/a/
EXAMPLES OF QUESTIONS
Enzymes. Coenzymes. Bioenergetics. Citric Acid Cycle of Krebs. Tissue respiration.
1. Pain along large nervous stems and increased amount of pyruvate in the blood were revealed
in the patient. Insufficiency of what vitamin can cause such change?
A
В1*
B
В2
C
РР
D
Pantothenic acid
E
Biotin
2. In case of enterobiasis acrihine - the structural analogue of vitamin B2 - is administered. The
synthesis disorder of which enzymes does this medicine cause in microorganisms?
A
FAD-dependent dehydrogenases *
B
Cytochromeoxidases
C
Peptidases
D
NAD-dependet dehydrogenases
E
Aminotransferases
3. A 10-year-old girl often experiences acute respiratory infections with multiple spotty
haemorrages in the places of clothes friction. Hypovitaminosis of what vitamin is present at the
girl?
A
С*
B
В6
C
В1
D
А
E
В2
4. There is observed inhibited fibrillation in the patients with bile ducts obstruction, bleeding due
to low level of absorbtion of some vitamin. What vitamin is in deficit?
A
К*
B
А
C
D
D
Е
E
Carotene
5. During endotoxemia active forms of the oxygen including superoxide anion radical are formed
in the human body. With help of what enzyme is this anion activated?
A
Superoxide dismutase*
B
Catalase
C
Peroxidase
D
Glutathioneperoxidase
E
Glutathionereductase
6. A patient presents high activity of LDH1,2, aspartate aminotransferase, creatine
phosphokinase. In what organ (organs) is the development of a pathological process the most
probable?
A
In the heart muscle (initial stage of myocardium infarction) *
B
In skeletal muscles (dystrophy, atrophy)
C
In kidneys and adrenals
D
In connective tissue
E
In liver and kidneys
7. While examining the child the doctor revealed symmetric cheeks roughness, diarrhea,
disfunction of the nervous system. Lack of what food components caused it?
A
Nicotinic acid, tryptophane*
B
Lysine, ascorbic acid
C
Threonine, pantothenic acid
D
Methionine, lipoic acid
E
Phenylalanine, pangamic acid
8. A13-year-old boy complains of general weakness, dizziness, tiredness. He is mentally
retarded. Increased level of valine, isoleucine, leucine is in the blood and urine. Urine has
specific smell. What is the diagnosis?
A
Maple syrup urine disease*
B
Addison's disease
C
Tyrosinosis
D
Histidinemia
E
Graves' disease
9. Increased breaking of vessels, enamel and dentine destruction in scurvy patients are caused by
disorder of collagen maturing. What stage of modification of procollagen is disordered in this
avitaminosis?
A
Hydroxylation of proline*
B
Formation of polypeptide chains
C
Glycosylation of hydroxylysine residues
D
Removal of C-ended peptide from procollagen
E
Detaching of N-ended peptide
10. Aspirin has antiinflammatory effect due to inhibition of the cyclooxygenase activity. Level of
what biological active acids will decrease?
A
Prostaglandins*
B
Leucotriens
C
Catecholamines
D
Biogenic amines
E
Iodinethyronyns
11. Examination of a patient revealed typical presentations of collagenosis. This pathology is
characterized by increase of the following urine index:
A
Hydroxyproline*
B
Arginine
C
Glucose
D
Mineral salts
E
Ammonium salts
12. Marked increase of activity of МВ-forms of CPK (creatinephosphokinase) and LDH1 were
revealed on the examination of the patient's blood. What is the most likely pathology?
A
Miocardial infarction*
B
Hepatitis
C
Rheumatism
D
Pancreatitis
E
Cholecystitis
13. Examination of a patient suffering from frequent haemorrhages in the inner organs and
mucous membranes revealed proline and lysine being included in collagen fibers. Impairment of
their hydroxylation is caused by lack of the following vitamin:
A
C*
B
E
C
K
D
A
E
D
14. A patient has an increased pyruvate concentration in blood. A large amount of it is excreted
with the urine. What vitamin is lacking in this patient?
A
B1*
B
E
C
B3
D
B6
E
B2
15. Increased production of thyroidal hormones T_3 and T_4, weight loss, tachycardia, psychic
excitement and so on present on thyrotoxicosis. How do thyroidal hormones effect energy
metabolism in the mitochondrion of cells?
A
Disconnect oxidation and oxidated phosphorylation *
B
Activates phosphorylation of substance
C
Stops phosphorylation of substance
D
Stops respiratory chain
E
Activates oxidated phosphorylation
16. A patient consulted a doctor about symmetric dermatitis of open skin areas. It was found out
that the patient lived mostly on cereals and ate too little meat, milk and eggs. What vitamin
deficiency is the most evident?
A
Nicotinamide *
B
Calciferol
C
Folic acid
D
Biotin
E
Tocopherol
17. 12 hours after an accute attack of retrosternal pain a patient presented a jump of aspartate
minotransferase activity in blood serum. What pathology is this deviation typical for?
A
Myocardium infarction *
B
Viral hepatitis
C
Collagenosis
D
Diabetes mellitus
E
Diabetes insipidus
18. Profuse foam appeared when dentist put hydrogen peroxide on the mucous of the oral cavity.
What enzyme caused such activity?
A
Catalase *
B
Cholinesterase
C
Acetyltransferase
D
Glucose-6-phosphatdehydrogenase
E
Methemoglobin reductase
19. A newborn child has convulsions that have been observed after prescription of vitamin B6.
This most probable cause of this effect is that vitamin B6 is a cofactor of the following enzyme:
A
Glutamate decarboxylase *
B
Pyruvate dehydrostase
C
Netoglubarate dehydromine
D
Aminolevulinate synthase
E
Glycogen phosphorylase
20. A woman who has been keeping to a clean-rice diet for a long time was diagnosed with
polyneuritis (beriberi). What vitamin deficit results in development of this disease?
A
Thiamine *
B
Ascorbic acid
C
Pyridoxine
D
Folic acid
E
Riboflavin
21. Removal of gall bladder of a patient has disturbed processes of Ca absorption through the
intestinal wall. What vitamin will stimulate this process?
A
D3 *
B
PP
C
C
D
B12
E
K
22. Examination of a patient with frequent hemorrhages from internals and mucous membranes
revealed proline and lysine being a part of collagene fibers. What vitamin absence caused
disturbance of their hydroxylation?
A
Vitamin C *
B
Vitamin K
C
Vitamin A
D
Thiamine
E
Vitamin E
23. Vitamin A together with specific cytoreceptors penetrates through the nuclear membranes,
induces transcription processes that stimulate growth and differentiation of cells. This biological
function is realized by the following form of vitamin A:
A
Trans-retinoic acid *
B
Trans-retinal
C
Cis-retinal
D
Retinol
E
Carotin
24. A newborn child suffers from milk curdling in stomach, this means that soluble milk proteins
(caseins) transform to insoluble proteins (paracaseins) by means of calcium ions and a certain
enzyme. What enzyme takes part in this process?
A
Renin *
B
Pepsin
C
Gastrin
D
Secretin
E
Lipase
25. To prevent postoperative bleeding a 6 y.o. child was administered vicasol that is a synthetic
analogue of vitamin K. Name post-translational changes of blood coagulation factors that will be
activated by vicasol:
A
Carboxylation of glutamin acid *
B
Phosphorylation of serine radicals
C
Partial proteolysis
D
Polymerization
E
Glycosylation
26. According to clinical indications a patient was administered pyridoxal phosphate. What
processes is this medication intended to correct?
A
Transamination and decarboxylation of aminoacids *
B
Oxidative decarboxylation of ketoacids
C
Desamination of purine nucleotide
D
Synthesis of purine and pyrimidine bases
E
Protein synthesis
27. As a result of posttranslative modifications some proteins taking part in blood coagulation,
particularly prothrombin, become capable of calcium binding. The following vitamin takes part
in this process:
A
K*
B
C
C
A
D
B1
E
B2
28. A 3 year old child with symptoms of stomatitis, gingivitis and dermatitis of open skin areas
was delivered to a hospital. Examination revealed inherited disturbance of neutral amino acid
transporting in the bowels. These symptoms were caused by the deficiency of thefollowing
vitamin:
A
Niacin *
B
Pantothenic acid
C
Vitamin A
D
Cobalamin
E
Biotin
29. Surgical removal of a part of stomach resulted in disturbed absorption of vitamin B12, it is
excreted with feces. The patient was diagnosed with anemia. What factor is necessary for
absorption of this vitamin?
A
Gastromucoprotein *
B
Gastrin
C
Hydrochloric acid
D
Pepsin
E
Folic acid
30. In clinical practice tuberculosis is treated with izoniazid preparation - that is an antivitamin
able to penetrate into the tuberculosis bacillus. Tuberculostatic effect is induced by the
interference with replication processes and oxidation-reduction reactions due to the buildup of
pseudo-coenzyme:
A
NAD *
B
FAD
C
FMN
D
TDP
E
CoQ
31. In a patient's blood the activities of lactate dehydrogenase (LDH4,LDH5), alanine
aminotransferase, carbamoyl ornithine transferase are increased. What organ is the pathological
process developing in?
A
In skeletal muscles
B
In the myocardium (myocardial infarction is possible).
C.
In the liver (hepatitis is possible)*.
D
In kidneys
E
In connective tissue CoQ
32. An ophthalmologist found that an outpatient had the increase of the time of sight adaptation
for darkness. What kind of vitamin deficiency can be the cause of the symptom?
A.
E.
B.
A*
C.
C.
D.
K
E.
D.
33. A patient was diagnosed with megaloblastic anemia. The lack of which substance in the human
organism can cause this disease''
A.
Copper.
B.
Glycine.
C.
Cobalamine*
D
Cholecalciferol.
E.
Magnesium.
34. Pathological processes associated with the development of hypoxia can be caused by incomplete
reduction of an oxygen molecule in the electron transport chain and accumulation of hydrogen
peroxide. Choose the enzyme which breaks the hydrogen peroxide.
A.
Catalase.*
B.
Cytochrome oxidase.
C.
Succinate dehydrogenase.
D.
a-Ketoglutarate dehydrogenase.
E.
Aconitase.
35.
There is an increase of the pyruvate level in the patient's blood and urine. What kind of
avitaminosis developed in this case?
A.
B2 avitaminosis.
B.
E avitaminosis.
C.
B3 avitaminosis.
D.
B6 avitaminosis.
E.
B1 avitaminosis.*
36. Potassium cyanide is a very dangerous poison that causes instantaneous death of a human
organism. What mitochondrial enzyme is affected by potassium cyanide?
A.
Cytochrome P450.
B.
Flavine enzymes.
C.
Cytochrome b.
D.
NAD+-dependent dehydrogenases.
E.
Cytochrome oxidase (cytochrome aa3)*.
37. A 47-year-old patient was brought to an emergency department with the diagnosis of
myocardial infarction. What lactate dehydrogenase (LDH) fractions activity would prevail in the
patient's blood serum during the first two days after hospitalization?
A.
LDH4.
B.
LDH2
c.
LDH3
D.
LDH1*
E.
LDH5
38. A 50-year-old woman was brought to an emergency clinic with the diagnosis of myocardial
infarction. The activity of what enzyme will prevail in her blood plasma during the first two days
after hospitalization?
A.
Alkaline phosphatase.
B.
g-Glutamyl transpeptidase.
C.
Aspartate aminotransferase.*
D.
Acidic phosphatase.
E.
Hexokinase.
39. A 2-year-old child developed intestinal dysbacteriosis with a hemorrage syndrome. The most
probable cause of this syndrome is:
A.
Vitamin K deficiency.*
B.
Activation of tissue thromboplastin.
C.
Vitamin PP deficiency.
D.
Fibrinogen deficiency.
E.
Hypocalcemia.
40. The living organisms that did develop the system of defence against the unfavorable action
of H2O2 during the evolution can exist only in anaerobic conditions. Which of the enzymes can
destroy hydrogen peroxide?
A.
Oxygenases and hydroxylases.
B.
Peroxidase and catalase.*
C.
Cytochrome oxidase, cytochrome b.
D.
Oxygenase and catalase.
E.
Flavin-linked oxidases.
41. The central intermediate which is common for the catabolic pathways of proteins,
carbohydrates and lipids is:
A.
Succinyl-CoA.
B.
Acetyl-CoA.*
C.
Oxaloacetate.
D.
Lactate.
E.
Citrate.
42. During the necropsy of a 20-year old girl a pathologist concluded that the death of the patient
had resulted from poisoning by cyanides. The activity of what enzyme is mostly inhibited by
cyanides?
A.
Malate dehydrogenase.
B.
Cytochrome oxidase.*
C.
Heme synthase.
D.
Aspartate aminotransferase.
E.
Carbamoyl phosphate synthetase.
Metabolism of carbohydrates
1. Galactosemia is revealed in the child. Concentration of glucose in the blood is not
considerably changed. Deficiency of what enzyme caused this illness?
A
Galactose-1-phosphate uridyltransferase*
B
Amylo-1,6-glucosidase
C
Phosphoglucomutase
D
Galactokinase
E
Hexokinase
2. Characteristic sign of glycogenosis is muscle pain during physical work. Blood examination
reveals usually hypoglycemia. This pathology is caused by congenital deficiency of the
following enzyme:
A.
Glycogen phosphorylase*
B.
Glucose 6-phosphate dehydrogenase
C.
Alpha amylase
D.
Gamma amylase
E.
Lysosomal glycosidase
3. A 34-year-old patient's resistance to heavy physical load is reduced while the skeletal muscles
glycogen level is increased. By decreasing of the activity of what enzyme can this phenomenon
be explained?
A.
Phosphofructokinase.
B.
Glucose-6-phosphate dehydrogenase.
C.
Glycogen phosphorylase. *
D.
Glycogen synthetase.
E.
Glucose-6-phosphatase.
4. A patient is ill with diabetes mellitus that is accompanied by hyperglycemia of over 7,2
millimole/l on an empty stomach. The level of what blood plasma protein allows to estimate the
glycemia rate retrospectively (4-8 weeks before examination)?
A.
Glycated hemoglobin *
B.
Albumin
C.
Fibrinogen
D.
C-reactive protein
E.
Ceruloplasmin
5. A 62-year-old female patient has developed a cataract (lenticular opacity) secondary to the
diabetes mellitus. What type of protein modification is observed in case of diabetic cataract?
A.
Glycosylation *
B.
Phosphorylation
C.
ADP-ribosylation
D.
Methylation
E.
Limited proteolysis
6. The B cells of endocrine portion of pancreas are selectively damaged by alloxan poisoning.
How will it be reflected in blood plasma?
A.
The content of sugar increases *
B.
The content of fibrinogen decrease
C.
The level of sugar decreases
D.
The content of globulins decreases
E.
The content of albumins decreases
7. Untrained people often have muscle pain after sprints as a result of lactate accumulation. This
might be caused by intensification of the following biochemical process:
A.
Glycolysis *
B.
Gluconeogenesis
C.
Pentose phosphate pathway
D.
Lipogenesis
E.
Glycogenesis
8. A patient was delivered to the hospital by an emergency team. Objectively: grave condition,
unconscious, adynamy. Cutaneous surfaces are dry, eyes are sunken, face is cyanotic. There is
tachycardia and smell of acetone from the mouth. Analysis results: blood glucose - 20,1
micromole/l, urine glucose - 3,5% . What is the most probable diagnosis?
A.
Hyperglycemic coma *
B.
Hypoglycemic coma
C.
Acute heart failure
D.
Acute alcoholic intoxication
E.
Anaphylactic shock
9. Patient with diabetes mellitus experienced loss of consciousness and convulsions after
injection of insulin. What is the result of biochemical blood analysis for concentration of the
sugar?
A.
1,5 mmol/L *
B.
8,0 mmol/L
C.
10,0 mmol/L
D.
3,3 mmol/L
E.
5,5 mmol/L
10. On the empty stomach in the patients blood glucose level was 5,65 mmol/L, in an hour after
usage of sugar it was 8,55 mmol/L, in a 2 hours - 4,95 mmol/L. Such indicators are typical for:
A.
Healthy person*
B.
Patient with hidden diabetes mellitus
C.
Patient with insulin-dependent diabetes mellitus
D.
Patient with non-insulin dependent diabetes mellitus
E.
Patient with thyrotoxicosis
11. A child is languid, apathetic. Liver is enlarged and liver biopsy revealed a significant excess
of glycogene. Glucose concentration in the blood stream is below normal. What is the cause of
low glucose concentration?
A.
Low (absent) activity of glycogene phosphorylase in liver *
B.
Low (absent) activity of hexokinase
C.
High activity of glycogen synthetase
D.
Low (absent) activity of alfa-1,4- glucosidase
E.
Deficit of glucose 1-phosphaturidine transferase
12. After a sprint an untrained person develops muscle hypoxia. This leads to the accumulation
of the following metabolite in muscles:
A.
Lactate *
B.
Ketone bodies
C.
Acetyl CoA
D.
Glucose 6-phosphate
E.
Oxaloacetate
13. Myocyte cytoplasm contains a big number of dissolved metabolites of glucose oxidation.
Name one of them that turns directly into a lactate:
A.
Pyruvate *
B.
Oxaloacetate
C.
Glycerophosphate
D.
Glucose 6-phosphate
E.
Fructose 6-phosphate
14. A child's blood presents high content of galactose, glucose concentration is low. There are
such presentations as cataract, mental deficiency, adipose degeneration of liver. What disease
is it?
A.
Galactosemia *
B.
Diabetes mellitus
C.
Lactosemia
D.
Steroid diabetes
E.
Fructosemia
15. A 45 y.o. woman suffers from Cushing's syndrome - steroid diabetes. Biochemical
examination revealed: hyperglycemia, hypochloremia. Which of the under-mentioned processes
is the first to be activated?
A.
Gluconeogenesis *
B.
Glycogenolysis
C.
Glucose reabsorption
D.
Glucose transport to the cell
E.
Glycolysis
16. The patient with complaints of permanent
Hyperglycemia,polyuria and increased concentration of
revealed. What disease is the most likely?
A.
Steroid diabetes *
B.
Insulin-dependent diabetes mellitus
C.
Myxoedema
D.
Type I glycogenosis
E.
Addison's disease
thirst applied to the doctor.
17-ketosteroids in the urine were
17. When blood circulation in the damaged tissue is restored, then lactate accumulation comes to
a stop and glucose consumption decelerates. These metabolic changes are caused by activation
of the following process:
A.
Aerobic glycolysis *
B.
Anaerobic glycolysis
C.
Lipolysis
D.
Gluconeogenesis
E.
Glycogen biosynthesis
18. During starvation muscle proteins break up into free amino acids. These compounds will be
the most probably involved into the following process:
A.
Cori cycle *
B.
Gluconeogenesis in muscles
C.
Synthesis of higher fatty acids
D.
Glycogenolysis
E.
Decarboxylation
19. A newborn develops dyspepsia after the milk feeding. When the milk is substituted by the
glucose solution the dyspepsia symptoms disappear. The newborn has the subnormal activity of
the following enzyme:
A.
Lactase *
B.
Invertase
C.
Maltase
D.
Amylase
E.
Isomaltase
20. After taking sulfonamides and aspirin by a 38-year-old patient, hemolysis of erythrocytes
caused by the insufficiency of glucose-6-phosphate dehydrogenase developed. The disturbance
of what coenzyme formation does this pathology result from?
A.
Ubiquinone.
B.
FADH2
C.
Pyridoxal phosphate
D.
FMNH2.
E.
NADPH*
21. A child with point mutation has the absence of glucose- 6- phosphate body tissues,
hypoglycemia and hepatomegaly detected. Define the type of pathology which these symptoms
are characteristic of:
A.
Girke's disease. *
B.
Measles.
C.
Addison's disease.
D.
Parkinson's disease.
E.
McArdle's disease.
22. The concentration of glucose in the blood plasma of a healthy man varies within the
following limits:
A.
2.0-4.0 mM/L.
B.
3.3-5.5 mM/L. *
C.
10.0-25.0 mM/L.
D.
6.0-9.5 mM/L.
E.
1.0-2.0 mM/L.
23. Some hours after an intensive physical training a sportsman showed activated
gluconeogenesis. Which of the following is the basic substrate of gluconeogenesis?
A.
Serine.
B.
Aspartate.
C.
Glutamate.
D.
a-Ketoglutarate.
E.
Lactate. *
24. A newborn child had dyspepsia phenomena (diarrhea, vomiting) detected after feeding with
milk. After additional feeding with glucose the morbid symptoms disappeared. The insufficient
activity of what enzyme that takes part in the carbohydrates breakdown causes the indicated
disorders?
A. Saccharase.
B. Amylase.
C. Lactase. *
D.lsomaltase.
E. Maltase.
25. A 2-year-old boy has the increase of liver and spleen sizes detected and eye cataract present.
The total sugar level in blood is increased, but glucose tolerance is within the normal range. The
inherited disturbance of the metabolism of what substance is the cause of the indicated state?
A. Glucose.
B. Fructose.
C. Galactose. *
D. Maltose.
E. Saccharose.
26. A 57-year-old patient, suffering from insulin dependent diabetes mellitus, showed the
development of ketoacidosis. The biochemical mechanism of the development of this pathology
is decreasing of acetyl-CoA utilization due to the deficiency of:
A. 2-0xoglutarate.
B. Oxaloacetate.*
C. Glutamate.
D. Aspartate.
E. Succinate.
27. A 38-year-old man is receiving treatment for schizophrenia in hospital. The initial levels of
glucose, ketone bodies and urea in the blood are within the normal range. Shock therapy put into
practice by regular insulin injections resulted in the development of the comatose state which
improved the clinical status of the patient. What is the most probable cause of insulin coma?
A. Hyperglycemia.
B. Dehydratation of tissues.
C. Metabolic acidosis.
D. Ketonemia.
E. Hypoglycemia. *
28. A 7-year-old girl manifests obvious signs of anemia. Laboratory tests showed the deficiency
of pyruvate kinase activity in erythrocytes. The disorder of what biochemical process is a major
factor in the development of anemia?
A. Deamination of amino acid.
B. Oxidative phosphorylation.
C. Tissue respiration.
D. Breaking up of peroxides.
E. Anaerobic glycolysis. *
29. A 45-year-old woman does not have any symptoms of insulin dependent diabetes mell itus
but testing on an empty stomach showed the increase of the blood glucose level (7.5 mM/l).
What additional laboratory test needs to be done to substantiate the diagnosis?
A. Determination of tolerance to glucose.
B. Determination of ketone bodies concentration in the urine.
C. Determination of rest nitrogen level in the blood.
D. Determination of tolerance to glucose on an empty stomach. *
E. Determination of glycosylated hemoglobin level.
30. What biochemical process is stimulated in the liver and kidneys of a patient exhausted by
starvation?
A. Synthesis of bilirubin.
B. Synthesis of urea.
C. Gluconeogenesis. *
D.Formation of hippuric acid.
E. Synthesis of uric acid.
Metabolism of lipids
1. After consumption of rich food a patient has nausea and heartburn, steatorrhea. Thiscondition
might be caused by:
A
Bile acid deficiency*
B
Increased lipase secretion
C
Disturbed tripsin synthesis
D
Amylase deficiency
E
Disturbed phospholipase synthesis
2. Fatty of phospholipids is disordered due to fat infiltration of the liver. Indicate which of the
presented substances can enhance the process of methylation during phospholipids synthesis?
A
Methionine *
B
Ascorbic acid
C
Glucose
D
Glycerin
E
Citrate
3. Increased amount of free fatty acids is observed in the blood of the patients with diabetes
mellitus. It can be caused by:
A
Increased activity of triglyceridelipase adipocytes*
B
Storage of palmitatoil-CoA
C
Activation of the ketone bodies utilization
D
Activation of the synthesis of the apolipoproteins
E
Decreased activity of phosphatidylcholine-cholesterol-acyltransferase blood plasma
4. A patient with high rate of obesity was advised to use carnitine as a food additive in order to
enhance "fat burning". What is the role of carnitine in the process of fat oxidation?
A
Transport of FFA (free fatty acids) from cytosol to the mitochondria *
B
Transport of FFA from fat depots to the tissues
C
It takes part in one of reactions of FFA beta-oxidation
D
FFA activation
E
Activation of intracellular lipolysis
5. An experimantal animal that was kept on protein-free diet developed fatty liver infiltration, in
particular as a result of deficiency of methylating agents. This is caused by disturbed generation
of the following metabolite:
A
Choline *
B
DOPA
C
Cholesterol
D
Acetoacetate
E
Linoleic acid
6. Carnitine including drug was recomended to the sportsman for improving results. What
process is activated most of all with help of carnitine?
A
Transport of fatty acids to the mitochondria*
B
Synthesis of steroid hormones
C
Synthesis of ketone bodies
D
Synthesis of lipids
E
Tissue respiratio
7. After intake of rich food a patient feels nausea and sluggishness; with time there appeared
signs of steatorrhea. Blood cholesterine concentration is 9,2 micromole/l. This condition was
caused by lack of:
A
Bile acids *
B
Triglycerides
C
Fatty acids
D
Phospholipids
E
Chylomicrons
8. Examination of a man who hadn't been consuming fats but had been getting enough
carbohydrates and proteins for a long time revealed dermatitis, poor wound healing, vision
impairment. What is the probable cause of metabolic disorder?
A
Lack of linoleic acid, vitamins A, D, E, K *
B
Lack of palmitic acid
C
Lack of vitamins PP, H
D
Low caloric value of diet
E
Lack of butiric acid
9. An experimental animal has been given excessive amount of carbon-labeled glucose for a
week. What compound can the label be found in?
A
Palmitic acid *
B
Methionine
C
Vitamin A
D
Choline
E
Arachidonic acid
10. A sportsman was recommended to take a medication that contains carnitine in order to
improve his results. What process is activated by carnitine the most?
A
Fatty acids transport to mitochondrions *
B
Synthesis of steroid hormones
C
Synthesis of ketone bodies
D
Synyhesis of lipids
E
Tissue respiration
11. Examination of a patient suffering from chronic hepatitis revealed a significant decrease in
the synthesis and secretion of bile acids. What process will be mainly disturbed in the patient’s
bowels?
A
Fats emulsification *
B
Protein digestion
C
Carbohydrate digestion
D
Glycerin absorption
E
Amino acid absorption
12. A 6 year old child was delivered to a hospital. Examination revealed that the child couldn't
fix his eyes, didn't keep his eyes on toys, eye ground had the cherry-red spot sign. Laboratory
analyses showed that brain, liver and spleen had high rate of ganglioside glycometide. What
congenital disease is the child ill with?
A
Tay-Sachs disease *
B
Wilson's syndrome
C
Turner's syndrome
D
Niemann-Pick disease
E
MacArdle disease
13. NSAID blockade the utilization of arachidonic acid via cyclooxigenase pathway, which
results in formation of some bioactive substances. Name them:
A
Prostaglandins *
B
Thyroxine
C
Biogenic amins
D
Somatomedins
E
Insulin-like growth factors
14. Arachidonic acid, an essential component of a human diet, acts as a precursor of the vitally
important physiologically active biomolecules. Which substances are synthesized via
cyclooxigenase pathway from arachidonic acid?
A. Ethanolamine.
B. Choline.
C. Noradrenaline.
D. Prostaglandins *
E. Triiodothyronine.
15. A 1-year-old child with symptoms of muscle involvement was admitted to the hospital.
Examination revealed carnitine deficiency in his muscles. What process disturbance is the
biochemical basis of this pathology?
A
Transporting of fatty acids to mitochodrions *
B
Regulation of Са2+ level in mitochondrions
C
Substrate phosphorylation
D
Lactic acid utilization
E
Actin and myosin synthesis
16. Laboratory investigation of the patient's blood plasma, which was performed 4 hours after a
consumption of a fat diet, displayed a marked increase of plasma turbidity. The most credible
cause of this phenomenon is the increase of …….... in the plasma.
A. HDL.
B. Chylomicrons.*
C. LDL.
D. Cholesterol.
E. Phospholipids.
17. Patients who suffer from severe diabetes and don't receive insulin have metabolic acidosis.
This is caused by increased concentration of the following metabolites:
A
Ketone bodies *
B
Fatty acids
C
Unsaturated fatty acids
D
Triacylglycerols
E
Cholesterol
18. In a human body the adipose tissue is the basic location of triacylglycerols (TAG) deposit. At
the same time their synthesis takes place in hepatocytes. In the form of what molecular complex
are TAG transported from the liver into the adipose tissue?
A. Chylomicrons.
B. VLDL.*
C. LDL.
D. HDL.
E. Complexes with albumin.
19. Laboratory investigation of a patient revealed a high level of plasma LDL. What disease can
be diagnosed?
A. Gastritis.
B. Nephropathy.
C. Acute pancreatitis.
D.Atherosclerosis*.
E. Pneumonia.
20. Aerobic oxidation of substrates is typical for cardiac myocytes. Which of the following is the
major oxidation substrate of cardiac muscles?
A. Fatty acids.*
B. Triacylglycerols.
C. Glycerol.
D. Glucose.
E. Amino acids.
21. Which of the following enzymes accelerates the lipolysis under the action of epinephrine in
stress situations?
A. Triacylglycerol lipase. *
B. Lypoprotein lipase.
C. Phospholipase A2
D. Phospholi pase C.
E. Cholesterol esterase.
22. Clinical signs and laboratory testing of a patient allow make the assumption of gall-bladder
inflammation, colloid properties of bile disorder and occurrence of gall-stones. Which substances
can underlie the formation of gall-stones?
A. Oxalates.
B. Urates.
C. Cholesterol. *
D. Chlorides.
E. Phosphates.
23. Emotional stress causes activation of hormon-sensitive triglyceride lipase in the adipocytes.
What secondary mediator takes part in this process?
A
Cyclic adenosine monophosphate *
B
Cyclic guanosine monophosphate
C
Adenosine monophosphate
D
Diacylglycerol
E
Ions of Са2+
24. The insufficient secretion of what enzyme is the cause of incomplete fats degradation in the
digestive tract and appearance of great quantity of neutral fats in feces?
A. Pepsin.
B. Phospholipase.
C. Enterokinase.
D.Amylase.
E. Pancreatic lipase *
Metabolism of simple proteins
1. Patient with encephalopathy was admitted to the neurological in-patient department.
Correlation of increasing of encephalopathy and substances absorbed by the bloodstream from
the intestines was revealed. What substances that are created in the intestines can cause
endotoxemia?
A
Indole*
B
Butyrate
C
Acetacetate
D
Biotin
E
Ornithine
2. Examination of a patient suffering from cancer of urinary bladder revealed high rate of
serotonin and hydroxyanthranilic acid. It is caused by excess of the following amino acid in
the organism:
A
Tryptophan*
B
Alanine
C
Histidine
D
Methionine
E
Tyrosine
3. A 4 y.o. child with signs of durative protein starvation was admitted to the hospital. The signs
were as follows: growth inhibition, anemia, edema, mental deficiency. Choose a cause of edema
development:
A
Reduced synthesis of albumins *
B
Reduced synthesis of globulins
C
Reduced synthesis of hemoglobin
D
Reduced synthesis of lipoproteins
E
Reduced synthesis of glycoproteins
4. The concentration of albumins in human blood sample is lower than normal. This leads to
edema of tissues. What blood function is damaged?
A
Maintaining the oncotic blood pressure *
B
Maintaining the Ph level
C
Maintaining the body temperature
D
Maintaining the blood sedimentation system
E
All answers are correct
5. Ammonia is a very toxic substance, especially for nervous system. What substance takesthe
most active part in ammonia detoxication in brain tissues?
A
Glutamic acid *
B
Lysine
C
Proline
D
Histidine
E
Alanine
6. A patient has pellagra. Interrogation revealed that he had lived mostly on maize for a long
time and eaten little meat. This disease had been caused by the deficit of the following substance
in the maize:
A
Tryptophan *
B
Tyrosine
C
Proline
D
Alanine
E
Histidine
7. A patient with serious damage of muscular tissue was admitted to the traumatological
department. What biochemical urine index will be increased in this case?
A
Creatinine *
B
Common lipids
C
Glucose
D
Mineral salts
E
Uric acid
8. Nappies of a newborn have dark spots that witness of formation of homogentisic acid.
Metabolic imbalance of which substance is it connected with?
A
Thyrosine *
B
Galactose
C
Methionine
D
Cholesterine
E
Tryptophane
9. A 1,5-year-old child presents with both mental and physical lag, decolorizing of skin and hair,
decrease in catecholamine concentration in blood. When a few drops of 5% solution of
trichloroacetic iron had been added to the child’s urine it turned olive green. Such alteration are
typical for the following pathology of the amino acid metabolism:
A
Phenylketonuria *
B
Alkaptonuria
C
Tyrosinosis
D
Albinism
E
Xanthinuria
10. The greater amount of nitrogen is excreted from the organism in form of urea. Inhibition of
urea synthesis and accumulation of ammonia in blood and tissues are induced by the
decreased activity of the following liver enzyme:
A
Carbamoyl phosphate synthetase *
B
Aspartate aminotransferase
C
Urease
D
Amylase
E
Pepsin
11. After a serious viral infection a 3-year-old child has repeated vomiting, loss of
consciousness, convulsions. Examination revealed hyperammoniemia. What may have caused
changes of biochemical blood indices of this child?
A
Disorder of ammonia neutralization in ornithinic cycle *
B
Activated processes of aminoacids decarboxylation
C
Disorder of biogenic amines neutralization
D
Increased purtefaction of proteins in intestines
E
Inhibited activity of transamination enzymes
12. Albinos can't stand sun impact - they don't aquire sun-tan but get sunburns. Disturbed
metabolism of what aminoacid underlies this phenomenon?
A
Phenilalanine *
B
Methionine
C
Tryptophan
D
Glutamic acid
E
Histidine
13. Glutamate decarboxylation results in formation of inhibitory transmitter in CNS. Name it:
A
B
C
D
E
GABA *
Glutathione
Histamine
Serotonin
Asparagine
14. In course of histidine catabolism a biogenic amin is formed that has powerful vasodilatating
effect. Name it:
A
Histamine *
B
Serotonin
C
Dioxyphenylalanine
D
Noradrenalin
E
Dopamine
15. A patient diagnosed with carcinoid of bowels was admitted to the hospital. Analysis revealed
high production of serotonin. It is known that this substance is formed of tryptophane
aminooacid. What biochemical mechanism underlies this process?
A
Decarboxylation *
B
Desamination
C
Microsomal oxydation
D
Transamination
E
Formation of paired compounds
16. During hypersensitivity test a patient got subcutaneous injection of an antigen which caused
reddening of skin, edema, pain as a result of histamine action. This biogenic amine is generated
as a result of transformation of the following histidine amino acid:
A
Decarboxylation *
B
Methylation
C
Phosphorylation
D
Isomerization
E
Deaminization
17. A patient complained about dizziness, memory impairment, periodical convulsions. It was
revealed that these changes were caused by a product of decarboxylation of glutamic acid. Name
this product:
A
GABA *
B
Pyridoxal phosphate
C
TDP
D
ATP
E
THFA
18. Laboratory examination of a child revealed increased concentration of leucine, valine,
isoleucine and their ketoderivatives in blood and urine. Urine smelt of maple syrup. This disease
is characterized by the deficit of the following enzyme:
A
Dehydrogenase of branched amino acids *
B
Aminotransferase
C
Glucose-6-phosphatase
D
Phosphofructokinase
E
Phosphofructomutase
19. A newborn child was found to have reduced intensity of sucking, frequent vomiting,
hypotonia. In urine and blood exhibit increased concentration of citrulline. What metabolic
process is disturbed?
A
Ornithinic cycle *
B
Tricarboxylic acid cycle
C
Glycolysis
D
Glyconeogenesis
E
Cori cycle
20. Plasmic factors of blood coagulation are exposed to post-translational modification with the
participation of vitamin K. It is necessary as a cofactor in the enzyme system of gammacarboxylation of protein factors of blood coagulation due to the increased affinity of their
molecules with calcium ions. What amino acid is carboxylated in these proteins?
A
Glutamate *
B
Valine
C
Serine
D
Phenylalanine
E
Arginine
21. Pharmacological effects of antidepressants are connected with inhibition of an enzyme
catalyzing biogenic amines noradrenaline and serotonine in the mitochondrions of cerebral
neurons. What enzyme participates in this process?
A
Monoamine oxidase *
B
Transaminase
C
Decarboxylase
D
Peptidase
E
Lyase
22. A child manifests epileptic seizures caused by vitamin B6 deficiency. This is conditioned by
the decrease of the gamma-aminobutyrate level in the nervous tissue which acts as an inhibiting
neurotransmitter. The activity of which enzyme is decreased in this case?
A.
Pyridoxal kinase.
B.
Alanine aminotransferase.
C.
Glutamate dehydrogenase.
D.
Glutamate decarboxylase.*
E.
Glutamate synthetase.
Metabolism of complex proteins
1. Methotrexate (competitive inhibitor of the dihydrofolatreductase) is prescribed for treatment
of the tumour.On which level does methotrexate inhibit synthesis of the nucleic acids?
A
Mononucleotide synthesis *
B
Replication
C
Transcription
D
Reparation
E
Processing
2. Blood of a 12 year old boy presents low concentration of uric acid and accumulation of
xanthine and hypoxanthine. This child has genetic defect of the following enzyme:
A
Xanthine oxidase*
B
Arginase
C
Urease
D
Ornithine carbamoyltransferase
E
Glycerylkinase
3.An experiment proved that UV-radiated cells of patients with xeroderma pigmentosum restore
the native DNA structure slower than cells of healthy individuals as a result of reparation
enzyme defect. What enzyme helps this process?
A
Endonuclease *
B
RNA ligase
C
Primase
D
DNA polymerase III
E
DNA gyirase
4. A 20 year old patient complains of general weakness, dizziness, quick fatigability. Blood
analysis results: Hb- 80 g/l. Microscopical examination results: erythrocytes are of modified
form. This condition might be caused by:
A
Sickle-cell anemia *
B
Hepatocellular jaundice
C
Acute intermittent porphyria
D
Obturative jaundice
E
Addison's disease
5. A 48 year old patient complained about intense pain, slight swelling and reddening of skin
over the joints, temperature rise up to 38oC. Blood analysis revealed high concentration of urates.
This condition might be caused by disturbed metabolism of:
A
Purines *
B
Collagen
C
Cholesterol
D
Pyrimidines
E
Carbohydrates
6. A patient has yellow skin colour, dark urine, achromatic feces. What substance will have
strengthened concentration in the blood serum?
A
Unconjugated bilirubin
B
Conjugated bilirubin *
C
Mesobilirubin
D
Verdoglobin
E
Biliverdin
7. A 46 year old woman suffering from chololithiasis developed jaundice. Her urine became
dark-yellow and feces became colourless. Blood serum will have the highest concentration of the
following substance:
A
Conjugated bilirubin *
B
Unconjugated bilirubin
C
Biliverdin
D
Mesobilirubin
E
Urobilinogen
8. A 46 year old patient applied to a doctor complaining about joint pain that becomes stronger
the day before weather changes. Blood examination revealed strengthened concentration of uric
acid. The most probable cause of the disease is the intensified disintegration of the following
substance:
A
Adenosine monophosphate *
B
Cytidine monophosphate
C
Uridine triphosphate
D
Uridine monophosphate
E
Thymidine monophosphate
9. A 42-year man suffering from gout has increased level of urinary acid in the blood.
Allopurinol was prescribed to decrease the level of urinary acid. Competitive inhibitor of what
enzyme is allopurinol?
A
Xanthinoxidase *
B
Adenosinedeaminase
C
Adeninephosphoribosiltransferase
D
Hypoxantinphosphoribosiltransferase
E
Guaninedeaminase
10. Patient experienced increased susceptibility of the skin to the sunlight. His urine after some
time became dark-red. What is the most likely cause of this?
A
Porphyria *
B
Hemolytic jaundice
C
Albinism
D
Pellagra
E
Alkaptonuria
11. A 65 year old man suffering from gout complains of kidney pain. Ultrasound examination
revealed renal calculi. The most probable cause of calculi formation is the strengthened
concentration of the following substance:
A
Uric acid *
B
Cholesterol
C
Bilirubin
D
Urea
E
Cystine
12. It was found out that some compounds, for instance fungi toxins and some antibiotics can
inhibit activity of RNA-polymerase. What process will be disturbed in a cell in case of inhibition
of this enzyme?
A
Transcription *
B
Processing
C
Replication
D
Translation
E
Reparation
13. An oncological patient was prescribed methotrexate. With the lapse of time target cells of the
tumour lost susceptibility to this drug. There is change of gene expression of the folowing
enzyme:
A
Dehydrofolate reductase *
B
Thiaminase
C
Deaminase
D
Folate oxidase
E
Folate decarboxylase
Functional biochemistry
1. An infant has apparent diarrhea resulting from improper feeding. One of the main diarrhea
effects is plentiful excretion of sodium bicarbonate. What form of acid-base balance disorder is
the case?
A
Metabolic acidosis*
B
C
D
E
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
No disorders of acid-base balance will be observed
2. Buffer capacity of blood was decreased in the worker due to exhausting muscular work. Entry
of what acid substance to the blood can this state be explained?
A
Lactate*
B
Pyruvate
C
1,3-bisphosphoglycerate
D
alpha-ketoglutarate
E
3-phosphoglycerate
3. A 38 year old patient suffers from rheumatism in its active phase. What laboratory
characteristic of blood serum is of diagnostic importance in case of this pathology?
A
C-reactive protein *
B
Uric acid
C
Urea
D
Creatinine
E
Transferrin
4. A 30 y.o. woman had been ill for a year when she felt pain in the area of joints for the first
time, they got swollen and skin above them became reddened. Provisional diagnosis is
rheumatoid arthritis. One of the most probable causes of this disease is a structure alteration of a
connective tissue protein:
A
Collagen *
B
Mucin
C
Myosin
D
Ovoalbumin
E
Troponin
5. Examination of a 27-year-old patient revealed pathological changes in liver and brain. Blood
plasma analysis revealed an abrupt decrease in the copper concentration, urine analysis revealed
an increased copper concentration. The patient was diagnosed with Wilson’s degeneration. To
confirm the diagnosis it is necessary to study the activity of the following enzyme in blood
serum:
A
Ceruloplasmin *
B
Carbonic anhydrase
C
Xanthine oxidase
D
Leucine aminopeptidase
E
Alcohol dehydrogenase
6. A patient complains about dyspnea provoked by the physical activity. Clinical examination
revealed anaemia and presence of the paraprotein in the zone of gamma-globulins. To confirm
the myeloma diagnosis it is necessary to determine the following index in the patient’s urine:
A
Bence Jones protein *
B
Bilirubin
C
Haemoglobin
D
Ceruloplasmin
E
Antitrypsin
7. A 62 y.o. woman complains of frequent pains in the area of her chest and backbone, rib
fractures. A doctor assumed myelomatosis (plasmocytoma). What of the following laboratory
characteristics will be of the greatest diagnostical importance?
A
Paraproteinemia *
B
Hyperalbuminemia
C
Proteinuria
D
Hypoglobulinemia
E
Hypoproteinemia
8. Pathological changes of the liver and brain were revealed in a 27-year-old patient.The copper
concentration is abruptly decreased in blood plasma and increased in the urine. Wilson's disease
was diagnosed. Activity of what enzyme in the blood serum should be examined to prove
diagnisis?
A
Ceruloplasmin*
B
Carboanhydraze
C
Xanthioxidase
D
Leucinamineopeptidaze
E
Alcoholdehydrogenaze
9. A 50-year-old patient complains about general weakness, appetite loss and cardiac arrhythmia.
The patient presents with muscle hypotonia, flaccid paralyses, weakened peristaltic activity of
the bowels. Such condition might be caused by:
A
Hypopotassemia *
B
Hypoproteinemia
C
Hyperkaliemia
D
Hypophosphatemia
E
Hyponatremia
10. A 63-year-old woman developed signs of rheumatoid arthritis. Increase of which indicated
blood values level could be helpful in proving diagnosis?
A
Additive glycosaminoglycans*
B
Lipoproteids
C
Acid phosphatase
D
General cholesterol
E
R-glycosidase
11. A 35 y.o. patient who often consumes alcohol was treated with diuretics. There appeared
serious muscle and heart weakness, vomiting, diarrhea, AP- 100/60 mm Hg, depression. This
condition is caused by intensified excretion with urine of:
A
Potassium *
B
Sodium
C
Chlorine
D
Calcium
E
Phosphates
12. A patient suffers from hepatic cirrhosis. Examination of which of the following substances
excreted by urine can characterize the state of antitoxic function of liver?
A
Hippuric acid *
B
Ammonium salts
C
Kreatinine
D
Uric acid
E
Aminoacids
13. Products of some proteins hydrolysis and modification are the biologically active substances
called hormones. Lipotropin, corticotropin, melanotropin and endorphins are synthesized in the
hypophysis of the following protein:
A
Proopiomelanocortin (POMC) *
B
Neuroalbumin
C
Neurostromin
D
Neuroglobulin
E
Thyreoglobulin
14. During examination of an 11-month-old infant a pediatrician revealed osteoectasia of the
lower extremities and delayed mineralization of cranial bones. Such pathology is usually
provoked by the deficit of the following vitamin:
A
Cholecalciferol *
B
Thiamin
C
Pantothenic acid
D
Bioflavonoids
E
Riboflavin
15. Desulfiram is widely used in medical practice to prevent alcocholism. It inhibits aldehyde
dehydrogenase. Increased level of what metabolite causes aversion to alcochol?
A
Acetaldehyde *
B
Ethanol
C
Malonyl aldehyde
D
Propionic aldehyde
E
Methanol
16. Index of pH of the blood changed and became 7,3 in the patient with diabetus mellitus.
Detecting of the components of what buffer system is used while diagnosing disorder of the acidbase equilibrium?
A
Bicarbonate*
B
Phosphate
C
Hemoglobin
D
Oxyhemoglobin
E
Protein
17. Diabetes mellitus causes ketosis as a result of activated oxidation of fatty acids. What
disorders of acid-base equilibrium may be caused by excessive accumulation of ketone bodies in
blood?
A
Metabolic acidosis *
B
Metabolic alcalosis
C
Any changes woun't happen
D
Respiratory acidosis
E
Respiratory alcalosis
18. Depressions and emotional insanities result from the deficit of noradrenalin, serotonin and
other biogenic amines in the brain. Their concentration in the synapses can be increased by
means of the antidepressants that inhibit the following enzyme:
A
Monoamine oxidase *
B
Diamine oxidase
C
L-amino-acid oxidase
D
D-amino-acid oxidase
E
Phenylalanine-4-monooxygenase
19. A patient with suspected diagnosis "progressing muscular dystrophy" got his urine tested.
What compound will confirm this diagnosis if found in urine?
A
Kreatine *
B
Collagen
C
Porphyrin
D
Myoglobin
E
Calmodulin
20. Dietary intake of a 30 year old nursing woman contains 1000 mg of calcium, 1300 mg of
phosphorus and 20 mg of iron per day. It is necessary to change content of these mineral
substances in the following way:
A
To increase phosphorus content *
B
To increase calcium content
C
To reduce fluorine content
D
To increase iron content
E
To reduce iron content
21. Cardinal symptoms of primary hyperparathyroidism are osteoporosis and renal lesion along
with development of urolithiasis. What substance makes up the basis of these calculi in this
disease?
A
Calcium phosphate *
B
Uric acid
C
Cystine
D
Bilirubin
E
Cholesterol
22. Study of conversion of a food colouring agent revealed that neutralization of this xenobiotic
takes place only in one phase - microsomal oxydation. Name a component of this phase:
A
Cytochrome Р-450 *
B
Cytochrome B
C
Cytochrome C
D
Cytochrome A
E
Cytochrome oxidase
23. A patient had hemorrhagic stroke. Blood examination revealed strengthened kinin
concentration.The patient was prescribed contrical. It was administered in order to inhibit the
following proteinase:
A
Kallikrein *
B
Pepsin
C
Trypsin
D
Chemotrypsin
E
Collagenase
24. A 42-year-old man was hospitalized to a cardiologic department with the diagnosis of
stenocardia. The inhibitor of phosphodiesterase was included in the medicinal treatment of the
patient The concentration of what substance will be increased in the cardiac muscle?
A.ADP.
B.GMP.
C.AMP
D.cAMP.*
E. ATP.
25. Under different pathological states the level of active forms of oxygen rises, which results in
the destruction of cellular membranes. In order to prevent the damage of membranes,
antioxidants are used. The most powerful natural antioxidant is:
A.a-Tocoferol.*
B. Glucose.
C. Vitamin A.
D.Fatty acids.
E. Glycerol.
26. A 4 year old child with hereditary renal lesion has signs of rickets, vitamin D concentration
in blood is normal. What is the most probable cause of rickets development?
A
Impaired synthesis of calcitriol *
B
Increased excretion of calcium
C
Hyperfunction of parathyroid glands
D
Hypofunction of parathyroid glands
E
Lack of calcium in food
27. A doctor examined a child and revealed symptoms of rachitis. Development of this desease
was caused by deficiency of the following compound:
A
1,25 [ОН]-dichydroxycholecalciferol *
B
Biotin
C
Tocopherol
D
Naphtaquinone
E
Retinol
V ebf68bc9
Krok \ Dentistry \ Krok 1 \ Bases \ Biochemistry \ 2010
1 Roentgenological examination of a patient revealed a cyst enclosing a tooth in its cavity in
the area of the premolar. Microscopical examination revealed that the cyst wall consisted of
connective tissue and was lined with multilayer squamous epithelium. What is the most
probable diagnosis?
A Follicular cyst
B Radicular cyst
C Primordial cyst
D Eosinophilic granuloma
E Epulis
2 A dentist was examining oral cavity of a 9 year old child in the buccal surface of gingiva in
the area of the lower canine he revealed a red, soft, node-like formation 1 cm in diameter
that started immediately bleeding when touched. Microscopical examination revealed that
this formation consisted of many small vessels like venules and capillaries separated by thin
layers of connective tissue, with focal infiltration by lymphoid and plasmatic cells. Such
changes are typical for:
A Angiomatous epulis
B Capillary hemangioma
C Radicular granuloma
D Fibrous epulis
E Papilloma
3 Analysis of urine from a 24-year-old man revealed the following changes: daily diuresis 10 l, relative density - 1,001, qualitative alterations are absent. A patient complains of
excessive thirst, frequent urination. What is the most likely cause of this disease?
A Vasopressin hyposecretion
B Glucocorticoid hypersecretion
C Vasopressin hypersecretion
D Relative insulin insufficiency
E Aldosteron hypersecretion
4 A patient suffering from syphilis was prescribed a drug the action of which based upon
disturbed generation of murein leading to death of the causative agent. What drug is it?
A Benzylpenicillin sodium salt
B Bijochinol
C Ciprofloxacin
D Azithromycin
E Doxycycline hydrochloride
V ebf68bc9
5 Osteolathyrism is characterized by a loss of tensile strength of collagen, which is induced
by a significant decrease in the formation of cross-links in collagen fibrils. The cause for it is
the reduced activity of:
A Lysyl oxidase
B Monoamine oxidase
C Prolyl hydroxylase
D Lysyl hydroxylase
E Collagenase
6 Periodontitis is accompanied by activation of proteolysis in the periodontium tissues. The
evidence of proteolysis activation is increase of the following component of oral liquid:
A Amino acids
B Organic acids
C Glucose
D Biogenic amines
E Cholesterol
7 Two weeks after hemotransfusion a patient developed fever. What protozoal disease can
be suspected?
A Malaria
B Toxoplasmosis
C Leishmaniasis
D Amebiasis
E Trypanosomiasis
8 A patient applied to a doctor complaining about dizziness, memory impairment,
periodical convulsions. It was found out that such changes were caused by a product of
glutamic acid decarboxylation. What product is meant?
A GABA
B Pyridoxalphosphate
C Thymidine diphosphate
D ATP
E Tetrahydrofolate
9 Laboratory examination of a child revealed high content of leucine, valine, isoleucine and
their ketoderivates in blood and urine. Urine had the typical smell of maple syrup. This
disease was caused by deficiency of the following enzyme:
A Dehydrogenase of branched amino acids
B Aminotransferase
C Glucose-6-phosphatase
D Phosphofructokinase
V ebf68bc9
E phosphofructomutase
10 Hepatic disfunctions accompanied by insufficient inflow of bile to the bowels result in
coagulation failure. This phenomenon can be explained by:
A Vitamin K deficiency
B Iron deficiency
C Thrombocytopenia
D Erythropenia
E Leukopenia
11 A child has disturbed processes of ossification and punctate enamel. What microelement
metabolism is disturbed?
A Fluorine
B Chromium
C Copper
D Iron
E Zinc
12 During examination of a 36-year-old woman a dentist revealed a formation in form of a
nodule up to 0,8 cm in diameter, of dark brown-red colour, soft, on a wide base. The
formation was found on the buccal surface of gum in the region of the 2nd molar.
Histological examination revealed that the formation had plenty of sinusoid vessels and a
lot of roundish mononuclear and big multinuclear cells; in some parts accumulations of
hemosiderin granules could be found. What is the most likely diagnosis?
A Giant-cell epulis
B Root granuloma
C Angiomatous epulis
D Ameloblastoma
E Mandibular osteoclastoma
13 While on holiday in the countryside a boy found a spider with the following
morphological peculiarities: body length at the rate of 2 cm, round black abdomen with two
rows of red dots on its dorsal surface, four pairs of segmented extremities covered with tiny
black hairs. Identify this arthropod:
A Steppe spider (Latrodectus tredeci-mguttatus)
B Scorpion
C Solifugae
D Mite
E Tarantula
14 A girl who was provisionally diagnosed with Turner’s syndrome came to a genetic
consultation. The diagnosis can be specified by means of the following genetic method:
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A Sex chromatin test
B Genealogical
C Hybridological
D Biochemical
E Dermatoglyphics
15 Cyanide poisoning causes immediate death. What is the mechanism of cyanide effect at
the molecular level?
A They inhibit cytochromoxidase
B They bind substrates of tricarboxylic acid cycle
C They block succinate dehydrogenase
D They inactivate oxygene
E They inhibit cytochrome B
16 A blood smear of a patient who has recently recovered from flu contains 10% of
roundish cells 4,5-7 micrometer large with a big round nucleus and basophi-lically stained
cytoplasm in form of a narrow border around the nucleus. What blood status are they
typical for?
A Lymphocytopenia
B Thrombopenia
C Leukopenia
D Lymphocytosis
E Monocytopenia
17 A patient was diagnosed with seborrheic dermatitis associated with vitamin H (biotin)
deficiency. The patient has disturbed activity of the following enzyme:
A Acetyl-CoA-carboxylase
B Pyruvate decarboxylase
C Alcohol dehydrogenase
D Amino transferase
E Carbomoyl phosphate synthetase
18 Active physical work induces rise of concentration of carbonic acid in blood. This causes
deepening and acceleration of respiration thus reducing concentration of carbonic acid and
hydrogen ions in blood. This maintains the following process:
A Homeostasis
B Immunity
C Ontogenesis
D Orthobiosis
E Anabiosis
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19 The activity of parotides reduces with age. Activity of what enzyme in saliva will be
reducing?
A Amylase
B Lysozime
C Phosphatase
D Hexokinase
E Maltase
20 Chronic overdosage of glucocorticoids leads to the development of hyperglycemia. What
process of carbohydrate metabolism is responsible for this effect?
A Gluconeogenesis
B Glycogenolysis
C Aerobic glycolisis
D Pentose-phosphate cycle
E Glycogenesis
21 A patient has mental retardation, small height, brachydactyly, mongoloid slant. Analysys
of his karyotype revealed trisomy 21. What chromosomal anomaly is it?
A Down’s disease
B Klinefelter’s syndrome
C Turner’s syndrome
D Trisomy X
E Specific fetopathy
22 Examination of urine in a newborn revealed presence of citrulline and high ammonia
concentration. This baby is most likely to have the disorder of the following substance
production:
A Urea
B Uric acid
C Ammonia
D Creatinine
E Creatine
23 In the mountains some clinically healthy people present with anaemia symptoms. Blood
test can reveal sickle cells. What is the genotype of such people?
A Aa
B aa
C AA
D XcXc
E XCXc
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24 To what total ATP quantity is the full glucose oxidation and its linking with
phosphorylation equivalent?
A 38
B8
C 12
D 52
E 58
25 While examining a blood smear taken form a patient and stained by Romanovsky’s
method a doctor revealed some protozoa and diagnozed the patient with Chagas disease.
What protozoan is the causative agent of this disease?
A Trypanosoma cruzi
B Toxoplasma gondii
C Leishmania donovani
D Leishmania tropica
E Trypanosoma brucei
26 A 10 year old child underwent Mantoux test (with tuberculin). 48 hours later there
apperaed a papule up to 8 mm in diameter on the site of tuberculin injection. Tuberculin
injection caused the following hypersensitivity reaction:
A IV type hypersensitivity reaction
B Arthus reaction
C Seroreaction
D Atopic reaction
E II type hypersensitivity reaction
27 A chiled was diagnosed with acute renal failure. What biochemic saliva indices can
confirm this diagnosis?
A Increased level of rest nitrogen
B Increase of immunoglobuline A
C Reduction of alkaline phosphatase
D Increase of alpha amylase
E Decreased level of phosphate
28 A 28 year old pregnant woman had the enzymes in the cells of amniotic fluid analyzed.
The analysis revealed insufficient activity of beta-glucuronidase. What pathological process
is it?
A Mucopolysaccharidosis
B Glycogenosis
C Collagenosis
D Lipidosis
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E Aglycogenosis
29 A patient with chronic hypoglycemia had adrenaline introduction. After introduction
blood test has not changed essentially. Doctor assumed liver pathology. What liver function
may have been changed?
A Function of glycogen depositing
B Ketogenic function
C Function of cholesterin production
D Glycolytic function
E Excretory function
30 In order to speed up healing of the thermal injury it is required to prescribe a drug that
facilitates epithelization of skin and mucous membranes. What drug is it?
A Retinol acetate
B Tocopherol acetate
C Nicotinic acid
D Ergocalciferol
E Ascorbic acid
31 A child has abnormal formation of tooth enamel and dentin as a result of low
concentration of calcium ions in blood. Such abnormalities might be caused by deficiency of
the following hormone:
A Parathormone
B Thyrocalcitonin
C Thyroxin
D Somatotropic hormone
E Triiodothyronine
32 Microscopical examination of discharges from the gums of a patient ill with paradontosis
revealed some protozoan pear-shaped organisms 6-13 micrometer long. The parasite has
one nucleus and undulating membrane, there are four flagella at the front of its body. What
protozoan were found?
A Trichomonads
B Leishmania
C Amoebae
D Balantidia
E Lamblia
33 A patient has painfulness along big nerve trunks and excessive content of pyruvate in
blood. What vitamin deficit may cause such changes?
ABi
B B2
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C PP
D Pantothenic acid
E Biotin
34 A patient with diabetes mellitus had an insuline injection. It caused loss of consciousness
and convulsions. What was the result of biochemic blood analysis on glucose content?
A 2,5 mmole/l
B 3,3 mmole/l
C 8,0 mmole/l
D 10 mmole/l
E 5,5 mmole/l
35 Examination of a 6 days old infant revealed phenyl pyruvate and phenyl acetate excess
in his urine. What ami-noacid metabolism is disturbed in the child’s organism?
A Phenylalanine
B Tryptophan
C Methionine
D Histidine
E Arginine
36 For assessment of the neutralizing function of liver a patient with chronic hepatitis went
through a test with natrium benzoate load. The excretion of what acid with urine will
characterize the neutralizing function of liver?
A Hippuric acid
B Phenylacetic acid
C Citric acid
D Valeric acid
E Oxalic acid
37 A 42 year old woman diagnosed with diabetes mellitus was admitted the
endocrinological department with complaints of thirst, excessive appetite. What
pathological components are revealed in course of laboratory examination of the patients
urine?
A Glucose, ketone bodies
B Protein, aminoacids
C Bilirubin, urobilin
D Blood
E Protein, creatine
38 A 2 year old child suffers from intestinal dysbacteriosis that lead to the development
hemorrhagic syndrome. The most probable cause of hemorrhage is:
A Vitamin K deficiency
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B Activation of tissue thromboplastin
C Hypovitaminosis PP
D Fibrinogen deficiency
E Hypocalcemia
39 Decreased ratio of adenylic nucleotides ATP/ADP results in intensified glycolysis in
parodentium tissues in hypoxic conditions. What reaction is activated in this case?
A Phosphofructokinase
B Lactate dehydrogenase
C Triosophosphate isomerase
D Aldolase
E Enolase
40 Helminthological examination of patient’s feces revealed oval brown eggs with tuberous
external membrane. Name the type of helminth:
A Ascarid
B Pinworm
C Whipworm
D Dwarf tapeworm
E Broad tapeworm
41 A patient has the folowing changes: disorder of twilight vision, drying out of conjunctiva
and cornea. Such disorders may be caused by deficiency of vitamin:
A Vitamin A
B Vitamin B
C Vitamin C
D Vitamin D
E Vitamin B12
42 Examination of a 10 y.o. child revealed on the alveolar submandibular process a fixed
tumourous mass 1,5 cm in diameter closing premolar crown on the vestibular side. Mucous
membrane of its surface is reddish-brown, it bleeds as a reaction to a slight mechanical
intervention. Biopsy results: the mass consists of small size vessels separated by thin layers
of connective tissue and infiltrated by plasmocytes, mucous membrane is here and there
ulcered. What is the most probable diagnosis?
A Angiomatous form of epulis
B Gingival fibromatosis
C Giant cell form of epulis
D Hypertrophic gingivitis
E Fibrous form of epulis
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43 A non trained man has usually muscular hypoxy after a sprint. What metabolite
accumulates in the muscles as a result of it?
A Lactate
B Ketone bodies
C Glucose 6-phosphate
D Oxaloacetate
E44 A man got poisoned with mushrooms. They contain muscarine that stimulates
muscarinic cholinoreceptors. What symptom is typical for poisoning with inedible
mushrooms?
A Miosis
B Mydriasis
C Bronchi dilation
D Heart rate rise
E Arterial pressure rise
45 Myocyte cytoplasm contains a big number of dissolved metabolites of glucose oxidation.
Name one of them that turns directly into lactate:
A Pyruvate
B Oxaloacetate
C Glycerophosphate
D Glucose 6-phosphate
E Fructose 6-phosphate
46 Roentgenological examination of mandible of a 27 year old man revealed a focus of
osseous tissue destruction. Histological examination revealed a tumour consisting of
odontogenous epithelium cords, immature connective tissue and dysplastic dentin rests.
What tumour is it?
A Dentinoma
B Ameloblastic fibro-odontoma
C Odontoameloblastoma
D Odontogenous fibroma
E Complex odontoma
47 Patient with pigmentary xeroderma are characterized by anamalously high sensivity to
ultraviolet rays that causes skin cancer as a result of enzyme systems incapability to restore
damages of hereditary apparatus of cells. What process abnormality is this pathology
connected with?
A DNA reparation
B Genetic conversion
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C DNA recombination
D Genetic complementation
E DNA reduplication
48 A patient has the sudden decrease of Са2+ content in blood. What hormone secretion
will increase?
A Parathormone
B Somatotropin
C Aldosterone
D Thyrocalcitonin
E Vasopressin
49 A female patient has symptoms of inflammation of urogenital tracts. A smear from the
vaginal mucous membrane contained big unicellular pyriform organisms with a sharp spike
on the back end of their bodies; big nucleus and undulating membrane. What protozoa were
revealed in the smear?
A Trichomonas vaginalis
B Trichomonas hominis
C Trichomonas buccalis
D Trypanosoma gambiense
E Lamblia intestinalis
50 A patient has increased content of uric acid in his blood that is clinically presented by
pain syndrome as a result of urate deposition in the joints. What process does this acid
result from?
A Lysis of purine nucleotides
B Lysis of pyrimidine nucleotides
C Heme catabolism
D Proteolysis
E Reutilization of purine bases
51 Among public catering workers examined by doctors of sanitary-and-epidemiologic
station often occur asymptomatic parasite carriers. This means that a healthy person
carries cysts that infect other people. Such parasitizing is impossible for the following
causative agent:
A Dysenteric amoeba
B Malarial plasmodium
C Intestinal trichomonad
D Dermatotropic leishmania
E Viscerotropic leishmania
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52 The 16th tooth of a patient is missing. X-ray picture shows in the depth of alveolar
process rarefaction of bone and a well-defined cavity that contained the underdeveloped
tooth crown. Microscopical examination revealed that the cavity wall was lined with
stratified squamous epithelium and enclosed within a fibrous capsule. Make a diagnosis:
A Follicular gnathic cyst
B Radicular gnathic cyst
C Cyst of the incisive canal
D Cystic ameloblastoma of jaw
E Primordial gnathic cyst
53 A patient has increased permeability of blood-vessel walls, increased gingival
hemorrhage, small punctate hematomas on his skin, falling of teeth. What disturbance of
vitamun metabolism can account for these symptoms?
A Hypovitaminosis C
B Hypervitaminosis D
C Hypervitaminosis C
D Hypovitaminosis D
E Hypovitaminosis A
54 A patient has liver cirrhosis. Analysis of what substance excreted with urine may
characterize the state of antitoxic liver function?
A Hippuric acid
B Ammonian salts
C Creatinine
D Uric acid
E Amino acids
55 A sportsman needs to improve his sporting results. He was recommended a drug
containing carnitine. What process is activated by this compound in the first place?
A Transport of fatty acids
B Transport of amino acids
C Transport of calcium ions
D Transport of glucose
E Transport of vitamin K
56 A child has disturbed enamel and dentine formation as a result of decreased content of
calcium ions in his blood. What hormone deficiency may cause such changes?
A Thyreocalcitonin
B Somatotropin
C Thyroxin
D Parathormone
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E Triiodothyronine
57 A hospital admitted a patient with complaints about abdominal swelling, diarrhea,
meteorism after consumption of food rich in proteins. It is indicative of disturbed protein
digestion and their intensified decaying. What substance is the product of this process in the
bowels?
A Indole
B Bilirubin
C Cadaverine
D Agmatine
E Putrescine
58 A 38 year old patient takes aspirin and sulfanilamides. After their intake intensified
erythrocyte haemolysis is observed which is caused by deficiency of glucose 6-phosphate
dehydrogenase. This pathology is caused by failure of the following coenzyme:
A NADP - H
B FAD - H2
C Pyridoxal phosphate
D FMN - H2
E Ubiquinone
59 Up to 50% of world population aged above thirty is affected by paradontosis. The
leading part in pathogenesis of this disease is played by:
A Neurodystrophic factor
B Parodontium tissues damaged by kalli-krein
C Parodontium damaged by active cells
D Dental calculus caused by microflora
E Immune damage of tissues
60 A 57 year old patient with diabetes mellitus was developed ketoacedosis. Biochemical
base of this condition is decrease of acetyl-CoA utilization. What cell compound deficit
causes this effect?
A Oxaloacetate
B Glutamate
C 2-oxoglutarate
D Aspartate
E Succinate
61 A patient was taken to the hospital with preliminary diagnosis progressive muscle
distrophy. What substance will be excessively contained in urine and confirm this
diagnosis?
A Creatine
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B Pyruvate
C Carnosine
D Troponine
E Hydroxiproline
62 Microscopical examination of a surgical specimen (an ulcered part of a lip) revealed in
the connective tissue of mucous membrane near the borders and under the floor of the
ulcer some epithelial complexes consisting of atypic multi-stratal epithelium with
accumulations of bright pink concentric formations. What pathology is it?
A Squamous cell keratinous carcinoma
B Squamous cell nonkeratinous carcinoma
C Transitional cell carcinoma
D Basal cell carcinoma
E Papilloma
63 Examination of a child who hasn’t got fresh fruit and vegetables during winter revealed
numerous subcutaneous hemorrhages, gingivitis, carious cavities in teeth. What vitamin
combination should be prescribed in this case?
A Ascorbic acid and rutin
B Thiamine and pyridoxine
C Folic acid and cobalamin
D Riboflavin and nicotinamide
E Calciferol and ascorbic acid
64 Coprological examination of a patient’s feces revealed small operculate eggs. It is known
from the anamnesis that the patient often consumes fish. What fluke parasitizes in the
patient’s organism?
A Cat liver fluke
B Blood fluke
C Lung fluke
D Liver fluke
E Lancet fluke
65 While the examination of patient’s oral cavity the dentist found xerostomia, numerous
erosions. What vitamin deficit caused this effect?
A Vitamin A
B Vitamin K
C Vitamin P
D Vitamin H
E Vitamin PP
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66 A sportsman was recommended to take a preparation with carnitine in order to improve
his achievements. What process is activated by carnitine to the most extent?
A Transporting of fatty acids to the mi-tochondrions
B Synthesis of steroid hormones
C Synthesis of ketone bodies
D Lypide synthesis
E Tissue respiration
67 After implantation of a cardiac valve a young man constantly takes indirect
anticoagulants. His state was complicated by hemorrhage. What substance content has
decreased in blood?
A Prothrombin
B Haptoglobin
C Heparin
D Creatin
E Ceruloplasmin
68 A 28 year old woman consulted a doctor about sterility. Examination revealed
underdeveloped ovaries and uterus, irregular menstrual cycle. Study of sex chromatin
revealed 2 Barr’s bodies in most somatic cells. What chromosome disease is the most
probable in this case?
A Triplo-X syndrome
B Edwards’ syndrome
C Patau’s syndrome
D Klinefelter’s syndrome
E Turner’s syndrome
69 A patient who is ill with scurvy displays disturbed processes of connective tissue
formation that leads to loosening and falling of teeth. Disturbed activity of what enzyme
causes these symptomps?
A Lisilhydroxylase
B Glycosiltransferase
C Elastase
D Procollagenpeptidase of N-terminal peptide
E Procollagenpeptidase of C-terminal peptide
70 During physical exercise people are less sensitive to pain. The reason for it is the
activation of:
A Antinociceptive system
B Nociceptive system
C Thyroid gland functions
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D Sympathoadrenal system
E Adrenal gland functions
71 A one year old child has enlarged head and belly, retarded cutting of teeth, destruction of
enamel structure. What hypovitaminosis causes these changes?
A Hypovitaminosis D
B Hypovitaminosis C
C Hypovitaminosis A
D Hypovitaminosis B 1
E Hypovitaminosis B2
72 A sample taken from the pharynx of a patient with angina was inoculated on the bloodtellurite agar. This resulted in growth of grey, radially striated (in form of rosettes) colonies
up to 4-5 mm in diameter. Microscopically there can be seen gram-positive rods with clubshaped ends arranged in form of spread fingers. What microorganisms are these?
A Corynebacteria diphtheriae
B Clostridium botulinum
C Diphtheroids
D Streptococci
E Streptobacilli
73 A patient with high obesity was recommended to take carnitine as a food additive for
better fat burning. What function is fulfilled by carnitine in the process of fat oxidation?
A Transport of fatty acids from the cytosol to the mitochondria
B Transport of fatty acids from the fat depots to the tissues
C Participation in one of the reactions of beta-oxidation of fatty acids
D Fatty acid activation
E Intracellular lipolysis activation
74 Laboratory of extremely dangerous infections received a sample taken from a patient
with assumed cholera. What express-diagnostics method can confirm this diagnosis?
A Immunofluorescence test
B Complement binding reaction
C Agglutination test
D Precipitation reaction
E Hemagglutination reaction
75 A patient with focal tuberculosis of superior lobe of his right lung takes isoni-azid as a
part of combined therapy. After a time he started complaining of muscular weakness,
decrease of skin sensitivity, sight and movement coordination disorder. What vitamin
preparation will be right for elimination of these occurances?
A Vitamin B6
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B Vitamin A
C Vitamin D
D Vitamin B12
E Vitamin C
76 The first grade pupils went through a medical examination aimed at selection of children
needing tuberculosis revaccination. What test was applied?
A Mantoux test
B Schick test
C Supracutaneous tularin test
D Burne test
E Anthracene test
77 A 15 year old girl was delivered to the hospital with inflammation of vermiform
appendix. Blood analysis revealed signs of anaemia. Her feces contained lemon-shaped
helminthic eggs (50x30 micrometer) with "plugs" on the poles. What type of helminth is it?
A Trichuris
B Hookworm
C Hymenolepis nana
D Echinococcus
E Pinworm
78 A patient has roundish ulcers on his face, inflammation and enlargement of lymph nodes.
These symptoms turned up as a result of mosquito bites. Laboratory examination of
discharge from the ulcers revealed unicellular aflagellar organisms. What is the most
probable diagnosis?
A Dermatotropic leishmaniasis
B Toxoplasmosis
C Scabies
D Trypanosomiasis
E Myasis
79 A patient has deformation of jaw bones. Histological examination revealed there growth
of fibrocellular tumourlike ill-defined tissue with primitive osteogenesis. What disease are
these presentations typical for?
A Fibrous dysplasia
B Ameloblastoma
C Osteosarcoma
D Eosinophilic granuloma
E Parathyroid osteodystrophy
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80 Cytogenetic examination of a patient with dysfunction of the reproductive system
revealed normal karyotype 46,XY in some cells, but most cells have Klinefelter’s syndrome
karyotype - 47,XXY Such phenomenon of cell inhomogeneity is called:
A Mosaicism
B Inversion
C Transposition
D Duplication
E Heterogeneity
81 Examination of an ill child’s blood revealed inherited hyperlipoproteinemia. Genetic
defect of what enzyme synthesis causes this phenomenon?
A Lipoprotein lipase
B Glycosidase
C Proteinase
D Hemsynthetase
E Phenylalanine hydroxylase
82 Dehelmintization of a patient revealed some long fragments of a helminth with
segmented structure. Mature segments were rectangular, 30x12 mm large, closed-type
matrix was in form of a stem with 17-35 lateral branches. Specify this helminth:
A Hookless tapeworm
B Alveococcus
C Echinococcus
D Dwarf tapeworm
E Armed tapeworm
83 Examination of a 30-year-old man mandible revealed in the region of his molar a dense
tumour-like formation that significantly deformed the mandible. The formation wasnt fully
detached from the bone tissue. Microscopical examination of a tissue sampling revealed that
stroma had some cords and follicles with odontogenous cylindric epithelial cells in
peripheria and stellate cells resembling of the enamel organ pulp in the centre. What is the
most likely diagnosis?
A Ameloblastoma
B Primary intraosteal cancer
C Adenomatoid tumour
D Adenocarcinoma
E Osteoclastoma
84 Histological examination of a micro specimen presenting a malignant lung tumour
revealed that the tumor consisted of lymphocyte-like cells forming any structures. Stroma is
mildely marked, there are a lot of mitoses and necroses. What tumour is it?
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A Small cell carcinoma
B Squamous cell nonkeratinous carcinoma
C Fibroma
D Squamous cell keratinous carcinoma
E Adenocarcinoma
85 A 40-year-old male patient had a tumour-like formation 8x7 cm large on his neck. A
surgeon removed it only partially because of close connection with large vessels.
Microscopical examination revealed marked cellular and tissue atypism, lipoblast-type cells
in different stages of maturity, with polymorphism and nuclear hyperchromia, pathological
mitoses, necrosis foci. Specify the histological form of the tumour:
A Liposarcoma
B Lipoma
C Fibroma
D Fibrosarcoma
E Hibernoma
86 In compliance with the clinical presentations a man was prescribed pyridoxalphosphate. What processes are corrected by this preparation?
