Крок 1 · Медицина 2014 · Англійська

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01

The infectious diseases department of a hospital admitted a patient with nausea, liquid stool with mucus and blood streaks, fever, weakness. Dysentery was suspected. What method of laboratory diagnostics should be applied to confirm the diagnosis?

A Mycological
B Microscopic
C Serological
D Bacteriological
E Protozoological
02

Malaria is treated with structural analogs of vitamin B2 (riboflavin). These drugs disrupt the synthesis of the following enzymes in plasmodium:

A FAD-dependent dehydrogenase
B Cytochrome oxidase
C Aminotransferase
D NAD-dependent dehydrogenase
E Peptidase
03

A 6-year-old child with suspected active tuberculous process underwent the diagnostic Mantoux test. What immunobiological preparation was injected?

A Tuberculin
B DTP vaccine
C Tularinum
D Td vaccine
E BCG vaccine
04

In a young man during exercise, the minute oxygen uptake and carbon dioxide emission equalled to 1000 ml. What substrates are oxidized in the cells of his body?

A Carbohydrates and fats
B Fats
C Carbohydrates and proteins
D Carbohydrates
E Proteins
05

A sportsman spontaneously held breath for 40 seconds, which resulted in an increase in heart rate and systemic arterial pressure. Changes of these indicators are due to activation of the following regulatory mechanisms:

A Unconditioned sympathetic reflexes
B Conditioned sympathetic reflexes
C -
D Unconditioned parasympathetic reflexes
E Conditioned parasympathetic reflexes
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06

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:

A Hemoglobin
B Fibrinogen
C Collagen
D Albumin
E Keratin
07

A patient has hoarseness of voice. During laryngoscopy a gray-white larynx tumor with papillary surface has been detected. Microscopic investigation has shown the following: growth of connective tissue covered with multilayer, strongly keratinized pavement epithelium, no cellular atypia. What is the most likely diagnosis?

A Papilloma
B Angiofibroma
C Polyp
D Fibroma
E Angioma
08

During autopsy approximately 2,0 liters of pus have been found in the abdominal cavity of the corpse. Peritoneum is lustreless and has grayish shade, serous tunic of intestines has grayishcolored coating that is easily removable. Specify the most likely type of peritonitis in the patient:

A Fibrinopurulent peritonitis
B -
C Hemorrhagic peritonitis
D Serous peritonitis
E Tuberculous peritonitis
09

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?

A Chronic lymphocytic leukemia
B Chronic myelogenous leukemia
C Hodgkin’s disease
D Polycythemia vera
E Multiple myeloma
10

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?

A Myocarditis
B Cardiosclerosis
C Myocardial infarction
D Cardiomyopathy
E Amyloidosis
11

An animal experiment is aimed at studying the cardiac cycle. All the heart valves are closed. What phase of the cycle is characterized by this status?

A Isometric contraction
B Protodiastolic period
C Rapid filling
D Reduced filling
E Asynchronous contraction
12

Cyanide is a poison that causes instant death of the organism. What enzymes found in mitochondria are affected by cyanide?

A Cytochrome P-450
B Cytochrome B5
C Cytochrome oxidase (aa3)
D NAD+-dependent dehydrogenase
E Flavin enzymes
13

Increased HDL levels decrease the risk of atherosclerosis. What is the mechanism of HDL antiatherogenic action?

A They remove cholesterol from tissues
B They activate the conversion of cholesterol to bile acids
C They promote absorption of cholesterol in the intestine
D They supply tissues with cholesterol
E They are involved in the breakdown of cholesterol
14

It has been found out that one of a pesticide components is sodium arsenate that blocks lipoic acid. Which enzyme activity is impaired by this pesticide?

A Glutathione peroxidase
B Glutathione reductase
C Methemoglobin reductase
D Microsomal oxidation
E Pyruvate dehydrogenase complex
15

Stool culture test revealed in a 6-month-old bottle-fed baby the strain of intestinal rod-shaped bacteria of antigen structure 0-111. What diagnosis can be made?

A Choleriform disease
B Food poisoning
C Colienteritis
D Gastroenteritis
E Dysentery-like disease
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16

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:

A Turner’s
B Trisomy X
C Klinefelter’s
D Edwards’
E Down’s
17

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:

A Phosphatidic acid
B Tristearin
C Phosphatidylcholine
D Urea
E Cholic acid
18

Ascarid eggs have been detected during stool analysis. What drug should be prescribed?

A Nystatin
B Furazolidone
C Mebendazole
D Tetracycline
E Chloramphenicol
19

Bacteriological examination of the urine of the patient with pyelonephritis revealed microorganisms that produced yellow-green pigment and a characteristic odor in meatpeptone agar. What are they called?

A Pseudomonas
B Azotobacter
C Escherichia
D Klebsiella
E Proteas
20

Feces of a patient contain high amount of undissociated fats and have grayish-white color. Specify the cause of this phenomenon:

A Enteritis
B Irritation of intestinal epithelium
C Hypovitaminosis
D Hypoactivation of pepsin by hydrochloric acid
E Obturation of bile duct
21

A 46-year-old female patient consulted a doctor about pain in the small joints of the upper and lower limbs. The joints are enlarged and shaped like thickened nodes. Serum test revealed an increase in urate concentration. This might be caused by a disorder in metabolism of:

A Amino acids
B Pyrimidines
C Carbohydrates
D Purines
E Lipids
22

A 26-year-old female consulted a doctor about having stool with white flat moving organisms resembling noodles. Laboratory analysis revealed proglottids with the following characteristics: long, narrow, with a longitudinal channel of the uterus with 17-35 lateral branches on each side. What kind of intestinal parasite was found?

A Echinococcus granulosus
B Hymenolepis nana
C Diphyllobothrium latum
D Taenia solium
E Taeniarhynchus saginatus
23

A male patient is 28 years old. Histological study of a cervical lymph node revealed a change of its pattern due to the proliferation of epithelioid, lymphoid cells and macrophages havi- ng nuclei in form of a horseshoe. In the center of some cell clusters there were non-structured light-pink areas with fragments of nuclei. What disease are these changes typical for?

A Tuberculosis
B Hodgkin’s disease
C Syphilis
D Tumor metastasis
E Actinomycosis
24

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:

A Hippuric acid
B Porphyrin
C Urea
D Creatinine
E Creatine
25

While examining foot blood supply a doctor checks the pulsation of a large artery running in the separate fibrous channel in front of articulatio talocruralis between the tendons of long extensor muscles of hallux and toes. What artery is it?

