Krok 1 MEDICINE · Krok 1 Medicine (англомовний варiант, iноземнi...

MINISTRY OF PUBLIC HEALTH OF UKRAINE

Department of human resources policy, education and science

Testing Board

Test items for licensing examination

Krok 1

MEDICINE

Student ID Last name

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ББК 54.1я73

УДК 61

Authors of items: Androshchuk O.V., Artysh Yu.P., Basiy R.V., Berezniak M.A., Bielan S.M.,

Bilenky S.A., Bohatyrova O.V., Boikiv D.P., Bondarchuk T.I., Cherkas L.P., Chernovska N.V.,

Danylchuk V.V., Deineka S.Ye., Demianenko I.A., Dron L.A., Dzhalilova E.A., Fartushok N.V.,

Fedoniuk L.Ya., Filchukov D.O., Haidash I.S., Hanulich T.V., Harets V.I., Harhin V.V.,

Herasymovych E.V., Hladchuk A.B., Hliebova L.Yu., Holdobina O.V., Hopkalov V.H., Hryhorenko V.K.,

Hryhorieva N.P., Hrytsenko L.Z., Hurmak I.S., Huryk Z.Ya., Husarenko V.D., Ivanochko V.M.,

Ivanova S.A., Ivniev B.B., Kachmarska M.O., Kaptiukh R.P., Khmara T.V., Kiriakulov H.S., Klishch I.M.,

Klopotsky H.A., Koldunov V.V., Kolesnikova S.V., Kolot E.H., Kononenko O.V., Korolenko H.S.,

Kovalenko O.Yu., Kratenko H.S., Kravets D.S., Kukurychkin Ye.R., Kulynych H.B., Kurinna S.S.,

Kutsyk R.V., Kuzyk I.Ya., Kyrychok L.T., Lahoda N.M., Levandovsky V.B., Linchevska L.P., Luchko I.M.,

Lukianchuk V.D., Luzin V.I., Lychyk H.Z., Makats Ye.F., Makovetsky O.V., Maksymchuk T.P.,

Malyshev S.L., Manzhelei O.S., Matveiko L.M., Melnyk O.I., Meshchyshen I.F., Mikhieieva N.H.,

Mishchenko A.F., Mitriaiev A.B., Mruh V.M., Mykhailiuk I.O., Nakonechna O.A., Nikolenko O.H.,

Obraztsova O.H., Oleshchuk O.M., Ostrivka O.I., Ovchynnikov S.O., Pavlova O.O., Pobihun A.A.,

Poeta O.M., Protsak T.V., Romanenko O.V., Rubina L.M., Rukavyshnikova S.M., Rusalov V.L., Saiuk N.P.,

Salata O.V., Salmanova O.M., Samoilovych I.M., Savchenko N.V., Savelieva O.V., Semeniuk T.M.,

Serdiuchenko I.Ya., Shanko V.M., Shapoval O.M., Shavaran S.S., Shcherbak L.F., Shemonaieva K.F.,

Sheremeta L.M., Shevchenko O.M., Shevtsova A.I., Shliakhovenko O.O., Shnaiderman O.Yu., Shults N.V.,

Shutak V.I., Siedov V.I., Sikoryn Ya.Ya., Slobodianiuk T.M., Smirnov S.M., Sokolenko V.M.,

Suprunov K.V., Tarasenko T.V., Tarasova K.V., Terekhovska O.I., Tkachenko V.L., Tkachuk O.V.,

Tsehelsky A.A., Tsivkovsky A.O., Tumansky V.O., Tusyk O.T., Tymofiychuk I.R., Tymoshenko S.H.,

Uhryn O.M., Uzun H.V., Vashchuk A.A., Vasylchenko O.A., Vernyhorodsky S.V., Verkhova O.O.,

Vinnikov Yu.M., Voitsekhovsky V.H., Volobuiev M.A., Vorobets Z.D., Voronych-Semchenko N.M.,

Vovk I.M., Yakubyshyna L.V., Yasinsky V.I., Yuzyfyshyn M.V., Zadorozhny S.P., Zakharchuk O.I.,

Zazhaieva V.V., Zelenina N.M., Zhulinsky V.O., Zhurakivska O.Ya., Ziatkovska N.Ye., Zinchenko O.V.,

Zinchenko S.A., Zlenko O.T. and Committees of professional expertise.

Item reviewers. Ananko S.Ya., Basy R.V., Bilash S.M., Deineka S. Ye., Deltsova O.I., Demydova K.Yu.,

Fomina L.V., Hahrin V.V., Haidash I.S., Holovatiuk O.L., Horhol N.I., Kava T.V., Koldunov V.V.,

Korolenko H.S., Kovalchuk L.Ye., Linchevska L.P., Maly K.D., Melnikova O.V., Melnyk N.O.,

Neporada K.S., Nikolenko O. H., Ovchynnikov S. O., Prokofieva N. V., Pushkar M. S., Pykaliuk V. S.,

Salata O.V., Shevelenkova A.V., Shumeiko O.V., Sikora V.Z., Skliarov O.Ya., Skorobohatova Z.M.,

Synytska A.M., Tananakina T.P., Teleshova O.V., Tertyshny S.I., Tkachuk S.S., Trzhetsynsky S.D,

Vinnykov Yu.M., Vorobets Z.D., Yoltukhivsky M.V., Zelenina N.M., Zhadinsky M.V., Zhylinsky V.O.,

Zinkovska L.Ya.

The book includes test items for use at licensing integrated examination “Krok 1. Medicine” and

further use in teaching.

The book has been developed for students of medical, pediatric and medical-and-prophylactic

faculties and academic staff of higher medical educational establishments.

Approved by Ministry of Public Health of Ukraine as examination and teaching

publication based on expert conclusions (Orders of MPH of Ukraine of 14.08.1998 №251,

of 27.12.1999 №303, of 18.06.2002 №221, of 16.10.2002 №374, of 16.04.2003 №239, of

29.05.2003 №233).

© Copyright Testing Board.

General Instruction

Every one of these numbered questions or unfinished statements in

this chapter corresponds to answers or statements endings. Choose the

answer (finished statements) that fits best and fill in the circle with the

corresponding Latin letter on the answer sheet.

Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 1

1. A 35-year-old man has been deli-vered into a surgical ward with a suppurati-ng wound in the neck, anterior to trachea(previsceral space). If a surgical operationis not performed urgently, there is a risk ofinfection spreading to:

A. Thoracic cavity - anterior mediastinumB. Thoracic cavity - middle mediastinumC. Thoracic cavity - posterior mediastinumD. Retrovisceral spaceE. Interaponeurotic suprasternal space

2. Characteristic sign of glycogenosis ismuscle pain during physical work. Bloodexamination usually reveals hypoglycemia.This pathology is caused by congenital defi-ciency of the following enzyme:

A. Glycogen phosphorylaseB. Glucose 6-phosphate dehydrogenaseC. α-amylaseD. γ-amylaseE. Lysosomal glycosidase

3. Histologic specimen of a kidneydemonstrates cells closely adjoined to therenal corpuscle in the distal convolutedtubule. Their basement membrane isextremely thin and has no folds. These cellssense the changes in sodium content of uri-ne and influence renin secretion occurringin juxtaglomerular cells. Name these cells:

A. Macula densa cellsB. Juxtaglomerular cellsC. Mesangial cellsD. PodocytesE. Glomerular capillary endothelial cells

4. Bacteriological analysis of tap water hasresulted in the following: total bacterialcount in 1,0 ml of water is 80, coli indexis 3. What would be the conclusion?

A. The water is safe for consumptionB. The water quality is doubtfulC. The water quality is extremely doubtfulD. The water is pollutedE. The water is extremely polluted

5. The process of metabolism in the humanbody produces active forms of oxygen,including superoxide anion radical �−

2 .This anion is inactivated by the followingenzyme:

A. Superoxide dismutaseB. CatalaseC. PeroxidaseD. Glutathione peroxidaseE. Glutathione reductase

6. What kind of muscle contraction occursin an upper limb during an attempt to lift aload beyond one’s strength?

A. IsometricB. IsotonicC. AuxotonicD. PhasicE. Single

7. A patient suffers from high fever,apnoea, pain in the thorax on the right.Pleurocentesis yielded 700 ml of yellow-green viscous liquid. Make the diagnosis:

A. Pleural empyemaB. Bronchial pneumoniaC. Serous pleurisyD. Hemorrhagic pleurisyE. Pleural carcinomatosis

8. A patient suffers from disrupted patencyof the airways at the level of smalland medium-sized bronchial tubes. Whatchanges of acid-base balance can occur inthe patient?

A. Respiratory acidosisB. Respiratory alkalosisC. Metabolic acidosisD. Metabolic alkalosisE. Acid-base balance remains unchanged

9. Upon toxic damage of hepatic cellsresulting in disruption of liver function thepatient developed edemas. What changes ofblood plasma are the main cause of edemadevelopment?

A. Decrease of albumin contentB. Increase of globulin contenC. Decrease of fibrinogen contenD. Increase of albumin contenE. Decrease of globulin conten

10. A 6-year-old child with suspected acti-ve tuberculous process has undergone di-agnostic Mantoux test. What immunobi-ological preparation was injected?

