Krok 1 – 2019 (General Medicine)

A patient with severe poisoning was brought into the intensive care unit. In the course of complex treatment the subclavian vein needs to be catherterized for medicine administration. This vein is located in the following topographic structure:

A 45-year-old woman presents with insufficient secretion of enterokinase enzyme. Enterokinase deficiency can cause disturbances of the following digestive function :

A 7-year-old boy is diagnosed with anemia. Laboratory analysis detects pyruvate kinase deficiency in his erythrocytes.What process is disturbed in this boy playing the main role in anemia development in this case?

The Gerontology institute recommends older people to take vitamins complexes that contain vitamin E.What is the main function of this vitamin?

A woman with polyarticular rheumatoid arthritis was prescribed a non -steroidal anti-inflammatory drug -diclofenac sodium. After the patient has been taking it for some time, her concomitant disease exacerbated, which forced by the doctor to cancel the prescription of this drug. What concomitant disease could necessitate cancellation of this drug prescription?

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

Ammonia is extremely toxic for human CNS. What is the main way of ammonia neutralization in the nervous tissue?

A 12- year-old boy with clinical presentation of influenza has developed respiratory mycoplasmosis. What type of infection has developed under these conditions?

Autopsy of a man, who served on a nuclear submarine , revealed the following pathologies: bone marrow atrophy (panmyelophthisis), anaemia, leukopenia, thrombocytopenia, lymphocytic disintegration in the lymph nodes, spleen ,gastrointestinal lymphatic system ,and hemorrhages into the adrenal glands . What disease had developed in this case?

Chronic overdose of glucocorticoids leads to the development  of  hyperglycemia in a patient . Name the process of carbohydrate metabolism that results in elevated blood glucose levels:

A 3-year-old child has been brought by ambulance to the intensive care unit of the infectious diseases hospital. On examination the child is in severe condition, skin  and mucosa are dry , tissue turgor is reduced. The patient’s history states that profuse diarrhoea and recurrent vomiting were observed throughout the previous day after the child had eaten food products of poor quality. What type of salt and water imbalance is likely to have developed in the patient?

Autopsy of a 49-year-old woman who died of chronic kidney failure shows small dense striated kidneys with areas of haemorrhage. Microscopically nuclei of epithelial channels contain hematoxylin bodies, glomerular capillaries resemble wire loops, have thickened basement membranes, and in places contain hyaline thrombi and foci of fibrinoid necrosis. What is the most likely diagnosis?

Before a surgery the patient was prescribed a synthetic antiprotozoal drug for prevention of wound infection. The prescribed drug is highly effective against helicobacter pylori . Name this drug:

After an X-ray examination of the tuberculosis clinic patient, he was diagnosed with tumor of the right lung. During operation the surgeon removed the middle lobe of the patient’s right lung . This lobe includes:

What changes can be expected to occur in the isolated heart of a toad , if excessive amount of calcium chloride is introduced into its perfusate?

To treat the burns, a patient was prescribed a drug with antiseptic properties that are based on formation of atomic oxygen in the presence of organic substances. This drug has also an astringent ( anti-inflammatory) effect due to formation of albuminates. Name this drug:

A histological specimen demonstrates a vessel with the wall that consists of endothelium, basement membrane, and loose connective tissue. This vessel belongs to the following type:

Histological analysis of a biopsy skin sample obtained from a 24-year-old patient detects caseous necrosis surrounded with cellular infiltrate consisting of lymphocytes, among which there are single giant cells, proliferation of connective tissue and endovasculities are observed. Characterize this pathologic process:

Prolonged vomiting resulted in dehydration of the patient’s body. Under these conditions,  water retention in the body is ensured primarily due to increased secretion of the following hormone:

An ovarian tumor was detected in a woman. She is prescribed a surgery. What ligament should be severed by the surgeon to separate the patient’s ovary from the uterus?

