krok

Krok 1 Medicine 2014 1

1.The infectious diseases departmentof a hospital admitted a patient wi-th nausea, liquid stool with mucusand blood streaks, fever, weakness.Dysentery was suspected. Whatmethod of laboratory diagnosticsshould be applied to confirm the di-agnosis?

A. BacteriologicalB. SerologicalC. MycologicalD. MicroscopicE. Protozoological

2. Malaria is treated with structuralanalogs of vitamin B2 (riboflavin).These drugs disrupt the synthesis ofthe following enzymes in plasmodium:

A. FAD-dependent dehydrogenaseB. Cytochrome oxidaseC. PeptidaseD. NAD-dependent dehydrogenaseE. Aminotransferase

3. A 6-year-old child with suspectedactive tuberculous process underwentthe diagnostic Mantoux test. Whatimmunobiological preparation wasinjected?

A. TuberculinB. BCG vaccineC. DTP vaccineD. TularinumE. Td vaccine

4. In a young man during exercise, theminute oxygen uptake and carbon di-oxide emission equalled to 1000 ml.What substrates are oxidized in thecells of his body?

A. CarbohydratesB. ProteinsC. FatsD. Carbohydrates and fatsE. Carbohydrates and proteins

5. A sportsman spontaneously heldbreath for 40 seconds, which resulted inan increase in heart rate and systemicarterial pressure. Changes of theseindicators are due to activation of thefollowing regulatory mechanisms:

A. Unconditioned sympathetic reflexesB. Unconditioned parasympatheticreflexesC. Conditioned sympathetic reflexesD. Conditioned parasympatheticreflexesE. -

6. A 53-year-old male patient is di-agnosed with Pagets disease. Theconcentration of oxyproline in dailyurine is sharply increased, which pri-marily means intensified disintegrationof:

A. CollagenB. KeratinC. AlbuminD. HemoglobinE. Fibrinogen

7. A patient has hoarseness of voi-ce. During laryngoscopy a gray-whitelarynx tumor with papillary surface hasbeen detected.Microscopic investigati-on has shown the following: growth ofconnective tissue covered with multi-layer, strongly keratinized pavementepithelium, no cellular atypia. What isthe most likely diagnosis?

A. PapillomaB. FibromaC. PolypD. AngiomaE. Angiofibroma

8. During autopsy approximately 2,0liters of pus have been found in theabdominal cavity of the corpse. Peri-toneum is lustreless and has grayishshade, serous tunic of intestines hasgrayish-colored coating that is easilyremovable. Specify the most likely typeof peritonitis in the patient:

A. Fibrinopurulent peritonitisB. Hemorrhagic peritonitisC. Serous peritonitisD. Tuberculous peritonitisE. -

9. Autopsy of a dead patientrevealed bone marrow hyperplasiaof tubular and flat bones (pyoidmarrow), splenomegaly (6 kg) andhepatomegaly (5 kg), enlargement ofall lymph node groups. What disease


are the identified changes typical for?

A. Chronic myelogenous leukemiaB. Chronic lymphocytic leukemiaC. Multiple myelomaD. Polycythemia veraE. Hodgkins disease

10. Autopsy of the dead patient whodied from pulmonary edema revealeda large yellow-grey nidus in themyocardium, and a fresh thrombus inthe coronary artery. What is the mostlikely diagnosis?

A. Myocardial infarctionB. CardiosclerosisC. MyocarditisD. AmyloidosisE. Cardiomyopathy

11. An animal experiment is aimed atstudying the cardiac cycle. All the heartvalves are closed. What phase of thecycle is characterized by this status?

A. Isometric contractionB. Asynchronous contractionC. Protodiastolic periodD. Rapid fillingE. Reduced filling

12. Cyanide is a poison that causesinstant death of the organism. Whatenzymes found in mitochondria areaffected by cyanide?

A. Cytochrome oxidase (aa3)B. Flavin enzymesC. Cytochrome 5D. NAD+-dependent dehydrogenaseE. Cytochrome P-450

13. Increased HDL levels decrease therisk of atherosclerosis. What is themechanism of HDL anti-atherogenicaction?

A. They remove cholesterol from ti-ssuesB. They supply tissues with cholesterolC. They are involved in the breakdownof cholesterolD. They activate the conversion ofcholesterol to bile acidsE. They promote absorption ofcholesterol in the intestine

14. It has been found out that one

of a pesticide components is sodiumarsenate that blocks lipoic acid. Whi-ch enzyme activity is impaired by thispesticide?

A. Pyruvate dehydrogenase complexB. Microsomal oxidationC. Methemoglobin reductaseD. Glutathione peroxidaseE. Glutathione reductase

15. Stool culture test revealed in a 6-month-old bottle-fed baby the strain ofintestinal rod-shaped bacteria of anti-gen structure 0-111. What diagnosiscan be made?

A. ColienteritisB. GastroenteritisC. Choleriform diseaseD. Food poisoningE. Dysentery-like disease

16. A boy referred to a genetics clinicwas found to have 1 drumstick in bloodneutrophils. The boy is likely to havethe following syndrome:

A. KlinefeltersB. DownsC. TurnersD. EdwardsE. Trisomy X

17. A drycleaners worker has beenfound to have hepatic steatosis. Thispathology can be caused by the di-sruption of synthesis of the followingsubstance:

A. PhosphatidylcholineB. TristearinC. UreaD. Phosphatidic acidE. Cholic acid

18. Ascarid eggs have been detectedduring stool analysis. What drugshould be prescribed?

A. MebendazoleB. NystatinC. ChloramphenicolD. TetracyclineE. Furazolidone

19. Bacteriological examination of theurine of the patient with pyelonephri-tis revealed microorganisms that


produced yellow-green pigment anda characteristic odor in meat-peptoneagar. What are they called?

A. PseudomonasB. EscherichiaC. ProteasD. KlebsiellaE. Azotobacter

20. Feces of a patient contain highamount of undissociated fats and havegrayish-white color. Specify the causeof this phenomenon:

A. Obturation of bile ductB. Hypoactivation of pepsin byhydrochloric acidC. HypovitaminosisD. EnteritisE. Irritation of intestinal epithelium

21. A 46-year-old female patientconsulted a doctor about pain in thesmall joints of the upper and lowerlimbs. The joints are enlarged andshaped like thickened nodes. Serumtest revealed an increase in urateconcentration. This might be causedby a disorder in metabolism of:

A. PurinesB. CarbohydratesC. LipidsD. PyrimidinesE. Amino acids

22. A 26-year-old female consulted adoctor about having stool with whi-te flat moving organisms resembli-ng noodles. Laboratory analysisrevealed proglottids with the followi-ng characteristics: long, narrow, with alongitudinal channel of the uterus wi-th 17-35 lateral branches on each side.What kind of intestinal parasite wasfound?

A. Taeniarhynchus saginatusB. Taenia soliumC. Hymenolepis nanaD. Diphyllobothrium latumE. Echinococcus granulosus

23. A male patient is 28 years old. Hi-stological study of a cervical lymphnode revealed a change of its patterndue to the proliferation of epithelioid,lymphoid cells and macrophages havi-

ng nuclei in form of a horseshoe. Inthe center of some cell clusters therewere non-structured light-pink areaswith fragments of nuclei. What diseaseare these changes typical for?

A. TuberculosisB. Hodgkins diseaseC. ActinomycosisD. Tumor metastasisE. Syphilis

24. A biochemical urine analysis hasbeen performed for a patient withprogressive muscular dystrophy. Inthe given case muscle disease can beconfirmed by the high content of thefollowing substance in urine:

A. CreatineB. PorphyrinC. UreaD. Hippuric acidE. Creatinine

25. While examining foot blood supplya doctor checks the pulsation of alarge artery running in the separatefibrous channel in front of articulatiotalocruralis between the tendons oflong extensor muscles of hallux andtoes. What artery is it?

A. A. dorsalis pedisB. A. tibialis anteriorC. A. tarsea medialisD. A. tarsea lateralisE. A. fibularis

26. A patient with chronic heart fai-lure with edema has increased levelof blood aldosterone. What diureticwould be most effective in this case?

