Before tooth extraction a patient was advised to take a certain drug for haemorrhage prevention. What drug was advised?
D. *Vicasolum
Autopsy of a man who died from influenza revealed that the heart was slightly enlarged and pastose. The surface of the incision of myocardium appeared to be pale, with specks. Microscopic examination revealed signs of parenchymatous adipose and hydropic degeneration, edematic stroma with scant lymphocytic and macrophage infiltration; plethoric vessels; perivascular petechial haemorrhages. What type of myocarditis is it?
C. *Serous diffuse
Examination of a patient revealed autoi mmune haemolytic anaemia (cytotoxic type). What substances act as antigens in the II-type allergic reactions?
E. *Modified receptors of cell membranes
Medical examination at the military regi stration and enlistment office revealed that a 15-year-old boy was high, with eunuchoid body proportions, gynecomastia, female pattern of pubic hair distribution. The boy had also fat deposits on the thighs, no facial hair, high voice, subnormal intelligence quotient. Which karyotype corresponds with this disease?
A. *47, XXY
5. Study of bacteriological sputum specimens stained by the Ziel-Neelsen method revealed some bright-red acid-resistant bacilli that were found in groups or singularly. When inoculated onto the nutrient media, the signs of their growth show up on the 10-15 day. These bacteria relate to the following family:
C. *Micobacterium tuberculosis
6. A 1,5-year-old child presents with both mental and physical lag, decolorizing of skin and hair, decrease in catecholamine concentration in blood. When a few drops of 5% solution of trichloroacetic iron had been added to the child's urine it turned olive green. Such alteration is typical for the following pathology of the amino acid metabolism:
C. *Phenylketonuria
7. A patient's organism has decreased concentration of magnesium ions that are necessary for attachment of ribosomes to the granular endoplasmatic reticulum. It is known that this causes protein biosynthesis disturbance. What stage of protein biosynthesis will be disturbed?
E. *Translation
The minute blood volume in a patient with transplanted heart has increased as a result of physical activity. What regulative mechanism is responsible for these changes?
C. *Catecholamines
A patient has been given high doses of hydrocortisone for a long time. This caused atrophy of one of the adrenal cortex zones. Which zone is it?
D. *Fascial
10. Autopsy of a man with a malignant stomach tumour who had died from cancer intoxication revealed in the posteroinferior lung fields some dense, grayish-red irregular foci protruding above the section surface: Microscopic examination revealed exudates containing a large amount of neutrophils in the lumen and walls of small bronchi and alveoles. Such pulmonary alterations indicate the following disease:
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E. *Acute purulent bronchopneumonia
An injured person was delivered to the hospital with a penetrating wound in the left lateral region of abdomen. What part of the large intestine is most likely damaged?
B. *Colon descendens
A 49-year-old patient consulted a doctor about increased fatigability and dyspnea provoked by physical activity. ECG results: heart rate — 50/min, PQ-interval is prolonged, QRS-complex is unchanged, the number of P-waves exceeds the number of QRS-complexes. What type of arrhythmia is it?
E. *Atrioventricular block
Colonoscopy of a patient with dysentery revealed that the mucous membrane of the large intestine was hyperemic, edematic, and its surface was covered with grey-and-green layerings. What morphological form of dysenteric colitis is it?
B. *Fibrinous
14. A histological specimen of a kidney shows a part of the distal tubule going between the afferent and efferent arteriole. The cells building the tubule wall have dense nuclei; basal membrane is absent. Such structural formation is called:
D. *Macula densa
An elderly female patient suffers from the type 2 diabetes mellitus accompanied by obesity, atherosclerosis, coronary artery disease. Basal hyperinsulinemia is also present. What treatment would be the most appropriate?
D. *Glibenclamid
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?
D. *Stenocardia
Examination of a patient revealed a dense, movable skin tumour that is standing out distinctly from the surrounding tissues. Its section is found to be white and composed of fibrous tissue. Microscopic examination revealed interlacing collagen fibers and few cells. What tumour is it?
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A. *Fibroma
Continuous use of a certain drug may cause osteoporosis, erosions of stomach mucosa, hypokaliemia, retention of sodium and water in the organism, decreased concentration of corticotropin in blood. What drug is it?
E. *Prednisolone
A female patient consulted a physician about digestive disorder, extended abdominal pain. Examination revealed drastic decrease in hemoglobin concentration. It is known from the anamnesis that while living in the Far East the patient used to eat freshlysalted caviar. Some relatives living with her had the similar condition. What is the most likely diagnosis?