Autopsy of a 60-year-old woman, who for a long time had been suffering from essential hypertension, shows significantly diminished kidneys (weight of both kidneys is 80g) with finely granular surface . Uniform renal cortical thinning can be observed on section. Name the described changes in the kidneys:

A 14-years-old adolescent has diphtheria. During the peak of the disease against the background of acute drop in body temperature and tachycardia the blood pressure is 70/90 mm Hg. What type of vascular tone disturbance is it?

Systemic blood pressure of a person equals 120/65 mmHg. Blood ejection into aorta occurs when left ventricular pressure exceeds:

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

A man has been working for a long time in oil processing. What type of carcinogens does he encounter at his workplace?

A 35-year-old man with a hand injury came to the traumatology department. Examination revealed an incised wound on the palmar surface of the left hand; middle phalanges of digits II-IV cannot be flexed. What muscles are damaged?

In the haematology unit a patient with leukaemia was prescribed 5-Fluorouracil. This drug:

A patient was hospitalized in a comatose state. The patient has a 5-year-long history of diabetes mellitus type 2. Objectively respiration is noisy, deep, with acetone breath odor. Blood glucose is 15.2 mmol/l , ketone bodies – 100 micromol/l. These signs are characteristic of the following diabetes complication:

A 27-year-old woman has undergone a sector resection of a mammary gland tissue. Macroscopy detects a dense white node ,4cm in diameter, with clear margins in the excised tissue. Immediate histological analysis shows the tumor to consist of a large amount of fibrous stroma with stromal proliferation around the small canaliculi . Canalicular epithelium overlays the basement membrane and retains its polarity. Make the diagnosis:

The bacteriological laboratory needs to prepare for analysis of materials that are suspected to be contaminated with spores of anthrax causative agent. What diagnostic preparation allows for quick detection of these spores?

Domestic accident has resulted in a significant blood loss in the patient, which was accompanied by a drop in blood pressure. What hormones ensure quick restoration of the blood pressure caused by blood loss?

A 30-year-old person has been stung by a bee. The stung area exhibits edema, hyperaemia, and elevated temperature. What is the initial pathogenetic factor of the inflammatory edema in this case?

On examination the patient was determined to have a strong, balanced, inert type of higher nervous activity according to Pavlov’s classification. What temperament according to Hippocrates is it?

A patient with diabetes mellitus after an insulin injection lost his consciousness and developed convulsions. What will be the result of a biochemical test for blood glucose level in this case?

A patient with arrhythmia was hospitalized into the cardiology unit. What antiarrhythmic drug should be prescribed?

A patient has been suffering from bronchial asthma for 15 years. What changes in the patient’s leukogram can be expected in this case?

A 27-year-old patient presents with pathologic changes in the liver and brain. Blood plasma exhibits acute decrease in copper levels, while urine copper level is elevated. The patient is diagnosed with Wilson’s disease. To confirm this diagnosis, it is necessary to measure activity of the following enzyme in the patient’s serum:

After hyperventilation an athlete developed a brief respiratory arrest. It occurred due to the following changes in the blood:

An inflammation can be characterized by hemocapillary dilation in the affected area, decreased blood circulation, and increased vessel wall permeability. What cells plays the key role in this process?

In an experiment a laboratory rat was subjected to a stress factor (electric current), which resulted in muscular hypotonia, arterial hypotension, hypothermia, and hypoglycaemia in the animal. What period if general adaptation syndrome is it?

24 hours after an appendectomy the patient’s blood test shows neutrophilic leucocytosis with a regenerative shift. What is the most likely mechanism of absolute leucocytosis development in the patients peripheral blood?

A 39-year-old man presents with hyperkeratosis, disturbed twilight vision, and high risk of infectious processes. What vitamin preparation should be prescribed?

After a prolonged attack of severe headache the patient lost mobility in his left arm and leg. Muscle tone is decreased in the affected limbs, the muscles are spasmed, spinal tendon reflexes are acutely intensified, reflex zones are increased. What nervous system disorder can be observed in this patient?

