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Krok-1 Full Test Bank 21-22 edited by rola
Lecture 1 ,4 semester (Kharkiv National University of Construction and Architecture)
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PART 1
Enzymes
1. Indicate a class of enzymes, wich performs the process of phosphorylation of substrates:
*А. Transferases В. Oxidoreductases С. Isomerases
D. Lyases
Е. Ligases
2. How are enzymes called, which catalyze the same reaction, but differ one from another
by their primary structure and physico-chemical properties?
*А. Isoenzymes В. Holoenzymes С. Zymogens
D. Cofactors Е. Apoenzymes
3. Which of the below mentioned properties is characteristic only for biologic catalysts?
*А. Ability to regulation
В. Increase a velocity of reaction, decreasing energy of activation
С. Don’t change the state of equilibrium of chemical reaction
D. Increase a velocity of reaction, but are not consumed and aren’t irreversibly changed
4. Indicate the substrate of salivary amylase:
*А. Starch В. Protein С. Sucrose D. Glucose Е. Amino acid
5. Enzymes of the class of lyases are able to catalyze the type of reactions:
*А. Decarboxylation
В. Oxidation
С. Reduction
D. Transamination Е. Hydrolysis
6. Give the full name of conjugated enzyme, polypeptide chains of which are combined
with nonprotein part:
*А. Holoenzyme В. Cofactor
С. Coenzyme
D. Apoenzyme Е. Prosthetic group
7. D-oxidase of alanine is able to deaminize of D-аlanine only, but it doesn’t break down
the structure of L-alanine. Give the type of specificity of this enzyme:
*А. Stereochemical
В. Absolute
С. Absolute group
D. Relative group
8. Choose nonprotein part of enzymes, which is used for formation of active forms of fatty
acids:
*А. НSCоА
В. CоQ С. ТPP
D. NADP
Е. FMN
9. Yeast extract was added to the test-tube with unknown substrate. Mixture in the test-tube
gave the positive reaction of Fellinge after 15 minutes of incubation. Which substrate was in the
test-tube?
*А. Sucrose В. Starch С. Lactose D. Glycogen Е. Cellulose
10. A reaction mixture gives yellow color with iodine and positive Fellinge’s reaction after
10 minutes of incubation of starch with saliva. The mixture contains:
*А. Maltose and dextrins В. Fructose and glucose С. Sucrose
D. Lactose
11. Choose the activator of salivary amylase:
*А. Sodium chloride В. Ammonium sulfate С. Copper sulfate
D. Magnesium chloride Е. Calcium gluconate
12. Name the enzyme, which activity should be determined in patient’s urine in acute
pancreatitis:
*А. Amylase
В. Protein kinase
С. Cholinesterase
D. Leucine aminopeptidase
Е. Alkaline phosphatase
13. Indicate the pathology, in which the activity of blood amylase increases 10 fold and
more:
*А. Acute pancreatitis
В. Virus hepatitis
С. Chronic cholecystitis
D. Miocardial infarction
Е. Diabetes mellitus
14. Name the enzyme, the activity of which is determined in blood plasma of patients with
pathology of bone tissue:
*А. Alkaline phosphatase
В. Trypsin
С. Amylase
D. Acid phosphatase Е. Pepsin
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15. The degree of the liver parenchyma lesion is estimated by the determination of:
*А. concentration of isoforms LDH4 (HM3) and LDH5 (M4) of blood plasma
В. concentration of isoforms LDH1 (H4) and LDH2 (H3M) of blood plasma
С. activity of amylase of urine
D. activity of acid phosphatase
Е. Concentration of isoform LDH3 (H2M2) of blood plasma
16. Choose isoforms of LDH, concentration of which increase in blood plasma of patients
with myocardial infarction:
*А. LDH1 and LDH2 В. LDH3 and LDH4 С. LDH3 D. LDH4 and LDH5 Е. LDH5
17. Choose the enzyme of blood plasma, which is used in therapeutic practice for the
decrease of blood pressure:
*А. Kallikrein В. Trypsin С. Chymotrypsin
D. Cholinesterase Е. LDH1
18. What is the mechanism of inhibition of folic acid synthesis by sulfanylamides?
*А. Competitive
В. Irreversible С. Denaturation of enzyme
D. Noncompetitive
Е. Binding with allosteric site of enzymes
19. The enzymes, which belong to III class are:
*A. Amylase, pepsin, lipase
B. Trypsin, catalase, arginase
C. Elastase, lactate dehydrogenase, thiolase
D. Glycogen phosphorylase, gastrixin, maltase
E. Citrate synthase, pyruvate carboxylase, sucrase
20. Oxidoreductases do not catalyze the reactions of:
*A. Dehydration B. Dehydrogenation
C. Electron transfer
D. Oxygen incorporation
E. Hydrogen peroxide destruction
21. The enzyme inactivation under its heating till 100оС is caused by:
*A. Denaturation
B. Renaturation
C. Competitive inhibition
D. Phosphorylation
E. Decarboxylation
22. Call the reaction, which is catalyzed by enzymes from transferases class:
*A. Amino group carrying from alanine to α-ketoglutarate
B. Taking of carboxyl group from pyruvate
C. Electron transfer from cytochrome oxydase to oxygen
D. Water combining with fumarate
E. Glucose conversion to galactose
23. The competitive inhibition proceeds by:
*A. Inhibitor binding at the active site of enzyme B. Inhibitor binding at the allosteric
site of enzyme C. Enzyme dephosphorylation D. Enzyme denaturation
E. Enzyme hydroxylation
24. Call the enzyme, which belongs to oxidoreductases:
*A. Catalase B. Peptidase C. Amylase D. Lipase E. Lactase
25. Enzymes of V class catalyze reactions of:
*A. Isomerization
B. Intermolecular carrying of chemical groups and radicals
C. Reduction
D. Oxydation
E. Hydrolysis
26. Enzyme DNA-polymerase belongs to the class:
*A. Ligases
B. Isomerases
C. Hydrolases
D. Transferases
E. Lyases
27. Enzymes, consisting of some polypeptide chains, are called:
*A. Olygomeric
B. Thermolabile
C. Allosteric
D. Isomeric E. Monomeric
28. Enzymes are not characteristic by:
*A. Photolability B. Thermolability C. Specificity D. Ability to regulation E. рН-lability
29. Call the type of inhibition, under which enzyme is not reactivated after inhibitor
removal:
*A. Irreversible
B. Noncompetitive
C. Reversible D. Competitive
E. Substrate
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30. Enzyme sucrase breaks down sucrose to glucose and fructose with water molecule
participation. Which class is this enzyme concerned to?
*A. Hydrolases B. Isomerases C. Lyases
D. Ligases
E. Oxidoreductases
31. Aspirin is used as anti-inflammatory drug because it inhibits the activity of:
*A. Cyclooxygenase
B. Xanthine oxidase
C. Thymidylate synthase
D. Monoamine oxidase
E. Lysyl oxidase
32. 5-Flurouracil is used as anticancer drug because it inhibits the activity of:
*A. Thymidylate synthase
B. Cyclooxygenase
C. Xanthine oxidase
D. Lysyl oxidase
E. Monoamine oxidase
33. A 60-years-old man was admitted to the hospital with complains of sever chest pain
and deficiency breathing. Biochemical analysis of blood revealed high levels of MB isoenzyme
of creatine kinase and H4 of lactate dehydrogenase (LDH1). Which disease may be diagnosed in
that patient?
*A. Myocardial infarction
B. Acute hepatitis
C. Prostate cancer
D. Acute pancreatitis
E. Muscle disorders
34. Elevation or depression of activity of specific enzymes may indicate either the presence
of a disease or damage to a specific tissue. The increase of alkaline phosphatase indicates:
*A. Liver disease, bone disorders B. Acute pancreatitis
C. Muscle disorders
D. Prostate cancer
E. Heart attack
35. An allosteric modulator influences enzyme activity by:
*A. Binding to a site on the enzyme molecule distinct from catalytic site
B. Competing for the catalytic site with the substrate
C. Changing the nature of the product formed
D. Changing the specificity of the enzyme for its substrate
E. Covalent modifying the enzyme.
36. Which of the below-mentioned changes of biochemical parameters are characteristic
for myocardial infarction?
*A. Increased MB fraction of serum creatine phosphokinase
B. Increased MM fraction of serum creatine phosphokinase
C. Decreased creatinine level in the urine
D. Increased LPH5 fraction in blood serum
E. Increased α-amylase in blood
37. Presently enzymes are widely applied in medicine as medicinal preparations. Which of
below mentioned enzymes is used to resolute scars?
*A. Hyaluronidase
B. Catalase
C. Amylase
D. Sacharase E. Pepsin
38. In medicine practice, enzyme inhibitors are used known as antimetabolites. These
compounds are:
*A. Structural analogues of natural substrates
B. Irreversible inhibitors of enzymes
C. Cofactors
D. Regulatory proteins
E. Proteolytic enzymes
39. Many enzymes are formed from proenzymes in the result of cleavage of part of their
polypeptide chain. Name the process.
*A. Limited proteolysis
B. Phosphorylation
C. Dephosphorylation
D. Transamination E. Deamination
40. Which enzymes are used in the trearment of viral conjunctivitis?
*A. DNAase
B. Pepsin
C. Trypsin D. Collagen
E. Hyaluronidase
41. In clinical practice thromboses are prevented or cured by administration a certain
medical preparation in the human organism. Name this preparation.
*A. Streptokinase
B. Lydase
C. Hyaluronidase D. Collagenase
E. Pepsin
42. The reasons causing liberation of intracellular enzymes in blood are:
*A. Breakdown of cellular membranes
B. Enzyme secretion
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C. Increase in body temperature
D. Dehydration
E. Increase in osmotic pressure
43. Protection function of saliva is provided by some mechanisms. One of them is
occurrence of enzyme which has bactericidal action, provides a lysis of polysaccharide complex
of capsules of streptococcus, staphylococcus. What is this enzyme?
*A. Lysozyme
B. α-Amylase
C. Oligo-1-6-glucosidase
D. Collagenase E. β-Glucocuronidase
44. In pancretic disease the synthesis and the secretion of trypsin are disturbed. Indicate
substances hydrolysis of which is changed as a result of that?
*A. Proteins B. Lipids
C. Carbohydrates D. Nucleic acids
E. Phospholipids
45. The activities of LDH4, LDH5, alanine aminotransferase, ornithine
carbamoyltransferase are increased in a patient’s blood. What organ is involved in pathological
process?
*A. Liver (hepatitis) B. Heart (myocardial infarction)
C. Skeletal muscle
D. Kidney
E. Connective tissue
46. The increase of activities of LDH1, LDH2, aspartate aminotransferase, creatine
phosphokynase was revealed at the examination of a patient’s blood. Which organ (organs) are
possibly involved in development of pathological process?
*A. Heart (initial stage of myocardial infarction) B. Skeletal muscle (dystrophy, atrophy)
C. Kidneys and adrenal glands D. Connective tissue
E. Liver and kidneys
47. A 42-year-old man was admitted to cardiology department with diagnosis of
stenocardia. Inhibitor of phosphodiesterase was included to complex of preparations prescribed
to the patient. What substance concentration will be increased in myocardium?
*A. cAMP
B. GMP C. AMP
D. ADP
E. ATP
48. A 47-year-old patient with diagnosis of myocardial infarction was admitted at the
reanimation department. What fraction of lactate dehydrogenase (LDH) will prevail in blood
serum for the first two days?
*A. LDH1 B. LDH2
C. LDH3 D. LDH4
E. LDH5
49. A 54-year-old woman was admitted to the intensive therapeutic department with
diagnosis of myocardial infarction. What enzyme activity is mostly increased during the first two
days?
*A. Aspartate aminotransferase B. Alanine aminotransferase
C. Alanine aminopeptidase
D. LDH4
E. LDH5
50. Activity of blood serum aspartate aminotransferase is significantly increased in the
patient organism in 12 hours after acute attack of poststernum pain. Indicate the pathology,
which is characterized by these changes.
*A. Miocardial infarction
B. Viral hepatitis
C. Collagenosis
D. Diabetes mellitus
E. Diabetes insipidus
51. Pathological changes of liver and brain were revealed in a 27-year-old-patient. The
blood plasma level of copper got abruptly decreased while the urine excretion of this metal
become. Wilson’s disease was diagnosed. What enzyme activity in the blood serum should be
examined to prove the diagnosis?
*A. Ceruloplasmin B. Carboanhydrase
C. Xanthine oxidase
D. Leucine aminopeptidase
E. Alcohol dehydrogenase
52. One of diagnostic test for acute pancreatitis is determination of the following enzyme
activity in urine:
*A. Amylase
B. Lactate dehydrohenase
C. Creatine kinase
D. Aldolase
E. Alanine aminopeptidase
53. A patient with acute pancreatitis has sharply increased blood and urine activity of one
of the enzymes mentioned below in blood and urine that confirms the diagnosis. Give this
enzyme.
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*A. α-Amylase
B. Pepsin C. Dipeptidase
D. Sucrase E. Lactase
54. A patient has myocardial infarction. The first several hours of such medical condition
will be characterized by significant increase of activity of the following enzyme in his blood
serum:
*A. Creatine phosphokinase B. Aspartate aminotransferase
C. Alanine aminotransferase
D. Lactate dehydrogenase4
E. Lactate dehydrogenase5
55. Saliva includes the enzyme, which has a high bactericidal effect by means of
destruction the peptidoglycans of bacterial wall. Give this enzyme.
*A. Lysozyme B. α-Amylase C. Trypsin D. Phosphatase E. Ribonuclease
56. A patient has acute pancreatitis. What drugs must be prescribed by a physician to
prevent autolysis of pancreas?
*A. Inhibitors of proteases B. Activators of proteases C. Trypsin
D. Chymotrypsin
E. Amylase
57. Succinate dehydrogenase catalyses the dehydrogenation of succinate. Malonic acid
HOOC-CH2-COOH is used to interrupt the action of this enzyme. Choose the inhibition type:
*A. Competitive B. Limited proteolysis
C. Allosteric
D.
Non-competitive
E. Dephosphorylation
58. In the process of metabolism human body produces active oxygen forms, including
superoxide anion radical O2. This anion is inactivated by the following enzyme:
*A. Superoxide dismutase B. Catalase C. Peroxidase D. Glutathione reductase
E. Glutathione peroxidase
59. One of the means of regulating enzyme activity in a human body is the covalent
modification. Glycogen phosphorylase and glycogen synthetase activities are regulated by the
following type of covalent modification:
A.
*Phosphorylation-dephosphorylation
B.
ADP-ribosylation
C.
Methylation
D.
Hydrolysis
E.
Sulfonation
60. Periodontitis induces the development of lipid peroxidation in the periodontal tissues,
as well as an increase in malondialdehyde and hydrogen peroxide concentration in the oral
cavity. Which of the following enzymes provides antioxidant protection?
A.
*Catalase
B.
Amylase
C.
Maltase
D.
Lactase
E.
Invertase
61. A 50-year-old woman with myocardial infarction has been delivered to the intensive care
unit. Which enzyme’s activity will be most increased during the first two days?
A.
*Aspartate aminotransferase
B.
Alanine aminotransferase
C.
Alanine aminopeptidase
D.
LDH4
E.
LDH5
62. A 60-year-old man consulted a doctor about an onset of chest pain. In blood serum analysis
showed a significant increase in the activity of the following enzymes: creatine kinase and its
MB-isoform, aspartate aminotransferase. These changes indicate the development of the
pathological process in the following tissues:
A.
*Cardiac muscle
B.
Lungs
C.
Skeletal muscles
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D.
Liver
E.
Smooth muscles
63. Certain infections caused by bacteria are treated with sulphanilamides that block the
synthesis of bacterial growth factor. What is the mechanism of these drugs action?
A.
*They are antivitamins of para-aminobenzoic acid
B.
They inhibit the folic acid absorption
C.
They are allosteric enzyme inhibitors
D.
They are involved in redox processes
E.
They are allosteric enzymes
64. Oral mucosa of a patient was treated with hydrogen peroxide. Instead of foaming, the blood
turned brown. That is possible in case of reduced concentration of the following enzyme:
A.
*Catalase
B.
Pseudocholinesterase
C.
Glucose-6-phosphate dehydrogenase
D.
Acetyltransferase
E.
Methemoglobin reductase
65. A 60-year-old female patient presents with hypoactivity of the principal digestive enzyme of
saliva. This is usually accompanied by disturbed primary hydrolysis of:
A.
*Carbohydrates
B.
Fats
C.
Proteins
D.
Cellulose
E.
Lactose
66. A 46-year-old female patient has a continuous history of progressive muscular (Duchenne’s)
dystrophy. Which blood enzyme changes will be of diagnostic value in this case?
A.
*Creatine phosphokinase
B.
Lactate dehydrogenase
C.
Pyruvate dehydrogenase
D.
Glutamate dehydrogenase
E.
Adenylate cyclase
67. Researchers isolated 5 isoenzymic forms of lactate dehydrogenase from the human blood
serum and studied their properties. What property indicates that the isoenzymic forms were
isolated from the same enzyme?
A.
*Catalyzation of the same reaction
B.
The same molecular weight
C.
The same physicochemical properties
D.
Tissue localization
E.
The same electrophoretic mobility
68. 12 hours after an acute attack of retrosternal pain a patient presented a jump of aspartate
aminotransferase activity in blood serum. What pathology is this deviation typical for?
A.
*Myocardial infarction
B.
Viral hepatitis
C.
Collagenosis
D.
Diabetes mellitus
E.
Diabetes insipidus
69. There are several groups of molecular mechanisms playing important part in pathogenesis of
insult to cells which contributes to the pathology development. What processes are stimulated by
proteinic damage mechanisms?
A.
*Enzyme inhibition
B.
Lipid peroxidation
C.
Phospholipase activation
D.
Osmotic membrane distension
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E.
Acidosis
70. 6 hours after the myocardial infarction a patient was found to have elevated level of lactate
dehydrogenase in blood. What isoenzyme should be expected in this case?
A.
*LDH1
B.
LDH2
C.
LDH3
D.
LDH4
E.
LDH5
71. 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 down
hydrogen peroxide?
A.
*Peroxidase and catalase
B.
Oxygenase and hydroxylase
C.
Cytochrome oxidase, cytochrome B5
D.
Oxygenase and catalase
E.
Flavin-dependent oxidase
72. For biochemical diagnostics of myocardial infarction it is necessary to measure activity of a
number of enzymes and their isoenzymes. What enzymatic test is considered to be the best to
prove or disprove the diagnosis of infarction in the early period after the chest pain is detected?
A.
*Creatine kinase isoenzyme CK-MB
B.
Creatine kinase isoenzyme CK-MM
C.
LDH1 lactate dehydrogenase isoenzyme
D.
LDH2 lactate dehydrogenase isoenzyme
E.
Aspartate aminotransferase cytoplasmic isoenzyme
73. A patient is diagnosed with myocardial infarction. Blood test for cardiospecific enzymes
activity was performed. Which of the enzymes has three isoforms?
A.
*Creatine kinase
B.
Pyruvate kinase
C.
Alanine transaminase
D.
Aspartate transaminase
E.
Lactate dehydrogenase
74. A 32-year-old patient has B2 hypovitaminosis. The specific symptoms such as epithelial,
mucosal, skin and corneal lesions are the most likely to be caused by the deficiency of:
A.
*Flavin coenzymes
B.
Cytochrome a1
C.
Cytochrome oxidase
D.
Cytochrome b
E.
Cytochrome c
75. Indicate the type of inhibition, in which the product of reaction is the inhibitor of enzyme:
*А. Retroinhibition В. Noncompetitive С. Stereochemical D. Competitive
76. 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
staphylococcus and streptococcus. Name this enzyme:
A.
*Lysozyme
B.
Alpha-amylase
C.
Oligo-1,6-glucosidase
D.
Collagenase
E.
Beta-glucuronidase
77. Blood test of the patient revealed albumine content of 20 g/l and increased activity of lactate
dehydrogenase isoenzyme 5 (LDH5). These results indicate disorder of the following organ:
A.
*Liver
B.
Kidneys
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C.
Heart
D.
Lungs
E.
Spleen
78. There is increased activity of AST, LDH1, LDH2, and CPK in the patient’s blood.
Pathological process most likely occurs in the:
A.
*Heart
B.
Skeletal muscles
C.
Kidneys
D.
Liver
E.
Adrenal glands
79. A patient is diagnosed with pancreatitis. Starch decomposition disturbance occurs in the
patient’s intestine due to deficiency of the following pancreatic enzyme:
A.
*Amylase
B.
Tripsin
C.
Chymotrypsin
D.
Lipase
E.
Carboxypeptidase
80. The first-aid center has received a victim of a traffic accident diagnosed with closed
displaced fracture of the middle third of the thigh. For repositioning of bone fragments the
patient received 10 ml of 2% dithylinum solution intravenously, which resulted in prolonged
period of apnoea and muscle relaxation. What enzyme is deficient, resulting in such
pharmacogenetic enzymopathy?
A. Pseudocholinesterase
B. N-acetyltransferase
C. Methemoglobin reductase
D. Uridine diphosphate glucuronyltransferase
E. Glucose 6-phosphate dehydrogenase
81. 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
staphylococcus and streptococcus. Name this enzyme:
A. Lysozyme
B. 0ligo-l,6-glucosidase
C. α-amylase
D. Collagenase
E. β-glucuronidase
82. What enzyme has demineralization effect, i. e. intensifies decomposition of mineral
components of the tooth tissues?
A.
*Alkaline phosphatase
B. Glycogen phosphorylase
C. Acid phosphatase
D. Phosphotransferase
E. Glucose 6-phosphatase
83. Beriberi is a classical example of thiamine deficiency. Active form of this vitamin is
synthesized by an enzyme belonging to the following group:
A. Transferase
B. Isomerase
C. Oxidoreductases
D. Lyases
E. Hydrolases
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84. An enzyme, connected to substrate, interacts with it only with a part of its molecule. Name
this part:
A. Active center
B. Allosteric center
C. Cofactor
D. Coenzyme
E. Polypeptide chain portion
Vitamins
1. Patients with bile duct obstruction have hemorrhages, which are due to bad assimilability of
vitamin:
*А. K В. A С. E D. D Е. F
2. A physician found the increase in time of the patient eye adaptation to darkness. Which
vitamin deficiency may be the cause of that symptom?
*А. A
В. E
С. C
D. K
Е. D
3. A complex of vitamins with vitamin E is recommended to old persons. What is the main
function of this vitamin?
*А. Antioxidant В. Antihemorrhagic С. Antiscorbutic D. Antineuritic Е. Antidermatic
4. Which hypovitaminosis is manifested by disturbance of reproductive function of organism and
muscular dystrophy?
*А. E
В. A С. K
D. D Е. B1
5. Vicasol (synthetic analog of vitamin K) is recommended to a 6-year old boy to prevent the
post-operational bleeding. Which posttranslational changes of blood clotting factors are
activated by vicasol?
*А. Carboxylation of glutamic acid
В. Phosphorylation of serine radicals
С. Limited proteolysis
D. Polymerization Е. Glycosylation
6. The calcium absorption in the intestine was disturbed in the patient organism after the removal
of gall-bladder. Which preparation must be prescribed to stimulate this process?
*А. D3
В. K
С. PP
D. E
Е. A
7. Linoleic and linolenic acids are necessary for the synthesis of eicosanoids. The main source of
these acids is:
*А. Alimentary factor
В. Biosynthesis of fatty acids
С. Cholesterol degradation D. Microsomal oxidation Е. Oxidation of fatty acids
8. Patient complains of loss of appetite, headache, insomnia. Hyperkeratosis, inflammation of
their eye, loss of hair, general physical exhaustion are observed. It is known from anamnesis, that
the patient took cod-liver oil during a long time. What is the cause of this state?
*А. Hypervitaminosis of vitamin A
В. Hypovitaminosis of vitamin D
С. Hypervitaminosis of vitamin D
D. Hypovitaminosis of vitamin A
Е. Hypervitaminosis of vitamin F
9. The mother of breast-fed baby complains of its insomnia, frequent weeping, irritability,
disposition to sweat, bald back of the head. Which disease may be diagnozed?
*А. Rickets В. Scurvy С. Beriberi
D. Pellagra
Е. Anemia of Addison-Birmer
10. Hydroxyproline is the important amino acid, which is included in collagen structure. Which
vitamin participates in the formation of this amino acid by hydroxylation of proline?
*A. C
В. D
С.
B1
D. B2
Е. B6
11. A patient has dermatitis, diarrhea and dementia. Which vitamin lack is the cause of that
state?
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*А. Nicotinamide В. Ascorbic acid С.
Folic acid D. Biotin
E. Rutin
12. Pyridoxal phosphate was prescribed to a patient. What processes are corrected by this
preparation?
*A. Transamination and decarboxylation of amino acids
B. Oxidative decarboxylation of α-ketoacids.
C. Deamination of amino acids
D. Protein synthesis
E. Synthesis of purine and pyrimidine nucleotides
13. Dermatitis appears on the patient skin after eating raw eggs. What avitaminosis is developed?
*A. Biotin
B. Folic acid
C. Pantothenic acid
D. Paraaminobenzoic acid
E. Inositol
14. Concentration of pyruvate is increased in patient’s blood. Its large amount is excreted with
urine. What avitaminosis is observed in the patient?
*A. Avitaminosis B1
B. Avitaminosis E
C. Avitaminosis B3
D. Avitaminosis B6
E. Avitaminosis B2
15. Pernicious hyperchromatic anemia (Birmer’s disease) appears as a result of deficiency of
vitamin B12. What bioelement is included in the structure of this vitamin?
*A. Cobalt
B. Molibdenum
C. Zink
D. Iron
E. Magnesium
16. After resection of 2/3 stomach, a quantity of erythrocytes in the patient’s blood is decreased,
their volume is increased, hemoglobin level is decreased. What vitamin deficiency results in such
changes in blood?
*A. B12
B. C
C. P
D. B6
E. PP
17. A patient has developed a sharp enhance of the hemorrhagity of the gingivae. What vitamins
must be prescribed to the patient?
*A. C, K
B. B1, B2
C. A, E
D. PP, B12 E. D, F
18. The structural analogue of vitamin B2 acrichin is prescribed to patients with enterobiosis.
What enzyme synthesis is disturbed by this preparation?
*A. FAD-dependent dehydrogenases B. Cytochrome oxydases
C. Peptidases
D. NAD-dependent dehydrogenases
E. Aminotransferases
19. Coenzyme of pyruvate dehydrogenase is the derivative of one of the vitamins. Choose the
name of this coenzyme.
*А. Thiamine pyrophosphate
В. Pyridoxal phosphate
С. Nicotinamide D. Riboflavin phosphate
Е. Tetrahydrofolic acid
20. Which vitamin is synthesized in human’s organism from tryptophan?
*А. Nicotinic acid В. Riboflavin С. Pantothenic acid D. Vicasol E. Tocopherol
21. Which vitamin is the component of coenzyme, which participates in reactions of
transamination, decarboxylation and racemation of amino acids?
*A. Vitamin B6 B. Ubiquinone C. Vitamin PP D. Vitamin B2 E. Vitamin P
22. Patient complains of general muscular weakness, pains in heart. Objectively: inflammations
of the tongue and lips, keratitis, vascularization of the retina of the eye. Which vitamin hypo- or
hypervitaminosis is the cause of this state?
*А. Hypovitaminosis of vitamin B2 В. Hypovitaminosis of vitamin A
С. Hypervitaminosis of vitamin B2 D. Hypervitaminosis of vitamin A
Е. Hypovitaminosis of vitamin C
23. Chemical nature of intrinsic factor of vitamin B12 is:
*А. Mucoprotein В. Lipid С. Simple protein D. Polypeptide Е. Nucleoprotein
24. The decrease of acidity of gastric juice and disordered activity of nervous system were found
in examination of patient. Macrocytic anemia, presence of big erythrocytes (megalocytes) was
observed in blood. Which vitamin hypo- or hypervitaminosis may be believed?
*А. Hypovitaminosis of vitamin B12 В. Hypervitaminosis of vitamin PP
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С. Hypervitaminosis of vitamin B6 D. Hypovitaminosis of vitamin B6
Е. Hypovitaminosis of vitamin PP
25. Patient of psychiatric department shows disorientation in the space and time, particular
amnesia. There is long alcohol abuse in anamnesis. Which vitamin is necessary to recommend
this patient?
*A. В1
B. В2
C. С
D. Е
E. Н
26. When hypovitaminosis of folic acid, one is to observe the disturbance of regeneration of
gastro-intestinal tract epithelium. This is caused by:
*A. Insufficiency of purines and pyrimidines synthesis for DNA
B. Disturbances of growth factor synthesis
C. Activation of interleukins synthesis
D. Impairment of posttranslational modification of proteins
E. Proteolysis activation
27. Hydroxyprolyne is an important amino acid of collagen composition. What vitamin
participates in the formation of this amino acid by prolyne hydroxylation?
*A. C
B. D
C. B1
D. B2
E. B6
28. A 10-year-old girl often experiences acute respiratory infections with multiple spotty
hemorrhages in the places of clothes friction. What vitamin hypovitaminosis is present in the
girl?
*A. C
B. A
C. B6
D. B2
E. B1
29. Vitamin therapy was prescribed to a expectant mother with some spontaneous abortions in
anamnesis. What vitamin facilitates the normal course of pregnancy?
*A. α-Tocopherol
B. Folic acid
C.Cyanocobalamine
D. Pyridoxal phosphate
E. Rutin
30. Epileptic convulsions due to a deficiency of vitamin B6 are observed in the infant organism.
This is caused by decrease of content of the inhibition mediator (γ-aminobutyric acid) in nervous
tissue. What enzyme activity is decreased?
*A. Glutamate decarboxylase
B. Alanine aminotransferase
C. Glutamate dehydrogenase
D. Pyridoxalkinase
E. Glutamate synthetase
31. A patient was diagnosed with megaloblastic anemia. What substance deficiency in the
organism can result in development of this disease?
*A. Cyanocobalamin
B. Glycine
C. Copper
D. Cholecalciferol
E. Magnesium
32. Lysine and proline were found in composition of collagen fibers in a patient with frequent
internal and submucous hemorrhages. What vitamin absence results in disturbance of lysine and
proline hydroxylation?
*A. C
B. E
C. K
D. A
E. D
33. Pyridoxal phosphate was prescribed to a patient according to clinical symptoms. What
processes are corrected by this preparation?
*A. Transamination and decarboxylation of amino acids
B. Oxidative decarboxylation of α-keto-acids.
C. Deamination of amino acids
D. Synthesis of purine and pyrimidine nucleotides
E. Protein synthesis
34. Concentration of pyruvate is increased in patient’s blood, the most of which is excreted with
urine. What avitaminosis is observed in the patient organism?
*A. Avitaminosis B1 B. Avitaminosis E
C. Avitaminosis PP
D. Avitaminosis B6
E. Avitaminosis B2
35. The content of reactive oxygen species is significantly increased and that results in
destruction of cellular membranes. Antioxidants are used to prevent the destruction. Give the
most potent natural antioxidant.
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*A. α-Tocopherol
B. Glucose
C. Vitamin D
D. Fatty acids
E. Glycerol
36. Most participants of Maggelan’s round-the-word expedition perished from avitaminosis,
which was manifested by general weakness, subcutaneous hemorrhages, loosening of the teeth,
hemorrhages from gingivae. Give this avitaminosis.
*A. Scurvy B. Pellagra C. Rickets
D. Polyneuritis (beriberi) E. Birmer’s anemia
37. During regular prophylactic and medical attendance a physician found in the child organism
symmetric roughness of skin, diarrhea, disturbances of nervous activity. What nutrient factor
deficiency is the cause of this state?
*A. Nicotinic acid, tryptophan
B. Lysine, ascorbic acid
C. Threonine, pantothenic acid D. Methionine, lipoic acid
E. Phenylalanine, pangamic acid
38. A gerontology institute recommends old people usage of vitamin complex that includes
vitamin E. What is the main function of this vitamin?
*A. Antioxidant B. Antihemorrhagic
C. Antiscorbutic D. Antineuritic
E. Antidermatitic
39. After course of medical treatment a physician recommends a patient with ulcer of duodenum
usage of cabbage and potato juices. What substance present in these vegetables facilitates a
prophylaxis and treatment of the ulcer?
*A. Vitamin U
B. Pantothenic acid C. Vitamin C D.Vitamin B1 E. Vitamin P
40. Dermatitis, bad healing of wounds, imperfection of vision were found in the organism of
man, who had not consumed fats for a long time, but received a sufficient amount of
carbohydrates and proteins. What is the possible cause of substance metabolism disturbance?
*A. Deficiency of linoleic acid; A, D, E, K vitamins
B. Deficiency of palmitic acid
C. Deficiency of PP, H vitamins
D. Low-caloric content of food
E. Deficiency of oleic acid
41. Patients with alcoholism receive most calories with alcoholic drinks. Typical deficiency of
thiamine (Wernicke-Korsakov’s syndrome) can appear in their organism. Disturbances of central
nervous system, psychoses, amnesia are observed in this syndrome. What enzyme activity
decrease is the disease linked with?
*A. Pyruvate dehydrogenase B. Alcohol dehydrogenase C. Transaminase
D. Aldolase
E. Hexokinase
42. The treatment of rachitic child by means of vitamin D has proven to have no positive result.
What is the most possible cause of inefficiency of treatment?
*A. Disturbance of hydroxylation of vitamin D3
B. Deficiency of lipids in diet
C. Disturbance of vitamin D3 incorporation to enzyme
D. Increased utilization of vitamin D3 by intestinal microflora.
E. Disturbance of vitamin D3 transport by blood proteins
43. What avitaminosis is possible as a result of inhibition of intestinal microflora after treatment
of a patient with antibiotics?
*A. B12
B.C C. A D. P
E. D
44. Natural and artificial antioxidants are applied for treatment of parodontosis. What of the
natural substances mentioned below is used as antioxidant remedy?
*A. Tocopherol
B. Thiamine C. Gluconate D. Pyridoxin
E. Choline
45. A patient with obturation of bile ducts has inhibited blood clotting. Hemorrhages appear as a
result of insufficient assimilability of vitamin:
*A. K B. A
C. D
D. E
E. Carotene
46. A patient has the following changes of their health: imperfection of vision in a dim light,
dryness of conjunctiva and cornea. Such symptoms are the result of deficiency of:
*A. Vitamin A B. Vitamin B C. Vitamin C D. Vitamin D E. Vitamin B12
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47. After resection of 2/3 stomach, a quantity of erythrocytes in the patient’s blood is decreased,
their volume is increased, hemoglobin level is decreased. What vitamin deficiency results in such
changes in blood?
*A. B12 B. C
C. P
D. B6
E. PP
48. 2-year-old child has intestinal disbactertiosis, which is accompanied by hemorrhagic
syndrome. The most possible cause of hemorrhages in this child is:
*A. Deficiency of vitamin K
B. Activation of tissue tromboplastin
C. Hypovitaminosis of vitamin PP D. Deficiency of fibrinogen
E. Hypocalciemia
49. Hydroxylation of endogenous substrates and xenobiotics requires a donor of protons. Which
of the following vitamins can play this role?
*A. Vitamin C
B. Vitamin A
C. Vitamin P
D. Vitamin B6 E. Vitamin E
50. Increased fragility of vessels, enamel and dentine destruction resulting from scurvy are
caused by disorder of collagen maturation. What stage of procollagen modification is disturbed
under this avitaminosis?
*A. Hydroxylation of proline
B. Formation of polypeptide chains
C. Detaching of N-ended peptide
D. Removal of C-ended peptide from procollagen
E. Glycosylation of hydroxylysine residues
51. A patient who was previously ill with mastectomy as a result of breast cancer was prescribed
radiation therapy. What vitamin preparation has marked radioprotective action caused by
antioxidant activity?
*A. Tocopherol acetate
B. Ergocalciferol
C. Thiamine chloride
D. Ribof1avin
E. Folic acid
52. A patient suffers from vision impairment - hemeralopy (night blindness). What vitamin
preparation should be administered the patient in order to restore his vision?
*A. Retinol acetate B. Tocopherol acetate C. Thiamine chloride
D. Vicasol E. Pyridoxine
53. A woman who has been keeping to a clean-rice diet for a long time was diagnosed with
polyneuritis (beriberi). What vitamin deficiency results in development of this disease?
*A. Thiamine B. Pyridoxine C. Ascorbic acid D. Folic acid E. Riboflavin
54. Removal of gall bladder of a patient has disturbed processes of Ca absorption through the
intestinal wall. What vitamin will stimulate this process?
*A. D3
B. PP
C. C
D. K
E. B12
55. Examination of a patient with frequent hemorrhages from internals and mucous membranes
revealed proline and lysine being a part of collagene fibers. What vitamin absence caused
disturbance of their hydroxylation?
*A. Vitamin С
B. Vitamin E
C. Vitamin A
D. Vitamin K
E. Thiamine
56. A 3 year old child with symptoms of stomatitis, gingivitis and dermatitis of open skin areas
was delivered to a hospital. Examination revealed inherited disturbance of neutral amino acid
transporting in the bowels. These symptoms were caused by the deficiency of the following
vitamin:
*A. Niacin
B. Pantothenic acid
C. Cobalamin
D. Biotin
E. Vitamin A
57. As a result of post translational modifications some proteins taking part in blood coagulation,
particularly prothrombin, become capable of calcium binding. The following vitamin takes part
in this process:
*A. K
B. B1
C. A
D. C
E. B2
58. Vitamin B1 deficiency results in disturbance of oxidative decarboxylation of α- ketoglutaric
acid. This will disturb synthesis of the following coenzyme:
*A. Thiamine pyrophosphate
B. Lipoic acid
C. Flavine adenine dinucleotide (FAD)
D. Nicotinamide adenine dinucleotide (NAD)
E. Coenzyme A
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59. A 16 year old boy after an illness has diminished function of protein synthesis in liver as a
result of vitamin K deficiency. It will cause disturbance of:
*A. Blood coagulation
B. Anticoagulant generation
C. Erythropoietin secretion
D. Erythrocyte sedimentation rate
E. Osmotic blood pressure
60. A doctor examined a child and revealed symptoms of rickets. Development of this desease
was caused by deficiency of the following compound:
*A. 1,25-dihydroxycholecalciferol
B. Retinol
C. Biotin
D. Naphtoquinone
E. Tocopherol
61. A patient consulted a doctor about symmetric dermatitis of open skin areas. It was found out
that the patient lived mostly on cereals and ate too little meat, milk and eggs. What vitamin
deficiency is the most evident?
*A. Nicotinamide
B. Biotin
C. Tocopherol
D. Folic acid
E. Calciferol
62. Surgical removal of a part of stomach resulted in disturbed absorption of vitamin B12, it is
excreted with feces. The patient was diagnosed with anemia. What factor is necessary for
absorption of this vitamin?
*A. Gastromucoprotein B. Hydrochloric acid C. Gastrin
D. Folic acid
E. Pepsin
63. An oncological patient was prescribed methotrexate. With the lapse of time target cells of the
tumour lost susceptibility to this drug. There is change of gene expression of the folowing
enzyme:
*A. Dihydrofolate reductase
B. Deaminase
C. Thiaminase
D. Folate decarboxylase
E. Folate oxidase
64. During examination of an 11-month-old infant a pediatrician revealed osteoectasia of the lower
extremities and delayed mineralization of cranial bones. Such pathology is usually provoked by the
deficit of the following vitamin:
*A. Cholecalciferol B. Pantothenic acid C. Thiamin D. Bioflavonoids E. Riboflavin
65. In clinical practice tuberculosis is treated with izoniazid preparation - that is an antivitamin able
to penetrate into the tuberculosis bacillus. Tuberculostatic effect is induced by the interference
with replication processes and oxidation-reduction reactions due to the build up of
pseudocoenzyme:
*A. NAD B. TDP C. FAD D. FMN E. CoQ
66 A patient has pellagra. Interrogation revealed that he had eaten mostly on maize and a little
meat for a long time. This disease had been caused by the deficit of the following substance in the
maize:
*A. Tryptophan B. Proline
C. Histidine
D. Tyrosine
E. Alanine
67. A patient, who had been eating only polished rice, developed polyneuritis caused by thiamine
deficiency. What compound can be indicative of this kind of avitaminosis when excreted with
urine?
A. *Pyruvic acid
B. Malate
C. Methylmalonic acid
D. Uric acid
E. Phenylpyruvate
68. A patient has been prescribed pyridoxal phosphate. What processes are corrected with this
drug?
A. *Transamination and decarboxylation of amino acids
B. Protein synthesis
C. Oxidative decarboxylation of keto acids
D. Deaminization of amino acids
E. Synthesis of purine and pyrimidine bases
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A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
69. There are various diseases that cause sharp increase of active oxygen, leading to cell
membranes destruction. Antioxidants are used to prevent it from happening. The most potent
natural antioxidant is:
A.
*Alpha-tocopherol
B.
Glycerol
C.
Glucose
D.
Fatty acids
E.
Vitamin D
70. A patient is diagnosed with seborrheic dermatitis caused by vitamin H (biotin) deficiency.
Which enzyme activity is disturbed?
*Acetyl-CoA carboxylase
Alcohol dehydrogenase
Aminotranspherases
Pyruvate decarboxylase
Carbamoyl phosphate synthetase
71. Continuous treatment of cancer patients with methotrexate over time reduces the target cell’s
sensitivity to the drug. In this case gene amplification of the following enzyme is observed:
*Dihydrofolate reductase
Deaminase
Thioredoxin reductase
Thiaminase
–
72. A 9-month-old infant is on bottle feeding. Formula used in feeding has insufficient content of
vitamin B6. The infant has seizures possibly caused by disruption in production of the following
substance in the body:
*Gamma aminobutyric acid (GABA)
Histamine
Serotonin
Dopamine
B-alanine
73. Activation of free radical processes is a universal mechanism that triggers cell death. What
inhibitors of this process should be administered as a part of therapeutic interventions intended
for the treatment of generalized periodontitis?
*Tocopherol, ascorbate
Riboflavin, pyridoxine
Calciferol, naphthoquinone
Thiamin, folate
Cobalamin, pantothenic acid
74. A 32-year-old patient has B2 hypovitaminosis. The specific symptoms such as epithelial,
mucosal, skin and corneal lesions are most likely to be caused by the deficiency of:
*Flavin coenzymes
Cytochrome a1
Cytochrome oxidase
Cytochrome b
Cytochrome c
75. Pyruvic acid as an intermediate metabolite of carbohydrate, lipid and amino acid metabolism
can undergo oxidative decarboxylation. The cause of this process is the lack of the following
nutrient in the diet:
*Thiamin
Pyridoxine
Ascorbic acid
Citrine
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E. Pangamic acid
76. What vitamin is a component of glutamic acid decarboxylase, participates in the production
of GABA, and its deficiency is manifested by seizures?
A. *Pyridoxine
B. Cobalamin
C. Tocopherol
D. Folic acid
E. Ascorbic acid
77. A 24-year-old patient with catarrhal tonsillitis has been administered a drug from the group
of sulfonamides. Specify the mechanism of sulfonamide antibacterial action:
A. *Competitive antagonism of PABA
B. Disruption of the cell wall protein synthesis
C. Reduction of membrane permeability
D. Inhibition of sulfhydryl groups of thiol enzymes
E. Protein coagulation
78. A 48-year-old female patient with a history of cholelithiasis has recurring steatorrhea. What
vitamin deficiency may develop as a complication of the current disease?
A. *K
B. B6
C. C
D. PP
E. B12
79. Hormonal form of a certain vitamin induces genome level synthesis of Ca binding proteins in
enterocytes thus regulating the intestinal absorption of Ca2+ ions required for dental tissue
development. What vitamin is it?
A. *D3
B. A
C. B1
D. E
E. K
80. A patient has enamel erosion. What vitamin should be administered for its treatment?
A. *D3
B. C
C. K
D. B1
E. PP
81. A few days before an operation a patient should be administered vitamin K or its synthetic
analogue Vicasol. Vitamin K takes part in the following posttranslational modification of the II,
VII, IX, X blood clotting factors:
A.
*Carboxylation
B.
Decarboxylation
C.
Deamination
D.
Transamination
E.
Glycosylation
82. Leukoses are treated with anti metabolite methotrexate. Which vitamin is it antagonist?
A.
*Folic acid
B.
Cyanocobalamin
C.
Phyllochinone
D.
Piridoxine
E.
Rutin
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A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
83. Examination of a child who hasn’t got fresh fruit and vegetables during winter revealed
numerous subcutaneous hemorrhages, gingivitis, carious cavities in teeth. What vitamin
combination should be prescribed in this case?
*Ascorbic acid and rutin
Thiamine and pyridoxine
Folic acid and cobalamin
Riboflavin and nicotinamide
Calciferol and ascorbic acid
84. A patient’s blood shows an increased concentration of pyruvate which is excreted with urine
for the most part. This is typical for the following vitamin deficiency:
*B1
E
B3
B6
B2
85. Examination of a patient revealed that dental hypoplasia was caused by hypovitaminosis of
vitamins A and D. These vitamins were administered perorally but they didn’t have any
medicinal effect. What is the probable cause of disturbed vitamin assimilation?
*Bile acid deficiency
Hypochlorhydria
Hyperchlorhydria
Achylia
Achlorhydria
86. In spring a patient experiences petechial haemorrhages, loosening of teeth, high liability to
colds. A doctor supposes hypobitaminosis C. In this respect loosening of teeth can be explained
by:
*Structural failure of collagen in the periodontal ligaments
Structural change of glycosaminoglycan
Increased permeability of periodont membranes
Mechanical damage of teeth
Disturbed oxidation-reduction process in the periodont
87. Examination of a patient, suffering from atrophic gastritis, revealed megaloblastic anemia.
The anemia is likely to be caused by the deficiency of the following substance:
*Gastromucoproteid
Vitamin B6
Vitamin B1
Iron
Erythropoietins
88. A patient was diagnosed with seborrheic dermatitis associated with vitamin H (biotin)
deficiency. The patient has disturbed activity of the following enzyme:
*Acetyl-CoA-carboxylase
Pyruvate decarboxylase
Alcohol dehydrogenase
Amino transferase
Carbomoyl phosphate synthetase
89. A patient is found to have increased permeability of blood vessel walls accompanied by
increased gingival haemorrhage, petechial skin haemorrhages, dedentition. What pathology is
observed in this patient?
*Hypovitaminosis C
Hypervitaminosis D
Hypervitaminosis C
Hypovitaminosis D
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E.
Hypovitaminosis A
90. A newborn child has convulsions that disappeared after prescription of vitamin B6. The most
probable cause of this effect is that vitamin B6 is a component of the following enzyme:
A.
*Glutamate decarboxylase
B.
Pyruvate dehydrostase
C.
Netoglubarate dehydromine
D.
Aminolevulinate synthase
E.
Glycogen phosphorylase
91. A patient underwent an operation on account of gall bladder excision that resulted in
obstruction of Ca absorption through the bowels wall. What vitamin will stimulate this process?
A.
*D3
B.
PP
C.
C
D.
B12
E.
K
92. Vitamin A together with specific cytoreceptors penetrates through the nuclear membranes,
induces transcription processes that stimulate growth and differentiation of cells. This biological
function is realized by the following form of vitamin A:
A.
*Trans-retinoic acid
B.
Trans-retinal
C.
Cis-retinal
D.
Retinol
E.
Carotin
93. A clinic observes a 49 year old patient with significant prolongation of coagulation time,
gastrointestinal haemorrhages, subcutaneous hematomas. These symptoms might be explained by
the deficiency of the following vitamin:
A.
*K
B.
B1
C.
B6
D.
H
E.
E
94. A 64 year old woman has impairment of twilight vision (hemeralopy). What vitamin should be
recommended in the first place?
A.
*Vitamin A
B.
Vitamin B2
C.
Vitamin E
D.
Vitamin C
E.
Vitamin B6
95. A 10-year-old girl has a history of repeated acute respiratory viral infection. After recovering she
presents with multiple petechial hemorrhages on the sites of friction from clothing rubbing the skin.
What kind of hypovitaminosis has this girl?
A.
*C
B.
B6
C.
B1
D.
A
E.
B2
96. 4 year’s old child with hereditary renal lesion has signs of rickets, vitamin D concentration in
blood is normal. What is the most probable cause of rickets development?
A.
*Impaired synthesis of calcitriol
B.
Increased excretion of calcium
C.
Hyperfunction of parathyroid glands
D.
Hypofunction of parathyroid glands
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E.
Lack of calcium in food
97. A patient diagnosed with focal tuberculosis of the upper lobe of the right lung had been taking
isoniazid as a part of combination therapy. After some time, the patient reported of muscle
weakness, decreased skin sensitivity, blurred vision, impaired motor coordination. Which vitamin
preparation should be used to address these phenomena?
A.
*Vitamin B6
B.
Vitamin A
C.
Vitamin D
D.
Vitamin B12
E.
Vitamin C
98. A number of diseases can be diagnosed by evaluating activity of blood transaminases. What
vitamin is cofactor of these enzymes?
A.
*B6
B.
B2
C.
B1
D.
B8
E.
