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Question 1 of 200

1. An  unconscious   patient  was  delivered   to  the   admission   ward.   Objectively: the  patient’s skin is cold, pupils are myotic,  he  has  laboured Cheyne-Stokes respiration, arterial pressure is low,  urinary  bladder is full. What  substance  has caused intoxication?
2.

Characteristic   sign   of   glycogenosis is  muscle   pain   during   physical   work. Blood examination reveals usually hypoglycemia. This  pathology  is caused by congenital deficiency  of the  following enzyme:

3.

A woman works as railway traffic controller. She suffers from seasonal vasomotor rhinitis  and  gets  treatment in the outpatient setting. She was prescribed an antihistamine that  has no effect  upon central  nervous  system. What drug is it?

4. During  an operation a patient got injection  of  muscle  relaxant dithylinum. Relaxation of skeletal  muscles and inhibition of respiration lasted  two hours.  This condition was caused  by absence  of the following enzyme in blood serum:
5.

Examination of a patient suffering from cancer  of  urinary  bladder revealed  high rate  of serotonin and  hydroxyanthranilic acid. It is caused by excess of the following amino acid in the organism:

6.

Blood of a 12 year old boy presents low concentration of uric acid and accumulation  of  xanthine  and  hypoxanthine.  This child has  genetic  defect  of the  following enzyme:

7.

A  patient who  suffers  from  insomnia caused by emotional disorder was prescribed a hypnotic drug with tranquillizing effect. What hypnotic  was prescribed?

8.

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:

9. In course of laparotomy a surgeon revealed  gangrenous lesion  of  descending colon. It was caused  by thrombosis of the following artery:
10. A  60  year   old  patient  has  impaired perception of high-frequency sounds. These changes were caused by damage  of the following auditory analyzer structures:
11.

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?

12.

A healthy  man is in a region  with high risk of catching malaria. What drug should be administered for individual chemoprophylaxis of malaria?

13.

A full-term newborn  child has yellowish skin and mucous  membranes. This might be probably caused by temporary deficiency of the following enzyme:

14.

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:

15.

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:

16.

Students  who are taking examinations often  have  dry  mouth.   The  mechanism that  causes this state  is the  realization of the following reflexes:

17.

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?

18.

Examination of a patient revealed typical presentations of collagenosis.  This pathology is characterized by increase  of the following urine index:

19.

Untrained people  often  have  muscle pain after sprints as a result of lactate accumulation. This  might  be  caused  by intensification of the following biochemical process:

20.

Examination  of   a   patient  suffering  from  frequent  haemorrhages  in  the inner organs and mucous membranes revealed proline and lysine being included in collagen fibers. Impairment of their hydroxylation is caused by lack of the following vitamin:

21.

During    an   experiment  a   skeletal muscle is stimulated by a series of electric impulses.  What  type  of muscle  contraction  will be  observed   provided   that  each subsequent  impulse   comes  in  the  period  of  shortening of  the  previous  single muscle contraction?

22.

A   48   year   old   patient   complained   about   intense   pain,   slight   swelling  and  reddening of  skin  over  the  joints,  temperature rise  up  to  38oC . Blood analysis revealed  high concentration of urates.  This condition might be caused by disturbed metabolism of:

23.

An experimental animal that was kept on  protein-free  diet  developed  fatty  liver  infiltration,   in  particular as  a  result of deficiency  of methylating agents.  This is caused  by disturbed generation of the following metabolite:

24.

A 46 year  old woman  suffering  from chololithiasis developed jaundice.  Her urine  became  dark-yellow  and  feces became  colourless. Blood serum will have the highest concentration of the following substance:

25. A   patient  suffering   from   infectious mononucleosis has been taking glucocorticosteroids for  two  weeks.  This  resulted in remission  but  the  patient got exacerbation of chronic tonsillitis. This complication is induced  by the  following effect of glucocorticosteroids:
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.

A newborn child has convulsions  that have  been  observed  after  prescription of vitamin  B6 . This most  probable cause  of this effect is that vitamin B6  is a component of the following enzyme:

28.

A   patient  who   has   been   abusing tobacco  smoking  for a long time  has got cough  accompanied  by  excretion of  viscous mucus; weakness  after minor physical stress, pale  skin. The  patient has also lost  12,0 kg of body  weight.  Endoscopic examination of biopsy material his illness was diagnosed  as squamous cell carcinoma.  Name  a pathological process  that preceded formation of the tumour:

29. 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?
30.

A  patient caught  a  cold  after  which  there   appeared facial  expression disorder.  He cannot  close his eyes, raise his eyebrows,  bare  his teeth.  What  nerve  is damaged?

