Крок 1 · Медицина 2016 · Англійська

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01

A 35-year-old man has been delivered into a surgical ward with a suppurating wound in the neck, anterior to trachea (previsceral space). If a surgical operation is not performed urgently, there is a risk of infection spreading to:

A Thoracic cavity - middle mediastinum
B Interaponeurotic suprasternal space
C Retrovisceral space
D Thoracic cavity - anterior mediastinum
E Thoracic cavity - posterior mediastinum
02

Characteristic sign of glycogenosis is muscle pain during physical work. Blood examination usually reveals hypoglycemia. This pathology is caused by congenital deficiency of the following enzyme:

A Glucose 6-phosphate dehydrogenase
B Lysosomal glycosidase
C a-amylase
D 7- amylase
E Glycogen phosphorylase
03

Histologic specimen of a kidney demonstrates cells closely adjoined to the renal corpuscle in the distal convoluted tubule. Tbeir basement membrane is extremely thin and has no folds. These cells sense the changes in sodium content of urine and influence renin secretion occurring in juxtaglomerular cells. Name these cells:

A Juxtaglomerular cells
B Podocytes
C Macula densa cells
D Glomerular capillary endothelial cells
E Mesangial cells
04

Bacteriological analysis of tap water has resulted in the following: total bacterial count in 1,0 ml of water is 80, coli index is 3. What would be the conclusion?

A The water quality is doubtful
B The water is safe for consumption
C The water is polluted
D The water quality is extremely doubtful
E The water is extremely polluted
05

The process of metabolism in the human body produces active forms of oxygen, including superoxide anion radical O2. This anion is inactivated by the following enzyme:

A Superoxide dismutase
B Catalase
C Peroxidase
D Glutathione peroxidase
E Glutathione reductase
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06

What kind of muscle contraction occurs in an upper limb during an attempt to lift a load beyond one’s strength?

A Isometric
B Single
C Phasic
D Isotonic
E Auxotonic
07

A patient suffers from high fever, apnoea, pain in the thorax on the right. Pleurocentesis yielded 700 ml of yellow-green viscous liquid. Make the diagnosis:

A Pleural empyema
B Serous pleurisy
C Hemorrhagic pleurisy
D Bronchial pneumonia
E Pleural carcinomatosis
08

A patient suffers from disrupted patency of the airways at the level of small and medium-sized bronchial tubes. What changes of acid-base balance can occur in the patient?

A Metabolic acidosis
B Metabolic alkalosis
C Acid-base balance remains unchanged
D Respiratory acidosis
E Respiratory alkalosis
09

Upon toxic damage of hepatic cells resulting in disruption of liver function the patient developed edemas. What changes of blood plasma are the main cause of edema development?

A Increase of albumin conten
B Decrease of albumin content
C Decrease of fibrinogen conten
D Decrease of globulin conten
E Increase of globulin conten
10

A 6-year-old child with suspected active tuberculous process has undergone diagnostic Mantoux test. What immunobi-ological preparation was injected?

A Td vaccine
B BCG vaccine
C Tularinum
D Tuberculin
E DTP vaccine
11

A 15-year-old boy has been diagnosed with acute viral hepatitis. What blood value should be determined to confirm acute affection of hepatic cells?

A Cholesterol content
B Erythrocytes sedimentation rate (ESR)
C Unconjugated and conjugated bilirubin content
D Protein fraction content
E Aminotransferase activity (AST, ALT)
12

A 53-year-old man is diagnosed with Paget’s disease. Concentration of oxyproli-ne in daily urine is sharply increased, which primarily means intensified disintegration of:

A Albumin
B Fibrinogen
C Hemoglobin
D Keratin
E Collagen
13

When taking exams students often have dry mouth. The mechanism that causes this state results from the following reflexes:

A Conditioned sympathetic
B Unconditioned parasympathetic
C Unconditioned sympathetic
D Conditioned parasympathetic
E Unconditioned peripheral
14

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 Angiofibroma
B Papilloma
C Polyp
D Fibroma
E Angioma
15

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

A Fibrinopurulent peritonitis
B Serous peritonitis
C Tuberculous peritonitis
D Hemorrhagic peritonitis
E -
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16

Autopsy of a body 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 of?

A Multiple myeloma
B Chronic myelogenous leukemia
C Hodgkin’s disease
D Polycythemia vera
E Chronic lymphocytic leukemia
17

A bacteriological laboratory has been investigating a sample of homemade dried fish that was the cause of severe food poisoning. Microscopy of the culture inoculated in Kitt-Tarozzi medium revealed microorganisms resembling a tennis racket. What diagnosis can be made?

A Cholera
B Dysentery
C Typhoid fever
D Salmonellosis
E Botulism
18

An infant has been diagnosed with microcephaly. Doctors suspect that this brain disorder developed due to the fact that the mother had been taking actinomycin D during her pregnancy. What germinal layers have been affected by this teratogen?

A All germinal layers
B Entoderm and mesoderm
C Entoderm
D Mesoderm
E Ectoderm
19

A patient demonstrates sharp decrease of pulmonary surfactant activity. This condition can result in:

A Increased pulmonary ventilation
B Alveolar tendency to recede
C Decresed work of expiratory muscles
D Hyperoxemia
E Decreased airways resistance
20

A patient is diagnosed with diabetic coma. Blood sugar is 18,44 mmol/1. What glucoseregulating drug should be prescribed in the given case?

A Intermediate-acting insulin
B Long-acting insulin
C Sulfonylurea derivative
D Rapid-acting insulin
E Biguanide
21

Initial inoculation of water in 1% peptone water resulted in growth of a thin film on the medium surface in 6 hours. Such cultural properties are characteristic of causative agent of the following disesase:

A Tuberculosis
B Plague
C Cholera
D Dysentery
E Pseudotuberculosis
22

An infant born prematurely 2 days ago presents with yellow coloring of skin and mucosa. Such a condition in the infant is caused by temporary deficiency of the following enzyme:

A Aminolevulinate synthase
B UDP-glucuronyl transferase
C Heme synthetase
D Heme oxygenase
E Biliverdine reductase
23

It has been determined that one of a pesticide components is sodium arsenate that blocks lipoic acid. Enzyme activity can be impaired by this pesticide. Name this enzyme:

A Glutathione peroxidase
B Microsomal oxidation
C Pyruvate dehydrogenase complex
D Glutathione reductase
E Methemoglobin reductase
24

A 50-year-old woman diagnosed with cardiac infarction has been delivered into an intensive care ward. What enzyme will be the most active during the first two days?

A LDH5
B Alanine aminopeptidase
C LDHi
D Alanine aminotransferase
E Aspartate aminotransferase
25

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

A Dysentery-like disease
B Colienteritis
C Gastroenteritis
D Food poisoning
E Choleriform disease
26

Parents of a sick 5-year-old girl visited a genetic consultation. Karyotype investigation revealed 46 chromosomes. One chromosome of the 15th pair was abnormally long, having a part of the chromosome belonging to the 21st pair attached to it. What mutation occurred in this girl?

