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1.

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

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. 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:
4. A couple  has a son with haemophilia. The parents are healthy  but the maternal grandfather also has haemophilia. Specify the type of inheritance:
5.

Examination  of  newborns   in  one  of the  Ukrainian cities revealed  a baby  with phenylketonuria. The baby’s parents don’t  suffer  from  this  disease  and  have two    other     healthy    children.    Specify the most likely parents’ genotype with phenylketonuria gene:

6. A patient has a right-sided  fracture in the region of the frontal third of mandible accompanied by a haematoma in the region of chin. It is caused by the injury of the following artery:
7.

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?

8. As a result  of a cold a patient has the abnormal pain and temperature sensitivity of the frontal  2/3 of his tongue.  Which nerve must have been damaged?
9.

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

10.

After  a trauma of soft  tissues  in the region  of the  posterior surface  of medial condyle  of humerus  a patient has  got a skin prickle  of medial  forearm surface. Which of the listed nerves is located in the affected region?

11. A  boy  has  fallen  down  from  a tree. Now he finds it difficult to abduct  his arm into horizontal position. Which muscle is most likely to be injured?

12.

A  female  patient with  a  tumour of pancreas has developed mechanic  jaundice resulting  from  compression of a bile-excreting duct. Which duct is compressed?

13.

A 28 year old woman  has  been  diagnosed with extrauterine pregnancy complicated by the fallopian tube rupture. The blood is most likely to penetrate the following peritoneal space:

14.

Patients with similar complaints  applied to the doctor: weakness, pain in the intestines, disorder of GIT.  Examination of the faeces revealed that one patient with four nucleus  cysts should  be hospitalized  immediately.   For what  protozoa are such cysts typical?

15.

Autopsy of a 58 year old man revealed that bicuspid valve was deformed, thickened   and   unclosed.    Microscopically: foci of collagen   fibrilla  are   eosinophilic, react positively to fibrin. The most probably it is:

16.

Chronic inflammation and transformation   of   the   one-layer ciliated   epithelium  into   multiple-layers  flat  epithelium was  revealed   in  the  thickened  mucous membrane  of  the  bronchus bioptate  of the  patient with smoke  abuse.  Which  of the processes is the most likely?

17.

During  postembryonal haemopoiesis in the  red  bone  marrow  the  cells of one of  the  cellular  differons   demonstrate a gradual  decrease in cytoplasmic  basophilia  as  well  as  an  increase   in  oxyphilia, the nucleus is being forced out. Such morphological changes are typical for the following haemopoiesis type:

18. Students who are taking examinations often have dry mouth.   The mechanism that causes this state is the realization of the following reflexes:
19. The temperature of the ambient environment is 38oC and relative air humidity is 50%. What ways of heat emission provide maintaining a constant temperature of the human body?
20.

A microspecimen of heart shows rectangular cells from 50  to  120mcm large with central position of nucleus, developed myofibrils. The cells are connected by intercalated discs.  These cells are responsible for the following function:

21. A 30 year old woman has subnormal concentration of  enzymes  in  the pancreatic juice. This might be caused by the hyposecretion of the following gastrointestinal hormone:

22.

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

23.

A patient has a trauma of sternocleidomastoid muscle. This caused a decrease in value   of  the   following   indicator   of external  respiration:

24. A month   after surgical constriction of rabbit’s renal artery the considerable increase   of  systematic   arterial  pressure was observed.  What of the following regulation mechanisms   caused   the animal’s pressure change?
25.

Microscopic examination of the enlarged  neck   gland   of  a  14  year   old girl   revealed    destruction   of    the    tissue  structure  of  the  node,   absence   of the lymph follicles, sclerotic areas and necrosis foci, cell constitution of the node is polymorphous, lymphocytes,  eosinophils, big atypical cells with multilobular nuclei (Beresovsky-Sternberg cells) and mononuclear cells  of  the  large  size  are present. What is the most likely diagnosis?

