Krok 1 – 2015 Base(Path-Physiology)
1. A patient who suffers from severe disorder of water-salt metabolism experienced cardiac arrest in diastole. What is the most probable mechanism of cardiac arrest in diastole?
1. Hyponatremia
2. Hypernatremia
3. Organism dehydratation
4. Hypokaliemia
5. Hyperkaliemia
2. In a 45-year-old patient on ECG it was revealed: sinus rhythm, the number of auricular complexesexceeds number of ventricular complexes; progressing extension of the P-Q interval from complex to complex; fallout of some ventricular complexes; Р waves and QRST complexes are without changes. Name the type of heart rhythm disfunction.
1. Synoauricular block
2. Intraatrial block
3. Atrioventricular blockade of the I degree
4. Atrioventricular block of the II degree
5. Complete atrioventricular block
3. A married couple came to the genetic counseling. The husband suffers from the insulin-dependant diabetes, the wife is healthy. What is the probability that this couple will have an insulin-dependant child?
1. Lower than throughout the population
2. The same as throughout the population
3. Higher than throughout the population
4. 100%
5. 50%
4. As a result of a trauma a patient has developed traumatic shock that led to the following disorders: AP is 140/90 mm Hg, Ps is 120 bpm. The patient is fussy, talkative, pale. Such state relates to the following shock phase:
1. Latent period
2. Torpid
3. Terminal
4. Erectile
5. A 32-year-old patient was admitted to the hospital with gross bloodloss due to auto accident trauma. Ps – 110Bpm, RR- 22 pm, BP- 100/60mm Hg. What changes in the blood will occur in an hour after the bloodloss?
1. Hypochromia of erythrocytes
2. Leukopenia
3. Hypovolemia
4. Hypoproteinemia
5. Erythropenia
6. Pyruvate concentration in the patient’s urine has increased 10 times from normal amount. What vitamin deficiency can be the reason of this change:
1. Vitamin B6
2. Vitamin A
3. Vitamin C
4. Vitamin E
5. Vitamin B1
7. A 30 year old woman has face edemata. Examination revealed proteinuria (5,87 g/l), hypoproteinemia, dysproteinemia, hyperlipidemia. What condition is the set of these symptoms typical for?
1. Nephrotic syndrome
2. Chronic pyelonephritis
3. Nephritic syndrome
4. Acute renal failure
5. Chronic renal failure
8. A rabbit’s nerve that innervates the right ear was cut and its right superior cervical ganglion was removed. Immediately after operation the temperature of ear skin was measured. It was revealed that the temperature of the rabbit’s ear skin on the side of denervation was by 1,5oC higher than on the opposite intact side. What of the following is the most probable explanation of the above-mentioned effects?
1. Atrerial hyperemia induced by metabolic factors
2. Arterial neurotopical hyperemia
3. Physiological arterial hyperemia
4. Reactive arterial hyperemia
5. Arterial neuroparalytic hyperemia
9. Examination of a miner revealed pulmonary fibrosis accompanied by disturbance of alveolar ventilation. What is the main mechanism of this disturbance?
1. Bronchi spasm
2. Limitation of respiratory surface of lungs
3. Constriction of superior respiratory tracts
4. Limitation of breast mobility
5. Disturbance of neural respiration control
10. A 47 year old man with myocardium infarction was admitted to the cardiological department. What changes of cellular composition of peripheral blood are induced by necrotic changes in the myocardium?
1. Eosinophilic leukocytosis
2. Thrombocytopenia
3. Monocytosis
4. Lymphopenia
5. Neutrophilic leukocytosis
11. A woman who was sick with rubella during the pregnancy gave birth to a deaf child with hare lip and cleft palate. This congenital defect is an example of:
1. Phenocopy
2. Genocopy
3. Edward’s syndrome
4. Down’s syndrome
5. Patau’s syndrome
12. 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?
1. Exudative
2. Gouty
3. Asthenic
4. Hemorrhagic
5. Lymphohypoplastic
13. Arterial pressure of a surgeon who performed a long operation rised up to 140/110 mm Hg. What changes of humoral regulation could have caused the rise of arterial pressure in this case?
1. Activation of kallikrein kinin system
2. Activation of formation and excretion of aldosterone
3. Activation of renin angiotensive system
4. Activation of sympathoadrenal system
5. Inhibition of sympathoadrenal system
14. Violation of safety rules resulted in calomel intoxication. Two days later the daily diuresis was 620 ml. A patient experienced headache, vomiting, convulsions, dyspnea, moist rales in lungs. What pathology is it?
1. Uraemic coma
2. Chronic renal insufficiency
3. Acute renal insufficiency
4. Glomerulonephritis
5. Pyelonephritis
15. Disorder of the airways passage in small and middle bronchi was revealed in the patient. What disorder of the acid-base equilibrium can be detected in the blood?
1. Respiratory acidosis
2. Respiratory alkalosis
3. Metabolic alkalosis
4. Metabolic acidosis
16. 2 years ago a patient underwent resection of pyloric part of stomach. He complains of weakness, periodical dark shadows beneath his eyes, dyspnea. In blood: Hb – 70 g/l, erythrocytes – 3,0*1012/l, colour index – 0,7. What changes of erythrocytes in blood smears are the most typical for this condition?
1. Microcytes
2. Schizocytes
3. Megalocytes
4. Macrocytes
5. Ovalocytes
17. Prophylactic medical examination of a 36 year old driver revealed that his AP was 150/90 mm Hg. At the end of working day he usually hears ear noise, feels slight indisposition that passes after some rest. He was diagnosed with essential hypertension. What is the leading pathogenetic mechanism in this case?
