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Base of Krok 1 med

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Quite often the cause of secondary immunodeficiency is an infection involvement, when the
causative agents propagate directly in the cells of immune system and destroy it. The following
diseases are characterized by:
{=Infectious mononucleosis, AIDS
~Tuberculosis, mycobacteriosis
~Poliomyelitis, type A hepatitis
~Dysentery, cholera
~Q-febris, epidemic typhus}
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?
{=C
~B6
~B1
~A
~B2}
A 2-year-old child with mental and physical retardation has been delivered to a hospital. He
presents with frequent vomiting after having meals. There is phenylpyruvic acid in urine. Which
metabolism abnormality is the reason for this pathology?
{=Amino-acid metabolism
~Lipidic metabolism
~Carbohydrate metabolism
~Water-salt metabolism
~Phosphoric calcium metabolism}
Medical examination at the military registration and enlistment office revealed that a 15-year-old
boy was high, with eunuchoid body proportions, gynecomastia, female pattern of pubic hair
distribution. The boy had also fat deposits on the thighs, no facial hair, high voice, subnormal
intelligence quotient. Which karyotype corresponds with this disease?
{=47, XXY
~45, XO
~46, XX
~46, XY
~47, XXX}
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?
{=Vitamin U
~Pantothenic acid
~Vitamin C
~Vitamin B1
~Vitamin K}
Urine analysis of a 12-year-old boy reveals high concentration of all aliphatic amino acids with the
highest excretion of cystine and cysteine. US of kidneys revealed kidney concrements. What is the
most likely pathology?
{=Cystinuria
~Alkaptonuria
~Cystitis
~Phenylketonuria
~Hartnup disease}
It was revealed that T-lymphocytes were affected by HIV. Virus enzyme - reverse transcriptase
(RNA-dependent DNA-polymerase) - catalyzes the synthesis of:
{=DNA on the matrix of virus mRNA
~Virus informational RNA on the matrix of DNA
~DNA on virus ribosomal RNA
~Viral DNA on DNA matrix
~mRNA on the matrix of virus protein}
After transfusion of 200 ml of blood a patient presented with body temperature rise up to 37,9oC.
Which of the following substances is the most likely cause of temperature rise?
{=Interleukin-1
~Interleukin-2
~Tumour necrosis factor
~Interleukin-3
~Interleukin-4}
A patient has an increased pyruvate concentration in blood, most of it is excreted with the urine.
What kind of avitaminosis has this patient?
{=B1
~E
~B3
~B6
~B2}
One of the parents is suspected of having phenylketonuria recessive gene. What is the risk of giving
birth to a child with inborn phenylketonuria?
{=0%
~25%
~50%
~75%
~100%}
A 12-year-old teenager has signifi- cantly put off weight within 3 months; glucose concentration
rose up to 50 millimole/l. He fell into a coma. What is the main mechanism of its development?
{=Hyperosmolar
~Hypoglycemic
~Ketonemic
~Lactacidemic
~Hypoxic}
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?
{=Nongaseous alkalosis
~Gaseous alkalosis
~Gaseous acidosis
~Metabolic acidosis
~Excretory acidosis}
A 10-year-old child had the mantoux tuberculin test administered. 48 hours later a papule up to 8
mm in diameter appeared on the site of the injection. What type of hypersensitivity reaction
developed after the tuberculin injection?
{=Type IV hypersensitivity reaction
~Arthus phenomenon
~Seroreaction
~Atopic reaction
~Type II hypersensitivity reaction}
Examination of a pregnant woman having Rh-negative blood revealed high level of antierythrocytic
antibodies. For its reduction she was implanted with her husband’s Rh-positive skin graft. The graft
was rejected in two weeks. Its microscopic examination revealed circulatory disturbance, edema
and cellular infiltration with lymphocytes, neutrophils and macrophages predominance. What is the
most likely pathology?
{=Graft immunity
~Immediate hypersensitivity
~Delayed-type hypersensitivity
~Granulomatous inflammation
~Interstitial inflammation}
The patient with complaints of permanent thirst applied to the doctor. Hyperglycemia, polyuria and
increased concentration of 17-ketosteroids in the urine were revealed. What disease is the most
likely?
{=Steroid diabetes
~Insulin-dependent diabetes mellitus
~Myxoedema
~Type I glycogenosis
~Addison’s disease}
An infant has pylorospasm, weakness, hypodynamia, convulsions as a result of frequent vomiting.
What kind of acid-base disbalance is it?
{=Excretory alkalosis
~Excretory acidosis
~Metabolic acidosis
~Exogenous nongaseous acidosis
~Gaseous alkalosis}
A 19-year-old female patient has had low haemoglobin rate of 90-95 g/l since childhood. Blood
count results obtained after hospitalisation are as follows: erythrocytes - 3, 2 · 1012/l, Hb- 85 g/l,
colour index - 0,78; leukocytes - 5, 6 · 109/l, platelets - 210 · 109/l. Smear examination revealed
anisocytosis, poikilocytosis and target cells. Reticulocyte rate is 6%. Iron therapy was ineffective.
What blood pathology corresponds with the described clinical presentations?
{=Thalassemia
~Enzymopathy
~Membranopathy
~Sickle-cell anemia
~Favism}
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:
{=C-reactive protein
~Prothrombin
~Fibrinogen
~G immunoglobulin
~A immunoglobulin}
There is a severe time restriction for people’s staying at a height of over 800 m above the sea level
without oxygen bombs. What is the life limiting factor in this case?
{=Partial oxygen pressure
~Ultraviolet intensity
~Moisture level
~Temperature
~Earth gravity}
During surgical manipulations a patient has been given novocaine injection for anesthesia. 10
minutes later the patient developed paleness, dyspnea, hypotension. What type of allergic reaction is
it?
{=Anaphylactic immune reaction
~Cellulotoxic immune reaction
~Aggregate immune reaction
~Stimulating immune reaction
~Cell-mediated immune reaction}
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?
{=Transcription
~Processing
~Replication
~Translation
~Reparation}
A child with a history of frequent angine and pharyngitis has been diagnosed with lymphadenopathy
and splenomegaly. His appearance is characterised by pastosity and paleness, muscular tissue is
poorly developed. Lymphocytosis is present. What kind of diathesis is it?
{=Lymphohypoplastic diathesis
~Exudative diathesis
~Gouty diathesis
~Asthenic diathesis
~Hemorrhagic diathesis}
After an immunoassay a child was diagnosed with immunodeficiency of humoral immunity. What
is the reason for the primary immunodeficiency development in the child?
{=Hereditary abnormality of immune system
~Embryonal development abnormalities
~Pathometabolism in mother’s organism
~Immune responsiveness and resistance disorders
~Toxic damage of B-lymphocytes}
Examination of a 12-year-old boy with developmental lag revealed achondroplasia: disproportional
constitution with evident shortening of upper and lower limbs as a result of growth disorder of
epiphyseal cartilages of long tubal bones. This disease is:
{=Inherited, dominant
~Inherited, recessive
~Inherited, sex-linked
~CongenitalA man suffering from a hereditary disease married a healthy woman. They got 5
children, three girls and two boys. All the girls inherited their father’s disease. What is the type of
the disease inheritance?
{=Dominant, X-linked
~Autosomal recessive
~Asutosomal dominant
~Y –linked
~Recessive, X-linked}
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:
{=Glycogen phosphorylase
~Glucose 6-phosphate dehydrogenase
~Alpha amylase
~Gamma amylase
~Lysosomal glycosidase}
A couple has a son with haemophilia. The parents are healthy but the maternal grandfather also has
haemophilia. Specify the type of inheritance:
{=Recessive sex-linked
~Recessive autosomal
~Dominant sex-linked
~Semidominance
~Autosomal dominant}
Examination of newborns in one of the Ukrainian cities revealed a baby with phenylketonuria. The
baby’s parents don’t suffer from this disease and have two other healthy children. Specify the most
likely parents’ genotype with phenylketonuria gene:
{=Аа х Аа
~АА х аа
~аа х аа
~Аа х аа
~Аа х АА}
46 chromosomes were revealed onkaryotype examination of the 5 year old girl. One of the 15th pair
of chromosomes is longer than usual due to connected chromosome from the 21 pair. What type of
mutation does this girl have?
{=Translocation
~Deletion
~Inversion
~Insufficiency
~Duplication}
A patient with obliterating endarteritis underwent ganglionic sympathectomy. What type of arterial
hyperaemia should have developed as a result of the surgery?
{=Neuroparalytic
~Neurotonic
~Metabolic
~Functional
~Reactive}
A man with a long-term history of bronchial asthma died from asphyxia. Histological examination
of his lungs revealed that the lumens of bronchioles and minor bronchi contained a lot of mucus
with some eosinophils. There was also sclerosis of interalveolar septa, dilatation of alveole lumens.
What mechanism accounts for the development of hypersensitivity reaction?
{=Reagine reaction
~Cytotoxic reaction
~Immune complex reaction
~Lymphocyte-mediated cytolysis
~Granulomatosis}
The immunoblot detected gp120 protein in the blood serum. This protein is typical for the following
disease:
{=HIV-infection
~Virus B hepatitis
~Tuberculosis
~Syphilis
~Poliomyelitis}
HIV has gp41 and gp120 on its surface interacts with target cells of an organism. Which of the
following human lymphocyte antigens is gp120 complementary bound with
{=CD 4
~CD 3
~CD 8
~CD 19
~CD 28}
During a prophylactic medical examination a 7-year-old boy was diagnosed with daltonism. His
parents are healthy and have normal colour vision, but his grandfather on his mother’s side has the
same abnormality. What is the type of the abnormality inheritance?
{=Recessive, sex-linked
~Dominant, sex-linked
~Semidominance
~Autosomal recessive
~Autosomal dominant}
A 56 year old patient suffering from cardiac insufficiency has edema of feet and shins, edematous
skin is pale and cold. What is the leding mechanism of edema pathogenesis?
{=Rise of hydrostatic pressure in venules
~Drop of oncotic pessure in capillaries
~Increase of capillary permeability
~Disorder of lymph outflow
~Positive water balance}
A 10 year old child had the mantoux tuberculin test administered. 48 hours later a papule up to 8
mm in diameter appeared on the site of the injection. What type of hypersensitivity reaction
developed after the tuberculin injection?
{=Type IV hypersensitivity reaction
~Arthus phenomenon
~Seroreaction
~Atopic reaction
~Type II hypersensitivity reaction}
According to the phenotypic diagnosis a female patient has been provisionally diagnosed with Xchromosome polysomia. This diagnosis can be confi- rmed by a cytogenetic method. What
karyotype will allow to confirm the di- agnosis?
{=47(ХХХ)
~48(XXXY)
~48(XXYY)
~47(XXY)
~46(XX)}
A patient has been diagnosed with acute glomerulonephritis that developed after he had had
streptococcal infection. It is most likely that the affection of basal glomerular membrane is caused
by an allergic reaction of the following type:
{=Immune complex
~Anaphylactic
~Cytotoxic
~Delayed
~Stimulating}
Examination of patients with periodontitis revealed the interdependence between the rate of
affection of periodontal tissues and the amount of lysozymes in saliva and gingival liquid. These
results can be obtained during studying the following protection system of an organism:
{=Non-specific resistance
~Humoral immunity
~Cellular immunity
~Autoresponsiveness
~Tolerance}
An infant has pylorospasm, weakness, hypodynamia, convulsions as a result of frequent vomiting.
What kind of acid-base disbalance is it?
{=Excretory alkalosis
~Excretory acidosis
~Metabolic acidosis
~Exogenous nongaseous acidosis
~Gaseous alkalosis}
A 49 year old woman spent a lot of time standing. As a result of it she got leg edema. What is the
most likely cause of the edema?
{=Increase in hydrostatic pressure of blood in veins
~Decrease in hydrostatic pressure of blood in veins
~Decrease in hydrostatic pressure of blood in arteries
~Increase in oncotic pressure of blood plasma
~Increase in systemic arterial pressure}
Blood test of a patient suffering from atrophic gastritis gave the following results: RBCs - 2, 0 ·
1012/l, Hb- 87 g/l, colour index - 1,3, WBCs - 4, 0 · 109/l, thrombocytes - 180 · 109/l. Anaemia
migh have been caused by the following substance deficiency:
{=Vitamin B12
~Vitamin A
~Vitamin K
~Iron
~Zinc}
As a result of a trauma a patient has developed traumatic shock that led to the following disorders:
AP is 140/90 mm Hg, Ps is 120 bpm. The patient is fussy, talkative, pale. Such state relates to the
following shock phase:
{=Erectile
~Latent period
~Terminal
~Torpid
~–}
Cytogenetic examination of a patient with dysfunction of the reproductive system revealed normal
karyotype 46,ХУ in some cells, but most cells have Klinefelter’s syndrome karyotype - 47,ХХУ.
Such phenomenon of cell inhomogeneity is called:
{=Mosaicism
~Inversion
~Transposition
~Duplication
~Heterogeneity}
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
signifi- cantly reduced. Analysis showed also lack of B-lymphocytes and plasmocytes. What disease
are these symptoms typical for?
{=Bruton’s disease
~Swiss-type agammaglobulinemia
~Dysimmunoglobulinemia
~Louis-Bar syndrome
~Di George syndrome}
A cell at the stage of mitosis anaphase was stimulated by colchicine that inhibits chromosome
separation to the poles. What type of mutation will be caused?
{=Polyploidy
~Inversion
~Deletion
~Duplication
~Translocation}
A 45 year old male died from disseminated tuberculosis. On autopsy the symptoms of tuberculosis
were confirmed by both microscopical and histological analyses. All the affected organs had
epithelioid cell granulomas with caseous necrosis in the centre. What kind of hypersensitivity
reaction underlies the process of granuloma development?
{=Delayed
~Antibody-dependent cytotoxicity
~Complement-dependent cytotoxicity
~Anaphylactic
~Immune complex}
Sex chromosomes of a woman didn’t separate and move to the opposite poles of a cell during
gametogenesis (meiosis). The ovum was impregnated with a normal spermatozoon. Which
chromosomal disease can be found in her child?
{=Turner’s syndrome
~Down’s syndrome
~Patau’s syndrome
~Edwards’ syndrome
~Cat cry syndrome}
After taking poor-quality food a patient developed repeated episodes of diarrhea. On the next day he
presented with decreased arterial pressure, tachycardia, extrasystole. Blood pH is 7,18. These
abnormalities were caused by the development of:
{=Nongaseous acidosis
~Gaseous acidosis
~Nongaseous alkalosis
~Gaseous alkalosis
~Metabolic alkalosis}
A patient has been diagnosed with influenza. His condition became drastically worse after taking
antipyretic drugs. His consciousness is confused, AP is 80/50 mm Hg, Ps is 140/m, body
temperature droped down to 35, 8oC. What complication developed in this patient?
{=Collapse
~Hyperthermia
~Hypovolemia
~Acidosis
~Alkalosis}
~Acquired}
During starvation muscle proteins break up into free amino acids. These compounds will be the
most probably involved into the following process:
{=Gluconeogenesis in liver
~Gluconeogenesis in muscles
~Synthesis of higher fatty acids
~Glycogenolysis
~Decarboxylation}
A 28-year-old female patient consulted a gynecologist about sterility. Examination revealed
underdeveloped ovaries and uterus, irregular menstrual cycle. Analysis of the sex chromatin
revealed 2 Barr’s bodies in most somatic cells. What chromosome disease is most likely?
{=Triple X syndrome
~Edwards’ syndrome
~Patau’s syndrome
~Klinefelter’s syndrome
~Turner’s syndrome}
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:
{=Lactase
~Invertase
~Maltase
~Amylase
~Isomaltase}
A patient with enteritis accompanied by massive diarrhea has low water rate in the extracellular
space, high water rate inside the cells and low blood osmolarity. What is such disturbance of
waterelectrolytic metabolism called?
{=Hypo-osmolar hypohydration
~Hyperosmolar hypohydration
~Osmolar hypohydration
~Hypo-osmolar hyperhydration
~Hyperosmolar hyperhydration}
Sex chromosomes of a woman didn’t separate and move to the opposite poles of a cell during
gametogenesis (meiosis). The ovum was impregnated with a normal spermatozoon. Which
chromosomal disease can be found in her child?
{=Turner’s syndrome
~Down’s syndrome
~Patau’s syndrome
~Edwards’ syndrome
~Cat cry syndrome}
A 25-year-old man has spent a long time in the sun under high air humidity. As a result of it his
body temperature rose up to 39oC. What pathological process is it?
{=Hyperthermia
~Infectious fever
~Hypothermia
~Noninfectious fever
~Burn disease}
Cytogenetic examination of a patient with reproductive dysfunction revealed normal karyotype 46
ХY in some cells, but most cells have karyotype of Klinefelter’s syndrome - 47 ХХY. Such cell
heterogenity is called:
{=Mosaicism
~Inversion
~Transposition
~Duplication
~Monomorphism}
A man suffering from a hereditary disease married a healthy woman. They got 5 children, three girls
and two boys. All the girls inherited their father’s disease. What is the type of the disease
inheritance?