A patient with periodontitis of the lower molar came to the doctor. It was determined that the inflammatory process spread to the lymph nodes. What lymph nodes were the first to be affected by the inflammatory process?

A 36-year-old man provisionally diagnosed with renal tuberculosis has undergone urinary sediment analysis. Microscopy revealed acid-fast bacteria, but Pryce method detected no cord factor. Name the most reliable method of investigation that can confirm or refute this provisional diagnosis:

The mother’s karyotype has 45 chromosomes. It was determined that translocation of chromosome 21 to chromosome 14 had occurred. What disorder is likely to be observed in the child of this woman if the father’s karyotype is normal?

A patient has gradually developed a skin plaque on his face. In the center of this plaque there are necrotic patch and an ulcer. Histopathological analysis of the biopsy material reveals proliferation of atypical epithelial cells with large number of pathologic mitoses. What is the most likely diagnosis?

Human brain produces endogenous peptides that are similar to morphine and can reduce pain perception. Name the peptides:

Regional lymph nodes surrounding an infected wound are enlarged. Histological examination shows increased number of macrophages, lymphocytes, and lymphatic follicles in the cortical layer of the lymph nodes, as well as a large amount of plasma cells. What process in the lymph nodes is indicated by these histological changes?

A 33-year-old woman, who for a long time has been treated for chronic polyarthritis, complains of elevated blood pressure, changes in adipose tissue distribution, and disturbed menstrual cycle. What drug does this patient take?

The first-aid centre has received a victim of a traffic accident diagnosed with closed displaced fracture of the middle third of the thigh. For repositioning of the bone fragments the patient received 10ml of 2% dithylinum solution intravenously, which resulted in the prolonged period of apnoea and muscle relaxation. What enzyme is deficient, resulting in such pharmacogenetic enzymopathy?

A 45-year-old woman presents with breast cancer. Metastases can spread in this case to the following regional lymph nodes:

A patient for a long time was on an imbalanced diet low in proteins, which resulted in hepatic fatty infiltration. This condition is likely to develop if a certain substance is absent in a person’s diet. Name this substance:

An isolated heart was used to study excitation conduction velocity in different areas of the heart. What area had the lowest velocity of excitation conduction?

Urinalysis of a patient with acute cystitis shows leukocytes and a large number of gram-negative bacilli. Inoculation has resulted in the growth of mucous colonies that produce a green soluble pigment. What microorganism is the most likely cause of the patient’s disorder?

A patient has elevated blood pressure due to increased vascular tone. To lower the blood pressure in this case it is necessary to prescribe the blockers of;

A 47 -year-old person developed elevated blood pressure after an emotional excitement. What is the likely cause of this effect?

Pathologic material mucosal excretion from the nasal passages) obtained from a patient provisionally diagnosed with influenza was sent to the virological laboratory. What quick test allows detecting specific viral antigen in the investigated material?

Autopsy of a 3-year-old shows tumor in the cerebellum. The tumor has no clear margins separating it from the surrounding tissues. Histologically it is made of small atypical cells with hyperchromic nuclei. This tumor is most likely a:

A 39-year-old man underwent a surgery for peptic ulcer disease of the stomach. He died 7 days after the surgery. On autopsy the peritoneal layers are plethoric, dull, and covered with massive yellow-green membranous deposits. The peritoneal cavity contains approximately 300ml of thick yellow-green fluid. What pathologic process was detected in the peritoneal cavity?

I.M. Siechenov has proven that a tired limb restores its working capacity faster if during its period of rest another limb works. It became a basis for the concept of :

Histone protein synthesis is artificially blocked in a cell. What cell structure will be damaged as a result?

A young woman, a foreign student from Tehran, has made an appointment with the urologist. She complains of the sensation of heaviness in her abdomen and a small amount of blood being excreted with urine detects the presence of parasite eggs, approximately 140 x 70 micron in size, with a terminal spike. What diagnosis can be made by the infectious diseases specialist?

