913020 1. A. patient was brought by at ambulance’ to. the inpatient department FUR provisionally diagnosed with acute fe was false To confirm this diagnosis, pancrents 7 canter Ie acy oa sensiy enzyme In the pavient’s blood an: urine, Name this enzyme: ‘A. Aspartate transaminase B. Choline esterase janine transaminase B. Lactate dehydrogenase 2, Blood test of the albumin content of 20 g/L and increas activity of lactate dehydrogenase isoenzyme 5 (LDHs). These results indicate disorder of the following organ: tient revealed A. Lungs B. Kidneys © Heart 3. A. 2S.yearold woman complains of ‘Geterioraling vision. Examination revealed $ defect in accommodation, the pupil is Gilated and unresponsive to light. What muscles are functionally disturhed in this case’ ‘A. Lateral rectus muscle, iris sphincter muscle B. Iris dilator muscle, ciliary muscle Cc yhincter and iris dilator muscles Be ies rare cilia a 4. One of the eauses of pernicious anemia ig the disturbed synthesis of transcorrin - Castle's intrinsic factor - in the parietal cells of the stomach. What substance is called Castle's extrinsic factor? “A. Cobalamin B. Folic acid C. Biotin D. Riboflavin E. Pyridoxine 5. Proliferation of connective tissue in the liver parenchyma (fibrosis) that results from chronic disorders causes a blood flow disturbance in the classical hepatic lobules. Describe the blood flow direction in these ules: A. Around the lobule B. From the center to iT Bi trom te bare a ‘apex E. From the apex to the base od type, of cl surgery, the bloo & tent i f8eP% termined aceon Lan Se oy ot antibodics again Pe i get por anti-B reagents, NetinaliOn \ what blood type is it A. ABUY) 1B. BAN) CALL ¢ oan a. When checking donor blood at the vlood transfusion station, antibodies to transtnodeficiency virus were foun’ jmmunsorum of one of the donors. Ti blood dis recommended for confirmatl DY HIV-infection diagnosis? A. Immunofluores: m iaked immunosorbent assay 8 During a surgery with application of § Dition aarcosis and, muscle relaxants, fe anesthesiologist noticed rapid increase We ne patient's body temperature to 43°C. What pathology developed in this patient? ‘A. Physical hyperthermia hire ic shock D. Overheating E, Infection-induced fever 9, During the exercise testing on a training bicycle, the patient's respiration rate increased. What is the main cause of the changed activity of the respiration center in this case? ~ A, pesrense. of O2 tension in the blood C. Decrease of CO; tension in the blood D. Increase of blood adrenaline levels E. Increase of Op tension in the blood 10. A man was hospitalized on Sth day alter the Meee eT the aisease, He has jaundice, myalgia, chills, and nasal bleeding. During ‘the laboratory diagnostics, the bacteriologist performed dark field ‘microscopy of the blood drop obtained from the patient, Name the causative agent of this disease: B. Bartonella bacitloformis C. Borrelia duttonit D. Rickettsia mooseri E. Calymmatobacterium granulomatis Scanned with CamScanner913020 AL. A 5-year-old child presents with severe prouression of bacterial diseases, During ood serum examination, a significant decrease of immunoglobulin concentration and absence of B lymphocytes are observed, What immunodeficiency Is it? A. DiGeorge syndrome B.D simmunoplobulineria Sin aa . Svsstype agammaglobulinemin F, Louis-Bar syndrome (ataxia-telangiectasia) 12, Autopsy of the body revealed waxy degeneration of the rectus abdominis muscles. In the terminal segment of the small’ intestine there are ulcers 3-5 cm in diameter, The ulcer walls are covered in a crumbling grayish-yellow substance. The ulcer edges are moderately raised above the mucosa, Widal test is positive. Make the diagnosi A. Dysenter B. Nonspccilic ulcerative colitis C. Crohn's disease Di. Relapsing fover 13. A 15-year-old girl complains of rapid fatigability, weakness, and palpitations. Blood test: erythrocytes - 2.5 p/L, Hb « 20 pil color index = 0.6, anisocytosis with the prevalence of microcytosis serum iron is 5.4 mmol. What hematologic pathology is observed in this case? A. Acute posthemorrhagic anemia Chey ii irons anemia D. Acquired absolute erythrocytosis E. Bz and folate deficiency anemia 14, Alter a traffic accident, the lower limb of the injured person had to be amputated, For a long time the patient was still feeling the amputated limb and intense unbearable pain in it. What type of pain developed in this paticnt? A. Reflective pain B. Visceral pain C. Causalgic pain . D. Referred pain 15. A laboratory rat with chronic kidney failure has _ osteoporosis, _ pathologic calcification of the internal organs, and arterial hypertension. These disturbances are associated with the increased activity of the following hormone: B. Trilodot ae C.Thyroxin D. Adrenaline E. Caleitonin 16, A 26-year-old woman was brought into the maternity department. Considering the term of her pregnancy (40 weeks), she should have gone into labor already. Examination determined that the uterine cervix Is open but uterine contractions arc absent, The doctor gave her a hormone drug for Intensification of Inbor activity. Name this drug: A. Hydrocortisone c oa D. Adrenocorticotropic hormone E. Testosterone 17% A test animal receives clectrical impulses that irritate the sympathetic nerve that innervates blood vessels of the skin, What reaction will it cause in the blood vessels? A. Arterial dilation B. Venous dilation D.Anerat and venots ‘fiaon E. No reaction 18. A 50-year-old man complains of hoarse voice and difficult breathing, Examination detected a laryngeal tumor in the region of the vocal cords. In this case metastases can spread to the following regional lymph nodes: | A. Submandibular lymph nodes B. mph nodes * D. Deep cervical lymph nodes E. Submental lymph nodes 19, Clinical instrumental examination of a patient allowed to provisionally diagnose him with liver cancer, What protein is indicative of this diagnosis, if it is present in the blood scrum? A. Gamma globulins C. Properdin D. Paraproteins E. C-reactive protein 20, 10 days after the administration of an antitoxic anti-diphtheritic serum, a child with diphtheria