Krok 1 – 2007 (General Medicine)

A patient is followed up in an endocrinological dispensary on account of hyperthyreosis. Weight loss, tachycardia, fi­nger tremor are accompanied by hypoxia symptoms – headache, fatigue, eye flicker. What mechanism of thyroid hormones acti­on underlies the development of hypoxia?

A laboratory received a material from a patient’s wound. Ppreliminary diagnosis is gaseous gangrene. What microbiologi­cal method should be applied to determine species of causative agent?

A 4 y.o. child with signs of durative proteinic starvation was admitted to the hospital. The signs were as follows: growth inhibition,anemia, edemata, mental deficiency. Choose a cause of edemata development:

A 45 y.o. patient consulted a doctor about plaque-shaped formation on his neck. Histological   examination   of biopsy skinmaterial revealed tumourous cells of round and oval form with thin ring of basophilic cytoplasma that resemble of cells of basal epidermal layer. What tumour is it?

A boy is 7 y.o. Objectively: against the background of hyperemic skin   there   is knobby bright-pink rash on his forehead,neck, at the bottom of abdomen, in the popliteal spaces; nasolabial triangle is pale. Examination   of   oropharyngeal   surface revealed   localized   bright-red hyperemia; tonsils are swollen, soft, lacunas contain pus, tongue is crimson. Cervical lymph nodes are enlarged, dense and painful. What is the most probable diagnosis?

A 45 y.o. woman suffers from Cushing’s syndrome – steroid diabetes. Biochemi­cal examination revealed: hyperglycemia,hypochloremia.   Which  of   the   under­ mentioned processes is the first to be acti­vated?

Examination of an isolated cardiomyocyte revealed that it didn’t generate excitation impulses automatically. This cardiomyocyte was obtained from:

Inhabitants of territories with cold cli­mate have high content of an adaptive thermoregulatory hormone. What hormone is meant?

As a result of damage to certain structures of brainstem an animal lost orientation reflexes. What structures were damaged?

According to the data of WHO, for about 250 mln of Earth population fall ill with malaria. This disease is mostly spread in tropical and subtropical regions. Range of its spread falls into the areal of the following mosquitoes:

A 35 y.o. patient who often consumes alcohol was treated with diuretics. There appeared serious muscle and heart weakness, vomiting, diarrhea, AP- 100/60 mm Hg, depression. This condition is caused by intensified excretion with urine of:

On the 6th day of treatment a pati­ent with acute renal insufficiency developed polyuria. Diuresis intensification at the begi­nning of polyuria stage of acute renal insuffi­ciency is caused by:

Osmotic pressure of a man’s blood plasma is 350 mosmole/1 (standard pressure is 300 mosmole/1). First of all it will result inhigh secretion of the following hormone:

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 32 y.o. man is tall, he has gynecomastia, adult woman pattern of hair distribution, hi­gh voice, mental deficiency, sterility. Provisi­onal diagnosis is Klinefelter’s syndrome. In order to specify diagnosis it is necessary to analize:

A patient was diagnosed with active focal pulmonary tuberculosis. What drug should be prescribed in the first place?

Examination of a young man in the AI­DS centre produced a positive result of immune-enzyme assay with HIV antigens. Patient’s complaints about state of his health were absent. What can the positive result of immune-enzyme assay be evidence of?

RNA   that   contains   AIDS   virus penetrated into a leukocyte and by means of reverse transcriptase forced a cell to synthetize a viral DNA. This process is based upon:

A patient is ill with diabetes mellitus that is accompanied by hyperglycemia of over 7,2millimole/1 on an empty stomach. The levelof what blood plasma protein allows to esti­mate the glycemia rate retrospectively (4-8 weeks before examination)?

A sportsman was recommended to take a medication that contains carnitine in order to improve his results. What process is acti­vated by carnitine the most?

A patient consulted a doctor about bowels   disfunction.   The   doctor establi­shed symptoms of duodenitis and enteritis.Laboratory examination helped to make the following diagnosis: lambliosis. What medi­cation should be administered?

A man took a quiet expiration. Name an air volume that is meanwhile contained in his lungs:

During pubescence the cells of male sexual   glands   begin   to   produce   male sex hormon testosterone that calls forthsecondary sexual characters. What cells of male sexual glands produce this hormone?

A 16 y.o. boy from a countryside entered an educational establishment.   Scheduled Manteux test revealed that the boy had negative   reaction.   What   are   the   most reasonable actions in this case?