A. TuberculinB. BCG vaccineC. DTP vaccineD. TularinumE. Td vaccine

11. A 15-year-old boy has been diagnosedwith acute viral hepatitis. What blood valueshould be determined to confirm acuteaffection of hepatic cells?

A. Aminotransferase activity (AST, ALT)B. Unconjugated and conjugated bilirubincontentC. Erythrocytes sedimentation rate (ESR)D. Cholesterol contentE. Protein fraction content

12. A 53-year-old man is diagnosed with


Paget’s disease. Concentration of oxyproli-ne in daily urine is sharply increased, whichprimarily means intensified disintegrationof:

A. CollagenB. KeratinC. AlbuminD. HemoglobinE. Fibrinogen

13. When taking exams students often havedry mouth. The mechanism that causes thisstate results from the following reflexes:

A. Conditioned sympatheticB. Unconditioned parasympatheticC. Conditioned parasympatheticD. Unconditioned sympatheticE. Unconditioned peripheral

14. A patient has hoarseness of voice. Duri-ng laryngoscopy a gray-white larynx tumorwith papillary surface has been detected.Microscopic investigation has shown thefollowing: growth of connective tissuecovered with multilayer, strongly kerati-nized pavement epithelium, no cellularatypia. What is the most likely diagnosis?

A. PapillomaB. FibromaC. PolypD. AngiomaE. Angiofibroma

15. During autopsy approximately 2,0 litersof pus have been found in the abdominalcavity of the body. Peritoneum is dull andof grayish shade, serous tunic of intestineshas grayish-colored coating that is easilyremovable. Specify the most likely type ofperitonitis in the patient:

A. Fibrinopurulent peritonitisB. Hemorrhagic peritonitisC. Serous peritonitisD. Tuberculous peritonitisE. -

16. Autopsy of a body revealed bonemarrow hyperplasia of tubular and flatbones (pyoid marrow), splenomegaly (6 kg)and hepatomegaly (5 kg), enlargement ofall lymph node groups. What disease arethe identified changes typical of?

A. Chronic myelogenous leukemiaB. Chronic lymphocytic leukemiaC. Multiple myelomaD. Polycythemia veraE. Hodgkin’s disease

17. A bacteriological laboratory has beeninvestigating a sample of homemade dri-ed fish that was the cause of severe

food poisoning. Microscopy of the cultureinoculated in Kitt-Tarozzi medium revealedmicroorganisms resembling a tennis racket.What diagnosis can be made?

A. BotulismB. SalmonellosisC. CholeraD. DysenteryE. Typhoid fever

18. An infant has been diagnosed with mi-crocephaly. Doctors suspect that this braindisorder developed due to the fact thatthe mother had been taking actinomycin Dduring her pregnancy. What germinal layershave been affected by this teratogen?

A. EctodermB. EntodermC. MesodermD. Entoderm and mesodermE. All germinal layers

19. A patient demonstrates sharp decreaseof pulmonary surfactant activity. This condi-tion can result in:

A. Alveolar tendency to recedeB. Decreased airways resistanceC. Decresed work of expiratory musclesD. Increased pulmonary ventilationE. Hyperoxemia

20. A patient is diagnosed with diabeticcoma. Blood sugar is 18,44 mmol/l. Whatglucose-regulating drug should be prescri-bed in the given case?

A. Rapid-acting insulinB. Intermediate-acting insulinC. Long-acting insulinD. BiguanideE. Sulfonylurea derivative

21. Initial inoculation of water in 1%peptone water resulted in growth of a thinfilm on the medium surface in 6 hours.Such cultural properties are characteristicof causative agent of the following disesase:

A. CholeraB. PlagueC. TuberculosisD. DysenteryE. Pseudotuberculosis

22. An infant born prematurely 2 days agopresents with yellow coloring of skin andmucosa. Such a condition in the infantis caused by temporary deficiency of thefollowing enzyme:


A. UDP-glucuronyl transferaseB. Aminolevulinate synthaseC. Heme oxygenaseD. Heme synthetaseE. Biliverdine reductase

23. It has been determined that one of apesticide components is sodium arsenatethat blocks lipoic acid. Enzyme activity canbe impaired by this pesticide. Name thisenzyme:

A. Pyruvate dehydrogenase complexB. Microsomal oxidationC. Methemoglobin reductaseD. Glutathione peroxidaseE. Glutathione reductase

24. A 50-year-old woman diagnosed withcardiac infarction has been delivered intoan intensive care ward. What enzyme willbe the most active during the first two days?

A. Aspartate aminotransferaseB. Alanine aminotransferaseC. Alanine aminopeptidaseD. LDH4E. LDH5

25. Stool culture test of a 6-month-oldbottlefed baby revealed a strain of intesti-nal rod-shaped bacteria of antigen structure0-111. What diagnosis can be made?

A. ColienteritisB. GastroenteritisC. Choleriform diseaseD. Food poisoningE. Dysentery-like disease

26. Parents of a sick 5-year-old girl vi-sited a genetic consultation. Karyotypeinvestigation revealed 46 chromosomes.One chromosome of the 15th pair wasabnormally long, having a part of thechromosome belonging to the 21st pairattached to it. What mutation occurred inthis girl?

A. TranslocationB. DeletionC. InversionD. DeficiencyE. Duplication

27. A patient consulted a doctor withcomplaints of dyspnea occurring afterphysical exertion. Physical examinationrevealed anemia, paraprotein was detectedamong gamma globulins. What value shouldbe determined in the patient’s urine toconfirm the diagnosis of myeloma?

A. Bence Jones proteinB. BilirubinC. HemoglobinD. CeruloplasminE. Antitrypsin

28. A patient complaining of dizziness, thi-rst, difficult swallowing, and impaired visi-on of close objects has addressed a doctor.Objectively: respiratory rate is increased,pupils are dilated, general agitation, talkati-veness, though the speech is indistinct. BP is110/70 mm Hg, heart rate is 110/min. Givensymptoms can indicate overdosage of thefollowing drug:

A. AtropineB. MorphineC. EphedrineD. AminazineE. Caffeine

29. A dry-cleaner’s worker has been foundto have hepatic steatosis. This pathology canbe caused by disruption of synthesis of thefollowing substance:

A. PhosphatidylcholineB. TristearinC. UreaD. Phosphatidic acidE. Cholic acid

30. A 35-year-old man with peptic ulcer di-sease has undergone antrectomy. After thesurgery secretion of the following gastro-intestinal hormone will be disrupted themost:

A. GastrinB. HistamineC. SecretinD. CholecystokininE. Neurotensin

31. A 16-year-old adolescent is di-agnosed with hereditary UDP (uridine di-phosphate) glucuronyltransferase defici-ency. Laboratory tests revealed hyperbi-lirubinemia caused mostly by increasedblood content of the following substance:

A. Unconjugated bilirubinB. Conjugated bilirubinC. UrobilinogenD. StercobilinogenE. Biliverdine

32. A 60-year-old patient with a long hi-story of atherosclerosis and a previousmyocardial infarction developed an attackof retrosternal pain. 3 days later the patientwas hospitalized and then died of progressi-ve cardiovascular insufficiency. Duringautopsy a white fibrous depressed areaabout 3 cm in diameter with clear margi-


ns was found within the area of posteriorwall of the left ventricle and interventricularseptum. The dissector considered thesechanges to be:

A. Focal cardiosclerosisB. Myocardial ischemiaC. Myocardial infarctionD. MyocarditisE. Myocardial degeneration

33. A patient with hypertension hasdeveloped headache, tinnitus, vomiting, hi-gh BP up to 220/160 mm Hg. On exami-nation: facial asymmetry on the right, voli-tional mobility is absent, increased tendonreflexes and muscle tone of extremities onthe right. What motor disorder of nervoussystem occurred in this case?

A. HemiplegiaB. ParaplegiaC. TetraplegiaD. HyperkinesisE. Monoplegia

34. A 7-year-old child in the state of allergicshock caused by a bee sting has beendelivered into an emergency ward. Highconcentration of histamine was observedin blood. Production of this amine was theresult of the following reaction:

A. DecarboxylationB. HydroxylationC. DehydrogenationD. DeaminizationE. Reduction

35. A 26-year-old woman consulted a doctorabout having stool with white flat movingorganisms resembling noodles. Laboratoryanalysis revealed proglottids with thefollowing characteristics: long, narrow, wi-th a longitudinal channel of the uterus with17-35 lateral branches on each side. Whatkind of intestinal parasite was found?

A. Taeniarhynchus saginatusB. Taenia soliumC. Hymenolepis nanaD. Diphyllobothrium latumE. Echinococcus granulosus

36. A man is 28 years old. Histologicalinvestigation of the cervical lymph noderevealed a change of its pattern due to proli-feration of epithelioid, lymphoid cells andmacrophages with horseshoe-shaped nuclei.In the center of some cell clusters therewere non-structured light-pink areas withfragments of nuclei. What disease are thesechanges typical of?

