Krok 1 – 2015 (General Medicine)

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

Histologic specimen of a kidney demonstrates cells closely adjoined to the renal corpuscle in the distal convoluted tubule. Their basement membrane is extremely thin and has no folds. These cells sense the changes in sodium content of urine and influence renin secretion occurring in juxtaglomerular cells. Name these cells:

A 46-year-old female patient has continuous history of progressive muscular (Duchenne’s) dystrophy. Which blood enzyme changes will be of diagnostic value in this case?

A laboratory experiment on a dog was used to study central parts of auditory system. One of the mesencephalon structures was destroyed. The dog has lost the orienting response to auditory signals. What structure was destroyed?

A patient has decreased concentration of magnesium ions that are required for ribosomes connection to granular endoplasmic reticulum. This condition is known to disrupt the process of protein bi-osynthesis. Disruption occurs at the following stage:

A 6-year-old child with suspected active tuberculous process has undergone diagnostic Mantoux test. What immunobiological preparation was injected?

During postembryonal haemopoiesis in red bone marrow the cells of one of the cellular differons demonstrate gradual decrease in cytoplasmic basophilia as well as increase in oxyphilia, the nucleus is being forced out. Such morphological changes are typical for the following haemopoiesis type:

When taking exams students often have dry mouth. The mechanism that causes this state results from the following reflexes:

A 67-year-old patient with clinical diagnosis of chronic bronchitis, pneumosclerosis, and cardiopulmonary decompensation has the biopsy material taken from the suspicious area in his right bronchus mucosa. Cellular and tissue atypism along with pearly bodies can be histologically detected. What pathologic process is characterized by the described histological changes?

A microspecimen of heart shows rectangular cells from 50 to 120 micrometers large with central position of nucleus and developed myofibrils. The cells are connected by intercalated discs. These cells are responsible for the following function:

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

Poisoning caused by botulinum toxin that prevents calcium ions from entering axone nerve endings of motoneurons is life-threatening because it can lead to:

Increased HDL levels decrease the risk of atherosclerosis. What is the mechanism of HDL anti-atherogenic action?

It has been found out that one of a pesticide components is sodium arsenate that blocks lipoic acid. Which enzyme activity is impaired by this pesticide?

A drycleaner’s worker has been found to have hepatic steatosis. This pathology can be caused by the disruption of synthesis of the following substance:

A 35-year-old man with peptic ulcer disease has undergone antrectomy. After the surgery secretion of the following gastro-intestinal hormone will be disrupted the most:

Atretic bodies and developed yellow body can be observed along with follicles of various orders in an ovary specimen. What stage of ovarian and menstrual cycle is characterized by the described ovary condition?

A 16-year-old adolescent is diagnosed with hereditary UDP (uridine di-phosphate) glucuronyltransferase deficiency. Laboratory tests revealed hyperbilirubinemia caused mostly by increased blood content of the following substance:

Prior to glucose utilization in cells it is transported inside cells from extracellular space through plasmatic membrane. This process is stimulated by the following hormone:

After implantation of a cardiac valve a young man systematically takes indirect anticoagulants. His state was complicated by hemorrhage. What substance content has decreased in blood?

A 12-year-old patient has white non-pigmented spots on the skin. The spots appeared after the patient became 10 years old, and they constantly grow. This spots appeared due to the lack of the following skin cells:

A group of Ukrainian tourists returning from Samarqand was bringing with them gerbils. During examination in customs office ulcers were detected on the skin of the animals. What protozoa is the most likely to cause the disease in the animals, if mosquitos are the carriers?

A 5-year-old child has been diagnosed with acute right distal pneumonia. Sputum inoculation revealed that the causative agent is resistant to penicillin and senstive to macrolides. What drug should be prescribed?

To an emergency ward a 7-year-old child was delivered in the condition of allergic shock caused by a bee sting. High concentration of histamine is observed in blood. Production of this amine is the result of the following reaction:

A 65-year-old man suffering from gout complains of pain in his kidneys. Ultrasonic examination revealed kidney stones. A certain substance in increased concentration can cause kidney stones formation. Name this substance:

Sex chromatin was detected during examination of a man’s buccal epithelium. It is characteristic of the following chromosome disease:

Pure culture of microorganisms was obtained from pharynx of a child with suspected diphtheria. Morphologic, tinctorial, cultural, and biochemical properties of the microorganisms were studied and revealed to be characteristic of diphtheria agents. What investigation should be additionally performed to make a conclusion, that these microorganisms are pathogenic diphtheria bacilli?

