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1. 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?
2.

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?

3.

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?

4. 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?
5.

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

6. 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?
7.

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?

8. 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?
9.

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:

10.

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

11. 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?
12.

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?

 
13. 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?
14.

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?

15.

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:

16.

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

 
17.

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?

18.

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

19.

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:

20.

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?

21.

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?

22.

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?

23.

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:

24.

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:

25.

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?

26.

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?

27.

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:

28.

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:

29.

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?

30.

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

31.

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?

32.

In allergic diseases, a dramatic increase in basophilic leukocyte number in patients’ blood is observed. This phenomenon is due to the following basophil function:

33.

A patient has been admitted to the contagious isolation ward with signs of jaundice caused by hepatitis virus. Which of the symptoms given below is strictly specific for hepatocellular jaundice?

34. A patient has acute bronchitis. The fever up to 38, 5oC had lasted for a week, presently there is a decrease in temperature down to 37, 0oC. Specify the leading mechanism in the 3rd stage of fever:
35.

A public utility specialist went down into a sewer well without protection and after a while lost consciousness. Ambulance doctors diagnosed him with hydrogen sulfide intoxication. What type of hypoxia developed?

36.

A child with a normal karyotype is diagnosed with cleft lip and hard palate, defects of the cardiovascular system, microcephaly. The child’s mother suffered rubella during pregnancy. This pathology in the child may be an example of:

37.

A 28-year-old patient undergoing treatment in the pulmonological department has been diagnosed with pulmonary emphysema caused by splitting of alveolar septum by tissular tripsin. The disease is caused by the congenital deficiency of the following protein:

38. A patient with signs of osteoporosis and urolithiasis has been admitted to the endocrinology department.    Blood test has revealed hypercalcemia and hypophosphatemia. These changes are associated with abnormal synthesis of the following hormone:
39.

Pancreas is known as a mixed gland. Endocrine functions include production of insulin by beta cells. This hormone affects the metabolism of carbohydrates. What is its effect upon the activity of glycogen phosphorylase (GP) and glycogen synthase (GS)?

40.

A patient complains of palpitation after stress. The pulse is 104 bpm, P-Q=0,12 seconds, there are no changes of QRS complex. What type of arrhythmia does the patient have?

41. A 30-year-old patient has undergone keratoplasty in the transplantation center, cornea has been taken from a donor, who died in a road accident. What kind of transplantation was performed?
42.

A patient has been diagnosed with ARVI. Blood serum contains immunoglobulin M. What is the stage of infection in this case?

43.

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?

44.

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?

45.

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:

46.

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?

47. 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  hystiocyte damage in this case?
48. 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:
49.

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?

50. Jaundice treatment involves administration of barbiturates inducing the synthesis  of UDP-glucuronyl transferase. A medicinal  effect is caused by the production of:
51. 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?
52.

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%?

53.

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?

54.

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:

55.

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

56. 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?
57.

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:

58.

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

59.

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?

 
60.

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?

 
61.

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

62.

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?

63. 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?
64.

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:

 
65.

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:

66.

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?

 
67.

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:

68.

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:

69.

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?

 
70.

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?

71.

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?

72.

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

 
73.

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

74.

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:

75.

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?

76. 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:
77. 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?
78.

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?

79.

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?

80.

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?

81.

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?

82. 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:
83.

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:

84.

As a result  of a road  accident  a 26- year-old   man  is  in  the  torpid   phase  of shock.  Blood   count:   leukocytes   -  3, 2 · 109/l. What  is the  leading  mechanism  of leukopenia development?

85. 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:
86.

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:

87.

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?

 
88. An infant has pylorospasm, weakness, hypodynamia, convulsions as a result of frequent vomiting.  What kind of acid-base disbalance is it?
89.

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:

90. 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:
91. The patient with acute miocardial infarction was given intravenously different solutions during  8    hours with medical dropper 1500ml and oxygen  intranasally. He died because of pulmonary edema.  What caused the pulmonary edema?
92.