A Translocation
B Duplication
C Deficiency
D Inversion
E Deletion
27

A patient consulted a doctor with complaints of dyspnea occurring after physical exertion. Physical examination revealed anemia, paraprotein was detected among gamma globulins. What value should be determined in the patient’s urine to confirm the diagnosis of myeloma?

A Bence Jones protein
B Hemoglobin
C Ceruloplasmin
D Bilirubin
E Antitrypsin
28

A patient complaining of dizziness, thirst, difficult swallowing, and impaired vision of close objects has addressed a doctor. Objectively: respiratory rate is increased, pupils are dilated, general agitation, talkativeness, though the speech is indistinct. BP is 110/70 mm Hg, heart rate is 110/min. Given symptoms can indicate overdosage of the following drug:

A Aminazine
B Atropine
C Morphine
D Ephedrine
E Caffeine
29

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

A Urea
B Cholic acid
C Phosphatidylcholine
D Tristearin
E Phosphatidic acid
30

A 35-year-old man with peptic ulcer disease has undergone antrectomy. After the surgery secretion of the following gastrointestinal hormone will be disrupted the most:

A Gastrin
B Secretin
C Cholecystokinin
D Neurotensin
E Histamine
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31

A 16-year-old adolescent is diagnosed with hereditary UDP (uridine diphosphate) glucuronyltransferase deficiency. Laboratory tests revealed hyperbilirubinemia caused mostly by increased blood content of the following substance:

A Conjugated bilirubin
B Urobilinogen
C Biliverdine
D Stercobilinogen
E Unconjugated bilirubin
32

A 60-year-old patient with a long history of atherosclerosis and a previous myocardial infarction developed an attack of retrosternal pain. 3 days later the patient was hospitalized and then died of progressive cardiovascular insufficiency. During autopsy a white fibrous depressed area about 3 cm in diameter with clear margi- ns was found within the area of posterior wall of the left ventricle and interventricular septum. The dissector considered these changes to be:

A Myocarditis
B Myocardial infarction
C Focal cardiosclerosis
D Myocardial ischemia
E Myocardial degeneration
33

A patient with hypertension has developed headache, tinnitus, vomiting, high BP up to 220/160 mm Hg. On examination: facial asymmetry on the right, volitional mobility is absent, increased tendon reflexes and muscle tone of extremities on the right. What motor disorder of nervous system occurred in this case?

A Hemiplegia
B Paraplegia
C Tetraplegia
D Monoplegia
E Hyperkinesis
34

A 7-year-old child in the state of allergic shock caused by a bee sting has been delivered into an emergency ward. High concentration of histamine was observed in blood. Production of this amine was the result of the following reaction:

A Hydroxylation
B Reduction
C Deaminization
D Dehydrogenation
E Decarboxylation
35

A 26-year-old woman 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 Hymenolepis папа
B Diphyllobothrium latum
C Taenia solium
D Echinococcus granulosus
E Taeniarhynchus saginatus
36

A man is 28 years old. Histological investigation of the cervical lymph node revealed a change of its pattern due to proliferation of epithelioid, lymphoid cells and macrophages with horseshoe-shaped nuclei. In the center of some cell clusters there were non-structured lightpink areas with fragments of nuclei. What disease are these changes typical of?

A Actinomycosis
B Syphilis
C Tuberculosis
D Tumor metastasis
E Hodgkin’s disease
37

Sex chromatin was detected during examination of a man’s buccal epithelium. It is characteristic of the following chromosome disease:

A Triple X syndrome
B Turner’s syndrome
C Klinefelter’s syndrome
D Down’s disease
E Hypophosphatemic rickets
38

A patient, having suffered a thermal burn, developed painful boils filled with turbid liquid in the skin. What morphological type of inflammation has developed in the patient?

A Granulomatous
B Serous
C Croupous
D Diphtheritic
E Proliferative
39

Autopsy of a man with tuberculosis revealed a 3x2 cm large cavity in the superior lobe of the right lung. The cavity was interconnected with a bronchus, its wall was dense and consisted of three layers: the internal layer was pyogenic, the middle layer was made of tuberculous granulation tissue and the external one was made of connective tissue. What is the most likely diagnosis?

A Tuberculoma
B Acute focal tuberculosis
C Fibrous cavernous tuberculosis
D Fibrous focal tuberculosis
E Acute cavernous tuberculosis
40

A 7-year-old child has acute onset of disease: temperature rise up to 38°C, rhinitis, cough, lacrimation, and large-spot rash on the skin. Pharyngeal mucosa is edematous, hyperemic, with whitish spots' in the buccal area. What kind of inflammation caused the changes in the buccal mucosa?

A Fibrinous inflammation
B Catarrhal inflammation
C Hemorrhagic inflammation
D Serous inflammation
E Suppurative inflammation
41

After a traffic accident a 36-year-old patient has developed muscle paralysis of the extremitis on the right, lost pain and thermal sensitivity on the left, and partially lost tactile sensitivity on both sides. What part of the brain is the most likely to be damaged?

A Motor cortex on the left
B Anterior horn of the spinal cord
C Right-hand side of the spinal cord
D Posterior horn of the spinal cord
E Left-hand side of the spinal cord
42

A 4-year-old child has been admitted to an orthopaedic department with displaced shin fracture. Bone fragments reposition requires analgesia. What drug should be chosen?

A Promedol
B Analgin
C Morphine hydrochloride
D Panadol
E -
43

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 medialis
C A. tibialis anterior
D A. tarsea lateralis
E A. fibularis
44

Representatives of a certain human population can be characterized by elongated body, height variability, decreased volume of muscle mass, increased length of limbs, decreased size and volume of rib cage, increased perspiration, decreased indices of base metabolism and fat synthesis. What type of adaptive evolution is it?

A Moderate
B Arctic
C Mountain
D Tropical
E Intermediate
45

A 59-year-old woman has been hospiali- zed in a surgical ward due to exacerbation of chronic osteomyelitis of the left shin. Blood test: leukocytes - 15,0- 109/1. Leukogram: myelocytes - 0%, metamyelocytes - 8%, stab neutrophils - 28%, segmented neutrophils - 32%, lymphocytes 29 %, monocytes - 3%. Such blood count would be called :

A Hyperregenerative left shift
B Degenerative left shift
C Right shift
D Regenerative-degenerative left shift
E Regenerative left shift
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46

A 41-year-old man 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 of the following adrenal pathology:

A Hyperfunction of the medulla
B Primary aldosteronism
C Hypofunction of the adrenal cortex
D Hypofunction of the medulla
E Hyperfunction of the adrenal cortex
47

During autopsy of a man, who died of acute transmural cardiac infarction, the following has been detected on the pericardium surface: fibrous whitish-brown deposit connecting parietal and visceral pericardial layers. What kind of inflammation occurred in the pericardium?

