revision ( question paper) Flashcards
What stage of development of Plasmodium is infective for anopheles-female
gametocytes
. Helminthes of while color and 5-10 mm long were found on the underwear. On microscopy of the scrape from the perianal folds achromic ovums of unsymmetrical form were revealed
enterobins vermicularis
methylatio n
methionine
A patient in three weeks after acute myocardial infarction has pain in the heart and joints and pneumonia. What is the main mechanism of development of post-infarction Dressler’s syndrome?
autoimmune inflammation
methotrexate inhibits
mononucleotide synthesis
What substances created in the intestines can cause endotoxemia
indole
Botallo’s) duct
pulmonary truck and aorta
A lung of a premature infant is presented on electronic photomicrography of biopsy material. Collapse of the alveolar wall caused by the deficiency of surfactant was revealed.
alveolocytes type ii
A young man felt sharp pain in the back during active tightening on the horizontal bar. Objectively: pain while moving upper extremity, limited pronation and adduction functions. Sprain of what muscle can be observed here?
latissimus dorsi
Electrocardiogram of a 45-year-old man showed absence of P-wave in all the leads. What part of the conducting system is blocked?
sa node
Live vaccine is injected into the human body. Increasing activity of what cells of connective tissue can be expected?
plasocytes and lymphocytes
18% of erythrocytes of the spherical, ball-shaped, flat and thorn-like shape have been revealed. Other eritrocytes were in the form of the concavo-concave disks
physiological poikilocitosis
The conjugated protein necessarily contains special component as a non-protein part. Choose the substance that can’t carry out this function:
HNO3
Hydroxylation of endogenous substrates and xenobiotics requires a donor of protons. Which of the following vitamins can play this role?
vit c
A patient with complaints of 3-day-long fever, general weakness, loss of appetite came to visit the infectionist. The doctor suspected enteric fever. Which method of laboratory diagnosis
detachment of blood culture
tubercle (Koch’s) bacillus
method od ziel neiselsen
A patient has a malignisation of thoracic part of esophagus. What lymphatic nodes are regional for this organ?
Anulus lymphaticus cardia
bronchial asthma was treated with glucocorticoids. Fever reaction appeared as a result of postinjective abscess. The patient had subfebrile temperature, which didn’t correspond to latitude and severity of inflammatory process. Why did patient have low fever reaction?
inhibited endogen pyrogen productioj
A patient’s blood was analyzed and the decreased erythrocyte’s sedimentation rate (ESR) was discovered. What disease from the listed below is accompanied with decreased ESR?
polycyctimia
A 16 year-old patient got numerous traumas in automobile accident. Now the patient is having a shock. АP – 80/60 mm Hg. daily urine volume 60-80 ml. What pathogenic mechanism leads to kidneys function violation?
decrease hydrostatic pressure in the glomerular capsules
medial group of femoral muscles
adduction
A mother of a newborn complains of her baby’s constant belching with undigested milk. Which developmental anomaly is it an evidence of?
esophageal arterisia
During the endoscopy the inflammation of a major papilla of the duodenum and the disturbances of bile secretion were found. In which part of duodenum were the problems found?
descending part
bartholins glands
labia major
Crunching sounds are heard while moving the joint
knee cap
Usually the intravenous injection is done into median cubital vein because it is slightly movable due to fixation by the soft tissues. What does it fix in the cubital fossa?
aponeurosis the the biceps musle
You have decided to use phenytoin instead of procainamid
anticholinergic effecct
antituberculosis drugs are known for causing high uric acid levels?
pyrazinamide
woman with red and itchy eczematoid dermatitis visits your offi She had a dental procedure one day earlier with administration of a local anesthetic. There were no other findings, although she indicated that she had a history of allergic reactions
procaine
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 can be found in the intercellular fluid. What kind of edema are to be observed in this case?
Mixed
thyrotoxicosis symptoms of vegetoasthenic syndrome was revealed. What of the following would show the histological appearance of a thyroid gland being stimulated by thyroid-stimulating hormone (TSH)?
columnar shaped follicular cells
The reason of occurrence of some diseases of an oral cavity is connected with structural peculiarities of its mucous membrane. What morphological attributes characterize these features?
No muscularis mucosa, stratified squamous epithelium
A 16-year-old boy was performed an appendectomy. He has been hospitalized for right lower quadrant abdominal pain within 18 hours. The surgical specimen is edematous and erythematous
neutrophilis
acute alcoholic poisoning was brought to the hospital. What carbohydrates metabolism changes are typical for this condition?
gluconeogenesis velocity in the liver is decreased
The process of heart transplantation determined the viability of myocardial cells. The determination of what myocardium parameter is the most important?
rest potential of cardio myocites
The calcium canals of cardiomyocytes have been blocked on an isolated rabbit’s heart. What changes in the heart’s activity can happen as a result?
decreased rate and force of heart beat
Obturative jaundice developed in a 60-year-old patient because of malignant tumour of the big papillary of the duodenal. Lumen of what anatomical structure is squeezed with tumour?
hepato pancreatic ampulla
Necrosis focus was observed in the area of hyperemia and skin edema in a few hours after burn. What mechanism strengthens destructive effects in the inflammation area?
secondary alteration
Necrosis focus was observed in the area of hyperemia and skin edema in a few hours after burn. What mechanism strengthens destructive effects in the inflammation area?
secondary alteration
A patient with bronchial asthma had been taking tablets which caused insomnia, headache, increased blood pressure. What medicine can cause such complications?
ephedrine
The increased intraocular tension is observed in a patient with glaucoma.Secretion of aqueous humor by the ciliar body is normal. Injury of what structure of the eyeball caused the disorder of flow-out from the anterior chamber?
venous sinus
Where should the cathetor for evacuation of the lymph from the thoracic lymph duct be inserted?
to left venous corner
A man after 1.5 litre blood loss has suddenly reduced diuresis. The increased secretion of what hormone caused such diuresis alteration?
vasopressin
infectious diseases department with high body temperature. Objectively: marked meningeal symptoms. A spinal cord punction was made. What anatomic formation was puncturated?
spapium subarchanoidium
A woman with 0 (I) blood group has born a child with AB blood group. This woman’s husband has A blood group. What genetic interaction explains this phenomenon?
recessive epitasis
Inflammatory process of modified subserous layer around cervix of the uterus caused an intensive pain syndrome. In what region of genitals does the pathological process take place?
parametrium
A child has inhaled a button. Where is it likely to be?
right main borncus
Low level of albumins and fibrinogen was detected in the patient’s blood. Decreased activity of what organelle of the liver hepatocytes can most probably cause it?
granular endoplasmic reticulum
44-year-old patient had a rupture of left palm muscle tendons and of the superficial blood vessels. After operation and removal of the most part of the necrotically changed muscle tissue the bloodstream was normalized
Arcus palmaris prof undus
child choked and aspirated the food. Heavy cough has started, skin and mucose are cyanotic, pulse is rapid, respiration is infrequent, expiration is prolonged
Stage of expiratory dyspnea on asphyxia
An experiment proved that UV-radiated cells of patients with xeroderma pigmentosum restore the native DNA structure slower than cells of healthy individuals as a result of reparation enzyme defection. What enzyme helps this process?
endonuclease
Diagnostic scraping was performed to the woman with dysfunctional uterine bleeding. Multiple convoluted glands, ganglially dilated lumens of some glands were revealed histologically in the scrape. Name the type of general pathological process in endometry:
hyperplasia granulocytica
A person has reduced diuresis, hypernatremia, hypokalemia. Hypersecretion of what hormone can cause such changes?
aldosterone
Microscopic examination of the sputum of a patient with pneumonia occasionally revealed some larvae. Eosinophiles were detected on blood examination. What helminthiasis can be diagnosed?
ascariasis
A patient has got a spasm of smooth muscles of bronchi. Activators of what membrane cytoreceptors are phisiologically reasoned to stop an attack?
b adrenoreceptors
Thyrotoxicosis leads to increased production of thyroidal hormones T3 and T4, weight loss, tachycardia, psychic excitement and so on. How do thyroidal hormones effect energy metabolism in the mitochondrion of cells?
disconnect oxidation and oxidative phosphorylation
A 58-year-old patient with acute cardiac insufficiency has decreased volume of daily urine – oliguria. What is the mechanism of this phenomenon?
dec glomerular filtration
its neurons form motor endings in the skeletal muscles. What nucleus of spinal cord is meant?
proper nucleus of the anterior horn
complaints of pain in the right subcostal region, vomiting with blood. Objectively: enlarged liver, varicose veins in the stomach and esophagus
vena porta
Intrapleural pressure of an individual is being measured. In what phase did he hold his breath if the pressure is – 25 cm H2O?incr
forced inspiration
3-year-old child has repeated vomiting, loss of consciousness, convulsions. Examination revealed hyperammoniemia. What may have caused changes of biochemical blood indices of this child?
disorder of neutralization of ammonia in ornithinic cycle
A physician examined a patient and found inguinal hernia. Through what anatomic formation does it penetrate into the skin?
hiatus sepinus
increased resorbtion of calcium ions and decreased resorbtion of phosphate ions
parathyroid hormone
Healthy parents have got a fair-haired, blue-eyed girl. Irritability, anxiety, sleep and feeding disturbance developed in the first months of the infant’s life. Neurological examination revealed developmental lag. What method of genetic investigation should be used for the exact diagnosis?
biochemical al analysis
Parents with an ill child consulted an infectionist. They had been working in one of Asian countries for a long time. The child has sallow skin, loss of appetite, laxity, enlarged liver, spleen, peripheral lymph nodes. What protozoal illness can be suspected?
visceral lesimaniasis
A 50 y.o. patient was admitted to the hospital with complaints about pain behind his breastbone, asphyxia during physical activity. Angiography revealed pathological changes in the posterior interventricular branch of the right coronary artery. What heart parts are affected?
posterior wall of the right and left ventricules
As a result of an accident a patient has intense painfullness and edema of the anterior crus surface; dorsal flexion of foot is hindered. Function of which crus muscle is most likely to be disturbed?
M tibialis anterior
24 hours after appendectomy blood of a patient presents neutrophilic leukocytosis with regenerative shift. What is the most probable mechanism of leukocytosis development?
amplification of leukopoiesis
died from influenza revealed that his heart was slightly enlarged, pastous, myocardium was dull and had specks. Microscopical examination of myocardium revealed signs of parenchymatous adipose and hydropic dystrophy; stroma was edematic with poor macrophagal and lymphocytic infiltration,
serous diffuse
1/3. The muscle has multiple whitish layers of connective tissue.
diffuse cardiosclerosis
Autopsy of a 56 y.o. man revealed in the right temporal part of brain a big focus of softened grey matter that was semi-liquid and light grey. Arteries of cerebral tela contain multiple whitish-yellow thickenings of intima that abruptly narrow the lumen. What is your diagnosis?
ischemic stroke
Analysis of blood serum of a patient revealed increase of alanine aminotransferase and aspartate aminotransferase level. What cytological changes can cause such a situation?
cellular breakdown
Examination of a patient revealed hyperkaliemia and hyponatremia. Low secretion of which hormone may cause such changes?
aldosterone
Continious taking of a drug can result in osteoporosis, erosion of stomach mucous membrane, hypokaliemia, retention of sodium and water, reduced content of corticotropin in blood. Name this drug:
prednisolone
A 23 y.o. patient complains of weakness, temperature rise up to 38 – 40°C. Objectively: liver and spleen are enlarged. Hemogram: Hb-100 g/1, erythrocytes – 2.9×1012/l, leukocytes -4.4×109/l, thrombocytes – 48×109/l, segmentonuclear neutrophils – 17%, lymphocytes – 15%, blast cells – 68%. All cytochemical reactions are negative. Make a hematological conclusion:
undifferentiated leukosis
A man was admitted to the hospital on the 5th day of disease that manifested itself by jaundice, muscle aching, chill, nose bleedings. In course of laboratory diagnostics a bacteriologist performed dark-field microscopy of the patient’s blood drop. Name a causative agent of this disease:
leptospira interrogans
A child is languid, apathetic. Liver is enlarged and liver biopsy revealed a significant excess of glycogene. Glucose concentration in the blood stream is below normal. What is the cause of low glucose concentration?
Low (absent) activity of glycogene phosphorylase in liver
Urine examination of a patient with acute cystitis revealed leukocytes and a lot of gram-negative bacilli. Inoculation resulted in growth of colonies of mucous nature that formed green soluble pigment. What microorganism is the most probable cause of the disease?
pseudomonas aerugunosa
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?
disturbance of pumping ability of heart
A 63 y.o. man with collapse symptoms was delivered to the emergency hospital. A doctor chose noradrenaline in order to prevent hypotension. What is the action mechanism of this medication?
activation of alpha adrenoreceptors
An injured man has bleeding from branches of carotid artery. For a temporary arrest of bleeding it is necessary to press the carotid artery to the tubercle of a cervical vertebra. Which vertebra is it?
6
As a result of spinal-cord trauma a 33 y.o. man has a disturbed pain and temperature sensitivity that is caused by damage of the following tract:
spinothalamic
Microscopical examination of a removed appendix revealed an edema, diffuse neutrophilic infiltration of appendix wall along with necrosis and defect of mucous membrane with affection of its muscle plate. What appendicitis form was developed?
ulcerophlegmonour
Autopsy of a 48 y.o. man revealed a round formation 5 cm in diameter with clear-cut outlines in the region of the 1st segment of his right lung. This formation was encircled with a thin layer of connective tissue full of white brittle masses. Make a diagnosis of the secondary tuberculosis form:
tuberculoma
In course of an operation surgeon aremoved a part of a lung that was ventilated by a tertiary bronchus accompanied by branches of pulmonary artery and other vessels. What part of a lung was removed?
bronchoplumonary segment
Colonoscopy of a patient ill with dysentery revealed that mucous membrane of his large intestine is hyperemic, edematic, its surface was covered with grey-and-green coats. Name the morphological form of dysenteric collitis:
fibrinous
Autopsy of a patient who suffered from croupous pneumonia and died from pneumococcal sepsis revealed 900 ml of turbid greenish-yellow liquid in the right pleural cavity. Pleural leaves are dull, plephoric
emphyma
A patient with a stab wound of the anterior stomach wall is in surgical care. What formation of abdominal cavity did the stomach contents get into?
antegasterial bursa
skin in the anterosuperior area of his thigh and his foot’s thumb
superficial inguinal
Examination of a patient revealed an abscess of pterygopalatine fossa. Where can the infection spread to unless the disease is managed in time?
to the orbit
A lymph node punctate of a patient with suspected protozoal disease was examined. Examination of the stained specimen (Romanovsky’s stain) revealed some crescent bodies with pointed end, blue cytoplasm and red nucleus. What protozoan were revealed in the smears?
toxoplasm
A patient who suffers from cancer of back of tongue has an intense bleeding as a result of affection of dorsal lingual artery by the tumour. What vessel should be ligated to stop bleeding?
dorso lingual artery
Osmotic pressure of a man’s blood plasma is 350 mosmole/1 (standard pressure is 300 mosmole/1). First of all it will result inhigh secretion of the following hormone:
vasopressin
A 45 y.o. woman suffers from Cushing’s syndrome – steroid diabetes. Biochemical examination revealed: hyperglycemia,hypochloremia. Which of the under mentioned processes is the first to be activated?
gluconeogenesis
A man with cut wound of his right foot sole was admitted to the hospital ward. The patient has limited elevation of the lateral foot edge. In course of wound management the injury of a muscle tendon was revealed. What muscle is injured?
long peroneal
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 continuous current. What type of paralysis is it?
flaccid preripheral
While palpating mammary gland of a patient a doctor revealed an induration in form of a node in the inferior medial quadrant. Metastases may extend to the following lymph nodes:
parasternal
A patient was admitted to the surgical department with suspected inflammation of Meckel’s diverticulum. What part of bowels should be examined in order to discover the diverticulum in course of an operation?
ilieum
Autopsy of a man ill with severe hypothyroidism revealed that connective tissue, organ stroma, adipose and cartilaginous tissues were swollen, semi-transparent, mucus-like. Microscopic examination of tissues revealed stellate cells having processes with mucus between them. What type of dystrophy is it?
stromal vasular carbohydrate
If a man has an attack of bronchi-ospasm it is necessary to reduce the effect of vagus on smooth muscles of bronchi. What membrane cytoreceptors should be blocked for this purpose?
M cholinoreceptors
stab wound in the area of quadrilateral foramen applied to a doctor. Examination revealed that the patient was unable to draw his arm aside from his body
axillary nerve
n course of laparotomy a surgeon revealed gangrenous lesion of descending colon. It was caused by thrombosis of the following artery:
sinister colic
A 35 year old patient applied to a doctor with complaints about having intense rhinitis and loss of sense of smell for a week. Objectively: nasal cavity contains a lot of mucus that covers mucous membrane and blocks olfactory receptors. In what part of nasal cavity are these receptors situated?
superior nasal turbinate
Histological examination revealed drusen of a fungus, plasmatic and xanthome cells, macrophages
actinomycosis
chromophilic and chromophobic
hypophysis
Repeated inoculation into blood agar caused growth of small transparent round colonies surrounded by hemolysis zone. Examination of a smear from the sedi-ment revealed gram-positive cocci in form of long chains
streptococci
A 35 year old man with a trauma of his left hand was admitted to the traumatology department. Objectively: cut wound of palmar surface of left hand; middle phalanxes of II–V fingers don’t bend. What muscles are damaged?
superficial finger flexor
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?
traumatization of peripheral nerve
haversian canals and periosteum. Under the periosteum there are multiple abscesses, adjoining soft tissues of thigh also have signs of phlegmonous inflammation.
acute hematogenous osteomylitis
A patient with cholelithiasis fell with mechanic jaundice. Examination revealed that the stone was in the common bile duct. What bile-excreting ducts make up the obturated duct?