31.

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?

32.

A 70 year  old female  patient was diagnosed  with fracture of left femoral neck accompanied by disruption of ligament  of head  of femur. The branch  of the following artery is damaged:

33.

ECG  of a patient shows prolongation of T-wave. This is caused  by deceleration in ventricles of:

34. 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?
35.

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?

36. A  patient  complained about   being unable   to  adduct   and  abduct   fingers  in the metacarpophalangeal articulations towards   and  away  from  the  3rd  finger. Which muscles’ function  is impaired?
37.

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?

38. A   34   year   old   woman    was   diagnosed with hereditary microspherocytic hemolytic anemia (Minkowsky-Shauffard disease). What mechanism caused haemolysis of erythrocytes?
39.

According  to  the  model   of  double DNA  helix that was suggested  by Watson and Creek,  it was established that  one of chains would not be lost during replication and  the  second  chain  would  be synthesized complementary to the first one. What way of replication is it?

40.

A  4 year  old  child  was  admitted to the orthopaedic department with shin fracture together with displacement. Bone fragments reposition requires preliminary analgesia. What preparation should be chosen?

41.

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

42.

A   22  year   old   patient  from   the West   Ukraine  complains    of   laboured nasal breathing. Morphological examination  of biopsy material of nasal mucous membrane  revealed   lymphoid,   epithelioid, plasma cells as well as Mikulicz’s cells. What is the most probable diagnosis?

43.

Vitamin  A together with specific cytoreceptors penetrates through the nuclear   membranes, induces  transcription  processes  that  stimulate growth  and differentiation  of  cells.  This   biological  function  is realized  by the following form of vitamin A:

44.

During  preparation of a patient to  a heart  surgery it was necessary  to measure pressure  in  heart   chambers.  In  one  of them  pressure varied  from  0 mm Hg up to  120 mm  Hg  within  one  cardiac  cycle. What heart chamber is it?

45.

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?

46.

In order  to determine toxigenicity  of diphtheria bacilli  a  strip  of  filter  paper impregnated with antitoxic  diphtherial serum was put on the dense nutrient medium.  There   were  also  inoculated  a  microbial  culture  under  examination and  a strain  that  is known  to  be  toxigenic.  If the   microbial   culture   under   examination  produces exotoxin,  this  will result  in formation of:

47.

A   63  year   old   male   patient  who had   been    suffering   from   chronic    diffuse obstructive disease, pulmonary emphysema, for 15 years died from cardiac insufficiency. Autopsy revealed  nutmeg liver cirrhosis,  cyanotic  induration of kidneys   and   spleen,   ascites,   edemata  of lower limbs. These changes of internal organs  are  typical  for  the  following  disease:

48.

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?

49.

A  newborn  child  suffers  from  milk curdling in stomach, this means that soluble  milk proteins (caseins)  transform to   insoluble   proteins    (paracaseins)  by means   of   calcium   ions   and   a  certain enzyme.  What  enzyme  takes  part  in this process?

50.

A patient suffers from  diabetes mellitus.   After    the   regular    insulin   injection his condition grew worse:  there appeared  anxiety,    cold   sweat,   tremor of   limbs,   general    weakness,   dizziness. What preparation can eliminate these symptoms?

51.

A    patient   has    difficulties    with hand movement. Examination revealed inflammation of common  synovial sheath of  flexor  muscles.  It  is known  from  the patient’s   anamnesis  that   he  got  a  stab wound of finger a week ago. Which finger was most probably  damaged?

52. Clinical  diagnosis  of  a  female  patient  was  gonorrhoea. What  examination  method can  be  applied  for  confirmation of this diagnosis?
53.

Autopsy  of  a  man  who  died  from burn   disease   revealed   brain   edema,   liver  enlargement as well as  enlargement of  kidneys  with  wide  light-grey  cortical layer and plethoric medullary area. Microscopic  examination revealed   necrosis of tubules  of main  segments  along  with destruction of basal  membranes, intersticium   edema   with   leukocytic   infiltration  and  haemorrhages. What  is the  most probable postmortem diagnosis?

54.

A 30 year old man had been suffering from  acute  respiratory disease  and  died from cardiopulmonary decompensation. Autopsy revealed  fibrinous-haemorrhagic inflammation  in  the  mucous  membrane of larynx and trachea, destructive panbronchitis, enlarged lungs that look black due to the multiple abcesses, haemorrhages, necrosis. What is the most probable postmortem diagnosis?

55.

A  19  year  old  woman  suffers  from primary    syphilis.   Doctor   administered her complex therapy that includes benzylpenicillin sodium  salt. What  is the mechanism  of action of this drug?