Autopsy of a 56 y.o. man revealed in the right temporal part of brain a big focus of softened grey matter that was semi-liquid and light grey. Arteries of cerebral tela contain multiple whitish-yellow thickenings of intima that abruptly narrow the lumen. What is your diagnosis?

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

Labeled   aminoacids   alanine   and tryptophane were introducted to a mouse in order to study localization of protein biosynthesis   in   its   cells.   Around   what organellas will the accumulation of labeled aminoacids be observed?

48 hours after performing tuberculin test   (Mantoux   test)   to   a   child   a   10mm   papule   appeared   on   the   spot   of tuberculin introduction. What hypersensitivity mechanism underlies these changes?

A patient who has been suffering from cardiac insufficiency for several months has been taking digoxin on an outpatient basis. At a certain stage of treatment there appeared symptoms of drug overdose. What phenomenon underlies the development of this complication?

Examination of  a  patient   revealed reduced contents of magnesium ions that are necessary for attachment of ribosomes to the granular endoplasmatic reticulum. It is known that it causes disturbance of protein biosynthesis. What stage of protein biosynthesis will be disturbed?

A child complains of general weakness,loss of appetite, a troubled sleep, itching in the perianal area. The provisional diagnosis is enterobiasis. In order to specify this di­agnosis it is necessary to perform:

In some regions of South Africa there is a spread sickle-shaped cell anemia, in whi­ch erythrocytes have shape of a sickle as a result of substitution of glutamin by valine in the hemoglobin molecule. What is the cause of this disease?

A patient suffers from vision impairment- hemeralopy (night blindness). What vi­tamin preparation should be administered the patient in order to restore his vision?

A patient presents high activity of LDi/12, aspartate aminotransferase, creatine phosphokinase. In what organ (organs) is the development of a pathological process the most probable?

A woman who has been keeping to a clean-rice diet for a long time was diagnosed with polyneuritis (beriberi). What vitamin deficit results in development of this di­sease?

Colonoscopy   of   a patient   ill   with dysentery revealed that mucous membrane of his large intestine is hyperemic, edematic, its surface was covered with grey-and-green coats. Name the morphological form of dysenteric collitis:

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?

24 hours after appendectomy blood of a patient presents neutrophilic leukocytosis with   regenerative   shift.   What   is   the most probable mechanism of leukocytosis development?

Examination of cell culture got from a patient with lysosomal pathology revealed accumulation of great quantity of lipids in the lysosomes. What of the following di­seases is this disturbance typical for?

A group of mountain climbers went through the blood analysis at the height of 3000 m. It revealed decrease of HCO^ to 15 micromole/1 (standard is 22-26 micromole/1). What is the mechanism of HCO3 decrease?

A patient ill with diabetes mellitus felt acute pain in his right foot. Objectively: foot thumb is black, foot tissues are edematous, there are foci of epidermis desquamation, stinking discharges. What clinicopathological form of necrosis is it?

Power inputs of a boy increased from 500 to 2000 kJ pro hour. What can be the cause of it?

For   the   preparation   of   a   patient’s burn skin surface a certain medication was used. Its antiseptic action is provided by free oxygen that segregates in presence of organic substances. Choose the right answer:

Bacteriological examination of a patient with food poisoning required inoculation of a pure culture of bacteria with the following properties: gram-negative movable bacillus that grows in the Endo’s medium in form of colourless colonies. A representative of whi­ch species caused this disease?

A lymph node punctate of a patient wi­th suspected protozoal disease was exami­ned.   Examination   of the   stained   speci­men (Romanovsky’s stain) revealed some crescent   bodies with pointed   end, blue cytoplasm and red nucleus. What protozoan were revealed in the smears?

Long-term starvation cure of a pati­ent resulted in diminished ratio of albumines and globulines in plasma. What of the following will be result of these changes?

Histological examination of a 40 y.o. man’s thymus revealed decreased share of parenchymatous gland elements, increased share of adipose and loose connective ti­ssue, its enrichment with thymus bodies. The organ’s mass was unchanged. What phenomenon is it?

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?

In course of indirect histogenesis of tubular   bone   tissue   a   plate   is   formed between epiphyseal and diaphyseal ossi­fication   centres   that   provides   further lengthwise growth of bones. What structure is it?

A man with cut wound of his right foot sole was admitted to the hospital ward. The patient has limited elevation of the lateral foot edge. In course of wound management the injury of a muscle tendon was revealed. What muscle is injured?

