Krok 1 Medicine 2004 icon

Krok 1 Medicine 2004

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KROK 1 Medicine 2004

1. The examination of skin biopsy of a patient with hemorrhage vasculitis revealed the next: the vessel wall was thickened, homogenous, stained in yellow colour by means of picrofuchsin, PAS-positive. What pathologic process has developed in the vessels walls?

A. Mucoid swelling

B. Fibrinoid swelling




2. Patients with collagenosis have the destruction of the connective tissue. It is confirmed by increasing in the blood of:

A. Contents of urates

B. Contents of oxyprolin and oxylysin

C. Contents of creatine and creatinine

D. Activity of transaminases

E. Acyivity of isoenzymes of LDH

3. Patients with diabetes mellitus and people during starvation have the increased contents of acetone bodies in their blood, which are used as energy material. What substance are they synthesized from?

A. Ketoglutarate

B. Malate

C. Acetyl-CoA carboxylase

D. Citrate

E. Succinyl-CoA carboxylase

4. The penetration of the irritable cell membrane for potassium ions has been increased experimentally. What changes of membrane electric status can occur?

A. No changes

B. Action potential

C. Depolarization

D. Local response

E. Hyperpolarization

5. An old man had infarction of the right cerebrum hemisphere. One year later, taking into consideration the absence of movements of his left extremities, the patient underwent

computer tomography of the cerebrum, which revealed a smooth-walled cavity, full of liquor. What pathological process is found out in the cerebrum?

A. Brain infarction

B. Gray maceration of the brain

C. Postinfarction cyst

D. Hematoma

E. Hydrocephaly

6. On bacteriological examination of the defecation of a 4-months-old baby with the symptoms of acute bowel infection there were revealed red colonies spread in the large quantity in the Endo medium. What microorganism can it be?

A. Streptococcus

B. Shigell

C. Escherichia

D. Staphylococcus

E. Salmonella

7. In case of enterobiasis acrihine - the structural analogue of vitamin В2 - is administered. The synthesis disorder of which enzymes does this medicine cause in microorganisms?

A. Peptidases

B. Cytochromeoxidases

C. Aminotransferases

D. NAD - dependent dehydrogenases

E. FAD - dependent dehydrogenases

8. A 42-year-old man was administered prymahin in order to prevent the distant results of quartan malaria. 3 days since the beginning of the treatment with therapeutic dosage of this medicine the patient has developed pain in the cardiac and abdominal regions, dyspepsia and general cyanosis. What could cause such side effects?

A. Accumulation of the medication

B. Delay preparation excretion with urine

C. Reduced activity of microsomal liver enzymes

D. Potential activity with other preparations

E. Genetic insufficiency of glucose 6-phosphate dehydrogenase

9. A 6-month-old child is suffocating while lying on his back.The palpation on the anterior wall of trachea up to jugular notch of the sternum revealed tumor-like mass, stretching into the anterior mediastinum. What from the belowmentioned can squeeze trachea?

A. Parathyroid lymph nodes

B. Parathyroid glands

C. Thyroid gland

D. Thymus gland

E. Peritracheal lymph nodes

10. Synthesis of phospholipids is disordered due to fat infiltration of liver. Indicate which of the presented substances can enhance the process of methylation during phospholipids synthesis?

A. Methionine

B. Glucose

C. Ascorbic acid

D. Citrate

E. Glycerin

11. Dystrophic changes of the heart muscle are accompanied with cardiac cavity enlargement, decrease of the strength of heart contraction, increased amount of blood, which remains in the heart during systolic phase, overfilled veins. For what state of heart is it characteristic?

A. Myogenic dilatation

B. Cardiosclerosis

C. Tonogenic dilatation

D. Tamponage of the heart

E. Emergency stage of hyperfunction and hypertrophy

12. In the blood smear, stained according to Romanovsky-Giemsa method, there are 20\% big (20 mcm in diametre), rounded cells with pale-basophilic cytoplasm and bean-shaped nucleus. How is this condition characterised clinically?

A. Neutrophilosis

B. Leukopenia

C. Reticulocytosis

D. Lymphocytosis

E. Monocytosis

13. Person has stable HR, not more than 40 bpm. What is the pacemaker of the heart rhythm in this person?

A. Sinoatrial node

B. Purkinye' fibers

C. Branches of His' bundle

D. Atrioventricular node

E. His' bundle

14. Child asked you to puff up the balloon as much as possible for a one exhalation.What air volume will you use?

A. Functional residual volume

B. Vital volume of the lungs

C. Backup volume of the inspiration

D. Inspiration volume

E. Total volume of the lungs

15. A female patient complaining of indigestion and diffuse abdominal pain came to the doctor. During the examination the doctor found out considerably decreased hemoglobulin level in the blood. During the inquiry it turned out that the woman, living in the Far East, was frequently eating lightly salted caviar. Some relatives, who were living with her, had the same complaints. What was the diagnosis?