56. A    65   year    old    female    patient suffers from chronic renal insufficiency accompanied by evident  edemata caused by chronic  glomerulonephritis. What  diuretic  should  be administered for forced diuresis?
57.

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?

58.

Atria  of an experimental animal were superdistended by blood  that  resulted in decreased reabsorption of N a+ and water in renal tubules.  This can be explained  by the influence of the following factor upon kidneys:

59.

A patient suffering from periodical attacks  caused  by inhalation of different flavoring  substances  was diagnosed  with atopic bronchial asthma. IgE level was increased.  This is typical  for the  following type of reactions:

60.

During  regular  examination of schoolchildren it was revealed  that  a 10 year old girl had asymmetric  oval eggs with a larva in the scrape from her perianal folds. What diagnosis should be made?

61. Histological examination of a 40 year old man’s thymus revealed  reduced share of parenchymatous elements, increased share  of adipose  and loose connective tissue, its enrichment with thymus  bodies. The organ’s mass was unchanged. What is this phenomenon called?

62.

A  56 year  old patient suffering  from cardiac  insufficiency  has  edema   of  feet and shins, edematous skin is pale and cold. What  is the  leading  mechanism  of edema pathogenesis?

63.

Researchers of a bacteriological laboratory examine  tinned  meat  for botulinic  toxin.  For  this purpose a group of mice was injected with an extract of the material under  examination and antitoxic antibotulinic serum  of A,  B, E  types.  A control  group  of mice  was injected  with the  same  extract  but  without  antibotulinic serum.  What  serological  reaction was applied?

64.

A   clinic   observes   a   49  year   old patient   with    significant    prolongation of coagulation time, gastrointestinal haemorrhages, subcutaneous hematomas. These  symptoms  might  be  explained  by the deficiency of the following vitamin:

65. 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?
66. A  cerebral trauma caused  increased ammonia  generation. What amino acid participates in the  excretion of ammonia from the cerebral tissue?
67.

During  the  repeated Widal’s agglutination  test  it was noticed  that  the  ratio of antibody  titers  and  O-antigens S.typhi in the patient’s serum had increased  from 1:100 to 1:400. How  would  you interpret these results?

68.

It is known  that  the gene responsible for development of blood groups according  to  AB0  system  has  three  allele  variants. If a man has IV blood  group,  it can be explained by the  following  variability form:

69. 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?
70.

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

71.

A  patient complains  about  impaired evacuatory  function   of  stomach   (long-term retention of food in stomach). Examination revealed  a tumour of initial part  of duodenum. Specify localization of the tumour:

72. 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:
73.

People  adapted to high external temperatures  have  such  peculiarity: profuse   sweating   isn’t  accompanied  by loss of large volumes  of sodium  chloride. This is caused by the effect of the following hormone upon the perspiratory glands:

74.

Emotional stress  causes  activation  of hormone-sensitive   triglyceride  lipase   in the adipocytes.  What secondary mediator takes part in this process?

75. A patient has been suffering from diarrhea for 5 day. On the fifth day colonoscopy   revealed    that    membrane of rectum  was inflamed,  there  were greyish-green  films  closely  adhering to the  subjacent   tissue.  What   is  the  most  probable diagnosis?

76. 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?
77.

A 25 year old Palestinian woman complains   of   weakness,   dizziness, dyspnea. In anamnesis: periodically exacerbating anemia.  In  blood:  Hb  - 60 g/l, erythrocytes - 2, 5 · 1012/l, reticulocytes  -  35o/oo,  anisocytosis   and  poikilocytosis of erythrocytes, a lot  of target  cells and  polychromatophils. What  type  of anemia is it?

78.

A patient suffering from initial hypertension has been taking an anti- hypertensive preparation  for  a  long  time. Suddenly  he stopped taking this preparation.   After    this   his   condition grew  worse,  this  led  to  development of hypertensive crisis. This by-effect  can be classified as:

79.

Inflammatory  processes   cause synthesis   of  protein  of  acute   phase   in an organism.  What  substances  stimulate their synthesis?

80. A 42 year  old woman  with neuralgia of  trifacial  nerve  complains  about   periodical  reddening of the  right  part  of her face and neck, sense of warmth gush, increased   skin  sensitivity.   These   effects can  be  explained by  the  following  type of arterial hyperemia:
81.

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?

82.

Autopsy of  a  17  year  old  girl  who died   from   pulmonary  failure   revealed a small area of caseous necrosis in the inferior  lobe of the right lung, and occurrences of caseous necrosis in the bronchopulmonary, bronchial  and bifurcational lymph nodes. What is the most probable postmortem diagnosis?