A Transamination and decarboxylation of amino acids
B Oxidative decarboxilation of keto acids
C Desamination of purine nucleotides
D Synthesis of purine and pyrimidine bases
E Protein synthesis
V 02b91030
Krok \ Dentistry \ Krok 1 \ Bases \ Biochemistry \ 2010
1 Active physical work induces rise of concentration of carbonic acid in blood. This causes
deepening and acceleration of respiration thus reducing concentration of carbonic acid and
hydrogen ions in blood. This maintains the following process:
A Orthobiosis
B Homeostasis
C Ontogenesis
D Anabiosis
E Immunity
2 The first grade pupils went through a medical examination aimed at selection of children
needing tuberculosis revaccination. What test was applied?
A Anthracene test
B Supracutaneous tularin test
C Mantoux test
D Schick test
E Burne test
3 Cyanide poisoning causes immediate death. What is the mechanism of cyanide effect at
the molecular level?
A They inhibit cytochrome B
B They bind substrates of tricarboxylic acid cycle
C They block succinate dehydrogenase
D They inhibit cytochromoxidase
E They inactivate oxygene
4 Periodontitis is accompanied by activation of proteolysis in the periodontium tissues. The
evidence of proteolysis activation is increase of the following component of oral liquid:
A Glucose
B Organic acids
C Amino acids
D Biogenic amines
E Cholesterol
5 A 40-year-old male patient had a tumour-like formation 8x7 cm large on his neck. A
surgeon removed it only partially because of close connection with large vessels.
Microscopical examination revealed marked cellular and tissue atypism, lipoblast-type cells
in different stages of maturity, with polymorphism and nuclear hyperchromia, pathological
mitoses, necrosis foci. Specify the histological form of the tumour:
A Fibroma
V 02b91030
B Liposarcoma
C Fibrosarcoma
D Hibernoma
E Lipoma
6 A child has disturbed processes of ossification and punctate enamel. What microelement
metabolism is disturbed?
A Chromium
B Zinc
C Fluorine
D Iron
E Copper
7 Two weeks after hemotransfusion a patient developed fever. What protozoal disease can
be suspected?
A Leishmaniasis
B Trypanosomiasis
C Amebiasis
D Malaria
E Toxoplasmosis
8 In compliance with the clinical presentations a man was prescribed pyri-doxalphosphate.
What processes are corrected by this preparation?
A Transamination and decarboxylation of amino acids
B Desamination of purine nucleotides
C Oxidative decarboxilation of keto acids
D Protein synthesis
E Synthesis of purine and pyrimidine bases
9 The activity of parotides reduces with age. Activity of what enzyme in saliva will be
reducing?
A Lysozime
B Maltase
C Phosphatase
D Amylase
E Hexokinase
10 Laboratory examination of a child revealed high content of leucine, valine, isoleucine and
their ketoderivates in blood and urine. Urine had the typical smell of maple syrup. This
disease was caused by deficiency of the following enzyme:
A Glucose-6-phosphatase
B Phosphofructokinase
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C Dehydrogenase of branched amino acids
D phosphofructomutase
E Aminotransferase
11 In the mountains some clinically healthy people present with anaemia symptoms. Blood
test can reveal sickle cells. What is the genotype of such people?
A AA
B aa
C XcXc
D XCXc
E Aa
12 Examination of a 10 y.o. child revealed on the alveolar submandibular process a fixed
tumourous mass 1,5 cm in diameter closing premolar crown on the vestibular side. Mucous
membrane of its surface is reddish-brown, it bleeds as a reaction to a slight mechanical
intervention. Biopsy results: the mass consists of small size vessels separated by thin layers
of connective tissue and infiltrated by plasmocytes, mucous membrane is here and there
ulcered. What is the most probable diagnosis?
A Gingival fibromatosis
B Angiomatous form of epulis
C Giant cell form of epulis
D Fibrous form of epulis
E Hypertrophic gingivitis
13 Examination of a 6 days old infant revealed phenyl pyruvate and phenyl acetate excess
in his urine. What ami-noacid metabolism is disturbed in the child’s organism?
A Phenylalanine
B Histidine
C Methionine
D Tryptophan
E Arginine
14 Laboratory of extremely dangerous infections received a sample taken from a patient
with assumed cholera. What express-diagnostics method can confirm this diagnosis?
A Hemagglutination reaction
B Agglutination test
C Precipitation reaction
D Complement binding reaction
E Immunofluorescence test
V 02b91030
15 A man got poisoned with mushrooms. They contain muscarine that stimulates
muscarinic cholinoreceptors. What symptom is typical for poisoning with inedible
mushrooms?
A Heart rate rise
B Arterial pressure rise
C Bronchi dilation
D Mydriasis
E Miosis
16 Helminthological examination of patient’s feces revealed oval brown eggs with tuberous
external membrane. Name the type of helminth:
A Whipworm
B Broad tapeworm
C Dwarf tapeworm
D Ascarid
E Pinworm
17 A girl who was provisionally diagnosed with Turner’s syndrome came to a genetic
consultation. The diagnosis can be specified by means of the following genetic method:
A Genealogical
B Sex chromatin test
C Dermatoglyphics
D Hybridological
E Biochemical
18 While examining a blood smear taken form a patient and stained by Romanovsky’s
method a doctor revealed some protozoa and diagnozed the patient with Chagas disease.
What protozoan is the causative agent of this disease?
A Trypanosoma brucei
B Toxoplasma gondii
C Leishmania tropica
D Trypanosoma cruzi
E Leishmania donovani
19 A 28 year old pregnant woman had the enzymes in the cells of amniotic fluid analyzed.
The analysis revealed insufficient activity of beta-glucuronidase. What pathological process
is it?
A Lipidosis
B Collagenosis
C Mucopolysaccharidosis
D Aglycogenosis
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E Glycogenosis
20 A patient has painfulness along big nerve trunks and excessive content of pyruvate in
blood. What vitamin deficit may cause such changes?
ABi
B Pantothenic acid
C PP
D Biotin
E B2
21 A 15 year old girl was delivered to the hospital with inflammation of vermiform
appendix. Blood analysis revealed signs of anaemia. Her feces contained lemon-shaped
helminthic eggs (50x30 micrometer) with "plugs" on the poles. What type of helminth is it?
A Hymenolepis nana
B Trichuris
C Echinococcus
D Hookworm
E Pinworm
22 A sample taken from the pharynx of a patient with angina was inoculated on the bloodtellurite agar. This resulted in growth of grey, radially striated (in form of rosettes) colonies
up to 4-5 mm in diameter. Microscopically there can be seen gram-positive rods with clubshaped ends arranged in form of spread fingers. What microorganisms are these?
A Diphtheroids
B Corynebacteria diphtheriae
C Streptococci
D Streptobacilli
E Clostridium botulinum
23 A patient was diagnosed with seborrheic dermatitis associated with vitamin H (biotin)
deficiency. The patient has disturbed activity of the following enzyme:
A Alcohol dehydrogenase
B Carbomoyl phosphate synthetase
C Pyruvate decarboxylase
D Amino transferase
E Acetyl-CoA-carboxylase
24 Roentgenological examination of mandible of a 27 year old man revealed a focus of
osseous tissue destruction. Histological examination revealed a tumour consisting of
odontogenous epithelium cords, immature connective tissue and dysplastic dentin rests.
What tumour is it?
A Odontogenous fibroma
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B Ameloblastic fibro-odontoma
C Complex odontoma
D Dentinoma
E Odontoameloblastoma
25 A patient suffering from syphilis was prescribed a drug the action of which based upon
disturbed generation of murein leading to death of the causative agent. What drug is it?
A Benzylpenicillin sodium salt
B Doxycycline hydrochloride
C Azithromycin
D Ciprofloxacin
E Bijochinol
26 A hospital admitted a patient with complaints about abdominal swelling, diarrhea,
meteorism after consumption of food rich in proteins. It is indicative of disturbed protein
digestion and their intensified decaying. What substance is the product of this process in the
bowels?
A Bilirubin
B Putrescine
C Indole
D Agmatine
E Cadaverine
27 A patient has roundish ulcers on his face, inflammation and enlargement of lymph nodes.
These symptoms turned up as a result of mosquito bites. Laboratory examination of
discharge from the ulcers revealed unicellular aflagellar organisms. What is the most
probable diagnosis?
A Toxoplasmosis
B Trypanosomiasis
C Scabies
D Myasis
E Dermatotropic leishmaniasis
28 A patient has increased permeability of blood-vessel walls, increased gingival
hemorrhage, small punctate hematomas on his skin, falling of teeth. What disturbance of
vitamun metabolism can account for these symptoms?
A Hypovitaminosis A
B Hypovitaminosis D
C Hypervitaminosis C
D Hypovitaminosis C
E Hypervitaminosis D
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29 Hepatic disfunctions accompanied by insufficient inflow of bile to the bowels result in
coagulation failure. This phenomenon can be explained by:
A Vitamin K deficiency
B Thrombocytopenia
C Leukopenia
D Iron deficiency
E Erythropenia
30 Analysis of urine from a 24-year-old man revealed the following changes: daily diuresis 10 l, relative density - 1,001, qualitative alterations are absent. A patient complains of
excessive thirst, frequent urination. What is the most likely cause of this disease?
A Vasopressin hyposecretion
B Vasopressin hypersecretion
C Relative insulin insufficiency
D Aldosteron hypersecretion
E Glucocorticoid hypersecretion
31 Dehelmintization of a patient revealed some long fragments of a helminth with
segmented structure. Mature segments were rectangular, 30x12 mm large, closed-type
matrix was in form of a stem with 17-35 lateral branches. Specify this helminth:
A Dwarf tapeworm
B Hookless tapeworm
C Armed tapeworm
D Alveococcus
E Echinococcus
32 Coprological examination of a patient’s feces revealed small operculate eggs. It is known
from the anamnesis that the patient often consumes fish. What fluke parasitizes in the
patient’s organism?
A Liver fluke
B Lancet fluke
C Blood fluke
D Cat liver fluke
E Lung fluke
33 Examination of a child who hasn’t got fresh fruit and vegetables during winter revealed
numerous subcutaneous hemorrhages, gingivitis, carious cavities in teeth. What vitamin
combination should be prescribed in this case?
A Thiamine and pyridoxine
B Calciferol and ascorbic acid
C Folic acid and cobalamin
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D Ascorbic acid and rutin
E Riboflavin and nicotinamide
34 A patient with high obesity was recommended to take carnitine as a food additive for
better fat burning. What function is fulfilled by carnitine in the process of fat oxidation?
A Transport of fatty acids from the fat depots to the tissues
B Intracellular lipolysis activation
C Transport of fatty acids from the cytosol to the mitochondria
D Participation in one of the reactions of beta-oxidation of fatty acids
E Fatty acid activation
35 A one year old child has enlarged head and belly, retarded cutting of teeth, destruction of
enamel structure. What hypovitaminosis causes these changes?
A Hypovitaminosis C
B Hypovitaminosis A
C Hypovitaminosis B 1
D Hypovitaminosis D
E Hypovitaminosis B2
36 A non trained man has usually muscular hypoxy after a sprint. What metabolite
accumulates in the muscles as a result of it?
A Glucose 6-phosphate
B Ketone bodies
C Lactate
D Oxaloacetate
E37 During physical exercise people are less sensitive to pain. The reason for it is the
activation of:
A Nociceptive system
B Antinociceptive system
C Adrenal gland functions
D Sympathoadrenal system
E Thyroid gland functions
38 A patient applied to a doctor complaining about dizziness, memory impairment,
periodical convulsions. It was found out that such changes were caused by a product of
glutamic acid decarboxylation. What product is meant?
A ATP
B GABA
C Thymidine diphosphate
D Tetrahydrofolate
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E Pyridoxalphosphate
39 A patient has liver cirrhosis. Analysis of what substance excreted with urine may
characterize the state of antitoxic liver function?
A Uric acid
B Creatinine
C Hippuric acid
D Amino acids
E Ammonian salts
40 A child has abnormal formation of tooth enamel and dentin as a result of low
concentration of calcium ions in blood. Such abnormalities might be caused by deficiency of
the following hormone:
A Thyroxin
B Triiodothyronine
C Somatotropic hormone
D Thyrocalcitonin
E Parathormone
41 While the examination of patient’s oral cavity the dentist found xerostomia, numerous
erosions. What vitamin deficit caused this effect?
A Vitamin H
B Vitamin P
C Vitamin PP
D Vitamin K
E Vitamin A
42 A 42 year old woman diagnosed with diabetes mellitus was admitted the
endocrinological department with complaints of thirst, excessive appetite. What
pathological components are revealed in course of laboratory examination of the patients
urine?
A Blood
B Glucose, ketone bodies
C Protein, aminoacids
D Bilirubin, urobilin
E Protein, creatine
43 Microscopical examination of a surgical specimen (an ulcered part of a lip) revealed in
the connective tissue of mucous membrane near the borders and under the floor of the
ulcer some epithelial complexes consisting of atypic multi-stratal epithelium with
accumulations of bright pink concentric formations. What pathology is it?
A Squamous cell keratinous carcinoma
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B Basal cell carcinoma
C Papilloma
D Transitional cell carcinoma
E Squamous cell nonkeratinous carcinoma
44 A patient has the folowing changes: disorder of twilight vision, drying out of conjunctiva
and cornea. Such disorders may be caused by deficiency of vitamin:
A Vitamin C
B Vitamin D
C Vitamin B12
D Vitamin B
E Vitamin A
45 A chiled was diagnosed with acute renal failure. What biochemic saliva indices can
confirm this diagnosis?
A Decreased level of phosphate
B Increased level of rest nitrogen
C Reduction of alkaline phosphatase
D Increase of alpha amylase
E Increase of immunoglobuline A
46 For assessment of the neutralizing function of liver a patient with chronic hepatitis went
through a test with natrium benzoate load. The excretion of what acid with urine will
characterize the neutralizing function of liver?
A Valeric acid
B Hippuric acid
C Oxalic acid
D Citric acid
E Phenylacetic acid
47 Microscopical examination of discharges from the gums of a patient ill with paradontosis
revealed some protozoan pear-shaped organisms 6-13 micrometer long. The parasite has
one nucleus and undulating membrane, there are four flagella at the front of its body. What
protozoan were found?
A Amoebae
B Trichomonads
C Balantidia
D Leishmania
E Lamblia
48 A female patient has symptoms of inflammation of urogenital tracts. A smear from the
vaginal mucous membrane contained big unicellular pyriform organisms with a sharp spike
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on the back end of their bodies; big nucleus and undulating membrane. What protozoa were
revealed in the smear?
A Trichomonas buccalis
B Trypanosoma gambiense
C Lamblia intestinalis
D Trichomonas vaginalis
E Trichomonas hominis
49 A 57 year old patient with diabetes mellitus was developed ketoacedosis. Biochemical
base of this condition is decrease of acetyl-CoA utilization. What cell compound deficit
causes this effect?
A 2-oxoglutarate
B Succinate
C Aspartate
D Glutamate
E Oxaloacetate
50 A sportsman needs to improve his sporting results. He was recommended a drug
containing carnitine. What process is activated by this compound in the first place?
A Transport of vitamin K
B Transport of calcium ions
C Transport of amino acids
D Transport of glucose
E Transport of fatty acids
51 Patient with pigmentary xeroderma are characterized by anamalously high sensivity to
ultraviolet rays that causes skin cancer as a result of enzyme systems incapability to restore
damages of hereditary apparatus of cells. What process abnormality is this pathology
connected with?
A DNA reparation
B DNA reduplication
C Genetic complementation
D DNA recombination
E Genetic conversion
52 Among public catering workers examined by doctors of sanitary-and-epidemiologic
station often occur asymptomatic parasite carriers. This means that a healthy person
carries cysts that infect other people. Such parasitizing is impossible for the following
causative agent:
A Malarial plasmodium
B Viscerotropic leishmania
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C Dermatotropic leishmania
D Intestinal trichomonad
E Dysenteric amoeba
53 A sportsman was recommended to take a preparation with carnitine in order to improve
his achievements. What process is activated by carnitine to the most extent?
A Transporting of fatty acids to the mi-tochondrions
B Synthesis of steroid hormones
C Tissue respiration
D Lypide synthesis
E Synthesis of ketone bodies
54 The 16th tooth of a patient is missing. X-ray picture shows in the depth of alveolar
process rarefaction of bone and a well-defined cavity that contained the underdeveloped
tooth crown. Microscopical examination revealed that the cavity wall was lined with
stratified squamous epithelium and enclosed within a fibrous capsule. Make a diagnosis:
A Cystic ameloblastoma of jaw
B Follicular gnathic cyst
C Primordial gnathic cyst
D Radicular gnathic cyst
E Cyst of the incisive canal
55 A 38 year old patient takes aspirin and sulfanilamides. After their intake intensified
erythrocyte haemolysis is observed which is caused by deficiency of glucose 6-phosphate
dehydrogenase. This pathology is caused by failure of the following coenzyme:
A NADP - H
B Ubiquinone
C FAD - H2
D Pyridoxal phosphate
E FMN - H2
56 A patient has the sudden decrease of Са2+ content in blood. What hormone secretion
will increase?
A Somatotropin
B Vasopressin
C Parathormone
D Aldosterone
E Thyrocalcitonin
57 Examination of urine in a newborn revealed presence of citrulline and high ammonia
concentration. This baby is most likely to have the disorder of the following substance
production:
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A Creatinine
B Uric acid
C Creatine
D Ammonia
E Urea
58 Histological examination of a micro specimen presenting a malignant lung tumour
revealed that the tumor consisted of lymphocyte-like cells forming any structures. Stroma is
mildely marked, there are a lot of mitoses and necroses. What tumour is it?
A Squamous cell keratinous carcinoma
B Adenocarcinoma
C Small cell carcinoma
D Squamous cell nonkeratinous carcinoma
E Fibroma
59 A patient has mental retardation, small height, brachydactyly, mongoloid slant. Analysys
of his karyotype revealed trisomy 21. What chromosomal anomaly is it?
A Trisomy X
B Down’s disease
C Turner’s syndrome
D Klinefelter’s syndrome
E Specific fetopathy
60 To what total ATP quantity is the full glucose oxidation and its linking with
phosphorylation equivalent?
A 38
B8
C 58
D 52
E 12
61 A 2 year old child suffers from intestinal dysbacteriosis that lead to the development
hemorrhagic syndrome. The most probable cause of hemorrhage is:
A Vitamin K deficiency
B Hypovitaminosis PP
C Fibrinogen deficiency
D Hypocalcemia
E Activation of tissue thromboplastin
62 A patient who is ill with scurvy displays disturbed processes of connective tissue
formation that leads to loosening and falling of teeth. Disturbed activity of what enzyme
causes these symptomps?
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A Procollagenpeptidase of N-terminal peptide
B Elastase
C Glycosiltransferase
D Procollagenpeptidase of C-terminal peptide
E Lisilhydroxylase
63 A patient has increased content of uric acid in his blood that is clinically presented by
pain syndrome as a result of urate deposition in the joints. What process does this acid
result from?
A Heme catabolism
B Lysis of purine nucleotides
C Lysis of pyrimidine nucleotides
D Proteolysis
E Reutilization of purine bases
64 A child has disturbed enamel and dentine formation as a result of decreased content of
calcium ions in his blood. What hormone deficiency may cause such changes?
A Thyroxin
B Parathormone
C Triiodothyronine
D Thyreocalcitonin
E Somatotropin
65 While on holiday in the countryside a boy found a spider with the following
morphological peculiarities: body length at the rate of 2 cm, round black abdomen with two
rows of red dots on its dorsal surface, four pairs of segmented extremities covered with tiny
black hairs. Identify this arthropod:
A Mite
B Steppe spider (Latrodectus tredeci-mguttatus)
C Tarantula
D Solifugae
E Scorpion
66 Examination of a 30-year-old man mandible revealed in the region of his molar a dense
tumour-like formation that significantly deformed the mandible. The formation wasnt fully
detached from the bone tissue. Microscopical examination of a tissue sampling revealed that
stroma had some cords and follicles with odontogenous cylindric epithelial cells in
peripheria and stellate cells resembling of the enamel organ pulp in the centre. What is the
most likely diagnosis?
A Osteoclastoma
B Adenomatoid tumour
C Ameloblastoma
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D Primary intraosteal cancer
E Adenocarcinoma
67 Roentgenological examination of a patient revealed a cyst enclosing a tooth in its cavity
in the area of the premolar. Microscopical examination revealed that the cyst wall consisted
of connective tissue and was lined with multilayer squamous epithelium. What is the most
probable diagnosis?
A Follicular cyst
B Primordial cyst
C Radicular cyst
D Eosinophilic granuloma
E Epulis
68 Examination of an ill child’s blood revealed inherited hyperlipoproteinemia. Genetic
defect of what enzyme synthesis causes this phenomenon?
A Lipoprotein lipase
B Phenylalanine hydroxylase
C Proteinase
D Glycosidase
E Hemsynthetase
69 Osteolathyrism is characterized by a loss of tensile strength of collagen, which is induced
by a significant decrease in the formation of cross-links in collagen fibrils. The cause for it is
the reduced activity of:
A Prolyl hydroxylase
B Lysyl hydroxylase
C Collagenase
D Lysyl oxidase
E Monoamine oxidase
70 Up to 50% of world population aged above thirty is affected by paradontosis. The
leading part in pathogenesis of this disease is played by:
A Immune damage of tissues
B Parodontium tissues damaged by kalli-krein
C Parodontium damaged by active cells
D Dental calculus caused by microflora
E Neurodystrophic factor
71 A 10 year old child underwent Mantoux test (with tuberculin). 48 hours later there
apperaed a papule up to 8 mm in diameter on the site of tuberculin injection. Tuberculin
injection caused the following hypersensitivity reaction:
A II type hypersensitivity reaction
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B Arthus reaction
C Seroreaction
D Atopic reaction
E IV type hypersensitivity reaction
72 During examination of a 36-year-old woman a dentist revealed a formation in form of a
nodule up to 0,8 cm in diameter, of dark brown-red colour, soft, on a wide base. The
formation was found on the buccal surface of gum in the region of the 2nd molar.
Histological examination revealed that the formation had plenty of sinusoid vessels and a
lot of roundish mononuclear and big multinuclear cells; in some parts accumulations of
hemosiderin granules could be found. What is the most likely diagnosis?
A Giant-cell epulis
B Angiomatous epulis
C Mandibular osteoclastoma
D Ameloblastoma
E Root granuloma
73 A patient with chronic hypoglycemia had adrenaline introduction. After introduction
blood test has not changed essentially. Doctor assumed liver pathology. What liver function
may have been changed?
A Excretory function
B Function of cholesterin production
C Glycolytic function
D Ketogenic function
E Function of glycogen depositing
74 A 28 year old woman consulted a doctor about sterility. Examination revealed
underdeveloped ovaries and uterus, irregular menstrual cycle. Study of sex chromatin
revealed 2 Barr’s bodies in most somatic cells. What chromosome disease is the most
probable in this case?
A Turner’s syndrome
B Patau’s syndrome
C Edwards’ syndrome
D Klinefelter’s syndrome
E Triplo-X syndrome
75 A patient with focal tuberculosis of superior lobe of his right lung takes isoni-azid as a
part of combined therapy. After a time he started complaining of muscular weakness,
decrease of skin sensitivity, sight and movement coordination disorder. What vitamin
preparation will be right for elimination of these occurances?
A Vitamin A
B Vitamin D
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C Vitamin C
D Vitamin B6
E Vitamin B12
76 A dentist was examining oral cavity of a 9 year old child in the buccal surface of gingiva
in the area of the lower canine he revealed a red, soft, node-like formation 1 cm in diameter
that started immediately bleeding when touched. Microscopical examination revealed that
this formation consisted of many small vessels like venules and capillaries separated by thin
layers of connective tissue, with focal infiltration by lymphoid and plasmatic cells. Such
changes are typical for:
A Fibrous epulis
B Papilloma
C Capillary hemangioma
D Radicular granuloma
E Angiomatous epulis
77 After implantation of a cardiac valve a young man constantly takes indirect
anticoagulants. His state was complicated by hemorrhage. What substance content has
decreased in blood?
A Ceruloplasmin
B Heparin
C Prothrombin
D Creatin
E Haptoglobin
78 Decreased ratio of adenylic nucleotides ATP/ADP results in intensified glycolysis in
parodentium tissues in hypoxic conditions. What reaction is activated in this case?
A Lactate dehydrogenase
B Phosphofructokinase
C Enolase
D Triosophosphate isomerase
E Aldolase
79 A patient has deformation of jaw bones. Histological examination revealed there growth
of fibrocellular tumourlike ill-defined tissue with primitive osteogenesis. What disease are
these presentations typical for?
A Ameloblastoma
B Fibrous dysplasia
C Osteosarcoma
D Parathyroid osteodystrophy
E Eosinophilic granuloma
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80 In order to speed up healing of the thermal injury it is required to prescribe a drug that
facilitates epithelization of skin and mucous membranes. What drug is it?
A Ascorbic acid
B Retinol acetate
C Tocopherol acetate
D Nicotinic acid
E Ergocalciferol
81 A patient with diabetes mellitus had an insuline injection. It caused loss of consciousness
and convulsions. What was the result of biochemic blood analysis on glucose content?
A 3,3 mmole/l
B 10 mmole/l
C 2,5 mmole/l
D 5,5 mmole/l
E 8,0 mmole/l
82 A blood smear of a patient who has recently recovered from flu contains 10% of
roundish cells 4,5-7 micrometer large with a big round nucleus and basophi-lically stained
cytoplasm in form of a narrow border around the nucleus. What blood status are they
typical for?
A Lymphocytopenia
B Leukopenia
C Monocytopenia
D Thrombopenia
E Lymphocytosis
83 A patient was taken to the hospital with preliminary diagnosis progressive muscle
distrophy. What substance will be excessively contained in urine and confirm this
diagnosis?
A Troponine
B Hydroxiproline
C Carnosine
D Creatine
E Pyruvate
84 Chronic overdosage of glucocorticoids leads to the development of hyperglycemia. What
process of carbohydrate metabolism is responsible for this effect?
A Aerobic glycolisis
B Glycogenolysis
C Gluconeogenesis
D Pentose-phosphate cycle
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E Glycogenesis
85 Cytogenetic examination of a patient with dysfunction of the reproductive system
revealed normal karyotype 46,XY in some cells, but most cells have Klinefelter’s syndrome
karyotype - 47,XXY Such phenomenon of cell inhomogeneity is called:
A Duplication
B Heterogeneity
C Transposition
D Mosaicism
E Inversion
86 Myocyte cytoplasm contains a big number of dissolved metabolites of glucose oxidation.
Name one of them that turns directly into lactate:
A Fructose 6-phosphate
B Oxaloacetate
C Glucose 6-phosphate
D Pyruvate
E Glycerophosphate
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Keys: 1 B, 2 C, 3 D, 4 C, 5 B, 6 C, 7 D, 8 A, 9 D, 10 C, 11 E, 12 B, 13 A, 14 E, 15 E, 16 D, 17 B,
18 D, 19 C, 20 A, 21 B, 22 B, 23 E, 24 D, 25 A, 26 C, 27 E, 28 D, 29 A, 30 A, 31 B, 32 D, 33 D,
34 C, 35 D, 36 C, 37 B, 38 B, 39 C, 40 E, 41 E, 42 B, 43 A, 44 E, 45 B, 46 B, 47 B, 48 D, 49 E,
50 E, 51 A, 52 E, 53 A, 54 B, 55 A, 56 C, 57 E, 58 C, 59 B, 60 A, 61 A, 62 E, 63 B, 64 D, 65 B,
66 C, 67 A, 68 A, 69 D, 70 E, 71 E, 72 A, 73 E, 74 E, 75 D, 76 E, 77 C, 78 B, 79 B, 80 B, 81 C,
82 A, 83 D, 84 C, 85 D, 86 D,
Ministry of Public Health of Ukraine
O. O. BOGOMOLETS NATIONAL MEDICAL UNIVERSITY
Department of Bioorganic and Biological Chemistry
LIST OF TEST QUESTIONS
for preparation of Content module № 2
"General regularities of metabolism of
carbohydrates, lipids, amino acids"
FOR STUDENTS OF THE 2ST YEAR OF STUDY
OF MEDICAL and STOMATOLOGICAL FACULTIES
Kyiv-2018
Enzymes and coenzymes. Regulation of metabolism
1. A denaturation of proteins can befound in
some substances. Specify thesubstance that is
used for the incompletedenaturation of
hemoglobin:
A. Urea
B. Toluene
C. Sulfuric acid
D. Nitric acid
E. Sodium hydroxide
2. Some proteins of saliva have aprotective
function. Which of themprotects the oral
mucosa from themechanical damage?
A. Mucin
B. Lysozyme
C. Catalase
D. Peroxidase
E. Renin
3. For the study of serum proteinsvarious
physical and physicochemicalmethods can be
used. In particular, serumalbumins and
globulins can be separatedby this method:
A. Electrophoresis
B. Polarography
C. Dialysis
D. Spectrography
E. Refractometry
4. Electrophoretic study of blood serumof a
patient with pneumonia revealed anincrease in
one of the protein fractions.What fraction is it?
A. γ-globulins
B. Albumins
C. α1-globulins
D. α2-globulins
E. β-globulins
5. A woman, 36 years after surgery, received
intravenous injection of a concentrated albumin
solution. This resulted in the increased
movement of water in the following direction:
A. From intercellular fluid to capillaries
B. From the intercellular fluid to the cells
C. From cells to the intercellular fluid
D. From capillaries to intercellular fluid
E. There will be no change in the flow of water
6.
Cationic
glycoproteins
are
the
majorcomponents of parotid saliva. What
aminoacids
are
responsible
for
their
positivecharge?
A. Lysine, arginine, histidine
B. Aspartate, glutamate, glycine
C. Aspartate, arginine, glutamate
D. Glutamate, valine, leucine
E. Cysteine, glycine, proline
7. Parodontitis is accompanied byactivation of
proteolysis in parodentiumtissues. Increase of
what oral fluid’scomponent is the evidence of
proteolysisactivation?
A. Aminoacids
B. Organic acids
C. Glucose
D. Biogenic amines
E. Cholesterol
8. The student used conserved donor blood to
determine the time of its clotting. However, any
positive result had not been obtained. The
reason for this is the lack in this sample of
blood:
A. Ionized calcium
B. Factor Hageman
C. Thromboplastin
D. Fibrinogen
E. Vitamin K
9. Long-term effects on the body of toxic
substances led to a significant reduction in
protein synthesis in hepatocytes. What
organelles suffered from intoxication most?
A. Granular endoplasmic reticulum
B. Mitochondria
C. Microtubules
D. Lysosomes
E. The Golgi’s complex
10. Children with kwashiorkor, along with other
signs, violations of the process of dentition were
revealed. At the heart of this phenomenon is the
insufficient receipt into the body:
A. Lipids
B. Proteins
C. Carbohydrates
D. Vitamin C
E. Vitamin B1
11. In the daily diet of an adult healthy person,
there must be fats, proteins, carbohydrates,
vitamins, mineral salts and water. Specify the
daily amount of protein (g) that provides normal
life activity of the body:
A. 100-120
B. 50-60
C. 10-20
D. 70-80
E. 40-50
12. A patient with a hepatic failure has been
examined for the electrophoretic spectrum of
blood serum proteins. Which of the physicochemical properties of the protein molecules lie
in the basis of this method?
A. Presence of a charge
B. Hydrophilicity
C. Ability to swell
D. Optical activity
E. Non-dialysable
13. The surgeon used a 70% solution of ethyl
alcohol to disinfect the hands before surgery.
What is the main mechanism of antiseptic action
of the drug on microorganisms?
A. Denaturation of protoplasmic proteins.
B. Interaction with amino groups of
protoplasmic proteins.
C. Interaction with hydroxyl groups of enzymes.
D. Blockade of sulfhydryl groups of enzyme
systems.
E. Oxidation of organic components of
protoplasm.
14. What substance makes saliva viscousand
mucous, has protective function, protects
mucous membrane of oralcavity from
mechanical damage?
A. Mucin
B. Glucose
C. Kallikrein
D. Amylase
E. Lysozyme
15. Only one factor can affect the charge of
amino acid radicals in the active center of the
enzyme. Name of this factor is:
A. pH
B. Pressure
C. Temperature
D. The presence of a competitive inhibitor
E. Excessproduct
16. The conjugated protein necessarily contains
special component as a nonprotein part. Choose
the substance that can’t carry out this function:
A. HNO3
B. АТP
C. Thiamine pyrophosphate
D. AMP
E. Glucose
17. 60-year-old man went to the doctor after the
appearance of pain in the chest. In blood serum
showed a significant increase in the activity of
enzymes: CPK and its MB isoform, aspartate
aminotransferase. On the development of the
pathological process in which tissue do these
changes indicate?
A. Heart muscle
B. Lungs
C. Skeletal muscle
D. Liver
E. Smooth muscles
18. There are several groups of molecular
mechanisms that are important in the
pathogenesis of cell damage, which contributes
to the development of pathology. What
processes provide protein damage mechanisms?
A. Inhibition of enzymes
B. Peroxide oxidation of lipids
C. Acidosis
D. Osmotic stretching of membranes
E. Activation of phospholipases
19. It is known that the activity of parotid
salivary glands susceptible to age-related
changes. The activity of which enzyme will
decrease sharply in saliva?
A. Amylase.
B. Hexokinase.
C. Renin.
D. Maltase.
E. Phosphatase.
20. For biochemical diagnostics of cardiac
infarction it is necessary to determine activity of
a number of enzymes and their izoenzymes in
the blood. What enzyme assay is considered to
be optimal for confirming or ruling out cardiac
infarction at the early stage, after the patient
develops thoracic pain?
A. Creatine kinase MB isoenzyme
B. Creatine kinase MM isoenzyme
C. LDH1 isoenzyme
D. LDH5 isoenzyme
E.
Cytoplasmic
isoenzyme
of
aspartateaminotransferase
21. For the treatment of some infectious
diseases caused by bacteria, sulfonamides drugs
are used. What is the mechanism of action of
these drugs?
A. They are antivitamins of p-aminobenzoic
acid.
B. They are alosteric enzyme inhibitors.
C. They are alosteric enzyme activators.
D. They are participate in redox processes.
E. They are inhibit folic acid absorption.
22. In the intensive care unit entered a man 47years old with a diagnosis of myocardial
infarction. Which of the lactate dehydrogenase
(LDH) fractions will prevail in the blood serum
during the first two days?
A. LDH 1
B. LDH 2
C. LDH 3
D. LDH 4
E. LDH 5
23. Researchers isolated 5 isoenzymicforms of
lactate dehydrogenase from thehuman blood
serum and studied theirproperties. What
property indicates thattheisoenzymic forms
were isolated fromthe same enzyme?
A. Catalyzation of the same reaction
B. The same molecular weight
C. The same physicochemical properties
D. Tissue localization
E. The same electrophoretic mobility
24. One of the means of regulating enzyme
activity in a human body is the covalent
modification. Glycogen phosphorylase and
glycogen synthetase activity is regulated by the
following type of covalent modification:
A. Phosphorylation-dephosphorylation
B. ADP-ribosylation
C. Methylation
D. Hydrolysis
E. Sulfonation
25. When the patient's blood analysis revealed a
significant increase in the activity of MB-forms
CPK (CPK) and lactate dehydrogenase-1. What
pathology can be assumed?
A. Myocardial infarction
B. Hepatitis
C. Rheumatism
D. Pancreatitis
E. Cholecystitis
26. An increase in the activity of LDH1, LDH2,
AsAT, and creatine kinase was detected in the
patient's blood. In which organ of the patient is
the most likely development of the pathological
process?
A. Heart
B. Pancreas
C. Liver
D. Kidneys
E. Skeletal muscle
27. An increase in the activity of LDH 4,5,
AlAT, carbamoyl ornithine transferase was
detected in the patient's blood. In what organ
can assume development of the pathological
process?
A. Cardiac muscle (possible myocardial
infarction)
B. Liver (possible hepatitis)
C. Skeletal muscle
D. Kidneys
E. Connective tissue
28. Albumin concentration in the patient’s blood
is 2.8 g/l, increased concentration of lactate
dehydrogenase 5 (LDH5). On the disease of
what organ does that indicate?
A. Liver
B. Kidney
C. Heart
D. Lung
E. Spleen
29. There is increased activity of AST, LDH1,
LDH2, and CPK in the patient’s blood.
Pathological process most likely occurs in the:
A. Heart
B. Skeletal muscles
C. Kidneys
D. Liver
E. Adrenal glands
30. In the patient's blood plasma the activity of
LDH1 and LDH2 isoenzymes increased. About
which pathology of the body does this mean?
A. Myocardium
B. Liver
C. Kidney
D. Brain
E. Skeletal muscle
31. In a patient revealed increased the activity of
AsAT, LDH1,2, and creatine phosphokinase. In
which organ (s) is the most likely development
of the pathological process?
A. Heart muscle
B. Skeletal muscle
C. Kidney and adrenal gland
D. Connective tissue
E. Liver and kidneys
32. 49-year-old patient, a driver by profession,
complains of unbearable compressive pain
behind the sternum, "giving away" to the neck.
Pain occurred 2 hours ago. Objectively: the
condition is severe, pallor, heart sounds are
weakened. Laboratory studies have shown high
activity of creatine kinase and LDH1. What
diseases are characterized by such symptoms?
A. Acute myocardial infarction
B. Acute pancreatitis
C. Stenocardia
D. Cholelithiasis
E. Diabetes
33. Six hours after myocardial infarction, the
lactate dehydrogenase activity in the patient
increased in the blood. What isoenzymes should
be expected in this case?
A. LDH 1
B. LDH 2
C. LDH 3
D. LDH 4
E. LDH 5
34. The high level of lactate dehydrogenase
(LDH) isozymes concentration showed the
increase of LDH-1 and LDH-2 in a patient’s
blood plasma. Point out the most probable
diagnosis:
A. Myocardial infarction
B. Skeletal muscle dystrophy
C. Diabetes mellitus
D. Viral hepatitis
E. Acute pancreatitis
35. Succinate dehydrogenase catalyses the
dehydrogenation of succinate. Malonic acid
HOOC − CH2− COOH is used to interrupt the
action of this enzyme. Choose the inhibition
type:
A. Competitive
B. Allosteric
C. Non-competitive
D. Limited proteolysis
E. Dephosphorylation
Water-soluble vitamins
1. Examination of a patient revealed dermatitis,
diarrhea, dementia. What vitamin deficiency is
the cause of this condition?
A. Nicotinamide
B. Ascorbic acid
C. Folic acid
D. Biotin
E. Rutin
2. A patient consulted a doctor about symmetric
dermatitis of open skin areas. It was found out
that the patient lived mostly on cereals and ate
too little meat, milk and eggs. What vitamin
deficiency is the most evident?
A. Nicotinamide
B. Calciferol
C. Folic acid
D. Biotin
E. Tocopherol
3. A 3 year old child with symptoms of
stomatitis, gingivitis and dermatitis of open skin
areas was delivered to a hospital. Examination
revealed inherited disturbance of neutral amino
acid transporting in the bowels. These
symptoms were caused by the deficiency of the
following vitamin:
A. Niacin
B. Pantothenic acid
C. Vitamin A
D. Cobalamin
E. Biotin
4. A patient is ill with dermatitis, diarrhea,
dementia. During history taking it was revealed
that the main food stuff of the patient was
maize. These disturbances are caused by
deficiency of the following vitamin:
A. PP
B. B1
C. B2
D. B9
E. B8
5. A 50-year-old man addressed a hospital
withcomplaints of memory disorders, painful
sensations along the nerve trunks, decreased
mental ability, circulatory disorders and
dyspepsia. Anamnesis states excessive alcohol
consumption. What vitamin deficiency can
result in such signs?
A. Thiamine
B. Niacin
C. Retinol
D. Calciferol
E. Riboflavin
6. A patient has painfulness along bignerve
trunks and excessive content of pyruvate in
blood. What vitamin deficit may cause such
changes?
A. В1
B. Biotin
C. РР
D. Pantothenic acid
E. В2
7. A woman who has been keeping to a cleanrice diet for a long time was diagnosed with
polyneuritis (beri-beri). What vitamin deficit
results in development of this disease?
A. Thiamine
B. Ascorbic acid
C. Pyridoxine
D. Folic acid
E. Riboflavin
8. A patient has an increased pyruvate
concentration in blood. A large amount of it is
excreted with the urine. What vitamin is lacking
in this patient?
A. B1
B. E
C. B3
D. B6
E. B2
9. A patient, who has been subsisting
exclusively on polished rice, has developed
polyneuritis due to thiamine deficiency. What
substance is an indicator of such avitaminosis,
when it is excreted with urine?
A. Pyruvic acid
B. Malate
C. Methylmalonic acid
D. Uric acid
E. Phenyl pyruvate
10. Vitamin B1 deficiency causes disturbance of
oxidative decarboxylation of α-ketoglutaric
acid. This leads to the impaired synthesis of the
following coenzyme:
A. Thiamine pyrophosphate
B. Nicotinamide adenine dinucleotide
C. Flavine adenine dinucleotide
D. Lipoic acid
E. Coenzyme A
11. To improve the trophism of the heart
muscle, the patient is prescribed a drug that
includes cocarboxylase (thiamine diphosphate) a coenzyme form of the vitamin:
A. B1
B. B2
C. B5
D. B6
E. B12
12. Pyruvic acid as an intermediate metabolite
of carbohydrate, lipid and amino acid
metabolism
can
undergo
oxidative
decarboxylation. The cause of this process is the
lack of the following nutrient in the diet:
A. Thiamin
B. Pyridoxine
C. Ascorbic acid
D. Citrine
E. Pangamic acid
13. A patient with chronic alcoholism has
symptoms of polyneuritis and cardiac
insufficiensy. What vitamin preparation should
be prescribed to this patient?
A. Thiamine
B. Ergocalciferol
C. Retinol
D. Rutin
E. Phylloquinone
14. A 36-year-old female patient has a history of
B2-hypovitaminosis. The most likely cause of
specific symptoms (epithelial, mucosal,
cutaneous, corneal lesions) is the deficiency of:
A. Flavin coenzymes
B. Cytochrome A1
C. Cytochrome oxidase
D. Cytochrome B
E. Cytochrome C
15. Malaria is treated with structural analogs of
vitamin B2 (riboflavin). These drugs disrupt the
synthesis of the following enzymes in
plasmodium:
A. FAD-dependent dehydrogenase
B. NAD-dependent dehydrogenase
C. Peptidase
D. Cytochrome oxidase
E. Aminotransferase
16. In case of enterobiasis acrihine – the
structural analogue of vitamin B2 – is
administered. The synthesis disorder of which
enzymes does this medicine cause in
microorganisms?
A. FAD-dependent dehydrogenases
B. Cytochromeoxidases
C. Peptidases
D. NAD-depended dehydrogenases
E. Aminotransferases
17. The preparation comlex for periodontitis
treatment includes the medicine from the group
of water soluble vitamins, bioflavonide
derivative, which is prescribed together with
ascorbic acid. This preparation has antioxidative properties, decreases gingival
hemorrhage. What preparation is meant?
A. Rutin
B. Calcium pantothenate
C. Calcium panganate
D. Cyanocobalamin
E. Folic acid
18. Examination of a child who hasn’t got fresh
fruit and vegetables during winter revealed
numerous
subcutaneous
hemorrhages,
gingivitis, carious cavities in teeth. What
vitamin combination should be prescribed in
this case?
A. Ascorbic acid and rutin
B. Thiamine and pyridoxine
C. Folic acid and cobalamin
D. Riboflavin and nicotinamide
E. Calciferol and ascorbic acid
19. Examination of a patient with frequent
hemorrhages from internals and mucous
membranes revealed proline and lysine being a
part of collagene fibers. What vitamin absence
caused disturbance of their hydroxylation?
A. Vitamin С
B. Vitamin K
C. Vitamin A
D. Thiamine
E. Vitamin Е
20. In spring a patient experiences petechial
haemorrhages, loosening of teeth, high liability
to colds. A doctor suspects hypovitaminosis C.
In this respect loosening of teeth can be
explained by:
A. Structural failure of collagen in the
periodontal ligaments
B. Structural change of glycosaminoglycans
C. Increased permeability of periodont
membranes
D. Mechanical damage of teeth
E. Disturbed oxidation-reduction process in the
periodont
21. Most of the members of the expedition of
Magellan to America died from vitamin
deficiency. This disease was manifested by
general weakness, subcutaneous hemorrhage,
tooth loss, bleeding from the gums. As the name
of this vitamin deficiency?
A. scurvy (scurvy)
B. Pellagra
C. Rickets
D. Polyneuritis (beriberi)
E. Biermer’s anemia
22. A 10-year-old girl has a history of repeated
acute respiratory viral infection. After
recovering she presents with multiple petechial
hemorrhages on the sites of friction from
clothing rubbing the skin. What kind of
hypovitaminosis has this girl?
A. C
B. B6
C. B1
D. A
E. B2
23. The patient has an increase in the
permeability of the walls of blood vessels with
the development of increased bleeding and the
appearance of small point hemorrhages on the
skin, tooth loss. How does the vitamin exchange
disorder explain these symptoms?
A. Hypovitaminosis C
B. Hypervitaminosis D
C. Hypervitaminosis C
D. Hypovitaminosis D
E. Hypovitaminosis A
24. A 20-year-old male patient complains of
general weakness, rapid fatigability, irritability,
decreased performance, bleeding gums,
petechiae on the skin. What vitamin deficiency
may be a cause of these changes?
A. Ascorbic acid
B. Riboflavin
C. Thiamine
D. Retinol
E. Folic acid
25. A patient diagnosed with focal tuberculosis
of the upper lobe of the right lung had been
taking isoniazid as a part of combination
therapy. After some time, the patient reported of
muscle weakness, decreased skin sensitivity,
blurred vision, impaired motor coordination.
Which vitamin preparation should be used to
address these phenomena?
A. Vitamin B6
B. Vitamin A
C. Vitamin D
D. Vitamin B12
E. Vitamin C
26. A 40-year-old male patient with pulmonary
tuberculosis was administered isoniazid. What
vitamin deficiency can develop as a result of
taking this drug for a long time?
A. Pyridoxine.
B. Cobalamin.
C. Biotin.
D. Thiamine.
E. Folic acid.
27. What vitamin is a component of glutamic
acid decarboxylase, participates in the
production of GABA, and its deficiency is
manifested by seizures?
A. Pyridoxine
B. Cobalamin
C. Tocopherol
D. Folic acid
E. Ascorbic acid
28. A 9-month-old child feeds on artificial
mixtures that are not balanced in terms of
vitamin B6 content. A child has pellagra similar
dermatitis,
convulsions,
anemia.
The
development of seizures may be associated with
impaired formation:
A. GABA
B. Histamine
C. Serotonin
D. DOPA
E. Dopamine
29. The infant has epileptiform convulsions
caused by vitamin B6 deficiency. This is due to
a decrease in the nerve tissue of the inhibitory
mediator - γ-aminobutyric acid. What enzyme
activity is reduced due to this?
A. Glutamate decarboxylase
B. Alanine aminotransferase
C. Glutamate dehydrogenase
D. Pyridoxal kinase
E. Glutamate synthetase
30. In compliance with the clinical presentations
a man was prescribed pyridoxalphosphate. What
processes are corrected by this preparation?
A. Transamination and decarboxylation of
amino acids
B. Oxidative decarboxilation of keto acids
C. Desamination of purine nucleotides
D. Synthesis of purine and pyrimidine bases
E. Protein synthesis
31. In the clinical practice for the treatment of
tuberculosis drug isoniazid used - antivitamin
which is able to penetrate into the tubercle
bacillus. The tuberculostatic effect is due to the
violation of replication processes, redox
reactions, due to the formation of not real
coenzyme from:
A. NAD+
B. FAD
C. FMN
D. TDP
E. KoQ
32. Reactions of intermolecular transport of
one-carbon radicals are necessary for the
synthesis of proteins and nucleic acids. From
which of the following vitamins does the
coenzyme form necessary for the above
reactions?
A. Folic acid
B. Thiamine
C. Pantothenic acid
D. Ascorbic acid
E. Riboflavin
33. In the synthesis of purine nucleotides
involved some amino acids, derivatives of
vitamins, phosphorus esters of ribose. What
coenzyme form of vitamin provides one-carbon
fragments for this synthesis?
A. Folic acid
B. Pantothenic acid
C. Nicotinic acid
D. Riboflavin
E. Pyridoxine
34. In the normal course of a replication process
need thymidylic nucleotides, the synthesis of
which occurs with the participation of
thymidylate synthetase, are used as a coenzyme:
A. Methylenetetrahydrofolate
B. Carboxybiotin
C. Thiamine diphosphate
D. Pyridoxal phosphate
E. Nicotinamide adenine dinucleotide
35. Pterin derivatives (aminopterin and
methotrexate) are the inhibitors of dihydrofolate
reductase, so that they inhibit the regeneration
of tetrahydrofolic acid from dihydrofolate.
These drugs inhibit the intermolecular tranfer of
monocarbon groups, thus suppressing the
synthesis of the following polymer:
A. DNA
B. Protein
C. Homopolysaccharides
D. Gangliosides
E. Glycosaminoglycans
36. After an extended treatment with
sulfanamides a patient has developed
macrocyticanemia. Production of active forms
of the following vitamin is disrupted in such a
condition:
A. Folic acid
B. Thiamine
C. Riboflavin
D. Pyridoxine
E. Cyanocobalamin
37. It is known that part of carbon dioxide is
used in the body in the biosynthesis of fatty
acids, urea, gluconeogenesis, etc. Which
vitamin forms the CO2-transporting form for
these reactions?
A. Biotin
B. thymine
C. Riboflavin
D. Nicotinamide
E. Retinol
38. A patient was diagnosed with seborrheic
dermatitis associated with vitamin H (biotin)
deficiency. The patient has disturbed activity of
the following enzyme:
A. Acetyl-CoA-carboxylase
B. Pyruvate decarboxylase
C. Alcohol dehydrogenase
D. Amino transferase
E. Carbomoyl phosphate synthetase
39. The patient was diagnosed megaloblastic
anemia. Specify a vitamin deficiency which can
lead to the development of this disease.
A. Cyanocobalamin.
B. Rutin.
C. Nicotinamide.
D. Thiamine.
E. Cholecalciferol.
40. 47. A patient 43 years old with chronic
atrophic
gastritis
and
hyperchromic
megaloblastic anemia increased methylmalonic
acid excretion in the urine. The lack of which
vitamin caused the occurrence of this symptom
complex?
A. В12
B. В2
C. В3
D. В5
E. В6
41. After removing 2/3 of the stomach in the
patient’s blood, the hemoglobin content
decreased, the number of red blood cells
increased, the size of these blood cells
increased. What vitamin deficiency leads to
such changes in the blood?
A. B12
B. C
C. P
D. B6
E. PP
42. In examining the oral cavity of the patient,
the dentist paid attention to the presence of an
inflammatory and dystrophic process in the
mucous membrane (Hunter’s glossitis, atrophic
stomatitis). A blood test revealed hyperchromic
anemia. What factor is the cause of this disease?
A. Hypovitaminosis B12
B. Hypovitaminosis B1
C. Hypovitaminosis B6
D. Increasing pH of the gastric juice
E. Hypovitaminosis A
43. A year after subtotal stomach resection on
account of ulcer of lesser curvature the
following blood changes were revealed: anemia,
leukocytopenia and thrombocytopenia, color
index - 1,3, megaloblasts and megalocytes.
What factor deficiency caused the development
of thos pathology?
A. Castle’s factor
B. Hydrochloride acid
C. Mucin
D. Pepsin
E. Gastrin
44. In the patient with complaints about pain in
the stomach found a decrease in its secretory
function, which is accompanied by anemia.
What substance deficiency causes the
development of B12 hypovitaminosis in a patient
and the appearance of anemia?
A. Castle factor
B. Thiamine
C. Biotin
D. Pyridoxine
E. Calciferol
45. After the surgical removal of part of the
stomach of the patient disrupted the absorption
of vitamin B12, it is excreted in the feces.
Anemia has developed. What factor is necessary
for the absorption of this vitamin?
A. Gastromukoprotein
B. Gastrin
C. Hydrochloric acid
D. Pepsin
E. Folic acid
46. In a 65-year-old patient with long-lasting
complaints characteristic of chronic gastritis,
megalocytes were found in peripheral blood and
megaloblastic erythropoiesis in the bone
marrow. What is the most likely diagnosis?
A. B12-folic deficiency anemia
B. Aplastic anemia
C. Hypoplastic anemia
D. Hemolytic anemia
E. Iron deficiency anemia
47. A 13-year-old girl has been prescribed a
certain drug for treatment of megaloblastic
anemia. This drugstimulates a transfer from
megaloblastic haemopoiesis to normoblastic,
participates in synthesis of purine and
pyrimidine bases, activates proteine and
methionine synthesis.What drug does the patient
take?
A. Cyanocobalamin
B. Erythropoietin
C. Haemostimulinum
D. Ferricsulfate
E. Rosehiptea
48. A 50-year-old patient has been examined by
a dentist and found to have crimson smooth
tongue. Blood analysis revealed a decrease in
RBC level and hemoglobin concentration,
colour index of 1,3, symptoms of megaloblastic
hematopoiesis, degenerative changes in
WBCs.What blood disorder was found in this
patient?
A. B12-folic-acid-deficiency anemia
B. Iron deficiency anemia
C. Myeloid leukemia
D. Aplastic anemia
E. Hemolytic anemia
49. Coenzym A participates in numerous
important metabolic reactions. It is aderivative
of the following vitamin:
A. Pantothenic acid
B. Thiamine
C. Niacin
D. Calciferol
E. Ubiquinone
50. A doctor recommends a patient with
duodenal ulcer to drink cabbage and potato juice
after the therapy course. Which substances
contained in these vegetables help to heal and
prevent the ulcers?
A. Vitamin U
B. Pantothenic acid
C. Vitamin C
D. Vitamin B1
E. Vitamin K
Fat -soluble vitamins
1. A 2 year old child suffers fromintestinal
dysbacteriosis that lead to thedevelopment
hemorrhagic syndrome. Themost probable cause
of hemorrhage is:
A. Vitamin K deficiency
B. Activation of tissue thromboplastin
C. Hypovitaminosis PP
D. Fibrinogen deficiency
E. Hypocalcemia
blood - decrease in activity II, VII, X blood
clotting factors; lengthening of blood clotting
time. What vitamin deficiency are caused by
these changes?
A. Vitamin K
B. Vitamin A
C. Vitamin C
D. Vitamin D
E. Vitamin E
2. Surgery in patients with obstructive jaundice
and malabsorption in the intestine complicated
by bleeding. What vitamin insufficiency has led
to this?
A. Vitamin K
B. Vitamin B12
C. Vitamin C
D. Vitamin B6
E. Folic acid
7. Plasma coagulation factors are subject to
posttranslational
modification
with
the
participation of vitamin K. As a cofactor, it is
needed in the γ-carboxylation enzyme system of
protein coagulation factors due to an increase in
the affinity of their molecules by calcium ions.
What amino acid is carboxylated in these
proteins?
A. Glutamine
B. Valin
C. Serine
D. Phenylalanine
E. Arginine
3. Hepatic disfunctions accompaniedby
insufficient in flow of bile to the bowels result
in coagulation failure. This phenomenon can be
explained by:
A. Vitamin K deficiency
B. Leucopenia
C. Thrombocytopenia
D. Erythropenia
E. Iron deficiency
4. The function of protein synthesis in the liver
due to a lack of vitamin K is reduced in a young
man of 16 years after suffering the disease. This
can lead to a violation of:
A. Blood coagulation
B. Erythrocyte sedimentation rate
C. Education anticoagulants
D. Formation of erythropoietin
E. Blood pH
5. In the patient observed hemorrhage, reduced
the concentration of prothrombin in the blood.
What vitamin deficiency led to a violation of the
synthesis of this blood clotting factor?
A. K
B. A
C. D
D. C
E. E
6. In the patient 37 years against the background
of long-term use of antibiotics observed
increasing bleeding after small injuries. In the
8. A 49-year-old man is observed in the clinic
with a significant increase in blood clotting
time, gastrointestinal bleeding, subcutaneous
hemorrhage. What vitamin deficiency can
explain these symptoms?
A. K
B. B1
C. PP
D. H
E. E
9. As a result of post-translational modifications
of certain proteins involved in blood
coagulation, in particular prothrombin, they
acquire the ability to bind calcium. In this
process participate vitamin
A. K
B. C
C. A
D. B1
E. B2
10. To prevent postoperative bleeding, a 6-yearold child is recommended to take vikasol, which
is a synthetic analogue of vitamin K. Specify
which post-translational changes of blood
clotting factors are activated under the influence
of vikasol?
A. Carboxylation of glutamic acid
B. Phosphorylation of serine radicals
C. Partial proteolysis
D. Polymerization
E. Glycosylation
11. In patients with the biliary tract obstruction
the blood coagulation isinhibited; the patients
have frequent haemorrhages caused by the
subnormal assimilation of the following
vitamin:
A. К
B. А
C. D
D. E
E. C
12. A few days before an operation apatient
should be administered vitamin K or its
synthetic analogue Vicasol. Vitamin K takes
part in the following posttranslational
modification of the II, VII, IX, X blood clotting
factors:
A. Carboxylation
B. Decarboxylation
C. Deamination
D. Transamination
E. Glycosylation
13. A patient, who has been suffering for a long
time from intestine disbacteriosis, has increased
hemorrhaging
caused
by
disruptionof
posttranslational modification of bloodcoagulation factors II, VII, IХ, and Х in the
liver. What vitamin deficiency is thecause of
this condition?
A. К
B. B12
C. B9
D. С
E. Р
14. 10 month old child has high excitability,
sleep disturbance, amyotonia, retarded dentition,
teeth erupt withinadequate enamel calcification.
Thesechanges are caused by deficiency of
thefollowing vitamin:
A. Cholecalciferol
B. Riboflavin
C. Thiamine
D. Retinol
E. Nicotinamide
15. In the patient with renal insufficiency has
developed osteodystrophy, accompanied by
intense bone demineralization. Violation of the
formation of which vitamin active form was the
cause of this complication?
A. Calciferol
B. Retinol
C. Thiamine
D. Naphthoquinone
E. Riboflavin
16. The child has a delayed teething, their
wrong
arrangement,
upon
examination
noticeable dryness of the oral cavity, in the
corners of the mouth there are cracks with
suppuration. With the lack of the vitamin this
condition may be related?
A. Vitamin D.
B. Vitamin C.
C. Vitamin E.
D. Vitamin K.
E. Vitamin A.
17. In a child of the first year of life is observed
an increase in the size of the head and abdomen,
late teething, violation of the enamel structure.
The consequence of vitamin deficiencies are
these changes?
A. Hypovitaminosis D
B. Hypovitaminosis C
C. Hypovitaminosis A
D. Hypovitaminosis B1
E. Hypovitaminosis B2
18. A 6-year-old child suffers from delayed
growth, disrupted ossification processes,
decalcification of the teeth.What can be the
cause?
A. Vitamin D deficiency
B. Decreased glucagon production
C. Insulin deficiency
D. Hyperthyroidism
E. Vitamin C deficiency
19. A 35-year-old female patient with a chronic
renal disease has developed osteoporosis. The
cause of this complication is the deficiency of
the following substance:
A. 1,25-dihydroxy-D3
B. 25-hydroxy-D3
C. D3
D. D2
E. Cholesterol
20. A child with renal insufficiency exhibits
delayed teeth eruption. This is mostlikely
caused by the abnormal formationof the
following substance:
A. 1,25 (OH)2D3
B. Glycocyamine
C. Glutamate
D. α-ketoglutarate
E. Hydroxylysine
21. When examining a child, the doctor revealed
signs
of
rickets.
Which
compounds
insufficiency in the child’s body facilitates the
development of this disease?
A. 1,25 [OH] -dihydroxycholecalciferol
B. Biotin
C. Tocopherol
D. Naphthoquinone
E. Retinol
22. During regular check-up a child is detected
with interrupted mineralization of the bones.
What vitamin deficiency can bethe cause?
A. Calciferol
B. Riboflavin
C. Tocopherol
D. Folic acid
E. Cobalamin
23. In patients after gallbladder removal
processes are hampered Ca2+ absorption through
the intestinal wall. What vitamin prescription
will stimulate this process?
A. D3
B. RR
C. C
D. B12
E. K
24. A patient who suffers from chronic renal
insufficiency fell ill with osteoporosis.
Disturbed
synthesis
of
what
mineral
metabolism’s regulator is the cause of
osteoporosis?
A. Formation of 1, 25(OH)2D3
B. Proline hydroxylation
C. Lysine hydroxylation
D. Glutamate carboxylation
E. Cortisol hydroxylation
25. A patient has enamel erosion. What vitamin
should be administered for itstreatment?
A. D3
B. C
C. K
D. B1
E. PP
26. A 5 years old child has insufficient
calcification of enamel, tooth decay. Which
vitamin hypovitaminosis leads to the
development of this process?
A. Calciferol
B. Tocopherol
C. Biotin
D. Nicotinic acid
E. Folic acid
27. On examination of 11 months’ child, the
pediatrician found a curvature of the bones of
the lower extremities and a delay in the
mineralization of the bones of the skull. What
vitamin deficiency leads to this pathology?
A. Cholecalciferol
B. Thiamine
C. Pantothenic acid
D. Bioflavonoids
E. Riboflavin
28. A child with signs of rickets has been
prescribed a certain liposoluble vitamin drug by
pediatrician and dentist. This drug affects the
metabolism of phosphorus and calcium in the
body and facilitates calcium accumulation in
bone tissue and dentine. If its content in the
body is insufficient, there developdisruptions of
ossification
process,
dental
structureandocclusion. Name this drug:
A. Ergocalciferol
B. Retinolacetate
C. Tocopherolacetate
D. Menadione (Vicasolum)
E. Thyroidin
29. Hormonal form of a certain vitamin induces
genome level synthesis of Ca binding proteins
and enterocytes thus regulating the intestinal
absorption of Ca2+ ions required for dental
tissuedevelopment. What vitamin is it?
A. D3
B. A
C. B1
D. E
E. K
30. A 4-year-old child with hereditary renal
lesion has signs of rickets; vitamin D
concentration in blood is normal. What is the
most probable cause of rickets development?
A. Impaired synthesis of calcitriol
B. Increased excretion of calcium
C. Hyperfunction of parathyroid glands
D. Hypofunction of parathyroid glands
E. Lack of calcium in food
31. Vitamin A together with specific
cytoreceptors penetrates through thenuclear
membranes, induces transcriptionprocesses that
stimulate growth anddifferentiation of cells.
This biologicalfunction is realized by the
following formof vitamin A:
A. Trans-retinoic acid
B. Carotin
C. Cis-retinal
D. Retinol
E. Trans-retinal
32. A patient suffers from vision impairmenthemeralopy (night blindness). What vitamin
preparation should beadministered the patient in
order torestore his vision?
A. Retinol acetate
B. Vicasol
C. Pyridoxine
D. Thiamine chloride
E. Tocopherol acetate
33. An oculist detected increased time of
darkness adaptation of a patient’s eye. What
vitamin deficiency can cause such symptom?
A. А
B. Е
C. С
D. К
E. D
34. A patient complains of photoreception
disorder and frequent acute viral diseases. He
has been prescribed a vitamin that affects
photoreception
processes
by
producing
rhodopsin, the photosensitive pigment. What
vitamin is it?
A. Retinol acetate
B. Tocopherol acetate
C. Pyridoxine hydrochloride
D. Cyanocobalamin
E. Thiamine
35. In order to accelerate healing of a radiation
ulcer a vitamin drug was administered. What
drug is it?
A. Retinol acetate
B. Retabolil
C. Prednisolone
D. Levamisole
E. Methyluracil
36. While the examination of patient’s oral
cavity the dentist found xerostomia, numerous
erosions. What vitamin deficit caused this
effect?
A. Vitamin A
B. Vitamin K
C. Vitamin P
D. Vitamin H
E. Vitamin PP
37. In order to prevent gum inflammation and to
improve regeneration of epithelial periodontium
cells manufacturers add to the tooth pastes one
of the following vitamins:
A. Retinol
B. Calciferol
C. Thiamine
D. Biotin
E. Phyloquinone
38. A 64 year old woman has impairment of
twilight vision (hemeralopy). What vitamin
should be recommended in the first place?
A. A
B. B2
C. E
D. C
E. B6
39. The patient has worsened twilight vision.
Which of the vitamin preparations should be
prescribed to the patient?
A. Retinol acetate
B. Cyanocobalamin
C. Pyridoxine hydrochloride
D. Ascorbic acid
E. Nicotinic acid
40. The patient with periodontal disease was
prescribed a fat-soluble vitamin preparation,
which is actively involved in the redox
processes in the body. Antioxidant is a growth
factor, antixerphthalmic, provides normal
vision. In dental practice it is used to accelerate
epithelization in case of mucosal diseases with
periodontitis. Identify this drug:
A. Retinol acetate
B. Ergocalciferol
C. Tocopherol acetate
D. Vikasol
E. Cyanocobalamin
41. A patient has the folowing changes: disorder
of twilight vision, drying out of conjunctiva and
cornea. Such disordersmay be caused by
deficiency of vitamin:
A. Vitamin A
B. Vitamin B
C. Vitamin C
D. Vitamin D
E. Vitamin B12
42. A patient complains of photoreception
disorder and frequent acute viral diseases. He
has been prescribed a vitamin that affects
photoreception
processes
by
producing
rhodopsin, the photosensitive pigment.
What vitamin is it?
A. Retinol acetate
B. Tocopherol acetate
C. Pyridoxine hydrochloride
D. Cyanocobalamin
E. Thiamine
43. There are various diseases that cause sharp
increase of active oxygen, leading tocell
membranes destruction. Antioxidantsare used to
prevent it from happening. Themost potent
natural antioxidant is:
A. Alpha-tocopherol
B. Glycerol
C. Vitamin D
D. Fatty acids
E. Glucose
44. A pregnant woman with several
miscarriagesin anamnesis is prescribed atherapy
that includes vitamin preparations.What vitamin
facilitates carrying of apregnancy?
A. Alpha-tocopherol
B. Folic acid
C. Cyanocobalamin
D. Pyridoxal phosphate
E. Rutin
45. Parodontosis is treated by meansof
antioxidants. Which of the followingnatural
compounds is used as an antioxidant:
A. Tocopherol
B. Thiamine
C. Gluconate
D. Pyridoxine
E. Choline
46. When treating sialadenitis (inflammation of
the salivary glands), preparations of vitamins
are used. Which of the following vitamins plays
an important role in antioxidant defense?
A. Tocopherol
B. Pantothenic acid
C. Riboflavin
D. Thiamine
E. Pyridoxine
47. A woman, who had undergone mastectomy
due to breast cancer, wasprescribed a course of
radiation therapy.What vitamin preparation has
markedantiradiation
effect
due to
its
antioxidantactivity?
A. Tocopherol acetate
B. Ergocalciferol
C. Riboflavin
D. Cyanocobalamin
E. Folic acid
48. What vitamin deficiency leads to both
disorder of reproductive function and distrophy
of skeletal muscles?
A. Vitamin E
B. Vitamin A
C. Vitamin K
D. Vitamin D
E. Vitamin B1
49. Ionizing radiation or vitamin E
deficiencyaffect the cell by increasing
lysosomemembrane permeability.What are the
possibleconsequences of this pathology?
A. Partial or complete cell destruction
B. Intensive protein synthesis
C. Intensive energy production
D. Restoration of cytoplasmic membrane
E. Formation of maturation spindle
50. Examination of a man who hadn’t been
consuming fats but had been gettingenough
carbohydrates and proteinsfor a long time
revealed dermatitis, poor wound healing, vision
impairment. Whatis the probable cause of
metabolic disorder?
A. Lack of linoleic acid, vitamins A, D, E, K
B. Lack of palmitic acid
C. Lack of vitamins PP, H
D. Low caloric value of diet
E. Lack of oleic acid
51. For the prevention of atherosclerosis,
coronary heart disease, cerebrovascular accident,
the consumption of high-fat polyunsaturated fatty
acids is recommended. One of the following fatty
acids is:
A. Linolic
B. Oleic
C. Lauric
D. Palmitooleic
E. Stearic
Basic laws of metabolism and energy
1. The Krebs cycle plays an important role in
the realization of the glucoplastic effect of
amino acids. This is due to the mandatory
transformation of a nitrogen-free residue into:
A. Oxaloacetate.
B. Malate.
C. Succinate.
D. Fumarat.
E. Citrate.
2. At the patient of 57 years, suffering from a
diabetes, the keto-acidosis has developed. The
biochemical basis of this condition is a decrease
in the degree of utilization of acetyl-CoA. The
disadvantage of which is the connection in cells
that is due?
A. Oxaloacetate
B. 2-oxoglutarate
C. Glutamate
D. Aspartate
E. Succinate
3. During the oxidation of carbohydrates, lipids,
a large amount of energy is formed, the bulk of
which is formed due to the oxidation of acetylCoA. How many ATP molecules are formed
when a single molecule of acetyl-CoA is
completely oxidized?
A. 12.
B. 8.
C. 38.
D. 24.
E. 36
4. Prussic acid and cyanide are among the
strongest poisons. Depending on the dose, death
occurs in a few seconds or minutes. The
inhibition of the activity of which enzyme is the
cause of death?
A. Cytochrome oxidase.
B. Acetyl holinesesterase.
C. Catalase.
D. Methemoglobin reductase.
E. ATP synthetases.
5. Cyanide poisoning causes immediate death.
What is the mechanism of cyanide effect at the
molecular level?
A. They inhibit cytochromoxidase
B. They bind substrates of tricarboxylic acid
cycle
C. They block succinate dehydrogenase
D. They inactivate oxygene
E. They inhibit cytochrome B
6. A patient with poisoning with an insecticiderotenone was taken to the hospital. Which part
of the mitochondrial electron transfer chain is
blocked by this substance?
A. NADH coenzyme Q-reductase.
B. ATP synthetases.
C. Coenzyme Q-cytochrome C-reductase.
D. Succinate-coenzyme Q-reductase.
E. Cytochrome C-oxidase.
7. Rotenone is known to inhibit respiratory
chain. What complex of mitochondrial
respiratory chain is inhibited by this substance?
A. NADH-coenzymeQreductase
B. Cytochromeoxidase
C. CoenzymeQ-cytochromecreductase
D. Succinate-coenzyme Qreductase
E. Adenosine triphosphate synthetase
8. In the intensive care unit in a serious
condition, unconscious, the patient was
admitted. Diagnosed overdose of barbiturates,
which caused the phenomenon of tissue
hypoxia. At what level was blocking the
electron transport?
A. NADH-Coenzyme-Q-reductase
B. Cytochrome oxidase
C. Cytochrome b - cytochrome c1
D. Ubiquinone
E. ATP synthase
9. Hyperthermia, bulimia, weight loss, which is
observed in patients with thyrotoxicosis,
associated with a violation:
A.
Conjugation
of
oxidation
and
phosphorylation.
B. Reactions of fat synthesis.
C. Decay of ATP.
D. Reactions of the citric acid cycle
E. Reactions of beta-oxidation of fatty acids.
10. With thyrotoxicosis, the production of
thyroid hormones T3 and T4 increases, weight
loss develops, tachycardia, mental excitability
and so on. The mechanism of their action?
A. separates oxidation and oxidative
phosphorylation.
B. Activate substrate phosphorylation.
C. Block the substrate by phosphorylation.
D. Block the respiratory chain.
E. Oxidative phosphorylation is activated.
11. A woman who is receiving treatment for
hyperthyroidism, there is an increase in body
temperature. What is the basis of this
phenomenon?
A. Separation of oxidative phosphorylation
B. Decreased glucose utilization by tissues
C. Reduced fat oxidation in the liver
D. Violation of amino acid deamination
E. Violation of glycogen synthesis
cytochrome C. What is its function in a normal
cell?
A. Enzyme of respiratory chain of
electrontransport
B. Enzyme of tricarboxylic acid cycle
C. Enzyme of beta-oxidation of fatty acids
D. Component of H+ATP system
E.
Component
of
pyruvatedehydrogenasesystem
12. A 38-year-old woman complains of
increased sweating, heartbeat, and an increase in
temperature in the evening. The main exchange
is increased by 60%. The doctor diagnosed
thyrotoxicosis. What properties of thyroxin lead
to increased heat production?
A. Separation of oxidative phosphorylation
B. Increases conjugation of oxidation and
phosphorylation
C. Reduces β-oxidation of fatty acids
D. Reduces the deamination of amino acids
E. Contributes to the accumulation of acetyl
CoA
16. Cyanide is a poison that causes instant death
of the organism. What enzymes found in
mitochondria are affected by cyanide?
A. Cytochrome oxidase (aa3)
B. Flavin enzymes
C. Cytochrome 5
D. NAD+-dependent dehydrogenase
E. Cytochrome P-450
13. Cells were treated with a substance that
blocks the phosphorylation of nucleotides in the
mitochondria. The process of cell activity will
be violated in the first place?
A. Oxidative phosphorylation.
B. Glycolysis.
C. Integration of functional protein molecules.
D. Aerobic oxidation of glucose
E. Synthesis of mitochondria proteins.
14. In the presence of 2,4-dinitrophenol, the
oxidation of substrates can continue, but the
synthesis of ATP molecules is impossible. What
is the mechanism of its action?
A. Separation of oxidation and phosphorylation
in mitochondria
B. Activation of the enzyme ATPase
C. Transfer of substrates beyond mitochondria
D. Stimulation of hydrolysis of formed ATP
E. Inhibition of the enzyme cytochrome oxidase
15. Researches of the latest decades established
that immediate "executors"ofcell apoptosis are
special enzymes calledcaspases. Generation of
one of themproceeds with participation of
17. Hydrocyanic acid and cyanides are the most
violent poisons. According to the dose the death
follows after a few seconds or minutes. The
death is caused by the inhibited activity of the
following enzyme:
A. Cytochrome oxidase
B. Acetylcholinesterase
C. ATP-synthetase
D. Catalase
E. Methemoglobin reductase
18. Potassium cyanide that is a poison came into
a patient’s organism and caused death a few
minutes after it. The most probable cause of its
toxic effect was abnormal activity of:
A. Cytochrome oxidase
B. Catalase
C. ATP-synthetase
D. NADP − H-dehydrogenase
E. Haemoglobin synthesis
19. The resuscitation unit has admitted a patient
in grave condition. It is known that he had
mistakenly taken sodium fluoride which blocks
cytochrome oxidase. What type of hypoxia
developed in the patient?
A. Tissue
B. Hemic
C. Cardiovascular
D. Hypoxic
E. Respiratory
Carbohydrate metabolism and its regulation
1. In a patient of 60 years the activity of the
main digestive enzyme of saliva is reduced. In
this case, the primary hydrolysis of which
organic compounds is disturbed?
A. Carbohydrates.
B. Fats.
C. Proteins.
D. Cellulose.
E. Lactose.
2. With age, the activity of the parotid glands
decreases.The activity of what enzyme of
carbohydrate metabolism will decrease?