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?

93.

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

94. Emotional stress  causes  activation of hormone-sensitive triglyceride  lipase in the adipocytes. What secondary mediator takes part in this process?
95.

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?

96.

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?

97.

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

98. 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?
99.

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?

 
100.

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:

101. 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:
102.

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?

103.

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?

104. The immunoblot detected gp120 protein in the blood serum. This protein is typical for the following disease:
105.

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?

106. 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?
107.

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?

108.

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

109.

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?

110.

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:

 
111.

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

112.

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

113.

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?

 
114.

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?

115.

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:

116.

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

117.

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?

118.

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

119. 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:
120.

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?

121. 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?
122.

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:

123.

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

124.

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

 
125.

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:

126.

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?

127.

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?

128.

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

129.

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?

130. 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:
131. 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?
132. A male patient has been diagnosed with acute post-streptococcal glomerulonephritis. It is most likely that the lesion of the basement membrane of renal corpuscles was caused by the following allergic reaction:
133.

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?

 
134.

A   patient   with   a   pathology   of the cardiovascular system developed edemata of the  lower  extremities. What is the mechanism  of cardiac edema development?

135.

A patient with extensive burns of torso skin exhibits  signs of severe  intoxication. What stage of the burn disease is this typical for?

136.

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?

137.

Thermometry   revealed     that    the temperature of the  exposed  skin is by 1-1,5o   lower  than  the  temperature of  the adjacent areas covered with clothing from natural fabrics. The reason  for this is that the clothes reduce  the heat loss through:

138.

The temperature in a production room is  36oC .  Relative  air  humidity   is  80%. Under these  conditions the  human  body transfers heat mainly through:

139.

14 days after quinsy a 15-year-old  child presented with morning  facial swelling, high  blood  pressure, \"meat   slops\" urine. Immunohistological   study    of   a   renal biopsy sample revealed  deposition of immune complexes on the basement membranes of the  capillaries  and  in the glomerular mesangium.  What disease developed in the patient?

140.

A patient has normally  coloured stool including a large amount of free fatty acids. The reason  for this is a disturbance of the following process:

141.

A   patient  with   lobar   pneumonia has  had  body  temperature of  39oC  with  daily  temperature  fluctuation  of  no more   than   1oC  for  9  days.  This  fever can be characterized by the following temperature curve:

142. A male with a lesion of one of the CNS parts has asthenia, muscular dystonia, balance   disorder.  Which  CNS  part   has been affected?
143. A 12-year-old  patient has been  admitted   to  a  hospital   for  hemarthrosis  of the knee joint. From early childhood he suffers from frequent bleedings. Diagnose the boy’s disease:
144.

A   patient  with   jaundice   has   high total bilirubin that is mainly indirect (unconjugated), high concentration of stercobilin  in  the  stool  and  urine.   The level  of  direct  (conjugated) bilirubin   in the blood plasma is normal.  What kind of jaundice  can you think of?

145.

A  35-year-old  male  patient has been referred by an andrologist for the genetic counselling  for  the  deviations  of  physical and mental  development. Objectively: the patient is tall, has asthenic  constitution, gynecomastia, mental retardation. Microscopy of the oral mucosa cells revealed sex chromatin (single Barr  body)  in 30% of cells. What is the most likely diagnosis?

146.

A patient with respiratory failure  has blood   pH   of  7,35.  pCO2    test   revealed hypercapnia. Urine  pH  test  revealed  an increase in the urine acidity. What form of acid-base  imbalance is the case?

147. Measurements of  the  arterial pC O2 and   pO2    during   an  attack   of  bronchial asthma  revealed  hypercapnia and hypoxemia  respectively. What kind of hypoxia occurred in this case?
148.