A. SpironolactoneB. TriamtereneC. AcetazolamideD. HydrochlorothiazideE. Furosemide

27. During autopsy the followinghas been revealed: the meningesof the upper cerebral hemispheresare extremely plethoric, of yellow-green color and are soaked withpurulent effluent. What kind of meni-ngitis is characterised by such clinicalpresentations?


A. Meningococcal meningitisB. Tuberculous meningitisC. Grippal meningitisD. Anthrax-inducedE. Epidemic typhus-induced

28. A 41-year-old male patienthas a history of recurrent attacksof heartbeats (paroxysms), profusesweating, headaches. Examinationrevealed hypertension, hyperglycemia,increased basal metabolic rate, andtachycardia. These clinical presentati-ons are typical for the followingadrenal pathology:

A. Hyperfunction of the medullaB. Hypofunction of the medullaC. Hyperfunction of the adrenal cortexD. Hypofunction of the adrenal cortexE. Primary aldosteronism

29. A comminuted fracture ofinfraglenoid tubercle caused byshoulder joint injury has been detectedduring X-ray examination of a patient.What muscle tendon attached at thissite has been damaged?

A. Long head of m. triceps brachiiB. Long head of m. biceps brachiiC. Medial head of m. triceps brachiiD. Lateral head of m. triceps brachiiE. Short head of m. biceps brachii

30. A patient has increased thicknessof alveolar-capillary membrane causedby a pathologic process. The directconsequence will be reduction of thefollowing value:

A. Diffusing lung capacityB. Oxygen capacity of bloodC. Respiratory minute volumeD. Alveolar ventilation of lungsE. Expiratory reserve volume

31.What drug will be most appropriatefor the patient who has chronic gastri-tis with increased secretion?

A. PirenzepineB. PancreatineC. PepsinD. AprotininE. Chlorphentermine

32. As a result of careless handling ofan iron, a 34-year-old female patient

has got acute pain, redness, swellingof her right index finger. A few mi-nutes later, there appeared a blister fi-lled with a transparent liquid of straw-yellow color. The described changesare a manifestation of the followingpathological process:

A. Exudative inflammationB. Traumatic edemaC. Alternative inflammationD. Proliferative inflammationE. Vacuolar degeneration

33. A 42-year-old male with a lesion ofthe ulnar nerve is unable to flex theII and V fingers to the midline. Whi-ch muscle function is impaired in thiscase?

A. Palmar interosseous musclesB. Dorsal interosseous muscleC. FidicinalesD. Short palmar muscleE. Abductor muscle of little finger

34. A smear from the tonsillar coatingof a patient with suspected diphtheriawas found to contain blue bacilli with athickening at the poles. What methodof smear staining was used?

A. LefflerB. BurriC. HinsD. GramE. Neisser

35. A child was born asphyxiated.What drug must be administered to thenewborn to stimulate breathing?

A. AethimizolumB. LobelineC. PrazosinD. AtropineE. Proserine

36. A 40-year-old patient with theprogressing staphylococcal purulentperiodontitis developed purulentinflammation of bone marrow spacesof the alveolar process, and then ofthe body of mandible. Microscopyrevealed thinning of bone trabeculae,foci of necrosis, bone sequesterssurrounded by the connective tissuecapsule. What is the most likely di-agnosis?


A. Chronic osteomyelitisB. Acute osteomyelitisC. ParodontomeD. Chronic fibrous periostitisE. Purulent abscess

37. Human red blood cells do notcontain mitochondria. What is themain pathway for ATP production inthese cells?

A. Anaerobic glycolysisB. Aerobic glycolysisC. Oxidative phosphorylationD. Creatine kinase reactionE. Cyclase reaction

38. A 40-year-old female patient hasundergone thyroidectomy. Histologicalstudy of thyroid gland found the folli-cles to be of different size and containfoamy colloid, follicle epithelium is hi-gh and forms papillae, there is focallymphocytic infiltration in stroma. Di-agnose the thyroid gland disease:

A. Basedows diseaseB. Hashimotos thyroiditisC. Riedels thyroiditisD. De Quervains diseaseE. Nodular goiter

39. A 43-year-old-patient has arteri-al hypertension caused by an increasein cardiac output and general peri-pheral resistance. Specify the variant ofhemodynamic development of arterialhypertension in the given case:

A. EukineticB. HyperkineticC. HypokineticD. CombinedE. -

40. A patient has been hospitalisedwith provisional diagnosis of virus Bhepatitis. Serological reaction basedon complementation of antigen withantibody chemically bound to peroxi-dase or alkaline phosphatase has beenused for disease diagnostics. What isthe name of the applied serologicalreaction?

A. Immune-enzyme analysisB. Radioimmunoassay techniqueC. Immunofluorescence testD. Bordet-Gengou testE. Antigen-binding assay

41. A patient has been hospitalised wi-th provisional diagnosis of botulism.What serological reaction should beused to reveal botulinum toxin?

A. Neutralization reactionB. Agglutination reactionC. Bordet-Gengou testD. Precipitation reactionE. Immunofluorescence test

42. Examination of a 52-year-oldfemale patient has revealed a decreasein the amount of red blood cells andan increase in free hemoglobin inthe blood plasma (hemoglobinemia).Color index is 0,85. What type ofanemia is being observed in the pati-ent?

A. Acquired hemolyticB. Hereditary hemolyticC. Acute hemorrhagicD. Chronic hemorrhagicE. Anemia due to diminishederythropoiesis

43. The processes of heat transfer ina naked person at room temperaturehave been studied. It was revealed thatunder these conditions the greatestamount of heat is transferred by:

A. Heat radiationB. Heat conductionC. ConvectionD. EvaporationE. -

44. Urine analysis has shown highlevels of protein and erythrocytesin urine. This can be caused by thefollowing:

A. Renal filter permeabilityB. Effective filter pressureC. Hydrostatic blood pressure inglomerular capillariesD. Hydrostatic primary urine pressurein capsuleE. Oncotic pressure of blood plasma

45. The development of both immune


and allergic reactions is based uponthe same mechanisms of the immunesystem response to an antigen. Whatis the main difference between theimmune and allergic reactions?

A. Development of tissue lesionB. Amount of released antigenC. Antigen structureD. Routes by which antigens are deli-vered into the bodyE. Hereditary predisposition

46.After a craniocerebral injury a pati-ent is unable to recognize objects bytouch. What part of brain has beendamaged?

A. Postcentral gyrusB. Occipital lobeC. Temporal lobeD. Precentral gyrusE. Cerebellum

47. A patient complaining of rapidpulse, dyspnea and bluish color ofmucosa has been admitted to the cardi-ological department. The objectivesymptoms are as follows: edema oflower extremities, ascites. Which ofthe given medicines should be prescri-bed for intravenous administration toimprove the patients general state?

A. CorglyconumB. CordiaminC. Adrenalin hydrochlorideD. DigitoxinE. Drotaverine

48. As a result of a continuouschronic encephalopathy, a patient hasdeveloped spontaneous motions anda disorder of torso muscle tone. Theseare the symptoms of the disorder of thefollowing conduction tract:

A. Tractus rubrospinalisB. Tractus corticospinalisC. Tractus corticonuclearisD. Tractus spinothalamicusE. Tractus tectospinalis

49. A 10-year-old child has painfulswallowing, neck edema, temperaturerise up to 39, 0oC, the whole bodyis covered with bright-red petechialrash. Back of the throat and tonsilsare hyperemic, the tongue is crimson-

colored. Tonsillar surface is coveredwith isolated grayish-colored necrosisnidi. What disease is it?

A. Scarlet feverB. Meningococcal nasopharyngitisC. DiphtheriaD. InfluenzaE. Measles

50. In a patient elevation of bodytemperature takes turns with dropsdown to normal levels during the day.The rise in temperature is observedperiodically once in four days. Speci-fy the type of temperature curve:

A. Febris internuttensB. Febris continuaC. Febris reccurensD. Febris hecticaE. Febris remitens

51. As a result of a craniocerebralinjury, a patient has a decreased skinsensitivity. What area of the cerebralcortex is likely to be damaged?

A. Posterior central gyrusB. Occipital regionC. Cingulate gyrusD. Frontal cortexE. Anterior central gyrus

52. Diabetic nephropathy with uremiahas developed in a patient withpancreatic diabetes. The velocity ofglomerular filtration is 9 ml/min. Whatmechanism of a decrease in glomerularfiltration velocity and chronic renal fai-lure development is most likely in thecase of this patient?

