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causes hypoxia that activates fibroblasts was admitted to the neurological in-
function. Volume of what elements is patient department. There was revealed
increased in this case? a correlation between increasing of
encephalopathy and substances absorbed
A. Intercellular substance by the bloodstream from the intestines.
B. Vessels of microcircular stream What substances that are formed in the
C. Nerve elements intestines can cause endotoxemia?
D. Parenchymatous elements of an organ
E. Lymphatic vessels A. Indole
B. Butyrate
11. RNA-polymerase B(II) is blocked due C. Acetacetate
to amanitine poisoning (poison of death- D. Biotin
cup). It disturbs: E. Ornithine
A. Synthesis of m-RNA 16. A 50-year-old man has felt vague
B. Synthesis of t-RNA abdominal discomfort within past 4
C. Reverse transcription months. Physical examination revealed
D. Primers synthesis no lymphadenopathy, and no abdomi-
E. Maturation of m-RNA nal masses or organomegaly at palpation.
Bowel sounds are heard. An abdominal
12. Secretion of what gastrointestinal CT scan shows a 20 cm retroperitoneal
hormones will be primarily decreased as a soft tissue mass obscuring the left psoas
result of iduodenum removal? muscle. A stool specimen tested for occult
blood is negative. Which of the following
A. Cholecystokinin and secretin neoplasms is this man most likely to have?
B. Gastrin
C. Histamine A. Lipoma
D. Gastrin and histamine B. Melanoma
E. Neurotensin C. Hamartoma
D. Adenocarcinoma
13. It is planned to use the territory of E. Lymphoma
an old cattle burial ground (which is
not used for more than 50 years) for 17. A patient has undergone an amputati-
building houses. But ground analysis on of lower extremity. Some time later
revealed presence of the pathogen of a painful nodules appeared in a stump.
very dangerous illness. Which of the indi- Amputatious neuromas were found out
cated microorgonisms is likely to remain at the microscopic examination. To what
in the ground for such a long time? pathological processes do those formati-
ons relate?
A. Bacillus anthracis
B. Francisella tularensis A. Regeneration
C. Brucella abortus B. Dystrophy
D. Yersinia pestis C. Inflammation
E. Mycobacterium bovis D. Hyperemia
E. Metaplasia
14. From the nasopharynx of a 5-
year-old child it was excreted a mi- 18. During the fetal period of the
croorganism which is identical to development in the vascular system of
Corynebacterium diphtheriae dose the fetus a large arterial (Botallo’s)
according to morphological and bi- duct is functioning which converts into
ochemical signs. But this microorganism lig.arteriosum after birth. What anatomi-
does not produce exotoxin. As a result cal formations does this duct connect?
of what process can this microorganism
become toxigenic? A. Pulmonary trunk and aorta
B. Right and left auricles
A. Phage conversion C. Aorta and inferior vena cava
B. Cultivation in the telluric environment D. Pulmonary trunk and superior vena
C. Passing through the organism of the cava
sensative animals E. Aorta and superior vena cava
D. Growing with antitoxic serum
E. Chromosome mutation 19. A 22-year-old patient was admitted
to the hospital with complaints of heavy
15. A patient with encephalopathy nasal breathing. During the examination
Krok 1 Medicine 2006 3
22. A 45-year-old woman suffers from 27. The alternate usage of dichlotiazide,
seasonal allergic rhinitis caused by the etacrin acid and lasex did not influence
ambrosia blossoming. What medicine diuretically upon the patient with marked
from the stabilizer of the adipose cells peripheral edemata. The aldosterone rate
group can be used for prevention of this in the blood is increased. Indicate which
disease? medicine should be prescribed:
A. Ketotifen A. Spironolacton
B. Diazoline B. Mannit
C. Phencarol C. Clopamid
D. Tavegyl D. Urea
E. Dimedrol E. Amilorid
23. A young man felt acute pain in the 28. A 46-year-old man complains of di-
back during active drawing up on the hori- fficulties with nasal breathing. Mikulicz’s
zontal bar. Objectively: pain while movi- cells, accumulation of epithelioid cells,
ng upper extremity, reduced pronation plasmocytes, lymphocytes, hyaline balls
and adduction functions. Sprain of what were discovered in the biopsy material of
muscle can be observed here? the thickened nasal mucosa. What is the
most likely diagnosis?
Krok 1 Medicine 2006 4
32. A 38-year-old woman was admitted to 37. In the blood of a 26-year-old man
the admission-diagnostic department with 18% of erythrocytes of the spherical, ball-
uterine bleeding. What are the most likely shaped, flat and spinous shape have been
changes of blood? revealed. Other eritrocytes were in form
of the concavo-concave disks. How is this
phenomenon called?
