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1. A 26 year old man has a large furuncle in the soft tissues of his face. It is located close to the nasal root and lower eyelid, A possible dangerous complication of this condition can lead to the infection spreading through the venous plexuses into the sinuses of the dura mater. What sinus is the most likely to be affected in this case?

2. A 16-year-old female has no hair on the pubis and in the armpits, her mammary glands are underdeveloped, no menstruations. This condition can be caused by the following hormone imbalance?

3. A patient has ascites, his spleen is double the normal size, he has esophageal and rectal varices. Histology of the biopsy material obtained from the liver revealed micronodular cirrhosis. What complicated the hepatic cirrhosis in this case?

4. The patient underwent blood test that showed albumin of 20 g/L and increased activity of Lactate dehydrogenase isoenzyme 5 (LDH5). These results indicate a disorder of the following organ:

5. Section shows significant enlargement of the patient\'s right kidney. There is a nephrolith at the place of incision. Renal pelvic lumen is distended with accumulating urine. Renal parenchyma is substantially thinned out. What is the most correct diagnosis?  

6. A 2 year old child was diagnosed with thymic hypoplasia. What indicator of the immune system status is the most characteristic of this type of immunodeficiency?

7. A bacteriologist found in a sick child the causative agents of Flexner dysentery type 2, Sonne Dysentery type 1, and enteropathogenic colibacillus - 055/B5. Name this type of infection:

8. Autopsy of the body revealed a large  wedge-shaped patch of a dense dark red tissue with clear margins in the upper lobe of the right lung. Histological examination detected there necrosis of the alveolar walls; the alveolar lumen is tightly packed with erythrocytes. What process occurred in the lungs?

9. Regional lymph nodes surrounding an infected wound are enlarged. Histological examination show increased number of macrophages, lymphocytes and lymphatic follicles in the cortical layer of the lymph nodes, as well as a large amount of plasma cells. What process i the lymph node is indicated by these histological changes?

10. After a domestic trauma, a 34-year old man has limited flexion of the middle phalanges of his fingers 2-5, which results in the overall limited mobility of the fingers. What muscles are likely to be  functionally impaired in this case?

11. An inguinal hernia was found in a patient. During herniotomy, a reinforcement of the anterior wall of the inguinal canal is necessary. What anatomical structures of the anterior abdominal wall are used for reinforcement in this case?

12. T lymphocyte were affected by HIV. In the process, viral enzyme reverse transcriptase (RNA- dependent DNA-polymerase) catalyzes the synthesis of:

13. An electronic microphotograph shows a fragment of the renal corpuscle. In the photograph, there is  a large epithelial cell with numerous appendages. The appendages are attached to the basement membrane of the capillaries. What type of cell is it?

14.  

Proliferation of connective tissue in the liver parenchyma (fibrosis) that results from chronic disorders causes a blood flow disturbance in the classical hepatic lobules. Describe the blood flow direction in these lobules: 

15. After a spinal trauma the patient has lost proprioceptive sensitivity in the lower half of the body and in the lower limbs. What sensory conduction pathway was likely damaged, leading to the loss of sensitivity?

16.  

A 45-year-old woman has breast cancer. Metastases can spread in this case to the following regional lymph nodes:

17. A test animal receives electrical impulses that irritate the sympathetic nerve that innervates blood vessels of the skin. What reaction will it cause in the blood vessels?

18.

In an experiment, a frog neuromuscular preparation had been processed with a curare-like substance, which led to the disappearance of muscle contractions in response to electrical stimulation. What function of the muscle cell membrane is disrupted by curare-like substances?

19. Body fluids, especially urine, of a sick child produce a specific sweet odor. It is associated with the disturbed metabolism of such amino acids as leucine, isoleucine, and valine. What diagnosis will be made by the doctor in this case?

20. Examination showed that total leukocyte count in the patient’s blood is 11 • 109/L, with 80% neutrophils, among which 9% are band neutrophils. Characterize the changes in the cell composition of ’’white” blood in this case:

21. The mountain climbers, who without oxygen equipment were climbing a mountain, at the altitude of 5000 meters above the sea level developed tachycardia, low blood pressure, fast respiration rate. What type of hypoxia did they develop?

22. A patient has heart rhythm disturbances. To restore the rhythm, the doctor prescribed the patient calcium antagonists. What effect do calcium ions have on the myocardium?

23. In the process of acetylcholine interaction with muscarinic acetylcholine receptors of contractile cardiomyocytes, a bioactive substance is being produced. This bioactive substance leads to inactivation of calcium channels, decrease of calcium ions entry into the cardiomyocytes, and development of negative inotropic effect. Name this substance:

24. A young woman suddenly developed cough and bronchial spasm, when she entered into a room with high concentration of tobacco smoke. What receptors activated this defensive reflex?

