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Question 1 of 200

1.

After   consumption  of   rich   food a patient has nausea  and heartburn, steatorrhea.   This   condition   might   be caused by:

2.

An infant has apparent diarrhea resulting  from  improper  feeding.  One   of  the main  diarrhea effects  is plentiful  excretion of sodium  bicarbonate. What  form  of acid-base  balance  disorder is the case?

3.

A  3  year  old  child  with  fever  was given   aspirin.   It   resulted  in   intensified erythrocyte haemolysis. Hemolytic anemia  might  have  been  caused  by congenital  insufficiency of the following enzyme:

4. A  patient  is  ill  with  diabetes  mellitus   accompanied  by  hyperglycemia  on an  empty  stomach  (7,2 millimole/l).  The hyperglycemia  rate   can  be  retrospectively  estimated (over  the  last  4-8 weeks before   the  examination) on  the  ground of the rate  of the following blood  plasma protein:
5.

In course of laparotomy a surgeon revealed  gangrenous lesion  of  descending colon. It was caused  by thrombosis of the following artery:

6.

A  37 year  old  patient suffering  from obliterating vascular endarteritis of lower limbs takes  daily 60 microgram/kilogram of   phenylin.   Because   of   presentations of convulsive disorder (craniocerebral trauma  in  anamnesis)  he   was  prescribed phenobarbital. Withholding this drug caused nasal hemorrhage. What is this complication connected with?

7.

A 60 year old patient has impaired perception   of   high-frequency   sounds. These changes were caused by damage  of the following auditory analyzer structures:

8.

Researchers   isolated    5   isoenzymic forms  of lactate  dehydrogenase from  the human blood serum and studied their properties. What  property indicates  that the  isoenzymic  forms  were  isolated  from the same enzyme?

9.

It   was  proved   that   a  molecule   of immature mRNA (precursor mRNA) contained more  triplets  than  amino  acids   found    in   the   synthesized    protein. The  reason  for  that  is that  translation is normally preceded by:

10. A patient has low rate  of magnesium ions that  are  necessary  for affixion of ribosomes   to  the  endoplasmic  reticulum. It  is  known   that   it  causes  disturbance of protein biosynthesis. At what stage is protein biosynthesis impaired?

11.

A  student takes  notes  of  a  lecture. Quality  of his notes  became  significantly worse when his neighbours began talking. What type of conditional reflex inhibition was the cause of it?

12.

A patient ill with neurodermatitis has been  taking prednisolone for a long time. Examination revealed  high rate  of sugar in his blood.  This complication is caused by the drug influence  upon  the  following link of carbohydrate metabolism:

13.

Labelled amino acids alanine  and tryptophane  were  injected   to  a  mouse in order  to  study  localization  of protein synthesis  in  its  cells.  The  labelled   amino acids will be accumulated near the following organellas:

14.

A patient with frequent attacks  of stenocardia  was  prescribed  sustak-forte to be taken  one tablet  twice a day. At first the effect was positive  but on the second day  stenocardia attacks   resumed.  What can explain  inefficiency of the prescribed drug?

 
15. Inflammation of the tympanic cavity (purulent otitis  media)  was  complicated by  inflammation of  mammillary   process sockets.   What   wall  of  tympanic   cavity did the pus penetrate into the sockets through?

16.

In  order   to  speed   up  healing  of  a wound of oral mucosa a patient was prescribed a drug  that  is a thermostable protein occurring  in tears,  saliva, mother’s milk as well as in a new-laid  hen’s egg. It is known  that  this  protein is a factor  of natural resistance  of an organism. What is it called?

17. An aged man had raise of arterial pressure under  a stress. It was caused  by activation of:
18.

A  20 year  old  patient complains  of general weakness, dizziness, quick fatigability.  Blood   analysis  results:  Hb-  80 g/l. Microscopical  examination results: erythrocytes are  of  modified  form.  This condition might be caused by:

19.

Blood minute  volume of a 30 year old woman at rest is 5 l/m. What blood volume is pumped  through the pulmonary vessels per minute?

20. As a result of long-term starvation the glomerular filtration of a man was accelerated by 20%.  The  most  probable cause of filtration changes under such conditions is:

21.

A patient has yellow skin colour, dark urine,  dark-yellow  feces. What  substance will have  strengthened concentration in the blood serum?

22.

A  patient consulted   a  doctor   about symmetric  dermatitis of open  skin areas. It  was  found  out  that  the  patient lived mostly on cereals  and ate too little meat, milk and eggs. What vitamin deficiency is the most evident?

23.

A  46 year  old  patient applied   to  a doctor complaining about joint pain that becomes  stronger the day before  weather changes. Blood examination revealed strengthened concentration of  uric  acid. The  most  probable cause  of the  disease is the intensified  disintegration of the following substance:

24.

A  38  year  old  patient suffers  from rheumatism in its active phase. What laboratory characteristic of blood  serum is of diagnostic  importance in case of this pathology?

25. ECG  of a patient with hyperfunction of thyroid  gland showed  heart  hurry.  It is  indicated by depression of the following ECG element:
26.

A     62    year     woman     complains   of   frequent   pain    attacks    in   the area   of   her   chest   and   backbone,  rib fractures. Her  doctor  suspected  myeloma (plasmocytoma). What of the following laboratory  characteristics will be  of  the greatest diagnostic importance?

27.