1. Neurogenetic
2. Humoral
3. Endocrinal
4. Nephric
5. Reflexogenic
18. A 46-year-old patient suffering from the diffuse toxic goiter underwent resection of the thyroid gland. After the surgery the patient presents with appetite loss, dyspepsia, increased neuromuscular excitement. The body weight remained unchanged. Body temperature is normal. Which of the following has caused such a condition in this patient?
1. Increased production of calcitonin
2. Increased production of thyroxin
3. Reduced production of parathormone
4. Increased production of thyroliberin
5. Reduced production of thyroxin
19. 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?
1. Transformation of prothrombin into thrombin
2. Prothrombinase activation
3. Thrombocyte adhesion
4. Transformation of fibrinogen into fibrin
5. Impaired heparin synthesis
20. A 58-year-old patient suffers from the cerebral atherosclerosis. Examination revealed hyperlipoidemia. What class of lipoproteins will most probably show increase in concentration in this patient’s blood serum?
1. Low-density lipoproteins
2. High-density lipoproteins
3. Fatty acid complexes with albumins
4. Chylomicrons
5. Cholesterol
21. A patient suffers from the haemorrhagic syndrome that shows itself in frequent nasal bleedings, posttraumatic and spontaneous intracutaneous and intra-articular haemorrhages. After a laboratory study a patient was diagnosed with the type B haemophilia. This disease is provoked by the deficit of the following factor of blood coagulation:
1. VIII
2. XI
3. VII
4. IX
5. V
22. A child was born with cleft palate. Examination revealed aorta defects and reduced number of T-lymphocytes in blood. What immunodeficient syndrome is it?
1. Chediak-Higashi
2. Wiskott-Aldrich
3. Swiss-type
4. Louis-Bar
5. DiGeorge
23. An infant has pylorospasm, weakness, hypodynamia, convulsions as a result of frequent vomiting. What kind of acid-base disbalance is it?
1. Metabolic acidosis
2. Excretory acidosis
3. Excretory alkalosis
4. Gaseous alkalosis
5. Exogenous nongaseous acidosis
24. A 26 year old man is in the torpid shock phase as a result of a car accident. In blood: 3,2*109/l. What is the leading mechanism of leukopenia development?
1. Lysis of leukocytes in the blood-forming organs
2. Redistribution of leukocytes in bloodstream
3. Disturbed going out of mature leukocytes from the marrow into the blood
4. Leikopoiesis inhibition
5. Intensified elimination of leukocytes from the organism
25. A patient who had been working hard under conditions of elevated temperature of the environment, has now a changed quantity of blood plasma proteins. What penomenon is the case?
1. Absolute hypoproteinemia
2. Relative hyperproteinemia
3. Disproteinemia
4. Paraproteinemia
5. Absolute hyperproteinemia
26. A newborn child with pylorostenosis has often repeating vomiting accompanied by apathy, weakness, hypertonicity, sometimes convulsions. What disorder form of acid-base balance is it?
1. Excretory acidosis
2. Gaseous acidosis
3. Gaseous alkalosis
4. Nongaseous alkalosis
5. Metabolic acidosis
27. Upper neck node of sympathetic trunk was removed from the rabbit on experiment. Reddening and increased temperature of the skin of head is observed. What form of peripheral circulation of the blood developed in the rabbit?
1. Neurotonic arterial hyperemia
2. Metabolic arterial hyperemia
3. Neuroparalytic arterial hyperemia
4. Stasis
5. Venous hyperemia
28. 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?
1. Heart overload by resistance
2. Heart overload by volume
3. Primary myocardial insufficiency
4. Cardiac tamponade
5. Coronary insufficiency
29. A 70 year old man is ill with vascular atherosclerosis of lower extremities and coronary heart disease. Examination revealed disturbance of lipidic blood composition. The main factor of atherosclerosis pathogenesis is the excess of the following lipoproteins:
1. Cholesterol
2. High-density lipoproteins
3. Low-density lipoproteins
4. Chylomicrons
5. Intermediate density lipoproteins
30. On simulation of inflammation of the lower extremity the animal exrerienced raise of the temperature, increase of amount of antibodies and leucocytes in the blood. What substances caused this general reaction of the organism on inflammation?
1. Leucotriens
2. Glucocorticoid
3. Somatomedins
4. Interleukin
5. Mineralcorticoid
31. Dystrophic changes of the heart muscle are accompanied with cardiac cavity enlargement, decrease of the strength of heart contraction, increased amount of blood, which remains in the heart during systolic phase, overfilled veins. For what state of heart is it characteristic?
1. Emergency stage of hyperfunction and hypertrophy
2. Myogenic dilatation
3. Tonogenic dilatation
4. Tamponage of the heart
5. Cardiosclerosis
32. Oval and round organelles with double wall are seen at the electron micrograph. The outer membrane is smooth, the inner membrane folded into cristae contain enzyme ATPase synthetase. These are:
1. Centrioles
2. Golgi complex
3. Mitochondria
4. Lysosomes
5. Ribosomes
33. A 55 y.o. woman consulted a doctor about having continuous cyclic uterine hemorrhages for a year, weakness, dizziness. Examination revealed skin pallor. Hemogram: Hb – 70 g/l, erythrocytes – 3,2*1012/l, color index – 0,6, leukocytes – 6,0*109/l, reticulocytes – 1%; erythrocyte hypochromia. What anemia is it?
1. Hemolytic anemia
2. Chronic posthemorrhagic anemia
3. B12-folate-deficiency anemia
4. Aplastic anemia
5. Iron-deficiency anemia
34. Inflamation is characterised by increasing penetration of vessels of microcirculation stream, increasing of their fluid dynamic blood pressure. Increasing of the osmotic concentration and dispersity of protein structures present in the intercellular fluid. What kind of edema will appear in this case?
