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MINISTRY OF PUBLIC HEALTH OF UKRAINE

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Test items for licensing examination

Krok 1
MEDICINE
General Instruction
Every one of these numbered questions or unfinished statements in
this chapter corresponds to answers or statements endings. Choose the
answer (finished statements) that fits best and fill in the circle with the
corresponding Latin letter on the answer sheet.
ББК 54.1я73
УДК 61

Authors of items: Androshchuk O.V., Artysh Yu.P., Basiy R.V., Berezniak M.A., Bielan S.M.,
Bilenky S.A., Bohatyrova O.V., Boikiv D.P., Bondarchuk T.I., Cherkas L.P., Chernovska N.V.,
Danylchuk V.V., Deineka S.Ye., Demianenko I.A., Dron L.A., Dzhalilova E.A., Fartushok N.V.,
Fedoniuk L.Ya., Filchukov D.O., Haidash I.S., Hanulich T.V., Harets V.I., Harhin V.V.,
Herasymovych E.V., Hladchuk A.B., Hliebova L.Yu., Holdobina O.V., Hopkalov V.H., Hryhorenko V.K.,
Hryhorieva N.P., Hrytsenko L.Z., Hurmak I.S., Huryk Z.Ya., Husarenko V.D., Ivanochko V.M.,
Ivanova S.A., Ivniev B.B., Kachmarska M.O., Kaptiukh R.P., Khmara T.V., Kiriakulov H.S., Klishch I.M.,
Klopotsky H.A., Koldunov V.V., Kolesnikova S.V., Kolot E.H., Kononenko O.V., Korolenko H.S.,
Kovalenko O.Yu., Kratenko H.S., Kravets D.S., Kukurychkin Ye.R., Kulynych H.B., Kurinna S.S.,
Kutsyk R.V., Kuzyk I.Ya., Kyrychok L.T., Lahoda N.M., Levandovsky V.B., Linchevska L.P., Luchko I.M.,
Lukianchuk V.D., Luzin V.I., Lychyk H.Z., Makats Ye.F., Makovetsky O.V., Maksymchuk T.P.,
Malyshev S.L., Manzhelei O.S., Matveiko L.M., Melnyk O.I., Meshchyshen I.F., Mikhieieva N.H.,
Mishchenko A.F., Mitriaiev A.B., Mruh V.M., Mykhailiuk I.O., Nakonechna O.A., Nikolenko O.H.,
Obraztsova O.H., Oleshchuk O.M., Ostrivka O.I., Ovchynnikov S.O., Pavlova O.O., Pobihun A.A.,
Poeta O.M., Protsak T.V., Romanenko O.V., Rubina L.M., Rukavyshnikova S.M., Rusalov V.L., Saiuk N.P.,
Salata O.V., Salmanova O.M., Samoilovych I.M., Savchenko N.V., Savelieva O.V., Semeniuk T.M.,
Serdiuchenko I.Ya., Shanko V.M., Shapoval O.M., Shavaran S.S., Shcherbak L.F., Shemonaieva K.F.,
Sheremeta L.M., Shevchenko O.M., Shevtsova A.I., Shliakhovenko O.O., Shnaiderman O.Yu., Shults N.V.,
Shutak V.I., Siedov V.I., Sikoryn Ya.Ya., Slobodianiuk T.M., Smirnov S.M., Sokolenko V.M.,
Suprunov K.V., Tarasenko T.V., Tarasova K.V., Terekhovska O.I., Tkachenko V.L., Tkachuk O.V.,
Tsehelsky A.A., Tsivkovsky A.O., Tumansky V.O., Tusyk O.T., Tymofiychuk I.R., Tymoshenko S.H.,
Uhryn O.M., Uzun H.V., Vashchuk A.A., Vasylchenko O.A., Vernyhorodsky S.V., Verkhova O.O.,
Vinnikov Yu.M., Voitsekhovsky V.H., Volobuiev M.A., Vorobets Z.D., Voronych-Semchenko N.M.,
Vovk I.M., Yakubyshyna L.V., Yasinsky V.I., Yuzyfyshyn M.V., Zadorozhny S.P., Zakharchuk O.I.,
Zazhaieva V.V., Zelenina N.M., Zhulinsky V.O., Zhurakivska O.Ya., Ziatkovska N.Ye., Zinchenko O.V.,
Zinchenko S.A., Zlenko O.T. and Committees of professional expertise.

Item reviewers. Ananko S.Ya., Basy R.V., Bilash S.M., Deineka S. Ye., Deltsova O.I., Demydova K.Yu.,
Fomina L.V., Hahrin V.V., Haidash I.S., Holovatiuk O.L., Horhol N.I., Kava T.V., Koldunov V.V.,
Korolenko H.S., Kovalchuk L.Ye., Linchevska L.P., Maly K.D., Melnikova O.V., Melnyk N.O.,
Neporada K.S., Nikolenko O. H., Ovchynnikov S. O., Prokofieva N. V., Pushkar M. S., Pykaliuk V. S.,
Salata O.V., Shevelenkova A.V., Shumeiko O.V., Sikora V.Z., Skliarov O.Ya., Skorobohatova Z.M.,
Synytska A.M., Tananakina T.P., Teleshova O.V., Tertyshny S.I., Tkachuk S.S., Trzhetsynsky S.D,
Vinnykov Yu.M., Vorobets Z.D., Yoltukhivsky M.V., Zelenina N.M., Zhadinsky M.V., Zhylinsky V.O.,
Zinkovska L.Ya.

The book includes test items for use at licensing integrated examination “Krok 1. Medicine” and
further use in teaching.

The book has been developed for students of medical, pediatric and medical-and-prophylactic
faculties and academic staff of higher medical educational establishments.

Approved by Ministry of Public Health of Ukraine as examination and teaching


publication based on expert conclusions (Orders of MPH of Ukraine of 14.08.1998 №251,
of 27.12.1999 №303, of 18.06.2002 №221, of 16.10.2002 №374, of 16.04.2003 №239, of
29.05.2003 №233).

© Copyright Testing Board.


Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 1

1. A 35-year-old man has been deli-


vered into a surgical ward with a suppurati- A. Isometric
ng wound in the neck, anterior to trachea B. Isotonic
(previsceral space). If a surgical operation C. Auxotonic
is not performed urgently, there is a risk of D. Phasic
infection spreading to: E. Single

A. Thoracic cavity - anterior mediastinum 7. A patient suffers from high fever,


B. Thoracic cavity - middle mediastinum apnoea, pain in the thorax on the right.
C. Thoracic cavity - posterior mediastinum Pleurocentesis yielded 700 ml of yellow-
D. Retrovisceral space green viscous liquid. Make the diagnosis:
E. Interaponeurotic suprasternal space
A. Pleural empyema
2. Characteristic sign of glycogenosis is B. Bronchial pneumonia
muscle pain during physical work. Blood C. Serous pleurisy
examination usually reveals hypoglycemia. D. Hemorrhagic pleurisy
This pathology is caused by congenital defi- E. Pleural carcinomatosis
ciency of the following enzyme:
8. A patient suffers from disrupted patency
A. Glycogen phosphorylase of the airways at the level of small
B. Glucose 6-phosphate dehydrogenase and medium-sized bronchial tubes. What
C. α-amylase changes of acid-base balance can occur in
D. γ -amylase the patient?
E. Lysosomal glycosidase
A. Respiratory acidosis
3. Histologic specimen of a kidney B. Respiratory alkalosis
demonstrates cells closely adjoined to the C. Metabolic acidosis
renal corpuscle in the distal convoluted D. Metabolic alkalosis
tubule. Their basement membrane is E. Acid-base balance remains unchanged
extremely thin and has no folds. These cells
9. Upon toxic damage of hepatic cells
sense the changes in sodium content of uri-
ne and influence renin secretion occurring resulting in disruption of liver function the
in juxtaglomerular cells. Name these cells: patient developed edemas. What changes of
blood plasma are the main cause of edema
A. Macula densa cells development?
B. Juxtaglomerular cells
C. Mesangial cells A. Decrease of albumin content
B. Increase of globulin conten
D. Podocytes
E. Glomerular capillary endothelial cells C. Decrease of fibrinogen conten
D. Increase of albumin conten
4. Bacteriological analysis of tap water has E. Decrease of globulin conten
resulted in the following: total bacterial
count in 1,0 ml of water is 80, coli index 10. A 6-year-old child with suspected acti-
is 3. What would be the conclusion? ve tuberculous process has undergone di-
agnostic Mantoux test. What immunobi-
A. The water is safe for consumption ological preparation was injected?
B. The water quality is doubtful
C. The water quality is extremely doubtful A. Tuberculin
B. BCG vaccine
D. The water is polluted
E. The water is extremely polluted C. DTP vaccine
D. Tularinum
5. The process of metabolism in the human E. Td vaccine
body produces active forms of oxygen,
including superoxide anion radical −
11. A 15-year-old boy has been diagnosed
2. with acute viral hepatitis. What blood value
This anion is inactivated by the following should be determined to confirm acute
enzyme: affection of hepatic cells?
A. Superoxide dismutase A. Aminotransferase activity (AST, ALT)
B. Catalase B. Unconjugated and conjugated bilirubin
C. Peroxidase content
D. Glutathione peroxidase C. Erythrocytes sedimentation rate (ESR)
E. Glutathione reductase D. Cholesterol content
6. What kind of muscle contraction occurs E. Protein fraction content
in an upper limb during an attempt to lift a 12. A 53-year-old man is diagnosed with
load beyond one’s strength?
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 2