While  playing  volleyball  a sportsman made  a jump  and  landed  on the  outside edge of his foot. He felt acute  pain in the talocrural joint,  active movements are  limited,  passive  movements are  unlimited but  painful.  A bit later  there  appeared a swelling in the area of external  ankle, the skin became  red and warm. What type of peripheral circulation   disturbance is the case?

28.

Bacterioscopic examination of a smear from the  pharynx  of a diphtheria suspect revealed   bacilli  with  volutine   granules. What  etiotropic drug  should  be  chosen in this case?

29. A  patient  underwent  an  operation on  account  of gall bladder excision  that resulted in obstruction of Ca2+ absorption through the  bowels  wall.  What  vitamin will stimulate  this process?
30.

A woman underwent an operation on account  of extrauterine (tubal) pregnancy. In  course  of  the  operation the  surgeon should  ligate the branches  of the following arteries:

31.

A 6 month  old baby ill with bronchitis was taken  for an X-ray of chest. Apart of changes associated with bronchi the X-ray film showed  a shadow  of  thymus  gland. What might have caused such changes?

32.

A  patient complains  of  frequent diarrheas, especially  after  consumption of rich food, weight loss. Laboratory examination    revealed    steatorrhea;  his   feces were hypocholic. What might have caused such condition?

33.

Examination of a patient with pustular skin lesions  allowed  to isolate  a causative agent that forms in the blood agar roundish yellow middle-sized  colonies surrounded by  haemolysis  zone.  Smears from the colonies contain irregular- shaped   clusters   of  gram-positive  cocci. The   culture   is  oxidase-   and   catalase- positive,  ferments mannitol and synthesizes plasmocoagulase.   What    causative agent was isolated?

34.

A 65 year old man suffering from gout complains of kidney pain. Ultrasound examination revealed   renal  calculi.  The most probable cause of calculi formation is the  strengthened concentration of the following substance:

35. Microscopic  examination of a Gram- stained  scrape  from  patient’s  tongue revealed  oval, round,  elongated chains of dark-violet gemmating cells. What disease can be caused by this causative agent?
36. A  44 year  old  woman  complains  of general weakness, heart pain, significant increase   of   body   weight.   Objectively: moon  face, hirsutism,  AP  is 165/100 mm Hg, height  - 164 cm, weight - 103 kg; the fat  is mostly  accumulated on  her  neck, thoracic   girdle,  belly.  What  is the  main pathogenetic mechanism  of obesity?
37.

Blood  of  a  patient with  presumable sepsis was inoculated into sugar broth. There  appeared bottom  sediment. Repeated inoculation into  blood  agar caused growth of small transparent round colonies  surrounded by  hemolysis  zone. Examination of  a  smear  from  the  sediment revealed  gram-positive cocci in form of long chains. What  microorganisms are present in blood of this patient?

38.

2 years ago a patient underwent resection of pyloric  part  of stomach.  He complains of weakness, periodical dark shadows beneath his eyes, dyspnea. In blood:  Hb  - 70 g/l, erythrocytes - 3, 0 ·1012/l,  colour  index  - 0,7. What  changes of  erythrocytes in blood  smears  are  the most typical for this condition?

 
39.

A  patient is ill with  hepatocirrhosis. State of antitoxic liver function can be characterized   by   examination   of   the following substance  excreted by urine:

40.

The  territory of an old burial  ground for animal refuse that hasn’t been used for over 50 years is meant  for house building. But soil investigation showed the presence of viable spores of a causative agent causing  a  very  dangerous disease.  What  microorganism might  have  been  preserved in soil for such a long period  of time?

41.

Autopsy  of  a  man   who  had   been working as a miner for many years and died from  cardiopulmonary decompensation   revealed    that    his   lungs   were   airless, sclerosed, their apexex had emphysematous changes, the lung surface was  greyish-black,   the   incised   lung  tissue was coal-black.  What  disease caused death?

42.

Microscopy  of stained  (Ziehl-Neelsen staining)  smears  taken  from  the  sputum of  a patient with  chronic  pulmonary disease revealed  red bacilli. What  property of tuberculous bacillus was shown up?

43.

Parents of a 10 year old boy consulted a doctor  about  extension  of hair-covering, growth  of beard  and moustache, low voice. Intensified secretion of which hormone must be assumed?

44.

Examination of coronary arteries revealed  atherosclerotic calcified plaques closing  vessel  lumen  by 1/3. The  muscle has multiple  whitish layers  of connective tissue.  What  process  was revealed  in the myocardium?

45.

It  was  revealed   that   T-lymphocytes were  affected   by  HIV. Virus  enzyme - reverse    transcriptase (RNA-dependent DNA polymerase)  -  catalyzes the synthesis of:

46. A  35  year  old  man  with  a  trauma of his left hand was admitted to the traumatology  department.   Objectively: cut wound of palmar  surface of left hand; middle  phalanxes  of  II–V  fingers  don’t bend. What muscles are damaged?
47.

Histological   examination  of  a  skin tissue sampling revealed granulomas consisting of macrophagal nodules with lymphocytes   and  plasmatic   cells.  There are also some big macrophages with fatty vacuoles  containing   causative   agents  of  a  disease  packed  up  in form  of  spheres (Virchow’s  cells).  Granulation  tissue   is well vascularized.  What disease is this granuloma typical for?

48.

In order  to estimate toxigenity  of diphtheria  agents   obtained  from  patients the cultures  were inoculated on Petri dish with nutrient agar on either  side of a filter paper  strip  that  was put  into  the  centre and  moistened with  antidiphtheric anti-toxic serum. After incubation of inoculations in agar the strip-like areas of medium turbidity  were found between separate cultures  and the strip of filter paper.  What immunological reaction was conducted?