1. Hydrodynamic
2. Colloid-osmotic
3. Mixed
4. Membranogenic
5. Lymphogenic
35. A patient was diagnosed with autoimmune hemolitic cytotoxic anemia. What substances are antigens in II type allergic reactions?
1. Antibiotics
2. Modified receptors of cell membranes
3. Serum proteins
4. Hormones
5. Inflammation modulators
36. A patient has been diagnosed with influenza. His condition became drastically worse after taking antipyretic drugs. His consciousness is confused, AP is 80/50 mm Hg, Ps is 140/m, body temperature droped down to 35,8oC. What complication developed in this patient?
1. Hypovolemia
2. Collapse
3. Hyperthermia
4. Acidosis
5. Alkalosis
37. After taking poor-quality food a patient developed repeated episodes of diarrhea. On the next day he presented with decreased arterial pressure, tachycardia, extrasystole. Blood pH is 7,18. These abnormalities were caused by the development of:
1. Non-gaseous acidosis
2. Gaseous alkalosis
3. Gaseous acidosis
4. Metabolic alkalosis
5. Nongaseous alkalosis
38. A 12-year-old teenager has significantly put off weight within 3 months; glucose concentration rose up to 50 millimole\l. He fell into a coma. What is the main mechanism of its development?
1. Hypoglycemic
2. Ketonemic
3. Lactacidemic
4. Hypoxic
5. Hyperosmolar
39. A 45 year old woman is ill with breast cancer. Her left arm has symptoms of lymphatic system insufficiency – limb edema, lymph node enlargement. What form of lymphatic circulation insufficiency is it?
1. Combined insufficiency
2. Dynamic insufficiency
3. Mechanic insufficiency
4. Resorption insufficiency
40. A patient was ill with burn disease that was complicated by DIC syndrome. What stage of DIC syndrome can be suspected if it is known that the patient’s blood coagulates in less than 3 minutes?
1. Terminal
2. Transition phase
3. Fibrinolysis
4. Hypercoagulation
5. Hypocoagulation
41. A patient with nephrotic syndrome has massive edemata of his face and limbs. What is the leading pathogenetic mechanism of edemata development?
1. Rise of hydrodynamic blood pressure
2. Increase of vascular permeability
3. Lymphostasis
4. Increase of lymph outflow
5. Drop of oncotic blood pressure
42. A patient suffering from pheochromocytoma complains of thirst, dry mouth, hunger. Blood test for sugar revealed hyperglycemia. What type of hyperglycemia is it?
1. Hypercorticoid
2. Adrenal
3. Alimentary
4. Hypoinsulinemic
5. Somatotropic
43. A patient suffering from stenocardia was taking nitroglycerine which caused restoration of blood supply of myocardium and relieved pain in the cardiac area. What intracellular mechanism provides restoration of energy supply of insulted cells?
1. Intensification of ATP resynthesis
2. Intensification of oxygen transporting into the cell
3. Increased permeability of membranes
4. Intensification of RNA generation
5. Reduction of ATP resynthesis
44. Hepatitis has led to the development of hepatic failure. Mechanism of edemata formation is activated by the impairment of the following liver function:
1. Protein-synthetic
2. Chologenetic
3. Barrier
4. Antitoxic
5. Glycogen-synthetic
45. 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?
1. Rise of arterial pressure
2. Myocardium hypertrophy
3. Tachycardia
4. Cyanosis
5. Dyspnea
46. A 59 year old patient is a plant manager. After the tax inspection of his plant he felt intense pain behind his breastbone irradiating to his left arm. 15 minutes later his condition came to normal. Which of the possible mechanisms of stenocardia development is the leading in this case?
1. Coronary thrombosis
2. Intravascular aggregation of blood corpuscles
3. Coronary atherosclerosis
4. Functional heart overload
5. High catecholamine concentration in blood
47. During a prophylactic medical examination a 7-year-old boy was diagnosed with daltonism. His parents are healthy and have normal colour vision, but his grandfather on his mother’s side has the same abnormality. What is the type of the abnormality inheritance?
1. Recessive, sex-linked
2. Autosomal recessive
3. Semidominance
4. Autosomal dominant
5. Dominant, sex-linked
48. On the 6th day of treatment a patient with acute renal insufficiency developed polyuria. Diuresis intensification at the beginning of polyuria stage of acute renal insufficiency is caused by:
1. Reduction of vasopressin content in plasma
2. Volume expansion of circulating blood
3. Reduction of aldosteron content in plasma
4. Renewal of filtration in nephrons
5. Growth of natriuretic factor
49. A 32 y.o. man is tall, he has gynecomastia, adult woman pattern of hair distribution, high voice, mental deficiency, sterility. Provisional diagnosis is Klinefelter’s syndrome. In order to specify diagnosis it is necessary to analize:
1. Spermatogenesis
2. Caryotype
3. Leukogram
4. Blood group
5. Genealogy
50. Examination of a 42 year old patient revealed a tumour of adenohypophysis. Objectively: the patient’s weight is 117 kg, he has moon-like hyperemic face, red-blue striae of skin distension on his belly. Osteoporosis and muscle dystrophy are present. AP is 210/140 mm Hg. What is the most probable diagnosis?
1. Cushing's disease
2. Conn's disease
3. Diabetes mellitus
4. Cushing's syndrome
5. Essential hypertension
51. Shock and signs of acute renal failure (ARF) developed in the patient due to permanent injury. What is the leading cause of development of ARF in the case?
1. Urine excretion violation
2. Decreased arterial pressure
3. Increased pressure in the renal arteries
4. Increased pressure in the nephron capsule
5. Decreased oncotic BP
52. 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?
