Krok 1 – 2018 (General Medicine)

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1. Question
The carotid bodies on both sides were removed in a test animal. Which of the listed
factors WILL NOT be able to cause hyperventilation in the test animal?

1. Acidosis

2. Hypoxemia

3. Hypercapnia

4. Physical exertion

5. Increase of core body temperature

2. Question
An 18-year-old student presents with enlarged thyroid gland accompanied by
accelerated metabolism and increased heart rate. These signs can be observed
during hypersecretion of thyroxin. What organelles of thyroid cells are primarily
responsible for hormone production and secretion?

1. Golgi apparatus

2. Centrosomes

3. Mitochondria

4. Lysosomes

5. Ribosomes

3. Question
A 64-year-old woman presents with disturbed fine motor function of her fingers,
marked muscle rigidity, and tremor. The neurologist diagnosed her with
Parkinson’s disease. What brain structures are damaged resulting in this disease?

1. Red nuclei

2. Thalamus
 3. Substantia nigra

4. Reticular formation

5. Cerebellum

4. Question
Initial inoculation of water in 1% peptone water resulted in growth of a thin film on
the medium surface in 6 hours. Such cultural properties are characteristic of
causative agent of the following disease:

1. Dysentery

2. Pseudotuberculosis

3. Plague

4. Cholera

5. Tuberculosis

5. Question
After an X-ray examination of the tuberculosis clinic patient, he was diagnosed
with tumor of the right lung. During operation the surgeon removed the middle
lobe of the patient’s right lung. This lobe includes:

1. Segmentum apicale (superius) et segmentum basale mediale

2. Segmentum anterius et segmentum apicale

3. Segmentum basale anterius et posterius

4. Segmentum laterale et segmentum mediale

5. Segmentum lingualare superius et inferius

6. Question
A 20-year-old young man with tall stature, asthenic body type, signs of
hypogonadism and gynecomastia, and low sperm count (azoospermia) has
karyotype 47, XXY. What hereditary syndrome can be characterized by this
chromosomal anomaly?

1. Turner syndrome

2. Wiskott-Aldrich syndrome

3. Klinefelter syndrome

4. Louis-Bar syndrome (ataxia-telangiectasia)

5. Down syndrome

7. Question
A 40-year-old woman on examination presents with intensified basal metabolic
rate. What hormone present in excess leads to such condition?

1. Thyrocalcitonin

2. Glucagon

3. Aldosterone

4. Triiodothyronine

5. Somatostatin

8. Question
Autopsy revealed a large wedge-shaped patch of a dense dark red 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?

1. Carneous degeneration

2. Gangrene

3. Hemorrhagic infarction

4. Hemorrhage

5. Atelectasis

9. Question
A patient was brought into the infectional diseases hospital on the 8th day since the
disease onset. The patient complains of headache, malaise, and weakness. A sample
of blood was taken for the serological test. Widal agglutination test results with
blood sample diluted 1:200 and typhoid fever O-diagnosticum were positive. What
diagnosis can be made based on the results of this test?

1. Leptospirosis

2. Cholera

3. Tuberculosis

4. Typhoid fever

5. Dysentery

10. Question
Pathogenic staphylococcus was obtained from the purulent wound of the patient.
Its antibiotic sensitivity was determined to be as follows: penicillin growth
inhibition zone – 8 mm; oxacillin – 9 mm, ampicillin – 10 mm, gentamicin – 22 mm,
lincomycin – 11 mm. What antibiotic should be chosen for treatment in this case?

1. Ampicillin
 2. Penicillin

3. Oxacillin

4. Gentamicin

5. Lincomycin

11. Question
A patient complains of dizziness, thirst, difficult swallowing, and impaired vision of
close objects. Objectively: respiratory rate is increased, pupils are dilated, general
agitation, talkativeness, though the speech is indistinct. BP is 110/70 mm Hg, heart
rate is 110/min. Given symptoms can indicate overdosage of the following drug:

1. Atropine

2. Morphine

3. Ephedrine

4. Aminazine

5. Caffeine

12. Question
During the fight a man has received a strong blow to the upper anterior abdominal
wall, which resulted in the cardiac arrest. What mechanism has led to the cardiac
arrest in this case?

1. Sympathetic conditioned

2. Parasympathetic conditioned

3. Sympathetic unconditioned

4. Parasympathetic unconditioned

5. Peripheral

13. Question
Vascular endothelium is characterized by high metabolic activity and synthesizes
vasoactive substances. Among these substances there is a potent vasodilator
synthesized from L-arginine. Name this vasodilator:

1. Bradykinin

2. Acetylcholine

3. Histamine

4. Adrenaline

5. Nitrogen oxide
14. Question
A patient has been brought into a surgical ward with an incised wound of the
anterior surface of the shoulder in its lower one-third. Flexing function was
disturbed in the shoulder and elbow joints, which is caused by the damage to the:

1. Triceps muscle of the arm

2. Anconeus muscle

3. Coracobrachial muscle

4. Deltoid muscle

5. Biceps muscle of the arm

15. Question
Histological analysis of a removed skin tumor shows clusters and bands composed
of atypical stratified squamous epithelium cells that penetrate into the underlying
tissue. What preliminary diagnosis can be made?

1. Papilloma

2. Carcinoma in situ

3. Solid cancer

4. Non-keratinizing squamous cell carcinoma

5. Adenoma

16. Question
After a hand fracture the man has lost the ability to touch his little finger with the
thumb on the affected hand. Examination of the palmar surface shows one of the
palmar muscles to be atrophied. Name the affected muscle:

1. M. flexor digiti minimi

2. Mm. lumbricales

3. Mm. interossei

4. M. palmaris brevis

5. M. opponens policis

17. Question
A 45-year-old woman presents with breast cancer. Metastases can spread in this
case to the following regional lymph nodes:

1. Aortic, mediastinal

2. Parasternal, mediastinal
 3. Abdominal, cervical

4. Axillary, parasternal

5. Cervical, parasternal

18. Question
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 hospitalization?

1. Fourfold increase in number of antibodies to Epstein-Barr virus was detected

2. IgM antibodies to herpes simplex virus were detected

3. Herpesvirus was isolated

4. IgM antibodies to Epstein-Barr virus were detected

5. Cytomegalovirus antibodies were detected

19. Question
A 45-year-old man diagnosed with hepatic cirrhosis and ascites underwent
drainage of 5 liters of fluid from his abdominal cavity, which resulted in
development of syncopal state due to insufficient blood supply to the brain. What
circulatory disorder occurred in the abdominal cavity in this case?

1. Embolism

2. Ischemia

3. Venous hyperemia

4. Thrombosis

5. Arterial hyperemia

20. Question
An electron micrograph shows a small vessel with endothelial layer but without
basement membrane and pericytes; anchoring fibrils are present. Name this vessel:

1. Lymph capillary

2. Sinusoid hemocapillary

3. Venule

4. Visceral hemocapillary

5. Arteriole

21. Question
Patients with bile duct obstruction typically present with inhibited blood clotting
and develop hemorrhages due to insufficient assimilation of vitamin:

1. C

2. A

3. K

4. E

5. D

22. Question
First-year schoolchildren have received tuberculin skin test (Mantoux test) at the
school nurse’s office. The purpose of this test was:

1. To detect parotitis in the schoolchildren

2. To measure immunity stress toward diphtheria

3. To determine the children that need to receive BCG vaccination

4. To preventively vaccinate against tuberculosis

5. To measure allergization rate toward rickettsia

23. Question
A 34-year-old man died in a comatose state. According to his family after a business
trip to an African country he developed periodical jaundice attacks. Autopsy shows
the following: dense enlarged spleen with slate-black pulp; enlarged plethoric liver,
gray-black on section; cerebral gray matter is brown-gray; cerebral white matter
contains numerous small hemorrhages. What infectious disease can be suspected?

1. Prion infection

2. Meningococcemia

3. Malaria

4. Generalized herpetic infection

5. Generalized cryptococcosis

24. Question
A 54-year-old man complains of general weakness, frequent colds, and bruises
constantly appearing on his body. Blood test: erythrocytes – 2.5 × 1012/L; Hb- 80
g/L; color index – 0.9; reticulocytes – absent; platelets – 50 × 109/L; leukocytes – 58
× 109/L; leukogram: basocytes – 5%, eosinophils – 15%, myeloblasts – 6%,
myelocytes – 10%, juvenile – 18%, stab neutrophils – 26%, segmented neutrophils –
10%, lymphocytes – 8%, monocytes – 2%, ESR – 40 mm/hour. What hematologic
conclusion can be made?
 1. Chronic myelogenous leukemia

2. Basophilic eosinophilic leukocytosis

3. Chronic lymphocytic leukemia

4. Myeloblastic leukemia

5. Leukemoid response

25. Question
During influenza epidemic, morbidity in the schoolchildren, who did not
participate in sports, was 40%, while in the schoolchildren, who engaged in regular
physical activities, morbidity did not exceed 20%. What adaptation mechanism
ensured low morbidity in the physically active schoolchildren?

