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1. To treat the burns, a patient was prescribed a drug with E.

Adrenaline
antiseptic properties that are based on formation of atomic
oxygen in the presence of organic substances. This drug has 9. When examining a biopsy material obtained from the
also an astringent (anti-inflammatory) effect due to formation thyroid gland, the pathologist discovered lymphocyte
of albuminates. Name this drug: infiltration of the thyroid tissues and destruction of the
A. Hydrogen peroxide parenchymal elements. Diffuse lymphocyte infiltration with
B. Potassium permanganate lymphoid follicles was detected in the stroma. What is the
C. Chlorhexidine digluconate most likely diagnosis?
D. Ethyl alcohol A. Graves' disease (toxic diffuse goiter)
E. Sodium bicarbonate B. Papillary thyroid cancer
C. Undifferentiated thyroid carcinoma
2. A woman has lately been excessively excitable and D. Hashimoto's thyroiditis (chronic lymphocytic thyroiditis)
irritable and had insomnia She was prescribed diazepam. E. Solid adenoma of the thyroid
What is the main mechanism of action of this drug?
A. Benzodiazepine receptor stimulation 10. A pathological process involves conduction pathways of
B. Muscarinic acetylcholine receptor stimulation the spinal cord, resulting in disturbed pain sensation in the
C. Beta-adrenergic receptor stimulation skin and muscles. What pathways are affected?
D. Nicotinic acetylcholine receptor blockade A. Medial corticospinal
E. Serotonin receptor blockade B. Anterior spinocerebellar
C. Spinothalamic
3. Shigella capable of producing exotoxin was obtained from D. Lateral corticospinal
a patient diagnosed with dysentery. What Shigella species is E. Ventral spinocerebellar
it?
A. Shigella dysenteriae 11. Secretion of orotic acid many times exceeds the form in
B. Shigella flexneri patients with hereditary orotic aciduria. This pathology is
C. Shigella sonnei associated with disturbed synthesis of:
D. Shigella boydii A. Pyrimidine nucleotides
E. Shigella newcastle B. Uric acid
C. Purine nucleotides
4. After an out-of-hospital abortion, a woman developed D. Biogenic amines
progressing purulent endomyometritis, of which she died. E. Urea
Autopsy of the body revealed numerous pulmonary
abscesses, small subcapsular pustules in the kidneys, 12. A diet must contain fats. What plasticity function do they
splenic hyperplasia. What type of sepsis developed in the fulfill in the body?
woman? A. They are a part of cellular ion channels
A. Urosepsis B. They are a part of cellular ion pumps
B. Chroniosepsis C. They are a part of cellular membranes
C. Septicemia D. They are a part of cellular receptors
D. Septicopyemia E. They are a part of glycocalyx
E. Pulmonary sepsis
13. A 47-year-old man complains of weakness and dizziness.
5. A patient has developed status epilepticus. What medicine Half a year ago he undervent a gastric resection Blood test:
should be used in this case to stop the seizures? Hb -80 L. erythrocytes -3.5 1012/L, color index-0.64. ESR -
A. Cyclodol (Trihexyphenidyl) 15 mm/hour, serum iron - 5.4 mcmol/L. erythrocvie
B. Sodium bromide hypochromia. What type of anemia is the most likely in this
C. Diazepam patient?
D. Diprazinc (Promcihazinc) A. B12 or folate deficiency anemia
E. Valerian extract B. Sideroachrestic anemia
C. Hemolytic anemia
6. Biological studies proved that the intensity of testosterone D. Hemorrhagic anemia
secretion and spermatogenesis varies in then throughout E. Iron deficiency anemia
each 24 hours. These biorhythms are called:
A. Lunar 14. A 48-year-old man has arterial hypertension of endocrine
B. Annual genesis, headache. muscle weakness, and convulsions. His
C. Seasonal blood levels of K+ (potassium) are low, while his blood levels
D. Circadian of Na+ (sodium) are high, which is the result of hormone
E. Tidal hypersecretion.
A. Aldosterone
7. Because of health concerns, one of the patient's adrenal B. Cortisol
glands had to be removed. How will the structure of the C. Dihydrocholesterol
remaining adrenal gland change? D. Adrenaline
A. Hypertrophy of cortical and medullary E. Parathormone
B. Atrophy of medullary cells
C. Atrophy of cortical cells 15. Fasting energy expenditure is being measured in a
D. Necrosis of medullary cells person, who is lying down in a state al physical and mental
E. Lysis of cortical cells rest, while the room temperature is within the comfort zone.
When will the energy expenditure be at its highest?
8. A patient with myocardial infarction has acute heart failure. A. 03:00-04:00
Among the drugs that increase the force of heart B. 7:00-8:00
contractions the least dangerous in this case will be: C. 10:00-12:00
A. Isadrinum (Isoprenaline) D. 20:00-00:00
B. Caffeine E. 17:00-18:00
C. Euphyllin (Aminophylline)
D. Dobutamine 16. A woman hospitalized in the surgical department
complains of pain in her lower abdomen and in the small of eyes and nose, rhinorrhea, cough, and urticaria on the
her back, frequent and painful urination. Urine culture test exposed areas of her skin. Examination detected a sharp
revealed gram-negative oxidase-positive bacilli that formed increase in IgE levels. The allergologist prescribed her a
green mucoid colonies with a specific smell. What causative special hyposensitization therapy. How is this kind of
agent can be suspected? treatment administered?
A. Str. pyogenes A. Administration of calcium chloride
B. Mycoplasma pneumonie B. Exposure to repeated low doses of allergen
C. Pseudomonas aeruginosa C. Administration of adrenal gland hormones
D. E. coli D. Administration of antihistaminic agents
E. Proteus mirabilis E. Exposure to one large dose of allergen

17. A patient has severe peripheral edema. Consecutive 24. A patient complains of pain in the upper umbilical region.
administration of dichlothiazide (hydrochlorothiazide), On palpation there is a mobile painful intestine. What
etacrynic acid, and furosemide did not have any significant intestine is being palpated by the doctor?
diuretic effect. In the blood there is a significant increase of A. Ileum
aldosterone levels. What is the drug of choice in this case? B. Duodenum
A. Triamterene C. Sigmoid colon
B. Amiloride D. Transverse colon
C. Metoclopramide E. Jejunum
D. Mannitol
E. Spironolactone 25. Proliferation of the connective tissue in the hepatic
parenchyma (fibrosis) caused by chronic discases is often
18. A ballet dancer spins to the left. During the spin, her eyes associated with disturbed blood circulation in the classical
sap quickly to the left. This fast eye movement is caused by lobules. What blood flow direction can be observed in these
the activation of: lobules?
A. Tendon receptors A. From the periphery to the center
B. Muscle spindles B. From the base to the apex
C. Joint receptors C. Around the lobule
D. Otolith vestibular receptors D. From the apex to the base
E. Vestibular receptors of the semicircular ducts E. From the center lo the periphery