A. TuberculosisB. Hodgkin’s diseaseC. ActinomycosisD. Tumor metastasisE. Syphilis

37. Sex chromatin was detected duringexamination of a man’s buccal epitheli-um. It is characteristic of the followingchromosome disease:

A. Klinefelter’s syndromeB. Down’s diseaseC. Turner’s syndromeD. Triple X syndromeE. Hypophosphatemic rickets

38. A patient, having suffered a thermalburn, developed painful boils filled withturbid liquid in the skin. What morphologi-cal type of inflammation has developed inthe patient?

A. SerousB. ProliferativeC. CroupousD. GranulomatousE. Diphtheritic

39. Autopsy of a man with tuberculosisrevealed a 3x2 cm large cavity in the superi-or lobe of the right lung. The cavity wasinterconnected with a bronchus, its wallwas dense and consisted of three layers:the internal layer was pyogenic, the middlelayer was made of tuberculous granulationtissue and the external one was made ofconnective tissue. What is the most likelydiagnosis?

A. Fibrous cavernous tuberculosisB. Fibrous focal tuberculosisC. TuberculomaD. Acute focal tuberculosisE. Acute cavernous tuberculosis

40. A 7-year-old child has acute onset of di-sease: temperature rise up to 38oC , rhinitis,cough, lacrimation, and large-spot rash onthe skin. Pharyngeal mucosa is edematous,hyperemic, with whitish spots in the buccalarea. What kind of inflammation caused thechanges in the buccal mucosa?

A. Catarrhal inflammationB. Suppurative inflammationC. Fibrinous inflammationD. Hemorrhagic inflammationE. Serous inflammation

41. After a traffic accident a 36-year-oldpatient has developed muscle paralysis ofthe extremitis on the right, lost pain andthermal sensitivity on the left, and partiallylost tactile sensitivity on both sides. Whatpart of the brain is the most likely to be


damaged?

A. Right-hand side of the spinal cordB. Motor cortex on the leftC. Left-hand side of the spinal cordD. Anterior horn of the spinal cordE. Posterior horn of the spinal cord

42. A 4-year-old child has been admitted toan orthopaedic department with displacedshin fracture. Bone fragments repositionrequires analgesia. What drug should bechosen?

A. PromedolB. AnalginC. Morphine hydrochlorideD. PanadolE. -

43. While examining foot blood supply adoctor checks the pulsation of a large arteryrunning in the separate fibrous channel infront of articulatio talocruralis between thetendons of long extensor muscles of halluxand toes. What artery is it?

A. A. dorsalis pedisB. A. tibialis anteriorC. A. tarsea medialisD. A. tarsea lateralisE. A. fibularis

44. Representatives of a certain humanpopulation can be characterized byelongated body, height variability, decreasedvolume of muscle mass, increased lengthof limbs, decreased size and volume of ribcage, increased perspiration, decreased indi-ces of base metabolism and fat synthesis.What type of adaptive evolution is it?

A. TropicalB. ArcticC. ModerateD. IntermediateE. Mountain

45. A 59-year-old woman has been hospiali-zed in a surgical ward due to exacerbation ofchronic osteomyelitis of the left shin. Bloodtest: leukocytes - 15, 0 · 109/l. Leukogram:myelocytes - 0%, metamyelocytes -8%, stab neutrophils - 28%, segmentedneutrophils - 32%, lymphocytes - 29%,monocytes - 3%. Such blood count wouldbe called:

A. Regenerative left shiftB. Right shiftC. Hyperregenerative left shiftD. Degenerative left shiftE. Regenerative-degenerative left shift

46. A 41-year-old man has a hi-story of recurrent attacks of heartbeats

(paroxysms), profuse sweating, headaches.Examination revealed hypertension,hyperglycemia, increased basal metabolicrate, and tachycardia. These clinicalpresentations are typical of the followingadrenal pathology:

A. Hyperfunction of the medullaB. Hypofunction of the medullaC. Hyperfunction of the adrenal cortexD. Hypofunction of the adrenal cortexE. Primary aldosteronism

47. During autopsy of a man, who di-ed of acute transmural cardiac infarction,the following has been detected on thepericardium surface: fibrous whitish-browndeposit connecting parietal and visceralpericardial layers. What kind of inflammati-on occurred in the pericardium?

A. CroupousB. DiphtheriticC. SerousD. SuppurativeE. Granulomatous

48. A 12-year-old child developed nephri-tic syndrome (proteinuria, hematuria, cyli-ndruria) 2 weeks after a case of tonsilli-tis, which is a sign of affected glomerularbasement membrane in the kidneys. Whatmechanism is the most likely to cause thebasement membrane damage?

A. Immune complexB. GranulomatousC. Antibody-mediatedD. ReaginicE. Cytotoxic

49. A man arrived into a traumatologi-cal department with a trauma of the rightshoulder. Examination revealed a displacedhumeral shaft fracture on the right in themiddle one-third of the humerus; the pati-ent cannot extend the fingers of his righthand. What nerve is damaged?

A. RadialB. UlnarC. MedianD. MusculocutaneousE. Axillary

50. Work in a mine is known to causeinhalation of large amounts of coal dust.Inhaled coal dust can be detected in thefollowing pulmonary cells:

A. Alveolar macrophagesB. Respiratory epithelial cellsC. Secretory epithelial cellsD. Capillary endothelial cellsE. Pericapillary cells


51. What drug will be the most appropriatefor a patient suffering from chronic gastritiswith increased secretion?

A. PirenzepineB. PancreatineC. PepsinD. AprotininE. Chlorphentermine

52. A 63-year-old man, who has beensuffering from chronic fibrous-cavernouspulmonary tuberculosis for 24 years, hasbeen delivered to a nephrology departmentwith uremia. Intravital diagnostic test foramyloid in the kidneys was positive. Whatamyloidosis is it in this case?

A. Secondary systemicB. Primary systemicC. Localized (focal)D. Hereditary (genetic)E. Senile

53. Cells of a healthy liver actively synthesi-ze glycogen and proteins. What organellesare the most developed in them?

A. Granular and agranular endoplasmicreticulumB. Cell centerC. LysosomesD. MitochondriaE. Peroxisomes

54. Immune-enzyme assay has detectedHBs antigen in blood serum. What diseaseis it characteristic of?

A. Viral hepatitis type BB. Viral hepatitis type AC. AIDSD. TuberculosisE. Syphilis

55. A patient has been diagnosed withgonorrhea. As fluoroquinolones are thedrugs of choce for treatment of gonorrheathe patient should be prescribed:

A. CiprofloxacinB. FurazolidoneC. FluorouracilD. Sulfacarbamide (Urosulfanum)E. Cefazolin

56. Autopsy of a Middle-Eastern woman,who had been suffering from wastingfever for a long time, revealed enlargedblackened liver and spleen. Bone marrowwas hyperplastic and black-colored as well.Cerebral cortex was smoky grey. What di-sease is it characteristic of?

A. MalariaB. AIDSC. Epidemic typhusD. SepsisE. Hepatitis

57. Human red blood cells contain no mi-tochondria. What is the main pathway forATP production in these cells?

A. Anaerobic glycolysisB. Aerobic glycolysisC. Oxidative phosphorylationD. Creatine kinase reactionE. Cyclase reaction

58. Atria of an experimental animal weresuperdistended with blood, which resultedin decreased reabsorption of Na+ and waterin renal tubules. This can be explained bythe influence of the following factor on ki-dneys:

A. Natriuretic hormoneB. AldosteroneC. ReninD. AngiotensinE. Vasopressin

59. A woman gave birth to a stillbornbaby with numerous malformations. Whatprotozoan disease could cause intrauterinedeath?

A. ToxoplasmosisB. LeishmaniasisC. MalariaD. AmebiasisE. Lambliasis

60. A 42-year-old patient complains ofpain in the epigastral area, vomiting; vomitmasses have the color of coffee-grounds;the patient suffers from melena. Anamnesisrecords gastric ulcer disease. Blood formula:erythrocytes - 2, 8 · 1012/l, leukocytes -8 · 109/l, Hb- 90 g/l. What complication isit?

A. HemorrhageB. PenetrationC. PerforationD. CancerationE. Pyloric stenosis

61. A patient has been hospitalisedwith provisional diagnosis of virus Bhepatitis. Serological reaction based oncomplementation of antigen with antibodychemically bound to peroxidase or alkalinephosphatase was used for disease diagnosti-cs. What is the name of the applied serologi-cal reaction?


A. Immune-enzyme analysisB. RadioimmunoassayC. Immunofluorescence testD. Bordet-Gengou testE. Antigen-binding assay

62. A patient with insulin-dependent di-abetes mellitus has been administeredinsulin. After a certain period of timethe patient developed fatigue, irritabili-ty, excessive sweating. What is the mainmechanism of such presentations developi-ng?

A. Carbohydrate starvation of the brainB. Increased glycogenolysisC. Increased ketogenesisD. Increased lipogenesisE. Decreased glyconeogenesis

63. Examination of a 52-year-old womanhas revealed a decrease in the amountof red blood cells and an increase infree hemoglobin in the blood plasma(hemoglobinemia). Color index is 0,85.What type of anemia is being observed inthe patient?

