Krok Medicine-2011 icon

Krok Medicine-2011

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Krok 1. Medicine-2011

1 A 2-year-old child with mental and physical retardation has been delivered to a hospital. He presents with frequent vomiting after having meals. There is phenylpyruvic acid in urine. Which metabolism abnormality is the reason for this pathology?

A. Phosphoric calcium metabolism

B. Water-salt metabolism

C. Amino-acid metabolism

D. Carbohydrate metabolism

E. Lipidic metabolism

2 When measuring power inputs of a man by the method of indirect calorimetry the following results were obtained: 1000 ml oxygen consumption and 800 ml carbon dioxide liberation per minute. The man under examination has the following respiratory coefficient:

A. 1,0

B. 0,9

C. 0,8

D. 1,25

E. 0,84

3 Microscopical examination of an enlarged cervical lymph node revealed blurring of its structure, absence of lymphoid follicles; all the microscopic fields showed cells with roundish nuclei and thin limbus of basophil cytoplasm. It is known from the clinical data that other groups of lymph nodes are also enlarged as well as spleen and liver. What disease might be suspected?

^ A. Myeloid leukosis

B. Multiple myeloma

C. Lymphosarcoma

D. Lymphoid leukosis

E. Lymphogranulomatosis

4 A student failed to answer all the questions of examination paper correctly. As a result he blushed, felt hot and lost confidence. What type of arterial hyperemia has developed in this case?

^ A. Postishemic hyperemia

B. Neurotonic hyperemia

C. Pathologic hyperemia

D. Metabolic hyperemia

E. Neuroparalytic hyperemia

5 Heart rate of a 30-year-old man under emotional stress reached 112 bpm. The reason for the heart rate increase is the altered condition of the following conducting system of heart:

^ A. Purkinje's fibers

B. Sinoatrial node

C. His' bundle branches

D. Atrioventricular node

E. His' bundle

6 During examination of a 6-year-old child a doctor revealed greyish films on the pharyngeal tonsils. Their removal provoked moderate haemorrhage. Bacterioscopy revealed gram-positive clublike bacteria. What symptoms will develop in this child within the next few days if no specific treatment is provided?

^ A. Strong paroxysmal cough

B. Intermittent fever

C. Pulmonary edema

D. Papulous skinrash

E. Toxic lesions of myocard, liver and kidney

7 A patient with coronary disease and arrhythmia has been administered a drug that blocks potassium channels and prolongs the action potential. What drug is it?

A. Amiodarone

B. Corglyconum

C. Dobutamine

D. Nitroglycerin

E. Lisinopril

8 A 45-year-old patient was admitted to the cardiological department. ECG data: negative P wave overlaps QRS complex, diastolic interval is prolonged after extrasystole. What type of extrasystole is it?

A. Sinus

B. Ventricular

C. Atrioventricular

D. Atrial

E. Bundle-branch

9 A patient consulted a doctor about a sensation of imbalance which appeared after a trauma. Which nerve is damaged?

A. Facial nerve

B. Vagus nerve

C. Intermediate nerve

D. Vestibulocochlear nerve

E. Trigeminal nerve

10 A 25-year-old man has spent a long time in the sun under high air humidity. As a result of it his body temperature rose up to 39oC. What pathological process is it?

A. Hyperthermia

B. Burn disease

C. Hypothermia

D. Infectious fever

E. Noninfectious fever

11 After an immunoassay a child was diagnosed with immunodeficiency of humoral immunity. What is the reason for the primary immunodeficiency development in the child?

^ A. Toxic damage of B-lymphocytes

B. Hereditary abnormality of immune system

C. Pathometabolism in mother's organism

D. Embryonal development abnormalities

E. Immune responsiveness and resistance disorders

12 A patient takes digoxin for cardiac insufficiency. What diuretic may increase digoxin toxicity due to the intensified excretion of K+ ions?

A. Siliborum

B. Panangine

C. Hydrochlorothiazide

D. Spironolactone

E. Lisinopril

13 Before a surgery a blood sample of a 30-year-old man has been typed. Blood is Rh-positive. Standard serums of such groups as 0 (I), А (II), В (III) didn’t activate erythrocyte agglutination reaction. The group of the analyzed blood is:

A. А (II)

B. 0 (I)

C. -

D. В (III)

E. АВ (IV)

14 12 hours after an accute attack of retrosternal pain a patient presented a jump of aspartate aminotransferase activity in blood serum. What pathology is this deviation typical for?