1. Specific adaptation

2. Biochemical adaptation

3. Physiological adaptation

4. Genetic adaptation

5. Cross-adaptation

26. Question
In the process of an experiment, vascular resistance to the blood flow was
measured in the different areas of circulatory system. The highest resistance was
detected in the:

1. Arteries

2. Veins

3. Capillaries

4. Venules

5. Arterioles

27. Question
A patient with myocardial infarction has acute heart failure. Among the drugs that
increase the force of heart contractions the least dangerous in this case will be:

1. Euphyllin (Aminophylline)

2. Dobutamine

3. Adrenaline

4. Isadrinum (Isoprenaline)

5. Caffeine
28. Question
A patient has been taking bisacodyl for a long time to treat chronic constipation.
However, several weeks later the aperient effect of the drug diminished. What is the
possible cause of this?

1. Drug dependence

2. Sensitization

3. Acquired tolerance

4. Material cumulation

5. Functional cumulation

29. Question
After a case of common cold the patient developed numbness of the right side of the
face. Examination revealed disturbed pain and thermal sensitivity in the right half
of the face. What nerve was damaged?

1. Glossopharyngeal

2. Facial

3. Trigeminal

4. Hypoglossal

5. Vagus

30. Question
A patient presents with acute attack of cholelithiasis. Laboratory examination of
the patient’s feces will show the following in this case:

1. Negative reaction to stercobilin

2. Positive reaction to stercobilin

3. Connective tissue

4. Partially digested cellulose

5. Starch granules

31. Question
A patient has undergone surgical removal of the pylorus. Decreased secretion of the
following hormone can be expected:

1. Histamine

2. Secretin

3. Cholecystokinin
 4. Gastrin

5. Gastric inhibitory polypeptide

32. Question
In a township there was registered an outbreak of hepatitis, which had supposedly
spread through the water supply. What hepatitis virus could be the cause of the
outbreak in this township?

1. Hepatitis E virus

2. Hepatitis G virus

3. Hepatitis B virus

4. Hepatitis D virus

5. Hepatitis C virus

33. Question
A 40-year-old man developed skin redness and swelling in the neck area, where
eventually a small abscess appeared. On section the focus is dense and yellow-green
colored. In the purulent masses there are white granules. Histologically there are
fungal druses, plasma and xanthome cells, and macrophages detected. Specify the
most correct etiological name of this pathological process:

1. Leprosy

2. Furuncle

3. Syphilis

4. Actinomycosis

5. Carbuncle

34. Question
A patient complains of pain in the upper umbilical region. On palpation there is a
mobile painful intestine. What intestine is being palpated by the doctor?

1. Ileum

2. Duodenum

3. Jejunum

4. Transverse colon

5. Sigmoid colon

35. Question
A 59-year-old man, a business manager, developed intense burning retrosternal
pain that irradiates to the left arm. The pain occurred in the evening after the tax
audit. 15 minutes later the patient’s condition normalized. What mechanism of
angina pectoris development is leading in this patient?

1. Coronary atherosclerosis

2. Intravascular aggregation of blood cells

3. Coronary artery thrombosis

4. Increased level of blood catecholamines

5. Functional cardiac overload

36. Question
Genealogical analysis of a child with myotonic dystrophy determined that this
disease is present in every generation, equally presented by the relatives of both
genders, the risk of inheriting this disease is equal no matter which parent is
affected. If one of the parents is heterozygous for this disease and the other parent
is healthy, the risk of them giving birth to a sick child is 50%. What type of disease
inheritance is it?

1. Autosomal dominant

2. Y-linked

3. X-linked recessive

4. X-linked dominant

5. Autosomal recessive

37. Question
A 46-year-old patient suffering from ulcer disease of the stomach is diagnosed with
rheumatoid arthritis. What antii-nflammatory drug would be the most advisable in
this case?

1. Promedol (Trimeperidine)

2. Analgin (Metamizole)

3. Prednisolone

4. Paracetamol

5. Celecoxib

38. Question
Condition of a patient with diabetes mellitus sharply deteriorated after a regular
injection of insulin. The patient became anxious and broke out in cold sweat;
tremor of the extremities, general weakness, and dizziness appeared. What
medicine can remove these symptoms?
 1. Tolbutamide

2. Caffeine

3. Noradrenaline

4. Adrenaline

5. Glibutid (Buformin)

39. Question
An 18-year-old patient has developed candidiasis after the case of pneumonia
treated with β-lactam antibiotic. What anti-mycotic agent should be prescribed?

1. Phthalylsulfathiazole

2. Streptomycin

3. Ampicillin

4. Trimethoprim/sulfamethoxazole (Bi-septol)

5. Fluconazole

40. Question
During the first year of life an infant presents with disturbed process of breast milk
curdling. What cells of the proper gastric glands are functionally disturbed?

1. Parietal exocrinocytes

2. Cervical mucous cells

3. Main exocrinocytes

4. Accessory mucous cells

5. Exocrinocytes

41. Question
A child diagnosed with purulent inflammation of the middle ear was brought to the
otolaryngology department. The disease started with the inflammation of the
nasopharynx. It was determined that the infection had reached the tympanic cavity
through the eustachian tube that is located in the:

1. Сanalis caroticus

2. Сanaliculus chordae tympani

3. Canalis musculotubarius

4. Сanaliculi caroticо tympanici

5. Сanaliculus tympanicus

42. Question
Collagenosis patients typically present with connective tissue destruction
processes. The presence of these processes can be confirmed by the increase in:

1. Transaminase activity in the blood

2. Blood creatine and creatinine

3. Blood oxyproline and oxylysine

4. Blood urates

5. LDH-isoenzyme activity in the blood

43. Question
A young woman presents with a tumor along the auditory nerve. The tumor is
node-shaped, 3 cm in diameter, soft and elastic, pink-white colored, and has
homogeneous structure. Microscopically the tumor contains bundles of cells with
oval nuclei. These cellular fibrous bundles form regular structures made up of
parallel rows of regularly oriented cells arranged in the form of a palisade with
acellular homogeneous area in between (Verocay bodies). Name this type of tumor:

1. Neuroblastoma

2. Malignant neurinoma

3. Ganglioneuroblastoma

4. Ganglioneuroma

5. Neurinoma

44. Question
A 63-year-old man suffers from esophageal carcinoma, presents with metastases
into the mediastinal lymph nodes and cancerous cachexia. What pathogenetic stage
of neoplastic process is observed in the patient?

1. Promotion

2. Initiation

3. Transformation

4. Progression

45. Question
Preventive vaccination against poliomyelitis is made with inactivated vaccine
introduced parenterally. What immunoglobulins create the postvaccinal immunity
in this case?

1. IgM, IgG

2. IgG, secretory IgA

 3. IgM, secretory IgA

4. Serum IgА, IgM

5. IgЕ, IgM

46. Question
A woman with the III (В), Rh (-) blood group gave birth to a child with the II (А)
blood group. The child is diagnosed with hemolytic disease of newborn caused by
rhesus incompatibility. What blood group and Rh does the father have?

1. II (A), Rh (-)

2. I (0), Rh (+)

3. III (B), Rh (+)

4. II (А), Rh (+)

5. I (0), Rh (-)

47. Question
A 40-year-old pregnant woman underwent amniocentesis. Examination
determined the fetal karyotype to be 47, XY+21. What fetal pathology was detected?

1. Klinefelter syndrome

2. Down syndrome

3. Turner syndrome

4. Phenylketonuria

5. Patau syndrome

48. Question
Neutralization of xenobiotics and active endogenous metabolites often occurs via
introduction of an oxygen atom into the substrate molecule. What process occurs as
the result?

1. Decarboxylation

2. Deaminization

3. Hydroxylation

4. Transamination

5. Phosphorilation

49. Question
A woman with enteritis accompanied by severe diarrhea presents with loss of water
in the extracellular space, increased water content in the cells, and decreasing
blood osmolarity. Name this type of water-electrolyte imbalance:
 1. Hyperosmolar hyperhydration

2. Isoosmolar hypohydration

3. Hypoosmolar hyperhydration

4. Hyperosmolar hypohydration

5. Hypoosmolar hypohydration

50. Question
Histological specimen shows organ parenchyma to consist of lymphoid tissue that
forms lymph nodules; the nodules are located diffusely and have a central artery.
What anatomical structure has such morphological characteristics?