A A. dorsalis pedis
B A. tarsea lateralis
C A. tibialis anterior
D A. tarsea medialis
E A. fibularis
26

A patient with chronic heart failure with edema has increased level of blood aldosterone. What diuretic would be most effective in this case?

A Spironolactone
B Hydrochlorothiazide
C Acetazolamide
D Furosemide
E Triamterene
27

During autopsy the following has been revealed: the meninges of the upper cerebral hemispheres are extremely plethoric, of yellow-green color and are soaked with purulent effluent. What kind of meningitis is characterised by such clinical presentations?

A Tuberculous meningitis
B Meningococcal meningitis
C Grippal meningitis
D Epidemic typhus-induced
E Anthrax-induced
28

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:

A Hyperfunction of the adrenal cortex
B Hypofunction of the medulla
C Primary aldosteronism
D Hyperfunction of the medulla
E Hypofunction of the adrenal cortex
29

A comminuted fracture of infraglenoid tubercle caused by shoulder joint injury has been detected during X-ray examination of a patient. What muscle tendon attached at this site has been damaged?

A Medial head of m. triceps brachii
B Short head of m. biceps brachii
C Long head of m. biceps brachii
D Lateral head of m. triceps brachii
E Long head of m. triceps brachii
30

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

A Expiratory reserve volume
B Diffusing lung capacity
C Respiratory minute volume
D Alveolar ventilation of lungs
E Oxygen capacity of blood
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31

What drug will be most appropriate for the patient who has chronic gastritis with increased secretion?

A Pirenzepine
B Pancreatine
C Pepsin
D Chlorphentermine
E Aprotinin
32

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:

A Vacuolar degeneration
B Proliferative inflammation
C Traumatic edema
D Exudative inflammation
E Alternative inflammation
33

A 42-year-old male with a lesion of the ulnar nerve is unable to flex the II and V fingers to the midline. Which muscle function is impaired in this case?

A Palmar interosseous muscles
B Dorsal interosseous muscle
C Short palmar muscle
D Abductor muscle of little finger
E Fidicinales
34

A smear from the tonsillar coating of a patient with suspected diphtheria was found to contain blue bacilli with a thickening at the poles. What method of smear staining was used?

A Burri
B Leffler
C Hins
D Neisser
E Gram
35

A child was born asphyxiated. What drug must be administered to the newborn to stimulate breathing?

A Lobeline
B Aethimizolum
C Atropine
D Prazosin
E Proserine
36

A 40-year-old patient with the progressing staphylococcal purulent periodontitis developed purulent inflammation of bone marrow spaces of the alveolar process, and then of the body of mandible. Microscopy revealed thinning of bone trabeculae, foci of necrosis, bone sequesters surrounded by the connective tissue capsule. What is the most likely diagnosis?

A Acute osteomyelitis
B Parodontome
C Chronic osteomyelitis
D Chronic fibrous periostitis
E Purulent abscess
37

Human red blood cells do not contain mitochondria. What is the main pathway for ATP production in these cells?

A Cyclase reaction
B Oxidative phosphorylation
C Anaerobic glycolysis
D Aerobic glycolysis
E Creatine kinase reaction
38

A 40-year-old female patient has undergone thyroidectomy. Histological study of thyroid gland found the follicles to be of different size and contain foamy colloid, follicle epithelium is high and forms papillae, there is focal lymphocytic infiltration in stroma. Diagnose the thyroid gland disease:

A Nodular goiter
B Hashimoto’s thyroiditis
C Riedel’s thyroiditis
D Basedow’s disease
E De Quervain’s disease
39

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:

A Hyperkinetic
B -
C Eukinetic
D Combined
E Hypokinetic
40

A patient has been hospitalised with provisional diagnosis of virus B hepatitis. Serological reaction based on complementation of antigen with antibody chemically bound to peroxidase or alkaline phosphatase has been used for disease diagnostics. What is the name of the applied serological reaction?

A Bordet-Gengou test
B Antigen-binding assay
C Radioimmunoassay technique
D Immunofluorescence test
E Immune-enzyme analysis
41

A patient has been hospitalised with provisional diagnosis of botulism. What serological reaction should be used to reveal botulinum toxin?

A Bordet-Gengou test
B Immunofluorescence test
C Agglutination reaction
D Neutralization reaction
E Precipitation reaction
42

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?

A Hereditary hemolytic
B Chronic hemorrhagic
C Anemia due to diminished erythropoiesis
D Acquired hemolytic
E Acute hemorrhagic
43

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:

A -
B Heat conduction
C Convection
D Evaporation
E Heat radiation
44

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

A Hydrostatic primary urine pressure in capsule
B Hydrostatic blood pressure in glomerular capillaries
C Renal filter permeability
D Oncotic pressure of blood plasma
E Effective filter pressure
45

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?

A Antigen structure
B Amount of released antigen
C Development of tissue lesion
D Routes by which antigens are delivered into the body
E Hereditary predisposition
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46

After a craniocerebral injury a patient is unable to recognize objects by touch. What part of brain has been damaged?

A Temporal lobe
B Cerebellum
C Occipital lobe
D Precentral gyrus
E Postcentral gyrus
47

A patient complaining of rapid pulse, dyspnea and bluish color of mucosa has been admitted to the cardiological department. The objective symptoms are as follows: edema of lower extremities, ascites. Which of the given medicines should be prescribed for intravenous administration to improve the patient’s general state?

A Cordiamin
B Digitoxin
C Drotaverine
D Adrenalin hydrochloride
E Corglyconum
48

As a result of a continuous chronic encephalopathy, a patient has developed spontaneous motions and a disorder of torso muscle tone. These are the symptoms of the disorder of the following conduction tract:

A Tractus corticospinalis
B Tractus spinothalamicus
C Tractus rubrospinalis
D Tractus tectospinalis
E Tractus corticonuclearis
49

A 10-year-old child has painful swallowing, neck edema, temperature rise up to 39,0oC, the whole body is covered with bright-red petechial rash. Back of the throat and tonsils are hyperemic, the tongue is crimson- colored. Tonsillar surface is covered with isolated grayishcolored necrosis nidi. What disease is it?

A Diphtheria
B Influenza
C Measles
D Scarlet fever
E Meningococcal nasopharyngitis
50

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:

A Febris reccurens
B Febris hectica
C Febris remitens
D Febris internuttens
E Febris continua
51

As a result of a craniocerebral injury, a patient has a decreased skin sensitivity. What area of the cerebral cortex is likely to be damaged?