26. A  child  has  abnormal  formation  of tooth  enamel and dentin  as a result of low concentration of  calcium  ions  in  blood. Such abnormalities might be caused  by deficiency of the following hormone:
27.

A sportsman was examined after an intensive physical activity. The examination revealed disorder of movement coordination but the force of muscle  contractions remained the same. It can be explained by retarded speed of excitement conduction through:

28. After     a    long    training     session a sportsman has developed fatigue accompanied by abrupt performance decrement. What link  of the  reflex  arch was the fatigue initiated  in?
29. Blood minute volume of a 30 year old woman at rest is 5 l/m. What blood volume is pumped through the pulmonary vessels per minute?
30.

After    a   tourniquet application  a patient was found  to have petechial haemorrhages. The reason for it is the dysfunction of the following cells:

31.

A patient under test was subjected to a moderate physical stress. His minute blood volume amounted 10 l/min.  What blood volume was pumped   through his lung vessels every minute?

32.

A patient presents with the following motor activity disturbances: tremor, ataxia and asynergia movements, dysarthria. The disturbances are most likely to be localized in:

33.

A  man  has  a  considerable decrease in diuresis  as a result  of 1,5 l blood  loss. The primary   cause of  such  diuresis  disorder is the hypersecretion of the following hormone:

34.

The  patient with  thymoma (thymus gland  tumour) has cyanosis, extension of subcutaneous venous  net  and  edema  of the  soft tissues  of face, neck,  upper  part of the trunk  and upper  extremities. What venous trunk is pressed with tumour?

35.

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:

36.

Vegetative abnormalities in the sleep, heat  regulation, all kinds  of metabolism, diabetes insipidus  are  developing  in the patient due  to  growth  of  the  tumour in the III ventricle  of brain. Irritation of the nucleus of what part of the brain can cause this symptoms?

37.

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

38.

Examination  of  a  child  who  hasn’t got fresh  fruit  and  vegetables  during  winter revealed numerous subcutaneous hemorrhages, gingivitis, carious cavities in teeth.  What vitamin combination should be prescribed in this case?

39.

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?

40. 46 chromosomes were revealed on karyotype examination of the  5 year  old girl. One of the 15th pair of chromosomes is longer than usual due to connected chromosome from the 21 pair. What type of mutation does this girl have?

41.

A   62   year   old   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?

42. Before the cells can utilize the glucose, it is first transported from the extracellular space  through the  plasmatic   membrane inside them. This process is stimulated by the following hormone:
43.

Parodontitis is treated with  calcium preparations and a hormone that stimulates  tooth  mineralization and inhibits tissue resorption. What hormone is it?

44.

A child has an  acute   renal  failure. What biochemical factor found in saliva can confirm this diagnosis?

45. After implantation of a cardiac valve a young man constantly takes  indirect  anti-coagulants.  His state was complicated by hemorrhage, What substance content has decreased in blood?

46. After severe viral hepatitis a 4 year old boy presents with vomiting,  occasional loss of consciousness, convulsions. Blood test revealed hyperammoniemia. Such condition is caused by a disorder of the following biochemical hepatic process:
47.

Having  helped  to  eliminate consequences  of  a  failure   at  a  nuclear power  plant,  a  worker  got  an  irradiation  doze  of  500  roentgen.  He  complains of  headache, nausea,  dizziness.  What changes in leukocytes quantity can be expected 10 hours after irradiation?

48.

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?

49.

A    patient    with    a    history     of chronic      glomerulonephritis     presents with azotemia, oliguria, hypo- and isosthenuria, proteinuria. What is the leading factor in the pathogenesis of these symptoms   development under    chronic renal failure?

 
50.

After an attack  of bronchial  asthma  a patient had  his  peripheral blood  tested. What changes can be expected?

51.

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:

52.

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

53.

After  the  traumatic tooth  extraction a  patient is  complaining   of  acute,  dull, poorly-localized pain in gingiva, body temperature rise up to 37, 5oC . The patient has been diagnosed with alveolitis. Specify the kind of pain in this patient:

54.