Krok 1 Medicine 2006 5
51. A sick man with high temperature and 56. The preventive radioprotector was
a lot of tiny wounds on the body has been given to a worker of a nuclear power
admitted to the hospital. Lice have been station. What mechanism from the below
found in the folds of his clothing. What mentioned is considered to be the main
disease can be suspected? mechanism of radioprotection?
52. A patient with suspicion on epidemic 57. The pulmonalis embolism has
typhus was admitted to the hospital. Some suddenly developed in a 40-year-old pati-
arachnids and insects have been found in ent with opened fracture of the hip.
his flat. Which of them may be a carrier of Choose the possible kind of embolism:
the pathogen of epidemic typhus?
Krok 1 Medicine 2006 7
spores, air bubbles and fat drops were di- 90. A person has reduced di-
scovered on microscopy of the patient’s uresis, hypernatremia, hypokalemia.
hair excluded from the infected areas. Hypersecretion of what hormone can
What fungus disease is characterised by cause such changes?
this microscopic picture?
A. Aldosterone
A. Favus B. Vasopressin
B. Microspory C. Auricular sodiumuretic factor
C. Trichophytosis D. Adrenalin
D. Epidermophytosis E. Parathormone
E. Sporotrichosis
91. Microspecimen of red bone marrow
86. On autopsy of the 58-year-old man it contains multiple capillares through
was revealed: mitral valve is deformed, the walls of which mature blood cells
thickened, not totally closed. Microscopi- penetrate into the bloodstream. What
cally: foci of collagen fibers are eosinophi- type of capillares are these?
lic, have positive fibrin reaction. The most
likely it is: A. Sinusoidal
B. Fenestrational
A. Fibrinoid swelling C. Somatical
B. Fibrinoid inflammation D. Visceral
C. Mucoid swelling E. Lymphatic
D. Hyalinosis
E. Amyloidosis 92. A 57-year-old patient was admitted
to the gastroenterological department wi-
87. Hypertrychosis of auricles is caused by th suspicion of Zollinger-Ellison syndrom
a gene that is localized in Y-chromosome. because of rapid increase of gastrin level
Father has this feature. What is the in the blood serum. What is the most
probability to give birth to a boy with such probable disorder of the secretory functi-
anomaly? on of stomach?
A. 100% A. Hyperacidic hypersecretion
B. 0% B. Hyperacidic hyposecretion
C. 25% C. Achylia
D. 35% D. Hypoacidic hyposecretion
E. 75% E. Hypoacidic hypersecretion
88. A 54-year-old man was admitted to the 93. For a long time a 49-year-old woman
hospital with complaints of pain in the ri- had suffered from glomerulonephritis
ght subcostal region, vomiting with blood. which caused death. The autopsy revealed
Objectively: enlarged liver, varicose veins that the size of her kidneys was 7 х
in the stomach and esophagus. Disfuncti- 3 х 2,5 cm, weight 65,0 g, they were
on of what vessel is likely to have taken dense and small-grained. Microscopically:
place? fibrinogenous inflammation of serous
and mucous membranes, dystrophic
A. V ena porta changes of parenchymatous organs, brain
B. Aorta abdominalis edema. What complication can cause such
C. V ena hepatica changes of serous membranes and inner
D. V ena cava superior organs?
E. V ena cava inf erior
A. Uraemia
89. A 37-year-old man was admitted B. Anemia
to the surgical department with the C. Sepsis
symptoms of acute pancreatitis: vomiti- D. DIC-syndrome
ng, diarrhea, bradycardia, hypotention, E. Thrombopenia
weakness, dehydration of the organism.
What medicine should be used first of all? 94. Upper neck node of sympathetic
trunk was removed from the rabbit on
A. Contrycal experiment. Reddening and increased
B. No-spa temperature of the skin of head is
C. Platyphylline observed. What disorder of peripheral ci-
D. Etaperazine rculation of the blood has developed?
E. Ephedrine
Krok 1 Medicine 2006 11
98. An isolated muscle of a frog 103. Autopsy of a man who died from
is rhythmically irritated with electric chronic cardiacvascular collapse revealed
impulses. Every next impulse is in a period "tiger heart". Sidewards of endocardium
of relaxation from the previus contraction. a yellowish-white banding can be seen;
What contraction of the muscle occurs? myocardium is dull, dark-yellow. What
process caused this pathology?