A Frontal cortex
B Cingulate gyrus
C Anterior central gyrus
D Occipital region
E Posterior central gyrus
52

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?

A Obstruction of nephron tubules with hyaline casts
B Reduction of active nephron mass
C Arteriolar spasm
D Decrease in systemic arterial pressure
E Tissue acidosis
53

A 40-year-old patient has ulcer perforation in the posterior wall of stomach. What anatomical structure will blood and stomach content leak to?

A Bursa praegastrica
B Bursa omentalis
C Left lateral channel (canalis lateralis sinister)
D Bursa hepatica
E Right lateral channel (canalis lateralis dexter)
54

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:

A Thrombin formation
B Clot retraction
C -
D Thromboplastin formation
E Fibrin formation
55

Angiocardiography of a 60-year-old male patient revealed constriction of a vessel located in the left coronary sulcus of the heart. What is the pathological vessel called?

A V. cordis parva
B A. coronaria dextra
C Ramus interventricularis anterior
D Ramus circumflexus
E Ramus interventricularis posterior
56

Those organisms which in the process of evolution failed to develop protection from H2O2 can exist only in anaerobic conditions. Which of the following enzymes can break hydrogen peroxide down?

A Peroxidase and catalase
B Oxygenase and catalase
C Flavin-dependent oxidase
D Oxygenase and hydroxylase
E Cytochrome oxidase, cytochrome B5
57

A patient complains of pain in the right lateral abdomen. Palpation revealed a dense, immobile, tumorlike formation. A tumor is likely to be found in the following part of the digestive tube:

A Colon descendens
B Colon ascendens
C Caecum
D Colon transversum
E Colon sigmoideum
58

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?

A Epicritic
B Visceral
C Radiating
D Phantom
E Protopathic
59

A patient has a critical impairment of protein, fat and hydrocarbon digestion. Most likely it has been caused by low secretion of the following digestive juice:

A Intestinal juice
B Gastric juice
C Saliva
D Pancreatic juice
E Bile
60

A female patient has facial neuritis that has caused mimetic paralysis and hearing impairment. Hearing impairment results from the paralysis of the following muscle:

A Posterior auricular muscle
B Anterior auricular muscle
C Nasal muscle
D Stapedius muscle
E Superior auricular muscle
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61

A 22-year-old female student consulted a physician about fever up to 38oC, weakness, sore throat. Objectively: there is white coating of the tongue. What histological structures of the tongue are involved in the formation of this coating?

A Epithelium of the fungiform papillae
B Epithelium of the circumvallate papillae
C Connective-tissue base of all the lingual papillae
D Epithelium of the foliate papillae
E Epithelium of the filiform papillae
62

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

A Expiratory reserve volume
B Respiratory volume
C Residual volume
D Inspiratory reserve volume
E Functional residual lung capacity
63

The receptors under study provide transfer of information to the cortex without thalamic involvement. Specify these receptors:

A Olfactory
B Tactile
C Gustatory
D Visual
E Auditory
64

Prolonged fasting causes hypoglycemia which is amplified by alcohol consumption, as the following process is inhibited:

A Glycolysis
B Glycogenolysis
C Lipolysis
D Proteolysis
E Gluconeogenesis
65

A 39-year-old female patient with a history of diabetes was hospitalized in a precomatose state for diabetic ketoacidosis. This condition had been caused by an increase in the following metabolite level:

A Acetoacetate
B Citrate
C Aspartate
D Alpha-ketoglutarate
E Malonate
66

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:

A Metaplastic anemia
B Minkowsky-Shauffard disease
C Iron-deficiency anemia
D Iron refractory anemia
E Hypoplastic anemia
67

During an animal experiment, surgical damage of certain brain structures has caused deep prolonged sleep. What structure is most likely to cause such condition, if damaged?

A Hippocampus
B Reticular formation
C Basal ganglion
D Red nuclei
E Cerebral cortex
68

A patient takes cholagogues. What other process besides biliary excretion will be stimulated?

A Water absorption
B Pancreatic juice secretion
C Gastric motor activity
D Gastric juice secretion
E Intestinal motility
69

A 3-year-old child with meningeal symptoms died. Postmortem macroscopy of the pia matter revealed miliary nodules which were microscopically represented by a focus of caseous necrosis with masses of epithelioid and lymphoid cells with some crescent-shaped large cells inbetween having peripheral nuclei. Specify the type of meningitis in the child:

A Syphilitic
B Meningococcal
C Grippal
D Brucellar
E Tuberculous
70

A patient with homogentisuria has signs of arthritis, ochronosis. In this case, the pain in the joints is associated with the deposition of:

A Phosphates
B Oxalates
C Homogentisates
D Urates
E Carbonates
71

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:

A Argininosuccinate
B Carbamoyl phosphate
C Ornithine
D Citrulline
E Urea
72

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

A Turner’s syndrome
B Down’s syndrome
C Patau syndrome
D Klinefelter syndrome
E Trisomy X
73

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?

A Immunoglobulin
B Hemoplexin, haptoglobin
C Ceruloplasmin, transferrin
D Cryoglobulin, interferon
E «2-macroglobulin, ai-antitrypsin
74

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?

A Increasing arterial pressure
B Decreasing venous return
C Decreasing oncotic pressure of blood plasma
D Increasing venous return
E Increasing central venous pressure
75

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?

A Chronic colitis
B Chronic gastritis
C Hemolytic jaundice
D Cholelithiasis
E Hepatitis
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76

A child patient has dry cough. What non-narcotic antitussive drug will relieve the patient’s condition?

A Codeine phosphate
B Althaea officinalis root extract
C Potassium iodide
D Morphine hydrochloride
E Glaucine hydrochloride
77

A patient complains of acute pain attacks in the right lumbar region. During examination the nephrolithic obturation of the right ureter in the region between its abdominal and pelvic segments has been detected. What anatomical boundary exists between those two segments?

A Linea arcuata
B Linea transversa
C Linea terminalis
D Linea semilunaris
E Linea inguinalis
78

When measuring total muscle action potential it was revealed that it was subject to the powerlaw relationship. The reason for this is that individual muscle fibers differ in:

A Diameter
B Depolarization threshold
C Critical level of depolarization
D Resting potential
E Conduction velocity
79

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 greately affected by the following substance:

A Norepinephrine
B Renin
C Angiotensin II
D Catecholamines
E Angiotensinogen
80

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?

