Krok 1 – 2006 (General Medicine)

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

A 27-year-old woman has dropped penicillin containing eye drops. In a few minutes there appeared feeling of itching, burning of the skin, lips and eyelids edema, whistling cough, decrease of BP. What imunoglobulins take part in the development of this allergic reaction?

A person felt thirsty after staying under the conditions of hot weather for a long time. Signals of what receptors caused it first of all?

Slime, blood and protozoa 30-200 microns long have been revealed in a man’s feces. The body is covered with cilias and has correct oval form with a little bit narrowed anterior and wide round shaped posterior end. At the anterior end a mouth is visible. In cytoplasm there are two nucleui and two short vacuoles. What are the described features typical for?

A child has got galactosemia. Concentration of glucose in blood has not considerably changed. Deficiency of what enzyme caused this illness?

Synthesis of phospholipids is disturbed as a result fatty infiltration of liver. 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 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 the deep crural veins suddenly died. 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 morbid anatomist?

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

RNA-polymerase B(II) is blocked due to amanitine poisoning (poison of death-cup). It disturbs:

Secretion of what gastrointestinal hormones will be primarily decreased as a result of duodenum removal?

It is planned to use the territory of an old cattle burial ground (which is not used for more than 50 years) for building houses. But ground analysis revealed presence of the pathogen of a very dangerous illness. Which of the indicated microorgonisms is likely to remain in the ground for such a long time?

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

A   patient   with   encephalopathy  was admitted to the neurological in-patient department. There was revealed a correlation between increasing of encephalopathy and substances absorbed by the bloodstream from the intestines. What substances that are formed 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 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?

Intake of oral contraceptives containing sex hormones inhibits secretion of the hypophysiae hormones. Secretion of which of the indicated hormones is inhibited while taking oral contraceptives with sex hormones?

A 60-year-old patient was admitted 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 seasonal allergic rhinitis caused by the ambrosia blossoming. What medicine from the stabilizer of the adipose cells group can be used for prevention of this disease?

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

A 52-year-old patient has the following diagnosis: systemic amebiasis with involvment of intestines, liver, lungs. What drug should be prescribed?

A 38-year-old man who poisoned himself with mercury dichloride was taken to the admission room in grave condition. What antidote should be immediately introduced?

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

The alternate usage of dichlotiazide, etacrin acid and lasex did not influence diuretically upon the patient with marked peripheral edemata. The aldosterone rate in the blood is increased. Indicate which medicine should be prescribed:

A 46-year-old man complains of difficulties with nasal breathing. Mikulicz’s cells, accumulation of epithelioid cells, plasmocytes, lymphocytes, hyaline balls were discovered in the biopsy material of the thickened nasal mucosa. 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?

A man who was bitten by the unknown dog applied to the surgeon. Wide ragged wounds were localized on the face. What curative-prophylactic aid should be given to prevent rabies?

A patient with clinical signs of immunodeficiency has no changes of the number and functional activity of T- and B- lymphocytes. Defect with disfunction of antigen-presentation to the immunocompetent cells was found during examinatio on the molecule level. Defect of what cells is the most probable?

A 38-year-old woman was admitted to the admission-diagnostic department with uterine bleeding. What are the most likely changes of blood?

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

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

Live vaccine was injected into the human body. Increasing activity of what connective tissue cells 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 spinous shape have been revealed. Other eritrocytes were in form of the concavo-concave disks. How is this phenomenon called?

A 10-year-old girl often experiences acute respiratory infections with multiple punctate haemorrages in the places of clothes friction. Hypovitaminosis of what vitamin has the girl?

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:

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

During examination of a patient, there was found a neoplasm in the white substance of cerebral hemispheres with localization in the knee and frontal part of posterior crus of internal capsule. fibres of what conductive tract of the brain will be disrupted?

A 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:

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

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?

Under some diseases it is observed aldosteronism accompanied by hypertension and edema due to sodium retention in the organism. What organ of the internal secretion is affected under 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 has tissue ischemia below the knee joint accompanied with intermittent claudication. What artery occlusion should be suspected?

An experiment proved that UV-radiated cells of patients with xeroderma pigmentosum restore the native DNA structure slower than cells of healthy individuals as a result of reparation enzyme defection. What enzyme helps this process?

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

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?

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?

Patients with bile ducts obstruction suffer from inhibition of blood coagulation, bleedings as a result of low level of vitamin assimilation. 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 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 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 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?