A. Amilase.
B. Lysozyme.
C. Phosphatase.
D. Hexokinase.
E. Maltase.
3. A newborn develops dyspepsia after the milk
feeding. When the milk is substituted by the
glucose solution the dyspepsia symptoms
disappear. The newborn has the subnormal
activity of the following enzyme:
A. Lactase
B. Invertase
C. Maltase
D. Amylase
E. Isomaltase
4. While determining power inputs of apatient’s
organism it was established thatthe respiratory
coefficient equaled 1,0. This means that in the
cells of the patientthe following substances are
mainlyoxidized:
A. Carbohydrates
B. Proteins
C. Fats
D. Proteins and carbohydrates
E. Carbohydrates and fats
5. Аfter the transition to a mixed diet in a
newborn child has arisen dyspepsia with
diarrhea, meteorism developmental delay.The
biochemical basis of this pathology is
insufficiency of:
A. Saccharaseandisomaltase.
B. Lactaseandcellobiase.
C. Trypsinandchymotrypsin.
D. Lipaseandcreatinekinase.
E. Cellulase.
6. Analysis of a patient’s saliva revealedhigh
concentration of lactate. This is mostprobably
caused by activation of thefollowing process:
A. Anaerobic glucose breakdown
B. Aerobic glucose breakdown
C. Glycogen breakdown
D. Carbohydrate hydrolysis
E. Glucose-lactate cycle
7. Clinical examination enabled to make a
provisional diagnosis: stomach cancer. Gastric
juice contained lactic acid.What type of glucose
catabolism turns upin the cancerous cells?
A. Anaerobic glycolysis
B. Pentose-phosphate cycle
C. Gluconeogenesis
D. Aerobic glycolysis
E. Glucose-alanine cycle
8. What process provides erythrocytes with the
required amount of energy in the form of ATP
for their vital activity?
A. Glycolysis.
B. Aerobic oxidation of glucose.
C. β-Oxidation of fatty acids.
D. Pentose phosphate cycle.
E. Tricarbonic acid cycle.
9. Human red blood cells do notcontain
mitochondria. What is themain pathway for
ATP production inthese cells?
A. Anaerobic glycolysis
B. Aerobic glycolysis
C. Oxidative phosphorylation
D. Creatine kinase reaction
E. Cyclase reaction
10. During consumption of biscuits, sweets in
the mixed saliva temporarily increases the level
of lactate. The activation of which biochemical
process leads to this?
A. Anaerobic glycolysis
B. Tissue breathing
C. Aerobic glycolysis
D. Gluconeogenesis
E. Microsomal oxidation
11. During long-distance running, skeletal
muscle of a trained person uses glucose to
obtain the energy of ATP for muscle
contraction. Indicate the main process of
utilization of glucose in these conditions:
A. Aerobic glycolysis
B. Anaerobic glycolysis
C. Glycogenolysis
D. Gluconeogenesis
E. Glycogenesis
12. After restoration of blood circulationin
damaged tissue accumulation oflactate comes to
a stop and speed ofglucose consumption slows
down. Thesemetabolic changes are caused by
activationof the following process:
A. Aerobic glycolysis
B. Anaerobic glycolysis
C. Lipolysis
D. Gluconeogenesis
E. Glycogen biosynthesis
13. When blood circulation in the damaged
tissue is restored, then lactateaccumulation
comes to a stop andglucose consumption
decelerates. These metabolic changes are caused
by activation of the following process:
A. Aerobic glycolysis
B. Anaerobic glycolysis
C. Lipolysis
D. Gluconeogenesis
E. Glycogen biosynthesis
14. A 32-year-old female patientsuffers from
gingivitis accompaniedby gum hypoxia. What
metabolite ofcarbohydrate metabolism is
produced inthe periodontium tissues more
actively inthis case?
A. Lactate
B. Ribose 5-phosphate
C. Glycogen
D. Glucose 6-phosphate
E. NADPH-H
15. Untrained people often have musclepain
after sprints as a result of lactateaccumulation.
This might be caused byintensification of the
following biochemicalprocess:
A. Glycolysis
B. Gluconeogenesis
C. Pentose phosphate pathway
D. Lipogenesis
E. Glycogenesis
16. Anaerobic splitting of glucose to lactic acid
is regulated by the relevant enzymes. What
enzyme is the main regulator of this process?
A. Phosphofructokinase
B. Glucose-6-phosphate isomerase
C. Aldolase
D. Enolase
E. Lactate dehydrogenase
17. Cytoplasm of the myocytes contains a lot of
dissolved metabolites resulting fromglucose
oxidation. Name the metabolite that turns
directly into lactate:
A. Pyruvate
B. Oxaloacetate
C. Glycerophosphate
D. Glucose-6-phosphate
E. Fructose-6-phosphate
18. Treatment of many diseasesinvolves use of
cocarboxylase (thiaminepyrophosphate) for
supplying cells withenergy. What metabolic
process is activatedin this case?
A. Oxidizing decarboxylation of pyruvate
B. Glutamate deamination
C. Amino acids decarboxylation
D. Decarboxylation of biogenic amines
E. Detoxication of harmful substances inliver
19. A worker of a chemical enterprise was taken
to the hospital with signs of poisoning. In the
hair of this woman found increased
concentration of arsenate, which blocks lipoic
acid. Violation of which process is the most
likely cause of poisoning?
A. Oxidation decarboxylation of pyruvate.
B. Microsomal oxidation.
C. Restoration of methemoglobin.
D. Restoration of organic peroxides.
E. Removal of superoxide ions.
20. Oxidative decarboxylation of pyruvic acid is
catalyzed by a multienzyme complex with
several functionally linked coenzymes. Name
this complex:
A. Thymidine diphosphate (TDP), flavin
adenine dinucleotide (FAD), coenzyme A
(CoASH), nicotine amide adenine dinucleotide
(NAD), lipoic acid
B. Flavin adenine dinucleotide (FAD),
tetrahydrofolic acid, pyridoxal-5-phosphate,
thymidine diphosphate (TDP), choline
C. Nicotine amide adenine dinucleotide (NAD),
pyridoxal-5-phosphate, thymidine diphosphate
(TDP), methylcobalamin, biotin
D. Coenzyme A (CoASH), flavin adenine
dinucleotide (FAD), pyridoxal-5- phosphate,
tetrahydrofolic acid,carnitine
E. Lipoic acid, tetrahydrofolic acid, pyridoxal5-phosphate, methylcobalamin
21. It has been found out that one of pesticide
components is sodium arsenate that blocks
lipoic acid. Which enzyme activityis impaired
by this pesticide?
A. Pyruvate dehydrogenase complex
B. Microsomal oxidation
C. Methemoglobin reductase
D. Glutathione peroxidase
E. Glutathione reductase
22. In erythrocytes of the patient with hemolytic
anemia, the activity of pyruvate kinase was
significantly reduced. What metabolic process is
violated under these conditions?
A. Glycolysis
B. Glycogenolysis
C. Gluconeogenesis
D. Pentosophosphate pathway of glucose
oxidation
E. Synthesis of glycogen
23. Decreased ratio of adenylic nucleotides
ATP/ADP results in intensifiedglycolysis in
parodentium tissues underhypoxia conditions.
What reaction is activatedin this case?
A. Phosphofructokinase
B. Aldolase
C. Triosophosphate isomerase
D. Enolase
E. Lactate dehydrogenase
24. In some anaerobic bacteria the pyruvate
produced by glycolysis is converted to the ethyl
alcohol (alcoholic fermentation). What is the
biological significance of this process?
A. NAD+ replenishment
B. Lactate production
C. ADP production
D. Providing the cells with NADPH
E. ATP production
25. In medical practice for preventionof
alcoholism, a drug that is an aldehyde
dehydrogenase inhibitor is widely used. The
increase of which metabolite in the blood causes
disgust to alcohol?
A. Acetaldehyde
B. Ethanol
C. Malone aldehyde
D. Propionic aldehyde
E. Methanol
26. The patient during the course of treatment
with a drug that blocks alcohol dehydrogenase,
consumed a small amount of alcohol, resulting
in severe poisoning. Explain the cause of
poisoning:
A. Accumulation of acetaldehyde
B. Allergic reaction
C. Neuralgia disorders
D. Cardiovascular insufficiency
E. Violation of the function of the kidneys
27. The biosynthesis of the purine ring occurs
on ribose-5-phosphate by gradual build-up of
nitrogen and carbon atoms and the closure of
the rings. The source of ribose-5-phosphate is
the following process:
A. Pentose phosphate cycle
B. Glycolysis
C. Glyconeogenesis
D. Gluconeogenesis
E. Glycogenolysis
28. Due to the long-term use of sulfanilamide
drugs in a young woman appeared signs of
hemolytic anemia due to hereditary violation of
the synthesis of the enzyme pentosophosphate
pathway glucose-6-phosphate dehydrogenase,
which provides formation in the body:
A. NADРН.
B. ATP.
C. NAD
D. FAD
E. FMN.
29. 22 year old woman has been taking
sulfanilamides for a long time that led to
symptoms of hemolytic anaemia caused by
hereditary disturbance of synthesis of glucose 6phosphate dehydrogenase. This enzyme of
pentose-phosphate cycle is responsible for
generation of:
A. NADP − H2
B. NAD
C. FAD
D. FMN
E. ATP
30. Sulfanilamides are applied as antimicrobal
agents in clinical practice. Sulfanilamide
treatment, however, can result in hemolytic
anemia development in patients that suffer from
genetic defect of the following enzyme of
pentose phosphatemetabolismin erythrocytes:
A. Glucose-6-phosphate dehydrogenase
B. Hexokinase
C. Transketolase
D. Transaldolase
E. Pyruvatekinase
31. 38 year old patient takes aspirin and
sulfanilamides. After their intake intensified
erythrocyte haemolysis is observed which is
caused by deficiency of glucose 6-phosphate
dehydrogenase. This pathology is caused by
failure of the following coenzyme:
A. NADP − H
B. FAD − H2
C. Pyridoxal phosphate
D. FMN − H2
E. Ubiquinone
32. The patient has a chronic inflammatory
process of the tonsils. Due to the what
biochemical process in the inflammation
centers, the concentration of NADPH, which is
necessary for the implementation of the
mechanism of phagocytosis, is maintained?
A. Pentose phosphate pathway
B. Cori Cycle
C. Krebs cycle
D. Ornithine cycle
E. Glycolysis
33. A 7-year-old child has symptoms of
hemolytic anemia. In the biochemical analysis
of erythrocytes, a reduced concentration of
NADPH and reduced glutathione has been
established. The deficiency of which enzyme in
this case causes biochemical changes and
clinical manifestations?
A. Glucose-6-phosphate dehydrogenase
B. Hexokinase
C. Fructokinase
D. Pyruvate kinase
E. Lactate dehydrogenase
34. A child’s blood presents high content of
galactose, glucose concentration is low. There
are such presentations as cataract, mental
deficiency, adipose degeneration of liver.What
disease is it?
A. Galactosemia
B. Diabetes mellitus
C. Lactosemia
D. Steroid diabetes
E. Fructosemia
35. A sick child has a delayed mental
development, enlarged liver, and decreased
vision. The physician binds these symptoms to
deficiency
in
the
galactose-1phosphate uridylyltransferase. What is the
pathological process in the child?
A. Galactosaemia
B. Fructosemia
C. Hyperglycemia
D. Hypoglycemia
E. Hyperlactate acidemia
36. In the 2-year-old boy, an increase in the size
of the liver and spleen, cataract is observed. The
concentration of sugar is elevated in the blood,
but the test of glucose tolerance is normal. An
hereditary violation of the metabolism of which
substance is the cause of this condition?
A. Galactose
B. Fructose
C. Glucose
D. Maltose
E. Saccharose
37. Indicate, hereditary insufficiency of which
enzyme is the cause of vomiting and diarrhea
after taking the fruit juices in a 9-month-old
child whose fructose intake has led to
hypoglycemia?
A. Fructose-1-phosphataldolase.
B. Phosphofructokinase
C. Hexokinase.
D. Fructose-1,6-diphosphatase.
E. Fructokinase.
38. In the 8-month-old child, vomiting and
diarrhea are observed after taking fruit juices.
Fructose intake led to hypoglycemia. Hereditary
insufficiency of which enzyme is the cause of
these disorders?
A. Fructose-1-phosphataldolase
B. Fructokinase
C. Hexokinase
D. Phosphofructokinase
E. Fructose-1,6-diphosphatase
39. The excess concentration of glucose in the
oral solution in diabetes leads to development:
A. Multiple caries
B. Hyperplasia of enamel
C. Hypoplasia of enamel
D. Fluorosis
E. Intensifiedcalcification of enamel
40. In the biochemical study of the patient's
blood, hyperglycemia, hyperketonemia, glucose
and ketone bodies in urine were detected. On
the electrocardiogram diffuse changes in the
myocardium was detected. She complains of dry
mouth, thirst, frequent urination, general
weakness. The patient suffers from:
A. Diabetes mellitus.
B. Alimentary hyperglycemia.
C. Acute pancreatitis.
D. Ischemic heart disease.
E. Non-diabetes mellitus.
41. A 42 year old woman diagnosed with
diabetes
mellitus
was
admitted
the
endocrinological department with complaints of
thirst, excessive appetite. What pathological
components are revealed in course of laboratory
examination of the patient’s urine?
A. Glucose, ketone bodies
B. Protein, aminoacids
C. Protein, creatine
D. Bilirubin, urobilin
E. Blood
42. A patient with insulin-dependent diabetes
mellitus has been injected with insulin. After
some time at the patient has developed
weakness, irritability, and increased sweating.
What is the main mechanism of development of
hypoglycemic coma?
A. Carbohydrate starvation of the brain.
B. Decrease of gluconeogenesis.
C. Increaseof glycogenolysis.
D. Increase of ketogenesis.
E. Increase of lipogenesis.
43. Examination of a 56-year-oldfemale patient
with a history of type 1 diabetes revealed a
disorder ofprotein metabolism that is
manifestedby aminoacidemia in the laboratory
blood test values, and clinically by the delayed
wound healing and decreased synthesis of
antibodies. Which ofthe following mechanisms
causes the development of aminoacidemia?
A. Increased proteolysis
B. Albuminosis
C. Decrease in the concentration ofamino acids
in blood
D. Increase in the oncotic pressure inthe blood
plasma
E. Increase in low-density lipoproteinlevel
44. It is known that in patients with diabetes
mellitus often found inflammatory processes,
reduced regeneration, and healing of wounds
decreases. The reason for this is:
A. Decrease of proteosynthesis
B. Increase of lipolysis
C. Acceleration of gluconeogenesis
D. Reduction of lipolysis
E. Increase of catabolism
45. Diabetes mellitus causes ketosis as a result
of activated oxidation of fatty acids. What
disorders of acid-base equilibrium may be
caused by excessive accumulation of ketone
bodies in blood?
A. Metabolic acidosis
B. Metabolic alcalosis
C. Any changes woun’t happen
D. Respiratory acidosis
E. Respiratory alcalosis
46. A patient is ill with diabetes mellitus that is
accompanied by hyperglycemia of over 7,2
millimole/l on an empty stomach. The level of
what blood plasma protein allows to estimate
the glycemia rate retrospectively (4-8 weeks
before examination)?
A. Glycated hemoglobin
B. Albumin
C. Fibrinogen
D. C-reactive protein
E. Ceruloplasmin
47. A 62-year-old female patient has developed
a cataract (lenticular opacity) secondary to the
diabetes mellitus. What type of protein
modification is observed in case of diabetic
cataract?
A. Glycosylation
B. Phosphorylation
C. ADP-ribosylation
D. Methylation
E. Limited proteolysis
48. After recovering from epidemic parotiditis a
patient began to put off weight, he was
permanently thirsty, drank a lot of water, had
frequent urination, voracious appetite. Now he
has complaints of skin itch, weakness,
furunculosis. His blood contains: glucose - 16
mmole/L, ketone bodies - 100 mcmole/L;
glucosuria. What disease has developed?
A. Insulin-dependent diabetes
B. Insulin-independent diabetes
C. Steroid diabetes
D. Diabetes insipidus
E. Malnutrition diabetes
49. Patient with diabetes mellitus experienced
loss of consciousness and convulsions after an
injection of insulin. What might be the result of
biochemical blood analysis for concentration of
sugar?
A. 1,5 mmol/L
B. 8,0 mmol/L
C. 10,0 mmol/L
D. 3,3 mmol/L
E. 5,5 mmol/L
50. A 46-year-old patient complains of dry
mouth, thirst, urination, general weakness. In
the blood: hyperglycemia, hyperketonemia. In
the urine: glucose, ketone body. On the ECG:
diffuse changes in myocardium. What is the
most probable diagnosis?
A. Diabetes mellitus
B. Alimentary hyperglycemia
C. Acute pancreatitis
D. Non-diabetes mellitus
E. Ischaemic heart disease
51. After the epidemic parotitis, the patient loses
weight, constantly feels thirst, drinks a lot of
water, indicates frequent urination, increased
appetite, itching, weakness, furunculosis. In the
blood: glucose - 16 mmol/l, ketone bodies - 100
μmol/l; glucosuria What disease has developed
in the patient?
A. Insulin-dependent diabetes mellitus
B. Non-dependent diabetes mellitus
C. Steroidal diabetes
D. Non-diabetes mellitus
E. Malnutrition-related diabetes mellitus
52. A 38-year-old patient was delivered to the
reanimation unit with unconscious. Reflexes are
absent. Blood sugar is 2.1 mmol/L. In
anamnesis - diabetes since 18 years of age.
What coma does a patient have?
A. Hypoglycemic
B. Ketoacidotic
C. Lactacidotic
D. Hyperosmolar
E. Hyperglycemic
53. In the patient's blood, glucose is 5.6
mmol/L, 1 hour after the sugar intake - 13.8
mmol/l, and after 3 hours - 9.2 mmol/l. What
pathology is characterized by such indicators?
A. Hidden form of diabetes mellitus
B. Healthy person
C. Thyrotoxicosis
D. Itsenko-Kushing's disease
E. Akromegalia
54. In a patient 15 years of age, glucose
concentration is 4,8 mmol/l, an hour after the
sugar intake - 9.0 mmol/l, after 2 hours - 7.0
mmol/l, after 3 hours - 4.8 mmol/l . These
indices are characteristic of such a disease:
A. Hidden diabetes mellitus
B. Type I diabetes
C. Type II diabetes
D. Itsenko-Kushing's disease
E. –
55. A nurse accidentally injected a nearly
double dose of insulin to a patient with diabetes
mellitus. The patient lapsed into a hypoglycemic
coma. What drug should be injected in order to
help him out of coma?
A. Glucose
B. Lidase
C. Insulin
D. Somatotropin
E. Noradrenaline
56. For type II diabetes, the characteristic
features are hyperglycemia, hypochloremia.
Which of the following processes is activated in
the first place?
A. Gluconeogenesis.
B. Glycolysis.
C. Glycogenolysis.
D. Glucose reabsorption.
E. Transport of glucose to the cell.
57. A 57 year old patient with diabetes mellitus
was developed ketoacedosis. Biochemical base
of this condition is smaller extent of acetylCoAutilization.What cell compound deficit
causes this effect?
A. Oxaloacetate
B. 2-oxoglutarate
C. Glutamate
D. Aspartate
E. Succinate
58. A patient with diagnose of diabetes mellitus,
in the morning received an assigned dose of
insulin of prolonged action. He missed the next
meal, and soon felt weakness, headache,
dizziness, greediness, trembling of the body,
convulsions, hunger, and the phenomenon of
hypoglycemia. The use of glucose does not
improve the condition. What drug should be
entered to alleviate this condition?
A. Adrenaline
B. Triamcinolone
C. Noradrenaline
D. Prednisolone
E. Hydrocortisone
59. A patient for 5 years suffering from
diabetes. As a result of a violation of a diet, he
developed a coma. An ambulance doctor gave
him glucose. The condition of the patient has
improved. What kind of coma was in the
patient?
A. Hypoglycemic
B. Acidotic
C. Hyperglycemic
D. Hepatic
E. Hypothyroid
60. Patients with Itsenko-Cushing's syndrome
are observed with a hyperglycemia and
glucosuria. Synthesis and secretion of which
hormone is increased in this patient?
A. Cortisol
B. Adrenaline
C. Glucagone
D. Thyroxine
E. Aldosterone
61. Pancreas is known as a mixed gland.
Endocrine functions include production of
insulin by beta cells. This hormone affects the
metabolism of carbohydrates. What is its effect
upon the activity of glycogen phosphorylase
(GP) and glycogen synthase (GS)?
A. It inhibits GP and activates GS
B. It activates both GP and GS
C. It inhibits both GP and GS
D. It activates GP and inhibits GS
E. It does not affect the activity of GP and GS
62. Medical ambulance delivered a 2 year old
girl to the children’s department.Objectively:
the child is languid, apathetic. Liver is enlarged
and liver biopsy revealed a significant excess of
glycogene. Glucose concentration in the blood
streamis below normal. What is the cause of low
glucose concentration?
A. Low (absent) activity of glycogene
phosphorylase in liver
B. Low (absent) activity of hexokinase
C. High activity of glycogen synthetase
D. Low (absent) activity of glucose 6phosphatase
E. Deficit of a gene that is responsible for
synthesis
of
glucose
1-phosphaturidine
transferase
63. After the introduction of adrenaline in a
patient with persistent hypoglycemia, blood test
has not changed significantly. In such
circumstances, there is a possibility of
disturbances in the liver. What function of the
liver is changed?
A. Glycogendeposing.
B. Glycolytic.
C. Excretory.
D. Ketogenic.
E. Cholesterol-forming.
64. A 2-year-old child has been diagnosed with
Girke's disease, which is manifested by severe
hypoglycemia. The reason for this condition is
the absence of the enzyme glucose-6phosphatase. With the violation of which
process is this pathology involved?
A. Mobilization of glycogen.
B. Gluconeogenesis.
C. Glycolysis.
D. Ketogenesis.
E. Synthesis of glycogen.
65. The glycogen that came from the food was
digested in the gastrointestinal tract. Which final
product was formed as a result of this process?
A. Glucose
B. Lactate
C. Lactose
D. Galactose
E. Fructose
66. In the human diet there are a large number
of carbohydrates. The number of which
structures will increase in cytoplasm of
hepatocytes?
A. Glycogen granules
B. Drops of fat
C. The lysosomes
D. Free ribosomes
E. Inclusion of lipofuscine
67. Andersen's disease belongs to a group of
hereditary diseases that develop due to the
congenital malformation of the synthesis of
certain enzymes of glycogenolysis. The
inadequacy of which enzyme is the molecular
basis of this glycogenose?
A. Amilo (1-4 → 1-6) transglycosidases.
B. Glycogen synthase.
C. Glucose-6-phosphatase.
D. Lysosomal glycosidase.
E. Phosphofructokinase.
68. Characteristic sign of glycogenosis is
muscle pain during physical work. Blood
examination reveals usually hypoglycemia. This
pathology is caused by congenital deficiency of
the following enzyme:
A. Glycogen phosphorylase
B. Glucose 6-phosphate dehydrogenase
C. Alpha amylase
D. Gamma amylase
E. Lysosomal glycosidase
69. During starvation normal rate ofglucose is
maintained by means ofactivation of
gluconeogenesis. Whatsubstance can be used as
a substrate forthis process?
A. Alanine
B. Ammonia
C. Adenine
D. Urea
E. Guanine
70. It is known that human carbohydrate
reserves rapidly disappear as a result of
prolonged fasting. Which of the metabolic
processes restores glucose in the blood?
A. Gluconeogenesis.
B. Aerobic oxidation of glucose.
C. Glycolysis.
D. Glycogenolysis.
E. Pentose phosphate pathway.
71. Hyperglycemia develops due to chronic
overdose of glucocorticoids in a patient. Specify
the process of carbohydrate metabolism, due to
which the concentration of glucose increases:
A. Gluconeogenesis.
B. Aerobic oxidation of glucose.
C. Glycogenolysis.
D. Glycogenenesis.
E. Pentose phosphate cycle.
72. During the fasting the muscle proteins break
down into free amino acids. In which process
will most likely be used amino acids under such
conditions?
A. Gluconeogenesis in the liver.
B. Gluconeogenesis in the muscles.
C. Glycogenolysis.
D. Decarboxylation.
E. Synthesis of higher fatty acids.
73. In a patient undergoing a course of medical
starvation, the normal level of glucose in the
blood is maintained mainly due to
gluconeogenesis. From what amino acids at the
same time in the human liver most actively
synthesized glucose?
A. Alanine
B. Lysine
C. Valine
D. Glutamic acid
E. Leucine
74. The gluconeogenesis is activated in the liver
after intensive physical trainings. What
substance is utilized in gluconeogenesis first of
all in this case:
A. Lactate
B. Pyruvate
C. Glucose
D. Glutamate
E. Alanine
75. During intensive physical work, muscle
tissue accumulates lactic acid, which diffuses
into the blood and is absorbed by the liver and
heart. What process ensures the recovery of
glycogen stores in the muscles?
A. Cori Cycle
B. Citric acid cycle
C. Ornithine cycle
D. Cycle of tricarboxylic acids
E. Pentose phosphate pathway
76. The patient was diagnosed with beri-beri.
What is the enzyme's activity affected by the
patient?
A. Pyruvate dehydrogenase.
B. Citrate synthase.
C. Malate dehydrogenase.
D. Succinate dehydrogenase.
E. Fumarase.
77. If insufficient thiamine - vitamin B1 occurs
disease beriberi (polyneuritis) and disturbed
carbohydrate metabolism. What metabolite thus
accumulates in the blood?
A. Pyruvate.
B. Lactate.
C. Succinate.
D. Citrate.
E. Malat.
78. Some students developed myodynia after
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. Glycolysis
B. Gluconeogenesis
C. Lipolysis
D. Pentose-phosphate cycle
E. Glyconeogenesis
79. It is known that the pentosephosphate
pathway occuring in the adipocytesof adipose
tissue acts as a cycle.What is the main function
of this cycle inthe adipose tissue?
A. NADPH2 generation
B. Ribose-phosphate production
C. Xenobiotic detoxification
D. Energy generation
E. Glucose oxidation to end products
80. Fructosuria is known to be connected with
inherited deficiency of fructose-1-phosphate
aldolase.What product of fructose metabolism
will accumulate in the organism resulting in
toxicaction?
A. Fructose-1-phosphate
B. Glucose-1-phosphate
C. Glucose-6-phosphate
D. Fructose-1,6-biphosphate
E. Fructose-6-phosphate
81. The genetic defect of pyruvatecarboxylase
deficiency is the cause of delayed physical and
mental development and early death in children.
This defectis characterized by lacticemia,
lactaciduria, disorder of a number of metabolic
path ways. In particular, the following process is
inhibited:
A. Citric acid cycle and gluconeogenesis
B. Glycolysis and glycogenolysis
C. Glycogenesis and glycogenolysis
D. Lipolysis and lipogenesis
E. Pentose phosphate pathway andglycolysis
82. Glycogen polysaccharide is synthesizedfrom
the active form of glucose. Theimmediate donor
of glucose residues duringthe glycogenesis is:
A. UDP-glucose
B. Glucose-1-phosphate
C. ADP-glucose
D. Glucose-6-phosphate
E. Glucose-3-phosphate
83. A child with point mutation presents with
absence
of
glucose-6-phosphatase,
hypoglycemia, and hepatomegaly. What
pathology are these signs characteristic of?
A. Von Gierke’s disease (Glycogen storage
disease type I)
B. Cori’s disease (Glycogen storage disease
type III)
C. Addison’s disease (Primary adrenal
insufficiency)
D. Parkinson’s disease
E. McArdle’s disease (Glycogen storage disease
type V)
84. A child has a history ofhepatomegaly,
hypoglycemia, seizures,especially on an empty
stomach andin stressful situations. The child is
diagnosedwith Gierke disease. This diseaseis
caused by the genetic defect ofthe following
enzyme:
A. Glucose-6-phosphatase
B. Amyloid-1,6-glycosidase
C. Phosphoglucomutase
D. Glycogen phosphorylase
E. Glucokinase
85. In patients with glycogenosis, that is von
Gierke’s disease, the conversion of glucose-6phosphate in to glucose is inhibited, which is
accompanied by the improper breakdown of
glycogen in the liver. The cause of this
condition is the following enzyme deficiency:
A. Glucose-6-phosphatase
B. Glycogen phosphorylase
C. Glucose-6-phosphate dehydrogenase
D. Phosphofructokinase
E. Phosphoglucomutase
Metabolism of lipids and its regulation
1. Examination of a patient revealed that dental
hypoplasia was caused by hypovitaminosis of
vitamins A and D. These vitamins were
administered perorally but they didn’t have any
medicinal effect. What is the probable cause of
disturbed vitamin assimilation?
A. Bile acid deficiency
B. Phospholipase A2 deficiency
C. Cholesterolesterase deficiency
D. Colipase deficiency
E. Pancreatic lipase deficiency
2. Examination of a man who hadn’t been
consuming fats but had been getting enough
carbohydrates and proteins for long time
revealed dermatitis, poor wound healing, vision
impairment. Whatis the probable cause of
metabolic disorder?
A. Lack of linoleic acid, vitamins A, D, E, K
B. Lack of palmitic acid
C. Lack of vitamins PP, H
D. Low caloric value of diet
E. Lack of oleic acid
3. In humans, the absorption of products of the
hydrolysis of fats is impaired. The reason for
this may be a deficiency in the cavity of the
small intestine:
A. Bile acids
B. Lipolytic enzymes
C. Bile pigments
D. Sodium ions
E. Fat-soluble vitamins
4. A patient has normally colored stool
including a large amount of free fatty acids. The
reason for this is a disturbance of the following
process:
A. Fat absorption
B. Fat hydrolysis
C. Biliary excretion
D. Bilification
E. Lipase secretion
5. A 65-year-old patient suffers from
cholelithiasis. Recently, there were signs of
achilic syndrome due to obturation of the biliary
tract. Which components of food will be
mastered the most?
A. Fats
B.Carbohydrates
C. Proteins
D. Nucleic acids
E. Electrolytes
6. A patient was prescribed a drug with apparent
lipophilic properties. What is the main
mechanism of its absorption?
A. Passive diffusion
B. Active transporting
C. Binding with transport proteins
D. Pinocytosis
E. Filtration
7. Due to the blockage of the common bile duct
(which was radiographically confirmed), the
biliary flow to the duodenum was stopped. We
should expect the impairment of:
A. Fat emulsification
B. Protein absorption
C. Carbohydrate hydrolysis
D. Secretion of hydrochloric acid
E. Salivation inhibition
8. After eating fatty foods, the patient has
nausea and heartburn, steatorrhea occurs. The
reason for such a state can be:
A. Lack of bile
B. Increased lipase secretion
C. Violation of trypsin synthesis
D. Lack of amylase
E. Impaired phospholipase synthesis
9. A coprological study found that the feces are
discolored, there are found drops of neutral fat.
The most likely cause of this is a violation:
A. Flow of bile into the intestine
B. pH of gastric juice
C. Secretions of pancreatic juice
D. Secretion of intestinal juice
E. Absorption processes in the intestine
10. The respiratory ratio of the patient is 0.7.
This indicates that in human cells prevails:
A. Oxidation of fats
B. Oxidation of carbohydrates
C. Oxidation of proteins
D. Mixed oxidation of fats and carbohydrates
E. Mixed oxidation of fats and proteins
11. A sportsman was recommended to take a
preparation with carnitine in order to improve
his achievements. What process is activated by
carnitine to the most extent?
A. Transporting of fatty acids to the
mitochondria
B. Lipid synthesis
C. Synthesis of ketone bodies
D. Synthesis of steroid hormones
E. Tissue respiration
B. Pancreatic amylase
C. Pancreatic proteases
D. Bile lipase
E. Gastric proteases
12. One of the factors that cause obesity is the
inhibition of fatty acids oxidation due to:
A. Low level of carnitine
B. Impaired phospholipid synthesis
C. Excessive consumption of fatty foods
D. Choline deficiency
E. Lack of carbohydrates in the diet
17. Obesity is a common disease. The aim of its
treatment is to lower content of neutral fats in
the body. What hormone-sensitive enzyme is
the most important for intracellular lipolysis?
A. Triacylglycerol lipase
B. Protein kinase
C. Adenylate cyclase
D. Diacylglycerol lipase
E. Monoacylglycerol lipase
13. A patient with a high degree of obesity in
the quality of a dietary supplement is
recommended carnitine to improve the
"burning" of fat. What is the direct involvement
of carnitine in the process of oxidation of fats?
A. Transport of fatty acids from cytosol to
mitochondria
B. Activation of fatty acids
C. Involved in one of the reactions of betaoxidation of fatty acids
D. Transport of fatty acids from fat depots to
tissues
E. Activation of intracellular lipolysis
14. A 1-year-old child entered the clinic with
signs of damage to the muscles of the
extremities and trunk. After the examination
revealed a deficit of carnitine in the muscles.
The biochemical basis of this pathology is the
disruption of the process:
A. Transport of fatty acids in mitochondria
B. Regulation of Ca2+level in mitochondria
C. Substrate phosphorylation
D. Utilization of lactic acid
E. Oxidizing phosphorylation
15. Emotional stress causes activation of
hormone-sensitive triglyceride lipase in the
adipocytes. What secondary mediator takes part
in this process?
A. Cyclic adenosine monophosphate
B. Cyclic guanosine monophosphate
C. Adenosine monophosphate
D. Diacylglycerol
E. Ions of Ca2+
16. A significant amount of undigested fat was
found in the patient's coprogram.The violation
of which enzymes secretion most likely occurs
in this person?
A. Pancreatic lipase
18. Disorderthe splitting of the lipids in the
small intestine is due to a disorder of lipase
activity. Which of the following factors
activates the lipase?
A. Bile acids
B. Hydrochloric acid
C. Enterokinase
D. Pepsin
E. Solts of Na+
19. A man has 35 years of pheochromocytoma.
In the blood there is an elevated level of
adrenaline
and
norepinephrine,
the
concentration of free fatty acids increased in 11fold. Indicate which activation of any enzyme
under the influence of adrenaline increases
lipolysis?
A. TAG-lipase.
B. Lipoprotein lipase.
C. Phospholipases A2.
D. Phospholipase C.
E. Cholesterol esterase
20. The patient, who was in the clinic about
pneumonia complicated by pleurisy, was
included in the complex therapy of
prednisolone. The anti-inflammatory action of
this synthetic glucocorticoid is associated with
blocking the release of arachidonic acid by
inhibition:
A. A2 phospholipases
B. Lipoxygenase
C. Phospholipases C.
D. Peroxidase
E. Cyclooxygenase
21. In the laboratory examination of blood of a
person who was bitten by a change, hemolysis
of erythrocytes, hemoglobinuria was revealed.
The action of a mixed poison is due to the
presence of an enzyme in it:
A. Phospholipase A2
B. Phospholipase D
C. Phospholipase S.
D. Phospholipase A1
E. Sphingomyelinase
22. Patients with pain syndrome in the joints
permanently appoint aspirin. Which of the
enzymes that he enfolds?
A. Phospholipase A2
B. Cyclooxygenase
C. Phospholipase D
D. Lipoxygenase
E.PhospholipaseC
23. Thromboxanes belong to the bioregulators
of cellular functions of lipid nature. The source
for the synthesis of these compounds is:
A. Arachidonic acid
B. Stearic acid
C. Palmitic acid
D. Phosphatidic acid
E. Palmiotoleic acid
24. Methyl groups (-CH3) are used in the body
for synthesis such important compounds as
creatine, choline, adrenaline, and others. The
source of these groups is one of the essential
amino acids, namely:
A. Methionine
B. Valine
C. Leicine
D. Isoleucine
E. Tryptophan
C. Interferons
D. Catecholamins
E. Corticosteroids
27. The drug "Geptral", which is used in liver
diseases contains S-adenosylmethionine. This
active amino acid is involved in the synthesis
of:
A. Phospholipids
B. Fatty acids
C. Triacylglycerols
D. Cholesterol
E. Heme
28. It is known that a part of carbon dioxide is
used in the body in the biosynthesis of fatty
acids, urea, gluconeogenesis, and the like. What
kind of vitamin forms a CO2-transporting form
for these reactions?
A. Biotine
B. Timine
C. Riboflavin
D. Nicotinamide
E. Retinol
29. A young man of 25 years consumes an
excessive amount of carbohydrates (600 g per
day) that exceeds its energy needs. What
process will be activated in the human organism
in this case?
A. Lypogenesis
B. Glycolysis
C. Lypolis
D. Gluconeogenesis
E. Oxidation of fatty acids
25. At deficiency of biotin, there is a disorder of
higher fatty acids synthesis. Which of these
metabolites can be affected by this?
A. Malonyl-CoA
B. Succinyl-CoA
C. Pyruvate
D. Alanine
E. Serotonin
30. Disorders of the processes of mielinisation
neuronal fibers' leads to neurological disorders
and mental retardation. Such symptoms are
characteric for hereditary and acquired
metabolic disturbances:
A. Sphingolipids
B. Neutral fat
C. Higher fatty acids
D. Cholesterol
E. Phosphatidic acid
26. Deficiency in the body of linoleic and
linoleic acids leads to skin damage, hair loss,
delayed healing of wounds, thrombocytopenia,
and reduced probability of infection. Disorders
the synthesis of which substances most likely
causes these symptoms?
A. Eicosanoids
B. Interleukins
31. The mother asked the doctor about the bad
health of the child - the lack of appetite, poor
sleep, irritability. At the biochemical
examination in the blood, the absence of the
enzyme glucocerebrosidase was detected. For
which pathology is this characteristic?
A. Gaucher’s disease
B. Tay-Sachs disease
C. Niemann-Pika's disease
D. Girke's disease
E. Pompe’s disease
A. Choline
B. DOPA
C. Cholesterol
D. Acetoacetate
E. Linolic acid
32.
A
patient
is
diagnosed
with
glucocerebrosidelipidosis (Gaucher’s disease)
that manifests as splenomegaly, liver
enlargement, affected bone tissue, and
neuropathies. What enzyme of complex lipid
catabolism is deficient, thus causing this
disease?
A. Sphingomyelinase
B. β-galactosidase
C. Glucocerebrosidase
D. Hexosaminidase
E. Hyaluronidase
37.
Synthesis
of
phospholipids
is
disorderedunder the liver fat infiltration.
Indicate which of the following substances can
enhance the process of methylation during
phospholipids synthesis?
A. Methionine
B. Ascorbic acid
C. Glucose
D. Glycerin
E. Citrate
33. At utilization of arachidonic acid by
cyclooxygenase pathways, biologically active
substances are formed. Indicate them:
A. Prostaglandins
B. Thyroxine
C. Biogenic amines
D. Somatomedin
E. Insulin-like growth factors
38. Examination of cell culture gotfrom a
patient with lysosomal pathology revealed
accumulation of great quantity of lipids in the
lysosomes. What of the following diseases is
this disturbance typical for?
A. Tay-Sachs disease
B. Gout
C. Phenylketonuria
D.Wilson disease
E. Galactosemia
34. The patient appointed a lipotropic drug a
donor of methyl groups, to prevent a fatty liver
distrophia. This is sensible:
A. S-Adenosylmethionine
B. Cholesterol
C. Bilirubin
D. Valine
E. Glucose
35. Steatosis occurs as a result of the
accumulation of triacylglycerols in hepatocytes.
One of the mechanisms of development of this
disease is reduction of utilization neutral fat
LDL. What lipotropic substances prevent the
development of steatosis?
A. Methionine, BC, B12
B. Arginine, B2, B3
C. Alanine, B1, PP
D. Valine, B3, B2
E. Isoleucine, B1, B2
36. In an experimental animal, receiving nonprotein diet, fatty infiltration of the liver has
developed due to the deficiency of the
methylating agents. The formation of which
metabolite is disturbed in the experimental
animal?
39. An experimental animal has been
givenexcessive
amount
of
carbonlabeledglucose for a week. What compound
canthe label be found in?
A. Palmitic acid
B. Methionine
C. Vitamin A
D. Choline
E. Arachidonic acid
40. A 6 years old child was delivered to
ahospital. Examination revealed that thechild
couldn’t fix his eyes, didn’t keephis eyes on
toys, eye ground had thecherry-red spot sign.
Laboratory analyses showed that brain, liver and
spleen had highrate of ganglioside glycometide.
What congenital disease is the child ill with?
A. Tay-Sachs disease
B.Wilson’s syndrome
C. Turner’s syndrome
D. Niemann-Pick disease
E. MacArdle disease
41. A dry cleaner’s worker has been found to
have hepatic steatosis. This pathology can be
caused by the disruption of synthesis of the
following substance:
A. Phosphatidylcholine
B. Tristearin
C. Urea
D. Phosphatidic acid
E. Cholic acid
42. The key reaction of fatty acid synthesis is
production of malonyl-CoA. What metabolite is
the source of malonyl-CoA synthesis?
A. Acetyl-CoA
B. Succinyl-CoA
C. Acyl-CoA
D. Malonate
E. Citrate
43. A 2-year-old child presents with acute
psychomotor retardation, vision and hearing
impairment, sharp enlargement of the liver and
spleen. The child is diagnosed with hereditary
Niemann-Pick disease. What genetic defect is
the cause of this disease?
A. Sphingomyelinase deficiency
B. Glucose 6-phosphatase deficiency
C. Amylo-1,6-glucosidase deficiency
D. Acid lipase deficiency
E. Xanthine oxidase deficiency
44.
A
3-year-oldgirlwithmentalretardation
hasbeendiagnosedwithsphingomyelin lipidosis
(Niemann-Pickdisease).
Inthis
conditionsynthesisofthefollowing
substance
isdisrupted:
A. Sphingomyelinase
B. Glycosyltransferase
C. Sphingosine
D. Ceramides
E. Gangliosides
45. Modern antiatherosclerotic drugs are used
for the preventions and treatment of
atherosclerosis. Such drugs as gemfibrozil and
fenfibrate is inhibiting cholesterol biosynthesis
by enzyme digestion:
A. β-HMG-reductase
B. Hexokinase
C. Glucose-6-phosphatase
D. Acyltransferase
E. Acyl-CoA-cholesterolacyltransferase
46. The doctor gave the woman a
recommendation to continuethe low-calorie diet.
She decided to get the same amount of calories,
but to replace carbohydrates on fats. Which of
the following lipoprotein fractions will bee
levated as a result of this diet?
A. Chylomicrons
B. VLDL
C. LDL
D. LPID
E. HDL
47. For the prevention of atherosclerosis,
coronary heart disease, cerebrovascular
accident, the consumption of high-fat
polyunsaturated fatty acids is recommended.
One of the following fatty acids is:
A. Linolic
B. Oleic
C. Lauric
D. Palmitooleic
E. Stearic
48. Hereditary hyperlipoproteinemia of type I is
duetoin sufficiency of the lipoproteinlipase.
Increasing of which transport forms of lipid in
plasma is characteric even on an empty
stomach?
A. Lipoproteinsoflowdensity
B. Chylomicrons
C. Lipoproteinsofverylowdensity
D. High-densitylipoproteins
E. Modifiedlipoproteins
49. After 4 hours taking of fatty food is found
that patient blood plasma is muddy. The most
probable reason for this state is increasing the
concentration in plasma:
A. Chilomicrons
B. VLDL
C. LDL
D. Cholesterol
E. Phospholipids
50. In the diseased child is established
hyperlipoproteinemia, inherited. Genetic defect
of what synthesis enzyme causes this
phenomenon?
A. Lipoproteinlipase
B. Glycosidase
C. Proteinase
D. Hemesynthetase
E. Fenylanininehydroxylase
51. Rabbits were fed with cholesterol
supplementation.
After
5
months,
atherosclerotic changes were detected in the
aorta. Name the main cause of atherogenesis in
this case:
A. Exogenous hypercholesterinemia
B. Overeating
C. Hypodynamia
D. Endogenous hypercholesterinemia
E. Stress
52. In the examination, was established the
female
has
insufficient
activity
of
lipoproteinlipase
which
hydrolizes
the
cholymocrons triglycerides on the surface of the
endothelium adipose tissue. What biochemical
disorders should wait?
A. Hyperlipoproteinemia type I
B. Hyperlipoproteinemia II A type
C. Hyperlipoproteinemia of type III
D. Hyperlipoproteinemia of type IV
E. Hyperlipoproteinemia II B type
53. A 58-year-old patient suffers from the
cerebral atherosclerosis. Examination revealed
hyperlipoidemia. What class of lipoproteins will
most probably show increase in concentration in
this patient’s blood serum?
A. Low-density lipoproteins
B. High-density lipoproteins
C. Fatty acid complexes with albumins
D. Chylomicrons
E. Cholesterol
54. A patient underwent a course oftreatment
for atherosclerosis. Laboratorytests revealed an
increase in the antiatherogeniclipoprotein
fraction in theblood plasma. The treatment
efficacy isconfirmed by the increase in:
A. HDL
B. VLDL
C. IDL
D. LDL
E. Chylomicrons
55. During the examination of the patient, the
increase in blood serum in low density
lipoproteins was detected. What disease can be
foreseen in this patient?
A. Atherosclerosis
B. Kidney damage
C. Acute pancreatitis
D. Gastritis
E. Lung inflammation
56. During examination of a teenagerwith
xanthomatosis
the
family
history
ofhypercholesterolemia
is
revealed.
Whattransportable
lipids
are
increased
inconcentration in case of such a disease?
A. Low-density lipoproteins
B. Chylomicrons
C. Very low-density lipoproteins
D. High-density lipoproteins
E. Intermediate-density lipoproteins
57. Inthebloodofpatientswithdiabetesmellitus,
increasesthecontentoffreefattyacids
(HFAs)
areobserved. Thereasonforthismaybe:
A.
Increasingtheactivityofadipocytestriglyceridelip
ase
B. Accumulationinthecytosolof palmitic-CoA
C. Activationofketone bodies utilization
D.
Activationofthesynthesisofapolipoproteins
A-1, А-2, А-4
E.
Reducedplasma
phosphatidylcholinecholesteine acyltransferaseactivity
58. In the case of diabetes mellitus and
starvation in the blood, the amount of acetone
bodies used in the quality of energy material
increases. Name the substance from which they
are synthesized:
A. Acetyl-CoA
B. Succinyl-CoA
C. Citrate
D. Malate
E. Ketoglutarate
59. A 67-year-old man consumes eggs, pork fat,
butter, milk and meat. Blood test results:
cholesterol - 12,3 mmol/l, total lipids - 8,2 g/l,
increased low-density lipoprotein fraction
(LDL). What type of hyperlipoproteinemia is
observed in the patient?
A. Hyperlipoproteinemia type IIa
B. Hyperlipoproteinemia type I
C. Hyperlipoproteinemia type IIb
D. Hyperlipoproteinemia type IV
E. Cholesterol, hyperlipoproteinemia
60. Cholesterol content in blood serum of a 12year-old boy is 25 mmol/l. Anamnesis states
hereditary familial hypercholesterolemia caused
by synthesis disruption of receptor-related
proteins for:
A. Low-density lipoproteins
B. High-density lipoproteins
C. Chylomicrons
D. Very low-density lipoproteins
E. Middle-density lipoproteins
61. Increased HDL levels decrease the risk of
atherosclerosis. What is the mechanism of HDL
antiatherogenic action?
A. They remove cholesterol from tissues
B. They supply tissues with cholesterol
C. They are involved in the breakdown of
cholesterol
D. They activate the conversion of cholesterol
to bile acids
E. They promote absorption of cholesterol in the
intestine
Amino- acid metabolism and its regulation
1. A 36-year-old female patientwho has been
limiting the number offoodstuffs in her diet for
3 monthspresents with a decrease in body
weight, deterioration of physical andmental
health, face edemata. Thesechanges may be
caused by the deficiencyof the following
nutrients:
A. Proteins
B. Vitamins
C. Fats
D. Carbohydrates
E. Micronutrients
2. In the daily diet of an adult healthy person
should be fats, proteins, carbohydrates,
vitamins, mineral salts and water. Specify the
amount of protein per day, which provides
normal functioning of the body.
A. 100-120 g
B. 50-60 g
C.10-20 g
D. 70-80 g
E. 40-50 g
3. A 30 years old patient with acute
inflammation of the liver (pancreatitis),
violations of cavity digestion of proteins were
detected. This may be due to insufficient
synthesis and secretion of the gland of such an
enzyme:
A. Trypsin
B. Pepsin
C. Lipase
D. Dipeptidase
E. Amilaza
4. The patient was brought to the hospital with
burns of skin. To clean the wounds from dead
tissues and mucus, the doctor prescribed an
enzyme preparation for local treatment. Name
it:
A. Tripsin
B. Pansinorm
C. Asparaginase
D. Pepsin
E. Streptokinase
5. A patient with gastric juice hypersecretion
has been recommended to exclude from the
dietric broths and vegetable in fused water. A
doctor recommended it, because these food
products stimulate production of the following
hormone:
A. Gastrin
B. Secretin
C. Cholecystokinin
D. Somatostatin
E. Neurotensin
6. Young man, due to the irritation of the carotic
plexus by the inflammatory process (solarium),
the functional activity of the glands of the
stomach is increased, which is expressed, in
particular, in the increase of the product of
chloride acid. Which of the following
substances causes hypochlorhydria in this case?
A. Gastrin
B. Gastrointing peptide
C. Urologist
D. Glukagon
E. Kalikrein
7. The pyloric part of the stomach has been
removed. Reducing the secretion of which
hormone should be seen first of all?
A. Gastrin
B. Gistamin
C. Secretin
D. Kholetsistokinin
E. Stinging digestive peptide
8. In order to determine the maximum secretion
of hydrochloric acid in gastric juice, a solution
of histaminewas given to 42-year-old patient.
This led to increasing of the secretion of the
parietal gland of such component of juice as:
A. Bicarbonates
B. Trypsinogen
C. Lipase
D. Amilaza
E. Slime
9. In the acute experiment, a weak solution of
hydrochloric acid was introduced into the cavity
of the duodenum of animal. Will it increase the
secrecy of the gastrointestinal hormone?
A. Sekretin
B. Gastrin
C. Motilin
D. Neurotensin
E. Gistamin
10. Transformation of proteins in the stomach is
the initial stage of protein digestion in the
human digestive tract. What are the enzymes
involved in digestive proteins in the stomach:
A. Pepsin and gastriksin
B. Trypsin and Cathepsin
C. Chymotropins and lysozyme
D. Enteropeptidase and elastase
E. Carboxypeptidase and aminopeptidase
11. A newborn child suffers from milkcurdling
in stomach, this means thatsoluble milk proteins
(caseins) transformto insoluble proteins
(paracaseins) bymeans of calcium ions and a
certainenzyme. What enzyme takes part in
thisprocess?
A. Renin
B. Pepsin
C. Gastrin
D. Secretin
E. Lipase
12. A patient has been prescribed
pyridoxalphosphate. What processes are
correctedwith this drug?
A. Transamination and decarboxylation
ofaminoacids
B. Oxidative decarboxylation of keto acids
C. Deaminization of amino acids
D. Synthesis of purine and pyrimidine bases
E. Protein synthesis
13. To the hospital delivered 7 years-old
childwith allergic shock, which developed after
she was stomped by bee. In the blood, the
concentration of histamine is increased.The
result of which reaction formed this amine?
A. Decarboxylation
B. Hydroxylation
C. Degradation
D. Deamination
E. Restoration
14. The allergen was administered to the patient,
tested for hypersensitivity, under the skin,and
than saw reddening, edema, and even after the
action of histamine. As a result of which the
amino acid conversion of histidine forms this
biogenic amine?
A. Decarboxylation
B. Methylation
C. Phosphorylation
D. Isolation
E. Depositing
15.
Pharmacological
effects
of
antidepressantsare connected with inhibition of
an enzyme catalyzing biogenic amines
noradrenaline
and
serotonine
in
the
mitochondrions of cerebral neurons. What
enzyme participates in this process?
A. Monoamine oxidase
B. Transaminase
C. Decarboxylase
D. Peptidase
E. Lyase
16. It is known that in the metabolism of
catecholamine mediators a special role belongs
to the enzyme monoamine oxidase (MAO).
How does this enzyme inactivate mediators
(noradrenaline, adrenaline, dopamine)?
A. The oxidative deamination
B. Addition of an amino group
C. Removal of the metal group
D. Carboxylation
E. Hydrolisis
17. During the catabolism of histidine, a
biogenic amine is formed, which has a powerful
vasodilating effect. Name it.
A. Histamine.
B. DOPA.
C. Dopamine.
D. Serotonin.
E. Noradrenalin.
18. When decarboxylating glutamate in the
central nervous system, a mediator of inhibition
is formed. Name it.
A. GAMK.
B. Glutathione.
C. Histamine.
D. Serotonin.
E. Asparagine.
19. Biogenic amines are used in psychiatry for
the treatment of a number of diseases of the
central nervous system. Specify the drug of this
group, which is a mediator of inhibition:
A. γ-aminobutyric acid.
B. Dopamine.
C. Histamine.
D. Serotonin.
E. Taurin.
20. A child 9 months old eats artificial sweeties
that are not balanced by the vitamin B6. A child
have a pelagic dermatitis, convulsions, anemia.
The development of a cramps may be related
with a violation of forming of:
A. GAMK
B. Gistamin
C. Serotonin
D. DOPA
E. Dopamin
21. What neurotransmitter in the brain tissue
can be synthesized from the product of
reamination of alpha-ketoglutaric acid?
A. GAMK
B. Tryptamine
C. Dopamine
D. Serotonin
E. Noradrenalin
22. In a patient with a diagnosis of malignant
carcinoma, the severely increased amount of
serotonin in the blood.Choose the amino acid
from which this compound is formed:
A. Tryptophan
B. Allanin
C. Leicin
D. Treonin
E. Methionin
23. Hospitalized patient with diagnosis of
intestinal carcinoids. Analizes showed an
increasing secretion of serotonin. It is known
that this substance is formed from an amino acid
tryptophan. What biomechanical mechanism is
the basis of this process?
A. Decarboxylation
B. Deamination
C. Microsomal oxidation
D. Transamination
E. Formation of paired compounds
24. Methyl groups (-CH3) are used in the body
to synthesize such important compounds as
creatine, choline, adrenaline, and others. The
source of these groups is one of the essential
amino acids, namely:
A. Methionin
B. Valin
C. Leicin
D. Isoleucine
E. Tryptophan
25. Cationic glycoproteins are the main
components of salivation of parotid glands.
What amino acids cause their positive charge?
A. Lizin, arginine, histystine
B. Aspartate, glutamate, glycine
C. Aspartate, arginine, glutamate
D. Glutamate, valine, leucine
E. Cysteine, glucine, proline
26. There are several ways to dispose of
ammonia in the body, but for specific organs are
specific. What is the way to neutralize this toxic
substance is typical for brain cells?
A. Formation of glutamine.
B. Formation NH 4 +.
C. Formation of asparagine.
D. Formation of Creatine.
E. Formation of urea.
27. Ammonia is a very poisonous substance,
especially for the nervous system. What
substance is particularly active in ammonia
disinfection in brain tissues?
A. Glutamic acid.
B. Lizin.
C. Proline.
D. Hystidine.
E. Alanin.
28. It is known that accumulation of ammonia is
the main cause of cerebral coma in hepatic
insufficiency. What is a free amino acid plays a
primary role in the use of this toxic substance in
the brain?
A. Glutamic acid.
B. Alanin.
C. Histidine.
D. Tryptophan.
E. Cysteine.
29. After an injury to the brain, the patient has
an increased ammonia formation. What amino
acid is involved in removing ammonia from this
tissue?
A. Glutaminov.
B. Valin.
C. Lizin.
D. Tyrosin
E. Tryptophan
30. The patient entered the clinic with a
concussion of the brain. On the background of
neurological symptoms, the concentration of
ammonia in the blood increases. What substance
should be used to neutralize this substance in
the brain tissue?
A. Glutamic acid
B. Gistamin
C. Ascorbic acid
D. Serotonin
E. Nicotinic acid
31. After the operation on the intestines, the
patient appeared symptoms of poisoning with
ammonia according to the type of stomach
coma. What mechanism of action of ammonia
on the energy supply of the central nervous
system?
A. Braking (slowdown) CTK due to the binding
of alpha ketoglutarate
B. Braking of glycolysis
C. Braking of beta-oxidation of fatty acids
D. Inactivation of the enzymes of respiratory
chain
E. Dissociation of oxidative phosphorylation
32. In a newborn child there is a decrease in
intensity of sucking, frequent vomiting,
hypotension. In urine and blood, the
concentration of citrulline is significantly
increased. What metabolic process is affected?
A. Ornithine cycle
В. Glycolysis
C. Core's cycle
D. СТК
E. Gluconeogenesis
33. In a 3 year old child, which outlived the
severe viral infection, the doctor has indicated
re-vomiting, unconsciousness, convulsions. The
hyperammonemia was detected during the
analysis. What can be connected with changing
of the biochemical indicators of blood in this
child?
A. Violation of ammonia neutralization in the
ornithine cycle
B.
Activation
of
the
processes
of
decarboxylation of amino acids
C. Violation of neutralizing of biogenic amines
D. Strengthening of decay of proteins in the
intestines
E. Depressing the activity of transamination
enzymes
34. The main part of nitrogen is taking out of
organism as element of urea. Reducing the
activity of what liver enzyme leads to inhibition
of the synthesis of urea and increasing the
accumulation of ammonia in blood and tissues?
A. Carbamoyl phosphate synthase
B. Aspartate aminotransferase
C. Urease
D. Amilaza
E. Pepsin
35. In a 2 year old child, there is a Intellectual
disability, intolerance of protein foods, severe
hyperammonia as the result of reduced level of
urea in the plasma of blood, which is connected
with birth deficiency of such mythohondrial
enzyme as:
A. Carbamoyl phosphate synthase
B. Citrate synthase
C. Succinate dehydrogenase
D. Malatedehydrogenase
E. Monoamine oxidase
36. In the biosynthesis of urea in the liver, the
formation of ornithine and urea is stimulated.
What amino acid is the intermediate product of
this synthesis?
A. Аrginine
B. Leicinc.
C. Сitrate.
D. Valin.
E. Tryptophan.
37. In the urine of the newborn, determined by
citrulline and high levels of ammonia. Indicate
which substance is most likely to be inflicted on
a baby?
A. Urea.
B. Bilirubin.
C. Creatine.
D. Creatinine.
E. Uric acid.
38. In a patient with reduced singular function
of the kidneys, an unpleasant odor is noted from
the mouth. Increased excretion of the salivary
glands of what substance is the cause of this?
A. Urea
B. α-amylase.
C. Mutsina.
D. Lysozyme.
E. Fosfatasi.
39. A patient in an unconscious state is
delivered by an ambulance brigade to the
hospital. Objectively: reflexes are absent,
seizures occur periodically, breathing is
unequal. After a laboratory examination, the
liver was diagnosed with a coma. The
accumulation of which metabolites in the blood
is essential for the appearance of central nervous
system disorders?
A. Ammonia.
B. Bilirubin.
C. Gistamin.
D. Glutamin.
E. Urea.
D. Methionine
E. Glutamine
40. In a boy of 4 years after suffering from
severe viral hepatitis, vomiting, episodes of
nephropathy, seizures are observed. In the blood
there is hyperammonia. Violation of which of
the biochemical process in the liver caused such
a condition of the patient?
A. Disposal of ammonia.
B. Decarboxylation of amino acids.
C. Disposal of Biogenic Amines.
D. Synthesis of alphabets.
E. Gluconeogenesis.
45. A 46-year-old patient suffers from
progressing Duchenne muscular dystrophy.
Changes of the following blood enzyme level
may diagnose this condition:
A. Creatine phosphokinase
B. Lactate dehydrogenase
C. Pyruvate dehydrogenase
D. Glutamate dehydrogenase
E. Adenylate kinase
41. Examination of a 2 year-old child with renal
insufficiency revealed hyperoxaluria that caused
depositing of calcium oxalate stones in the
kidneys. The reason for this condition is a
disturbance of metabolism of the following
aminoacid:
A. Glycine
B. Lysine
C. Methionine
D. Arginine
E. Histidine
42. Antioxidant enzymes inhibit lipid
peroxidation processes. Decrease of glutathione
peroxidase activity is caused by deficiency of
the following microelement:
A. Selenium
B. Molybdenum
C. Cobalt
D. Manganese
E. Copper
43. Blood vessels endothelium has a
significantly high metabolic activity as it
synthesizes a variety of vasoactive substances.
What powerful vasodilatator is synthesized from
L-arginine?
A. Nitric oxide
B. Histamine
C. Bradykinin
D. Acetylcholine
E. Epinephrine
44. Nitric oxide is a powerful vasodilatator and
blood pressure regulator. In human organism it
is synthesized from:
A. Arginine
B. Proline
C. Lysine
46. It was found that the cause of dizziness,
memory impairment, and periodic judgment in
the patient is a violation of the decarboxylation
of glutamic acid. What is the product of this
reaction:
A. GAMK.
B. PAUL
C. TDP
D. ATP.
E. TGFK.
47. A 24 year-old patient that suffers from
epilepsy was administered glutamic acid. What
product of its decarboxylation caused the
therapeutic effect?
A. GABA
B. Histamine monooxygenase
C. Serotonin
D. Dopamine
E. Taurine
48. A baby has epileptical convulsions that are
caused by vitamin B6 defficiency. It is due to
the decrease of GABA in the neural tissue.
What enzyme activity is decrased in this case?
A. Glutamate decarboxylase
B. Alanine aminotransferase
C. Glutamate degydrogenase
D. Pyridoxal kinase
E. Glutamate synthetase
49. In a patient with a sharp increase in
serotonin level, the diagnosis of "malignant
carcinoid" is observed in the blood. Choose the
amino acid from which the given biogenic
amine can be formed.
A. Tryptophan.
B. Alanine.
C. Leicin.
D. Methionine
E. Threonine.
50. А patient suffering from pellagra was
examined. It was found that his diet included
almost no meat and consisted mostly of corn.
His condition was caused by the deficiency of
the following substance in corn: A. Tryptophan
B. Tyrosine
C. Proline
D. Alanine
E. Histidine
51. A patient that is suffering from congenital
Hartnup disease has pellagra-like dermatosis
and mental retardation due to the deficiency of
nicotinic acid. The reason for this condition is
the violation of the following process:
A. Tryptophan absorption and reabsorption in
the kidneys
B. Phenylalanine transamination
C. Tryptophan decarboxylation
D. Methionine absorption and reabsorption in
the kidneys
E. Cysteine absorption and reabsorption
52. A woman was bitten by a wasp. Shortly
after the bite a painful and itching blister was
formed. After some more time hives and
dyspnea developed. What factor was the reason
for it?
A. Histamine
B. Hagemann factor
C. Lysosomal enzymes
D. Norepinephrine
E. Epinephrine
53. Shortly after the dental treatment the patient
has developed red itching blemishes on the
facial skin and oral mucosa. Urticaria was
diagnosed. Vasodilatation and itching were
caused by the following bioactive substance:
A. Histamine
B. Prostaglandin Е2
C. Leucotriene В4
D. Interleukin-1
E. Bradykinin
54. The patient has an allergic reaction, which is
accompanied by itching, swelling and reddening
of the skin. Concentration of which biogenic
amine has increased in tissues?
A. Histamine.
B. Gamma-aminobutyric acid.
C. Dopamine.
D. Serotonin.
E. Triptamin.
55. A patient has the initial stage of gingivitis.
Dilatation of the microcirculatory vessels
caused gum hyperaemia. What substance
produced by mast cells caused the changes
mentioned above?
A. Histamine
B. Epinephrine
C. Substance P
D. Endorphins
E. Actylcholine
56. A cook burned his hand incautiously. What
substance has caused the reddening, swelling
and pain of the damaged area?
A. Histamine
B. Thiamine
C. Glutamine
D. Lysine
E. Galactosamine
57. L-DOPA is the precursor chemical of
dopamine. It is prescribed for Parkinson’s
disease treatment. What aminoacid is used for
its biosynthesis?
A. Tyrosine
B. Alanine
C. Cysteine
D. Histidine
E. Tryptophan
58. A patient suffering from Parkinson’s disease
has tremor of both hands. This symptom is
caused by the deficiency of the following
neurotransmitter in the striatopallidal structures:
A. Dopamine
B. GABA
C. Substance P
D. Epinephrine
E. Serotonin
59. An 84 year-old patient suffers from the
Parkinson’s disease. One of its pathogenetic
causes is the defficiency of a neurotransmitter in
certain neural structures. What neurotransmitter
is it?
A. Dopamine
B. Epinephrine
C. Norepinephrine
D. Histamine
E. Acetylcholine
60. At the examination in the clinic, the man
was diagnosed with acute radiation sickness.
Laboratory has established a sharp decrease in
serotonin in platelets. The metabolism of a
substance is a possible cause of this condition?
A. 5-oxytriptophane.
B. Tyrosine.
C. Histidine.
D. Phenylalanine.
E. Serine.
61. A 20-year-old woman came to the doctor
with complaints of general weight loss, loss of
appetite,
weakness,
skin
discoloration
resembling bronze tan. In addtition to
hyperpigmentation, examination in the hospital
revealed bilateral adrenal tuberculosis. What
substance leads to skin hyperpigmentation,
when accumulated excessively?
A. Melanin
B. Bilirubin
C. Hemozoin
D. Lipofuscin
E. Adrenochrome
62. A person consumed methionine-poor
products for a long period of time. As a result
neural and endocrine disorders have developed.
They may be caused by the disturbance of the
following substance synthesis:
A. Adrenaline
B. Pyruvate
C. Thyronine
D. Fatty acids
E. Glucagon
63. A 12-year-old boy in the urine revealed high
levels of all amino acids in the aliphatic row. In
this case, the highest excretion of cysteine and
cysteine was noted. In addition, ultrasound of
the kidneys showed the presence of stones in
them. Choose a possible pathology.
A. Cystinuria.
B. Alpathururia.
C. Cystitis
D. Phenylketonuria.
E. Hartnup's disease.
64. Parents of the 3-year-old child drew
attention to the fact that the child's urine
becomes dark when restrained. Objectively: the
body temperature is normal, the skin is pink,
clean, the stove is not elevated. What disease is
accompanied by such manifestations.
A. Alkaptonuria.
B. Hemolytic anemia.
C. Itsenko-Cushing syndrome.
D. Gout.
E. Fenilketonuria.
65. What is the most probable diagnosis in a
child of infancy, in which there is darkening of
sclera, mucous membranes, auricles, separated
urine darkens in the air, in the blood and urine
found homogensic acid?
A. Alkaptonuria.
B. Albinism.
C. Hemolytic anemia.
D. Porphyria.
E. Cystinuria.
66. A baby has coloured sclera and mucouses
and her urine is darkening when exposed to air.
Homogentisic acid was found in urine and blood
samples. What is the reason for this condition?
A Alcaptonuria
B. Albinism
C. Galactosemia
D. Cystinuria
E. Histidinemia
67. Dark stains on baby’s diapers indicate
homogentisic acid synthesis. What substance’s
metabolism is disturbed?
A. Tyrosine
B. Galactose
C. Methionine
D. Cholesterol
E. Tryptophan
68. Excretion of homogentisic acid with the
urine is the reason for the condition called
alcaptonuria. Disturbance of which amino acid
metabolism causes this condition?
A. Tyrosine
B. Phenylalanine
C. Alanine
D. Methionine
E. Asparagine
69. A 5-year old child has darkened urine but no
bile enzymes were found in it. The child is
diagnosed with alcaptonuria. Which enzyme
deficiency is the reason for it?
A. Homogentisic acid oxydase
B. Phenylalanine hydroxylase
C. Tyrosinase
D. Oxyphenylpyruvate oxydase
E. Phenylpyruvate decarboxylase
70. What kind of treatment is needed in a child
with phenylketonuria, in whose blood there is
an increased amount of phenylpyruvic acid?
A. Diet therapy.
B. Antibacterial therapy.
C. Vitamin therapy.
D. Hormonotherapy.
E. Fermentotherapy.
71. A 9-year-old child has a mental and physical
lag. In the biochemical analysis of blood, an
increased amount of phenylalanine has been
detected. Blocking of an enzyme can lead to this
condition?
A. Phenylalanine-4-monooxygenase.
B. Aspartate aminotransferases.
C. Glutamintransaminase.
D. Glutamate-carboxylase.
E. Oxidazes of homogenetic acetic acid.
72. In a sick child, a raised level of
phenylpyruvate was detected in the urine (in the
norm practically absent). The amount of
phenylalanine in the blood is 350 mg/l (about 15
mg/l). Which disease is characterized by the
above symptoms?
A. Fenilketonuria.
B. Albin.
C. Alpathonuria.
D. Gout
E. Tyrosinosis.
73. A certain type of congenital pathology is
accompanied with the inhibition of tyrosine
formation from phenylalanine. Biochemical
indicator of this condition is depositing of the
following acid in the organism:
A. Phenylpyruvate
B. Citric acid
C. Pyruvate
D. Lactic acid
E. Glutamine
74. A 6 month-old baby has mental and physical
development
retardation,
seizures,
pale
eczematous skin, light hair, blue eyes. What
substance presence in blood and urine can help
to make a diagnosis in this case?
A. Phenylpyruvate
B. Tryptophan
C. Histidine
D. Leucine
E. Valine
75. Excess of phenylpyruvate and phenylacetate
was detected in the urine sample of a 6 day-old
baby. Which amino acid metabolism is
disturbed?
A. Phenylalanine
B. Tryptophan
C. Methionine
D. Histidine
E. Arginine
76. A 1.5 year-old child is mentally and
physically retarded, hair and skin are whitened,
the level of catecholamines in the blood is
decreased. After adding few drops of 5%
solution of ferrum trichloracetate to the urine it
changes its colour to olive green. This
symptoms are typical for the following
condition:
A. Phenylketonuria
B. Alcaptonuria
C. Tyrosinosis
D. Albinism
E. Xanthinuria
77. A child with mental and physical
development retardation was delivered to the
hospital. Phenylpyruvate was found in the urine.
Disturbance of which process is the reason for
this pathology?
A. Amino acid metabolism
B. Lipid metabolism
C. Carbohydrate metabolism
D. Water-salt balance regulation
E. Calcium and phosphate homeostasis
78. A patient with complaints about intolerance
to solar radiation was contacted by a doctor.
There is burn skin and visual impairment.
Preliminary diagnosis of albinism. Disturbance
of the exchange of amino acids observed in this
patient?
A. Tyrosine.
B. Proline
C. Lizin.
D. Alanin.
E. Tryptophan
79. Albinoses has increased sensitivity to
sunlight therefore they get burns instead of tan.
Which amino acid metabolism disturbance is
the reason for the condition?
A. Phenylalanine
B. Methionine
C. Tryptophan
D. Glutamine
E. Histidine
80. The patient is 12 years old, he has a general
weakness, dizziness, fatigability, lag in mental
development. In the laboratory examination,
high concentrations of valine, isoleucine,
leucine in blood and urine were detected. Urine
specific odor. What disease does this happen?
A. Disease of maple syrup.
B. Basetic disease.
C. Hystidominemia.
D. Tyrosinosis.
E. Addison's Illness.
81. A 13 year-old boy is complaining about
general weakness, dizziness, fatigue. Mental
retardation is detected. The examination
revealed high concentrations of valine,
isoleucine, and leucine in blood and urine. The
urine has a specific smell. What is the most
possible diagnosis?
A. Maple syrup urine disease
B. Addison’s disease
C. Tyrosinosis
D. Histidinemia
E. Grave’s disease
82. The child's urine had a characteristic smell
of maple syrup. In the laboratory study, high
levels of leucine, valine, isoleucine and their
keto-derivatives were found in blood and urine.
What kind of enzyme is inadequate for this
disease?
A. Dehydrogenases of branched-chain amino
acids.
B. Aminotransferases.
C. Glucose-6-phosphatase.
D. Phosphorutokinase.
E. Phosphofructomatase.
83. A baby refuses breastfeeding, it is nervous,
its respiration is arrhythmic and urine has a
specific smell of maple syrup. What congenital
enzymopathy is the reason for this condition?
A. Keto acid dehydrogenase
B. Glucose-6-phospate dehydrogenase
C. Glycerol kinase
D. Aspartate aminotranspherase
E. UDP-glucoronosyltranspherase
84. A lab test revealed increased concentration
of leucine, valine, isoleucine and ketone
derivatives in the blood and urine. The urine has
a specific smell of maple syrup. Which enzyme
deficiency is typical for this condition?
A. Amino acid dehydrogenase
B. Aminotranspherase
C. Glucose-6-phosphatase
D. Phosphofructokinase
E. Phosphofructomutase
85. A hospital admitted a patient with
complaints about abdominal swelling, diarrhea,
meteorism after consumption of food rich in
proteins. It is indicative of disturbed protein
digestion and their intensified decaying. What
substance is the product of this process in the
bowels?
A. Bilirubin
B. Indole
C. Cadaverine
D. Agmatine
E. Putrescine
86. A 60 year-old man suffers from chronic
intestinal obstruction. The processes of protein
decomposition in the large intestine are
intensified. What is the evidence of these
processes?
A. Indicanuria
B. Bilirubinuria
C. Hyperuricosuria
D. Creatinuria
E. Glucosuria
87. A patient has been operated due to acute
abdomen. His urine is brown, concentration of
indican is higher than 93 mmol/day. What does
it indicate?
A. High intensity of protein decomposition
processes in the intestine
B. Decreased activity of the urea cycle enzymes
C. Acceleration of aromatic amino acids
desamination
D. Disturbance of the kidney absorption
E. Decrease of ammonia detoxification
88. A 43 year-old woman has been operated due
to acute abdomen. Her urine is brown and the
concentration of indican in the blood has
increased rapidly. What does it indicate?
A.High intensity of protein decomposition
B. Acceleration of amino acids desamination
C. Supression of glomerular filtration
D. Decreased intensity of the urea cycle
E. Inhibition of gluconeogenesis
89. Indican is a byproduct of certain amino acid
decomposition in the large intestine. Its
excretion with the urine is used to indicate the
functional condition of the liver. What is this
amino acid?
A. Tryptophan
B. Valine
C. Glycine
D. Serine
E. Cysteine
Ministry of Public Health of Ukraine
O. O. BOGOMOLETS NATIONAL MEDICAL UNIVERSITY
Department of Bioorganic and Biological Chemistry
LIST OF TEST QUESTIONS
for preparation of Content module № 3
" Biochemistry of tissues and physiological
functions "
FOR STUDENTS OF THE 2ST YEAR OF STUDY
OF MEDICAL and STOMATOLOGICAL FACULTIES
Kyiv-2019
1
Content
Fundamentals of Molecular Biology and Genetics ................................... 3
Biochemistry of intercellular communications:
hormones of protein-peptide nature .................................... 14
hormones of steroid and thyroid nature .............................. 22
Functional and clinical biochemistry of organs and tissues:
Biochemistry and pathobiochemistry of blood ......................................... 29
Biochemistry of immune system................................................................ 46
Biochemistry of liver .................................................................................. 51
Pathologic urine components .................................................................... 59
Biochemistry of nervous tissue.................................................................. 65
Biochemistry of muscle tissue ................................................................... 68
Biochemistry of connective tissue ............................................................. 71
Biochemistry of tooth and saliva (for stomat. faculty) ............................. 74
2
Fundamentals of Molecular Biology and Genetics
1. Gastroenterologists were assigned allopurinol,
which inhibits the synthesis of uric acid by
inactivating such an enzyme:
A. Xanthine oxidase
B. Deaminase
C. Hyaluronidase
D. Lactate dehydrogenase
E. Transaminase
2. On the basis of laboratory analysis, the
patient was diagnosed with gout. Based on
laboratory analysis, the patient confirmed the
diagnosis of gout. What was the analysis for the
diagnosis?