First-year schoolchildren have received tuberculin skin test (Mantoux test) at the school nurse’s office. The purpose of this test was:

A patient with inoperable lung cancer accompanied by unbearable pain was prescribed an analgesic therapy the patient developed signs of intestinal obstruction. What analgesic could have caused this complication?

Ingestion of plants and mushrooms that grow along highways is dangerous due to risk of lead poisoning. What is the main source of environmental pollution with this chemical element?

A 34-year-old man died in a comatose state. According to his family after busines trip to an African country he developed periodical jaundice attacks. Autopsy shows the following; dense enlarged spleen with dark-slate pulp, enlarged plethoric liver, grey-black on section, cerebral grey matter is brown-grey, cerebral white matter contains numerous small haemorrhages. What infectious diseases can be suspected?

The bacteriological laboratory has received for analysis of a sample of dried fish from a focus of food poisoning outbreak. The bacteriologist inoculated the sample into a Kitt-Tarozzi medium, where growth of tennis racquet-shaped microorganisms could be observed. These microorganisms are likely to be the causative agents of:

Autopsy revealed a large wedge-shaped patch of a dense dark red tissue with clear margins in the upper lobe of the right lung. Histological examination detected there necrosis of the alveolar wall, the alveolar lumen is tightly packed with erythrocytes. What process occurred in the lungs?

A patient developed punctuate haemorrhages after a tourniquet had been applied. It occurred due to functional disturbance of the following blood corpuscles:

After a trauma the patient has developed right-sided paralysis and disturbed pain sensitivity. On the left side no paralysis is observed, but pain and thermal sensitivity is disturbed. What is the cause of this condition?

An experiment was conducted to measure the skin sensitivity threshold. What patches of the skin have the highest sensitivity threshold?

Anti-leukocytic antibodies are detected in the blood of a patient with leukopenia. What type of Coombs-Gells hypersensitivity reaction developed in this case?

A person has increased pulmonary ventilation due to physical exertion. What indicator of external respiration will be significantly increased compared to the resting state?

A 30-year-old man with an incised wound on the plantar surface of the left foot was brought to the traumatology department. Lifting of the lateral side of the foot is limited. What muscle is likely to be functionally disturbed?

Autopsy of a 58-year-old man, who for a long time has been drinking alcohol in large amounts and died at home, is being conducted. Macroscopically the right lung is dense and enlarged, its tissue is grey and homogeneous on section, its pleura is covered with grayish membranous deposits. Microscopically the alveolar cavities contain fibrin threads, neutrophils, and homolysed erythrocytes. Make the diagnosis:

A 45-year-old woman exhibits no signs of diabetes mellitus, but her fasting blood glucose levels are elevated (7.2 mmol/l). What should be measured next?

A patient with asphyxia after a brief respiratory arrest developed single infrequent respirations with passive expiration, after which he stopped breathing completely. What type of respiration was observed in this case?

A patient is diagnosed with severe B12 deficiency anemia resulting in the disturbed hematopoiesis and appearance of atypical erythrocytes in the blood. The patient has a history of total gastric resection. This diagnosis can be confirmed if the following cells are present in the peripheral blood:

Examination of a patient shows decreased leukocyte and erythrocyte count and low hemoglobin levels in peripheric blood, as well as appearance of large cells (megaloblasts). What vitamin deficiency can cause these clinical presentations?

A patient has been taking bisacodyl for a long time to treat chronic constipation. However, several weeks later the aperient effect of the drug diminished. What is the possible cause of this?

A 63-year-old man, who has been suffering from chronic diffuse obstructive pulmonary emphysema for 15 years, died of progressive heart failure. Autopsy shows nutmeg liver cirrhosis, cyanotic induration of kidneys and spleen, ascites, and edemas of the lower limbs. What type of heart failure can be characterized by such changes in the internal organs?

Wernicke-Korsakoff syndrome often develops in chronic alcoholics, who have a low vitamin diet. Decreased transketolase activity can be observed in the course of this disease. What vitamin deficiency causes this development?