A. Acquired hemolyticB. Hereditary hemolyticC. Acute hemorrhagicD. Chronic hemorrhagicE. Anemia due to diminished erythropoiesis

64. Poisoning caused by mercury (II) chlori-de (corrosive sublimate) occurred in theresult of safety rules violation. In 2 daysthe patient’s diurnal diuresis was 620 ml.The patient developed headache, vomiting,convulsions, dyspnea; moist crackles wereobserved in the lungs. Name this pathology:

A. Acute renal failureB. Chronic renal failureC. Uremic comaD. GlomerulonephritisE. Pyelonephritis

65. For people adapted to high externaltemperatures profuse sweating is notaccompanied by loss of large volumes ofsodium chloride. This is caused by the effectthe following hormone has on perspiratoryglands:

A. AldosteroneB. VasopressinC. CortisolD. TgyroxinE. Natriuretic

66. The processes of heat transfer in a nakedperson at room temperature have beenstudied. It was revealed that under theseconditions the greatest amount of heat istransferred by:

A. Heat radiationB. Heat conductionC. ConvectionD. EvaporationE. -

67. Due to destruction of certain structuresof the brainstem an animal has lost its ori-entation reflexes in response to strong lightstimuli. What structures were destroyed?

A. Anterior quadrigeminal bodiesB. Posterior quadrigeminal bodiesC. Red nucleiD. Vestibular nucleiE. Substantia nigra

68. Urine analysis has shown high levels ofprotein and erythrocytes in urine. This canbe caused by the following:

A. Renal filter permeabilityB. Effective filter pressureC. Hydrostatic blood pressure in glomerularcapillariesD. Hydrostatic primary urine pressure incapsuleE. Oncotic pressure of blood plasma

69. Along with normal hemoglobin typesthere can be pathological ones in the organi-sm of an adult. Name one of them:

A. HbSB. HbFC. HbA1D. HbA2E. HbO2

70. Development of both immune andallergic reactions is based upon the samemechanisms of immune system responseto an antigen. What is the main differencebetween immune and allergic reactions?

A. Development of tissue lesionB. Amount of released antigenC. Antigen structureD. Routes by which antigens are deliveredinto the bodyE. Hereditary predisposition

71. Histologic preparation stained wi-th orcein demonstrates from 40 to 60fenestrated elastic membranes within themiddle coat of vessel. Name this vessel:

A. Elastic arteryB. Muscular arteryC. Mixed type arteryD. Muscular veinE. Nonmuscular vein

72. Angiocardiography of a 60-year-old manrevealed constriction of a vessel located in


the left coronary sulcus of the heart. Namethis pathological vessel:

A. Ramus circumflexusB. Ramus interventricularis posteriorC. A. coronaria dextraD. V.cordis parvaE. Ramus interventricularis anterior

73. A comatose patient was taken to thehospital. He has a history of diabetes melli-tus. Objectively: Kussmaul breathing, lowblood pressure, acetone odor of breath.After the emergency treatment the pati-ent’s condition improved. What drug hadbeen administered?

A. InsulinB. AdrenalineC. IsadrinumD. GlibenclamideE. Furosemide

74. A patient complains of pain in the ri-ght lateral abdomen. Palpation revealed adense, immobile, tumor-like formation. Thetumor is likely to be found in the followingpart of the digestive tube:

A. Colon ascendensB. Colon transversumC. Colon descendensD. Colon sigmoideumE. Caecum

75. A patient hospitalized due to mercuryintoxication presents with the followi-ng processes in the kidneys: focalnecrotic changes of tubules of majorrenal regions, edema, leukocyte infiltrati-on and hemorrhages in the interstitial ti-ssue, venous congestion. What conditiondeveloped in the patient?

A. Acute necrotic nephrosisB. Acute glomerulonephritisC. Chronic renal failureD. Acute pyelonephritisE. Chronic pyelonephritis

76. According to phenotypic diagnosis afemale patient has been provisionally di-agnosed with X-chromosome polysomia.This diagnosis can be confirmed bycytogenetic method. What karyotype willconfirm the diagnosis?

A. 47(ХХХ)B. 48(XXXY)C. 48(XXYY)D. 47(XXY)E. 46(XX)

77. An uconscious young man in the state ofmorphine intoxication has been deliveredinto an admission room. The patient’s respi-

ration is slow and shallow due to suppressi-on of the respiratory center. What kind ofrespiratory failure occurred in this case?

A. Ventilatory disregulationB. Ventilatory obstructionC. Ventilatory restrictionD. PerfusionE. Diffusion

78. On histological examination of uterinemucosa the following is detected: sinuousglands, serratiform and corkscrew-shapedelongated growths of stroma with cell proli-feration. Make the diagnosis:

A. Glandular endometrial hyperplasiaB. Acute endometritisC. LeiomyomaD. Vesicular moleE. Placental polyp

79. 10 minutes after the beginning ofheavy physical work a person demonstratesincrease of erythrocyte number in bloodfrom 4, 0 · 1012/l to 4, 5 · 1012/l. What is thecause of this phenomenon?

A. Erythrocytes exit from depotB. Suppression of erythrocyte destructionC. Erythropoiesis activationD. Increase of cardiac outputE. Water loss

80. A patient has a traumatic injuryof sternocleidomastoid muscle. This hasresulted in a decrease of the following value:

A. Inspiratory reserve volumeB. Expiratory reserve volumeC. Respiratory volumeD. Residual volumeE. Functional residual lung capacity

81. Autopsy of a 40-year-old woman,who died of cerebral hemorrhage duri-ng hypertensic crisis, revealed: upper-body obesity, hypertrichosis, hirsutism,stretchmarks on the skin of thighs andabdomen. Pituitary basophil adenoma isdetected in the anterior lobe. What di-agnosis is the most likely?

A. Cushing’s diseaseB. Essential hypertensionC. Alimentary obesityD. Simmonds’ diseaseE. Hypothalamic obesity

82. A specimen shows an organ coveredwith the connective tissue capsule withradiating trabeculae. There is also cortexcontaining lymph nodules, and medullarycords made of lymphoid cells. What organis under study?


A. Lymph nodeB. ThymusC. SpleenD. Red bone marrowE. Tonsils

83. After a craniocerebral injury a patienthas lost the ability to recognize shapes ofobjects by touch (stereognosis). What areaof cerebral cortex normally contains therelevant center?

A. Superior parietal lobuleB. Inferior parietal lobuleC. Supramarginal gyrusD. Postcentral gyrusE. Angular gyrus

84. Monoamine oxidase inhibitors arewidely used as psychopharmacologicaldrugs. They change the level of nearlyall neurotransmitters in synapses, withthe following neurotransmitter being theexception:

A. AcetylcholineB. NoradrenalineC. AdrenalineD. DopamineE. Serotonin

85. A worker of an agricultural enterprisehad been suffering from an acute diseasewith aggravating intoxication signs, whichresulted in his death. On autopsy: the spleenis enlarged, flaccid, dark cherry-red in thesection, yields excessive pulp scrape. Softmeninges of fornix and base of the brainare edematous and saturated with blood(”cardinal’s cap”). Microscopically: serous-hemorrhagic inflammation of meninges andcerebral tissues. Make the diagnosis:

A. AnthraxB. TularemiaC. PlagueD. CholeraE. Brucellosis

86. Autopsy of an 8-month-old boy, who di-ed of severe pneumonia complicated withsepsis, revealed absence of thymus. Lymphnodes have no lymphoid follicles and corti-cal substance. In the spleen the follicles aredecreased in size and have no light centers.What is the cause of such changes?

A. Thymus agenesisB. Thymus aplasiaC. Thymus atrophyD. Thymus hypoplasiaE. Accidental thymic involution

87. A patient has been delivered into asurgical ward with an incised wound of theanterior surface of the shoulder in its lower

one-third. Flexing function was disruptedin the shoulder and elbow joints, which iscaused by the damage to the:

A. Biceps muscle of the armB. Triceps muscle of the armC. Anconeus muscleD. Deltoid muscleE. Coracobrachial muscle

88. A 40-year-old patient suffersfrom bronchial asthma and prolongedtachycardia. Choose the optimal drug forrapid relief of bronchial spasm in the givencase:

A. SalbutamolB. Adrenalin hydrochlorideC. Ephedrine hydrochlorideD. OrciprenalineE. Isoprenaline (Isadrinum)

89. A patient with urolithiasis hasdeveloped severe pain attacks. For painshock prevention he was administered anantispasmodic narcotic analgesic along withatropine. Name this drug:

A. PromedolB. NalorphineC. TramadolD. Ethylmorphine hydrochlorideE. Morphine hydrochloride

90. A patient suffers from acute cardi-opulmonary failure with pulmonary edema.What diuretic should be prescribed in thegiven case?

A. FurosemideB. TriamtereneC. SpironolactoneD. Hydrochlorothiazide (Dichlothiazidum)E. Acetazolamide (Diacarb)

91. A patient with acute myocardial infarcti-on has been administered heparin as apart of complex therapy. Some time afterheparin injection the patient developedhematuria. What heparin antagonist shouldbe injected to remove the complication?

A. Protamine sulfateB. VicasolC. Aminocaproic acidD. NeodicumarinE. Fibrinogen

92. The key reaction of fatty acid synthesisis production of malonyl-CoA. Whatmetabolite is the source of malonyl-CoAsynthesis?