A. Determination of uric acid in the blood and
urine
B. Determination of urinary creatinine
C. Determination of residual nitrogen in the
blood
D. The determination of urea in the blood and
urine
E. Determination of urine ammonia
3. A patient suffering from gout was prescribed
allopurinol.What pharmacological property of
allopurinol provides the rapeutic effect in this
case?
A. Competitive inhibition of xanthine oxidase
B.
Acceleration
of
nitrogen-containing
substances excretion
C. Acceleration of pyrimidine nucleotides
catabolism
D. Deceleration of pyrimidine nucleotides
salvage
E. Acceleration of nucleic acids synthesis
4. Blood of a 12 year old boy presents low
concentration of uric acid and accumulation of
xanthine and hypoxanthine. This child has
genetic defect of the following enzyme:
A. Xanthine oxidase
B. Arginase
C. Urease
D. Ornithine carbamoyltransferase
E. Glycerylkinase
5. A 42-year-old man suffering from gout has
increased level of urinary acid in blood.
Allopurinol was prescribed to decrease the level
of urinary acid. Competitive inhibitor of what
enzyme is allopurinol?
A. Xanthine oxidase
B. Adenosine deaminase
C. Adenine phosphoribosiltransferase
D. Hypoxanthine phosphoribosiltransferase
E. Guanine deaminase
6. Allopurinol is a competitor of xanthine
oxidase, who was prescribed for urolithiasis
after the examination. The basis for this was the
chemical analysis of kidney stones, which
consisted mainly of:
A. Urat sodium
B. Dihydrate calcium oxalate
C. Monohydrate calcium oxalate
D. Phosphate calcium
E. Calcium Sulphate
7. A 48 year old patient complained about
intense pain, slight swelling and reddening of
skin over the joints, temperature rise up to
38oC.
Blood
analysis
revealed
high
concentration of urates. This condition might be
caused by disturbed metabolism of:
A. Purines
B. Collagen
C. Cholesterol
D. Pyrimidines
E. Carbohydrates
8. A 46 year old patient applied to a doctor
complaining about joint pain that becomes
stronger the day before weather changes. Blood
examination
revealed
strengthened
concentration of uric acid. The most probable
cause of the disease is the intensified
disintegration of the following substance:
A. Adenosine monophosphate
B. Cytidine monophosphate
C. Uridine triphosphate
D. Uridine monophosphate
E. Thymidine monophosphate
9. A patient has increased content of uric acid in
his blood that is clinically presented by pain
syndrome as a result of urate deposition in the
joints. What process does this acid result from?
A. Lysis of purine nucleotides
B. Lysis of pyrimidine nucleotides
C. Heme catabolism
D. Proteolysis
E. Reutilization of purine bases
10. A 65 year old man suffering from gout
complains of kidney pain. Ultrasound
3
examination revealed renal calculi. The most
probable cause of calculi formation
is the strengthened concentration of the
following substance:
A. Uric acid
B. Cholesterol
C. Bilirubin
D. Urea
E. Cystine
11. In the synthesis of purine nucleotides, some
amino acids, indigenous vitamins, phosphoric
ribozymes are involved. Name the most
important vitamin needed for purine nucleotide
synthesis de novo.
A. Folic acid
B. Pantothenic acid
C. Nicotinic acid
D. Ryboflavin
E. Pyridoxine
12. The patient has a hypovitaminosis of folate,
which may lead to a violation of the synthesis:
A. Purin and Tymidyl nucleotides
B. Purine nucleotides and cholesterol
C. Tymidyl nucleotides and fatty acids
D. Heme and creatine
E. Citrate and ketone bodies
13. Purine ring biosynthesis occurs in ribose-5phosphate through gradual accumulation of
nitrogen and carbon atoms and closing of the
rings. The source of ribose phosphate is the
process of:
A. Pentose phosphate cycle
B. Glycolysis
C. Glyconeogenesis
D. Gluconeogenesis
E. Glycogenolysis
14. A 8 year old boy suffering from the LeshNichan disease.He has increased content of uric
acid in his blood. Indicate which violation of
the process is the cause of this hereditary
disease?
A. Lysis of purine nucleotides
B. Synthesis of purine nucleotides
C. Synthesis of pyrimidine nucleotides
D. Lysis of pyrimidine nucleotides
E. Formation of deoxyribonucleotides
15. Children with Lesch-Nyhan syndrome have
a severe form of hyperuricemia accompanied by
the formation of tophi, urate calculi in the
urinary tracts, as well as serious neuropsychiatric disorders. The cause of this disease
is the reduced activity of the following enzyme:
A.Hypoxanthine-guanine
phosphoribosyltransferase
B. Xanthine oxidase
C. Dihydrofolate reductase
D. Thymidylate synthase
E. Karbamoyl phosphate synthetase
16. A 1,7-year-old child with a developmental
delay and manifestations of self-agression has
the concentration of uric acid in blood at the rate
of 1,96 millimole/l. What metabolic disoder is
this typical for?
A. Lesch-Nyhan syndrome
B. Podagra
C. Acquired immunodeficiency syndrome
D. Gierke’s disease
E. Cushing’s basophilism
17. A newborn child gains weight very slowly,
his urine contains too much orotic acid that is
indicative of disturbed synthesis of pyrimidine
nucleotides. What metabolite should be used in
order to normalize metabolism?
A. Uridine
B. Adenosine
C. Guanosine
D. Thymidine
E. Histidine
18. In orоtaciduria the release of Orotic acid is
many times higher than normal. Synthesis of
what substances will be disturbed in this
pathology?
A. Pyrimidine nucleotides.
B. Biogenic Amines.
C. Purine nucleotides.
D. Urea
E. Uric acid
19. Pterin derivatives (aminopterin and
methotrexate) are the inhibitors of dihydrofolate
reductase, so that they inhibit the regeneration
of tetrahydrofolic acid from dihydrofolate.
These drugs inhibit the intermolecular tranfer of
monocarbon groups, thus suppressing the
synthesis of the following polymer:
A. DNA
B. Protein
C. Homopolysaccharides
4
D. Gangliosides
E. Glycosaminoglycans
D. Pyridoxalphosphate
E. Nicotinamidadenindynucleotide
20. Methotrexate (structural analogue of the
folic acid which is competitive inhibitor of the
dihydrofolatreductase) is prescribed for
treatment of the malignant tumour. On which
level does methotrexate hinder synthesis of the
nucleic acids?
A. Mononucleotide synthesis
B. Replication
C. Transcription
D. Reparation
E. Processing
25. radiation and chemotherapy. The complex
of medicinal products included 5-fluorodeoxyuridine - thymidylate synthetase inhibitor.
Synthesis of what substance is blocked by this
drug?
A. DNA
B. i-RNA
C. p-RNA
D. t-RNA
E. -
21. Methotrexate (structural analogue of the
folic acid which is competitive inhibitor of the
dihydrofolatreductase) is prescribed for
treatment of the malignant tumour. On which
level does methotrexate hinder synthesis of the
nucleic acids?
A. Mononucleotide synthesis
B. Replication
C. Transcription
D. Reparation
E. Processing
22. An oncological patient was administered
methotrexate. With the lapse of time the target
cells of the tumour lost sensitivity to this
preparation. We can observe changes in the
gene expression of the following enzyme:
A. Dihydrofolate reductase
B. Thiminase
C. Desaminase
D. Folate oxidase
E. Folate decarboxylase
23. Leukoses are treated with antimetabolite
methotrexate. What vitamin is its antagonist?
A. Folic acid
B. Cyanocobalamin
C. Phyllochinone
D. Piridoxine
E. Rutin
24. For the normal of the replication process
necessary Thimidyl nucleotides
that are
synthesized by the enzyme Thymidylate
synthase are , as coenzyme is used:
A. Methylenetetrahydrofolate
B. Carboxybiotin
C. Thiamindyfosphate
26. According to the model of double DNA
helix that was suggested by Watson and Creek,
it was established that one of chains would not
be lost during replication and the second chain
would be synthesized complementary to the first
one. What way of replication is it?
A. Semiconservative
B. Analogous
C. Identical
D. Dispersed
E. Conservative
27. Among organic substances of a cell there is
a polymer composed of dozens, hundreds, and
thousands of monomers. This molecule is
capable of self-reproduction and can be an
information carrier. X-ray structure analysis
shows this molecule to consist of two
complementary spiral threads. Name this
compound:
A. DNA
B. RNA
C. Cellulose
D. Carbohydrate
E. Hormone
28. Ability to divide is characteristic of
procariotic and eukaryotic cells. Procariotic cell
division is different from that of eukaryotic, but
there is one molecular process that is the basis
of both types of division. Name this process.
A. DNA replication
B. Transcription
C. Reparation
D. Translation
E. Gene amplification
29. Epithelium regeneration of mucous
membrane of oral cavity (cell reproduction) was
5
accompanied by semiconservative DNA
replication (selfreproduction). Nucleotides of a
new DNA chain are complementary to:
A. Maternal chain
B. Sense codons
C. DNA-polymerase enzyme
D. Introns
E. RNA-polymerase enzyme
30. 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. Helicase
B. RNA polymerase
C. Ligase
D. Restrictase
E. DNA polymerase
31. A group of researchers set an experiment
and obtained anucleatemutant cells. In the first
place they will have disturbed synthesis of the
following compounds:
A. Ribosomal RNA
B. Transfer RNA
C. Lipids
D. Monosaccharides
E. Polysaccharides
32.
Nucleolus
organizers
of
human
chromosomes 13-15, 21, 22 include about 200
gene clusters that synthesize RNA. These
chromosomal regions contain the information
on the following type of RNA:
A. rRNA
B. tRNA
C. mRNA
D. snRNA
E. tRNA + rRNA
33. Amino acids join to each other in ribosomes
of granular endoplasmic reticulum. Knowing
the sequence of amino acids and applying
genetic code, it is possible to determine the
sequence of nucleoids in:
A. mRNA
B. Introns
C. Proteins
D. Carbohydrates
E. rRNA
34. You are studying functioning of a bacteria
operon. The operator gene has been released
from the repressor gene. Immediately after this
the following process will start in the cell:
A. Transcription
B. Translation
C. Replication
D. Processing
E. Repression
35. It was proved that a molecule of immature
mRNA (precursor mRNA) contained more
triplets than amino acids found in the
synthesized protein. The reason for that is that
translation is normally preceded by:
A. Processing
B. Initiation
C. Reparation
D. Mutation
E. Replication
36. Nowadays about 50 minor bases have been
found in the t-RNA structure besides the main
four nitrogenous bases. Choose the minor
nitrogenous base:
A. Dihydrouracil
B. Uracil
C. Cysteine
D. Adenine
E. Cytosine
37. Inside a human cell the informational RNA
containing both exons and introns was delivered
to the granular endoplasmic reticulum to the
ribosomes. What process does NOT take place?
A. Processing
B. Replication
C. Transcription
D. Translation
E. Prolongation
38. Synthesis of i-RNA passes on the DNA matrix,
taking
into
account
the
principle
of
complementarity. If the triplets in the DNA are the
following - ATG-CGT, then the corresponding iRNA codons will be:
A. UAC-GCA
B. AUG-CGU
C. ATG-CGT
D. UAG-CGU
E. TAG-UGU
39. General structure of eukaryotic genes is as
follows: exon-intron-exon. Such functional
6
structure of a gene leads to certain specifics of
the transcription process. What sequence will
correspond with precursor mRNA (immature)?
A. Exon-intron-exon
B. Exon-exon-intron
C. Exon-exon
D. Intron-exon
E. Exon-intron
40. In the nucleus of eukaryote’s cells the first
pro-RNA molecule is synthesized that is
complementary to the exons and introns of the
structural gene. But the ribosome receives such
i-RNA, which is complementary to exons only.
This indicates that the nucleus takes place:
A. Processing
B. Transcription
C. Reparation
D. Replication
E. Reverse transcription
41. As a result of intoxication in the epithelial
cell of the mucous membrane of the oral cavity,
enzymes that provide splicing are not
synthesized. What is the reason for the
termination of protein biosynthesis in this case?
A. The i-RNA is not synthesised
B. ATP is not synthesised
C. The p-RNA is not synthesised
D. Amino acids are not activated
E. Transport of amino acids has been disturbed
E. Regulator
44. A patient with pulmonary tuberculosis is
prescribed the most effective antituberculous
antibiotic. Name this drug:
A. Rifampicin
B. Tetracycline
C. Streptocide
D. Furasolidone
E. Bactrim (Co-trimoxazole)
45. Tuberculosis can be treated by means of
combined
chemotherapy
that
includes
substances with different mechanisms of
action.What antituberculous medication inhibits
transcription of RNA into DNA in
mycobacteria?
A. Rifampicin
B. Isoniazid
C. Streptomycin
D. Ethionamide
E. Para-aminosalicylic acid
46. RNA that contains AIDS virus penetrated
into a leukocyte and by means of reverse
transcriptase forced a cell to synthetize a viral
DNA. This process is based upon:
A. Reverse transcription
B. Operon repression
C. Reverse translation
D. Operon depression
E. Convariant replication
42. During reproduction of some RNAcontaining viruses that cause tumors in animals,
genetic information can be transmitted in the
opposite direction from the RNA to the DNA
via a specific enzyme. The enzyme of reverse
transcription is called:
A. Reverse transcriptase
B. DNA polymerase
C. Ligase
D. Primase
E. Topoisomerase
47. T-lymphocytes are determined to be affected
with HIV. In this case viral enzyme reverse
transcriptase
(RNA-dependent
DNApolymerase) catalyzes the synthesis of:
A. DNA based on the viral RNA matrix
B. Viral RNA based on the DNA matrix
C. Viral protein based on the viral RNA matrix
D. Viral DNA based on the DNA matrix
E. Informational RNA based on the viral protein
matrix
43. In the body of a person transcription occurs.
The RNA polymerase, moving along the DNA
molecule, has reached a certain sequence of
nucleotides. After this transcription stopped.
This section of the DNA is called:
A. Terminator
B. Promoter
C. Repressor
D. Operator
48. For the treatment of urogenital infections
use hinolones - inhibitors of the enzyme DNA
gyrase. What process is disrupted by hinolones
in the first place?
A. Replication of DNA
B. Reparation of DNA
C. Amplification of the genes
D. Recombination of the genes
E. Reverse transcription
7
49. It was found out that some compounds, for
instance fungi toxins and some antibiotics can
inhibit activity of RNA-polymerase. What
process will be disturbed in a cell in case of
inhibition of this enzyme?
A. Transcription
B. Processing
C. Replication
D. Translation
E. Reparation
50. At the stage of translation in the rough
endoplasmic reticulum, the ribosome moves
along the mRNA. Amino acids are joined
together by peptide bonds in a specific
sequence, and thus polypeptide synthesis takes
place. The sequence of amino acids in a
polypeptide corresponds to the sequence of:
A. mRNA codons
B. tRNA nucleotides
C. tRNA anticodons
D. rRNA nucleotides
E. rRNA anticodons
51. Students studying the features of the genetic
code found that there are amino acids that are
answered by 6 codons, 5 amino acids - 4
different codons. Other amino acids are encoded
by three or two codons and only two amino
acids by one codon. What feature of the genetic
code did students discover?
A. Degeneracy (Redundancy)
B. Universality
C. Collinearity
D. Unidirectional
E. Compose of three nucleotide
52. The mutation of the structural gene did not
lead to the substitution of amino acids in protein
molecules. This revealed the following property
of the genetic code:
A. Degeneracy (Redundancy)
B. Mutable
C. Collinearity
D. Insufficiency
E. Universality
53. It is known that information about amino
acid sequence in a protein molecule is stored as
a sequence of four nucleotide types in a DNA
molecule, and different amino acids are encoded
by different quantity of triplets ranging from
one to six. Name this property of genetic code:
A. Degeneracy
B. Universality
C. Disjointness
D. Triplety
E. Specificity
54. Formation of ribosome subunits in a cell
was disturbed in course of an experiment
(bymeans of . activated mutagenic factors). This
will have an effect on the following metabolic
process:
A. Protein biosynthesis
B. Carbohydrate biosynthesis
C. ATP synthesis
D. Photosynthesis
E. Biological oxidation
55. Amino acids join to each other in ribosomes
of granular endoplasmic reticulum. Knowing
the sequence of amino acids and applying
genetic code, it is possible to determine the
sequence of nucleoids in:
A. mRNA
B. Introns
C. Proteins
D. Carbohydrates
E. rRNA
56. A tissue sample of benign tumor was studied
under the electron microscope. A lot of small
(15-20 nm) spherical bodies, consisting of 2
unequal subunits were
detected. These are:
A. Ribosomes
B. Golgi complex
C. Smooth endoplasmic reticulum
D. Microtubules
E. Mitochondria
57. A 36-year-old patient under went tooth
extraction at a dental clinic. After two weeks the
stratified squamous epithelium regenerate dat
the site of extraction.What organelles were
involved in there storation of the mucous
membrane?
A. Ribosomes
B. Centrosomes
C. Postlysosomes
D. Smooth EPR
E. Mitochondria
8
58. Genetic information is stored in DNA but
does not participate directly in protein synthesis
with in DNA cells. What process ensures
transfer of genetic information into polypeptide
chain?
A. Translation
B. FormationofrRNA
C. FormationoftRNA
D. FormationofiRNA
E. Replication
59. 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 biosynthesis. Disruption occurs at the
following stage:
A. Translation
B. Transcription
C. Replication
D. Amino acids activation
E. Processing
60. For the formation of a transport form of
amino acids for the synthesis of a protein, it is
necessary:
A. Aminoacyl-tRNA synthetase
B. GTP
C. m-RNA
D. Ribosome
E. Revertase
61. During the study of cells, a high content of
the aminoacyl-tRNA synthetase enzyme was
established in their cytoplasm. This enzyme
provides the following process in a cell:
A. Activation of amino acids
B. Reparation
C. Elongation
D. Transcription
E. Replication
62. In the cell there is a process of translation.
When the ribosome reaches the codons of UAA,
UAG, or UGA, the polypeptide chain synthesis
is terminated. These codons are not recognized
by any t-RNA in the biosynthesis of the
polypeptide and this is a signal:
A. Termination
B. Post-translational modification
C. Begin transcription
D. Elongation
E. Initiation
63. One of the protein synthesis stages is
recognition. The first iRNA triplet starts with
UAU triplet. What complementary triplet is
found in tRNA?
A. AUA
B. AAA
C. GUG
D. UGU
E. CUC
64. Cytological studies revealed a large number
of different t-RNA molecules that deliver amino
acids to the ribosome. The number of different
types of t-RNA in a cell will be equal to the
number of:
A. Triplets encoding amino acids
B. Nucleotides
C. Amino acid
D. Proteins synthesised in the cell
E. Different types of RNA
65. Labelled amino acids alanine and
tryptophane were injected to a mouse in order to
study localization of protein synthesis in its
cells. The labelled amino acids will be
accumulated near the following organellas:
A. Ribosomes
B. Smooth endoplasmic reticulum
C. Cell centre
D. Lysosomes
E. Golgi apparatus
66. The patient was prescribed antibiotic
chloramphenicol (levometsitin), which disrupts
protein synthesis in the body by inhibiting the
process:
A. Translation elongation
B. Formation of polyribosomes
C. Transcription
D. Processing
E. Gene amplification
67. Infectious diseases are treated with
antibiotics
(streptomycin,
erythromycin,
chloramphenicol). They inhibit the following
stage of protein synthesis:
A. Translation
B. Transcription
C. Replication
D. Processing
E. Splicing
9
68. A 28-year-old patient with bacterial
pneumonia was prescribed a course of treatment
with erythromycin. Its antibacterial properties
are known to be due to the ability of this
substance to combine with the free 50S-subunit
of the ribosome. What substances synthesis does
this antibiotic block in bacterial cells?
A. Proteins
B. RNA
C. DNA
D. Fat
E. Polysaccharides
69. Streptomycin and other aminoglycosides
prevent the joining of formylmethionyl tRNA
by bonding with the 30S ribosomal subunit.
This effect leads to disruption of the following
process:
A. Translation initiation in procaryotes
B. Translation initiation in eucaryotes
C. Transcription initiation in procaryotes
D. Transcription initiation in eucaryotes
E. Replication initiation in procaryotes
70. In a genetical laboratory in course of work
with DNA molecules of white rats of Wistar’s
line a nucleotide was substituted for another
one. At that only one amino acid was
substituded in the peptide. This
result is caused by the following mutation:
A. Transversion
B. Deletion
C. Duplication
D. Displacement of reading frame
E. Translocation
71. Hurtnup’s disease is caused by point
mutation of only one gene. This results in
abnormal absorption of tryptophane in the
intestine as well as its abnormal
reabsorption in renal tubules. This causes
synchronous disorders in digestive and urinary
excretion systems. What genetic phenomenon is
observed in this case?
A. Pleiotropy
B. Complementary interaction
C. Polymery
D. Codominance
E. Semidominance
72. During the experiment, an increase in βgalactosidase activity was demonstrated after
lactose was added to the culture medium with
E.coli. What portion of the lactose operon will
be unlocked from the repressor in these
conditions?
A. Operator
B. Promoter
C. Structural gene
D. Regulatory gene
E. Primer
73. It is known that the gene responsible for the
development of the MN blood groups has two
allelic states. If the gene M is considered as the
initial gene, the allelic gene N appeared due to:
A. Mutations
B. Gene combinations
C. DNA repair
D. DNA replication
E. Crossing over
74. As a result of treatment of viral RNA with
nitrous acid, UCA triplet mutated to UGA
triplet. What kind of mutation occurred?
A. Transition
B. Nucleotide deletion
C. Missense
D. Nucleotide insertion
E. Inversion
75. A mutation has occurred in a cell in the first
exon of the structural gene. The number of
nucleotide pairs changed from 290 to 250.
Name this type of mutation:
A. Deletion
B. Inversion
C. Duplication
D. Translocation
E. Nullisomy
76. When examining a 2-month-old child, the
pediatrician noticed that the crying of the child
resembles a cat's cry. Diagnosed microcephaly
and heart disease. Using the cytogenetic
method, the child's cartiotype: 46, XX, 5p. This
disease is a consequence of this process:
A. Deletion
B. Duplication
C. Inversion
D. Translocation
E. Pleiotropy
77. Parents of a sick 5-year-old girl visited a
genetic consultation. Karyotype investigation
revealed 46 chromosomes. One chromosome of
10
the 15th pair was abnormally long, having a part
of the chromosome belonging to the21st pair
attached to it. What mutation occurred in this
girl?
A. Translocation
B. Deletion
C. Inversion
D. Deficiency
E. Duplication
78. In some regions of South Africa there is a
spread sickle-shaped cell anemia, in which
erythrocytes have shape of a sickle as a result of
substitution of glutamin by valine in the
hemoglobin molecule. What is the cause of this
disease?
A. Gene mutation
B. Disturbance of mechanisms of genetic
information realization
C. Crossingover
D. Genomic mutations
E. Transduction
79. Sickle-shaped e cell anemia in humans is
accompanied by the appearance of abnormal
hemoglobin in the blood, a change in the form
of red blood cells and the development of
anemia. This disease is the result of:
A. Gene mutations
B. Polythene
C. Chromosomal aberration
D. Polyplody
E. Mitochondrial mutation
80. A 15-year-old man is complaining of
general weakness, dizziness, rapid fatigability.
During the examination, erythrocytes of a
modified form were detected, their number was
reduced. Preliminary diagnosis: sickle cell
anemia. What type of mutation causes the
development of this pathological condition?
A. Point mutation
B. Reading frame shift mutation
C. Deletion
D. Inversion
E. Chromosomal aberration
81. Part of the DNA chain turned 180 degree as
a result of gamma radiation. What type of
mutation took place in the DNA chain?
A. Inversion
B. Deletion
C. Doubling
D. Translocation
E. Replication
82. An experiment proved that UV irradiated
skin cells of patients with xeroderma
pigmentosum restore the native structure of
DNA slower than the cells of healthy people
due to the defect in repair enzyme. What
enzyme takes part in this process?
A. Endonuclease
B. RNA ligase
C. Primase
D. DNA polymerase
E. DNA gyrase
83. In the course of evolution there developed
molecular mechanisms for correction of
damaged DNA molecules. This process is
called:
A. Reparation
B. Transcription
C. Translation
D. Replication
E. Processing
84. In the human cells under the action of
ultraviolet radiation the DNA molecule has been
damaged. The system of repairing the damaged
area of the DNA molecule to the intact chain
through a specific enzyme was revised. What is
the name of this phenomenon?
A. Reparation
B. Duplication
C. Replication
D. Initiation
E. Termination
85. Cells of a person working in the Chornobyl
Exclusion Zone have under gone a mutation in
DNA molecule. However, with time the
damaged interval of DNA molecule has been
restored to its initial structure with a specific
enzyme. In this case the following occurred:
A. Repair
B. Replication
C. Transcription
D. Reverse transcription
E. Translation
86. Under the influence of physical factors there
can develop defect sin a DNA molecule.
Ultraviolet irradiation, for instance, can cause
development of dimers. Dimers are two adjacent
11
pyrimidine bases joined together. Name these
bases:
A. Thymine and cytosine
B. Adenine and thymine
C. Guanine and cytosine
D. Adenine and guanine
E. Guanine and thymine
87. Patients suffering from xeroderma
pigmentosum have extremely photosensitive
skin due to disrupted excision repair. Specify
the process that is affected in such patients:
A. Repair of DNA molecule
B. Synthesis of iRNA
C. Maturation of iRNA
D. Synthesis of protein primary structure
E. Intron extraction and exon connection
Test items for licensing examination Krok 1
«Stomatology». – 2016. - № 192.
88. An employee of a chemical enterprise was
exposed to nitric acid and nitrite, which cause
cytosine deamination in the DNA molecule.
What enzyme initiates a chain of reparation
processes?
A. Uridine DNA glycosidase
B. Citidine triphosphate synthetase
C. Orotidyl monophosphate decarboxylase
D. DNA-dependent RNA polymerase
E. Thymidylat synthase
89. Tetracycline taking in the first half of
pregnancy causes abnormalities of fetus organs
and systems, including tooth hypoplasia and
alteration of their colour. What type of
variability is the child’s disease related to?
A. Modification
B. Combinative
C. Mutational
D. Hereditary
E. Recombinan
90. The woman took antibiotics in the first half
of pregnancy. This led to the hypoplasia of the
teeth and the change in their color in the child.
The genotype has not changed. Set the type of
variability that underlies the disease:
A. Modification
B. Combinative
C. Mutational
D. Correlative
E. Recombinative
91. Fetal malformations may result from such
maternal diseases as rubella, syphilis,
toxoplasmosis, cytomegaly, herpes, chlamydia.
What is the form of variability relating to such
malformations?
A. Modifiation
B. Mutational
C. Combinative
D. Genomic imprinting
E. Epimutational
92. As a result of
iodine deficiency in
foodstuffs Transcarpathian people often have
endemic goiter. This disease is caused by the
following type of variability:
A. Modification
B. Mutational
C. Combinative
D. Ontogenetical
E. Correlative
93. Lymphocyte is affected by HIV retrovirus
(AIDS). In this case, the direction of
information flow in the cell will be:
A. RNA → DNA → i-RNA → polypeptide
B. DNA → i-RNA → polypeptide → DNA
C. DNA → Polypeptide → i-RNA
D. i-RNA → polypeptide → DNA
E. Polypeptide → RNA → DNA → i-RNA
94. A young family came for a genetic
counseling to identify the father of their child.
The husband insists that the child does not
resemble him at all and cannot possibly be his.
Polymerase chain reaction method
for person identification is based on the
following:
A. Gene amplification
B. Nucleotide deletion
C. Genetic recombination
D. Missense mutation
E. Transduction
95. 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:
A. Gene amplification
B. Transcription
C. Genetic recombination
D. Genomic mutation
12
E. Chromosome mutation
96. 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:
A. Combinative
B. Mutational
C. Phenotypic
D. Genocopy
E. Phenocopy
97. A mother had taken synthetic hormones
during pregnancy. Her daughter was born with
hirsutismformally resembling of adrenal
syndrome. Such
manifestation of variability is called:
A. Phenocopy
B. Mutation
C. Recombination
D. Heterosis
E. Replication
98. The doctor discovered a kid's disease due to
a lack of vitamin D, but in his manifestation
similar to hereditary vitamin-resistant rickets
(curvature of tubular bones, deformity of joints
of lower extremities, dental abscesses). How
called defects of development, which resemble
hereditary, but not inherited?
A. Phenocopy
B. Genocopy
C. Monosomies
D. Trisomy
E. Gene diseases
13
Biochemistry of intercellular communications: hormones of proteinpeptide nature
1. Degeneration of glycogen in liver is
stimulated by glucagon. What secondary
messenger (mediator) is thus formed in the cell?
A. c-AMP
B. c-GMP
C. CO
D. NO
E. Triacylglycerol
2. The ions of metals take part in the regulation
of physiological functions. One of them was
named the “king of messengers”. Such a
bioelement mediator is:
A. Ca ++
B. Na +
C. K +
D. Fe +++
E. Zn ++
3. Tissue inosytol triphosphates are generated as
a result of the phosphatidyl inositol diphosphate
hydrolysis and act as secondary agents
(mediators) in the mechanism of hormone
action. Their effect in cells is directed at:
A. Calcium ion liberation from cellular depot
B. Adenylate cyclase activation
C. Protein kinase A activation
D. Phosphodiesterase inhibition
E. Protein kinase A inhibition
4. The formation of a secondary mediatoris
obligatory
in
membrane-intracellular
mechanism of hormone action. Point out the
substance that is unable to be a secondary
mediator:
A. Glycerol
B. Diacylglycerol
C. Inositol-3,4,5-triphosphate
D. CAMP
E. Ca2+
5. A patient with a diagnosis of diabetes, in the
morning on an empty stomach received a
prescribed dose of insulin with prolonged
action. He missed another meal and soon felt
weakness, pain, dizziness, sweating, trembling
of the body, convulsions, feeling of hunger,
hypoglycemia. The use of glucose did not
alleviate the condition. What hormonal drug is
necessary to enter to stop this condition?
A. Adrenaline
B. Triamcinolone
C. Norepinephrine
D. Prenisolone
E. Hydrocortisone
6. Condition of a patient with diabetes mellitus
sharply deteriorated after a regular injection of
insulin. The patient became anxious and broke
out in cold sweat; tremor of the extremities,
general weakness, and dizziness appeared. What
medicine can remove these symptoms?
A. Adrenaline
B. Tolbutamide
C. Caffeine
D. Noradrenaline
E. Glibutid(Buformin)
7. Dentists widely apply local anaesthesia
adding adrenalin to an anaesthetic solution.
What is the purpose of this method?
A. Local vasoconstriction
B. Local vasodilatation
C. Lowering of arterial pressure
D. Local reduction of vascular resistance
E. Microcirculation improvement
8. A 50-year-old man declined anaesthesia
during dental manipulations. Due to severe pain
he developed anuria caused by acute increase in
production of:
A. Adrenaline
B. Renin
C. Thymosin
D. Thyroxin
E. Glucagon
9. A sick woman after parenteral administration
of the hormone had an increase in blood
pressure, as well as increased levels of glucose
and lipids in the blood. What hormone was
introduced?
A. Adrenaline
B. Glucagon
C. Insulin
D. Progesterone
E. Folliculin
10. A patient suffering from pheochromocytoma
complains of thirst, dry mouth, hunger. Blood
test for sugar revealed hyperglycemia. What
type of hyperglycemia is it?
14
A. Adrenal
B. Hypercorticoid
C. Alimentary
D. Somatotropic
E. Hypoinsulinemic
11. Patient with diabetes mellitus experienced
loss of consciousness and convulsions after an
injection of insulin. What might be the result of
biochemical blood analysis for concentration of
sugar?
A. 1,5 mmol/L
B. 8,0 mmol/L
C. 10,0 mmol/L
D. 3,3 mmol/L
E. 5,5 mmol/L
12. A patient with diabetes mellitus had an
insuline injection. It caused loss of
consciousness and convulsions. What was the
result of biochemic blood analysis on glucose
content?
A. 2,5 mmоle/l
B. 3,3 mmоle/l
C. 8,0 mmоle/l
D. 10 mmоle/l
E. 5,5 mmоle/l
13. A 16-year-old young man was taken to
hospital, the patient had insulin-dependent
diabetes mellitus. The patient's blood glucose
level was 1.8 mmol/l. The patient was given
insulin. Two hours later, the glucose level
decreased to 8.2 mmol/l, since insulin:
A. Stimulates the conversion of glucose to
glycogen and TAG in the liver
B. Stimulates glucose transport through plasma
membranes in the brain and liver
C. It inhibits the synthesis of ketone bodies from
glucose
D. Stimulates the breakdown of glycogen in the
liver E. Stimulates the breakdown of glycogen
in the muscles
14. A patient with insulin-dependent diabetes
had an insulin injection. Some time later he felt
weakness, irritability, excessive sweating. What
is the main reason of these disorders?
A. Carbohydrate starvation of brain
B. Intensified glycogenolysis
C. Intensified ketogenesis
D. Intensified lypogenesis
E. Reduced glyconeogenesis
15. Before the cells can utilize the glucoze, it is
first transported from the extracellular space
through the plasmatic membrane inside theml.
This process is stimulated by the following
hormone:
A. Insulin
B. Glucagon
C. Thyroxin
D. Aldosterone
E. Adrenalin
16. After insulin injection, glucose levels fall
within a few seconds. This is due to the
activation of this process: A. Transport of
glucose into cells
B. Glycolysis
C. Synthesis of glycogen
D. Synthesis of lipids
E. Pentose phosphate cycle
17. 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:
A. Insulin
B. Glucagon
C. Thyroxin
D. Aldosterone
E. Adrenalin
18. A patient is in the state of hypoglycemic
coma. What hormone can cause this condition if
overdosed?
A. Insulin
B. Progesterone
C. Cortisol
D. Somatotropin
E. Corticotropin
19. A patient during fasting developed
ketoacidosis as a result of increased fatty acids
decomposition. This decomposition can be
inhibited with:
A. Insulin
B. Glucagon
C. Adrenaline
D. Thyroxin
E. Cortisol
20. Examination of a patient revealed
overgrowth of facial bones and soft tissues,
tongue enlargement, wide interdental spaces in
15
the enlarged dental arch. What changes of the
hormonal secretion are the most likely?
A. Hypersecretion of the somatotropic hormone
B. Hyposecretion of the somatotropic hormone
C. Hypersecretion of insulin
D. Hyposecretion of thyroxin
E. Hyposecretion of insulin
21. A 49-year-old patient was found to have a
disproportionate enlargement of hands, feet,
nose, ears, superciliary arches and cheek bones.
Blood test revealed hyperglycemia, impaired
glucose tolerance. What is the most likely cause
of this pathology development?
A. Hypersecretion of growth hormone
B. Posterior pituitary hormone hypersecretion
C. Insulin hyposecretion
D. Vasopressin hyposecretion
E. Glucocorticoid hypersecretion
22. A woman after labor lost 20 kg of body
weight, her hair and teeth fall out, she has
muscle atrophy (hypophysial cachexia).
Synthesis of what hypophysis hormone is
disturbed?
A. Somatotropic
B. Corticotrophic
C. Thyreotropic
D. Gonadotropic
E. Prolactin
23. Adult height 100 cm with a proportional
body structure and normal mental development.
It might be caused by deficiency secretion of the
following hormone:
A. Somatotropic
B. Gonadotropic
C. Adrenocorticotropic
D. Thyroid-stimulating
E. Prolactin
24. Examination of a patient revealed
enlargement of some body parts (jaw, nose,
ears, feet, hands), but body proportions were
conserved. It might be caused by intensified
secretion of the following hormone:
A. Somatotropin
B. Somatostatin
C. Tetraiodothyronine
D. Triiodothyronine
E. Cortisol
25. A student who passes an exam has a plasma
glucose content of 8 mmol/l. Increased secretion
which of hormones contributes to the
development of hyperglycemia?
A. Glucagon
B. Insulin
C. Thyroxine
D. Triiodothyronine
E. Aldosterone
26. A patient with tress and painful sensation
before a visit to the dentist is accompanied by
anuria (lack of urination). This phenomenon is
due to an increase in:
A. Secretion of vasopressin and adrenaline
B. Activity of the parasympathetic nervous
system
C. Activity antinociceptive system
D. Secretion of vasopressin and a decrease in
adrenaline
E. Secretion of adrenaline and a decrease in
vasopressin
27. As a result of a home injury, a patient
suffered a significant blood loss, which led to a
fall in blood pressure. Rapid blood pressure
recovery after the blood loss is provided by the
following hormones:
A. Adrenaline, vasopressin
B. Cortisol
C. Sex hormones
D. Oxytocin
E. Aldosterone
28. A severe injury in a 36-year-old patient
resulted in a significant blood loss which was
accompanied by a blood pressure drop. What
hormones provide rapid recovery of blood
pressure after the blood loss?
A. Adrenalin, vasopressin
B. Cortisol
C. Sex hormones
D. Oxytocin
E. Aldosterone
29. A man has the increased volume of
circulating blood and reduced osmotic pressure
of plasma considerable. He has decrease in
diuresis. The primary cause of such diuresis
disorder is the hypersecretion of the following
hormone:
A. Vasopressin
B. Aldosterone
16
C. Adrenalin
D. Renin
E. Natriuretic
C. Vasopressin
D. Thyrocalcitonin
E. Glucagon
30. A 20 year old patient complains of excessive
thirst and urinary excretion upto 10 L a day. The
level of glucose in blood is normal, there is no
glucose in urine. What hormone deficit can
cause such changes?
A. Vasopressin
B. Oxytocin
C. Insulin
D. Triiodothyronine
E. Cortisol
35. A 25-year-old woman one month after
giving birth consulted a doctor about a decrease
in milk production. What hormone deficiency
led to this condition?
A. Prolactin
B. Somatostatin
C. Adrenocorticotropic hormone
D. Insulin
E. Glucagon
31. A patient with pituitary tumor complains of
increased daily diuresis (polyuria). Glucose
concentration in blood plasma equals 4,8
mmol/l. What hormone can be the cause of this
if its secretion is disturbed?
A. Vasopressin
B. Aldosterone
C. Natriuretic hormone
D. Insulin
E. Angiotensin I
32. Limiting water intake has led to dehydration
of the organism. What mechanism is activated
under these conditions to preserve water in the
body?
A. Increased vasopressin secretion
B. Increased somatostatin secretion
C. Reduced vasopressin secretion
D. Increased aldosterone secretion
E. Reduced aldosterone secretion
33. At ria of a test animal were super distended
with blood,which resulted in decreased
reabsorption of Na+ and water in renal
tubules.This can be explained by the effect of
the following factor on the kidneys:
A. Natriuretic hormone
B. Aldosterone
C. Renin
D. Angiotensin
E. Vasopressin
34. A 32-year-old patient consulted a doctor
about the absence of lactation after parturition.
Such disorder might be explained by the deficit
of the following hormone:
A. Prolactin
B. Somatotropin
36. Products of some proteins hydrolysis and
modification are the biologically active
substances called hormones. Lipotropin,
corticotropin, melanotropin and endorphins are
synthesized in the hypophysis of the following
protein:
A. Proopiomelanocortin (POMC)
B. Neuroalbumin
C. Neurostromin
D. Neuroglobulin
E. Thyreoglobulin
37. After a case of sepsis a 27-year-old woman
developed ”bronzed” skin discoloration
characteristic
of
Addison’s
disease.
Hyperpigmentation mechanismin this case is
based on increased secretion of:
A. Melanocyte-stimulating hormone
B. Somatotropin
C. Gonadotropin
D. β-lipotropin
E. Thyroid-stimulating hormone
38. A 20-year-old woman came to the doctor
with complaints of general weight loss, loss of
appetite,
weakness,
skin
discoloration
resembling bronze tan. In addtition to
hyperpigmentation, examination in the hospital
revealed bilateral adrenal tuberculosis. What
substance leads to skin hyperpigmentation,
when accumulated excessively?
A. Melanin
B. Bilirubin
C. Hemozoin
D. Lipofuscin
E. Adrenochrome
39. A patient with gastric juice hypersecretion
has been recommended to exclude from the diet
17
rich broths and vegetable infused water. A
doctor recommended it, because these food
products stimulate production of the following
hormone:
A. Production of gastrin
B. Taste Receptors
C. Mechano-receptors of the oral cavity
D. Mechanoreceptors of the stomach
E. Formation of secretin
40. During an acute experiment some of diluted
solution of hydrochloric acid was injected into
the duodenal cavity of an experimental animal.
This will result in hypersecretion of the
following hormone:
A. Secretin
B. Gastrin
C. Motilin
D. Neurotensin
E. Histamine
41. A pregnant woman with a low labor activity
entered the maternity ward. Assign a hormonal
remedy to enhance labor activity:
A. Oxytocin
B. Progesterone
C. Methandrostenolone
D. Hydrocortisone
E. ACTH
42. A 26-year-old woman at 40 weeks pregnant
has been delivered to the maternity ward.
Objectively: the uterine cervix is opened, but
the contractions are absent. The doctor has
administered her a hormonal drug to stimulate
the labor. Name this drug:
A. Oxytocin
B. Hydrocortisone
C. Estrone
D. Testosterone
E. ACTH
43. To stimulate the laboractivity aparturient
woman was prescribed a drug a posterior
pituitary hormone that does not affect the blood
pressure. As the pregnancy progresses, the
sensitivity to this hormone increases.Name the
prescribed drug:
A. Oxytocin
B. Dinoprostone
C. Dinoprost
D. Pituitrin
E. Ergotal
44. A 40-year-old patient complains of intensive
heartbeats, sweating, nausea, visual impairment,
arm tremor, hypertension. From his anamnesis:
2 years ago he was diagnosed with
pheochromocytoma. Hyperproduction of what
hormones causes the given pathology?
A. Catecholamines
B. Aldosterone
C. Glucocorticoids
D. ACTH
E. Thyroidal hormones
45. A special diet has led to a decrease in Ca2+
ions in the blood. What hormone will increase
the secretion?
A. Parathormone
B. Thyrocalcitonin
C. Vasopressin
D. Somatotropin
E. Thyroxine
46. A patient has the sudden decrease of Ca2+
content in blood. What hormone secretion will
increase?
A. Parathormone
B. Thyrocalcitonin
C. Aldosterone
D. Vasopressin
E. Somatotropin
47. The calcium ions in the blood plasma of a
patient is increased, reduced - in the bones. The
excessive secretion of which hormone may
cause such changes?
A. Parathormone
B. Thyroxine
C. Triiodothyronine
D. Thyreocalcitonin
E. Aldosteron
48. Kidneys of a man under examination show
increased resorbtion of calcium ions and
decreased resorbtion of phosphate ions. What
hormone causes this phenomenon?
A. Parathormone
B. Thyrocalcitonin
C. Hormonal form D3
D. Aldosterone
E. Vasopressin
49. Following thyroid surgery, a 47-year old
female patient had fibrillary twitching of
18
muscles in the arms, legs and face. These
disorders can be treated by the introduction of
the following hormone:
A. Parathyroid hormone
B. Triiodothyronine
C. Thyrotropin
D. Thyroxine
E. Thyroid-stimulating hormone
50. During removal of the hyperplastic thyroid
gland of a 47-year-old woman, the parathyroid
gland was damaged.One month after the surgery
the
patient
developed
signs
of
hypoparathyroidism: frequent convulsions,
hyperreflexia, laryngospasm. What is the most
likely cause of the patient’s condition?
A. Hypocalcemia
B. Hyponatremia
C. Hyperchlorhydria
D. Hypophosphatemia
E. Hyperkalemia
51. A child has abnormal formation of tooth
enamel and dentin as a result of low
concentration of calcium ions in blood. Such
abnormalities might be caused by deficiency of
the following hormone:
A. Parathormone
B. Thyrocalcitonin
C. Thyroxin
D. Somatotropic hormone
E. Triiodothyronine
52. Owing to a pronounced decrease in plasma
calcium concentration, a 2-year-old child had
tetanic reductions in the respiratory and
pharyngeal muscles. Decreased secretion of
what hormone can be the cause of this?
A. hormone
B. Calcitonin
C. Aldosterone
D. Somatotropin
E. Cortisol
53. A 2-year-old child experienced convulsions
because of lowering calciumions concentration
in the blood plasma. Function of what structure
is decreased?
A. Parathyroid glands
B. Hypophysis
C. Adrenal cortex
D. Pineal gland
E. Thymus
54. A patient has hypocalcemia. What hormone
deficiency may be it’s cause?
A. Parathormone
B. Thyrocalcitonin
C. Aldosterone
D. Corticotropin
E. Corticoliberin
55. A patient presents with osteoporosis;
hypercalcemia and hypophosphatemia are
observed in the patient’s blood. What is the
cause of this condition?
A. Increased parathormone secretion
B. Increased thyroxin secretion
C. Inhibited parathormone secretion
D. Increased corticosteroid secretion
E. Inhibited corticosteroid secretion
56. A 5-month-old boy was hospitalized for
tonic convulsions. He has a lifetime history of
this disease. Examination revealed coarse hair,
thinned and fragilenails, pale and dry skin. In
blood: calcium - 1,5 millimole/l, phosphor - 1,9
millimole/l. These changes are associated with:
A. Hypoparathyroidism
B. Hyperparathyroidism
C. Hyperaldosteronism
D. Hypoaldosteronism
E. Hypothyroidism
57. A 5-month-old boy was hospitalized for
tonic convulsions. Sick since birth. On
examination, the hair is hard, the nails are
thinned and brittle, the skin is pale and dry. In
the blood: calcium - 1.5 mmol / l, phosphorus 1.9 mmol / l. What are these changes related to?
A. Hypoparathyroidism
B. Hyperparathyroidism
C. Hyperaldosteronism
D. Hypoaldosteronism
E. Hypothyroidism
58. Periodic renal colics attacks areobserved in
a woman with primery hyperparathyroidizm.
Ultrasonic examination revealed small stones in
the kidneys. What is the most plausible reason
of the stones’s formation?
A. Hypercalcemia
B. Hyperphosphatemia
C. Hypercholesterinemia
D. Hyperuricemia
E. Hyperkalemia
19
59. A 56-year-old man presents with
parathyroid tumor. The following is observed:
muscle
weakness,
osteoporosis,
bone
deformation, nephroliths consisting of oxalates
and phosphates. The patient’s condition is
caused by:
A. Increased secretion of parathyroid hormone
B. Decreased secretion of parathyroid hormone
C. Increased secretion of calcitonin
D. Decreased secretion of calcitriol
E. Increased secretion of thyroxin
60. Due to trauma the patient’s parathyroid
glands have been removed, which resulted in
inertness,
thirst,
sharp
increase
of
neuromuscular excitability. Metabolism of the
following substance is disturbed:
A. Calcium
B. Manganese
C. Chlorine
D. Molybdenum
E. Zinc
61. There is a 9 year old boy in endocrinological
department, who has already had a few fractures
of extremeties caused by fragility of bones.
Malfunction of what endocrinous glands (gland)
takes place?
A. Parathyroid glands
B. Thyroid gland
C. Thymus
D. Adrenal glands
E. Epiphysis
62. A patient with signs of osteoporosis and
urolithiasis has been admitted to the
endocrinology department. Blood test revealed
hypercalcemia and hypophosphatemia. These
changes are associated with abnormal synthesis
of the following hormone:
A. Parathyroid hormone
B. Calcitonin
C. Cortisol
D. Aldosterone
E. Calcitriol
63.
Cardinal
symptoms
of
primary
hyperparathyroidism are osteoporosis andrenal
lesion along with development of urolithiasis.
What substance makes up the basis of these
calculi in this disease?
A. Calcium phosphate
B. Uric acid
C. Cystine
D. Bilirubin
E. Cholesterol
64. Parodontitis is treated with calcium
preparations and a hormone that stimulates
tooth mineralization and inhibits tissue
resorption. What hormone is it?
A. Calcitonin
B. Parathormone
C. Adrenalin
D. Aldosterone
E. Thyroxine
65. A patient with hypoparathyreosis has
multiple carious lesions of teeth. This pathology
is caused by insufficiency of the following
hormone:
A. Calcitonin
B. Thyroxin
C. Triiodothyronine
D. Thyroid-stimulating hormone
E. Somatotropin
66. A 46-year-old patient suffering from the
diffuse toxic goiter underwent resection of the
thyroid gland. After the surgery the patient
presents with appetite loss, dyspepsia, increased
neuromuscular excitement. The body weight
remained unchanged. Body temperature is
normal. Which of the following has caused such
a condition in this patient?
A. Reduced production of parathormone
B. Increased production of thyroxin
C. Increased production of calcitonin
D. Increased production of thyroliberin
E. Reduced production of thyroxin
67. During surgery on the thyroid gland due to
the disease of the Basedow's disease, the
parathyroid glands were mistakenly removed.
There were convulsions, tetany. Exchange of
which item was broken?
A. Calcium
B. Magnesium
C. Potassium
D. Iron
E. Sodium
68. Soldiers injured in the midst of a battle may
not feel pain before it is completed. What
20
hormones of the opiate antinociceptive system
reduce the sensation of pain?
A. Endorphins
B. Serotonin
C. Vasopresin
D. Aldosterone
E. Oxytocin
21
Biochemistry of intercellular communications: hormones of steroid and
thyroid nature
1. A girl is diagnosed with adrenogenital
syndrome
(pseudohermaphroditism).
This
pathology was caused by hypersecretion of the
following adrenal hormone:
A. Androgen
B. Estrogen
C. Aldosterone
D. Cortisol
E. Adrenalin
6. Parents of a 10 y.o. boy consulted a doctor
about extension of hair-covering, growth of
beard and moustache, low voice. Intensified
secretion of which hormone must be assumed?
A. Of testosterone
B. Of somatotropin
C. Of oestrogen
D. Of progesterone
E. Of cortisol
2. The secretion of which hypophysial
hormones will be inhibited after taking the oral
contraceptives containing sexhormones?
A. Gonadotropic hormone
B. Vasopressin
C. Thyrotrophic hormone
D. Somatotropic hormone
E. Ocytocin
7. A female patient presents with endocrine
dysfunction of follicular cells of the ovarian
follicles resulting from an inflammation. The
synthesis of the following hormone will be
inhibited:
A. Estrogen
B. Progesterone
C. Lutropin
D. Follicle stimulating hormone
E. Follistatine
3. The woman was threatened with premature
termination of pregnancy. This is most likely
due to insufficient secretion of such a hormone:
A. Progesterone
B. Estradiol
C. Oxytocin
D. Testosterone
E. Aldosterone
4. Testosterone and it’s analogs increase the
mass of skeletal muscles that allows to use them
for treatment of dystrophy. Dueto interaction of
the hormone with what cell substrate is this
action caused?
A. Nuclear receptors
B. Membrane receptors
C. Ribosomes
D. Chromatin
E. Proteins-activators of transcription
5. A 30-year-old female exhibits signs of
virilism (growth of body hair, balding temples,
menstrual disorders). This condition can be
caused by the over production of the following
hormone:
A. Testosterone
B. Oestriol
C. Relaxin
D. Oxytocin
E. Prolactin
8. Intake of oral contraceptives containing sex
hormones inhibits secretion of the hypophysiae
hormones. Secretion of which of the indicated
hormones is inhibited while taking oral
contraceptives with sexhormones?
A. Follicle-stimulating
B. Vasopressin
C. Thyrotropic
D. Somatotropic
E. Oxytocin
9. Corticosteroid hormones regulate the
adaptation processes of the body as a whole to
environmental changes and ensure the
maintenance of internal homeostasis. What
hormone activates the hypothalamo-pituitaryadrenal axis?
A. Corticoliberin
B. Somatoliberin
C. Somatostatin
D. Corticostatin
E. Thyroliberin
10. A man prescribed by a doctor for a long
time took the preparation of a group of
glucocorticoid hormones. Which of the
following hormones will be depressed due to
this?
A. Corticotropic
B. Somatotropic
22
C. Tyrotropic
D. Sexual
E. Mineralocorticoid
C. Muscle glycogenolysis
D. Intestinal glucose absorption
E. Synthesis of glycogen
11. The release of adrenal hormones is regulated
by ACTH of the adenohypophysis. What
hormones are secreted by the adrenal glands
under the action of the latter?
A. Glucocorticoids
B. Androgenes
C. Catecholamines
D. Mineralocorticoid
E. Prostaglandins
16. A patient with Itsenko-Cushing syndrome
has persistent hyperglycemia and glycosuria,
hypertension, osteoporosis, obesity. What
hormon’s synthesis and secretion are intensified
in this case?
A. Cortisol
B. Adrenaline
C. Glucagon
D. Thyroxin
E. Aldosterone
12. A patient has been taking glucocorticoids
for a long time. Drug withdrowal caused acute
attack of his disease, blood pressure reduction,
weakness. What are these occurences connected
with?
A. Adrenal glands insufficiency
B. Drug habituation
C. Sensibilisation
D. Hyperproduction of corticotroph hormone
E. Cumulation
13. Chronic overdosage of glucocorticoids leads
to the development of hyperglycemia. What
process of carbohydrate metabolism is
responsible for this effect?
A. Gluconeogenesis
B. Glycogenolysis
C. Aerobic glycolisis
D. Pentose-phosphate cycle
E. Glycogenesis
14. A 40-year-old woman with Cushing’s
disease presents with steroid diabetes. On
biochemical examination she has hyperglycemia
and hypochloremia. What process activates in
the first place in such patients?
A. Gluconeogenesis
B. Glycogenolysis
C. Glucose reabsorption
D. Glucose transportation into a cell
E. Glycolysis
15. A 28-year-old patient with Itsenko-Cushing
syndrome Hyperglycemia, glycosuria were
detected hyperglycemia, glycosuria. The main
mechanism of hyperglycemia in this patient is
stimulation:
A. Gluconeogenesis
B. Liver glycogenolysis
17. On examination of the patient, the doctor
suspected
Itsenko-Cushing's
syndrome.
Determination of what substance in the patient's
blood will confirm the doctor's presumption
A. Cortisol
B. Tocopherol
C. Retinol
D. Adrenaline
E. Cholesterol
18. A patient with a diagnosis of ItsenkoCushing's disease (hyperproduction of adrenal
hormones) has an increased concentration of
glucose, ketone bodies, sodium in the blood .
What is the biochemical mechanism leading to
the occurrence of hyperglycemia?
A. Gluconeogenesis
B. Glycogenesis
C. Glycogenolysis
D. Glycolysis
E. Aerobic glycolysis
19. The patient was found to have obesity,
hirsutism, a “moon-shaped” face, scarring of a
purple color on the skin of the thighs. Blood
pressure is 180/110 mm Hg, blood glucose is
17.2 mmol / l. What change in the production of
adrenal hormones is possible such a picture?
A. Hyperproduction of glucocorticoids
B. Hypoproducts of glucocorticoids
C. Hyperproduction of mineralocorticoids
D. Hypoproducts of mineralocorticoids
E. Hypoproduction of adrenaline
20. A 44 year old woman complains of general
weakness, heart pain, significant increase of
body weight. Objectively: moon face, hirsutism,
AP is 165/100 mm Hg, height - 164 cm, weight
23
- 103 kg; the fat is mostly accumulated on her
neck, thoracic girdle, belly. What is the main
pathogenetic mechanism of obesity?
A. Increased production of glucocorticoids
B. Reduced production of thyroid hormones
C. Increased insulin production
D. Reduced glucagon production
E. Increased mineralocorticoid production
21. A 16-year-old patient suffering from
Itsenko-Cushing's disease was counseled for
over weight. During the survey, it turned out
that the energy value of the food consumed is
1700-1900 kcal / day. What is the leading cause
of obesity in this case?
A. Excess glucocorticoid
B. Lack of insulin
C. Excess insulin
D. Lack of glucocorticoids
E. Hypodynamia
22. A 29-year-old female patient has moon shaped face, upper body obesity, stretch marks
on the abdomen, hirsutism; urine shows an
increased rate of 17-oxy ketosteroids. What
disease are these presentations typical for?
A. Itsenko-Cushing syndrome
B. Pheochromocytoma
C. Conn’s syndrome
D. Primary aldosteronism
E. Secondary aldosteronism
23. The patient with complaints of permanent
thirst applied to the doctor. Hyperglycemia,
polyuria and increased concentration of 17ketosteroids in the urine were revealed. What
disease is the most likely?
A. Steroid diabetes
B. Insulin-dependent diabetes mellitus
C. Myxoedema
D. Type I glycogenosis
E. Addison’s disease
24. 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, redblue striae of
skin distension on his belly. Osteoporosis and
muscle dystrophy are present. AP is 210/140
mm Hg. What is the most probable diagnosis?
A. Cushing’s disease
B. Cushing’s syndrome
C. Conn’s disease
D. Diabetes mellitus
E. Essential hypertension
25. A 38-year-old female patient complains of
general weakness, cardiac pain, increased
appetite, no menstruation. Objectively: the
height is 166 cm, weight 108 kg, the patient has
moon-shaped face, subcutaneous fat is
deposited mainly in the upper body, torso and
hips. There are also blood-red streaks. Ps62/min, AP-160/105 mm Hg. Which of the
following diseases is the described pattern of
obesity most typical for?
A. Cushing pituitary basophilism
B. Alimentary obesity
C. Myxedema
D. Insulinoma
E. Babinski-Frohlich syndrome
26. Examination of a patient with high blood
pressure
revealed
secondary
arterial
hypertension. It was found that the cause of this
condition of the patient is a hormonally active
tumor of the adrenal cortex. Hyperproduction of
what hormone is the cause of secondary arterial
hypertension in a patient?
A. Cortisol
B. Adrenaline
C. Thyroxine
D. Insulin
E. Glucagon
27. Acceptance of corticosteroid analogues
causes the breakdown of muscle proteins to free
amino acids. In which process will amino acids
be involved in such conditions?
A. Gluconeogenesis in the liver
B. Muscle glycolysis
C. Synthesis of higher fatty acids
D. Glycogenolysis
E. Decarboxylation
28. A 19-year-old male was found to have an
elevated level of potassium in the secondary
urine. These changes might have been caused
by the increase in the following hormone level:
A. Aldosterone
B. Oxytocin
C. Adrenaline
D. Glucagon
E. Testosterone
24
29. A concentrated solution of sodium chloride
was intravenously injected to ananimal. This
caused decreased reabsorption of sodium ions in
the renal tubules. It is the result of the following
changes of hormonal secretion:
A. Aldosterone reduction
B. Aldosterone increase
C. Vasopressin reduction
D. Vasopressin increase
E. Reduction of atrial natriuretic factor
30. A patient with adenoma of glomeral zone of
adrenal cortex (Conn’s disease) has arterial
hypertension, convulsions, polyuria. What is the
main link in pathogenesis of these disorders?
A. Aldosterone hypersecretion
B. Aldosterone hyposecretion
C. Catecholamine hypersecretion
D. Glucocorticoid hypersecretion
E. Glucocorticoid hyposecretion
31. After a traffic accident a man presents with
severe blood loss, consciousness disturbance,
low blood pressure, as well as compensatory
activation of the reninangiotensin system, which
results in:
A. Hyperproduction of aldosterone
B. Increased blood coagulation
C. Intensification of erythropoiesis
D. Hyperproduction of vasopressin
E. Intensification of heart contractions
32. A patient has hyperkaliemia and
hyponatremia. Reduced secretion of what
hormone may cause such changes?
A. Aldosterone
B. Vasopressin
C. Cortosol
D. Parathormone
E. Natriuretic hormone
33. People adapted to high external
temperatures have such pecularity: profuse
sweating isn’t accompanied by loss of large
volumes of sodium chloride.This is caused by
the effect of the following hormone upon the
perspiratory glands:
A. Aldosterone
B. Vasopressin
C. Cortisol
D. Tgyroxin
E. Natriuretic
34. A humans are reduced diuresis,
hypernatremia and hypokalemia. What hormone
hypersecretion can cause such changes?
A. Aldosterone
B. Vasopressin
C. Atrial Natriuretic Factor
D. Adrenaline
E. Parathormone
35. Atria of an experimental animal were
superdistended by blood that resulted in
decreased reabsorption of Na+ and water in
renal tubules. This can be explained by the
influence of the following factor upon kidneys:
A. Natriuretic hormone
B. Aldosterone
C. Renin
D. Angiotensin
E. Vasopressin
36. A patient has insufficient blood supply to
the kidneys, which has caused the development
of pressor effect due to the constriction of
arterial resistance vessels. This is the result of
the vessels being greately affected by the
following substance:
A. Angiotensin II
B. Angiotensinogen
C. Renin
D. Catecholamines
E. Norepinephrine
37. Examination of a patient with high blood
pressure showed him secondary arterial
hypertension. The cause of this condition is a
renin-producing tumor of the kidney. What is
the main link in the pathogenesis of secondary
arterial hypertension in a patient?
A. Angiotensin 2, aldosterone hyperproduction
B. Cortisol hyperproduction
C. Insulin hyperproduction
D. Insufficient vasopressin production
E. Insufficient catecholamines production
38. A patient with cirrhosis of the liver has
sustained arterial hypotension (BP is 90/50 mm
Hg). What is the reason for lowering blood
pressure in this pathology of the liver?
A. Reduced angiotensin synthesis
B. Increased synthesis of Na-uretic hormone
C. Excessive inactivation of vasopressin
D. Increasing the reflex influence from the
receptor zone of the aortic arch
25
E. Activation of the kallikrein-kinin system
39. A patient with kidney disease has high blood
pressure, espesially the diastolic one.
Hypersecretion of what biologically active
substance causes blood pressure rise?
A. Renin
B. Adrenaline
C. Noradrenaline
D. Vasopressin
E. Catecholamines
44. Indirect calorimetry allowed to establish that
a 30-year-old male patient had a 30% decrease
in basal metabolic rate. This might be caused by
the reduced concentration of the following
hormones in blood plasma:
A. Triiodothyronine, tetraiodothyronine
B. Thyrocalcitonin, parathormone
C. Glucocorticoids
D. Catecholamines
E. Somatoliberin, somatostatin
40. Under the experimental conditions, a rabbit
was tied up the renal artery, it was resulted in a
significant increase in blood pressure after 2
weeks. As a result of an increase in the secretion
of a biologically active substance, this
happened?
A. Renin
B. Adrenaline
C. Vasopressin
D. Norepinephrine
E. Natriuretic hormone
45. A 37-year-old patient has has lost 5 kg in
weight over the past three months, he complains
of
hand
tremor,
excessive
sweating,
exophthalmos, tachycardia. These changes
might have been caused by the increased
secretion of the following hormone:
A. Thyroxine
B. Cortisol
C. Insulin
D. Glucagon
E. Thyrocalcitonin
41. A patient who had been continuously taking
drugs blocking the production of angiotensin II
developed bradycardia and arrhythmia. A likely
cause of these disorders is:
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
E. Hypercalcemia
46. A 38-year-old woman complains of
excessive sweating, palpitations, fever in the
evening hours. The main exchange is increased
by 60%. The doctor decided the diagnosis thyrotoxicosis. What properties of thyroxin lead
to increased heat production?
A. Separates oxidative phosphorylation
B. Increases conjugation of oxidation and
phosphorylation
C. Reduces β-oxidation of fatty acids
D. Reduces amino acid deamination
E. Promotes acetyl-coA accumulation
42. A patient with kidney disease has high blood
pressure, espesially the diastolic one.
Hypersecretion of what biologically active
substance causes blood pressure rise?
A. Renin
B. Adrenaline
C. Noradrenaline
D. Vasopressin
E. Catecholamines
43. A 40-year-old woman on examination
presents with intensified basal metabolic rate.
What hormone present in excess leads to such
condition?
A. Triiodothyronine
B. Thyrocalcitonin
C. Glucagon
D. Aldosterone
E. Somatostatin
47. A 40-year-old woman suffering from diffuse
toxic goiter presents with constant increase of
her body temperature. What mechanism results
in such clinical presentation?
A. Separation of oxidation and phosphorization
in cell mitochondria
B. Increased breakdown of glycogen inhepatic
cells
C. Increased catabolism of protein incells
D. Increased excitability of nerve cells
E. Increased cell sensitivity to catecholamines
48. A patient is followed up in an
endocrinological dispensary on account of
hyperthyreosis. Weight loss, tachycardia, finger
tremor are accompanied by hypoxia symptoms 26
headache, fatigue, eye flicker. What mechanism
of thyroid hormones action underlies the
development of hypoxia?
A. Disjunction, oxydation and phosphorilation
B. Inhibition of respiratory ferment synthesis
C. Competitive inhibition of respiratory
ferments
D. Intensification of respiratory ferment
synthesis
E. Specific binding of active centres of
respiratory ferments
49. A 56 y.o. patient has been suffering from
thyreotoxicosis for a long time.What type of
hypoxia can be developed?
A. Tissue
B. Hemic
C. Circulatory
D. Respiratory
E. Mixed
50. The patient mistakenly took an excess dose
of thyroxine. What changes in secretion of
thyroliberin and thyrotropin will it lead to?
A. Secretion of hormones will decrease
B. Secretion of hormones will increase.
C. Secretion of hormones will not change
D. Secretion of thyroliberin will increase,
thyrotropin will decrease
E. Secretion of thyrotropin will increase,
thyroliberin will decrease
51. A 19-year-old female suffers from
tachycardia in rest condition, weight loss,
excessive
sweating,
exophtalmos
and
irritability. What hormone would you expect to
find elevated in her serum?
A. Thyroxine
B. Cortisol
C. Mineralocorticoids
D. ACTH
E. Insulin
52. A child presents with symptoms of psychic
and physical retardation (cretinism). It is usually
associated with the following hormone
deficiency:
A. Thyroxin
B. Somatotropic
C. Calcitonin
D. Insulin
E. Testosterone
53. A doctor has established significant growth
retardation, disproportional body build, and
mental deficiency of a child. What is the most
likely cause of this pathology?
A. Hypothyroidism
B. Insufficient nutrition
C. Hyperthyroidism
D. Genetic defects
E. Hypopituitarism
54. A 12-year-old child is of short stature, has
disproportionate body structure and mental
retardation. These characteristics might be
caused by the hyposecretion of the following
hormone:
A. Thyroxine
B. Insulin
C. Cortisol
D. Somatotropin
E. Glucagon
55. Inhabitants of territories with cold climate
have
high
content
of
an
adaptive
thermoregulatory hormone. What hormone is
meant?
A. Thyroxin
B. Insulin
C. Glucagon
D. Somatotropin
E. Cortisol
56. The clinical examination of the patient
revealed an increase in the thyroid gland
(goiter), an increase in basal metabolism, loss of
body weight, an imbalance of heat, an increase
in appetite, an increase in excitability and
irritability, exophthalmos and tachycardia were
detected. What endocrine disruption leads to
these symptoms?
A. Hyperfunction of the thyroid gland
B. Hypofunction of the parathyroid glands
C. Pituitary Hyperfunction
D. Epiphysis hypofunction
E. Hypofunction of the thyroid gland
57. It is known that steroid anti-inflammatory
drugs inhibit the activity of phospholipase A2,
which is necessary for the synthesis of
prostaglandins. What substance is the precursor
of these inflammatory mediators?
A. Arachidonic acid
B. Cholesterol
C. Tyrosine
27
D. Proopiomelanocortin
E. Palmitic acid
58. A patient is followed up in the clinic on
account of for pneumonia complicated by
pleurisy. He was given prednisolon as part of a
combination therapy. The anti-inflammatory
effect of this synthetic glucocorticoid is
associated with blocking the release of
arachidonic acid by inhibiting:
A. Phospholipase A2
B. Cyclo-oxygenase
C. Phospholipase C
D. Lipoxygenase
E. Peroxidase
59. Utilization of arachidonic acid via
cyclooxigenase pathway results in formation of
some bioactive substances. Name them:
A. Prostaglandins
B. Thyroxine
C. Biogenic amins
D. Somatomedins
E. Insulin-like growth factors
60. Experimental studies revealed steroid
hormones to have an effect on proteosynthesis.
They influence synthesis of the following
substances:
A. Specific messenger RNA
B. Adenosine triphosphate
C. Specific transfer RNA
D. Guanosine triphosphate
E. Specific ribosomal RNA
28
Biochemistry and pathobiochemistry of blood
1. A 7-year-old girl has signsof anemia.
Laboratory examination revealed pyruvate
kinase deficiency in erythrocytes. What process
disturbance plays the main role in
anemiadevelopment?
A. Anaerobic glycolysis
B. Oxidative phosphorylation
C. Tissue respiration
D. Peroxide decomposition
E. Aminoacids desamination
2. Human red blood cells contain no
mitochondria. What is the main pathway
forATP production in these cells?
A. Anaerobic glycolysis
B. Aerobic glycolysis
C. Oxidative phosphorylation
D. Creatine kinase reaction
E. Cyclase reaction
3. Erythrocytes of the patient withhemolytic
anemia present with significantdecrease of
pyruvate kinase activity. Whatmethabolic
process is disturbed in thiscase?
A. Glycolysis
B. Glycogenolysis
C. Gluconeogenesis
D.
Pentose-phosphate
pathway
of
glucoseoxidation
E. Glycogen synthesis
4. A 3 year old child with fever wasgiven
aspirin. It resulted in intensified erythrocyte
haemolysis. Hemolyticanemia might have been
caused bycongenital insufficiency of the
followingenzyme:
A. Glucose 6-phosphate dehydrogenase
B. Glucose 6-phosphatase
C. Glycogen phosphorylase
D. Glycerol phosphate dehydrogenase
E. γ-glutamiltransferase
5. There is an increased tendency of
erythrocytes to hemolysis in patients with a
hereditary defect of glucose-6-phosphate
dehydrogenase. What metabolic process is
impaired under these conditions?
A. Pentose phosphate pathway of glucose
oxidation
B. Gluconeogenesis
C. Aerobic glucose oxidation
D. Synthesis of glycogen
E. 6. Sulfanilamides are applied as antimicrobal
agents in clinical practice.Sulfanilamide
treatment, however, canresult in hemolytic
anemia developmentin patients that suffer from
geneticdefect of the following enzyme
ofpentose phosphate metabolism inerythrocytes:
A. Glucose-6-phosphate dehydrogenase
B. Hexokinase
C. Transketolase
D. Transaldolase
E. Pyruvate kinase
7.
Biochemical
analysis
of
an
infant’serythrocytes
revealed
evident
glutathioneperoxidase deficiency and low
concentration of reduced glutathione. What
pathological condition can develop in this
infant?
A. Hemolytic anemia
B. Pernicious anemia
C. Megaloblastic anemia
D. Sicklemia
E. Iron-deficiency anemia
8. A 20 year old patient complains ofgeneral
weakness, dizziness, quick fatigability. Blood
analysis results: Hb-80g/l. Microscopical
examination results:erythrocytes are of modified
form. Thiscondition might be caused by:
A. Sickle-cell anemia
B. Hepatocellular jaundice
C. Acute intermittent porphyria
D. Obturative jaundice
E. Addison’s disease
9. With a number of hemoglobinopathies, amino
acid substitutions occur in the α- and β-chains of
hemoglobin. Which of them is characteristic of
Hb S (sickle cell anemia)?
A. Glutamate-valine
B. Aspartate-lysine
C. Alanin-serine
D. Methionine-histidine
E. Glycine-serine
10. Substitution of the glutamic acid onvaline
was revealed while examining initial molecular
structure. For what inheritedpathology is this
symptom typical?
A. Sickle-cell anemia
29
B. Thalassemia
C. Minkowsky-Shauffard disease
D. Favism
E. Hemoglobinosis
11. A patient suffers from mutation of a gene
that corresponds with hemoglobin synthesis.
This condition led to development of sicklecell
disease. Name the pathologicalhemoglobin
characteristic of this disease:
A. HbS
B. HbA
C. HbF
D. HbA1
E. Bart-Hb
12. Along with normal hemoglobin typesthere
can be pathological ones in the organism of an
adult. Name one of them:
A. HbS
B. HbF
C. HbA1
D. HbA2
E. HbO2
13. After an extended treatment with
sulfanamides a patient has developedmacrocytic
anemia. Production of activeforms of the
following vitamin is disruptedin such a
condition:
A. Folic acid
B. Thiamine
C. Riboflavin
D. Pyridoxine
E. Cyanocobalamin
14. A 50-year-old patient has beenexamined by
a dentist and found tohave crimson smooth
tongue. Bloodanalysis revealed a decrease in
RBC leveland hemoglobin concentration,
symptoms
of
megaloblastichematopoiesis,
degenerative changes inWBCs. What blood
disorder was found inthis patient?
A. B12-folic-acid-deficiency anemia
B. Iron deficiency anemia
C. Myeloid leukemia
D. Aplastic anemia
E. Hemolytic anemi
15. After removal in the patient 2/3 of the
stomach in the blood decreased the amount of
hemoglobin, the number of erythrocytes,
increased the size of these blood counts. What
vitamin deficiency leads to such changes in
blood?
A. B12
B. C
C. P
D. B6
E. PP
16. A 43-year-old patient with chronic atrophic
gastritis and megaloblastic hyperchromic
anemia excreted methylmalonic acid in the
urine. What vitamin deficiency is caused by the
occurrence of the specified symptom complex?
A. В12
B. В2
C. В3
D. В5
E. В6
17. A pregnant woman turned to the
obstetrician-gynecologist, who was diagnosed
with megaloblastic anemia. Which of the
following drugs should be prescribed?
A. Cyanocobalamin
B. Pentoxyl
C. Methyluracil
D. Glaucin
E. Streptokinase
18. The patient was diagnosed with
megaloblastic anemia. Specify a vitamin
deficiency which can lead to the development of
this disease.
A. Cyanocobalamin.
B. Rutin.
C. Nicotinamide.
D. Thiamine.
E. Cholecalciferol
19. In a 65-year-old patient with prolonged
complaints characteristic of chronic gastritis,
megalocytes were found in peripheral blood,
and megaloblastic erythropoiesis was found in
the bone marrow. What is the most likely
diagnosis?
A. B12-folic deficiency anemia
B. Aplastic anemia
C. Hypoplastic anemia
D. Hemolytic anemia
E. Iron deficiency anemia
A patient who had subtotal gastrectomy 5 years
ago developed B12 folic acid deficiency
30
anemia. What is the leading mechanism in the
development of such anemia?
A. The absence of an internal factor Castle
B. The absence of an external factor Castle
C. Impaired absorption of vitamin B12 in the
small intestine
D. Folic acid deficiency
E. Transcobalamin deficiency.
20. Examination of a patient, suffering from
atrophic
gastritis,
revealedmegaloblastic
anemia. The anemia is likely to be caused by the
deficiency of the following substance:
A. Gastromucoproteid
B. Vitamin B6
C. Vitamin B1
D. Iron
E. Erythropoietins
21. Surgical removal of a part of
stomachresulted in disturbed absorption of
vitamin B12, it is excreted with feces.
Thepatient was diagnosed with anemia.
Whatfactor is necessary for absorption of
thisvitamin?
A. Gastromucoprotein
B. Gastrin
C. Hydrochloric acid
D. Pepsin
E. Folic acid
22. Examination of a 52-year-oldfemale patient
has revealed a decreasein the amount of red
blood cells andan increase in free hemoglobin
inthe blood plasma (hemoglobinemia).What
type ofanemia is being observed in the patient?