B5
99. A 20-year-old male patient complains of general weakness, rapid fatigability, irritability,
decreased performance, bleeding gums, petechiae on the skin. What vitamin deficiency may be a
cause of these changes?
A.
*Ascorbic acid
B.
Riboflavin
C.
Thiamine
D.
Retinol
E.
Folic acid
100. Malaria is treated with structural analogs of vitamin B2 (riboflavin). These drugs disrupt the
synthesis of the following enzymes in plasmodium:
A.
*FAD-dependent dehydrogenase
B.
Cytochrome oxidase
C.
Peptidase
D.
NAD-dependent dehydrogenase
E.
Aminotransferase
101. A patient complains of photoreception disorder and frequent acute viral diseases. He has
been prescribed a vitamin that affects photoreception processes by producing rhodopsin, the
photosensitive pigment. What vitamin is it?
A.
*Retinol acetate
B.
Tocopherol acetate
C.
Pyridoxine hydrochloride
D.
Cyanocobalamin
E.
Thiamine
102. During regular check-up a child is detected with interrupted mineralization of the bones.
What vitamin deficiency can be the cause?
A. *Calciferol
B. Cobalamin
C. Tocopherol
D. Folic acid
E. Riboflavin
103. A 6-year-old child suffers from delayed growth, disrupted ossification processes,
decalcification of the teeth. What can be the cause?
A. * Vitamin D deficiency
B. Decreased glucagon production
C. Vitamin C deficiency
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D. Hyperthyroidism
E. Insulin deficiency
104. Activation of a number of hemostatic factors occurs through their joining with calcium ions.
What structural component allows for adjoining of calcium ions?
A.
*Gamma-carboxyglutamic acid
B.
Gamma-aminobutyric acid
C.
Monoamine-dicarboxylic acids
D.
Hydroxyproline
E.
Gamma-oxybutyric acid
105. A patient presents with dry peeling skin, frequent cases of acute respiratory diseases,
xerophthalmia. What vitamin preparation should prescribed in this case?
A.
*Retinol acetate
B.
Thiamine
C.
Ergocalciferol
D.
Menadione (Vikasolum)
E.
Cyanocobalamine
106. A 6-year-old child suffers from delayed growth, disrupted ossification processes,
decalcification of the teeth. What can be the cause?
A.
*Vitamin D deficiency
B.
Vitamin C deficiency
C.
Decreased glucagon production
D.
Hyperthyroidism
E.
Insulin deficiency
107. Coenzyme A participates in numerous important metabolic reactions. It is a derivative of
the following vitamin:
A.
*Pantothenic acid
B.
Calciferol
C.
Thiamine
D.
Niacin
E.
Ubiquinone
108. After an extended treatment with sulfonamides a patient has developed macrocytic anemia.
Production of active forms of the following vitamin is disrupted in such a condition:
A.
*Folic acid
B.
Pyridoxine
C.
Thiamine
D.
Cyanocobalamin
E.
Riboflavin
109. It has been determined that one of pesticide components is sodium arsenate that blocks
lipoic acid. Enzyme activity can be impaired by this pesticide. Name this enzyme:
A.
*Pyruvate dehydrogenase complex
B.
Glutathione reductase
C.
Methemoglobin reductase
D.
Microsomal oxidation
E.
Glutathione peroxidase
110. After an extended treatment with sulfonamides a patient has developed macrocytic anemia.
Production of active forms of the following vitamin is disrupted in such a condition:
A.
*Folic acid
B.
Pyridoxine
C.
Thiamine
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D.
Cyanocobalamin
E.
Riboflavin
111. A patient, who has been subsisting exclusively on polished rice, has developed polyneuritis
due to thiamine deficiency. What substance is an indicator of such avitaminosis, when it is
excreted with urine?
A.
*Pyruvic acid
B.
Uric acid
C.
Malate
D.
Phenyl pyruvate
E.
Methyl malonic acid
112. There are various diseases that cause sharp increase of active oxygen, thus leading to cell
membranes destruction. Antioxidants are used to prevent it from happening. The most potent
natural antioxidant is:
A.
*α-tocopherol
B.
Glucose
C.
Vitamin D
D.
Fatty acids
E.
Glycerol
113. A 50-year-old man addressed a hospital with complaints of memory disorders, painful
sensations along the nerve trunks, decreased mental ability, circulatory disorders and dyspepsia.
Anamnesis states excessive alcohol consumption. What vitamin deciency can result in such
signs?
A.
*Thiamine
B.
Niacin
C.
Retinol
D.
Calciferol
E.
Riboflavin
114. A child with signs of rickets has been prescribed a certain liposoluble
vitamin drug by pediatrician and dentist. This drug affects the metabolism of phosphorus and
calcium in the body and facilitates calcium accumulation in bone tissue and dentine. If its
content in the body is insufficient, there develop disruptions of ossification process, dental
structure and occlusion. Name this drug:
A.
*Ergocalciferol
B.
Retinol acetate
C.
Tocopherol acetate
D.
Menadione (Vicasolum)
E.
Thyroidin
115. A 13-year-old girl has been prescribed a certain drug for treatment of megaloblastic
anemia. This drug stimulates a transfer from megaloblastic haemopoiesis to normoblastic,
participates in synthesis of purine and pyrimidine bases, activates proteine and methionine
synthesis. What drug does the patient take?
A.
*Cyanocobalamin
B.
Ferric sulfate
C.
Haemostimulinum
D.
Erythropoietin
E.
Rosehip tea
116. A pregnant woman with several miscarriages in anamnesis is prescribed a therapy that
includes vitamin preparations. What vitamin facilitates carrying of a pregnancy?
A. *Alpha-tocopherol
B. Folic acid
C. Cyanocobalamin
D. Pyridoxal phosphate
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E. Rutin
117. An infant, who was on synthetic formula feeding, developed signs of vitamin B1 deficiency.
What reactions does this vitamin take part in?
A. * Keto acid oxidative decarboxylation
B. Amino acids transamination
C. Amino acids decarboxylation
D. Proline hydroxylation
E. Redox reactions
118. An oculist has detected increased time of darkness adaptation of a patient’s eye. What
vitamin deficiency can cause such symptom?
A. *А
B. Е
C. С
D. К
E. D
119. A woman, who had undergone mastectomy due to breast cancer, was prescribed a course
of radiation therapy. What vitamin preparation has marked antiradiation effect due to its
antioxidant activity?
A. *Tocopherol acetate
B. Ergocalciferol
C. Riboflavin
D. Cyanocobalamin
E. Folic acid
120. A 50-year-old man came to a hospital with complaints of memory disorders, painful
sensations along the nerve trunks, decreased mental ability, circulatory disorders and dyspepsia.
Anamnesis states excessive alcohol consumption. What vitamin deficiency can result in such
symptoms?
A. *Thiamine
B. Niacin
C. Retinol
D. Calciferol
E. Riboflavin
121. One of the causes of pernicious anemia is disturbed synthesis of transcorrin - Castle's
intrinsic factor - by the parietal cells of the stomach. What substance is called Castle's extrinsic
factor?
A. *Cobalamin
B. Riboflavin
C. Folic acid
D. Biotin
E. Pyridoxine
122. Patients with bile duct obstruction typically present with inhibited blood clotting and
develop hemorrhages due to insufficient assimilation of vitamin:
A. *K
B. C
C. D
D. A
E. E
123. A hereditary disease - homocystinuria - is caused by disturbed transformation of
homocysteine into methionine. Accumulated homocysteine forms its dimer (homocystine) that
can be found in urine. What vitamin preparation can decrease homocysteine production?
A. *Vitamin B12
B. Vitamin B2
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C. Vitamin B1
D. Vitamin PP
E. Vitamin C
124. A 25-year-old young man came to the doctor complaining of general weakness, rapid
fatigability, irritability, reduced working ability, and bleeding gums. What vitamin is likely to be
deficient in this case?
A. *Ascorbic acid
B. Riboflavin
C. Thiamine
D. Folic acid
E. Retinol
125. An 8-year-old girl presents with signs of disturbed twilight vision. This condition is caused
by the deficiency of vitamin:
A. * A
B. E
C. K
D. D
E. F
126. A 50-year-old man came to a hospital with complaints of memory disorders, painful
sensations along the nerve trunks, decreased mental ability, circulatory disorders and dyspepsia.
Anamnesis states excessive alcohol consumption. What vitamin deficiency can result in such
symptoms?
A. *Thiamine
B. Niacin
C. Retinol
D. Riboflavin
E. Calciferol
127. A patient with megaloblastic anemia was taking a water-soluble vitamin. Name this
substance:
A. *Cyanocobalamin
B. Tocopherol acetate
C. Thiamine chloride
D. Pyridoxine
E. Ascorbic acid
128. A patient with glossitis presents with disappearance of lingual papillae, reddening and
burning pain in the tongue. Blood test: erythrocytes - 2.2 • 1012/1, hemoglobin -103 g/1, color
index -1.4. What type of anemia is it?
A. *B12 folate-deficiency
B. β-thalassemia
C. Iron deficiency
D. α-thalassemia
E. Iron refractory
129. A child with signs of rickets has been prescribed a certain liposoluble vitamin drug by the
pediatrician and dentist. This drug affects the metabolism of phosphorus and calcium in the body
and facilitates calcium accumulation in bone tissue and dentine. If its content in the body is
insufficient, there develop disorders of ossification process, dental structure, and occlusion.
Name this drug:
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A.
*Ergocalciferol
B. Tocopherol acetate
C. Retinol acetate
D. Thyroidin
E. Menadione (Vicasolum)
130. A patient with parodontosis was prescribed a fat-soluble vitamin that actively participates
in redox processes in the organism. This antioxidant is a growth factor, has antixerophthalmic
action, and contributes to maintenance of normal vision. In dental practice it is used to
accelerate mucosal re-epithelization during parodontosis. Name this substance:
A. *Retinol acetate
B. Tocopherol acetate
C. Cyanocobalamin
D. Menadione (Vicasolum)
E. Ergocalciferol
131. A certain vitamin is a component of glutamic acid decarboxylase as a coenzyme, takes part
in the formation of gamma-aminobutyric acid, and its deficiency manifests as convulsions. Name
this vitamin:
A. Pyridoxine
B. Ascorbic acid
C. Folic acid
D. Tocopherol
E. Cobalamin
132. One of the causes of pernicious anemia is the disturbed synthesis of transcorrin – Castle’s
intrinsic factor – in the parietal cells of the stomach. What substance is called Castle’s extrinsic
factor?
A. Cobalamin
B. Pyridoxine
C. Riboflavin
D. Biotin
E. Folic acid
133. Vitamin B1 deficiency impairs oxidative decarboxylation of alpha-ketoglutaric acid, due to
disturbed synthesis of a certain coenzyme. Name this coenzyme:
A. Thiamine pyrophosphate (TPP)
B. Flavin adenine pyrophosphate (FAD)
C. Lipoic acid
D. Coenzyme A
E. Nicotinamide adenine dinucleotide (NAD)
134. A 10-year-old homeless boy was brought to the admission room with a severe case of
bronchitis. Objectively, the child is exhausted; he presents with delayed physical development,
dry peeling skin, trophic ulcers in some places, and a loss of twilight vision (“night-blindness”).
What vitamin supplements should be prescribed to this boy?
A. Retinol acetate
B. Tocopherol acetate
C. Cyanocobalamin
D. Pyridoxine hydrochloride
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E. Ascorbic acid
135. After eating raw eggs the patient developed dermatitis. What type of avitaminosis is it?
A. Biotin deficiency
B. Para-aminobenzoic acid deficiency
C. Inositol deficiency
D. Folic acid deficiency
E. Pantothenic acid deficiency
136. A patient has frequent visceral and mucosal hemorrhages. Analysis shows that the collagen
fibers in the patient’s body lack hydroxyproline and hydroxylysine. The hydroxylation processes
of these amino acids are disrupted because of a vitamin deficiency. What vitamin is deficient in
this case?
A. C
B. H
C. PP
D. A
E. K
137. A patient complains of stomachache. Biochemical testing revealed decreased secretory
function of the stomach accompanied by anemia. Hypovitaminosis B12 and development of
anemia are caused by the low levels of a certain substance. What substance is it?
A. Castle factor
B. Pyridoxine
C. Calciferol
D. Biotin
E. Thiamine
138. A 1.5-year-old child on examination has deformed legs and foci of thickening in the area of
the ribs and wrists. A dentist pointed out the late eruption of teeth, disturbed order of tooth
eruption, uneven mineralization of the enamel and dentin, and horizontal configuration of the
upper jaw that forms a high-arched palate. What disease developed in this child?
A. Rickets
B. Fluorosis
C. Osteoporosis
D. Gout
E. Sialolithiasis
139. After a prolonged izoniazid treatment, the patient developed polyneuritis, paresthesia,
memory disorders, and convulsions. What is the likely mechanism of the described isoniazid
side-effects?
A. Inhibition of pyridoxal phosphate formation
B. Disruption of cell membrane synthesis
C. Inhibition of RNA synthesis
D. Para-aminobenzoic acid antagonism
E. Inhibition of protein synthesis
140. Formation of dental bone tissue requires calcium. The active form of vitamin D plays a
large role in calcium metabolism and is produced in:
A. Kidneys and liver
B. Stomach and heart
C. Liver and muscles
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D. Kidneys and heart
E. Intestine and liver
141. A 35-year-old woman is brought to the physician because of a 4-month history of
progressive weakness of both lower limbs. She notes difficulty climbing stairs and complains of
lethargy and loss of muscle bulk. Her diet consists primarily of “polished” rice. A diagnosis of
dry beriberi is suspected. Deficiency of which of the following vitamins is most likely to be
detected in her blood?
A. Vitamin B1 (thiamine)
B. Vitamin B6 (pyridoxine)
C. Vitamin B3 (niacin)
D. Vitamin C (ascorbic acid)
E. Vitamin B2 (riboflavin)
142. A certain natural antioxidant is used in treatment of parodontosis. Which of the listed
natural compounds is used as an antioxidant?
A. Tocopherol
B. Gluconate
C. Pyridoxine
D. Choline
E. Thiamine
143. A 40-year-old man with pulmonary tuberculosis was prescribed isoniazid. Prolonged taking
of this drug can result in development of the following vitamin deficiency:
A. Pyridoxine
B. Thiamine
C. Cobalamin
D. Folic acid
E. Biotin
144. One of the causes of pernicious anemia is disturbed synthesis of transcorrin – Castle’s
intrinsic factor – by the parietal cells of the stomach. What substance is called Castle’s extrinsic
factor?
A. Cobalamin
B. Folic acid
C. Biotin
D. Riboflavin
E. Pyridoxine
Biological oxidation. Tricarboxylic acid cycle
1. Show the point of coupling oxidation and phosphorylation in respiratory chain, which is
blocked by barbiturate:
*А. FMNH2DH→CoQ В. CoQH2→2b(Fe3+) С. 2b(Fe2+)→2c1 (Fe3+)
D. Cytochrome oxidase→1/2O2
Е. NADH→FMNDH
2. Experimental animals were treated by preparation, which removes the pH gradient on
the inner mitochondrial membrane, to uncouple the tissue respiration and oxidative
phosphorylation. Which substance has been injected?
*А. Dinitrophenol В. Cholesterol С. Ketone bodies D. Urea
Е. Somatotropin
3. After the treatment with Phenobarbital, which is the inductor of cytochrome P450
synthesis, patient has the intensified:
*А. Microsomal oxidation В. Peroxide oxidation of lipids С. Biological oxidation
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D. Oxidative phosphorylation
Е. Substrate level phosphorylation
4. The organisms, which have not created a system of protection from H2O2 in process of
evolution, are able to exist only under anaerobic conditions. What of the enzymes mentioned
below are able to destroy hydrogen peroxide?
A. Oxygenases and hydroxylases
B. Cytochrome oxidase
C. Oxygenase and catalase
*D. Peroxidase and catalase
E. Flavin-dependent oxidases
5. Central intermediate of protein, lipid, carbohydrate metabolisms is:
A. Succinyl-CoA *B. Acetyl-CoA C. Oxaloacetate
D. Lactate
E. Citrate
6. Mechanisms of many pathologic processes are realized through hypoxia state. The result
of the latter is formation of hydrogen peroxide. Name the enzyme which evokes its breakdown.
*A. Catalase
B. Cytochrome oxidase
C. Lactate dehydrogenase
D. Creatine phosphokinase
E. Elastase
7. Incomplete reduction of oxygen molecule in respiratory chain and accumulation of
hydrogen peroxide occur in pathology processes, which are accompanied by hypoxia. What
enzyme provides hydrogen peroxide degradation?
*A. Catalase
B. Cytochrome oxidase
C. Succinate dehydrogenase
D. α-Ketoglutarate dehydrogenase
E. Aconitase
8. Potassium cyanide is a poison, which leads to momentary death of the organism. What
mitochondrial enzymes are influenced by potassium cyanide?
A. Cytochrome P450
B. Flavin-dependent enzymes
C. Cytochrome b
D. NAD-dependent dehydrogenases
*E. Cytochrome oxidase (aa3)
9. The universal biological system of nonpolar substance oxidation (many of drugs, toxic
substances, steroid hormones, cholesterol) is microsomal oxidation. What cytochrome is
included to the composition of microsomal oxidation chain?
A. Cytochrome c.
B. Cytochrome a3
C. Cytochrome b
*D. Cytochrome P450
E. Cytochrome a
10. A forensic medicine expert performing postmortem of a 20-year-old girl’s body has
found that the cause of death was poisoning by cyanides. What enzyme activity was inhibited by
cyanides in the greatest extent?
A. Malate dehydrogenase
*B. Cytochrome oxidase
C. Heme syntase
D. Aspartate aminotransferase
E. Carbamoyl phosphate syntase
11. A forensic medicine expert performing postmortem of a 20-year-old girl’s body has
found that the cause of death was poisoning by cyanides. What process disturbance is the most
possible cause of the girl’s death?
*A. Tissue respiration
B. Hemoglobin synthesis
C. Transport of oxygen by hemoglobin
D. Synthesis of urea
E. Hydrogen transport by means of malate-aspartate mechanism
12. How many ATP may be synthesized during full oxidation of acetyl-CoA in Krebs
cycle?
A. 1
*B. 12
C. 5
D. 8
E. 3
13. The increased tolerance of winter swimmers to cool water is explained by the synthesis
of large amounts of hormones that induce the process of oxidation and heat production in
mitochondrion by uncoupling the biological oxidation and oxidative phosphorylation in their
organisms. What are these hormones (hormone)?
A. glucagon
B. Adrenaline and noradrenaline
*C. Thyroid hormones
D. Insulin
E. Corticosteroids
14. Stimulation of lipid and biopolymer peroxidation is one of basic mechanisms of
damage of structure and functions of cellular membranes and cell destruction. The cause of that
is:
A. Hypervitaminosis of B12
B. Hypovitaminosis of B1
C. Hypervitaminosis of B1
D. Hypovitaminosis of B12
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A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
*E. Increased production of oxygen free radicals and inhibition of antioxidant system
15. Increased production of thyroid hormones T3 and T4, weight loss, tachycardia, psychic
excitement and so on are present at thyrotoxicosis. How do thyroid hormones affect the energy
metabolism in the mitochondria of cells?
A. Stop respiratory chain
B. Activate substrate level phosphorylation
C. Stop substrate level phosphorylation
*D. Disconnect oxidation and oxidative phosphorylation
E. Activate oxidative phosphorylation
16. Poisoning with cyanides results in momentary death. What is the mechanism of cyanide
action on molecular level?
*A. They inhibit cytochrome oxidase
B. They combine substances of Krebs cycle
C. They block succinate dehydrogenase
D. They inactivate oxygen
E. They inhibit cytochrome b
17. Bioenergetics of brain considerably depends on oxygen supply. What substrate of
oxidation has the greatest significance for providing brain with energy?
A. Fatty acids
*B. Glucose
C. Ketone bodies
D. Glycerol-3-phosphate
E. Phosphoenolpyruvate
18. A patient with abscess of the cut wound applied to the traumatological department. The
wound was washed with 3% hydrogen peroxide to be cleaned from the pus. Foam was not
observed. What caused inefficiency of the drug?
A. Pus in the wound
B. Shallow wound
*C. Inherited insufficiency of catalase
D. Low concentration H202
E. Inherited insufficiency erythrocyte's phosphatdehydrogenase
19. In course of metabolic process active forms of oxygen including superoxide anion
radical are formed in the human body. By means of what enzyme is this anion inactivated?
A. Peroxidase *B. Superoxide dismutase C. Catalase
D. Glutathioneperoxidase
E. Glutathionereductase
20. A patient is followed up in an endocrinological dispensary on account of
hyperthyreosis. Weight loss, tachycardia, finger tremor are accompanied by hypoxia symptoms headache, fatigue, eye flicker. What mechanism of thyroid hormones action underlies the
development of hypoxia?
A. Intensification of respiratory ferment synthesis
B. Inhibition of respiratory ferment synthesis
C. Specific binding of active centres of respiratory ferments
*D. Disjunction of oxidation and phosphorylation
E. Competitive inhibition of respiratory ferments
21. Examination of a patient revealed II grade obesity. It is known that he consumes a lot of
sweets and rich food, has sedentary way of life. That’s why anabolic metabolism has the priority
in his organism. Which of the following pathways is amphibolic?
*Cycle of tricarboxylic acids
Gluconeogenesis
Lipolysis
Glycolysis
Fatty acids oxidation
22. A cell has been treated with a substance that blocks nucleotide phosphorylation in the
mitochondrions. What process of cell activity will be disturbed in the first place?
*ATP resynthesis
Synthesis of mitochondrial proteins
Oxidative phosphorylation
Integration of functional protein molecules
Fragmentation of big mitochondrions into lesser ones
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A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
23. Treatment of many diseases involves use of cocarboxylase (thiamine pyrophosphate) for
supplying cells with energy. What metabolic process is activated in this case?
*Oxidative decarboxylation of pyruvate
Glutamate deamination
Amino acids decarboxylation
Decarboxylation of biogenic amines
Detoxication of harmful substances in liver
24. Researches of the latest decades established that immediate "executors"of cell apoptosis are
special enzymes called caspases. Generation of one of them proceeds with participation of
cytochrome c. What is its function in a normal cell?
*Enzyme of respiratory chain of electron transport
Enzyme of tricarboxylic acid cycle
Enzyme of beta-oxidation of fatty acids
Component of H+ATP system
Component of pyruvate-dehydrogenase system
25. A patient complains about attacks of laboured breathing, dizziness. He works at a chemical
plant producing hydrocyanic acid. The described symptoms might be associated with
dysfunction of the following enzyme:
*Cytochrome oxidase
Lactate dehydrogenase
Succinate dehydrogenase
Catalase
Pyruvate dehydrogenase
26. Cyanide is a poison that causes instant death of the organism. What enzymes found in
mitochondria are affected by cyanide?
*Cytochrome oxidase (aa3)
Flavin enzymes
Cytochrome b5
NAD+-dependent dehydrogenase
Cytochrome P-450
27. The process of metabolism in the human body produces active forms of oxygen, including
superoxide anion radical O -2. This anion is inactivated by the following enzyme:
A. *Superoxide dismutase
B. Glutathione reductase
C. Catalase
D. Peroxidase
E. Glutathione peroxidase
28. A woman 40-year-old suffering from diffuse toxic goiter presents with constant increase of
her body temperature. What mechanism results in such clinical presentation?
A. *Separation of oxidation and phosphorylation in cell mitochondria
B. Increased breakdown of glycogen in hepatic cells
C. Increased catabolism of protein in cells
D. Increased excitability of nerve cells
E. Increased cell sensitivity to catecholamines
29. Periodontitis induces development of lipid peroxidation in the periodontal tissues, as well as
increase in malondialdehyde and hydrogen peroxide concentration in the oral cavity. Which of
the following enzymes provides antioxidant protection?
A. *Catalase
B. Amylase
C. Maltase
D. Lactase
E. Invertase
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30. Cytochrome oxidase is a hemeprotein that is an end component of the mitochondrial
respiratory chain. What reaction is catalyzed with this enzyme?
A. *Transfer of reduced equivalents to molecular oxygen
B. Cytochrome synthesis
C. Transfer of reduced equivalents to ubiquinone
D. Cytochrome splicing
E. Adenosine triphosphate synthesis
31. What coenzyme of flavin-dependent dehydrogenases participates in the reactions of
tricarboxylic acid cycle?
A. *Flavin adenine dinucleotide (FAD)
B. Flavin mononucleotide (FMN)
C. Nicotinamide-adenine dinucleotide (NAD+)
D. Thymidine diphosphate (TDP)
E. Heme
32. Rotenone is known to inhibit respiratory chain. What complex of mitochondrial respiratory
chain is inhibited by this substance?
a. NADH-coenzyme Q reductase
b. Succinate-coenzyme Q reductase
c. Cytochrome oxidase
d. Coenzyme Q-cytochrome c reductase
e. Adenosine triphosphate synthetase
33. Oxidative decarboxylation of pyruvic acid is catalyzed by a multienzyme complex with
several functionally linked coenzymes. Name this complex:
A. Thymidine diphosphate (TDP), flavin Adenine dinucleotide (FAD), coenzyme A (Co ASH),
nicotine amide adenine dinucleotide (NAD), lipoic acid
B. Flavin adenine dinucleotide (FAD), tetrahydrofolic acid, pyridoxal-5-phosphate, thymidine
diphosphate (TDP), choline
C. Coenzyme A (CoASH), flavin adenine dinucleotide (FAD), pyridoxal-5-phosphate,
tetrahydrofolic acid, carnitine
D. Nicotine amide adenine dinucleotide (NAD), pyridoxal-5-phosphate, thymidine diphosphate
(TDP), methylcobalamin, biotin
E. Lipoic acid, tetrahydrofolic acid, pyridoxal-5-phosphate, methylcobalamin
34. A 25-year-old young man complains of general weakness, rapid fatigability, irritability,
reduced working ability, and bleeding gums. What vitamin deficiency is the most likely cause of
this condition?
A. Ascorbic acid
B. Retinol
C. Riboflavine
D. Thiamine
E. Folic acid
35. Lab rats were used to study the effect of a certain vitamin on the body. Deficiency of this
vitamin has resulted in a disturbed reproductive function and skeletal muscle dystrophy. What
vitamin is it?
A. E
B. A
C. B2
D. D
E. K
36. During histologic examination of the skeletal muscle specimen, the investigator discovers an
organelle that has 2 membrane: smooth outer membrane and internal, that forms multiple ridges
of visible folds (crysts). Which of the following is the most likely function of this structure?
A. Synthesis and energy accumulation in the form of ATP
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B. Synthesis of carbohydrates
C. –
D. Intracellular digestion of macromolecules
E. Formation of mitotic spindle
37. A 35-year-old woman is brought to the physician because of a 4-month history of
progressive weakness of both lower limbs. She notes difficulty climbing stairs and complains of
lethargy and loss of muscle bulk. Her diet consists primarily of “polished” rice. A diagnosis of
dry beriberi is suspected. Deficiency of which of the following vitamins is most likely to be
detected in her blood?
A. Vitamin B1 (thiamine)
B. Vitamin C (ascorbic acid)
C. Vitamin B3 (niacin)
D. Vitamin B2 (riboflavin)
E. Vitamin B6 (pyridoxine)
38. The Gerontology Institute recommends older people to take vitamin complexes that contain
vitamin E. What is the main function of this vitamin?
A. Antioxidant
B. Antidermatitic
C. Antihemorrhagic
D. Antineuritic
E. Antiscorbutic
39. A patient with myocardial infarction in the acute phase has been hospitalized into the
cardiology unit. To induce platelet lysis in the patients coronary vessels during the early hours
of infarction, the following enzyme should be used:
A. Streptocinase
B. Lysozyme
C. Hyaluronidase
D. Trypsin
E. Chymotrypsin
40. A 39-year-old man presents with hyperkeratosis, disturbed twilight vision, and high risk of
infectious processes. What vitamin preparation shoud he be prescribed?
A. Retinol acetate
B. Pyridoxine hydrochloride
C. Ergocalcsferol
D. Riboflavin
E. Tocopherol acetate
41. A 40-year-old man with pulmonary tuberculosis was prescribed isoniazid. Prolonged taking
of this drug can result in development of the following vitamin deficiency:
A. Pyridoxine
B. Cobalamin
C. Folic acid
D. Biotin
E. Thiamine
42. Wernicke-Korsakoff syndrome often develops in chronic alcoholics, who have a low-vitamin
diet. Decreased transketolase activity can be observed in the course of this disease. What vitamin
deficiency causes this development?
A. Thiamine
B. Cobalamin
C. Niacin
D. Riboflavin
E. Retinol
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43. A 37-year-old man is admitted to hospital with mental confusion and disorientation. His wife
reports he become more irritable and forgetful in the past year. In addition, she notes that he
became a vegan a year ago, and currently, his diet consists of starchy foods like potatoes, corn,
and leafy vegetables. GI symptoms include anorexia, diarrhea and vomiting. He has glossitis and
skin lesions that appear as vesicles over the extremities. Eczema-like lesions around the mouth,
as well as desquamation and rough skin over the hands are also present. Neurologic examination
reveals symmetrical hypesthesia for all types of sensation in both upper and lower extremities in
a “gloves and socks” distribution. Deficiency in diet of which of the following amino acids is the
most likely cause of the condition?
A. Tryptophan
B. Histidine
C. Lysine
D. Treonine
E. Arginine
44. The process of tissue respiration is accompanied by oxidation of organic compounds and
synthesis of macroergic molecules. In what organelles does this process occur?
A. Mitochondria
B. Lysosomes
C. Golgi apparatus
D. Ribosomes
E. Peroxisomes
45. Name the supramolecular multienzyme complex that is integrated into the lipid layer of inner
mitochondrial membrane that creates conditions for redox reactions:
A. Respiratory chain
B. Carboxypeptidase
C. G-protein transducer
D. Hexokinase
E. Pyruvate kinase
46. General catabolism pathway of biological macromolecules includes, besides tricarboxylic
acid cycle and mitochondrial respiratory chain, the process of peruvate oxidative
decarboxylation. What is the product of pyruvate oxidative decarboxylation?
A. Acetyl-CoA
B. Malonyl-CoA
C. Alpha-ketoglutarate
D. Lactate
E. Citrate
47. Mitochondrial destruction is observed in some hereditary diseases (for example, KearnsSayre syndrome). What processes can be disturbed, as a result, in the cell?
A. Adenosine triphosphate synthesis
B. Amino acid synthesis
C. Nuclear division
D. Crossingover
E. Glycolysis
48. Electrons release their energy, when they are being transported in the course of tissue
respiration. This energy is used for the following process:
A. Oxidative phosphorylation
B. Substrate-level phosphorylation
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C. Microsomal oxidation
D. Peroxidation
E. Lipid mobilization
49. Mitochondrial respiratory chain contains complex cytochrome proteins. What type of
reactions do they catalyze?
A. Redox reactions
B. Reactions of transamination
C. Reactions of decarboxylation
D. Reactions of hydration
E. Reactions of deamination
50. A patient with scurvy presents with impaired hydroxylation of collagen proline and lysine. What
biochemical process is inhibited in this case, being the reason for this disorder?
A. Microsomal oxidation
B. Tissue respiration
C. Lipid peroxidation
D. Peroxidase oxidation of fats
E. Oxidative phosphorylation
PART 2
Hormones
1. Which substance imitating the effects of morphine but being synthesized in CNS is
applied for the analgesia?
А. Growth hormone-releasing hormone
В. Oxytocin
С. Calcitonin
*D. Endorphin
E. Insulin
2. A patient, age 23, complains of headache, alterations of his appearance (large feet,
hands, face). Objectively: increased brow-arches; nose, lips. What is the cause?
A. Aldosterone deficiency
B. Glucagon deficiency
C. Thyroxine deficiency
*D. Somatotropin overproduction
E. Corticosteroids overproduction
3. Ca2+ ions may function as second messengers. They are activators of many processes if
they react with:
A. Calcitonin *B. Calmodulin
C. Calciferol
D. Myosin
E. Phosphorylase
4. Patient, age 67, suffers from diabetes insipidus after hemorrhage of brain with damage
of hypothalamic nuclei. Diabetes is accompanied by polyuria in result of:
A. Hypoglycemia
B. Decreased potassium reabsorption
C. Enhance in kidney filtration
D. Hyperglycemia
* E. Decreased water reabsorption
5. Tachycardia, loss of weight, increased body temperature, overexcitation are observed in the
patient. This state is caused by increased level of hormone:
*А. Thyroxin
В. Vasopressin
С. Growth hormone
D. Insulin
E. Adrenocorticotropic hormone
6. The frequency of heart beat of sportsman after training increases to 120 per minute.
Which hormones provide this effect?
А. Glucocorticoids
*В. Catecholamines
С. Releasing-factors
D. Sex hormones
Е. Mineralocorticoids
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7. Disturbance of the hormone synthesis results in development of different pathologic
states. Which hormone synthesis deficiency leads to inhibition of growth without disturbance of
mental activity?
А. Thyroxin В. Prolactin *С. Growth hormone D. Adrenaline E. Gonadotropin
8. Extremities fractures due to bone fragility were observed in the organism of 9 year-old
boy. Function of which endocrine organ is disturbed?
*A. Parathyroid gland B. Thyroid gland C. Epiphysis D. Adrenal gland E. Pancreas
9. Some substances facilitate uncoupling mitochondrial inner membrane oxidation and
ADP phosphorylation processes and cause activation of Na+, K+- ATP-ase. Choose one of these
substances.
A. Vasopressin
B. Insulin C. Oxytocin
D. Adrenaline *E. Thyroxin
10. A 50-year-old man was in the state of severe stress. Adrenaline and noradrenaline
levels in blood increased. Which enzymes catalyze inactivation of these hormones?
A. Glucosidases
*B. Monoaminoxidases C. Peptidases D. Carboxylases E. Tyrosinases
11. A patient is observed with losing their weight, over excitation, light increase in body
temperature, exophthalmus, hyperglycemia, azotemia. Which hormone overproduction results in
the appearance of these symptoms?
A. Adrenaline
*B. Thyroxin
C. Calcitonin D. Aldosterone E. Vasopressin
12. A patient with low blood pressure is observed to have increased blood pressure,
glucose and lipids levels after the injection of a hormone. Which hormone was injected?
A. Insulin B. Glucagon *C. Adrenaline D. Progesterone E. Follicle-stimulating hormone
13. Goiter is a disease which is widely spread in some biogeochemical areas of the Earth.
Which element deficiency causes this disease?
A. Iron
*B. Iodine
C. Zinc
D. Copper
E. Cobalt
14. A patient is in hypoglycemic coma. Which hormone overdose can result in this
situation?
*A. Insulin
B. Cortisol
C. Somatotropin
D. Progesterone
E. Сorticotropin
15. Which hormone stimulates transport of glucose from extracellular space through
cellular membrane to cytosol?
*A. Insulin
B. Glucagon
C. Thyroxin
D. Aldosterone E. Adrenaline
16. Hypercalciemia, hypophosphatemia in blood and hyperphosphateuria are observed in
patient. Which is the possible cause of this state?
*A. The increased secretion of parathyroid hormone
B. The inhibition of secretion of parathyroid hormone
C. The increased secretion of calcitonin
D. The inhibition of secretion of calcitonin
E. The increased secretion of thyroxin
17. Arachidonic acid (an essential component of food) is the precursor of biologically
active substances. Which substances are synthesized from arachidonic acid?
А. Ethanolamine В. Choline С. Noradrenaline *D. Prostaglandin E1
Е. Triiodothyronine
18. The patient complains of continuous thirst. The analysis revealed hyperglycemia,
polyuria and increased level of 17-ketosteroids in urine. Which disease causes the symptoms?
*A. Steroid diabetes
B. Diabetes mellitus
C. Myxedema
D. Addison's disease
E. I type of glycogenosis
19. Hyperglycemia is observed due to Cushing’s disease. Which process is stimulated in
this state?
А. Glycolysis
В. Phosphorolysis of glycogen
С. Krebs cycle
D. Pentose phosphate pathway of glucose oxidation
*E. Gluconeogenesis
20. Medical examination of a patient revealed hypokaliemia, hypernatremia and
hypervolemia. What is the possible cause of that state?
*A. Hyperaldosteronism
B. Hypoaldosteronism
C. Addison’s disease
D. Basedow’s disease
E. Diabetes mellitus
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21. The intake of oral contraceptives which contain sex hormones inhibits the secretion of
pituitary hormones. Which of the below mentioned hormones secretion is inhibited in that state?
A. Vasopressin B. Somatotropin C. Oxytocin *D. Follitropin
E. Corticotropin
22. Testosterone and its analogs increase the mass of skeletal muscles that allows apply
them for treatment of dystrophy. What cellular substrate should the hormone interact with to
cause this action?
A. Membrane receptors
B. Chromatin
C. Ribosomes
*D. Nuclear receptors
E. Proteins-activators of transcription
23. A patient had been taking glucocorticoids over a long period of time. The abolition of
this medicine led to an acute pathologic state displayed with the decrease of the arterial pressure,
and weakness. This phenomenon is explained by:
*A. The appearance of adrenal gland insufficiency
B. Cumulative effect
C. Drug habituation
D. Overproduction of ACTH
E. Sencibilization
24. A patient had been taking glucocorticoids over a long period of time. After the sharp
abolition of the medicinal preparation they complain of myalgia, high fatigability, emotional
instability, headache. The medicine abstinent syndrome was developed. Which medicine must be
prescribed to correct this state?
*A. ACTH B. Glucocorticoids C. Mineralocorticoids D. Adrenaline E. Corticosteroids
25. A prevalence of proliferation processes is found in a patient with chronic dermatitis.
Which hormone deficiency can result in this?
*A. Cortisol B. Aldosterone
C. Insulin
D. Somatotropin
E. Thyroxin
26. A patient with Cushing’s syndrome has the increased blood level of cortisol. Which
endocrine gland pathology causes this state?
*A. Adrenal cortex B. Adrenal medulla C. Pancreas D. Hypophysis E. Thyroid gland
27. A 42-year-old man had prolonged stress. The considerably increased level of 17-ketosteroids
in the urine of the man indicates in the first place the overproduction of:
A. Estradiol
B. Aldosterone
C. Estriol
*D. Cortisol
E. Progesterone
28. A 40-year-old patient was hospitalized with complaints to general weakness, cramps of high
extremities, arterial pressure 160/100 Hg. Results of investigation: glucose of blood – 6.5 mmol/L,
cholesterol – 6 mmol/L, calcium – 2 mmol/L, phosphorus – 1 mmol/L, sodium – 160 mmol/L, diuresis
- 700 ml/day. Which pathology can be the most possible cause of his state?
A. Hypoaldosteronism
B. Thyrotoxicosis
C. Rickets
* D. Hyperaldosteronism
E. Hyperparathyroidism
29. Aspirin shows anti-inflammatory action because it inhibits the activity of
cyclooxygenase. Which biologically active substances level will decrease?
A. Catecholamines
*B. Prostaglandins
C. Melatonin
D. Iodothyronines
E. Mineralocorticoids
30. Indicate the process of metabolism, the rate of which is decreased in insulin-dependent
diabetes mellitus:
*A. Glucose uptake by tissues
B. Glycogenolysis
C. Gluconeogenesis
D. Proteolysis
E. Lipolysis
31. The patient’s glucose blood level was 5.55 mmol / l before the first meal, it
increased to 8.55 mmol/l an hour after sugar intake and after one more hour it dropped
to 4.95 mmol/l. Those indexes are characteristic to:
*A. The state of complete health
B. Thyrotoxicosis
C. Obscured sugar diabetes
D. Insulin - dependent diabetes mellitus
E. Insulin - independent diabetes mellitus
32. An old woman was developed an eye cataract on diabetes mellitus background.
Indicate the process, which stimulation is the cause of cloudiness of crystalline lens:
* A. Protein glycosylation
B. Proteolysis of proteins
C. Lipogenesis
D. Lipolysis
E. Gluconeogenesis
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33. A patient complains of high fatigability, continuous thirst. Preliminary diagnosis of
physician is diabetes mellitus. Choose the concentration of glucose which confirms this
diagnosis:
*A. 8.5 mmol/l
B. 2.0 mmol/l C. 4.5 mmol/l
D. 5.0 mmol/l
E. 3.3 mmol/l
34. A 44-year-old woman complains of dryness in oral cavity, thirst, general weakness.
Hyperglycemia, hyperketonemia were found during biochemical investigation. Ketone bodies,
glucose were in the urine. Electrocardiogram manifested diffuse changes in myocardium.
Possible disease of this woman is:
A. Alimentary hypoglycemia
B. Acute pancreatitis
C. Diabetes insipidus
D. Ischemic disease of heart
*E. Diabetes mellitus
35. A patient is revealed to have headaches, their appearance alteration (the overgrowth of
their limbs, brows, nose and tongue), rough voice, memory retardation. The disease set on
approximately three years ago. What may be the cause of this state?
*A. Somatotropin hyperproduction
B. Glucagon deficiency
C. Thyroxin deficiency
D. Aldosterone deficiency
E. Glucocorticoid hyperproduction
36. The patient complains of thirst, often and abnormal urination. The urine analysis
revealed: daily diuresis - 19 l; urine density - 1.001. Which disease causes the indexes?
A. Diabetes mellitus
B. Steroid diabetes
*C. Diabetes insipidus
D. Thyrotoxicosis
E. Addison's disease
37. A surgeon made an error to have removed patient’s parathyroid gland while operating
thyroid gland. The patient developed convulsions. Which element metabolism is disturbed?
A. Magnesium
*B. Calcium
C. Potassium
D. Iron
E. Sodium
38. A patient is observed with losing their weight, overexcitation, light increase in body
temperature, exophthalmus, hyperglycemia, azotemia. What is the diagnosis?
A. Neurosis
B. Addison's disease
*C. Diffuse toxic goiter
D. Adrenal glands tuberculosis
E. Myxedema
39. A substance which imitates the morphine effects may be used as a painkiller. This
substance is produced in CNS. What is its name?
A. Somatoliberin
B. Oxytocin
C. Vasopressin D. Calcitonin
*E. Endorphin
40. The patient's blood plasma potassium level is 7 mmol/l. What is the plausible cause of
the state?
A. Increased level of sex hormones
B. Increase in aldosterone content
C. Decreased contents of thyroid hormones
D. Increase in thyroid hormones level
*E. Decreased aldosterone concentration
41. The patient's blood plasma sodium level is 160 mmol/l. Which hormone contents
alterations may evoke the state?
*A. Increase in aldosterone level
B. Decrease in aldosterone level
C. Increase in glucocorticoid level
D. Increase in thyroid hormone level
E. Increase in sodium-diuretic hormone level
42. A woman with the low arterial pressure was injected a hormone-medicine. After the
injection her arterial pressure increased as well as the blood level of glucose and lipids. What
hormone was administered?
A. Insulin
B. Glucagon
*C. Epinephrine D. Progesterone
E. Folliculine
43. A patient, age 35, who abuses alcohol is observed with pronounced muscle and
myocardium weakness, nausea, diarrhea, depression on the background of being treated by
urination-stimulating medicines. Which compound is excessively excreted with the urine.
A. Clorides
B. Sodium
*C. Potassium
D. Calcium
E. Phosphates
44. The organism loses a large quantity of water and sodium ions at cholera disease. What
is the main action of cholera toxin?
A. Activation of synthesis of sodium-diuretic hormone
*B. Activation of adenylate cyclase of intestine
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C. Inhibition of synthesis of hypothalamic vasopressin
D. Induction of renin secretion by juxtaglomerular apparatus
E. Aldosterone oxidation in adrenal cortex
45. Some hormones are the products of protein hydrolysis and modification. Which protein
is the precursor of lipotropin, ACTH and MSH?
A. Neuroglobulin B. Neuroalbumin C. Neurostromin *D. Proopiomelanocortin E.Thyroglobulin
46. The onset of Cushing's disease (overproduction of corticosteroids) leads to
hyperglycemia. What process is stimulated?
A. Glycolysis
B. Glycogen breakdown
C. Krebs cycle
D. Penthose phosphate pathway *E. Gluconeogenesis
47. Ca ions may function as second messengers. They are activators of glycogenesis if they
react with:
A. Calcitonin
*B. Calmodulin
C. Calciferol
D. Myosin
E. Phosphorylase
48. A woman, age 67, suffers from diabetes insipidus. Her daily diuresis is about 15 L.
What is the cause of polyuria?
A. Hypoglycemia
B. Decreased potassium reabsorption
C. Enhance in kidney filtration
D. Hyperglycemia
*E. Decreased water reabsorption
49. A boy, age 10, has a small height comparing to the standards of his age. Which
hormone insufficiency causes the state?
A. Thyrotropin
B. Corticotropin C. Gonadotropin *D. Somatotropin
E. Parathormone
50. A man, age 50, has been under severe stress. The blood level of epinephrine is high.
Which enzyme deactivates the hormone?
A. Glucosidase *B. Monoamine oxidase C. Peptidase D. Carboxylase
E. Tyrosinase
51. A man after 1.5 liters blood loss has suddenly reduced diuresis. The increased secretion
of what hormone caused such diuresis alteration?
A. Parathormone
B. Corticotropin
*C. Vasopressin
D. Cortisol
E. Natriuretic
52. Periodic renal colics attacks are observed in a woman with primary
hyperparathyroidizm. Ultrasonic examination revealed small stones in the kidneys. What is the
most plausible reason of the stones formation?
A. Hyperphosphatemia
B. Hyperuricemia
*C. Hypercalcemia
D. Hyperkalemia
E. Hypercholesterinemia
53. Some diseases reveal symptoms of aldosteronism with hypertension and edema due to
sodium retention in the organism. What organ of the internal secretion is affected by
aldosteronism?
*A. Adrenal glands
B. Pancreas
C. Hypophysis
D. Testicle
E. Ovaries
54. A 46 year-old patient has complained of headache, fatigue, thirst, pains in the spine and
joints for the last 2 years. Clinically observed disproportional enlargement of hands, feet, nose,
superciliary arches. He notes that he needed to buy bigger shoes three times. What is the main
reason of such disproportional enlargement of different parts of the body?
A. Increased sensitivity of the tissues to insulin.
B. Joints dystrophy development
*C. Cartilaginous tissue proliferation under growth hormone influence
D. Increased sensitivity of the tissues to growth hormone
E. Joints chronic inflammation development
55. A patient had been taking glucocorticoids for a long time. When the preparation was
withdrawn he developed the symptoms of disease aggravation, decreased blood pressure and
weakness. What is the reason of this condition?
A. Sensibilization
*B. Development of adrenal insufficiency C. Cumulation
D. Hyperproduction of ACTH
E. Habituation
56. The B cells of endocrine portion of pancreas are selectively damaged by alloxan
poisoning. How will it be reflected in blood plasma?
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A. The content of globulins decreases
B. The level of sugar decreases
C. The content of albumins decreases
*D. The content of sugar increases
E. The content of fibrinogen decrease
57. A patient with diabetes mellitus experienced loss of consciousness and convulsions
after an injection of insulin. What might be the result of biochemical blood analysis for
concentration of sugar?
A. 3.3 mmol/L
B. 8.0 mmol/L
C. 10.0 mmol/L *D. 1.5 mmol/L
E. 5.5 mmol/L
58. A 19-year-old female suffers from tachycardia in rest condition, weight loss, excessive
sweating, exophthalmos and irritability. What hormone would you expect to find elevated in her
blood serum?
A. Cortisol
B. Insulin
*C. Thyroxin
D. ACTH
E. Mineralocorticoids
59. A patient with diabetes mellitus has been delivered in hospital in unconsciousness.
Their arterial pressure is low. The patient has acidosis. Indicate the substances, which
accumulation in their blood results in these manifestations:
A. Cholesterol esters
B. High fatty acids
C. Monosaccharides
D. Amino acids
*E. Ketone bodies
60. A 44-year-old woman complains of general weakness, heart pain, considerable increase
of body weight. Objectively: moonlike face, hairsutism, AP- 165/100 mm Hg; height- 164 cm,
weight - 103 kg: fat is mostly accumulated in the region of neck, upper shoulder girdle, stomach.
What is the main pathogenetic mechanism of obesity?
A. Decreased production of thyroidal hormones
B. Increased production of insulin
C. Decreased production of glucagon
*D. Increased production of glucocorticoid
E. Increased production of mineralocorticoids.
61. Secretion of which of the indicated hormones is inhibited while taking oral
contraceptives with sex hormones?
A. GH
B. Oxytocin
C. Vasopressin
*D. FSH
E. TSH
62. Kidneys of a man under examination show increased reabsorption of calcium ions and
decreased reabsorption of phosphate ions. What hormone causes this phenomenon?
*A. Parathormone
B. Hormonal form D3
C. Aldosterone
D. Thyrocalcitonin
E. Vasopressin
63. A patient with diabetes mellitus has been delivered in hospital in the state of
unconsciousness. Arterial pressure is low. The patient has acidosis. Indicate the substances,
which accumulation in the blood results in these manifestations:
A. Palmitic acid
B. Phenylalanine
*C. Acetone
D. Cholesterol esters
E. Glucose
64. A person has reduced diuresis, hypernatremia, hypokalemia. Hypersecretion of what
hormone can cause such changes?
