Krok 1 – 2005 (General Medicine)

A patient with hypochromic anemia has splitting and loss of hair, increased nail brittling and taste alteration. What is the mechanism of the symptoms development?

A 27- year-old woman has used penicillin containing eye drops. In a few minutes itching, skin burning, lips and eyelids edema, whistling cough, decreasing BP appeared. What antibodies can lead to this allergic reaction?

A patient with hypersecretion of the gastric juices was recomended to exclude concentrated bouillons and vegetable decoctions from the diet because of their stimulation of gastric secretion. What is dominating mechanism of stimulation of secretion in this case?

A journalist’s body temperature has sharply increased in the morning three weeks after his mission in India, it was accompanied with shivering and bad headache. A few hours later the temperature decreased. The attacks began to repeat in a day. He was diagnosed with tropical malaria. What stage of development of Plasmodium is infective for anopheles-female?

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 39.9⁰C. 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?

Galactosemia has been revealed in a child. Concentration of glucose in the blood has not considerably changed. What enzyme deficiency caused this illness?

Synthesis of phospholipids is disordered under the liver fat infiltration. Indicate which of the following substances can enhance the process of methylation during phospholipids synthesis?

An individual is characterized by rounded face, broad forehead, a mongolian type of eyelid fold, flattened nasal bridge, permanently open mouth, projecting lower lip, protruding tongue, short neck, flat hands, and stubby fingers. What diagnosis can be put to the patient?

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?

A patient visited a dentist with complaints of redness and edema of his mouth mucous membrane in a month after dental prosthesis. The patient was diagnosed with allergic stomatitis. What type of allergic reaction by Gell and Cumbs underlies this disease?

A patient suffering from trombophlebitis of deep veins suddenly died. The autopsy has shown freely lying red friable masses with dim crimped surface in the trunk and bifurcation of the pulmonary artery. What pathologic process was revealed by the morbid anatomist?

Purulent endometritis developed in a woman after delivery. Treating with anti-biotics inhibitors of murein synthesis was ineffective. Wide spectrum bactericidal antibiotic was administered to her. In 6 hours temperature rapidly increased up to 40⁰C with shiver. Muscle pains have appeared. BP dropped down to 70/40 mmHg. Oligura has developed. What is the main reason for the development of this condition?

Decreased blood supply to the organs causes hypoxia that activates fibroblasts function. Volume of what elements is increased in this case?

Methotrexate (structural analogue of the folic acid which is competitive inhibitor of the dihydrofolatreductase) is prescribed for treatment of the malignant tumour. On which level does methotrexate hinder synthesis of the nucleic acids?

A 2-year-old child experienced convulsions because of lowering calcium ions concentration in the blood plasma. Function of what structure is decreased?

From the nasopharynx of a 5-year-old child a microorganism was excreted which is identical to Corynebacterium diphtheriae dose according to morphological and biochemical signs. Microorganism does not produce exotoxin. As a result of what process can this microorganism become toxigenic?

A patient with encephalopathy was admitted to neurological department. Correlation of increasing encephalopathy and substances absorbed by the bloodstream from the intestines was revealed. What substances created in the intestines can cause endotoxemia?

A 50-year-old man has felt vague abdominal discomfort within past 4 months. Physical examination revealed no lymphadenopathy, and no abdominal masses or organomegaly at palpation. Bowel sounds are heard. An abdominal CT scan shows a 20 cm retroperitoneal soft tissue mass obscuring the left psoas muscle. A stool specimen tested for occult blood is negative. Which of the following neoplasms is this man most likely to have?

A 40-year-old woman has had a feeling of abdominal discomfort for the past 8 months. On pelvic examination, there is the right adnexal mass. Abdominal CT scan demonstrates a 7 cm cystic mass involving the right ovary with small areas of calcification. The uterus is normal in size. The right fallopian tube and ovary have been removed surgically. Grossly, the mass on sectioning is filled with abundant hair and sebum. Microscopically, the mass has glandular spaces lined by columnar epithelium, squamous epithelium with hair follicles, cartilage, and dense connective tissue. What type of tumour is it?

A man died 8 days after the beginning of the disease. He was diagnosed with dysentery. At the autopsy it was found out a thickened wall of the sigma and rectum, fibrinous membrane on the surface of mucous membrane. Histologically: there is a deep necrosis of mucous membrane with infiltration of necrotic masses with fibrin. What kind of colitis does correspond to the changes?