83.

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?

84. A 35 year old man consulted  a dentist  about   reduced  density   of  dental   tissue,  high  fragility  of  teeth  during  eating  solid  food.   This  patient  suffers  the  most probably from the deficiency of the following mineral element:

85. A patient staying in the pulmonological department was diagnosed  with pulmonary emphysema accompanied by reduced elasticity of pulmonary tissue. What type of respiration is observed?
86.

A  4  year  old  child  complained  of pain during deglutition, indisposition. Objectively:   palatine arches  and  tonsils are  moderately edematic and  hyperemic, there  are greyish-white films up to 1 mm thick closely adhering to the subjacent tissues. What pathological process are these changes typical for?

87.

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?

88.

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?

89.

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?

90.

After  destruction of  CNS  structures an animal  lost orientative reflexes.  What structure was destroyed?

91.

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:

92. A  62  year   old  patient  who  previously  worked  as stoker  was admitted to a hospital  with complaints  about  general weakness,  abrupt weight loss, hoarse  voice, dyspnea, dry cough. Laryngoscopy revealed  a tumour in the pharynx that invaded  vocal cords  and  epiglottis.  What is the most probable cause of tumour development?
93. 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?
94. 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?
95.

During   influenza   epidemic   40%  of pupils  who  didn’t go  in  for  sports  were affected  by  the  disease,  and  among  the pupils who regularly did physical exercises this index  was only 20%. What  adaptative mechanisms  determined such a low sickness  rate  of pupils  participating in the sports?

96. A  patient  suffers  from  stenocardia and takes isosorbide  mononitrate. He was prescribed a complementary drug with disaggregating  effect. What drug is it?
97. A patient in postoperative period  was prescribed an anticholinesterase drug for stimulation of intestinal peristalsis  and tonus of urinary bladder. What drug is it?
98. 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?
99.

Among   junior  children   of  an orphanage an outbreak of intestinal infection with signs of colienteritis was registered. In  order   to  identify  isolated causative agent it is necessary to:

100.

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?

101.

A 45 year old patient was admitted to the  cardiological  department. ECG  data: negative  P wave overlaps  QRS  complex, diastolic  interval  is prolonged after extrasystole. What  type  of extrasystole is it?

102.

A virological laboratory obtained pathological material (mucous  discharges from  nasal  meatuses) taken  from  a patient with provisional diagnosis \\\"influenza\\\". What quick test will allow to reveal specific viral antigen  in the material under examination?

103.

A   family   of  students  who   came from  Africa  got  a child  with  anemia  signs.   The   child   died   soon.   Examination  revealed  that  the  child’s erythrocytes have  abnormal semilunar shape.  Specify genotypes of the child’s parents:

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.

A   66   year    old   female    patient got   intravenous  injection    of   magnesium sulfate solution for the purpose of elimination of hypertensive crisis. But arterial  pressure  didn’t   go   down   and after  repeated introduction of  the  same preparation there  appeared sluggishness, slow response, inhibition  of consciousness and respiration. What preparation is antagonist of magnesium  sulfate  and  can eliminate symptoms of its overdose?

106. Hepatitis has led to the development of hepatic  failure. Mechanism  of edemata formation is activated by the impairment of the following liver function:
107.

A patient working at a pig farm complains    about    paroxysmal    abdominal pain,  liquid  feces with admixtures of mucus and blood, headache, weakness, fever. Examination of large intestine revealed  ulcers from  1 mm up to several cm large, feces contained oval unicellular organisms  with cilia. What disease should be suspected?

108.

A  patient staggers  and  walks astraddle. He  has  hypomyotonia of arm and leg muscles, staccato  speech.  In what brain section is this affection localized?

109.

During  hypersensitivity test a patient got subcutaneous injection  of an antigen which  caused  reddening of skin,  edema, pain as a result  of histamine action.  This biogenic amine  is generated as a result of transformation of the  following  histidine amino acid:

110. Normal actively dividing cells of human  red bone marrow are  analyzed. What  number   of  cells’  chromosomes is typical for G1 period?
111.

Blood group of a 30 year old man was specified  before  an operation. His blood is Rh-positive. Reaction of erythrocyte agglutination  was  absent   with  standard sera of 0αβ  (I), Аβ  (II),  Вα (III)  groups. The  blood  under   examination is of  the following group:

112.

A 64 year old woman has impairment of twilight vision (hemeralopy). What  vitamin should be recommended in the first place?

113. A patient underwent appendectomy. In the  postoperative period  he  has been taking an antibiotic.  The patient complains  about  hearing  impairment and  vestibular disorders.  What group of antibiotics has such by-effects?
114.