A. Echinococcosis

B. Thenyosis

C. Diphyllobothriasis

D. Ascariasis

E. Trichinosis

16. During the staining of sputum smear of a patient with suspected croupous pneumonia the following reactives and stainers were used: gential violet solution, Lugol's solution, 960 spiritus and water fuchsin. What method of staining is used in this case?

A. Leffler's

B. Gram's

C. Ziehl-Neelsen's

D. Neisser's

E. Romanovsky's

17. A patient complaining of weight loss (10 kg during 2 months), pallpitation and exophthalmos came to the endocrinologist. For the hyperfunction of what endocrine gland (glands) are these complaints the most typical?

A. Pancreas

B. Ovaria

C. Parathyroid glands

D. Adrenal glands

E. Thyroid

18. A 56-year-old patient with cardiac failure notices edematous feet and shins, the skin in the place of edema is pale and cold. What is the leading pathogenesis of this patient's edema?

A. Increased hydrostatic pressure in venulaes

B. Reduced oncotic pressure in capillaries

C. Lymph outflow impairment

D. Increased capillary penetration

E. Positive water balance

19. The intraoperative biopsy of mammal gland has revealed the signs of atypical tissue with disorder of parenchyma-stroma proportion with domination of the last, gland structures of different size and shape, lined with single-layer proliferative epithelium. What is the most appropriate diagnosis?

A. Mastitis

B. Papilloma

C. Noninfiltrative cancer

D. Fibroadenoma

E. Infiltrative cancer

20. A 50-year-old man had been blocked up for 2 days because of earthquake. After he was rescued, the diagnosis of compression syndrome was made. What further complication is the most likely to develop in this case?

A. Acute vascular failure

B. Acute cardiac failure

C. Acute renal failure

D. Acute hepatic failure

E. Acute respiratory failure

21. A patient because of pathological process has thickened alveolar membrane. What will be reduced directly as a result this?

A. Oxygen capacity of blood

B. Alveolar lung ventilation

C. Diffuse lung capacity

D. Reserve expiratiory capacity

E. Minute respiratory capacity

22. A doctor made the diagnosis of gonorrhoea. It was known from the anamnesis that a patient had had gonorrhoea before and he had been treated completely. What type of infection can this new disease be attributed to?

A. Superinfection

B. Reinfection

C. Secondary infection

D. Relapse

E. Autoinfection

23. A 58-year-old woman complaints of increased tiredness, decreased capasity for work, somnolence and dyspnea during fast walking. Blood test revealed: erythrocytes - 4,6*1012/l, hemoglobin - 92 g/l, colour index - 0,6. Blood smear demonstrated high contents of microcytes and anulocytes. What anemia is it typical for?

A. Acute posthemorrhagic

B. Hemolytic

C. Iron deficiency

D. Penicious

E. Sickle cell

24. A patient, who had been blowing a cloud (smoking tobacco) for a long time developed lung cancer. Which of the suggested cancerogenic substances is contained in the tobacco smoke and is attributed to the polyunsaturated aromatic carbohydrates (PAC)?

A. ?- naphthylamine

B. Orthoaminoazotoluene

C. Benzpyrene

D. Dimethylaminoazobenzene

E. Diethylnitrosamine

25. Patient with vomiting, dizziness, sensation of dubble vision, difficult swallowing was admitted to the hospital. Doctor suspects botulism. What diagnostic methods should be used for diagnosis approving?

A. Bacteriological, mycological

B. Biological test, bacteriological

C. Allergic test, serological

D. -

E. Protozoological, microscopical

26. A patient after hypertension stroke has no voluntary movements in his right arm and leg, muscle tone in these extremites is increased. What type of dysfunction of nervous system is it?

A. Central paresis

B. Central paralysis

C. Peripheral paresis

D. Reflex paresis

E. Peripheral paralysis

27. The person was selling "homemade pork" sausages on the market. State sanitary inspector suspected falcification of the sausages.With help of what serological immune reaction can food substance be identified?

A. Agglutination test

B. Immunofluorescence test

C. Complement- fixation test

D. Indirect hemagglutination test

E. Precipitation test

28. The autopsy of the man's body, that was working for a long time as a miner and died beacuse of chronic pulmonary-cardiac insufficiency, revealed that lungs were not in their ful volume, significantly thickened, sclerotic, the apexis were emphysematously changed, the surface was gray-black in colour, on section the lung tissue was aspid-black in colour. What disease caused the death?

A. Asbestosis

B. Anthracosis

C. Aluminosis

D. Silicosis

E. Talcosis

29. In the microspecimen of red bone marrow there were revealed multiple capillares through the walls of which mature blood cells penetrated. What type of capillares is it?

A. Fenestrational

B. Visceral

C. Lymphatic

D. Sinusoidal

E. Somatical

30. The alternate usage of dichlotiazide, etacrin acid and lasex didn't cause substantial diuretic effect in patient with evident peripheral edema. There is increased amount of aldosterone in the blood. Indicate the medicine to be prescribed.

A. Urea

B. Clopamid

C. Mannit

D. Amilorid

E. Spironolacton

31. Unpainfull formation without marked borders appeared in the soft tissues of the thigh left of the young man. On the tissue bioptate the formation lookes like a meat of a fish, consisting of the immature fibroblast-like cells with multiple mitosis, which grow through the muscles. What is the most likely diagnosis?

A. Fibrosarcoma

B. Fibroma

C. Cancer

D. Myosarcoma

E. Myoma

32. The auscultation of a patient with dry pleuritis has revealed plueral friction rub. What epithelium type can cause such signs?

A. Simple cubical epithelium

B. Simple flat epithelium

C. Transitional epithelium

D. Simple prismatic epithelium

E. Laminated epithelium

33. The autopsy a 35-year-old man body revealed in the second segment of the right lung the focus of carnification, which was 5 cm in diametre and was enclosed in a thin capsule. The focus was a tough dry friable tissue with a dim surface. What disease are such morphological changes typical for?

A. Chondroma

B. Tumorous form of silicosis

C. Lung cancer

D. Postinflammatory pneumosclerosis

E. Tuberculoma

34. During metabolic process active forms of the oxygen including superoxide anion radical are formed in the human body. With help of what enzyme is this anion activated?

A. Peroxidase

B. Superoxide dismutase

C. Catalase

D. Glutathioneperoxidase

E. Glutathionereductase

35. A patient has myocardial infarction in the region ofanterior wall of the left ventricle. What artery basin has the circulatory impairment occured in?

A. Atrioventricular branch of left coronal artery

B. Circumflex branch of left coronal artery

C. Left marginal branch of left coronal artery

D. Anterior interventricular branch of left coronal artery

E. Anterior ventricular branches of right coronal artery

36. A patient underwent the surgical removal of pathologically disordered distal quarter of small intestine. How will it influense the absorption of nutritional substances in case of patient's ordinary diet?

A. Carbohydrates absorption will be reduced

B. Proteins absorption will be reduced

C. Water absorption will be reduced

D. Lipids absorption will be reduced

E. Absorption will not be altereded

37. The study of mitotic cycle phases of onion root revealed the cell, in which the chromosomes are situated in the equatorial plane, forming a star. What stage of the cell mitosis is it?

A. Prophase

B. Anaphase

C. Telophase

D. Interphase

E. Metaphase

38. A patient with paroxysmal attacks of asphyxia, which appear after inhalation of different aromatic substances has been made a diagnosis of bronchial asthma. Ig E rate is elevated. What type of reaction is it the most typical for?

A. Anaphylactic

B. Delayed type of hypersensitivity

C. Autoimmune

D. Cytotoxic

E. Immunocomplex

39. Substitution of the glutamic acid on valine was revealed while examining initial molecular structure. For what inherited pathology is this typical?

A. Hemoglobinosis

B. Minkowsky-Shauffard disease

C. Sickle-cell anemia

D. Thalassemia

E. Favism

40. A patient was admitted to the hospital with a wound in the region of his neck. The examination revealed the damaged nerve, situated in front of the anterior ladder muscle. What nerve is damaged?

A. Vagus

B. Phrenic

C. Cervical part of sympathetic trunk

D. Sublingual

E. Glossopharyngeal

41. A patient during a visit to his dentist developed severe hypotension. Which of the medicines, stimulating adrenergic structures, should be used to normalise blood pressure?

A. Sanorin

B. Doxazozin

C. Xylomethazolin hydrochloride

D. Ergotamine

E. Mesaton

42. A student is thoroughly summarising a lecture. When his groupmates began talking the quality of the summarising worsened greatly. What type of the inhibition in the cerebral cortex is the cause of this?