Ductus hepaticus communis et ductus cysticus
A chemical burn caused esophagus stenosis. Difficulty of ingestion led to the abrupt loss of weight. In blood: 3, 0 · 1012/l, Hb – 106 g/l, crude protein – 57 g/l. What type of starvation is it?
incomplete
A patient ill with amebiasis was prescribed a certain drug. The use of alcohol together with this drug is contraindicated because the drug inhibits metabolism of ethyl alcohol. What drug is it?
metronidazole
A 30 year old woman has face edemata. Examination revealed protei-nuria (5,87 g/l), hypoproteinemia, dysproteinemia, hyperlipidemia. What condition is the set of these symptoms typical for?
nephrotic syndrome
Examination of a 55 year old woman revealed under the skin of submandibular area a movable slowly growing pasty formation with distinct borders 1,0×0,7 cm large. Histological examination revealed lipocytes that form segments of diffrent forms and sizes separated from each other by thin layers of connective tissue with vessels. What is the most probable diagnosis?
lipoma
While performing an inguinal canal operation on account of hernia a surgeon damaged the canal’s contents. What exactly was damaged?
funiculus spermaticus
heart was sluggish, with significant cavity dilatation. Histological examinati-on of myocardium revealed plephora of microvessels and diffuse infiltration of stroma by lymphocytes and histiocytes.
myocarditis
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?
myocardium hypertrophy
brown atrophy of liver, myocardium, spleen and cross-striated muscles as well as renal amyloidosis.
chrioniosepsis
1% mesaton solution for the diagnostic purpose (pupil dilation for eye-ground examination).
activation of alpha 1 adrenoreceptors
Inflammation of the tympanic cavity (purulent otitis media) was complicated by inflammation of mammillary process sockets. What wall of tympanic cavity did the pus penetrate into the sockets through?
posterior
A patient has yellow skin colour, dark urine, dark-yellow feces. What substance will have strengthened concentration in the blood serum?
unconjugated billirubin
It was found out that some compounds, for instance fungi toxins and some antibiotics can inhibit activity of RNA-polymerase. What process will be disturbed in a cell in case of inhibition of this enzyme?
transcription
pregnant woman had her blood group identified. Reaction of erythrocyte agglutination with standard serums of 0αβ (I), Bα (III) groups didn’t proceed wi-th standard serum of Aβ (II) group. The blood group under examination is:
Aβ (II)
Preventive examination of a patient revealed an enlarged lymph node of metastatic origin on the medial wall of the left axillary crease. Specify the most likely localization of the primary tumour:
mammary gland
A patient has lost skin sensitivity in the region of the medial surface of his shoulder. This is the result of dysfunction of the following nerve:
medial brachial cutaneous nerve
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?
catecholamines
Microscopical examination of an enlarged cervical lymph node revealed blurring of its structure, absence of lymphoid follicles; all the microscopic fields showed cells with roundish nuclei and thin limbus of basophil cytoplasm. It is known from the clinical data that other groups of lymph nodes are also enlarged as well as spleen and liver
lymphoid leukosis
After a road accident a driver was delivered to the hospital with an injury of the medial epicondyle of humerus. What nerve might be damaged in this case?
n.ulnaris
A 12-year-old teenager has significantly put off weight within 3 months; glucose concentration rose up to 50 millimoleł. He fell into a coma. What is the main mechanism of its development?
hyperosmolar
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?
thrombocytes adhesion
An 18-year-old man was delivered to the hospital after a road accident. Examination at the traumatological department revealed multiple injuries of soft tissues of face in the region of the medial eye angle. The injuries caused massive haemorrhage. What arterial anastomosis might have been damaged in this region?
a. carotis externa et a. carotis interna
A patient with a limb fracture must be administered a depolarizing drug from the myorelaxant group for the purpose of a short-time surgery. What drug is it?
dithylinum
While examining the oral cavity a stomatologist revealed inflammation of papillae on the border of the median and posterior third of the back of tongue. What papillae are inflamed?
papillar valvatte
Autopsy of a 73-year-old man who had been suffering from the coronary heart disease along with cardiac insufficiency for a long time revealed: nutmeg liver, brown induration of lungs, cyanotic induration of kidneys and spleen. What kind of circulation disorder was the cause of such effects?
General chronic venous congestion
A patient suffering from stomach ulcer has been treated with an antacid drug almagel. For acute bronchitis treatment he was prescribed the antibiotic methacycline. However within next 5 days the fever didn’t fall, cough and sputum nature remained unchanged. A physician came to the conclusion that the drugs were incompatible. What type of drug incompatibility is the case?
pharmacokinetic absorption stage
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:
activation of fibrinolytic system
After a surgery a 36-year-old woman was given an intravenous injection of concentrated albumin solution. This has induced intensified water movement in the following direction:
fro intercellus fluid to the capilaries
A patient suffering from chronic bronchitis takes a synthetic mucolytic drug that facilitates the sputum thinning. What drug is it?
acetylcisteine
A patient complains about edemata of legs, skin cyanosis, small ulcers on one side of the lateral condyle. Examination revealed a swelling, enlarged veins, formation of nodes. The pathological process has started in the following vein:
v sapena parva
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?
reduction of renal blood flow
A patient suffering from coronary artery disease had taken a certain drug many times a day in order to arrest stenocardia attacks. Overdose of this drug finally caused intoxication. Objectively: cyanotic skin and mucous membranes, dramatic fall in the arterial pressure, tachycardia, respiration inhibition. Blood has increased concentration of methemoglobin. The drug the patient had taken relates to the following group:
organic nitrates
While studying a microslide obtained from the punctuate of a regional lymph node and stained by Romanovsky-Giemsa method a physician revealed some light-pink thin microorganisms with 12-14 regular spiral coils and pointed ends, up to 10-13 micrometer long. This might be the causative agent of the following disease:
spyhillis
An electronic microphotograph shows a macrophagic cell with erythrocytes at different stages of differentiation located along its processes. This is the cell of the following organ:
red bone marrow
A man with an injury in the nuchal region (regio nuchae) was admitted to the resuscitation department. What muscle occupies this region?
trapezius
A patient has a transversal laceration in the spinal cord. What respiratory changes will result from this?
Respiration will present no significant changes
he “worms”were sent to the laboratory. During examination the physician saw white filiform helminths 0.5-1 cm long, with pointed ends, some helminths had twisted ends. What is the most likely diagnosis?
enterobiasis
A histological specimen shows a blood vessel. Its inner coat is composed by endothelium, subendothelium and internal elastic membrane. The middle coat is enriched with smooth myocytes. Such morphological characteristics are typical for the following vessel:
muscular type artery
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 exudate containing a large amount of neutrophils in the lumen and walls of small bronchi and alveoles. Such pulmonary alterations indicate the following disease:
acute purulent bronchopneumonia
n response to a change in body position from horizontal to vertical blood circulation system develops reflectory pressor reaction. Which of the following is its compulsory component?
systemic constrict of venous vessels
Autopsy of a 1.5-year-old child revealed haemorrhagic skin rash, moderate hyperaemia and edema of nasopharyngeal mucous membrane, small haemorrhages in the mucous membranes and internal organs; dramatic dystrophic alterations in liver and myocardium; acute necrotic nephrosis; massive haemorrhages in the adrenal glands. What disease are these alterations the most typical for?
meningococcal infection
Retrospective diagnostics of bacterial dysentery involved serological analysis of blood serum intended for determination of Shigella antibody titre. Which of the following reactions should be applied for this purpose?
Passive haemagglutination
A 62-year-old female patient complains about frequent pains in the region of thorax and vertebral column, rib fractures. A physician suspected myelomatosis (plasmocytoma)
paraporteinnemia
A man who is riding the carousel presents with increased heart rate, sweating, nausea. This condition is caused primarily by the stimulation of the following receptors:
vestibular ampullar receptors
punctuate bright-red skin rash. The child was diagnosed as having scarlet fever. hyperaemic and edematic, the tonsils are enlarged and have dull yellowish-grey foci with some black areas.
purulent necrotic
Autopsy of a man, who had been suffering from the multiple bronchiectasis for 5 years and died from chronic renal insufficiency, revealed that kidneys were dense and enlarged, with thickened cortical layer of white colour with greasy lustre. What renal disease might be suspected?
secondary amoiloidosis
Lung ventilation in a person is increased as a result of physical activity. Which of the following indices of the external respiration is much higher than in a state of rest?
respiratory volume
A patient died from acute cardiac insufficiency, among clinical presentations there was gastrointestinal haemorrhage. Examination of mucous membrane of sromach revealed some defects reaching myenteron; their edges and bottom were mostly even and loose, some of them contained dark-red blood. What pathological process was revealed?
acute ulcers
Characteristic sign of glycogenosis is muscle pain during physical work. Blood examination reveals usually hypoglycemia. This pathology is caused by congenital deficiency of the following enzyme
glycogen phosphorylase
70 year old female patient was diagnosed with fracture of left femoral neck accompanied by disruption of ligament of head of femur. The branch of the following artery is damaged:
obturator
A patient got a trauma that caused dysfunction of motor centres regulating activity of head muscles. In what parts of cerebral cortex is the respective centre normally localized?
inferior part of the pre central gyris
A patient was diagnosed with paralysis of facial and masticatory muscles. The haematoma is inside the genu of internal capsule. What conduction tract is damaged?
cortico nuclear
Examination of a 66 year old patient revealed a lytic tumor in the locus of pathological rib fracture. Histologically this tumor consists of atypical plasmoblasts. Further examination revealed osteoporosis in the bones of vertebral column and pelvis. These changes are typical for:
myelometotis
A patient complains about impaired evacuatory function of stomach (long-term retention of food in stomach). Examination revealed a tumour of initial part of duodenum. Specify localization of the tumor:
pars superior
In course of laparotomy a surgeon revealed gangrenous lesion of descending colon. It was caused by thrombosis of the following artery:
sinister colic
utopsy revealed that his right lung was hyperemic; in the 2nd, 6th and 10th segments and on the incision there were airless yellowish foci of irregular form, from several mm up to 1 cm large
focal pneumonia
perforation of hard palat E. In the area of this perforation there was a compact well-defined formation. Microscopic examination of the resected formation revealed a large focus of caseous necrosis surrounded by granulation tissue with endovasculitis, cellular infiltration composed of lymphocytes, epithelioid cells (mainly plasmocytes). What is the most probable diagnosis?
spyhilis
mong junior children of an orphanage an outbreak of intestinal infection with signs of colienteritis was registered. In order to identify isolated causative agent it is necessary to:
to study antigenic properties of the agents
A 63 year old male patient who had been suffering from chronic diffuse obstructive disease, pulmonary emphysema, for 15 years died from cardiac insufficiency. Autopsy revealed nutmeg liver cirrhosis, cyanotic induration of kidneys and spleen, ascites, edemata of lower limbs. These changes of internal organs are typical for the following disease:
chronic right ventricular insufficiency
patient has been suffering from elevated temperature and attacks of typical cough for 10 days. Doctor administered inoculation of mucus from the patient’s nasopharynx on the agar. What microorganism is presumed?
pertussis bacillus
A 4 year old child with hereditary renal lesion has signs of rickets, vitamin D concentration in blood is normal. What is the most probable cause of rickets development?
impaired synthesis of calcicitrol
A patient suffering from periodical attacks caused by inhalation of different flavoring substances was diagnosed with atopic bronchial asthm A. IgE level was increased. This is typical for the following type of reactions:
anaphylactic reaction
Autopsy of a 17 year old girl who died from pulmonary failure revealed a small area of caseous necrosis in the inferior lobe of the right lung, and occurences of caseous necrosis in the bronchopulmonary, bronchial and bifurcational lymph nodes. What is the most probable postmortem diagnosis?
primary tuberclosis
Introduction of a big dose of histamine to an experimental animal caused abrupt drop of arterial pressure as a result of:
dilation of hear tvessels
Microscopical examination of a microbal culture revealed fusiform spore-forming microorganisms that get violet-blue Gram’s stain. What microorganisms were revealed?
clostridia
Examination of a patient with impaired blood coagulation revealed thrombosis of a branch of inferior mesenteric artery. What bowel segment is damaged?
colon sigmoidom
A full-term newborn child has yellowish skin and mucous membranes. This might be probably caused by temporary deficiency of the following enzyme:
UDPglucoronyltransferase
Atria of an experimental animal were superdistended by blood that resulted in decreased reabsorption of Na+ and water in renal tubules. This can be explained by the influence of the following factor upon kidneys:
natireitc factor
Clinical diagnosis of a female patient was gonorrhoe A. What examination method can be applied for confirmation of this diagnosis?
microscopy of pathological material
Roentgenological examination of skull base bones revealed enlargement of sellar cavity, thinning of anterior clinoid processes, destruction of different parts, destruction of different parts of sella turcica. Such bone destruction might be caused by a tumor of the following wndocrinous gland:
hypophysis
Untrained people often have muscle pain after sprints as a result of lactate accumulation. This might be caused by intensification of the following biochemical process:
glycolysis
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:
neurotonic
A patient was admitted to the surgical department with inguinal hernia. During the operation the surgeon performs plastic surgery on posterior wall of inguinal canal. What structure forms this wall?
transverse fascia
blood count of an athlete is as follows: erythrocytes – 5,51012/l, Hb- 180 g/l, leukocytes – 7109/l, neutrophils – 64%, basophils – 0,5%, eosinophils – 0,5%, monocytes – 8%, lymphocytes – 27%. First of all, such results indicate the stimulation of:
erythropoeisis
Tissue inosytol triphosphates are generated as a result of the phosphatidylinositol diphosphate hydrolysis and act as secondary agents (mediators) in the mechanism of hormone action. Their effect in cells is directed at:
calcium ion liberation from cellular pot
After an immunoassay a child was diagnosed with immunodeficiency of humoral immunity. What is the reason for the primary immunodeficiency development in the child?
hereditary abnormality of immune system
2 days after labour a woman developed shock along with DIC syndrome that caused her death. Autopsy revealed purulent endomyometritis, regional purulent lymphangitis, lymphadenitis and purulent thrombophlebitis. There were also dystrophic alterations and interstitial inflammation of parenchymal organs
septicimia
A patient with marked pneumofibrosis that developed after infiltrating pulmonary tuberculosis has been diagnosed with respiratory failure. What is its pathogenetic type?
restrictive
An alcoholic has alcoholic psychosis with evident psychomotor agitation. What neuroleptic drug should be administered for emergency care?
aminazine
A child has inhaled a . Where is it likely to be?
right main borncus
Examination of a pregnant woman having Rh-negative blood revealed high level of antierythrocytic antibodies. For its reduction she was implanted with her husband’s Rh-positive skin graft. The graft was rejected in two weeks. Its microscopic examination revealed circulatory disturbance, edema and cellular infiltration with lymphocytes, neutrophils and macrophages predominance. What is the most likely pathology?
graft immunity
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 v
A male patient has fever and enanthesis. As a result of the examination involving serological tests he has been diagnosed with fasciola hepatica. It was found out that the patient had been infected through raw river water. Which stage of fasciola life cycle is invasive for humans?
adolescaria
A 49-year old female patient has limitation of left limbs arbitrary movements. Muscular tonus of left hand and leg is overstrained and spasmodic, local tendon reflexes are strong, pathological reflexes are presented. What is the most likely development mechanism of hypertension and hyperreflexia?
reduction of descending inhibitory influence
17-year-old girl took a high dose of phenobarbital to commit a suicide. An ambulance doctor cleansed her stomach and gave her an intravenous injection of bemegride and sodium hydrocarbonate solution. What was sodium hydrocarbonate injected for?
for increasing the renal excretion of phenobarbital
After a trauma of the upper third of the anterior forearm surface a patient presents with difficult pronation, weakening of palmar flexor muscles and altered skin sensitivity of 1-3 fingers. Which nerve is damaged?
N medianus
A 38-year-old man died in the attempt of lifting weight. He had collaptoid state. Autopsy revealed an extensive aneurism rupture of thoracic aorta. He suffered from visceral syphilis during his lifetime. What pathological process caused weakness of aortic wall, its dilatation and rupture?
vanishing of elastic fibers
A doctor prescribed a cephalosporin antibiotic to the patient after appendectomy for infection prevention. Antimicrobial activity of this group of antibiotics is based upon the disturbance of the following process:
microbial wall formation
A patient complains of hydruria (7 liters per day) and polydipsia. Examination reveals no disorders of carbohydrate metabolism. These abnormalities might be caused by the dysfunction of the following endocrine gland:
neuriphypophysis
A doctor recommends a patient with duodenal ulcer to drink cabbage and potato juice after the therapy course. Which substances contained in these vegetables help to heal and prevent the ulcers?
vitamin u
It was found out that some compounds, for instance fungi toxins and some antibiotics can inhibit activity of RNA-polymerase. What process will be disturbed in a cell in case of inhibition of this enzyme?
transcription
A 70-year-old male patient died from acute coronary insufficiency. He had knee joint swelling, gonycampsis and gonalgia during his lifetime. Pathomorphologic examination of the deformed joints and synovial membranes revealed membrane hyperaemia with multiple perivascular inflammatory infltrations made by lymphocytes, plasmocytes and macrophagocytes. There was an accumulation of organized fibrin covering some areas of synovium membrane and looking like rice grains in the articular liquid. What is the most likely diagnosis?
