1 semestr
ALLERGY
A 27- year-old woman has dropped penicillin containing eye drops. In few minutes there
appeared feeling of itching, burning of the skin, lips and eyelids edema, whistling cough,
decreasing of BP. What antibodies take part in the development of this allergic reaction?
A IgE and IgG
B IgM and IgG
C IgA and IgM
D IgM and IgD
E IgG and IgD
A 27 y.o. patient put eye drops that contain penicillin. After a few minutes she felt itching
and burning of her body, there appeared lip and eye-lid edemata; arterial pressure began
to drop. What immunoglobulins took part in the development of this allergic reaction?
A $lgE$ and $lgG$
B $IgM$ and $IgG$
C $IgA$ and $IgM$
D $IgM$ and $IgD$
E $IgG$ and $IgD$
A woman has been applying a new cosmetic preparation for a week that resulted in eye-lid
inflammation accompanied by hyperemia, infiltration and painfulness. What type of allergic
reaction was developed?
A ІV
B I
C II
D III
E V
The patient with acute miocardial infarction was given intravenously different solutions
during 8 hours with medical dropper 1500ml and oxygen intranasally. He died because of
pulmonary edema. What caused the pulmonary edema?
A Volume overload of the left ventricular
B Decreased oncotic pressure due to hemodilution
C Allergic reaction
D Neurogenic reaction
E Inhalation of the oxygen
A patient was stung by a bee. Examination revealed that his left hand was hot, pink,
edematic, there was a big red blister on the site of sting. What is the leading mechanism of
edema development?
A Increased vessel permeability
B Reduced vessel filling
C Injury of vessels caused by the sting
D Drop of oncotic pressure in tissue
E Drop of osmotic pressure in tissue
A patient was diagnosed with autoimmune hemolitic cytotoxic anemia. What substances are
antigens in II type allergic reactions?
A Modified receptors of cell membranes
B Antibiotics
C Hormones
D Serum proteins
E Inflammation modulators
MOUNTAIN DIS
A group of mountain climbers went through the blood analysis at the height of 3000 m. It
revealed decrease of $HCO_3$ to 15 micromole/l (standard is 22-26 micromole/l). What is
the mechanism of $HCO_3$ decrease?
A Hyperventilation
B Intensification of acidogenesis
C Hypoventilation
D Decrease of ammoniogenesis
E Decrease of bicarbonate reabsorption in kidneys
FEVER
A patient who suffers from pneumonia has high body temperature. What biologically active
substance plays the leading part in origin of this phenomenon?
A Interleukin-I
B Histamine
C Bradykinin
D Serotonin
E Leukotrienes
A 25 year old man has spent a long time in the sun under high air humidity. As a result of it
his body temperature rose up to $39^oC$. What pathological process is it?
A Hyperthermia
B Infectious fever
C Hypothermia
D Noninfectious fever
E Burn disease
After transfusion of 200 ml of blood a patient presented with body temperature rise up to
$37,9^oC$. Which of the following substances is the most likely cause of temperature rise?
A Interleukin-1
B Interleukin-2
C Tumour necrosis factor
D Interleukin-3
E Interleukin-4
A patient who had been working hard under conditions of elevated temperature of the
environment, has now a changed quantity of blood plasma proteins. What penomenon is
the case?
A Relative hyperproteinemia
B Absolute hyperproteinemia
C Absolute hypoproteinemia
D Disproteinemia
E Paraproteinemia
VITAMINS DIS.
Pyruvate concentration in the patient’s urine has increased 10 times from normal amount.
What vitamin deficiency can be the reason of this change:
A Vitamin $B_1$
B Vitamin C
C Vitamin A
D Vitamin E
E Vitamin $B_6$
DIS. MICROCIRCULATION .
A 70-year-old patient suffers from atherosclerosis complicated by the lower limb thrombosis
that has caused gangrene on his left toes. What is the most likely cause of the thrombosis
origin?
A Thrombocyte adhesion
B Prothrombinase activation
C Transformation of prothrombin into thrombin
D Transformation of fibrinogen into fibrin
E
A patient with obliterating atherosclerosis underwent sympathectomy of femoral artery in
the region of femoral trigone. What type of arterial hyperemia was induced by the
operation?
A Neuroparalytic
B Reactive
C Metabolic
D Neurotonic
E Functional
Impaired heparin synthesis A rabbit's nerve that innervates the right ear was cut and its right
superior cervical ganglion
was removed. Immediately after operation the temperature of ear skin was measured. It
was revealed that the temperature of the rabbit's ear skin on the side of denervation was
by $1,5^0C$ higher than on the opposite intact side. What of the following is the most
probable explanation of the above-mentioned effects?
A Arterial neuroparalytic hyperemia
B Arterial neurotopical hyperemia
C Atrerial hyperemia induced by metabolic factors
D Reactive arterial hyperemia
E Physiological arterial hyperemia
Upper neck node of sympathetic trunk was removed from the rabbit on experiment.
Reddening and increased temperature of the skin of head is observed. What form of
peripheral circulation of the blood developed in the rabbit?
A Neuroparalytic arterial hyperemia
B Neurotonic arterial hyperemia
C Metabolic arterial hyperemia
D Venous hyperemia
E Stasis
While playing volleyball a sportsman made a jump and landed on the outside edge of his
foot. He felt acute pain in the talocrural joint, active movements are limited, passive
movements are unlimited but painful. A bit later there appeared a swelling in the area of
external ankle, the skin became red and warm. What type of peripheral circulation
disturbance is the case?
A Arterial hyperemia
B Stasis
C Embolism
D Venous hyperemia
E Thrombosis
A 42 year old woman with neuralgia of trifacial nerve complains about periodical reddening
of the right part of her face and neck, sense of warmth gush, increased skin sensitivity.
These effects can be explained by the following type of arterial hyperemia:
A Neurotonic
B Neuroparalytic
C Metabolic
D Functional
E Reactive
INFLAMATION
Inflamation is characterised by increasing penetration of vessels of microcirculation
stream, increasing of their fluid dynamic blood pressure. Increasing of the osmotic
concentration and dispersity of protein structures present in the intercellular fluid. What
kind of edema will appear in this case?
A Mixed
B Hydrodynamic
C Colloid-osmotic
D Lymphogenic
E
Membranogenic Necrosis focus appeared in the area of hyperemia and skin edema in few hours
after burn.
What mechanism strengthens destructive events in the inflammation area?
A Secondary alteration
B Primary alteration
C Emigration of lymphocytes
D Diapedesis of erythrocytes
E Proliferation of fibroblasts
Inflammatory processes cause synthesis of protein of acute phase in an organism. What
substances stumulate their synthesis?
A Interleukin-1
B Immunoglobulins
C Interferons
D Biogenic amins
E Angiotensin
On simulation of inflammation of the lower extremity the animal exrerienced raise of the
temperature, increase of amount of antibodies and leucocytes in the blood. What
substances caused this general reaction of the organism on inflammation?
A Interleukin
B Glucocorticoid
C Mineralcorticoid
D Leucotriens
E Somatomedins
Inflammation of a patient's eye was accompanied by accumulation of turbid liquid with high
protein at the bottom of anterior chamber that was called hypopyon. What process
underlies the changes under observation?
A Disturbance of microcirculation
B Primary alteration
C Secondary alteration
D Proliferation
E -
Tuberculine was injected intraperitoneally to the animal sensibilized with tuberculine.
Venous hyperemia and peritonial edema were detected on the laparotomy in 24 hours.
Increased amount of lymphocytes and monocytes were in the smear-print from the
peritonium. What pathological process is in the animal?
A Allergic inflammation
B Serous inflammation
C Suppurative inflammation
D Fibrinous inflammation
E Aseptic inflammation
METABOLIC DIS.
A newborn child with pylorostenosis has often repeating vomiting accompanied by apathy,
weakness, hypertonicity, sometimes convulsions. What disorder form of acid-base balance
is it?
A Nongaseous alkalosis
B Gaseous alkalosis
C Gaseous acidosis
D Metabolic acidosis
E Excretory acidosis
A patient ill with enteritis accompanied by massive diarrhea has low water rate in the
extracellular space, high water rate inside the cells and low blood osmolarity. What is such
disturbance of water-electrolytic metabolism called?
A Hypo-osmolar hypohydration
B Hyperosmolar hypohydration
C Osmolar hypohydration
D Hypo-osmolar hyperhydration
E Hyperosmolar hyperhydration
Disorder of the airways passage in small and middle bronchi was revealed in the patient.
What disorder of the acid-base equilibrium can be detected in the blood?
A Respiratory acidosis
B Metabolic acidosis
C Respiratory alkalosis
D Metabolic alkalosis
Patient with diabetes didn't get insulin injection in time that caused hyperglycemic coma
(glucose in the blood 50mmol/L). What mechanism is prevalent in the development of the
coma?
A Hyperosmia
B Hypokaliemia
C Hypoxia
D Hyponatremia
E Acidosis
A patient who suffers from heart failure has enlarged liver, edemata of lower extremities,
ascites. What is the leading mechanism in the development of this edema?
A Hydrodynamic
B Colloid osmotic
C Lymphogenous
D Membranogenic
E -
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
A 12-year-old teenager has significantly put off weight within 3 months; glucose
concentration rose up to 50 millimole\l. He fell into a coma. What is the main mechanism of
its development?
A Hyperosmolar
B Hypoglycemic
C Ketonemic
D Lactacidemic
E Hypoxic
After taking poor-quality food a patient developed repeated episodes of diarrhea. On the
next day he presented with decreased arterial pressure, tachycardia, extrasystole. Blood
$pH$ is 7,18. These abnormalities were caused by the development of:
A Nongaseous acidosis
B Gaseous acidosis
C Nongaseous alkalosis
D Gaseous alkalosis
E Metabolic alkalosis
A patient was admitted to the infectious department. His symptoms: dry skin, decreased
skin turgor, rice-water stool. The patient was diagnosed with cholera. What disorder of
water-electrolytic balance is most often observed in this disease?
A Isoosmotic hypohydration
B Hyperosmotic hyperhydration
C Hypoosmotic hypohydration
D Hyperosmotic hypohydration
E Hypoosmotic hyperhydration
HEREDITARY
A healthy woman has three sons affected by color blindness who were born after her two
marriages. Children both of her husbands are healthy. What is the most possible pattern of
inheritance of this disease?
A X-linked recessive
B Y-linked
C Autosomal recessive
D Autosomal dominant
E X-linked dominant
A couple came for medical genetic counseling. The man has hemophilia, the woman is
healthy and there were no cases of hemophilia in her family. What is the risk of having a
sick child in this family?
A0
B 100\%
C 75\%
D 50\%
E 25\%
A 32 y.o. man is tall, he has gynecomastia, adult woman pattern of hair distribution, high
voice, mental deficiency, sterility. Provisional diagnosis is Klinefelter's syndrome. In order to
specify diagnosis it is necessary to analize:
A Caryotype
B Leukogram
C Spermatogenesis
D Blood group
E Genealogy
A woman who was sick with rubella during the pregnancy gave birth to a deaf child with
hare lip and cleft palate. This congenital defect is an example of:
A Phenocopy
B Edward’s syndrome
C Genocopy
D Patau’s syndrome
E Down’s syndrome
A couple had a child with Down's disease. Mother is 42 years old. This disease is most
probably caused by the following impairment of prenatal development:
A Gametopathy
B Blastopathy
C Embryopathy
D Non-specific fetopathy
E Specific fetopathy
A woman who was infected with toxoplasmosis during the pregnancy has a child with
multiple congenital defects.This is a result of:
A Teratogenesis
B Cancerogenesis
C Biological mutogenesis
D Chemical mutogenesis
E Recombination
During a prophylactic medical examination a 7-year-old boy was diagnosed with daltonism.
His parents are healthy and have normal colour vision, but his grandfather on his mother’s
side has the same abnormality. What is the type of the abnormality inheritance?
A Recessive, sex-linked
B Dominant, sex-linked
C Semidominance
D Autosomal recessive
E Autosomal dominant
Daltonism was diagnosed in a 7-year-old boy while prophylactic medical examination.
Parents are healthy, color vision is normal. Grandfather from the mother's side has the
same disorder. What is the type of inheriting of this anomaly?
A Recessive, connected with sex
B Dominant, connected with sex
C Incomplete domination
D Autosomal-recessive
E Autosomal-dominant
A married couple came to the genetic counseling. The husband suffers from the
insulin-dependant diabetes, the wife is healthy. What is the probability that this couple will
have an insulin-dependant child?
A Higher than throughout the population
B The same as throughout the population
C Lower than throughout the population
D 100\%
E 50\%
Examination of a 12 year old boy with developmental lag revealed achondroplasia:
disproportional constitution with evident shortening of upper and lower limbs as a result of
growth disorder of epiphyseal cartilages of long tubal bones. This disease is:
A Inherited, dominant
B Inherited, recessive
C Inherited, sex-linked
D Congenital
E Acquired
IMMUNOLOGY
A patient with skin mycosis has disorder of cellular immunity. The most typical characteristic
of it is reduction of the following index:
A T-lymphocytes
B Immunoglobulin G
C Immunoglobulin E
D B-lymphocytes
E Plasmocytes
12-year-old boy often suffers from virus and bacterial infections and eczematous skin
lesions. Enlargement of T-lymphocytes and IgM with normal IgA and IgG was revealed on
examination. What type of immune system pathology is presented in the patient?
A Composite immunedefficiency
B Hypoplasia of thymus
C Bruton's hypogammaglobulinemia
D Turner's syndrome
E Hereditary immundeficiency of the complement system
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 Sexual hormones
D Catecholamines
E Thyroid
A child was born with cleft palate. Examination revealed aorta defects and reduced number
of T-lymphocytes in blood. What immunodeficient syndrome is it?
A DiGeorge
B Wiskott-Aldrich
C Chediak-Higashi
D Louis-Bar
E Swiss-type
Examination of a child who frequently suffers from infectious diseases revealed that IgG
concentration in blood serum was 10 times less than normal, IgA and IgM concentration
was also significantly reduced. Analysis showed also lack of B-lymphocytes and
plasmocytes. What disease are these symptoms typical for?
A Bruton's disease
B Swiss-type agammaglobulinemia
C Dysimmunoglobulinemia
D Louis-Bar syndrome
E Di George syndrome
CELL INJURY
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
E Acidosis
Oval and round organelles with double wall are seen at the electron micrograph. The outer
membrane is smooth, the inner membrane folded into cristae contain enzyme ATPase
synthetase. These are:
A Mitochondria
B Golgi complex
C Lysosomes
D Centrioles
E Ribosomes
A tissue sample of benign tumor was studied under the electron microscope. A lot of small
(15-20 nm) spherical bodies, consisting of 2 unequal subunits were detected. These are:
A Ribosomes
B Golgi complex
C Smooth endoplasmic reticulum
D Microtubules
E Mitochondria
STARVATION
A chemical burn caused esophagus stenosis. Difficulty of ingestion led to the abrupt loss of
weight. In blood: $3,0\cdot10^{12}$/l, Hb - 106 g/l, crude protein - 57 g/l. What type of
starvation is it?
A Incomplete
B Proteinic
C Complete
D Water
E Absolute
TUMOURS
A 62 year old patient who previously worked as stoker was admitted to a hospital with
complaints about general weakness, abrupt weight loss, hoarse voice, dyspnea, dry cough.
Laryngoscopy revealed a tumour in the pharynx that invaded vocal cords and epiglottis.
What is the most probable cause of tumour development?
A Polycyclic aromatic carbohydrates
B Nitrosamines
C Aromatic amines and amides
D Retroviruses
E Ionizing radiation
A 45 year old woman is ill with breast cancer. Her left arm has symptoms of lymphatic
system insufficiency - limb edema, lymph node enlargement. What form of lymphatic
circulation insufficiency is it?
A Mechanic insufficiency
B Dynamic insufficiency
C Resorption insufficiency
D Combined insufficiency
E -
2 semestr
BLOOD DIS.
Patient with hypochromic anemia has splitting hair and loss of hair, increased nail brittling
and taste alteration. What is the mechanism of the development of these symptoms?
A Deficiency of iron-containing enzymes
B Deficiency of vitamin $В_{12}$
C Decreased production of parathyrin
D Deficiency of vitamin А
E
Decreased production of thyroid hormones
Substitution of the glutamic acid on valine was revealed while examining initial molecular
structure. For what inherited pathology is this typical?
A Sickle-cell anemia
B Thalassemia
C Minkowsky-Shauffard disease
D Favism
E Hemoglobinosis
A patient underwent a surgery for excision of a cyst on pancreas. After this he developed
haemorrhagic syndrome with apparent disorder of blood coagulation. Development of this
complication can be explained by:
A Activation of fibrinolytic system
B Insufficient fibrin production
C Reduced number of thrombocytes
D Activation of anticoagulation system
E Activation of Christmas factor
A 43-year-old patient has thrombopenia, reduction of fibrinogen, products of degradation
of fibrin presented in the blood, petechial haemorrhage along with septic shock. What is
the most likely cause of the changes?
A DIC-syndrom
B Autoimmune thrombocytopenia
C Haemorrhagic diathesis
D Disorder of thrombocytes production
E Exogenous intoxication
A patient with tissue trauma was taken a blood sample for the determination of blood
clotting parameters. Specify the right sequence of extrinsic pathway activation.
A III – VIIa – Xa
B III – IV – Xa
C IV – VIII: TF – Xa
D IV – VIIa – Xa
E III – VIII: TF – Xa
In result of the damage of one of the Atomic Power Plant reacttor the run-out of
radioelements happened. People in the increased radiation zone were radiated with
approximately 250-300 r. They were immediately hospitalized. What changes in the blood
count would be typical?
A Lymphopenia
B Leukopenia
C Anemia
D Thrombopenia
E Neutropenia
Having helped to eliminate consequences of a failure at a nuclear power plant, a worker
got an irradiation doze of 500 roentgen. He complains of headache, nausea, dizziness.
What changes in leukocytes quantity can be expected 10 hours after irradiation?
A Neutrophilic leukocytosis
B Lymphocytosis
C Leukopenia
D Agranulocytosis
E Leukemia
A 34 year old woman was diagnosed with hereditary microspherocytic hemolytic anemia
(Minkowsky-Shauffard disease). What mechanism caused haemolysis of erythrocytes?
A Membranopathy
B Enzymopathy
C Hemoglobinopathy
D Autoimmune disorder
E Bone marrow hypoploasia
2 years ago a patient underwent resection of pyloric part of stomach. He complains of
weakness, periodical dark shadows beneath his eyes, dyspnea. In blood: Hb - 70 g/l,
erythrocytes - $3,0\cdot10^{12}/l$, colour index - 0,7. What changes of erythrocytes in
blood smears are the most typical for this condition?
A Microcytes
B Megalocytes
C Schizocytes
D Ovalocytes
E Macrocytes
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 Calcium
C Acidotic
D Protein
E Nucleic
24 hours after appendectomy blood of a patient presents neutrophilic leukocytosis with
regenerative shift. What is the most probable mechanism of leukocytosis development?
A Amplification of leukopoiesis
B Redistribution of leukocytes in the organism
C Decelerated leukocyte destruction
D Deceleratied emigration of leukocytes to the tissues
E Amplification of leukopoiesis and decelerated emigration of leukocytes to the tissues
A 55 y.o. woman consulted a doctor about having continuous cyclic uterine hemorrhages
for a year, weakness, dizziness. Examination revealed skin pallor. Hemogram: Hb- 70 g/l,
erythrocytes - $3,2\cdot10^{12}$/l, color index - 0,6, leukocytes - $6,0\cdot10^9$/l,
reticulocytes - 1\%; erythrocyte hypochromia. What anemia is it?
A Chronic posthemorrhagic anemia
B Hemolytic anemia
C Aplastic anemia
D $B_{12}$-folate-deficiency anemia
E Iron-deficiency anemia
A 56 year old patient came to a hospital with complaints about 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 - $2,0\cdot10^{12}$/l; colour index - 1,2,
leukocytes - $3,5\cdot10^9$/l. What anemia type is it?
A $B_{12}$-folate deficient
B Hemolytic
C Posthemorrhagic
D Aplastic
E Iron-deficient
A 23 y.o. patient complains of weakness, temperature rise up to $38-40^0C$. Objectively:
liver and spleen are enlarged. Hemogram: Hb- 100 g/l, erythrocytes - $2,9\cdot10^{12}$/l,
leukocytes - $4,4\cdot10^9$/l, thrombocytes - $48\cdot10^9/$l, segmentonuclear
neutrophils - 17\%, lymphocytes - 15\%, blast cells - 68\%. All cytochemical reactions are
negative. Make a hematological conclusion:
A Undifferentiated leukosis
B Chronic myeloleukosis
C Acute myeloblastic leukosis
D Acute lymphoblastic leukosis
E Acute erythromyelosis
A 25 year old Palestinian woman complains of weakness, dizziness, dyspnea. In
anamnesis: periodically exacerbating anemia. In blood: Hb - 60 g/l, erythrocytes $2,5\cdot10^{12}$/l, reticulocytes - $35^o/_{oo}$, anisocytosis and poikilocytosis of
erythrocytes, a lot of target cells and polychromatophils. What type of anemia is it?
A Thalassemia
B Sickle-cell anemia
C Minkowsky-Shauffard disease
D Addison-Biermer disease
E Glucose 6-phosphate dehydrogenase-deficient anemia
Two hours after an exam a student had a blood count done and it was revealed that he
had leukocytosis without significant leukogram modifications. What is the most probable
mechanism of leukocytosis development?
A Redistribution of leukocytes in the organism
B Leukopoiesis intensification
C Deceleration of leukocyte lysis
D Deceleration of leukocyte migration to the tissues
E Leukopoiesis intensification and deceleration of leukocyte lysis
Examination of a patient admitted to the surgical department with symptoms of acute
appendicitis revealed the following changes in the white blood cells: the total count of
leukocytes is $16\cdot10^9$/l. Leukocyte formula: basophils - 0, eosinophils - 2\%, juvenile
forms - 2\%, stabnuclear - 8\%, segmentonuclear - 59\%, lymphocytes - 25\%, monocytes4\%. The described changes can be classified as:
A Neutrophilia with regenerative left shift
B Neutrophilia with right shift
C Neutrophilia with degenerative left shift
D Neutrophilic leukemoid reaction
E Neutrophilia with hyperregenerative left shift
A patient suffers from the haemorrhagic syndrome that shows itself in frequent nasal
bleedings, posttraumatic and spontaneous intracutaneous and intra-articular
haemorrhages. After a laboratory study a patient was diagnosed with the type B
haemophilia. This disease is provoked by the deficit of the following factor of blood
coagulation:
A IX
B VIII
C XI
D V
E VII
A 47 year old man with myocardium infarction was admitted to the cardiological department.
What changes of cellular composition of peripheral blood are induced by necrotic changes
in the myocardium?
A Neutrophilic leukocytosis
B Monocytosis
C Eosinophilic leukocytosis
D Thrombocytopenia
E Lymphopenia
A child is pale, pastose, muscular tissue is bad developed, lymph nodes are enlarged. He
often suffers from angina and pharyngitis, blood has signs of lymphocytosis. The child is
also predisposed to autoallergic diseases. What type of diathesis can be presumed in this
case?
A Lymphohypoplastic
B Exudative
C Gouty
D Asthenic
E Hemorrhagic
Parents of a 3 year old child have been giving him antibiotics with purpose of preventing
enteric infections for a long time. A month later the child's condition changed for the worse.
Blood examination revealed apparent leukopenia and granulocytopenia. What is the most
probable mechanism of blood changes?
A Myelotoxic
B Autoimmune
C Redistributive
D Age-specific
E Hemolytic
A 15 year old girl has pale skin, glossitis, gingivitis. Blood count: erythrocytes $3,3\cot10^{12}$/l, hemoglobin - 70 g/l, colour index - 0,5. Examination of blood smear
revealed hypochromia, microcytosis, poikilocytosis. What type of anemia is it?
A Iron-deficient
B $B_{12}$-folic acid-deficient
C Sickle-cell
D Hemolytic
E Thalassemia
A 5 year old child is ill with measles. Blood analysis revealed increase of total number of
leukocytes up to $13\cdot10^9$/l. Leukogram: basophils - 0, eosinophils - 1, myelocytes 0, juvenile neutrophils - 0, band neutrophils - 2, segmented neutrophils - 41, lymphocytes 28, monocytes - 28. Name this phenomenon:
A Monocytosis
B Agranulocytosis
C Lymphocytosis
D Eosinopenia
E Neutropenia
A 26 year old man is in the torpid shock phase as a result of a car accident. In blood:
$3,2\cdot10^9$/l. What is the leading mechanism of leukopenia development?
A Redistribution of leukocytes in bloodstream
B Leikopoiesis inhibition
C Disturbed going out of mature leukocytes from the marrow into the blood
D Lysis of leukocytes in the blood-forming organs
E Intensified elimination of leukocytes from the organism
CARDIO - V. S-M DIS.
A patient ill with essential arterial hypertension had a hypertensic crisis that resulted in an
attack of cardiac asthma. What is the leading mechanism of cardiac insufficiency in this
case?
A Heart overload caused by high pressure
B Heart overload caused by increased blood volume
C Absolute coronary insufficiency
D Myocardium damage
E Blood supply disturbance
A patient who suffers from acute myocarditis has clinical signs of cardiogenic shock. What
of the under-mentioned pathogenetic mechanisms plays the main part in shock
development?
A Disturbance of pumping ability of heart
B Depositing of blood in organs
C Reduction of diastolic flow to the heart
D Decrease of vascular tone
E Increase of peripheral vascular resistance
A 58-year-old patient suffers from the cerebral atherosclerosis. Examination revealed
hyperlipoidemia. What class of lipoproteins will most probably show increase in
concentration in this patient’s blood serum?
A Low-density lipoproteins
B High-density lipoproteins
C Fatty acid complexes with albumins
D Chylomicrons
E Cholesterol
In course of a preventive examination of a miner a doctor revealed changes of
cardiovascular fitness which was indicative of cardiac insufficiency at the compensation
stage. What is the main proof of cardiac compensation?
A Myocardium hypertrophy
B Tachycardia
C Rise of arterial pressure
D Dyspnea
E Cyanosis
A patient was ill with burn disease that was complicated by DIC syndrome. What stage of
DIC syndrome can be suspected if it is known that the patient's blood coagulates in less
than 3 minutes?
A Hypercoagulation
B Transition phase
C Hypocoagulation
D Fibrinolysis
E Terminal
A 59 year old patient is a plant manager. After the tax inspection of his plant he felt intense
pain behind his breastbone irradiating to his left arm. 15 minutes later his condition came to
normal. Which of the possible mechanisms of stenocardia development is the leading in
this case?
A High catecholamine concentration in blood
B Coronary atherosclerosis
C Intravascular aggregation of blood corpuscles
D Coronary thrombosis
E Functional heart overload
Arterial pressure of a surgeon who performed a long operation rised up to 140/110 mm Hg.
What changes of humoral regulation could have caused the rise of arterial pressure in this
case?
A Activation of sympathoadrenal system
B Activation of formation and excretion of aldosterone
C Activation of renin angiotensive system
D Activation of kallikrein kinin system
E Inhibition of sympathoadrenal system
A 70 year old man is ill with vascular atherosclerosis of lower extremities and coronary
heart disease. Examination revealed disturbance of lipidic blood composition. The main
factor of atherosclerosis pathogenesis is the excess of the following lipoproteins:
A Low-density lipoproteins
B Cholesterol
C High-density lipoproteins
D Intermediate density lipoproteins
E Chylomicrons
From the group of children who were eating sweet sappy watermelon two kids developed
the signs of poisoning: rapid weakness, dizziness, headache, vomiting, edema,
tachycardia, cyanosis of mouth, ears, tips of the fingers cyanosis. High concentration of
nitrates was detected. What is the leading mechanism of the pathogenesis of the
poisoning in the two children?
A Insufficiency of met-Hb-reductase
B Insufficiency of superoxiddismutase
C Block cytochrome oxidase
D Insufficiency glutathione pyroxidase
E Insufficiency of catalase
A 56 year old patient suffering from cardiac insufficiency has edema of feet and shins,
edematous skin is pale and cold. What is the leding mechanism of edema pathogenesis?
A Rise of hydrostatic pressure in venules
B Drop of oncotic pessure in capillaries
C Increase of capillary permeability
D Disorder of lymph outflow
E Positive water balance
Prophylactic medical examination of a 36 year old driver revealed that his AP was 150/90
mm Hg. At the end of working day he usually hears ear noise, feels slight indisposition that
passes after some rest. He was diagnosed with essential hypertension. What is the leading
pathogenetic mechanism in this case?
A Neurogenetic
B Nephric
C Humoral
D Endocrinal
E Reflexogenic
Person has stable HR, not more than 40 bpm. What is the pacemaker of the heart rhythm
in this person?
A Atrioventricular node
B Sinoatrial node
C His' bundle
D Branches of His' bundle
E Purkinye' fibers
ECG of a 44-year-old patient shows signs of hypertrophy of both ventricles and the right
atrium. The patient was diagnosed with the tricuspid valve insufficiency. What pathogenetic
variant of cardiac dysfunction is usually observed in case of such insufficiency?
A Heart overload by volume
B Heart overload by resistance
C Primary myocardial insufficiency
D Coronary insufficiency
E Cardiac tamponade
A 32-year-old patient was admitted to the hospital with gross bloodloss due to auto
accident trauma. Ps - 110Bpm, RR- 22 pm, BP- 100/60mm Hg. What changes in the blood
will occur in an hour after the bloodloss?
A Hypovolemia
B Erythropenia
C Hypochromia of erythrocytes
D Leukopenia
E Hypoproteinemia
Shock and signs of acute renal failure (ARF) developed in the patient due to permanent
injury. What is the leading cause of development of ARF in the case?
A Decreased arterial pressure
B Urine excretion violation
C Increased pressure in the nephron capsule
D Increased pressure in the renal arteries
E Decreased oncotic BP
In a 45-year-old patient on ECG it was revealed: sinus rhythm, the number of auricular
complexesexceeds number of ventricular complexes; progressing extension of the P-Q
interval from complex to complex; fallout of some ventricular complexes; Р waves and
QRST complexes are without changes. Name the type of heart rhythm disfunction.
A Atrioventricular block of the II degree
B Synoauricular block
C Atrioventricular blockade of the I degree
D Intraatrial block
E Complete atrioventricular block
Transmural myocardial infarction in the patient was complicated with progressive acute left
ventricle insufficiency. What is the most typical for this state?
A Edema of the lungs
B Edema of the extremities
C Cyanosis
D Ascites
E Arterial hypertension
Processes of repolarisation are disturbed in ventricular myocardium in examined person. It
will cause amplitude abnormalities of configuration and duration of the wave:
AТ
B Q
C R
D S
E P
Dystrophic changes of the heart muscle are accompanied with cardiac cavity enlargement,
decrease of the strength of heart contraction, increased amount of blood, which remains in
the heart during systolic phase, overfilled veins. For what state of heart is it characteristic?
A Myogenic dilatation
B Tonogenic dilatation
C Emergency stage of hyperfunction and hypertrophy
D Cardiosclerosis
E Tamponage of the heart
Arterial hypertention is caused by the stenosis of the renal arteries in the patient. Activation
of what system is the main link in the pathogenesys of this form of hypertension?
A Renin-angiotensin
B Sympathoadrenal
C Parasympathetic
D Kallikrein-kinin
E Hypothalamic-pituitary
After a serious psycho-emotional stress a 45-year-old patient suddenly felt constricting
heart pain irradiating to the left arm, neck and left scapula. His face turned pale, the cold
sweat stood out on it. The pain attack was stopped with nitroglycerine. What process has
developed in this patient?
A Stenocardia
B Myocardial infarction
C Stroke
D Psychogenic shock
E Stomach ulcer perforation
ECG of a patient shows such alterations: $P$-wave is normal, $P-Q$-interval is short,
ventricular $QRST$ complex is wide, $R$-wave is double-peak or two-phase. What form of
arrhythmia is it?
A WPW syndrome (Wolff-Parkinson-White)
B Frederick's syndrome (atrial flutter)
C Atrioventricular block
D Ventricular fibrillation
E Ciliary arrhythmia
A patient who suffers from severe disorder of water-salt metabolism experienced cardiac
arrest in diastole. What is the most probable mechanism of cardiac arrest in diastole?
A Hyperkaliemia
B Hypernatremia
C Organism dehydratation
D Hypokaliemia
E Hyponatremia
A 49 y.o. woman consulted a doctor about heightened fatigue and dyspnea during physical
activity. ECG: heart rate is 50/min, PQ is extended, QRS is unchanged, P wave quanity
exceeds quantity of QRS complexes. What type of arrhythmia does the patient have?
A Atrioventricular block
B Extrasystole
C Sinus bradycardia
D Ciliary arhythmia
E Sinoatrial block
An animal with aortic valve insufficiency got hypertrophy of its left heart ventricle. Some of
its parts have local contractures. What substance accumulated in the myocardiocytes
caused these contractures?
A Calcium
B Potassium
C Lactic acid
D Carbon dioxide
E Sodium
A patient has extrasystole. ECG shows no $P$ wave, $QRS$ complex is deformed, there is
a full compensatory pause. What extrasystoles are these?
A Ventricular
B Atrial
C Atrioventricular
D Sinus
E -
A 45 year old patient was admitted to the cardiological department. ECG data: negative
$P$ wave overlaps $QRS$ complex, diastolic interval is prolonged after extrasystole. What
type of extrasystole is it?
A Atrioventricular
B Sinus
C Atrial
D Ventricular
E Bundle-branch
A patient suffering from stenocardia was taking nitroglycerine which caused restoration of
blood supply of myocardium and relieved pain in the cardiac area. What intracellular
mechanism provides restoration of energy supply of insulted cells?
A Intensification of ATP resynthesis
B Reduction of ATP resynthesis
C Increased permeability of membranes
D Intensification of oxygen transporting into the cell
E Intensification of RNA generation
LUNGS DIS.
A 62-year-old patient was admitted to the neurological department due to cerebral
haemorrage. Condition is grave. There is observed progression of deepness and
frequency of breath that turnes into reduction to apnoea,and the cycle repeates. What
respiration type has developed in the patient?
A Cheyne-Stockes respiration
B Kussmaul respiration
C Biot's respiration
D Gasping respiration
E Apneustic respiration
While having the dinner the child choked and aspirated the food. Meavy cough has started,
skin and mucose are cyanotic, rapid pulse, rear breathing, expiration is prolonged. What
disorder of the external breathing developed in the child?
A Stage of expiratory dyspnea on asphyxia
B Stage of inspiratory dyspnea on asphyxia
C Stenotic breathing
D Alternating breathing
E Biot's breathing
A 12 y.o. boy who suffers from bronchial asthma has an acute attack of asthma: evident
expiratory dyspnea, skin pallor. What type of alveolar ventilation disturbance is it?
A Obstructive
B Restrictive
C Throracodiaphragmatic
D Central
E Neuromuscular
Examination of a miner revealed pulmonary fibrosis accompanied by disturbance of
alveolar ventilation. What is the main mechanism of this disturbance?
A Limitation of respiratory surface of lungs
B Constriction of superior respiratory tracts
C Disturbance of neural respiration control
D Limitation of breast mobility
E Bronchi spasm
A 56 y.o. patient has been suffering from thyreotoxicosis for a long time. What type of
hypoxia can be developed?
A Tissue
B Hemic
C Circulatory
D Respiratory
E Mixed
A patient staying in the pulmonological department was diagnosed with pulmonary
emphysema accompanied by reduced elasticity of pulmonary tissue. What type of
respiration is observed?
A Expiratory dyspnea
B Inspiratory dyspnea
C Superficial respiration
D Infrequent respiration
E Periodic respiration
An unconscious young man with signs of morphine poisoning entered admission office. His
respiration is shallow and infrequent which is caused by inhibition of respiratory centre.
What type of respiratory failure is it?
A Ventilative dysregulatory
B Ventilative obstructive
C Ventilative restrictive
D Perfusive
E Diffusive
GASTROINTESTINAL DIS.
A 57-year-old patient was admitted to the gastroenterological department with suspicion on
Zollinger-Ellison syndrom because of rapid increase of gastrin level in the blood serum.
What disorder of the secretory function of the stomach is the most likely?
A Hyperacid hypersecretion
B Hyperacid hyposecretion
C Achylia
D Hypoacid hyposecretion
E Hypoacid hypersecretion
NERVOUS. S-M. DIS.
A 68-year-old woman can't move by the upper and lower right extremities due to insult.
Muscle tone of these extremities and reflexes are increased. There are pathological
reflexes. What form of the paralysis is it?
A Hemiplegia
B Paraplegia
C Tetraplegia
D Monoplegia
E Dissociation
A patient caught a cold after which there appeared facial expression disorder. He cannot
close his eyes, raise his eyebrows, bare his teeth. What nerve is damaged?
A Facial
B Vagus
C Trigeminus
D Glossopharyngeal
E Infraorbital
An experimental rat with extremity paralysis has no tendon and cutaneous reflexes, muscle
tone is decreased, but muscles of the affected extremity maintain their ability to react with
excitation to the direct action of continious current. What type of paralysis is it?
A Flaccid peripheral
B Flaccid central
C Spastic peripheral
D Spastic central
E Extrapyramidal
A 28 year old man had a gunshot wound of shin that resulted in an ulcer from the side of
the injury. What is the main factor of neurodystrophy pathogenesis in this case?
A Traumatization of peripheral nerve
B Psychical stress
C Microcirculation disturbance
D Infection
E Tissue damage
KIDNEYS DIS.
Periodic renal colics attackes are observed in the woman with primery hyperparathyroidizm.
Ultrasonic examination revealed small stones in the kidneys. What is the cause of the
formation of the stones?
A Hypercalcemia
B Hyperphosphatemia
C Hypercholesterinemia
D Hyperuricemia
E Hyperkalemia
Chronic glomerulonephritis was diagnosed in a 34-year-old patient 3 years ago. Edema
has developed in the last 6 monthes. What caused it?
A Proteinuria
B Hyperproduction of vasopressin
C Disorder of albuminous kidneys function
D Hyperosmolarity of plasma
E Hyperaldosteronism
A driver who got a trauma in a road accident and is shocked has reduction of daily urinary
output down to 300 ml. What is the main pathogenetic factor of such diuresis change?
A Drop of arterial pressure
B Drop of oncotic blood pressure
C Increased vascular permeability
D Decreased number of functioning glomerules
E Secondary hyperaldosteronism
A patient with massive burns developed acute renal insufficiency characterized by a
significant and rapid deceleration of glomerular filtration. What is the mechanism of its
development?
A Reduction of renal blood flow
B Damage of glomerular filter
C Reduction of functioning nephron number
D Rise of pressure of tubular fluid
E Renal artery embolism
Two weeks after lacunar tonsillitis a 20-year-old man started complaining about general
weakness, lower eyelid edemata. After examination the patient was diagnosed with acute
glomerulonephritis. What are the most likely pathological changes in the urine formula?