A Serous
B Granulomatous
C Diphtheritic
D Suppurative
E Croupous
48

A 12-year-old child developed nephritic syndrome (proteinuria, hematuria, cyli-ndruria) 2 weeks after a case of tonsillitis, which is a sign of affected glomerular basement membrane in the kidneys. What mechanism is the most likely to cause the basement membrane damage?

A Immune complex
B Antibody-mediated
C Cytotoxic
D Granulomatous
E Reaginic
49

A man arrived into a traumatological department with a trauma of the right shoulder. Examination revealed a displaced humeral shaft fracture on the right in the middle one-third of the humerus; the patient cannot extend the fingers of his right hand. What nerve is damaged?

A Median
B Radial
C Musculocutaneous
D Ulnar
E Axillary
50

Work in a mine is known to cause inhalation of large amounts of coal dust. Inhaled coal dust can be detected in the following pulmonary cells:

A Pericapillary cells
B Alveolar macrophages
C Capillary endothelial cells
D Secretory epithelial cells
E Respiratory epithelial cells
51

What drug will be the most appropriate for a patient suffering from chronic gastritis with increased secretion?

A Pirenzepine
B Chlorphentermine
C Aprotinin
D Pepsin
E Pancreatine
52

A 63-year-old man, who has been suffering from chronic fibrous-cavernous pulmonary tuberculosis for 24 years, has been delivered to a nephrology department with uremia. Intravital diagnostic test for amyloid in the kidneys was positive. What amyloidosis is it in this case?

A Primary systemic
B Senile
C Secondary systemic
D Hereditary (genetic)
E Localized (focal)
53

Cells of a healthy liver actively synthesize glycogen and proteins. What organelles are the most developed in them?

A Granular and agranular endoplasmic reticulum
B Lysosomes
C Cell center
D Peroxisomes
E Mitochondria
54

Immune-enzyme assay has detected HBs antigen in blood serum. What disease is it characteristic of?

A Syphilis
B Viral hepatitis type A
C Tuberculosis
D AIDS
E Viral hepatitis type B
55

A patient has been diagnosed with gonorrhea. As fluoroquinolones are the drugs of choce for treatment of gonorrhea the patient should be prescribed:

A Fluorouracil
B Sulfacarbamide (Urosulfanum)
C Furazolidone
D Ciprofloxacin
E Cefazolin
56

Autopsy of a Middle-Eastern woman, who had been suffering from wasting fever for a long time, revealed enlarged blackened liver and spleen. Bone marrow was hyperplastic and blackcolored as well. Cerebral cortex was smoky grey. What disease is it characteristic of?

A Epidemic typhus
B Hepatitis
C AIDS
D Malaria
E Sepsis
57

Human red blood cells contain no mitochondria. What is the main pathway for ATP production in these cells?

A Aerobic glycolysis
B Creatine kinase reaction
C Cyclase reaction
D Anaerobic glycolysis
E Oxidative phosphorylation
58

Atria of an experimental animal were superdistended with blood, which resulted in decreased reabsorption of Na+ and water in renal tubules. This can be explained by the influence of the following factor on kidneys:

A Aldosterone
B Angiotensin
C Vasopressin
D Natriuretic hormone
E Renin
59

A woman gave birth to a stillborn baby with numerous malformations. What protozoan disease could cause intrauterine death?

A Amebiasis
B Malaria
C Toxoplasmosis
D Lambliasis
E Leishmaniasis
60

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

A Pyloric stenosis
B Penetration
C Perforation
D Canceration
E Hemorrhage
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61

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 was used for disease diagnostics. What is the name of the applied serological reaction?

A Immunofluorescence test
B Immune-enzyme analysis
C Radioimmunoassay
D Antigen-binding assay
E Bordet-Gengou test
62

A patient with insulin-dependent diabetes mellitus has been administered insulin. After a certain period of time the patient developed fatigue, irritability, excessive sweating. What is the main mechanism of such presentations developing?

A Decreased glyconeogenesis
B Carbohydrate starvation of the brain
C Increased glycogenolysis
D Increased ketogenesis
E Increased lipogenesis
63

Examination of a 52-year-old woman 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 Acquired hemolytic
B Anemia due to diminished erythropoiesis
C Hereditary hemolytic
D Chronic hemorrhagic
E Acute hemorrhagic
64

Poisoning caused by mercury (II) chloride (corrosive sublimate) occurred in the result of safety rules violation. In 2 days the patient’s diurnal diuresis was 620 ml. The patient developed headache, vomiting, convulsions, dyspnea; moist crackles were observed in the lungs. Name this pathology:

A Glomerulonephritis
B Uremic coma
C Chronic renal failure
D Pyelonephritis
E Acute renal failure
65

For people adapted to high external temperatures profuse sweating is not accompanied by loss of large volumes of sodium chloride. This is caused by the effect the following hormone has on perspiratory glands:

A Aldosterone
B Natriuretic
C Tgyroxin
D Vasopressin
E Cortisol
66

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 Heat conduction
B Heat radiation
C Evaporation
D Convection
E -
67

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

A Anterior quadrigeminal bodies
B Posterior quadrigeminal bodies
C Substantia nigra
D Red nuclei
E Vestibular nuclei
68

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 Effective filter pressure
E Oncotic pressure of blood plasma
69

Along with normal hemoglobin types there can be pathological ones in the organism of an adult. Name one of them:

A HbA2
B HbA1
C HbS
D Hb02
E HbF
70

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

A Hereditary predisposition
B Antigen structure
C Routes by which antigens are delivered into the body
D Development of tissue lesion
E Amount of released antigen
71

Histologic preparation stained with orcein demonstrates from 40 to 60 fenestrated elastic membranes within the middle coat of vessel. Name this vessel:

A Muscular vein
B Elastic artery
C Muscular artery
D Mixed type artery
E Nonmuscular vein
72

Angiocardiography of a 60-year-old man revealed constriction of a vessel located in the left coronary sulcus of the heart. Name this pathological vessel:

A A. coronaria dextra
B V. cordisparva
C Ramus circumflexus
D Ramus interventricularis anterior
E Ramus interventricularis posterior
73

A comatose patient was taken to the hospital. He has a history of diabetes melli-tus. Objectively: Kussmaul breathing, low blood pressure, acetone odor of breath. After the emergency treatment the patient’s condition improved. What drug had been administered?

A Glibenclamide
B Insulin
C Adrenaline
D Isadrinum
E Furosemide
74

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

A Colon descendens
B Caecum
C Colon ascendens
D Colon transversum
E Colon sigmoideum
75

A patient hospitalized due to mercury intoxication presents with the following processes in the kidneys: focal necrotic changes of tubules of major renal regions, edema, leukocyte infiltration and hemorrhages in the interstitial tissue, venous congestion. What condition developed in the patient?