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:

An experimental animal was first sensibilized whereupon an antigen dose was introduced subcutaneously. This injection resulted in the development of a fibrinous inflammation with alteration of vessel walls, basal substance and fibrous structures of connective tissue in form of mucoid and fibrinoid swelling and necrosis. What immunological reaction took place?

Autopsy of a patient who suffered from croupous pneumonia and died from pneumococcal sepsis revealed 900 ml of turbid   greenish-yellow   liquid   in   the   ri­ght pleural cavity. Pleural leaves are dull, plephoric.   Name   the   clinicopathological form of inflammation in the pleural cavi­ty:

A patient was delivered to the hospi­tal by an emergency team.   Objectively: grave   condition,   unconscious,   adynamy. Cutaneous surfaces are dry, eyes are sunken face is cyanotic. There is tachycardia and smell of acetone from the mouth. Analysis results: blood glucose – 20,1 micromole/1 (standard   is   3,3-5,5   micromole/1),   urine glucose – 3,5% (standard is – 0). What is the most probable diagnosis?

A patient has a disturbed absorbtion of fat hydrolysates. It might have been caused by a deficit in the small intestine cavity:

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?

Reaction of passive hemagglutination conducted with erythrocytic typhoid Vi- diagnosticum helped to reveal some anti­ bodies in the dilution of the patient’s serum at a ratio of 1:80 that exceeds the diagnostic titer. Such result witnesses of:

A   patient   with   clinical   presentati­ons of immunodeficiency went   through immunological examinations. They revealed significant loss of cells that form rosettes wi­th erythrocytes of a ram. What conclusion can be made according to the analysis data?

Examination of a 60 y.o. patient revealed hyperglycemia and glucosuria. A doctor administered him a medication for internal use. What medication is it?

In order to estimate toxigenity of di­phtheria agents obtained from patients the cultures were inoculated on Petri dish with nutrient agar on either side of a filter paper strip that was put into the centre and moi­stened with antidiphtheric antitoxic serum. After incubation of inoculations in agar the strip-like areas of medium turbidity were found between separate cultures and the strip of filter paper. What immunological reaction was conducted?

A woman with /// (B), Rh   blood group born a child with // (A) blood group. The child is diagnosed with hemolytic disease of newborn as a result of rhesus incompatibi­lity. What blood group is the child’s father likely to have?

A 12 y.o. boy who suffers from bronchial asthma has an acute attack of asthma: evi­dent expiratory dyspnea, skin pallor. What type of alveolar ventilation disturbance is it?

A patient diagnosed with carcinoid of bowels   was   admitted   to the   hospi­tal. Analysis revealed high production of serotonin. It is known that this substance is   formed   of   tryptophane   aminooacid. What biochemical mechanism underlies this process?

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

Examination of a man established that cardiac output equaled 3500 ml, systolic output – 50 ml. What is the man’s heart rate pro minute?

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

Mucous membrane of the right palati­ne tonsil has a painless ulcer with smooth lacquer fundus and regular cartilagenous edges. Microscopically: inflammatory infi­ltration   that   consists   of   lymphocytes, plasmocytes, a small number of neutrophils and epithelioid cells; endovasculitis and perivasculitis. What disease is it?

For trie purpose of retrtospective di­agnostics of recent bacterial dysentery it was decided to perform serological examination of blood serum in order to determine anti­body titer towards Shiga bacilli. What of the following reactions should be applied?

Autopsy of a 48 y.o. man revealed a round formation 5 cm in diameter with clear-cut outlines in the region of the 1st segment of his right lung. This formation was encircled with a thin layer of connective tissue full of white brittle masses. Make a di­agnosis of the secondary tuberculosis form:

A man’s intrapleural pressure is being measured. In what phase did the man hold his breath, if his pressure is 7.5 cm Hg?

In the surgical department of a hospital there was an outbreak of hospital infecti­on that showed itself in often postoperative wound abscesses. Bacteriological examinati­on of pus revealed aurococcus. What exami­nation shall be conducted to find out the source of this causative agent among the department personnel?

Heart   rate   of   a   man   permanently equals 40 beats pro minute. What is the pacemaker?

A 4 y.o. boy has had recently serious viral hepatitis. Now there are such clinical presentations as vomiting, loss of consciousness, convulsions. Blood analysis revealed hyperammoniemia.   Disturbunce of which biochemical process caused such pathological condition of the patient?