A. Acetyl-CoAB. Succinyl-CoAC. Acyl-CoAD. MalonateE. Citrate

93. A family of healthy students, who havearrived from Africa, gave birth to a chi-ld with signs of anemia. The child has di-ed shortly after. Examination has revealedthat the child’s erythrocytes are abnormallycrescent-shaped. The disease is characreri-zed by autosomal recessive inheritance.Determine the genotype of the child’sparents:

A. Аа х АаB. Аа х ааC. АА х ААD. аа х ааE. Аа х АА

94. At a certain stage of cell cyclechromosomes reach cellular poles, undergodespiralization; nuclear membranes arebeing formed around them; nucleolus isrestored. What stage of mitosis is it?

A. TelophaseB. ProphaseC. PrometaphaseD. MetaphaseE. Anaphase

95. Cardiac arrest occurred in a patientduring a surgery of the small intestine.What regulatory mechamisms resulted inthe cardiac arrest in this case?

A. Unconditioned parasympathetic reflexesB. Unconditioned sympathetic reflexesC. Conditioned parasympathetic reflexesD. Conditioned sympathetic reflexesE. Metasympathetic reflexes

96. Vestibular receptors of semicircularcanals of an animal have been destroyed.What reflexes will disappear as a result?

A. Statokinetic reflex during movementswith angular accelerationB. Statokinetic reflex during movementswith linear accelerationC. Head-righting reflexD. Body-righting reflexE. Primary orienting reflex

97. A patient working at a pig farm complai-ns of paroxysmal abdominal pain, liquidfeces with mucus and blood, headache,weakness, fever. Examination of largeintestine revealed ulcers from 1 mm up toseveral cm in diameter, feces contained ovalunicellular organisms with cilia. What di-sease can be suspected?

A. BalantidiasisB. AmebiasisC. ToxoplasmosisD. LambliasisE. Trichomoniasis

98. Blood group of a 30-year-old man hasbeen determined before a surgery. Theblood was Rhesus-positive. Agglutinationdid not occur with standard 0 (I), А (II),and В (III) serums. The blood belongs tothe following group:

A. 0 (I)B. А (II)C. В (III)D. АВ (IV)E. -

99. Histological specimen of a hemopoieticorgan shows clusters of node- and band-shaped lymphocytes that along with stromaelements compose cortical and medullarsubstances. Name this organ:

A. Lymph nodeB. SpleenC. Red bone marrowD. ThymusE. Palatine tonsil

100. It is known that in catecholami-ne metabolism a special role belongsto monoamine oxidase (MAO). Thisenzyme inactivates mediators (noadrenalin,adrenalin, dopamine) by:

A. Oxidative deaminationB. Adjoining amino groupsC. Removing methyl groupsD. CarboxylationE. Hydrolysis

101. Cellular composition of exudatelargely depends on the etiological factor ofinflammation. What leukocytes are the firstto be involved in the focus of inflammationcaused by pyogenic bacteria?

A. Neutrophil granulocytesB. MonocytesC. MyelocytesD. Eosinophilic granulocytesE. Basophils

102. A surgeon has detected inflammationof the Meckel’s diverticulum in a patient.During surgical invasion it can be located inthe:

A. IleumB. JejunumC. ColonD. DuodenumE. Sigmoid colon


103. A patient complains of acute painattacks in the right lumbar region. Duri-ng examination the nephrolithic obturationof the right ureter in the region betweenits abdominal and pelvic segments wasdetected. What anatomical boundary exi-sts between those two segments?

A. Linea terminalisB. Linea semilunarisC. Linea arcuataD. Linea transversaE. Linea inguinalis

104. A patient died of cancerous cachexiawith primary localization of cancer in thestomach. Autopsy revealed acutely enlargedliver with uneven surface and numerousprotruding nodes; the nodes had clearmargins in the section, rounded shape,gray-pink color, varying density, someti-mes contained necrotic foci. Histologically:there are atypical cells in the nodes. Whatpathologic process occurred in the liver?

A. Cancer metastasesB. AbscessesC. Regeneratory nodesD. InfarctionE. Hepatic cancer

105. A patient has insufficient bloodsupply to the kidneys, which causedthe development of pressor effect dueto the constriction of arterial resistancevessels. This is the result of the vesselsbeing greately affected by the followingsubstance:

A. Angiotensin IIB. AngiotensinogenC. ReninD. CatecholaminesE. Norepinephrine

106. Experimental stimulation ofsympathetic nerve branches that innervateheart caused an increase in force of heartcontractions because membrane of typicalcardiomyocytes permitted an increase in:

A. Calcium ion entryB. Calcium ion exitC. Potassium ion exitD. Potassium ion entryE. Calcium and potassium ion exit

107. Parents of a 5-year-old child report himto have frequent colds that develop intopneumonias, presence of purulent rasheson the skin. Laboratory tests have revealedthe following: absence of immunoglobuli-ns of any type; naked cells are absent fromthe lymph nodes punctate. What kind ofimmune disorder is it?

A. X-linked hypogammaglobulinemia(Bruton type agammaglobulinemia)B. Autosomal recessive agammaglobuli-naemia (Swiss type)C. Hypoplastic anemiaD. AgranulocytosisE. Louis-Barr syndrome

108. A microslide contains the specimenof a gland composed of several secretorysaccule-shaped parts that open in thecommon excretory duct. What gland is it?

A. Simple branched alveolar glandB. Compound branched alveolar glandC. Simple unbranched alveolar glandD. Compound unbranched alveolar glandE. Simple branched tubular gland

109. Microelectrode technique allowed toregister a potential following ”all-or-none”law and capable of undecremental spreadi-ng. Specify this potential:

A. Action potentialB. Excitatory postsynaptic potentialC. Rest potentialD. Inhibitory postsynaptic potentialE. Receptor potential

110. Examination of a patient revealedhypertrophy and inflammation of lymphoidtissue, edema of mucous membranebetween palatine arches (acute tonsillitis).What tonsil is normally situated in this area?

A. Tonsilla palatinaB. Tonsilla pharyngealisC. Tonsilla tubariaD. Tonsilla lingualisE. -

111. Histological specimen of an ovarydemonstrates a spherical structurecomposed of large glandular cells contai-ning lutein. What hormone is produced bythe cells of this structure?

A. ProgesteroneB. EstrogensC. TestosteroneD. CorticosteroneE. Aldosterone

112. A patient, who has been subsistingexclusively on polished rice, has developedpolyneuritis due to thiamine deficiency.What substance is an indicator of such avi-taminosis, when it is excreted with urine?

A. Pyruvic acidB. MalateC. Methylmalonic acidD. Uric acidE. Phenyl pyruvate


113. When blood circulation in the damagedtissue is restored, lactate accumulationstops and glucose consumption decelerates.These metabolic changes are caused by acti-vation of the following process:

A. Aerobic glycolysisB. Anaerobic glycolysisC. LipolysisD. GluconeogenesisE. Glycogen biosynthesis

114. A 67-year-old patient complains ofperiodic heartache, dyspnea during lightphysical activities. ECG reveals extraordi-nary contractions of heart ventricles. Sucharrhythmia is called:

A. ExtrasystoleB. BradycardiaC. TachycardiaD. FlutterE. Fibrillation

115. In investigation of serum proteins vari-ous physical and physicochemical methodscan be used. In particular, serum albumi-ns and globulins can be separated by themethod of:

A. ElectrophoresisB. PolarographyC. DialysisD. SpectrographyE. Refractometry

116. Pupil dilation occurs when a personsteps from a light room into a dark one.What reflex causes such a reaction?

A. Sympathetic unconditioned reflexB. Sympathetic conditioned reflexC. Metasympathetic reflexD. Parasympathetic unconditioned reflexE. Parasympathetic conditioned reflex

117. Cells of a person working in theChornobyl Exclusion Zone have undergonea mutation in DNA molecule. However,with time the damaged interval of DNAmolecule has been restored to its initialstructure with a specific enzyme. In this casethe following occurred:

A. RepairB. ReplicationC. TranscriptionD. Reverse transcriptionE. Translation

118. Autopsy of a 5-year-old child revealedin the area of the vermis of cerebellum a softgrayish-pink node 2 cm in diameter withblurred margins and areas of haemorrhage.Histologically this tumour consisted ofatypical monomorphous small round cells

with large polymorphous nuclei. Whattumour is it?

A. MedulloblastomaB. MeningiomaC. GlioblastomaD. AstrocytomaE. Oligodendroglioma

119. When studying the signs of pulmonaryventilation, reduction of forced expiratoryvolume has been detected. What is the li-kely cause of this phenomenon?

A. Obstructive pulmonary diseaseB. Increase of respiratory volumeC. Increase of inspiratory reserve volumeD. Increase of pulmonary residual volumeE. Increase of functional residual lungcapacity

120. A specimen of a parenchymal organshows poorly delineated hexagonal lobulessurrounding a central vein, and theinterlobular connective tissue containsembedded triads (an artery, a vein and anexcretory duct). What organ is it?

A. LiverB. PancreasC. ThymusD. SpleenE. Thyroid

121. A patient had a trauma that causeddysfunction of motor centers regulatingactivity of head muscles. In what parts ofcerebral cortex can these centers normallybe located?