A Acute necrotic nephrosis
B Chronic pyelonephritis
C Chronic renal failure
D Acute pyelonephritis
E Acute glomerulonephritis
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76

According to phenotypic diagnosis a female patient has been provisionally diagnosed with Xchromosome polysomia. This diagnosis can be confirmed by cytogenetic method. What karyotype will confirm the diagnosis?

A 48( XXXY )
B 47( XXY )
C 48( XXYY )
D 47(ХХХ)
E 46( XX )
77

An uconscious young man in the state of morphine intoxication has been delivered into an admission room. The patient’s respi- ration is slow and shallow due to suppression of the respiratory center. What kind of respiratory failure occurred in this case?

A Ventilatory obstruction
B Perfusion
C Ventilatory disregulation
D Ventilatory restriction
E Diffusion
78

On histological examination of uterine mucosa the following is detected: sinuous glands, serratiform and corkscrew-shaped elongated growths of stroma with cell proliferation. Make the diagnosis:

A Acute endometritis
B Glandular endometrial hyperplasia
C Placental polyp
D Vesicular mole
E Leiomyoma
79

10 minutes after the beginning of heavy physical work a person demonstrates increase of erythrocyte number in blood from 4, 0 • 1012/l to 4, 5 • 1012/l. What is the cause of this phenomenon?

A Erythropoiesis activation
B Water loss
C Erythrocytes exit from depot
D Increase of cardiac output
E Suppression of erythrocyte destruction
80

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

A Expiratory reserve volume
B Respiratory volume
C Residual volume
D Functional residual lung capacity
E Inspiratory reserve volume
81

Autopsy of a 40-year-old woman, who died of cerebral hemorrhage during hypertensic crisis, revealed: upper-body obesity, hypertrichosis, hirsutism, stretchmarks on the skin of thighs and abdomen. Pituitary basophil adenoma is detected in the anterior lobe. What diagnosis is the most likely?

A Simmonds’ disease
B Cushing’s disease
C Alimentary obesity
D Hypothalamic obesity
E Essential hypertension
82

A specimen shows an organ covered with the connective tissue capsule with radiating trabeculae. There is also cortex containing lymph nodules, and medullary cords made of lymphoid cells. What organ is under study?

A Lymph node
B Thymus
C Red bone marrow
D Spleen
E Tonsils
83

After a craniocerebral injury a patient has lost the ability to recognize shapes of objects by touch (stereognosis). What area of cerebral cortex normally contains the relevant center?

A Inferior parietal lobule
B Supramarginal gyrus
C Angular gyrus
D Postcentral gyrus
E Superior parietal lobule
84

Monoamine oxidase inhibitors are widely used as psychopharmacological drugs. They change the level of nearly all neurotransmitters in synapses, with the following neurotransmitter being the exception:

A Dopamine
B Serotonin
C Acetylcholine
D Noradrenaline
E Adrenaline
85

A worker of an agricultural enterprise had been suffering from an acute disease with aggravating intoxication signs, which resulted in his death. On autopsy: the spleen is enlarged, flaccid, dark cherry-red in the section, yields excessive pulp scrape. Soft meninges of fornix and base of the brain are edematous and saturated with blood (’’cardinal’s cap”). Microscopically: serous-hemorrhagic inflammation of meninges and cerebral tissues. Make the diagnosis:

A Tularemia
B Plague
C Cholera
D Brucellosis
E Anthrax
86

Autopsy of an 8-month-old boy, who died of severe pneumonia complicated with sepsis, revealed absence of thymus. Lymph nodes have no lymphoid follicles and cortical substance. In the spleen the follicles are decreased in size and have no light centers. What is the cause of such changes?

A Thymus agenesis
B Thymus hypoplasia
C Thymus aplasia
D Thymus atrophy
E Accidental thymic involution
87

A patient has been delivered into a surgical ward with an incised wound of the anterior surface of the shoulder in its lower one-third. Flexing function was disrupted in the shoulder and elbow joints, which is caused by the damage to the:

A Triceps muscle of the arm
B Deltoid muscle
C Coracobrachial muscle
D Anconeus muscle
E Biceps muscle of the arm
88

A 40-year-old patient suffers from bronchial asthma and prolonged tachycardia. Choose the optimal drug for rapid relief of bronchial spasm in the given case:

A Orciprenaline
B Salbutamol
C Ephedrine hydrochloride
D Adrenalin hydrochloride
E Isoprenaline (Isadrinum)
89

A patient with urolithiasis has developed severe pain attacks. For pain shock prevention he was administered an antispasmodic narcotic analgesic along with atropine. Name this drug:

A Ethylmorphine hydrochloride
B Nalorphine
C Promedol
D Morphine hydrochloride
E Tramadol
90

A patient suffers from acute cardiopulmonary failure with pulmonary edema. What diuretic should be prescribed in the given case?

A Spironolactone
B Hydrochlorothiazide (Dichlothiazidum)
C Acetazolamide (Diacarb)
D Triamterene
E Furosemide
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91

A patient with acute myocardial infarction has been administered heparin as a part of complex therapy. Some time after heparin injection the patient developed hematuria. What heparin antagonist should be injected to remove the complication?

A Aminocaproic acid
B Vicasol
C Neodicumarin
D Protamine sulfate
E Fibrinogen
92

The key reaction of fatty acid synthesis is production of malonyl-CoA. What metabolite is the source of malonyl-CoA synthesis?

A Acetyl-CoA
B Succinyl-CoA
C Acyl-CoA
D Citrate
E Malonate
93

A family of healthy students, who have arrived from Africa, gave birth to a child with signs of anemia. The child has died shortly after. Examination has revealed that the child’s erythrocytes are abnormally crescent-shaped. The disease is characreri-zed by autosomal recessive inheritance. Determine the genotype of the child’s parents:

A Аа х аа
B аа х аа
C Аа х Аа
D Аа х АА
E АА х АА
94

At a certain stage of cell cycle chromosomes reach cellular poles, undergo despiralization; nuclear membranes are being formed around them; nucleolus is restored. What stage of mitosis is it?

A Anaphase
B Metaphase
C Telophase
D Prometaphase
E Prophase
95

Cardiac arrest occurred in a patient during a surgery of the small intestine. What regulatory mechamisms resulted in the cardiac arrest in this case?

A Metasympathetic reflexes
B Unconditioned parasympathetic reflexes
C Conditioned sympathetic reflexes
D Conditioned parasympathetic reflexes
E Unconditioned sympathetic reflexes
96

Vestibular receptors of semicircular canals of an animal have been destroyed. What reflexes will disappear as a result?

A Primary orienting reflex
B Statokinetic reflex during movements with angular acceleration
C Head-righting reflex
D Statokinetic reflex during movements with linear acceleration
E Body-righting reflex
97

A patient working at a pig farm complains of paroxysmal abdominal pain, liquid feces with mucus and blood, headache, weakness, fever. Examination of large intestine revealed ulcers from 1 mm up to several cm in diameter, feces contained oval unicellular organisms with cilia. What disease can be suspected?