1. Tonsil

2. Lymph node

3. Thymus

4. Spleen

5. Red bone marrow

51. Question
A patient with a chemical burn has developed esophageal stenosis. The patient
presents with acute weight loss due to problematic food intake. Blood test:
erythrocytes – 3.0 × 1012/L, Hb- 106 g/L, total protein – 57 g/L. What type of
starvation does this patient suffer from?

1. Protein starvation

2. Incomplete starvation

3. Complete starvation

4. Water starvation

5. Absolute starvation

52. Question
Blood of the patients with diabetes mellitus shows increased content of free fatty
acids. Name the most likely cause of this:

1. Accumulation of palmitoyl-CoA in cytosol

2. Decreased activity of plasma phosphatidylcholine-cholesterol-acyltransferase

3. Increased activity of adipose triglyceride lipase

4. Activation of ketone bodies utilization

5. Activation of apoА1, apoА2, and apoА4 apolipoprotein synthesis

53. Question
Ionizing radiation or vitamin E deficiency affect the cell by increasing lysosome
membrane permeability. What are the possible consequences of this pathology?

1. Intensive energy production

2. Partial or complete cell destruction

3. Formation of maturation spindle

4. Restoration of cytoplasmic membrane

5. Intensive protein synthesis

54. Question
24 hours after an appendectomy the patient’s blood test shows neutrophilic
leukocytosis with a regenerative shift. What is the most likely mechanism of
absolute leukocytosis development in the patient’s peripheral blood?

1. Leukocyte redistribution

2. Intensification of leukopoiesis

3. Immunity activation

4. Decreased leukocyte disintegration

5. Deceleration of leukocyte migration to the tissues

55. Question
A woman has been limiting the amount of products in her diet to lose some weight.
3 months later she developed edemas and her diuresis increased. What dietary
component deficiency is the cause of this?

1. Fats

2. Carbohydrates

3. Proteins

4. Minerals

5. Vitamins

56. Question
Atria of a test animal were superdistended with blood, which resulted in decreased
reabsorption of Na+ and water in renal tubules. This can be explained by the effect
of the following factor on the kidneys:

1. Angiotensin

2. Natriuretic hormone
 3. Aldosterone

4. Vasopressin

5. Renin

57. Question
Examination of the coronary arteries revealed atherosclerotic plaques with
calcinosis that narrow the arterial opening by 1/3. In the muscle there are
numerous whitish layers of connective tissue. Name the process detected in the
myocardium:

1. Postinfarction cardiosclerosis

2. Diffuse cardiosclerosis

3. Myocardial infarction

4. Tiger heart

5. Myocarditis

58. Question
Congenital pyruvate carboxylase deficiency causes physical and mental
retardation in children and leads to early death. It is characterized by lactic
acidemia, lactaciduria, and a number of metabolic disorders. Among others,
inhibition of the following occurs:

1. Citric acid cycle and gluconeogenesis

2. Lipolysis and lipogenesis

3. Pentose-phosphate pathway and glycolysis

4. Glycogenesis and glycogenolysis

5. Glycolysis and glycogenolysis

59. Question
X-ray examination of a 57-year-old man indicates local areas of hard bone tissue
resorption in some of the patient’s bones. These changes can be associated with
increased activity of:

1. Chondrocytes

2. Osteoblasts

3. Osteoclasts

4. Chondroblasts

5. Osteocytes

60. Question
A microslide of the skin sample taken from the finger of a child shows that
epidermis is insufficiently developed. What germ layer was damaged in the process
of embryo development?

1. Endoderm

2. Mesoderm

3. Ectoderm

4. Mesenchyme

5. Ectomesenchyme

61. Question
A patient presents with indigestion, stomachaches, and excessive salivation.
Similar symptoms had already been observed in this patient previously.
Laboratory analysis detected oval eggs covered with lumpy capsules in the
patient’s feces. What is the most likely cause of the patient’s disorder?

1. Trichocephaliasis

2. Fascioliasis

3. Ascariasis

4. Diphyllobothriasis

5. Enterobiasis

62. Question
On examination the patient presents with hirsutism, moon-shaped face, stretch
marks on the abdomen. BP is 190/100 mm Hg, blood glucose is 17.6 mmol/L. What
pathology is such clinical presentation characteristic of?

1. Hyperthyroidism

2. Adrenocortical hyperfunction

3. Hypothyroidism

4. Hyperfunction of the insular apparatus

5. Gonadal hypofunction

63. Question
After a trauma the man has lost skin sensitivity on the lateral surface of his
forearm. What nerve of the brachial plexus  provides sensitivity of the affected
area?

1. N. radialis

2. N. musculocutaneus
 3. N. axillaris

4. N. ulnaris

5. N. medianus

64. Question
Sanitary assessment of a pond, where the children from a recreation summer camp
take their swims, detected there oval cysts 50-60 micron in diameter, with 2 nuclei
visible in their cytoplasm (macronucleus and micronucleus). What protozoa do
these cysts belong to?

1. Lamblia

2. Toxoplasma

3. Euglena

4. Balantidium

5. Amoeba

65. Question
A patient with clinical signs of a primary immunodeficiency has functionally
disturbed mechanism of antigen-presentation to the immunocompetent cells. What
cells are likely to have structural defects?

1. Fibroblasts

2. B-lymphocyte

3. Macrophages, monocytes

4. T-lymphocyte

5. O-lymphocytes

66. Question
A patient used an indirect-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:

1. Idiosyncrasy

2. Allergy

3. Cumulation

4. Teratogenicity

5. Tachyphylaxis

67. Question
Kidney X-ray image obtained by means of pyelography shows that the minor
calyces converge to form 2 major calyces that adjoin to the renal pelvis, from which
the ureter exits. What type of urinary tract is it?

1. Embryonic

2. Bicornuate

3. Mature

4. Cystic

5. Fetal

68. Question
Autopsy of a woman revealed the following morphologic changes: stenosis of the
atrioventricular opening, mitral insufficiency. Histologically there are focal
cardiosclerosis and ”blooming” Aschoff nodules in the myocardium. What is the
most likely diagnosis?

1. Systemic lupus erythematosus

2. Polyarteritis nodosa

3. Dermatomyositis

4. Rheumatism

5. Scleroderma

69. Question
A patient with streptococcal infection of the gingiva was prescribed a drug with β-
lactam ring in its structure. What drug of those listed below belongs to this
pharmacological group?

1. Benzylpenicillin

2. Streptomycin sulfate

3. Erythromycin

4. Rifampicin

5. Levomycetin (Chloramphenicol)

70. Question
Autopsy of a patient, who died of bi-lateral bronchopneumonia, shows in the left
lung lower lobe a cavity 5 cm in diameter, filled with yellowish-white liquid. What
complication of the patient’s pneumonia had developed?

1. Tuberculoma

2. Sequestrum
 3. Granuloma

4. Gangrene

5. Abscess

71. Question
A victim of a traffic accident was received by the intensive care unit. The patient is
in a grave condition that can be characterized as a severe pathologic process that
leads to exhaustion of vital functions and puts the patient into the marginal state
between life and death due to critical reduction of capillary circulation in the
affected organs. The patient is in the state of:

1. Preagony

2. Collapse

3. Shock

4. Agony

5. Coma

72. Question
A patient was hospitalized into the infectious diseases unit on the 11th day since the
disease onset and provisionally diagnosed with typhoid fever. What biological
material should be collected from the patient for the analyzes at this stage?

1. Bile

2. Roseola secretion

3. Blood serum

4. Feces

5. Urine

73. Question
A patient, who had received a thermal burn, developed painful boils filled with
turbid liquid on the skin. What morphological type of inflammation has developed
in the patient?