 
49. A patient taking clonidine  for essential hypertension treatment was using alcohol that caused intense inhibition of central  nervous  system.  What  mait be connected with?
50.

Examination of an ovary specimen stained   by  hematoxylin-eosine  revealed a follicle in which follicular epithelium consisted of 1-2 layers of cubic cells. There was also  a bright  red  membrane around the ovocyte. What follicle is it?

51.

A patient with clinical signs of encephalitis was delivered to the  infectious diseases hospital. Anamnesis registers a tick bite. Hemagglutination-inhibition reaction helped to reveal antibodies to the causative  agent of tick-borne encephalitis in the dilution 1:20 which is not diagnostic. What actions should the doctor  take after he had got such result?

 
52.

A 40 year old man noticed  a reddening  and  an  edema   of  skin  in  the   area of  his  neck  that  later  developed into  a small abscess. The  incised focus is dense, yellowish-green.  The  pus  contains   white granules. Histological examination revealed drusen of a fungus, plasmatic and xanthome cells, macrophages. What  type of mycosis is the most probable?

53.

Continuous taking of some drugs foregoing  the  pregnancy  increase  the  risk of giving birth  to a child with genetic defects. What is this effect called?

54.

A man with a wound  of his limb that had been  suppurating for a long time died  from  intoxication. Autopsy  revealed extreme emaciation, dehydration, brown atrophy of liver, myocardium, spleen  and cross-striated muscles as well as renal amyloidosis. What diagnosis corresponds with the described  picture?

 
55.

6  months    after   labour    a   woman had   uterine  hemorrhage.  Gynaecological examination of uterine cavity revealed a  dark-red tissue  with  multiple   cavities resembling of a \\\"sponge\\\". Microscopic examination  of   a   tumour  revealed   in blood lacunas atypic light epithelial Langhans  cells and  giant cells of syncytiotrophoblast. What tumour is it?

56.

An  animal  with  aortic  valve  insufficiency    got    hypertrophy   of    its    left heart   ventricle.   Some  of  its  parts  have local contractures. What substance accumulated  in  the  myocardiocytes caused these contractures?

57.

A  girl is diagnosed with adrenogenital syndrome (pseudohermaphroditism). This pathology was caused by hypersecretion of  the  following  adrenal hormone:

58.

In  course   of  an  experiment  a  big number  of stem cells of red bone  marrow was in some way destructed. Regeneration of which cell populations in the  loose connective tissue will be inhibited?

59.

Examination  of  a  70 year  old  patient revealed insulin-dependent diabetes. What drug should be administered?

60. A  human  body  cools  in water  much faster  that  in the  air.  What  way of heat emission in water is much more efficient?
61.

A   patient  suffering   from   chronic cardiac   insufficiency  was  recommended to undergo a prophylactic course  of treatment with a cardiological  drug  from the  group   of  cardiac   glycosides  that   is to be taken  enterally. What drug was recommended?

62.

An  ophthalmologist used  a 1% mesaton  solution  for  the  diagnostic purpose (pupil dilation  for eye-ground examination). What is the cause of mydriasis induced  by the drug?

63.

Prophylactic medical  examination of a  36  year  old  driver   revealed   that   his AP  was  150/90 mm  Hg.  At  the  end  of workin day  he  usually  hear ear  noise,  feels  slight  indisposition  that  passes after  some  rest.  He  was diagnosed with essential  hypertension. What  is the leading pathogenetic mechanism  in this case?

64. A  cerebral trauma caused  increased ammonia  generation. What amino acid participates in the  excretion of ammonia from the cerebral tissue?
65.

While  studying  maximally  spiralized chromosomes of human karyotype the process of cell division was stopped in the following phase:

 
66. 48   hours    after    tuberculine   test (Mantoux test)  a child  had  a  papule  10 mm in diameter on the spot of tuberculine injection.  What hypersensitivity mechanism underlies these changes?
67.

A patient was admitted to the surgical department with suspected  inflammation of Meckel’s diverticulum. What part of bowels  should  be  examined in  order  to discover  the diverticulum in course  of an operation?

68. Power inputs of a man were measured. In  what  state  was this  man  if his power inputs were lower than basal metabolism?
69.

Examination of a newborn  boy’s genitalia   revealed   an   urethral  hiatus   that opens on the undersite of his penis. What malformation is it?

70. A concentrated solution  of sodium chloride  was intravenously injected  to an animal. This caused decreased reabsorption of sodium  ions in the renal  tubules.  It is the  result  of the  following  changes  of hormonal secretion:
71. As  a result  of destruction of certain brainstem structures an  animal  has  lost its  orientative  reflexes   in  response   to strong   photic   stimuli.   What   structures were destroyed?

72. Myocyte cytoplasm  contains  a big number  of  dissolved  metabolites of glucose oxidation.  Name one of them that turns directly into a lactate:
73.

Mother   of   a   2   year    old   child consulted   a  stomatologist.  In  the   period of pregnancy  she was irregularly  taking antibiotics  for an infectious disease. Examination of  the  child  revealed   incisor destruction, yellow enamel, brown rim around the  dental  cervix. What  drug  has apparent teratogenic effect?

74.

A   59  year   old   patient  is  a  plant manager. After  the  tax  inspection of his plant he felt intense pain behind his breastbone  irradiating  to  his  left  arm. 15 minutes  later his condition came to normal.  Which  of the  possible  mechanisms of stenocardia development is the leading in this case?