A Proteinuria
B Cylindruria
C Presence of fresh erythrocytes
D Pyuria
E Natriuria
Violation of safety rules resulted in calomel intoxication. Two days later the daily diuresis
was 620 ml. A patient experienced headache, vomiting, convulsions, dyspnea, moist rales
in lungs. What pathology is it?
A Acute renal insufficiency
B Chronic renal insufficiency
C Uraemic coma
D Glomerulonephritis
E Pyelonephritis
A 50-year-old patient complains of thirst, drinking of a lot of water, marked polyuria. Blood
glucose is 4,8mmol/L, urine glucose and acetone bodies are absent, urine is colorless,
specific gravity is 1,002-1,004. What is the cause of polyuria?
A Vasopressin insufficiency
B Hypothyroidism
C Insulin insufficiency
D Aldosteronism
E Thyrotoxicosis
On the 6th day of treatment a patient with acute renal insufficiency developed polyuria.
Diuresis intensification at the beginning of polyuria stage of acute renal insufficiency is
caused by:
A Renewal of filtration in nephrons
B Volume expansion of circulating blood
C Growth of natriuretic factor
D Reduction of aldosteron content in plasma
E Reduction of vasopressin content in plasma
A 30 year old woman has face edemata. Examination revealed proteinuria (5,87 g/l),
hypoproteinemia, dysproteinemia, 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
A patient with nephrotic syndrome has massive edemata of his face and limbs. What is the
leading pathogenetic mechanism of edemata development?
A Drop of oncotic blood pressure
B Increase of vascular permeability
C Rise of hydrodynamic blood pressure
D Lymphostasis
E Increase of lymph outflow
ENDOKRINE DIS.
A 46-year-old patient suffering from the diffuse toxic goiter underwent resection of the
thyroid gland. After the surgery the patient presents with appetite loss, dyspepsia,
increased neuromuscular excitement. The body weight remained unchanged. Body
temperature is normal. Which of the following has caused such a condition in this patient?
A Reduced production of parathormone
B Increased production of thyroxin
C Increased production of calcitonin
D Increased production of thyroliberin
E Reduced production of thyroxin
A patient is followed up in an endocrinological dispensary on account of hyperthyreosis.
Weight loss, tachycardia, finger tremor are accompanied by hypoxia symptoms - headache,
fatigue, eye flicker. What mechanism of thyroid hormones action underlies the
development of hypoxia?
A Disjunction, oxydation and phosphorilation
B Inhibition of respiratory ferment synthesis
C Competitive inhibition of respiratory ferments
D Intensification of respiratory ferment synthesis
E Specific binding of active centres of respiratory ferments
A girl is diagnosed with adrenogenital syndrome (pseudohermaphroditism). This pathology
was caused by hypersecretion
of the following adrenal hormone:
A Androgen
B Estrogen
C Aldosterone
D Cortisol
E Adrenalin
Examination of a 42 year old patient revealed a tumour of adenohypophysis. Objectively:
the patient's weight is 117 kg, he has moon-like hyperemic face, red-blue striae of skin
distension on his belly. Osteoporosis and muscle dystrophy are present. AP is 210/140 mm
Hg. What is the most probable diagnosis?
A Cushing's disease
B Cushing's syndrome
C Conn's disease
D Diabetes mellitus
E Essential hypertension
LIVER DIS.
A 48 y.o. patient was admitted to the hospital with complaints about weakness, irritability,
sleep disturbance. Objectively: skin and scleras are yellow. In blood: conjugated bilirubin,
cholalemia. Feces are acholic. Urine is of dark colour (bilirubin). What jaundice is it?
A Mechanic
B Hemolytic
C Parenchymatous
D Gilbert's syndrome
E Crigler-Najjar syndrome
A patient presents with icteritiousness of skin, scleras and mucous membranes. Blood
plasma the total bilirubin is increased, stercobilin is increased in feces, urobilin is increased
in urine. What type of jaundice is it?
A Haemolytic
B Gilbert's disease
C Parenchymatous
D Obturational
E Cholestatic
Hepatitis has led to the development of hepatic failure. Mechanism of edemata formation is
activated by the impairment of the following liver function:
A Protein-synthetic
B Barrier
C Chologenetic
D Antitoxic
E Glycogen-synthetic
A patient being treated for viral hepatitis type B got symptoms of hepatic insufficiency.
What blood changes indicative of protein metabolism disorder will be observed in this
case?
A Absolute hypoalbuminemia
B Absolute hyperalbuminemia
C Absolute hyperfibrinogenemia
D Proteinic blood composition is unchanged
E Absolute hyperglobulinemia
TERMINAL STATE
As a result of a trauma a patient has developed traumatic shock that led to the following
disorders: AP is 140/90 mm Hg, Ps is 120 bpm. The patient is fussy, talkative, pale. Such
state relates to the following shock phase:
A Erectile
B Latent period
C Terminal
D Torpid
E -
Rats being under stress have muscular hypertonia and high arterial pressure, high glucose
concentration in blood and intensified secretion of corticotropin and corticosteroids. In
what stress phase are these animals?
A Antishock phase
B Exhaustion
C Shock phase
D Erectile
E Terminal
GENERAL NOSOLOGY
Study about disease
1. A 40-year-old man sustained trauma of the cornea and after long treatment cataract appeared. What is
the designation of such an ending of the disease?
A.
B.
C.
D.
E.
Pathological state
Pathological process
Pathological reaction
Chronic disease
Remission
2. In a patient after long lasting sever disease blood pressure decreased (60/40 mm Hg), it is accompanied
by tachycardia, dispnoae, dizziness. This state can be regarded as:
A.
B.
C.
D.
E.
Preagony
Agony
Shock
Clinical death
Relapse
3. What are the criteria of mountain disease classification?
A.
B.
C.
D.
E.
Ecological
Topographical-anatomical
Etiological
Pathogenetic
Statistic
4. What are the criteria of acute leukemia classification?
A.
B.
C.
D.
E.
Topographical-anatomical
Etiological
Ecological
Statistic
Pathogenetic
5. What are the criteria of tumours classification?
A.
B.
C.
D.
E.
Pathogenetic
Etiological
Ecological
Statistic
Topographical-anatomical
6. What are the criteria of chicken pox classification?
A.
B.
C.
D.
E.
Etiological
Ecological
Pathogenetic
Topographical-anatomical
Statistic
7. What are the criteria of allergic disorders classification?
A. Pathogenetic
B. Etiological
C. Ecological
D. Topographical-anatomical
E. Statistic
8. What are the criteria of tropical malaria classification?
A.
B.
C.
D.
E.
Ecological
Topographical-anatomical
Etiological
Pathogenetic
Statistic
9. What are the criteria of fibromioma of uterus classification?
A.
B.
C.
D.
E.
By sex
By age
By topographical-anatomical principle
By ecological principle
By pathogenetic principle
10. What are the criteria of Alzheimer disease classification?
A.
B.
C.
D.
E.
By age
By sex
By course
By ecological
By pathogenetic principle
11. What are the criteria of miners’ disease (antracosis) classification?
A.
B.
C.
D.
E.
By ecological
By pathogenetic
By age
By sex
By statistic
12. What are the criteria of Down disease classification?
A.
B.
C.
D.
E.
By etiological
By pathogenetic
By age
By sex
By statistic
13. What are the criteria of Kleinfelter disease classification?
A.
B.
C.
D.
E.
By etiological
By pathogenetic
By age
By sex
By statistic
14. On the second day after sport events a 12-year-schoolboy developed malaise, headache, increased
body temperature up to 37.8о С. What period of disease are these symptoms characteristic of?
A.
B.
C.
D.
E.
Prodromal
Latent
Contact
Period of outburst
Final period
15. A 39-year-old patient has been suffering from a stomach disease for the last three years. The patient’s
state worsens in autumn and spring and manifests as pain in the upper part of abdomen, nausea,
heartburns, constipations. What is the designation of this period?
A.
B.
C.
D.
E.
Relapse
Remission
Pathologic state
Complication
Pathologic reaction
16. In a patient with a sever obstructive pulmonary disease gasp-breathing appeared. What terminal state
is this breathing characteristic of?
A.
B.
C.
D.
E.
Agony
Preagony
Terminal pause
Clinical death
Biological death
17. A student-girl after she came from university classes felt malaise, nausea, headache, flash. What is the
period of disease in the girl?
A.
B.
C.
D.
E.
Prodromal
Contact
Latent
Outburst
Final
18. A 45-year-old man has complained for the past week on running nose, malaise, headaches, subfebrile
body temperature. The day before hospitalization jaundice, dark urine emerged. Blood laboratory analysis
revealed direct hyperbilirubinaemia; stool is white. What is the period of jaundice in the patient?
A.
B.
C.
D.
E.
Outburst
Contact
Prodromal
Latent
Final
19. A scientist has sustained ionizing radiation while an accident at a laboratory. A disease manifested by
severe reduction of RBC, WBC and platelets count, depression of the organism’s protection forces. What is
period of the disease?
A.
B.
C.
D.
E.
Period of outburst
Latent
Final
Contact
Prodromal
20. A 7-year-old boy became felt malaise and fatigue, increased temperature in the evening. In the morning
catharal symptoms, fever and lesions on the oral cavity mucosa – Belsky-Filatov-Coplic plaques appeared.
What is period of the disease?
A.
B.
C.
D.
E.
Prodromal
Period of outburst
Latent
Final
Contact
21. Clinical death is characterized by:
A.
B.
C.
D.
E.
Stop of heart work, absence of breathing and reflexes, anaerobic glycolysis;
Stop of breathing, presence of pulse and iris reflex, anaerobic glycolysis;
Stop of heart work, gasp-breathing, presence of iris reflex, anaerobic glycolysis;
Stop of heart work, absence of breathing, reflexes and complete cessation of matters metabolism;
Heart fibrillation; gasp-breathing, presence of iris reflex, anaerobic glycolysis.
22. Development of iron-deficient anemia results in heavy brain hypoxia. What type of disorder is the
anemia in this case?
A.
B.
C.
D.
E.
Typical pathological process
Disease
Pathological state
Pathological reaction
Pathological process
1.23. A 33-year-old woman has fallen down and received an open fracture of ulnar bone. On the fractured
bone a plaster of Paris was applied. Because of inobservance of recommendations by the woman she soon
presented with movements disorders in the ulnar joint. Give the designation to this type of state.
A.
B.
C.
D.
E.
Pathological state
Typical pathological process
Pathological reaction
Pathological process
Disease
1.24. While an attempt to experimentally reproduce anaphylactic shock a mice developed seizures, gaspbreathing which lasted for 3 min. What type of terminal state developed in the mice?
A.
B.
C.
D.
E.
Agony
Preagony
Clinical death
Biological death
Terminal pause
1.25. What factors are the first to determine duration of clinical death?
A.
B.
C.
D.
E.
ATP and creatinine phosphate stores
Patient’s age
Disease that caused death
Rate of the organism’s injury
Patient’s sex
1.26. Which factor can substantially prolong duration of clinical death?
A.
B.
C.
D.
E.
Hypothermia
Hyperthermia
Indirect heart massage
Artificial breathing
Defibrillation
1.27. A 37-year-old woman has been suffering on peptic ulcer disease for 4 years. Every spring she must
take stationary treatment due to:
A.
B.
C.
D.
E.
Relapse
Remission
Exacerbation
Complication
Pathological reaction
1.28. A 65-year-old man complaints on frequent infections with fevers, fatigue, headaches. After detailed
examination of the patient the diagnosis of chronic leucosis was established. The patient’s state and
laboratory analysis after treatment improved. The patient has:
A.
B.
C.
D.
E.
Remission
Curing
Relapse
Pathological state
Pathological reaction
1.1.29. A patient with ulcerative disease of the stomach complicated by bleeding, after stationary
treatment felt better. Nevertheless endoscopic investigation revealed a scar and pylorus narrowing on the
place of the previous ulcer. That should be regarded as:
A.
B.
C.
D.
E.
Pathological state
Pathological process
Pathological reaction
Exacerbation
Complication
1.1.30. A student bought .meat pie on the street near university. After several hours he felt pain in the
stomach, nausea, headache, fluttering before his eyes. Soon vomiting and diarrhea emerged. The student
developed:
A.
B.
C.
D.
E.
Pathological process
Pathological reaction
Pathological state
Relapse
Exacerbation
1.1.31. During dentist review of the 37-year-old patient’s oral cavity absence of the 1st upper premolar
tooth was discovered. Such a phenomenon is designated as:
A.
B.
C.
D.
E.
Pathological state
Pathological reaction
Pathological process
Chronic process
Complication
1.1.32. A druggist, that has worked for many years on chemical-pharmaceutical enterprise has poisoned
with cyanides. What criterion should this disorder be classified by?
A.
B.
C.
D.
E.
Etiological
Topographical-anatomical
Sex
Course
Pathogenetical
1.1.33. A man after a car accident developed acute blood loss, which was accompanied by acute
cardiovascular deficiency. After half an hour the bleeding stopped, blood pressure began rising, tachycardia
and tachypnoe appeared. What mechanism has come into play?
A.
B.
C.
D.
E.
Urgent recovery mechanisms
Relatively stable recovery mechanisms
Prolonged recovery mechanisms
Pathological reactions
Renewal reactions
1.1.34. A 10-year-old-child’s mother decided to become a donor for her boy suffering from chronic renal
failure, and to give him her kidney for transplantation. Compensation due to what mechanisms would allow
the mother to restore her viability?
A.
B.
C.
D.
E.
Prolonged recovery mechanisms
Urgent recovery mechanisms
Relatively stable recovery mechanisms
Adaptation reactions
Pathological reactions
1.1.35. Which of the following terminal states is characterized by irreversible changes in the organism?
A.
B.
C.
D.
E.
Biological death
Clinical death
Preagony
Agony
Terminal pause
1.1.36. In the process of dying the first cells to die are:
A.
B.
C.
D.
E.
Neurons of the brain cortex
Liver cells
Myocardium cells
Neurons of the spinal brain
Epithelial cells of the skin
1.1.37. A patient who has sustained an electrical shock is lying unconscious, without breathing, pulse is
impalpable. What terminal state is the patient in?
A.
B.
C.
D.
E.
Clinical death
Biological death
Preagony
Agony
Terminal pause
1.1.38. Resuscitation is possible if the time of clinical death not more than:
A.
B.
C.
D.
E.
5 min
10min
20 min
30 min
60 min
1.1.39. Chose the indication for electrical heart defibrillation:
A.
B.
C.
D.
E.
Ventricles fibrillations
Absence of arterial pressure
Asystoly
“Ineffective heart”
Absent pulse above carotid artery
1.1.40. Resuscitation measures includes administration of sodium hydrocarbon solution with the purpose
of:
A.
B.
C.
D.
E.
Correction of metabolic acidosis
Prevention of respiratory acidosis
Liquidation of hypoxia
Correction of metabolic alkalosis
Prevention of brain edema
1.1.41. Arterial blood pressure in a patient with a massive brain hemorrhage is 60/30 mm Hg, pulse – 110 /
min; breathing rate – 36 / min, the patient is unconscious. Hoe can this state be designated?
A.
B.
C.
D.
E.
Preagony
Shock
Collapse
Clinical death
Agony
1.1.42. Clinical death in the terms of normothermia lasts for:
A.
B.
C.
D.
E.
5-6 min
7-8 min
1-3 min
9-12 min
up to 10 min
1.1.43. In a woman suffering from lung tuberculosis calcifications were diagnosed during roentgenogram;
they may be regarded as:
A.
B.
C.
D.
E.
Pathological state
Relapse
Period of maximally developed clinical symptoms
Pathological process
Complication
1.1.44. A 56-yeal-old man was delivered to a hospital with complaints of the pain in abdomen, nausea,
vomiting, and constipations. He said that he had been suffering for three days. After objective examination
the diagnosis “Intestinal obliteration”. What period of the disease is the patient in?
A.
B.
C.
D.
E.
Period of maximally developed clinical symptoms
Latent period
Reconvalescent period
Prodromal period
Contact period
1.1.45. A woman complaints of an acute pulsating pain in the 2nd low right tooth, that aggravates in the
night. On examination caries and pulpitis were diagnosed. What of the following is a typical pathological
process?
A.
B.
C.
D.
E.
Inflammation
Pulpitis
Pain
Caries
Redness
1.1.46. A 50-year-old man has received treatment for ulcerative disease of the stomach after which he got
relief: the process of digestion normalized, pain disappeared, general state was improved. However several
days after the pain and heartburn in the stomach appeared again. How can this process be designated?
A.
B.
C.
D.
E.
Relapse of disease
Terminal state
Typical pathological process
Latent period
Remission
1.1.47. What category of pathology can be inborn thigh luxation taken to?
A.
B.
C.
D.
E.
Pathological state
Disease
Pathological reaction
Pathological process
Complication
1.1.48. A 28-year-old man was hospitalized to surgical department with the symptoms of acute
appendicitis. Objectively was found: pain on palpation in the right iliac region, positive ShchotkinBlumberg’s symptom. What is the period of disease in the patient?
A.
B.
C.
D.
E.
Period of maximally developed clinical symptoms
Contact period
Latent period
Prodromal period
Reconvalescent period
1.1.49. A 16-year-old patient was admitted to a surgical department with the diagnosis “Acute
appendicitis”. What typical pathological process is the main one in development of the disease?
A.
B.
C.
D.
E.
Inflammation
Hypoxia
Fever
Tumor
Disorder of microcirculation
1.1.50. A 28-year-old woman came to a doctor with complaints of the sore throat, headache and increased
body temperature. What category of pathology can these states be taken to?
A.
B.
C.
D.
E.
Pathological process
Pathological reaction
Pathological state
Pathological reflex
Protective reaction
INFLUENCE OF ENVIRONMENTAL FACTORS ON THE ORGANISM
1.2.1. What develops during gradual decrease of barometric pressure?
A.
B.
C.
D.
E.
Mountain disease
Barometric trauma
Explosive decompression
Pain shock
Caisson disease
1.2.2 Alpinists slowly climbed up a mountain slope. They had already 6 hours of climbing behind. Every step
was hard to make due to general lassitude, it was difficult to breath, they felt palpitation. The pulse rate
approached 140 / min. Headache, depression, anorexia and dizziness were present. What is the main
reason of these disorders?
A.
B.
C.
D.
E.
Decrease of oxygen partial pressure in the air inhaled
Physical load
Decrease of atmospheric pressure
Decrease of arterial pressure
Changes of air temperature
1.2.3. Tourists who have ascended on the height of 2500 m developed mountain disease, that was
accompanied by hypoxic hypoxia. What leading mechanism lies in the basis of this type of hypoxia
development?
A.
B.
C.
D.
E.
Decrease of рО2 in the air inhaled
Decrease of рCО2 in the air inhaled
Increase of рО2 in the air inhaled
Relative blood circulation deficiency
Increase of рCО2 in the air inhaled
1.2.4. An alpinist, who was climbing onto the high of 6000 m above the see level, developed euphoria,
inadequate orientation, and hallucinations. What is the main reason of development of these mountain
disease manifestations?
A.
B.
C.
D.
E.
Decrease of oxygen partial pressure in the air inhaled
Physical load
Decrease of atmospheric pressure
Decrease of arterial pressure
Hyperinflation of frontal sinuses
1.2.5. Tourists during their climbing on the mountains developed signs of mountain disease. What is the
main moment in the pathogenesis of this disease development?
A.
B.
C.
D.
E.
Hypoxia
Hypocapnia
Relative erythrocytosis
Absolute erythrocytosis
Hypercapnia
1.2.6. A man during his ascending on mountains has developed mountain disease, which is characterized by
a number of sequential changes in the organism. Point out what from the following is the primary
pathogenetical factor in the development of the disease.
A.
B.
C.
D.
E.
Hypoxemia
Hypocapnia
Breathlessness
Tachycardia
Decrease of mobile activity
1.2.7. Frequent and deep breathing developed in alpinists while their climbing on a mountain slope, pulse
rate was up to 120 /min. What is the initiating factor in the arising of these symptoms?
A.
B.
C.
D.
E.
Hypoxemia
Hyperoxya
Hypocapnia
Hypercapnia
Hypertonia
1.2.8. During prolonged travel in the mountains partial pressure of oxygen in arterial blood has decreased
to 60 mm Hg (8.0 kPa). What is the reaction of the respiratory system to such a change in homeostasis?
A.
B.
C.
D.
E.
Hyperventilation
Hypoventilation
Tissue hyperoxygenation
Hyperoxya
Hypercapnia
1.2.9. A traveling man on his ascending on mountains has developed symptoms of mountain disease. What
is the main compensatory reaction of the human organism to hypoxia during ascending on the mountains?
A.
B.
C.
D.
E.
Lung hyperventilation
Bradycardia
Decrease of red blood cells count
Decrease of hemoglobin level
Decrease of affinity of hemoglobin to oxygen
1.2.10. On physical load in tourists ascending on mountains changes in partial pressure of oxygen, СО2, and
рН are observed. The most effective irritator of carotid sinus chemoreceptors, which increases lung
ventilation is:
A.
B.
C.
D.
E.
Low O2 level in the blood
Low СО2 level in the blood
Increased partial pressure of O2 in the blood
Accumulation of lactate in the blood
Increase of рН in the blood
1.2.11. A 40-year-old man on his ascending on the height of 3800 m above the sea level developed
mountain disease manifested by changes of breathing pattern. What is the breathing pattern on the initial
stages of mountain disease?
A. Superficial frequent
B. Superficial rare
C. Periodical
D. Slowed deep
E. Rare deep
1.2.12. Tourists who have ascended on the height of 3000 m, developed frequent and deep breathing.
These changes are the result of the stimulation of which structures?
A.
B.
C.
D.
E.
Chemoreceptors of carotid sinuses
Mechanoreceptors of lung alveoli
Baroreceptors of the aorta arc
Brain cortex neurons
Myocytes of breathing muscles
1.2.13. What can be regarded as compensatory mechanism of mountain disease?
A.
B.
C.
D.
E.
Erythrocytosis
Bradycardia
Anemia
Bradypnoae
Leukocytosis
1.2.14. Euphoria was observed in a group of students during their mountain climbing; the students also
developed tachypnoae, tachycardia, increased level of erythrocytes and hemoglobin in the blood. What
changes in the blood accompany this state?
A.
B.
C.
D.
E.
Erythrocytosis
Genuine erythraemia
Leukocytosis
Leukopenia
Thrombocytopenia
1.2.15. A 36-year-old man after prolonged staying on mountains developed increased oxygen capacity of
the blood. Point out the reason of such changes in the organism.
A.
B.
C.
D.
E.
Increased erythropoesis
Increased lung ventilation
Increased blood volume
Increase of heart rate
Deficiency of iodine in ground and water
1.2.16. People living in the mountain region have increased level of erythrocytes; what is the mechanism of
the red blood cells increased production?
A.
B.
C.
D.
E.
Erythropoietin
Renin
Urokinasa
Prostaglandins
Provitamin D
1.2.17. People suffering from lung deficiency are recommended to live for some time in a mountain region.
What is the mechanism of their symptoms improvement?
A.
B.
C.
D.
E.
Reaction of the organism to hypoxia
Low temperature of environment
Clean air
Decrease of nervous tension
Decrease of physical load
1.2.18. What are the adaptive mechanisms playing an important role during breathing on a high level above
the sea level?
A.
B.
C.
D.
E.
All the stated above
Increase of alveolar ventilation
Shift of hemoglobin dissociation curve to the left
Increase of the lungs diffuse capacity
Increase of erythrocytes and hemoglobin level
1.2.19. An alpinist on his mountain climbing developed euphoria, which later changed on headache,
dizziness, palpitation and breathlessness; apnoae emerged some time after. What changes in the acid-base
balance developed in this case?
A.
B.
C.
D.
E.
Gas alkalosis
Nongas acidosis
Nongas alkalosis
Excretion alkalosis
Gas acidosis
1.2.20. An alpinists while his mountain climbing has developed mountain disease signs: euphoria,
tachycardia, impairment of breathing rhythm with the development of Chein-Stocks pattern of breathing.
What type of acid-base disorder is observed in this patient?
A.
B.
C.
D.
E.
Respiratory alkalosis
Respiratory acidosis
Metabolic alkalosis
Metabolic acidosis
Mixed acidosis
1.2.21. An alpinists while his mountain climbing has developed mountain disease signs: euphoria,
tachycardia, impairment of breathing rhythm with the development of Chein-Stocks pattern of breathing.
Which pathogenetic factor underlies development of mountain disease symptoms?
F.
G.
H.
I.
J.
Hypocapnia
Hypercapnia
Hyperoxya
Hyperasotemia
Hypokaliemia
1.2.22. What is the direct reason of hypocapnia in mountain disease?
A.
B.
C.
D.
E.
Increase of frequency and deepness of breathing
Decrease of breathing frequency
Decrease of breathing deepness
Increase of heart rate
Increase of blood output per minute
1.2.23. After several intensive arbitrary breathing movements (hyperventilation) made by an alpinists
climbing at a high mountains, he felt unwillingness to breath for some time. What can be the reason of
such a state development?
A.
B.
C.
D.
E.
Decrease of the breathing centre excitation
Increase of breathing centre excitation
Increase of СО2 partial pressure
Decrease of О2 partial pressure
Increase of blood pH
1.2.24. A traveling man on his mountain climbing developed sighs of mountain disease. Which of the
compensatory mechanisms can deteriorate his state?
A.
B.
C.
D.
E.
Lung hyperventilation
Tachycardia
Increase of red blood cells count
Increase of hemoglobin level
Increase of hemoglobin affinity to oxygen
1.2.25. A man who has ascended on the height of 2500 m felt general fatigue, dizziness, his breathing
became frequent and deep. After some time the man lost his consciousness. Hypocapnia that underlies this
state develops due to:
A. Lung hyperventilation
B. Metabolism depression
C. Binding of carbon dioxide with proteins
D. Neutralization of carbonic acid by bicarbonates
E. Absorption of carbonic acid by erythrocytes
1.2.26. A member of a high mountain expedition developed dizziness and weakness on the height of 6 km.
The alpinists lost consciousness, his breathing stopped. These disorders developed as a result of:
A.
B.
C.
D.
E.
Excessive СО2 removal from the organism
Excessive creation of СО2 in tissues
Deficient О2 income to the organism
Insufficient О2 utilization by tissues
Insufficient release of О2 by oxyhemoglobin
1.2.27. What will be the effect of decrease of O2 pressure in the blood passing through carotid sinus on
systemic arterial pressure?
A.
B.
C.
D.
E.
Decrease of systemic arterial pressure
Increase of systemic arterial pressure
No change
Increase and later decrease
Decrease and then increase
1.2.28. A 27-year-old alpinist during sleep on the height of 5000 m above the sea level manifested changes
in his breathing pattern. After several deep inspirations breathing stops, after which deep breathing
movements follow again and so on. What is the most plausible reason of changes in external breathing?
A. Decrease of the breathing centre excitation
B. Increase of the breathing centre excitation
C. Increase of О2 partial pressure
D. Increase of blood circulation speed
E. Decrease of air temperature
1.2.29. Due to a long staying of a woman in the mountains on the height of 1000 m above the sea level she
developed an increased oxygen capacity of the blood. What is the direct reason of this state?
A.
B.
C.
D.
E.
Increased production of erythropoietin
Increased production of carboxyhemoglobin
Increased production of carbhemoglobin
Increased production of of catecholamines
Increased production of 2,3-dyphosfoglycerate
1.2.30. A frog and mouse were placed in a barocamera and then atmospheric pressure began to be
decreased. It was the mouse that first reacted to decrease of pressure. The frog appeared more stable to
that pressure. This is due to:
A. Lower grade of frog evolutional development
B. Higher dependence of metabolic processes of the frog’s organism on the oxygen content in
environment
C. Higher grade of frog evolutional development
D. Sufficient development of the frog’s systems responsible for utilization
E. Preliminary saturation of the frog’s organism with oxygen
1.2.31. A newborn and sexually mature rats were placed in a barocamera, in which pressure was gradually
decreased. The newborn rat appeared to be more stable to hypoxia due to:
A.
B.
C.
D.
E.
Lower grade of central nervous system development
Sufficient development of systems responsible for oxygen utilization by cells
Accumulation of toxic products in the organism
Higher grade of evolutional development
Saturation of the organism with oxygen
1.2.32. A mouse was placed in a barocamera and the model of mountain disease was reproduced, the first
manifestation of which became appearance of seizures. This is connected with the fact that the most
sensitive to hypoxia are:
A.
B.
C.
D.
E.
Brain neurons
Muscle tissue
Bone marrow
Lungs
Kidneys
1.2.33. Two rats were placed in a barocamera with the pressure in it being gradually decreased. To one rat
the somnolent substance Nembutal was administered, the second rat was a control one. In the rat to
whom Nembutal was administered the appearance of seizures and terminal breathing came later than in
the control one. How can it be explained?
A.
B.
C.
D.
E.
Decrease of the organism’s reactivity
Increase of the organism’s reactivity
Decrease of anaerobic glycolysis intensity
Increase of anaerobic glycolysis intensity
Increase of carbohydrate metabolism intensity
1.2.34. Two rats were placed in a barocamera with the pressure in it being gradually decreased. To one rat
the adrenalin was administered, the second rat was a control one. In the rat to whom adrenalin was
administered the appearance of seizures and terminal breathing came earlier than in the control one. How
can it be explained?
A.
B.
C.
D.
E.
Increase of the main metabolism intensity
Decrease of the main metabolism intensity
Decrease of anaerobic glycolysis intensity
Increase of anaerobic glycolysis intensity
Increase of carbohydrate metabolism intensity
1.2.35. When the plane is flying up some people feel pain in the ears. This is due to:
A. Expansion of gases in tympanic cavities
B. Expansion of gases in maxillary cavities (sinuses)
C. Expansion of gases in frontal cavities (sinuses)
D. Inflammation of the inner ear
E. Inflammation of maxillary cavities (sinuses)
1.2.36. Passengers of a plane with impaired hermetic conditions rapidly developed symptoms of pain in
ears, frontal sinuses and accumulations of gases in the intestines. What lies in the bases of pathogenesis of
these symptoms?
A.
B.
C.
D.
E.
Increase of gases volume
Decrease of gases volume
Saturation of gases
Desaturation of gases
Acute compression
1.2.37. On the height of 10000 m an abrupt lost of hermetic conditions has appeared on a plane board.
Some seconds after the barometric pressure inside the plane became as atmospheric one on this height
(180 mm Hg). Pilots could not perform quick descending, the plane continued its fly on this height for some
time. What pathological process develops in passengers of the plane?
A.
B.
C.
D.
E.
Syndrome of explosive decompression
Mountain disease
Deepness sickness
Caisson disease
Pain shock
1.2.38. After a plane cabin lost its hermetic conditions a pilot developed sensor functions impairment and
lost consciousness. What is the reason of this condition?
A.
B.
C.
D.
E.
Acute hypoxia
Decrease of gases volume
Speed of air movement
Phenomenon of saturation
Air humidity
1.2.39. As a result of an accident at a space ship on the height of 70000 m the ship lost its hermetic
conditions that led to abrupt death of the ship members. What is the mechanism of their death?
A.
B.
C.
D.
E.
Boiling of all the organisms’ fluids
Toxic action of nitrogen
Toxic action of oxygen
Decrease of gases volume
Saturation of gases
1.2.40. Which of the following processes causes death of humans in the terms of lost hermetic conditions in
flying objects at the height of more than 19000 m without oxygen devises?
A.
B.
C.
D.
E.
Boiling of the blood
Saturation of gases in fluids
Toxic action of oxygen
Toxic action of nitrogen
Low concentration of oxygen in the air inhaled
1.2.41. A diver while working on depth developed signs of the central nervous system disorder, which
manifested as light excitation resembling euphoria. In these conditions CNS is damaged predominantly by:
A.
B.
C.
D.
E.
Nitrogen
Carbon dioxide
Combined action of oxygen and carbon dioxide
Oxygen
Lactic acid
1.2.42. On submerging on the depth of 100 m a diver developed impairment of central nervous system
function. What is the most probable reason of the CNS disorders?
A.
B.
C.
D.
E.
Saturation of nitrogen
Desaturation of nitrogen
Hypocapnia
Hypoxemia
Hypercapnia
1.2.43. On submerging on the depth of 60 m a diver developed impairment of central nervous system
function: euphoria, lost of attention and professional mistakes. These symptoms are related to the toxic
action on neurons of:
A.
B.
C.
D.
E.
Nitrogen
Oxygen
Lactate
Carbon acid
Amonium
1.2.44. A diver working on the depth of 40 m using breathing mixture of nitrogen, oxygen and carbon
dioxide developed light excitation and euphoria, his movement became uncoordinated, the sense of
responsibility for the work performed was diminished. What is the predominance of neurological disorders
conditioned by?
A.
B.
C.
D.
E.
Increased nitrogen dissolving in lipids
Decreased nitrogen dissolving in lipids
Increased oxygen dissolving
Decreased oxygen dissolving
Increased СО2 dissolving
1.2.45. A diver working on the depth of 40 m using breathing mixture of nitrogen, oxygen and carbon
dioxide developed light excitation and euphoria, his movement became uncoordinated, the sense of
responsibility for the work performed was diminished. How is it possible to predict the development of
these symptoms?
F.
G.
H.
I.
J.
Replace nitrogen by helium
Replace СО2 by helium
Carry out the preventive treatment with vitamins before the work
Conduct a course of psychological training before the work
Replace oxygen by helium
1.2.46. What is the most likely cause of toxicity of hyperbaric oxygenation?
A.
B.
C.
D.
E.
Formation of active oxygen compounds
Braking of chemoreceptors reflexogenic zones
Mechanical damage to blood vessels
Excessive activation of oxidative reactions
Mechanical damage to the lungs.
1.2.47. The man, who was in a vacuum chamber with high oxygen pressure over 1 atmosphere, developed
significantly increased levels of lipid peroxidation products. How will be vessel’s lumen changed in these
conditions?
A. Vessels narrow due to increased permeability of cell membranes for Ca ++
B. Vessels dilate due to reducing membrane permeability to Ca ++
C. Vessels dilate due to increased level of cAMP
D. Vessels narrow due to increased permeability of cell membranes to Na +
E. Vessels narrow due to increased cGMP
1.2.48. After the rapid rise of a diver from the depth of 25 m, he developed: joint pain, itching of the skin,
and poor vision. This syndrome is called:
A.
B.
C.
D.
E.
Decompression sickness
Deep disease
Altitude sickness
Mountain disease
Sea disease
1.2.49. Elevation of divers after work at depth is conducting very slowly. This is done with the purpose to
prevent the development of:
A.
B.
C.
D.
E.
Gas embolism
Compression ischemia
Saturation
Venostasis
Thrombosis
1.2.50. A diver has performed caisson works at the depth of 15 m for one hour, then quickly raised to the
surface. After half an hour he felt weakness, increasing pain in muscles and joints, headache, visual and
hearing impairment. What is the reason of the disorders described above?
A.
B.
C.
D.
E.
Gas embolism
Thromboembolism
Saturation
Venostasis
Compression ischemia
1.2.51. An accident happened during works performed at a depth and necessity f an urgent salvage of a
diver emerged. Soon his state got worse. What can be the possible reason of this deterioration?
A.
B.
C.
D.
E.
Gas embolism
Hyperoxia
Trombembolism
Hypercapnia
Hypocapnia
1.2.52. A diver has carried out a caisson work at the depth of 15 m for an hour, and then he was quickly
raised on the surface. After half an hour he felt weakness, increasing pain in muscles and joints, headache,
impairment of hearing and vision. What measures should be carried out for removal of these disorders?
A.
B.
C.
D.
E.
Put the patient into barocamera with an increased pressure.
Put the patient into barocamera with an decreased pressure.
Administer pain-relieving medicines
Conduct general strengthening of the organism
Administer membrane stabilizers
1.3. EFFECT OF IONIZING RADIATION ON THE ORGANISM
1.3.1. A 45-year-old man, who worked on liquidation of the consequences of Chernobyl disaster, sustained
ionizing radiation and in the course of acute radiation sickness developed hemorrhagic syndrome. What has
the greatest importance in the pathogenesis of this syndrome?
Thrombocytopenia
Abnormal structure of the vascular wall
Increased activity of anticoagulation factors
Increased activity of fibrinolytic factors
Dicreased activity of coagulation factors
1.3.2. Liquidators of the consequences of Chernobyl disaster have sustained radiation exposure of different
dosages. What is the mechanism of direct action of ionizing radiation on the organism?
Formation of free radicals
Damage to nervous cells
Damage to the red bone marrow
Change of the hereditary information in DNA
Destruction of the cell membranes
1.3.3. One of the molecular mechanisms of indirect effects of ionizing radiation is the formation of lipid and
quinone radiotoxins. What is the mechanism of radiotoxins effects on cells?
A.
B.
C.
D.
E.
Inhibition of nucleic acids synthesis
Activation of LPO (lipid peroxidation)
Stimulation of pyrimidine bases oxidation
Inhibition of the antioxidant system activity
Deamination of purine bases
1.3.4. One of the manifestations of acute radiation sickness is the hematological syndrome. What changes
in the peripheral blood are characteristic of the period of initial reactions?
A.
B.
C.
D.
E.
Leukocytosis, limphocytopenia
Leukopenia, limphocytopenia
Leukopenia, thrombocytopenia
Leukocytosis, thrombocytopenia
Leukopenia, anemia, thrombocytopenia
1.3.5. The leakage of radioactive products occurred as a result of damage to a nuclear reactor. There were
three people in the area of increased radiation. Tentatively, they got 2.50 - 3.0 Gy. They were immediately
hospitalized. What consequences should be expected concerning the patients?
A.
B.
C.
D.
E.
Medullary form of acute radiation disease
Intestinal form of acute radiation disease
Chronic radiation disease
Cerebral form of acute radiation disease
Acute leukemia
1.3.6. Which investigations should be perfomed for the interpretation of severity of hjury in the
hospitalized patients with acute radiation disease?
A. Total blood cell count, bone marrow aspiration, immunological investigations of blood, coagulation
assay
B. Immunological investigations of blood
C. Coagulation assay, total blood cell count, bone marrow aspiration
D. Bone marrow aspiration
E. Bone marrow aspiration, immunological investigations of blood
1.3.7. What pathological changes occur with the patient after ionizing radiation in the second period of
acute radiation disease?
Disappearance of manifestations of the nervous system overexcitation, leukopenia, thrombocytopenia
Leukopenia, thrombocytopenia, anemia, infectious complications
Headache, anxiety, lability of blood pressure and pulse
Headache, anxiety, lability of blood pressure, limphopenia
Dyspeptic disorders, autointoxication
1.3.8. A patient after exposure to ionizing radiation in the dosages of 3.5 Gy developed anemia,
leukocytopenia, thrombocytopenia, limphopenia. What period of acute radiation disease are these signs
characteristic of?
A.
B.
C.
D.
E.