1. Croupous

2. Granulomatous

3. Diphtheritic

4. Proliferative

5. Serous

74. Question
A 42-year-old man with gout presents with high content of uric acid in blood. The
patient was prescribed allopurinol to lower the concentration of uric acid.
Allopurinol is a competitive inhibitor of the following enzyme:

1. Guanine deaminase

2. Xanthine oxidase

3. Hypoxanthine phosphoribosyltransferase

4. Adenine phosphoribosyltransferase

5. Adenosine deaminase

75. Question
During autopsy of a 34-year-old man, who died of chronic kidney failure due  to
renal amyloidosis, in the lungs (mainly in the lower lobes) the pathologist detected
multiple bronchial dilations filled with purulent masses accumulated in the
bronchial lumen. Surface of the lungs section has fine-meshed pattern and
resembles a honeycomb. Histologically there is a chronic inflammation detected in
the bronchial wall, muscle fibers are replaced with connective tissue. These changes
in the lungs can be defined as:

1. Chronic bronchitis

2. Bronchopneumonia

3. Lung abscesses

4. Chronic pneumonia

5. Bronchiectases

76. Question
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-white substance. The ulcer
edges are markedly raised above the mucosa. Widal test is positive. Make the
diagnosis:

1. Typhoid fever

2. Dysentery

3. Crohn’s disease

4. Relapsing fever

5. Nonspecific ulcerative colitis

77. Question
Due to prolonged stay in the mountains at the altitude of 3000 m above the sea
level, a person developed increased oxygen capacity of blood, which was directly
caused by intensified production of:

1. Leukopoietins

2. Catecholamines

3. Erythropoietins

4. 2,3-bisphosphoglycerate

5. Carbaminohemoglobin

78. Question
Regional lymph nodes surrounding an infected wound are enlarged. Histological
examination shows increased number of macrophages, lymphocytes, and
lymphatic follicles, as well as a large amount of plasma cells, in the cortical layer of
the lymph nodes. What process in the lymph nodes is indicated by these histologic
changes?

1. Acquired deficiency of lymphoid tissue

2. Congenital deficiency of lymphoid tissue

3. Antigen stimulation

4. Neoplastic aberration

5. Transplant rejection

79. Question
Cell membrane rest potential changed from -85 to -90 mV. It can be caused by
activation of the following cell membrane channels:

1. Potassium and sodium

2. Calcium

3. Sodium

4. Potassium

5. Potassium and calcium

80. Question
A patient was prescribed atropine sulfate to treat intestinal colic. What
concomitant disease can be a contraindication for this drug?

1. Bronchial asthma

2. Vertigo

3. Glaucoma
 4. Hypotension

5. Sinus bradycardia

81. Question
A patient developed pyoinflammatory process of periodontal tissues caused by
activation of the microorganisms inherent in the body, which are a part of oral
mucosal microflora. What type of infection is it?

1. Relapse

2. Exogenous infection

3. Superinfection

4. Autoinfection

5. Reinfection

82. Question
Protective function of saliva is based on several mechanisms, including the
presence of enzyme that has bactericidal action and causes lysis of complex
capsular polysaccharides of staphylococci and streptococci. Name this enzyme:

1. Lysozyme

2. α-amylase

3. β-glucuronidase

4. Oligo-1,6-glucosidase

5. Collagenase

83. Question
After a psychic trauma a woman developed periodical increases in her blood
pressure accompanied by headache, palpitations, and general weakness. What
mechanism of hypertension development does this woman have?

1. Tachycardia

2. Decreased cardiac output

3. Increased circulating blood volume

4. Increased arteriolar tone

5. Venoconstriction

84. Question
Microscopy of the puncture sample obtained from the inflammation focus of the
patient with cutaneous abscess revealed numerous blood cells of different types.
What cells are the first to transfer from vessels to tissues during inflammation?
 1. Lymphocytes

2. Eosinophils

3. Basocytes

4. Monocytes

5. Neutrophils

85. Question
Due to destruction of certain structures of the brainstem a test animal has lost its
orientation reflexes in response to strong light stimuli. What structures were
destroyed?

1. Vestibular nuclei

2. Red nuclei

3. Anterior quadrigeminal bodies

4. Posterior quadrigeminal bodies

5. Substantia nigra

86. Question
A 17-year-old girl suffers from periodical palpitations that last several minutes. Her
heart rate is 200/min., rhythmic. What heart rhythm disorder developed in this
patient?

1. Atrioventricular block

2. Extrasystole

3. Sinus tachycardia

4. Paroxysmal tachycardia

5. Sinus bradycardia

87. Question
A microslide of the lung tissue sample taken from a patient with pneumonia shows
damage to the cells that carry out respiratory function. What cells of the alveolar
wall are damaged?

1. Type 1 alveolar cells

2. Type 2 alveolar cells

3. Macrophages

4. Lymphocytes

5. Club cells
88. Question
Coronary artery thrombosis resulted in development of myocardial infarction.
What mechanisms of cell damage are leading in this disease?

1. Lipid

2. Calcium

3. Acidotic

4. Protein

5. Electroosmotic

89. Question
The right leg of a 40-year-old woman measured at the shin level is by 2 cm smaller
in the diameter than the left leg. Ankle-jerk (Achilles) and knee-jerk reflexes are
absent on the right. What is the most likely mechanism of hyporeflexia development
during peripheral paralysis?

1. Activation of excitatory impulses from the CNS

2. Inhibition of pyramidal motoneuron

3. Disturbed perception of stimulation

4. Disturbed conduction of stimulation

5. Disturbed synaptic impulse transmission

90. Question
A patient presents with dilated blood vessels of the anterior medial surface of the
lower leg. This condition resulted from the dilation of the following blood vessel:

1. А. tibialis anterior

2. V. poplitea

3. V. saphena magna

4. А. tibialis posterior

5. V. saphena parva

91. Question
A traumatology unit has received a patient with a wrist trauma and a clinical
presentation of the damage to the nerve that passes through the carpal tunnel.
Name this nerve:

1. N. ulnaris

2. N. radialis
 3. N. axillaris

4. N. musculocutaneus

5. N. medianus

92. Question
The first-aid center has received a victim of a traffic accident diagnosed with closed
displaced fracture of the middle third of the thigh. For repositioning of bone
fragments the patient received 10 ml of 2% dithylinum solution intravenously,
which resulted in prolonged period of apnoea and muscle relaxation. What enzyme
is deficient, resulting in such pharmacogenetic enzymopathy?

1. Methemoglobin reductase

2. Uridine diphosphate glucuronyltransferase

3. Pseudocholinesterase

4. N-acetyltransferase

5. Glucose 6-phosphate dehydrogenase

93. Question
In human organism significant blood loss leads to decreased blood pressure,
tachycardia, and weakness. Eventually the sensation of thirst appears. What
hormone participates in the development of this sensation?

1. Cortisol

2. Serotonin

3. Dopamine

4. Adrenalin

5. Angiotensin 2

94. Question
Genetic recombination is achieved via several mechanisms. One such mechanism is
crossingover. It occurs at the following stage of prophase in the first meiotic
division:

1. Diakinesis

2. Pachynema

3. Leptonema

4. Zygonema

5. Diplonema

95. Question
A 19-year-old young man was examined in the nephrology clinic. High calcium was
detected in his secondary urine. What hormone is likely to cause such change, if it is
produced in excess?

1. Testosterone

2. Adrenaline

3. Aldosterone

4. Glucagon

5. Oxytocin

96. Question
During intensive muscle work there is a large amount of ammonia produced in the
muscles. What amino acid plays the main role in the transportation of ammonia to
the liver and participates in gluconeogenesis reactions?

1. Arginine

2. Lysine

3. Alanine

4. Ornithine

5. Aspartate

97. Question
An 8-year-old girl presents with signs of disturbed twilight vision. This condition is
caused by the deficiency of vitamin:

1. E

2. D

3. A

4. F

5. K

98. Question
A 40-year-old woman was diagnosed with glomerulonephritis based on her clinical
symptoms and the results of urine analysis. Anamnesis states chronic tonsillitis.
What microorganisms are the most likely cause for her kidney damage?

1. Mycoplasma

2. Meningococci

3. Escherichia
 4. Streptococci

5. Staphylococci

99. Question
During the prestart period an athlete develops increased frequency and force of
cardiac contractions. These changes are caused by intensification of the following
reflex responces:

1. Sympathetic unconditioned

2. Sympathetic conditioned

3. Parasympathetic conditioned

4. Parasympathetic unconditioned

5. Peripheral

100. Question
During surgery performed in abdominal cavity a surgeon located the ligament of
liver stretching from the anterior abdominal wall (navel) to the inferior surface of
liver. What ligament is it?

1. Falciform ligament of the liver

2. Coronary ligament of the liver

3. Venous ligament of the liver

4. Triangular ligament of the liver

5. Round ligament of the liver

101. Question
ECG analysis of the patient shows that the T waves are positive in the second
standard limb lead and their amplitude and duration is normal. The conclusion can
be made that the following process occurs normally in the patient’s ventricles:

1. Repolarization

2. Contraction

3. Relaxation

4. Excitation

5. Depolarization

102. Question
Autopsy of the body of a man, who for a long time had been working at the  factory
with high content of silicon dioxide in the air, revealed enlarged dense lungs with
numerous round and oval sclerotic foci. The foci were miliary and larger in size and
colored gray or gray-black. What is the most likely diagnosis?