developed skin rashes accompanied by severe itching, body temperature increased up to 38°C, the child developed pain in the joints, What Scanned with CamScanner913020 3 likely cause of these phenomena can be suggested? A por ggesction P) o D. Contact alltpy E, Delayedstype hypersensitivity 21, Parents of a sick child came to the infectious disease specialist, The parents were working in India for a long time. The child has the following. signs: a gray tint to the skin tone, loss of appetite, inertness, enlarged liver, spleen, and lymph nodes, What protozoan disease can be suspected inthe child? B. Lambliasis C Balantidiasis D. Toxoplasmosis E. Amebiasis ~ 22, ECG of the patient shows increased Guration of the ORS complex. What is the most likely cause? “BDisurbed eondus ed con ie atrioventricular node . Increased atrial and ventricular excitability D. Increascd period of atrial excitation E. Increased atrial excitability 23, Blood test shows the following: sodium ~ 115 mmol/L, chlorides - 85 mmol/L, glucose = 6 mmol/L, total protein - 65 g/L. The first consequence of such changes will be the decrease of: A. Blood c Sen espera n rate D. Circulating blood volume E. Oncotic blood pressure 24, A patient complains of frequent and ‘excessive urination and thirst. Urinalysis revealed the following: 24-hour diuresis 19 liters, specific gravity 1.001. These values are characteristic of: A. Diabetes mellitus B. Addison's disease C.Thyrotoxicosis. * D, Steroid diabetes 25, A W6-yearold girl hus no hair on the pubis and in the armpits, her mammary glands are underdeveloped, no menstruations, This condition can be caused by the following hormone imbalance: A. Hyperthyroidism, By Adrenal 7 snal medulla hyperfunction 7h Oran a c Islet failure E, Hypothyroidism 26, A patient has an allergic response with itching, edemas, and skin redness, In the tissues there Is an increased concentration of a certain biogenic amine. Name this biogenic amine: A. Dopamine ryplaml . Serotonin E. Gamma-aminobutyric acid 27. It is Known that hepatitis D_ virus telongs to. defective viruses and can reproduce in the host cells only in the presence of another hepatitis virus. Name this other hepatitis virus: A, Hepatitis C virus B, Hepatitis G virus Hepatitis E virus D. Hout An 28. Genealogical analysis of a child with myotonic dystrophy determined that this disease manifests in every generation, is fn equal measure present in the relatives of both genders, the risk of inheritin this discase is equal no, matter whic arent is affected. If one of the parents is \eterozygous for this disease and the other ant beat, the risk of them giving irth to-a sick child is $0%. What type of disease inheritance is it?” B, X-linked dominant C, X-linked recessiv z ‘Autosomal recessive 29. A certain vitamin is a component ‘of glutamic acid decarboxylase asa coenzyme, takes part in the formation of gamma-aminobutyric acid, and its deficiency manifests as convulsions, Name this vitamin: A. Cobalamin € Tocopherol D. Ascorbic acid E. Folicacid 30. Histological —_specimon shows parenchyma of an organ that consists of Scanned with CamScanner913020 7 lymphoid tissue that forms lymph nodules; the nodules are located aiffusely and have a central artery. What anatomical structure has such morphological characteristics? A. Red bone marrow 3 Lyaph node C. Tonsil ymus 31, A medical student was hospitalized into. the infectious diseases unit on the 2nd day after the disease onset. The | patient is suspected | to have infectious mononucleosis. What_ results of laboratory analysis can. confirm this diagnosis immediately on the day of the hospitaliza ‘A. IgM antibodies to simplex virus were detected herpes simplex win B. Herpesvirus was isolated Cc D, Cytomegalovirus antibodies were detected E. Fourfold increase in the number of antibodies to. Epstein-Barr virus was detected 32, After a spinal trauma the patient has iost proprioceptive sensitivity in the lower half of the body and in the lower limbs. What sensory conduction pathway was likely damaged, leading to the loss of sensitivity? A. Tk spino-thalamicus anterior Cn a eal is D. Ti spino-cerebellaris ventralis (Gowers column) f, Fascicuelus cuneates (Burdach column) 33, A patient presents with an acute attack of cholelithiasis. Laboratory ‘examination of the patient’s feces will show the following in this case: A. Connective tissue B. Partially digested cellulose ) Starch granules _ E, Positive reaction to stercobilin 4, Autopsy of the body of a 72-year aa ma who was suffering tom rheumatoid ‘arthritis and died of uremia, ceealed enlarged pale gray kidneys with Tossy lardaccous surface on section. Biased ‘on the macroscopic changes, the pathologist suspected: A. Primary-wrinkled kidae) B, Aterosdlcrotie nephrosclerosis C. Chronic pyelonephritis Re hroni a lomerulonephritis 35. The patient notes frequent di especially after eating {ati food, and Toss of weight, Laboratory testing “detected steatorthea and hypocholic feces. Wh: the likely cause of this condition? ate ‘A. Lipase deficiency B, Imbalanced diet C. Disturbed P ospholipase mar E. Inflammation of the small intestine mucosa 36. A person developed increased pulmonary ventilation due to physical exertion, What indicator of external respiration will be significantly increased comparcd to the resting state? ‘A. Expiratory reserve volume B. Inspiratory reserve volume €. Vital lung capacity tal apacity 37, A 48-year-old man is unconscious. He has a history of several syncopal episodes with convulsions. ECG shows deformed ORS complexes unconnected with P waves, arial contractions are "approximately 70/min., ventricular contracuons - | 2)- 30/min. Name the type of arrhythmia in this case: A. First-degree atrioventricular block B. Intraatrial block C. Intraventricular block E. Second-degree atrioventricular block 38, An oncology patient is to undergo @ surgery on the descending colon. Name the main source of the blood supply to this organ: ‘A. Middle colic artery B. Celiac trunk C. Superior mesenteric artery D. Spleni + 49, Body Muids, especially urine, of 2 sick iid produce a specific ‘sweet odor. It is Seoegted with the disturbed metabolism fof such amino acids as leucine, isoleucine, and valine. What diagnosis will be made by the doctor in this case? Scanned with CamScanner913020 ‘A. Alkaptonuria jalactosemia C.Fructosuria E, Phenylketonuria 40, Examination of the femoral bont detected chronic suppurative inflammation of the compact substance and bone marrow, formation of bone sequestra, What discasc is associated with such changes? A. Reticulosarcoma B. Periosttis C.Multiple myeloma D. g pales fener of bone 41, Autopsy of the body revealed a large wedge-shaped patch of a dense dark rod tissue with clear margins in the upper lobe of the right lung, Histological examination detected there necrosis of the alveolar walls; the alveolar lumen is tightly packed with erythrocytes. What process occurred in the lungs? A. Hemorrhage B, Gangrene C. Carneous degeneration zp Atel rage ima 42, A. nurse mistakenly gave nearly a double dose of insulin to a patient with diabets mellitus, which ‘caused hypoglycemic coma in the patient, What medicine should be administered to bring the patient out of the coma? A. Lidase ymatotropin D. Noradrenaline E. Insulin 43, A lab rat has subcutaneously received mercury({) chloride in the amount of 5 mg/kg. 24 hours later the plasma creatinine concentration increased several times. ‘What mechanism of retention azotemia is ‘observed in this case? ‘A. Increased creatinine secretion in the renal tubules B. Increased creatinine reabsorption Increased creatinine production in the muscles D. Increased omar filtration 44, In the hospital a patient was diagnosed wilh anemia, “During | the "ana collection, it was revealed that the patient had been suffering from peptic ulcer disease of the stomach for several years already. What type of anemia is most fikely inthis patient? ‘A. Acute posthemorrhagic anemia 1B. Hereditary hemolytic anemia . Acquired hemolytic anemia E, Sickle cell anemia 4S. 24 hours after an appendectomy the falents blood test shows, neutcophile leukocytosis with a regenerative shift. What is the most likely mechanism of absolute leukocytosis development in the patient's peripheral blood? ® . Leukocyte redistribution €. Deceleration of leukocyte migration to the tissues D, Decreased leukocyte disintegration E. Immunity activation 46. A pationt with massive burns received askin praft from a donor. On the 8th day after the grafting, the transplant became ‘edematous and discolored. On the 11th day transplant rejection started, What cells take part in this process? ‘A. Basophils 1B. Erythrocytes CB lymphocytes Echos 41 A ASyearold teenager. comping of general weakness, dizziness, and rapid) fatigability, Examination detected deformed ‘erythrocytes, their number is decreased. The provisional diagnosis of sickle-cell’ anemia was made. What amino acid replacement in hemoglobin causes the development of this” pathological condition? B. Glutamate replaced with aspartate C. Valine replaced with glutamate D, Glutamate replaced with alanine E, Valine replaced with aspartate 48, Name the supramolecular multienzyme complex that is integrated into the iipid layer of inner mitochondrial membrane that croates conditions for redox reactions: A. G-protein transducer B, Pyruvate kinase C. Hexokinase ‘arboxypeptidase 49, The process of tissue respiration is Scanned with CamScanner913020 accompanied by oxydation of organi compounds, and yates of mace jolecules. In what organell process occur? ronehes Seay A. Golgi apparatus & wise D. Lysosomes E, Ribosomes 50. A patient with ischemic heart disease has increascd levels of triglycerides and low-density lipoproteins in his blood plasma, What medicine should he be prescribed? e Dobutamine C. Famotidine D. Lisinopril E. Amiodarone 51. A woman with enteritis accompanied by severe diarrhea presents with the loss of water in the extracellular space, increased. water content in the cells, and decreasing blood osmolarity, Name this type of water- electrolyte imbalance: Hi boon poosmalas Non yrauon CC Hyperosmolar hypohydration D.Isoosmolar hypohydration E, Hyperosmolar hyperhydration 52, Autopsy of the body of a person, who Gied after an abdominal surgery, revealed humerous thrombi in the veins of the fessor pelvis. Clinically, thromboembolism syndrome was registered. Where should the pathologist search for thromboembolas? . a tt ventricle of the heart C. Brain D. Lower limb veins E. Portal vein 53. A paticnt with essential hypertension developed a cough during the systematic treatment with a hypotensive drug. What drug of those listed below can cause such a side effect? A. Dibazol (pendazol i C.Apressin (Iydralazine) Pe Peaco " Peri ivatives - aminopterin 54. Pterin derivatives sminopler And methotrexate = ale competitive inhibitors of dihydrofolate reductase, AS a result, they suppress the regeneration 6 of tetrahydrofolic acid from dit These medicines lead t0 the inhibition ot intermolecular transport of one-carbon groups, In the process, the biosynthesis af The following polymer is suppressed: Hebinopotysaecharides G Protein . Glycosaminoglyeans E-Gangliosides 55, A 2eycar-old child presents with marked delay in psychomotor development, vision and hearing deterioration, marked enlargement of the liver and spleen. ‘The child is diegnosed with hereditary Niemann-Pick discase. What genotic defect is the cause of this diseasc? D. Amyl E. Xanthine oxidase deficiency 56. The patient presents with smoothed out nasolabial fold, dilated right palpebral fissure (it cannot be closed when squinting, because the evelids would not close), there are difficulties during speaking and cating (flood gots stuck between the cheek and teeth). What nerve is damaged in this case? ALN. glossopharyngeus sinister B.N. vagus dexter CN, abduceus dexter » N. trigeminus dexter §7. A woman was hospitalized in a severe condition with the following diagnosis: hemorthagic stroke in the region of the medial surface of the right frontal lobe. What artery is likely to be damaged, causing this condition ia the patient? A. A. communicans anterior CA. communicans posterior D. A. cerebrt media E. A. cerebri