A. Inferior part of precentral gyrusB. Superior part of precentral gyrusC. Supramarginal gyrusD. Superior parietal lobuleE. Angular gyrus

122. At the post-mortem examination thestomach of a patient with renal failure wasfound to have a yellow-brown coating onthe thickened mucosa. The coating was fi-rmly adhering to its surface and had si-gnificant thickness. Microscopy revealedcongestion and necrosis of mucosal andsubmucosal layers, fibrin presence. What isthe most likely diagnosis?

A. Fibrinous gastritisB. Croupous gastritisC. Gastric abscessD. EsogastritisE. Corrosive gastritis

123. A 60-year-old man suffering fromchronic hepatitis frequently observes nasaland gingival hemorrhages, spontaneoushemorrhagic rashes on the skin and mucosa.


Such presentations result from:

A. Decreased synthesis of prothrombin andfibrinogenB. Increased blood content of ami-notransferasesC. Decreased synthesis of serum albuminsD. Increased blood content of macroglobuli-ns and cryoglobulinsE. Decreased blood content of choli-nesterase

124. Leading symptoms of primaryhyperparathyroidism are osteoporosis andrenal damage resulting in urolithiasisdevelopment. What substances are the basisof uroliths in such cases?

A. Calcium phosphateB. Uric acidC. CystineD. BilirubinE. Cholesterol

125. An oncology department has admitteda patient with suspected pulmonary tumor.On examination a pathology localized wi-thin the lower lobe of the right lung wasdetected. How many bronchopulmonarysegments are there in this lobe?

A. 5B. 6C. 4D. 3E. 2

126. A 45-year-old woman suffersfrom arterial hypertension with highblood concentration of angiotensin II.What antihypertensive drug is the mostrecommended in the given case?

A. LisinoprilB. PrazosinC. MetoprololD. ReserpineE. Verapamil

127. An alcoholic suffers from alcoholicpsychosis with evident psychomotor agitati-on. What neuroleptic drug should be admi-nistered for emergency aid?

A. AminazineB. DiazepamC. Sodium bromideD. ReserpineE. Halothane

128. In one of Polessia regions there wasan outbreak of helminthiasis manifested bycramps and facial edemas. The developedpreventive measures in particular includedban for eating infested pork even afterheat processing. What helminthiasis was the

case?

A. TrichinosisB. TaeniarhynchosisC. TeniasisD. EchinococcosisE. Alveococcosis

129. A patient demonstrates functional lossof nasal halves of the retinas. What area ofvisual pathways is affected?

A. Optic chiasmB. Left optic tractC. Right optic tractD. Left optic nerveE. Right optic nerve

130. A 26-year-old woman with bronchitishas been administered a broad spectrumantibiotic as a causal treatment drug. Speci-fy this drug:

A. DoxycyclineB. InterferonC. BCG vaccineD. AmbroxolE. Dexamethasone

131. A 16-year-old young man sufferi-ng from seasonal allergic rhinitis hasbeen prescribed a highly active second-generation H1 blocker, which can becharacterized by absence of marked sedati-ve action. Name this drug:

A. LoratadineB. PipolphenC. Chloropyramine (Suprastin)D. IndometacinE. Erythromycin

132. Examination of a 56-year-old womanwith a history of type 1 diabetes mellitusrevealed a disorder of protein metaboli-sm that is manifested by aminoacidemia inthe laboratory blood test values, and cli-nically by the delayed wound healing anddecreased synthesis of antibodies. Whichof the following mechanisms causes thedevelopment of aminoacidemia?

A. Increased proteolysisB. AlbuminosisC. Decrease in the concentration of aminoacids in bloodD. Increase in the oncotic pressure in theblood plasmaE. Increase in low-density lipoprotein level

133. A patient with injury sustained to a partof the central nervous system demonstratesdisrupted coordination and movementamplitude, muscle tremor during volitionalmovements, poor muscle tone. What part ofthe central nervous system was injured?


A. CerebellumB. Medulla oblongataC. OliencephalonD. MesencephalonE. Prosencephalon

134. A 36-year-old patient has been admini-stered a depolarizing muscle relaxant duri-ng a surgery. Name this drug:

A. DithylinumB. ProserinC. Pipecuronium bromide (Arduan)D. DiazepamE. Aminazine

135. A man has suffered multiple bonefractures of his lower extremities duri-ng a traffic accident. During transportati-on to a hospital his condition was furtheraggravated: blood pressure decreased, therewere signs of pulmonary artery embolism.What kind of embolism is the most likely inthe given case?

A. Fat embolismB. Air embolismC. Gas embolismD. Tissue embolismE. Thromboembolism

136. UN volunteers have arrived in Ni-geria to assist the locals in aftermathof earthquakes. What drug should theyprescribe for individual chemoprophylaxisof malaria?

A. ChingaminB. PyrantelC. Pyrimethamine (Chloridinum)D. PrimaquineE. Interferon (Laferon)

137. After an extended treatment wi-th sulfanamides a patient has developedmacrocytic anemia. Production of activeforms of the following vitamin is disruptedin such a condition:

A. Folic acidB. ThiamineC. RiboflavinD. PyridoxineE. Cyanocobalamin

138. A woman resting in the countrysi-de has been stung by a bee. Immediatelyafter she developed pain in the stung area.In a few minutes there developed a vesi-cle, erythema and intense itch; later - urti-caria and expiratory dyspnea. What factorsresulted in the patient developing expi-ratory dyspnea?

A. HistamineB. Hageman’s factorC. Lysosomal enzymesD. NoradrenalineE. Adrenaline

139. Autopsy of a 28-year-old patient, whohad been suffering from rheumatism anddied of heart failure, revealed pancardi-tis. Histological investigation of myocardi-um of the left ventricle posterior walland interventricular septum detected peri-vascular cellular focal infiltrates composedof macrophages and creating palisadestructures surrounding areas of fibrinoidnecrosis. Determine the type of myocarditis:

A. GranulomatousB. Diffuse interstitial productiveC. Diffuse interstitial exudativeD. Focal interstitial exudativeE. -

140. When ascending to the top of Elbrus,a mountain climber experiences oxygenstarvation, dyspnea, palpitations, andnumbness of the extremities. What kind ofhypoxia has developed in the mountain cli-mber?

A. HypoxicB. CirculatoryC. HemicD. TissueE. Cardiac

141. A 2-year-old boy is diagnosed wi-th Down syndrome. What chromosomalchanges can cause this disease?

A. Trisomy 21B. Trisomy 13C. Trisomy XD. Trisomy 18E. Monosomy X

142. A 62-year-old patient has been hospi-talized due to massive cerebral hemorrhage.Blood pressure is 70/30 mm Hg, heartrate is 120/min., respiratory rate is 4/min.,unconscious, no response to external sti-muli. Such condition can be determined as:

A. ComaB. ShockC. CollapseD. StressE. Agony

143. A 3-year-old girl with mental retardati-on has been diagnosed with sphingomyelinlipidosis (Niemann-Pick disease). In thiscondition synthesis of the followingsubstance is disrupted:


A. SphingomyelinaseB. GlycosyltransferaseC. SphingosineD. CeramidesE. Gangliosides

144. What condition may develop 15-30 mi-nutes after re-administration of an antigenas a result of the increased level of anti-bodies, mainly IgE, that are adsorbed onthe surface of target cells, namely tissuebasophils (mast cells) and blood basophi-ls?

A. AnaphylaxisB. Antibody-dependent cytotoxicityC. Delayed-type hypersensitivityD. Immune complex hyperresponsivenessE. Serum sickness

145. Local anesthetics (novocaine, lidocaineand others) decreases pain sensitivity of ti-ssues by blocking Na+ and K+ ions frompermeating membranes of nerve fibers andendings. Such mechanism of drug action iscalled:

A. Membrane ionicB. ReceptorC. EnzymeD. AntienzymeE. Direct chemical

146. After a road accident a victim hastachycardia, arterial blood pressure 130/90mm Hg, tachypnoe, the skin is pale anddry, excitation of central nervous system isobserved. What shock stage is the patientmost likely in?

A. ErectileB. TerminalC. TorpidD. Preshock (compensation stage)E. Agony

147. A woman complaining of sharp painin her lower abdomen has been deliveredinto an admission room. A gynecologist onexamination makes a provisional diagnosisof extrauterine pregnancy. What anatomicalstructure should be punctated to confirm di-agnosis?

A. Rectouterine pouchB. Utriculosaccular chamberC. Recto-vesical pouchD. Retropubic spaceE. Intersigmoidal recess

148. A passenger of a fixed-run taxi has asudden and expressed attack of tachycardia.A doctor travelling by the same taxi hasmanaged to slow down his heart rate bypressing upon the eyeballs and thus causing

the following reflex:

A. Dagnini-Aschner reflexB. Bainbridge reflexC. Holtz’s reflexD. Hering-Breuer reflexE. Frank-Starling mechanism

149. A 47-year-old man developed intesti-nal colic against the background of essenti-al hypertension. In this situation it wouldbe the most efficient to arrest the colic byadministering drugs of the following group:

A. Myotropic antispasmodicsB. Anticholinesterase agentsC. SympathomimeticsD. M-cholinomimeticsE. Adrenomimetics

150. A therapeutist has an appointmentwith a 40-year-old patient complaining ofrecurrent pain attacks in his hallux jointsand their swelling. Urine analysis revealedits marked acidity and pink color. Whatsubstances can cause such changes in uri-ne?