A Balantidiasis
B Lambliasis
C Amebiasis
D Trichomoniasis
E Toxoplasmosis
98

Blood group of a 30-year-old man has been determined before a surgery. The blood was Rhesus-positive. Agglutination did not occur with standard 0 (I), А (II), and В (III) serums. The blood belongs to the following group:

A А (II)
B В (III)
C 0 (I)
D -
E АВ (IV)
99

Histological specimen of a hemopoietic organ shows clusters of node- and bandshaped lymphocytes that along with stroma elements compose cortical and medullar substances. Name this organ:

A Red bone marrow
B Palatine tonsil
C Spleen
D Lymph node
E Thymus
100

It is known that in catecholamine metabolism a special role belongs to monoamine oxidase ( MAO). This enzyme inactivates mediators (noadrenalin, adrenalin, dopamine) by :

A Adjoining amino groups
B Oxidative deamination
C Hydrolysis
D Removing methyl groups
E Carboxylation
101

Cellular composition of exudate largely depends on the etiological factor of inflammation. What leukocytes are the first to be involved in the focus of inflammation caused by pyogenic bacteria?

A Eosinophilic granulocytes
B Basophils
C Myelocytes
D Monocytes
E Neutrophil granulocytes
102

A surgeon has detected inflammation of the Meckel’s diverticulum in a patient. During surgical invasion it can be located in the:

A Colon
B Duodenum
C Jejunum
D Ileum
E Sigmoid colon
103

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 was detected. What anatomical boundary exists between those two segments?

A Linea semilunaris
B Linea arcuata
C Linea transversa
D Linea inguinalis
E Linea terminalis
104

A patient died of cancerous cachexia with primary localization of cancer in the stomach. Autopsy revealed acutely enlarged liver with uneven surface and numerous protruding nodes; the nodes had clear margins in the section, rounded shape, gray-pink color, varying density, sometimes contained necrotic foci. Histologically: there are atypical cells in the nodes. What pathologic process occurred in the liver?

A Cancer metastases
B Abscesses
C Regeneratory nodes
D Infarction
E Hepatic cancer
105

A patient has insufficient blood supply to the kidneys, which 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 Angiotensinogen
B Renin
C Catecholamines
D Angiotensin II
E Norepinephrine
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106

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

A Calcium and potassium ion exit
B Potassium ion entry
C Calcium ion entry
D Potassium ion exit
E Calcium ion exit
107

Parents of a 5-year-old child report him to 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; naked cells are absent from the lymph nodes punctate. What kind of immune disorder is it?

A Autosomal recessive agammaglobulinaemia (Swiss type)
B X-linked hypogammaglobulinemia (Bruton type agammaglobulinemia)
C Louis-Barr syndrome
D Hypoplastic anemia
E Agranulocytosis
108

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

A Simple branched alveolar gland
B Compound unbranched alveolar gland
C Simple unbranched alveolar gland
D Simple branched tubular gland
E Compound branched alveolar gland
109

Microelectrode technique allowed to register a potential following ”all-or-none” law and capable of undecremental spreading. Specify this potential:

A Inhibitory postsynaptic potential
B Receptor potential
C Excitatory postsynaptic potential
D Action potential
E Rest potential
110

Examination of a patient revealed hypertrophy and inflammation of lymphoid tissue, edema of mucous membrane between palatine arches (acute tonsillitis). What tonsil is normally situated in this area?

A -
B Tonsilla tubaria
C Tonsilla palatina
D Tonsilla lingualis
E Tonsilla pharyngealis
111

Histological specimen of an ovary demonstrates a spherical structure composed of large glandular cells containing lutein. What hormone is produced by the cells of this structure?

A Progesterone
B Testosterone
C Estrogens
D Aldosterone
E Corticosterone
112

A patient, who has been subsisting exclusively on polished rice, has developed polyneuritis due to thiamine deficiency. What substance is an indicator of such avitaminosis, when it is excreted with urine?

A Methylmalonic acid
B Phenyl pyruvate
C Malate
D Uric acid
E Pyruvic acid
113

When blood circulation in the damaged tissue is restored, lactate accumulation stops and glucose consumption decelerates. These metabolic changes are caused by activation of the following process:

A Gluconeogenesis
B Aerobic glycolysis
C Lipolysis
D Anaerobic glycolysis
E Glycogen biosynthesis
114

A 67-year-old patient complains of periodic heartache, dyspnea during light physical activities. ECG reveals extraordinary contractions of heart ventricles. Such arrhythmia is called:

A Fibrillation
B Bradycardia
C Flutter
D Tachycardia
E Extrasystole
115

In investigation of serum proteins various physical and physicochemical methods can be used. In particular, serum albumins and globulins can be separated by the method of:

A Refractometry
B Polarography
C Electrophoresis
D Dialysis
E Spectrography
116

Pupil dilation occurs when a person steps from a light room into a dark one. What reflex causes such a reaction?

A Sympathetic conditioned reflex
B Parasympathetic conditioned reflex
C Sympathetic unconditioned reflex
D Metasympathetic reflex
E Parasympathetic unconditioned reflex
117

Cells of a person working in the Chornobyl Exclusion Zone have undergone a mutation in DNA molecule. However, with time the damaged interval of DNA molecule has been restored to its initial structure with a specific enzyme. In this case the following occurred:

A Reverse transcription
B Transcription
C Replication
D Translation
E Repair
118

Autopsy of a 5-year-old child revealed in the area of the vermis of cerebellum a soft grayishpink node 2 cm in diameter with blurred margins and areas of haemorrhage. Histologically this tumour consisted of atypical monomorphous small round cells with large polymorphous nuclei. What tumour is it?

A Meningioma
B Astrocytoma
C Medulloblastoma
D Glioblastoma
E Oligodendroglioma
119

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

A Increase of functional residual lung capacity
B Increase of respiratory volume
C Increase of pulmonary residual volume
D Increase of inspiratory reserve volume
E Obstructive pulmonary disease
120

A specimen of a parenchymal organ shows poorly delineated hexagonal lobules surrounding a central vein, and the interlobular connective tissue contains embedded triads (an artery, a vein and an excretory duct). What organ is it?

A Thymus
B Liver
C Pancreas
D Spleen
E Thyroid
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121

A patient had a trauma that caused dysfunction of motor centers regulating activity of head muscles. In what parts of cerebral cortex can these centers normally be located?

A Superior parietal lobule
B Superior part of precentral gyrus
C Inferior part of precentral gyrus
D Angular gyrus
E Supramarginal gyrus
122

At the post-mortem examination the stomach of a patient with renal failure was found to have a yellow-brown coating on the thickened mucosa. The coating was firmly adhering to its surface and had significant thickness. Microscopy revealed congestion and necrosis of mucosal and submucosal layers, fibrin presence. What is the most likely diagnosis?