{=Dominant, X-linked
~Autosomal recessive
~Asutosomal dominant
~Y –linked
~Recessive, X-linked}
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:
{=Glycogen phosphorylase
~Glucose 6-phosphate dehydrogenase
~Alpha amylase
~Gamma amylase
~Lysosomal glycosidase}
A couple has a son with haemophilia. The parents are healthy but the maternal grandfather also has
haemophilia. Specify the type of inheritance:
{=Recessive sex-linked
~Recessive autosomal
~Dominant sex-linked
~Semidominance
~Autosomal dominant}
Examination of newborns in one of the Ukrainian cities revealed a baby with phenylketonuria. The
baby’s parents don’t suffer from this disease and have two other healthy children. Specify the most
likely parents’ genotype with phenylketonuria gene:
{=Аа х Аа
~АА х аа
~аа х аа
~Аа х аа
~Аа х АА}
chromosomes were revealed onkaryotype examination of the 5 year old girl. One of the 15th pair of
chromosomes is longer than usual due to connected chromosome from the 21 pair. What type of
mutation does this girl have?
{=Translocation
~Deletion
~Inversion
~Insufficiency
~Duplication}
A patient with obliterating endarteritis underwent ganglionic sympathectomy. What type of arterial
hyperaemia should have developed as a result of the surgery?
{=Neuroparalytic
~Neurotonic
~Metabolic
~Functional
~Reactive}
A man with a long-term history of bronchial asthma died from asphyxia. Histological examination
of his lungs revealed that the lumens of bronchioles and minor bronchi contained a lot of mucus
with some eosinophils. There was also sclerosis of interalveolar septa, dilatation of alveole lumens.
What mechanism accounts for the development of hypersensitivity reaction?
{=Reagine reaction
~Cytotoxic reaction
~Immune complex reaction
~Lymphocyte-mediated cytolysis
~Granulomatosis}
The immunoblot detected gp120 protein in the blood serum. This protein is typical for the following
disease:
{=HIV-infection
~Virus B hepatitis
~Tuberculosis
~Syphilis
~Poliomyelitis}
HIV has gp41 and gp120 on its surface interacts with target cells of an organism. Which of the
following human lymphocyte antigens is gp120 complementary bound with
{=CD 4
~CD 3
~CD 8
~CD 19
~CD 28}
During a prophylactic medical examination a 7-year-old boy was diagnosed with daltonism. His
parents are healthy and have normal colour vision, but his grandfather on his mother’s side has the
same abnormality. What is the type of the abnormality inheritance?
{=Recessive, sex-linked
~Dominant, sex-linked
~Semidominance
~Autosomal recessive
~Autosomal dominant}
A 56 year old patient suffering from cardiac insufficiency has edema of feet and shins, edematous
skin is pale and cold. What is the leding mechanism of edema pathogenesis?
{=Rise of hydrostatic pressure in venules
~Drop of oncotic pessure in capillaries
~Increase of capillary permeability
~Disorder of lymph outflow
~Positive water balance}
A 10 year old child had the mantoux tuberculin test administered. 48 hours later a papule up to 8
mm in diameter appeared on the site of the injection. What type of hypersensitivity reaction
developed after the tuberculin injection?
{=Type IV hypersensitivity reaction
~Arthus phenomenon
~Seroreaction
~Atopic reaction
~Type II hypersensitivity reaction}
According to the phenotypic diagnosis a female patient has been provisionally diagnosed with Xchromosome polysomia. This diagnosis can be confi- rmed by a cytogenetic method. What
karyotype will allow to confirm the di- agnosis?
{=47(ХХХ)
~48(XXXY)
~48(XXYY)
~47(XXY)
~46(XX)}
A patient has been diagnosed with acute glomerulonephritis that developed after he had had
streptococcal infection. It is most likely that the affection of basal glomerular membrane is caused
by an allergic reaction of the following type:
{=Immune complex
~Anaphylactic
~Cytotoxic
~Delayed
~Stimulating}
Examination of patients with periodontitis revealed the interdependence between the rate of
affection of periodontal tissues and the amount of lysozymes in saliva and gingival liquid. These
results can be obtained during studying the following protection system of an organism:
{=Non-specific resistance
~Humoral immunity
~Cellular immunity
~Autoresponsiveness
~Tolerance}
An infant has pylorospasm, weakness, hypodynamia, convulsions as a result of frequent vomiting.
What kind of acid-base disbalance is it?
{=Excretory alkalosis
~Excretory acidosis
~Metabolic acidosis
~Exogenous nongaseous acidosis
~Gaseous alkalosis}
A 49 year old woman spent a lot of time standing. As a result of it she got leg edema. What is the
most likely cause of the edema?
{=Increase in hydrostatic pressure of blood in veins
~Decrease in hydrostatic pressure of blood in veins
~Decrease in hydrostatic pressure of blood in arteries
~Increase in oncotic pressure of blood plasma
~Increase in systemic arterial pressure}
Blood test of a patient suffering from atrophic gastritis gave the following results: RBCs - 2, 0 ·
1012/l, Hb- 87 g/l, colour index - 1,3, WBCs - 4, 0 · 109/l, thrombocytes - 180 · 109/l. Anaemia
migh have been caused by the following substance deficiency:
{=Vitamin B12
~Vitamin A
~Vitamin K
~Iron
~Zinc}
As a result of a trauma a patient has developed traumatic shock that led to the following disorders:
AP is 140/90 mm Hg, Ps is 120 bpm. The patient is fussy, talkative, pale. Such state relates to the
following shock phase:
{=Erectile
~Latent period
~Terminal
~Torpid
~–}
Cytogenetic examination of a patient with dysfunction of the reproductive system revealed normal
karyotype 46,ХУ in some cells, but most cells have Klinefelter’s syndrome karyotype - 47,ХХУ.
Such phenomenon of cell inhomogeneity is called:
{=Mosaicism
~Inversion
~Transposition
~Duplication
~Heterogeneity}
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
signifi- cantly reduced. Analysis showed also lack of B-lymphocytes and plasmocytes. What disease
are these symptoms typical for?
{=Bruton’s disease
~Swiss-type agammaglobulinemia
~Dysimmunoglobulinemia
~Louis-Bar syndrome
~Di George syndrome}
A cell at the stage of mitosis anaphase was stimulated by colchicine that inhibits chromosome
separation to the poles. What type of mutation will be caused?
{=Polyploidy
~Inversion
~Deletion
~Duplication
~Translocation}
A 45 year old male died from disseminated tuberculosis. On autopsy the symptoms of tuberculosis
were confirmed by both microscopical and histological analyses. All the affected organs had
epithelioid cell granulomas with caseous necrosis in the centre. What kind of hypersensitivity
reaction underlies the process of granuloma development?
{=Delayed
~Antibody-dependent cytotoxicity
~Complement-dependent cytotoxicity
~Anaphylactic
~Immune complex}
Sex chromosomes of a woman didn’t separate and move to the opposite poles of a cell during
gametogenesis (meiosis). The ovum was impregnated with a normal spermatozoon. Which
chromosomal disease can be found in her child?
{=Turner’s syndrome
~Down’s syndrome
~Patau’s syndrome
~Edwards’ syndrome
~Cat cry syndrome}
After taking poor-quality food a patient developed repeated episodes of diarrhea. On the next day he
presented with decreased arterial pressure, tachycardia, extrasystole. Blood pH is 7,18. These
abnormalities were caused by the development of:
{=Nongaseous acidosis
~Gaseous acidosis
~Nongaseous alkalosis
~Gaseous alkalosis
~Metabolic alkalosis}
A patient has been diagnosed with influenza. His condition became drastically worse after taking
antipyretic drugs. His consciousness is confused, AP is 80/50 mm Hg, Ps is 140/m, body
temperature droped down to 35, 8oC. What complication developed in this patient?
{=Collapse
~Hyperthermia
~Hypovolemia
~Acidosis
~Alkalosis}
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
{=Vitamin B6
~Vitamin A
~Vitamin
~Vitamin B12
~Vitamin C 2}
A 60-year-old male patient has a 9-year history of diabetes and takes insulin Semilente for the
correction of hyperglycemia. 10 days ago he began taking anaprilin for hypertension. One hour after
administration of the antihypertensive drug the patient developed hypoglycemic coma. What is the
mechanism of hypoglycemia in case of anaprilin use?
{=Inhibition of glycogenolysis
~Reduction of glucagon half-life
~Increase of insulin Semilente half-life
~Increase of bioavailability of insulin Semilente
~Decrease in glucose absorption}
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?
{=Mononuclear cells, T-lymphocytes and lymphokines
~Granulocytes, T-lymphocytes and IgG
~Plasma cells, T-lymphocytes and lymphokines
~B-lymphocytes, IgM
~Macrophages, B-lymphocytes and monocytes}
A patient with diabetes developed a diabetic coma due to the acid-base imbalance. Specify the kind
of this imbalance:
{=Metabolic acidosis
~Metabolic alkalosis
~Respiratory acidosis
~Gaseous alkalosis
~Non-gaseous alkalosis}
A female patient has been diagnosed with cervical erosion, which is a precancerous pathology.
What defense mechanism can prevent the development of a tumor?
{=Increase in natural killer level (NKcells)
~High-dose immunological tolerance
~Increase in the activity of lysosomal enzymes
~Simplification of the antigenic structure of tissues
~Low-dose immunological tolerance}
Examination of an 18-year-old girl revealed the following features: hypoplasia of the ovaries, broad
shoulders, narrow pelvis, shortening of the lower extremities, "sphinx neck". Mental development is
normal. The girl was diagnosed with Turner’s syndrome. What kind of chromosome abnormality is
it?
{=Monosomy X
~Trisomy X
~Trisomy13
~Trisomy 18
~Nullisomy X}
Hypertrichosis is the Y-linked character. The father has hypertrichosis, and the mother is healthy. In
this family, the probability of having a child with hypertrichosis is:
{=0,5
~0,25
~0,125
~0,625
~1}
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?
{=Compensated respiratory acidosis
~Compensated metabolic acidosis
~Decompensated metabolic acidosis
~Compensated respiratory alkalosis
~Decompensated respiratory alkalosis}
A 35-year-old male patient has been referred by an andrologist for the genetic counselling for the
deviations of physical and mental development. Objectively: the patient is tall, has asthenic
constitution, gynecomastia, mental retardation. Microscopy of the oral mucosa cells revealed sex
chromatin (single Barr body) in 30% of cells. What is the most likely diagnosis?
{=Klinefelter syndrome
~DiGeorge syndrome
~Down syndrome
~Recklinghausen’s disease
~Cushing pituitary basophilism}
A patient with lobar pneumonia has had body temperature of 39oC with daily temperature
fluctuation of no more than 1oC for 9 days. This fever can be characterized by the following
temperature curve:
{=Persistent
~Hectic
~Remittent
~Hyperpyretic
~Recurrent}
A diseased child has a high fever, sore throat, swelling of submandibular lymph nodes. Objectively:
pharyngeal mucosa is edematous, moderately hyperemic, the tonsils are enlarged, covered with
grayish membrane tightly adhering to the tissues above. Attempts to remove the membrane produce
the bleeding defects. What disease are these presentations typical for?
{=Diphtheria
~Catarrhal tonsillitis
~Scarlet fever
~Meningococcal disease
~Measles}
Healthy parents with unremarkable family history have the child with multiple developmental
defects. Cytogenetic analysis revealed the trisomy 13 in the somatic cells (Patau syndrome). What
phenomenon has caused the defects?
{=Abnormal gametogenesis
~Somatic mutation
~Recessive mutation
~Dominant mutation
~Chromosomal mutation}
A 25-year-old patient consulted a doctor about dysmenorrhea and infertility. Examination revealed
that the patient was 145 cm high and had underdeveloped secondary sex characteristics, alar folds
on the neck. Cytological study didn’t reveal any Barr bodies in the somatic cells. What diagnosis
was made?
{=Turner’s syndrome
~Klinefelter syndrome
~Morris syndrome
~Trisomy X syndrome
~–}
A patient with a pathology of the cardiovascular system developed edemata of the lower
extremities. What is the mechanism of cardiac edema development?
{=Increased hydrostatic pressure at the venous end of the capillary
~Increased oncotic pressure
~Increased hydrostatic pressure at the arterial end of the capillary
~Reduced osmotic pressure
~Lymph efflux disorder}
Amniocentesis revealed two sex chromatin bodies (Barr bodies) in each cell of the sample. What
disease is this character typical for?
{=Trisomy X
~Klinefelter syndrome
~Turner’s syndrome
~Down’s syndrome
~Patau syndrome}
A male patient has been diagnosed with acute post-streptococcal glomerulonephritis. It is most
likely that the lesion of the basement membraneof renal corpuscles was caused by the following
allergic reaction:
{=Immune complex
~Anaphylactic
~Cytotoxic
~Delayed
~Stimulating}
During the intravenous transfusion of the saline the patient’s condition deteriorated dramatically,
and the patient died from asphyxiation. Autopsy revealed acute venous congestion of internal
organs with the dramatic right heart dilatation. When the right ventricle was punctured underwater,
the bubbles escaped. What pathological process occurred in the patient?
{=Air embolism
~Gaseous embolism
~Adipose embolism
~Tissue embolism
~Thromboembolism}
A child cut his leg with a piece of glass while playing and was brought to the clinic for the injection
of tetanus toxoid. In order to prevent the development of anaphylactic shock the serum was
administered by Bezredka method. What mechanism underlies this method of desensitization of the
body?
{=Binding of IgE fixed to the mast cells
~Blocking the mediator synthesis in the mast cells
~Stimulation of immune tolerance to the antigen
~Stimulation of the synthesis of antigenspecific IgG
~Binding of IgE receptors to the mast cells}
A mother had taken synthetic hormones during pregnancy. Her daughter was born with hirsutism
formally resembling of adrenal syndrome. Such manifestation of variability is called:
{=Phenocopy
~Mutation
~Recombination
~Heterosis
~Replication}
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 postvaccination immunity in this case?
{=Secretory IgA
~IgM
~IgG
~Serum IgA
~IgE}
An experiment proved that UVirradiated 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?
{=Endonuclease
~RNA ligase
~Primase
~DNA polymerase
~DNA gyrase}
What condition may develop 15-30 minutes after re-administration of the antigen as a result of the
increased level of antibodies, mainly IgE, that are adsorbed on the surface of target cells, namely
tissue basophils (mast cells) and blood basophils?
{=Anaphylaxis
~Antibody-dependent cytotoxicity
~Delayed-type hypersensitivity
~Immune complex hyperresponsiveness
~Serum sickness}
10 days after having quinsy caused by beta-hemolytic streptococcus a 6- year-old child exhibited
symptoms of glomerulonephritis. What mechanism of glomerular lesion is most likely in this case?
{=Immunocomplex
~Cellular cytotoxicity
~Anaphylaxis
~Atopy
~Antibody-dependent cell-mediated cytolysis}
A hypertensive patient had been keeping to a salt-free diet and taking antihypertensive drugs
together with hydrochlorothiazide for a long time. This resulted in electrolyte imbalance. What
disorder of the internal environment occurred in the patient?
{=Hypochloremic alkalosis
~Metabolic acidosis
~Hyperkalemia
~Hypermagnesemia
~Increase in circulating blood volume}
A 54-year-old female was brought to the casualty department after a car accident. A traumatologist
diagnosed her with multiple fractures of the lower extremities. What kind of embolism is most
likely to develop in this case?
{=Adipose
~Tissue
~Thromboembolism
~Gaseous
~Air}
On allergological examination a patient has been diagnosed with pollinosis. Specific desensitization
can be performed by:
{=Intermittent administration of allergen
~Antihistamines
~Glucocorticoids
~Administration of saline
~–}
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:
{=Hyperkalemia
~Hypokalemia
~Hypernatremia
~Hypocalcemia
~Hypercalcemia}
A female patient complains of vision impairment. On examination she was found to have obesity,
fasting hyperglycemia. What complication of diabetes can cause vision impairment?
{=Microangiopathy
~Macroangiopathy
~Atherosclerosis
~Neuropathy
~Glomerulopathy}
Analysis of the family history of children with Van der Woude syndrome revealed that in their
families one of the parents had the typical for this syndrome defects (cleft lip and palate, lip pits
regardless of gender). What is the type of inheritance of this syndrome?
{=Autosomal dominant
~X-linked recessive
~X-linked dominant
~Autosomal recessive
~Multifactorial}
A 6-year-old child with suspected active tuberculous process underwent the diagnostic Mantoux
test. What immunobiological preparation was injected?