posterior 58, In an experiment, a frog neuromuscular preparation had been processed with, @ Pimare-like substance, which led to the + disupparance of muscle contractions, in response 10 clectrica) stimulation, What function of the muscle cell membrane is disrupted by curare-like substances? Scanned with CamScanner913020 mange in the permeability for different substances Ci Mitintenance ofthe internal cll structureys its cytoskeleton * D. Creation of a barrier between the Intracellular environment and surrounding intercellular fluid -. E- Creation of the electric potentials on the both sides of the membrane 59. An unconscious patient was brought into the admission room. He presents With cold skin, constricted pupils, difficult respiration with Cheync-Stokes pattern, Tow blood pressure,” overfilled urinary bladder. He was diagnosed with morphine poisoning, What drug should the patient be fBiven as an antagonist in this case? A. Cytitone D. Sodium thiosulfate E, Unithiol 60. A paticnt has developed status epilepticus. What medicine should be used in this ease to stop the seizures? ‘A. Cyclodol (Trihexyphenidyl) Sodium bromide 2, Diprarine (Promethazine) E. Valerian extract 61. In. the process of acetylcholine interaction with muscarinic acetylcholine receptors of contractile cardiomyocytes, a bioactive substance is being produced. This bioactive substance leads to inactivation of calcium channels, decrease of calcium ions entry into the’ cardiomyocytes, and development of negative inotropic effect. Name this substance Ea lic guanosine monophosphat (cGMP) €. Cyclic guanosine triphosphate (¢GTP) D, Cyclic adenosinc triphosphate (cATP) E. Cyclic adenosine diphosphate (cADP) 62. Examination showed that | total leukocyte count in the patient's blood is 11 10°, with 80% neutrophils, among which 9% are band neutrophils, Characterize the crangs in the cell composition of "white blood in this case: AA. Nuclear right shift of neutrophils 1, Leukopenia E, Neutropenia 63, Blood smear analysis of a blood sample Qdtained from a patient with inflammatory process shows a large number of round cells fith segmented nucleus (three or more segmens) and fine pink-violet granulation inthe cytoplasm, Name these blaod cells: A. Erythrocytes B. Basophilic granulocytes . Lymphos Br Bostnophilic granulocytes 64. A newborn boy has dolichocephalic Skull, microcephaly, and defects of heart, icidndys, and digestive system. The child's Karyotype is 42 X¥, + 18. Make the diagnosis: A. Klinefelter syndrome au syndrome D. Down ayo: irom E. Turner syndrome 65. A histological specimen demonstrates fa vessel with the wall that consists of endothelium, bascment membrane, and Joose connective issue, What type of vessel is it? ‘A. Hemocapillary B.Artery Lymph capillary D. Musutar vein 66. Arterial blood pH is 74; primary urine pH is 74; final urine pH is'5.8. Decreased pH of the final urine results from the secretion of a certain substance in the nephron tubules, Name this substance: A. Potassium ions B. Hydrogen carbonate ions . Ure: E, Creatinine 67 A_ patient came to the hospital complaining of abdominal distension, diarthea, and meteorism that occur after eating protein-rich food, which indicates disturbed protein metabolism snd intensified protein pulefaction. What substance is the prod substance is the product of this process in Scanned with CamScanner913020 8 A. Apmatine B. Bilirubin & Puree Cad 68, A patient complains of acute increase in diuresis (up to $-7 liters of urine per 24 hours), Examination revealed decreased secretion of vasopressin in this patient What cells have insufficient secrctory activity in this case? A. Endoc pituitary . Pituieytes jocytes of the intermediate Bent ased fibrinolytic activity c C. Increased blood viscosity D. Increased fibrinogen synthesis E, Decreased activity of the blood coagulation system 73. Section shows a significant enlargement ‘of the patient's right kidney. There, is nephrolith at the place of the Incision. Real pelvic lumen, is dizended with accumulating urine. The ronal parenchyma tecipstanaly thinned ut. (wats the most correct diagnosis? A, Pyeleciasis C. Endocrinocytes of the anterior pituitary Betonepies C.Nephroblastoma D rn poate cells, 69. A 35-year-old man complains of a Sots rhialte and a loss of the sense of smell for a week. Examination detected in the nasal cavity a large amount of mucus that covered the mucosa and blocked the olfactory receptors. Where in the nasal tavily are these receptors located? ‘A. Inferior nasal concha B. Middle nasal conel D. Common nasal meatus E. Vestibule of the nose 70. A 50-year-old man expericnced & severe stress. His blood levels of adrenaline and. noradrenaline sharply increased. What ‘enzymes catalyze the process of noradrenafine inactivation? PRapES C.Tyrosinase D. Carboxylases E. Glycosidases 71. Due to a case of diphtheria, preventive Tamunization of the whole contact group tr students is necessary. What preparation should be used to produce artificial active immunity? ‘A. Anti-diphtheria serum B. DTP vaccine Coenen ic — yun BE. Inactivated vaccine 72. A woman, who works as ashop assistant And suffers from phlebitis, developed a {hrombus in the area of the varicose Auins in her leg. What pathogenetic factor was primary in the process of thrombus Formation in this ease? DD. Hydroureteronephrosis E. Renal cyst 7 A 46-year-old man was brought to the ospital 5 ¢ in nervous, system Houses. ibe man was provisionally diagnosed with cerebral hemorrhage. The tient preseats with frequent spontancous Tints ‘movements intermittent with the state of limb muscle hypertonia, These signs can be explained by the damage to the following brain structures: ~ A. Brain stem 1B, Frontal cortex C. Hypophysis D. Hypotkalzs 75, Alter 2 boy fell from a tree, the arm Abduction to. the horizontal position is difficult for Bim. What muscle is likely to be damaged in this case? AM. CM. supinstor D. M. coracobrechialis ELM. riceps brachii 76, A T-year-old child developed sore throat, and high body temperature. On the 2nd day after the onset of the disease, there fappeared dense ted rashes that look ike Shall