A. Parathormone
*B. Aldosterone
C. Adrenaline
D. Vasopressin
E. Auricular sodiumuretic factor
65. 40-year-old patient complains of intensive heartbeats, sweating, nausea, visual
impairment, hand tremor, hypertension. From his anamnesis: 2 years ago he was diagnosed with
pheochromocytoma. Hyperproduction of what hormones causes the given pathology?
*A. Catecholamines
B. Aldosterone
C. Glucocorticoids
D. Thyroid hormones
E. ACTH
66. Among some diseases it is observed aldosteronism is accompanied by hypertension
and edema due to sodium retention in the organism. What organ of the internal secretion is
affected under aldosteronism?
A. Thymus
B. Pancreas
C. Anterior pituitary *D. Adrenal cortex
E. Adrenal medulla
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67. A 45-year-old woman suffers from Cushing's syndrome - steroid diabetes. Biochemical
examination revealed: hyperglycemia, hypochloremia. Which of the undermentioned processes
is the first to be activated?
*A. Gluconeogenesis
B. Glycolysis
C. Glycogenolysis
D. Glycogenesis
E. Glycerol breakdown
68. Inhabitants of territories with cold climate have high content of an adaptive
thermoregulatory hormone. What hormone is meant?
A. Insulin
B. Glucagon
*C. Thyroxin
D. Cortisol
E. Somatotropin
69. A 35-year-old patient who often consumes alcohol was treated with diuretics. There
appeared serious muscle and heart weakness, vomiting, diarrhea, AP - 100/60 mm Hg,
depression. This condition is caused by intensified excretion with urine of:
*A. K+
B. P
C. ClD. Na+
E. Ca2+
70. A patient is ill with diabetes mellitus that is accompanied by hyperglycemia of over 7.2
mmol/l on an empty stomach. The level of what blood plasma protein allows to estimate the
glycemia rate retrospectively (4-8 weeks before examination)?
A. Ceruloplasmin
*B. Glycosylated hemoglobin
C. Fibrinogen
D. Albumin
E. C-reactive protein
71. A patient was delivered to the hospital by an emergency team. Objectively:
unconscious, adynamic. Cutaneous surfaces are dry, eyes are sunken, the face is cyanotic. There
is tachycardia and smell of acetone from the mouth. Analysis results: blood glucose - 20,1
mmol/l (standard is 3.3-5.5 mmol/l), urine glucose – 3.5% (norm is - 0). What is the most
probable diagnosis?
A. Hypoglycemic coma
B. Acute heart failure
C. Anaphylactic shock
*D. Hyperglycemic coma
E. Acute alcoholic intoxication
72. Utilization of arachidonic acid via cyclooxygenase pathway results in formation of
some bioactive substances. Name them:
*A. Prostaglandins
B. Biogenic amines
C. Insulin-like growth factors
D. Somatomedins
E. Thyroxine
73. Parents of a 10-year-old boy consulted a doctor about their son’s extension of haircovering, growth of beard and moustache, low voice. Intensified secretion of which hormone
must be assumed?
*A. Testosterone
B. Somatotropin
C. Cortisol
D. Estrogen
E. Progesterone
74. Examination of a patient revealed hyperkaliemia and hyponatremia. Low secretion of
which hormone may cause such changes?
A. Natriuretic
B. Parathormone
C. Cortisol
*D. Aldosterone
E. Vasopressin
75. A 2-year-old child has convulsions as a result of lowered concentration of calcium ions
in blood plasma. It is caused by reduced function of:
A. Adrenal cortex
B. Pineal gland
C. Hypophysis
*D. Parathyroid glands
E. Thymus
76. A patient ill with neurodermatitis has been taking prednisolone for a long time.
Examination revealed high level of sugar in his blood. This complication is caused by the drug
influence upon the following link of carbohydrate metabolism:
A. Activation of insulin decomposition
B. Intensification of intestinal glucose absorption
*C. Gluconeogenesis activation
D. Glycogenogenesis activation
E. Inhibition of glycogen synthesis
77. A concentrated solution of sodium chloride was intravenously injected to an animal.
This caused decrease in reabsorption of sodium ions in the renal tubules. It is the result of the
following changes of hormonal secretion:
A. Aldosterone increase
B. Reduction of atrial natriuretic factor
C. Vasopressin increase
*D. Aldosterone reduction
E. Vasopressin reduction
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78. A patient has a decreased vasopressin synthesis that causes polyuria and as a result of it
evident organism dehydratation. What is the mechanism of polyuria development?
A. Reduced tubular reabsorption of protein
B. Reduced tubular reabsorption of Na ions
C. Reduced glucose reabsorption
*D. Reduced tubular reabsorption of water
E. Acceleration of glomerular filtration
79. A patient with android-type obesity had been suffering from arterial hypertension,
hyperglycemia, glycosuria for a long time and died from the cerebral hemorrhage. Pathologic
examination revealed pituitary basophil adenoma, adrenal cortex hyperplasia. What is the most
likely diagnosis?
A. Acromegaly
*B. Cushing's syndrome
C. Diabetes mellitus
D. Adiposogenital dystrophy
E. Pituitary nanism
80. To prevent the transplant rejection after organ transplantation it is required to administer
hormonotherapy for the purpose of immunosuppression. What hormones are used for this purpose?
*A. Glucocorticoids
B. Mineralocorticoids
C. Sex hormones
D. Catecholamines
E. Thyroid hormones
81. Products of some proteins hydrolysis and modification are the biologically active
substances called hormones. Lipotropin, corticotropin, melanotropin and endorphins are
synthesized in the hypophysis of the following protein:
A. Thyreoglobulin
*B. Proopiomelanocortin (POMC)
C. Neurostromin
D. Neuroalbumin
E. Neuroglobulin
82. A patient has osmotic pressure of blood plasma at the rate of 350 mOsmol/1 (norm is 300
mOsmol/1). This was caused by hypersecretion of the following hormone:
A. Adrenocorticotropin *B. Aldosterone C. Cortisol D. Vasopressin
E. Natriuretic
83. Examination of a patient revealed overgrowth of facial bones and soft tissues, tongue
enlargement, wide interdental spaces in the enlarged dental arch. What changes of the hormonal
secretion are the most likely?
A. Hyposecretion of thyroxin
B. Hyposecretion of insulin
C. Hyposecretion of the somatotropic hormone
*D. Hypersecretion of the somatotropic hormone
E. Hypersecretion of insulin
84. A middle-aged man went to a foreign country because he had been offered a job there.
However, he had been unemployed for quite a long time. What endocrine glands were exhausted
most of all in this man?
A. Thyroid gland B. Substernal gland C. Parathyroid glands *D. Adrenal glands E. Sex glands
85. A 46-year-old patient suffering from the diffuse toxic goiter underwent resection of the
thyroid gland. After the surgery the patient presents with appetite loss, dyspepsia, - increased
neuromuscular excitement. The body weight remained unchanged. Body temperature is normal.
Which of the following has caused such a condition in this patient?
*A. Reduced production of parathormone
B. Increased production of calcitonin
C. Reduced production of thyroxin
D. Increased production of thyroliberin
E. Increased production of thyroxin
86. A girl has been diagnosed with adrenogenital syndrome (pseudohermaphroditism).
This pathology is caused by hypersecretion of the following adrenal hormone:
A. Glucocorticoids
B. Estrogens
C. Mineralocorticoids
D. Catecholamines
*E. Androgens
87. A 32-year-old patient consulted a doctor about the absence of lactation after parturition.
Such disorder might be explained by the deficit of the following hormone:
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A. Vasopressin
B. Thyrocalcitonin
C. Glucagon
D. Somatotropin
*E. Prolactin
88. The results of biochemical screening a newborn revealed increased blood level of
thyrotropin. What is the most plausible diagnosis?
*A. Congenital hypothyroidism
B. Endemic goiter
C. Diffuse toxic goiter
D. Mixedema
E. The newborn is healthy
89. A 26-year-old woman at 40 weeks’ gestation was admitted to the maternity ward.
Examination revealed that the cervix was open, but uterine contractions were absent. The doctor
gave her a hormonal drug to induce labor. Specify this drug:
A. *Oxytocin
B. ACTH
C. Hydrocortisone
D. Testosterone
E. Estrone
90. A patient with pituitary tumor complains of increased daily diuresis (polyuria). Glucose
concentration in blood plasma equals 4.8 mmol/1. What hormone can be the cause of this if its
secretion is disturbed?
A. *Vasopressin
B. Insulin
C. Natriuretic hormone
D. Angiotensin I
E. Aldosterone
91. A 40-year-old patient was revealed to have blood clotting time of 2 minutes under a stressful
condition. It is primarily caused by the following hormone affecting hemocoagulation:
A. *Catecholamine
B. Aldosterone
C. Cortisol
D. Vasopressin
E. Somatotropin
92. A severe injury in a 36-year-old patient resulted in a significant blood loss which was
accompanied by a blood pressure drop. What hormones provide rapid recovery of blood pressure
after the blood loss?
A. *Adrenaline, vasopressin
B. Cortisol
C. Sex hormones
D. Oxytocin
E. Aldosterone
93. A 43-year-old female complains of weight loss, hyperhidrosis, low-grade fever, increased
irritability. She has been found to have hyperfunction of the sympathetic-adrenal system and
basal metabolism. These disorders can be caused by hypersecretion of the following hormone:
A. *Thyroxin
B. Somatotropin
C. Corticotropin
D. Insulin
E. Aldosterone
94. A 12-year-old child is of short stature, has disproportionate body structure and mental
retardation. These characteristics might be caused by the hyposecretion of the following
hormone:
A. *Thyroxin
B. Insulin
C. Cortisol
D. Somatotropin
E. Glucagon
95. A 36-year-old patient with diabetes mellitus had seizures with loss of consciousness after an
insulin injection. What was the result of blood glucose test?
A. *2.5 mmol/l
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B. 3.3 mmol/l
C. 8.0 mmol/l
D. 10 mmol/l
E. 5.5 mmol/l
96. An animal has been given a weak solution of hydrochloric acid introduced into the
duodenum through a tube. Which hormone concentration will increase in the animal?
A. *Secretin
B. Cholecystokinin (pancreozymin)
C. Gastrin
D. Glucagon
E. Neurotensin
97. Degeneration of glycogen in liver is stimulated by glucagon. What secondary messenger
(mediator) is thus formed in the cell?
A. *cAMP
B. cGMP
C. CO
D. NO
E. Triacylglycerol
98. A 37-year-old patient has lost 5 kg in weight over the past three months, he complains of
hand tremor, excessive sweating, exophthalmos, tachycardia. These changes might have been
caused by the increased secretion of the following hormone:
A. *Thyroxine
B. Cortisol
C. Insulin
D. Glucagon
E. Thyrocalcitonin
99. 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 mmol/l, phosphorus – 1.9 mmol/l. These changes are associated with:
A. *Hypoparathyroidism
B. Hyperparathyroidism
C. Hyperaldosteronism
D. Hypoaldosteronism
E. Hypothyroidism
100. A 45-year-old woman has been diagnosed with endemic goiter. What mechanism has
caused hyperplasia of thyroid gland in this patient?
A. *Increased thyrotropin production
B. Increased thyroxine production
C. Increased iodine absorption
D. Increased hydration of derma and hypodermic cellulose
E. Increased catecholamine production
101. A comatose patient has been delivered to a hospital. He has a 5-year history of type 2
diabetes mellitus. Objectively: breathing is deep and noisy, there is a smell if acetone around the
patient. The concentration of glucose in blood is 15,2 mmol/l, of ketone bodies – 10 mmol/l.
These disorders are typical for the following complication of this disease:
A. *Ketoacidotic coma
B. Hepatic coma
C. Hyperglycemic coma
D. Hypoglycemic coma
E. Hyperosmolar coma
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102. 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?
A. *Angiotensin-II
B. Vasopressin
C. Adrenaline
D. Noradrenaline
E. Serotonin
103. A nurse accidentally injected a nearly double dose of insulin to a patient with diabetes
mellitus. The patient lapsed into a hypoglycemic coma. What drug should be injected in order to
help him out of coma?
A. *Glucose
B. Lidase
C. Insulin
D. Somatotropin
E. Noradrenaline
104. A 29-year-old female patient has moon face, upper body obesity, striae on her anterior
abdominal wall, hirsutism; urine shows an increased rate of 17- oxyketosteroids. What disease
are these presentations typical for?
A. *Itsenko-Cushing syndrome
B. Pheochromocytoma
C. Conn’s syndrome
D. Primary aldosteronism
E. Secondary aldosteronism
105. An emotional stress induces activation of hormone-sensitive triglyceride lipase in the
adipocytes. What secondary mediator takes part in this process?
A. *Cyclic adenosine monophosphate
B. cGMP
C. AMP
D. Diacylglycerol
E. Ca2+ ions
106. A 50-year-old man sustained a great stress. This caused a dramatic increase in adrenaline
and noradrenaline concentration. What enzymes catalyze the inactivation of the latter?
A. *Monoamine oxidases
B. Glycosidases
C. Peptidases
D. Carboxylase
E. Tyrosinase
107. Before the cells can utilize the glucose, it is first transported from the extracellular space
through the plasmatic membrane inside them. This process is stimulated by the following
hormone:
A. *Insulin
B. Glucagon
C. Thyroxin
D. Aldosterone
E. Adrenalin
108. Indirect calorimetry allowed to establish that a 30-year-old male patient had a 30% decrease
in basal metabolic rate. This might be caused by the reduced concentration of the following
hormones in blood plasma:
A. *Triiodothyronine, tetraiodothyronine
B. Thyrocalcitonin, parathormone
C. Glucocorticoids
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D. Catecholamines
E. Somatoliberin, somatostatin
109. A child presents with symptoms of psychic and physical retardation (cretinism). It is usually
associated with the following hormone deficiency:
A. *Thyroxine
B. Somatotropic
C. Calcitonin
D. Insulin
E. Testosterone
110. It is known that patients with diabetes mellitus are more subject to inflammatory processes,
they have low regeneration and slower wound healing. What is the reason for this?
A. *Decrease in proteosynthesis
B. Increase in lipolysis
C. Accelerated gluconeogenesis
D. Decrease in lipolysis
E. Intensification of catabolism
111. Clinical examination of a female patient revealed reduction of basal metabolism by 40%,
gain in body mass, drop of body temperature, face puffiness, sexual dysfunctions, inertness and
apathy, lowered intelligence. These symptoms are caused by dysfunction of the following
endocrine gland:
A. *Hypofunction of thyroid gland
B. Hypofunction of parathyroid glands
C. Hypophysis hyperfunction
D. Epiphysis hypofunction
E. Hyperfunction of thyroid gland
112. Parodontitis is treated with calcium preparations and a hormone that stimulates tooth
mineralization and inhibits tissue resorption. What hormone is it?
A. *Calcitonin
B. Parathormone
C. Adrenalin
D. Aldosterone
E. Thyroxine
113. A child has abnormal formation of tooth enamel and dentin as a result of low concentration
of calcium ions in blood. Such abnormalities might be caused by deficiency of the following
hormone:
A. *Parathormone
B. Thyrocalcitonin
C. Thyroxin
D. Somatotropic hormone
E. Triiodothyronine
114. People adapted to high external temperatures have such peculiarity: profuse sweating isn’t
accompanied by loss of large volumes of sodium chloride. This is caused by the effect of the
following hormone upon the perspiratory glands:
A. *Aldosterone
B. Vasopressin
C. Cortisol
D. Thyroxin
E. Natriuretic
115. Emotional stress causes activation of hormone-sensitive triglyceride lipase in the adipocytes.
What secondary mediator takes part in this process?
A. *Cyclic adenosine monophosphate
B. Cyclic guanosine monophosphate
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C. Adenosine monophosphate
D. Diacylglycerol
E. Ca2+ ions
116. A patient suffering from pheochromocytoma complains of thirst, dry mouth, hunger. Blood test
for sugar revealed hyperglycemia. What type of hyperglycemia is it?
A. *Adrenal
B. Hypercorticoid
C. Alimentary
D. Somatotropic
E. Hypoinsulinemic
117. Cardinal symptoms of primary hyperparathyroidism are osteoporosis and renal lesion along
with development of urolithiasis. What substance makes up the basis of these calculi in this disease?
A. *Calcium phosphate
B. Uric acid
C. Cystine
D. Bilirubin
E. Cholesterol
118. The secretion of which hypophysial hormones will be inhibited after taking the oral
contraceptives containing sex hormones?
A. *Gonadotropic hormone
B. Vasopressin
C. Thyrotrophic hormone
D. Somatotropic hormone
E. Oxytocin
119. 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?
A. *Steroid diabetes
B. Insulin-dependent diabetes mellitus
C. Myxedema
D. Type I glycogenosis
E. Addison’s disease
120. Tissue inositol triphosphates are generated as a result of the phosphatidylinositol diphosphate
hydrolysis and act as secondary agents (mediators) in the mechanism of hormone action. Their effect
in cells is directed at:
A. *Calcium ion liberation from cellular depot
B. Adenylate cyclase activation
C. Protein kinase A activation
D. Phosphodiesterase inhibition
E. Protein kinase A inhibition
121. A 30-year-old woman has subnormal concentration of enzymes in the pancreatic juice. This
might be caused by the hyposecretion of the following gastrointestinal hormone:
A. *Cholecystokinin-pancreozymin
B. Somatostatin
C. Secretin
D. Gastro-inhibiting peptide
E. Vasointestinal peptide
122. 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?
A. *Vasopressin
B. Cortisol
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C. Thyroxin
D. Oxytocin
E. Insulin
123. Atria of an experimental animal were superdistended by blood that resulted in decreased
reabsorption of Na+ and water in renal tubules. This can be explained by the influence of the
following factor upon kidneys:
A. *Natriuretic hormone
B. Aldosterone
C. Renin
D. Angiotensin
E. Vasopressin
124. Examination of a 42-year-old patient revealed a tumor of adenohypophysis. Objectively: the
patient’s weight is 117 kg, he has moon-like hyperemic face, red blue striae of skin distension on his
belly. Osteoporosis and muscle dystrophy are present. AP is 210/140 mm Hg. What is the most
probable diagnosis?
A. *Cushing’s disease
B. Cushing’s syndrome
C. Conn’s disease
D. Diabetes mellitus
E. Essential hypertension
125. A 19-year-old male was found to have an elevated level of potassium in the secondary
urine. These changes might have been caused by the increase in the following hormone level:
A. *Aldosterone
B. Oxytocin
C. Adrenaline
D. Glucagon
E. Testosterone
126. 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:
A. *Testosterone
B. Oestriol
C. Relaxin
D. Oxytocin
E. Prolactin
127. As a result of a home injury, a patient suffered a significant blood loss, which led to a fall in
blood pressure. Rapid blood pressure recovery after the blood loss is provided by the following
hormones:
A. *Adrenaline, vasopressin
B. Cortisol
C. Sex hormones
D. Oxytocin
E. Aldosterone
128. 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:
A. *Tropic hormones
B. Thyroid hormones
C. Somatotropin
D. Cortisol
E. Thyroxin
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129. Prolonged treatment of hypothyroidism has caused general dystrophy, dental caries,
tachycardia, tremor of extremities. What drug is the cause of these side effects?
A. *L-thyroxine
B. Parathyreoidinum
C. Thyrocalcitonin
D. Prednisolone
E. Humulin (Human insulin)
130. Prior to glucose utilization in cells it is transported inside cells from extracellular space
through plasmatic membrane. This process is stimulated by the following hormone:
A. * Insulin
B. Aldosterone
C. Glucagon
D. Adrenalin
E. Thyroxine
131. After a severe stress a patient was found to have eosinopenia. A decrease in the eosinophil
number can be explained by the changed concentration of the following hormones:
A. *Glucocorticoids
B. Adrenaline
C. Insulin
D. Mineralocorticoids
E. Vasopressin
132. 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:
A. *Parathyroid hormone
B. Aldosterone
C. Calcitriol
D. Calcitonin
E. Cortisol
133. 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:
A. *Hyperfunction of medulla
B. Hypofunction of medulla
C. Hypofunction of the adrenal cortex
D. Hyperfunction of the adrenal cortex
E. Primary aldosteronism
134. A man has a considerable decrease in diuresis as a result of 1.5 L blood loss. The primary
cause of such diuresis disorder is the hypersecretion of the following hormone:
A. *Vasopressin
B. Corticotropin
C. Natriuretic
D. Cortisol
E. Parathormone
135. On the 4th day of treatment with diclofenac sodium a 55-year-old patient has developed
gastric hemorrhage due to an ulcer appearing on the gastric mucosa. Ulcerogenic action of this
drug is caused by decreased secretion of:
*A. Prostaglandin E2
B. Leukotriene
C. Prostaglandin E1
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D. Cyclic endoperoxides
E. Thromboxane
136. Corticosteroid analogues induce breakdown of muscle proteins into free amino acids. Under
such conditions these amino acids become involved with the following processes:
A. *Gluconeogenesis in liver
B. Glycolysis in muscles
C. Synthesis of higher fatty acids
D. Glycogenolysis
E. Decarboxylation
137. A 49-year-old patient was found to have a disproportionate enlargement of hands, feet,
nose, ears, superciliary arches and cheek bones. Blood test revealed hyperglycemia, impaired
glucose tolerance. What is the most likely cause of this pathology development?
A. *Hypersecretion of growth hormone
B. Posterior pituitary hormone hypersecretion
C. Insulin hyposecretion
D. Vasopressin hyposecretion
E. Glucocorticoid hypersecretion
138. During removal of the hyperplastic thyroid gland of a 47-year-old woman, the parathyroid
gland was damaged. One month after the surgery the patient developed signs of
hypoparathyroidism: frequent convulsions, hyperreflexia, laryngospasm. What is the most likely
cause of the patient’s condition?
A. *Hypocalcemia
B. Hyponatremia
C. Hyperchlorhydria
D. Hypophosphatemia
E. Hyperkalemia
139. 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?
A. *Adrenocortical hyperfunction
B. Hyperthyroidism
C. Hypothyroidism
D. Gonadal hypofunction
E. Hyperfunction of the insular apparatus
140. A 40-year-old woman with Cushing’s disease presents with steroid diabetes. On
biochemical examination she has hyperglycemia and hypochloremia. What process activates in
the first place in such patients?
A. *Gluconeogenesis
B. Glycogenolysis
C. Glucose reabsorption
D. Glucose transportation into a cell
E. Glycolysis
141. A 30-year-old woman developed the signs of virilism (body hair growth, balding temples,
disturbed menstrual cycle). What hormone can cause this condition when hyperproduced?
A. *Testosterone
B. Estriol
C. Relaxin
D. Oxytocin
E. Prolactin
142. Corticosteroid hormones regulate the adaptation processes of the body as a whole to
environmental changes and ensure the maintenance of internal homeostasis. What hormone
activates the hypothalamo-pituitary- adrenal axis?
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A. *Corticoliberin
B. Somatoliberin
C. Somatostatin
D. Corticostatin
E. Thyroliberin
143. On examination the patient is found to have low production of adrenocorticotropic
hormone. How would this affect production of the other hormones?
A. *Decrease adrenal cortex hormones synthesis
B. Decrease hormone synthesis in the adrenal medulla
C. Decrease insulin synthesis
D. Increase sex hormones synthesis
E. Increase thyroid hormones synthesis
144. A patient is in the state of hypoglycemic coma. What hormone can cause this condition if
overdosed?
A. *Insulin
B. Progesterone
C. Cortisol
D. Somatotropin
E. Corticotropin
145. Due to morbid affection of the supraoptic and paraventricular nuclei of the hypothalamus
a 40-year-old patient as developed polyuria (10-12 L per day) and polydipsia. The following
hormone is deficient, thus leading to this disturbance:
A. *Vasopressin
B. Oxytocin
C. Corticotropin
D. Somatotropin
E. Thyrotropin
146. Due to trauma the patient’s parathyroid glands have been removed, which resulted in
inertness, thirst, sharp increase of neuromuscular excitability. Metabolism of the following
substance is disturbed:
A. *Calcium
B. Manganese
C. Chlorine
D. Molybdenum
E. Zinc
147. A doctor has established significant growth retardation, disproportional body build, and
mental deficiency of a child. What is the most likely cause of this pathology?
A. *Hypothyroidism
B. Insufficient nutrition
C. Hyperthyroidism
D. Genetic defects
E. Hypopituitarism
148. After introduction of adrenaline the patient’s blood glucose level increased. It is caused by
intensified:
A. *Glycogenolysis in the liver
B. Glycolysis in the liver
C. Glycolysis in the skeletal muscles
D. Glycogen synthesis
E. Glycogenolysis in the muscles
149. A patient during fasting developed ketoacidosis as a result of increased fatty acids
decomposition. This decomposition can be inhibited with:
A. *Insulin
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B. Glucagon
C. Adrenaline
D. Thyroxin
E. Cortisol
150. A 56-year-old man presents with parathyroid tumor. The following is observed: muscle
weakness, osteoporosis, bone deformation, nephroliths consisting of oxalates and phosphates.
The patient’s condition is caused by:
A. *Increased secretion of parathyroid hormone
B. Decreased secretion of parathyroid hormone
C. Increased secretion of calcitonin
D. Decreased secretion of calcitriol
E. Increased secretion of thyroxin
151. A patient has undergone surgical removal of the pylorus. Decreased secretion of the
following hormone can be expected:
A *Gastrin
B. Secretin
C. Gastric inhibitory polypeptide
D. Cholecystokinin
E. Histamine
152. A 49-year-old patient was found to have a disproportionate enlargement of hands, feet,
nose, ears, superciliary arches and cheek bones. Blood test revealed hyperglycemia, impaired
glucose tolerance. What is the most likely cause of this pathology development?
A. *Hypersecretion of growth hormone
B. Posterior pituitary hormone hypersecretion
C. Insulin hyposecretion
D. Vasopressin hyposecretion
E. Glucocorticoid hypersecretion
153. After a case of sepsis a 27-year- old woman developed "bronzed" skin discoloration
characteristic of Addison's disease. Hyperpigmentation mechanism in this case is based on
increased secretion of:
A. *Melanocyte-stimulating hormone
B. Thyroid-stimulating hormone
C. Somatotropin
D. β-lipotropin
E. Gonadotropin
154. A 16-year-old girl presents with no hair on the pubis and in the armpits, her mammary
glands are underdeveloped, no menstruations. What hormone imbalance can it be indicative of?
A. Ovarian failure
B. Hyperthyroidism
C. Pancreatic islet failure
D. Adrenal medulla hyperfunction
E. Hypothyroidism
155. A 40-year-old woman on examination presents with intensified basal metabolic rate.
What hormone present in excess leads to such condition?
A. *Triiodothyronine
B. Thyrocalcitonin
C. Somatostatin
D. Aldosterone
E. Glucagon
156. A 19-year-old young man was examined in the nephrology clinic. High Potassium was
detected in his secondary urine. What hormone is likely to cause such change, if it is produced in
excess?
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A. *Aldosterone
B. Testosterone C. Glucagon
D. Oxytocin
E. Adrenaline
157. Breakdown of cyclic adenosine monophosphate (cAMP) and cyclic guanosine
monophosphate (cGMP) into simple, non-cyclic nucleoside monophosphates is catalyzed by the
following enzyme:
A. *Phosphodiesterase
B. Adenylate cyclase
C. Protein kinase
D. Glucose 6-phosphatase
E. Glycogen phosphorylase
158. After introduction of adrenaline the patient's blood glucose level increased. It is caused by
intensified:
A. *Glycogenolysis in the liver
B. Glycogenolysis in the muscles
C. Glycolysis in the liver
D. Glycolysis in the skeletal muscles
E. Glycogen synthesis
159. A patient presents with osteoporosis; hypercalcemia and hypophosphatemia are observed
in the patient's blood. What is the cause of this condition?
A.* Increased parathormone secretion
B. Inhibited corticosteroid secretion
C. Increased corticosteroid secretion
D. Increased thyroxin secretion
E. Inhibited parathormone secretion
160. Due to trauma the patient's parathyroid glands have been removed, which resulted in
inertness, thirst, sharp increase of neuromuscular excitability. Metabolism of the following
substance is disturbed:
A. *Calcium
B. Manganese
C. Zinc
D. Chlorine
E. Molybdenum
161. A 30-year-old woman complains of intense thirst and dryness of the mouth that developed
after a severe emotional shock. Laboratory analysis revealed increase of the patient's blood sugar
level up to 10 mmol/L. What endocrine gland is affected in the patient?
A. *Adrenal glands
B. Pineal gland
C. Pancreas
D. Thyroid gland
E. Gonads
162. After a traffic accident a man presents with severe blood loss, consciousness disturbance,
low blood pressure, as well as compensatory activation of the renin-angiotensin system,
which results in:
A. *Hyperproduction of aldosterone
B. Increased blood coagulation
C. Hyperproduction of vasopressin
D. Intensification of heart contractions
E. Intensification of erythropoiesis
163. A patient presents with high content of vasopressin (antidiuretic hormone) in the blood.
What changes in the patient's diuresis will occur?
A. *Oliguria
B. Anuria
C. Glycosuria
D. Polyuria E. Natriuria
164. Chronic overdosage of glucocorticoids leads to the development of hyperglycemia. What
process of carbohydrate metabolism is responsible for this effect?
A. Gluconeogenesis
B. Glycogenesis
C. Aerobic glycolysis
D. Pentose-phosphate cycle
E. Glycogenolysis
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165. A patient complains of frequent and excessive urination and thirst. Urinalysis revealed the
following: 24-hours diuresis – 19 liters, specific gravity – 1.001. These values are characteristic
of:
A. Diabetes insipidus
B. Diabetes mellitus
C. Thyrotoxicosis
D. Addison’s disease
E. Steroid diabetes
166. A 26-year-old woman was brought into the maternity department. Considering the term of
her pregnancy (40 weeks), she should have gone into labor already. Examination determined that
the uterine cervix is open but uterine contractions are absent. The doctor gave her a hormone
drug for intensification of labor activity. Name this drug:
A. Oxytocin
B. Hydrocortisone
C. Testosterone
D. Adrenocorticotropic hormone
E. Estrone
167. A 45-year-old man complains of frequent fevers, tachycardia, irritability, hair loss, weight
loss, and hand tremor. In this case, blood test will show the high levels of the hormones
produced in the:
A. Thyroid
B. Adrenal medulla
C. Adrenal cortex
D. Pancreas
E. Gonads
168. A patient with neurodermatitis was taking prednisolone for a long time. Examination
revealed high blood glucose. This complication occurs, when glucocorticosteroids affect a
certain stage of carbohydrate metabolism. What stage of carbohydrate metabolism is affected?
A. Gluconeogenesis activation
B. Glycogen synthesis inhibition
C. Increased absorption of glucose in the intestine
D. Activation of the insulin breakdown
E. Glycogen synthesis activation
169. A patient was diagnosed with a parathyroid tumor. He has generalized fibrous
osteodystrophy and periodic attacks of renal colic. Ultrasound detected small stones in the
kidneys. What is the most likely cause of kidney stone formation?
A. Hypercalcemia
B. Hyperuricemy
C. Hyperphosphosphatemia
D. Hypercholesterolemia
E. Hypocalcemia
170. Decreased vasopressin synthesis causes polyuria and, as a result, marked dehydration. What
is the mechanism of polyuria development?
A. Decreased canalicular reabsorption of water
B. Decreased canalicular reabsorption of proteins
C. Decreased canalicular reabsorption of Na ions
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D. Decreased reabsorption of glucose
E. Increased glomerular filtration
171. A 48-year-old man has arterial hypertension of endocrine genesis, headache, muscle
weakness, and convulsions. His blood levels of K+ (potassium) are low, while his blood levels of
Na+ (sodium) are high, which is the result of hormone hypersecretion. What hormone is being
overproduced in this case?
A. Aldosterone
B. Adrenaline
C. Parathormone
D. Cortisol
E. Dihydrocholesterol
172. A 29-year-old man complains of headache, swelling, weight gain, low urine output, and
marked weakness. Laboratory testing revealed increased concentration of TSH. The levels of
estrogen, growth hormone, glucose, urea, and creatinine are normal. What medical condition
corresponds with these signs?
A. Hypothyroidism
B. Hyperthyroidism
C. Acromegalia
D. Glomerulonephritis
E. Alimentary obesity
173. Tyrosine is used as a substrate in the thyroxine synthesis. What chemical element takes part
in this process?
A. Iodine
B. Zinc
C. Iron
D. Copper
E. Calcium
174. A patient presents with osteoporosis. Hypercalcemia and hypophosphatemia are observed in
the patient’s blood. What is the cause of this condition?
A. Increased parathormone secretion
B. Increased corticosteroid secretion
C. Inhibited corticosteroid secretion
D. Increased thyroxin secretion
E. Inhibited parathormone secretion
175. On the day before a surgery, the patient was stressed out. This condition is associated with
high blood levels of the following hormone:
A. Adrenaline
B. Insulin
C. Progesterone
D. Prolactin
E. Glucagon
176. After a glucose-lowering therapy, a patient with diabetes mellitus developed hypoglycemia.
What hormone, taken in excess, could have caused this hypoglycemic condition?
A. Insulin
B. Thyroxine
C. Adrenaline
D. Cortisol
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E. Glucagon
177. A patient with Cushing syndrome presents with persistent hyperglycemia and glucosuria.
This patient is likely to have increased synthesis and secretion of the following hormone:
A. Cortisol
B. Adrenaline
C. Aldosterone
D. Glucagon
E. Thyroxine
178. An acute blood loss has caused a decrease in the systemic blood pressure. This situation can
be stabilized with the intensified secretion of a certain hormone. Name this hormone:
A. Renin
B. Testosterone
C. Glucagon
D. Gastrin
E. Insulin
179. On clinical examination a woman presents with excessive sweating, tachycardia, loss of
weight, and tremor. What endocrine pathology can cause these signs?
A. Hyperthyroidism
B. Hypoaldosteronism
C. Hypothyroidism
D. Hypergonadism
E. Hypogonadism
180. Prolonged taking of large doses of aspirin (acetylsalicylic acid) leads to inhibition of
prostaglandin synthesis because of decreased activity of the following enzyme:
A. Cyclooxygenase
B. Peroxidase
C. 5-Lipoxygenase
D. Phospholipase A2
E. Phosphodiesterase
181. A patient complaining of polydipsia, polyphagia, and polyuria excretes glucose with urine.
What disease can be suspected?
A. Diabetes mellitus
B. Diabetes insipidus
C. Acromegalia
D. Insulinoma
E. Addison disease
182. A 9-year-old boy is hospitalized in the endocrinology department. He has already had
several limb fractures because of fragile bones. What endocrine gland does not function properly
in this patient?
A. Parathyroid gland
B. Thyroid gland
C. Thymus gland
D. Pineal glands
E. Adrenal glands
183. Examination of a 32-year-old man shows tall stature and enlargement of the supraorbital
ridge, nose, lips, tongue, jawbones, and feet. What is the likely cause of these disturbances?
A. Increased levels of somatotropin
B. Increased concentration of glucagon
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C. Decreased concentration of insulin
D. Increased levels of thyroxine
E. Increased levels of catecholamines
184. A child presents with delayed mental development, delayed growth and formation of the
teeth, late development of ossification foci, and low basal metabolic rate. What endocrine gland
is functionally insufficient, causing this condition?
A. Thyroid gland
B. Gonads
C. Neurohypophysis
D. Adrenal glands
E. Pancreas
185. A 40-year-old woman during examination presents with intensified basal metabolic rate.
Excees in present of what hormone leads to such condition?
A. Triiodothyronine
B. Glucagon
C. Thyrocalcitonin
D. Somatostatin
E. Aldosterone
186. A group of researchers aimed to study cardiac physiology found that overstretching of atria
in the heart leads to decreased sodium reabsorption in the distal convoluted tubule and increase
in glomerular filtration rate. Which of the following is the most likely cause of physiologic
effects discovered by researchers?
A. Natriuretic peptide
B. Vasopressin
C. Angiotensin
D. Aldosterone
E. Renin
187. People, who live in hot climates, have reduced blood levels of a certain hormone that is important for
adaptive thermoregulation. What hormone is it?
A. Thyroxine
B. Glucagon
C. Insulin
D. Cortisol
E. Somatotropin
188. Cushing syndrome (hyperfunction of the adrenal cortex with increased production of corticosteroids)
leads to the development of hyperglycemia. What process is stimulated in this case?
A. Gluconeogenesis
B. Glycolysis
C. Krebs cycle
D. Pentose phosphate pathway of glucose oxidation
E. Glycogen phosphorolysis
Carbohydrate metabolism
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1. Vomiting, diarrhea, general dystrophy, hepato- and splenomegaly were observed in a
newborn. These symptoms decrease after exclusion of milk from the diet. Which main hereditary
defect results in the pathology?
*А. Disturbance of galactose metabolism
В. Disturbance of phenylalanine metabolism
С. Hypersecretion of endocrine glands
D. Disturbance of glucose metabolism
E. Deficiency of glucose-6-phosphate dehydrogenase
2. A newborn has good feeling after breast-feeding. Vomiting, abdominal ache, diarrhea,
hypoglycemia appear after adding fruits and juices to the diet. What is the cause?
А. Hyperglycemia
В. Ketosis
С. von Gierke’s disease
D. Glucosuria
*E. Hereditary fructose intolerance
3. Post synthetic covalent modification plays an important role in enzymes activity regulation.
How are glycogen phosphorylase and glycogen synthase activities regulated?
A. Methylation
B. Adenylation
C. Limited proteolysis D. ADP-ribosylation
*E. Phosphorylation-dephosphorylation
4. Concentration of glucose in blood plasma of healthy human varies:
A. 2-4 mmol/L *B. 3.3-5.5 mmol/L C. 10-25 mmol/L D. 6-9.5 mmol/L
E. 1-2 mmol/L
5. Tolerance of a 34-year-old patient to physical load is decreased, but glycogen content in
skeletal muscles of the patient is increased. Which enzyme activity decrease can explain the
phenomenon?
A. Phosphofructokinase
B. Glucose-6-phosphate dehydrogenase
*C. Glycogen phosphorylase
D. Glycogen synthase
E. Glucose-6-phosphatase
6. Fatty liver, galactosuria and aminoaciduria are observed in a newborn. Which substance must
be excluded from diet?
*A. Milk sugar B. Fatty acids
C. Phenylalanine D .Cholesterol E. Sucrose
7. Glucose-6-phosphatase absence, hypoglycemia and hepatomegaly were found in a child with
point mutation of genes. What pathology is characterized by these signs?
*A. Gierke’s disease
B. Cori’s disease
C. Addison’s disease
D. Parkinson’s disease
E. Mc-Ardle’s disease
8. A baby is week and apathic. Its liver is increased and liver biopsy test reveals
excessive contents of glycogen. The glucose blood level is reduced. What causes the
reduction?
*A. Decreased ( minimal ) activity of liver glycogen phosphorylase
B. Decreased ( minimal) activity of glycogen synthetase
C. Increased activity of glycogen synthetase
D. Decreased ( minimal) activity of glucose-6-phosphatase
E. The deficiency of gene which is responsible for the synthesis of glucose-1-phosphate
uridyltransferase.
9. Gierke’s disease is an illness which develops the excessive accumulation glycogen in
liver and kidney tissues. Which enzyme deficiency is the cause of the disease.
A. Glycogenphosphorylase *B. Glucose-6-phosphatase
C. Phosphorylase kinase
D. Phosphoglucomutase
E. Glucokinase
10. A 40 year-old patient suffers from whole milk intolerance. Which digestion enzyme
deficiency explains the phenomenon?
A. Amylase B. Lactate dehydrogenase C. Maltase
D. Lipase
*E. Lactase
11. One of characteristic features of glycogenosis is muscle ache
during the
performance of physical work. Which enzyme hereditary deficiency causes this pathology?
*A. Glycogen phosphorylase
B. Glucose-6-phosphatase
C. Glycogen synthase
D. Amilo-1-6-glucosidase
E. Lysosomal glucosidase
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12. Characteristic sign of glycogenosis is muscle pain during physical work. Blood examination
usually reveals hypoglycemia. This pathology is caused by congenital deficiency of the
following enzyme:
A. *Glycogen phosphorylase
B. Glucose-6-phosphate dehydrogenase
C. α-Amylase
D. Lysosomal glycosidase
E. γ-Amylase
13. Gluconeogenesis in liver is activated in the organism of sportsman after intensive training.
Indicate the main substrate of this process:
А. Serine *В. Lactate С. α-Ketoglutarate D. Aspartate E. Glutamate
14. Deficiency of pyruvate kinase in erythrocytes is found in the organism of a child with
symptoms of anemia. Which process is disturbed in erythrocytes?
A. Oxidative phosphorylation
B. Tissue respiration
*C. Anaerobic glycolysis
D. Elimination of peroxides
E. Deamination of amino acids
15. The second stage of aerobic oxidation of glucose in cell is oxidative decarboxylation of
pyruvate. Indicate the main product of this process:
A. Succinyl-CoA
B. Pyruvate C. Citrate
D. Oxaloacetate
*E. Acetyl-CoA
16. Energy in form of ATP is necessary for vital functions of erythrocytes. Which process
provides these cells by sufficient amount of ATP?
*A. Anaerobic glycolysis B. Aerobic oxidation of glucose
C. Pentose phosphate pathway
D. Tricarboxylic acid cycle
E. β-Oxidaton of fatty acids
17. Human red blood cells contain no mitochondria. What is the main pathway for ATP
production in these cells?
A. *Anaerobic glycolysis
B. Oxidative phosphorylation
C. Cyclase reaction
D. Aerobic glycolysis
E. Creatine kinase reaction
18. Carbohydrates are nonessential components of the human diet. They are synthesized in
organism by means of gluconeogenesis from:
A. Glycerol, fatty acids, leucine B. Lactate, cholesterol, carnitine
*C. Alanine, glycerol, lactate
D. Choline, pyruvate, acetyl-CoA
E. Glutamate, leucine, butyrate
19. The increased hemolysis of erythrocytes is observed in a 3-year-old child who had had the
increased body temperature and was given aspirin. Which enzyme congenital deficiency could
cause hemolytic anemia?
A. Glycerol phosphate dehydrogenase
B. Glucose-6-phosphatase
C. Glycogen phosphorylase
*D. Glucose-6-phospate dehydrogenase
E. γ-Glutaminyl transferse
20. A 2-year–old boy is observed with cataract and increased liver and spleen size. The sugar
blood level is increased too, although glucose tolerance test results are normal. The cause of the
state is hereditary impaired metabolism of a substance. What is the substance?
A. Glucose
B. Fructose
*C. Galactose
D. Maltose
E. Sucrose
21. Postsynthetic covalent modification of enzymes plays an important role in regulation of their
activity. What of mechanisms mentioned below is the regulation of glycogen phosphorylase and
glycogen synthetase activities performed with?
A. ADP-rybosylation
B. Methylation
C. Adenylation
D. Limited proteolysis
*E. Phosphorylation - dephosphorylation
22. Gluconeogenesisis is activated in a sportsman sometime after intensive physical training.
What is its main substrate?
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A. Serine
B. Aspartic acid
C. Glutamic acid
D. α-Ketoglutarate
*E. Lactate
23. A patient in comatose state was admitted to the medical institution. According to explanation
of accompanying people the patient lost consciousness in training at the final stage of the
Marathon distance. What coma is diagnosed?
*A. Hypoglycemic
B. Hyperglycemic
C. Acidic
D. Hypothyroid
E. Hepatic
24. Dyspepsia phenomenon (diarrhea, vomiting) was observed in a newborn fed with milk.
These symptoms disappeared after feeding with glucose solution. Give the enzyme, which takes
part in carbohydrate digestion and deficiency of which leads to these disturbances.
A. Sucrase
B. Amylase
*C. Lactase
D. Isomerase
E. Maltase
25. After running a sprint distance muscular rigidity is observed in untrained people as a result of
lactate accumulation. What biochemical process intensification is it linked with?
A. Gluconeogenesis
*B. Glycolysis
C. Pentose phosphate pathway
D. Lipogenesis
E. Glycogenesis
26. A woman-worker of chemical industry is delivered to clinics. She possesses the
symptoms of poisoning. Her hair contains the high level of arsenate. The latter blocks
lipoic acid activity. What biochemical process is most likely to suffer from this?
*A. Oxidative decarboxylation of pyruvic acid
B. Microsomal oxidation
C. Methemoglobin renovation
D. Organic oxides renovation
E. Superoxide ions detoxification
27. A type I of glycogenosis, Gierke’s disease, causes the disturbance of glucose-6phosphate to glucose conversion. This results in accumulation of glycogen in the liver
and kidney. Which enzyme deficiency is observed at this state?
A. Phosphorylase
B. Glycogensynthetase
*C. Glucose-6-phosphatase
D. Hexokinase
E. Aldolase
28. Avidin is a strong specific inhibitor of biotin-dependent enzymes. Which of the
following reactions is to be blocked if avidin is added to cellular homogenate?
A. Glucose to ribose-5-phospha
B. Glucose to pyruvic acid
C. Oxaloacetate to glucose
*D. Pyruvate to oxaloacetate
E. Lactate to pyruvate
29. A 38 year-old man suffering from schizophrenia has been treated at clinics. The
glucose, ketone bodies and urea blood levels of the patient were original. The shock
therapy by regular insulin coma was provided and after that the state of the patient
was getting better. What was the most probable cause of the insulin coma?
A. Glucosuria
B. Dehydration of tissues
C. Metabolic acidosis
D. Ketonemia
*E. Hypoglycemia
30. A 7 year-old girl possesses the pronounced anemia symptoms. The laboratory-made
blood analysis reveals pyruvate kinase
deficiency in erythrocytes. Which process
impairment plays the main role in the anemia development?
A. TCA cycle
B. Oxidative phosphorylation
C. Tissue respiration
D. Peroxide breakdown
*E. Anaerobic glycolysis
31. A baby has been delivered to the clinics emergency department. It has the
symptoms of vomiting, diarrhea, growth impairment, cataract, mental retardation. The
diagnosis is galactosemia. is What enzyme deficiency present at this case?
*A. Hexose-1-phophate uridyl transferase
B. Glukokinase
C. UDP- glucose-4-epimerase
D. UDP- glucose pyrophosphorylase
E. Glucose- 6- phosphate dehydrogenase
32. A person who was at hypodynamia state for a long time develops intensive ache
in muscles after physical work. What is the cause of this ache?
A. Decrease in lipid contents of muscles
B. Enhanced breakdown of muscle lipids
C. Creatine accumulation in muscles
*D. Lactic acid accumulation in muscles
E. Increase in ADP contents of muscles
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33. A 45 year- old woman does not have any symptoms of sugar diabetes, although, she
has increased glucose blood level (7.5 mmol/l ) in the morning before the first meal.
Which additional test should be performed this case ?
A. Determination of glucose tolerance
B. Determination of ketone bodies blood level
C. Determination of residual nitrogen blood level
*D. Determination of glucose tolerance before the first meal
E. Determination of glycated hemoglobin level
34. Which of the following processes is enhanced in the liver and kidney of patient
exhausted by starvation?
A. Bilirubin synthesis
B. Urea synthesis
*C. Gluconeogenesis
D. Hippuric acid formation
E. Uric acid synthesis
35. The thiamine deficiency results in beri-beri disease onset ( polyneuritis ) which is
characterized by carbohydrate metabolism disturbances. What metabolite is accumulated in
blood at this state?
A. Lactate
*B. Pyruvate
C. Succinate
D. Citrate
E. Malate
36. Anaerobic breakdown of glucose to lactic acid is regulated by certain enzymes. Which
enzyme is the main regulator of this process?
A. Lactate dehydrogenase
B. Glucose 6-phosphate isomerase
C. Aldolase
D. Enolase
*E. Phosphofructokinase
37. The biosynthesis of purine ring proceeds with the participation of ribose -5phosphate by gradual up building nitrogen and carbon atoms and up locking the rings.
What is the source of ribose -5-phosphate?
*A. Penthose phosphate pathway
B. Glycolysis
C. Glycogenesis
D. Gluconeogenesis
E. Glycogenolysis
38. An unconscious woman - patient was delivered to the clinics emergency department.
The clinical analysis of b1ood reveals the following indexes: glucose – 1.98mmol/l, Hb –
82g/l, EPR – 18mm/hour. What is the most plausible diagnosis?
*A. Hypoglycemia
B. Diabetes mellitus
C. Galactosemia
D. Somatotropin deficiency
E. Kidney diabetes
39. The consequence of long-term starvation is the quick carbohydrate reserves outrun.
What process renovates the glucose blood level?
A. Aerobic glycolysis
B. Anaerobic glycolysis
*C. Gluconeogenesis
D. Glycogenolysis
E. Pentose-phosphate pathway
40. Galactosemia has been revealed in a child. Concentration of glucose in the blood has not
considerably changed. What enzyme deficiency caused this illness?
A. Galactokinase
*B. Galactose-1-phosphate uridyltransferase
C. Hexokinase
D. Amylo-1,6-glucosidase
E. Phosphoglucomutase
41. To prevent long-term effects of 4-day malaria a 42-year-old patient was prescribed
primaquine. On the 3-rd day from the beginning of treatment there appeared stomach and heart
pains, dyspepsia, general cyanosis, hemoglobinuria. What caused side effects of the preparation?