A 50  year  old  patient suffers  from essential   hypertension. After   a physical stress he  experienced muscle  weakness, breathlessness, cyanosis  of lips, skin and face. Respiration was accompanied by distinctly heard bubbling rales. What mechanism underlies the development of this syndrome?

55. 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?
56.

A patient suffering from chronic myeloleukemia   has    got    the    following symptoms  of  anemia:  decreased number  of erythrocytes and low haemoglobin    concentration,    oxyphilic and  polychromatophilic normocytes, microcytes. What is the leading pathogenetic mechanism of anemia  development?

57.

A patient with obliterating endarteritis underwent ganglionic sympathectomy. What type of arterial hyperaemia should have developed as a result of the surgery?

58.

Autopsy of  a  woman  with  cerebral atherosclerosis  revealed   in  the  left cerebral hemisphere a certain  focus that is  presented by  flabby,  anhistic,  greyish and yellowish tissue with indistinct  edges. What pathological process is the case?

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

60. A 63 year  old  patient with  collapse presentations was delivered to the emergency  hospital.  A physician has chosen noradrenalin against hypotension. What is its mechanism of action?
61.

Autopsy   of    a    man    who    had tuberculosis revealed a 3x2 cm large cavity in the  superior lobe  of the  right  lung. The cavity was interconnected with a bronchus,   its  wall  was  dense  and  consisted  of  three   layers:  the  internal  layer was pyogenic, the middle layer was made by tuberculous granulation tissue and the external one  was made  by connective tissue. What is the most likely diagnosis?

62. A patient suffering from syphilis has been  treated with  bismuth  preparations. As  a result  of it some  grey spots  turned up on the  mucous  membrane of the  oral cavity; nephropathy symptoms  were  also present. What drug should  be  used  for treatment of bismuth intoxication?
63.

Autopsy of a man who died from ethylene glycol poisoning   revealed   that his   kidneys   are   a   little   bit   enlarged, edematic; their capsule can be easily removed.  Cortical substance is broad and light-grey.  Medullary substance   is dark- red. What pathology had this man?

64.

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?

65.

A  man  with  a  long-term  history  of bronchial asthma died from asphyxia. Histological  examination of his lungs revealed  that  the  lumens  of bronchioles and   minor   bronchi   contained  a  lot  of mucus  with some  eosinophils.  There  was also  sclerosis  of  interalveolar septa,  dilatation of alveoli lumens. What mechanism accounts for the development of hypersensitivity reaction?

66.

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:

67. Bacterioscopy of  nasopharyngeal mucus  taken   from  a  2,5  year  old  child with nasopharyngitis revealed  gram- positive   diplococci   looking   like   coffee grains. What organs of the child are most likely to be affected if these microorganisms penetrate the blood?
68. Histologic  analysis  of uterus  mucous membrane  revealed   twisting  glands, serrated and spinned,  they were extended by stroma  growth with proliferation of its cells. Formulate a diagnosis:
69.

Analysis of sputum taken from a patient with  suspected   pneumonia revealed rather elongated gram-positive diplococci with  somewhat   pointed  opposite   ends. What   microorganisms were  revealed   in the sputum?

70.

Serological diagnostics of infectious diseases  is based  upon  specific interaction  with  antigens. Specify  the  serological reaction that underlies adhesion of microorganisms  when  they  are  affected by  specific antibodies in presence of  an electrolyte:

71.

The immunoblot detected gp120 protein in the blood serum. This protein is typical for the following disease:

72.

HIV   has   gp41   and   gp120 on   its surface    interacts   with   target    cells   of an   organism.   Which   of   the   following human lymphocyte  antigens is gp120 complementary bound  with?

73.

A  65 year  old  patient with  chronic heart  failure  has been  taking  digitoxin  in self-administered dosages  for  a  long  time. She was admitted to the hospital for general health aggravation, arrhythmia, nausea,  reduced diuresis, insomnia.  What is the primary action to be taken?