Paget’s disease. Concentration of oxyproli- food poisoning. Microscopy of the culture


ne in daily urine is sharply increased, which inoculated in Kitt-Tarozzi medium revealed
primarily means intensified disintegration microorganisms resembling a tennis racket.
of: What diagnosis can be made?
A. Collagen A. Botulism
B. Keratin B. Salmonellosis
C. Albumin C. Cholera
D. Hemoglobin D. Dysentery
E. Fibrinogen E. Typhoid fever
13. When taking exams students often have 18. An infant has been diagnosed with mi-
dry mouth. The mechanism that causes this crocephaly. Doctors suspect that this brain
state results from the following reflexes: disorder developed due to the fact that
the mother had been taking actinomycin D
A. Conditioned sympathetic during her pregnancy. What germinal layers
B. Unconditioned parasympathetic have been affected by this teratogen?
C. Conditioned parasympathetic
D. Unconditioned sympathetic A. Ectoderm
E. Unconditioned peripheral B. Entoderm
C. Mesoderm
14. A patient has hoarseness of voice. Duri- D. Entoderm and mesoderm
ng laryngoscopy a gray-white larynx tumor E. All germinal layers
with papillary surface has been detected.
Microscopic investigation has shown the 19. A patient demonstrates sharp decrease
following: growth of connective tissue of pulmonary surfactant activity. This condi-
covered with multilayer, strongly kerati- tion can result in:
nized pavement epithelium, no cellular
atypia. What is the most likely diagnosis? A. Alveolar tendency to recede
B. Decreased airways resistance
A. Papilloma C. Decresed work of expiratory muscles
B. Fibroma D. Increased pulmonary ventilation
C. Polyp E. Hyperoxemia
D. Angioma
E. Angiofibroma 20. A patient is diagnosed with diabetic
coma. Blood sugar is 18,44 mmol/l. What
15. During autopsy approximately 2,0 liters glucose-regulating drug should be prescri-
of pus have been found in the abdominal bed in the given case?
cavity of the body. Peritoneum is dull and
of grayish shade, serous tunic of intestines A. Rapid-acting insulin
has grayish-colored coating that is easily B. Intermediate-acting insulin
removable. Specify the most likely type of C. Long-acting insulin
peritonitis in the patient: D. Biguanide
E. Sulfonylurea derivative
A. Fibrinopurulent peritonitis
B. Hemorrhagic peritonitis 21. Initial inoculation of water in 1%
C. Serous peritonitis peptone water resulted in growth of a thin
D. Tuberculous peritonitis film on the medium surface in 6 hours.
E. - Such cultural properties are characteristic
of causative agent of the following disesase:
16. Autopsy of a body revealed bone
marrow hyperplasia of tubular and flat A. Cholera
bones (pyoid marrow), splenomegaly (6 kg) B. Plague
and hepatomegaly (5 kg), enlargement of C. Tuberculosis
all lymph node groups. What disease are D. Dysentery
the identified changes typical of? E. Pseudotuberculosis

A. Chronic myelogenous leukemia 22. An infant born prematurely 2 days ago


B. Chronic lymphocytic leukemia presents with yellow coloring of skin and
C. Multiple myeloma mucosa. Such a condition in the infant
D. Polycythemia vera is caused by temporary deficiency of the
E. Hodgkin’s disease following enzyme:

17. A bacteriological laboratory has been


investigating a sample of homemade dri-
ed fish that was the cause of severe
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 3

A. UDP-glucuronyl transferase A. Bence Jones protein


B. Aminolevulinate synthase B. Bilirubin
C. Heme oxygenase C. Hemoglobin
D. Heme synthetase D. Ceruloplasmin
E. Biliverdine reductase E. Antitrypsin
23. It has been determined that one of a 28. A patient complaining of dizziness, thi-
pesticide components is sodium arsenate rst, difficult swallowing, and impaired visi-
that blocks lipoic acid. Enzyme activity can on of close objects has addressed a doctor.
be impaired by this pesticide. Name this Objectively: respiratory rate is increased,
enzyme: pupils are dilated, general agitation, talkati-
veness, though the speech is indistinct. BP is
A. Pyruvate dehydrogenase complex 110/70 mm Hg, heart rate is 110/min. Given
B. Microsomal oxidation symptoms can indicate overdosage of the
C. Methemoglobin reductase following drug:
D. Glutathione peroxidase
E. Glutathione reductase A. Atropine
B. Morphine
24. A 50-year-old woman diagnosed with C. Ephedrine
cardiac infarction has been delivered into D. Aminazine
an intensive care ward. What enzyme will E. Caffeine
be the most active during the first two days?
29. A dry-cleaner’s worker has been found
A. Aspartate aminotransferase to have hepatic steatosis. This pathology can
B. Alanine aminotransferase be caused by disruption of synthesis of the
C. Alanine aminopeptidase following substance:
D. LDH4
E. LDH5 A. Phosphatidylcholine
B. Tristearin
25. Stool culture test of a 6-month-old C. Urea
bottlefed baby revealed a strain of intesti- D. Phosphatidic acid
nal rod-shaped bacteria of antigen structure E. Cholic acid
0-111. What diagnosis can be made?
30. A 35-year-old man with peptic ulcer di-
A. Colienteritis sease has undergone antrectomy. After the
B. Gastroenteritis surgery secretion of the following gastro-
C. Choleriform disease intestinal hormone will be disrupted the
D. Food poisoning most:
E. Dysentery-like disease
A. Gastrin
26. Parents of a sick 5-year-old girl vi- B. Histamine
sited a genetic consultation. Karyotype C. Secretin
investigation revealed 46 chromosomes. D. Cholecystokinin
One chromosome of the 15th pair was E. Neurotensin
abnormally long, having a part of the
chromosome belonging to the 21st pair 31. A 16-year-old adolescent is di-
attached to it. What mutation occurred in agnosed with hereditary UDP (uridine di-
this girl? phosphate) glucuronyltransferase defici-
ency. Laboratory tests revealed hyperbi-
A. Translocation lirubinemia caused mostly by increased
B. Deletion blood content of the following substance:
C. Inversion
D. Deficiency A. Unconjugated bilirubin
E. Duplication B. Conjugated bilirubin
C. Urobilinogen
27. A patient consulted a doctor with D. Stercobilinogen
complaints of dyspnea occurring after E. Biliverdine
physical exertion. Physical examination
revealed anemia, paraprotein was detected 32. A 60-year-old patient with a long hi-
among gamma globulins. What value should story of atherosclerosis and a previous
be determined in the patient’s urine to myocardial infarction developed an attack
confirm the diagnosis of myeloma? of retrosternal pain. 3 days later the patient
was hospitalized and then died of progressi-
ve cardiovascular insufficiency. During
autopsy a white fibrous depressed area
about 3 cm in diameter with clear margi-
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 4

ns was found within the area of posterior A. Tuberculosis


wall of the left ventricle and interventricular B. Hodgkin’s disease
septum. The dissector considered these C. Actinomycosis
changes to be: D. Tumor metastasis
E. Syphilis
A. Focal cardiosclerosis
B. Myocardial ischemia 37. Sex chromatin was detected during
C. Myocardial infarction examination of a man’s buccal epitheli-
D. Myocarditis um. It is characteristic of the following
E. Myocardial degeneration chromosome disease:
33. A patient with hypertension has A. Klinefelter’s syndrome
developed headache, tinnitus, vomiting, hi- B. Down’s disease
gh BP up to 220/160 mm Hg. On exami- C. Turner’s syndrome
nation: facial asymmetry on the right, voli- D. Triple X syndrome
tional mobility is absent, increased tendon E. Hypophosphatemic rickets
reflexes and muscle tone of extremities on
the right. What motor disorder of nervous 38. A patient, having suffered a thermal
system occurred in this case? burn, developed painful boils filled with
turbid liquid in the skin. What morphologi-
A. Hemiplegia cal type of inflammation has developed in
B. Paraplegia the patient?
C. Tetraplegia
D. Hyperkinesis A. Serous
E. Monoplegia B. Proliferative
C. Croupous
34. A 7-year-old child in the state of allergic D. Granulomatous
shock caused by a bee sting has been E. Diphtheritic
delivered into an emergency ward. High
concentration of histamine was observed 39. Autopsy of a man with tuberculosis
in blood. Production of this amine was the revealed a 3x2 cm large cavity in the superi-
result of the following reaction: or lobe of the right lung. The cavity was
interconnected with a bronchus, its wall
A. Decarboxylation was dense and consisted of three layers:
B. Hydroxylation the internal layer was pyogenic, the middle
C. Dehydrogenation layer was made of tuberculous granulation
D. Deaminization tissue and the external one was made of
E. Reduction connective tissue. What is the most likely
diagnosis?
35. A 26-year-old woman consulted a doctor
about having stool with white flat moving A. Fibrous cavernous tuberculosis
organisms resembling noodles. Laboratory B. Fibrous focal tuberculosis
analysis revealed proglottids with the C. Tuberculoma
following characteristics: long, narrow, wi- D. Acute focal tuberculosis
th a longitudinal channel of the uterus with E. Acute cavernous tuberculosis
17-35 lateral branches on each side. What
kind of intestinal parasite was found? 40. A 7-year-old child has acute onset of di-
sease: temperature rise up to 38o C , rhinitis,
A. Taeniarhynchus saginatus cough, lacrimation, and large-spot rash on
B. Taenia solium the skin. Pharyngeal mucosa is edematous,
C. Hymenolepis nana hyperemic, with whitish spots in the buccal
D. Diphyllobothrium latum area. What kind of inflammation caused the
E. Echinococcus granulosus changes in the buccal mucosa?
36. A man is 28 years old. Histological A. Catarrhal inflammation
investigation of the cervical lymph node B. Suppurative inflammation
revealed a change of its pattern due to proli- C. Fibrinous inflammation
feration of epithelioid, lymphoid cells and D. Hemorrhagic inflammation
macrophages with horseshoe-shaped nuclei. E. Serous inflammation
In the center of some cell clusters there
were non-structured light-pink areas with 41. After a traffic accident a 36-year-old
fragments of nuclei. What disease are these patient has developed muscle paralysis of
changes typical 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
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 5

