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Krok 1 Medicine 2004




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Дата24.09.2012
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55. 2 weeks since the blood transfusion a recepient has developed fever. What protozoal disease can it be?

A. Trypanosomiasis

B. Malaria

C. Amebiasis

D. Toxoplasmosis

E. Leishmaniasis

56. A patient died 3 days after the operation because of perforated colon with the manifestations of diffuse purulent peritonitis. The autopsy demonstrated: colon mucos membrane was thickened and covered with a fibrin film, isolated ulcers penetrated into different depth. Results of histology: mucous membrane necrosis, leukocytes infiltration with hemorrhages focuses. The complication of what disease caused the patient's death?

A. Nonspecific ulcerative colitis

B. Typhoid

C. Crohn's disease

D. Amebiasis

E. Dysentery

57. The examination of a foreigner revealed intestinal schistosomiasis. How could the patient be infected?

A. While eating fish

B. While eating meat

C. During river swimming

D. Through dirty hands

E. Through insects bites

58. For serological diagnostics of the whooping cough there was made a large-scale reaction with parapertussis and pertussis diagnostici. At the bottom of the test-tubes with diagnosticum of Bordetella parapertussis grain-like sediment was formed. What antibodies have this reaction revealed?

A. Agglutinins

B. Antitoxins

C. Precipitins

D. Opsonins

E. Bacteriolysins

59. Isolated muscle of a frog is rhythmically irritated with electric impulses. Every next impulse is in a period of relaxation from the previus contraction. What contraction of the muscle appears?

A. Tonic

B. Waved tetanus

C. Continuous (smooth) tetanus

D. Single

E. Asynchronous

60. A woman with myasthenia developed respiratory disorders, which required artificial ventilation. What type pf respiratory insufficiency did the woman have?

A. Centrogenic

B. Restrictive

C. Neuromuscular

D. Thoracophrenic

E. Obstructive

61. A 59-year-old man has signs of the parenchymatous jaundice and portal hypertension. On histological examination of the puncture of the liver bioptate, it was revealed: beam-lobule structure is affected, part of hepatocytes has signs of fat dystrophy, port-portal connective tissue septa with formation of pseudo-lobules,with periportal lympho-macrophage infiltrations. What is the most probable diagnosis?

A. Viral hepatitis

B. Liver cirrhosis

C. Chronic hepatosis

D. Toxic dystrophy

E. Alcohol hepatitis

62. A 46-year-old man on his head skin has got a little bulged out nevus pigmentosis of a dark colour which didn't trouble him. For the last time the nevus began growing in size, a pain developed, the colour became black-brown; the palpation of it demonstrated a node at its base. The histological examination of the removed tissue revealed spindle-shaped and polymorphic cells, the cytoplasm of which contained the pigment of fulvous colour. What tumor is it about?

A. Hematoma

B. Basalioma

C. Melanoma

D. Carcinoid

E. Hemangioma

63. A 26-year-old woman is complaining of thirst and dryness in her mouth. The examination has revealed glucosuria and blood glucose content of 6,5 mmol/l. What condition are these symptoms the most typical for?

A. Diabetes insipidus

B. Steroid diabetes

C. Diabetes mellitus

D. Renal diabetes

E. Alimentary glucosuria

64. After the radiactive exposure a patient has stem cells disorder. The regeneration of what cells of friable connective tissue will be damaged?

A. Macrophages

B. Pericytes

C. Fibroblasts

D. Pigment cells

E. Adipocytes

65. The study of the genealogy of a family with hypertrichosis (helix excessive pilosis)

demonstrated, that this feature is manifested in all generations only in men and is inherited by son from his father. What is the type of hypertrichosis inheritance?

A. Y-linked chromosome

B. X-linked recessive chromosome

C. Autosome-recessive

D. Autosome-dominant

E. X-linked dominant chromosome

66. The speed of excitement conduction through the atrioventricular node in a healthy adult is 0,02-0,05 mps. What does artrioventricular delay supply?

A. Sufficient force of atria contraction

B. Sequence of atria and ventricles contraction

C. Simultaneous contraction of both ventricles

D. Sufficient force of ventricles contraction

E. Simultaneous contraction of both atria

67. A patient has got frequent internal organs' and mucosal hemorrhages. The analysis indicated insufficiency of hydroxyproline and hydroxylysine in the collagenous fibres. The insufficiencuy of what vitamin caused the impairment of hydroxylysation of abovementioned aminoacids in a patient?