19. ECG shows absent P waves replaced by f waves. ORST 26. A patient with neurodermatitis was taking prednisolone
completes have irregular intervals between them (RR for long time. Examination revealed high blood glucose. This
interval varies). R waves have different voltage. What type complication occurs, when glucocorticosteroids affect a
of arrhythmia is it? certain stage of carbohydrate metabolism. What stage of
A. Sinus tachycardia carbohydrate metabolism is affected?
B. Atrial fibrillation A. Activation of the insulin breakdown
C. Idioventricular rhythm B. Gluconeogenesis activation
D. Paroxysmal tachycardia C. Increased absorption of glucose in the intestine
E. Sinus arrhythmia D. Glycogen synthesis activation
E. Glycogen synthesis inhibition
20. A 40-year-old man with pulmonary tuberculosis was
prescribed isoniazid. Prolonged taking of this drug can result 27. A bacteriologist found in a sick child the causative agents
in the development of the following vitamin deficiency: of Flexner dysentery type 2. Sonne dysentery type 1. and
A. Biotin enteropathogenic colibacillus - 055/B5. Name this type of
B. Thiamine infection:
C. Cobalamin A. Mixed infection
D. Pyridoxine B. Superinfection
E. Folic acid C. Secondary infection
D. Carriage of pathogenic bacteria
21. During inflammatory process, the vessels of the E. Reinfection
microvasculature develop increased permeability and
hydrodynamic pressure. Protein structures in the interstitial 28. Histology of the liver detected there a vesicle with chitin
fluid exhibit increased osmotic concentration and dispersion. and protein membrane, filled with a colorless transparent
What mechanism of edema formation will be observed fluid. What disease can manifest this way?
during inflammatory process? A. Opisthorchiasis
A. Membranogenic B. Balantidiasis
B. Colloid-osmotic C. Echinococcosis
C. Hydrodynamic D. Cysticercosis
D. Lymphogenic E. Schistosomiasis
E. Mixed
29. A sick child has no anti-hemophilic factor (factor VIII) in
22. A patient was diagnosed with a parathyroid tumor. He the blood plasma. What pathology of hemostasis is it?
has generalized fibrous osteodystrophy and periodic attacks A. Thrombophilia
of renal colic Ultrasound detected small stones in the kidneys. B. Hereditary angiopathy
What is the most likely cause of kidney stone formation? C. Hereditary coagulopathy
A. Hypercholesterolemia D. Immune-mediated angiopathy
B. Hyperphosphatemia E. Acquired coagulopathy
C. Hyperuricemy
D. Hypocalcemia 30. For diagnostic purposes a parenchyma sample of the
E. Hypercalcemia patient's blood-forming organ was obtained. The sample
contained megakaryocytes. What organ is it?
23. For the third spring in a row, when poplars start to bloom, A. Thymus
a 20-year-old student develops itching and hyperemia in her B. Tonsil
C. Lymph node alter a meal?
D. Red bone marrow A. Decreased erythrocyte count
E. Spleen B. Increased number of plasma proteins
C. Increased leukocyte count
31. A patient suffers from episodes of arterial hypertension D. Decreased platelet count
that are accompanied by tachycardia. profuse sweating, and E. Increased erythrocyte count
sharp pain in the epigastric region. What neoplastic disease
of the endocrine lands is the most likely in this case, based 38. A 56-year-old woman with angioneurotic edema was
on these signs? prescribed an H1 blocker with antispasmodic, sedative. and
A. Adenoma or the adrenal zona glomerulosa local anesthetic action. Select this H1 blocker from the list:
B. Pituitary basophil adenoma A. Oxoline (Dioxotetrahydrooxytetrahydronaphthaline)
C. Pheochromocytoma B. Ambroxol
D. Thyroid adenoma C. Dimedrol (Diphenhydramine)
E. Ovarian tumor D. Acyclovir
E. Levodopa
32. A 6-year-old child had acute onset of the disease that
started as catarrhal nasopharyngitis. 2 days later the patient 39. A patient with characteristiclly hypoplastic thymus suffers
died, Autopsy of the body shows markedly plethoric and from DiGeorge syndrome. What type of immunological
swollen pia mater that is soaked with thick turbid yellow- pathology is it?
green fluid. The brain is swollen, the cerebellar tonsils are A. Congenital T cell deficiency
enlarged, and there is a clearly visible ligature mark on the B. Acquired T cell deficiency
brain. The described changes are characteristic of: C. Congenital B cell deficiency
A. Diphtheria D. Acquired B cell deficiency
B. Pertussis E. Immune depression in the system of T cells
C. Meningococcosis
D. Measles 40. It is a known fact that in the human body the biosynthesis
E. Influenza of purine nucleotides occurs de novo from amino acids.
Name the amino acids that are used in the synthesis of the
33. A young woman, a foreign student from Tehran, has purine nucleotide cycle:
made an appointment will the urologist. She complains of the A. Glycine, aspartate, glutamine
sensation of heaviness in her lover abdomen and a small B. Proline, tyrosine, phenylalanine
amount of blood being excreted with urine at the end of each C. Leucine, glutamine, cysteine
urination. Microscopy of urine detects the presence of D. Methionine, tryptophan, alanine
parasite eggs approximately 140x70 micron in size, with a E. Isoleucine, serine, valine
terminal spike. What diagnosis can be made by the
infectious disease specialist? 41. A medical student was hospitalized into the infectious