Atropic artheritis
A patient has been diagnosed with a compression fracture of a lumbar vertebra. As a result he has a considerable increase in curvature of the lumbar lordosis. Which ligament damage can induce such changes in the spine curvature?
anterior longitudinal ligament
A patient has corestenoma. What is the reason of such condition?
increased bonus of parasympathetic centers
During examination of a 6-year-old child a doctor revealed greyish films on the pharyngeal tonsils. Their removal provoked moderate haemorrhage. Bacterioscopy revealed gram-positive clublike bacteria. What symptoms will develop in this child within the next few days if no specific treatment is provided?
toxic lesion of myocardium liver and kidney
Jaundice treatment involves administration of barbiturates inducing the synthesis of UDP-glucuronyl transferase. A medicinal effect is caused by the production of:
direct reacting conjugated bilirubin
Surgical approach to the thyroid gland from the transverse (collar) approach involves opening of interaponeurotic suprasternal space. What anatomic structure localized in this space is dangerous to be damaged?
jugular venous arch
A man with a wound of his limb that had been suppurating for a long time died from intoxication. Autopsy revealed extreme emaciation, dehydration, brown atrophy of liver, myocardium, spleen and cross-striated muscles as well as renal amyloidosis. What diagnosis corresponds with the described presentations?
chroniosepsis
ECG of a 44-year-old patient shows signs of hypertrophy of both ventricles and the right atrium. The patient was diagnosed with the tricuspid valve insufficiency. What pathogenetic variant of cardiac dysfunction is usually observed in case of such insufficiency?
heart overload by volume
A victim with a head trauma in the temporal region has been diagnosed with epidural hematoma. What artery is most likely to be damaged?
medial membranous artery
A man having a hearing loss after a head trauma was delivered to the neurosurgery department. The cause of the hearing loss might be the damage of the following lobe of cerebral cortex:
temporal
A 46-year-old patient consulted a doctor complaining about joint pain that becomes stronger the day before the weather changes. Blood examination revealed an increased concentration of uric acid. The most probable cause of the disease is the intensified disintegration of the following substance:
adenosine monophosphate
A 35-year-old man developed acute heart failure while running for a long time. What changes in ionic composition can be observed in the cardiac muscle?
Accumulation of Na+ and Ca2+ ions in the myocardium cells
Characteristic sign of glycogenosis is muscle pain during physical work. Blood examination reveals usually hypoglycemia. This pathology is caused by congenital deficiency of the following enzyme:
glycogen phosphorylase
A patient has a right-sided fracture in the region of the frontal third of mandible accompanied by a haematoma in the region of chin. It is caused by the injury of the following artery:
mental
As a result of a cold a patient has the abnormal pain and temperature sensitivity of the frontal 2/3 of his tongue. Which nerve must have been damaged?
trigeminus
A female patient with a tumour of pancreas has developed mechanic jaundice resulting from compression of a bile-excreting duct. Which duct is compressed?
ductus colidus
Patients with similar complaints applied to the doctor: weakness, pain in the intestines, disorder of GIT. Examination of the faeces revealed that one patient with four nucleus cysts should be hospitalized immidiately. For what protozoa are such cysts typical?
dysenteric amaeba
A child has abnormal formation of tooth enamel and dentin as a result of low concentration of calcium ions in blood. Such abnormalities might be caused by deficiency of the following hormone:
parathhormone
The patient with thymoma (thymus gland tumour) has cyanosis, extention of subcutaneous venous net and edema of the soft tissues of face, neck, upper part of the trunk and upper extremities. What venous trunk is pressed with tumour?
superior venacava
After implantation of a cardiac valve a young man constantly takes indirect anti-coagulants. His state was complicated by hemorrhage. What substance content has decreased in blood?
pro thrombin
A patient with a history of chronic glomerulonephritis presents with azotemia, oliguria, hypo- and isosthenuria, proteinuria. What is the leading factor in the pathogenesis of these symptoms development under chronic renal failure?
mass destruction of active nephrons
A patient suffering from chronic myeloleukemia has got the following symptoms of anemia: decreased number of erythrocytes and low haemoglobin concentration, oxyphilic and polychromatophilic normocytes, microcytes. What is the leading pathogenetic mechanism of anemia development?
substitution of hemoblast
Bacterioscopy of nasopharyngeal mucus taken from a 2,5 year old child with nasopharyngitis revealed gram-positive diplococci looking like coffee grains. What organs of the child are most likely to be affected if these microorganisms penetrate the blood?
brain tunics
gram-positive diplococci with somewhat pointed opposite ends.
streptococcus pneumonia
A 63 year old male patient who had been suffering from chronic diffuse obstructive disease, pulmonary emphysema, for 15 years died from cardiac insufficiency. Autopsy revealed nutmeg liver cirrhosis, cyanotic induration of kidneys and spleen, ascites, edemata of lower limbs. These changes of internal organs are typical for the following disease:
chronic right ventricular insufficiency
A 38 year old man died all of a sudden. Autopsy revealed myocardial infarction in the posterior wall of the left ventri-cle. What are the most likely alterations in myocardiocyte structure that can be revealed microscopically in the infarcti-on focus?
karyolysis
After a serious psychoemotional stress a 48 year old patient suddenly developed acute heart ache irradiating to the left arm. Nitroglycerine relieved pain after 10 minutes. What is the leading pathogenetic mechanism of this process development?
spasm of coronary arteries
While under barbituric anaesthesia a 65 year old male patient developed respiratory inhibition. Anesthesiologist made him a 10 ml intravenous injection of 0,5% bemegride solution. The patient’s condition got better, the pulmonary ventilati-on volume increased. What phenomenon underlies the interaction of these medi-vcations?
direct antogonism
In course of an operation surgeon removed a part of a lung that was ventilated by a tertiary bronchus accompanied by branches of pulmonary artery and other vessels. What part of a lung was removed?
brochopulmonary segment
A 39 year old man who had been operated for the stomach ulcer died 7 days after the surgery. Autopsy revealed that peritoneal leaves were dull, plephoric, covered with massive yellow-greenish films, the peritoneal cavity contained for about 300 ml of thick yellow-greenish liquid. What pathologic process was revealed in the peritoneal cavity?
fibrous supportive peritonititis
Osteolaterism is charcterized by a decrease in collagen strength caused by much less intensive formation of cross-links in collagen fibrils. This phenomenon is caused by the low activity of the following enzyme:
Lysol oxidase
A 26 year old pregnant woman is under treatment at an in-patient hospital. After a continuous attack of vomiting she was found to have reduced volume of circulating blood. What kind of change in general blood volume is the case?
polycythemia hypovolumia
A child with suspected tuberculosis was given Mantoux test. After 24 hours the site of the allergen injection got swollen, hyperemic and painful. What are the main components that determine such response of the body?
Mononuclear cells, T-lymphocytes and lymphokines
After the diagnostic tests a 40-year-old male has been referred for the lymphography of the thoracic cavity. The surgeon revealed that the tumor had affected an organ whose lymphatic vessels drain directly into the thoracic duct. Speci-fy this organ:
esophagus
In order to stimulate breathing in a child born with asphyxia, the doctor gave him a drug injection into the umbilical vein. What drug might have been injected?
aethimazole
At the end of the working day a worker of a hot work shop has been delivered to a hospital. The patient complains of a headache, dizziness, nausea, general weakness. Objectively: the patient is conscious, his skin is hyperemic, dry, hot to the touch. Heart rate is of 130/min. Respiration is rapid, superficial. What disorder of thermoregulation is most likely to have occurred in this patient?
reduced heat transfer
Alveolar space of the acinus was invaded by some bacteria which interacted with the surfactant. This led to the activation of the cells that are localized in the alveolar walls and on the surface. What cells are these?
alveolar macrohphages
A 3-year-old child had eaten some strawberries. Soon he developed a rash and itching. What was found in the child’s leukogram?
esonoplilia
Anatomical dead space is the portion of the air that is left in the airways after expiration. The reduction of the anatomical dead space is typical for the following situation:
tracheostomy
For the direct injection of medications into the liver surgeons use the round ligament of liver. This manipulation involves bougienage (lumen dilatation) of the following vessel:
venous umbilicalis
The cellular composition of exudate largely depends on the etiological factor of inflammation. What leukocytes are the first to get into the focus of inflammation caused by pyogenic bacteria?
neutrophilic granulocytes
A patient has been hospitalized for a suspected tumor of the prostate. During the surgery, it was revealed that the tumor invaded the bladder. Which part of the bladder was affected?
cervix
A surgeon examined the patient and found the injury of the upper third of the kidney. Considering the syntopy of the left kidney, the intactness of the following organ should be checked at the same time:
stomach
A patient died from progressive heart failure. Autopsy revealed that the heart was enlarged in diameter, flabby. The muscle section exhibited irregular blood supply. Histological study of myocardium revealed hyperemia, the stroma was found to have lymphohistiocytic infiltrates with degeneration of cardiomyocytes. The revealed morphological changes are indicative of:
no purulent interstitial myocarditis
During the operation on the small intestine the surgeon revealed an area of the mucous membrane with a single longitudinal fold among the circular folds. Which portion of the small intestine is this structure typical for?
descending
To assess the effectiveness of breathing in patients, the indicator of functional residual capacity is used. It includes the following volumes:
expiratory reserve volume and residual volume
Mother of a boy who had recently returned from a summer camp found some small whitish insects up to 3 mm long on the child’s clothing. Specify the parasite:
pedicures hum ans humans
Since a patient has had myocardial infarction, atria and ventricles contract independently from each other with a frequency of 60-70 and 35-40 per minute. Specify the type of heart block in this case:
complete atrioventricular block
A diseased child has a high fever, sore throat, swelling of submandibular lymph nodes. Objectively: pharyngeal mucosa is edematous, moderately hyperemic, the tonsils are enlarged, covered with grayish membrane tightly adhering to the tissues above. Attempts to remove the membrane produce the bleeding defects. What disease are these presentations typical for?
diphtheria
A hypertensive patient had been keeping to a salt-free diet and taking antihypertensive drugs together with hydrochlorothiazide for a long time. This resulted in electrolyte imbalance. What disorder of the internal environment occurred in the patient?
hyperchloramic alkalosis
Healthy parents with unremarkable family history have the child with multiple developmental defects. Cytogenetic analysis revealed the trisomy 13 in the somatic cells (Patau syndrome). What phenomenon has caused the defects?
abnormal gametogenesis
patient has severe catarrhal symptoms. Material growth on Bordet-Gengou agar showed mercury-drop-like colonies. Examination of the blood smears revealed some small ovoid gram-positive bacilli sized 1-3 microns. What microorganisms were isolated?
bordetella
eCG of a patient displays an abnormally long R wave (up to 0,18 s). This is caused by a decrease in the conduction velocity of the following heart structures:
ventricular
When examining a patient, the doctor revealed a tumor of the bronchus which borders on the aorta. Which bronchus is affected?
left principal
After a car accident a 23-year-old male presented to the hospital with a cut wound of the anteromedial region of shoulder and arterial bleeding. Which artery was damaged?
A brachialis
A 50-year-old patient with food poisoning is on a drip of 10% glucose solution. It not only provides the body with necessary energy, but also performs the function of detoxification by the production of a metabolite that participates in the following conjugation reaction:
glucoronidatio
A 60-year-old male patient has a 9-year history of diabetes and takes insulin Semilente for the correction of hyperglycemia. 10 days ago he began taking anaprilin for hypertension. One hour after administration of the antihypertensive drug the patient developed hypoglycemic coma. What is the mechanism of hypoglycemia in case of anaprilin use?
inhibition of glycogenolysis
Glycogen polysaccharide is synthesized from the active form of glucose. The immediate donor of glucose residues during the glycogenesis is:
UDP GLUCOSE
A patient has normally coloured stool including a large amount of free fatty acids. The reason for this is a disturbance of the following process:
fat absortion
A child cut his leg with a piece of glass while playing and was brought to the clinic for the injection of tetanus toxoid. In order to prevent the development of anaphylactic shock the serum was administered by Bezredka method. What mechanism underlies this method of desensitization of the body?
Binding of IG e fixed to the mast cells
Microscopy of the bronchial wall revealed atrophy of the mucosa, metaplastic change from columnar to squamous epithelium, an increase in the number of goblet cells, diffuse infiltration of the bronchial wall with lymphoplasmacytic elements with a large number of neutrophilic granulocytes, pronounced sclerosis. Spesify the morphological form of bronchitis:
chronic purulent bronchitis
Microscopy of the myocardium of a patient who had died from heart failure revealed foci of fibrinoid necrosis located diffusely in the interstitial stroma, and often around the vessels. Such foci were surrounded by lymphocytes, macrophages, histiocytes. Pericardium was found to have signs of sero-fibrinous pericarditis. What is the most likely diagnosis?
rheumatic heart disease
Typical manifestations of food poisoning caused by C. botulinum are double vision, abnormal functioning of the swallowing and breathing. These symptoms develop as a result of:
exotoxin
During ventricular systole, the cardiac muscle does not respond to additional stimulation because it is in the phase of:
absolute refractoriness
For the study of serum proteins various physical and physicochemical methods can be used. In particular, serum albumins and globulins can be separated by this method:
electrophoresis
A patient has recurrent attacks of epileptic seizures and stays unconscious between them. In order to stop convulsions the drugs of the following group should be used in the first place:
tranquilizers
A patient with lobar pneumonia has had body temperature of 39oC with daily temperature fluctuation of no more than 1oC for 9 days. This fever can be characterized by the following temperature curve:
persistant
A miner consulted a physician about the appearance of body rash followed by a loss of appetite, bloating, duodenal pain, frequent bowel movements, dizziness. Ovoscopic probes of feces and duodenal contents revealed some eggs covered with a transparent membrane through which 4-8 germinal cells could be seen. What disease is likely to have occurred in the patient?
ancyclostomiasis
At autopsy the occipital lobe of brain was found to have a cavity 2,5×1,5 cm large filled with a transparent liquid. The cavity had smooth brownish walls. What process had developed in the brain?
cyst on the site of hemorrage
n the surgical ward, the dressing material was undergoing sterilization in an autoclave. Through an oversi-ght of a nurse the mode of sterilization was changed and the temperature in the autoclave reached only 100oC instead of the due 120OC. What microorganisms can stay viable under these conditions?
bacilli and clostridia
At the stage of translation in the rough endoplasmic reticulum, the ribosome moves along the mRNA. Amino acids are joined together by peptide bonds in a specific sequence, and thus polypeptide synthesis takes place. The sequence of amino acids in a polypeptide corresponds to the sequence of:
mRNA codons
A 23-year-old patient has been admitted to a hospital with a craniocerebral injury. The patient is in a grave condition. Respiration is characterized by prolonged convulsive inspiration followed by a short expiration. What kind of respiration is it typical for?
apnestic
A 3-year-old boy with pronounced hemorrhagic syndrome doesnt have antihemophilic globulin A (factor VIII) in the blood plasma. Hemostasis has been impaired at the following stage:
internal mechanism of prothrombin activation
The genetic defect of pyruvate carboxylase deficiency is the cause of delayed physical and mental development and early death in children. This defect is characterized by lacticemia, lactaciduria, disorder of a number of metabolic pathways. In particular, the following process is inhibited:
gluconeogenesis and citric acid cycle
male patient is 28 years old. Histological study of a cervical lymph node revealed a change of its pattern due to the proliferation of epithelioid, lymphoid cells and macrophages having nuclei in form of a horseshoe. In the center of some cell clusters there were non-structured light-pink areas with fragments of nuclei. What disease are these changes typical for?
tuberclosis
In a car accident a man got injured and lost a lot of blood. What changes in peripheral blood are most likely to occur on the 2nd day after the injury?
erythropenia
Histological examination of the removed skin neoplasm revealed clusters and cords of atypical cells of stratified squamous epithelium, growing into the underlying tissue. What diagnosis can be assumed?
no keratinizing sqmours cell carcinoma
Some infectious diseases caused by bacteria are treated with sulfanilamides which block the synthesis of bacteria growth factor. What is the mechanism of their action?
they are anti vitamins of paraaminobenzoic acid
The neurosurgical department has admitted a 54-year-old male complaining of no sensitivity in the lower eyelid skin, lateral surface of nose, upper lip. On examination the physician revealed the inflammation of the second branch of the trigeminal nerve. This branch comes out of the skull through the following foramen:
round foramen
On examination a patient was found to have medial strabismus, the inward deviation of the eyeball and inability to abduct the eyeball outwards. What nerve is damaged?
abducent
As a result of an injury of the knee joint a patient shows a drawer sign, that is the anterior and posterior displacement of the tibia relative to the femur. What ligaments are damaged?
cruciate ligaments
A patient with urolithiasis has unbearable spasmodic pain. To prevent pain shock, he has been given an injection of atropine along with a narcotic analgesic having antispasmodic effect. What drug was it?
promedol
Human skin has a high breaking strength. It is known that the skin consists of epithelial tissue and two kinds of connective tissue. Which of the following tissues provides the skin strength?
unformed dense connective tissue
vision impairment
microangiopathy
A 10-year-old child was found to have a congenital hypoplasia of the left kidney. Ultrasound examination revealed that the right kidney was markedly enlarged and had regular shape. No functional disorders were revealed. Specify the process that developed in the right kidney:
vicarious hypertrophy
A 42-year-old male with a lesion of the ulnar nerve is unable to flex the II and V fingers to the midline. Which muscle function is impaired in this case?
palmar interosseous muscle
The development of both immune and allergic reactions is based upon the same mechanisms of the immune system response to an antigen. What is the main difference between the immune and allergic reactions?