A patient has undergone an amputation of lower extremity. Some time later painful nodules appeared in a stump. Amputatious neuromas were found out at the microscopic examination. To what pathological processes do those formations relate?

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

A 22-year-old patient was admitted to the hospital with complaints of heavy nasal breathing. During the examination of her nasal cavity the doctors found thickened mucous membrane, a lot of mucus and nodular infiltrates without erosions in the nose.The nasal rhinoscleroma was diagnosed. The biopsy was taken. What typical morphological changes may be found?

A woman suffering from dysfunctional metrorrhagia was made a diagnostic abortion. Histologically in the scrape there were a lot of small stamped glandulars covered with multirowed epithelium. The lumens of some glandulars were cystically extended. Choose the variant of general pathologic process in the endometrium.

A 60-year-old patient was hospitali-sed to the surgical department because of infection caused by blue pus bacillus (Pseudomonas aeruginosa) which is sensative to penicillin antibiotics. Indicate which of the given penicillins has marked activity to the Pseudomonas aeruginosa?

A 45-year-old woman suffers from allergic seasonal coryza caused by the ambrosia blossoming. What adipose cells group stabilizer medicine can be used for prevention of this disease?

A lung of a premature infant is presented on electronic photomicrography of biopsy material. Collapse of the alveolar wall caused by the deficiency of surfactant was revealed. Disfunction of what cells of the alveolar wall caused it?

A young man felt sharp pain in the back during active tightening on the horizontal bar. Objectively: pain while moving upper extremity, limited pronation and adduction functions. Sprain of what muscle can be observed here?

The alternate usage of dichlotiazide, etacrin acid and lasex did not cause marked diuretic effect in the patient with marked peripheral edema. The aldosterone level in the blood is increased. Indicate which medicine should be prescribed:

A 46 year-old man complains of difficult nose breathing. Mikulich cells, storage of epithelioid cells, plasmocytes, lymphocytes, hyaline balls are discovered in the biopsy material of the nose thickening. What is the most likely diagnosis?

A 56-year-old patient complaining of thirst and frequent urination was diagnosed with diabete mellitus. Butamin was prescribed. How does the medicine act?

During the breakout of acute respiratory infection in order to diagnose influenza the express-diagnosis, based on revealing of specific viral antigen in the examined material (nasopharyngial lavage), is carried out. Which reaction is used for this?

A patient with clinical signs of immunodeficiency has unchanged number and functional activity of T and B lymphocytes. Dysfunction’s defect of antigen-presentation to the immunocompetent cells was found during investigation on the molecule level. Defect of what cells is the most probable here?

The action of electric current on the exitable cell caused depolarization of its membrane. Movement of what ions through the membrane caused depolarisation?

Electrocardiogram of a 45-year-old man showed absence of P-wave in all the leads. What part of the conducting system is blocked?

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 histological examination of the stomach it was found out that glands contained very small amount of pariental cells or they were totally absent. Mucose  membrane of what part of the stomach was studied?

Live vaccine is injected into the human body. Increasing activity of what cells of connective tissue can be expected?

When a patient with traumatic impairment of the brain was examined, it was discovered that he had stopped to distinguish displacement of an object on the skin. What part of the brain was damaged?

In the blood of a 26-year-old man 18% of erythrocytes of the spherical, ball-shaped, flat and thorn-like shape have been revealed. Other eritrocytes were in the form of the concavo-concave disks. How is this phenomenon called?

In case of enterobiasis acrihine – the structural analogue of vitamin B₂ – is administered. The synthesis disorder of which enzymes does this medicine cause in microorganisms?

When the pH level of the stomach lumen decreases to less than 3, the antrum of the stomach releases peptide that acts in paracrine fashion to inhibit gastrin release. This peptide is:

Different functional groups can be presented in the structure of L-amino acid’s radicals. Identify the group that is able to form ester bond:

The conjugated protein necessarily contains special component as a non-protein part. Choose the substance that can’t carry out this function:

A denaturation of proteins can be found in some substances. Specify the substance that is used for the incomplete denaturation of hemoglobin:

Moving of the daughter chromatids to the poles of the cell is observed in the mitotically dividing cell. On what stage of the mitotic cycle is this cell?

