KROK I 2013 EXPLAINED

 

Introduction

This material aims to explain answers and sometimes, point out why the other options are not the correct ones. We encourage the student preparing for Krok I to avoid memorizing answers and instead set out to understand questions and the concepts behind them. It would also help a great deal to seek out topics that occur repeatedly, and study them thoroughly so one is ready for those questions in whatever form.

 

Note: All answers are A

 

  1. 1. A patient diagnosed with focal tuberculosis of the upper lobe of the right lung had been taking isoniazidas a part of combination therapy. After some time, the patient reported of muscle weakness, decreased skin sensitivity, blurred vision, and impaired motor coordination. Which vitamin preparation should be used to address these phenomena?
    1. Vitamin B6
    2. Vitamin A Vitamin D
    3. Vitamin B12
    4. Vitamin C

Answer: The ‘muscle weakness, skin sensitivity and other symptoms are indicative of peripheral neuropathy, a side effect of Isoniazid. Vitamin B6 (Pyridoxine)aids neurotransmitter synthesis and Isoniazid also causes its hypovitaminosis.

 

  1. A 60-year-old male patient has a 9-year history of diabetes and takes insulin Semilente for the correction of hyperglycemia. 10 days ago he began taking Anaprilinfor hypertension. One hour after administration of the antihypertensive drug the patient developed hypoglycemic coma. What is the mechanism of hypoglycemia in case of Anaprilin use?
    1. Inhibition of glycogenolysis
    2. Reduction of glucagon half-life
    3. Increase of insulin Semilente half-life
    4. Increase of bioavailability of insulin Semilente
    5. Decrease in glucose absorption

Answer: Inhibition of glycogenolysis._ Anapirilin is a non-selective beta blocker used both as an anti-arrhythmic, anti-angina, anti-hypertensive drug. One of the side effects is causing hypoglycemia in patients with insulin dependent diabetes  by inhibiting glycogenolysis.

 

  1. Pterin derivatives (aminopterin and methotrexate) are the inhibitors of dihydrofolate reductase, so that they inhibit the regeneration of tetrahydrofolic acid from dihydrofolate. These drugs inhibit the intermolecular transfer of monocarbon groups, thus suppressing the synthesis of the following polymer:
    1. DNA
    2. Protein
    3. Homopolysaccharides
    4. Gangliosides
    5. Glycosaminoglycans

Answer: DNA. Methotrexate inhibits synthesis of DNA.

 

  1. A child with suspected tuberculosis was given Mantoux test. After 24 hours the site of the allergen injection got swollen, hyperemic and painful. What are the main components that determine such response of the body?
    1. Mononuclear cells, T-lymphocytes and lymphokines
    2. Granulocytes, T-lymphocytes and IgG
    3. Plasma cells, T-lymphocytes and Lymphokines
    4. B-lymphocytes, IgM
    5. Macrophages, B-lymphocytes and monocytes

      Answer: Mononuclear cells, T-lymphocytes and lymphokines aid in Antigen uptake. Antigen here is M. Tuberculosis.

 

  1. Hemoglobin catabolism results in release of iron which is transported to the bone marrow by a certain transfer protein and used again for the synthesis of hemoglobin. Specify this transfer protein:
  2. Transferrin ( siderophilin )
  3. Transcobalamin
  4. Haptoglobin
  5. Ceruloplasmin
  6. Albumin

Answer: Transferrin. Transferrin is a plasma protein found in the blood that carries iron compound round the body and controls the level of free iron in biological fluids

 

  1. A 12-year-old boy has been hospitalized for suspected food poisoning. The fecal samples were inoculated on the Endo agar, which resulted in growth of a large number of colorless colonies. What microorganism is most likely to be EXCLUDED from the list of possible causative agents of the disease?
  2. Escherichia coli
  3. Salmonella enteritidis
  4. Proteus vulgaris
  5. Pseudomonas aeruginosa
  6. Yersinia enterocolitica

Answer: E. coli. This is because even though t is inoculated in Endo’s agar it forms pink colonies unlike all other microbes listed.