^ A. Myocardium infarction

B. Diabetes insipidus

C. Collagenosis

D. Diabetes mellitus

E. Viral hepatitis

15 A male patient has fever and enanthesis. As a result of the examination involving serological tests he has been diagnosed with fasciola hepatica. It was found out that the patient had been infected through raw river water. Which stage of fasciola life cycle is invasive for humans?

A. Miracidium

B. Ovum

C. Cysticercus

D. Adolescaria

E. Metacercaria

16 A male patient has been diagnosed with gastric ulcer. Bacteriological examination of biopsy material from the affected part of stomach revealed small colonies of gram-negative, oxide reductase-positive flexibacteria that grew on the chocolate agar on the fifth day. Which of the following microorganisms is the most likely causative agent?

^ A. Campilobacter fetus

B. Chlamydia trachomatis

C. Campilobacter jejuni

D. Mycoplasma hominis

E. Helicobacter pylori

17 An infant has pylorospasm, weakness, hypodynamia, convulsions as a result of frequent vomiting. What kind of acid-base disbalance is it?

^ A. Excretory acidosis

B. Metabolic acidosis

C. Excretory alkalosis

D. Gaseous alkalosis

E. Exogenous nongaseous acidosis

18 Proserin increases skeletal muscle tone when given systematically. Halothane induces relaxation of skeletal muscles and reduces proserin effects. What is the nature of proserin and halothane interaction?

^ A. Competitive antagonism

B. Independent antagonism

C. Noncompetitive antagonism

D. Indirect functional antagonism

E. Direct functional antagonism

19 Blood analysis of a patient with jaundice reveals conjugated bilirubinemia, increased concentration of bile acids. There is no stercobilinogen in urine. What type of jaundice is it?

^ A. Hepatocellular jaundice

B. Parenchymatous jaundice

C. Cythemolytic jaundice

D. Hemolytic jaundice

E. Obstructive jaundice

20 A man is being measured power inputs on an empty stomach, in the lying position, under conditions of physical and psychic rest at a comfortable temperature. Power inputs will reach the maximum at:

A. 7-8 a.m.

B. 10-12 a.m.

C. 3-4 a.m.

D. 5-6 p.m.

E. 2-3 p.m.

21 A woman suffering from osteochondrosis has acute pain in her humeral articulation that gets worse when she tries to abduct her shoulder. These symptoms might be caused by damage of the following nerve:

^ A. Subclavicular nerve

B. Axillary nerve

C. Subscapular nerve

D. Thoracodorsal nerve

E. Dorsal scapular nerve

22 A 26-year-old man is in the torpid shock phase as a result of a car accident. In blood: 3,2*109/l. What is the leading mechanism of leukopenia development?

^ A. Redistribution of leukocytes in bloodstream

B. Disturbed going out of mature leukocytes from the marrow into the blood

C. Leikopoiesis inhibition

D. Lysis of leukocytes in the blood-forming organs

E. Intensified elimination of leukocytes from the organism

23 ECG of a 44-year-old patient shows signs of hypertrophy of both ventricles and the right atrium. The patient was diagnosed with the tricuspid valve insufficiency. What pathogenetic variant of cardiac dysfunction is usually observed in case of such insufficiency?

^ A. Heart overload by volume

B. Coronary insufficiency

C. Heart overload by resistance

D. Primary myocardial insufficiency

E. Cardiac tamponade

24 A man with a wound of his limb that had been suppurating for a long time died from intoxication. Autopsy revealed extreme emaciation, dehydration, brown atrophy of liver, myocardium, spleen and cross-striated muscles as well as renal amyloidosis. What diagnosis corresponds with the described presentations?

A. Septicemia

B. Septicopyemia

C. Chernogubov's syndrome

D. Brucellosis

E. Chroniosepsis

25 Examination of a 70-year-old patient revealed insulin-dependent diabetes. What drug should be administered?

A. Glibenclamid

B. Mercazolilum

C. Cortisone

D. Insulin

E. Parathyroidin

26 A 30-year-old male patient with acute pancreatitis has been found to have a disorder of cavitary protein digestion. The reason for such condition can be the hyposynthesis and hyposecretion of the following enzyme:

A. Pepsin

B. Dipeptidase

C. Amylase

D. Lipase

E. Tripsin

27 A female patient consulted a doctor about a sense of epigastric discomfort, nausea and anorexia. A duodenal content analysis revealed lamblia. What drug should be prescribed?