A. Schistosomiasis diseases unit on the 2nd day after the disease onset. The
B. Dicroceliasis patient is suspected to have infectious mononucleosis. What
C. Opisthorchiasis results of laboratory analysis can confirm this diagnosis
D. Paragonimiasis immediately on the day of the hospitalization?
E. Fascioliasis A. Detection of Cytomegalovirus antibodies
B. Fourfold increase in number of IgG antibodies to Epstein-
34. Various physical and physico-chemical methods are Barr virus
used in research of blood Serum proteins. In particular, C. Detection of IgM antibodies to Epstein-Barr virus
scrum albumins and globulins can be separated using the D. Detection of IgM antibodies to herpes simplex virus
following method: E. Isolation of Herpes simplex virus
A. Spectrophotometry
B. Dialysis 42. Bacterioscopy of purulent cervical discharge detected
C. Refractometry gram-negative bean-shaped diplococci, both inside and
D. Electrophoresis outside of the leukocytes. What is the causative agent of the
E. Polarography purulent inflammation of the uterine cervix in this case?
A. Chlamidia trachomatis
35. During gastric resection the patient received mixed B. Neisseria gonorroeae
anesthesia with tubocurarine chloride muscle relaxant. To C. Trichomonas vaginalis
restore unassisted respiration in the patient was given D. Haemophilus vaginalis
procerin. What pharmacological group do drug belong to? E. Calymmatobacterium granulomatis
A. Muscarinic agonists
B. Muscarinic antagonists 43. A patient died with signs of heart failure. Autopsy shows
C. Angiotensin-converting enzyme inhibitors the following: postinfarction cardiosclerosis. cardiac
D. Calcium channel blockers hypertrophy, and dilated cardiac chambers. The liver is
E. Cholinesterase inhibitors enlarged, has smooth surface. is plethoric on section,
covered in dark red specks against the brown-tinted
36. A 2-year-old child was diagnosed with thymic hypoplasia. background of the tissue. Histologically. the central veins of
What indicator of the immune system status is most the hepatic lobules arc plethoric: there is erythrocyte
characteristic of this type immunodeficiency? diapedesis into the perivascular space. Central hepatocytes
A. Low levels of immunoglobulin M are dystrophic, while peripheral hepatocytes are enlarged
B. Low B cell count and affected by fatty degeneration. What process occurred
C. Absence of plasma cells in the patient's liver?
D. T and B cell deficiency A. Amyloidosis
E. Low T cell count B. Pseudonutmeg liver
C. Hepatic steatosis
37. Clinical blond testing is recommended to be clone in the D. Hepatic cirrhosis
morning and on an empty stomach. What change in the E. Nutmeg liver
blood composition is likely if a blood sample was obtained
44. A 2-year-old child presents with marked delay in characteristic of the following pathology:
psychomotor development, vision and hearing deterioration, A. Tay-Sachs disease
marked enlargement of the liver and spleen. The child is B. Pompe disease (glycogen storage disease type II)
diagnosed with hereditary Niemann-Pick disease. What C. Gaucher disease
genetic defect is the cause of this disease? D. Niemann-Pick disease
A. Sphingomyelinase deficiency E. Von Gierke disease (glycogen storage disease type I)
B. Acid lipase deficiency
C. Amylo-1,6-glucosidase deficiency 52. A patient developed a purulent inflammatory process in
D. Glucose 6-phosphatase deficiency the periodontal tissues. The process was caused by
E. Xanthine oxidase deficiency activation of the microorganisms inherent in the body, which
are a part of oral mucosal microflora. What type of infection
45. A man was hospitalized with a lower limb trauma in the is it?
upper third of the shin. He is unable to extend his foot. What A. Reinfection
nerve was damaged because of this trauma? B. Superinfection
A. N plantaris lateralis C. Autoinfection
B. N fibularis communis D. Relapse
C. N plantaris medialis E. Exogenous infection
D. N fibularis profundus
E. N. fibularis superficialis 53. A patient has signs of striatopallidal system damage.
These signs are caused by disturbed synthesis of a certain
46. It has been found experimentally that activation of amino mediator in a certain structure. Name this mediator and its
acids and their binding to the tRNA is an important stage of corresponding structure:
preparation for protein synthesis in the cells. What A. Noradrenaline – putamen
substance takes part in this process? B. Adrenaline - globus pallidus
A. FAD C. Adrenaline – thalamus
В. Сoеnzyme A D. Dopamine - substantia nigra
C. Phosphoric acid E. Serotonin - caudate nucleus
D. NAD+
E. ATP 54. Histology of the liver of a deceased, who was an injection
drug user, revealed the following: hydropic degeneration of
47. Microscopy of autopsy material detected that the alveolar hepatocytes, ground glass hepatocytes, acidophilic
lumens in the lungs are filled with exudate, consisting mainly Councilman bodies, lymphocytic-macrophageal infiltrations
of erythrocytes. What is the most likely cause of this in the portal tracts. What is the most likely etiology of this
development? disease?
A. Measles pneumonia A. Viral
B. Influenza virus pneumonia B. Parasitic
C. Typhoid pneumonia C. Toxic
D. Staphylococcal pneumonia D. Bacterial
E. Pneumococcal pneumonia E. Fungal