A. Vitamin Н

B. Vitamin К

C. Vitamin С

D. Vitamin РР

E. Vitamin А

68. Patient in the unconscious state was admitted to the emergency room. Skin is cold, pupils are delayed, breathing is heavy, with cycles of the Cheyne-Stokes type, blood pressure is decreased, urinary bladder is overloaded. Poisoning with what substance is the most likely?

A. Non-narcotic analgesics

B. -

C. М-cholinergic antagonists

D. Narcotic analgesics

E. Sedatives

69. A 65-year-old man with signs of profuse obesity and risk of fatty liver dystrophy was recommended high-lipotropic diet. The contents of what substance in his diet is the most effective in this case?

A. Glycin

B. Methionine

C. Glucose

D. Cholesterol

E. Vitamin C

70. A patient died from acute cardiac insufficiency.The histological examination of his heart revealed in myocardium of the left ventricle the necrotized section, which was separated from undamaged tissue by the zone of hyperimic vessels, small hemorrhages and leukocytic infiltration. What is the most likely diagnosis?

A. Myocardial infarction

B. Productive myocarditis

C. Myocardial ischemic dystrophy

D. Focal exudate myocarditis

E. Diffuse exudate myocarditis

71. Ion cells have been blocked in the excitative cell. It doesn't change significantly the quiet potential, but the cell has lost its capacity to the generation of AP (action potential). What canals have been blocked?

A. Sodium and potassium

B. Chlorine

C. Calcium

D. Potassium

E. Sodium

72. A 44-year-old woman was admitted to the therapeutic department because of right-side pleuritis. The examination confirmed the presence of liquid in the pleural cavity. What sinus of the pleura will have the biggest accumulation of the serosity?

A. Right mediastinodiaphragmatic

B. Right costodiaphragmatic

C. Right costomediastinal

D. Left mediastinodiaphragmatic

E. Left costomediastinal

73. Patient was admitted to the infection unit with diagnosis of bacterial dysentery. On laboratory studies it was revealed that causative element is sensitive to many antimicrobial medicines, but patient had anemia. What medicine was contra-indicated to the patient?

A. Levomycetin

B. Ampicillin

C. Enteroseptol

D. Furazolidone

E. Phthalazol

74. A 63-year-old man, suffering from cancer of esophagus, has metastases to mediastenum, lymph nodes and cancer cachexy. What is the pathogenetic stage of the given tumorous process?

A. Progression

B. Transformation

C. -

D. Initiation

E. Promotion


75. A 58-year-old man has a clinical picture of acute pancreatitis. The increase of what substance in the urine from belowmentioned will confirm the diagnosis?

A. Albumin

B. Nonprotein (rest) nitrogen

C. Urea

D. Uric acid

E. Amylase

76. A patient after tooth extraction developed persistent substernal pain. Sublingual antianginal substance releaved the substernal pain, but the patient complained of headache and dizziness. What medicine did the patient use?

A. Validol

B. Nytroglycerin

C. Metoprolol

D. Anapriline

E. Verapamil

77. During ultrasound examination of the heart the doctor observes the leaves of the mitral valve. What happends to them during the systole?

A. They turn inside the cavity of the atrium

B. They clasp with wall of the vessel

C. They close up covering the lumen of the orifice

D. They turn inside the cavity of the ventricle

E. They clasp with the walls of the atrium

78. Blood sampling for bulk analysis is recommended to be performed on an empty stomack and in the morning. What changes in blood count can occur if to perform blood sampling after food intake?

A. Increased plasma proteins

B. Increased contents of leukocytes

C. Increased contents of erythrocytes

D. Reduced contents of thrombocytes

E. Reduced contents of erythrocytes

79. A patient with ascariasis was administered a medicine which influenses the immune system and is used as immunomodulator. What medicine was administered?

A. Levamisole

B. Naphthamon

C. Pyrantel

D. Piperazine adipinate

E. Phenasol

80. Systemic amebiasis with involvment of intestines, liver, lungs was diagnosed in a 52-year-old patient. What drug should be prescribed?

A. Tetracycline

B. Enteroseptol

C. Quiniofone

D. Metronidasol

E. Quingamine

81. A 39-year-old man has got an increased risk of infectious processes development,

hyperkeratinizattion, disorder of mesopic vision. What vitamin should be administered?