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

The patient with diabetes mellitus has been delivered in hospital in the state of unconsciousness. Arterial pressure is low. The patient has acidosis. Point substances, which accumulation in the blood results in these manifestations:

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

The high level of Lactate Dehydrogenase (LDH) isozymes concentration showed the increase of LDH-1 and LDH-2 in a patient’s blood plasma. Point out the most probable diagnosis:

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:

Pyruvate concentration in the patient’s urine has increased 10 times from normal amount. What vitamin deficiency can be the reason of this change:

Hydroxylation of endogenous substrates and xenobiotics requires a donor of protons. Which of the following vitamins can play this role?

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

The formation of a secondary mediator is obligatory in membrane-intracellular mechanism of hormone action. Point out the substance that is unable to be a secondary mediator:

There is only one hormone among the neurohormones which refers to the derivatives of amino acids according to classification. Point it out:

A patient with complaints of 3-day-long fever, general weakness, loss of appetite came to visit the infectionist. The doctor suspected enteric fever. Which method of laboratory diagnosis is the best to confirm the diagnosis?

A consumptive patient has an open pulmonary form of disease. Choose what sputum staining should be selected for finding out the tubercle (Koch’s) bacillus?

During surgical operation a blood transfusion was made. The blood must be checked to find antigens of some disease. What disease is expected to be found?

A person has steady HR not exceeding 40 bpm. What is the pacemaker of the heart rhythm in this person?

The sterile Petri dishes and pipettes are necessary to prepare for microbiological tests in bacteriological laboratory. What way of sterilization should be applied in this case?

A 50-year-old male farm worker has been brought to the emergency room. He was found confused in the orchard and since then has remained unconscious. His heart rate is 45 and his blood pressure is 80/40 mm Hg. He is sweating and salivating profusely. Which of the following should be prescribed?

A 58-year-old female has undergone surgery for necrotic bowel. Despite having been treated with antibiotics, on postoperative day 5, she develops symptoms (fever, hypotension, tachycardia, declining urine output, and confusion) consistent with septic shock. What hemodynamic support would be helpful?

A 42-year-old man who has been injured in a car accident is brought into the emergency room. His blood alcohol level on admission is 250 mg/dL. Hospital records show a prior hospitalization for alcohol related seizures. His wife confirms that he has been drinking heavily for 3 weeks. What treatment should be provided to the patient if he goes into withdrawal?

A 13-year-old girl with history of asthma complained of cough, dyspnea and wheezing. Her symptoms became so severe that her parents brought her to the emergency room. Physical examination revealed diaphoresis, dyspnea, tachycardia and tachypnea. Her respiratory rate was 42/min, pulse rate was 110 beats per minute, and blood pressure was 130/70 mm Hg. Choose from the following list the most appropriate drug to reverse the bronchoconstriction rapidly:

A doctor administered Allopurinol to a 26-year-old young man with the symptoms of gout. What pharmacological action of Allopurinol ensures therapeutical effect?

A patient who came to the doctor because of his infertility was administered to make tests for toxoplasmosis and chronic gonorrhoea. Which reaction should be performed to reveal latent toxoplasmosis and chronic gonorrhoea of the patient?

Some diseases reveal symptoms of aldosteronism with hypertension and edema due to sodium retention in the organism. What organ of the internal secretion is affected on aldosteronism?

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 after hypertension stroke does not have voluntary movements in his right arm and leg with the increased muscle tone in these extremites. What type of disfunction of nervous system is it?

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?

A sick man with high temperature and a lot of tiny wounds on the body has been admitted to the hospital. Lice have been found in the folds of his clothing. What disease can be suspected in the patient?

A patient with suspicion on epidemic typhus was admitted to the hospital. Some arachnids and insects have been found in his flat. Which of them may be a carrier of the pathogen of epidemic typhus?

A businessman came to India from South America. On examination the physician found that the patient was suffering from sleeping-sickness. What was the way of invasion?

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?

There is an inhibited coagulation in the patients with bile ducts obstruction, bleeding due to the low level of absorbtion of a vitamin. What vitamin is in deficiency?

Blood analysis of a patient showed signs of HIV infection (human immunodeficiency virus). Which cells does HIV-virus primarily affect?

The preventive radioprotector was given to a worker of a nuclear power station. What mechanism from the below mentioned is considered to be the main mechanism of radioprotection?