A 59-year-old man, a business manager, developed intense burning retrosternal pain that irradiates to the left arm. The pain occurred in the evening after the tax audit. 15 minutes later the patient’s condition normalized. What mechanism of angina pectoris development is leading is this patient?

A patient with diabetes mellitus and allergic dermatitis was prescribed a certain fluorinated hormone drug in the ointment dosage form. When the patient asked, how this drug was better than hydrocortisone ointment, the doctor explained that the prescribed medicine:

Dwellers of a village located in the taiga make a living by harvesting berries. Lately the occurrence of alveococcosis in the village population has increased. What is the source of invasion in this case?

A patient was administered a certain drug for relief of cardiac rhythm disturbance. This drug can be used as a local anaesthetic as well. Name this drug:

A 40-year old man with impaired venous patency in the lower limbs developed edemas. What mechanism plays the main role in the development of this disturbance?

A married couple came for a genetic counselling. The husband suffers of insulin-independent diabetes mellitus, while the wife is healthy. What is the probability of their child developing insulin-independent diabetes mellitus?

A patient with streptococcal infection of the gingiva was prescribed a drug with Beta-lactam ring in its structure. What drug of those listed below belongs to this pharmacological group?

Some diseases of large intestine lead to the changes in the quantitative ratio between mucosal epithelial cells. What cell types are normally predominant in the cryptal epithelium of the large intestine?

In the course of an urgent surgery, the vermiform appendix of the patient was excised. The appendix was acutely distended and gray-black throughout its whole length. In the distal segment a defect of the appendix wall was detected, through which a foul-smelling gray-brown substance was being discharged from the appendix lumen. Histological analysis shows necrotization of the appendix wall with haemorrhagic foci; lumen of the mesenteric artery is filled with a thrombus. What type of appendicitis is it?

A 9-month-old child presents with delayed tooth eruption, improper sequence of tooth eruption, and horizontal maxillary configuration (high-arched palate). Microscopically enamel mineralization pattern is irregular, enamel columns are wrinkled, some of them are vacuolated, predentin zones are widened, single denticles can be observed. What disease is it?

A student, whose educational achievements throughout the semester were poor, feels emotionally tense during the final test. What is the primary cause that induced the leading mechanism of emotional tension in this case?

Hematologic study shows the following pattern: erythrocytes – 2,8. 10¹²/L, Hb – 80 g/L, colour index – 0.85, reticulocytes -0,1%, platelets -160 thousand per microliter, leukocytes -60 x 10⁹/L. Basocytes -2%, eosinophils- 8%, promyelocytes- 5%, myelocytes- 5%, juvenile- 16%, stab neutrophils- 20%, segmented neutrophils- 34%, leukocytes- 5%, monocytes- 5%. This clinical presentation indicates the following blood pathology:

Long-term taking of medicines can affect cells of the liver. Particularly, it can cause marked hypertrophy of agranular endoplasmic reticulum due to the following function of this organelle:

A patient presents with an acute attack of cholelithiasis. Laboratory examination of the patient’s faeces will show the following in this case:

ABO blood group is being determined. Erythrocyte agglutination occurred when standard sera of group I and group II were introduced into the blood being analysed, while group III serum caused no agglutination. What agglutinogens do these erythrocytes have?

The neurological department received a patient complaining of memory deterioration and loss of mental work capacity that developed after a head trauma. Recommend him a medicine for improvement in cerebral metabolism:

Examination of a surgically excised adrenal gland shows large cells that can be impregnated with a potassium dichromate solution. What hormone is being synthesized by these cells?

The surgeon noticed aggregated lymphoid nodules (Peyer’s patches) on the intestinal mucosa. What portion of intestine is it?

A man is a carrier of HIV that is an RNA virus. The cells of this patient synthesize viral DNA. This process is based on:

Toxic damage to hepatic cells resulted in disruption of the patient’s liver function and the patient developed edema. What changes of blood plasma are the main cause of edema development?