1. Increase of peripheral vascular resistance
2. Reduction of diastolic flow to the heart
3. Disturbance of pumping ability of heart
4. Depositing of blood in organs
5. Decrease of vascular tone
53. 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?
1. Serous inflammation
2. Suppurative inflammation
3. Fibrinous inflammation
4. Aseptic inflammation
5. Allergic inflammation
54. 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?
1. Ventricular
2. Atrial
3. Atrioventricular
4. Sinus
5. Bundle-branch
55. 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?
1. Inhalation of the oxygen
2. Volume overload of the left ventricular
3. Decreased oncotic pressure due to hemodilution
4. Allergic reaction
5. Neurogenic reaction
56. Chronic glomerulonephritis was diagnosed in a 34 -year-old patient 3 years ago. Edema has developed in the last 6 monthes. What caused it?
1. Hyperproduction of vasopressin
2. Disorder of albuminous kidneys function
3. Proteinuria
4. Hyperosmolarity of plasma
5. Hyperaldosteronism
57. A woman has been applying a new cosmetic preparation for a week that resulted in eye-lid inflammation accompanied by hyperemia, infiltration and painfulness. What type of allergic reaction was developed?
1. II
2. ІV
3. I
4. V
5. III
58. While having the dinner the child choked and aspirated the food. Meavy cough has started, skin and mucose are cyanotic, rapid pulse, rear breathing, expiration is prolonged. What disorder of the external breathing developed in the child?
1. Stage of inspiratory dyspnea on asphyxia
2. Alternating breathing
3. Stage of expiratory dyspnea on asphyxia
4. Biot's breathing
5. Stenotic breathing
59. Examination of a patient admitted to the surgical department with symptoms of acute appendicitis revealed the following changes in the white blood cells: the total count of leukocytes is 16*109/l. Leukocyte formula: basophils – 0, eosinophils – 2%, juvenile forms – 2%, stabnuclear – 8%, segmentonuclear – 59%, lymphocytes – 25%, monocytes-4%. The described changes can be classified as:
1. Neutrophilia with regenerative left shift
2. Neutrophilia with right shift
3. Neutrophilia with degenerative left shift
4. Neutrophilic leukemoid reaction
5. Neutrophilia with hyperregenerative left shift
60. Two hours after an exam a student had a blood count done and it was revealed that he had leukocytosis without significant leukogram modifications. What is the most probable mechanism of leukocytosis development?
1. Leukopoiesis intensification
2. Redistribution of leukocytes in the organism
3. Deceleration of leukocyte lysis
4. Leukopoiesis intensification and deceleration of leukocyte lysis
5. Deceleration of leukocyte migration to the tissues
61. A 62 year old patient who previously worked as stoker was admitted to a hospital with complaints about general weakness, abrupt weight loss, hoarse voice, dyspnea, dry cough. Laryngoscopy revealed a tumour in the pharynx that invaded vocal cords and epiglottis. What is the most probable cause of tumour development?
1. Ionizing radiation
2. Aromatic amines and amides
3. Polycyclic aromatic carbohydrates
4. Nitrosamines
5. Retroviruses
62. Inflammation of a patient’s eye was accompanied by accumulation of turbid liquid with high protein at the bottom of anterior chamber that was called hypopyon. What process underlies the changes under observation?
1. Secondary alteration
2. Primary alteration
3. Proliferation
4. Disturbance of microcirculation
63. Substitution of the glutamic acid on valine was revealed while examining initial molecular structure. For what inherited pathology is this typical?
1. Hemoglobinosis
2. Thalassemia
3. Minkowsky-Shauffard disease
4. Favism
5. Sickle-cell anemia
64. A 49 y.o. woman consulted a doctor about heightened fatigue and dyspnea during physical activity. ECG: heart rate is 50/min, PQ is extended, QRS is unchanged, P wave quanity exceeds quantity of QRS complexes. What type of arrhythmia does the patient have?
1. Extrasystole
2. Atrioventricular block
3. Sinus bradycardia
4. Ciliary arrhythmia
5. Sinoatrial block
65. Arterial hypertention is caused by the stenosis of the renal arteries in the patient. Activation of what system is the main link in the pathogenesys of this form of hypertension?
1. Parasympathetic
2. Sympathoadrenal
3. Renin-angiotensin
4. Kallikrein-kinin
5. Hypothalamic-pituitary
66. A couple had a child with Down’s disease. Mother is 42 years old. This disease is most probably caused by the following impairment of prenatal development:
1. Blastopathy
2. Non-specific fetopathy
3. Embryopathy
4. Specific fetopathy
5. Gametopathy
67. A 27 y.o. patient put eye drops that contain penicillin. After a few minutes she felt itching and burning of her body, there appeared lip and eye-lid edemata; arterial pressure began to drop. What immunoglobulins took part in the development of this allergic reaction?
1. lgE and lgG
2. IgM and IgG
3. IgM and IgD
4. IgA and IgM
5. IgG and IgD
68. A patient who suffers from heart failure has enlarged liver, edemata of lower extremities, ascites. What is the leading mechanism in the development of this edema?
1. Membranogenic
2. Colloid osmotic
3. Lymphogenous
4. Hydrodynamic
69. Patient with hypochromic anemia has splitting hair and loss of hair, increased nail brittling and taste alteration. What is the mechanism of the development of these symptoms?
1. Deficiency of vitamin В12
2. Deficiency of iron-containing enzymes
3. Decreased production of thyroid hormones
4. Deficiency of vitamin А
5. Decreased production of parathyrin
70. A 43-year-old patient has thrombopenia, reduction of fibrinogen, products of degradation of fibrin presented in the blood, petechial haemorrhage along with septic shock. What is the most likely cause of the changes?