damaged? (paroxysms), profuse sweating, headaches.


Examination revealed hypertension,
A. Right-hand side of the spinal cord hyperglycemia, increased basal metabolic
B. Motor cortex on the left rate, and tachycardia. These clinical
C. Left-hand side of the spinal cord presentations are typical of the following
D. Anterior horn of the spinal cord adrenal pathology:
E. Posterior horn of the spinal cord
A. Hyperfunction of the medulla
42. A 4-year-old child has been admitted to B. Hypofunction of the medulla
an orthopaedic department with displaced C. Hyperfunction of the adrenal cortex
shin fracture. Bone fragments reposition D. Hypofunction of the adrenal cortex
requires analgesia. What drug should be E. Primary aldosteronism
chosen?
47. During autopsy of a man, who di-
A. Promedol ed of acute transmural cardiac infarction,
B. Analgin the following has been detected on the
C. Morphine hydrochloride pericardium surface: fibrous whitish-brown
D. Panadol deposit connecting parietal and visceral
E. - pericardial layers. What kind of inflammati-
on occurred in the pericardium?
43. While examining foot blood supply a
doctor checks the pulsation of a large artery A. Croupous
running in the separate fibrous channel in B. Diphtheritic
front of articulatio talocruralis between the C. Serous
tendons of long extensor muscles of hallux D. Suppurative
and toes. What artery is it? E. Granulomatous
A. A. dorsalis pedis 48. A 12-year-old child developed nephri-
B. A. tibialis anterior tic syndrome (proteinuria, hematuria, cyli-
C. A. tarsea medialis ndruria) 2 weeks after a case of tonsilli-
D. A. tarsea lateralis tis, which is a sign of affected glomerular
E. A. fibularis basement membrane in the kidneys. What
44. Representatives of a certain human mechanism is the most likely to cause the
population can be characterized by basement membrane damage?
elongated body, height variability, decreased A. Immune complex
volume of muscle mass, increased length B. Granulomatous
of limbs, decreased size and volume of rib C. Antibody-mediated
cage, increased perspiration, decreased indi- D. Reaginic
ces of base metabolism and fat synthesis. E. Cytotoxic
What type of adaptive evolution is it?
49. A man arrived into a traumatologi-
A. Tropical cal department with a trauma of the right
B. Arctic shoulder. Examination revealed a displaced
C. Moderate humeral shaft fracture on the right in the
D. Intermediate middle one-third of the humerus; the pati-
E. Mountain ent cannot extend the fingers of his right
45. A 59-year-old woman has been hospiali- hand. What nerve is damaged?
zed in a surgical ward due to exacerbation of A. Radial
chronic osteomyelitis of the left shin. Blood B. Ulnar
test: leukocytes - 15, 0 · 109 /l. Leukogram: C. Median
myelocytes - 0%, metamyelocytes - D. Musculocutaneous
8%, stab neutrophils - 28%, segmented E. Axillary
neutrophils - 32%, lymphocytes - 29%,
monocytes - 3%. Such blood count would 50. Work in a mine is known to cause
be called: inhalation of large amounts of coal dust.
Inhaled coal dust can be detected in the
A. Regenerative left shift following pulmonary cells:
B. Right shift
C. Hyperregenerative left shift A. Alveolar macrophages
D. Degenerative left shift B. Respiratory epithelial cells
E. Regenerative-degenerative left shift C. Secretory epithelial cells
D. Capillary endothelial cells
46. A 41-year-old man has a hi- E. Pericapillary cells
story of recurrent attacks of heartbeats
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 6

51. What drug will be the most appropriate A. Malaria


for a patient suffering from chronic gastritis B. AIDS
with increased secretion? C. Epidemic typhus
D. Sepsis
A. Pirenzepine E. Hepatitis
B. Pancreatine
C. Pepsin 57. Human red blood cells contain no mi-
D. Aprotinin tochondria. What is the main pathway for
E. Chlorphentermine ATP production in these cells?
52. A 63-year-old man, who has been A. Anaerobic glycolysis
suffering from chronic fibrous-cavernous B. Aerobic glycolysis
pulmonary tuberculosis for 24 years, has C. Oxidative phosphorylation
been delivered to a nephrology department D. Creatine kinase reaction
with uremia. Intravital diagnostic test for E. Cyclase reaction
amyloid in the kidneys was positive. What
amyloidosis is it in this case? 58. Atria of an experimental animal were
superdistended with blood, which resulted
A. Secondary systemic in decreased reabsorption of Na+ and water
B. Primary systemic in renal tubules. This can be explained by
C. Localized (focal) the influence of the following factor on ki-
D. Hereditary (genetic) dneys:
E. Senile
A. Natriuretic hormone
53. Cells of a healthy liver actively synthesi- B. Aldosterone
ze glycogen and proteins. What organelles C. Renin
are the most developed in them? D. Angiotensin
E. Vasopressin
A. Granular and agranular endoplasmic
reticulum 59. A woman gave birth to a stillborn
B. Cell center baby with numerous malformations. What
C. Lysosomes protozoan disease could cause intrauterine
D. Mitochondria death?
E. Peroxisomes
A. Toxoplasmosis
54. Immune-enzyme assay has detected B. Leishmaniasis
HBs antigen in blood serum. What disease C. Malaria
is it characteristic of? D. Amebiasis
E. Lambliasis
A. Viral hepatitis type B
B. Viral hepatitis type A 60. A 42-year-old patient complains of
C. AIDS pain in the epigastral area, vomiting; vomit
D. Tuberculosis masses have the color of coffee-grounds;
E. Syphilis the patient suffers from melena. Anamnesis
records gastric ulcer disease. Blood formula:
55. A patient has been diagnosed with erythrocytes - 2, 8 · 1012 /l, leukocytes -
gonorrhea. As fluoroquinolones are the 8 · 109 /l, Hb- 90 g/l. What complication is
drugs of choce for treatment of gonorrhea it?
the patient should be prescribed:
A. Hemorrhage
A. Ciprofloxacin B. Penetration
B. Furazolidone C. Perforation
C. Fluorouracil D. Canceration
D. Sulfacarbamide (Urosulfanum) E. Pyloric stenosis
E. Cefazolin
61. A patient has been hospitalised
56. Autopsy of a Middle-Eastern woman, with provisional diagnosis of virus B
who had been suffering from wasting hepatitis. Serological reaction based on
fever for a long time, revealed enlarged complementation of antigen with antibody
blackened liver and spleen. Bone marrow chemically bound to peroxidase or alkaline
was hyperplastic and black-colored as well. phosphatase was used for disease diagnosti-
Cerebral cortex was smoky grey. What di- cs. What is the name of the applied serologi-
sease is it characteristic of? cal reaction?
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 7

A. Immune-enzyme analysis
B. Radioimmunoassay A. Heat radiation
C. Immunofluorescence test B. Heat conduction
D. Bordet-Gengou test C. Convection
E. Antigen-binding assay D. Evaporation
E. -
62. A patient with insulin-dependent di-
abetes mellitus has been administered 67. Due to destruction of certain structures
insulin. After a certain period of time of the brainstem an animal has lost its ori-
the patient developed fatigue, irritabili- entation reflexes in response to strong light
ty, excessive sweating. What is the main stimuli. What structures were destroyed?
mechanism of such presentations developi-
ng? A. Anterior quadrigeminal bodies
B. Posterior quadrigeminal bodies
A. Carbohydrate starvation of the brain C. Red nuclei
B. Increased glycogenolysis D. Vestibular nuclei
C. Increased ketogenesis E. Substantia nigra
D. Increased lipogenesis
E. Decreased glyconeogenesis 68. Urine analysis has shown high levels of
protein and erythrocytes in urine. This can
63. Examination of a 52-year-old woman be caused by the following:
has revealed a decrease in the amount
of red blood cells and an increase in A. Renal filter permeability
free hemoglobin in the blood plasma B. Effective filter pressure
(hemoglobinemia). Color index is 0,85. C. Hydrostatic blood pressure in glomerular
What type of anemia is being observed in capillaries
the patient? D. Hydrostatic primary urine pressure in
capsule
A. Acquired hemolytic E. Oncotic pressure of blood plasma
B. Hereditary hemolytic
C. Acute hemorrhagic 69. Along with normal hemoglobin types
D. Chronic hemorrhagic there can be pathological ones in the organi-
E. Anemia due to diminished erythropoiesis sm of an adult. Name one of them:

64. Poisoning caused by mercury (II) chlori- A. HbS


de (corrosive sublimate) occurred in the B. HbF
result of safety rules violation. In 2 days C. HbA1
the patient’s diurnal diuresis was 620 ml. D. HbA2
The patient developed headache, vomiting, E. HbO2
convulsions, dyspnea; moist crackles were 70. Development of both immune and
observed in the lungs. Name this pathology: allergic reactions is based upon the same
A. Acute renal failure mechanisms of immune system response
B. Chronic renal failure to an antigen. What is the main difference
C. Uremic coma between immune and allergic reactions?
D. Glomerulonephritis A. Development of tissue lesion
E. Pyelonephritis B. Amount of released antigen
65. For people adapted to high external C. Antigen structure
temperatures profuse sweating is not D. Routes by which antigens are delivered
accompanied by loss of large volumes of into the body
sodium chloride. This is caused by the effect E. Hereditary predisposition
the following hormone has on perspiratory 71. Histologic preparation stained wi-
glands: th orcein demonstrates from 40 to 60
A. Aldosterone fenestrated elastic membranes within the
B. Vasopressin middle coat of vessel. Name this vessel:
C. Cortisol A. Elastic artery
D. Tgyroxin B. Muscular artery
E. Natriuretic C. Mixed type artery
66. The processes of heat transfer in a naked D. Muscular vein
person at room temperature have been E. Nonmuscular vein
studied. It was revealed that under these 72. Angiocardiography of a 60-year-old man
conditions the greatest amount of heat is revealed constriction of a vessel located in
transferred by:
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 8

the left coronary sulcus of the heart. Name ration is slow and shallow due to suppressi-
this pathological vessel: on of the respiratory center. What kind of
respiratory failure occurred in this case?
A. Ramus circumflexus
B. Ramus interventricularis posterior A. Ventilatory disregulation
C. A. coronaria dextra B. Ventilatory obstruction
D. V.cordis parva C. Ventilatory restriction
E. Ramus interventricularis anterior D. Perfusion
E. Diffusion
73. A comatose patient was taken to the
hospital. He has a history of diabetes melli- 78. On histological examination of uterine
tus. Objectively: Kussmaul breathing, low mucosa the following is detected: sinuous
blood pressure, acetone odor of breath. glands, serratiform and corkscrew-shaped
After the emergency treatment the pati- elongated growths of stroma with cell proli-
ent’s condition improved. What drug had feration. Make the diagnosis:
been administered?
A. Glandular endometrial hyperplasia
A. Insulin B. Acute endometritis
B. Adrenaline C. Leiomyoma
C. Isadrinum D. Vesicular mole
D. Glibenclamide E. Placental polyp
E. Furosemide
79. 10 minutes after the beginning of
74. A patient complains of pain in the ri- heavy physical work a person demonstrates
ght lateral abdomen. Palpation revealed a increase of erythrocyte number in blood
dense, immobile, tumor-like formation. The from 4, 0 · 1012 /l to 4, 5 · 1012 /l. What is the
tumor is likely to be found in the following cause of this phenomenon?
part of the digestive tube:
A. Erythrocytes exit from depot
A. Colon ascendens B. Suppression of erythrocyte destruction
B. Colon transversum C. Erythropoiesis activation
C. Colon descendens D. Increase of cardiac output
D. Colon sigmoideum E. Water loss
E. Caecum
80. A patient has a traumatic injury
75. A patient hospitalized due to mercury of sternocleidomastoid muscle. This has
intoxication presents with the followi- resulted in a decrease of the following value:
ng processes in the kidneys: focal
necrotic changes of tubules of major A. Inspiratory reserve volume
renal regions, edema, leukocyte infiltrati- B. Expiratory reserve volume
on and hemorrhages in the interstitial ti- C. Respiratory volume
ssue, venous congestion. What condition D. Residual volume
developed in the patient? E. Functional residual lung capacity
A. Acute necrotic nephrosis 81. Autopsy of a 40-year-old woman,
B. Acute glomerulonephritis who died of cerebral hemorrhage duri-
C. Chronic renal failure ng hypertensic crisis, revealed: upper-
D. Acute pyelonephritis body obesity, hypertrichosis, hirsutism,
E. Chronic pyelonephritis stretchmarks on the skin of thighs and
abdomen. Pituitary basophil adenoma is
76. According to phenotypic diagnosis a detected in the anterior lobe. What di-
female patient has been provisionally di- agnosis is the most likely?
agnosed with X-chromosome polysomia.
This diagnosis can be confirmed by A. Cushing’s disease
cytogenetic method. What karyotype will B. Essential hypertension
confirm the diagnosis? C. Alimentary obesity
D. Simmonds’ disease
A. 47(ХХХ) E. Hypothalamic obesity
B. 48(XXXY)
C. 48(XXYY) 82. A specimen shows an organ covered
D. 47(XXY) with the connective tissue capsule with
E. 46(XX) radiating trabeculae. There is also cortex
containing lymph nodules, and medullary
77. An uconscious young man in the state of cords made of lymphoid cells. What organ
morphine intoxication has been delivered is under study?
into an admission room. The patient’s respi-
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 9

A. Lymph node one-third. Flexing function was disrupted


B. Thymus in the shoulder and elbow joints, which is
C. Spleen caused by the damage to the:
D. Red bone marrow
E. Tonsils A. Biceps muscle of the arm
B. Triceps muscle of the arm
83. After a craniocerebral injury a patient C. Anconeus muscle
has lost the ability to recognize shapes of D. Deltoid muscle
objects by touch (stereognosis). What area E. Coracobrachial muscle
of cerebral cortex normally contains the
relevant center? 88. A 40-year-old patient suffers
from bronchial asthma and prolonged
A. Superior parietal lobule tachycardia. Choose the optimal drug for
B. Inferior parietal lobule rapid relief of bronchial spasm in the given
C. Supramarginal gyrus case:
D. Postcentral gyrus
E. Angular gyrus A. Salbutamol
B. Adrenalin hydrochloride
84. Monoamine oxidase inhibitors are C. Ephedrine hydrochloride
widely used as psychopharmacological D. Orciprenaline
drugs. They change the level of nearly E. Isoprenaline (Isadrinum)
all neurotransmitters in synapses, with
the following neurotransmitter being the 89. A patient with urolithiasis has
exception: developed severe pain attacks. For pain
shock prevention he was administered an
A. Acetylcholine antispasmodic narcotic analgesic along with
B. Noradrenaline atropine. Name this drug:
C. Adrenaline
D. Dopamine A. Promedol
E. Serotonin B. Nalorphine
C. Tramadol
85. A worker of an agricultural enterprise D. Ethylmorphine hydrochloride
had been suffering from an acute disease E. Morphine hydrochloride
with aggravating intoxication signs, which
resulted in his death. On autopsy: the spleen 90. A patient suffers from acute cardi-
is enlarged, flaccid, dark cherry-red in the opulmonary failure with pulmonary edema.
section, yields excessive pulp scrape. Soft What diuretic should be prescribed in the
meninges of fornix and base of the brain given case?
are edematous and saturated with blood
(”cardinal’s cap”). Microscopically: serous- A. Furosemide
hemorrhagic inflammation of meninges and B. Triamterene
cerebral tissues. Make the diagnosis: C. Spironolactone
D. Hydrochlorothiazide (Dichlothiazidum)
A. Anthrax E. Acetazolamide (Diacarb)
B. Tularemia
C. Plague 91. A patient with acute myocardial infarcti-
D. Cholera on has been administered heparin as a
E. Brucellosis part of complex therapy. Some time after
heparin injection the patient developed
86. Autopsy of an 8-month-old boy, who di- hematuria. What heparin antagonist should
ed of severe pneumonia complicated with be injected to remove the complication?
sepsis, revealed absence of thymus. Lymph
nodes have no lymphoid follicles and corti- A. Protamine sulfate
cal substance. In the spleen the follicles are B. Vicasol
decreased in size and have no light centers. C. Aminocaproic acid
What is the cause of such changes? D. Neodicumarin
E. Fibrinogen
A. Thymus agenesis
B. Thymus aplasia 92. The key reaction of fatty acid synthesis
C. Thymus atrophy is production of malonyl-CoA. What
D. Thymus hypoplasia metabolite is the source of malonyl-CoA
E. Accidental thymic involution synthesis?
87. A patient has been delivered into a
surgical ward with an incised wound of the
anterior surface of the shoulder in its lower
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 10

