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A 25-year-old patient consulted a doctor about dysmenorrhea and infertility. Examination revealed that the patient was 145 cm high and had underdeveloped secondary sex characteristics, alar folds on the neck. Cytological study didn’t reveal any Barr bodies in the somatic cells. What diagnosis was made?
A patient died from progressive heart failure. Autopsy revealed that the heart was enlarged in diameter, flabby. The muscle section exhibited irregular blood supply. Histological study of myocardium revealed hyperemia, the stroma was found to have lymphohistiocytic infiltrates with degeneration of cardiomyocytes. The revealed morphological changes are indicative of:
A 13-year-old teenager underwent X-ray examination of the hip joint. Examination revealed a 3mm wide radiolucent zone between the head and the shaft of femur. This situation should be evaluated as:
A surgeon examined the patient and found the injury of the upper third of the kidney. Considering the syntopy of the left kidney, the intactness of the following organ should be checked at the same time:
A patient with urolithiasis has unbearable spasmodic pain. To prevent pain shock, he has been given an injection of atropine along with a narcotic analgesic having antispasmodic effect. What drug was it?
Despite the administration of cardiotonics and a thiazide diuretic a patient with chronic heart failure has persistent edemata, there is a risk of ascites. What medication should be administered in order to enhance the diuretic effect of the drugs used?
A patient with a pathology of the cardiovascular system developed edemata of the lower extremities. What is the mechanism of cardiac edema development?
Amniocentesis revealed two sex chromatin bodies (Barr bodies) in each cell of the sample. What disease is this character typical for?
A hospital has admitted a patient complaining of abdominal bloating, diarrhea, flatulence after eating protein foods. These signs are indicative of the impaired digestion of proteins and their increased degradation. Which of the following compounds is the product of this process?
An attack of tachycardia that occurred in a patient was stopped by pressing on his eyeballs. Which of the following reflexes underlies this phenomenon?
An unconscious patient was taken by ambulance to the hospital. On objective examination the patient was found to have no reflexes, periodical convulsions, irregular breathing. After laboratory examination the patient was diagnosed with hepatic coma. Disorders of the central nervous system develop due to the accumulation of the following metabolite:
A 20-year-old male patient complains of general weakness, rapid fatigability, irritability, decreased performance, bleeding gums, petechiae on the skin. What vitamin deficiency may be a cause of these changes?
It is known that the monoamine oxidase (MAO) enzyme plays an important part in the metabolism of catecholamine neurotransmitters. In what way does the enzyme inactivate these neurotransmitters (norepinephrine, epinephrine, dopamine)?
At the end of the working day a worker of a hot work shop has been delivered to a hospital. The patient complains of a headache, dizziness, nausea, general weakness. Objectively: the patient is conscious, his skin is hyperemic, dry, hot to the touch. Heart rate is of 130/min. Respiration is rapid, superficial. What disorder of thermoregulation is most likely to have occurred in this patient?
Alveolar space of the acinus was invaded by some bacteria which interacted with the surfactant. This led to the activation of the cells that are localized in the alveolar walls and on the surface. What cells are these?
A 35-year-old male developed acute heart failure while running for a long time. What changes in the ionic composition can be observed in the cardiac muscle?
Mother of a boy who had recently returned from a summer camp found some small whitish insects up to 3 mm long on the child’s clothing. Specify the parasite:
Histological examination of the removed skin neoplasm revealed clusters and cords of atypical cells of stratified squamous epithelium, growing into the underlying tissue. What diagnosis can be assumed?
An 18-year-old male has been diagnosed with Marfan syndrome. Examination revealed a developmental disorder of connective tissue and eye lens structure, abnormalities of the cardiovascular system, arachnodactylia. What genetic phenomenon has caused the development of this disease?
A patient has severe catarrhal symptoms. Material growth on Bordet-Gengou agar showed mercury-drop-like colonies. Examination of the blood smears revealed some small ovoid gram-positive bacilli sized 1-3 microns. What microorganisms were isolated?
Enzymatic jaundices are accompanied by abnormal activity of UDP-glucuronyl transferase. What compound is accumulated in blood serum in case of these pathologies?
For the study of serum proteins various physical and physicochemical methods can be used. In particular, serum albumins and globulins can be separated by this method:
The laboratory for especially dangerous infections conducts microscopic examination of pathological material from a patient with suspected plague. The sample was stained by Burri-Gins technique. What property of the causative agent can be identified by this technique?
