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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.

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:

3. Heart rate  of a 30-year-old  man under emotional stress  reached 112 bpm.  The reason   for   the   heart   rate   increase   is the altered condition of the following conducting  system of heart:
4.

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:

5. A   46-year-old    female    patient   has a       continuous   history    of    progressive muscular   (Duchenne’s)  dystrophy.   Which blood  enzyme  changes  will be  of  diagnostic value in this case?
6.

Extensive    thromboembolic   infarction   of   the   left   cerebral  hemispheres, large septic spleen, immunocomplex glomerulonephritis, ulcers on the edges of the  aortic  valves, covered  with polypous thrombus with colonies of staphylococcus were  revealed   on  autopsy  of  the  young man  who  died  in  coma.  What   disease caused cerebral thromboemboli?

7.

A  10-year-old   girl  has  a  history   of repeated acute respiratory viral infection. After  recovering  she presents with multiple petechial hemorrhages on the sites of friction  from  clothing  rubbing   the  skin. What kind of hypovitaminosis has this girl?

8. Autopsy  of  a  patient  who  suffered from croupous  pneumonia and died from pneumococcal sepsis  revealed  900 ml of turbid   greenish-yellow  liquid  in  the  right pleural  cavity. Pleural  leaves are dull, plephoric. Name the clinicopathological form of inflammation in the pleural cavity:
9.

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

10. 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?
11.

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?

12.

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?

13. 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?
14.

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

15. Autopsy  of  a  man  who  died  from chronic  cardiovascular collapse  revealed \\\"tiger  heart\\\". Sidewards  of endocardium a yellowish-white banding can be seen; myocardium is dull, dark-yellow.  What process caused this pathology?
16. A 55-year-old  male patient was hospitalised  to  a  surgical  clinic for  suspected septicemia.    What    material   should    be taken  for analysis?
17.

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:

18.

During    examination  of   a   6-year- old    child    a    doctor     revealed     greyish    films    on    the    pharyngeal    tonsils. Their removal  provoked moderate haemorrhage. Bacterioscopy revealed gram-positive clublike bacteria. What symptoms will develop in this child within the next few days if no specific treatment is provided?

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

20. 12 hours after an acute attack  of retrosternal  pain  a  patient presented a jump of aspartate aminotransferase activity in blood  serum. What pathology is this deviation  typical for?
21.

After   a  trauma of  the  upper   third of the  anterior forearm surface  a patient presents with difficult pronation, weakening of palmar  flexor  muscles  and  altered skin sensitivity of 1-3 fingers. Which nerve is damaged?

22.

A  2-year-old  child  with  mental   and physical  retardation has  been  delivered to  a hospital.  He  presents with frequent vomiting after having meals. There is phenylpyruvic acid in urine. Which metabolism abnormality is the reason  for this pathology?

23. A 38-year-old man died in the attempt of lifting weight. He had collaptoid state. Autopsy revealed  an  extensive  aneurism rupture  of  thoracic   aorta.   He   suffered from   visceral  syphilis  during   his  lifetime. What pathological process caused weakness  of aortic  wall, its dilatation and rupture?
24.

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?

25.

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?

26.

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?

27. 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?
28.

A  doctor  recommends a  patient with  duodenal ulcer  to  drink  cabbage  and potato  juice   after   the   therapy  course. Which substances  contained in these vegetables  help  to  heal  and  prevent the ulcers?

29. Urine  analysis  of  a  12-year-old  boy reveals high concentration of all aliphatic amino  acids  with  the  highest  excretion of cystine and cysteine. US of kidneys revealed  kidney concrements. What is the most likely pathology?
30.

A 5-year-old child has been diagnosed with    acute     right    distal    pneumonia. Sputum  inoculation revealed  that the causative  agent  is resistant  to  penicillin, but it is sensitive to macrolides.  What drug should be prescribed?

31. 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?
32. 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?
33.