A. Acetyl-CoA A. Balantidiasis
B. Succinyl-CoA B. Amebiasis
C. Acyl-CoA C. Toxoplasmosis
D. Malonate D. Lambliasis
E. Citrate E. Trichomoniasis
93. A family of healthy students, who have 98. Blood group of a 30-year-old man has
arrived from Africa, gave birth to a chi- been determined before a surgery. The
ld with signs of anemia. The child has di- blood was Rhesus-positive. Agglutination
ed shortly after. Examination has revealed did not occur with standard 0 (I), А (II),
that the child’s erythrocytes are abnormally and В (III) serums. The blood belongs to
crescent-shaped. The disease is characreri- the following group:
zed by autosomal recessive inheritance.
Determine the genotype of the child’s A. 0 (I)
parents: B. А (II)
C. В (III)
A. Аа х Аа
B. Аа х аа D. АВ (IV)
C. АА х АА E. -
D. аа х аа 99. Histological specimen of a hemopoietic
E. Аа х АА organ shows clusters of node- and band-
94. At a certain stage of cell cycle shaped lymphocytes that along with stroma
chromosomes reach cellular poles, undergo elements compose cortical and medullar
despiralization; nuclear membranes are substances. Name this organ:
being formed around them; nucleolus is A. Lymph node
restored. What stage of mitosis is it? B. Spleen
A. Telophase C. Red bone marrow
B. Prophase D. Thymus
C. Prometaphase E. Palatine tonsil
D. Metaphase 100. It is known that in catecholami-
E. Anaphase ne metabolism a special role belongs
95. Cardiac arrest occurred in a patient to monoamine oxidase (MAO). This
during a surgery of the small intestine. enzyme inactivates mediators (noadrenalin,
What regulatory mechamisms resulted in adrenalin, dopamine) by:
the cardiac arrest in this case?
A. Oxidative deamination
A. Unconditioned parasympathetic reflexes B. Adjoining amino groups
B. Unconditioned sympathetic reflexes C. Removing methyl groups
C. Conditioned parasympathetic reflexes D. Carboxylation
D. Conditioned sympathetic reflexes E. Hydrolysis
E. Metasympathetic reflexes
101. Cellular composition of exudate
96. Vestibular receptors of semicircular largely depends on the etiological factor of
canals of an animal have been destroyed. inflammation. What leukocytes are the first
What reflexes will disappear as a result? to be involved in the focus of inflammation
caused by pyogenic bacteria?
A. Statokinetic reflex during movements
with angular acceleration A. Neutrophil granulocytes
B. Statokinetic reflex during movements B. Monocytes
with linear acceleration C. Myelocytes
C. Head-righting reflex D. Eosinophilic granulocytes
D. Body-righting reflex E. Basophils
E. Primary orienting reflex
102. A surgeon has detected inflammation
97. A patient working at a pig farm complai- of the Meckel’s diverticulum in a patient.
ns of paroxysmal abdominal pain, liquid During surgical invasion it can be located in
feces with mucus and blood, headache, the:
weakness, fever. Examination of large
intestine revealed ulcers from 1 mm up to A. Ileum
several cm in diameter, feces contained oval B. Jejunum
unicellular organisms with cilia. What di- C. Colon
sease can be suspected? D. Duodenum
E. Sigmoid colon
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 11

103. A patient complains of acute pain A. X-linked hypogammaglobulinemia


attacks in the right lumbar region. Duri- (Bruton type agammaglobulinemia)
ng examination the nephrolithic obturation B. Autosomal recessive agammaglobuli-
of the right ureter in the region between naemia (Swiss type)
its abdominal and pelvic segments was C. Hypoplastic anemia
detected. What anatomical boundary exi- D. Agranulocytosis
sts between those two segments? E. Louis-Barr syndrome
A. Linea terminalis 108. A microslide contains the specimen
B. Linea semilunaris of a gland composed of several secretory
C. Linea arcuata saccule-shaped parts that open in the
D. Linea transversa common excretory duct. What gland is it?
E. Linea inguinalis
A. Simple branched alveolar gland
104. A patient died of cancerous cachexia B. Compound branched alveolar gland
with primary localization of cancer in the C. Simple unbranched alveolar gland
stomach. Autopsy revealed acutely enlarged D. Compound unbranched alveolar gland
liver with uneven surface and numerous E. Simple branched tubular gland
protruding nodes; the nodes had clear
margins in the section, rounded shape, 109. Microelectrode technique allowed to
gray-pink color, varying density, someti- register a potential following ”all-or-none”
mes contained necrotic foci. Histologically: law and capable of undecremental spreadi-
there are atypical cells in the nodes. What ng. Specify this potential:
pathologic process occurred in the liver?
A. Action potential
A. Cancer metastases B. Excitatory postsynaptic potential
B. Abscesses C. Rest potential
C. Regeneratory nodes D. Inhibitory postsynaptic potential
D. Infarction E. Receptor potential
E. Hepatic cancer
110. Examination of a patient revealed
105. A patient has insufficient blood hypertrophy and inflammation of lymphoid
supply to the kidneys, which caused tissue, edema of mucous membrane
the development of pressor effect due between palatine arches (acute tonsillitis).
to the constriction of arterial resistance What tonsil is normally situated in this area?
vessels. This is the result of the vessels
being greately affected by the following A. Tonsilla palatina
substance: B. Tonsilla pharyngealis
C. Tonsilla tubaria
A. Angiotensin II D. Tonsilla lingualis
B. Angiotensinogen E. -
C. Renin
D. Catecholamines 111. Histological specimen of an ovary
E. Norepinephrine demonstrates a spherical structure
composed of large glandular cells contai-
106. Experimental stimulation of ning lutein. What hormone is produced by
sympathetic nerve branches that innervate the cells of this structure?
heart caused an increase in force of heart
contractions because membrane of typical A. Progesterone
cardiomyocytes permitted an increase in: B. Estrogens
C. Testosterone
A. Calcium ion entry D. Corticosterone
B. Calcium ion exit E. Aldosterone
C. Potassium ion exit
D. Potassium ion entry 112. A patient, who has been subsisting
E. Calcium and potassium ion exit exclusively on polished rice, has developed
polyneuritis due to thiamine deficiency.
107. Parents of a 5-year-old child report him What substance is an indicator of such avi-
to have frequent colds that develop into taminosis, when it is excreted with urine?
pneumonias, presence of purulent rashes
on the skin. Laboratory tests have revealed A. Pyruvic acid
the following: absence of immunoglobuli- B. Malate
ns of any type; naked cells are absent from C. Methylmalonic acid
the lymph nodes punctate. What kind of D. Uric acid
immune disorder is it? E. Phenyl pyruvate
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 12

113. When blood circulation in the damaged with large polymorphous nuclei. What
tissue is restored, lactate accumulation tumour is it?
stops and glucose consumption decelerates.
These metabolic changes are caused by acti- A. Medulloblastoma
vation of the following process: B. Meningioma
C. Glioblastoma
A. Aerobic glycolysis D. Astrocytoma
B. Anaerobic glycolysis E. Oligodendroglioma
C. Lipolysis
D. Gluconeogenesis 119. When studying the signs of pulmonary
E. Glycogen biosynthesis ventilation, reduction of forced expiratory
volume has been detected. What is the li-
114. A 67-year-old patient complains of kely cause of this phenomenon?
periodic heartache, dyspnea during light
physical activities. ECG reveals extraordi- A. Obstructive pulmonary disease
nary contractions of heart ventricles. Such B. Increase of respiratory volume
arrhythmia is called: C. Increase of inspiratory reserve volume
D. Increase of pulmonary residual volume
A. Extrasystole E. Increase of functional residual lung
B. Bradycardia capacity
C. Tachycardia
D. Flutter 120. A specimen of a parenchymal organ
E. Fibrillation shows poorly delineated hexagonal lobules
surrounding a central vein, and the
115. In investigation of serum proteins vari- interlobular connective tissue contains
ous physical and physicochemical methods embedded triads (an artery, a vein and an
can be used. In particular, serum albumi- excretory duct). What organ is it?
ns and globulins can be separated by the
method of: A. Liver
B. Pancreas
A. Electrophoresis C. Thymus
B. Polarography D. Spleen
C. Dialysis E. Thyroid
D. Spectrography
E. Refractometry 121. A patient had a trauma that caused
dysfunction of motor centers regulating
116. Pupil dilation occurs when a person activity of head muscles. In what parts of
steps from a light room into a dark one. cerebral cortex can these centers normally
What reflex causes such a reaction? be located?
A. Sympathetic unconditioned reflex A. Inferior part of precentral gyrus
B. Sympathetic conditioned reflex B. Superior part of precentral gyrus
C. Metasympathetic reflex C. Supramarginal gyrus
D. Parasympathetic unconditioned reflex D. Superior parietal lobule
E. Parasympathetic conditioned reflex E. Angular gyrus
117. Cells of a person working in the 122. At the post-mortem examination the
Chornobyl Exclusion Zone have undergone stomach of a patient with renal failure was
a mutation in DNA molecule. However, found to have a yellow-brown coating on
with time the damaged interval of DNA the thickened mucosa. The coating was fi-
molecule has been restored to its initial rmly adhering to its surface and had si-
structure with a specific enzyme. In this case gnificant thickness. Microscopy revealed
the following occurred: congestion and necrosis of mucosal and
submucosal layers, fibrin presence. What is
A. Repair the most likely diagnosis?
B. Replication
C. Transcription A. Fibrinous gastritis
D. Reverse transcription B. Croupous gastritis
E. Translation C. Gastric abscess
D. Esogastritis
118. Autopsy of a 5-year-old child revealed E. Corrosive gastritis
in the area of the vermis of cerebellum a soft
grayish-pink node 2 cm in diameter with 123. A 60-year-old man suffering from
blurred margins and areas of haemorrhage. chronic hepatitis frequently observes nasal
Histologically this tumour consisted of and gingival hemorrhages, spontaneous
atypical monomorphous small round cells hemorrhagic rashes on the skin and mucosa.
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 13

Such presentations result from: case?


