After consumption of rich food a patient has nausea and heartburn, steatorrhea. This condition might be caused by:
An infant has apparent diarrhea resulting from improper feeding. One of the main diarrhea effects is plentiful excretion of sodium bicarbonate. What form of acid-base balance disorder is the case?
A 3 year old child with fever was given aspirin. It resulted in intensified erythrocyte haemolysis. Hemolytic anemia might have been caused by congenital insufficiency of the following enzyme:
4. 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:
In course of laparotomy a surgeon revealed gangrenous lesion of descending colon. It was caused by thrombosis of the following artery:
A 37 year old patient suffering from obliterating vascular endarteritis of lower limbs takes daily 60 microgram/kilogram of phenylin. Because of presentations of convulsive disorder (craniocerebral trauma in anamnesis) he was prescribed phenobarbital. Withholding this drug caused nasal hemorrhage. What is this complication connected with?
A 60 year old patient has impaired perception of high-frequency sounds. These changes were caused by damage of the following auditory analyzer structures:
Researchers isolated 5 isoenzymic forms of lactate dehydrogenase from the human blood serum and studied their properties. What property indicates that the isoenzymic forms were isolated from the same enzyme?
It was proved that a molecule of immature mRNA (precursor mRNA) contained more triplets than amino acids found in the synthesized protein. The reason for that is that translation is normally preceded by:
10. A patient has low rate of magnesium ions that are necessary for affixion of ribosomes to the endoplasmic reticulum. It is known that it causes disturbance of protein biosynthesis. At what stage is protein biosynthesis impaired?
A student takes notes of a lecture. Quality of his notes became significantly worse when his neighbours began talking. What type of conditional reflex inhibition was the cause of it?
A patient ill with neurodermatitis has been taking prednisolone for a long time. Examination revealed high rate of sugar in his blood. This complication is caused by the drug influence upon the following link of carbohydrate metabolism:
Labelled amino acids alanine and tryptophane were injected to a mouse in order to study localization of protein synthesis in its cells. The labelled amino acids will be accumulated near the following organellas:
A patient with frequent attacks of stenocardia was prescribed sustak-forte to be taken one tablet twice a day. At first the effect was positive but on the second day stenocardia attacks resumed. What can explain inefficiency of the prescribed drug?
15. Inflammation of the tympanic cavity (purulent otitis media) was complicated by inflammation of mammillary process sockets. What wall of tympanic cavity did the pus penetrate into the sockets through?
In order to speed up healing of a wound of oral mucosa a patient was prescribed a drug that is a thermostable protein occurring in tears, saliva, mother’s milk as well as in a new-laid hen’s egg. It is known that this protein is a factor of natural resistance of an organism. What is it called?
17. An aged man had raise of arterial pressure under a stress. It was caused by activation of:
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:
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?
20. As a result of long-term starvation the glomerular filtration of a man was accelerated by 20%. The most probable cause of filtration changes under such conditions is:
A patient has yellow skin colour, dark urine, dark-yellow feces. What substance will have strengthened concentration in the blood serum?
A patient consulted a doctor about symmetric dermatitis of open skin areas. It was found out that the patient lived mostly on cereals and ate too little meat, milk and eggs. What vitamin deficiency is the most evident?
A 46 year old patient applied to a doctor complaining about joint pain that becomes stronger the day before weather changes. Blood examination revealed strengthened concentration of uric acid. The most probable cause of the disease is the intensified disintegration of the following substance:
A 38 year old patient suffers from rheumatism in its active phase. What laboratory characteristic of blood serum is of diagnostic importance in case of this pathology?
25. ECG of a patient with hyperfunction of thyroid gland showed heart hurry. It is indicated by depression of the following ECG element:
A 62 year woman complains of frequent pain attacks in the area of her chest and backbone, rib fractures. Her doctor suspected myeloma (plasmocytoma). What of the following laboratory characteristics will be of the greatest diagnostic importance?
While playing volleyball a sportsman made a jump and landed on the outside edge of his foot. He felt acute pain in the talocrural joint, active movements are limited, passive movements are unlimited but painful. A bit later there appeared a swelling in the area of external ankle, the skin became red and warm. What type of peripheral circulation disturbance is the case?
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?
29. A patient underwent an operation on account of gall bladder excision that resulted in obstruction of Ca2+ absorption through the bowels wall. What vitamin will stimulate this process?
A woman underwent an operation on account of extrauterine (tubal) pregnancy. In course of the operation the surgeon should ligate the branches of the following arteries:
A 6 month old baby ill with bronchitis was taken for an X-ray of chest. Apart of changes associated with bronchi the X-ray film showed a shadow of thymus gland. What might have caused such changes?
A patient complains of frequent diarrheas, especially after consumption of rich food, weight loss. Laboratory examination revealed steatorrhea; his feces were hypocholic. What might have caused such condition?