1. Autoimmune thrombocytopenia
2. DIC-syndrome
3. Haemorrhagic diathesis
4. Disorder of thrombocytes production
5. Exogenous intoxication
71. Rats being under stress have muscular hypertonia and high arterial pressure, high glucose concentration in blood and intensified secretion of corticotropin and corticosteroids. In what stress phase are these animals?
1. Terminal
2. Erectile
3. Exhaustion
4. Shock phase
5. Antishock phase
72. A 48 y.o. patient was admitted to the hospital with complaints about weakness, irritability, sleep disturbance. Objectively: skin and scleras are yellow. In blood: conjugated bilirubin, cholalemia. Feces are acholic. Urine is of dark colour (bilirubin). What jaundice is it?
1. Gilbert's syndrome
2. Parenchymatous
3. Hemolytic
4. Mechanic
5. Crigler-Najjar syndrome
73. A 25 year old man has spent a long time in the sun under high air humidity. As a result of it his body temperature rose up to 39 C. What pathological process is it?
1. Hypothermia
2. Infectious fever
3. Hyperthermia
4. Burn disease
5. Noninfectious fever
74. After transfusion of 200 ml of blood a patient presented with body temperature rise up to 37,9oC. Which of the following substances is the most likely cause of temperature rise?
1. Interleukin-2
2. Interleukin-1
3. Tumour necrosis factor
4. Interleukin-3
5. Interleukin-4
75. In result of the damage of one of the Atomic Power Plant reacttor the run-out of radioelements happened. People in the increased radiation zone were radiated with approximately 250-300 r. They were immediately hospitalized. What changes in the blood count would be typical?
1. Anemia
2. Leukopenia
3. Thrombopenia
4. Neutropenia
5. Lymphopenia
76. A patient is followed up in an endocrinological dispensary on account of hyperthyreosis. Weight loss, tachycardia, finger tremor are accompanied by hypoxia symptoms – headache, fatigue, eye flicker. What mechanism of thyroid hormones action underlies the development of hypoxia?
1. Disjunction, oxydation and phosphorilation
2. Inhibition of respiratory ferment synthesis
3. Competitive inhibition of respiratory ferments
4. Specific binding of active centres of respiratory ferments
5. Intensification of respiratory ferment synthesis
77. Patient with diabetes didn’t get insulin injection in time that caused hyperglycemic coma (glucose in the blood 50mmol/L). What mechanism is prevalent in the development of the coma?
1. Hyponatremia
2. Hyperosmia
3. Hypokaliemia
4. Hypoxia
5. Acidosis
78. A patient who suffers from pneumonia has high body temperature. What biologically active substance plays the leading part in origin of this phenomenon?
1. Bradykinin
2. Histamine
3. Leukotrienes
4. Interleukin-I
5. Serotonin
79. A 68-year-old woman can’t move by the upper and lower right extremities due to insult. Muscle tone of these extremities and reflexes are increased. There are pathological reflexes. What form of the paralysis is it?
1. Dissociation
2. Paraplegia
3. Hemiplegia
4. Monoplegia
5. Tetraplegia
80. 24 hours after appendectomy blood of a patient presents neutrophilic leukocytosis with regenerative shift. What is the most probable mechanism of leukocytosis development?
1. Amplification of leukopoiesis and decelerated emigration of leukocytes to the tissues
2. Decelerated leukocyte destruction
3. Deceleratied emigration of leukocytes to the tissues
4. Amplification of leukopoiesis
5. Redistribution of leukocytes in the organism
81. 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?
1. Traumatization of peripheral nerve
2. Psychical stress
3. Microcirculation disturbance
4. Infection
5. Tissue damage
82. Processes of repolarisation are disturbed in ventricular myocardium in examined person. It will cause amplitude abnormalities of configuration and duration of the wave:
1. R
2. Q
3. T
4. S
5. P
83. Two weeks after lacunar tonsillitis a 20-year-old man started complaining about general weakness, lower eyelid edemata. After examination the patient was diagnosed with acute glomerulonephritis. What are the most likely pathological changes in the urine formula?
1. Cylindruria
2. Presence of fresh erythrocytes
3. Pyuria
4. Proteinuria
5. Natriuria
84. After a serious psycho-emotional stress a 45-year-old patient suddenly felt constricting heart pain irradiating to the left arm, neck and left scapula. His face turned pale, the cold sweat stood out on it. The pain attack was stopped with nitroglycerine. What process has developed in this patient?
1. Stroke
2. Psychogenic shock
3. Myocardial infarction
4. Stenocardia
5. Stomach ulcer perforation
85. Person has stable HR, not more than 40 bpm. What is the pacemaker of the heart rhythm in this person?
1. Branches of His' bundle
2. Sinoatrial node
3. Purkinye' fibers
4. Atrioventricular node
5. His' bundle
86. A girl is diagnosed with adrenogenital syndrome (pseudohermaphroditism). This pathology was caused by hypersecretion of the following adrenal hormone:
1. Aldosterone
2. Estrogen
3. Androgen
4. Cortisol
5. Adrenalin
87. An experimental rat with extremity paralysis has no tendon and cutaneous reflexes, muscle tone is decreased, but muscles of the affected extremity maintain their ability to react with excitation to the direct action of continious current. What type of paralysis is it?
1. Flaccid peripheral
2. Spastic peripheral
3. Flaccid central
4. Spastic central
5. Extrapyramidal
88. A patient has extrasystole. ECG shows no P wave, QRS complex is deformed, there is a full compensatory pause. What extrasystoles are these?
1. Atrial
2. Atrioventricular
3. Ventricular
4. Sinus
89. Necrosis focus appeared in the area of hyperemia and skin edema in few hours after burn. What mechanism strengthens destructive events in the inflammation area?