An 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 injury 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 50-year-old patient was injured on the occipital region of the head. The closed skull 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 patient with complaints of dryness in the mouth, photophobia and vision impairment was admitted to the reception-room. Skin is hyperemic, dry, pupils are dilated, tachycardia. Poisoning with belladonna alkaloids was diagnosed on further examination. What medicine should be prescribed?

Autopsy revealed that right lung is enlarged, solid, there are fibrin layers on the pleura. Lung tissue is light grey color on incision with muddy liqued exudates. What lung disease are these symptoms typical for?

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

On autopsy it was revealed: pia mater of the upper parts of cerebral hemisphere is plethoric, of yellowish-green color, soaked with purulent and fibrose exudate, looks like a cap. What disease is it typical for?

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 pain onset of right big toe, swelling, and low-grade fever. The gouty arthritis was diagnosed and high serum uric acid level was found. Which of the following antituberculous drugs are known for causing high uric acid levels?

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

A patient with rheumatoid arthritis who had been treated with indometacin has got signs of gastropathy. What activity of the drug can this complication be connected with?

A 25-year-old woman with red and itchy eczematoid dermatitis visits your office. 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?

In course of metabolic process active forms of oxygen including superoxide anion radical are formed in the human body. By means of what enzyme is this anion inactivated?

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

A student is writing a thorough summary of a lecture. Quality of summarizing has considerably worsened when his neighbours started talking. What kind of inhibition in the cerebral cortex caused this effect?

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 didn’t donate the blood for a long time was investigated with IFA method. Anti-HBs antibodies were revealed. What does positive result of IFA in this case mean?

Testosterone and it’s analogs increase the mass of skeletal muscles that allows to use them for treatment of dystrophy. Due to interaction of the hormone with what cell substrate is this action caused?

Inhibition of α-motoneuron of the extensor muscles was noticed after stimulation of α-motoneuron of the flexor muscles during the experiment on the spinal cord. What type of inhibition is this process based upon?

A patient who has been strictly keeping to a certain diet for 10 days went through examination of respiratory coefficient. It was determined that it was equal 1. What have the patient been keeping to?

Buffer capacity of a worker’s blood was decreased due to exhausting muscular work. By coming of what acid substance in the blood can this state be explained?

Examination of initial molecular structure revealed substitution of the glutamic acid by valine. What inherited pathology is it typical for?

Inflamation is characterised by increased permeability of vessels of microcirculation stream, increase of their hydrodynamic blood pressure. Increasing of the osmotic concentration and dispersity of protein structures is present in the intercellular fluid. What kind of edema will appear in this case?

Increased fragility of vessels, enamel and dentine destruction resulting from scurvy are caused by disorder of collagen maturation. What stage of procollagen modification is disturbed under this avitaminosis?

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?

On autopsy of the 58-year-old man it was revealed: mitral valve is deformed, thickened, not totally closed. Microscopically: foci of collagen fibers are eosinophilic, have positive fibrin reaction. The most likely it is:

Hypertrychosis of auricles is caused by a gene that is localized in Y-chromosome. Father has this feature. What is the probability to give birth to a boy with such anomaly?

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 have taken place?

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?

A person has reduced diuresis, hypernatremia, hypokalemia. Hypersecretion of what hormone can cause such changes?

Microspecimen of red bone marrow contains multiple capillares through the walls of which mature blood cells penetrate into the bloodstream. What type of capillares are these?

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 is the most probable disorder of the secretory function of stomach?

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 7 х 3 х 2.5 cm, weight 65.0 g, they were dense and small-grained. Microscopically: fibrinogenous inflammation of serous and mucous membranes, dystrophic changes of parenchymatous organs, brain edema. What complication can cause such changes of serous membranes and inner organs?

Upper neck node of sympathetic trunk was removed from the rabbit on experiment. Reddening and increased temperature of the skin of head is observed. What disorder of peripheral circulation of the blood has developed?

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 infected with toxoplasmosis during the pregnancy has born a child with multiple congenital defects.This is a result of:

A considerable increase of activity of МВ-forms of CPK (creatinephosphoki-nase) and LDH-1 was revealed on the examination of patient’s blood. What is the most likely 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?

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?

ATP synthesis is totally blocked in a cell. How will the value of membrane rest potential change?