Development of tissue lesion
Autopsy of the dead patient who died from pulmonary edema revealed a large yellow-grey nidus in the myocardium, and a fresh thrombus in the coronary artery. What is the most likely diagnosis?
myocardial infraction
A patient with suspected tumor of lung had been admitted to the oncological department. Examination revealed localised pathology in the inferior lobe of the left lung. How many bronchopulmonary segments does this lobe have?
5
Patients with erythropoietic porphyria (Gunther’s disease) have teeth that fluoresce with bright red color when subjected to ultraviolet radiation; their skin is light-sensitive, urine is red-colored. What enzyme can cause this disease, when it is deficient?
uroproferinogen 1 cosyntehtase
A patient has hoarseness of voice. During laryngoscopy a gray-white larynx tumor with papillary surface has been detected. Microscopic investigati-on has shown the following: growth of connective tissue covered with multi-layer, strongly keratinized pavement epithelium, no cellular atypia. What is the most likely diagnosis?
papilloma
A smear from the tonsillar coating of a patient with suspected diphtheria was found to contain blue bacilli with a thickening at the poles. What method of smear staining was used?
leffler
A patient has been hospitalised with provisional diagnosis of virus B hepatitis. Serological reaction based on complementation of antigen with antibody chemically bound to peroxi-dase or alkaline phosphatase has been used for disease diagnostics. What is the name of the applied serological reaction?
immune enzyme analysis
In the course of an experiment adenohypophysis of an animal has been removed. The resulting atrophy of thyroid gland and adrenal cortex has been caused by deficiency of the following hormone:
trophic hormones
organ with walls comprised of mucous, submucous, fibrous-cartilaginous and adventitial membranes. Epithelium is multirowed and ciliated, muscular layer of mucous membrane is absent, submucous membrane contains serous-mucous glands, hyaline cartilage forms open circles
trachea
Angiocardiography of a 60-year-old male patient revealed constriction of a vessel located in the left coronary sulcus of the heart. What is the pathological vessel called?
ramus surcumflexes
A 29-year-old male with a knife wound of neck presents with bleeding. During the initial d-bridement of the wound the surgeon revealed the injury of a vessel found along the lateral edge of the sternocleidomastoid muscle. Specify this vessel:
V jugular’s externa
second branch of trigeminal nerve. What cranial foramen does this branch go through?
supraorbital fissure
While examining foot blood supply a doctor checks the pulsation of a large artery running in the separate fibrous channel in front of articulatio talocruralis between the tendons of long extensor muscles of hallux and toes. What artery is it?
A dorsallis pedis
Histological examination of biopsy samples taken from the thickened edges of a gastric ulcer revealed small clusters of small, markedly atypical hyperchromatic epithelial cells that were localized in the overdeveloped stroma. Specify the tumor:
Scirrhous undifferentiated carcinoma
A patient has severe blood loss caused by an injury. What kind of dehydration will be observed in this particular case?
isoosmolar
A child has a history of hepatomegaly, hypoglycemia, seizures, especially on an empty stomach and in stressful situations. The child is diagnosed with Gierke disease. This disease is caused by the genetic defect of the following enzyme:
glucose 6 phosphatase
A 3-year-old child with meningeal symptoms died. Postmortem macroscopy of the pia matter revealed miliary nodules which were microscopically represented by a focus of caseous necrosis with masses of epithelioid and lymphoid cells with some crescent-shaped large cells inbetween having peripheral nuclei. Specify the type of meningitis in the child:
tuberculous
A 19-year-old victim has been delivered to the casualty department with a cut wound of the trapezius muscle. Which of the cervical fasciae forms a sheath for this muscle?
investing layer of cervical fascia
Histological specimen of a 10-day human embryo represents 2 contacting sacs (amniotic and yolk sacs). Specify the structure that separates the amniotic cavity from the yolk sac:
embryonic shield
A public utility specialist went down into a sewer well without protection and after a while lost consciousness. Ambulance doctors diagnosed him with hydrogen sulfide intoxication. What type of hypoxia developed?
hemic
Nucleolar organizers of the 13-15, 21, 22 human chromosomes contain about 200 cluster genes that synthesize RNA. These regions of chromosomes bear the information on the following type of RNA:
r RNA
A 37-year-old male patient developed pseudoarthrosis after a closed fracture of the femur. Specify the type of regeneration in the patient:
pathological hypo regeneration
A 22-year-old female student consulted a physician about fever up to 38oC, weakness, sore throat. Objectively: there is white coating of the tongue. What histological structures of the tongue are involved in the formation of this coating?
epithelium of the filiform papillae
During autopsy peritonitis has been revealed, with numerous ulcers covering the colon mucosa and reaching as deep as muscular and, in places, serous tunic. The ulcers have smooth edges and even floor.
clean ulcer
patient complains of palpitation after stress. The pulse is 104 bpm, P-Q=0,12 seconds, there are no changes of QRS complex. What type of arrhythmia does the patient have?
sinus tacchycardia
A blood drop has been put into a test tube with 0,3% solution of NaCl. What will happen to erythrocytes?
somatic hemolysis
A newborn baby has numerous hemorrhages. Blood coagulation tests reveal increased prothrombin time. The child is most likely to have a disorder of the following biochemical process:
production of gamma carboxyglutamate
A female suffered rubella during pregnancy. The child was born with developmental abnormalities, namely cleft lip and palate. The child’s genotype is normal. These malformations are a manifestation of:
modification variability
Bacteriological examination of the urine of the patient with pyelonephritis revealed microorganisms that produced yellow-green pigment and a characteristic odor in meat-peptone agar. What are they called?
pseudomonas
dense gray-white nidus in form of a nodule 2 cm in diameter in the subpleural portion of the upper right lobe. The pleura in this region was thickened, in the pleural cavity there was a small amount of serous hemorrhagic fluid. Histological study of the region revealed some glandular structures wi-th signs of cellular atypia and abnormal mitoses, which were found within the fibrous connective tissue
adenocarcinoma
Examination of a 52-year-old female patient has revealed a decrease in the amount of red blood cells and an increase in free hemoglobin in the blood plasma (hemoglobinemia). Color index is 0,85. What type of anemia is being observed in the patient?
acquired hemolytic
A patient complains of acute pain attacks in the right lumbar region. During examination the nephrolithic obturation of the right ureter in the region between its abdominal and pelvic segments has been detected. What anatomical boundary exists between those two segments?
linea terminalis
As a result of a road accident a 37-year-old female victim developed urinary incontinence. What segments of the spinal cord had been damaged?
S2 - S4
A patient with hereditary hyperammonemia due to a disorder of ornithine cycle has developed secondary orotaciduria. The increased synthesis of orotic acid is caused by an increase in the following metabolite of ornithine cycle:
carbonyl phosphate
A 40-year-old female patient has undergone thyroidectomy. Histological study of thyroid gland found the follicles to be of different size and contain foamy colloid, follicle epithelium is high and forms papillae, there is focal lymphocytic infiltration in stroma. Diagnose the thyroid gland disease:
basedovs disease
Experimental stimulation of the sympathetic nerve branches that innervate the heart caused an increase in force of heart contractions because the membrane of typical cardiomyocytes permitted an increase in:
calcium ion entry
A 55-year-old patient with a characteristic rash, fever, dizziness has been admitted to a hospital. He has been provisionally diagnosed with typhus. No similar cases have been reported. In his youth (15 years old) the patient suffered typhus in a boardi-ng school. What disease is it?
brills disease
In course of invasive abdominal surgery a surgeon has to locate the origin of the mesenteric root. Where is it normally localized?
duodenal jujanal flexure
During autopsy approximately 2,0 liters of pus have been found in the abdominal cavity of the corpse. Peri-toneum is lustreless and has grayish shade, serous tunic of intestines has grayish-colored coating that is easily removable. Specify the most likely type of peritonitis in the patient:
fibrinopurulent peritotitis
developed fever up to 39oC accompanied by a strong headache. Examination revealed marked nuchal rigidity. Spinal puncture was performed. Gram-stained smear of cerebrospinal fluid contained many neutrophils and Gram-positive diplococci
tessera meningetides
Prolonged fasting causes hypoglycemia which is amplified by alcohol consumption, as the following process is inhibited:
gluconeogenesis
According to the results of glucose tolerance test, the patient has no disorder of carbohydrate tolerance. Despite that, glucose is detected in the patients’s urine (5 mmol/l). The patient has been diagnosed with renal diabetes. What renal changes cause glucosuria in this case?
decreased activity of glucose reabsorption enzymes
A microslide contains the preparation of a gland composed of several secretory saccule-shaped parts that open in the common excretory duct. What gland is it?
simple branched alveolar cells
Ultrasonic examination of a patient revealed aneurism in the area of aortic arch that caused alteration of vocal function of larynx. What nerve was constricted?
recurrent laryngeal
Children often have heavy nasal breathing resulting from excessive development of lymphoid tissue of pharyngeal mucous membrane. What tonsils growth may cause this effect?
tonsilla pharnygea
A patient suffering from chronic myeloleukemia has got the following symptoms of anemia: decreased number of erythrocytes and low haemoglobin concentration, oxyphilic and polychromatophilic normocytes, microcytes. What is the leading pathogenetic mechanism of anemia development?
substitution of hemoblast
A patient has lost skin sensitivity in the region of the medial surface of his shoulder. This is the result of dysfunction of the following nerve:
medical branch of the cutaneous nerve
A patient has pain, edema and reddening of his skin in the anterosuperior area of his thigh and his foot’s thumb. What lymph nodes of his lower extremity responded to the inflammatory process?
superficial inguina;
A patient complains of acute pain attacks in the right lumbar region. During examination the nephrolithic obturation of the right ureter in the region between its abdominal and pelvic segments has been detected. What anatomical boundary exists between those two segments?
linea terminalis
While examining foot blood supply a doctor checks the pulsation of a large artery running in the separate fibrous channel in front of articulatio talocruralis between the tendons of long extensor muscles of hallux and toes. What artery is it?
dorsalis pedis
A 42-year-old male with a lesion of the ulnar nerve is unable to flex the II and V fingers to the midline. Which muscle function is impaired in this case?
palmar interosseous muscle
A 58-year-old patient with acute cardiac insufficiency has decreased volume of daily urine – oliguria. What is the mechanism of this phenomenon?
dec glomerular filtration
Microspecimen of spinal cord contains a nucleus that should be analyzed. Its neurons form motor endings in the skeletal muscles. What nucleus of spinal cord is meant?
proper nucleus of the anterior horn
Extensive thromboembolic infarction of the left cerebral hemispheres, large septic spleen, immunocomplex glomerulonephritis, ulcers on the edges of the aortic valves, covered with polypous thrombus with colonies of staphylococcus were revealed on autopsy of the young man who died in coma. What disease caused cerebral thromboemboly?
septic bacterial endocarditis
Local lymphonodules enlarged near the infected wound. Increased amount of macrophages, lymphocytes, lymphatic follicles in the cortical layer and large amount of plasma cells were revealed on histological examination. What process in the lymphatic nodules represent these histological changes?
antigen stimulation
A 20 year old patient died from intoxication 8 days after artificial illegal abortion performed in her 14-15th week of pregnancy. Autopsy of the corpse revealed yellowish colour of eye sclera and of skin, necrotic suppurative endometritis, multiple pulmonary abscesses, spleen hyperplasia with a big number of neutrophils in its sinuses. What complication after abortion was developed?
septicopymia
A 33 year old man died from uraemia. Autopsy revealed enlarged kidneys weighing 500,0 each and consisting of multiple cavities 0,5-2 cm in diameter. The cavities were full of light-yellow transparent liquid. Renal pelvis and ureters had no pecularities. What renal disease caused uraemia?
bilateral polycystic renal disease
Autopsy of a man who died from the sepsis in his femoral bone revealed phlegmonous inflammation that affected the marrow, haversian canals and periosteum. Under the periosteum there are multiple abscesses, adjoining soft tissues of thigh also have signs of phlegmonous inflammation. What pathological process was described?
acute hematogenous osteomylitis
Examination of a 66 year old patient revealed a lytic tumour in the locus of pathological rib fracture. Histologically this tumour consists of atypical plasmoblasts. Further examination revealed osteoporosis in the bones of vertebral column and pelvis. These changes are typical for:
myelomatosis
Multiple oval ulcers along the intestine were revealed on autopsy of the person, who died from diffuse of peritonitis in the distant part of the small intestine. Bottom parts of the ulcers are clear, smooth, formed with muscular or serous covering, edges of ulcers are flat, rounded. There are perforations up to 0,5 cm in diameter in two ulcers. What diseasis can be diagnosed?
typhoid fever
On autopsy it is revealed that kidneys are enlarged, surface is large-granular because of multiple cavities with smooth wall, which are filled with clear fluid. What kidney disease did the patient have?
polycystic kidney
It was revealed that T-lymphocytes were affected by HIV. Virus enzyme – reverse transcriptase (RNA-dependent DNA polymerase) – catalyzes the synthesis of:
dna on the matrix of rival mrna
Electrocardiogram of a 45-year-old man showed absence of P-wave in all the leads. What part of the conducting system is blocked?
sa node
A 5-year-old child who often fells ill with respiratory diseases has eczematous appearances after consumption of some food products, tendency to prolonged course of inflammatory processes. What kind of diathesis can be suspected in this case?
exudative catarrhal
Characteristic sign of glycogenosis is muscle pain during physical work. Blood examination reveals usually hypoglycemia. This pathology is caused by congenital deficiency of the following enzyme:
glycogen phosphorylase
A 65-year-old suffering from the gout man complains of the pain in the kidney’s region. On ultrasonic examination the renal calculi were revealed. As a result of what process were they formed?
decay of purine nucleotide
Patient experienced increased susceptibility of the skin to the sunlight. His urine after some time became dark-red. What is the most likely cause of this?
porypria
To prevent long-term effects of 4-day malaria a 42-year-old patient was prescribed primaquine. On the 3-rd day from the begin of treatment there appeared stomach and heart pains, dyspepsia, general cyanosis, hemoglobinuria. What caused side effects of the preparation?
genetic deficiency of glucose 6 phosphate dehydrogenase
As a result of spinal-cord trauma a 33 y.o. man has a disturbed pain and temperature sensitivity that is caused by damage of the following tract:
spinothalami tract
Child asked you to puff up the balloon as much as possible for a one exhalation.What air volume will you use?
vital volume of lungs
Long-term starvation cure of a patient resulted in diminished ratio of albumines and globulines in plasma. What of the following will be result of these changes?
increase of ESR
If a man has an attack of bronchiospasm it is necessary to reduce the effect of vagus on smooth muscles of bronchi. What membrane cytoreceptors should be blocked for this purpose?
M cholinoreceptors
After a tooth extraction a patient felt persistent pain behind his breast bone. After sublingual intake of an antianginal drug the pain behind the breast bone disappeared, but the patient complained of headache and dizziness. What drug are these properties typical for?
nitroglycerine
Anapriline therapy caused positive effect in the dynamic of the disease of a 44-year-old woman suffering from stenocardia. What is the main mechanism of the effect of this medicine?
Blockade of β-adrenoreceptors and decrease myocardial requirements to the oxygen
Diuretic drug was prescribed to the patient with hypertension in the course of complex treatment. In a few days BP decreased but signs of hypokaliemia developed. What drug could cause such complications?
lasix
Patient with pneumonia has intolerance to antibiotics. Which of the conbined sulfanilamide medicines should be prescribed to the patient?
biseptol
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?
disturbance of pumping ability of heart
calomel intoxication. Two days later the daily diuresis was 620 ml. A patient experienced headache, vomiting, convulsions, dyspnea
acute renal insufficiency
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?
allergic inflammation
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
parathormone def
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?
drop of aterial pressure
acute oholic poisoning was brought to the hospital. What carbohydrates metabolism changes are typical for this condition?
gluconeogenesis velocity in the liver is decreased
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?
obstructive
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?
lymphoplastic
A 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?
composite immuneeficiency
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?
volume overload of left ventricle
A 56 year old patient suffering from cardiac insufficiency has edema of feet and shins, edematous skin is pale and cold. What is the leding mechanism of edema pathogenesis?
rise of hydrostatic pressure in venules
A patient has a malignisation of thoracic part of esophagus. What lymphatic nodes are regional for this organ?