A. Waved tetanus
B. Single A. Fatty parenchymatous degeneration
C. Asynchronous B. Carbohydrate degeneration
D. Continuous (smooth) tetanus C. Hyaline degeneration
E. Tonic D. Fatty vascular-stromal degeneration
E. Amyloidosis
99. A 16-year-old boy was performed an
appendectomy. He has been hospitalized 104. Parents with an ill child consulted
for right lower quadrant abdominal pain an infectionist. They had been working in
within 18 hours. The surgical specimen is one of Asian countries for a long time.
edematous and erythematous. Infiltration The child has sallow skin, loss of appeti-
by what of the following cells is the most te, laxity, enlarged liver, spleen, peripheral
typical for the process occuring here? lymph nodes. What protozoal illness can
be suspected?
Krok 1 Medicine 2006 12
gout has increased level of urinary acid with acute attack of chronic tonsillitis.
in blood. Allopurinol was prescribed What action of glucocorticoids caused this
to decrease the level of urinary acid. complication?
Competitive inhibitor of what enzyme is
allopurinol? A. Immunosuppressive
B. Anti-inflammatory
A. Xanthine oxidase C. Antishock
B. Adenosine deaminase D. Antiallergic
C. Adenine phosphoribosiltransferase E. Antitoxic
D. Hypoxanthine phosphoribosi-
ltransferase 129. Autopsy of a 12-year-old gi-
E. Guanine deaminase rl revealed: multiple cutaneous
hemmorhages (mostly into the skin of
124. A child has inhaled a button. Where buttocks, lower extremities), serous and
is it likely to be? mucous memrane hemmorhages, cerebral
hemmorhages. Adrenal glands show focal
A. In the right main bronchus necrosis and massive hemmorhages; ki-
B. In the left main bronchus dneys show necrotic nephrosis, suppurati-
C. In the trachea ve arthritis, iridocyclitis, vasculitis. What
D. In the larynx is the most probable diagnosis?
E. In the esophagus
A. Meningococcemia
125. A patient with serious damage of B. Epidemic typhus
muscular tissue was admitted to the C. Periarteritis nodosa
traumatological department. What bi- D. Systemic lupus erythematosus
ochemical urine index will be increased E. Radiation sickness
in this case?
130. A 68-year-old woman can’t move her
A. Creatinine upper and lower right extremities due to
B. Common lipids the stroke. Muscle tone of these extremiti-
C. Glucose es and their reflexes are increased. There
D. Mineral salts are pathological reflexes. What form of
E. Uric acid paralysis is it?
126. Donor skin transplantation was A. Hemiplegia
performed to a patient with extensive B. Paraplegia
burns. On the 8-th day the graft became C. Tetraplegia
swollen and changed colour; on the 11-th D. Monoplegia
day graft rejection started. What cells take E. Dissociation
part in this process?
131. Most participants of Magellan
A. T-lymphocytes expedition to America died from avi-
B. Erythrocytes tominosis. This disease declared itself
C. Basophils by general weakness, subcutaneous
D. Eosinophils hemmorhages, falling of teeth, gingival
E. B-lymphocytes hemmorhages. What is the name of this
127. As a result of craniocerebral trauma avitiminosis?
a patient reveals the following symptoms: A. Scurvy
intention tremor, dysmetry, adiadochoki- B. Pellagra
nesis, dysarthria. What structure of the C. Rachitis
brain is injured? D. Polyneuritis (beriberi)
A. Cerebellum E. Biermer’s anemia
B. Striatum 132. A large-scale reaction with
C. Motor cortex parapertussis and pertussis diagnosticums
D. Pale sphere was made in order to make serologi-
E. Black substance cal diagnostics of the whooping cough.
128. A patient with infectious At the bottom of the test-tubes with di-
mononucleosis had been taking agnosticum of Bordetella parapertussis
glucocorticoids for two weeks. He was a granular sediment formed. What anti-
brought into remission, but he fell ill bodies did this reaction reveal?
Krok 1 Medicine 2006 15
nogen was detected in the patient’s blood. sturbed metabolism of what aminoacid
Decreased activity of what organelle of underlies this phenomenon?
the liver hepatocytes can most probably
cause it? A. Phenilalanine
B. Methionine
A. Granular endoplasmatic reticulum C. Tryptophan
B. Agranular endoplasmatic reticulum D. Glutamic acid
C. Mitochondrions E. Histidine
D. Golgi complex
E. Lysosomes 157. A 25-year-old patient complained of
the decreased vision. Accommodation di-
153. A duodenal content smear of a pati- sorders, dilated pupil, lack of reaction for
ent with indigestion contains protosoa 10- the light were revealed on examination.
