrocytes
Basophilic granulocytes
177 із 295
Blood testing of a patient with jaundice revealed an increase in total bilirubin due to its indirect fraction. Patient's urine and feces have a saturated color. What is the most likely mechanism of these disorders?
Increased hemolysis of erythrocytes
Disturbed urobilinogen conversion in the liver
Damaged liver parenchyma
Impaired bile outflow from the liver
Disturbed formation of direct bilirubin
178 із 295
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?
Terminal line
Curved line
Crescent line
Transverse line
Inguinal line
179 із 295
A blood drop has been put into a test tube with 0.3% solution of NaCl. What will happen to erythrocytes?
Osmotic haemolysis
No changes will be observed
Shrinkage
Mechanical haemolysis
Biological haemolysis
180 із 295
After a cholecystectomy, the processes of Ca²⁺ absorption through the intestinal wall became impaired in the patient. What vitamin must be prescribed to stimulate this process?
Vitamin D3
Vitamin A
Vitamin K
Vitamin B12
Vitamin C
181 із 295
Six hours have passed since the development of an acute myocardial infarction in the patient. During autopsy of the body, staining was used to identify the area of infarction. What was used to detect the area of necrosis?
Tetrazolium salts
Methyl violet
Congo red
Picrofuchsin
Toluidine blue
182 із 295
Due to blood loss the circulating blood volume of a patient decreased. How will it affect the blood pressure in this patient?
Systolic and diastolic pressure will decrease
Only systolic pressure will decrease
Systolic pressure will decrease, while diastolic will increase
Diastolic pressure will decrease, while systolic will increase
Only diastolic pressure will decrease
183 із 295
The key reaction of fatty acid synthesis is production of malonyl-CoA. What metabolite is the source of malonyl-CoA synthesis?
Acetyl-CoA
Succinyl-CoA
Acyl-CoA
Citrate
Malonate
184 із 295
A 25-year-old man presents to his physician with a 1-week history of fever, sore throat, nausea, and fatigue. His vital signs include: temperature - 38.5°C, pulse - 72/min., blood pressure - 120/70 mm Hg, and respiratory rate - 17/min. On physical examination, he has bilateral posterior cervical lymphadenopathy, exudates over the palatine tonsil walls with soft palate petechiae, an erythematous macular rash on the trunk and arms. This patient most likely has infectious mononucleosis. Which of the following would be the most appropriate diagnostic laboratory test?
Positive serum IgM antibodies for Epstein-Barr virus
A 4-fold increase in anti-EBV titers
A detection of Cytomegalovirus (CMV) antibodies
Herpes simplex virus isolation
Positive serum IgM antibodies for Herpes simplex virus
185 із 295
Acute herpetic gingivostomatitis is the most common primary infection caused by herpes simplex virus, type 1. What material should a dentist obtain for the laboratory analysis to confirm this diagnosis?
Fluid from the vesicles
Urine
Blood
Sputum
Saliva
186 із 295
Diphtheria toxin is a potent inhibitor of protein synthesis in eukaryotes. What is its molecular mechanism of action?
Irreversible modification of an elongation factor
Protein kinase phosphorylation
Dephosphorylation of the termination factor
Protein kinase inhibition
Inactivation of the initiation factor
187 із 295
With the development of anaphylactic reactions, pronounced hyperemia, swelling of the mucous membranes, and pain are observed. What mediator of anaphylaxis determines the development of the above-mentioned disorders?
Histamine
Complement proteins
Chemotaxis factors
Platelet activation factor
Heparin
188 із 295
Transcription is the reaction of mRNA matrix synthesis on DNA matrix. Name the stages of transcription.
Initiation, elongation, termination
Initiation, elongation, translation
Initiation, processing, splicing
Processing, splicing, termination
Initiation, translation, elongation
189 із 295
During the first year of life, children easily develop seizures that can be associated with incomplete myelination of nerve fibers. What neuroglial cells are associated with this condition the most?
Oligodendrocytes
Protoplasmic astrocytes
Microglial cells
Fibrous astrocytes
Ependymocytes
190 із 295
During an ultrasound examination of the heart, the doctor observes the semilunar valves. What happens to them during ventricular diastole?
They are thickened, closing the lumen of the vessels
Press against the walls of the ventricle
Turn into the cavities of blood vessels
Turn into the cavities of the ventricles
Pressed against the walls of blood vessels
191 із 295
Autopsy shows clinical presentation of diffuse osteoporosis with foci of bone tissue destruction. In the bone marrow, proliferation of atypical plasma cells can be observed. Bence Jones protein is detected in urine. What diagnosis can be made in this case?
Multiple myeloma
Bekhterev disease (ankylosing spondylitis)
Osteodystrophy
Lymphogranulomatosis
Osteoporosis
192 із 295
S. aureus can cause various infections - from purulent complications of wounds to pneumonia and sepsis. Why is penicillin therapy of staphylococcal infections not very effective?
Penicillinase production by S. aureus
Acetylase production by S. aureus
Penicillin's inability to penetrate the membrane of S. aureus
No penicillin receptors in the cell envelope of S. aureus
Allergic response to staphylococcal proteins
193 із 295
The tonsils of a 4-year-old child are enlarged, hyperemic, and covered with non-removable whitish membranes. What type of inflammation characterizes the changes in the child's tonsils?