A 38-year-old female patient complains of general weakness, cardiac pain, increased  appetite, no menstruation. Objectively:  the  height  is 166 cm, weight 108 kg, the patient has moon-shaped face, subcutaneous fat  is deposited mainly  in the upper  body, torso  and hips. There  are also  blood-red streaks.  Ps-  62/min,  AP-160/105 mm  Hg.  Which  of the  following diseases is the described  pattern of obesity most typical for?

149.

Examination of an 18-year-old girl revealed the following features: hypoplasia of the ovaries, broad shoulders, narrow pelvis, shortening of the lower extremities, \"sphinx  neck\".  Mental development is normal. The girl was diagnosed with Turner’s syndrome. What kind of chromosome abnormality is it?

150.

Electrophoretic  study   of   a   blood serum sample, taken from the patient with pneumonia, revealed an increase in one of the protein fractions. Specify this fraction:

151.

A  patient  with  diabetes  developed a diabetic coma due to the acid-base imbalance. Specify the kind of this imbalance:

152. A   female    patient   has   been    diagnosed   with  cervical  erosion,   which  is a precancerous pathology. What  defense mechanism  can prevent the development of a tumor?
153.

  Autopsy   of   a   dead   patient revealed bone marrow hyperplasia of tubular and flat bones (pyoid marrow), splenomegaly (6 kg) and hepatomegaly (5 kg), enlargement of all lymph node groups. What disease are the identified changes typical for?

 

154.

A 53-year-old male patient is diagnosed with Paget’s disease. The concentration of oxyproline in daily urine is sharply increased, which primarily means intensified disintegration of:

 

155.

Autopsy of the dead patient who died from pulmonary edema revealed a large yellow-grey nidus in the myocardium, and a fresh thrombus in the coronary artery. What is the most likely diagnosis? 

156.

Increased HDL levels decrease the risk of atherosclerosis. What is the mechanism of HDL anti-atherogenic action?

157.

A boy referred to a genetics clinic was found to have 1 drumstick in blood neutrophils. The boy is likely to have the following syndrome:

158.

A drycleaner’s worker has been found to have hepatic steatosis. This pathology can be caused by the disruption of synthesis of the following substance:

159. A biochemical urine analysis has been performed for a patient with progressive muscular dystrophy. In the given case muscle disease can be confirmed by the high content of the following substance in urine:
160. A 41-year-old male patient has a history of recurrent attacks of heartbeats (paroxysms), profuse sweating, headaches. Examination revealed hypertension, hyperglycemia, increased basal metabolic rate, and tachycardia. These clinical presentations are typical for the following adrenal pathology:
161. As a result of careless handling of an iron, a 34-year-old female patient has got acute pain, redness, swelling of her right index finger. A few minutes later, there appeared a blister filled with a transparent liquid of straw-yellow color. The described changes are a manifestation of the following pathological process:
162.

A 43-year-old-patient has arterial hypertension caused by an increase in cardiac output and general peripheral resistance. Specify the variant of hemodynamic development of arterial hypertension in the given case:

163.

  Examination of a 52-year-old female patient has revealed a decrease in the amount of red blood cells and an increase in free hemoglobin in the blood plasma (hemoglobinemia). Color index is 0,85. What type of anemia is being observed in the patient?

164.

The processes of heat transfer in a naked person at room temperature have been studied. It was revealed that under these conditions the greatest amount of heat is transferred by:

165.

Urine analysis has shown high levels of protein and erythrocytes in urine. This can be caused by the following:

166.

The development of both immune and allergic reactions is based upon the same mechanisms of the immune system response to an antigen. What is the main difference between the immune and allergic reactions?

167.

In a patient elevation of body temperature takes turns with drops down to normal levels during the day. The rise in temperature is observed periodically once in four days. Specify the type of temperature curve:

168.

Diabetic nephropathy with uremia has developed in a patient with pancreatic diabetes. The velocity of glomerular filtration is 9 ml/min. What mechanism of a decrease in glomerular filtration velocity and chronic renal failure development is most likely in the case of this patient?