An experimental rat with extremity paralysis has no tendon and cutaneous reflexes, muscle   tone is   decreased, but muscles of the affected extremity maintain their ability to react with excitation to the direct action of continuous current. What type of paralysis is it?

Autopsy of a 58 y.o. man revealed that bicuspid valve was deformed, thickened and unclosed. Microscopically: foci of collagen fibrilla are eosinophilic, react positively to fibrin. The most probably it is:

In course of an operation surgeon aremoved 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?

Vitamin A deficit results in the impai­rment of twilight vision. Name the cells that have the above-mentioned photoreceptor function:

Microscopical examination of a removed appendix   revealed   an   edema,   diffuse neutrophilic infiltration of appendix wall along with necrosis and defect of mucous membrane with affection of its muscle plate. What appendicitis form was developed?

Introduction   of   a   pharmaceutical substance   to   an   experimental   animal resulted in reduction of salivation, pupil mydriasis. Next intravenous introduction of acetylcholine didn’t lead to any significant changes of heart rate. Name this substance:

Examination of a 43 y.o. anephric pati­ent revealed anemia symptoms. What is the cause of these symptoms?

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 it?

A patient ill with collagenesis has been taking prednisolone for a long time. Hypokaliemia development caused spastic pain of skeletal muscles. What medication should be used in order to correct potassium exchange?

From pharynx of a child with suspected diphtheria a pure culture of microorgani­sms was isolated. Their morphological, ti­nctorial, cultural and biochemical properti­es appeared to be typical for diphtheria causative agents. What study should be conducted in order to drow a conclusion that this is a pathogenic diphtheria bacillus?

A man was admitted to the hospital on the 5th day of disease that manifested itself by jaundice, muscle aching, chill, nose bleedings. In course of laboratory diagnosti­cs a bacteriologist performed dark-field mi­croscopy of the patient’s blood drop. Name a causative agent of this disease:

Nappies of a newborn have dark spots that witness of formation of homogentisic acid.   Metabolic imbalance   of which substance is it connected with?

12 hours after an accute attack of retrosternal pain a patient presented a jump of aspartate aminotransferase activity in blood serum. What pathology is this devi­ation typical for?

A peripheral segment of vagus nerve on a dog’s neck was being stimulated in course of an experiment. The following changes of cardiac activity could be meanwhile observed:

A 39 y.o.   woman went through an operation   in   course   of which   surgeons removed her uterine tube that was enlarged and a part of an ovary with a big cyst. Histological examination of a tube wall revealed decidual cells, chorion villi. What was the most probable diagnosis made after examination of the uterine tube?

A forensic medical expert examines the body of a 58 y.o. man who had been consuming large amounts of alcochol for a long time and died at home. Microscopicaly: the right lung is dense and enlarged, its inci­sion revealed that the tissue is greyish and homogenous, pleura is covered with greyi­sh layers. Microscopically – alveolar caviti­es contain fibrin, hemolyzed erythrocytes. Make a diagnosis:

A 40 y.o. woman was admitted to the infectious   diseases   department   with   hi­gh body temperature. Objectively: evident meningeal symptoms. A spinal cord punction was made. What anatomic formation was punctured?

A patient with II stage hypertension has been taking one of hypotensive medications for the purpose of treatment. After a time arterial pressure decreased, but the patient started complaining of flaccidity, sleepiness, indifference. A bit later he felt stomach pain. He was diagnosed with ulcer. What hypotensive medication has the patient been taking?

A patient had to go through an operati­on.   Doctors introduced him dithylinum (listenone)   and   performed   intubation. After the end of operation and cessation of anesthesia the independent respirati­on wasn’t restored. Which enzyme deficit prolongs the action of muscle relaxant?

Ammonia is a very toxic substance,especially   for   nervous   system.   What substance takes the most active part in ammonia detoxication in brain tissues?

A child’s blood presents high content of galactose, glucose concentration is low. There are such presentations as cataract, mental deficiency, adipose degeneration of liver. What disease is it?

In course of an experiment a big number of column cells of red bone marrow was in some way destructed. Regeneration of whi­ch cell populations in the loose connective tissue will be inhibited?

6 months after delivery a woman had uterine bleeding. Gynecological examinati­on revealed in the uterine cavity a dark-red tissue with multiple cavities that resembled of “sponge”. Microscopic examination of the tumour revealed some atypic light epi­thelial Langhans cells and giant cells of cyncytiotrophoblast in blood lacunas. What tumour is it?