A patient was stung by a bee. Examination  revealed  that his left hand was hot, pink, edematic,  there  was a big red blister on  the  site of sting.  What  is the  leading mechanism  of edema development?

115.

A patient complained about  dizziness,  memory   impairment, periodical convulsions. It was revealed  that these changes were caused by a product of decarboxylation of  glutamic  acid.  Name this product:

116.

A  sportsman needs  to  improve  his sporting  results. He was recommended to take a preparation that contains  carnitine. What process is activated the most by this compound?

117.

Laboratory  examination of  a  child revealed  increased  concentration of leucine, valine,  isoleucine  and  their  ketoderivatives in blood and urine. Urine  smelt of maple syrup. This disease is characterized by the deficit of the following enzyme:

118.

A 7 year old child often  suffers from streprococcic angina. Doctor suspected development of rheumatism and administered serological examination. The provisional diagnosis will be most probably confirmed  by  presence of  antibodies  to the following streptococcic antigen:

119.

A 46 year old patient who had been suffering from tuberculosis for 6 years died from massive pulmonary haemorrhage. Autopsy revealed   different-sixed foci  of sclerosis and caseous  necrosis  in lungs, in the upper  part of the right lung there  was a cavity 5 cm in diameter with dense grey walls,  the  cavity  contained liquid  blood and blood clots. What type of tuberculosis is it?

 
120.

A patient suffering from pheochromocytoma complains of thirst, dry mouth, hunger. Blood  test for sugar  revealed  hyperglycemia. What type of hyperglycemia is it?

121. A  patient has  been  suffering  from elevated temperature and attacks  of typical  cough  for  10  days.  Doctor  administered inoculation of mucus from the patient’s nasopharynx on the  agar. What  microorganism is presumed?
122. A patient suffering from stenocardia was  taking  nitroglycerine which  caused restoration of blood  supply  of myocardium and relieved  pain in the cardiac  area. What intracellular mechanism  provides restoration of  energy  supply  of  insulted cells?
123.

A 50 year old patient has been  taking treatment thrice  for the last 6 months because  of fractures caused  by domestic accidents.   Microscopical   examination of bony tissue revealed foci of lacunar resolution, giant-cell granulomas in the tumour-like formations, cysts. Bony tissue was substituted by fibrous  connective tissue. Examination revealed  also adenoma of parathyroid gland  and  hypercalcemia. What is the most probable diagnosis?

124. A couple had a child with Down’s disease. Mother is 42 years old. This disease is most probably  caused  by the following impairment of prenatal development:
125.

A man weighs 80 kg, after long physical activity his circulating blood volume is reduced down  to 5,4 l, hematocrit makes up  50%,  whole  blood  protein is 80 g/l. These  blood  characteristics are  determined first of all by:

126.

Examination of  a  pregnant woman revealed  twice as much  concentration of fibrinogen  in blood plasma. What ESR can this woman have?

127.

Examination  of  a  child  who frequently suffers from infectious diseases revealed  that  IgG concentration in blood serum was 10 times less than normal,  IgA and  IgM  concentration was  also  significantly reduced. Analysis showed also lack of B-lymphocytes and plasmocytes.  What disease are these symptoms typical for?

128.

Introduction of a big dose of histamine to an experimental animal caused abrupt drop of arterial pressure as a result of:

129.

Examination of a 42 year old patient revealed   a  tumour of  adenohypophysis. Objectively:   the  patient’s  weight  is  117 kg, he has moon-like hyperemic  face, red- blue striae  of skin distension  on his belly. Osteoporosis and muscle dystrophy are present. AP  is 210/140 mm  Hg.  What  is the most probable diagnosis?

130.

Vagus branches that  innervate heart are  being  stimulated  during   an  experiment.  This caused reduction of heart  rate due  to  the  intensification of the  following process (through the cell membrane of cardiac pacemaker):

131. A patient got an injury of spinal marrow   in  a  road  accident   that  caused loss of tactile sensation,  posture sense, vibration sense. What conduction tracts are damaged?
132.

A  scheme   presents  an  exocrinous gland that has unbranched excretory duct with a terminal part  in form of a saccule opening into the duct. How is this gland called according to the morphological classification of exocrinous  glands?

 
133.

Examination  of  a  patient revealed hypertrophy  and   inflammation  of lymphoid tissue, edema of mucous membrane between palatine arches (acute tonsillitis).   What   tonsil   is  normally   situated in this area?

134.