A 30-year-old  male patient with acute pancreatitis has been found to have a disorder   of   cavitary   protein  digestion. The reason  for such condition can be the hyposynthesis  and  hyposecretion of  the following enzyme:

34. 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?
35. A victim of an accident  has bleeding from the  soft tissues  anteriad the  mandibular  angle.  Which  vessel  should  be  ligated for the bleeding arrest?
36.

Microscopic  examination of a  gram-stained scrape from a patient’s tongue revealed  oval, round,  elongated chains of dark-violet gemmating cells. What disease can be caused by this causative agent?

37. 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:

38. A 36-year-old female patient has a history of collagen disease. Urine analysis is likely to reveal an increased concentration of the following metabolite:
39.

A coprological  survey revealed  light-colored  feces containing drops  of neutral fat. The most likely reason  for this condition is the disorder of:

40. The  secretion  of  which  hypophysial hormones will be  inhibited after  taking the  oral contraceptives containing sex hormones?
41.

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:

42.

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?

43.

A  patient with  essential  hypertension  has  a high  rate  of blood  renin.  Which of antihypertensive drugs should be preferred?

44.

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:

45.

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

46.

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?

47.

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?

48.

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?

49.

As  a  result  of  activation   of  the  ion channels  of  the  external membrane the rest   potential  of  an  excitable   cell  has greatly increased. What channels were activated?

50.

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:

51.

A patient with cardiogenic  shock, hypotension, asphyxia  and  edemata was given an injection  of non-glycosidic cardiotonic. What drug was injected?

52.

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?

53.

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:

54.

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?

55. Which of the listed diuretic agents WILL NOT have diuretic  effect on a patient with Addison’s disease?
56. A man with a wound of his limb that had been suppurating for a long time died from intoxication.  Autopsy revealed extreme emaciation, dehydration, brown atrophy of liver, myocardium, spleen  and cross-striated muscles as well as renal amyloidosis. What diagnosis corresponds with the described  presentations?

57.

This drug  has  a destructive effect  on erythrocytic forms  of malarial  plasmodia and  dysenteric amoebae.  It  is  used  for treatment and prevention of such diseases as malaria,  amebiasis  and  interstitial disease. What drug is it?

58.

A  patient has  an  increased pyruvate concentration  in  blood,   most   of   it  is excreted with the urine. What kind of avitaminosis  has this patient?

59. A child suffers from drug idiosyncrasy. What is the cause of such reaction?
60.

One  of  the  parents is  suspected   of having phenylketonuria recessive gene. What  is the  risk of giving birth  to a child with inborn  phenylketonuria?

61.

Pulmonary  examination  of  a  patient  who  has  worked  as  a  stone  grinder for 9 years  revealed  small dense  roundish  nodules   consisting   of  connective  tissue. The nodules were found to have peripheral macrophages. Such pulmonary  alterations are indicative  of the following disease:

62.

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

63.

Which  way  of  heat  emission  by  the bodies  of greenhouse workers  is the most effective   at   the   temperature  of   36oC degrees and relative humidity of 70%?

64.

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

65.

A disaster  fighter  at a nuclear  power plant  developed  hemorrhagic syndrome on the  background of acute  radiation disease. What  is the  most  important factor of syndrome  pathogenesis?

66.

Jaundice treatment involves administration of barbiturates inducing the synthesis  of UDP-glucuronyl transferase. A medicinal  effect is caused by the production of:

67. 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:

68.

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?

69.

Autopsy of a 75-year-old  man  with a long history  of atherosclerosis revealed  a grey irregular-shaped focus of loose consistency in the right parietotemporal region of brain.  What  is the most likely cause of this process?

70.

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:

71. A  surgeon  has  to  find  the  common hepatic duct during the operative intervention on account of concrements in the  gall ducts.  The  common  hepatic  duct is located  between the leaves of:
72.

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?

73.