 
75.

A patient recovered from Sonne dysentery and was once more infected with the same causative  agent. What is such infection form called?

76.

A  56  year   old  patient  came   to  a hospital with complaints about general weakness, tongue pain and burning, sensation  of limb  numbness. In  the  past he underwent resection of forestomach. In blood: Hb- 80 g/l; erythrocytes - 2, 0 · 1012/l; colour  index - 1,2, leukocytes  - 3, 5 · 109/l. What anemia  type is it?

77.

A   35  year   old   patient  applied   to a  doctor   with   complaints   about   having  intense   rhinitis  and  loss  of  sense  of smell for a week. Objectively:  nasal cavity  contains   a  lot  of  mucus  that  covers mucous  membrane and  blocks  olfactory receptors. In what part of nasal cavity are these receptors situated?

 
78.

A  17 year  old  boy  fell  seriously  ill, the  body temperature rose up to 38, 5oC , there  appeared cough,  rhinitis,  lacrimation,  nasal  discharges.  What  inflammation is it?

79.

A patient with disturbed cerebral circulation   has  problems with  deglutition. What part of brain was damaged?

80.

Vitamin  B1    deficiency  results  in  disturbance  of  oxidative   decarboxylation of  α-ketoglutaric  acid.  This  will disturb synthesis of the following coenzyme:

81.

A chemical burn caused esophagus stenosis.  Difficulty of ingestion  led to the abrupt loss of weight. In blood: 3, 0 · 1012/l, Hb - 106 g/l, crude  protein - 57 g/l. What type of starvation is it?

82.

A   30   year   old   woman   has   face edemata. Examination revealed  proteinuria (5,87 g/l), hypoproteinemia, dysproteinemia, hyperlipidemia. What condition is  the  set  of  these  symptoms typical for?

83.

Skin  of a man  who  died  from  cardiac insufficiency  has  an  eruption in form of   spots   and   specks.   There    are   also bedsores  in the  area  of sacrum  and  spinous vertebral processes.  Microscopical examination of CNS, skin, adrenal glands revealed  in the vessels of microcirculatory bed and in small arteries destructive-proliferative endothrombovasculitis with Popov’s granulomas; interstitial myocarditis. What  diagnosis  corresponds with the described picture?

84.

Autopsy  of  a  man  who  died  from the sepsis in his femoral bone revealed phlegmonous inflammation that  affected the  marrow,   haversian canals  and  periosteum.  Under the  periosteum there  are multiple  abscesses,  adjoining  soft  tissues of thigh  also have  signs of phlegmonous inflammation. What  pathological process was described?

85.

A patient has a decreased vasopressin synthesis  that  causes  polyuria   and  as  a result  of it evident  organism  dehydration.  What  is the  mechanism   of  polyuria development?

86. A  patient with  nephrotic  syndrome has  massive  edemata of his face  and  limbs. What is the leading pathogenetic mechanism  of edemata development?
87.

Examination of a 55 year  old woman revealed   under   the   skin  of  submandibular area a movable slowly growing pasty formation with distinct borders 1,0x0,7 cm large.  Histological  examination revealed lipocytes that form segments of different forms and sizes separated from each other by  thin  layers  of  connective tissue  with vessels. What is the most probable diagnosis?

88.

An unconscious  young man with signs of  morphine poisoning  entered admission  office. His  respiration is shallow  and infrequent which  is caused  by inhibition of respiratory centre.  What  type of respiratory failure is it?

89. A   patient  with   cholelithiasis    fell ill  with  mechanic   jaundice.   Examination  revealed   that   the  stone   was  in  the common   bile  duct.  What   bile-excreting ducts make up the obturated duct?
90.

A patient is 44 years old. Laboratory examination of  his  blood  revealed   that content of proteins  in plasma  was 40 g/l. What   influence   will  be  exerted on  the transcapillary water exchange?

91.

The cerebrospinal fluid is being examined for the purpose of differential meningitis diagnostics.  At what site is the lumbar puncture safe?

92.

An isolated  cell of human  heart automatically generates excitement impulses  with frequency of 60 times  per minute. This cell was taken from the following heart  structure:

93.

Examination of a 60 year old patient revealed  hyperglycemia and glucosuria. A doctor  administered him a medication for internal use. What medication is it?

94.

As  a result  of posttranslative modifications some proteins taking part in blood coagulation, particularly prothrombin, become    capable    of   calcium    binding. The  following  vitamin  takes  part  in this process:

95.

Examination of a man who had been working  hard  under  higher  temperature of the environment revealed abnormal quantity of blood  plasma  proteins. What phenomenon is the case?

96.

A patient ill with thrombophlebitis of his lower limbs had chest pain, blood spitting, progressing  respiratory insufficiency that  led to his death.  Autopsy diagnosed multiple lung infarctions. What is the most probable cause of their development?

 
97.

A woman suffering from osteochondrosis felt acute pain in her humeral articulation that  became  stronger when she abducted her  shoulder. These  symptoms  might  be caused by damage of the following nerve:

98.

A patient has a deep cut wound on the posterior surface of his shoulder in its middle third. What muscle might be injured?

99. A patient has acne on his face. Microscopic  examination of scrapings from the affected  areas  revealed  living porrect vermiform   arthropoda 0,2-0,5 mm  large with four pairs of short  extremities in the front part of their bodies. What is the laboratory diagnosis?

100.