Anulus lymphaticus cardiae
While examining the oral cavity a stomatologist revealed inflammation of on the border of the median and posterior third of the back of tongue. What papillae are inflamed?
papillar valvatte
In case of a penetrating wound of the anterior abdominal wall the wound tract went above the lesser curvature of stomach. What peritoneum formation is most likely to be injured?
ligamentum hepatogastricum
A 54-year-old man was admitted to the hospital with complaints of pain in the right subcostal region, vomiting with blood. Objectively: enlarged liver, varicose veins in the stomach and esophagus. Disfunction of what vessel is likely to be?
vena porta
A 19-year-old female suffers from tachycardia in rest condition, weight loss, excessive sweating, exophtalmos and irritability. What hormone would you expect to find elevated in her serum?
throxine
A patient’s blood was analyzed and the decreased erythrocyte’s sedimentation rate (ESR) was discovered. What disease from the listed below is accompanied with decreased ESR?
POLUCYCTEMIA
A man with internal abdominal right side injury and suspicion of liver rupture was admitted to the traumatological department. In what peritonial structure will blood accumulate?
excavation rectovesicalis
During complicated labour the symphysis pubis ruptured. What organ can be damaged mostly?
urinary bladder
hree separate bones connected with cartilage in the area of pelvis cavity are noticed on the X-ray of the pelvis. What are these bones?
iliac pubic sciatic
A 5-year-old child was admitted to the otorhinolaryngological department with diagnosis – suppurative inflammation of the middle ear. Disease started from the inflammation of the nasopharynx. Through the what canal of the temporal bone did the infection get into the tympanic cavity?
Musculortubal canal
A 19 year-old patient was diagnosed with appendicitis and was hospitalized. The surgical operation on ablating appendix vermiformis is to be performed. What artery must be fixed to stop bleeding during the surgical operation?
`
iliocolic artery
attacks of typical cough for 10 days
pertussis basillus
On autopsy of the 58-year-old man it is revealed: mitral valve is deformed, thickened, not totally closed. Microscopically: centers of collagen fibers are eosinophilic, have positive fibrin reaction. The most likely it is:
fibrinoid swelling
20 cm retroperitoneal soft tissue mass obscuring the left psoas muscle
lipoma
rib fracture
myelomastosis
muddy liquid exudates
lung fever
corpus pneumonia
gastrointestinal hemorrhage
mucous membrane
acute ulcers
grayish green films
shigella
dysentry
500 weight
uremia
light yellow
bilateral polycystic renal disease
reed brown /mahogany color
rheumatoid atheritis
sago spleen
distant part of the small intestine
in two ulcers
typhoid fever
haemorrhagic skin rash, massive haemorrhages in the adrenal glands
meningococcal meningitis
round formation
1st segment
fibrin connective tissue
tuberculoma
cavity
fibrin
cavernous
white colour with greasy lustre.
secondary amyloidosis
paraproctitis
ulceration stage
first sensibilized whereupon an antigen dose
immediate hypersensitivity
lack of epithelial nuclei of convoluted tubules, tubulorrhexis, phlebostasis
red renal pyramids
necronephrosis
small areas of calcification
filled with abundant hair and sebum
teratoma
nephrolithic obturation of the right ureter in the region between its abdominal and pelvic segments has been detected. What anatomical boundary exists between those two segments?
linea terminalis
lack of thymus is observed.
thymus agnesis( lack of it)
candidiasis after the case of pneumonia treated with β-lactam antibiotic
flucanazole
antifungal
remain in bed in a forced (supine) position
bedsore
complementation of antigen with antibody chemically bound to peroxidase or alkaline phosphatas
immune enzyme analysis
homogeneous eosinophilic masses in glomerular mesangium, arterial and arteriolar walls, and stroma, which became red when stained with Congo red
amyloidosis
is extremely thin and has no folds. These cells sense the changes in sodium content of urine and influence renin secretion occurring in juxtaglomerular cells
macula densa cells
increase in cardiac output and general peripheral resistance
eukinetic
hyperurecemia
goat
What diabetes complication can cause visual impairment/blindness?
microangiopathy
deviation of his electrical axis of heart to the left
hyperasthenic body type
peptic ulcer disease has undergone antrectomy. After the surgery secretion of the following gastro-intestinal hormone will be disrupted the most:
gastrin
skin of legs is pale, no hair-covering, toenails are with trophic changes, no pulsation of pedal arteries
ishemia
patient with suspected necrosis of the upper abdominal cavity organs was delivered to a surgical department. This condition is associated with acute circulatory disturbance of the following vessel:
celiac trunk
patient with suspected necrosis of the upper abdominal cavity organs was delivered to a surgical department. This condition is associated with acute circulatory disturbance of the following vessel:
tunics coleicus
During appendectomy a patient had the a. appendicularis ligated. This vessel branches from the following artery:
A ileocolic
damaged spinal cord white matter in the middle area of the posterior white column, disrupted proprioceptive sensibility of the lower limb joints and muscles
gracile fasciculus
damaged spinal cord white matter in the middle area of the posterior white column, disrupted proprioceptive sensibility of the lower limb joints and muscles
funicular gracilis
A 15-year-old patient has fasting plasma glucose level 4,8 mmol/l, one hour after glucose challenge it becomes 9,0 mmol/l, in 2 hours it is 7,0 mmol/l, in 3 hours it is 4,8 mmol/l. Such parameters are characteristic of:
subclinical diabetes mellitus
bluish-red with yellow center, on the skin of his neck
furuncle
90 mV. Its initial rest potential was 85 mV
hyperpolariztion
UDP (uridine di-phosphate)
unconjugated billirubin
A patient has developed paroxysmal ventricular tachycardia against the background of cardiac infarction. What anti-arrhythmic drug should be chosen to avoid lowering cardiac output?
lidocaine hydrochloride
Doctors make mostly radial incisions during mammary gland surgery. What particulars of anatomical organization make such surgical technique preferable?
lobe apexes converge towards the nipple
A 30-year-old man has sustained an injury to his thorax in a traffic incident, which caused disruption of his external respiration. What type of ventilatory difficulty can be observed in the given case?
Restrictive extrapulmonary ventilatory impairment
A patient has been found to have a marked dilatation of the saphenous veins in the region of anterior abdominal wall around the navel. This is symptomatic of pressure increase in the following vessel:
hepatic portal vein
strawberries
esonophilia
alcoholic psychosis with evident psychomotor agitation
aminazine
patient complains of palpitation after stress. The pulse is 104 bpm, P-Q=0,12 seconds, there are no changes of QRS complex. What type of arrhythmia does the patient have?
8
sinus tacchycardia
Patient’s systolic blood pressure is 90 mm Hg, diastolic – 70 mm Hg. Such blood pressure is caused by decrease of the following factor:
piping ability of left heart
cardinal’s cap
anthrax
joining with calcium ions
Gamma-carboxyglutamic acid
95% mortality of test animals was found. What unit of virulence measurement was determined?
DLM
pyogenic bacteria
NEUTROPHIl granulocytes
macrocytic anemia. Production of active forms of the following vitamin is disrupted in such a condition:
folic acid
A patient suffers from high fever, apnoea, pain in the thorax on the right. Pleurocentesis yielded 700 ml of yellow-green viscous liquid. Make the diagnosis:
plural emphysema
isplaced humeral shaft fracture on the right in the middle one-third of the humerus; the patient cannot extend the fingers of his right hand
radial nerve
muscle paralysis of the extremitis on the right, lost pain and thermal sensitivity on the left, and partially lost tactile sensitivity on both sides. What part of the brain is the most likely to be damaged?
right hand side of the spinal cored
ibrous whitish-brown deposit connecting parietal and visceral pericardial layers. What kind of inflammation occurred in the pericardium?
corpous
malonyl-CoA
acetyl co a
Cerebral cortex was smoky grey
malaria
tennis racet
botulism
dilation of the alveolar spaces and destruction of thealveolar walls
emphysema
negative reaction to anti-D
IV (АВ) Rh (-)
periodontal tissues caused by activation of the microorganisms inherent in the body, which are a part of oral mucosal microflora. What type of infection is it?
autoinfection
parotid gland secretion
N. petrosus minor
while feces are light-colored
conjugated
mushroom poisoning
he capsule is wrinkled; the tissue is ochre-yellow on section. Microscopically: fatty degeneration of hepatocytes, necrotic central segments of the hepatic lobes
massive progressing necrosis
disease onset 5 days ago the doctor suspected tularemia and prescribed the patient tularin intracutaneously. What is the purpose of this drug administration in the patient?
allergy diagnostic
Chagas disease
traitanomi bug
developed increased blood content of HCO3− against the background of repeated and uncontrollable vomiting. What will be the leading mechanism in compensation of developed acid-base imbalance?
dec pulmonary ventilation
otitis, pneumonia, and furuncles in the patient. Blood test: platelets – 70 × 109/l, low activity of T helper and T suppressor cells, low IgM, with normal IgA and IgG. What immunodeficient disease does this boy have?
Wiskott-Aldrich syndrome
erythrocytes – 5, 5 × 1012/l, hemoglobin – 180 g/l, leukocytes – 7 × 109/l, neutrophils – 64%, basophils – 0,5%, eosinophils – 0,5%, monocytes – 8%, lymphocytes – 27%. These values primarily indicate the stimulation of:
erythropeosis
The patient’s pyramids of the medulla oblongata are damaged by tumor growth. As a result the conduction of nervous impulses will be impaired in the following pathway:
cortico spinalis
Pupil dilation occurs when a person steps from a light room into a dark one. What reflex causes such a reaction?
sympathetic uncondiction reflex
A 50-year-old inpatient during examination presents with glucosuria and blood glucose of 3,0 mmol/l,
renal disorder
lacrimation disorder. This disorder was caused by functional disturbance of the following autonomic ganglion:
pterygopalatine
transparent membrane and radiating crown and is situated in the cumulus oophorus, the wall is made of follicular cell layer and theca
mature tertiary follicle
diabetes mellitus shows increased content of free fatty acids. Name the most likely cause of this:
increased activity of adipose triglyceride lypase
A child with suspected colienteritis was delivered to the infectious diseases hospital. Colibacillus was obtained from the child’s feces. How to determine whether this bacillus is of pathogenic variety?
agglutination with serum zero
It is known that pentose-phosphate pathway actively functions in the erythrocytes. What is the main function of this metabolic pathway in the erythrocytes?
counteraction of lipid peroxidation
beta-lactam antibiotic. Its mechanism of action is based on inhibition of murein production, which results in death of the causative agent. Name this drug:
pennicilin G sodium salt
During ascent into mountains a person develops increased respiration rate and rapid heart rate. What is the cause of these changes?
decrease of oxygen partial pressure
At the post-mortem examination the stomach of a patient with renal failure was found to have a yellow-brown coating on the thickened mucosa. The coating was firmly adhering to its surface and had significant thickness. Microscopy revealed congestion and necrosis of mucosal and submucosal layers, fibrin presence. What is the most likely diagnosis?
diphtheric gasritis
A patient ungergoes right-sided pulmonectomy due to lung cancer. Name the anatomical structures of the right lung radix (downward order):
bronchus artery veins
heaviness in the chest on the right, general weakness. Body temperature is 38,9oC. Objectively the right side of the chest lags behind the left side during respiration. Pleurocentesis yielded exudate.
increased vessel permeabiliyt of vessel wall
On examination of a 6-year-old child the doctor noticed grayish film on the child’s tonsils. Microscopy of the smears stained by Neisser method detected there Corynebacterium diphtheriae. What morphologic feature was the most indicative for determining the type of the agent?
polar placemnt of volition granules
On bronchoscopy there is a polypoid growth 1,0 cm in diameter with ulcer in its center in the upper lobe of the right lung. Histological investigation revealed a tumor composed of lymphocyte-like cells with hyperchromic nuclei, the cells form layers and bands. What is the most likely tumor type?
undifferentiated small cell carcinoma
cystine stones in the kidneys (homozygous individuals) or increased cystine content in the urine (heterozygous individuals). Cystinuria is a monogenic disorder. Determine the type of interaction between the genes of cystinuria and normal urine cystine excretion:
semidominance
The brain trauma unit received a patient with damaged greater wing of the sphenoid bone. The fracture line crosses the spinous foramen of the sphenoid. What vessel was damaged?
middle meningeal artery
Negri bodies
rabies
A 63-year-old man suffers from esophageal carcinoma, presents with metastases into the mediastinal lymph nodes and cancerous cachexia. What pathogenetic stage of neoplastic process is observed in the patient?
progression
A 50-year-old man is diagnosed with ischemic heart disease and cardiosclerosis with hypertensive syndrome. What drug should be prescribed in this case?
metoprolol
upper umbilical region
transverse colon
During autopsy of a man, who had been suffering from mitral stenosis, the lungs are revealed to be dense and brown-colored. What pathologic process had occurred in the lungs?
himosiderosis
Heart rate is 130/min., BP is 100/60 mm Hg. ECG: QRS complex has normal shape and duration. The number of P waves and ventricular complexes is equal, T wave merges with P wave. What type of cardiac arrhythmia is observed in the teenager?
sinus tacchycardia
Bruton syndrome(X-linked agammaglobulinemia)
dec IG a and IG m
After pancreatic surgery the patient developed hemorrhagic syndrome with disturbed 3rd stage of blood clotting. What will be the most likely mechanism of the hemostatic disorder?
finrinolysis activators
blood-glucose agar resulted in growth of the colonies surrounded with hemolysis zone
c perfringens
Electron micrograph of the kidney shows fenestrated endothelium lying on the basement membrane; the external surface of the membrane has adjacent dendritic epithelial cells. What do these structures form in the kidney?
filtration barrier
skin redness and swelling in the neck area, where eventually a small abscess appeared. On section the focus is dense and yellow-green colored. In the purulent masses there are white granules. Histologically there are fungal druses, plasma and xanthome cells, and macrophages detected. Specify the most correct etiological name of this pathological process:
antinomycosis
A woman, who has been suffering from marked hypertension for 15 years, has lately developed dyspnea, palpitations, slightly decreased systolic pressure, while diastolic pressure remains the same. What is the main mechanism of heart failure development in this case?
increased vascular resistance
Section shows significant enlargement of the patient’s right kidney. There is a nephrolith at the place of incision. Renal pelvic lumen is distended with accumulating urine. Renal parenchyma is acutely thinned out. What is the most correct diagnosis?
HYDROheprosis
A patient with pneumonia has body temperature of 39,2oC. What cells are the main producers of endogenous pyrogen that had caused such temperature rise?
monocytes
A woman suffers from tonsillitis complicated with retropharyngeal abscess that is localized in the spatium retrovi-scerale. In this case the suppurative process can spread to the:
posterior mediasstinum
During dehelmintization there was a 3,5-meter-long tapeworm produced from the patient’s intestine.There are 4 suckers and hooks on the tapeworm’s scolex. Mature segments of the tapeworm are immobile and have up to 12 uterine branches. What disease is it?
teniasis
Autopsy of a patient, who died of bilateral bronchopneumonia, shows in the left lung lower lobe a cavity 5 cm in diameter, filled with liquid yellowish-white substance. What complication of the patient’s pneumonia had developed?
abcess
A man presents with glomerular filtration rate of 180 ml/min., while norm is 125±25 ml/min. The likely cause of it is the decreased:
plasma oncotic proteins
A 37-year-old man, who was working in a caisson, after being lifted to the surface suddenly developed signs of acute cerebral circulation disturbance and loss of consciousness. Several days later he died. On autopsy in the left cerebral hemisphere there was detected a gray soft irregular focus 5×6×3,5 cm in size. What process had occurred in the brain?
ishemic stroke
A man has an inguinal hernia. The hernial sac exits through the following opening:
Anulus superficialis canalis inguinalis
tuberculosis
Ziehl-Neelsen
The dog has lost the orienting response to auditory signals. What structure was destroyed?
Inferior colliculi of corpora quadrigemina
A 17-year-old girl suffers from periodical palpitations that last several minutes. Her heart rate is 200/min., rhythmic. What heart rhythm disorder developed in this patient?
Paroxysmal tachycardia
A person becomes less receptive to pain in physically or emotionally straining situations due to activation of:
Antinociceptive system
kidney to be swollen and plethoric, with easily removable capsule. Renal pelvis and calyces are dilated and filled with turbid urine; their mucosa is dull and has hemorrhagic foci. On section the renal tissue is variegated, there are yellow-gray
acute pyelenopheritis
A lab rat has subcutaneously received mercury(II) chloride in the amount of 5 mg/kg. 24 hours later the plasma creatinine concentration increased several times. What mechanism of retention azotemia is observed in this case?
dec glomerular filtration
Kidney X-ray image obtained by means of pyelography shows that the minor calyces converge to form 2 major calyces that adjoin to the renal pelvis, from which the ureter exits. What type of urinary tract is it?
mature
X-ray examination of a 57-year-old man indicates local areas of hard bone tissue resorption in some of the patient’s bones. These changes can be associated with increased activity of:
osteoclasts
After a hand fracture the man has lost the ability to touch his little finger with the thumb on the affected hand. Examination of the palmar surface shows one of the palmar muscles to be atrophied. Name the affected muscle:
M. opponens policis
elderly man revealed yellow spots and streaks in the aortic intima and white-yellow protruding plaques in the area of aortic bifurcation. Microscopy (with hematoxylin and eosin staining) shows round cavities in the thickened aortic intima. The cavities color orange when stained with sudan 3
metabolicdisorder of cholesterol and xholesterol esters
After a trauma the man has lost skin sensitivity on the lateral surface of his forearm. What nerve of the brachial plexus provides sensitivity of the affected area?
musculocutaneous
Various biological preparations can be used for poliomyelitis prevention. What drug induces the type of local intestinal mucosal immunity that lasts the longest?
oral vacination with live vaccine
increased duration of the QRS complex
increased period o ventricular excitation
cervical lymph node shows smoothed-out pattern, absent follicles, homogeneous cell composition represented by lymphoblasts. The cells penetrate into the lymph node capsule. What diagnosis can be made?
lymphoblastic keukemia
After a psychic trauma a woman developed periodical increases in her blood pressure accompanied by headache, palpitations, and general weakness. What mechanism of hypertension development does this woman have?
increase ateriole
Sanitary assessment of a pond, where the children from a recreation summer camp take their swims, detected there oval cysts 50-60 micron in diameter, with 2 nuclei visible in their cytoplasm (macronucleus and micronucleus). What protozoa do these cysts belong to?
balantidium
A patient has disturbed blood supply to the anterior papillary muscle of the left ventricle. What cardiac artery supplies this muscle with blood?