A. Uric acid saltB. ChloridesC. Ammonium saltsD. Calcium phosphateE. Magnesium sulfate

151. Exophthalmus observed duringthyrotoxicosis is caused by accumulation ofhighly water-binding substances within theretrobulbar tissues. Name these substances:

A. GlycosaminoglycansB. CholesterolC. ATPD. KreatineE. Phospholipids

152. A patient presents with dry peeli-ng skin, frequent cases of acute respi-ratory diseases, xerophthalmia. What vi-tamin preparation should be prescribed inthis case?

A. Retinol acetateB. ThiamineC. CyanocobalaminD. Menadione (Vikasolum)E. Ergocalciferol

153. Parenchyma of an organ is composed ofpseudounipolar neurons localized under thecapsule of connective tissue. Central placebelongs to nerve fibers. Name this organ:


A. Spinal ganglionB. Sympathetic ganglionC. Intramural ganglionD. Nerve trunkE. Spinal cord

154. A patient consulted a physician aboutchest pain, cough, fever. Roentgenographyof lungs revealed eosinophilic infiltratesthat were found to contain larvae. What ki-nd of helminthiasis are these presentationstypical of?

A. AscariasisB. EchinococcosisC. FascioliasisD. CysticercosisE. Trichinosis

155. During appendectomy a patient hadthe a. appendicularis ligated. This vesselbranches from the following artery:

A. A. ileocolicaB. A. colica dextraC. A. colica mediaD. A. sigmoideaE. A. mesenterica inferior

156. A patient with signs of osteoporosisand urolithiasis has been admittedto an endocrinology department.Blood test revealed hypercalcemia andhypophosphatemia. These changes areassociated with abnormal synthesis of thefollowing hormone:

A. Parathyroid hormoneB. CalcitoninC. CortisolD. AldosteroneE. Calcitriol

157. Prescription of penicillin G sodiumsalt has caused development of neurotoxiceffects (hallucinations, convulsions). Suchreaction is the result of antagonism with thefollowing neurotransmitter:

A. GABAB. DopamineC. SerotoninD. AdenosineE. Acetylcholine

158. A 30-year-old woman exhibits signsof virilism (growth of body hair, baldingtemples, menstrual disorders). This condi-tion can be caused by overproduction of thefollowing hormone:

A. TestosteroneB. OestriolC. RelaxinD. OxytocinE. Prolactin

159. During a surgery for femoral hernia asurgeon operates within the boundaries offemoral trigone. What structure makes upits upper margin?

A. Lig. inguinaleB. Arcus iliopectineusC. Lig. lacunareD. Lig. pectinaleE. Fascia lata

160. Activation of a number of hemostaticfactors occurs through their joining withcalcium ions. What structural componentallows for adjoining of calcium ions?

A. Gamma-carboxyglutamic acidB. Gamma-aminobutyric acidC. Gamma-oxybutyric acidD. HydroxyprolineE. Monoamine-dicarboxylic acids

161. A patient has arterial hypertension.What long-acting calcium channel blockershould be prescribed?

A. AmlodipineB. OctadineC. PyrroxanumD. AtenololE. Reserpine

162. Material obtained from a patientcontains several types of microorganisms(staphylococci and streptococci) causativeof the patient’s disease. Name this type ofinfection:

A. Mixed infectionB. SuperinfectionC. ReinfectionD. Consecutive infectionE. Coinfection

163. A laboratory has been investigati-ng virulence of a diphtheria agent. In theprocess of the experiment the infection wasintroduced intraperitoneally into test ani-mals. The dosage of bacteria resulting in95% mortality of test animals was found.What unit of virulence measurement wasdetermined?

A. DLMB. DCLC. LD50D. IDE. LD5

164. A patient complains of palpitations


after stress. Pulse is 104/min., P-Q=0,12seconds, there are no changes in QRScomplex. What type of arrhythmia does thepatient have?

A. Sinus tachycardiaB. Sinus bradycardiaC. Sinus arrhythmiaD. Ciliary arrhythmiaE. Extrasystole

165. A patient consulted a dentist aboutrestricted mouth opening (trismus). He hasa history of a stab wound of the lowerextremity. What infection can cause thesesymptoms?

A. TetanusB. BrucellosisC. Whooping coughD. Wound anaerobic infectionE. Tularemia

166. Patient’s systolic blood pressure is90 mm Hg, diastolic - 70 mm Hg. Suchblood pressure is caused by decrease of thefollowing factor:

A. Pumping ability of the left heartB. Pumping ability of the right heartC. Aortic complianceD. Total peripheral resistanceE. Vascular tone

167. A 29-year-old man with a knife woundof the neck presents with bleeding. Duri-ng the initial d-bridement of the wounda surgeon revealed the injury of a vesselsituated along the lateral edge of thesternocleidomastoid muscle. Specify thisvessel:

A. V. jugularis externaB. V. jugularis anteriorC. A. carotis externaD. A. carotis internaE. V. jugularis interna

168. A 6-year-old child suffers from delayedgrowth, disrupted ossification processes,decalcification of the teeth. What can bethe cause?

A. Vitamin D deficiencyB. Decreased glucagon productionC. Insulin deficiencyD. HyperthyroidismE. Vitamin C deficiency

169. A patient addressed a hospital withcomplaints of lost sensitivity of the skin ofthe little finger. What nerve is the most li-kely to be damaged?

A. UlnarB. MedianC. RadialD. MusculocutaneousE. Medial cutaneous nerve of the forearm

170. A 30-year-old patient’s blood test hasrevealed the following: erythrocyte countis 6 · 1012/l, hemoglobin is 10,55 mmol/l.Vaquez’s disease was diagnosed. Name theleading part of pathogenesis:

A. Neoplastic erythroid hyperplasiaB. Iron-deficiencyC. B12-deficiencyD. HypoxiaE. Acidosis

171. Pancreas is known as a mixed gland.Endocrine functions include productionof insulin by beta cells. This hormoneaffects metabolism of carbohydrates. Whatis its effect on the activity of glycogenphosphorylase (GP) and glycogen synthase(GS)?

A. It inhibits GP and activates GSB. It activates both GP and GSC. It inhibits both GP and GSD. It activates GP and inhibits GSE. It does not affect the activity of GP andGS

172. This year influenza epidemic ischaracterised by patients’ body temperaturevarying from 36, 9oC to 37, 9oC . Such feveris called:

A. SubfebrileB. HighC. HyperpyreticD. ApyreticE. Moderate

173. Fructosuria is known to be connectedwith inherited deficiency of fructose 1-phosphate aldolase. What product offructose metabolism will accumulate in theorganism resulting in toxic action?

A. Fructose 1-phosphateB. Glucose 1-phosphateC. Glucose 6-phosphateD. Fructose 1,6-biphosphateE. Fructose 6-phosphate

174. A woman complains of visual impai-rment. Examination revealed obesity in thepatient and her fasting plasma glucose levelis hyperglycemic. What diabetes complicati-on can cause visual impairment/blindness?


A. MicroangiopathyB. MacroangiopathyC. AtherosclerosisD. NeuropathyE. Glomerulopathy

175. Administration of doxycyclinehydrochloride has caused an imbalance ofthe symbiotic intestinal microflora. Specifythe kind of imbalance caused by the antibi-otic therapy:

A. DysbacteriosisB. SensibilizationC. IdiosyncrasyD. Superimposed infectionE. Bacteriosis

176. Cholesterol content in blood serumof a 12-year-old boy is 25 mmol/l.Anamnesis states hereditary familialhypercholesterolemia caused by synthesisdisruption of receptor-related proteins for:

A. Low-density lipoproteinsB. High-density lipoproteinsC. ChylomicronsD. Very low-density lipoproteinsE. Middle-density lipoproteins

177. During recording of a spirogram a pati-ent calmly exhaled. How do we call thevolume of air remaining in the lungs?

A. Functional residual capacityB. Pulmonary residual volumeC. Expiratory reserve volumeD. Tidal volumeE. Vital capacity of lungs

178. A 40-year-old woman was diagnosedwith glomerulonephritis based on her cli-nical symptoms and the results of urineanalysis. Anamnesis states chronic tonsilli-tis. What microorganisms are the most likelycause for the kidney damage in this case?

A. StreptococciB. StaphylococciC. EscherichiaD. MycoplasmaE. Meningococci

179. A man is suffering from diarrhea. Insummer he spent his vacation in the southat the sea coast. Bacteria with the followingproperties were detected in his feces: gram-negative curved mobile monotrichous baci-lli that do not produce spores or capsules.Bacilli are undemanding to nutrient medi-um but require alkaline reaction (рН 8,5-9,5). Described are the agents of the followi-ng enteric infection:

A. CholeraB. ShigellosisC. Typhoid feverD. ColienteritisE. Pseudotuberculosis

180. An athlete (long-distance runner) duri-ng a contest developed a case of acute cardi-ac insufficiency. This pathology resultedfrom:

A. Cardiac volume overloadB. Disrupted coronary circulationC. Direct damage to myocardiumD. Pericardium pathologyE. Cardiac pressure overload

181. Parkinson’s disease is caused by di-sruption of dopamine synthesis. What brainstructure synthesizes this neurotransmitter?