A Increased iron assimilation by body
B -
C Disorder of iron absorption in bowels
D Excessive iron intake with food
E Failure to assimilate iron leading to iron accumulation in tissues
81

In a village, a case of anthrax had been registered. Medical services began epidemiologically indicated specific prophylaxis of population against anthrax. What preparation was used for this purpose?

A Chemical vaccine
B Live vaccine
C Inactivated vaccine
D Anatoxin
E Genetically engineered vaccine
82

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

A Potassium ion entry
B Potassium ion exit
C Calcium ion entry
D Calcium and potassium ion exit
E Calcium ion exit
83

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

A Increased glucose filtration
B Increased glucose secretion
C Increased activity of glucose reabsorption enzymes
D Decreased activity of glucose reabsorption enzymes
E Exceeded glucose reabsorption threshold
84

As a result of past encephalitis, a male patient has developed an increase in cerebrospinal fluid pressure in the right lateral ventricle. What can be the cause of this condition?

A Closure of left interventricular foramen
B Closure of right interventricular foramen
C Atresia of the fourth ventricle foramina
D Atresia of tubus medullaris
E Atresia of sylvian aqueduct
85

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?

A Louis-Barr syndrome
B Autosomal recessive agammaglobulinaemia (Swiss type)
C Hypoplastic anemia
D Agranulocytosis
E X-linked hypogammaglobulinemia (Bruton type agammaglobulinemia)
86

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?

A Herpetic lymphadenopathy
B Cytomegalovirus infection
C Generalized infection caused by herpes-zoster
D Burkitt’s lymphoma
E Infectious mononucleosis
87

A microslide contains the preparation of a gland composed of several secretory saccule-shaped parts that open in the common excretory duct. What gland is it?

A Compound branched alveolar gland
B Simple branched alveolar gland
C Simple branched tubular gland
D Simple unbranched alveolar gland
E Compound unbranched alveolar gland
88

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?

A Accessory ovary
B Female pseudohermaphroditism
C Ectopia of testis
D Male pseudohermaphroditism
E True hermaphroditism
89

An 18-year-old male has been diagnosed with Marfan syndrome. Examination revealed a developmental disorder of connective tissue and eye lens structure, abnormalities of the cardiovascular system, arachnodactylia. What genetic phenomenon has caused the development of this disease?

A Pleiotropy
B Multiple allelism
C Incomplete dominance
D Complementarity
E Codominance
90

In case of alkaptonuria, homogenti-sic 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:

A Asparagine
B Phenylalanine
C Alanine
D Tyrosine
E Methionine
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91

A male patient complains of skin insensitivity of inferior eyelid, external lateral surface of nose and upper lip. A doctor in the course of examination has revealed inflammation of the second branch of trigeminal nerve. What cranial foramen does this branch go through?

A Superior orbital fissure
B Oval
C Spinosum
D Supraorbital
E Lacerum
92

An patient with insomnia induced by allergic rash and itch has been prescribed the drug that has antihistamine and hypnotic effect. Specify this drug:

A Acetylsalicylic acid
B Loratadine
C Benadryl
D Prednisolone
E Analgin
93

In a cat with decerebrate rigidity the muscle tone is to be decreased. This can be achieved by:

A Stimulation of the ampullar vestibular receptors
B Stimulation of the vestibular nuclei of Deiters
C Destruction of the vestibular nuclei of Deiters
D Stimulation of the otolithic vestibular receptors
E Stimulation of the vestibulocochlear nerve
94

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

A Increase of inspiratory reserve volume
B Increase of functional residual lung capacity
C Obstructive pulmonary disease
D Increase of pulmonary residual volume
E Increase of respiratory volume
95

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:

A Axillary
B Anterior mediastinum
C Inferior mediastinum
D Sternal
E Deep lateral cervical
96

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?

A Rubella
B Measles
C Brill’s disease
D Cholera
E Typhoid fever
97

A young woman suddenly developed fever up to 39oC accompanied by a strong headache. Examination revealed marked nuchal rigidity. Spinal puncture was performed. Gram-stained smear of cerebrospinal fluid contained many neutrophils and Gram-positive diplococci. What bacteria could be the cause of this disease?

A Staphylococcus aureus
B Haemophilus influenzae
C Streptococcus pneumonia
D Pseudomonas aeruginosa
E Neisseria meningitidis
98

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:

A Somatotropin
B Thyroxin
C Cortisol
D Tropic hormones
E Thyroid hormones
99

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:

A Norepinephrine
B Acetylcholine
C Dopamine
D Myelin
E Serotonin
100

A patient with suspected tumor of lung had been admitted to the oncological department. Examination revealed localised pathology in the inferior lobe of the left lung. How many bronchopulmonary segments does this lobe have?

A 5
B 6
C 2
D 3
E 4
101

During local anesthetization the patient has gone into anaphylactic shock. What drug must be administered to the patient?

A Propranolol
B Atropine sulfate
C Diazepam
D Epinephrine hydrochloride
E Nitroglycerin
102

As a result of an injury, the integrity of the anterior spinal cord root was broken. Specify the neurons and their processes that had been damaged:

A Axons of motor neurons
B Dendrites of sensory neurons
C Dendrites of association neurons
D Axons of sensory neurons
E Motor neuron dendrites
103

A patient who had been taking diclofenac sodium for arthritis of mandibular joint developed an acute condition of gastric ulcer. Such side effect of this medicine is caused by inhibition of the following enzyme:

A Monoamine oxidase
B Phosphodiesterase
C Cyclooxygenase-2 (COX-2)
D Lipoxygenase
E Cyclooxygenase-1 (COX-1)
104

In one of Polessye regions there was an outbreak of helminthiasis manifested by cramps and facial edmata. The developed preventive measures in particular included ban for eating infested pork even after heat processing. What helminthiasis was the case?

A Teniasis
B Echinococcosis
C Trichinosis
D Alveococcosis
E Taeniarhynchosis
105

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:

A Klinefelter’s
B Turner’s
C Down’s
D Patau’s
E Edwards’
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106

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

A IV type (granulomatosis)
B II type (antibody-dependent)
C IV type (cellular cytotoxicity)
D III type (immune complex)
E I type (anaphylactic)
107

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?