A 50 y.o. patient with chronic cardi­ac insufficiency and tachyarrythmia was prescribed a cardiotonic drug. What drug was prescribed?

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?

Violation of safety rules resulted in calomel intoxication. Two days later the daily   diuresis   was   620   ml.   A   patient experienced headache, vomiting, convulsi­ons, dyspnea, moist rales in lungs. What pathology is it?

A patient has a transverse disruption of spinal cord below the IV thoracic segment. What changes of respiration will it cause?

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 with infectious mononucleosis has 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?

Removal of gall bladder of a patient has disturbed processes of Ca absorption through the intestinal wall. What vitamin will stimulate this process?

A 9 m.o. child has delayed dentition, it is also out of order. Upper jaw configuration is horizontal (“high”palate); microscopically- irregular mineralization of tooth enamel, wrinkled enamel prisms, some of them are vacuolized.   Predentin zone   is extended; there are solitary denticles. What disease is it?

Examination of a patient revealed a strong, balanced, inert type of higher nervous activity according to Pavlov. What temperament type does the patient have (according to Hippocrates classification)?

A patient suffers from hepatic cirrhosis. Examination   of which of the following substances excreted by urine can characteri­ze the state of antitoxic function of liver?

Examination of a child revealed some whitish spots looking like coagulated milk on the mucous membrane of his cheeks and tongue. Analysis of smears revealed gram positive oval yeast-like cells. What causative agents are they?

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?

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?

Examination   of a   43   y.o.   patient revealed that his stomach has difficulties wi­th digestion of protein food. Gastric juice analysis revealed low acidity. Function of which gastric cells is disturbed in this case?

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

An   ovary   specimen   stained   by hematoxylin-eosin presents a follicle, where cells of follicular epithelium are placed in 1-2 layers and have cubic form, there is a bright-red membrane around the ovocyte. What follicle is it?

Utilization of arachidonic acid via cyclooxigenase pathway results in formation of some bioactive substances. Name them:

A woman has been applying a new cosmetic   preparation   for   a   week   that resulted in eye-lid inflammation accompani­ed   by   hyperemia,   infiltration   and   painfulness. What type of allergic reaction was developed?

A doctor administered a patient with allergic dermatitis a i/i-histamine blocker as a part of complex treatment. Name this medication:

A 1 y.o. child with symptoms of muscle affection was admitted to the hospital. Examination revealed carnitine deficit in muscles. Biochemical base of this pathology is disturbed process of:

A 30 y.o. woman- had been ill for a year when she felt pain in the area of joi­nts for the first time, they got swollen and skin above them became reddened. Provisi­onal diagnosis is rheumatoid arthritis. One of the most probable causes of this disease is a structure alteration of a connective tissue protein:

A 56 y.o. patient has been suffering from thyreotoxicosis for a long time. What type of hypoxia can be developed?

A 48 y.o. patient was admitted to the hospital with complaints about weakness, irritability, sleep disturbance. Objectively: skin   and   scleras   are   yellow.   In   blood: conjugated bilirubin, cholalemia. Feces are acholic. Urine is of dark colour (bilirubin). What jaundice is it?

A lightly dressed man is standing in a room, air temperature is +14°C, windows and doors are closed. In what way does he emit heat the most actively?

A patient complains of pain in the area of his liver. Duodenal intubation revealed yellowish, oval, narrowed at the poles eggs with an operculum at the end. Size of these eggs is the smallest among all helminth eggs. What is the most probable diagnosis?

A patient who suffers from severe di­sorder of water-salt metabolism experienced cardiac arrest in diastole. What is the most probable mechanism of cardiac arrest in di­astole?

A 36 y.o. man has a craniocerebral trauma.   Objectively:   diminished   breath sounds, thready pulse, no reflexes. What way of pyracetam introduction will be the most apropriate in this case?

Short-term physical activity resulted in reflex amplification of heart rate and raise of systemic arterial pressure. What receptors activation was the main cause of pressor reflex realization?

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?

A 55 y.o. woman consulted a doctor about   having   continuous   cyclic   uterine hemorrhages for a year, weakness, dizzi­ness.   Examination revealed   skin pallor. Hemogram:   Hb-   70   g/1,   erythrocytes   – 3.2×10¹²/l, color index – 0.6, leukocytes – 6.0×10⁹/l, reticulocytes – 1%; erythrocyte hypochromia. What anemia is it?