Fibrinous inflammation (diphtheritic)
Fibrioid necrosis
Fibrinous inflammation (croupous)
Purulent inflammation
Caseous necrosis
194 із 295
A patient with suspected dysentery was admitted to the infectious diseases department. What diagnostic method can confirm this diagnosis?
Bacteriological method
Serological method
Microscopy
Allergy testing
Biological method
195 із 295
During a surgery for a splenic injury, the surgeon must identify the artery that supplies the spleen with blood. This artery is a branch of:
Celiac trunk
A. gastroduodenalis
A. hepatica propria
A. left gastric
A. hepatica communis
196 із 295
A group of researchers aimed to study cardiac physiology found that overstretching of atria in the heart leads to decreased sodium reabsorption in the distal convoluted tubule and increase in glomerular filtration rate. Which of the following is the most likely cause of physiological effects discovered by researchers?
Natriuretic peptide
Antidiuretic hormone
Aldosterone
Renin
Angiotensin
197 із 295
An 8-year-old child with an incised wound on the sole of the right foot has been brought to the hospital. Deep wound with dissection of the tendon of a muscle on the plantar surface, closer to the lateral edge of the foot, was detected during the surgical treatment. The patient presents with limited elevation of the lateral edge of the foot. What muscle is most likely functionally impaired in this case?
M. peroneus longus
M. extensor digitorum longus
M. tibialis anterior
M. triceps surae
M. quadriceps femoris
198 із 295
What will be observed in a 23-year-old man with untreated type 1 diabetes mellitus?
Acidosis, hyperkalemia
Alkalosis, hyperkalemia
Acidosis, hypokalemia
Acidosis, normokalemia
Alkalosis, hypokalemia
199 із 295
Liver diseases with insufficient bile supply to the intestine lead to worsening of hemocoagulation. How can this phenomenon be explained?
Vitamin K deficiency
Erythropenia
Iron deficiency
Leukopenia
Thrombocytopenia
200 із 295
A 29-year-old woman has a fever of 38.3°C and intense pain in her lower abdomen, observed for the last several days. What substances mediate the synaptic transmission between the pain fibers that go from the pelvic organs and spinal cord neurons?
Glutamate, substance P
Acetylcholine, nitrogen monoxide
Serotonin, vasoactive intestinal polypeptide (VIP)
Endorphins, GABA
Noradrenaline, ATP
201 із 295
A patient complains of solar radiation intolerance. He has burns on his skin and vision loss. He was provisionally diagnosed with albinism. What amino acid metabolism is disturbed in this patient?
Tyrosine
Proline
Alanine
Tryptophan
Lysine
202 із 295
In an experiment, despiralization of the DNA molecule was disrupted in an animal cell. What processes will primarily stop occurring in this cell?
Transcription
Repair
Termination
Translation
Processing
203 із 295
A 50-year-old man suddenly developed intense palpitations, pain in the heart, acute weakness, increased blood pressure, and an irregular pulse with pulse deficit. ECG shows f-waves instead of a P wave; RR intervals are irregular. What heart rhythm disorder is observed in the patient?
Ciliary arrhythmia
Paroxysmal tachycardia
Respiratory sinus arrhythmia
Transverse heart block
Sinus extrasystole
204 із 295
In the 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 Cl⁻
Ca²⁺ and Cl⁻
Ca²⁺
K⁺ and Na⁺
205 із 295
A 56-year-old woman is rushed to the emergency department with sudden onset of severe chest pain radiating to her left arm and jaw. She has a history of periodic chest pain for which she uses nitroglycerine sublingually, but today her medication did not relieve the pain. Her blood pressure is 140/100 mm Hg, pulse - 130/min., respiratory rate - 18/min., temperature - 37°C. A bedside electrocardiogram shows ST-segment elevation in leads II, III, and aVF. Blood is drawn and sent to the lab, which is positive for specific biomarker inferior myocardial infarction is made, and the patient is sent to the catheterization lab for angioplasty with stent placement. Which of the following is the most likely specific and sensitive biomarker of cardiac injury?
Troponin (cTn) I or T
Alanine aminopeptidase (AAP)
Lactate dehydrogenase 5 (LDH-5)
Lactate dehydrogenase 4 (LDH-4)
Alanine aminotransferase (ALAT)
206 із 295
Monoamine oxidase inhibitors are widely used as psychotropic drugs. In the synapses, they change the levels of all the neurotransmitters listed below, except:
Acetylcholine
Adrenaline
Serotonin
Dopamine
Noradrenaline
207 із 295
A 45-year-old woman has an attack of atrial fibrillation. She suffers from stage II essential hypertension. What is the drug of choice for stopping this attack?
Anaprilin (Propranolol)
Potassium chloride
Sustac forte (Nitroglycerin)
Strophanthine
Lidocaine
208 із 295
A patient has been diagnosed with myocardial infarction of the posterior wall of the left ventricle. In this case, thrombosis has occurred in the basin of the following artery:
Posterior interventricular branch of the right coronary artery
-
Posterior septal branch of right coronary artery
Anterior septal branch of the left coronary artery
Anterior interventricular branch of the right coronary artery
209 із 295
A 75-year-old man was diagnosed with rectal cancer. Into what regional lymph nodes can the metastases spread in this case?
Into the inferior mesenteric lymph nodes
Into the perivesical lymph nodes
Into the superior mesenteric lymph nodes
Into the thoracic lymphatic duct
Into the lumbar lymph nodes
210 із 295
The parents with normal hearing have two daughters and a son, who are congenitally deaf. Their other 5 children are healthy. What is the pattern of deafness inheritance in this case?