74.

A 20 year old patient complains of morbid thirst and hyperdiuresis (up to 10 l daily). Glucose concentration in blood is normal but it is absent in urine. The patient has been diagnosed with diabetes insipidus.  What hormonal drug is the most appropriate for management of this disorder?

75.

A   patient has myocardial   infarction  with  thrombosis of  the  left  coronary artery. What pharmacological preparation group should be used to reestablish blood flow?

76.

A nurse  accidentally  injected  a nearly double dose of insulin to a patient with diabetes  mellitus. The patient lapsed  into a hypoglycemic coma. What drug should be injected in order to help him out of coma?

77. A patient has a slowly healing fracture. What  medicine  can be used to accelerate formation of connective tissue matrix?

78.

From  the group  of children  who were eating  sweet  sappy  watermelon two kids developed the  signs  of  poisoning:  rapid weakness,  dizziness,  headache, vomiting, edema,   tachycardia,  cyanosis  of  mouth, ears, tips of the fingers cyanosis. High concentration of nitrates was detected. What is the leading mechanism of the pathogenesis of the  poisoning  in the  two children?

79. As a result of a trauma a patient has damaged  anterior  roots   of  spinal  cord. What structures have been affected?
80.

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

81.

The contents of vesicles that appeared on the  mucous  membrane  of  a  patient with variola was sent to a virological laboratory.  Which of the  listed  changes were revealed during the smear microscopy?

82.

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:

83.

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:

84.

A   63 years   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:

85.

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:

86.

A patient underwent esophagogastroduodenoscopy. Analysis of the  biopsy  material enabled doctors to diagnose him with helicobacteriosis. What property of the bacteria found  in this  patient had  to  be obligatory taken into account  during their cultivation?

87.

A 38 year old man died all of a sudden. Autopsy revealed   myocardial   infarction in the posterior wall of the  left  ventricle. What are the most likely alterations in  myocardiocyte structure  that   can  be revealed   microscopically   in  the  infarction focus?

88.

During  cytoscopy  mucous  membrane of urinary  bladder normally  makes  folds except  for  a  single  triangular area  with smooth  mucosa. This triangle is located in the following part of urinary bladder:

89. A child suffers from drug idiosyncrasy. What is the cause of such reaction?
90.

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:

91.

After a serious psychoemotional stress a 48 year old patient suddenly  developed acute heart   ache  irradiating  to  the  left arm. Nitroglycerine relieved  pain after 10 minutes. What is the leading pathogenetic mechanism of this process development?

92.

A   42 year   old   patient complains of  pain  in  the   epigastral  area,   vomiting;  vomit   masses   have   the   colour   of \\\"coffee-grounds\\\", the patient has also melena.  Anamnesis records gastric ulcer. Blood formula:  erythrocytes - 2, 8 · 1012/l, leukocytes   - 8 · 109/l, Hb-  90 g/l. What complication is it?

93. 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?
94.

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?

95. To prevent postoperative bleeding a 6-year old child was administered vicasol that  is a synthetic  analogue  of vitamin K . Name post-translational changes of blood coagulation factors  that  will be activated by vicasol:

96.

While  under  barbituric anaesthesia a 65 year old male patient developed respiratory inhibition.  Anesthesiologist made him a 10 ml intravenous injection  of 0,5% bemegride solution.  The  patient’s  condition got better, the  pulmonary ventilation volume  increased.  What  phenomenon underlies the  interaction of  these  medications?

97. 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:
98. 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?
99.

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:

100.

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

101. 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:
102.

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:

103.

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:

104.

As a result of damage to certain structures of brainstem an animal lost orientation reflexes.  What   structures were damaged?

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

106.

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

107. 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?
108.

The   patient  with  acute   miocardial infarction  was given intravenously different    solutions     during     8    hours with   medical    dropper   1500   ml   and oxygen   intranasally.  He   died   because of  pulmonary edema.   What  caused  the pulmonary edema?

