Krok 1 – 2015 Base(Anatomy)

A 10-year-old child complains of weakness, nausea, irritability. Helminthes of while color and 5-10 mm long were found on the underwear. On microscopy of the scrape from the perianal folds achromic ovums of unsymmetrical form were revealed. Indicate what helminth is parasiting on the child?

A patient has been brought to the hospital with the complaints of headache, pain in left hypochondrium. He has been ill for 1,5 weeks. The sudden illness began with the increase of body temperature up to 39,9^oC. In 3 hours the temperature decreased and hydropoiesis began. The attacks repeat rhythmically in 48 hours. The patient had visited one an African country. The doctors have suspected malaria. What method of laboratory diagnostics is necessary to use?

Slime, blood and protozoa 30-200 microns of length have been revealed in a man’s feces. The body is covered with cilias and has correct oval form with a little bit narrowed forward and wide round shaped back end. On the forward end a mouth is visible. In cytoplasm there are two nucleuses and two short vacuoles. For whom are the described attributes typical?

A patient in three weeks after acute myocardial infarction has pain in the heart and joints and pneumonia. What is the main mechanism of development of post-infarction Dressler’s syndrome?

During the fetal period of the development in the vascular system of the fetus large arterial (Botallo’s) duct is functioning which converts into lig. arteriosum after birth. What anatomical formations does this duct connect between each other?

Young man felt sharp pain in the back during active tightening on the horizontal bar. Objectively: pain while moving of upper extremity, limited pronation and adduction functions. Sprain of what muscle is presented?

Children often have heavy nasal breathing resulting from excessive development of lymphoid tissue of pharyngeal mucous membrane. What tonsils growth may cause this effect?

In course of laparotomy a surgeon revealed gangrenous lesion of descending colon. It was caused by thrombosis of the following artery:

Three separate bones connected with cartilage in the area of pelvis cavity are noticed on the X-ray of the pelvis. What are these bones?

A 60-year-old patient has reduced perception of high-frequency sounds. What structures’ disorder of auditory analizer caused these changes?

The alveolar ventilation of the patient is 5 L/min, the breath frequency is 10 per/min, and the tidal volume is 700 ml. What is the patient’s dead space ventilation?

During investigation of patient, it was found formation in the white substance of cerebral hemispheres with location in the knee and frontal part of posterior crus of internal capsule. Fibres of what conductive tract of the brain will be disrupted?

Only one factor can influence the charge of amino acid radicals in the active centre of enzyme. Name this factor:

Succinate dehydrogenase catalyses the dehydrogenation of succinate. Malonic acid HOOC- CH2-COOH is used to interrupt the action of this enzyme. Choose the inhibition type:

The gluconeogenesis is activated in the liver after intensive physical trainings .What substance is utilized in gluconeogenesis first of all in this case:

A patient with a stab wound of the anterior stomach wall is in surgical care. What formation of abdominal cavity did the stomach contents get into?

A patient had been taking glucocorticoids for a long time. When the preparation was withdrawn he developed the symptoms of disease aggravation, decreased blood pressure and weakness. What is the reason of this condition?

A patient has tissue ischemia below the knee joint accompanied with intermittent claudication. What artery occlusion should be suspected?

A patient, who suffers from congenital erythropoietic porphyria, has skin photosensitivity. The accumulation of what compound in the skin can cause it?

A patient has a malignisation of thoracic part of esophagus. What lymphatic nodes are regional for this organ?

The patient has come to the hospital from the smelting workshop in the condition of hyperthermia. What is the direct cause of loss of consciousness at the heat stroke?

A patient’s blood was analyzed and the decreased erythrocyte’s sedimentation rate (ESR) was discovered. What disease from the listed below is accompanied with decreased ESR?

A 55-year-old patien was hospitalized in result of the trauma of the medial group of femoral muscles. What kind of movements is the patient unable to do?

A mother of a newborn complains of her baby’s constant belching with undigested milk. Which developmental anomaly is it an evidence of?

During the endoscopy the inflammation of a major papilla of the duodenum and the disturbances of bile secretion were found. In which part of duodenum were the problems found?

A 18-year-old patient came to the out-patient department with the complaints of bleeding trauma in the vestibule of his nose. On examination: the mechanical injure of the mucous layer of the vestibule without continuation into nasal cavity proper. What is the boundary between the vestibule and nasal cavity proper?

A 32-year-old patient has been diagnosed with bartholinitis (inflammation of Bartholin’s glands ). In what part of the female urogenital system are the Bartholin’s glands located?