Autosomal recessive
X-linked recessive
Autosomal dominant
X-linked dominant
Y-linked
211 із 295
What diagnostic method should be used in industry to test the raw leather for presence of Bacillus anthracis?
Ascoli's thermoprecipitation test
Microscopy with Burry-Gins stain
Serological test
Bacteriological analysis
Microscopy with Aujeszky stain
212 із 295
An adult man has a 24-hour urine output of 20 liters with low specific gravity. This condition is most likely caused by the deficiency of a certain substance in the body. Name this substance.
Antidiuretic hormone
Natriuretic factor
Aldosterone
Renin
Parathyroid hormone
213 із 295
The most important mediator of the central nervous system is gamma-aminobutyric acid. When decarboxylated, which of the amino acids is this biogenic amine formed?
Glutamate
Lysine
Tryptophan
Tyrosine
Histidine
214 із 295
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
Floor of the amniotic sac
Extraembryonic mesoderm
Roof of the amniotic sac
Amniotic stalk
215 із 295
What happens when blood pressure and stimulation of baroreceptors and atrial volume receptors are decreased?
Activation of the hypothalamic supraoptic nuclei and production of vasopressin
Reduced production of renin in juxtaglomerular cells
Reduced production of aldosterone
Increased production of atrial natriuretic peptide
Vasodilation of the systemic resistance vessels
216 із 295
Oral mucosa can sometimes be traumatized during tooth brushing. However, such bleeding quickly stops by itself due to the presence of the following in the saliva:
Procoagulants
Lipolytic enzymes
Lysozyme and mucin
Minerals
Amylolytic enzymes
217 із 295
An unidentified surgical specimen is received for histopathologic analysis. A portion of the specimen is cut and stained with hematoxylin and eosin. Under the microscope, you see an organ encapsulated by dense connective tissue that extends to the deeper areas by way of the trabecular extensions. The organ can be subdivided into two regions: a cortex with lymphoid nodules and medulla with medullary cords populated by plasma cells, B-cells and T-cells. Which of the following structures is most likely the origin of this surgical specimen?
Lymph node
Bone marrow
Spleen
Tonsils
Thymus
218 із 295
Autopsy of the body of a 44-year-old man, who died of cardiopulmonary failure, revealed pneumosclerosis, pulmonary emphysema, and hypertrophy of the right ventricle of the heart. Multiple mostly subpleural foci up to 1 cm in diameter are observed in both lungs. Histologically, in the center of the foci there is a zone of necrosis, while on their periphery a border consisting of epithelioid cells and lymphocytes with addition of macrophages and plasma cells is present. A small number of blood capillaries can be detected on the periphery of the lesion foci.
Hematogenous tuberculosis
Silicosis
Sarcoidosis
Syphilis
Pulmonary actinomycosis
219 із 295
A 38-year-old man complains of fatigue. When standing with his eyes closed, he staggers and loses balance. Skeletal muscle tone is reduced. Which of the following brain structures is most likely affected in the patient?
Cerebellum
Thalamus
Precentral gyrus of the cerebral cortex
Basal ganglia
Hypothalamus
220 із 295
During a surgery, a patient developed signs of dithiline (suxamethonium) overdose. What will reduce the effects of intoxication in this case?
Blood transfusion
Ganglionic blockers
Nicotinic antagonists
Muscarinic antagonists
Anticholinesterase drugs
221 із 295
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:
Deletion
Nullisomy
Duplication
Translocation
Inversion
222 із 295
A 50-year-old man presents to the office with the complaint of pain in his left great toe. The pain started 2 days ago and has been progressively getting worse to the point that it is difficult to walk even a few steps. He adds that his left big toe is swollen and hot to the touch. He normally drinks 2-3 glasses of red wine each day. Physical examination is notable for an overweight gentleman (BMI of 35) in moderate pain, with an erythematous, swollen, and exquisitely tender left great toe. A complete blood count shows: hemoglobin - 120 g/L, hematocrit - 0.45, platelets - 160 × 10⁹/L, leukocytes - 8.0 × 10⁹/L, segmented neutrophils - 65%, lymphocytes - 25%, eosinophils - 3%, and monocytes - 7%. Synovial fluid analysis shows cell count of 15,000 cells/mm³ (80% neutrophils), negatively birefringent crystals present. Elevated concentration of which of the following compounds is the most common laboratory finding in these patients?
Uric acid
Cholesterol
Urea
Cystine
Bilirubin
223 із 295
A 37-year-old female presents to the clinic complaining of severe pain in her left wrist and tingling sensation in her left thumb, index finger, and middle finger, and some part of her ring finger. The pain started as an occasional throb and she could ignore it or take ibuprofen but now the pain is much worse and wakes her up at night. She works as a typist and her pain mostly increases after typing day. Her right wrist and fingers are fine. Nerve conduction studies reveal nerve compression. Which of the following nerves is most likely compressed in this patient?
Median nerve
Ulnar nerve
Musculocutaneous nerve
Axillary nerve
Radial nerve
224 із 295
A 78-year-old woman presents to the emergency department for fever and generalized malaise. Her symptoms began several days ago, when she noticed pain with urination and mild blood in her urine. Earlier this morning she experienced chills, flank pain and mild nausea. Her temperature is 38.7°C, blood pressure is 140/80 mm Hg. Later she dies of unknown cause. At autopsy, her kidney is swollen with punctate abscesses that are outlined by a thin red margin. Microscopic observation reveals a large number of neutrophils. Which of the following is the most likely diagnosis?