1. Silicoanthracosis

2. Anthracosilicosis

3. Diffuse sclerotic silicosis

4. Asbestosis

5. Nodular silicosis

103. Question
Preoperative examination revealed prothrombin deficiency in the blood of the
patient. What drug should be preliminarily prescribed to mitigate blood loss in the
patient during the surgery?

1. Phenylin (Phenindione)

2. Thrombin

3. Contrykal (Aprotinin)

4. Aminocapronic acid

5. Vicasol (Menadione)

104. Question
A patient with pulmonary tuberculosis is prescribed the most effective anti-
tuberculous antibiotic. Name this drug:

1. Furasolidone

2. Streptocide

3. Rifampicin

4. Bactrim (Co-trimoxazole)

5. Tetracycline

105. Question
A patient demonstrates sharp decrease of pulmonary surfactant activity. This
condition can result in:

1. Increased pulmonary ventilation

2. Decreased airways resistance

3. Alveolar tendency to recede

4. Hyperoxemia

5. Decreased work of expiratory muscles

106. Question
A young 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 presence of parasite eggs, approximately 140х70
micron in size, with a terminal spike. What diagnosis can be made by the infectious
diseases specialist?

1. Schistosomiasis

2. Dicroceliasis

3. Opisthorchiasis

4. Fascioliasis

5. Paragonimiasis

107. Question
During removal of the hyperplastic thyroid gland of a 47-year-old woman, the
parathyroid gland was damaged. One month after the surgery the patient
developed signs of hypoparathyroidism: frequent convulsions, hyperreflexia,
laryngospasm. What is the most likely cause of the patient’s condition?

1. Hypophosphatemia

2. Hyponatremia

3. Hypocalcemia

4. Hyperchlorhydria

5. Hyperkalemia

108. Question
A person with the fourth blood group (genotype IAIB) has in erythrocytes both
antigen A controlled by allele IA and antigen B controlled by allele IB. This
phenomenon is an example of the following gene interaction:

1. Semidominance

2. Polymery

3. Epistasis

4. Complementarity

5. Codominance

109. Question
An oncology patient is to undergo a surgery on the descending colon. Name the
main source of blood supply to this organ:
 1. Superior mesenteric artery

2. Inferior mesenteric artery

3. Splenic artery

4. Celiac trunk

5. Middle colic artery

110. Question
In the process of hemoglobin catabolism iron is released and then as a part of
special transport protein is returned to the bone marrow, to be used again for
hemoglobin synthesis. Name this transport protein:

1. Transcobalamin

2. Haptoglobin

3. Transferrin

4. Ceruloplasmin

5. Albumin

111. Question
Due to trauma the patient has lost 25% of circulating blood volume. Name the
emergency compensatory mechanism against blood loss:

1. Restoration of blood protein composition

2. Increase of reticulocyte number

3. Interstitial fluid inflow to the vessels

4. Erythropoiesis activation

5. Restoration of erythrocyte number

112. Question
A patient suffers from posttraumatic hemorrhage that resulted in development of
hemorrhagic shock. What volume of circulating blood was lost by the patient?

1. 3-20%

2. 12-25%

3. 25-40%

4. 40-50%

5. 50-75%

113. Question
A  25-year-old  woman at  her  third  pregnancy with impending miscarriage was
brought to the hospital. What combination of Rh-factor of the mother and the fetus
can be the cause of this condition?

1. Mother Rh (-), fetus Rh (-)

2. Mother Rh (+), fetus Rh (-)

3. Mother Rh (-), fetus Rh (+)

4. Mother Rh (+), fetus Rh (+)

114. Question
In an experiment it is necessary to assess neuromotor and muscle excitability.
What value should be measured to make the assessment?

1. Sensory threshold

2. Action potential duration

3. Threshold potential

4. Resting potential

5. Action potential amplitude

115. Question
During the skill-building session in microbiology the students need to stain the
prepared and fixed sputum smears obtained form a tuberculosis patient. What
staining technique should be used in this case?

1. Gram

2. Gins

3. Giemsa

4. Burry

5. Ziehl-Neelsen

116. Question
After a case of sepsis a 27-year-old woman developed ”bronzed” skin di-scoloration
characteristic of Addison’s disease. Hyperpigmentation mechanism in this case is
based on increased secretion of:

1. Melanocyte-stimulating hormone

2. Somatotropin

3. Thyroid-stimulating hormone

4. Gonadotropin
 5. β-lipotropin

117. Question
A man with ischemic heart disease has been taking his medicine too often
throughout a day, which resulted in poisoning. Examination detects cyanosis of
skin and mucosa, sharp drop of blood pressure, tachycardia, and respiratory
depression. Blood methemoglobin is high. What type of medicine did the patient
overdose on?

1. α-adrenergic blockers

2. Adenosine-based drugs

3. Organic nitrates

4. Myotropic antispasmodics

5. Calcium channel blockers

118. Question
ECG of the patient shows increased duration of the QRS complex. What is the most
likely cause?

1. Increased atrial and ventricular excitability

2. Increased period of ventricular excitation

3. Disturbed conduction in the atrioventricular node

4. Increased period of atrial excitation

5. Increased atrial excitability

119. Question
Stool test detects in the patients feces a large amount of undigested fats.This patient
is the most likely to have disturbed secretion of the following enzymes:

1. Pancreatic proteases

2. Bile lipase

3. Gastric protease

4. Pancreatic amylase

5. Pancreatic lipases

120. Question
A patient is diagnosed with glucocerebroside lipidosis (Gaucher’s disease) that
manifests as splenomegaly, liver enlargement, affected bone tissue, and
neuropathies. What enzyme of complex lipid catabolism is deficient, thus causing
this disease?
 1. β-galactosidase

2. Sphingomyelinase

3. Hyaluronidase

4. Glucocerebrosidase

5. Hexosaminidase

121. Question
Nitrogen is being excreted from the body mainly as urea. When activity of a certain
enzyme in the liver is low, it results in inhibition of urea synthesis and nitrogen
accumulation in blood and tissues. Name this enzyme:

1. Amylase

2. Urease

3. Pepsin

4. Aspartate aminotransferase

5. Carbamoyl phosphate synthetase

122. Question
After a nephrectomy the patient developed enteroparesis. What cholinergic agent
with anticholinesterase action should be prescribed in this case?

1. Carbacholine

2. Aceclidine

3. Proserin

4. Pilocarpine

5. Acetylcholine

123. Question
Representatives of a certain human population can be characterized by elongated
body, height variability, decreased volume of muscle mass, increased length of
limbs, decreased size and volume of rib cage, increased perspiration, decreased
indices of base metabolism and fat synthesis. What type of adaptive evolution is it?

1. Moderate

2. Arctic

3. Intermediate

4. Tropical

5. Mountain
124. Question
A man is a carrier of HIV that is an RNA virus. The cells of this patient synthesize
viral DNA. This process is based on:

1. Replication

2. Transcription

3. Translation

4. Repair

5. Reverse transcription

125. Question
Parenchyma of an organ is composed of pseudounipolar neurons localized under
the capsule of connective tissue. Central place belongs to nerve fibers. Name this
organ:

1. Sympathetic ganglion

2. Spinal cord

3. Nerve trunk

4. Spinal ganglion

5. Intramural ganglion

126. Question
A 30-year-old man has undergone surgical removal of a thyroid tumor.
Histologically the tumor is made up of papillary structures varying in size that
emerge from the inner surface of dilated cystic follicles and are covered with
atypical epithelium. What is the most likely diagnosis?

1. Medullary carcinoma

2. Papillary carcinoma

3. Follicular carcinoma

4. Macrofollicular adenoma

5. Colloid nodular goiter

127. Question
A laboratory experiment on a dog was used to study central parts of auditory
system. One of the mesencephalon structures was destroyed. The dog has lost the
orienting response to auditory signals. What structure was destroyed?