{=Tuberculin
~BCG vaccine
~DTP vaccine
~Tularinum
~Td vaccine}
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
{=Collagen
~Keratin
~Albumin
~Hemoglobin
~Fibrinogen}
A boy referred to a genetics clinic was found to have 1 drumstick in blood neutrophils. The boy is
likely to have the following syndrome:
{=Klinefelter’s
~Down’s
~Turner’s
~Edwards’
~Trisomy X}
A 46-year-old female patient consulted a doctor about pain in the small joints of the upper and
lower limbs. The joints are enlarged and shaped like thickened nodes. Serum test revealed an
increase in urate concentration. This might be caused by a disorder in metabolism of:
{=Purines
~Carbohydrates
~Lipids
~Pyrimidines
~Amino acids}
As a result of careless handling of an iron, a 34-year-old female patienthas got acute pain, redness,
swelling of her right index finger. A few minutes later, there appeared a blister fi- lled with a
transparent liquid of strawyellow color. The described changes are a manifestation of the following
pathological process:
{=Exudative inflammation
~Traumatic edema
~Alternative inflammation
~Proliferative inflammation
~Vacuolar degeneration}
The development of both immune and allergic reactions is based upon the same mechanisms of the
immune system response to an antigen. What is the main difference between the immune and
allergic reactions?
{=Development of tissue lesion
~Amount of released antigen
~Antigen structure
~Routes by which antigens are delivered into the body
~Hereditary predisposition}
A 10-year-old child has painful swallowing, neck edema, temperature rise up to 39, 0oC, the whole
body is covered with bright-red petechial rash. Back of the throat and tonsils are hyperemic, the
tongue is crimsoncolored. Tonsillar surface is covered with isolated grayish-colored necrosis nidi.
What disease is it?
{=Scarlet fever
~Meningococcal nasopharyngitis
~Diphtheria
~Influenza
~Measles}
In a patient elevation of body temperature takes turns with drops down to normal levels during the
day. The rise in temperature is observed periodically once in four days. Specify the type of
temperature curve:
{=Febris internuttens
~Febris continua
~Febris reccurens
~Febris hectica
~Febris remitens}
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?
{=Peroxidase and catalase
~Oxygenase and hydroxylase
~Cytochrome oxidase, cytochrome B5
~Oxygenase and catalase
~Flavin-dependent oxidase}
Amniocentesis revealed two sex chromatin bodies (Barr bodies) in each cell of the sample. What
disease is this character typical for?
{=Trisomy X
~Klinefelter syndrome
~Turner’s syndrome
~Down’s syndrome
~Patau syndrome}
A 16-year-old female patient has fainted after quickly changing her body position from horizontal to
vertical one. Which process from the ones listed below has caused the loss of consciousness in the
first place?
{=Decreasing venous return
~Increasing venous return
~Increasing central venous pressure
~Decreasing oncotic pressure of blood plasma
~Increasing arterial pressure}
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?
{=X-linked hypogammaglobulinemia (Bruton type agammaglobulinemia)
~Autosomal recessive agammaglobulinaemia (Swiss type)
~Hypoplastic anemia
~Agranulocytosis
~Louis-Barr syndrome}
A 3-year-old child has continuous fever, lymph nodes are enlarged, the amount of lymphocytes in
blood is significantly increased. Enzymelinked immunosorbent assay (ELISA) revealed antigen of
Epstein-Barr virus. What diagnosis can be made based on the information given above?
{=Infectious mononucleosis
~Burkitt’s lymphoma
~Herpetic lymphadenopathy
~Generalized infection caused by herpes-zoster
~Cytomegalovirus infection}
A female patient saught medicalgenetic consultation. Physical examination revealed pterygium colli
deformity (webbed neck), broad chest, underdeveloped breasts. Study of buccal epithelium cells
revealed no X-chromatin in the nuclei. This indicates that the patient has the following syndrome:
{=Turner’s
~Klinefelter’s
~Patau’s
~Down’s
~Edwards’}
During blood transfusion a patient has developed intravascular erythrocyte hemolysis. What kind of
hypersensitivity does the patient have?
{=II type (antibody-dependent) B.
~I type (anaphylactic)
~III type (immune complex)
~IV type (cellular cytotoxicity)
~IV type (granulomatosis)}
An 8-week-pregnant woman with acute respiratory disease and temperature rise up to 39, 0oC has
called in a doctor. The doctor insisted on her avoiding taking paracetamol, because in this period of
pregnancy there is a risk of its:
{=Teratogenicity
~Embryotoxicity
~Fetotoxicity
~Hepatotoxicity
~Allergenicity}
Examination of a 56-year-old female patient with a history of type 1 diabetes revealed a disorder of
protein metabolism that is manifested by aminoacidemia in the laboratory blood test values, and
clinically by the delayed wound healing and decreased synthesis of antibodies. Which of the
following mechanisms causes thedevelopment of aminoacidemia?
{=Increased proteolysis
~Albuminosis
~Decrease in the concentration of amino acids in blood
~Increase in the oncotic pressure in the blood plasma
~Increase in low-density lipoprotein level}
In the course of puncture biopsy of transplanted kidney the following has been revealed: diffuse
infi- ltration of stroma by lymphocytes and plasmocytes and necrotic arteritis. What pathological
process has developed in the transplant?
{=Immune rejection
~Ischemic kidney failure
~Glomerulonephritis
~Tubular necrosis
~Pyelonephritis}
A 2-year-old boy is diagnosed with Down syndrome. What chromosomal changes may be the cause
of this disease?
{=Trisomy 21
~Trisomy 13
~Trisomy X
~Trisomy 18
~Monosomy X}
A patient has severe blood loss caused by an injury. What kind of dehydration will be observed in
this particular case?
{=Iso-osmolar
~Hyposmolar
~Hyperosmolar
~Normosmolar}
~–
A 30-year-old patient has dyspnea fits, mostly at night. He has been diagnosed with bronchial
asthma. What type of allergic reaction according to the Gell-Coombs classification is most likely in
this case?
{=Anaphylactic
~Cytotoxic
~Stimulating
~Immune complex
~Delayed-type hypersensitivity}
After a road accident a victim has tachycardia, arterial blood pressure 130/90 mm Hg, tachypnoe,
the skin is pale and dry, excitation of central nervous system is observed. What shock stage is the
patient most likely in?
{=Erectile
~Terminal
~Torpid
~Preshock (compensation stage)
~Agony}
In allergic diseases, a dramaic increase in basophilic leukocyte number in patients’ blood is
observed. This phenomenon is due to the following basophil function:
{=Participation of heparin and histamine in metabolism
~Phagocytosis of microorganisms and small particles
~Immunoglobulin synthesis
~Phagocytosis of immune complexes
~Participation in blood clotting}
A patient has acute bronchitis. The fever up to 38, 5oC had lasted for a week, presently there is a
decrease intemperature down to 37, 0oC. Specify the leading mechanism in the 3rd stage of fever:
{=Peripheral vasodilation
~Increased heat production
~Development of chill
~Increased diuresis
~Increased respiratory rate}
A 54-year-old female was brought to the casualty department after a car accident. A traumatologist
diagnosed her with multiple fractures of the lower extremities. What kind of embolism is most
likely to develop in this case?
{=Fat
~Tissue
~Thromboembolism
~Gaseous
~Air}
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:
{=Glucose-6-phosphatase
~Amyloid-1,6-glycosidase
~Phosphoglucomutase
~Glycogen phosphorylase
~Glucokinase}
A child with a normal karyotype is diagnosed with cleft lip and hard palate, defects of the
cardiovascular system, microcephaly. The child’s mother suffered rubella during pregnancy. This
pathology in the child may be an example of:
{=Genocopy
~Trisomy
~Phenocopy
~Monosomy
~–}
A patient has been diagnosed with ARVI. Blood serum contains immunoglobulin M. What is the
stage of infection in this case?
{=Acute
~Prodromal
~Incubation
~Reconvalescence
~Carriage}
A 30-year-old patient has undergone keratoplasty in the transplantation center, cornea has been
taken fron a donor, who died in a road accident. What kind of transplantation was performed?
{=Allotransplantation
~Autotransplantation
~Xenotransplantation
~Explantation
~Heterotransplantation}
A patient has the oxyhemoglobin dissociation curve shifted to the left. What blood changes induce
this condition?
{=Alkalosis, hypocapnia, temperature drop
~Acidosis, hypercapnia, temperature rise
~Acidosis, hypercapnia, temperature drop
~Acidosis, hypocapnia, temperature rise
~–}
Characteristic sign of glycogenosis is muscle pain during physical work. Blood examination usually
reveals hypoglycemia. This pathology is caused by congenital defi- ciency of the following enzyme:
{=Glycogen phosphorylase
~Glucose 6-phosphate dehydrogenase
~α-amylase
~γ-amylase
~Lysosomal glycosidase}
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?
{=Creatine phosphokinas
~Lactate dehydrogenase
~Pyruvate dehydrogenase
~Glutamate dehydrogenase
~Adenylate cyclase}
Sex chromatin was detected during examination of a man’s buccal epithelium. It is characteristic of
the following chromosome disease:
{=Klinefelter’s syndrome
~Down’s disease
~Turner’s syndrome
~Triple X syndrome
~Hypophosphatemic rickets}
A 7-year-old child has acute onset of disease: temperature rise up to 38oC, rhinitis, cough,
lacrimation, and large-spot rash on the skin. Pharyngeal mucosa is edematous, hyperemic, with
whitish spots in the buccal area. What kind of inflammation causes the changes in the buccal
mucosa?
{=Catarrhal inflammation
~Suppurative inflammation
~Fibrinous inflammation
~Hemorrhagic inflammation
~Serous inflammation}
A 12-year-old child has developed nephritic syndrome (proteinuria, hematuria, cylindruria) 2 weeks
after the case of tonsillitis, which is a sign of affected glomerular basement membrane in the
kidneys. What mechanism is the most likely to cause the basement membrane damage?
{=Immune complex
~Granulomatous
~Antibody-mediated
~Reaginic
~Cytotoxic}
Several minutes after a dentist administered novocaine for local anaesthesia of a patient’s tooth, the
following symptoms sharply developed in the patient: fatigue, skin itching. Objectively the
following can be observed: skin hyperemia, tachycardia, BP dropped down to 70/40 mm Hg. What
kind of allergic reaction is this pathology?
{=Anaphylactic
~Cytotoxic
~Stimulating
~Cell-mediated immune reaction
~Immune complex}
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:
{=Combinative
~Mutational
~Phenotypic
~Genocopy
~Phenocopy}
A patient suffers from intermittent fevers and normalizations of body temperature that occur during
the day. The temperature rise is observed regularly every fourth day. Specify the type of temperature
curve:
{=Febris internuttens
~B. Febris continua
~C. Febris reccurens
~D. Febris hectica
~E. Febris remitens}
A woman with the III (В), Rh- blood group gave birth to a child with the II (А) blood group. The
child is diagnosed with hemolytic disease of newborn caused by rhesus incompatibility. What blood
group and Rh can the father have?
{=II (А), Rh+
~I (0), Rh+
~III (B), Rh+
~I (0), Rh−
~II (A), Rh−}
An infant has pylorospasm, weakness, hypodynamia, convulsions as a result of frequent vomiting.
What kind of acid-base disbalance is it?
{=Excretory alkalosis
~Excretory acidosis
~Metabolic acidosis
~Exogenous nongaseous acidosis
~Gaseous alkalosis}
Parents of a 5-year-old boy report him to have frequent colds that develop into pneumonias,
presence of purulent rashes on the skin. Laboratory tests have revealed the following: absence of
immunoglobulins of any type, and naked cells are absent from the lymph nodes punctate. What kind
of immune disorder is it?
{=X-linked hypogammaglobulinemia (Bruton type agammaglobulinemia)
~Autosomal recessive agammaglobulinaemia (Swiss type)
~Hypoplastic anemia
~Agranulocytosis
~Louis-Barr syndrome}
In case of alkaptonuria, homogentisic acid is excreted in urine in large amounts. The development
of this disease is associated with metabolic disorder of the following amino acid:
{=Tyrosine
~Phenylalanine
~Alanine
~Methionine
~Asparagine}
During intravenous saline transfusion a patient’s condition deteriorated drastically, and the patient
died from asphyxiation. Autopsy revealed acute venous congestion of internal organs with sharp
right heart dilatation. When the right ventricle was punctured underwater, the bubbles escaped.
What pathological process occurred in the patient?
{=Air embolism
~Gaseous embolism
~Adipose embolism
~Tissue embolism
~Thromboembolism}
Sex chromosomes of a woman didn’t separate and move to the opposite poles of a cell during
gametogenesis (meiosis). The ovum was impregnated with a normal spermatozoon. Which
chromosomal disease can be found in her child?
{=Turner’s syndrome
~Down’s syndrome
~Patau’s syndrome
~Edwards’ syndrome
~Cat cry syndrome}
A patient has been diagnosed with influenza. His condition drastically worsened after taking
antipyretic drugs. He is unconscious, AP is 80/50 mm Hg, Ps is 140/m, body temperature dropped
down to 35, 8oC. What complication developed in this patient?
{=Collapse
~Hyperthermia
~Hypovolemia
~Acidosis
~Alkalosis}
During blood transfusion a patient has developed intravascular erythrocyte hemolysis. What kind of
hypersensitivity does the patient have?
{=II type (antibody-dependent)
~I type (anaphylactic)
~III type (immune complex)
~IV type (cellular cytotoxicity)
~IV type (granulomatosis)}
A 2-year-old boy is diagnosed with Down syndrome. What chromosomal changes may be the cause
of this disease?
{=Trisomy 21
~Trisomy 13
~Trisomy X
~Trisomy 18
~Monosomy X}
After a road accident a victim has tachycardia, arterial blood pressure 130/90 mm Hg, tachypnoe,
the skin is pale and dry, excitation of central nervous system is observed. What shock stage is the
patient most likely in?
{=Erectile
~Terminal
~Torpid
~Preshock (compensation stage)
~Agony}
A 54-year-old woman was brought to a casualty department after a car accident. A traumatologist
diagnosed her with multiple fractures of the lower extremities. What kind of embolism is most
likely to develop in this case?
{=Adipose
~Tissue
~Thromboembolism
~Gaseous
~Air}
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?
{=Metabolic acidosis
~Metabolic alkalosis
~Respiratory acidosis
~Respiratory alkalosis
~Normal acid-base balance}
A 15-year-old patient has fasting plasma glucose level 4,8 mmol/l, one hour after glucose challenge
it becomes 9,0 mmol/l, in 2 hours it is 7,0 mmol/l, in 3 hours it is 4,8 mmol/l. Such parameters are
characteristic of:
{=Subclinical diabetes mellitus
~Diabetes mellitus type 1
~Diabetes mellitus type 2
~Healthy person
~Cushing’s disease}
A patient has been diagnosed with URTI. Blood serum contains immunoglobulin M. What stage of
infection is it?
{=Acute
~Prodromal
~Incubation
~Reconvalescence
~Carriage}
Lymphocytes and other cells of our body synthesize universal antiviral agents as a response to viral
invasion. Name these protein factors:
{=Interferon
~Interleukin - 2
~Cytokines
~Interleukin - 4
~Tumor necrosis factor}
A 25-year-old patient complains of increasing pain in his leg muscles occurring during walking and
forcing him to make frequent stops. Objectively: skin of legs is pale, no hair-covering, toenails are
with trophic changes, no pulsation of pedal arteries. The most probable cause of these changes is:
{=Ischemia
~Venous hyperemia
~Arterial hyperemia
~–
~Embolism}
This year influenza epidemic is characterised by patients’ body temperature varying from 36, 9oC
to 37, 9oC. Such fever is called:
{=Subfebrile
~High
~Hyperpyretic
~Apyretic
~Moderate}
A woman complains of visual impairment. Examination revealed obesity in the patient and her
fasting plasma glucose level is hyperglycemic. What diabetes complication can cause visual
impairment/blindness?
{=Microangiopathy
B. Macroangiopathy
C. Atherosclerosis
D. Neuropathy
E. Glomerulopathy}
An 18-year-old woman has body disproportion, wing-like folds on the skin of her neck,
underdeveloped ovaries, nuclei of her buccal epithelium cells have no Barr bodies.
Dermatoglyphics method revealed that her adt angle is 66o. What provisional diagnosis can be
made in this case?
{=Turner’s syndrome
~Cri du chat (cat cry) syndrome
~Kleinfelter’s syndrome
~Patau’s syndrome
~Edwards’ syndrome}
A 48-year-old man has had a fever and dry cough for 4 days, and now has difficulty breathing and a
cough productive of sputum. On physical examination his temperature is 38.5°C. Diffuse rales are
auscultated over lower lung fields. A chest radiograph shows a right pleural effusion. A right
thoracentesis is performed. The fluid obtained has a cloudy appearance with a cell count showing
15,500 leukocytes per microliter, 98% of which are neutrophils. Which of the following terms best
describes his pleural process?
{=Purulent inflammation
~Serous inflammation
~Fibrinous inflammation
~Chronic inflammation
~Granulomatous inflammation}
A 24-year-old man develops marked right lower quadrant abdominal pain over the past day. On
physical examination there is rebound tenderness on palpation over the right lower quadrant.
Laparoscopic surgery is performed, and the appendix is swollen, erythematous, and partly covered
by a yellowish exudate. It is removed, and a microscopic section shows infiltration with numerous
neutrophils. The pain experienced by this patient is predominantly the result of which of the
following two chemical mediators?