A patient complained about  muscle rigidity, constrained motions, constant tremor of arms. On the grounds of examination his disease was diagnosed  as Parkinson’s disease. What drug should be administered?

135.

Examination of a patient with impaired  blood coagulation revealed thrombosis of a branch of inferior mesenteric artery.  What  bowel  segment is damaged?

136.

When  blood  circulation  in the damaged tissue  is restored, then  lactate accumulation   comes    to    a   stop    and glucose consumption decelerates. These metabolic changes are caused  by activation of the following process:

137.

A woman  was delivered to a hospital for trachea intubation. What of the following drugs  should  be applied  in this case?

138.

A patient suffers from pulmonary tuberculosis. During  treatment neuritis  of visual nerve  arose. What  drug has caused this by-effect?

139.

A  patient suffers  from  chronic  left-ventricular insufficiency. What medication should be administered?

140.

Roentgenological   examination   of skull base bones  revealed  enlargement of sellar  cavity,  thinning  of anterior clinoid processes,  destruction of  different   parts, destruction of different parts of sella turcica. Such bone destruction might be caused by a tumour of the following endocrinous gland:

141.

Patients who  suffer  from  severe  diabetes  and don’t receive insulin have metabolic acidosis. This is caused by increased  concentration of the  following metabolites:

142.

A  4 year  old  child  with  hereditary renal lesion has signs of rickets, vitamin D concentration in  blood  is normal.  What is the most probable cause of rickets development?

143.

A man was intoxicated with mushrooms. They contain  muscarine  that stimulates muscarinic cholinoreceptors. What symptoms  signalize intoxication with inedible mushrooms?

 
144.

A  47 year  old  man  with  myocardium infarction  was admitted to the  cardiological department. What changes of cellular  composition of peripheral blood are induced by necrotic changes in the myocardium?

145. A  patient with skin mycosis has disorder   of  cellular   immunity.   The   most typical  characteristic of it is reduction of the following index:
146.

A 50 year old patient underwent resection  of  tumour  of  large   intestine wall. Microscopically  it presents itself as fascicles of divergent collagen fibers of different thickness  and form and some monomorphous fusiform cells that are irregularly  distributed among  the  fibers. Cellular    atypia   is   not   evident.    What tumour is it?

147.

A cell at the stage of mitosis anaphase was stimulated by colchicine  that  inhibits  chromosome separation  to  the  poles. What type of mutation will be caused?

148.

Autopsy of a 5 year old child revealed in  the  area   of  vermis  of  cerebellum a soft greyish-pink  node  2 cm in diameter with   areas   of  haemorrhage.  Histologically this tumour consisted  of atypical monomorphous small  roundish cells  with big polymorphous nuclei. What tumour is it?

149. Voluntary breath-holding caused increase   of  respiration  depth   and frequency.   The   main  factor   stimulating these changes of external  respiration is:
150.

A patient was admitted to the surgical department with inguinal hernia. During  the  operation the  surgeon   performs plastic surgery on posterior wall of inguinal canal. What structure forms this wall?

151. A  patient  has  delayed   conduction of  excitement  through  the   atrioventricular  node.  What  changes  of  ECG   will be observed?
152. Surface  with an intact toad  on it was inclined to the right. Tone of extensor muscles  became  reflectory  higher  due  to the activation  of the following receptors:
153.

A female patient underwent liver transplantation. 1,5 month  after it her condition became worse because of reaction of transplant rejection. What  factor  of immune  system plays the  leading  part  in this reaction?

154.

Microscopical  examination of a microbial culture revealed fusiform spore- forming  microorganisms that  get  violet- blue  Gram’s stain.  What  microorganisms were revealed?

155.

A bacteriological laboratory received sputum  sample of a patient suffering from tuberculosis. Bacterioscopic examination of  smears  and  detection of  tuberculosis bacillus can be realized by one of enrichment  methods  that  involves processing of  sputum  only  with  solution  of  caustic soda. What is this method called?

156.

Electronic microphotography of pulmonary alveoli’s wall  presents a  big cell. Its cytoplasm  has a lot of mitochondria, developed Golgi apparatus, osmiophil  lamellated corpuscles.  What  is the main function  of this cell?

157. A patient in a transplantation centre underwent heart  transplantation. The organ  was  taken  from  a  donor  who  died in a road  accident.  Foreign  heart  can be  rejected as  a  result  of  development of transplantation immunity.  It is usually prevented by means of:c
158.

A child is pale, pastose,  muscular  tissue  is bad  developed, lymph  nodes  are enlarged.  He   often   suffers   from   angina and pharyngitis,  blood has signs of lymphocytosis.  The child is also predisposed to autoallergic diseases. What type of diathesis can be presumed in this case?