Inherited diseases, such as mucopolysaccharidoses, are manifested in metabolic disorders of connective tissue, bone and joint pathologies. The sign of this disease is the excessive urinary excretion of the following substance:
A specimen of a parenchymal organ shows poorly delineated hexagonal lobules surrounding a central vein, and the interlobular connective tissue contains embedded triads (an artery, a vein and an excretory duct). What organ is it?
A patient has been admitted to the infectious diseases department for malaise, fever up to 38oC , jaundice. A few months ago, the patient underwent blood transfusion. The doctor suspected viral hepatitis B. What are the principal methods of laboratory diagnosis of hepatitis B?
After resection of the middle third of the femoral artery obliterated by a thrombus the limb is supplied with blood through the bypasses. What artery plays the main part in the restoration of the blood flow?
During the intravenous transfusion of the saline the patient’s condition deteriorated dramatically, and the patient died from asphyxiation. Autopsy revealed acute venous congestion of internal organs with the dramatic right heart dilatation. When the right ventricle was punctured underwater, the bubbles escaped. What pathological process occurred in the patient?
At the post-mortem examination the stomach of a patient with renal failure was found to have a yellow-brown coating on the thickened mucosa. The coating was firmly adhering to its surface and had significant thickness. Microscopy revealed congestion and necrosis of mucosal and submucosal layers, fibrin presence. What is the most likely diagnosis?
Infectious diseases are treated with antibiotics (streptomycin, erythromycin, chloramphenicol). They inhibit the following stage of protein synthesis:
A patient has been hospitalized for a suspected tumor of the prostate. During the surgery, it was revealed that the tumor invaded the bladder. Which part of the bladder was affected?
A 19-year-old male was found to have an elevated level of potassium in the secondary urine. These changes might have been caused by the increase in the following hormone level:
Analysis of the ECG revealed the missing of several PQRST cycles. The remaining waves and complexes are not changed. Specify the type of arrhythmia:
ECG of a patient displays an abnormally long R wave (up to 0,18 s). This is caused by a decrease in the conduction velocity of the following heart structures:
6 hours after the myocardial infarction a patient was found to have elevated level of lactate dehydrogenase in blood. What isoenzyme should be expected in this case?
A 46-year-old female is scheduled for a maxillofacial surgery. It is known that the patient is prone to high blood coagulation. What natural anticoagulant can be used to prevent blood clotting?
A 50-year-old patient with food poisoning is on a drip of 10% glucose solution. It not only provides the body with necessary energy, but also performs the function of detoxification by the production of a metabolite that participates in the following conjugation reaction:
Due to the use of poor-quality measles vaccine for preventive vaccination, a 1-year-old child developed an autoimmune renal injury. The urine was found to contain macromolecular proteins. What process of urine formation was disturbed?
A pneumonia patient has been administered acetylcysteine as a part of complex therapy. What principle of therapy was taken into consideration when applying this drug?
A 26-year-old female patient with bronchitis has been administered a broad spectrum antibiotic as a causal treatment drug. Specify this drug:
A 65-year-old male suddenly lost the vision in one eye due to the retinal detachment. The patient underwent enucleation. Histological examination of the removed eye retina and choroid revealed clusters of atypical cells with marked polymorphism of cells and nuclei, with a moderate number of mitoses including the pathological ones. The cell cytoplasm and intercellular medium contained brown pigment giving a positive DOPA reaction. Perls’ reaction was negative. What is the most likely diagnosis?
A child cut his leg with a piece of glass while playing and was brought to the clinic for the injection of tetanus toxoid. In order to prevent the development of anaphylactic shock the serum was administered by Bezredka method. What mechanism underlies this method of desensitization of the body?
Microscopy of the myocardium of a patient who had died from heart failure revealed foci of fibrinoid necrosis located diffusely in the interstitial stroma, and often around the vessels. Such foci were surrounded by lymphocytes, macrophages, histiocytes. Pericardium was found to have signs of sero-fibrinous pericarditis. What is the most likely diagnosis?