{=Prostaglandin and bradykinin
~Complement C3b and IgG
~Interleukin-1 and tumor necrosis factor
~Histamine and serotonin
~Leukotriene and IgG}
A 22-year-old man has experienced painful urination for 3 days. A urethritis is suspected,
and Neisseria gonorrheae is cultured. Numerous neutrophils are present in a smear of the exudate
from the penile urethra. These neutrophils undergo diapedesis to reach the organisms. Release of
which of the following chemical mediators is most likely to drive neutrophil exudation?
{=Histamine
~Prostaglandin
~Hageman factor
~Bradykinin
~Complement}
A 16-year-old boy has had episodes of sneezing with watery eyes and runny nose for the past 2
weeks. On physical examination she has red, swollen nasal mucosal surfaces. She has had similar
episodes each Spring and Summer when the amount of pollen in the air is high. Her symptoms are
most likely to be mediated by the release of which of the following chemical mediators?
{=Complement C3b
~Platelet activating factor (PAF)
~Tumor necrosis factor (TNF)
~Histamine
~Immunoglobulin G}
A patient has pathological processes resulted from X-linked gene mutation. This disease is
accompanied by deficiency of VIII factor of blood coagulation and prolongation of blood
coagulation time to 25 min. What is this disease?
{=Glaucoma
~Hemeralopia
~Hemophilia
~Daltonism
~Galactosemia}
Congenital diseases are diseases, which are:
{=Manifesting at birth of a child
~All hereditary diseases
~Hereditary dominant disorders
~Result from pathologic labor
~Transplacental infectious diseases}
Which disorder is X-linked?
{=Hemophilia A
~Klinefelter’s syndrome
~Trisomy X-syndrome
~Hypophosphatemic rickets
~Short fingers}
A 2-year-old boy suffering from chronic pneumonia has low indices of B-lymphocyte system.
Bruton’s hypogammaglobulinemia was diagnosed in him. What is the consequence of Blymphocyte system deficiency?
{=Decreased resistance of organism to pyogenic coccus flora
~Decreased resistance of organism to viruses
~Decreased resistance of organism to fungous and tuberculosis infection
~Absence of graft rejection reactions
~Increased risk of tumor development in organism}
A 10-year-old girl was getting breast feeding during the first year of life. She suffered prolonged
severe pneumonia in the end of the first year. She started walking late. Her gait was unsteady and
her movements were discoordinated. Telangiectasia appeared in her skin and conjunctivas. IgA is
absent from and levels of T-lymphocytes is decreased in her blood. What immunodeficiency disease
does the girl have?
{=Luis-Barr syndrome
~Wiskott-Aldrich syndrome
~Chediak-Higashi syndrome
~Swiss type of immunodeficiency
~Di George syndrome}
A patient was suffering from chronic renal insufficiency. He has renal transplantation from donor,
who died in motorcar accident. Donor had blood group same as recipient. Renal insufficiency
occurs in patient again after a time. Which system incompatibility takes part in transplant rejection?
{=HLA
~RH
~MNS
~HLAABO
~Kel-Chelano}
An 20-year-old boy has insulin-dependent diabetes mellitus I type. What type of allergic reactions
underlies beta cells damage?
{=II type, cytotoxic
~I type, anaphylactic
~III type, immune complex-mediated
~IV type, delayed-type hypersensitivity
~Pseudoallergic reaction}
A patient suffers from high fever, apnoea, pain in the thorax on the right. Pleurocentesis yielded 700
ml of yellowgreen viscous liquid. Make the diagnosis:
{=Pleural empyema
~Serous pleurisy
~Pleural carcinomatosis
~Hemorrhagic pleurisy
~Bronchial pneumonia}
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?
{=Metabolic alkalosis
~Acid-base balance remains unchanged
~Respiratory alkalosis
~Metabolic acidosis
~Respiratory acidosis}
A 53-year-old man is diagnosed with Paget’s disease. Concentration of oxyproline in daily urine is
sharply increased, which primarily means intensified disintegration of:
{=Fibrinogen
~Collagen
~Albumin
~Keratin
~Hemoglobin}
Parents of a sick 5-year-old girl visited a genetic consultation. Karyotype investigation revealed 46
chromosomes. One chromosome of the 15th pair was abnormally long, having a part of the
chromosome belonging to the 21st pair attached to it. What mutation occurred in this girl?
{=Duplication
~Translocation
~Inversion
~Deletion
~Deficiency}
Sex chromatin was detected during examination of a man’s buccal epithelium. It is characteristic of
the following chromosome disease:
{=Triple X syndrome
~Hypophosphatemic rickets
~Down’s disease
~Turner’s syndrome
~Klinefelter’s syndrome}
A patient, having suffered a thermal burn, developed painful boils filled with turbid liquid in the
skin. What morphological type of inflammation has developed in the patient?
{=Croupous
~Proliferative
~Serous
~Granulomatous
~Diphtheritic}
A 7-year-old child has acute onset of disease: temperature rise up to 38°C, rhinitis, cough,
lacrimation, and large-spot rash on the skin. Pharyngeal mucosa is edematous, hyperemic, with
whitish spots in the buccal area.What kind of inflammation caused the changes in the buccal
mucosa?
{=Suppurative inflammation
~Hemorrhagic inflammation
~Serous inflammation
~Catarrhal inflammation
~Fibrinous inflammation}
A 12-year-old child developed nephritic syndrome (proteinuria, hematuria, cylindruria) 2 weeks
after a case of tonsillitis, which is a sign of affected glomerular basement membrane in the kidneys.
What mechanism is the most likely to cause the basement membrane damage?
{=Antibody-mediated
~Granulomatous
~Immune complex
~Reaginic
~Cytotoxic}
A patient with insulin-dependent diabetes mellitus has been administered insulin. After a certain
period of time the patient developed fatigue, irritability, excessive sweating. What is the main
mechanism of such presentations developing?
{=Increased glycogenolysis
~Increased lipogenesis
~Decreased glyconeogenesis
~Carbohydrate starvation of the brain
~Increased ketogenesis}
The processes of heat transfer in a naked person at room temperature have been studied. It was
revealed that under these conditions the greatest amount of heat is transferred by:
{=Convection
~Heat conduction
~Heat radiation
~Evaporation
~-}
According to phenotypic diagnosis a female patient has been provisionally diagnosed with Xchromosome polysomia. This diagnosis can be confirmed by cytogenetic method. What karyotype
will confirm the diagnosis?
{=47(XXY)
~46(XX)
~48(XXXY)
~48(XXYY)
~47(ХХХ)}
Parents of a 5-year-old child report him to have frequent colds that develop into pneumonias,
presence of purulent rashes on the skin. Laboratory tests have revealed the following: absence of
immunoglobulins of any type; naked cells are absent from the lymph nodes punctate. What kind of
immune disorder is it?
{=X-linked hypogammaglobulinemia (Bruton type agammaglobulinemia)
~Hypoplastic anemia
~Louis-Barr syndrome
~Agranulocytosis
~Autosomal recessive agammaglobulinaemia (Swiss type)}
A man has suffered multiple bone fractures of his lower extremities during a traffic accident. During
transportation to a hospital his condition was further aggravated: blood pressure decreased, there
were signs of pulmonary artery embolism. What kind of embolism is the most likely in the given
case?
{=Tissue embolism
~Thromboembolism
~Air embolism
~Gas embolism
~Fat embolism}
A 2-year-old boy is diagnosed with Down syndrome. What chromosomal changes can cause this
disease?
{=Monosomy X
~Trisomy 21
~Trisomy X
~Trisomy 13
~Trisomy 18}
A 62-year-old patient has been hospitalized due to massive cerebral hemorrhage. Blood pressure is
70/30 mm Hg, heart rate is 120/min., respiratory rate is 4/min., unconscious, no response to external
stimuli. Such condition can be determined as:
{=Collapse
~Shock
~Coma
~Stress
~Agony}
What condition may develop 15-30 minutes after re-administration of an antigen as a result of the
increased level of antibodies, mainly IgE, that are adsorbed on the surface of target cells, namely
tissue basophils (mast cells) and blood basophils?
{=Immune complex hyperresponsiveness
~Serum sickness
~Antibody-dependent cytotoxicity
~Delayed-type hypersensitivity
~Anaphylaxis}
After a road accident a victim has tachycardia, arterial blood pressure 130/90 mm Hg, tachypnoe,
the skin is pale and dry, excitation of central nervous system is observed. What shock stage is the
patient most likely in?
{=Agony
~Erectile
~Torpid
~Terminal
~Preshock (compensation stage)}
A 6-year-old child suffers from delayed growth, disrupted ossification processes, decalcification of
the teeth. What can be the cause?
{=Insulin deficiency
~Decreased glucagon production
~Vitamin D deficiency
~Hyperthyroidism
~Vitamin C deficiency}
A 30-year-old patient’s blood test has revealed the following: erythrocyte count is 6 × 1012/l,
hemoglobin is 10,55 mmol/l. Vaquez’s disease was diagnosed. Name the leading part of
pathogenesis:
{=Acidosis
~Neoplastic erythroid hyperplasia
~B12-deficiency
~Iron-deficiency
~Hypoxia}
This year influenza epidemic is characterised by patients’ body temperature varying from 36, 9°C to
37, 9°C. Such fever is called:
{=Apyretic
~Moderate
~High
~Hyperpyretic
~Subfebrile}
A woman complains of visual impairment. Examination revealed obesity in the patient and her
fasting plasma glucose level is hyperglycemic.What diabetes complication can cause visual
impairment/blindness?
{=Neuropathy
~Glomerulopathy
~Macroangiopathy
~Atherosclerosis
~Microangiopathy}
30 minutes after drinking mango juice a child suddenly developed a local swelling in the area of the
soft palate, which impeded swallowing and, eventually, respiration. Mucosa of the swollen area was
hyperemic and painless. Blood test revealed moderate eosinophilia. Body temperature was normal.
Anamnesis states that the elder sister of the child has been suffering from bronchial asthma attacks.
What kind of edema has developed in the child?
{=Alimentary
~Hepatic
~Inflammatory
~Cardiac
~Allergic}
Protective function of saliva is based on several mechanisms, including the presence of enzyme that
has bactericidal action and causes lysis of complex capsular polysaccharides of staphylococci and
streptococci. Name this enzyme:
{=Collagenase
~Beta-glucuronidase
~Alpha-amylase
~Oligo-1,6-glucosidase
~Lysozyme}
A patient with chronic heart failure presents with increased blood viscosity. Capillaroscopy detected
damage to the vessel walls of the microcirculation system. What disorder is possible in the given
case?
{=Arterial hyperemia
~Venous hyperemia
~Thrombosis
~Embolism
~Blood ”sludge” phenomenon}
A patient with periodontitis of the lower molar came to the doctor. It was determined that the
inflammatory process spread to the lymph nodes. What lymph nodes were the first to be affected by
the inflammatory process?
{=Submandibular
~Anterior cervical
~Facial
~Submental
~Lateral cervical}
A 63-year-old man suffers from esophageal carcinoma, presents with metastases into the
mediastinal lymph nodes and cancerous cachexia. What pathogenetic stage of neoplastic process is
observed in the patient?
{=Promotion
~Initiation
~~Progression
~Transformation}
A person is in a room with air temperature of 38°C and relative air humidity of 50%. What type of
heat transfer ensures maintenance of constant body core temperature under these conditions?
{=Convection
~~Radiation
~Conduction and convection
~Evaporation}
A child with point mutation presents with absence of glucose 6-phosphatase, hypoglycemia, and
hepatomegaly. What pathology are these signs characteristic of?
{=McArdle’s disease (Glycogen storage disease type V)
~Von Gierke’s disease (Glycogen storage disease type I)
~Addison’s disease (Primary adrenal insufficiency)
~Cori’s disease (Glycogen storage disease type III)
~Parkinson’s disease}
Exposure to colchicine resulted in metaphase plate of a human containing 23 chromosomes more
than it is normal. Name this mutation?
{=Aneuploidy
~Inversion
~Translocation
~Polyploidy
~Polyteny}
~GlucoseA traumatology unit received a patient with crushed muscular tissue. What biochemical
indicator of urine will be raised in this case?
{=Mineral salts
~Uric acid
~Total lipids
~Creatinine}
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?
{=Hypocalcemia
~Hyperchlorhydria
~Hyperkalemia
~Hypophosphatemia
~Hyponatremia}
T-lymphocytes are determined to be affected with HIV. In this case viral enzyme reverse
transcriptase (RNA-dependent DNA-polymerase) catalyzes the synthesis of:
{=Viral protein based on the viral RNA matrix
~Viral RNA based on the DNA matrix
~DNA based on the viral RNA matrix
~Viral DNA based on the DNA matrix
~Informational RNA based on the viral protein matrix}
To lose some weight a woman has been limiting the amount of products in her diet. 3 months later
she developed edemas and her diuresis increased. What dietary component deficiency is the cause
of this?
{=Minerals
~Proteins
~Carbohydrates
~Fats
~Vitamins}
A 10-year-old child had cut his leg with a glass shard, when playing, and was delivered to the
outpatient department to receive antitetanus serum. To prevent development of anaphylactic shock
the serum was introduced by Bezredka method. This method of organism hyposensitization is based
on the following mechanism:
{=Stimulation of immune tolerance to antigen
~Blocking of mast cell mediators synthesis
~Binding of mast cell-fixed IgE
~Stimulation of antigen-specific IgG2
~Stabilization of mast cell membranes}
Woman with polyarticular rheumatoid arthritis was prescribed a non-steroidal antiinflammatory
drug - diclofenac sodium. After the patient has been taking it for some time, her concomitant
disease exacerbated, which forced the doctor to cancel the prescription of this drug. What
concomitant disease could necessitate cancellation of this drug prescription?
{=Bronchial asthma
~Ulcer disease
~Diabetes mellitus
~Ischemic heart disease
~Essential hypertension}
A woman with the III (В), Rh (-) blood group gave birth to a child with the II (А) blood group. The
child is diagnosed with hemolytic disease of newborn caused by rhesus incompatibility. What blood
group and Rh are likely in the father?
{=I (0),Rh (-)
~II (A), Rh (-)
~I (0), Rh (+)
~III (B), Rh (+)
~II (А), Rh (+)}
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?
{=Glycogenolysis
~Glucose transportation into a cell
~Glycolysis
~Gluconeogenesis
~Glucose reabsorption}
After sensitization a test animal received subcutaneously a dose of antigen. At the site of injection a
fibrinous inflammation developed with alteration of vessel walls, basal substance, and fibrous
structures of connective tissue. The inflammation took form of mucoid and fibrinoid degeneration,
fibrinoid necrosis. What immune response occurred in the test animal?
{=Transplantation immune reaction
~Delayed hypersensitivity
~Immediate hypersensitivity
~Normergic reaction
~Granulomatosis}
During regular check-up a child is determined to have interrupted mineralization of the bones. What
vitamin deficiency can be the cause?
{=Calciferol
~Tocopherol
~Cobalamin
~Folic acid
~Riboflavin}
On examination the patient was determined to have strong, balanced, inert type of higher nervous
activity according to Pavlov’s classification. What temperament according to Hippocrates is it?
{=Choleric
~Sanguine
~Phlegmatic
~Melancholic
~-}
A married couple came for a genetic counseling. The husband suffers from insulin-independent
diabetes mellitus,while the wife is healthy.What is the probability of their child developing insulinindependent diabetes mellitus?
{=50%
~Higher than in the population
~Lower than in the population
~The same as in the population
~100%}
A 45-year-old woman gave birth to a boy with cleft maxilla (cleft lip and palate). On additional
examination there are significant disturbances of the boy’s nervous, cardiovascular, and visual
systems. Karyotype investigation allowed diagnosing the patient with trisomy 13.What syndrome is
present in the boy?
{=Turner
~DiGeorge
~Down
~Kleinfelter
~Patau}
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?
{=Decreased IgD, IgE
~Increased IgA, IgM
~Decreased IgA, IgM
~Increased IgD, IgE
~No changes}
ECG of a 44-year-old patient shows signs of hypertrophy of both ventricles and the right atrium.
The patient was diagnosed with the tricuspid valve insufficiency. What pathogenetic variant of
cardiac dysfunction is usually observed in case of such insufficiency?
{=Heart overload by volume
~Heart overload by resistance
~Primary myocardial insufficiency
~Coronary insufficiency
~Cardiac tamponade}
During examination of a 6-yearold child a doctor revealed greyish films on the pharyngeal tonsils.
Their removal provoked moderate haemorrhage. Bacterioscopy revealed gram-positive clublike
bacteria. What symptoms will develop in this child within the next few days if no specific treatment
is provided?
{=Toxic lesions of myocard, liver and kidney
~Pulmonary edema
~Strong paroxysmal cough
~Papulous skinrash
~Intermittent fever}
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
~Viral hepatitis
~Collagenosis
~Diabetes mellitus
~Diabetes insipidus}
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?