A. Decreased synthesis of prothrombin and A. Trichinosis
fibrinogen B. Taeniarhynchosis
B. Increased blood content of ami- C. Teniasis
notransferases D. Echinococcosis
C. Decreased synthesis of serum albumins E. Alveococcosis
D. Increased blood content of macroglobuli-
ns and cryoglobulins 129. A patient demonstrates functional loss
E. Decreased blood content of choli- of nasal halves of the retinas. What area of
nesterase visual pathways is affected?

124. Leading symptoms of primary A. Optic chiasm


hyperparathyroidism are osteoporosis and B. Left optic tract
renal damage resulting in urolithiasis C. Right optic tract
development. What substances are the basis D. Left optic nerve
of uroliths in such cases? E. Right optic nerve

A. Calcium phosphate 130. A 26-year-old woman with bronchitis


B. Uric acid has been administered a broad spectrum
C. Cystine antibiotic as a causal treatment drug. Speci-
D. Bilirubin fy this drug:
E. Cholesterol
A. Doxycycline
125. An oncology department has admitted B. Interferon
a patient with suspected pulmonary tumor. C. BCG vaccine
On examination a pathology localized wi- D. Ambroxol
thin the lower lobe of the right lung was E. Dexamethasone
detected. How many bronchopulmonary
segments are there in this lobe? 131. A 16-year-old young man sufferi-
ng from seasonal allergic rhinitis has
A. 5 been prescribed a highly active second-
B. 6 generation H1 blocker, which can be
C. 4 characterized by absence of marked sedati-
D. 3 ve action. Name this drug:
E. 2
A. Loratadine
126. A 45-year-old woman suffers B. Pipolphen
from arterial hypertension with high C. Chloropyramine (Suprastin)
blood concentration of angiotensin II. D. Indometacin
What antihypertensive drug is the most E. Erythromycin
recommended in the given case?
132. Examination of a 56-year-old woman
A. Lisinopril with a history of type 1 diabetes mellitus
B. Prazosin revealed a disorder of protein metaboli-
C. Metoprolol sm that is manifested by aminoacidemia in
D. Reserpine the laboratory blood test values, and cli-
E. Verapamil nically by the delayed wound healing and
decreased synthesis of antibodies. Which
127. An alcoholic suffers from alcoholic of the following mechanisms causes the
psychosis with evident psychomotor agitati- development of aminoacidemia?
on. What neuroleptic drug should be admi-
nistered for emergency aid? A. Increased proteolysis
B. Albuminosis
A. Aminazine C. Decrease in the concentration of amino
B. Diazepam acids in blood
C. Sodium bromide D. Increase in the oncotic pressure in the
D. Reserpine blood plasma
E. Halothane E. Increase in low-density lipoprotein level
128. In one of Polessia regions there was 133. A patient with injury sustained to a part
an outbreak of helminthiasis manifested by of the central nervous system demonstrates
cramps and facial edemas. The developed disrupted coordination and movement
preventive measures in particular included amplitude, muscle tremor during volitional
ban for eating infested pork even after movements, poor muscle tone. What part of
heat processing. What helminthiasis was the the central nervous system was injured?
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 14

A. Histamine
A. Cerebellum B. Hageman’s factor
B. Medulla oblongata C. Lysosomal enzymes
C. Oliencephalon D. Noradrenaline
D. Mesencephalon E. Adrenaline
E. Prosencephalon
139. Autopsy of a 28-year-old patient, who
134. A 36-year-old patient has been admini- had been suffering from rheumatism and
stered a depolarizing muscle relaxant duri- died of heart failure, revealed pancardi-
ng a surgery. Name this drug: tis. Histological investigation of myocardi-
um of the left ventricle posterior wall
A. Dithylinum and interventricular septum detected peri-
B. Proserin vascular cellular focal infiltrates composed
C. Pipecuronium bromide (Arduan) of macrophages and creating palisade
D. Diazepam structures surrounding areas of fibrinoid
E. Aminazine necrosis. Determine the type of myocarditis:
135. A man has suffered multiple bone A. Granulomatous
fractures of his lower extremities duri- B. Diffuse interstitial productive
ng a traffic accident. During transportati- C. Diffuse interstitial exudative
on to a hospital his condition was further D. Focal interstitial exudative
aggravated: blood pressure decreased, there E. -
were signs of pulmonary artery embolism.
What kind of embolism is the most likely in 140. When ascending to the top of Elbrus,
the given case? a mountain climber experiences oxygen
starvation, dyspnea, palpitations, and
A. Fat embolism numbness of the extremities. What kind of
B. Air embolism hypoxia has developed in the mountain cli-
C. Gas embolism mber?
D. Tissue embolism
E. Thromboembolism A. Hypoxic
B. Circulatory
136. UN volunteers have arrived in Ni- C. Hemic
geria to assist the locals in aftermath D. Tissue
of earthquakes. What drug should they E. Cardiac
prescribe for individual chemoprophylaxis
of malaria? 141. A 2-year-old boy is diagnosed wi-
th Down syndrome. What chromosomal
A. Chingamin changes can cause this disease?
B. Pyrantel
C. Pyrimethamine (Chloridinum) A. Trisomy 21
D. Primaquine B. Trisomy 13
E. Interferon (Laferon) C. Trisomy X
D. Trisomy 18
137. After an extended treatment wi- E. Monosomy X
th sulfanamides a patient has developed
macrocytic anemia. Production of active 142. A 62-year-old patient has been hospi-
forms of the following vitamin is disrupted talized due to massive cerebral hemorrhage.
in such a condition: Blood pressure is 70/30 mm Hg, heart
rate is 120/min., respiratory rate is 4/min.,
A. Folic acid unconscious, no response to external sti-
B. Thiamine muli. Such condition can be determined as:
C. Riboflavin
D. Pyridoxine A. Coma
E. Cyanocobalamin B. Shock
C. Collapse
138. A woman resting in the countrysi- D. Stress
de has been stung by a bee. Immediately E. Agony
after she developed pain in the stung area.
In a few minutes there developed a vesi- 143. A 3-year-old girl with mental retardati-
cle, erythema and intense itch; later - urti- on has been diagnosed with sphingomyelin
caria and expiratory dyspnea. What factors lipidosis (Niemann-Pick disease). In this
resulted in the patient developing expi- condition synthesis of the following
ratory dyspnea? substance is disrupted:
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 15

A. Sphingomyelinase the following reflex:


B. Glycosyltransferase
C. Sphingosine A. Dagnini-Aschner reflex
D. Ceramides B. Bainbridge reflex
E. Gangliosides C. Holtz’s reflex
D. Hering-Breuer reflex
144. What condition may develop 15-30 mi- E. Frank-Starling mechanism
nutes after re-administration of an antigen
as a result of the increased level of anti- 149. A 47-year-old man developed intesti-
bodies, mainly IgE, that are adsorbed on nal colic against the background of essenti-
the surface of target cells, namely tissue al hypertension. In this situation it would
basophils (mast cells) and blood basophi- be the most efficient to arrest the colic by
ls? administering drugs of the following group:
A. Anaphylaxis A. Myotropic antispasmodics
B. Antibody-dependent cytotoxicity B. Anticholinesterase agents
C. Delayed-type hypersensitivity C. Sympathomimetics
D. Immune complex hyperresponsiveness D. M-cholinomimetics
E. Serum sickness E. Adrenomimetics
145. Local anesthetics (novocaine, lidocaine 150. A therapeutist has an appointment
and others) decreases pain sensitivity of ti- with a 40-year-old patient complaining of
ssues by blocking Na+ and K + ions from recurrent pain attacks in his hallux joints
permeating membranes of nerve fibers and and their swelling. Urine analysis revealed
endings. Such mechanism of drug action is its marked acidity and pink color. What
called: substances can cause such changes in uri-
ne?
A. Membrane ionic
B. Receptor A. Uric acid salt
C. Enzyme B. Chlorides
D. Antienzyme C. Ammonium salts
E. Direct chemical D. Calcium phosphate
E. Magnesium sulfate
146. After a road accident a victim has
tachycardia, arterial blood pressure 130/90 151. Exophthalmus observed during
mm Hg, tachypnoe, the skin is pale and thyrotoxicosis is caused by accumulation of
dry, excitation of central nervous system is highly water-binding substances within the
observed. What shock stage is the patient retrobulbar tissues. Name these substances:
most likely in? A. Glycosaminoglycans
A. Erectile B. Cholesterol
B. Terminal C. ATP
C. Torpid D. Kreatine
E. Phospholipids
D. Preshock (compensation stage)
E. Agony 152. A patient presents with dry peeli-
147. A woman complaining of sharp pain ng skin, frequent cases of acute respi-
ratory diseases, xerophthalmia. What vi-
in her lower abdomen has been delivered
into an admission room. A gynecologist on tamin preparation should be prescribed in
this case?
examination makes a provisional diagnosis
of extrauterine pregnancy. What anatomical A. Retinol acetate
structure should be punctated to confirm di- B. Thiamine
agnosis? C. Cyanocobalamin
A. Rectouterine pouch D. Menadione (Vikasolum)
B. Utriculosaccular chamber E. Ergocalciferol
C. Recto-vesical pouch 153. Parenchyma of an organ is composed of
D. Retropubic space pseudounipolar neurons localized under the
E. Intersigmoidal recess capsule of connective tissue. Central place
148. A passenger of a fixed-run taxi has a belongs to nerve fibers. Name this organ:
sudden and expressed attack of tachycardia.
A doctor travelling by the same taxi has
managed to slow down his heart rate by
pressing upon the eyeballs and thus causing
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 16