A Corrosive gastritis
B Gastric abscess
C Esogastritis
D Croupous gastritis
E Fibrinous gastritis
123

A 60-year-old man suffering from chronic hepatitis frequently observes nasal and gingival hemorrhages, spontaneous hemorrhagic rashes on the skin and mucosa. Such presentations result from:

A Increased blood content of aminotransferases
B Decreased blood content of cholinesterase
C Decreased synthesis of prothrombin and fibrinogen
D Increased blood content of macroglobulins and cryoglobulins
E Decreased synthesis of serum albumins
124

Leading symptoms of primary hyperparathyroidism are osteoporosis and renal damage resulting in urolithiasis development. What substances are the basis of uroliths in such cases?

A Cystine
B Calcium phosphate
C Bilirubin
D Uric acid
E Cholesterol
125

An oncology department has admitted a patient with suspected pulmonary tumor. On examination a pathology localized within the lower lobe of the right lung was detected. How many bronchopulmonary segments are there in this lobe?

A 5
B 2
C 6
D 3
E 4
126

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

A Reserpine
B Lisinopril
C Prazosin
D Verapamil
E Metoprolol
127

An alcoholic suffers from alcoholic psychosis with evident psychomotor agitation. What neuroleptic drug should be administered for emergency aid?

A Sodium bromide
B Halothane
C Aminazine
D Diazepam
E Reserpine
128

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

A Alveococcosis
B Teniasis
C Echinococcosis
D Trichinosis
E Taeniarhynchosis
129

A patient demonstrates functional loss of nasal halves of the retinas. What area of visual pathways is affected?

A Left optic nerve
B Optic chiasm
C Left optic tract
D Right optic tract
E Right optic nerve
130

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

A Doxycycline
B Dexamethasone
C Interferon
D BCG vaccine
E Ambroxol
131

A 16-year-old young man suffering from seasonal allergic rhinitis has been prescribed a highly active second-generation H1 blocker, which can be characterized by absence of marked sedative action. Name this drug:

A Chloropyramine (Suprastin)
B Loratadine
C Pipolphen
D Indometacin
E Erythromycin
132

Examination of a 56-year-old woman with a history of type 1 diabetes mellitus 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 Decrease in the concentration of amino acids in blood
B Increase in low-density lipoprotein level
C Increase in the oncotic pressure in the blood plasma
D Increased proteolysis
E Albuminosis
133

A patient with injury sustained to a part of the central nervous system demonstrates disrupted coordination and movement amplitude, muscle tremor during volitional movements, poor muscle tone. What part of the central nervous system was injured?

A Mesencephalon
B Cerebellum
C Oliencephalon
D Prosencephalon
E Medulla oblongata
134

A 36-year-old patient has been administered a depolarizing muscle relaxant during a surgery. Name this drug:

A Diazepam
B Proserin
C Aminazine
D Pipecuronium bromide (Arduan)
E Dithylinum
135

A man has suffered multiple bone fractures of his lower extremities during a traffic accident. During transportation to a hospital his condition was further aggravated: blood pressure decreased, there were signs of pulmonary artery embolism. What kind of embolism is the most likely in the given case?

A Thromboembolism
B Air embolism
C Fat embolism
D Gas embolism
E Tissue embolism
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136

UN volunteers have arrived in Nigeria to assist the locals in aftermath of earthquakes. What drug should they prescribe for individual chemoprophylaxis of malaria?

A Pyrimethamine (Chloridinum)
B Chingamin
C Pyrantel
D Interferon (Laferon)
E Primaquine
137

After an extended treatment with sulfanamides a patient has developed macrocytic anemia. Production of active forms of the following vitamin is disrupted in such a condition:

A Folic acid
B Pyridoxine
C Riboflavin
D Cyanocobalamin
E Thiamine
138

A woman resting in the countryside has been stung by a bee. Immediately after she developed pain in the stung area. In a few minutes there developed a vesicle, erythema and intense itch; later - urticaria and expiratory dyspnea. What factors resulted in the patient developing expiratory dyspnea?

A Histamine
B Lysosomal enzymes
C Hageman’s factor
D Adrenaline
E Noradrenaline
139

Autopsy of a 28-year-old patient, who had been suffering from rheumatism and died of heart failure, revealed pancarditis. Histological investigation of myocardium of the left ventricle posterior wall and interventricular septum detected perivascular cellular focal infiltrates composed of macrophages and creating palisade structures surrounding areas of fibrinoid necrosis. Determine the type of myocarditis:

A Granulomatous
B Diffuse interstitial productive
C -
D Focal interstitial exudative
E Diffuse interstitial exudative
140

When ascending to the top of Elbrus, a mountain climber experiences oxygen starvation, dyspnea, palpitations, and numbness of the extremities. What kind of hypoxia has developed in the mountain climber?

A Hemic
B Tissue
C Circulatory
D Cardiac
E Hypoxic
141

A 2-year-old boy is diagnosed with Down syndrome. What chromosomal changes can cause this disease?

A Trisomy X
B Monosomy X
C Trisomy 21
D Trisomy 13
E Trisomy 18
142

A 62-year-old patient has been hospitalized due to massive cerebral hemorrhage. Blood pressure is 70/30 mm Hg, heart rate is 120/min., respiratory rate is 4/min., unconscious, no response to external stimuli. Such condition can be determined as:

A Stress
B Coma
C Collapse
D Shock
E Agony
143

A 3-year-old girl with mental retardation has been diagnosed with sphingomyelin lipidosis ( Niemann-Pick disease). In this condition synthesis of the following substance is disrupted :

A Sphingosine
B Gangliosides
C Sphingomyelinase
D Glycosyltransferase
E Ceramides
144

What condition may develop 15-30 minutes after re-administration of an antigen as a result of the increased level of antibodies, mainly IgE, that are adsorbed on the surface of target cells, namely tissue basophils (mast cells) and blood basophils?

A Anaphylaxis
B Immune complex hyperresponsiveness
C Antibody-dependent cytotoxicity
D Serum sickness
E Delayed-type hypersensitivity
145

Local anesthetics (novocaine, lidocaine and others) decreases pain sensitivity of tissues by blocking Na+ and K + ions from permeating membranes of nerve fibers and endings. Such mechanism of drug action is called:

A Enzyme
B Antienzyme
C Membrane ionic
D Direct chemical
E Receptor
146

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 Erectile
B Terminal
C Preshock (compensation stage)
D Torpid
E Agony
147

A woman complaining of sharp pain in her lower abdomen has been delivered into an admission room. A gynecologist on examination makes a provisional diagnosis of extrauterine pregnancy. What anatomical structure should be punctated to confirm diagnosis?