A. Reduction of active nephron massB. Decrease in systemic arterialpressureC. Obstruction of nephron tubules withhyaline castsD. Tissue acidosisE. Arteriolar spasm

53. A 40-year-old patient has ulcerperforation in the posterior wall ofstomach. What anatomical structurewill blood and stomach content leakto?


A. Bursa omentalisB. Bursa praegastricaC. Right lateral channel (canalislateralis dexter)D. Left lateral channel (canalis lateralissinister)E. Bursa hepatica

54. A patient is diagnosed with heredi-tary coagulopathy that is characterisedby factor VIII deficiency. Specify thephase of blood clotting during whichcoagulation will be disrupted in the gi-ven case:

A. Thromboplastin formationB. Thrombin formationC. Fibrin formationD. Clot retractionE. -

55. Angiocardiography of a 60-year-old male patient revealed constri-ction of a vessel located in the leftcoronary sulcus of the heart. What isthe pathological vessel called?

A. Ramus circumflexusB. Ramus interventricularis posteriorC. A. coronaria dextraD. V.cordis parvaE. Ramus interventricularis anterior

56. Those organisms which in theprocess of evolution failed to developprotection from H2O2 can exist onlyin anaerobic conditions. Which of thefollowing enzymes can break hydrogenperoxide down?

A. Peroxidase and catalaseB. Oxygenase and hydroxylaseC. Cytochrome oxidase, cytochrome B5D. Oxygenase and catalaseE. Flavin-dependent oxidase

57. A patient complains of pain inthe right lateral abdomen. Palpationrevealed a dense, immobile, tumor-like formation. A tumor is likely to befound in the following part of the di-gestive tube:

A. Colon ascendensB. Colon transversumC. Colon descendensD. Colon sigmoideumE. Caecum

58. A patient complaining of pain inthe left shoulder-blade region has beendiagnosed with miocardial infarction.What kind of pain does the patienthave?

A. RadiatingB. VisceralC. PhantomD. ProtopathicE. Epicritic

59. A patient has a critical impairmentof protein, fat and hydrocarbon digesti-on. Most likely it has been caused bylow secretion of the following digesti-ve juice:

A. Pancreatic juiceB. SalivaC. Gastric juiceD. BileE. Intestinal juice

60. A female patient has facial neuritisthat has caused mimetic paralysis andhearing impairment. Hearing impai-rment results from the paralysis of thefollowing muscle:

A. Stapedius muscleB. Anterior auricular muscleC. Superior auricular muscleD. Posterior auricular muscleE. Nasal muscle

61. A 22-year-old female studentconsulted a physician about fever up to38oC, weakness, sore throat. Objecti-vely: there is white coating of thetongue. What histological structures ofthe tongue are involved in the formati-on of this coating?

A. Epithelium of the filiform papillaeB. Epithelium of the foliate papillaeC. Epithelium of the fungiform papillaeD. Epithelium of the circumvallatepapillaeE. Connective-tissue base of all thelingual papillae

62. A patient has a traumatic injury ofsternocleidomastoid muscle. This hasresulted in a decrease in the followingvalue:


A. Inspiratory reserve volumeB. Expiratory reserve volumeC. Respiratory volumeD. Residual volumeE. Functional residual lung capacity

63. The receptors under study providetransfer of information to the cortexwithout thalamic involvement. Specifythese receptors:

A. OlfactoryB. TactileC. GustatoryD. VisualE. Auditory

64. Prolonged fasting causeshypoglycemia which is amplified byalcohol consumption, as the followi-ng process is inhibited:

A. GluconeogenesisB. GlycolysisC. GlycogenolysisD. LipolysisE. Proteolysis

65. A 39-year-old female patient wi-th a history of diabetes was hospitali-zed in a precomatose state for diabeticketoacidosis. This condition had beencaused by an increase in the followingmetabolite level:

A. AcetoacetateB. CitrateC. Alpha-ketoglutarateD. MalonateE. Aspartate

66. A 37-year-old female patientcomplains of headache, vertigo,troubled sleep, numbness of limbs. Forthe last 6 years she has been workingat the gas-discharge lamp-producingfactory in the lead-processing shop.Blood test findings: low hemoglobinandRBC level, serum iron concentrati-on exceeds the norm by several times.Specify the type of anemia:

A. Iron refractory anemiaB. Iron-deficiency anemiaC. Minkowsky-Shauffard diseaseD. Hypoplastic anemiaE. Metaplastic anemia

67. During an animal experiment,

surgical damage of certain brainstructures has caused deep prolongedsleep. What structure is most likely tocause such condition, if damaged?

A. Reticular formationB. Basal ganglionC. Red nucleiD. HippocampusE. Cerebral cortex

68. A patient takes cholagogues. Whatother process besides biliary excretionwill be stimulated?

A. Intestinal motilityB. Gastric juice secretionC. Pancreatic juice secretionD. Gastric motor activityE. Water absorption

69. A 3-year-old child with meni-ngeal symptoms died. Postmortemmacroscopy of the pia matter revealedmiliary nodules which were mi-croscopically represented by a focusof caseous necrosis with masses of epi-thelioid and lymphoid cells with somecrescent-shaped large cells inbetweenhaving peripheral nuclei. Specify thetype of meningitis in the child:

A. TuberculousB. SyphiliticC. BrucellarD. GrippalE. Meningococcal

70. A patient with homogentisuria hassigns of arthritis, ochronosis. In thiscase, the pain in the joints is associ-ated with the deposition of:

A. HomogentisatesB. UratesC. PhosphatesD. OxalatesE. Carbonates

71. A patient with hereditaryhyperammonemia due to a disorderof ornithine cycle has developedsecondary orotaciduria. The increasedsynthesis of orotic acid is caused by anincrease in the following metabolite ofornithine cycle:


A. Carbamoyl phosphateB. CitrullineC. OrnithineD. UreaE. Argininosuccinate

72. Amniocentesis revealed two sexchromatin bodies (Barr bodies) in eachcell of the sample. What disease is thischaracter typical for?

A. Trisomy XB. Klinefelter syndromeC. Turners syndromeD. Downs syndromeE. Patau syndrome

73. A 49-year-old male patient wi-th acute pancreatitis was likely todevelop pancreatic necrosis, while acti-ve pancreatic proteases were absorbedinto the blood stream and tissue protei-ns broke up. What protective factors ofthe body can inhibit these processes?

A. 2-macroglobulin, 1-antitrypsinB. ImmunoglobulinC. Cryoglobulin, interferonD. Ceruloplasmin, transferrinE. Hemoplexin, haptoglobin

74. A 16-year-old female patient hasfainted after quickly changing her bodyposition from horizontal to verticalone. Which process from the oneslisted below has caused the loss ofconsciousness in the first place?

A. Decreasing venous returnB. Increasing venous returnC. Increasing central venous pressureD.Decreasing oncotic pressure of bloodplasmaE. Increasing arterial pressure

75. A 53-year-old male patientcomplains of acute pain in the righthypochondrium. Objective examinati-on revealed scleral icterus. Laboratorytests revealed increased ALT activity,and stercobilin was not detected in thestool. What disease is characterized bythese symptoms?

A. CholelithiasisB. Hemolytic jaundiceC. HepatitisD. Chronic colitisE. Chronic gastritis

76.A child patient has dry cough.Whatnon-narcotic antitussive drug will reli-eve the patients condition?

A. Glaucine hydrochlorideB. Codeine phosphateC. Morphine hydrochlorideD. Potassium iodideE. Althaea officinalis root extract

77. A patient complains of acute painattacks in the right lumbar region.During examination the nephrolithicobturation of the right ureter in theregion between its abdominal andpelvic segments has been detected.What anatomical boundary existsbetween those two segments?

A. Linea terminalisB. Linea semilunarisC. Linea arcuataD. Linea transversaE. Linea inguinalis

78. When measuring total muscle acti-on potential it was revealed that it wassubject to the power-law relationship.The reason for this is that individualmuscle fibers differ in:

A. Depolarization thresholdB. DiameterC. Conduction velocityD. Resting potentialE. Critical level of depolarization

79. A patient has insufficient bloodsupply to the kidneys, which hascaused the development of pressoreffect due to the constriction of arterialresistance vessels. This is the result ofthe vessels being greately affected bythe following substance:

A. Angiotensin IIB. AngiotensinogenC. ReninD. CatecholaminesE. Norepinephrine

80. A patient is diagnosed with iron-deficiency sideroachrestic anemia,


progression of which is characteri-sed by skin hyperpigmentation, pi-gmentary cirrhosis, heart and pancreasaffection. Iron level in the blood serumis increased. What disorder of ironmetabolism causes this disease?