A   75-year-old-female patient   with complaints of visual impairment has been delivered to the ophthalmologic department. Objective examination revealed a brain tumor in area of the left optic tract.  The patient has a visual field defect in the following area:

74. A   patient  with   coronary    disease has been diagnosed with myocardial hypertrophy, tachycardia and  a decrease in  minute   blood   volume.   What   is  the leading  mechanism  of cardiac  histiocyte damage in this case?
75. Blood    analysis   of   a   patient   with jaundice reveals conjugated bilirubinemia, increased concentration of bile acids. There  is no  stercobilinogen in urine. What type of jaundice  is it?
76. While  studying  maximally  spiralized chromosomes of human karyotype the process of cell division was stopped in the following phase:
77.

A man is being measured power inputs on  an  empty  stomach,  in the  lying position, under  conditions of physical and psychic rest at a comfortable temperature. Power inputs will reach the maximum at:

78.

When  measuring   power  inputs  of  a man  by  the  method  of  indirect   calorimetry the following results were obtained: 1000 ml oxygen consumption and 800 ml carbon  dioxide liberation per minute.  The man under  examination has the following respiratory coefficient:

79.

A newborn child with pylorostenosis has often  repeating vomiting  accompanied by apathy, weakness, hypertonicity, sometimes    convulsions.   What   disorder form of acid-base  balance  is it?

80.

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:

81. A  patient has  been  diagnosed   with alkaptonuria. Choose  an  enzyme  whose deficiency can be the reason for this pathology:
82. 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?
83.

A 49-year old female patient has limitation  of left limbs arbitrary movements. Muscular tonus of left hand and leg is overstrained and spasmodic,  local tendon reflexes  are  strong,  pathological reflexes are  presented. What   is  the  most  likely development  mechanism   of  hypertension and hyperreflexia?

84.

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?

85.

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?

86.

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

87.

Examination of a pregnant woman having   Rh-negative  blood   revealed   high  level  of  antierythrocytic  antibodies. For  its reduction she  was implanted with  her  husband’s  Rh-positive skin  graft. The   graft   was  rejected  in  two   weeks. Its  microscopic  examination revealed  circulatory disturbance, edema  and cellular infiltration  with lymphocytes,  neutrophils and macrophages predominance. What  is the most likely pathology?

88. A  17-year-old  girl  took  a  high  dose of   phenobarbital   to   commit    a   suicide. An ambulance doctor  cleansed her stomach and gave her an intravenous injection of bemegride and sodium hydrocarbonate solution.  What  was sodium hydrocarbonate injected for?
89.

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?

90.

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

91. A  patient has  corestenoma. What  is the reason of such condition?
92.

A  46-year-old   man   had   a  bulging dark macula on skin that caused no discomfort.  With  time  it began  to increase in size and became  painful. It turned dark brown and there  was a nodule  on palpation. Histological  examination of tissues revealed spindle and polymorphous cells with multiple mitoses. Their cytoplasm contained brown  pigment.  What  tumour is it?

93.

The    patient   with    complaints   of permanent thirst  applied   to  the  doctor. Hyperglycemia, polyuria  and increased concentration of 17-ketosteroids in the urine  were  revealed.  What  disease  is the most likely?

94. 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:
95.

An infant has pylorospasm, weakness, hypodynamia, convulsions  as a result  of frequent vomiting. What kind of acid-base disbalance  is it?

96. A weightlifter  has a disruption of thoracic  lymphatic  duct  as a result  of lifting a weight. Choose  the most likely site of injury:
97.

A woman suffering from osteochondrosis has acute pain in her humeral articulation that  gets worse  when  she tries  to abduct her  shoulder. These  symptoms  might  be caused by damage of the following nerve:

98.

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?

99. A female patient presents with endocrine dysfunction   of  follicular  cells of  the   ovarian   follicles  resulting   from an inflammation. The synthesis of the following hormone will be inhibited:
100.