A. Acyclovir

B. Rifampicin

C. Metronidazole

D. Isoniazid

E. Chingamin

28 A patient consulted a doctor about loss of taste sensitivity on the tongue root. The doctor revealed that it is caused by nerve affection. Which nerve is it?

^ A. Trigeminal nerve

B. Glossopharyngeal

C. Vagus nerve

D. Facial nerve

E. Superlaryngeal nerve

29 A 38-year-old patient came to a traumatology centre and complained about an injury of his right hand. Objectively: the patient has a cut wound in the region of the thenar eminence on the right hand; distal phalanx of the I finger cannot be flexed. What muscle was injured?

^ A. Abductor muscle of thumb

B. Opposer muscle of thumb

C. Long flexor muscle of thumb

D. Short abductor muscle of thumb

E. Short flexor muscle of thumb

30 Blood count of an athlete is as follows: erythrocytes - 5,5*1012/l, Hb- 180 g/l, leukocytes – 7*109/l, neutrophils - 64%, basophils - 0,5%, eosinophils - 0,5%, monocytes - 8%, lymphocytes - 27%. First of all, such results indicate the stimulation of:

A. Leukopoiesis

B. Lymphopoiesis

C. Immunogenesis

D. Erythropoiesis

E. Granulocytopoiesis

31 An older woman has been hospitalised for acute pain and edema of the right hip joint that appered after a fall. Objectively: the hip is adduced inwards, hip joint movements are impaired. The patient is most likely to have a fracture of the following bone or bone part:

A. Shaft of femur

B. Femoral neck

C. Pubic bone

D. Ischial bone

E. Condyle of femur

32 A 1-year-old baby has been hospitalised for body and limbs lesions. Examination revealed carnitine deficiency in the child's muscles. A biochemical reason for this pathology is the disorder of:

^ A. Substrate-linked phosphorylation

B. Transport of fatty acids to mitochondria

C. Utilization of lactic acid

D. Oxidative phosphorylation

E. Regulation of Ca2+ rate in mitochondria

33 During anesthetization a patient presented with symptoms of tonus increase of parasympathetic nervous system such as hypersalivation and laryngospasm. What drug could have prevented these undesirable effects?

A. Pyracetam

B. Neostigmine

C. Atropine sulphate

D. Adrenaline hydrochloride

E. Analgin

34 After inoculation of the material obtained from the pharynx of an angina patient onto the blood-tellurite agar, grey colonies could be observed. They were 4-5 mm in diameter, radially striated (in form of rosettes). Microscopical examination revealed gram-positive bacilli with clavate swollen ends arranged in form of wide-spread fingers. Identify these microorganisms:

^ A. Clostridium botulinum

B. Streptococci

C. Diphtheroids

D. Diphtheria corynebacteria

E. Streptobacilli

35 A 19-year-old female patient has had low haemoglobin rate of 90-95 g/l since childhood. Blood count results obtained after hospitalisation are as follows: erythrocytes - 3,2*1012/l, Hb- 85 g/l, colour index - 0,78; leukocytes - 5,6*109/l, platelets – 210*109/l. Smear examination revealed anisocytosis, poikilocytosis and target cells. Reticulocyte rate is 6%. Iron therapy was ineffective. What blood pathology corresponds with the described clinical presentations?

A. Membranopathy

B. Favism

C. Sickle-cell anemia

D. Enzymopathy

E. Thalassemia

36 Autopsy of a man with a malignant stomach tumour who had died from cancer intoxication revealed in the posteroinferior lung fields some dense, grayish-red irregular foci protruding above the section surface. Microscopic examination revealed exudate containing a large amount of neutrophils in the lumen and walls of small bronchi and alveoles. Such pulmonary alterations indicate the following disease:

^ A. Acute serous bronchopneumonia

B. Acute purulent bronchopneumonia

C. Croupous pneumonia

D. Intermittent pneumonia

E. Acute bronchitis

37 It was revealed that T-lymphocytes were affected by HIV. Virus enzyme - reverse transcriptase (RNA-dependent DNA-polymerase) - catalyzes the synthesis of:

^ A. DNA on the matrix of virus mRNA

B. Virus informational RNA on the matrix of DNA

C. DNA on virus ribosomal RNA

D. Viral DNA on DNA matrix

E. mRNA on the matrix of virus protein

38 An injured person was delivered to the hospital with a penetrating wound in the left lateral region of abdomen. What part of the large intestine is most likely damaged?

