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1.

A   30-year-old   patient  complains about   having   abdominal  pain   and   diarrhea for  five  days;  body  temperature rise  up  to  37, 5oC  along  with  chills. The day   before   a   patient  had   been   in   a forest and drunk from an open water reservoir.  Laboratory  analyses   enabled to make the following diagnosis: amebic dysentery. What  is the  drug of choice  for its treatment?

 
2.

A man  suffering  from  a hereditary disease married a healthy  woman. They got 5 children,  three  girls and  two  boys. All the  girls inherited their  father’s  disease. What  is the  type  of  the  disease  inheritance?

3. An  electronic microphotograph shows a  macrophagic cell  with  erythrocytes at different stages of differentiation located along its processes.  This is the cell of the following organ:
4.

Quite  often the cause of secondary immunodeficiency is an infection involvement, when the causative agents propagate directly  in the cells of immune system  and  destroy  it. The  following  diseases are characterized by:

5.

Examination  of  a  patient revealed   a dense, movable skin tumour that is standing out distinctly  from the surrounding tissues. Its section is found to be white and composed  of fibrous tissue. Microscopic examination revealed  interlacing collagen fibers and few cells. What tumour is it?

6.

A patient underwent a surgery for excision of a cyst on pancreas.  After  this he developed haemorrhagic syndrome   with apparent disorder   of  blood  coagulation. Development of this complication can be explained by:

7.

A mother consulted  a doctor  about  her 5-year-old  child who develops  erythemas, vesicular   rash  and  skin  itch  under   the influence    of   sun.   Laboratory   studies revealed  decreased iron  concentration in the  blood  serum,  increased  uroporphyrinogen  I excretion with the urine.  What  is the most likely inherited pathology  in this child?

8. A baby refuses the breast, he is anxious, presents with arrhythmic respiration. The urine smells of \\\"brewer’s yeast\\\" or \\\"maple syrup\\\".  This pathology  was caused by the inherited defect of the following enzyme:
9. While  studying  a  microslide  obtained from  the  punctuate of a regional  lymph node and stained by Romanovsky-Giemsa method  a physician  revealed  some  light- pink   thin   microorganisms   with   12-14 regular  spiral  coils and  pointed ends,  up to 10-13 micrometer long. This might  be the  causative  agent  of  the  following  disease:
10.

Sanitary   bacteriological research  on water by the membrane filter method revealed  two red colonies on a membrane filter (Endo agar)  through which 500 ml of analyzed  water  were passed.  Calculate the coli index and coli titer of the analyzed water:

 
11.

While examining  a patient an otolaryngologist noticed  hyperaemia and significantly edematous tonsils with a grayish film upon them. Microscopical examination of  this  film  revealed   some gram-positive bacilli  placed  at  an  angle with each other. What disease might be suspected?

12. A 38-year-old  patient with an uterine haemorrhage lasting  for 2 days was delivered to the admission ward. Which of the following will be revealed  in the patient’s blood?
13.

After    a   hypertonic  crisis   a   patient presents with lacking spontaneous movements  in  his  right   arm   and   leg, muscle  tone  of these  extremities is increased.  What  type of motor  dysfunction has developed in this case?

14. A patient\\\'s organism has decreased concentration of magnesium ions that are necessary for attachment of ribosomes to the  granular endoplasmatic reticulum. It  is known  that  this  causes  protein biosynthesis disturbance. What stage of protein biosynthesis  will be disturbed?

15.

A patient suffering from stomach ulcer has  been  treated with  an  antacid   drug almagel. For acute bronchitis treatment he was prescribed the  antibiotic methacycline.   However    within   next   5  days   the fever   didn’t   fall,   cough    and    sputum nature  remained unchanged. A  physician came to the  conclusion  that  the  drugs were incompatible. What type of drug incompatibility is the case?

16. A 70-year-old  patient suffers from atherosclerosis complicated by the  lower limb thrombosis that has caused gangrene on  his left  toes.  What  is the  most  likely cause of the thrombosis origin?
17.

ECG  of  a  44-year-old  patient shows signs  of  hypertrophy  of  both   ventricles and the right atrium.  The patient was diagnosed  with the tricuspid  valve insufficiency. What pathogenetic variant of cardiac dysfunction is usually observed in case of such insufficiency?

18.

Bacteriological  examination  of purulent discharges  from the urethra revealed  gram-negative bacteria looking like  coffee  beans.   They  were  localized in the leukocytes  and could decompose glucose and maltose to acid. These are the causative agents of the following disease:

19.

Proserin increases skeletal muscle tone when given systematically. Halothane induces   relaxation  of  skeletal   muscles and   reduces   proserin  effects.   What   is the nature of proserin and halothane interaction?

20.

A 62-year-old  female patient has developed a cataract (lenticular opacity) secondary  to the  diabetes  mellitus.  What type  of protein modification  is observed in case of diabetic  cataract?

21.

Examination of a 2-year-old  child revealed  physical  developmental lag, the child  often   has  pneumonias.  The  child was diagnosed  with nonclosure of ductus arteriosus. Haemodynamics disorder  was caused  by the  intercommunication of the following vessels:

22.

The temperature of the ambient environment is 38oC and relative  air humidity is 50%. What ways of heat emission provide maintaining a constant temperature of the human  body?

 
23. A  married couple  consulted  a specialist at the genetic consultation about probability of having children  with hemophilia. Both spouses are healthy,  but the  wife’s father  has  hemophilia. In  this  family hemophilia may be passed to:
24. The minute  blood volume in a patient with transplanted heart  has increased  as a result  of physical  activity.  What  regulative mechanism  is responsible for these changes?
25.

A    female    patient   consulted     a physician  about   digestive  disorder, extended abdominal pain. Examination revealed  drastic  decrease in hemoglobin concentration. It is known from the anamnesis that while living in the Far East the patient used to eat freshly-salted caviar. Some relatives  living with her had the similar condition. What  is the most likely diagnosis?