Ramus interventricularis anterior
A patient with clinical signs of a primary immunodeficiency has functionally disturbed mechanism of antigen-presentation to the immunocompetent cells. What cells are likely to have structural defects?
Macrophages, monocytes
Gaston Ramon for diphtheria prevention
anatoxin
passes through the carpal tunnel
N medianus
The right leg of a 40-year-old woman measured at the shin level is by 2 cm smaller in the diameter than the left leg. Ankle-jerk (Achilles) and knee-jerk reflexes are absent on the right. What is the most likely mechanism of hyporeflexia development during peripheral paralysis?
distributed conduction of stimulation
A hospital has received a 24-year-old man, who had received a penetrating wound to the eye, which has caused the vitreous body to run out. As the result of this, retinal detachment occurred. What retinal layer was tightly adherent to the vascular tunic of the eye and did not detach?
retinal pigment epithlium
Microscopy of the myocardium of a girl, who died of diphtheria due to heart failure, shows fatty degeneration, multiple foci of cardiomyocytes necrosis, and small foci of cellular infiltrates in the interstit
alterative
140х70 micron in size, with a terminal spike.
scschitomisasis
n the process of an experiment, vascular resistance to the blood flow was measured in the different areas of circulatory system. The highest resistance was detected in the:
arterriols
Due to trauma the patient has lost 25% of circulating blood volume. Name the emergency compensatory mechanism against blood loss:
interstitial fluid inflow into vessels
Autopsy of the body of a 50-year-old man, who had been suffering from tuberculosis and died of cardiopulmonary decompensation, shows lobar affection of the lungs: the upper lobe of the right lung is enlarged, dense, yellow on section, crumbling, with pleural fibrin deposition. What type of secondary tuberculosis can be characterized by this pathology?
caseous pneumonia
stenosis of the atrioventricular opening, mitral insufficiency. Histologically there are focal cardiosclerosis and ”blooming” Aschoff nodules in the myocardium. What is the most likely diagnosis?
rheumatism
Genetic recombination is achieved via several mechanisms. One such mechanism is crossingover. It occurs at the following stage of prophase in the first meiotic division:
pacyynema
An electron micrograph of a nephron segment shows cuboidal cells with ciliated lining on their apical surfaces; their basal surfaces have basal striation with mitochondria located between the cytolemma invaginations. Name the described nephron segment:
proxtubule
Microscopy of the puncture sample obtained from the inflammation focus of the patient with cutaneous abscess revealed numerous blood cells of different types. What cells are the first to transfer from vessels to tissues during inflammation?
neutrophils
Autopsy of the body of a man, who for a long time had been working at the factory with high content of silicon dioxide in the air, revealed enlarged dense lungs with numerous round and oval sclerotic foci. The foci were miliary and larger in size and colored gray or gray-black. What is the most likely diagnosis?
nodular silicosis
What diagnostic method should be used in industry to test the raw leather for presence of antracis?
Ascoli’s thermo precipitation test
A patient presents with indigestion, stomachaches, and excessive salivation. Similar symptoms had already been observed in this patient previously. Laboratory analysis detected oval eggs covered with lumpy capsules in the patient’s feces. What is the most likely cause of the patient’s disorder?
ascariasis
A microslide of the skin sample taken from the finger of a child shows that epidermis is insufficiently developed. What germ layer was damaged in the process of embryo development?
ectoderm
Coronary artery thrombosis resulted in development of myocardial infarction. What mechanisms of cell damage are leading in this disease?
calcium
A patient presents with dilated blood vessels of the anterior medial surface of the lower leg. This condition resulted from the dilation of the following blood vessel:
v sapna mgna
During the first year of life an infant presents with disturbed process of breast milk curdling. What cells of the proper gastric glands are functionally disturbed?
main exocrinocytes
After a case of common cold the patient developed numbness of the right side of the face. Examination revealed disturbed pain and thermal sensitivity in the right half of the face. What nerve was damaged?
trigeminal
A child diagnosed with purulent inflammation of the middle ear was brought to the otolaryngology department. The disease started with the inflammation of the nasopharynx. It was determined that the infection had reached the tympanic cavity through the eustachian tube that is located in the:
canalis musculotubareas
levomycetin (chloramphenicol) for prevention of enteric infection. Blood test: erythrocytes – 1.9 × 10 12/L, hemoglobin – 58 g/L, color index – 0.9, leukocytes – 2.2 G/L, reticulocytes – 0.3%. What type of anemia is it indicative of?
hypolastic
A patient with streptococcal infection of the gingiva was prescribed a drug with β-lactam ring in its structure. What drug of those listed below belongs to this pharmacological group?
benzylpennicilin
In an experiment it is necessary to assess neuromotor and muscle excitability. What value should be measured to make the assessment?
sensory threshhold
Autopsy of a 30-year-old man shows enlarged spleen (weight -900.0g), enlarged liver (weight -4000.0g), and enlarged lymph nodes. Bone marrow of the femoral shaft is bright red and moist. Microscopically in the liver there are thick infiltrates located along the portal tract. The infiltrate consists of juvenile hemopoietic cells with round nuclei and thin layer of cytoplasm. What disease can be suspected?
chronic lymphoplastic leukemia
During an invasive operation the surgeon needs to access the omental bursa of the peritoneal cavity via the omental foremen (foramen of Winslow). What anatomical structure makes up the anterior border of this foramen?
hepatoduodenal ligament
A patient presents with an inner ear inflammation. On examination the doctor states that the 1st neurons of the auditory analyser are affected. Where are these neurons located?
G spirale
A 40-year old man with impaired venous patency in the lower limbs developed edemas. What mechanism plays the main role in the development of this disturbance?
elevated filtration pressure
The bacteriological laboratory needs to prepare for analysis of materials that are suspected to be contaminated with spores of anthrax causative agent. What diagnostic preparation allows for quick detection of these spores?
antianthrax floresnt serum
Wernicke-Korsakoff syndrome often develops in chronic alcoholics, who have a low vitamin diet. Decreased transketolase activity can be observed in the course of this disease. What vitamin deficiency causes this development?
vitamin B 1
A 3-year-old child with elevated body temperature has taken aspirin and developed increased hemolysis of erythrocytes. In this case hemolytic anemia can be caused by congenital deficiency of the following enzyme:
glycol 6 phosphate dehydrogenase
A 63-year-old man, who has been suffering from chronic diffuse obstructive pulmonary emphysema for 15 years, died of progressive heart failure. Autopsy shows nutmeg liver cirrhosis, cyanotic induration of kidneys and spleen, ascites, and edemas of the lower limbs. What type of heart failure can be characterized by such changes in the internal organs?
chronic heart failure
Disturbed activity of trypsin and chymotrypsin leads to disturbed protein breakup in the small intestine. Activity of these enzyme depends on the presence of the following factor:
enterokinase
Systemic blood pressure of a person equals 120/65 mmHg. Blood ejection into aorta occurs when left ventricular pressure exceeds:
65
An experiment was conducted to measure the skin sensitivity threshold. What patches of the skin have the highest sensitivity threshold?
back
A patient has elevated blood pressure due to increased vascular tone. To lower the blood pressure in this case it is necessary to prescribe the blockers of;
alpha adrenoreceptors
After hyperventilation an athlete developed a brief respiratory arrest. It occurred due to the following changes in the blood:
decrease of co2 pressure
Autopsy of a 60-year-old woman, who for a long time had been suffering from essential hypertension, shows significantly diminished kidneys (weight of both kidneys is 80g) with finely granular surface . Uniform renal cortical thinning can be observed on section. Name the described changes in the kidneys:
primary contracted kidney
24 hours after an appendectomy the patient’s blood test shows neutrophilic leucocytosis with a regenerative shift. What is the most likely mechanism of absolute leucocytosis development in the patients peripheral blood?
Intensification of leukopoiesis
A patient is diagnosed with severe B12 deficiency anemia resulting in the disturbed hematopoiesis and appearance of atypical erythrocytes in the blood. The patient has a history of total gastric resection. This diagnosis can be confirmed if the following cells are present in the peripheral blood:
megalosytes
What changes can be expected to occur in the isolated heart of a toad , if excessive amount of calcium chloride is introduced into its perfusate?
increased cardiac force and frequency
Anti-leukocytic antibodies are detected in the blood of a patient with leukopenia. What type of Coombs-Gells hypersensitivity reaction developed in this case?
cytotoxic
A laboratory rat with chronic kidney failure presents with osteoporosis, pathologic calcification of the internal organs, and arterial hypertension. These disturbances are associated with increased activity of the following hormone:
parathhormone
A patient has a pancreatic tumor. During surgery it was accessed by making an opening through the lig .gastrocolicum, but in the process a vessel passing through this ligament was damaged. As a result the surgeon had to stop the bleeding from the following vessel:
A.gastroomentalis dexter
Clinical course of urolithiasis was complicated by the passage of a renal calculus. Where in the uterus is it most likely to stop?
At the border between the abdominal and pelvic segments
A 45-year-old woman presents with breast cancer. Metastases can spread in this case to the following regional lymph nodes:
ancillary and parasternal
with acetone breath odor. Blood glucose is 15.2 mmol/l , ketone bodies – 100 micromol/l. These signs are characteristic of the following diabetes complication:
ketoacidotic coma
Histological analysis of a biopsy skin sample obtained from a 24-year-old patient detects caseous necrosis surrounded with cellular infiltrate consisting of lymphocytes, among which there are single giant cells, proliferation of connective tissue and endovasculities are observed. Characterize this pathologic process:
proliferative granulomatours inflamattion
A 45-year-old woman exhibits no signs of diabetes mellitus, but her fasting blood glucose levels are elevated (7.2 mmol/l). What should be measured next?
glucose tolerance
A 30-year-old man with an incised wound on the plantar surface of the left foot was brought to the traumatology department. Lifting of the lateral side of the foot is limited. What muscle is likely to be functionally disturbed?
Peroneus longus muscle
Histone protein synthesis is artificially blocked in a cell. What cell structure will be damaged as a result?
nuclear chromatin
Dwellers of a village located in the taiga make a living by harvesting berries. Lately the occurrence of alveococcosis in the village population has increased. What is the source of invasion in this case?
foxes
A 30-year old woman developed facial edemas. Examination detected proteinuria (5.87 g/L), hypoproteinaemia, dysproteinaemia, and hyperlipidaemia. Such combination of signs is characteristic of:
neprotic syndrome
A patient with severe poisoning was brought into the intensive care unit. In the course of complex treatment the subclavian vein needs to be catherterized for medicine administration. This vein is located in the following topographic structure:
Spatium anterscalenum
Hematologic study shows the following pattern: erythrocytes – 2,8. 1012/L, Hb – 80 g/L, colour index – 0.85, reticulocytes -0,1%, platelets -160 thousand per microliter, leukocytes -60 x 109/L. Basocytes -2%, eosinophils- 8%, promyelocytes- 5%, myelocytes- 5%, juvenile- 16%, stab neutrophils- 20%, segmented neutrophils- 34%, leukocytes- 5%, monocytes- 5%. This clinical presentation indicates the following blood pathology:
chronic myelokeukemia
In an experiment a laboratory rat was subjected to a stress factor (electric current), which resulted in muscular hypotonia, arterial hypotension, hypothermia, and hypoglycaemia in the animal. What period if general adaptation syndrome is it?
shock phase
A victim has received a deep incised stab wound to the upper posterior surface of the shoulder. Extension of elbow, hand, and digits is impaired; skin sensitivity of the posterior surface of the shoulder and forearm is lost. What nerve is damaged in this case?
N radialis
KCl concentration in a solution that surrounds an isolated cell was increased. How will resting membrane potential (RMP) and cell excitability change in this case?
resting membrane potential decrease
excitability increases
A family has two children. The younger child is under a year. The child has developed spastic cough attacks. Similar clinical presentation was observed in the elder preschool child one month ago. The doctor suspects pertussis infection. What method enables retrospective diagnostics of this disease?
serological
In the haematology unit a patient with leukaemia was prescribed 5-Fluorouracil. This drug:
inhibits dna synthesis
A 36-year-old man provisionally diagnosed with renal tuberculosis has undergone urinary sediment analysis. Microscopy revealed acid-fast bacteria, but Pryce method detected no cord factor. Name the most reliable method of investigation that can confirm or refute this provisional diagnosis:
allergy skin test
In case of inflammation, local anesthetic effect of novocaine decreases in strength. What process in the inflammation focus lead to disturbed hydrolysis of novocaine salt and therefore disturbed release of active anesthetic base?
local tissue acidosis
One of the functions of central inhibition is the selection and reduction of the sensory information influx to the cerebral cortex. What type of inhibition performs this function?
lateral inhibition
A man with chronic constipation was taking daily one tablet of Bisacodyl. After a time, he had to start taking 2 tablets daily to achieve the same effect. This type of change in the action of active substances is called:
habituation
A 60-year-old man suffered a spontaneous rib fracture. X-ray shows multiple foci of bilateral costal osteoporosis. Biopsy material obtained from the place of the fracture shows uniform proliferation of lymphocytic-plasmacytic cells with signs of cellular atypia. Name this disease:
multiple myeloma
In an experiment after a prolonged electrical stimulation of the peripheral n.vagus a brief cardiac arrest occurred in the subject. What ion mechanisms in the cardiac cells cause this effect?
increase k+ efflux
Healthy parents gave birth to a son with phenylketonuria. The child presents with normal development due to special diet. What type of variability is associated with the convalescence of this child?
moedification variability
Radioactive isotope of phosphorus was introduced into the systems of artificial cell culture. What organic substances can accumulate this isotope?
nucleic acids
A patient with an adenoma in the zona glomerulosa of the adrenal gland (Conn’s syndrome) presents with arterial hypertension, convulsive attacks, and polyuria. Name the main link in the pathogenesis of these disorders:
hyperaldosteronnism
Energy is necessary for the work of cardiac muscle. What substrate is the main source of energy in the working muscle?
fatty acids
A journalist for a long time was stationed in India. After his return from this country he developed a string-like torus on the right leg in subcutaneous tissues of the popliteal area. At the end of this torus a vesicle filled with necrotic masses was formed. What type of helminthiasis can be suspected?
dracunculiasis
Histological microslide of a certain endocrine gland shows epithelial bands that consist of chromophile (acidophilic, basophilic) and chromophobe cells. What organ is it?
adenohypophysis
A woman giving birth has an increased pain threshold due to activation of the following system:
antinociceptive
As a result of an abdominal trauma, one of the muscles that form the superior wall of inguinal canal was damaged. Name this muscle:
internal abdominal oblique muscles
A 60-year-old patient with diabetes mellitus was found to have ketoacidosis. Biochemically ketoacidosis in diabetes mellitus leads to decreased acetyl-CoA utilization due to deficiency of:
oxaloacetate
Patients with alcoholism receive the bulk of their calories with alcoholic drinks. They may develop a characteristic thiamine deficiency (Wernicke-Korsakoff syndrome) that causes nervous system dysfunction, psychoses and memory loss. This process is associated with decreased activity of the following enzyme:
pyruvate dehydrogenase
A patient presents with high blood aldosterone. What physiologically active substance is the likely cause of this development?
angiotensin 2
A patient with an occipital head injury was brought into the neurosurgical unit. During the surgery the doctor dissected a part of the dura mater that separates the occipital lobes from the posterior cranial fossa. What anatomical structure was dissected?
tentorium cerebilli
Due to early taking of antibiotics by a patient with typical clinical presentation of dysentery, bacteriological analysis of the patient’s feces detected no Shigellae in the samples. Passive hemagglutination reaction shows a four time increase in the titer of anti shigella antibodies in the patients’s paried sera. What does it indicate?
confirms diagnosid of dysentry
A patient simultaneously present with high levels of conjugated(direct) and unconjugated(indirect) bilirubin in the blood plasma, while stercobilinogen levels in feces and urine are sharply decreased. What type of jaundice does the patient have?
obstructive jaundice
A patient presents with absence of T-lymphocytes, facial defects, defects if thyroid and parathyroid glands, heart disease. Cellular immune responses do not develop. The patient was diagnosed with DiGeorge syndrome. This syndrome is caused by :
thymus hypoplasia
During appointment with the dentist, patients often develop anxiety, fear and depression. These psych emotional disturbances can be reduced if secretion of a certain mediator is intensified in the central nervous system. Name this mediator:
GABA
A patient with neurologic disorders was diagnosed with a brain tumor. The tumor was removed surgically. It looks like dense node attached to the dura mater. Histologically this tumor consists of tightly packed endothelium-like cells. Make the diagnosis:
meningioma
A patient with an eye trauma was prescribed a substance that induces a long-term (upto 10days) relaxation of the accommodation muscles. Name this substance:
atropine sulfate
A patient presents with signs of exudative pleurisy. The liquid will accumulate predominantly in the following anatomical structure:
Recessus costodiaphragmaticus pleure
ECG of the patient shows increased duration of the QRS complex. What is the most likely cause?
increased period of ventricular contracturactio
What enzymatic system uses the energy of electrochemical potential for ATP synthesis in mitochondria?