A Uroporphyrinogen III cosynthase
B Uroporphyrinogen I synthase
C Delta-aminolevulinate synthase
D Uroporphyrinogen decarboxylase
E Ferrochelatase
108

During the air and bone conduction tests it was revealed that in the left ear the tones were louder by bone conduction. This might be associated with the disease of:

A Right middle ear
B Left middle ear
C Right inner ear
D Left inner ear
E Right external ear
109

In course of invasive abdominal surgery a surgeon has to locate the origin of the mesenteric root. Where is it normally localized?

A Left flexure of colon
B Sigmoid colon
C Right flexure of colon
D Duodenojejunal flexure
E Right mesenteric sinus
110

A 55-year-old male had been delivered to the resuscitation unit unconscious. Relatives reported him to have mistakenly drunk an alcoholic solution of unknown origin. On examination the patient was diagnosed with methanol intoxication. What antidote should be used in this case?

A Naloxone
B Teturamum
C Acetylcysteine
D Ethanol
E Protamine sulfate
111

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?

A Reabsorption
B Secretion
C Filtration
D Secretion and filtration
E Reabsorption and secretion
112

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?

A Th2 — Th5
B Li — L2
C Thi — Th5
D S2 - S4
E Thi — Li
113

An 8-week-pregnant woman with acute respiratory disease and temperature rise up to 39,0oC has called in a doctor. The doctor insisted on her avoiding taking paracetamol, because in this period of pregnancy there is a risk of its:

A Fetotoxicity
B Allergenicity
C Teratogenicity
D Embryotoxicity
E Hepatotoxicity
114

A pneumonia patient has been administered acetylcysteine as a part of complex therapy. What principle of therapy has been taken into consideration when applying this drug?

A Immunomodulatory
B Symptomatic
C Etiotropic
D Antimicrobial
E Pathogenetic
115

A 26-year-old female patient with bronchitis has been administered a broad spectrum antibiotic as a causal treatment drug. Specify this drug:

A Doxycycline
B Dexamethasone
C Interferon
D Ambroxol
E BCG vaccine
116

When defining blood group according to the AB0 system, using salt solutions of monoclonal antibodies, agglutination didn’t occur with any of the solutions. What blood group is it?

A A (II)
B B (III)
C -
D 0 (I)
E AB (IV)
117

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?

A Increase in low-density lipoprotein level
B Albuminosis
C Increase in the oncotic pressure in the blood plasma
D Decrease in the concentration of amino acids in blood
E Increased proteolysis
118

Symptoms of pellagra (vitamin PP deficiency) is particularly pronounced in patients with low protein diet, because nicotinamide precursor in humans is one of the essential amino acids, namely:

A Lysine
B Threonine
C Tryptophan
D Histidine
E Arginine
119

A 68-year-old patient consults a cardiologist, complaining of high arterial blood pressure, pain in the heart egion, intermittent pulse. Prescribe the (3\ -adrenoreceptor blocker for the treatment of the described pathology:

A Metoprolol
B Nootropil
C Fenoterol
D Benzylpenicillin
E Morphine hydrochloride
120

A female suffered rubella during pregnancy. The child was born with developmental abnormalities, namely cleft lip and palate. The child’s genotype is normal. These malformations are a manifestation of:

A Combinative variability
B Aneuploidy
C Chromosomal mutation
D Modification variability
E Polyploidy
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121

An electron micrograph shows a cell-to-cell adhesion consisting, in each cell, of an attachment plaque. The intercellular space is filled with electron-dense substance including transmembrane fibrillar structures. Specify this adhesion:

A Tight junction
B Adherens junction
C Synapse
D Desmosome
E Nexus
122

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?

A LDH1 lactate dehydrogenase isoenzyme
B Creatine kinase isoenzyme CK-MM
C Creatine kinase isoenzyme CK-MB
D LDH2 lactate dehydrogenase isoenzyme
E Aspartate aminotransferase cytoplasmic isoenzyme
123

A patient complains of pain in the heart area during acute attack of gastric ulcer. What vegetative reflex can cause this painful feeling?

A Viscerovisceral reflex
B Dermatovisceral reflex
C Motor-visceral reflex
D Visceromotor reflex
E Viscerodermal reflex
124

A patient is diagnosed with acute morphine hydrochloride intoxication. Prescribe an oxidizing agent for gastric lavage:

A Sulfocamphocainum (Procaine + Sulfocamphoric acid)
B Chlorhexidine (bi)gluconate
C Chloramine
D Potassium permanganate
E Cerigel
125

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?

A Immune rejection
B Ischemic kidney failure
C Tubular necrosis
D Glomerulonephritis
E Pyelonephritis
126

During cell division, DNA replication occurs by a signal from the cytoplasm, and a certain portion of the DNA helix unwinds and splits into two individual strains. What enzyme facilitates this process?

A Restrictase
B RNA polymerase
C DNA polymerase
D Ligase
E Helicase
127

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?

A Stretch receptors of lungs
B Juxtacapillary (J) receptors
C Thermoreceptors
D Irritant receptors
E Proprioceptors of respiratory muscles
128

Since a patient has had myocardial infarction, his atria and ventricles contract independently from each other with a frequency of 60-70 and 3540 per minute. Specify the type of heart block in this case:

A Sino-atrial
B Partial atrioventricular
C Intra-atrial
D Intraventricular
E Complete atrioventricular
129

A 35-year-old female patient has been hospitalised with acute intoxication caused by salts of high-density metals (lead, most probably). As a part of complex therapy the antidote that contains two active sulfhydric groups has been prescribed. Specify this antidote:

A Mannitol
B Metamizole
C Calcium chloride
D Nalorphine hydrochloride
E Dimercaprol
130

A 60-year-old male patient has type II diabetes. A doctor has prescribed him synthetic hypoglycemic long-acting drug that is sulfonylurea derivative. What drug is it?

A Butamide
B Acarbose
C Actrapid (soluble insulin)
D Glibenclamide
E Metformin
131

A patient has been given atropine sulfate for rapid relief of spastic colon symptoms. The use of this drug is contraindicated during the followng disease:

A Glaucoma
B Bronchial asthma
C Bradycardia
D Hypotension
E Gastric ulcer
132

As an example of specific human parasites one can name Plasmodium falciparum, human pinworm and some others. The source of parasite invasion is always a human. Such specific human parasites cause the diseases that are called:

A Anthroponoses
B Zoonoses
C Multifactorial diseases
D Infections
E Anthropozoonoses
133

In an experiment a dog had been conditioned to salivate at the sight of food and a flash of light. After conditioning the reflex, the light was then paired with the bell. The dog didn’t start to salivate. What type of inhibition was observed?