26.

A man has normal  sensitivity of his finger  skin,  however  he  doesn’t sense  his wedding ring around the finger. What process  induced   by  wearing  of  the  ring has caused this phenomenon?

27.

It is necessary  to take  the cerebrospinal  fluid  from  a  patient with  suspected inflammation of brain  tunics.  Diagnostic puncture was performed between the arches  of  the  lumbar   vertebras. During the puncture the needle  went through the following ligament:

28.

ECG  study  showed  that  the  T -waves were  positive  in  the  standard extremity leads, their  amplitude and  duration were normal.   The  right  conclusion   would  be that  the  following  process  runs  normally in the heart  ventricles:

29.

A  patient has  an  increased pyruvate concentration in blood.  A  large  amount of it is excreted with the  urine.  What  vitamin is lacking in this patient?

30.

A patient has pellagra.  Interrogation revealed  that he had lived mostly on maize for a long time  and  eaten  little  meat. This disease had been caused by the deficit of the following substance  in the maize:

31.

Study of bacteriological sputum  specimens stained  by the Ziel-Neelsen method revealed  some bright-red acid-resistant bacilli that were found in groups or singularly. When inoculated onto  the nutrient media, the signs of their growth show up on the 10-15 day. These bacteria relate to the following family:

32.

A patient with high rate of obesity was advised to use carnitine as a food additive in order  to enhance \"fat  burning\". What is the role of carnitine in the process of fat oxidation?

33.

In  a  2-year-old  child  with  catarrhal presentations  and  skin  rash  a  pediatrician  suspected   scarlet   fever.   The   child was given  intracutaneously a small  dose of  serum  antibody to  the  streptococcal erythrogenic toxin; on the site of injection the rash disappeared. What do the reaction results mean?

 
34.

A  patient has  a  transversal laceration in the spinal cord. What respiratory changes will result from this?

35. A female  patient suffering  from bronchial  asthma  had  got a viral infection  that  provoked status  asthmaticus with fatal  outcome.  Histological  examination of lungs revealed  spasm and edema  of bronchioles, apparent infiltration  of their walls with  lymphocytes,  eosinophils   and other   leukocytes;   labrocyte   degranulation.  What  mechanism  of hypersensitivity underlies the described  alterations?
36.

In  the  perianal  folds  of a 5-year-old girl her mother has found some white \\\"worms\\\" that caused  itch  and  anxiety  in the  child.  The  \\\"worms\\\" were sent  to  the laboratory. During examination the physician saw white filiform helminths 0,5-1 cm long, with pointed ends,  some  helminths had twisted ends. What  is the most likely diagnosis?

 
37.

Examination of a 27-year-old  patient revealed  pathological changes in liver and brain.  Blood  plasma  analysis revealed  an abrupt decrease in the copper concentration, urine analysis revealed an increased copper  concentration. The patient was diagnosed  with  Wilson’s degeneration. To confirm  the  diagnosis  it  is necessary   to study the activity of the following enzyme in blood serum:

38.

A  patient complains  about   dyspnea provoked by  the  physical  activity.  Clinical examination revealed  anaemia and presence of the  paraprotein in the  zone of gamma-globulins. To confirm the myeloma  diagnosis it is necessary  to determine the following index in the patient’s urine:

39. After    a   serious   psycho-emotional stress  a 45-year-old  patient suddenly  felt constricting  heart  pain  irradiating to  the left  arm,  neck  and  left  scapula.  His face turned pale,  the  cold sweat stood  out  on it. The  pain  attack  was stopped with nitroglycerine. What process has developed in this patient?
40. A 62-year-old female patient complains about  frequent pains  in the  region  of thorax and vertebral column, rib fractures. A physician suspected myelomatosis (plasmocytoma). Which  of the  following laboratory indices  will be of the  greatest diagnostic importance?
41.

An   8-year-old   child   was  admitted to  the  infectious  department with  fever (up  to  38oC )  and  punctuate  bright-red skin  rash.  The  child  was  diagnosed  as having scarlet  fever. Objectively:  mucous membrane of pharynx  is apparently hyperaemic and edematic,  the  tonsils are enlarged and have dull yellowish-grey foci with some black areas.  What  inflammation is the  reason  for the  pharynx  alterations?

42.

Nappies  of a newborn have dark spots being  the  evidence  of homogentisic acid formation. This is caused by the metabolic disorder  of the following substance:

43.

A  histological   specimen   presents a receptor zone  of a sensoepithelial sense organ.  Cells of this zone are placed  upon the basal membrane and include the following types: external and internal receptor cells, external  and internal phalangeal cell, stem cells, external  limiting cells and external supporting cell. The described   receptor zone  belongs  to  the following sense organ:

44.

A patient was admitted to the  hospital   with   an   asphyxia   attack   provoked by a spasm of smooth muscles of the respiratory tracts.  This  attack   was  mainly caused  by alterations in the following parts of the airways:

45.

While   eating   a   child   choked    on food   and   aspirated  it.   The   child   has severe cough, cyanotic skin and mucous membranes, rapid pulse, infrequent respiration,   prolonged  expiration.  The  child has  developed the  following  disorder of the external  respiration:

46.

A    50-year-old    patient   complains about   general   weakness,   appetite  loss and  cardiac  arrhythmia. The  patient presents with muscle hypotonia, flaccid paralyses,   weakened  peristaltic  activity of  the  bowels.  Such  condition might  be caused by:

47.

While  playing  volleyball  a sportsman jumped    and   then    landed    across   the external  edge  of  his  foot.  This  caused acute  pain  in the  talocrural articulation, active movements became limited, passive movements remained unlimited  but  painful. In the  region  of the  external ankle a swelling appeared, the  skin turned red and  became  warmer  to  the  touch.  What type of peripheral circulation  disorder  has developed in this case?

48.