Acute pyelonephritis
Polycystic kidney disease
Amyloidosis
Acute glomerulonephritis
Nephrolithiasis
225 із 295
A 6-year-old child, who suffers from frequent respiratory diseases, develops eczema after eating citrus fruits. Inflammatory processes tend to have a protracted course in this child. What type of diathesis can be suspected in this case?
Exudative catarrhal
Neuroarthritic
Hemorrhagic
Lymphohypoplastic
Asthenic
226 із 295
A patient complains of drooping eyelid (ptosis) that appeared recently. What nerve is affected in this case?
Oculomotor
Abducting
Ophthalmic
Trochlear
Optic
227 із 295
Branches of which nerve provide cutaneous sensation to the anterolateral surface of the forearm?
N. musculocutaneus
N. axillaris
N. radialis
N. medianus
N. ulnaris
228 із 295
Methyl groups (-CH₃) are used in the body for the synthesis of such important compounds as creatine, choline, adrenaline, etc. What essential amino acid is the source of these groups?
Methionine
Valine
Isoleucine
Tryptophan
Leucine
229 із 295
A 7-week-old infant is brought to the pediatrician due to feeding difficulty for the last 4 days. She has been drinking very little breast milk and stops feeding as if she is tired, only to start sucking again after a few minutes. On chest auscultation, bilateral wheezing is present. A cardiac murmur starts immediately after the onset of the first heart sound (S1), reaching its maximal intensity at the end of systole, and waning during late diastole. The murmur is best heard over the second intercostal space and radiates to the left clavicle. The first heart sound (S1) is normal, while the second heart sound (S2) is obscured by the murmur. The pediatrician suspects a patent ductus arteriosus. Communication between which of the following arteries is the most likely cause of hemodynamic instability?
Pulmonary artery and aorta
Superior vena cava and pulmonary artery
Superior vena cava and aorta
Pulmonary artery and pulmonary veins
Aorta and pulmonary veins
230 із 295
A patient complains of paroxysmal pain in the area of upper teeth and lip. The pain radiates into the infraorbital region. Examination detects disturbed sensitivity in the area of the lip, cheek, and wings of the nose. What nerve is affected in this case?
Maxillary
Accessory
Mandibular
Facial
Ophthalmic
231 із 295
The patient's ECG shows an increased duration of the QRS complex. What is the likely cause of this finding?
Increased ventricular excitation time
Disturbed conduction in the atrioventricular nodes
Increased atrial excitation time
Increased atrial and ventricular excitability
Increased atrial excitability
232 із 295
A patient with cholelithiasis has fatty colorless stool because of obturation of the biliary tract. What bile component is absent, causing steatorrhea in the patient?
Bile acids
Cholesterol
Alkaline phosphatase
Bile pigments
Fatty acids
233 із 295
The activity of which enzyme increases in the patient's blood during myocardial infarction?
Creatine phosphokinase MB
Alkaline phosphatase
Creatine phosphokinase BB
Creatine phosphokinase MM
Carbamoylphosphate synthetases
234 із 295
What regulatory mechanisms cause an increase in heart rate when changing body position from horizontal to vertical?
Unconditioned sympathetic reflexes
Sympathetic reflexes and catecholamines
Conditioned and unconditioned sympathetic reflexes
Conditioned sympathetic reflexes
Catecholamines
235 із 295
Specify the effective conditions for oxidative phosphorylation.
ADP availability, oxygen, reduced equivalents
AMP availability, oxygen, oxidized equivalents
GDP availability, oxygen, restored equivalents
ATP availability, oxidized equivalents, carbon dioxide
AMP availability, oxygen, reduced equivalents
236 із 295
A 54-year-old woman has a total thyroidectomy for papillary thyroid carcinoma. 11 hours after operation she complains of tingling around her mouth. On physical examination, the Trousseau's sign and Chvostek's sign are present. Her condition rapidly deteriorates with laryngospasm and focal seizures. Which of the following is the most likely cause of this patient's neurological abnormality?
Hypocalcemia
Hyponatremia
Hyperkalemia
Hypophosphatemia
Hyperchloremia
237 із 295
In a person who died from chronic renal failure, the kidney is macroscopically enlarged, dense, has a yellowish-white color on the cut and resembles old fat - 'lardaceous kidney'. Specify the pathological process.
Amyloidosis
Fatty dystrophy
Fibrinoid swelling
Hyalinosis
Hyaline-droplet dystrophy
238 із 295
A 12-year-old patient was found to have blood serum cholesterol at the rate of 25 mmol/L. The boy has a history of hereditary familial hypercholesterolemia, which is caused by the impaired synthesis of the following protein receptors:
Low density lipoproteins
Intermediate density lipoproteins
High density lipoproteins
Very low density lipoproteins
Chylomicrons
239 із 295
A patient with type 1 diabetes mellitus has been prescribed insulin as a substitution therapy. What is the mechanism of action of this drug?
Increase of the glucose permeability of cell plasma membranes
Stimulation of α-cells of pancreatic islets
Intensification of anaerobic glycolysis
COX-2 inhibition
Blockade of H1-histamine receptors
240 із 295
A 6-year-old child has purulent inflammation of the middle ear that was complicated by purulent inflammation of the mastoid cells. Trepanation (dissection) of the mastoid process became necessary. In this case, the surgeon must remember that a certain venous sinus is located close by, to avoid damaging it.