Examination of a patient with pustular skin lesions allowed to isolate a causative agent that forms in the blood agar roundish yellow middle-sized colonies surrounded by haemolysis zone. Smears from the colonies contain irregular- shaped clusters of gram-positive cocci. The culture is oxidase- and catalase- positive, ferments mannitol and synthesizes plasmocoagulase. What causative agent was isolated?
A 65 year old man suffering from gout complains of kidney pain. Ultrasound examination revealed renal calculi. The most probable cause of calculi formation is the strengthened concentration of the following substance:
35. Microscopic examination of a Gram- stained scrape from patient’s tongue revealed oval, round, elongated chains of dark-violet gemmating cells. What disease can be caused by this causative agent?
36. 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?
Cushing Syndrome: Etiology
*INCREASE Cortisol due to a variety of causes (Glucocorticoids).
*Exogenous corticosteroids: result in DECREASE ACTH (MCC).
*Primary adrenal adenoma, hyperplasia or carcinoma (Cushing’s Syndrome). *ACTH-secreting pituitary adenoma (Cushing Disease).
Findings: Hypertension, Weight Gain, Moon Facies, Truncal Obesity, Buffalo Hump, Skin Changes (thinning striae), Osteoporosis, Hyperglycemia (Insulin resistance), Amenorrhea, Immunosuppression.
Blood of a patient with presumable sepsis was inoculated into sugar broth. There appeared bottom sediment. Repeated inoculation into blood agar caused growth of small transparent round colonies surrounded by hemolysis zone. Examination of a smear from the sediment revealed gram-positive cocci in form of long chains. What microorganisms are present in blood of this patient?
2 years ago a patient underwent resection of pyloric part of stomach. He complains of weakness, periodical dark shadows beneath his eyes, dyspnea. In blood: Hb - 70 g/l, erythrocytes - 3, 0 ·1012/l, colour index - 0,7. What changes of erythrocytes in blood smears are the most typical for this condition?
A patient is ill with hepatocirrhosis. State of antitoxic liver function can be characterized by examination of the following substance excreted by urine:
The territory of an old burial ground for animal refuse that hasn’t been used for over 50 years is meant for house building. But soil investigation showed the presence of viable spores of a causative agent causing a very dangerous disease. What microorganism might have been preserved in soil for such a long period of time?
There are two medically important Bacillus species: Bacillus anthracis and Bacillus cereus. Bacillus anthracis causes anthrax. Human disease occurs in 3 main forms: cutaneous, pulmonary (inhalation) and gastrointestinal. Humans are most often infected cutaneously at the time of trauma to the skin, which allows the spores on animal products such as hides, bristles and wool to enter. Spores can also be inhaled or when contaminated meat is ingested. After being inhaled, the organism moves rapidly to the mediastinal lymph nodes and causes hemorrhagic mediastinitis. Pathogenesis is based on the production of two exotoxins (Anthrax toxin) – edema factor and lethal factor. Hemorrhagic mediastinitis, septic shock hemorrhagic meningitis and death are severe life-threatening complications. In fatal cases, the organism may affect the spleen, liver, intestines, kidneys, adrenal glands and meninges.
Autopsy of a man who had been working as a miner for many years and died from cardiopulmonary decompensation revealed that his lungs were airless, sclerosed, their apexex had emphysematous changes, the lung surface was greyish-black, the incised lung tissue was coal-black. What disease caused death?
Microscopy of stained (Ziehl-Neelsen staining) smears taken from the sputum of a patient with chronic pulmonary disease revealed red bacilli. What property of tuberculous bacillus was shown up?
Parents of a 10 year old boy consulted a doctor about extension of hair-covering, growth of beard and moustache, low voice. Intensified secretion of which hormone must be assumed?
Examination of coronary arteries revealed atherosclerotic calcified plaques closing vessel lumen by 1/3. The muscle has multiple whitish layers of connective tissue. What process was revealed in the myocardium?
It was revealed that T-lymphocytes were affected by HIV. Virus enzyme - reverse transcriptase (RNA-dependent DNA polymerase) - catalyzes the synthesis of:
46. A 35 year old man with a trauma of his left hand was admitted to the traumatology department. Objectively: cut wound of palmar surface of left hand; middle phalanxes of II–V fingers don’t bend. What muscles are damaged?
Histological examination of a skin tissue sampling revealed granulomas consisting of macrophagal nodules with lymphocytes and plasmatic cells. There are also some big macrophages with fatty vacuoles containing causative agents of a disease packed up in form of spheres (Virchow’s cells). Granulation tissue is well vascularized. What disease is this granuloma typical for?
In order to estimate toxigenity of diphtheria agents obtained from patients the cultures were inoculated on Petri dish with nutrient agar on either side of a filter paper strip that was put into the centre and moistened with antidiphtheric anti-toxic serum. After incubation of inoculations in agar the strip-like areas of medium turbidity were found between separate cultures and the strip of filter paper. What immunological reaction was conducted?