169.

A patient complaining of pain in the left shoulder-blade region has been diagnosed with miocardial infarction. What kind of pain does the patient have?

170.

A patient is diagnosed with hereditary coagulopathy that is characterised by factor VIII deficiency. Specify the phase of blood clotting during which coagulation will be disrupted in the given case:

171.

A patient has a traumatic injury of sternocleidomastoid muscle. This has resulted in a decrease in the following value:

172.

A 37-year-old female patient complains of headache, vertigo, troubled sleep, numbness of limbs. For the last 6 years she has been working at the gas-discharge lamp-producing factory in the lead-processing shop. Blood test findings: low hemoglobin and RBC level, serum iron concentration exceeds the norm by several times. Specify the type of anemia:

173.

A patient with hereditary hyperammonemia due to a disorder of ornithine cycle has developed secondary orotaciduria. The increased synthesis of orotic acid is caused by an increase in the following metabolite of ornithine cycle:

174. Amniocentesis revealed two sex chromatin bodies (Barr bodies) in each cell of the sample. What disease is this character typical for?
175.

A 49-year-old male patient with acute pancreatitis was likely to develop pancreatic necrosis, while active pancreatic proteases were absorbed into the blood stream and tissue proteins broke up. What protective factors of the body can inhibit these processes?

176. A patient is diagnosed with iron-deficiency sideroachrestic anemia, progression of which is characterised by skin hyperpigmentation, pigmentary cirrhosis, heart and pancreas affection. Iron level in the blood serum is increased. What disorder of iron metabolism causes this disease?
177.

A patient has insufficient blood supply to the kidneys, which has caused the development of pressor effect due to the constriction of arterial resistance vessels. This is the result of the vessels being greatly affected by the following substance:

178.

A 16-year-old female patient has fainted after quickly changing her body position from horizontal to vertical one. Which process from the ones listed below has caused the loss of consciousness in the first place?

179.

A 53-year-old male patient complains of acute pain in the right hypochondrium. Objective examination revealed scleral icterus. Laboratory tests revealed increased ALT activity, and stercobilin was not detected in the stool. What disease is characterized by these symptoms?

180.

Experimental stimulation of the sympathetic nerve branches that innervate the heart caused an increase in force of heart contractions because the membrane of typical cardiomyocytes permitted an increase in:

181.

According to the results of glucose tolerance test, the patient has no disorder of carbohydrate tolerance. Despite that, glucose is detected in the patients’ urine (5 mmol/l). The patient has been diagnosed with renal diabetes. What renal changes cause glucosuria in this case?

182.

Parents of 5-year-old child report him o have frequent colds that develop into pneumonias, presence of purulent rashes on the skin. Laboratory tests have revealed the following: absence of immunoglobulins of any type, and naked cells are absent from the lymph nodes punctate. What kind of immune disorder is it?

183.

A 3-year-old child has continuous fever, lymph nodes are enlarged, the amount of lymphocytes in blood is significantly increased. Enzyme-linked immunosorbent assay (ELISA) revealed antigen of Epstein-Barr virus. What diagnosis can be made based on the information given above?

184.

A patient intending to undergo a gender reassignment surgery has been admitted to a specialised clinic. In the course of examination both male and female gonades have been revealed, with male structure of external genitals. What kind of genital maldevelopment has the patient?

185. 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?
186.

In case of alkaptonuria, homogentisic acid is excreted in urine in large amounts. The development of this disease is associated with a disorder of metabolism of the following amino acid:

187.

When studying the signs of pulmonary ventilation, reduction of forced expiratory volume has been detected. What is the likely cause of this phenomenon?

188.

A 55-year-old patient with a characteristic rash, fever, dizziness has been admitted to a hospital. He has been provisionally diagnosed with typhus. No similar cases have been reported. In his youth (15 years old) the patient suffered typhus in a boarding school. What disease is it?