 

  1. A 23-year-old patient has been admitted to a hospital with a craniocerebral injury. The patient is in a grave condition. Respiration is characterized by prolonged convulsive inspiration followed by a short expiration. What kind of respiration is it typical for?
  2. Apneustic
  3. Gasping breath
  4. Kussmaul’s
  5. Cheyne-Stokes
  6. Biot’s

Answer: Apneustic. This is an abnormal pattern of breathing characterized by deep, gasping inspiration with a pause at full inspiration followed by brief insufficient.

 

  1. It has been experimentally proven that the excitation of the motor neurons of flexor muscles is accompanied by the inhibition of the motor neurons of extensor muscles. What type of inhibition underlies this phenomenon?
  2. Reciprocal
  3. Inhibition after excitation
  4. Pessimal
  5. Feedback
  6. Lateral

 

Answer: Reciprocal, Simple because excitation of one group of muscles (flexors) will inhibit the Extensors.

 

 

  1. A 3-year-old boy with pronounced hemorrhagic syndrome doesn’t have antihemophilic globulin A (factor VIII) in the blood plasma. Hemostasis has been impaired at the following stage:
  2. Internal mechanism of prothrombinase activation
  3. External mechanism of prothrombinase activation
  4. Conversion of prothrombin to thrombin
  5. Conversion of fibrinogen to fibrin E. Blood clot retraction

Answer: Factor VIII is involved in the Internal mechanism of Coagulation.

 

  1. A patient got a gunshot wound of hip which damaged the sciatic nerve. Any impact on the affected limb causes severe, excruciating pain. What mechanism of pain is most likely in this case?
  2. Causalgic
  3. Reflex
  4. Phantom
  5. Endorphin hypofunction
  6. Enkephalin hypofunction

Answer: Causalgic. It is a neuralgia distinguished by a burning pain along certain nerves.

 

  1. A 60-year-old patient with a long history of stenocardia takes coronarodilator agents. He has also been administered acetylsalicylic acid to reduce platelet aggregation. What is the mechanism of antiplatelet action of acetylsalicylic acid?
  2. It reduces the activity of cyclooxygenase B. It reduces the activity of phosphodiesterase
  3. It enhances the activity of platelet adenylate cyclase
  4. It enhances the synthesis of prostacyclin
  5. It has membrane stabilizing effect

Answer: It reduces the activity of cyclooxygenase B. It reduces the activity of phosphodiesterase. Acetlysalicyclic acid inhibit d activity of cyclooxygenase B.

 

  1. A patient with bronchial asthma has developed acute respiratory failure. What kind of respiratory failure occurs in this case?
  2. Obstructive disturbance of alveolar

ventilation

  1. Restrictive ventilatory defect
  2. Perfusion
  3. Diffusion
  4. Dysregulation of alveolar ventilation

Answer: Bronchial asthma is an example of an obstructive form of respiratory disease.

 

  1. On the fifth day after the acute blood loss a patient has been diagnosed with hypochromic anemia. What is the main mechanism of hypochromia development?
  2. Release of immature red blood cells from the bone marrow
  3. Impaired iron absorption in the intestines
  4. Increased destruction of red blood cells in the spleen

D           Impaired globin synthesis

  1.           Increased excretion of body iron

        Answer: Release of immature red blood cells from the bone marrow. Hypochromic anemia is a form of anemia where RBC are paler than normal. Immature red blood cells lack hemoglobin which is the responsible for the red pigment.

 

  1. A patient with diabetes developed a diabetic coma due to the acid-base imbalance. Specify the kind of this imbalance:
  2. Metabolic acidosis
  3. Metabolic alkalosis
  4. Respiratory acidosis
  5. Gaseous alkalosis
  6. Non-gaseous alkalosis

Answer: Metabolic acidosis. Presence of ketone bodies causes ketoacidosis which leads to increased acidosis of the blood.

 

  1. A girl receives antibiotics of the penicillin group for acute bronchitis. On the third day of treatment she developed allergic dermatitis. Which drug should be administered?
  2. Loratadine
  3. Cromolyn sodium
  4. Beclomethasone
  5. Ephedrine hydrochloride
  6. Levamisole

Answer: Loratadine is an H1- anti histamine drug used to treat allergies.