49. A patient taking clonidine for essential hypertension treatment was using alcohol that caused intense inhibition of central nervous system. What may it be connected with?
Examination of an ovary specimen stained by hematoxylin-eosine revealed a follicle in which follicular epithelium consisted of 1-2 layers of cubic cells. There was also a bright red membrane around the ovocyte. What follicle is it?
A patient with clinical signs of encephalitis was delivered to the infectious diseases hospital. Anamnesis registers a tick bite. Hemagglutination-inhibition reaction helped to reveal antibodies to the causative agent of tick-borne encephalitis in the dilution 1:20 which is not diagnostic. What actions should the doctor take after he had got such result?
A 40 year old man noticed a reddening and an edema of skin in the area of his neck that later developed into a small abscess. The incised focus is dense, yellowish-green. The pus contains white granules. Histological examination revealed drusen of a fungus, plasmatic and xanthome cells, macrophages. What type of mycosis is the most probable?
Continuous taking of some drugs foregoing the pregnancy increase the risk of giving birth to a child with genetic defects. What is this effect called?
A man with a wound of his limb that had been suppurating for a long time died from intoxication. Autopsy revealed extreme emaciation, dehydration, brown atrophy of liver, myocardium, spleen and cross-striated muscles as well as renal amyloidosis. What diagnosis corresponds with the described picture?
6 months after labour a woman had uterine hemorrhage. Gynaecological examination of uterine cavity revealed a dark-red tissue with multiple cavities resembling of a \\\"sponge\\\". Microscopic examination of a tumour revealed in blood lacunas atypic light epithelial Langhans cells and giant cells of syncytiotrophoblast. What tumour is it?
An animal with aortic valve insufficiency got hypertrophy of its left heart ventricle. Some of its parts have local contractures. What substance accumulated in the myocardiocytes caused these contractures?
A girl is diagnosed with adrenogenital syndrome (pseudohermaphroditism). This pathology was caused by hypersecretion of the following adrenal hormone:
In course of an experiment a big number of stem cells of red bone marrow was in some way destructed. Regeneration of which cell populations in the loose connective tissue will be inhibited?
Examination of a 70 year old patient revealed insulin-dependent diabetes. What drug should be administered?
60. A human body cools in water much faster that in the air. What way of heat emission in water is much more efficient?
A patient suffering from chronic cardiac insufficiency was recommended to undergo a prophylactic course of treatment with a cardiological drug from the group of cardiac glycosides that is to be taken enterally. What drug was recommended?
An ophthalmologist used a 1% mesaton solution for the diagnostic purpose (pupil dilation for eye-ground examination). What is the cause of mydriasis induced by the drug?
Prophylactic medical examination of a 36 year old driver revealed that his AP was 150/90 mm Hg. At the end of working day he usually hears ear noise, feels slight indisposition that passes after some rest. He was diagnosed with essential hypertension. What is the leading pathogenetic mechanism in this case?
64. A cerebral trauma caused increased ammonia generation. What amino acid participates in the excretion of ammonia from the cerebral tissue?
While studying maximally spiralized chromosomes of human karyotype the process of cell division was stopped in the following phase:
66. 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?
Type IV (cell mediated, delayed, cellular cytotoxicity): antibody-independent T-cell mediated reactions e.g. positive mantoux reaction (tuberculin test), hashimoto’s thyroiditis or transplant rejection etc.
Mantoux test is a type IV Hypersensitivity reaction (HSR), which involves macrophages,T-lymphocytes and lymphokines(cytokines). Mononuclear cells (lymphocytes,monocytes,macrophages).
Remember,it is antibody independent (i.e does not involve antibodies).
B-lymphocytesàPlasma cellsàIg(Antibodies)------- none is involved in Tyoe IV HSR.
The Mantoux skin test should be read between 48 and 72hrs after administration. The basis of reading is the presence or absence of induration, which may be determined by inspection and by palpation. A record should also be made of formation of vesicles, bullae, lymphangitis, ulceration and necrosis at the test site. The formation of vesicles, bullae or necrosis at the test site indicates positive result. A negative mantoux result usually signifies that the individual has never been exposed to Mycobacterium tuberculosis i.e. absence of cell mediated immunity to tuberculin.
A patient was admitted to the surgical department with suspected inflammation of Meckel’s diverticulum. What part of bowels should be examined in order to discover the diverticulum in course of an operation?
68. Power inputs of a man were measured. In what state was this man if his power inputs were lower than basal metabolism?
Examination of a newborn boy’s genitalia revealed an urethral hiatus that opens on the undersite of his penis. What malformation is it?