B. *Diphyllobothriasis
20. Examination of a patient with frequent haemorrhages from the internal organs and mucous membranes revealed proline and lysine within the collagen fibers. Disorder of their hydroxylation is caused by lack of the following vitamin:
D. *Vitamin C
21. 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:
C. *Activation of fibrinolytic system
A patient with android-type obesity had been suffering from arterial hypertension, hyperglycemia, glycosuria for a long time and died from the cerebral haemorrhage. Pathologic examination revealed pituitary basophil adenoma, adrenal cortex hyperplasia. What is the most likely diagnosis?
C. *Itsenko-Cushing's syndrome
23. During an experiment the myotatic reflex has been studied in frogs. After extension in a skeletal muscle its reflectory contraction was absent. The reason for it might be a dysfunction of the following receptors:
B. *Muscle spindles
24. The greater amount of nitrogen is excreted from the organism in form of urea. Inhibition of urea synthesis and accumulation of ammonia in blood and tissues are induced by the decreased activity of the following liver enzyme:
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A. *Carbamoyl phosphate synthesize
25. A pathology-histology laboratory received a vermiform appendix up to 2,0 cm thick. Its serous membrane was pale, thick and covered with yellowish-green films. The wall was flaccid, of grayish-red colour. The appendix lumen was dilated and filled with yellowish-green substance. Histological examination revealed that the appendix wall was infiltrated with neutrophils. Specify the appendix disease:
D. *Acute phlegmonous appendicitis
Gynecological examination of the uterine cervix in a 30-year-old woman revealed some bright-red lustrous spots that easily bleed when touched. Biopsy showed that a part of the uterine cervix was covered with cylindrical epithelium with papillary outgrowths; in the depth of tissue the growth of glands was present. What pathology of the uterine cervix was revealed?
C. *Pseudoerosion
27. After a craniocerebral trauma a patient lost the ability to execute learned purposeful movements (apraxia). The injury is most likely localized in the following region of the cerebral cortex:
D. *Gyrus supramarginalis
28. On the ground of clinical presentations a patient was prescribed pyridoxal phosphate. This medication is recommended for correction of the following processes:
B. *Transamination and decarboxylation of amino acids
29. In patients with the biliary tract obstruction the blood coagulation is inhibited; the patients have frequent haemorrhages caused by the subnormal assimilation of the following vitamin:
E. *K
A patient with coronary artery disease was admitted to the cardiological department. For stenocardia prevention a drug from the group of -adrenoceptor blockers was administered. What drug is it?
A. *Metoprolol
31. A man has normal sensitivity of his finger skin; however he doesn't sense his wedding ring around the finger. What process induced by wearing of the ring has caused this phenomenon?
B. *Receptor adaptation
32. A man suffering from osteochondrosis got acute pain in the abdominal muscles (lateral and anterior). During objective examination a physician diagnosticated increased pain sensitivity of skin in the hypogastric region. This pain might be caused by affection of the following nerve:
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E. *Iliohypogastric
33. An 8-year-old child was admitted to the infectious department with fever (up to 38°C) and punctuate bright-red skin rash. The child was diagnosed as having scarlet fever. Objectively: mucous membrane of pharynx is apparently hyperaemic and edematic, the tonsils are enlarged and have dull yellowish-grey foci with some black areas. What inflammation is the reason for the pharynx alterations?
C. *Purulent necrotic
34. Examination of a patient suffering from chronic hepatitis revealed a significant decrease in the synthesis and secretion of bile acids. What process will be mainly disturbed in the patient's bowels?
B. *Fat emulsification
In response to a change in body position from horizontal to vertical blood circulation system develops reflectory pressor reaction. Which of the following is its compulsory component?
D. *Systemic constriction of the venous vessels
36. A newborn develops dyspepsia after the milk feeding. When the milk is substituted by the glucose solution the dyspepsia symptoms disappear. The newborn has the subnormal activity of the following enzyme:
E. *Lactase
37. Examination of a 2-year-old child revealed physical developmental lag, the child often has pneumonias. The child was diagnosed with nonclosure of ductus arteriosus. Haemodynamics disorder was caused by the intercommunication of the following vessels:
C. *Aorta and pulmonary trunk
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?
D. *Reduction of renal blood flow
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