A  28 year  old  man  had  a  gunshot wound    of   shin   that    resulted   in   an ulcer  from  the  side  of  the  injury.  What is the main factor of neurodystrophy pathogenesis in this case?

101.

A 45 year old man consulted  a doctor about a plaque-like formation on his neck. Histological   examination  of  a  skin  bioptate  revealed   clusters   of  round   and oval tumour cells with a narrow  border of basophilic  cytoplasm  resembling of cells of basal epidermal layer. What  tumour is it?

102.

A patient ill with essential hypertension  was  recommended a  drug that prevents thrombosis. It is to be taken parenterally. What drug is it?

103.

Packed   cell  volume  of  a  man  was 40% before  the trauma. What packed  cell volume  will be  observed 24 hours  after blood loss of 750 ml?

104. Two hours after an exam a student had   a   blood   count   done   and   it   was revealed   that   he   had   leukocytosis   without significant leukogram modifications. What  is the most probable mechanism  of leukocytosis  development?

105.

Golgi  complex   exports   substances from    a   cell   due    to    the    fusion    of the membrane saccule with the cell membrane.  The   saccule   contents  flows out. What process is it?

106.

A boy found a spider with the following morphological characteristics: it is 2 cm long,  has  roundish black  abdomen with two  rows of red  spots  on its dorsal  side; four pairs of jointed limbs are covered with small black hairs. What arthropod is it?

107.

A  3 year  old  child  with  symptoms of   stomatitis,    gingivitis   and    dermatitis   of   open   skin   areas   was   delivered to a hospital. Examination revealed inherited  disturbance  of  neutral  amino acid transporting in the bowels. These symptoms  were  caused  by the  deficiency of the following vitamin:

 
108. A  patient with  suspected   diagnosis \\\"progressing muscular  dystrophy\\\" got his urine tested. What compound will confirm this diagnosis if found in urine?
109.

A patient being treated for viral hepatitis type B got symptoms  of hepatic insufficiency. What blood changes indicative of protein metabolism disorder will be observed in this case?

110. A  pregnant woman  had  her  blood group  identified.  Reaction of erythrocyte agglutination with standard serums of 0αβ (I),  Bα  (III)   groups  didn’t  proceed with standard serum  of Aβ  (II)  group.  The blood group under  examination is:d
111. A sensitive  neural  ganglion  consists of roundish neurocytes with one  extension that  divides into axon and dendrite at some distance  from the perikaryon. What are these cells called?
112. A doctor examined a child and revealed symptoms of rachitis. Development of this disease  was caused by deficiency of the following compound:
113.

An embryo displays disturbed process of dorsal mesoderm segmentation and  somite  formation. What  part  of skin will have developmental abnormalities?

114.

It  was  found  out  that  some compounds, for instance  fungi toxins and some  antibiotics   can  inhibit   activity  of RNA-polymerase.  What  process  will be disturbed in a cell in case of inhibition  of this enzyme?

 
115.

A 7 year old child is ill with bronchitis. It  is necessary to administer him an antibacterial drug. What   drug of fluoroquinolone group is CONTRA- INDICATED at this age?

116.

A culture  of monkey  cells (Vero) and a group of mouse  sucklings were infected with an inoculum  taken  from a child with provisional  diagnosis \\\"enterovirus infection\\\".  There  was  no  cytopathic effect  on the cell culture  but mouse  sucklings died. What enteric viruses might have caused disease of this child?

 
117.

A patient died from cardiopulmonary decompensation. Histological  examination   revealed    diffused    pulmonary   lesion together with interstitial edema, infiltration of tissue by limphocytes, macrophages, plasmocytes;  pulmonary fibrosis,  panacinar  emphysema. What  disease  corresponds with the  described  picture?

118. Vagus branches that innervate heart are being stimulated in course of an experiment.  As  a  result  of  it  the  excitement conduction from atria  to the ventricles   was  brought  to  a  stop.  It  is caused  by electrophysical changes  in the following structures:

119.

If a man  has  an  attack  of bronchiospasm it is necessary to reduce  the effect of vagus  on  smooth  muscles  of bronchi. What  membrane cytoreceptors should  be blocked for this purpose?

120.

A patient of surgical department complains  about  pain  in the  small of her back  and  in the  lower  part  of her  belly; painful  and  frequent  urination. Bacteriological examination of urine revealed gram-negative oxidase-positive rod-like bacteria forming  greenish  mucoid  colonies  with  specific  smell.  What   causative agent can it be?

121.

There     are     several     groups     of molecular mechanisms  playing important part   in  pathogenesis  of  insult   to  cells which contributes to the pathology development. What processes are stimulated  by  proteinic   damage   mechanisms?

122. A  child  was born  with  cleft  palate. Examination revealed  aorta  defects  and reduced  number    of   T-lymphocytes   in blood.  What  immunodeficient syndrome is it?
123.

A 16 year old boy after an illness has diminished  function  of protein synthesis in liver as a result of vitamin K deficiency. It will cause disturbance of:

124.

Life  cycle  of  a  cell  includes   the process  of DNA  autoreduplication. As a result  of it monochromatid chromosomes turn  into  bichromatid ones.  What  period of  cell  cycle  does  this  phenomenon fall into?

125.

A driver who got a trauma in a road accident  and  is shocked  has reduction of daily urinary output down to 300 ml. What is the main pathogenetic factor of such diuresis change?

126.

Systemic arterial pressure of an adult dropped  from  120/70  to  90/50  mm  Hg that led to reflectory vasoconstriction. The vasoconstriction  will be  maximal  in  the following organ:

127.