70. 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:
71. As a result of destruction of certain brainstem structures an animal has lost its orientative reflexes in response to strong photic stimuli. What structures were destroyed?
72. Myocyte cytoplasm contains a big number of dissolved metabolites of glucose oxidation. Name one of them that turns directly into a lactate:
Mother of a 2 year old child consulted a stomatologist. In the period of pregnancy she was irregularly taking antibiotics for an infectious disease. Examination of the child revealed incisor destruction, yellow enamel, brown rim around the dental cervix. What drug has apparent teratogenic effect?
A 59 year old patient is a plant manager. After the tax inspection of his plant he felt intense pain behind his breastbone irradiating to his left arm. 15 minutes later his condition came to normal. Which of the possible mechanisms of stenocardia development is the leading in this case?
A patient recovered from Sonne dysentery and was once more infected with the same causative agent. What is such infection form called?
A 56 year old patient came to a hospital with complaints about general weakness, tongue pain and burning, sensation of limb numbness. In the past he underwent resection of forestomach. In blood: Hb- 80 g/l; erythrocytes - 2, 0 · 1012/l; colour index - 1,2, leukocytes - 3, 5 · 109/l. What anemia type is it?
A 35 year old patient applied to a doctor with complaints about having intense rhinitis and loss of sense of smell for a week. Objectively: nasal cavity contains a lot of mucus that covers mucous membrane and blocks olfactory receptors. In what part of nasal cavity are these receptors situated?
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?
A patient with disturbed cerebral circulation has problems with deglutition. What part of brain was damaged?
Vitamin B1 deficiency results in disturbance of oxidative decarboxylation of α-ketoglutaric acid. This will disturb synthesis of the following coenzyme:
A chemical burn caused esophagus stenosis. Difficulty of ingestion led to the abrupt loss of weight. In blood: 3, 0 · 1012/l, Hb - 106 g/l, crude protein - 57 g/l. What type of starvation is it?
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?
Skin of a man who died from cardiac insufficiency has an eruption in form of spots and specks. There are also bedsores in the area of sacrum and spinous vertebral processes. Microscopical examination of CNS, skin, adrenal glands revealed in the vessels of microcirculatory bed and in small arteries destructive-proliferative endothrombovasculitis with Popov’s granulomas; interstitial myocarditis. What diagnosis corresponds with the described picture?
Autopsy of a man who died from the sepsis in his femoral bone revealed phlegmonous inflammation that affected the marrow, haversian canals and periosteum. Under the periosteum there are multiple abscesses, adjoining soft tissues of thigh also have signs of phlegmonous inflammation. What pathological process was described?
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?
86. A patient with nephrotic syndrome has massive edemata of his face and limbs. What is the leading pathogenetic mechanism of edemata development?
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?
An unconscious young man with signs of morphine poisoning entered admission office. His respiration is shallow and infrequent which is caused by inhibition of respiratory centre. What type of respiratory failure is it?
89. A patient with cholelithiasis fell ill with mechanic jaundice. Examination revealed that the stone was in the common bile duct. What bile-excreting ducts make up the obturated duct?
A patient is 44 years old. Laboratory examination of his blood revealed that content of proteins in plasma was 40 g/l. What influence will be exerted on the transcapillary water exchange?
The cerebrospinal fluid is being examined for the purpose of differential meningitis diagnostics. At what site is the lumbar puncture safe?
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:
Examination of a 60 year old patient revealed hyperglycemia and glucosuria. A doctor administered him a medication for internal use. What medication is it?
As a result of posttranslative modifications some proteins taking part in blood coagulation, particularly prothrombin, become capable of calcium binding. The following vitamin takes part in this process:
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?
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?
A woman suffering from osteochondrosis felt acute pain in her humeral articulation that became stronger when she abducted her shoulder. These symptoms might be caused by damage of the following nerve:
A patient has a deep cut wound on the posterior surface of his shoulder in its middle third. What muscle might be injured?
99. A patient has acne on his face. Microscopic examination of scrapings from the affected areas revealed living porrect vermiform arthropoda 0,2-0,5 mm large with four pairs of short extremities in the front part of their bodies. What is the laboratory diagnosis?
A 28 year old man had a gunshot wound of shin that resulted in an ulcer from the side of the injury. What is the main factor of neurodystrophy pathogenesis in this case?
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?
A patient ill with essential hypertension was recommended a drug that prevents thrombosis. It is to be taken parenterally. What drug is it?
Packed cell volume of a man was 40% before the trauma. What packed cell volume will be observed 24 hours after blood loss of 750 ml?
104. Two hours after an exam a student had a blood count done and it was revealed that he had leukocytosis without significant leukogram modifications. What is the most probable mechanism of leukocytosis development?
Golgi complex exports substances from a cell due to the fusion of the membrane saccule with the cell membrane. The saccule contents flows out. What process is it?