The pulmonalis embolism has suddenly developed in a 40 year-old patient with opened fracture of the hip. Choose the possible kind of embolism.

A 52 year-old patient with bronchial asthma was treated with glucocorticoids. Fever reaction appeared as a result of postinjective abscess. The patient had subfebrile temperature, which didn’t correspond to latitude and severity of inflammatory process. Why did patient have low fever reaction?

Patient 54 year-old, 5th day after surgical operation. Blood count:  Erythrocytes 3.6×10¹²/l, Hemoglobin 95 g/l, Erythrocyte’s hemoglobin content (color index) 0.78; Leukocytes 16×10⁹/l, Platelets 450×10⁹/l Blood picture: anizocytosis, poikilocytosis, reticulocytes-3,8%. What anemia does this patient have?

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?

X-ray examination discovered lungs emphysema in the patient. What is the reason of short breath development in this case?

The patient with pneumonia was treated with antibiotics for a long period. After treatment patient complains of frequent and watery stool, abdomenal pain. What is the reason of intestine function disorder?

A 16 year-old patient got numerous traumas in automobile accident. Now the patient is having a shock. АP – 80/60 mm Hg. daily urine volume 60-80 ml. What pathogenic mechanism leads to kidneys function violation?

A 46 year-old patient has complained of headache, fatigue, thirst, pains in the spine and joints for the last 2 years. Clinically observed disproportional enlargement of hands, feet, nose, superciliary arches. He notes that he needed to buy bigger shoes three times. What is the main reason of such disproportional enlargement of different parts of the body?

A 55-year-old patient 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 was injured on the occipital region of the head. The closed skull’s trauma was diagnosed. She was taken to the hospital. The medical examination: deregulation of walking and balance, trembling of arms. What part of brain was injured?

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?

An autopsy has revealed that kidneys are enlarged, surface is large-granular because of multiple cavities with smooth wall, which are filled with clear fluid. What kidney disease did the patient have?

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 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?

An autopsy revealed: soft arachnoid membrane of the upper parts of cerebral hemisphere is plethoric, of yellowish-green color, soaked with purulent and fibrose exudate, it lookes like a cap. What disease is characterised by these symtoms?

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?

A 55-year-old patient with continuing ventricular arrhythmias was admitted to the hospital. The patient is taking timolol drops for glaucoma, daily insulin injections for diabetes mellitus, and an ACE inhibitor for hypertension. You have decided to use phenytoin instead of procainamide. What is the reason?

A 35-year-old man under the treatment for pulmonary tuberculosis has acute-onset of right big toe pain, swelling, and low-grade fever. The gouty arthritis was diagnosed and high serum uric acid level was found. Which of the following antituberculosis drugs are known for causing high uric acid levels?

A person was selling “homemade pork”sausages on the market. State sanitary inspector suspected falcification of the sausages. What serological immune reaction can identifiy food substance?

A 25-year-old woman with red and itchy eczematoid dermatitis visits your offi She had a dental procedure one day earlier with administration of a local anesthetic. There were no other findings, although she indicated that she had a history of allergic reactions. Which of the following drugs is most likely involved?

The CNS stimulation produced by methylxanthines, such as caffeine, is most likely due to the antagonism of one of the following receptors:

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

A student is thoroughly summarising a lecture. When his groupmates begin talking the quality of the summarising worsens greatly. What type of inhibition in the cerebral cortex is the cause of it?

While enrolling a child to school Mantu’s test was made to define whether revaccination was needed. The test result is negative. What does this test result mean?

The donor who had not donated the blood for a long time was examined with IFA method. Anti-HBs antibodies were revealed. What does positive result of IFA in this case mean?

Inhibition of alpha-motoneuron of the extensor muscles was noticed after stimulation of α-motoneuron of the flexor muscles during the experiment on the spinal column. What type of inhibition can be caused by this process?

A worker has decreased buffer capacity of blood due to exhausting muscular work The influx of what acid substance in the blood can cause this symptom?

Substitution of the glutamic acid on valine was revealed while examining initial molecular structure. For what inherited pathology is this symptom typical?

Inflamation is characterised by increasing penetration of vessels of microcirculation stream, increasing of their fluid dynamic blood pressure. Increasing of the osmotic concentration and dispersity of protein structures can be found in the intercellular fluid. What kind of edema are to be observed in this case?

