Krok 1 Medicine 2004 icon

Krok 1 Medicine 2004




НазваKrok 1 Medicine 2004
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Дата24.09.2012
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110. A 16-year-old patient died because of diffuse fibrinopurulent peritonitis. The autopsy in the inferior region of small intestine revealed an ulcer with a form of Peyer's plaque, with the perforation of intestine wall. The microscopic examination revealed lymph tissue pattern vagueness, the displacement of this tissue with proliferating monocytes, which were forming granulomata. Complication of what disease caused the death?

A. Brucellosis

B. Nonspecific ulcerative colitis

C. Cholera

D. Typhoid

E. Dysentry

111. After the usage of acetylsalicylic acid a patient developed epigastric pain because of exacerbation of his ulcer. What are the principles of this medication ulcerogenity?

A. Immunodepressive effect

B. Cholagogic effect

C. Antiprostaglandinic effect

D. Stimulation of pepsin secretion

E. Spasm of vessels

112. Because of present gallstone in the common bile duct, a patient has no bile excretion into duodenum. What disorder can it cause?

A. Carbohydrates digestion

B. Proteins absorption

C. Proteins digestion

D. Carbohydrates absorption

E. Lipids digestion

113. In the microspacemen of spinal medulla it is necessary to analyse the condition of the nucleus, neurons of which form the motor endings in the skeletal musculature. What nucleus of the spinal medulla is it about?

A. Posterior horn proper nucleus

B. Gray substance proper nucleus

C. Nucleus thoracicus (Clarke'snucleus)

D. Nucleus intermediolaterallis

E. Disseminate nucleus

114. A patient suffers from nocturnal paroxysms of bronchial asthma accompanied by bradycardia, spastic intestinal pains and diarrhea. Medicine of what group can releave these symptoms?

A. Sympatholytics

B. H-cholinergic receptors

C. M-cholinergic receptors

D. Saluretics

E. β-adrenoblockers

115. A patient becomes quickly tired during his work. In vertical position with closed eyes he is dizzying and loosing equilibrium. Skeletal muscle tone is reduced. Which of the belowmentioned brain structures is damaged?

A. Cerebellum

B. Hypothalamus

C. Precentral gyrus of cerebral hemispheres cortex

D. Basal ganglia

E. Thalamus

116. A young man increased his energy inputs from 500 to 2000 kJ per hour. What from the suggested can cause it?

A. Food taking

B. Change of sleeping for waking

C. Mental activity

D. Physical activity

E. Rising of external temperature

117. A 30-year-old patient with bacteriologically proved dysentery developed the signs of paraproctitis. What is the stage of local changes of this patient?

A. Fibrinous colitis

B. Healing of the ulcers stage

C. Follicular colitis

D. Ulceration stage

E. Catarrhal colitis

118. Genetic structure of eukaryote is "exon-intron-exon". This structure-functional organization of gene caused transcription peculiarities. What will be pro-i-RNA according to the scheme?

A. Exon-intron-exon

B. Intron-exon

C. Exon-exon-intron

D. Exon-intron

E. Exon-exon

119. A 42-year-old woman with trigeminal nerve neuralgia complaints of redness of right part of her face and neck, feeling of heat rush and increased dermal sensitiveness. What is the arterial hyperemia in this case according to pathophysiological mechanism?

A. Neuroparalytic

B. Reactive

C. Working

D. Neurotonic

E. Metabolic

120. A 56-year-old patient with complains of thirst and frequent urination was diagnosed to have diabetes mellitus and butamin was prescribed. What is the mechanism of action of this medicine?

A. It relieves transport of glucose through the cells' membranes

B. It inhibits absorption of glucose in the intestines

C. It helps to absorb the glucose by the cells of the organism tissues

D. It stimulates beta-cells of Langergans' islets

E. It inhibits alpha cells of Langergans' islets

121. Shock and signs of acute renal failure (ARF) developed in the patient due to severe injury. What is the leading cause of development of ARF in the case?

A. Increased pressure in the renal arteries

B. Decreased arterial pressure

C. Urine excretion violation

D. Decreased oncotic BP

E. Increased pressure in the nephron capsule

122. A malarial plasmodium (haemamoeba) - the pathogene of vivax malaria - has two strains: southern and northern. They differ by the duration of their incubation period: the southern has short and the northern - long one. What selection works in this case?