1. Primary alteration
2. Emigration of lymphocytes
3. Secondary alteration
4. Proliferation of fibroblasts
5. Diapedesis of erythrocytes
90. A patient staying in the pulmonological department was diagnosed with pulmonary emphysema accompanied by reduced elasticity of pulmonary tissue. What type of respiration is observed?
1. Superficial respiration
2. Inspiratory dyspnea
3. Expiratory dyspnea
4. Infrequent respiration
5. Periodic respiration
91. A disaster fighter at a nuclear power plant developed hemorrhagic syndrome on the background of acute radiation disease. What is the most important factor of syndrome pathogenesis?
1. Increased activity of anticoagulative system factors
2. Increased activity of fibrinolysis factors
3. Thrombocytopenia
4. Vascular wall damage
5. Decreased activity of coagulative factors
92. A 56 year old patient came to a hospital with complaints about general weakness, tongue pain and burning, sensation of limb numbness. In the past he underwent resection of forestomach. In blood: Hb- 80 g/l; erythrocytes – 2,0*1012/l; colour index – 1,2, leukocytes – 3,5*109/l. What anemia type is it?
1. Hemolytic
2. Iron-deficient
3. B12-folate deficient
4. Posthemorrhagic
5. Aplastic
93. A 5 year old child is ill with measles. Blood analysis revealed increase of total number of leukocytes up to 13*109/l. Leukogram: basophils – 0, eosinophils – 1, myelocytes – 0, juvenile neutrophils – 0, band neutrophils – 2, segmented neutrophils – 41, lymphocytes – 28, monocytes – 28. Name this phenomenon:
1. Agranulocytosis
2. Lymphocytosis
3. Monocytosis
4. Eosinopenia
5. Neutropenia
94. A patient ill with enteritis accompanied by massive diarrhea has low water rate in the extracellular space, high water rate inside the cells and low blood osmolarity. What is such disturbance of water-electrolytic metabolism called?
1. Hyperosmolar hypohydration
2. Hypo-osmolar hyperhydration
3. Hypo-osmolar hypohydration
4. Hyperosmolar hyperhydration
5. Osmolar hypohydration
95. A patient ill with essential arterial hypertension had a hypertensic crisis that resulted in an attack of cardiac asthma. What is the leading mechanism of cardiac insufficiency in this case?
1. Absolute coronary insufficiency
2. Heart overload caused by increased blood volume
3. Heart overload caused by high pressure
4. Myocardium damage
5. Blood supply disturbance
96. While playing volleyball a sportsman made a jump and landed on the outside edge of his foot. He felt acute pain in the talocrural joint, active movements are limited, passive movements are unlimited but painful. A bit later there appeared a swelling in the area of external ankle, the skin became red and warm. What type of peripheral circulation disturbance is the case?
1. Embolism
2. Venous hyperemia
3. Stasis
4. Arterial hyperemia
5. Thrombosis
97. 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:
1. Neurotonic
2. Neuroparalytic
3. Metabolic
4. Reactive
5. Functional
98. Parents of a 3 year old child have been giving him antibiotics with purpose of preventing enteric infections for a long time. A month later the child’s condition changed for the worse. Blood examination revealed apparent leukopenia and granulocytopenia. What is the most probable mechanism of blood changes?
1. Myelotoxic
2. Autoimmune
3. Hemolytic
4. Redistributive
5. Age-specific
99. 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?
1. Complete
2. Proteinic
3. Incomplete
4. Water
5. Absolute
100. A patient being treated for viral hepatitis type B got symptoms of hepatic insufficiency. What blood changes indicative of protein metabolism disorder will be observed in this case?
1. Absolute hyperalbuminemia
2. Absolute hypoalbuminemia
3. Absolute hyperfibrinogenemia
4. Proteinic blood composition is unchanged
5. Absolute hyperglobulinemia
101. Inflammatory processes cause synthesis of protein of acute phase in an organism. What substances stumulate their synthesis?
1. Immunoglobulins
2. Biogenic amins
3. Angiotensin
4. Interferons
5. Interleukin-1
102. Examination of a child who frequently suffers from infectious diseases revealed that IgG concentration in blood serum was 10 times less than normal, IgA and IgM concentration was also significantly reduced. Analysis showed also lack of B-lymphocytes and plasmocytes. What disease are these symptoms typical for?
1. Swiss-type agammaglobulinemia
2. Dysimmunoglobulinemia
3. Bruton's disease
4. Di George syndrome
5. Louis-Bar syndrome
103. From the group of children who were eating sweet sappy watermelon two kids developed the signs of poisoning: rapid weakness, dizziness, headache, vomiting, edema, tachycardia, cyanosis of mouth, ears, tips of the fingers cyanosis. High concentration of nitrates was detected. What is the leading mechanism of the pathogenesis of the poisoning in the two children?
1. Insufficiency of met-Hb-reductase
2. Insufficiency of superoxiddismutase
3. Insufficiency glutathione pyroxidase
4. Block cytochrome oxidase
5. Insufficiency of catalase
104. A patient with tissue trauma was taken a blood sample for the determination of blood clotting parameters. Specify the right sequence of extrinsic pathway activation.
1. III – VIII: TF – Xa
2. III – IV – Xa
3. IV – VIII: TF – Xa
4. IV – VIIa – Xa
5. III – VIIa – Xa
105. 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?
1. Disorder of lymph outflow
2. Drop of oncotic pessure in capillaries
3. Increase of capillary permeability
4. Rise of hydrostatic pressure in venules
5. Positive water balance
106. A couple came for medical genetic counseling. The man has hemophilia, the woman is healthy and there were no cases of hemophilia in her family. What is the risk of having a sick child in this family?