A boy found a spider with the following morphological characteristics: it is 2 cm long, has roundish black abdomen with two rows of red spots on its dorsal side; four pairs of jointed limbs are covered with small black hairs. What arthropod is it?
A 3 year old child with symptoms of stomatitis, gingivitis and dermatitis of open skin areas was delivered to a hospital. Examination revealed inherited disturbance of neutral amino acid transporting in the bowels. These symptoms were caused by the deficiency of the following vitamin:
108. A patient with suspected diagnosis \\\"progressing muscular dystrophy\\\" got his urine tested. What compound will confirm this diagnosis if found in urine?
A patient being treated for viral hepatitis type B got symptoms of hepatic insufficiency. What blood changes indicative of protein metabolism disorder will be observed in this case?
110. A pregnant woman had her blood group identified. Reaction of erythrocyte agglutination with standard serums of 0αβ (I), Bα (III) groups didn’t proceed with standard serum of Aβ (II) group. The blood group under examination is:d
111. A sensitive neural ganglion consists of roundish neurocytes with one extension that divides into axon and dendrite at some distance from the perikaryon. What are these cells called?
112. A doctor examined a child and revealed symptoms of rachitis. Development of this disease was caused by deficiency of the following compound:
An embryo displays disturbed process of dorsal mesoderm segmentation and somite formation. What part of skin will have developmental abnormalities?
It was found out that some compounds, for instance fungi toxins and some antibiotics can inhibit activity of RNA-polymerase. What process will be disturbed in a cell in case of inhibition of this enzyme?
A 7 year old child is ill with bronchitis. It is necessary to administer him an antibacterial drug. What drug of fluoroquinolone group is CONTRA- INDICATED at this age?
A culture of monkey cells (Vero) and a group of mouse sucklings were infected with an inoculum taken from a child with provisional diagnosis \\\"enterovirus infection\\\". There was no cytopathic effect on the cell culture but mouse sucklings died. What enteric viruses might have caused disease of this child?
A patient died from cardiopulmonary decompensation. Histological examination revealed diffused pulmonary lesion together with interstitial edema, infiltration of tissue by limphocytes, macrophages, plasmocytes; pulmonary fibrosis, panacinar emphysema. What disease corresponds with the described picture?
118. Vagus branches that innervate heart are being stimulated in course of an experiment. As a result of it the excitement conduction from atria to the ventricles was brought to a stop. It is caused by electrophysical changes in the following structures:
If a man has an attack of bronchiospasm it is necessary to reduce the effect of vagus on smooth muscles of bronchi. What membrane cytoreceptors should be blocked for this purpose?
Muscarinic receptors belong to the class of G protein-coupled receptors. These receptors, in addition to binding Acetylcholine, it also recognizes muscarine – an alkaloid that is present in certain poisonous mushrooms. Muscarinic effects include miosis, spasm of accommodation, increasing of lacrimal, salivary, gastrointestinal, bronchial and sweat glands secretion, increase of smooth muscle tonus of internal organs, bradycardia, decreased arterial pressure.
M-cholinoreceptors increase muscle tonus of internal organs. Therefore blocking this receptor will relieve the bronchospasm.
A patient of surgical department complains about pain in the small of her back and in the lower part of her belly; painful and frequent urination. Bacteriological examination of urine revealed gram-negative oxidase-positive rod-like bacteria forming greenish mucoid colonies with specific smell. What causative agent can it be?
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?
122. A child was born with cleft palate. Examination revealed aorta defects and reduced number of T-lymphocytes in blood. What immunodeficient syndrome is it?
A 16 year old boy after an illness has diminished function of protein synthesis in liver as a result of vitamin K deficiency. It will cause disturbance of:
Life cycle of a cell includes the process of DNA autoreduplication. As a result of it monochromatid chromosomes turn into bichromatid ones. What period of cell cycle does this phenomenon fall into?
A driver who got a trauma in a road accident and is shocked has reduction of daily urinary output down to 300 ml. What is the main pathogenetic factor of such diuresis change?
Systemic arterial pressure of an adult dropped from 120/70 to 90/50 mm Hg that led to reflectory vasoconstriction. The vasoconstriction will be maximal in the following organ:
Examination of a 12 year old boy with developmental lag revealed achondroplasia: disproportional constitution with evident shortening of upper and lower limbs as a result of growth disorder of epiphyseal cartilages of long tubal bones. This disease is:
A patient was diagnosed with autoimmune hemolytic cytotoxic anemia. What substances are antigens in II type allergic reactions?
While performing an operation in the area of axillary crease a surgeon has to define an arterial vessel surrounded by fascicles of brachial plexus. What artery is it?
A patient takes digoxin for treatment of cardiac insufficiency. What diuretic may increase digoxin toxicity due to the intensified excretion of K + ions?