18 mcm large. They have piriform bodi- What muscles function is disturbed?
es, 4 pairs of filaments, two symmetrically
located nuclei in the broadened part of A. Pupil narrowing muscle, ciliary
body. What kind of the lowest organisms B. Pupil dilating muscle, ciliary
is it? C. Inferior oblique muscle, ciliary
D. Lateral rectus muscle, pupil narrowing
A. Lamblia E. Pupil narrowing and dilating muscles
B. Dysentery ameba
C. Trichomonas 158. A patient with continious
D. Intestinal ameba bronchopneumonia was admitted to
E. Balantidium the therapeutic department. Antibiotic
therapy didn’t give much effect. What
154. A 44-year-old woman complains of medication for improvement of immune
common weakness, heart pain, consi- state should be added to the complex
derable increase of body weigt. Objecti- treatment of this patient?
vely: moon-like face, hirsutism, AP-
165/100 mm Hg, height - 164 cm, wei- A. Timaline
ght - 103 kg; fat is mostly accumulated in B. Analgin
the region of neck, upper shoulder girdle, C. Sulfocamphocaine
stomach. What is the main pathogenetic D. Benadryl
mechanism of obesity? E. Paracetamol
A. Increased production of glucocorticoids 159. Patient with abscess of the cut
B. Decreased production of thyroidal wound applied to the traumatological
hormones department. In order to clean the wound
C. Increased production of insulin from the pus doctor washed it with 3%
D. Decreased production of glucagon hydrogen peroxide. Foam was absent.
E. Increased production of mineralocorti- What caused the absence of the drug acti-
coids vity?
155. After a serious viral infection a 3- A. Inherited insufficiency of catalase
year-old child has repeated vomiting, loss B. Low concentration H2 O2
of consciousness, convulsions. Examinati- C. Inherited insufficiency of erythrocyte
on revealed hyperammoniemia. What phosphatdehydrogenase
may have caused changes of biochemical D. Shallow wound
blood indices of this child? E. Pus in the wound
A. Disorder of ammonia neutralization in 160. Microspecimen of spinal cord contai-
ornithinic cycle ns a nucleus that should be analyzed.
B. Activated processes of aminoacids Its neurons form motor endings in the
decarboxylation skeletal muscles. What nucleus of spinal
C. Disorder of biogenic amines neutrali- cord is meant?
zation
D. Increased purtefaction of proteins in A. Proper nucleus of the anterior horn
intestines B. Thoracic nucleus
E. Inhibited activity of transamination C. Intermediate lateral nucleus
enzymes D. Proper nucleus of the posterior horn
E. Proper nucleus of gray substance
156. Albinos can’t stand sun impact - they
don’t aquire sun-tan but get sunburns. Di- 161. Patient with injured muscles of
Krok 1 Medicine 2006 18
occasionally revealed some larvae. Eosi- 176. A 17-year-old boy fell seriously ill,
nophiles were detected on blood exami- body temperature rose up to 38, 50 , there
nation. What helminthiasis can be di- is cough, rhinitis, lacrimation, nasal di-
agnosed? scharges. What kind of inflammation is
it?
A. Ascariasis
B. Enterobiosis A. Catarrhal inflammation
C. Trichocephaliasis B. Serous inflammation
D. Paragonimiasis C. Fibrinous inflammation
E. Opisthorchosis D. Suppurative inflammation
E. Hemorrhagic inflammation
172. A 40-year-old woman was admitted
to the infectious diseases department wi- 177. A genetics specialist analyzed the
th high body temperature. Objectively: genealogy of a family and found that both
marked meningeal symptoms. A spinal males and females may have the illness,
cord punction was made. What anatomic not across all the generations, and that
formation was puncturated? healthy parents may have ill children.
What is the type of illness inheritance?