spots the size of a poppy seed. They Gaver the whole body, except the nasolabial triangle. Examination of the oral cavity fevealed bright red pharynx, enlarged Tonsils, and respberry-red tongue. Make the diagnosis: ‘A. Adenovirus infection B, Measles C. Pharyngeal diphtheria ep occal tonsillitis Scanned with CamScanner913020 ‘77. For the relief of intestinal colic a atlent. was preseribed atropine sulfate, What disease can be a contraindication for administration of this medicine? etna ee C. Bronchial asthma D. Headache E. Vertigo 78. Puncture biopsy of a transplanted Binoy detected there a diffuse stromal infiltration by lymphocytes, plasma cells, lymphoblasts, and. plasmablasis, as well as necrotizing arteritis, What pathological process developed in the transplant? A. Ischemic kidney damage B. Glomeruionephritis C. Pyelonephritis D, Tubular necrosis 79. A young woman suddenly developed cough and bronchial spasm, when she entered into a room with high concentration of tobacco smoke. What receptors activated this defensive reflex? A. Pleural recey Ban a D, Pulmonary mechanoreceptors E. Juxtacapillary receptors 80. A patient has peptic ulcer of the stomach, What medicine can decrease the secretion of hydrochloric acid and pepsin by blocking the H2 receptors? A. Phthalazol (Phthalylsulfathiazole) B. Fluvoxamine C. Phenobarbital Physostigmine 81. A. 40-year-old woman was diagnosed with bronchial asthma that manifests as periodical asphyxia attacks. What type of Yentilatory insufficiency can be observed in the patient during an attack? ‘A. Extrapulmonary “Be Plimonary restctive D. Hypoxemic E. Dysregulatory 82. A patient with an injury of the proater psoas muscle was delivered to the Traumatology center. The patient has lost the ability fo extend the lower leg at the knee joint. What nerve is damaged in this case? “fobmater urator = €, Ilioinguinal nerve 1. Genitofemoral nerve E, Miohypogastric nerve 83. A patient complains of pain in the upper ua! region. On palgation there 3 mobile painful intestine. What intestine Is being palpated by the doctor? A. Duodenum B, Jejunum cme colon 7 m BA. A Seyear-old child is diagnosed with Bruton’s disease (X-linked agammaglobuli- nemia) that manifests itself in severe clinical course of bacterial infections and absence of B lymphocytes and plasma ells, What changes in the immunoglobulin content can be observed in the blood serum Ol the child with immunodeficiency? A. Decreased Ig, IgE B. Increased IgA, IgM C.Increased 12D, IgE Begala 0 changes 85. In a hypothetical experiment, the action of a toxic substance disrupts the mechanism of nerve impulse transmission between neurons, What structure enables this function? A. Neurolemma, 1B. Neurofibril C. Mitochondrion D, Niss! substance. 86. A 45-year-old woman has breast cancer. Melasases can spread in this case to the following regional lymph nodes: A. Parasternal, bronchomediastinal Abdominal, cervi D. Cervical, parasternal E. Aortic, bronchomediastinal 87 Due to a cerebral hemorrhage, the patient developed a disturbed ‘speech perception (ensory aphasia). What ‘brain structure is Tikely to be damaged in this case’ Scanned with CamScanner10 913020 A, Inferior frontal gyrus Ber ened ezae central pyus DB. Suparior frontal ¢yrus Brinterior temporal gyrus 88. Acute herpetic gingivostomatitis is the most common primary infection caused by herpes simplex virus {ype 1. What material should be obtained by a dentist for the laboratory testing that will confirm this diagnosis Urine D. Blood E, Sputum 89. The mountain climbers, who without oxygen equipment were’ climbing mountain, at the altitude of 5000 meters Above the sea level developed tachycardia, iow blood pressure, fast respiration rale. ‘What type of hypoxia did they develop? ‘A. Circulatory hypoxia eee ayo : D. Hypoxemic hypoxia E. Hemic hypoxia 90, A. S-yearold child developed @ severe case. of purulent destructive pacumonia, for which the child received p massive antibacterial therapy. The discase was rapidly progressing. Against | the background of marked intoxication, a sharp drop in blood pressure was registered, the paent went into a state of shock, which Resulted in the death of the patient. What Cliopathogenetic type of shock developed in the child? ‘A, Hemolytic shock ‘C. Anaphylactic shock D. Hypovolemic shock E. Cardiogenic shock s from the eye muscle paralysis, there are pupillary disturbances pad pain along the trigeminal nerve. ‘Aneurysm (dilation) of a certain venous Gaus can be suspected. Name this venous sinus: 91, A patient suffer B, Sinus cavernosus C Sinus occipitalis D, Sinus iransverss us petrosus superior patient has cardiac, chythm 92. A (CG shows heart rate of disturbance. Et 60imin,, prolongation of PQ Interval, periodical’ loss of QRS complex. What cardiac rhythm disturbance Is It? ‘A. First-degree incomplete AV block By Complete AV Bost Sick sinus syndrome Bienes ight bun ingen block 93, A person has diabetes mellitus with Tasting hyperglycemia of over 72 mmol/L. What’ blood plasma protein allows for retrospective assessment (4-8 weeks before the examination) of glycemia levels? ‘A. Fibrinogen B. Albumin C.Creactive protein 1D, Geruloplasm 94, During 2 surgery for spleen injury, the surgeon needs to isolate an artery that supplies the spleen with blood. What ‘branch of the arterial vessel is it? A.A. hepatica communis . hep D.A. gastrica sinistra ELA. gastroduodenalis 9, During an intense workout, the number ‘of trophic inclusions in the cells of the alklete’s liver and skeletal muscles creases, What substance belongs to such trophic inclusions? A. Lipofuscin granules 1B, Melanin granules Starch granules Seana alc acl — s 96, A. 49-year-old woman developed fa leg edenia after a long time spent Standing, What is the likely cause of edema development? ‘A. Decrease of hydrostatic arterial pressure ‘ic blood plasma pressure Bi Increase of oncoti . Decrease of hydrostal 5 pressure E: Increase of arterial pressure Sr Autopsy of the body of a 40-year-old patient detected groups of enlarged follicles hthe small intestine. Their surface hes ridges and fissures arranged in a pattern