A. Drug potentiation by other preparations
B. Cumulation of the preparation
C. Delayed urinary excretion of the preparation
D. Decreased activity of microsomal liver enzymes
*E. Genetic insufficiency of glucose 6-phosphate dehydrogenase
42. A child's blood presents high content of galactose, glucose concentration is low. There are
such presentations as cataract, mental deficiency, adipose degeneration of liver. What disease is
it?
*A. Galactosemia
B. Steroid diabetes
C. Lactosemia
D. Diabetes mellitus
E. Fructosemia
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43. A child is languid, apathetic. Their liver is enlarged and liver biopsy revealed a significant
excess of glycogen. Glucose concentration in the blood stream is below normal. What is the
cause of low glucose concentration?
A. Deficit of a gene that is responsible for synthesis of glucose 1-phosphaturidine transferase
B. Low (absent) activity of hexokinase
C. High activity of glycogen synthetase
D. Low (absent) activity of glucose 6-phosphatase
*E. Low (absent) activity of glycogen phosphorylase in liver
44. Sarcoplasm contains a wide spectrum of glucose metabolites oxidation. Name one of them
that is directly converted to lactate:
*A. Pyruvate
B. Glycerophosphate
C. Glucose 6-phosphate
D. Oxaloacetate
E. Fructose 6-phosphate
45. During starvation muscle proteins are degraded into free amino acids. These compounds will
be the most probably involved into the following process:
A. Glycogenolysis
B. Decarboxylation
C. Gluconeogenesis in muscles
*D. Gluconeogenesis in liver
E. Synthesis of higher fatty acids
46. A 62-year-old female patient has developed a cataract (lenticular opacity) secondary to the
diabetes mellitus. What type of protein modification is observed in case of diabetic cataract?
*A. Glycosylation
B. Methylation
C. Phosphorylation
D. ADP-ribosylation
E. Limited proteolysis
47. After a sprint an untrained person develops muscle hypoxia. This leads to the accumulation of
the following metabolite in muscles:
A. Acetyl CoA
B. Ketone bodies *C. Lactate
D. Oxaloacetate E. Glucose 6-phosphate
48. A newborn develops dyspepsia after the milk feeding. When the milk is substituted by the glucose
solution the dyspepsia symptoms disappear. The newborn has the subnormal activity of the following
enzyme:
A. Invertase
B. Maltase
*C. Lactase
D. Amylase
E. Isomaltase
49. Glucose may be synthesized in humans from non - carbohydrate compounds. Each of the
following metabolites provides carbons for glucose synthesis by the process of gluconeogenesis,
except:
*A. Even-chain fatty acids from adipose triacylglycerols
B. Amino acids from muscle proteins
C. Lactate from red blood cells and exercising muscle
D. Glycerol from adipose triacylglycerols
E. All the mentioned
50. After 2 days of fasting the major process by which blood glucose is produced is:
*A. Gluconeogenesis
B. Glycolysis
C. Glycogenolysis
D. The pentose phosphate pathway
E. All the mentioned
51. An individual accidently ingests a compound that inhibits glucose-6-phosphatase. After an
overnight fast, this individual, compared with a healthy person, would have a higher
*A. Level of liver glycogen
B. Level of blood glucose
C. Rate of gluconeogenesis
D. Rate of glycogenolysis
E. All the mentioned
52. Which of the following liver enzymes becomes less active when a diabetic person is treated
with insulin?
*A. Fructose 1,6-bisphosphatase
B. Pyruvate kinase
C. Pyruvate dehydrogenase
D. Phosphofructokinase 1
E. All the mentioned
53. 34-year-old patient has low endurance of physical loads. At the same time skeletal muscles
have increased concentration of glycogen. This is caused by the reduced activity of the enzyme:
A. *Glycogen phosphorylase
B. Glucose-6-phosphate dehydrogenase
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C. Glucose-6-phosphatase
D. Phosphofructokinase
E. Glycogen synthase
54. Glucose content of blood stays at sufficient level after one week of starvation. Is it caused by
activation of the following process:
A. *Gluconeogenesis
B. Glycogenolysis
C. Glycogen phosphorolysis
D. Glycolysis
E. Tricarboxylic acid cycle
55. A patient is diagnosed with pancreatic diabetes with associated hyperglycemia. Glycemia
rate can be assessed retrospectively (4-8 weeks prior to examination) by measuring concentration
of the following blood plasma protein:
A. *Glycated hemoglobin (glycozylated)
B. Ceruloplasmin
C. Fibrinogen
D. Albumin
E. C-reactive protein
56. In patients with glycogenolysis, that is von Gierke’s disease, the conversion of glucose-6phosphate into glucose is inhibited, which is accompanied by the improper breakdown of
glycogen in the liver. The cause of this condition is the following enzyme deficiency:
A. *Glucose-6-phosphatase
B. Glycogen phosphorylase
C. Glucose-6-phosphate dehydrogenase
D. Phosphofructokinase
E. Phosphoglucomutase
57. In some anaerobic bacteria the pyruvate produced by glycolysis is converted to the ethyl
alcohol (alcoholic fermentation). What is the biological significance of this process?
A. *NAD+ replenishment
B. Lactate production
C. ADP production
D. Providing the cells with NADPH
E.
ATP production
58. A 23-year-old patient with diabetes has hyperglycemia at the rate of 19 mmol/l which is
clinically manifested by glycosuria, polyuria, polydipsia. Which of the listed below mechanisms
is responsible for the development of glycosuria?
A. *Exceedance of glucose renal threshold
B. Non-enzymatic glycosylation of proteins
C. Polyuria
D. Polydipsia
E. Tissue dehydration
59. It has been revealed that intense physical exercise causes activation of gluconeogenesis in
liver of experimental rats. Which substance is glucose precursor in this case?
A.
*Pyruvate B. Glycogen
C. Palmitate
D. Urea
E. Stearate
60. It is known that many hormones act through the adenylate cyclase system causing the
enzyme activation by phosphorylation. What enzyme is activated by hormonal signals and
catalyzes glycogen breakdown?
A. *Phosphorylase B. Phosphotransferase C. Glucomutase D. Phosphatase E. Tyrosinase
61. It is known that the pentose phosphate pathway occurring in the adipocytes of adipose tissue
acts as a cycle. What is the main function of this cycle in the adipose tissue?
A. *NADPH2 generation
B. Ribose-phosphate production
C. Xenobiotic detoxification
E. Energy generation
62. A patient with rheumatoid arthritis has been given hydrocortisone for a long time. He has
developed hyperglycemia, polyuria, glycosuria, thirst. These complications of treatment result
from the activation of the following process:
A. *Gluconeogenesis
B. Glycogenolysis C. Glycogenesis D. Glycolysis
E. Lipolysis
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63. After restoration of blood circulation in damaged tissue accumulation of lactate comes to a
stop and speed of glucose consumption slows down. These metabolic changes are caused by
activation of the following process:
A. *Aerobic glycolysis
B. Anaerobic glycolysis
C. Lipolysis
D. Gluconeogenesis
E. Glycogen biosynthesis
64. After prolonged exercising people usually experience intense muscle pain. What is its most
likely cause?
A. *Accumulation of lactic acid in muscles
B. Intensified disintegration of muscle proteins
C. Accumulation of creatinine in muscles
D. Increased muscle excitability
E. Increased concentration of ADP in muscles
65. Chronic overdosage of glucocorticoids leads to the development of hyperglycemia. What
process of carbohydrate metabolism is responsible for this effect?
A. *Gluconeogenesis
B. Glycogenolysis
C. Aerobic glycolisis
D. Pentose-phosphate cycle
E. Glycogenesis
66. A 32-year-old female patient suffers from gingivitis accompanied by gum hypoxia. What
metabolite of carbohydrate metabolism is produced in the periodontium tissues more actively in
this case?
A. *Lactate
B. Ribose 5-phosphate
C. Glycogen
D. Glucose 6-phosphate
E. NADPH-H
67. During starvation normal rate of glucose is maintained by means of gluconeogenesis
activation. What substance can be used as a substrate for this process?
A. *Alanine B. Ammonia C. Adenine
D. Urea
E. Guanine
68. Characteristic sign of glycogenosis is muscle pain during physical work. Blood examination
reveals usually hypoglycemia. This pathology is caused by congenital deficiency of the following
enzyme:
A. *Glycogen phosphorylase
B. Glucose 6-phosphate dehydrogenase
C. Alpha amylase
D. Gamma amylase
E. Lysosomal glycosidase
69. Untrained people often have muscle pain after sprints as a result of lactate accumulation. This
might be caused by intensification of the following biochemical process:
A. *Glycolysis
B. Gluconeogenesis
C. Pentose phosphate pathway
D. Lipogenesis
E. Glycogenesis
70. When blood circulation in the damaged tissue is restored, then lactate accumulation comes to a
stop and glucose consumption decelerates. These metabolic changes are caused by activation of the
following process:
A. *Aerobic glycolysis
B. Anaerobic glycolysis
C. Lipolysis
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D.
Gluconeogenesis E. Glycogen biosynthesis
71. A 12-year-old teenager has significantly put off weight within 3 months; glucose concentration
rise up to 50 millimol/l. He fell into a coma. What is the main mechanism of its development?
A. *Hyperosmolar
B. Hypoglycemic
C. Ketogenic
D. Lactacidemic
E. Hypoxic
72. Some students developed myodynia after continuous physical activity during physical education.
The reason for such condition was accumulation of lactic acid in the skeletal muscles. It was
generated in the students’ bodies after activation of the following process:
A. *Glycolysis
B. Gluconeogenesis
C. Pentose-phosphate cycle
D. Lipolysis
E. Glycogenolysis
73. A 60 –year- old patient was found to have a dysfunction of main digestive enzyme of saliva.
This causes the disturbance of primary hydrolysis of:
A.*Carbohydrates
B. Fats
C. Proteins
D. Cellulose
E. Lactose
74. Glycogen polysaccharide is synthesized from the active form of glucose. The immediate donor
of glucose residues during the glycogenesis is:
A. *UDP-glucose
B. Glucose-1-phosphate
C. ADP-glucose
D. Glucose-6-phosphate
E. Glucose-3-phosphate
75. Diseases of the respiratory system and circulatory disorders impair the transport of oxygen,
thus leading to hypoxia. Under these conditions the energy metabolism is carried out by
anaerobic glycolysis. As a result, the following substance is generated and accumulated in blood:
A. *Lactic acid
B. Pyruvic acid
C. Glutamic acid
D. Citric acid
E. Fumaric acid
76. Prolonged fasting causes hypoglycemia which is amplified by alcohol consumption, as the
following process is inhibited:
A. *Gluconeogenesis
B. Glycolysis
C. Glycogenolysis
D. Lipolysis
E. Proteolysis
77. According to the results of glucose tolerance test, the patient has no disorder of carbohydrate
tolerance. Despite that, glucose is detected in the patient’s urine (5 mmol/l). The patient has been
diagnosed with renal diabetes. What renal changes cause glycosuria in this case?
A. *Decreased activity of glucose reabsorption enzymes
B. Increased activity of glucose reabsorption enzymes
C. Exceeded glucose reabsorption threshold
D. Increased glucose secretion
E. Increased glucose filtration
78. A child has a history of hepatomegaly, hypoglycemia, seizures, especially on an empty
stomach and in stressful situations. The child is diagnosed with von Gierke’s disease. This
disease is caused by the genetic defect of the following enzyme:
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A. *Glucose-6-phosphatase
B. Amyloid-1,6-glycosidase
C. Phosphoglucomutase
D. Glycogen phosphorylase
E. Glucokinase
79. Pancreas is known as a mixed gland. Endocrine functions include production of insulin by
beta cells. This hormone affects the metabolism of carbohydrates. What is its effect upon the
activity of glycogen phosphorylase (GP) and glycogen synthase (GS)?
A. *It inhibits GP and activates GS
B. It activates both GP and GS
C. It inhibits both GP and GS
D. It activates GP and inhibits GS
E. It does not affect the activity of GP and GS
80. A 15-year-old patient has fasting plasma glucose level 4.8 mmol/1, one hour after glucose
challenge it becomes 9.0 mmol/1, in 2 hours it is 7.0 mmol/1, in 3 hours it is 4.8 mmol/1. Such
parameters are characteristic of:
A. *Healthy person
B. Cushing’s disease
C. Subclinical diabetes mellitus
D. Diabetes mellitus type 1
E. Diabetes mellitus type 2
81. A patient with diabetes mellitus suffers from persistently no healing surgical wound which is
a sing of disrupted tissue trophism. What is the cause of such disorder?
A. *Disruption of protein metabolism regulation
B. Ketonemia
C. Increased lipid catabolism
D. Hypoglycemia
E. Anemia
82. 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?
A. *Increased proteolysis
B. Decrease in the concentration of amino acids in blood
C. Increase in the oncotic pressure in the blood plasma
D. Increase in low-density lipoprotein level
E. Albuminosis
83. Fructosuria is known to be connected with inherited deficiency of fructose 1-phosphate
aldolase. Which product of fructose metabolism will accumulate in the organism resulting in
toxic action?
A. *Fructose1-phosphate
B. Fructose 1,6-biphosphate
C. Glucose 1-phosphate
D. Fructose 6-phosphate
E. Glucose 6-phosphate
84. Exophthalmus observed during thyrotoxicosis is caused by accumulation of highly waterbinding substances within the retro bulbar tissues. Name these substances:
A.*Glycosaminoglycans B. ATP C. Creatine D. Cholesterol E. Phospholipids
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85. When investigating human saliva it is necessary to assess its hydrolytic properties. What
substance should be used as a substance in the process?
A. *Starch
B. Amino acids C. Proteins D. Fiber E. Fats
86. 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?
A. *Carbohydrate starvation of the brain
B. Increased lipogenesis
C. Increased ketogenesis
D. Increased glycogenolysis
E. Decreased glyconeogenesis
87. Glucose content of blood keeps at sufficient level after one week of starvation. Is it caused by
activation of the following process:
A. *Gluconeogenesis
B. Glycolysis
C. Glycogenolysis
D. Tricarboxylic acid cycle
E. Glycogen phosphorolysis
88. Sulfanilamides are applied as antimicrobal agents in clinical practice. Sulfanilamide
treatment, however, can result in hemolytic anemia development in patients that suffer from
genetic defect of the following enzyme of pentose phosphate metabolism in erythrocytes:
A. *Glucose-6-phosphate dehydrogenase
B. Hexokinase
C. Transketolase
D. Transaldolase
E. Pyruvate kinase
89. A 40-year-old patient suffers from intolerance of dairy food products. This condition has
likely developed due to insufficiency of the following digestive enzyme:
A. *Lactase
B. Lipase
C. Maltase D. Invertase E. Amylase
90. A child with point mutation presents with absence of glucose 6-phosphatase, hypoglycemia,
and hepatomegaly. What pathology are these signs characteristic of?
A. *Von Gierke’s disease (Glycogen storage disease type I)
B. Cori’s disease (Glycogen storage disease type III)
C. Addison’s disease (Primary adrenal insufficiency)
D. Parkinson’s disease
E. McArdle’s disease (Glycogen storage disease type V)
91. It is known that pentose-phosphate pathway actively functions in the erythrocytes. What is
the main function of this metabolic pathway in the erythrocytes?
A. *Counteraction to lipid peroxidation
B. Activation of microsomal oxidation
C. Neutralization of xenobiotics
D. Oxidation of glucose into lactate
E. Increase of lipid peroxidation
92. Mucin aggregates retain water, which results in their viscosity and protective action. It is
possible because mucin structure contains:
A. *Glycosaminoglycans
B. Homopolysaccharides
C. Disaccharides
D. Oligosaccharides
E. Glucose
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93. In post absorptive state glycogen synthesis is increased in liver and muscles. The synthesis
involves the following substance:
A. *Uridine triphosphate (UTP)
B. Guanosine triphosphate (GTP)
C. Cytidine triphosphate (CTP)
D. Thymidine triphosphate (TTP)
E. Adenosine triphosphate (ATP)
94. A patient has undergone recurring blood tests that revealed sharp fluctuations of glucose
content: significant increase in absorptive state and significant decrease in post absorptive state.
What pathology can be the cause of it?
A. *Aglycogenosis (glycogenosis type 0)
B. Diabetes mellitus type I
C. Diabetes mellitus type II
D. Acromegaly
E. Endemic goiter
95. A patient suffering from malaria has developed hemolytic anemia after taking primaquine,
antimalarial drug. Hereditary insufficiency of the following enzyme in erythrocytes will be
observed in this case:
A. *Glucose 6-phosphate dehydrogenase
B. Triose phosphate isomerase
C. Lipase
D. Fructose-1-phosphate aldolase
E. Phosphofructokinase
96. Corticosteroid analogues induce breakdown of muscle proteins into free amino acids. Under
such conditions these amino acids become involved with the following processes:
A. *Gluconeogenesis in liver
B. Glycolysis in muscles
C. Synthesis of higher fatty acids
D. Glycogenolysis
E. Decarboxylation
97. People, who for a long time remained in hypodynamic state, develop intense pain in the
muscles after a physical exertion. What is the most likely cause of this pain?
A. *Accumulation of lactic acid in muscles
B. Accumulation of creatinine in muscles
C. Intensive breakdown of muscle proteins
D. Decreased content of lipids in muscles
E. Increased content of ADP in muscles
98. Congenital pyruvate carboxylase deficiency causes physical and mental retardation in
children and leads to early death. It is characterized by lactic acidemia, lactaciduria, and a
number of metabolic disorders. Among others, inhibition of the following occurs:
A. *Citric acid cycle and gluconeogenesis
B. Pentose-phosphate pathway and glycolysis
C. Glycogenesis and glycogenolysis
D. Lipolysis and lipogenesis
E. Glycolysis and glycogenolysis
99. A 7-year-old child presents with marked signs of hemolytic anemia. Biochemical analysis of
erythrocytes determined low concentration of NADPH and reduced glutathione. What enzyme is
deficient in this case leading to the biochemical changes and their clinical manifestations?
A. *Glucose-6-phosphate dehydrogenase
B. Pyruvate kinase C. Fructokinase
D. Lactate dehydrogenase
E. Hexokinase
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100. A 40-year-old woman suffers from Cushing's disease - steroid diabetes. On biochemical
examination she has hyperglycemia and hyperchloremia. What process activates in the first place
in such patients?
A. *Gluconeogenesis
B. Glucose transport to the cells
C. Glycogenolysis
D. Glycolysis
E. Glucose reabsorption
101. During intensive physical exertion, one of the energy sources for the working muscles is
glucose produced as the result of gluconeogenesis. This process is the most intensive in the
following organ:
A. *Liver
B. Muscles
C. Lungs
D. Brain
E. Stomach
102. A diabetes mellitus patient developed unconsciousness and convulsions after administration
of insulin. What result of blood glucose analysis is the most likely in this case?
A. *1.5 mmol/L
B. 3.3 mmol/L
C. 8 mmol/L
D. 5.5 mmol/L
E. 10 mmol/L
103. The patient exhausted by starvation presents with intensification of the following process in
the liver and kidneys:
A. *Gluconeogenesis
B. Uric acid synthesis
C. Urea synthesis
D. Hippuric acid synthesis
E. Bilirubin synthesis
104. There is a large amount of glucose oxidation metabolites dissolved in the cytoplasm of
myocytes. Name one such metabolite that converts directly into lactate:
A. Pyruvate
B. Glycerophosphate
C. Glucose 6-phosphate
D. Fructose 6-phosphate
E. Oxaloacetate
105. A nurse mistakenly gave nearly a double dose of insulin to a patient with diabetes mellitus,
which caused hypoglycemic coma in the patient. What medicine should be administered to bring
the patient out of the coma?
A. Glucose
B. Noradrenaline
C. Insulin
D. Somatotropin
E. Lidase
106. A person has diabetes mellitus with fasting hyperglycemia of over 7.2 mmol/L. What blood
plasma protein allows for retrospective assessment (4-8 weeks before the examination) of
glycemia levels?
A. Glycated hemoglobin
B. Fibrinogen
C. C-reactive protein
D. Albumin
E. Ceruloplasmin
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107. Some adults develop signs of dyspepsia after drinking milk. What enzyme deficiency is
associated with milk intolerance?
A. Lactase
B. Maltase
C. Peptidase
D. Lipase
E. Amylase
108. During an intense workout, the number of trophic inclusions in the cells of the athlete’s
liver and skeletal muscles decreases. What substance belongs to such trophic inclusions?
A. Glycogen granules
B. Melanin granules
C. Starch granules
D. Lipofuscin granules
E. Oxalic acid crystals
109. A patient was brought by an ambulance to the inpatient department. He was provisionally
diagnosed with acute pancreatitis. To confirm this diagnosis, it is necessary to measure the
activity of a certain enzyme in the patient’s blood and urine. Name this enzyme:
A. Alpha-amylase
B. Choline esterase
C. Aspartate transaminase
D. Alanine transaminase
E. Lactate dehydrogenase
110. A 7-year-old girl has signs of anemia. Laboratory testing determined the deficiency of
pyruvate kinase in her erythrocytes. In this case the main role in anemia development belongs to
the disturbance of a certain process. What process is disturbed in this girl?
A. Anaerobic glycolysis
B. Oxydative phosphorylation
C. Tissue respiration
D. Peroxide decomposition
E. Amino acid deamination
111. An experiment demonstrates that Jensen sarcoma leads to a significant increase in glucose
uptake from the tumor afferent artery, while tumor efferent vein has high levels of lactic acid.
This phenomenon indicates:
A. Intensified anaerobic glycolysis
B. Intensified protein oxidation
C. Intensified oxidizing processes
D. Decreased anaerobic glycolysis
E. Decreased oxidizing processes
112. Various substances can be used as anticoagulants. Among them there is a certain naturally
derived polysaccharide. Name this polysaccharide:
A. Heparin
B. Dextran
C. Hyaluronic acid
D. Chondroitin sulfate
E. Dermatan sulfate
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113. Urinalysis shows glucosuria in a patient with diabetes mellitus. What is the renal threshold
for glucose?
A. 8.88 mmol/L
B. 5.55 mmol/L
C. 20.0 mmol/L
D. 15.5 mmol/L
E. 1.0 mmol/L
114. It has been established that from the same amount of glucose a tumor tissue receives 20-25 times less
energy than a healthy cell. This phenomenon indicates the following change in the tumor glucose
metabolism:
A. Intensified anaerobic glycolysis
B. Intensified tissue respiration
C. Intensified oxidative processes
D. Normal ratio of the processes
E. Decreased anaerobic respiration
Lipid metabolism
1. A patient complains of bad feeling after a meal of fatty food. They have frequent diarrhea, loss
of weight. Causes of those events may be all the below mentioned except:
А. Pancreatitis В. Enterocolitis *С. Gastritis
D. Cholelithiasis E. Hepatitis
2. A patient has vomiting and steatorrhea after a meal of fatty food. The cause of that state may
be:
A. Deficiency of amylase
B. Increased secretion of lipase
C. Disturbance of phospholipase synthesis
D. Disturbance of trypsin synthesis
*E. Deficiency of bile acids
3. Fatty liver is prevented by lipotropic substances. Which of the below mentioned substances
belongs to those?
* A. Methionine
B. Cholesterol
C. Bilirubin
D. Glycine
E. Glucose
4. Synthesis of phospholipids is disturbed in fatty liver. Which of the below mentioned
substances can stimulate the processes of methylation in synthesis of phospholipids?
*A. Methionine
B. Vitamin C
C. Glucose
D. Glycerol
E. Citrate
5. Pheochromocytoma is observed in the organism of 35 year-old man. The increased levels of
adrenaline and noradrenaline were found in his blood. The concentration of fatty acids is
increased by 11 times. Which enzyme activation enhances lipolysis under the action of
adrenaline?
*A. TAG-lipase
B. Lipoprotein lipase
C. Phospholipase A
D. Phospholipase C
E. Cholesterol esterase
6. The woman, age 40, complained of thirst and enhanced appetite. She was delivered to the
endocrine clinic with diagnose of diabetes mellitus. Which pathologic components can be
identified during the laboratory analysis?
A. Protein, ketone bodies
B. Protein, creatine
*C. Glucose, ketone bodies
D. Bilirubin, urobilin
E. Blood
7. Aerobic oxidation of substrates is characteristic for cardiac muscle. Indicate the main one of
the mentioned below.
*A. Fatty acids
B. Triacylglycerols
C. Glycerol
D. Glucose
E. Amino acids
8. The use of medicine that contains carnitine is recommended to an athlete to increase
their sport results. What process is activated by carnitine at the most degree?
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A. Ketone bodies synthesis
B. Tissue respiration
C. Lipid synthesis
*D. Transport of fatty acid to mitochondria
E. Steroid hormone synthesis
9. Colloidal properties of bile are disturbed in inflammatory processes of gallbladder. This can
result in the formation of bile stones. Which substance crystallization is the basic cause of their
formation?
A. Urates
B. Chlorides
*C. Cholesterol
D. Oxalates
E. Phosphates
10. A 57-year-old man, suffering from diabetes mellitus develops ketoacidosis. The
biochemical cause of this state is the decreased level of acetyl-CoA utilization due to the
deficiency of:
A. α- ketoglutarate
*B. Oxaloacetate
C. Glutamate
D. Aspartate
E. Succinate
11. One of the diabetes mellitus symptoms is the increase in ketone bodies blood level.
This results in metabolic acidosis. What substance are ketone bodies synthesized from?
A. Methylmalonyl-CoA
B. Succinyl-CoA
C. Propionyl-CoA
D. Malonyl-CoA
*E. Acetyl-CoA
12. A patient feels discomfort in their stomach after having eaten fatty food. The
feces contain indigested drops of fat. The urinal bile acids test is positive. What substance
deficit causes this state?
A. Phospholipids B. Fatty acids C. Chylomicrones D. Triacylglycerols
*E. Bile acids
13. A patient suffers from arterial hypertension, atherosclerotic impairment of vessels.
Which lipid must they be recommended to reduce in their diet?
A. Lecithin
B. Oleic acid
*C. Cholesterol
D. Monooleateglyceride
E. Phosphatidylserine
14. A man, age 35, develops pheochromocytosis. The epinephrine and norepinephrine as well
as blood concentration of free fatty acids is increased. Which enzyme activation by
epinephrine accelerates lipolysis?
*A. TAG- lipase
B. Lipoprotein lipase
C. Phospholipase A2
D. Phospholipase
E. Cholesterol esterase
15. The adipose tissue of organism is the main TAG depot. Simultaneously their synthesis
proceeds in the liver. What particles transport TAG from liver to adipose tissue?
A. Chylomicrons
*B. VLDL
C. LDL
D. HDL
E. Albumin complex
16. The patient organism diagnosis displayed increased blood serum level of LDL.
Which disease onset may be predicted?
A. Gastritis B. Kidney inflammation C. Acute pancreatitis *D. Atherosclerosis E. Pneumonia
17. The patient diagnosis displayed the following indices: sugar blood level – 16 mmol/l ,
ketone bodies blood level – 1.52 mmol/l , daily diuresis – 10 L/day , sugar urinal contents –
2%, urinal ketone bodies - +++. What is the disease?
A. Kidney diabetes
B. Diabetes insipidus
C. Steroid diabetes
*D. Diabetes mellitus
E. Cushing’s disease
18. After having eaten fatty food, a patient feels nausea, flabbiness; with time passing
steatorrhea appears. Cholesterol blood level – 9.2 mmol/l. What substance deficit causes the
state:
A. Fatty acids
B. TAG
*C. Bile acids D. Phospholipids
E. Chylomicrons
19. Fat infiltration of liver is caused by impaired synthesis of phospholipids. What
substance can enhance methylation processes in phospholipid synthesis.
*A. Methionine
B. Ascorbic acid
C. Glucose D. Glycerol
E. Citrate
20. The data of subjective and objective diagnosis allow to suggest the occurrence of
inflammation process in the patient gallbladder, the disturbance of bile colloidal
properties and the possibility of bile stones formation. What may cause the bile stones
formation?
*A. Cholesterol
B. Urates
C. Oxalates
D. Chlorides
E. Phosphates
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21. A patient, age 65, with general obesity and liver fat dystrophy onset plausibility. They
are recommended to use the diet enriched with lipotropic substances, amongst which the
main compound is :
A. Vitamin C
B. Cholesterol
C. Glucose
*D. Methionine
E. Glycine
22. Arachidonic acid is an essential component of the diet. It serves as a precursor of
biologically active substances. Which substance is synthesized from arachidonic acid?
A. Ethanolamine
B. Choline
C. Norepinephrine
* D. Prostaglandin E1
E. Triiodothyronine
23. The patients’ blood plasma was cloudy while being investigated in 4 hours after the patient
had eaten fatty food. Which substance level is increased in the blood plasma which causes the
state:
A. HDL
*B. Chylomicrons
C. LDL
D. Cholesterol
E. Phospholipids
24. What enzyme insufficient secretion causes the impaired digestion of lipids in gastrointestinal tract and the appearance of the large quantities of neutral fats in feces.
A. Pepsin
B. Phospholipase C. Enterokinase
D. Amylase
*E. Pancreatic lipase
25. A baby, age 1, was admitted to the clinics with the features of muscle impairment. The
observation revealed the deficiency of carnitine in muscles. Which process is impaired
*A. Fatty acid transport to mitochondria
B. Ca2+ level regulation in mitochondria
C. Substrate phosphorylation
D. Uric acid utilization
E. Actin and myosin synthesis
26. The preventive radioprotector was given to a worker of a nuclear power station. What
mechanism from the below mentioned is considered to be the main mechanism of
radioprotection?
A. Activation of oxidation reactions
B. Prevention of tissue's hypoxia
C. Increasing of tissue blood supply
*D. Inhibition of free radicals formation
E. Increasing of respiration
27. A l-year-old child with symptoms of muscle dystrophy was admitted to the hospital. The
clinical examination revealed carnitine deficiency in muscles. What process disturbance is the
biochemical basis of this pathology?
A. Actin and myosin synthesis
B. Regulation of Ca2+ level in mitochondrion
C. Substrate phosphorylation
D. Lactic acid utilization
*E. Transporting of fatty acids to mitochondrion
28. Examination of cell culture got from a patient with lysosomal pathology revealed
accumulation of great quantity of lipids in the lysosomes. What of the following diseases is this
disturbance typical for?
A. Phenylketonuria B. Galactosemia C. Gout *D. Tay-Sach’s disease E. Wilson disease
29. A patient has a disturbed absorption of fat hydrolysates. It might have been caused by a
deficit in the small intestine cavity of:
A. Bile pigments
B. Sodium ions
*C. Bile acids
D. Lipolytic enzymes
E. Fat-soluble vitamins
30. A 58-year-old patient suffers from the cerebral atherosclerosis. Examination revealed
hyperlipidemia. What class of lipoproteins will most probably show increase in concentration in
this patient's blood serum?
A. Cholesterol
B. Chylomicrons
C. Fatty acid complexes with albumins
D. High-density lipoprotein
*E. Low-density lipoproteins
31. A 67-year-old patient has atherosclerosis of cardiac and cerebral vessels. Examination
revealed hyperlipidemia. What class of blood plasma lipoproteins is most important in
atherosclerosis pathogenesis?
A. *Low-density lipoproteins
B. α- lipoproteins
C. High-density lipoproteins
D. Chylomicrons
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32. A patient has symptoms of atherosclerosis. What plasma lipid transport forms should have an
increased concentration?
A. *LDL
B. HDL
C. IDL
D. VLDL
E. Chylomicrons
33. Steatosis is caused by accumulation of triacylglycerols in hepatocytes. One of the
mechanisms of this disease is to reduce the utilization of neutral fat VLDL. What lipotropic
substances prevent the steatosis development?
A. *Methionine, B6, B12
B. Arginine, B2, B3
C. Alanine, B1, PP
D. Valine, B3, B2
E. Isoleucine, B1, B2
34. Deficiency of linoleic and linolenic acids in an organism induces skin damages, hair loss,
slow wound healing, thrombocytopenia, low resistance to infectious diseases. These symptoms
are most likely to be caused by the disturbed synthesis of the following substances:
A. *Eicosanoids
B. Interleukins
C. Interferons
D. Catecholamines
E. Corticosteroids
35. A sportsman needs to improve his sporting results. He was recommended a drug containing
carnitine. What process is activated by this compound in the first place?
A. *Transport of fatty acids
B. Transport of amino acids
C. Transport of calcium ions
D. Transport of glucose
E. Transport of vitamin K
36. A patient suffers from hypertension and atherosclerosis. He should reduce the consumption
of the following lipid:
A. *Cholesterol
B. Oleic acid
C. Lecithin
D. Monooleate glyceride
E. Phosphatidyl serine
37. A patient with high obesity was recommended to take carnitine as a food additive for better
fat burning. What function is fulfilled by carnitine in the process of fat oxidation?
A. *Transport of fatty acids from the cytosol to the mitochondria
B. Transport of fatty acids from the fat depots to the tissues
C. Participation in one of the reactions of beta-oxidation of fatty acids
D. Fatty acid activation
E. Intracellular lipolysis activation
38. 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:
A. *Fat absorption
B. Fat hydrolysis
C. Biliary excretion
D. Choleresis
E. Lipase secretion
39. One of the factors that causes obesity is the inhibition of fatty acids oxidation due to:
A. *Low level of carnitine
B. Impaired phospholipid synthesis
C. Excessive consumption of fatty foods
D. Choline deficiency
E. Lack of carbohydrates in the diet
40. The genetic defect of pyruvate carboxylase deficiency is the cause of delayed physical and
mental development and early death in children. This defect is characterized by lacticemia,
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lactaciduria, disorder of a number of metabolic pathways. In particular, the following process is
inhibited:
A. *Citric acid cycle and gluconeogenesis
B. Glycolysis and glycogenolysis
C. Glycogenesis and glycogenolysis
D. Lipolysis and lipogenesis
E. Pentose phosphate pathway and glycolysis
41. A 67-year-old male patient consumes eggs, pork fat, butter, milk and meat. Blood test
results: cholesterol – 12.3 mmol/l, total lipids – 8.2 g/l, increased low density lipoprotein fraction
(LDL). What type of hyperlipoproteinemia is observed in the patient?
A. *Hyperlipoproteinemia type IIa
B. Hyperlipoproteinemia type I
C. Hyperlipoproteinemia type IIb
D. Hyperlipoproteinemia type IV
E. Cholesterol, hyperlipoproteinemia
42. Due to the blockage of the common bile duct (which was radiographically confirmed), the
biliary flow to the duodenum was stopped. We should expect the impairment of:
A. *Fat emulsification
B. Protein absorption
C. Carbohydrate hydrolysis
D. Secretion of hydrochloric acid
E.
Salivation inhibition
43. 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:
A.*HDL
B. VLDL
C. IDL
D. LDL
E. Chylomicrons
44. 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:
A. *Low density lipoproteins
B. High density lipoproteins
C. Chylomicrons
D. Very low density lipoproteins
E. Intermediate density lipoproteins
45. Cholesterol content in blood serum of 12-year-old is 25 mmol/l. Anamnesis states hereditary
familial hypercholesterolemia caused by synthesis disruption of receptor-related proteins for:
A. *Low-density lipoproteins
B. High-density lipoproteins
C. Middle-density lipoproteins
D. Very low-density lipoproteins
E. Chylomicrons
46. Increased HDL levels decrease the risk of atherosclerosis. What is the mechanism of HDL
anti-atherogenic action?
A. *They remove cholesterol from tissues
B. They supply tissues with cholesterol
C. They are involved in the breakdown of cholesterol
D. They activate the conversion of cholesterol to bile acids
E. They promote absorption of cholesterol in the intestine
47. A drycleaner’s worker has been found to have hepatic steatosis. This pathology can be
caused by the disruption of synthesis of the following substance:
A. *Phosphatidylcholine
B. Tristearin
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C. Urea
D. Phosphatidic acid
E. Cholic acid
48. A 39-year-old female patient with a history of diabetes was hospitalized in a precomatose
state for diabetic ketoacidosis. This condition had been caused by an increase in the following
metabolite level:
A. *Acetoacetate
B. Citrate
C. Alpha-ketoglutarate
D. Malonate
E. Aspartate
49. Disruption of nerve fiber myelinogenesis causes neurological disorders and mental
retardation. These symptoms are typical for hereditary and acquired alterations in the metabolism
of:
A. *Sphingolipids
B. Neutral fats
C. Higher fatty acids
D. Cholesterol
E. Phosphatidic acid
50. Obesity is a common disease. The aim of its treatment is to lower content of neutral fats in
the body. What hormone-sensitive enzyme is the most important for intracellular lipolysis?
A. *Triacylglycerol lipase
B. Diacylglycerol lipase
C. Monoacylglycerol lipase
D. Adenylate kinase
E. Protein kinase
51. A 3-year-old girl with mental retardation has been diagnosed with sphingomyelin lipidosis
(Niemann-Pick disease). In this condition synthesis of the following substance is disrupted:
A. *Sphingomyelinase
B. Gangliosides
C. Ceramides
D. Glycosyltransferase
E. Sphingosine
52. The key reaction of fatty acid synthesis is production of malonyl-CoA. What metabolite is
the source of malonyl-CoA synthesis?
A. *Acetyl-Co
B. Citrate C. Succinyl-CoA
D. Malonate
E. Acyl-CoA
53. Blood of the patients with diabetes mellitus shows increased content of free fatty acids.
Name the most likely cause of this:
A. *Increased activity of adipose triglyceride lipase
B. Accumulation of palmitoyl-CoA in cytosol
C. Activation of ketone bodies utilization
D. Activation of apoА1, apoА2, and apoА4 apolipoprotein synthesis
E. Decreased activity of plasma phosphatidylcholine-cholesterolacyltransferase
54. A 2-year-old child presents with acute psychomotor retardation, vision and hearing
impairment, sharp enlargement of the liver and spleen. The child is diagnosed with hereditary
Niemann-Pick disease. What genetic defect is the cause of this disease?
A. *Sphingomyelinase deficiency
B. Glucose 6-phosphatase deficiency
C. Amylo-1,6-glucosidase deficiency
D. Acid lipase deficiency
E. Xanthine oxidase deficiency
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55. A patient presents with steatorrhea. This disorder can be linked to disturbed supply of the
intestine with the following substances:
A. *Bile acids
B. Carbohydrates
C. Trypsin
D. Chymotrypsin
E. Amylase
56. Roentgenologically confirmed obstruction of common bile duct resulted in preventing bile
from inflowing to the duodenum. What process is likely to be disturbed?
A. *Fat emulgation
B. Protein absorption
C. Carbohydrate hydrolysis
D. Hydrochloric acid secretion in stomach
E. Salivation inhibition
57. Stool test detects in the patient’s feces a large amount of undigested fats. This patient is the
most likely to have disturbed secretion of the following enzymes:
A. *Pancreatic lipases
B. Bile lipase
C. Pancreatic proteases
D. Gastric protease
E. Pancreatic amylase
58. Blood of the patients with diabetes mellitus shows increased content of free fatty acids.
Name the most likely cause of this:
A. *Increased activity of adipose triglyceride lipase
B. Accumulation of palmitoyl-CoA in cytosol
C. Decreased activity of plasma phosphatidylcholine-cholesterol-acyltransferase
D. Activation of ketone bodies utilization
E. Activation of apoAl, apoA2, and apoA4 apolipoprotein synthesis
59. A patient is diagnosed with glucocerebroside lipidosis (Gaucher's disease) that manifests as
splenomegaly, liver enlargement, affected bone tissue, and neuropathies. What enzyme of
complex lipid catabolism is deficient, thus causing this disease?
A. *Glucocerebrosidase
B. Hyaluronidase
C. Sphingomyelinase
D. β-galactosidase
E. Hexosaminidase
60. Blood serum of the patient has milky appearance. Biochemical analysis revealed high
content of triacylglycerols and chylomicrons. This condition is caused by hereditary defect of
the following enzyme:
A. *Lipoprotein lipase
B. Phosphodiesterase
C. Adipose tissue hormone-sensitive lipase
D. Phospholipase
E. Pancreatic lipase
61. Various substances can be used as anticoagulants. Among them there is a certain naturally
derived polysaccharide. Name this polysaccharide:
A. *Heparin
B. Dextran
C. Hyaluronic acid
D. Dermatan sulfate
E. Chondroitin sulfate
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62. A child presents with hepatomegaly, hypoglycemia, and convulsions those occur
predominantly during fasting or in stress-inducing situations. The child is diagnosed with von
Gierke’s disease (glycogen storage disease type ). What enzyme is affected by the genetic defect
that is the cause of this disease?
A. *Glucose 6-phosphatase
B. Phosphoglucomutase
C. Glycogen phosphorylase
D. Amylo-1.6-glycosidase
E. Glucokinase
63. A 37-year-old woman presents with fructosemia and fructosuria. Her blood glucose is 2.1
mmol/L. She is diagnosed with fructose intolerance. What congenital enzyme deficiency is the
molecular basis of this disease?
A. *Fructose 1-phosphate aldolase
B. Phosphofructokinase
C. Triose phosphate isomerase
D. Hexokinase
E. Phosphoglucomutase
64. A 30-year-old woman has developed sings of virilism (body hair growth, balding temples, a
disturbed menstrual cycle). This condition can be caused by hyperproduction of the following
hormone:
A. *Testosterone
B. Relaxin
C. Prolactin
D. Estriol
E. Oxytocin
65. A patient was diagnosed with a genetic disorder leading to lipoprotein lipase deficiency.
What finding will be characteristic of biochemical blood analysis in the case?
A. *Hypertriacylglycerolemia
B. Hypochylomicronemia
C. Hyperglycemia
D. Hypoglycemia
E. Hypotriacylglycerolemia
66. A patient with Cushing’s syndrome presents with persistent hyperglycemia and glycosuria.
This patient is likely to have increased production and secretion of the following hormone:
A. *Cortisol
B. Adrenaline
C. Aldosterone
D. Thyroxine
E. Glucagon
67. A patient of tall stature with drooping lower lip, big nose, and large extremities has made an
appointment with the doctor. What gland is likely to present with excessive secretion in this
patient?
A. *Anterior lobe of the pituitary gland
B. Parathyroid glands
C. Pineal gland
D. –
E. Thyroid gland
68. A woman was diagnosed with peptic ulcer of the stomach. She has a long history of
rheumatoid arthritis. What drugs are the likely cause of this disease in the patient?
A. *Glucocorticoids
B. Antibiotics
C. Antihypertensive
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D. Antihistamines
E. H2 blockers
69. On clinical examination a woman presents with excessive sweating, tachycardia, loss of
weight, and tremor. What endocrine pathology can cause these sings?
A. *Hyperthyroidism
B. Hypogonadism
C. Hypothyroidism
D. Hypoaldosteronism
E. Hypergonadism
70. A 6-year-old girl exhibits marked signs of hemolytic anemia. Biochemical analysis of her
erythrocytes shows deficiency of glucose-6-phosphate dehydrogenase enzyme. What metabolic
process is disturbed in this patient and has leading role in the development of this pathology?
A. *Pentose phosphate pathway
B. Oxidative phosphorylation
C. Tissue respiration
D. Gluconeogenesis
E. Anaerobic glycolysis
71. In the experiment an investigator reveals that glucose is actively taken up by cells (except
brain cells). Moreover, gluconeogenesis in liver is inhibited and glycogen synthesis in liver and
muscles is increased. Which of the following hormones is most likely responsible for these
changes?
A. *Insulin
B. Aldosterone
C. Somatostatin
D. Glucagon
E. Triiodotryronine (T3)
72. During diabetes mellitus and starvation, the number of acetone bodies in blood increases.
These bodies are used as a source of energy and synthesized from the following substance:
A. *Acetyl-CoA
B. Succinyl-CoA
C. Malate
D. Citrate
E. Ketoglutarate
73. A 3-year-old child with elevated body temperature has taken aspirin and developed increased
hemolysis of erythrocytes. In this case hemolytic anemia can be caused by congenital deficiency
of the following enzyme:
A. *Glucose -6-phosphate dehydrogenase
B. Glycerol phosphate dehydrogenase
C. Glucose - 6-phosphatase
D. Glycogen phosphorylase
E. Gamma-glutamyltransferase
74. Chronic overdose of glucocorticoids leads to the development of hyperglycemia in a patient.
Name of process of carbohydrate metabolism that results in elevated blood glucose levels:
A. *Gluconeogenesis
B. Aerobic glycolysis
C. Pentose- phosphate pathway
D. Glycogenolysis
E. Gluconeogenesis
75. A laboratory rat with chronic kidney failure presents with osteoporosis, pathologic
calcification of the internal organs, and arterial hypertension. These disturbances are associated
with increased activity of the following hormone:
A. *Parathyroid hormone
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B. Triiodothyronine
C. Calcitonin
D. Thyroxin
E. Adrenaline
76. A patient for a long time was on an imbalanced diet low in proteins, which resulted in
hepatic fatty infiltration. This condition is likely to develop if a certain substance is absent in a
persons diet. Name this substance:
A. *Methionine
B. Acetic acid
C. Alanine
D. Cholesterol
E. Biotin
77. A 45-year-old woman exhibits no signs of diabetes mellitus, but her fasting blood glucose
levels are elevated (7.2 mmol/L). What should be measured next?
A. *Glucose tolerance
B. Blood urea
C. Glycated hemoglobin
D. Residual blood nitrogen
E. Urine glucose
78. A patient with diabetes mellitus after an insulin injection lost his consciousness and
developed convulsions. What will be the result of a biochemical test for blood glucose level in
this case?
A. *2.5 mmol/L
B. 8.0 mmol/L
C. 5.5 mmol/L
D. 3.3 mmol/L
E. 10 mmol/L
79. Patients with ischemic heart disease are usually prescribed small doses of aspirin. This drug
inhibits synthesis of platelet aggregation activator, thromboxane A2. What substance is this
activator synthesized from?
A. *Arachidonic acid
B. Malonic acid
C. Acetic acid
D. Glutamic acid
E. Homogentisic acid
80. A patient was hospitalized in a comatose state. The patient has a 5-year-long history of
diabetes mellitus type 2. Objectively respiration is noisy, deep. Blood glucose is 15.2 mmol/L,
ketone bodies – 100 micromol/L. These signs are characteristic of the following diabetes
complication:
A. *Hyperglycemic coma
B. Hypoglycemic coma
C. Ketoacidotic coma
D. Hepatic coma
E. Hyperosmolar coma
81. Human brain produces endogenous peptides that are similar to morphine and can reduce pain
perception. Name these peptides:
A. *Endorphins
B. Vasopressin
C. Oxytocin
D. Statins
E. Liberins
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82. A 54-year-old woman has a total thyroidectomy for papillary thyroid carcinoma. 11 hours
after operation she complains of tingling around her mouth. On physical examination, the
Trousseau’s sign and Chvostek’ sign are present. Her condition rapidly deteriorates with
laryngospasm and focal seizures. The surgeon suggests surgical destruction of parathyroid
glands. Which of following is the most likely cause of this patient’s neurologic abnormality?
A. *Hypocalcemia
B. Hyperchloremia
C. Hypophosphatemia
D. Hyponatremia
E. Hyperkalemia
83. A 45-year-old woman comes to her physician with complaints of excessive fatigue and
weakness. She says that these symptoms have been present for the past month. On further
questioning, she admits having lost 3 kilograms in the last 2 weeks. On physical examination,
she is a tired-appearing thin woman. Hyperpigmentation is present over many areas of her body,
most prominently over the face, neck and back of hands (areas exposed to light). Increased
production of the following hormones is the most likely cause of hyperpigmentation in this
patient?
A. *Melanocyte-stimulating hormone (MSH)
B. -Lipotropin
C. Gonadotropins
D. Thyroid-stimulating hormone (TSH)
E. Growth hormone (GH)
84. A mother of a 4-month-old male infant brought him to pediatrician with complaints of food
rejection and weight loss. He started having trouble latching onto his bottle. He has also become
extremely lethargic. Examination reveals diminished muscle tone in all four limbs, and
hepatosplenomegaly. An ophthalmoscopic exam reveals macular cherry red spots. During the
next few weeks, hepatosplenomegaly progresses, the boy fails to thrive, and he continues to
reject food. Chest X-ray shows a reticulonodular pattern and calcified nodules. Biopsy of the
liver shows foamy histiocytes. A Niemann-Pick disease is suspected. Which of the following is
the most likely deficient enzyme in this patient?
A. *Sphingomyelinase
B. Glucose-6-phosphatase
C. Galactocerebrosidase
D. Phenylalanine-hydroxylase
E. Glucocerebrosidase
85. On your physiology class, the professor asks you to report about the effects of various body
hormones and neurotransmitters on the metabolism of glucose. You begin your report with the
statement that the use of glucose by the cell is preceded by absorption trough the plasma
membrane from the extracellular matrix into the cell. Which of the following hormones is most
likely responsible for the glucose uptake by the cell?