189. X-ray examination of a patient allowed to diagnose a tumor in the superior lobe of the right lung. There is a probability of metastases spread to the following lymph nodes:
190.

In the course of an experiment adenohypophysis of an animal has been removed. The resulting atrophy of thyroid gland and adrenal cortex has been caused by deficiency of the following hormone:

191.

Degenerative changes in posterior and lateral columns of spinal cord (funicular myelosis) caused by methylmalonic acid accumulation occur in patients with B12-deficiency anemia. This results in synthesis disruption of the following substance:

 
192. Patients with erythropoietic porphyria (Gunther’s disease) have teeth that fluoresce with bright red color when subjected to ultraviolet radiation; their skin is light-sensitive, urine is red-colored. What enzyme can cause this disease, when it is deficient?
193.

A female patient saught medical-genetic consultation. Physical examination revealed pterygium colli deformity (webbed neck), broad chest, underdeveloped breasts. Study of buccal epithelium cells revealed no X-chromatin in the nuclei. This indicates that the patient has the following syndrome:

194. During blood transfusion a patient has developed intravascular erythrocyte hemolysis. What kind of hypersensitivity does the patient have?
195.

Examination of a 56-year-old female patient with a history of type 1 diabetes revealed a disorder of protein metabolism that is manifested by aminoacidemia in the laboratory blood test values, and clinically by the delayed wound healing and decreased synthesis of antibodies. Which of the following mechanisms causes the development of aminoacidemia?

196.

For biochemical diagnostics of myocardial infarction it is necessary to measure activity of a number of enzymes and their isoenzymes. What enzymatic test is considered to be the best to prove or disprove the diagnosis of infarction in the early period after the chest pain is detected?

197.

Due to the use of poor-quality measles vaccine for preventive vaccination, a 1-year-old child has developed an autoimmune renal injury. The urine was found to contain macromolecular proteins. What process of urine formation has been disturbed?

198. As a result of a road accident a 37-year-old female victim developed urinary incontinence. What segments of the spinal cord had been damaged?
199. In the course of puncture biopsy of transplanted kidney the following has been revealed: diffuse infiltration of stroma by lymphocytes and plasmocytes and necrotic arteritis. What pathological process has developed in the transplant?
200. A female patient, having visited the factory premises with lots of dust in the air for the first time, has got cough and burning pain in the throat. What respiratory receptors, when irritated, cause this kind of reaction?
201. A newborn baby has numerous hemorrhages. Blood coagulation tests reveal increased prothrombin time. The child is most likely to have a disorder of the following biochemical process:
202.

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?

203.

The resuscitation unit has admitted a patient in grave condition. It is known that he had mistakenly taken sodium fluoride which blocks cytochrome oxidase. What type of hypoxia developed in the patient?

204.

On the fifth day after the acute blood loss a patient has been diagnosed with hypochromic anemia. What is the main mechanism of hypochromia development?

205.

A patient has severe blood loss caused by an injury. What kind of dehydration will be observed in this particular case?

206.

A 30-year-old patient has dyspnea fits, mostly at night. He has been diagnosed with bronchial asthma. What type of allergic reaction according to the Gell-Coombs classification is most likely in this case?

207.

After a road accident a victim has tachycardia, arterial blood pressure 130/90 mm Hg, tachypnoe, the skin is pale and dry, excitation of central nervous system is observed. What shock stage is the patient most likely in?

208. Autopsy has revealed shrunken kidneys weighing 50 mg, with fine-grained surface and uniformly thinned substance. Microscopic investigation has shown the thickening of arteriole walls due to accumulation of homogeneous anhistic pink-coloured masses in them. Glomerules were undersized, sclerotic, with atrophied tubules. What disease are these changes characteristic of?
209.