109.

In  course  of  an  operation surgeon removed a part  of a lung that  was ventilated  by a tertiary bronchus  accompanied by branches  of pulmonary artery  and other vessels. What part of a lung was removed?

110. After  the  second  abortion a 23 year old   woman   has   been diagnosed with toxoplasmosis. Which drug should be used for toxoplasmosis treatment?
111.

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?

112.

After  4 months  of treatment for tuberculosis the patient began complaining of toes and fingers numbness, sensation of creeps. He was diagnosed with polyneuritis.  What  antituberculous drug might have caused these complications?

113.

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

114. According to the phenotypic diagnosis  a female  patient has been  provisionally diagnosed with X-chromosome polysomia.  This  diagnosis  can  be  confi- rmed by a cytogenetic  method.  What karyotype will allow  to  confirm  the  diagnosis?

115.

A  patient has  been  diagnosed  with acute  glomerulonephritis that  developed after   he  had  had   streptococcal  infection. It is most  likely that  the  affection  of basal  glomerular membrane is caused  by an allergic reaction of the following type:

116. An elderly patient has chronic constipations induced by large intestine hypotonia. What  drug  should  be administered?
117.

Examination  of  patients with  periodontitis revealed  the interdependence between  the   rate   of  affection   of  periodontal  tissues  and  the  amount of lysozymes in saliva and gingival liquid. These results can be obtained during studying  the  following  protection system of an organism:

118. 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:
119.

A patient with epilepsy and depressive reaction has been  administered a drug that  reduced epilepsy  manifestations and improved  the patient’s psychic condition.

120. A patient diagnosed  with morphinism has been  admitted to the narcological department. A  doctor  noted  a  decrease in  pharmacological  activity   of  morphine.  Repetitive use  of  a  drug  may  result in tolerance to its effect, and this phenomenon is called:
121.

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

122.

A  man  got  poisoned  with mushrooms. They contain  muscarine  that stimulates muscarinic cholinoreceptors. What  symptom   is  typical  for  poisoning with inedible mushrooms?

123.

A patient complains  of skin itch, especially between fingers, in the inguinal creases,  on  the  lower  abdomen. Examination   of  these   regions   revealed   there some small vesicles. Laboratory diagnostics allowed to establish  that  this condition had  been  caused  by  a  representative of Arthropoda. Specify  the  disease  caused by this arthropod:

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

125.

During  influenza  epidemic  40%  of pupils  who  didnt 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 sicknesrate  of pupils  participating in the sports?

126.

A  39 year  old  man  who  had  been operated for the stomach ulcer died 7 days after  the  surgery.  Autopsy revealed  that peritoneal leaves were dull, plephoric, covered  with  massive  yellow-greenish films,  the  peritoneal cavity  contained for about  300 ml of thick yellow-greenish liquid.  What  pathologic process  was revealed  in the peritoneal cavity?

127.

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

128.

A  60  year  old  patient  was  found to  have  a  dysfunction   of  main  digestive enzyme  of saliva. This  causes  the  disturbance of primary hydrolysis of:

129.

A  patient suffers  from  stenocardia and takes isosorbide  mononitrate. He was prescribed a complementary drug with disaggregating  effect. What drug is it?

130.

A 49 year old woman  spent  a lot of time standing.  As a result of it she got leg edema.  What  is the  most  likely cause  of the edema?

131.

A patient presented to a hospital  with complaints about  quick fatigability and significant  muscle  weakness.  Examination revealed  an autoimmune disease  that causes  functional   disorder  of  receptors in the  neuromuscular synapses.  This  will result  in  the  disturbed activity  of  the following mediator:

132.

Blood   test   of  a  patient  suffering from  atrophic gastritis  gave  the  following results: RBCs - 2, 0 · 1012/l, Hb- 87 g/l, colour  index  - 1,3, WBCs  - 4, 0 · 109/l, thrombocytes - 180 · 109/l. Anaemia  might have been caused by the following substance  deficiency:

133.