A patient who was previously ill with mastectomy as a result of breast cancer was prescribed radiation therapy. What vitamin preparation has marked radioprotective action caused by antioxidant activity?

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:

Autopsy of a man who died from chronic cardiacvascular collapse revealed “tiger heart”. Sidewards of endocardium a yellowish-white banding can be seen; myocardium is dull, dark-yellow. What process caused this pathology?

Parents with an ill child consulted an infectionist. They had been working in one of Asian countries for a long time. The child has sallow skin, loss of appetite, laxity, enlarged liver, spleen, peripheral lymph nodes. What protozoal illness can be suspected?

Healthy parents have got a fair-haired, blue-eyed girl. Irritability, anxiety, sleep and feeding disturbance developed in the first months of the infant’s life. Neurological examination revealed developmental lag. What method of genetic investigation should be used for the exact diagnosis?

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 result from it?

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 areas and necrosis foci, cell constitution of the node is polymorphous, lymphocites, eosinophiles, big atypical cells with multilobular nuclei (Beresovsky-Sternberg cells) and mononuclear cells of the large size are present. What is the most likely diagnosis?

As a result of the damage of one of the Atomic Power Plant reactors the run-out of radioelements took place. People in the high-radiation area were radiated with approximately 250-300 r. They were immediately hospitalized. What changes in the blood count would be typical for the victims?

Dystrophic alterations of heart are accompanied with dilation of heart cavities, decreased force of heart contractions, increased blood volume that remains during systole in the heart cavity, vein overfill. What heart condition is it typical for?

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

A 60-year-old patient fell ill with obturative jaundice as a result of malignant tumour of the big papillary of the duodenal. Lumen of what anatomical structure is compressed by tumour?

Thyrotoxicosis leads to increased production of thyroidal hormones T₃ and T₄, weight loss, tachycardia, psychic excitement and so on. How do thyroidal hormones effect energy metabolism in the mitochondrion of cells?

While shifting the gaze to the closely situated object the refracting power of eye’s optical mediums will increase by 10 diopters. It results from changing of such eye structure:

Necrosis focus appeared in the area of hyperemia and skin edema in few hours after burn. What mechanism strengthens destructive effect 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?

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?

A patient has got a spasm of smooth muscles of bronchi. Activators of what membrane cytoreceptors are phisiologically reasoned to stop an attack?

Intrapleural pressure of an individual is being measured. In what phase did he hold his breath if the pressure is – 25 cm H₂O?

Blood sampling for the haematology is recommended to carry out on an empty stomach and in the morning. What changes in blood formula are possible if blood sampling was carried out after food intake?

Glomerular filtration rate (GFR) increased by 20% as a result of prolonged starvation of an individual. The most evident cause of filtration changes under this conditions is:

The ovary specimen colored with hematoxylin-eosin contains a follicle, in which cubic-shaped follicle epithelium cells are placed in 1-2 layers, and scarlet membrane is seen around the ovocyte. Name this follicle:

A  42-year-old man  suffering from gout has increased level of urinary acid in blood. Allopurinol was prescribed to decrease the level of urinary acid. Competitive inhibitor of what enzyme is allopurinol?

A child has inhaled a button. Where is it likely to be?

A patient with serious damage of muscular tissue was admitted to the traumatological department. What biochemical urine index will be increased in this case?

Donor skin transplantation was performed to a patient with extensive burns. On the 8^th day the graft became swollen and changed colour; on the 11^th day graft rejection started. What cells take part in this process?

As a result of craniocerebral trauma a patient reveals the following symptoms: intention tremor, dysmetry, adiadochokinesis, dysarthria. What structure of the brain is injured?

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?

Autopsy of a 12-year-old girl revealed: multiple cutaneous hemmorhages (mostly into the skin of buttocks, lower extremities), serous and mucous memrane hemmorhages, cerebral hemmorhages. Adrenal glands show focal necrosis and massive hemmorhages; kidneys show necrotic nephrosis, suppurati-ve arthritis, iridocyclitis, vasculitis. What is the most probable diagnosis?

A 68-year-old woman can’t move her upper and lower right extremities due to the stroke. Muscle tone of these extremities and their reflexes are increased. There are pathological reflexes. What form of paralysis is it?

Most participants of Magellan expedition to America died from avitominosis. This disease declared itself by general weakness, subcutaneous hemmorhages, falling of teeth, gingival hemmorhages. What is the name of this avitiminosis?