A 50 year-old patient had hemorrhage of the brain and was taken to the hospital. The place of hemorrhage was revealed on the lateral hemispheres surfaces during the medical examination. What artety was injured

A 30-year-old patient was hospitalized due to bleeding of the facial artery . What place on the face has to be pressed to stop bleeding?

A 19 year-old patient was diagnosed with appendicitis and was hospitalized. The surgical operation on ablating appendix vermiformis is to be performed. What artery must be fixed to stop bleeding during the surgical operation?

A 45-year-old man fell on the right knee and felt the acute pain in the joint. On examination: severe edema on the anterior surface of the knee joint. Crunching sounds are heard while moving the joint. Which bone is destroyed?

During the operation on the hip joint of a 5-year- old child her ligament was damaged which caused bleeding.What ligament was damaged?

A 6-year-old child fell on the cutting object and traumatized soft tissues between tibia and fibula . What kind of bone connection was injured?

Usually the intravenous injection is done into median cubital vein because it is slightly movable due to fixation by the soft tissues. What does it fix in the cubital fossa?

Victim has elbow joint trauma with avulsion of medial epicondyle of humerus. What nerve can be damaged in this trauma?

A 54-year-old man was admitted to the hospital with complaints of pain in the right subcostal region, vomiting with blood. Objectively: enlarged liver, varicose veins in the stomach and esophagus. Disfunction of what vessel is likely to be?

Examination of a 2-year-old child revealed physical developmental lag, the child often has pneumonias. The child was diagnosed with nonclosure of ductus arteriosus. Haemodynamics disorder was caused by the intercommunication of the following vessels:

A 5-year-old child was admitted to the otorhinolaryngological department with diagnosis – suppurative inflammation of the middle ear. Disease started from the inflammation of the nasopharynx. Through the what canal of the temporal bone did the infection get into the tympanic cavity?

Inflammation of the tympanic cavity (purulent otitis media) was complicated by inflammation of mammillary process sockets. What wall of tympanic cavity did the pus penetrate into the sockets through?

A 19-year-old female suffers from tachycardia in rest condition, weight loss, excessive sweating, exophtalmos and irritability. What hormone would you expect to find elevated in her serum?

A 60-year-old patient was diagnosed with hypothalamic lateral nuclei stroke. What changes in patient’s behavior may be expected?

The process of heart transplantation determined the viability of myocardial cells. The determination of what myocardium parameter is the most important?

It is necessary to take the cerebrospinal fluid from a patient with suspected inflammation of brain tunics. Diagnostic puncture was performed between the arches of the lumbar vertebras. During the puncture the needle went through the following ligament:

Nowadays about 50 minor bases have been found in the t-RNA structure besides the main four nitrogenous bases. Choose the minor nitrogenous base:

Obturative jaundice developed in a 60-year-old patient because of malignant tumour of the big papillary of the duodenal. Lumen of what anatomical structure is squeezed with tumour?

The patient with thymoma (thymus gland tumour) has cyanosis, extention of subcutaneous venous net and edema of the soft tissues of face, neck, upper part of the trunk and upper extremities. What venous trunk is pressed with tumour?

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

Patient complains of frequent and difficult urination. Imperfection of what formation can cause it?

Child inspired button. Where is it likely to be?

Vegetative abnormalities in the sleep, heat regulation, all kinds of metabolism, diabetes insipidus are developing in the patient due to grouth of the tumour in the III ventricle of brain. Irritation of the nucleus of what part of the brain can cause this symptoms?

A patient with infectious mononucleosis had been taking glucocorticoids for two weeks. He was brought into remission, but he fell ill with acute attack of chronic tonsillitis. What action of glucocorticoids caused this complication?

A 45-year-old man with domestic apper arm injuiry came to the trauma unit. The objective data are: there are no extension, adduction or pronation functions of the arm. What muscle damage caused this condition?

A man with internal abdominal right side injury and suspicion of liver rupture was admitted to the traumatological department. In what peritonial structure will blood accumulate?

A histological spacemen presents parenchymal organ, which has cortex and medulla. Cortex consists of epitheliocytes bars with blood capillaries between them; the bars form three zones. Medulla consists of chromaffinocytes and venous sinusoids. Which organ has these morphological features?

After trauma a 44-year-old patient had a rupture of left palm muscle tendons and of the surface of blood vessels. After operation and removal of the most part of the necrotically changed muscle tissue the bloodstream was normalized. What vessels have helped with restoration of bloodstream?