A  patient suffering  from  myasthenia has been  administered proserin. After  its administration the patient has got nausea, diarrhea, twitch  of  tongue   and  skeletal muscles. What  drug  would  help  to eliminate the intoxication?

49.

A  man  died  from  an  acute  infectious disease accompanied by fever, jaundice,    haemorrhagic   rash    on    the    skin and  mucous   membranes  as  well  as  by acute renal insufficiency. Histological examination of  renal  tissue  (stained by Romanovsky-Giemsa method) revealed some   convoluted  bacteria  looking   like C und S letters.  What bacteria were revealed?

50.

A   12-year-old   adolescent  suffering from bronchial  asthma has a severe attack of asthma:  he presents with marked expiratory  dyspnea,  skin pallor.  What  type of alveolar ventilation disorder is observed?

51.

A  46-year-old  patient suffering  from the diffuse toxic goiter underwent resection   of   the    thyroid    gland.   After    the surgery the patient presents with appetite loss, dyspepsia,  increased neuromuscular excitement. The body weight remained unchanged. Body  temperature is normal. Which of the following has caused such a condition in this patient?

 
52.

A patient who had myocardial infarction was administered 75 mg of acetylsalicinic acid a day. What is the purpose of this administration?

53. Medical examination at the military registration and enlistment office revealed   that  a  15-year-old  boy  was  high, with eunuchoid body proportions, gynecomastia,  female   pattern  of  pubic hair distribution. The boy had also fat deposits  on the  thighs,  no facial hair,  high voice, subnormal intelligence quotient. Which karyotype corresponds with this disease?
54.

To  prevent  the  transplant  rejection after   organ   transplantation  it  is  required   to  administer  hormonotherapy  for the purpose of immunosuppression. What hormones are used for this purpose?

55.

A 53-year-old  female  patient was diagnosed  with liver rupture resulting  from a  blunt   abdominal  injury.  The  escaped blood  will be  assembled   in  the  following anatomic  formation:

56.

A  patient complains  about  edemata of  legs,  skin  cyanosis,   small  ulcers   on one  side  of  the  lateral  condyle.  Examination  revealed  a swelling, enlarged veins, formation of nodes.  The  pathological process has started in the following vein:

57.

A 1,5-year-old child presents with both mental  and  physical  lag, decolorizing  of skin and  hair,  decrease in catecholamine concentration in blood. When a few drops of 5% solution  of trichloroacetic iron had been  added  to the  child’s urine  it turned olive green. Such alteration are typical for the following pathology of the amino acid metabolism:

58.

Autopsy of a 73-year-old man who had been suffering from the coronary heart disease along  with cardiac  insufficiency for a long time revealed:  nutmeg  liver, brown induration of  lungs,  cyanotic  induration of kidneys  and  spleen.  What  kind  of circulation  disorder was the  cause  of such effects?

59.

A patient suffering from chronic hyperacidic    gastritis   takes    an   antacid drug  for heartburn elimination. After  its ingestion the patient feels better but at the same time he has a sensation  of stomach swelling. Which of the following drugs might be the cause of such side effect?

60.

Continuous use of a certain  drug may cause  osteoporosis, erosions  of  stomach mucosa,  hypokaliemia, retention of sodium and water  in the organism,  decreased concentration of  corticotropin  in  blood. What drug is it?

61.

A patient has been  given high doses of hydrocortisone for a long time. This caused   atrophy  of  one   of  the   adrenal cortex zones. Which zone is it?

62. A  63-year-old   patient with  collapse presentations was delivered to the emergency  hospital.  A physician  has chosen noradrenalin against hypotension. What is its mechanism of action?
63.

The greater amount of nitrogen is excreted from  the  organism  in  form  of urea. Inhibition of urea synthesis and accumulation of  ammonia in  blood  and tissues are induced  by the decreased activity of the following liver enzyme:

64.

A patient suffering  from  syphilis has been  treated with  bismuth  preparations. As  a result  of it some  grey spots  turned up on the  mucous  membrane of the  oral cavity; nephropathy symptoms  were  also present. What  drug  should  be  used  for treatment of bismuth intoxication?

65.

ECG  of a patient shows such alterations: P -wave is normal,  P − Q-interval is short,  ventricular QRST   complex  is wide, R-wave  is double-peak or two-phase. What form of arrhythmia is it?

66.

In a histological specimen parenchyma of an organ is represented by lymphoid tissue that forms lymph nodes; the latter are arranged in a diffuse manner and enclose a central artery. What anatomic  formation has such morphological structure?

67. Examination of a patient with frequent haemorrhages from the internal organs and mucous  membranes revealed  proline and  lysine within the  collagen  fibers. Disorder  of their hydroxylation is caused by lack of the following vitamin:

68.

During  a prophylactic medical examination   a  7-year-old   boy  was  diagnosed with  daltonism.   His  parents are  healthy and have normal colour vision, but his grandfather on his mother’s side has the same abnormality. What is the type of the abnormality inheritance?

69.

In   a   healthy   adult   speed   of   the excitement conduction through the  atrioventricular node is 0,02-0,05 m/sec. Atrioventricular delay enables:

70.

A  histological  specimen  of a kidney shows a part of the distal tubule going between the  afferent and  efferent arteriole. The cells building the tubule wall have dense  nuclei;  basal  membrane is absent. Such structural formation is called:

71. Stimulation of an excitable  cell by the electric current has led to the depolarization  of its  membrane. The  depolarization has been  caused  mainly by the  following ions penetrating into  the  cell through its membrane:
72.

Products of some  proteins hydrolysis and   modification    are   the   biologically active substances  called hormones. Lipotropin,    corticotropin,    melanotropin and endorphins are synthesized  in the hypophysis  of the following protein:

73.

In patients with the biliary tract obstruction the blood coagulation is inhibited;  the patients have frequent haemorrhages caused  by  the  subnormal assimilation  of the following vitamin:

74.