Autopsy of a man who had tuberculosis revealed a 3×2 cm large cavity in the superior lobe of the right lung. The cavity was interconnected with a bronchus, its wall was dense and consisted of three layers: the internal layer was pyogenic, the middle layer was made of tuberculous granulation tissue and the external one was made of connective tissue. What is the most likely diagnosis?

A 7-year-old child has acute onset of disease: temperature rise up to 38^oC , rhinitis, cough, lacrimation, and large-spot rash on the skin. Pharyngeal mucosa is edematous, hyperemic, with whitish spots in the buccal area. What kind of inflammation causes the changes in the buccal mucosa?

Analysis of sputum taken from a patient with suspected pneumonia revealed slightly elongated gram-positive diplococci with pointed opposite ends. What microorganisms were revealed in the sputum?

Serological diagnostics of infectious diseases is based upon specific interaction with antigenes. Specify the serological reaction that underlies adhesion of microorganisms when they are affected by specific antibodies in presence of an electrolyte:

A 4-year-old child was admitted to an orthopaedic department with displaced shin fracture. Bone fragments reposition requires analgesia. What drug should be chosen?

Doctors make mostly radial incisions during mammary gland surgery. What particulars of anatomical organization make such surgical technique preferable?

A 41-year-old man has a history of recurrent attacks of heartbeats (paroxysms), profuse sweating, headaches. Examination revealed hypertension, hyperglycemia, increased basal metabolic rate, and tachycardia. These clinical presentations are typical for the following adrenal pathology:

A 12-year-old child has developed nephritic syndrome (proteinuria, hematuria, cylindruria) 2 weeks after the case of tonsillitis, which is a sign of affected glomerular basement membrane in the kidneys. What mechanism is the most likely to cause the basement membrane damage?

Several minutes after a dentist administered novocaine for local anaesthesia of a patient’s tooth, the following symptoms sharply developed in the patient: fatigue, skin itching. Objectively the following can be observed: skin hyperemia, tachycardia, BP dropped down to 70/40 mm Hg. What kind of allergic reaction is this pathology?

A patient with probable liver abscess was delivered to a surgical department. The patient for a long time had been on an assignment in an African country and had recurrent cases of acute gastrointestinal disturbance. What protozoan disease can it be?

Work in a mine is known to cause inhalation of large amounts of coal dust. Inhaled coal dust can be detected in the following pulmonary cells:

Electrical activity of neurons is being measured. They fire prior to and at the beginning of inhalation. Where are these neurons situated?

Electrocardiogram analysis demonstrates that cardiac cycle of a human equals 1 second. It means that heart rate per minute equals:

Glomerular filtration of a person, who has been starving for a long time, has increased by 20%. The most likely cause of filtration changes in the given conditions is:

Cells of healthy liver actively synthesize glycogen and proteins. What organelles are the most developed in them?

Atria of an experimental animal were superdistended with blood, which resulted in decreased reabsorption of N a⁺ and water in renal tubules. This can be explained by the influence of the following factor on kidneys:

A patient with hypertensic crisis has increased content of angiotensin II in blood. Angiotensin pressor effect is based on:

A 43-year-old-patient has arterial hypertension caused by increase in cardiac output and general peripheral resistance. Specify the variant of hemodynamic development of arterial hypertension in the given case:

A patient has been hospitalised with provisional diagnosis of virus B hepatitis. Serological reaction based on complementation of antigen with antibody chemically bound to peroxidase or alkaline phosphatase has been used for disease diagnostics. Name this serological reaction:

A surgeon has to find the common hepatic duct during operative intervention for treatment of concrements in the gall ducts. The common hepatic duct is located between the leaves of:

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

When measuring power inputs of a person by the method of indirect calorimetry the following results were obtained: oxygen consumption is 1000 ml and carbon dioxide production is 800 ml per minute. The person under examination has the following respiratory coefficient:

On examination of a newborn boy’s external genitalia a fissure in the urethra opening on the inferior surface of his penis is detected. What maldevelopment is it?

Poisoning caused by mercury (II) chloride (corrosive sublimate) occurred in the result of safety rules violation. In 2 days the patient’s diurnal diuresis became 620 ml. The patient developed headache, vomiting, convulsions, dyspnea; moist crackles are observed in the lungs. Name this pathology:

For people adapted to high external temperatures profuse sweating is not accompanied by loss of large volumes of sodium chloride. This is caused by the effect the following hormone has on the perspiratory glands:

Along with normal hemoglobin types there can be pathological ones in the organism of an adult. Name one of them:

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

A patient has been diagnosed with alkaptonuria. Choose an enzyme that can cause this pathology when deficient:

As a result of a continuous chronic encephalopathy a patient has developed spontaneous motions and disorder of torso muscle tone. These are the symptoms of the disorder of the following conduction tract:

A child is 10 years old. The following presentations have developed: sharp pain during swallowing, swollen neck, body temperature rise up to 39, 0^oC , bright-red finely papular rash all over the body. Pharynx and tonsils are sharply hyperemic (“flaming pharynx”), “crimson tongue”. On the tonsils surface there are isolated greyish necrosis focuses. What disease it might be?

A patient suffers from intermittent fevers and normalizations of body temperature that occur during the day. The temperature rise is observed regularly every fourth day. Specify the type of temperature curve:

A woman with the III (В), Rh- blood group gave birth to a child with the II (А) blood group. The child is diagnosed with hemolytic disease of newborn caused by rhesus incompatibility. What blood group and Rh can the father have?

A patient is diagnosed with hereditary coagulopathy that is characterised by factor VIII deficiency. Specify the phase of blood clotting during which coagulation will be disrupted in the given case:

Angiocardiography of a 60-year-old man revealed constriction of the vessel located in the left coronary sulcus of his heart. Name this pathological vessel:

A patient complains of pain in the right lateral abdomen. Palpation revealed a dense, immobile, tumor-like formation. The tumor is likely to be found in the following part of the digestive tube:

During regular check-up a child is detected with interrupted mineralization of the bones. What vitamin deficiency can be the cause?

During  hystological  analysis  of  the lymph node  situated  in  the  posterior neck triangle  of  an  18-year-old  patient  a morphologist  detected  a  cluster of cells including the following: isolated multinucleate Reed-Sternberg cells, large and small Hodgkin’s cells and numerous lymphocytes, isolated plasma cells, eosinophils. What disease has developed in the patient?

An infant has pylorospasm, weakness, hypodynamia, convulsions as a result of frequent vomiting. What kind of acid-base disbalance is it?

A 39-year-old man who had been operated for the stomach ulcer died 7 days after the surgery. Autopsy revealed that peritoneal leaves were dull, plephoric, covered with massive yellow-greenish films, the peritoneal cavity contained about 300 ml of thick yellow-greenish liquid. What pathologic process was revealed in the peritoneal cavity?

Monoamine  oxidase  inhibitors  are widely   used as  psychopharmacological drugs.  They change  the  level  of  nearly all neurotransmitters  in  synapses, with the following neurotransmitter being the exception:

A patient with urolithiasis has developed severe pain attacks. For pain shock prevention he was administered an antispasmodic narcotic analgesic along with atropine. Name this drug:

A patient with acute myocardial infarction has been administered heparin as a part of complex therapy. Some time after heparin injection the patient developed hematuria. What heparin antagonist should be injected to remove the complication?

A 37-year-old woman complains of headache, vertigo, troubled sleep, numbness of limbs. For the last 6 years she has been working at a gas-discharge lamp-producing factory in a lead-processing shop. Blood test findings: low hemoglobin and RBC level, serum iron concentration exceeds the norm by several times. Specify the type of anemia:

Despite the administration of cardiotonics and thiazide diuretic a patient with chronic heart failure has persistent edemas and the risk of ascites arose. What medication should be administered to enhance the diuretic effect of the administered drugs?

Acute renal impairment caused death of a patient with hemorrhage. Autopsy revealed enlarged kidneys with broad pale-pink cortical layer expressively demarcated from dark-red renal pyramids. Macroscopic examination revealed lack of epithelial nuclei of convoluted tubules, tubulorrhexis, phlebostasis. The cell nuclei of choroid glomus and straight tubules were present. What pathology is it?

A 3-year-old child with meningeal symptoms died. Postmortem macroscopy of the pia matter revealed miliary nodules which were microscopically represented by a focus of caseous necrosis with masses of epithelioid and lymphoid cells with large cells containing crescent-shaped peripheral nuclei situated between them. Specify the type of meningitis in the child:

A 66-year-old woman had intravenous injection of magnesium sulfate solution to stop hypertensive crisis. However her arterial pressure did not decrease and after repeated introduction of the same preparation she developed sluggishness, slow response to stimuli; the patient is unconsciousness and her respiration is inhibited. What preparation is antagonist of magnesium sulfate and can remove the symptoms of its overdose?

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

An unconscious patient was delivered by ambulance to the hospital. On objective examination the patient was found to present no reflexes, periodical convulsions, irregular breathing. After laboratory examination the patient was diagnosed with hepatic coma. Disorders of the central nervous system develop due to accumulation of the following metabolite:

When playing a child received a hit to the presternum region. As a result of this trauma an organ located behind the presternum was damaged. Name this organ:

A child suffers from dry cough. What non-narcotic antitussive drug will relieve the patient’s condition?

A patient complains of acute pain attacks in the right lumbar region. During examination a nephrolithic obturation of the right ureter in the region between its abdominal and pelvic segments has been detected. What anatomical boundary exists between those two segments?

A patient has insufficient blood supply to the kidneys, which has caused the development of pressor effect due to constriction of arterial resistance vessels. This condition results from the vessels being strongly affected by the following substance:

In a village a case of anthrax has been registered. Medical services began epidemiologically indicated specific prophylaxis of population against anthrax. What preparation was used for this purpose?

Experimental stimulation of the sympathetic nerve branches that innervate the heart caused an increase in the force of heart contractions because the membrane of typical cardiomyocytes permitted an increase in:

According to the results of glucose tolerance test a patient has no disorder of carbohydrate tolerance. Despite that glucose is detected in the patients’s urine (5 mmol/l). The patient has been diagnosed with renal diabetes. What renal changes cause glucosuria in this case?

Alveolar space of acinus was invaded by bacteria that interacted with the surfactant. This led to the activation of the cells that are localized in the alveolar walls and on the surface. Name these cells:

Parents of a 5-year-old boy report him to have frequent colds that develop into pneumonias, presence of purulent rashes on the skin. Laboratory tests have revealed the following: absence of immunoglobulins of any type, and naked cells are absent from the lymph nodes punctate. What kind of immune disorder is it?

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?

2 days after labour a woman developed shock along with DIC syndrome that caused her death. Autopsy revealed purulent endomyometritis, regional purulent lymphangitis, lymphadenitis and purulent thrombophlebitis. There were also dystrophic alterations and interstitial inflammation of parenchymal organs. What is the most likely diagnosis?

In case of alkaptonuria, homogentisic acid is excreted in urine in large amounts. The development of this disease is associated with metabolic disorder of the following amino acid:

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

A doctor examined a patient, studied the blood analyses, and reached a conclusion, that peripheral immunogenesis organs are affected. What organs are the most likely to be affected?

A doctor asked a patient to make a deep exhalation after a normal inhalation. What muscles contract during such exhalation?

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?

In a cat with decerebrate rigidity the muscle tone is to be decreased. This can be achieved by:

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 blurred margins and areas of haemorrhage. Histologically this tumour consisted of atypical monomorphous small round cells with large polymorphous nuclei. What tumour 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:

A patient with high-titer antinuclear antibodies died from progressing renal impairment. Autopsy revealed mesangi-oproliferative glomerulonephritis and abacterial polypous endocarditis. Periarterial bulbar sclerosis was detected in spleen and productive proliferative vasculitis in skin. What is the most likely diagnosis?

When studying the signs of pulmonary ventilation, reduction of forced expiratory volume has been detected. What is the likely cause of this phenomenon?

A specimen of a parenchymal organ shows poorly delineated hexagonal lobules surrounding a central vein, and the interlobular connective tissue contains embedded triads (an artery, a vein and an excretory duct). What organ is it?

A patient had a trauma that caused dysfunction of motor centres regulating activity of head muscles. In what parts of cerebral cortex can the respective centre normally be located?

During intravenous saline transfusion a patient’s condition deteriorated drastically, and the patient died from asphyxiation. Autopsy revealed acute venous congestion of internal organs with sharp right heart dilatation. When the right ventricle was punctured underwater, the bubbles escaped. What pathological process occurred in the patient?

Diseases of respiratory system and circulatory disorders impair the transport of oxygen, thus causing hypoxia. Under these conditions the energy metabolism is carri-ed out by anaerobic glycolysis. As a result,the following substance is generated and accumulated in blood:

Examination of a 6-month-old child revealed a delay in closure of the occipital fontanelle. When should it normally close?

Sex chromosomes of a woman didn’t separate and move to the opposite poles of a cell during gametogenesis (meiosis). The ovum was impregnated with a normal spermatozoon. Which chromosomal disease can be found in her child?

A patient was prescribed loratadine to treat allergic cheilitis. What is the mechanism of action of this drug?

During introduction of local anesthesia a patient has gone into anaphylactic shock. What drug must be administered to the patient?

A  patient has been  diagnosed  with influenza. His condition  drastically worsened after taking antipyretic drugs. He is unconscious, AP is 80/50 mm Hg, Ps is 140/m, body temperature dropped down to 35, 8^oC . What complication developed in this patient?

An alcoholic has alcoholic psychosis with evident psychomotor agitation. What neuroleptic drug should be administered for emergency aid?

During blood transfusion a patient has developed intravascular erythrocyte hemolysis. What kind of hypersensitivity does the patient have?

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

A 4-year-old child presents with general weakness, sore throat and deglutitive problem. After his examination a doctor suspected diphtheria and sent the material to a bacteriological laboratory. To determine the diphtheria causative agent the material should be inoculated into the following differential diagnostic medium:

When treating a patient with chronic cardiac failure a doctor detected bradycardia and deterioration of the patient’s general state. Such condition is caused by cumulative effect of a drug. Which drug of those listed below has cumulative action?

A doctor was addressed by a 30-year-old man. There is a probability of the patient being HIV-positive. To clarify the diagnosis the doctor proposed to perform polymerase chain reaction. The basic process in this kind of investigation is:

Due to the use of poor-quality measles vaccine for preventive vaccination, a 1-year-old child developed an autoimmune renal injury. The urine was found to contain macromolecular proteins. What process of urine formation was disturbed?

A 26-year-old female patient with bronchitis has been administered a broad spectrum antibiotic as a causal treatment drug. Specify this drug:

A 65-year-old man suddenly lost vision in one eye due to the retinal detachment. The patient underwent enucleation. Hi-stological examination of the removed eye retina and choroid revealed clusters of atypical cells with marked polymorphism of cells and nuclei, with a moderate number of mitoses including the pathological ones. The cell cytoplasm and intercellular medium contained brown pigment resulting in positive DOPA reaction. Perls’ reaction was negative. What is the most likely diagnosis?

During determining the blood group according to the AB0 system with salt solutions of monoclonal antibodies agglutination did not occur with any of the solutions. What blood group is it?

One of the factors that cause obesity is inhibition of fatty acids oxidation due to:

During ventricular systole the cardiac muscle does not respond to additional stimulation because it is in the phase of:

A patient is diagnosed with acute morphine hydrochloride intoxication. Prescribe the oxidizing agent for gastric lavage:

During cell division DNA replication occurs after a signal is received from the cytoplasm, then a certain portion of the DNA helix unwinds and splits into two individual strains. What enzyme facilitates this process?

A patient has been given atropine sulfate for rapid relief of spastic colon symptoms. The use of this drug is contraindicated during the following disease:

As an example of specific human parasites one can name Plasmodium falciparum, human pinworm and some others. The source of parasite invasion in these cases is always a human. Such specific human parasites cause the diseases that are called:

In the course of an experiment there has been increase in nerve conduction  velocity. This may be caused by increase in concentration of the following ions that are present in the solution around the cell:

An HIV-positive patient’s cause of death is acute pulmonary insufficiency resulting from pneumonia. Pathohistological investigation of lungs has revealed interstitial pneumonia, alveolocyte desquamati-on and methamorphoses: alveolocyte enlargement, large intranuclear inclusions surrounded by lightly-coloured areas. Transformed cells resemble owl’s eye. Name the causative agent of pneumonia:

The organisms to be identified have a nucleus surrounded by a nuclear membrane. Genetic material is concentrated predominantly in the chromosomes that consist of DNA strands and protein molecules. These cells divide mitotically. Identify these organisms:

A 2-year-old boy is diagnosed with Down syndrome. What chromosomal changes may be the cause of this disease?

After a road accident a victim has tachycardia, arterial blood pressure 130/90 mm Hg, tachypnoe, the skin is pale and dry, excitation of central nervous system is observed. What shock stage is the patient most likely in?

As a result of a mechanical injury an over 10 cm long portion of a peripheral  nerve was damaged. This caused an impai-rment of the upper limb activity. The patient was offered nerve transplantation. What glial cells will participate in regeneration and provide the trophism of the injured limb?

A 47-year-old man developed intestinal colic against the background of essential hypertension. In this situation it would be most efficient to arrest the colic by administering drugs of the following group:

Microscopy of a female patient’s swabs made from vaginal secretion revealed gram-negative bean-shaped diplococci. What provisional diagnosis can be made?

A 54-year-old woman was brought to a casualty department after a car accident. A traumatologist diagnosed her with multiple fractures of the lower extremities. What kind of embolism is most likely to develop in this case?

A therapeutist has an appointment with a 40-year-old patient complaining of recurrent pain attacks in his hallux joints and their swelling. Urine analysis revealed its marked acidity and pink colour. What substances can cause such changes in the urine?

A 30-year-old man with diabetes mellitus type I was hospitalised. The patient is comatose. Laboratory tests revealed hyperglycemia and ketonemia. What metabolic disorder can be detected in this patient?

A 15-year-old patient has fasting plasma glucose level 4,8 mmol/l, one hour after glucose challenge it becomes 9,0 mmol/l, in 2 hours it is 7,0 mmol/l, in 3 hours it is 4,8 mmol/l. Such parameters are characteristic of:

A patient has undergone surgical removal of a cavitary liver lesion 2 cm in diameter. It was revealed that the cavity wall was formed by dense fibrous connective tissue; the cavity contained murky thick yellowish-green fluid with an unpleasant odor. Microscopically the fluid consisted mainly of polymorphonuclear leukocytes. What pathological process are these morphological changes typical for?

A patient consulted a physician about chest pain, cough, fever. Roentgenography of lungs revealed eosinophilic infiltrates which were found to contain the larvae. What kind of helminthiasis are these presentations typical for?

During appendectomy a patient had the a. appendicularis ligated. This vessel branches from the following artery:

A 28-year-old patient undergoing treatment in a pulmonological department has been diagnosed with pulmonary emphysema caused by splitting of alveolar septum by tissular tripsin. The disease is caused by the congenital deficiency of the following protein:

A patient, who has been suffering for a long time from intestine disbacteriosis, has increased hemorrhaging caused by disruption of posttranslational modification of blood-coagulation factors II, VII, IХ, and Х in the liver. What vitamin deficiency is the cause of this condition?

During a surgery for femoral hernia a surgeon operates within the boundaries of femoral trigone. What structure makes up its upper margin?

An obstetrician-gynecologist measures pelvis size of a pregnant woman. A caliper was used to measure the distance between the two iliac crests. What measurement of large pelvis was made?

A patient has arterial hypertension. What long-acting drug from the group of calcium channel blockers should be prescribed?

A   patient   has   been   diagnosed with URTI. Blood serum contains immunoglobulin M. What stage of infection is it?

A 43-year-old patient suffers from acute pancreatitis with disrupted common bile duct patency. What condition can develop in this case?

A patient has a tumor of the eyesocket tissues behind the eyeball. Disruption of accomodation and pupil constriction is observed. What anatomical structure is damaged?

Lymphocytes and other cells of our body synthesize universal antiviral agents as a response to viral invasion. Name these protein factors:

A patient consulted a dentist about restricted mouth opening (trismus). Anamnesis states a stab wound of the lower extremity. What infection may cause these symptoms?

A patient has damaged spinal cord white matter in the middle area of the posterior white column, disrupted proprioceptive sensibility of the lower limb joints and muscles. What fibers are affected?

In an elderly person the change in heart force and vessels physical properties were detected; they can be clearly observed on graphic recording of carotid pulse waves. What method was applied?

A patient has developed paroxysmal ventricular tachycardia against the background of cardiac infarction. What anti-arrhythmic drug should be chosen to avoid lowering cardiac output?

Electrocardiogram of a young man reveals deviation of his electrical axis of heart to the left. This phenomenon can be caused by:

A 6-year-old child suffers from delayed growth, disrupted ossification processes, decalcification of the teeth. What can be the cause?

A 30-year-old patient’s blood test revealed the following: erythrocyte count is 6 · 10¹² /l, hemoglobin is 10,55ммоль/l. Vaquez’s disease was diagnosed. Name the leading part of pathogenesis:

A 25-year-old patient complains of increasing pain in his leg muscles occurring during walking and forcing him to make frequent stops. Objectively: skin of legs is pale, no hair-covering, toenails are with trophic changes, no pulsation of pedal arteries. The most probable cause of these changes is:

This year influenza epidemic is characterised by patients’ body temperature varying from 36, 9^o C to 37, 9^oC . Such fever is called:

A woman complains of visual impairment. Examination revealed obesity in the patient and her fasting plasma glucose level is hyperglycemic. What diabetes complication can cause visual impairment/blindness?

Prolonged treatment of hypothyroidism has caused general dystrophy, dental caries, tachycardia, tremor of extremities. What drug is the cause of these side effects?

A 3-year-old child has eaten some strawberries. Soon he developed a rash and itching. What was found in the child’s leukogram?

A patient has been found to have a marked dilatation of the saphenous veins in the region of anterior abdominal wall around the navel. This is symptomatic of pressure increase in the following vessel:

Cholesterol content in blood serum of a 12-year-old boy is 25 mmol/l. Anamnesis states hereditary familial hypercholesterolemia caused by synthesis disruption of receptor-related proteins for:

Obesity is a common disease. The aim of its treatment is to lower content of neutral fats in the body. What hormon-sensitive enzyme is the most important for intracellular lipolysis?

A 40-year-old woman was diagnosed with glomerulonephritis based on her clinical symptoms and the results of urine analysis. Anamnesis states chronic tonsillitis. What microorganisms are the most likely cause for her kidney damage?

A man is suffering from diarrhea. In summer he spent his vacation in the south at the sea coast. Bacteria with the following properties were detected in his feces: gram-negative curved mobile monotrichous bacilli that do not produce spores or capsules. They are undemanding to nutrient medium but require alkaline reaction (рН 8,5-09,5). Described are the agents of the following enteric infection:

A patient is diagnosed with chronic atrophic gastritis attended by deficiency of Castle’s intrinsic factor. What type of anemia does the patient have?

A pregnant woman was detected with IgM to rubella virus. An obstetrician-gynecologist recommended therapeutic abortion due to the high risk of teratogenic affection of the fetus. Detection of IgM was of great importance as it is these specific immunoglobulins that:

A patient is diagnosed with cardiac infarction. Blood test for cardiospecific enzymes activity was performed. Which of the enzymes has three isoforms?

A 50-year-old man, who has been suffering from chronic hepatic failure for several years, has developed ascites. What is the main mechanism of this disorder development?

A 30-year-old man has sustained an injury to his thorax in a traffic incident, which caused disruption of his external respiration. What type of ventilatory difficulty can be observed in the given case?

A 53-year-old man suffering from diabetes mellitus has developed a painful conical induration, bluish-red with yellow center, on the skin of his neck. Such changes are characteristic of:

Biochemical analysis of an infant’s erythrocytes revealed evident glutathione peroxidase deficiency and low concentration of reduced glutathione. What pathological condition can develop in this infant?

In winter a 3-year-old child has sharp rise of body temperature up to 40^oC . Hemorrhagic rash is observed on the skin and mucosa. Bean-shaped gram-negative microorganisms situated in pairs are detected in the blood. What provisional diagnosis can be made?

Microelectrode analysis of nerve fiber biolectrical activity revealed, that its membrane potential equals 90 mV. Its initial rest potential was 85 mV. What process occurs in this case?

Parkinson’s disease is caused by disruption of dopamine synthesis. What brain structure synthesizes this neurotransmitter?

Determining a patient’s blood group with monoclonal test-reagents revealed positive agglutination reaction to anti-A and anti-B reagents, and negative reaction to anti-D. What blood group does this patient have?

A patient visited a dentist to extract a tooth. After the tooth had been extracted, bleeding from the tooth socket continued for 15 minutes. Anamnesis states that the patient suffers from active chronic hepatitis. What phenomenon can extend the time of hemorrhage?

Name the halogen-containing antiseptic with fungicidal properties, which is used to treat dermatomycosis:

Due to severe pain syndrome a patient was prescribed a narcotic analgesic. Name this drug:

During pathomorphological kidney investigation of a patient, who for a long time had been suffering from osteomyelitis and died from progressing renal failure, the following was revealed: deposits of homogeneous eosinophilic masses in glomerular mesangium, arterial and arteriolar walls, and stroma, which became red when stained with Congo red. What pathological process is this?

A microslide presents a tissue with spherical cells, each of them containing a large fat drop covered with thin cytoplasm layer in its center. Nucleus is compressed and situated at the cell periphery. What tissue is it?

To  treat  rheumatoid  arthritis  a 65-year-old woman was prescribed an immunosuppressive hormonal drug as a part of her complex therapy. Name this drug:

An experiment was aimed at testing flexor reflex in a spinal frog, which was initiated by simultaneous stimulation with isolated pre-threshold electrical impulses. The frequency of those impulses was such, that the reflex occurred. What process in the nerve centers can be observed during this experiment?

An 18-year-old woman has body disproportion, wing-like folds on the skin of her neck, underdeveloped ovaries, nuclei of her buccal epithelium cells have no Barr bodies. Dermatoglyphics method revealed that her adt angle is 66^o. What provisional diagnosis can be made in this case?

A patient diagnosed with acute dysentery has been treated for 3 days in an infectious diseases hospital. On admission there were complaints of high temperature, stomachache and fluid excrements with mucus as often as 8-10 times a day. What sample should be taken for analysis?

A 27-year-old patient with injury to the neck has lost approximately 30% of the blood volume. The patient’s condition is severe: blood pressure is 60/40 mm Hg, heart rate is 140/min., respiratory rate is 30/min., conscious. Characterize the condition of the patient’s circulatory system:

A soldier with explosion-caused trauma was delivered to a hospital. Examination revealed his tympanic membrane to be intact. What defense reflex prevented the tympanic membrane from rupturing?

A person with the fourth blood group (genotype IAIB) has in erythrocytes both antigen A controlled by allele IA and antigen B controlled by allele IB. This phenomenon is an example of the following gene interation:

During narcosis a patient developed a risk of cerebral edema. What drug should be administered in this case?

During surgery performed in abdominal cavity a surgeon located ligament of liver stretching from anterior abdominal wall (navel) to inferior surface of liver. What ligament is it?

A 9-year-old boy has acute onset of disease: sore throat, body temperature rise up to 39, 5^oC ; on the second day diffuse skin rash was detected all over his skin exept for nasolabial triangle. On examination of oral cavity: crimson tongue, “flaming pharynx”, necrotic tonsillitis. What diagnosis is the most likely?

A 49-year-old man complains of pain in his metatarsophalangeal joints and joint deformation. In blood hyperuricemy can be observed. X-ray has revealed metatarsophalangeal joint space narrowing, erosion, periarticular calcification of the both joints, osteoporosis. Microscopy has revealed inflammatory granulomatous reaction surrounding necrotizing masses in the area of the first metatarsophalangeal joint. Choose the most likely diagnosis:

Granulomas containing lymphocytes and macrophages were detected during analysis of skin biopsy material. Among macrophages there are large cells with fat inclusions, which contain microorganisms in spheric packages (Virchow’s cells). The following disease is based on the described type of hypersensitivity:

A patient with suspected necrosis of the upper abdominal cavity organs was delivered to a surgical department. This condition is associated with acute circulatory disturbance of the following vessel:

Name the drug that inhibits excretory function of pancreas during treatment of acute pancreatitis:

An 18-year-old patient has developed candidiasis after the case of pneumonia treated with β-lactam antibiotic. What anti-mycotic agent should be prescribed?

During autopsy of a 9-month-old girl’s body, who died due to severe pneumonia complicated with sepsis, lack of thymus is observed. In the lymph nodes the lymphoid follicles and cortical substance are absent; follicles of spleen are reduced in size with no light zones and plasma cells. What is the cause of such structural changes?

A patient with femoral neck fracture, who for a long time had to remain in bed in a forced (supine) position, has developed dark-brown lesions along the backbone; soft tissues are swollen, in the areas of maceration there is a foul-smelling liquid. Name the clinicopathologic type of necrosis:

A woman poisoned with unknown substance was hospitalised in a toxicological department. What group of drugs can be administered to decrease absorption and introduction of the poison to her body?

A patient after disrupted cerebral circulation has developed paralysis. Choose the anticholinesterase drug to be prescribed in this case:

A 50-year-old woman is being treated for shingles in a neurology unit. What reactivated virus causes this disease?

During examination of a patient a doctor should use anatomical division of anterior abdominal wall into regions for more precise diagnostics. How many such regions can abdomen be divided into?