ATP synthase
A patient diagnosed with downward displacement of the right kidney (nephroptosis) was brought into the nephrology department. Where is the right kidney located normally in relation to the 12th rib?
The 12th rib bisects the kidney in the middle
A person with a heatstroke was brought into an admission room. What defensive and compensatory mechanism develops in this condition?
peripheral vessel dialtion
Autopsy of a 9-year-old child shows numerous irregular defects of varying depth with uneven margins and gray-white films tightly attached to the underlying tissue on the rectal mucosa of the body . What disease can be suspected?
dysentry
A 50-year-old man complains of a hoarse voice and difficult breathing. Examination detected a laryngeal tumor in the region of the vocal cords. In this case metastases can spread to the following regional lymph nodes:
deep cervical lymph nodes
A woman who works as a shop assistant and suffers from phlebitis, developed a thrombus in the area of the varicose veins in her leg. What pathogenetic factor was primary in the process of thrombus formation in this case?
vasular wall injury
A woman was hospitalized in a severe condition with the following diagnosis; hemorrhagic stroke in the region of the medial surface of the right frontal lobe. What artery is likely to be damaged, causing this condition in the patient?
anterior cerebral artery
A 46-year-old man was brought to the hospital specializing in nervous system disease. The man was provisionally diagnosed with cerebral hemorrhage. The patient presents with frequent spontaneous limb movements intermittent with the state of limb muscle hypertonia. These signs can be explained by the damage to the following brain structures:
basal ganglia
Due to a trauma, the posterior roots of the spinal cord of a 40-year-old man were destroyed. What disorders will be observed in the innervation region of these roots?
loss of all types of sensation
A 35-year-old woman has a history of 2 strokes. Her biochemical blood analysis shows increased levels of antiphospholipid autoantibodies. Target phospholipids in this case include:
cardiolipin
A man with caisson disease died with the signs of acute disturbances of cerebral circulation in the basin of a. meningea media in the left-brain hemisphere. Autopsy detected in this area a focus of gray cerebral softening 6x7x3.4 cm in size. What is the character of the process that caused the death of the patient?
gas embolism
An oncology patient is to undergo a surgery on the descending colon. Name the main source of the blood supply to this organ:
inferior mesenteric artery
Proliferation of connective tissue in the liver parenchyma (fibrosis) that results from chronic disorders causes of blood flow disturbance in the classical hepatic lobules. Describe the blood flow direction in these lobules:
from periphery to the center
During a surgery with application of inhalation narcosis and muscle relaxants, the anesthesiologist noticed rapid increase of the patient’s body temperature to 43 degree C. What pathology developed in this patient?
hyperthermic syndrome
The patient presents with smoothed out nasolabial fold, dilated right palpebral fissures (It cannot be closed when squinting, because of eyelids would not close), there are difficulties during speaking and eating (Food gets stuck between the cheek and teeth). What nerve is damaged in this case?
- N. facialis dexter
A test animal received electrical impulses that irritate the sympathetic nerve that innervates blood vessels of the skin. What reaction will it cause in the blood vessels?
arterial and venous contriction
Examination of a patient, who for a long time was taking glucocorticoids, detected lymphopenia. How can the functional state of the patient’s immune system be characterized?
secondary immunodefficiency
Blood smear analysis of a blood sample obtained from a patient with inflammatory process shows a large number of round cells with segmented nucleus (three or more segments) and fine pink-violet granulation in the cytoplasm. Name the blood cells:
neutrophilic granulacytosis
A patient was brought by an ambulance to the impatient department. He was provisionally diagnosed with acute pancreatitis. To confirm this diagnosis, it is necessary to measure the activity of a certain enzyme in the patient’s blood and urine. Name the enzyme:
alpha amylase
Acute herpetic gingivostomatitis is the most common primary infection caused by herpes simplex virus type 1. What material should be obtained by a dentist for the laboratory testing that will confirm the diagnosis?
vesicular fluid
A 15-year-old girl complains of rapid fatigability, weakness and palpitations. Blood test: Erythrocytes – 2.5 g/L, Hb – 50 g/L, color index – 0.6, anisocytosis with the prevalence of microcytosis. Blood serum iron is 5.4 mmol. What hematologic pathology is observed in this case?
iron deficiency anemia
Section shows a significantly enlargement of the patient’s right kidney. There is a nephrolith at the place of the incision. Renal pelvic lumen is distended with accumulating urine. The renal parenchyma is substantially thinned out. What is the most correct diagnosis?
hydronephrosis
A patient with ischemic heart disease has increased levels of triglycerides and low density lipoproteins in this blood plasma. What medicine should he be prescribed?
finofibrate
A patient suffers from the eye muscle paralysis, there are pupillary disturbances and pain along the trigeminal nerve. Aneurysm(dilation) of a certain venous sinus can be suspected. Name this venous sinus:
sinus cavernous
Clinical instrumental examination of a patient allowed to provisionally diagnose him with liver cancer. What protein is indicative of this diagnosis, if it is present in the blood serum?
alpha feto protein
Autopsy of the body of a 40-year-old patient detected groups of enlarged follicles in the small intestine. Their surface has ridges and fissures arranged in a pattern that resembles gyri and sulci of the brain. The follicles protrude above the surface of the intestinal mucosa. On section they are gray red and juicy. Microscopy shows proliferation of monocytes, histiocytes and reticular cells, there are macrophage clusters that form granulomas, while lymphocytes are depleted. What disease can be characterized by these changes?
typhoid fever
Gyrus like brain in intestines is Charcterstic
thyroid fever
10 days after the administration of an antitoxic anti-diphtheritic serum, a child with diphtheria developed skin rashes accompanied by severe itching, body temperature increased up to 38 degree C, the child developed pain in the joints. What likely cause of these phenomena can be suggested?
serum sickness
Due to a case of diphtheria, preventive immunization of the whole contact group of students is necessary. What preparation should be used to produce artificial active immunity?
diphtheria anatoxin
Due to a cerebral hemorrhage, the patient developed a disturbed speech perception (sensory aphasia). What brain structure is likely to be damaged in this case?
superior temporal gyrus
A patient with an injury of the greater psoas muscle was delivered to the traumatology center. The patient has lost the ability to extend the lower leg at the knee joint. What nerve is damaged in this case?
femoral nerve
A patient complains of pain in the upper umbilical region. On palpation there is a mobile painful intestine. What intestine is being palpated by the doctor?
transverse colon
A 36-year-old man developed angina pectoris attacks immediately after a past case of staphylococcal sepsis. Coronarography detected mural thrombosis without signs of atherosclerosis in the left coronary artery. Thrombus formation occurred in the result of damage to the vascular endothelium and release of:
platelet activating factor
The mountain climbers, who without oxygen equipment were climbing a mountain, at the altitude of 5000 meters above the sea level developed tachycardia, low blood pressure, fast respiration rate. What type of hypoxia did they develop?
hypoximic hypoxia
A patient has cardiac rhythm disturbance. ECG shows heart rate of 60/min, prolongation of PQ interval, periodical loss of QRS complex. What cardiac rhythm disturbances is it?
Second-degree incomplete AV block
Autopsy of the body of a person, who died after an abdominal surgery, revealed numerous thrombi in the veins of the lesser pelvis. Clinically, thromboembolism syndrome was registered. Where should the pathologist search for thromboembolas?
pulmonary arteries
A bioterrorist mailed an envelope with a powder that is suspected to contain anthrax causative agent. This envelope can remain dangerous for a long time, because anthrax causative agent:
is a spore former
During a surgery for spleen injury, the surgeon needs to isolate an artery that supplies the spleen with blood. What branch of the arterial vessel is it?
truncus cholaecus
After a spinal trauma the patient was lost proprioceptive sensitivity in the lower half of the body and in the lower limbs. What sensory conduction pathway was likely damaged, leading to the loss of sensitivity?
Fasciculus gracilis (Goll column)
A patient is diagnosed with glucocerebroside lipidosis (Gaucher’s disease) that manifests as splenomegaly, liver enlargement, affected bone tissue and neuropathies. What enzyme of complex lipid catabolism is deficient, causing this disease?
glucocerebroxidase
A 65-year-old woman against the background of chronic heart failure developed secondary hyperaldosteronism. What medicine should be prescribed to increase the patient’s diuresis?
spirinolactone
A patient complains of acute increase in diuresis (upto 5-7 liters of urine per 24 hours). Examination of vasopressin in this patient. What cells have insufficient secretory activity in this case?
Neurosecretory cells of the hypothalamus
A patient has signs of striatopallidal system damage. These signs are caused by disturbed synthesis of a certain mediator in a certain structure. Name this mediator and its corresponding structure:
dopamine
substantia nigra
An inguinal hernia was found in a patient. During herniotomy, a reinforcement of the anterior wall of the inguinal canal is necessary. What anatomical structures of the anterior abdominal wall are used for the reinforcement in this case?
Aponeurosis of the abdominal external oblique muscle
A patient hospitalized into the pulmonology department was diagnosed with pulmonary emphysema accompanied by the loss of elasticity in the pulmonary tissue, What type of respiration can be observed in this case?
expiratory dsypnea
A 45-year-old man complains of frequent fevers, tachycardia, irritability, hair loss, weight loss, and hand tremor. In this case, blood test will show the high levels of the hormones produced in the:
thyroid
A victim of a traffic accident suffered damage to one half of the spinal cord and developed Brown-Sequard syndrome. What causes motor function disturbance on the damaged side below the site of trauma?
After their cross over the pyrarnidal tracts pass through the lateral funiculi of the spinal cord on the side of the muscles they innervate
A person was hospitalized with markedly icteric skin, sclera and mucosa. Urinalysis shows the presence of direct bilirubin. Patient’s urine is the color of dark beer. Fecal levels of bile pigments are low What type of jaundice is observed in this patient?
obstructive
A patient has ascites, his spleen is double the normal size. He has esophageal and rectal varices. Histology of the biopsy material obtained from the liver revealed micronodular cirrhosis. What complicated the hepatic cirrhosis in this case?
portal hypertension
duck Egg cream
salmonella
After a domestic trauma a 34-year- old man has limited flexion of the middle phalanges of his fingers 2-5, which results in the overall limited mobility of the fingers. What muscles are likely to be functionally impaired in this case?
superficial finger flexure
A 50-year-old man undergoes pancreatitis How is the affected organ located in relation to the peritoneum?
intraperitonnically
A 5-year-old kindergartener has diphtheria. To find the carriers of this disease among the kindergarten staff, samples of pharyngeal mucus were obtained from the employees. One of the employees had gram-positive bacilli in her sample. They were situated at an angle to each other and colored unevenly, when stained according to Loeffler. What method can confirm that this carrier is dangerous to the other people?
toxin prouction test
Histology of the liver detected there a vesicle with chitin and protein membrane, filled with a colorless transparent fluid. What disease can manifest this way?
q
echinococcis
Autopsy of the body of an 18-year-old young man shows that the spleen weight is 580 grams, it is dark-red on section, spleen pulp easily serapes off. Histologically, there is marked proliferation of reticular cells and a large number of mature neutrophils in the sinusoidal capillaries. In this case the spleen can be described as:
septic
Shigella capable of producing exotoxin was obtained from a patient diagnosed with dysentery. What Shigella species is
shigella dysentry
An electronic microphotograph shows a fragment of the renal corpuscle. In the photograph there is a large epithelial cell’ with numerous appendages. The appendages are attached to the basement membrane of the capillaries. What type of cell is it?
podocyte
Secretion of orotic acid many times exceeds the norm in patients with hereditary orotic aciduria. This pathology is associated with disturbed synthesis of:
pyrimidine neucleotides
Patient suffers from episodes of arterial hypertension that are accompanied by tachycardia, profuse sweating, sharp Pain in the epigastric region. What neoplastic disease of the endocrine glands is the most likely in this case, based on these signs?
pheochromocytoma
ECG shows absent P waves replaced by f waves, QRST complexes have irregular intervals between them (RR interval varies). R waves have different voltage. What type of arrhythmia is it?
atrial fibrillation
To study a normal menstruation cycle, the OB-GYN specialist, taking into account the pyrogenic effect of progesterone, measured the patient’s rectal basal body temperature. At what phase of the cycle will the rectal temperature increase by 0.4-0.5C?
ovulation of the beginning of luteal phase
It is a known fact that in the human body the biosynthesis of purine nucleotides occurs de novo from amino acids, Name the amino acids that are used in the synthesis of the purine nucleotide cycle:
glycine, aspartate, glutamine
A man for a long time of suffering from hemoblastosis. Autopsy of the body revealed brown color of bone marrow, spleen, liver and lymph nodes. Perl’s histochemical reaction was performed. It was determined that reticular, endothelial and histiocytic elements of the affected organs contain blue granules. What pigment was detected using the Perl’s histochemical reaction?
hemosiderin
A patient developed left ventricular heart failure. What compensatory responses in the patient’s body will aimed at the prevention of pulmonary edema?
Reflex spasm of the pulmonary arterioles and decrease of blood pressure in the pulmonary microvasculature
A woman gave birth to twins. One of them was provisionally diagnosed with cri-du-chat syndrome that manifests as underdeveloped laryngeal muscles and “meowing” voice timbre. This syndrome occurs because of chromosome mutation. What method can verify or refute this diagnosis?
cytogenetic
A person received a penetrating wound of the abdominal cavity. The anterior abdominal wall is injured. The wound tract passes through the plica umbilicalis lateralis. What vessel is damaged?
inferior epigastric
A 29-year-old man complains of headache, swelling, weight gain, low urine output, and marked weakness. Laboratory Testing revealed increased concentration of T SH. The levels of estrogen, growth hormone, glucose, urea, and creatinine are normal. What medical condition corresponds with these signs?
hypothyroidism
A biopsy material obtained from a mammary tumor has solid layers that consist of small epithelial cells with polymorphic nuclei and numerous pathological mitoses. The stroma is scant and has lymphocyte infiltration. Make the diagnosis:
medullary carcinoma
A ballet dancer spins to the left. During the spin, her eyes snap quickly in the left. This fast eye movement is caused by the activation of:
Vestibular receptors of the semicircular ducts
A 2-year-old child was diagnosed with thymic hypoplasia. What indicator of the immune system status is the most characteristic of this type of immunodeficiency?
low t cell count
Autopsy of a 56 y.o. man revealed in the right part of brain a big focus of softened grey matter that was semi-liquid and light grey. Arteries of cerebral tela contain multiple whitish-yellow thickenings of intima that abruptly narrow the lumen. What is your diagnosis?
ischemic stroke
A patient was hospitalized in a proshock condition. He has a penetrating wound to the chest and coughs constantly What medicine will have analgesic and antitussive effect in this case?
morphine hydrochloride
The doctor examines patient with diabetes mellitus. Ile needs to check the pulsation of an artery that enters the foot between the tendon’s of extensor digitorum longus and extensor hallucis longus. What artery is it?
dorsalis pedis
A 3-year-old child has been brought by an ambulance to the intensive care unit of the infectious diseases hospital. On examination the child is in severe condition, skin and mucosa are dry, tissue turgor is reduced. The patient’s history states that profuse diarrhea and recurrent vomiting were observed throughout the previous day after the child had eaten food products of poor quality. What type of salt and water imbalance is likely to have developed in the patient?
hypo osmolar dehydration
You work with the following specimens:
brucellosis topical vaccine;
leptospirosis vaccine;
BCG vaccine;
adsorbed diphtheria-tetanus pertussis vaccine (DTP vaccine);
tetanus toxoid adsorbed.
What kind of immunity do they
artificial active immunity
A man presents with convergent strabismus. What muscle of the eyeball is damaged in this case?
lateral rectus
A 7-year-old girl has signs of anemia. Laboratory testing determined the deficiency of pyruvate kinase in her erythrocytes. In this case the main role in anemia development belongs to the disturbance of a certain process. What process is disturbed in this girl?
anearobic glycolysiss
Exo- and endotoxins, aggression enzymes play a significant role in the pathogenesis of cholera. Dehydration is the main syndrome of this disease. Which of the following pathogenetic effects is the main cause of dehydration?
adenylate yclase activation
During an abdominal surgery, a reflex cardiac arrest has occurred. Where is this reflex center located?
medulla oblanga
Due to an uncontrolled intake of a vitamin supplement, a child developed anorexia, nausea, vomiting, diarrhoea, hyperthermia, haemorrhages on the skin and mucosa, as well as the signs of meningism. What supplement was the child taking?
retinol acetate
With age a person develops presbyopia (farsightedness). Why does it happen?
decreased elasticity of lens
A 35-year-old parturient woman is diagnosed with a pain syndrome associated with a delay in the first stage of labor. What medicine would be optimal for pain relief in this case?
promedol
A patient with an acute transmural left ventricular myocardial infarction has died of cardiac rupture and tamponade. What process in the infarction zone could have contributed to the rupture?