A Persistent
B Extinctive
C Differential
D Protective
E External
134

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:

A Conversion of homocysteine to methionine
B Hydroxylation of proline
C Production of gamma-carboxyglutamate
D Degradation of glutathione
E Conversion of methylmalonyl CoA to succinyl CoA
135

A 63-year-old male patient with bladder atony had been prescribed a medication, which he had been arbitrarily taking at a higher dose. The patient developed hypehydration, salivation, diarrhea, muscle spasms. The prescribed drug relates to the following group:

A Adrenergc blockers
B Ganglionic blockers
C Cholinesterase reactivators
D Cholinomimetics
E Tocolytics
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136

A 67-year-old male patient consumes eggs, pork fat, butter, milk and meat. Blood test results: cholesterol - 12,3 mmol/l, total lipids - 8,2 g/l, increased low-density lipoprotein fraction (LDL). What type of hyperlipoproteinemia is observed in the patient?

A Hyperlipoproteinemia type IIa
B Hyperlipoproteinemia type IIb
C Hyperlipoproteinemia type I
D Cholesterol, hyperlipoproteinemia
E Hyperlipoproteinemia type IV
137

Tissue sampling of a 37-year-old male patient with chronic renal disease has revealed the following: sclerosis, lymphocytic and plasmocytic infiltration of renal pelvis and calices walls, dystrophy and atrophy of tubules. Remaining tubules are enlarged and stretched with colloid masses, epithelium is flattened out ('scutiform' or 'shield-shaped' kidney). What is the most likely diagnosis?

A Glomerulonephritis
B Chronic pyelonephritis
C Nephrosclerosis
D Acute pyelonephritis
E Tubular interstitial nephritis
138

During the hystological study of cortical shaft, basophilic cells with developed synthesis organelles can be seen on the bone surface under the layer of fibers. These cells take part in bone tissue regeneration. What shaft layer are they located in?

A Bone
B Periosteum
C Osteon layer
D Outer lamellae of compact bone tissue
E Inner lamellae of compact bone tissue
139

Autopsy of a 50-year-old male who had tuberculosis revealed a dense gray-white nidus in form of a nodule 2 cm in diameter in the subpleural portion of the upper right lobe. The pleura in this region was thickened, in the pleural cavity there was a small amount of serous hemorrhagic fluid. Histological study of the region revealed some glandular structures with signs of cellular atypia and abnormal mitoses, which were found within the fibrous connective tissue. What other pathology had developed in the lungs?

A Fibroma
B Fibrosarcoma
C Squamous cell carcinoma
D Adenoma
E Adenocarcinoma
140

In course of an experiment there has been an increase in the nerve conduction velocity. This may be caused by an increase in the concentration of the following ions that are present in the solution around the cell:

A Na+
B Ca2+
C K+ and ClC. K + and Na+
D Ca2+ and Cl
141

Hepatitis B is diagnosed through laboratory tests that determine the presence of HBA-DNA in blood serum of the patient. What reference method is applied for this purpose?

A Hybridization method
B Hybridization signal amplification method
C Polymerase chain reaction
D Ligase chain reaction method
E ELISA diagnostic method
142

On the 24th day since the onset of disease, a male patient diagnosed with typhoid fever and undergoing treatment in an infectious diseases hospital has suddenly developed clinical presentations of acute abdomen leading to the death of the patient. During autopsy peritonitis has been revealed, with numerous ulcers covering the colon mucosa and reaching as deep as muscular and, in places, serous tunic. The ulcers have smooth edges and even floor. The intestinal wall is perforated. What stage of typhoid fever has the lethal complication arisen at?

A Regeneration
B Medullary swelling
C Clean ulcer
D Dirty ulcer
E Necrosis
143

An HIV-positive patient’s cause of death is acute pulmonary insufficiency resulting from pneumonia. Pathohistological investigation of lungs has revealed interstitial pneumonia, alveolocyte desquamation and their methamorphoses: alveolocyte enlargement, large intranuclear inclusions surrounded by lightly-colored areas. Transformed cells resemble owl’s eye. Name the pneumonia causative agent:

A Influenza virus
B Pneumococcus
C Candida fungi
D Cytomegalovirus
E Toxoplasma
144

The organisms to be identified have a nucleus surrounded by a nuclear membrane. Genetic material is concentrated predominantly in the chromosomes which consist of DNA strands and protein molecules. These cells divide mitotically. Identify these organisms:

A Viruses
B Bacteriophages
C Bacteria
D Eukaryotes
E Prokaryotes
145

A 37-year-old male patient developed pseudoarthrosis after a closed fracture of the femur. Specify the type of regeneration in the patient:

A Pathological hypo-regeneration
B -
C Pathological hyper-regeneration
D Physiological
E Reparative
146

Nucleolar organizers of the 13-15, 21, 22 human chromosomes contain about 200 cluster genes that synthesize RNA. These regions of chromosomes bear the information on the following type of RNA:

A tRNA
B snRNA
C tRNA + rRNA
D rRNA
E mRNA
147

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?

A Hypoxic
B Cardiovascular
C Tissue
D Hemic
E Respiratory
148

Steatosis is caused by the accumulation of triacylglycerols in hepatocytes. One of the mechanisms of this disease development is a decrease in the utilization of VLDL neutral fat. What lipotropics prevent the development of steatosis?

A Alanine, B1, PP
B Isoleucine, B1, B2
C Arginine, ^ B3
D Methionine, B6, B12
E Valine, B3, B2
149

A 2-year-old boy is diagnosed with Down syndrome. What chromosomal changes may be the cause of this disease?

A Trisomy 21
B Trisomy 18
C Monosomy X
D Trisomy 13
E Trisomy X
150

A patient who has recently arrived from an endemic area presents with elevated body temperature, headache, chills, malaise, that is with the symptoms which are typical for a common cold. What laboratory tests are necessary to prove or to disprove the diagnosis of malaria?

A Microscopy of blood smears
B Microscopy of bone marrow punctate
C Study of cerebrospinal fluid
D Study of lymph node punctate
E Urinalysis
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151

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

A Hyperosmolar
B Hyposmolar
C -
D Iso-osmolar
E Normosmolar
152

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?