A. Acquired hemolytic
B. Hereditary hemolytic
C. Acute hemorrhagic
D. Chronic hemorrhagic
E. Anemia due to diminishederythropoiesis
23. A patient with hemolytic anemia showed
pyruvate kinase deficiency in erythrocytes. In these
conditions, the cause of hemolysis of red blood cells
are:
A. Reduced Na+, K+ -ATPases
B. Na+ deficiency in red blood cells
C. Excess K+ in red blood cells
D. Genetic defects of glycophorin A
E. Spectrin deficiency
24. During laboratory examination of the blood
of a person who was bitten by a snake,
hemolysis
of
red
blood
cells
and
hemoglobinuria were detected. The action of
snake venom due to the presence of the enzyme
in it:
A. Phospholipase A2
B. Phospholipase A1
C. Phospholipase C
D. Phospholipase D
E. Sphingomyelinase
25. For people who permanently reside in highlands,
adaptation to "oxygen starvation" is carried out by
facilitating the release of hemoglobin oxygen due to:
A. Increased formation of 2,3-diphosphoglycerate in
erythrocytes
B. Reduced formation of 2,3-diphosphoglycerate in
erythrocytes
C. The increase in CO2 partial pressure
D. Increasing blood pH
E. Decreased blood temperature
26. After the accident in the chemical industry,
the environment was polluted with nitro
compounds. The people living in this area, there
was a sharp weakness, headache, shortness of
breath, dizziness. What is the cause of hypoxia?
A. Methemoglobin formation
B. Inhibition of dehydrogenase
C. Formation of carboxyhemoglobin
D. Reduced function of flavin enzymes
E. Inactivation of cytochrome oxidase
27. A 7-year-old child presents with marked
signs of hemolytic anemia. Biochemical
analysis of erythrocytes determined low
concentration of NADPH and reduced
glutathione. What enzyme is deficient in this
case leading to the biochemical changes and
their clinical manifestations?
A. Glucose-6-phosphate dehydrogenase
B. Hexokinase
C. Fructokinase
D. Pyruvate kinase
E. Lactate dehydrogenase
28. A 38 year old patient takes aspirin and
sulfanilamides. After their intake intensified
erythrocyte haemolysis is observed which is
caused by deficiency of glucose 6-phosphate
dehydrogenase. This pathologyis caused by
failure of the following coenzyme:
A. NADP – H
B. FAD - H2
C. Pyridoxal phosphate
31
D. FMN - H2
E. Ubiquinone
29. A 22 year old woman has been taking
sulfanilamides for a long time that led to
symptoms of hemolytic anaemia caused by
hereditary disturbance of synthesis of glucose 6phosphate dehydrogenase. This enzyme of
pentose-phosphate cycleis responsible for
generation of:
A. NADP - H2
B. NAD
C. FAD
D. FMN
E. ATP
30. It is known that pentose-phosphate pathway
actively functions in the erythrocytes. What is
the main function of this metabolic pathway in
the erythrocytes?
A. Counteraction to lipid peroxidation
B. Activation of microsomal oxidation
C. Neutralization of xenobiotics
D. Oxidation of glucose into lactate
E. Increase of lipid peroxidation
31. In course of metabolic process active forms
of oxygen including superoxide anion radical
are formed in the human body. By means of
what enzyme is this anion inactivated?
A. Superoxide dismutase
B. Catalase
C. Peroxidase
D. Glutathioneperoxidase
E. Glutathionereductase
32. Reduced activity of antioxidant enzymes
enhances peroxidation of cell membrane lipids.
The reduction of glutathione peroxidase activity
is caused by the following microelement
deficiency:
A. Selenium
B. Molybdenum
C. Cobalt
D. Manganese
E. Copper
33. In pathological processes accompanied by
hypoxia, an incomplete reduction of the oxygen
molecule in the respiratory chain and
accumulation of hydrogen peroxide occurs.
Specify the enzyme that ensures its destruction:
A. Catalase
B. Cytochrome oxidase
C. Succinate dehydrogenase
D. Ketoglutarate dehydrogenase
E. Aconitase
34. When periodontitis develops lipid
peroxidation in periodontal tissues, the content
of malondialdehyde, hydrogen peroxide
increases in the oral cavity. Which of the
following
enzymes
provide
antioxidant
protection?
A. Superoxide dismutase, catalase
B. Amylase, trypsin
C. Maltase, chymotrypsin
D. Lactase, lysozyme
E. Sucrase, prothrombin
35. Periodontitis induces the development of
lipid peroxidation in the periodontal tissues, as
well as an increase in malondialdehyde and
hydrogen peroxide concentration in the oral
cavity. Which of the following enzymes
provides antioxidant protection?
A. Catalase
B. Amylase
C. Maltase
D. Lactase
E. Invertase
36. Those organisms which in the process of
evolution failed to develop protection from
H2O2 can exist only in anaerobic conditions.
Which of the following enzymes can break
hydrogen peroxide down?
A. Peroxidase and catalase
B. Oxygenase and hydroxylase
C. Cytochrome oxidase, cytochrome B5
D. Oxygenase and catalase
E. Flavin-dependent oxidase
37. Patient with abscess of the cut wound
applied to the traumatological department. In
order to clean the wound from the pus doctor
washed it with 3% hydrogen peroxide. Foam
was absent. What caused the absence of the
drug activity?
A. Inherited insufficiency of catalase
B. Low concentration H2O2
C. Inherited insufficiency of erythrocyte
phosphatdehydrogenase
D. Shallow wound
E. Pus in the wound
32
38. A worker has decreased buffer capacity of
blood due to exhausting muscular work. The
influx of what acid substance in the blood can
cause this symptom?
A. Lactate
B. Pyruvate
C. 1,3-bisphosphoglycerate
D. α-ketoglutarate
E. 3-phosphoglycerate
39. A child during the first 3 months after birth
developed a severe form of hypoxia, which was
manifested by asphyxia and cyanosis of skin.
The reason for this is a violation of the
replacement of fetal hemoglobin on:
A. Hemoglobin A
B. Hemoglobin S
C. Glycated hemoglobin
D. Methemoglobin
E. Hemoglobin M
40. Diseases of the respiratory system and
circulatory disorders impair the transport of
oxygen, thus leading to hypoxia. Under these
conditions the energy metabolism is carried out
byanaerobic glycolysis. As a result, the
following substance is generated and
accumulated in blood:
A. Lactic acid
B. Pyruvic acid
C. Glutamic acid
D. Citric acid
E. Fumaric acid
41. A patient is followed up in an
endocrinological dispensary on account of
hyperthyreosis. Weight loss, tachycardia, finger
tremor are accompanied by hypoxia symptoms headache, fatigue, eye flicker. What mechanism
of thyroid hormones action underlies the
development of hypoxia?
A. Disjunction oxydation and phosphorilation
B. Inhibition of respiratory fermentsynthesis
C. Competitive inhibition of respiratoryferments
D.
Intensification
of
respiratory
fermentsynthesis
E. Specific binding of active centres
ofrespiratory ferments
42. After a sprint an untrained person develops
muscle hypoxia. This leads to the accumulation
of the following metabolite in muscles:
A. Lactate
B. Ketone bodies
C. Acetyl CoA
D. Glucose 6-phosphate
E. Oxaloacetate
43. A 32-year-old female patient suffers from
gingivitis accompanied by gum hypoxia. What
metabolite of carbohydrate metabolism is
produced inthe periodontium tissues more
actively in this case?
A. Lactate
B. Ribose 5-phosphate
C. Glycogen
D. Glucose 6-phosphate
E. NADPH-H
44. A 29-year-old patient was delivered to a
hospital because of intoxication with carbon
monoxide. Objectively: the patient presents with
symptoms of severe hypoxia- evident dyspnea,
cyanosis, tachycardia. What compound is
produced as a result of intoxication with carbon
monooxide?
A. Carboxyhemoglobin
B. Methemoglobin
C. Carbhemoglobin
D. Sulfhemoglobin
E. Oxyhemoglobin
45. A man lost consciousness in a car with
running engine where he had been waiting for a
friend for a long time. What hemoglobin
compaund can be found in the blood of the
patient?
A. Carboxyhemoglobin
B. Deoxyhemoglobin
C. Carbhemoglobin
D. Methemoglobin
E. Oxyhemoglobin
46. A patient with respiratory failure has blood
pH of 7,35. pCO2 test revealed hypercapnia.
Urine pH test revealed an increase in the urine
acidity. What form of acid-base imbalance is the
case?
A. Compensated respiratory acidosis
B. Compensated metabolic acidosis
C. Decompensated metabolic acidosis
D. Compensated respiratory alkalosis
E. Decompensated respiratory alkalosis
47. An infant has apparent diarrhea resulting
from improper feeding. One of the main
33
diarrhea effects is plentiful excretion of sodium
bicarbonate. What form of acid-base balance
disorder is the case?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
E. No disorders of acid-base balance will be
observed
52. Prophylactic examination of a patient
revealed hyperglycemia, ketonuria, polyuria,
glycosuria. What form of acid-base balance
disorder is the case?
A. Metabolic acidosis
B. Gaseous acidosis
C. Nongaseous acidosis
D. Gaseous alkalosis
E. Metabolic alkalosis
48. 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. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
E. Normal acid-base balance
53. A patient with diabetes developed a diabetic
coma due to the acid-base imbalance. Specify
the kind of this imbalance:
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Gaseous alkalosis
E. Non-gaseous alkalosis
49. A patient suffers from disrupted patency of
the airways at the level of small and mediumsized bronchial tubes. What changes of acidbase balance can occur in the patient?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
E. Acid-base balance remains unchanged
50. Diabetes mellitus causes ketosis as a result
of activated oxidation of fatty acids. What
disorders of acid-base equilibrium may be
caused by excessive accumulation of ketone
bodies in blood?
A. Metabolic acidosis
B. Metabolic alcalosis
C. Any changes woun’t happen
D. Respiratory acidosis
E. Respiratory alcalosis
51. Ketosis develops in the patients with
diabetes mellitus, as the result of activation of
fatty acids oxidation processes. What acidbase
imbalance can result from accumulation of
excessive ketone bodies in the blood?
A. Metabolic acidosis
B. Metabolic alkalosis
C. No imbalance occurs
D. Respiratory acidosis
E. Respiratory alkalosis
54. Ketoacidosis that develops due to
accumulation of ketone bodies in blood serum is
a primary complication of diabetes mellitus.
What acid-base disbalance develops during this
condition?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
E. –
55. Due to recurring vomiting a patient has lost
significant amount of gastric juice, which led to
development of acidbase dysbalance. What type
of acid-base dysbalance has developed?
A. Nongaseous alkalosis
B. Gaseous acidosis
C. Nongaseous acidosis
D. Gaseous alkalosis
E. Metabolic acidosis
56. A mountaineer who rose to a height of
5200m developed gas alkalosis. What is the
cause of its development?
A. Hyperventilation
B. Hypoventilation of the lungs
C. Hyperoxemia
D. Hypoxemia
E. Reduced ambient temperature
57. In a laboratory study of the respiratory
function of the blood, it has been established
that there is a deterioration of CO2 transport.
34
What enzyme deficiency in red blood cells can
this be due to?
A. Carboanhydrase
B. 2,3-diphosphoglycerate
C. Adenylate cyclase
D. Protein kinase
E. Phosphorylase
58. In the process of hemoglobin catabolismiron
is released and then as a part of special transport
protein is returned to the bonemarrow, to be
used again for hemoglobinsynthesis. Name this
transport protein:
A. Transferrin
B. Transcobalamin
C. Haptoglobin
D. Ceruloplasmin
E. Albumin
59. Hemoglobin catabolism results in release of
iron which is transported to the bone marrow by
a certain transfer protein and used again for the
synthesis of hemoglobin. Specify this transfer
protein:
A. Transferrin (siderophilin)
B. Transcobalamin
C. Haptoglobin
D. Ceruloplasmin
E. Albumin
60. In the liver of a patient suffering from iron
deficiency anemia, a violation of the synthesis
of iron-containing protein, which is a source of
iron for heme synthesis, was found. What is the
name of this protein?
A. Ferritin
B. Transferrin
C. Hemosiderin
D. Ceruloplasmin
E. Hemoglobin
61. In men of 40 years as a result of enhanced
hemolysis of erythrocytes, the iron content in
the blood plasma increased. What protein
provides its deposition in the tissues?
A. Ferritin
B. Haptoglobin
C. Transferrin
D. Transcortin
E. Albumin
62. A patient complains about dyspnea
provoked by the physical activity. Clinical
examination revealed anaemia and presence of
the paraprotein in the zone of gamma-globulins.
To confirm the myeloma diagnosis it is
necessary to determine the following index in
the patient’s urine:
A. Bence Jones protein
B. Bilirubin
C. Haemoglobin
D. Ceruloplasmin
E. Antitrypsin
63. A 16-year-old girl, who has been starving
herself for a long time to lose weight, developed
an edema. This phenomenon is mainly caused
by:
A. Hypoproteinemia due to protein synthesis
disturbance
B. Hypoglycemia due to glycogen synthesis
disturbance
C. Venous congestion and increased venous
pressure
D. Deceleration of glomerular filtration rate
E. Decreased production of vasopressin in the
hypothalamus
64. A 36-year-old female patient who has been
limiting the number of food stuffs in her diet for
3 months presents with a decrease in body
weight, deterioration of physical and mental
health, face edemata. These changes may be
caused by the deficiency of the following
nutrients:
A. Proteins
B. Vitamins
C. Fats
D. Carbohydrates
E. Micronutrients
65. Upon toxic damage of hepatic cells resulting
in disruption of liver function the patient
developed edemas. What changes of blood
plasma are the main cause of edema
development?
A. Decrease of albumin content
B. Increase of globulin content
C. Decrease of fibrinogen content
D. Increase of albumin content
E. Decrease of globulin content
66. In case of toxic damage to hepatocytes with
a violation of their protein synthesis function,
the patient's content of albumin in the blood
plasma and oncotic pressure of the plasma
35
sharply decreased. What will be the result of
these changes?
A. The appearance of edema
B. Reduced diuresis
C. Reduced ESR
D. Increased circulating blood volume
E. Increased blood viscosity
67. Toxic affection of liver results in
dysfunction of protein synthesis. It is usually
accompanied by the following kind of
dysproteinemia:
A. Absolute hypoproteinemia
B. Relative hypoproteinemia
C. Absolute hyperproteinemia
D. Relative hyperproteinemia
E. Paraproteinemia
68. The concentration of albumins in human
blood sample is lower than normal. This leads to
edema of tissues. What blood function is
damaged?
A. Maintaining the oncotic blood pressure
B. Maintaining the Ph level
C. Maintaining the body temperature
D. Maintaining the blood sedimentation system
E. All answers are correct
69. A 4 y.o. child with signs of durative
proteinic starvation was admitted to the hospital.
The signs were as follows: growth inhibition,
anemia, edemata, mental deficiency. Choose a
cause of edemata development:
A. Reduced synthesis of albumins
B. Reduced synthesis of globulins
C. Reduced synthesis of hemoglobin
D. Reduced synthesis of lipoproteins
E. Reduced synthesis of glycoproteins
70. The prolonged action of a number of
antibiotics and sulfonamides is due to the fact
that they circulate in the blood for a long time in
combination with:
A. Albumin
B. Transferrin
C. Hemoglobin
D. Haptoglobin
E. Hemopexin
71. Electrophoretic study of a bloodserum
sample, taken from the patient with pneumonia,
revealed an increase in one of the protein
fractions. Specify this fraction:
A. γ-globulins
B. Albumins
C. α1-globulins
D. α2-globulins
E. β-globulins
72. When the inflammatory process is activated,
some autoimmune and infectious diseases in the
blood plasma sharply increase the level of
proteins of the acute phase. Which of the
following proteins can form a gel when the
whey cools?
A. Cryoglobulin
B. Haptoglobin
C. Ceruloplasmin
D. C-reactive protein
E. α2 macroglobin
73. A 49-year-old male patient with acute
pancreatitis was likely to develop pancreatic
necrosis, while active pancreatic proteases were
absorbed into the blood stream and tissue
proteins broke up. What protective factors of the
body can inhibit these processes?
A. α2-macroglobulin, α1-antitrypsin
B. Immunoglobulin
C. Cryoglobulin, interferon
D. Ceruloplasmin, transferrin
E. Hemoplexin, haptoglobin
74. Wilson’s disease is a disorder of copper
transport which leads to the accumulation of this
metal in brain and liver cells. It is associated
with a disturbance in the synthesis of the
following protein:
A. Ceruloplasmin
B. Metallothionein
C. Transcobalamin
D. Haptoglobin
E. Siderophilin
75. Examination of a 27-year-old patient
revealed pathological changes in liver and brain.
Blood plasma analysis revealed an abrupt
decrease in the copper concentration, urine
analysis revealed an increased copper
concentration. The patient was diagnosed with
Wilson’s degeneration. To confirm the
diagnosis it is necessary to study the activity of
the following enzyme in blood serum:
A. Ceruloplasmin
B. Carbonic anhydrase
C. Xanthine oxidase
36
D. Leucine aminopeptidase
E. Alcohol dehydrogenase
76. Biochemical analysis of the blood serum of
a patient with hepatolenticular degeneration
(Wilson-Konovalov disease) revealed a
decrease in the content of ceruloplasmin. In this
patient, the concentration of such ions in the
serum will be increased:
A. Copper
B. Calcium
C. Phosphorus
D. Potassium
E. Sodium
77. A patient suffering from hepatocerebral
degeneration has low concentration of
ceruloplasmin in blood serum. What element
accumulation will be observed in liver,
cerebrum and kidneys of the patient?
A. Cuprum
B. Calcium
C. Sodium
D. Potassium
E. Ferrum
78. A 33-year-old woman suffers from
hepatocerebral dystrophy (Wilson's disease). In
the blood - low content of ceruloplasmin. In the
urine - sharply elevated amino acids. What
process has increased these changes?
A. Complexation of amino acids with copper
B. Urea synthesis
C. Transamination of amino acids
D. Disintegration of tissue proteins
E. Gluconeogenesis
79. A 38 year old patient suffers from
rheumatism in its active phase. What laboratory
characteristic of blood serumis of diagnostic
importance in case of this pathology?
A. C-reactive protein
B. Uric acid
C. Urea
D. Creatinine
E. Transferrin
80. Blood plasma of a healthy man contains
several dozens of proteins. During an illness
new proteins can originate, namely the protein
of "acute phase". Select such protein from the
listed below:
A. C-reactive protein
B. Prothrombin
C. Fibrinogen
D. G immunoglobulin
E. A immunoglobulin
81. A 60-year-old man complains of joint pain.
An increase in the concentration of C-reactive
protein and hydroxyproline was detected in the
patient's serum. What disease are these
symptoms characteristic of?
A. Rheumatism
B. Gout
C. Hepatitis
D. Jaundice
E. Diabetes
82. A 6-month-old child experienced frequent
and intense subcutaneous hemorrhages. The
appointment of a synthetic analogue of vitamin
K (vikasol) gave a positive effect. In the γcarboxylation of glutamic acid, what protein of
the blood coagulation system is this vitamin
taking part in?
A. Prothrombin
B. Fibrinogen
C. Hageman factor
D. Antihemophilic globulin A
E. Rosenthal factor
83. After implantation of a cardiac valve a
young man
constantly takes
indirect
anticoagulants. His state was complicated by
hemorrhage. What substance content has
decreased in blood?
A. Prothrombin
B. Haptoglobin
C. Heparin
D. Creatin
E. Ceruloplasmin
84. The patient complains of frequent bleeding
from the gums. A deficiency of coagulation
factor II (prothrombin) was found in the blood.
What phase of blood coagulation is impaired in
a person, above all?
A. Thrombin formation
B. The formation of prothrombinase
C. Formation of fibrin
D. Fibrinolysis
E. Clot retraction
37
85. Inflammatory processes cause synthesis of
protein of acute phase in an organism. What
substances stumulate their synthesis?
A. Interleukin-1
B. Immunoglobulins
C. Interferons
D. Biogenic amins
E. Angiotensin
90. The student used canned donor blood to
determine the time it was collected. However,
he could not get any positive result. The reason
for this is the lack of blood:
A. Ionized calcium
B. Hageman factor
C. Thromboplastin
D. Fibrinogen
E. Vitamin K.
86. Pyrogenal administered to a rabbit, in the
course of an experiment, resulted in increase of
its body temperature. What substance of those
named below acts as a secondary pyrogen that is
a part of fever inducing mechanism?
A. Interleukin 1
B. Pseudomonas polysaccharide (Piromen)
C. Histamine
D. Bradykinin
E. Immunoglobulin
91. A 16 year old boy after an illness has
diminished function of protein synthesis in liver
as a result of vitamin K deficiency. It will cause
disturbance of:
A. Blood coagulation
B. Erythrocyte sedimentation rate
C. Anticoagulant generation
D. Erythropoietin secretion
E. Osmotic blood pressure
87. A patient who suffers from pneumonia has
high body temperature. What biologically active
substance plays the leading part in origin of this
phenomenon?
A. Interleukin-I
B. Histamine
C. Bradykinin
D. Serotonin
E. Leukotrienes
92. The patient has hemorrhages, the
concentration of prothrombin is reduced in the
blood. What vitamin deficiency led to a
violation of the synthesis of this clotting factor?
A. K
B. A
C. D
D. C
E. E
88. After transfusion of 200 ml of blood apatient
presented with body temperature rise up to
37,9oC. Which of the following substances is
the most likely cause of temperature rise?
A. Interleukin-1
B. Interleukin-2
C. Tumour necrosis factor
D. Interleukin-3
E. Interleukin-4
93. A 37-year-old patient, with long-term use of
antibiotics, has increased bleeding with minor
injuries. In the blood - a decrease in activity II,
VII, X blood clotting factors; lengthening of
blood clotting time. What vitamin deficiency
caused these changes?
A. Vitamin K
B. Vitamin A
C. Vitamin C
D. Vitamin D
E. Vitamin E
89. For the development of febrile conditions,
an increase in the level of the “acute phase”
proteins of ceruloplasmin, fibrinogen, and Creactive protein is characteristic. Specify the
possible mechanism of this phenomenon:
A. Stimulating effect of IL-1 on hepatocytes
B. The destructive effect of temperature on the
cells of the body
C. Proliferative effect of IL-2 on T-lymphocytes
D. Degranulation of tissue basophils
E. -
94. Plasmic factors of blood coagulationare
exposed to post-translational modification with
the participation of vitamin K. It is necessary as
a cofactor in the enzyme system of γcarboxylation of protein factors of blood
coagulation due to the increased affinity of their
molecules with calcium ions. What amino acid
is carboxylated in these proteins?
A. Glutamic
B. Valine
C. Serine
38
D. Phenylalanine
E. Arginine
95. As a result of posttranslative modifications
some proteins taking part in blood coagulation,
particularly prothrombin, become capable of
calcium binding. The following vitamin takes
part in this process:
A. K
B. C
C. A
D. B1
E. B2
96. To prevent postoperative bleeding a 6 y.o.
child was administered vicasol that is a
synthetic analogue of vitamin K. Name posttranslational changes of blood coagulation
factors that will be activated by vicasol:
A. Carboxylation of glutamin acid
B. Phosphorylation of serine radicals
C. Partial proteolysis
D. Polymerization
E. Glycosylation
97. A few days before an operation apatient
should be administered vitamin K or its
synthetic analogue Vicasol. Vitamin K takes
part in the following posttranslational
modification of the II, VII, IX, X blood clotting
factors:
A. Carboxylation
B. Decarboxylation
C. Deamination
D. Transamination
E. Glycosylation
98. A patient, who has been suffering for a long
time from intestine disbacteriosis, has increased
hemorrhaging caused by disruption of
posttranslational modification of bloodcoagulation factors II, VII, IХ, and Х in the
liver. What vitamin deficiency is the cause of
this condition?
A. К
B. 12
C. 9
D. С
E. Р
99. A newborn baby has numerous
hemorrhages. Blood coagulation tests reveal
increased prothrombin time. The child is most
likely to have a disorder of the following
biochemical process:
A. Production of gammacarboxyglutamate
B. Conversion of homocysteine to methionine
C. Conversion of methylmalonyl CoA to
succinyl CoA
D. Degradation of glutathione
E. Hydroxylation of proline
100. Activation of a number of hemostatic
factors occurs through their joining with
calcium ions. What structural component allows
for adjoining of calcium ions?
A. Gamma-carboxyglutamic acid
B. Gamma-aminobutyric acid
C. Gamma-oxybutyric acid
D. Hydroxyproline
E. Monoamine-dicarboxylic acids
101. A 46-year-old female patient hasa
continuous history of progressive muscular
(Duchenne’s) dystrophy. Which blood enzyme
changes will be of diagnostic value in this case?
A. Creatine phosphokinase
B. Lactate dehydrogenase
C. Pyruvate dehydrogenase
D. Glutamate dehydrogenase
E. Adenylate cyclase
102. A 15-year-old boy has been diagnosedwith
acute viral hepatitis. What blood values hould
be determined to confirm acute affection of
hepatic cells?
A. Aminotransferase activity (AST, ALT)
B. Unconjugated and conjugated bilirubin
content
C. Erythrocytes sedimentation rate (ESR)
D. Cholesterol content
E. Protein fraction content
103. 12 hours after an accute attack of
retrosternal pain a patient presented a jump of
aspartate aminotransferase activity in blood
serum. What pathology is this deviation typical
for?
A. Myocardium infarction
B. Viral hepatitis
C. Collagenosis
D. Diabetes mellitus
E. Diabetes insipidus
104. A 43-year-old man after eating fatty foods
and alcohol complains of severe abdominal
39
pain. The serum content of trypsin is 850 mmol
/ (h • l) (normal 60-240 mmol / (h • l)). What is
the most characteristic pathology of the
digestive system?
A. Acute pancreatitis
B. Dynamic intestinal obstruction
C. Mechanical intestinal obstruction
D. Gastric ulcer
E. Hepatitis
105. For biochemical diagnostics of myocardial
infarction it is necessary to measure activity of a
number of enzymes and their isoenzymes. What
enzymatic test is considered to be the best to
prove or disprove the diagnosis of infarction in
the early period after the chest pain is detected?
A. Creatine kinase isoenzyme CK-MB
B. Creatine kinase isoenzyme CK-MM
C. LDH1 lactate dehydrogenaseisoenzyme
D. LDH2 lactate dehydrogenaseisoenzyme
E.
Aspartate
aminotransferasecytoplasmic
isoenzyme
106. An increase in the activity of LDH4,5,
ALT, carbamoylornitene transferase was
detected in the patient's blood. In which body
can you predict the development of the
pathological process?
A. Liver (possible hepatitis)
B. Heart muscle (possible myocardial
infarction)
C. Skeletal muscle
D. Kidneys
E. Connective tissue
107. Albumin concentration in the patient’s
blood is 2.8 g / l, increased concentration of
lactate dehydrogenase 5 (LDH 5). What kind of
organ disease does this indicate?
A. Liver
B. Kidney
C. Heart
D. Lung
E. Spleen
108. Blood test of the patient revealed albumine
content of 20 g/l and increased activity of
lactate dehydrogenase isoenzyme 5 (LDH5).
These results indicate disorder of the following
organ:
A. Liver
B. Kidneys
C. Heart
D. Lungs
E. Spleen
109. In the serum of the patient increased
activity of hyaluronidase. Determining what
biochemical index of serum will allow to
confirm the assumption of connective tissue
pathology?
A. Sialic acids
B. Bilirubin
C. Uric acid
D. Glucose
E. Galactose
110. Marked increase of activity of МВ forms
of CPK (creatinephosphokinase) and LDH-1
was revealed by examination of the patient’s
blood. What is the most probable pathology?
A. Miocardial infarction
B. Hepatitis
C. Rheumatism
D. Pancreatitis
E. Cholecystitis
111. An increase in the activity of LDH 1, LDH
2, AsAT, and creatine kinase was found in the
patient's blood. In which organ of the patient is
the most likely development of the pathological
process?
A. Heart
B. Pancreas
C. Liver
D. Kidneys
E. Skeletal muscle
112. There is increased activity of AST, LDH1,
LDH2, and CPK in the patient’s blood.
Pathological process most likely occurs in the:
A. Heart
B. Skeletal muscles
C. Kidneys
D. Liver
E. Adrenal glands
113. The activity of the isoenzymes LDG1 and
LDG2 appeared in the patient's blood plasma.
On the pathology of a body that indicates?
A. Myocardium
B. Liver
C. Kidney
D. Brain
E. Skeletal muscle
40
114. A patient presents high activity of LDH1,2,
aspartate
aminotransferase,
creatine
phosphokinase. In what organ (organs) is the
development of apathological process the most
probable?
A. In the heart muscle (initial stage of
myocardium infarction)
B. In skeletal muscles (dystrophy, atrophy)
C. In kidneys and adrenals
D. In connective tissue
E. In liver and kidneys
115. A 49-year-old driver complains about
unbearable constricting pain behind the
breastbone irradiating to the neck. The pain
arose 2 hours ago. Objectively: the patient’s
condition is grave, he is pale, heart tones are
decreased. Laboratory studies revealed high
activity of creatinekinase and LDH1. What
disease are these symptoms typical for?
A. Acute myocardial infarction
B. Acute pancreatitis
C. Stenocardia
D. Cholelithiasis
E. Diabetes mellitus
116. 6 hours after the myocardial infarction a
patient was found to have elevated level of
lactate dehydrogenase in blood. What
isoenzyme should be expected in this case?
A. LDH1
B. LDH2
C. LDH3
D. LDH4
E. LDH5
117. A 47-year-old male patient was diagnosed
with myocardial infarction in the intensive care
unit. Which of the lactate dehydrogenase (LDH)
fractions will prevail in the blood serum during
the first two days?
A. LDH 1
B. LDH 2
C. LDG 3
D. LDH 4
E. LDG 5
118. The high level of Lactate Dehydrogenase
(LDH) isozymes concentration showed the
increase of LDH-1 and LDH-2 in a patient’s
blood plasma. Point out the most probable
diagnosis:
A. Myocardial infarction
B. Skeletal muscle dystrophy
C. Diabetes mellitus
D. Viral hepatitis
E. Acute pancreatitis
119. A 60-year-old man consulted a doctor
about an onset of chest pain. In blood serum
analysis showed a significant increase in the
activity of the following enzymes: creatine
kinase and its MB-isoform, aspartate
aminotransferase. These changes indicate the
development of the pathological process in the
following tissues:
A. Cardiac muscle
B. Lungs
C. Skeletal muscles
D. Liver
E. Smooth muscles
120. Hereditary hyperlipoproteinemia type I is
caused by lipoprotein lipase deficiency.
Increasing the level of some transport forms of
lipids in plasma even on an empty stomach is
characteristic?
A. Chylomicrons
B. Low density lipoproteins
C. Very low density lipoproteins
D. High density lipoproteins
E. Modified lipoproteins
121. Cholesterol content in blood serum of a 12year-old boy is 25 mmol/l. Anamnesis states
hereditary familial hypercholesterolemia caused
by synthesis disruption of receptor-related
proteins for:
A. Low-density lipoproteins
B. High-density lipoproteins
C. Chylomicrons
D. Very low-density lipoproteins
E. Middle-density lipoproteins
М-а-2016-176
122. Examination of the patient revealed an
increase in the content of low-density
lipoproteins in the blood serum. What disease
can be assumed in this patient?
A. Atherosclerosis
B. Kidney damage
C. Acute pancreatitis
D. Gastritis
E. Inflammation of the lungs
41
123. A 58-year-old patient suffers from the
cerebral atherosclerosis. Examination revealed
hyperlipoidemia. What class of lipoproteins will
most probably show increase in concentration in
this patient’s blood serum?
A. Low-density lipoproteins
B. High-density lipoproteins
C. Fatty acid complexes with albumins
D. Chylomicrons
E. Cholesterol
124. Rabbits lived on food with addition of
cholesterol.
Five
months
later
the
atherosclerotic aorta changes were revealed.
Name the main cause of atherogenesis in this
case:
A. Exogenous hypercholesterolemia
B. Overeating
C. Hypodynamia
D. Endogenous hypercholesterolemia
E. –
125. Examination of an ill child’s blood
revealed
inherited
hyperlipoproteinemia.
Genetic defect of what enzyme synthesis causes
this phenomenon?
A. Lipoprotein lipase
B. Glycosidase
C. Proteinase
D. Hemsynthetase
E. Phenylalanine hydroxylase
126. In the study of the patient's blood plasma 4
hours after ingestion of fatty foods, it was found
that it is cloudy. The most likely cause of this
condition is an increase in plasma
concentration:
A. Chylomicrons
B. HDL
C. LDL
D. Cholesterol
E. Phospholipids
127. Blood serum of the patient has milky
appearance. Biochemical analysis revealed high
content of triacylglycerols and chylomicrons.
This condition is caused by hereditary defect of
the following enzyme:
A. Lipoprotein lipase
B. Phospholipase
C. Pancreatic lipase
D. Adipose tissue hormone-sensitive lipase
E. Phosphodiesterase
128. During examination of a teenager with
xanthomatosis
the
family
history
of
hypercholesterolemia is revealed. What
transportable
lipids
are
increased
in
concentration in case of such a disease?
A. Low-density lipoproteins
B. Chylomicrons
C. Very low-density lipoproteins
D. High-density lipoproteins
E. Intermediate-density lipoproteins
129. The level of which plasma protein allows
retrospectively (for the previous 4-8 weeks
before the examination) to assess the level of
glycemia, if the patient has diabetes mellitus,
which is accompanied by fasting hyperglycemia
more than 7.2 mmol / l?
A. Glycosylated hemoglobin.
B. Albumin.
C. C-reactive protein.
D. Ceruloplasmin.
E. Fibrinogen.
130. A patient is diagnosed with pancreatic
diabetes with associated hyperglycemia.
Glycemia rate can be assessed retrospectively
(4-8 weeks prior to examination) by measuring
concentration of the following blood plasma
protein:
A. Glycated hemoglobin
B. Albumin
C. Fibrinogen
D. C-reactive protein
E. Ceruloplasmin
131. A patient is ill with diabetes mellitus that is
accompanied by hyperglycemia of over 7,2
millimole/l on an empty stomach. The level of
what blood plasma protein allows to estimate
the glycemia rate retrospectively (4-8 weeks
before examination)?
A. Glycated hemoglobin
B. Albumin
C. Fibrinogen
D. C-reactive protein
E. Ceruloplasmin
132. A 42-year-old woman, who has been
keeping to a vegetarian diet for a long period of
time, consulted a doctor. Examination revealed
negative nitrogen balance in the patient. What
42
factor is the most likely cause of such a
condition?
A. Insufficient amount of proteins in the diet
B. Insufficient amount of dietary fiber
C. Excessive amount of fats in the diet
D. Insufficient amount of fats in the diet
E. Decreased rate of metabolic processses
133. Examination of a 45-year-old man whohad
kept to a vegeterian diet for a long time revealed
negative nitrogen balance.Which peculiarity of
his diet is the causeof this phenomenon?
A. Lack of proteins
B. Lack of fats
C. Excess of water
D. Excess of carbohydrates
E. Lack of vitamins
134. A 14 year old child was found to have a
positive nitrogen balance. Which of the
following could be the reason for this?
A. Body growth
B. Fasting
C. Reduced protein in food
D. Significant physical loads
E. Emotional stress
135. A month after a serious operation a 38year-old patient has recovered and has now
positive nitrogen balance. Urine of this patient
may be found to have low concentration of the
following nitrogencontaining substance:
A. Urea
B. Lactate
C. Stercobilinogen
D. Galactose
E. 17-ketosteroids
136. A chiled was diagnosed with acuterenal
failure. What biochemic saliva indices can
confirm this diagnosis?
A. Increased level of rest nitrogen
B. Increase of immunoglobuline A
C. Reduction of alkaline phosphatase
D. Increase of alpha amylase
E. Decreased level of phosphate
137. A patient who goes out of a state of
prolonged fasting has determined nitrogen
metabolism. What result can you expect?
A. Reducing nitrogen excretion
B. Increased nitrogen excretion
C. Nitrogen equilibrium
D. Nitrogen balance unchanged
E. Ketonemia
138. A patient with primary nephrotic syndrome
has the following content of whole protein: 40
g/l. What factor caused hypoproteinemia?
A. Proteinuria
B. Transition of protein from vessels to tissues
C. Reduced protein synthesis in liver
D. Increased proteolysis
E. Disturbance of intestinal protein absorption
139. Examination of a patient with chronicrenal
insufficiency revealed an increase in residual
nitrogen concentration in blood up to 35
millimole/l, more than half of which is urea.
What type of hyperazotemia is it?
A. Retentional
B. Hepatic
C. Productional
D. Residual
E. Combined
140. On the basis of laboratory analysis, the
patient confirmed the diagnosis of gout. To
establish the diagnosis was carried out
determination of the content:
A. Urinary acid in the blood and urine
B. Creatinine in urine
C. Residual nitrogen in the blood
D. Urea in the blood and urine
E. Ammonia in the urine
141. A young man of 18 years old was
diagnosed with muscular dystrophy. Is the
increase in the serum content of the substance
most likely in this pathology?
A. Creatine
B. Myoglobin
C. Myosin
D. Lactate
E. Alanin
142. A 46-year-old patient complains of dry
mouth, thirst, frequent urination, and general
weakness. In the blood: hyperglycemia,
hyperketonemia. In the urine: glucose, ketone
bodies. On ECG: diffuse changes in the
myocardium. What is the most likely diagnosis?
A. Diabetes
B. Alimentary hyperglycemia
C. Acute pancreatitis
D. Diabetes mellitus
43
E. Coronary heart disease
143. The patient after suffering parotitis lost
weight, constantly feeling thirsty, drinks a lot of
water, notes frequent urination, increased
appetite, pruritus, weakness, furunculosis. In the
blood: glucose - 16 mmol / l, ketone bodies 100
mkmol / l. What disease has the patient
developed?
A. Insulin-dependent diabetes mellitus
B. Insulin independent diabetes
C. Steroid diabetes
D. Diabetes mellitus
E. Diabetes mellitus malnutrition
144. A patient was delivered to the hospital by
an emergency team. Objectively: grave
condition, unconscious, adynamy. Cutaneous
surfaces are dry, eyes are sunken, face is
cyanotic. There is tachycardia and smell of
acetone from the mouth. Analysis results: blood
glucose -20,1 micromole/l (standard is 3,3-5,5
micromole/l), urine glucose - 3,5% (standardis 0). What is the most probable diagnosis?
A. Hyperglycemic coma
B. Hypoglycemic coma
C. Acute heart failure
D. Acute alcoholic intoxication
E. Anaphylactic shock
145. A 38-year-old patient was admitted to the
intensive care unit in an unconscious state.
Reflexes are absent. Blood sugar - 2.1 mmol / l.
In history - diabetes mellitus from 18 years.
What kind of coma does the patient have?
A. Hypoglycemic
B. Ketoacidotic
C. Lacticidemic
D. Hyperosmolar
E. Hyperglycemic
146. A patient with a diagnosis of ItsenkoCushing's disease (hyperproduction of adrenal
hormones) in the blood has an increased
concentration of glucose, ketone bodies,
sodium. What is the biochemical mechanism
leading to the occurrence of hyperglycemia?
A. Gluconeogenesis
B. Glycogenesis
C. Glycogenolysis
D. Glycolysis
E. Aerobic glycolysis
147. A 48 year old patient complained about
intense pain, slight swelling and reddening of
skin over the joints, temperature rise up to
38oC.
Bloodanalysis
revealed
high
concentration ofurates. This condition might be
caused by disturbed metabolism of:
A. Purines
B. Collagen
C. Cholesterol
D. Pyrimidines
E. Carbohydrates
148. A patient has increased content of uric acid
in his blood that is clinically presented by pain
syndrome as a result of urate deposition in the
joints. What process does this acid result from?
A. Lysis of purine nucleotides
B. Lysis of pyrimidine nucleotides
C. Heme catabolism
D. Proteolysis
E. Reutilization of purine bases
149. A 1,7-year-old child with a developmental
delay and manifestations of self-agression has
the concentration of uric acid in blood at the rate
of 1,96 millimole/l. What metabolic disoder is
this typical for?
A. Lesch-Nyhan syndrome
B. Podagra
C. Acquired immunodeficiency syndrome
D. Gierke’s disease
E. Cushing’s basophilism
150. M-r S presents all signs of the hepatic
coma: loss of consciousness, absence of
reflexes, cramps, convulsion, disorder of heart
activity, recurrent (periodical) respiration. What
are cerebrotoxical substances which accumulate
in blood under hepar insufficiency?
A. Ammonia
B. IL-1
C. Autoantibody
D. Necrosogenic substances
E. Ketonic body
151. After a serious viral infection a 3-year-old
child has repeated vomiting, loss of
consciousness,
convulsions.
Examination
revealed hyperammoniemia. What may have
caused changes of biochemical blood indices of
this child?
A. Disorder of ammonia neutralization in
ornithinic cycle
44
B. Activated processes of aminoacids
decarboxylation
C. Disorder of biogenic amines neutralization
D. Increased purtefaction of proteins in
intestines
E. Inhibited activity of transamination enzymes
152. A 2-year-old child presents with mental
development retardation, intolerance of
proteins, severe hyperammonemia against the
background of low blood urea content. This
condition is caused by the congenital deficiency
of the following mitochondrial enzyme:
A. Carbamoyl phosphate synthetase
B. Citrate synthase
C. Succinate dehydrogenase
D. Malate dehydrogenase
E. Monoamine oxidase
153. A newborn presents with weak suckling,
frequent vomiting, and hypotonia. Blood and
urine citrulline are very high. What metabolic
process is disturbed?
A. Ornithine cycle
B. Tricarboxylic acid cycle
C. Glycolysis
D. Gluconeogenesis
E. Cori cycle
154. Nitrogen is being excreted from thebody
mainly as urea. When activity of acertain
enzyme in the liver is low, it resultsin inhibition
of urea synthesis and nitrogenaccumulation in
blood and tissues. Namethis enzyme:
A. Carbamoyl phosphate synthetase
B. Aspartate aminotransferase
C. Urease
D. Amylase
E. Pepsin
155. The patient has a reduced content of
indican in the blood serum, and also his daily
excretion with urine is reduced. Impairment of
which organ is the cause of this?
A. Liver
B. Kidney
C. Heart
D. Lungs
E. Pancreas
156. Laboratory examination of a child revealed
increased concentration of leucine, valine,
isoleucine and their ketoderivatives in blood and
urine. Urine smelt of maple syrup. This disease
is characterized by the deficit of the following
enzyme:
A. Dehydrogenase of branched amino acids
B. Aminotransferase
C. Glucose-6-phosphatase
D. Phosphofructokinase
E. Phosphofructomutase
157. A sick child presents with high content of
phenyl pyruvate in urine (normally it is
practically absent). Blood phenylalanine level is
350 mg/L (norm - 15 mg/L). What disease are
these symptoms characteristic of?
A. Phenylketonuria
B. Albinism
C. Tyrosinosis
D. Alkaptonuria
E. Gout
158. A hospital admitted a 9 y.o. boy with
mental and physical retardation. Biochemical
blood analysis revealed high content of
phenylalanine. Such condition may be caused
by blocking of the following enzyme:
A. Phenylalanine-4-monooxigenase
B. Oxidase of homogentisic acid
C. Glutamine transaminase
D. Aspartate aminotransferase
E. Glutamate decarboxylase
159. Blood of the patients with diabetes mellitus
shows increased content of free fatty acids.
Name the most likely cause of this:
A. Increased activity of adipose triglyceride
lipase
B. Accumulation of palmitoyl-CoA in cytosol
C. Activation of ketone bodies utilization
D. Activation of apoА1, apoА2, and apoА4
apolipoprotein synthesis
E.
Decreased
activity
of
plasma
phosphatidylcholine-cholesterolacyltransferase
45
Biochemistry of immune system
1. Differentiation of B-lymphocytes into plasma
cells leads to synthesis of immunoglobulins that
ensure specific immune response of the body.
Differentiation of B-lymphocytes takes place in
the following organ of immune system:
A. Tonsils
B. Red bone marrow
C. Liver
D. Thymus
E. Thyroid gland
2. Among lymphocytes, there are populations of
cells with membrane receptors for IgM, they are
activated by the action of specific antigens,
mitotically multiply, and differentiate into
plasma cells
that produce antibodies
(immunoglobulins). What are these cells called?
A. B-lymphocytes
B. Memory T lymphocytes
C. T-killer lymphocytes
D. T-suppressor lymphocytes
E. 3. A 2-year-old boy often became ill with
respiratory diseases, stomatitis, pustular skin
lesions. Even small damage to the gums and
mucous membranes is complicated by
prolonged inflammation. It is established that
the blood of the child is practically absent
immunoglobulins of all classes. Reduction
the functional activity of a cell population is the
basis of the syndrome described?
A. B-lymphocytes
B. T lymphocytes
C. Neutrophils
D. Macrophages
E. NK lymphocytes
4. A 13-year-old boy presents with eczematous
rashes on his shins and torso. Anamnesis states
cases of otitis, pneumonia, and furuncles in the
patient. Blood test: platelets - 70 • 109/l, low
activity of T helper and T suppressor cells, low
IgM, with normal IgA and IgG. What
immunodeficient disease does this boy have?
A.Wiskott-Aldrich syndrome
B. Louis-Bar syndrome (Ataxiatelangiectasia)
C. Severe combined immunodeficiency (Swiss
type)
D. DiGeorge syndrome
E. Chediak-Higashi syndrome
5. Bone marrow has been transplanted to the
liquidator of Chernobyl atomic power station
accident which was irradiated. The reaction “a
transplant against a host” development was
diagnosed at the patient after operation. Which
antigens are the reason of this reaction?
A. Antigens of HLA system in the cells of
liquidator’s organism
B. Antigens of Rh system in the erythrocytes of
liquidator
C. Antigens HBs, HBc, HBe
D. Antigens of ABO system in the erythrocytes
of liquidator
E. Antigens of HLA system in the cells of
donor’s spinal cord
6. A male patient has been diagnosed with acute
poststreptococcal glomerulonephritis. It is most
likely that the lesion of the basement membrane
of renal corpuscles was caused by the following
allergic reaction:
A. Immune complex
B. Anaphylactic
C. Cytotoxic
D. Delayed
E. Stimulating
7. A 5-year-old child is diagnosed with Bruton
syndrome (X-linked agammaglobulinemia) that
manifests itself in severe clinical course of
bacterial infections and absence of B
lymphocytes and plasma cells. What changes of
immunoglobulin content can be observed in
blood
serum
of
the
child
with
immunodeficiency?
A. Decreased IgA, IgM
B. Increased IgA, IgM
C. Decreased IgD, IgE
D. Increased IgD, IgE
E. No changes
8. Examination of a child who frequently suffers
from infectious diseases revealed that IgG
concentration in blood serum was 10 times less
than normal, IgA and IgM concentration was
also significantly reduced. Analysis showed also
lack of B-lymphocytes and plasmocytes. What
disease are these symptoms typical for?
A. Bruton’s disease
B. Swiss-type agammaglobulinemia
C. Dysimmunoglobulinemia
D. Louis-Bar syndrome
46
E. Di George syndrome
9. Parents of 5-year-old child report him o 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?
A. X-linked hypogammaglobulinemia
(Bruton type agammaglobulinemia)
B. Autosomal recessive agammaglobulinaemia
(Swiss type)
C. Hypoplastic anemia
D. Agranulocytosis
E. Louis-Barr syndrome
10. A child with suspected tuberculosis was
given Mantoux test. After 24 hours the site of
the allergen injection got swollen, hyperemic
and painful.What are the main components that
determine such response of the body?
A. Mononuclear cells, T-lymphocytes and
lymphokines
B. Granulocytes, T-lymphocytes and IgG
C.
Plasma
cells,
T-lymphocytes
and
lymphokines
D. B-lymphocytes, IgM
E. Macrophages, B-lymphocytes and monocytes
11. A 27-year-old woman has dropped penicillin
containing eye drops. In a few minutes there
appeared feeling of itching, burning of the skin,
lips and eyelids
edema, whistling cough, decrease of BP. What
imunoglobulins take part in the development of
this allergic reaction?
A. IgE and IgG
B. IgM and IgG
C. IgA and IgM
D. IgM and IgD
E. IgG and IgD
12. A 3 year old child with multiple impaired
development of the bones of the facial skull
died. The cause of death is sepsis, which
developed
on
the
background
of
bronchopneumonia.
Blood
content
immunoglobulins within the physiological
norm. At the autopsy revealed the absence of
the thymus. Name the main cause of the child’s
illness:
A. Syndrome of cellular immunity deficiency
B. Combined Immunodeficiency Syndrome
C. Secondary immunodeficiency syndrome
D. Acute lymphocytic leukemia
E. Syndrome of chronic intoxication
13. During the examination of the patient a
insufficient quantity of immunoglobulins was
detected. What kind of immune cells do they
produce?
A. Plasma cells
B. T-helper
C. T-killers
D. T-suppressors
E. Plasmoblasty
14. Following exposure to radiation a lot of
mutant cells appeared in a patient. Some time
later most of them were detected and destroyed
by the following cells of the immune system:
A. T-lymphocytes-killers
B. Plasmoblasts
C. T-lymphocytes-supressors
D. B-lymphocyte
E. Stem cells
15. Numerous plasma cells were found in the
blood girl 16 years old, suffering from an
autoimmune inflammation of the thyroid gland.
With the proliferation and differentiation of
what blood cells cause increase of plasmocyte?
A B-lymphocytes
B T-helper
C Mast cells
D T-killer
E T-suppressor
16. The patient is diagnosed with ARVI. Class
M immunoglobulins have been found in the
serum. What is the period of the infection
process in this case?
A. Acute
B. Prodromally
C. Incubation
D. Reconvalescence
E. Micro carrier
17. A 34-year-old patient, after suffering an
intestinal infection caused by Salmonella,
symptoms of the disease began to fade. What
class of immunoglobulins will be detected in the
patient's blood during the recovery period?
A. Ig G
B. Ig A
47
C. Ig D
D. Ig E
E. Ig M
18. Preventive vaccination against polyomyelitis
is made with inactivated vaccine introduced
parenterally. What immunoglobulins create the
postvaccinal immunity in the case?
A. IgM, IgG
B. IgG, secretory IgA
C. IgM, secretory IgA
D. Serum IgA, IgM
E. Ig E, IgM
19. A 37-year-old man was injected with
novocaine solution in the treatment of acute
pulpitis. A few minutes later the patient
developed
an
anaphylactic
shock.What
immunoglobulin does the antigen mainly
interact with in the body during a given allergic
reaction?
A. IgE
B. IgM
C. IgA
D. IgD
E. IgG
20. After the introduction of lidocaine, a 25year-old patient developed shortness of breath,
bronchospasm, and his blood pressure dropped
sharply, which required the use of immediate
relief from a dentist doctor. What mechanism is
the basis of such phenomena?
A. Allergic reactions involving IgE
B. Allergic cytotoxic reactions
C. The phenomenon of idiosyncrasy
D. Hypersensitivity due to T-lymphocytes
E. Effects caused by T-killers
21. Skin samples of a patient with bronchial
asthma revealed allergen sensitization of poplar
fuzz. What factor of immune system plays the
main part in
development of this immunopathological state?
A. IgE
B. IgD
C. IgM
D. Sensitized Т-lymphocytes
E. –
22. A teenger had his tooth extracted under
novocain anaesthesia. 10 minutes later he
presented
with
skin
pallor,
dyspnea,
hypotension. When this reaction is developed
and the allergen achieves tissue basophils, it
reacts with:
A. IgE
B. IgА
C. IgD
D. IgМ
E. T-lymphocytes
23. A 34-year-old patient, after suffering an
intestinal infection caused by Salmonella,
symptoms of the disease began to fade. What
class of immunoglobulins will be detected in the
patient's blood during the recovery period?
A. Ig G
B. Ig A
C. Ig D
D. Ig E
E. Ig M
24. One of the functions of saliva is protective,
which is realized by the formation of local
immunity of the mucous membrane due to the
secretion of the parotid glands of such a protein:
A. Secretory Immunoglobulin A
B. Collagen
C. Elastin
D. Fibrinogen
E. Albumin
25. Various cells of the oral mucous membrane
and antimicrobial substances synthesized by
these cells play an important part in the local
immunity of the oral cavity. Specify the key
factors for the local immunity:
A. Secretory IgA
B. B-lymphocytes
C. IgG
D. Macrophages
E. Eosinophils
26. In our country, routine preventive
vaccinations against poliomyelitis ivolve using
live vaccine that is administered orally. What
immunoglobulins are responsible for the
development of local post-vaccination immunity
in this case?
A. Secretory IgA
B. IgM
C. IgG
D. Serum IgA
E. IgE
48
27. Throughout a year a 37-year-old woman
periodically got infectious diseases of bacterial
origin, their course was extremely lingering,
remissions were short. Examination revealed
low level of major classes of immunoglobulins.
The direct cause of this phenomenon may be the
following cell dysfunction:
A. Plasmocytes
B. Phagocytes
C. Neutrophils
D. Macrophages
E. Lymphocytes
28. A patient has been hospitalized 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. What is the name
of the applied serological reaction?
A. Immune-enzyme analysis
B. Radioimmunoassay technique
C. Immunofluorescence test
D. Bordet-Gengou test
E. Antigen-binding assay
29. A doctor examined a patient with recurrent
aphthous
stomatitis
with
concominant
candidosis and decided to eliminate a possibility
of HIV-infection. What examination can help to
clear the situation up and make a provisional
diagnosis?
A. Immune-enzyme analysis
B. Gel precipitation reaction
C. Reaction of hemagglutination inhibition
D. Reaction of hemagglutination
E. Phase-contrasr microscopy
30. T-lymphocytes are determined to be affected
with HIV. In this case viral enzyme reverse
transcriptase
(RNA-dependent
DNApolymerase) catalyzes the synthesis of:
A. DNA based on the viral RNA matrix
B. Viral RNA based on the DNA matrix
C. Viral protein based on the viral RNA matrix
D. Viral DNA based on the DNA matrix
E. Informational RNA based on the viral protein
matrix
31. Lymphocytes are affected by HIV retrovirus
(AIDS). In this case, the direction of
information flow in the cell will be:
A. RNA → DNA → i-RNA → Polypeptide
B. DNA → i-RNA → polypeptide → DNA
C. DNA → polypeptide → i-RNA
D. i-RNA → polypeptide → DNA
E. Polypeptide → RNA → DNA → i-RNA
32. A patient with acquired immunodeficiency
syndrome (СНІД) the immunological reactivity,
manifested by the development of chronic
inflammatory processes, infectious diseases,
tumor growth, is significantly reduced. What
types of blood cells damages HIV-infections,
which results in reduced immune protection?
A. T4 helper
B. Natural Kileri (NK)
C. T-suppressors
D. T8-Effects
E. B-lymphocytes
33. A 20-year-old patient, an AIDS diagnosis
was established. What cell populations are most
sensitive to human immunodeficiency virus?
A. T-helpers
B. Hepatocytes
C. Endotheliocytes
D. Epithelial cells
E. B lymphocytes
34. A 1-year-old child often suffers from viral
and bacterial infections that are difficult to treat.
During the investigation the immunological
status revealed the absence of lymphocytes in
the blood providing cellular immunity. What
immunodeficiency and what system is detected
in this child?
A. In a T cell primary response
B. In a T-cell secondary response
C. In a B cell primary response
D. In a macrophage system primary response
E. In a microphages primary response
35. Blood serum of a newborn contains
antibodies to measles virus. What kind of
immunity is this indicative of?
A. Natural passive
B. Natural active
C. Artificial passive
D. Artificial active
E. Heredoimmunity
36. A child was born with cleft palate.
Examination revealed aorta defects and reduced
number of T-lymphocytes in blood. What
immunodeficient syndrome is it?
49
A. Di George
B.Wiskott-Aldrich
C. Chediak-Higashi
D. Louis-Bar
E. Swiss-type
A. Interleukin-1
B. Immunoglobulins
C. Interferons
D. Biogenic amins
E. Angiotensin
37. A female patient underwent liver
transplantation. 1,5 month after it her condition
became worse because of reaction of transplant
rejection. What factor of
immune system plays the leading part in this
reaction?
A. T-killers
B. Interleukin-1
C. Natural killers
D. B-lymphocytes
E. T-helpers
42. Donor skin transplantation was performed to
a patient with extensive burns. On the 8-th day
the graft became swollen and changed colour;
on the 11-th day graft rejection started.What
cells take part in this process?
A. T-lymphocytes
B. Erythrocytes
C. Basophils
D. Eosinophils
E. B-lymphocytes
38. A patient consulted an immunologist about
diarrhea, weight loss within several months,
low-grade fever, enlarged lymph nodes. The
doctor suspected HIV infection. What
immunocompetent cells must be studied in the
first place?
A. Helper T-lymphocytes
B. Suppressor T-lymphocytes
C. B-lymphocytes
D. Monocytes
E. Plasma cells
39. After transfusion of 200 ml of blood a
patient presented with body temperature rise up
to 37,9°C. Which of the following substances is
the most likely cause of temperature rise?
A. Interleukin-1
B. Interleukin-2
C. Tumour necrosis factor
D. Interleukin-3
E. Interleukin-4
40. A patient with skin mycosis has disorder of
cellular
immunity.
The
most
typical
characteristic of it is reduction of the following
index:
A. T-lymphocytes
B. Immunoglobulin G
C. Immunoglobulin E
D. B-lymphocytes
E. Plasmocytes
41. Inflammatory processes cause synthesis of
protein of acute phase in an organism. What
substances simulate their synthesis?
43. The patient contacted the dermatologist with
complaints about eczematous lesions of the skin
that appeared after contact with the detergent
"Lotus". The use of rubber gloves prevents this.
The pathological reaction of the skin is caused
by activation:
A. T-lymphocytes
B. B-lymphocytes
C. Monocytes
D. Neutrophils
E. Basohiles
44. The development of febrile states are
characterized by an increase in the level “the
acute phase” proteins. There are ceruloplasmin,
fibrinogen, C-reactive protein. Enter the
Possible mechanism of this phenomenon:
A. Stimulating effect of IL-1 on hepatocytes
B. The destructive effect of temperature on the
cells of the body
C. The proliferative effect of IL-2 on
T lymphocytes
D. Degranulation of tissue basophils
E. 45. A pregnant woman with the previous
diagnosis of toxoplasmosis has been
hospitalized. What serological reaction should
be used to determine toxoplasmosis in test
specimens?
A. Complement fixation test.
B. Neutralization
C. Haemadsorption
D. Agglutination
E. Inhibition of hemagglutination
50
Biochemistry of liver
1. Disorderthe splitting of the lipids in the small
intestine is due to a disorder of lipase activity.
Which of the following factors activates the
lipase?
A. Bile acids
B. Hydrochloric acid
C. Enterokinase
D. Pepsin
E. Solts of Na+
2. Examination of a patient revealed that dental
hypoplasia was caused by hypovitaminosis of
vitamins A and D. These vitamins were
administered perorally but they didn’t have any
medicinal effect. What is the probable cause of
disturbed vitamin assimilation?
A. Bile acid deficiency
B. Phospholipase A2 deficiency
C. Cholesterolesterase deficiency
D. Colipase deficiency
E. Pancreatic lipase deficiency
3. A coprological study found that the feces are
discolored, there are found drops of neutral fat.
The most likely cause of this is a violation:
A. Flow of bile into the intestine
B. pH of gastric juice
C. Secretions of pancreatic juice
D. Secretion of intestinal juice
E. Absorption processes in the intestine
4. After eating fatty foods, the patient has
nausea and heartburn, steatorrhea occurs. The
reason for such a state can be:
A. Lack of bile
B. Increased lipase secretion
C. Violation of trypsin synthesis
D. Lack of amylase
E. Impaired phospholipase synthesis
5. Due to the blockage of the common bile duct
(which was radiographically confirmed), the
biliary flow to the duodenum was stopped. We
should expect the impairment of:
A. Fat emulsification
B. Protein absorption
C. Carbohydrate hydrolysis
D. Secretion of hydrochloric acid
E. Salivation inhibition
achilic syndrome due to obturation of the biliary
tract. Which components of food will be
mastered the most?
A. Fats
B.Carbohydrates
C. Proteins
D. Nucleic acids
E. Electrolytes
7. The drug "Geptral", which is used in liver
diseases contains S-adenosylmethionine. This
active amino acid is involved in the synthesis
of:
A. Phospholipids
B. Fatty acids
C. Triacylglycerols
D. Cholesterol
E. Heme
8. The patient appointed a lipotropic drug a
donor of methyl groups, to prevent a fatty liver
distrophia. This is sensible:
A. S-Adenosylmethionine
B. Cholesterol
C. Bilirubin
D. Valine
E. Glucose
9. Examination of cell culture gotfrom a patient
with
lysosomal
pathology
revealed
accumulation of great quantity of lipids in the
lysosomes. What of the following diseases is
this disturbance typical for?
A. Tay-Sachs disease
B. Gout
C. Phenylketonuria
D.Wilson disease
E. Galactosemia
10. Steatosis occurs as a result of the
accumulation of triacylglycerols in hepatocytes.
One of the mechanisms of development of this
disease is reduction of utilization neutral fat
LDL. What lipotropic substances prevent the
development of steatosis? A. Methionine, BC,
B12
B. Arginine, B2, B3
C. Alanine, B1, PP
D. Valine, B3, B2
E. Isoleucine, B1, B2
6. A 65-year-old patient suffers from
cholelithiasis. Recently, there were signs of
51
11. In an experimental animal, receiving nonprotein diet, fatty infiltration of the liver has
developed due to the deficiency of the
methylating agents. The formation of which
metabolite is disturbed in the experimental
animal?
A. Choline
B. DOPA
C. Cholesterol
D. Acetoacetate
E. Linolic acid
12. A dry cleaner’s worker has been found to
have hepatic steatosis. This pathology can be
caused by the disruption of synthesis of the
following substance:
A. Phosphatidylcholine
B. Tristearin
C. Urea
D. Phosphatidic acid
E. Cholic acid
13. In the 2-year-old boy, an increase in the size
of the liver and spleen, cataract is observed. The
concentration of sugar is elevated in the blood,
but the test of glucose tolerance is normal. An
hereditary violation of the metabolism of which
substance is the cause of this condition?
A. Galactose
B. Fructose
C. Glucose
D. Maltose
E. Saccharose
14. During starvation normal rate ofglucose is
maintained by means ofactivation of
gluconeogenesis. Whatsubstance can be used as
a substrate forthis process?
A. Alanine
B. Ammonia
C. Adenine
D. Urea
E. Guanine
15. In a patient undergoing a course of medical
starvation, the normal level of glucose in the
blood is maintained mainly due to
gluconeogenesis. From what amino acids at the
same time in the human liver most actively
synthesized glucose?
A. Alanine
B. Lysine
C. Valine
D. Glutamic acid
E. Leucine
16. The gluconeogenesis is activated in the liver
after intensive physical trainings. What substance is
utilized in gluconeogenesis first of all in this case:
A. Lactate
B. Pyruvate
C. Glucose
D. Glutamate
E. Alanine
17. In patients with glycogenosis, that is von
Gierke’s disease, the conversion of glucose-6phosphate in to glucose is inhibited, which is
accompanied by the improper breakdown of
glycogen in the liver. The cause of this
condition is the following enzyme deficiency:
A. Glucose-6-phosphatase
B. Glycogen phosphorylase
C. Glucose-6-phosphate dehydrogenase
D. Phosphofructokinase
E. Phosphoglucomutase
18. A child has a history of hepatomegaly,
hypoglycemia, seizures, especially on an empty
stomach and in stressful situations. The child is
diagnosed with Gierke disease. This disease is
caused by the genetic defect of the following
enzyme:
A. Glucose-6-phosphatase
B. Amyloid-1,6-glycosidase
C. Phosphoglucomutase
D. Glycogen phosphorylase
E. Glucokinase
19. A patient with chronic hypoglycemia had
adrenaline introduction. After introduction
blood test hasn’t changed essentially. Doctor
assumed liver pathology. What liver function
may have been changed?
A. Function of glycogen depositing
B. Function of cholesterin production
C. Ketogenic function
D. Glycolytic function
E. Excretory function
20. After the introduction of adrenaline in a
patient with persistent hypoglycemia, blood test
has not changed significantly. In such
circumstances, there is a possibility of
disturbances in the liver. What function of the
liver is changed?
A. Glycogendeposing.
B. Glycolytic.
52
C. Excretory.
D. Ketogenic.
E. Cholesterol-forming.
21. In the human diet there are a large number
of carbohydrates. The number of which
structures will increase in cytoplasm of
hepatocytes?
A. Glycogen granules
B. Drops of fat
C. The lysosomes
D. Free ribosomes
E. Inclusion of lipofuscine
22. The main part of nitrogen is taking out of
organism as element of urea. Reducing the
activity of what liver enzyme leads to inhibition
of the synthesis of urea and increasing the
accumulation of ammonia in blood and tissues?
A. Carbamoyl phosphate synthase
B. Aspartate aminotransferase
C. Urease
D. Amilaza
E. Pepsin
23. In the biosynthesis of urea in the liver, the
formation of ornithine and urea is stimulated.
What amino acid is the intermediate product of
this synthesis?
A. Аrginine
B. Leicinc.
C. Сitrate.
D. Valin.
E. Tryptophan.
24. In a boy of 4 years after suffering from
severe viral hepatitis, vomiting, episodes of
nephropathy, seizures are observed. In the blood
there is hyperammonia. Violation of which of
the biochemical process in the liver caused such
a condition of the patient?
A. Disposal of ammonia.
B. Decarboxylation of amino acids.
C. Disposal of Biogenic Amines.
D. Synthesis of alphabets.
E. Gluconeogenesis.
25. Upon toxic damage of hepatic cells resulting
in disruption of liver function the patient
developed edemas. What changes of blood
plasma are the main cause of edema
development?
A. Decrease of albumin content
B. Increase of globulin conten
C. Decrease of fibrinogen conten
D. Increase of albumin conten
E. Decrease of globulin conten
26. A 25-year-old patient has been diagnosed
with chronic hepatitis. The patient complains of
10 kg weight loss within 2 months. Objectively:
the patient has dry peeling skin, pale with
yellow
shade,
petechial
haemorrhages,
stomatorrhagia. Petechial haemorrhages and
stomatorrhagia are caused by the disturbance of
the following hepatic function:
A. Protein synthesizing
B. Chromogenic
C. Glycogen synthesizing
D. Detoxication
E. Depositing
27. Hepatitis has led to the development of
hepatic failure. Mechanism of edemata
formation is activated by the impairment of the
following liver function:
A. Protein-synthetic
B. Barrier
C. Chologenetic
D. Antitoxic
E. Glycogen-synthetic
28. A patient being treated for viral hepatitis
type B got symptoms of hepatic insufficiency.
What blood changes indicative of protein
metabolism disorder will be observed in this
case?
A. Absolute hypoalbuminemia
B. Absolute hyperalbuminemia
C. Absolute hyperfibrinogenemia
D. Proteinic blood composition is unchanged
E. Absolute hyperglobulinemia
29. In obstructive jaundice and bile ducts,
prothrombin insufficiency is often observed.
With a deficiency in the organism of which
vitamin it is connected?
A. K
B. B6
C. A
D. C
E. E
30. A patient has been admitted to the
contagious isolation ward with signs of jaundice
caused by hepatitis virus.Which of the
53
symptoms given below is strictly specific for
hepatocellular jaundice?
A. Increase of ALT, AST level
B. Hyperbilirubinemia
C. Bilirubinuria
D. Cholemia
E. Urobilinuria
syndrome. Which type of jaundice is developed
in this patient?
A. Gallstone
B. Hemolytic jaundice
C. Hepatitis
D. Chronic gastritis
E. Chronic colitis
31. A 15-year-old boy has been diagnosed with
acute viral hepatitis. What blood value should
be determined to confirm acute affection of
hepatic cells?
A. Aminotransferase activity (AST, ALT)
B. Unconjugated and conjugated bilirubin
content
C. Erythrocytes sedimentation rate (ESR)
D. Cholesterol content
E. Protein fraction content
36. The patient turned to doctor with
disturbances in the right side of the subarea.
After examination of the patient, the doctor was
found yellow sclera. Laboratory diagnostic
revealed increased ALT, negative stercobilin in
feces. Which type of disease is developed these
symptoms?
A. Hepatitis
B. Haemolytic jaundice
C. Chronic gastroduodenitis
D. Chronic colitis
E. Chronic gastritis
32. Blood analysis of a patient with jaundice
reveals conjugated bilirubinemia, increased
concentration of bile acids. There is no
stercobilinogen in urine. What type of jaundice
is it?
A. Obstructive jaundice
B. Hepatocellular jaundice
C. Parenchymatous jaundice
D. Hemolytic jaundice
E. Cythemolytic jaundice
33. Encephalopathy has developed in a child
with hemolytic disease of the newborn. What
substance had increased in the child’s blood,
resulting in damage to the CNS?
A. Unconjugated bilirubin
B. Bilirubin-albumin complex
C. Bilirubin glucuronide
D. Verdohemoglobin
E. Bileacids
34. Barbiturates prescribed for jaundice
treatment
because
it
induces
UDPglucuronosyltransferase
synthesis.
Which
substance formation provide therapeutic effect?
A. Direct (conjugated) bilirubin
B. Indirect (unconjugated) bilirubin
C. Biliverdin
D. Protoporphyrin
E. Heme
35. The patient came to doctor with compliance
about
yellow
sclera
and
skin.
No
encephalopathy,
cholestasis
or
acholic
37. The 20-years-old man is diagnosed with
heredity
deficiency
of
UDPglucuronosyltransferase. Change in which blood
parameter can prove this diagnosis?
A. Indirect (unconjugated) bilirubin
B. Direct (conjugated) bilirubin
C. Urobilin
D. Stercobilinogen
E. Animal indican
38. The preterm newborn has a jaundice. Which
enzyme is probably deficient in this baby?
A. UDP-glucosyltransferase
B. alkaline phosphatase
C. acidic phosphatase
D. catalase
E. NAD+-dehydrogenase
39. The born in time newborn has yellow skin
and mucus color. The most probable reason of
this condition is temporary insufissiency of the
following enzyme:
A. UDP-glucosyltransferase
B. Glucuronosyltransferase
C. Heme synthase
D. Heme oxygenase
E. Biliverdin reductase
40. The newborn has a physiological jaundice.
The level of blood free bilirubin considerably
higher than normal. What enzyme deficiency
can cause this
54
A. UDP-glucosyltransferase
B. Transaminase
C. Xanthine oxidase
D. Adenosine deaminase
E. Heme oxygenase
41. Transfusion of Rh-incompatible blood
resulted in hemolytic jaundice development in
the patient. What laboratory blood value
confirms this type of jaundice?
A. Accumulation of unconjugated bilirubin
B. Reduction of unconjugated bilirubin
C. Accumulation of urobilinogen
D. Reduction of stercobilin
E. Reduction of conjugated bilirubin
42. The patient has a following symptoms:
yellow skin, dark urine, yellow-dark feces.
Which substance you will predict to be
increased in blood serum?
A. Free bilirubin
B. Conjugated bilirubin
C. Mesobilirubin
D. Verdoglobin
E. Biliverdin
43. A 46 year old woman suffering from
chololithiasis developed jaundice. Her urine
became dark-yellow and feces became
colourless. Blood serum will have the highest
concentration of the following substance:
A. Conjugated bilirubin
B. Unconjugated bilirubin
C. Biliverdin
D. Mesobilirubin
E. Urobilinogen
44. Enzymatic jaundices are accompanied by
abnormal
activity
of
UDPglucuronyl
transferase. What compound is accumulated in
blood serum in case of these pathologies?
A. Unconjugated bilirubin
B. Conjugated bilrubin
C. Dehydrobilirubin
D. Hydrobilirubin
E. Choleglobin
45. The 20-years-old patient has a jaundice and
the following laboratory parameter: increase
general blood bilirubin, predominantly by
indirect (free) fraction; urine and feces has a
high stercobilin; blood direct (conjugated)
bilirubin is normal. Which type of jaundice this
patient is most probably develop?
A. Hemolytic
B. Parenchymatous (hepatic)
C. Mechanical
D. Newborn jaundice
E. Gilbert's syndrome
46. The patient develops yellowish of skin and
mucus membranes. Analysis of blood plasma
revealed increased total bilirubin, feces –
increased stercobilin, urine – increased urobilin.
What type of jaundice this patient has?
A. Hemolytic
B. Gilbert's syndrome
C. Parenchymatous
D. Obstructive
E. Cholestatic
47. After blood transfusion patient has
yellowish of skin and mucus membrane,
increased total and indirect bilirubin, increased
urine urobilin and feces stercobilin. What kind
of jaundice can be the reason?
A. Hemolytic jaundice.
B. Newborn jaundice.
C. Obstructive jaundice.
D. Parenchymatous jaundice.
E. Genetic jaundice.
48. The patient who suffers from jaundice
because of increased bilirubin as part of its
indirect fraction. Urine and feces have intensive
color. What is the most probable explanation to
these disruptions?
A. Increased erythrocyte hemolysis
B. Disrupted liver urobilinogen transformation.
C. Disruption of direct bilirubin formation.
D. Liver parenchyma damage.
E. Disruption of bile flow from liver
49. The 28-years-old woman came to infectious
department with yellow skin, sclera, mucus
membrane. Laboratory diagnosis revealed
increased blood direct bilirubin; urobilinogen
and bilirubin in urine. Which of following
condition can lead to those symptoms?
A. Parenchymatous jaundice
B. Hemolytic jaundice
C. Kidney infarction
D. Renal tuberculosis
E. Mechanical jaundice
55
50. The 28-years old man came to doctor to
complaints about acute disturbances in the right
side of the subarea, nausea, vomiting.
Objectively: jaundice of the skin and sclera; the
temperature of the body is elevated, the urine is
dark color. Feces is hypochloric. The patient
have hyperbilirubinemia (bilateral and indirect
biliary),
bilirubinuria,
urobilinuria,
gipoproteinemiya,
reduction
of
blood
transfusion. Which of following condition can
lead to those symptoms?
A. Hemolitic jaundice
B. Subacute jaundice
C. Suprachondrial hemolytic jaundice
D. Acute cholecystitis
E. Acute pancreatitis
51. The 48-years-old woman was delivered to
hospital with compliance of general weakness,
sleep disturbance. Objectively: skin and sclera
are yellow. Blood analysis has increased total
bilirubin with direct bilirubin predominance.
Feces is acholic. Urine has dark color, because
of bile pigments. Which type of jaundice this
patient has?
A. Mechanical
B. Hemolytic
C. Parenchymatous
D. Gilbert's syndrome
E. Crigler–Najjar syndrome
52. The patient was delivered to hospital with
complaints about general weakness and sleep
disturbance. Skin has yellow color. There is
increased blood direct bilirubin and bile acids.
Feces is acholic. Which type of disease can
provoke those changes?
A. Mechanical jaundice
B. Hemolytic jaundice
C. Pre-hepatic jaundice
D. Gilbert's syndrome
E. Chronic cholecestitis
53. The patient with jaundice has increased
direct bilirubin and bile acids in blood; no
stercobilinogen was revealed in urine. What
type of jaundice can be the reason of these
symptoms?