Scraps of the mycelium of a fungus, spores, air bubbles and fat drops were discovered on microscopy of the patient’s hair excluded from the infected areas. What fungus disease is characterised by this microscopic picture?

Autopsy of the 58-year-old man hads revealed that mitral valve is deformed, thickened, does not totally close. Microscopically: centers of collagen fibers are eosinophilic, have positive fibrin reaction. The most probable diagnosis is:

A highly injured person has gradually died. Please choose the indicator of biological death:

A 37-year-old man was admitted to the surgical department with the symptoms of acute pancreatitis: vomiting, diarrhea, bradycardia, hypotention, weakness, dehydration of the organism. What medicine should be used first of all?

On autopsy a 35-year-old man the focus of carnification 5 cm in diametre enclosed in a thin capsule was revealed in the second segment of the right lung . The focus consists of a tough dry friable tissue with a dim surface. For what disease are these morphological changes typical?

A 62-year-old patient was admitted to the neurological department due to cerebral haemorrage. His condition is grave. There is evident progression of deep and frequent breath that turnes into reduction to apnoea and the cycle repeates. What respiration type has developed in the patient?

Punctata hemorrhage was found out in the patient after application of a tourniquet. With disfunction of what blood cells is it connected?

In the microspecimen of red bone marrow multiple capillares were revealed through the walls of which mature blood cells penetrated. What type of capillares is it?

A 57-year-old patient was admitted to the gastroenterological department with suspicion of Zollinger-Ellison syndrom because of rapid increase of gastrin level in the blood serum. What the most probable disorder of the secretory function of the stomach here?

After breathing with poisonous steams there is an increased quantity of slime in respiratory passages of a chemical production worker. What of respiratory tract epithelial cells participate in mucousa moistening?

A patient suffering from thyrotoxicosis symptoms of vegetoasthenic syndrome was revealed. What of the following would show the histological appearance of a thyroid gland being stimulated by thyroid-stimulating hormone (TSH)?

For a long time a 49-year-old woman had suffered from glomerulonephritis which caused death. The autopsy revealed that the size of her kidneys was 7х3х2.5 cm, weight 65.0 g, they were dense and small-grained. Microscopically: fibrinogenous inflammation of serous and mucous capsules, dystrophic changes of parenchymatous organs, brain edema. What complication can cause such changes of serous capsules and inner organs?

The reason of occurrence of some diseases of an oral cavity is connected with structural peculiarities of its mucous membrane. What morphological attributes characterize these features?

There is the change of teeth at the 6-8-year-old children: deciduous are replaced by permanent. What embrionic tissues are the sources of formation of permanent teeth tissues?

The B cells of endocrine portion of pancreas are selectively damaged by alloxan poisoning. How will it be reflected in blood plasma?

A healthy woman has three sons affected by color blindness who were born after her two marriages. Children both of her husbands are healthy. What is the most possible pattern of inheritance of this disease?

A couple came for medical genetic counseling. The man has hemophilia, the  woman is healthy and there were no cases of hemophilia in her family. What is the risk of having a sick child in this family?

Oval and round organelles with double wall are seen at the electron micrograph. The outer membrane is smooth, the inner membrane folded into cristae contain enzyme ATPase synthetase. These are:

A tissue sample of benign tumor was studied under the electron microscope. A lot of small (15-20 nm) spherical bodies, consisting of 2 unequal subunits were detected. These are:

A woman who was sick with rubella during the pregnancy gave birth to a deaf child with hare lip and cleft palate. This congenital defect is an example of:

A woman who was infected with toxoplasmosis during the pregnancy has a child with multiple congenital defects.This is a result of:

At the aboratory experiment the eukocyte culture was mixed with staphylococci. Neutrophile leukocytes engulfed and digested bacterial cells. This processes are termed:

Marked increase of activity of МВ-forms of CPK (creatinephosphokinase) and LDH-1 was revealed by examination of the patient’s blood. What is the most probable pathology?

An isolated muscle of a frog is rhythmically irritated with electric impulses. Every next impulse is in a period of relaxation from the previus contraction. What contraction of the muscle occurs?

M-r S presents all signs of the hepatic coma: loss of consciousness, absence of reflexes, cramps, convulsion, disorder of heart activity, recurrent (periodical) respiration. What are cerebrotoxical substances which accumulate in blood under hepar insufficiency?