Third
Second
First
First and second
Second and third
1.3.9. What is the pathogenesis of changes that occur in the third period of acute radiation disease?
Inhibition of hemopoiesis due to the affect of ionizing radiation
Stimulation of hemopoiesis due to the affect of ionizing radiation
Inhibition of mielopoesis, unchanged limphotopoiesis as a result of ionizing radiation
Selective influence of ionizing radiation on erythropoiesis
Stimulation of oxidation by free radicals
1.3.10. A patient developed “roentgen hangover”. What period of acute radiation disease is this condition
characteristic of?
First
Second
Third
Fourth
Fifth
1.3.11. The blood picture of the patient with acute radiation sickness is significant for the presence of
leukocytosis and limfopeniya. What is the period of the disease in the patient?
I
II
III
IV
V
1.3.12. A patient presents with progressing limphocytopenia and leukopenia. What is the period of acute
radiation disease in the patient?
A.
B.
C.
D.
E.
I
II
III
IV
V
1.3.13. A worker sustained radiation exposure in the dosage of 0.5 Gy after an accident at the atomic
electrostation. What form of acute radiation disease can develop in the patient?
A.
B.
C.
D.
E.
Medullary
Cerebral
Spinal
Intestinal
Chronic
1.3.14. What period of the radiation disease after a patient’s single radiation exposure will be characterized
as follows: autoinfection, multiple hemorrhages, anemia, leukopenia, and thrombocytopenia?
A.
B.
C.
D.
E.
III
II
I
IV
V
1.3.15. A patient presents with intestinal obstruction, upper abdominal pain, vomiting, and anorexia. What
form of acute radiation disease has developed in the patient?
A.
B.
C.
D.
E.
Intestinal
Cerebral
Spinal
Medullary
Gastric
1.3.16. A 39-year-old man was admitted to the hospital in a very serious condition with convulsions and
abnormal vascular tone. What form of acute radiation disease did the patient most likely develop?
A.
B.
C.
D.
E.
Cerebral
Intestinal
Spinal
Medullary
Gastric
1.3.17. What are the possible long-term consequences in the patient after acute radiation disease?
A.
B.
C.
D.
E.
Tumors
Pneumonia
Peritonitis
Hemorrhage
Autoinfection
1.3.18. A patient who has long been working near a source of ionizing radiation was revealed to have
changes in the blood in the form of moderate leucopenia and thrombocytopenia. What pathology is
responsible for such changes?
A.
B.
C.
D.
E.
Chronic radiation sickness, I degree
Chronic radiation disease, II degree
Chronic radiation disease, III degree
Chronic radiation disease, medullary form
Chronic radiation disease, IV degree
1.3.19. A 40-year-old worker has for a long time been subject to low doses of ionizing radiation. What
disorder may develop in this man in the long-term perspective?
A.
B.
C.
D.
E.
Tumor
Pneumonia
Peritonitis
Hemorrhage
Autoinfection
1.3.20. A patient who has long been working with sources of ionizing radiation developed severe supresion
of hematopoesis, ulcerative-necrotic changes of mucous membranes and CNS disorders. What degree of
severity of chronic radiation disease do these signs point to?
A.
B.
C.
D.
E.
Chronic radiation disease of III degree
Chronic radiation disease of II degree
Chronic radiation disease of I degree
Chronic radiation disease of V degree
Chronic radiation disease of IVdegree
1.3.21. A patient sustained ionizing radiation in the dose of 10 Gy. The patient’s condition is satisfactory;
the only changes are leukopenia and limphocytopenia. What is the period of acute radiation disease?
A.
B.
C.
D.
E.
II
III
I
IV
The period of the maximal manifestations of the disease
1.3.22. A patient with acute radiation disorder developed leucopenia and anemia, necrotic angina, and
bleeding. What do these signs suggest to?
A.
B.
C.
D.
E.
Bigining of the third period
Bigining of the second period
Transition into chronic form
Bigining of the IV period
Transition into the intestinal form
1.3.23. What system is responsible for the protection of the organism against ionizing radiation?
A.
B.
C.
D.
E.
Antioxidant system
Nervous system
Endocrine system
Autonomic nervous system of
Immune system
1.3.24. What of the following can not be used in the treatment of patients with acute radiation disease?
A.
B.
C.
D.
E.
Immunosuppressants
Antioxidants
Hypothermia
Administration of DNA
Bone marrow transplantation
1.3.25. What of the following is the method of choice in the treatment of patients with medullary form of
acute radiation disease?
A.
B.
C.
D.
Bone marrow transplantation
Administration of antioxidants
Hypothermia
Administration of DNA
E. Application of immunosuppressants
1.3.26. What tissue will be injured first after exposure to ionizing radiation?
A.
B.
C.
D.
E.
Hematopoetic
Epithelium
Bone
Cartilaginous
Muscular
1.3.27. What is the sequence of blood changes in the patient after exposure to ionizing radiation?
A.
B.
C.
D.
E.
Lymphopenia, granulocytopenia, thrombocytopenia, anemia
Granulocytopenia, limphopenia, thrombocytopenia, anemia
Granulocytopenia, limphopenia, anemia, thrombocytopenia
Granulocytopenia, anemia, limfopeniya, thrombocytopenia
Anemia, granulocytopenia, limphopenia, thrombocytopenia
1.3.28. What is the main cause of bleeding in patients with acute radiation disease?
F.
G.
H.
I.
J.
Thrombocytopenia
Granulocytopenia
Damage to blood vessels
Activation of anticoagulation system of the blood
Anemia
1.3.29. What is a frequent cause of death in patients with acute radiation disease?
A.
B.
C.
D.
E.
Pneumonia
Necrotic tonsillitis
Enteric autoinfection
Hemorrhage
Anemia
1.3.30. Which of the following tissues will be injured last after exposure to ionizing radiation?
A.
B.
C.
D.
E.
Muscular
Epithelium
Bone
Cartilaginous
Hematopoetic
1.3.31. Which of the following symptoms will point to the immune system disfunctioning due to the
influence ionizing radiation?
F.
G.
H.
I.
J.
Pneumonia, necrotic tonsillitis
Peritonitis, paralytic intestinal obstruction
Enteric autoinfection, vomiting
Hemorrhage, presence of blood in stool and urine
Anemia, thrombocytopenia
1.3.32. Which of the following symptoms will not indicate damage to the gastrointestinal epithelium due to
ionizing radiation?
Pneumonia
Peritonitis
Autotointoxication
Bakteriemia
Intestinal autoinfection
1.3.33. Which of the following symptoms will point to the digestive system injury due to ionizing radiation?
Intestinal autoinfection, bacteriemia
Limphopenia, anemia, thrombocytopenia
Pneumonia, necrotic tonsillitis
Hemorrhage, presence of blood in stool and urine
Anemia, thrombocytopenia
1.3.34. What can the impaiment of immunologic reactivity in the patient after ionizing radiation suggest to?
The development of necrotic tonsillitis and pneumonia
Limphopenia, anemia, thrombocytopenia
Intestinal autoinfection, bakteriemiya
Hemorrhage, presence of blood in stool and urine
Anemia, thrombocytopenia
1.3.35. What will be the manifestations of thrombocytopenia in the patient with acute radiation disease?
Hemorrhages, presence of blood in stool and urine
Limphopenia, anemia
Pneumonia, necrotic tonsillitis
Intestinal autoinfection, vomiting
Anemia, intestinal obstruction
1.3.36. What is a good prognostic sign in acute radiation disease?
A.
B.
C.
D.
E.
Normalization of the blood picture
Disappearance of vomiting and weakness
Dicrease of body temperature
Disappearance of anemia
The increase of leukocytes count
1.3.37. Which form of acute radiation disease is assotiated with the patient’s worst condition?
Cerebral
Intestinal
Spinal
Medullary
Gastrointestinal
1.3.38. Which form of acute radiation disease is assotiated with the patient’s mildest condition?
A.
B.
C.
D.
E.
Medullary
Intestinal
Spinal
Cerebral
Gastrointestinal
1.3.39. What form of acute radiation disease may develop in the patient who sustained ionizing radiation in
the dose of 50 Gy?
Cerebral
Intestinal
Spinal
Medullary
Gastrointestinal
1.3.40. A patient was diagnosed with medullary form of acute radiation disease. The blood demonstrated
limphopenia. What stage of the disease is characterized by these changes?
Primary reactions
Latent
Period of maximal expression of the disease
Recovery from the disease
Period of delayed consequences
1.4. FACTORS OF SPACE FLIGHT
1.4.1. Which of the following conditions on the stage of the orbital phase of the spacecraft can be regarded
as unusual for the human organism?
A.
B.
C.
D.
E.
Gravity
Overloading
Hypothermia
Hyperthermia
Hypoxia
1.4.2. The most pathogenic factor by its effect on the human organism during dynamic phase of a space
flight is:
F.
G.
H.
I.
J.
Overloading
Gravity
Themerature change
Increased temperature
Hypokinesia
1.4.3. During an orbital space flight an accident on the space ship has occurred with the following
development of a partial decompression in the cabin. What was the immediate cause of death of the crew?
A.
B.
C.
D.
E.
Acute hypoxia
Disorders of the cardiovascular system
Pulmonary circulation and gas exchange impairment
Pain shock
Total body intoxication
1.4.4. During effect on the organism of the transverse overload pathological changes primarily consist of
the disorder of wich of the following systems?
External respiration and gas exchange
Musculoskeletal
Nervous trophic
Hemodynamics
Digestive system
1.4.5. Which of the following overloads is better endured by the human organism?
A.
B.
C.
D.
E.
Lateral
Longitudinal
Side
Longitudinal-negative
Longitudinal-positive
1.4.6. During the start of a spaceship an astronaut's body is oriented so that the effect of overload:
A.
B.
C.
D.
E.
Did not coincide with the longitudinal axis of the body and was directed across the body
Coincided with the longitudinal axis of the body
Did not coincide with the longitudinal axis of the body
Coincided with the transverse axis of the body
Was directed laterally
1.4.7. Disorder in the respiratory system with the action on the body of the transverse overload leads
eventually to:
F.
G.
H.
I.
J.
Hypoxia of organs and tissues
Reduction of vital lung capacity
Shortness of breath \
Asphyxia
Pulmonary edema
1.4.8. Reduction of the astronaut’s body weight after a long stay in weightlessness can be explained by wich
of the following facts?
A.
B.
C.
D.
E.
The negative balance of nitrogen and water loss
Increased excretion of sodium and potassium from the organism
Increased diuresis
Increased excretion of chlorine and iron from the organism
Metabolism regulation disorder
1.4.9. Changes from the side of the cardiovascular system in conditions of weightlessness can be explained
as:
A.
B.
C.
D.
E.
Adaptations of the cardiovascular system to the reduced mechanical loads
Decreased volume of circulating blood
Increased excretion of water and sodium ions
Increased diuresis
Dehydration and reduction of circulating blood volume
1.4.10. In conditions of zero gravity changes in the cardio-vascular system develop:
A.
B.
C.
D.
E.
Due to loss of hydrostatic pressure in blood vessels and redistribution of the blood
Due to decreased energy expenditure from the organism
As a result of reduced muscular exertions
As a result of decreased number of vascular and tissue mechanicoreceptors
As a result of dehydration and reduction of circulating blood volume
2.6. STARVATION
2.6.1. An animal in the terms of starvation demonstrates stupor, decrease of body weight by 20%. Body
temperature is 36.2 оС, heart rate is 68/min, breathing coefficient 0.7. What is the period of starvation?
A.
B.
C.
D.
E.
Maximal adaptation
Inexpedient energy expenditure
Tissue destruction
Excitation
Dying
2.6.2. After a severe burn a man developed stenosis of the esophagus. Due to impairment of eating a rapid
lost of body weight occurred. Blood analysis: erythrocytes: 3,0х1012/l, Нb-106 g/l, serum protein 57 g/l.
What kind of starvation is present in the patient?
A.
B.
C.
D.
E.
Incomplete
Protein
Complete
Water
Absolute
2.6.3. In what period of complete starving is found a woman if she has the state of excitation with the
feeling of starvation, blood analysis shows hypoglycemia, negative nitrogen balance, breathing coefficient is
1.0?
A.
B.
C.
D.
E.
Period of unconstructive energy expenditure
Maximal adaptation
Excitation
Period of constructive energy expenditure
Terminal period
2.6.4. The main matters exchange in a patient is decreased by 15%, negative nitrogen balance is observed
in the patient. Blood analysis demonstrates hypoglycaemia, hyperlipiacidaemia, ketonaemia, acidosis.
Breathing coefficient is 0.7. What is the period of starvation?
A.
B.
C.
D.
E.
Maximal adaptation
Excitation
Period of unconstructive energy expenditure
Terminal period
First
2.6.5. A group of animals has been kept without food for 10 hours. The level if blood sugar at the end of
starvation in all the animals was found on the lowest level of the norm. How can maintenance of sugar
concentration on the lowest level of the norm be explained?
A.
B.
C.
D.
E.
Activation of glycogenolysis processes
Activation of glycogenesis processes
Activation of glyconeogenesis processes
Depression of glycogenesis processes
Depression of glyconeogenesis processes
2.6.6. In a rat after 48 hours of starvation with only water consumption main matters exchange dropped by
20%, respiratory coefficient is 0.7, lipaemia, and negative nitrogen balance were present. What period of
complete starvation are these changes typical of?
A.
B.
C.
D.
E.
Maximum adapration
Excitation
Wasteful spending
Terminal
First
2.6.7. In a rat after 72 hours of starvation with only water consumption main matters exchange dropped by
40%, respiratory coefficient is 0.8, there are ketoneaemia, acidosis, edema. What period of complete
starvation are these changes typical of?
A.
B.
C.
D.
E.
Terminal
Wasteful energy spending
Maximal adaptation
First
Second
2.6.8. On the 10th hour of fasting with only water consumption a rat developed raised basal metabolism;
breathing coefficient is 1.0; in the blood: increased level of glucocorticoids, catecholamines. Increased
urinary nitrogen. What period of complete starvation are these changes typical of?
A.
B.
C.
D.
E.
The period of wasteful energy consumption
Maximal adaptation
Period of stimulation
Period saving energy consumption
Terminal period
2.6.9. After chemical burns a patient developed esophageal stenosis. Rapid weight loss occurred as a result
of eating difficulties. Blood tests showed red blood cells count – 3.0*1012/l, hemoglobin - 106 g/l, protein 57
g/l. What type of starvation has the patient?
A.
B.
C.
D.
E.
Quantitative
Qualitative
Water
Complete
Absolute
2.6.10. In a starving animal a general depression, lowering basal metabolism by 18%, reduction of body
weight by 20%, hiperlipidaemia were observed. Body temperature 36.2 °C, heart rate 68/min., breathing
coefficient 0.7. What period of complete starvation are these changes typical of?
A.
B.
C.
D.
E.
Maximal adaptation
Period of protein catabolism
The period of wasteful energy consumption
Terminal period
Excitation
2.6.11. In a starving animal a general excitation, increasing basal metabolism by 25%, breathing coefficient
1.0, heart rate 78/min were observed. What period of complete starvation are these changes typical of?
A.
B.
C.
D.
E.
The period of wasteful energy consumption
Maximal adaptation
Period of protein catabolism
Terminal period
Excitation
2.6.12. A pregnant woman developed iron deficient anemia. What type of starving has triggered this
disorder?
A.
B.
C.
D.
E.
Qualitative
Quantitative
Water
Complete
Absolute
2.6.13. A man has an esophageal tumor. Eating is impossible. What is the difference between complete
starvation from the incomplete one?
A.
B.
C.
D.
E.
Duration
Increased basal metabolism
Nongas alkalosis
Carbon dioxide acidosis
Gas alkalosis
2.6.14. In a starving animal excitation, aggression, and breathing coefficient 1.0 are observed. Basal
metabolism is increased. What is pathophysiological period of starvation?
A.
B.
C.
D.
E.
The period of wasteful energy consumption
Maximal adaptation
Period of protein catabolism
Terminal period
Excitation
2.6.15. On the 9th day of starvation an experimental animal developed malaise, and apathy; it is lying in a
whorled position. Basic matters exchange is reduced. What is the breathing coefficient in the animal?
A.
B.
C.
D.
E.
1.0
2.0
0.8
0.7
0.1
2.6.16. A man has an esophageal tumor. Eating is impossible. For how long can a man live in the conditions
of complete starvation?
A. 65-70 days
B.
C.
D.
E.
25-30
1.2
15-20
120-130
2.6.17. On the 9th day of starvation an experimental animal developed malaise, and apathy; it is lying in a
whorled position. Basic matters exchange is reduced. Respiratory coefficient is 0.7. What is the main energy
substrate for the organism?
A.
B.
C.
D.
E.
Fats
Carbohydrates
Proteins
Vitamins
Minerals
2.6.18. A man who has long worked in the hot shop developed hypovitaminosis. What kind of
hypovitaminosis evolved in the man?
A.
B.
C.
D.
E.
Vitamin PP
Vitamin K
Vitamin A
Vitamin E
Vitamin D
2.6.19. A starving animal developed drowsiness, indifference. What adaptive phenomena are observed
during starvation?
A.
B.
C.
D.
E.
Reduction of basal metabolism
Increase of the basal metabolism
Increase of temperature production
Increase in gastric secretion
Increased urine excretion
2.6.20. An animal was withdrawn from eating but drinking was not restricted. What are the organs that lose
weight when fasting the least?
A.
B.
C.
D.
E.
Liver
Pancreas
Lung
Kidneys
Heart
2.6.21. A patient developed kwashiorkor. Which type of starvation does it belongs to?
A.
B.
C.
D.
E.
Protein and energy
Carbohydrate
Fatty
Energy
Vitamin
2.6.22. A man has an esophageal tumor. Eating is impossible. Which conditions is the increase of complete
starvation duration observed at?
A.
B.
C.
D.
E.
At lowering basal metabolism
When the organism is exposed to high temperatures
In thyroid hyperfunctions
At increasing basal metabolism
In increasing the specific body surface
2.6.23. In a starving animal signs of excitation, and aggression were observed; breathing coefficient is 1.0.
Basal metabolism is increased. What is the main energy substrate of the organism in these conditions?
A.
B.
C.
D.
E.
Carbohydrates
Fats
Proteins
Vitamins
Minerals
2.6.24. On the second day of starvation a starving animal manifested signs of excitation and aggression.
Basal metabolism became increased. What is the breathing coefficient?
A.
B.
C.
D.
E.
1.0
2.0
0.8
0.7
0.1
2.6.25. On the 9th day of starvation a test animal developed fatigue, apathy and was lying in a whorled
position. Basal metabolism was reduced. Respiratory coefficient is 0.7. What is pathophysiological period of
starvation?
A.
B.
C.
D.
E.
Maximal adaptation
Proteins decay
The period of wasteful energy consumption
Terminal
Excitation
2.6.26. A patient has B12-deficient anemia. What kind of hunger has triggered the disorder?
A.
B.
C.
D.
E.
Qualitative
Quantitative
Partial
Full
Absolute
2.6.27. In a patient with atrophic gastritis iron is absorbed poorly. What are manifestations of this state?
A.
B.
C.
D.
Hypochromic anemia
Impairment of bone formation
Tetany
Goiter
E. Caries
2.6.28. A patients was diagnosed with endemic goiter. Insufficient income of which microelement is
responsible for development of this disease?
A.
B.
C.
D.
E.
Iodine
Potassium
Fluoride
Cobalt
Iron
2.6.29. In a child abnormalities of bone forming and signs of development of caries were found. Insufficient
income of which microelement is responsible for development of this disease?
A.
B.
C.
D.
E.
Fluorine
Potassium
Iodine
Cobalt
Iron
2.6.30. In a patient slowing down of normoblasts maturation and the release of mature red blood cells into
the blood circulation were revealed. Insufficient income of which microelement is responsible for
development of this disease?
A.
B.
C.
D.
E.
Cobalt
Potassium
Fluoride
Yoda
Iron
2.6.31. Experimental animals were fed with a special feed. After some time the animals lost appetite,
developed impairment of the liver, gastrointestinal tract, and kidneys functioning; blood osmotic pressure,
and arterial blood pressure in the animals decreased. Insufficient income of which substance is responsible
for development of this disorders?
A.
B.
C.
D.
E.
Sodium chloride
Potassium
Fluoride
Calcium
Iron
2.6.32. An experimental animal developed tetany. Insufficient income of which microelement is responsible
for development of this disease?
A.
B.
C.
D.
E.
Potassium
Calcium
Fluoride
Cobalt
Iron
2.6.33. An experimental animal died on the seventh day of absolute starvation. What causes the most
severe changes in the organism?
A.
B.
C.
D.
E.
Deprivation of water
Deprivation of minerals
Deprivation of proteins
Deprivation of fats
Deprivation of carbohydrates
2.6.34. After multiple administration of avidin to animals they developed hypovitaminosis. Antagonist of
what vitamin is avidin?
A.
B.
C.
D.
E.
Vitamin H
Vitamin B1
Vitamin B12
Vitamin C
Vitamin D
2.6.35. In a patient a malignant lung tumor was diagnosed. What type of starvation will the patient
develop?
A.
B.
C.
D.
E.
Qualitative
Quantitative
Partial
Complete
Absolute
2.6.36. In an experimental animal growth retardation, reduction of body weight, muscle weakness and
impairment of the nervous system are observed. The lack of which vitamin may have caused these
disorders?
A.
B.
C.
D.
E.
Vitamin PP
Vitamin E
Vitamin A
Vitamin C
Vitamin D
2.6.37. In an experimental animal growth retardation, reduction of body weight, muscle weakness and
impairment of the nervous system are observed. The lack of which vitamin may have caused these
disorders?
A.
B.
C.
D.
E.
Vitamin B1
Vitamin E
Vitamin A
Vitamin C
Vitamin D
2.6.38. In an experimental animal growth retardation, reduction of body weight, muscle weakness and
impairment of the nervous system are observed. The lack of which vitamin may have caused these
disorders?
A.
B.
C.
D.
E.
Vitamin B12
Vitamin E
Vitamin A
Vitamin C
Vitamin D
2.6.39. In an experimental animal growth retardation, reduction of body weight, muscle weakness and
impairment of the nervous system are observed. The lack of which vitamin may have caused these
disorders?
A.
B.
C.
D.
E.
Vitamin B6
Vitamin E
Vitamin A
Vitamin C
Vitamin D
2.6.40. In an experimental animal growth retardation, reduction of body weight, muscle weakness and
impairment of the endocrine system are observed. The lack of which vitamin may have caused these
disorders?
A.
B.
C.
D.
E.
Vitamin E
Vitamin H
Vitamin A
Vitamin C
Vitamin D
2.6.41. In an experimental animal growth retardation, reduction of body weight, muscle weakness and
impairment of the endocrine system are observed. The lack of which vitamin may have caused these
disorders?
A.
B.
C.
D.
E.
Vitamin B1
Vitamin H
Vitamin A
Vitamin C
Vitamin D
2.6.42. In an experimental animal growth retardation, reduction of body weight, muscle weakness and
impairment of the endocrine system are observed. The lack of which vitamin may have caused these
disorders?
A.
B.
C.
D.
E.
Vitamin B5
Vitamin H
Vitamin A
Vitamin C
Vitamin D
2.6.43. In an experimental animal growth retardation, reduction of body weight, muscle weakness and
impairment of the GIT system are observed. The lack of which vitamin may have caused these disorders?
A. Vitamin PP
B. Vitamin H
C. Vitamin A
D. Vitamin C
E. Vitamin D
2.6.44. In an experimental animal growth retardation, reduction of body weight, muscle weakness and
impairment of the endocrine system are observed. The lack of which vitamin may have caused these
disorders?
A.
B.
C.
D.
E.
Vitamin B1
Vitamin H
Vitamin A
Vitamin C
Vitamin D
2.6.45. A man who has long worked in the North developed hypovitaminosis. What kind of hypovitaminosis
evolved in the man?
A.
B.
C.
D.
E.
Lack of retinol
Lack of ascorbic acid
Lack of nicotinic acid
Biotin deficiency
Lack of tocopherol
2.6.46. A man who has long worked in the North developed hypovitaminosis. What kind of hypovitaminosis
evolved in the man?
A.
B.
C.
D.
E.
Lack of calciferol
Lack of ascorbic acid
Lack of nicotinic acid
Biotin deficiency
Lack of tocopherol
2.6.47. A man who has long worked in the North developed hypovitaminosis. What kind of hypovitaminosis
evolved in the man?
A.
B.
C.
D.
E.
Lack of B-group vitamins
Lack of ascorbic acid
Lack of nicotinic acid
Biotin deficiency
Lack of tocopherol
2.6.48. A man who has long worked in the hot shop developed hypovitaminosis. What kind of
hypovitaminosis evolved in the man?
A.
B.
C.
D.
E.
Vitamin B1
Vitamin K
Vitamin A
Vitamin E
Vitamin D
2.6.49. A man who has long worked in the hot shop developed hypovitaminosis. What kind of
hypovitaminosis evolved in the man?
A.
B.
C.
D.
E.
Vitamin B12
Vitamin K
Vitamin A
Vitamin E
Vitamin D
2.6.50. A man who has long worked in the hot shop developed hypovitaminosis. What kind of
hypovitaminosis evolved in the man?
A.
B.
C.
D.
E.
Vitamin C
Vitamin K
Vitamin A
Vitamin E
Vitamin D
2.6.51. A patient has the signs of dermatitis, diarrhea, and dementia. When collecting anamnesis it was
revealed that the main meal in the patient’s ration is corn. The lack of which vitamin has caused these
disorders?
A.
B.
C.
D.
E.
Vitamin PP
Vitamin B1
Vitamin B2
Vitamin V8
Vitamin B9
2.6.52. On examination of the child, who did not have fresh fruits and vegetables in her ration during
winter, multiple subcutaneous hematomas, gingivitis, cavities in carious teeth were revealed. Combination
of which vitamins should be prescribed to the child?
A.
B.
C.
D.
E.
Calciferol and ascorbic acid
Riboflavin and nicotine amid
Folic acid and cobalamin
Ascorbic acid and rutin
Thiamine and pyridoxine
2.6.53. In a patient the following signs were found: impairment in the twilight, dry conjunctiva and cornea.
Such disturbances may be observed in the shortage of which vitamins?
A.
B.
C.
D.
E.
Vitamin A
Vitamin C
Vitamin D
Vitamin B
Vitamin B12
2.6.54. Deficiency of which vitamin is associated with impairment of the reproductive function and skeletal
muscles dystrophy?
A. Vitamin E
B.
C.
D.
E.
Vitamin K
Vitamin B1
Vitamin D
Vitamin A
2.6.55. A child manifests the signs of ossification processes impairment and spotty enamel. Metabolism of
which microelement is disturbed in this case?
A.
B.
C.
D.
E.
Fluoride
Zinc
Copper
Iron
Chrome
2.6.56. In a patient an increased permeability of blood vessel walls with the development of bleeding gums,
the emergence of small dotted hemorrhages (petechias) on the skin, loss of teeth are observed. The lack of
which vitamin can explain these symptoms?
A.
B.
C.
D.
E.
Hypovitaminosis C
Hypervitaminosis D
Hypovitaminosis D
Hypovitaminosis A
Hypervitaminosis C
2.6.57. In a 1-year-old infant the increase in the size of the head and stomach, delayed dentition,
impairment of the enamel structure are observed. The lack of which vitamin can explain these symptoms?
A.
B.
C.
D.
E.
Hypovitaminosis D
Hypovitaminosis C
Hypovitaminosis B1
Hypovitaminosis A
Hypovitaminosis B2
2.6.58. During examination of the patient’s oral cavity, a dentist determined dry mucous membranes and
numerous erosions. The lack of which vitamin can give these symptoms?
A.
B.
C.
D.
E.
Vitamin A
Vitamin R
Vitamin H
Vitamin PP
Vitamin K
2.6.59. A patient suffers from pain along the major nerve trunks, and the high level of pyruvate in the
patient’s blood was determined. Lack of which vitamin may cause these changes?
A.
B.
C.
D.
E.
B1
Pantothenic acid
B2
Biotin
PP
2.6.60. In a 43-year-old patient with chronic atrophic gastritis and megaloblastic hyperchromic anemia
increased excretion of methylmalonic acid was found. Insufficiency of which vitamin caused the
appearance of this symptom?
A.
B.
C.
D.
E.
B12
B2
B3
B6
B5
2.7. HYPOXIA
2.7.1. A doctor-researcher together with a mountaineering expedition climbed to a height of 5000 meters.
On the 3rd day of his stay in the mountains the doctor developed signs of mountain sickness: shortness of
breath, headache, loss of appetite, malaise, cyanosis. What type of hypoxia is present in this case?
A.
B.
C.
D.
E.
Hypoxic
Circulatory
Congestive
Hemic
Tissue
2.7.2. A 40-years-old man complains of malaise, headache, cough with sputum, shortness of breath. After
clinical examination he was diagnosed: focal pneumonia. What type of hypoxia developed in this case?
A.
B.
C.
D.
E.
Breathing (respiratory)
Circulatory
Hemic
Tissue
Hypoxic
2.7.3. A patient has been hospitalized due to chronic heart failure. Objective signs: cyanotic color of the skin
and mucous membranes; tachycardia, hyperventilation. What type of hypoxia developed in this case?
A.
B.
C.
D.
E.
Circulatory
Anemic
Block of Hb
Tissue
Hypoxic
2.7.4. A patient has been hospitalized due to an accident - collapse in the mine. General condition of the
patient is serious. In the foreground there is a sign of hypoxia: flashing before eyes, shortness of breath,
tachycardia, cyanotic color of the skin and mucous membranes. What type of hypoxia developed in this
case?
A.
B.
C.
D.
E.
Hypoxic
Hemic
Circulatory
Breathing (respiratory)
Tissue
2.7.5. A patient has been admitted to hospital due to pneumonia. What type of hypoxia developed in this
case?
A.
B.
C.
D.
E.
Breathing (respiratory)
Hemic
Hypoxic
Tissue
Circulatory
2.7.6. A 34-year-old woman has iron deficient anemia. What type of hypoxia is the woman suffering of?
A.
B.
C.
D.
E.
Hemic
Breathing (respiratory)
Hypoxic
Tissue
Circulatory
2.7.7. 1 ml of 1% solution of potassium cyanide was administered subcutaneously to a frog and a result of
this the frog developed hypoxia. What type of hypoxia developed in this case?
A.
B.
C.
D.
E.
Histotoxic
Hemic
Circulatory
Breathing (respiratory)
Hypoxic
2.7.8. A patient visited his dentist concerning long-term bleeding gums, staggering of the teeth. Periodontal
disease was diagnosed. What type of hypoxia developed in the patient?
A.
B.
C.
D.
E.
Hemic
Circulatory
Breathing (respiratory)
Tissue
Hypoxic
2.7.9. On having administered 1% solution of sodium nitrate (0.1 ml/kg body weight) to a white mouse
inraabdominally the animal died from acute hypoxia. What the type of hypoxia developed in the mouse?
A.
B.
C.
D.
E.
Hemic
Circulatory
Breathing (respiratory)
Tissue
Hypoxic
2.7.10. A dog was poisoned with urethane. Name the type of hypoxia?
A.
B.
C.
D.
E.
Tissue
Hemic
Circulatory
Breathing (respiratory)
Hypoxic
2.7.11. With the help of experimental pulmonary edema performed on an experimental animal hypoxia has
been modeled. Name the type of hypoxia:
A.
B.
C.
D.
E.
Breathing (respiratory)
Tissue
Hemic
Circulatory
Hypoxic
2.7.12. A patient after an accident at work suffered toxic effects of potassium cyanide, which caused the
blockade of cytochromeoxydase. What pathological process takes place?
A.
B.
C.
D.
E.
Tissue hypoxia
Hemic hypoxia
Circulatory hypoxia
Hypoxic hypoxia
Respiratory hypoxia
2.7.13. Hypoxia by inflation of gas mixture poor in oxygen was modeled on an experimental animal. Name
the type of hypoxia.
A.
B.
C.
D.
E.
Hypoxic
Breathing (respiratory)
Tissue
Hemic
Circulatory
2.7.14. A non-lethal dose of potassium cyanide was administered to an experimental animal. What is the
type of hypoxia?
A.
B.
C.
D.
E.
Tissue
Hypoxic
Breathing (respiratory)
Hemic
Circulatory
2.7.15. A pregnant woman visited her doctor complaining of dizziness, malaise, increased fatigue. She was
diagnosed with anemia. What type of hypoxia has the woman?
A.
B.
C.
D.
E.
Hemic
Tissue
Hypoxic
Breathing (respiratory)
Circulatory
2.7.16. A patient has chronic cardiovascular failure. What type of hypoxia is the man suffering of?
A.
B.
C.
D.
E.
Congestive
Coronary
Anemic
As a result of hemoglobin inactivation
Tissue
2.7.17. A patients was hospitalized due to myocardial infarction. What type of hypoxia will develop in heart
muscle?
A.
B.
C.
D.
Ischemic
Anemic
Hypoxic
Congestive
E. Tissue
2.7.18. A patient developed kidney infarction. What type of hypoxia will develop in the injured kidney?
A.
B.
C.
D.
E.
Ischemic
Anemic
Hypoxic
Congestive
Tissue
2.7.19. Tourists who climbed to a height of 3.5 km, developed hypoxic hypoxia in the form of mountain
sickness. What the leading initial mechanism underlies the development of this type of hypoxia?
A.
B.
C.
D.
E.
Reduction of pO2 in the inhaled air
Reduction of pCO2 in the inhaled air
Anemia
Relative insufficiency of blood circulation
Intense muscular work
2.7.20. A patient was admitted to hospital due to chronic heart failure. Objective signs: cyanotic color of the
skin and mucous membranes; tachycardia, hyperventilation. What type of hypoxia has the patient
developed?
A.
B.
C.
D.
E.
Circulatory
Anemic
Toxic
Hypoxic
Tissue
2.7.21. A patient after stomach resection developed В12-deficient anemia. Which type of hypoxia developed
in the patient?
A.
B.
C.
D.
E.
Haemic
Breathing
Hypoxic
Tissue
Circulatory
2.7.22. As a result of ascending on the mountains a group of alpinists developed pathological process,
which is characterized by energetic deficiency in the organism. What is it designated?
A.
B.
C.
D.
E.
Hypoxia
Hypercapnia
Alkalosis
Hyperoxia
Hypertrophy
2.7.23. In a patient due to poisoning with cyanides the blockade of cytochromeoxydase developed. What
type of hypoxia developed in this case?
A.
B.
C.
D.
E.
Tissue
Haemic
Congestive
Circulatory
Breathing
2.7.24. As a result of spleen rupture a patient developed massive internal bleeding with signs of severe
hypoxia. Which of the listed structures is most susceptible to hypoxia?
A.
B.
C.
D.
E.
Brain
Stomach
Kidney
Lungs
Muscle
2.7.25. During bronchial asthma attack a patient presents with expiratory dispnoea, cyanosis. What type of
hypoxia is characteristic of this pathologic state?
A.
B.
C.
D.
E.
Breathing
Hypoxic
Circulatory ischemic
Circulatory congestive
Haemic
2.7.26. In a patient after surgery DIC syndrome developed. What type of hypoxia is observed in this
patient?
A.
B.
C.
D.
E.
Circulatory
Haemic
Breathing
Tissue
Load
2.7.27. A patient with pneumothorax developed hypoxia. What type of hypoxia is observed in this patient?
A.
B.
C.
D.
E.
Respiratory
Haemic
Hypoxic
Circulatory
Tissue
2.7.28. A patient was admitted to the intensive care unit with the diagnosis of pulmonary artery
thromboembolism. What type of hypoxia is observed in this patient?
A.
B.
C.
D.
E.
Respiratory
Haemic
Hypoxic
Circulatory
Tissue
2.7.29. A patient was admitted to the intensive care unit with the diagnosis of laryngeal edema. What type
of hypoxia is observed in this patient?
A.
B.
C.
D.
E.
Respiratory
Haemic
Hypoxic
Circulatory
Tissue
2.7.30. A women has sustained carbon monoxide poisoning. What is the organs’ sensitivity to hypoxia due
to?
A.
B.
C.
D.
E.
Intensity of energy exchange
Intensity of glycolysis
Intensity of free radicals formation
Increased activity of antioxidants
Reduced energy metabolism
2.7.31. A patient was diagnosed with hypoxic hypoxia, in which blood pO2 is reduced. At which type of
hypoxia the blood oxygen tension (pO2) does not change?
A.
B.
C.
D.
E.
Tissue
Respiratory
Haemic
Hypoxic
Circulatory
2.7.32. After acute blood loss a patient was diagnosed with haemic hypoxia. How is it possible to increase
artificially the organism’s resistance to acute hypoxia?
A.
B.
C.
D.
E.
By antioxidants
By caffeine
By increase of body temperature
By increased metabolic rate
By intensification of LPO
2.7.33. After acute blood loss a patient was diagnosed with haemic hypoxia. How is it possible to increase
artificially the organism’s resistance to acute hypoxia?
A.
B.
C.
D.
E.
By decrease of body temperature
By caffeine
By increase of body temperature
By increased metabolic rate
By intensification of LPO
2.7.34. After acute blood loss a patient was diagnosed with haemic hypoxia. How is it possible to increase
artificially the organism’s resistance to acute hypoxia?
A. By narcotic drugs
B. By caffeine
C. By increase of body temperature
D. By increased metabolic rate
E. By intensification of LPO
2.7.35. A patient with chronic cardiovascular insufficiency was diagnosed with hypoxia. What changes in
the organism can be attributed to long-term adaptation?
A.
B.
C.
D.
E.
Bone marrow hyperplasia
Tachycardia
Cramps
Euphoria
Periodic breathing
2.7.36. A patient with chronic cardiovascular insufficiency was diagnosed with hypoxia. What changes in
the organism can not be attributed to the mechanisms of compensation?
A.
B.
C.
D.
E.
Cramps
Tachycardia
Bone marrow hyperplasia
Hyperventilation
Hypertrophy of myocardium
2.7.37. A group of climbers developed at an altitude of 4500 meters signs of hypoxia. What changes in the
organism can not be attributed to the mechanisms of compensation?
A.
B.
C.
D.
E.
Euphoria
Tachycardia
Bone marrow hyperplasia
Hyperventilation
Hypertrophy of myocardium
2.7.38. A patient with chronic cardiovascular insufficiency was diagnosed with hypoxia. What changes in
the organism can not be attributed to the mechanisms of compensation?
A.
B.
C.
D.
E.
Periodic breathing
Tachycardia
Bone marrow hyperplasia
Hyperventilation
Hypertrophy of myocardium
2.7.39. A 43-year-woman with cachexia complains of dizziness, flickers before her eyes, shortness of
breath, increased heartbeat. What type of hypoxia is observed in this patient?
A.
B.
C.
D.
E.
Tissue
Haemic
Respiratory
Hypoxic
Circulatory
2.7.40. A patient with DIC-syndrome presents with signs of hypoxia. What underlies the development of
this hypoxia:
A.
B.