A  48-year-old   patient was  admitted to the hospital with complaints about weakness, irritability, sleep disturbance. Objectively:  skin and scleras are of yellow colour.  In blood:  increased  concentration of total bilirubin  with prevailing direct bilirubin. The feces are acholic. The urine is dark  (contains  bile pigments).  What  type of jaundice  is it?

75.

A bacteriological laboratory has received  smears  from  the  sputum   of  a  patient with a chronic pulmonary disease. Microscopical  examination of the smears stained   by  the  Ziehl-Neelsen technique revealed  red bacilli. What property of the tuberculosis bacillus has shown itself?

76. Microscopical examination of an enlarged cervical lymph node revealed blurring  of its structure, absence  of lymphoid  follicles; all the  microscopic  fields showed cells with roundish nuclei and thin limbus of basophil cytoplasm. It is known from the clinical data that other groups  of lymph  nodes  are  also enlarged as well as spleen  and  liver. What  disease might be suspected?

77.

Two weeks after lacunar tonsillitis a 20- year-old  man  started complaining  about general weakness, lower eyelid edemata. After  examination the patient was diagnosed with acute glomerulonephritis. What are the most likely pathological changes in the urine formula?

78.

A 38-year-old  patient came to a traumatology   centre    and    complained about  an injury of his right hand. Objectively: the  patient has a cut wound  in the region of the thenar eminence on the right hand; distal phalanx  of the I finger cannot be flexed. What muscle was injured?

79.

Lung   ventilation   in   a   person    is increased   as  a  result  of  physical  activity. Which  of the  following  indices  of the external  respiration is much  higher  than in a state of rest?

 
80. As  a  result   of  continuous  starvation the glomerular filtration  rate has increased   by  20%.  The   most   probable cause of the glomerular filtration  alteration under  the mentioned conditions is:
81. After  transfusion of 200 ml of blood a patient presented with body temperature rise up to 37, 9oC . Which  of the  following substances  is the  most  likely cause  of temperature rise?
82.

A man who is riding the carousel presents with increased  heart  rate, sweating, nausea.  This  condition is caused  primarily by the stimulation of the following receptors:

 
83.

A worker  of a cattle  farm fell acutely ill and then died from the progressing intoxication. Autopsy revealed  enlarged, hyposthenic spleen  of dark-cherry colour when  dissected;  excessive  pulp  scraping. At the base and fornix of brain pia maters are  edematous, soaked  with blood,  dark- red  (\\\"scarlet hat\\\").   Microscopic   examination revealed serous haemorrhagic inflammation  of  brain  tissues  and  tunics along  with destruction of small vessel walls. What is the most likely diagnosis?

84.

A   49-year-old   patient  consulted   a doctor about increased fatigability and dyspnea   provoked  by  physical   activity. ECG   results:  heart   rate   -  50/min,  P Q- interval    is   prolonged,   QRS-    complex is  unchanged,  the   number   of  P -waves exceeds  the  number  of QRS-complexes. What type of arrhythmia is it?

85.

A  patient  suffering   from   coronary artery    disease    had    taken    a    certain drug   many   times   a   day   in   order   to arrest   stenocardia  attacks.   Overdose  of this drug finally caused intoxication. Objectively: cyanotic skin and mucous membranes, dramatic fall in the  arterial pressure, tachycardia, respiration inhibition. Blood  has increased concentration of methemoglobin. The drug the patient had taken  relates to the following group:

86.

A  patient  with  android-type  obesity had been suffering from arterial hypertension, hyperglycemia, glycosuria for a long time and died from the cerebral haemorrhage. Pathologic  examination revealed  pituitary basophil  adenoma, adrenal cortex  hyperplasia. What  is the most likely diagnosis?

87.

A middle-aged man went to a foreign country because he had been offered a job there.  However he had been unemployed for  quite   a  long  time.  What   endocrine glands were exhausted most of all in this man?

88. A   girl   has   been   diagnosed    with adrenogenital syndrome (pseudohermaphroditism).    This    pathology    is   caused    by hypersecretion of  the  following  adrenal hormone:
89. A woman  delivered  a dead  child with multiple  developmental defects.  What protozoan disease  might have caused  the intrauterine death?
90.

A patient has a massive haemorrhage caused    by   damage    of   the   dorsal    lingual  artery   by  cancer  of  tongue   back. What vessel should be ligated for the haemorrhage arrest?

91.

A 12-year-old  teenager has significantly put off weight within 3 months; glucose  concentration rose  up  to  50 millimole. He fell into a coma. What  is the main mechanism  of its development?

92.

As  a  result  of  increased   permeability     of    the     erythrocyte    membrane in  a  patient with  microspherocytic anaemia  (Minkowsky-Shauffard disease) cells receive sodium ions and water. Erythrocytes  take   form   of  spherocytes and  can  be  easily  broken  down.  What is the  leading  mechanism  of erythrocyte damage  in this case?

 
93. A   histological    specimen    shows   a blood  vessel. Its  inner  coat  is composed by endothelium, subendothelium and internal  elastic  membrane.  The   middle coat  is enriched with  smooth  myocytes. Such   morphological  characteristics  are  typical for the following vessel:
94.

Cooling of the human body in water is much  more  faster  than  in the  air.  What way  of  heat  emission  in  water  is much more effective?

95.

An  18-year-old  man  was delivered  to the hospital  after a road accident.  Examination  at the traumatological department revealed multiple injuries of soft tissues of face in the region of the medial eye angle. The injuries caused massive haemorrhage. What   arterial  anastomosis  might   have been damaged in this region?

96. After  a surgery  a 36-year-old  woman was given an intravenous injection of concentrated albumin  solution.  This  has induced   intensified   water   movement  in the following direction:
97.