A. Spatium subarachnoideum
B. Spatium subdurale A. Autosomal recessive
C. Spatium epidurale B. Autosomal dominant
D. Cavum trigeminale C. X-linked dominant
E. Cisterna cerebellomedullaris posterior D. X-linked recessive
E. Y-linked
173. The energy inputs of a healthy man
have been measured. In what state was 178. A patient who has been treated
the patient if his energy inputs were less with diazepam on account of neurosis
than the main exchange? complains of toothache. Doctor admi-
nistered him an analgetic, but its dose
A. Sleep was lower than average therapeutic dose.
B. Rest What phenomenon did the doctor take
C. Easy work into account while prescribing the patient
D. Nervous exertion an underdose?
E. Calmness
A. Potentiation
174. Examination of a newborn boy’s geni- B. Summation
tals revealed a cleft of urethra that opens C. Cumulation
on the inferior surface of his penis. What D. Drug dependence
developmental anomaly is meant? E. Tolerance
A. Hypospadia 179. Inflammatory process of modified
B. Hermaphroditism subserous layer around cervix of the
C. Epispadia uterus caused an intensive pain syndrome.
D. Monorchism In what region of genitals does the
E. Cryptorchism pathological process take place?
175. To prevent long-term effects of 4-day A. P arametrium
malaria a 42-year-old patient was prescri- B. Mesometrium
bed primaquine. On the 3-rd day from C. Myometrium
the begin of treatment there appeared D. Endometrium
stomach and heart pains, dyspepsia, E. P erimetrium
general cyanosis, hemoglobinuria. What
caused side effects of the preparation? 180. Analysis of amniotic fluid that was
obtained as a result of amniocentesis
A. Genetic insufficiency of glucose 6- (puncture of amniotic sac) revealed cells
phosphate dehydrogenase the nuclei of which contain sex chromatin
B. Cumulation of the preparation (Barr’s body). What can it be evidence of?
C. Decreased activity of microsomal liver
enzymes
D. Delayed urinary excretion of the
preparation
E. Drug potentiation by other preparations
Krok 1 Medicine 2006 20
nute. What structure does this cell belong 194. Objective examination of a patient
to? revealed: slender figure, big skull, highly
developed frontal region of face, short
A. Sinoatrial node extremities. What constitutional type is
B. Atrium it characteristic for?
C. Ventricle
D. Atrioventricular node A. Respiratory
E. His’ bundle B. Muscular
C. Digestive
190. While preparing a patient to the D. Cerebral
operation the heart chambers’ pressure E. Mixed
was measured. In one of them the
pressure changed during one heart cycle 195. A 38-year-old patient died during
from 0 to 120 mm Hg. What chamber of intractable attack of bronchial asthma.
heart was it? Histologic examination revealed mucus
accumulation in bronchial lumen, a lot
A. Left ventricle of fat cells (labrocytes) in the wall of
B. Right ventricle bronches, many of them are in the state of
C. Right atrium degranulation, there are also a lot of eosi-
D. Left atrium nophils. What pathogenesis of bronchial
E. - changes is it?
191. Part of alveoles of a preterm infant A. Atopy
didn’t spread because of enhanced elastic B. Cytotoxic, cytolytic action of antibodies
recoil of lungs. How can this recoil be C. Immunocomplex mechanism
reduced? D. Cellular cytolysis
E. Granulomatosis
A. By surfactant introduction
B. By pure oxygene inhalation 196. A patient with thrombophlebitis
C. By artificial pulmonary ventilation of lower extremities had got chest pai-
D. By fluid suction from the respiratory ns, blood spitting, growing respiratory
tracts failure that caused his death. Autopsy
E. By glycose introduction revealed multiple pulmonary infarctions.
What is the most probable reason of their
192. A young man has a painlessl formati- development?
on without marked borders in the soft ti-
ssues of his thigh. On the tissue bioptate A. Pulmonary artery embolism
the formation looks like flesh of fish and B. Pulmonary artery thrombosis
consists of immature fibroblast-like cells C. Bronchial artery thrombosis
with multiple mitosis growing through D. Bronchial artery embolism
the muscles. What is the most likely di- E. Pulmonary venous thrombosis
agnosis?
197. Diabetes mellitus causes ketosis as a
A. Fibrosarcoma result of activated oxidation of fatty acids.
B. Myosarcoma What disorders of acid-base equilibrium
C. Fibroma may be caused by excessive accumulation
D. Cancer of ketone bodies in blood?
E. Myoma
A. Metabolic acidosis
193. In course of prophylactic medi- B. Metabolic alcalosis
cal examination a 7-year-old boy was C. Any changes woun’t happen
diagnosed to have daltonism. Parents D. Respiratory acidosis
are healthy, color vision is normal. But E. Respiratory alcalosis
grandfather from the mother’s side has
the same disorder. What is the type of 198. A woman with 0 (I) bllod group has
inheriting of this anomaly? born a child with AB blood group. This
woman’s husband has A blood group.
A. Recessive, sex-linked What genetic interaction explains this
B. Dominant, sex-linked phenomenon?
C. Incomplete domination
D. Autosomal-recessive
E. Autosomal-dominant
Krok 1 Medicine 2006 22