As a result of exhausting muscular work a worker has largely reduced buffer capacity of blood. What acidic substance that came to blood caused this phenomenon?

Bacteriological laboratory examines canned meat whether it contains botulinum toxin. For this purpose an extract of test specimen and antitoxic antibotulinic serum of A, B, E types were introducted to a group of mice under examination; a control group of mice got the extract without antibotulinic serum. What serological reaction was appli­ed?

Parents of a 10 y.o. boy consulted a doctor about extension of hair-covering, growth of beard and moustache, low voi­ce. Intensified secretion of which hormone must be assumed?

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

In course of an experiment a skeletal muscle is being stimulated by a series of electric impulses.   What   type   of muscle contraction will arise, if every subsequent impulse comes in the period of relaxation of single muscle contraction?

A liquidator of a breakdown at a nuclear power plant who was irradiated complained about vomiting that occurs all of a sudden. What medication should be prescribed?

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

A patient ill with bronchial asthma di­dn’t inform his doctor that he had attacks of stenocardia. Doctor administered him a medication, which taking resulted in less frequent attacks of bronchial asthma, but stenocardia attacks became more frequent. What medication was administered?

Autopsy of a man who died from influenza revealed that his heart was sli­ghtly enlarged, pastous, myocardium was dull and had specks. Microscopical exami­nation of myocardium revealed signs of parenchymatous   adipose   and   hydropic dystrophy; stroma was edematic with poor macrophagal and lymphocytic infiltration, vessels were plethoric; perivascular analysis revealed petechial hemorrhages. What type of myocarditis was developed in this case?

In course of practical training students studied a stained blood smear of a mouse wi­th bacteria phagocyted by leukocytes. What cell organella completes digestion of these bacteria?

A 22 y.o. woman has enlarged lymph nodes. Histologically: a lymph node contai­ns lymphocytes, histiocytes, reticular cells,small   and   big   Hodgkin’s   cells,   multinucleated Sternberg cells, isolated foci of caseous necrosis. What disease are these changes typical for?

A 49 y.o. woman consulted a doctor about heightened fatigue and dyspnea duri­ng physical activity. ECG: heart rate is 50/min, PQ is extended, QRS is unchanged, P wave quanity exceeds quantity of QRS complexes. What type of arrhythmia does the patient have?

A patient who suffers from pneumonia has high body temperature. What biologi­cally active substance plays the leading part in origin of this phenomenon?

A teenager was irradiated with hi­gh radiation dose that resulted in seri­ous damages of lymphoid system, lysis of many lymphocytes. Restoration of normal hemogram is possible due to the functioning of the following gland:

In course of histidine catabolism a biogenic amin is formed that has powerful vasodilatating effect. Name it:

According to audiometry data a pati­ent has a disturbed perception of medium frequency sounds. It might have been caused by a damage of:

A patient with fracture of his lower jaw   was   admitted   to   the   maxillofacial department.   It   was   decided   to   fix his bones surgically under anaesthetic. After intravenous introduction of muscle relaxant there arose short fibrillar contractions of the patient’s facial muscles. What muscle relaxant was applied?

Analysis   of   blood   serum of a patient revealed increase of alanine aminotransferase and aspartate aminotransferase level. What cytological changes can cause such a situation?

A 63 y.o. man fell ill with acute tracheitis and bronchitis accompanied by bronchi­al pneumonia. On the 10th day the patient died from cardiopulmonary insufficiency. Autopsy revealed fibrinous hemorrhagic laryngotracheobronchitis;     lungs     were enlarged, their incision revealed the “coal miner’s “effect caused by interlacing of secti­ons of bronchial pneumonia, hemorrhages into   the   pulmonary   parenchyma,   acute abscesses and atelectases. Internal organs have discirculatory and dystrophic changes. What is the most probable diagnosis?

As a result of spinal-cord trauma a 33 y.o. man has a disturbed pain and temperature sensitivity that is caused by damage of the following tract:

A patient who suffers from heart fai­lure has enlarged liver, edemata of lower extremities, ascites. What is the leading mechanism   in   the   development   of this edema?

A rabbit’s nerve that innervates the right ear was cut and its right superior cervical ganglion was removed. Immedi­ately after operation the temperature of ear skin was measured. It was revealed that the temperature of the rabbit’s ear skin on the side of denervation was by 1,5°C higher than on the opposite intact side. What of the following is the most probable explanation of the above-mentioned effects?