 

  1. A female patient has been diagnosed with cervical erosion, which is a precancerous pathology. What defense mechanism can prevent the development of a tumor?
  2. Increase in natural killer level (NK-

cells)

  1. High-dose immunological tolerance C. Increase in the activity of lysosomal enzymes
  2. Simplification of the antigenic structure of tissues
  3. Low-dose immunological tolerance

Answer: Increase of natural killer level. Natural killer cells are cells which play major roles in fighting both tumor cells and viral infected cells.

 

  1. Microscopy of the coronary artery of a dead 53-year-old patient revealed luminal occlusion due to a fibrous plaque with some lipids. The most likely form of atherosclerosis in this case is:
  2. Liposclerosis
  3. Lipidosis
  4. Prelipid stage
  5. Atheromatosis
  6. Ulceration

Answers: Liposclerosis. Occlusion was due to fibrous plague with LIPIDS.

 

  1. Autopsy of the patient revealed bone marrow hyperplasia of tubular and flat bones (pyoid marrow), splenomegaly (6 kg) and hepatomegaly (5 kg), enlargement of all lymph node groups. What disease are the identified changes typical for?
  2. Chronic myelogenous leukemia
  3. Chronic lymphocytic leukemia
  4. Multiple myeloma
  5. Polycythemia vera
  6. Hodgkin’s disease

Answer: CML, the characteristic feature of this disease is Pyoid Marrow(large pale nuclei possessing neutrophilic qualities)

 

  1. As a result of an injury a patient cannot extend his arm at the elbow. This may cause abnormal functioning of the following muscle:
  2. Musculus triceps brachii
  3. Musculus infraspinatus
  4. Musculus levator scapulae
  5. Musculus teres major
  6. Musculus subscapularis

Answer: Triceps muscle is responsible for extension of the arm.

 

  1. A man sitting with his eyes closed, undergoes electroencephalography. What rhythm will be recorded on the EEG if there is an audible signal?
  2. Beta rhythm
  3. Theta rhythm
  4. Delta rhythm
  5. Alpha rhythm
  6. Gamma rhythm

Answers: Beta rhythm. This is the frequency of the brain wave normal waking consciousness with eyes closed.

 

  1. Electrophoretic study of a blood serum sample, taken from the patient with pneumonia, revealed an increase in one of the protein fractions. Specify this fraction:
  2. γ-globulins’
  3. Albumins
  4. α1-globulins
  5. α2-globulins
  6. β-globulins

Answer:  γ-globulins. IgG also known as gamma globulins produced by plasma cells arise during bacterial infection to fight foreign bodies.

 

  1. Examination of an 18-year-old girl revealed the following features: hypoplasia of the ovaries, broad shoulders, narrow pelvis, shortening of the lower extremities, “sphinx neck”. Mental development is normal. The girl was diagnosed with Turner’s syndrome. What kind of chromosome abnormality is it?
  2. Monosomy X
  3. Trisomy X
  4. Trisomy 13
  5. Trisomy 18
  6. Nullisomy X

Answer: Monosomy X. it is also known as Turner’s syndrome. With karyotype of 47XXX.

 

  1. Hypertrichosis is the Y-linked character. The father has hypertrichosis, and the mother is healthy. In this family, the probability of having a child with hypertrichosis is:
  2. 0 , 5
  3. 0 , 25
  4. 0,125
  5. 0,625
  6. 1

Answer: 0.5 , basically a 50% chance, they can have a girl.

 

  1. A casualty has a fracture in the region of the inner surface of the left ankle. What is the most likely site for the fracture?
  2. Medial malleolus
  3. Lower third of the fibula
  4. Astragalus
  5. Lateral malleolus
  6. Calcaneus

Reason: The inner side of the left ankle is called the medial malleolus.

 

  1. Some infectious diseases caused by bacteria are treated with sulfanilamides which block the synthesis of bacteria growth factor. What is the mechanism of their action?
  2. They are antivitamins of para-amino benzoic acid
  3. They inhibit the absorption of folic acid
  4. They are allosteric enzyme inhibitors
  5. They are involved in redox processes
  6. They are allosteric enzymes

Reason: Sulfanilamide is an anti-bacterial drug that inhibits then function of PABA (Para Amino benzoic Acid).

 

  1. A 42-year-old male patient with gout has an increased blood uric acid concentration. In order to reduce the level of uric acid the doctor administered him allopurinol. Allopurinol is the competitive inhibitor of the following enzyme:
  2. Xanthine oxidase
  3. Adenosine deaminase
  4. Adenine phosphoribosyltransferase
  5. Hypoxanthine-phosphoribosyltransferase
  6. Guanine deaminase

 

  1. A 40-year-old female patient diagnosed with acute pancreatitis has been delivered to the admission department of a regional hospital. What drug should be administered the patient in the first place?
  2. Contrycal
  3. Platyphyllin
  4. Atropine
  5. Metacin
  6. Pirenzepine

Reason: Contrycal is a choice of drug for treating acute pancreatitis. JUST ACUTE.

 

  1. A patient consulted a doctor about being unable to abduct his right arm after a past trauma. Examination revealed that the passive movements were not limited. The patient was found to have the atrophy of the deltoid muscle. What nerve is damaged?
  2. Axillary
  3. Radial
  4. Ulnar
  5. Median
  6. Suprascapular

Reason: The axillary nerve innervates the posterior part of the deltoid muscle.

 

  1. After a trauma of the upper third of the anterior forearm a patient exhibits difficult pronation, weakening of palmar flexor muscles and impaired skin sensitivity of 1-3 fingers. Which nerve has been damaged?
  2. medianus
  3. musculocutaneus
  4. ulnaris
  5. cutaneus antebrachii medialis
  6. radialis

Reason: The median nerve innervates the first three fingers in the palmar surface.

 

  1. A 38-year-old female patient complains of general weakness, cardiac pain, increased appetite, no menstruation. Objectively: the height is 166 cm, weight 108 kg, the patient has moon-shaped face, subcutaneous fat is deposited mainly in the upper body, torso and hips. There are also blood-red streaks. Ps- 62/min, AP160/105 mm Hg. Which of the following diseases is the described pattern of obesity most typical for?
  2. Cushing pituitary basophilism
  3. Alimentary obesity
  4. Myxedema
  5. Insulinoma
  6. Babinski-Frohlich syndrome

Reason: Cushing pituitary basophilisim- caused by an ACTH (Adrenocorticotropic Hormone) secreting basophil adenoma of the pituitary gland. One of the main clinical manifestation of Cushing’s disease is MOON SHAPED FACE.

 

  1. A 60-year-old patient with a long history of atherosclerosis and a previous myocardial infarction developed an attack of retrosternal pain. 3 days later the patient was hospitalized and then died of progressive cardiovascular insufficiency. At autopsy a white fibrous depressed area about 3 cm in diameter with clear boundaries was found in the posterior wall of the left ventricle and interventricular septum. The dissector evaluated these changes as:
  2. Focal cardiosclerosis
  3. Myocardial ischemia
  4. Myocardial infarction
  5. Myocarditis
  6. Myocardial degeneration

Reason: This characterized y a clear boundary and uniform distribution of fibrous tissue in a defined area.

 

  1. Measurements of the arterial pCO2 and pO2 during an attack of bronchial asthma revealed hypercapnia and hypoxemia respectively. What kind of hypoxia occurred in this case?

 

  1. Respiratory
  2. Hemic
  3. Circulatory
  4. Tissue
  5. Histotoxic

Reason: Only Respiratory hypoxia can occur in Bronchial Asthma.

 

  1. A female patient with bronchial asthma had taken prednisolone tablets (1 tablet 3 times a day) for 2 months. Due to a significant improvement of her condition the patient suddenly stopped taking it. What complication is likely to develop in this case?
  2. Withdrawal syndrome
  3. Cushing’s syndrome
  4. Gastrorrhagia
  5. Upper body obesity
  6. Hypotension

Reason: also called a discontinuation syndrome is a set of symptoms occurring in discontinuation or dosage reduction of some types of medications.

 

  1. A patient with suspected dysentery has been admitted to the infectious diseases hospital. Which basic method of laboratory diagnosis must be applied in the first place?
  2. Bacteriological
  3. Serological
  4. Allergic
  5. Biological
  6. Microscopic

Reason: To diagnose Dysentery caused by S. dysentery, a Bacteriological exam should be conducted (culture or smear).

 

  1. During a surgery with the use of hygronium the patient had an abrupt fall in blood pressure. Blood pressure can be normalized by the representatives of the following drug group:
  2. α-adrenergic agonists
  3. α- blockers C. Ganglionic blockers
  4. M-cholinergic agents
  5. N-cholinergic agents

Reason: Hygronium provide short term ganglion-blocking action and is suitable for anesthetic practice for controlled hypotension.

 

  1. A patient with respiratory failure has blood pH of 7,35. pCO2 test revealed hypercapnia. Urine pH test revealed an increase in the urine acidity. What form of acid-base imbalance is the case?
  2. Compensated respiratory acidosis
  3. Compensated metabolic acidosis
  4. Decompensated metabolic acidosis
  5. Compensated respiratory alkalosis
  6. Decompensated respiratory alkalosis

Reason: Hypercapnia shows Respiratory acidosis, a pH of 7.35 shows compensation.

 

  1. On examination a patient was found to have medial strabismus, the inward deviation of the eyeball and inability to abduct the eyeball outwards. What nerve is damaged?
  2. Abducent
  3. Oculomotor
  4. Ocular
  5. Trochlear
  6. Visual

Reason: Easy, Abducens nerve is responsible for abduction of eyeball.

 

  1. A patient with a dislocated shoulder had been admitted to a hospital. With the purpose of skeletal muscle relaxation he was given an injection of relaxant dithylinum acting normally 5-7 minutes. However, the effect of dithylinum in this patient lasted up to 8 hours. What is the most likely cause of the prolonged effect of dithylinum in this patient?
  2. Genetic deficiency of blood cholinesterase
  3. Reduced activity of microsomal liver enzymes C. Reduced drug excretion
  4. Material accumulation of the drug
  5. Potentiation by another drug

Reason: Dithyilinum is a myorelaxant which destroys pseudocholinesterase and breaks down into choline and succinic acid.

 

  1. As a result of an injury of the knee joint a patient shows a drawer sign, that is the anterior and posterior displacement of the tibia relative to the femur. What ligaments are damaged?
  2. Cruciate ligaments
  3. Arcuate popliteal ligaments
  4. Oblique popliteal ligament
  5. Interosseous membrane
  6. Collateral ligaments

Reason: “drawer sign”- the ability to move tibia forward when the femur is fixed is a positive drawer sign which indicates rupture of only cruciate ligaments.

 

  1. The neurosurgical department has admitted a 54-year-old male complaining of no sensitivity in the lower eyelid skin, lateral surface of nose, upper lip. On examination the physician revealed the inflammation of the second branch of the trigeminal nerve. This branch comes out of the skull through the following foramen:
  2. Round foramen
  3. Lacerated foramen
  4. Oval foramen
  5. Spinous foramen
  6. Superior orbital fissure

Answer: The Maxillary nerve leaves the cranium through the Round Foramen.

 

  1. Bacteriological examination of purulent discharges from the urethra revealed some gram-negative beanshaped bacteria located in the leukocytes. They can be identified as the causative agent of the following disease:
  2. Gonorrhea
  3. Syphilis
  4. Venereal lymphogranulomatosis
  5. Chancroid
  6. Trichomoniasis

Reason: Neissera gonorrhea is a gram – bacteria, bean shaped and normally inhabits the Urinary tract.

 

  1. A male patient is 28 years old. Histological study of a cervical lymph node revealed a change of its pattern due to the proliferation of epithelioid, lymphoid cells and macrophages having nuclei in form of a horseshoe. In the center of some cell clusters there were non-structured lightpink areas with fragments of nuclei. What disease are these changes typical for?
  2. Tuberculosis
  3. Hodgkin’s disease
  4. Actinomycosis
  5. Tumor metastasis
  6. Syphilis

Reason: Pirogov-Langhans cells are formed by a fusion of epitheloid cells and are arranged in a horseshoe pattern, this is specific for granulomatous diseases e.g Tuberculosis, Sarcoidosis.

 

  1. A 35-year-old male patient has been referred by an andrologist for the genetic counselling for the deviations of physical and mental development. Objectively: the patient is tall, has asthenic constitution, gynecomastia, mental retardation. Microscopy of the oral mucosa cells revealed sex chromatin (single Barr body) in 30 % of cells. What is the most likely diagnosis?
  2. Klinefelter syndrome
  3. DiGeorge syndrome
  4. Down syndrome
  5. Recklinghausen’s disease
  6. Cushing pituitary basophilism

Reason: Klinefelter’s syndrome- 47 XXY. A condition in which there is an addition of a barr body in the male karyotype.

 

  1. A patient with jaundice has high total bilirubin that is mainly indirect

(unconjugated), high concentration of stercobilin in the stool and urine. The level of direct (conjugated) bilirubin in the blood plasma is normal. What kind of jaundice can you think of?

  1. Hemolytic
  2. Parenchymal ( hepatic )
  3. Mechanical
  4. Neonatal jaundice
  5. Gilbert’s disease

Reason: Hemolytic jaundice- blood protein ALBUMIN carries unconjugated bilirubin from the spleen to the liver where it is converted to conjugated bilirubin. So the destruction will lead to an increased number of unconjugated bilirubin.

 

  1. A male with a lesion of one of the CNS parts has asthenia, muscular dystonia, balance disorder. Which CNS part has been affected?
  2. Cerebellum
  3. Black substance
  4. Reticular formation
  5. Red nuclei
  6. Vestibular nuclei

 

Reason:  The Cerebellum is responsible for balance and co-ordination of movements.

 

 

  1. A 50-year-old patient has been administered laevomycetin for the treatment of typhoid fever, but on the next day the patient’s condition worsened, the temperature rose to 39,60C. The deterioration of the patient’s condition can be explained by:
  2. Effects of endotoxins of the causative agent
  3. Allergic reaction
  4. Insensitivity of the pathogen to levomycetin
  5. Secondary infection
  6. Re-infection

Reason: Laevomycetin is a Bactericidal drug, when it kills the bacteria, its cell wall breaks down and the endotoxins contained in the bacteria are released into the blood therefore causing such reaction.

 

  1. A 12-year-old patient has been admitted to a hospital for hemarthrosis of the knee joint. From early childhood he suffers from frequent bleedings. Diagnose the boy’s disease:
  2. Hemophilia
  3. Hemorrhagic vasculitis
  4. Hemolytic anemia
  5. B12 (folic acid)-deficiency anemia
  6. Thrombocytopenic purpura

Reason: Haemophilia  is a group of hereditary genetic disorders that impairs the body’s ability to control blood clotting, which is used to stop bleeding when a blood vessel is broken. Characteristic sign is Hemarthrosis(bleeding in joints).

 

  1. Examination of a patient with ischemic heart disease revealed the impaired venous blood flow in the territory of the cardiac vein running in the anterior interventricular sulcus of heart. What vein is it?
  2. cordis magna
  3. cordis media
  4. cordis parva
  5. posterior ventriculi sinistri
  6. obliqua atrii sinistri

 

  1. For the direct injection of medications into the liver surgeons use the round ligament of liver. This manipulation involves bougienage (lumen dilatation) of the following vessel:
  2. umbilicalis
  3. umbilicalis
  4. Ductus venosus
  5. porta
  6. hepatica propria

Reason: The round ligament is a remnant of vena umbilicus in the fetal stage of life.