Examination   of   a   12   year    old boy with developmental lag revealed achondroplasia: disproportional constitution  with  evident  shortening of  upper and lower limbs as a result of growth disorder of epiphyseal cartilages  of long tubal bones. This disease is:

128.

A patient was diagnosed with autoimmune  hemolytic cytotoxic anemia.  What substances  are antigens  in II type allergic reactions?

129.

While performing an operation in the area  of axillary  crease  a surgeon  has  to define  an  arterial vessel  surrounded by fascicles of brachial plexus. What artery is it?

130.

A patient takes digoxin for treatment of   cardiac   insufficiency.   What   diuretic may increase  digoxin  toxicity  due  to the intensified excretion of K +  ions?

 
131.

During  starvation muscle proteins break up into free amino acids. These compounds will be the most probably involved into the following process:

132.

A patient ill with amebiasis  was prescribed  a  certain   drug.   The   use  of alcohol  together with this drug is contra- indicated because  the drug inhibits metabolism of ethyl  alcohol.  What  drug is it?

 
133.

Surgical removal of a part of stomach resulted in disturbed absorption of vitamin  B12 , it is excreted with  feces.  The patient was diagnosed  with anemia.  What factor  is necessary  for absorption of this vitamin?

134.

A   patient  ill  with   chronic   cardiac         insufficiency     was    prescribed    an average  therapeutic dose of digoxin. Two weeks   after   begin   of  its  taking   there appeared symptoms  of drug  intoxication (bradycardia, extrasystole, nausea). Name the phenomenon that  caused  accumulation of the drug in the organism?

 
135.

In  course   of  a  preventive  examination   of   a   miner   a   doctor   revealed changes   of  cardiovascular  fitness  which was indicative  of cardiac  insufficiency  at the compensation stage. What is the main proof of cardiac compensation?

136. Rest  potential of a cell equals  80 mV . At what stage of action potential did the membrane potential equal +30 mV ?
137.

A  35  year  old  man  got  an  injury that  caused  complete disruption of  spinal  cord  at  the  level of the  first cervical segment.   What  respiration changes  will be observed?

138.

In  course  of an  experiment a peripheral section of vagus of an experimental animal is being stimulated. What changes will be observed?

 
139.

2  hours   after   a  skeletal   extension was performed to  a 27 year  old  patient with  multiple   traumas (closed  injury  of chest,  closed  fracture of right  thigh)  his condition abruptly became  worse and the patient died from acute  cardiopulmonary decompensation. Histological  examination of pulmonary and cerebral vessels stained with Sudan III revealed  orange  drops occluding the vessel lumen. What complication of polytrauma was developed?

140.

In  course  of  severe  respiratory viral  infection   there   appeared  clinical  signs  of  progressing   cardiac   insufficiency that  caused  death  of a patient in the 2nd week  of  disease.  Autopsy revealed   that the  heart   was  sluggish,  with  significant cavity  dilatation. Histological  examination  of myocardium revealed  plethora of microvessels   and   diffuse   infiltration   of stroma by lymphocytes and histiocytes. What disease corresponds with the described picture?

141.

A specimen  stained  by Ozheshko method  contains   rod-like   microorganisms stained blue with round terminal components stained  red.  What  are  these components called?

142.

A 38 year old patient with full-blown jaundice,  small cutaneous hemorrhages, general weakness and loss of appetite underwent puncture biopsy  of  liver.  Histological  examination revealed  disseminated  dystrophy,  hepatocyte necrosis, Councilman’s  bodies.   Lobule   periphery has signs of significant infiltration  by lymphocytes, there are also individual multinuclear  hepatocytes.  What   is  the most probable diagnosis?

 
143.

A  man  with an injury  of the  dorsal area of his neck was admitted to the resuscitation department. What  muscle occupies this area?

144. In course  of an experiment a toad’s right labyrinth  was destroyed. It will cause amyotonia of the following muscles:
145.

A 20 year old patient died from intoxication 8 days  after  artificial  illegal abortion    performed    in    her    14-15th week    of   pregnancy.    Autopsy    of   the corpse revealed yellowish colour of eye sclera   and   of  skin,  necrotic   suppurative endometritis, multiple pulmonary abscesses,  spleen  hyperplasia with  a  big number    of   neutrophils  in   its   sinuses. What complication after abortion was developed?

 
146.

A patient complains  of dizziness and hearing loss. What nerve is damaged?

147.

A 6 year old child was delivered to a hospital.  Examination revealed   that  the child  couldn’t  fix  his  eyes,  didn’t  keep his  eyes  on  toys,  eye  ground   had   the cherry-red spot sign. Laboratory analyses showed that brain, liver and spleen had high rate  of ganglioside  glycometide.  What congenital  disease is the child ill with?

148.

A  patient has  a  cluster  of  matted together dense  lymph nodes  on his neck. Histological  examination of a removed lymph node revealed  proliferation of reticular cells, presence of Reed-Sternberg cells. What disease is meant?

149.

While palpating  mammary gland of a patient a  doctor  revealed  an  induration in form  of a node  in the  inferior  medial quadrant. Metastases may  extend  to  the following lymph nodes:

150.

A  pregnant woman  was  registered in an antenatal clinic and underwent complex examination for a number of infections.  Blood  serum  contained IgM to  the  rubella  virus.  What  is this  result indicative of?