During starvation muscle proteins break up into free amino acids. These compounds will be the most probably involved into the following process:
A patient ill with amebiasis was prescribed a certain drug. The use of alcohol together with this drug is contra- indicated because the drug inhibits metabolism of ethyl alcohol. What drug is it?
Surgical removal of a part of stomach resulted in disturbed absorption of vitamin B12 , it is excreted with feces. The patient was diagnosed with anemia. What factor is necessary for absorption of this vitamin?
A patient ill with chronic cardiac insufficiency was prescribed an average therapeutic dose of digoxin. Two weeks after begin of its taking there appeared symptoms of drug intoxication (bradycardia, extrasystole, nausea). Name the phenomenon that caused accumulation of the drug in the organism?
In course of a preventive examination of a miner a doctor revealed changes of cardiovascular fitness which was indicative of cardiac insufficiency at the compensation stage. What is the main proof of cardiac compensation?
136. Rest potential of a cell equals −80 mV . At what stage of action potential did the membrane potential equal +30 mV ?
A 35 year old man got an injury that caused complete disruption of spinal cord at the level of the first cervical segment. What respiration changes will be observed?
In course of an experiment a peripheral section of vagus of an experimental animal is being stimulated. What changes will be observed?
2 hours after a skeletal extension was performed to a 27 year old patient with multiple traumas (closed injury of chest, closed fracture of right thigh) his condition abruptly became worse and the patient died from acute cardiopulmonary decompensation. Histological examination of pulmonary and cerebral vessels stained with Sudan III revealed orange drops occluding the vessel lumen. What complication of polytrauma was developed?
In course of severe respiratory viral infection there appeared clinical signs of progressing cardiac insufficiency that caused death of a patient in the 2nd week of disease. Autopsy revealed that the heart was sluggish, with significant cavity dilatation. Histological examination of myocardium revealed plethora of microvessels and diffuse infiltration of stroma by lymphocytes and histiocytes. What disease corresponds with the described picture?
A specimen stained by Ozheshko method contains rod-like microorganisms stained blue with round terminal components stained red. What are these components called?
A 38 year old patient with full-blown jaundice, small cutaneous hemorrhages, general weakness and loss of appetite underwent puncture biopsy of liver. Histological examination revealed disseminated dystrophy, hepatocyte necrosis, Councilman’s bodies. Lobule periphery has signs of significant infiltration by lymphocytes, there are also individual multinuclear hepatocytes. What is the most probable diagnosis?
A man with an injury of the dorsal area of his neck was admitted to the resuscitation department. What muscle occupies this area?
144. In course of an experiment a toad’s right labyrinth was destroyed. It will cause amyotonia of the following muscles:
A 20 year old patient died from intoxication 8 days after artificial illegal abortion performed in her 14-15th week of pregnancy. Autopsy of the corpse revealed yellowish colour of eye sclera and of skin, necrotic suppurative endometritis, multiple pulmonary abscesses, spleen hyperplasia with a big number of neutrophils in its sinuses. What complication after abortion was developed?
A patient complains of dizziness and hearing loss. What nerve is damaged?
A 6 year old child was delivered to a hospital. Examination revealed that the child couldn’t fix his eyes, didn’t keep his eyes on toys, eye ground had the cherry-red spot sign. Laboratory analyses showed that brain, liver and spleen had high rate of ganglioside glycometide. What congenital disease is the child ill with?
A patient has a cluster of matted together dense lymph nodes on his neck. Histological examination of a removed lymph node revealed proliferation of reticular cells, presence of Reed-Sternberg cells. What disease is meant?
While palpating mammary gland of a patient a doctor revealed an induration in form of a node in the inferior medial quadrant. Metastases may extend to the following lymph nodes:
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?
151. Parents of a 3 year old child have been giving him antibiotics with purpose of preventing enteric infections for a long time. A month later the child’s condition changed for the worse. Blood examination revealed apparent leukopenia and granulocytopenia. What is the most probable mechanism of blood changes?
A pathological process in bronchi resulted in epithelium desquamation. What cells will regenerate bronchial epithelium?
A patient ill with tuberculosis died from progressing cardiopulmonary decompensation. Autopsy in the area of the right lung apex revealed a cavity 5 cm in diameter communicating with lumen of a segmental bronchus. On the inside cavity walls are covered with caseous masses with epithelioid and Langhans cells beneath them. What morphological form of tuberculosis is it?
Workers of a hothouse farm work under conditions of unfavourable microclimate: air temperature is +37oC , relative humidity is 90%, air speed is 0,2 m/s. The way of heat emission under these conditions will be:
A gynaecologist was examining a patient and revealed symptoms of genital tract inflammation. A smear from vagina contains pyriform protozoa with a spine, flagella at their front; there is also an undulating membrane. What disease can be suspected?
156. A boy has I (I 0I 0) blood group and his sister has IV (I A I B ) blood group. What blood groups do their parents have?