A 3-year-old child with elevated body temperature has taken aspirin and developed increased hemolysis of erythrocytes. In this case hemolytic anemia can be caused by congenital deficiency of the following enzyme:

A patient with myocardial infarction in the acute phase has been hospitalized into the cardiology unit. To induce platelet lysis in the patient’s coronary vessels during the early hours of infarction, the following enzyme should be used:

A 40-year-old woman on examination presents with intensified basal metabolic rate. What hormone presents in excess leads to such condition?

After a certain CNS structure had been destroyed in a test animal, this animal lost its orientation reflexes. What structure had been destroyed?

What diagnostic method should be used in industry to test the raw leather for the presence of b.antracis?

During diabetes mellitus and starvation, the number of acetone bodies in blood increases. These bodies are used as a source of energy and are synthesized from the following substances:

Blood test of the patient revealed albumin content of 20g/l and increased activity of lactate dehydrogenase isoenzyme5(LDH5). These results indicate disorders of the following organ:

An unconscious young man in the state of morphine intoxification has been brought into admission room. The patient’s respiration is slow and shallow due to suppression of the respiratory centre. What kind of respiratory failure occurred in this case?

During regular examination of schoolchildren, a scrape from the perianal folds of a 10-year-old girl shows asymmetrical oval eggs with larvae inside. What diagnosis can be made?

A patient has a pancreatic tumor. During surgery it was accessed by making an opening through the lig .gastrocolicum, but in the process a vessel passing through this ligament was damaged. As a result the surgeon had to stop the bleeding from the following vessel:

A laboratory rat with chronic kidney failure presents with osteoporosis, pathologic calcification of the internal organs, and arterial hypertension. These disturbances are associated with increased activity of the following hormone:

A family has two children. The younger child is under a year. The child has developed spastic cough attacks. Similar clinical presentation was observed in the elder preschool child one month ago. The doctor suspects pertussis infection. What method enables retrospective diagnostics of this disease?

A patient with essential hypertension was prescribed a drug that inhibits angiotensin-converting enzyme (ACE). What drug is it?

A victim has received a deep incised stab wound to the upper posterior surface of the shoulder. Extension of elbow, hand, and digits is impaired; skin sensitivity of the posterior surface of the shoulder and forearm is lost. What nerve is damaged in this case?

Clinical course of urolithiasis was complicated by the passage of a renal calculus. Where in the uterus is it most likely to stop?

Autopsy of a man, who had been suffering from mitral stenosis, reveals dense brown lungs. What pathologic process had occurred in the lungs?

KCl concentration in a solution that surrounds an isolated cell was increased. How will resting membrane potential (RMP) and cell excitability change in this case?

The parents with normal hearing have two daughters and a son, who are congenitally deaf. Their other 5 children are healthy. What is the pattern of deafness inheritance in this case?

During gastric secretion the patient received mixed anaesthesia with tubocurarine chloride muscle relaxant; to restore spontaneous respiration the patient received proserin. What pharmacological group does this drug belong to?

A 30-year old woman developed facial edemas. Examination detected proteinuria (5.87 g/L), hypoproteinaemia, dysproteinaemia, and hyperlipidaemia. Such combination of signs is characteristic of:

Human genetic apparatus consists of approximately 30 thousand of genes, while the number of antibody variants can be as high as millions. What mechanism leads to formation of new genes that ensure the synthesis of such a number of antibodies?

A new born presents with weak suckling, frequent vomiting, and hypotonia. Blood and urine citrulline are very high. What metabolic process is disturbed?

A 48-year old man is unconscious. He has a history of several syncopal episodes with convulsions. ECG shows deformed QRS complexes unconnected with P waves, atrial contractions are approximately 70/min, ventricular contractions -25-30/min. Name the type of arrythmia in this case:

A patient with obliterating endarteritis has undergone a ganglionic sympathectomy. Positive therapeutic effect of this surgery is associated with development of arterial hyperaemia of the lower limbs, which can be described as:

A 52- year-old woman came to the neurologist with complaints of loss of skin sensitivity on the right half of her face in the area of the lower eyelid, nasal arch, and upper lip. What branch of what nerve is damaged in this patient?

To determine toxigenicity of diphtheria causative agents obtained from patients, the cultures were inoculated in a Petri dish with nutrient agar, bilaterally to a strip of filter paper spotted with antidiphtheric antitoxic serum and situate din the centre of the petri dish. After the incubation of the inoculated cultures in the agar, strip like areas of medium turbidity formed between some of the cultures and the filter paper. What immunological test was conducted?

A 63- year -old man suffers from oesophageal carcinoma, presents with metastases into the mediastinal lymph nodes and cancerous cachexia. What pathogenetic stage of neoplastic process is observed in the patient?

A 45-year old man with acute pneumonia was prescribed a penicillin antibiotic. However, when tested for personal tolerance to this antibiotic, he developed an allergic response. What drug should be prescribed for treatment instead?

The dorsal root of the spinal nerve of a test animal was severed. What changes will occur in innervation area?

An oncology patient is to undergo a surgery on the descending colon. Name the main source of blood supply to this organ

To test donor blood for hepatitis B antigens, it is necessary to use highly sensitive detection methods. What test should be used for this purpose?

A 6-year-old girl presents with acute onset of a disease. She developed sore throt and high temperature that were later accompanied by a punctuate skin rash. Oral examination reveals acute pharyngeal hyperaemia, raspberry tongue, and enlarged bright red tonsils with dull gray and yellow foci that spread to the peritonsillar tissues. The submandibular lymph nodes are enlarged. What disease are these changes characteristic of?

Collagenosis patients typically present with the processes of connective tissue destruction. The presence of these processes can be confirmed by the increase in:

Disturbed activity of trypsin and chymotrypsin leads to disturbed protein breakup in the small intestine. Activity of these enzyme depends on the presence of the following factor:

A 25-year-old child is provisionally diagnosed with pharyngeal diphtheria. Smear from the child’s mucosa was obtained and inoculated into a coagulated equine serum. What is the purpose of this stage of microbiological diagnostics?

Patient with ischemic heart diseases are usually prescribed small dose of aspirin. This drug inhibits the synthesis of platelet aggregation activator, thromboxane A2. What substance is this activator synthesized from?

Autopsy of a 30-year-old man shows enlarged spleen (weight -900.0g), enlarged liver (weight -4000.0g), and enlarged lymph nodes. Bone marrow of the femoral shaft is bright red and moist. Microscopically in the liver there are thick infiltrates located along the portal tract. The infiltrate consists of juvenile hemopoietic cells with round nuclei and thin layer of cytoplasm. What disease can be suspected?

People, who for a long time remained in hypodynamic state, develop intense pain in the muscles after a physical exertion. What is the most likely cause of this pain?

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

A histological specimen shows significant amount of mucous connective tissue(Wharton’s jelly), vessels, as well as remnants of the yolk sac stalk and allantois. Name this organ:

A Young man has come to the genetic consultation. He complains of abnormalities in his physical and reproductive development. Microscopy of his oral mucosa cells shows one Barr body. What karyotype is the most likely in this young man?

During an invasive operation the surgeon needs to access the omental bursa of the peritoneal cavity via the omental foremen (foramen of Winslow). What anatomical structure makes up the anterior border of this foramen?

A 45-year-old woman has an attack of cardiac fibrillation. She suffers from stage II essential hypertension. What is the drug of choice for this stopping this attack?

A 40-year-old man with pulmonary tuberculosis was prescribed isoniazid. Prolonged taking of this drug can result in development of the following vitamin deficiency:

A woman with allergic neurodermatitis was prescribed a second-generation antihistamine without depressing effect on the CNS. Name this drug:

A patient presents with an inner ear inflammation. On examination the doctor states that the 1^st neurons of the auditory analyser are affected. Where are these neurons located?

A patient with peptic ulcer disease was prescribed famotidine. As a result his gastric juice significantly decreased, What is the mechanism of action of this drug?