C.
D.
E.
Disorder of microcirculation
Respiratory disorders
Hemoglobin blockade
Formation of methemoglobin
Nitrate poisoning
2.7.41. A patient was diagnosed with hypoxic hypoxia. This type of hypoxia occurs in:
A.
B.
C.
D.
E.
Mountain diseases
Carbon monoxide poisoning
Nitrite poisoning
Poisoning with cyanides
Pneumoconiosis
2.7.42 A patient was diagnosed with haemic hypoxia. This type of hypoxia occurs in:
A.
B.
C.
D.
E.
Carbon monoxide poisoning
Mountain diseases
Decompression sickness
Pneumoconiosis
Myocardial infarction
2.7.43. A patient was diagnosed with respiratory hypoxia. This type of hypoxia occurs in:
A.
B.
C.
D.
E.
Pulmonary artery thromboembolism
Acute heart failure
Poisoning with cyanides
Nitrite poisoning
Mountain diseases
2.7.44. A patient was diagnosed with tissue hypoxia. This type of hypoxia occurs in:
A.
B.
C.
D.
E.
Poisoning with cyanides
Pulmonary artery thromboembolism
Nitrite poisoning
Carbon monoxide poisoning
Pneumoconiosis
2.7.45. A patient was diagnosed with circulatory hypoxia. This type of hypoxia occurs in:
A. Acute heart failure
B. Pulmonary artery thromboembolism
C. Poisoning with cyanides
D. Nitrite poisoning
E. Mountain diseases
2.7.46. A patient was diagnosed with haemic hypoxia. This type of hypoxia occurs in:
A.
B.
C.
D.
E.
Iron deficiency anemia
Mountain diseases
Decompression sickness
Poisoning with cyanides
Pneumoconiosis
2.7.47. A patient was diagnosed with circulatory hypoxia. This type of hypoxia occurs in:
A.
B.
C.
D.
E.
DIC-syndrome
Pulmonary artery thromboembolism
Poisoning with cyanides
Nitrate poisoning
Mountain diseases
2.7.48. A patient was diagnosed with tissue hypoxia. This type of hypoxia occurs in:
A.
B.
C.
D.
E.
Cachexia
Pulmonary artery thromboembolism
Nitrate poisoning
Carbon monoxide poisoning
Pneumoconiosis
2.7.49. A patient was diagnosed with respiratory hypoxia. This type of hypoxia occurs in:
A.
B.
C.
D.
E.
Pneumoconiosis
Acute heart failure
Poisoning with cyanides
Nitrate poisoning
Mountain diseases
2.7.50. A patient was diagnosed with tissue hypoxia. This type of hypoxia occurs in:
A.
B.
C.
D.
E.
Hypovitaminosis A.
Pulmonary artery thromboembolism
Nitrate poisoning
Carbon monoxide poisoning
Pneumoconiosis
2.7.51. A woman during childbirth has lost about 800 ml of blood. Tachycardia, arterial blood pressure
100/70 mmHg, and tachypnoea -28/min are observed. What type of hypoxia primarily develops in this
clinical situation?
A.
B.
C.
D.
E.
Cardiovascular
Tissue
Blood
Mixed
Respiratory
2.7.52. After cyanide poisoning the instantaneous death follows. What is the mechanism of cyanide action
on the molecular level?
A.
B.
C.
D.
E.
Inhibition of cytochromeoxidase
Inhibition of cytochrome B
Inactivation of oxygen
Blocking of succinate dehydrogenase
Binding of nuclear substrates
2.7.53. While running for short distances an untrained man developed muscle hypoxia. Accumulation of
which metabolite occurs in the muscles?
A.
B.
C.
D.
E.
Lactate
Ammonium
Glucose-6-phosphate
Oksaloatsetat
Ketone bodies
2.7.54 A man has lost consciousness in a saloon car, where he has been waiting a friend for a long time,
with the engine enabled. What compound of hemoglobin can be detected in the blood of the affected
person?
A.
B.
C.
D.
E.
Carbhemoglobin
Carboxyhemoglobin
Desoxyhemoglobin
Metmemoglobin
Oxyhemoglobin
2.7.55. Decrease of the adenil nucleotides ratio ATP/ADP leads to increased glycolysis in the periodontal
tissues in the terms of hypoxia. What reaction is activated here?
A.
B.
C.
D.
E.
Lactatedehydrogenase
Phosfofructokinase
Aldolase
Enolase
Thriosophosfatisomerase
2.7.56. A patient is diagnosed with circulatory hypoxia. Hypoxia is a condition in which tissues:
A.
B.
C.
D.
E.
Receive insufficient quantity of oxygen
Do not receive oxygen at all
Receive increased quantity of oxygen
Do not get carbon dioxide
Get insufficient quantity of carbon dioxide
2.7.57. A patient was admitted to a hospital as a result of a mine collapse. General condition is critical. The
most prominent are the signs of hypoxia: flickering before eyes, shortness of breath, tachycardia, cyanotic
dye of the skin and mucous membranes. Hypoxia is a reduction of:
A.
B.
C.
D.
E.
Oxygen in tissues
Oxygen in the blood
Alveolar ventilation
Carbon dioxide in the blood
Carbon dioxide in tissues
2.7.58. A patient was diagnosed with haemic hypoxia; the decrease of blood oxygen capacity is observed.
What is normal oxygen capacity of arterial blood?
A.
B.
C.
D.
E.
19-22 %
15-17 %
25-30 %
22-25 %
13-15 %
2.7.59. A patient was diagnosed with haemic hypoxia; the decrease of blood oxygen capacity is observed.
To determine the blood oxygen capacity it is necessary to multiply hemoglobin concentration (in g%) by …
A.
B.
C.
D.
E.
1.34
2.34
3.4
1.05
0.5
2.7.60 A patient was diagnosed with tissue hypoxia; the decrease in arteriovenous oxygen difference is
observed. Arteriovenous difference for oxygen in healthy people is:
A.
B.
C.
D.
E.
5-6 %
8-10 %
10-12 %
2-4 %
12-15 %
HYDROCARBON METABOLISM DISORDERS
2.8.1. Insulin deficiency and the prevalence of hormones with contrary to insulin actions induce
hyperglycemia. Specify the leading mechanisms of this condition development:
A.
B.
C.
D.
E.
Reduction of alosteric effect of insulin
Reduction of cell membranes permeability
Enhancement of glyconeogenesis
Deceleration of hexocinase reaction speed
Deceleration of glucose metabolism.
2.8.2. What is the mechanism of insulin action on hydrocarbon metabolism?
A.
B.
C.
D.
E.
Reduction of the blood sugar concentration because insulin increases cell membranes permeability
Reduction of the blood sugar concentration because insulin inhibits secretion of glucagon
Reduction of the blood sugar concentration because insulin increases synthesis of glucagon
Increase of the blood sugar concentration because insulin increases glyconeogenesis
Increase of the blood sugar concentration because insulin promotes glycogen decay
2.8.3. A 45-years-old female has been suffering from diabetes for 5 years. Specify key signs of the illness.
A.
B.
C.
D.
E.
Hyperglycemia
Angiopathy
Acidosis
Urorrhagia
Thirst
2.8.4. A patient after mumps began to lose his body weight; he constantly feel thirsty, drinks plenty of
water, observing frequent urination, increased appetite, complains of general weakness, skin itching, and
furunculosis. Blood glucose 16mmol/l ketone bodies 100 micromole/l, glycosuria. What kind of disease is in
the patient?
A.
B.
C.
D.
E.
Insulin dependent diabetes mellitus
Steroid diabetes
Diabetes insipidus
Insulin independent diabetes
Diabetes of malnutrition
2.8.5. The main manifestations of diabetes mellitus are the following ones except:
A.
B.
C.
D.
E.
Increased tolerance to carbohydrates
Hyperglycemia
Glycosuria
Urorrhagia
Poliphagia and polidypsiya
2.8.6. When examining a patient he was diagnosed with hyperglycemia, ketonuria, urorrhagia,
hyperstenuria and glycosuria. Which form of the acid-base balance disorder occurs in this situation?
A. Metabolic acidosis
B. Excretory acidosis
C. Gas alkalosis
D. Carbon dioxide acidosis
E. Metabolic alkalosis
2.8.7. A 38-year-old woman was admitted to a intensive care unit in an unconscious state. Reflexes were
absent. Blood glucose 2.1 mmol/liter. Anamnesis suggests to diabetes since 18 years of age. What kind of
coma has place in the patient?
A.
B.
C.
D.
E.
Hypoglycemic
Lactate
Ketoacidic
Hyperosmolarity
Hyperglycaemic
2.8.8. What disease is characterized by reduced activity of amilo-1 ,6-glucosidase, edema, bleeding,
deposits of glycogen in the liver, muscle, erythrocytes, leukocytes
A.
B.
C.
D.
E.
Fobs’ disease
Hirke’s disease
Hers' disease
Fructoseuria
Pentoseuria
2.8.9. To the intensive care unit a child with the following symptoms was delivered: vomiting, diarrhea,
breach of growth and development, cataracts, mental retardation. Galactosemia was established.
Deficiency of which enzyme is present in this case?
A.
B.
C.
D.
E.
Hexose-1-phosphate urydyltransferase
Galactokinase
Glucose-6-phosphate dehydrogenase
UDF glucose-4-polymerase
UDF glucose-pirofosforylase
2.8.10. Mucopolysaccharidoses is a group of diseases which are characterized by deposits of:
A.
B.
C.
D.
E.
Glycosaminoglycans
Galactose
Gangliozids
Glycogen
Specific lysosomal hydrolase
2.8.11. Specify the level of glucose in the blood critical for the development of hypoglycemic coma:
A.
B.
C.
D.
E.
2.5 mmol / l
3.0 mmol / l
3.5 mmol / l
4.5 mmol / l
5.5 mmol / l
2.8.12. What are the pathogenetic mechanisms that contribute to the development of diabetes with
obesity?
A.
B.
C.
D.
E.
Reduction of the insulin receptors number
Increase of the insulin receptors number
Increase of lipocytes
Increase of lipocytes volume
Insulin deficiency
2.8.13. A patient who complain of constant thirst, increased appetite, increased urine output and weight
loss hyperglycemia was found. This is a consequence of:
A.
B.
C.
D.
E.
Lower level of insulin in the blood
Increased level of adrenaline in the blood
Increase of aldosterone level in the blood
Increase of the insulin level in the blood
Increase of thyroxin level in the blood
2.8.14. Patient 24 R., height 157 cm, weight 72 kg, complained of dry mouth, thirst, decrease in body
weight despite increased appetite, urorrhagia. What research is necessary to appoint in the first place?
A.
B.
C.
D.
E.
Determination of glucose in the daily urine
Urinalysis for Zymnytsky
Investigation of blood serum protein fractions
Total urine
Coagulogramm
2.8.15. In diabetes mellitus the following carbohydrate metabolism disorders occur, except for:
A.
B.
C.
D.
E.
Increase of glycogenogenesis
Increased glycogenolysis
Increase of glyconeogenesis
The slowdown of glycolysis
The slowdown of pentose cycle
2.8.16. Which of the manifestations of diabetes mellitus plays a role in the mechanisms of its
complications?
A.
B.
C.
D.
E.
Hyperglycemia
Acidosis
Hyperketonemia
Insulin deficiency
Glycosuria
2.8.17. A patient with diabetes mellitus was delivered to hospital in the state of unconsciousness.
Kusmaull’s breath type is observed, blood pressure is 80/50 mmHg, the smell of acetone in breath can be
felt. Accumulation of which substances in the organism can be attributed to these disorders?
A. Ketone bodies
B. Complex carbohydrates
C. Lactic acid
D. Modified lipoproteins
E. Carbonic acid
2.8.18. A 56 years old female, who has been suffering from diabetes mellitus for 6 years, feels heart pain.
What is the most likely cause of heart damage in the patient?
A.
B.
C.
D.
E.
Macroangiopathy of coronary arteries
Heart obesity
Myocarditis
Microangiopathy of vascular infarction
Autonomic neuropathy of the heart
2.8.19. A child after taking honey presents with vomiting and muscle cramps. Congenital fructose
intolerance has been suspected. Lack of which of the following enzymes does most accurately confirm the
diagnosis?
A.
B.
C.
D.
E.
Fructosodyphosphate aldolase
Hexokinase
Glykogen phosphorilase
Fructokinase
Fructosoodyphosphate kinase
2.8.20. Mucopolysaccharidoses is a group of diseases which are characterized by deposits of
glycosaminoglycans in:
A.
B.
C.
D.
E.
Lysosomes
Endoplasmic reticulum
Mitochondria
Ribosome
Nucleus
2.8.21. Indicate which of the listed diseases is not accompanied by hypoglycemia:
A.
B.
C.
D.
E.
Metapituitary diabetes
Addison disease
Hard muscle work
Glycogenosis
Miksedema
2.8.22. In a 4 year boy the level of plasma glucose is 12 mmol/l. What could be reason of this abnormality?
A.
B.
C.
D.
E.
Insulin deficiency
Glucagon deficiency
Cortisol deficiency
Deficiency of corticotropin
Somatotropin deficiency
2.8.23. A patient’s disease presents with the signs of hyperglycemia, glycosuria, polydypsia, and urorrhagia.
What disease is it?
A.
B.
C.
D.
E.
Diabetes
Galaktosemia
Glycogenosis
Renal diabetes
Fructosuria
2.8.24. A patient after recovery from mumps developed insulin dependent diabetes mellitus. What is the
main mechanism in the development of hyperglycemia?
A.
B.
C.
D.
E.
Activation of glycogenesis and glyconeogenesis
Activating glycogenogenesis
Activation of glycolysis
Activation of adipogenesis
Increasing the flow of glucose to the tissues
2.8.25. A patient was admitted to a hospital in an unconscious state; the smell of acetone from his mouth
was felt . Blood sugar 25 mmol/l, ketone bodies 0.57 mmol/l. Deficiency of what hormone can yield this
condition?
A.
B.
C.
D.
E.
Insulin
Aldosterone
Glucocorticoids
Thyroxin
Somatotropin
2.8.26. Reduction of blood sugar concentration after insulin administration in diabetes mellitus is caused
by:
A.
B.
C.
D.
E.
Increased permeability of cell membranes
Inhibition of glucagon secretion
Strengthening of glyconeogenesis
Increased synthesis of glucagon
Increased catabolism of glycogen
2.8.27. A patient with diabetes mellitus due to delayed insulin administration developed coma with signs of
hyperketonemia and metabolic acidosis. What kind of comma is it?
A.
B.
C.
D.
E.
Hyperglycemic
Hyperosmotic
Hypoglycemic
Liver
Uremic
2.8.28. When examining a girl aged 1 year old with hepatomegaly (increased liver) the deposition of
glycogen in the liver and leukocytes, and low phosphorylase activity were revealed. This is typical of:
A.
B.
C.
D.
E.
Hers' disease
Girke’s diseases
Fobs’ diseases
Fructosuria
Pentosuria
2.8.29. What feature is common to pentosuria, fruktosuria, galactosemia
A.
B.
C.
D.
E.
Recessive inheritance
Hypoglycemia
Benign course
Lactose milk intolerance
Lens pathology
2.8.30. Point out the disease, that is characterized by the following signs: grotesque features of the face,
deformed skeleton bones (multiple dysostosis), joints, pathology of the liver, spleen, heart, and mental
retardation
A.
B.
C.
D.
E.
Mucopolysaccharidosis
Galactosemia
Glycogenosis
Pentosuria
Fructosuria
2.8.31. Glycosuria occurs when blood glucose exceeds renal threshold, namely:
A.
B.
C.
D.
E.
8 mmol/l
4 mmol/l
6 mmol/l
10 mmol/l
12 mmol/l
2.8.32. Indicate which of the following diseases is not accompanied by hyperglycemia:
A.
B.
C.
D.
E.
Insulinoma
Acromegaly
Hyperthyroidism
Cushing’s disease
Feochromocytoma
2.8.33. A patient, who complains of constant thirst, has increased appetite, increased urine output, weight
loss and hyperglycemia. This condition may be the result of increase in the blood of the following
hormones, except for:
A.
B.
C.
D.
E.
Insulin
Adrenaline
Glucagon
Cortisol
Thyroxin
2.8.34. A young 25-year-old man complains of dry mouth, polydypsia, urorrhagia, weight loss despite
increased appetite. His height is 170 cm, weight 60 kg, blood glucose 10.5 mmol/l; glycosuria has been
detected in the urine. Which of the following conditions are this findings typical of?
A. Diabetes mellitus
B.
C.
D.
E.
Dietetic glycosuria
Diabetes insipidus
Renal diabetes
Steroid diabetes
2.8.35. Which of the pathogenetic mechanisms are specific to diabetes mellitus?
A.
B.
C.
D.
E.
Absolute or relative insulin deficiency
Adrenalinemia
Hyperinsulinemia
Hypoglycemia
Excess of glucagons
2.8.36. What disorder of the acid-alkaline balance is observed in severe forms of diabetes mellitus?
A.
B.
C.
D.
E.
Metabolic acidosis
Excretory alkalosis
Carbon dioxide acidosis
Metabolic alkalosis
Respiratory alkalosis
2.8.37. During treatment of diabetic coma with large doses of insulin the following side effect may develop:
A.
B.
C.
D.
E.
Hypoglycemia
Hyperglycemia
Hyperkaliemia
Metabolic acidosis
Urorrhagia
2.8.38. Examination of an infant with signs of delayed physical and mental development revealed
hypoglycemia, deposition of glycogen in the liver and kidneys, deficiency of glucose-6-phosphatase. This is
typical of:
A.
B.
C.
D.
E.
Girke’s siseases
Hers' Disease
Fobs’ diseases
Pentosuria
Fructosuria
2.8.39. In a 5-month-old girl galactosemia was diagnosed, characterized by the following features except:
A.
B.
C.
D.
E.
Accumulation of glucose-1-phosphate
Hepatomegaly
Cataract,
Mental retardation
Cirrhosis
2.8.40. In which of the following metabolic disorders one should avoid consumption of sweets?
A. Diabetes mellitus
B. Pentosuria
C. Phenylketonuria
D. Fruktosuria
E. Girke’s siseases
2.8.41. The tolerance to carbohydrates is determined by the maximum quantity of glucose accepted in
empty stomach, which the body can assimilate without the occurrence of glycosuria. In humans this level is:
A.
B.
C.
D.
E.
160 - 180 g
40-60 g
80-100 g
120-140 g
200-220g
2.8.42. Hyperglycemia is observed when there is excessive blood concentration of the following hormones
except:
A.
B.
C.
D.
E.
Insulin
Adrenaline
Glucagon
Thyroxin
Glucocorticoids
2.8.43. A 26-year-old female complains of dry mouth, thirst, decrease of body weight. On examination:
blood glucose level 9.6 mmol/l, glucosuria. For which of the following conditions is most typical of these
symptoms?
A.
B.
C.
D.
E.
Diabetes mellitus
Dietetic glycosuria
Diabetes insipidus
Renal diabetes
Steroid diabetes
2.8.44. In diabetes mellitus carbohydrate metabolism disorder presents with the following features except:
A.
B.
C.
D.
E.
Hypoglycemia
Hyperglycemia and glycosuria
Increased protein catabolism
Increased formation and accumulation in the body of ketone bodies
Inhibition of anabolic processes
2.8.45. A 56-year-old patient suffering from diabetes mellitus, complains of constant dry mouth, feeling of
thirst. What is the main cause of these manifestations of the disease?
A.
B.
C.
D.
E.
Dehydration of tissues due to hyperglycemia
Excretion of toxic substances through the lungs
Metabolic acidosis
Development of pathogenic flora in the mouth
Impairment of oral mucosa trophic
2.8.46. In a patient with insulin dependent diabetes mellitus hyperglycemia, hyperketonemia, glucosuria,
acetoneuria, and urorrhagia have been detected. Indicate the main mechanism responsible for ketonemia
in diabetes mellitus:
A.
B.
C.
D.
E.
Metabolic acidosis and coma
Makroanhiopatiyi
Microangiopathy
Neuropathy
Polydipsia
2.8.47. A patient was admitted to a hospital in the state of coma. Which of the following laboratory
parameters is most characteristic of hyperglycemic coma?
A.
B.
C.
D.
E.
High hyperglycemia
High glycosuria
Increased level of ketone bodies in urine and blood
The slight increase of sugar urine
The slight increase of blood sugar
2.8.48. A 2-year-old boy was diagnosed with Girke’s disease, that is associated with excessive glycogen
deposition in the liver and kidneys, and hypoglycemia. What can be detected in biochemical blood analysis:
A.
B.
C.
D.
E.
Deficiency of glucose-6-phosphatase
Deficit ketogexokinase
Deficiency of fructose-diphosphate aldolase
Decrease of amilo-1 ,6-glukosidase activity
Decrease of phosphorylase activity
2.8.49. A 3-year-old boy was diagnosed with a syndrome of carbohydrates absorption disorder. Which of
the following features is not characteristic of this pathology?
A.
B.
C.
D.
E.
Decrease of intestinal secret osmolarity
Abdominal pain and bloating, diarrhea
Dehydration
Deficiency of specific dysaccharidase of the intestinal brush border epithelium
Lack of monosaccharide transport system in the small intestine wall
2.8.50. A 14-year-old patient (height 157 cm, weight 52 kg) complains of dry mouth, decrease of body
weight despite increased appetite, and recurrent furunculosis. What kind of examination is it necessary to
appoint first of all?
A.
B.
C.
D.
E.
Examining of blood sugar level
Examining of salivary amylase
Examining of pancreatic amylase
Common blood analysis
Common urine analysis
2.11. WATER-SALT EXCHANGE DISORDERS
2.11.1. In a patient with chronic heart failure the increased hydrostatic pressure in vena cava inferior was
determined; that caused development of pathological process designated as:
A.
B.
C.
D.
E.
Cardiac edema
Liver swelling
Renal edema
Lymphocytic edema
Toxic edema
2.11.2. A 7-year-old boy after consumption of a seafood developed swellings and skin rash. What is the
cause of such reactions to food?
A.
B.
C.
D.
E.
Increased capillary permeability
High filter pressure
Reduction of osmotic pressure gradient through the capillary wall
Venules constriction
Increased level of plasma proteins
2.11.3. A patient was admitted to infectious department with complaints of extensive vomiting. What
disorders of water-salt metabolism are present in the patient?
A.
B.
C.
D.
E.
Hypoosmotic dehydration
Isoosmotic dehydration
Hyperosmotic dehydration
Hypoosmotic hyperhydration
Hyperosmotic hyperhydration
2.11.4. After a catastrophe people found themselves on the ocean island, where there were no fresh water.
What kind of water-salt metabolism has developed in those people?
A.
B.
C.
D.
E.
Hyperosmotic hyperhydration
Isoosmotic dehydration
Hypoosmotic hyperhydration
Hyperosmotic dehydration
Hypoosmotic dehydration
2.11.5. Diabetes mellitus is associated with osmotic diuresis. What kind of water-salt metabolism is
observed with this state?
A.
B.
C.
D.
E.
Hyperosmotic dehydration
Isoosmotic dehydration
Hypoosmotic dehydration
Hypoosmotic hyperhydration
Hyperosmotic hyperhydration
2.11.6. A patient with an infectious disease accompanied with severe vomiting and diarrhea developed
hypoosmotic dehydration. What are the reasons of this pathological condition?
A.
B.
C.
D.
E.
Loss of salts
Loss of water
Inflammatory process
Polydipsia
Polifagia
2.11.7. Sever vomiting in a pregnant women led to the development of hypovolemia due to significant
dehydration. The main endocrine mechanism for compensation of this state is:
A.
B.
C.
D.
E.
Increase of aldosterone level
Increase of vasopressin (ADH) level
Increase of corticotrope hormone synthesis
Increase of prolactine secretion
Increased production of calcitonine
2.11.8. A patient was admitted to a hospital with complaints of general weakness, headaches, pain in the
lumbar region, massive swelling of the face and limbs, accompanied by pronounced proteinuria,
leukocyturia, cylinders detected in urine analysis. What are the leading pathogenetic mechanisms of
edema?
A.
B.
C.
D.
E.
Reduction of oncotic blood pressure
Increase of vascular permeability
Increase of hydrostatic blood pressure
Hormonal balance disorders
Lymph flow impairment
2.11.9. An experimental animal was placed in the thermostat at the temperature of 36 оС. For a long time
the animal has presented with a significant increase in respiratory frequency. What kind of waterelectrolyte exchange disorder developed in this pathological state?
A.
B.
C.
D.
E.
Hyperosmotic dehydration
Hypoosmotic dehydration
Isoosmotic dehydration
Positive water balance
Edema
2.11.10. Experimental rats, that have long received only carbohydrate diet, the accumulation of water in
tissues was observed. What is the main pathogenetic mechanism in the development of edema in this
case?
A.
B.
C.
D.
E.
Hypooncotic
Membranogenic
Dysregulatory
Lymphogenous
Hyperosmotic
2.11.11. With prolonged fasting a human develops "hungry" swellings. What are the reasons of this
phenomenon?
A. Reduction of oncotic blood pressure
B. Reduction of vasopressin secretion
C. Increased secretion of vasopressin
D. Reduction of osmotic pressure in tissues
E. Increased oncotic blood pressure
2.11.12. A 6-year-old girl after she ate an orange, developed edema of eyelids, lips, neck, tongue mucosa.
The girl had the reaction to oranges before, which manifested as skin rashes, and its itching. What is the
pathogenetic mechanism leading to the development of edema in the girl?
A.
B.
C.
D.
E.
Increased capillary wall permeability
Lymph flow obstruction
Increased oncotic tissue fluid pressure
Increased hydrostatic pressure of the blood in capillaries
Decrease of oncotic blood pressure
2.11.13. A 32-year-old woman has sustained a wasp bite. Edema and hyperemia developed at the site of
the bite. What is the primary mechanism of edema in this case?
A.
B.
C.
D.
E.
Increased capillary wall permeability
Increased hydrostatic pressure of the blood in capillaries
Increased oncotic tissue fluid pressure
Lymph flow obstruction
Decrease of oncotic blood pressure
2.11.14. A patient is diagnosed with mixedema. What kind of water-electrolyte exchange disorder is
observed in the patients?
A.
B.
C.
D.
E.
Isoosmotic hyperhydration
Hypoosmotic hyperhydration
Hyperosmotic hyperhydration
Isoosmotic hypohydration
Hypoosmotic hypohydration
2.11.15. A patient is hospitalized due to chronic heart failure. What kind of water-electrolyte exchange
disorder will be the observed in the patient?
A.
B.
C.
D.
E.
Isoosmotic hyperhydration
Hypoosmotic hyperhydration
Hyperosmotic hyperhydration
Isoosmotic hypohydration
Hypoosmotic hypohydration
2.11.16. After a ship wrack in the ocean, sailors were deprived of fresh water. What changes in relation to
osmotic pressure and extracellular fluid volume are observed as a result of drinking salty water?
A.
B.
C.
D.
E.
Volume increases, osmotic pressure increases
Volume is reduced, osmotic pressure increases
Volume increases, osmotic pressure decreases
The volume does not change osmotic pressure decreases
Volume decreases with decreasing osmotic pressure
2.11.17. A patient with acute glomerulonephritis developed acute renal failure. There is total diuresis
deficiency. What kind of water-electrolyte exchange disorder will be the observed in the patient?
A.
B.
C.
D.
E.
Hypoosmotic hyperhydration
Isoosmotic hyperhydration
Hyperosmotic hyperhydration
Isoosmotic hypohydration
Hypoosmotic hypohydration
2.11.18. An experimental animal was given water load supported with vasopressin (ADH). What kind of
water-electrolyte exchange disorder will be the observed in the animal?
A.
B.
C.
D.
E.
Hypoosmotic hyperhydration
Isoosmotic hyperhydration
Hyperosmotic hyperhydration
Isoosmotic hypohydration
Hypoosmotic hypohydration
2.11.19. A patient is diagnosed with glomerulonephritis. The increased blood pressure and swellings are
observed. What is the pathogenesis of edema in glomerulonephritis?
A.
B.
C.
D.
E.
Decreased glomerular filtration
Increased glomerular filtration
Phlebostasis (congestion in the veins)
Increased filtration of plasma in capillaries
Increased capillary wall permeability
2.11.20. A patient is diagnosed with liver cirrhosis, accompanied by the development of edema. What is the
leading mechanism in the development of hepatic edema?
F.
G.
H.
I.
J.
Hypoproteinemia
Hyperproteinemia
Phlebostasis (congestion in the veins)
Increased capillary wall permeability
Increased filtration of plasma in capillaries
2.11.21. A patient is diagnosed with liver cirrhosis. What is the leading mechanism in the development of
ascites?
A.
B.
C.
D.
E.
Increased hydrostatic pressure in the portal venous system
Increased glomerular filtration
Phlebostasis (congestion in the veins)
Increased filtration of plasma in capillaries
Increased capillary wall permeability
2.11.22. A patient is diagnosed with angiotrophoneurosis that is accompanied by the development of
edema. What kind of edema by its etiology will be observed in the patient?
A. Neurogenic
B. Inflammatory
C. Allergic
D. Toxic
E. Lymphogenous
2.11.23. A patient is diagnosed with cancer of the stomach, accompanied by the development of edema.
The cause of edema is:
A.
B.
C.
D.
E.
Hypoproteinemia
Hyperproteinemia
Phlebostasis (congestion in the veins)
Increased capillary wall permeability
Increased filtration of plasma in capillaries
2.11.24. A patient was delivered to a hospital and diagnosed with Quincke’s edema. The main pathogenetic
factor in the development of allergic edema is:
A.
B.
C.
D.
E.
Increased capillary wall permeability
Decreased capillary wall permeability
Decreased oncotic blood pressure
Increased oncotic blood pressure
Phlebostasis (congestion in the veins)
2.11.25. 3 days after acute blood loss a man developed signs of hypovolemia. What kind of waterelectrolyte exchange disorder will be the observed in the patient?
A.
B.
C.
D.
E.
Isoosmotic hypohydration
Hypoosmotic hypohydration
Hyperosmotic hypohydration
Isoosmotic hyperhydration
Hypoosmotic hyperhydration
2.11.26. A man, after he had celebrated a wedding, developed signs of poisoning: vomiting, diarrhea, and
fever. As a result of these symptoms he drank small amount of fluids. What kind of water-electrolyte
exchange disorder will be observed in the patient?
A.
B.
C.
D.
E.
Hyperosmotic hypohydration
Isoosmotic hypohydration
Hyperosmotic hypohydration
Isoosmotic hyperhydration
Hypoosmotic hyperhydration
2.11.27. A patient has developed isoosmotic hypohydration. What reason can lead to this pathology?
A.
B.
C.
D.
E.
Acute blood loss
Diarrhea
Vomiting
Sweating
Hyperventilation
2.11.28. A patient has developed hypoosmotic hypohydration. What reason can lead to this pathology?
A.
B.
C.
D.
E.
Vomiting
Hypersalivation
Acute blood loss without drinking water
Sweating
Hyperventilation
2.11.29. An excessive amount of 0.5% solution of sodium chloride was administered to a patient. What kind
of water-electrolyte exchange disorder will be the observed in the patient?
A.
B.
C.
D.
E.
Hypoosmotic hyperhydration
Isoosmotic hyperhydration
Hyperosmotic hyperhydratation
Hypoosmotic hypohydratation
Hyperosmotic hypohydration
2.11.30. An excessive amount of 0.9% solution of sodium chloride was administered to a patient. What kind
of water-electrolyte exchange disorder will be the observed in the patient?
A.
B.
C.
D.
E.
Isoosmotic hyperhydration
Hypoosmotic hyperhydration
Hyperosmotic hyperhydratation
Hypoosmotic hypohydratation
Hyperosmotic hypohydration
2.11.31. An excessive amount of 0.05% solution of sodium chloride was administered to a patient. What
kind of water-electrolyte exchange disorder will be the observed in the patient?
A.
B.
C.
D.
E.
Hypoosmotic hyperhydration
Isoosmotic hyperhydration
Hyperosmotic hyperhydratation
Hypoosmotic hypohydratation
Hyperosmotic hypohydration
2.11.32. A man has sustained a long deprivation of drinking water. What pathological changes may result
from dehydration?
A.
B.
C.
D.
E.
Oliguria
Urorrhagia
Pulmonary edema
Cachexia
Vomiting
2.11.33. A patient developed dehydration. What pathological conditions can cause dehydration?
A.
B.
C.
D.
E.
Vomiting
Excessive consumption of sodium chloride
Hypothermia
Institution of isotonic solutions
All the listed above
2.11.34. A patient developed dehydration. What pathological processes can cause dehydration?
A.
B.
C.
D.
E.
Burns
Allergies
Hypothermia
Infection
All the listed above
2.11.35. A patient with liver cirrhosis developed edema. Disorders of which liver functions promote the
development of hepatic edema?
A.
B.
C.
D.
E.
Protein synthesis
Bile-forming
Deposition of microelements
Deposition of macroelements
Synthesis of urea
2.11.36. After a bee sting a child developed swelling. In the pathogenesis of what kind of edema the leading
role is played by biologically active substances?
A.
B.
C.
D.
E.
Allergic
Cardiac
Kidney
Starving
All the listed above
2.11.37. A patient complains of edema of the legs that emerges in the evening. Increase of what indexes
promote development of edema?
A.
B.
C.
D.
E.
Hydrostatic blood pressure
Intercellular fluid hydrostatic pressure
Oncotic blood pressure
Osmotic blood pressure
All the listed above
2.11.38. A child developed laryngeal edema. In the pathogenesis of what kind of edema the leading role is
played by biologically active substances?
A.
B.
C.
D.
E.
Inflammatory
Cardiac
Renal
Starving
All the listed above
2.11.39. A patient with thrombophlebitis has developed lower extremities edema in the evening. In the
pathogenesis of what kind of edema the leading role is played by increase of tissue oncotic pressure?
A.
B.
C.
D.
Inflammatory
Cardiac
Renal
Starving
E. All the listed above
2.11.40. In a patient who has worked in dangerous conditions, edema began to appear. In the pathogenesis
of what kind of edema the leading role is played by increase of tissue oncotic pressure?
A.
B.
C.
D.
E.
Toxic
Cardiac
Renal
Starving
All the listed above
2.11.41. A 34-year-old woman, who has long been on a diet, developed swellings. In the pathogenesis of
what kind of edema the leading role is played by hypoproteinemia?
A.
B.
C.
D.
E.
Cachectic
Cardiac
Allergic
Inflammatory
All the listed above
2.11.42. In a patient, who has long worked in a paintwork factory, swellings began to appear. In the
pathogenesis of what kind of edema the leading role is played by hypoproteinemia?
A.
B.
C.
D.
E.
Liver
Cardiac
Allergic
Inflammatory
All the listed above
2.11.43. A 44-year-old woman, who has long been on a diet, developed swellings. In the pathogenesis of
what kind of edema the leading role is played by hypoproteinemia?
A.
B.
C.
D.
E.
Starving
Cardiac
Allergic
Inflammatory
All the listed above
2.11.44. A patient has developed edema. In the pathogenesis of what kind of edema the leading role is
played by increased vessel wall permeability?
A.
B.
C.
D.
E.
Allergic
Cardiac
Cachectic
Mixedematous
Liver
2.11.45. A patient with thrombophlebitis has developed lower extremities edema in the evening. In the
pathogenesis of what kind of edema the leading role is played by increased vessel wall permeability?
A.
B.
C.
D.
E.
Inflammatory
Cardiac
Cachectic
Renal
Starving
2.11.46. A patient complains of breathlessness, palpitations, swelling of the lower extremities. In the
pathogenesis of what kind of edema the leading role is played by increased hydrostatic blood pressure?
A.
B.
C.
D.
E.
Cardiac
Cachectic
Allergic
Inflammatory
E. All the listed above
2.11.47. There is a sick woman with mixedema in endocrinological clinic. What is the water-electrolyte
exchange disorder observed in this patient?
A.
B.
C.
D.
E.
Isoosmotic hyperhydration
Hypoosmotic hyperhydration
Hyperosmotic hyperhydratation
Isoosmotic hypohydration
Hypoosmotic hypohydratation
2.11.48. A patient has been hospitalized due to chronic heart failure. What is the water-electrolyte
exchange disorder observed in this patient?
A.
B.
C.
D.
E.
Isoosmotic hyperhydration
Hypoosmotic hyperhydration
Hyperosmotic hyperhydratation
Isoosmotic hypohydration
Hypoosmotic hypohydratation
2.11.49. A man 3 days after acute blood loss developed signs of hypovolemia. What is the water-electrolyte
exchange disorder observed in this patient?
A.
B.
C.
D.
E.
Isoosmotic hypohydration
Hypoosmotic hypohydratation
Hyperosmotic hypohydratation
Isoosmotic hyperhydration
Hypoosmotic hyperhydration
2.11.50. A man, after he had celebrated a wedding, developed signs of food poisoning: vomiting, diarrhea,
and fever. As a result of these symptoms he drinks small amount of fluids. What kind of water-electrolyte
exchange disorder will be observed in the patient?
A.
B.
C.
D.
E.
Hyperosmotic hypohydration
Isoosmotic hypohydration
Hypoosmotic hypohydration
Isoosmotic hyperhydration
Hypoosmotic hyperhydration
2.12. ACID-BASE BALANCE DISORDERS
2.12.1. Examination of a patient revealed hyperglycemia, ketonuria, urorrhagia, hyperstenuria and
glycosuria. Which form of the acid-base disorder has place in this situation?
A.
B.
C.
D.
E.
Nongas alkalosis
Nongas acidosis
Metabolic acidosis
Carbon dioxide acidosis
Gas alkalosis
2.12.2. What kind of the acid-base disorder can be observed in a patients with diabetes mellitus due to the
accumulation of acetoacetate and -hydroxybutyrate in the patient’s serum?
A.
B.
C.
D.
E.
Metabolic acidosis
Metabolic alkalosis
Carbon dioxide acidosis
Gas alkalosis
Nongas alkalosis
2.12.3. An infant with pilorostenosis presents with frequent vomiting, accompanied by apathy, drowsiness,
increased muscle tone, and occasional cramps. Which form of the acid-base disorder developed in the
patient?
A.
B.
C.
D.
E.
Nongas alkalosis
Gas alkalosis
Carbon dioxide acidosis
Metabolic acidosis
Excretory acidosis
2.12.4. A tourist, who climbed to the height of 5200 m, developed gas alkalosis. What is the cause of
alkalosis?
A.
B.
C.
D.
E.
Hyperventilation of the lungs
Hypoventilation of the lungs
Institution of alkali
Institution of acids
Increased environmental temperature
2.12.5. A patient with diarrhea presents with arterial blood pH 7.34, рСО2 33 mm Hg. Which form of the
acid-base disorder developed in the patient?
A.
B.
C.
D.
E.
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
Mixed acidosis
2.12.6. A patient as a result of a long-standing vomiting has lost a lot of gastric juice, which led to acid-base
disorder. What kind of the acid-base disorder developed in the patient?