A. *Insulin
B. Thyroxine
C. Aldosterone
D. Glucagon
E. Epinephrine
A. 352.
86. A 35-year-old woman has a history of two strokes. Her biochemical blood analysis shows
increased levels of antiphospholipid autoantibodies. Targeted phospholipids in this case include:
A. Cardiolipin
B. Prostaglandin
C. Cholesterol
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D. Sphingosine
E. Ceramide
87. The patient notes frequent diarrheas, especially after eating fatty food, and loss of weight.
Laboratory testing detected steatorrhea and hypocholic feces. What is the likely cause of this
condition?
A. Obturation of the bile ducts
B. Lipase deficiency
C. Imbalanced diet
D. Disturbed phospholipase activity
E. Inflammation of the small intestine mucosa
88. A woman complains that her child is unwell: the child developed loss of appetite, insomnia,
and irritability. Biochemical testing shows that there is no glucocerebrosidase enzyme in the
child’s blood. It is characteristic of the following pathology:
A. Gaucher disease
B. Tay-Sachs disease
C. Pompe disease (glycogen storage disease type II)
D. Niemann-Pick disease
E. Von Gierke disease (glycogen storage disease type I)
89. A 60-year-old man complains of pain in his lower abdomen and frequent stools. Stool
analysis shows increased levels of neutral fats in the patient’s feces. Incomplete digestion of fats
is caused by the deficiency of a certain enzyme. Name this enzyme:
A. Lipase
B. Maltase
C. Aminopeptidase
D. Enterokinase
E. Pepsin
90. Ketone bodies were detected in the urine of a patient. Ketone bodies appear in the urine
during the following disease:
A. Diabetes mellitus
B. Renal tuberculosis
C. Urolithiasis
D. Renal infarction
E. Acute glomerulonephritis
91. Increased levels of high-density lipoproteins lead to decreased risk of atherosclerosis. What
is the mechanism of anti-atherosclerotic effect of high-density lipoproteins?
A. They extract cholesterol from tissues
B. They supply tissues with cholesterol
C. They facilitate cholesterol absorption in the intestine
D. They activate cholesterol transformation into bile acids
E. They take part in cholesterol breakdown
92. Absence or insufficient production of lipotropic factors in the human body causes
development of fatty degeneration in the liver. What substance can be classified as lipotropic?
A. Choline
B. Fatty acids
C. Triacylglycerides
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D. Cholesterol
E. Riboflavin
93. After eating fatty foods, the patient develops nausea, heartburn, and steatorrhea. What is the
likely cause of this condition?
A. Bile acid deficiency
B. Increased lipase production
C. Disturbed phospholipase synthesis
D. Disturbed trypsin synthesis
E. Amylase deficiency
PART 3
METABOLISM OF PROTEINS AND NUCLEIC ACIDS
1. Patient was hospitalized with diarrhea after taking protein food. Physician believes the
disturbance of protein digestion which results in their intensified putrefaction. Which of the
below mentioned substances is the product of protein putrefaction in intestine?
А. Bilirubin
В. Lactate
С. Porphobilinogen
*D.Cadaverin
Е. Tryptophan
2. Patient has bad appetite, belching. Total acidity of gastric juice is 10 units. This state is
typical for:
A. Anacidic gastritis
B.Hyperacidic gastritis
C. Acute pancreatitis
*D. Hypoacidic gastritis
E. Stomach ulcer
3. The daily diet of the adult man should be composed of lipids, proteins, carbohydrates,
vitamins, mineral salts and water. Name the amount of protein, which ensures normal vital
activity of the organism.
*А. 100-120 g per day.
В. 50-60 g per day.
C. 10-20 g per day.
D. 70-80 g per day.
Е. 40-50 g per day.
4. In newborn the curdling milk (the conversion of soluble caseins into insoluble paracaseins) is
performed with participation of enzymes and calcium ions. Which enzyme participates in this
process?
A. Secretin B. Pepsin C. Gastrixin
*D. Rennin E. Lipase
5. Negative nitrogen balance was found in 45–year-old man after prolonged vegetable diet.
Which feature of diet is the cause of that state?
A. Excessive amount of water
B. Excessive amount of carbohydrates
*C. Insufficient amount of proteins
D. Insufficient amount of fats
E. Insufficient amount of fats and proteins
6. A child, 7 years old, was admitted to the hospital in state of an allergic shock, developed after
a sting of a wasp. In the blood concentration of histamine increased. What reaction does this
amine result from?
А. Reduction
В. Hydroxylation
С. Dehydrogenation
D. Deamination.
*Е.
Decarboxylation
7. Human organism has a peptide, which formation is performed with participation of γcarboxylic group of glutamic acid. What is the name of this peptide?
A.Vasopressin B.Carnosine
C.Anserine
D. Oxytocine
*E. Glutathione
8. Which food product should be excluded from diet in treatment by antidepressants – inhibitors
of MAO?
A. Beef
B. Cabbage
C. Potato
*D. Solid cheese
E. Apples
9. Psychopharmacologic drugs with antidepressant effect inhibit the oxidative deamination of
noradrenaline and serotonin in brain by means of inhibition of enzyme:
A. Oxidase of L-amino acids
B. Cytochrome oxidase
*C. Monoaminoxidase
D. Glutamate dehydrogenase
E. Oxidase of D-amino acid
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10. Pyridoxal phosphate was prescribed to patient according to clinical indices. Which processes
correction is used this preparation for:
А. Synthesis of purine and pyrimidine nucleotides
В. Oxidative decarboxylation of α-keto
acids
С. Deamination of amino acids *D. Transamination and decarboxylation of amino acids
Е. Protein synthesis
11. In hepatitis, myocardial infarction the transaminase activity sharply increases in blood
plasma of patients. Point the possible cause:
А. The increase of enzymes activity by hormones
*В. Damage of cellular membrane and entering enzymes to the blood
С. Deficiency of pyridoxine
D. The increase of amino acids synthesis velocity in tissues
Е. The increase of amino acids degradation velocity in tissues
12. Hyperargininemia and argininuria are observed in a 25-year-old patient. The urea level is
decreased in blood and urine. Which enzyme deficiency is observed?
A. Glutamate dehydrogenase
*B. Arginase
C. Ornithine carbamoyl transferase
D. Argininosuccinate synthetase
E. Tryptophan-5-monooxigenase
13. Olive green color appears after treatment of newborn child’s urine by FeCl3 solution. Which
amino acid metabolism disturbance is observed?
A. Histidine
B. Cysteine *C. Phenylalanine D. Glutamine E. Lysine
14. Albinos cannot stand sun impact – they don't acquire sun-tan but get sunburns. Point the
metabolic disturbance which is the base of this event:
A. Degradation of melanin
B. Disturbance of cholesterol transport *C. Lack of tyrosinase
D. Disturbance of serine hydroxylation
E. Degradation of vitamin D3
15. A 6-month-old infant has physical and mental retardation, a lighter hair, skin and iris, positive
Fellinge’s reaction. Which disease was revealed in infant?
A. Albinism
B. Down’s disease *C. Phenylketonuria D. Galactosemia
E.Alkaptonuria
16. In intestinal carcinoma about 60% of tryptophan is oxidized by means of serotonin pathway.
Which vitamin requirement increases in that state?
А. Folic acid
В. Pantothenic acid С. Pyridoxine D. Riboflavin *Е. Nicotinic acid
17. Alkaptonuria was diagnosed in patient. Which enzyme deficiency causes this pathology?
A. Phenylalanine hydroxylase
B. Tyrosinase C. Tyrosine hydroxylase
D. Monoaminoxidase
*E. Homogentisate oxidase
18. As an effect of ultra-violet rays the human skin darkens, which is defensive reaction of the
organism. What defensive substance – derivative of amino acids - is synthesized under influence
of ultra-violet rays?
A. Tyrosine B. Phenylalanine C. Tryptophan D. Vitamin D *E. Melanin
19. In urine of child the increased level of homogentisinic acid was found. The urine secreted
darkens in the air. Which pathology is this characteristic for?
А. Cystinuria B. Phenylketonuria C. Albinism *D. Alkaptonuria E. Amino aciduria
20. The urinary bladder cancer patient blood possesses high level of serotonin and
hydroxyantranilic acid. Which amino acid metabolism disturbance is this connected?
A.Phenylalanine *B.Tryptophan C. Tyrosine
D. Histidine
E. Alanine
21. The suppression of conversion of phenylalanine to tyrosine is observed in one of the
inherited pathologies. Biochemical indicator of disease is the accumulation in organism of some
organic acids, including:
*А. Phenylpyruvate B. Aspartate C. Pyruvate D. Lactate E. Glutamate
22. The Kreb’s citric acid cycle plays an important role in realization of glucoplastic effect of
amino acids. This is provided by obligatory transformation of their carbon skeletons into:
А. Citrate В. Succinate
C. Malate
*D. Оxaloacetate
Е. Fumarate
23. At repeated impact of ultra-violet rays the skin darkens owing to synthesizing melanin in it,
which protects cells from damage. The main mechanism to start the defensive activity is:
А. Depression of tyrosinase *В. Activation of tyrosinase
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С. Activation of oxidase of homogentisic acid
D. Depression of oxidase of homogentisic acid
Е. Depression of phenylalanine hydroxylase.
24. The diagnosis of the young man, 18 years, is muscle dystrophy. Which substance the
increased level in blood serum is the most possible in this pathology?
А. Myoglobin В. Myosin *С. Creatine
D. Lactate
Е. Alanine
25. The considerable increase of MB-form creatine kinase activity was found in patient’s blood.
Point a possible pathology:
А. Hepatitis *B. Myocardial infarction C. Rheumatism D. Pancreatitis E. Cholecystitis
26. Hormones and mediators are formed in metabolism of some amino acids. Which amino acid
metabolism leads to the formation of gas mediator NO?
A. Methionine
B. Leucine C. Glycine *D. Arginine E. Serine
27. A child complains of general weakness, easy fatigability. On examination high concentration
of valine, isoleucine, leucine in blood and urine has been detected. The urine has a spesific
smell. What can be the cause of this condition?
А. Histidinemia
В. Addison’s disease
С. Alkaptonuria
D. Phenylketonuria
*E. Maple syrup urine disease
28. The increase of urea and creatinine levels and the decrease of these parameters in the urine
were revealed in the patient. Point possible causes of that state:
*А. Renal disease
В. Liver disease С. Muscle disease
D. Disturbances of binding, transport and excretion of ammonia with urine
Е. Disturbance of acid-base balance
29. Obesity, necrotic changes in liver, adrenal gland insufficiency, low levels of phospholipids,
choline and adrenaline in blood are revealed in 32-year-old patient. The most possible cause of
that state development is the deficiency of:
A. Alanine *B. Methionine C. Valine D. Arginine
E. Glycine
30. Methyl groups are used in organism for the synthesis of the important substances such as
creatine, choline, adrenaline. The source of these groups is the essential amino acid:
A. Valine B. Glycine *C. Methionine D. Cysteine E. Arginine
31. A 57-year-old patient has ischemic disease of heart, arterial and venous thromboses, neuronal
and psychiatric disorders, renal insufficiency. The level of homocysteine in blood is 3.5 times
more than normal one (normal value is less than 10 mmol/l). The patient probably has:
А. Hartnup’s disease
B. Albinism
*C. Hyperhomocysteinemia
D. Alkaptonuria
E. Phenylketonuria
32. Patient shows the pain in small joints, joints are enlarged. Urate level is increased in the
blood serum. Which substances metabolism is disordered?
A. Amino acids.
B. Disaccharides.
*C. Purines.
D. Pyrimidines.
E. Glycerol
33. Child shows delay of grows and psychic development, high amount of orotic acid is exreted
with urine. This disease is observed as result of disorder of:
*A. Pyrimidine nucleotide synthesis.
B. Pyrimidine nucleotide breakdown.
C. Purine nucleotide synthesis
D. Purine nucleotide breakdown.
E. Convertion of ribonucleotides to desoxyribonucleotides.
34. Boy, 5 years, with signs of child cerebral paralysis is examined increased concentration of
uric acid in blood serum. Lesch-Nyhan syndrome is diagnosed. Which enzyme genetic defect is
the reason of such pathology occurrence?
A. UDP- glucuronyl transferase.
B. UDP-glycosyl transferase.
C. Hyaluronidase.
D. Lactate dehydrogenase.
*E. Hypoxantine guanine phosphoribosyl transferase.
35. Pterine derivatives – aminopterine and methotrexate - are competitive inhibitors of
dihydrofolate reductase, as result of which they depress tetrahydrofolic acid formation from
dihydrofolate. These drugs lead to inhibition of single-carbon group transport. Which nucleotide
biosynthesis is depressed?
A. IMP
B. UMP
C. AMP
D. Carbamoyl phosphate
*E. dTMP
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36. Child, 3 years, suffers by mental retardation and hard form of megaloblastic anemia, which is
resistant to treatment by vitamins B9 and B12. Orotic acid in urine is examined. Which substances
synthesis disorder is megaloblastic anemia caused by?
A. AMP, GMP
B. CTP
C. ATP
D. GTP
*E. UMP
37. Joints are enlarged in the patient. Urate content is increased in the blood. Point the pathology.
A. Rickets
B. Scurvy
C. Pellagra
D. Caries
*E. Gout
38. Which biochemical test should be performed to precise the diagnosis “gout”?
A. Examination of amino acid content in the blood
B. Examination of urea concentration in the blood and urine
C. Examination of creatinine content in the blood
D. Examination of uricase activity in the blood
*E. Examination of uric acid level in the blood and urine
39. Antibiotic rifamycin, which is used for tuberculosis treatment, influences to the several
biochemical processes. Point them.
A. Inhibits DNA- polymerase at the initiation stage
*B. Inhibits RNA- polymerase at the initiation stage
C. Inhibits DNA- ligase
D. Inhibits amino-acyl-tRNA- synthetase
E. Inhibits the protein factors action at the protein synthesis.
40. At the patients with pigment xeroderma skin is very sensitive to sunrise, cancer of skin can
develop. The reason is hereditary deficiency of enzyme UV-endonuclease. This defect leads to
disturbance of:
A. DNA replication
B. Transcription
*C. DNA repair
D. Translation
E. Reverse transcription
41. Patient with inflammation is recommended to use erythromycin, which binds with 50S
subunit of ribosome and blocks translocase. Inhibition of protein synthesis in prokaryotes occurs
at the stage:
A. Termination
B. Amino acids activation
*C. Elongation.
D. Posttranslational protein modification.
E. Initiation.
42. Worker of the chemical factory as result of infringement of prevention of accidents
regulations is influenced by nitrite acid and nitrites, which causes the cytosine deamination in
DNA molecule. Which enzyme starts the repair cascade?
A. CTP- synthetase
B. DNA-dependent-RNA-polymerase
*C. Uracil-DNA-glycosidase
D. Amino-acyl-tRNA- synthetase.
E. Glucose-6-phosphate dehydrogenase.
43. HIV-infection has been diagnosed at young man by polymerase reaction. What the main
principle of this reaction?
A. Genetic recombination
*B. Gene amplification
C. Transcription
D. Gene mutation
E. Chromosome mutation
44. To precise the diagnosis patient is recommended to make DNA investigation. Synthetic
primers are known to be used, which contains:
A. Desoxypibonucleotides
*B. Ribonucleotides
C. Amino acids
D. Pyrimidine nucleotides
E. Purine nucleotides
45. Abnormal hemoglobin M appears as result of change at the β-chain of globine amino acid
valine to glutamate at the 67 position. Which type of mutation in DNA?
*A. Missence mutation
B. Deletion of one nucleotide
C. Insertion of one nucleotide
D. Deletion of three nucleotides
E. Insertion of three nucleotides
46. A man, age50, has been under severe stress. The blood level of epinephrine is high. Which
enzyme deactivates the hormone?
A. Glucosidase *B. Monoamine oxidase C. Peptidase D. Carboxylase E. Tyrosinase
47. The organism produces nitrous acid from nitrates, nitrites and nitroamines, which conditions
oxidative deamination of nitrogen bases of nucleotides. This may lead to the local mutation – the
replacement of cytosine for:
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A. Thymine
B. Guanine
*C. Uracil
D. Adenine
E. Inosine
48. The urinary bladder cancer patient blood possesses high level of serotonin and
hydroxyantranilic acid. This is connected with the excessive delivery of an amino acid to the
organism. Name the amino acid.
*A. Tryptophan B. Alanine
C. Hystidine
D. Methionine
E. Tyrosine
49. A newborn rejects the mother breast, is overexcited, possesses arrhythmic breath. The urine
has a smell of beer yeast or marple syrup. Which enzyme hereditary defect causes this
pathology?
A. Aspartate aminotransferase
B.Glucose-6-phosphate dehydrogenase
C. Glycerol kinase *D. Branched -ketoacids degydrogenase E.UDP-glucuronyltransferase
50. A 6 day’s newborn possesses the excess of phenylpyruvate and phenylacetate in the urine.
Which amino acid metabolism is impaired?
A. Methionine
B. Tryptophan
*C. Phenylalanine
D. Hystidine
E. Arginine
51. A 12-year-old boy possesses decreased the level of uric acid and increased level of xanthine
and hypoxanthine in blood. Which enzyme genetic defect causes the state?
A. Arginase *B. Xanthine oxidase C. Urease D. Ornithine carbamoyltransferase
E.
Glycerolkinase
52. A 46-year-old woman suffers from progressive muscle dystrophy for a long time (Duchen’s
disease).Which enzyme activity level alterations in blood may be considered as a diagnostic test
at this case?
A. Lactate dehydrogenase
*B. Creatine phosphokinase
C. Pyruvate dehydrogenase
D. Glutamate dehydrogenase
E. Adenylate kinase
53. The known fact is that albinos get burns while sun tanning. Which amino acid metabolism
disturbance lies in the base of this phenomenon?
A. Glutamate
B. Methionine C. Tryptophan
*D. Phenylalanine
E. Histidine
54. Quinolones are the medicines that are used to cure urogenital infections. They are inhibitors
of DNA-gyrase. Which process is impaired primarily by their action?
A. Reverse transcription
B. Repair
C. Gene amplification
D. Gene recombination
*E. Replication
55. A patient with cerebral cranium trauma develops convulsive epileptomorphic seizures which
are repeated regularly. Which biogenic amine formation is disturbed at this state?
A. Hystamine
*B. GABA
C. Adrenaline
D. Serotonin
E. Dopamine
56. The urine of patient with alkaptonuria processes a great amount of homogentisinic acid.
Which enzyme hereditary defect is observed?
*A. Homogentisinic acid oxidase B. Alanine aminotransferase
C. Tyrosinase
D. Phenylalanine-4-monooxigenase
E. Tyrosine aminotransferase
57. Biogenic amines are used in clinical psychiatry to cure some CNS disease. Name the
medicine of this group which is an inhibitory neurotransmitter.
A. Dopamine
B. Histamine
C. Serotonin
*D. γ–Aminobutyric acid
E. Taurine
58. The experimental investigations established the influence of steroid hormones on protein
synthesis. Which stage of this process is influenced by them?
A. GTP synthesis
B. ATP synthesis
C. Specific tRNA synthesis
*D. Specific mRNA synthesis
E. Specific rRNA synthesis
59. Patients with Wilson’s disease (hepatolenticular degeneration) have decreased blood level of
ceruloplasmin. What is the consequence of the insufficiency of this transport protein?
A. Amino acid decarboxylation
B. Tissue protein breakdown
*C. Amino acids – copper complexes formation
D. Urea synthesis
E. Amino acid
transamination
60. A patient, age 50, is diagnosed with gout. The blood test reveals hyperuricemia. Which
substances metabolism is impaired?
*A. Purines B. Fats C. Amino acids
D. Carbohydrates
E. Pyrimidines
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61. A breast-fed baby develops the darkening of sclera, mycoses membranes, ears. Its urine gets
dark at the open air. The blood and urine tests reveal the presence of homogentisinic acid. What
is the diagnosis?
*A. Alkaptonuria
B. Albinism
C. Cysteinurea D. Porphyria E. Hemolytic anemia
62. A boy, age 9, was delivered to the clinics with the mental and physic retardation. The
biochemical blood test revealed the increased quantity of phenylalanine. Which enzyme
insufficient activity can lead to the state?
A. Glutamate decarboxylase
B. Homogentisinic acid oxidase
C. Glutamine
transaminase
D. Aspartate aminotransferase
*E. Phenylalanine-4-monooxygenase
63. A mother found out that her child’s urine has a very dark color. The child does not complain
of anything. The urine does not contain bile pigments. The diagnosis is alkaptonuria. Which
enzyme deficiency is observed?
A. Hydroxyphenylpyruvate oxydase B. Phenylalanine hydroxylase
C. Tyrosinase
*D. Homogentisinic acid oxydase
E. Phenylpyruvate decarboxylase
64. A patient with gout was delivered to the clinics. Which biochemical analysis must be held to
verify the diagnosis?
A. Amino acid determination in blood
B. Urea contents determination in blood and urine
C. Creatine level determination in blood
D. Uricase activity determination in blood
*E. Uric acid contents in blood and urine
65. A therapeutist has an appointment with a 40-year-old patient complaining of recurrent pain
attacks in his hallux joints and their swelling. Urine analysis revealed its marked acidity and pink
color. What substrances can cause such changes in urine?
A. *Uric acid salt
B. Chlorides
C. Calcium phosphate
D. Magnesium sulfate
E. Ammonium salts
66. Ammonia is a very toxic substance, especially for central nervous system. Which compound
takes exclusively active part in ammonia detoxification in brain tissue?
A. Lysine
*B. Glutamate
C. Proline
D. Histidine
E. Alanine
67. Biogenic amines – serotonin, dopamine etc. are very active substances, which influence on
different physiological functions of the organism. Which process forms biogenic amines in
organism tissues?
*A. Amino acid decarboxylation
B. Amino acid deamination
C. Amino acid
transamination
D. Amino acid oxidation
E. Reductive reamination
68. A patient, age 46, applied to the doctor complain of joints ache which responds to the
weather alterations. The blood test revealed the increased level of uric acid. Which substance
enhanced breakdown is the most probable reason of the patient’s state?
A. UTP
B. CTP
*C. AMP
D. UMP
E. TMP
69. The urine of a newborn reveals citrulline and high level of ammonia. Which substance
formation is most probably impaired?
A. Ammonia
B. Uric acid
*C. Urea
D. Creatinine
E. Creatine
70. A patient, age13, complains of feeling poorly, giddy, easy fatigability. The lagging in mental
progressing is observed. On examination high concentration of valine, isoleucine, leucine in
blood and urine has been detected. The urine has a particular smell. What can be the cause of this
condition?
А. Histidinemia
В. Addison’s disease
С. Tyrosinosis
*D. Maple syrup urine disease
Е. Diffuse toxic goiter
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71. A two-year-old boy with a frequent vomiting, especially after meal, was admitted to hospital.
The child does not gain weight, lags behind in physical progressing. The hair is dark, but with
gray-haired spins. Administer the proper treatment.
А. Introducing particular amino acid mixtures
В. Enzymatic therapy
С. The diet with lower content of phenylalanine
*D. The diet with higher content of carbohydrates (or lipids) and lower content of protein.
Е. Protein-free diet.
72. A man, 58 years old, has been operated on cancer of prostate. In 3 months he undergone
course of radio and chemotherapy. Complex of medicine included 5-fluorodeoxyuridine thymidylate synthase inhibitor. Synthesis of what substance is blocked first of all under influence
of this drug?
А. Protein В. mRNA С. rRNA.
D. tRNA *Е. DNA.
73. A man, 65 years old, suffering from gout, complains of a pain in the region of kidneys. On
ultrasonic examination the presence of renal stone was discovered. Increase of concentration of
what substance is the most probable cause for formation of stone in this case?
*А. Uric acid
В. Cholesterol
С. Bilirubin
D. Urea
Е. Cystine.
74. A man, 65 years old, suffering from gout, complains of a pain in the region of kidneys. On
ultrasonic examination the presence of renal stone was discovered. What process causes the renal
stone to be formed?
А. Ornithine cycle В. Catabolism of protein
*С. Degradation of purine nucleotides
D. Degradation of a heme Е. Reduction of cysteine
75. A women, 40 years old, came to the doctor with complaints on a pain in small joints of legs
and arms. The joints are augmented and look like dwarfed clusters. In serum of blood is
discovered increased content of urates. The cause is failure of metabolism of:
А. Amino acids *B. Purines
С. Carbohydrates D. Lipids
Е. Pyrimidines.
76. A child 10 months old, that parents are brunettes, has fair hair, very light skin and blue eyes.
His look at birth was normal, but within the last 3 months failure of blood circulation in the
brain, lagging in mental development were observed. The cause for such condition is:
*А. Phenylketonuria
В. Galactosemia.
С. Glycogenosis
D. Acute porphyria
E.
Histidinemia.
77. A baby has dark color of sclera, mucous membranes. The urine secreted darkens in the air. In
blood and urine the homogentisinic acid is detected. What can cause this state?
А.Cystinuria
В. Albinism
С. Galactosemia
*D. Alkaptonuria
E. Histidinemia
78. Allopurinol was administered to a patient with a gout. What pharmacological property of
allopurinol makes therapeutic effect in this case?
А. Acceleration of catabolism pyrimidine nucleotides
В. Increase of velocity of nitrogen substances excretion.
*С. Competitive inhibition of xanthine oxidase.
D. Retardation of reutilization of pyrimidine nucleotides.
Е. Acceleration of nucleic acids synthesis
79. For formation of the transport form of amino acids during protein synthesis on ribosomes the
following is necessary:
А. mRNA
В. GTP *С. Amino acyl-tRNA-synthetase D. Ribosome
Е. Revertase
80. For formation of the transport form of amino acids during protein synthesis on ribosomes the
following is necessary:
А. mRNA
В. Revertase
С. GTP
*D. tRNA Е. Ribosome
81. At poisoning with amanitine RNA-polymerase B (ІІ) is blocked. This ceases:
*А. Synthesis of mRNA В. Synthesis of tRNA
С. Reverse transcription.
D. Synthesis of primers
Е. Processing of mRNA.
82. Genetic apparatus of man contains about 30 thousand genes, and the amount of alternatives
of antibodies reaches millions. What mechanism will be utilized for formation of new genes,
which are responsible for synthesizing such number of antibodies?
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*А. Recombination of genes
В. Amplification of genes
С. Replication of DNA
D. Reparation of DNA
Е. Formation of Okazaki fragments
83. One of the forms of an inborn pathology is accompanied by retarded transformation of
phenylalanine in tyrosine. Biochemical sign of the disease is accumulation of some organic acids
in the organism, including:
*А. Phenylpyruvate
В. Citrate
С. Pyruvate
D. Lactate
Е. Glutamate
84. In a young man, 19 years old, signs of a depigmentation of the skin, conditioned by
disturbance of melanin synthesis, are present. Which amino acid metabolism disturbance causes
this condition?
А. Histidine
В. Tryptophan
*C. Tyrosine
D. Proline
Е. Glycine
85. At repeated impact of ultra-violet rays the skin darkens owing to synthesizing melanin in it,
which protects cells from damage. The main mechanism to start the defensive activity is:
А. Depression of tyrosinase
*В. Activation of tyrosinase
С. Activation of oxidase of homogentisic acid
D. Depression of oxidase of homogentisic
acid.
Е. Depression of phenylalanine hydroxylase
86. A man, 46 years old, consulted a doctor complaining of pain in smaller joints, which became
aggravated after meat food. The diagnosis for the patient was urolithiasis with accumulation of
uric acid. To this patient was administered allopurinol, which is competitive inhibitor of an
enzyme:
*А. Xanthine oxidase
В. Urease
С. Arginase
D. Dihydrouracildehydrogenase
Е. Carbamoyl synthetase.
87. Labelled amino acids of alanine and tryptophan were injected to the mouse blood in order to
study localization of protein synthesis in its cells. The labelled amino acids will be accumulated
near the following organellas:
A. Smooth endoplasmic reticulum
*B. Ribosomes
C. Lysosomes
D. Cell nucleas
E. Golgi apparatus
88. A 46 year old patient applied to a doctor complaining about joint pain that becomes stronger
the day before weather changes. Blood examination revealed increased concentration of uric
acid. The most probable cause of the disease is the intensified catabolism of the following
substance:
A. Uridine triphosphate
B. Thymidine monophosphate
C. Uridine monophosphate
*D. Adenosine monophosphate
E. Cytidine monophosphate
89. A cerebral trauma caused increased ammonia generation. Which amino acid participates in
the detoxification of ammonia from the brain?
*A. Glutamic
B. Lysine
C. Tyrosine
D. Tryptophan
E. Valine
90. It was revealed that T-lymphocytes were affected by HIV. Virus enzyme reverse
transcriptase (RN A –dependent DNA polymerase) - catalyzes the synthesis of:
A. Viral DNA on DNA matrix
B. Viral RNA on the matrix of DNA
*C. DNA on viral RNA
D. RNA on the matrix of virus RNA
E. mRNA on the matrix of virus protein
91. Pharmacological effects of antidepressants are connected with inhibition of an enzyme
catalyzing biogenic amines noradrenaline and serotonin breakdown in mitochondria of cerebral
neurons. What enzyme participates in this process?
A. Lyase
*B. Monoamine oxidase
C. Transaminase
D. Peptidase
E. Decarboxylase
92. An oncological patient was prescribed methotrexate. With the lapse of time target cells of the
tumour lost susceptibility to this drug. There is change of gene expression of the folowing
enzyme:
A. Thiaminase
B. Deaminase
*C. Dihydrofolate reductase
D. Folate decarboxylase
E. Folate oxidase
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93. It was proved that a molecule of immature mRNA (precursor mRNA) contained more triplets
than amino acids found in the synthesized protein. Which process precedes translation?
*A. Processing
B. Initiation
C. Reparation
D. Replication
E. Mutation
94. It was found out that some compounds, for instance fungi toxins and some antibiotics can
inhibit activity of RNA-polymerase. What process will be disturbed in a cell in case of inhibition
of this enzyme?
A. Reparation
B. Translation
*C. Transcription
D. Replication
E.
Processing
95. Plasma factors of blood coagulation are exposed to post-translational modification with the
participation of vitamin K. It is necessary as a cofactor in the enzyme system of γ-carboxylation
of protein factors of blood coagulation due to the increased affinity of their molecules to calcium
ions. What amino acid is carboxylated in these proteins?
A. Valine
B. Arginine
C. Phenylalanine
*D. Glutamic
E. Serine
96. A patient has low rate of magnesium ions that are necessary for affixion of ribosomes to the
endoplasmic reticulum. It is known that it causes disturbance of protein biosynthesis. At what
stage is protein biosynthesis impaired?
A. Termination
*B. Translation
C. Amino acid activation
D. Replication
E. Transcription
97. A denaturation of proteins can be found in some substances. Specify the substance that is
used for the incomplete denaturation of hemoglobin:
A. Toluene
B. Sulfuric acid
C. Nitric acid
*D. Urea
E. Sodium hydroxide
98. M-r S presents all signs of the hepatic coma: loss of consciousness, absence of reflexes,
cramps, convulsion, disorder of heart activity, recurrent (periodical) respiration. What are
cerebrotoxical substances which accumulate in blood under hepatic insufficiency?
A. Autoantibody
B. IL-l
C. Necrosogenic substances
*D. Ammonia
E. Ketonic body
99. A patient with encephalopathy was admitted to neurological department. Correlation of
increasing encephalopathy and substances absorbed by the bloodstream from the intestines was
revealed. What substances created in the intestines can cause endotoxemia?
A. Biotin
*B. Indole
C. Ornithine
D. Butyrate
E. Acetacetate
100. Methotrexate (structural analogue of the folic acid which is competitive inhibitor of the
dihydrofolatreductase) is prescribed for treatment of the malignant tumor. On which level does
methotrexate hinder synthesis of the nucleic acids?
A. Processing
B. Mononucleotide synthesis
C. Transcription
D. Reparation
*E. Replication
101. Nowadays about 50 minor bases have been found ill the t-RNA structure besides the main
four nitrogenous bases. Choose the minor nitrogenous base:
A. Adenine
B. Cytosine
C. Cysteine
D. Uracil
*E. Dihydrouracil
102. Synthesis of phospholipids is disordered under the liver fat infiltration. Indicate which of
the following substances can enhance the process of methylation during phospholipids synthesis?
A. Citrate
B. Ascorbic acid
*C. Methionine
D. Glycerin
E. Glucose
103. An experiment proved that UV-radiated cells of patients with xeroderma pigmentosum
restore the native DNA structure slower than cells of healthy individuals as a result of reparation
enzyme defection. What enzyme helps this process?
A. Primase
B. DNA polymerase III
C. DNA hyrase
D. RNA ligase
*E. Endonuclease
104. A doctor administered Allopurinol to a 26-year-old young man with the symptoms of gout.
What pharmacological action of Allopurinol ensures therapeutical effect?
A. By inhibiting leucocyte migration into the joint
B. By general analgetic effect
C. By increasing uric acid excretion
D. By general anti-inflammatory effect
*E. By inhibiting uric acid synthesis
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105. After a serious viral infection a 3-year-old child has repeated vomiting, loss of
consciousness, convulsions. Examination revealed hyperammoniemia. What may have caused
changes of biochemical blood indices of this child?
A. Inhibited activity of transamination enzymes
*B. Disorder of ammonia neutralization in ornithine cycle
C. Disorder of biogenic amines neutralization
D. Activated processes of amino acids decarboxylation
E. Increased putrefaction of proteins in intestines
106. A 30-vear-old woman was diagnosed with insufficiency of exocrine function of pancreas.
Hydrolysis of what nutrients will be disturbed?
A. Proteins
B. Fats, carbohydrates
C. Proteins, carbohydrates
D. Proteins, fats
*E. Proteins, fats, carbohydrates
107. A patient with serious damage of muscular tissue was admitted to the traumatological
department. What biochemical urine index will be increased in this case?
*A. Creatinine
B. Uric acid
C. Glucose
D. Common lipids
E. Mineral salts
108. RNA-polymerase B(II) is blocked due to amanitine poisoning (poison of deathcup). It
disturbs:
A. Synthesis of t-RNA
*B. Synthesis of mRNA
C. Maturation of mRNA
D. Primers synthesis
E. Reverse transcription
109. Cerebral trauma caused increase of ammonia formation. What amino acid takes part in
removal of ammonia from cerebral tissue?
*A. Glutamic
B. Tryptophan
C. Tyrosine
D. Valine
E. Lisine
110. RNA that contains HIV penetrated into a leukocyte and by means of reverse transcriptase
forced a cell to synthesize a viral DNA. This process is based upon:
A. Operon repression
B. Operon depression
*C. Reverse transcription
D. Convariant replication
E. Reverse translation
111. In some regions of South Africa there is a spread sickle-shaped cell anemia, in which
erythrocytes have shape of a sickle as a result of substitution of glutamate by valine in the
hemoglobin molecule. What is the cause of this disease?
A. Genome mutations B. Crossingover
*C. Gene mutation
D. Transduction
E. Disturbance of mechanisms of genetic information realization
112. A patient diagnosed with carcinoid of bowels, was admitted to the hospital. Analysis
revealed high production of serotonin. It is known that this substance is formed of tryptophan
amino acid. What biochemical mechanism underlies this process?
A. Microsomal oxidation
B. Formation of paired compounds
C. Desamination
*D. Decarboxylation
E. Transamination
113. A 4 y.o. boy has had recently serious viral hepatitis. Now there are such clinical
presentations as vomiting, loss of consciousness, convulsions. Blood analysis revealed
hyperammoniemia. Disturbance of which biochemical process caused such pathological
condition of the patient?
*A. Disturbed neutralization of ammonia in liver
B. Inhibition of transamination enzymes
C. Increased putrefaction of proteins in bowels
D. Activation of amino acid decarboxylation
E. Disturbed neutralization of biogenic amines
114. Nappies of a newborn have dark spots that witness of formation of homogentisic acid.
Metabolic imbalance of which substance is it connected with:
A. Methionine
*B. Tyrosine
C. Galactose
D. Tryptophan
E. Cholesterol
115. Ammonia is a very toxic substance, especially for nervous system. What substance takes the
most active part in ammonia detoxification in brain tissues?
*A. Glutamic acid
B. Alanine
C. Proline
D. Histidine
E. Lysine
116. A patient suffers from hepatic cirrhosis. Examination of which of the following substances
excreted by urine can characterize the state of antitoxic function of liver?
*A. Hippuric acid
B. Ammonium salts
C. Amino acids
D. Creatinine
E. Uric acid
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117. In course of histidine catabolism a biogenic amine is formed that has powerful vasodilating
effect. Name it:
*A. Histamine
B. Dopamine
C. Dihydroxyphenylalanine
D. Noradrenalin
E. Serotonin
118. Glutamate decarboxylation results in formation of inhibitory transmitter in CNS. Name it:
A. Serotonin
B. Histamine
C. Glutathione
D. Asparagine
*E. GABA
119. According to clinical indications a patient was administered pyridoxal phosphate. What
processes is this medication intended to correct?
A. Oxidative decarboxylation of keto acids
*B. Transamination and decarboxylation of amino acids
C. Desamination of purine nucleotide
D. Synthesis of purine and pyrimidine bases
E. Protein synthesis
120. A 1,5-year-old child presents with both mental and physical lag, decolorizing of skin and
hair, decrease in catecholamine concentration in blood. When a few drops of 5% FeCl3 solution
have been added to the child's urine it turned olive green. Such alterations are typical for the
following pathology of the amino acid metabolism:
A. Albinism
B. Tyrosinosis
C. Alkaptonuria
D. Xanthinuria
*E. Phenylketonuria
121. A newborn child was found to have reduced intensity of sucking, frequent vomiting,
hypotonia. Urine and blood exhibit increased concentration of citrulline. What metabolic process
is disturbed?
*A. Ornithine cycle
B. Cori cycle
C. Tricarboxylic acid cycle
D. Glyconeogenesis
E. Glycolysis
122. An oncological patient was treated by methotrexate. After some time the tumour cells lost
sensitivity to it. What enzyme gene expression changes in this case?
A. Folate oxidase
B. Folate decarboxylase
C Thiaminase
*D. Dihydrofolate reductase
E. Desaminase
123. Depressions and emotional insanities result from the deficiency of noradrenaline, serotonin
and other biogenic amines in the brain. Their concentration in the synapses may be increased by
means of the antidepressants that inhibit the following enzyme:
A. Phenylalanine-4-monooxygenase
B. Diamine oxidase
*C. Monoamine oxidase
D. D-amino-acid oxidase
E. L-amino-acid oxidase
124. You are studying functioning of a bacteria operon. The operator gene has been released from
the repressor gene. Immediately after this the following process will start in the cell:
*A. Transcription
B. Processing
С. Repression
D. Translation E. Replication
125. The greatest amount of nitrogen is excreted from the organism in form of urea. Inhibition of
urea synthesis and accumulation of ammonia in blood and tissues are induced by the decreased
activity of the following liver enzyme:
*A. Carbamoyl phosphate synthetase
B. Urease
C. Aspartate aminotransferase
D. Amylase
E. Pepsin
126. A 9-month-old infant is fed with artificial formulas with unbalanced vitamin B6
concentration. The infant presents with pellagra-like dermatitis, convulsions, anemia.
Convulsion development might be caused by the disturbed formation of:
A. Dopamine
B. Serotonin
*C. GABA
D. Histamine
E. DOPA
127. A person ate mushrooms picked in a wooded area. Shortly thereafter, he was rushed to the
hospital, where he died. He had no pervious medical problems. The cause of his death was most
likely the RNA polymerase inhibitor
A. Rifampicin
*B. α-Amanitin
C. Streptolydigin
D. Actinomycin D
E. All of the above mentioned
128. Patiens with xeroderma pigmentosum suffer DNA damage when they are exposed to UV
light because UV light causes the formation of
A. Purine dimers in DNA
*B. Pyrimidine dimers in DNA
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A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
C. Deoxyribose dimers in DNA
D. Anhydride bonds between phosphate groups in DNA
E. All of following are true
129. The molecular mechanism of diphtheria toxin action consists in elongation factor eEF-2
inactivation by:
*A. ADP-ribosilation
B. Phosphorylation
C. Hydroxylation
D. Methylation
E. Glycosylation
130. A female patient has scalded her hand with boiling water. The affected skin area became
red, swollen and painful. This effect is caused by accumulation of the following substance:
A.
*Histamine
B.
Lysine
C.
Thiamine
D.
Glutamine
E.
Asparagine
131. As a result of treatment of viral RNA with nitrous acid, UCA triplet mutated to UGA triplet.
What kind of mutation occurred?
A.
*Missense
B.
Nucleotide insertion
C.
Inversion
D.
Nucleotide deletion
E.
Transition
132. Mother had noticed her 5-year-old child’s urine to become dark in colour. Bile pigments in
urine were not detected. The diagnosis of alkaptonuria was made. What pigment is deficient?
A.
*Homogentisic acid oxidase
B.
Tyrosinase
C.
Oxyphenylpyruvate oxidase
D.
Phenylalanine hydroxylase
E.
Phenylpyruvate decarboxylase
133. Vitamin-like substance choline is contained in phospholipids which are the main
components of biological membranes. What sulphur-containing amino acid serves as the donor
of methyl groups for the synthesis of choline?
*Methionine
Serine
Glycine
Alanine
Threonine
134. A 36-year-old female patient who has been limiting the number of foodstuffs in her diet for
3 months presents with a decrease in body weight, deterioration of physical and mental health,
face edemata. These changes may be caused by the deficiency of the following nutrients:
*Proteins
Vitamins
Fats
Carbohydrates
Micronutrients
135. Some proteins of saliva have a protective function. Which of them protects the oral mucosa
from the mechanical damage?
*Mucin
Lysozyme
Catalase
Peroxidase
Renin
136. A 60-year-old man with a history of chronic intestinal obstruction has excessive protein
putrefaction in the colon.What is the indicator of this process?
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A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
*Indicanuria
Bilirubinuria
Hyperuricuria
Creatinuria
Glycosuria
137. Cationic glycoproteins are the major components of parotid saliva. What amino acids are
responsible for their positive charge?
*Lysine, arginine, histidine
Aspartate, glutamate, glycine
Aspartate, arginine, glutamate
Glutamate, valine, leucine
Cysteine, glycine, proline
138. A cell of granular endoplasmatic reticulum is at the stage of translation, when mRNA
advances to the ribosomes. Amino acids get bound by peptide bonds in a certain sequence thus
causing polypeptide biosynthesis. The sequence of amino acids in a polypeptide corresponds
with the sequence of:
*mRNA codons
tRNA nucleotides
tRNA anticodons
rRNA nucleotides
rRNA anticodons
139. A patient presents with dysfunction of cerebral cortex accompanied by epileptic seizures.
He has been administered a biogenic amine synthetized from glutamate and responsible for
central inhibition. What substance is it?
*Gamma-aminobutyric acid
Serotonin
Dopamine
Acetylcholine
Histamine
140. Examination of a 45-year-old man who had kept to a vegeterian diet for a long time
revealed negative nitrogen balance. Which peculiarity of his diet is the cause of this
phenomenon?
*Lack of proteins
Lack of fats
Excess of water
Excess of carbohydrates
Lack of vitamins
141. After severe viral hepatitis a 4-year old boy presents with vomiting, 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
142. Analysis of a newborn’s urine revealed phenylpyruvic acid. Its presence in urine is
associated with the following pathology:
*Phenylketonuria
Alkaptonuria
Albinism
Tyrosinosis
Gout
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143. A month after a serious operation a 38-year-old patient has recovered and has now positive
nitrogen balance. Urine of this patient may be found to have low concentration of the following
nitrogen containing substance:
A.
*Urea
B.
Lactate
C.
Stercobilinogen
D.
Galactose
E.
17-ketosteroids
144. Examination of a patient with chronic renal insufficiency revealed an increase in residual
nitrogen concentration in blood up to 35 millimole/l, more than half of which is urea. What type
of hyperazotemia is it?
A.
*Retentional
B.
Hepatic
C.
Productional
D.
Residual
E.
Combined
145. On examination a male patient was diagnosed with acute radiation disease. Laboratory
examination revealed abrupt decrease in serotonin found in blood platelets. A likely cause of
decrease in serotonin concentration would be metabolic imbalance of the following substance:
A.
*5-oxytryptophan
B.
Tyrosine
C.
Histidine
D.
Phenylalanine
E.
Serine
146. Pellagra may be caused by maize domination and low quantity of animal foodstuffs in the
dietary intake. This pathology results from lack of the following amino acid:
A.
*Tryptophan
B.
Isoleucine
C.
Phenylalanine
D.
Methionine
E.
Histidine
147. Examination of urine in a newborn revealed presence of citrulline and high ammonia
concentration. This baby is most likely to have the disorder of the following substance
production:
A.
*Urea
B.
Uric acid
C.
Ammonia
D.
Creatinine
E.
Creatine
148. An experimental animal that was kept on protein-free diet developed fatty liver infiltration, in
particular as a result of deficiency of methylating agents. This is caused by disturbed generation of
the following metabolite:
A.
*Choline
B.
DOPA
C.
Cholesterol
D.
Acetoacetate
E.
Linoleic acid
149. A newborn child suffers from milk curdling in stomach, this means that soluble milk proteins
(caseins) transform to insoluble proteins (paracaseins) by means of calcium ions and a certain
enzyme. What enzyme takes part in this process?
A.
Renin
B.
Pepsin
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C.
Gastrin
D.
Secretin
E.
Lipase
150. A patient complained about dizziness, memory impairment, periodic convulsions. It was
revealed that these changes were caused by a product of decarboxylation of glutamic acid. Name this
product:
A.
*GABA
B.
Pyridoxal phosphate
C.
TDP
D.
ATP
E.
THFA
151. Laboratory examination of a child revealed increased concentration of leucine, valine,
isoleucine and their ketoderivatives in blood and urine. Urine smelt of maple syrup. This disease is
characterized by the deficit of the following enzyme:
A.
*Dehydrogenase of branched amino acids
B.
Aminotransferase
C.
Glucose-6-phosphatase
D.
Phosphofructokinase
E.
Phosphofructomutase
152. A patient consumed a lot of reach in proteins food that caused increase of rate of proteolytic
enzymes of pancreatic juice. It is also accompanied by increase of rate of the following enzyme:
A.
*Trypsin
B.
Pepsin
C.
Enterokinase
D.
Gastrixin
E.
Renin
153. 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?
A.
*Amino-acid metabolism
B.
Lipid metabolism
C.
Carbohydrate metabolism
D.
Water-salt metabolism
E.
Phosphoric calcium metabolism
154. 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?
A.
*Cystinuria
B.
Alkaptonuria
C.
Cystitis
D.
Phenylketonuria
E.
Hartnup disease
155. A 30-year-old male patient with acute pancreatitis has been found to have a disorder of cavitary
protein digestion. The reason for such condition can be the hyposynthesis and hyposecretion of the
following enzyme:
A.
*Trypsin
B.
Pepsin
C.
Lipase
D.
Dipeptidase
E.
Amylase
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156. The greater amount of nitrogen is excreted from the organism in form of urea. Inhibition of urea
synthesis and accumulation of ammonia in blood and tissues are induced by the decreased activity of
the following liver enzyme:
A.
*Carbamoyl phosphate synthetase
B.
Aspartate aminotransferase
C.
Urease
D.
Amylase
E.
Pepsin
157. A patient has been diagnosed with alkaptonuria. Choose an enzyme whose deficiency can be
the reason for this pathology:
A.
*Homogentisic acid oxidase
B.
Phenylalanine hydroxylase
C.
Glutamate dehydrogenase
D.
Pyruvate dehydrogenase
E.
Dioxyphenylalanine decarboxylase
158. By the decarboxylation of glutamate in the CNS an inhibitory mediator is formed. Name it:
A.
*GABA
B.
Glutathione
C.
Histamine
D.
Serotonin
E.
Asparagine
159. An unconscious patient was taken by ambulance to the hospital. On objective examination
the patient was found to have no reflexes, periodical convulsions, irregular breathing. After
laboratory examination the patient was diagnosed with hepatic coma. Disorders of the central
nervous system develop due to the accumulation of the following metabolite:
A.
*Ammonia
B.
Urea
C.
Glutamine
D.
Bilirubin
E.
Histamine
160. It is known that the monoamine oxidase (MAO) enzyme plays an important part in the
metabolism of catecholamine neurotransmitters. In what way does the enzyme inactivate these
neurotransmitters (norepinephrine, epinephrine, dopamine)?
A.
*Oxidative deamination
B.
Addition of an amino group
C.
Removal of a methyl group
D.
Carboxylation
E.
Hydrolysis
161. A patient with homogentisuria has signs of arthritis, ochronosis. In this case, the pain in the
joints is associated with the deposition of:
A.
*Homogentisates
B.
Urates
C.
Phosphates
D.
Oxalates
E.
Carbonates
162. A patient with hereditary hyperammonemia due to a disorder of ornithine cycle has
developed secondary orotaciduria. The increased synthesis of orotic acid is caused by an increase
in the following metabolite of ornithine cycle:
A.
*Carbamoyl phosphate
B.
Citrulline
C.
Ornithine
D.