A Delayed-type hypersensitivity
B Anaphylactic
C Stimulating
D Immune complex
E Cytotoxic
153

Decarboxylation of glutamate induces production of gamma- aminobutyric acid (GABA ) neurotransmitter. After breakdown, GABA is converted into a metabolite of the citric acid cycle, that is:

A Succinate
B Citric acid
C Oxaloacetate
D Malate
E Fumarate
154

An outbreak of an intestinal infection occurred in a kindergarten on the eve of New Year holidays. Bacteriological examination of patients’ faeces didn’t reveal any pathogenic bacteria. Electron microscopy revealed roundish structures with clear outer edges and a thick core resembling a wheel. Specify the most likely causative agent of this infection:

A P.vulgaris
B Coxsacki-virus
C E.coli
D Rotavirus
E Adenovirus
155

A smear of streptobacillus preparation stained by Ozheshko method has been studied microscopically with oil immersion. What structural feature of the bacteria has been studied?

A Inclusions
B Spores
C Flagella
D Structure of cell wall
E Capsule
156

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?

A Torpid
B Agony
C Erectile
D Terminal
E Preshock (compensation stage)
157

Autopsy has revealed shrunken kidneys weighing 50 mg, with finegrained surface and uniformly thi- nned 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?

A Renal amyloidosis
B Acute glomerulonephritis
C Essential hypertension
D Pyelonephritis with kidney shrinkage
E Membranous nephropathy
158

A fixed-run taxi passenger has a sudden and expressed attack of tachycardia. A doctor travelling by the same taxi has managed to slow down his heart rate by pressing upon the eyeballs and thus causing the following reflex:

A Dagnini-Aschner reflex
B Bainbridge reflex
C Hering-Breuer reflex
D Holtz’s reflex
E Frank-Starling mechanism
159

Histological examination of biopsy samples taken from the thickened edges of a gastric ulcer revealed small clusters of small, markedly atypical hyperchromatic epithelial cells that were localized in the overdeveloped stroma. Specify the tumor:

A Undifferentiated sarcoma
B Medullary carcinoma
C Adenocarcinoma
D Adenoma
E Scirrhous undifferentiated carcinoma
160

A 10-year-old child was found to have a congenital hypoplasia of the left kidney. Ultrasound examination revealed that the right kidney was markedly enlarged and had regular shape. No functional disorders were revealed. Specify the process that developed in the right kidney:

A Hypertrophic growth
B Working hypertrophy
C Pseudohypertrophy
D Metaplasia
E Vicarious hypertrophy
161

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

A Phagocytosis of microorganisms and small particles
B Phagocytosis of immune complexes
C Participation in blood clotting
D Participation of heparin and histamine in metabolism
E Immunoglobulin synthesis
162

A 47-year-old male patient developed intestinal colic against the background of essential hypertension. In this situation it would be most efficient to arrest the colic by using drugs of the following group:

A M-cholinomimetics
B Sympathomimetics
C Adrenomimetics
D Myotropic antispasmodics
E Anticholinesterase agents
163

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?

A Increase of ALT, AST level
B Hyperbilirubinemia
C Urobilinuria
D Bilirubinuria
E Cholemia
164

An underage patient has signs of achondroplasia (dwarfism). It is known that this is a monogenic disease and the gene that is responsible for the development of such abnormalities is a dominant one. The development of that child’s brother is normal. Specify the genotype of the healthy child:

A aa
B AaBb
C AABB
D Aa
E AA
165

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:

A Increased respiratory rate
B Peripheral vasodilation
C Increased heat production
D Development of chill
E Increased diuresis
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166

A 35-year-old female patient has undergone biopsy of the breast nodules. Histological examination has revealed enhanced proliferation of the small duct and acini epithelial cells, accompanied by the formation of glandular structures of various shapes and sizes, which were located in the fibrous stroma. What is the most likely diagnosis?

A Invasive ductal carcinoma
B Mastitis
C Cystic breast
D Adenocarcinoma
E Fibroadenoma
167

At a bacteriological laboratory animal skins are analyzed by means of Ascoli precipitaion test. What is detected if the reaction is positive?

A Yersinia surface antigen
B Plague agent
C Anaerobic infection toxin
D Brucellosis agent
E Anthrax agent antigens
168

Examination of the duodenal contents revealed some pear-shaped protozoa with two nuclei and four pairs of flagella. The organisms had also two axostyles between the nuclei and a ventral adhesive disc. What protozoan representative was found in the patient?

A Toxoplasma
B Lamblia
C Trypanosome
D Intestinal trichomonad
E Leishmania
169

A 36-year-old female patient has a history of 52-hypovitaminosis. The most likely cause of specific symptoms (epithelial, mucosal, cutaneous, corneal lesions) is the defi- ciency of:

A Flavin coenzymes
B Cytochrome B
C Cytochrome oxidase
D Cytochrome A1
E Cytochrome C
170

A 54-year-old female was brought to the casualty department after a car accident. A traumatologist diagnosed her with multiple fractures of the lower extremities. What kind of embolism is most likely to develop in this case?

A Fat
B Air
C Tissue
D Gaseous
E Thromboembolism
171

A blood drop has been put into a test tube with 0,3% solution of NaCl. What will happen to erythrocytes?

A Shrinkage
B Mechanical haemolysis
C Osmotic haemolysis
D Biological haemolysis
E Any changes will be observed
172

There are cortical and medullary substances separated by connective tissue layer in the endocrine gland specimen. Parenchyma cells make up three zones in cortical substance, with rounded masses in the superficial zone, parallel chords in the middle one, reticular structure of cell chords in the deep one. What gland is it?

A Hypothalamus
B Thyroid gland
C Epiphysis
D Pituitary gland
E Adrenal gland
173

Histological specimen of a 10-day human embryo represents 2 contacting sacs (amniotic and yolk sacs). Specify the structure that separates the amni-otic cavity from the yolk sac:

A Extraembryonic mesoderm
B Embryonic shield
C Floor of the amniotic sac
D Roof of the yolk sac
E Amniotic stalk
174

An electron micrograph shows a cell of neural origin. The terminal portion of the cell dendrite has cylindrical shape and consists of 1000 closed membrane disks. What cell is represented by the micrograph?

A Rod receptor cell
B Spinal node neuron
C Cone receptor cell
D Neuron of the anterior horns of the spinal cord
E Neuron of the cerebral cortex
175

Disruption of nerve fiber myelinogenesis causes neurological disorders and mental retardation. These symptoms are typical for hereditary and acquired alterations in the metabolism of:

A Neutral fats
B Cholesterol
C Higher fatty acids
D Sphingolipids
E Phosphatidic acid
176

A patient underwent surgical removal of a cavitary liver lesion 2 cm in diameter. It was revealed that the cavity wall was formed by dense fibrous connective tissue; the cavity contained muddy, thick, yellowish-greenish fluid with an unpleasant odor. Microscopically, the fluid consisted mainly of polymorphonuclear leukocytes. What pathological process are these morphological changes typical for?