Inflammation of a patient’s eye was accompanied by accumulation of turbid li­quid with high protein at the bottom of anterior chamber that was called hypopyon. What process underlies the changes under observation?

A patient was ill with burn disease that was complicated by DIC syndrome. What stage of DIC syndrome can be suspected if it is known that the patient’s blood coagulates in less than 3 minutes?

An experimental animal has been given excessive amount of carbon-labeled glucose for a week. What compound can the label be found in?

A patient complains of dryness of head skin, itching, fragility and loss of hair. After examination he was diagnosed with seborrhea. Disturbed activity of which cells caused this condition?

A patient who had been working hard under conditions of elevated temperature of the environment, has now a changed quantity of blood plasma proteins. What phenomenon is the case?

Examination of a patient revealed extremely     myotic     pupils,     sleepiness, infrequent Chain-Stoke’s respiration, uri­nary   retention,   slowing-down   of   heart rate, enhancement of spinal reflexes. What substance caused the poisoning?

Examination of a patient with frequent hemorrhages from internals and mucous membranes revealed proline and lysine being a part of collagene fibers. What vi­tamin absence caused disturbance of their hydroxylation?

The first grade pupils were examined in order to sort out children for tuberculosis revaccination. What test was applied for this purpose?

A patient has extrasystole. ECG shows no P wave, QRS complex is deformed, there is a full compensatory pause. What extrasystoles are these?

After intake of rich food a pati­ent feels nausea and sluggishness; with ti­me there appeared signs of steatorrhea. Blood cholesterine concentration is 9,2 micromole/1. This condition was caused by lack of:

A 27 y.o. patient put   eye   drops that contain penicillin. After a few mi­nutes   she   felt itching and burning of her body, there appeared lip and eye-lid edemata; arterial pressure began to drop. What immunoglobulins took part in the development of this allergic reaction?

A patient suffers  from severe postoperative pseudomonadous infection. What of the following antibiotics should be administered in this case?

A   patient   complains   of   frequent diarrheas,   especially   after   consumption of fattening food, and of body weight loss.   Laboratory   examination   revealed steatorrhea; hypocholic feces. What can be the cause of this condition?

Having     helped     to     eliminate consequences of a failure at a nuclear power plant, a worker got an irradiation doze of 500 roentgen. He complains of headache, nausea, dizziness. What changes in leukocytes quantity can be expected 10 hours after irradiation?

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?

An electron micrograph of a kidney fragment presents an afferent arteriole. Under its endothelium some big cells can be seen that contain secretory granules. What type of cells is it?

Arterial pressure of a surgeon who performed a long operation rised up to 140/110 mm Hg. What changes of humoral regulation could have caused the rise of arterial pressure in this case?

A patient with chronic cardiac insuffici­ency has been treated with cardiotonic drugs and a thiazide diuretic, but in spite of it there are still edemata and risk of ascites. What medication should be prescribed to amplify diuretic effect of the applied drugs?

A newborn child with pylorostenosis has often repeating vomiting accompanied by apathy, weakness, hypertonicity, someti­mes convulsions. What disorder form of acid-base balance is it?

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?

In course of an experiment a skeletal muscle is being stimulated by a series of electric   impulses.   What   type   of muscle contraction will arise, if every subsequent impulse comes in the period of shortening of the previous single muscle contraction?

Examination   of   a   miner   revealed pulmonary   fibrosis   accompanied   by   di­sturbance of alveolar ventilation. What is the main mechanism of this disturbance?

A patient has symptoms of inflammati­on of urogenital tracts. Examination of a vaginal smear revealed big monocellular, pear-shaped organisms with the pointed spi­ke at the posterior end of body, big nucleus and undulating membrane. What protozoa were found in the smear?

A child is languid, apathetic. Liver is enlarged and liver biopsy revealed a significant excess of glycogene.   Glucose concentration in the blood stream is below normal. What is the cause of low glucose concentration?

A man who went for a ride on a roundabout had amplification of heart rate, sweating and nausea. What receptors sti­mulation is it primarily connected with?

Two   days   after   consumption   of smoked pork a patient got face and eye­lid edemata, gastrointestinal disturbances, abrupt temperature rise, muscle pain. Blood analysis   showed full-blown   eosinophilia. What helminth could the patient be infected with?

Examination of a patient revealed hyperkaliemia   and   hyponatremia.   Low secretion of which hormone may cause such changes?