A. Cutting

B. Stabilizing

C. Artificial

D. Moving

E. Sexual

123. A patient with bronchial asthma is administered inhalation of 0,5\% isadrine solution. Bronchospasm was releaved, but the patient began complaining of pain in the heart region and palpitation. It is connected with the stimulation of:

A. α1 -adrenoreceptors

B. β1 -adrenoreceptors

C. β2 -adrenoreceptors

D. Acetylcholine synthesis

E. M-cholinergic receptors

124. During the expirement performed on a rabbit the superior cervical node of sympathatic stem was removed. On the side of the extraction there is redness and rising temperature of the head skin. What form of peripheral circulation disorder developed in this case?

A. Neuroparalytic arterial hyperemia

B. Venous hyperemia

C. Stasis

D. Neurotonic arterial hyperemia

E. Metabolic arterial hyperemia

125. A woman complaining of coryza, phonastenia, eyelids redness and lacrymation during spring period came to the doctor. What type of allergic reaction by Gell ano Coombs classification develops in this case?

A. Delayed type of hypersensitivity

B. Immunocomplex

C. Stimulating

D. Cytotoxic

E. Anaphylactic

126. A patient with burn disease died due to progressive septicaemia. The autopsy in the anterior abdominal wall by means of microscopic examination revealed diffuse infiltration of intermuscular spaces by segmentonuclear leukocytes, tissues edema and lysis of muscular fibres. Determine the nature of the pathological process.

A. Abscess

B. Catarrhal inflammation

C. Diphtheritic inflammation

D. Phlegmon

E. Necrosis

127. During investigation of patient, it was found formation in the white substance of cerebral hemispheres with location in the knee and frontal part of posterior crus of internal capsule. Fibres of what conductive tract of the brain will be disrupted?

A. Tr. frontothalamicus

B. Tr. parietooccipitopontinus

C. Tr. pyramidalis

D. Tr. frontopontinus

E. Тr. thalamocorticalis

128. A 25-year-old patient complained of vision reduction. Accommodation disorder, dilated pupil, not reacting on the light were revealed on examination. Function of what muscles is disturbed?

A. Inferior oblique muscle, ciliary

B. Pupil narrowing and dilating muscle

C. Lateral rectus muscle, pupil narrowing

D. Pupil narrowing muscle, ciliary

E. Pupil dilating muscle, ciliary

129. A patient with iron deficiency anemia has been treated at the in-patient hematological department of the regional children's hospital during 13 years. What hypoxia type does this patient have?

A. Hemic

B. Respiratory

C. Combined

D. Circulatory

E. Tissue

130. Decreased blood supply to the organs causes hypoxia that activates fibroblasts function. Volume of what elements is increased in this case?

A. Lymphatic vessels

B. Parenchymatous elements of the organ

C. Nerve elements

D. Vessels of microcircular stream

E. Intercellular substance

131. A 6-months-old baby has got frequent and extensive subdermal hemorrhages. The administration of the synthetic analogue of vitamin K (vicasol) was effective. γ-carboxylation of glutamic acid of what protein of blood coagulation system does this vitamin take part in?

A. Antihemophilic globulin A

B. Fibrinogen

C. Prothrombin

D. Hageman's factor

E. Rosental's factor

132. A 45-year-old man with domestic apper arm injuiry applied to the trauma unit. The objective data are: no extension, adduction and pronation functions of the arm. What muscle damage caused this condition?

A. Teres minor

B. Subspinous

C. Subscapular

D. Supraspinous

E. Teres major

133. A 30-year-old man with cutting wound of his forearm has got an impairment of his fingers extension. What nerve is damaged?

A. Ulnar

B. Radial

C. Middle

D. Medial antebrachial cutaneous nerve

E. Muscularcutaneous

134. The energy inputs of a healthy man have been identified. What position was the patient if his energy inputs were less than the main exchange?

A. Sleep

B. Nervous exertion

C. Rest

D. Calmness

E. Easy work

135. A patient with brain bloodstream disorder has got difficulties with swallowing, he can choke over while eating liquid food. What part of the brain is damaged?

A. Medulla

B. Midbrain

C. Cerebellum

D. Thalamencephalon

E. Cervical part of the spinal medulla

136. During total (with water) alimentary starvation the generalized edemata have developed. Which of the pathogenic factors is dominant in this case?

A. Reduced oncolitic pressure of blood plasma

B. Reduced hydrostatic pressure of interstitial fluid

C. Reduced osmotic pressure of blood plasma

D. Increased oncolitic pressure of interstitial fluid

E. Increased osmotic pressure of interstitial fluid

137. While examining the child the doctor revealed symmetric cheeks roughness, diarrhea, disfunction of the nervous system. Lack of what food components caused it?