1. Reticular formation nuclei

2. Superior colliculi of corpora quadrigemina

 3. Inferior colliculi of corpora quadrigemina

4. Red nucleus

5. Substantia nigra

128. Question
To stimulate the labor activity a parturient woman was prescribed a drug – a
posterior pituitary hormone that does not affect the blood pressure. As the
pregnancy progresses, the sensitivity to this hormone increases. Name the
prescribed drug:

1. Pituitrin

2. Dinoprost

3. Oxytocin

4. Ergotal

5. Dinoprostone

129. Question
A man has an inguinal hernia. The hernial sac exits through the following opening:

1. Foramen suprapiriforme

2. Linea alba

3. Anulus profundus canalis inguinalis

4. Anulus femoralis

5. Anulus superficialis canalis inguinalis

130. Question
A person becomes less receptive to pain in physically or emotionally straining
situations due to activation of:

1. Thyroid gland functions

2. Adrenal glands functions

3. Nociceptive system

4. Parasympathetic nervous system

5. Antinociceptive system

131. Question
A 30-year-old man complains of suffocation, heaviness in the chest on the right,
general weakness. Body temperature is 38.9oC. Objectively the right side of the
chest lags behind the left side during respiration. Pleurocentesis yielded exudate.
What is the leading factor of exudation in the patient?

1. Increased blood pressure

2. Hypoproteinemia

3. Increased permeability of the vessel wall

4. Erythrocyte aggregation

5. Decreased resorption of pleural fluid

132. Question
During cholecystectomy besides cystyca another artery was pulled into the
ligature. Ligation of this artery resulted in right-sided necrosis of the liver which
led to the death of the patient. What artery was mistakenly ligated along with a.
cystyca?

1. Ramus sinister a. hepatica propria

2. А. pancreato-duodenalis sup

3. А. gasro-duodenalis

4. Ramus dexter a. hepatica propria

5. А. hepatica communis

133. Question
During intensive physical exertion, one of the energy sources for the working
muscles is glucose produced as the result of gluconeogenesis. This process is the
most intensive in the following organ:

1. Muscles

2. Brain

3. Stomach

4. Liver

5. Lungs

134. Question
A lab rat has subcutaneously received mercury(II) chloride in the amount of 5
mg/kg. 24 hours later the plasma creatinine concentration increased several times.
What mechanism of retention azotemia is observed in this case?

1. Increased glomerular filtration

2. Decreased glomerular filtration

3. Increased creatinine reabsorption

 4. Increased creatinine production in the muscles

5. Increased creatinine production in the renal tubules

135. Question
A 38-year-old man, who has been suffering from systemic lupus erythematosus for
3 years, developed diffuse renal lesions accompanied by massive edemas, marked
proteinuria, hyperlipidemia, and dysproteinemia. What is the most likely
mechanism of proteinuria develoment in this case?

1. Inflammatory damage to the nephrons

2. Ischemic damage to the tubules

3. Autoimmune damage to the nephrons

4. Increased blood proteins

5. Morbid affection of the urinary tracts

136. Question
Histological investigation of the uterine scrape of the 45-year-old woman with
disturbed ovarian menstrual cycle revealed increased number of endometrial
glands, some of which are serrated, while others are dilated and cyst-like. Make the
diagnosis:

1. Endometrial adenocarcinoma

2. Placental polyp

3. Atypical endometrial hyperplasia

4. Endometrial cystic glandular hyperplasia

5. Glandular endometrial polyp

137. Question
General structure of eukaryotic genes is as follows: exon-intron-exon. Such
functional structure of a gene leads to certain specifics of the transcription process.
What sequence will correspond with precursor mRNA (immature)?

1. Exon-intron-exon

2. Exon-intron

3. Exon-exon

4. Intron-exon

5. Exon-exon-intron

138. Question
What diagnostic method should be used in industry to test the raw leather for
presence of antracis?

1. Microscopy with Aujeszky stain

2. Ascoli’s thermo precipitation test

3. Bacteriological analysis

4. Serological test

5. Microscopy with Burry-Gins stain

139. Question
A 25-year-old young man came to the doctor complaining of general weakness,
rapid fatigability, irritability, reduced working ability, and bleeding gums. What
vitamin is likely to be deficient in this case?

1. Retinol

2. Folic acid

3. Thiamine

4. Riboflavin

5. Ascorbic acid

140. Question
A 16-year-old girl presents with no hair on the pubis and in the armpits, her
mammary glands are underdeveloped, no menstruations. What hormone
imbalance can it be indicative of?

1. Adrenal medulla hyperfunction

2. Ovarian failure

3. Pancreatic islet failure

4. Hypothyroidism

5. Hyperthyroidism

141. Question
A 48-year-old man is unconscious. He has a history of several syncopal episodes
with convulsions. ECG shows deformed QRS complexes unconnected with P waves,
atrial contractions are approximately 70/min., ventricular contractions – 25-
30/min. Name the type of arrhythmia in this case:

1. Complete atrioventricular block

2. Intraatrial block

3. Intraventricular block
 4. Second-degree atrioventricular block

5. First-degree atrioventricular block

142. Question
A 2-year-old child presents with physical retardation and frequent pneumonias.
The child was diagnosed with non-closure of the arterial canal. Hemodynamics
disturbance in this case is caused by communication between the:

1. Pulmonary trunk and pulmonary veins

2. Aorta and pulmonary trunk

3. Superior vena cava and aorta

4. Superior vena cava and pulmonary trunk

5. Aorta and pulmonary veins

143. Question
Various biological preparations can be used for poliomyelitis prevention. What
drug induces the type of local intestinal mucosal immunity that lasts the longest?

1. Parenteral introduction of normal human immunoglobulin

2. Parenteral vaccination with inactivated vaccine

3. Oral introduction of poliovirus-specific immunoglobulin

4. Oral vaccination with live vaccine

5. Parenteral vaccination with live vaccine

144. Question
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 a light blue film on the
1% alkaline peptone water. Such properties are characteristic of the following
microorganism:

1. Spirochaete

2. Clostridium

3. Bacillus

4. Spirilla

5. Vibrio

145. Question
A 7-year-old child presents with marked signs of hemolytic anemia. Biochemical
analysis of erythrocytes determined low concentration of NADPH and reduced
glutathione. What enzyme is deficient in this case leading to the biochemical
changes and their clinical manifestations?

1. Hexokinase

2. Fructokinase

3. Lactate dehydrogenase

4. Glucose-6-phosphate dehydrogenase

5. Pyruvate kinase

146. Question
A toxin neutralized with 0.4% formaldehyde under 37-40oC for 4 weeks is used for
vaccination. This preparation was first used by Gaston Ramon for diphtheria
prevention. Name this preparation:

1. Anatoxin

2. Adjuvant

3. Immunoglobulin

4. Inactivated vaccine

5. Antitoxic serum

147. Question
A patient with hypochromic anemia has hair with split ends and suffers from hair
loss. The nails are brittle. Gustatory sensations are affected. What is the
mechanism of development of these symptoms?

1. Vitamin B12 deficiency

2. Low production of thyroid hormones

3. Iron enzymes deficiency

4. Low production of parathyroid hormone

5. Vitamin A deficiency

148. Question
A 4-year-old child presents with numerous carious cavities and yellow-colored
teeth. The mother has a history of antibiotic treatment during her pregnancy. What
antibiotic was the most likely taken by the child’s mother?

1. Streptomycin sulfate

2. Erythromycin
 3. Ampicillin

4. Cefazolin

5. Doxycycline

149. Question
A woman has lost a lot of blood during the childbirth. Her blood group needs to be
determined. Erythrocyte agglutination occurred with standard serums 0 (I) and А
(II) and did not occur with standard serum B (III). What blood group does this
woman have?

1. АВ (IV)

2. А (II)

3. B (III)

4. 0 (I)

150. Question
A 56-year-old man complains of thirst and frequent urination. The endocrinologist
diagnosed this patient with diabetes mellitus and prescribed him glibenclamide.
What mechanism of action does this drug have?

1. Facilitates glucose uptake by the tissues

2. Suppression of α-cells of islets of Langerhans

3. Inhibits glucose absorption in the intestine

4. Stimulation of β-cells of islets of Langerhans

5. Facilitates glucose transport through cell membranes

151. Question
Ketosis develops in the patients with diabetes mellitus, as the result of activation of
fatty acids oxidation processes. What acid-base imbalance can result from
accumulation of excessive ketone bodies in the blood?

1. Metabolic acidosis

2. Metabolic alkalosis

3. Respiratory acidosis

4. No imbalance occurs

5. Respiratory alkalosis

152. Question
A patient has developed status epilepticus. What medicine should be used in this
case to stop the seizures?
 1. Cyclodol (Trihexyphenidyl)

2. Sodium bromide

3. Diprazine (Promethazine)

4. Valerian extract

5. Diazepam

153. Question
Renal examination shows the kidney to be swollen and plethoric, with easily
removable capsule. Renal pelvis and calyces are dilated and filled with turbid
urine; their mucosa is dull and has hemorrhagic foci. On section the renal tissue is
variegated, there are yellow-gray areas surrounded with plethoric and
hemorrhagic zone. What disease can be characterized by such results of
macroscopic examination?