25. Human skin has very high tensile strength. It is known that the skin consists of epithelial tissue and two kinds of connective tissue. Which of the following tissues is providing the skin strength

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

27. Against the background of prolonged heparin treatment, the man developed gastric bleeding. What specific heparin antidote have to be used in this case?

28. During cholecystectomy besides a. cystyca another artery was pulled into the ligature. Ligation of this artery resulted in right-sided necrosis of the liver, which has led to the death of the patient. What artery was mistakenly ligated along with a. cystyca

29. A histological specimen demonstrates a vessel with the wall, which consists of endothelium, basement membrane, and loose connective tissue. This vessel belongs to the following type:

30. A man presents with increased thickness of alveolar-capillary membrane caused by a pathologic process. The direct consequence will be the reduction of the following value:

31. A patient is complaining of acute increase in diuresis (up to 5-7 liters of urine per 24 hours). Examination has revealed decreased secretion of vasopressin in this patient. What cells have insufficient secretory activity in this case

32. A patient with signs of intestinal infection (vomiting, diarrhea, abdominal pain) has been presenting with increasing signs of intoxication for three days. Papular rash appeared on the uncovered skin areas and spread to the torso. A doctor is suspecting pseudotuberculosis. What laboratory test allows confirming this diagnosis within the first week after the onset of disease?

33. A 45-year-old woman is suffering from arterial hypertension with high blood concentration of angiotensin II. What antihypertensive drug is the most recommended in the given case

34. A shepherd, who tended to the flock of sheep with his dogs, gradually developed pain in the chest and bloody expectorations. X-ray has revealed spheric helminth larvae in the patient’s lungs. Specify the helminth that might be the causative agent of this disease:

35. Due to the destruction of certain structures of the brainstem an animal has lost its orientation reflexes in response to strong light stimuli. What structures were destroyed?

36. A 30-year-old man with an incised wound on the plantar surface of the left foot was brought to the traumatology department. Lifting of the lateral side of the foot is limited. What muscle is likely to be functionally disturbed?

37. Some diseases of large intestine lead to the changes in the quantitative ratio between mucosal epithelial cells. What cell types are normally predominant in the cryptal epithelium of the large intestine?

38. On examination the patient was determined to have a strong, balanced, inert type of higher nervous activity according to Pavlov’s classification. What temperament according to Hippocrates is it?

39. Systemic blood pressure of a person equals 120/65 mm Hg. Blood ejection into aorta occurs when left ventricular pressure exceeds:

40. An experiment was conducted to measure the skin sensitivity threshold. What patches of skin have the highest sensitivity threshold?

41. Human genetic apparatus consists of approximately 30 thousand of genes, while the number of antibody variants can be as high as millions. What mechanism leads to formation of new genes that ensure the synthesis of such a number of antibodies?

42. 24 hours after an appendectomy the patient’s blood test shows neutrophilic leukocytosis with a regenerative shift. What is the most likely mechanism of absolute leukocytosis development in the patient’s peripheral blood?

43. Hematologic study shows the following pattern: erythrocytes - 2, 8 · 1012/L, Нb - 80 g/L, color index - 0.85, reticulocytes - 0,1%, platelets - 160 thousand per microliter, leukocytes - 60 · 109/L. Basocytes - 2%, eosinophils - 8%, promyelocytes - 5%, myelocytes - 5%, juvenile - 16%, stab neutrophils - 20%, segmented neutrophils - 34%, lymphocytes - 5%, monocytes - 5%. This clinical presentation indicates the following blood pathology:

44. Autopsy of a 58-year-old man, who for a long time has been drinking alcohol in large amounts and died at home, is being conducted. Macroscopically the right lung is dense and enlarged, its tissue is gray and homogeneous on section, its pleura is covered with grayish membranous deposits. Microscopically the alveolar cavities contain fibrin threads, neutrophils, and hemolysed erythrocytes. Make the diagnosis:

45. To test donor blood for hepatitis B antigens, it is necessary to use highly sensitive detection methods. What test should be used for this purpose?

46. Pathologic material (mucosal excretion from the nasal passages) obtained from a patient provisionally diagnosed with influenza was sent to the virological laboratory. What quick test allows detecting specific viral antigen in the investigated material?

47. A patient has been taking bisacodyl for a long time to treat chronic constipation. However, several weeks later the aperient effect of the drug diminished. What is the possible cause of this?

48. A 45-year-old woman has an attack of cardiac fibrillation. She suffers from stage II essential hypertension. What is the drug of choice for stopping this attack?

49. Before a surgery the patient was prescribed a synthetic antiprotozoal drug for prevention of wound infection. The prescribed drug is highly effective against Helicobacter pylori. Name this drug:

50. A histological specimen shows significant amount of mucous connective tissue (Wharton’s jelly), vessels, as well as remnants of yolk sac stalk and allantois. Name this organ: