krok 1 - 2011 question paper (general medicine)

Krok 1 Medicine 2011 1

1. A 30-year-old patient complainsabout having abdominal pain and di-arrhea for five days; body temperaturerise up to 37, 5oC along with chills. Theday before a patient had been in aforest and drunk from an open waterreservoir. Laboratory analyses enabledto make the following diagnosis: amebicdysentery. What is the drug of choice forits treatment?

A. MetronidazoleB. FurazolidonumC. LevomycetinD. PhthalazolE. Emetine hydrochloride

2. Quite often the cause of secondaryimmunodeficiency is an infectioninvolvement, when the causative agentspropagate directly in the cells of immunesystem and destroy it. The following di-seases are characterized by:

A. Infectious mononucleosis, AIDSB. Tuberculosis, mycobacteriosisC. Poliomyelitis, type A hepatitisD. Dysentery, choleraE. Q-febris, epidemic typhus

3. Heart rate of a 30-year-old man underemotional stress reached 112 bpm. Thereason for the heart rate increase isthe altered condition of the followingconducting system of heart:

A. Sinoatrial nodeB. Purkinje’s fibersC. His’ bundle branchesD. Atrioventricular nodeE. His’ bundle

4. Sanitary bacteriological research onwater by the membrane filter methodrevealed two red colonies on a membranefilter (Endo agar) through which 500 mlof analyzed water were passed. Calculatethe coli index and coli titer of the analyzedwater:

A. 4 and 250B. 2 and 500C. 250 and 4D. 500 and 2E. 250 and 2

5. A 46-year-old female patient hasa continuous history of progressivemuscular (Duchenne’s) dystrophy. Whi-ch blood enzyme changes will be of di-agnostic value in this case?

A. Creatine phosphokinaseB. Lactate dehydrogenaseC. Pyruvate dehydrogenaseD. Glutamate dehydrogenaseE. Adenylate cyclase

6. Extensive thromboembolic infarcti-on of the left cerebral hemispheres,large septic spleen, immunocomplexglomerulonephritis, ulcers on the edges ofthe aortic valves, covered with polypousthrombus with colonies of staphylococcuswere revealed on autopsy of the youngman who died in coma. What diseasecaused cerebral thromboemboly?

A. Septic bacterial endocarditisB. SepticemiaC. Acute rheumatic valvulitisD. SepticopyemiaE. Rheumatic thromboendocarditis

7. A 10-year-old girl has a history ofrepeated acute respiratory viral infection.After recovering she presents with multi-ple petechial hemorrhages on the sites offriction from clothing rubbing the skin.What kind of hypovitaminosis has this gi-rl?

A. CB. B6

C. B1

D. AE. B2

8. Autopsy of a patient who sufferedfrom croupous pneumonia and died frompneumococcal sepsis revealed 900 ml ofturbid greenish-yellow liquid in the ri-ght pleural cavity. Pleural leaves are dull,plephoric. Name the clinicopathologicalform of inflammation in the pleural cavity:

A. EmpyemaB. Fibrinous inflammationC. PhlegmonD. Chronic abscessE. Acute abscess

9. Researchers isolated 5 isoenzymicforms of lactate dehydrogenase from thehuman blood serum and studied theirproperties. What property indicates thatthe isoenzymic forms were isolated fromthe same enzyme?

A. Catalyzation of the same reactionB. The same molecular weightC. The same physicochemical propertiesD. Tissue localizationE. The same electrophoretic mobility


10. A patient suffering from stomach ulcerhas been treated with an antacid drugalmagel. For acute bronchitis treatment hewas prescribed the antibiotic methacycli-ne. However within next 5 days thefever didn’t fall, cough and sputumnature remained unchanged. A physici-an came to the conclusion that the drugswere incompatible. What type of drugincompatibility is the case?

A. Pharmacokinetic, absorption stageB. Pharmacokinetic, biotransformationstageC. PharmaceuticD. PharmacodynamicE. Direct antagonism

11. ECG of a 44-year-old patient showssigns of hypertrophy of both ventriclesand the right atrium. The patient was di-agnosed with the tricuspid valve insuffici-ency. What pathogenetic variant of cardiacdysfunction is usually observed in case ofsuch insufficiency?

A. Heart overload by volumeB. Heart overload by resistanceC. Primary myocardial insufficiencyD. Coronary insufficiencyE. Cardiac tamponade

12. Proserin increases skeletal muscle tonewhen given systematically. Halothaneinduces relaxation of skeletal musclesand reduces proserin effects. What isthe nature of proserin and halothaneinteraction?

A. Indirect functional antagonismB. Direct functional antagonismC. Competitive antagonismD. Independent antagonismE. Noncompetitive antagonism

13. The minute blood volume in a patientwith transplanted heart has increased as aresult of physical activity. What regulati-ve mechanism is responsible for thesechanges?

A. CatecholaminesB. Sympathetic unconditioned reflexesC. Parasympathetic unconditioned reflexesD. Sympathetic conditioned reflexesE. Parasympathetic conditioned reflexes

14. An aged man had raise of arterialpressure under a stress. It was caused byactivation of:

A. Sympathoadrenal systemB. Parasympathetic nucleus of vagusC. Functions of thyroid glandD. Functions of adrenal cortexE. Hypophysis function

15. Autopsy of a man who died fromchronic cardiovascular collapse revealed"tiger heart". Sidewards of endocardiuma yellowish-white banding can be seen;myocardium is dull, dark-yellow. Whatprocess caused this pathology?

A. Fatty parenchymatous degenerationB. Carbohydrate degenerationC. Hyaline degenerationD. Fatty vascular-stromal degenerationE. Amyloidosis

16. A 55-year-old male patient was hospi-talised to a surgical clinic for suspectedsepticemia. What material should betaken for analysis?

A. Blood, sugar brothB. Liquor, serum agarC. Urine, beef-extract brothD. Pus, yolk saline agarE. Lymph node punctate, cysteine agar

17. A patient has pellagra. Interrogationrevealed that he had lived mostly on mai-ze for a long time and eaten little meat.This disease had been caused by the defi-cit of the following substance in the maize:

A. TryptophanB. TyrosineC. ProlineD. AlanineE. Histidine

18. During examination of a 6-year-old child a doctor revealed greyi-sh films on the pharyngeal tonsi-ls. Their removal provoked moderatehaemorrhage. Bacterioscopy revealedgram-positive clublike bacteria. Whatsymptoms will develop in this child withinthe next few days if no specific treatmentis provided?

A. Toxic lesions of myocard, liver andkidneyB. Pulmonary edemaC. Strong paroxysmal coughD. Papulous skinrashE. Intermittent fever

19. A 46-year-old patient consulted adoctor complaining about joint pain thatbecomes stronger the day before theweather changes. Blood examination


revealed an increased concentration ofuric acid. The most probable cause of thedisease is the intensified disintegration ofthe following substance:

A. Adenosine monophosphateB. Cytidine monophosphateC. Uridine triphosphateD. Uridine monophosphateE. Thymidine monophosphate

20. 12 hours after an accute attack ofretrosternal pain a patient presented ajump of aspartate aminotransferase activi-ty in blood serum. What pathology is thisdeviation typical for?

A. Myocardium infarctionB. Viral hepatitisC. CollagenosisD. Diabetes mellitusE. Diabetes insipidus

21. After a trauma of the upper thirdof the anterior forearm surface a patientpresents with difficult pronation, weakeni-ng of palmar flexor muscles and alteredskin sensitivity of 1-3 fingers. Which nerveis damaged?

A. n. medianusB. n. musculocutaneusC. n. ulnarisD. n. cutaneus antebrachii medialisE. n. radialis

22. A 2-year-old child with mental andphysical retardation has been deliveredto a hospital. He presents with frequentvomiting after having meals. There isphenylpyruvic acid in urine. Whichmetabolism abnormality is the reason forthis pathology?

A. Amino-acid metabolismB. Lipidic metabolismC. Carbohydrate metabolismD. Water-salt metabolismE. Phosphoric calcium metabolism

23. A 38-year-old man died in the attemptof lifting weight. He had collaptoid state.Autopsy revealed an extensive aneurismrupture of thoracic aorta. He sufferedfrom visceral syphilis during his lifeti-me. What pathological process causedweakness of aortic wall, its dilatation andrupture?

A. Vanishing of elastic fibersB. Vanishing of collagen fibersC. Muscle layer atrophyD. Intima changes by shagreen leathertypeE. Vascularization

24. A patient suffering from myastheniahas been administered proserin. After itsadministration the patient has got nausea,diarrhea, twitch of tongue and skeletalmuscles. What drug would help to elimi-nate the intoxication?

A. Atropine sulfateB. PhysostigmineC. Pyridostigmine bromideD. IsadrineE. Mesatonum

25. A man died from an acute infecti-ous disease accompanied by fever, jaundi-ce, haemorrhagic rash on the skinand mucous membranes as well as byacute renal insufficiency. Histologicalexamination of renal tissue (stained byRomanovsky-Giemsa method) revealedsome convoluted bacteria looking likeC und S letters. What bacteria wererevealed?

A. LeptospiraB. TreponemaC. SpirillaD. BorreliaE. Campilobacteria

26. A 46-year-old patient suffering fromthe diffuse toxic goiter underwent resecti-on of the thyroid gland. After thesurgery the patient presents with appetiteloss, dyspepsia, increased neuromuscularexcitement. The body weight remainedunchanged. Body temperature is normal.Which of the following has caused such acondition in this patient?

A. Reduced production of parathormoneB. Increased production of thyroxinC. Increased production of calcitoninD. Increased production of thyroliberinE. Reduced production of thyroxin

27. Medical examination at the mili-tary registration and enlistment officerevealed that a 15-year-old boy was hi-gh, with eunuchoid body proportions,gynecomastia, female pattern of pubichair distribution. The boy had also fatdeposits on the thighs, no facial hair, hi-gh voice, subnormal intelligence quotient.Which karyotype corresponds with this di-sease?


A. 47, XXYB. 45, XOC. 46, XXD. 46, XYE. 47, XXX

28. A doctor recommends a patient wi-th duodenal ulcer to drink cabbage andpotato juice after the therapy course.Which substances contained in thesevegetables help to heal and prevent theulcers?

A. Vitamin UB. Pantothenic acidC. Vitamin CD. Vitamin B1

E. Vitamin K

29. Urine analysis of a 12-year-old boyreveals high concentration of all aliphaticamino acids with the highest excretionof cystine and cysteine. US of kidneysrevealed kidney concrements. What is themost likely pathology?

A. CystinuriaB. AlkaptonuriaC. CystitisD. PhenylketonuriaE. Hartnup disease

30. A 5-year-old child has been diagnosedwith acute right distal pneumonia.Sputum inoculation revealed that thecausative agent is resistant to penicillin,but it is senstive to macrolides. What drugshould be prescribed?

A. AzithromycinB. TetracyclineC. GentamycinD. StreptomycinE. Ampicillin

31. Autopsy of a 73-year-old man who hadbeen suffering from the coronary heart di-sease along with cardiac insufficiency fora long time revealed: nutmeg liver, browninduration of lungs, cyanotic indurationof kidneys and spleen. What kind of ci-rculation disorder was the cause of sucheffects?

A. General chronic venous congestionB. Arterial hyperaemiaC. General acute venous congestionD. Acute anaemiaE. Chronic anaemia

32. A patient suffering from chronichyperacidic gastritis takes an antacid

drug for heartburn elimination. After itsingestion the patient feels better but at thesame time he has a sensation of stomachswelling. Which of the following drugs mi-ght be the cause of such side effect?

A. Sodium hydrocarbonateB. Magnesium oxideC. Magnesium trisilicateD. Aluminium hydrooxideE. Pepsin

33. A 30-year-old male patient with acutepancreatitis has been found to have adisorder of cavitary protein digestion.The reason for such condition can be thehyposynthesis and hyposecretion of thefollowing enzyme:

A. TripsinB. PepsinC. LipaseD. DipeptidaseE. Amylase

34. A patient has been given high dosesof hydrocortisone for a long time. Thiscaused atrophy of one of the adrenalcortex zones. Which zone is it?

A. FascialB. GlomerularC. ReticularD. Glomerular and reticularE. -

35. A victim of an accident has bleedingfrom the soft tissues anteriad the mandi-bular angle. Which vessel should be li-gated for the bleeding arrest?

A. A.facialisB. A.carotis internaC. A.temporalis superficialisD. A.alveolaris inferiorE. A.lingvalis

36. Microscopic examination of a gram-stained scrape from a patient’s tonguerevealed oval, round, elongated chains ofdark-violet gemmating cells. What diseasecan be caused by this causative agent?

A. CandidiasisB. ActinomycosisC. Streptococcic infectionD. Staphylococcic infectionE. Diphtheria

37. The greater amount of nitrogen isexcreted from the organism in form ofurea. Inhibition of urea synthesis andaccumulation of ammonia in blood and


tissues are induced by the decreased acti-vity of the following liver enzyme:

A. Carbamoyl phosphate synthetaseB. Aspartate aminotransferaseC. UreaseD. AmylaseE. Pepsin

38. A 36-year-old female patient has a hi-story of collagen disease. Urine analysis islikely to reveal an increased concentrati-on of the following metabolite:

A. OxyprolineB. IndicanC. CreatinineD. UreaE. Urobilinogen

39. A coprological survey revealed light-colored feces containing drops of neutralfat. The most likely reason for this condi-tion is the disorder of:

A. Bile inflow into the bowelB. Gastric juice acidityC. Pancreatic juice secretionD. Intestinal juice secretionE. Intestinal absorption

40. The secretion of whixh hypophysi-al hormones will be inhibited after taki-ng the oral contraceptives containing sexhormones?

A. Gonadotropic hormoneB. VasopressinC. Thyrotrophic hormoneD. Somatotropic hormoneE. Ocytocin

41. A histological specimen of a kidneyshows a part of the distal tubule goingbetween the afferent and efferent arteri-ole. The cells building the tubule wall havedense nuclei; basal membrane is absent.Such structural formation is called:

A. Macula densaB. Juxtaglomerular cellsC. Mesangial cellsD. Juxtavascular cellsE. -

42. During preparation of a patient to aheart surgery it was necessary to measurepressure in heart chambers. In one ofthem pressure varied from 0 mm Hg upto 120 mm Hg within one cardiac cycle.What heart chamber is it?

A. Left ventricleB. Right ventricleC. Right atriumD. Left atriumE. -

43. A patient with essential hypertensi-on has a high rate of blood renin. Whi-ch of antihypertensive drugs should bepreferred?

A. LisinoprilB. PropranololC. PrazosinumD. NifedipineE. Dichlothiazide

44. In order to determine toxigenicity ofdiphtheria bacilli a strip of filter paperimpregnated with antitoxic diphtherialserum was put on the dense nutrient medi-um. There were also inoculated a mi-crobal culture under examination and astrain that is known to be toxigenic. Ifthe microbal culture under examinati-on produces exotoxin, this wil result information of:

A. Precipitin linesB. Haemolysis zonesC. Zones of diffuse opacificationD. Zones of lecithovitellinous activityE. Precipitin ring

45. It was revealed that T-lymphocyteswere affected by HIV. Virus enzyme -reverse transcriptase (RNA-dependentDNA-polymerase) - catalyzes thesynthesis of:

A. DNA on the matrix of virus mRNAB. Virus informational RNA on the matrixof DNAC. DNA on virus ribosomal RNAD. Viral DNA on DNA matrixE. mRNA on the matrix of virus protein

46. Microscopical examination of anenlarged cervical lymph node revealedblurring of its structure, absence oflymphoid follicles; all the microscopic fi-elds showed cells with roundish nuclei andthin limbus of basophil cytoplasm. It isknown from the clinical data that othergroups of lymph nodes are also enlargedas well as spleen and liver. What diseasemight be suspected?


A. Lymphoid leukosisB. LymphogranulomatosisC. LymphosarcomaD. Myeloid leukosisE. Multiple myeloma

47. A 38-year-old patient came to atraumatology centre and complainedabout an injury of his right hand. Objecti-vely: the patient has a cut wound in theregion of the thenar eminence on the righthand; distal phalanx of the I finger cannotbe flexed. What muscle was injured?

A. Long flexor muscle of thumbB. Short flexor muscle of thumbC. Short abductor muscle of thumbD. Opposer muscle of thumbE. Abductor muscle of thumb

48. Lung ventilation in a person isincreased as a result of physical activi-ty. Which of the following indices of theexternal respiration is much higher thanin a state of rest?

A. Respiratory volumeB. Vital capacity of lungsC. Inspiratory reserve volumeD. Expiratory reserve volumeE. Total lung capacity

49. As a result of activation of the ionchannels of the external membrane therest potential of an excitable cell hasgreatly increased. What channels wereactivated?

A. Potassium channelsB. Sodium channelsC. Fast calcium channelsD. Slow calcium channelsE. Sodium and calcium channels

50. As a result of continuous starvati-on the glomerular filtration rate hasincreased by 20%. The most probablecause of the glomerular filtration alterati-on under the mentioned conditions is:

A. Decrease in the oncotic pressure ofblood plasmaB. Increase in the systemic arterial pressureC. Increase in the permeability of the renalfilterD. Increase of the filtartion quotientE. Increase of the renal blood flow

51. A patient with cardiogenic shock,hypotension, asphyxia and edemata wasgiven an injection of non-glycosidic cardi-otonic. What drug was injected?

A. DobutamineB. Caffeine sodium benzoateC. CordiaminD. AethimizolumE. Bemegride

52. After transfusion of 200 ml of blood apatient presented with body temperaturerise up to 37, 9oC. Which of the followi-ng substances is the most likely cause oftemperature rise?

A. Interleukin-1B. Interleukin-2C. Tumour necrosis factorD. Interleukin-3E. Interleukin-4

53. A man who is riding the carouselpresents with increased heart rate, sweati-ng, nausea. This condition is caused pri-marily by the stimulation of the followingreceptors:

A. Vestibular ampullarB. ProprioceptorsC. Vestibular otolithicD. AuditoryE. Visual

54. A worker of a cattle farm fell acutelyill and then died from the progressingintoxication. Autopsy revealed enlarged,hyposthenic spleen of dark-cherry colourwhen dissected; excessive pulp scraping.At the base and fornix of brain pia matersare edematous, soaked with blood, dark-red ("scarlet hat"). Microscopic exami-nation revealed serous haemorrhagicinflammation of brain tissues and tuni-cs along with destruction of small vesselwalls. What is the most likely diagnosis?

A. AnthraxB. TularemiaC. BrucellosisD. PlaqueE. Cholera

55. Which of the listed diuretic agents WI-LL NOT have diuretic effect on a patientwith Addison’s disease?

A. SpironolactoneB. FurosemideC. HydrochlorothiazideD. TriamtereneE. Ethacrynic acid

56. A man with a wound of his limb thathad been suppurating for a long time di-ed from intoxication. Autopsy revealedextreme emaciation, dehydration, brown


atrophy of liver, myocardium, spleen andcross-striated muscles as well as renalamyloidosis. What diagnosis correspondswith the described presentations?

A. ChroniosepsisB. SepticopyemiaC. SepticemiaD. Chernogubov’s syndromeE. Brucellosis

57. This drug has a destructive effect onerythrocytic forms of malarial plasmodiaand dysenteric amoebae. It is used fortreatment and prevention of such diseasesas malaria, amebiasis and interstitial di-sease. What drug is it?

A. ChingaminB. Emetine hydrochlorideC. TetracyclineD. ErythromycinE. Quinine

58. A patient has an increased pyruvateconcentration in blood, most of it isexcreted with the urine. What kind of avi-taminosis has this patient?

A. B1

B. EC. B3

D. B6

E. B2

59. A child suffers from drug idiosyncrasy.What is the cause of such reaction?

A. Hereditary enzymopathyB. Exhaustion of substrate interacting withpharmaceutical substanceC. Accumulation of pharmaceuticalsubstanceD. Inhibition of microsomal liver enzymesE. Associated disease of target organ

60. One of the parents is suspected ofhaving phenylketonuria recessive gene.What is the risk of giving birth to a chi-ld with inborn phenylketonuria?

A. 0%B. 25%C. 50%D. 75%E. 100%

61. Pulmonary examination of a pati-ent who has worked as a stone grinderfor 9 years revealed small dense roundi-sh nodules consisting of connective ti-ssue. The nodules were found to haveperipheral macrophages. Such pulmonary

alterations are indicative of the followingdisease:

A. SilicosisB. Acute pneumoniaC. Multiple bronchiectasisD. Chronic bronchitisE. Bronchial asthma

62. A 12-year-old teenager has signifi-cantly put off weight within 3 months;glucose concentration rose up to 50 mi-llimole/l. He fell into a coma. What is themain mechanism of its development?

A. HyperosmolarB. HypoglycemicC. KetonemicD. LactacidemicE. Hypoxic

63. Which way of heat emission by thebodies of greenhouse workers is the mosteffective at the temperature of 36oCdegrees and relative humidity of 70%?

A. Liquid evaporationB. Thermal conductionC. Heat radiationD. ConvectionE. -

64. Examination of a 70-year-old pati-ent revealed insulin-dependent diabetes.What drug should be administered?

A. GlibenclamidB. InsulinC. MercazolilumD. ParathyroidinE. Cortisone

65. A disaster fighter at a nuclear powerplant developed hemorrhagic syndromeon the background of acute radiation di-sease. What is the most important factorof syndrome pathogenesis?

A. ThrombocytopeniaB. Vascular wall damageC. Increased activity of fibrinolysis factorsD. Increased activity of anticoagulativesystem factorsE. Decreased activity of coagulative factors

66. Jaundice treatment involves admi-nistration of barbiturates inducing thesynthesis of UDP-glucuronyl transferase.A medicinal effect is caused by theproduction of:


A. Direct reacting (conjugated) bilirubinB. Indirect reacting (unconjugated) bili-rubinC. BiliverdinD. ProtoporphyrinE. Heme

67. A histological specimen shows ablood vessel. Its inner coat is composedby endothelium, subendothelium andinternal elastic membrane. The middlecoat is enriched with smooth myocytes.Such morphological characteristics aretypical for the following vessel:

A. Muscular-type arteryB. Elastic-type arteryC. CapillaryD. Non-muscular veinE. Muscular-type vein

68. An 18-year-old man was delivered tothe hospital after a road accident. Exami-nation at the traumatological departmentrevealed multiple injuries of soft tissues offace in the region of the medial eye angle.The injuries caused massive haemorrhage.What arterial anastomosis might havebeen damaged in this region?

A. a. carotis externa et a. carotis internaB. a. carotis externa et a. subclaviaC. a. carotis interna et a. subclaviaD. a. subclavia et a. ophthalmicaE. a. carotis interna et a. ophthalmica

69. Autopsy of a 75-year-old man with along history of atherosclerosis revealed agrey irregular-shaped focus of loose consi-stency in the right parietotemporal regionof brain. What is the most likely cause ofthis process?

A. Thrombosis of the right medial cerebralarteryB. Thrombosis of the right anteriorcerebral arteryC. Thrombosis of the right posteriorcerebral arteryD. Thrombosis of basilar arteryE. Thrombosis of tomentum cerebri

70. Autopsy of a man with a mali-gnant stomach tumour who had di-ed from cancer intoxication revealedin the posteroinferior lung fields somedense, grayish-red irregular foci protrudi-ng above the section surface. Microscopicexamination revealed exudate containi-ng a large amount of neutrophils in thelumen and walls of small bronchi andalveoles. Such pulmonary alterations indi-cate the following disease:

A. Acute purulent bronchopneumoniaB. Acute bronchitisC. Croupous pneumoniaD. Intermittent pneumoniaE. Acute serous bronchopneumonia

71. A surgeon has to find the commonhepatic duct during the operativeintervention on account of concrements inthe gall ducts. The common hepatic ductis located between the leaves of:

A. Hepatoduodenal ligamentB. Hepatogastric ligamentC. Hepatorenal ligamentD. Round ligament of liverE. Venous ligament

72. Autopsy of a 1,5-year-old chi-ld revealed haemorrhagic skin rash,moderate hyperaemia and edema ofnasopharyngeal mucous membrane, smallhaemorrhages in the mucous membranesand internal organs; dramatic dystrophicalterations in liver and myocardium; acutenecrotic nephrosis; massive haemorrhagesin the adrenal glands. What disease arethese alterations the most typical for?

A. Meningococcal infectionB. Scarlet feverC. DiphtheriaD. MeaslesE. Epidemic typhus

73. A 75-year-old-female patient wi-th complaints of visual impairment hasbeen delivered to the ophthalmologicdepartment. Objective examinationrevealed a brain tumor in area of the leftoptic tract. The patient has a visual fielddefect in the following area:

A. Left half of both eyes retinaB. Right half of both eyes retinaC. Left and right halves of the left eyeretinaD. Left and right halves of the right eyeretinaE. Left and right halves of both eyes retina

74. A patient with coronary diseasehas been diagnosed with myocardialhypertrophy, tachycardia and a decreasein minute blood volume. What is theleading mechanism of cardiac hystiocytedamage in this case?


A. Damage of specific membrane pumpsB. Increase in α and β adrenoreceptorsquantityC. Mg2+ loss by cardiac hystiocytesD. Ca2+ loss by cardiac hystiocytesE. Cardiac hystiocyte dehydration

75. Blood analysis of a patient wi-th jaundice reveals conjugated bilirubi-nemia, increased concentration of bile aci-ds. There is no stercobilinogen in urine.What type of jaundice is it?

A. Obstructive jaundiceB. Hepatocellular jaundiceC. Parenchymatous jaundiceD. Hemolytic jaundiceE. Cythemolytic jaundice

76. While studying maximally spiralizedchromosomes of human karyotype theprocess of cell division was stopped in thefollowing phase:

A. MetaphaseB. ProphaseC. InterphaseD. AnaphaseE. Telophase

77. A man is being measured power inputson an empty stomach, in the lying posi-tion, under conditions of physical andpsychic rest at a comfortable temperature.Power inputs will reach the maximum at:

A. 5-6 p.m.B. 7-8 a.m.C. 10-12 a.m.D. 2-3 p.m.E. 3-4 a.m.

78. When measuring power inputs of aman by the method of indirect calori-metry the following results were obtained:1000 ml oxygen consumption and 800 mlcarbon dioxide liberation per minute. Theman under examination has the followingrespiratory coefficient:

A. 0,8B. 1,25C. 0,9D. 0,84E. 1,0

79. A newborn child with pylorostenosishas often repeating vomiting accompani-ed by apathy, weakness, hypertonicity,sometimes convulsions. What disorderform of acid-base balance is it?

A. Nongaseous alkalosisB. Gaseous alkalosisC. Gaseous acidosisD. Metabolic acidosisE. Excretory acidosis

80. A concentrated solution of sodiumchloride was intravenously injected to ananimal. This caused decreased reabsorpti-on of sodium ions in the renal tubules. Itis the result of the following changes ofhormonal secretion:

A. Aldosterone reductionB. Aldosterone increaseC. Vasopressin reductionD. Vasopressin increaseE. Reduction of atrial natriuretic factor

81. A patient has been diagnosed withalkaptonuria. Choose an enzyme whosedeficiency can be the reason for thispathology:

A. Homogentisic acid oxidaseB. Phenylalanine hydroxylaseC. Glutamate dehydrogenaseD. Pyruvate dehydrogenaseE. Dioxyphenylalanine decarboxylase

82. A patient consulted an urologist aboutpain during urination. Analysis of his uri-ne taken in the daytime revealed eggs wi-th a characteristic sharp point. It is knownfrom the anamnesis that the patient hasrecently returned from Australia. What isthe most likely diagnosis?

A. Urogenital schistosomiasisB. Intestinal schistosomiasisC. Japanese schistosomiasisD. OpisthorchiasisE. Dicroceliasis

83. A 49-year old female patient has limi-tation of left limbs arbitrary movements.Muscular tonus of left hand and leg isoverstrained and spasmodic, local tendonreflexes are strong, pathological reflexesare presented. What is the most likelydevelopment mechanism of hypertensi-on and hyperreflexia?

A. Reduction of descending inhibitoryinfluenceB. Motoneuron activation induced bystrokeC. Activation of excitatory influence fromthe focus of strokeD. Activation of synaptic transmissionE. Ihibition of cerebral cortexmotoneurons


84. A 35-year-old patient complains abouthaving severe rhinitis and loss of senseof smell for a week. Objectively: the nasalcavity contains a lot of mucus covering themucous membrane and blocking olfactoryreceptors. In what region of the nasal cavi-ty are these receptors located?

A. Superior nasal conchaB. Median nasal conchaC. Inferior nasal conchaD. Common nasal meatusE. Vestibule of nose

85. A 10-year-old child had the mantouxtuberculin test administered. 48 hourslater a papule up to 8 mm in diameterappeared on the site of the injection.What type of hypersensitivity reactiondeveloped after the tuberculin injection?

A. Type IV hypersensitivity reactionB. Arthus phenomenonC. SeroreactionD. Atopic reactionE. Type II hypersensitivity reaction

86. Vitamin B1 deficiency causes di-sturbance of oxidative decarboxylati-on of α-ketoglutaric acid. This leads tothe impaired synthesis of the followingcoenzyme:

A. Thiamine pyrophosphateB. Nicotinamide adenine dinucleotideC. Flavine adenine dinucleotideD. Lipoic acidE. Coenzyme A

87. Examination of a pregnant womanhaving Rh-negative blood revealed hi-gh level of antierythrocytic antibodies.For its reduction she was implanted wi-th her husband’s Rh-positive skin graft.The graft was rejected in two weeks.Its microscopic examination revealed ci-rculatory disturbance, edema and cellularinfiltration with lymphocytes, neutrophilsand macrophages predominance. What isthe most likely pathology?

A. Graft immunityB. Immediate hypersensitivityC. Delayed-type hypersensitivityD. Granulomatous inflammationE. Interstitial inflammation

88. A 17-year-old girl took a high doseof phenobarbital to commit a suici-de. An ambulance doctor cleansed herstomach and gave her an intravenousinjection of bemegride and sodiumhydrocarbonate solution. What was sodi-

um hydrocarbonate injected for?

A. For increasing renal excretion ofphenobarbitalB. For breathing stimulationC. For arterial pressure normalizationD. For phenobarbital inactivationE. For bringing the patient to consci-ousness

89. While examining the oral cavity astomatologist revealed inflammation ofpapillae on the border of the medianand posterior third of the back of tongue.What papillae are inflamed?

A. Papillae vallataeB. Papillae fungiformesC. Papillae foliataeD. Papillae filiformesE. Papillae conicae

90. A patient is 44 years old. Laboratoryexamination of his blood revealed thatcontent of proteins in plasma was 40 g/l.What influence will be exerted on thetranscapillary water metabolism?

A. Filtration will be increased, reabsorpti-on - decreasedB. Both filtration and reabsorption will beincreasedC. Both filtration and reabsorption will bedecreasedD. Filtration will be decreased, reabsorpti-on - increasedE. Metabolism will stay unchanged

91. A patient has corestenoma. What isthe reason of such condition?

A. Increased tonus of parasympatheticcentresB. Increased tonus of sympathetic centresC. Increased activity of sympathoadrenalsystemD. Adrenaline actionE. Noradrenaline action

92. A 46-year-old man had a bulgingdark macula on skin that caused no di-scomfort. With time it began to increasein size and became painful. It turned darkbrown and there was a nodule on palpati-on. Histological examination of tissuesrevealed spindle and polymorphous cellswith multiple mitoses. Their cytoplasmcontained brown pigment. What tumouris it?


A. MelanomaB. BasaliomaC. HemangiomaD. NevusE. -

93. The patient with complaints ofpermanent thirst applied to the doctor.Hyperglycemia, polyuria and increasedconcentration of 17-ketosteroids in theurine were revealed. What disease is themost likely?

A. Steroid diabetesB. Insulin-dependent diabetes mellitusC. MyxoedemaD. Type I glycogenosisE. Addison’s disease

94. A 32-year-old patient consulted adoctor about the absence of lactationafter parturition. Such disorder might beexplained by the deficit of the followinghormone:

A. ProlactinB. SomatotropinC. VasopressinD. ThyrocalcitoninE. Glucagon

95. An infant has pylorospasm, weakness,hypodynamia, convulsions as a result offrequent vomiting. What kind of acid-basedisbalance is it?

A. Excretory alkalosisB. Excretory acidosisC. Metabolic acidosisD. Exogenous nongaseous acidosisE. Gaseous alkalosis

96. A weightlifter has a disruption ofthoracic lymphatic duct as a result of li-fting a weight. Choose the most likely siteof injury:

A. In the region of aortic hiatusB. In the region of lumbosacral plexusC. In the posterior mediastinumD. In the region of venous angleE. In the region of neck

97. A woman suffering from osteochondrosishas acute pain in her humeral articulationthat gets worse when she tries to abducther shoulder. These symptoms might becaused by damage of the following nerve:

A. Axillary nerveB. Subscapular nerveC. Dorsal scapular nerveD. Subclavicular nerveE. Thoracodorsal nerve

98. Pyeloureterography X-ray photoshowed a renal pelvis with minor calycesonly (major calyces were absent). Whatform of urinary tracts of a kidney wasrevealed?

A. EmbryonalB. FetalC. MatureD. AmpullarE. -

99. A female patient presents withendocrine dysfunction of follicular cellsof the ovarian follicles resulting froman inflammation. The synthesis of thefollowing hormone will be inhibited:

A. EstrogenB. ProgesteroneC. LutropinD. Follicle stimulating hormoneE. Follistatine

100. A 19-year-old female patient hashad low haemoglobin rate of 90-95 g/l si-nce childhood. Blood count results obtai-ned after hospitalisation are as follows:erythrocytes - 3, 2 · 1012/l, Hb- 85 g/l,colour index - 0,78; leukocytes - 5, 6 · 109/l,platelets - 210 · 109/l. Smear examinati-on revealed anisocytosis, poikilocytosisand target cells. Reticulocyte rate is 6%.Iron therapy was ineffective. What bloodpathology corresponds with the describedclinical presentations?

A. ThalassemiaB. EnzymopathyC. MembranopathyD. Sickle-cell anemiaE. Favism

101. A liquidator of a breakdown at anuclear power plant who was irradiatedcomplained about vomiting that occurs allof a sudden. What medication should beprescribed?

A. MetoclopramideB. ReserpineC. AtropineD. AeronE. De-Nol

102. A patient with acute myocardialinfarction has been administered heparin


as a part of complex therapy. Sometime after heparin injection the pati-ent developed hematuria. What heparinantagonist should be injected in order tomanage the complication?

A. Protamine sulfateB. VicasolC. Aminocaproic acidD. NeodicumarinE. Fibrinogen

103. A 45-year-old patient was admitted tothe cardiological department. ECG data:negative P wave overlaps QRS complex,diastolic interval is prolonged afterextrasystole. What type of extrasystole isit?

A. AtrioventricularB. SinusC. AtrialD. VentricularE. Bundle-branch

104. A patient complains of hydruria (7liters per day) and polydipsia. Examinati-on reveals no disorders of carbohydratemetabolism. These abnormalities mightbe caused by the dysfunction of thefollowing endocrine gland:

A. NeurohypophysisB. AdenohypophysisC. Islets of Langerhans (pancreatic islets)D. Adrenal cortexE. Adrenal medulla

105. Before a surgery a blood sample of a30-year-old man has been typed. Bloodis Rh-positive. Standard serums of suchgroups as 0 αβ (I), Аβ (II), Вα (III) didn’tactivate erythrocyte agglutination reacti-on. The group of the analyzed blood is:

A. 0 αβ (I)B. Аβ (II)C. Вα (III)D. АВ (IV)E. -

106. Medical examination of a 20-year-old woman revealed a dense incapsulatednode 1 cm in diameter that was palpatedin the mammary gland. The postoperati-ve biopsy revealed connective tissueovergrowth around the mammary ductsand glandular components of different di-ameter that didn’t make lobules and boreno signs of cellular abnormality. What di-agnosis will be made?

A. FibroadenomaB. FibromaC. Metastatic cancerD. AdenomaE. Fibrocarcinoma

107. A 38-year-old male patient has beenill with systemic lupus erythematosus forthree years. He was diagnosed with diffuserenal affection accompanied by massi-ve edemata and expressive proteinuria.What is the most likely cause of protei-nuria development?

A. Autoimmune renal affectionB. Aseptic renal affectionC. Ischemic renal affectionD. Urinary bladder inflammationE. Urinary tracts inflammation

108. A student failed to answer all thequestions of examination paper correctly.As a result he blushed, felt hot andlost confidence. What type of arterialhyperemia has developed in this case?

A. Neurotonic hyperemiaB. Neuroparalytic hyperemiaC. Metabolic hyperemiaD. Pathologic hyperemiaE. Postishemic hyperemia

109. Acute renal impairment causeddeath of a bleeding patient. Autopsyrevealed enlarged kidneys with a broadpale pink cortical layer expressivelydemarcated from dark red renal pyrami-ds. Macroscopic examination revealedlack of epithelial nuclei of convolutedtubules, tubulorrhexis, phlebostasis. Thecell nuclei of choroid glomus and straighttubules were present. What pathology isit?

A. NecronephrosisB. InfarctionC. GlomerulonephritisD. PyelonephritisE. Nephrosis

110. A female patient consulted a doctorabout pain and limited movements inthe knee joints. Which of the followi-ng nonsteroid anti-inflammatory drugsshould be administered taking into consi-deration that the patient has a history ofchronic gastroduodenitis?


A. CelecoxibB. Diclofenac sodiumC. PromedolD. Acetylsalicilic acidE. Butadiounum

111. A patient presents with icteriti-ousness of skin, scleras and mucousmembranes. Blood plasma the total bili-rubin is increased, stercobilin is increasedin feces, urobilin is increased in urine.What type of jaundice is it?

A. HaemolyticB. Gilbert’s diseaseC. ParenchymatousD. ObturationalE. Cholestatic

112. Blood plasma of a healthy mancontains several dozens of proteins. Duri-ng an illness new proteins can originate,namely the protein of "acute phase".Select such protein from the listed below:

A. C-reactive proteinB. ProthrombinC. FibrinogenD. G immunoglobulinE. A immunoglobulin

113. A patient working at a pig farmcomplains about paroxysmal abdomi-nal pain, liquid feces with admixtures ofmucus and blood, headache, weakness,fever. Examination of large intestinerevealed ulcers from 1 mm up to severalcm large, feces contained oval unicellularorganisms with cilia. What disease shouldbe suspected?

A. BalantidiasisB. AmebiasisC. ToxoplasmosisD. LambliasisE. Trichomoniasis

114. During hypersensitivity test a patientgot subcutaneous injection of an antigenwhich caused reddening of skin, edema,pain as a result of histamine action. Thisbiogenic amine is generated as a result oftransformation of the following histidineamino acid:

A. DecarboxylationB. MethylationC. PhosphorylationD. IsomerizationE. Deaminization

115. During fighting a man had a cardiacarrest as a result of a hard blow to the

upper region of anterior abdominal wall.Which of the described mechanisms mighthave provoked the cardiac arrest?

A. Parasympathetic unconditioned reflexesB. Sympathetic unconditioned reflexesC. Parasympathetic conditioned reflexesD. Sympathetic conditioned reflexesE. Peripheric reflexes

116. There is a severe time restriction forpeople’s staying at a height of over 800m above the sea level without oxygenbombs. What is the life limiting factor inthis case?

A. Partial oxygen pressureB. Ultraviolet intensityC. Moisture levelD. TemperatureE. Earth gravity

117. A patient with marked pneumofi-brosis that developed after infiltrati-ng pulmonary tuberculosis has been di-agnosed with respiratory failure. What isits pathogenetic type?

A. RestrictiveB. ObstructiveC. DysregulatoryD. ReflexE. Apneistic

118. During surgical manipulations a pati-ent has been given novocaine injection foranesthesia. 10 minutes later the patientdeveloped paleness, dyspnea, hypotensi-on. What type of allergic reaction is it?

A. Anaphylactic immune reactionB. Cellulotoxic immune reactionC. Aggregate immune reactionD. Stimulating immune reactionE. Cell-mediated immune reaction

119. A sensitive neural ganglion consistsof roundish neurocytes with one extensi-on that divides into axon and dendrite at asome distance from the perikaryon. Whatare these cells called?

A. PseudounipolarB. UnipolarC. BipolarD. MultipolarE. Apolar

120. A patient complained about di-zziness, memory impairment, periodicalconvulsions. It was revealed that thesechanges were caused by a product ofdecarboxylation of glutamic acid. Name


this product:

A. GABAB. Pyridoxal phosphateC. TDPD. ATPE. THFA

121. It was found out that somecompounds, for instance fungi toxins andsome antibiotics can inhibit activity ofRNA-polymerase. What process will bedisturbed in a cell in case of inhibition ofthis enzyme?

A. TranscriptionB. ProcessingC. ReplicationD. TranslationE. Reparation

122. During an experiment the myotaticreflex has been studied in frogs. Afterextension in a skeletal muscle itsreflectory contraction was absent. Thereason for it might be a dysfunction ofthe following receptors:

A. Muscle spindlesB. NociceptorsC. ArticularD. Golgi tendon organsE. Tactile

123. An adult man presents with systemicarterial pressure drop from 120/70 to90/50 mm Hg. This resulted in reflexvasoconstriction. Vasoconstriction will beminimal in the following organ:

A. HeartB. SkinC. BowelsD. Skeletal musclesE. Liver

124. A culture of monkey cells (Vero) anda group of mouse sucklings were infectedwith an inoculum taken from a child withprovisional diagnosis "enterovirus infecti-on". There was no cytopathic effect onthe cell culture but mouse sucklings died.What enteric viruses might have causeddisease of this child?

A. Coxsackie AB. Coxsackie BC. ECHO virusD. PoliovirusesE. Unclassified enteric viruses 68-71

125. An electron microphotography of afragment of proper gastric gland shows

a big irregular round-shaped cell. Thereare a lot of intracellular tubules and mi-tochondria in the cytoplasm. Specify thiscell:

A. Parietal cellB. Principal cellC. Undifferentiated cellD. Mucous cellE. Endocrine cell

126. Blood count of an athlete is asfollows: erythrocytes - 5, 5 · 1012/l, Hb-180 g/l, leukocytes - 7 · 109/l, neutrophils -64%, basophils - 0,5%, eosinophils - 0,5%,monocytes - 8%, lymphocytes - 27%. Firstof all, such results indicate the stimulationof:

A. ErythropoiesisB. LeukopoiesisC. LymphopoiesisD. GranulocytopoiesisE. Immunogenesis

127. A patient died from cardiopulmonarydecompensation. Histological examinati-on revealed diffused pulmonary affectionalong with interstitial edema, infiltrationof tissue by limphocytes, macrophages,plasmocytes; pulmonary fibrosis, panaci-nar emphysema. What is the most likelydiagnosis?

A. Fibrosing alveolitisB. Chronic bronchitisC. BronchopneumoniaD. Pulmonary atelectasisE. Bronchial asthma

128. If a man has an attack of bronchi-ospasm it is necessary to reduce the effectof vagus on smooth muscles of bronchi.What membrane cytoreceptors should beblocked for this purpose?

A. M-cholinoreceptorsB. N-cholinoreceptorsC. α-adrenoreceptorsD. β-adrenoreceptorsE. α- and β-adrenoreceptors

129. A male patient has been di-agnosed with gastric ulcer. Bacteriologi-cal examination of biopsy material fromthe affected part of stomach revealedsmall colonies of gram-negative, oxidereductase-positive flexibacteria that grewon the chocolate agar on the fifth day.Which of the following microorganismsis the most likely causative agent?


A. Helicobacter pyloriB. Campilobacter jejuniC. Campilobacter fetusD. Mycoplasma hominisE. Chlamydia trachomatis

130. There are several groups ofmolecular mechanisms playing importantpart in pathogenesis of insult to cellswhich contributes to the pathologydevelopment. What processes are sti-mulated by proteinic damage mechani-sms?

A. Enzyme inhibitionB. Lipid peroxidationC. Phospholipase activationD. Osmotic membrane distensionE. Acidosis

131. A patient has been diagnosed wi-th a compression fracture of a lumbarvertebra. As a result he has a consi-derable increase in curvature of thelumbar lordosis. Which ligament damagecan induce such changes in the spinecurvature?

A. Anterior longitudinal ligamentB. Posterior longitudinal ligamentC. Yellow ligamentD. Iliolumbar ligamentE. Interspinous ligament

132. A 49-year-old patient with croupouspneumonia died from pneumococcalsepticemia. Autopsy revealed up to 700ml of turbid greenish-yellow foul-smellingliquid in the left pleural cavity. The pleuralleaflets were dull and plethoric. Whatform of pleural inflammation is it?

A. EmpyemaB. Chronic abscessC. Acute abscessD. PhlegmonE. Fibrinous inflammation

133. A 35-year-old man developed acuteheart failure while running for a long time.What changes in ionic composition can beobserved in the cardiac muscle?

A. Accumulation of Na+ and Ca2+ ions inthe myocardium cellsB. Accumulation of K+ and Mg2+ ions inthe myocardium cellsC. Reduction of Na+ and Ca2+ ions in themyocardium cellsD. Reduction of K+ and Mg2+ ions in theextracellular spaceE. Reduction of Na+ and Ca2+ ions in theextracellular space

134. A child with a history offrequent angine and pharyngitis hasbeen diagnosed with lymphadenopathyand splenomegaly. His appearance ischaracterised by pastosity and paleness,muscular tissue is poorly developed.Lymphocytosis is present. What kind ofdiathesis is it?

A. Lymphohypoplastic diathesisB. Exudative diathesisC. Gouty diathesisD. Asthenic diathesisE. Hemorrhagic diathesis

135. In response to a change in body posi-tion from horizontal to vertical bloodcirculation system develops reflectorypressor reaction. Which of the followingis its compulsory component?

A. Systemic constriction of the venousvesselsB. Systemic dilatation of the arterial resi-stive vesselsC. Decrease in the circulating bloodvolumeD. Increase in the heart rateE. Weakening of the pumbing ability ofheart

136. After an immunoassay a chi-ld was diagnosed with immunodefici-ency of humoral immunity. What is thereason for the primary immunodeficiencydevelopment in the child?

A. Hereditary abnormality of immunesystemB. Embryonal development abnormalitiesC. Pathometabolism in mother’s organismD. Immune responsiveness and resistancedisordersE. Toxic damage of B-lymphocytes

137. Life cycle of a cell includes theprocess of DNA autoreduplication. As aresult of it monochromatid chromosomesturn into bichromatid ones. What periodof cell cycle does this phenomenon fallinto?


A. SB. Go

C. G1

D. G2

E. M

138. Examination of a 12-year-oldboy with developmental lag revealedachondroplasia: disproportional consti-tution with evident shortening of upperand lower limbs as a result of growthdisorder of epiphyseal cartilages of longtubal bones. This disease is:

A. Inherited, dominantB. Inherited, recessiveC. Inherited, sex-linkedD. CongenitalE. Acquired

139. 2 days after labour a womandeveloped shock along with DICsyndrome that caused her death. Autopsyrevealed purulent endomyometritis, regi-onal purulent lymphangitis, lymphadeni-tis and purulent thrombophlebitis. Therewere also dystrophic alterations andinterstitial inflammation of parenchymalorgans. What is the most likely diagnosis?

A. SepticemiaB. SyphilisC. Tuberculosis of genital organsD. Chorioadenoma destruensE. Hydatid mole

140. After a craniocerebral trauma a pati-ent lost the ability to execute learnedpurposeful movements (apraxia). Theinjury is most likely localized in thefollowing region of the cerebral cortex:

A. Gyrus supramarginalisB. Gyrus angularisC. Gyrus paracentralisD. Gyrus lingualisE. Gyrus parahippocampalis

141. Tissue inosytol triphosphates aregenerated as a result of the phosphati-dylinositol diphosphate hydrolysis andact as secondary agents (mediators) inthe mechanism of hormone action. Theireffect in cells is directed at:

A. Calcium ion liberation from cellulardepotB. Adenylate cyclase activationC. Protein kinase A activationD. Phosphodiesterase inhibitionE. Protein kinase A inhibition

142. A patient with coronary diseaseand arrhythmia has been administered adrug that blocks potassium channels andprolongs the action potential. What drugis it?

A. AmiodaroneB. CorglyconumC. NitroglycerinD. DobutamineE. Lisinopril

143. A patient takes digoxin for cardiacinsufficiency. What diuretic may increasedigoxin toxicity due to the intensifiedexcretion of K+ ions?

A. HydrochlorothiazideB. SpironolactoneC. PanangineD. SiliborumE. Lisinopril

144. During starvation muscle proteinsbreak up into free amino acids. Thesecompounds will be the most probablyinvolved into the following process:

A. Gluconeogenesis in liverB. Gluconeogenesis in musclesC. Synthesis of higher fatty acidsD. GlycogenolysisE. Decarboxylation

145. A female patient consulted a doctorabout a sense of epigastric discomfort,nausea and anorexia. A duodenal contentanalysis revealed lamblia. What drugshould be prescribed?

A. MetronidazoleB. ChingaminC. RifampicinD. IsoniazidE. Acyclovir

146. A 28-year-old female patientconsulted a gynecologist about sterility.Examination revealed underdevelopedovaries and uterus, irregular menstrualcycle. Analysis of the sex chromatinrevealed 2 Barr’s bodies in most somaticcells. What chromosome disease is mostlikely?

A. Triple X syndromeB. Edwards’ syndromeC. Patau’s syndromeD. Klinefelter’s syndromeE. Turner’s syndrome

147. A 1-year-old baby has been hospitali-sed for body and limbs lesions. Exami-


nation revealed carnitine deficiency in thechild’s muscles. A biochemical reason forthis pathology is the disorder of:

A. Transport of fatty acids to mitochondriaB. Regulation of Ca2+ rate in mitochondriaC. Substrate-linked phosphorylationD. Utilization of lactic acidE. Oxidative phosphorylation

148. During anesthetization a pati-ent presented with symptoms of tonusincrease of parasympathetic nervoussystem such as hypersalivation andlaryngospasm. What drug could haveprevented these undesirable effects?

A. Atropine sulphateB. Adrenaline hydrochlorideC. NeostigmineD. AnalginE. Pyracetam

149. Some students developed myodyniaafter continuous physical activity duringphysical education. The reason for suchcondition was accumulation of lactic acidin the skeletal muscles. It was generatedin the students’ bodies after activation ofthe following process:

A. GlycolysisB. GluconeogenesisC. Pentose-phosphate cycleD. LipolysisE. Glycogeny

150. A newborn develops dyspepsiaafter the milk feeding. When the mi-lk is substituted by the glucose solutionthe dyspepsia symptoms disappear. Thenewborn has the subnormal activity of thefollowing enzyme:

A. LactaseB. InvertaseC. MaltaseD. AmylaseE. Isomaltase

151. A doctor asked a patient to breathout fully after taking a normal breath.What muscles contract during suchexhalation?

A. Abdominal musclesB. External intercostal musclesC. DiaphragmD. Trapezius musclesE. Pectoral muscles

152. On an electron micrograph a sci-entist has identified a structure formed

by eight histone proteins and a part ofDNA molecule which makes about 1,75revolutions around the molecules. Whichstructure has been identified?

A. NucleosomaB. Elemetary fibrilC. Half-chromatidD. ChromatidE. Chromosome

153. A patient with massive burnsdeveloped acute renal insufficiencycharacterized by a significant andrapid deceleration of glomerular fi-ltration. What is the mechanism of itsdevelopment?

A. Reduction of renal blood flowB. Damage of glomerular filterC. Reduction of functioning nephronnumberD. Rise of pressure of tubular fluidE. Renal artery embolism

154. A three-year-old child has hadmarked diarrhea for three days. Immuneelectron microscopy of his excrementsrevealed bilayer pseudocovered capsid vi-ruses that looked like small spoke wheels.What viruses have been revealed?

A. RotavirusesB. Coxsackie virusesC. ECHO virusesD. CoronavirusesE. Reoviruses

155. A male patient has fever andenanthesis. As a result of the exami-nation involving serological tests he hasbeen diagnosed with fasciola hepatica. Itwas found out that the patient had beeninfected through raw river water. Whichstage of fasciola life cycle is invasive forhumans?

A. AdolescariaB. MetacercariaC. OvumD. MiracidiumE. Cysticercus

156. A patient with high-titer antinuclearantibodies died from progressing renalimpairment. Autopsy revealed mesangi-oproliferative glomerulonephritis andabacterial polypous endocarditis. Therewas periarterial bulbar sclerosis in spleenand productive proliferative vasculitis inskin. What is the most likely diagnosis?


A. Systemic lupus erythematosusB. Nephrotic syndromeC. RheumatismD. DermatomyositisE. Periarteritis nodosa

157. Electronic microphotography ofpulmonary alveole’s wall presents a bigcell. Its cytoplasm has a lot of mi-tochondria, developed Golgi apparatus,osmiophil lamellated corpuscles. What isthe main function of this cell?

A. It produces surfactantB. It is a component of blood-air barrierC. It warms the airD. It purifies the airE. It absorbs microorganisms

158. A patient has food poisoning.Laboratory analysis revealed a cultureof anaerobic gram-positive spore-formingbacteria. What is the most likely kind ofthe isolated causative agent?

A. C. perfringensB. Proteus vulgarisC. P. mirabilisD. Vibrio parahemolyticusE. Esherichia coli

159. An animal has an increased tonusof extensor muscles. This the resultof intensified information transmissi-on to the motoneurons of the spinalcord through the following descendingpathways:

A. VestibulospinalB. Medial corticospinalC. ReticulospinalD. RubrospinalE. Lateral corticospinal

160. A 70-year-old male patient died fromacute coronary insufficiency. He had kneejoint swelling, gonycampsis and gonalgiaduring his lifetime. Pathomorphologicexamination of the deformed joi-nts and synovial membranes revealedmembrane hyperaemia with multipleperivascular inflammatory infltrationsmade by lymphocytes, plasmocytesand macrophagocytes. There was anaccumulation of organized fibrin coveringsome areas of synovium membrane andlooking like rice grains in the articular li-quid. What is the most likely diagnosis?

A. Atrophic arthritisB. Periarteritis nodosaC. Ankylosing spondylitisD. Tuberculous arthritisE. Deforming arthrosis

161. A man having a hearing loss aftera head trauma was delivered to theneurosurgery department. The cause ofthe hearing loss might be the damage ofthe following lobe of cerebral cortex:

A. TemporalB. Postcentral gyrusC. ParietalD. OccipitalE. Frontal

162. A pregnant woman was registeredin an antenatal clinic and underwentcomplex examination for a number ofinfections. Blood serum contained IgMto the rubella virus. What is this resultindicative of?

A. Of primary infectionB. Of a chronic processC. The woman is healthyD. Of exacerbation of a chronic diseaseE. Of recurring infection with rubella virus

163. A patient with tuberculosis di-ed from progressing cardiopulmonarydecompensation. Autopsy in the region ofthe right lung apex revealed a cavity 5 cmin diameter communicating with lumenof a segmental bronchus. On the insi-de cavity walls are covered with caseousmasses with epithelioid and Langhanscells beneath them. What morphologicalform of tuberculosis is it?

A. Acute cavernous tuberculosisB. TuberculomaC. Caseous pneumoniaD. Infiltrative tuberculosisE. Acute focal tuberculosis

164. Vomiting matters of a patientsuspected of having cholera were deli-vered to the bacteriological laboratory.The material was used for preparing a"hanging drop"specimen. What type ofmicroscopy will be applied for identificati-on of the causative agent by its mobility?

A. Phase-contrast microscopyB. Electron microscopyC. Immune and electron microscopyD. Fluorescence microscopyE. Immersion microscopy

165. A patient with enteritis accompanied


by massive diarrhea has low water ratein the extracellular space, high water rateinside the cells and low blood osmolari-ty. What is such disturbance of water-electrolytic metabolism called?

A. Hypo-osmolar hypohydrationB. Hyperosmolar hypohydrationC. Osmolar hypohydrationD. Hypo-osmolar hyperhydrationE. Hyperosmolar hyperhydration

166. Examination of a 6-month-old childrevealed a delay in closure of the occipi-tal fontanelle. When should it normallyclose?

A. Until 3 monthsB. Before the child is bornC. Until 6 monthsD. Until the end of the first year of lifeE. Until the end of the second year of life

167. A newborn child was found to havereduced intensity of sucking, frequentvomiting, hypotonia. Urine and bloodexhibit increased concentration of citrulli-ne. What metabolic process is disturbed?

A. Ornithinic cycleB. Tricarboxylic acid cycleC. GlycolysisD. GlyconeogenesisE. Cori cycle

168. A male patient has been diagnosedwith acute radiation disease. Laboratoryexamination revealed a considerablereduction of platelet serotonin level. Thelikely cause of platelet serotonin reducti-on is the disturbed metabolism of thefollowing substance:

A. 5-oxytryptofaneB. TyrosineC. HistidineD. PhenylalanineE. Serine

169. In course of a conditional experimentthe development of mesenchyma cellswas completely inhibited. Developmentof the following muscular tissue will be di-sturbed:

A. Smooth muscular tissueB. Neural muscular tissueC. Epidermal muscular tissueD. Cardiac muscular tissueE. Skeletal muscular tissue

170. A histologic specimen shows anorgan’s parenchyma which is presented

by lymphoid tissue making some lymphnodes. The nodes are located diffusi-vely and contain a central artery. Whatanatomic formation might have suchmorphological structure?

A. SpleenB. Red bone marrowC. ThymusD. TonsilE. Lymph node

171. A victim with a head trauma in thetemporal region has been diagnosed withepidural hematoma. What artery is mostlikely to be damaged?

A. Medial membranous arteryB. Medial cerebral arteryC. Superficial temporal arteryD. Anterior membranous arteryE. Posterior auricular artery

172. A child has mental and physicalretardation, grave damage of internalconnective tissue. Urine analysis revealskeratan sulfates. What metabolic processis disturbed?

A. GlycosaminoglycansB. CollagenC. ElastinD. FibronectinE. Hyaluronic acid

173. A tooth extraction in a patientwith chronic persistent hepatitis wascomplicated with prolonged hemorrhage.What is the reason for the haemorrhagicsyndrome?

A. Decrease in thrombin productionB. Increase in thromboplastin productionC. Decrease in fibrin productionD. Increase in fibrinogen synthesisE. Fibrinolysis intensification

174. Sex chromosomes of a woman didn’tseparate and move to the opposite polesof a cell during gametogenesis (meiosis).The ovum was impregnated with a normalspermatozoon. Which chromosomal di-sease can be found in her child?

A. Turner’s syndromeB. Down’s syndromeC. Patau’s syndromeD. Edwards’ syndromeE. Cat cry syndrome

175. A female patient was administeredloratadine for allergic cheilitis treatment.What is the mechanism of the drug’s acti-


on?

A. It blocks the activity of H1 histaminereceptorsB. It blocks the adrenergic receptorsC. It stimulates the activity of monoamineoxidaseD. It inhibits the activity of Na,K-ATPE. It inhibits the activity of choline esterase

176. Ultramicroscopical examination of"dark"hepatocyte population in the cellcytoplasm detected a developed granularendoplasmic reticulum. What function hasthis organella in these cells?

A. Synthesis of blood plasma proteinsB. Carbohydrate synthesisC. Deintoxicative functionD. Bile productionE. Calcium ion depositing

177. A doctor prescribed a cephalosporinantibiotic to the patient after appendectomyfor infection prevention. Antimicrobialactivity of this group of antibiotics is basedupon the disturbance of the followingprocess:

A. Microbial wall formationB. Nucleic acid synthesisC. Ribosome protein synthesisD. Energy metabolismE. Choline esterase block

178. A patient underwent an extraction ofa part of a CNS structures by medical indi-cations. As a result of the extraction thepatient developed atony, astasia, intenti-on tremor, ataxy and adiadochokinesis.Which part of CNS structure had beenextracted?

A. CerebellumB. Amygdaloid corpusC. HippocampD. Basal ganglionsE. Limbic system

179. A patient has been diagnosed withinfluenza. His condition became drasti-cally worse after taking antipyretic drugs.His consciousness is confused, AP is 80/50mm Hg, Ps is 140/m, body temperaturedroped down to 35, 8oC. What complicati-on developed in this patient?

A. CollapseB. HyperthermiaC. HypovolemiaD. AcidosisE. Alkalosis

180. A patient consulted a doctor aboutloss of taste sensitivity on the tongue root.The doctor revealed that it is caused bynerve affection. Which nerve is it?

A. GlossopharyngealB. Vagus nerveC. Facial nerveD. Superlaryngeal nerveE. Trigeminal nerve

181. Which muscle contraction will beobserved in the upper extremity duri-ng holding (but not moving) a load in acertain position?

A. IsometricB. IsotonicC. AuxotonicD. ConcentricE. Excentric

182. An older woman has been hospitali-sed for acute pain and edema of the righthip joint that appered after a fall. Objecti-vely: the hip is adduced inwards, hip joi-nt movements are impaired. The patientis most likely to have a fracture of thefollowing bone or bone part:

A. Femoral neckB. Shaft of femurC. Condyle of femurD. Pubic boneE. Ischial bone

183. A 45-year-old woman has breastcancer. Her left arm has symptoms oflymphatic system insufficiency - limbedema, lymph node enlargement. Whatform of lymphatic circulation insufficiencyis it?

A. Mechanic insufficiencyB. Dynamic insufficiencyC. Resorption insufficiencyD. Combined insufficiencyE. -

184. Study of conversion of a food colouri-ng agent revealed that neutralization ofthis xenobiotic takes place only in onephase - microsomal oxydation. Name acomponent of this phase:

A. Cytochrome Р-450B. Cytochrome BC. Cytochrome CD. Cytochrome AE. Cytochrome oxidase

185. While performing an inguinal canaloperation on account of hernia a surgeon


damaged the canal’s contents. Whatexactly was damaged?

A. Funiculus spermaticusB. UrarchusC. Lig. teres uteriD. Lig. inguinalеE. -

186. A patient with myocardial infarcti-on was admitted to the cardiologicaldepartment. For pain relief it was deci-ded to potentiate fentanyl action wi-th a neuroleptic. Which of the followi-ng neuroleptics is the most suitable forneuroleptanalgesia?

A. DroperidolB. AminazineC. TriftazineD. HaloperidolE. Sulpiride

187. A 25-year-old man has spent a long ti-me in the sun under high air humidity. Asa result of it his body temperature rose upto 39oC. What pathological process is it?

A. HyperthermiaB. Infectious feverC. HypothermiaD. Noninfectious feverE. Burn disease

188. A 26-year-old man is in the torpidshock phase as a result of a car accident.In blood: 3, 2 · 109/l. What is the leadingmechanism of leukopenia development?

A. Redistribution of leukocytes inbloodstreamB. Leikopoiesis inhibitionC. Disturbed going out of matureleukocytes from the marrow into thebloodD. Lysis of leukocytes in the blood-formingorgansE. Intensified elimination of leukocytesfrom the organism

189. A patient consulted a doctor about asensation of imbalance which appearedafter a trauma. Which nerve is damaged?

A. Vestibulocochlear nerveB. Trigeminal nerveC. Facial nerveD. Intermediate nerveE. Vagus nerve

190. An alcoholic has alcoholic psychosiswith evident psychomotor agitation. Whatneuroleptic drug should be administered

for emergency care?

A. AminazineB. DiazepamC. Sodium bromideD. ReserpineE. Halothane

191. A patient who has been treated ina neural clinic and has been taking asedative for a long time got the followi-ng complication: cough, rhinitis, epiphora.What drug caused these disturbances?

A. Sodium bromideB. DiazepamC. ValerianD. PhenazepamE. Reserpine

192. The liver puncture biopsy of a patientwith hepatocellular insufficiency revealedhydropic and ballooning degenerationofhepatocytes, necrosis of certain cells,presence of Kaunsilmen’s bodies. Portaland lobular stroma were infiltrated mostlywith lymphocytes and macrophagesas well as with a small number ofpolymorphonuclear lymphocytes. What isthe most likely diagnosis?

A. Acute viral hepatitisB. Chronic persistent hepatitisC. Chronic aggressive hepatitisD. Autoimmune hepatitisE. Alcoholic hepatitis

193. In order to accelerate healing of aradiation ulcer a vitamin drug was admi-nistered. What drug is it?

A. Retinol acetateB. RetabolilC. PrednisoloneD. LevamisoleE. Methyluracil

194. After inoculation of the materialobtained from the pharynx of an anginapatient onto the blood-tellurite agar, greycolonies could be observed. They were4-5 mm in diameter, radially striated (inform of rosettes). Microscopical exami-nation revealed gram-positive bacilli wi-th clavate swollen ends arranged in formof wide-spread fingers. Identify these mi-croorganisms:


A. Diphtheria corynebacteriaB. Clostridium botulinumC. DiphtheroidsD. StreptococciE. Streptobacilli

195. Cytogenetic examination of a patientwith reproductive dysfunction revealednormal karyotype 46 ХY in some cells, butmost cells have karyotype of Klinefelter’ssyndrome - 47 ХХY. Such cell heterogeni-ty is called:

A. MosaicismB. InversionC. TranspositionD. DuplicationE. Monomorphism

196. A patient presents with acne andinflammatory alterations of facial skin.Microscopial investigation of lesion focihas revealed live arthropods sized 0,2-0,5 mm. They have prolate vermiformform and four pairs of thin short limbslocated in the middle part of the body.The revealed arthropods cause:

A. DemodicosisB. ScabiesC. PediculosisD. PhthiriasisE. Dermamyiasis

197. Surgical approach to the thyroidgland from the transverse (collar)approach involves opening of interaponeuroticsuprasternal space. What anatomicstructure localized in this space isdangerous to be damaged?

A. Jugular venous archB. External jugular veinC. Subclavicular veinD. Inferior thyroid artheryE. Superior thyroid arthery

198. An injured person was delivered tothe hospital with a penetrating wound inthe left lateral region of abdomen. Whatpart of the large intestine is most likelydamaged?

A. Colon descendensB. Colon ascendensC. Colon transversesD. CaecumE. Rectum

199. A 4-year-old child presents withgeneral weakness, sore throat and degluti-tive problem. After his examination adoctor suspected diphtheria and sent thematerial to the bacteriological laboratory.In order to determine the diphtheriacausative agent the material should beinoculated into the following differenti-al diagnostic medium:

A. Blood tellurite agarB. Endo’s agarC. Ploskyrev’s agarD. Sabouraud’s agarE. Levenshtein-Yessen agar

200. Examination of the anterior abdomi-nal wall of a pregnant woman revealeda tumour-like formation that arose onthe spot of a tumour that was removedtwo years ago. The neoplasm was well-defined, dense, 2х1 cm large. Histologicalexamination revealed that the tumour wascomposed of differentiated connective ti-ssue with prevailing collagen fibres. Whattumour might be suspected?

A. DesmoidB. LipomaC. FibrosarcomaD. HibernomaE. Leiomyoma

krok 1 - 2011 question paper (general medicine)

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