48. A lab rat has subcutaneously received Mercury(II) 55. A patient who for a long time was suffering from
chloride in the amount of 5 mg/kg, 24 hours later the plasma rheumatism and had mitral stenosis died of cardiopulmonary
creatinine concentration increased several times. What failure. Autopsy revealed brown induration of the lungs. What
mechanism of retention azotemia is observed in this case? circulatory disorder leads to such changes in the lungs?
A. Increased creatinine secretion in the renal tubules A. Acute left ventricular failure
B. Increased glomerular filtration B. Portal hypertension
C. Increased creatinine production in the muscles C. Chronic right ventricular failure
D. Increased creatinine reabsorption D. Acute right ventricular failure
E. Decreased glomerular filtration E. Chronic left ventricular failure

49. A 25-year-old woman complains of deteriorating vision. 56. Autopsy of the body revealed a large wedge-shaped
Examination revealed a defect in accommodation, the pupil patch of a dense dark red tissue with clear margins in the
15 dilated and unresponsive to light. What muscles are upper lobe of the right lung. Histological examination
functionally disturbed in case? detected there necrosis of the alveolar walls; the alveolar
A. Lateral reclus muscle, iris sphincter muscle lumen is tightly packed with erythrocytes. What process
B. Superior oblique muscle, ciliary muscle occurred in the lungs?
C. Iris sphincter muscle. ciliary muscle A. Gangrene
D. Iris dilator muscle, ciliary muscle B. Atelectasis
E. Iris sphincter and iris dilator muscles C. Hemorrhage
D. Hemorrhagic infarction
50. A person received a penetrating wound of the abdominal E. Carneous degeneration
cavity: "The anterior abdominal wall is injured. The wound
tract passes through the plica umbilicalis lateralis. What 57. A laboratory rat with chronic kidney failure has
vessel is damaged? osteoporosis, pathologic calcification of the internal organs,
A. A. umbilicalis and arterial hypertension. These disturbances are
B. A. epigastrica inferior associated with the increased activity of the following
C. A. circumflexa ilium profunda hormone:
D.A. epigastrica superior A. Thyroxin
E. A. testicularis B. Parathyroid hormone
C. Triiodothyronine
51. A woman complains that her child is unwell: the child D. Adrenaline
developed loss of appetite, insomnia, and irritability. E, Calcitonin
Biochemical testing shows that there is no
glucocerebrosidase enzyme in the child's blood. It is 58. One of the causes of pernicious anemia is the disturbed
synthesis of transcortin. Castle's intrinsic factor - in the D. -
parietal cells of the stomach. What substance is called E. Preventive therapy
Castle's extrinsic factor?
A. Biotin 66. Autopsy of the body of an 18-year-old young man shows
B. Riboflavin that the spleen weight is 580 grams, it is dark-red on section,
C. Folic acid spleen pulp easily scrapes off. Histologically, there is marked
D. Cobalamin proliferation of reticular cells and a large number of mature
E. Pyridoxine neutrophils in the sinusoidal capillaries. In this case the
spleen can be described as:
59. Histological specimen shows parenchyma of an organ A. Porphyric
that consists of lymphoid tissue that forms lymph nodules; B. Sago
the nodules are located diffusely and have a central artery. C. Cyanotic
What anatomical structure has such morphological D. Septic
characteristics? E. Leukemia
A. Tonsil
B. Thymus 67. Vitamin B deficiency impairs oxidative decarboxylation of
C. Lymph node alpha-ketoglutaric acid, which leads to disturbed synthesis of
D. Red bone marrow a certain coenzyme. Name this coenzyme:
E. Spleen A. Thiamine pyrophosphate (TPP)
B. Lipoic acid
60. After a celebratory dinner, several people, who were C. Nicotinamide adenine dinucleotide (NAD)
eating a cake with duck egg cream, developed food D. Flavin adenine dinucleotide (FAD)
poisoning. What genus of bacteria is the most likely cause of E. Coenzyme A
food poisoning in this case?
A. Salmonella 68. The patient's ECG shows that in the second standard
B. Clostridium lead from the extremities the P waves are positive, their
C. Corynebacterium amplitude is 0.1 mV (norm is 0.05-0.25 mV), duration - 0.1
D. Yersinia seconds (norm is 0,07-0.10 seconds). It can be concluded
E. Shigella that the following process occurs normally in the cardiac
atria:
61. A patient complains of stomachache. Biochemical testing A. Depolarization
revealed decreased secretory function of the stomach B. Repolarization
accompanied by anemia. Hypovitaminosis B12 and C. Excitation
development of anemia are caused by the low levels of a D. Relaxation
certain substance. What substance is it? E. Contraction
A. Castle factor
B. Biotin 69. Electrons release their energy when they are being
C. Pyridoxine transported in the course of tissue respiration. This energy is
D. Thiamine used for the following process:
E. Calciferol A. Substrate-level phosphorylation
B. Lipid mobilization
62. An oncology patient is to undergo a surgery on the C. Microsomal oxidation
descending colon. Name the main source of the blood supply D. Oxidative phosphorylation
to this organ: E. Peroxidation
A. Superior mesenteric artery
B. Celiac trunk 70. Regional lymph nodes surrounding an infected wound
C. Splenic artery are enlarged. Histological examination shows increased
D. Inferior mesenteric artery number of macrophages, lymphocytes, and lymphatic
E. Middle colic artery follicles in the cortical layer of the lymph nodes, as well as a
large amount of plasma cells. What process in the lymph
63. Protein synthesis occurs in several stages. During one of nodes is indicated by these histological changes?
them, messenger RNA is being synthesized on one of the A. Neoplastic aberration
strands of a DNA segment. Name this process: B. Antigen stimulation
A. Transcription C Congenital deficiency of lymphoid tissue
B. Termination D. Acquired deficiency of lymphoid tissue
C. Elongation E. Transplant rejection
D. Translation
E. Replication 71. A 29-year-old man complains of headache, swelling,
weight gain, low urine output, and marked weakness.
64. A 40-year-old woman on examination presents with Laboratory testing revealed increased concentration of TSH.
intensified basal metabolic rate. What hormone present in The levels of estrogen. growth hormone, glucose, urea, and
excess leads to such condition? creatinine are normal. What medical condition corresponds
A. Glucagon with these signs?
B. Aldosterone A. Acromegalia
C. Somatostatin B. Hypothyroidism
D. Thyrocalcitonin C. Alimentary obesity
E. Triiodothyronine D. Glomerulonephritis
E. Hyperthyroidism
65. A 47-year-old woman with chronic pancreatitis
accompanied by exocrine pancreatic insufficiency was 72. A certain type of digestion is disturbed in the patient's
prescribed pancreatic enzymes. What type of therapy is it? small intestine. This type of digestion occurs on the apical
A. Replacement therapy surface of enterocytes and uses the membrane-bound
B. Pathogenetic therapy enzymes adsorbed in the glycocalyx. What type of digestion
C. Etiotropic therapy is it?
A. Cavitary D. Pantothenic acid deficiency
B. Autolytic E. Biotin deficiency