A patient ill 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?
Hypoosmolar hypohydration (salt deficit) develops due to diarrhea, vomiting, sweating, adrenal insufficiency, hypokalemia, CNS lesions, salt-losing nephritis.
Hyperosmolar hypohydration (water defcit) develops due to the loss of the fluid which lacks electrolytes e.g. in diabetes insipidus, hyperventilation.
Isoosmolar hypohydration (isoosmotic loss): proportional volume decrease of fluids and electrolytes e.g. in blood loss, burns, diuretic therapy, especially diarrhea in cholera.
Hypoosmolar hyperhydration (water excess) develops in acute renal failure (in the stage of anuria), Parhon’s syndrome (syndrome of inappropriate ADH secretion –SIADH).
Hyperosmolar hyperhydration (salt excess) develops rarely e.g. in drinking salt (sea) water, infusion of hypertonic saline, adrenal hyperactivity or steroid therapy.
Low water level extracellularly – Hypohydration
Low blood osmolarity – Hypoosmolar
For the purpose of myocardium infarction treatment a patient was injected with embryonal stem cells derived from this very patient by means of therapeutic cloning . What transplantation type is it?
159. A histological specimen of spleen shows a vessel with a wall consisting of endothelium and subendothelial layer, median membrane is absent, exterior membrane inosculates with the layers of spleen connective tissue. What vessel is it?
160. In course of a conditional experiment the development of mesenchyma cells was completely inhibited. Development of the following muscular tissue will be disturbed:
161. A patient ill with chronic gastritis went for endogastric pH-metry that allowed to reveal decreased acidity of gastric juice. It is indicative of diminished function of the following cells:
Vagi of an experimental animal were cut on both sides. What respiration changes will be observed?
A 70 year old man is ill with vascular atherosclerosis of lower extremities and coronary heart disease. Examination revealed disturbance of lipidic blood composition. The main factor of atherosclerosis pathogenesis is the excess of the following lipoproteins:
On the 2-3rd day after stomach resection intestinal peristalsis wasn’t restored. What is to be administered for stimulation of gastrointestinal tract?
A cardiac electric stimulator was implanted to a 75 year old man with heart rate of 40 bpm. Thereafter the heart rate rose up to 70 bpm. The electric stimulator has undertaken the function of the following heart part:
A stomatologist injected a patient with a certain drug in order to reduce salivation during tooth filling. What drug is it?
Acetylcholine is a neurotransmitter. It increases salivary secretion and stimulates intestinal secretions and motility. It increases bronchial secretions, increases tone of detrusor urinae muscle, causing expulsion of urine, stimulates ciliary muscle contraction (accommodation). It increases exocrine gland secretions (e.g. lacrimal, salivary, gastric acid); gut peristalsis, bladder contraction, bronchoconstriction, papillary sphincter muscle contraction (miosis). Poisoning by cholinomimetics causes diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle and central nervous system, lacrimation, sweating and salivation. Cholinomimetics are cholinergic agonists which produce analogous effects of acetylcholine.
Atropine sulfate (M-cholinoblocker) blocks the acetylcholine response.
A 30 year old woman has applied a lipstick with a fluorescent substance for a long time. Then she got a limited erythema and slight peeling on her lip border, later there appeared transversal striae and cracks. Special methods of microscopic examination of the affected area helped to reveal sensibilized lymphocytes and macrophages in the connective tissue; cytolysis. What type of immunological hypersensitivity was developed?
A patient ill with essential arterial hypertension had a hypertensic crisis that resulted in an attack of cardiac asthma. What is the leading mechanism of cardiac insufficiency in this case?
A man who has been taking a drug for a long time cannot withhold it because this causes impairment of psychic, somatic and vegetative functions. Name the syndrome of different disturbances caused by drug discontinuation:
170. A patient consulted a stomatologist about purulent inflammation of his gums. What drug will be the most effective if it is suspected that a causative agent is an anaerobe?
171. Rats being under stress have muscular hypertonia and high arterial pressure, high glucose concentration in blood and intensified secretion of corticotropin and corticosteroids. In what stress phase are these animals?
A patient came to the hospital complaining about quick fatigability and apparent muscle weakness. Examination revealed an autoimmune disease that causes disorder of functional receptor condition in neuromuscular synapses. What transmitter will be blocked?
Examination of a 35 year old patient revealed high acidity of gastric juice. What receptors should be blocked in order to reduce it?
174. Examination of a young woman revealed a node-like, soft and elastic homogenous tumour of pinkish-white colour along the acoustic nerve. The tumour contains cell bundles with oval nuclei. Cellular fibrous bundles form rhythmic structures made up by parallel rows of regularly oriented cells arranged in form of a palisade with cell-free homogenous zone (Verocay bodies) between them. What tumour is it?