that resembles gyri and sulci of the brain. ‘The follicles protrude above the. surface of the intestinal mucosa. On section they are gray-red and juicy. Microscopy shows proliferation of monocytes, histiocytes, Scanned with CamScannerana rei ctu tious 913020 cr Ir cells, ers tha there are macrophage Lymphocytes ang nr Reamer ville be charac depleted. What disease ed by these changes? BQ eheiatever Gb ySentery 2 Amebiasis ‘almonellosis 98, Doo gsRe catabolism, pathway of resides, , Macromolecules includes, mitochond gro, acid cycle and nochondral "respiratory chain, the Paces of pyruvate daiatve dacrbowsation © product oie onda ena ths rout of pyruvate od i. ‘Malonyt-CoA ba Iplia-ketoglutarate Citrate 99. A mountain cli is mountain climber was climbing & ouniain for several days, At the altitude Of S000 meters, he develoned tachypaea, tachycardia, and bursting headache. What 1 likely cause of these signs? A: Decrease of barometric alt presse é Gas embolism D. Insufficient pulmonary ventilation E, Decrease of air temperature 100. A _pationt has heart ehiyt disturbances. ore the rhythm, the forest doctor prescribed the patient calcium do calcium ions antagonists, What effect have on the myocardium? A. nD — force and frequency of cardiac contractions : ; @Activate parasympathetic autonomic nervous system D, Activate sympa stem ‘Suppress sympathetic autonomic nervous system 101. Re thetic autonomic nervous jonal lymph nodes surrounding an iMfected wound are enlarged. Histological iMamination shows increased number of cxrcrophages, lymphocytes, and lymphatic follicles in the cortical layer of the Fymph (ides, as well as a large amount of plasma Bale, What process in the lymph nodes is ceificated by these histologic changes? u ant rejection deficiency of yng Sti A. Transpl paid tissue phoid tse G-month- fed the vingenital deficiency of ly sy af the bod} iho died of se ind dl in, Micrasco} 102. Autops ‘old child, wl absence of (hymus i weight of the splec 3 spleen detected the absence of f cl ed Pependent zones of the folices and rateTdpletion; in the Tymph nodes there fre fePmeorical zone that Is ePresenyp 1 ae any lymphocytes. B zones 1h the Peripheral immune orBans ‘are develope perio What pathological process |S a ‘A. Glanzmann-Riniker syndrome (cellular A phumoral immune deficienes) Accidental thymic involution Co yruton syndrome (humoral deficiency) immune DH leer adcome (cellar mune | ener) 103, A ized _ into an infectious diseases His skin ig dry, with low turgor, sta ice water, The patient was dia cholera, What waterelectro/yte islikely to occur dur ring this ‘A. Hyperosmotic hypohydration B. inyperhydration ase’ tic hyperhydration ic hypohydration 144 the enlarged cervical lymph node UA Tyeat-old girl microscopy detected Ghe following: issue structuce of the lymph fade is disturbed, no lymphoid follicles, There are selerotic areas and necrotic foci, thituiar composition of the lymph node {S polymorphous, there are Iymphocytes, cosinophils, large atypical it fnultilobular nuclei (Berezovsky-Reed- Sternberg cals), ‘and large mononuclear cells. Make the diagnosis: A. Burkitt's lymphoma B. Chronic lymphocytic leukemia Acute lymphocytic leukemia Myc fungoides 40s. A Tycar-old girl has, signs of Anemia, Laboratory testing determined ihe deficiency of pyruvate kinase in her In this case the main role 1 ‘development belongs 10, the disturbance of a certain process. \ . Hyperosmo! E, Hypoosmoti Scanned with CamScanner913020 Process is disturbed in this git!? i A. Peroxide decomposition B- Oxidative phosphorylation ion, ssue respiration 106. Biopsy material of a 67-year-old man, who for 17 years fas been sulferin from chronic bronchitis, shows cylindrica bronchiectasis, the mucous glands have gystic changes, there are patches, where cuboidal epithelium is replaced with stratified squamous epithelium, What pathological process was detected in the yronchial mucosa? CG Hyps y D. Hyperplasia « E.Hoterotopia 107. A 59-year-old man in a_ severe condition was hospitalized into the cardiology department with the following diagnosis: acute myocardial infarction in the region of the posterior wall of the left ventricle and septum, initial pulmonary edema, What mechanism of pulmonary edema development is primary in this patient? A. Pulmonary venous hypertension B. Decrease of alveolar-capillary oxygen diffusion C. Hypoxemia 108. A patient developed a purulent inflammatory process in the periodontal tissues. The process was caused by activation of the microorganisms inherent in the body, which are a part of oral mucosal microflora. What type of infection is it? Reinfection C Superinfection D. Relapse E, Exogenous infection 109. A paticnt suffers from disturbed renal function. To check the filtration ability of the kidneys, he was referred for clearance measurement of the following substance: A. Hydrogen carbonate B.Urica Sino indole E, Glutamine 2 0. During emotional excitation the heart Tale of a a0-yenr-old person reached 112/min, ‘The increased heart rate was caused by a change that occurred In ferlain structure of the cardiac conduction system, Name this structure: A. Purkinje fibers B. Atrioventricular node C. His’ bundle le s’ bundle branches LLL. A 40-year-old man_with pulmona {utereulosis was. preserbed »Wsoniaz Prolonged taking of this drug can result in the development of the following vitamin deficiency: D. Biotin E. Cobalamin 112, A patient with suppurative bronchitis was. hospitalized inte ‘the pulmonology department, As a part of complex therapy, he was prescribed n medicine that liquefies sputum and facilitates expectoration. this medicine: ‘A. Valerian tincture B. Prednisolone C Cholosas DM spas seothioride 113, In an experiment on an isolated squid giant axon submerged in a salt solution, the extracellular potassium jons concentration was. increased to the level of the intracelliglar potassium ions concentration. What changes in the membrane potential will occur in this case? A. Potential decreases B. Potential remains unchanged G Foienti os E. Potential first decreases and then increases 114, A patient with essential hypertension