One of the factors that cause obesity is the inhibition of fatty acids oxidation due to:
The genetic defect of pyruvate carboxylase deficiency is the cause of delayed physical and mental development and early death in children. This defect is characterized by lacticemia, lactaciduria, disorder of a number of metabolic pathways. In particular, the following process is inhibited:
Deficiency of linoleic and linolenic acids in the body leads to the skin damage, hair loss, delayed wound healing, thrombocytopenia, low resistance to infections. These changes are most likely to be caused by the impaired synthesis of the following substances:
During ventricular systole, the cardiac muscle does not respond to additional stimulation because it is in the phase of:
A 67-year-old male patient consumes eggs, pork fat, butter, milk and meat. Blood test results: cholesterol - 12,3 mmol/l, total lipids - 8,2 g/l, increased low- density lipoprotein fraction (LDL). What type of hyperlipoproteinemia is observed in the patient?
A 12-year-old child has a viral infection complicated by obstructive bronchitis. Bronchospasm can be eliminated by inhalations of a drug from the following pharmacological group:
In course of an experiment there has been an increase in the nerve conduction velocity. This may be caused by an increase in the concentration of the following ions that are present in the solution around the cell:
A male working as a blacksmith has been tested for auditory acuity. The tests revealed 50% hearing loss in the low-frequency range and a near-normal auditory acuity in the high-frequency range. This condition has been caused by the damage to the following structures of the auditory system:
In our country, routine preventive vaccinations against poliomyelitis involve using live vaccine that is administered orally. What immunoglobulins are responsible for the development of local post-vaccination immunity in this case?
An experiment proved that UV-irradiated skin cells of patients with xeroderma pigmentosum restore the native structure of DNA slower than the cells of healthy people due to the defect in repair enzyme. What enzyme takes part in this process?
A patient who has recently come from an endemic area presents with elevated body temperature, headache, chills, malaise, that is with the symptoms which are typical for a common cold. What laboratory tests are necessary to confirm or to refute the diagnosis of malaria?
What condition may develop 15-30 minutes after re-administration of the antigen as a result of the increased level of antibodies, mainly IgE, that are adsorbed on the surface of target cells, namely tissue basophils (mast cells) and blood basophils?
10 days after having quinsy caused by beta-hemolytic streptococcus a 6- year-old child exhibited symptoms of glomerulonephritis. What mechanism of glomerular lesion is most likely in this case?
A 22-year-old woman ate some seafood. 5 hours later the trunk and the distal parts of limbs got covered with small itchy papules which were partially fused together. After one day, the rash disappeared spontaneously. Specify the hypersensitivity mechanism underlying these changes:
A hypertensive patient had been keeping to a salt-free diet and taking antihypertensive drugs together with hydrochlorothiazide for a long time. This resulted in electrolyte imbalance. What disorder of the internal environment occurred in the patient?
A miner consulted a physician about the appearance of body rash followed by a loss of appetite, bloating, duodenal pain, frequent bowel movements, dizziness. Ovoscopic probes of feces and duodenal contents revealed some eggs covered with a transparent membrane through which 4-8 germinal cells could be seen. What disease is likely to have occurred in the patient?
In a car accident a man got injured and lost a lot of blood. What changes in peripheral blood are most likely to occur on the 2nd day after the injury?
In the surgical ward, the dressing material was undergoing sterilization in an autoclave. Through an oversight of a nurse the mode of sterilization was changed and the temperature in the autoclave reached only 100oC instead of the due 120oC . What microorganisms can stay viable under these conditions?
As a result of a mechanical injury an over 10 cm long portion of a peripheral nerve was damaged. This led to the impairment of the upper limb activity. The patient was offered nerve transplantation. What glial cells will participate in regeneration and provide the trophism of the injured limb?
A patient has recurrent attacks of epileptic seizures and stays unconscious between them. In order to stop convulsions the drugs of the following group should be used in the first place:
A patient with arthritis and varicose veins has been taking a non-steroidal anti-inflammatory drug for a long time, which caused thrombosis of skin veins. Which of the following drugs might have caused this complication?
Students study the stages of gametogenesis. They analyze a cell having a haploid number of chromosomes, and each chromosome consists of two chromatids. The chromosomes are located in the equatorial plane of the cell. Such situation is typical for the following stage of meiosis:
A 35-year-old female patient underwent biopsy of the breast nodules. Histological examination revealed enhanced proliferation of the small duct epithelial cells and acini, accompanied by the formation of glandular structures of various shapes and sizes, which were located in the fibrous stroma. What is the most likely diagnosis?