Sigmoid sinus
Inferior sagittal sinus
Superior sagittal sinus
Transverse sinus
Cavernous sinus
241 із 295
Blood testing of a 45-year-old man, who had gastrectomy three years ago, shows the following: erythrocyte count - 2.0 × 10¹²/L, Hb - 85 g/L, color index - 1.27. These changes in erythropoiesis were caused by problems with absorption of a certain vitamin.
B₁₂
P
A
C
B₆
242 із 295
A patient complains of pain in the right lateral abdomen. Palpation revealed a dense, immobile, tumor-like formation. A tumor is likely to be found in the following part of the digestive tube:
Colon ascendant
Descending colon
Blind
Colon sigmoideum
Colon transversum
243 із 295
A 37-year-old man is admitted to hospital with mental confusion and disorientation. His wife reports he became more irritable and forgetful in the past year. In addition, she notes that he became a vegan a year ago, and currently, his diet consists of starchy foods like potatoes, corn, and leafy vegetables. GI symptoms include anorexia, diarrhea and vomiting. He has glossitis and skin lesions that appear as vesicles over the extremities. Eczema-like lesions around the mouth, as well as desquamation and roughened skin over the hands are also present. Neurologic examination reveals symmetrical hypesthesia for all types of sensation in both upper and lower extremities in a 'glove and stocking' distribution. Deficiency in diet of which of the following amino acids is the most likely cause of this condition?
Tryptophan
Histidine
Arginine
Lysine
Threonine
244 із 295
A 58-year-old woman with essential hypertension was prescribed amlodipine by her doctor. What group of drugs does it belong to?
Calcium channel blockers
Potassium channel blockers
Beta blockers
Potassium channel activators
Sodium channel blockers
245 із 295
In the hematology unit a patient with leukemia was prescribed 5-fluorouracil. What is the mechanism of action of this drug?
Inhibits DNA synthesis
Inhibits transcription
Inhibits translation
Catalyzes replication
Stimulates DNase
246 із 295
A 50-year-old man presents to the office with the complaint of pain in his left great toe. The pain started 2 days ago and has been progressively getting worse to the point that it is difficult to walk even a few steps. He adds that his left big toe is swollen and hot to the touch. He normally drinks 2-3 glasses of red wine each day. Overweight gentleman (BMI of 35) in moderate pain, with an erythematous, swollen, and exquisitely tender left great toe. A complete blood count shows: hemoglobin - 120 g/L, hematocrit - 0.45, platelets - 160 × 10⁹/L, leukocytes - 8.0 × 10⁹/L, segmented neutrophils - 65%, lymphocytes - 25%, eosinophils - 3%, and monocytes - 7%. Synovial fluid analysis shows cell count of 15,000 cells/mm³ (80% neutrophils), negatively birefringent crystals present. Elevated concentration of which of the following compounds is the most common laboratory finding in these patients?
Uric acid
Bilirubin
Urea
Cholesterol
Cystine
247 із 295
A patient has been hospitalized into the infectious diseases department with complaints of recurrent episodes of diarrhea and vomiting, pain in the leg muscles, weakness, and dizziness. After the examination, the doctor provisionally diagnosed the patient with cholera. What studies must be performed with the material obtained from the patient to make the express diagnosis?
Direct and indirect immunofluorescence
Biological method
Bacteriology
Serology
Agglutination reaction
248 із 295
A 65-year-old woman presents to the emergency department because of shortness of breath and chest pain that started a few hours ago. She did not have a fever, expectoration, or any accompanying symptoms. She has a history of right leg deep vein thrombosis. Some time later, she dies of severe respiratory distress. A pulmonary autopsy specimen reveals a red loose mass that is lodged in the bifurcation of the pulmonary trunk with extensions into both the left and right main pulmonary arteries. Which of the following is the most likely diagnosis?
Thromboembolism
Myocardial infarction
---
Pneumonia
Pneumothorax
249 із 295
A 34-year-old man visits his dentist complaining of toothache. After a dental procedure that involved extraction of several teeth, he develops severe bleeding lasting more than 15 minutes. He has a history of chronic hepatitis C. Which of the following is the most likely cause of prolonged bleeding in this patient?
Hypofibrinogenemia
Thrombocytopenia
Hypocalcemia
Hypoalbuminemia
---
250 із 295
During the surgery for a femoral hernia, the doctor operates within the borders of the femoral triangle. What structure forms its upper border?
Lig. inguinale
Inguinal ligament
Iliopectineal arch
Fascia lata
Close link
251 із 295
A 36-year-old man developed angina pectoris attacks after a case of staphylococcal sepsis. In the left coronary artery, coronary angiography revealed parietal thrombosis without signs of atherosclerosis. In this case, the thrombus formation started because of the damage to the vascular endothelium and the release of:
Platelet-activating factor
Serotonin
Adenosine diphosphate
Phospholipase A2
Adenosine triphosphate
252 із 295
Autopsy of a 47-year-old miner's body, who worked down in the shaft for 10 years, reveals bands of a whitish fibrous tissue and nodules 0.2-0.3 cm in diameter in his lungs. Histology detects in the nodules a small amount of brownish dust and concentric proliferation of a cell-poor connective tissue with marked hyalinosis. What disease can be suspected in this case?