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?

134.

A 71 year old man had been presenting with diarrhea for 10 days.  The feces had admixtures of blood and  mucus.  He was delivered to a hospital in grave condition and died 2 days later. Autopsy of the body revealed   the following:  diphtheritic colitis with multiple irregularly-shaped ulcers of different depth  in both  sigmoid colon and rectus.  Bacteriological analysis revealed Shigella. What  was the main disease?

135.

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

136.

Autopsy  of  a  75  year  old  patient who  had   been   suffering   from   disseminated  atherosclerosis and died under chronic cardiac failure revealed  constriction and deformation of coronary  arteries, tuberous intima  whose  section  appeared to be white and petrosal. Specify the stage of atherosclerosis morphogenesis:

137. Examination of a bronchial  tissue sample revealed atrophy  of mucous membrane, cystic degeneration of glands, focal  metaplastic changes  of  lining  prismatic epithelial cells into multilayer squamous cells; increase in goblet cell number;  in some  parts  of bronchial wall and  especially  in the  mucous  membrane there  was marked cellular inflammatory infiltration and growth of granulation tissue bulging into the bronchial lumen in form of  a polyp. What is the most likely diagnosis?

138.

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?

139.

Osteolaterism is charcterized by a decrease in  collagen  strength   caused  by much  less  intensive  formation  of  cross- links in collagen fibrils. This phenomenon is caused by the low activity of the following enzyme:

140.

A    histological    specimen    of   kidney shows a structure consisting of a glomerulus  of fenestrated capillaries  and a  bilayer  epithelial capsule.  Specify  this structure:

141.

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?

142.

As a result  of a road  accident  a 26- year-old   man  is  in  the  torpid   phase  of shock.  Blood   count:   leukocytes   -  3, .109/l. What  is the  leading  mechanism  of leukopenia development?

143.

A  5-month-old  boy  was  hospitalized  for  tonic  convulsions.  He  has  a life- time  history  of this disease.  Examination revealed  coarse  hair,  thinned and  fragile nails,  pale  and  dry  skin.  In  blood:  calcium - 1,5 millimole/l, phosphor - 1,9 millimole/l. These changes are associated with:

144.

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

145.

Cytogenetic examination of  a  patient  with dysfunction  of the  reproductive system revealed  normal  karyotype 46,ХУ in some cells, but most cells have Klinefelter’s syndrome  karyotype - 47,ХХУ. Such phenomenon of cell inhomogeneity is called:

146.

An oncological  patient had been administered methotrexate. With time target cells of the tumour lost sensitivity to this drug. At the same time the change in gene expression of the  following  enzyme is observed:

147.

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

148.

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?

149.

While  playing  a  child  got  a  punch in  the   presternum  region.   As  a  result of  this  trauma an  organ  located  behind the presternum was damaged.  Name  this organ:

150. In  an  embryo  the  process  of dorsal mesoderm segmentation and somite formation  is  disturbed.  What   part   of skin will probably  have developmental abnormalities?
151.

A patient consulted  a dentist  about itching and burning in the oral cavity; high temperature. The  patient was diagnosed with trichomonal gingivostomatitis. What drug should be chosen for his treatment?

152.

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:

153.

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?

154.

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?

155.

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?

156.

When  water  affects  mucous membrane of the inferior  nasal meatuses, this causes \\\"diver reflex\\\" that provokes:

157.

Life   cycle   of   a   cell   includes   a process   of  DNA   autoreduplication.  As a result of this process monochromatid chromosomes become  bichromatid. This phenomenon is observed within the following period  of the cell cycle:

158.

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?

159.

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?

160.

Microelectrode  technique   allowed  to register a potential following \\\"all-or-none\\\" law and being able  of  undecremental   spreading.  Specify this potential:

161.

A  patient has  been  diagnosed  with transmural  myocardial   infarction.   What drug should  be given in order  to prevent cardiogenic  shock?

162.

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?

163.

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?

164.