A. Mechanical
B. Hepatic
C. Parenchymatous
D. Hemolytic
E. Post-hepatic
54. The patient has yellow skin, skin rash,
general weakness. In the urine: there is no
urobilin. Which type of pathology this patient is
most probably develop?
A. Mechanical jaundice
B. Parenchymal jaundice
C. Acute liver insufficiency
D. Haemolytic jaundice
E. Chronic liver insufficiency
55. The 43-years-old patient during 10 years has
a repetitive compliance about acute bellyache,
cramps, vision problems. His relatives have
Patient urine have red color. He was diagnosed
with acute intermittent porphyria. The reason of
he his disease is not being a vampire but
disrupted biosynthesis of:
A. Heme
B. Bile acids
C. Insulin
D. Collagen
E. Prostaglandin
56. The patients with erythropoietic porphyria
(Gunther disease) have ultraviolet redfluorescent tooth, sun-sensitive skin, redcolored urine. Which enzyme deficiency cause
this disease?
A. Uroporphyrinogen III synthase
B. δ- aminolevulinic acid synthase
C. Uroporphyrinogen I synthase
D. Uroporphyrinogen decarboxylase
E. Ferrochelatase
57. The patient who suffers from anemia has
increased protoporphyrin IX. Which mineral
deficiency can lead to such pathology?
A. Iron
B. Potassium
C. Magnesium
D. Sodium
E. Phosphorus
58. The patient has increased photosensitivity,
after prolong sun exposure urine starts to get
dark-red color. Which type of disease has this
characteristic?
A. Porphyria
B. Alkaptonuria
C. Albinism
D. Hemolytic jaundice
E. Pellagra
56
59. The 33 years old patient worries 10 years.
Periodically, he addresses the doctor with
complaints of acute abdominal pain,
convulsions, visual impairment. His relatives
are witnessing similar symptoms. Urine red.
Hospitalized with diagnoses - acute diarrhea
porphyria. The cause of the disease may be a
violation of the biosynthesis of such a
substance:
A. Gem
B. Insulin
C.Chicken acids
D. Prostaglandins
E. Collagen
60. A 43-year-old woman complains of general
weakness, weight loss, apathy, and drowsiness.
Chronic lead intoxication confirmed laboratory revealed hypochromic anemia. In the blood, an
increased level of Zn-protoporphyrin and a
reduced level of alpha-aminolevulinic acid,
indicating a violation of the synthesis:
A. Heme
B. DNA
C. RNA
D. Protein
E. Mevalonic acid
61. A mother consulted a doctor about her 5year-old child who develops erythemas,
vesicular rash and skin itch under the influence
of sun. Laboratory studies revealed decreased
iron concentration in the blood serum, increased
uroporphyrinogen I excretion with the urine.
What is the most likely inherited pathology in
this child?
A. Erythropoietic porphyria
B. Methemoglobinemia
C. Hepatic porphyria
D. Coproporphyria
E. Intermittent porphyria
62. A patient suffering from chronic hepatitis
complains of increasing the sensitivity to
barbiturates, which were earlier tolerated
without symptoms of intoxication. With the
disturbance of which of the liquor functions,
this is connected at the highest possible level?
A. Detoxification
B. Hemopoietic
C. Hemodynamic
D. Formation of bile
E. Phagocytic
63. Detoxification of xenobiotics (drugs,
epoxides, the arena oxides, aldehydes, nitro
derivatives, etc.) and endogenous metabolites
(estradiol, prostaglandins, leukotrienes) takes
place in the liver by conjugation with:
A. Glutathione
B. Aspartic acid
C. Glycine
D. S-Adenozylmethionin
E. Fosfoadenozyn
64. For a patient suffering from chronic
hepatitis, a load of sodium benzoate was carried
out to evaluate the degreasing function of the
liver. For the discharge of what substances with
urine judge the neutralizing function of the
stomach?
A. Hippuric acid
B. Phenylacetic acid
C. Citric acid
D. Valerian acid
E. Oxalic acid
65. Patient has cirrhosis of the liver. The study
of which of the listed substances that are
excreted in the urine can characterize the state
of the antitoxic function of the liver?
A. Hippuric acid
B. Ammonium salts
C. Creatinine
D. Uric acid
E. Amino acids
66. A woman of a chemical enterprise due to
violation of the rules of safe work has suffered a
toxic action of nitric acid and nitrites, which
cause deamination of cytosine in the DNA.
What enzyme initiates a chain of reparative
processes?
A. Uridine-DNA-glucosidase
B. Cytidine triphosphate synthetase
C. Orthotidyl monophosphate-decarboxylase
D. DNA-Dependent-RNA Polymerase
E. Timidilatsintaza
67. In the 70's, scientists found that the cause of
severe jaundice of newborns is a disturbance of
the binding of bilirubin in hepatocytes. What
substance is used to form a conjugate?
A. Glucuronic acid
B. Uric acid
C. Sulfuric acid
D. Lactic acid
57
E. Pyruvic acid
68. A 50-year-old patient with food poisoning
was prescribed a dropper with a 10% glucose
solution. It not only provides the energy needs
of the body, but also performs a detoxification
function due to the formation of a metabolite
that participates in the conjugation reaction:
A. Gluuronation
B. Sulfonation
C. Methylation
D. Glycosylation
E. Hydroxylation
69. To determine the antitoxic function of the
liver, the patient is assigned sodium benzonate,
which in the liver turns into hippuric acid. What
compound is used for this?
A. Glycine
B. Methionine
C. Cysteine
D. FAFS
E. UDF-glucuronic acid
70. In a patient with chronic alcoholic liver
disease, processes of xenobiotics and
endogenous toxic compounds biotransformation
are disturbed. Reducing the activity of which
chromoprotein can be the cause of this?
A. Cytochrome P-450
B. Hemoglobin
C. Cytochrome Oxidase
D. Cytochrome b
E. Cytochrome c1
71. In the liver, detoxification of natural
metabolites and xenobiotics is impaired. Name
cytochrome, the activity of which can be
reduced:
A. Cytochrome P-450
B. Cytochrome oxidase
C. Hemoglobin
D. Cytochrome b
E. Cytochrome c1
72. Study of conversion of a food colouring
agent revealed that neutralization of this
xenobiotic takes place only in one phase microsomal oxydation. Name a component of
this phase:
A. Cytochrome Р-450
B. Cytochrome B
C. Cytochrome C
D. Cytochrome A
E. Cytochrome oxidase
73. The universal biological system of oxidation
of nonpolar compounds (drugs, toxic
compounds), steroid hormones, cholesterol is
microsomal oxidation. What is the name of the
cytochrome, which is part of the oxygenase
chain of the microsome.
A. Cytochrome P 450.
B. Cytochrome a3.
C. Cytochrome in.
D. Cytochrome c.
E. Cytochrome a.
58
Pathologic urine components
1. A 13 year-old boy is complaining about
general weakness, dizziness, fatigue. Mental
retardation is detected. The examination
revealed high concentrations of valine,
isoleucine, and leucine in blood and urine. The
urine has a specific smell. What is the most
possible diagnosis?
A. Maple syrup urine disease
B. Addison’s disease
C. Tyrosinosis
D. Histidinemia
E. Grave’s disease
2. Excess of phenylpyruvate and phenylacetate
was detected in the urine sample of a 6 day-old
baby. Which amino acid metabolism is
disturbed?
A. Phenylalanine
B. Tryptophan
C. Methionine
D. Histidine
E. Arginine
3. In a sick child, a raised level of
phenylpyruvate was detected in the urine (in the
norm practically absent). The amount of
phenylalanine in the blood is 350 mg/l (about 15
mg/l). Which disease is characterized by the
above symptoms?
A. Fenilketonuria.
B. Albin.
C. Alpathonuria.
D. Gout
E. Tyrosinosis.
4. A child with mental and physical
development retardation was delivered to the
hospital. Phenylpyruvate was found in the urine.
Disturbance of which process is the reason for
this pathology?
A. Amino acid metabolism
B. Lipid metabolism
C. Carbohydrate metabolism
D. Water-salt balance regulation
E. Calcium and phosphate homeostasis
5. A 12-year-old boy in the urine revealed high
levels of all amino acids in the aliphatic row. In
this case, the highest excretion of cysteine and
cysteine was noted. In addition, ultrasound of
the kidneys showed the presence of stones in
them. Choose a possible pathology.
A. Cystinuria.
B. Alpathururia.
C. Cystitis
D. Phenylketonuria.
E. Hartnup's disease.
6. A 36-year-old female patient has a history of
collagen disease. Urine analysis is likely to
reveal an increased concentration of the
following metabolite:
A. Oxyproline
B. Indican
C. Creatinine
D. Urea
E. Urobilinogen
7. A patient with systemic scleroderma has an
intensified collagen destruction. Collagen
destruction will be reflected by intensified
urinary excretion of the
following amino acid:
A. Oxyproline
B. Alanine
C. Tryptophane
D. Serine
E. Phenylalanine
8. A child has physical and mental retardation,
serious abnormalities in connective tissue of
internal organs; urine contains keratan sulfates.
This is caused by metabolic disorder of the
following substance:
A. Glycosaminoglycan
B. Collagen
C. Elastin
D. Fibronectin
E. Hyaluronic acid
9. A traumatology unit received a patient with
crushed muscular tissue. What biochemical
indicator of urine will be raised in this case?
A. Creatinine
B. Total lipids
C. Glucose
D. Mineral salts
E. Uric acid
10. A biochemical urine analysis has been
performed for a patient with progressive
muscular dystrophy. In the given case muscle
disease can be confirmed by the high content of
the following substance in urine:
59
A. Creatine
B. Porphyrin
C. Urea
D. Hippuric acid
E. Creatinine
11. A biochemical urine analysis has been
performed for a patient with progressive
muscular dystrophy. In the given case muscle
disease can be confirmed by the high content of
the following substance in urine:
A. Creatine
B. Porphyrin
C. Urea
D. Hippuric acid
E. Creatinine
12. A baby has coloured sclera and mucouses
and her urine is darkening when exposed to air.
Homogentisic acid was found in urine and blood
samples. What is the reason for this condition?
A Alcaptonuria
B. Albinism
C. Galactosemia
D. Cystinuria
E. Histidinemia
13. A 5-year old child has darkened urine but no
bile enzymes were found in it. The child is
diagnosed with alcaptonuria. Which enzyme
deficiency is the reason for it?
A. Homogentisic acid oxydase
B. Phenylalanine hydroxylase
C. Tyrosinase
D. Oxyphenylpyruvate oxydase
E. Phenylpyruvate decarboxylase
14. A lab test revealed increased concentration
of leucine, valine, isoleucine and ketone
derivatives in the blood and urine. The urine has
a specific smell of maple syrup. Which enzyme
deficiency is typical for this condition?
A. Amino acid dehydrogenase
B. Aminotranspherase
C. Glucose-6-phosphatase
D. Phosphofructokinase
E. Phosphofructomutase
15. Excretion of homogentisic acid with the
urine is the reason for the condition called
alcaptonuria. Disturbance of which amino acid
metabolism causes this condition?
A. Tyrosine
B. Phenylalanine
C. Alanine
D. Methionine
E. Asparagine
16. The 28-years old man came to doctor to
complaints about acute disturbances in the right
side of the subarea, nausea, vomiting.
Objectively: jaundice of the skin and sclera; the
temperature of the body is elevated, the urine is
dark color. Feces is hypochloric. The patient
have hyperbilirubinemia (bilateral and indirect
biliary),
bilirubinuria,
urobilinuria,
gipoproteinemiya,
reduction
of
blood
transfusion. Which of following condition can
lead to those symptoms?
A. Hemolitic jaundice
B. Subacute jaundice
C. Suprachondrial hemolytic jaundice
D. Acute cholecystitis
E. Acute pancreatitis
17. A patient has an increased pyruvate
concentration in blood. A large amount of it is
excreted with the urine. What vitamin is lacking
in this patient?
A. B1
B. E
C. B3
D. B6
E. B2
18. A patient, who has been subsisting
exclusively on polished rice, has developed
polyneuritis due to thiamine deficiency. What
substance is an indicator of such avitaminosis,
when it is excreted with urine?
A. Pyruvic acid
B. Malate
C. Methylmalonic acid
D. Uric acid
E. Phenyl pyruvate
19. A patient 43 years old with chronic atrophic
gastritis and hyperchromic megaloblastic
anemia increased methylmalonic acid excretion
in the urine. The lack of which vitamin caused
the occurrence of this symptom complex?
A. В12
B. В2
C. В3
D. В5
E. В6
60
20. A hereditary disease - homocystinuria - is
caused by disturbed transformation of
homocysteine in to methionine. Accumulated
homocysteine forms its dimer (homocystine)
that can be found in urine. What vitamin
preparation
can
decrease
homocysteine
production?
A. Vitamin B12
B. Vitamin C
C. Vitamin B1
D. Vitamin B2
E. Vitamin PP
21. In a newborn child there is a decrease in
intensity of sucking, frequent vomiting,
hypotension. In urine and blood, the
concentration of citrulline is significantly
increased. What metabolic process is affected?
A. Ornithine cycle
В. Glycolysis
C. Core's cycle
D. СТК
E. Gluconeogenesis
22. In the urine of the newborn, determined by
citrulline and high levels of ammonia. Indicate
which substance is most likely to be inflicted on
a baby?
A. Urea.
B. Bilirubin.
C. Creatine.
D. Creatinine.
E. Uric acid.
23. 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?
A. Decreased activity of glucose reabsorption
enzymes
B. Increased activity of glucose reabsorption
enzymes
C. Exceeded glucose reabsorption threshold
D. Increased glucose secretion
E. Increased glucose filtration
24. A 42 year old woman diagnosed with
diabetes
mellitus
was
admitted
the
endocrinological department with complaints of
thirst, excessive appetite. What pathological
components are revealed in course of laboratory
examination of the patient’s urine?
A. Glucose, ketone bodies
B. Protein, aminoacids
C. Protein, creatine
D. Bilirubin, urobilin
E. Blood
25. A patient at the early stage of diabetes
mellitus was found to have polyuria.What is its
cause?
A. Hyperglycemia
B. Ketonemia
C. Hypocholesterolemia
D. Hypercholesterolemia
E. Hyperkaliemia
26. At the reception to the therapist came a man
of 37 years of age with complaints of periodic
intense pain in the joints of the thumb and their
swelling. In the urine: slightly acidic reaction
and pink color. With the presence of which
substances can these changes be associated?
A. Salt of uric acid
B. Chlorides
C. Amoniev's salt
D. Phosphate calcium
E. Magnesium sulphate
27. On the basis of laboratory analysis, the
patient was diagnosed with gout. Based on
laboratory analysis, the patient confirmed the
diagnosis of gout. What was the analysis for the
diagnosis?
A. Determination of uric acid in the blood and
urine
B. Determination of urinary creatinine
C. Determination of residual nitrogen in the
blood
D. The determination of urea in the blood and
urine
E. Determination of urine ammonia
28. A patient has been operated due to acute
abdomen. His urine is brown, concentration of
indican is higher than 93 mmol/day. What does
it indicate?
A. High intensity of protein decomposition
processes in the intestine
B. Decreased activity of the urea cycle enzymes
C. Acceleration of aromatic amino acids
desamination
D. Disturbance of the kidney absorption
61
E. Decrease of ammonia detoxification
29. A 43 year-old woman has been operated due
to acute abdomen. Her urine is brown and the
concentration of indican in the blood has
increased rapidly. What does it indicate?
A.High intensity of protein decomposition
B. Acceleration of amino acids desamination
C. Supression of glomerular filtration
D. Decreased intensity of the urea cycle
E. Inhibition of gluconeogenesis
30. A 60 year-old man suffers from chronic
intestinal obstruction. The processes of protein
decomposition in the large intestine are
intensified. What is the evidence of these
processes?
A. Indicanuria
B. Bilirubinuria
C. Hyperuricosuria
D. Creatinuria
E. Glucosuria
31. A newborn child gains weight very slowly,
his urine contains too much orotic acid that is
indicative of disturbed synthesis of pyrimidine
nucleotides. What metabolite should be used in
order to normalize metabolism?
A. Uridine
B. Adenosine
C. Guanosine
D. Thymidine
E. Histidine
32. In orоtaciduria the release of Orotic acid is
many times higher than normal. Synthesis of
what substances will be disturbed in this
pathology?
A. Pyrimidine nucleotides.
B. Biogenic Amines.
C. Purine nucleotides.
D. Urea
E. Uric acid
33. The patient has increased photosensitivity,
after prolong sun exposure urine starts to get
dark-red color. Which type of disease has this
characteristic?
A. Porphyria
B. Alkaptonuria
C. Albinism
D. Hemolytic jaundice
E. Pellagra
34. Analysis of a dentist’s urine obtained at the
end of his working day revealed protein
concentration at the rate of 0,7 g/l. His morning
urine hadn’t such changes. What is this
phenomenon called?
A. Functional proteinuria
B. Organic proteinuria
C. Nonselective proteinuria
D. Extrarenal proteinuria
E. Hematuria
35. Chronic glomerulonephritis was diagnosed
in a 34-year-old patient 3 years ago. Edema has
developed within the last 6 monthes. What
caused the edema?
A. Proteinuria
B. Hyperproduction of vasopressin
C. Liver disfunction of protein formation
D. Hyperosmolarity of plasma
E. Hyperaldosteronism
36. Glucose concentration in a patient’s blood is
15 millimole/l (reabsorption threshold is 10
millimole/l). What effect can be expected?
A. Glucosuria
B. Diuresis reduction
C. Reduced glucose reabsorption
D. Reduced vasopressin secretion
E. Reduced aldosterone secretion
37. A patient with rheumatoid arthritis has been
given hydrocortisone for a long time. He has
developed hyperglycemia, polyuria, glycosuria,
thirst. These complications of treatment result
from the activation of the following process:
A. Gluconeogenesis
B. Glycogenolysis
C. Glycogenesis
D. Glycolysis
E. Lipolysis
38. A 28-year-old patient with Itsenko-Cushing
syndrome Hyperglycemia, glycosuria were
detected hyperglycemia, glycosuria. The main
mechanism of hyperglycemia in this patient is
stimulation:
A. Gluconeogenesis
B. Liver glycogenolysis
C. Muscle glycogenolysis
D. Intestinal glucose absorption
E. Synthesis of glycogen
62
39. Fructosuria is known to be connected with
inherited deficiency of fructose-1-phosphate
aldolase.What product of fructose metabolism
will accumulate in the organism resulting in
toxicaction?
A. Fructose-1-phosphate
B. Glucose-1-phosphate
C. Glucose-6-phosphate
D. Fructose-1,6-biphosphate
E. Fructose-6-phosphate
40. Prophylactic examination of a patient
revealed hyperglycemia, ketonuria, polyuria,
glycosuria. What form of acidbase balance
disorder is the case?
A. Metabolic acidosis
B. Gaseous acidosis
C. Nongaseous acidosis
D. Gaseous alkalosis
E. Metabolic alkalosis
41. Examination of a 2 year-old child with renal
insufficiency revealed hyperoxaluria that caused
depositing of calcium oxalate stones in the
kidneys. The reason for this condition is a
disturbance of metabolism of the following
aminoacid:
A. Glycine
B. Lysine
C. Methionine
D. Arginine
E. Histidine
42.
Cardinal
symptoms
of
primary
hyperparathyroidism are osteoporosis andrenal
lesion along with development of urolithiasis.
What substance makes up the basis of these
calculi in this disease?
A. Calcium phosphate
B. Uric acid
C. Cystine
D. Bilirubin
E. Cholesterol
43. In the laboratory examination of blood of a
person who was bitten by a change, hemolysis
of erythrocytes, hemoglobinuria was revealed.
The action of a mixed poison is due to the
presence of an enzyme in it:
A. Phospholipase A2
B. Phospholipase D
C. Phospholipase S.
D. Phospholipase A1
E. Sphingomyelinase
44. A patient presents with high content of
vasopressin (antidiuretic hormone) in the blood.
What changes in the patient’s diuresis will
occur?
A. Oliguria
B. Polyuria
C. Anuria
D. Glycosuria
E. Natriuria
45. A patient with tress and painful sensation
before a visit to the dentist is accompanied by
anuria (lack of urination). This phenomenon is
due to an increase in:
A. Secretion of vasopressin and adrenaline
B. Activity of the parasympathetic nervous
system
C. Activity antinociceptive system
D. Secretion of vasopressin and a decrease in
adrenaline
E. Secretion of adrenaline and a decrease in
vasopressin
46. A patient with pituitary tumor complains of
increased daily diuresis (polyuria). Glucose
concentration in blood plasma equals 4,8
mmol/l. What hormone can be the cause of this
if its secretion is disturbed?
A. Vasopressin
B. Aldosterone
C. Natriuretic hormone
D. Insulin
E. Angiotensin I
47. After a person had drunk 1,5 liters of water,
the amount of urine increased significantly, and
its relative density decreased to 1,001. These
changes are a result of decreased water
reabsorption in the distal nephron portion due to
reduced secretion of:
A. Vasopressin
B. Aldosterone
C. Angiotensin II
D. Renin
E. Prostaglandins
48. A man has a considerable decrease in
diuresis as a result of 1,5 l blood loss. The
primary cause of such diuresis disorder is the
hypersecretion of the following hormone:
A. Vasopressin
63
B. Corticotropin
C. Natriuretic
D. Cortisol
E. Parathormone
49. Analysis of urine from a 24-year-old man
revealed the following changes: daily diuresis 10 l, relative density - 1,001, qualitative
alterations are absent. A patient complains of
excessive thirst, frequent urination. What is the
most likely cause of this disease?
A. Vasopressin hyposecretion
B. Glucocorticoid hypersecretion
C. Vasopressin hypersecretion
D. Relative insulin insufficiency
E. Aldosteron hypersecretion
50. A 50 year old patient complains of excessive
thirst, drinks a lot of water; expressed polyuria.
Blood glucose - 4.8 mmol / l. There is no
glucose and acetone bodies in urine, colorless
urine, specific gravity - 1.002 - 1.004. What is
the cause of polyuria?
A. Lack of vasopressin
B. Hypothyroidism
C. Insulin Deficiency
D. Aldosteronism
E. Thyrotoxicosis
51. A patient with damage to the posterior lobe
of the pituitary gland has increase in daily
diuresis to 10-15 liters What is the main
mechanism in the development of polyuria?
A. Vasopressin deficiency
B. Excess vasopressin
C. Excess aldosterone
D. Excess natriuretic factor
E. Corticotropin deficiency
52. A 20 year old patient complains of excessive
thirst and urinary excretion upto 10 L a day. The
level of glucose in blood is normal, there is no
glucose in urine. What hormone deficit can
cause such changes?
A. Vasopressin
B. Oxytocin
C. Insulin
D. Triiodothyronine
E. Cortisol
53. A 19-year-old male was found to have an
elevated level of potassium in the secondary urine.
These changes might have been caused by the
increase in the following hormone level:
A. Aldosterone
B. Oxytocin
C. Adrenaline
D. Glucagon
E. Testosterone
54. A concentrated solution of sodium chloride
was intravenously injected to an animal. This
caused decreased reabsorption of sodium ions in
the renal tubules. It is the result of the following
changes of hormonal secretion:
A. Aldosterone reduction
B. Aldosterone increase
C. Vasopressin reduction
D. Vasopressin increase
E. Reduction of atrial natriuretic factor
55. At ria of a test animal were super distended
with blood,which resulted in decreased
reabsorption of Na+ and water in renal
tubules.This can be explained by the effect of
the following factor on the kidneys:
A. Natriuretic hormone
B. Aldosterone
C. Renin
D. Angiotensin
E. Vasopressin
64
Biochemistry of nervous tissue
1. A substance that is synthesized in the central
nervous system and simulates the effects of
morphine can be used for analgesia. Specify the
following substance:
A. β-endorphin
B. Oxytocin
C. Vasopressin
D. Calcitonin
E. Somatoliberin
2. Cell membrane restpotential changed from-85
to-90mV. It can becaused by activation of the
following cell membrane channels:
A. Potassium
B. Sodium
C. Potassium and sodium
D. Calcium E. Potassium and calcium
3. The speed of the excitation nerve fibers is
120 m / s. Which of the above factors, above all,
provides such speed?
A. Presence of myelin sheath
B. Great resting potential
C. Large amplitude potential effects
D. Low threshold of depolarization
E. A big factor of reliability
4. The patient is trembling hands, which is
associated with Parkinson's disease. What
mediator deficiency in striopalidar structures
leads to such symptoms?
A. Dopamine
B. GABA
C. Substance P
D. Norepinephrine
E. Serotonin
5. An 84-year-old patient suffers from
parkinsonism. One of the pathogenetic
development elements of this disease is
deficiency of a certain mediator in some of the
brain structures. Name this mediator:
A. Dopamine
B. Adrenaline
C. Noradrenaline
D. Histamine
E. Acetylcholine
6. In the experiment, the permeability of the
excitable cell membrane to potassium ions was
magnified. What changes in the electrical state
of the membrane will occur?
A. Hyperpolarization
B. Depolarization
C. Action potential
D. Local response
E. There will be no changes
7. A 50-year-old man came to a hospital with
complaints of memory disorders, painful
sensations along the nerve trunks, decreased
mental ability, circulatory disorders and
dyspepsia. Anamnesis states excessive alcohol
consumption. What vitamin deficiency can
result in such symptoms?
A. Thiamine
B. Niacin
C. Retinol
D. Calciferol
E. Riboflavin
8. Decarboxylation of glutamate induces
production of gamma aminobutyric acid
(GABA) neurotransmitter. After breakdown,
GABA is converted into a metabolite of the
citric acid cycle, that is:
A. Succinate
B. Citric acid
C. Malate
D. Fumarate
E. Oxaloacetate
9. Degenerative changes in posterior and lateral
columns of spinal cord (funicular myelosis)
caused by methylmalonic acid accumulation
occur in patients with B12-deficiency anemia.
This results in synthesis disruption of the
following substance:
A. Myelin
B. Acetylcholine
C. Norepinephrine
D. Dopamine
E. Serotonin
10. After pharmacological blockade ion
channels of the nerve fiber membrane resting
potential decreased from -90 to -80 mV. What
channels were blocked?
A. Potassium
B. Sodium
C. Calcium
D. Magnesium
E. Chloric
65
11. Disruption of nerve fiber myelinogenesis
causes neurological disorders and mental
retardation. These symptoms are typical for
hereditary and acquired alterations in the
metabolism of:
A. Sphingolipids
B. Neutral fats
C. Higher fatty acids
D. Cholesterol
E. Phosphatidic acid
12. A patient complained about dizziness,
memory impairment, periodical convulsions. It
was revealed that these changes were caused by
a product of decarboxylation of glutamic acid.
Name this product:
A. GABA
B. Pyridoxal phosphate
C. TDP
D. ATP
E. UDP
13. A patient presents with dysfunction of the
cerebral cortex accompanied by epileptic
seizures. He has been administered a biogenic
amine synthetized from glutamate and
responsible for central inhibition. What
substance is it?
A. γ-aminobutyric acid
B. Serotonin C.
С. Dopamine
D. Acetylcholine
E. Histamine
14. An unconscious patient was taken by
ambulance to the hospital. On objective
examination the patient was found to have 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 the accumulation of the following
metabolite:
A. Ammonia
B. Urea
C. Glutamine
D. Bilirubin
E. Histamine
15. For the treatment of depression of different
genesis, antidepressants are used, which are
monoamine oxidase inhibitors. What substance
is a "neurotransmitter of well-being" and its
concentration increases in the brain under the
action of antidepressants?
A. Serotonin
B. Dopamine
C. Glycine
D. Taurine
E. Norepinephrine
16. Brain cells are very sensitive to energy
deficiency, which can be caused by a high
content of ammonia, which stimulates the
outflow of alpha-ketoglutarate from:
A. Citric acid cycle
B. Ornithine cycle
C. Glycolysis
D. Glycogenolysis
E. Pentose phosphate pathway
17. Depressions and emotional insanities result
from the deficit of noradrenalin, serotonin and
other biogenic amines in the brain. Their
concentration in the synapses can be increased
by means of the antidepressants that inhibit the
following enzyme:
A. Monoamine oxidase
B. Diamine oxidase
C. L-amino-acid oxidase
D. D-amino-acid oxidase
E. Phenylalanine-4-monooxygenase
18. Pharmacological effects of antidepressants
are based upon blocking (inhibiting) the enzyme
that acts as a catalyst for the breakdown of
biogenic amines noradrenalin and serotonin in
the mitochondria of cephalic neurons. What
enzyme takes part in this process?
A. Monoamine oxidase
B. Transaminase
C. Decarboxylase
D. Peptidase
E. Lyase
19. A 9-month-old infant is fed with artificial
formulas with unbalanced vitamin B6
concentration. The infant presents with pellagral
dermatitis, convulsions, anaemia. Convulsion
development might be caused by the disturbed
formation of:
A. GABA
B. Histamine
C. Serotonin
D. DOPA
E. Dopamine
66
20. Cerebral trauma caused increase of
ammonia formation. What aminoacid takes part
in removal of ammonia from
cerebral tissue?
A. Glutamic
B. Tyrosine
C. Valine
D. Tryptophan
E. Lisine
21. Ammonia is a very toxic substance,
especially for nervous system. What substance
takes the most active part in ammonia
detoxication in brain tissues?
A. Glutamic acid
B. Lysine
C. Proline
D. Histidine
E. Alanine
22. A patient presented to a hospital with
complaints about quick fatigability and
significant muscle weakness. Examination
revealed an autoimmune disease that
causes functional disorder of receptors in the
neuromuscular synapses. This will result in the
disturbed activity of the following mediator:
A. Acetylcholine
B. Noradrenaline
C. Dopamine
D. Serotonin
E. Glycine
23. Glutamate decarboxylation results in
formation of inhibitory transmitter in CNS.
Name it:
A. GABA
B. Glutathione
C. Histamine
D. Serotonin
E. Asparagine
inhibitor aldehyde dehydro- nazy The increase
in blood of what tabolita aversion to al to
someone?
A. Acetaldehyde
B. Ethanol
C. Malonic aldehyde
D. Propionic aldehyde
E. Methanol
25. Soldiers who were injured in the midst of
the battle may not be aware of the pain until it is
completed. What hormones are opiate
antinociceptive system reduce the sensation of
pain?
A. Endorfines
B. Serotonines
C. Vasopressin
D. Aldosterone
E. Oxytocine
26. In an excitable cell the ion channels were
blocked. It hasn’t changed essentially the value
of rest potential, but the cell lost its ability to
generate AP (action potential). What channels
were blocked?
A. Natrium
B. Potassium
C. Natrium and potassium
D. Chloric
E. Calcium
27. The infant has epileptiform convulsions
caused by vitamin B6 deficiency. This is due to
a decrease in the nervous tissue of the inhibitory
mediator, γ-aminobutyric acid. What is the
enzyme's activity reduced in this case?
A. Glutamate decarboxylase
B. Alanine aminotransferase
C. Glutamate dehydrogenase
D. Pyridoxal kinase
E. Glutamate Synthetase
24. In medical practice for alcoholism
prevention widely used teturam, which is
67
Biochemistry of muscle tissue
1. Buffer capacity of a worker’s blood was
decreased due to exhausting muscular work. By
coming of what acid substance in the blood can
this state be explained?
A. Lactate
B. Pyruvate
C. 1,3-bisphosphoglycerate
D. α-ketoglutarate
E. 3-phosphoglycerate
2. A biochemical urine analysis has been
performed for a patient with progressive
muscular dystrophy. In the given case muscle
disease can be confirmed by the high content of
the following substance in urine:
A. Creatine
B. Porphyrin
C. Urea
D. Hippuric acid
E. Creatinine
3. A considerable increase of activity of МВforms of CPK (creatinephosphokinase) and
LDH-1 was revealed on the examination of
patient’s blood. What is the most likely
pathology?
A. Miocardial infarction
B. Hepatitis
C. Rheumatism
D. Pancreatitis
E. Cholecystitis
4. With intense physical work, muscle tissue
accumulates lactic acid, which diffuses into the
blood and is absorbed by the liver and the heart.
What process ensures the recovery of glycogen
stores in the muscles?
A. The Cori Cycle
B. Citric Acid Cycle
C. Urea Cycle
D. A Cycle of Tricarboxylic Acids
E. Hexose Monophosphate Pathway
5. A sportsman needs to improve his sporting
results. He was recommended to take a
preparation that contains carnitine. What
process is activated the most by this compound?
A. Fatty acids transporting
B. Amino acids transporting
C. Calcium ions transporting
D. Glucose transporting
E. Vitamin K transporting
6. A 35-year-old man developed acute heart
failure while running for a long time. What
changes in ionic composition can be observed in
the cardiac muscle?
A. Accumulation of Na+ and Ca2+ ions in the
myocardium cells
B. Accumulation of K+ and Mg2+ ions in the
myocardium cells
C. Reduction of Na+ and Ca2+ ions in the
myocardium cells
D. Reduction of K+ and Mg2+ ions in the
extracellular space
E. Reduction of Na+ and Ca2+ ions in the
extracellular space
7. A patient is diagnosed with cardiac infarction.
Blood test for cardiospecific enzymes activity
was performed. Which of the enzymes has three
isoforms?
A. Creatine kinase
B. Lactate dehydrogenase
C. Aspartate transaminase
D. Alanine transaminase
E. Pyruvate kinase
8. A 50-year-old woman diagnosed with cardiac
infarction has been delivered into an intensive
care ward. What enzyme will be the most active
during the first two days?
A. Aspartate aminotransferase
B. Alanineaminotransferase
C. Alanineaminopeptidase
D. LDH4
E. LDH5
9. Untrained people often have muscle pain
after sprints as a result of lactate accumulation.
This might be caused by intensification of the
following biochemical process:
A. Glycolysis
B. Gluconeogenesis
C. Pentose phosphate pathway
D. Lipogenesis
E. Glycogenesis
10. A patient with suspected diagnosis
"progressing muscular dystrophy"got his urine
tested.What compound will confirm this
diagnosis if found in urine?
A. Kreatine
B. Collagen
68
C. Porphyrin
D. Myoglobin
E. Calmodulin
C. Acetyl CoA
D. Glucose 6-phosphate
E. Oxaloacetate
11. Rheography of an 18 year old student during
exercise showed redistribution of blood flow
between organs. The peak blood flow will be
observed in the following vessels:
A. Skeletal muscles
B. Liver
C. Cerebrum
D. Kidneys
E. Gastrointestinal tract
16. A 49-year-old driver complains about
unbearable constricting pain behind the
breastbone irradiating to the neck. The pain
arose 2 hours ago. Objectively: the patient’s
condition is grave, he is pale, heart tones are
decreased. Laboratory studies revealed high
activity of creatine kinase and LDH1. What
disease are these symptoms typical for?
A. Acute myocardial infarction
B. Acute pancreatitis
C. Stenocardia
D. Cholelithiasis
E. Diabetes mellitus
12. 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. Creatine phosphokinase
B. Lactate dehydrogenase
C. Pyruvate dehydrogenase
D. Glutamate dehydrogenase
E. Adenylate cyclase
13. A 50-year-old patient complains about
general weakness, appetite loss and cardiac
arrhythmia. The patient presents with muscle
hypotonia,
flaccid
paralyses,
weakened
peristaltic activity of the bowels. Such condition
might be caused by:
A. Hypokaliemia
B. Hypoproteinemia
C. Hyperkaliemia
D. Hypophosphatemia
E. Hyponatremia
14. Some students developed myodynia after
continuous physical activity during physical
education. The reason for such condition was
accumulation of lactic acid in the skeletal
muscles. It was generated in the students’
bodies after activation of the following process:
A. Glycolysis
B. Gluconeogenesis
C. Pentose-phosphate cycle
D. Lipolysis
E. Glycogeny
15. After a sprint an untrained person develops
muscle hypoxia. This leads to the accumulation
of the following metabolite in muscles:
A. Lactate
B. Ketone bodies
17. Cytoplasm of the myocytes contains a lot of
dissolved metabolites resulting from glucose
oxidation. Name the metabolite that turns
directly into lactate:
A. Pyruvate
B. Oxaloacetate
C. Glycerophosphate
D. Glucose-6-phosphate
E. Fructose-6-phosphate
18. A patient came to the hospital complaining
about quick fatigability and apparent muscle
weakness.
Examination
revealed
an
autoimmune disease that causes disorder of
functional receptor condition in neuromuscular
synapses. What transmitter will be blocked?
A. Acetylcholine
B. Noradrenalin
C. Dopamine
D. Serotonin
E. Glycine
19. During processing of the atypical
cardiomyocytes of the synaptic node with a
biologically active substance, an increase in
their membrane potential was recorded due to
increased permeability for potassium ions. What
biologically
active
substance
affects
cardiomyocytes?
A. Acetylcholine
B. Adrenalin
C. Noradrenaline
D. Thyroxine
E. Atriopeptide
69
20. 12 hours after an accute attack of
retrosternal pain a patient presented a jump of
aspartate aminotransferase activity in blood
serum. What pathology is this deviation typical
for?
A. Myocardium infarction
B. Viral hepatitis
C. Collagenosis
D. Diabetes mellitus
E. Diabetes insipidus
21. A patient presents high activity of LDH 1,2,
aspartate
aminotransferase,
creatine
phosphokinase. In what organ (organs) is the
development of a pathological process the most
probable?
A. In the heart muscle (initial stage of
myocardium infarction)
B. In skeletal muscles (dystrophy, atrophy)
C. In kidneys and adrenals
D. In connective tissue
E. In liver and kidneys
22. A traumatology unit received a patient with
crushed muscular tissue. What biochemical
indicator of urine will be raised in this case?
A. Creatinine
B. Total lipids
C. Glucose
D. Mineral salts
E. Uric acid
23. A 1 y.o. child with symptoms of muscle
affection was admitted to the hospital.
Examination
revealed
carnitine
deficit
inmuscles. Biochemical base of this pathology
is disturbed process of:
A. Transporting of fatty acids to mitochondrions
B. Regulation of Ca2+ rate in mitochondrions
C. Substrate phosphorylation
D. Lactic acid utilization
E. Actin and myosin synthesis
24. After a sprint an long distantion the skeletal
muscle training person uses glucose for the
purpose of obtaining energy ATP for muscle
contraction. Specify basic glucose utilization
process in these conditions:
A. Aerobic glycolysis
B. Anaerobic glycolysis
C. Glycogenolysis
D. Gluconeogenesis
E. Glycogenesis
25. The gluconeogenesis is activated in the liver
after
intensive
physical
trainings.What
substance is utilized in gluconeogenesis first of
all in this case:
A. Lactate
B. Pyruvate
C. Glucose
D. Glutamate
E. Alanine
26. 6 hours after the myocardial infarction a
patient was found to have elevated level of
lactate dehydrogenase in blood. What is enzyme
should be expected in this case?
A. LDH1
B. LDH2
C. LDH3
D. LDH4
E. LDH5
70
Biochemistry of connective tissue
1. Examination of a patient revealed typical
presentations of collagenosis. This pathology is
characterized by increase of the following urine
index:
A. Hydroxyproline
B. Arginine
C. Glucose
D. Mineral salts
E. Ammonium salts
2. A child has physical and mental retardation,
serious abnormalities in connective tissue of
internal organs; urine contains keratan sulfates.
This is caused by metabolic disorder of the
following substance:
A. Glycosaminoglycan
B. Collagen
C. Elastin
D. Fibronectin
E. Hyaluronic acid
3.
Inherited
diseases,
such
as
mucopolysaccharidoses, are manifested in
metabolic disorders of connective tissue, bone
and joint pathologies. The sign of this disease is
the excessive urinary excretion of the following
substance:
A. Glycosaminoglycans
B. Amino acids
C. Glucose
D. Lipids
E. Urea
4. A 28 year old pregnant woman had the
enzymes in the cells of amniotic fluid analyzed.
The analysis revealed insufficient activity of βglucuronidase. What pathological process is it?
A. Mucopolysaccharidosis
B. Glycogenosis
C. Aglycogenosis
D. Collagenosis
E. Lipidosis
5. The five year old boy was observed small
stature, mental retardation, limited movement,
rough facial features. These features have
become noticeable from 18 months of age. He
was diagnosed with a deficiency of Liduronidase. The exchange of which compounds
is broken?
A. Glycosminoglycans
B. Proteins
C. Nucleotides
D. Vitamins
E. Phospholipids
6. A patient in the dental department has been
diagnosed with Paget's disease, which is
accompanied by collagen degradation. The
decisive fact for the diagnosis was the detection
in the patient's urine of an elevated level:
A. Hydroxproline
B. Arginine
C. Tryptophan
D. Serina
E. Alanina
7. A 60 year old man complains about in the
joints. In the serum of the patient, the
concentration of C-reactive protein and
oxyproline was found to increase. what disease
these symptoms can be associated with:
A. Rheumatism
B. Gout
C. Hepatitis
D. Jaundice
E. Diabetes
8. A 36-year-old female patient has a history of
collagen disease. Urine analysis is likely to
reveal an increased concentration of the
following metabolite:
A. Oxyproline
B. Indican
C. Creatinine
D. Urea
E. Urobilinogen
9. A 30-year-old woman first developed pain,
swelling, and skin redness in the area of joints
about a year ago. Provisional diagnosis is
rheumatoid arthritis. One of the likely causes of
this disease is change in the structure of the
following connective tissue protein:
A. Collagen
B. Mucin
C. Myosin
D. Ovalbumin
E. Troponin
10. Collagenosis patients typically present with
connective tissue destruction processes.The
presence of the seprocesses can beconfirmed by
the increasein:
71
A. Blood oxyproline and oxylysine
B. Blood creatine and creatinine
C. LDH-isoenzyme activity in the blood
D. Transaminase activity in the blood
E. Blood urates
11. A 53-year-old male patient is diagnosed
with Paget’s disease. The concentration of
oxyproline in daily urine is sharply increased,
which primarily means intensified disintegration
of:
A. Collagen
B. Keratin
C. Albumin
D. Hemoglobin
E. Fibrinogen
alkaline phosphatase in the intercellular
substance. What cell produces this enzyme?
A. Osteoblast
B. Osteocyte
C. Osteoclast
D. Chondroblast
E. Chondrocyte
16. When a wound heals, a scar takes its place.
What substance is the main component of its
connective tissue?
A. Collagen
B. Elastin
C. Keratan sulfate
D. Chondroitin sulfate
E. Hyaluronic acid
12. A 63-year-old woman developed symptoms
of rheumatoid arthritis. Their increase of which
blood values indicators could be the most
significant in proving the diagnosis?
A. Additive glycosaminoglycans
B. Lipoproteids
C. Acid phosphatase
D. General cholesterol
E. R-glycosidase
17. A patient with systemic scleroderma has an
intensified collagen destruction. Collagen
destruction will be reflected by intensified
urinary excretion of the following amino acid:
A. Oxyproline
B. Alanine
C. Tryptophane
D. Serine
E. Phenylalanine
13. Osteolaterism is charcterized by a decrease
in collagen strength caused by much less
intensive formation of crosslinks in collagen
fibrils. This phenomenon is caused by the low
activity of the following enzyme:
A. Lysyl oxidase
B. Monoamino-oxidase
C. Prolyl hydroxylase
D. Lysyl hydroxylase
E. Collagenase
18. A patient who is ill with scurvy displays
disturbed processes of connective tissue
formation that leads to loosening and falling of
teeth. Disturbed activity of what enzyme causes
these symptomps?
A. Lisilhydroxylase
B. Glycosiltransferase
C. Elastase
D. Procollagenpeptidase of N-terminal peptide
E. Procollagenpeptidase of C-terminal peptide
14. A 34-year-old patient has a history of
periodontitis. As a result of increased collagen
degradation, there is a significantly increased
urinary excretion of one of the amino acids.
Which one?
A. Hydroxyproline
B. Valine
C. Alanine
D. Glycine
E. Serine
19. In spring a patient experiences petechial
haemorrhages, loosening of teeth, high liability
to colds. A doctor supposes hypobitaminosis C.
In this respect loosening of teeth can be
explained by:
A. Structural failure of collagen in the
periodontal ligaments
B. Structural change of glycosaminoglycan
C. Increased permeability of periodont
membranes
D. Mechanical damage of teeth
E. Disturbed oxidation-reduction process in the
periodont
15. Calcification of the intercellular substance
of bone tissue is accompanied by the deposition
of hydroxyapatite crystals along the collagen
fibers. This process requires the presence of
72
20. Increased fragility of vessels, enamel and
dentine destruction resulting from scurvy are
caused by disorder of collagen maturation. What
stage of procollagen modification is disturbed
under this avitaminosis?
A. Hydroxylation of proline
B. Formation of polypeptide chains
C. Glycosylation of hydroxylysine residues
D. Removal of C-ended peptide from
procollagen
E. Detaching of N-ended peptide
73
Biochemistry of tooth and saliva
1. What enzyme has a demineralizing effect enhances the cleavage of the mineral
components of the tissues in the tooth?
A. Sulfate phosphatase
B. Alkaline phosphatase
C. Glucose-6-phosphatase
D. Glucogenphosphorylase
E. Phosphotransferase
2. The hydroxyapatite crystals are deposited
along the collagen fibers in the process of
grafting the intercellular substance of the tissue.
In order to realize this process, the presence of
intercellular alkaline phosphatase must be
present. What kind of creatine produces this
enzyme?
A. Osteoblast
B. Osteocyte
C. Osteoclasts
D. Hondroblaste
E. Chondrocyte
6. The periodontal dentist must be assessed in
the patient by factors of non-specific resistance
of saliva and excretory mucous membrane of
the oral cavity. What factor of non-specific
resistance should first be studied in the
investigated material?
A. Lysozyme
B. Secretory IgA
C. Properdine
D. Interferon
E. Complement
7. What substance gives slime a viscous mucous
character, performs a protective role and
including from mechanical damage to the oral
mucosa?
A. Mutsin
B. Glucose
C. Kalikrein
D. Amilaza
E. Lysozyme
3. The pH of saliva is 6.4 - 7.8 it is in the norm.
What changes in the enamel leads to a shift in
the pH of saliva in the sour beet (less than 6.2)?
A. Demineralization
B. Calcification
C. Fluorosis
D. Mineralization
E. Strengthening of stability
8. Some beards of saliva perform a protective
function. Which one protects the oral mucosa
from mechanical damage?
A. Mutsin
B. Lysozyme
C. Catalase
D. Peroxidase
E. Renin
4. Cationic glycoproteins are the main
components of salivation of the parotid glands.
What Amino Acids cause their positive charge?
A. Lizin, arginine, hististine
B. Aspartate, glutamate, glucine
C. Aspartate, arginine, glutamate
D. Glutamate, valine, leucine
E. Cysteine, glucine, proline
9. The patient with chronic inflammation of
submaxilar salivary glands have observed
giposalivation. What violation of the increment
of which biologically active substance is
observed at this process?
A. Parotin
B. Calcitonin
C. Paratyrin
D. Gluckagon
E. Somatostatin
5. The protective function of saliva is due to
several mechanisms, including the presence of
an enzyme that has bactericidal action, causes
lysis of the polysaccharide complex of the
staphylococcal shell, streptococci. Indicate this
enzyme:
A. Lysozyme
B. α-amylase
C. Oligo-1,6-glucosidase
D. Collagenase
E. β-glucuronidase
10. Patient with symptoms of reduced excretory
function of the kidneys, an unpleasant smell
from the mouth is indicated. What substance are
increased excretion of the salivary glands is the
cause of this?
A. Urea
B. Alpha amylase
C. Lysozyme
D. Phosphatase
E. Mutsin
74
11. The child has acute renal insufficiency.
What biochemical indicators of saliva can be
confirmed?
A. Increasing the level of residual nitrogen
B. Increase in immunoglobulin A.
C. Reduction of alkaline phosphatase
D. Increase in alpha amylase
E. Reducing the phosphate level
12. Periodontitis is accompanied by activation
of proteolysis in periodontal tissues. The
increase of which oral fluid component testifies
to the activation of proteolysis?
A. Amino acids
B. Organic acids
C. Glucose
D. Biogenic Amines
E. Cholesterol
13. When treated with hydrogen peroxide in the
mucous membrane of the patient's oral cavity,
the blood was painted in a brown color instead
of pene formation. When the concentration of
any of the enzymes listed below is reduced, is it
possible?
A. Catalase
B. Pseudocholinesterase
C. Glucose-6-phosphate dehydrogenase
D. Acetyltransferase
E. Methemoglobin reductase
14. In periodontites, lipid peroxidation develops
in the periodontal tissues, and the content of
malonic dialdehyde, hydrogen peroxide
increases in the oral cavity. Which of the
enzymes is antioxidant protection?
A. Superoxide dismutase, catalase
B. Amilase, trypsin
C. Maltase, Chymotrypsin
D. Lactase, lysozyme
E. Saharaza, prothrombin.
15. With age, the activity of the peripheral
salivary glands decreases. Which does an
enzyme's activity decrease in slime?
A. Amilaza
B. Lysozyme
C. Phosphatase
D. Geksokinase
E. Malthus
16. A 60 year old patient was found to have a
dysfunction of main digestive enzyme of saliva.
This causes the disturbance of primary
hydrolysis of:
A. Carbohydrates
B. Fats
C. Proteins
D. Cellulose
E. Lactose
17. It is necessary to evaluate the digestible
properties of saliva. With what substrate for this
it needs to be shifted?
A. Starch
B. Casein
C. Fat
D. DNA
E. RNA
18. When investigating human saliva it is
necessary to assessits hydrolytic properties.
What substance should be used as a substrate in
the process?
A. Starch
B. Proteins
C. Fats
D. Fiber
E. Amino acids
19. Afther using cookies, sweets in mixed
saltines temporarily increases the level of
lactate. The activation of which biomic process
leads to this?
A. Anaerobic digestion
B. Tissue breathing
C. Aerobic Glucose
D. Gluconeogenesis
E. Microsomal oxidation
20. In the saliva of patient is increased content
of lactate was detected. Activation of a process
is the main reason for the increase of lactate?
A. Anaerobic decomposition of glucose
B. Aerobic decomposition of glucose
C. Decomposition of glycogen
D. Hydrolysis of carbohydrates
E. Glucose-lactate cycle
21. To form a mineral matrix of hard tooth
tissues, a high concentration of phosphate ions
is required, which is formed during the process
of hydrolysis of phosphorous-bonded bonds
with the participation of alkaline phosphatase.
75
What ions of the metal are the triggers of this
process:
A. Zinc
B. Magnium
C. Iron
D. Calcium
E. Natrium
22. In economically developed countries,
common caries is a cureus of teeth. This disease
affects more than 95% of the population. What
role plays in the demineralization of hard tooth
tissues in caries?
A. Organic acids
B. Malnutrition
C. Extreme effects on the organism
D. Disturbance of regulation of metabolism
E. Insufficient vitamin C
23. The high excess concentration of glucose in
oral solution in diabetes leads to development:
A. Multiple caries
B. Hyperplasia enamel
C. Hypoplasia of enamel
D. Fluorosis
E. Enhanced calcification of enamel
24. In the Transcarpathian settlement, after
prophylactic examination of many children have
found a multiple of caries. With mineral of the
insufficiency in food you can link development
of careers?
A. Fluoride
B. Iodine
C. Molibden
D. Iron
E. Cobalt
25. A child has disturbed processes of
ossification and "punctate"enamel. What
microelement metabolism is disturbed?
A. Fluorine
B. Iron
C. Zinc
D. Chromium
E. Copper
26. A saline metal was assigned for salvage
therapy at the initial caries of the teeth. Which
drug is determinated of this process?
A. Sodium fluoride
B. Sodium bromide
C. Sodium chloride
D. Calcium chloride
E. Kalia bromide
27. A patient with renal insufficiency developed
osteodystrophy, which is accompanied by
intensive demineralization of the hips. Which
active form of vitamin violation’s of the
formation is the cause of this complication?
A. Calcipherol
B. Retinol
C. Thiamin
D. Naftohinon
E. Ryboflavin
28. The enamel is characterized by high stability
to the action of various mechanical and
chemical factors. Which component is synthesis
of provides such resistance?
A. Fluorapatite
B. Hydroxyapatite
C. Chlorapatite
D. Collagen
E. Carbonate apatite
29. Calcification of dental tissues is
significantly influenced by osteocalcin protein
which has an ability to bind calcium ions due to
the presence of the following modified amino
acid residues in the polypeptide chain:
A. γ-carbon glutamine
B. Alanine
C. γ-aminobutyric
D. Carboxy aspargine
E. δ-aminopropionic
30. A 35-year-old patient consulted a dentist
about low density of dental tissues, increased
fragility of teeth on eating solid food. In order to
determine Ca/P relation a scrape of enamel was
sent to the laboratory. What value of this index
is suggestive of intensified demineralization?
A. 0,9
B. 1,67
C. 1,85
D. 2,5
E. 1,5
31. The preparation comlex for periodontitis
treatment includes the medicine from the group
of water soluble vitamins, bioflavonide
derivative, which is prescribed together with
ascorbic acid. This preparation has anti76
oxidative properties, decreases gingival
hemorrhage. What preparation is meant?
A. Rutin
B. Calcium pantothenate
C. Calcium panganate
D. Cyanocobalamin
E. Folic acid
32. Examination of a child who hasn’t got fresh
fruit and vegetables during winter revealed
numerous
subcutaneous
hemorrhages,
gingivitis, carious cavities in teeth. What
vitamin combination should be prescribed in
this case?
A. Ascorbic acid and rutin
B. Thiamine and pyridoxine
C. Folic acid and cobalamin
D. Riboflavin and nicotinamide
E. Calciferol and ascorbic acid
33. The patient has an increase in the
permeability of the walls of blood vessels with
the development of increased bleeding and the
appearance of small point hemorrhages on the
skin, tooth loss. How does the vitamin exchange
disorder explain these symptoms?
A. Hypovitaminosis C
B. Hypervitaminosis D
C. Hypervitaminosis C
D. Hypovitaminosis D
E. Hypovitaminosis A
34. In examining the oral cavity of the patient,
the dentist paid attention to the presence of an
inflammatory and dystrophic process in the
mucous membrane (Hunter’s glossitis, atrophic
stomatitis). A blood test revealed hyperchromic
anemia. What factor is the cause of this disease?
A. Hypovitaminosis B12
B. Hypovitaminosis B1
C. Hypovitaminosis B6
D. Increasing pH of the gastric juice
E. Hypovitaminosis A
35. 10 month old child has high excitability,
sleep disturbance, amyotonia, retarded dentition,
teeth erupt withinadequate enamel calcification.
Thesechanges are caused by deficiency of
thefollowing vitamin:
A. Cholecalciferol
B. Riboflavin
C. Thiamine
D. Retinol
E. Nicotinamide
36. The child has a delayed teething, their
wrong
arrangement,
upon
examination
noticeable dryness of the oral cavity, in the
corners of the mouth there are cracks with
suppuration. With the lack of the vitamin this
condition may be related?
A. Vitamin D.
B. Vitamin C.
C. Vitamin E.
D. Vitamin K.
E. Vitamin A.
37. In a child of the first year of life is observed
an increase in the size of the head and abdomen,
late teething, violation of the enamel structure.
The consequence of vitamin deficiencies are
these changes?
A. Hypovitaminosis D
B. Hypovitaminosis C
C. Hypovitaminosis A
D. Hypovitaminosis B1
E. Hypovitaminosis B2
38. A child with renal insufficiency exhibits
delayed teeth eruption. This is mostlikely
caused by the abnormal formationof the
following substance:
A. 1,25 (OH)2D3
B. Glycocyamine
C. Glutamate
D. α-ketoglutarate
E. Hydroxylysine
39. A patient has enamel erosion. What vitamin
should be administered for itstreatment?
A. D3
B. C
C. K
D. B1
E. PP
40. A 5 years old child has insufficient
calcification of enamel, tooth decay. Which
vitamin hypovitaminosis leads to the
development of this process?
A. Calciferol
B. Tocopherol
C. Biotin
D. Nicotinic acid
E. Folic acid
77
41. Hormonal form of a certain vitamin induces
genome level synthesis of Ca binding proteins
and enterocytes thus regulating the intestinal
absorption of Ca2+ ions required for dental
tissuedevelopment. What vitamin is it?
A. D3
B. A
C. B1
D. E
E. K
42. While the examination of patient’s oral
cavity the dentist found xerostomia, numerous
erosions. What vitamin deficit caused this
effect?
A. Vitamin A
B. Vitamin K
C. Vitamin P
D. Vitamin H
E. Vitamin PP
43. In order to prevent gum inflammation and to
improve regeneration of epithelial periodontium
cells manufacturers add to the tooth pastes one
of the following vitamins:
A. Retinol
B. Calciferol
C. Thiamine
D. Biotin
E. Phyloquinone
44. There are various diseases that cause sharp
increase of active oxygen, leading tocell
membranes destruction. Antioxidantsare used to
prevent it from happening. Themost potent
natural antioxidant is:
A. Alpha-tocopherol
B. Glycerol
C. Vitamin D
D. Fatty acids
E. Glucose
45. When treating sialadenitis (inflammation of
the salivary glands), preparations of vitamins
are used. Which of the following vitamins plays
an important role in antioxidant defense?
A. Tocopherol
B. Pantothenic acid
C. Riboflavin
D. Thiamine
E. Pyridoxine
78
1. Buffer capacity of a worker’s blood was decreased due to
exhausting muscular work. By coming of what acid substance
in the blood can this state be explained?
•
•
alpha-ketoglutarate
1,3-bisphosphoglycerate
•
3-phosphoglycerate
•
Pyruvate
•
Lactate
2. A biochemical urine analysis has been performed for a
patient with progressive muscular dystrophy. In the given case
muscle disease can be confirmed by the high content of the
following substance in urine:
•
Hippuric acid
•
Creatine
•
Porphyrin
•
•
Urea
Creatinine
3. A considerable increase of activity of ??-forms of CPK
(creatinephosphokinase) and LDH-1 was revealed on the
examination of patient’s blood. What is the most likely
pathology?
•
Miocardial infarction
•
Pancreatitis
•
Cholecystitis
•
Rheumatism
•
Hepatitis
4. With intense physical work, muscle tissue accumulates
lactic acid, which diffuses into the blood and is absorbed by
the liver and the heart. What process ensures the recovery of
glycogen stores in the muscles?
•
•
•
•
•
Urea Cycle
The Cori Cycle
Citric Acid Cycle
A Cycle of Tricarboxylic Acids
Hexose Monophosphate Pathway
5. A sportsman needs to improve his sporting results. He was
recommended to take a preparation that contains carnitine.
What process is activated the most by this compound?
•
Amino acids transporting
•
•
•
•
Glucose transporting
Vitamin K transporting
Fatty acids transporting
Calcium ions transporting
6. A 35-year-old man developed acute heart failure while
running for a long time. What changes in ionic composition
can be observed in the cardiac muscle?
•
Reduction of K+ and Mg2+ ions in the extracellular space
•
Reduction of Na+ and Ca2+ ions in the myocardium cells
•
Accumulation of K+ and Mg2+ ions in the myocardium cells
•
Reduction of Na+ and Ca2+ ions in the extracellular space
•
Accumulation of Na+ and Ca2+ ions in the myocardium cells
7. A patient is diagnosed with cardiac infarction. Blood test for
cardiospecific enzymes activity was performed. Which of the
enzymes has three isoforms?
•
Aspartate transaminase
•
Alanine transaminase
•
Creatine kinase
•
Pyruvate kinase
•
Lactate dehydrogenas
8. A 50-year-old woman diagnosed with cardiac infarction has
been delivered into an intensive care ward. What enzyme will
be the most active during the first two days?
•
•
•
Alanineaminotransferase
Alanineaminopeptidase
Aspartate aminotransferase
•
LDH5
•
LDH4
9. Untrained people often have muscle pain after sprints as a
result of lactate accumulation. This might be caused by
intensification of the following biochemical process:
•
Glycogenesis
•
•
Gluconeogenesis
Pentose phosphate pathway
•
Lipogenesis
•
Glycolysis
10. A patient with suspected diagnosis "progressing muscular
dystrophy"got his urine tested.What compound will confirm
this diagnosis if found in urine?
•
Myoglobin
•
Collagen
•
Porphyrin
•
Calmodulin
•
Kreatine
11. Rheography of an 18 year old student during exercise
showed redistribution of blood flow between organs. The peak
blood flow will be observed in the following vessels:
•
Gastrointestinal tract
•
Skeletal muscles
•
Cerebrum
•
•
Liver
Kidneys
12. 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?
•
•
•
Lactate dehydrogenase
Pyruvate dehydrogenase
Glutamate dehydrogenase
•
Creatine phosphokinase
•
Adenylate cyclase
13. A 50-year-old patient complains about general weakness,
appetite loss and cardiac arrhythmia. The patient presents with
muscle hypotonia, flaccid paralyses, weakened peristaltic
activity of the bowels. Such condition might be caused by:
•
Hyponatremia
•
Hypoproteinemia
•
•
Hyperkaliemia
Hypophosphatemia
•
Hypokaliemia
14. Some students developed myodynia after continuous
physical activity during physical education. The reason for
such condition was accumulation of lactic acid in the skeletal
muscles. It was generated in the students’ bodies after
activation of the following process:
•
Pentose-phosphate cycle
•
Glycogeny
•
Glycolysis
•
Gluconeogenesis
•
Lipolysis
15. After a sprint an untrained person develops muscle
hypoxia. This leads to the accumulation of the following
metabolite in muscles:
•
Oxaloacetate
•
•
Acetyl CoA
Glucose 6-phosphate
•
•
Lactate
Ketone bodies
16. A 49-year-old driver complains about unbearable
constricting pain behind the breastbone irradiating to the neck.
The pain arose 2 hours ago. Objectively: the patient’s condition
is grave, he is pale, heart tones are decreased. Laboratory
studies revealed high activity of creatine kinase and LDH1.
What disease are these symptoms typical for?
•
Acute myocardial infarction
•
Stenocardia
•
Acute pancreatitis
•
Diabetes mellitus
•
Cholelithiasis
17. Cytoplasm of the myocytes contains a lot of dissolved
metabolites resulting from glucose oxidation. Name the
metabolite that turns directly into lactate:
•
Glycerophosphate
•
Oxaloacetate
•
Pyruvate
•
Glucose-6-phosphate
•
Fructose-6-phosphate
18. A patient came to the hospital complaining about quick
fatigability and apparent muscle weakness. Examination
revealed an autoimmune disease that causes disorder of
functional receptor condition in neuromuscular synapses.
What transmitter will be blocked?
•
•
Glycine
Noradrenalin
•
Dopamine
•
Serotonin
•
Acetylcholine
19. During processing of the atypical cardiomyocytes of the
synaptic node with a biologically active substance, an increase
in their membrane potential was recorded due to increased
permeability for potassium ions. What biologically active
substance affects cardiomyocytes?
•
Acetylcholine
•
Noradrenaline
•
•
Thyroxine
Atriopeptide
•
Adrenalin
20. 12 hours after an accute attack of retrosternal pain a patient
presented a jump of aspartate aminotransferase activity in
blood serum. What pathology is this deviation typical for?
•
Myocardium infarction
•
Diabetes mellitus
•
Diabetes insipidus
•
Collagenosis
•
Viral hepatitis
21. A patient presents high activity of LDH 1,2, aspartate
aminotransferase, creatine phosphokinase. In what organ
(organs) is the development of a pathological process the most
probable?
•
•
In connective tissue
In the heart muscle (initial stage of myocardium infarction)
•
•
•
In liver and kidneys
In kidneys and adrenals
In skeletal muscles (dystrophy, atrophy)
22. A traumatology unit received a patient with crushed
muscular tissue. What biochemical indicator of urine will be
raised in this case?
•
Total lipids
•
•
•
•
Glucose
Creatinine
Uric acid
Mineral salts
23. A 1 y.o. child with symptoms of muscle affection was
admitted to the hospital. Examination revealed carnitine deficit
inmuscles. Biochemical base of this pathology is disturbed
process of:
•
•
Regulation of Ca2+ rate in mitochondrions
Transporting of fatty acids to mitochondrions
•
Lactic acid utilization
•
Actin and myosin synthesis
•
Substrate phosphorylation
24. After a sprint an long distantion the skeletal muscle training
person uses glucose for the purpose of obtaining energy ATP
for muscle contraction. Specify basic glucose utilization
process in these conditions:
•
Glycogenesis
•
•
•
Glycogenolysis
Aerobic glycolysis
Anaerobic glycolysis
•
Gluconeogenesis
25. The gluconeogenesis is activated in the liver after intensive
physical trainings.What substance is utilized in
gluconeogenesis first of all in this case:
•
•
Pyruvate
Glutamate
•
Lactate
•
Alanine
•
Glucose
26. 6 hours after the myocardial infarction a patient was found
to have elevated level of lactate dehydrogenase in blood. What
is enzyme should be expected in this case?
•
LDH3
•
LDH4
•
LDH5
•
LDH2
•
LDH1
1. A substance that is synthesized in the central nervous
system and simulates the effects of morphine can be used for
analgesia. Specify the following substance:
•
Vasopressin
•
beta-endorphin
•
Oxytocin
•
Calcitonin
•
Somatoliberin
2. Cell membrane restpotential changed from-85 to-90mV. It
can becaused by activation of the following cell membrane
channels:
•
Potassium and calcium
•
•
Potassium
•
Sodium
•
Calcium
Potassium and sodium
3. The speed of the excitation nerve fibers is 120 m / s. Which
of the above factors, above all, provides such speed?
•
•
A big factor of reliability
Large amplitude potential effects
•
Low threshold of depolarization
•
Presence of myelin sheath
•
Great resting potential
4. The patient is trembling hands, which is associated with
Parkinson's disease. What mediator deficiency in striopalidar
structures leads to such symptoms?
•
•
•
GABA
Serotonin
Substance P
•
Norepinephrine
•
Dopamine
5. An 84-year-old patient suffers from parkinsonism. One of the
pathogenetic development elements of this disease is
deficiency of a certain mediator in some of the brain
structures. Name this mediator:
•
Noradrenaline
•
•
Histamine
Acetylcholine
•
Dopamine
•
Adrenaline
6. In the experiment, the permeability of the excitable cell
membrane to potassium ions was magnified. What changes in
the electrical state of the membrane will occur?
•
•
Local response
There will be no changes
•
Hyperpolarization
•
Depolarization
•
Action potential
7. A 50-year-old man came to a hospital with complaints of
memory disorders, painful sensations along the nerve trunks,
decreased mental ability, circulatory disorders and dyspepsia.
Anamnesis states excessive alcohol consumption. What
vitamin deficiency can result in such symptoms?
•
Riboflavin
•
Calciferol
•
Thiamine
•
Retinol
•
Niacin
8. Decarboxylation of glutamate induces production of gamma
aminobutyric acid (GABA) neurotransmitter. After breakdown,
GABA is converted into a metabolite of the citric acid cycle,
that is:
•
Fumarate
•
Citric acid
•
•
Malate
Oxaloacetate
•
Succinate
9. Degenerative changes in posterior and lateral columns of
spinal cord (funicular myelosis) caused by methylmalonic acid
accumulation occur in patients with B12-deficiency anemia.
This results in synthesis disruption of the following substance:
•
•
Serotonin
•
Dopamine
Acetylcholine
•
Norepinephrine
•
Myelin
10. After pharmacological blockade ion channels of the nerve
fiber membrane resting potential decreased from -90 to -80 mV.
What channels were blocked?
•
Magnesium
•
Potassium
•
Sodium
•
Chloric
•
Calcium
11. Disruption of nerve fiber myelinogenesis causes
neurological disorders and mental retardation. These
symptoms are typical for hereditary and acquired alterations in
the metabolism of:
•
Phosphatidic acid
•
Higher fatty acids
•
•
Neutral fats
Sphingolipids
•
Cholesterol
12. A patient complained about dizziness, memory impairment,
periodical convulsions. It was revealed that these changes
were caused by a product of decarboxylation of glutamic acid.
Name this product:
•
ATP
•
TDP
•
UDP
•
•
GABA
Pyridoxal phosphate
13. A patient presents with dysfunction of the cerebral cortex
accompanied by epileptic seizures. He has been administered
a biogenic amine synthetized from glutamate and responsible
for central inhibition. What substance is it?
•
Serotonin C.
•
Histamine
•
•
C. Dopamine
gamma-aminobutyric acid
•
Acetylcholine
14. An unconscious patient was taken by ambulance to the
hospital. On objective examination the patient was found to
have 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 the accumulation of the following metabolite:
•
Bilirubin
•
Glutamine
•
Histamine
•
•
Urea
Ammonia
15. For the treatment of depression of different genesis,
antidepressants are used, which are monoamine oxidase
inhibitors. What substance is a "neurotransmitter of wellbeing" and its concentration increases in the brain under the
action of antidepressants?
•
Taurine
•
Serotonin
•
Dopamine
•
Glycine
•
Norepinephrine
16. Brain cells are very sensitive to energy deficiency, which
can be caused by a high content of ammonia, which stimulates
the outflow of alpha-ketoglutarate from:
•
•
Glycogenolysis
Pentose phosphate pathway
•
Ornithine cycle
•
•
Glycolysis
Citric acid cycle
17. Depressions and emotional insanities result from the deficit
of noradrenalin, serotonin and other biogenic amines in the
brain. Their concentration in the synapses can be increased by
means of the antidepressants that inhibit the following
enzyme:
•
Monoamine oxidase
•
•
D-amino-acid oxidase
Phenylalanine-4-monooxygenase
•
L-amino-acid oxidase
•
Diamine oxidase
18. Pharmacological effects of antidepressants are based upon
blocking (inhibiting) the enzyme that acts as a catalyst for the
breakdown of biogenic amines noradrenalin and serotonin in
the mitochondria of cephalic neurons. What enzyme takes part
in this process?
•
•
Lyase
•
Decarboxylase
•
Transaminase
Monoamine oxidase
•
Peptidase
19. A 9-month-old infant is fed with artificial formulas with
unbalanced vitamin B6 concentration. The infant presents with
pellagral dermatitis, convulsions, anaemia. Convulsion
development might be caused by the disturbed formation of:
•
Histamine
•
Serotonin
•
GABA
•
DOPA
•
Dopamine
20. Cerebral trauma caused increase of ammonia formation.
What aminoacid takes part in removal of ammonia from
cerebral tissue?
•
Valine
•
Lisine
•
Tryptophan
•
Glutamic
•
Tyrosine
21. Ammonia is a very toxic substance, especially for nervous
system. What substance takes the most active part in ammonia
detoxication in brain tissues?
•
•
Histidine
•
Alanine
•
Proline
Glutamic acid
•
Lysine
22. A patient presented to a hospital with complaints about
quick fatigability and significant muscle weakness.
Examination revealed an autoimmune disease that causes
functional disorder of receptors in the neuromuscular
synapses. This will result in the disturbed activity of the
following mediator:
•
Dopamine
•
Noradrenaline
•
Serotonin
•
•
Glycine
Acetylcholine
23. Glutamate decarboxylation results in formation of inhibitory
transmitter in CNS. Name it:
•
Histamine
•
Serotonin
•
Glutathione
•
Asparagine
•
GABA
24. In medical practice for alcoholism prevention widely used
teturam, which is inhibitor aldehyde dehydro- nazy The
increase in blood of what tabolita aversion to al to someone?
•
Acetaldehyde
•
•
•
•
Ethanol
Methanol
Malonic aldehyde
Propionic aldehyde
25. Soldiers who were injured in the midst of the battle may not
be aware of the pain until it is completed. What hormones are
opiate antinociceptive system reduce the sensation of pain?
•
Vasopressin
•
Endorfines
•
Serotonines
•
Oxytocine
•
Aldosterone
26. In an excitable cell the ion channels were blocked. It hasn’t
changed essentially the value of rest potential, but the cell lost
its ability to generate AP (action potential). What channels were
blocked?
•
•
Potassium
•
•
Natrium
Calcium
Natrium and potassium
•
Chloric
27. The infant has epileptiform convulsions caused by vitamin
B6 deficiency. This is due to a decrease in the nervous tissue
of the inhibitory mediator, ?-aminobutyric acid. What is the
enzyme's activity reduced in this case?
•
Glutamate decarboxylase
•
Glutamate dehydrogenase
•
•
Glutamate Synthetase
Alanine aminotransferase
•
Pyridoxal kinase
1.Human red blood cells do not contain mitochondri= What is the main pathway for ATP
production in these cells?
Select one:
a. Anaerobic glycolysis
b. Oxidative phosphorylation
c. Creatine kinase reaction
d. Aerobic glycolysis
e. Cyclase reaction
2.Biochemical analysis of an infant’s erythrocytes revealed evident glutathione peroxidase
deficiency and low concentrati¬on of reduced glutathion~ What pathologi¬cal condition can
develop in this infant?
Select one:
a. Hemolytic anemia
b. Iron-deficiency anemia
c. Megaloblastic anemia
d. Pernicious anemia
e. Sicklemia
3.A patient with respiratory failure has blood pH of 7,35. pCO2 test revealed hypercapni=
Urine pH test revealed an increase in the urine acidity.What form of acid-base imbalance is
the case?
Select one:
a. Compensated respiratory alkalosis
b. Decompensated respiratory alkalosis
c. Compensated respiratory acidosis
d. Decompensated metabolic acidosis
e. Compensated metabolic acidosis
4.An infectious disease unit admitted a patient with signs of jaundice caused by hepatitis
virus. Select an indicator that is specific only for parenchymatous jaundice:
Select one:
a. Increase in ALT and AST rate
b. Urobilinuria
c. Cholaemia
d. Hyperbilirubinemia
e. Bilirubinuria
5.A 62 year old woman complains of frequent pain attacks in the area of her chest and
backbone, rib fractures. Her doctor suspected myeloma (plasmocytoma). What of the
following laboratory characteristics will be of the greatest diagnostic importance?
Select one:
a. Hypoproteinemia
b. Hypoglobulinemia
c. Hyperalbuminemia
d. Proteinuria
e. Paraproteinemia
6.Toxic affection of liver results in dysfunction of protein synthesis. It is usually accompanied
by the following kind of dysproteinemia:
Select one:
a. Paraproteinemia
b. Relative hyperproteinemia
c. Absolute hyperproteinemia
d. Absolute hypoproteinemia
e. Relative hypoproteinemia
7.A 28-year-old patient undergoing treatment in the pulmonological department has been
diagnosed with pulmonary emphysema caused by splitting of alveolar septum by tissular
tripsin. The disease is cased by the congenital deficiency of the following protein:
Select one:
a. α1-proteinase inhibitor
b. Haptoglobin
c. Transferrin
d. Cryoglobulin
e. α2-macroglobulin
8.
Question text
A month after surgical constriction of rabbit’s renal artery the considerable increase of
systematic arterial pressure was observe~ What of the following regulation mechanisms
caused the animal’s pressure change?
Select one:
a. Noradrenaline
b. Serotonin
c. Angiotensin-II
d. Vasopressin
e. Adrenaline
9.A newborn child with pylorostenosis has often repeating vomiting accompanied by apathy,
weakness, hypertonicity, sometimes convulsions. What disorder form of acid-base balance is
it?