Silicosis
Talcosis
Asbestosis
Berylliosis
Siderosis
253 із 295
One of the tunics of a hollow organ contains nucleated anastomosing fibers. The fibers consist of cells that form intercalated discs in the contact areas. What tissue forms this tunic of an organ?
Cross-striated cardiac muscle
Cross-striated skeletal muscle
Smooth muscle
Loose fibrous connective tissue
Dense irregular connective tissue
254 із 295
A male neonate born to a 24-year-old, who was pregnant for the first time, had jaundice at 8 hours of life. The neonate's red blood cell type was A+, while the mother's RBC type was O+. Laboratory studies revealed elevated titer of mother's anti-A antibody, normal erythrocyte glucose-6-phosphate and negative sickle cell test. The infant's hemoglobin was 106 g/L. Which of the following is the most likely cause of infant's jaundice?
Hyperbilirubinemia
Glucose-6-phosphate dehydrogenase (G6PD) deficiency
Decrease in hemoglobin level
Rh incompatibility
Sickle cell disease
255 із 295
A patient has ascites, his spleen is twice the normal size, he has esophageal and rectal varices. Histology of the biopsy material obtained from the liver revealed micronodular cirrhosis. What process has complicated the hepatic cirrhosis in this case?
Portal hypertension syndrome
Hepatocellular dysfunction
Heart failure
Budd-Chiari syndrome
Hepatolienal syndrome
256 із 295
A 25-year-old male visits his family physician for a 5-day history of fever and fatigue. Upon further questioning, he says that he also had constant muscular pain and headaches. He adds additional information by giving a history of regular unprotected sexual relations with multiple partners. Vital signs: heart rate - 98/min, respiratory rate - 16/min, temperature - 38°C and blood pressure - 120/80 mm Hg. On physical examination, he is icteric and hepatosplenomegaly is evident with abdominal tenderness particularly in the right upper quadrant. Serology shows the following pattern: IgM anti-HBc positive, HBsAg positive. Which of the following is the most likely diagnosis?
Viral hepatitis B
Tuberculosis
Viral hepatitis A
Acquired immune deficiency syndrome (AIDS)
Syphilis
257 із 295
A person with suspected liver abscess has been admitted into the surgical department of a hospital. This person was on a business trip in one of the African countries for a long time and repeatedly had been suffering from an acute gastrointestinal disease. What protozoan disease is likely in this patient?
Amoebiasis
Malaria
Toxoplasmosis
Leishmaniasis
Trypanosomiasis
258 із 295
A histological specimen of a woman's ovary shows a round formation, consisting of large glandular cells that contain lutein pigment. In the center of this structure, there is a small scar made of connective tissue. Name this formation:
Corpus luteum
Secondary follicle
Atretic body
Mature follicle
Corpus albicans
259 із 295
Histology of the red bone marrow biopsy material detected cells of the granulocytic series. What changes occur in the nucleus during the differentiation of these cells?
Segmentation
Enucleation
Polyploidization
Enlargement
Pyknosis
260 із 295
During the autopsy of a 58-year-old woman with diabetes, histological examination of the kidneys revealed segmental homogeneous oxyphilic deposits in the glomeruli, and the walls of the arterioles were diffusely thickened, homogeneous, and oxyphilic. What pathological condition occurred in the glomeruli and renal vessels?
Hyalinosis
Mucoid swelling
Fibrinoid swelling
Amyloidosis
Hyaline-droplet dystrophy
261 із 295
A 30-year-old patient with a femoral fracture was brought to the hospital after a car accident. The patient presents with sharply reduced blood pressure of 70/40 mm Hg, a weak pulse, and increased pain response provoked by the slightest touch in the damaged area. What should be administered in this case to prevent traumatic shock in the patient?
Morphine
Paracetamol
Papaverine
Analgin (Metamizole)
Pentazocine
262 із 295
A 43-year-old man seeks evaluation at an emergency department with complaints of fever with chills, malaise, diffuse abdominal pain for over a week, diarrhea and loss of appetite. He says that his symptoms are progressively getting worse. He recalls that the fever began slowly and climbed its way up stepwise to the current 39.8°C. Blood pressure is 110/70 mm Hg. A physical exam reveals an enlarged spleen and rose spots on the abdomen. Serologic study shows the agglutinin O titre of 1:200. Which of the following is the most likely causative organism for this patient's condition?
Salmonella typhi
Leptospira interrogans
Enterohemorrhagic E. coli
Mycobacterium tuberculosis
Vibrio cholerae
263 із 295
During examination the patient is found to have low production of adrenocorticotropic hormone. How would this affect production of the other hormones?
Decrease adrenocortical hormones synthesis
Increase thyroid hormones synthesis
Decrease insulin synthesis
Decrease hormone synthesis in the adrenal medulla
Increase sex hormones synthesis
264 із 295
During a blood transfusion, intravascular hemolysis of erythrocytes started developing in the patient. What type of hypersensitivity has developed in this patient?
Type II hypersensitivity (antibody-dependent)
Type IV hypersensitivity (cell-mediated cytotoxicity)
Type III hypersensitivity (immune complex)
Type I hypersensitivity (anaphylactic)
Type V hypersensitivity (granulomatosis)
265 із 295
Laboratory study of the blood of a 33-year-old patient revealed erythrocyte agglutination reaction in standard sera of groups I and II. Agglutination reaction was not observed with a group III serum and an anti-rhesus serum. What blood group (taking into account the CDE system) can be transfused to this person, if necessary?