A  19-year-old   female   patient  has had low haemoglobin rate  of 90-95 g/l since childhood.  Blood  count  results obtained  after  hospitalisation are  as  follows: erythrocytes  -  3, 2 ·  1012/l,  Hb-   85  g/l, colour index - 0,78; leukocytes  - 5, 6 · 109/l, platelets - 210 · 109/l. Smear  examination  revealed   anisocytosis,   poikilocytosis and  target  cells. Reticulocyte rate  is 6%. Iron  therapy was ineffective.  What  blood pathology corresponds with the described clinical presentations?

101.

A  liquidator of  a  breakdown  at  a nuclear  power  plant  who  was irradiated complained about  vomiting that occurs all of a sudden.  What  medication should  be prescribed?

102. A patient with acute myocardial infarction has been administered heparin as   a   part   of   complex   therapy.  Some time   after   heparin  injection   the   patient  developed hematuria. What  heparin antagonist should  be injected  in order  to manage the complication?
103.

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?

104.

A  patient complains  of hydruria (7 liters per day) and polydipsia.  Examination  reveals  no  disorders of carbohydrate metabolism.  These   abnormalities  might be caused by the dysfunction  of the following endocrine gland:

105.

Before  a surgery a blood sample of a 30-year-old  man  has  been  typed.  Blood is Rh-positive. Standard  serums  of  such groups as 0 αβ (I), Аβ (II), Вα (III) didn’t activate  erythrocyte agglutination reaction. The group of the analyzed blood is:

106.

Medical  examination of  a  20-year- old woman revealed  a dense encapsulated node  1 cm in diameter that  was palpated in the  mammary gland.  The  postoperative biopsy revealed  connective tissue overgrowth around  the  mammary ducts and glandular components of different  diameter that didn’t make lobules  and bore no signs of cellular  abnormality. What  diagnosis will be made?

107. A 38-year-old  male patient has been ill with systemic lupus  erythematosus for three years. He was diagnosed with diffuse renal   affection   accompanied  by  massive  edemata and  expressive   proteinuria. What  is the  most  likely  cause  of proteinuria development?
108.

A  student failed  to  answer  all  the questions  of examination paper  correctly. As   a  result   he   blushed,   felt   hot   and lost confidence. What type of arterial hyperemia has developed in this case?

109.

Acute    renal    impairment   caused death  of a bleeding patient. Autopsy revealed  enlarged kidneys  with  a  broad pale pink cortical layer expressively demarcated from  dark  red  renal  pyramids.   Macroscopic    examination  revealed lack of epithelial nuclei of convoluted tubules,  tubulorrhexis,  phlebostasis. The cell nuclei of choroid  glomus and straight tubules  were  present. What  pathology is it?

110.

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?

111.

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?

112.

Blood   plasma   of  a  healthy   man contains  several dozens of proteins.  During an illness new proteins  can originate, namely   the   protein  of  \\\"acute   phase\\\". Select such protein from the listed below:

113.

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?

114.

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:

 
115. During fighting a man had a cardiac arrest as a result of a hard blow to the upper  region  of anterior abdominal wall. Which of the described  mechanisms might have provoked the cardiac arrest?

116.

There  is a severe time restriction for people’s  staying  at  a height  of over  800 m  above   the  sea  level  without   oxygen bombs.  What  is the  life limiting factor  in this case?

117.

A patient with marked pneumofibrosis   that    developed   after    infiltrating  pulmonary tuberculosis has  been  diagnosed  with respiratory failure.  What  is its pathogenetic type?

118.

During surgical manipulations a patient has been given novocaine  injection for anesthesia. 10 minutes  later  the  patient developed paleness,  dyspnea,  hypotension. What type of allergic reaction is it?

119.

A sensitive  neural  ganglion  consists of roundish neurocytes with one  extension that divides into axon and dendrite at a some distance  from the perikaryon. What are these cells called?