A large-scale reaction with parapertussis and pertussis diagnosticums was made in order to make serological diagnostics of the whooping cough. At the bottom of the test-tubes with diagnosticum of Bordetella parapertussis a granular sediment formed. What anti-bodies did this reaction reveal?

Part of the DNA chain turned 180 degree as a result of gamma radiation. What type of mutation took place in the DNA chain?

While having the dinner the child choked and aspirated the food. Heavy cough has started, skin and mucose are cyanotic, pulse is rapid, respiration is infrequent, expiration is prolonged. What disorder of the external respiration has the child?

A pregnant woman had been having toxicosis with severe repeated vomiting for 24 hours. In the end of the day there appeared tetanic convulsions and fluid loss. What shift of acid-base state caused these changes?

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

An 18-year-old patient has enlarged inguinal lymphnodes, they are painless,  thickened on palpation. In the area of genital mucous membrane there is a small-sized ulcer with thickened edges and “laquer”bottom of greyish colour. What is the most probable diagnosis?

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

Diagnostic scraping was performed to the woman with dysfunctional uterine bleeding. Multiple convoluted glands, ganglially dilated lumens of some glands were revealed histologically in the scrape. Name the type of general pathological process in endometry:

Tuberculine was introduced intracutaneously to the child for tuberculin test. Marked hyperemia, tissue infiltration developed on the place of injection in 24 hours. What mechanism caused these modifications?

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

A 34-year-old patient was diagnosed with chronic glomerulonephritis 3 years ago. Edemata have developed within the last 6 monthes. What caused the edemata?

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?

Concentration of pyruvate is increased in the patient’s blood, the most of which is excreted with urine. What avi-taminosis has the patient?

A patient with suspected diphtheria went through bacterioscopic examination. Examination of throat swab revealed rod-shaped bacteria with volutin granules. What etiotropic preparation should be chosen in this case?

A patient with diabetes mellitus experienced loss of consciousness and convulsions after injection of insulin. What is the result of biochemical blood analysis for concentration of the sugar?

A patient working at a chemical plant was admitted to the toxicological department with mercury poisoning. What medicine should be used?

A 63-year-old woman shows symptoms of rheumatoid arthritis. The increase of what blood indices could be the most significant for 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?

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 5-year-old child who often fells ill with respiratory diseases has eczematous appearances after consumption of some food products, tendency to prolonged course of inflammatory processes. What kind of diathesis can be suspected in this case?

Low  level  of  albumins  and  fibrinogen was detected in the patient’s blood. Decreased activity of what organelle of the liver hepatocytes can most probably cause it?

A duodenal content smear of a patient with indigestion contains protosoa 10-18 mcm large. They have piriform bodies, 4 pairs of filaments, two symmetrically located nuclei in the broadened part of body. What kind of the lowest organisms is it?

A 44-year-old woman complains of common weakness, heart pain, considerable increase of body weight. Objectively: moon-like face, hirsutism, AP-165/100 mm Hg, height – 164 cm, weight – 103 kg; fat is mostly accumulated in the region of neck, upper shoulder girdle, stomach. What is the main pathogenetic mechanism of obesity?

After a serious viral infection a 3-year-old child has repeated vomiting, loss of consciousness, convulsions. Examination revealed hyperammoniemia. What may have caused changes of biochemical blood indices of this child?

Albinos can’t stand sun impact – they don’t aquire sun-tan but get sunburns. Disturbed metabolism of what aminoacid underlies this phenomenon?

A 25-year-old patient complained of the decreased vision. Accommodation disorders, dilated pupil, lack of reaction for the light were revealed on examination. What muscles function is disturbed?

A patient    with    continious bronchopneumonia was admitted to the therapeutic department. Antibiotic therapy didn’t give much effect. What medication for improvement of immune state should be added to the complex treatment of this patient?

Patient with abscess of the cut wound applied to the traumatological department. In order to clean the wound from the pus doctor washed it with 3% hydrogen peroxide. Foam was absent. What caused the absence of the drug activity?

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?

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?

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

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:

A physician examined a patient and found inguinal hernia. Through what anatomic formation does it penetrate into the skin?

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

A 60-year-old man felt asleep after cerebral hemorrhage for a long time. Damage of what structure caused this state?

Tuberculosis can be treated by means of combined chemotherapy that includes substances with different mechanisms of action.What antituberculous medication inhibits transcription of RNA into DNA in mycobacteria?