159.

A  patient had  been  suffering  from  profuse  diarrhea and vomiting for 2 days. He died from acute dehydration. Autopsy revealed  that the intestinal wall was edematic and hyperemic, with multiple haemorrhages in the  mucous  membrane. Intestine lumen contains  whitish fluid resembling of rice water. What disease caused death?

160.

Examination   of   a   66   year   old patient  revealed   a  lytic  tumour  in  the locus of pathological rib fracture. Histologically  this tumour consists of atypical    plasmoblasts.   Further    examination  revealed   osteoporosis  in  the   bones of vertebral column and pelvis. These changes are typical for:

161.

A  patient died  from  acute  cardiac insufficiency, among clinical presentations there   was  gastrointestinal haemorrhage. Examination of mucous membrane of stomach   revealed   some  defects   reaching  myenteron;  their   edges  and  bottom were   mostly   even   and   loose,   some   of them contained dark-red blood. What pathological process was revealed?

162.

A 33 year old man died from uraemia. Autopsy revealed  enlarged kidneys  weighing 500,0 each and consisting  of multiple cavities 0,5-2 cm in diameter. The cavities  were  full of light-yellow  transparent liquid.  Renal  pelvis  and  ureters had  no peculiarities. What renal disease caused uraemia?

 
163. A  patient got  a trauma that  caused dysfunction  of  motor   centres  regulating  activity  of  head  muscles.  In  what  parts of cerebral cortex  is the respective centre normally localized?
164.

Material taken   from  a  patient with provisional diagnosis \\\"influenza\\\" was referred to  a  laboratory. For  virological examination the  hemadsorption reaction was applied.  This reaction can be applied for detection of the following viruses:

165.

Lungs of a preterm infant have areas of  atelectasis (pulmonary collapse).  The main cause is:

166.

An  alcoholic  woman  has born  a girl with mental  and  physical  developmental lag. Doctors diagnosed the girl with fetal alcohol syndrome. What effect is the cause of the girl’s state?

167. A  viral  infection  has  damaged  cells that form walls of bile capillaries. This stimulated conditions for inflow of bile into the  blood  of sinusoidal  capillaries.  What cells are damaged?
168.

Dietary  intake  of a 30 year old nursing woman  contains  1000 mg of calcium, 1300 mg of phosphorus and 20 mg of iron per day. It is necessary  to change  content of these mineral substances  in the following way:

169. A patient with obliterating atherosclerosis underwent sympathectomy of femoral  artery  in the region of femoral trigone.  What  type  of arterial hyperemia was induced  by the operation?  
170.

A 15 year old girl has pale skin, glossitis, gingivitis. Blood  count:  erythrocytes -  3, 3 cot 1012/l, hemoglobin - 70 g/l, colour index  - 0,5. Examination of blood  smear revealed  hypochromia, microcytosis,  poikilocytosis. What type of anemia  is it?

 
171.

Burned skin surface  was treated with a certain preparation. Its antiseptic properties are provided  by atomic oxygen that is formed  in presence of organic substances.  What  preparation was applied?

172.

Cardinal symptoms  of primary hyperparathyroidism are osteoporosis and renal lesion along with development of urolithiasis.  What substance  makes up the basis of these calculi in this disease?

173.

A patient with chronic cardiac insufficiency  has  been  taking   foxglove  (Digitalis)  preparations for  a  long  time.  Due to  the  violation   of  intake   schedule   the woman   got   symptoms   of   intoxication.  These symptoms result from:

 
174. A    patient   was    diagnosed   with paralysis of facial and masticatory muscles.  The   haematoma  is  inside  the genu of internal capsule. What conduction tract is damaged?
175.

A 5 year old child is ill with measles. Blood  analysis  revealed  increase  of total number   of  leukocytes   up  to  13 · 109/l. Leukogram:  basophils   -  0,  eosinophils  - 1,  myelocytes  - 0,  juvenile  neutrophils - 0, band  neutrophils  - 2, segmented neutrophils - 41, lymphocytes  - 28, monocytes  - 28. Name this phenomenon:

176.

A patient was admitted to the infectious department. His symptoms:  dry skin, decreased  skin  turgor,   rice-water  stool. The  patient was diagnosed with cholera. What  disorder  of  water-electrolytic balance  is most often  observed in this disease?

177.

A  foreign   body  (a  button)  closed space of the right superior lobar bronchus. What segments  of the right lung won’t be supplied with air?

178. A patient was diagnosed with bartholinitis (inflammation of greater vulvovaginal glands). In which organ of urogenital system are these  glands localized?

179.