Urea
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E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
Argininosuccinate
163. 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
164. Decarboxylation of glutamate induces production of gamma aminobutyric acid (GABA)
neurotransmitter. After breakdown, GABA is converted into a metabolite of the citric acid cycle,
that is:
*Succinate
Citric acid
Malate
Fumarate
Oxaloacetate
165. To an emergency ward a 7-year-old child was delivered in the condition of allergic shock
caused by a bee sting. High concentration of histamine is observed in blood. Production of this
amine is the result of the following reaction:
*Decarboxylation
Reduction
Deamination
Dehydrogenation
Hydroxylation
166. Ability to divide is characteristic of procariotic and eukaryotic cells. Procariotic cell
division is different from that of eukaryotic, but there is one molecular process that is the basis of
both types of division. Name this process.
*DNA replication
Transcription
Reparation
Translation
Gene amplification
167. Experimental studies revealed steroid hormones to have an effect on proteosynthesis. They
influence synthesis of the following substances:
*Specific messenger RNA
Adenosine triphosphate
Specific ribosomal RNA
Specific transfer RNA
Guanosine triphosphate
168. During reproduction of some RNA-containing viruses that cause tumors in animals, genetic
information can be transmitted in the opposite direction from the RNA to the DNA via a specific
enzyme. The enzyme of reverse transcription is called:
*Reverse transcriptase
DNA polymerase
Ligase
Primase
Topoisomerase
169. DNA replication occurs during the cell division when a signal is received from the
cytoplasm, and a certain portion of the DNA helix is unwound and divided into two chains. The
helix is unwound by the following enzyme:
*Helicase
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B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
RNA polymerase
Ligase
Restrictase
DNA polymerase
170. Skin of patients with xeroderma pigmentosum is very sensitive to the sun radiation, there is
a risk of skin cancer development. The reason for this is hereditary deficiency of
UFendonuclease. As a result of this defect the following process is disturbed:
*DNA reparation
Transcription
DNA replication
Translation
Initiation
171. In the course of evolution there appeared molecular mechanisms for correction of damaged
DNA molecules. This process is called:
*Reparation
Transcription
Translation
Replication
Processing
172. A 1,7-year-old child with a developmental delay and manifestations of self-agression has
the concentration of uric acid in blood at the rate of 1,96 millimole/l. What metabolic disoder is
this typical for?
*Lesch-Nyhan syndrome
Podagra
Acquired immunodeficiency syndrome
Gierke’s disease
Cushing’s basophilism
173. One of the protein synthesis stages is recognition. The first iRNA triplet starts with UAU
triplet. What complementary triplet is found in tRNA?
*AUA
AAA
GUG
UGU
CUC
174. Epithelium regeneration of mucous membrane of oral cavity (cell reproduction) was
accompanied by semiconservative DNA replication (selfreproduction). Nucleotides of a new
DNA chain are complementary to:
*Maternal chain
Sense codons
DNA-polymerase enzyme
Introns
RNA-polymerase enzyme
175. Blood of a child and putative father was referred to forensic medical examination for
affiliation. What chemical components should be identified in the blood under study?
*DNA
Transfer RNA
Ribosomal RNA
Messenger RNA
SnRNA
176. Inside a human cell the informational RNA containing both exons and introns was delivered
to the granular endoplasmic reticulum to the ribosomes. What process does NOT take place?
*Processing
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B.
Replication
C.
Transcription
D.
Translation
E.
Prolongation
177. Blood of a 12 year old boy presents low concentration of uric acid and accumulation of
xanthine and hypoxanthine. This child has genetic defect of the following enzyme:
A.
*Xanthine oxidase
B.
Arginase
C.
Urease
D.
Ornithine carbamoyltransferase
E.
Glycerylkinase
178. A 48 year old patient complained about intense pain, slight swelling and reddening of skin over
the joints, temperature rise up to 38oC. Blood analysis revealed high concentration of urates. This
condition might be caused by disturbed metabolism of:
A.
*Purines
B.
Collagen
C.
Cholesterol
D.
Pyrimidines
E.
Carbohydrates
179. According to the model of double DNA helix that was suggested by Watson and Creek, it was
established that one of chains would not be lost during replication and the second chain would be
synthesized complementary to the first one. What way of replication is it?
A.
*Semiconservative
B.
Analogous
C.
Identical
D.
Dispersed
E.
Conservative
180. A 46-year-old patient consulted a doctor complaining about joint pain that becomes stronger the
day before the weather changes. Blood examination revealed an increased concentration of uric acid.
The most probable cause of the disease is the intensified disintegration of the following substance:
A.
*Adenosine monophosphate
B.
Cytidine monophosphate
C.
Uridine triphosphate
D.
Uridine monophosphate
E.
Thymidine monophosphate
181. Pterin derivatives (aminopterin and methotrexate) are the inhibitors of dihydrofolate reductase,
so that they inhibit the regeneration of tetrahydrofolic acid from dihydrofolate. These drugs inhibit
the intermolecular tranfer of monocarbon groups, thus suppressing the synthesis of the following
polymer:
A.
*DNA
B.
Protein
C.
Homopolysaccharides
D.
Gangliosides
E.
Glycosaminoglycans
182. A 42-year-old male patient with gout has an increased blood uric acid concentration. In order to
reduce the level of uric acid the doctor administered him allopurinol. Allopurinol is the competitive
inhibitor of the following enzyme:
A.
*Xanthine oxidase
B.
Adenosine deaminase
C.
Adenine phosphoribosyltransferase
D.
Hypoxanthinephosphoribosyltransferase
E.
Guanine deaminase
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A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
183. Infectious diseases are treated with antibiotics (streptomycin, erythromycin,
chloramphenicol). They inhibit the following stage of protein synthesis:
*Translation
Transcription
Replication
Processing
Splicing
184. Children with Lesch-Nyhan syndrome have a severe form of hyperuricemia accompanied
by the formation of tophi, urate calculi in the urinary tracts, as well as serious neuro-psychiatric
disorders. The cause of this disease is the reduced activity of the following enzyme:
*Hypoxanthine-guanine phosphoribosyltransferase
Xanthine oxidase
Dihydrofolate reductase
Thymidylate synthase
Karbamoyl phosphate synthetase
185. At the stage of translation in the rough endoplasmic reticulum, the ribosome moves along
the mRNA. Amino acids are joined together by peptide bonds in a specific sequence, and thus
polypeptide synthesis takes place. The sequence of amino acids in a polypeptide corresponds to
the sequence of:
*mRNA codons
tRNA nucleotides
tRNA anticodons
rRNA nucleotides
rRNA anticodons
186. 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
187. In investigation of serum proteins various physical and physicochemical methods can be
used. In particular, serum albumins and globulins can be separated by the method of:
A. *Electrophoresis
B. Dialysis
C. Refractometry
D. Spectrography
E. Polarography
188. 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:
A. *Gastrin
B. Histamine
C. Secretin
D. Cholecystokinin
E. Neurotensin
189. It is knows that in catecholamine metabolism a special role belongs to monoamine oxidase
(MAO). This enzyme inactivates mediators (noradrenalin, adrenalin, dopamine) by:
A. *Oxidative deamination
B. Removing methyl groups
C. Adjoining amino groups
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D. Hydrolysis
E. Carboxylation
190. Cells of a person working in the Chornobyl Exclusion Zone have undergone a mutation in
DNA molecule. However, with time the damaged interval of DNA molecule has been restored to
its initial structure with a specific enzyme. In this case the following occurred:
A. *Repair
B. Translation
C. Transcription
D. Reverse transcription
E. Replication
191. Upon toxic damage of hepatic cells resulting in disruption of liver function the patient
developed
edemas. What change of blood plasma is the main cause of edema
development?
A. *Decrease of albumin content
B. Decrease of fibrinogen content
C. Increase of globulin content
D. Decrease of globulin content
E. Increase of albumin content
192. Monoamine oxidase inhibitors are widely used as psychopharmacological drugs. They
change the level of nearly all neurotransmitters in synapses, with the following
neurotransmitter being the exception:
A. *Acetylcholine
B. Serotonin
C. Dopamine
D. Adrenaline
E. Noradrenaline
193. A woman has scalded her hand with boiling water. The affected area of her skin became
red, swollen and painful. This effect is caused by accumulation of the following substance:
A. *Histamine
B. Lysine
C. Thiamine
D. Glutamine
E. Asparagine
194. Patients suffering from xeroderma pigmentosum have extremely photosensitive skin due
to disrupted excision repair. Specify the process that is affected in such patients:
A. *Repair of DNA molecule
B. Synthesis of iRNA
C. Maturation of iRNA
D. Synthesis of protein primary structure
E. Intron extraction and exon connection
195. A 2-year-old child presents with mental development retardation, intolerance of
proteins, severe hyperammonemia against the background of low blood urea content. This
condition is caused by the congenital deficiency of the following mitochondrial enzyme:
A. *Carbamoyl phosphate synthetase
B. Citrate synthase
C. Succinate dehydrogenase
D. Malate dehydrogenase
E. Monoamine oxidase
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196. Genetic information is stored in DNA but does not participate directly in protein
synthesis within DNA cells. What process ensures transfer of genetic information into
polypeptide chain?
A. *Translation
B. Formation of rRNA
C. Formation of tRNA
D. Formation of iRNA
E. Replication
197. Under the influence of physical factors there can develop defects in a DNA molecule.
Ultraviolet irradiation,for instance, can cause development of dimers. Dimers are two adjacent
pyrimidine bases joined together. Name these bases:
A. *Thymine and cytosine
B. Adenine and thymine
C. Guanine and cytosine
D. Adenine and guanine
E. Guanine and thymine
198. A patient has decreased concentration of magnesium ions that are required for ribosomes
connection to granular endoplasmic reticulum. This condition is known to disturb the process of
protein biosynthesis. Disturbance occurs at the following stage:
A. *Translation
B. Transcription
C. Replication
D. Amino acids activation
E. Processing
199. Nitrogen is being excreted from the body mainly as urea. When activity of a certain enzyme
in the liver is low, it results in inhibition of urea synthesis and nitrogen accumulation in blood
and tissues. Name this enzyme:
A. *Carbamoyl phosphate synthetase
B. Aspartate aminotransferase
C. Urease
D. Amylase
E. Pepsin
200. A patient suffering from gout was prescribed allopurinol.What pharmacological property of
allopurinol provides therapeutic effect in this case?
A. *Competitive inhibition of xanthine oxidase
B. Acceleration of nitrogen-containing substances excretion
C. Acceleration of pyrimidine nucleotides catabolism
D. Deceleration of pyrimidine nucleotides salvage
E. Acceleration of nucleic acids synthesis
201. T-lymphocytes are determined to be affected with HIV. In this case viral enzyme reverse
transcriptase (RNA-dependent DNA-polymerase) catalyzes the synthesis of:
A. *DNA based on the viral RNA matrix
B. Viral RNA based on the DNA matrix
C. Viral protein based on the viral RNA matrix
D. Viral DNA based on the DNA matrix
E. Informational RNA based on the viral protein matrix
202. 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?
A. *Proteins
B. Fats
C. Carbohydrates
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D. Vitamins
E. Minerals
203. Depression and emotional disturbances result from the lack of noradrenaline, serotonin, and
other biogenic amines in the brain. Their content in the synapses can be increased through
administration of antidepressants that inhibit the following enzyme:
A. *Monoamine oxidase
B. Diamine oxidase
C. L-amino acids oxidase
D. D-amino acid oxidase
E. Phenylalanine 4-monooxygenase
204. Streptomycin and other aminoglycosides prevent the joining of formylmethionyl- tRNA by
bonding with the 30S ribosomal subunit. This effect leads to disruption of the following process:
A. *Translation initiation in procaryotes
B. Translation initiation in eucaryotes
C. Transcription initiation in procaryotes
D. Transcription initiation in eucaryotes
E. Replication initiation in procaryotes
205. A young family came for a genetic counseling to identify the father of their child. The
husband insists that the child does not resemble him at all and cannot possibly be his.
Polymerase chain reaction method for person identification is based on the following:
A. *Gene amplification
B. Nucleotide deletion
C. Genetic recombination
D. Missense mutation
E. Transduction
206. A 52-year-old man presents with fever and pain in the joints. Both of his first
metatarsophalangeal articulations are deformed, swollen, and reddened. Blood urea is high. The
patient is diagnosed with gout. What is the main developmental factor in the pathogenesis of this
disease?
A. *Hyperuricemia
B. Argininosuccinic aciduria
C. Hyperazotemia
D. Hyperaminoacidemia
E. Citrullinuria
207. A 24-year-old patient has been administered glutamic acid to treat epilepsy. Medicinal
effect in this case occurs not due to glutamate itself, but due to the product of its
decarboxylation:
A. *γ-aminobutyric acid
B. Histamine 4-monooxygenase
C. Serotonin
D. Dopamine
E. Taurine
208. A 42-year-old woman, who has been keeping to a vegetarian diet for a long period of time,
consulted a doctor. Examination revealed negative nitrogen balance in the patient. What factor
is the most likely cause of such a condition?
A. *Insufficient amount of proteins in the diet
B. Insufficient amount of dietary fiber
C. Excessive amount of fats in the diet
D. Insufficient amount of fats in the diet
E. Decreased rate of metabolic processes
209. After examining a patient a doctor recommended him to exclude rich meat and vegetable
broths, spices, and smoked products from the diet, since the patient was found to have:
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A. *Increased secretion of hydrochloric acid by the stomach glands
B. Reduced secretion of hydrochloric acid by the stomach glands
C. Reduced motility of the gastrointestinal tract
D. Reduced salivation
E. Biliary dyskinesia
210. An 84-year-old patient suffers from parkinsonism. One of the pathogenetic development
elements of this disease is deficiency of a certain mediator in some of the brain structures.
Name this mediator:
A. *Dopamine
B. Adrenaline
C. Noradrenaline
D. Histamine
E. Acetylcholine
211. Amino acids join to each other in ribosomes of granular endoplasmic reticulum. Knowing
the sequence of amino acids and applying genetic code, it is possible to determine the sequence
of nucleoids in:
A. *mRNA
B. Introns
C. Proteins
D. Carbohydrates
E. rRNA
212. A sick child presents with high content of phenyl pyruvate in urine (normally it is
practically absent). Blood phenylalanine level is 350 mg/L (norm - 15 mg/L). What disease are
these symptoms characteristic of?
A. *Phenylketonuria
B. Alkaptonuria
C. Albinism
D. Tyrosinosis
E. Gout
213. During intensive muscle work there is a large amount of ammonia produced in the muscles.
What amino acid plays the main role in the transportation of ammonia to the liver and
participates in gluconeogenesis reactions?
A. *Alanine
B. Aspartate
C. Ornithine
D. Lysine
E. Arginine
214. A 42-year-old man with gout presents with high content of uric acid in blood. The patient
was prescribed allopurinol to lower the concentration of uric acid. Allopurinol is a competitive
inhibitor of the following enzyme:
A. *Xanthine oxidase
B. Hypoxanthine phosphoribosyltransferase
C. Adenine phosphoribosyltransferase
D. Guanine deaminase
E. Adenosine deaminase
215. A man is a carrier of HIV that is an RNA virus. The cells of this patient synthesize viral
DNA. This process is based on:
A. *Reverse transcription
B. Replication
C. Translation
D. Repair
E. Transcription
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A.
B.
C.
D.
E.
216. A newborn presents with weak suckling, frequent vomiting, and hypotonia. Blood and urine
citrulline are very high. What metabolic process is disturbed?
A. *Ornithine cycle
B. Cori cycle
C. Glycolysis
D. Gluсoneogenesis
E. Tricarboxylic acid cycle
217. During hypersensitivity skin test a patient received an allergen subcutaneously, after which
the patient developed skin redness, edema, and pain due to histamine action. This biogenic amine
is produced as the result of the following transformation of histidine amino acid:
*Decarboxylation
Methylation
Phosphorilation
Isomerization
Deaminization
218. Vascular endothelium is characterized by high metabolic activity and synthesizes
vasoactive substances. Among these substances there is a potent vasodilator synthesized from Larginine. Name this vasodilator:
A. *Nitrogen oxide
B. Acetylcholine
C. Adrenaline
D. Histamine
E. Bradykinin
219. Dopamine precursor - dioxyphenylalanine (DOPA) - is used in treatment of Parkinson's
disease. This active substance is produced from the following amino acid:
A. *Tyrosine
B. Cysteine
C. Alanine
D. Histidine
E. Tryptophan
220. Among organic substances of a cell there is a polymer composed of dozens, hundreds, and
thousands of monomers. This molecule is capable of self-reproduction and can be an
information carrier. X-ray structure analysis shows this molecule to consist of two
complementary spiral threads. Name this compound
A. *DNA
B. RNA
C. Hormone
D. Cellulose
E. Carbohydrate
221. It is known that in metabolism of catecholamine mediators the special role belongs to
monoamine oxidase (MAO). How does this enzyme inactivate these mediators
(noradrenaline, adrenaline, dopamine)?
A. *Oxidative deamination
B. Carboxylation
C. Methyl group removal
D. Amino group attachment
E. Hydrolisis
222. The patient, who for a long time has been keeping to an unbalanced low-protein diet,
developed fatty liver infiltration. Name the substance, absence of which in the diet can lead to
this condition:
A. *Methionine
B. Cholesterol
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C. Biotin
D. Arachidonic acid
E. Alanine
223. During cell analysis, their cytoplasm was determined to have high content of aminoacyl
tRNA synthetase. This enzyme ensures the following process:
A. *Amino acid activation
B. Transcription
C. Elongation
D. Repair
E. Replication
224. An experimental animal, a dog, received a weak solution of hydrochloric acid through a
tube inserted into the duodenum. Primarily it will result in increased secretion of the following
hormone:
A. *Secretin
B. Cholecystokinin
C. Histamine
D. Neurotensin
E. Gastrin
225. 30 minutes after dental treatment the patient developed red itching spots on the face and
oral mucosa. The patient I was diagnosed with urticaria. What bioactive substance with
vasodilating and pruriginous effect is produced during this type of allergic reaction?
A. *Histamine
B. Leukotriene B4
C. Interleukin-1
D. Bradykinin
E. Prostaglandin E2
226. To determine functional state of the patient's liver, the analysis of animal indican
excreted with urine was conducted. This substance is produced in the process of
detoxification of putrefaction products of a certain amino acid, which takes place in the
large intestine. Name this amino acid:
A. *Tryptophan
B. Serine
C. Cysteine
D. Glycine
E. Valine
227. A patient with pulmonary tuberculosis is prescribed rifampicin that inhibits RNApolymerase enzyme at the stage of initiation of the following process:
A. *Transcription
B. Translation
C. Termination
D. Elongation
E. Replication
228. Biochemical analysis of amino acid contents of freshly synthesized polypeptides
shows that in the process of their translation the first amino acid in each of these proteins will be
the same. Name this amino acid:
A. *Methionine
B. Histidine
C. Phenylalanine
D. Isoleucine
E. Serine
229. Formation of a large amount of immunoglobulins with various antigen specificity from a
small number of genes occurs due to:
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A. *Recombination
B. Transcription
C. Translocation
D. Replication
E. Deletion
230. Glucose synthesis from non-carbohydrate components is an important biochemical process.
Gluconeogenesis from amino acids occurs most actively if a diet is rich in proteins. Which
amino acid of those listed below is the most glucogenic?
A. *Alanine
B. Isoleucine
C. Leucine
D. Valine
E. Lysine
231. Histone protein synthesis is artificially blocked in a cell. What cell structure will be
damaged as a result?
A. *Nuclear chromatin
B. Golgi apparatus
C. Nuclear membrane
D. Nucleolus
E. Cell membrane
232. 45-year-old woman presents with insufficient secretion of enterokinase enzyme.
Enterokinase deficiency can cause disturbance of the following digestive function:
A. *Protein hydrolysis
B. Lipid hydrolysis
C. Vitamin absorption
D. Lipid absorption
E. Carbohydrate hydrolysis
233. Ammonia is extremely toxic for human CNS. What is the main way of ammonia
neutralization in the nervous tissue?
A. *Glutamine synthesis
B. Urea synthesis
C. Ammonium salts synthesis
D. Formation of paired compounds
E. Transamination
234.
Disturbed activity of trypsin and chymotrypsin leads to disturbed protein breakup
in the small intestine. Activity of these enzymes depends on the presence of the
following factor:
A. *Enterokinase
B. Hydrochoric acid
C. Bile acids
D. Pepsin
E. Na+ salts
235.
Human genetic apparatus consists of approximately 30 thousand of genes, while
the number of antibody variants can be as high as millions. What mechanism leads to
formation of new genes that ensure the synthesis of such a number of antibodies?
A. *Genetic recombination
B. DNA replication
C. DNA repair
D. Gene amplification
E. Formation of Okazaki fragments
236.
In the hematology unit a patient with leukemia was prescribed 5-Fluorouracil.
This drug:
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A.
B.
C.
D.
E.
*Inhibits DNA synthesis
Inhibits transcription
Catalyzes replication
Inhibits translation
Stimulates DNase
237.
Body fluids, especially urine, of a sick child produce a specific sweet odor. It is
associated with the disturbed metabolism of such amino acids as leucine, isoleucine, and
valine. What diagnosis will be made by the doctor in this case?
A. Maple syrup urine disease
B. Alkaptonuria
C. Galactosemia
D. Phenylketonuria
E. Fructosuria
238.
A patient has an allergic response with itching, edemas, and skin redness. In the
tissues there is an increased concentration of a certain biogenic amine. Name this
biogenic amine:
A. Histamine
B. Gamma-aminobutyric acid
C. Tryptamine
D. Serotonin
E. Dopamine
239.
When examining a child, the pediatrician noted that the child presents with
delayed physical and mental development. Urinalysis showed an acute increase in the
levels of a keto acid that produces qualitative color reaction with ferric chloride. What
metabolic disturbance was detected in this case?
A. Phenylketonuria
B. Albinism
C. Alkaptonuria
D. Tyrosinemia
E. Cystinuria
240.
A 50-year-old man experienced a severe stress. His blood levels of adrenaline and
noradrenaline sharply increased. What enzymes catalyze the process of noradrenaline
inactivation?
A. Monoamine oxidases
B. Glycosidases
C. Carboxylases
D. Peptidases
E. Tyrosinase
241. It is a known fact that in the human body the biosynthesis of purine nucleotides occurs
de novo from amino acids. Name the amino acids that are used in the synthesis of the purine
nucleotide cycle:
A. Glycine, aspartate, glutamine
B. Isoleucine, serine, valine
C. Proline, tyrosine, phenylalanine
D. Leucine, glutamine, cysteine
E. Methionine, tryptophan, alanine
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242. Secretion of orotic acid many times exceeds the norm in patients with hereditary orotic
aciduria. This pathology is associated with disturbed synthesis of:
A. Pyrimidine nucleotides
B. Purine nucleotides
C. Uric acid
D. Urea
E. Biogenic amines
243. Blood of a patient with bladder cancer has high levels of serotonin and hydroxyanthranilic
acid, because of excessive intake of a certain amino acid. Name this amino acid:
A. Tryptophan
B. Tyrosine
C. Methionine
D. Histidine
E. Alanine
244. Protein synthesis occurs in several stages. During one of them, messenger RNA is being
synthesized on one of the strands of a DNA segment. Name this process:
A. Transcription
B. Translation
C. Elongation
D. Replication
E. Termination
245. It has been found experimentally that activation of amino acids and their binding to the
tRNA is an important stage of preparation for protein synthesis in the cells. What substance takes
part in this process?
A. ATP
B. FAD
C. NAD+
D. Phosphoric acid
E. Coenzyme A
246. The patient’s joints are enlarged and painful. The patient’s blood urate levels are high.
Name this pathology:
A. Gout
B. Rickets
C. Pellagra
D. Scurvy
E. Caries
247. A patient delivered to the neurological department presents with increased inhibition
processes in the central nervous system. What neurotransmitter can cause this condition, when in
excess?
A. GABA
B. Acetylcholine
C. Noradrenaline
D. Adrenaline
E. Dopamine
248. A 42-year-old woman, who has been keeping to a vegetarian diet for a long period of time,
consulted a doctor. Examination revealed negative nitrogen balance in the patient. What factors
is the most likely cause of such a condition?
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A. Insufficient amount of proteins in the diet
B. Insufficient amount of dietary fiber
C. Insufficient amount of fats in the diet
D. Decreased rate of metabolic processes
E. Excessive amount of fats in the diet
249. A structural gene – a segment of a DNA molecule – was damaged. However, it did not
result in an amino acid replacement in the protein, because after a time the damage was
corrected. It indicates such DNA ability as:
A. Repair
B. Transcription
C. Mutation
D. Replication
E. Reverse transcription
250. Replication is one of the reactions of matrix synthesis. What new molecule forms on the
DNA molecule in the result of replication?
A. DNA
B. tRNA
C. mRNA
D. Pro-mRNA
E. rRNA
251. An AIDS patient presents with revertase enzyme activity in the cells affected by HIV
infection. This enzyme takes part in the synthesis of the following nucleic acid:
A. DNA
B. tRNA
C. mRNA
D. Pre-mRNA
E. rRNA
252. Some mRNA triplets (UAA, UAG, UGA) code no amino acids and terminate the
information readout instead, i.e., they can stop the process of transcription. These triplets are
called:
A. Stop codons
B. Anticodons
C. Operators
D. Introns
E. Exons
253. The process of aging in humans is associated with decreased synthesis and secretion of
pancreatic juice and its lower trypsin content. It results in disturbed breakdown of:
A. Proteins
B. Lipids
C. Nucleic acids
D. Polysaccharides
E. Phospholipids
254. A 16-year-old girl, who has been starving herself for a long time to lose weight, developed
an edema. This phenomenon is mainly caused by:
A. Hypoproteinemia due to protein synthesis disturbance
B. Hypoglycemia due to glycogen synthesis disturbance
C. Deceleration of glomerular filtration rate
D. Decreased production of vasopressin in the hypothalamus
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E. Venous congestion and increased venous pressure
255. 3-year-old child was hospitalized with sighs of stomatitis, gingivitis, and dermatitis
on the bare areas of skin. Examination determined a hereditary disorder of neutral amino
acid transport in the intestine. What vitamin is deficient in this patient, causing such
signs?
A. Niacin
B. Cobalamin
C. Pantothenic acid
D. Biotin
E. Vitamin A
256. Phenylketonuria belongs to the following group of molecular metabolic diseases:
A. Amino acid metabolism disorders
B. Hereditary disorders of lipid metabolism
C. Carbohydrate metabolism disorders
D. Hereditary disorders of connective tissue metabolism
E. Mineral metabolism disorders
257. To determine functional state of the patient’s liver, the analysis of animal indican excreted
with urine was conducted. This substance is produced in the process of detoxification of
putrefaction products of a certain amino acid, which takes place in the large intestine. Name this
amino acid:
A. Tryptophan
B. Glycine
C. Serine
D. Cysteine
E. Valine
258. In the process of human aging, the synthesis and secretion of pancreatic juice decreases and
its trypsin levels become lower. It results in disturbed breakdown of:
A. Proteins
B. Phospholipids
C. Nucleic acids
D. Lipids
E. Polysaccharides
259. A 32-year-old man was diagnosed with acute radiation sickness. Laboratory analysis
detected a sharp decrease in platelet serotonin levels. The most likely cause of a decrease in
platelet serotonin is a disturbed decarboxylation of:
A. 5-Hydroxytryptophan
B. Serine
C. Histidine
D. Tyrosine
E. Pyruvic acid
260. A 63-year-old woman had a gastrointestinal hemorrhage that exposed blood proteins to
intestinal microorganisms, i.e. they became a subject of putrefaction. It resulted in an increased
concentration of the following substance in the patient’s blood:
A. Indole
B. Creatinine
C. Globulin
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D. Creatine
E. Albumin
261. An infant presents with colored sclerae and mucous membranes. The infant’s urine becomes dark
when exposed to air. Homogentisic acid was detected in blood and urine. What disease is likely to be the
cause of the infant’s condition?
A. Alkaptonuria
B. Albinism
C. Histidinemia
D. Galactosemia
E. Cystinuria
PART 4
BIOCHEMISTRY OF BLOOD. WATER AND MINERAL METABOLISM.
BIOCHEMISTRY OF KIDNEY AND URINE. BIOCHEMISTRY OF TISSUES.
1. In a patient, the average daily output of water is lower than its intake. Which disease can lead
to that state?
*А. Renal disease В. Hepatitis С. Pancreatitis
D. Infectious diseases Е. Myocardial infarction
2. The development of Addison-Biermer’s disease (pernicious hyperchromic anemia) is due to a
deficiency of vitamin B12. Choose a metal, which is a component of this vitamin:
А. Zink *B. Cobalt C. Molybdenum
D. Magnesium
E. Iron
3. Calcium ions are the second messengers in cells. They activate catabolism of glycogen
interacting with:
*A. Calmodulin B. Calcitonin C. Calciferol D. Glutamine
E. Phospholipase C
4. In a patient, the blood plasma level of potassium is 8 mmol/l (normal values are 3.6-5.3
mmol/l). That state is accompanied by:
A. Tachycardia
*B. Arrhythmia, heart arrest
C. Low arterial pressure
D. High arterial pressure
E. Bradycardia
5. A patient complains of thirst and polyuria. The urine analysis revealed: daily diuresis - 10 L;
urine density - 1.001 (normal values are 1.012-1.024). Which disease causes such changes?
A. Diabetes mellitus
B.Steroid diabetes C. Thyrotoxicosis
D. Acromegaly *E. Diabetes incipidus
6. What is the normal blood calcium level (in mmol/l)?
A. 1.50-1.75
B. 1.75-2.00
*C. 2.25-2.75
D. 3.0-4.5
E. 0.65-1.60
7. A surgeon made an error removing a parathyroid gland while operating the thyroid gland.
Convulsions, tetany developed. Which element metabolism is disturbed?
A.Magnesium
* B.Calcium
C.Potassium
D.Iron
E.Sodium
8. Pathological changes of liver and brain were revealed in a 27-year-old-patient. Copper
concentration is abruptly decreased in blood the plasma and increased in the urine. Wilson’s
disease was diagnosed. What enzyme activity in the blood serum should be examined to prove
the diagnosis?
A. Carbonic anhydrase B. Xanthinoxidase C. Alcohol dehydrogenase
D. Leucinaminopeptidase
*E. Ceruloplasmin
9. Goiter is a disease which is widely spread in some biogeochemical areas of the earth. Which
element deficiency causes this disease?
A.Iron
*B.Iodine
C.Zinc
D.Copper
E.Cobalt
10. What is the cause of metabolic acidosis development?
А. Increasing production and decreasing oxidation of ketone bodies
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В. Increasing production and decreasing oxidation of lactate
С. Loss of basic equivalents
D. Ineffective hydrogen ions secretion, delay of acids
*Е. All the above mentioned
11. What is the cause of metabolic alkalosis development?
А. Uncompensated loss of hydrogen ions
В. Loss of potassium
С. Retention of alkalis
D. Intake of alkalis
*Е. All the above mentioned
12. Considerable losses of gastric juice in prolonged vomiting provide the development of:
A. Respiratory acidosis
*B. Metabolic alkalosis
C. Respiratory alkalosis D.Metabolic
acidosis
13. Considerable disturbances of blood circulation in response to shock provide the development
of:
*A. Metabolic acidosis
B. Respiratory acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
14. Inhibition of respiratory center by narcotic drugs results in:
*A. Respiratory acidosis
B. Metabolic acidosis
C. Hyperglycemia
D. Respiratory alkalosis
E. Metabolic alkalosis
15. In a patient with diabetes mellitus pH of blood is 7.3. Which buffer system components are
used for diagnosis of acid-base balance disturbances?
A. Phosphate
*B. Bicarbonate
C. Oxyhemoglobin
D. Hemoglobin
E. Protein
16. Embolism of respiratory tract is observed in a patient. Which disturbances of acid-base
balance may be found in blood?
*A. Respiratory acidosis
B Metabolic acidosis
C. Acid-base balance in norm D. Respiratory alkalosis
D. Metabolic alkalosis
17. Artificial lung ventilator was used for a patient with severe trauma. Determination of acidbase balance indices showed a decrease in the content of blood carbon dioxide and its enhanced
excretion. These changes are typical for:
*A.Respiratory alkalosis B. Respiratory acidosis
C. Metabolic alkalosis
D.Metabolic
acidosis
18. Point a blood buffer system, which is the most important in regulation of acid-base balance:
A. Phosphate
*B. Hemoglobin C. System of blood plasma proteins D. Bicarbonate
19. Examination of a patient revealed hyperglycemia, glucosuria, hyperketonemia and ketonuria,
polyuria. Which type of acid-base balance is observed in that case?
A. Respiratory alkalosis *B. Metabolic acidosis C. Metabolic alkalosis
D. Respiratory acidosis
E. Acid-base balance is not disturbed
20. A man in a synthetic space-hold breathed frequently and deeply within 3-4 minutes. How
does it affect his acid – base balance?
А. Metabolic alkalosis.
В. Respiratory acidosis
*С. Respiratory alkalosis
D. Metabolic acidosis
E. Acid-base balance is not affected
21.Symptoms of liver cirrhosis with ascites and edema of lower extremities appeared in a patient
with hepatitis C who constantly consumed alcohol. Which changes in a blood composition
played a key role in development of edema?
A. Hypoglobulinemia
*B. Hypoalbulinemia
C. Hypokaliemia
D. Hypoglycemia
E. Hypocholesterolemia
22. In blood of a patient, the content of residual nitrogen is 48 mmol/l, the level of urea is 15.3
mmol/l. Which organ disease are these results indicative of:
A. Spleen B. Liver C. Stomach
D. *Kidney
E. Pancreas
23. A reduced blood residual nitrogen level was revealed in a patient with liver insufficiency.
The diminishing blood nonprotein nitrogen is due to:
*A. Urea
B. Ammonium C. Amino acids D. Bilirubin E. Uric acid
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24. A patient complains of vomiting, general weakness. Residual nitrogen in blood is 35 mmol/l,
renal function is not disturbed. Which type of azotemia developed?
*A. Relative B. Renal C. Retention D. Productive
25. Which components of blood residual nitrogen fraction prevail in productive azotemia?
A. Ketone bodies B. Lipids, carbohydrates
*C. Amino acids, urea D. Porphyrins, bilirubin
26. Interferons are synthesized in lymphocytes and other host cells invaded by viruses. These
substances inhibit viral multiplication suppressing synthesis of viral:
A. Lipids
*B. Proteins C. Vitamins
D. Biogenic amines E. Nucleotides
27. 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). Which of the following
laboratory characteristics will be of the greatest diagnostic importance?
A. Hypoproteinemia
B. Hyperalbuminemia
C. Hypoglobulinemia
*D. Paraproteinemia
E. Proteinuria
28. Which blood coagulation factor levels are not decreased in liver diseases, which are
accompanied by disturbance of protein synthesis?
*A. Tissue thromboplastin
B. Stuart-Prower factor
C. Fibrinogen
D. Proconvertin
E. Proaccelerin
29. Which action of heparin provides its wide application in clinical practice to prevent blood
coagulation and to treat thromboses?
A. Inhibition of antithrombin III
*B. Activation of antithrombin III
C. Binding factor IX
D. Stimulation of fibrin hydrolysis
30. Which conversion is catalysed by plasmin?
A. Plasminogen to plasmin
B. Fibrinogen to fibrin
C. Prothrombin to thrombin
D. Proconvertin to convertin
*E. Fibrin to peptides
31. A-(hypo)-fibrinogenemia is diagnosed in a patient with periodical severe bleeding due to
complete uncapacity to coagulation. This disease is due to a deficiency of:
A. Proconvertin
B. Proaccelerin
C. Thromboplastin
*D. Fibrinogen
32. A boy has hemophilia A, which is manifected by prolonged bleeding even in case of small
injury of vessels. Which blood clotting factor deficiency causes hemophilia A?
A. Fibrinogen
B. Prothrombin
C. Proaccelerin
*D. Antihemophilic globulin A
E. Antihemophilic globulin B
33. Coumarin drugs that inhibit carboxylation of glutamate are used in clinical practice as
anticoagulants. They are structural analogs of vitamin:
A. C
B. B
*C. K
D. A
E. E
34. Cascade of reactions of thrombin formation may be realized by two pathways: extrinsic and
intrinsic. Which stage unites them?
A. Prothrombin to thrombin
B. Fibrinogen to fibrin
*C. Factor X to factor Xa
D. Factor V to Va
E. Factor IX to IXa.
35. Hemophilia C is diagnosed in a patient with intense bleeding. Which factor disturbed
synthesis causes this form of hemophilia:
A. IV
B. VIII
*C. XI
D. III
E. II
36. Which factor does not participate in the intrinsic mechanism of blood coagulation?
A. VIII
B. XI
*C. III
D. IXa
E. X
37. In experiments in vitro it has been demonstrated that kallikrein takes part in the intrinsic
pathway of blood coagulation. What is its role?
*A. Accelerates the conversion of factor XII to XIIa
B. Is necessary for initiation of intrinsic pathway of blood clotting
C. Participates in retraction of blood clot
D. Has transglutaminase activity
E. Initiates anticlotting system of blood
38. The formation of stable clot is impossible in inherited deficiency of factor XIII. What is the
role of factor XIII?
A. Participation in fibrin monomer formation
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*B. Participation in fibrin polymer formation
C. Participation in synthesis of fibrinogen in liver
D. Participation in the removal of fragments A and B from fibrinogen molecule.
39. Urokinase was prescribed to a patient with thrombophlebitis to dissolve thrombi. What is the
mechanism of this drug action?
A. Activation of antithrombin III
*B. Activation of plasminogen
C. The increase of heparin synthesis
D. The increase of α2-macroglobulin level in blood
E. Disturbance of conversion of fibrin monomer to fibrin polymer.
40. Calcium ions play an important role in blood coagulation. They activate certain factors of
blood clotting by means of an attachment to sites of calcium binding. Which amino acid has a
major role in those sites?
A. Glutamic acid
B. γ-Aminobutyric acid
C. Glucuronic acid
*D. γ-Carboxyglutamic acid
E. γ-Hydroxybutyric acid
41. A patient has deficiency of factor VII. Which stage of blood clotting is disturbed?
A. Conversion of prothrombin to thrombin
B. Retraction of blood clot
C. Aggregation of thrombocytes
*D. Conversion of factor X to Xa
E. Conversion of fibrin monomer to fibrin polymer
42. Thromboses and embolism of vessels are observed in a patient. Those are due to inherited
deficiency of blood plasma protein, which is the most potent inhibitor of blood clotting. Which
protein is it?
A. Fibrinogen
B. α1-Antitrypsin
*C. Antithrombin III
D. Factor VIII
E.
Bradykinin
43. Impossibility of the formation of stable fibrin clot was found in patients with hemorrhage.
Which factor deficiency causes this state?
*A. XIII
B. XII
C. XI
D. X
E. Prothrombin
44. Which process results in activation of many factors of blood coagulation that are synthesized
as zymogens?
A. Phosphorylation
B. Amidination
*C. Limited proteolysis
D. Glycosylation
45. Intracardiac injection of immobilized streptokinase was made to a patient with acute
myocardial infarction. Which substance formation is stimulated by this drug?
*A. Plasmin B. Thrombin
C. Heparin
D. Prothrombin
E. Antithrombin
46. Determination of several classes of immunoglobulins in birth period can be used as a
diagnostic test to verify the fetal infection. Which class of immunoglobulins can pass through
placenta?
A. Ig M.
B. Ig A.
*C. Ig G.
D. Ig E.
E. Ig D.
47. Host immune reactions are provided by the high-specific “antigen-antibody” interaction.
Such specificity of immunoglobulins depends on their molecular structure. Which class of
complex proteins do they belong to?
A. Lipoproteins.
B. Metalloproteins.
C. Chromoproteins. *D. Glycoproteins.
E.
Nucleoproteins.
48. Interleukin-2 is a cytokine, which is produced by mature T-helpers as a result of their
stimulation by an antigen. It is crucial for interleukin-mediated regulation of immunity. Select
the chemical nature of interleukin-2.
A.
Proteoglycan.
B. Lipoprotein.
C. Simple protein. D. Phosphoprotein.
*E.
Glycoprotein.
49. Tumor necrosis factors (TNF) cause lysis of several tumor cells and are considered as
promising anticancer drugs. One of them is lymphotoxin, protein, which has cytotoxic effects.
Which cells produce lymphotoxin?
*A. T-lymphocytes. B. B-lymphocytes.
C. T- and B-lymphocytes.
D. Macrophages.
E. Monocytes.
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50. In a 5-year-old child, Brutton disease is found, which resulted in hard proceeding of bacterial
infections, absence of B-lymphocytes and plasma cells. Which changes in immunoglobulins can
be found in blood serum of this child with immunodeficiency?
A. The increase of Ig D, Ig E. B. The increase of Ig A, Ig M. C. The decrease of Ig D, Ig E
*D. The decrease of Ig A, Ig M.
E. No changes.
51. The immune system provides the distinguishing, binding and destroying of antigens with the
help of cellular and humoral mechanisms. The main classes of blood immunoglobulins, which
promote the humoral immune response, are.
A. Ig A and Ig E. *B. Ig G and Ig M. C. Ig D and Ig A. D. Ig A and Ig M. E. Ig E and
Ig D.
52. In fever development, high levels of “acute phase” proteins (ceruloplasmin, fibrinogen, Creactive protein) are common. What is the mechanism?
A. Proliferative action of IL-2 on T-lymphocytes.
B. Temperature-mediated damage to host cells.
C. Degranulation of tissue basophils.
*D. Stimulating influence of IL-1 on hepatocytes.
53. For prevention of atherosclerosis and angina pectoris, humans should daily consume 2 – 6
grams of essential fatty acids. Synthesis of which substances requires these fatty acids?
A. Neurotransmitters.
*B. Prostaglandins.
C. Bile acids.
D. Steroids.
E. Vitamin D.
54. The synthesis of heme is regulated by feed-back mechanism at the stage of:
А. Incorporation of iron ion into protoporphyrin *В. Formation of δ-aminolevulinic acid
С. Condensation of porphobilinogen molecules D. Formation of protoporphyrin III
E. Synthesis of porphobilinogen
55. A patient has photosensitivity, lesions of skin, abdominal pain, and neuropsychiatric
disturbances. Urine becomes red when being stayed untouched for some period of time. Which
diagnosis is the most probable?
А. Hemolytic jaundice В. Pellagra С. Alkaptonuria *D. Porphyria E. Albinism
56. In liver of a patient with iron deficiency anemia, the disturbance of formation of a
metalloprotein (the source of iron for heme synthesis) was revealed. Point this protein:
А. Transferrin
*B.Ferritin C. Hemosiderin
D. Myoglobin
E. Cytochrome c
57. The red color of urine is characteristic for patients with erythropoietic porphyria (Gunter’s
disease). This is due to the urinary presence of:
*A.Uroporphyrinogen I
B. Uroporphyrinogen III
C. Coproporphyrinogen III
D.Porphobilinogen
E. Protoporphyrin
58. An allosteric regulator of affinity of Hb to oxygen is synthesized in erythrocytes from an
intermediate of glycolysis. Point this regulator:
A. 3-Phosphoglycerate
B. 1,3-Bisphosphoglycerate
*C. 2, 3-Bisphosphoglycerate
D. 2-Phosphoglycerate
E. Phosphoenolpyruvate
59. An important factor facilitating atherogenesis is hypoxia induced by smoking. Which
substance formation results in insufficient provision of tissues with oxygen?
A. Deoxyhemoglobin
B. Methemoglobin
C. Carbhemoglobin
*D. Carboxyhemoglobin
E. Oxyhemoglobin
60. The increased concentration of methemoglobin has therapeutic significance in the treatment
of HCN and cyanide poisoning, since methemoglobin forms nontoxic cyanmethemoglobin which
is slowly converted to Hb. Which of the following substances facilitates methemoglobin
formation and is used for the treatment of cyanide poisoning?
A. Methylene blue
B. Glucose *C. Nitrates D. Ascorbic acid E. Adrenaline
61. In a 42-years-old woman, the excessive accumulation of iron in tissues is observed. The
accumulation is due to transferrin deficiency. Each of the following statements about transferrin
is correct except:
*A. Transferrin is a protein which binds iron and is secreted by neutrophiles
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B. Transferrin is a glycoprotein which is secreted by liver parenchymatous cells
C. Binding iron by transferring is the mechanism of protection from iron toxicity
D. Iron and transferin amounts are proportional in blood
E. Transferrin directs a flow of iron to cells which actively synthesize hemoglobin
62. Thermal hypoxia can appear in a result of poisoning with some substances, including carbon
oxide. Point the form of Hb which appears due to the interaction of CO with normal hemoglobin:
*A. Carboxyhemoglobin
B. Methemoglobin C. Carbhemoglobin
D. Hemoglobin S
E. Hemoglobin F
63. α-Talassemia is diagnosed in a patient. Which disturbance of hemoglobin synthesis is
observed in this disease?
*A. Suppressing synthesis of α-chains
B. Suppressing synthesis of β-chains
C. Suppressing synthesis of γ-chains
D. Suppressing synthesis of δ- and β-chains
E. Suppressing synthesis of δ-chains
64. The high-gravity form of a hypoxia (short breath, cyanosis) developed in a 3-month-old
child. What process of hemoglobin formation is disturbed?
А. Substitution of hemoglobin F to hemoglobin М.
В. Substitution of hemoglobin F to hemoglobin S.
С. Substitution of hemoglobin F to glycosylated hemoglobin.
D. Substitution of hemoglobin F to methemoglobin.
*Е. Substitution of hemoglobin F to hemoglobin А.
65. An investigation of a child’s blood revealed crescent-shaped erythrocytes (sickle cells). Point
the type of disease, which is characterized by this anomaly:
A. Oncologic
B. Infectious C. Traumatic D. Neurologic *E. Inherited
66. A 48-years-old man with yellow skin has anemia, splenomegaly, hyperbilirubinemia
(indirect bilirubin), urobilinuria, and dark-yellow feces. These changes are the most typical for:
*A. Hemolytic jaundice B. Obstructive jaundice C. Hepatocellular jaundice
D. Gilbert’s syndrome E. Syndrome of liver insufficiency
67. In a newborn, bilirubin content (indirect bilirubin) is elevated. Feces are intensively colored
(the enhanced level of stercobilin). Bilirubin is not found in urine. Which type of jaundice is it?
А. Hepatocellular В. Hemolytic С. Obstructive
D. Inherited
*E. Neonatal physiologic
jaundice
68. Skin, scleras and mucosa are of yellow color in a patient. Urine has the color of dark beer,
feces are acholic. The increased levels of both direct and indirect bilirubin, the enhanced ALAT,
LDH4 and LDH5 activities are revealed in blood. Bilirubin is found in the urine. What type of
jaundice is it?
А. Inherited В. Hemolytic С. Obstructive *D. Hepatic E. Neonatal physiologic jaundice
69. Neurologic abnormalities, skin jaundice, an increase in blood serum unconjugated bilirubin
level were revealed in a sick 10-year-old child. Which enzyme disturbed synthesis leads to the
development of Gilbert’s disease?
A. UDP-dehydrogenase
*B. UDP-glucuronyltransferase
C. Glycerol kinase
D. Galactose-1-phosphate uridyltransferase
70. A patient was hospitalized with the complaints of general weakness, abdominal pain, and bad
appetite. Symptoms of jaundice were observed. Blood serum total bilirubin content was 77.3
μmol/l, whereas conjugated bilirubin level was 70.76 μmol/l. Which diagnosis is the most
possible?
*А. Obstructive jaundice
В. Acute hepatitis
С. Cirrhosis of liver
D. Hepatic jaundice
Е. Hemolytic jaundice
71. An athlete who consumed a lot of protein in diet has the acidic reaction of urine. What could
cause such changes?
A. Chlorides and phosphates
B. Chlorides and sulfates
*C. Phosphates and sulfates
D. Urates and sulfates
E. Urates and chlorides
72. An organ-specific enzyme for kidneys is:
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A. Lactate dehydrogenase.
B. Succinate dehydrogenase.
C. Aspartate aminotransferase.
*D. Transamidinase.
E. Creatine phosphokinase.
73. Ammonia content in urine is an important index of acid-base balance. Ammonia amount
increases both in respiratory and metabolic acidosis. It is connected with the stimulation of an
enzyme in the renal epithelial cells in acidosis:
*A. Glutaminase.
B. Krebs cycle.
C. Carbonic anhydrase.
D. ATP-ase.
E. Hyaluronidase.
74. A 45-year-old patient complains of thirst, high liquid consumption (up to 5 liters), increased
daily urine output (up to 6 liters per day). Glucose concentration in blood is 4.4 mmol/L, ketone
bodies level is not increased. Urine is colorless. Its density is 1.002; sugar in urine is not
revealed. Which hormone deficiency causes such changes?
A. Glucagon.
B. Aldosteron
C. Insulin.
*D. Vasopressin.
75. During the laboratory investigation of a child, the increased amount of leucine, valine,
isoleucine and their derivatives was found in urine. The urine has a typical odor of maple syrup.
Which enzyme deficiency causes such changes?
*A. Branched-chain alpha-keto acid dehydrogenase
B. Aminotransferase
C. Glucose-6-phosphatase.
D. Phosphofructokinase.
E. Phosphofructomutase.
76. To control the diet of a patient with diabetes mellitus, namely the dietary fats-tocarbohydrates ratio, it is possible to determine the following substances in urine:
*A. Ketone bodies.