A patient experienced a sudden temperature rise up to 39⁰ . After 6 hours the temperature normalized. On the 2^nd day the attack recurred: in the period of paroxysm the temperature reached 41⁰ , apyrexial period began after 8 hours. What type of temperature profile is it?

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

Microscopic examination of the sputum of a patient with pneumonia occasionally revealed some larvae. Eosinophiles were detected on blood examination. What helminthiasis can be diagnosed?

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?

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

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?

To prevent long-term effects of 4-day malaria a 42-year-old patient was prescribed primaquine. On the 3^rd day from the begin of treatment there appeared stomach and heart pains, dyspepsia, general cyanosis, hemoglobinuria. What caused side effects of the preparation?

A 17-year-old boy fell seriously ill, body temperature rose up to 38.5⁰ , there is cough, rhinitis, lacrimation, nasal discharges. What kind of inflammation is it?

A genetics specialist analyzed the genealogy of a family and found that both males and females may have the illness, not across all the generations, and that healthy parents may have ill children. What is the type of illness inheritance?

A patient who has been treated with diazepam on account of neurosis complains of toothache. Doctor administered him an analgetic, but its dose was lower than average therapeutic dose. What phenomenon did the doctor take into account while prescribing the patient an underdose?

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?

Analysis of amniotic fluid that was obtained as a result of amniocentesis (puncture of amniotic sac) revealed cells the nuclei of which contain sex chromatin (Barr’s body). What can it be evidence of?

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

Autopsy of a 46-year-old man revealed multiple brown-and-green layers and hemmorhages on the mucous membrane of rectum and sigmoid colon; slime and some blood in colon lumen; histologically – fibrinous colitis. In course of bacteriological analysis of colon contents S.Sonne were found. What is the most probable diagnosis?

A patient had been ill with bronchial asthma for many years and died from asthmatic fit. Histologic lung examination revealed: lumen of bronchioles and small bronches contain a lot of mucus with some eosinophils, there is sclerosis of alveolar septums, dilatation of alveole lumen. What mechanism of development of hypersensibility reaction took place?

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

Desulfiram is widely used in medical practice to prevent alcocholism. It inhibits aldehyde dehydrogenase. Increased level of what metabolite causes aversion to alcochol?

A 1-year-old child with symptoms of muscle involvement was admitted to the hospital. Examination revealed carnitine deficiency in his muscles. What process disturbance is the biochemical basis of this pathology?

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?

Kidneys of a man under examination show increased resorbtion of calcium ions and decreased resorbtion of phosphate ions. What hormone causes this phenomenon?

An isolated cell of human heart automatically generates excitation impulses with frequency 60 times pro minute. What structure does this cell belong to?

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?

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

In course of prophylactic medical examination a 7-year-old boy was diagnosed to have daltonism. Parents are healthy, color vision is normal. But grandfather from the mother’s side has the same disorder. What is the type of inheriting of this anomaly?

Objective examination of a patient revealed: slender figure, big skull, highly developed frontal region of face, short extremities. What constitutional type is it characteristic for?

A 38-year-old patient died during intractable attack of bronchial asthma. Histologic examination revealed mucus accumulation in bronchial lumen, a lot of fat cells (labrocytes) in the wall of bronches, many of them are in the state of degranulation, there are also a lot of eosinophils. What pathogenesis of bronchial changes is it?

A patient with thrombophlebitis of lower extremities had got chest pains, blood spitting, growing respiratory failure that caused his death. Autopsy revealed multiple pulmonary infarctions. What is the most probable reason of their development?

Diabetes mellitus causes ketosis as a result of activated oxidation of fatty acids. What disorders of acid-base equilibrium may be caused by excessive accumulation of ketone bodies in blood?

A woman with 0 (I) blood group has born a child with AB blood group. This woman’s husband has A blood group. What genetic interaction explains this phenomenon?

A 30-year-old woman was diagnosed with insufficiency of exocrinous function of pancreas. Hydrolisis of what nutrients will be disturbed?

A    39-year-old    woman    has madescence in the region of mammilla, a small ulcer with inflammatory hyperemia and cutaneous edema. Histologic examination of tissue sampling from this area revealed in the malpighian layer of thickened epidermis atypical cells with light and optically empty cytoplasm, with no intracellular bridges. Such cells were also found in the orifice of big mammal gland ducts. What is the most probable diagnosis?