120. 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:

121.

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

122.

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:

123.

An adult man presents with systemic arterial  pressure  drop   from   120/70  to  90/50  mm   Hg.   This   resulted  in  reflex vasoconstriction. Vasoconstriction will be  minimal in the following organ:

124.

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

125. An electron microphotography of a fragment of proper gastric gland shows a big irregular round-shaped cell. There are  a lot of intracellular tubules  and  mitochondria in the  cytoplasm.  Specify this cell:

126.

Blood   count   of  an   athlete  is  as follows:  erythrocytes  -  5, 5 · 1012/l,  Hb - 180 g/l, leukocytes  - 7 . 109/l, neutrophils - 64%, basophils - 0,5%, eosinophils - 0,5%, monocytes  - 8%, lymphocytes  - 27%. First of all, such results indicate the stimulation of:

127.

A patient died from cardiopulmonary decompensation. Histological  examination revealed  diffused pulmonary affection along  with interstitial edema,  infiltration of tissue by limphocytes,  macrophages, plasmocytes;  pulmonary fibrosis,  panacinar  emphysema. What  is the  most  likely diagnosis?

128.

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

129.

A    male    patient   has    been    diagnosed  with  gastric  ulcer.  Bacteriological examination of biopsy  material from the   affected   part   of  stomach   revealed small colonies of gram-negative, oxide reductase-positive flexibacteria  that  grew on  the  chocolate  agar  on  the  fifth  day. Which  of  the  following  microorganisms is the most likely causative agent?

130.

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

131.

A  patient has  been  diagnosed   with  a  compression fracture  of  a  lumbar vertebra.  As  a  result   he  has  a  considerable  increase    in   curvature   of   the lumbar  lordosis.  Which ligament  damage can induce such changes in the spine curvature?

132.

A 49-year-old  patient with croupous pneumonia died from pneumococcal septicemia. Autopsy  revealed  up  to  700 ml of turbid greenish-yellow foul-smelling liquid in the left pleural cavity. The pleural leaflets   were   dull  and   plethoric.  What form of pleural inflammation is it?

133.

A 35-year-old  man  developed acute heart failure while running for a long time. What changes in ionic composition can be observed  in the cardiac muscle?

134.

A     child     with     a    history     of frequent   angine    and    pharyngitis    has been   diagnosed   with  lymphadenopathy and splenomegaly. His appearance is characterised by  pastosity  and  paleness, muscular  tissue is poorly developed. Lymphocytosis is present. What  kind  of diathesis is it?

135.

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?

136.

After    an    immunoassay   a    child   was   diagnosed    with   immunodeficiency  of  humoral immunity.  What  is the reason  for the primary  immunodeficiency development in the child?

137. Life   cycle  of  a  cell  includes   the process  of DNA  autoreduplication. As a result of it monochromatid chromosomes turn  into  bichromatid ones.  What  period of  cell  cycle  does  this  phenomenon fall into?
138.

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

139.

2   days   after    labour    a   woman developed  shock  along  with  DIC syndrome  that caused her death.  Autopsy revealed  purulent endomyometritis, regional  purulent lymphangitis,  lymphadenitis and  purulent thrombophlebitis. There were also dystrophic alterations and interstitial inflammation of  parenchymal organs. What is the most likely diagnosis?

140.

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:

141.

Tissue inosytol triphosphates are generated as  a  result  of  the  phosphatidylinositol   diphosphate  hydrolysis   and act  as  secondary   agents   (mediators)  in the  mechanism  of hormone action.  Their effect in cells is directed at:

142.

A   patient  with   coronary    disease and  arrhythmia has been  administered a drug that blocks potassium channels and prolongs  the  action  potential. What  drug is it?

143. A  patient takes  digoxin  for  cardiac insufficiency.  What  diuretic  may increase digoxin toxicity due to the intensified excretion of K + ions?
144.