{=Reduced production of parathormone
~Increased production of thyroxin
~Increased production of calcitonin
~Increased production of thyroliberin
~Reduced production of thyroxin}
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:
{=Oxyproline
~Indican
~Creatinine
~Urea
~Urobilinogen}
A coprological survey revealed lightcolored feces containing drops of neutral fat. The most likely
reason for this condition is the disorder of:
{=Bile inflow into the bowel
~Gastric juice acidity
~Pancreatic juice secretion
~Intestinal juice secretion
~Intestinal absorption}
Microscopical examination of an enlarged cervical lymph node revealed blurring of its structure,
absence of lymphoid follicles; all the microscopic fi- elds showed cells with roundish nuclei and
thin limbus of basophil cytoplasm. It is known from the clinical data that other groups of lymph
nodes are also enlarged as well as spleen and liver. What disease might be suspected?
{=Lymphoid leukosis
~Lymphogranulomatosis
~Lymphosarcoma
~Myeloid leukosis
~Multiple myeloma}
Lung ventilation in a person is increased as a result of physical activity. Which of the following
indices of the external respiration is much higher than in a state of rest?
{=Respiratory volume
~Vital capacity of lungs
~Inspiratory reserve volume
~Expiratory reserve volume
~Total lung capacity}
As a result of continuous starvation the glomerular filtration rate has increased by 20%. The most
probable cause of the glomerular filtration alteration under the mentioned conditions is:
{=Decrease in the oncotic pressure of blood plasma
~Increase in the systemic arterial pressure
~Increase in the permeability of the renal filter
~Increase of the filtartion quotient
~Increase of the renal blood flow}
Pulmonary examination of a patient who has worked as a stone grinder for 9 years revealed small
dense roundish nodules consisting of connective tissue. The nodules were found to have peripheral
macrophages. Such pulmonaryalterations are indicative of the following disease:
{=Silicosis
~Acute pneumonia
~Multiple bronchiectasis
~Chronic bronchitis
~Bronchial asthma}
A disaster fighter at a nuclear power plant developed hemorrhagic syndrome on the background of
acute radiation disease. What is the most important factor of syndrome pathogenesis?
{=Thrombocytopenia
~Vascular wall damage
~Increased activity of fibrinolysis factors
~Increased activity of anticoagulative system factors
~Decreased activity of coagulative factors}
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?
{=Obstructive jaundice
~Hepatocellular jaundice
~Parenchymatous jaundice
~Hemolytic jaundice
~Cythemolytic jaundice}
A 49-year old female patient has limitation of left limbs arbitrary movements. Muscular tonus of
left hand and leg is overstrained and spasmodic, local tendon reflexes are strong, pathological
reflexes are presented. What is the most likely development mechanism of hypertension and
hyperreflexia?
{=Reduction of descending inhibitory influence
~Motoneuron activation induced by stroke
~Activation of excitatory influence from the focus of stroke
~Activation of synaptic transmission
~Ihibition of cerebral cortex motoneurons}
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:
{=Estrogen
~Progesterone
~Lutropin
~Follicle stimulating hormone
~Follistatine}
A 45-year-old patient was admitted to the cardiological department. ECG data: negative P wave
overlaps QRS complex, diastolic interval is prolonged after extrasystole. What type of extrasystole
is it?
{=Atrioventricular
~Sinus
~Atrial
~Ventricular
~Bundle-branch}
A patient complains of hydruria (7 liters per day) and polydipsia. Examination reveals no disorders
of carbohydrate metabolism. These abnormalities might be caused by the dysfunction of the
following endocrine gland:
{=Neurohypophysis
~Adenohypophysis
~Islets of Langerhans (pancreatic islets)
~Adrenal cortex
~Adrenal medulla}
A 38-year-old male patient has been ill with systemic lupus erythematosus for three years. He was
diagnosed with diffuse renal affection accompanied by massive edemata and expressive proteinuria.
What is the most likely cause of proteinuria development?
{=Autoimmune renal affection
~Aseptic renal affection
~Ischemic renal affection
~Urinary bladder inflammation
~Urinary tracts inflammation}
A student failed to answer all the questions of examination paper correctly. As a result he blushed,
felt hot and lost confidence. What type of arterial hyperemia has developed in this case?
{=Neurotonic hyperemia
~Neuroparalytic hyperemia
~Metabolic hyperemia
~Pathologic hyperemia
~Postishemic hyperemia}
A patient presents with icteritiousness of skin, scleras and mucous membranes. Blood plasma the
total bilirubin is increased, stercobilin is increased in feces, urobilin is increased in urine. What type
of jaundice is it?
{=Haemolytic
~Gilbert’s disease
~Parenchymatous
~Obturational
~Cholestatic}
A patient with marked pneumofi- brosis that developed after infiltrating pulmonary tuberculosis has
been diagnosed with respiratory failure. What is its pathogenetic type?
{=Restrictive
~Obstructive
~Dysregulatory
~Reflex
~Apneistic}
Blood count of an athlete is as follows: erythrocytes - 5, 5 · 1012/l, Hb- 180 g/l, leukocytes - 7 ·
109/l, neutrophils - 64%, basophils - 0,5%, eosinophils - 0,5%, monocytes - 8%, lymphocytes 27%. First of all, such results indicate the stimulation of:
{=Erythropoiesis
~Leukopoiesis
~Lymphopoiesis
~Granulocytopoiesis
~Immunogenesis}
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?
{=Accumulation 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 myocardium cells
~Reduction of K+ and Mg2+ ions in the extracellular space
~Reduction of Na+ and Ca2+ ions in the extracellular space}
In response to a change in body position from horizontal to vertical blood circulation system
develops reflectory pressor reaction. Which of the following is its compulsory component?
{=Systemic constriction of the venous vessels
~Systemic dilatation of the arterial resistive vessels
~Decrease in the circulating blood volume
~Increase in the heart rate
~Weakening of the pumbing ability of heart}
A patient with massive burns developed acute renal insufficiency characterized by a significant and
rapid deceleration of glomerular fi- ltration. What is the mechanism of its development?
{=Reduction of renal blood flow
~Damage of glomerular filter
~Reduction of functioning nephron number
~Rise of pressure of tubular fluid
~Renal artery embolism}
A patient with high-titer antinuclear antibodies died from progressing renal impairment. Autopsy
revealed mesangioproliferative glomerulonephritis and abacterial polypous endocarditis. There was
periarterial bulbar sclerosis in spleen and productive proliferative vasculitis in skin. What is the
most likely diagnosis?
{=Systemic lupus erythematosus
~Nephrotic syndrome
~Rheumatism
~Dermatomyositis
~Periarteritis nodosa}
A tooth extraction in a patient with chronic persistent hepatitis was complicated with prolonged
hemorrhage. What is the reason for the haemorrhagic syndrome?
{=Decrease in thrombin production
~Increase in thromboplastin production
~Decrease in fibrin production
~Increase in fibrinogen synthesis
~Fibrinolysis intensification}
A patient has been diagnosed with influenza. His condition became drastically worse after taking
antipyretic drugs. His consciousness is confused, AP is 80/50 mm Hg, Ps is 140/m, body
temperature droped down to 35, 8oC. What complication developed in this patient?
{=Collapse
~Hyperthermia
~Hypovolemia
~Acidosis
~Alkalosis}
A 45-year-old woman has breast cancer. Her left arm has symptoms of lymphatic system
insufficiency - limb edema, lymph node enlargement. What form of lymphatic circulation
insufficiency is it?
{=Mechanic insufficiency
~Dynamic insufficiency
~Resorption insufficiency
~Combined insufficiency
~–}
A 26-year-old man is in the torpid shock phase as a result of a car accident. In blood: 3, 2 · 109/l.
What is the leading mechanism of leukopenia development?
{=Redistribution of leukocytes in bloodstream
~Leikopoiesis inhibition
~Disturbed going out of mature leukocytes from the marrow into the blood
~Lysis of leukocytes in the blood-forming organs
~Intensified elimination of leukocytes from the organism}
A month after surgical constriction of rabbit’s renal artery the considerable increase of systematic
arterial pressure was observed. What of the following regulation mechanisms caused the animal’s
pressure change?
{=Angiotensin-II
~Vasopressin
~Adrenaline
~Noradrenaline
~Serotonin}
Microscopic examination of the enlarged neck gland of a 14 year old girl revealed destruction of the
tissue structure of the node, absence of the lymph follicles, sclerotic areas and necrosis foci, cell
constitution of the node is polymorphous, lymphocites, eosinophiles, big atypical cells with
multilobular nuclei (Beresovsky-Sternberg cells) and mononuclear cells of the large size are
present. What is the most likely diagnosis?
{=Lymphogranulomatosis
~Acute lympholeucosis
~Chronic lympholeucosis
~Berkitt’s lymphoma
~Fungoid mycosis}
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:
{=Parathormone
~Thyrocalcitonin
~Thyroxin
~Somatotropic hormone
~Triiodothyronine}
After a tourniquet application a patient was found to have petechial haemorrhages. The reason for it
is the dysfunction of the following cells:
{=Platelets
~Eosinophils
~Monocytes
~Lymphocytes
~Neutrophils}
A patient presents with the following motor activity disturbances: tremor, ataxia and asynergia
movements, dysarthria. The disturbances are most likely to be localized in:
{=Cerebellum
~Basal ganglions
~Limbic system
~Brainstem
~Medulla oblongata}
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:
{=Vasopressin
~Corticotropin
~Natriuretic
~Cortisol
~Parathormone}
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?
{=Paraproteinemia
~Hyperalbuminemia
~Proteinuria
~Hypoglobulinemia
~Hypoproteinemia}
Parodontitis is treated with calcium preparations and a hormone that stimulates tooth mineralization
and inhibits tissue resorption. What hormone is it?
{=Calcitonin
~Parathormone
~Adrenalin
~Aldosterone
~Thyroxine}
A child has an acute renal failure. What biochemical factor found in saliva can confirm this
diagnosis?
{=Increase in urea concentration
~Increase in glucose concentration
~Decrease in glucose concentration
~Increase in concentration of higher fatty acids
~Decrease in nucleic acid concentration}
After severe viral hepatitis a 4 year old boy presents with vommiting, occasional loss of
consciousness, convulsions. Blood test revealed hyperammoniemia. Such condition is caused by a
disorder of the following biochemical hepatic process:
{=Disorder of ammonia neutralization
~Disorder of biogenic amines neutralization
~Protein synthesis inhibition
~Activation of amino acid decarboxylation
~Inhibition of transamination enzymes}
Having helped to eliminate consequences of a failure at a nuclear power plant, a worker got an
irradiation doze of 500 roentgen. He complains of headache, nausea, dizziness. What changes in
leukocytes quantity can be expected 10 hours after irradiation?
{=Neutrophilic leukocytosis
~Lymphocytosis
~Leukopenia
~Agranulocytosis
~Leukemia}
A patient with a history of chronic glomerulonephritis presents with azotemia, oliguria, hypo- and
isosthenuria, proteinuria. What is the leading factor in the pathogenesis of these symptoms
development under chronic renal failure?
{=Mass decrease of active nephrons
~Intensification of glomerular filtration
~Tubular hyposecretion
~Disturbed permeability of glomerular membranes
~Intensification of sodium reabsorption}
After an attack of bronchial asthma a patient had his peripheral blood tested. What changes can be
expected?
{=Eosinophilia
~Leukopenia
~Lymphocytosis
~Thrombocytopenia
~Erythrocytosis}
A 50 year old patient suffers from essential hypertension. After a physical stress he experienced
muscle weakness, breathlessness, cyanosis of lips, skin and face. Respiration was accompanied by
distinctly heard bubbling rales. What mechanism underlies the development of this syndrome?
{=Acute left-ventricular failure
~Chronic right-ventricular failure
~Chronic left-ventricular failure
~Collapse
~Cardiac tamponade}
A patient suffering from chronic myeloleukemia has got the following symptoms of anemia:
decreased number of erythrocytes and low haemoglobin concentration, oxyphilic and
polychromatophilic normocytes, microcytes. What is the leading pathogenetic mechanism of
anemia development?
{=Substitution of haemoblast
~Intravascular hemolysis of erythrocytes
~Deficiency of vitamin B12
~Reduced synthesis of erythropoietin
~Chronic haemorrhage}
A 44 year old woman complains of general weakness, heart pain, significant increase of body
weight. Objectively: moon face, hirsutism, AP is 165/100 mm Hg, height - 164 cm, weight - 103 kg;
the fat is mostly accumulated on her neck, thoracic girdle, belly. What is the main pathogenetic
mechanism of obesity?
{=Increased production of glucocorticoids
~Reduced production of thyroid hormones
~Increased insulin production
~Reduced glucagon production
~Increased mineralocorticoid production}
A 20 year old patient complains of morbid thirst and huperdiuresis (up to 10 l daily). Glucose
concentration in blood is normal but it is absent in urine. The patient has been diagnosed with
diabetes insipidus. What hormonal drug is the most appropriate for management of this disorder?
{=Vasopressin
~Cortisol
~Thyroxin
~Oxytocin
~Insulin}
After a serious psychoemotional stress a 48 year old patient suddenly developed acute heart ache
irradiating to the left arm. Nitroglycerine relieved pain after 10 minutes. What is the leading
pathogenetic mechanism of this process development?
{=Spasm of coronary arteries
~Dilatation of peripheral vessels
~Obstruction of coronary vessels
~Compression of coronary vessels
~Increase in myocardial oxygen consumption}
A disaster fighter at a nuclear power plant developed hemorrhagic syndrome on the background of
acute radiation disease. What is the most important factor of syndrome pathogenesis?
{=Thrombocytopenia
~Vascular wall damage
~Increased activity of fibrinolysis factors
~Increased activity of anticoagulative system factors
~Decreased activity of coagulative factors}
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?
{=Obstructive jaundice
~Hepatocellular jaundice
~Parenchymatous jaundice
~Hemolytic jaundice
~Cythemolytic jaundice}
The patient with acute miocardial infarction was given intravenously different solutions during 8
hours with medical dropper 1500 ml and oxygen intranasally. He died because of pulmonary edema.
What caused the pulmonary edema?
{=Volume overload of the left ventricular
~Decreased oncotic pressure due to hemodilution
~Allergic reaction
~Neurogenic reaction
~Inhalation of the oxygen}
As a result of a road accident a 26- year-old man is in the torpid phase of shock. Blood count:
leukocytes - 3, 2 · 109/l. What is the leading mechanism of leukopenia development?
{=Leukocyte redistribution in the bloodstream
~Leukopoiesis inhibition
~Faulty release of mature leukocytes from the bone marrow into the blood
~Leukocyte destruction in the hematopietic organs
~Increased excretion of the leukocytes from the organism}
A 5-month-old boy was hospitalized for tonic convulsions. He has a lifetime history of this disease.
Examination revealed coarse hair, thinned and fragile nails, pale and dry skin. In blood: calcium 1,5 millimole/l, phosphor - 1,9 millimole/l. These changes are associated with:
{=Hypoparathyroidism
~Hyperparathyroidism
~Hyperaldosteronism
~Hypoaldosteronism
~Hypothyroidism}
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
When water affects mucous membrane of the inferior nasal meatuses, this causes "diver reflex"that
provokes:
{=Reflectory apnea
~Reflectrory dyspnea
~Reflectory hyperpnea
~Cough
~Bronchospasm}
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
bellyOsteoporosis and muscle dystrophy are present. AP is 210/140 mm Hg. What is the most
probable diagnosis?
{=Cushing’s disease
~Cushing’s syndrome
~Conn’s disease
~Diabetes mellitus
~Essential hypertension}
A 67 year old patient complains of periodic heart ache, dyspnea during light physical activities.
ECG reveals extraordinary contractions of heart ventricles. Such arrhythmia is called:
{=Extrasystole
~Bradycardia
~Tachycardia
~Flutter
~Fibrillation}
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?
{=Impaired synthesis of calcitriol
~Increased excretion of calcium
~Hyperfunction of parathyroid glands
~Hypofunction of parathyroid glands
~Lack of calcium in food}
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:
A. Increase in ALT and AST rate
B. Hyperbilirubinemia
C. Bilirubinuria
D. Cholaemia
E. Urobilinuria
Toxic affection of liver results in dysfunction of protein synthesis. It is usually accompanied by the
following kind of dysproteinemia:
{=Absolute hypoproteinemia
~Relative hypoproteinemia
~Absolute hyperproteinemia
~Relative hyperproteinemia
~Paraproteinemia}
A child is pale, pastose, muscular tissue is bad developed, lymph nodes are enlarged. He often
suffers from angina and pharyngitis, blood has signs of lymphocytosis. The child is also
predisposed to autoallergic diseases. What type of diathesis can be presumed in this case?
{=Lymphohypoplastic
~Exudative
~Gouty
~Asthenic
~Hemorrhagic}
A 26 year old pregnant woman is under treatment at an in-patient hospital. After a continuous attack
of vomiting she was found to have reduced volume of circulating blood. What kind of change in
general blood volume is the case?