A histological  specimen  presents an artery.  One  of the  membranes of its wall has flat cells lying on the basal membrane. What type of cells is it?

180.

Study of conversion of a food colouring  agent  revealed  that  neutralization of this  xenobiotic  takes  place  only  in  one phase  - microsomal   oxydation.   Name  a component of this phase:

181.

Ultrasonic examination of a patient revealed   aneurism   in  the  area  of  aortic arch that caused alteration of vocal function of larynx. What nerve was constricted?

182.

A 25 year old man has spent  a long time  in the  sun under  high air humidity. As a result of it his body temperature rose up to 39oC . What  pathological process  is it?

 
183. A 23 year old man has perforation of hard  palate.  In the  area  of this perforation there was a compact well-defined formation.  Microscopic   examination  of the  resected formation revealed   a  large focus   of   caseous   necrosis   surrounded by  granulation  tissue  with  endovasculitis, cellular infiltration composed of lymphocytes, epithelioid cells (mainly plasmocytes). What is the most probable diagnosis?  
184. A young woman who entered a production department where  it strongly smelt of paints and varnishes had a bronchospasm. This reflex was caused  by irritation of the following receptors:
185.

A 50 year old man who was referred to  the  hospital  for  treatment of cervical lymphadenitis underwent test  for individual  sensitivity  to  penicillin.  30 seconds after  he  went  hot  all over,  AP  dropped down  to  0  mm  Hg  that  led  to  cardiac arrest.  Resuscitation was unsuccessful. Autopsy  results:  acute   venous   plethora of internal organs; histological  examination of skin (from the site of injection) revealed  degranulation of mast  cells (tissue  basophils). Degranulation  was  also revealed  in myocardium and lungs. What type of hypersensitivity reaction is it?

186.

One  of  sections  of  central  nervous system has layerwise arrangement of neurocytes. Among  them  there  are  cells of the  following forms: stellate,  fusiform, horizontal, pyramidal. What section of central  nervous  system is this structure typical for?

187. Study of fingerprints (dactylography) is used by criminalists for personal identification   as   well   as   for   diagnostics   of genetic abnormalities, particularly Dawn’s  disease. What layer of skin determines individuality of fingerprints?

188. A  patient has  herpetic rash.  What medication should be administered?
189.

Cytogenetic examination of a patient with reproductive dysfunction  revealed normal karyotype 46 ХY in some cells, but most cells have karyotype of Klinefelter’s syndrome  - 47 ХХY. Such cell heterogeneity is called:

190.

An isolated  muscle fiber is under examination. It  was established that  the threshold of stimulation force became  significantly lower. What is the cause of this phenomenon?

191.

During    examination   of   a   patient  a  dentist   revealed   a  lot  of  \\\"white spots  zones  of enamel  demineralization. What microorganisms take part in the development of this process?

192. Surgical   approach  to   the   thyroid gland     from     the     transverse    (collar) approach involves opening of interaponeurotic suprasternal    space.     What anatomic  structure localized in this space is dangerous to be damaged?

193.

A  doctor  revealed  tissues  injury  on patient’s   scalp  with  localized  suppurations and diagnosed his disease  as myiasis. This infestation is caused by larvae of the following insect:

194.

A patient with hip fracture was prescribed  a  narcotic   analgetic.   Its anesthetic action is determined by interaction with the following receptors:

195.

A patient consumed  a lot of reach in proteins  food that  caused increase  of rate of proteolytic enzymes of pancreatic juice. It is also accompanied by increase  of rate of the following enzyme:

196.

In course of an experiment thalamocortical tracts  of an animal  were cut. What type of sensory perception remained intact?

197.

A   2   year   old   child   had   acute respiratory   viral    infection     and    died from     cardiopulmonary    decompensation.  Autopsy revealed  that  his right  lung was hyperemic;  in the  2nd, 6th and  10th segments  and  on the  incision  there  were airless  yellowish  foci  of  irregular form, from  several  mm  up  to  1cm large.  Microscopical examination revealed  exudate consisting  mainly  of  neutrophils  in  the given areas of pulmonary tissue in the alveole\\\'s, bronchioles and bronchial tubes. What is the most probable diagnosis?

198.

A 25 year old patient was examined by a medical board. Examination revealed pathology  of  chest.  Transverse dimensions  were  to  small  and  the  sternum was strongly protruding. What chest type is it?

 
199.

An  infectious   disease  caused contractive activity  of  muscles  that contract   and  dilate  eye  pupil  (paralytic state). What functional eye system was damaged?

200.

Brain tomography revealed  a tumour in the region of red nucleus. What part of brain is damaged?