A patient operated on complicated appendicitis has the following changes of blood count: erythrocytes - 4, 0 · 1012/l,  Нb - 120 g/l, color index - 0,9, leukocytes - 18 · 109/l,  basophils - 0,   eosinophils  -  0,   myelocytes  -   0,   juvenile  -  0,  stab neutrophils - 20, segmentonuclear neutrophils - 53, lymphocytes - 21, monocytes - 5. How is such nuclear shift of leukocytic formula called?

210.

A  child  was born  with  cleft  palate. Examination revealed  aorta  defects  and reduced  number    of   T-lymphocytes   in blood.  What  immunodeficient syndrome is it?

 
211. A  20 year  old  patient complains  of general weakness, dizziness, quick fatigability.  Blood   analysis  results:  Hb-  80 g/l. Microscopical  examination results: erythrocytes are  of  modified  form.  This condition might be caused by:
212.

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

213.

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

214.

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

215.

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

216.

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

217. Cardinal symptoms  of primary hyperparathyroidism are osteoporosis and renal lesion along with development of urolithiasis.  What substance  makes up the basis of these calculi in this disease?
218.

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

219. A patient with obliterating atherosclerosis underwent sympathectomy of femoral  artery  in the region of femoral trigone.  What  type  of arterial hyperemia was induced  by the operation?
220.

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


221.

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

222. A female patient underwent liver transplantation. 1,5 month  after it her condition became worse because of reaction of transplant rejection. What  factor  of immune  system plays the  leading  part  in this reaction?
223. A patient has delayed conduction of excitement through the atrioventricular node. What changes of  ECG will be observed?
224.

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

 
225.

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

226. A  47 year  old  man  with  myocardium infarction  was admitted to the  cardiological department. What changes of cellular  composition of peripheral blood are induced by necrotic changes in the myocardium?
227.

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

228.

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

229.

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

230.

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

 
231.

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

232.

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

233.

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

234.

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:

235. A  patient staggers  and  walks astraddle. He  has  hypomyotonia of arm and leg muscles, staccato  speech.  In what brain section is this affection localized?
236.

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

237.

Two hours after an exam a student had a blood count done and it was revealed that he had  leukocytosis without significant leukogram modifications. What is the most probable mechanism  of leukocytosis  development?

238. A patient ill with thrombophlebitis of his lower limbs had chest pain, blood spitting, progressing  respiratory insufficiency that  led to his death.  Autopsy diagnosed multiple lung infarctions. What is the most probable cause of their development?
239.

Examination of a man who had been working  hard  under  higher  temperature of the environment revealed abnormal quantity of blood  plasma  proteins. What phenomenon is the case?

240. A  62  year   old  patient  who  previously  worked  as stoker  was admitted to a hospital  with complaints  about  general weakness,  abrupt weight loss, hoarse  voice, dyspnea, dry cough. Laryngoscopy revealed  a tumour in the pharynx that invaded  vocal cords  and  epiglottis.  What is the most probable cause of tumour development?
241. A patient staying in the pulmonological department was diagnosed  with pulmonary emphysema accompanied by reduced elasticity of pulmonary tissue. What type of respiration is observed?
242. A 35 year old man consulted  a dentist  about   reduced  density   of  dental   tissue,  high  fragility  of  teeth  during  eating  solid  food.   This  patient  suffers  the most probably from the deficiency of the following mineral element:
243.

A patient has a decreased vasopressin synthesis  that  causes  polyuria   and  as  a result  of it evident  organism  dehydration.  What  is the  mechanism   of  polyuria development?

244.

A   30   year   old   woman   has   face edemata. Examination revealed  proteinuria (5,87 g/l), hypoproteinemia, dysproteinemia, hyperlipidemia. What condition is  the  set  of  these  symptoms typical for?

245.

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

246.

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

247.

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

248.

A  17 year  old  boy  fell  seriously  ill, the  body temperature rose up to 38, 5oC , there  appeared cough,  rhinitis,  lacrimation,  nasal  discharges.  What  inflammation is it?

249.