Select one:
a. Gaseous acidosis
b. Excretory acidosis
c. Metabolic acidosis
d. Gaseous alkalosis
e. Nongaseous alkalosis
10.A patient underwent a course of treatment for atherosclerosis. Laboratory tests revealed
an increase in the antiatherogenic lipoprotein fraction in the blood plasm= The treatment
efficacy is confirmed by the increase in:
Select one:
a. HDL
b. Chylomicrons
c. IDL
d. LDL
e. VLDL
11.A patient who had been continuously taking drugs blocking the production of angiotensin
II developed bradycardia and arrhythmi= A likely cause of these disorders is:
Select one:
a. Hypokalemia
b. Hypercalcemia
c. Hypernatremia
d. Hyperkalemia
e. Hypocalcemia
12.A patient complains about dyspnea provoked by the physical activity. Clinical examination
revealed anaemia and presence of the paraprotein in the zone of gamma-globulins. To
confirm the myeloma diagnosis it is necessary to determine the following index in the
patient’s urine:
Select one:
a. Ceruloplasmin
b. Bence Jones protein
c. Haemoglobin
d. Antitrypsin
e. Bilirubin
13.Increased HDL levels decrease the risk of atherosclerosis. What is the mechanism of
HDL anti-atherogenic action?
Select one:
a. They activate the conversion of cholesterol to bile acids
b. They supply tissues with cholesterol
c. They promote absorption of cholesterol in the intestine
d. They are involved in the breakdown of cholesterol
e. They remove cholesterol from tissues
14.In human organism significant blood loss leads to decreased blood pressure, tachycardia,
and weakness. Eventually the sensation of thirst appears. What hormone participates in the
development of this sensation?
Select one:
a. Angiotensin 2
b. Dopamine
c. Cortisol
d. Serotonin
e. Adrenalin
15.A patient consulted a doctor with complaints of dyspnea occurring after physical exertion.
Physical examination revealed anemia, paraprotein was detected among gamma globulin.
What value should be determined in the patient’s urine to confirm the diagnosis of myeloma?
Select one:
a. Antitrypsin
b. Bence Jones protein
c. Ceruloplasmin
d. Hemoglodin
e. Bilirubin
16.Increased HDL levels decrease the risk of atherosclerosis. What is the mechanism of
HDL anti-atherogenic action?
Select one:
a. They promote absorption of cholesterol in the intestine
b. They remove cholesterol from tissues
c. They supply tissues with cholesterol
d. They are involved in the breakdown of cholesterol
e. They activate the conversion of cholesterol to bile acids
17.For biochemical diagnostics of myocardial infarction it is necessary to measure activity of
a number of enzymes and their isoenzymes. What enzymatic test is considered to be the
best to prove or disprove the diagnosis of infarction in the early period after the chest pain is
detected?
Select one:
a. LDH2 lactate dehydrogenase isoenzyme
b. LDH1 lactate dehydrogenase isoenzyme
c. Creatine kinase isoenzyme CK-MB
d. Aspartate aminotransferase cytoplasmic isoenzyme
e. Creatine kinase isoenzyme CK-MM
18.A patient suffers from disrupted patency of the airways at the level of small and medium –
sized bronchial tubes. What changes of acid-base balance can occur in the patient?
Select one:
a. Respiratory acidosis
b. Acid-base balance remains unchanged
c. Respiratory alkalosis
d. Metabolic acidosis
e. Metabolic alkalosis
19.An infant has pylorospasm, weakness, hypodynamia, convulsions as a result of frequent
vomiting. What kind of acid-base disbalance is it?
Select one:
a. Metabolic acidosis
b. Exogenous nongaseous acidosis
c. Excretory acidosis
d. Excretory alkalosis
e. Gaseous alkalosis
20.Toxic damage to hepatic cells resulted in discruption of the patients liver function and the
patient developed edemas. What changes of blood plasma are the main cause of edema
development?
Select one:
a. Decrease of globulin content
b. Increase globulin content
c. Decrease of fibrinogen content
d. Increase of albumin content
e. Decrease of albumin content
21.Hemoglobin catabolism results in release of iron which is transported to the bone marrow
by a certain transfer protein and used again for the synthesis of hemoglobin. Specify this
transfer protein:
Select one:
a. Transcobalamin
b. Transferrin (siderophilin)
c. Ceruloplasmin
d. Albumin
e. Haptoglobin
22.A patient with diabetes developed a diabetic coma due to the acid-base imbalanc~
Specify the kind of this imbalance:
Select one:
a. Metabolic acidosis
b. Non-gaseous alkalosis
c. Metabolic alkalosis
d. Respiratory acidosis
e. Gaseous alkalosis
23.A 49-year-old male patient with acute pancreatitis was likely to develop pancreatic
necrosis, while active pancreatic proteases were absorbed into the blood stream and tissue
proteins broke up.What protective factors of the body can inhibit these processes?
Select one:
a. Ceruloplasmin, transferrin
b. Cryoglobulin, interferon
c. Hemoplexin, haptoglobin
d. α2-macroglobulin, α1-antitrypsin
e. Immunoglobulin
24.A 30-year-old man with diabetes mellitus type I was hospitalise~ The patient is comatos~
Laboratory tests revealed hyperglycemia and ketonemi= What metabolic disorder can be
detected in this patient?
Select one:
a. Metabolic acidosis
b. Normal acid-base balance
c. Respiratory alkalosis
d. Respiratory acidosis
e. Metabolic alkalosis
25.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:
Select one:
a. Angiotensinogen
b. Catecholamines
c. Renin
d. Norepinephrine
e. Angiotensin II
26.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:
Select one:
a. Haptoglobin
b. α1-proteinase inhibitor
c. α2-macroglobulin
d. Transferrin
e. Cryoglobulin
27.
Question text
A 15-year-old boy has been diagnosed with acute viral hepatitis. What blood value should be
determined to confirm acute affection of hepatic cells?
Select one:
a. Cholesterol content
b. Aminotransferase activity (AST, ALT)
c. Protein fraction content
d. Erythrocytes sedimentation rate (ESR)
e. Unconjugated and conjugated bilirubin content
28.A 12-year-old patient was found to have blood serum cholesterol at the rate of 25 mmol/l.
The boy has a history of hereditary familial hypercholesterolemia, which is caused by the
impaired synthesis of the following protein receptors:
Select one:
a. Low density lipoproteins
b. Very low density lipoproteins
c. High density lipoproteins
d. Intermediate density lipoproteins
e. Chylomicrons
29.A patient has been admitted to the contagious isolation ward with signs of jaundice
caused by hepatitis virus. Which of the symptoms given below is strictly specific for
hepatocellular jaundice?
Select one:
a. Bilirubinuria
b. Cholemia
c. Urobilinuria
d. Increase of ALT, AST level
e. Hyperbilirubinemia
30.Deficiency of linoleic and linolenic acids in the body leads to the skin damage, hair loss,
delayed wound healing, thrombocytopenia, low resistance to infections. These changes are
most likely to be caused by the impaired synthesis of the following substances:
Select one:
a. Catecholamines
b. Interleukins
c. Interferons
d. Eicosanoids
e. Corticosteroids
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Krok \ Dentistry \ Krok 1 \ Bases \ Biochemistry \ 2010
1 Roentgenological examination of a patient revealed a cyst enclosing a tooth in its cavity in
the area of the premolar. Microscopical examination revealed that the cyst wall consisted of
connective tissue and was lined with multilayer squamous epithelium. What is the most
probable diagnosis?
A Follicular cyst
B Radicular cyst
C Primordial cyst
D Eosinophilic granuloma
E Epulis
2 A dentist was examining oral cavity of a 9 year old child in the buccal surface of gingiva in
the area of the lower canine he revealed a red, soft, node-like formation 1 cm in diameter
that started immediately bleeding when touched. Microscopical examination revealed that
this formation consisted of many small vessels like venules and capillaries separated by thin
layers of connective tissue, with focal infiltration by lymphoid and plasmatic cells. Such
changes are typical for:
A Angiomatous epulis
B Capillary hemangioma
C Radicular granuloma
D Fibrous epulis
E Papilloma
3 Analysis of urine from a 24-year-old man revealed the following changes: daily diuresis 10 l, relative density - 1,001, qualitative alterations are absent. A patient complains of
excessive thirst, frequent urination. What is the most likely cause of this disease?
A Vasopressin hyposecretion
B Glucocorticoid hypersecretion
C Vasopressin hypersecretion
D Relative insulin insufficiency
E Aldosteron hypersecretion
4 A patient suffering from syphilis was prescribed a drug the action of which based upon
disturbed generation of murein leading to death of the causative agent. What drug is it?
A Benzylpenicillin sodium salt
B Bijochinol
C Ciprofloxacin
D Azithromycin
E Doxycycline hydrochloride
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5 Osteolathyrism is characterized by a loss of tensile strength of collagen, which is induced
by a significant decrease in the formation of cross-links in collagen fibrils. The cause for it is
the reduced activity of:
A Lysyl oxidase
B Monoamine oxidase
C Prolyl hydroxylase
D Lysyl hydroxylase
E Collagenase
6 Periodontitis is accompanied by activation of proteolysis in the periodontium tissues. The
evidence of proteolysis activation is increase of the following component of oral liquid:
A Amino acids
B Organic acids
C Glucose
D Biogenic amines
E Cholesterol
7 Two weeks after hemotransfusion a patient developed fever. What protozoal disease can
be suspected?
A Malaria
B Toxoplasmosis
C Leishmaniasis
D Amebiasis
E Trypanosomiasis
8 A patient applied to a doctor complaining about dizziness, memory impairment,
periodical convulsions. It was found out that such changes were caused by a product of
glutamic acid decarboxylation. What product is meant?
A GABA
B Pyridoxalphosphate
C Thymidine diphosphate
D ATP
E Tetrahydrofolate
9 Laboratory examination of a child revealed high content of leucine, valine, isoleucine and
their ketoderivates in blood and urine. Urine had the typical smell of maple syrup. This
disease was caused by deficiency of the following enzyme:
A Dehydrogenase of branched amino acids
B Aminotransferase
C Glucose-6-phosphatase
D Phosphofructokinase
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E phosphofructomutase
10 Hepatic disfunctions accompanied by insufficient inflow of bile to the bowels result in
coagulation failure. This phenomenon can be explained by:
A Vitamin K deficiency
B Iron deficiency
C Thrombocytopenia
D Erythropenia
E Leukopenia
11 A child has disturbed processes of ossification and punctate enamel. What microelement
metabolism is disturbed?
A Fluorine
B Chromium
C Copper
D Iron
E Zinc
12 During examination of a 36-year-old woman a dentist revealed a formation in form of a
nodule up to 0,8 cm in diameter, of dark brown-red colour, soft, on a wide base. The
formation was found on the buccal surface of gum in the region of the 2nd molar.
Histological examination revealed that the formation had plenty of sinusoid vessels and a
lot of roundish mononuclear and big multinuclear cells; in some parts accumulations of
hemosiderin granules could be found. What is the most likely diagnosis?
A Giant-cell epulis
B Root granuloma
C Angiomatous epulis
D Ameloblastoma
E Mandibular osteoclastoma
13 While on holiday in the countryside a boy found a spider with the following
morphological peculiarities: body length at the rate of 2 cm, round black abdomen with two
rows of red dots on its dorsal surface, four pairs of segmented extremities covered with tiny
black hairs. Identify this arthropod:
A Steppe spider (Latrodectus tredeci-mguttatus)
B Scorpion
C Solifugae
D Mite
E Tarantula
14 A girl who was provisionally diagnosed with Turner’s syndrome came to a genetic
consultation. The diagnosis can be specified by means of the following genetic method:
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A Sex chromatin test
B Genealogical
C Hybridological
D Biochemical
E Dermatoglyphics
15 Cyanide poisoning causes immediate death. What is the mechanism of cyanide effect at
the molecular level?
A They inhibit cytochromoxidase
B They bind substrates of tricarboxylic acid cycle
C They block succinate dehydrogenase
D They inactivate oxygene
E They inhibit cytochrome B
16 A blood smear of a patient who has recently recovered from flu contains 10% of
roundish cells 4,5-7 micrometer large with a big round nucleus and basophi-lically stained
cytoplasm in form of a narrow border around the nucleus. What blood status are they
typical for?
A Lymphocytopenia
B Thrombopenia
C Leukopenia
D Lymphocytosis
E Monocytopenia
17 A patient was diagnosed with seborrheic dermatitis associated with vitamin H (biotin)
deficiency. The patient has disturbed activity of the following enzyme:
A Acetyl-CoA-carboxylase
B Pyruvate decarboxylase
C Alcohol dehydrogenase
D Amino transferase
E Carbomoyl phosphate synthetase
18 Active physical work induces rise of concentration of carbonic acid in blood. This causes
deepening and acceleration of respiration thus reducing concentration of carbonic acid and
hydrogen ions in blood. This maintains the following process:
A Homeostasis
B Immunity
C Ontogenesis
D Orthobiosis
E Anabiosis
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19 The activity of parotides reduces with age. Activity of what enzyme in saliva will be
reducing?
A Amylase
B Lysozime
C Phosphatase
D Hexokinase
E Maltase
20 Chronic overdosage of glucocorticoids leads to the development of hyperglycemia. What
process of carbohydrate metabolism is responsible for this effect?
A Gluconeogenesis
B Glycogenolysis
C Aerobic glycolisis
D Pentose-phosphate cycle
E Glycogenesis
21 A patient has mental retardation, small height, brachydactyly, mongoloid slant. Analysys
of his karyotype revealed trisomy 21. What chromosomal anomaly is it?
A Down’s disease
B Klinefelter’s syndrome
C Turner’s syndrome
D Trisomy X
E Specific fetopathy
22 Examination of urine in a newborn revealed presence of citrulline and high ammonia
concentration. This baby is most likely to have the disorder of the following substance
production:
A Urea
B Uric acid
C Ammonia
D Creatinine
E Creatine
23 In the mountains some clinically healthy people present with anaemia symptoms. Blood
test can reveal sickle cells. What is the genotype of such people?
A Aa
B aa
C AA
D XcXc
E XCXc
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24 To what total ATP quantity is the full glucose oxidation and its linking with
phosphorylation equivalent?
A 38
B8
C 12
D 52
E 58
25 While examining a blood smear taken form a patient and stained by Romanovsky’s
method a doctor revealed some protozoa and diagnozed the patient with Chagas disease.
What protozoan is the causative agent of this disease?
A Trypanosoma cruzi
B Toxoplasma gondii
C Leishmania donovani
D Leishmania tropica
E Trypanosoma brucei
26 A 10 year old child underwent Mantoux test (with tuberculin). 48 hours later there
apperaed a papule up to 8 mm in diameter on the site of tuberculin injection. Tuberculin
injection caused the following hypersensitivity reaction:
A IV type hypersensitivity reaction
B Arthus reaction
C Seroreaction
D Atopic reaction
E II type hypersensitivity reaction
27 A chiled was diagnosed with acute renal failure. What biochemic saliva indices can
confirm this diagnosis?
A Increased level of rest nitrogen
B Increase of immunoglobuline A
C Reduction of alkaline phosphatase
D Increase of alpha amylase
E Decreased level of phosphate
28 A 28 year old pregnant woman had the enzymes in the cells of amniotic fluid analyzed.
The analysis revealed insufficient activity of beta-glucuronidase. What pathological process
is it?
A Mucopolysaccharidosis
B Glycogenosis
C Collagenosis
D Lipidosis
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E Aglycogenosis
29 A patient with chronic hypoglycemia had adrenaline introduction. After introduction
blood test has not changed essentially. Doctor assumed liver pathology. What liver function
may have been changed?
A Function of glycogen depositing
B Ketogenic function
C Function of cholesterin production
D Glycolytic function
E Excretory function
30 In order to speed up healing of the thermal injury it is required to prescribe a drug that
facilitates epithelization of skin and mucous membranes. What drug is it?
A Retinol acetate
B Tocopherol acetate
C Nicotinic acid
D Ergocalciferol
E Ascorbic acid
31 A child has abnormal formation of tooth enamel and dentin as a result of low
concentration of calcium ions in blood. Such abnormalities might be caused by deficiency of
the following hormone:
A Parathormone
B Thyrocalcitonin
C Thyroxin
D Somatotropic hormone
E Triiodothyronine
32 Microscopical examination of discharges from the gums of a patient ill with paradontosis
revealed some protozoan pear-shaped organisms 6-13 micrometer long. The parasite has
one nucleus and undulating membrane, there are four flagella at the front of its body. What
protozoan were found?
A Trichomonads
B Leishmania
C Amoebae
D Balantidia
E Lamblia
33 A patient has painfulness along big nerve trunks and excessive content of pyruvate in
blood. What vitamin deficit may cause such changes?
ABi
B B2
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C PP
D Pantothenic acid
E Biotin
34 A patient with diabetes mellitus had an insuline injection. It caused loss of consciousness
and convulsions. What was the result of biochemic blood analysis on glucose content?
A 2,5 mmole/l
B 3,3 mmole/l
C 8,0 mmole/l
D 10 mmole/l
E 5,5 mmole/l
35 Examination of a 6 days old infant revealed phenyl pyruvate and phenyl acetate excess
in his urine. What ami-noacid metabolism is disturbed in the child’s organism?
A Phenylalanine
B Tryptophan
C Methionine
D Histidine
E Arginine
36 For assessment of the neutralizing function of liver a patient with chronic hepatitis went
through a test with natrium benzoate load. The excretion of what acid with urine will
characterize the neutralizing function of liver?
A Hippuric acid
B Phenylacetic acid
C Citric acid
D Valeric acid
E Oxalic acid
37 A 42 year old woman diagnosed with diabetes mellitus was admitted the
endocrinological department with complaints of thirst, excessive appetite. What
pathological components are revealed in course of laboratory examination of the patients
urine?
A Glucose, ketone bodies
B Protein, aminoacids
C Bilirubin, urobilin
D Blood
E Protein, creatine
38 A 2 year old child suffers from intestinal dysbacteriosis that lead to the development
hemorrhagic syndrome. The most probable cause of hemorrhage is:
A Vitamin K deficiency
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B Activation of tissue thromboplastin
C Hypovitaminosis PP
D Fibrinogen deficiency
E Hypocalcemia
39 Decreased ratio of adenylic nucleotides ATP/ADP results in intensified glycolysis in
parodentium tissues in hypoxic conditions. What reaction is activated in this case?
A Phosphofructokinase
B Lactate dehydrogenase
C Triosophosphate isomerase
D Aldolase
E Enolase
40 Helminthological examination of patient’s feces revealed oval brown eggs with tuberous
external membrane. Name the type of helminth:
A Ascarid
B Pinworm
C Whipworm
D Dwarf tapeworm
E Broad tapeworm
41 A patient has the folowing changes: disorder of twilight vision, drying out of conjunctiva
and cornea. Such disorders may be caused by deficiency of vitamin:
A Vitamin A
B Vitamin B
C Vitamin C
D Vitamin D
E Vitamin B12
42 Examination of a 10 y.o. child revealed on the alveolar submandibular process a fixed
tumourous mass 1,5 cm in diameter closing premolar crown on the vestibular side. Mucous
membrane of its surface is reddish-brown, it bleeds as a reaction to a slight mechanical
intervention. Biopsy results: the mass consists of small size vessels separated by thin layers
of connective tissue and infiltrated by plasmocytes, mucous membrane is here and there
ulcered. What is the most probable diagnosis?
A Angiomatous form of epulis
B Gingival fibromatosis
C Giant cell form of epulis
D Hypertrophic gingivitis
E Fibrous form of epulis
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43 A non trained man has usually muscular hypoxy after a sprint. What metabolite
accumulates in the muscles as a result of it?
A Lactate
B Ketone bodies
C Glucose 6-phosphate
D Oxaloacetate
E44 A man got poisoned with mushrooms. They contain muscarine that stimulates
muscarinic cholinoreceptors. What symptom is typical for poisoning with inedible
mushrooms?
A Miosis
B Mydriasis
C Bronchi dilation
D Heart rate rise
E Arterial pressure rise
45 Myocyte cytoplasm contains a big number of dissolved metabolites of glucose oxidation.
Name one of them that turns directly into lactate:
A Pyruvate
B Oxaloacetate
C Glycerophosphate
D Glucose 6-phosphate
E Fructose 6-phosphate
46 Roentgenological examination of mandible of a 27 year old man revealed a focus of
osseous tissue destruction. Histological examination revealed a tumour consisting of
odontogenous epithelium cords, immature connective tissue and dysplastic dentin rests.
What tumour is it?
A Dentinoma
B Ameloblastic fibro-odontoma
C Odontoameloblastoma
D Odontogenous fibroma
E Complex odontoma
47 Patient with pigmentary xeroderma are characterized by anamalously high sensivity to
ultraviolet rays that causes skin cancer as a result of enzyme systems incapability to restore
damages of hereditary apparatus of cells. What process abnormality is this pathology
connected with?
A DNA reparation
B Genetic conversion
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C DNA recombination
D Genetic complementation
E DNA reduplication
48 A patient has the sudden decrease of Са2+ content in blood. What hormone secretion
will increase?
A Parathormone
B Somatotropin
C Aldosterone
D Thyrocalcitonin
E Vasopressin
49 A female patient has symptoms of inflammation of urogenital tracts. A smear from the
vaginal mucous membrane contained big unicellular pyriform organisms with a sharp spike
on the back end of their bodies; big nucleus and undulating membrane. What protozoa were
revealed in the smear?
A Trichomonas vaginalis
B Trichomonas hominis
C Trichomonas buccalis
D Trypanosoma gambiense
E Lamblia intestinalis
50 A patient has increased content of uric acid in his blood that is clinically presented by
pain syndrome as a result of urate deposition in the joints. What process does this acid
result from?
A Lysis of purine nucleotides
B Lysis of pyrimidine nucleotides
C Heme catabolism
D Proteolysis
E Reutilization of purine bases
51 Among public catering workers examined by doctors of sanitary-and-epidemiologic
station often occur asymptomatic parasite carriers. This means that a healthy person
carries cysts that infect other people. Such parasitizing is impossible for the following
causative agent:
A Dysenteric amoeba
B Malarial plasmodium
C Intestinal trichomonad
D Dermatotropic leishmania
E Viscerotropic leishmania
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52 The 16th tooth of a patient is missing. X-ray picture shows in the depth of alveolar
process rarefaction of bone and a well-defined cavity that contained the underdeveloped
tooth crown. Microscopical examination revealed that the cavity wall was lined with
stratified squamous epithelium and enclosed within a fibrous capsule. Make a diagnosis:
A Follicular gnathic cyst
B Radicular gnathic cyst
C Cyst of the incisive canal
D Cystic ameloblastoma of jaw
E Primordial gnathic cyst
53 A patient has increased permeability of blood-vessel walls, increased gingival
hemorrhage, small punctate hematomas on his skin, falling of teeth. What disturbance of
vitamun metabolism can account for these symptoms?
A Hypovitaminosis C
B Hypervitaminosis D
C Hypervitaminosis C
D Hypovitaminosis D
E Hypovitaminosis A
54 A patient has liver cirrhosis. Analysis of what substance excreted with urine may
characterize the state of antitoxic liver function?
A Hippuric acid
B Ammonian salts
C Creatinine
D Uric acid
E Amino acids
55 A sportsman needs to improve his sporting results. He was recommended a drug
containing carnitine. What process is activated by this compound in the first place?
A Transport of fatty acids
B Transport of amino acids
C Transport of calcium ions
D Transport of glucose
E Transport of vitamin K
56 A child has disturbed enamel and dentine formation as a result of decreased content of
calcium ions in his blood. What hormone deficiency may cause such changes?
A Thyreocalcitonin
B Somatotropin
C Thyroxin
D Parathormone
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E Triiodothyronine
57 A hospital admitted a patient with complaints about abdominal swelling, diarrhea,
meteorism after consumption of food rich in proteins. It is indicative of disturbed protein
digestion and their intensified decaying. What substance is the product of this process in the
bowels?
A Indole
B Bilirubin
C Cadaverine
D Agmatine
E Putrescine
58 A 38 year old patient takes aspirin and sulfanilamides. After their intake intensified
erythrocyte haemolysis is observed which is caused by deficiency of glucose 6-phosphate
dehydrogenase. This pathology is caused by failure of the following coenzyme:
A NADP - H
B FAD - H2
C Pyridoxal phosphate
D FMN - H2
E Ubiquinone
59 Up to 50% of world population aged above thirty is affected by paradontosis. The
leading part in pathogenesis of this disease is played by:
A Neurodystrophic factor
B Parodontium tissues damaged by kalli-krein
C Parodontium damaged by active cells
D Dental calculus caused by microflora
E Immune damage of tissues
60 A 57 year old patient with diabetes mellitus was developed ketoacedosis. Biochemical
base of this condition is decrease of acetyl-CoA utilization. What cell compound deficit
causes this effect?
A Oxaloacetate
B Glutamate
C 2-oxoglutarate
D Aspartate
E Succinate
61 A patient was taken to the hospital with preliminary diagnosis progressive muscle
distrophy. What substance will be excessively contained in urine and confirm this
diagnosis?
A Creatine
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B Pyruvate
C Carnosine
D Troponine
E Hydroxiproline
62 Microscopical examination of a surgical specimen (an ulcered part of a lip) revealed in
the connective tissue of mucous membrane near the borders and under the floor of the
ulcer some epithelial complexes consisting of atypic multi-stratal epithelium with
accumulations of bright pink concentric formations. What pathology is it?
A Squamous cell keratinous carcinoma
B Squamous cell nonkeratinous carcinoma
C Transitional cell carcinoma
D Basal cell carcinoma
E Papilloma
63 Examination of a child who hasn’t got fresh fruit and vegetables during winter revealed
numerous subcutaneous hemorrhages, gingivitis, carious cavities in teeth. What vitamin
combination should be prescribed in this case?
A Ascorbic acid and rutin
B Thiamine and pyridoxine
C Folic acid and cobalamin
D Riboflavin and nicotinamide
E Calciferol and ascorbic acid
64 Coprological examination of a patient’s feces revealed small operculate eggs. It is known
from the anamnesis that the patient often consumes fish. What fluke parasitizes in the
patient’s organism?
A Cat liver fluke
B Blood fluke
C Lung fluke
D Liver fluke
E Lancet fluke
65 While the examination of patient’s oral cavity the dentist found xerostomia, numerous
erosions. What vitamin deficit caused this effect?
A Vitamin A
B Vitamin K
C Vitamin P
D Vitamin H
E Vitamin PP
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66 A sportsman was recommended to take a preparation with carnitine in order to improve
his achievements. What process is activated by carnitine to the most extent?
A Transporting of fatty acids to the mi-tochondrions
B Synthesis of steroid hormones
C Synthesis of ketone bodies
D Lypide synthesis
E Tissue respiration
67 After implantation of a cardiac valve a young man constantly takes indirect
anticoagulants. His state was complicated by hemorrhage. What substance content has
decreased in blood?
A Prothrombin
B Haptoglobin
C Heparin
D Creatin
E Ceruloplasmin
68 A 28 year old woman consulted a doctor about sterility. Examination revealed
underdeveloped ovaries and uterus, irregular menstrual cycle. Study of sex chromatin
revealed 2 Barr’s bodies in most somatic cells. What chromosome disease is the most
probable in this case?
A Triplo-X syndrome
B Edwards’ syndrome
C Patau’s syndrome
D Klinefelter’s syndrome
E Turner’s syndrome
69 A patient who is ill with scurvy displays disturbed processes of connective tissue
formation that leads to loosening and falling of teeth. Disturbed activity of what enzyme
causes these symptomps?
A Lisilhydroxylase
B Glycosiltransferase
C Elastase
D Procollagenpeptidase of N-terminal peptide
E Procollagenpeptidase of C-terminal peptide
70 During physical exercise people are less sensitive to pain. The reason for it is the
activation of:
A Antinociceptive system
B Nociceptive system
C Thyroid gland functions
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D Sympathoadrenal system
E Adrenal gland functions
71 A one year old child has enlarged head and belly, retarded cutting of teeth, destruction of
enamel structure. What hypovitaminosis causes these changes?
A Hypovitaminosis D
B Hypovitaminosis C
C Hypovitaminosis A
D Hypovitaminosis B 1
E Hypovitaminosis B2
72 A sample taken from the pharynx of a patient with angina was inoculated on the bloodtellurite agar. This resulted in growth of grey, radially striated (in form of rosettes) colonies
up to 4-5 mm in diameter. Microscopically there can be seen gram-positive rods with clubshaped ends arranged in form of spread fingers. What microorganisms are these?
A Corynebacteria diphtheriae
B Clostridium botulinum
C Diphtheroids
D Streptococci
E Streptobacilli
73 A patient with high obesity was recommended to take carnitine as a food additive for
better fat burning. What function is fulfilled by carnitine in the process of fat oxidation?
A Transport of fatty acids from the cytosol to the mitochondria
B Transport of fatty acids from the fat depots to the tissues
C Participation in one of the reactions of beta-oxidation of fatty acids
D Fatty acid activation
E Intracellular lipolysis activation
74 Laboratory of extremely dangerous infections received a sample taken from a patient
with assumed cholera. What express-diagnostics method can confirm this diagnosis?
A Immunofluorescence test
B Complement binding reaction
C Agglutination test
D Precipitation reaction
E Hemagglutination reaction
75 A patient with focal tuberculosis of superior lobe of his right lung takes isoni-azid as a
part of combined therapy. After a time he started complaining of muscular weakness,
decrease of skin sensitivity, sight and movement coordination disorder. What vitamin
preparation will be right for elimination of these occurances?
A Vitamin B6
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B Vitamin A
C Vitamin D
D Vitamin B12
E Vitamin C
76 The first grade pupils went through a medical examination aimed at selection of children
needing tuberculosis revaccination. What test was applied?
A Mantoux test
B Schick test
C Supracutaneous tularin test
D Burne test
E Anthracene test
77 A 15 year old girl was delivered to the hospital with inflammation of vermiform
appendix. Blood analysis revealed signs of anaemia. Her feces contained lemon-shaped
helminthic eggs (50x30 micrometer) with "plugs" on the poles. What type of helminth is it?
A Trichuris
B Hookworm
C Hymenolepis nana
D Echinococcus
E Pinworm
78 A patient has roundish ulcers on his face, inflammation and enlargement of lymph nodes.
These symptoms turned up as a result of mosquito bites. Laboratory examination of
discharge from the ulcers revealed unicellular aflagellar organisms. What is the most
probable diagnosis?
A Dermatotropic leishmaniasis
B Toxoplasmosis
C Scabies
D Trypanosomiasis
E Myasis
79 A patient has deformation of jaw bones. Histological examination revealed there growth
of fibrocellular tumourlike ill-defined tissue with primitive osteogenesis. What disease are
these presentations typical for?
A Fibrous dysplasia
B Ameloblastoma
C Osteosarcoma
D Eosinophilic granuloma
E Parathyroid osteodystrophy
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80 Cytogenetic examination of a patient with dysfunction of the reproductive system
revealed normal karyotype 46,XY in some cells, but most cells have Klinefelter’s syndrome
karyotype - 47,XXY Such phenomenon of cell inhomogeneity is called:
A Mosaicism
B Inversion
C Transposition
D Duplication
E Heterogeneity
81 Examination of an ill child’s blood revealed inherited hyperlipoproteinemia. Genetic
defect of what enzyme synthesis causes this phenomenon?
A Lipoprotein lipase
B Glycosidase
C Proteinase
D Hemsynthetase
E Phenylalanine hydroxylase
82 Dehelmintization of a patient revealed some long fragments of a helminth with
segmented structure. Mature segments were rectangular, 30x12 mm large, closed-type
matrix was in form of a stem with 17-35 lateral branches. Specify this helminth:
A Hookless tapeworm
B Alveococcus
C Echinococcus
D Dwarf tapeworm
E Armed tapeworm
83 Examination of a 30-year-old man mandible revealed in the region of his molar a dense
tumour-like formation that significantly deformed the mandible. The formation wasnt fully
detached from the bone tissue. Microscopical examination of a tissue sampling revealed that
stroma had some cords and follicles with odontogenous cylindric epithelial cells in
peripheria and stellate cells resembling of the enamel organ pulp in the centre. What is the
most likely diagnosis?
A Ameloblastoma
B Primary intraosteal cancer
C Adenomatoid tumour
D Adenocarcinoma
E Osteoclastoma
84 Histological examination of a micro specimen presenting a malignant lung tumour
revealed that the tumor consisted of lymphocyte-like cells forming any structures. Stroma is
mildely marked, there are a lot of mitoses and necroses. What tumour is it?
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A Small cell carcinoma
B Squamous cell nonkeratinous carcinoma
C Fibroma
D Squamous cell keratinous carcinoma
E Adenocarcinoma
85 A 40-year-old male patient had a tumour-like formation 8x7 cm large on his neck. A
surgeon removed it only partially because of close connection with large vessels.
Microscopical examination revealed marked cellular and tissue atypism, lipoblast-type cells
in different stages of maturity, with polymorphism and nuclear hyperchromia, pathological
mitoses, necrosis foci. Specify the histological form of the tumour:
A Liposarcoma
B Lipoma
C Fibroma
D Fibrosarcoma
E Hibernoma
86 In compliance with the clinical presentations a man was prescribed pyridoxalphosphate. What processes are corrected by this preparation?
A Transamination and decarboxylation of amino acids
B Oxidative decarboxilation of keto acids
C Desamination of purine nucleotides
D Synthesis of purine and pyrimidine bases
E Protein synthesis
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Krok \ Dentistry \ Krok 1 \ Bases \ Biochemistry \ 2010
1 Active physical work induces rise of concentration of carbonic acid in blood. This causes
deepening and acceleration of respiration thus reducing concentration of carbonic acid and
hydrogen ions in blood. This maintains the following process:
A Orthobiosis
B Homeostasis
C Ontogenesis
D Anabiosis
E Immunity
2 The first grade pupils went through a medical examination aimed at selection of children
needing tuberculosis revaccination. What test was applied?
A Anthracene test
B Supracutaneous tularin test
C Mantoux test
D Schick test
E Burne test
3 Cyanide poisoning causes immediate death. What is the mechanism of cyanide effect at
the molecular level?
A They inhibit cytochrome B
B They bind substrates of tricarboxylic acid cycle
C They block succinate dehydrogenase
D They inhibit cytochromoxidase
E They inactivate oxygene
4 Periodontitis is accompanied by activation of proteolysis in the periodontium tissues. The
evidence of proteolysis activation is increase of the following component of oral liquid:
A Glucose
B Organic acids
C Amino acids
D Biogenic amines
E Cholesterol
5 A 40-year-old male patient had a tumour-like formation 8x7 cm large on his neck. A
surgeon removed it only partially because of close connection with large vessels.
Microscopical examination revealed marked cellular and tissue atypism, lipoblast-type cells
in different stages of maturity, with polymorphism and nuclear hyperchromia, pathological
mitoses, necrosis foci. Specify the histological form of the tumour:
A Fibroma
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B Liposarcoma
C Fibrosarcoma
D Hibernoma
E Lipoma
6 A child has disturbed processes of ossification and punctate enamel. What microelement
metabolism is disturbed?
A Chromium
B Zinc
C Fluorine
D Iron
E Copper
7 Two weeks after hemotransfusion a patient developed fever. What protozoal disease can
be suspected?
A Leishmaniasis
B Trypanosomiasis
C Amebiasis
D Malaria
E Toxoplasmosis
8 In compliance with the clinical presentations a man was prescribed pyri-doxalphosphate.
What processes are corrected by this preparation?
A Transamination and decarboxylation of amino acids
B Desamination of purine nucleotides
C Oxidative decarboxilation of keto acids
D Protein synthesis
E Synthesis of purine and pyrimidine bases
9 The activity of parotides reduces with age. Activity of what enzyme in saliva will be
reducing?
A Lysozime
B Maltase
C Phosphatase
D Amylase
E Hexokinase
10 Laboratory examination of a child revealed high content of leucine, valine, isoleucine and
their ketoderivates in blood and urine. Urine had the typical smell of maple syrup. This
disease was caused by deficiency of the following enzyme:
A Glucose-6-phosphatase
B Phosphofructokinase
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C Dehydrogenase of branched amino acids
D phosphofructomutase
E Aminotransferase
11 In the mountains some clinically healthy people present with anaemia symptoms. Blood
test can reveal sickle cells. What is the genotype of such people?
A AA
B aa
C XcXc
D XCXc
E Aa
12 Examination of a 10 y.o. child revealed on the alveolar submandibular process a fixed
tumourous mass 1,5 cm in diameter closing premolar crown on the vestibular side. Mucous
membrane of its surface is reddish-brown, it bleeds as a reaction to a slight mechanical
intervention. Biopsy results: the mass consists of small size vessels separated by thin layers
of connective tissue and infiltrated by plasmocytes, mucous membrane is here and there
ulcered. What is the most probable diagnosis?
A Gingival fibromatosis
B Angiomatous form of epulis
C Giant cell form of epulis
D Fibrous form of epulis
E Hypertrophic gingivitis
13 Examination of a 6 days old infant revealed phenyl pyruvate and phenyl acetate excess
in his urine. What ami-noacid metabolism is disturbed in the child’s organism?
A Phenylalanine
B Histidine
C Methionine
D Tryptophan
E Arginine
14 Laboratory of extremely dangerous infections received a sample taken from a patient
with assumed cholera. What express-diagnostics method can confirm this diagnosis?
A Hemagglutination reaction
B Agglutination test
C Precipitation reaction
D Complement binding reaction
E Immunofluorescence test
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15 A man got poisoned with mushrooms. They contain muscarine that stimulates
muscarinic cholinoreceptors. What symptom is typical for poisoning with inedible
mushrooms?
A Heart rate rise
B Arterial pressure rise
C Bronchi dilation
D Mydriasis
E Miosis
16 Helminthological examination of patient’s feces revealed oval brown eggs with tuberous
external membrane. Name the type of helminth:
A Whipworm
B Broad tapeworm
C Dwarf tapeworm
D Ascarid
E Pinworm
17 A girl who was provisionally diagnosed with Turner’s syndrome came to a genetic
consultation. The diagnosis can be specified by means of the following genetic method:
A Genealogical
B Sex chromatin test
C Dermatoglyphics
D Hybridological
E Biochemical
18 While examining a blood smear taken form a patient and stained by Romanovsky’s
method a doctor revealed some protozoa and diagnozed the patient with Chagas disease.
What protozoan is the causative agent of this disease?
A Trypanosoma brucei
B Toxoplasma gondii
C Leishmania tropica
D Trypanosoma cruzi
E Leishmania donovani
19 A 28 year old pregnant woman had the enzymes in the cells of amniotic fluid analyzed.
The analysis revealed insufficient activity of beta-glucuronidase. What pathological process
is it?
A Lipidosis
B Collagenosis
C Mucopolysaccharidosis
D Aglycogenosis
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E Glycogenosis
20 A patient has painfulness along big nerve trunks and excessive content of pyruvate in
blood. What vitamin deficit may cause such changes?
ABi
B Pantothenic acid
C PP
D Biotin
E B2
21 A 15 year old girl was delivered to the hospital with inflammation of vermiform
appendix. Blood analysis revealed signs of anaemia. Her feces contained lemon-shaped
helminthic eggs (50x30 micrometer) with "plugs" on the poles. What type of helminth is it?
A Hymenolepis nana
B Trichuris
C Echinococcus
D Hookworm
E Pinworm
22 A sample taken from the pharynx of a patient with angina was inoculated on the bloodtellurite agar. This resulted in growth of grey, radially striated (in form of rosettes) colonies
up to 4-5 mm in diameter. Microscopically there can be seen gram-positive rods with clubshaped ends arranged in form of spread fingers. What microorganisms are these?
A Diphtheroids
B Corynebacteria diphtheriae
C Streptococci
D Streptobacilli
E Clostridium botulinum
23 A patient was diagnosed with seborrheic dermatitis associated with vitamin H (biotin)
deficiency. The patient has disturbed activity of the following enzyme:
A Alcohol dehydrogenase
B Carbomoyl phosphate synthetase
C Pyruvate decarboxylase
D Amino transferase
E Acetyl-CoA-carboxylase
24 Roentgenological examination of mandible of a 27 year old man revealed a focus of
osseous tissue destruction. Histological examination revealed a tumour consisting of
odontogenous epithelium cords, immature connective tissue and dysplastic dentin rests.
What tumour is it?
A Odontogenous fibroma
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B Ameloblastic fibro-odontoma
C Complex odontoma
D Dentinoma
E Odontoameloblastoma
25 A patient suffering from syphilis was prescribed a drug the action of which based upon
disturbed generation of murein leading to death of the causative agent. What drug is it?
A Benzylpenicillin sodium salt
B Doxycycline hydrochloride
C Azithromycin
D Ciprofloxacin
E Bijochinol
26 A hospital admitted a patient with complaints about abdominal swelling, diarrhea,
meteorism after consumption of food rich in proteins. It is indicative of disturbed protein
digestion and their intensified decaying. What substance is the product of this process in the
bowels?
A Bilirubin
B Putrescine
C Indole
D Agmatine
E Cadaverine
27 A patient has roundish ulcers on his face, inflammation and enlargement of lymph nodes.
These symptoms turned up as a result of mosquito bites. Laboratory examination of
discharge from the ulcers revealed unicellular aflagellar organisms. What is the most
probable diagnosis?
A Toxoplasmosis
B Trypanosomiasis
C Scabies
D Myasis
E Dermatotropic leishmaniasis
28 A patient has increased permeability of blood-vessel walls, increased gingival
hemorrhage, small punctate hematomas on his skin, falling of teeth. What disturbance of
vitamun metabolism can account for these symptoms?
A Hypovitaminosis A
B Hypovitaminosis D
C Hypervitaminosis C
D Hypovitaminosis C
E Hypervitaminosis D
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29 Hepatic disfunctions accompanied by insufficient inflow of bile to the bowels result in
coagulation failure. This phenomenon can be explained by:
A Vitamin K deficiency
B Thrombocytopenia
C Leukopenia
D Iron deficiency
E Erythropenia
30 Analysis of urine from a 24-year-old man revealed the following changes: daily diuresis 10 l, relative density - 1,001, qualitative alterations are absent. A patient complains of
excessive thirst, frequent urination. What is the most likely cause of this disease?
A Vasopressin hyposecretion
B Vasopressin hypersecretion
C Relative insulin insufficiency
D Aldosteron hypersecretion
E Glucocorticoid hypersecretion
31 Dehelmintization of a patient revealed some long fragments of a helminth with
segmented structure. Mature segments were rectangular, 30x12 mm large, closed-type
matrix was in form of a stem with 17-35 lateral branches. Specify this helminth:
A Dwarf tapeworm
B Hookless tapeworm
C Armed tapeworm
D Alveococcus
E Echinococcus
32 Coprological examination of a patient’s feces revealed small operculate eggs. It is known
from the anamnesis that the patient often consumes fish. What fluke parasitizes in the
patient’s organism?
A Liver fluke
B Lancet fluke
C Blood fluke
D Cat liver fluke
E Lung fluke
33 Examination of a child who hasn’t got fresh fruit and vegetables during winter revealed
numerous subcutaneous hemorrhages, gingivitis, carious cavities in teeth. What vitamin
combination should be prescribed in this case?
A Thiamine and pyridoxine
B Calciferol and ascorbic acid
C Folic acid and cobalamin
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D Ascorbic acid and rutin
E Riboflavin and nicotinamide
34 A patient with high obesity was recommended to take carnitine as a food additive for
better fat burning. What function is fulfilled by carnitine in the process of fat oxidation?
A Transport of fatty acids from the fat depots to the tissues
B Intracellular lipolysis activation
C Transport of fatty acids from the cytosol to the mitochondria
D Participation in one of the reactions of beta-oxidation of fatty acids
E Fatty acid activation
35 A one year old child has enlarged head and belly, retarded cutting of teeth, destruction of
enamel structure. What hypovitaminosis causes these changes?
A Hypovitaminosis C
B Hypovitaminosis A
C Hypovitaminosis B 1
D Hypovitaminosis D
E Hypovitaminosis B2
36 A non trained man has usually muscular hypoxy after a sprint. What metabolite
accumulates in the muscles as a result of it?
A Glucose 6-phosphate
B Ketone bodies
C Lactate
D Oxaloacetate
E37 During physical exercise people are less sensitive to pain. The reason for it is the
activation of:
A Nociceptive system
B Antinociceptive system
C Adrenal gland functions
D Sympathoadrenal system
E Thyroid gland functions
38 A patient applied to a doctor complaining about dizziness, memory impairment,
periodical convulsions. It was found out that such changes were caused by a product of
glutamic acid decarboxylation. What product is meant?
A ATP
B GABA
C Thymidine diphosphate
D Tetrahydrofolate
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E Pyridoxalphosphate
39 A patient has liver cirrhosis. Analysis of what substance excreted with urine may
characterize the state of antitoxic liver function?
A Uric acid
B Creatinine
C Hippuric acid
D Amino acids
E Ammonian salts
40 A child has abnormal formation of tooth enamel and dentin as a result of low
concentration of calcium ions in blood. Such abnormalities might be caused by deficiency of
the following hormone:
A Thyroxin
B Triiodothyronine
C Somatotropic hormone
D Thyrocalcitonin
E Parathormone
41 While the examination of patient’s oral cavity the dentist found xerostomia, numerous
erosions. What vitamin deficit caused this effect?
A Vitamin H
B Vitamin P
C Vitamin PP
D Vitamin K
E Vitamin A
42 A 42 year old woman diagnosed with diabetes mellitus was admitted the
endocrinological department with complaints of thirst, excessive appetite. What
pathological components are revealed in course of laboratory examination of the patients
urine?
A Blood
B Glucose, ketone bodies
C Protein, aminoacids
D Bilirubin, urobilin
E Protein, creatine
43 Microscopical examination of a surgical specimen (an ulcered part of a lip) revealed in
the connective tissue of mucous membrane near the borders and under the floor of the
ulcer some epithelial complexes consisting of atypic multi-stratal epithelium with
accumulations of bright pink concentric formations. What pathology is it?
A Squamous cell keratinous carcinoma
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B Basal cell carcinoma
C Papilloma
D Transitional cell carcinoma
E Squamous cell nonkeratinous carcinoma
44 A patient has the folowing changes: disorder of twilight vision, drying out of conjunctiva
and cornea. Such disorders may be caused by deficiency of vitamin:
A Vitamin C
B Vitamin D
C Vitamin B12
D Vitamin B
E Vitamin A
45 A chiled was diagnosed with acute renal failure. What biochemic saliva indices can
confirm this diagnosis?
A Decreased level of phosphate
B Increased level of rest nitrogen
C Reduction of alkaline phosphatase
D Increase of alpha amylase
E Increase of immunoglobuline A
46 For assessment of the neutralizing function of liver a patient with chronic hepatitis went
through a test with natrium benzoate load. The excretion of what acid with urine will
characterize the neutralizing function of liver?
A Valeric acid
B Hippuric acid
C Oxalic acid
D Citric acid
E Phenylacetic acid
47 Microscopical examination of discharges from the gums of a patient ill with paradontosis
revealed some protozoan pear-shaped organisms 6-13 micrometer long. The parasite has
one nucleus and undulating membrane, there are four flagella at the front of its body. What
protozoan were found?
A Amoebae
B Trichomonads
C Balantidia
D Leishmania
E Lamblia
48 A female patient has symptoms of inflammation of urogenital tracts. A smear from the
vaginal mucous membrane contained big unicellular pyriform organisms with a sharp spike
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on the back end of their bodies; big nucleus and undulating membrane. What protozoa were
revealed in the smear?
A Trichomonas buccalis
B Trypanosoma gambiense
C Lamblia intestinalis
D Trichomonas vaginalis
E Trichomonas hominis
49 A 57 year old patient with diabetes mellitus was developed ketoacedosis. Biochemical
base of this condition is decrease of acetyl-CoA utilization. What cell compound deficit
causes this effect?
A 2-oxoglutarate
B Succinate
C Aspartate
D Glutamate
E Oxaloacetate
50 A sportsman needs to improve his sporting results. He was recommended a drug
containing carnitine. What process is activated by this compound in the first place?
A Transport of vitamin K
B Transport of calcium ions
C Transport of amino acids
D Transport of glucose
E Transport of fatty acids
51 Patient with pigmentary xeroderma are characterized by anamalously high sensivity to
ultraviolet rays that causes skin cancer as a result of enzyme systems incapability to restore
damages of hereditary apparatus of cells. What process abnormality is this pathology
connected with?
A DNA reparation
B DNA reduplication
C Genetic complementation
D DNA recombination
E Genetic conversion
52 Among public catering workers examined by doctors of sanitary-and-epidemiologic
station often occur asymptomatic parasite carriers. This means that a healthy person
carries cysts that infect other people. Such parasitizing is impossible for the following
causative agent:
A Malarial plasmodium
B Viscerotropic leishmania
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C Dermatotropic leishmania
D Intestinal trichomonad
E Dysenteric amoeba
53 A sportsman was recommended to take a preparation with carnitine in order to improve
his achievements. What process is activated by carnitine to the most extent?
A Transporting of fatty acids to the mi-tochondrions
B Synthesis of steroid hormones
C Tissue respiration
D Lypide synthesis
E Synthesis of ketone bodies
54 The 16th tooth of a patient is missing. X-ray picture shows in the depth of alveolar
process rarefaction of bone and a well-defined cavity that contained the underdeveloped
tooth crown. Microscopical examination revealed that the cavity wall was lined with
stratified squamous epithelium and enclosed within a fibrous capsule. Make a diagnosis:
A Cystic ameloblastoma of jaw
B Follicular gnathic cyst
C Primordial gnathic cyst
D Radicular gnathic cyst
E Cyst of the incisive canal
55 A 38 year old patient takes aspirin and sulfanilamides. After their intake intensified
erythrocyte haemolysis is observed which is caused by deficiency of glucose 6-phosphate
dehydrogenase. This pathology is caused by failure of the following coenzyme:
A NADP - H
B Ubiquinone
C FAD - H2
D Pyridoxal phosphate
E FMN - H2
56 A patient has the sudden decrease of Са2+ content in blood. What hormone secretion
will increase?
A Somatotropin
B Vasopressin
C Parathormone
D Aldosterone
E Thyrocalcitonin
57 Examination of urine in a newborn revealed presence of citrulline and high ammonia
concentration. This baby is most likely to have the disorder of the following substance
production:
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A Creatinine
B Uric acid
C Creatine
D Ammonia
E Urea
58 Histological examination of a micro specimen presenting a malignant lung tumour
revealed that the tumor consisted of lymphocyte-like cells forming any structures. Stroma is
mildely marked, there are a lot of mitoses and necroses. What tumour is it?
A Squamous cell keratinous carcinoma
B Adenocarcinoma
C Small cell carcinoma
D Squamous cell nonkeratinous carcinoma
E Fibroma
59 A patient has mental retardation, small height, brachydactyly, mongoloid slant. Analysys
of his karyotype revealed trisomy 21. What chromosomal anomaly is it?
A Trisomy X
B Down’s disease
C Turner’s syndrome
D Klinefelter’s syndrome
E Specific fetopathy
60 To what total ATP quantity is the full glucose oxidation and its linking with
phosphorylation equivalent?
A 38
B8
C 58
D 52
E 12
61 A 2 year old child suffers from intestinal dysbacteriosis that lead to the development
hemorrhagic syndrome. The most probable cause of hemorrhage is:
A Vitamin K deficiency
B Hypovitaminosis PP
C Fibrinogen deficiency
D Hypocalcemia
E Activation of tissue thromboplastin
62 A patient who is ill with scurvy displays disturbed processes of connective tissue
formation that leads to loosening and falling of teeth. Disturbed activity of what enzyme
causes these symptomps?
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A Procollagenpeptidase of N-terminal peptide
B Elastase
C Glycosiltransferase
D Procollagenpeptidase of C-terminal peptide
E Lisilhydroxylase
63 A patient has increased content of uric acid in his blood that is clinically presented by
pain syndrome as a result of urate deposition in the joints. What process does this acid
result from?
A Heme catabolism
B Lysis of purine nucleotides
C Lysis of pyrimidine nucleotides
D Proteolysis
E Reutilization of purine bases
64 A child has disturbed enamel and dentine formation as a result of decreased content of
calcium ions in his blood. What hormone deficiency may cause such changes?
A Thyroxin
B Parathormone
C Triiodothyronine
D Thyreocalcitonin
E Somatotropin
65 While on holiday in the countryside a boy found a spider with the following
morphological peculiarities: body length at the rate of 2 cm, round black abdomen with two
rows of red dots on its dorsal surface, four pairs of segmented extremities covered with tiny
black hairs. Identify this arthropod:
A Mite
B Steppe spider (Latrodectus tredeci-mguttatus)
C Tarantula
D Solifugae
E Scorpion
66 Examination of a 30-year-old man mandible revealed in the region of his molar a dense
tumour-like formation that significantly deformed the mandible. The formation wasnt fully
detached from the bone tissue. Microscopical examination of a tissue sampling revealed that
stroma had some cords and follicles with odontogenous cylindric epithelial cells in
peripheria and stellate cells resembling of the enamel organ pulp in the centre. What is the
most likely diagnosis?
A Osteoclastoma
B Adenomatoid tumour
C Ameloblastoma
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D Primary intraosteal cancer
E Adenocarcinoma
67 Roentgenological examination of a patient revealed a cyst enclosing a tooth in its cavity
in the area of the premolar. Microscopical examination revealed that the cyst wall consisted
of connective tissue and was lined with multilayer squamous epithelium. What is the most
probable diagnosis?
A Follicular cyst
B Primordial cyst
C Radicular cyst
D Eosinophilic granuloma
E Epulis
68 Examination of an ill child’s blood revealed inherited hyperlipoproteinemia. Genetic
defect of what enzyme synthesis causes this phenomenon?
A Lipoprotein lipase
B Phenylalanine hydroxylase
C Proteinase
D Glycosidase
E Hemsynthetase
69 Osteolathyrism is characterized by a loss of tensile strength of collagen, which is induced
by a significant decrease in the formation of cross-links in collagen fibrils. The cause for it is
the reduced activity of:
A Prolyl hydroxylase
B Lysyl hydroxylase
C Collagenase
D Lysyl oxidase
E Monoamine oxidase
70 Up to 50% of world population aged above thirty is affected by paradontosis. The
leading part in pathogenesis of this disease is played by:
A Immune damage of tissues
B Parodontium tissues damaged by kalli-krein
C Parodontium damaged by active cells
D Dental calculus caused by microflora
E Neurodystrophic factor
71 A 10 year old child underwent Mantoux test (with tuberculin). 48 hours later there
apperaed a papule up to 8 mm in diameter on the site of tuberculin injection. Tuberculin
injection caused the following hypersensitivity reaction:
A II type hypersensitivity reaction
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B Arthus reaction
C Seroreaction
D Atopic reaction
E IV type hypersensitivity reaction
72 During examination of a 36-year-old woman a dentist revealed a formation in form of a
nodule up to 0,8 cm in diameter, of dark brown-red colour, soft, on a wide base. The
formation was found on the buccal surface of gum in the region of the 2nd molar.
Histological examination revealed that the formation had plenty of sinusoid vessels and a
lot of roundish mononuclear and big multinuclear cells; in some parts accumulations of
hemosiderin granules could be found. What is the most likely diagnosis?
A Giant-cell epulis
B Angiomatous epulis
C Mandibular osteoclastoma
D Ameloblastoma
E Root granuloma
73 A patient with chronic hypoglycemia had adrenaline introduction. After introduction
blood test has not changed essentially. Doctor assumed liver pathology. What liver function
may have been changed?
A Excretory function
B Function of cholesterin production
C Glycolytic function
D Ketogenic function
E Function of glycogen depositing
74 A 28 year old woman consulted a doctor about sterility. Examination revealed
underdeveloped ovaries and uterus, irregular menstrual cycle. Study of sex chromatin
revealed 2 Barr’s bodies in most somatic cells. What chromosome disease is the most
probable in this case?
A Turner’s syndrome
B Patau’s syndrome
C Edwards’ syndrome
D Klinefelter’s syndrome
E Triplo-X syndrome
75 A patient with focal tuberculosis of superior lobe of his right lung takes isoni-azid as a
part of combined therapy. After a time he started complaining of muscular weakness,
decrease of skin sensitivity, sight and movement coordination disorder. What vitamin
preparation will be right for elimination of these occurances?
A Vitamin A
B Vitamin D
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C Vitamin C
D Vitamin B6
E Vitamin B12
76 A dentist was examining oral cavity of a 9 year old child in the buccal surface of gingiva
in the area of the lower canine he revealed a red, soft, node-like formation 1 cm in diameter
that started immediately bleeding when touched. Microscopical examination revealed that
this formation consisted of many small vessels like venules and capillaries separated by thin
layers of connective tissue, with focal infiltration by lymphoid and plasmatic cells. Such
changes are typical for:
A Fibrous epulis
B Papilloma
C Capillary hemangioma
D Radicular granuloma
E Angiomatous epulis
77 After implantation of a cardiac valve a young man constantly takes indirect
anticoagulants. His state was complicated by hemorrhage. What substance content has
decreased in blood?
A Ceruloplasmin
B Heparin
C Prothrombin
D Creatin
E Haptoglobin
78 Decreased ratio of adenylic nucleotides ATP/ADP results in intensified glycolysis in
parodentium tissues in hypoxic conditions. What reaction is activated in this case?
A Lactate dehydrogenase
B Phosphofructokinase
C Enolase
D Triosophosphate isomerase
E Aldolase
79 A patient has deformation of jaw bones. Histological examination revealed there growth
of fibrocellular tumourlike ill-defined tissue with primitive osteogenesis. What disease are
these presentations typical for?
A Ameloblastoma
B Fibrous dysplasia
C Osteosarcoma
D Parathyroid osteodystrophy
E Eosinophilic granuloma
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80 In order to speed up healing of the thermal injury it is required to prescribe a drug that
facilitates epithelization of skin and mucous membranes. What drug is it?
A Ascorbic acid
B Retinol acetate
C Tocopherol acetate
D Nicotinic acid
E Ergocalciferol
81 A patient with diabetes mellitus had an insuline injection. It caused loss of consciousness
and convulsions. What was the result of biochemic blood analysis on glucose content?
A 3,3 mmole/l
B 10 mmole/l
C 2,5 mmole/l
D 5,5 mmole/l
E 8,0 mmole/l
82 A blood smear of a patient who has recently recovered from flu contains 10% of
roundish cells 4,5-7 micrometer large with a big round nucleus and basophi-lically stained
cytoplasm in form of a narrow border around the nucleus. What blood status are they
typical for?
A Lymphocytopenia
B Leukopenia
C Monocytopenia
D Thrombopenia
E Lymphocytosis
83 A patient was taken to the hospital with preliminary diagnosis progressive muscle
distrophy. What substance will be excessively contained in urine and confirm this
diagnosis?
A Troponine
B Hydroxiproline
C Carnosine
D Creatine
E Pyruvate
84 Chronic overdosage of glucocorticoids leads to the development of hyperglycemia. What
process of carbohydrate metabolism is responsible for this effect?
A Aerobic glycolisis
B Glycogenolysis
C Gluconeogenesis
D Pentose-phosphate cycle
V 02b91030
E Glycogenesis
85 Cytogenetic examination of a patient with dysfunction of the reproductive system
revealed normal karyotype 46,XY in some cells, but most cells have Klinefelter’s syndrome
karyotype - 47,XXY Such phenomenon of cell inhomogeneity is called:
A Duplication
B Heterogeneity
C Transposition
D Mosaicism
E Inversion
86 Myocyte cytoplasm contains a big number of dissolved metabolites of glucose oxidation.
Name one of them that turns directly into lactate:
A Fructose 6-phosphate
B Oxaloacetate
C Glucose 6-phosphate
D Pyruvate
E Glycerophosphate
V 02b91030
Keys: 1 B, 2 C, 3 D, 4 C, 5 B, 6 C, 7 D, 8 A, 9 D, 10 C, 11 E, 12 B, 13 A, 14 E, 15 E, 16 D, 17 B,
18 D, 19 C, 20 A, 21 B, 22 B, 23 E, 24 D, 25 A, 26 C, 27 E, 28 D, 29 A, 30 A, 31 B, 32 D, 33 D,
34 C, 35 D, 36 C, 37 B, 38 B, 39 C, 40 E, 41 E, 42 B, 43 A, 44 E, 45 B, 46 B, 47 B, 48 D, 49 E,
50 E, 51 A, 52 E, 53 A, 54 B, 55 A, 56 C, 57 E, 58 C, 59 B, 60 A, 61 A, 62 E, 63 B, 64 D, 65 B,
66 C, 67 A, 68 A, 69 D, 70 E, 71 E, 72 A, 73 E, 74 E, 75 D, 76 E, 77 C, 78 B, 79 B, 80 B, 81 C,
82 A, 83 D, 84 C, 85 D, 86 D,
Krok \ Dentistry \ Krok 1 \ Bases \ Biochemistry \ 2010
V 98705547
1 A child has disturbed processes of ossification and punctate enamel. What microelement metabolism is
disturbed?
A Iron
B Zinc
C Fluorine
D Chromium
E Copper
2 A patient applied to a doctor complaining about dizziness, memory impairment, periodical convulsions.
It was found out that such changes were caused by a product of glutamic acid decarboxylation. What
product is meant?
A Pyridoxalphosphate
B GABA
C Tetrahydrofolate
D Thymidine diphosphate
E ATP
3 Laboratory examination of a child revealed high content of leucine, valine, isoleucine and their
ketoderivates in blood and urine. Urine had the typical smell of maple syrup. This disease was caused by
deficiency of the following enzyme:
A Aminotransferase
B Phosphofructokinase
C Glucose-6-phosphatase
D Dehydrogenase of branched amino acids
E phosphofructomutase
4 A 40-year-old male patient had a tumour-like formation 8x7 cm large on his neck. A surgeon removed it
only partially because of close connection with large vessels. Microscopical examination revealed
marked cellular and tissue atypism, lipoblast-type cells in different stages of maturity, with
polymorphism and nuclear hyperchromia, pathological mitoses, necrosis foci. Specify the histological
form of the tumour:
A Lipoma
B Fibrosarcoma
C Liposarcoma
D Hibernoma
E Fibroma
5 A non trained man has usually muscular hypoxy after a sprint. What metabolite accumulates in the
muscles as a result of it?
A Oxaloacetate
B Ketone bodies
C Lactate
D Glucose 6-phosphate
E6 A 10 year old child underwent Mantoux test (with tuberculin). 48 hours later there apperaed a papule
up to 8 mm in diameter on the site of tuberculin injection. Tuberculin injection caused the following
hypersensitivity reaction:
A Arthus reaction
B Seroreaction
C II type hypersensitivity reaction
D Atopic reaction
E IV type hypersensitivity reaction
7 A patient with high obesity was recommended to take carnitine as a food additive for better fat
burning. What function is fulfilled by carnitine in the process of fat oxidation?
A Fatty acid activation
B Participation in one of the reactions of beta-oxidation of fatty acids
C Transport of fatty acids from the fat depots to the tissues
D Intracellular lipolysis activation
E Transport of fatty acids from the cytosol to the mitochondria
8 A blood smear of a patient who has recently recovered from flu contains 10% of roundish cells 4,5-7
micrometer large with a big round nucleus and basophi-lically stained cytoplasm in form of a narrow
border around the nucleus. What blood status are they typical for?
A Leukopenia
B Lymphocytosis
C Monocytopenia
D Thrombopenia
E Lymphocytopenia
9 Hepatic disfunctions accompanied by insufficient inflow of bile to the bowels result in coagulation
failure. This phenomenon can be explained by:
A Erythropenia
B Vitamin K deficiency
C Thrombocytopenia
D Leukopenia
E Iron deficiency
10 A patient has increased content of uric acid in his blood that is clinically presented by pain syndrome
as a result of urate deposition in the joints. What process does this acid result from?
A Proteolysis
B Heme catabolism
C Lysis of pyrimidine nucleotides
D Lysis of purine nucleotides
E Reutilization of purine bases
11 Examination of urine in a newborn revealed presence of citrulline and high ammonia concentration.
This baby is most likely to have the disorder of the following substance production:
A Creatinine
B Uric acid
C Creatine
D Urea
E Ammonia
12 A patient has liver cirrhosis. Analysis of what substance excreted with urine may characterize the
state of antitoxic liver function?
A Uric acid
B Creatinine
C Hippuric acid
D Amino acids
E Ammonian salts
13 While the examination of patient’s oral cavity the dentist found xerostomia, numerous erosions. What
vitamin deficit caused this effect?
A Vitamin PP
B Vitamin K
C Vitamin P
D Vitamin A
E Vitamin H
14 A patient has increased permeability of blood-vessel walls, increased gingival hemorrhage, small
punctate hematomas on his skin, falling of teeth. What disturbance of vitamun metabolism can account
for these symptoms?
A Hypervitaminosis D
B Hypovitaminosis A
C Hypovitaminosis C
D Hypovitaminosis D
E Hypervitaminosis C
15 The activity of parotides reduces with age. Activity of what enzyme in saliva will be reducing?
A Lysozime
B Maltase
C Hexokinase
D Amylase
E Phosphatase
16 Analysis of urine from a 24-year-old man revealed the following changes: daily diuresis - 10 l, relative
density - 1,001, qualitative alterations are absent. A patient complains of excessive thirst, frequent
urination. What is the most likely cause of this disease?
A Aldosteron hypersecretion
B Relative insulin insufficiency
C Vasopressin hyposecretion
D Glucocorticoid hypersecretion
E Vasopressin hypersecretion
17 A female patient has symptoms of inflammation of urogenital tracts. A smear from the vaginal
mucous membrane contained big unicellular pyriform organisms with a sharp spike on the back end of
their bodies; big nucleus and undulating membrane. What protozoa were revealed in the smear?
A Trichomonas buccalis
B Trypanosoma gambiense
C Trichomonas hominis
D Trichomonas vaginalis
E Lamblia intestinalis
18 A patient suffering from syphilis was prescribed a drug the action of which based upon disturbed
generation of murein leading to death of the causative agent. What drug is it?
A Azithromycin
B Bijochinol
C Ciprofloxacin
D Benzylpenicillin sodium salt
E Doxycycline hydrochloride
19 Decreased ratio of adenylic nucleotides ATP/ADP results in intensified glycolysis in parodentium
tissues in hypoxic conditions. What reaction is activated in this case?
A Lactate dehydrogenase
B Triosophosphate isomerase
C Phosphofructokinase
D Aldolase
E Enolase
20 Examination of a 6 days old infant revealed phenyl pyruvate and phenyl acetate excess in his urine.
What ami-noacid metabolism is disturbed in the child’s organism?
A Tryptophan
B Histidine
C Phenylalanine
D Methionine
E Arginine
21 Examination of a child who hasn’t got fresh fruit and vegetables during winter revealed numerous
subcutaneous hemorrhages, gingivitis, carious cavities in teeth. What vitamin combination should be
prescribed in this case?
A Ascorbic acid and rutin
B Folic acid and cobalamin
C Thiamine and pyridoxine
D Riboflavin and nicotinamide
E Calciferol and ascorbic acid
22 Two weeks after hemotransfusion a patient developed fever. What protozoal disease can be
suspected?
A Trypanosomiasis
B Amebiasis
C Leishmaniasis
D Toxoplasmosis
E Malaria
23 Osteolathyrism is characterized by a loss of tensile strength of collagen, which is induced by a
significant decrease in the formation of cross-links in collagen fibrils. The cause for it is the reduced
activity of:
A Lysyl oxidase
B Prolyl hydroxylase
C Collagenase
D Monoamine oxidase
E Lysyl hydroxylase
24 A sportsman needs to improve his sporting results. He was recommended a drug containing
carnitine. What process is activated by this compound in the first place?
A Transport of glucose
B Transport of vitamin K
C Transport of amino acids
D Transport of calcium ions
E Transport of fatty acids
25 While on holiday in the countryside a boy found a spider with the following morphological
peculiarities: body length at the rate of 2 cm, round black abdomen with two rows of red dots on its
dorsal surface, four pairs of segmented extremities covered with tiny black hairs. Identify this arthropod:
A Scorpion
B Tarantula
C Mite
D Solifugae
E Steppe spider (Latrodectus tredeci-mguttatus)
26 A patient has deformation of jaw bones. Histological examination revealed there growth of
fibrocellular tumourlike ill-defined tissue with primitive osteogenesis. What disease are these
presentations typical for?
A Eosinophilic granuloma
B Parathyroid osteodystrophy
C Ameloblastoma
D Osteosarcoma
E Fibrous dysplasia
27 During physical exercise people are less sensitive to pain. The reason for it is the activation of:
A Antinociceptive system
B Sympathoadrenal system
C Thyroid gland functions
D Adrenal gland functions
E Nociceptive system
28 To what total ATP quantity is the full glucose oxidation and its linking with phosphorylation
equivalent?
A 12
B 58
C 52
D8
E 38
29 A 2 year old child suffers from intestinal dysbacteriosis that lead to the development hemorrhagic
syndrome. The most probable cause of hemorrhage is:
A Hypovitaminosis PP
B Activation of tissue thromboplastin
C Hypocalcemia
D Fibrinogen deficiency
E Vitamin K deficiency
30 A patient with chronic hypoglycemia had adrenaline introduction. After introduction blood test has
not changed essentially. Doctor assumed liver pathology. What liver function may have been changed?
A Ketogenic function
B Excretory function
C Glycolytic function
D Function of cholesterin production
E Function of glycogen depositing
31 Patient with pigmentary xeroderma are characterized by anamalously high sensivity to ultraviolet
rays that causes skin cancer as a result of enzyme systems incapability to restore damages of hereditary
apparatus of cells. What process abnormality is this pathology connected with?
A Genetic conversion
B DNA reduplication
C Genetic complementation
D DNA reparation
E DNA recombination
32 A 57 year old patient with diabetes mellitus was developed ketoacedosis. Biochemical base of this
condition is decrease of acetyl-CoA utilization. What cell compound deficit causes this effect?
A Glutamate
B Oxaloacetate
C 2-oxoglutarate
D Succinate
E Aspartate
33 Microscopical examination of a surgical specimen (an ulcered part of a lip) revealed in the connective
tissue of mucous membrane near the borders and under the floor of the ulcer some epithelial complexes
consisting of atypic multi-stratal epithelium with accumulations of bright pink concentric formations.
What pathology is it?
A Squamous cell nonkeratinous carcinoma
B Transitional cell carcinoma
C Papilloma
D Basal cell carcinoma
E Squamous cell keratinous carcinoma
34 Active physical work induces rise of concentration of carbonic acid in blood. This causes deepening
and acceleration of respiration thus reducing concentration of carbonic acid and hydrogen ions in blood.
This maintains the following process:
A Ontogenesis
B Orthobiosis
C Immunity
D Homeostasis
E Anabiosis
35 A patient who is ill with scurvy displays disturbed processes of connective tissue formation that leads
to loosening and falling of teeth. Disturbed activity of what enzyme causes these symptomps?
A Lisilhydroxylase
B Elastase
C Glycosiltransferase
D Procollagenpeptidase of N-terminal peptide
E Procollagenpeptidase of C-terminal peptide
36 Helminthological examination of patient’s feces revealed oval brown eggs with tuberous external
membrane. Name the type of helminth:
A Ascarid
B Broad tapeworm
C Dwarf tapeworm
D Whipworm
E Pinworm
37 A dentist was examining oral cavity of a 9 year old child in the buccal surface of gingiva in the area of
the lower canine he revealed a red, soft, node-like formation 1 cm in diameter that started immediately
bleeding when touched. Microscopical examination revealed that this formation consisted of many small
vessels like venules and capillaries separated by thin layers of connective tissue, with focal infiltration by
lymphoid and plasmatic cells. Such changes are typical for:
A Fibrous epulis
B Angiomatous epulis
C Radicular granuloma
D Papilloma
E Capillary hemangioma
38 In the mountains some clinically healthy people present with anaemia symptoms. Blood test can
reveal sickle cells. What is the genotype of such people?
A XCXc
B XcXc
C AA
D Aa
E aa
39 A 15 year old girl was delivered to the hospital with inflammation of vermiform appendix. Blood
analysis revealed signs of anaemia. Her feces contained lemon-shaped helminthic eggs (50x30
micrometer) with "plugs" on the poles. What type of helminth is it?
A Echinococcus
B Trichuris
C Hookworm
D Pinworm
E Hymenolepis nana
40 Coprological examination of a patient’s feces revealed small operculate eggs. It is known from the
anamnesis that the patient often consumes fish. What fluke parasitizes in the patient’s organism?
A Lung fluke
B Lancet fluke
C Cat liver fluke
D Liver fluke
E Blood fluke
41 Dehelmintization of a patient revealed some long fragments of a helminth with segmented structure.
Mature segments were rectangular, 30x12 mm large, closed-type matrix was in form of a stem with 1735 lateral branches. Specify this helminth:
A Armed tapeworm
B Echinococcus
C Dwarf tapeworm
D Alveococcus
E Hookless tapeworm
42 Roentgenological examination of a patient revealed a cyst enclosing a tooth in its cavity in the area of
the premolar. Microscopical examination revealed that the cyst wall consisted of connective tissue and
was lined with multilayer squamous epithelium. What is the most probable diagnosis?
A Radicular cyst
B Epulis
C Primordial cyst
D Eosinophilic granuloma
E Follicular cyst
43 Up to 50% of world population aged above thirty is affected by paradontosis. The leading part in
pathogenesis of this disease is played by:
A Parodontium tissues damaged by kalli-krein
B Dental calculus caused by microflora
C Neurodystrophic factor
D Parodontium damaged by active cells
E Immune damage of tissues
44 Cytogenetic examination of a patient with dysfunction of the reproductive system revealed normal
karyotype 46,XY in some cells, but most cells have Klinefelter’s syndrome karyotype - 47,XXY Such
phenomenon of cell inhomogeneity is called:
A Duplication
B Inversion
C Transposition
D Mosaicism
E Heterogeneity
45 A patient has the folowing changes: disorder of twilight vision, drying out of conjunctiva and cornea.
Such disorders may be caused by deficiency of vitamin:
A Vitamin C
B Vitamin A
C Vitamin B12
D Vitamin D
E Vitamin B
46 In compliance with the clinical presentations a man was prescribed pyri-doxalphosphate. What
processes are corrected by this preparation?
A Synthesis of purine and pyrimidine bases
B Protein synthesis
C Oxidative decarboxilation of keto acids
D Desamination of purine nucleotides
E Transamination and decarboxylation of amino acids
47 In order to speed up healing of the thermal injury it is required to prescribe a drug that facilitates
epithelization of skin and mucous membranes. What drug is it?
A Retinol acetate
B Ascorbic acid
C Nicotinic acid
D Tocopherol acetate
E Ergocalciferol
48 A sportsman was recommended to take a preparation with carnitine in order to improve his
achievements. What process is activated by carnitine to the most extent?
A Synthesis of ketone bodies
B Lypide synthesis
C Synthesis of steroid hormones
D Transporting of fatty acids to the mi-tochondrions
E Tissue respiration
49 Examination of a 10 y.o. child revealed on the alveolar submandibular process a fixed tumourous
mass 1,5 cm in diameter closing premolar crown on the vestibular side. Mucous membrane of its surface
is reddish-brown, it bleeds as a reaction to a slight mechanical intervention. Biopsy results: the mass
consists of small size vessels separated by thin layers of connective tissue and infiltrated by plasmocytes,
mucous membrane is here and there ulcered. What is the most probable diagnosis?