Autolytic processes with pathologic softening of myocardial tissue (myomalacia)
Against the background of an allergic reaction, a child has developed laryngeal edema. What type of respiratory failure developed in this case?
obstructive type
A man has asked a cosmetologist to remove a tattoo from his shoulder. What substance, contained in the connective tissue, limits the spread of the dye?
hyaluronic acid
A man had a trauma and subsequent hemorrhagic, bursitis of the left knee joint. When examined 3 months later, he has a limited range of motion in this joint because of scar formation. What component of inflammation is the basis for the development of this complication?
proliferation
Fibrogastroscopy of a 48-year-old man, a driver, with complaints of epigastric pain after eating shows hyperemic gastric mucosa with reduced folds. In the gastrobiopsy specimen, microscopy detects thinned mucosa, reduced number of glands, and proliferation of connective tissue infiltrated by lymphocytes and plasma cells. Make a diagnosis.
Chronic atrophic gastritis
A patient for a long time was on an imbalanced diet low in proteins, which resulted in hepatic fatty infiltration. This condition is likely to develop if a certain substance is absent in a person’s diet. Name this substance:
methinine
A man presents with atrophy of the posterior group of calf muscles. What nerve is affected in this case?
tibial nerve
A patient has elevated blood pressure due to increased vascular tone. To lower the blood pressure in this case it is necessary to prescribe the blockers of
alpha adrenoreceptors
A 43-year-old man came to a neurologist with complaints of shortness of breath, chest pain, hiccups, and problematic cough movements. What nerves are affected in this case?
phrenic
Chest X-ray of a newborn child with convulsive syndrome and a defect of the interventricular septum revealed thymus hypoplasia. What type of immunodeficiency can be suspected in the child?
DiGeorge syndrome
A patient with scurvy presents with impaired hydroxylation of collagen proline and lysine. What biochemical process is inhibited in this case, being the reason for this disorder?
microsomal oxidation
Analysis of a clear lemon-yellow liquid obtained from a patient via abdominal tap shows the following: relative density – 1012, albumin – 1%. globulins – 0.2%, no fibrinogen, leukocytes -1-3 in the vision field. The liquid is sterile, it did not curdle after an hour. Which of the listed phenomena is associated with such findings?
Ascites caused by blood stagnation in the portal system
Hematologic study shows the following pattern: erythrocytes -2,8 x 1012/L, Hb – 80 g/L, color ‘index – 0.85, reticulocytes – 0,1%, platelets – 160 thousand per microliter, leukocytes – 60 x 109 /L. Basocytes – 2%, eosinophils – 8%, promyelocytes – 5%, myelocytes – 5%, juvenile – 16%, stab neutrophils – 20%, segmented neutrophils – 34%, lymphocytes – 5%, monocytes – 5%. This clinical presentation indicates the following blood pathology:
Chronic myelokeukemia
A toad was given a solution of a certain chemical substance. As a result, it responds with generalized convulsions to any kind of irritation. What was the toad given in this case?
Strychnine
On examination a woman presents with a swelling, distended veins, and node formation on the medial surface of her thigh. It is a pathology of the following vein:
V saphena magna
ECG of a man shows an increased duration of the QT interval. It may be due to a decrease in the speed of the following in the ventricles:
depolarization and repolaria\zation
Stool analysis detected ascaris eggs in the patient’s feces. What medicine should be prescribed for this patient’s treatment?
mebendazole
A smear prepared from the material obtained from a patient with suspected diphtheria contains yellow bacilli with blue grains at their ends. What staining was used in this case?
neisser
Examination revealed that the patient has an insufficient immunoglobulin count. The likely cause of this finding is a dysfunction of the following immune system cells:
plasma cells
Oxygen tension in the arterial blood of a person has increased to 104 mm Hg., while carbon dioxide tension has been reduced to 36 mm Hg. It is likely to be caused by:
voluntary hyperventilation
Microscopy of a lung tissue shows an inflamed area that consists of a necrotic focus surrounded by regular rows of epithelioid and lymphoid cells. There are plasma cells, macrophages, and Pirogov Langhans giant multinucleated cells Specify the type of such inflammation.
tuberculous inflammation
A 9-year-old child developed a severe case of purulent destructive pneumonia, for which the child received à massive antibacterial therapy. The disease was rapidly progressing. Against the background of marked intoxication, a sharp drop in blood pressure was registered, the patient went into a state of shock, which resulted in the death of the patient. What etiopathogenetic type of shock developed in the child?
toxic shock syndrome
A patient with an injury of the greater psoas muscle was delivered to the traumatology center. The patient has lost the ability to extend the lower leg at the knee joint. What nerve is damaged?
femoral
A 25-ycar-old man came to a neurologist with complaints of a weakness in his legs and disturbed gait. The doctor diagnosed him with myasthenia gravis and prescribed him prostin injection. What is the mechanism of action of this medicine?
anticholinoesterase drug
A 45-year-old woman developed an acute inflammatory disease of her upper respiratory tract and eyes during the flowering period. She presents with hyperaemia, oedema, and mucous discharge. Increase in the number of what type of leucocytosis would be characteristic in this case?
eosinophils
A 54-year-oId man was diagnosed with macrofocal myocardial infarction of the left ventricle anterior wall. In which artery is the blood flow impaired in this case?
Anterior interventricular branch of the right coronary artery
A patient has been taking bisacodyl for a long time to treat chronic constipation. However, several weeks later the aperient effect of the drug diminished. What is the possible cause of this?
acquired tolerance
A child was diagnosed with helminths. What changes in the peripheral blood will be observed with this pathology?
esonophilia
Because of the violation of the safety rule while working with organophosphorus insecticide, a worker has developed bronchospasm. Which of the listed broncholytics is indicated in this case?
atropine
Histology of the cardiac auricle in a patient with mitral valve stenosis revealed Aschoff-Talalaev granulomas. What genesis of heart disease is in this case evident, according to this histological study?
rhumatic
A man is being treated for chronic pneumonia for a long time. Microscopy of sputum smears stained using the Ziehl-Nielsen method reveals red bacilli 0.25×4 microns in size, located separately or sometimes in small clusters. What disease can be suspected?
pulmonary tuberculosis
The Wasserman reaction is markedly positive (++++) in a 30-year-old man. What infectious disease is diagnosed using the Wasserman reaction?
iu
Syphilis
A 10-year-old child, due to the detected tumor, underwent a removal of the posterior pituitary lobe. As a result, the following state will occur:
inc diuresis
A man with tetanus developed acute respiratory failure. What type of respiratory failure develops in such cases?
A man with tetanus developed acute respiratory failure. What type of respiratory failure develops in such cases?
In von Gierke disease, glycogen accumulation can be observed in liver and kidneys. This disease is caused by deficiency of the following enzyme:
glucose 6 phosphatase
A 14-year-old boy was diagnosed with Hutchinson’s triad: barrel-shaped teeth, parenchymatous keratitis, and deafness. These signs are characteristic of:
spyhilis
Oxygen supply of skeletal muscles during their intensive work is often problematic because of compressed vessels and disrupted blood flow. What supplies muscles with oxygen in this case?
myoglobin
A child has signs of delayed physical and mental development (cretinism). This condition is caused by deficiency of the following hormone:
thyroxine
A woman with chronic hepatitis complains of increased sensitivity to barbiturates that previously she could take without any signs of intoxication. Her condition is mainly associated with disturbance of the following hepatic function:
metabolic
A person has retained gustatory sensations, but overall sensitivity of the oral structures is lost, which indicates a damage to the:
trigeminal
A 48-year-old woman with diabetes mellitus has been hospitalized in a severe precomatose state. Analysis of her acid-base balance revealed metabolic acidosis. What primary mechanism is the cause of the changes detected in the woman’s acid- base balance?
formation of underoxidixed products
Autopsy of the body of a 42- year-old man, who had chronic diffuse bronchitis and died of cardiopulmonary failure, shows large hyperinflated lungs that cover the mediastinum with their edges. The lungs do not deflate, are pale gray, emit crackling sound when cut. Pressing a finger to the surface of the lungs leaves an indentation. Bronchial lumen produces mucopurulent exudate. Make the diagnosis:
chronic diffuse obstructive pulmonary emphysem
Increased resistance to blood ejection from the left ventricle has activated the homeometric compensation mechanism in the patient. In what pathological process can this compensation mechanism develop in the left ventricle?
aortic valve stenosis
An older man with parkinsonism was prescribed a certain drug. Several days later the man developed complaints of dry mouth and rapid heart rate. The prescribed drug is a
cholinoblocker
During patient examination, the doctor conducts auscultation to assess the functioning of the mitral valve. Where can the tones of this valve be auscultated?
at cardiac apex
To assess their adaptation to physical exertion, the doctor has examined the workers after a severe workload. What changes in the complete blood count can be detected in this case?
`
Redistributive leucocytosis`
During a dry for spleen injury, the surgeon needs to isolate an artery that supplies the spleen with blood. Which branch of the arterial vessel is it?
Truncus coeliacus
A woman with ischemic heart disease was prescribed amiodarone. This medicine has antianginal effect. What other effect does it have?
antiarryhmatic
Synovial fluid is known to reduce the friction between articular surfaces. In rheumatism or arthritis, its viscosity decreases because of depolymerization (destruction) of the following substance:
hyaluronidc acid
After a severe case of poliomyelitis, disturbed function of the central nervous system has caused weakening of the movements of all four limbs in the patient. What diagnostic term is used to describe this condition?
parasis
During a fall, a small child has received a trauma of the anterior fontanelle. What type of cranial bone junction was pathologically affected in this case?
Syndesmosis
After a myocardial infarction, the morphological intactness of the wall was restored in the patient. In this case, regeneration occurred because of the following tissue:
connective tissue
There is a sensation of tingling in thumb, index and middle finger, earlier pain was resolved using ibuprofen, but now the pain is much worse and wakes her up at night. She works as a typist and the pain often increases after typing all day. Her right wrist and fingers are line. Nerve conduction studies reveal nerve compression. Which of the following nerves is most likely compressed in this patient?
median nerve
A 1.5-year-old boy, who previously received no regular immunization, was in contact with a measles patient. For urgent specific prevention, the child was administered donor gamma globulin. What type of immunity develops in this case?
passive
A man has atrioventricular block of the I degree with a prolonged PQ interval of 0.25 seconds. What cardiac ability is disturbed in this case?
conductivity
A man has received a hit to the area of the inferior angle of the scapula on the right, which resulted in rib fracture. What ribs were damaged in this case?
6 to 7
Watson and Crick determined that the DNA double helix structure is stabilized with the bonds between complementary nitrogenous bases. What type of bond is it?
hyderogen
A man complains of a burning pain in the area of his heart. Based on the analysis of his ECG, he has been diagnosed with infarction of the posterior wall of the left ventricle. What artery has damaged branches in this case?
right coronary artery
After examination, a man, who lived in the Ural region, was diagnosed with taiga encephalitis. The causative agent of this disease could have been transmitted to the patient via a bite of
Ixodes persulcatus
Feces of a child with an acute intestinal infection were inoculated onto Endo medium, which resulted in growth of numerous raspberry-red colonies with a metallic sheen. It indicates that the colibacillus is the kely causative agent of the disease. What properly of the causative agent was used to distinguish it from other intestinal bacteria?
fermentation of lactose
A man had a case of epidemic typhus 5 years ago. After an acute respiratory viral disease, against the background of weakened immune system, he developed signs of typhus again. The exacerbation occurred because of the causative agents, remaining in his body. What type of infection is it?
relapse
An older man developed an acute cerebrovascular accident, followed by coma and death. Autopsy revealed a large blood-filled cavity in the right hemisphere of his brain. What pathological process was detected in the brain?
hemotoma
In the haematology unit a patient with leukaemia was prescribed 5- fluorouracil. This drug:
inhibits dna synthesis
What differs a sanguinic from a phlegmatic?
monility of nervouys process
A man had an acute onset of the disease. He complained of chills, fever of 40°C, headache, cough, and dyspnoea. The man died on the 5 day after the onset. Autopsy shows enlarged lungs with variegated appearance – «large variegated lung”. Such clinical presentation of the lungs is characteristic of the following disease:
Influnza
X-ray has detected multiple foci of osteoporosis and osteolysis in the flat bones of a man. Trephine biopsy material contains high levels of neoplastic plasma cells. Make the diagnosis:
myltuple myeloma
A man, who has arrived from Tunisia, has alpha-thalassemia with hemolysis of erythrocytes and jaundice. The disease was diagnosed based on the presence of the following in the patient’s blood:
target erythrocytes
Wernicke-Korsakoff syndrome often develops in chronic alcoholics, who have a low-vitamin dict. Decreased transketolase activity can be observed in the course causes this development?
THIAMINE
According to the Schade’s physicochemical theory, hyperosmia, hyperonchia and acidosis can be observed in the area of inflammation. The development of hyperosmia is, to an extent, associated with the increasing concentration of K+ in the inflamed area. What causes the hyperkalaemia of the inflammatory exudate?
intersive3 destruction of damaged cells
To determine the type of leukaemia, the patient needs to undergo a bone marrow aspiration. What bone is usually punctured for this analysis?
sternum
After putting in eye drops, a man with glaucoma developed miosis and myopia. His intraocular pressure decreased. What drugs can have such effect?
M cholinimimometrics
In typhoid fever, the necrotized Peyer’s patches in the small intestine color yellow-brown. What pigment permeates the necrotized tissue?
lipofuscin
A 50-year-old man has undergone a surgery for gastric cancer. Complex anaesthesia included dithylin (suxa-methonium iodide). After the surgery was over, dithylin effect continued. Why is proserine (neostigmine) contraindicated in case of dithylin overdose?
Increases synanthic membrane depolarization
A child with mushroom (fly agaric) poisoning was brought into a toxicology department. What drug should be administered first as a part of emergency aid?
atropoine
Lung pathologies stimulate adaptive changes in the human body to ensure better oxygen supply to the tissues. One of these adaptive changes is the increased synthesis of the following in the erythrocytes:
2,3-diphosphoglycerate
In an experiment, electrical stimulation of neurons in the brain of a test animal resulted in hypophagia (refusal to eat). Electrodes were applied to the following area of the brain in this case:
hypothalamus
A urology department has received a 48-year-old man with signs of renal colic. What medicine will be the most advisable in his condition?
atropine
A measles outbreak has occurred in a maternity clinic. What class of maternal antibodies can provide newborn with immunity to measles virus?
IgG
Due to prolonged stay in the mountains at the altitude of 3000 m above the sea level, a person developed increased oxygen capacity of blood, which was directly caused by intensified production of:
erythropoetins
Due to destruction of certain structures of the brainstem a test animal has lost its orientation reflexes in response to strong light stimuli. What structures were destroyed?
Anterior quadrigeminal bodies
A woman with hypophyseal diabetes insipidus developed a water-mineral imbalance. What type of water-mineral imbalance develops in such cases?
Hyperosmolar dehydration
A 25-year-old child is provisionally diagnosed with pharyngeal diphtheria. Smear from the child’s mucosa was obtained and inoculated into a coagulated eA patient with asphyxia after a brief respiratory arrest developed single infrequent respirations with passive expiration, after which he stopped breathing completely. What type of respiration was observed in this case?quine serum. What is the purpose of this stage of microbiological diagnostics?
detection of toxigenicity
A patient with asphyxia after a brief respiratory arrest developed single infrequent respirations with passive expiration, after which he stopped breathing completely. What type of respiration was observed in this case?
gasping respiration
A 63-year-old man, who has been suffering from chronic diffuse obstructive pulmonary emphysema for 15 years, died of progressive heart failure. Autopsy shows nutmeg liver cirrhosis, cyanotic induration of kidneys and spleen, ascites, and edemas of the lower limbs. What type of heart failure can be characterized by such changes in the internal organs?
chronic heart failure
An inflammation can be characterized by hemocapillary dilation in the affected area, decreased blood circulation, and increased vessel wall permeability. What cells plays the key role in this process?
tissue basophils
A patient for a long time was on an imbalanced diet low in proteins, which resulted in hepatic fatty infiltration. This condition is likely to develop if a certain substance is absent in a person’s diet. Name this substance:
methionine
After a prolonged attack of severe headache the patient lost mobility in his left arm and leg. Muscle tone is decreased in the affected limbs, the muscles are spasmed, spinal tendon reflexes are acutely intensified, reflex zones are increased. What nervous system disorder can be observed in this patient?
central paralysis
A 40-year old man with impaired venous patency in the lower limbs developed edemas. What mechanism plays the main role in the development of this disturbance?
elevated filtration pressure
Wernicke-Korsakoff syndrome often develops in chronic alcoholics, who have a low vitamin diet. Decreased transketolase activity can be observed in the course of this disease. What vitamin deficiency causes this development?
thiamine