A Chronic abscess
B Acute abscess
C Phlegmon
D Empyema
E -
177

A patient complains of photoreception disorder and frequent acute viral diseases. He has been prescribed a vitamin that affects photoreception processes by producing rhodopsin, the photosensitive pigment. What vitamin is it?

A Tocopherol acetate
B Pyridoxine hydrochloride
C Cyanocobalamin
D Thiamine
E Retinol acetate
178

A 7-year-old boy got ill with diphtheria. On the third day he died of asphyxiation. At autopsy the mucosa of the larynx, trachea and bronchi had thickened, edematous, lustreless appearance and was covered with gray films which could be easily removed. Specify the type of laryngeal inflammation:

A Diphtheritic
B Intermediate
C Purulent
D Croupous
E Catarrhal
179

A child has a history of hepatomegaly, hypoglycemia, seizures, especially on an empty stomach and in stressful situations. The child is diagnosed with Gierke disease. This disease is caused by the genetic defect of the following enzyme:

A Glucose-6-phosphatase
B Glycogen phosphorylase
C Amyloid-1,6-glycosidase
D Glucokinase
E Phosphoglucomutase
180

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?

A Respiratory
B Circulatory
C Overload
D Hemic
E Tissue
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181

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:

A Trisomy
B Monosomy
C Genocopy
D -
E Phenocopy
182

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 cased by the congenital deficiency of the following protein:

A a2-macroglobulin
B Haptoglobin
C a1-proteinase inhibitor
D Transferrin
E Cryoglobulin
183

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:

A Cortisol
B Calcitonin
C Parathyroid hormone
D Calcitriol
E Aldosterone
184

During a surgery for femoral hernia a surgeon operates within the boundaries of femoral trigone. What structure makes up its upper margin?

A Fascia lata
B Lig. pectinale
C Arcus iliopectineus
D Lig.inguinale
E Lig.lacunare
185

A 19-year-old victim has been delivered to the casualty department with a cut wound of the trapezius muscle. Which of the cervical fasciae forms a sheath for this muscle?

A Muscular part of the pretacheal layer of cervical fascia
B Investing layer of cervical fascia
C Carotid sheath of cervical fascia
D Prevertebral layer of cervical fascia
E Visceral part of the pretracheal layer of cervical fascia
186

A patient with acne has been prescribed doxycycline hydrochloride. What recommendations should be given to the patient, while he is taking this drug?

A Take before meal
B Do not take with vitamins
C The course of treatment should not exceed 1 day
D Take with large quantity of liquid, preferably milk
E Avoid long stay in the sun
187

A 30-year-old patient with a past history of virus B hepatitis complains of prolonged nosebleeds. What drug will be most efficient in remedying this condition?

A Folic acid
B Dipiridamol
C Asparcam
D Fraxiparine
E Vicasolum
188

A patient has arterial hypertension. What long-acting drug from the group of calcium channel blockers should be prescribed?

A Amlodipine
B Atenolol
C Reserpine
D Octadine
E Pyrroxanum
189

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

A Reconvalescence
B Prodromal
C Incubation
D Acute
E Carriage
190

In a dysentery patient undergoing treatment in the contagious isolation ward, a significant increase in packed cell volume has been observed (60%). What other value will be affected by this change?

A Increasing blood viscosity
B Leukopenia
C Increasing volume of blood circulation
D Increasing erythrocyte sedimentation rate (ESR)
E Thrombocytopenia
191

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?

A Ciliary arrhythmia
B Sinus tachycardia
C Sinus arrhythmia
D Sinus bradycardia
E Extrasystole
192

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

A Heterotransplantation
B Explantation
C Autotransplantation
D Allotransplantation
E Xenotransplantation
193

A 29-year-old male with a knife wound of neck presents with bleeding. During the initial dbridement of the wound the surgeon revealed the injury of a vessel found along the lateral edge of the sternocleidomastoid muscle. Specify this vessel:

A A. carotis externa
B V jugularis externa
C A. carotis interna
D V jugularis anterior
E V jugularis interna
194

A histologic specimen represents an organ with walls comprised of mucous, submucous, fibrous-cartilaginous and adventitial membranes. Epithelium is multirowed and ciliated, muscular layer of mucous membrane is absent, submucous membrane contai- ns serousmucous glands, hyaline cartilage forms open circles. What organ has the described morphological features?

A Terminal bronchiole
B Tertiary bronchi (segmental bronchi)
C Trachea
D Secondary bronchi (lobar bronchi)
E Larynx
195

In cancer patients who have been continuously receiving methotrexate, the target cells of tumor with time become insensitive to this drug. In this case, gene amplification of the following enzyme is observed:

A -
B Dihydrofolate reductase
C Thioredoxin reductase
D Deaminase
E Thiaminase
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196

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)?

A It does not affect the activity of GP and GS
B It inhibits both GP and GS
C It activates both GP and GS
D It activates GP and inhibits GS
E It inhibits GP and activates GS
197

A patient has the oxyhemoglobin dissociation curve shifted to the left. What blood changes induce this condition?

A -
B Acidosis, hypercapnia, temperature rise
C Alkalosis, hypocapnia, temperature drop
D Acidosis, hypocapnia, temperature rise
E Acidosis, hypercapnia, temperature drop
198

Administration of doxycycline hydrochloride caused an imbalance of the symbiotic intestinal microflora. Specify the kind of imbalance caused by the antibiotic therapy:

A Bacteriosis
B Superimposed infection
C Idiosyncrasy
D Dysbacteriosis
E Sensibilization
199

A patient with signs of emotional lability that result in troubled sleep has been prescribed nitrazepam. Specify the sleep-inducing mechanism of this drug:

A Blockade of opiate receptors
B Supression of serotonergic neurotransmission
C Inhibition of stimulating amino acids
D GABA-ergic system activation
E H1-histamine receptors stimulation
200

A patient has been found to have a marked dilatation of saphenous veins in the region of anterior abdominal wall around the navel. This is symptomatic of pressure increase in the following vessel:

A V cava superior
B V mesenterica inferior
C Vportae hepatis
D V cava inferior
E V mesenterica superior