A Angiomatous form of epulis
B Gingival fibromatosis
C Hypertrophic gingivitis
D Giant cell form of epulis
E Fibrous form of epulis
50 Chronic overdosage of glucocorticoids leads to the development of hyperglycemia. What process of
carbohydrate metabolism is responsible for this effect?
A Aerobic glycolisis
B Glycogenolysis
C Pentose-phosphate cycle
D Glycogenesis
E Gluconeogenesis
51 While examining a blood smear taken form a patient and stained by Romanovsky’s method a doctor
revealed some protozoa and diagnozed the patient with Chagas disease. What protozoan is the causative
agent of this disease?
A Toxoplasma gondii
B Leishmania tropica
C Leishmania donovani
D Trypanosoma brucei
E Trypanosoma cruzi
52 A patient has mental retardation, small height, brachydactyly, mongoloid slant. Analysys of his
karyotype revealed trisomy 21. What chromosomal anomaly is it?
A Trisomy X
B Down’s disease
C Klinefelter’s syndrome
D Specific fetopathy
E Turner’s syndrome
53 Histological examination of a micro specimen presenting a malignant lung tumour revealed that the
tumor consisted of lymphocyte-like cells forming any structures. Stroma is mildely marked, there are a
lot of mitoses and necroses. What tumour is it?
A Squamous cell keratinous carcinoma
B Squamous cell nonkeratinous carcinoma
C Adenocarcinoma
D Small cell carcinoma
E Fibroma
54 A child has abnormal formation of tooth enamel and dentin as a result of low concentration of calcium
ions in blood. Such abnormalities might be caused by deficiency of the following hormone:
A Thyrocalcitonin
B Parathormone
C Triiodothyronine
D Thyroxin
E Somatotropic hormone
55 A child has disturbed enamel and dentine formation as a result of decreased content of calcium ions
in his blood. What hormone deficiency may cause such changes?
A Thyroxin
B Triiodothyronine
C Thyreocalcitonin
D Parathormone
E Somatotropin
56 Microscopical examination of discharges from the gums of a patient ill with paradontosis revealed
some protozoan pear-shaped organisms 6-13 micrometer long. The parasite has one nucleus and
undulating membrane, there are four flagella at the front of its body. What protozoan were found?
A Trichomonads
B Leishmania
C Balantidia
D Lamblia
E Amoebae
57 Examination of a 30-year-old man mandible revealed in the region of his molar a dense tumour-like
formation that significantly deformed the mandible. The formation wasnt fully detached from the bone
tissue. Microscopical examination of a tissue sampling revealed that stroma had some cords and follicles
with odontogenous cylindric epithelial cells in peripheria and stellate cells resembling of the enamel
organ pulp in the centre. What is the most likely diagnosis?
A Adenomatoid tumour
B Ameloblastoma
C Adenocarcinoma
D Osteoclastoma
E Primary intraosteal cancer
58 For assessment of the neutralizing function of liver a patient with chronic hepatitis went through a
test with natrium benzoate load. The excretion of what acid with urine will characterize the neutralizing
function of liver?
A Valeric acid
B Citric acid
C Phenylacetic acid
D Oxalic acid
E Hippuric acid
59 A patient has the sudden decrease of Са2+ content in blood. What hormone secretion will increase?
A Parathormone
B Aldosterone
C Vasopressin
D Thyrocalcitonin
E Somatotropin
60 A sample taken from the pharynx of a patient with angina was inoculated on the blood-tellurite agar.
This resulted in growth of grey, radially striated (in form of rosettes) colonies up to 4-5 mm in diameter.
Microscopically there can be seen gram-positive rods with club-shaped ends arranged in form of spread
fingers. What microorganisms are these?
A Diphtheroids
B Streptococci
C Streptobacilli
D Clostridium botulinum
E Corynebacteria diphtheriae
61 Periodontitis is accompanied by activation of proteolysis in the periodontium tissues. The evidence of
proteolysis activation is increase of the following component of oral liquid:
A Cholesterol
B Amino acids
C Organic acids
D Glucose
E Biogenic amines
62 Roentgenological examination of mandible of a 27 year old man revealed a focus of osseous tissue
destruction. Histological examination revealed a tumour consisting of odontogenous epithelium cords,
immature connective tissue and dysplastic dentin rests. What tumour is it?
A Ameloblastic fibro-odontoma
B Odontoameloblastoma
C Odontogenous fibroma
D Dentinoma
E Complex odontoma
63 Cyanide poisoning causes immediate death. What is the mechanism of cyanide effect at the molecular
level?
A They bind substrates of tricarboxylic acid cycle
B They block succinate dehydrogenase
C They inhibit cytochrome B
D They inactivate oxygene
E They inhibit cytochromoxidase
64 A 28 year old pregnant woman had the enzymes in the cells of amniotic fluid analyzed. The analysis
revealed insufficient activity of beta-glucuronidase. What pathological process is it?
A Mucopolysaccharidosis
B Collagenosis
C Glycogenosis
D Lipidosis
E Aglycogenosis
65 The first grade pupils went through a medical examination aimed at selection of children needing
tuberculosis revaccination. What test was applied?
A Mantoux test
B Anthracene test
C Supracutaneous tularin test
D Burne test
E Schick test
66 A patient was taken to the hospital with preliminary diagnosis progressive muscle distrophy. What
substance will be excessively contained in urine and confirm this diagnosis?
A Troponine
B Carnosine
C Creatine
D Pyruvate
E Hydroxiproline
67 A patient has roundish ulcers on his face, inflammation and enlargement of lymph nodes. These
symptoms turned up as a result of mosquito bites. Laboratory examination of discharge from the ulcers
revealed unicellular aflagellar organisms. What is the most probable diagnosis?
A Toxoplasmosis
B Scabies
C Myasis
D Dermatotropic leishmaniasis
E Trypanosomiasis
68 A patient with focal tuberculosis of superior lobe of his right lung takes isoni-azid as a part of
combined therapy. After a time he started complaining of muscular weakness, decrease of skin
sensitivity, sight and movement coordination disorder. What vitamin preparation will be right for
elimination of these occurances?
A Vitamin D
B Vitamin C
C Vitamin B6
D Vitamin A
E Vitamin B12
69 A girl who was provisionally diagnosed with Turner’s syndrome came to a genetic consultation. The
diagnosis can be specified by means of the following genetic method:
A Sex chromatin test
B Dermatoglyphics
C Genealogical
D Hybridological
E Biochemical
70 A patient has painfulness along big nerve trunks and excessive content of pyruvate in blood. What
vitamin deficit may cause such changes?
A PP
B Pantothenic acid
C B2
D Biotin
EBi
71 Myocyte cytoplasm contains a big number of dissolved metabolites of glucose oxidation. Name one of
them that turns directly into lactate:
A Glucose 6-phosphate
B Pyruvate
C Fructose 6-phosphate
D Oxaloacetate
E Glycerophosphate
72 A hospital admitted a patient with complaints about abdominal swelling, diarrhea, meteorism after
consumption of food rich in proteins. It is indicative of disturbed protein digestion and their intensified
decaying. What substance is the product of this process in the bowels?
A Bilirubin
B Agmatine
C Indole
D Putrescine
E Cadaverine
73 A 38 year old patient takes aspirin and sulfanilamides. After their intake intensified erythrocyte
haemolysis is observed which is caused by deficiency of glucose 6-phosphate dehydrogenase. This
pathology is caused by failure of the following coenzyme:
A FAD - H2
B NADP - H
C Pyridoxal phosphate
D Ubiquinone
E FMN - H2
74 The 16th tooth of a patient is missing. X-ray picture shows in the depth of alveolar process
rarefaction of bone and a well-defined cavity that contained the underdeveloped tooth crown.
Microscopical examination revealed that the cavity wall was lined with stratified squamous epithelium
and enclosed within a fibrous capsule. Make a diagnosis:
A Primordial gnathic cyst
B Follicular gnathic cyst
C Radicular gnathic cyst
D Cyst of the incisive canal
E Cystic ameloblastoma of jaw
75 A chiled was diagnosed with acute renal failure. What biochemic saliva indices can confirm this
diagnosis?
A Increase of alpha amylase
B Reduction of alkaline phosphatase
C Decreased level of phosphate
D Increase of immunoglobuline A
E Increased level of rest nitrogen
76 A 42 year old woman diagnosed with diabetes mellitus was admitted the endocrinological department
with complaints of thirst, excessive appetite. What pathological components are revealed in course of
laboratory examination of the patients urine?
A Protein, aminoacids
B Bilirubin, urobilin
C Glucose, ketone bodies
D Blood
E Protein, creatine
77 A man got poisoned with mushrooms. They contain muscarine that stimulates muscarinic
cholinoreceptors. What symptom is typical for poisoning with inedible mushrooms?
A Heart rate rise
B Bronchi dilation
C Miosis
D Mydriasis
E Arterial pressure rise
78 Examination of an ill child’s blood revealed inherited hyperlipoproteinemia. Genetic defect of what
enzyme synthesis causes this phenomenon?
A Phenylalanine hydroxylase
B Lipoprotein lipase
C Hemsynthetase
D Proteinase
E Glycosidase
79 After implantation of a cardiac valve a young man constantly takes indirect anticoagulants. His state
was complicated by hemorrhage. What substance content has decreased in blood?
A Ceruloplasmin
B Haptoglobin
C Creatin
D Heparin
E Prothrombin
80 A 28 year old woman consulted a doctor about sterility. Examination revealed underdeveloped
ovaries and uterus, irregular menstrual cycle. Study of sex chromatin revealed 2 Barr’s bodies in most
somatic cells. What chromosome disease is the most probable in this case?
A Turner’s syndrome
B Triplo-X syndrome
C Patau’s syndrome
D Edwards’ syndrome
E Klinefelter’s syndrome
81 Laboratory of extremely dangerous infections received a sample taken from a patient with assumed
cholera. What express-diagnostics method can confirm this diagnosis?
A Hemagglutination reaction
B Precipitation reaction
C Complement binding reaction
D Immunofluorescence test
E Agglutination test
82 Among public catering workers examined by doctors of sanitary-and-epidemiologic station often
occur asymptomatic parasite carriers. This means that a healthy person carries cysts that infect other
people. Such parasitizing is impossible for the following causative agent:
A Intestinal trichomonad
B Viscerotropic leishmania
C Dermatotropic leishmania
D Malarial plasmodium
E Dysenteric amoeba
83 During examination of a 36-year-old woman a dentist revealed a formation in form of a nodule up to
0,8 cm in diameter, of dark brown-red colour, soft, on a wide base. The formation was found on the
buccal surface of gum in the region of the 2nd molar. Histological examination revealed that the
formation had plenty of sinusoid vessels and a lot of roundish mononuclear and big multinuclear cells; in
some parts accumulations of hemosiderin granules could be found. What is the most likely diagnosis?
A Angiomatous epulis
B Root granuloma
C Mandibular osteoclastoma
D Giant-cell epulis
E Ameloblastoma
84 A patient was diagnosed with seborrheic dermatitis associated with vitamin H (biotin) deficiency. The
patient has disturbed activity of the following enzyme:
A Pyruvate decarboxylase
B Amino transferase
C Alcohol dehydrogenase
D Carbomoyl phosphate synthetase
E Acetyl-CoA-carboxylase
85 A patient with diabetes mellitus had an insuline injection. It caused loss of consciousness and
convulsions. What was the result of biochemic blood analysis on glucose content?
A 10 mmole/l
B 2,5 mmole/l
C 3,3 mmole/l
D 8,0 mmole/l
E 5,5 mmole/l
86 A one year old child has enlarged head and belly, retarded cutting of teeth, destruction of enamel
structure. What hypovitaminosis causes these changes?
A Hypovitaminosis B 1
B Hypovitaminosis B2
C Hypovitaminosis D
D Hypovitaminosis C
E Hypovitaminosis A
V 98705547
Keys: 1 C, 2 B, 3 D, 4 C, 5 C, 6 E, 7 E, 8 E, 9 B, 10 D, 11 D, 12 C, 13 D, 14 C, 15 D, 16 C, 17 D, 18 D, 19
C, 20 C, 21 A, 22 E, 23 A, 24 E, 25 E, 26 E, 27 A, 28 E, 29 E, 30 E, 31 D, 32 B, 33 E, 34 D, 35 A, 36 A,
37 B, 38 D, 39 B, 40 C, 41 E, 42 E, 43 C, 44 D, 45 B, 46 E, 47 A, 48 D, 49 A, 50 E, 51 E, 52 B, 53 D, 54
B, 55 C, 56 A, 57 B, 58 E, 59 A, 60 E, 61 B, 62 D, 63 E, 64 A, 65 A, 66 C, 67 D, 68 C, 69 A, 70 E, 71 B,
72 C, 73 B, 74 B, 75 E, 76 C, 77 C, 78 B, 79 E, 80 B, 81 D, 82 E, 83 D, 84 E, 85 B, 86 C,
Krok \ Dentistry \ Krok 1 \ Bases \ Biochemistry \ 2010
V efc41401
1 Roentgenological examination of a patient revealed a cyst enclosing a tooth in its cavity in the area of
the premolar. Microscopical examination revealed that the cyst wall consisted of connective tissue and
was lined with multilayer squamous epithelium. What is the most probable diagnosis?
A Follicular cyst
B Radicular cyst
C Primordial cyst
D Eosinophilic granuloma
E Epulis
2 A dentist was examining oral cavity of a 9 year old child in the buccal surface of gingiva in the area of
the lower canine he revealed a red, soft, node-like formation 1 cm in diameter that started immediately
bleeding when touched. Microscopical examination revealed that this formation consisted of many small
vessels like venules and capillaries separated by thin layers of connective tissue, with focal infiltration by
lymphoid and plasmatic cells. Such changes are typical for:
A Angiomatous epulis
B Capillary hemangioma
C Radicular granuloma
D Fibrous epulis
E Papilloma
3 Analysis of urine from a 24-year-old man revealed the following changes: daily diuresis - 10 l, relative
density - 1,001, qualitative alterations are absent. A patient complains of excessive thirst, frequent
urination. What is the most likely cause of this disease?
A Vasopressin hyposecretion
B Glucocorticoid hypersecretion
C Vasopressin hypersecretion
D Relative insulin insufficiency
E Aldosteron hypersecretion
4 A patient suffering from syphilis was prescribed a drug the action of which based upon disturbed
generation of murein leading to death of the causative agent. What drug is it?
A Benzylpenicillin sodium salt
B Bijochinol
C Ciprofloxacin
D Azithromycin
E Doxycycline hydrochloride
5 Osteolathyrism is characterized by a loss of tensile strength of collagen, which is induced by a
significant decrease in the formation of cross-links in collagen fibrils. The cause for it is the reduced
activity of:
A Lysyl oxidase
B Monoamine oxidase
C Prolyl hydroxylase
D Lysyl hydroxylase
E Collagenase
6 Periodontitis is accompanied by activation of proteolysis in the periodontium tissues. The evidence of
proteolysis activation is increase of the following component of oral liquid:
A Amino acids
B Organic acids
C Glucose
D Biogenic amines
E Cholesterol
7 Two weeks after hemotransfusion a patient developed fever. What protozoal disease can be suspected?
A Malaria
B Toxoplasmosis
C Leishmaniasis
D Amebiasis
E Trypanosomiasis
8 A patient applied to a doctor complaining about dizziness, memory impairment, periodical convulsions.
It was found out that such changes were caused by a product of glutamic acid decarboxylation. What
product is meant?
A GABA
B Pyridoxalphosphate
C Thymidine diphosphate
D ATP
E Tetrahydrofolate
9 Laboratory examination of a child revealed high content of leucine, valine, isoleucine and their
ketoderivates in blood and urine. Urine had the typical smell of maple syrup. This disease was caused by
deficiency of the following enzyme:
A Dehydrogenase of branched amino acids
B Aminotransferase
C Glucose-6-phosphatase
D Phosphofructokinase
E phosphofructomutase
10 Hepatic disfunctions accompanied by insufficient inflow of bile to the bowels result in coagulation
failure. This phenomenon can be explained by:
A Vitamin K deficiency
B Iron deficiency
C Thrombocytopenia
D Erythropenia
E Leukopenia
11 A child has disturbed processes of ossification and punctate enamel. What microelement metabolism
is disturbed?
A Fluorine
B Chromium
C Copper
D Iron
E Zinc
12 During examination of a 36-year-old woman a dentist revealed a formation in form of a nodule up to
0,8 cm in diameter, of dark brown-red colour, soft, on a wide base. The formation was found on the
buccal surface of gum in the region of the 2nd molar. Histological examination revealed that the
formation had plenty of sinusoid vessels and a lot of roundish mononuclear and big multinuclear cells; in
some parts accumulations of hemosiderin granules could be found. What is the most likely diagnosis?
A Giant-cell epulis
B Root granuloma
C Angiomatous epulis
D Ameloblastoma
E Mandibular osteoclastoma
13 While on holiday in the countryside a boy found a spider with the following morphological
peculiarities: body length at the rate of 2 cm, round black abdomen with two rows of red dots on its
dorsal surface, four pairs of segmented extremities covered with tiny black hairs. Identify this arthropod:
A Steppe spider (Latrodectus tredeci-mguttatus)
B Scorpion
C Solifugae
D Mite
E Tarantula
14 A girl who was provisionally diagnosed with Turner’s syndrome came to a genetic consultation. The
diagnosis can be specified by means of the following genetic method:
A Sex chromatin test
B Genealogical
C Hybridological
D Biochemical
E Dermatoglyphics
15 Cyanide poisoning causes immediate death. What is the mechanism of cyanide effect at the molecular
level?
A They inhibit cytochromoxidase
B They bind substrates of tricarboxylic acid cycle
C They block succinate dehydrogenase
D They inactivate oxygene
E They inhibit cytochrome B
16 A blood smear of a patient who has recently recovered from flu contains 10% of roundish cells 4,5-7
micrometer large with a big round nucleus and basophi-lically stained cytoplasm in form of a narrow
border around the nucleus. What blood status are they typical for?
A Lymphocytopenia
B Thrombopenia
C Leukopenia
D Lymphocytosis
E Monocytopenia
17 A patient was diagnosed with seborrheic dermatitis associated with vitamin H (biotin) deficiency. The
patient has disturbed activity of the following enzyme:
A Acetyl-CoA-carboxylase
B Pyruvate decarboxylase
C Alcohol dehydrogenase
D Amino transferase
E Carbomoyl phosphate synthetase
18 Active physical work induces rise of concentration of carbonic acid in blood. This causes deepening
and acceleration of respiration thus reducing concentration of carbonic acid and hydrogen ions in blood.
This maintains the following process:
A Homeostasis
B Immunity
C Ontogenesis
D Orthobiosis
E Anabiosis
19 The activity of parotides reduces with age. Activity of what enzyme in saliva will be reducing?
A Amylase
B Lysozime
C Phosphatase
D Hexokinase
E Maltase
20 Chronic overdosage of glucocorticoids leads to the development of hyperglycemia. What process of
carbohydrate metabolism is responsible for this effect?
A Gluconeogenesis
B Glycogenolysis
C Aerobic glycolisis
D Pentose-phosphate cycle
E Glycogenesis
21 A patient has mental retardation, small height, brachydactyly, mongoloid slant. Analysys of his
karyotype revealed trisomy 21. What chromosomal anomaly is it?
A Down’s disease
B Klinefelter’s syndrome
C Turner’s syndrome
D Trisomy X
E Specific fetopathy
22 Examination of urine in a newborn revealed presence of citrulline and high ammonia concentration.
This baby is most likely to have the disorder of the following substance production:
A Urea
B Uric acid
C Ammonia
D Creatinine
E Creatine
23 In the mountains some clinically healthy people present with anaemia symptoms. Blood test can
reveal sickle cells. What is the genotype of such people?
A Aa
B aa
C AA
D XcXc
E XCXc
24 A hospital admitted a patient with complaints about abdominal swelling, diarrhea, meteorism after
consumption of food rich in proteins. It is indicative of disturbed protein digestion and their intensified
decaying. What substance is the product of this process in the bowels?
A Indole
B Bilirubin
C Cadaverine
D Agmatine
E Putrescine
25 A 38 year old patient takes aspirin and sulfanilamides. After their intake intensified erythrocyte
haemolysis is observed which is caused by deficiency of glucose 6-phosphate dehydrogenase. This
pathology is caused by failure of the following coenzyme:
A NADP - H
B FAD - H2
C Pyridoxal phosphate
D FMN - H2
E Ubiquinone
26 Up to 50% of world population aged above thirty is affected by paradontosis. The leading part in
pathogenesis of this disease is played by:
A Neurodystrophic factor
B Parodontium tissues damaged by kalli-krein
C Parodontium damaged by active cells
D Dental calculus caused by microflora
E Immune damage of tissues
27 A 57 year old patient with diabetes mellitus was developed ketoacedosis. Biochemical base of this
condition is decrease of acetyl-CoA utilization. What cell compound deficit causes this effect?
A Oxaloacetate
B Glutamate
C 2-oxoglutarate
D Aspartate
E Succinate
28 A patient was taken to the hospital with preliminary diagnosis progressive muscle distrophy. What
substance will be excessively contained in urine and confirm this diagnosis?
A Creatine
B Pyruvate
C Carnosine
D Troponine
E Hydroxiproline
29 To what total ATP quantity is the full glucose oxidation and its linking with phosphorylation
equivalent?
A 38
B8
C 12
D 52
E 58
30 Microscopical examination of a surgical specimen (an ulcered part of a lip) revealed in the connective
tissue of mucous membrane near the borders and under the floor of the ulcer some epithelial complexes
consisting of atypic multi-stratal epithelium with accumulations of bright pink concentric formations.
What pathology is it?
A Squamous cell keratinous carcinoma
B Squamous cell nonkeratinous carcinoma
C Transitional cell carcinoma
D Basal cell carcinoma
E Papilloma
31 Examination of a child who hasn’t got fresh fruit and vegetables during winter revealed numerous
subcutaneous hemorrhages, gingivitis, carious cavities in teeth. What vitamin combination should be
prescribed in this case?
A Ascorbic acid and rutin
B Thiamine and pyridoxine
C Folic acid and cobalamin
D Riboflavin and nicotinamide
E Calciferol and ascorbic acid
32 Coprological examination of a patient’s feces revealed small operculate eggs. It is known from the
anamnesis that the patient often consumes fish. What fluke parasitizes in the patient’s organism?
A Cat liver fluke
B Blood fluke
C Lung fluke
D Liver fluke
E Lancet fluke
33 While the examination of patient’s oral cavity the dentist found xerostomia, numerous erosions. What
vitamin deficit caused this effect?
A Vitamin A
B Vitamin K
C Vitamin P
D Vitamin H
E Vitamin PP
34 While examining a blood smear taken form a patient and stained by Romanovsky’s method a doctor
revealed some protozoa and diagnozed the patient with Chagas disease. What protozoan is the causative
agent of this disease?
A Trypanosoma cruzi
B Toxoplasma gondii
C Leishmania donovani
D Leishmania tropica
E Trypanosoma brucei
35 A 10 year old child underwent Mantoux test (with tuberculin). 48 hours later there apperaed a papule
up to 8 mm in diameter on the site of tuberculin injection. Tuberculin injection caused the following
hypersensitivity reaction:
A IV type hypersensitivity reaction
B Arthus reaction
C Seroreaction
D Atopic reaction
E II type hypersensitivity reaction
36 A chiled was diagnosed with acute renal failure. What biochemic saliva indices can confirm this
diagnosis?
A Increased level of rest nitrogen
B Increase of immunoglobuline A
C Reduction of alkaline phosphatase
D Increase of alpha amylase
E Decreased level of phosphate
37 A sportsman was recommended to take a preparation with carnitine in order to improve his
achievements. What process is activated by carnitine to the most extent?
A Transporting of fatty acids to the mi-tochondrions
B Synthesis of steroid hormones
C Synthesis of ketone bodies
D Lypide synthesis
E Tissue respiration
38 After implantation of a cardiac valve a young man constantly takes indirect anticoagulants. His state
was complicated by hemorrhage. What substance content has decreased in blood?
A Prothrombin
B Haptoglobin
C Heparin
D Creatin
E Ceruloplasmin
39 A 28 year old woman consulted a doctor about sterility. Examination revealed underdeveloped
ovaries and uterus, irregular menstrual cycle. Study of sex chromatin revealed 2 Barr’s bodies in most
somatic cells. What chromosome disease is the most probable in this case?
A Triplo-X syndrome
B Edwards’ syndrome
C Patau’s syndrome
D Klinefelter’s syndrome
E Turner’s syndrome
40 A patient who is ill with scurvy displays disturbed processes of connective tissue formation that leads
to loosening and falling of teeth. Disturbed activity of what enzyme causes these symptomps?
A Lisilhydroxylase
B Glycosiltransferase
C Elastase
D Procollagenpeptidase of N-terminal peptide
E Procollagenpeptidase of C-terminal peptide
41 During physical exercise people are less sensitive to pain. The reason for it is the activation of:
A Antinociceptive system
B Nociceptive system
C Thyroid gland functions
D Sympathoadrenal system
E Adrenal gland functions
42 A one year old child has enlarged head and belly, retarded cutting of teeth, destruction of enamel
structure. What hypovitaminosis causes these changes?
A Hypovitaminosis D
B Hypovitaminosis C
C Hypovitaminosis A
D Hypovitaminosis B 1
E Hypovitaminosis B2
43 A sample taken from the pharynx of a patient with angina was inoculated on the blood-tellurite agar.
This resulted in growth of grey, radially striated (in form of rosettes) colonies up to 4-5 mm in diameter.
Microscopically there can be seen gram-positive rods with club-shaped ends arranged in form of spread
fingers. What microorganisms are these?
A Corynebacteria diphtheriae
B Clostridium botulinum
C Diphtheroids
D Streptococci
E Streptobacilli
44 A patient with high obesity was recommended to take carnitine as a food additive for better fat
burning. What function is fulfilled by carnitine in the process of fat oxidation?
A Transport of fatty acids from the cytosol to the mitochondria
B Transport of fatty acids from the fat depots to the tissues
C Participation in one of the reactions of beta-oxidation of fatty acids
D Fatty acid activation
E Intracellular lipolysis activation
45 A 28 year old pregnant woman had the enzymes in the cells of amniotic fluid analyzed. The analysis
revealed insufficient activity of beta-glucuronidase. What pathological process is it?
A Mucopolysaccharidosis
B Glycogenosis
C Collagenosis
D Lipidosis
E Aglycogenosis
46 Laboratory of extremely dangerous infections received a sample taken from a patient with assumed
cholera. What express-diagnostics method can confirm this diagnosis?
A Immunofluorescence test
B Complement binding reaction
C Agglutination test
D Precipitation reaction
E Hemagglutination reaction
47 A patient with focal tuberculosis of superior lobe of his right lung takes isoni-azid as a part of
combined therapy. After a time he started complaining of muscular weakness, decrease of skin
sensitivity, sight and movement coordination disorder. What vitamin preparation will be right for
elimination of these occurances?
A Vitamin B6
B Vitamin A
C Vitamin D
D Vitamin B12
E Vitamin C
48 A patient with chronic hypoglycemia had adrenaline introduction. After introduction blood test has
not changed essentially. Doctor assumed liver pathology. What liver function may have been changed?
A Function of glycogen depositing
B Ketogenic function
C Function of cholesterin production
D Glycolytic function
E Excretory function
49 In order to speed up healing of the thermal injury it is required to prescribe a drug that facilitates
epithelization of skin and mucous membranes. What drug is it?
A Retinol acetate
B Tocopherol acetate
C Nicotinic acid
D Ergocalciferol
E Ascorbic acid
50 A child has abnormal formation of tooth enamel and dentin as a result of low concentration of calcium
ions in blood. Such abnormalities might be caused by deficiency of the following hormone:
A Parathormone
B Thyrocalcitonin
C Thyroxin
D Somatotropic hormone
E Triiodothyronine
51 The first grade pupils went through a medical examination aimed at selection of children needing
tuberculosis revaccination. What test was applied?
A Mantoux test
B Schick test
C Supracutaneous tularin test
D Burne test
E Anthracene test
52 Microscopical examination of discharges from the gums of a patient ill with paradontosis revealed
some protozoan pear-shaped organisms 6-13 micrometer long. The parasite has one nucleus and
undulating membrane, there are four flagella at the front of its body. What protozoan were found?
A Trichomonads
B Leishmania
C Amoebae
D Balantidia
E Lamblia
53 A 15 year old girl was delivered to the hospital with inflammation of vermiform appendix. Blood
analysis revealed signs of anaemia. Her feces contained lemon-shaped helminthic eggs (50x30
micrometer) with "plugs" on the poles. What type of helminth is it?
A Trichuris
B Hookworm
C Hymenolepis nana
D Echinococcus
E Pinworm
54 A patient has painfulness along big nerve trunks and excessive content of pyruvate in blood. What
vitamin deficit may cause such changes?
ABi
B B2
C PP
D Pantothenic acid
E Biotin
55 A patient has roundish ulcers on his face, inflammation and enlargement of lymph nodes. These
symptoms turned up as a result of mosquito bites. Laboratory examination of discharge from the ulcers
revealed unicellular aflagellar organisms. What is the most probable diagnosis?
A Dermatotropic leishmaniasis
B Toxoplasmosis
C Scabies
D Trypanosomiasis
E Myasis
56 A patient has deformation of jaw bones. Histological examination revealed there growth of
fibrocellular tumourlike ill-defined tissue with primitive osteogenesis. What disease are these
presentations typical for?
A Fibrous dysplasia
B Ameloblastoma
C Osteosarcoma
D Eosinophilic granuloma
E Parathyroid osteodystrophy
57 A patient with diabetes mellitus had an insuline injection. It caused loss of consciousness and
convulsions. What was the result of biochemic blood analysis on glucose content?
A 2,5 mmole/l
B 3,3 mmole/l
C 8,0 mmole/l
D 10 mmole/l
E 5,5 mmole/l
58 Examination of a 6 days old infant revealed phenyl pyruvate and phenyl acetate excess in his urine.
What ami-noacid metabolism is disturbed in the child’s organism?
A Phenylalanine
B Tryptophan
C Methionine
D Histidine
E Arginine
59 For assessment of the neutralizing function of liver a patient with chronic hepatitis went through a
test with natrium benzoate load. The excretion of what acid with urine will characterize the neutralizing
function of liver?
A Hippuric acid
B Phenylacetic acid
C Citric acid
D Valeric acid
E Oxalic acid
60 Cytogenetic examination of a patient with dysfunction of the reproductive system revealed normal
karyotype 46,XY in some cells, but most cells have Klinefelter’s syndrome karyotype - 47,XXY Such
phenomenon of cell inhomogeneity is called:
A Mosaicism
B Inversion
C Transposition
D Duplication
E Heterogeneity
61 Examination of an ill child’s blood revealed inherited hyperlipoproteinemia. Genetic defect of what
enzyme synthesis causes this phenomenon?
A Lipoprotein lipase
B Glycosidase
C Proteinase
D Hemsynthetase
E Phenylalanine hydroxylase
62 Dehelmintization of a patient revealed some long fragments of a helminth with segmented structure.
Mature segments were rectangular, 30x12 mm large, closed-type matrix was in form of a stem with 1735 lateral branches. Specify this helminth:
A Hookless tapeworm
B Alveococcus
C Echinococcus
D Dwarf tapeworm
E Armed tapeworm
63 A 42 year old woman diagnosed with diabetes mellitus was admitted the endocrinological department
with complaints of thirst, excessive appetite. What pathological components are revealed in course of
laboratory examination of the patients urine?
A Glucose, ketone bodies
B Protein, aminoacids
C Bilirubin, urobilin
D Blood
E Protein, creatine
64 Examination of a 30-year-old man mandible revealed in the region of his molar a dense tumour-like
formation that significantly deformed the mandible. The formation wasnt fully detached from the bone
tissue. Microscopical examination of a tissue sampling revealed that stroma had some cords and follicles
with odontogenous cylindric epithelial cells in peripheria and stellate cells resembling of the enamel
organ pulp in the centre. What is the most likely diagnosis?
A Ameloblastoma
B Primary intraosteal cancer
C Adenomatoid tumour
D Adenocarcinoma
E Osteoclastoma
65 Histological examination of a micro specimen presenting a malignant lung tumour revealed that the
tumor consisted of lymphocyte-like cells forming any structures. Stroma is mildely marked, there are a
lot of mitoses and necroses. What tumour is it?
A Small cell carcinoma
B Squamous cell nonkeratinous carcinoma
C Fibroma
D Squamous cell keratinous carcinoma
E Adenocarcinoma
66 A 40-year-old male patient had a tumour-like formation 8x7 cm large on his neck. A surgeon removed
it only partially because of close connection with large vessels. Microscopical examination revealed
marked cellular and tissue atypism, lipoblast-type cells in different stages of maturity, with
polymorphism and nuclear hyperchromia, pathological mitoses, necrosis foci. Specify the histological
form of the tumour:
A Liposarcoma
B Lipoma
C Fibroma
D Fibrosarcoma
E Hibernoma
67 In compliance with the clinical presentations a man was prescribed pyri-doxalphosphate. What
processes are corrected by this preparation?
A Transamination and decarboxylation of amino acids
B Oxidative decarboxilation of keto acids
C Desamination of purine nucleotides
D Synthesis of purine and pyrimidine bases
E Protein synthesis
68 A 2 year old child suffers from intestinal dysbacteriosis that lead to the development hemorrhagic
syndrome. The most probable cause of hemorrhage is:
A Vitamin K deficiency
B Activation of tissue thromboplastin
C Hypovitaminosis PP
D Fibrinogen deficiency
E Hypocalcemia
69 Decreased ratio of adenylic nucleotides ATP/ADP results in intensified glycolysis in parodentium
tissues in hypoxic conditions. What reaction is activated in this case?
A Phosphofructokinase
B Lactate dehydrogenase
C Triosophosphate isomerase
D Aldolase
E Enolase
70 Helminthological examination of patient’s feces revealed oval brown eggs with tuberous external
membrane. Name the type of helminth:
A Ascarid
B Pinworm
C Whipworm
D Dwarf tapeworm
E Broad tapeworm
71 A patient has the folowing changes: disorder of twilight vision, drying out of conjunctiva and cornea.
Such disorders may be caused by deficiency of vitamin:
A Vitamin A
B Vitamin B
C Vitamin C
D Vitamin D
E Vitamin B12
72 Examination of a 10 y.o. child revealed on the alveolar submandibular process a fixed tumourous
mass 1,5 cm in diameter closing premolar crown on the vestibular side. Mucous membrane of its surface
is reddish-brown, it bleeds as a reaction to a slight mechanical intervention. Biopsy results: the mass
consists of small size vessels separated by thin layers of connective tissue and infiltrated by plasmocytes,
mucous membrane is here and there ulcered. What is the most probable diagnosis?
A Angiomatous form of epulis
B Gingival fibromatosis
C Giant cell form of epulis
D Hypertrophic gingivitis
E Fibrous form of epulis
73 A non trained man has usually muscular hypoxy after a sprint. What metabolite accumulates in the
muscles as a result of it?
A Lactate
B Ketone bodies
C Glucose 6-phosphate
D Oxaloacetate
E74 A man got poisoned with mushrooms. They contain muscarine that stimulates muscarinic
cholinoreceptors. What symptom is typical for poisoning with inedible mushrooms?
A Miosis
B Mydriasis
C Bronchi dilation
D Heart rate rise
E Arterial pressure rise
75 Myocyte cytoplasm contains a big number of dissolved metabolites of glucose oxidation. Name one of
them that turns directly into lactate:
A Pyruvate
B Oxaloacetate
C Glycerophosphate
D Glucose 6-phosphate
E Fructose 6-phosphate
76 Roentgenological examination of mandible of a 27 year old man revealed a focus of osseous tissue
destruction. Histological examination revealed a tumour consisting of odontogenous epithelium cords,
immature connective tissue and dysplastic dentin rests. What tumour is it?
A Dentinoma
B Ameloblastic fibro-odontoma
C Odontoameloblastoma
D Odontogenous fibroma
E Complex odontoma
77 Patient with pigmentary xeroderma are characterized by anamalously high sensivity to ultraviolet
rays that causes skin cancer as a result of enzyme systems incapability to restore damages of hereditary
apparatus of cells. What process abnormality is this pathology connected with?
A DNA reparation
B Genetic conversion
C DNA recombination
D Genetic complementation
E DNA reduplication
78 A patient has the sudden decrease of Са2+ content in blood. What hormone secretion will increase?
A Parathormone
B Somatotropin
C Aldosterone
D Thyrocalcitonin
E Vasopressin
79 A female patient has symptoms of inflammation of urogenital tracts. A smear from the vaginal
mucous membrane contained big unicellular pyriform organisms with a sharp spike on the back end of
their bodies; big nucleus and undulating membrane. What protozoa were revealed in the smear?
A Trichomonas vaginalis
B Trichomonas hominis
C Trichomonas buccalis
D Trypanosoma gambiense
E Lamblia intestinalis
80 A patient has increased content of uric acid in his blood that is clinically presented by pain syndrome
as a result of urate deposition in the joints. What process does this acid result from?
A Lysis of purine nucleotides
B Lysis of pyrimidine nucleotides
C Heme catabolism
D Proteolysis
E Reutilization of purine bases
81 Among public catering workers examined by doctors of sanitary-and-epidemiologic station often
occur asymptomatic parasite carriers. This means that a healthy person carries cysts that infect other
people. Such parasitizing is impossible for the following causative agent:
A Dysenteric amoeba
B Malarial plasmodium
C Intestinal trichomonad
D Dermatotropic leishmania
E Viscerotropic leishmania
82 The 16th tooth of a patient is missing. X-ray picture shows in the depth of alveolar process
rarefaction of bone and a well-defined cavity that contained the underdeveloped tooth crown.
Microscopical examination revealed that the cavity wall was lined with stratified squamous epithelium
and enclosed within a fibrous capsule. Make a diagnosis:
A Follicular gnathic cyst
B Radicular gnathic cyst
C Cyst of the incisive canal
D Cystic ameloblastoma of jaw
E Primordial gnathic cyst
83 A patient has increased permeability of blood-vessel walls, increased gingival hemorrhage, small
punctate hematomas on his skin, falling of teeth. What disturbance of vitamun metabolism can account
for these symptoms?
A Hypovitaminosis C
B Hypervitaminosis D
C Hypervitaminosis C
D Hypovitaminosis D
E Hypovitaminosis A
84 A patient has liver cirrhosis. Analysis of what substance excreted with urine may characterize the
state of antitoxic liver function?
A Hippuric acid
B Ammonian salts
C Creatinine
D Uric acid
E Amino acids
85 A sportsman needs to improve his sporting results. He was recommended a drug containing
carnitine. What process is activated by this compound in the first place?
A Transport of fatty acids
B Transport of amino acids
C Transport of calcium ions
D Transport of glucose
E Transport of vitamin K
86 A child has disturbed enamel and dentine formation as a result of decreased content of calcium ions
in his blood. What hormone deficiency may cause such changes?
A Thyreocalcitonin
B Somatotropin
C Thyroxin
D Parathormone
E Triiodothyronine
MINISTRY OF PUBLIC HEALTH OF UKRAINE
NATIONAL O.O.BOGOMOLETS MEDICAL UNIVERSITY
Department of Bioorganic and Biological Chemistry
"Approved"
at the methodical council of the department
bioorganic and biological chemistry
Head of Department
d.m.s professor ___________ L.V. Gayova
"___" ______________ 2019
METHODOLOGICAL RECOMMENDATIONS
TRAINING FOR PRACTICAL LESSON
Studying discipline
Module №3
Semantic module
Topic:3
Course
Faculty
Number of hours
Bioorganic and Biological Chemistry
Molecular biology. Biochemistry of
physiological functions.
Fundamentals of molecular biology.
Hemoglobin biosynthesis. Porphyria.
Heme catabolism. Jaundice
pathochemistry
II
Medical
3 hours
Prepared by PhD Ischenko A.A.
Translated by PhD Mazur Iu.
Kyiv -2019
Hemoglobin biosynthesis. Porphyria. Heme catabolism. Jaundice pathochemistry
Theoritical questions for the class
1. Porphirin synthesis:
• substrates for heme synthesis;
• δ-aminolevulenic acid synthase role;
• uroporphirinogene III formation;
• protoporphirinogene convertion into protoporphitrin III (IX);
• heme synthase role;
• cheme of heme biosyntesis reactions.
2. Heridaty disease of porphirin metabolism:
• porphirias clinical sympoms клінічні: photosensitivity, neurological disorders;
• porphirias classification – erythropoietic porphiria (Gunther disease), hepatic
porphyrias.
3. Catabolism of hemoglobin and its prosthetic group (heme):
• formation of verdoglobin as a result of tetrapyrrole ring breakup;
• disintegration of verdoglobin to biliverdin;
• conversion of biliverdin to bilirubin
• bilirubin transport from mononuclear phagocyte (reticuloendothelial) system to
liver;
• bilirubin glucuronide formation;
• bilirubin glucuronide biotransformation in the intestines;
• recirculation of biotransformation products.
4. Jaundice pathochemistry:
• Pre-hepatic/ hemolytic jaundice;
• Hepatic/ hepatocellular jaundice;
• Post-Hepatic/ cholestatic jaundice;
• enzymatic jaundice.
5. Clinical and biochemical characteristic of jaundice by following parameters: indirect
bilirubin, direct bilirubin, bilirubin in urine, urobilinogen in urine, stercobilin in feces.
6. Biochemical parameters which used for liver disease diagnosis: ALA, AST, glutamate
dehydrogenase activity, level of direct, indirect bilirubin, functional probe.
2
Case studies
Case 1. Patient diagnosed with jaundice. Total bilirubin is 80 M/l, direct bilirubin is
normal, indirect is increased, urine bilirubin is not revealed, urobilinogen in urine is increased.
Feces has dark color, stercobilinogen is increased. What type of jaundice it is? Prove your
answer.
Etalon of answer: hemolytic jaundice.
Erythrocyte hemolysis and intensive heme degradation cause hyperbilirubinemia mainly
by indirect bilirubin. Increased bilirubin flow in intestines is a source of stercobilinogen which
secreted as stercobilin with feces (dark, almost black hypercholic feces) and as urobilin with
urine (urine intensive color) after its absorption in large intestine.
Case 2. The 48-old-patient come to hospital with compliance of general weakness,
irritability, sleep disturbance. Her skin and sclera has a yellow color. Blood parameters:
increased total bilirubin with prevalence of direct. Feces is acholic. Urine has a dark color
because of bile pigment. Which type of jaundice this patient has? Prove your answer.
Etalon of answer: cholestatic jaundice.
When bile ducts are blocked cholestatic jaundice is develop. Overwhelming bile ducts is
damaged and leak bilirubin in blood capillaries. Thus, huge quantity of direct bilirubin appears
in blood. Its excreted by urine which gives it golden-brownish color (“urine of bear color”).
Direct bilirubin as a part of bile couldn’t be transported into intestine, thus, feces does not
contain stercobilinogen (acholic feces).
Case 3. Patients with erythropoietic protoporphyria (Gunther disease) has a redfluorescent tooth in ultra-wave, their skin is sensitive to light, urine has red color. Which
enzyme deficiency cause this disease? Explain your answer
Etalon of answer: uroporphyrinogen III synthase .
Erythropoietic protoporphyria (Gunther disease) is a pathology which develops in case of
uroporphyrinogen III synthase disrupted synthesis. This biochemical defect cause formation
of non-physiological isomer of uroporphyrinogen I. This disease is characterized by red urine
color (in some cases bones and tooth) because of uroporphyrinogen I accumulation in kidney
which finally converts to uroporphyrin I..
Recommended literature.
Main:
1. Біологічна і біоорганічна хімія: у 2 книгах: підручник. Кн. 2. Біологічна хімія (ВНЗ
ІV р. а.) / за ред. Ю.І. Губського, І.В. Ніженковської. Вид.: ВСВ "Медицина", 2016. –
544 с.
2. Скляров О.Я. Біологічна хімія: підруч. для студентів стоматол. ф-тів вищ. мед. навч.
закл. IV рівня акредитації / О. Я. Скляров, Н. В. Фартушок, Т. І. Бондарчук.–
Тернопіль: ТДМУ: Укр медкнига, 2015. – 705 с.
3
3. Біологічна і біоорганічна хімія: у 2 кн.: підручник. Кн. 1. Біоорганічна хімія (ВНЗ ІV
р. а.) / за ред. Б.С. Зіменковського, І.В. Ніженковської. Вид.: ВСВ "Медицина", 2014.
– 272 с.
Additional:
1. Гонський Я.І., Максимчук Т.П., Калинський М.І. Біохімія людини. Підручник. –
Тернопіль: Укрмедкнига, 2013. –744 с.
2. Функціональна біохімія: навчальний посібник для студ. вищого фарм. навч. закл.
ІVрівня акредитації / А.Л.Загайко [та ін.]. – Харків: НФаУ, 2010. – 219 с.
3. Біологічна хімія з біохімічними методами дослідження: підручник для студ. вищих
мед. навч. закл. І-ІІ рівнів акредитації / О.Я. Скляров.– К.: Медицина, 2009. – 352 с.
4. Біологічна хімія : підруч. для студ. вищ. мед. навч. закл. IV рівня акредитації / Ю. І.
Губський. – Вид. 2-ге. – К.; Вінниця: НОВА КНИГА, 2009. – 664 с.
4
Hemoglobin biosynthesis. Porphyria. Heme catabolism. Jaundice pathochemistry
In “KROK-1” MCQ old terminology may appear e.g. obstructive jaundice, mechanical jaundicem
conjugated bilirubin, unconjugated bilirubin
MCQ
Correct answer
1. Barbiturates prescribed for jaundice treatment because Correct answer: Direct (conjugated) bilirubin.
it induces UDP-glucuronosyltransferase synthesis. In endoplasmic reticulum of erythrocytes bilirubin is
Which substance formation provide therapeutic effect?
conjugated with glucuronic acid (UDP-glucoronate)
A. *Direct (conjugated) bilirubin
and form water-soluble product (bilirubin mono- or
B. Indirect (unconjugated) bilirubin
diglucoronid, e.g. conjugated, direct bilirubin). This
C. Biliverdin
compound is hydrophilic and has low toxicity.
D. Protoporphyrin
Described process is catalyzed by UDPE. Heme
glucuronosyltransferase.
Expression
of
Test question collection for licensed exam Krok-1 «General medical preparation». glucuronosyltransferase can be increased with such
– 2010. – №82.
drugs as phenobarbital.
2. The patient came to doctor with compliance about Correct answer: Gallstone
yellow sclera and skin. No encephalopathy, cholestasis When gallstone moves through gall duct, bile flow is
or acholic syndrome. Which type of jaundice is blocked, person experience acute pain attack, after
developed in this patient?
some time jaundice develops which reminds
A. *Gallstone
obstructive by following parameters: conjugated
B. Hemolytic jaundice
bilirubin cannot with the bile move to the intestine,
C. Hepatitis
thus no stercobilin is produced. Bile stasis in the bile
D. Chronic gastritis
capillaries leads to hepatocytes necrosis,
E. Chronic colitis
consequently some enzymes are released in blood,
including ALA
Test question collection for licensed exam Krok-1 «General medical preparation».
– 2015. – №187.; – 2016. – №183.
3. The 53-years-old man compliance about acute pain in
right under rib area. Doctor noticed yellow sclera.
Laboratory diagnostic revealed increased ALA, negative
stercobilin in feces. Which disease can be diagnosed with
these symptoms?
A. * Gallstone
B. Hemolytic jaundice
C. Hepatitis
D. Chronic colitis
E. Chronic gastritis
Correct answer: Gallstone
When gallstone moves through gall duct, bile flow is
blocked, person experience acute pain attack, after
some time jaundice develops which reminds
obstructive by following parameters: conjugated
bilirubin cannot with the bile move to the intestine,
thus no stercobilin is produced. Bile stasis in the bile
capillaries leads to hepatocytes necrosis,
consequently some enzymes are released in blood,
including ALA
Test question collection for licensed exam Krok-1 «General medical preparation»..
– 2013. – №116.; – 2014. – №101.
4. The born in time newborn has yellow skin and mucus
color. The most probable reason of this condition is
temporary insufissiency of the following enzyme:
A. *UDP-glucosyltransferase
B. Glucuronosyltransferase
C. Heme synthase
D. Heme oxygenase
E. Biliverdin reductase
Correct answer: UDP-glucosyltransferase.
The newborn jaundice characterized by high
conjugated bilirubin concentration. This condition is
cause by immature enzyme system, specially UDPglucosyltransferase which catalyze conjugation of
free bilirubin with glucuronic acid.
Test question collection for licensed exam Krok-1 «General medical preparation»..
– 2017. – №15.
5. The preterm newborn has a jaundice. Which enzyme Correct answer: UDP-glucosyltransferase.
is probably deficient in this baby?
The newborn jaundice characterized by high
A. * UDP-glucosyltransferase
conjugated bilirubin concentration. This condition is
B. alkaline phosphatase
cause by immature enzyme system, specially UDP5
C. acidic phosphatase
D. catalase
E. NAD+-dehydrogenase
glucosyltransferase which catalyze conjugation of
free bilirubin with glucuronic acid.
Test question collection for licensed exam Krok-1 «General medical preparation».
– 2013. – №173.; – 2014. – №165.
6. The newborn has a physiological jaundice. The level
of blood free bilirubin considerably higher than normal.
What enzyme deficiency can cause this
A. * UDP-glucosyltransferase
B. Transaminase
C. Xanthine oxidase
D. Adenosine deaminase
E. Heme oxygenase
Correct answer: UDP-glucosyltransferase.
Newborn jaundice characterized by considerably
high unconjugated bilirubin. As usual the main cause
is immature enzyme system, specially UDPglucosyltransferase which catalyze bilirubin
conjugation with glucuronic acid.
Test question collection for licensed exam Krok-1 «General medical preparation».
– 2006. – №123.
7. The patient has a following symptoms: yellow skin,
dark urine, yellow-dark feces. Which substance you will
predict to be increased in blood serum?
A. *Free bilirubin
B. Conjugated bilirubin
C. Mesobilirubin
D. Verdoglobin
E. Biliverdin
Correct answer: Free bilirubin.
Increased concentration of free (indirect,
unconjugated) bilirubin in blood cause rise in free
bilirubin flow to the intestine, thus, formation of
stercobilinogen which excreted with feces (black,
almost hypercholic feces) and its absorption in large
intestine and urine excretion (intensive urine color).
Test question collection for licensed exam Krok-1 «General medical preparation».
– 2008. – №21.; – 2017. – №31.
8. The 20-years-old patient has a jaundice and the
following laboratory parameter: increase general blood
bilirubin, predominantly by indirect (free) fraction; urine
and feces has a high stercobilin; blood direct
(conjugated) bilirubin is normal. Which type of jaundice
this patient is most probably develop?
A. *Hemolytic
B. Parenchymatous (hepatic)
C. Mechanical
D. Newborn jaundice
E. Gilbert's syndrome
Correct answer: Hemolytic.
Intensive erythrocyte hemolysis and heme breakup in
blood plasma cause hyperbilirubinemia mostly
because of indirect (unconjugated) bilirubin fraction.
High bilirubin amount in the intestine leads to
massive stercobilinogen production which excreted
as stercobilin with feces (dark, almost black
hyperholic feces) or absorbed in large intestines and
excreted with urine (intensive urine color).
Test question collection for licensed exam Krok-1 «General medical preparation».
– 2011. – №79.; – 2012 – №65.; – 2013. – №50.; – 2015. – №29.; – 2016. – №147.;
– 2017. – №59.
9. The patient develops yellowish of skin and mucus
membranes. Analysis of blood plasma revealed increased
total bilirubin, feces – increased stercobilin, urine –
increased urobilin. What type of jaundice this patient
has?
A. *Hemolytic
B. Gilbert's syndrome
C. Parenchymatous
D. Obstructive
E. Cholestatic
Correct answer: Hemolytic.
Intensive erythrocyte hemolysis and heme breakup in
blood plasma cause hyperbilirubinemia mostly
because of indirect (unconjugated) bilirubin fraction.
High bilirubin amount in the intestine leads to
massive stercobilinogen production which excreted
as stercobilin with feces (dark, almost black
hyperholic feces) or absorbed in large intestines and
excreted with urine (intensive urine color).
Test question collection for licensed exam Krok-1 «General medical preparation».
– 2009. – №141.; – 2010. – №123.
10. The patient with jaundice has increased direct
bilirubin and bile acids in blood; no stercobilinogen was
revealed in urine. What type of jaundice can be the reason
of these symptoms?
Correct answer: Mechanical.
Primary feature of mechanical (obstructive) jaundice
is untypical yellow color of skin, mucus membranes,
sclera. Bile which contains bile acids as well as direct
6
A. *Mechanical
B. Hepatic
C. Parenchymatous
D. Hemolytic
E. Post-hepatic
bilirubin formed from indirect in hepatocytes cannot
pass to duodenum because of bile duct blockage.
Consequently, as direct bilirubin is not able to be
transported to intestine as part of bile, feces and urine
do not contain stercobilinogen.
Test question collection for licensed exam Krok-1 «General medical preparation».
– 2010. – №91.
11. The 20-years-old man is diagnosed with heredity
deficiency of UDP-glucuronosyltransferase. Change in
which blood parameter can prove this diagnosis?
A. Indirect (unconjugated) bilirubin
B. Direct (conjugated) bilirubin
C. Urobilin
D. Stercobilinogen
E. Animal indican
Correct
answer:
Indirect
(unconjugated)
bilirubin.
In normal conditions UDP-glucuronosyltransferase
catalyze transfer of glucuronic acid to bilirubin with
formation of conjugated bilirubin. In case of
disrupted synthesis of this enzyme conjugation
process is impossible which cause accumulation of
unconjugated (indirect) bilirubin in blood
Test question collection for licensed exam Krok-1 «General medical preparation».
– 2016. – №67.
12. The 28-years-old woman came to infectious
department with yellow skin, sclera, mucus membrane.
Laboratory diagnosis revealed increased blood direct
bilirubin; urobilinogen and bilirubin in urine. Which of
following condition can lead to those symptoms?
A. * Parenchymatous jaundice
B. Hemolytic jaundice
C. Kidney infarction
D. Renal tuberculosis
E. Mechanical jaundice
Test question collection for licensed exam Krok-1 «General medical preparation».
– 2012. – №137.
13. The 48-years-old woman was delivered to hospital
with compliance of general weakness, sleep disturbance.
Objectively: skin and sclera are yellow. Blood analysis
has increased total bilirubin with direct bilirubin
predominance. Feces is acholic. Urine has dark color,
because of bile pigments. Which type of jaundice this
patient has?
A. *Mechanical
B. Hemolytic
C. Parenchymatous
D. Gilbert's syndrome
E. Crigler–Najjar syndrome
Correct answer: Parenchymatous jaundice.
In case of parenchymatous jaundice hepatocytes and
bile ducts are damaged which enable liver to
transport conjugated bilirubin from hepatocytes to
bile against concentration gradient. Formed
conjugated bilirubin partly get into big blood circle,
while its concentration in the intestines considerably
decreased. Mesobilinogen quantity decline, thus
feces in parenchymatous jaundice are hypocholyc
(almost colorless) and urine has intensive color
because of mesobilinogen (urobilinogen) and
conjugated hemoglobin.
Correct answer: Mechanical.
In case of bile duct stasis and obstruction of bile
outflow jaundice develops. The bile capillaries are
distended by the back pressure of bile; they rupture
and the bilirubin escapes into the blood capillaries.
Huge amount of direct (conjugated) bilirubin appears
in blood, which excreted with urine and coloring it in
golden-brown color (“urine of bear color”).
Test question collection for licensed exam Krok-1 «General medical preparation».
– 2007. – №59.; – 2009. – №74.
14. The patient was delivered to hospital with complaints
about general weakness and sleep disturbance. Skin has
yellow color. There is increased blood direct bilirubin
and bile acids. Feces is acholic. Which type of disease
can provoke those changes?
A. *Mechanical jaundice
B. Hemolytic jaundice
C. Pre-hepatic jaundice
D. Gilbert's syndrome
E. Chronic cholecestitis
Correct answer: Mechanical.
Primary feature of mechanical (obstructive) jaundice
is untypical yellow color of skin, mucus membranes,
sclera. Bile, which contains bile acids as well as
direct bilirubin formed from indirect in hepatocytes,
cannot pass to duodenum because of bile duct
blockage. Consequently, as direct bilirubin is not
able to be transported to intestine as part of bile, feces
and urine do not contain stercobilinogen.
7
Test question collection for licensed exam Krok-1 «General medical preparation».
– 2011. – №172.
15. After blood transfusion patient has yellowish of skin
and mucus membrane, increased total and indirect
bilirubin, increased urine urobilin and feces stercobilin.
What kind of jaundice can be the reason?
A. *Hemolytic jaundice.
B. Newborn jaundice.
C. Obstructive jaundice.
D. Parenchymatous jaundice.
E. Genetic jaundice.
Correct answer: Hemolytic jaundice.
Incompatible blood transfusion (by blood type or
Rhesus factor) provoke intensive erythrocyte
hemolysis, consequently heme degradation and
increased formation of indirect bilirubin. Liver is
enable to conjugate it all, thus, blood characterized
by increased total bilirubin (mainly by indirect).
Increased bilirubin in intestine leads to intensified
stercobilinogen synthesis which excreted as
Test question collection for licensed exam Krok-1 «General medical preparation». stercobilin in feces (dark, almost black hypercholic
– 2005. – № 121.
feces) and as urobilin in urine (intensive urine color).
16. The patient who suffers from jaundice because of Correct answer: Increased erythrocyte hemolysis.
increased bilirubin as part of its indirect fraction. Urine Incompatible blood transfusion (by blood type or
and feces have intensive color. What is the most probable Rhesus factor) provoke intensive erythrocyte
explanation to these disruptions?
hemolysis, consequently heme degradation and
A. *Increased erythrocyte hemolysis
increased formation of indirect bilirubin. Liver is
B. Disrupted liver urobilinogen transformation.
enable to conjugate it all, thus, blood characterized
C. Disruption of direct bilirubin formation.
by increased total bilirubin (mainly by indirect).
D. Liver parenchyma damage.
Increased bilirubin in intestine leads to intensified
E. Disruption of bile flow from liver
stercobilinogen synthesis which excreted as
Test question collection for licensed exam Krok-1 «General medical preparation». stercobilin in feces (dark, almost black hypercholic
– 2010. – №142.
feces) and as urobilin in urine (intensive urine color).
17. The 43-years-old patient during 10 years has a
repetitive compliance about acute bellyache, cramps,
vision problems. His relatives have Patient urine have red
color. He was diagnosed with acute intermittent
porphyria. The reason of he his disease is not being a
vampire but disrupted biosynthesis of:
A. *Heme
B. Bile acids
C. Insulin
D. Collagen
E. Prostaglandin
Correct answer: Heme.
Genetic diseases of heme biosynthesis (enzymes
deficiency) leads to accumulation of interment
products of synthesis – porphyrins. This cause acute
bellyache, vision problems, urine gets dark-red color.
Test question collection for licensed exam Krok-1 «General medical preparation».
–2011. – № 58.
18. The patients with erythropoietic porphyria (Gunther
disease) have ultraviolet red-fluorescent tooth, sunsensitive skin, red-colored urine. Which enzyme
deficiency cause this disease?
A. * Uroporphyrinogen III synthase
B. - aminolevulinic acid synthase
C. Uroporphyrinogen I synthase
D. Uroporphyrinogen decarboxylase
E. Ferrochelatase
Correct answer: Uroporphyrinogen III synthase.
Erythropoietic porphyria (Gunther disease) is a
pathology of disrupted uroporphyrinogen III
synthase synthesis. This biochemical defect leads to
formation of non-physiological isomer of
uroporphyrinogen I. This substance is accumulated
in kidneys where converted to uroporphyrin I and
colored urine in red (in some cases it also colors teeth
and bones).
Test question collection for licensed exam Krok-1 «General medical preparation».
– 2010. – № 182.
19. The patient who suffers from anemia has increased
protoporphyrin IX. Which mineral deficiency can lead to
such pathology?
A. *Iron
B. Potassium
C. Magnesium
Correct answer: Iron.
During heme biosynthesis heme synthetase attaches
iron to protoporphyrin IX and form heme which is a
part of hemoglobin. Disruption of its synthesis cause
anemia.
8
D. Sodium
E. Phosphorus
Test question collection for licensed exam Krok-1 «General medical preparation».
–2007. – № 117
20. The patient has increased photosensitivity, after
prolong sun exposure urine starts to get dark-red color.
Which type of disease has this characteristic?
A. *Porphyria
B. Alkaptonuria
C. Albinism
D. Hemolytic jaundice
E. Pellagra
Correct answer: Porphyria.
Genetic diseases of heme biosynthesis (enzymes
deficiency) leads to accumulation of interment
products of synthesis – porphyrins. This cause
increased photosensitivity, urine gets dark-ted color.
Test question collection for licensed exam Krok-1 «General medical preparation».
– 2009. – № 43.
9
MINISTRY OF HEALTHCARE OF UKRAINE
O.O. BOHOMOLETS NATIONAL MEDICAL UNIVERSITY
Department of bioorganic and biological chemistry
“Approved”
on the methodical meeting of the bioorganic and
biological chemistry department
Head of Department
M.D. Professor of ___________L.V. Gayova
„___”______________2019 р.
GUIDLINE FOR PRACTICAL CLASSES
Course unit
Modul 3
Biological and bioorganic chemistry
3
Content module.
Subject:
Course
Faculty
Number of hours
Investigation of xenobiotics and endogenous toxins
biotransformation processes. Microsomal oxidation,
cytochrome P 450
2
3 hours
Kyiv-2019
Investigation of xenobiotics and endogenous toxins biotransformation processes.
Microsomal oxidation, cytochrome P-450
Theoretical questions:
1. Detoxicational function of the liver: biotransformation of xenobiotics and endogenous toxins.
2. Basic stages of biotransformation of foreign chemical compounds in the liver:
• first stage - oxidation-reduction and hydrolytic reactions;
• second stage - synthesis reactions, or conjugation.
3. Microsomal oxidation reactions:
• microsomal oxygenase (monooxygenase);
• Electron transport chains of the endoplasmic reticulum membranes;
• cytochrome P 450;
• catalytic cycle of the cytochrome P 450 functioning.
4. Genetic polymorphism and inducibility of biosynthesis of cytochrome P 450.
5. The origin and nature of the tolerance to medicinal products development.
6. Reaction of conjugation in hepatocytes:
• glucuronidation reactions involving UDF-glucuronic acid;
• sulfation reaction involving 3'-phospho-adenosine-5'-phosphosulfate;
• methylation reaction involving S-adenosylmethionine;
• acetylation reaction involving acetyl-S-CoA;
• conjugation reactions with glycine.
7. Examples of endogenous toxins detoxification reactions in the liver:
• neutralization of bilirubin - the product of heme decomposition;
• neutralizing the scotol and indole products of the transformation of tryptophan.
Recommended literature.
Basic:
1. Richard A. Harvey, Denise R. Ferrier, / Lippincott’s Illustrated Reviews: Biochemistry 5-th
edition // Lippincott Williams & Wilkins, Walters Kluwer business. - 2011. - 522 P.
2. Robert K. Murray, Daryl K. Granner, Peter A. Mayes e.a. / Harper’s Illustrated Biochemistry,
Twenty-Sixth Edition // McGraw-Hill Companies, Inc. - 2003. - 702 P.
3. Voet D. Biochemistry / D. Voet, J. Voet. – Wiley, 2004. – 1514 p.
Additional:
1. Lehninger Principles of Biochemistry 6th Edition // by David L. Nelson, Michael M. Cox –
2012. – 1340 p.
2. Jan Koolman, Klaus-Heinrich Roehm / Color Atlas of Biochemistry Second edition, revised
and enlarged // ThiemeStuttgart New York. - 2005. - 467 P.
Investigation of xenobiotics and endogenous toxins biotransformation processes.
Microsomal oxidation, cytochrome P 450
Test questions
Answers
1. Detoxification of xenobiotics (drugs, epoxides, the Correct answer: Glutathione.
arena oxides, aldehydes, nitro derivatives, etc.) and Biotransformation of xenobiotics and endogenous
endogenous metabolites (estradiol, prostaglandins, toxic compounds occurs in the liver. This process
leukotrienes) takes place in the liver by conjugation consists of two stages - microsomal oxidation and
with:
conjugation reactions, the consistent functioning
A. *Glutathione
of which ensures the elimination of a number of
B. Aspartic acid
foreign substances of all chemical classes.
C. Glycine
The neutralization of various xenobiotic structures
D. S-Adenozylmethionin
(medicines, epoxides, aroxides, aldehydes, nitroE. Fosfoadenozyn
trophic, etc.) and endogenous metabolites
(estradiol, prostaglandins, leukotrienes) takes
place in the liver through their conjugation with
glutathione.
This process involves a number of steps. Initially,
glutathione transferase catalyzes the interaction of
the substrate (RX) with reduced glutathione.
Glutathione conjugates are sequentially secreted
glutamic acid and glycine. The generated
conjugates of xenobiotics with cysteine may be
excreted in the urine or converted into
mercaptanic acids, which are also excreted in the
urine, in the acetylation reaction.
2. In the 70's, scientists found that the cause of severe
jaundice of newborns is a disturbance of the binding
of bilirubin in hepatocytes. What substance is used to
form a conjugate?
A. * Glucuronic acid
B. Uric acid
C. Sulfuric acid
D. Lactic acid
E. Pyruvic acid
3. Patient has cirrhosis of the liver. The study of
which of the listed substances that are excreted in the
urine can characterize the state of the antitoxic
function of the liver?
A. * Hippuric acid
B. Ammonium salts
C. Creatinine
D. Uric acid
E. Amino acids
Correct answer: Glucuronic acid.
Jaundicinous neonates are characterized by
excessive concentration of unconjugated bilirubin
in the blood. The reason for this is usually
immaturity of enzyme systems, including
insufficient function UDF-glucuronyltransferase,
which provides conjugation of indirect bilirubin
with glucuronic acid.
4. For a patient suffering from chronic hepatitis, a
load of sodium benzoate was carried out to evaluate
the degreasing function of the liver. For the discharge
of what substances with urine judge the neutralizing
Correct answer: Hippuric acid.
Hyppuric acid (benzoylglycine) is formed due to
interaction in the liver (and partly in the kidneys)
of benzoic acid with glycine. In clinical practice,
Correct answer: Hippuric acid.
Hyppuric acid (benzoylglycine) is formed due to
interaction in the liver (and partly in the kidneys)
of benzoic acid with glycine. In clinical practice,
for the purpose of studying the detoxifying
function of the liver, a Quicks’ test is performed:
the amount of hippuric acid that is excreted in the
urine after 4 hours after per os administration of
the standard dose of sodium benzoate under the
normal conditions should be 2.0 - 2.5 g. Reduction
of this amount indicates a disturbance of the liver
detoxification function.
function of the stomach?
A. * Hippuric acid
B. Phenylacetic acid
C. Citric acid
D. Valerian acid
E. Oxalic acid
for the purpose of studying the detoxifying
function of the liver, a Quicks’ test is performed:
the amount of hippuric acid that is excreted in the
urine after 4 hours after per os administration of
the standard dose of sodium benzoate under the
normal conditions should be 2.0 - 2.5 g. Reduction
of this amount indicates a disturbance of the liver
detoxification function.
5. To determine the antitoxic function of the liver, the
patient is assigned sodium benzonate, which in the
liver turns into hippuric acid. What compound is used
for this?
A. * Glycine
B. Methionine
C. Cysteine
D. FAFS
E. UDF - glucuronic acid
Correct answer: Glycine.
Hippuric acid (benzoylglycine) is formed due to
interaction in the liver and in the kidneys of
benzoic acid with glycine.
6. In a patient with chronic alcoholic liver disease,
processes of xenobiotics and endogenous toxic
compounds
biotransformation
are
disturbed.
Reducing the activity of which chromoprotein can be
the cause of this?
A. * Cytochrome P-450
B. Hemoglobin
C. Cytochrome Oxidase
D. Cytochrome b
E. Cytochrome c1
Correct answer: Cytochrome P-450.
Biotransformation of xenobiotics and endogenous
toxic compounds occurs in the liver and consists
of two stages - microsomal oxidation and
conjugation reactions, the consistent functioning
of which provides for the elimination of a number
of foreign substances of all chemical classes. The
main component of the microsomal system is the
chromoprotein cytochrome P-450, which as a
prosthetic group contains heme and has binding
sites for oxygen and substrate.
7. A patient suffering from chronic hepatitis
complains of increasing the sensitivity to
barbiturates, which were earlier tolerated without
symptoms of intoxication. With the disturbance of
which of the liquor functions, this is connected at the
highest possible level?
A. * Detoxification
B. Hemopoietic
C. Hemodynamic
D. Formation of bile
E. Phagocytic
Correct answer: Detoxification.
In normal conditions, barbiturates undergo
biochemical
modification
in
the
liver
(hydroxylation in reactions of microsomal
oxidation and subsequent glucuronidation in the
conjugation reaction), resulting in the formation of
polar, water soluble metabolites (glucuronide
barbiturates) which are easily derived from the
body in urine. In chronic hepatitis the
detoxification function of hepatocytes decreases,
as a result of which the toxicity of xenobiotics
(including barbiturates) increases, causing
poisoning (intoxication).
8. The universal biological system of oxidation of
nonpolar compounds (drugs, toxic compounds),
steroid hormones, cholesterol is microsomal
oxidation. What is the name of the cytochrome,
which is part of the oxygenase chain of the
microsome.
A. * Cytochrome P 450.
Correct answer: Cytochrome P450.
The main component of the microsomal system is
the Cytochrome P-450. It belongs to
hemoproteins, as a prosthetic group contains hem
and has ligands for oxygen and substrate
(xenobiotics, steroids, fatty acids, etc.).
B. Cytochrome a3.
C. Cytochrome in.
D. Cytochrome c.
E. Cytochrome a.
9. Excretion of animal indican in the urine is
observed at decay products of detoxification of the
certain amino acid in the colon. Name this amino
acid.
A. * Tryptophan.
B. Valin.
C. Glycine.
D. Serin.
E. Cysteine
Correct answer: Tryptophan.
Free indole is formed in the colon as a result of the
action of enzymes of microorganisms on Ltryptophan, then by microsomal oxidation (phase I
of biotransformation) in the liver turns into indoxil
and gose to the conjugation reacts with FAFS
(Phase II of biotransformation). The indoxil
sulfate formed during the reaction is excreted in
the form of potassium salt in urine, which was
named "animal indican".
10. Study of conversion of a food colouring agent
revealed that neutralization of this xenobiotic takes
place only in one phase - microsomal oxydation.
Name a component of this phase:
A. *Cytochrome Р-450
B. Cytochrome B
C. Cytochrome C
D. Cytochrome A
E. Cytochrome oxidase
Correct answer: Cytochrome P-450.
Biotransformation of xenobiotics and endogenous
toxic compounds occurs in the liver and consists
of two stages - microsomal oxidation and
conjugation reactions, the consistent functioning
of which provides for the elimination of a number
of foreign substances of all chemical classes. The
main component of the microsomal system is the
chromoprotein cytochrome P-450, which as a
prosthetic group contains heme and has binding
sites for oxygen and substrate.
11. Test Kvika was administered for Male 32 years
with hepatic impairment to understand detoxication
ability. Results of urine show low levels of:
A. *Hippuric acid
B. Hydroxyproline
C. Sodium benzoate
D. Creatinine
E. Amino acids
Correct answer: Hippuric acid.
Hyppuric acid (benzoylglycine) is formed due to
interaction in the liver (and partly in the kidneys)
of benzoic acid with glycine. In clinical practice,
for the purpose of studying the detoxifying
function of the liver, a Quicks’ test is performed:
the amount of hippuric acid that is excreted in the
urine after 4 hours after per os administration of
the standard dose of sodium benzoate under the
normal conditions should be 2.0 - 2.5 g. Reduction
of this amount indicates a disturbance of the liver
detoxification function.
.
Investigation of xenobiotics and endogenous toxins biotransformation processes.
Microsomal oxidation, cytochrome P 450
1. Detoxification of xenobiotics (drugs, epoxides, the arena oxides, aldehydes, nitro derivatives,
etc.) and endogenous metabolites (estradiol, prostaglandins, leukotrienes) takes place in the liver
by conjugation with:
A.
*Glutathione
B.
Aspartic acid
C.
Glycine
D.
S-Adenozylmethionin
E.
Fosfoadenozyn
F.
2. In the 70's, scientists found that the cause of severe jaundice of newborns is a disturbance of
the binding of bilirubin in hepatocytes. What substance is used to form a conjugate?
A. * Glucuronic acid
B. Uric acid
C. Sulfuric acid
D. Lactic acid
E. Pyruvic acid
3. Patient has cirrhosis of the liver. The study of which of the listed substances that are excreted
in the urine can characterize the state of the antitoxic function of the liver?
A. * Hippuric acid
B. Ammonium salts
C. Creatinine
D. Uric acid
E. Amino acids
4. For a patient suffering from chronic hepatitis, a load of sodium benzoate was carried out to
evaluate the degreasing function of the liver. For the discharge of what substances with urine
judge the neutralizing function of the stomach?
A. * Hippuric acid
B. Phenylacetic acid
C. Citric acid
D. Valerian acid
E. Oxalic acid
5. To determine the antitoxic function of the liver, the patient is assigned sodium benzonate,
which in the liver turns into hippuric acid. What compound is used for this?
A. * Glycine
B. Methionine
C. Cysteine
D. FAFS
E. UDF - glucuronic acid
6. In a patient with chronic alcoholic liver disease, processes of xenobiotics and endogenous
toxic compounds biotransformation are disturbed. Reducing the activity of which chromoprotein
can be the cause of this?
A. * Cytochrome P-450
B. Hemoglobin
C. Cytochrome Oxidase
D. Cytochrome b
E. Cytochrome c1
7. A patient suffering from chronic hepatitis complains of increasing the sensitivity to
barbiturates, which were earlier tolerated without symptoms of intoxication. With the
disturbance of which of the liquor functions, this is connected at the highest possible level?
A. * Detoxification
B. Hemopoietic
C. Hemodynamic
D. Formation of bile
E. Phagocytic
8. The universal biological system of oxidation of nonpolar compounds (drugs, toxic
compounds), steroid hormones, cholesterol is microsomal oxidation. What is the name of the
cytochrome, which is part of the oxygenase chain of the microsome.
A. * Cytochrome P 450.
B. Cytochrome a3.
C. Cytochrome in.
D. Cytochrome c.
E. Cytochrome a.
9. Excretion of animal indican in the urine is observed at decay products of detoxification of the
certain amino acid in the colon. Name this amino acid.
A. * Tryptophan.
B. Valin.
C. Glycine.
D. Serin.
E. Cysteine
10. Study of conversion of a food colouring agent revealed that neutralization of this xenobiotic
takes place only in one phase - microsomal oxydation. Name a component of this phase:
A. *Cytochrome Р-450
B. Cytochrome B
C. Cytochrome C
D. Cytochrome A
E. Cytochrome oxidase
11. Test Kvika was administered for Male 32 years with hepatic impairment to understand
detoxication ability. Results of urine show low levels of:
A. *Hippuric acid
B. Hydroxyproline
C. Sodium benzoate
D. Creatinine
E. Amino acids