1. Nephrolithiasis

2. Renal amyloidosis

3. Acute glomerulonephritis

4. Acute pyelonephritis

5. Polycystic kidney

154. Question
A 40-year-old woman suffers from Cushing’s disease – steroid diabetes. On
biochemical examination she has hyperglycemia and hypochloremia. What process
activates in the first place in such patients?

1. Glycogenolysis

2. Glycolysis

3. Glucose reabsorption

4. Glucose transport to the cells

5. Gluconeogenesis

155. Question
A patient with contact dermatitis needs to be prescribed an antihistamine drug
without somnolescent effect. Select this drug from the list:

1. Diprazine (Promethazine)

2. Suprastin (Chloropyramine)

3. Loratadine

4. Ranitidine
 5. Dimedrol (Benadryl)

156. Question
An electron micrograph of a nephron segment shows cuboidal cells with ciliated
lining on their apical surfaces; their basal surfaces have basal striation with
mitochondria located between the cytolemma invaginations. Name the described
nephron segment:

1. Distal tubule

2. Proximal tubule

3. Glomerular capsule

4. Collecting ducts

5. Thin limbs of Henle’s loop

157. Question
During hypersensitivity skin test a patient received an allergen subcutaneously,
after which the patient developed skin redness, edema, and pain due to histamine
action. This biogenic amine is produced as the result of the following
transformation of histidine amino acid:

1. Isomerization

2. Phosphorilation

3. Deaminization

4. Methylation

5. Decarboxylation

158. Question
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?

1. Venous dilation

2. Arterial and venous dilation

3. Arterial and venous constriction

4. Arterial dilation

5. No reaction

159. Question
During pregnancy a woman has been taking an antiepileptic drug – sodium
valproate. It resulted in her child developing a vertebral column malformation –
spina bi-fida. Name the described effect of the drug:
 1. Sensitizing effect

2. Acquired tolerance

3. Immunosuppressive effect

4. Dependence

5. Teratogenic effect

160. Question
A patient has disturbed blood supply to the anterior papillary muscle of the left
ventricle. What cardiac artery supplies this muscle with blood?

1. Ramus interventricularis posterior

2. Ramus interventricularis anterior

3. Ramus marginalis

4. A. coronaria dextra

5. Ramus circumflexus

161. Question
A patient suffers from acute cardio-pulmonary failure with pulmonary edema.
What diuretic should be prescribed in the given case?

1. Triamterene

2. Spironolactone

3. Furosemide

4. Hydrochlorothiazide (Dichlothiazidum)

5. Acetazolamide (Diacarb)

162. Question
A person has increased pulmonary ventilation due to physical exertion. What
indicator of external respiration will be significantly increased compared to the
resting stage?

1. Vital lung capacity

2. Inspiratory reserve volume

3. Expiratory reserve volume

4. Total lung capacity

5. Respiratory volume

163. Question
A 25-year-old woman complains of visual impairment. Examination revealed
disturbed eye accommodation, the pupil is dilated and unresponsive to light. What
muscles are functionally disturbed in this case?

1. Lateral rectus muscle, iris sphincter muscle

2. Iris sphincter and iris dilator muscles

3. Superior oblique muscle, ciliary muscle

4. Iris dilator muscle, ciliary muscle

5. Iris sphincter muscle, ciliary muscle

164. Question
The dorsal root of the spinal nerve of a test animal was severed. What changes will
occur in the innervation area?

1. Loss of sensitivity and motor function

2. Loss of sensitivity

3. Decreased muscle tone

4. Loss of motor function

5. Increased muscle tone

165. Question
A patient suffers from hepatic cirrhosis. What substance excreted in urine should be
analyzed to characterize the antitoxic function of liver?

1. Amino acids

2. Hippuric acid

3. Uric acid

4. Creatinine

5. Ammonium salts

166. Question
One of the causes of pernicious anemia is disturbed synthesis of transcorrin –
Castle’s intrinsic factor – by the parietal cells of the stomach. What substance is
called Castle’s extrinsic factor?

1. Pyridoxine

2. Biotin

3. Folic acid

4. Cobalamin
 5. Riboflavin

167. Question
Microscopy of the myocardium of a girl, who died of diphtheria due to heart failure,
shows fatty degeneration, multiple foci of cardiomyocytes necrosis, and small foci
of cellular infiltrates in the interstitium. What type of myocarditis is it?

1. Focal exudative

2. Alterative

3. Granulomatous

4. Diffuse exudative

5. Interstitial

168. Question
Encephalopathy has developed in a child with hemolytic disease of the newborn.
What substance had increased in the child’s blood, resulting in damage to the CNS?

1. Verdohemoglobin

2. Bile acids

3. Bilirubin glucuronide

4. Bilirubin-albumin complex

5. Unconjugated bilirubin

169. Question
A mutation has occurred in a cell in the first exon of the structural gene. The
number of nucleotide pairs changed from 290 to 250. Name this type of mutation:

1. Duplication

2. Inversion

3. Translocation

4. Nullisomy

5. Deletion

170. Question
A 65-year-old woman, who had been suffering from deep vein thrombophlebitis of
the lower leg, suddenly died when awaiting her appointment with the doctor.
Autopsy revealed loose friable red masses with corrugated dull surface in the main
pulmonary artery and its bifurcation. What pathologic process was discovered by
the pathologist in the pulmonary artery?
 1. Thromboembolism

2. Foreign body embolism

3. Tissue embolism

4. Fat embolism

5. Thrombosis

171. Question
A specimen of a 10-day-old human embryo shows two interconnected sacs
(amniotic and yolk sacs). Name the structure located in the place where these two
sacs connect:

1. Floor of the amniotic sac

2. Roof of the amniotic sac

3. Amniotic stalk

4. Extraembryonic mesoderm

5. Embryonic shield

172. Question
People, who for a long time remained in hypodynamic state, develop intense pain in
the muscles after a physical exertion. What is the most likely cause of this pain?

1. Accumulation of lactic acid in muscles

2. Accumulation of creatinine in muscles

3. Increased content of ADP in muscles

4. Decreased content of lipids in muscles

5. Intensive breakdown of muscle proteins

173. Question
A force generated by the muscle is not enough to lift a load. What type of muscle
contraction occurs in this case?

1. Tetanic

2. Eccentric

3. Isometric

4. Concentric

5. Isotonic

174. Question
A 3-year-old girl with mental retardation has been diagnosed with sphingomyelin
lipidosis (Niemann-Pick disease). In this condition the synthesis of the following 
substance is disturbed:

1. Glycosyltransferase

2. Sphingosine

3. Ceramides

4. Sphingomyelinase

5. Gangliosides

175. Question
An obstetrician-gynecologist measures pelvis size of a pregnant woman. A caliper
was used to measure the distance between the two iliac crests. What measurement
of large pelvis was made?

1. Conjugata vera

2. Distantia throchanterica

3. Distantia cristarum

4. Distantia spinarum

5. Conjugata anatomica

176. Question
A patient, who has been taking β-adrenergic blockers, developed a bronchial
spasm. What group of bronchodilators should be chosen to stop the bronchial
spasm?

1. Indirect adrenergic agonists

2. β-adrenergic blockers

3. Muscarinic cholinomimetic agents

4. Cholinesterase inhibitors

5. Myotropic antispasmodics

177. Question
Autopsy of the body of an elderly man revealed yellow spots and streaks in the
aortic intima and white-yellow protruding plaques in the area of aortic bifurcation.
Microscopy (with hematoxylin and eosin staining) shows round cavities in the
thickened aortic intima. The cavities color orange when stained with sudan 3 and
are surrounded with overgrown connective tissue. What process developed in the
aortic intima?

1. Local hyalinosis
 2. Metabolic disorder of neutral fat

3. Metabolic disorder of cholesterol and cholesterol ethers

4. Systemic hyalinosis

5. Secondary amyloidosis

178. Question
A 52-year-old man presents with fever and pain in the joints. Both of his first
metatarsophalangeal articulations are deformed, swollen, and reddened. Blood
urea is high. The patient is diagnosed with gout. What is the main developmental
factor in the pathogenesis of this disease?