C. Membrane
D. Proper 80. A 48-year-old man is unconscious. He has a history of
E. Symbiotic several syncopal episodes with convulsions. ECG shows
deformed ORS complexes unconnected with P waves, atrial
73. A patient diagnosed with liver abscess was hospitalized contractions are approximately 70/min., ventricular
into the surgery department. He has a history of frequent contractions - 2530/min. Name the type of arrhythmia in this
gastrointestinal disturbances. Laboratory analysis of the case:
patient's feces detected round cells with 4 nuclei. What A. Complete atrioventricular block
species protozoa is this patient infected with? B. Intraatrial block
A. Balantidium coli C. Intraventricular block
B. Entamoeba gingivalis D. First-degree atrioventricular black
C. Trichomonas hominis E. Second-degree atrioventricular block
D. Entamoeba hystolytica
E. Trichomonas vaginalis 81. Blood of a patient with bladder cancer has high levels of
serotonin and hydroxyanthranilic acid, because of excessive
74. An infant developed darkened sclerae mucosa, and intake of a certain amino acid. Name this amino acid:
auricles. The urine becomes dark, when exposed to the air. A. Methionine
Blood and urine contain homogentisic acid. What is the most B. Tyrosine
likely disease in this case? C. Histidine
A. Cystinuria D. Tryptophan
B. Hemolytic anemia E. Alanine
C. Albinism
D. Porphyria 82. T lymphocytes were affected by HIV. In the process, viral
E. Alkaptonuria enzyme reverse transcriptase (RNA-dependent DNA-
polymerase) catalyzes the synthesis of:
75. Mother of a 5-year-old child complains that her child A. Viral RNA on the DNA matrix
develops itching skin, erythema, and vesicular rash after B. Viral DNA on the DNA matrix
exposure to the sun. Blood test revealed low levels of iron in C. DNA on the viral RNA matrix
the blood serum. Urine contains increased levels of D. Viral protein on the viral RNA matrix
uroporphyrinogen I. What hereditary pathology is the most E. Informational RNA on the viral protein matrix
likely in this child?
A. Coproporphyria 83. A 42-year-old man with intestinal atony was prescribed
B. Methemoglobinemia proserin, after which he developed signs of bronchospasm.
C. Hepatic porphyria What type of drug action is it?
D. Intermittent porphyria A. Main action
E. Erythropoietic porphyria B. Side-effect
C. Direct action
76. A patient needs to be prescribed a wide-spectrum D. Selective action
fluoroquinolone agent. Select one such agent from the list: E. Indirect action
A. Ciprofloxacin
B. Azlocillin 84. Decreased vasopressin synthesis causes polyuria and,
C. Carbenicillin as a result, marked dehydration. What is the mechanism of
D. Chinoxydin polyuria development?
E. Amoxicillin A. Decreased canalicular reabsorption of Na ions
B. Decreased canalicular reabsorption of water
77. 24 hours after an appendectomy the patient's blood test C. Increased glomerular filtration
shows neutrophilic leukocytosis with a regenerative shift. D. Decreased canalicular reabsorption of proteins
What is the most likely mechanism of absolute leukocytosis E. Decreased reabsorption of glucose
development in the patient's peripheral blood?
A. Intensification of leukopoiesis 85. A person was hospitalized with markedly icteric skin,
B. Decreased leukocyte disintegration sclerae, and mucosa. Urinalysis shows the presence of
C. Leukocyte redistribution direct bilirubin. Patient's urine is the color of dark beer. Fecal
D. Immunity activation levels of bile pigments are low. What type of jaundice is
E. Deceleration of leukocyte migration to the tissues observed in this patient?
A. Obstructive
78. Autopsy of the body revealed waxy degeneration of the B. Absorption
rectus abdominis muscles. In the terminal segment of the C. Hepatocellular
small intestine there are ulcers 3-5 cm in diameter. The ulcer D. Conjugated
walls are covered in a crumbling grayish-yellow substance. E. Hemolytic
The ulcer edges are moderately raised above the mucosa.
Widal test is positive. Make the diagnosis: 86. The patient underwent blood test that showed albumin of
A. Dysentery 20 g/L and increased activity of lactate dehydrogenase
B. Crohn's disease isoenzyme 5 (LDH5). These results indicate a disorder of the
C. Nonspecific ulcerative colitis following organ:
D. Typhoid fever A. Liver
E. Relapsing fever B. Spleen
C. Heart
79. After eating raw eggs the patient developed dermatitis. D. Kidneys
What type of avitaminosis is it? E. Lungs
A. Folic acid deficiency
B. Para-aminobenzoic acid deficiency 87. A 65-year-old man periodically feels pain under his left
C. Inositol deficiency shoulder blade and in his left shoulder. After a significant
physical exertion, the pain sharply intensified. Based on the of trauma in this case?
ECG findings, the diagnosis of acute myocardial infarction A. Medial frontal lobe
was made. What type of pain was observed in this case? B. Inferior frontal lobe
A. Phantom limb pain C. Superior temporal lobe
B. Visceral pain D. Superior frontal lobe
C. Causalgia E. Medial temporal lobe
D. Irradiating pain
E. – 95. A 45-year-old woman has breast cancer. Metastases can
spread in this case to the following regional lymph nodes:
88. A 50-year-old man was hospitalized with suspected A. Abdominal, cervical
gallbladder inflammation. He was prescribed B. Aortic, bronchomediastinal
fibrogastroscopy of the gastrointestinal tract with mandatory C. Parasternal, bronchomediastinal
examination of the major duodenal papilla. Where in the D. Cervical, parasternal
duodenum can doctor find this papilla? E. Axillary, parastcmal
A. Inferior (horizontal)
B. Ascending 96. After examination, the doctor diagnosed the patient with
C. Descending parainfluenza, based on the clinical findings. What route of
D. Ampulla of Vater transmission is characteristic of this disease?
E. Superior A. Saliva-to-blood transmission
B. Fecal-oral transmission
89. A patient used an indirect-acting adrenergic agonist to C. Parenteral transmission
treat rhinitis. Alter the patient has been administering in the D. Vector-borne transmission
nose drops for several days, the vasoconstrictive effect of E. Airborne
the drug gradually diminished. Name this phenomenon:
A. Tachyphylaxis 97. A 10-vear-old homeless boy was brought to the
В. Idiosyncrasy admission room with a severe case of bronchitis. Objectively,
C. Teratogenicity the child is exhausted; he presents with delayed physical
D. Allergy development, dry peeling skin, trophic ulcers in some places,
E. Cumulation and a loss twilight vision ("night-blindness"). What vitamin
supplements should be prescribed to this boy?
90. To study a normal menstruation cycle, the OB-GYN A. Pyridoxine hydrochloride
specialist, taking into account the pyrogenic effect of B. Ascorbic acid
progesterone, measured the patient's rectal basal body C. Cyanocobalamin
temperature. At what phase of the cycle will the rectal D. Tocopherol acetate
temperature increase by 0.4-0.5°C? E. Retinol acetate
A. Beginning of follicular phase
B. End of luteal phase 98. A 60-year-old man complains of pain in his lower
C. End of follicular phase abdomen and frequent stools. Stool analysis shows