A. Methionine, lipoic acid

B. Threonine, pantothenic acid

C. Nicotinic acid, tryptophane

D. Lysine, ascorbic acid

E. Phenylalanine, pangamic acid

138. Highly injured person gradually died. Please choose the indicator of biological death:

A. Absence of palpitation

B. Autolysis and decay in the cells

C. Disarray of chemical processes

D. Absence of movements

E. Loss of consciousness

139. Collagen, elastin and reticulin belong to the fibrillar elements of connective tissue. Indicate the aminoacid which constitutes only collagen, and identification of which in biological fluids is used for the diagnosing of the connective tissue diseases.

A. Lysine

B. Proline

C. Hydroxyproline

D. Phenylalanine

E. Glycine

140. A patient suffers from hemeralopia. Which of the suggested substances will have curable effect?

A. Keratin

B. Creatine

C. Carnitine

D. Carnosine

E. Carotene

141. The examination of an youth with mental retardation revealed eunuchoid body construction and genitals underdevelopment. The cells of the oral cavity cantained chromatine. What method of genetic investigation should be performed to make more specified diagnosis?

A. Biochemical

B. Dermatoglyphics

C. Population-statistic

D. Clinico-genealogical

E. Cytological

142. 4 months ago a 43-year-old man underwent traumatic amputation of his left lower extremity. At the time of his examination the patient complaints of feeling of present amputated extremity and constant sometimes unbearable pain in it. What pain type does the patient have?

A. Phantom limb

B. Thalamic

C. Neuralgia

D. Reflex

E. Causalgia

143. On examination of the person it was revealed that minute volume of heart is 3500mL, systolic volume is 50 mL. What is the frequency of cardiac contraction?

A. 60 bpm

B. 70 bpm

C. 90 bpm

D. 50 bpm

E. 80 bpm

144. An 18-year-old man with asthenic body constitution: tall, narrow shoulders, broad pelvis and with poor hair on his face came to the geneticist. There was marked mental retardatoin. The preliminary diagnosis was Klinefelter's syndrome. What method of medical genetics can confirm the diagnosis?

A. Population-statistic

B. Dermatoglyphics

C. Cytogenic

D. Gemellary

E. Genealogic

145. A patient with fibrillation, who has had bronchial asthma in his anamnethis, should be administered antiarrhythmic drug. Which preparation from the suggested group is contraindicated for this patient?


A. Ajmaline

B. Nifedipine

C. Anapriline (Propranolol)

D. Novocainamid

E. Verapamil

146. A histological spacemen presents parenchymal organ, which has cortex and medulla. Cortex consists of epitheliocytes bars, between them there are blood capillaries; the bars form three zones. Medulla consists of chromaffinocytes and venous sinusoids. What organ has these morphological features?

A. Adrenal gland

B. Kidney

C. Thyroid

D. Lymph node

E. Thymus

147. Complaints and objective data allow to suggest that a patient has inflammation in his gallblader, bile colloidoclasia, probability of gallstones formation. What can be the main cause of gallstones formation?

A. Oxolates

B. Chlorides

C. Cholesterol

D. Urates

E. Phosphates

148. The microscopic examination of liver biopsy revealed granulomata, consisting of plasmatic, lymphoid, giant polynuclear cells of Pirogov-Lachgans type, small vessels with the signs of endo- and perivasculitis, and there were focuses of caseation necrosis. What disease are these granulomata typical for?

A. Leprosy

B. Rhinoscleroma

C. Tuberculosis

D. Glanders

E. Syphilis

149. A patient after trauma has developed paralyses, algesthia impairment on the righf; there are no paralyses on the left but temperature and pain sensivity are also impaired. What is the cause of this?

A. Unilateral right-side spinal cord injuiry

B. Midbrain injuiry

C. Brainstem injuiry

D. Cerebellum injuiry

E. Motor zone brain cortex injuiry

150. Buffer capacity of blood was decreased in the worker due to exhausting muscular work. Entry of what acid substance to the blood can this state be explained by?

A. 3-phosphoglycerate

B. Pyruvate

C. 1,3-bisphosphoglycerate

D. Lactate

E. α-ketoglutarate

151. After trauma a 44-year-old patient had a rupture of left palm muscle tendons and of the surface of blood vessels. After operation and removal of the most part of the necrotically changed muscle tissue the bloodstream was normalized. What vessels helped to restore the bloodstream?