151. Parents of a 3 year old child have been  giving him antibiotics  with purpose of preventing enteric  infections  for a long time.  A  month  later  the  child’s  condition changed  for the  worse.  Blood  examination    revealed    apparent   leukopenia and  granulocytopenia. What  is the  most probable mechanism  of blood changes?

152.

A pathological process in bronchi resulted   in   epithelium   desquamation. What  cells will regenerate bronchial  epithelium?

153.

A  patient  ill  with  tuberculosis  died from progressing cardiopulmonary decompensation. Autopsy in the  area  of the right lung apex revealed  a cavity 5 cm in  diameter  communicating with  lumen of  a  segmental   bronchus.  On  the  inside cavity walls are  covered  with caseous masses   with   epithelioid  and   Langhans cells beneath them.  What  morphological form of tuberculosis is it?

 
154.

Workers of  a  hothouse farm  work under  conditions of unfavourable microclimate:   air   temperature  is  +37oC , relative  humidity  is 90%, air speed  is 0,2 m/s. The way of heat emission under  these conditions will be:

155.

A gynaecologist  was examining  a patient and revealed  symptoms  of genital tract  inflammation. A  smear  from  vagina contains  pyriform  protozoa with a spine, flagella at their  front;  there  is also an undulating membrane. What  disease  can be suspected?

156. A boy has I (I 0I 0) blood  group  and his sister has IV (I A I B ) blood group. What blood groups do their parents have?
157.

A patient ill with enteritis accompanied by massive diarrhea has low water rate in the extracellular space, high water rate inside  the  cells and  low blood  osmolarity. What is such disturbance of water-electrolytic  metabolism called?

 
158.

For the purpose of myocardium infarction treatment a patient was injected with  embryonal stem  cells derived  from this very patient by means  of therapeutic cloning . What transplantation type is it?

159. A histological  specimen  of spleen shows  a vessel  with  a wall consisting  of endothelium and subendothelial layer, median  membrane is absent,  exterior membrane inosculates with the  layers  of spleen connective  tissue. What vessel is it?
160. In course of a conditional experiment the   development  of  mesenchyma  cells was  completely   inhibited.   Development of the following muscular tissue will be disturbed:
161. A  patient  ill  with  chronic   gastritis  went  for  endogastric pH-metry that allowed   to  reveal   decreased  acidity   of gastric juice. It is indicative  of diminished function  of the following cells:
162.

Vagi   of   an   experimental  animal were  cut  on  both  sides.  What  respiration changes will be observed?

163.

A   70  year   old   man   is  ill  with vascular atherosclerosis of lower extremities  and  coronary heart  disease.  Examination    revealed    disturbance  of   lipidic blood composition. The main factor of atherosclerosis pathogenesis is the excess of the following lipoproteins:

164.

On the 2-3rd day after stomach resection intestinal peristalsis  wasn’t restored. What  is to be administered for stimulation of gastrointestinal tract?

165.

A cardiac electric stimulator was implanted  to  a  75  year   old  man   with heart  rate of 40 bpm. Thereafter the heart rate  rose  up  to 70 bpm.  The  electric  stimulator has  undertaken the  function  of the following heart part:

 
166.

A stomatologist injected a patient with a certain  drug  in order  to reduce  salivation during tooth filling. What drug is it?

167.

A  30 year  old  woman  has  applied a  lipstick   with  a  fluorescent  substance for a long time. Then she got a limited erythema and  slight  peeling  on  her  lip border, later  there   appeared transversal striae  and cracks. Special methods  of microscopic examination of the affected area helped  to reveal sensibilized  lymphocytes and macrophages in the connective tissue; cytolysis. What type of immunological hypersensitivity was developed?

168.

A  patient ill with  essential  arterial hypertension had a hypertensic crisis that resulted in an  attack  of cardiac  asthma. What is the leading mechanism  of cardiac insufficiency in this case?

169.

A   man   who   has   been   taking   a drug  for  a long  time  cannot  withhold  it because this causes impairment of psychic, somatic  and  vegetative  functions.  Name the syndrome of different disturbances caused by drug discontinuation:

170. A patient consulted  a stomatologist about  purulent inflammation of his gums. What  drug will be the  most effective  if it  is suspected that a causative agent is an anaerobe?

171. Rats    being    under     stress    have muscular hypertonia and high arterial pressure, high glucose concentration in blood and intensified secretion of corticotropin  and   corticosteroids.  In   what stress phase are these animals?
172.

A patient came to the hospital complaining about quick fatigability and apparent  muscle   weakness.   Examination revealed  an autoimmune disease  that causes disorder of functional receptor condition   in   neuromuscular   synapses. What transmitter will be blocked?

173.

Examination of a 35 year old patient revealed high acidity of gastric juice. What receptors should  be  blocked  in order  to reduce  it?

174. Examination of a young woman revealed a node-like, soft and elastic homogenous tumour of pinkish-white colour along the acoustic nerve. The tumour contains   cell  bundles   with  oval nuclei. Cellular fibrous bundles form rhythmic  structures made  up  by parallel rows of regularly  oriented cells arranged in form of a palisade with cell-free homogenous zone (Verocay bodies) between them. What tumour is it?

175.

A  45  year  old  woman   is  ill  with breast  cancer. Her left arm has symptoms of  lymphatic  system  insufficiency  - limb edema,  lymph  node  enlargement. What form of lymphatic circulation  insufficiency is it?