D. Ovulation and beginning of luteal phase increased levels of neutral fats in the patient's feces.
E. Endometrial desquamation phase Incomplete digestion of fats is caused by the deficiency of a
certain enzyme. Name this enzyme:
91. A 5-year-old child is diagnosed with Bruton's disease (X- Α. Aminopeptidase
linked agammaglobulinemia) that manifests itself in severe B. Enterokinase
clinical course of bacterial infections and absence of B C. Lipase
lymphocytes and plasma cells. What changes of D. Pepsin
immunoglobulin content can be observed in blood serum of E. Maltase
the child with immunodeficiency?
A. Increased IgA, IgM 99. A woman gave birth to twins. One of them was
B. Decreased IgA, IgM provisionally diagnosed with Cri-du-chat syndrome that
C. Increased IgD, IgE manifests as underdeveloped laryngeal muscles and
D. No changes "meowing” voice timbre. This syndrome occurs because of
E. Decreased IgD. IgE chromosome mutation. What method can verify or refute this
diagnosis?
92. An experiment demonstrates that Jensen sarcoma leads A. Population statistics
to a significant increase in glucose uptake from the tumor B. Biochemical
afferent artery, while tumor efferent vein has high levels of C. Twin study
lactic acid. This phenomenon indicates: D. Cytogenetic
A. Decreased anaerobic glycolysis E. Amniocentesis
B. Intensified anaerobic glycolysis
C. Intensified oxidizing processes 100. A patient cannot raise his eyebrow, fully close his eye
D. Intensified protein oxidation or bare his teeth on one side of his face. What nerve is likely
E. Decreased oxidizing processes to be damaged?
A. Mandibular nerve
93. A 50-year-old man undergoes pancreatectomy for B. Maxillary nerve
pancreatic tail due to pancreatitis. How is the affected organ C. Oculomotor nerve
located in relation to the peritoneum? D. Facial nerve
A. Mesoperitoneally E. Ophthalmic nerve
B. Intraperitoneally
C. Intramurally 101. After a domestic trauma a 34-year-old man has limited
D. Parenterally flexion of the middle phalanges of his fingers 2-5, which
E. Extraperitoneally results in the overall limited mobility of the fingers. What
muscles are likely to be functionally impaired in this case?
94. After a cerebral hemorrhage the patient has lost the A. M. palmaris brevis, M. abductor digiti minimi
ability to understand speech. Where in the cortex is the site B. M. flexor digitorum superficialis
C. M. opponens pollicis, M. adductor pollicis A. Total lung capacity
D. M. palmaris longus B. Expiratory reserve volume
E. M. flexor digitorum profundus C. Inspiratory reserve volume
D. Vital lune capacity
102. A child has cataract, delayed mental development, and E. Respiratory volume
enlarged liver. The doctor suspects these signs are caused
by the deficiency of hexose-1-phosphate uridyltransferase. 109. When preparing for an important sports contest, it is
What pathological process is observed in this case? recommended to train at high altitude (2-3 km above mean
A. Fructosemia sea level). Prolonged exposure to such conditions leads to:
B. Hyperlactacidemia A. Decrease of blood viscosity
C. Galactosemia B. Decease of pO2, which stimulates erythropoiesis and
D. Hypoglycemia increases blood oxygen capacity
E. Hyperlipidemia C. Decrease of ESR
D. Improvement of plasma colloid-suspension
103. The renal artery of a test rabbit was surgically narrowed. characteristics
One month later a significant increase in systemic arterial E. Increase of arteriovenous oxygen difference
pressure was registered in the animal. What regulatory
mechanism caused the change in the animal's blood 110. The mother or a 2-year-old child came to the dentist.
pressure"? During her pregnancy she was randomly taking antibiotics to
A. Serotonin treat an infectious disease. Examination of the child revealed
B. Noradrenaline destruction of the incisors, yellow enamel, and a brown
C. Vasopressin border near the dental cervices. What medicine has a
D. Angiotensin II marked teratogenic effect?
E. Adrenaline A. Octadine (Guanethidine)
B. Doxycycline
104. A histological specimen demonstrates a vessel with the C. Xantinol nicotinate
wall that consists of endothelium, basement membrane, and D. Ampiox (Ampicillin + Oxacillin)
loose connective tissue. What type of vessel is it? E. Furosemide
A. Hemocapillary
B. Artery 111. A woman with enteritis accompanied by severe diarrhea
C. Non-muscular vein presents with the loss of water in the extraocular space,
D. Muscular vein increased water content in the cells, and decreasing blood
E. Lymph capillary osmolarity. Name this type of water-electrolyte imbalance:
A. Hyperosmolar hyperhydration
105. A patient has ascites, his spleen is double the normal B. Isoosmolar hypohydration
size, he has esophageal and rectal varices. Histology of the C. Hypoosmolar hypohydration
biopsy material obtained from the liver revealed D. Hyperosmolar hypohydration
micronodular cirrhosis. What complicated the hepatic E. Hypoosmolar hyperhydration
cirrhosis in this case?
A. Budd-Chiari syndrome 112. A patient developed left ventricular heart failure. What
B. Hepatolienal syndrome compensatory responses in the patient's body will be aimed
C. Heart failure at the prevention of pulmonary edema?
D. Portal hypertension A. Increased central venous pressure
E. Hepatocellular dysfunction B. Decreased peripheral resistance in the systemic arterioles
C. Reflex spasm of the pulmonary arterioles and decrease
106. Genealogical analysis of a child with myotonic of blood pressure in the pulmonary microvasculature
dystrophy determined that this disease manifests in every D. Blood accumulation in the systemic veins
generation, is in equal measure present in the relatives of E. Increased permeability of the pulmonary capillaries
both genders, the risk of inheriting this disease is equal no
matter which parent is affected. If one of the parents is 113. An inguinal hernia was found in a patient. During
heterozygous for this disease and the other parent is healthy, herniotomy, a reinforcement of the anterior wall of the
the risk of them giving birth to a sick child is 50%. What type inguinal canal is necessary. What anatomical structures of
of disease inheritance is it? the anterior abdominal wall are used for the reinforcement in
A. X-linked recessive this case?
B. X-linked dominant A. Aponeurosis of the abdominal external oblique muscle
C. Autosomal recessive B. Transverse fascia
D. Autosomal dominant C. Aponeurosis of the abdominal internal oblique muscle
E. Y-linked D. Transverse abdominal muscle
E. Peritoneum
107. A patient complains of rapid
fatigability and severe muscle weakness. Examination 114. Autopsy of the body revealed large (1-2 cm) brown-red
detected in autoimmune disease that disturbs the deposits on the external surface of the aortic valve. The
functionality of the receptors in the neuromuscular synapses. deposits cover ulcers and crumble easily. What disease can
What mediator is likely to be blocked in this case? be suspected in this case?
A. Noradrenaline A. Diffuse endocarditis
B. Dopamine B. Fibroblastic endocarditis
C. Glycine C. Recurrent verrucous endocarditis
D. Serotonin D. Endocarditis ulcerupolyposa
E. Acetylcholine E. Acute verrucous endocarditis