Autopsy  of   a   man   with   a   malignant    stomach    tumour   who   had   died   from   cancer    intoxication  revealed in the posteroinferior lung fields some dense, grayish-red  irregular foci protruding above the section surface. Microscopic examination  revealed   exudate  containing a large  amount of neutrophils in the lumen and walls of small bronchi and alveoles. Such pulmonary alterations indicate the following disease:

98. Autopsy   of    a    1,5-year-old    child revealed  haemorrhagic skin rash, moderate hyperaemia and edema  of nasopharyngeal mucous membrane, small haemorrhages in the mucous  membranes and  internal organs;  dramatic  dystrophic alterations in liver and myocardium; acute necrotic nephrosis; massive haemorrhages in  the  adrenal glands.  What  disease  are these alterations the most typical for?
99. During     examination   of    an    11- month-old infant  a pediatrician revealed osteoectasia of the lower extremities and delayed  mineralization of  cranial  bones. Such pathology is usually provoked by the deficit of the following vitamin:
100.

Examination of  a  patient suffering from  chronic  hepatitis revealed  a significant decrease in the synthesis and secretion of bile acids. What process will be mainly disturbed in the patient’s bowels?

101. Retrospective diagnostics of bacterial dysentery involved serological  analysis of blood  serum  intended for  determination of Shigella antibody  titre. Which of the following reactions should  be applied  for this purpose?
102. You are studying functioning of a bacteria operon. The operator gene has   been   released  from   the   repressor gene.  Immediately after  this the  following process will start in the cell:

103.

While determining power inputs of a patient’s  organism  it was established that the   respiratory  coefficient   equaled  1,0. This  means  that  in the  cells of the  patient the following substances are mainly oxidized:

 
104.

During   an  experiment  the   dorsal roots of the spinal cord of an animal have been  cut. What  changes  will be observed in the innervation zone?

105.

An experimental animal has lost orientative reflexes  as a result  of destruction of certain  brainstem structures. What structures had been destroyed?

106. A  patient has  osmotic  pressure of blood plasma at the rate of 350 mOsmol/l (norm  is 300 mOsmol/l).  This will cause hypersecretion of the following hormone:
107.

After  a  sprint  an  untrained person develops muscle hypoxia. This leads to the accumulation of the following metabolite in muscles:

108. Cytoplasm of the myocytes contains a lot of dissolved metabolites resulting from glucose  oxidation.   Name  the  metabolite that turns directly into lactate:
109.

A young man complains about urination disorder. Examination of the external genitals revealed that the urethra was split and urine  could flow out of this orifice. What anomaly of the external genitals development is it?

110.

A   patient  consulted   an   urologist about  pain  during  urination. Analysis  of his urine  taken  in the  daytime  revealed eggs with a characteristic sharp point. It is known  from the anamnesis  that  the patient has recently  returned from Australia. What is the most likely diagnosis?

111.

Colonoscopy   of   a   patient   with dysentery revealed  that the mucous membrane of the large intestine was hyperemic, edematic,  and  its surface  was covered  with grey-and-green layerings. What  morphological form  of  dysenteric colitis is it?

 
112.

Examination of  a  patient 24 hours after  appendectomy revealed  neutrophilic leukocytosis   with  a  regenerative shift. What  is the  most  likely mechanism  of leukocytosis  development?

113.

A   35-year-old    patient  complains about  having  severe  rhinitis  and  loss  of sense of smell for a week. Objectively: the nasal cavity contains a lot of mucus covering  the  mucous  membrane and  blocking olfactory  receptors. In what region of the nasal cavity are these receptors located?

114.

A 10-year-old  child had the mantoux tuberculin  test   administered.  48  hours later  a  papule  up  to  8 mm  in  diameter appeared  on  the   site  of  the   injection. What type of hypersensitivity reaction developed after the tuberculin injection?

 
115.

Vitamin  B1  deficiency causes disturbance   of   oxidative    decarboxylation  of  α-ketoglutaric acid.  This  leads  to the  impaired synthesis  of  the  following coenzyme:

 
116.

On the ground  of clinical presentations    a    patient   was   prescribed   pyridoxal phosphate. This medication is recommended for correction of the following processes:

117.

A  patient  with  clinical  presentations  of immunodeficiency has  undergone immunological tests. They revealed  significant  decrease  in  number   of  cells  that form   rosettes  with  sheep   erythrocytes. What   conclusion   can  be  drown  on  the ground  of the analysis data?

 
118.

A  man  had  worked   in  a  coal  mine  for  over   20  years.  After   his  death autopsy   revealed    that   his   lungs   were dense,  grayish-black  and  had  large  areas of neogenic  connective tissue  containing a lot of macrophages with black  pigment in the cytoplasm.  What  is the most likely diagnosis?

119.

Autopsy   of   a   man    who    died from sepsis revealed a phlegmonous inflammation in the femoral bone of lower extremity.  The   inflammation  was  seen in  the   bone   marrow,   haversian   canals and  periosteum. There  were  also  multiple abscesses underneath the periosteum; the  surrounding soft  tissues  of the  thigh were also affected by the phlegmonous inflammation. What  pathological process is it?

120.

After     the    prior     sensibilization an experimental animal was given a subcutaneous  injection   of   an   antigen. The   place   of  injection   exhibited   a  fibrinous   inflammation with  alteration  of the  vessel  walls, basal  substance   and  fibrous  structures of the  connective tissue in form  of mucoid  and  fibrinoid  swelling and necrosis. What  immunological reaction is it?

121.

While  examining   the  oral  cavity  a stomatologist revealed  inflammation of papillae   on  the   border  of  the   median and posterior third of the back of tongue. What papillae are inflamed?

122.

Autopsy   of   a   50-year-old    man revealed  the  following  changes:  his right lung was moderately compact  in all parts, the  dissected  tissue  was found  to  be  airless, fine-grained,  dryish. Visceral pleura had  greyish-brown layers  of fibrin. What is the most likely diagnosis?

123.

In   the   pubertal  period    cells   of the  male  sexual  glands  start   producing the   male   sexual   hormone  testosterone that  is responsible for  formation of  the secondary  sexual  characters. What  cells of  the  male  sexual  glands  produce this hormone?