A. Spinal ganglion A. Testosterone


B. Sympathetic ganglion B. Oestriol
C. Intramural ganglion C. Relaxin
D. Nerve trunk D. Oxytocin
E. Spinal cord E. Prolactin
154. A patient consulted a physician about 159. During a surgery for femoral hernia a
chest pain, cough, fever. Roentgenography surgeon operates within the boundaries of
of lungs revealed eosinophilic infiltrates femoral trigone. What structure makes up
that were found to contain larvae. What ki- its upper margin?
nd of helminthiasis are these presentations
typical of? A. Lig. inguinale
B. Arcus iliopectineus
A. Ascariasis C. Lig. lacunare
B. Echinococcosis D. Lig. pectinale
C. Fascioliasis E. Fascia lata
D. Cysticercosis
E. Trichinosis 160. Activation of a number of hemostatic
factors occurs through their joining with
155. During appendectomy a patient had calcium ions. What structural component
the a. appendicularis ligated. This vessel allows for adjoining of calcium ions?
branches from the following artery:
A. Gamma-carboxyglutamic acid
A. A. ileocolica B. Gamma-aminobutyric acid
B. A. colica dextra C. Gamma-oxybutyric acid
C. A. colica media D. Hydroxyproline
D. A. sigmoidea E. Monoamine-dicarboxylic acids
E. A. mesenterica inferior
161. A patient has arterial hypertension.
156. A patient with signs of osteoporosis What long-acting calcium channel blocker
and urolithiasis has been admitted should be prescribed?
to an endocrinology department.
Blood test revealed hypercalcemia and A. Amlodipine
hypophosphatemia. These changes are B. Octadine
associated with abnormal synthesis of the C. Pyrroxanum
following hormone: D. Atenolol
E. Reserpine
A. Parathyroid hormone
B. Calcitonin 162. Material obtained from a patient
C. Cortisol contains several types of microorganisms
D. Aldosterone (staphylococci and streptococci) causative
E. Calcitriol of the patient’s disease. Name this type of
infection:
157. Prescription of penicillin G sodium
salt has caused development of neurotoxic A. Mixed infection
effects (hallucinations, convulsions). Such B. Superinfection
reaction is the result of antagonism with the C. Reinfection
following neurotransmitter: D. Consecutive infection
E. Coinfection
A. GABA
B. Dopamine 163. A laboratory has been investigati-
C. Serotonin ng virulence of a diphtheria agent. In the
D. Adenosine process of the experiment the infection was
E. Acetylcholine introduced intraperitoneally into test ani-
mals. The dosage of bacteria resulting in
158. A 30-year-old woman exhibits signs 95% mortality of test animals was found.
of virilism (growth of body hair, balding What unit of virulence measurement was
temples, menstrual disorders). This condi- determined?
tion can be caused by overproduction of the
following hormone: A. DLM
B. DCL
C. LD50
D. ID
E. LD5
164. A patient complains of palpitations
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 17

after stress. Pulse is 104/min., P-Q=0,12 A. Ulnar


seconds, there are no changes in QRS B. Median
complex. What type of arrhythmia does the C. Radial
patient have? D. Musculocutaneous
E. Medial cutaneous nerve of the forearm
A. Sinus tachycardia
B. Sinus bradycardia 170. A 30-year-old patient’s blood test has
C. Sinus arrhythmia revealed the following: erythrocyte count
D. Ciliary arrhythmia is 6 · 1012 /l, hemoglobin is 10,55 mmol/l.
E. Extrasystole Vaquez’s disease was diagnosed. Name the
leading part of pathogenesis:
165. A patient consulted a dentist about
restricted mouth opening (trismus). He has A. Neoplastic erythroid hyperplasia
a history of a stab wound of the lower B. Iron-deficiency
extremity. What infection can cause these C. B12 -deficiency
symptoms? D. Hypoxia
E. Acidosis
A. Tetanus
B. Brucellosis 171. Pancreas is known as a mixed gland.
C. Whooping cough Endocrine functions include production
D. Wound anaerobic infection of insulin by beta cells. This hormone
E. Tularemia affects metabolism of carbohydrates. What
is its effect on the activity of glycogen
166. Patient’s systolic blood pressure is phosphorylase (GP) and glycogen synthase
90 mm Hg, diastolic - 70 mm Hg. Such (GS)?
blood pressure is caused by decrease of the
following factor: A. It inhibits GP and activates GS
B. It activates both GP and GS
A. Pumping ability of the left heart C. It inhibits both GP and GS
B. Pumping ability of the right heart D. It activates GP and inhibits GS
C. Aortic compliance E. It does not affect the activity of GP and
D. Total peripheral resistance GS
E. Vascular tone
172. This year influenza epidemic is
167. A 29-year-old man with a knife wound characterised by patients’ body temperature
of the neck presents with bleeding. Duri- varying from 36, 9oC to 37, 9oC . Such fever
ng the initial d-bridement of the wound is called:
a surgeon revealed the injury of a vessel
situated along the lateral edge of the A. Subfebrile
sternocleidomastoid muscle. Specify this B. High
vessel: C. Hyperpyretic
D. Apyretic
A. V. jugularis externa E. Moderate
B. V. jugularis anterior
C. A. carotis externa 173. Fructosuria is known to be connected
D. A. carotis interna with inherited deficiency of fructose 1-
E. V. jugularis interna phosphate aldolase. What product of
fructose metabolism will accumulate in the
168. A 6-year-old child suffers from delayed organism resulting in toxic action?
growth, disrupted ossification processes,
decalcification of the teeth. What can be A. Fructose 1-phosphate
the cause? B. Glucose 1-phosphate
C. Glucose 6-phosphate
A. Vitamin D deficiency D. Fructose 1,6-biphosphate
B. Decreased glucagon production E. Fructose 6-phosphate
C. Insulin deficiency
D. Hyperthyroidism 174. A woman complains of visual impai-
E. Vitamin C deficiency rment. Examination revealed obesity in the
patient and her fasting plasma glucose level
169. A patient addressed a hospital with is hyperglycemic. What diabetes complicati-
complaints of lost sensitivity of the skin of on can cause visual impairment/blindness?
the little finger. What nerve is the most li-
kely to be damaged?
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 18

A. Microangiopathy A. Cholera
B. Macroangiopathy B. Shigellosis
C. Atherosclerosis C. Typhoid fever
D. Neuropathy D. Colienteritis
E. Glomerulopathy E. Pseudotuberculosis
175. Administration of doxycycline 180. An athlete (long-distance runner) duri-
hydrochloride has caused an imbalance of ng a contest developed a case of acute cardi-
the symbiotic intestinal microflora. Specify ac insufficiency. This pathology resulted
the kind of imbalance caused by the antibi- from:
otic therapy:
A. Cardiac volume overload
A. Dysbacteriosis B. Disrupted coronary circulation
B. Sensibilization C. Direct damage to myocardium
C. Idiosyncrasy D. Pericardium pathology
D. Superimposed infection E. Cardiac pressure overload
E. Bacteriosis
181. Parkinson’s disease is caused by di-
176. Cholesterol content in blood serum sruption of dopamine synthesis. What brain
of a 12-year-old boy is 25 mmol/l. structure synthesizes this neurotransmitter?
Anamnesis states hereditary familial
hypercholesterolemia caused by synthesis A. Substantia nigra
disruption of receptor-related proteins for: B. Globus pallidus
C. Corpora quadrigemina
A. Low-density lipoproteins D. Red nucleus
B. High-density lipoproteins E. Hypothalamus
C. Chylomicrons
D. Very low-density lipoproteins 182. Name the halogen-containing anti-
E. Middle-density lipoproteins septic with fungicidal properties, which is
used to treat dermatomycosis:
177. During recording of a spirogram a pati-
ent calmly exhaled. How do we call the A. Iodine solution
volume of air remaining in the lungs? B. Formalin solution
C. Methylene blue
A. Functional residual capacity D. Brilliant green
B. Pulmonary residual volume E. Boric acid solution
C. Expiratory reserve volume
D. Tidal volume 183. Due to severe pain syndrome a patient
E. Vital capacity of lungs was prescribed a narcotic analgesic. Name
this drug:
178. A 40-year-old woman was diagnosed
with glomerulonephritis based on her cli- A. Morphine
nical symptoms and the results of urine B. Metamizole (Analgin)
analysis. Anamnesis states chronic tonsilli- C. Nimesulide
tis. What microorganisms are the most likely D. Dimethyl sulfoxide
cause for the kidney damage in this case? E. Indometacin
A. Streptococci 184. During pathomorphological renal
B. Staphylococci investigation of a patient, who for a long
C. Escherichia time had been suffering from osteomyeli-
D. Mycoplasma tis and died of progressing renal fai-
E. Meningococci lure, the following was revealed: deposi-
ts of homogeneous eosinophilic masses
179. A man is suffering from diarrhea. In in glomerular mesangium, arterial and
summer he spent his vacation in the south arteriolar walls, and stroma, which colored
at the sea coast. Bacteria with the following red when stained with Congo red. What
properties were detected in his feces: gram- pathological process is this?
negative curved mobile monotrichous baci-
lli that do not produce spores or capsules. A. Amyloidosis
Bacilli are undemanding to nutrient medi- B. Mucoid swelling
um but require alkaline reaction (рН 8,5- C. Calcinosis
9,5). Described are the agents of the followi- D. Carbohydrate degeneration
ng enteric infection: E. Hyalinosis
185. During experiment a dog has
developed conditioned digestive reflex in
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 19