Examination of a patient revealed II grade obesity. It is known that he consumes  a lot  of sweets  and  rich  food, has sedentary way of life. That’s why anabolic  metabolism has  the  priority  in his organism. Which of the following pathways is amphibolic?

165.

A  patient who  abuses  smoking  has chronic  bronchitis.  Biopsy of his primary bronchus  revealed  multilayer pavement epithelium.  What   pathological  process was revealed  in the bronchus?

166.

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

167.

A  67 year  old  patient complains  of periodic  heart  ache, dyspnea  during  light physical activities. ECG reveals extraordinary contractions of heart ventricles. Such arrhythmia is called:

168. A patient with ischemic heart disease has   been   administered  an   anti-anginal drug that  reduces  the myocardial  oxygen consumption and  improves  blood  supply of myocardium. What drug is it?
169. A  doctor  asked  a patient to  breath out  fully  after  taking  a  normal   breath. What muscles contract during such exhalation?
170.

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?

171.

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

172.

There  was a record  of some anthrax cases  among   animals   in  a  countryside. The  spread  of disease  can  be  prevented by means  of immunization. What  kind of vaccine should be used?

173.

An infectious  disease unit admitted a patient with signs of jaundice  caused  by hepatitis virus. Select an indicator that  is specific only for parenchymatous jaundice:

174. A  patient  presents with  dysfunction of cerebral cortex accompanied by epileptic  seizures.  He  has  been  administered  a biogenic amine  synthetized from glutamate and responsible for central inhibition.  What substance  is it?
175.

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?

176.

Toxic affection  of liver results in dysfunction of protein synthesis. It is usually accompanied by the following kind of dysproteinemia:

177.

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?

178.

Examination  of  duodenal contents revealed   some   pyriform   protozoa  with twin  nuclei   and   four   pairs   of  flagella. There  were two supporting filaments between the  nuclei  and  a  suctorial  disc on  the  ventral  side. What  representative of protozoa was revealed  in this patient?

179.

In order  to prevent massive haemorrhage in the  region  of oral  cavity floor  it is required to  ligate  an  artery which is located  within Pirogov’s triangle. What artery is it?

180.

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?

181.

A    shepherd   who    has    tended sheep   together  with   dogs   consulted   a doctor  about  pain  in  his right  subcostal area, nausea, vomiting. Roentgenoscopy revealed  a  tumour-like formation. What kind of helminthiasis might be suspected?

182.

For  relief  of  hypertensive  crisis  a doctor   administered  a   patient  a   drug that   apart   from  antihypertensive  effect has also sedative, spasmolytic and anti-convulsive effect. The drug was taken parenterally. When  it  is  taken   enterally it acts as a laxative and cholagogue.  What drug was administered?

183. 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?
184.

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?

185. A patient with diabetes mellitus complicated by angiopathy has been recommended a drug which is a sulphonyl urease   derivate of  the  second  generation. It improves microcirculation and is known for its relatively good tolerance. What drug is it?
186.

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?

187.

A  26  year  old  pregnant woman  is under   treatment at  an  in-patient hospital. After  a continuous attack  of vomiting she was found to have reduced volume of circulating  blood. What kind of change in general blood volume is the case?

188. 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?

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

190. A  45 year  old  male  died  from  disseminated tuberculosis. On  autopsy  the symptoms  of tuberculosis were confirmed by both microscopical and histological analyses. All the affected organs had epithelioid cell granulomas with caseous necrosis in the centre. What kind of hypersensitivity reaction underlies the process of granuloma development?
191.

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:

192.

In course of a conditional experiment the   development of  mesenchyma  cells was  completely   inhibited.   Development of the following muscular tissue will be disturbed:

193. 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?
194. After taking poor-quality food a patient  developed repeated  episodes   of  diarrhea. On the next day he presented with decreased arterial pressure, tachycardia, extrasystole. Blood pH is 7,18. These abnormalities were caused by the development of:
195.

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

196.

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?

197.

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

198. 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?
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.

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