A 45-year-old man applied to the trauma unit because of domestic shoulder trauma. Objectively: flexibility, reduction and pronation functions of the shoulder are absent. What muscle was injured?

Ovarian tumour was diagnozed in the woman. Surgery was indicated. What ligament should be cut by the surgeon to disconnect the ovary and the uterus?

An old woman was hospitalized with acute pain, edema in the right hip joint; the movements in the joint are limited. Which bone or part of it was broken?

A 53-year-old female patient was diagnosed with liver rupture resulting from a blunt abdominal injury. The escaped blood will be assembled in the following anatomic formation:

A patient complains about edemata of legs, skin cyanosis, small ulcers on one side of the lateral condyle. Examination revealed a swelling, enlarged veins, formation of nodes. The pathological process has started in the following vein:

A 70 year old female patient was diagnosed with fracture of left femoral neck accompanied by disruption of ligament of head of femur. The branch of the following artery is damaged:

A woman underwent an operation on account of extrauterine (tubal) pregnancy. In course of the operation the surgeon should ligate the branches of the following arteries:

A 6 month old baby ill with bronchitis was taken for an X-ray of chest. Apart of changes associated with bronchi the X-ray film showed a shadow of thymus gland. What might have caused such changes?

A 7-year-old child can’t abduct the shoulder, raise it to the horizontal level. He can raise the hand to the face only with dorsal side with abduction of the shoulder (with help of supraspinous muscle ) – “bugler” arm. Active function of what muscle is absent?

A 7-year-old girl has signs of anemia. Laboratory examination revealed pyruvate kinase deficiency in erythrocytes. What process disturbance plays the main role in anemia development?

A patient complained about being unable to adduct and abduct fingers in the metacarpophalangeal articulations towards and away from the 3rd finger. Which muscles’ function is impaired?

A 25-year-old patient complained of the decreased vision. Accommodation disorders, dilated pupil, not reacting on the light were revealed on examination. Function of what muscles is disturbed?

A 45-year-old patient was admitted to the surgical department with complaints of abrupt sharp pain in the epigastric region. After examination it was diagnosed: perforated ulcer of the posterior wall of the stomach. Where did content of the stomach  flow out while perforation?

Microspecimen of spinal cord contains a nucleus that should be analyzed. Its neurons form motor endings in the skeletal muscles. What nucleus of spinal cord is meant?

A 35 year old man with a trauma of his left hand was admitted to the traumatology department. Objectively: cut wound of palmar surface of left hand; middle phalanxes of II–V fingers don’t bend. What muscles are damaged?

A 35 year old man with a trauma of his left hand was admitted to the traumatology department. Objectively: cut wound of palmar surface of left hand; middle phalanxes of II–V fingers don’t bend. What muscles are damaged?

A 38-year-old patient came to a traumatology centre and complained about an injury of his right hand. Objectively: the patient has a cut wound in the region of the thenar eminence on the right hand; distal phalanx of the I finger cannot be flexed. What muscle was injured?

A patient with neuritis of femoral nerve has disturbed flexion of thigh as well as disturbed crus extension in the knee joint. What muscle’s function is disturbed?

In the specimen of one of the parts of respiratory system a tubular organ was found. It has low epithelium, well developed muscular tunic, glands and cartilage are absent. Name this organ:

Where should the cathetor for evacuation of the lymph from the thoracic lymph duct be inserted?

A patient has difficulties with hand movement. Examination revealed inflammation of common synovial sheath of flexor muscles. It is known from the patient’s anamnesis that he got a stab wound of finger a week ago. Which finger was most probably damaged?

An injured man has bleeding from branches of carotid artery. For a temporary arrest of bleeding it is necessary to press the carotid artery to the tubercle of a cervical vertebra. Which vertebra is it?

As a result of an accident a patient has intense painfullness and edema of the anterior crus surface; dorsal flexion of foot is hindered. Function of which crus muscle is most likely to be disturbed?

A 40-year-old patient complains of intensive heartbeats, sweating, nausea, visual impairment, arm tremor, hypertension. From his anamnesis: 2 years ago he was diagnosed with pheochromocytoma. Hyperproduction of what hormones causes the given pathology?

A patient who suffers from cancer of back of tongue has an intense bleeding as a result of affection of dorsal lingual artery by the tumour. What vessel should be ligated to stop bleeding?