A. Failure to assimilate iron leading toiron accumulation in tissuesB. Excessive iron intake with foodC. Disorder of iron absorption inbowelsD. Increased iron assimilation by bodyE. -

81. In a village, a case of anthraxhad been registered. Medical servi-ces began epidemiologically indicatedspecific prophylaxis of population agai-nst anthrax. What preparation wasused for this purpose?

A. Live vaccineB. Inactivated vaccineC. Chemical vaccineD. Genetically engineered vaccineE. Anatoxin

82. Experimental stimulation of thesympathetic nerve branches thatinnervate the heart caused an increasein force of heart contractions becausethe membrane of typical cardi-omyocytes permitted an increase in:

A. Calcium ion entryB. Calcium ion exitC. Potassium ion exitD. Potassium ion entryE. Calcium and potassium ion exit

83. According to the results of glucosetolerance test, the patient has nodisorder of carbohydrate tolerance.Despite that, glucose is detected inthe patientss urine (5 mmol/l). Thepatient has been diagnosed with renaldiabetes. What renal changes causeglucosuria in this case?

A. Decreased activity of glucosereabsorption enzymesB. Increased activity of glucosereabsorption enzymesC. Exceeded glucose reabsorptionthresholdD. Increased glucose secretionE. Increased glucose filtration

84. As a result of past encephalitis, amale patient has developed an increasein cerebrospinal fluid pressure in theright lateral ventricle. What can be thecause of this condition?

A. Closure of right interventricularforamenB. Closure of left interventricularforamenC. Atresia of tubus medullarisD. Atresia of sylvian aqueductE. Atresia of the fourth ventricleforamina

85. Parents of 5-year-old child reporthim o have frequent colds that developinto pneumonias, presence of purulentrashes on the skin. Laboratory testshave revealed the following: absenceof immunoglobulins of any type, andnaked cells are absent from the lymphnodes punctate. What kind of immunedisorder is it?

A. X-linked hypogammaglobulinemia(Bruton type agammaglobulinemia)B. Autosomal recessiveagammaglobulinaemia (Swiss type)C. Hypoplastic anemiaD. AgranulocytosisE. Louis-Barr syndrome

86. A 3-year-old child has conti-nuous fever, lymph nodes are enlarged,the amount of lymphocytes in bloodis significantly increased. Enzyme-linked immunosorbent assay (ELISA)revealed antigen of Epstein-Barr virus.What diagnosis can be made based onthe information given above?

A. Infectious mononucleosisB. Burkitts lymphomaC. Herpetic lymphadenopathyD. Generalized infection caused byherpes-zosterE. Cytomegalovirus infection

87.Amicroslide contains the preparati-on of a gland composed of severalsecretory saccule-shaped parts thatopen in the common excretory duct.What gland is it?


A. Simple branched alveolar glandB. Compound branched alveolar glandC. Simple unbranched alveolar glandD. Compound unbranched alveolarglandE. Simple branched tubular gland

88. A patient intending to undergoa gender reassignment surgery hasbeen admitted to a specialised cli-nic. In the course of examinationboth male and female gonades havebeen revealed, with male structure ofexternal genitals. What kind of genitalmaldevelopment has the patient?

A. True hermaphroditismB. Male pseudohermaphroditismC. Female pseudohermaphroditismD. Accessory ovaryE. Ectopia of testis

89. An 18-year-old male hasbeen diagnosed with Marfansyndrome. Examination revealed adevelopmental disorder of connecti-ve tissue and eye lens structure,abnormalities of the cardiovascularsystem, arachnodactylia. Whatgenetic phenomenon has caused thedevelopment of this disease?

A. PleiotropyB. ComplementarityC. CodominanceD. Multiple allelismE. Incomplete dominance

90. In case of alkaptonuria, homogenti-sic acid is excreted in urine in largeamounts. The development of this di-sease is associated with a disorder ofmetabolism of the following aminoacid:

A. TyrosineB. PhenylalanineC. AlanineD. MethionineE. Asparagine

91. A male patient complains of skininsensitivity of inferior eyelid, externallateral surface of nose and upper lip.A doctor in the course of examinati-on has revealed inflammation of thesecond branch of trigeminal nerve.What cranial foramen does this branch

go through?

A. SupraorbitalB. LacerumC. Superior orbital fissureD. SpinosumE. Oval

92. An patient with insomnia inducedby allergic rash and itch has beenprescribed the drug that has antihi-stamine and hypnotic effect. Specifythis drug:

A. BenadrylB. LoratadineC. PrednisoloneD. Acetylsalicylic acidE. Analgin

93. In a cat with decerebrate rigiditythemuscle tone is to be decreased. Thiscan be achieved by:

A. Destruction of the vestibular nucleiof DeitersB. Stimulation of the otolithic vesti-bular receptorsC. Stimulation of the vestibular nucleiof DeitersD. Stimulation of the vestibulocochlearnerveE. Stimulation of the ampullar vesti-bular receptors

94. When studying the signs ofpulmonary ventilation, reduction offorced expiratory volume has beendetected.What is the likely causeof thisphenomenon?

A. Obstructive pulmonary diseaseB. Increase of respiratory volumeC. Increase of inspiratory reservevolumeD. Increase of pulmonary residualvolumeE. Increase of functional residual lungcapacity

95. X-ray examination of a patientallowed to diagnose a tumor in thesuperior lobe of the right lung. Thereis a probability of metastases spread tothe following lymph nodes:


A. SternalB. Inferior mediastinumC. Anterior mediastinumD. AxillaryE. Deep lateral cervical

96. A 55-year-old patient with acharacteristic rash, fever, dizzinesshas been admitted to a hospital. Hehas been provisionally diagnosed wi-th typhus. No similar cases have beenreported. In his youth (15 years old)the patient suffered typhus in a boardi-ng school. What disease is it?

A. Brills diseaseB. Typhoid feverC. MeaslesD. RubellaE. Cholera

97. A young woman suddenlydeveloped fever up to 39oC accompani-ed by a strong headache. Examinati-on revealed marked nuchal rigidi-ty. Spinal puncture was performed.Gram-stained smear of cerebrospi-nal fluid contained many neutrophi-ls and Gram-positive diplococci. Whatbacteria could be the cause of this di-sease?

A. Neisseria meningitidisB. Streptococcus pneumoniaC. Haemophilus influenzaeD. Staphylococcus aureusE. Pseudomonas aeruginosa

98. In the course of an experimentadenohypophysis of an animal hasbeen removed. The resulting atrophyof thyroid gland and adrenal cortexhas been caused by deficiency of thefollowing hormone:

A. Tropic hormonesB. Thyroid hormonesC. SomatotropinD. CortisolE. Thyroxin

99. Degenerative changes in posteri-or and lateral columns of spinalcord (funicular myelosis) caused bymethylmalonic acid accumulationoccur in patients with B12-deficiencyanemia. This results in synthesis di-sruption of the following substance:

A. MyelinB. AcetylcholineC. NorepinephrineD. DopamineE. Serotonin

100. A patient with suspected tumorof lung had been admitted to theoncological department. Examinati-on revealed localised pathology in theinferior lobe of the left lung. Howmany bronchopulmonary segmentsdoes this lobe have?

A. 5B. 6C. 4D. 3E. 2

101. During local anesthetization thepatient has gone into anaphylacticshock. What drug must be admini-stered to the patient?

A. Epinephrine hydrochlorideB. DiazepamC. Atropine sulfateD. PropranololE. Nitroglycerin

102.As a result of an injury, the integri-ty of the anterior spinal cord root wasbroken. Specify the neurons and theirprocesses that had been damaged:

A. Axons of motor neuronsB. Motor neuron dendritesC. Axons of sensory neuronsD. Dendrites of sensory neuronsE. Dendrites of association neurons

103. A patient who had been taking di-clofenac sodium for arthritis of mandi-bular joint developed an acute conditi-on of gastric ulcer. Such side effect ofthis medicine is caused by inhibition ofthe following enzyme:

A. Cyclooxygenase-1 (COX-1)B. Cyclooxygenase-2 (COX-2)C. LipoxygenaseD. PhosphodiesteraseE. Monoamine oxidase

104. In one of Polessye regions therewas an outbreak of helminthiasis mani-fested by cramps and facial edmata.


The developed preventive measuresin particular included ban for eatinginfested pork even after heat processi-ng. What helminthiasis was the case?