After a tooth extraction a patient felt persistent pain behind his breast bone. After sublingual intake of an antianginal drug the pain behind the breast bone disappeared, but the patient complained of headache and dizziness. What drug are these properties typical for?

A 63 y.o. man with collapse symptoms was delivered to the emergency hospital. A doctor chose noradrenaline in order to prevent hypotension. What is the action mechanism of this medication?

Urine examination of a patient wi­th acute cystitis revealed leukocytes and a lot of gram-negative bacilli. Inoculation resulted in growth of colonies of mucous nature that formed green soluble pigment. What microorganism is the most probable cause of the disease?

An isolated cell of human heart automatically generates excitation impulses with frequency 60 times pro minute. What heart structure was this cell obtained from?

A patient died under conditions of cardiovascular insufficiency. Autopsy results: postinfarction cardiosclerosis, myocardium hypertrophy and dilatation of its caviti­es, especially of its right ventricle. Liver is enlarged, its surface is smooth, incision revealed that it was plethoric, with dark-red specks against the background of browni­sh tissue. Histologically: plethora of central parts of lobules; peritheral parts around portal tracts contain hepatocytes in a state of adipose degeneration. How are these li­ver changes called?

Autopsy of a newborn boy revealed polydactylia,   microcephalia,   cheiloschisis and uranoschisis as well as hypertrophy of parenchimatous organs. These defects correspond with the description of Patau’s syndrome. What is the most probable cause of this pathology?

Glutamate decarboxylation results in formation of inhibitory transmitter in CNS. Name it:

A patient who suffers from acute myocarditis has clinical signs of cardiogenic shock. What of the under-mentioned pathogenetic mechanisms plays the main part in shock development?

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?

A 23 y.o. patient complains of weakness, temperature rise up to 38 – 40°C. Objectively: liver and spleen are enlarged. Hemogram: Hb-100 g/1, erythrocytes – 2.9×10¹²/l, leukocytes -4.4×10⁹/l, thrombocytes – 48×10⁹/l, segmentonuclear neutrophils – 17%, lymphocytes – 15%, blast cells – 68%. All cytochemical reactions are negative. Make a hematological conclusion:

Continious taking of a drug can result in osteoporosis, erosion of stomach mucous membrane, hypokaliemia, retention of sodi­um and water, reduced content of corticotropin in blood. Name this drug:

A patient has a haemorrhage into the posterior central gyrus. What type of sensi­tivity on the opposite side will be disturbed?

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 2 y.o. child has convulsions as a result of lowered concentration of calcium ions in blood plasma. It is caused by reduced functi­on of:

Histological specimen presents a vessel the wall of which consists of endothelium, basal membrane and loose connective ti­ssue. What type of vessel is it?

Examination of a man who hadn’t been consuming fats but had been getting enough carbohydrates and proteins for a long time revealed dermatitis, poor wound healing, vi­sion impairment. What is the probable cause of metabolic disorder?

Analysis of a punction biopsy material of liver revealed hepatocyte dystrophy with necroses as well as sclerosis with disorder of beam and lobulous structure, with formati­on of pseudolobules and regenerative nodes. What is the most probable diagnosis:

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 hepatitis outbreak was registered in a settlement. This episode is connected wi­th water factor. What hepatitis virus could have caused the infective outbreak in this settlement?

Examination   of   coronary   arteries revealed atherosclerotic calcific plaques that close vessel lumen by 1/3. The muscle has multiple whitish layers of connective tissue. What process was revealed in myocardium?

Microscopical renal examination of a 36 y.o. woman who died from renal insuffi­ciency revealed in the glomerules proli­feration of capsule nephrothelium as well as of podocytes and phagocytes accompanied by formation of “crescents”, capillary loop necrosis, fibrinous thrombs in their lumens; sclerosis   and   hyalinosis   of   glomerules, atrophy of tubules and fibrosis of renal stroma. What is the most probable di­agnosis?

To   prevent   postoperative   bleeding a 6 y.o.   child was   administered vicasol that is a synthetic analogue of vitamin K. Name post-translational changes of blood coagulation factors that will be activated by vicasol:

According to clinical indications a pati­ent was administered pyridoxal phosphate. What processes is this medication intended to correct?

A   62   y.o.   woman   complains   of frequent pains in the area of her chest and backbone, rib fractures. A doctor assumed myelomatosis (plasmocytoma). What of the following laboratory characteristics will be of the greatest diagnostical importance?

A hypertensive glucose solution was introduced to a patient. It will intensify water movement: