Krok 1 – 2010 (General Medicine)

Two hours after an exam a student had a blood count done and it was revealed that he had leukocytosis without significant leukogram modifications. What is the most probable mechanism of leukocytosis development?

A patient was stung by a bee. Examination revealed that his left hand was hot, pink, edematic, there was a big red blister on the site of sting. What is the leading mechanism of edema development?

A patient caught a cold after which there appeared facial expression disorder. He cannot close his eyes, raise his eyebrows, bare his teeth. What nerve is damaged?

A newborn child has convulsions that have been observed after prescription of vitamin B₆. This most probable cause of this effect is that vitamin B₆ is a componet of the following enzyme:

Bacterioscopic examination of a smear from the pharynx of a diphtheria suspect revealed bacilli with volutine granules. What etiotropic drug should be chosen in this case?

A patient has a decreased vasopressin synthesis that causes polyuria and as a result of it evident organism dehydratation. What is the mechanism of polyuria development?

A 62 year old patient who previously worked as stoker was admitted to a hospital with complaints about general weakness, abrupt weight loss, hoarse voice, dyspnea, dry cough. Laryngoscopy revealed a tumour in the pharynx that invaded vocal cords and epiglottis. What is the most probable cause of tumour development?

Patients who suffer from severe diabetes and don’t receive insulin have metabolic acidosis. This is caused by increased concentration of the following metabolites:

A 62 year woman complains of frequent pain attacks in the area of her chest and backbone, rib fractures. Her doctor suspected myeloma (plasmocytoma). What of the following laboratory characteristics will be of the greatest diagnostic importance?

A 2 year old child had acute respiratory viral infection and died from cardiopulmonary decompensation. Autopsy revealed that his right lung was hyperemic; in the 2nd, 6th and 10th segments and on the incision there were airless yellowish foci of irregular form, from several mm up to 1 cm large. Microscopical examination revealed exudate consisting mainly of neutrophils in the given areas of pulmonary tissue in the alveoles, bronchioles and bronchial tubes. What is the most probable diagnosis?

Autopsy of a 17 year old girl who died from pulmonary failure revealed a small area of caseous necrosis in the inferior lobe of the right lung, and occurences of caseous necrosis in the bronchopulmonary, bronchial and bifurcational lymph nodes. What is the most probable postmortem diagnosis?

People adapted to high external temperatures have such pecularity: profuse sweating isn’t accompanied by loss of large volumes of sodium chloride. This is caused by the effect of the following hormone upon the perspiratory glands:

An experimantal animal that was kept on protein-free diet developed fatty liver infiltration, in particular as a result of deficiency of methylating agents. This is caused by disturbed generation of the following metabolite:

A man weighs 80 kg, after long physical activity his circulating blood volume is reduced down to 5,4 l, hematocrit makes up 50%, whole blood protein is 80 g/l. These blood characteristics are determined first of all by:

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

A 42 year old woman with neuralgia of trifacial nerve complains about periodical reddening of the right part of her face and neck, sense of warmth gush, increased skin sensitivity. These effects can be explained by the following type of arterial hyperemia:

A 7 year old child often suffers from streprococcic angin A. Doctor suspected development of rheumatism and administered serological examination. The provisional diagnosis will be most probably confirmed by presence of antibodies to the following streptococcic antigen:

Clinical diagnosis of a female patient was gonorrhoe A. What examination method can be applied for confirmation of this diagnosis?

A patient staggers and walks astraddle. He has hypomyotonia of arm and leg muscles, staccato speech. In what brain section is this affection localized?

A bacteriological laboratory received sputum sample of a patient suffering from tuberculosis. Bacterioscopic examination of smears and detection of tuberculosis bacillus can be realized by one of enrichment methods that involves processing of sputum only with solution of caustic soda. What is this method called?

Examination of an ovary specimen stained by hematoxylin-eosine revealed a follicle in which follicular epithelium consisted of 1-2 layers of cubic cells. There was also a bright red membrane around the ovocyte. What follicle is it?

Laboratory examination of a child revealed increased concentration of leucine, valine, isoleucine and their ketoderivatives in blood and urine. Urine smelt of maple syrup. This disease is characterized by the deficit of the following enzyme:

Autopsy of a man who died from burn disease revealed brain edema, liver enlargement as well as enlargement of kidneys with wide light-grey cortical layer and plethoric medullary area. Microscopic examination revealed necrosis of tubules of main segments along with destruction of basal membranes, intersticium edema with leukocytic infiltration and haemorrhages. What is the most probable postmortem diagnosis?

A couple had a child with Down’s disease. Mother is 42 years old. This disease is most probably caused by the following impairment of prenatal development:

A patient suffering from pheochromocytoma complains of thirst, dry mouth, hunger. Blood test for sugar revealed hyperglycemia. What type of hyperglycemia is it?

Examination of a newborn boy’s genitalia revealed an urethral hiatus that opens on the undersite of his penis. What malformation is it?

Blood of a 12 year old boy presents low concentration of uric acid and accumulation of xanthine and hypoxanthine. This child has genetic defect of the following enzyme:

Cytogenetic examination of a patient with reproductive dysfunction revealed normal karyotype 46 ХY in some cells, but most cells have karyotype of Klinefelter’s syndrome – 47 ХХY. Such cell heterogenity is called:

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

A 15 year old girl has pale skin, glossitis, gingivitis. Blood count: erythrocytes – 3,3*10¹²/l, hemoglobin – 70 g/l, colour index – 0,5. Examination of blood smear revealed hypochromia, microcytosis, poikilocytosis. What type of anemia is it?

Blood group of a 30 year old man was specified before an operation. His blood is Rh-positive. Reaction of erythrocyte agglutination was absent with standard sera of 0a\b (I), Аb (II), Вa (III) groups. The blood under examination is of the following group:

A female patient underwent liver transplantation. 1,5 month after it her condition became worse because of reaction of transplant rejection. What factor of immune system plays the leading part in this reaction?

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

A patient suffers from pulmonary tuberculosis. During treatment neuritis of visual nerve arose. What drug has caused this by-effect?

A patient with chronic cardiac insufficiency has been taking foxglove (Digitalis) preparations for a long tim E. Due to the violation of intake schedule the woman got symptoms of intoxication. These symptoms result from:

A patient had been suffering from profuse diarrhea and vomiting for 2 days. He died from acute dehydration. Autopsy revealed that the intestinal wall was edematic and hyperemic, with multiple haemorrhages in the mucous membrane. Intestine lumen contains whitish fluid resembling of rice water. What disease caused death?

A 30 year old man had been suffering from acute respiratory disease and died from cardiopulmonary decompensation. Autopsy revealed fibrinous-haemorrhagic inflammation in the mucous membrane of larynx and trachea, destructive panbronchitis, enlarged lungs that look black due to the multiple abcesses, haemorrhages, necrosis. What is the most probable postmortem diagnosis?

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

Examination of a patient revealed typical presentations of collagenosis. This pathology is characterized by increase of the following urine index:

After destruction of CNS structures an animal lost orientative reflexes. What structure was destroyed?

A patient has been syffering from diarrhea for 5 day. On the fith day colonoscopy revealed that membrane of rectum was inflamed, there were greyish-green films closely adhering to the subjacent tissue. What is the most probable diagnosis?

A cerebral trauma caused increased ammonia generation. What amino acid participates in the excretion of ammonia from the cerebral tissue?

A patient suffers from diabetes melitus. After the regular insulin injection his condition grew worse: there appeared anxiety, cold sweat, tremor of limbs, general weakness, dizziness. What preparation can eliminate these symptoms?

Examination of a child who frequently suffers from infectious diseases revealed that IgG concentration in blood serum was 10 times less than normal, IgA and IgM concentration was also significantly reduced. Analysis showed also lack of B-lymphocytes and plasmocytes. What disease are these symptoms typical for?

A patient suffering from stenocardia was taking nitroglycerine which caused restoration of blood supply of myocardium and relieved pain in the cardiac area. What intracellular mechanism provides restoration of energy supply of insulted cells?

A 66 year old female patient got intravenous injection of magnesium sulfate solution for the purpose of elimination of hypertensive crisis. But arterial pressure didn’t go down and after repeated introduction of the same preparation there appered sluggishness, slow response, inhibition of consciousness and respiration. What preparation is antagonist of magnesium sulfate and can eliminate symptoms of its overdose?

A 19 year old woman suffers from primary syphilis. Doctor administered her complex therapy that includes benzylpenicillin sodium salt. What is the mechanism of action of this drug?

Students who are taking examinations often have dry mouth. The mechanism that causes this state is the realization of the following reflexes:

A patient is 44 years old. Laboratory examination of his blood revealed that content of proteins in plasma was 40 g/l. What influence will be exerted on the transcapillary water exchange?

A viral infection has damaged cells that form walls of bile capillaries. This stimulated conditions for inflow of bile into the blood of sinusoidal capillaries. What cells are damaged?

A healthy man is in a region with high risk of catching malaria. What drug should be administered for individual chemoprophylaxis of malaria?

A child is pale, pastose, muscular tissue is bad developed, lymph nodes are enlarged. He often suffers from angina and pharyngitis, blood has signs of lymphocytosis. The child is also predisposed to auto allergic diseases. What type of diathesis can be presumed in this case?

Autopsy of a 5 year old child revealed in the area of vermis of cerebellum a soft greyish-pink node 2 cm in diameter with areas of hemorrhage. Histologically this tumour consisted of atypical monomorphous small roundish cells with big polymorphous nuclei. What tumor is it?

Surface with an intact toad on it was inclined to the right. Tone of extensor muscles became reflectory higher due to the activation of the following receptors:

Lungs of a preterm infant have areas of atelectasis (pulmonary collapse). The main cause is:

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

A patient suffers from stenocardia and takes isosorbide mononitrate. He was prescribed a complementary drug with disaggregating effect. What drug is it?

A patient in a transplantation centre underwent heart transplantation. The organ was taken from a donor who died in a road accident. Foreign heart can be rejected as a result of development of transplantation immunity. It is usually prevented by means of:

A woman was delivered to a hospital for trachea intubation. What of the following drugs should be applied in this case?

A patient with skin mycosis has disorder of cellular immunity. The most typical characteristic of it is reduction of the following index:

Examination of a patient suffering from frequent haemorrhages in the inner organs and mucous membranes revealed proline and lysine being included in collagen fibers. Impairment of their hydroxylation is caused by lack of the following vitamin:

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

A newborn child suffers from milk curdling in stomach, this means that soluble milk proteins (caseins) transform to insoluble proteins (paracaseins) by means of calcium ions and a certain enzym E. What enzyme takes part in this process?

During preparation of a patient to a heart surgery it was necessary to measure pressure in heart chambers. In one of them pressure varied from 0 mm Hg up to 120 mm Hg within one cardiac cycle. What heart chamber is it?

A 50 year old patient underwent resection of tumour of large intestine wall. Microscopically it presents itself as fascicles of divergent collagen fibers of different thickness and form and some monomorphous fusiform cells that are irregularly distributed among the fibers. Cellular atypia is not evident. What tumour is it?

During regular examination of schoolchildren it was revealed that a 10 year old girl had asymmetric oval eggs with a larva in the scrape from her perianal folds. What diagnosis should be made?

Examination of a man who had been working hard under higher temperature of the environment revealed abnormal quantity of blood plasma proteins. What phenomenon is the case?

A patient consumed a lot of reach in proteins food that caused increase of rate of proteolytic enzymes of pancreatic juice. It is also accompanied by increase of rate of the following enzyme:

6 months after labour a woman had uterine hemorrhage. Gynaecological examination of uterine cavity revealed a dark-red tissue with multiple cavities resembling of a “sponge”. Microscopic examination of a tumour revealed in blood lacunas atypic light epithelial Langhans cells and giant cells of syncytiotrophoblast. What tumour is it?

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

A sportsman needs to improve his sporting results. He was recommended to take a preparation that contains carnitine. What process is activated the most by this compound?

An unconscious young man with signs of morphine poisoning entered admission office. His respiration is shallow and infrequent which is caused by inhibition of respiratory centre. What type of respiratory failure is it?

A patient has delayed conduction of excitement through the atrioventricular node. What changes of ECG will be observed?

Roentgenological examination of skull base bones revealed enlargement of sellar cavity, thinning of anterior clinoid processes, destruction of different parts, destruction of different parts of sella turcica. Such bone destruction might be caused by a tumor of the following wndocrinous gland:

A 33 year old man died from uraemi A. Autopsy revealed enlarged kidneys weighing 500,0 each and consisting of multiple cavities 0,5-2 cm in diameter. The cavities were full of light-yellow transparent liquid. Renal pelvis and ureters had no pecularities. What renal disease caused uraemia?

Inflammatory processes cause synthesis of protein of acute phase in an organism. What substances stumulate their synthesis?

In order to determine toxigenicity of diphtheria bacilli a strip of filter paper impregnated with antitoxic diphtherial serum was put on the dense nutrient medium. There were also inoculated a microbal culture under examination and a strain that is known to be toxigenic. If the microbial culture under examination produces exotoxin, this will result in formation of:

A patient was admitted to the infectious department. His symptoms: dry skin, decreased skin turgor, rice-water stool. The patient was diagnosed with choler A. What disorder of water-electrolytic balance is most often observed in this disease?

A patient has herpetic rash. What medication should be administered?

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

ECG of a patient shows prolongation of T-wave. This is caused by deceleration in ventricles of:

A patient suffers from chronic left-ventricular insufficiency. What medication should be administered?

A patient suffering from infectious mononucleosis has been taking glucocorticosteroids for two weeks. This resulted in remission but the patient got exacerbation of chronic tonsillitis. This complication is induced by the following effect of glucocorticosteroids:

An alcoholic woman has born a girl with mental and physical developmental lag. Doctors diagnosed the girl with fetal alcohol syndrome. What effect is the cause of the girl’s state?

A patient complained about dizziness, memory impairment, periodical convulsions. It was revealed that these changes were caused by a product of decarboxylation of glutamic acid. Name this product:

During an experiment a skeletal muscle is stimulated by a series of electric impulses. What type of muscle contraction will be observed provided that each subsequent impulse comes in the period of shortening of the previous single muscle contraction?

Vagus branches that innervate heart are being stimulated during an experiment. This caused reduction of heart rate due to the intensification of the following process (through the cell membrane of cardiac pacemaker):

Untrained people often have muscle pain after sprints as a result of lactate accumulation. This might be caused by intensification of the following biochemical process:

A patient complains of frequent diarrheas, especially after consumption of rich food, weight loss. Laboratory examination revealed steatorrhea; his feces were hypocholic. What might have caused such condition?

A 30 year old woman has face edema. Examination revealed proteinuria (5,87 g/l), hypoproteinemia, dysproteinemia, hyperlipidemia. What condition is the set of these symptoms typical for?

A scheme presents an exocrinous gland that has unbranched excretory duct with a terminal part in form of a saccule openining into the duct. How is this gland called according to the morphological classification of exocrinous glands?

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

Brain tomography revealed a tumor in the region of red nucleus. What part of brain is damaged?

A patient has been suffering from elevated temperature and attacks of typical cough for 10 days. Doctor administered inoculation of mucus from the patient’s nasopharynx on the agar. What microorganism is presumed?

A 44 year old woman complains of general weakness, heart pain, significant increase of body weight. Objectively: moon face, hirsutism, AP is 165/100 mm Hg, height – 164 cm, weight – 103 kg; the fat is mostly accumulated on her neck, thoracic girdle, belly. What is the main pathogenic mechanism of obesity?

A patient in postoperative period was prescribed an anticholinesterase drug for stimulation of intestinal peristalsis and tonus of urinary bladder. What drug is it?

A patient suffering from initial hypertension has been taking an antihypertensive preparation for a long time. Suddenly he stopped taking this preparation. After this his condition grew worse, this led to development of hypertensive crisis. This by-effect can be classified as:

Hepatitis has led to the development of hepatic failure. Mechanism of edema formation is activated by the impairment of the following liver function:

A patient has acne on his face. Microscopic examination of scrapings from the affected areas revealed living porrect vermiform arthropoda 0,2-0,5 mm large with four pairs of short extremities in the front part of their bodies. What is the laboratory diagnosis?

A 64 year old woman has impairment of twilight vision (hemeralopy). What vitamin should be recommended in the first place?

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

A patient with obliterating atherosclerosis underwent sympathectomy of femoral artery in the region of femoral trigone. What type of arterial hyperemia was induced by the operation?

A 47 year old man with myocardium infarction was admitted to the cardiological department. What changes of cellular composition of peripheral blood are induced by necrotic changes in the myocardium?

A 60 year old patient has impaired perception of high-frequency sounds. These changes were caused by damage of the following auditory analyzer structures:

Examination of a 42 year old patient revealed a tumour of adenohypophysis. Objectively: the patient’s weight is 117 kg, he has moon-like hyperemic face, red-blue striae of skin distension on his belly. Osteoporosis and muscle dystrophy are present. AP is 210/140 mm Hg. What is the most probable diagnosis?

A histological specimen presents an artery. One of the membranes of its wall has flat cells lying on the basal membrane. What type of cells is it?

A patient with hip fracture was prescribed a narcotic analgetic. Its anesthetic action is determined by interaction with the following receptors:

A 46 year old woman suffering from chololithiasis developed jaundice. Her urine became dark-yellow and feces became colourless. Blood serum will have the highest concentration of the following substance:

Normal, actively dividing cells of human red bone marrow are analyzed. What number of cells’ chromosomes is typical for G1 period?

A patient is ill with diabetes mellitus accompanied by hyperglycemia on an empty stomach (7,2 millimole/l). The hyperglycemia rate can be retrospectively estimated (over the last 4-8 weeks before the examination) on the ground of the rate of the following blood plasma protein:

When blood circulation in the damaged tissue is restored, then lactate accumulation comes to a stop and glucose consumption decelerates. These metabolic changes are caused by activation of the following process:

During influenza epidemic 40% of pupils who didn’t go in for sports were affected by the disease, and among the pupils who regularly did physical exercises this index was only 20%. What adaptative mechanisms determined such a low sickness rate of pupils participating in the sports?

A 65 year old female patient suffers from chronic renal insufficiency accompanied by evident edema caused by chronic glomerulonephritis. What diuretic should be administered for forced diuresis?

A patient suffering from chronic cardiac insufficiency was recommended to undergo a prophylactic course of treatment with a cardiological drug from the group of cardiac glycosides that is to be taken enterally. What drug was recommended?

One of sections of central nervous system has layerwise arrangement of neurocytes. Among them there are cells of the following forms: stellate, fusiform, horizontal, pyramidal. What section of central nervous system is this structure typical for?

A 4 year old child complained of pain during deglutition, indisposition. Objectively: palatine arches and tonsils are moderately edematic and hyperemic, there are greyish-white films up to 1 mm thick closely adhering to the subjacent tissues. What pathological process are these changes typical for?

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

A patient ill with thrombophlebitis of his lower limbs had chest pain, blood spitting, progressing respiratory insufficiency that led to his death. Autopsy diagnosed multiple lung infarctions. What is the most probable cause of their development?

A full-term newborn child has yellowish skin and mucous membranes. This might be probably caused by temporary deficiency of the following enzyme:

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

Atria of an experimental animal were superdistended by blood that resulted in decreased reabsorption of Na⁺ and water in renal tubules. This can be explained by the influence of the following factor upon kidneys:

A patient suffers from hepatocirrhosis. State of antitoxic liver function can be characterized by examination of the following substance exreted by urine:

Dietary intake of a 30 year old nursing woman contains 1000 mg of calcium, 1300 mg of phosphorus and 20 mg of iron per day. It is necessary to change content of these mineral substances in the following way:

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

A 50 year old patient has been taking treatment thrice for the last 6 months because of fractures caused by domestic accidents. Microscopical examination of bony tissue revealed foci of lacunar resolution, giant-cell granulomas in the tumour-like formations, cysts. Bony tissue was substituted by fibrous connective tissue. Examination revealed also adenoma of parathyroid gland and hypercalcemia. What is the most probable diagnosis?

A young woman who entered a production department where it strongly smelt of paints and varnishes had a bronchospasm. This reflex was caused by irritation of the following receptors:

An isolated muscle fiber is under examination. It was established that the threshold of stimulation force became significantly lower. What is the cause of this phenomenon?

Burned skin surface was treated with a certain preparation. Its antiseptic properties are provided by atomic oxygen that is formed in presence of organic substances. What preparation was applied?

Examination of a patient suffering from cancer of urinary bladder revealed high rate of serotonin and hydroxyanthranilic acid. It is caused by excess of the following amino acid in the organism:

A man was intoxicated with mushrooms. They contain muscarine that stimulates muscarinic cholinoreceptors. What symptoms signalize intoxication with inedible mushrooms?

A patient who suffers from insomnia caused by emotional disorder was prescribed a hypnotic drug with tranquillizing effect. What hypnotic was prescribed?

Examination of a 66 year old patient revealed a lytic tumor in the locus of pathological rib fracture. Histologically this tumor consists of atypical plasmoblasts. Further examination revealed osteoporosis in the bones of vertebral column and pelvis. These changes are typical for:

A 46 year old patient who had been suffering from tuberculosis for 6 years died from massive pulmonary haemorrhag E. Autopsy revealed different-sixed foci of sclerosis and caseous necrosis in lungs, in the upper part of the right lung there was a cavity 5 cm in diameter with dense grey walls, the cavity contained liquid blood and blood clots. What type of tuberculosis is it?

During the repeated Widal’s agglutination test it was noticed that the ratio of antibody titers and O-antigens S.typhi in the patient’s serum had increased from 1:100 to 1:400. How would you interpret these results?

A patient complained about muscle rigidity, constrained motions, constant tremor of arms. On the grounds of examination his disease was diagnosed as Parkinson’s disease. What drug should be administered?

Labelled amino acids alanine and tryptophane were injected to a mouse in order to study localization of protein synthesis in its cells. The labelled amino acids will be accumulated near the following organelles:

A 56 year old patient suffering from cardiac insufficiency has edema of feet and shins, edematous skin is pale and cold. What is the leding mechanism of edema pathogenesis?

A 50 year old man who was referred to the hospital for treatment of cervical lymphadenitis underwent test for induvidual sensitivity to penicillin. 30 seconds after he went hot all over, AP dropped down to 0 mm Hg that led to cardiac arrest. Resuscitation was unsuccessful. Autopsy results: acute venous plethora of internal organs; histological examination of skin (from the site of injection) revealed degranulation of mast cells (tissue basophils). Degranulation was also revealed in myocardium and lungs. What type of hypersensitivity reaction is it?

During examination of a patient a dentist revealed a lot of “white spots” – zones of enamel demineralization. What microorganisms take part in the development of this process?

A patient who has been abusing tobacco smoking for a long time has got cough accompanied by excretion of viscous mucus; weakness after minor physical stress, pale skin. The patient has also lost 12,0 kg of body weight. Endoscopic examination of biopsy material his illness was diagnosed as squamous cell carcinom A. Name a pathological process that preceded formation of the tumor:

In course of an experiment thalamocortical tracts of an animal were cut. What type of sensory perception remained intact?

Among junior children of an orphanage an outbreak of intestinal infection with signs of colienteritis was registered. In order to identify isolated causative agent it is necessary to:

Vitamin A together with specific cytoreceptors penetrates through the nuclear membranes, induces transcription processes that stimulate growth and differentiation of cells. This biological function is realized by the following form of vitamin A:

A 4 year old child with hereditary renal lesion has signs of rickets, vitamin D concentration in blood is normal. What is the most probable cause of rickets development?

A 35 year old man consulted a dentist about reduced density of dental tissue, high fragility of teeth during eating solid food. This patient suffers the most probably from the deficiency of the following mineral element:

A patient working at a pig farm complains about paroxysmal abdominal pain, liquid feces with admixtures of mucus and blood, headache, weakness, fever. Examination of large intestine revealed ulcers from 1 mm up to several cm large, feces contained oval unicellular organisms with cilia. What disease should be suspected?

A 25 year old Palestinian woman complains of weakness, dizziness, dyspne A. In anamnesis: periodically exacerbating anemi A. In blood: Hb – 60 g/l, erythrocytes – 2,5*10¹²/l, reticulocytes – 35^o/_oo, anisocytosis and poikilocytosis of erythrocytes, a lot of target cells and polychromatophils. What type of anemia is it?

A woman works as railway traffic controller. She suffers from seasonal vasomotor rhinitis and gets treatment in the outpatient setting. She was prescribed an antihistamine that has no effect upon central nervous system. What drug is it?

Examination of a patient with pustular skin lesions allowed to isolate a causative agent that forms in the blood agar roundish yellow middle-sized colonies surrounded by haemolysis zone. Smears from the colonies contain irregular-shaped clusters of gram-positive cocci. The culture is oxidase- and catalase-positive, ferments mannitol and synthesizes plasmocoagulase. What causative agent was isolated?

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

Histological examination of a 40 year old man’s thymus revealed reduced share of parenchymatous elements, increased share of adipose and loose connective tissue, its enrichment with thymus bodies. The organ’s mass was unchanged. What is this phenomenon called?

An infectious disease caused contractive activity of muscles that contract and dilate eye pupil (paralytic state). What functional eye system was damaged?

Study of conversion of a food colouring agent revealed that neutralization of this xenobiotic takes place only in one phase – microsomal oxydation. Name a component of this phase:

Study of fingerprints (dactylography) is used by criminalists for personal identification as well as for diagnostics of genetic abnormalities, particularly Dawn’s disease. What layer of skin determines individuality of fingerprints?

A 23 year old man has perforation of hard palat E. In the area of this perforation there was a compact well-defined formation. Microscopic examination of the resected formation revealed a large focus of caseous necrosis surrounded by granulation tissue with endovasculitis, cellular infiltration composed of lymphocytes, epithelioid cells (mainly plasmocytes). What is the most probable diagnosis?

A clinic observes a 49 year old patient with significant prolongation of coagulation time, gastrointestinal haemorrhages, subcutaneous hematomas. These symptoms might be explained by the deficiency of the following vitamin:

A doctor revealed tissues injury on patient’s scalp with localized suppurations and diagnosed his disease as myiasis. This infestation is caused by larvae of the following insect:

A 4 year old child was admitted to the orthopaedic department with shin fracture together with displacement. Bone fragments reposition requires preliminary analgesia. What preparation should be chosen?

Emotional stress causes activation of hormon-sensitive triglyceride lipase in the adipocytes. What secondary mediator takes part in this process?

A patient suffering from periodical attacks caused by inhalation of different flavoring substances was diagnosed with atopic bronchial asthm A. IgE level was increased. This is typical for the following type of reactions:

Researchers of a bacteriological laboratory examine tinned meat for botulinic toxin. For this purpose a group of mice was injected with an extract of the material under examination and antitoxic antibotulinic serum of A, B, E types. A control group of mice was injected with the same extract but without antibotulinic serum. What serological reaction was applied?

Cardinal symptoms of primary hyperparathyroidism are osteoporosis and renal lesion along with development of urolithiasis. What substance makes up the basis of these calculi in this disease?

A 45 year old man consulted a doctor about a plaque-like formation on his neck. Histological examination of a skin bioptate revealed clusters of round and oval tumour cells with a narrow border of basophilic cytoplasm resembling of cells of basal epidermal layer. What tumor is it?

A cell at the stage of mitosis anaphase was stimulated by colchicine that inhibits chromosome separation to the poles. What type of mutation will be caused?

48 hours after tuberculine test (Mantoux test) a child had a papule 10 mm in diameter on the spot of tuberculine injection. What hypersensitivity mechanism underlies these changes?

Introduction of a big dose of histamine to an experimental animal caused abrupt drop of arterial pressure as a result of:

A patient died from acute cardiac insufficiency, among clinical presentations there was gastrointestinal haemorrhage. Examination of mucous membrane of sromach revealed some defects reaching myenteron; their edges and bottom were mostly even and loose, some of them contained dark-red blood. What pathological process was revealed?

Electronic microphotography of pulmonary alveole’s wall presents a big cell. Its cytoplasm has a lot of mitochondria, developed Golgi apparatus, osmiophil lamellated corpuscles. What is the main function of this cell?

A patient underwent an operation on account of gall bladder excision that resulted in obstruction of Ca absorption through the bowels wall. What vitamin wil stimulate this process?

A 48 year old patient complained about intense pain, slight swelling and reddening of skin over the joints, temperature rise up to 38^oC. Blood analysis revealed high concentration of urates. This condition might be caused by disturbed metabolism of:

A 17 year old boy fell seriously ill, the body temperature rose up to 38,5^oC, there appeared cough, rhinitis, lacrimation, nasal discharges. What inflammation is it?

It is known that the gene responsible for development of blood groups according to AB0 system has three allele variants. If a man has IV blood group, it can be explained by the following variability form:

Characteristic sign of glycogenosis is muscle pain during physical work. Blood examination reveals usually hypoglycemia. This pathology is caused by congenital deficiency of the following enzyme:

A concentrated solution of sodium chloride was intravenously injected to an animal. This caused decreased reabsorption of sodium ions in the renal tubules. It is the result of the following changes of hormonal secretion:

An unconscious patient was delivered to the admission ward. Objectively: the patient’s skin is cold, pupils are myotic, he has labored Cheney-Stokes respiration, arterial pressure is low, urinary bladder is full. What substance has caused intoxication?

A 22 year old patient from the West Ukraine complains of laboured nasal breathing. Morphological examination of biopsy material of nasal mucous membrane revealed lymphoid, epithelioid, plasma cells as well as Mikulicz’s cells. What is the most probable diagnosis?

An isolated cell of human heart automatically generates excitement impulses with frequency of 60 times per minute. This cell was taken from the following heart structure:

Voluntary breath-holding caused increase of respiration depth and frequency. The main factor stimulating these changes of external respiration is:

A patient has low rate of magnesium ions that are necessary for affixion of ribosomes to the endoplasmic reticulum. It is known that it causes disturbance of protein biosynthesis. At what stage is protein biosynthesis impaired?

A 45 year old patient was admitted to the cardiological department. ECG data: negative P wave overlaps QRS complex, diastolic interval is prolonged after extrasystole. What type of extrasystole is it?

A 5 year old child is ill with measles. Blood analysis revealed increase of total number of leukocytes up to 13*10⁹/l. Leukogram: basophils – 0, eosinophils – 1, myelocytes – 0, juvenile neutrophils – 0, band neutrophils – 2, segmented neutrophils – 41, lymphocytes – 28, monocytes – 28. Name this phenomenon:

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

During an operation a patient got injection of muscle relaxant dithylinum. Relaxation of skeletal muscles and inhibition of respiration lasted two hours. This condition was caused by absence of the following enzyme in blood serum:

Microscopical examination of a microbal culture revealed fusiform spore-forming microorganisms that get violet-blue Gram’s stain. What microorganisms were revealed?

A 63 year old male patient who had been suffering from chronic diffuse obstructive disease, pulmonary emphysema, for 15 years died from cardiac insufficiency. Autopsy revealed nutmeg liver cirrhosis, cyanotic induration of kidneys and spleen, ascites, edemata of lower limbs. These changes of internal organs are typical for the following disease:

A patient staying in the pulmonological department was diagnosed with pulmonary emphysema accompanied by reduced elasticity of pulmonary tissue. What type of respiration is observed?

A virological laboratory obtained pathological material (mucous discharges from nasal meatuses) taken from a patient with provisional diagnosis “influenza”. What quick test will allow to reveal specific viral antigen in the material under examination?

A patient ill with neurodermatitis has been taking prednisolone for a long time. Examination revealed high rate of sugar in his blood. This complication is caused by the drug influence upon the following link of carbohydrate metabolism:

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

A 34 year old woman was diagnosed with hereditary microspherocytic hemolytic anemia (Minkowsky-Shauffard disease). What mechanism caused haemolysis of erythrocytes?

Examination of a patient revealed hypertrophy and inflammation of lymphoid tissue, edema of mucous membrane between palatine arches (acute tonsillitis). What tonsil is normally situated in this area?

Material taken from a patient with provisional diagnosis “influenza” was referred to a laboratory. For virological examination the hemadsorption reaction was applied. This reaction can be applied for detection of the following viruses:

During hypersensitivity test a patient got subcutaneous injection of an antigen which caused reddening of skin, edema, pain as a result of histamine action. This biogenic amine is generated as a result of transformation of the following histidine amino acid:

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

A 25 year old man has spent a long time in the sun under high air humidity. As a result of it his body temperature rose up to 39^oC. What pathological process is it?

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

Examination of a pregnant woman revealed twice as much concentration of fibrinogen in blood plasm. What ESR can this woman have?

A family of students who came from Africa got a child with anemia signs. The child died soon. Examination revealed that the child’s erythrocytes have abnormal semilunar shape. Specify genotypes of the child’s parents:

According to the model of double DNA helix that was suggested by Watson and Creek, it was established that one of chains would not be lost during replication and the second chain would be synthesized complementary to the first one. What way of replication is it?

A patient underwent appendectomy. In the postoperative period he has been taking an antibiotic. The patient complains about hearing impairment and vestibular disorders. What group of antibiotics has such by-effects?