A specimen of an onion rootlet includes a cell in which the fully condensed chromosomes are located in the equatorial plane making the monaster. What phase of the mitotic cycle is the cell in?
When examining a patient, the doctor revealed a tumor of the bronchus which borders on the aorta. Which bronchus is affected?
A 54-year-old female was brought to the casualty department after a car accident. A traumatologist diagnosed her with multiple fractures of the lower extremities. What kind of embolism is most likely to develop in this case?
Due to the blockage of the common bile duct (which was radiographically confirmed), the biliary flow to the duodenum was stopped. We should expect the impairment of:
Typical manifestations of food poisoning caused by C. botulinum are double vision, abnormal functioning of the swallowing and breathing. These symptoms develop as a result of:
At the stage of translation in the rough endoplasmic reticulum, the ribosome moves along the mRNA. Amino acids are joined together by peptide bonds in a specific sequence, and thus polypeptide synthesis takes place. The sequence of amino acids in a polypeptide corresponds to the sequence of:
On allergological examination a patient has been diagnosed with pollinosis. Specific desensitization can be performed by:
A patient consulted a physician about chest pain, cough, fever. Roentgenography of lungs revealed eosinophilic infiltrates which were found to contain the larvae. What kind of helminthiasis are these presentations typical for?
A patient with signs of osteoporosis and urolithiasis has been admitted to the endocrinology department. Blood test revealed hypercalcemia and hypophosphatemia. These changes are associated with abnormal synthesis of the following hormone:
Histological examination of the biopsy material obtained from the lower third of the esophagus of a 57-year-old male with the symptoms of continuous reflux revealed the change of the stratified squamous epithelium to the single-layer columnar glandular epithelium with signs of mucus production. Specify the pathological process in the mucous membrane:
A 30-year-old female exhibits signs of virilism (growth of body hair, balding temples, menstrual disorders). This condition can be caused by the overproduction of the following hormone:
A patient with extensive myocardial infarction has developed heart failure. What pathogenetic mechanism contributed to the development of heart failure in the patient?
A patient who had been continuously taking drugs blocking the production of angiotensin II developed bradycardia and arrhythmia. A likely cause of these disorders is:
A patient has arterial hypertension. What long-acting drug from the group of calcium channel blockers should be prescribed?
Human skin has a high breaking strength. It is known that the skin consists of epithelial tissue and two kinds of connective tissue. Which of the following tissues provides the skin strength?
As a result of a home injury, a patient suffered a significant blood loss, which led to a fall in blood pressure. Rapid blood pressure recovery after the blood loss is provided by the following hormones:
A patient with constant headaches, pain in the occipital region, tinnitus, dizziness has been admitted to the cardiology department. Objectively: AP- 180/110 mm Hg, heart rate - 95/min. Radiographically, there is a stenosis of one of the renal arteries. Hypertensive condition in this patient has been caused by the activation of the following system:
A patient complains that at the bare mention of the tragic events that once occurred in his life he experiences tachycardia, dyspnea and an abrupt rise in blood pressure. What structures of the CNS are responsible for these cardiorespiratory reactions in this patient?
A patient consulted a dentist about limited mouth opening (trismus). He has a history of a stab wound of the lower extremity. What infection may cause these symptoms?
Analysis of the experimental spirogram of a 55-year-old person revealed a decrease in tidal volume and respiratory amplitude compared to the situation of ten years ago. The change in these indicators is caused by:
A patient underwent a course of treatment for atherosclerosis. Laboratory tests revealed an increase in the anti-atherogenic lipoprotein fraction in the blood plasma. The treatment efficacy is confirmed by the increase in:
A 65-year-old female patient has chronic constipations due to the colon hypotonia. What drug should be chosen in this case?
A female patient complains of vision impairment. On examination she was found to have obesity, fasting hyperglycemia. What complication of diabetes can cause vision impairment?
Analysis of the family history of children with Van der Woude syndrome revealed that in their families one of the parents had the typical for this syndrome defects (cleft lip and palate, lip pits regardless of gender). What is the type of inheritance of this syndrome?
Administration of doxycycline hydrochloride caused an imbalance of the symbiotic intestinal microflora. Specify the kind of imbalance caused by the antibiotic therapy:
A 3-year-old child had eaten some strawberries. Soon he developed a rash and itching. What was found in the child’s leukogram?