{=Polycythemic hypovolemia
~Simple hypovolemia
~Oligocythemic hypovolemia
~Polycythemic hypervolemia
~Oligocythemic hypervolemia}
A 23-year-old patient has been admitted to a hospital with a craniocerebral injury. The patient is in a
grave condition. Respiration is characterized by prolonged convulsive inspiration followed by a
short expiration. What kind of respiration is it typical for?
{=Apneustic
~Gasping breath
~Kussmaul’s
~Cheyne-Stokes
~Biot’s}
A 3-year-old boy with pronounced hemorrhagic syndrome doesn’t have antihemophilic globulin A
(factor VIII) in the blood plasma. Hemostasis has been impaired at the following stage:
{=Internal mechanism of prothrombinase activation
~External mechanism of prothrombinase activation
~Conversion of prothrombin to thrombin
~Conversion of fibrinogen to fibrin
~Blood clot retraction}
A patient got a gunshot wound of hip which damaged the sciatic nerve. Any impact on the affected
limb causes severe, excruciating pain. What mechanism of pain is most likely in this case?
{=Causalgic
~Reflex
~Phantom
~Endorphin hypofunction
~Enkephalin hypofunction}
A patient with bronchial asthma has developed acute respiratory failure. What kind of respiratory
failure occurs in this case?
{=Obstructive disturbance of alveolar ventilation
~Restrictive ventilatory defect
~Perfusion
~Diffusion
~Dysregulation of alveolar ventilation}
On the fifth day after the acute blood loss a patient has been diagnosed with hypochromic anemia.
What is the main mechanism of hypochromia development?
{=Release of immature red blood cells from the bone marrow
~Impaired iron absorption in the intestines
~Increased destruction of red blood cells in the spleen
~Impaired globin synthesis
~Increased excretion of body iron}
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. Ps- 62/min, AP- 160/105 mm Hg. Which of the following diseases is the described pattern
of obesity most typical for?
{=Cushing pituitary basophilism
~Alimentary obesity
~Myxedema
~Insulinoma
~Babinski-Frohlich syndrome}
Measurements of the arterial pCO2 and pO2 during an attack of bronchial asthma revealed
hypercapnia and hypoxemia respectively. What kind of hypoxia occurred in this case?
{=Respiratory
~Hemic
~Circulatory
~Tissue
~Histotoxic}
A patient with jaundice has high total bilirubin that is mainly indirect (unconjugated), high
concentration of stercobilin in the stool and urine. The level of direct (conjugated) bilirubin in the
blood plasma is normal. What kind of jaundice can you think of?
{=Hemolytic
~Parenchymal (hepatic)
~Mechanical
~Neonatal jaundice
~Gilbert’s disease}
A male with a lesion of one of the CNS parts has asthenia, muscular dystonia, balance disorder.
Which CNS part has been affected?
{=Cerebellum
~Black substance
~Reticular formation
~Red nuclei
~Vestibular nuclei}
A 12-year-old patient has been admitted to a hospital for hemarthrosis of the knee joint. From early
childhood he suffers from frequent bleedings. Diagnose the boy’s disease:
{=Hemophilia
~Hemorrhagic vasculitis
~Hemolytic anemia
~B12 (folic acid)-deficiency anemia
~Thrombocytopenic purpura}
14 days after quinsy a 15-year-old child presented with morning facial swelling, high blood
pressure, "meat slops"urine. Immunohistological study of a renal biopsy sample revealed deposition
of immune complexes on the basement membranes of the capillaries and in the glomerular
mesangium. What disease developed in the patient?
{=Acute glomerulonephritis
~Acute interstitial nephritis
~Lipoid nephrosis
~Acute pyelonephritis
~Necrotizing nephrosis}
A patient has normally coloured stool including a large amount of free fatty acids. The reason for
this is a disturbance of the following process:
{=Fat absorption
~Fat hydrolysis
~Biliary excretion
~Choleresis
~Lipase secretion}
The cellular composition of exudate largely depends on the etiological factor of inflammation. What
leukocytes are the first to get into the focus of inflammation caused by pyogenic bacteria?
{=Neutrophil granulocytes
~Monocytes
~Myelocytes
~Eosinophilic granulocytes
~Basophils}
Enzymatic jaundices are accompanied by abnormal activity of UDPglucuronyl transferase. What
compound is accumulated in blood serum in case of these pathologies?
{=Unconjugated bilirubin
~Conjugated bilrubin
~Dehydrobilirubin
~Hydrobilirubin
~Choleglobin}
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:
{=Glycosaminoglycans
~Amino acids
~Glucose
~Lipids
~Urea}
A patient has been admitted to the infectious diseases department for malaise, fever up to 38oC,
jaundice. A few months ago, the patient underwent blood transfusion. The doctor suspected viral
hepatitis B. What are the principal methods of laboratory diagnosis of hepatitis B?
{=Serological and gene diagnostics
~Virus isolation in cell culture and its identification by the cytopathic effects
~Detection of virions in blood by electron microscopy
~Isolation of the virus in laboratory animals (neutralization reaction)
~Isolation of the virus in chicken embryos}
Analysis of the ECG revealed the missing of several PQRST cycles. The remaining waves and
complexes are not changed. Specify the type of arrhythmia:
{=Sinoatrial block
~Atrial fibrillation
~Atrioventricular block
~Atrial premature beat
~Intra-atrial block}
Due to the use of poor-quality measles vaccine for preventive vaccination, a 1-year-old child
developed an autoimmune renal injury. The urine was found to contain macromolecular proteins.
What process of urine formation was disturbed?
{=Filtration
~Reabsorption
~Secretion
~Reabsorption and secretion
~Secretion and filtration}
Since a patient has had myocardialinfarction, atria and ventricles contract independently from each
other with a frequency of 60-70 and 35-40 per minute. Specify the type of heart block in this case:
{=Complete atrioventricular
~Partial atrioventricular
~Sino-atrial
~Intra-atrial
~Intraventricular}
In a car accident a man got injured and lost a lot of blood. What changes in peripheral blood are
most likely to occur on the 2nd day after the injury?
{=Erythropenia
~Hypochromia
~Anisocytosis
~Microplania
~Significant reticulocytosis}
After the prolonged vomiting a pregnant 26-year-old woman was found to have the reduced volume
of circulating blood. What change in the total blood volume can be the case?
{=Polycythemic hypovolemia
~Simple hypovolemia
~Oligocythemic hypovolemia
~Polycythemic hypervolemia
~Oligocythemic hypervolemia}
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:
{=Parathyroid hormone
~Calcitonin
~Cortisol
~Aldosterone
~Calcitriol}
A 30-year-old female exhibits signs of virilism (growth of body hair, balding temples, menstrual
disorders). This condition can be caused by the overproduction of the following hormone:
{=Testosterone
~Oestriol
~Relaxin
~Oxytocin
~Prolactin}
A patient with extensive myocardial infarction has developed heart failure. What pathogenetic
mechanism contributed to the development of heart failure in the patient?
{=Reduction in the mass of functioning myocardiocytes
~Pressure overload
~Volume overload
~Acute cardiac tamponade
~Myocardial reperfusion injury}
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:
{=Adrenaline, vasopressin
~Cortisol
~Sex hormones
~Oxytocin
~Aldosterone}
A patient with constant headaches, pain in the occipital region, tinnitus, dizziness has been admitted
to the cardiology department. Objectively: AP- 180/110 mm Hg, heart rate - 95/min.
Radiographically, there is a stenosis of one of the renal arteries. Hypertensive condition in this
patient has been caused by the activation of the following system:
{=Renin-angiotensin
~Hemostatic
~Sympathoadrenal
~Kinin
~Immune}
A patient complains that at the bare mention of the tragic events that once occurred in his life he
experiences tachycardia, dyspnea and an abrupt rise in blood pressure. What structures of the CNS
are responsible for these cardiorespiratory reactions in this patient?
{=Cerebral cortex
~Cerebellum
~Lateral hypothalamic nuclei
~Specific thalamic nuclei
~Quadrigemina of mesencephalon}
Analysis of the experimental spirogram of a 55-year-old person revealed a decrease in tidal volume
and respiratory amplitude compared to the situation of ten years ago. The change in these indicators
is caused by:
{=Decreased force of respiratory muscle contraction
~Gas composition of the air
~Physical build of a person
~Height of a person
~Body mass of a person}
A patient underwent a course of treatment for atherosclerosis. Laboratory tests revealed an increase
in the antiatherogenic lipoprotein fraction in the blood plasma. The treatment efficacy is confirmed
by the increase in:
{=HDL
~VLDL
~IDL
~LDL
~Chylomicrons}
A 3-year-old child had eaten some strawberries. Soon he developed a rash and itching. What was
found in the child’s leukogram?
{=Eosinophilia
~Hypolymphemia
~Neutrophilic leukocytosis
~Monocytosis
~Lymphocytosis}
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:
{=Low density lipoproteins
~High density lipoproteins
~Chylomicrons
~Very low density lipoproteins
~Intermediate density lipoproteins}
Feces of a patient contain high amount of undissociated fats and have grayish-white color. Specify
the cause of this phenomenon:
{=Obturation of bile duct
~Hypoactivation of pepsin by hydrochloric acid
~Hypovitaminosis
~Enteritis
~Irritation of intestinal epithelium}
A 41-year-old male patient has a history of recurrent attacks of heartbeats (paroxysms), profuse
sweating, headaches. Examination revealed hypertension, hyperglycemia, increased basal metabolic
rate, and tachycardia. These clinical presentations are typical for the following adrenal pathology:
{=Hyperfunction of the medulla
~Hypofunction of the medulla
~Hyperfunction of the adrenal cortex
~Hypofunction of the adrenal cortex
~Primary aldosteronism}
A patient has increased thickness of alveolar-capillary membrane caused by a pathologic process.
The direct consequence will be reduction of the following value:
{=Diffusing lung capacity
~Oxygen capacity of blood
~Respiratory minute volume
~Alveolar ventilation of lungs
~Expiratory reserve volume}
A 43-year-old-patient has arterial hypertension caused by an increase in cardiac output and general
peripheral resistance. Specify the variant of hemodynamic development of arterial hypertension in
the given case:
{=Eukinetic
~Hyperkinetic
~Hypokinetic
~Combined}
~–
Examination of a 52-year-old female patient has revealed a decrease in the amount of red blood
cells and an increase in free hemoglobin in the blood plasma (hemoglobinemia). Color index is
0,85. What type of anemia is being observed in the patient?
{=Acquired hemolytic
~Hereditary hemolytic
~Acute hemorrhagic
~Chronic hemorrhagic
~Anemia due to diminished erythropoiesis}
Urine analysis has shown high levels of protein and erythrocytes in urine. This can be caused by the
following:
{=Renal filter permeability
~Effective filter pressure
~Hydrostatic blood pressure in glomerular capillaries
~Hydrostatic primary urine pressure in capsule
~Oncotic pressure of blood plasma}
Diabetic nephropathy with uremia has developed in a patient with pancreatic diabetes. The velocity
of glomerular filtration is 9 ml/min. What mechanism of a decrease in glomerular filtration velocity
and chronic renal failure development is most likely in the case of this patient?
{=Reduction of active nephron mass
~Decrease in systemic arterial pressure
~Obstruction of nephron tubules with hyaline casts
~Tissue acidosis
~Arteriolar spasm}
A patient is diagnosed with hereditary coagulopathy that is characterised by factor VIII deficiency.
Specify the phase of blood clotting during which coagulation will be disrupted in the given case:
{=Thromboplastin formation
~Thrombin formation
~Fibrin formation
~Clot retraction
~-}
A patient complaining of pain in the left shoulder-blade region has been diagnosed with miocardial
infarction. What kind of pain does the patient have?
{=Radiating
~Visceral
~Phantom
~Protopathic
~Epicritic}
A patient has a critical impairment of protein, fat and hydrocarbon digestion. Most likely it has been
caused by low secretion of the following digestive juice:
{=Pancreatic juice
~Saliva
~Gastric juice
~Bile
~Intestinal juice}
A 37-year-old female patient complains of headache, vertigo, troubled sleep, numbness of limbs.
For the last 6 years she has been working at the gas-discharge lamp-producing factory in the leadprocessing shop. Blood test findings: low hemoglobin and RBC level, serum iron concentration
exceeds the norm by several times. Specify the type of anemia:
{=Iron refractory anemia
~Iron-deficiency anemia
~Minkowsky-Shauffard disease
~Hypoplastic anemia
~Metaplastic anemia}
During an animal experiment, surgical damage of certain brain structures has caused deep
prolonged sleep. What structure is most likely to cause such condition, if damaged?
{=Reticular formation
~Basal ganglion
~Red nuclei
~Hippocampus
~Cerebral cortex}
A patient takes cholagogues. What other process besides biliary excretion will be stimulated?
{=Intestinal motility
~Gastric juice secretion
~Pancreatic juice secretion
~Gastric motor activity
~Water absorption}
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?
{=α2-macroglobulin, α1-antitrypsin
~Immunoglobulin
~Cryoglobulin, interferon
~Ceruloplasmin, transferrin
~Hemoplexin, haptoglobin}
A 53-year-old male patient complains of acute pain in the right hypochondrium. Objective
examination revealed scleral icterus. Laboratory tests revealed increased ALT activity, and
stercobilin was not detected in the stool. What disease is characterized by these symptoms?
{=Cholelithiasis
~Hemolytic jaundice
~Hepatitis
~Chronic colitis
~Chronic gastritis}
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:
{=Angiotensin II
~Angiotensinogen
~Renin
~Catecholamines
~Norepinephrine}
A patient is diagnosed with irondeficiency sideroachrestic anemia, progression of which is
characterised by skin hyperpigmentation, pigmentary cirrhosis, heart and pancreas affection. Iron
level in the blood serum is increased. What disorder of iron metabolism causes this disease?
{=Failure to assimilate iron leading to iron accumulation in tissues
~Excessive iron intake with food
~Disorder of iron absorption in bowels
~Increased iron assimilation by body
~–}
According to the results of glucose tolerance test, the 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?
{=Decreased activity of glucose reabsorption enzymes
~Increased activity of glucose reabsorption enzymes
~Exceeded glucose reabsorption threshold
~Increased glucose secretion
~Increased glucose filtration}
In case of alkaptonuria, homogentisic acid is excreted in urine in large amounts. The development
of this disease is associated with a disorder of metabolism of the following amino acid:
{=Tyrosine
~Phenylalanine
~Alanine
~Methionine
~Asparagine}
When studying the signs of pulmonary ventilation, reduction of forced expiratory volume has been
detected. What is the likely causeof this phenomenon?
{=Obstructive pulmonary disease
~Increase of respiratory volume
~Increase of inspiratory reserve volume
~Increase of pulmonary residual volume
~Increase of functional residual lung capacity}
In the course of an experiment adenohypophysis of an animal has been removed. The resulting
atrophy of thyroid gland and adrenal cortex has been caused by deficiency of the following
hormone:
{=Tropic hormones
~Thyroid hormones
~Somatotropin
~Cortisol
~Thyroxin}
Due to the use of poorquality measles vaccine for preventive vaccination, a 1-year-old child has
developed an autoimmune renal injury. The urine was found to contain macromolecular proteins.
What process of urine formation has been disturbed?
{=Filtration
~Reabsorption
~Secretion
~Reabsorption and secretion
~Secretion and filtration}
A female suffered rubella during pregnancy. The child was born with developmental abnormalities,
namely cleft lip and palate. The child’s genotype is normal. These malformations are a
manifestation of:
{=Modification variability
~Polyploidy
~Combinative variability
~Chromosomal mutation
~Aneuploidy}
Since a patient has had myocardial infarction, his atria and ventricles contract independently from
each other with a frequency of 60-70 and 35- 40 per minute. Specify the type of heart block in this
case:
{=Complete atrioventricular
~Partial atrioventricular
~Sino-atrial
~Intra-atrial
~Intraventricular}
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?
{=Tissue
~Hemic
~Cardiovascular
~Hypoxic
~Respiratory}
A public utility specialist went down into a sewer well without protection and after a while lost
consciousness. Ambulance doctors diagnosed him with hydrogen sulfide intoxication. What type of
hypoxia developed?
{=Hemic
~Overload
~Tissue
~Circulatory
~Respiratory}
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:
{=α1-proteinase inhibitor
~α2-macroglobulin
~Cryoglobulin
~Haptoglobin
~Transferrin}
A patient with signs of osteoporosis and urolithiasis has been admitted to the endocrinology
department. Blood test has revealed hypercalcemia and hypophosphatemia. These changes are
associated with abnormal synthesis of the following hormone:
{=Parathyroid hormone
~Calcitonin
~Cortisol
~Aldosterone
~Calcitriol}
In a dysentery patient undergoing treatment in the contagious isolation ward, a significant increase
in packedcell volume has been observed (60%). What other value will be affected by this change?
A. Increasing blood viscosity B. Increasing volume of blood circulation C. Leukopenia D.
Thrombocytopenia E. Increasing erythrocyte sedimentation rate (ESR) 191. A patient complains of
palpitation after stress. The pulse is 104 bpm, P-Q=0,12 seconds, there are no changes of QRS
complex. What type of arrhythmia does the patient have?