A 16-year-old boy was performed an appendectomy. He has been hospitalized for right lower quadrant abdominal pain within 18 hours. The surgical specimen is edematous and erythematous. Infiltration by what of the following cells is the most typical for the process occuring here?

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?

The concentration of albumins in human blood sample is lower than normal. This leads to edema of tissues. What blood function is damaged?

A patient with tissue trauma was taken a blood sample for the determination of blood clotting parameters. Specify the right sequence of extrinsic pathway activation.

A patient has been taking a mixture prescribed by neuropathologist for neurasthenia for two weeks. The patient feels better but has developed coryza, conjunctivitis, rash, inertia, decrease of memory. She is diagnosed with bromizm. What should be prescribed to decrease the symptoms?

On autopsy of a still-born infant abnormalities have been revealed: ventricles are not separated, a single arterial trunk originates from the right part. For what class of vertebrates is such heart construction characteristic?

If strong oxidizers get into the bloodstream, a methemoglobin is formed. It is a compound, where iron (II) becomes iron (III). What has to be done to save the  patient?

A 10-year-old child complains of weakness, nausea, irritability. Helminthes of white color and 5-10 mm long have been found on the underwear. On microscopy of the scrape from the perianal folds achromic ova of the unsymmetrical form have been revealed. Which helminth is in the organism of the child?

The low specific gravity of the secondary urine (1002) was found out in the sick person. What is the most distant part of nephron where concentration of secondary urine takes place?

A patient with the symptoms of acute alcoholic poisoning was brought to the hospital. What carbohydrates metabolism changes are typical for this condition?

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

During the experiment on the influence of chemical substances in the muscles the reaction of Ca²⁺-pump is weakened. Which phenomenum will be observed?

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

The calcium canals of cardiomyocytes have been blocked on an isolated rabbit’s heart. What changes in the heart’s activity can happen as a result?

After the trauma, the patient’s right n.vagus was damaged. Which violation of the cardiac activity is possible in this case?

A 59-year-old man has symptoms of parenchymatous jaundice and portal hypertension. Histological examination of the puncture of the liver bi- optate has revealed an affected beam-lobule structure, part of hepatocytes has signs of fat dystrophy, port-portal connective tissue septa with formation of pseudo-lobules, with periportal lympho-macrophage infiltrations. What is the most probable diagnosis?

A microscopic examination of the enlarged neck gland of a 14-year-old girl revealed destruction of the tissue structure of the node, absence of the lymph follicles, sclerotic and necrosis parts. Cell constitution of the node is polymorphous, lymphocites, eosinophiles, atypical cells of the large size with multiple-lobule nuclei (Beresovsky-Shternberg cells) and onenucleus large size cells are observed. What is the most likely diagnosis?

A damage of the atomic power plant reactor resulted in the run-out of radioelements. People in the superstandard radiation zone were radiated with approximately 250-300 r. and were immediately hospitalized. What changes in the blood count would be typical?

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?

Necrosis focus was observed in the area of hyperemia and skin edema in a few hours after burn. What mechanism strengthens destructive effects in the inflammation area?

Analeptical remedy of reflective type from the H-cholinomimetics group was given to the patient for restoration of breathing after poisoning with carbon monoxide. What medicine was prescribed to the patient?

Intrapleural pressure is being measured in a person. In what phase does a person hold his breath if the pressure is – 25 cm H₂O?

Blood sampling for bulk analysis is recommended to be performed on an empty stomach and in the morning. What changes in blood composition can occur if to perform blood sampling after food intake?

Examination of a person revealed that minute volume of heart is 3500 mL, systolic volume is 50 mL. What is the frequency of cardiac contraction?

Glomerular filtration rate (GFR) increased by 20% due to prolonged starvation of the person. The most evident cause of filtration changes under this conditions is:

In the ovary specimen colored with hematoxylin-eosin, follicle is determined where cubic-shaped follicle epithelium cells are placed in 1-2 layers, and scarlet covering is seen around ovocyte. Name this follicle:

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

A 45-year-old man with domestic upper arm injury 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 68-year-old woman can not move her upper and lower right extremities after stroke. Muscle tone of these extremities and reflexes are increased. There are pathological reflexes. What form of the paralysis is it?