A 58-year-old patient with acute cardiac insufficiency has decreased volume of daily urine – oliguria. What is the mechanism of this phenomenon?

An 18-year-old man was delivered to the hospital after a road accident. Examination at the traumatological department revealed multiple injuries of soft tissues of face in the region of the medial eye angle. The injuries caused massive haemorrhage. What arterial anastomosis might have been damaged in this region?

After a 2 y.o. child has had flu, there appeared complaints about ear ache. A doctor revealed hearing impairment and inflammation of the middle ear. How did the infection penetrate into the middle ear?

A surgeon has to find the common hepatic duct during the operative intervention on account of concrements in the gall ducts. The common hepatic duct is located between the leaves of:

Cerebral trauma caused increase of ammonia formation. What aminoacid takes part in removal of ammonia from cerebral tissue?

A 40-year-old woman was admitted to the infectious diseases department with high body temperature. Objectively: marked meningeal symptoms. A spinal cord punction was made. What anatomic formation was puncturated?

After resection of the middle third of femoral artery obliterated by a thromb the lower extremity is supplied with blood due to the surgical bypass. Name an artery that plays the main role in reestablishment of blood flow:

A patient’s knee joint doesn’t extend, there is no knee-jerk reflex, skin sensitivity of the anterior femoral surface is disturbed. What nerve structures are damaged?

The electronic microphoto of kidney fragment has exposed afferent glomerular arteriole, which has giant cells under its endothelium, containing secretory granules. Name the type of these cells:

A 50 y.o. patient was admitted to the hospital with complaints about pain behind his breastbone, asphyxia during physical activity. Angiography revealed pathological changes in the posterior interventricular branch of the right coronary artery. What heart parts are affected?

A patient was admitted to the surgical department with suspected inflammation of Meckel’s diverticulum. What part of bowels should be examined in order to discover the diverticulum in course of an operation?

Examination of a newborn boy’s genitals revealed a cleft of urethra that opens on the inferior surface of his penis. What developmental anomaly is meant?

A patient complains about impaired evacuatory function of stomach (long-term retention of food in stomach). Examination revealed a tumour of initial part of duodenum. Specify localization of the tumour:

A man after 1,5 litre blood loss has suddenly reduced diuresis. The increased secretion of what hormone caused such diuresis alteration?

A young man consulted a doctor about disturbed urination. Examination of his external genitals revealed that urethra is split on top and urine runs out of this opening. What anomaly of external genitals development is the case?

A 35 year old patient applied to a doctor with complaints about having intense rhinitis and loss of sense of smell for a week. Objectively: nasal cavity contains a lot of mucus that covers mucous membrane and blocks olfactory receptors. In what part of nasal cavity are these receptors situated?

Inflammatory process of modified subserous layer around cervix of the uterus caused an intensive pain syndrome. In what region of genitals does the pathological process take place?

In course of an operation surgeon removed a part of a lung that was ventilated by a tertiary bronchus accompanied by branches of pulmonary artery and other vessels. What part of a lung was removed?

While examining the oral cavity a stomatologist revealed inflammation of papillae on the border of the median and posterior third of the back of tongue. What papillae are inflamed?

Examination of a patient revealed an abscess of pterygopalatine fossa. Where can the infection spread to unless the disease is managed in time?

During complicated labour the symphysis pubis ruptured. What organ can be damaged mostly?

A patient with cholelithiasis fell ill with mechanic jaundice. Examination revealed that the stone was in the common bile duct. What bile-excreting ducts make up the obturated duct?

Neurological examination of a 65 y.o. patient revealed a haemorrhage within the superior temporal gyrus. In the blood supply area of which artery is it?

A 70 y.o. man has cut an abscess off in the area of mammiform process during shaving. Two days later he was admitted to the hospital with inflammation of arachnoid membranes. How did the infection penetrate into the cavity of skull?

The cerebrospinal fluid is being examined for the purpose of diffrential meningitis diagnostics. At what site is the lumbal puncture safe?

While preparing a patient to the operation the heart chambers’ pressure was measured. In one of them the pressure changed during one heart cycle from 0 to 120 mm Hg. What chamber of heart was it?

Part of alveoles of a preterm infant didn’t spread because of enhanced elastic recoil of lungs. How can this recoil be reduced?