A. TrichinosisB. TaeniarhynchosisC. TeniasisD. EchinococcosisE. Alveococcosis

105. A female patient saught medical-genetic consultation. Physical exami-nation revealed pterygium collideformity (webbed neck), broad chest,underdeveloped breasts. Study ofbuccal epithelium cells revealed noX-chromatin in the nuclei. This indi-cates that the patient has the followingsyndrome:

A. TurnersB. KlinefeltersC. PatausD. DownsE. Edwards

106. During blood transfusion apatient has developed intravascularerythrocyte hemolysis. What kind ofhypersensitivity does the patient have?

A. II type (antibody-dependent)B. I type (anaphylactic)C. III type (immune complex)D. IV type (cellular cytotoxicity)E. IV type (granulomatosis)

107. Patients with erythropoieticporphyria (Gunthers disease) haveteeth that fluoresce with bright redcolor when subjected to ultravioletradiation; their skin is light-sensitive,urine is red-colored. What enzyme cancause this disease, when it is deficient?

A. Uroporphyrinogen III cosynthaseB. Uroporphyrinogen I synthaseC. Delta-aminolevulinate synthaseD. Uroporphyrinogen decarboxylaseE. Ferrochelatase

108. During the air and bone conducti-on tests it was revealed that in theleft ear the tones were louder by boneconduction. This might be associatedwith the disease of:

A. Left middle earB. Right middle earC. Left inner earD. Right inner earE. Right external ear

109. In course of invasive abdominalsurgery a surgeon has to locate the ori-gin of the mesenteric root. Where is itnormally localized?

A. Duodenojejunal flexureB. Right flexure of colonC. Left flexure of colonD. Sigmoid colonE. Right mesenteric sinus

110. A 55-year-old male had beendelivered to the resuscitation unitunconscious. Relatives reported himto have mistakenly drunk an alcoholicsolution of unknown origin. On exami-nation the patient was diagnosed withmethanol intoxication. What antidoteshould be used in this case?

A. EthanolB. TeturamumC. NaloxoneD. Protamine sulfateE. Acetylcysteine

111. Due to the use of poor-quality measles vaccine for preventi-ve vaccination, a 1-year-old chi-ld has developed an autoimmunerenal injury. The urine was foundto contain macromolecular proteins.What process of urine formation hasbeen disturbed?

A. FiltrationB. ReabsorptionC. SecretionD. Reabsorption and secretionE. Secretion and filtration

112. As a result of a road accident a 37-year-old female victim developed uri-nary incontinence. What segments ofthe spinal cord had been damaged?

A. S2 S4B. Th1 Th5C. L1 L2D. Th2 Th5E. Th1 L1113. An 8-week-pregnant woman


with acute respiratory disease andtemperature rise up to 39, 0oC hascalled in a doctor. The doctor insistedon her avoiding taking paracetamol,because in this period of pregnancythere is a risk of its:

A. TeratogenicityB. EmbryotoxicityC. FetotoxicityD. HepatotoxicityE. Allergenicity

114. A pneumonia patient has beenadministered acetylcysteine as a partof complex therapy. What principleof therapy has been taken into consi-deration when applying this drug?

A. PathogeneticB. SymptomaticC. EtiotropicD. AntimicrobialE. Immunomodulatory

115. A 26-year-old female patient wi-th bronchitis has been administered abroad spectrum antibiotic as a causaltreatment drug. Specify this drug:

A. DoxycyclineB. InterferonC. BCG vaccineD. AmbroxolE. Dexamethasone

116. When defining blood groupaccording to the AB0 system, usingsalt solutions of monoclonal antibodi-es, agglutination didnt occur with anyof the solutions. What blood group isit?

A. 0 (I)B. (II)C. (III)D. (IV)E. -

117. Examination of a 56-year-oldfemale patient with a history of type1 diabetes revealed a disorder ofprotein metabolism that is manifestedby aminoacidemia in the laboratoryblood test values, and clinically by thedelayed wound healing and decreasedsynthesis of antibodies. Which ofthe following mechanisms causes the

development of aminoacidemia?

A. Increased proteolysisB. AlbuminosisC. Decrease in the concentration ofamino acids in bloodD. Increase in the oncotic pressure inthe blood plasmaE. Increase in low-density lipoproteinlevel

118. Symptoms of pellagra (vitamin PPdeficiency) is particularly pronouncedin patients with low protein diet,because nicotinamide precursor inhumans is one of the essential aminoacids, namely:

A. TryptophanB. ThreonineC. ArginineD. HistidineE. Lysine

119. A 68-year-old patient consultsa cardiologist, complaining of higharterial blood pressure, pain in theheart egion, intermittent pulse. Prescri-be the 1-adrenoreceptor blockerfor the treatment of the describedpathology:

A. MetoprololB. Morphine hydrochlorideC. NootropilD. FenoterolE. Benzylpenicillin

120. A female suffered rubella duri-ng pregnancy. The child was bornwith developmental abnormalities,namely cleft lip and palate. The childsgenotype is normal. These malformati-ons are a manifestation of:

A. Modification variabilityB. PolyploidyC. Combinative variabilityD. Chromosomal mutationE. Aneuploidy

121. An electron micrograph showsa cell-to-cell adhesion consisting, ineach cell, of an attachment plaque.The intercellular space is filled wi-th electron-dense substance includi-ng transmembrane fibrillar structures.Specify this adhesion:


A. DesmosomeB. SynapseC. Tight junctionD. NexusE. Adherens junction

122. For biochemical diagnostics ofmyocardial infarction it is necessaryto measure activity of a number ofenzymes and their isoenzymes. Whatenzymatic test is considered to be thebest to prove or disprove the diagnosisof infarction in the early period afterthe chest pain is detected?

A. Creatine kinase isoenzyme CK-MBB. Creatine kinase isoenzyme CK-MMC. LDH1 lactate dehydrogenaseisoenzymeD. LDH2 lactate dehydrogenaseisoenzymeE. Aspartate aminotransferasecytoplasmic isoenzyme

123. A patient complains of pain inthe heart area during acute attack ofgastric ulcer. What vegetative reflexcan cause this painful feeling?

A. Viscerovisceral reflexB. Viscerodermal reflexC. Visceromotor reflexD. Dermatovisceral reflexE. Motor-visceral reflex

124. A patient is diagnosed with acutemorphine hydrochloride intoxication.Prescribe an oxidizing agent for gastriclavage:

A. Potassium permanganateB. ChloramineC. Sulfocamphocainum (Procaine +Sulfocamphoric acid)D. CerigelE. Chlorhexidine (bi)gluconate

125. In the course of puncture biopsyof transplanted kidney the followi-ng has been revealed: diffuse infi-ltration of stroma by lymphocytesand plasmocytes and necrotic arteri-tis. What pathological process hasdeveloped in the transplant?

A. Immune rejectionB. Ischemic kidney failureC. GlomerulonephritisD. Tubular necrosisE. Pyelonephritis

126. During cell division, DNA repli-cation occurs by a signal from thecytoplasm, and a certain portion of theDNA helix unwinds and splits into twoindividual strains. What enzyme facili-tates this process?

A. HelicaseB. RNA polymeraseC. LigaseD. RestrictaseE. DNA polymerase

127. A female patient, having visitedthe factory premises with lots of dust inthe air for the first time, has got coughand burning pain in the throat. Whatrespiratory receptors, when irritated,cause this kind of reaction?