1. 100%
2. 25%
3. 75%
4. 0
5. 50%
107. A 62-year-old patient was admitted to the neurological department due to cerebral haemorrage. Condition is grave. There is observed progression of deepness and frequency of breath that turnes into reduction to apnoea,and the cycle repeates. What respiration type has developed in the patient?
1. Kussmaul respiration
2. Cheyne-Stockes respiration
3. Apneustic respiration
4. Biot's respiration
5. Gasping respiration
108. As a result of increased permeability of the erythrocyte membrane in a patient with microspherocytic anaemia (Minkowsky-Shauffard disease) cells receive sodium ions and water. Erythrocytes take form of spherocytes and can be easily broken down. What is the leading mechanism of erythrocyte damage in this case?
1. Calcium
2. Acidotic
3. Electrolytic osmotic
4. Protein
5. Nucleic
109. 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:
1. Activation of fibrinolytic system
2. Reduced number of thrombocytes
3. Insufficient fibrin production
4. Activation of anticoagulation system
5. Activation of Christmas factor
110. A 25 year old Palestinian woman complains of weakness, dizziness, dyspnea. In anamnesis: periodically exacerbating anemia. In blood: Hb – 60 g/l, erythrocytes – 2,5*1012/l, reticulocytes – 35o/oo, anisocytosis and poikilocytosis of erythrocytes, a lot of target cells and polychromatophils. What type of anemia is it?
1. Sickle-cell anemia
2. Minkowsky-Shauffard disease
3. Addison-Biermer disease
4. Glucose 6-phosphate dehydrogenase-deficient anemia
5. Thalassemia
111. A patient with the symptoms of acute alcoholic poisoning was brought to the hospital. What carbohydrates metabolism changes are typical for this condition?
1. The gluconeogenesis velocity in liver is decreased
2. The gluconeogenesis is increased in liver
3. The anaerobic breakage of glucose is increased in muscles
4. The breakage of glycogen is increased in liver
5. The anaerobic glucose metabolism predominates in muscles
112. Having helped to eliminate consequences of a failure at a nuclear power plant, a worker got an irradiation doze of 500 roentgen. He complains of headache, nausea, dizziness. What changes in leukocytes quantity can be expected 10 hours after irradiation?
1. Lymphocytosis
2. Neutrophilic leukocytosis
3. Leukopenia
4. Leukemia
5. Agranulocytosis
113. A 56 y.o. patient has been suffering from thyreotoxicosis for a long time. What type of hypoxia can be developed?
1. Circulatory
2. Hemic
3. Respiratory
4. Tissue
5. Mixed
114. A driver who got a trauma in a road accident and is shocked has reduction of daily urinary output down to 300 ml. What is the main pathogenetic factor of such diuresis change?
1. Drop of arterial pressure
2. Secondary hyperaldosteronism
3. Decreased number of functioning glomerules
4. Drop of oncotic blood pressure
5. Increased vascular permeability
115. A patient was stung by a bee. Examination revealed that his left hand was hot, pink, edematic, there was a big red blister on the site of sting. What is the leading mechanism of edema development?
1. Increased vessel permeability
2. Reduced vessel filling
3. Injury of vessels caused by the sting
4. Drop of osmotic pressure in tissue
5. Drop of oncotic pressure in tissue
116. A patient with skin mycosis has disorder of cellular immunity. The most typical characteristic of it is reduction of the following index:
1. Immunoglobulin E
2. B-lymphocytes
3. Immunoglobulin G
4. Plasmocytes
5. T-lymphocytes
117. Transmural myocardial infarction in the patient was complicated with progressive acute left ventricle insufficiency. What is the most typical for this state?
1. Cyanosis
2. Edema of the extremities
3. Arterial hypertension
4. Edema of the lungs
5. Ascites
118. To prevent the transplant rejection after organ transplantation it is required to administer hormonotherapy for the purpose of immunosuppression. What hormones are used for this purpose?
1. Mineralocorticoids
2. Catecholamines
3. Glucocorticoids
4. Sexual hormones
5. Thyroid
119. A 57-year-old patient was admitted to the gastroenterological department with suspicion on Zollinger-Ellison syndrom because of rapid increase of gastrin level in the blood serum. What disorder of the secretory function of the stomach is the most likely?
1. Achylia
2. Hyperacid hyposecretion
3. Hyperacid hypersecretion
4. Hypoacid hyposecretion
5. Hypoacid hypersecretion
120. 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?
1. Obstructive
2. Throracodiaphragmatic
3. Restrictive
4. Central
5. Neuromuscular
121. A healthy woman has three sons affected by color blindness who were born after her two marriages. Children both of her husbands are healthy. What is the most possible pattern of inheritance of this disease?
1. Y-linked
2. Autosomal recessive
3. X-linked dominant
4. Autosomal dominant
5. X-linked recessive
122. A 23 y.o. patient complains of weakness, temperature rise up to 38-40oC. Objectively: liver and spleen are enlarged. Hemogram: Hb- 100 g/l, 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:
1. Acute erythromyelosis
2. Acute lymphoblastic leukosis
3. Acute myeloblastic leukosis
4. Chronic myeloleukosis
5. Undifferentiated leukosis
123. ECG of a patient shows such alterations: P-wave is normal, P-Q-interval is short, ventricular QRST complex is wide, R-wave is double-peak or two-phase. What form of arrhythmia is it?
1. Frederick's syndrome (atrial flutter)
2. WPW syndrome (Wolff-Parkinson-White)
3. Atrioventricular block
4. Ciliary arrhythmia
5. Ventricular fibrillation
124. A patient presents with icteritiousness of skin, scleras and mucous membranes. Blood plasma the total bilirubin is increased, stercobilin is increased in feces, urobilin is increased in urine. What type of jaundice is it?