124.

Examination  of  a  patient revealed overgrowth  of   facial   bones    and   soft tissues, tongue  enlargement, wide interdental spaces  in the  enlarged dental arch. What changes of the hormonal secretion  are the most likely?

125. Autopsy of a man, who had been suffering from the multiple bronchiectasis for  5 years  and  died  from  chronic  renal insufficiency, revealed that kidneys were dense  and enlarged, with thickened cortical layer of white colour with greasy lustre. What renal disease might be suspected?  
126.

Autopsy  of  a  49-year-old   woman who died from chronic renal insufficiency, revealed: kidneys were dense, reduced, multicoloured, with  haemorrhagic areas. Microscopic  examination revealed   some hematoxylin   bodies    in   the   nuclei   of the renal tubule  epithelium; \\\"wire- loop\\\" thickening of  the  glomerular capillary basement membrane; here and there in  the  capillaries  some  hyaline  thrombi and foci of fibrinoid necrosis were present. What is the most likely diagnosis?

 
127.

As a result of durative antibiotic therapy a 37-year  old  patient developed intestinal  dysbacteriosis.  What   type   of drugs should be used in order  to normalize intestinal microflora?

128.

A married couple came to the genetic counseling.  The husband suffers from the insulin-dependent diabetes, the wife is healthy.  What  is the  probability that  this couple will have an insulin-dependent child?

129.

An   elderly   female   patient  suffers from the type 2 diabetes mellitus accompanied by  obesity,  atherosclerosis, coronary artery disease. Basal hyperinsulinemia  is  also  present.  What treatment would be the most appropriate?

130.

A 32-year-old  patient consulted  a doctor   about   the   absence   of  lactation after  parturition. Such disorder might be explained by the  deficit of the  following hormone:

131.

Preventive  examination  of  a  patient  revealed  an enlarged lymph  node  of metastatic origin on the medial wall of the left axillary crease. Specify the most likely localization  of the primary tumour:

132. A man suffering from osteochondrosis got acute  pain  in the  abdominal muscles (lateral and  anterior). During   objective examination a physician diagnosticated increased pain sensitivity of skin in the hypogastric region. This pain might be caused by affection of the following nerve:
133.

Pyeloureterography X-ray photo showed  a renal  pelvis with minor  calyces only  (major  calyces  were  absent). What form of urinary tracts of a kidney was revealed?

134. Autopsy   of   a   man    who    died from  influenza   revealed   that   the  heart was slightly enlarged and pastose.  The surface of the incision of myocardium appeared to be pale, with specks. Microscopic  examination revealed   signs  of parenchymatous  adipose   and   hydropic degeneration, edematic stroma with scant lymphocytic and macrophage infiltration; plethoric vessels; perivascular petechial haemorrhages. What type of myocarditis is it?

135.

In spite of treatment with cardiotonics and thiazide diuretic  a patient suffering from chronic  cardiac  failure  still presents with edemata and  faces a risk of ascites. What  medication should  be administered in order  to increase  the diuretic  effect of the above mentioned drugs?

 
136.

Gynecological examination of the uterine cervix in a 30-year-old  woman revealed   some  bright-red lustrous   spots that  easily  bleed  when  touched. Biopsy showed  that  a part  of the  uterine cervix was  covered  with  cylindrical  epithelium with papillary  outgrowths; in the depth  of tissue  the  growth  of glands  was present. What pathology of the uterine cervix was revealed?

137.

A  stillborn  child was found  to have thickened skin  resembling  of the  tortoise shell, underdeveloped auricles. Histological examination of skin revealed hyperkeratosis, atrophy  of  the  granular epidermis layer; inflammatory changes were not present. What  is the most likely diagnosis?

138. A patient presents with twilight vision  impairment. Which  of  the  following vitamins should be administered?
139.

A female  patient consulted  a doctor about   pain   and   limited   movements  in the   knee   joints.  Which  of  the  following nonsteroid anti-inflammatory drugs should  be administered taking into consideration that  the  patient has a history  of chronic gastroduodenitis?

140.

Depressions and  emotional insanities result  from the deficit of noradrenalin, serotonin and  other   biogenic  amines  in the brain. Their concentration in the synapses can be increased by means of the antidepressants that  inhibit  the following enzyme:

141.

A patient presents with icteritiousness of skin, scleras and mucous membranes. Blood  plasma  the  total  bilirubin is increased,  stercobilin is increased in  feces,  urobilin   is  increased   in  urine. What type of jaundice  is it?

142.

A pathology-histology laboratory received  a vermiform  appendix  up to 2,0 cm thick.  Its serous  membrane was pale, thick and covered with yellowish-green films. The  wall was flaccid, of grayish-red colour.  The  appendix lumen  was dilated and filled with yellowish-green substance. Histological   examination  revealed   that the appendix wall was infiltrated with neutrophils. Specify the appendix disease:

143.

While on holiday  in the  countryside a  boy  found  a  spider  with  the  following  morphological  peculiarities: body length   of  2  cm,  round   black  abdomen with  two  rows  of red  dots  on  its dorsal surface,  four pairs of segmented extremities covered with tiny black hairs. Identify this arthropod:

144.

As a result of a trauma a patient has developed traumatic shock that led to the following disorders:  AP is 140/90 mm Hg, Ps is 120 bpm. The patient is fussy, talkative, pale. Such state relates to the following shock phase:

145.

Examination of a patient admitted to the surgical department with symptoms of acute  appendicitis revealed  the following changes in the white blood cells: the total count of leukocytes  is 16 · 109/l. Leukocyte formula:  basophils  - 0, eosinophils  - 2%, juvenile  forms  - 2%,  stabnuclear - 8%, segmentonuclear   -   59%,    lymphocytes  -  25%,  monocytes-   4%.  The  described changes can be classified as:

146. After  a trauma a patient lost ability of elbow extension. This might have been caused  by  dysfunction  of  the  following main muscle:
147.