A. Irritant receptorsB. Juxtacapillary (J) receptorsC. Stretch receptors of lungsD. Proprioceptors of respiratorymusclesE. Thermoreceptors

128. Since a patient has had myocardi-al infarction, his atria and ventri-cles contract independently from eachother with a frequency of 60-70 and 35-40 per minute. Specify the type of heartblock in this case:

A. Complete atrioventricularB. Partial atrioventricularC. Sino-atrialD. Intra-atrialE. Intraventricular

129. A 35-year-old female patient hasbeen hospitalised with acute intoxi-cation caused by salts of high-densitymetals (lead, most probably). As a partof complex therapy the antidote thatcontains two active sulfhydric groupshas been prescribed. Specify this anti-dote:


A. DimercaprolB. MetamizoleC. MannitolD. Nalorphine hydrochlorideE. Calcium chloride

130. A 60-year-old male patient hastype II diabetes. A doctor has prescri-bed him synthetic hypoglycemic long-acting drug that is sulfonylurea deri-vative. What drug is it?

A. GlibenclamideB. ButamideC. MetforminD. Actrapid (soluble insulin)E. Acarbose

131. A patient has been given atropi-ne sulfate for rapid relief of spasticcolon symptoms. The use of this drugis contraindicated during the followngdisease:

A. GlaucomaB. Bronchial asthmaC. BradycardiaD. HypotensionE. Gastric ulcer

132. As an example of specific humanparasites one can name Plasmodiumfalciparum, human pinworm and someothers. The source of parasite invasionis always a human. Such specific humanparasites cause the diseases that arecalled:

A. AnthroponosesB. ZoonosesC. AnthropozoonosesD. InfectionsE. Multifactorial diseases

133. In an experiment a dog had beenconditioned to salivate at the sight offood and a flash of light. After conditi-oning the reflex, the light was then pai-red with the bell. The dog didnt startto salivate. What type of inhibition wasobserved?

A. ExternalB. DifferentialC. ExtinctiveD. PersistentE. Protective

134. A newborn baby has numerous

hemorrhages. Blood coagulation testsreveal increased prothrombin time.The child is most likely to have a di-sorder of the following biochemicalprocess:

A. Production of gamma-carboxyglutamateB. Conversion of homocysteine tomethionineC. Conversion of methylmalonyl CoAto succinyl CoAD. Degradation of glutathioneE. Hydroxylation of proline

135. A 63-year-old male patient withbladder atony had been prescribed amedication, which he had been arbi-trarily taking at a higher dose. Thepatient developed hypehydration, sali-vation, diarrhea, muscle spasms. Theprescribed drug relates to the followi-ng group:

A. CholinomimeticsB. Cholinesterase reactivatorsC. Adrenergc blockersD. TocolyticsE. Ganglionic blockers

136. A 67-year-old male patientconsumes eggs, pork fat, butter, mi-lk and meat. Blood test results:cholesterol - 12,3 mmol/l, total lipi-ds - 8,2 g/l, increased low-density li-poprotein fraction (LDL). What typeof hyperlipoproteinemia is observed inthe patient?

A. Hyperlipoproteinemia type IIaB. Hyperlipoproteinemia type IC. Hyperlipoproteinemia type IIbD. Hyperlipoproteinemia type IVE. Cholesterol, hyperlipoproteinemia

137. Tissue sampling of a 37-year-oldmale patient with chronic renal diseasehas revealed the following: sclerosis,lymphocytic and plasmocytic infiltrati-on of renal pelvis and calices walls,dystrophy and atrophy of tubules.Remaining tubules are enlarged andstretched with colloid masses, epitheli-um is flattened out ("scutiform"or"shield-shaped"kidney). What is themost likely diagnosis?


A. Chronic pyelonephritisB. Tubular interstitial nephritisC. Acute pyelonephritisD. GlomerulonephritisE. Nephrosclerosis

138. During the hystological studyof cortical shaft, basophilic cells wi-th developed synthesis organelles canbe seen on the bone surface under thelayer of fibers. These cells take part inbone tissue regeneration. What shaftlayer are they located in?

A. PeriosteumB. BoneC. Osteon layerD. Outer lamellae of compact bonetissueE. Inner lamellae of compact bonetissue

139. Autopsy of a 50-year-old malewho had tuberculosis revealed a densegray-white nidus in form of a nodule2 cm in diameter in the subpleuralportion of the upper right lobe. Thepleura in this region was thickened,in the pleural cavity there was asmall amount of serous hemorrhagicfluid. Histological study of the regionrevealed some glandular structures wi-th signs of cellular atypia and abnormalmitoses, which were found within thefibrous connective tissue. What otherpathology had developed in the lungs?

A. AdenocarcinomaB. Squamous cell carcinomaC. AdenomaD. FibrosarcomaE. Fibroma

140. In course of an experimentthere has been an increase in thenerve conduction velocity. This maybe caused by an increase in theconcentration of the following ionsthat are present in the solution aroundthe cell:

A. Na+B. K+ and ClC. K+ and Na+D. Ca2+ and ClE. Ca2+

141. Hepatitis B is diagnosed through

laboratory tests that determine thepresence of HBA-DNA in blood serumof the patient. What reference methodis applied for this purpose?

A. Polymerase chain reactionB. Hybridization methodC. Hybridization signal amplificationmethodD. Ligase chain reaction methodE. ELISA diagnostic method

142. On the 24th day since the onsetof disease, a male patient diagnosedwith typhoid fever and undergoingtreatment in an infectious diseaseshospital has suddenly developed cli-nical presentations of acute abdomenleading to the death of the patient.During autopsy peritonitis has beenrevealed, with numerous ulcers coveri-ng the colon mucosa and reaching asdeep as muscular and, in places, seroustunic. The ulcers have smooth edgesand even floor. The intestinal wallis perforated. What stage of typhoidfever has the lethal complication ari-sen at?

A. Clean ulcerB. Medullary swellingC. NecrosisD. Dirty ulcerE. Regeneration

143. An HIV-positive patients causeof death is acute pulmonary insuffi-ciency resulting from pneumonia.Pathohistological investigation of lungshas revealed interstitial pneumonia,alveolocyte desquamation andtheir methamorphoses: alveolocyteenlargement, large intranuclearinclusions surrounded by lightly-colored areas. Transformed cellsresemble owls eye. Name thepneumonia causative agent:

A. CytomegalovirusB. PneumococcusC. Influenza virusD. Candida fungiE. Toxoplasma

144. The organisms to be identifi-ed have a nucleus surrounded by anuclear membrane. Genetic materialis concentrated predominantly in the


chromosomes which consist of DNAstrands and protein molecules. Thesecells divide mitotically. Identify theseorganisms:

A. EukaryotesB. BacteriophagesC. ProkaryotesD. VirusesE. Bacteria

145. A 37-year-old male patientdeveloped pseudoarthrosis after aclosed fracture of the femur. Specifythe type of regeneration in the patient:

A. Pathological hypo-regenerationB. Pathological hyper-regenerationC. ReparativeD. PhysiologicalE. -

146. Nucleolar organizers of the 13-15,21, 22 human chromosomes containabout 200 cluster genes that synthesizeRNA. These regions of chromosomesbear the information on the followingtype of RNA:

A. rRNAB. tRNAC. mRNAD. snRNAE. tRNA + rRNA

147. The resuscitation unit has admi-tted a patient in grave condition.It is known that he had mistakenlytaken sodium fluoride which blockscytochrome oxidase. What type ofhypoxia developed in the patient?

A. TissueB. HemicC. CardiovascularD. HypoxicE. Respiratory

148. Steatosis is caused by theaccumulation of triacylglycerols inhepatocytes. One of the mechani-sms of this disease development is adecrease in the utilization of VLDLneutral fat. What lipotropics preventthe development of steatosis?

A. Methionine, B6, B12B. Arginine, B2, B3C. Alanine, B1, PPD. Valine, B3, B2E. Isoleucine, B1, B2

149.A 2-year-old boy is diagnosed withDown syndrome. What chromosomalchanges may be the cause of this di-sease?

A. Trisomy 21B. Trisomy 13C. Trisomy XD. Trisomy 18E. Monosomy X

150. A patient who has recently arri-ved from an endemic area presentswith elevated body temperature,headache, chills, malaise, that is withthe symptoms which are typical for acommon cold. What laboratory testsare necessary to prove or to disprovethe diagnosis of malaria?

A. Microscopy of blood smearsB. Study of lymph node punctateC. UrinalysisD. Study of cerebrospinal fluidE. Microscopy of bone marrowpunctate

151. A patient has severe blood losscaused by an injury. What kind ofdehydration will be observed in thisparticular case?