B. Lipids.
C. Carbohydrates. D. Proteins. E. Phosphates.
77. A 43-year-old patient, who has been working for a long period of time at the chlorineorganic compounds factory, complains of hypotonus and muscle weakness. Myodistrophy was
diagnosed. The decrease of which index in urine is informative to verify the diagnosis?
A. Homogentisinic acid.
B. Creatine phosphate.
*C. Creatinine.
D. Creatine sulfate.
E. Glycosamine.
78. The percentage of dietary proteins is not degraded in the gut and is exposed to colonic
microbiota. This process is called putrefaction of proteins. Which substance indicates the
intensity of putrefaction?
A. Protein.
B. Urea.
C. Creatine and creatinine.
D. Urates.
*E. Indican.
79. A patient has glucosuria, glucose content in blood is normal. Which process disorder can
lead to glycosuria?
A. Gluconeogenesis.
B. Breakdown of renal glycogen.
C. Glycolysis.
D. Function of pancreas.
*E. Function of renal tubules.
80. A 40-year-old patient complains of the periodic pain in joints of big toe and their swelling.
Urine is acidic and pink. Which substance found in urine can cause such changes?
*A. Uric acid salts.
B. Chlorides.
C. Ammonium salts.
D. Calcium phosphate.
E. Magnesium sulfate.
81. A 43-year-old patient was diagnosed with chronic glomerulonephritis. Edemas have
developed during last 6 months. What is the reason of their development?
A. Hyperaldosteronism.
B. Overproduction of vasopressin.
*C. Proteinuria
D. Hyperosmolarity of plasma.
E. Disturbance of a hepatic protein synthesizing function.
82. The detoxification of natural metabolites and xenobiotics is disturbed in the patient’s liver.
Which chromoprotein activity is reduced?
A. Cytochrome b.
B. Hemoglobin.
C. Cytochromeoxidase.
*D. Cytochrome P450.
E. Cytochrome c1.
83. Liver fatty dystrophy is found in a patient. The disturbance of which substance synthesis can
lead to such pathology?
A. Cholic acid.
B. Urea.
C. Phosphatidic acid.
D. Tristearylglycerol.
*E. Phosphatidylcholine.
84. A 53-year-old male was hospitalized to an intensive care unit wit hepatic coma. Arginine was
added to the complex of intensive therapy. It activates:
*A. Urea synthesis.
B. Glucose synthesis.
C. Protein synthesis.
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D. Scatol detoxification.
E. Cholesterol synthesis.
85. Liver cirrhosis is observed in a 52-year-old obese female. Hypoalbuminemia,
hyperglobulinemia are found. Edemas of hands, feet, eyelids are present. The most probable
reason is an abnormal:
A. Acid-base balance.
B. Detoxification function of liver.
C. Glycogen synthesis in
liver.
*D. Albumin synthesis in liver.
E. Lipoprotein synthesis in liver.
86. Liver damage (hepatitis, cyrrhosis, tumor) leads to all the below mentioned disturbances of
protein metabolism, except for:
*A. Hyperalbuminemia.
B. Hemorrhages
C. Hyperaminoacidemia.
D. Azotemia.
E. Hyper α-globulinemia.
87. Which compound takes part in the bilirubin conjugation in hepatocytes?
A. Glucose.
B. Fructose.
C. Gluconic acid. *D. Glucuronic acid.
E. Glycine.
88. Reactions of xenobiotics and endogenous toxins biotransformation in hepatocytes occur
either by redox and hydrolytic conversions or by conjugation. During the conjugation a
compound, which should be detoxified, cannot bind to:
*A. Gluconic acid.
B. Glucuronic acid.
C. Sulfatic acid.
D. Glycine.
E. Glutathione.
89. Liver glycogen is a source of glucose for different tissues, but muscle glycogen is only used
by muscles. Which enzyme determines this feature?
*A. Glucose-6-phosphatase B. Phosphoglucomutase C. Glycogen phosphorylase
D. Amylo-1, 6-glycosidase E. Glycogen synthase
90. Toxicity of ammonia (especially for the brain) is due to its capacity to disturb the functioning
of Krebs cycle as result of the removal of:
А. Malate
В. Citrate
*С. α-Ketoglutarate D. Succinate
E. Fumarate
91. GABA (γ-aminobutyric acid), which belongs to inhibitory neurotransmitters, is a product of
glutamate decarboxylation. Which vitamin prescription is reasonable in convulsion states due to
the decreased formation of GABA?
A. B9
*B. B6
C. B1
D. B5
E. B2
92. A 46-year-old woman complains of progressing Duchenne-type muscular dystrophy. Which
enzyme activity change is a diagnostic test in this case?
А. Glutamate dehydrogenase
В. Lactate dehydrogenase С. Pyruvate dehydrogenase
*D. Creatine phosphokinase
Е. Adenylylkinase
93. Psycho-pharmacologic drugs with antidepressive action inhibit oxidative deamination of
noradrenaline and serotonin in mitochondria of brain by inhibition of:
*A. Monoamine oxidase
B. Cytochrome oxidase
C. Pyruvate dehydrogenase
D. Aldolase
E. Succinate dehydrogenase
94. Tabun, zarin, diisopropyl phosphate (phosphororganic substances) are poisons of neuroparalytic action. Which of the mentioned enzymes is inhibited by phosphororganic substances?
A. Cytochrome P450
B. Phospholipase A2
C. Angiotensin converting enzyme
D. Tyrosine aminotransferase *E. Acetylcholine esterase
95. Some vitamin deficiency causes neuropathy and other neurology symptoms. Which process
abnormalities provide the damage to the nervous system in vitamin B1 deficiency?
A. Synthesis of amino acids and nucleotides
B. Antioxidant defense
*C. Oxidative decarboxylation of α-ketoacids
D. Transamination and decarboxylation of amino acids
E. Dehydrogenation of tissue respiration substrates
96. Disturbance of myelinization in nerve fibers leads to severe neurology disorders and mental
retardation. This clinical picture is typical for inherited disturbances of metabolism of:
97. A 36-year-old patient suffers from collagenosis. Which metabolite increased amount is more
possible to be found in the urine?
A. Indican *B. Hydroxyproline
C. Creatinine
D. Urea
E. Urobilinogen
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98. A baby has marked diarrhea due to improper feeding. One of the main consequences is
excessive sodium excretion. What form of acid-base balance disturbance is observed in this
case?
А. The acid – base balance is not disturbed.
В. Metabolic alkalosis.
С. Respiratory
acidosis.
D. Respiratory alkalosis.
*E. Metabolic acidosis
99. A mother consulted a doctor concerning a 5-year-old child who developed erythemas,
vesicular rash, itching sensation when exposed to sunlight. Blood analysis revealed decreased
content of iron in blood serum, increased secretion of uroporphyrinogen I with urine. The most
probable inherited pathology is:
А. Coproporphyria.
В. Methemoglobinemia.
С. Renal porphyria.
*D. Congenital erythropoetic porphyria.
Е. Intermittent acute porphyria.
100. A patient visually demonstrates blisters and pigmentation when exposed to ultra-violet rays.
The urine acquires red color when exposed to the air. What blood index allows verifying
Gunther’s disease?
А. Acetone.
В. Hemoglobin.
С. Bilirubin.
D. Creatinine.
*Е.
Uroporphyrinogen I.
101. In the blood serum of a patient, the increased concentration of hydroxyproline, sialic acids,
C - reactive protein is detected. Exacerbation of what disease is observed?
А. Coloenteritis.
*В. Rheumatic disease.
С. Hepatitis.
D. Bronchitis.
Е. Pancreatitis.
102. In the blood serum of a patient, hyaluronidase is overactive. What biochemical index of the
blood serum allows confirming the assumption about the pathology of connective tissue?
А. Galactose.
В. Bilirubin.
С. Urine acid.
D. Glucose.
*Е. Sialic acids.
103. During catabolism of hemoglobin iron is released. It binds to a special transport protein,
enters the bone marrow and is reused for synthesizing hemoglobin. This transport protein is:
*А. Transferrin.
В. Transcobalamine.
С. Haptoglobin.
D. Hepatocuprein.
Е. Albumine.
104. Affected by oxidants (hydrogen peroxide, nitric oxide etc.), hemoglobin containing Fе2 + is
converted into a compound which contains Fе3 + and is not capable of transporting oxygen. How
is this compound called?
А. Carbhemoglobin.
В. Carboxyhemoglobin.
*С. Methemoglobin.
D. Oxyhemoglobin.
Е. Glycosylated hemoglobin.
105. In the liver of a patient, detoxification of natural metabolites and xenobiotics is disturbed.
Choose a cytochrome whose activity can be decreased?
А. Cytochrome c1.
В. Cytochrome oxydase.
С. Hemoglobin.
D. Cytochrome b.
*Е. Cytochrome P450.
106. A newborn has yellowish color of the skin and mucous membranes. A possible cause of this
condition can be temporary deficiency of:
*А. UDP-glucuronosyltransferase.
В. Uridine transferase.
С. Heme synthase.
D. Heme oxygenase.
Е. Biliverdin reductase.
107. A 6-month-old child suffers from the frequent and profuse hypodermic bleeding. Treatment
by a synthetic analog of vitamin K (Vicasol) gave positive effect. This vitamin participates in
glutamic acid -carboxylation of:
А. Fibrinogen.
*В. Thrombinogen.
С. Hageman’s factor.
D. Antihemophilic globulin А.
Е. Rosenthal’s factor.
108. The preliminary diagnosis of a patient is myocardial infarction. A characteristic feature of
this disease is an increase in the blood serum activity of:
А. Glucose-6-phosphate dehydrogenase.
В. Catalase.
*С. Creatine phosphokinase.
D. α-Amylase.
Е. Arginase.
109. In a patient, edemas are quickly developed. Which protein is reduced in blood?
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А. 1-Globulins.
*В. Albumins.
С. 2-Globulins.
D. -Globulins.
Е.
Fibrinogen.
110. A patient has sickle-cell anemia. Which amino acid is replaced with valine in a polypeptide
chain of Hb?
*А. Glutamic acid.
В. Aspartic acid.
С. Leucine.
D. Arginine.
Е.
Threonine.
111. The symptoms of jaundice appeared in a newborn. Small doses of phenobarbital, which
induces synthesis of UDP-glucuronyl transferase, ameliorated the state of the child. Which
processes will be activated under the influence of the enzyme induced by phenobarbital?
А. Gluconeogenesis.
В. Microsomal oxidation.
С. Tissue respiration.
*D. Conjugation.
Е. Glycogen synthesis
112. A higher activity of МB-form of creatine phosphokinase and LDH1 is found in a patient.
Choose a probable pathology.
А. Hepatitis.
*В. Myocardial infarction.
С. Rheumatic disease.
D. Pancreatitis.
Е. Cholecystitis.
113. A 33-year-old patient has been ill during 10 years. Periodically he addresses to a doctor
with complaints of an acute abdominal pain, cramp, vision problems. His relatives have the
similar symptoms. Urine is red. He was hospitalized with acute intermittent porphyria. The
disease develops as a result of the abnormal biosynthesis of:
А. Insulin.
*В. Heme.
С. Bile acids.
D. Prostaglandins.
Е. Collagen.
114. Yellow color of skin, dark urine, feces of dark yellow color are found in a patient. What
substance concentration will be elevated in blood serum?
А. Conjugated bilirubin.
*В. Free bilirubin.
C. Mesobilirubin
D. Verdohemoglobin.
Е. Biliverdin.
115. The diagnosis of a young 18-year-old male is muscle dystrophy. Which substance level is
elevated in blood serum is the most possible in this pathology?
*А. Creatine
В. Myoglobin
С. Myosin
D. Lactate
Е. Alanine
116. A man breathed frequently and deeply within 3-4 minutes. How will it affect the acid - base
balance?
А. There is a metabolic alkalosis.
В. There is a respiratory acidosis
*С. There is a respiratory alkalosis
D. There is a metabolic acidosis
E. Acid-base balance is not affected.
117. A 46-year-old woman suffers from cholelithiasis, severe jaundice. The urine turned yellow
and feces were colorless. Which substance concentration in blood serum will be elevated at
most?
А. Free bilirubin.
*В. Conjugated bilirubin.
С. Biliverdin.
D. Mesobilirubin.
Е. Urobilinigen.
118. In a premature 2-day-old newborn for 2 day, skin and mucous membranes are yellow. What
enzyme is temporary deficient?
А. Aminolevulenate synthetase.
*В. UDP glucuronyl transferase.
С. Heme oxygenase.
D. Heme synthetase.
Е. Biliverdin reductase.
119. The symptoms of hemorrhagic illness due to hypovitaminosis K appeared in a newborn.
What is the role of vitamin K?
А. Inhibitor of antithrombins.
В. Cofactor of thrombinogen.
*С. Cofactor of -glutamate carboxylase.
D. Proteolytic activator of thrombin.
Е. Inhibitor of heparin synthesis.
120. Molecular analysis of hemoglobin in a patient with an anemia revealed a substitution of
6Glu with 6Val in a -chain. What is the molecular mechanism of this pathology?
*А. Gene mutation.
В. Chromosome mutation.
С. Genome mutation
D. Аmplification of genes.
Е. Transduction of genes.
121. A 38-year-old patient has rheumatic disease in active phase. Which substance is elevated in
blood?
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А. Urea.
В. Uric acid.
*С. C - reactive protein. D. Creatinine.
Е. Transferrin
122. A 16-year-old male is diagnosed with inherited UDP-glucoronyl transferase deficiency.
Hyperbilirubinemia develops due to the elevation of:
А. Urobilinigen.
В. Conjugated bilirubin.
*C. Unconjugated bilirubin.
D. Stercobilinogen.
Е. Biliverdin.
123. The man was bitten by a snake. He started choking, in urine, hemoglobin was detected. In
blood, there was hemolysis of erythrocytes. The toxic promoted:
*А. Formation of lysolecithin.
В. Acidosis.
С. Polyuria.
D. Progressing an alkalosis.
Е. Formation of triglycerides.
124. A 43-year-old woman, the employee of varnish-paint factory, complains of general
weakness, decrease of a weight, apathy, and sleepiness. Chronic lead intoxication and the
hypochromic anemia were detected. High protoporphyrin and reduced -aminolevulinic acid
levels are found in blood. This indicates the inability to produce:
А. DNA.
*В. Heme.
С. RNA.
D. Protein.
Е. Mevalonic acid.
125. Nitrogen is mainly excreted as urea. Which enzyme deficiency results in the inability to
produce urea and, hence, accumulation of ammonia?
*A. Carbamoyl phosphate synthetase.
В. Aspartate transaminase.
С. Urease.
D. Amylase.
Е. Pepsin.
126. Elevated blood serum levels of total bilirubin due to the indirect (free) fraction were found
in a patient with jaundice. The high content of stercobilin is observed in feces and urine. Levels
of conjugated bilirubin in blood plasma are within normal ranges. Which type of jaundice is it?
А. Mechanic.
В. Parenchymatous (hepatic).
*С. Hemolytic.
D. Neonatal jaundice
Е. Gilbert’s disease.
127. The symptoms of rheumatic arthritis are observed in a 63-year-old female. Which
compound can be elevated in blood?
А. Acidic phosphatase.
В. Lipoproteins.
*С. Total glycosaminoglycans.
D. Total cholesterol.
Е. R-Glycosidases.
128. A patient was hospitalized with complaints of general weakness, abdominal pain, and bad
appetite. Symptoms of jaundice were observed. Blood serum total bilirubin content was 77.3
μmol/l. Conjugated bilirubin level was 70.76 μmol/l. Which diagnosis is the most possible?
*А. Obstructive jaundice
В. Acute hepatitis
С. Liver cyrrhosis
D. Hepatic jaundice
Е. Hemolytic jaundice
129. Glucosuria was found in a patient. The content of glucose in blood is normal. This state is
the consequence of abnormal:
А. Gluconeogenesis.
В. Glycogen degradation in kidney.
С. Function of a pancreas.
*D. Function of renal channels
Е. Glycolysis.
130. A patient has liver cyrrhosis. Which substance in urine reflects the liver detoxification
function?
*А. Hippuric acid.
В. Ammonius salts.
С. Creatinine.
D. Uric acid. Е. Amino acids.
131. The detoxification of xenobiotics (pharmaceuticals, epoxides, arenoxydes, aldehydes, nitroderivatives and endogenous metabolites (estradiol, prostaglandines, leukotriens) occurs in the
liver by conjugation with:
А. Phosphadenosine.
В. Aspartic acid.
С. Glycine.
D. S-Adenosyl methionine.
*Е. Glutathione.
132. Different substances can be used as anticoagulants, including a naturally occurring
polysaccharide:
*А. Heparin.
В. Hyaluronic acid.
С. Dermatan sulfate.
D. Chondroitin sulfate.
Е. Dextrane.
133. The high sensibility of skin to sunlights is observed in a patient. When exposed to the air
the urine acquires dark-red color. What is the most possible reason of such state?
А. Alkaptonuria.
В. Hemolytic jaundice.
С. Albinism.
D. Pellagra.
*Е.
Porphyria.
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134. The yellowness of skin and mucous membranes is observed in a patient after
hemotransfusion. Higher levels of total and indirect bilirubin in blood, urobilin in urine,
stercobilin in feces are found. Which type of jaundice is it?
А. Neonatal jaundice.
В. Hereditary.
С. Obstructive.
D. Parenchymatous.
*Е. Hemolytic.
135. The increased activity of amylase in the blood and urine, as well as trypsin in the urine, is
revealed in a patient. What organ is affected?
А. Liver.
*В. Pancreas.
С. Stomach.
D. Kidneys.
Е. Intestine.
136. A patient has the decreased blood рН levels and hydrocarbonate ion content (reduced blood
alkaline reserve), the increased levels of lactate and pyruvate in blood and urine. What type of
acid – base imbalance is it?
А. Metabolic alkalosis.
В. Respiratory acidosis.
*С. Metabolic acidosis.
D. Respiratory alkalosis.
Е. Respiratory alkalosis.
137. Increased concentration of carbon monoxide in the air can lead to poisoning. Transport of
oxygen by hemoglobin from lungs to tissues is disturbed. What derivative of hemoglobin will be
formed?
А. Methemoglobin.
В. Oxyhemoglobin.
*С. Carboxyhemoglobin.
D. Carbon monoxide hemoglobin.
Е. Hemochromogen.
138. There is strong evidence that sinovial fluid diminishes abrasion of joint surfaces. In
rheumatic disease or arthritis, its viscosity decreases due to depolymerisation (breakdown):
А. Albumin.
В. Glycogen.
С. Collagen.
D. Heparin.
*Е. Hyaluronic acid.
139. A driver was hospitalized with symptoms of poisoning with exhaust gases after repair of the
car in a barn. Which hemoglobin type is elevated in blood?
*А. Carboxyhemoglobin.
В. Methemoglobin.
С. Carbhemoglobin.
D. Oxyhemoglobin.
Е. Glycosylated hemoglobin.
140. Bleeding after an insignificant damage is found in a 37-year-old patient against the
background of long-term administration of antibiotics. A decrease in the activity of blood
coagulation factors II, VII, X, prolongation of blood coagulation is observed. What vitamin
deficiency causes the outlined changes?
А. D.
В. А.
C. C.
*D. К.
Е. Е.
141. A newborn has physiological jaundice. The level of free bilirubin in blood considerably
exceeds the normal values. What enzyme deficiency is it?
А. Heme oxygenase.
В. Transaminase.
С. Xantine oxidase.
D. Adenosine deaminase.
*Е. UDP-glucoronyltransferase.
142. Barbiturates, which induce synthesis of UDP-glucuronyl transferase, are administered for
treatment of jaundice. The medical effect is mediated by the formation of:
*А.Conjugated bilirubin
В.Unconjugated bilirubin.
С. Biliverdin.
D. Protoporphyrin.
Е. Heme.
143. The diagnosis of a 20-year-old young male is an inherited UDP-glucoronyl transferase
deficiency. Which parameter is used to verify the diagnosis?
А. Stercobilinogen.
В. Conjugated bilirubin.
С. Urobilin.
*D. Unconjugated bilirubin.
Е. Animal indican.
144. Vicasol (a synthetic counterpart of vitamin K) was recommended to a 6-year-old child for
preventing a postoperative bleeding. What posttranslational modification of the blood
coagulation factors is activated under the influence of vicasol?
*А. Carboxylation of glutamic acid.
В. Phosphorilation of serine residues.
С. Limited proteolysis.
D. Polymerization.
Е. Glycosilation.
145. Yellow color of skin and mucous membranes is found in a 2-day-old child. Which enzyme
temporary deficiency can cause this?
А. Heme oxygenase.
В. Sulphotransferase.
С. Heme synthetase.
*D. UDP-glucoronyltransferase.
Е. Bilirubin reductase.
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146. A patient has yellow skin, dark urine, and dark-yellow feces. What substance concentration
is increased in the blood serum?
A. Verdoglobin
B. Conjugated bilirubin
C. Biliverdin
*D. Unconjugated bilirubin
E. Mesobilirubin
147. A patient complains of frequent diarrheas, especially after consumption of food, rich in fat,
weight loss. Laboratory examination revealed steatorrhea; his feces were hypocholic. What
might cause such condition?
A. lnflammation of small intestinal mucous membrane
*B. Obstruction of bile ducts
C. Lack of pancreatic lipase
D. Lack of pancreatic phospholipase
E. Unbalanced diet
148. A patient has diabetes mellitus accompanied by hyperglycemia on an empty stomach (7.2
mmol/l). The hyperglycemia rate can be retrospectively assessed (over the last 4-8 weeks before
the examination) on the basis of the levels of the following blood plasma protein:
A. Albumin
B. Ceruloplasmin
C. Fibrinogen
*D. Glycosylated hemoglobin
E. C-reactive protein
149. A 38-year-old patient suffers from rheumatism in its active phase. What laboratory
parameter of blood serum is of diagnostic importance in case of this pathology?
A. Uric acid
B. Creatinine
*C. C-reactive protein
D. Transferrin
E. Urea
150. A patient has liver cirrhosis. The state of antitoxic liver function can be characterized by
examination of the following substance excreted in the urine:
A. Uric acid
*B. Hippuric acid
C. Ammonium salts
D. Amino acids
E. Creatinine
151. A 56-year-old patient was hospitalized with complaints of general weakness, tongue pain
and burning, sensation of limb numbness. In the past he underwent resection of forestomach. In
blood: Hb - 80 g/l; erythrocytes – 2.0*1012/l; colour index - 1.2, leukocytes – 3.5*109/l. What
anemia type is it?
A. Hemolytic
*B. B12-folate deficiency
C. Aplastic
D. Posthemorrhagic
E. Iron-deficient
152. A concentrated solution of sodium chloride was intravenously injected to an animal. This
caused a decrease in reabsorption of sodium ions in the renal tubules. It is the result of the
following changes in hormonal secretion:
A. Aldosterone increase
B. Reduction of atrial natriuretic factor
C. Vasopressin increase
*D. Aldosterone reduction
E. Vasopressin reduction
153 A 16-year-old boy after an illness has diminished function of protein synthesis in the liver as
a result of vitamin K deficiency. It will cause disturbance of:
*A. Blood coagulation
B. Anticoagulant generation
C. Erythropoietin secretion
D. Erythrocyte sedimentation rate
E. Osmotic blood pressure
154. A patient treated from viral hepatitis type B got symptoms of hepatic insufficiency. What
blood changes indicative of protein metabolism disorder will be observed in this case?
A. Absolute hyperfibrinogenemia
B. Absolute hyperalbuminemia
*C. Absolute hypoalbuminemia
D. Blood proteine composition is unchanged
E. Absolute hyperglobulinemia
155. Examination of a man who had been working hard under high temperature revealed
abnormal quantity of blood plasma proteins. What phenomenon is the case of such changes?
A. Absolute hyperproteinemia
B. Paraproteinemia
*C. Relative hyperproteinemia
D. Absolute hypoproteinemia
E. Dysproteinemia
156. A patient came to the hospital complaining of quick fatigability and apparent muscle
weakness. Examination revealed an autoimmune disease that causes disorder of functional
receptor condition in neuromuscular synapses. What transmitter will be blocked?
A. Noradrenaline
B. Serotonin
C. Glycine
D. Dopamine
*E. Acetylcholine
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157. A 20-year-old patient complains of general weakness, dizziness, quick fatigability. Blood
analysis results: Hb- 80 g/l. Microscopical examination of erythrocytes revealed that they are of
modified shape. This condition might be caused by:
A. Obstructive jaundice
B. Acute intermittent porphyria
*C. Sickle-cell anemia
D. Addison's disease
E. Hepatocellular jaundice
158. After consumption of food rich in fats, a patient has nausea and heartburn, steatorrhea. This
condition might he caused by:
A. Increased lipase secretion
*B. Bile acid deficiency
C. Amylase deficiency
D. Disturbed phospholipase synthesis
E. Disturbed trypsin synthesis
159. Substitution of the glutamic acid to valine was revealed while examining Hb initial
molecular structure. Which inherited pathology is it?
A. Thalassemia
*B. Sickle-cell anemia
C. Favism
D. Minkowsky-Shauffard disease
E. Hemoglobinosis
160. A worker has decreased buffer capacity of blood due to the exhausting muscular work. An
increase in what acidic substance in the blood can cause this symptom?
A. 3-Phosphoglycerate
B. l,3-Bisphosphoglycerate
C. Pyruvate
D. α-Ketoglutarate
*E. Lactate
161. A 63-year-old woman developed symptoms of rheumatoid arthritis. Which blood indicators
could be the most significant in proving the diagnosis?
*A. Glycosaminoglycans
B. Acid phosphatase
C. Lipoproteins
D. Total cholesterol
E. R-Glycosidase
162. A patient with hypochromic anemia has loss of hair, increased nail brittling and taste
alteration. What is the mechanism of the symptoms development?
A. Decreased production of parathyroid hormone
B. Deficiency of vitamin A
*C. Deficiency of iron-containing enzymes
D. Decreased production of thyroid hormones
E. Deficiency of vitamin B12
163. The high level of lactate dehydrogenase (LDH) isozymes concentration with the increase of
LDH-l and LDH-2 is found in a patient's blood plasma. Point out the most probable diagnosis:
*A. Myocardial infarction
B. Acute pancreatitis
C. Skeletal muscle dystrophy
D. Viral hepatitis
E. Diabetes mellitus
164. A marked increase in the activity of MB-forms of CPK (creatine phosphokinase) and LDHl
was revealed in the patient's blood. What is the most probab1e pathology?
A. Rheumatism
B. Hepatitis
*C. Myocardial infarction
D. Pancreatitis
E. Cholecystitis
165. Chronic glomerulonephritis was diagnosed in a 34-year-old patient 3 years ago. Edema has
developed within the last 6 monthes. What caused the edema?
A. Hyperosmolarity of plasma
B. Hyperaldosteronism
C. Liver disfunction of protein formation
D. Hyperproduction of vasopressin
*E. Proteinuria
166. A patient, who suffers from congenital erythropoietic porphyria, has skin photosensitivity.
The accumulation of what compound in the skin can cause it?
A. Heme
B. Uroporphyrinogen 2
C. Coproporphyrinogen 3
D. Protoporphyrin
*E. Uroporphyrinogen 1
167. The concentration of albumins in a human blood sample is lower than normal. This leads to
edema of tissues. What blood function is damaged?
A. Maintaining the pH level
B. Maintaining the blood sedimentation system
C. All answers are correct
*D. Maintaining the oncotic blood pressure
E. Maintaining the body temperature
168. A patient with diabetes mellitus was delivered to a hospital in the state of
unconsciousness. Arterial pressure is low. The patient has acidosis. Point substances whose
accumulation in the blood results in these manifestations:
A. Cholesterol esters
B. High fatty acids
C. Monosaccharides
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D. Amino acids
*E. Ketone bodies
169. Desulfiram is widely used in medical practice to prevent alcocholism. It inhibits aldehyde
dehydrogenase. Increased level of what metabolite causes aversion to alcochol?
A. Propionic aldehyde
B. Methanol
С. Ethanol
*D. Acetaldehyde
E. Malonyl aldehyde
170. A 34-year-old patient was diagnosed with chronic glomerulonephritis 3 years ago. Edema
has developed within the last 6 months. What caused the edema?
A. Hyperosmolarity of plasma
B. Hyperproduction of vasopressin
*C. Proteinuria
D. Liver dysfunction of protein formation
E. Hyperaldosteronism
171. A considerable increase in the activity of MB-forms of CPK (creatine phosphokinase) and
LDH-1 was revealed in the patient's blood. What is the most likely pathology?
A. Pancreatitis
B. Rheumatism
C. Hepatitis
*D. Myocardial infarction
E. Cholecystitis
172. Diabetes mellitus causes ketosis as a result of activated oxidation of fatty acids. What
disorders of acid-base equilibrium may be caused by excessive accumulation of ketone bodies in
blood?
A. Metabolic alkalosis
*B. Metabolic acidosis
C. No changes
D. Respiratory acidosis
E. Respiratory alkalosis
173. A 4-year-old child with signs of long-term protein starvation was admitted to the hospital.
The signs were as follows: growth inhibition, anemia, edema, mental disorders. Choose the cause
of edema development:
*A. Reduced synthesis of albumins
B. Reduced synthesis of hemoglobin
C. Reduced synthesis of glycoproteins
D. Reduced synthesis of globulins
E. Reduced synthesis of lipoproteins
174. A 35-year-old patient who often consumes alcohol was treated with diuretics. Serious
muscle and heart weakness, vomiting, diarrhea, AP- 100/60 mm Hg, depression appeared. This
condition is caused by intensified renal excretion of:
*A. Potassium
B. Phosphates
C. Chloride
D. Sodium
E. Calcium
175. Osmotic pressure of blood plasma is 350 mosmole/l (standard pressure is 300 mosmole/l). It
is primarily due to oversecretion of the following hormone:
A. Vasopressin
B. Adrenocorticotropin
C. Cortisol
D. Natriuretic factor *E.
Aldosterone
176. A patient has high activity of LDH1, 2, aspartate aminotransferase, creatine phosphokinase.
In what organ (organs) is the development of a pathological process the most probable?
*A. In the heart muscle (initial stage of myocardium infarction)
B. In skeletal muscles (dystrophy, atrophy)
C. In kidneys and adrenal glands
D. In liver and kidneys
E. In connective tissue
177. Examination of a 43 year-old-patient with nephritis revealed anemia symptoms. What is the
cause of these symptoms?
A. Folic acid deficiency
B. Iron deficiency
*C. Reduced synthesis of erythropoietins
D. Vitamin B12 deficiency
E. Enhanced destruction of erythrocytes
178. Twelve hours after an acute attack of retrosternal pain, a patient had an increase in aspartate
aminotransferase activity in blood serum. What pathology is this deviation typical for?
*A. Myocardium infarction
B. Viral hepatitis
C. Diabetes mellitus
D. Collagenosis
E. Diabetes insipidus
179. A 30-year-old woman felt pain in the area of joints for the first time one year ago. They got
swollen and skin above them became red. Initial diagnosis is rheumatoid arthritis. One of the
most probable causes of this disease is a structure alteration of a connective tissue protein:
*A. Collagen
B. Troponin
C. Ovoalbumin
D. Mucin
E. Myosin
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180. A 48-year-old patient was admitted to the hospital with complaints of weakness, irritability,
sleep disturbance. Objectively: skin and scleras are yellow. In blood: high conjugated bilirubin,
cholalemia. Feces are acholic. Urine is of dark colour (bilirubin). What type of jaundice is it?
*A. Mechanic
B. Crygler-Najjar syndrome
C. Hemolytic
D. Parenchymatous
E. Gilbert's syndrome
181. Analysis of blood serum of a patient revealed an increase in alanine aminotransferase and
aspartate aminotransferase. What cytological changes can cause such a situation?
A. Disturbance of cellular interrelations
*B. Cellular breakdown
C Disturbance of genetic apparatus of cells
D. Disturbed function of energy supply of cells
E. Disorder of enzyme systems of cells
182. A patient complains of dyspnea provoked by the physical activity. Clinical examination
revealed anemia and the presence of the paraprotein in the fraction of gamma-globulins. To
confirm the myeloma diagnosis, it is necessary to determine the following index in the patient's
urine:
*A. Bence Jones protein
B. Hemoglobin
C. Bilirubin
D. Antitrypsin
E.
Ceruloplasmin
183. A 50-year-old patient complains of general weakness, appetite loss and cardiac arrhythmia.
The patient has muscle hypotonia, flaccid paralysis, weakened peristaltic activity of the bowels.
Such condition might be caused by:
A. Hypoproteinemia
B. Hypophosphatemia
C. Hyponatremia
*D. Hypokalemia
E. Hyperkalemia
184. After a surgery, a 36-year-old woman was given an intravenous injection of concentrated
albumin solution. This induced intensified water movement in the following direction:
A. From the capillaries to the intercellular fluid
B. From the intercellular fluid to the cells
C. No changes of water movement will be
observed
*D. From the intercellular fluid to the capillaries
E. From the cells to the intercellular
fluid
185. Two weeks after lacunar tonsillitis, a 20-year-old man started complaining of general
weakness, lower eyelid edema. After examination, the patient was diagnosed with acute
glomerulonephritis. What are the most probable pathological changes in the urine?
A. Natruria
B. Pyuria
*C. Proteinuria
D. Presence of fresh erythrocytes
E. Cylindruria
186. A 62-year-old female patient complains of frequent pains in the region of thorax and
vertebral column, rib fractures. A physician suspected myelomatosis (plasmocytoma). Which of
the following laboratory indices will be of the greatest diagnostic importance?
A. Proteinuria
B. Hypoglobulinemia
C. Hyperalbuminemia
D. Hypoproteinemia
*E. Paraproteinemia
187. Examination of a 27-year-old patient revealed pathological changes in liver and brain.
Blood plasma analysis revealed an abrupt decrease in the copper concentration, urine analysis
revealed an increased copper concentration. The patient was diagnosed with Wilson's
degeneration. To confirm the diagnosis, it is necessary to study the activity of the following
enzyme in blood serum:
A. Alcohol dehydrogenase
*B. Ceruloplasmin
C. Leucine aminopeptidase
D. Carbonic anhydrase
E. Xanthine oxidase
188. As a result of increased permeability of the erythrocyte membrane in a patient with
microspherocytic anaemia (Minkowsky-Shauffard disease), cells receive sodium ions and water.
Erythrocytes take form of spherocytes and can be easily broken down. What is the leading
mechanism of erythrocyte damage in this case?
*A. Electrolytic osmotic
B. Nucleic
C. Calcium
D. Acidotic
E. Protein
189. Tooth extraction in a patient with chronic persistent hepatitis was complicated by a
prolonged bleeding. What is the cause of hemorrhagic syndrome?
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A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
*Decreased production of thrombin
Decreased production of fibrin
Increased fibrinolysis
Increased production of thromboplastin
Increased synthesis of fibrinogen
190. Wilson’s disease is a disorder of copper transport, which leads to the accumulation of this
metal in brain and liver cells. It is associated with a disturbance in the synthesis of the following
protein:
*Ceruloplasmin
Transcobalamin
Metallothionein
Haptoglobin
Siderophilin
191. Activation of certain hemostasis system factors is done through calcium ions attachment.
What structural component allows this attachment?
A. *Gamma-carboxyglutamic acid
B. Gamma-aminobutyric acid
C. Gamma-oxybutyric acid
D. Hydroxyproline
E. Mono amino dicarboxylic acids
192. A 50-year-old patient was examined by a dentist and found to have crimson smooth tongue.
Blood analysis revealed a decrease in RBC level and hemoglobin concentration, colour index of
1.3, symptoms of megaloblastic hematopoiesis, degenerative changes in WBCs. Which blood
disorder was found in this patient?
*B12-folic acid-deficiency anemia
Iron deficiency anemia
Myeloid leukemia
Aplastic anemia
Hemolytic anemia
193. Electrophoretic study of blood serum in a patient with pneumonia revealed an increase in
one of the protein fractions. What fraction is it?
*Gamma-globulins
Albumins
α1-Globulins
α2-Globulins
β-Globulins
194. A 30-year-old comatous patient with type I diabetes mellitus was admitted to a hospital.
Laboratory tests revealed hyperglycemia, ketonemia. Which of the following metabolic disorders
might be found in this patient?
*Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
Normal acid-base state
195. 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
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A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
196. A 46-year-old female patient needs a surgery in the maxillofacial region. The patient is
known to be disposed to increased hemocoagulation. What natural anticoagulant can be used in
order to prevent thrombosis?
*Heparin
Hirudin
Sodium citrate
Fibrinolysin
None of the listed drugs
197. After implantation of a cardiac valve, a young man constantly has been taking indirect
anticoagulants. His state was complicated by a hemorrhage. What substance content is decreased
in blood?
*Prothrombin
Haptoglobin
Heparin
Creatin
Ceruloplasmin
198. A man is in the state of rest. He has been forcing himself to breath deeply and frequently for
3-4 minutes. What effect will it have upon acid-bace balance of the organism?
*Respiratory alkalosis
Respiratory acidosis
Metabolic alkalosis
Metabolic acidosis
There will be no change in acid-base balance
199. 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 can be caused by the following substance deficiency:
*Vitamin B12
Vitamin A
Vitamin K
Iron
Zinc
200. A patient with diabetes mellitus lapsed into diabetic coma as a result of acid-base
disbalance. Specify the type of disbalance:
*Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Gaseous alkalosis
Non-gaseous alkalosis
201. A 29-year-old patient was delivered to a hospital due to the intoxication with carbon
monoxide. Objectively: the patient shows symptoms of severe hypoxia - evident dyspnea,
cyanosis, tachycardia. What compound is produced as a result of intoxication with carbon
monooxide?
*Carboxyhemoglobin
Methemoglobin
Carbhemoglobin
Sulfhemoglobin
Oxyhemoglobin
202. A patient complains of frequent gingival haemorrhages he has been experiencing since his
childhood. Blood test revealed a deficiency in blood-coagulation factor VIII. This means that the
patient has an impairment of:
*Prothrombinase generation
Thrombin generation
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C.
D.
E.
Fibrin generation
Thrombocyte adhesion
Thrombocyte aggregation
203. It is known that people who permanently live in highlands have an increased concentration
of erythrocytes per each blood volume unit. Owing to this fact, blood can optimally fulfill the
following function:
A.
*Gas transport
B.
Amino acid transport
C.
Haemostasis participation
D.
Maintenance of acid-base balance
E.
Maintenance of ionic equilibrium
204. Patients with erythropoietic porphyria (Gunther’s disease) are known to have photosensitive
skin, red urine. In the ultraviolet light their teeth exhibit bright red fluorescence. This disease is
associated with deficiency of the following enzyme:
A.
*Uroporphyrinogen-III-cosynthase
B.
Uroporphyrinogen-I-synthase
C.
Delta-aminolevulinate synthase
D.
Uroporphyrinogen decarboxylase
E.
Ferrochelatase
205. Prophylactic examination of a patient revealed hyperglycemia, ketonuria, polyuria,
glycosuria. What form of acid base balance disorder is the case?
A.
*Metabolic acidosis
B.
Gaseous acidosis
C.
Nongaseous acidosis
D.
Gaseous alkalosis
E.
Metabolic alkalosis
206. A patient treated from viral hepatitis B developed symptoms of hepatic insufficiency. What
changes indicating disorders in protein metabolism are likely to be observed in this case?
A.
*Absolute hypoalbuminemia
B.
Absolute hyperalbuminemia
C.
Absolute hyperfibrinogenemia
D.
Protein rate in blood will stay unchanged
E.
Absolute hyperglobulinemia
207. A 38-year-old patient takes aspirin and sulfanilamides. After their intake, intensified
erythrocyte haemolysis is observed, which is caused by glucose 6- phosphate dehydrogenase
deficiency. This pathology is caused by failure of the following coenzyme:
A.
*NADP − H
B.
FAD − H2
C.
Pyridoxal phosphate
D.
FMN − H2
E.
Ubiquinone
208. A woman with vomiting was admitted to an infectious disease ward. What changes of
water-salt metabolism are likely to be observed?
A.
*Hypoosmolar dehydration
B.
Isoosmolar dehydration
C.
Hyperosmolar dehydration
D.
Hypoosmolar hyperdehydration
E.
Hyperosmolar hyperdehydration
209. A full-term newborn child has yellowish skin and mucous membranes. This might be probably
caused by temporary deficiency of the following enzyme:
A.
*UDP-glucoronyltransferase
B.
Uridine transferase
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C.
Heme synthetase
D.
Heme oxygenase
E.
Biliverdin reductase
210. A 46-year-old woman suffering from chololithiasis developed jaundice. Her urine became darkyellow and feces became colourless. Blood serum will have the highest concentration of the
following substance:
A.
*Conjugated bilirubin
B.
Unconjugated bilirubin
C.
Biliverdin
D.
Mesobilirubin
E.
Urobilinogen
211. A patient is 44 years old. Laboratory examination of his blood revealed that the content of
proteins in plasma was 40 g/l. What influence will be exerted on the transcapillary water exchange?
A.
*Filtration will be increased, reabsorption – decreased
B.
Both filtration and reabsorption will be increased
C.
Both filtration and reabsorption will be decreased
D.
Filtration will be decreased, reabsorption – increased
E.
Exchange will stay unchanged
212. A man weighs 80 kg, after long physical activity his circulating blood volume is reduced to 5.4
l, hematocrit made up 50%, while his total blood protein was 80 g/l. These blood characteristics are
determined primarily by:
A.
*Water loss with sweat
B.
Increased number of erythrocytes
C.
Increased protein concentration in plasm
D.
Increased circulating blood volume
E.
Increased dieresis
213. Patients who suffer from severe diabetes and don’t receive insulin have metabolic acidosis.
This is caused by the increased concentration of the following metabolites:
A.
*Ketone bodies
B.
Fatty acids
C.
Unsaturated fatty acids
D.
Triacylglycerols
E.
Cholesterol
214. A 15-year-old girl has pale skin, glossitis, and gingivitis. Blood count: erythrocytes – 3.3 .
1012/l, hemoglobin - 70 g/l, colour index – 0.5. Examination of blood smear revealed hypochromia,
microcytosis, and poikilocytosis. What type of anemia is it?
A.
*Iron-deficient
B.
B12-folic acid-deficient
C.
Sickle-cell
D.
Hemolytic
E.
Thalassemia
215. A newborn with pylorostenosis often has repeating vomiting accompanied by apathy,
weakness, hypertonicity, sometimes convulsions. What disorder of acid-base balance is it?
A.
*Non-gaseous alkalosis
B.
Gaseous alkalosis
C.
Gaseous acidosis
D.
Metabolic acidosis
E.
Excretory acidosis
216. A male patient was diagnosed with acute radiation disease. Laboratory examination revealed a
considerable reduction of platelet serotonin level. The likely cause of platelet serotonin reduction is
the disturbed metabolism of the following substance:
A.
*5-oxytryptophane
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B.
Tyrosine
C.
Histidine
D.
Phenylalanine
E.
Serine
217. Hemoglobin catabolism results in the release of iron, which is transported to the bone marrow
by a certain transfer protein and re-used for the synthesis of hemoglobin. Tell the name of this
transfer protein:
A.
*Transferrin (siderophilin)
B.
Transcobalamin
C.
Haptoglobin
D.
Ceruloplasmin
E.
Albumin
218. A patient with diabetes mellitus developed a diabetic coma due to the acid-base imbalance.
Specify the kind of this imbalance:
A.
*Metabolic acidosis
B.
Metabolic alkalosis
C.
Respiratory acidosis
D.
Gaseous alkalosis
E.
Non-gaseous alkalosis
219. 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 this?
A.
*Compensated respiratory acidosis
B.
Compensated metabolic acidosis
C.
Decompensated metabolic acidosis
D.
Compensated respiratory alkalosis
E.
Decompensated respiratory alkalosis
220. For the study of serum proteins, various physical and physicochemical methods can be
used. In particular, serum albumins and globulins can be separated by the method of:
A.
*Electrophoresis
B.
Polarography
C.
Dialysis
D.
Spectrography
E.
Refractometry
221. A 49-year-old male patient with acute pancreatitis was likely to develop pancreatic necrosis,
while active pancreatic proteases were released into the bloodstream and tissue proteins were
broken down. What protective factors of the body can inhibit these processes?
A.
*α2-Macroglobulin, α1-antitrypsin
B.
Immunoglobulin
C.
Cryoglobulin, interferon
D.
Ceruloplasmin, transferrin
E.
Hemoplexin, haptoglobin
222. A newborn has numerous hemorrhages. Blood coagulation tests revealed the increased
prothrombin time. The child is most likely to have a disorder of the following biochemical
process:
A.
*Production of gamma-carboxyglutamate
B.
Conversion of homocysteine to methionine
C.
Conversion of methylmalonyl CoA to succinyl CoA
D.
Degradation of glutathione
E.
Hydroxylation of proline
223. A patient has severe blood loss caused by an injury. What kind of dehydration will be
observed in this particular case?
A.
*Isoosmolar
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B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
Hyposmolar
Hyperosmolar
Nonmosmolar
224. A 28-year-old patient undergoing treatment in the pulmonological department was
diagnosed with pulmonary emphysema caused by splitting of alveolar septum by trypsin. The
disease is caused by the congenital deficiency of the following protein:
*α1-Proteinase inhibitor
α2-Macroglobulin
Cryoglobulin
Haptoglobin
Transferrin
225. Biochemical analysis of infant’s erythrocytes revealed evident glutathione peroxidase
deficiency and low concentration of reduced glutathione. What pathological condition can
develop in this infant?
*Hemolytic anemia
Iron-deficiency anemia
Megaloblastic anemia
Pernicious anemia
Sickle-cell anemia
226. Along with normal hemoglobin types, the pathological ones can exist in adults. Name one
of them:
*HbS
HbA2
HbO2
HbA1
HbF
227. 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 in the fibrinogen content in blood
Hypocalcemia
Increased activity of the anticoagulation system
Decrease in the albumin content in blood
Thrombocytopenia
228. An isolated heart of a mammal had diastolic arrest in the process of perfusion with an ionrich solution. The solution had excess of the following ions:
*Potassium
Sodium
Magnesium
Chloride
Calcium
229. A 30-year-old man with diabetes mellitus type I was hospitalised. The patient is comatose.
Laboratory tests revealed hyperglycemia and ketonemia. What metabolic disorder can be
detected in this patient?
A. *Metabolic acidosis
B. Respiratory acidosis
C. Normal acid-base balance
D. Respiratory alkalosis
E.
Metabolic alkalosis
230. A female patient with toxemia of pregnancy has hypersalivation resulting in a daily loss of
3-4 liters of saliva. What disorder of water-salt metabolism occurs in such cases?
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A.
B.
C.
D.
E.
*Hyperosmolar hypohydration
Hypoosmolar hypohydration
Isoosmolar hypohydration
Hypokalemia
Hyponatremia
231. A 36-year-old male patient has malabsorption of sodium ions from the intestinal lumen. At
the same time, absorption of the following substances REMAINS UNCHANGED:
A. *Fats
B. Carbohydrates
C. Proteins
D. Water
E. Chlorides
232. Reduced activity of antioxidant enzymes enhances peroxidation of cell membrane lipids.
The reduction of glutathione peroxidase activity is caused by the following microelement
deficiency:
A. *Selenium
B. Molybdenum
C. Cobalt
D. Manganese
E. Copper
233. A 5-month-old boy was hospitalized due to tonic convulsions. He has a lifetime history of
this disease. Examination revealed coarse hair, thin and fragile nails, pale and dry skin. In blood:
calcium – 1.5 mmol/l, phosphorus – 1.9 mmol/l. These changes are associated with:
A.
*Hypoparathyroidism
B.
Hyperparathyroidism
C.
Hyperaldosteronism
D.
Hypoaldosteronism
E.
Hypothyroidism
234. A 35-year-old man consulted a dentist about reduced density of dental tissue, high fragility of
teeth during eating solid food. This patient suffers the most probably from the deficiency of the
following mineral element:
A.
*Calcium
B.
Potassium
C.
Sodium
D.
Magnesium
E.
Iron
235. A patient with signs of osteoporosis and urolithiasis was admitted to the endocrinology
department. Blood test revealed hypercalcemia and hypophosphatemia. These changes are
associated with abnormal synthesis of the following hormone:
A.
*Parathyroid hormone
B.
Calcitonin
C.
Cortisol
D.
Aldosterone
E.
Calcitriol
236 A patient taking drugs that block the production of angiotensin II developed bradycardia and
arrhythmia. The probable cause of these disorders is:
A.
*Hyperkalemia
B.
Hypokalemia
C.
Hypernatremia
D.
Hypocalcemia
E.
Hypercalcemia
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A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
A.
B.
C.
D.
237. A patient has oliguria caused by acute renal failure. What daily amount of urine corresponds
to this symptom?
*100-500 ml
1500-2000 ml
1000-1500 ml
50-100 ml
500-1000 ml
238. A patient at the early stage of diabetes mellitus was found to have polyuria. What is its
cause?