A.
B.
C.
D.
E.
Nongas alkalosis
Carbon dioxide acidosis
Nongas acidosis
Gas alkalosis
Metabolic acidosis
2.12.7. A 56-year-old woman suffers from emphysema and respiratory insufficiency. Investigation of the
acid-base balance determined the following values: pH 7.26; рСО2 56 mm Hg, BB - 50 mmol / L, SB +8
mmol/l. Change of which indicator in this case is primary?
A.
B.
C.
D.
E.
pH
рСО2
BB
SB
pH and рСО2
2.12.8. What is the cause of the acid-base disorder in the organism of a 15-year-old girl, who was admitted
to a hospital with the diagnosis of acute pneumonia? There are no pulmonary diseases in anamnesis of the
girl; on investigation of acid-base state of the girl the following date were found: alkalosis, decrease of
рСО2, buffer bases shift - 8 mmol/l, reduction of the buffer bases and reduction of standard bicarbonates.
A.
B.
C.
D.
E.
Reduction of standard bicarbonates
Reduction of buffer bases
Adolescent period
Acute pneumonia
Shift of buffer bases
2.12.9. Basic parameters of acid-base balance are:
A.
B.
C.
D.
E.
pH of the blood, рСО2 , SB - standard bicarbonate
BB, pH, рСО2 , SB
pH, рСО2
BB, SB
pH, рСО2 , BB, SB
2.12.10. What changes of acid-base disorder are typical for gas acidosis?
A.
B.
C.
D.
E.
Increase of рСО2 and SB
Decrease of рСО2 and SB
Increase of SB
Decrease of рСО2
Decrease of рСО2 and SB
2.12.11. Development of acidosis in a patient with diabetes mellitus will cause first of all the disorder in:
A. Bicarbonate buffer system
B. Phosphate buffer system
C. Hemoglobin buffer system
D. Oxyhemoglobin buffer system
E. Protein buffer system
2.12.12. Prolonged seizures in a patient with epilepsy caused the following changes in laboratory tests: pH
7.14, рСО2 45 mm Hg., НСО3 14 mmol/l, Na + 140 mmol/l, Cl 98 mmol/l. What kind of the acid-base disorder
developed in the patient?
A.
B.
C.
D.
E.
Metabolic lactic acidosis
Metabolic ketone acidosis
Respiratory alkalosis
Metabolic alkalosis
Any disorders in the patient’s acid-base disorder are absent
2.12.13. While climbing the mountains climbers developed headache, shortness of breath, and then apnea. What kind of the acid-base disorder developed in the climbers?
A.
B.
C.
D.
E.
Carbon dioxide acidosis
Nongas acidosis
Excretory acidosis
Gas alkalosis
Nongas alkalosis
2.12.14. A patient with chronic glomerulonephritis developed uremic coma. What kind of the acid-base
disorder accompanies uremic comma?
A.
B.
C.
D.
E.
Nongas excretory acidosis
Nongas excretory alkalosis
Carbon dioxide acidosis
Gas alkalosis
Respiratory alkalosis
2.12.15. A pregnant women with toxicosis developed vomiting that has been observed for 24 hours. After
that she developed dehydration and tetanic twitches. What kind of changes in acid-base balance led to the
disorders described?
A.
B.
C.
D.
E.
Nongas excretory acidosis
Nongas metabolic alkalosis
Nongas metabolic acidosis
Gas acidosis
Gas alkalosis
2.12.16. A patients with diabetes mellitus was hospitalized due to deterioration of general condition:
urorrhagia, insomnia, Kussmaul's breathing, arrhythmias, the smell of acetone in the air exhaled. What kind
of the acid-base disorder corresponds to these symptoms?
A.
B.
C.
D.
E.
Nongas metabolic acidosis
Gas acidosis
Gas alkalosis
Nongas excretory alkalosis
Nongas metabolic alkalosis
2.12.17. A group of mountaineers, who were at an altitude of 3000 meters above the sea level, has
undergone a blood test analysis and the following results were obtained: lowering НСО3 to 15 mmol/l
(norm 22-26 mmol/l). What is the mechanism of reduction of НСО3?
A.
B.
C.
D.
E.
Result of hyperventilation
Decrease of bicarbonate reabsorbtion in the kidneys
Intensification of acidogenesis
Result of hypoventilation
Decrease of ammonia production
2.12.18. A patient with diabetes mellitus has blood pH 7.3. What components of the buffer system can be
used for the diagnosis of acid-base disorders?
A.
B.
C.
D.
E.
Bicarbonates
Oxyhemoglobin
Phosphate
Hemoglobin
Protein
2.12.19. A patients was found to have nongas metabolic acidosis. What is the possible reasons of these
changes?
A.
B.
C.
D.
E.
Excessive lactate formation
Anions excretion impairment
K reabsorbtion impairment
Increase of Na+-ions reabsorbtion
Institution of hydrochloric acid in the organism
2.12.20. A patient was found to have decreased blood pH, increased concentrations of H+, and increase of
рСО2. What kind of the acid-base disorder has place?
A.
B.
C.
D.
E.
Gas acidosis
Gas alkalosis
Nongas excretory alkalosis
Nongas exogenous alkalosis
Nongas acidosis
2.12.21. What is a possible reason of development of nongas excretory alkalosis?
A.
B.
C.
D.
E.
Administration of chloric diuretics
Administration of acids body
Hypoxia
Diabetes mellitus
Starving
2.12.22. A patient as a result of brain injury developed hyperventilation. What are the typical compensatory
responses for acid-base disorders in the patient?
A. Decreased secretion of H+, and decreased hydrocarbons reabsorbtion in the kidneys
B. Increased output of hydrocarbons excess in the kidneys
C. Exchange of H+ plasma proteins to the plasma Са2+
D. Excretion of ammonium salts by the kidneys
E. Increased secretion of H+ by the kidneys
2.12.23. As a result of long-lasting vomiting a patient developed changes in acid-base balance of the blood.
What kinds of violations of acid-base balance occur? What kind of the acid-base disorder developed in the
patient?
A.
B.
C.
D.
E.
Nongas alkalosis
Gas alkalosis
Gas acidosis
Nongas excretory acidosis
Nongas metabolic acidosis
2.12.24. A patient was diagnosed with nongas excretory acidosis. What is the possible reason of acid-base
disorder?
A.
B.
C.
D.
E.
Diarrhea
Diabetes mellitus
Hypoxia
Starvation
Hyperaldosteronism
2.12.25. What mechanisms of temporary compensation have place in a patient with diabetes mellitus?
A.
B.
C.
D.
E.
Hyperventilation
Hypoventilation
Reabsorbtion of bicarbonates in the kidneys
Bicarbonate secretion in the urine
Ammonium genesis be the kidneys
2.12.26. What kind of blood electrolyte disorders will occur in a patient with nongas alkalosis?
F.
G.
H.
I.
J.
Hypokaliemia, hypocalcaemia
Hyperkaliemia, hypercalcaemia
Hypocapnia, hyperkaliemia
Hypokaliemia, hypercalcaemia
Hyperkaliemia, hypocalcaemia
2.12.27. How can be explained the development of muscle weakness, hypotension and arrhythmia in a
patient with nongas alkalosis?
A.
B.
C.
D.
E.
Hypokaliemia
Hypocalcaemia
Hyperkaliemia
Hypercalcaemia
Hypocapnia
2.12.28. A patient with chronic acidosis developed signs of diabetes mellitus. What can explain this?
A. Excessive production of glucocorticoids
B.
C.
D.
E.
Increased -adrenoreceptors excitability
Reduction of nervus vagus tone
Release of calcium from the bone
Hyperaldosteronism
2.12.29. What can not be the reason of the development of nongas excretory alkalosis in a patient?
A.
B.
C.
D.
E.
Ammonium genesis impairment
Hyperaldosteronism
Continuous use of glucocorticoids
Introduction of chloric diuretics
Vomiting
2.12.30. What changes in the patient's blood pH will be compatible with life?
A.
B.
C.
D.
E.
7.0 - 7.8
7.0 - 7.7
7.1 - 7.8
7.45 - 7.35
7.0 - 7.4
3. PATHOPHYSIOLOGY OF SYTSTEMS AND ORGANS
3.1. Blood
3.2. PATHOPHYSIOLOGY OF THE HEART
3.2.1. In a patient the sense of periodic “heart fading” appeared. On ECG: complexes, which are preceded
by decreased interval TP, reduced voltage of R wave, shortened RQ interval, complex QRST - normal, that is
followed by extended interval TR. What form of cardiac arrhythmia has place in this case?
A.
B.
C.
D.
E.
Atrial extrasystole
Atrial fibrillation
Incomplete atrioventricular block
Ventricular fibrillation
Ventricular extrasystole
3.2.2. An athlete -stayer (distance runner) during competition developed acute heart failure. What is the
reason of this pathology?
A.
B.
C.
D.
E.
Volume overload of the heart
Coronary circulation disorder
Direct myocardial damage
Pathology of pericardium
Overload of the heart with increased resistance
3.2.3. A 5-year-old boy with congenital pulmonary artery stenosis while walking developed dyspnea,
cyanosis appeared on his face and finally he lost consciousness. What is the primary mechanism of
development of this condition?
A.
B.
C.
D.
E.
Acute hypoxia of the brain
Expansion of peripheral vessels
Decrease of blood pressure
Disorder of pulmonary ventilation
Disorder of gases diffusion in the lungs
3.2.4. ECG of a women with ischemic heart disease showed heart rate 230 / minute, slightly deformed P
wave, ventricular complexes are intact. What heart rate disorder is observed in the patient?
A.
B.
C.
D.
E.
Paroxysmal atrial tachycardia
Fibrillation
Atrial fibrillation
Ventricular fibrillation
Ventricular extrasystole
3.2.5. A patient with essential hypertension developed myocardium hypertrophy. What is the primary
mechanism of myocardium hypertrophy?
A.
B.
C.
D.
E.
Hyperplasia of cardiomyocytes
Increased number of mitochondria
Increased myocardium capillary networks
Increased endoplasmic reticulum
Increased synthesis of retractive proteins
3.2.6. A 55-year-old man, who has for years suffered from mitral valve insufficiency, developed acute heart
failure. Which pathophysiological type of heart failure is observed in this case?
A.
B.
C.
D.
E.
Due to heart overload ]
Due to hypoxic damage of the heart
As a result of coronary heart damage
Due to neurogenic heart damage
As a result of acute tamponade of the heart
3.2.7. A 25-year-old patient after acute endocarditis developed aortic valves insufficiency due to which left
ventricular hypertrophy emerged. After eight weeks, heart weight increased by 100% and then its growth
ceased. What stopped the growth of myocardium ?
A.
B.
C.
D.
E.
Decreased load per unit of muscle mass
Coronary circulation impairment
Deterioration of cardiomiocytes energetic supply
Disorder of the regulatory heart supply
Decreased protein synthesis and impairment of cardiomyocytes supply with plastic material
3.2.8. In the experiment conducted on animals, which have undergone removal of adrenals, a significant
delay of potassium in the organism that led to the development of hyperkaliemia was observed. What
heart rate disorder is most likely to occur in such animals?
A.
B.
C.
D.
E.
Sinus bradycardia
Sinus tachycardia
Atrial extrasystole
Ventricular extrasystole
Atrioventricular block
3.2.9. While recording a patient’s ECG a doctor easily pressed with his fingers on the patient’s eyes and
continued to record ECG. Slowing down of the heart rate – bradycardia emerged. Impairment of what heart
conduction system property underlies this phenomenon?
A.
B.
C.
D.
E.
Automatism
Nervous
Contractile
Conductivity
Dissociation
3.2.10. While taking electrocardiogram of a patient, the periodic appearance of ventricular extrasystoles
was identified. It was found that P-waves are missing before extrasystoles. What is the most likely reason of
P-wave disappearance in this clinical situation?
A.
B.
C.
D.
E.
Failure of retrograde impulse conduction through AV-node
Blockade of impulse conduction through the atriums
Emergence of refractory period in the ventricles
Blockade of impulses in the sinus node
The emergence of refractory period in atriums
3.2.11. A patients with extensive myocardial infarction developed heart failure (shortness of breath began
to intensify, crepitation in the lungs appeared). What pathogenetic mechanism underlies the development
of heart failure in the patient?
A.
B.
C.
D.
E.
Decrease of the mass of functioning cardiomyocytes
Pressure overload
Volume overload
Acute heart tamponade
Reperfusion myocardial damage
3.2.12. In patients with coronary cardiosclerosis atriums and ventricles contract independently – each by its
own rhythm: atrial contraction rate is about 70, ventricles contraction rate is about 35 per 1 min. What kind
of rhythm is it?
A.
B.
C.
D.
E.
Idioventricular
Atrioventricular
Slow atrial
Alternation
Heart rate driver migration
3.2.13. A patient suffers from mitral valve insufficiency resulting in heart volume overload. What
mechanism of urgent compensation is the main one in heart volume overload?
A.
B.
C.
D.
E.
Heterometric
Homeometric
Chronotropic
Inotropic effect of catecholamines
Compensatory myocardial hypertrophy
3.2.14. A patient suffers from tachycardia, and dyspnea at rest. He acquires a sitting position. An attempt of
the patient to get a horizontal position leads to the development of cardiac asthma attack. What type of
circulatory decompensation developed?
A.
B.
C.
D.
E.
Left ventricle
Right ventricle
Total
Vascular
Extracardial
3.2.15. A 27-year-old patient periodically developed recurrent attacks of palpitations, which lasted for
several minutes. Cardiac work is rhythmic, heart contraction rate is up to 220 beats/min. What is the type
of arrhythmia?
A.
B.
C.
D.
E.
Paroxysmal tachycardia
Sinus tachycardia
Fibrillation
Sinus arrhythmia
Sinus extrasystole
3.2.16. A patient with myocarditis developed clinical signs of cardiogenic shock. Which of the following
pathogenetic mechanisms is the leading one?
A. Impairment of the heart pump function
B. Deposition blood in the organs
C. Decrease of diastolic inflow to the heart
D. Decrease of vascular tone
E. Increase of peripheral vessels resistance
3.2.17. Arrhythmia with generation of atrial contractions up to 400 / min was observed in a patient with
cardiosclerosis. This was accompanied by reduced pulse rate comparatively to the heart rate. Impairment
of what heart muscle function is observed in this case?
A.
B.
C.
D.
E.
Generation of an impulse and its conduction
Automatism
Generation of an impulse
Contractile
Conduction
3.2.18. A patient with heart failure developed arrhythmia in the form of generation of early impulses in the
His bunch. Impairment of what heart muscle function is observed in this case?
A.
B.
C.
D.
E.
Generation of an impulse
Automatism
Conduction
Generation of an impulse and its conduction
Contractile
3.2.19. Exstrasystole was identified in a patient. On ECG: absent P-wave, deformed QRS-complex, complete
compensatory break is present. What kind of exstrasystole is it?
A.
B.
C.
D.
E.
Ventricular
Atrial
Atrioventricular
Sinus
Extracardial
3.2.20. A patient with heart failure developed arrhythmia associated with decrease of the atrial contraction
frequency to 70/min, and ventricles contraction frequency to 35 / min. Impairment of what heart muscle
function is observed in this case?
A.
B.
C.
D.
E.
AV conduction
Generation of an impulse
Automatism
Generation of an impulse and its conduction
Contractile
3.2.21. The analysis of ECG revealed: missing P-waves, instead of them - numerous f-waves, QRSTcomplexes go in different intervals, RR differ, R-waves are of different voltage. Name the type of
arrhythmia.
A.
B.
C.
D.
E.
Atrial
Sinus
Paroxysmal tachycardia
Sinus tachycardia
Idioventricular rhythm
3.2.22. One of the most severe complications of myocardial infarction is cardiogenic shock, which is
manifested by which of the following signs?
A.
B.
C.
D.
E.
Oliguria
Long-lasting pain
Dyzuriya
Tachycardia
Acute heart failure
3.2.23. A patient has congenital mitral stenosis. Which of the following processes will develop in the
patient’s heart?
A.
B.
C.
D.
E.
Hypertrophy
Hypotrophy
Anaplasia
Atrophy
Regeneration
3.2.24. In myocardium hypertrophy the heart muscle volume is increased due to:
A.
B.
C.
D.
E.
Thickening each muscle fiber
Overgrowth of connective tissue
Increased number of cardiomyocytes
Buildup of adipose tissue
Increased blood supply of the heart
3.2.25. Resorption of necrotized areas of damaged heart cells in myocardial infarction is responsible for:
A.
B.
C.
D.
E.
Appearance of creatinecinase in the blood
Increased activity of alaninaminotransferase
Slowing down of ESR
Leukopenia
Decrease of free fatty acids
3.2.26. A 56-year-old male addressed a doctor with complaints of pain in heart area, shortness of breath.
Objective findings: edema of the lower extremities, cyanosis of the lips. From the patient’s history: long and
steady increase of arterial pressure. What is the mechanism of heart failure in this case?
A.
B.
C.
D.
E.
Overload with increased peripheral resistance
Overload with blood volume
Immune destruction of the myocardium
Electrolyte-steroid cardiopathy
Hypoxic myocardium necrosis
3.2.27. Changes on ECG manifested initially by extended PQ-interval, then – by occasional loss of QRScomplexes, later - by increasing number of missing ventricular complexes and, ultimately, - by reducing
atrial contraction rate to 70 beats/min, and the ventricles contraction rate to 35 beats/min. These changes
are characteristic of:
A. Atrioventricular block
B. Intraatrial blockade
C. Intraventricular blockade
D. Arrhythmia due to automatism disorder
E. Arrhythmia due to rhythm accepting impairment
3.2.28. Ventricles contract before they are filled with blood and their contractions do not illicit pulse waves.
In this case, pulse rate is less than heart contraction rate (pulse deficit). This disorder of heart rhythm is
called:
A.
B.
C.
D.
E.
Fibrillation
Sinus fibrillation
Extrasystole
Ventricular fibrillation
Blockade
3.2.29. In a patient with neurocirculatory dystonia heart rate increased up to 130 beats/min. Clinical
symptoms of organic heart lesions were not found. On pressing on the carotid sinus the heart rhythm slows
down for a short time, and then is restored. What is the cause of the dysrhythmia?
A.
B.
C.
D.
E.
Increased impact of sympathetic autonomic nervous system
Fluctuations in parasympathetic tone
Inflammatory injury of myocardium
Ischemic myocardial damage
Toxic injury of myocardium
3.2.30. The pulse rate of a patient who sustained cerebral haemorrhage slowed down to 50/min. Pulse is
rhythmical. What is the mechanism of such a heart rhythm disorder?
A.
B.
C.
D.
E.
Irritation of nervus vagus
Replacement of glutamic acid in the globin beta chain with serine
Influence of sympathetic mediator
Stretching sinoatrial node zone
Increase of slow diastolic depolarization speed
3.2.31. In a patient with arterial hypertension the pulse rate during crisis fell from 72 to 52 beats / min. and
holds for 10 days. Intramuscular administration of 1 mg atropine led to the pulse deceleration to 16 beats /
min. Which group of arrhythmias does the described heart disorder belong to?
A.
B.
C.
D.
E.
Automatism disorder
AV conduction
Impairment rate adoption
Atrial fibrillation
Ventricular fibrillation
3.2.32. What compensatory mechanism is triggered in conditions of heart failure caused by blood volume
overload?
A.
B.
C.
D.
E.
Heterometric (Frank - Starling)
Tachycardia
Homeometric
Hypertrophy of myocardium
Chronoinotropic
3.2.33. What compensatory mechanism is triggered in conditions of heart failure caused by increased
resistance of blood outflow?
A.
B.
C.
D.
E.
Homeometric
Heterometric (Frank - Starling)
Bradycardia
Hypertrophy of myocardium
Increased frequency of breathing rate
3.2.34. What form of heart failure develops with rheumatism?
A.
B.
C.
D.
E.
Mixed
Overload
Miocardial
Right heart
Left heart
3.2.35. What kind of compensation in heart failure develops in conditions of hypertension?
A.
B.
C.
D.
E.
Hypertrophy of myocardium
Heterometric (Frank - Starling)
Homeometric
Tachycardia
The increase of minute blood volume
3.2.36. A 50-year-old man has been diagnosed with essential hypertension. During physical training the
man developed feeling of muscle weakness and asphyxia; cyanosis of the lips and face appeared then;
respiration is accompanied by bubbling rales audible at a distance. What is the cause of this syndrome?
A.
B.
C.
D.
E.
Acute left heart insufficiency
Chronic right heart failure
Chronic left heart failure
Collapse
Cardiac tamponade
3.2.37. A 59-year-old man, a director of a private enterprise, has come to home from work where he
sustained some problems; in the evening of the same day the man felt intense burning chest pain
irradiating to the left hand. 15 minutes later the patient's condition returned to the normal state. What is
the leading mechanisms of the development of angina in this patient?
A.
B.
C.
D.
E.
Increase of catecholamines level in the blood
Atherosclerosis of coronary vessels
Intravascular thrombosis
Coronary thrombosis
Functional overload of the heart
3.2.38. A. patient was diagnosed with mitral stenosis. Which pathophysiological variation can this heart
deficiency be attributed to?
A. Heart failure due to overload
B. Heart failure due to myocardium damage
C. Mixed form of failure
D. Miocardial failure
E. Cardiovascular failure
3.2.39. On overload the heart linear dimensions are being increased by 25%. Expansion of the heart
chambers in this condition is accompanied by increase of blood outflow volume and is called:
A.
B.
C.
D.
E.
Tonogenic dilation
Myogenic dilation
Myocardium hypertrophy
Homeometric compensatory mechanism
Tachycardia
3.2.40. A patient is diagnosed with heart valve insufficiency. What kind of long-lasting compensatory
mechanism will develop in the patient if this defect is nor removed?
A.
B.
C.
D.
E.
Myocardial hypertrophy
Heterometric compensatoty mechanism
Homeometric compensatory mechanism
Myogenic dilation
Tachycardia
3.2.41. A patient died of myocardial infarction, a diagnosis that was confirmed by clinical examinations and
ECG- test. At the section no evidence of sclerotic changes of coronary vessels was found. What was the
cause of myocardial infarction in this case?
A.
B.
C.
D.
E.
Increased secretion of catecholamines
Increased tone of sympathetic nervous system
Obturation of the vessel with vascular embolus
Coronary thrombosis
Rheumatoid coronaritis
3.2.42. A 56-year-old man suddenly felt chest pain with irradiation to the left hand associated with fear of
death. His face became pale coated with cold sweat. Application of nitroglycerin did not relieve the pain. A
doctor diagnosed heart attack. What is the cause of myocardial ischemia?
A.
B.
C.
D.
E.
Atherosclerosis of coronary vessels
Spasm of coronary vessels
Thrombosis of heart vessels
Coronary embolism
Aggregation of erythrocytes in coronary vessels
3.2.43. A patients with ischemic heart disease on the background of arteriosclerotic lesions of coronary
arteries developed acute myocardial infarction after considerable physical exertion. What is the most likely
cause of the coronary circulation failure?
A.
B.
C.
D.
E.
Coronary artery stenosis
Spasm of coronary arteries
Redistribution of blood
Coronary artery thromboembolism
Rupture of coronary artery
3.2.44. What pathology leads to coronary myocardial failure?
A.
B.
C.
D.
E.
Ischemic heart disease
Aortic valve insufficiency
Stenosis of a valve opening
Hypercalcaemia
Mitral valve insufficiency
3.2.45. A 75-year-old patient, whose heart rate was 40 beats/min, has undergone electrical stimulator
implantation. After that procedure heart rate increased to 70 beats/min. The function of which structure
has the electrical stimulator adopted?
A.
B.
C.
D.
E.
Synoatrial node
His’ bundle fibers
His’ brunches fibers
Atrioventricular node
Purkynye fibers
3.2.46. A 50-year-old patient suddenly developed heart palpitation, chest pain, weakness, increased blood
pressure, irregular and insufficient pulse. ECG revealed: absent P-waves and different intervals R-R. What
kind of heart rate disorder is observed in the patient?
A.
B.
C.
D.
E.
Fibrillation
Paroxysmal tachycardia
Sinus extrasystole
Heart block
Respiratory arrhythmia
3.2.47. A patients on the next day after myocardial infarction developed sharp decrease of systolic blood
pressure to 60 mm Hg accompanied by tachycardia 140 beats/min, shortness of breath and loss of
consciousness. What is the main mechanism in the pathogenesis of shock that has developed?
A.
B.
C.
D.
E.
Reduction of the blood volume output from the heart
Reduction of the circulating blood volume
Severe anaphylactic reactions to myocardial proteins
Paroxysmal tachycardia
Intoxication with products of necrotic debris
3.2.48. A 24-year-old woman while waiting for tooth extraction developed increased tone of the
sympathetic nervous system. What of the following will be observed in the patient?
A.
B.
C.
D.
E.
Increased heart rate
Increased peristalsis
Myosis
Bronchoconstriction
Increased secretion of digestive juices
3.2.49. A patient with acute myocarditis developed clinical signs of cardiogenic shock. What is the main
pathogenetic mechanism in the development of shock?
A. Impairment of the heart pump function
B.
C.
D.
E.
Reduction of diastolic blood inflow to the heart
Depositing blood in the veins
Vasodilatation
The increase of vascular tone
3.2.50. During ECG analysis it was determined that the duration of cardiac cycle in man is 1 sec. What is it
heart rate per minute in this case?
A.
B.
C.
D.
E.
60
50
70
80
100
3.2.51. A 68-year-old patient underwent myocardial infarction. During ECG a progressive increase of PQinterval duration until complete loss of QRS complex was observed, then PQ-interval is restored. Disorder
of which of the heart function is related to such a cardiac rhythm abnormality?
A.
B.
C.
D.
E.
Conduction
Automatism
Excitement
Contractility
All of the above is correct
3.2.52. A 43-year-old patient after psychological overstrain suddenly developed sharp pain in the heart area
with irradiation to the left hand. Nitroglycerin brought relief of the pain attack 10 minutes after its
application. What is the main pathogenetic mechanism in the development of pain?
A.
B.
C.
D.
E.
Spasm of coronary vessels
Dilation of peripheral vessels
Obturation of coronary vessels
Increased requirements of myocardium in oxygen
Compression of coronary vessels
3.2.53. Dystrophic changes of heart muscle cells are accompanied by heart enlargement, reduced force of
cardiac contractility, increased volume of blood that remains in the heart chambers during systole; veins
are overfilled. What pathological state does this clinical picture correspond to?
A.
B.
C.
D.
E.
Miogenic dilatation
Stage cardiosclerosis
Tonogenic dilatation
Heart tamponade
Critical phase of myocardial hypertrophy
3.2.54. A 33-year-old man after psychological overstrain developed heart rate 112 beats/min. Changes of
which structure of the heart conduction system causes increased heart rate?
A.
B.
C.
D.
Synoatrial node
His’ branch
His’ legs
Pourcinye fibers
E. Atrioventricular node
3.3. PATHOPHYSIOLOGY OF BLOOD VESSELS
3.3.1. A 55-year-old woman suffers from renal failure and has blood pressure 170/100 mm Hg. Excessive
activation of which of the following systems determines constant increase of blood pressure in the woman?
A.
B.
C.
D.
E.
Renin-angiotensin-aldosterone
Simpatico-adrenal
Hypothalamus-pituitary
CNS
Kalikrein-kinin system
3.3.2. A 58-year-old patient appealed to a doctor with complaints of the steady increase of arterial blood
pressure. On clinical examination of the patient chronic kidney disease with impairment of renal blood
circulation was found. Activation of which of the mechanisms led to development of increased blood
pressure in the man?
A.
B.
C.
D.
E.
Renin-angiotensin-aldosterone
Parasympathetic nervous system
Sympathetic nervous system
Cardiovascular
Metasympathetic nervous system
3.3.3. What mechanism is responsible for the development of hypertension in a patient with renal
insufficiency?
A.
B.
C.
D.
E.
Increase the renin secretion
Reduction of water reabsorption
Reduction of electrolytes reabsorption
Increase of glucose reabsorption
Proteinuria
3.3.4. According to Pauzel’s formula: P = QR, where P it’s a fluid pressure in the pipe, Q - value of their
filling and R - resistance of fluid flow. What hemodynamic type of arterial hypertension the increase of as Q
so R is characteristic of?
A.
B.
C.
D.
E.
Eukinetic
Hyperkinetic
Hipokinetic
Mixed
For all of these types
3.3.5. A 24-year-old female was admitted to the hospital with complaints of headaches, pain in lower back
and general weakness. A month before the patient sustained tonsillitis. Objectively: blood pressure180/110
mmHg, peripheral blood analysis: Er - 3.1х1012 / l, Le - 12,6х109/l, ESR-28 mm/hr. Urine analysis
demonstrates pronounced proteinuria, hematuria, leukocyteuria. What is the mechanism of development
of hypertension in this case?
A. Renal
B.
C.
D.
E.
Mineralocorticoid
Renovascular
Reflexogenous
Aldosterone
3.3.6. In a patient with hypertension an increased concentration of angiotensin II in the blood has been
detected. What is the hypertensive effect of angiotensin associated with?
A.
B.
C.
D.
E.
Muscle arterioles contraction
Activation of biogenic amines synthesis
Excessive prostaglandins synthesis
Stimulation of vasopressin production
Activation of kalikrein-kinin system
3.3.7. In a patient with hypertension an increased concentration of vasopressin in the blood has been
detected. Which organ is the target of this hormone?
A.
B.
C.
D.
E.
Kidneys
Liver
Heart
Lungs
Adrenals
3.3.8. Arterial hypertension due to artificial narrowing of the renal arteries has been made in a dog. The
increase of renin-angiotensin-aldosterone system activity has been observed. What component of this
system has most powerful hypertensive effect?
A.
B.
C.
D.
E.
Angiotensin II
Renin
Angiotensin I
Vasopressin
Oxytocin
3.3.9. A 65-year-old man has been suffering from marked arterial hypertension for 15 years. Recently his
systolic pressure began to decrease but diastolic remained unchanged. What is haemodynamic type of
hypertension in the patient?
A.
B.
C.
D.
E.
Hypokinetic
Normokinetic
Hyperkinetic
Eukinetic
Akinetic
3.3.10. A 47-year-old man has high cholesterol levels in the blood. Which vessels are the primary targets for
cholesterol deposition?
A.
B.
C.
D.
E.
Arteries
Arteriols
Capillaries
Venules
Veins
3.3.11. A patient is experiencing high blood pressure, headaches. It was established that this pathological
state is related to a kidney disease. Which substance can cause this?
A.
B.
C.
D.
E.
Renin
Creatine
NH4+
Urea
Histamine
3.3.12. A patient complains of headache. He has high blood pressure and angiotensin levels in the blood.
What exactly causes this?
A.
B.
C.
D.
E.
Renin
Creatine
NH4+
Urea
Histamine
3.3.13. Routine medical examinations of a 36-year-old man, who is a driver by profession, determined
blood pressure 150/90 mm Hg. The patient complains of tinnitus and weakness at the end of his working
day, the symptoms disappears after rest. Hypertension was diagnosed. What is the leading pathogenetic
mechanism in this disease?
A.
B.
C.
D.
E.
Nervous
Renal
Humoral
Endocrine
Reflexogenous
3.3.14. In a patient, who suffers from hypertension, daily fluctuations in peripheral vascular resistance to
blood flow were determined. What type of vessels are responsible for the vascular resistance?
A.
B.
C.
D.
E.
Arterioles
Aorta
Capillaries
Arteriolo-venular bypass
Veins
3.3.15. A 82-year-old patient has been admitted to a hospital with systolic and diastolic blood pressure 195
mm Hg. and 115 mm Hg respectively. What is the most important index for determining atherosclerosis?
A.
B.
C.
D.
E.
Pulse wave velocity
Arterial pressure
Cardiac output
Blood viscosity
Volume of circulating blood
3.3.16. A 39-year-old woman with a poor health condition preceding comma due to chronic renal failure
was admitted to the kidney center. Objective findings: edema of the legs and face; congestive and enlarged
liver. Blood pressure 190/120 mm Hg. What is the primary pathogenic mechanisms that most likely led to
the development of hypertension in this patient?
A.
B.
C.
D.
E.
Increased renin secretion
Increased glucocorticoids secretion
Increased aldosterone secretion
Increased secretion catecholamines
Increased concentration of angiotensin in the blood serum
3.3.17. A 54-year-old man suffering from atherosclerosis, ischemic heart disease, and angina has been
hospitalized to the cardiological department. Increased lipids levels were found on laboratory examination
of the patient’s blood serum. What class of plasma lipids performs a central role in the pathogenesis of
atherosclerosis?
A.
B.
C.
D.
E.
Low density lipoproteins
Hilomicrons
Alpha-lipoproteins
High density lipoproteins
Complexes of fatty acids with albumin
3.3.18. In an experimental animal one kidney was removed, and a ligature narrowing conralateral kidney
artery was put. What type of secondary hypertension appeared?
A.
B.
C.
D.
E.
Renovascular
Metabolic
Endocrine
Neurogenic
Anhiogenic
3.3.19. A patient was diagnosed with renal hypertension. Name the initial pathogenetic factor in the
development of hypertension in this case?
A.
B.
C.
D.
E.
Renal ischemia
Hypernatriemia
Hyperaldosteronism
Increased renin synthesis
Increased angiotensin synthesis
3.3.20. A 65-year-old female suffers from atherosclerosis of brain vessels. Laboratory examination
discovered hyperlipidemia. Increase of what class of plasma lipoproteins has been detected in this
biochemical study?
A.
B.
C.
D.
E.
Low density lipoproteins
Alpha-lipoproteins
Hilomicrons
High density lipoproteins
Complexes of fatty acids with albumin
3.3.21. Nowadays it has been proved that not native but modified lipoproteins play a central role in the
development of atherosclerosis. Capture and accumulation of modified complexes in the vascular wall is
accomplished by:
A.
B.
C.
D.
E.
Monocytes
Fibroblast
Endothelial cells
Myocytes
Neutrophils
3.3.22. Rabbits were fed with foods supplemented with cholesterol. Atherosclerotic changes in aorta were
revealed after 3 months. What is the main cause of atherosclerosis in this case?
A.
B.
C.
D.
E.
Exogenous hypercholesterolemia
Overeating
Stress
Hypodynamia
Endogenous hypercholesterolemia
3.3.23. A 35-year-old patient has been diagnosed with arterial hypertension. What is characteristic of
primary pulmonary hypertension?
A.
B.
C.
D.
E.
Dyspnea and cyanosis
Edema of lower extremities
Paroxysmal tachycardia
Cough
Bradycardia
3.3.24. A 47-year-old patient has been diagnosed with atherosclerosis. What is the initial moment in the
pathogenesis of atherosclerosis?
A.
B.
C.
D.
E.
Excessive deposition of plasma lipoproteins in the artery’s intima
Slowdown of blood flow
Proliferative-degenerative changes of endarterium
Formation on the inner shell artery fibrous plaques
Impairment of the arterial walls integrity
3.3.25. A 62-year-old patient has been treated for arterial hypertension for 20 years. Recently he began to
feel dizziness and twinkling in the eyes. What is the most likely complication of hypertensive disease one
should beware of?
A.
B.
C.
D.
E.
Stroke
Myocardial infarction
Renal insufficiency
Pulmonary hypertension
Shock
3.3.26. An autopsy revealed atherosclerotic changes in aorta and arteries of flexible and muscular-elastic
types. Which functional type do these vessels belong to?
A.
B.
C.
D.
E.
Compensatory vessels
Resistant vessels
Shunt vessels
Vessels of exchange
Reservoir vessels
3.3.27. Following a 38-year-old woman’s family history it has been revealed that the patient has an
inherent predilection to atherosclerosis due to high incidence of the disease in her family members.
Atherosclerotic changes in the woman began to appear 2 years ago when a routine hysterectomy and
removal of ovaries were performed. Which of the following etiological factors is responsible in the
development of atherosclerosis in this woman?
A.
B.
C.
D.
E.
Insufficiency of sex glands function
Hereditary factor
Female gender
Age of the patient
High content of fats on her diet
3.3.28. A 54-year-old man has been diagnosed with hypertension. Which type of hypertension can be this
nosological unit attributed to?
A.
B.
C.
D.
Essential
Due to renovascular disorders
Due to disorders in mineralocorticoids metabolism
Due to salt disorders
3.3.29. A 56-year-old man has been affected by atherosclerosis of aorta, coronary arteries, cerebral
arteries, and arteries of lower limbs. Due to decreased elasticity these vessels:
A.
B.
C.
D.
E.
Can not adequately alter their diameter according to tissues’ needs
Can be obstructed by an exogenous embolus
Can be obstructed by an endogenous embolus
Can undergo spasm
May be replaced with connective tissue
3.3.30. A 55-year-old man has developed impairment of functional state of cortical and subcortical centers
regulating vascular tone. Hypertension, resulting from bilateral cerebral ischemia can be attributed to:
A.
B.
C.
D.
E.
Central ischemic
Reflexogenic
Renovascular
Due to disorders in glucocorticoids metabolism
Due to disorders in mineralocorticoids metabolism
3.3.31. A patient suffers from hypertensive disease. What hemodynamic type of hypertension does
essential hypertension belong to?
A.
B.
C.
D.
E.
Hypokinetic
Hyperkinetic
Eukinetic
Not to any of these types
Not any of these types
3.3.32. A patient due to impairment of renal circulation developed arterial hypertension. What has a direct
impact on the precapillary vascular wall?
A.
B.
C.
D.
E.
Angiotensin II
Angiotensin
Renin
Aldosterone
Angiotensynase
3.3.33. A 45-year-old patient developed circulatory failure by right heart type. What type of hypertension
developed in this case?
A.
B.
C.
D.
E.
Pulmonary hypertension
Central ischemic hypertension
Essential hypertension
Reflexogenic hypertension
Salt hypertension
3.3.34. A 56-year-old woman weighing 120 kg developed constant pain in the heat region, that is a
consequence of atherosclerotic changes in coronary vessels. Increased levels of which substances in the
blood is important in the pathogenesis of atherosclerosis?
A.
B.
C.
D.
E.
Low density lipoproteins
Alpha- lipoproteins
High density lipoproteins
Hilomicrons
Fatty acids
3.3.35. A 56-year-old patient suddenly felt a sever retrosternal pain irradiating to the left hand,
accompanied with a fear of death. Face became pale coated with cold sweat. Nitroglycerin did not alleviate
the pain. The diagnosis of myocardium infarction was established. What is the most frequent cause of
myocardial ischemia?
A.
B.
C.
D.
E.
Atherosclerosis of coronary arteries
Spasm of coronary arteries
Thrombosis of heart vessels
Coronary embolism
Aggregation of erythrocytes in coronary vessels
3.3.36. A 42-year-old man with chronic heart failure developed edema of the lower extremities. The main
role in the development of edema is performed by:
A.
B.
C.
D.
E.