A. Iso-osmolarB. HyposmolarC. HyperosmolarD. NormosmolarE. -

152. A 30-year-old patient has dyspneafits, mostly at night. He has been di-agnosed with bronchial asthma. Whattype of allergic reaction according tothe Gell-Coombs classification is mostlikely in this case?

A. AnaphylacticB. CytotoxicC. StimulatingD. Immune complexE. Delayed-type hypersensitivity

153. Decarboxylation of glutamateinduces production of gamma-


aminobutyric acid (GABA )neurotransmitter. After breakdown,GABA is converted into a metaboli-te of the citric acid cycle, that is:

A. SuccinateB. Citric acidC. MalateD. FumarateE. Oxaloacetate

154. An outbreak of an intestinalinfection occurred in a kindergarten onthe eve of New Year holidays. Bacteri-ological examination of patientsfaeces didnt reveal any pathogenicbacteria. Electronmicroscopy revealedroundish structures with clear outeredges and a thick core resembling awheel. Specify the most likely causati-ve agent of this infection:

A. RotavirusB. AdenovirusC. Coxsacki-virusD. E.coliE. P.vulgaris

155. A smear of streptobacilluspreparation stained by Ozheshkomethod has been studied microscopi-cally with oil immersion. Whatstructural feature of the bacteria hasbeen studied?

A. SporesB. CapsuleC. FlagellaD. InclusionsE. Structure of cell wall

156. After a road accident a victimhas tachycardia, arterial blood pressure130/90 mm Hg, tachypnoe, the skinis pale and dry, excitation of centralnervous system is observed. Whatshock stage is the patient most likelyin?

A. ErectileB. TerminalC. TorpidD. Preshock (compensation stage)E. Agony

157. Autopsy has revealed shrunkenkidneys weighing 50 mg, with fine-grained surface and uniformly thi-

nned substance. Microscopic investi-gation has shown the thickening ofarteriole walls due to accumulation ofhomogeneous anhistic pink-colouredmasses in them. Glomerules wereundersized, sclerotic, with atrophi-ed tubules. What disease are thesechanges characteristic of?

A. Essential hypertensionB. Pyelonephritis with kidney shrinkageC. Renal amyloidosisD. Acute glomerulonephritisE. Membranous nephropathy

158. A fixed-run taxi passenger hasa sudden and expressed attack oftachycardia. A doctor travelling by thesame taxi has managed to slow downhis heart rate by pressing upon theeyeballs and thus causing the followingreflex:

A. Dagnini-Aschner reflexB. Bainbridge reflexC. Holtzs reflexD. Hering-Breuer reflexE. Frank-Starling mechanism

159. Histological examination of bi-opsy samples taken from the thickenededges of a gastric ulcer revealed smallclusters of small, markedly atypicalhyperchromatic epithelial cells thatwere localized in the overdevelopedstroma. Specify the tumor:

A. Scirrhous undifferentiated carci-nomaB. Medullary carcinomaC. AdenocarcinomaD. Undifferentiated sarcomaE. Adenoma

160. A 10-year-old child was found tohave a congenital hypoplasia of theleft kidney. Ultrasound examinationrevealed that the right kidney wasmarkedly enlarged and had regularshape. No functional disorders wererevealed. Specify the process thatdeveloped in the right kidney:

A. Vicarious hypertrophyB. Working hypertrophyC. Hypertrophic growthD. PseudohypertrophyE. Metaplasia


161. In allergic diseases, a dramaicincrease in basophilic leukocytenumber in patients blood is observed.This phenomenon is due to the followi-ng basophil function:

A. Participation of heparin and histami-ne in metabolismB. Phagocytosis of microorganisms andsmall particlesC. Immunoglobulin synthesisD. Phagocytosis of immune complexesE. Participation in blood clotting

162. A 47-year-old male patientdeveloped intestinal colic against thebackground of essential hypertension.In this situation it would be most effi-cient to arrest the colic by using drugsof the following group:

A. Myotropic antispasmodicsB. Anticholinesterase agentsC. SympathomimeticsD. M-cholinomimeticsE. Adrenomimetics

163.Apatient has been admitted to thecontagious isolation ward with signsof jaundice caused by hepatitis virus.Which of the symptoms given belowis strictly specific for hepatocellularjaundice?

A. Increase of ALT, AST levelB. HyperbilirubinemiaC. BilirubinuriaD. CholemiaE. Urobilinuria

164. An underage patient has signs ofachondroplasia (dwarfism). It is knownthat this is a monogenic disease andthe gene that is responsible for thedevelopment of such abnormalities isa dominant one. The development ofthat childs brother is normal. Specifythe genotype of the healthy child:

A. aaB. AAC. AaD. AaBbE. AABB

165. A patient has acute bronchitis.The fever up to 38, 5oC had lasted for aweek, presently there is a decrease in

temperature down to 37, 0oC. Specifythe leading mechanism in the 3rd stageof fever:

A. Peripheral vasodilationB. Increased heat productionC. Development of chillD. Increased diuresisE. Increased respiratory rate

166. A 35-year-old female patienthas undergone biopsy of the breastnodules. Histological examination hasrevealed enhanced proliferation ofthe small duct and acini epithelialcells, accompanied by the formation ofglandular structures of various shapesand sizes, which were located in the fi-brous stroma. What is the most likelydiagnosis?

A. FibroadenomaB. AdenocarcinomaC. Cystic breastD. Invasive ductal carcinomaE. Mastitis

167. At a bacteriological laboratoryanimal skins are analyzed by meansof Ascoli precipitaion test. What isdetected if the reaction is positive?

A. Anthrax agent antigensB. Anaerobic infection toxinC. Brucellosis agentD. Yersinia surface antigenE. Plague agent

168. Examination of the duodenalcontents revealed some pear-shapedprotozoa with two nuclei and four pai-rs of flagella. The organisms had alsotwo axostyles between the nuclei and aventral adhesive disc. What protozoanrepresentative was found in the pati-ent?

A. LambliaB. ToxoplasmaC. LeishmaniaD. Intestinal trichomonadE. Trypanosome

169. A 36-year-old female patienthas a history of B2-hypovitaminosis.The most likely cause of speci-fic symptoms (epithelial, mucosal,cutaneous, corneal lesions) is the defi-


ciency of:

A. Flavin coenzymesB. Cytochrome A1C. Cytochrome oxidaseD. Cytochrome BE. Cytochrome C

170. A 54-year-old female was broughtto the casualty department after a caraccident. A traumatologist diagnosedher with multiple fractures of the lowerextremities. What kind of embolism ismost likely to develop in this case?

A. FatB. TissueC. ThromboembolismD. GaseousE. Air

171. A blood drop has been put into atest tube with 0,3% solution of NaCl.What will happen to erythrocytes?

A. Osmotic haemolysisB. ShrinkageC. Mechanical haemolysisD. Any changes will be observedE. Biological haemolysis

172. There are cortical and medullarysubstances separated by connectivetissue layer in the endocrine glandspecimen. Parenchyma cells make upthree zones in cortical substance, wi-th rounded masses in the superficialzone, parallel chords in the middle one,reticular structure of cell chords in thedeep one. What gland is it?

A. Adrenal glandB. Thyroid glandC. Pituitary glandD. EpiphysisE. Hypothalamus

173. Histological specimen of a 10-dayhuman embryo represents 2 contactingsacs (amniotic and yolk sacs). Specifythe structure that separates the amni-otic cavity from the yolk sac:

A. Embryonic shieldB. Amniotic stalkC. Floor of the amniotic sacD. Roof of the yolk sacE. Extraembryonic mesoderm

174. An electron micrograph showsa cell of neural origin. The terminalportion of the cell dendrite has cyli-ndrical shape and consists of 1000closed membrane disks. What cell isrepresented by the micrograph?

A. Rod receptor cellB. Cone receptor cellC. Spinal node neuronD. Neuron of the cerebral cortexE. Neuron of the anterior horns of thespinal cord

175. Disruption of nerve fiber myeli-nogenesis causes neurological di-sorders and mental retardation. Thesesymptoms are typical for heredi-tary and acquired alterations in themetabolism of:

A. SphingolipidsB. Neutral fatsC. Higher fatty acidsD. CholesterolE. Phosphatidic acid

176. A patient underwent surgicalremoval of a cavitary liver lesion 2cm in diameter. It was revealed thatthe cavity wall was formed by densefibrous connective tissue; the cavi-ty contained muddy, thick, yellowish-greenish fluid with an unpleasantodor. Microscopically, the fluid consi-sted mainly of polymorphonuclearleukocytes. What pathological processare these morphological changes typi-cal for?