*Hyperglycemia
Hypocholesterolemia
Ketonemia
Hyperkaliemia
Hypercholesterolemia
239. Arterial pH is 7.4; primary urine pH is 7.4; final urine pH is 5.8. A decrease in the pH of
final urine is the result of the secretion of the following ions in the nephron tubules:
*Hydrogen ions
Potassium ions
Hydrogen carbonate ions
Urea
Creatinine
240. After a person had drunk 1.5 liters of water, the amount of urine increased significantly, and
its relative density decreased to 1.001. These changes are a result of decreased water
reabsorption in the distal nephron portion due to the reduced secretion of:
*Vasopressin
Aldosterone
Angiotensin II
Renin
Prostaglandins
241. A 20-year-old patient complains of morbid thirst and hyperdiuresis (up to 10 l daily).
Glucose concentration in blood is normal, but it is absent in urine. The patient was diagnosed
with diabetes insipidus. What hormonal drug is the most appropriate for the management of this
disorder?
*Vasopressin
Cortisol
Thyroxin
Oxytocin
Insulin
242. 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
243. A patient was delivered to a hospital with a provisional diagnosis of progressing muscle
dystrophy. This diagnosis can be confirmed by the increased concentration of the following
substance found in urine:
*Creatine
Pyruvate
Carnosine
Troponin
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E.
Hydroxyproline
244. Analysis of urine obtained from a 24-year-old man revealed the following changes: daily
diuresis – 10 l, relative density – 1.001, qualitative alterations are absent. A patient complains of
excessive thirst, frequent urination. What is the most likely cause of this disease?
A.
*Vasopressin hyposecretion
B.
Glucocorticoid hypersecretion
C.
Vasopressin hypersecretion
D.
Relative insulin insufficiency
E.
Aldosterone hypersecretion
245. A child with renal insufficiency exhibits delayed teeth eruption. This is most likely caused
by the abnormal formation of the following substance:
A.
*1,25 (OH)2D3
B.
Glycocyamine
C.
Glutamate
D.
α-Ketoglutarate
E.
Hydroxylysine
246. Glucose concentration in a patient’s blood is 15 mmol/l (reabsorption threshold is 10
mmol/l). What effect can be expected?
A.
*Glucosuria
B.
Diuresis reduction
C.
Reduced glucose reabsorption
D.
Reduced vasopressin secretion
E.
Reduced aldosterone secretion
247. A 30-year-old woman has face edema. Examination revealed proteinuria (5.87 g/l),
hypoproteinemia, dysproteinemia, and hyperlipidemia. What condition is the set of these symptoms
typical for?
A.
*Nephrotic syndrome
B.
Nephritic syndrome
C.
Chronic pyelonephritis
D.
Acute renal failure
E.
Chronic renal failure
248. A patient had had 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:
A.
*Angiotensin II
B.
Angiotensinogen
C.
Renin
D.
Catecholamines
E.
Nor-epinephrine
249. A patient with hypertensic crisis has increased content of angiotensin II in blood.
Angiotensin pressor effect is based on:
A. *Contraction of arteriole muscles
B. Vasopressin production stimulation
C. Activation of biogenic amine synthesis
D. Prostaglandin hyperproduction
E. Activation of the kinin-kallikrein system
250. A patient with alcohol-induced liver injury has an impairment of biotransformation of
xenobiotics and endogenous toxic compounds. These changes are likely to be caused by
hypoactivity of the following chromoprotein:
A. *Cytochrome P-450
B. Hemoglobin
C. Cytochrome oxidase
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D. Cytochrome b
E. Cytochrome c1
251. For several days a 55-year-old female patient has had pain attacks in the right upper
quadrant after eating fatty foods. Visually, there is yellowness of sclera and skin. The patient has
acholic stool, beer-colored urine. What substance present in the patient’s urine causes its dark
color?
A. *Conjugated bilirubin
B. Ketone bodies
C. Unconjugated bilrubin
D. Stercobilin
E. Bilirubin glucuronides
252. Transfusion of Rh-incompatible blood resulted in hemolytic jaundice development in a
patient. What laboratory blood parameter confirms this type of jaundice?
A. *Accumulation of unconjugated bilirubin
B. Reduction of unconjugated bilirubin
C. Accumulation of urobilinogen
D. Reduction of stercobilin
E. Reduction of conjugated bilirubin
253. Examination of a chemical plant worker who had had a poisoning revealed an increase in
total bilirubin concentration at the expense of indirect fraction. Feces and urine are characterized
by high stercobilin concentration. The level of direct bilirubin in blood plasma is normal. What
type of jaundice is this?
A. *Hemolytic
B. Obstructive
C. Hepatic
D. Parenchymatous
E. Mechanical
254. A patient with signs of jaundice caused by hepatitis virus was hospitalized to an infectious
disease unit. Select an indicator that is specific only for parenchymatous jaundice:
A.
*Increase in ALT and AST activity
B.
Hyperbilirubinemia
C.
Bilirubinuria
D.
Cholemia
E.
Urobilinuria
255. In the second week of being ill with viral hepatitis, sleep disorder, headache,
aggressiveness, unbearable skin itching developed in a patient. Objectively: AP drop, a decrease
in blood coagulation and reflectory activity, bradycardia. What is the cause of these changes?
A.
*Cholemia
B.
Hyperlipemia
C.
Urobilinemia
D.
Hypercholesterolemia
E.
Stercobilinemia
256. A 25-year-old patient was diagnosed with chronic hepatitis. The patient complains of 10 kg
weight loss within 2 months. Objectively: the patient has dry peeling skin, pale with yellow
shade, petechial haemorrhages, and stomatorrhagia. Petechial haemorrhages and stomatorrhagia
are caused by the disturbance of the following hepatic function:
A.
*Protein synthesizing
B.
Chromogenic
C.
Glycogen synthesizing
D.
Detoxication
E.
Storage
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257. A 2-day-old baby has yellowish skin and mucous membranes. This might be caused by the
temporary lack of the following enzyme:
A.
*UDP-glucuronyl transferase
B.
Sulfotransferase
C.
Heme synthetase
D.
Heme oxygenase
E.
Biliverdin reductase
258. Blood analysis of a patient suffering from jaundice revealed an increase in total bilirubin by
its indirect fraction. Urine and feces have intense colouring. What is the most probable
mechanism of these abnormalities?
A.
*Increased hemolysis of erythrocytes
B.
Obstruction of bile ducts
C.
Damage to liver parenchyma
D.
Impaired generation of direct bilirubin
E.
Impaired transformation of urobilinogen in the liver
259. A patient suffers from liver cirrhosis. The state of antitoxic liver function can be characterized
by examination of the following substance exreted in the urine:
A.
*Hippuric acid
B.
Ammonium salts
C.
Creatinine
D.
Uric acid
E.
Amino acids
260. Hepatitis led to the development of hepatic failure. The mechanism of edema formation is
activated by the impairment of the following liver function:
A.
*Protein-synthetic
B.
Barrier
C.
Bile-producing
D.
Antitoxic
E.
Glycogen-synthetic
261. Study of conversion of a food colouring agent revealed that neutralization of this xenobiotic
takes place only in one phase - microsomal oxidation. Name a component of this phase:
A.
*Cytochrome Р-450
B.
Cytochrome B
C.
Cytochrome C
D.
Cytochrome A
E.
Cytochrome oxidase
262. Jaundice treatment involves administration of barbiturates inducing the synthesis of UDPglucuronyl transferase. A medicinal effect is caused by the production of:
A.
*Direct reacting (conjugated) bilirubin
B.
Indirect reacting (unconjugated) bilirubin
C.
Biliverdin
D.
Protoporphyrin
E.
Heme
263. After severe viral hepatitis, a 4-year-old boy has vomiting, occasional loss of consciousness,
convulsions. Blood test revealed hyperammonemia. Such condition is caused by a disorder of the
following biochemical hepatic process:
A.
*Disorder of ammonia neutralization
B.
Disorder of biogenic amines neutralization
C.
Protein synthesis inhibition
D.
Activation of amino acid decarboxylation
E.
Inhibition of transamination enzymes
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264. Blood analysis of a patient with jaundice reveals conjugated bilirubinemia, increased
concentration of bile acids. There is no stercobilinogen in urine. What type of jaundice is it?
A.
*Obstructive jaundice
B.
Hepatocellular jaundice
C.
Parenchymatous jaundice
D.
Hemolytic jaundice
E.
Cythemolytic jaundice
265. 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?
A.
*Hemolytic
B.
Parenchymal (hepatic)
C.
Mechanical
D.
Neonatal jaundice
E.
Gilbert’s disease
266. Enzymatic jaundices are accompanied by abnormal activity of UDP-glucuronyl transferase.
What compound is accumulated in blood serum in case of these pathologies?
A.
*Unconjugated bilirubin
B.
Conjugated bilrubin
C.
Dehydrobilirubin
D.
Hydrobilirubin
E.
Choleglobin
267. A 50-year-old patient with food poisoning is on a drip of 10% glucose solution. It not only
provides the body with necessary energy, but also performs the function of detoxification by the
production of a metabolite that participates in the following conjugation reaction:
A.
*Glucuronidation
B.
Sulfation
C.
Methylation
D.
Glycosylation
E.
Hydroxylation
268. 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?
A.
*Cholelithiasis
B.
Hemolytic jaundice
C.
Hepatitis
D.
Chronic colitis
E.
Chronic gastritis
269. A 16-year-old adolescent is diagnosed with hereditary UDP (uridine diphosphate)glucuronyl transferase deficiency. Laboratory tests revealed hyperbilirubinemia caused mostly
by the increased blood content of the following substance:
A.
*Unconjugated bilirubin
B.
Stercobilinogen
C.
Biliverdin
D.
Urobilinogen
E.
Conjugated bilirubin
270. A patient was hospitalized with complaints of quick fatigability and significant muscle
weakness. Examination revealed an autoimmune disease that causes functional disorder of
receptors in the neuromuscular synapses. This will result in the disturbed activity of the
following mediator:
A. *Acetylcholine
A. Serotonin
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B. Dopamine
C. Noradrenaline
D. Glycine
271. A 34-year-old patient has a history of periodontitis. As a result of increased collagen
degradation, there is a significantly increased urinary excretion of one of the amino acids. Which
amino acid is this?
A. *Hydroxyproline
B. Valine
C. Alanine
D. Glycine
E. Serine
272. Monoamine oxidase inhibitors are widely used in clinics as psychopharmacological drugs.
They change the level of the following neurotransmitter in the synapses:
A. *Norepinephrine
B. Acetylcholine
C. ATP
D. Substance P
E. L-glutamate
273. Inhibitory effect of GABA is due to the increased permeability of the postsynaptic
membrane for chloride ions. This mediator is produced as a result of decarboxylation of the
following amino acid:
A. *Glutamate
B. Aspartate
C. Glutamine
D. Asparagine
E. Arginine
274. After a diver had dived to a depth of 60 meters, he got the following symptoms of CNS
dysfunction: anxiety, euphoria, lack of attention, professional errors. These symptoms are
associated with neurons exposed to:
A. *Nitrogen
B. Oxygen
C. Carbon dioxide
D. Ammonia
E. Lactate
275. When a wound heals, a scar is formed. What substance is the main component of its
connective tissue?
A. *Collagen
B. Elastin
C. Keratan sulfate
D. Chondroitin sulfate
E. Hyaluronic acid
276. Osteolaterism is characterized by a decrease in collagen strength caused by much less
intensive formation of crosslinks in collagen fibers. This phenomenon is caused by the low
activity of the following enzyme:
A.
*Lysyl oxidase
B.
Monoamino-oxidase
C.
Prolyl hydroxylase
D.
Lysyl hydroxylase
E.
Collagenase
277. Examination of a patient revealed typical manifestations of collagenosis. This pathology is
characterized by an increase in the following urine index:
A.
*Hydroxyproline
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B.
Arginine
C.
Glucose
D.
Mineral salts
E.
Ammonium salts
278. A 36-year-old female patient has a history of collagen disease. Urine analysis is likely to reveal
an increased concentration of the following metabolite:
A.
*Oxyproline
B.
Indican
C.
Creatinine
D.
Urea
E.
Urobilinogen
279. A child has mental and physical retardation, severe damage to internal connective tissue. Urine
analysis reveals keratan sulfates. Metabolism of which substances is affected?
A.
*Glycosaminoglycans
B.
Collagen
C.
Elastin
D.
Fibronectin
E.
Hyaluronic acid
280. Inherited diseases, such as mucopolysaccharidoses, are manifested in metabolic disorders of
connective tissue, bone and joint pathologies. The sign of this disease is the excessive urinary
excretion of the following substance:
A.
*Glycosaminoglycans
B.
Amino acids
C.
Glucose
D.
Lipids
E.
Urea
281. A 53-year-old male patient is diagnosed with Paget’s disease. The concentration of
oxyproline in daily urine is sharply increased, which primarily means intensified disintegration
of:
A.
*Collagen
B.
Keratin
C.
Albumin
D.
Hemoglobin
E.
Fibrinogen
282. A 15-year-old boy was diagnosed with acute viral hepatitis. What blood parameter should
be determined to confirm acute affection of hepatic cells?
A. *Aminotransferase activity (AST, ALT)
B. Cholesterol content
C. Protein fraction content
D. Unconjugated and conjugated bilirubin content
E. Erythrocyte sedimentation rate (ESR)
283. 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?
A. *Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Acid-base balance remains unchanged
E. Metabolic alkalosis
284. A 50-year-old woman diagnosed with cardiac infarction was delivered to an intensive
care ward. What enzyme will be the most active during the first two days?
A. *Aspartate aminotransferase
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B. Alanine aminotransferase
C. LDH4
D. Alanine aminopeptidase
E. LDH5
285. Which of the substances mentioned below is the substrate of activated Christmas factor
that takes part in blood coagulation?
A. *Factor X
B. Vitamin K
C. Fibrinogen
D. Fibrin
E. Thrombin
286. A pregnant woman developed severe toxemia with exhausting recurrent vomiting
throughout a day. By the end of the day she developed titanic convulsions and dehydration.
The described changes were caused by the following type of acid-base disbalance:
A. *Non-gaseous excretory alkalosis
B. Gaseous alkalosis
C. Gaseous acidosis
D. Non-gaseous metabolic acidosis
E. Non-gaseous excretory acidosis
287. A patient has a gene mutation involved in hemoglobin synthesis. This condition led to
development of sickle-cell disease. Name the pathological hemoglobin characteristic of this
disease:
A. *HbS
B. HbA
C. HbF
D. HbA1
E. Bart-Hb
288. Due to recurring vomiting a patient lost significant amounts of gastric juice, which led
to development of acid-base disbalance. What type of acid-base disbalance developed?
A. *Non-gaseous alkalosis
B. Gaseous acidosis
C. Non-gaseous acidosis
D. Gaseous alkalosis
E. Metabolic acidosis
289. A patient suffering from parkinsonism was prescribed with levodopa, which resulted in
rapid improvement of the patient’s condition. What mechanism of action is characteristic of this
drug?
A. *Stimulation of dopamine synthesis
B. Block of muscarinic receptors
C. Stimulation of dopamine receptors
D. Anticholinesterase action
E. Stimulation of muscarinic receptors
290. For several days a 55-year-old woman has been suffering from pain attacks in the right
upper quadrant after eating fatty foods. Visually, there is yellowness of sclera and skin. The
patient has acholic stool, beer-colored urine.What substance present in the patient’s urine causes
its dark color?
A. *Conjugated bilirubin
B. Ketone bodies
C. Unconjugated bilrubin
D. Stercobilin
E. Bilirubin glucuronides
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291. A 45-year-old woman addressed a doctor with complaints of rapid mood swings,
tearfulness, and apathy. Antidepressants prescribed for her treatment are monoamine oxidase
inhibitors. These drugs have a certain effect on catecholamines, which results in their medicinal
action. Name this effect:
A. *Increased concentration
B. Increased deamination
C. Decreased concentration
D. Neutralization activation
E. Inhibition of re-uptake
292. A 19-year-old young man was examined in a nephrological hospital. The increased
potassium content was detected in secondary urine of the patient. Such changes were most likely
caused by the increased secretion of the following hormone:
A. *Aldosterone
B. Oxytocin
C. Adrenaline
D. Glucagon
E. Testosterone
293. Osteolaterism is charcterized by a decrease in collagen strength caused by signicantly less
intensive formation of cross-links in collagen fibers. This phenomenon is caused by the low
activity of the following enzyme:
A. *Lysyl oxidase
B. Monoamine oxidase
C. Prolyl hydroxylase
D. Lysyl hydroxylase
E. Collagenase
294. A patient with pituitary tumor complains of increased daily diuresis
(polyuria). Glucose concentration in blood plasma is 4.8 mmol/l. What hormone can be the cause
of this, if its secretion is disturbed?
A. *Vasopressin
B. Aldosterone
C. Natriuretic hormone
D. Insulin
E. Angiotensin I
295. Ketoacidosis that develops due to accumulation of ketone bodies in blood serum is a
primary complication of diabetes mellitus. What type of acid-base disbalance develops during
this condition?
A. *Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
E. 296. During auscultation, a 26-year-old patient was asked to breathe deeply. After 10 breaths the
patient lost consciousness, which is associated with the development of the following condition:
A. *Respiratory alkalosis
B. Carbon dioxide acidosis
C. Erythropenia
D. Polycythemia
E. Reduced oxygen capacity of blood
297. Specify the calcium-binding enamel protein, which plays a signicant part in carious
destruction of enamel, when its function is disrupted:
A. *Amelogenin
B. Calmodulin
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C. Osteocalcin
D. Calcitonin
E. Parotin
298. Calcification of dental tissues is signicantly influenced by osteocalcin protein that can bind
calcium ions due to the presence of the following modified amino acid residues in the
polypeptide chain:
A. *γ-Carboxyglutamate
B. Alanine
C. γ-Aminobutyric acid
D. Carboxyasparagine
E. δ-Aminopropionic acid
299. A 28-year-old patient complains of frequent gingival hemorrhages. Blood test revealed the
clotting factor II (prothrombin) deficiency. What phase of blood coagulation is impaired in this
patient?
A. *Thrombin generation
B. Vascular-platelet hemostasis
C. D. Fibrinolysis
E. Clot retraction
300. During perfusion of an isolated heart of a mammal with a high ion content solution the
cardiac arrest in diastole occurred. The cardiac arrest was caused by the following ions present
excessively in the solution:
A. *Potassium
B. Sodium
C. Chloride
D. Magnesium
E. Calcium
301. A 3-year-old boy with pronounced hemorrhagic syndrome has no antihemophilic
globulin A (factor VIII) in the blood plasma. Hemostasis is impaired at the following stage:
A. *Intrinsic mechanism of prothrombinase activation
B. Extrinsic mechanism of prothrombinase activation
C. Conversion of prothrombin to thrombin
D. Conversion of fibrinogen to fibrin
E. Blood clot retraction
302. 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 the blood
serum in this case?
A. *Conjugated bilirubin
B. Unconjugated bilirubin
C. Biliverdin
D. Mesobilirubin
E. Urobilinogen
303. A traumatology unit received a patient with crushed muscular tissue. What biochemical
indicator of urine will be raised in this case?
A. *Creatinine
B. Total lipids
C. Glucose
D. Mineral salts
E. Uric acid
304. A 30-year-old woman first developed pain, swelling, and skin redness in the area of joints
about a year ago. Provisional diagnosis is rheumatoid arthritis. One of the likely causes of this
disease is a change in the structure of the following connective tissue protein:
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A. *Collagen
B. Mucin
C. Myosin
D. Ovalbumin
E. Troponin
305. A 5-year-old child is diagnosed with Bruton syndrome (X-linked agammaglobulinemia)
that manifests as severe clinical course of bacterial infections and absence of B lymphocytes and
plasma cells. What changes in the immunoglobulin content can be observed in blood serum of
the child with immunodeficiency?
A. *Decreased IgA, IgM
B. Increased IgA, IgM
C. Decreased IgD, IgE
D. Increased IgD, IgE
E. No changes
306. A patient was admitted to the contagious isolation ward with signs of jaundice caused by
hepatitis virus.Which of the symptoms given below is strictly specific for hepatocellular
jaundice?
A. *Increased ALT, AST activity
B. Hyperbilirubinemia
C. Bilirubinuria
D. Cholemia
E. Urobilinuria
307. A 50-year-old patient during examination has glucosuria and blood glucose level of 3.0
mmol/l, which is the most likely to be caused by:
A. *Renal disorder
B. Diabetes insipidus
C. Myxedema
D. Essential hypertension
E. Pellagra
308. A patient suffers from diabetes mellitus with fasting hyperglycemia over 7.2 mmol/l. What
blood plasma protein would allow assessing the patient’s glycemia level retrospectively (4-8
weeks prior to examination)?
A. *Glycated hemoglobin
B. Albumin
C. Fibrinogen
D. C-reactive protein
E. Ceruloplasmin
309. A patient with glossitis has disappearance of lingual papillae, reddening and burning pain
in the tongue. Blood test: erythrocytes – 2.2 · 1012/l, hemoglobin - 103 g/l, color index – 1.4.
What type of anemia is it?
A. *B12 folate-deficient
B. Iron deficiency
C. α-Thalassemia
D. β-Thalassemia
E. Iron refractory
310. A patient with chronic renal failure has reduced inulin clearance of 60 ml/min. The
following renal function is disturbed:
A. *Glomerular filtration
B. Tubular secretion
C. Reabsorption in the proximal tubular segment of the nephron
D. Reabsorption in the distal tubular segment of the nephron
E. Reabsorption in the tubules of collecting duct
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311. Examination of a patient revealed glycosuria and hyperglycemia. He complains of dry
mouth, itchy skin, frequent urination, and thirst. He is diagnosed with diabetes mellitus. What
is the cause of polyuria in this patient?
A. *Increased urine osmotic pressure
B. Decreased plasma oncotic pressure
C. Increased filtration pressure
D. Decreased cardiac output
E. Increased plasma oncotic pressure
312. Where biotransformation (metabolic transformation) of most medicinal agents occurs
upon their introduction into an organism?
A. *Liver
B. Kidneys
C. Intestine
D. Skin
E. Lungs
313. An unconscious patient with diabetes mellitus was delivered to a hospital. BP is low,
Kussmaul’s respiration is observed. The odor of acetone can be detected from the patient’s
mouth. What mechanism leads to the coma development in this case?
A. *Accumulation of ketone bodies in blood
B. Accumulation of potassium ions
C. Accumulation of sodium ions
D. Accumulation of chloride ions
E. Accumulation of urea
314. The patient’s saliva was tested for antibacterial activity. What saliva component has
antibacterial properties?
A. *Lysozyme
B. Amylase
C. Ceruloplasmin
D. Parotin
E. Cholesterol
315. A 35-year-old man came to a dentist with complaints of decreased density of the dental
tissue and increased brittleness of his teeth during consumption of solid food. The Ca/P ratio
was determined in an enamel sample. What value of the Ca/P ratio indicates increased
demineralization?
A. *0.9
B. 1.67
C. 1.85
D. 2.5
E. 1.5
316. To assess the rate of collagen disintegration during certain connective tissue disturbances,
it is necessary to measure the urine content of:
A. *Oxyproline
B. Ornithine
C. Proline
D. Lysine
E. Urea
317. During tooth brushing bleeding occurs. However, bleeding quickly stops on its own.What
substances in saliva quickly staunch the flow of blood during minor oral injuries?
A. *Procoagulants
B. Lipolytic enzymes
C. Amylolytic enzymes
D. Mineral substances
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E. Lysozyme and mucin
318. A 50-year-old man, who has been suffering for a long time from viral hepatitis, developed
mental impairments, impairments of consciousness, and motor disturbances (tremor, ataxia,
etc.). What is the mechanism of such condition?
A. *Decreased detoxification function of the liver
B. Insufficient phagocytic function of stellate macrophages
C. Decreased synthesis of albumins and globulins in the liver
D. Disturbed lipid exchange in the liver
E. Alterations in the lipid composition of blood
319. Highlanders typically demonstrate chronically intensified respiration and decreased blood
pCO2 values. What mechanism leads to the compensation of their asid-base imbalance?
A. *Decreased renal reabsorption of bicarbonate
B. Increased ammonia excretion with urine
C. Decreased pulmonary ventilation
D. Increased pulmonary ventilation
E. –
320. A 30-year-old man with glomerulonephritis developed nephrotic syndrome. What
symptom invariably accompanies nephrotic syndrome?
A. *Proteinuria
B. Glucosuria
C. Low urine specific gravity
D. Anemia
E. Azotemia
321. Due to the prolonged stay in the mountains at the altitude of 3000 m above the sea level, a
person developed increased oxygen capacity of blood, which was directly caused by intensified
production of:
A. Erythropoietins
B. Catecholamines
C. Carbaminohemoglobin
D. 2,3-Bisphosphoglycerate
E. Leukopoietins
322. A woman with enteritis accompanied by severe diarrhea shows loss of water in the
extracellular space, increased water content in the cells, and decreased blood osmolarity. Name
this type of water-electrolyte imbalance:
A. Hypoosmolar hypohydration
B. Hyperosmolar hypohydration
C. Isoosmolar hypohydration
D. Hyperosmolar hyperhydration
E. Hypoosmolar hyperhydration
323. Atria of an animal were superdistended with blood, which resulted in decreased
reabsorption of Na+ and water in renal tubules. This can be explained by the effect of the
following factor on the kidneys:
A. Natriuretic hormone
B. Vasopressin
C. Aldosterone
D. Angiotensin
E. Renin
324. In the process of hemoglobin catabolism, iron is released and then as a part of special
transport protein is returned to the bone marrow to be re-used for hemoglobin synthesis. Name
this transport protein:
A. Transferrin
B. Albumin
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C. Ceruloplasmin
D. Transcobalamin
E. Haptoglobin
325. Ketosis develops in patients with diabetes mellitus, as the result of activation of fatty acid
oxidation. What type of acid-base imbalance can result from accumulation of excessive ketone
bodies in the blood?
A. Metabolic acidosis
B. Metabolic alkalosis
C. No imbalance occurs
D. Respiratory acidosis
E. Respiratory alkalosis
326. A 50-year-old patient during examination shows glucosuria and blood glucose of 3.0
mmol/L, which is the most likely to be caused by:
A. Renal disorder
B. Myxedema
C. Diabetes insipidus
D. Pellagra
E. Essential hypertension
327. In a human organism, significant blood loss leads to decreased blood pressure, tachycardia,
and weakness. Eventually the sensation of thirst appears. What hormone participates in the
development of this sensation?
A. Angiotensin 2
B. Adrenaline
C. Cortisol
D. Dopamine
E. Serotonin
328. Neutralization of xenobiotics and active endogenous metabolites often occurs via
incorporation of an oxygen atom into the substrate molecule. What process occurs as the result?
A. Hydroxylation
B. Phosphorylation
C. Transamination
D. Decarboxylation
E. Deamination
329. Patients with collagenosis typically have connective tissue destruction processes. The
presence of these processes can be confirmed by the increase in:
A. Blood oxyproline and oxylysine
B. Blood urates
C. Blood creatine and creatinine
D. LDH-isoenzyme activity in the blood
E. Transaminase activity in the blood
330. A woman resticts the amount of products in her diet to lose some weight. Three months
later she experienced edemas and her diuresis increased. What dietary component deficiency is
the cause of this?
A. Proteins
B. Fats
C. Carbohydrates
D. Minerals
E. Vitamins
331. A 5-year-old child is diagnosed with Bruton syndrome (X-linked agammaglobulinemia)
that manifests as severe clinical course of bacterial infections and absence of B lymphocytes and
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plasma cells. What changes of the immunoglobulin content can be observed in blood serum of
the child with immunodeficiency?
A. Decreased IgA, IgM
B. Increased IgA, IgM
C. No changes
D. Increased IgD, IgE
E. Decreased IgD, IgE
332. Encephalopathy developed in a child with neonatal hemolytic disease. What substance
increased in the child's blood, resulting in damage to the CNS?
A. Unconjugated bilirubin
B. Bile acids
C. Bilirubin glucuronide
D. Verdohemoglobin
E. Bilirubin-albumin complex
333. A woman with hypophyseal diabetes insipidus developed a water-mineral imbalance. What
type of water-mineral imbalance develops in such cases?
A. Hyperosmolar dehydration
B. Hyperosmolar hyperhydration
C. Isoosmolar dehydration
D. Hypoosmolar dehydration
E. Hypoosmolar hyperhydration
334. A patient suffers from hepatic cirrhosis. What substance excreted in urine should be
analyzed to characterize the antitoxic function of liver?
A. Hippuric acid
B. Ammonium salts
C. Creatinine
D. Amino acids
E. Uric acid
335. A patient with hypochromic anemia has hair with split ends and suffers from hair loss.
The nails are brittle. Gustatory sensations are affected. What is the mechanism of development
of these symptoms?
A. Iron-containing enzymes deficiency
B. Vitamin B12 deficiency
C. Low production of thyroid hormones
D. Low production of parathyroid hormone
E. Vitamin A deficiency
336.A 30-year-old breastfeeding woman keeps to the diet that daily provides her with 1000 mg
of calcium, 1300 mg of phosphorus, and 20 mg of iron. How should the daily dosages of
minerals in this diet be adjusted?
A. Increase phosphorus intake
B. Decrease iron intake
C. Increase calcium intake
D. Decrease fluorine intake
E. Increase iron intake
337. A patient suffers from diabetes mellitus with fasting hyperglycemia over 7.2 mmol/L. What
blood plasma protein would allow assessing the patient's glycemia level retrospectively (4-8
weeks prior to examination)?
A. Glycated hemoglobin
B. Albumin
C. C-reactive protein
D. Fibrinogen
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E. Ceruloplasmin
338. During an ultrasound examination, a patient with atherosclerosis was diagnosed with
bilateral stenosis of the renal arteries. Specify the bioactive substance that is the key
pathogenetic link in the development of arterial hypertension in this case:
A. Renin
B. Vasopressin
C. Thyroxin
D. Cortisol
E. Adrenaline
339.Laboratory analysis revealed UDP-glucuronyl transferase deficiency in a patient. What
blood values can confirm this enzymopathy?
A. Hyperbilirubinemia
B. Uremia
C. Ketoacidosis
D. Indicanuria
E. Phenylketonuria
340. Erythrocytes of a patient with hemolytic anemia show significantly reduced pyruvate
kinase activity. What metabolic process is disturbed in this case?
A. Glycolysis
B. Glycogenolysis
C. Glycogen synthesis
D. Pentose phosphate pathway of glucose oxidation
E. Gluconeogenesis
341. A diver that submerged to the depth of 75 meters detected signs of CNS functional
disturbance: excitation, lapse of concentration, euphoria leading to professional errors. What
substance has toxic effect on the neurons, thus leading to the development of these signs?
A. Nitrogen
B. Oxygen
C. Ammonia
D. Lactate
E. Carbon dioxide
342. A pregnant woman developed severe toxemia with exhausting recurrent vomiting
throughout a day. By the end of the day she developed tetanic convulsions and dehydration. The
described changes were caused by the following type of acid-base imbalance:
A. Non-gaseous excretory alkalosis
B. Non-gaseous metabolic acidosis
C. Non-gaseous excretory acidosis
D. Gaseous alkalosis
E. Gaseous acidosis
343. Detoxification of bilirubin occurs in the membranes of endoplasmic reticulum of
hepatocytes. Bilirubin is secreted by hepatocytes into bile mostly as:
A. Bilirubin diglucuronide
B. Indirect reacting bilirubin
C. Bilirubin monoglucuronide
D. E. Unconjugated bilirubin
344. A patient came to a doctor with complaints of general weakness and sleep disturbances.
Objectively, the patient's skin is yellow. In blood there is increased concentration of direct
bilirubin and bile acids. Acholic stool is observed. What condition can be characterized by these
changes?
A. Mechanical jaundice
B. Parenchymatous jaundice
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C. Familial non-hemolytic (Gilbert's) syndrome
D. Chronic cholecystitis
E. Hemolytic jaundice
345. Mucin aggregates retain water, which results in their viscosity and protective action. It is
possible because mucin structure contains:
A. Glycosaminoglycans
B. Disaccharides
C. Glucose
D. Oligosaccharides
E. Homopolysaccharides
346. A 55-year-old man was diagnosed with acute glomerulonephritis. Name the main
mechanism of anemia development in this case:
A. Decreased erythropoietin synthesis
B. Decreased glomerular filtration
C. Decreased synthesis of renal prostaglandins
D. Renal azotemia
E. Decreased tubular reabsorption
347. A 28-year-old patient complains of frequent gingival hemorrhages. Blood test revealed the
clotting factor II (prothrombin) deficiency. What phase of blood coagulation is impaired in this
patient?
A. Thrombin generation
B. C. Clot retraction
D. Vascular-platelet hemostasis
E. Fibrinolysis
348. During appointment with a dentist, patients often develop anxiety, fear, and depression.
These psychoemotional changes occur due to increased secretion of a certain mediator in the
central nervous system. Name this mediator:
A. Noradrenaline
B. Acetylcholine
C. Dopamine
D. Serotonin
E. GABA
349. During a class of molecular biology, the mutations resulting in production of abnormal
hemoglobin were studied. What amino acid substitution occurs when S-hemoglobin is produced,
resulting in the development of sickle-cell anemia?
A. Glutamic acid is substituted with valine
B. Treonine is substituted with lysine
C. Histidine is substituted with arginine
D. Lysine is substituted with glutamine
E. Glycine is substituted with asparagines
350. An athlete overexerted himself during training and developed a muscle contracture. In such
cases the muscle loses its flexibility and gradually becomes rigid due to its inability to relax.
What is the likely cause of the contracture in this case?
A. Increased blood levels of lactic acid
B. Decreased blood levels of Ca++
C. Tropomyosin structural changes
D. ATP deficiency
E. Increased blood levels of K+
351. A 49-year-old man has facial edema, significant proteinuria, hypoproteinemia,
dysproteinemia, and hyperlipidemia. What provisional diagnosis can be made?
A. Nephrotic syndrome
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B. Pyelonephritis
C. Prostatitis
D. Urolithiasis
E. Cystitis
352. Thirty minutes after the dental treatment, a patient developed red itching spots on the face
and oral mucosa. The patient was diagnosed with urticaria. What bioactive substance with
vasodilating and pruriginous effect is produced during this type of allergic reaction?
A. Histamine
B. Bradykinin
C. Interleukin-1
D. Prostaglandin E2
E. Leukotriene B4
353. A 16-year-old girl, who has been starving for a long time to lose weight, developed an
edema. This phenomenon is mainly caused by:
A. Hypoproteinemia due to protein synthesis disturbance
B. Deceleration of glomerular filtration rate
C. Decreased production of vasopressin in the hypothalamus
D. Hypoglycemia due to glycogen synthesis disturbance
E. Venous congestion and increased venous pressure
354. Persistent and heavy proteinuria (albuminuria) associated with nephrotic syndrome leads to
hypoalbuminemia, which changes plasma pressure resulting in severe generalized edema.
According to the description, which of the following circumstances tends to cause nephrotic
edema?
A. Decreased plasma oncotic pressure
B. Decreased venous pressure
C. Increased plasma oncotic pressure
D. –
E. Increased tissue hydrostatic pressure
355. A molecular-level process of spontaneous passive transport of water-soluble molecules
across a cell membrane is modeled. The molecules move across cell membranes from an area of
higher concentration toward an area of lower concentration via specific transmembrane integral
proteins.This transport does not directly require chemical energy from ATP hydrolysis. Which of
the following transport mechanisms is most likely mentioned?
A. Facilitated diffusion
B. –
C. Pinocytosis
D. Active transport
E. Osmosis
356. A 40-year-old male comes to a physician because of recurrent painful flares and swelling of
the metatarsal-phalangeal joint of the big toe. Laboratory study of a urine sample shows
extremely low pH and pink coloration. Which of the following metabolic intermediates is the
most likely cause of changes in this patients urine?
A. Uric acid
B. Ammonia
C. Tricalcium phosphate
D. Magnesium sulfate
E. Chloride
357. Prolonged vomiting resulted in dehydration of the patients body. Under these conditions,
water retention in the body is ensured primarily due to the increased secretion of the following
hormone:
A. Vasopressin
B. Aldosterone
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C. Natriuretic hormone
D. Adrenaline
E. Calcitonin
358. A patient has an acute attack of cholelithiasis. Laboratory examination of the patients feces
will show:
A. Negative reaction to stercobilin
B. Connective tissue
C. Partially digested cellulose
D. Positive reacton to stercobilin
E. Starch granules
359. A 27-year-old patient has pathologic changes in the liver and brain. Blood plasma exhibits
acute decrease in copper levels, while urine copper levels are elevated. The patient is diagnosed
with Wilson disease. To confirm this diagnosis, it is necessary to measure the activity of the
following enzyme in the patients blood serum:
A. Ceruloplasmin
B. Leucine aminopeptidase
C. Xanthine oxidase
D. Alcohol dehydrogenase
E. Carbonic anhydrase
360. Domestic accident resulted in a significant blood loss in a patient, which was accompanied
by a drop in blood pressure. What hormones ensure quick restoration of the blood pressure
caused by a blood loss?
A. Adrenaline, vasopressin
B. Aldosteron
C. Oxytocin
D. Reproductive
E. Cortisol
361. Toxic damage to hepatic cells resulted in discruption of the patients liver function and the
patient developed edemas. What changes of blood plasma can be the main cause of edema
development?
A. Decreased albumin content
B. Increased albumin content
C. Decreased fibrinogen content
D. Increased globulin content
E. Decreased globulin content
362. A 34-year-old man visits his dentist complaining of toothache. After a dental procedure that
involved extraction of several teeth, he develops severe bleeding lasting more than 15 minutes.
He has a history of chronic hepatitis C. Which of the most likely cause of prolonged bleeding in
this patient?
A. Hypofibrinogenemia
B. Thrombocytopenia
C. Hypoalbuminemia
D. –
E. Hypocalcemia
363. A male newborn to a 24-year-old primigravida had jaundice at the age of 8 hours. His red
blood cell type was A+, while the mother’s RBC type was O+. Laboratory studies revealed a
titer of mothers anti A-antibody, normal erythrocyte glucose-6-phosphate and negative sickle
cell tests. His hemoglobin level was 106 g/L. Which of the following is the most likely cause of
newborn’s jaundice?
A. Hyperbilirubinemia
B. Glucose-6-phosphate dehydrogenase (G6PD) deficiency
C. Rh incompatibility
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D. Decrease in hemoglobin level
E. Sickle cell disease
364. A 15-year-old teenager complains of general weakness, dizziness, and rapid fatigability.
Examination detected deformed erythrocytes, their number is decreased. The provisional
diagnosis of sickle-cell anemia was made. What amino acid replacement in hemoglobin causes
the development of this pathological condition?
A. Glutamate replaced with valine
B. Valine replaced with glutamate
C. Glutamate replaced with aspartate
D. Glutamate replaced with alanine
E. Valine replaced with aspartate
365. A lab rat has subcutaneously received mercury(II) chloride in the amount of 5 mg/kg. 24
hours later the plasma creatinine concentration increased several times. What mechanism of
retention azotemia is observed in this case?
A. Decreased glomerular filtration
B. Increased glomerular filtration
C. Increased creatinine production in the muscles
D. Increased creatinine secretion in the renal tubules
E. Increased creatinine reabsorption
366. In the process of acetylcholine interaction with muscarinic acetylcholine receptors of
contractile cardiomyocytes, a bioactive substance is being produced. This bioactive substance
leads to inactivation of calcium channels, decrease of calcium ions entry into the
cardiomyocytes, and development of negative inotropic effect. Name this substance:
A. Cyclic adenosine monophosphate (cAMP)
B. Cyclic adenosine triphosphate (cATP)
C. Cyclic guanosine monophosphate (cGMP)
D. Cyclic adenosine diphosphate (cADP)
E. Cyclic guanosine triphosphate (cGTP)
367. A patient suffers from disturbed renal function. To check the filtration ability of the
kidneys, he was referred for clearance measurement of the following substance:
A. Creatinine
B. Glutamine
C. Uric acid
D. Indole
E. Hydrogen carbonate
368. Arterial blood pH is 7.4; primary urine pH is 7.4; final urine pH is 5.8. Decreased pH of the
final urine results from the secretion of a certain substance in the nephron tubules. Name this
substance:
A. Hydrogen ions
B. Hydrogen carbonate ions
C. Potassium ions
D. Urea
E. Creatinine
369. Clinical instrumental examination of a patient allowed to provisionally diagnose him with
liver cancer. What protein is indicative of this diagnosis, if it is present in the blood serum?
A. Alpha-fetoprotein
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B. C-reactive protein
C. Paraproteins
D. Properdin
E. Gamma globulins
370. Mother of a 5-year-old child complains that her child develops itching skin, erythema, and
vesicular rash after exposure to the sun. Blood test revealed low levels of iron in the blood
serum. Urine contains increased levels of uroporphyrinogen I. What hereditary pathology is the
most likely in this child?
A. Erythropoietic porphyria
B. Coproporphyria
C. Intermittent porphyria
D. Methemoglobinemia
E. Hepatic porphyria
371. A 20-year-old man from the early childhood suffered from type I diabetes mellitus and was
constantly undergoing insulin therapy. Within the last year he started breaking his diet and was
taking his insulin doses irregularly. To detect possible complications, particularly glomerular
diseases, the endocrinologist referred him for urinalysis. What is the first persistent sigh of
glomerular filtration disorder?
A. Proteinuria
B. Oxaluria
C. Cylindruria
D. Leukocyturia
E. Hematuria
372. A 47-year-old man complains of weakness and dizziness. Half a year ago he undervent a
gastric resection. Blood test: Hb – 80 g/L, erythrocytes – 3.5*1012/L, color index – 0.69, ESR –
15 mm/hour, serum iron – 5.4 mcmol/L, erythrocyte hypochromia. What type of anemia is the
most likely in this patient?
A. Iron deficiency anemia
B. Sideroachrestic anemia
C. Hemolytic anemia
D. B12 or folate deficiency anemia
E. Hemorrhagic anemia
373. A patient with choledocholithiasis has fatty colorless stool because of obturation of the
biliary tract. What bile component is absent, causing steatorrhea?
A. Bile acids
B. Cholesterol
C. Fatty acids
D. Alkaline phosphatase
E. Bile pigments
374. A patient complains of rapid fatigability and severe muscle weakness. Examination detected
an autoimmune disease that disturbs the functionality of the receptors in the neuromuscular
synapses. What mediator is likely to be blocked in this case?
A. Acetylcholine
B. Noradrenaline
C. Serotonin
D. Glycine
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E. Dopamine
375. The renal artery of a test rabbit was surgically narrowed. One month later a significant
increase in systemic arterial pressure was registered in the animal. What regulatory mechanism
caused the change in the animal’s blood pressure?
A. Angiotensin II
B. Noradrenaline
C. Adrenaline
D. Vasopressin
E. Serotonin
376. A patient being treated for viral B hepatitis developed signs of hepatic failure. What
changes in the blood test that indicate a protein metabolism disorder will most likely be observed
in this case?
A. Absolute hypoalbuminemia
B. Absolute hyperalbuminemia
C. Absolute hyperfibrinogenemia
D. Absolute hyperglobulinemia
E. Blood protein composition is unchanged
377. A 58-year-old man has a clinical presentation of acute pancreatitis. This diagnosis can be
confirmed, if urine levels of a certain substance are elevated. Name this substance:
A. Amylase
B. Albumin
C. Residual nitrogen
D. Uric acid
E. Urea
378. In the blood plasma of a healthy person there are several dozens of proteins. Illness leads to
production of new proteins, in particular “acute-phase proteins”. Name one such protein:
A. C-reactive protein
B. Immunoglobulin G
C. Fibrinogen
D. Immunoglobulin A
E. Prothrombin
379. To improve tooth mineralization, dentists prescribe Ca2+ preparations. This substance HAS
NO EFFECT on the following processes in an organism:
A. Oncotic pressure generation
B. Development of myocardial depolarization
C. Hemostasis
D. Synaptic transmission of excitation
E. Muscle contraction
380. During examination of the patients, a dentist noted that many of them have dull, non-glossy
enamel with porcelain-like and pigmented spots. Some patients have single or multiple enamel
defects that manifest as colorless or pigmented erosions. These changes in the teeth developed in
the result of the excessive intake of a certain substance by the organism. Name this substance:
A. Fluorine
B. Calcium
C. Potassium
D. Magnesium
E. Sodium
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381. A sample of the patient’s blood was taken for analysis in the presence of heparin. By its
chemical structure, this anticoagulant belongs to:
A. Glycosaminoglycans
B. Hemeproteins
C. Phospholipids
D. Triacylglycerols
E. Simple proteins
382. During a class in molecular biology the mutations resulting in production of abnormal
hemoglobin are being studied. What amino acid substitution occurs when S-hemoglobin is being
produced, resulting in the development of sickle-cell anemia?
A. Glutamic acid is substituted with valine
B. Histidine is substituted with arginine
C. Threonine is substituted with lysine
D. Lysine is substituted with glutamine
E. Glycine is substituted with asparagines
383. What hormone of parotid glands intensifies teeth mineralization by stimulating calcium
supply to the calcified tissues?
A. Parotin
B. Glucagon
C. Calcitonin
D. Cortisol
E. Parathyrin
384. Acid resistance of human teeth depends on the ratio of calcium to phosphorus in the
enamel. What is the normal calcium to phosphorus ratio?
A. 1.67
B. 0.8
C. 1.1
D. 0.5
E. 0.9
385. A patient came to the doctor with complaints of general weakness and sleep disturbances.
Objectively the patient’s skin is yellow. In blood there is increased concentration of direct
bilirubin and bile acids. Acholic stool is observed. What condition can be characterized by these
changes?
A. Mechanical jaundice
B. Familial nonhemolytic (Gilbert’s) syndrome
C. Chronic cholecystitis
D. Hemolytic jaundice
E. Parenchymatous
386. Formation of a large amount of immunoglobulins with various antigen specificity from a
small number of genes occurs due to:
A. Recombination
B. Translocation
C. Deletion
D. Replication
E. Transcription
387. To improve tooth mineralization, dentists prescribe Ca2+ preparations. This substance has
no effect on the following processes in an organism:
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A. Oncotic pressure generation
B. Development of myocardial depolarization
C. Hemostasis
D. Muscle contraction
E. Synaptic transmission of excitation
388. Trying to lose weight, a woman has limited the amount of products in her diet. Three
months later she developed edema and increased urine output, which indicates that her diet is
low on the following type of nutrients:
A. Proteins
B. Minerals
C. Vitamins
D. Lipids
E. Carbohydrates
389. A man with a cardiovascular pathology presents with over production of angiotensin II.
What enzyme takes part in angiotensin II synthesis?
A. Angiotensin converting enzyme
B. Kininase
C. Kallikrein
D. Cyclooxygenase
E. Urokinase
390. A patient presents with disturbed patency of the respiratory tracts at the level of small and
medium bronchi. What acid-base imbalance is likely to be detected in the patient’s blood in this
case?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory acidosis
E. Acid-base balance is not changed
391. The patient’s salivary porphyrin concentration allowed diagnosing him with porphyria. This
disease leads to disturbed synthesis of the following compound:
A. Heme
B. Phospholipids
C. Uric acid
D. Creatine
E. Glycogen
392. A man presents with decreased blood pH, low levels of bicarbonate ions (a drop in the
blood alkaline reserve), and increased blood and urine levels of lactic and pyruvic acids. What
type of acid-base imbalance is it?
A. Metabolic acidosis
B. Mixed alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis
E. Respiratory alkalosis
393. A man presents with noticeable progressive muscular dystrophy. What indicator of urinary
nitrogen metabolism is characteristic of this condition?
A. Creatine
B. Urea
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C. Ammonium salts
D. Creatinine
E. Uric acid
394. In hepatitis and myocardial infarction, the activity of alanine and aspartate
aminotransferases sharply increases in the patients’ blood plasma. Why does this increase in the
activity of these enzymes in the blood occur?
A. Damage to cell membranes and release of enzymes into the blood
B. Pyridoxine deficiency
C. Hormone-induced increase in enzyme activity
D. Amino acid synthesis acceleration in tissues
E. Amino acid breakdown acceleration in tissues
395. The patient’s blood test shows a significant increase in the activity of the MB-fraction of
CPK (creatine phosphokinase) and LDH-1. What pathology can it indicate?
A. Myocardial infarction
B. Cholecystitis
C. Pancreatitis
D. Rheumatism
E. Hepatitis
396. A bite of a venomous snake can provoke hemolytic jaundice in a person. What blood plasma value
would be the first to increase in a bitten person?
A. Indirect (unconjugated) bilirubin
B. Direct (conjugated) bilirubin
C. Free amino acid
D. Uric acid
E. Urea
397. A man has asked a cosmetologist to remove a tattoo from his shoulder. What substance, contained in
the connective tissue, limits the spread of the dye?
A. Hyaluronic acid
B. Collagen
C. Elastin
D. Hyaluronidase
E. Fibronectin
398. Clinical and biochemical examination of a patient revealed sickle cell anemia. Measurement of what
blood component was decisive for the diagnosis in this case?
A. Hemoglobin S
B. Hemoglobin F
C. Hemoglobin C
D. Hemoglobin A1
E. Methemoglobin
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