response to a sound stimulus. This conditi- A. Disruption of protein metabolism


oned reflex will not be exhibited anymore regulation
after the extirpation of the following areas B. Hypoglycemia
of the cerebral hemispheres: C. Ketonemia
D. Increased lipid catabolism
A. Temporal lobe on both sides E. Anemia
B. Occipital lobe on one side
C. Parietal lobe on both sides 191. A patient with signs of intestinal
D. Temporal lobe on one side infection (vomiting, diarrhea, abdominal
E. Occipital lobe on both sides pain) has been presenting with increasing
symptoms of intoxication for three days.
186. Coenzym A participates in numerous Papular rash appeared on the uncovered
important metabolic reactions. It is a deri- skin areas and spread to the torso. A
vative of the following vitamin: doctor suspected pseudotuberculosis. What
laboratory test allows confirming this di-
A. Pantothenic acid agnosis within the first week from the onset
B. Thiamine of disease?
C. Niacin
D. Calciferol A. Bacteriological
E. Ubiquinone B. Microscopic
C. Serological
187. A patient diagnosed with acute D. Allergic
dysentery has been treated for 3 days in an E. Biological
infectious diseases hospital. On admission
there were complaints of high temperature, 192. A microslide demonstrates an organ
stomachache and fluid excrements with with its wall consisting of three membranes.
mucus up to 8-10 times a day. What sample The inner membrane has tubular glands and
should be taken for analysis? undergoes cyclic changes. Name this organ:
A. Feces A. Uterus
B. Urine B. Esophagus
C. Bile C. Vagina
D. Liquor D. Ureter
E. Blood E. Urinary bladder
188. A patient with arthritis has been 193. A patient with femoral neck fracture,
prescribed an anti-inflammatory selective who for a long time had to remain in bed
COX-2 inhibitor. Select this drug among in a forced (supine) position, has developed
those given below: dark-brown lesions along the backbone; soft
A. Celecoxib tissues are swollen, in the areas of macerati-
B. Phenylbutazone (Butadion) on there is a foul-smelling liquid. Name the
clinicopathologic type of necrosis:
C. Dimethylsulfoxide (Dimexid)
D. Indometacin A. Bedsore
E. Metamizole (Analgin) B. Infarction
C. Sequestrum
189. A person with the fourth blood group D. Coagulation necrosis
(genotype IAIB) has in erythrocytes both E. Dry gangrene
antigen A controlled by allele IA and
antigen B controlled by allele IB. This 194. A patient is 20 years old, an athlete. He
phenomenon is an example of the following addressed a doctor with complaints of fati-
gene interation: gue, fever up to 38o C - 40o C . Objectively:
the liver and spleen are enlarged, lymph
A. Codominance nodes on palpation are slightly enlarged,
B. Complementarity dense, painless. Blood test: Нb- 100 g/l;
C. Semidominance erythrocytes - 2, 9 · 1012 /l; leukocytes -
D. Polymery
E. Epistasis 4, 4 · 109 /l. Leukogram: 68% of blast cells.
Cytochemical investigation of blast cells
190. A patient with diabetes mellitus revealed negative reactions to glycogen,
suffers from persistently nonhealing surgi- peroxidase, non-specific esterase, lipids.
cal wound, which is a sign of disrupted ti- Name this disease:
ssue trophism. What is the cause of such
disorder?
Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 20

A. Acute undifferentiated leukemia edema has developed in the child?


B. Acute myeloid leukemia
C. Acute monoblastic leukemia A. Allergic
D. Acute lymphoblastic leukemia B. Inflammatory
E. Acute megakaryoblastic leukemia C. Cardiac
D. Alimentary
195. Impression smear of mucosa biopsy E. Hepatic
material has been obtained from a patient
with peptic ulcer disease of the stomach. 198. During examination of a patient a
Gram-negative arcuate bent microorgani- doctor should use anatomical division of
sms were detected, urease activity test anterior abdominal wall into regions for
was positive. What microorganisms were more precise diagnostics. How many regi-
detected in the patient? ons can abdomen be divided into?
A. Helicobacter A. 9
B. Spirochete B. 8
C. Spirilla C. 6
D. Leptospira D. 5
E. Treponema E. 4
196. A patient after disrupted cerebral ci- 199. A child has a wound located posterior
rculation has developed paralysis. Choose to the mastoid process. Bright red blood
the anticholinesterase drug to be prescribed flows from the wound. Damaged are the
in this case: branches of the following artery:
A. Proserin A. A. occipitalis
B. Cordiamin B. A. temporalis superior
C. Aceclidine C. A. maxillaris
D. Methacin D. A. carotis externa
E. Hexamethonium (Benzohexonium) E. A. carotis interna
197. 30 minutes after drinking mango juice 200. When investigating human saliva it is
a child suddenly developed a local swelli- necessary to assess its hydrolytic properti-
ng in the area of the soft palate, which es. What substance should be used as a
impeded swallowing and, eventually, respi- substrate in the process?
ration. Mucosa of the swollen area was
hyperemic and painless. Blood test revealed A. Starch
moderate eosinophilia. Body temperature B. Proteins
was normal. Anamnesis states that the elder C. Fats
sister of the child has been suffering from D. Fiber
bronchial asthma attacks. What kind of E. Amino acids
INSTRUCTIONAL BOOK
Testing Board

TEST ITEMS FOR LICENSING EXAMINATION: KROK 1. MEDICINE.

Kyiv. Testing Board.


(English language).

Approved to print 19.04/№100 Paper size 60х84 1/8


Offset paper. Typeface. Times New Roman Cyr. Offset print.
Conditional print pages 20. Accounting publishing pages 24.
Issue. 3141 copies.
List of abbreviations

A/G Albumin/globulin ratio HR Heart rate


A-ANON Alcoholics anonymous IDDM Insulin dependent diabetes mellitus
ACT Abdominal computed tomography IFA Immunofluorescence assay
ADP Adenosine diphosphate IHD Ischemic heart disease
ALT Alanin aminotranspherase IU International unit
AMP Adenosine monophosphate LDH Lactate dehydrogenase
AP Action potential MSEC Medical and sanitary expert committee
ARF Acute renal failure NAD Nicotine amide adenine dinucleotide
AST Aspartat aminotranspherase NADPH Nicotine amide adenine dinucleotide
ATP Adenosine triphosphate phosphate restored
BP Blood pressure NIDDM Non-Insulin dependent diabetes mellitus
bpm Beats per minute PAC Polyunsaturated aromatic carbohydrates
C.I. Color Index PAS Periodic acid & shiff reaction
CBC Complete blood count pCO2 CO2 partial pressure
CHF Chronic heart failure pO2 CO2 partial pressure
CT Computer tomography pm Per minute
DIC Disseminated intravascular coagualtion Ps Pulse rate
DCC Doctoral controlling committee r roentgen
DM-2 Non-Insulin dependent diabetes mellitus RBC Red blood count
DTP Anti diphtheria-tetanus vaccine RDHA Reverse direct hemagglutination assay
ECG Electrocardiogram Rh Rhesus
ESR Erythrocyte sedimentation rate (R)CFT Reiter's complement fixation test
FC Function class RIHA Reverse indirect hemagglutination assay
FAD Flavin adenine dinucleotide RNA Ribonucleic acid
FADH2 Flavin adenine dinucleotide restored RR Respiratory rate
FEGDS Fibro-esphago-gastro-duodenoscopy S1 Heart sound 1
FMNH2 Flavin mononucleotide restored S2 Heart sound 2
GIT Gastrointestinal tract TU Tuberculin unit
GMP Guanosine monophosphate U Unit
Hb Hemoglobin USI Ultrasound investigation
HbA1c Glycosylated hemoglobin V/f Vision field
Hct Hematocrit WBC White blood count
HIV Human immunodeficiency virus X-ray Roentgenogram

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