A. Ergocalciferol

B. Tocopherol acetate

C. Riboflavine

D. Retinol acetate

E. Pyridoxine hydrochloride

82. During the complicated labour the symphysis pubis ruptured. What organ can be damaged the most?

A. Rectum

B. Urinary blader

C. Uterus

D. Uterine tubes

E. Ovaria

83. The electrocardiogramme analysis demonstrated that the duration of man's heart cycle is 1sec. What is the heart rate per minute?

A. 60

B. 50

C. 70

D. 100

E. 80

84. A patient suffers from arterial hypertension strokes, accompanied by tachycardia, excessive sweat, sharp pain in the epigastric region. Which of the mentioned tumorous diseases are these symptoms the most typical for?

A. Pheochromocytoma

B. Glomerular adrenal adenoma

C. Pituitary basophil adenoma

D. Ovarian tumor

E. Thyroid adenoma

85. A 42-year-old man suffering from gout has increased level of urinary acid in the blood. Allopurinol was prescribed to decrease the level of urinary acid. Competitive inhibitor of what enzyme is allopurinol?

A. Hypoxantinphosphoribosiltransferase

B. Adenosinedeaminase

C. Xanthinoxidase

D. Guaninedeaminase

E. Adeninephosphoribosiltransferase

86. A patient has increased contents of uric acid in his blood, what is clinically manifested by pain syndrome due to accumulation of urates in his joints. What process does the formation of this acid result from?

A. Purine bases re-using

B. Proteolysis

C. Purine nucleotide decay

D. Heme catabolism

E. Pyrimidine nucleotide decay

87. A patient with chronic heart failure being treated by digitalis drugs developed the symptoms, which confirmed the beginning of cardiac glycosides toxic activity. What drug should be administered to reduce the negative effect of cardiac glycosides?

A. Atropine sulfate

B. Potassium chloride

C. Ethymizol

D. Sodium caffeine-benzoate

E. Dipiroxim

88. A child was diagnosed to have fracture of humerus. The broken arm began retarding in growth. What part of the bone was damaged?

A. Apophysis

B. Epiphysis

C. Metaphysis

D. Marrow canal

E. Diaphysis

89. Extensive thromboembolic infarction of the left cerebral hemispheres, large septic spleen, immunocomplex glomerulonephritis, ulcers on the edges of the aortic valves, covered with polypous thrombus with colonies of staphylococcus were revealed on autopsy of the young man who died in coma. What disease caused cerebral thromboemboly?

A. Septicemia

B. Rheumatic thromboendocarditis

C. Acute rheumatic valvulitis

D. Septicopyemia

E. Septic bacterial endocarditis

90. A patient in winter fall down into ice-hole, froze and fall ill. The temperature increased up to 39,70С and ranged from 39,00C tо 39,80С . Name the type of temperature curve of this patient.

A. Febris recurrens

B. Febris continua

C. Febris intermittens

D. Febris remittens

E. Febris hectica

91. After the genealogy analysis a geneticist came to the conclusion: a feature is manifested in each generation, men and women inherit the feature with equal frequency, parents in the equal way give this feature to their offspring. What type of inheritance does the investigated feature have?

A. Autosomal-dominant

B. Х-linked dominant inheritance

C. Х-linked recessive inheritance

D. Y-linked inheritance

E. Autosomal-recessive

92. The examination of blood serum of a patient with immunodeficiency signs revealed antybodies to gP120 i gP41 proteins. The presence of what infection of this patient does it confirm?

A. НLTV-1-infection

B. TORCH-infection

C. ЕСНО-infection

D. НВV-infection

E. HIV-infection

93. The increased intraocular tension is observed in the patient with glaucoma. Secretion of aqueous humor by the ciliar body is normal. Injury of what structure of the eyeball wall caused the disorder of fluid flow-out from the anterior chamber?

A. Back epithelium of cornea

B. Venous sinus

C. Choroid

D. Ciliary muscle

E. Ciliar body

94. A patient'l liver can not normally detoxify its natural metabolites and xenobiotics.The reduced activity of what cytochrome can cause this?

A. Cytochrome B

B. Cytochrome Р- 450

C. Hemoglobulin

D. Cytochromoxidase

E. Cytochrome C-1

95. A patient with prolonged bronchopneumonia was admitted to the therapeutic department. Antibiotic therapy was ineffective. What medicine should be added to the complex therapy of the patient to increase the immune status?

A. Analgin

B. Paracetamol

C. Sulfocamphocain

D. Timalin

E. Dimedrol

96. During the examination of a patient with bleeding wounds the doctor found out that the tissue was damaged by maggots, there were local maturations. The diagnosis was obligate myiasis. The maggots of what insect caused the disease?