48 hours  after  tuberculine test (Mantoux test)  a child  had  a  papule  10 mm in diameter on the spot of tuberculine injection.  What hypersensitivity mechanism underlies these changes?

250. A patient suffering from periodical attacks  caused  by inhalation of different flavoring  substances  was diagnosed  with atopic bronchial asthma. IgE level was increased.  This is typical  for the  following type of reactions:
251. A   34   year   old   woman    was   diagnosed with hereditary microspherocytic hemolytic anemia (Minkowsky-Shauffard disease). What mechanism caused haemolysis of erythrocytes?
252.

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

253.

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

254.

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

255.

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

256. A  patient  is  ill  with  diabetes  mellitus  accompanied  by  hyperglycemia  on an  empty  stomach  (7,2 millimole/l).  The hyperglycemia  rate   can  be  retrospectively estimated (over  the  last  4-8 weeks before   the  examination) on  the  ground of the rate  of the following blood  plasma protein:
257.

A  12-year-old  patient was found  to have  blood  serum  cholesterol at the  rate of  25 mmol/l.  The  boy  has  a  history  of hereditary familial hypercholesterolemia, which is caused by the impaired  synthesis of the following protein receptors:

258. 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?
259. A  3-year-old  child  had  eaten  some strawberries. Soon  he  developed a  rash and itching. What was found in the child’s leukogram?
260.

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:

261.

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?

 
262. 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:
263.

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:

264. A  patient with  extensive  myocardial infarction  has developed heart  failure. What pathogenetic mechanism  contributed  to the development of heart  failure in the patient?
265. 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:
266.

On allergological  examination a patient has been diagnosed with pollinosis. Specific desensitization can be performed by:

267. After  the prolonged vomiting a pregnant 26-year-old  woman  was  found to have  the  reduced volume  of circulating blood.  What  change  in the total  blood volume can be the case?
268.

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:

269. 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?
270.

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:

271.

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?

272.

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?

273. 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?
274. 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:
275.

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?

276.

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?

277.

ECG of a patient displays an abnormally long R wave (up to 0,18s). This is caused by a decrease in the conduction velocity of the following heart structures:

278.

Analysis  of  the  ECG   revealed   the missing of several PQRST  cycles. The remaining waves and  complexes  are  not changed. Specify the type of arrhythmia:

 
279.

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:

280.

Diseases  of  the  respiratory  system and  circulatory  disorders  impair  the transport  of   oxygen,   thus   leading   to hypoxia.  Under these  conditions the energy metabolism is carried  out by anaerobic glycolysis. As a result, the following substance  is generated and accumulated in blood:

281.

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?

282.

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:

283. Hemoglobin catabolism results in release of iron which is transported to the bone marrow by a certain   transfer protein and used again for the synthesis of hemoglobin. Specify this transfer protein:
284.

Enzymatic  jaundices  are accompanied  by  abnormal activity  of  UDP-glucuronyl   transferase. What  compound is accumulated in blood  serum  in case of these pathologies?

285. 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?
286. A  23-year-old  patient has  been  admitted to a hospital with a craniocerebral injury. The patient is in a grave condition. Respiration is characterized by prolonged convulsive inspiration followed by a short expiration. What  kind  of respiration is it typical for?
287. 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?
288.

A  patient got  a  gunshot   wound  of hip which damaged the sciatic nerve. Any impact on the affected limb causes severe, excruciating  pain.   What   mechanism   of pain is most likely in this case?

289.

A 3-year-old boy with pronounced hemorrhagic syndrome  doesn’t have anti-hemophilic  globulin  A  (factor   VIII)   in the  blood  plasma.  Hemostasis has  been impaired  at the following stage:

290.

The  cellular  composition of exudate largely  depends on the  etiological  factor of inflammation. What leukocytes  are the first to get into the focus of inflammation caused by pyogenic bacteria?

 
291. A  patient with bronchial  asthma  has developed acute respiratory failure. What kind  of respiratory failure  occurs  in this case?