1. Hyperuricemy

2. Hyperaminoacidemia

3. Argininosuccinic aciduria

4. Citrullinuria

5. Hyperazotemia

179. Question
Acute renal impairment caused death of a patient with hemorrhage. Autopsy
revealed enlarged kidneys with broad pale pink cortical layer expressively
demarcated from dark red renal pyramids. Macroscopic examination revealed lack
of epithelial nuclei of the convoluted tubules, tubulorrhexis, phlebostasis. The cell
nuclei of the choroid glomus and straight tubules were present. What pathology is
it?

1. Pyelonephritis

2. Infarction

3. Glomerulonephritis

4. Necronephrosis

5. Nephrosis

180. Question
Monoamine oxidase inhibitors are widely used as psychopharmacological drugs.
They change the level of nearly all neurotransmitters in synapses, with the
following neurotransmitter being the exception:

1. Noradrenaline

2. Acetylcholine

3. Adrenaline

4. Serotonin
 5. Dopamine

181. Question
A newborn presents with weak suckling, frequent vomiting, and hypotonia. Blood
and urine citrulline are very high. What metabolic process is disturbed?

1. Ornithine cycle

2. Tricarboxylic acid cycle

3. Glycolysis

4. Cori cycle

5. Gluconeogenesis

182. Question
When examining a biopsy material obtained from the thyroid gland, the
pathologist discovered lymphocyte infiltration of the thyroid tissues and
destruction of the parenchymal elements. Diffuse lymphocyte infiltration with
lymphoid follicles was detected in the stroma. What is the most likely diagnosis?

1. Hashimoto’s thyroiditis (chronic lymphocytic thyroiditis)

2. Graves’ disease (toxic diffuse goiter)

3. Solid adenoma of the thyroid

4. Undifferentiated thyroid carcinoma

5. Papillary thyroid cancer

183. Question
A woman has come to the hospital with complaints of general weakness, dizziness,
and dyspnea. Recently she has been taking levomycetin (chloramphenicol) for
prevention of enteric infection. Blood test: erythrocytes – 1.9 × 10 12/L, hemoglobin
– 58 g/L, color index – 0.9, leukocytes – 2.2 G/L, reticulocytes – 0.3%. What type of
anemia is it indicative of?

1. Metaplastic

2. Hypoplastic

3. Aplastic

4. Hemolytic

5. Iron-deficiency

184. Question
A 60-year-old man diagnosed with chronic heart failure was brought to the
hospital. After a long course of treatment the patient developed signs of
intoxication: dyspnea, extrasystole, nausea, and disturbed perception of colors.
What medicine has caused such side-effects?

1. Digoxin

2. Nitroglycerine

3. Furosemide

4. Anaprilin (Propranolol)

5. Drotaverine

185. Question
Autopsy of a 50-year-old woman, who had been suffering from systemic connective
tissue disease, reveals small dense kidneys with lumpy surface. Microscopy of the
renal glomeruli detects there foci of fibrinoid necrosis, hyaline thrombi,
hematoxylin bodies, and so-called ”wire loop thickening” of the basement
membranes. What disease can be characterized by such changes in the kidneys?

1. Systemic lupus erythematosus

2. Rheumatoid arthritis

3. Scleroderma

4. Dermatomyositis

5. Rheumatism

186. Question
Autopsy of the body of a 50-year-old man, who had been suffering from
tuberculosis and died of cardiopulmonary decompensation, shows lobar affection
of the lungs: the upper lobe of the right lung is enlarged, dense, yellow on section,
crumbling, with pleural fibrin deposition. What type of secondary tuberculosis can
be characterized by this pathology?

1. Caseous pneumonia

2. Tuberculoma

3. Acute focal tuberculosis

4. Fibrous focal tuberculosis

5. Infiltrative tuberculosis

187. Question
A hereditary disease – homocystinuria – is caused by disturbed transformati-on of
homocysteine into methionine. Accumulated homocysteine forms its dimer
(homocystine) that can be found in urine. What vitamin preparation can decrease
homocysteine production?

1. Vitamin PP

2. Vitamin C

3. Vitamin B1

4. Vitamin B12

5. Vitamin B2

188. Question
A hospital has received a 24-year-old man, who had received a penetrating wound
to the eye, which has caused the vitreous body to run out. As the result of this,
retinal detachment occurred. What retinal layer was tightly adherent to the
vascular tunic of the eye and did not detach?

1. Outer nuclear layer

2. Inner nuclear layer

3. Layer of rods and cones

4. Ganglion cell layer

5. Retinal pigment epithelium

189. Question
A patient has an open facial wound with undermined edges; tissue necrosis with
gradually developing partial gangrene that nearly reaches the bone tissue is
observed. On close examination the wound contains live larvae. The patient is
diagnosed with tissue myiasis. What Diptera larvae are the causative agents of this
disease?

1. Wohlfahrtia magnifica

2. Musca domestica

3. Stomoxys calcitrans

4. Phlebotomus pappatachi

5. Glossina palpalis

190. Question
A 5-year-old child is diagnosed with Bruton syndrome (X-linked
agammaglobulinemia) that manifests itself as severe clinical course of bacterial
infections and absence of B lymphocytes and plasma cells. What changes of
immunoglobulin content can be observed in blood serum of the child with
immunodeficiency?

1. No changes
 2. Increased IgD, IgE

3. Decreased IgA, IgM

4. Increased IgA, IgM

5. Decreased IgD, IgE

191. Question
A sick child presents with high content of phenyl pyruvate in urine (normally it is
practically absent). Blood phenylalanine level is 350 mg/L (norm – 15 mg/L). What
disease are these symptoms characteristic of?

1. Albinism

2. Phenylketonuria

3. Alkaptonuria

4. Gout

5. Tyrosinosis

192. Question
A boxer had sustained a blow to the left parotid area, after which he developed
paralysis of the facial muscles on this side. What nerve had been damaged?

1. Facial

2. Mandibular

3. Maxillary

4. Lesser petrosal

5. Ophthalmic

193. Question
A woman with hypophyseal diabetes insipidus developed a water-mineral
imbalance. What type of water-mineral imbalance develops in such cases?

1. Hypoosmolar hyperhydration

2. Hypoosmolar dehydration

3. Hyperosmolar dehydration

4. Hyperosmolar hyperhydration

5. Isoosmolar dehydration

194. Question
A patient with parkinsonism was prescribed levodopa, which led to rapid
improvement of the patient’s condition. What is the mechanism of action of this
drug?

1. Muscarinic acetylcholine receptor blockade

2. Stimulation of dopamine synthesis

3. Stimulation of dopamine receptors

4. Anticholinesterase action

5. Muscarinic acetylcholine receptor stimulation

195. Question
A patient with exacerbated peptic ulcer disease of the stomach has made an
appointment with the doctor. What type of drugs should be included in the complex
therapy of this patient?

1. H1 antagonists

2. α-adrenergic antagonists

3. β-adrenergic antagonists

4. α-adrenergic agonists

5. H2 antagonists

196. Question
Vestibular  receptors  of  semicircular canals of a test animal have been destroyed.
What reflexes will disappear as a result?

1. Primary orienting reflex

2. Statokinetic reflex during movements with linear acceleration

3. Head-righting reflex

4. Statokinetic reflex during movements with angular acceleration

5. Body-righting reflex

197. Question
When studying the pulmonary ventilation values, the reduction of forced
expiratory volume has been detected. What is the likely cause of this phenomenon?

1. Obstructive pulmonary disease

2. Increase of functional residual lung capacity

3. Increase of pulmonary residual volume

4. Increase of inspiratory reserve volume

 5. Increase of respiratory volume

198. Question
A schizophrenia patient was prescribed aminazine. What pharmacodynamic action
of this drug is the grounds for its prescription in this case?

1. Hypothermic

2. Muscle relaxant

3. Antiemetic

4. Antipsychotic

5. Hypotensive

199. Question
A patient presents with enlarged cervical lymph nodes. Other lymph nodes and
internal organs are without changes. Peripheral blood test results are normal.
Histological examination of biopsy material taken from the cervical lymph node
shows smoothed-out pattern, absent follicles, homogeneous cell composition
represented by lymphoblasts. The cells penetrate into the lymph node capsule.
What diagnosis can be made?

1. Burkitt lymphoma

2. Erythroblastic leukemia

3. Lymphoblastic leukemia

4. Myeloblastic leukemia

5. Sezary disease

200. Question
A 50-year-old inpatient during examination presents with glucosuria and blood
glucose of 3.0 mmol/L, which are the most likely to be caused by:

1. Renal disorder

2. Diabetes insipidus

3. Myxedema

4. Pellagra

5. Essential hypertension