Increased hydrostatic pressure
Increased plasma oncotic pressure
Increased plasma osmotic pressure
Reduction of hydrostatic pressure
Urorrhagia (polyuria)
3.3.37. A 52-year-old patient died of myocardial infarction, that was confirmed by clinical and
electrocardiographic examinations; nevertheless autopsy did not found any evidence of sclerotic changes in
coronary vessels. What was the probable cause of myocardial infarction in this patient?
A.
B.
C.
D.
E.
Increased secretion of catecholamines
Increased sympathetic tone of the autonomic nervous system
Obturation of coronary vessels by an embolus
Coronary thrombosis
Rheumatoid coronaritis
3.3.38. A 46-year-old patient with ischemic heart disease on the basis of arteriosclerotic lesions of coronary
arteries after considerable physical exertion developed acute myocardial infarction. What is the most likely
cause of coronary circulation failure in this case?
A.
B.
C.
D.
E.
Coronary artery stenosis
Embolism of coronary arteries
Coronary artery thromboembolism
Rupture of coronary artery
The blood redistribution
3.3.39. A 54-year-old female experiences cardiac arrhythmia with generation of cardiac contractions up to
400 b/min. Pulse rate is lower than the heart rate, suggesting disorders in excitability and conduction. What
pathology may cause such changes?
A.
B.
C.
D.
E.
Cardiosclerosis
Coronarosclerosis
Coronary embolism
Coronary stenosis
Coronary thrombosis
3.3.40. The first stage in the pathogenesis of atherosclerosis is:
A.
B.
C.
D.
E.
Excessive deposition of plasma lipoproteins in the inner membrane of arteries
Slowdown of blood flow
Proliferative degenerative changes of the intima
Formation of fibrous plaques on the inner artery’s wall
Disturbance of the arterial wall integrity
3.3.41. What is the main cause of hypertension in diabetes mellitus?
A.
B.
C.
D.
E.
Atherosclerosis
Renal failure
Heart failure
Lack of insulin
Hyperglycemia
3.3.42. A 43-year-old patient with pheochromocytoma (adrenal medullar tumor producing epinephrine)
developed elevated blood pressure. What type of hypertension can this blood pressure change be
attributed to?
A.
B.
C.
D.
E.
Secondary
Primary
Essential
Compensated
Tertiary
3.3.43. A 61-year-old female developed general adynamy, fatigue, shortness of breath, dizziness, and
headaches. Arterial pressure is decreased. What is the cause of the symptoms described?
A. Hypoxemia
B. Heart failure
C. Vascular insufficiency
D. Respiratory failure
E. Intoxication
3.3.44. After acute blood loss a patient developed hypotension. What is the cause of lowering blood
pressure?
A.
B.
C.
D.
E.
Anemia
Vasodilation
Increased tone of parasympathetic nervous system
Decreased tone of parasympathetic nervous system
Loss of blood proteins
3.3.45. An experimental animal while experiment developed inhibition of brain that spread on subcortical
vegetative structures, in particular – on vasomotor center. What changes of blood pressure are supposed
to occur?
A.
B.
C.
D.
E.
Reduction
No change
Increase
Oscillation
Increase and then return to normal level
3.3.46. A 34-year-old patients has blood pressure 140/100 mm Hg. What is the pulse pressure in the
patient?
A.
B.
C.
D.
E.
40
100
140
240
70
3.4. EXTERNAL BREATHING
3.4.1. A marked surfactant deficiency is observed in a patient with respiratory distress-syndrome as a result
of activation of lipids peroxide oxidation. What pathological changes will develop in lungs due to the
absence of this substance?
A.
B.
C.
D.
E.
Atelectasis
Emphysema
Bronchoconstriction
Edema
Lymphostasis
3.4.2. A patient with penetrating chest wall wound has been hospitalized. What pathogenetic form of the
external breathing disorder will develop in the patient?
A.
B.
C.
D.
E.
Restrictive
Obstructive
Primary dyskinetic
Diffuse-restrictive
Diffuse-pneumonic
3.4.3. Why has the application of the pure oxygen in a patient aggravated respiratory failure?
A.
B.
C.
D.
E.
Due to surfactant destruction
Due to oxygen toxicity of alveoli
Due to oxygen toxicity on the breathing centre
Breathing centre depression
Obstructive disorders ob external breathing
3.4.4. A patient on the basis of encephalitis developed breathing disorders, that are characterized by
constant amplitude, but occasionally breathing movements suddenly stop and then continue. What type of
pathological breathing has place in this patient?
A.
B.
C.
D.
E.
Biot’s
Apnea
Isteric
Cousmaul’s
Chein-Stocks’
3.4.5. A 57-year-old man has been hospitalized with the diagnosis of pneumoconiosis. Disorder of which
component of external breathing can be considered the main one?
A.
B.
C.
D.
E.
Gas diffusion disorder
Lungs ventilation disorder
Gas perfusion disorder
External breathing nervous regulation disorder
External breathing humoral regulation disorder
3.4.6. A 50-year-old man suffering from chronic bronchitis complains of breathlessness while exercising,
constant cough with sputum. On examining the patient a complication - pulmonary emphysema was
diagnosed. What has caused it?
A.
B.
C.
D.
E.
Reduction of lung elasticity
Reduction of the alveolar ventilation
Reduction of lung compliance
Reduction of the total blood flow in the lungs
Abnormal lung ventilation-perfusion ratio
3.4.7. Epileptic seizures in a patient were complicated by asphyxia due to destruction of dental prosthetic
appliances and their aspirations. Determine the type of respiratory failure in the patient:
A.
B.
C.
D.
E.
Ventilation obstructive
Ventilation restrictive
Ventilation dysregulatory
Perfusion
Diffusion
3.4.8 A patient with a deep vein thrombophlebitis of a leg has suddenly felt lack of the air, blood in the
sputum and acute decrease of blood pressure appeared. Thrombembolism of pulmonary artery has been
diagnosed. What kind of respiratory failure has the patient developed?
A.
B.
C.
D.
E.
Perfusion
Diffusion
Ventilation dysregulatory
Ventilation obstructive
Ventilation restrictive
3.4.9. As a result of an accident obturation of the trachea has occurred. Which stage of respiration will
suffer first?
A.
B.
C.
D.
E.
Ventilation of the lungs
Gas exchange in the lungs
Diffusion
Perfusion
Tissue respiration
3.4.10. In premature infants respiratory distress syndrome is frequently observed. What is the most likely
reason for this pathological state?
A.
B.
C.
D.
E.
Immaturity of lung alveoli due to lack of surfactant
Intrauterine asphyxia
Aspiration of amniotic fluid
Immaturity of nervous regulation of the respiratory act
Intrauterine hypercapnia of the fetus
3.4.11. A 47-year-old patient of the intensive care unit due to cranial trauma suddenly developed seizures
on the background of clarification of consciousness, short-lasting stop of breathing has changed by sighs of
decrescendo character. What type of breathing has developed in the patient?
A.
B.
C.
D.
E.
Gasp-breathing
Chein-Stokes respiration
Biot’s breathing
Kusmaul’s breathing
Apnoea
3.4.12. A newborn child is marked for skin pallor and dispnoea. Multiple diffuse atelectasis are observed on
the chest roentgen examination. What is the most likely cause of this condition?
A.
B.
C.
D.
E.
Deficiency of surfactant
Pneumothorax
Tuberculosis
Bronchial asthma
Hydrothorax
3.4.13. A young man in unconscious state has been hospitalized with suspicion on drug poisoning. What
kind of respiratory disorder should be expected in the man?
A.
B.
C.
D.
E.
Chein-Stokes respiration
Kussmaul's respiration
Stenotic breathing
Eupnoea
Hyperpnoee
3.4.14. Which factor plays a major role in the pathogenesis of periodic breathing with cerebral
hemorrhage?
A.
B.
C.
D.
E.
Brain hypoxia
Irritation of respiratory center
Damage to medulla oblongata
Damage of functions of spinal cord motoneurons
Intracranial pressure
3.4.15. A 5-year-old child sustained food aspiration during lunch. He developed a sever cough which ended
by expectoration of bread pieces. The skin and mucous membranes are cyanotic. Pulse is accelerated,
breathing is rare with prolonged exhalation. The doctor diagnosed foreign body in larynx. What is the stage
of asphyxia?
A.
B.
C.
D.
E.
Second
First
Third
Fourth
Fifth
3.4.16. A patients was found to have a significant infiltration in the lungs. What is affected the most:
ventilation, diffusion or perfusion?
A.
B.
C.
D.
Diffusion
Perfusion
Ventilation
Perfusion and diffusion
E. Perfusion and ventilation
3.4.17. A 5-year-old child with diphtheria developed laryngeal oedema. What type of respiratory
insufficiency developed in the patient?
A.
B.
C.
D.
E.
Obstructive respiratory insufficiency
Restrictive respiratory insufficiency
Disorder of non-respiratory lung functions
Mixed respiratory failure
Restrictive and obstructive respiratory insufficiencies
3.4.18. What does not cause obstructive respiratory insufficiency?
A.
B.
C.
D.
E.
Fibrosis and inflammation
Bronchioles spasm and swelling of the airways
Bronchioles spasm
Airway obstruction
Spasm of bronchioles and their fibrosis
3.4.19. A 33-year-old patient developed the bronchial asthma attack. What type of breathing is observed in
this patient?
A.
B.
C.
D.
E.
Expiratory dipnoea
Inspiratory dipnoea
Apnea
Gasp-breathing
Hyperpnoe
3.4.20. What type of the external respiration disorder is associated with the patient's feeling of lack of air?
A.
B.
C.
D.
E.
Dyspnoe
Hyperpnoe
Apnea
Hyperventilation
Bradipnoe
3.4.21. Amplitude of breathing movements of a patient with a disorder of the central nervous system
became irregular with periods of increasing and then decreasing inspiration up to complete apnoea. What
type of breathing does it correspond to?
A.
B.
C.
D.
E.
Cheyne-Stokes’ respiration
Biot’s respiration
Terminal breathing
Apnoea breathing
Gasp breathing
3.4.22. A patient sustained a penetrating chest wound. What pathogenetic kind of respiratory failure
should develop in this case?
A. Restrictive
B.
C.
D.
E.
Obstructive
Mixed
Dysregulatory
Parenchymal
3.4.23. What suggest to the onset of the second period of asphyxia?
A.
B.
C.
D.
E.
Bradycardia, intensification of expiration, narrowing of the pupils, decrease of blood pressure
Bradycardia, intensification of expiration, narrowing of the pupils, increased blood pressure
Tachycardia, intensification of expiration, narrowing of the pupils, decrease of blood pressure
Bradycardia, intensification of inspiration, narrowed pupils, decrease of blood pressure
Bradycardia, intensification of expiration, dilation of pupils, decrease of blood pressure
3.4.24. A 49-year-old patient developed hyperpnoea. What is possible cause of hyperpnoea?
A.
B.
C.
D.
E.
Reflex stimulation of the respiratory center
Inhibition of the respiratory center
Reduction of respiratory neurons excitability
Hyperoxia
Increased resistance of the air movement in the upper respiratory ways
3.4.25. What underlies the development of ventilation respiratory insufficiency in a patient with
pneumothorax?
A.
B.
C.
D.
E.
Reduction of the amount of functioning alveoli
Impairment of the elastic properties of lungs
Impairment of the breathing airways passability
Malfunction of respiratory center
Malfunction of neuro-muscular apparatus
3.4.26.What can not be the cause of pulmonary perfusion disorders?
A.
B.
C.
D.
E.
Reduction of the diffusion area
Reduction of the pressure in the right ventricle
Increased pressure in the left atrium
Increased blood viscosity
Collapse
3.4.27. What changes of gas composition and acid-base balance are characteristic of patients with
parenchymatous respiratory failure?
A.
B.
C.
D.
E.
Hypoxia, hypocapnia, gas alkalosis
Hypoxia, hypercapnia, gas alkalosis
Hypoxia, hypocapnia, gas acidosis
Hypoxia, hypercapnia, gas acidosis
Hyperoxia, hypocapnia, gas alkalosis
3.4.28. A 61-year-old patient has been diagnosed with parenchymal respiratory failure. What mechanisms
underlie its appearance?
A. Abnormality of gases diffusion
B.
C.
D.
E.
Abnormality of the central regulation
Abnormality of the airways passability
Reduction of the number of alveoli
Reduction of vital lung capacity
3.4.29. A patient developed hyperpnoea. What does it mean?
A.
B.
C.
D.
E.
Deep and frequent breathing
Deep and periodic breathing
Shallow and frequent breathing
Deep and sparse breathing
Sparse periodic breathing
3.4.30. A patient developed pulmonary embolism. What abnormalities are supposed to arise first of all?
A.
B.
C.
D.
E.
Perfusion respiratory failure
Ventilation respiratory insufficiency
Abnormality of ventilation-perfusion ratio
Restrictive lung disorders
Obstructive lung disorders
3.4.31.What changes of lung ventilation indexes will indicate restrictive respiratory insufficiency?
A. Reduction of: vital lung capacity, inspiratory reserved volume, total lung capacity
B. Increase of: vital lung capacity, inspiratory reserved volume, total lung capacity
C. Reduction of vital lung capacity, increased inspiratory reserved volume, increased total lung
capacity
D. Increase of vital lung capacity, increase of inspiratory reserved volume, reduced total lung capacity
E. Increase of vital lung capacity, reduction of inspiratory reserved volume, increased total lung
capacity
3.4.32. The total lung capacity can be assessed by estimation of the following parameters:
A.
B.
C.
D.
E.
Inspiratory reserved volume, expiratory reserved volume, breathing volume, residual lung volume
Inspiratory reserved volume, expiratory reserved volume, breathing volume
Inspiratory reserved volume, expiratory reserved volume, breathing volume, residual lung volume
Inspiratory volume, breathing volume, expiratory reserved volume
Inspiratory reserved volume, expiratory reserved volume, residual lung volume
3.4.33. A 54-year-old man with myocardial infarction choked with his prosthetic jaw. What pathogenic form
of breathing disorder developed in this patient?
A.
B.
C.
D.
E.
Obstructive
Primary dyskinetic
Ventilation-restrictive
Diffusion-restrictive
Diffusion-pneumonic
3.4.34. In a patient with cavitary form of tuberculosis reduced membrane area through which oxygen and
carbon dioxide diffusion occurs has developed. What is the most likely change in the blood gas composition
of the patient?
A.
B.
C.
D.
E.
Hypoxemia
Hypercapnia
Hypocapnia
Hypoxemia, hypercapnia
Hypoxemia, hypocapnia
3.4.35. A child has suddenly sustained aspiration with a small toy that caused a bronchiole obturation.
What kind of pathological breathing is the child supposed to develop?
A.
B.
C.
D.
E.
Stenotic breathing
Hyperventilation
Biot’s breathing
Kussmaul's respiration
Chein-Stokes respiration
3.4.36. Clinical examination of a 76-year-old patient identified a significant increase in residual lung volume,
which leads to expiratory type of dyspnoea. What pathology is most likely to be responsible for this
condition in the patient?
A.
B.
C.
D.
E.
Lung emphysema
Infection pleuritis
Pulmonary edema
Pneumonia
Pulmonary tuberculosis
3.4.37. What form of respiratory failure is surfactant deficiency responsible for?
A.
B.
C.
D.
E.
Restrictive
Central
Peripheral
Thoraco-diaphragmatic
Obstructive
3.3.38. What kind of respiratory insufficiency is observed with a bout of bronchial asthma?
A.
B.
C.
D.
E.
Obstructive
Restrictive pulmonary
Thoraco-diaphragmatic
Central
Peripheral
3.4.39. A patient is experiencing a significant shortage of surfactant. What pathological changes will occur
in the pulmonary tissue in the absence of this substance?
A.
B.
C.
D.
E.
Atelectasis
Emphysema
Bronchospasm
Edema
Limfostasis
3.4.40. A patient has been diagnosed with bronchial asthma. What changes of pulmonary ventilation
indexes are supposed to occur?
A.
B.
C.
D.
E.
Reduction of forced expiration volume
Increase of forced expiration volume
Increase of the reserved expiration volume
Reduction of residual lung volume
Increase of the lungs vital capacity
3.4.41. What kind of respiratory insufficiency is characteristic of emphysema?
A.
B.
C.
D.
E.
Obstructive respiratory insufficiency
Restrictive respiratory insufficiency
Dysregulatory respiratory failure
Impairment of gases diffusion
Impairment of gases perfusion
3.4.42. What is the cause of atelectasis?
A.
B.
C.
D.
E.
Spasm of bronchial smooth muscles
High pressure in the pleural cavity
Bronchial obstruction
Deficiency of surfactant
Pneumothorax
3.4.43. What is most important in the development of pneumothorax?
A.
B.
C.
D.
E.
Reduction of transpulmonary pressure
Periodic breathing
Inhibition of respiratory center function
Increased transpulmonary pressure
Impairment of gases diffusion
3.4.44. What is characteristic of restrictive respiratory insufficiency?
A. Reduction of lungs compliance, reduction of the total lungs capacity, reduction of the residual lung
volume
B. Increased inspiratory reserved volume
C. Increased residual lung volume, increased lungs compliance
D. Reduction of lungs compliance, increased total lungs capacity
E. Increased inspiratory and expiratory reserved volumes
.4.45. What ratio of the lung ventilation / perfusion can be considered normal?
A.
B.
C.
D.
E.
0.95
1.45
1.25
0.75
0.55
3.4.46. To an experimental animal cutting of both nervus vagus has been performed. What breathing
disorder is supposed to emerge in this case?
A.
B.
C.
D.
E.
Deep and sparse breathing
Kussmaul's respiration
Frequent shallow breathing
Gasp-breathing
Chein-Stokes respiration
3.4.47. Which of the following is the most essential for establishing symptom of breathlessness?
A.
B.
C.
D.
E.
Feeling of lack of air
Change of respiration rate
Change of the rhythm of breathing
Change of the depth of breathing
Increase of breathing volume for one minute
3.4.48. What pathological state is associated with increase of the lung reserved volume?
A.
B.
C.
D.
E.
Bronchial asthma
Atelectasis
Pneumonia
Pulmonary fibrosis
Surfactant deficiency
3.4.49. Name the types of periodic breathing.
A.
B.
C.
D.
E.
Biot’s breathing
Kussmaul's respiration
Gasp-breathing
Stenotic breathing
Apnoea breathing
3.5. DIGESTIVE SYSTEM
3.5.1. A patient with acute pancreatitis has sharply increased serum trypsin activity and decreased blood
pressure (80/60 mm Hg). What is the influence of trypsin on blood pressure?
A.
B.
C.
D.
E.
Activation of kinins synthesis
Inhibition of kinins synthesis
Activation of angiotensin II synthesis
Inhibition of angiotensin II synthesis
Activation of aldosterone synthesis
3.5.2. When examining a patient with peptic ulcer disease it was found that the gastric secretion reached
its maximum level 5 minutes after eating, and its decline occurred after 1 hour 25 min. What type of gastric
secretion is characteristic of this patient?
A.
B.
C.
D.
E.
Excitatory
Normal
Brake
Asthenic
Inert
3.5.3. Stenosis of pylorus was revealed on X-ray examination of a patient with peptic ulcer disease. This
disorder is:
A.
B.
C.
D.
E.
Pathologic state
Pathological process
Disease
Pathological reaction
Compensatory phenomenon
3.5.4. A patient visited a doctor complaining of “hunger” pains in the epigastrium, discomfort after eating
coarse, oily, spicy food. On examination a defect of gastric mucosa was revealed. The patient’s history is
marked for a long-lasting uncontrollable treatment with glucocorticoids. The main component in the
pathogenesis of the disorder was:
A.
B.
C.
D.
E.
Lack of prostaglandin
Excess of histamine
Increased tone of nervus vagus
Excess of prostaglandins
Lack of histamine
3.5.5. A 40-year-old patient complains of heartburn, constant belches, pain in epigastrium, frequent
constipation, which has been troubling him for a month. Which type of gastric secretory function disorders
do these clinical symptoms belong to?
A.
B.
C.
D.
Hypersecretory type
Hyposecretory type
Achilia
Dissociation of secretory process
E. Reduction of proteolytic activity of gastric juice
3.5.6. A 55-year-old patient has undergone partial removal of the pancreas. What products need to be
restricted in the patient’s diets?
A.
B.
C.
D.
E.
Sweets, fatty meat, strong broths
Lean boiled meat
Dairy products
Vegetables rich in protein (e.g. beans)
Fruits
3.5.7. Scatological study revealed discolored feces with drops of neutral fat in it. The most likely reason for
this pathology is the disorder of:
A.
B.
C.
D.
E.
Inflow of bile in the intestine
Acidity of gastric juice
Secretion of pancreatic juice
Processes of absorption in the intestine
Secretion of intestinal juice
3.5.8. The acute stress was reproduced in the experiment on white rats, after which multiple gastric ulcers
developed in the animals. The mechanism of the development of the ulcers in stress include:
A.
B.
C.
D.
E.
Mucosal ischaemia
Mucosal congestion
Increased secretion of mucus
Increased endorphin secretion
Activation of constituent of NO-synthase
3.5.9. A patient with peptic ulcer was found to have an ulcer in the area of small curvature of the stomach.
Which of the following factors primarily determine the localization of this lesion?
A.
B.
C.
D.
E.
A small number of parietal cells
Weak gastric mucous barrier
Neural trophic factor
Disorder of the stomach blood supply
Chronic irritation of nervus vagus
3.5.10. A patient addressed his doctor with complaints of a belch with the smell of hydrogen sulphide,
indicating the processes of fermentation in the stomach. What disorder of gastric juices secretion is this
symptom typical of?
A.
B.
C.
D.
E.
Achlorhydria
Hypersecretion
Hyperchlorhydria
Hyposecretion
Hypochlorhydria
3.5.11. Complete experimental removal of the duodenum in animals is incompatible with life (S. London).
Loss of which function is the sever disorder in the experimental animals’ life related to?
A.
B.
C.
D.
E.
Incretory
Secretory
Movement
Absorptive
Excretory
3.5.12. A patient’s gastric juice acidity is 20 units. Which of the listed diseases is a significant reduction of
gastric juice acidity characteristic of?
A.
B.
C.
D.
E.
Chronic atrophic gastritis
Chronic hypertrophic gastritis
Chronic colitis
Duodenal ulcer
Stomach ulcerative disease
3.5.13. In the pathogenesis of gastric and duodenal ulcer disease a major significance belongs to:
A.
B.
C.
D.
E.
Disequilibrium between aggressive and protective factors of gastric secretion
Status of hyperacidity
Disorder of the stomach and duodenum microcirculation
Injury of the gastric mucosa by stomach contents
Inflamed gastric and duodenum mucosa
3.5.14. Malabsorption syndrome is:
A.
B.
C.
D.
E.
A syndrome of intestinal absorption disorder
A syndrome of membrane digestion disorder
A syndrome of the stomach absorption disorder
A syndrome of small intestine absorption disorder
A syndrome of proteins absorption disorder
3.5.15. A 74-year-old patient with problems of chewing has enhanced salivation. What has caused it?
A.
B.
C.
D.
E.
Increased irritation of masseter’s proprioreceptors
Irritation of taste receptors
Irritation of oral mucosa pain receptors
Reflex from gastric receptors
Adaptation of salivary glands to a coarse meal
3.5.16. What could be the cause of augmentation of the of the stomach motility in a patient with stomach
hyperkinesis?
A.
B.
C.
D.
E.
Gastric ulcer disease
Hypoacidic gastritis
Atrophic gastritis
Feeding
Achilia
3.5.17. Which of the following substances inhibits gastric motor function?
A.
B.
C.
D.
E.
Secretin
Motylin
Acetylcholine
Histamine
Gastrin
3.5.18. A patient with atrophic gastritis developed achilia. What changes in the gastric secretion
composition are characteristic of atrophic gastritis?
A.
B.
C.
D.
E.
Lack of hydrochloric acid and enzymes
Absence of free hydrochloric acid
The appearance of bile acids in the blood
Absence of bile in the intestines
Hyperacidic state
3.5.19. What can be the cause of the membrane digestion disorder in the intestine of a patient with
malabsorbtion syndrome?
A.
B.
C.
D.
E.
Hereditary enzymopathies of enterocytes
Reduced gastrin secretion
Increased gastrin secretion
Achilia
Excessive protein consumption
3.5.20. What can lead to a luminal digestion disorder in a patient with maldigestion syndrome?
A.
B.
C.
D.
E.
Pancreatitis
Glucagon secretion disorder
Avitaminosis B6
Excessive protein consumption
Lack of fats in food
3.5.21. Acute intestinal obstruction developed in a patient with small intestine intussusception. What
contributes to the development of shock in acute intestinal obstruction?
A.
B.
C.
D.
E.
Pain and dehydration
Nausea and vomiting
Diarrhea and flatulence
Decrease of blood pressure
Acid-base balance disorder
3.5.22. What of the following can be a possible reason of mechanical intestinal obstruction?
A.
B.
C.
D.
E.
Coprostasia
Intestinal smooth muscle paresis
Intestinal smooth muscle spasm
Flatulence
Constipation
3.5.23. Intestinal obstruction is characterized by the following features:
A.
B.
C.
D.
E.
Pain, dehydration, acid-base disorder
Constipation, reduced intestinal peristalsis
Flatulence, and pain
Cyanosis and edema of lower extremities
Increase of blood pressure, pain, and thirst
3.5.24. Which of the following processes may lead to the development of intestinal obstruction?
A.
B.
C.
D.
E.
Paralysis of smooth muscles of the intestine
Bile excretion disorder
Pancreatic secretion disorder
Flatulence
Constipation
3.5.25. What could be the cause of reduced pancreatic juice secretion?
A.
B.
C.
D.
E.
Vagotomy
Augmented tone of the nerve vagus
Increased gastrin secretion
Increased cholecystokinin synthesis
Excessive sweets consumption
3.5.26. Select one possible cause of acute pancreatitis:
A. Excessive use of alcohol
B. Excessive intake of carbohydrates
C. Starvation
D. Dehydration
E. Smoking
3.5.27. Point out possible cause of hyperchlorhydria:
A.
B.
C.
D.
E.
Increased tone of pneumogastric nerve
Decreased tone of pneumogastric nerve
Vagotomy
Hyperadrenalinaemia
Hypoparathyroidism
3.5.28. Which of the following factors can be attributed to risk factors for ulcer disease?
A.
B.
C.
D.
E.
Duodenal-gastric reflux
Gastric-esophageal reflux
Excessive consumption of sweets
Atrophic gastritis
Dumping syndrome
3.5.29. What can be attributed to the ulcerogenic effects of excess corticosteroids?
A. Increased secretion of gastrine
B. Stimulation of prostaglandin E synthesis
C. Reduction of gastric juice secretion
D. Increased formation of mucus in the stomach
E. Atrophy of gastric mucosa
3.5.30. Achylia may be observed with:
A.
B.
C.
D.
E.
Atrophic gastritis
Minkowski-Shoffar’s anemia
Duodenal-gastric reflux
Pituitary Cushing disease
Adenoma of parathyroid glands
3.5.31. What can be associated with increase peristalsis of the stomach?
A.
B.
C.
D.
E.
Overproduction of motilin
Overproduction of secretin
Vagotomy
Decreased tone of pneumogastric nerve
Decreased acidity of the gastric juice
3.5.32. Indicate that can develop as a result of achlorhydria?
A.
B.
C.
D.
E.
Diarrhea
Constipation
Heartburn
Prolonged food retention in the stomach
Prolonged food retention in the intestines
3.5.33. What disease is oversecretion of gastric juice characteristic of?
A.
B.
C.
D.
E.
Pituitary Cushing disease
Gastric cancer
Atrophic gastritis
Pernicious anemia
Dumping syndrome
3.5.34. What does belong to inhibitors of gastric secretion?
A.
B.
C.
D.
E.
Gastroinhibitory peptide
Acetylcholine
Histamine
Cholecystokinin
Gastrin
3.5.35. Which of the listed substances belongs to stimulants of gastric secretion?
A.
B.
C.
D.
E.
Histamine
Kalikrein
Secretin
Glucagon
Gastroinhibitory peptide
3.5.36. What can result from hypersalivation?
A.
B.
C.
D.
E.
Neutralization of gastric juice
Heartburn
Gastro-esophageal reflux
Intestinal bacteria overgrowth
Atrophy of mouth cavity mucosa
3.5.37. One of the components of gastric juice is:
A.
B.
C.
D.
E.
Pepsinogenes
Amylase
Secretin
Chemotripsin
Insulin
3.5.38. Which of the following etiologic factors can bring about vomiting?
A.
B.
C.
D.
E.
Increased intracranial pressure
Increased blood pressure
Hypothermia
Increased sympathetic tone of the autonomic nervous system
Fever
3.5.39. Which of the following etiological factors may cause hyposalivation?
A.
B.
C.
D.
E.
Fever
Irritation of mucous membrane of the mouth
Increased tone of pneumogastric nerve
Hypothermia
Increased tone of pneumogastric nerve
3.5.40. Hypersalivation can be caused by
A.
B.
C.
D.
E.
The appearance of delicious food
Atrophy of mucous membrane of the mouth
Increased tone of sympathetic nervous system
Vagotomy
Dehydration of the organism
3.5.41. Y.S. London’s experiments of complete or partial removal of the duodenum in animals first
demonstrated the vital importance of the duodenum for the organism. It has been established that
extirpation of the duodenum caused profound disorders of metabolic functions of the nervous and
endocrine systems. Loss of which function of the duodenum are the mentioned above changes connected
with?
A.
B.
C.
D.
E.
Incretory
Secretory
Absorptive
Motile
Excretory
3.5.42. A patient during surgery has sustained injury of glossopharyngeal nerve. In the postoperative period
the patient could not eat and drink, food was aspirated into the airways. What is the term of the
phenomenon described above?
A.
B.
C.
D.
E.
Dysphagia
Anorexia
Bulemia
Increased appetite
Decreased appetite
3.5.43. A 46-year-old patient with antral gastritis presents with the stomach secretory function disorders,
namely - hypersecretion and hyperchlorhydria. What changes of basal and maximal gastric secretion are
observed in this case?
A.
B.
C.
D.
E.
Increased basal and maximal secretion
Decreased basal and maximal secretion
Increased basal and reduced maximal secretion
Increased maximum without changes in basal secretion
Basal and maximal secretions do not change
3.5.44. A 50-year-old patient due to the numerous inflammatory processes in the mouth cavity developed
hypersalivation. In this regard, there is neutralization of gastric juice and duodenal contents. What is the
main pathogenetic component in causing these processes in the patient?
A.
B.
C.
D.
E.
Increased levels of motilin in the blood
Increased levels of gastric inhibitory peptide in the blood
Increased levels of vasoactive intestinal peptide in the blood
Increased levels of secretin in the blood
Reduction of the histamine level
3.5.45. A 25-year-ld patient addressed the doctor complaining of weakness, fatigue, constant nausea and
frequent vomiting. She was diagnosed: early pregnancy toxicosis. What is the pathogenesis of nausea and
vomiting in this case?
A.
B.
C.
D.
Irritation of emetic center by impulses from uterus
Irritation of emetic center by impulses from the stomach
Increased intracranial pressure
Irritation of emetic center by the impulses from higher nervous centers (in response to unpleasant
odors)
E. Pathological pregnancy
3.5.46. While reproducing an experimental ulcer disease in rats, the animals were injected with
Prostaglandins E1 and E2. How will this tissue hormones affect the process of ulceration?
A.
B.
C.
D.
E.
Slowdown
Aggravate
No affect on ulceration
Stimulate
Initially slowdown, and then enhance
3.5.47. Which of the following digestion disorders is characteristic of a patient with gallbladder stone
disease?
A.
B.
C.
D.
E.
Luminal digestion disorder
Membrane digestion disorder
Disorder of excretory function of intestines
Disorder of secretory function of intestines
Disorder of incretory function of intestines
3.5.48. What types of digestion disorders will be characteristic of patients with polyps of the pancreatic
duct?
A.
B.
C.
D.
E.
Luminal digestion disorder
Membrane digestion disorder
Disorder of excretory function of intestines
Disorder of secretory function of intestines
Disorder of incretory function of intestines
3.5.49. After intensive treatment with antibiotics a patient developed membrane digestion disorder. What
is responsible for such a disorder in this case?
A.
B.
C.
D.
E.
Atrophy, reduction of intestinal villi and microvilli
Reduction of physiological flora in the gut
Disorder of pancreatic juice secretion
Processes of decomposition and fermentation in the guts
Increased production of enzymes
3.5.50. After partial resection of the small intestine, a patient developed intestinal obstruction. Which
pathogenetic type can this intestinal obstruction be referred to?
A.
B.
C.
D.
E.
Paralytic (postoperative)
Mechanical
Spastic
Helminthic
Hyperkinetic
3.6. LIVER
3.6.1. A 58-year-old man developed cholestatic liver failure. What is the reason for its occurrence?
A.
B.
C.
D.
E.
Obstructive jaundice
Hepatitis B viruses
Liver ischemia
Portal hypertension
Hepatic s poisons
3.6.2. A 62-year-old man developed hepatocellular failure. What is the possible reason for its occurrence?
A.
B.
C.
D.
E.
Hepatitis B viruses
Liver ischemia
Portal hypertension
Obstructive jaundice
Cholestasis
3.6.3. A 45-year-old woman developed hepato-vascular insufficiency. What is the reason for its
development?
A.
B.
C.
D.
E.
Liver ischemia
Cholestasis
Hepatic s poisons
Hepatitis viruses
Obstructive jaundice
3.6.4. What is the possible cause of the development of hepatocellular failure in a patient?
A.
B.
C.
D.
E.
Portal hypertension
Hepatic s poisons
Hepatitis B viruses
Dystrophic lesions of hepatocytes
Necrotic lesions hepatocytes
3.6.5. What carbohydrate metabolism changes will be found in a patient with liver pathology?
A.
B.
C.
D.
E.
Hypoglycemia, galactosemia, fructosuria, reduced activity of glicogenesis
Hyperglycemia, galactosemia, increased activity of glicogenesis
Hypoglycemia, increased activity of glicogenesis, hypogalactosemia
Hypogalactosemia, hyperglycemia, fructosuria
Hyperglycemia, decreased activity of gliconeogenesis, fructosemia
3.6.6. What underlies the development of liver pathology in patients with the following symptoms:
insomnia, emotional lability, headache, dizziness, and drowsiness during a day?
A.
B.
C.
D.
Abnormalities of the antitoxic liver function
Abnormalities of the protein synthesis by the liver
Abnormalities of bile excretion by the liver
Abnormalities of the liver hemodynamic function
E. Abnormalities of the liver excretory function
3.6.7. What changes in the blood are characteristic of patients with hepatic coma?
A.
B.
C.
D.
E.
Increased concentrations of cerebral toxic substances
Reduced concentrations of cerebral toxic substances
Hyperglycemia
Hyponatriemia
Cholemia
3.6.8. What concentration of indirect bilirubin is considered normal for a healthy person?
A.
B.
C.
D.
E.
6.8 - 20.5 micromole / l
6.8 - 20.5 mmol / l
1.7 - 17.0 micromole / l
1.7 - 17.0 mmol / l
4.44 - 6.66 mmol / l
3.6.9. A patient with liver pathology has developed cholaemic syndrome. What is the reason of arterial
hypotension and bradycardia in the patient?
A.
B.
C.
D.
E.
Increased tone of pneumogastric nerve
Decreased tone of pneumogastric nerve
CNS lesion
Irritation of nerve endings
Reduction of bilirubin levels in the blood
3.6.10. What changes are typical for acholic syndrome?
A.
B.
C.
D.
E.
Reduction of lipase activation, reduced fats absorption
Increased lipase activation, reduced fats absorption
Decrease of lipase activation, increased fats absorption
Increased tone of the intestines, reduced fats absorption
Increased fats emulsification, hypervitaminosis
3.6.11. Which type of jaundice is the cholaemic syndrome characteristic of?
A.
B.
C.
D.
E.
Liver and subliver types of jaundice
Liver and supraliver types of jaundice
Subliver and supraliver types of jaundice
Supraliver type of jaundice
All of types of jaundice given above
3.6.12. A 45-year-old patient developed ascites. What is the likely cause of this pathology?
A.
B.
C.
D.
E.
Portal hypertension
Portal hypotension
Hyperproteinaemia
Dyscholia
Bilirubinaemia
3.6.13. How many stages are required for complete removal of the liver with the purpose of modeling liver
failure?
A.
B.
C.
D.
E.
3
I2
4
1
5
3.6.14. What pathologic changes will be observed in an experimental animal (dog) after the liver extirpation
?
A.
B.
C.
D.
E.
Increased serum ammonia concentration
Hyperglycemia
Reduced level of amino acids in the blood
Bilirubinaemia
Bilirubinuria
3.6.15. What is the possible mechanism of the acholic syndrome development?
A.
B.
C.
D.
E.
Reduced hepatocytes function
Hypocinetic dyskinesia
Increase of direct bilirubin levels in the blood serum
Overproduction of secretin
Abnormal transportation of bilirubin in the blood
3.6.16. Which hereditary syndrome is characterized by increased levels of indirect bilirubin?
A.
B.
C.
D.
E.
Gilbert
Dubin-Johnson
Viskott-Oldritch
Rotor
Di Georgi
3.6.17. Which hereditary syndrome is characterized by increased levels of direct bilirubin?
A.
B.
C.
D.
E.
Rotor
Gilbert
Di Georgi
Crigler-Najjar
Louis Barr
3.6.18. A 38-year-old patient complains of the skin itching; objectively: skin jaundice, reduced blood
pressure. What type of jaundice are the following features characteristic of?
A.
B.
C.
D.
E.
Obturation jaundice
Hepatic jaundice
Supraliver jaundice
Haemolytic jaundice
Haemolytic and liver jaundice
3.6.19. A 32-year-old man developed acholic syndrome. Which of the following signs does not belong to
this syndrome?
A.
B.
C.
D.
E.
Tachycardia
Steatorrhea
Colorless stool
Avitaminosis
Constipation
3.6.20. Which of the following reasons can not be the cause of the bile formation abnormalities?
A.
B.
C.
D.
E.
Biliary tract innervation disorders
Liver lesions
Cholecystitis
Protein deficiency in the diet
Small intestine pathology
3.6.21. A 42-year-old patient’s urine has became colored like beer. What is the reason of change of the
urine color?
A.
B.
C.
D.
E.
Appearance of bilirubin in urine
Development of hepatic coma
Portal hypertension
Hepatitis
Haemolysis of erythrocytes
3.6.22. What changes in blood analysis are typical of hemolytic jaundice?
A.
B.
C.
D.
E.
Increased levels of indirect bilirubin
Increased levels of direct bilirubin and stercobilin
Increased levels of indirect bilirubin and cholesterol
Increased levels of direct bilirubin and bile acids
Increased levels of stercobilinogene and direct bilirubin
3.6.23. A 45-year-old female developed dyscholia. What of the following reasons is the most probable
cause of this symptom development?
A.
B.
C.
D.
E.