III (B) Rh-
IV (AB) Rh+
IV (AB) Rh-
I (O) Rh+
II (A) Rh-
266 із 295
A team of medical students is performing research on phases of cell cycle. During one of the mitotic phases the cell is nearly done dividing, the chromosomes decondense and two nuclei begin to form around them. Which of the following phases most likely takes place in the cell?
Telophase
Anaphase
Prophase
---
Metaphase
267 із 295
Autopsy of the body of a 14-year-old child who died of pneumonia revealed the following: multiple punctate and spotty hemorrhages in the skin, mucosa, and serous membranes; an enlarged flaccid spleen that is red on section and yields only a small amount of material when scraped; enlarged pale gray mediastinal and retroperitoneal lymph nodes with a slightly pinkish tint on the cross-section; raspberry-red bone marrow in flat and tubular bones. What disease is indicated by the described changes?
Acute lymphoblastic leukemia
Chronic lymphoid leukemia
Chronic myeloid leukemia
Acute myeloblastic leukemia
Lymphogranulomatosis
268 із 295
Because of a cerebral hemorrhage, a patient developed impaired speech perception (sensory aphasia). What brain structure is likely to be damaged in this case?
Superior temporal gyrus
Inferior frontal gyrus
Postcentral gyrus
Superior frontal gyrus
Inferior temporal gyrus
269 із 295
A 56-year-old woman complains of pain in the small joints of her hands and feet. She has been experiencing these symptoms for the last 12 years. Examination of her hands detects a subluxation of the metacarpophalangeal joints with fingers bent outwards ('walrus flippers'). There are high molecular weight immune complexes in the patient's blood. What diagnosis can be made in this case?
Rheumatoid arthritis
Gouty arthritis
Rheumatic polyarthritis
Systemic lupus erythematosus
Dermatomyositis
270 із 295
A mother of a 4-month-old male infant brought him to a pediatrician with complaints of food rejection and weight loss. He started having trouble latching onto his bottle. He has also become extremely lethargic. Examination reveals diminished muscle tone in all four limbs. An ophthalmoscopic exam reveals macular cherry red spots, hepatosplenomegaly progresses, and he continues to reject food. Chest X-ray shows reticulonodular nodules. Niemann-Pick disease is suspected. What is the most likely deficient enzyme in this patient?
Sphingomyelinase
Glucocerebrosidase
Glucose-6-phosphatase
Galactocerebrosidase
Phenylalanine-hydroxylase
271 із 295
During the examination of a newborn child, the doctor diagnosed congenital muscular torticollis. Which neck muscle is affected?
M. sternocleidomastoideus
M. platysma
M. sternohyoideus
M. omohyoideus
M. mylohyoideus
272 із 295
A 40-year-old woman dies of intracerebral hemorrhage after the hypertensive emergency. During an autopsy, the pathologist reveals severe obesity, excess of body hair and wide purplish stria on the abdomen. Microscopic examination of pituitary gland reveals hyperplastic acini populated by a homogenous cluster of deeply basophilic cells. Which of the following was the most likely underlying disease?
Cushing disease
Arterial hypertension
Hyperthyroidism
Sheehan's syndrome
---
273 із 295
When examining a 36-year-old woman, the doctor used urological instruments. After some time, the patient's urethra began to secrete serous fluid, in which pear-shaped cells with flagella, an undulating membrane, and an axostyle were found. Indicate the most likely pathogen based on the indicated morphology.
Trichomonas vaginalis
Trichomonas hominis
Trichomonas tenax
Leishmania tropica
Lamblia intestinalis
274 із 295
After bilateral adrenalectomy performed on a dog, the animal developed muscle weakness, adynamia, low body temperature, and hypoglycemia. What other sign is likely to be observed in case of adrenal insufficiency?
Arterial hypotension
Increased sodium and chloride levels in the blood serum
Increased resistance to bacteria and toxins
Increased glycogen synthesis
Lymphopenia
275 із 295
During microscopic examination: oval-shaped cells, 150 µm in size, cytoplasm with yolk inclusions, but no centrioles were detected. Specify this cell.
Oocyte
Myocyte
Macrophage
Fibroblast
Leukocyte
276 із 295
Two weeks ago, an illness was reported in several children at the orphanage. Based on the description of its clinical manifestations and epidemiological data, the epidemiologist suspects an outbreak of measles infection. What type of laboratory analysis can confirm this provisional diagnosis?
Serology
Inoculation of chicken embryos
Rhinocytoscopy
Immunofluorescence
Allergy testing
277 із 295
After 10 days of treatment with an antibiotic, a patient developed signs of dysbiosis: dyspepsia, candidiasis, jaundice, and photosensitization, which indicates that this antibiotic belongs to the following group:
Tetracycline group
Rifampicin group
Cephalosporin group
Aminoglycoside group
Penicillin group
278 із 295
A 42-year-old man with verified HIV infection developed a fever, generalized lymphadenopathy, diarrhea, and slight weight loss. What period of HIV infection corresponds with these symptoms?
AIDS-related complex
Incubation period
Period of acquired immunodeficiency syndrome
HIV encephalomyelitis
Period of persistent generalized lymphadenopathy
279 із 295
A 49-year-old woman developed leg edema after she had been standing for a long time. What is the likely cause of leg edema in this case?