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

145.

A female  patient consulted  a doctor about a sense of epigastric discomfort, nausea  and anorexia. A duodenal content analysis   revealed    lamblia.   What   drug should be prescribed?

146.

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?

,
147. A 1-year old baby has been hospitalized for body and limbs lesions. Examination  revealed  carnitine deficiency in the child’s muscles. A biochemical  reason  for this pathology is the disorder  of:

148. During     anesthetization   a    patient presented with symptoms of tonus increase  of  parasympathetic nervous system such as hypersalivation and laryngospasm. What drug could have prevented these undesirable effects?
149. Some  students  developed myodynia after  continuous physical  activity  during physical  education. The  reason  for  such condition was accumulation of lactic acid in the  skeletal  muscles.  It was generated in the students’ bodies  after  activation of the following process:
150.

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:

151. A  doctor  asked  a patient to  breath out  fully  after  taking  a  normal   breath. What muscles contract during such exhalation?
152.

On an electron micrograph a scientist has identified a structure formed by  eight  histone  proteins and  a  part  of DNA molecule which makes about 1,75 revolutions around the molecules.  Which structure has been identified?

153.

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?

154.

A   three-year-old   child   has   had marked diarrhea for three  days. Immune electron microscopy  of his excrements revealed  bilayer pseudocovered capsid viruses that looked  like small spoke wheels. What viruses have been revealed?

155.

A male patient has fever and enanthesis.  As   a  result   of  the   examination  involving  serological  tests  he  has been  diagnosed  with fasciola hepatica. It was found  out  that  the  patient had  been infected  through  raw river  water.  Which stage  of fasciola  life cycle is invasive  for humans?

156. A patient with high-titer antinuclear antibodies died from progressing  renal impairment. Autopsy  revealed   mesangioproliferative glomerulonephritis and a bacterial polypous  endocarditis. There was periarterial bulbar  sclerosis in spleen and  productive proliferative vasculitis  in skin. What is the most likely diagnosis?
157.

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?

158. A patient has food poisoning. Laboratory  analysis   revealed   a  culture of anaerobic gram-positive spore-forming bacteria. What  is the  most  likely kind  of the isolated  causative agent?
159. 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:
160.

A 70-year-old male patient died from acute coronary  insufficiency. He had knee joint  swelling, gonycampsis  and  gonalgia during his lifetime. Pathomorphologic examination of the deformed    joints and synovial membranes revealed membrane hyperaemia with multiple perivascular inflammatory infltrations made  by lymphocytes, plasmocytes and macrophagocytes. There was an accumulation of organized  fibrin covering some  areas  of synovium  membrane and looking  like rice grains in the articular liquid. What is the most likely diagnosis?

161. A  man  having  a  hearing  loss  after a head trauma was delivered to the neurosurgery department.  The  cause  of the  hearing  loss might  be the  damage  of the following lobe of cerebral cortex:
162.

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

163.

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

164.

Vomiting  matters of a patient suspected  of  having  cholera   were  delivered   to  the  bacteriological  laboratory. The  material  was  used  for  preparing a \\\"hanging drop\\\" specimen. What type of microscopy will be applied for identification of the causative agent by its mobility?

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

166. Examination of a 6-month-old child revealed  a delay in closure  of the  occipital  fontanelle. When  should  it  normally close?
167.

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?

168. A  male  patient has been  diagnosed with  acute  radiation disease.  Laboratory examination revealed  a considerable reduction of platelet serotonin level. The likely cause of platelet serotonin reduction is the disturbed metabolism of the following substance:
169. In course of a conditional experiment the   development  of  mesenchyma  cells was  completely   inhibited.   Development of the following muscular tissue will be disturbed:
170. A histologic specimen shows an organ\\\'s parenchyma which is presented by lymphoid  tissue  making  some  lymph nodes.   The   nodes   are   located   diffusively and contain a central artery. What anatomic formation might have such morphological structure?
171. A victim with a head  trauma in the temporal region has been  diagnosed  with epidural hematoma. What  artery  is most likely to be damaged?
172.