Preventive examination of a patient revealed an enlarged lymph node of metastatic origin on the medial wall of the left axillary crease. Specify the most likely localization of the primary tumour:

A man suffering from osteochondrosis got acute pain in the abdominal muscles (lateral and anterior). During objective examination a physician diagnosticated increased pain sensitivity of skin in the hypogastric region. This pain might be caused by affection of the following nerve:

A woman suffering from osteochondrosis felt acute pain in her humeral articulation that became stronger when she abducted her shoulder. These symptoms might be caused by damage of the following nerve:

Pyeloureterography X-ray photo showed a renal pelvis with minor calyces only (major calyces were absent). What form of urinary tracts of a kidney was revealed?

A patient has a deep cut wound on the posterior surface of his shoulder in its middle third. What muscle might be injured?

A patient has pain, edema and reddening of his skin in the anterosuperior area of his thigh and his foot’s thumb. What lymph nodes of his lower extremity responded to the inflammatory process?

A patient got a craniocerebral trauma that resulted in right-side convergent strabismus. Damage of which craniocerebral nerve caused such consequences?

In case of a penetrating wound of the anterior abdominal wall the wound tract went above the lesser curvature of stomach. What peritoneum formation is most likely to be injured?

After a trauma a patient lost ability of elbow extension. This might have been caused by dysfunction of the following main muscle:

A patient has been diagnosed with a compression fracture of a lumbar vertebra. As a result he has a considerable increase in curvature of the lumbar lordosis. Which ligament damage can induce such changes in the spine curvature?

After a craniocerebral trauma a patient lost the ability to execute learned purposeful movements (apraxia). The injury is most likely localized in the following region of the cerebral cortex:

A patient got an injury of spinal marrow in a road accident that caused loss of tactile sensation, posture sense, vibration sense. What conduction tracts are damaged?

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?

While performing an operation in the area of axillary crease a surgeon has to define an arterial vessel surrounded by fascicles of brachial plexus. What artery is it?

A patient was admitted to the surgical department with inguinal hernia. During the operation the surgeon performs plastic surgery on posterior wall of inguinal canal. What structure forms this wall?

Examination of a patient with impaired blood coagulation revealed thrombosis of a branch of inferior mesenteric artery. What bowel segment is damaged?

A man with an injury of the dorsal area of his neck was admitted to the resuscitation department. What muscle occupies this area?

A patient complains of dizziness and hearing loss. What nerve is damaged?

While palpating mammary gland of a patient a doctor revealed an induration in form of a node in the inferior medial quadrant. Metastases may extend to the following lymph nodes:

A patient got a trauma that caused dysfunction of motor centres regulating activity of head muscles. In what parts of cerebral cortex is the respective centre normally localized?

Examination of a 6-month-old child revealed a delay in closure of the occipital fontanelle. When should it normally close?

A patient was diagnosed with paralysis of facial and masticatory muscles. The haematoma is inside the genu of internal capsule. What conduction tract is damaged?

A patient has lost skin sensitivity in the region of the medial surface of his shoulder. This is the result of dysfunction of the following nerve:

A foreign body (a button) closed space of the right superior lobar bronchus. What segments of the right lung won’t be supplied with air?

A patient was diagnosed with bartholinitis (inflammation of greater vulvovaginal glands). In which organ of urogenital system are these glands localized?

While performing an inguinal canal operation on account of hernia a surgeon damaged the canal’s contents. What exactly was damaged?

Ultrasonic examination of a patient revealed aneurism in the area of aortic arch that caused alteration of vocal function of larynx. What nerve was constricted?

Surgical approach to the thyroid gland from the transverse (collar) approach involves opening of interaponeurotic suprasternal space. What anatomic structure localized in this space is dangerous to be damaged?

In course of a small pelvis operation it became necessary to ligate an ovarian artery. What formation may be accidentally ligated together with it?

An injured person was delivered to the hospital with a penetrating wound in the left lateral region of abdomen. What part of the large intestine is most likely damaged?

After a road accident a driver was delivered to the hospital with an injury of the medial epicondyle of humerus. What nerve might be damaged in this case?

A patient with a knife wound in the left lumbal part was delivered to the emergency hospital. In course of operation a surgeon found that internal organs were not damaged but the knife injured one of muscles of renal pelvis. What muscle is it?

A 25 year old patient was examined by a medical board. Examination revealed pathology of chest. Transverse dimensions were to small and the sternum was strongly protruding. What chest type is it?

A man with a stab wound in the area of quadrilateral foramen applied to a doctor. Examination revealed that the patient was unable to draw his arm aside from his body. What nerve is most probably damaged?

Brain tomography revealed a tumour in the region of red nucleus. What part of brain isdamaged?