Bile formation disorders
Weakness of the pump function of the heart
Hyperproteinaemia
Increased levels of cholesterol in blood serum
Encephalopathy
3.6.24. Arterial hypotension and bradycardia in jaundice is caused by:
A.
B.
C.
D.
E.
Increased tone of the pneumogastric nerve
Weakness of the pump function of the heart
Hyperproteinaemia
Increased cholesterol levels in the blood
Encephalopathy
3.6.25. A patient with jaundice has increased levels of direct bilirubin and bile acids in the blood serum;
stercobilinogene in urine was not found. Which type of jaundice is associated with these abnormalities?
A.
B.
C.
D.
E.
Mechanical
Liver
Parenchymal
Haemolytic
Supraliver
3.6.26. In a 38-year-old female developed jaundice in a day after attack of acute pain. Examination of the
patient revealed the following signs: slightly enlarged liver tender to palpation. In the blood: increased
levels of direct bilirubin. Urine is dark, feces discolored. Determine the type of jaundice.
A.
B.
C.
D.
E.
Obstructive jaundice
Haemolytic jaundice
Parenchymal jaundice
Suprahepatic jaundice
Hepatic jaundice
3.6.27. A 33-year-old man has developed weakness, headache, subfebrile temperature and catarrhal
phenomena for a week. A day before coming to the doctor the patient’s sclera became yellow, urine turned
dark. Increased levels of free and conjugated bilirubin are observed in the blood. Urine is of dark brown
colour and turbid, reaction to bilirubin is strongly positive. Stool is poorly coloured. Determine the type of
jaundice.
A.
B.
C.
D.
E.
Hepatic jaundice
Subhepatic
Suprahepatic jaundice
Haemolytic jaundice
None of the above listed
3.6.28. What caused the development of Kussmaul’s type of respiration in the patient with severe course of
viral hepatitis?
A.
B.
C.
D.
E.
Abnormalities of the antitoxic liver function
Abnormalities of phagocytic function of the liver
Vitamin metabolism disorders
Abnormalities of protein synthesis by the liver
Pulmonary dysfunction
3.6.29. On the 2nd day after parturition of the third child a Rh-negative woman with Rh-positive husband
developed pronounced jaundice of the skin and mucous membranes. What changes should be expected in
the blood of the woman?
A.
B.
C.
D.
E.
Increased indirect bilirubin
Increased direct bilirubin
Decreased indirect bilirubin
Decreased direct bilirubin
Decreased direct and increased indirect bilirubin
3.6.30. What does the emergence of high levels of conjugated (direct) bilirubin in the blood serum with
parenchymatous jaundice indicate to?
A.
B.
C.
D.
E.
The result of outcome of bile into the blood
Abnormal capture of bilirubin by hepatocytes
Increased bilirubin formation in mononuclear phagocyte cells
Abnormal hemodynamics
Decreased pressure in the bile capillaries
3.6.31. What pathogenesis leads to the reduction of the body’s resistance to the dose of alcohol in patients
with chronic alcoholism?
A.
B.
C.
D.
E.
Abnormality of the liver antitoxic function
Abnormality of water-electrolyte exchange
Abnormality of formation of biologically active forms of vitamins
Abnormality of excretory liver function
The increase of alcohol dehydrogenase synthesis
3.6.32. What is the reason of appearance of dark urine with the obstructive jaundice?
A.
B.
C.
D.
E.
Appearance of bilirubin in urine
Presence of stercobilinogene in urine
Abnormality of hemodynamics in the liver
Absence of bilirubin in urine
Abnormalities of protein synthesis by the liver
3.6.33. What changes of pigmentary metabolism are observed in the blood serum of the patient with
haemolytic jaundice?
A.
B.
C.
D.
E.
Increased levels of indirect bilirubin
Increased levels of direct and indirect bilirubin
Decreased levels of indirect bilirubin
Decreased levels of indirect bilirubin and increased levels of direct bilirubin
Decreased levels of direct bilirubin
3.6.34. What does the appearance of acholic (colourless) stool in a patient suggest to?
A.
B.
C.
D.
E.
The emergence of jaundice
Abnormalities of protein synthesis by the liver
Stomach disorders
Increased bile income into the intestine
Dysbacteriosis
3.6.35. A patients with jaundice has the following laboratory tests results: increased plasma total bilirubin
levels due to indirect (free) bilirubin (levels of direct (conjugated) bilirubin in the blood serum are within
normal ranges); in feces and urine - high levels of stercobilin. What type of jaundice do these results
correspond to?
A. Haemolytic
B. Parenchymal
C. Mechanical
D. Jaundice newborns
E. Gilbert's disease
3.6.36. What is the reason of the development of hypovitaminosis in a patient with liver pathology?
A.
B.
C.
D.
E.
Decreased absorption of vitamins in the gut
Augmented formation of the active form of vitamins
Augmented utilization of vitamins
Deposition of vitamins
Destruction of vitamins
3.6.37. What is the most probable cause of the development of hepatic coma in a patient?
A.
B.
C.
D.
E.
Toxic lesions of the CNS
Gastro-intestinal bypass formation
Administration of large doses of urea
Formation of Eck’s retrograde fistula
Formation of Eck-Pavlov’s fistula
3.6.38. What of the following is the most probable reason of suprahepatic jaundice?
A.
B.
C.
D.
E.
Medications that impede the capture of bilirubin by hepatocytes
Large haematoma
Protein starvation
β- thalassemia
Blood transfusion
3.6.39. A patient’s blood serum demonstrated elevated levels of conjugated and unconjugated bilirubin; in
his urine urobilin and traces of stercobilin were found. What type of jaundice has developed in the patient?
A.
B.
C.
D.
E.
Hepatic
Subhepatic
Suprahepatic
Haemolytic
Obturation
3.6.40. A patient with mechanical jaundice has decreased blood levels of vitamin K. What changes should
be expected?
A.
B.
C.
D.
E.
Abnormal coagulation function of the blood
Development of avitaminosis K
Increased coagulation
Formation of thrombemboli
Abnormality of liposoluble vitamins absorption
3.6.41. What of the following is the most probable cause of the development of subhepatic jaundice?
A.
B.
C.
D.
Abnormality of bile excretion
Increased pH of the bile
Liver pathology
Increased synthesis of bile acids
E. Increased haemolysis
3.6.42. What of the following is not typical for the syndrome of portal hypertension?
A.
B.
C.
D.
E.
Decreased pressure in the portal vein
Abnormality of the general hemodynamics
Formation of the portal vein anastomosis with vena cava inferior
Splenomegaly
Ascites
3.6.43. What is the mechanism of hemorrhagic syndrome with liver pathology?
A.
B.
C.
D.
E.
Abnormality of prothrombin formation
Abnormality of cyanocobalamin deposition
Reduced synthesis of plasminogen
Overproduction of secretin
Hypocholesterolaemia
3.6.44. A patient with portal hypertension has developed ascites. What is the mechanism of development
of this phenomenon?
A.
B.
C.
D.
E.
Accumulation of fluid in the abdominal cavity
Distension of the esophagus varicose veins
Gastrointestinal bleeding
Increased blood circulation
Splenomegaly
3.6.45. Laboratory tests results revealed appearance of bile acids in the blood; other symptoms include skin
itching and bradycardia. Which syndrome do these findings correspond to?
A.
B.
C.
D.
E.
Cholemic syndrome
Acholic syndrome
Dubin-Johnson syndrome
Rotor’s syndrome
Hepatocerebral deficiency syndrome
3.6.46. A patient developed acholic syndrome. What is the main feature of this syndrome?
A.
B.
C.
D.
E.
Bleaching of stool
Darkening of urine
Darkening of stool
Itching
Lack of bile in urine
3.6.47. A patient with jaundice developed flatulence, constipation and fat in faeces. The emergence of what
syndrome do these symptoms suggest to?
A.
B.
C.
D.
Acholic syndrome
Cholemic syndrome
Syndrome of portal hypertension
Rotor syndrome
E. Hepatocerebral deficiency syndrome
3.7. KIDNEYS
3.7.1. A patient with renal pathology developed massive proteinuria, edema, hypoproteinaemia, retention
hyperlipidaemia. What is the designation of this pathological process?
A.
B.
C.
D.
E.
Nephrotic syndrome
Hypertensive syndrome
Urinary syndrome
Anaemic syndrome
Loss syndrome
3.7.2. In a patient with chronic renal pathology Zymnytsky’s test found the loss of kidneys osmotic
concentration function. What changes in urination will occur at this pathology?
A.
B.
C.
D.
E.
Urorrhagia
Oliguria
Anuria
Polakiuriya
Hematuria
3.7.3. In a patient due to nephron tubular pathology Zymnytsky’s test revealed the loss of kidneys osmotic
concentration function. What is the designation of this pathological changes?
A.
B.
C.
D.
E.
Isohypostenuria
Proteinuria
Haematuria
Cylinderuria
Leukocyturia
3.7.4. As result of poisoning with sublimatum a patient has developed damage to kydneys with the
appearance of glycosuria and proteinuria. Which part of the nephron has sustained the largest injury with
this pathological process?
A.
B.
C.
D.
E.
Proximal tubule
Renal glomerulus
Distal tubule
Loop of Henle
Collecting tubules
3.7.5. As result of poisoning with sublimatum a patient has sustained destruction of nephrons with the loss
of substances with large molecular mass with urine. What is the designation of this pathological changes?
A.
B.
C.
D.
E.
Tubular proteinuria
Tubular acidaminuria
Tubular glycosuria
Tubular bicarbonateuria
Tubular phosphaturia
3.7.6. In a patient with multiple myeloma a protein was determined in urine. Which form of proteinuria has
place in this patient?
A.
B.
C.
D.
E.
Suprarenal
Renal glomerular
Renal tubular
Subrenal bullous
Subrenal uretral
3.7.7. A 35-year-old female complains of pain in her lower back. Laboratory analysis found in urine: protein
- 5 g/l, erythrocytes - 2-3 in the sight field, leukocytes - 20-30 in the sight field. Bacterial culturing found
Escherichia coli. What disease are these changes characteristic of?
A.
B.
C.
D.
E.
Acute pyelonephritis
Acute diffuse glomerulonephritis
Chronic glomerulonephritis
Nephrotic syndrome
Tuberculosis of kidney
3.7.8. A 58-year-old patient was admitted to hospital with acute heart failure. He was found to have
reduced daily urination volume (oliguria). What factors might have caused this phenomenon?
A.
B.
C.
D.
E.
Decreased glomerular filtration rate
Decreased number of functioning glomeruli
Decreased oncotic blood pressure
Increased hydrostatic pressure on the capillary walls
Decreased permeability of glomerular membranes
3.7.9. A 30-year-old male, who was admitted to the clinic with the diagnosis of acute hlomerulonephritis,
developed proteinuria. What disorder has caused this pathology?
A.
B.
C.
D.
E.
Increased permeability of glomerular membranes
Delayed excretion of the nitrogen methabolism end products
Decreased oncotic blood pressure
Increased hydrostatic pressure on the capillary walls
Reduced number of functioning nephrons
3.7.10. 2 weeks after the sore throat a 5-year-old child developed acute diffuse glomerulonephritis, which
was characterized by oliguria, proteinuria, haematuria, hyperazotaemia, arterial hypertension, and
oedema. Abnormality of which renal function is the most significant in the development of these disorders?
A.
B.
C.
D.
E.
Glomerular filtration
]Tubular reabsorption
Tubular secretion
Urine excretion
Incretory function
3.7.11. A patient complains of constant thirst, headache, weakness, massive urination (up to 10 l/day). The
patient admitted that he sustained head injury. Specific weight of urine is 1008; pathological elements are
absent. What is the most feasible mechanism for the development of water-electrolyte exchange disorder
in this case?
A.
B.
C.
D.
E.
Insufficient antidiuretic hormone production
Overproduction of antidiuretic hormone
Insufficient insulin synthesis
Overproduction of aldosterone
Inadequate aldosterone synthesis
3.7.12. After massive blood loss a patient is marked for oliguria, hyperazotaemia, brain and pulmonary
oedema. What mechanism is the most important in reducing diuresis in this case?
A.
B.
C.
D.
E.
Decreased efficiency of filtration pressure
Increased water reabsorption in canals
Increased tubular sodium reabsorption
Redistribution of water in the organism
Reduced glomerular membrane permeability
3.7.13. As a result of failure of safety rules observance a mechanicianin has sustained poisoning with
sublimatum (mercury chloride). After 2 days the patient’s daily diuresis became 620 ml. Headache,
vomiting, cramps, shortness of breath, and moist crepitation in the lungs developed in the patient. What is
the designation of such a renal dysfunction?
A.
B.
C.
D.
E.
Acute renal failure
Chronic renal failure
Uremic coma
Glomerulonephritis
Pyelonephritis
3.7.14. A 38-year-old patient at the 3rd year of the disease with systemic lupus erythematosus developed
diffuse lesions of the kidneys accompanied by massive swellings, pronounced proteinuria, hyperlipidaemia,
dysproteinaemia. What is the most likely mechanism of proteinuria in this clinical situation?
A.
B.
C.
D.
E.
Autoimmune damage to nephrons
Inflammatory damage to nephrons
Ischemic tubular injury
Increased level of protein in the blood
Urinary tract injury
3.7.15. A 27 year-old man was admitted to the hospital in a critical condition with profuse gastric bleeding.
Arterial pressure is 80/60 mmHg, daily diuresis of the patient constitutes 60 -80 ml with specific weight
1028-1036. Increased levels of urine nitrogen, urea, and creatine are found in the blood serum. What is the
most likely pathogenetic mechanism that led to the reduction of daily diuresis in this clinical situation?
A.
B.
C.
D.
E.
Decrease of hydrostatic pressure in the glomeruli capillaries
Increase of osmotic pressure of urine
The high level of residual urine nitrogen in the blood
Increase of colloid-osmotic pressure in blood
Increased hydrostatic pressure in Bowman’s capsule
3.7.16. Alkiline erythrocytes have been identified in the patient’s daily urine. Which renal pathology is the
found symptom characteristic to?
A.
B.
C.
D.
E.
Diffuse glomerulonephritis
Nephrotic syndrome
Renal stone disease
Pyelonephritis
Acute renal failure
3.7.17. Different abnormal substances appear in the urine with a renal pathology. Emergence of which
pathological substances in urine confirms the increased glomerular membrane permeability?
A.
B.
C.
D.
E.
Proteins
Glucose
Amine acids
Homogentisic acid
Piuriya
3.7.18. In a patient with acute renal failure (stage of urorrhagia) not only has azotaemia diminished, but
continued to grow. Abnormality of which renal function is it linked to?
A.
B.
C.
D.
E.
Secretion
Filtering
Reabsorption
Urine concentration
Urine dilution
3.7.19. During urine investigation in a patient with chronic pyelonephritis the decrease of urine specific
weight to 1010 associated with increased diuresis were found. What renal function is impaired?
A.
B.
C.
D.
E.
Sodium and water reabsorption
Glomerular filtration
Tubular secretion
Glucose reabsorption
Protein reabsorption
3.7.20. In a patient with acute renal failure at the 6th day of therapeutic activities urorrhagia appeared (daily
diuresis constituted 2.7 litres). Increase of diuresis at early stages of urorrhagic stage of acute renal failure
is caused by:
A.
B.
C.
D.
E.
Restoration of filtration in nephrons
Increased volume of circulating blood
Increased mass of existing nephrons
Decrease of plasma aldosterone
Decrease of plasma vasopressin
3.7.21. On the background of diabetes mellitus a 30-year-old woman developed swelling of legs and face
during a month. Examination revealed proteinuria (5.87 g/l), hypoproteinaemia, dysproteinaemia,
hyperlipidaemia. The combination of these features is characteristic of:
A. Nephrotic syndrome
B.
C.
D.
E.
Nephritic syndrome
Chronic pyelonephritis
Acute renal failure
Chronic renal failure
3.7.22. The levels of total blood protein in a patient with primary nephrotic syndrome are 40 g/l. What
reason caused hypoproteinaemia?
A.
B.
C.
D.
E.
Proteinuria
Extravasations of protein into tissues
Reduction of protein synthesis in the liver
Increased proteolysis
Abnormal protein absorption in the gut
3.7.23. In a patient with chronic glomerulonephritis glomerular filtration rate (GFR) has decreased to 20%
of the normal rate. What causes the lowering of GFR with chronic renal failure?
A.
B.
C.
D.
E.
Reduced number of functioning nephrons
Tubulopathy
Obturation of the urinary tract
Renal ischemia
Thrombosis of renal artery
3.7.24. A 55-year-old patient has been suffering from chronic glomerulonephritis for 15 years. What
changes in the blood or urine suggest most of the limitation of the kidneys filtration function?
A.
B.
C.
D.
E.
Hyperazotaemia
Hyperglycaemia
Hypoproteineamia
Proteinuria
Hypo -, isostenuria
3.7.25. A patient has been diagnosed with renal diabetes mellitus (renal glycosuria). When setting the
diagnosis a doctor hung upon:
A.
B.
C.
D.
E.
Decreased glucose reabsorption in the kidneys
Reduced secretion of PTH
Reduced insulin secretion
Reduced insulin sensitivity
Hyperglycaemia
3.7.26. In a 18-year-old man laboratory examination revealed glucose in urine at its normal concentrations
in plasma. The most likely reason for this condition is the disorder of:
A.
B.
C.
D.
E.
Glomerular filtration
Tubular secretion
Insulin secretion
Tubular reabsorbtsii
Secretion of glucocorticoids
3.7.27. A patient developed diabetes insipidus after acute stroke with damage to hypothalamus nuclei.
What is the cause of increased urination in this patient?
A.
B.
C.
D.
E.
Reduced water reabsorption
Reduction of blood pressure
Acceleration of glomerular filtration rate
Hyperglycaemia
Reduced sodium reabsorption
3.7.28. A 50-year-old man complains of thirst and marked urorrhagia. Levels of blood glucose 4.8 mmol/l;
ketone bodies and glucose in urine are absent; urine is colourless, specific weight - 1.002. What is the
reason of urorrhagia in the patient?
A.
B.
C.
D.
E.
Lack of ADH
Insulin deficiency
Thyrotoxicosis
Hyperaldosteronism
Hypothyroidism
3.7.29. The cause of anuria in the course of suprarenal acute renal failure is:
A.
B.
C.
D.
E.
Obturation of the urinary tract
Tubular epithelial necrosis
Glomerulonephritis
Poisoning by heavy metals
Hypoproteinemia
3.7.30. Anaemia often develops in the course of renal failure. Its reason is:
A. Reduction of erythropoietin synthesis
B. Haematuria
C. Haemoglobinuria
D. Hypoproteinaemia
E. Albuminuria
3.7.31. Specify what quantitative changes of diuresis can lead to uraemia?
A.
B.
C.
D.
E.
Anuria
Urorrhagia
Dysuria
Nikturia
Polakyuria
3.7.32. To study the clearance a substance that is not secreted and reabsorbed in the kidneys is used. This
substance is:
A.
B.
C.
D.
E.
Inulin
Glucose
Gencianviolet
Trypan blue
Haematoxylin
3.7.33. As a result of acute renal failure a patient developed oliguria. What daily amount of urine
corresponds to this concept?
A.
B.
C.
D.
E.
100 - 500 ml
1500 - 2000 ml
1000 - 1500 ml
500 - 1000 ml
50 – 100
3.7.34. A patient with acute renal failure developed anuria. Which of the following mechanisms underlies
its occurrence?
A.
B.
C.
D.
E.
Reduction of glomerular filtration rate
Increased sodium reabsorption
Obstruction of urine outflow
Disturbed blood circulation in the kidneys
Increased reabsorption of water
3.7.35. What is the mechanism of reduction of filtering in the case of prerenal form of acute renal failure?
A.
B.
C.
D.
E.
Decreased renal blood flow
Damage to glomerular filter apparatus
Reduced number of functioning nephrons
Increasing tubular fluid pressure
Decrease of oncotic blood pressure
3.7.36. A patient in shock state developed anuria. Abnormality of which kidney function is the main one in
the development of acute renal failure?
A.
B.
C.
D.
E.
Reduced glomerular filtration rate
Increased reabsorption of water
Increased sodium reabsorption
Reduction of potassium reabsorption
Abnormality of uric acid secretion in the tubules
3.7.37. A patient was diagnosed with acute pyelonephritis. The earliest symptom of this disease is:
A.
B.
C.
D.
E.
Bacteriuria
Hematuria
Leukocyturia
Cylindruria
Proteinuria
3.7.38. In a patient with nephrotic syndrome the development of oedema is associated primarily with:
A.
B.
C.
D.
E.
Massive proteinuria
Anaemia
Abnormality of urine output
Abnormality of the vascular wall permeability
Hyperaldosteronism
3.7.39. A patient with haemorrhage in the area of posterior lobe of the pituitary developed urorrhagia due
to reduced levels of vasopressin in the blood. What is the principal mechanism of urorrhagia in this case?
A.
B.
C.
D.
E.
Reduced reabsorption of water in canals
Increased water filtration in glomeruli
Increased sodium reabsorption
Reduced sodium reabsorption
Increased excretion of potassium
3.7.40. A 20-year-old patient 2 weeks after sore throat developed general weakness, swellings under the
eyes. He was diagnosed with acute glomerulonephritis. What pathological changes are supposed to be
observed in the patient’s urine?
A.
B.
C.
D.
E.
Proteinuria
Cylindruria
Intact erythrocytes
Piuria
Natriyuria
3.7.41. The most frequent complication is pyelonephritis is:
A.
B.
C.
D.
E.
Shrinkage of the kidney
Chronic glomerulonephritis
Nephrotic syndrome
Acute glomerulonephritis
Hypertension
3.7.42. In a patient the reduction of diuresis to 800 ml per day is observed. What's the designation of such
changes of diuresis?
A.
B.
C.
D.
E.
Oligouria
Urorrhagia
Leukocyturia
Proteinuriya
Anuria
3.7.43. A 25-year-ol female after supercooling developed pain in her lower back, dysuric manifestations
(leukocyturia, cylinderuria, bacteriuria, daily diuresis remained unchanged). The development of what
disease may this abnormalities be related to?
A. Pyelonephritis
B. Glomerulonephritis
C. Kidney stone disease
D. Radiculitis
E. Adnexitis
3.7.44. In a patients with acute glomerulonephritis increased levels of protein in urine were revealed.
Abnormal functions of which nephron structures is the presence of protein in urine related to?
A.
B.
C.
D.
Basement membrane of glomeruli capillaries
Distal tubular epithelium
Epithelium of Henle’s loop
Epithelium of thin tubules
E. Parietal epithelium of glomerulus
3.7.45. A 50-year-old man complains of thirst and marked urorrhagia. Blood glucose is 4.8 mmol/l, glucose
and ketone bodies in urine are absent, urine is colourless, specific weight 1.002. What is the reason of
urorrhagia?
A.
B.
C.
D.
E.
Hypoaldosteronism
Insulin deficiency
Thyrotoxicosis
ADH deficiency
Hypothyroidism
3.7.46. A 24-year-old man 1.5 weeks after severe streptococcal sore throat developed face swellings and
increased blood pressure. Haematuria and proteinuria 1.2 g/l have been revealed in the patient’s urine.
Antistreptococcal antibodies and decrease of complement components levels were established in the
blood. Capillaries of which structures are the most probable localization of immune complexes deposition
that resulted in the development of nephropathy?
A.
B.
C.
D.
E.
Proximal tubules
Henle’s loop
Pyramids
Descending part of tubules
Glomeruli
3.7.47. A patient with acute renal failure developed anuria. Which of the following mechanisms underlies
its occurrence?
A.
B.
C.
D.
E.
Reduction of glomerular filtration rate
Increased sodium reabsorption
Obstruction of urine outflow
Disturbed blood circulation in the kidneys
Increased reabsorption of water
3.7.48. A patients with diabetes insipidus is marked for urorrhagia that is associated with:
A.
B.
C.
D.
E.
Decreased sensitivity of distal tubules to vasopressin
Vasopressin oversecretion
Aldosterone oversecretion
Increased glomerular filtration rate
Reduced glomerular filtration rate
3.7.49. A 62-year-old man with prostate adenoma is observed to have increase body temperature, swelling
under the eyes, tachycardia, hypertension, urorrhagia, and polakiuria. In urine: isostenuria, leukocyturia,
haematuria, moderate proteinuria have been established. What disease has developed in the patient?
A.
B.
C.
D.
E.
Acute pyelonephritis
Acute glomerulonephritis
Chronic glomerulonephritis
Chronic lung disease
Nephrotic syndrome
3.7.50. Which of the following diseases is the detection of active leukocytes in urine characteristic of?
A.
B.
C.
D.
E.
Pyelonephritis
Kidney amyloidosis
Glomerulonephritis
Prostatitis
Kidney stone disease
3.8. ENDOCRINE SYSTEM
3.8.1. What of the following belongs to releasing factors (neurohormones)?
A.
B.
C.
D.
E.
Liberins and statines
Trophic hormones
Thyroxin and triiodinetyronin
Adrenaline and noradrenaline
Androgen and estrogen
3.8.2. Effects of hormones on target organs is implemented by the following ways:
A.
B.
C.
D.
E.
All the listed ways
Influence on biological membranes
Stimulation of enzyme activity
Inhibition of enzyme activity
Influence on the genetic apparatus of cells
3.8.3. In the experiment a white rat was exposed to stress (electric shock) after which muscle hypotension,
arterial hypotension, hypothermia and hypoglycaemia were observed in the animal. What period of
adaptation syndrome developed in the rat?
A.
B.
C.
D.
E.
Phase of shock
Phase of antishock
Phase of resistance
Stage of exhaustion
Latent stage
3.8.4. An injured by the road accident person was taken to the clinic in a state of vasomotor excitation.
While examination hypertension and tachycardia were observed. On the 3rd day the patient’s condition
improved, blood pressure and pulse rates stabilized, and only complaints about sleep disorders (insomnia)
remained. What stage of adaptation syndrome developed in the patient on the 3rd day?
A.
B.
C.
D.
E.
Stage of resistance
Stage of anxiety
Phase of shock reactions
Phase of antishock reactions
Stage of exhaustion
3.8.5. A patient complains of malaise, anorexia, and nausea. His anamnesis is significant for adrenal glands
tuberculosis. Examination of the patient revealed skin hyperpigmentation , arterial pressure 100/60 mm
Hg., blood glucose levels 3.33 mmol/l. What metabolism disorders will be observed with this pathology?
A.
B.
C.
D.
E.
Hypoglycaemia
Hyperglycaemia
Galactosaemia
Transporting hyperlipidaemia
Retention hyperlipidaemia
3.8.6. A patient complains of malaise, anorexia, and nausea. His anamnesis is significant for adrenal glands
tuberculosis. Examination of the patient revealed skin hyperpigmentation , arterial pressure 100/60 mm
Hg., blood glucose levels 3.33 mmol/l. Which endocrine gland function is compromised?
A.
B.
C.
D.
E.
Adrenal glands
Pituitary
Parathyroid gland
Thyroid gland
Epiphysis
3.8.7. A patient complains of malaise, anorexia, and nausea. His anamnesis is significant for adrenal glands
tuberculosis. Examination of the patient revealed skin hyperpigmentation , arterial pressure 100/60 mm
Hg., blood glucose levels 3.33 mmol/l. What pathology of the endocrine system can be suspected in the
patient?
A.
B.
C.
D.
E.
Addison’s disease
Conn’s disease
Acromegaly
Cushing’s disease
Simmonds’disease
3.8.8. A 23-year-old man complains of general weakness, excessive sweating, increased drowsiness,
headache, and parasthesia of extremities. Examination of the patient revealed disproportionately enlarged
jaw, brow arches, nose, hands and feet. The reason for this pathologic state can be:
A.
B.
C.
D.
E.
Overproduction of somatotropin
Overproduction of thyroxin
Overproduction of corticosteroids
Overproduction of glucagon
Overproduction of aldosterone
3.8.9. Examination of a 32-year-old patient revealed disproportionately increased brow arches, nose, lips,
tongue, jaw and limbs. Which endocrine gland function is abnormal?
A.
B.
C.
D.
E.
Pituitary
Adrenals
Pancreas
Thyroid gland
Epiphysis
3.8.10. A patient with prominent features of an endocrine disorder: very tall man with long thick fingers,
large mandible and flaccid lower lip came for medical attention. What pituitary dysfunction is present in the
patient?
A.
B.
C.
D.
E.
Acromegaly
Pituitary nanism
Panhypopituitarism
Cushing’s disease
Conn’s disease
3.8.11. A man with height of 110 cm, and intact mental development came for medical attention.
Deficiency of which hormone is responsible for development of this pathology?
A.
B.
C.
D.
E.
Somatotropin
Thyroxine
Mineralocorticoids
Gonadotropic hormone
Antidiuretic hormone
3.8.12. A 10-year-old child has height of 178 cm and weight 64 kg. Which endocrine gland function is
abnormal?
A.
B.
C.
D.
E.
Pituitary
Sex glands
Thyroid gland
Adrenals
Parathyroid gland
3.8.13. A 9-year-old boy is found in the endocrinology department; he has several times sustained
extremity fractures related to bone fragility. Which endocrine gland dysfunction is present?
A.
B.
C.
D.
E.
Parathyroid gland
Thyroid gland
Epiphysis
Adrenals
Thymus
3.8.14. A patient complains of fever, weight loss, irritability, palpitations, and ophthalmopathy. Which
endocrine gland function is disordered?
A.
B.
C.
D.
E.
Thyroid gland overactivity
Thyroid gland hypofunction
Sex glands overactivity
Pancreas hypofunction
Adrenal medulla overactivity
3.8.15. A patient presented with sharply decreased Ca2+ levels in the blood serum. Production of which
hormone will be increased in response to it?
A.
B.
C.
D.
E.
PTH
Aldosterone
Somatotropic
Vasopressin
Calcitonin
3.8.16. A child came for medical attention with abnormal enamel and dentin formation due to lowered
levels of calcium in the blood. Deficiency of which hormone can cause these changes?
A. PTH
B. Triiodothyronine
C. Calcitonin
D. Thyroxine
E. Somatotropin
3.8.17. After surgical intervention an experimental animal developed seizures. Which endocrine gland was
removed during the experiment?
A.
B.
C.
D.
E.
Parathyroid gland
Sex gland
Thyroid gland
Adrenal gland
Pituitary
3.8.18. A patient developed hyperkalaemia and hyponatriaemia. Decreased secretion of what hormone can
lead to such changes?
A.
B.
C.
D.
E.
Aldosterone
Cortisol
Natriuretic
PTH
Vasopressin
3.8.19. A patients developed hypocalciaemia. Deficiency of which hormone can cause these changes?
A.
B.
C.
D.
E.
Calcitonin
PTH
Corticotropin-releasing hormone
Aldosterone
Corticotropin
3.8.20. A 40-yeart-old woman came for medical attention complaining of thirst, urorrhagia, weakness, and
rapid fatigue. Examination of the patient revealed osteoporosis, calcium salts deposition in kidneys and
lungs. What disease are these symptoms characteristic of?
A.
B.
C.
D.
E.
Hyperparathyroidism
Hypothyroidism
Hypoparathyroidism
Hyperthyroidism
Insulinoma
3.8.21. Examination of a patient revealed signs of osteoporosis, deposition of calcium salts in kidneys and
lungs. Hyperparathyroidism has been diagnosed. What electrolyte exchange changes are supposed to occur
in this condition?
A.
B.
C.
D.
E.
Hypercalcaemia
Hyperkalaemia
Hypernatraemia
Hyponatraemia
Hyperfosfataemia
3.8.22. A 43-year-old female complains of thirst, frequent urination, weakness, and fatigue. Examination of
the patient revealed osteoporosis, deposition of calcium salts in kidneys and lungs. Hyperfunctioning of
which of the following gland do these signs indicate to?
A.
B.
C.
D.
E.
Parathyroid glands
Adrenals
Pituitary
Sex glands
Thyroid glands
3.8.23. A patient presents with hyperosmotic hyperhydration: pronounced thirst, increased arterial and
central venous pressures, increased circulating blood volume, and heart failure are observed in the patient.
Biochemical analysis of the blood showed the following parameters: sodium levels 170 mmol/l,
haematocrit 0.35. What is the possible reason of this state?
A.
B.
C.
D.
E.
Hyperaldosteronism (Conn syndrome)
Hypoaldosteronism
Hypoproteinaemia
Institution of hypotonic solutions
Cardiovascular disease
3.8.24. A patient with adenoma of glomerular zone of adrenal cortex (Conn syndrome) presents with
arterial hypertension, attacks of seizures and urorrhagia (polyuria). Which of the following hormones is
produced in excessive amount with this pathology?
A.
B.
C.
D.
E.
Aldosterone
Hydrocortisone
Cacitonin
Vasopressin
Epinephrine
3.8.25. A 9-year-old girl has been diagnosed with adrenogenital syndrome. Which of the following
hormones is produced in excessive amount with this pathology?
A.
B.
C.
D.
E.
Estrogen
Androgen
Aldosterone
Cortisol
Adrenaline
3.8.26. A body weight of a 25-year-old woman after childbirth decreased by 20 kg; shedding of teeth and
hair, and muscle wasting (signs of hypopituitarism) are observed. Abnormal synthesis of which of the
following pituitary hormones is this state connected with?
A.
B.
C.
D.
E.
Somatotropin
Gonadotropic hormone
Adrenocorticotropic hormone (corticotropin)
Prolactin
Thyroid-stimulating hormone (thyrotropin).
3.8.27. A 25-year-old female after childbirth complicated by massive bleeding sustained sever exhaustion,
the skin became dry, wrinkled, and of wax colour. Examination of the organism gave the following data:
body temperature 36ОС, blood pressure 100/60 mm Hg., blood glucose 3.3 mmol/l, levels of somatotropin
(growth hormone) and adrenocorticotropic hormone were decreased. What pituitary gland disorders
developed in the patient?
A.
B.
C.
D.
E.
Total hypopituitarism
Pituitary nanism
Acromegaly
Cushing disease
Diabetes insipidus
3.8.28. Deficiency of which of the following hormones is associated with pituitary nanism?
A.
B.
C.
D.
E.
Somatotropin
Adrenocorticotropic hormone (corticotropin)
Thyroxine
Testosterone
Insulin
3.8.29. What pathology is caused by overactivity of adenohypophysis?
A.
B.
C.
D.
E.
Pituitary gigantism
Pituitary nanism
Infantilism
Dwarfism
Pituitary cachexia
3.8.30. A 13-year-old boy has been diagnosed with pituitary gigantism. Overactivity of which of the
following hormones is associated with this disorder?
A.
B.
C.
D.
E.
Growth hormone (somatotropin)
Adrenocorticotropic hormone (corticotropin)
Gonadotropic hormone
TSH (thyroid stimulating hormone)
Vasopressin
3.8.31. A 35-year-old patient 2 months after cranial trauma was hospitalized with complaints of increased
thirst, sleep disturbance, frequent night urination, weakness, and fatigue. The patient’s daily diuresis was 7
litres. The patient was diagnosed with diabetes insipidus. Deficiency of which of the following hormones is
associated with this disorder?
A.
B.
C.
D.
E.
Vasopressin
Aldosterone
Glucocorticoids
Catecholamines
Renin
3.8.32. A child living in a remote mountainous area has been diagnosed with cretinism. What is the likely
cause of the disease?
A.
B.
C.
D.
E.
Iodine deficiency
Damage to thyroid gland by radioactive iodine
Thyroid gland tumour
Iodine surplus
Psychological trauma
3.8.33. A 36-year-old female complains of increased sweating, palpitation, and fever. Examination of the
organism detected thyroid gland enlargement , exophthalmia, increased basal metabolism, body
temperature 37,8 ° C. The woman has been diagnosed with thyrotoxicosis. What are the properties of
thyroxin that lead to increased body temperature?
A. Increases the permeability of mitochondria and disconnects oxidative phosphorylation
B. Reduces the permeability of mitochondria and increases the coupling of oxidation and
phosphorylation
C. Reduces the fatty acids oxidation
D. Reduces amino acids deamination
E. Promotes accumulation of acetyl-CoA
3.8.34. Overactivity of the thyroid gland manifests with the development of:
A.
B.
C.
D.
E.
Diffuse toxic goitre
Thyroid cachexia
Cretinism
Myxedoema
Endemic goitre
3.8.35. A patient complains of sleep disturbance, general weakness, irritability, and palpitation. A diffusely
enlarged thyroid gland is observed while palpation. What pathology has place in the patient?
A.
B.
C.
D.
E.
Toxic goitre
Riedel thyroiditis
de Quervain subacute thyroiditis
Endocrine goitre
Hashimoto thyroiditis
3.8.36. A 50-year-old patient complains of thirst, polydipsia, and marked urorrhagia (polyuria). Glucose
blood levels 4.8 mmol / l, glucose and acetone bodies in urine are absent, urine is colourless, specific
density 1.002. What is the reason of urorrhagia in this case?
A.
B.
C.
D.
E.
Thyrotoxicosis
Insulin deficiency
Adrenal insufficiency
Adenohypophysis
Hypothyroidism
3.8.37. A 30-year-old woman complains of fever, weight loss, irritability, palpitations, and exophthalmia.
These symptoms are the result of:
A. Hyperthyroidism
B. Hypothyroidism
C. Hyperaldosteronism
D. Hypoaldosteronismu
E. Hypercortisolism
3.8.38. What kind of metabolism disorder is the leading one in a patient with hyperthyroidism?
A.
B.
C.
D.
E.
Energy
Carbohydrate
Protein
Lipid
Mineral
3.8.39. A 2.5-year-old child living in a remote mountainous area has been diagnosed with cretinism.
Hypofunction of which of the following glands is present in the child?
A.
B.
C.
D.
E.
Thyroid
Adrenal cortex
Pituitary
Hypothalamus
Parathyroid glands
3.8.40. A 39-year-old patient presented with sharp drop of Ca2 + levels in the blood serum. Overproduction
of which of the following hormone is present in the man?
A.
B.
C.
D.
E.
Aldosterone
Calcitonin
Somatotropin
PTH
Vasopressin
3.8.41. A 35-year-old woman has been diagnosed with the Conn syndrome. Adenoma of which of the
following glands has caused this disease?
A.
B.
C.
D.
E.
Adrenal cortex
Thyroid gland
Parathyroid glands
Thymus
Gonads
3.8.42. A 56-year-old man came for medial attention with complaints of increased blood pressure up to
170/100 mmHg. Examinationof the patient revealed obesity with predominant fat deposition on the trunk.
Face is oedematous, hyperaemic, abdomen is marked for skin streaks. Biochemical analysis of the blood:
glucose 12 mmol/l, urea 6.0 mmol/l, creatinine 120 micromole/l, total bilirubin 16.0 micromole/l. Which
disease are these pathological findings characteristic of?
A.
B.
C.
D.
E.
Cushing syndrome
Conn syndrome
Graves' disease
Addison Disease
Waterhouse-Friderichsen syndrome
3.8.43. A patient with Cushing syndrome developed steady hyperglycaemia and glycosuria, hypertension,
osteoporosis, and obesity. Synthesis and secretion of which of the following hormones is increased in this
case?