A. Arcus palmaris profundus

B. Aa. perforantes

C. Aa. metacarpeae palmares

D. Arcus palmaris superficialis

E. Aa. digitales palmares communes

152. A patient died with uremia.The autopsy demonstrated kidneys to be enlarged, of flabby consistence, cortex was broad, edematous, with red spots; medulla was dark red in colour. Microscopic examination in the glomeruli capsule cavity revealed "semilunar formations", squeezing capillaries, nephrocytes dystrophy, edema and infiltration of stroma. What disease caused the death of the patient?

A. Renal amyloidosis

B. Pyelonephrosis

C. Nephrolithiasis

D. Nephrotic syndrome

E. Glomerulonephrosis

153. During the postsynthetic period of mitotic cycle the synthesis of proteins - tubulines, which take part in the mitosis formation, was destroyed. It can cause the impairment of:

A. Chromosome despiralization

B. Cytokinesis

C. Duration of mitosis

D. Chromosome separation

E. Chromosome spiralization

154. A 35-year-old woman with chronic renal disease has developed osteoporosis. Deficiency of which from the belowmentioned substances causes such complication?

A. 25OHD3

B. Cholesterol

C. D2

D. D3

E. 1.25(OH)2 D3

155. A 43-year-old man suffers from chronic atrophic gastritis and megaloblastic hyperchromic anemia. He also has methylmalonic aciduria. Insufficiency of what vitamin led to the development of such complex of symptoms?

A. Vitamin В3

B. Vitamin В12

C. Vitamin В2

D. Vitamin В1

E. Vitamin В5

156. On autopsy of the 58-year-old man it is revealed: mitral valve is deformed, thickened, not totally closed. Microscopically: centers of collagen fibers are eosinophilic, have positive fibrin reaction. The most likely it is:

A. Mucoid swelling

B. Fibrinoid inflammation

C. Amyloidosis

D. Hyalinosis

E. Fibrinoid swelling

157. A man in a quiet condition has increased activity of the muscles, responsible for the inspiration. What from the belowmentioned can cause this?

A. Infrequent breathing

B. Superficial breathing

C. Airways narrowing

D. Negative intrapleural pressure

E. Reduction of minute respiratory capacity

158. A child with diphtheria 10 days after injection of antitoxic antidiphtherial serum has developed skin rash, accompanied by severe itch, rising temperature up to 38^0C and joints pain. What is the cause of these symptoms?

A. Delayed type of hypersensitivity

B. Anaphylactic reaction

C. Contact allergy

D. Atopia

E. Serum sickness

159. The autopsy of the dead body revealed enlarged, solid with rounded margins liver, on section the tissue was yellow-brown in colour with dark red spots and stripes, which resembled nutmeg. What pathological process led to such liver changes?

A. Chronic hemorrhage

B. Chronic venous polyemia

C. Acute venous polyemia

D. Arterial polyemia

E. Arterial anemia

160. A 40-year-old man was admitted to the surgical department with spleen rupture. What anatomic formation will accumulate the blood?

A. Bursa pregastrica

B. Right lateral canal

C. Hepatic bursa

D. Rectovesical excavation

E. Omental bursa

161. A child, suffering from pylorostenosis accompanied by frequent vomiting, developed signs of dehydration. What form of acid-base disbalance can develop in this case?

A. Gaseous alkalosis

B. Gaseous acidosis

C. Nongaseous acidosis

D. Nongaseous alkalosis

E. Metabolic acidosis

162. A 33- year-old woman who has been treated for a long time from chronic polyarthritis complains of increased blood pressure, changes in the distribution of the adipose tissue and dysmenorrhea. The usage of what medicine could cause such complaints?

A. Butadion

B. Prednisolone

C. Sinaflan

D. Indometacin

E. Beclometasone

163. A 2-year-old child has got intestinal dysbacteriosis, which results in hemorrhagic syndrome. What is the most likely cause of hemorrhage of this child?

A. Vitamin К insufficiency

B. Hypocalcemia

C. РР hypovitaminosis

D. Fibrinogen deficiency

E. Activation of tissue thromboplastin

164. A woman came to the surgeon because of the solid mass in her mamma. What direction should the surgeon make an incision in during the operation to injure the lobe less?

A. -

B. Arcuate

C. Vertical

D. Radial

E. Transverse

165. Chronic glomerulonephritis was diagnosed in a 34-year-old patient 3 years ago. Edema has developed for the last 6 months. What caused it?

A. Hyperosmolarity of plasma

B. Hyperproduction of vasopressin

C. Proteinuria

D. Disorder the livers protein formation function

E. Hyperaldosteronism
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