A. Triatomic bug

B. Stable fly

C. Filth (house) fly

D. Tsetse fly (Glossina)

E. Blow fly (Musca Volfarti)

97. Woman applied to the medico-genetic consulting centre for information about the risk of haemophilia in her son. Her husband has been suffering from this disease since birth. Woman and her parents are healthy (don't have haemophilia). Is the boy likely to have the disease in this family?

A. 75% of the boys will be ill

B. 25% of the boys will be ill

C. All boys will be ill

D. 50% of the boys will be ill

E. All boys will be healthy

98. Local lymphonodules enlarged near the infected wound. Increased amount of macrophages, lymphocytes, lymphatic follicles in the cortical layer and large amount of plasma cells were revealed on histological examination. What process in the lymphatic nodules represent these histological changes?

A. Tumour transformation

B. Innate insufficiency of the lymphoid tissue

C. Antigen stimulation

D. Hypersensibility reaction

E. Acquired insufficiency of the lymphoid tissue

99. The patient has taken the mixture prescribed by neuropathologist for neurasthenia for 2 weeks. Patient felt better but developed coryza, conjunctivitis, rash, inertia, decrease of memory. Bromizm was diagnosed. What should be prescribed to decrease symptoms?

A. Polyglucin

B. -

C. Natrium chloride

D. Glucose solution 5%

E. Asparcam

100. During the intraoperative biopsy of thyroid gland the histological examination revealed lymphoid structures with growth centers, which were among the folliculi full of colloid. What disease was it?

A. Endemic goiter

B. Hashimoto's thyroiditis (lymphadenoid goiter)

C. Thyrotoxicosis (Basedow's goiter)

D. Ridel's goiter

E. Sporadic goiter

101. On blood grouping on the system ABO, standart serum of the I and II groups caused erythrocytes agglutination of the examined blood and serum group of the III didn't. What agglutinogens are in this erythrocytes?

A. В

B. D and C

C. С

D. А and В

E. А

102. The microscopic examination of wound lavage of a patient with acute woundy process of his shin revealed big contents of irregular extended-formed cells, with tough nucleus, the basophilic cytoplasm of which includes many lysosomes, phagosomes and pinocytotic bubbles. What cells are found out in the wound?

A. Tissue basophils

B. Connective tissue macrophages

C. Fibrocytes

D. Fibroblasts

E. Plasmocytes

103. To anaesthetize the manipulation connected with burn surface treatment, a patient was intravenously injected a medication for short-acting narcosis. 1 minute later the patient being under anaesthesia had elevated blood pressure, tachycardia, increased tone of sceletal muscles; the reflexes were reserved. After awakening the patient had desorientation and visual hallucinations. What medication was injected to the patient?

A. Nitrous oxide

B. Ketamine

C. Thiopental sodium

D. Sombrevin

E. Diethyl ether

104. A patient, undergoing a course of curative starvation, has a normal glucose level of the blood mainly due to glucogenesis. What aminoacid in human liver the most actively synthesizes glucose?

A. Valine

B. Glutamic acid

C. Lysine

D. Leucine

E. Alanine

105. During the football match a player injuried his knee joint. The X-ray examination showed fracture of the bone, which is situated in the tendon thickness of musculus quadriceps femoris. What of the mentioned groups does this bone belong to?

A. Tubular

B. Hollow

C. Sesamoid

D. Combined

E. Flat

106. A 27-year-old man has purulent inflammation of gallblader. What region of the peritoneal cavity will the pus fall into if gallblader ruptures in his typical position?

A. Into hepatic bursa

B. Into epiploic bursa

C. Into the superior duodenal sinus

D. Into the left lateral duct

E. Into pancreatic bursa

107. A man because of 1,5 litre blood loss has suddenly reduced diuresis. The increased secretion of what hormone caused such diuresis alteration?

A. Parathormone

B. Vasopressin

C. Natriuretic

D. Corticotropin

E. Cortisol

108. A 60-year-old man after cerebral hemorrhage felt asleep for a long time. Damage of what structure caused this state?

A. Nuclears of the cerebral nerves

B. Reticular formation

C. Cortex of the large hemispheres

D. Black substances

E. Hippocampus

109. A woman, who was keeping a diet for a long time and eating refined rice, has developed polyneuritis (beriberi disease). The absence of what vitamin in the diet causes the development of such disease?

A. Ascorbic acid

B. Pyridoxal

C. Riboflavin

D. Folic acid

E. Thiamine
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