108. A person developed increased pulmonary ventilation 115. A test animal kept on a low-protein diet developed fatty
due to physical exertion. What indicator of pulmonary infiltration of the liver due to low levels of methylating agents.
function will he significantly increased compared to the What amino acid is a methylating agent?
resting state? A. Methionine
B. Cysteine Perls histochemical reaction?
C. Phenylalanine A. Hematoporphyrin
D. Valine B. -
E. Tyrosine C. Hemosiderin
D. Hematoidin
116. A patient with choledocholithiasis has fatty colorless E. Bilirubin
stool because of obturation of the biliary tract. What bile
component is absent, causing steatorrhea? 123. A 26-year-old man has a large furuncle in the soft
A. Bile pigments tissues of his face. It is located class to the nasal root and
B. Cholesterol lower eyelid. A possible dangerous complication of this
C. Alkaline phosphatase condition can lead to the infection spreading through the
D. Bile acids venous plexuses into the sinuses of the dura mater. What
E. Fatty acids sinus is the most likely to be affected in this case?
A. Superior petrosal sinus
117. ECG of the patient shows increased duration of the B. Occipital sinus
ORS complex. What is the most likely cause? C. Superior sagittal sinus
A. Increased atrial excitability D. Sigmoid sinus
B. Disturbed conduction in the atrioventricular node E. Cavernous sinus
C. Increased atrial and ventricular excitability
D. Increased period of ventricular excitation 124. Microscopy of the sputum of a patient with lobar
E. Increased period of atrial excitation pneumonia revealed a large number of gram-positive lancet-
shaped encapsulated diplococci. What causative agent is it?
118. A patient with heart failure developed edema. What is A. Klebsiella pneumoniae
the main pathogenetic link of edema development in this B. Streptococcus pneumoniae
case? C. Chlamidia pneumoniae
A. Decrease of cardiac output D. Staphylococcus aureus
B. Stagnation of blood E. Escherichia coli
C. Changes in oncotic and osmotic blood pressure
D. Increased vascular permeability 125. One of the cell organelles is the place, where protein
E. Increased circulating blood volume molecules are being built and packaged with carbohydrates
and fats, before they are transported from the cell via
119. A 5-year-old kindergartener has diphtheria. To find the exocytosis. What organelle is it?
carriers of this disease among the kindergarten staff, A. Lysosomes
samples of pharyngeal mucus were obtained from the B. Peroxisomes
employees. One of the employees had gram-positive bacilli C. Golgi apparatus
in her sample. They were situated at an angle to each other D. Ribosomes
and colored unevenly, when stained according to Loeffler. E. Mitochondria
What method can confirm that this carrier is dangerous to
the other people? 126. After surgery. the patient for a long time was receiving
A. Mouse neutralization test Promedol (Trimeperidine) intravenously. When he stopped
B. Toxin production test receiving this drug, he developed severe psychosomatic
C. Immunofluorescence test disturbances. Name this phenomenon:
D. Complement fixation test A. Withdrawal syndrome
E. Serum agglutination test B. Steal syndrome
C. Rebound effect
120. A patient with schizophrenia was prescribed a drug to D. Idiosyncrasy
stop the hallucinations. After a month of taking this drug the E. Tachyphylaxis
hallucinations stopped, but the patient developed signs of
drug-induced parkinsonism. What drug was used for 127. A person received a head wound. To temporarily stop
treatment in this case? the bleeding, the doctor pressed with his finger an arterial
A. Amitriptyline vessel located in front of the auditory meatus and above the
B. Curantyl (Dipyridamole) zygomatic arch. Name the damaged artery:
C. Imizine (Imipramine) A. A. auricularis posterior
D. Sodium bromide B. A. pharyngea ascendens
E. Aminazine (Chlorpromazine) C. A. maxillaris
D. A. temporalis superficialis
121. A patient is diagnosed with glucocerebroside lipidosis E. A. carotis interna
(Gaucher's disease) that manifests as splenomegaly, liver
enlargement, affected bone tissue, and neuropathies. What 128. Section shows significant enlargement of the patient's
enzyme of complex lipid catabolism is deficient, causing this right kidney. There is a nephrolith at the place of incision.
disease? Renal pelvic lumen is distended with accumulating urine.
A. β. galactosidase Renal parenchyma is substantially thinned out. What is the
most correct diagnosis?
B. Hexosaminidase
A. Nephroblastoma
C. Glucocerebrosidase
B. Hydroureteronephrosis
D. Sphingomyelinase
C. Renal cyst
E. Hyaluronidase
D. Pyelectasis
E. Hydronephrosis
122. A man for a long time was suffering from hemoblastosis.
Autopsy of the body revealed brown color of the bone
129. A 20-year-old man from the early childhood suffered
marrow, spleen, liver and lymph nodes, Perls histochemical
from type I diabetes mellitus and was constantly undergoing
reaction was performed. It was determined that reticular,
Insulin therapy. Within the last your he started breaking his
endothelial, and histiocytic elements of the affected organs
diet and was taking his insulin doses irregularly. To detect
contain blue granules. What pigment was detected using the
possible complications, particularly glomerular diseases, the
endocrinologist referred him for urinalysis. What is the first A. Mesangial cell
persistent sign of glomerular filtration disorder? B. Endothelial cell
A. Oxaluria C. Podocyte
B. Proteinuria D. Smooth muscle cell
C. Leukocyturia E. Juxtavascular cell
D. Hematuria
E. Cylindruria 136. A patient with inherited immunodeficiency underwent
gene therapy: the gene of an enzyme was introduced into
130. A victim of a traffic accident suffered damage to one half the patient's cells using a retrovirus. What characteristic of
of the spinal cord and developed Brown-Sequard syndrome. the genetic code allows using retroviruses as vectors of
What causes motor function disturbance on the damaged functional genes?
side below the site trauma? A. Commaless
A. The spinothalamic tract crosses over at the level of its B. Colinearity
entry into the spinal cord and ascends on the opposite side C. Non-ambiguity
B. The spinothalamic tract does not cross over at the level of D. Degeneracy
its entry into the spinal cord and ascends on the side of the E. Universality
entry
C. After their cross over the pyramidal tracts pass through 137. During gastrulation, three germ layers are being formed
the lateral funiculi of the spinal cord on the side of the (ectoderm, endoderm, and mesoderm). Later they develop
muscles they innervate into tissues and organs. Ectoderm, in particular, develops
D. Goll, Burdach, and Flechsig tracts are straight, while into:
Gowers tract crosses over A. Blood and lymph
E. After their cross over the pyramidal tracts pass through B. Intestinal epithelium
the lateral funiculi of the spinal cord on the opposite side from C. Skeletal muscles
the muscles they innervate D. Neural tube
E. Hepatic cells
131. A 45-year-old man complains of frequent fevers,
tachycardia, irritability, hair loss, weight loss, and hand 138. A patient hospitalized into the pulmonology department
tremor. In this case, blood test will show the high levels of was diagnosed with pulmonary emphysema accompanied
the hormones produced in the: by the loss of elasticity in the pulmonary tissue. What type of
A. Gonads respiration can be observed in this case?
B. Pancreas A. Periodical breathing
C. Adrenal medulla B. Expiratory dyspnea
D. Adrenal cortex C. Slow breathing
E. Thyroid D. Inspiratory dyspnea
E. Shallow breathing
132. What compensatory response occurs in the human
body, when external temperature significantly rises? 139. A patient has frequent visceral and mucosal
A. Increased muscle tone hemorrhages. Analysis shows that the collagen fibers in the
B. Dilation of the cutaneous blood vessels patient's body lack hydroxyproline and hydroxylysine. The
C. Peripheral vasoconstriction hydroxylation processes of these amino acids are disrupted
D. Dilation of the visceral blood vessels because of a vitamin deficiency. What vitamin is deficient in
E. Decreased perspiration this case?
A. K
133. A biopsy material obtained from a mammary tumor has B. C
solid layers that consist of small epithelial cells with C. H
polymorphic nuclei and numerous pathological mitoses. The D. A
stroma is scant and has lymphocyte infiltration. Make the E. PP
diagnosis:
A. Scirrhous carcinoma 140. A patient presents with acute attack of
B. Adenolibroma choledocholithiasis. Laboratory examination of the patient's
C. Medullary carcinoma feces will likely to show the following in this case:
D. Paget disease A. Connective tissue
E. Adenoma B. Partially digested cellulose
C. Positive reaction to stercobilin
134. A 7-year-old boy has a bright-pink punctate rash against D. Starch granules
the background or hyperemia on his forehead, neck, lower E. Negative reaction to stercobilin
abdomen, and in the popliteal spaces. His nasolabial triangle
is pale. In the oropharynx there is a bright-red hyperemic 141. From the feces of a patient with acute gastroenteritis a
area with clear margins, the tonsils are swollen and friable, pure culture of microorganisms was obtained. The
lacunas contain pus, Microorganisms are small mobile slightly curved gram-
the tongue is raspberry pink. The cervical lymph nodes are negative bacilli that within 6 hours grow into a light blue film
enlarged and painful. Make the diagnosis: on the 1% alkaline peptone water. Such properties are
A. Pertussis characteristic of the following microorganism:
B. Rubella A. Clostridium
C. Infectious mononucleosis B. Spirochaete
D. Diphtheria C. Vibrio
E. Scarlet fever D. Spirillum
E. Bacillus
135. An electronic microphotograph shows a fragment of the
renal corpuscle. In the photograph there is a large epithelial 142. When there is a foreign body in the airways, what
cell with numerous appendages. The appendages are bronchus should the doctor examine first, while searching for
attached to the basement membrane of the capillaries. What the foreign body to extract it?
type of cell is it? A. Right primary bronchus
B. Right lobar bronchi A. Hyperthyroidism
C. Left lobar bronchi B. Hypothyroidism
D. Left primary bronchus C. Pancreatic islet failure
E. Left segmental bronchi D. Ovarian failure
E. Adrenal medulla hyperfunction
143. A patient was hospitalized in a preshock condition. He
has a penetrating wound to the chest and coughs constantly.
What medicine will have analgesic and antitussive effect in
this case?
A. Prednisolone
B. Morphine hydrochloride
C. Dimedrol (Diphenhydramine)
D. Libexin (Prenoxdiazine)
E. Adrenaline hydrochloride