{=Sinus tachycardia
~Sinus bradycardia
~Sinus arrhythmia
~Ciliary arrhythmia
~Extrasystole 1}
After implantation of a cardiac valve a young man systematically takes indirect anticoagulants. His
state was complicated by hemorrhage. What substance content has decreased in blood?
{=Prothrombin
~Haptoglobin
~Heparin
~Creatin
~Ceruloplasmin}
A 12-year-old patient has white nonpigmented spots on the skin. The spots appeared after the
patient became 10 years old, and they constantly grow. This spots appeared due to the lack of the
following skin cells:
{=Melanocytes
~Adipocytes
~Fibrocytes
~Plasmocytes
~Labrocytes}
A 41-year-old man has a history of recurrent attacks of heartbeats (paroxysms), profuse sweating,
headaches. Examination revealed hypertension, hyperglycemia, increased basal metabolic rate, and
tachycardia. These clinical presentations are typical for the following adrenal pathology:
{=Hyperfunction of the medulla
~Hypofunction of the medulla
~Hyperfunction of the adrenal cortex
~Hypofunction of the adrenal cortex
~Primary aldosteronism}
Work in a mine is known to cause inhalation of large amounts of coal dust. Inhaled coal dust can be
detected in the following pulmonary cells:
{=Alveolar macrophages
~Respiratory epithelial cells
~Secretory epithelial cells
~Capillary endothelial cells
~Pericapillary cells}
Glomerular filtration of a person, who has been starving for a long time, has increased by 20%. The
most likely cause of filtration changes in the given conditions is
{=Decrease of blood plasma oncotic pressure
~Increase of systemic blood pressure
~Increase of renal filter permeability
~Increase of filtration factor
~Increase of renal plasma flow}
A 43-year-old-patient has arterial hypertension caused by increase in cardiac output and general
peripheral resistance. Specify the variant of hemodynamic development of arterial hypertension in
the given case:
{=Eukinetic
~Hyperkinetic
~Hypokinetic
~Combined
~–}
Poisoning caused by mercury (II) chloride (corrosive sublimate) occurred in the result of safety
rules violation. In 2 days the patient’s diurnal diuresis became 620 ml. The patient developed
headache, vomiting, convulsions, dyspnea; moist crackles are observed in the lungs. Name this
pathology:
{=Acute renal failure
~Chronic renal failure
~Uremic coma
~Glomerulonephritis
~Pyelonephritis}
Along with normal hemoglobin types there can be pathological ones in the organism of an adult.
Name one of them:
{=HbS
~HbF
~HbA1
~HbA2
~HbO2}
A patient is diagnosed with hereditary coagulopathy that is characterised by factor VIII deficiency.
Specify the phase of blood clotting during which coagulation will be disrupted in the given case:
{=Thromboplastin formation
~Thrombin formation
~Fibrin formation
~Clot retraction}
A 37-year-old woman complains of headache, vertigo, troubled sleep, numbness of limbs. For the
last 6 years she has been working at a gas-discharge lamp-producing factory in a lead-processing
shop. Blood test findings: low hemoglobin and RBC level, serum iron concentration exceeds the
norm by several times. Specify the type of anemia:
{=Iron refractory anemia
~Iron-deficiency anemia
~Minkowsky-Shauffard disease
~Hypoplastic anemia
~Metaplastic anemia}
An unconscious patient was delivered by ambulance to the hospital. On objective examination the
patient was found to present no reflexes, periodical convulsions, irregular breathing. After
laboratory examination the patient was diagnosed with hepatic coma. Disorders of the central
nervous system develop due to accumulation of the following metabolite:
{=Ammonia
~Urea
~Glutamine
~Bilirubin
~Histamine}
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:
{=Angiotensin II
~Angiotensinogen
~Renin
~Catecholamines
~Norepinephrine}
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?
{=Decreased activity of glucose reabsorption enzymes
~Increased activity of glucose reabsorption enzymes
~Exceeded glucose reabsorption threshold
~Increased glucose secretion
~Increased glucose filtration}
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?
{=Cushing’s disease
~Cushing’s syndrome
~Conn’s disease
~Diabetes mellitus
~Essential hypertension}
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?
{=Impaired synthesis of calcitriol
~Increased excretion of calcium
~Hyperfunction of parathyroid glands
~Hypofunction of parathyroid glands
~Lack of calcium in food}
When studying the signs of pulmonary ventilation, reduction of forced expiratory volume has been
detected. What is the likely cause of this phenomenon?
{=Obstructive pulmonary disease
~Increase of respiratory volume
~Increase of inspiratory reserve volume
~Increase of pulmonary residual volume
~Increase of functional residual lung capacity}
Diseases of respiratory system and circulatory disorders impair the transport of oxygen, thus
causing hypoxia. Under these conditions the energy metabolism is carried out by anaerobic
glycolysis. As a result, the following substance is generated and accumulated in blood:
{=Lactic acid
~Pyruvic acid
~Glutamic acid
~Citric acid
~Fumaric acid}
Due to the use of poor-quality measles vaccine for preventive vaccination, a 1- year-old child
developed an autoimmune renal injury. The urine was found to contain macromolecular proteins.
What process of urine formation was disturbed?
{=Filtration
~Reabsorption
~Secretion
~Reabsorption and secretion
~Secretion and filtration}
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:
{=α1-proteinase inhibitor
~α2-macroglobulin
~Cryoglobulin
~Haptoglobin
~Transferrin}
A patient, who has been suffering for a long time from intestine disbacteriosis, has increased
hemorrhaging caused by disruption of posttranslational modification of blood-coagulation factors
II, VII, IХ, and Х in the liver. What vitamin deficiency is the cause of this condition?
{=К
~12
~9
~С
~Р}
A 43-year-old patient suffers from acute pancreatitis with disrupted common bile duct patency.
What condition can develop in this case?
{=Mechanical jaundice
~Hemolytic jaundice
~Hepatocellular jaundice
~Hepatic coma
~Portal hypertension}
Electrocardiogram of a young man reveals deviation of his electrical axis of heart to the left. This
phenomenon can be caused by:
{=Hypersthenic body type
~Asthenic body type
~Dilation of the right atrium
~Dilation of the right ventricle
~Dilation of the left atrium}
A 6-year-old child suffers from delayed growth, disrupted ossification processes, decalcification of
the teeth. What can be the cause?
{=Vitamin D deficiency
~Decreased glucagon production
~Insulin deficiency
~Hyperthyroidism
~Vitamin C deficiency}
A 30-year-old patient’s blood test revealed the following: erythrocyte count is 6 · 1012/l,
hemoglobin is 10,55ммоль/l. Vaquez’s disease was diagnosed. Name the leading part of
pathogenesis:
{=Neoplastic erythroid hyperplasia
~Iron-deficiency
~B12-deficiency
~Hypoxia
~Acidosis}
A 3-year-old child has eaten some strawberries. Soon he developed a rash and itching. What was
found in the child’s leukogram?
{=Eosinophilia
~Hypolymphemia
~Neutrophilic leukocytosis
~Monocytosis
~Lymphocytosis}
Cholesterol content in blood serum of a 12-year-old boy is 25 mmol/l. Anamnesis states hereditary
familial hypercholesterolemia caused by synthesis disruption of receptor-related proteins for:
{=Low-density lipoproteins
~High-density lipoproteins
~Chylomicrons
~Very low-density lipoproteins
~Middle-density lipoproteins}
A patient is diagnosed with chronic atrophic gastritis attended by deficiency of Castle’s intrinsic
factor. What type of anemia does the patient have?
{=B12-deficiency anemia
~Iron refractory anemia
~Hemolytic anemia
~Iron-deficiency anemia
~Protein-deficiency anemia}
A 50-year-old man, who has been suffering from chronic hepatic failure for several years, has
developed ascites. What is the main mechanism of this disorder development?
{=Increased pressure in portal vein system
~Decrease of albumin and globulin synthesis in liver
~Increased content of low-density and very low-density lipoproteins in blood
~Neurotoxins appearing in blood
~Increase of blood oncotic pressure}
A 30-year-old man has sustained an injury to his thorax in a traffic incident, which caused
disruption of his external respiration. What type of ventilatory difficulty can be observed in the
given case?
{=Restrictive extrapulmonary ventilatory impairment
~Restrictive pulmonary ventilatory impairment
~Obstructive ventilatory impairment
~Impaired ventilation regulation dysfunction
~Cardiovascular collapse}
Biochemical analysis of an infant’s erythrocytes revealed evident glutathione peroxidase deficiency
and low concentration of reduced glutathione. What pathological condition can develop in this
infant?
{=Hemolytic anemia
~Pernicious anemia
~Megaloblastic anemia
~Sicklemia
~Iron-deficiency anemia}
A patient visited a dentist to extract a tooth. After the tooth had been extracted, bleeding from the
tooth socket continued for 15 minutes. Anamnesis states that the patient suffers from active chronic
hepatitis. What phenomenon can extend the time of hemorrhage?
{=Decrease of fibrinogen content in blood
~Thrombocytopenia
~Hypocalcemia
~Increased activity of anticoagulation system
~Decrease of albumine content in blood}
A 27-year-old patient with injury to the neck has lost approximately 30% of the blood volume. The
patient’s condition is severe: blood pressure is 60/40 mm Hg, heart rate is 140/min., respiratory rate
is 30/min., conscious. Characterize the condition of the patient’s circulatory system:
{=Hypovolemic shock
~Cardiogenic shock
~Collapse
~Coma
~Arterial hypertension}
A 46-year-old reports reduced exercise tolerance over the past 5 years. In the past year he has noted
chest pain after ascending a flight of stairs. He smokes 2 packs of cigarettes per day. On
examination he has a blood pressure of 155/95 mm Hg. His body mass index is 30. Laboratory
findings include a total serum cholesterol of 245 mg/dL with an HDL cholesterol of 22 mg/dL.
Which of the following vascular abnormalities is he most likely to have?
{=Atherosclerosis
~Lymphedema
~Hyperplastic arteriolosclerosis
~Deep venous thrombosis
~Medial calcific sclerosis}
A 55 year old woman has primary biliary cirrhosis and is awaiting liver transplantation. She has
ascites and spider angiomata on physical examination and large esophageal varices on upper
endoscopy. Which of the following would most likely be decreased?
{=Peripheral vascular resistance
~Resistance to blood flow through the liver
~Rate of blood flow through the splanchnic circulation
~Level of vasodilators in the blood
~Hepatic vein pressure gradient}
A 52 year old man has abdominal pain, hematemesis, and melena. He is not taking NSAIDs
(nonsteroidal anti-inflammatory drugs) or aspirin. An upper endoscopy reveals a large posterior
wall duodenal ulcer. A biopsy is obtained from the gastric antrum and a rapid urease test is positive.
Which of the following findings is most likely?
{=Type A autoimmune gastritis
~CagA positive H pylori
~Low gastrin levels after a meal
~Normal gastric acid production
~Absence of gastric metaplasia in the duodenum}
An 70year old woman has a history of constipation and intermittent left lower quadrant abdominal
pain. A colonoscopy shows extensive diverticulosis in the sigmoid colon. He is at risk for which of
the following conditions?
{=Carcinoma of the colon
~Angiodysplasia
~Gastrointestinal hemorrhage
~Ulcerative colitis
~Malabsorption}
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?
{=Decrease of albumin content
~Decrease of fibrinogen conten
~Decrease of globulin conten
~Increase of albumin conten}
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?
{=Erythrocytes sedimentation rate (ESR)
~Unconjugated and conjugated bilirubin content
~Aminotransferase activity (AST, ALT)
~Cholesterol content
~Protein fraction content}
When taking exams students often have dry mouth. The mechanism that causes this state results
from the following reflexes:
{=Unconditioned peripheral
~Conditioned sympathetic
~Conditioned parasympathetic
~Unconditioned parasympathetic}
A patient demonstrates sharp decrease of pulmonary surfactant activity. This condition can result in:
{=Decreased airways resistance
~Increased pulmonary ventilation
~Hyperoxemia
~Alveolar tendency to recede
~Decresed work of expiratory muscles}
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?
{=Aspartate aminotransferase
~Alanine aminopeptidase
~LDH5
~LDH4
~Alanine aminotransferase}
A patient consulted a doctor with complaints of dyspnea occurring after physical exertion. Physical
examination revealed anemia, paraprotein was detected among gamma globulins.What value should
be determined in the patient’s urine to confirm the diagnosis of myeloma?
{=Bence Jones protein
~Hemoglobin
~Antitrypsin
~Ceruloplasmin
~Bilirubin}
A dry-cleaner’s worker has been found to have hepatic steatosis. This pathology can be caused by
disruption of synthesis of the following substance:
{=Cholic acid
~Phosphatidylcholine
~Urea
~Tristearin
~Phosphatidic aci}
A 35-year-old man with peptic ulcer disease has undergone antrectomy. After the surgery secretion
of the following gastrointestinal hormone will be disrupted the most:
{=Gastrin
~Secretin
~Neurotensin
~Cholecystokinin
~Histamine}
A 16-year-old adolescent is diagnosed with hereditary UDP (uridine diphosphate)
glucuronyltransferase deficiency. Laboratory tests revealed hyperbilirubinemia caused mostly by
increased blood content of the following substance:
{=Biliverdine
~Unconjugated bilirubin
~Urobilinogen
~Conjugated bilirubin
~Stercobilinogen}
A patient with hypertension has developed headache, tinnitus, vomiting, high BP up to 220/160 mm
Hg. On examination: facial asymmetry on the right, volitional mobility is absent, increased tendon
reflexes and muscle tone of extremities on the right. What motor disorder of nervous system
occurred in this case?
{=Tetraplegia
~Paraplegia
~Hemiplegia
~Hyperkinesis
~Monoplegia}
After a traffic accident a 36-year-old patient has developed muscle paralysis of the extremitis on the
right, lost pain and thermal sensitivity on the left, and partially lost tactile sensitivity on both sides.
What part of the brain is the most likely to be
damaged?
{=Anterior horn of the spinal cord
~Posterior horn of the spinal cord
~Motor cortex on the left
~Left-hand side of the spinal cord
~Right-hand side of the spinal cord}
A 59-year-old woman has been hospialized in a surgical ward due to exacerbation of chronic
osteomyelitis of the left shin. Blood test: leukocytes - 15, 0 × 109/l. Leukogram: myelocytes - 0%,
metamyelocytes - 8%, stab neutrophils - 28%, segmented neutrophils - 32%, lymphocytes - 29%,
monocytes - 3%. Such blood count would be called:
{=Regenerative left shift
~Hyperregenerative left shift
~Regenerative-degenerative left shift
~Degenerative left shift
~Right shift}
A 41-year-old man has a history of recurrent attacks of heartbeats (paroxysms), profuse sweating,
headaches. Examination revealed hypertension, hyperglycemia, increased basal metabolic rate, and
tachycardia. These clinical presentations are typical of the following adrenal pathology:
{=Primary aldosteronism
~Hyperfunction of the medulla
~Hyperfunction of the adrenal cortex
~Hypofunction of the medulla
~Hypofunction of the adrenal cortex}
Work in a mine is known to cause inhalation of large amounts of coal dust. Inhaled coal dust can be
detected in the following pulmonary cells:
{=Secretory epithelial cells
~Respiratory epithelial cells
~Alveolar macrophages
~Capillary endothelial cells
~Pericapillary cells}
Atria of an experimental animal were superdistended with blood, which resulted in decreased
reabsorption ofNa+ and water in renal tubules. This can be explained by the influence of the
following factor on kidneys:
{=Aldosterone
~Angiotensin
~Vasopressin
~Natriuretic hormone
~Renin}
A 42-year-old patient complains of pain in the epigastral area, vomiting; vomit masses have the
color of coffee-grounds; the patient suffers from melena. Anamnesis records gastric ulcer disease.
Blood formula: erythrocytes - 2, 8 × 1012/l, leukocytes - 8 × 109/l, Hb- 90 g/l. What complication is
it?
{=Perforation
~Penetration
~Hemorrhage
~Canceration
~Pyloric stenosis}
Examination of a 52-year-old woman has revealed a decrease in the amount of red blood cells and
an increase in free hemoglobin in the blood plasma (hemoglobinemia). Color index is 0,85. What
type of anemia is being observed in the patient?
{=Acquired hemolytic
~Acute hemorrhagic
~Anemia due to diminished erythropoiesis
~Chronic hemorrhagic
~Hereditary hemolytic}
Poisoning caused by mercury (II) chloride (corrosive sublimate) occurred in the result of safety
rules violation. In 2 days the patient’s diurnal diuresis was 620 ml. The patient developed headache,
vomiting, convulsions, dyspnea; moist crackles were observed in the lungs. Name this pathology:
{=Acute renal failure
~Uremic coma
~Pyelonephritis
~Glomerulonephritis
~Chronic renal failure}
For people adapted to high external temperatures profuse sweating is not accompanied by loss of
large volumes of sodium chloride. This is caused by the effect the following hormone has on
perspiratory glands:
{=Natriuretic
~Aldosterone
~Cortisol
~Vasopressin
~Tgyroxin}
Urine analysis has shown high levels of protein and erythrocytes in urine. This can be caused by the
following:
{=Renal filter permeability
~Hydrostatic blood pressure in glomerular capillaries
~Oncotic pressure of blood plasma
~Hydrostatic primary urine pressure in capsule
~Effective filter pressure}
Along with normal hemoglobin types there can be pathological ones in the organism of an adult.