was prescribed hydrochlorothiazide as a part of complex therapy. What mechanism of drug action facilitates a decrease in blood pressure in this case? Scanned with CamScanner3 913020 Serer creased production of angiotensin I Calcium channel hockade D. Carbonic anhydrase blockade * Decreased exeretion of sodium tons and water US, A. paticat is Elucocerebroside lipidosis (Gaucher's Glscase) that manifests ag eplenomeeay iver enlargement, affected bone tissue, and Reuropaties “Wat ename af caex lipid catabolism is deficient, causing this disease? i yaluronidase & Sphingomyelinase D. Hexosaminidase E. f-galactosidase 116, A Patient with Parkinson's discase ade an appointment with the doctor. The ‘Octor prescribed him a medicine that is a lopamine precursor in the central nervous pstem. at_ medicine of those. listed yelow has such mechanism of action? A. Plat i: Liatyrbytn byrotarate © Lor: e = jum bromide 117. During gastric, resection the Pationt received. mixed anesthesia with Wwbocurarine chloride muscle relaxant. To restore unassisted respiration in the Pationt, the pationt was given proserin, What pharmacological group does this drug belong to? ‘alcium channel blockers 1D, Muscarinic antagonists E. Angiotensin-converting-cnzyme inhibitors 118, A patient has a trauma of the knee joint with crushed patella. With such injury, itis likely that the tendon of a certain thigh muscle is damaged. Name this muscle: diagnosed with ‘A. Adductor longus muscle D Sartorius muscle CC. Adductor magnus muscle . Biceps muscle of the thigh 119, Mitochondrial destruction is observed in some hereditary diseases (for example, Kearns-Sayre syndrome), What processes can be disturbed, as a result, in the cell? A. Nuclear division 1; Amino acid synthesis, : C, Crossing over, D, Glycolysis 20, A 36-yearokl man developed Uepina poston altacks Immediately Micra "past. case of | staphylococcal cpsis, Coronarography detected mural Aerombosts without signs of atherosclrosts in the left coronary artery, “‘Thrombus formation occurred In the result of damage tothe vascular endothelium and release of: ‘A. Phospholipase A2 1h Adenosine triphosphate . Adenosine diphosphate E, Serotonin 121. T lymphocytes were affected by Tait In the proces, viral enzyme reverse transcriptase (RNA-dependent DNA- polymerase) catalyzes the synthesis of: ‘A.Viral DNA on the DNA matrix B. Viral protein on the viral RNA matrix €. Viral RNA on the DNA matrix D. Informational RNA on the viral protein matrix 122, There is a large amount of glucose oxidation metabolites dissolved in the cytoplasm of myocytes. Name onc such metabolite that converts directly into lactate: ‘A, Glucose 6-phosphate D. Fructose 6-phosphate BE, Glycerophosphate 123, From the feces of a patient with acute gastroenteritis a pure culture of microorganisms was obtained, ‘The microorganisms are small mobile slightly curved gram-negative bacilli that within 6 hours grow into alight biue film on the 1% alkaline peptone water. Such properties are characteristic of the following microorganism: A. Bacillus . Spirillum D, Clostridium E.Spirochacte 124, A bioterrorist mailed an envelope with a powder that is suspected to contain anthrax causative agent. This envelope can Scanned with CamScanner4 913020 remain dangerous for a long time, because anthrax causative agent A. Forms a polysaccharide capsule B. Belongs to actinomycetes a Ht E, Forms a one Capsule 125, A 65-year-old woman against the background” of chronic heart failure developed secondary hypernidostesonism. What medicine should be preseribed to increase the patient's diuresis? A. Clopamide 1B, Dichlothiazide (Hydrochlorothiazide) ide E. Orthosiphon grass 126. When examining a biopsy material oblained from the thyroid land, the pathologist discovered lymphocyte infiltration of the thyroid tissues and destruction of the parenchymal elements. Diffuse lymphocyte infiltration with Iymphoid follicles was detected in the stroma, What is the most likely diagnosis? ‘A. Undifferentiated thyroid carcinoma B, Graves’ disease (toxic diffuse goiter) ). Papillary thyroid cancer E, Solid adenoma of the thyroid 127 A patient used an_indiroct-acting adrenergic agonist to treat rhinitis. After the patient has been putting in the nose drops for several days, the vasoconstrictive effect of the drug gradually diminished. Name this phenomenon: B. Turton C Allergy D. Idiosyncrasy E. Cumulation 128. A 40-ycar-old woman on examination presents with intensified basal metabolic rate, What hormone present in excess leads to such condition’? B. Thyrocalcitonin C. Glucagon D. Aldosierone E. Somatostatin 129. Among lymphocytes there is a population of cells that have membrane receptors to IgM, activate in response to cerlain antigens, reproduce mitotically, differentiate into plasma cells that produce antibodies (immunoglobulins), Name these cells: A B. Suppressor T cells. E, Killer T cells 130, The ophthalmologist noticed | a purulent discharge from the conjunctiva Of a newborn, Microscopy of the smear ‘obtained from the conjunctiva found there G large number of leukocytes, as well ‘as gram-negative bean-shaped iplococci focdted inside the leukocytes, What is the causative agent of this disease? A. Staphylococcus epidermitis B. Streptococcus pyogenes C. Staphylococcus aureus Be Ntteera i halis 131. A biopsy material was obtained from the arches orihe ‘patient's soft palate due to fa suspected tumor (macroscopy detected fan ulcer with the dense floor). Inthe biopsy material the following was detected: necrosis of the mucosa with infiltration df the submucosal layer by lymphocytes, epithelioid calls, plasma cls ‘and single neutrophils, Notable is the presence of marked endovasculitis and perivasculitis. ‘The described changes are characteristic of: A. Ulcerative stomatitis, B, Aphthous stomatitis C. Necrotizing ulcerative stomatitis Betuinay op diphtheria 132. When examining a child, the pediatrician noted that the child presents with delayed physical and mental development. Urinalysis showed an acute increase in the levels of a keto acid that oduces qualitative color reaction with ferric chloride, What