A child has mental  and physical retardation, grave damage  of internal connective tissue.  Urine  analysis  reveals keratan sulfates.  What  metabolic process is disturbed?

173.

A   tooth    extraction  in   a   patient with chronic persistent hepatitis was complicated with prolonged hemorrhage. What  is the  reason  for the  haemorrhagic syndrome?

174. Sex chromosomes of a woman  didn’t separate and  move  to the  opposite  poles of a cell during  gametogenesis (meiosis). The ovum was impregnated with a normal spermatozoon. Which chromosomal disease can be found in her child?
175. A  female  patient was administered loratadine for allergic cheilitis treatment. What is the mechanism  of the drug’s action?
176.

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

177.

A doctor  prescribed a cephalosporin antibiotic to the patient after appendectomy for  infection   prevention.  Antimicrobial activity of this group of antibiotics  is based upon   the   disturbance  of  the   following process:

178.

A patient underwent an extraction of a part of a CNS structures by medical indications.  As a result  of the  extraction the patient developed atony,  astasia,  intention tremor, ataxy and adiadochokinesis. Which  part  of  CNS  structure had  been extracted?

179.

A  patient has  been  diagnosed  with influenza.  His  condition  became   drastically worse after taking antipyretic drugs. His consciousness  is confused, AP is 80/50 mm  Hg,  Ps  is 140/m, body  temperature dropped down to 35, 8oC . What complication developed in this patient?

180.

A  patient consulted  a doctor  about loss of taste sensitivity on the tongue  root. The  doctor  revealed  that  it is caused  by nerve affection. Which nerve is it?

181.

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

182.

An older  woman  has been  hospitalised for acute pain and edema  of the right hip joint that appeared after a fall. Objectively: the  hip is adduced inwards,  hip joint movements are  impaired. The  patient is most  likely  to  have  a  fracture of  the following bone or bone part:

183.

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

184.

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:

185. While  performing an inguinal  canal operation on account  of hernia  a surgeon damaged the canal\'s contents. What exactly was damaged?

186.

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?

187.

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?

188. A  26-year-old  man  is in the  torpid shock phase  as a result  of a car accident. In blood:  3, 2 · 109/l. What  is the  leading mechanism  of leukopenia development?
189.

A patient consulted a doctor  about  a sensation of  imbalance  which  appeared after a trauma. Which nerve is damaged?

190. An alcoholic has alcoholic psychosis with evident psychomotor agitation. What neuroleptic drug should be administered  for emergency  care?
191.

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

192. The liver puncture biopsy of a patient with hepatocellular insufficiency revealed hydropic  and  ballooning degeneration of hepatocytes, necrosis of certain  cells, presence of  Kaunsilmen’s bodies.  Portal and lobular stroma were infiltrated mostly with    lymphocytes    and     macrophages as well as with a small number of polymorphonuclear lymphocytes.  What is the most likely diagnosis?
193. In  order  to  accelerate healing  of  a radiation ulcer  a vitamin  drug was administered. What drug is it?
194.

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:

 
195.

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:

196.

A  patient  presents with  acne  and inflammatory alterations  of  facial  skin. Microscopical   investigation of  lesion  foci has  revealed   live  arthropods  sized  0,2-0,5  mm.  They  have  prolate  vermiform form and four pairs of thin short limbs located  in  the  middle  part  of  the  body. The revealed  arthropods cause:

197.

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?

198.

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?

199.

A   4-year-old   child   presents  with general weakness, sore throat and deglutitive  problem.  After   his  examination a doctor  suspected  diphtheria and sent  the material to the bacteriological laboratory. In order  to determine the diphtheria causative   agent   the  material should   be inoculated into  the  following  differential diagnostic medium:

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?