176. An   endocrinal  gland   with parenchyma consisting of epithelium and neural tissue  is  under   morphological examination. Epithelial trabecules have two types of cells: chromophilic and chromophobic. Identify this organ:  
177. While  performing an inguinal  canal operation on account  of hernia  a surgeon damaged the  canal’s contents. What exactly was damaged?
178. A  12 year  old  child has  intolerance to some foodstuffs. Their consumption causes an allergic reaction in form of itching  skin  eruptions.  What   antihistaminic drug should be administered so that the child could attend school?
179.

A  patient  that   entered  the  admission  office  had  the  following  signs  of acute cardiac insufficiency: paleness, acrocyanosis,   frequent shallow  respiration. What drug is indicated in this case?

 
180. A  26 year  old  man  is in the  torpid shock phase  as a result  of a car accident. In blood:  3, 2 · 109/l. What  is the  leading mechanism  of leukopenia development?
181.

A  patient had  hemorrhagic stroke. Blood examination revealed strengthened kinin concentration. The patient was prescribed contrical.  It was administered in  order  to  inhibit  the  following  proteinase:

182. A patient with bacterial pneumonia was  prescribed  benzylpenicillin. What  is the mechanism  of its antibacterial effect?
183. Hartnup disease is caused by point mutation of only one gene which results in  disturbance  of  tryptophane  absorption in the bowels and its resorption in the renal tubules.  It is the reason  for disorder of both  digestive  and  urination systems. What genetic phenomenon is observed  in this case?

184.

A  patient who  has  been  treated  in a  neural   clinic  and  has  been   taking   a sedative  for  a long  time  got  the  following complication: cough, rhinitis, epiphora. What drug caused these disturbances?

185.

In  order  to  accelerate healing  of  a radiation ulcer  a vitamin  drug was administered. What drug is it?

186.

Inoculum from  pharynx  of a patient ill with angina was inoculated into blood-tellurite  agar.  It  resulted  in  growth   of grey, radially striated (in form of rosettes) colonies 4-5 mm in diameter. Gram-positive  bacilli  with  clublike  thickenings on their ends placed in form of spread  wide apart  fingers are visible by microscope. What microorganisms are these?

 
187. Plasmic factors  of blood  coagulation are  exposed  to post-translational modification  with  the  participation of  vitamin K .  It  is  necessary   as  a  cofactor   in  the enzyme   system   of   γ-carboxylation  of protein factors  of blood  coagulation due to the increased  affinity of their molecules with calcium ions. What amino acid is carboxylated in these proteins?
188. Pharmacological effects of anti-depressants are connected with inhibition of an enzyme  catalyzing  biogenic  amines noradrenaline and  serotonine in the  mitochondrions of  cerebral neurons. What enzyme participates in this process?
189.

An  oncological  patient was prescribed methotrexate. With the lapse of time target  cells of the tumour lost susceptibility to this drug. There  is change  of gene expression  of the following enzyme:

190.

As  a  result   of  prophylactic  medical examination a 7 year old boy was diagnosed  with Lesch-Nyhan syndrome (only   boys  fall  ill  with  it).  The   boy’s parents are  healthy   but  his  grandfather by his mother’s side suffers from the same disease.  What  type of disease  inheritance is it?

191.

Planned mass vaccination  of all newborn 5-7 day old children  against tuberculosis plays an important role in tuberculosis prevention. In  this  case  the following vaccine is applied:

192. A patient with hypertensic crisis was admitted to the cardiological  department, he was injected intravenously with an anti-hypertensive drug - salt of an alkaline-earth metal. What drug was injected?

193. In course  of a small pelvis operation it  became   necessary   to  ligate  an  ovarian  artery.  What  formation may  be  accidentally ligated together with it?
194.

A patient with acute  morphine poisoning  was delivered to a hospital.  What specific narcotic  antagonist should be chosen in this case?

195.

The  upper   lobe  of  the  right  lung is enlarged, grey  and  airless,  the  inscision surface  is dripping  with turbid  liquid, the  pleura  has many  fibrinogenous films; microscopical  examination of alveoles revealed   exudate  containing  neutrophils,  desquamated alveolocytes   and  fibrin fibers. The bronchus  wall is intact. What is the most probable diagnosis?

196.

A   28  year   old   patient  had   high arterial   pressure,  hematuria   and   facial  edemata. In  spite  of  treatment renal insufficiency  was  progressing.   6  months later  the  patient died  from  uremia.  Microscopic examination of his kidneys  and their glomerules  revealed  proliferation of capsule  nephrothelium and  of podocytes with  \\\"demilune\\\" formation, sclerosis  and hyalinosis of glomerules. What disease corresponds with the described  picture?

197.

A  patient  with  a  knife  wound   in the  left lumbar  part  was delivered  to the emergency  hospital.  In course  of operation  a surgeon  found  that  internal organs were  not  damaged but  the  knife  injured one   of  muscles   of  renal   pelvis.  What muscle is it?

 
198. A  man  with  a  stab  wound  in  the area  of quadrilateral foramen  applied  to a doctor.  Examination revealed  that  the patient was unable  to  draw  his arm  aside  from  his  body.  What  nerve  is  most probably  damaged?
199.

Autopsy of a man ill with severe hypothyroidism  revealed   that   connective tissue, organ stroma, adipose and cartilaginous tissues  were  swollen,  semi- transparent, mucus-like.  Microscopic examination of  tissues  revealed   stellate cells  having  processes  with  mucus between them.  What  type  of  dystrophy is it?

200.

Ultramicroscopical examination of \"dark\" hepatocyte  population in  the  cell cytoplasm  detected a developed granular endoplasmic reticulum. What function has this organella in these cells?