A. Chronic abscessB. Acute abscessC. PhlegmonD. EmpyemaE. -

177. A patient complains ofphotoreception disorder and frequentacute viral diseases. He has beenprescribed a vitamin that affectsphotoreception processes by produci-ng rhodopsin, the photosensitive pi-gment. What vitamin is it?


A. Retinol acetateB. Tocopherol acetateC. Pyridoxine hydrochlorideD. CyanocobalaminE. Thiamine

178. A 7-year-old boy got ill with di-phtheria. On the third day he di-ed of asphyxiation. At autopsy themucosa of the larynx, trachea andbronchi had thickened, edematous,lustreless appearance and was coveredwith gray films which could be easilyremoved. Specify the type of laryngealinflammation:

A. CroupousB. DiphtheriticC. PurulentD. CatarrhalE. Intermediate

179. A child has a history ofhepatomegaly, hypoglycemia, seizures,especially on an empty stomach andin stressful situations. The child is di-agnosed with Gierke disease. This di-sease is caused by the genetic defect ofthe following enzyme:

A. Glucose-6-phosphataseB. Amyloid-1,6-glycosidaseC. PhosphoglucomutaseD. Glycogen phosphorylaseE. Glucokinase

180. A public utility specialist wentdown into a sewer well withoutprotection and after a while lostconsciousness. Ambulance doctors di-agnosed him with hydrogen sulfideintoxication. What type of hypoxiadeveloped?

A. HemicB. OverloadC. TissueD. CirculatoryE. Respiratory

181. A child with a normal karyotypeis diagnosed with cleft lip andhard palate, defects of the cardi-ovascular system, microcephaly. Thechilds mother suffered rubella duringpregnancy. This pathology in the childmay be an example of:

A. GenocopyB. TrisomyC. PhenocopyD. MonosomyE. -

182. A 28-year-old patient undergoi-ng treatment in the pulmonologicaldepartment has been diagnosed wi-th pulmonary emphysema caused bysplitting of alveolar septum by tissulartripsin. The disease is cased by thecongenital deficiency of the followingprotein:

A. 1-proteinase inhibitorB. 2-macroglobulinC. CryoglobulinD. HaptoglobinE. Transferrin

183. A patient with signs ofosteoporosis and urolithiasis hasbeen admitted to the endocri-nology department. Blood testhas revealed hypercalcemia andhypophosphatemia. These changes areassociated with abnormal synthesis ofthe following hormone:

A. Parathyroid hormoneB. CalcitoninC. CortisolD. AldosteroneE. Calcitriol

184. During a surgery for femoralhernia a surgeon operates within theboundaries of femoral trigone. Whatstructure makes up its upper margin?

A. Lig.inguinaleB. Arcus iliopectineusC. Lig.lacunareD. Lig. pectinaleE. Fascia lata

185. A 19-year-old victim has beendelivered to the casualty departmentwith a cut wound of the trapeziusmuscle. Which of the cervical fasciaeforms a sheath for this muscle?


A. Investing layer of cervical fasciaB. Muscular part of the pretacheal layerof cervical fasciaC. Visceral part of the pretracheal layerof cervical fasciaD. Prevertebral layer of cervical fasciaE. Carotid sheath of cervical fascia

186. A patient with acne has beenprescribed doxycycline hydrochloride.What recommendations should be gi-ven to the patient, while he is takingthis drug?

A. Avoid long stay in the sunB. Take with large quantity of liquid,preferably milkC. Take before mealD. The course of treatment should notexceed 1 dayE. Do not take with vitamins

187. A 30-year-old patient with a pasthistory of virus B hepatitis complainsof prolonged nosebleeds. What drugwill be most efficient in remedying thiscondition?

A. VicasolumB. FraxiparineC. Folic acidD. DipiridamolE. Asparcam

188. A patient has arterial hypertensi-on. What long-acting drug from thegroup of calcium channel blockersshould be prescribed?

A. AmlodipineB. OctadineC. PyrroxanumD. AtenololE. Reserpine

189. A patient has been diagnosedwith ARVI. Blood serum containsimmunoglobulin M. What is the stageof infection in this case?

A. AcuteB. ProdromalC. IncubationD. ReconvalescenceE. Carriage

190. In a dysentery patient undergoingtreatment in the contagious isolationward, a significant increase in packed

cell volume has been observed (60%).What other value will be affected bythis change?

A. Increasing blood viscosityB. Increasing volume of blood circulati-onC. LeukopeniaD. ThrombocytopeniaE. Increasing erythrocyte sedimentati-on rate (ESR)

191. A patient complains of palpi-tation after stress. The pulse is 104bpm, P-Q=0,12 seconds, there are nochanges of QRS complex. What typeof arrhythmia does the patient have?

A. Sinus tachycardiaB. Sinus bradycardiaC. Sinus arrhythmiaD. Ciliary arrhythmiaE. Extrasystole

192. A 30-year-old patient hasundergone keratoplasty in thetransplantation center, cornea has beentaken fron a donor, who died in a roadaccident. What kind of transplantationwas performed?

A. AllotransplantationB. AutotransplantationC. XenotransplantationD. ExplantationE. Heterotransplantation

193. A 29-year-old male with a knifewound of neck presents with bleedi-ng. During the initial d-bridement ofthe wound the surgeon revealed theinjury of a vessel found along thelateral edge of the sternocleidomastoidmuscle. Specify this vessel:

A. V. jugularis externaB. V. jugularis anteriorC. A. carotis externaD. A. carotis internaE. V. jugularis interna

194. A histologic specimen representsan organ with walls comprisedof mucous, submucous, fibrous-cartilaginous and adventitial membranes.Epithelium is multirowed and ciliated,muscular layer of mucous membrane isabsent, submucous membrane contai-


ns serous-mucous glands, hyalinecartilage forms open circles. Whatorgan has the described morphologi-cal features?

A. TracheaB. Tertiary bronchi (segmental bronchi)C. Secondary bronchi (lobar bronchi)D. Terminal bronchioleE. Larynx

195. In cancer patients who have beencontinuously receiving methotrexate,the target cells of tumor with timebecome insensitive to this drug. In thiscase, gene amplification of the followi-ng enzyme is observed:

A. Dihydrofolate reductaseB. ThiaminaseC. DeaminaseD. Thioredoxin reductaseE. -

196. Pancreas is known as a mixedgland. Endocrine functions includeproduction of insulin by beta cells. Thishormone affects the metabolism ofcarbohydrates. What is its effect uponthe activity of glycogen phosphorylase(GP) and glycogen synthase (GS)?

A. It inhibits GP and activates GSB. It activates both GP and GSC. It inhibits both GP and GSD. It activates GP and inhibits GSE. It does not affect the activity of GPand GS

197. A patient has the oxyhemoglobindissociation curve shifted to the left.What blood changes induce this condi-tion?

A. Alkalosis, hypocapnia, temperaturedropB. Acidosis, hypercapnia, temperatureriseC. Acidosis, hypercapnia, temperaturedropD. Acidosis, hypocapnia, temperatureriseE. -

198. Administration of doxycyclinehydrochloride caused an imbalanceof the symbiotic intestinal microflora.Specify the kind of imbalance causedby the antibiotic therapy:

A. DysbacteriosisB. SensibilizationC. IdiosyncrasyD. Superimposed infectionE. Bacteriosis

199. A patient with signs of emotionallability that result in troubled sleep hasbeen prescribed nitrazepam. Specifythe sleep-inducing mechanism of thisdrug:

A. GABA-ergic system activationB. Blockade of opiate receptorsC. Inhibition of stimulating amino acidsD. H1-histamine receptors stimulationE. Supression of serotonergicneurotransmission

200. A patient has been found to havea marked dilatation of saphenous vei-ns in the region of anterior abdomi-nal wall around the navel. This issymptomatic of pressure increase inthe following vessel:

A. V. portae hepatisB. V. cava superiorC. V. cava inferiorD. V. mesenterica inferiorE. V. mesenterica superior

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