Increased hydrostatic blood pressure in the veins
Decreased hydrostatic blood pressure in the veins
Increased oncotic blood plasma pressure
Decreased hydrostatic blood pressure in the arteries
Increased arterial blood pressure
280 із 295
A man has gradually developed a plaque on the skin of his face with necrosis and an ulcer in its center. Pathohistology of the biopsy material reveals proliferation of atypical epithelial cells with a large number of pathological mitoses. What disease can be characterized by such clinical and laboratory findings?
Skin cancer
Fibroma
Trophic ulcer
Sarcoma
Papilloma
281 із 295
A person has a knee injury with a crushed patella. In this case, damage is likely to be observed in a tendon of the following thigh muscle:
Quadriceps femoris muscle
Biceps femoris muscle
Sartorius muscle
Adductor longus muscle
Adductor magnus muscle
282 із 295
During the treatment of ciliary arrhythmia, a patient developed bronchoobstructive syndrome - problematic breathing and cough. What antiarrhythmic drug can cause such a complication?
Anaprilin (Propranolol)
Ajmaline
Novocainamide (Procainamide)
Verapamil
Nifedipine
283 із 295
A patient complains of palpitation after stress. The pulse is 104 bpm, PQ = 0.12 seconds, there are no changes of QRS complex. What type of arrhythmia does the patient have?
Sinus tachycardia
Sinus arrhythmia
Ciliary arrhythmia
Extrasystole
Sinus bradycardia
284 із 295
An 11-year-old girl is brought to the doctor's office by her mother who states her daughter has been weak with a swollen face for 3 days. The mother states her daughter had always been healthy and active until the initiation of symptoms. Upon inquiry, the girl describes a foamy appearance of her urine but denies blood in urine, urinary frequency at night, or pain during urination. Physical examination reveals generalized swelling of the face and pitting edema on the lower limbs. Laboratory study shows proteinuria and microscopic hematuria. Which of the following is the most likely cause of findings in the laboratory study of urine?
Increased permeability across the glomerular capillary wall
Increased glomerular hydrostatic pressure
Increased hydrostatic pressure in Bowman's capsule
---
Increased plasma oncotic pressure
285 із 295
Which of the following drugs, when instilled into the eyes, causes pupil dilation and accommodation paralysis?
Atropine sulfate
Prozerin
Galanthamine hydrobromide
Furacilin
Pilocarpine hydrochloride
286 із 295
Increased levels of angiotensin II have been detected in the blood of a patient with a hypertensive crisis. The pressor effect of angiotensin is associated with the:
Contraction of arteriolar muscles
Activation of the kallikrein-kinin system
Hyperproduction of prostaglandins
Activation of biogenic amine synthesis
Stimulation of vasopressin production
287 із 295
A worker was hospitalized with bleeding caused by an injury to the shoulder. Five days later, an increased concentration of certain blood cells will be observed in the patient's blood. Name these cells.
Reticulocytes
Megaloblasts
Erythroblasts
Lymphoblasts
Megalocytes
288 із 295
In Tay-Sachs amaurotic idiocy, which has an autosomal recessive pattern of inheritance, irreversible severe disorders of the central nervous system development lead to death in early childhood. In this disease, disturbed metabolism of certain substances is observed. Name these substances.
Lipids
Minerals
Nucleic acids
Amino acids
Carbohydrates
289 із 295
A person with vitamin A deficiency develops twilight vision disturbance. Name the cells that fulfill this photoreceptor function:
Rod cells
Ganglionic nerve cells
Bipolar neurons
Cone cells
Horizontal cells of retina
290 із 295
Karyotyping detected 47 chromosomes (3 copies of chromosome 13) in a newborn child with multiple defects of the skull, limbs, and internal organs. What diagnosis can be made in this case?
Patau syndrome
Klinefelter syndrome
Down syndrome
Turner syndrome
Edwards syndrome
291 із 295
A patient needs to be prescribed a broad-spectrum fluoroquinolone agent. Select this drug from the list.
Ciprofloxacin
Azlocillin
Amoxicillin
Carbenicillin
Chinoxydin
292 із 295
A 24-year-old man undergoes surgery and during the operation, an organ is excised and sent for histological evaluation. A light microscopic examination reveals the organ encased by a thin connective tissue capsule that enters the substance of the lobes to further subdivide the organ into irregular lobular units. Each lobule contains a cluster of follicles filled with colloid. Follicular epithelium consists of low columnar, cuboidal or squamous cells depending on the level of activity of the follicle. Which of the following organs does this tissue most likely belong to?
Thyroid gland
Pancreas
Thymus
Parathyroid gland
Parotid gland
293 із 295
A five-year-old child with hereditary kidney disease was examined for signs of rickets, and laboratory tests showed normal vitamin D levels. What is the most likely cause of rickets?
Disorder of calcitriol synthesis
Increased calcium excretion
Insufficient calcium in the diet
Hypofunction of the parathyroid glands
Hyperfunction of the parathyroid glands
294 із 295
Which drug belongs to the group of third-generation calcium channel blockers?
Amlodipine
Losartan
Magnesium sulfate
Lisinopril
Atenolol
295 із 295
Diazepam was prescribed to a person with psychoemotional disorders and disturbed sleep. The effect of diazepam is based on:
Activation of the GABA receptor system
Decrease of blood pressure
Inhibition of the limbic system
Excitation of reticular formation