1. Gilbert's disease
2. Obturational
3. Parenchymatous
4. Cholestatic
5. Haemolytic
125. A patient was admitted to the infectious department. His symptoms: dry skin, decreased skin turgor, rice-water stool. The patient was diagnosed with cholera. What disorder of water-electrolytic balance is most often observed in this disease?
1. Iso-osmotic hypohydration
2. Hyperosmotic hyperhydration
3. Hypoosmotic hyperhydration
4. Hypoosmotic hypohydration
5. Hyperosmotic hypohydration
126. Examination of a 12 year old boy with developmental lag revealed achondroplasia: disproportional constitution with evident shortening of upper and lower limbs as a result of growth disorder of epiphyseal cartilages of long tubal bones. This disease is:
1. Inherited, sex-linked
2. Inherited, dominant
3. Inherited, recessive
4. Congenital
5. Acquired
127. A 27- year-old woman has dropped penicillin containing eye drops. In few minutes there appeared feeling of itching, burning of the skin, lips and eyelids edema, whistling cough, decreasing of BP. What antibodies take part in the development of this allergic reaction?
1. IgM and IgG
2. IgA and IgM
3. IgE and IgG
4. IgM and IgD
5. IgG and IgD
128. A patient caught a cold after which there appeared facial expression disorder. He cannot close his eyes, raise his eyebrows, bare his teeth. What nerve is damaged?
1. Infraorbital
2. Trigeminus
3. Facial
4. Vagus
5. Glossopharyngeal
129. A woman who was infected with toxoplasmosis during the pregnancy has a child with multiple congenital defects.This is a result of:
1. Teratogenesis
2. Recombination
3. Chemical mutogenesis
4. Cancerogenesis
5. Biological mutogenesis
130. A patient with obliterating atherosclerosis underwent sympathectomy of femoral artery in the region of femoral trigone. What type of arterial hyperemia was induced by the operation?
1. Neuroparalytic
2. Functional
3. Reactive
4. Metabolic
5. Neurotonic
131. An animal with aortic valve insufficiency got hypertrophy of its left heart ventricle. Some of its parts have local contractures. What substance accumulated in the myocardiocytes caused these contractures?
1. Sodium
2. Lactic acid
3. Carbon dioxide
4. Calcium
5. Potassium
132. A 50-year-old patient complains of thirst, drinking of a lot of water, marked polyuria. Blood glucose is 4,8 mmol/L, urine glucose and acetone bodies are absent, urine is colorless, specific gravity is 1,002-1,004. What is the cause of polyuria?
1. Insulin insufficiency
2. Thyrotoxicosis
3. Hypothyroidism
4. Vasopressin insufficiency
5. Aldosteronism
133. A 34 year old woman was diagnosed with hereditary microspherocytic hemolytic anemia (Minkowsky-Shauffard disease). What mechanism caused haemolysis of erythrocytes?
1. Enzymopathy
2. Membranopathy
3. Hemoglobinopathy
4. Autoimmune disorder
5. Bone marrow hypoploasia
134. A group of mountain climbers went through the blood analysis at the height of 3000 m. It revealed decrease of HCO3 to 15 micromole/l (standard is 22-26 micromole/l). What is the mechanism of HCO3 decrease?
1. Decrease of bicarbonate reabsorption in kidneys
2. Hypoventilation
3. Intensification of acidogenesis
4. Decrease of ammoniogenesis
5. Hyperventilation
135. A tissue sample of benign tumor was studied under the electron microscope. A lot of small (15-20 nm) spherical bodies, consisting of 2 unequal subunits were detected. These are:
1. Microtubules
2. Ribosomes
3. Golgi complex
4. Smooth endoplasmic reticulum
5. Mitochondria
136. Daltonism was diagnosed in a 7-year-old boy while prophylactic medical examination. Parents are healthy, color vision is normal. Grandfather from the mother’s side has the same disorder. What is the type of inheriting of this anomaly?
1. Recessive, connected with sex
2. Incomplete domination
3. Dominant, connected with sex
4. Autosomal-recessive
5. Autosomal-dominant
137. There are several groups of molecular mechanisms playing important part in pathogenesis of insult to cells which contributes to the pathology development. What processes are stimulated by proteinic damage mechanisms?
1. Acidosis
2. Lipid peroxidation
3. Enzyme inhibition
4. Osmotic membrane distension
5. Phospholipase activation
138. An unconscious young man with signs of morphine poisoning entered admission office. His respiration is shallow and infrequent which is caused by inhibition of respiratory centre. What type of respiratory failure is it?
1. Ventilative obstructive
2. Ventilative restrictive
3. Perfusive
4. Ventilative dysregulatory
5. Diffusive
139. A 15 year old girl has pale skin, glossitis, gingivitis. Blood count: erythrocytes – 3,3*1012/l, hemoglobin – 70 g/l, colour index – 0,5. Examination of blood smear revealed hypochromia, microcytosis, poikilocytosis. What type of anemia is it?
1. Sickle-cell
2. B12-folic acid- deficient
3. Thalassemia
4. Iron-deficient
5. Hemolytic
140. 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?
1. Hypoplasia of thymus
2. Composite immunedefficiency
3. Bruton's hypogammaglobulinemia
4. Hereditary immundeficiency of the complement system
5. Turner's syndrome
141. Periodic renal colics attackes are observed in the woman with primery hyperparathyroidizm. Ultrasonic examination revealed small stones in the kidneys. What is the cause of the formation of the stones?
1. Hyperkalemia
2. Hyperphosphatemia
3. Hyperuricemia
4. Hypercholesterinemia
5. Hypercalcemia
142. 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?
1. Reduction of functioning nephron number
2. Reduction of renal blood flow
3. Damage of glomerular filter
4. Rise of pressure of tubular fluid
5. Renal artery embolism