metabolic disturbance was detected in this case? . Cystinuria C. Tyrosinemia D, Albinisim +E: Alkaptonuria 133. The patient's ECG shows that in the second standard lead from the extremities the P waves are positive, their amplitude is 0.1 mV (norm is 0,05-0.25 mV), duration - 0.4 seconds (norm is 0,070.10 seconds), 11 can be concluded that the following process, occurs normally in the cardiac atria: Scanned with CamScanner913020 A. Relaxation Repolarization Contraction c D. Eeciation 134, Some adults develop signs of dyspepsia after drinking milk, What enzyme deficiency is associated with milk: intolerance? A. Maltase B. Lipase tidase E. Amylase 138. A, ‘oung woman, a foreign student from Tehran, has made an appointment With the urologist. She complains of the sensation of heaviness in her lower abdomen and a small amount of blood being excreted with urine at the end of each urination. Microscopy of urine detects the resence of pari eggs, approximatel Pow rileron in size wilh a iceminal spike, What diagnosis can be made by the infectious disease specialist? A. Fascioliasis B Ditoceliass ). Paragonimiasis E. Opisthorchiasis 136, Examination of a patient, who for a long time was taking glucocorticoids, detected lymphopenia. How can the functional state of the patient's immune system be characterized? A. Primary immunodeficiency B.C ni D. Autoantigen tolerance E. Anaphylaxis 13% Autopsy of the body of a 15- year-old child revealed hemorrhagic skin Tashes, moderate hyperemia und edema of the nasopharyngeal mucosa, small hemorrhages in the mucosa and internal organs, markedly dystrophic changes in the liver and myocardium, acute necrotic nephrosis, and massive hemorrhages in the adrenal glands, These changes are characteristic of the following disease: A. Scarlet fever B. ie jemic typhus es E. Diphtheria + gynecomast 1s 138, Immediately after moving from horizontal to vertical position, the heart fale of 1 23eyearold man increased by 15 beats per minute, his systolic pressure remained unchanged, while his diastolic Pressure increased by 10 mm Hg. What reflex response of the execulive structures caused this inerease in the diastolic Pressure? A. Increase of the cardiac output Be Increase of the stroke volume C. Consiriction of the capacitance vessels D, Constriction of the resistance vessels 139, The patient's ECG was obtained What clement of ECG allows the doctor 10 assess the spread of atrial depolarization processes? A.S wave 140, A 32-year-old man has tall stature, female pattern of hair distrihution, high pitched voice, delayed mental development, ster y. He was provisionally diagnosed with Klinefelter syndrome. To clarify this diagnosis, it is necessary to analyze the patient's: A. Spermatogenesis B. Leuk t Blood type E. Genealogy 141. A patient with myocardial infarction has acute heart failure. Among the drugs that increase the force of heart contractions the Icast dangerous in this case will be: A. Adrenaline B. Caffeine € Isadrinum (Isoprensline) uh (Aminophylline) 142, To treat the burns, a patient was prescribed a drug with antiseptic properties that are based ‘on formation of atomic oxygen in the presence of organic substances, This drug has also an astringent (anti-inflammatory) effect due to formation Of albuminates, Name this drug: Scanned with CamScanner913020 8 A. Hydrogen peroxide ® B. Sodium bicarbonate ‘A. Left optic tract B. Retina C. Right optic tract i ote nees E. Chlorhexidine digluconate 143. A man with caisson disease died with the signs of ncute disturbances of ecrebral trealation in the basin of d. meningea Gieta in the left brain hemisphere. Autopsy Tiected in this area a focus of gray cerebral Sshoning 6x7<3.4 em in size. What is the Sponicter of the process that caused the death of the patient? A. Vascular atherosclerosis 2. Thromboembolism C. Thrombosis E, Fat embolism 144. A patient with essential hypertension, who is taking hypothiazide (hydrochloro- thiazide) treatment, complains of general weakness, loss of appetite, and palpitations. He has muscle hypotonia, flaccid paralyscs, and decreased intestinal peristalsi ‘What can be the cause of this condition? A, Hyperkalemia BH. D. Hyperuricemia E, Hyponatremia 145. Mother of a epearall child made an appointment wil the dentist. She complains of teeth destruction in her child. Examination shows that the milk teeth of the child are deformed, carious, and have a brown border at their cervices, Medical history of the mother revealed that during her pregnancy she had been taking antibiotics without the doctor’s prescription. What group of antibiotics with the most marked teratogenic effect was likely taken by the mother? A. Aminoglycosides B. Penicillins C. Macrolides Cephalosporins 146. A patient has disturbed vision in the lateral visual ficlds of both eyes (bilateral hemianopsia), What nerve structure is affected? 142. A 2Byear-old_ woman came 10, 9 polyclinic with complaints of 2 headache, Ine ductor offercd her paracetamol, taking pre agongideration that the woman has Into matic discase, What concomitant isease made it necessary to prescribe her specifically paracetamol? A. Cholecysti Gn tis nema G D. Atherosclerosis FE, Rheumatoid arthritis 148, Duc to a trauma, the posterior roots of Binal cord of a 40-year-old man werd ae epied, What disorders will be observed (athe innervation region of these roots? ie v 2 A. Disturbed function of smooth muscles B. Loss of pain sensation C. Loss of thermal and ston sensation . Disturbed function of cross-striated skeletal muscles 149. A 16-year-old young man complains of itching between the fingers and on his abdomen that intensifies at night. Examination detects thin gray streaks and fine rash on his skin, What is the most likely causative agent of this disease? A. Ixodes ricinus B. Dermacentor pictus c rus papitlipes E. Ixodes persulcatus 150. A 35-year-old woman has a histor of wwo strokes. Her biochemical bloc analysis shows increased levels antiphospholipid autoantibodies. Target phospholipids in this case include: A. Ceramide B. Prostaglandin C. Cholesterol phingosine . dD -E.Cardiolipin— Scanned with CamScanner