A Recto-vesical pouch
B Intersigmoidal recess
C Utriculosaccular chamber
D Rectouterine pouch
E Retropubic space
148

A passenger of a fixed-run taxi 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 Holtz’s reflex
C Hering-Breuer reflex
D Bainbridge reflex
E Frank-Starling mechanism
149

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

A Sympathomimetics
B Myotropic antispasmodics
C M-cholinomimetics
D Anticholinesterase agents
E Adrenomimetics
150

A therapeutist has an appointment with a 40-year-old patient complaining of recurrent pain attacks in his hallux joints and their swelling. Urine analysis revealed its marked acidity and pink color. What substances can cause such changes in urine?

A Ammonium salts
B Chlorides
C Calcium phosphate
D Uric acid salt
E Magnesium sulfate
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151

Exophthalmus observed during thyrotoxicosis is caused by accumulation of highly waterbinding substances within the retrobulbar tissues. Name these substances:

A Glycosaminoglycans
B ATP
C Phospholipids
D Kreatine
E Cholesterol
152

A patient presents with dry peeling skin, frequent cases of acute respiratory diseases, xerophthalmia. What vitamin preparation should be prescribed in this case?

A Cyanocobalamin
B Retinol acetate
C Menadione (Vikasolum)
D Thiamine
E Ergocalciferol
153

Parenchyma of an organ is composed of pseudounipolar neurons localized under the capsule of connective tissue. Central place belongs to nerve fibers. Name this organ:

A Spinal ganglion
B Nerve trunk
C Sympathetic ganglion
D Intramural ganglion
E Spinal cord
154

A patient consulted a physician about chest pain, cough, fever. Roentgenography of lungs revealed eosinophilic infiltrates that were found to contain larvae. What kind of helminthiasis are these presentations typical of?

A Cysticercosis
B Trichinosis
C Echinococcosis
D Fascioliasis
E Ascariasis
155

During appendectomy a patient had the a. appendicularis ligated. This vessel branches from the following artery:

A A. ileocolica
B A. mesenterica inferior
C A. sigmoidea
D A. colica media
E A. colica dextra
156

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

A Parathyroid hormone
B Aldosterone
C Calcitriol
D Calcitonin
E Cortisol
157

Prescription of penicillin G sodium salt has caused development of neurotoxic effects ( hallucinations, convulsions). Such reaction is the result of antagonism with the following neurotransmitter:

A Adenosine
B GABA
C Serotonin
D Acetylcholine
E Dopamine
158

A 30-year-old woman exhibits signs of virilism (growth of body hair, balding temples, menstrual disorders). This condition can be caused by overproduction of the following hormone:

A Prolactin
B Oxytocin
C Testosterone
D Relaxin
E Oestriol
159

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

A Lig. pectinale
B Fascia lata
C Lig. inguinale
D Arcus iliopectineus
E Lig. lacunare
160

Activation of a number of hemostatic factors occurs through their joining with calcium ions. What structural component allows for adjoining of calcium ions?

A Monoamine-dicarboxylic acids
B Gamma-aminobutyric acid
C Gamma-carboxyglutamic acid
D Hydroxyproline
E Gamma-oxybutyric acid
161

A patient has arterial hypertension. What long-acting calcium channel blocker should be prescribed?

A Reserpine
B Octadine
C Pyrroxanum
D Amlodipine
E Atenolol
162

Material obtained from a patient contains several types of microorganisms (staphylococci and streptococci) causative of the patient’s disease. Name this type of infection:

A Superinfection
B Mixed infection
C Reinfection
D Coinfection
E Consecutive infection
163

A laboratory has been investigating virulence of a diphtheria agent. In the process of the experiment the infection was introduced intraperitoneally into test animals. The dosage of bacteria resulting in 95% mortality of test animals was found. What unit of virulence measurement was determined?

A LD50
B DCL
C LD5
D DLM
E ID
164

A patient complains of palpitations after stress. Pulse is 104/min., P-Q=0,12 seconds, there are no changes in QRS complex. What type of arrhythmia does the patient have?

A Sinus arrhythmia
B Ciliary arrhythmia
C Sinus tachycardia
D Sinus bradycardia
E Extrasystole
165

A patient consulted a dentist about restricted mouth opening (trismus). He has a history of a stab wound of the lower extremity. What infection can cause these symptoms?

A Whooping cough
B Tetanus
C Tularemia
D Wound anaerobic infection
E Brucellosis
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166

Patient’s systolic blood pressure is 90 mm Hg, diastolic - 70 mm Hg. Such blood pressure is caused by decrease of the following factor:

A Total peripheral resistance
B Aortic compliance
C Pumping ability of the left heart
D Pumping ability of the right heart
E Vascular tone
167

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

A V jugularis externa
B V jugularis anterior
C V. jugularis interna
D A. carotis externa
E A. carotis interna
168

A 6-year-old child suffers from delayed growth, disrupted ossification processes, decalcification of the teeth. What can be the cause?

A Insulin deficiency
B Vitamin C deficiency
C Vitamin D deficiency
D Decreased glucagon production
E Hyperthyroidism
169

A patient addressed a hospital with complaints of lost sensitivity of the skin of the little finger. What nerve is the most likely to be damaged?

A Radial
B Ulnar
C Medial cutaneous nerve of the forearm
D Median
E Musculocutaneous
170

A 30-year-old patient’s blood test has revealed the following: erythrocyte count is 6 • 1012/l, hemoglobin is 10,55 mmol/l. Vaquez’s disease was diagnosed. Name the leading part of pathogenesis:

A Hypoxia
B Neoplastic erythroid hyperplasia
C Acidosis
D Iron-deficiency
E S12-deficiency
171

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

A It inhibits GP and activates GS
B It activates both GP and GS
C It does not affect the activity of GP and GS
D It inhibits both GP and GS
E It activates GP and inhibits GS
172

This year influenza epidemic is characterised by patients’ body temperature varying from 36,9oC to 37,9oC. Such fever is called:

A High
B Moderate
C Apyretic
D Hyperpyretic
E Subfebrile
173

Fructosuria is known to be connected with inherited deficiency of fructose 1-phosphate aldolase. What product of fructose metabolism will accumulate in the organism resulting in toxic action?

A Fructose 6-phosphate
B Glucose 6-phosphate
C Glucose 1-phosphate
D Fructose 1-phosphate
E Fructose 1,6-biphosphate
174

A woman complains of visual impairment. Examination revealed obesity in the patient and her fasting plasma glucose level is hyperglycemic. What diabetes complication can cause visual impairment/blindness?

A Microangiopathy
B Glomerulopathy
C Macroangiopathy
D Atherosclerosis
E Neuropathy
175

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

A Bacteriosis
B Dysbacteriosis
C Idiosyncrasy
D Sensibilization
E Superimposed infection
176

Cholesterol content in blood serum of a 12-year-old boy is 25 mmol/l. Anamnesis states hereditary familial hypercholesterolemia caused by synthesis disruption of receptor-related proteins for:

A Chylomicrons
B Low-density lipoproteins
C Very low-density lipoproteins
D High-density lipoproteins
E Middle-density lipoproteins
177

During recording of a spirogram a patient calmly exhaled. How do we call the volume of air remaining in the lungs?