Name one of them:
{=HbF
~HbA2
~HbO2
~HbS
~HbA1}
Development of both immune and allergic reactions is based upon the same mechanisms of immune
system response to an antigen. What is the main difference between immune and allergic reactions?
{=Amount of released antigen
~Routes by which antigens are delivered into the body
~Hereditary predisposition
~Development of tissue lesion
~Antigen structure}
An uconscious young man in the state of morphine intoxication has been delivered into an
admission room. The patient’s respiration is slow and shallow due to suppression of the respiratory
center. What kind of respiratory failure occurred in this case?
{=Ventilatory obstruction
~Perfusion
~Diffusion
~Ventilatory disregulation
~Ventilatory restriction}
10 minutes after the beginning of heavy physical work a person demonstrates increase of
erythrocyte number in blood from 4, 0 × 1012/l to 4, 5 × 1012/l. What is the cause of this
phenomenon?
{=Suppression of erythrocyte destruction
~Increase of cardiac output
~Water loss
~Erythrocytes exit from depot
~Erythropoiesis activation}
A patient has a traumatic injury of sternocleidomastoid muscle. This has resulted in a decrease of
the following value:
{=Inspiratory reserve volume
~Respiratory volume
~Functional residual lung capacity
~Residual volume
~Expiratory reserve volume}
Autopsy of a 40-year-old woman, who died of cerebral hemorrhage during hypertensic crisis,
revealed: upperbody obesity, hypertrichosis, hirsutism, stretchmarks on the skin of thighs and
abdomen. Pituitary basophil adenoma is detected in the anterior lobe. What diagnosis is the most
likely?
{=Alimentary obesity
~Essential hypertension
~Cushing’s disease
~Simmonds’ disease
~Hypothalamic obesity}
Cellular composition of exudate largely depends on the etiological factor of inflammation. What
leukocytes are the first to be involved in the focus of inflammation caused by pyogenic bacteria?
{=Basophils
~Neutrophil granulocytes
~Myelocytes
~Monocytes
~Eosinophilic granulocytes}
A patient has insufficient blood supply to the kidneys, which 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:
{=Renin
~Angiotensinogen
~Angiotensin II
~Catecholamines
~Norepinephrine}
Experimental stimulation of sympathetic nerve branches that innervate heart caused an increase in
force of heart contractions because membrane of typical cardiomyocytes permitted an increase in:
{=Calcium and potassium ion exit
~Calcium ion entry
~Potassium ion exit
~Calcium ion exit
~Potassium ion entry}
Histological specimen of an ovary demonstrates a spherical structure composed of large glandular
cells containing lutein. What hormone is produced by the cells of this structure?
{=Testosterone
~Estrogens
~Progesterone
~Corticosterone
~Aldosterone}
A 67-year-old patient complains of periodic heartache, dyspnea during light physical activities.
ECG reveals extraordinary contractions of heart ventricles. Such arrhythmia is called:
{=Bradycardia
~Flutter
~Fibrillation
~Extrasystole
~Tachycardia}
When studying the signs of pulmonary ventilation, reduction of forced expiratory volume has been
detected. What is the likely cause of this phenomenon?
{=Increase of functional residual lung capacity
~Obstructive pulmonary disease
~Increase of inspiratory reserve volume
~Increase of respiratory volume}
A 60-year-old man suffering from chronic hepatitis frequently observes nasal and gingival
hemorrhages, spontaneous hemorrhagic rashes on the skin and mucosa. Such presentations result
from:
{=Decreased synthesis of serum albumins
~Increased blood content of aminotransferases
~Decreased synthesis of prothrombin and fibrinogen
~Increased blood content of macroglobulins and cryoglobulins
~Decreased blood content of cholinesterase}
Leading symptoms of primary hyperparathyroidism are osteoporosis and renal damage resulting in
urolithiasis development.What substances are the basis of uroliths in such cases?
{=Bilirubin
~Cholesterol
~Uric acid
~Cystine
~Calcium phosphate}
Examination of a 56-year-old woman with a history of type 1 diabetes mellitus revealed a disorder
of protein metabolism that is manifested by aminoacidemia in the laboratory blood test values, and
clinically by the delayed wound healing and decreased synthesis of antibodies. Which of the
following mechanisms causes the development of aminoacidemia?
{=Decrease in the concentration of amino acids in blood
~Albuminosis
~Increased proteolysis
~Increase in the oncotic pressure in the blood plasma
~Increase in low-density lipoprotein level}
Apatient with injury sustained to a part of the central nervous system demonstrates disrupted
coordination and movement amplitude, muscle tremor during volitional movements, poor muscle
tone.What part of the central nervous system was injured?
{=Medulla oblongata
~Mesencephalon
~Prosencephalon
~Cerebellum
~Oliencephalon}
After an extended treatment with sulfanamides a patient has developed macrocytic anemia.
Production of active forms of the following vitamin is disrupted in such a condition:
{=Folic acid
~Riboflavin
~Cyanocobalamin
~Pyridoxine
~Thiamine}
A woman resting in the countryside has been stung by a bee. Immediately after she developed pain
in the stung area. In a few minutes there developed a vesicle, erythema and intense itch; later urticaria and expiratory dyspnea. What factors resulted in the patient developing expiratory
dyspnea?
{=Noradrenaline
~Adrenaline
~Hageman’s factor
~Lysosomal enzymes
~Histamine}
When ascending to the top of Elbrus, a mountain climber experiences oxygen starvation, dyspnea,
palpitations, and numbness of the extremities. What kind of hypoxia has developed in the mountain
climber?
{=Circulatory
~Tissue
~Cardiac
~Hypoxic
~Hemic}
A patient presents with dry peeling skin, frequent cases of acute respiratory diseases, xerophthalmia.
What vitamin preparation should be prescribed in this case?
{=Cyanocobalamin
~Thiamine
~Retinol acetate
~Menadione (Vikasolum)
~Ergocalciferol}
A patient with signs of osteoporosis and urolithiasis has been admitted to an endocrinology
department. Blood test revealed hypercalcemia and hypophosphatemia. These changes are
associated with abnormal synthesis of the following hormone:
{=Calcitriol
~Parathyroid hormone
~Cortisol
~Calcitonin
~Aldosterone}
Activation of a number of hemostatic factors occurs through their joining with calcium ions. What
structural component allows for adjoining of calcium ions?
{=Gamma-carboxyglutamic acid
~Gamma-oxybutyric acid
~Monoamine-dicarboxylic acids
~Hydroxyproline
~Gamma-aminobutyric acid}
A patient complains of palpitations after stress. Pulse is 104/min., P-Q=0,12 seconds, there are no
changes in QRS complex. What type of arrhythmia does the patient have?
{=Ciliary arrhythmia
~Extrasystole
~Sinus bradycardia
~Sinus arrhythmia
~Sinus tachycardia}
Patient’s systolic blood pressure is 90 mm Hg, diastolic - 70 mm Hg. Such blood pressure is caused
by decrease of the following factor:
{=Aortic compliance
~Pumping ability of the right heart
~Pumping ability of the left heart
~Total peripheral resistance
~Vascular tone}
Cholesterol content in blood serum of a 12-year-old boy is 25 mmol/l. Anamnesis states hereditary
familial hypercholesterolemia caused by synthesis disruption of receptor-related proteins for:
{=Low-density lipoproteins
~Chylomicrons
~Middle-density lipoproteins
~Very low-density lipoproteins
~High-density lipoproteins}
During recording of a spirogram a patient calmly exhaled. How do we call the volume of air
remaining in the lungs?
{=Functional residual capacity
~Expiratory reserve volume
~Vital capacity of lungs
~Tidal volume
~Pulmonary residual volume}
An athlete (long-distance runner) during a contest developed a case of acute cardiac insufficiency.
This pathology resulted from:
{=Pericardium pathology
~Cardiac pressure overload
~Disrupted coronary circulation
~Direct damage to myocardium
~Cardiac volume overload}
Parkinson’s disease is caused by disruption of dopamine synthesis. What brain structure synthesizes
this neurotransmitter?
{=Substantia nigra
~Corpora quadrigemina
~Hypothalamus
~Red nucleus
~Globus pallidus}
A patient is 20 years old, an athlete.He addressed a doctor with complaints of fatigue, fever up to
38°C - 40°C. Objectively: the liver and spleen are enlarged, lymph nodes on palpation are slightly
enlarged, dense, painless. Blood test: Нb- 100 g/l; erythrocytes - 2, 9 × 1012/l; leukocytes - 4, 4 ×
109/l. Leukogram: 68% of blast cells. Cytochemical investigation of blast cells revealed negative
reactions to glycogen, peroxidase, non-specific esterase, lipids. Name this disease:
{=Acute monoblastic leukemia
~Acute myeloid leukemia
~Acute undifferentiated leukemia
~Acute lymphoblastic leukemia
~Acute megakaryoblastic leukemia}
A pregnant woman with several miscarriages in anamnesis is prescribed a therapy that includes
vitamin preparations. What vitamin facilitates carrying of a pregnancy?
{=Folic acid
~Pyridoxal phosphate
~Rutin
~Alpha-tocopherol
~Cyanocobalamin}
A 3-year-old boy with pronounced hemorrhagic syndrome has no antihemophilic globulin A (factor
VIII) in the blood plasma. Hemostasis has been impaired at the following stage:
{=External mechanism of prothrombinase activation
~Conversion of fibrinogen to fibrin
~Blood clot retraction
~Internal mechanism of prothrombinase activation
~Conversion of prothrombin to thrombin}
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:
{=Kidneys
~Lungs
~Spleen
~Liver
~Heart}
After a case of cold the patient developed a lacrimation disorder. This disorder was caused by
functional disturbance of the following autonomic ganglion:
{=Sublingual
~Pterygopalatine
~Otic
~Ciliary
~Submandibular}
A 30-year-old man complains of suffocation, heaviness in the chest on the right, general weakness.
Body temperature is 38,9°C. Objectively the right side of the chest lags behind the left side during
respiration. Pleurocentesis yielded exudate. What is the leading factor of exudation in the patient?
{=Erythrocyte aggregation
~Decreased resorption of pleural fluid
~Increased blood pressure
~Hypoproteinemia
~Increased permeability of the vessel wall}
A 46-year-old woman suffering from cholelithiasis developed jaundice. Her urine became dark
yellow, while feces are lightcolored. What substance will be the most increased in concentration in
the blood serum in this case?
{=Mesobilirubin
~Urobilinogen
~Unconjugated bilirubin
~Biliverdine
~Conjugated bilirubin}
A 15-year-old teenager complains of lack of air, general weakness, palpitations. Heart rate is
130/min., BP is 100/60 mm Hg. ECG: QRS complex has normal shape and duration. The number of
P waves and ventricular complexes is equal, T wave merges with P wave. What type of cardiac
arrhythmia is observed in the teenager?
{=Atrial thrill
~Paroxysmal atrial tachycardia
~Sinus extrasystole
~Atrial fibrillation
~Sinus tachycardia}
On examination the patient presents with hirsutism, moon-shaped face, stretch marks on the
abdomen. BP is 190/100 mm Hg, blood glucose is 17,6 mmol/l. What pathology is such clinical
presentation characteristic of?
{=Hyperfunction of the insular apparatus
~Adrenocortical hyperfunction
~Hypothyroidism
~Hyperthyroidism
~Gonadal hypofunctio}
After pancreatic surgery the patient developed hemorrhagic syndrome with disturbed 3rd stage of
blood clotting. What will be the most likely mechanism of the hemostatic disorder?
{=Fibrinolysis activation
~Decrease of fibrinogen synthesis
~Fibrin-stabilizing factor deficiency
~Qualitative abnormalities of fibrinogenesis
~Decrease of prothrombin synthesis}
A patient with jaundice has high total bilirubin that is mainly indirect (unconjugated), high
concentration of stercobilin in the feces and urine. The level of direct (conjugated) bilirubin in the
blood plasma is normal.What type of jaundice can be suspected?
{=Hemolytic
~Mechanical
~Gilbert’s disease
~Neonatal
~Parenchymal (hepatic)}
A woman, who has been suffering from marked hypertension for 15 years, has lately developed
dyspnea, palpitations, slightly decreased systolic pressure, while diastolic pressure remains the
same. What is the main mechanism of heart failure development in this case?
{=Disorder of impulse conduction in the myocardium
~Dysregulation of cardiac function
~Cardiac overload due to increased blood volume
~Damage to the myocardium
~Cardiac overload due to increased vascular resistance}
Blood of the patients with diabetes mellitus shows increased content of free fatty acids. Name the
most likely cause of this:
{=Increased activity of adipose triglyceride lipase
~Activation of ketone bodies utilization
~Decreased activity of plasma phosphatidylcholine-cholesterolacyltransferase
~Activation of apoА1, apoА2, and apoА4 apolipoprotein synthesis
~Accumulation of palmitoyl-CoA in cytosol}
Examination of the coronary arteries revealed atherosclerotic plaques with calcinosis that close the
arterial opening by 1/3. In the muscle there are numerous whitish layers of connective tissue. Name
the process detected in the myocardium:
{=Tiger heart
~Myocarditis
~Myocardial infarction
~Diffuse cardiosclerosis
~Postinfarction cardiosclerosis}
Investigation of an isolated cardiac myocyte determined that it does not generate excitation
impulses automatically, which means this cardiac myocyte was obtained from the following cardiac
structure:
{=Ventricle
~Atrioventricular node
~Purkinje’s fibers
~His’ bundle
~Sinoatrial node}
A patient, who has been suffering from bronchial asthma for a long time, developed acute
respiratory failure. What is the main mechanism of pathology development in this case?
{=Obstructive disorders of pulmonary ventilation
~Pulmonary blood supply disturbance
~Decreased elasticity of the pulmonary tissue
~Pulmonary enzyme system disturbance
~Restrictive disorders of pulmonary ventilation}
A 40-year-old woman has undergone thyroidectomy.Histological study of thyroid gland found the
follicles to be of different size and contain foamy colloid, follicle epithelium is high and forms
papillae, there is focal lymphocytic infiltration in the stroma. Diagnose the thyroid gland disease:
{=Hashimoto’s thyroiditis
~De Quervain’s disease
~Nodular goiter
~Basedow’s disease
~Riedel’s thyroiditis}
Due to blood loss the circulating blood volume of a patient decreased. How will it affect the blood
pressure in this patient?
{=Only systolic pressure will decrease
~Systolic pressure will decrease, while diastolic will increase
~Diastolic pressure will decrease, while systolic will increase
~Systolic and diastolic pressure will decrease
~Only diastolic pressure will decrease}
Poisoning caused by mercury (II) chloride (corrosive sublimate) occurred in the result of safety
rules violation. In 2 days the patient’s diurnal diuresis became 620 ml. The patient developed
headache, vomiting, convulsions, dyspnea; moist crackles are observed in the lungs. Name this
pathology
{=Chronic renal failure
~Glomerulonephritis
~Pyelonephritis
~Acute renal failure
~Uremic coma}
A man presents with glomerular filtration rate of 180 ml/min., while norm is 125±25 ml/min. The
likely cause of it is the decreased:
{=Effective filtration pressure
~Renal blood flow
~Permeability of the renal filter
~Plasma oncotic pressure
~Hydrostatic blood pressure in the glomerular capillaries}
A 38-year-old man, who has been suffering from systemic lupus erythematosus for 3 years,
developed diffuse renal lesions accompanied by massive edemas, marked proteinuria,
hyperlipidemia, and dysproteinemia. What is the most likely mechanism of proteinuria develoment
in this case?
{=Inflammatory damage to the nephrons
~Increased blood proteins
~Morbid affection of the urinary tracts
~Autoimmune damage to the nephrons
~Ischemic damage to the tubules}
7-year-old boy died of acute posthemorrhagic anemia caused by profuse hemorrhage in the
gastrointestinal tract. Postmortem study revealed the following: macroscopically there were acutely
enlarged various groups of the lymph nodes, thymomegaly, hepatosplenomegaly, and bright red
bone marrow; microscopically there was hypercellular bone marrow with monomorphic infiltrations
composed of blasts and diffuse-focal tumor infiltrations in the liver, spleen, lymph nodes, brain
substance and tunics. Make the diagnosis:
{=Acute myeloblastic leukemia
~Acute monoblastic leukemia
~Acute plasmablastic leukemia
~Acute lymphoblastic leukemia
~Acute undifferentiated leukemia}
A short-term physical load resulted in reflex increase of heart rate and systemic arterial pressure in a
person. What receptor activation was the most contributory to inducing the pressor reflex?
{=Vascular chemoreceptors
~Vascular baroreceptors
~Hypothalamic thermoreceptors
~Proprioceptors of the working muscles
~Vascular volume receptors}
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