144. The Dentist detected herpetic stomatitis in a patient.


What medicine should the patient be prescribed?
A. Midantan (Amantadine)
B. Kanamycin
C. Erythromycin
D. Lincomycin
E. Acyclovir

145. A laboratory received a sputum sample obtained from a


patient with tuberculosis. What staining method should be
used to detect the causative agents of tuberculosis?
A. Romanowsky-Giemsa
B. Burri-Gins
C. Ziehl-Neelsen
D. Gram-Sinov
E. Neisser

146. A test animal receives electrical impulses that irritate the


sympathetic nerve that innervates blood vessels of the skin.
What reaction will it cause in the blood Vessels?
A. Arterial and venous dilation
B. Venous dilation
C. Arterial dilation
D. Arterial and venous constriction
E. No reaction

147. The doctor examines a patient with diabetes mellitus.


He needs to check the pulsation of an artery that enters the
foot between the tendons of extensor digitorum longus and
extensor hallucis longus. What artery is it?
A. A. plantaris medialis
B. A. plantaris lateralis
C. A. fibularis
D. A. dorsalis pedis
E. A. tibialis posterior

148. A woman who takes an indirect anticoagulant,


developed intestinal bleeding. What antagonist drug should
she be prescribed?
A. Trental (Pentoxifylline)
B. Vicasol (Vitamin K)
C. Mannitol
D. Fercoven (iron sucrose and cobalt gluconate)
E. Diacarb (Acetazolamide)

149. An electronic microphotograph shows a fragment of the


proper gastric gland. In the photograph there is a large
irregular rounded cell with numerous intracellular canaliculi
and mitochondria. Name this type of cell:
A. Chief cell
B. Undifferentiated cell
C. Parietal cell
D. Foveolar cell
E. Endocrine cell

150. A 16-year-old female has no hair on the pubis and in the


armpits, her mammary glands are underdeveloped, no
menstruations. This condition can he caused by the following
hormone imbalance:

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