A. Protective

B. External

C. Dying

D. Differential

E. Delayed

43. Galactosemia is revealed in a child. Concentration of glucose in the blood is not considerably changed. Deficiency of what enzyme caused this illness?

A. Hexokinase

B. Phosphoglucomutase

C. Galactokinase

D. Amylo-1,6-glucosidase

E. Galactose-1-phosphate uridyltransferase

44. Careless student occasionaly met his dean. The concentration of what hormone will most likely increase in the blood of the student?

A. Thyrotropin-releasing hormone

B. Cortisol

C. Somatotropin

D. Corticotropin

E. Adrenalin

45. Analeptical remedy of reflective type from the H-cholinomimetics group was given to the patient for restoration of breathing after poisoning with carbon monoxide. What medicine was prescribed to the patient?

A. Adrenalin hydrochloride

B. Mesaton

C. Lobeline hydrochloride

D. Pentamin

E. Atropine sulphate

46. Some time later after the intensive physical training a sportman activates his gluconeogenesis. What is its main substance?

A. Lactate

B. Glutamic acid

C. Serine

D. ?-ketoglutarate

E. Aspartic acid

47. Because of suspected intrahospital infection in the neonatal department of the maternity home the inspection was carried out. In some children and on some general things Staphylococcus aureus was revealed. What properties of these cultures allow to establish their origin from one source?

A. Antibioticogramma

B. Antigenic structure

C. Biochemical activity

D. Phagotype

E. Chromogenesis

48. The patient with complaints of permanent thirst applied to the doctor. Hyperglycemia, polyuria and increased concentration of 17-ketosteroids in the urine were revealed. What disease is the most likely?

A. Steroid diabetes

B. Type 1 glycogenosis

C. Myxoedema

D. Addison's disease

E. Insulin-dependent diabetes mellitus

49. A 40-year-old pregnant woman underwent amniocentesis. The examination of fetus karyotype revealed 47ХУ+21. What pathology of the fetus was found out?

A. Schereschevsky-Terner's disease

B. Patau's disease

C. Phenylketonuria

D. Down's syndrome

E. Klinefelter's syndrome

50. In the micropreparation made from patient's regional lymph node punctate and stained according to Romanovsky-Giemsa method, the doctor found out thin microorganisms with 12-14 equal ringlets and pale-pink sharp pointes 10-13 mkm in length. The pathogen of what disease is it about?

A. Leishmaniasis

B. Leptospirosis

C. Surra

D. Syphilis

E. Relapsing fever

51. A 50- year-old man suddenly began having severe palpitation, pain in the heart, sharp weakness, high blood pressure; arrhythmic pulse, with deficiency. The ECG revealed no P waves and there was different duration of R-R intervals. What disorder of heart rhythm did the patient have?

A. Paroxysmal tachicardia

B. Sinus extrasystolia

C. Atrial fibrillation

D. Transversal heart block

E. Respiratory arrhythmia

52. The heart rate and the systemic arterial blood pressure of a man have increased due to voluntary respiratory delay for 40 c. Realisation of what regulation mechanism caused these changes?

A. Conditioned sympathetic reflexes

B. Unconditioned sympathetic reflexes

C. -

D. Conditioned parasympathetic reflexes

E. Unconditioned parasympathetic reflexes

53. A patient with diabetes mellitus suddenly began having sharp pain in his right foot. The examination revealed black hallux, swallen foot tissues, focuses of epidermis detachment, secreta with unpleasant smell. What clinico-morphological form of necrosis developed in a patient?

A. Sequester

B. Bedsore

C. Dry gangrene

D. Infarction

E. Moist gangrene

54. A patient who had been suffering for many years from bronchial asthma died from asphyxia. The histological examination of his lungs revealed the following: much mucus with eosinophiles contents in the lumen of bronchioles and small bronci, sclerosis of interalveolar septa, dilation of alveolar lumen. Which of the mechanisms of allergy development is it?

A. Immunocomplex

B. Cytolysis, caused by lymphocytes

C. Cytotoxic

D. Reagin

E. Granulomatosis
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Krok 1 Medicine 2004 iconKrok 1 Medicine 2004
В2 is administered. The synthesis disorder of which enzymes does this medicine cause in microorganisms?
Krok 1 Medicine 2004 iconKrok 1 Medicine 2004
В2 is administered. The synthesis disorder of which enzymes does this medicine cause in microorganisms?
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