A  student  came   to  see  a  doctor and  asked  to  administer him  a drug  for treatment of allergic rhinitis that occurs in the period  of linden flowering. What drug may be used?

148.

In  an  embryo  the  process  of dorsal mesoderm segmentation and somite formation  is  disturbed.  What   part   of skin will probably  have developmental abnormalities?

 
149. A 9-month-old infant is fed with artificial formulas  with  unbalanced vitamin B6     concentration.  The   infant   presents with pellagral  dermatitis, convulsions, anaemia. Convulsion  development might be caused by the disturbed formation of:
150.

During  an  experiment the  myotatic reflex has been studied in frogs. After extension in  a  skeletal  muscle  its reflectory contraction was absent. The reason  for  it  might  be  a  dysfunction   of the following receptors:

151.

During   an  experiment  vagus branches that  innervate heart  are  being stimulated. This  has  stopped conduction of excitement from the atria to the ventricles. The reason  for it are electrophysical changes in the following structures:

152.

A   man   has   worked   in  an   African  country  for  3 years.  A  month  after his   return   to   Ukraine   he   consulted an    ophthalmologist    and    complained about  eye ache,  eyelid  edema,  lacrimation and temporary visual impairment. Underneath   the    eye   conjunctiva   the doctor  revealed  helminths  30-50 mm long with elongated filiform body. What diagnosis might be suspected?

153.

After   a  disease  a  16-year-old   boy is presenting with  decreased function  of protein synthesis in the liver as a result of vitamin  K  deficiency.  This may cause  disorder of:

154.

In response to a change in body position from horizontal to vertical blood circulation system develops reflectory pressor  reaction. Which  of the  following is its compulsory  component?

155. Life   cycle   of   a   cell   includes   a process   of  DNA   autoreduplication.  As a result of this process monochromatid chromosomes become  bichromatid. This phenomenon is observed within the following period  of the cell cycle:
156. As a result of a road accident a driver has gotten  a trauma. Now he is in shock condition and presents with a decrease in daily diuresis down to 300 ml. What is the main pathogenetic factor  of such alteration in the diuresis?

157.

Examination  of  a  patient revealed autoimmune haemolytic anaemia (cytotoxic type). What substances act as antigenin the II-type allergic reactions?

158.

A patient suffers from the haemorrhagic syndrome  that  shows itself in frequent nasal bleedings, posttraumatic and    spontaneous   intracutaneous   and intra-articular haemorrhages. After a laboratory study a patient was diagnosed with the type B haemophilia. This disease is provoked by the deficit of the following factor of blood coagulation:

159. After  a craniocerebral trauma a patient lost the ability to execute learned purposeful movements (apraxia). The injury is most likely localized in the following region of the cerebral cortex:l
160.

A  58-year-old   patient suffers  from the  cerebral  atherosclerosis. Examination revealed  hyperlipoidemia. What  class of lipoproteins will most  probably  show increase  in concentration in this patient’s blood serum?

161. A patient consulted a physician about muscle rigidity, constrained movements, permanent arm  tremor. The  patient was diagnosed  with Parkinson’s disease. What preparation should be administered?

162.

A  patient with  coronary   artery  disease  was  admitted to  the  cardiological department.  For  stenocardia prevention a drug from the group  of β-adrenoceptor blockers  was administered. What  drug  is it?

163.

A  28-year-old   female  patient consulted a  gynecologist   about   sterility. Examination revealed underdeveloped ovaries and uterus,  irregular menstrual cycle.   Analysis   of   the   sex   chromatin revealed  2 Barr’s bodies  in most  somatic cells. What  chromosome disease  is most likely?

164.

A patient with drug intoxication presented with the dryness of oral mucous membrane  and   mydriatic   pupils.   Such action  of this drug  is associated  with the following effect:

165.

A    newborn   develops    dyspepsia after   the   milk  feeding.   When   the   milk is substituted by the  glucose  solution the  dyspepsia  symptoms  disappear. The newborn  has the subnormal activity of the following enzyme:

166.

A man presents with increased  heart rate, mydriatic pupils, dry mouth. This condition results  from  the  activation   of the following system of function  regulation:

167.

A patient with a limb fracture must be administered a depolarizing drug from the myorelaxant group for the purpose of a short-time surgery. What drug is it?

168.

A patient suffering from chronic bronchitis    takes   a   synthetic   mucolytic drug that  facilitates  the  sputum  thinning. What drug is it?

169.

A patient with massive burns developed acute renal insufficiency characterized    by    a    significant     and rapid  deceleration of  glomerular filtration. What is the mechanism  of its development?

170. A patient with severe course of respiratory  viral infection  presented with clinical signs of progressing  heart  failure  that led to his death in the 2nd week of disease. Autopsy revealed   that  the  heart   cavities  were  significantly  dilated,   the   heart was  flabby.  Histological   examination  of the myocardium revealed  microvascular plethora  and  diffuse  stroma   infiltration with  lymphocytes   and  histiocytes.  What is the most likely diagnosis?
171.

During  the regular  sanitary-epidemiological inspection  of a pharmacy, the bacteriological analysis of air was performed. The air was found to have bacilli, yeast fungi, hemolytic streptococci, micrococci. Which of the detected microorganisms indicate  the direct epidemic danger?

172.

A man  with an injury  in the  nuchal region (regio nuchae) was admitted to the resuscitation department. What  muscle occupies this region?

173.

A section  of the  left lung was found to have  an area  of dense  red  tissue.  The area was cone-shaped, stood out distinctly from  the  healthy  tissue,  with its base  directed  to the pleura.  The dissected  tissue was granular, dark-red. What  is the  most likely diagnosis?

174.