A.
B.
C.
D.
E.
Glucagon
Epinephrine
Aldosterone
Thyroxine
Cortisol
3.8.44. A 16-year-old man suffering from Cushing syndrome came for medical attention due to excessive
body weight. On the examination of the patient it became evident that the energy value of the food he
consumes daily is about 1700-1900 kcal/day. What is the most probable cause of obesity in this case?
A.
B.
C.
D.
E.
Excess of insulin
Hypodynamia
Glucocorticoids deficiency
Glucocorticoids excess
Insulin deficiency
3.8.45. While examination of a patient a doctor suspected Cushing syndrome. Increased levels of which of
the following substances in the patient’s blood would confirms the doctor’s assumption of the disorder?
A.
B.
C.
D.
E.
Cortisol
Vitamin
Retinol
Adrenaline
Cholesterol
3.8.46. A 44-year-old female complains of general weakness, pain in the heart region, a significant increase
of body weight. Examination of the patient revealed oedematous face, hirsutism, blood pressure 165/100
mm Hg, height 164 cm, weight 103 kg, predominant fat deposition on the neck, upper shoulder girdle, and
abdomen. What is the main pathogenetic mechanism of obesity in the woman?
A.
B.
C.
D.
E.
Increased production of glucocorticoids
Increased insulin production
Increased production of mineralocorticoids
Decreased thyroid hormones synthesis
Decreased glucagon synthesis
3.8.47. A 17-year-old female suffering for 6 months, complains of growth of hair on her face, voice
lowering, absence of menstruations. Examination of the patient revealed: hair growth by the male type,
undeveloped breasts and genital organs. Abnormality of what glands led to this pathology?
A.
B.
C.
D.
E.
Adrenal
Genital
Neurohypophysis
Thyroid
Adenohypophysis
3.8.48. A 4-year-old child was brought for medical attention with the signs of delay in physical
development, irritability, poor sleep, thirst, and urorrhagia; sugar in urine was not found. The reaction to
vasopressin administration was negative. What is the mechanism of water-salt exchange disorder revealed
in the child?
A.
B.
C.
D.
E.
Abnormality of the realization of biological action of hormones
Abnormality of the nervous regulation of the endocrine glands
Abnormality of biosynthesis and secretion of hormones
Abnormality of neuroendocrine regulation
Abnormality of the feedback mechanism of hormones synthesis regulation
3.8.49. What endocrine disorder is accompanied by hypercalcaemia?
A.
B.
C.
D.
E.
Hyperparathyroidism
Hyperpituitarism
Hypothyroidism
Hypoparathyroidism
Hypocortisolism
3.8.50. When examining a 46-year-old patient adenoma of glomerular zone of adrenal cortex was revealed;
an increased aldosterone levels in the blood are present. What electrolyte metabolism will this hormone
have an effect on?
A.
B.
C.
D.
E.
Sodium
Potassium
Chloride
Calcium
Magnesium
3.8.51. Increased levels of which of the following hormones is observed in patients with
pheochromocytomas?
A.
B.
C.
D.
E.
Adrenaline
Glucagon
Insulin
Thyroxin
Somatotropin
3.8.52. Bronze disease (Addison's disease) arises due to:
A.
B.
C.
D.
E.
Adrenocortical insufficiency
Oversecretion of adrenocortical hormones
Hypofunction of the adrenal medulla
Hyperfunction of the adrenal medulla
Androgens oversecretion
3.8.53. A 52-year-old patient complains of weight loss, rapid physical fatigue, loss of appetite,
gastrointestinal dysfunction, arterial hypotension, yellowness of the skin. The anamnesis of the patient is
marked for long-term corticosteroid drugs treatment. What disease are these changes characteristic of?
A. Adrenocortical insufficiency
B.
C.
D.
F.
Hypercortisolism
Hyperparathyroidism
Hypofunction of the adrenal medulla
Adrenogenital syndrome
3.8.54. Producing a number of hormones, placenta plays the role of temporary endocrine organ. Which
hormone can be determined in the blood serum of a woman at the third-fourth day after implantation - the
method used in medical practice for diagnosis of early pregnancy?
A.
B.
C.
D.
E.
Chorionic gonadotropin
Oxytocin
Vasopressin
Somatostatin
Progesterone
3.9. PATHOPHYSIOLOGY OF THE NERVOUS SYSTEM
3.9.1. What motor function disorders have place in the absence of voluntary movements associated with
increased muscle tone of the right hand and foot after hypertensive crisis?
A.
B.
C.
D.
E.
Central paralysis
Peripheral paralysis
Peripheral paresis
Reflex paresis
Central paresis
3.9.2. Disorders of which of the following functions have place in hemiplegia?
A.
B.
C.
D.
E.
Movement
Equilibrium
Vision
Taste
Hearing
3.9.3. What is the designation of the state of the absence of motor function in half of the body after
cerebral insult?
A.
B.
C.
D.
E.
Hemiplegia
Ataxia
Dyskinesia
Myasthenia
Paraplegia
3.9.4. Which of the following disorders presents with muscular hypotonia, decreased reflexes, absence of
active movements in the left hand, transient pain and paresthesia in the area of the thoracic spine?
A.
B.
C.
D.
E.
Peripheral paralysis
Hyperkinesia
Ataxia
Central paralysis
Brown-Sekar syndrome
3.9.5. Which type of nervous system disorders do hypokinesia, decreased reflexes, muscular atrophy of
upper extremities in an infant after birth injury relate to?
A.
B.
C.
D.
E.
Peripheral paralysis
Neuritis
Bulbar paralysis
Myasthenia
Central paralysis
3.9.6. Point out the reason of Parkinson's syndrome with the development of progressive hand tremor,
muscle rigidity, and hypokinesia.
A.
B.
C.
D.
E.
Black substance neurons degeneration
Increased sensitivity of neuromuscular synapse
Abnormal influence of the cerebellum on motor centres
Increased motoneuron activity
Reduced braking by the upper movement centres
3.9.7. Point out a reason of spontaneous tremor of different parts of the body at rest and during voluntary
movements?
A.
B.
C.
D.
E.
Disorders of basal ganglia function
Disorders of the cerebellum functions
Disorders of the mesencephalon functions
Disorders of neuromuscular transmission of potential of action
Disorders of motor cortex
3.9.8. What CNS structure lesion presents with rapid, arrhythmic, involuntary movements of limbs and
trunk with decreased muscle tone, grimaces and smacking?
A.
B.
C.
D.
E.
Striated body
Medulla oblongata
Cerebellum
Corpus pallidum
Black substance
3.9.9. Which of the following statements characterising decerebral rigidity is correct?
A. Increased muscle tone of extremities extensors
B. Arises after crossing the brainstem below the pons
C. Is not associated with the loss of stimulation effects of higher motor centres on the brainstem
reticular system
D. Is accompanied by braking γ-motoneuron of the spinal cord
E. Is accompanied by stimulation of α-motoneuron of the spinal cord
3.9.10. Which of the following statements characterising decerebral rigidity is correct?
A. Is associated with the loss of braking influence of higher motor centres on the brainstem reticular
system
B. Arises after crossing the brainstem below the pons
C. Decreased muscle tone of extremities extensors
D. Is accompanied by braking γ-motoneuron of the spinal cord
E. Is accompanied by stimulation of α-motoneuron of the spinal cord
3.9.11. Damage to which brain stem levels causes decerebral rigidity?
A.
B.
C.
D.
E.
Below the red nucleus
Above black substance
Below the Deiters nucleus
Above the red nucleus
Above the Yakubovich nucleus
3.9.12. What are movement disorders associated with the cerebellum injury?
A.
B.
C.
D.
E.
Asynergy
Asymmetry
Asthenia
Athetosis
Chorea
3.9.13. What are movement disorders associated with the cerebellum injury?
A.
B.
C.
D.
E.
Ataxia
Athetosis
Asymmetry
Synergy
Chorea
3.9.14. What are movement disorders associated with the cerebellum injury?
A.
B.
C.
D.
E.
Dysmetria
Athetosis
Asthenia
Synergy
Chorea
3.9.15. Damage to what brain region is associated with precise movements impairments of upper
extremities while maintaining normal muscle strength, deep muscle feeling and coordination mechanisms?
A.
B.
C.
D.
E.
Supramarginal gyrus
Precentral gyrus
Broca's area
Wernicke's center
Calcarine fissure
3.9.16. Name the brain structure, neurosecretory cells of which produce endorfines.
A.
B.
C.
D.
E.
Hypothalamus
Precentral gyrus
Black substance
Wall of the cerebral aqeduct of mesencephalon level
Gelatinous substance of the spinal cord
3.9.17. Which of the following neuropeptides is involved in pain responses?
A.
B.
C.
D.
E.
Enkephalin
Thyrotropin-releasing hormone
Oxytocin
Lipotropin
Proopiocortyn
3.9.18. Which of the following statements characterising the mechanism of pain emergence is correct?
A. Activation of gelatinous substance neurons weakens the pain sensations
B. Pain is transmitted through the dorsal columns of the spinal cord
C. Too strong stimulation of the skin thermoreceptors can cause pain
D. Substance C is one of the mediators that is involved in transmitting pain sensation in the CNS
E. Pain receptors are suppressed by bradykinin
3.9.19. Which of the following statements characterising the mechanism of pain emergence is correct?
A.
B.
C.
D.
E.
Substance P is one of the mediators that is involved in transmitting pain sensation in the CNS
Inhibition of the gelatinous substance neurons weakens the pain
Too strong stimulation of the skin thermoreceptors can cause pain
Pain is transmitted through the dorsal columns of the spinal cord
Pain receptors are suppressed by bradykinin
3.9.20. Which of the following statements characterising the mechanism of pain emergence is correct?
A.
B.
C.
D.
E.
Pain receptors are activated by bradykinin
Inhibition of the gelatinous substance neurons weakens the pain
Too strong stimulation of the skin thermoreceptors can cause pain
Substance C is one of the mediators that is involved in transmitting pain sensation in the CNS
Pain is transmitted through the dorsal columns of the spinal cord
3.9.21. What is designation of the steady pain of the right half of the face augmented by slight irritation?
A.
B.
C.
D.
E.
Neuralgia
Causalgia
Visceral pain
Reflex pain
Phantom pain
3.9.22. What is designation of the severe pain that has for a long time irradiated to the missing limb after
its amputation?
A.
B.
C.
D.
E.
Phantom pain
Visceral pain
Epicritical
Protopathic
Reflex pain
3.9.23. What kind of pain occurs under the left scapula and left shoulder in case of acute myocardial
infarction?
A.
B.
C.
D.
E.
Irradiating
Visceral
Causalgia
Neuralgia of intercostal nerve
Phantom pain
3.9.24. Name the kind of pain in the left shoulder area in the patient with acute myocardial infarction?
A.
B.
C.
D.
Reflex pain
Visceral pain
Epicritical pain
Protopathic pain
E. Phantom pain
3.9.25. What mechanism is responsible for the development of sever pain as a result of damage to
myelinated somatic nerves fibres?
A.
B.
C.
D.
E.
Causalgia
Visceral pain
Reflex pain
Phantom pain
Nothing of listed above
3.9.26. What pathological process develops in the eye cornea after impairment of the trigeminal nerve
integrity?
A.
B.
C.
D.
E.
Ulcer
Venous congestion
Arterial hyperaemia
Ischemia
Edema
3.9.27. What function of the nervous system is broken in case of impairment of the trigeminal nerve
integrity with the following development of the ulcer in the eye cornea?
A.
B.
C.
D.
E.
Trophic
Physical
Autonomic
Secretion of mediators
Sensitive
3.9.28. What function of the nervous system is disordered in case of salivary gland denervation followed by
secretion of uniform, independent on the food nature saliva?
A.
B.
C.
D.
E.
Trophic
Autonomic
Physical
Secretion of mediators
Sensitive
3.9.29. What mechanism is responsible for pathogenesis of neurogenic dystrophy with peripheral nerve
damage?
A.
B.
C.
D.
E.
All the given mechanisms
Inadequate response to neurotransmitters
Pathological impulsation from the damaged nerve
Cessation of afferent information income from the denervated organ
Cessation of the axoplasmic flow
3.9.30. How are neurotrophic effects on tissues carried out?
A. Through all nerve types
B. Through sympathetic nerves only
C. Through parasympathetic nerves only
D. Through the motor nerves only
E. Through the sensitive nerves only
3.9.31. What changes can be observed in limb myocytes after two weeks of crossing the sciatic nerve?
A.
B.
C.
D.
E.
Increased sensitivity to acetylcholine
Increased mitochondrial mass
Increased activity of Krebs cycle enzymes
Reduced number of cholinoreceptors
Increased volume of lysosomes
3.9.32. What changes in the organism results from damage to dorsal roots of the spinal cord?
A.
B.
C.
D.
E.
Loss of muscle reflexes
Development flaccid paralysis
Increased sensitivity in denervated tissues
Increase of skeletal muscle tone
Increased skin reflexes
3.9.33. What changes in the organism results from damage to dorsal roots of the spinal cord?
A.
B.
C.
D.
E.
Loss of sensitivity in denervated tissues
Development flaccid paralysis
Increase of muscle reflexes
Increase of skeletal muscle tone
Increased skin reflexes
3.9.34. What changes in the organism results from damage to dorsal roots of the spinal cord?
A.
B.
C.
D.
E.
Loss of skin reflexes
Development flaccid paralysis
Increase of muscle reflexes
Increased sensitivity in denervated tissues
Increase of skeletal muscle tone
3.9.35. What are the consequences of muscle denervation?
A.
B.
C.
D.
E.
Atrophy
Anaplasia
Hyperplasia
Hypertrophy
Regeneration
3.9.36. Specify the basic mechanism of nerve fibre degeneration following traumatic rupture?
A.
B.
C.
D.
E.
Cessation of axoplasmic flow
Loss of nerve excitability
Damage to Ranvier nodes
Amyelination
Phagocytosis of nerve endings
3.9.37. Which of the following neuronal functions will be disordered with abnormal synthesis of γ-amino
butyric acid?
A.
B.
C.
D.
E.
Braking
Deafferentation
Depolarization
Desensitization
Excitation
3.9.38. Indicate the cause of the impaired ability of nerve fibres for excitation conduction.
A.
B.
C.
D.
E.
Deficiency of cyanocobalamin
Deficiency of ascorbic acid
Effects of cholinesterase inhibitors on the nerve
Reduction in blood catecholamine content
The increase of Ca ions levels in the blood
3.9.39. What effects may occur after the introduction of cholinesterase inhibitors in the organism?
A.
B.
C.
D.
E.
Bronchioles spasm
Intestinal atony
Reduction of gastric juice secretion
Increased pupils
Tachycardia
3.9.40. What effects may occur after the introduction of cholinesterase inhibitors in the organism?
A. Increased gastric juice secretion
B. Intestinal atony
C. Dilatation of bronchioles
D. Dilatation of pupils
E. Tachycardia
3.9.41. What vitally dangerous state occurs in acute organic phosphorus poisoning?
A.
B.
C.
D.
E.
Bronchospasm
Coordination disorders
Cerebral circulation disorders
Blindness
Tachycardia
3.9.42. Which of the following reasons lead to increase of neurons excitability?
A.
B.
C.
D.
E.
Inhibition of Na+/K+-pump function
Increased membrane potential at rest
Increase of K+ content in the cell
Increase of Са2+ levels in the blood
Reduction of critical level of membrane depolarization
3.9.43. What neurological disorder of central origin is observed in blood circulation disorders on the basis
of hypertensive crisis?
A.
B.
C.
D.
All is correct
Hyperreflexia
Pathologic reflexes
Spastic paralysis
E. Nothing is correct
3.9.44. What disorder occurs as a result of the black substance destruction in Parkinson's disease?
A.
B.
C.
D.
E.
Increase of muscle tone
Increased formation of dopamine if the motor centres neurons
Athetosis
Hypokinesia of extremities
Decrease of pain sensitivity
3.9.45. What disorder results from the black substance destruction in Parkinson's disease?
A.
B.
C.
D.
E.
Limbs tremor
Amyotonia
Increased formation of dopamine if the motor centres neurons
Athetosis
Decrease of pain sensitivity
3.9.46. Which of the following clinical signs is not characteristic of the spinal shock with the trauma of the
cervical spine?
A.
B.
C.
D.
E.
Aphasia
Insufficiency of urination and defecation reflexes
Loss of sensitivity
Decrease of blood pressure
Tetraparesis
3.9.47. Disappearance of which kind of sense should be expected after the rupture of the right half of the
spinal cord only on the side of injury?
A.
B.
C.
D.
E.
Proprioception [deep]
Pain
Tactile
Temperature
All the types of senses
3.9.48. What mediators are responsible for transmission of excitation in the ends of preganglion
sympathetic fibres?
A.
B.
C.
D.
E.
Acetylcholine, noradrenaline
Noradrenaline, adrenaline
Dopamine
Noradrenaline
Acetylcholine
3.9.49. What is the mechanism of slowing heart rate during the intraoperative revision of guts?
A.
B.
C.
D.
E.
Reflex increase of pneumogastric nerve tone
Irritation of the frontal spinal cord roots
Irritation of the rear spinal cord roots
Reflex increase of sympathetic innervation
Nothing is correct
3.9.50. What urinary disorders arise with the transverse spinal cord injury at the level of L1-L3 segments?
A.
B.
C.
D.
E.
Permanent incontinence
Uroschesis (retention of urine)
Periodic enuresis
Urge for urination
Nothing is correct
3.9.51. A 25-year-old women during riding carousel developed nausea, vomiting, and increased sweating.
Activation of which receptor caused reflex development of these symptoms?
A.
B.
C.
D.
E.
Vestibular receptors of semicircle channels
Proprioreceptors of skeletal muscles
Receptors of organ of Corti
Otolith vestibular receptors
Visual receptor
3.9.52. A patient complains of rapid fatigue after a short time of usual work. In a standing position with his
eyes closed the patient swings and then loses balance. Skeletal muscle tone is decreased. Which of the
following brain structures is injured in this man?
A.
B.
C.
D.
E.
Cerebellum
Basal ganglia
Hypothalamus
Thalamus
Cortex of precentral gyrus of large hemispheres
3.9.53. A patient after trauma developed paralysis, disorders of pain sensitivity on the right, impaired pain
and temperature sensitivity on the left. What is the reason for this phenomenon?
A.
B.
C.
D.
E.
Unilateral damage to the spinal cord on the right side
Damage to the cerebellum
Damage to the brain stem
Damage to the mesencephalon
Damage to motor areas of cerebral cortex
3.9.54. A 43-year-old patient suffered a traumatic amputation of the left lower extremity four months ago.
At the time of examination the patient complains of feeling his amputees and constant, sever, sometimes
unbearable pain. What kind of pain has the patient?
A.
B.
C.
D.
E.
Phantom
Neuralgia
Thalamic
Causalgia
Reflex
3.9.55. A patient became unable to perform active movements with his left hand and left foot after acute
hemorrhagic stroke. Muscles tone of the extremities is increased, spinal reflexes are greatly strengthened,
reflexes zones are expanded. There is positive Babinsky reflex on the left. What kind of movement disorder
occurred in the patient?
A.
B.
C.
D.
Central paralysis
Flaccid paralysis
Reflex paralysis
Flaccid paralysis
E. Spinal shock
3.9.56. A patient developed movements disorder that manifested as tremor, ataxia and movements
asynergy of, and dysarthria. What structure is the most likely affected?
A.
B.
C.
D.
E.
Cerebellum
Basal ganglia
Limbic system
Brain stem
Medulla oblongata
3.9.57. A patient with essential hypertension developed headache, tinnitus, and vomiting. The patient’s
arterial pressure elevated up to 220/160 mmHg. Examination revealed asymmetry on the right side of the
face, absence of random movements, increased tendon reflexes and muscle tone in the right hands and
feet. Which form of motor disorders is present in this case?
A.
B.
C.
D.
E.
Hemiplegia
Tetraplegia
Paraplegia
Hyperkinesis
Monoplegia
3.9.58. A 32-year-old patient came for medial attention complaining of general malaise, vomiting, pain in
the right lower part of the abdomen. After patient’s examination a doctor diagnosed acute appendicitis.
What kind of pain is present in the patient?
A.
B.
C.
D.
E.
Visceral
Somatic superficial late
Somatic deep
Phantom
Somatic superficial early
3.9.59. A 41-year-old man came for medial attention complaining of a rapid fatigue and muscle weakness.
Examination of the patient allowed to establish an autoimmune disease, as a result of which the functional
state of neuromuscular synapses receptors is impaired. The action of what mediators is blocked with this
disorder?
A.
B.
C.
D.
E.
Acetylcholine
Dopamine
Serotonin
Norepinephrine
Glycine
3.9.60. A 28-year-old man after gunshot wound of the shin developed ulcer on the damaged side. What is
the key factor in the pathogenesis of neurodystrophy in this case?
A.
B.
C.
D.
E.
Trauma of the peripheral nerve
Impairment of microcirculation
Psychological stress
Infection
Damage to soft tissues
3.10. EXTREME STATES
3.10.1. During earthquake a man was pressed by a large stone that dropped on him and pressed him the
hip. What extreme state has arisen as a result of prolonged crush of the soft tissues of extremities?
A.
B.
C.
D.
E.
Crush syndrome
Coma
Traumatic toxemia
Traumatic shock
Collapse
3.10.2. The binder was overlayed to a patient with brachial artery injury. After 4.5 hour the binder was
removed. What extreme state can develop after removal of the binder?
A.
B.
C.
D.
E.
Tourniquet shock
Traumatic shock
Traumatic toxemia
Crush syndrome
Pain shock
3.10.3. During repair work a worker fell from the roof of a building and injured the liver and spleen. The
patient had developed an internal bleeding. What extreme state can develop due to bleeding in the
patient?
A.
B.
C.
D.
E.
Hemorrhagic shock
Traumatic shock
Cardiogenic shock
Anaphylactic shock
Pain shock
3.10.4. A patient with shock has an acute blood circulation failure. What mechanisms underlies its
implementation?
A.
B.
C.
D.
E.
All the stated
Reduced volume of circulating blood
Reduction of heart minute volume
Reduced total peripheral resistance
Abnormal rheological properties of the blood
3.10.5. A patient developed collapse. What is the main feature of collapse?
A.
B.
C.
D.
E.
The fall of blood pressure
Loss of memory
Absence of reflexes
Tachycardia
Bradycardia
3.10.6. A 60-year-old woman suffering from pneumonia has been bedridden for 2 weeks. After prolonged
stay in the bed the patient stood up and 15 seconds later fainted. Skin became pale, pulse accelerated,
blood pressure lowered, pupils expanded. What extreme situation did the woman develop?
A. Collapse
B.
C.
D.
E.
Traumatic shock
Anaphylactic shock
Cardiogenic shock \
Burn shock
3.10.7. A 40-year-old man has visited sauna for the first time. First 5 minutes the man felt satisfactory, but
later he suddenly lost consciousness. What kind of extreme state arose in the patient?
A.
B.
C.
D.
E.
Vasodilatation collapse
Hypocapnic collapse
Cardiogenic collapse
Toxic-infectious collapse
Posthemorrhagic collapse
3.10.8. A 30-year-old female has been hospitalized to psychiatric clinic and stayed bedridden for 2 weeks.
Then she was allowed to stand up and walk. The patient got up, but suddenly lost her consciousness and
fell down. Which state is responsible for the loss of consciousness in the woman?
A.
B.
C.
D.
E.
Canting collapse
Posthemorrhagic collapse
Hypocapnic collapse
Hyperthermic collapse
Arrhythmic collapse
3.10.9. A man with peptic ulcer disease, complicated by severe gastric bleeding, has been hospitalized in an
unconscious state. The patient developed posthemorrhagic collapse. Which factor is responsible for the
development of this state?
A.
B.
C.
D.
E.
Hypovolemia
Hypervolemia
Compensatory angiospasm
Blood exit from the depot
All the listed above
3.10.10. A 20-year-old man with foot gangrene developed toxic-infectious shock. What is key in the
pathogenesis of this type of shock?
A.
B.
C.
D.
E.
Products of tissues decay
Abnormal microcirculation
Decrease of blood pressure
Fever
Oliguria
3.10.11. A patient has been diagnosed with the first stage of traumatic shock. What change in the function
of the nervous system is supposed to be observed?
A.
B.
C.
D.
E.
Excitation of the central nervous system
Inhibition of the central nervous system
Absence of response of the central nervous system
Function of the central nervous system is not changed
Nothing is correct
3.10.12. A patient has been diagnosed with the second stage of traumatic shock. What change in the
function of the nervous system is supposed to be observed?
A.
B.
C.
D.
E.
Inhibition of the central nervous system
Excitation of the central nervous system
Absence of response of the central nervous system
The function of the central nervous system is not changed
Nothing is correct
3.10.13. What is the approximate beginning and the end of the intermediary period (dominated by acute
renal failure) of the crash-syndrome?
A.
B.
C.
D.
E.
From the 3rd to 12th day
Before the 3 day
From the 12th to 24th day
From the 24th to 30th day
From the 1st to 2nd month
3.10.14. A 40-year-old miner developed crush syndrome due to a mine collapse. Which of the listed below
factors are important in the development of this state?
A.
B.
C.
D.
E.
All of them
Pain
Traumatic toxemia
Plasma loss
Blood loss
3.10.15. A patient developed hypocorticoid coma. What is the leading pathogenetic mechanism in the
development of this state?
A.
B.
C.
D.
E.
Water-electrolyte disorder
Energetic deficiency
Acid-base disorder
Abnormal intracranial pressure
All is correct
3.10.16. A 25-year-old patient developed hyperosmotic diabetic coma. What abnormality is the leading one
in the pathogenesis of this disorder?
A.
B.
C.
D.
E.
Water-electrolyte disorder
Energetic deficiency mechanism
Acid-base disorder
Increased intracranial pressure
All is correct
3.10.17. A patient developed hyperthermic coma. What abnormality is the leading one in the pathogenesis
of this disorder?
A.
B.
C.
D.
E.
Water-electrolyte disorder
Energetic deficiency mechanism
Acid-base disorder
Increased intracranial pressure
All is correct
3.10.18. A patient developed hypoxic coma. What abnormality is the leading one in the pathogenesis of this
disorder?
A. Energetic deficiency mechanism
B.
C.
D.
E.
Water-electrolyte disorder
Acid-base disorder
Increased intracranial pressure
All is correct
3.10.19. A 30-year-old patient with the insulin dependent diabetes mellitus developed hypoglycaemic
coma. What abnormality is the leading one in the pathogenesis of this disorder?
A.
B.
C.
D.
E.
Energetic deficiency mechanism
Water-electrolyte disorder
Acid-base disorder
Increased intracranial pressure
All is correct
3.10.20. A patient developed respiratory coma. What abnormality is the leading one in the pathogenesis of
this disorder?
A.
B.
C.
D.
E.
Energetic deficiency mechanism
Water-electrolyte disorder
Acid-base disorder
Increased intracranial pressure
All is correct
3.10.21. As a result of transfusion of incompatible blood a patient developed haemolytic coma. What is the
leading mechanism in the development of this state?
A.
B.
C.
D.
E.
Energetic deficiency mechanism
Water-electrolyte disorder
Acid-base disorder
Increased intracranial pressure
All is correct
3.10.22. A patient developed acidic diabetic coma. What is the leading mechanism in the development of
this state?
A.
B.
C.
D.
E.
Acid-base disorder
Water-electrolyte disorder
Energetic deficiency mechanism
Increased intracranial pressure
All is correct
3.10.23. A patient developed lactate-acid coma. What abnormality is the leading one in the pathogenesis of
this disorder?
A.
B.
C.
D.
E.
Acid-base disorder
Water-electrolyte disorder
Energetic deficiency mechanism
Increased intracranial pressure
All is correct
3.10.24. A patient with a cranial-cerebral trauma developed coma. What abnormality is the leading one in
the pathogenesis of this disorder?
A. Increased intracranial pressure
B.
C.
D.
E.
Water-electrolyte disorder
Energetic deficiency mechanism
Acid-base disorder
All is correct
3.10.25. A patient with extensive burns of the second and third degrees developed shock. What is (are) the
main factor(s) in the pathogenesis of this type of shock?
A.
B.
C.
D.
E.
All these factors
Pain
Toxaemia
Dehydration
Infection of burn surfaces
3.10.26. A patient developed hypovolemic collapse. What could be the cause of its development?
A.
B.
C.
D.
E.
All these factors
Profuse diarrhoea
Extensive areas of burn
Acute massive bleeding
Redistribution of blood with its deposition it in the venous vessels
3.10.27. A patient with insulin dependant diabetes mellitus administered himself a dose of insulin, but was
not able to eat. What complications can develop in the patient?
A.
B.
C.
D.
E.
Hypoglycaemic coma
Hyperglycaemic coma
Hipocorticoid coma
Hepatic coma
Pancreatic coma
3.10.28. A patient with insulin dependant diabetes mellitus shortly after taking insulin developed hunger,
dizziness, weakness, cold sweat, and irritability. What caused the emergence of these signs?
A.
B.
C.
D.
E.
Carboniferous starvation of the brain
Increased dissolution of glycogen in the liver
Increased ketogenesis
Increased adipogenesis
Decreased gluconeogenesis
3.10.29. A 42-year-old woman was hospitalized to the intensive care unit due to lactic coma. Accumulation
of what substance in the patient’s blood caused the coma?
A.
B.
C.
D.
E.
Lactate
Format
Succinic acid
Ketone bodies
Urea
3.10.30. A patient was hospitalized to hospital with hypoglycaemic comma. What is primary in the
pathogenesis of this kind of coma?
A.
B.
C.
D.
Reduced synthesis of ATP in the brain neurons
Inhibition of neuronal function
Reduction of ionic gradients and depolarization of neurons
Loss of consciousness
E. Reduced activity of sodium-potassium pump
3.10.31. A patient with insulin dependant diabetes mellitus developed hypoglycaemic coma shortly after
insulin administration. At which glucose levels in the blood can this coma develop?
A.
B.
C.
D.
E.
<2.5 mmol / l
<3.5 mmol / l
<4.5 mmol / l
<5.5 mmol / l
<6.5 mmol / l
3.10.32. A patient with diabetes mellitus developed ketoacidic coma. What caused its development?
A.
B.
C.
D.
E.
Accumulation of ketone bodies
Deficiency of ketone bodies
Hypoglycaemia
Metabolic alkalosis
Accumulation of lactic acid
3.10.33. A 14-year-old adolescent has sharply lost his body weight for 3-month period and developed coma.
Blood glucose levels are 50 mmol/l. What is the main mechanism of this coma?
A.
B.
C.
D.
E.
Hyperosmotic
Hypoglycaemic
Ketoacidic
Lactate-acidic
Hypoxic
3.10.34. A 50-year-old female was hospitalized by "ambulance" to the hospital. Hyperosmotic coma was
diagnosed. At which blood glucose levels can this coma develop?
A.
B.
C.
D.
E.
> 50 mmol / l
> 40 mmol / l
> 30 mmol / l
> 20 mmol / l
> 10 mmol / l
3.10.35. A 47-year-old male was hospitalized by "ambulance" to the hospital. Hyperosmotic coma was
diagnosed. What underlies the development of this type of coma?
A.
B.
C.
D.
E.
Hyperglycaemia
Accumulaton of ketone bodies
Glycosuria
Hypoglycaemia
Hypernatraemia
3.10.36. A patient with chronic alcoholic hepatitis developed hepatic coma. Impairment of what liver
function led to the development of this coma?
A.
B.
C.
D.
Antitoxic function
Phagocytic function
Protein synthesis function
Inactivation of hormones
E. Metabolic function
3.10.37. A patient with hepatitis B developed coma. What is the main mechanism in the pathogenesis of
this type of coma?
Increase of neurotoxic substances in the blood
Decreased synthesis of ATP in the brain neurons
Impairment of metabolic liver function
Portal hypertension
Loss of consciousness
3.10.38. A patient with liver cirrhosis developed hepatic coma. What changes of acid-base status will be
observed in this type of coma?
Metabolic acidosis
Gas alkalosis
No change
Metabolic alkalosis
Gas acidosis
3.10.39. A patient with chronic pyelonephritis with chronic renal insufficiency developed uremic coma.
What changes in the blood are characteristic of this pathologic state?
Azotemia
Ketonemia
Hyperglycemia
Hematuria
Proteinuria
3.10.40. A patient with uremic coma presents with anorexia, nausea, and vomiting. What caused the
development of these symptoms?
Toxic damage to the central nervous system
Toxic liver damage
Toxic damage to the pancreas
Toxic damage to the stomach
Toxic damage to intestine
3.10.41. A patient with chronic renal failure developed uremic coma. What causes coma with chronic renal
failure?
Retention hyperazotaemia
Pproduction hyperazotaemia
Hyperglycaemia
Hypoglycaemia
Hypoxia
3.10.42. A patient with chronic renal failure developed uremic coma. What signs are required for coma?
Weakening or absence of reflexes to external stimuli
Seasures
Hyperglycaemia
Hypoglyacemia
Increase of blood pressure
3.10.43. A patient’s general condition sharply deteriorated at the 3rd day after myocardial infarction. He
developed tachycardia, arrhythmia, AP 50/20 mmHg, shortness of breath, alteration of consciousness.
What complications developed in the patient?
Cardiogenic shock
Hypovolaemic shock
Traumatic shock
Angina
Coma
3.10.44. A patient with an aneurysm has developed complication in the form of cardiogenic shock. What is
the leading mechanism in the pathogenesis of this type of shock?
Reduction of cardiac minute volume
Increased minute volume of the heart
Reduction of circulating blood
Development of paroxysmal tachycardia
Longlasting spasm of arterioles
3.10.45. A patient with pericardial effusion has developed cardiogenic shock. What are the changes in
cardiac output and total peripheral vascular resistance with this complication?
Reduced cardiac output, increased peripheral resistance
Cardiac output and peripheral resistance are decreased
Increased cardiac output, and decreased peripheral resistance
Cardiac output and peripheral resistance are increased
Cardiac output does not change, peripheral resistance is decreased
3.10.46. A patient with acute blood loss was admitted to the hospital by the ambulance. The patient is
confused, his skin is pale, extremities are cold; he is also marked for presence of cold sweat, and shortness
of breath; pulse rate is 140 / min, AP - 95/50 mm Hg. What extreme condition developed in the patient?
A.
B.
C.
D.
E.
Hemorrhagic shock
Traumatic shock
Collapse
Traumatic coma
Haemotransfusion shock
3.10.47. A patient with hypovolemic shock was admitted to the hospital by the ambulance. What is the
main patogenetic mechanism in the development of this type of shock?
A.
B.
C.
D.
E.
Reduced volume of circulating blood
Increased volume of circulating blood
Loss of consciousness
Brain hypoxia
Centralization of blood circulation
3.10.48. A patient with burns of large areas of the body was admitted to the burning department of the
haspital. What is the cause of the organism intoxication with the combustion shock?
A.
B.
C.
D.
E.
Products of thermal protein denaturation
Increased permeability of vascular wall
Loss of plasma
Trombosis and microcirculation disorders
Pain
3.10.49. Affected by fire patient was admitted to the hospital due to burn shock. What is the cause of
dehydration of the organism with the burn shock?
A.
B.
C.
D.
Loss of plasma
Loss of blood
Increased coagulation
Reduced peripheral vascular tone
E. Denaturation of proteins in damaged tissues
3.10.50. After the introduction of penicillin the patient developed anaphylactic shock. What is crucial in the
pathogenesis of anaphylactic shock?
A.
B.
C.
D.
E.
Expansion of peripheral vessels
Narrowing of peripheral vessels
Reduction of cardiac ejection
Increase of cardiac fraction ejection
Opening of arteriovenous anastomoses
3.10.51. A 45-year-old man injured by a road accident was admitted to the hospital in traumatic shock.
What features are characteristic of the first phase of traumatic shock?
A.
B.
C.
D.
E.
Anxiety, narrowed pupils, tachycardia
Anxiety, narrowed pupils, hypotension
Abnormal consciousness, hypotension, bradycardia
Loss of consciousness, tachycardia, bradypnoe
Inhibition of consciousness, bradycardia, dilated pupils
3.10.52. A 45-year-old man injured by a road accident was admitted to the hospital in traumatic shock.
What features are characteristic of the second phase of traumatic shock?
A.
B.
C.
D.
E.
Inhibition of consciousness, hypotension, “shock lungs”
Anxiety, hypotension, “shock kidneys”
Abnormal consciousness, hypertension, bradycardia
Loss of consciousness, tachycardia, bradypnoe
Anxiety, dilated pupils, tachycardia
3.10.53. A 45-year-old man injured by a road accident was admitted to the hospital in traumatic shock.
What features are characteristic of the third phase of traumatic shock?
A.
B.
C.
D.
E.
Tachycardia
Hypotension
Bradycardia
Bradypnoe
Loss of consciousness
3.10.54. A 51-year-old man injured by a road accident was admitted to the hospital in traumatic shock.
What features are characteristic of the second phase of traumatic shock?
A.
B.
C.
D.
E.
Hypotension
Hypertension
Increased volume of circulating blood
Dilated pupils
Anxiety
3.10.55. To a 35-year-old woman with the blood group A injured in the road accident large quantities of the
blood group B were transfused in the ambulance automobile. What complication should have emerged in
the patien due to the blood transfusion?
Hemolytic shock
Hemorrhagic shock
Traumatic shock
Hypovolemic shock
Cardiogenic shock
3.10.56. A patient due to blood loss developed mild hypovolemic shock. What compensatory mechanisms
will participate in this shock?
Reduction of diuresis
Reduction of peripheral resistance vessels
Bradycardia
Euphoria
Abnormal consciousness
3.10.57. A patient as a result of blood loss developed hypovolemic shock of moderate severety. What
compensatory mechanisms will participate in this shock?
A.
B.
C.
D.
E.
Secretion of adrenaline
Oxytocin secretion
Secretion somatotropin
Secretion of thyrotropic hormone
Gonadotropin secretion
3.10.58. A patient as a result of blood loss in a car accident developed hypovolemic shock of moderate
severety. What compensatory mechanisms will participate in this shock?
A.
B.
C.
D.
E.
Vasoconstriction of peripheral vessels
Vasodilation of peripheral vessels
Bradypnoe
Uniform redistribution of the blood
Glucagon secretion
3.10.59. A child with intestinal infection due to profuse diarrhea developed anhydremic shock. What is the
leading pathogenetic mechanism in the development of this type of shock?
A.
B.
C.
D.
E.
Hypovolemia
Reduced minute blood volume
Dicrease of blood pressure
Hypoxemia
Intoxication
3.10.60. A patient with diabetes insipidus developed anhydremic shock. What factors are important in the
development of this type of shock?
A.
B.
C.
D.
E.
All of these
Hyperazotaemia
Intoxication
Hypoxemia
Acidosis