A. Substantia nigraB. Globus pallidusC. Corpora quadrigeminaD. Red nucleusE. Hypothalamus

182. Name the halogen-containing anti-septic with fungicidal properties, which isused to treat dermatomycosis:

A. Iodine solutionB. Formalin solutionC. Methylene blueD. Brilliant greenE. Boric acid solution

183. Due to severe pain syndrome a patientwas prescribed a narcotic analgesic. Namethis drug:

A. MorphineB. Metamizole (Analgin)C. NimesulideD. Dimethyl sulfoxideE. Indometacin

184. During pathomorphological renalinvestigation of a patient, who for a longtime had been suffering from osteomyeli-tis and died of progressing renal fai-lure, the following was revealed: deposi-ts of homogeneous eosinophilic massesin glomerular mesangium, arterial andarteriolar walls, and stroma, which coloredred when stained with Congo red. Whatpathological process is this?

A. AmyloidosisB. Mucoid swellingC. CalcinosisD. Carbohydrate degenerationE. Hyalinosis

185. During experiment a dog hasdeveloped conditioned digestive reflex in


response to a sound stimulus. This conditi-oned reflex will not be exhibited anymoreafter the extirpation of the following areasof the cerebral hemispheres:

A. Temporal lobe on both sidesB. Occipital lobe on one sideC. Parietal lobe on both sidesD. Temporal lobe on one sideE. Occipital lobe on both sides

186. Coenzym A participates in numerousimportant metabolic reactions. It is a deri-vative of the following vitamin:

A. Pantothenic acidB. ThiamineC. NiacinD. CalciferolE. Ubiquinone

187. A patient diagnosed with acutedysentery has been treated for 3 days in aninfectious diseases hospital. On admissionthere were complaints of high temperature,stomachache and fluid excrements withmucus up to 8-10 times a day. What sampleshould be taken for analysis?

A. FecesB. UrineC. BileD. LiquorE. Blood

188. A patient with arthritis has beenprescribed an anti-inflammatory selectiveCOX-2 inhibitor. Select this drug amongthose given below:

A. CelecoxibB. Phenylbutazone (Butadion)C. Dimethylsulfoxide (Dimexid)D. IndometacinE. Metamizole (Analgin)

189. A person with the fourth blood group(genotype IAIB) has in erythrocytes bothantigen A controlled by allele IA andantigen B controlled by allele IB. Thisphenomenon is an example of the followinggene interation:

A. CodominanceB. ComplementarityC. SemidominanceD. PolymeryE. Epistasis

190. A patient with diabetes mellitussuffers from persistently nonhealing surgi-cal wound, which is a sign of disrupted ti-ssue trophism. What is the cause of suchdisorder?

A. Disruption of protein metabolismregulationB. HypoglycemiaC. KetonemiaD. Increased lipid catabolismE. Anemia

191. A patient with signs of intestinalinfection (vomiting, diarrhea, abdominalpain) has been presenting with increasingsymptoms of intoxication for three days.Papular rash appeared on the uncoveredskin areas and spread to the torso. Adoctor suspected pseudotuberculosis. Whatlaboratory test allows confirming this di-agnosis within the first week from the onsetof disease?

A. BacteriologicalB. MicroscopicC. SerologicalD. AllergicE. Biological

192. A microslide demonstrates an organwith its wall consisting of three membranes.The inner membrane has tubular glands andundergoes cyclic changes. Name this organ:

A. UterusB. EsophagusC. VaginaD. UreterE. Urinary bladder

193. A patient with femoral neck fracture,who for a long time had to remain in bedin a forced (supine) position, has developeddark-brown lesions along the backbone; softtissues are swollen, in the areas of macerati-on there is a foul-smelling liquid. Name theclinicopathologic type of necrosis:

A. BedsoreB. InfarctionC. SequestrumD. Coagulation necrosisE. Dry gangrene

194. A patient is 20 years old, an athlete. Headdressed a doctor with complaints of fati-gue, fever up to 38oC - 40oC . Objectively:the liver and spleen are enlarged, lymphnodes on palpation are slightly enlarged,dense, painless. Blood test: Нb- 100 g/l;erythrocytes - 2, 9 · 1012/l; leukocytes -4, 4 · 109/l. Leukogram: 68% of blast cells.Cytochemical investigation of blast cellsrevealed negative reactions to glycogen,peroxidase, non-specific esterase, lipids.Name this disease:


A. Acute undifferentiated leukemiaB. Acute myeloid leukemiaC. Acute monoblastic leukemiaD. Acute lymphoblastic leukemiaE. Acute megakaryoblastic leukemia

195. Impression smear of mucosa biopsymaterial has been obtained from a patientwith peptic ulcer disease of the stomach.Gram-negative arcuate bent microorgani-sms were detected, urease activity testwas positive. What microorganisms weredetected in the patient?

A. HelicobacterB. SpirocheteC. SpirillaD. LeptospiraE. Treponema

196. A patient after disrupted cerebral ci-rculation has developed paralysis. Choosethe anticholinesterase drug to be prescribedin this case:

A. ProserinB. CordiaminC. AceclidineD. MethacinE. Hexamethonium (Benzohexonium)

197. 30 minutes after drinking mango juicea child suddenly developed a local swelli-ng in the area of the soft palate, whichimpeded swallowing and, eventually, respi-ration. Mucosa of the swollen area washyperemic and painless. Blood test revealedmoderate eosinophilia. Body temperaturewas normal. Anamnesis states that the eldersister of the child has been suffering frombronchial asthma attacks. What kind of

edema has developed in the child?

A. AllergicB. InflammatoryC. CardiacD. AlimentaryE. Hepatic

198. During examination of a patient adoctor should use anatomical division ofanterior abdominal wall into regions formore precise diagnostics. How many regi-ons can abdomen be divided into?

A. 9B. 8C. 6D. 5E. 4

199. A child has a wound located posteriorto the mastoid process. Bright red bloodflows from the wound. Damaged are thebranches of the following artery:

A. A. occipitalisB. A. temporalis superiorC. A. maxillarisD. A. carotis externaE. A. carotis interna

200. When investigating human saliva it isnecessary to assess its hydrolytic properti-es. What substance should be used as asubstrate in the process?

A. StarchB. ProteinsC. FatsD. FiberE. Amino acids

INSTRUCTIONAL BOOK

Testing Board

TEST ITEMS FOR LICENSING EXAMINATION: KROK 1. MEDICINE.

Kyiv. Testing Board.

(English language).

Approved to print 19.04/№100 Paper size 60х84 1/8

Offset paper. Typeface. Times New Roman Cyr. Offset print.

Conditional print pages 20. Accounting publishing pages 24.

Issue. 3141 copies.

List of abbreviations

A/G Albumin/globulin ratio

A-ANON Alcoholics anonymous

ACT Abdominal computed tomography

ADP Adenosine diphosphate

ALT Alanin aminotranspherase

AMP Adenosine monophosphate

AP Action potential

ARF Acute renal failure

AST Aspartat aminotranspherase

ATP Adenosine triphosphate

BP Blood pressure

bpm Beats per minute

C.I. Color Index

CBC Complete blood count

CHF Chronic heart failure

CT Computer tomography

DIC Disseminated intravascular coagualtion

DCC Doctoral controlling committee

DM-2 Non-Insulin dependent diabetes mellitus

DTP Anti diphtheria-tetanus vaccine

ECG Electrocardiogram

ESR Erythrocyte sedimentation rate

FC Function class

FAD Flavin adenine dinucleotide

FADH2 Flavin adenine dinucleotide restored

FEGDS Fibro-esphago-gastro-duodenoscopy

FMNH2 Flavin mononucleotide restored

GIT Gastrointestinal tract

GMP Guanosine monophosphate

Hb Hemoglobin

HbA1c Glycosylated hemoglobin

Hct Hematocrit

HIV Human immunodeficiency virus

HR Heart rate

IDDM Insulin dependent diabetes mellitus

IFA Immunofluorescence assay

IHD Ischemic heart disease

IU International unit

LDH Lactate dehydrogenase

MSEC Medical and sanitary expert committee

NAD Nicotine amide adenine dinucleotide

NADPH Nicotine amide adenine dinucleotide

phosphate restored

NIDDM Non-Insulin dependent diabetes mellitus

PAC Polyunsaturated aromatic carbohydrates

PAS Periodic acid & shiff reaction

pCO2 CO2 partial pressure

pO2 CO2 partial pressure

pm Per minute

Ps Pulse rate

r roentgen

RBC Red blood count

RDHA Reverse direct hemagglutination assay

Rh Rhesus

(R)CFT Reiter's complement fixation test

RIHA Reverse indirect hemagglutination assay

RNA Ribonucleic acid

RR Respiratory rate

S1 Heart sound 1

S2 Heart sound 2

TU Tuberculin unit

U Unit

USI Ultrasound investigation

V/f Vision field

WBC White blood count

X-ray Roentgenogram

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