Part of the DNA chain turned about 180 degrees due to gamma radiation. What type of mutation took place in the DNA chain?

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?

A patient with bronchial asthma had been taking tablets which caused insomnia, headache, increased blood pressure. What medicine can cause such complications?

A patient died 3 days after the operation because of perforated colon with manifestations of diffuse purulent peritonitis. The autopsy revealed: colon mucos membrane was thickened and covered with a fibrin film, isolated ulcers penetrated at different depth. The histology result: mucous membrane necrosis, leukocytes infiltration with hemorrhages focuses. What disease complication caused the patient’s death?

Periodic renal colics attacks are observed in a woman with primary hyperparathyroidizm. Ultrasonic examination revealed small stones in the kidneys. What is the most plausible reason of the stones’s formation ?

Ovarian tumor was diagnosed in a woman. Surgery should be performed. What ligament should be extracted by the surgeon to disconnect the ovary and the uterus?

An intraoperational biopsy of mammal gland has revealed the signs of atypical tissue with disorder of parenchyma stroma proportion with domination of the last, gland structures of different size and shape, lined with single-layer proliferative epithelium. What is the most probable diagnosis?

The increased intraocular tension is observed in a patient with glaucoma.Secretion of aqueous humor by the ciliar body is normal. Injury of what structure of the eyeball caused the disorder of flow-out from the anterior chamber?

Chronic glomerulonephritis was diagnosed in a 34-year-old patient 3 years ago. Edema has developed within the last 6 months. What caused the edema?

Patient with diabetes mellitus experienced loss of consciousness and convulsions after an injection of insulin. What might be the result of biochemical blood analysis for concentration of sugar?

A 63-year-old woman developed symptoms of rheumatoid arthritis. Their increase of which blood values indicators could be the most significant in proving the diagnosis?

An autopsy revealed large (1-2 cm) brownish-red, easy crumbling formations covering ulcerative defects on the external surface of the aortic valve. What is the most likely diagnosis?

Red colonies spread in the large quantity in the Endo culture medium were revealed on bacteriological stool examination of a 4-month-old baby with the symptoms of acute bowel infection. What microorganism can it be?

A patient with abscess of the cut wound applied to the traumatological department.The wound was washed with 3% hydrogen peroxide to be cleaned from the pus. Foam was not observed. What caused inefficiency of the drug?

A patient with injured muscles of the lower extremities was admitted to the traumatological department. Due to what cells is reparative regeneration of the muscle fibers and restoration of the muscle function possible?

The study of the genealogy of a family with hypertrichosis (helix excessive pilosis) has demonstrated that this symptom is manifested in all generations only in men and is inherited by son from his father. What is the type of hypertrichosis inheritance?

A 50-year-old patient with typhoid fever was treated with Levomycetin, the next day his condition became worse, temperature rose to 39.6⁰ . What caused the complication?

A patient after pathological process has a thickened alveolar membrane. The direct consequence of the process will be the reduction of:

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

The penetration of the irritable cell membrane for potassium ions has been increased during an experiment. What changes of membrane electric status can occur?

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:

The energy inputs of a healthy man have been measured. In what position was the patient if his energy inputs were less than the main exchange?

A man after 1.5 litre blood loss has suddenly reduced diuresis. The increased secretion of what hormone caused such diuresis alteration?

A 2-year-old child has got intestinal dysbacteriosis, which results in hemorrhagic syndrome. What is the most likely cause of hemorrhage of the child?

To anaesthetize the manipulation related to burn surface treatment, a patient was intravenously injected a medication for short-acting narcosis. 1 minute later the patient being under anaesthesia had increased blood pressure, tachycardia, increased tone of skeletal muscles; reflexes remained. After awakening the patient had desorientation and visual hallucinations. What medication was the patient injected?

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

A patient died from acute cardiac insufficiency. The histological examination of his heart revealed the necrotized section in myocardium of the left ventricle, which was separated from undamaged tissue by the zone of hyperimic vessels, small hemorrhages and leukocytic infiltration. What is the most likely diagnosis?

A young man has an unpainfull formation without marked borders in the soft tissues of his thigh. On the tissue bi-optate the formation lookes like flesh of fish and consists of immature fibroblast-like cells with multiple mitosis growing through the muscles. What is the most likely diagnosis?