An  animal  has  an  increased tonus of   extensor   muscles.   This   the   result of    intensified    information   transmission   to   the   motoneurons  of  the   spinal cord through the following descending pathways:

175. Following  exposure   to  radiation a lot  of  mutant cells  appeared in  a  patient.  Some  time  later  most  of them  were detected and  destroyed by the  following cells of the immune system:

176.

A   65-year-old   man   has   purulent abscess  on  his  neck.  Analyses   revealed a culture  of gram-positive cocci with plasmocoagulase activity. This culture relates most likely to:

177.

In clinical practice  tuberculosis is treated with  isoniazid  preparation - that is an  antivitamin able  to  penetrate into the  tuberculosis bacillus.  Tuberculostatic effect  is induced  by the  interference with replication processes  and oxidation- reduction reactions due to the buildup  of pseudo-coenzyme:

178.

A newborn child was found  to have reduced intensity of sucking, frequent vomiting, hypotonia. Urine and blood exhibit increased  concentration of citrulline. What metabolic process is disturbed?

179.

Vagus nerves of an experimental animal have been cut on the both sides. What respiratory changes will result from this?

180. Before   tooth   extraction  a  patient was  advised  to  take  a  certain   drug  for haemorrhage prevention. What drug was advised?

181. A patient who has been taking a drug for  a long  time  cannot  abruptly stop  its use, because  this may lead to psychic and somatic dysfunctions. Name the syndrome of different disorders caused by a drug withdrawal:

182. A  45-year-old  patient suffers  from neurosis characterized by irritability, sleeplessness,   motiveless   anxiety.   What drug would eliminate all the symptoms?
183.

After  taking poor-quality food a patient  developed repeated  episodes   of  diarrhea. On the next day he presented with decreased arterial  pressure, tachycardia, extrasystole. Blood pH is 7,18. These abnormalities were caused by the development of:

184.

Which muscle contraction will be observed in  the  upper   extremity during holding  (not  moving)  a load  in a certain position?

185. A patient has lost skin sensitivity  in the region of the medial surface of his shoulder. This  is the  result  of dysfunction of the following nerve:
186.

Examination of a young woman revealed   a  tumour  up  to  3  cm  in  diameter  in   form   of   a   knot    localized along  the  acoustic  nerve.  The  tumour is homogenous,  soft  and  elastic,  of  pink- and-white colour. Microscopically  the tumour contains  clusters of cells with oval nuclei.  Fibrous  cell clusters  form  regular structures made  up  by  parallel  rows  of regularly  oriented cells arranged in form of  a  palisade.  Zones   between the  rows of cells are acellular and homogenous (Verocai bodies).  What tumour is it?

187. A  patient with  myocardial   infarction was admitted to the cardiological department. For  pain  relief  it  was decided   to   potentiate  fentanyl   action   with  a  neuroleptic.  Which  of  the  following  neuroleptics is the  most  suitable  for neuroleptanalgesia?
188.

Treatment course of bacterial pneumonia included  benzylpenicillin sodium  salt.  What  is the  mechanism   of its antimicrobial action?

189.

A 49-year-old driver complains about unbearable constricting   pain  behind  the breastbone  irradiating to  the  neck.  The pain  arose  2 hours  ago.  Objectively:  the patient’s   condition  is  grave,  he  is  pale, heart  tones are decreased. Laboratory studies  revealed  high activity  of creatine kinase and LDH1.  What disease are these symptoms typical for?

190.

A  60-year-old   patient  presents with weakened peristaltic activity of the bowels. Which of the following foodstuffs would stimulate peristalsis most of all?

 
191.

After  inoculation of the material obtained from  the  pharynx  of an angina patient onto the blood-tellurite agar, grey colonies  could  be  observed.   They  were  4-5 mm in diameter, radially  striated (in form  of  rosettes). Microscopical   examination  revealed  gram-positive bacilli  with clavate  swollen ends arranged in form of wide-spread fingers. Identify  these  microorganisms:

192. A  microspecimen of the  submandibular  salivary  gland  shows some  basketshaped   cells   concentrated  around  the acines and excretory ducts. These cells surround  bases  of  the  serous  cells  and are  called  myoepitheliocytes. These  cells relate  to the following tissue:
193.

It  was  established that  agglutination  of  the  recipient’s  blood  erythrocytes had  been   caused   by  the  standard  sera from  the  I and  II groups.  Serum  from the  III group  as well as anti-Rh serum hadn‘t provoke any agglutination. Which blood  group  and  rhesus  is allowed  to be transfused this recipient?

194.

Pharmacological effects of anti- depressants are based upon blocking (inhibiting)  the   enzyme   that   acts  as  a catalyst for the breakdown of biogenic amines noradrenalin and serotonin in the mitochondria of cephalic  neurons. What enzyme takes part in this process?

195. An  oncological  patient was administered   methotrexate.  With  the  lapse  of time  the  target  cells of  the  tumour  lost sensitivity to this preparation. We can observe  changes  in  the  gene  expression of the following enzyme:
196.

A  patient with  a  hypertensive  crisis was admitted to the cardiological department. He was given an intravenous injection of an antihypertensive drug - alkali-earth metal salt. What drug was injected?

197.

An  injured  person  was delivered  to the  hospital  with a penetrating wound  in the  left lateral  region  of abdomen. What part  of the  large  intestine is most  likely damaged?

198.

After  a road  accident  a  driver  was delivered to the hospital  with an injury of the  medial  epicondyle  of humerus.  What nerve might be damaged in this case?

199.

A man with a stab wound in the region of the quadrilateral foramen  consulted a doctor  about  it. Examination revealed that  the  injured  couldn’t abduct  his arm from the  body. What  nerve  is most likely damaged?

200.

Examination of the anterior abdominal  wall  of  a  pregnant woman  revealed a  tumour-like  formation  that   arose   on the  spot  of a tumour that  was removed two years ago. The neoplasm  was well- defined,  dense, 2х1 cm large. Histological examination revealed that the tumour was composed  of differentiated connective tissue with prevailing  collagen fibres. What tumour might be suspected?