A 45 year old woman is ill with breast cancer. Her left arm has symptoms of lymphatic system insufficiency - limb edema, lymph node enlargement. What form of lymphatic circulation insufficiency is it?
176. An endocrinal gland with parenchyma consisting of epithelium and neural tissue is under morphological examination. Epithelial trabecules have two types of cells: chromophilic and chromophobic. Identify this organ:
177. While performing an inguinal canal operation on account of hernia a surgeon damaged the canal’s contents. What exactly was damaged?
178. A 12 year old child has intolerance to some foodstuffs. Their consumption causes an allergic reaction in form of itching skin eruptions. What antihistaminic drug should be administered so that the child could attend school?
A patient that entered the admission office had the following signs of acute cardiac insufficiency: paleness, acrocyanosis, frequent shallow respiration. What drug is indicated in this case?
180. 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?
A patient had hemorrhagic stroke. Blood examination revealed strengthened kinin concentration. The patient was prescribed contrical. It was administered in order to inhibit the following proteinase:
182. A patient with bacterial pneumonia was prescribed benzylpenicillin. What is the mechanism of its antibacterial effect?
183. Hartnup disease is caused by point mutation of only one gene which results in disturbance of tryptophane absorption in the bowels and its resorption in the renal tubules. It is the reason for disorder of both digestive and urination systems. What genetic phenomenon is observed in this case?
A patient who has been treated in a neural clinic and has been taking a sedative for a long time got the following complication: cough, rhinitis, epiphora. What drug caused these disturbances?
In order to accelerate healing of a radiation ulcer a vitamin drug was administered. What drug is it?
Inoculum from pharynx of a patient ill with angina was inoculated into blood-tellurite agar. It resulted in growth of grey, radially striated (in form of rosettes) colonies 4-5 mm in diameter. Gram-positive bacilli with clublike thickenings on their ends placed in form of spread wide apart fingers are visible by microscope. What microorganisms are these?
187. Plasmic factors of blood coagulation are exposed to post-translational modification with the participation of vitamin K . It is necessary as a cofactor in the enzyme system of γ-carboxylation of protein factors of blood coagulation due to the increased affinity of their molecules with calcium ions. What amino acid is carboxylated in these proteins?
188. Pharmacological effects of anti-depressants are connected with inhibition of an enzyme catalyzing biogenic amines noradrenaline and serotonine in the mitochondrions of cerebral neurons. What enzyme participates in this process?
An oncological patient was prescribed methotrexate. With the lapse of time target cells of the tumour lost susceptibility to this drug. There is change of gene expression of the following enzyme:
As a result of prophylactic medical examination a 7 year old boy was diagnosed with Lesch-Nyhan syndrome (only boys fall ill with it). The boy’s parents are healthy but his grandfather by his mother’s side suffers from the same disease. What type of disease inheritance is it?
Planned mass vaccination of all newborn 5-7 day old children against tuberculosis plays an important role in tuberculosis prevention. In this case the following vaccine is applied:
192. A patient with hypertensic crisis was admitted to the cardiological department, he was injected intravenously with an anti-hypertensive drug - salt of an alkaline-earth metal. What drug was injected?
193. In course of a small pelvis operation it became necessary to ligate an ovarian artery. What formation may be accidentally ligated together with it?
A patient with acute morphine poisoning was delivered to a hospital. What specific narcotic antagonist should be chosen in this case?
The upper lobe of the right lung is enlarged, grey and airless, the inscision surface is dripping with turbid liquid, the pleura has many fibrinogenous films; microscopical examination of alveoles revealed exudate containing neutrophils, desquamated alveolocytes and fibrin fibers. The bronchus wall is intact. What is the most probable diagnosis?
A 28 year old patient had high arterial pressure, hematuria and facial edemata. In spite of treatment renal insufficiency was progressing. 6 months later the patient died from uremia. Microscopic examination of his kidneys and their glomerules revealed proliferation of capsule nephrothelium and of podocytes with \\\"demilune\\\" formation, sclerosis and hyalinosis of glomerules. What disease corresponds with the described picture?
A patient with a knife wound in the left lumbar part was delivered to the emergency hospital. In course of operation a surgeon found that internal organs were not damaged but the knife injured one of muscles of renal pelvis. What muscle is it?
198. A man with a stab wound in the area of quadrilateral foramen applied to a doctor. Examination revealed that the patient was unable to draw his arm aside from his body. What nerve is most probably damaged?
Autopsy of a man ill with severe hypothyroidism revealed that connective tissue, organ stroma, adipose and cartilaginous tissues were swollen, semi- transparent, mucus-like. Microscopic examination of tissues revealed stellate cells having processes with mucus between them. What type of dystrophy is it?
Ultramicroscopical examination of \"dark\" hepatocyte population in the cell cytoplasm detected a developed granular endoplasmic reticulum. What function has this organella in these cells?