A Tidal volume
B Vital capacity of lungs
C Functional residual capacity
D Expiratory reserve volume
E Pulmonary residual volume
178

A 40-year-old woman was diagnosed with glomerulonephritis based on her clinical symptoms and the results of urine analysis. Anamnesis states chronic tonsillitis. What microorganisms are the most likely cause for the kidney damage in this case?

A Meningococci
B Mycoplasma
C Streptococci
D Staphylococci
E Escherichia
179

A man is suffering from diarrhea. In summer he spent his vacation in the south at the sea coast. Bacteria with the following properties were detected in his feces: gramnegative curved mobile monotrichous bacilli that do not produce spores or capsules. Bacilli are undemanding to nutrient medium but require alkaline reaction (рН 8,59,5). Described are the agents of the following enteric infection:

A Shigellosis
B Colienteritis
C Pseudotuberculosis
D Typhoid fever
E Cholera
180

An athlete (long-distance runner) during a contest developed a case of acute cardiac insufficiency. This pathology resulted from:

A Pericardium pathology
B Direct damage to myocardium
C Cardiac volume overload
D Disrupted coronary circulation
E Cardiac pressure overload
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181

Parkinson’s disease is caused by disruption of dopamine synthesis. What brain structure synthesizes this neurotransmitter?

A Red nucleus
B Hypothalamus
C Substantia nigra
D Globus pallidus
E Corpora quadrigemina
182

Name the halogen-containing antiseptic with fungicidal properties, which is used to treat dermatomycosis:

A Boric acid solution
B Methylene blue
C Brilliant green
D Iodine solution
E Formalin solution
183

Due to severe pain syndrome a patient was prescribed a narcotic analgesic. Name this drug:

A Dimethyl sulfoxide
B Indometacin
C Morphine
D Nimesulide
E Metamizole (Analgin)
184

During pathomorphological renal investigation of a patient, who for a long time had been suffering from osteomyelitis and died of progressing renal failure, the following was revealed: deposits of homogeneous eosinophilic masses in glomerular mesangium, arterial and arteriolar walls, and stroma, which colored red when stained with Congo red. What pathological process is this?

A Calcinosis
B Carbohydrate degeneration
C Mucoid swelling
D Hyalinosis
E Amyloidosis
185

During experiment a dog has developed conditioned digestive reflex in response to a sound stimulus. This conditioned reflex will not be exhibited anymore after the extirpation of the following areas of the cerebral hemispheres:

A Occipital lobe on both sides
B Occipital lobe on one side
C Temporal lobe on one side
D Temporal lobe on both sides
E Parietal lobe on both sides
186

Coenzym A participates in numerous important metabolic reactions. It is a derivative of the following vitamin:

A Niacin
B Calciferol
C Ubiquinone
D Pantothenic acid
E Thiamine
187

A patient diagnosed with acute dysentery has been treated for 3 days in an infectious diseases hospital. On admission there were complaints of high temperature, stomachache and fluid excrements with mucus up to 8-10 times a day. What sample should be taken for analysis?

A Bile
B Blood
C Liquor
D Feces
E Urine
188

A patient with arthritis has been prescribed an anti-inflammatory selective COX-2 inhibitor. Select this drug among those given below:

A Celecoxib
B Indometacin
C Metamizole (Analgin)
D Dimethylsulfoxide (Dimexid)
E Phenylbutazone (Butadion)
189

A person with the fourth blood group (genotype IAIB) has in erythrocytes both antigen A controlled by allele IA and antigen B controlled by allele IB. This phenomenon is an example of the following gene interation:

A Epistasis
B Codominance
C Complementarity
D Polymery
E Semidominance
190

A patient with diabetes mellitus suffers from persistently nonhealing surgical wound, which is a sign of disrupted tissue trophism. What is the cause of such disorder?

A Disruption of protein metabolism regulation
B Hypoglycemia
C Ketonemia
D Anemia
E Increased lipid catabolism
191

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

A Biological
B Bacteriological
C Allergic
D Microscopic
E Serological
192

A microslide demonstrates an organ with its wall consisting of three membranes. The inner membrane has tubular glands and undergoes cyclic changes. Name this organ:

A Esophagus
B Ureter
C Urinary bladder
D Vagina
E Uterus
193

A patient with femoral neck fracture, who for a long time had to remain in bed in a forced ( supine) position, has developed dark-brown lesions along the backbone; soft tissues are swollen, in the areas of maceration there is a foul-smelling liquid. Name the clinicopathologic type of necrosis:

A Infarction
B Coagulation necrosis
C Dry gangrene
D Bedsore
E Sequestrum
194

A patient is 20 years old, an athlete. He addressed a doctor with complaints of fatigue, fever up to 38oC - 40oC. Objectively: the liver and spleen are enlarged, lymph nodes on palpation are slightly enlarged, dense, painless. Blood test: НЬ- 100 g/l; erythrocytes - 2,9 • 1012/l; leukocytes -4,4 • 109/l. Leukogram: 68% of blast cells. Cytochemical investigation of blast cells revealed negative reactions to glycogen, peroxidase, non-specific esterase, lipids. Name this disease:

A Acute myeloid leukemia
B Acute lymphoblastic leukemia
C Acute undifferentiated leukemia
D Acute megakaryoblastic leukemia
E Acute monoblastic leukemia
195

Impression smear of mucosa biopsy material has been obtained from a patient with peptic ulcer disease of the stomach. Gram-negative arcuate bent microorganisms were detected, urease activity test was positive. What microorganisms were detected in the patient?

A Leptospira
B Treponema
C Spirilla
D Helicobacter
E Spirochete
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196

A patient after disrupted cerebral circulation has developed paralysis. Choose the anticholinesterase drug to be prescribed in this case:

A Proserin
B Methacin
C Aceclidine
D Hexamethonium (Benzohexonium)
E Cordiamin
197

30 minutes after drinking mango juice a child suddenly developed a local swelling in the area of the soft palate, which impeded swallowing and, eventually, respiration. Mucosa of the swollen area was hyperemic and painless. Blood test revealed moderate eosinophilia. Body temperature was normal. Anamnesis states that the elder sister of the child has been suffering from bronchial asthma attacks. What kind of edema has developed in the child?

A Allergic
B Hepatic
C Cardiac
D Inflammatory
E Alimentary
198

During examination of a patient a doctor should use anatomical division of anterior abdominal wall into regions for more precise diagnostics. How many regions can abdomen be divided into?

A 8
B 5
C 4
D 6
E 9
199

A child has a wound located posterior to the mastoid process. Bright red blood flows from the wound. Damaged are the branches of the following artery: A.

A A. temporalis superior
B A. maxillaris
C A. occipitalis
D A. carotis externa
E A. carotis interna
200

When investigating human saliva it is necessary to assess its hydrolytic properties. What substance should be used as a substrate in the process?

A Starch
B Fats
C Proteins
D Amino acids
E Fiber