^ A. Colon transverses

B. Rectum

C. Caecum

D. Colon ascendens

E. Colon descendens

39 A surgeon has to find the common hepatic duct during the operative intervention on account of concrements in the gall ducts. The common hepatic duct is located between the leaves of:

^ A. Hepatorenal ligament

B. Venous ligament

C. Hepatogastric ligament

D. Hepatoduodenal ligament

E. Round ligament of liver

40 In order to determine toxigenicity of diphtheria bacilli a strip of filter paper impregnated with antitoxic diphtherial serum was put on the dense nutrient medium. There were also inoculated a microbal culture under examination and a strain that is known to be toxigenic. If the microbal culture under examination produces exotoxin, this wil result in formation of:

^ A. Zones of lecithovitellinous activity

B. Haemolysis zones

C. Zones of diffuse opacification

D. Precipitin ring

E. Precipitin lines

41 Pyeloureterography X-ray photo showed a renal pelvis with minor calyces only (major calyces were absent). What form of urinary tracts of a kidney was revealed?

A. Embryonal

B. -

C. Ampullar

D. Fetal

E. Mature

42 A 35-year-old man developed acute heart failure while running for a long time. What changes in ionic composition can be observed in the cardiac muscle?

^ A. Accumulation of Na+ and Ca2+ ions in the myocardium cells

B. Reduction of Na+ and Ca2+ ions in the myocardium cells

C. Reduction of K+ and Mg2+ ions in the extracellular space

D. Accumulation of K+ and Mg2+ ions in the myocardium cells

^ E. Reduction of Na+ and Ca2+ ions in the extracellular space

43 A patient has corestenoma. What is the reason of such condition?

A. Noradrenaline action

B. Increased tonus of parasympathetic centres

^ C. Increased activity of sympathoadrenal system

D. Increased tonus of sympathetic centres

E. Adrenaline action

44 A patient is 44 years old. Laboratory examination of his blood revealed that content of proteins in plasma was 40 g/l. What influence will be exerted on the transcapillary water metabolism?

^ A. Metabolism will stay unchanged

B. Filtration will be increased, reabsorption - decreased

C. Both filtration and reabsorption will be increased

D. Filtration will be decreased, reabsorption - increased

E. Both filtration and reabsorption will be decreased

45 Ultramicroscopical examination of "dark" hepatocyte population in the cell cytoplasm detected a developed granular endoplasmic reticulum. What function has this organella in these cells?

^ A. Carbohydrate synthesis

B. Calcium ion depositing

C. Deintoxicative function

D. Synthesis of blood plasma proteins

E. Bile production

46 A sensitive neural ganglion consists of roundish neurocytes with one extension that divides into axon and dendrite at a some distance from the perikaryon. What are these cells called?

A. Multipolar

B. Pseudounipolar

C. Bipolar

D. Unipolar

E. Apolar

47 A 55-year-old male patient was hospitalised to a surgical clinic for suspected septicemia. What material should be taken for analysis?

^ A. Liquor, serum agar

B. Blood, sugar broth

C. Lymph node punctate, cysteine agar

D. Urine, beef-extract broth

E. Pus, yolk saline agar

48 This drug has a destructive effect on erythrocytic forms of malarial plasmodia and dysenteric amoebae. It is used for treatment and prevention of such diseases as malaria, amebiasis and interstitial disease. What drug is it?

A. Quinine

B. Erythromycin

C. Tetracycline

D. Emetine hydrochloride

E. Chingamin

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Krok Medicine-2011 iconKrok Medicine-2011

Krok Medicine-2011 iconKrok 1 Medicine 2004
В2 is administered. The synthesis disorder of which enzymes does this medicine cause in microorganisms?
Krok Medicine-2011 iconKrok 1 Medicine 2004
В2 is administered. The synthesis disorder of which enzymes does this medicine cause in microorganisms?
Krok Medicine-2011 iconKrok 1 Medicine 2004
В2 is administered. The synthesis disorder of which enzymes does this medicine cause in microorganisms?
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