 

  1. A patient with lobar pneumonia has had body temperature of 39oC with daily temperature fluctuation of no more than 1oC for 9 days. This fever can be characterized by the following temperature curve:
  2. Persistent
  3. Hectic
  4. Remittent
  5. Hyperpyretic
  6. Recurrent

Reason: Persistent or Continuous Fever increases not more than 10C for days. In Febris recurrens, there are periods of rising temp (5-8days), and periods of normal temp. In Febris hectica, there is daily fluctuation of up to 3-4oC. In Febris remittens (indulgence fever), fluctuation between morning and evening temps is 1-2oC.

 

  1. The temperature in a production room is 36oC. Relative air humidity is 80 %. Under these conditions the human body transfers heat mainly through:
  2. Sweat evaporation
  3. Heat conduction
  4. Radiation
  5. Convection

Reason: A Human body in an Empty room will only lose heat through evaporation.

 

  1. A hospitalized patient bitten by a rabid animal has an avulsive wound of shin. What kind of vaccine must be given to prevent rabies?
  2. Anti-rabies vaccine
  3. DTaP
  4. Td
  5. BCG
  6. TABte

Reason: Anti-rabies vaccine is a vaccine administered to prevent rabies.

 

  1.   At autopsy the occipital lobe of brain was found to have a cavity 2,5×1,5 cm large filled with a transparent liquid. The cavity had smooth brownish walls. What process had developed in the brain?
  2. Cyst on the site of a hemorrhage
  3.   Softening of the cerebrocortical grey matter
  4.   Brain abscess
  5. Paracephalia
  6. A cyst on the site of the softening of the cerebrocortical grey matter

Reason: Cyst is a sac-like pocket of tissue that contains clear fluid, air or other substances.

 

  1.   A child entering the school for the first time was given Mantoux test in order to determine if there was a need for revaccination. The reaction was negative. What is the meaning of this test result?
  2. No cell-mediated immunity to tuberculosis
  3. Availability of cell-mediated immunity to tuberculosis
  4. No antibodies to the tuberculosis bacteria
  5. No anti-toxic immunity to tuberculosis
  6. Presence of antibodies to the tuberculosis bacteria

 

Reason: A positive test would indicate that the boy has antibodies to M. Tuberculosis but the child had a negative reaction.

 

 

  1. Study of the biopsy material revealed a granuloma consisting of lymphocytes, plasma cells, macrophages with foamy cytoplasm (Mikulicz cells), many hyaline globules. What disease can you think of?
  2. Rhinoscleroma
  3. Leprosy
  4. Syphilis
  5. Tuberculosis
  6. Actinomycosis

Reason: Mikulicz cells are large vacuolated histiocytes that contain Klebsiella rhinoscleromatis.

 

  1. Autopsy of a 78-year-old patient revealed that retroperitoneal tissue was soaked with blood, the abdominal aorta had a sacciform protrusion including a defect with irregular edges. The wall of the aorta was here and there of stone-like density. This is the complication of the following disease:
  2. Atherosclerosis
  3. Essential hypertension
  4. Systemic vasculitis
  5. Visceral syphilis
  6. Marfan syndrome

Reason: Atherosclerosis is the accumulation of lipids in the Aorta and Arteries.

 

  1. Glycogen polysaccharide is synthesized from the active form of glucose. The immediate donor of glucose residues during the glycogenesis is:
  2. UDP-glucose
  3. Glucose-1-phosphate
  4. ADP-glucose
  5. Glucose-6-phosphate
  6. Glucose-3-phosphate

Reason: UDP glucose is a precursor of glycogen and can be converted into UDP galactose and UDP glucaronic acid which can be used as substrates by the enzyme that makes polysaccharide.

 

  1. After the diagnostic tests a 40-yearold male has been referred for the lymphography of the thoracic cavity. The surgeon revealed that the tumor had affected an organ whose lymphatic vessels drain directly into the thoracic duct.Specify this organ:
  2. Esophagus
  3. Trachea
  4. Left main bronchus
  5. Heart
  6. Pericardium

 

  1. A patient with biliary dyskinesia and constipations has been prescribed a cholagogue having also a laxative effect. What drug has been administered?
  2. Magnesium sulfate
  3. Allochol
  4. Cholosas
  5. Cholenzyme
  6. Nicodinum

Reason: Magnesium sulfate (commonly called ‘mixture of magnesium’ or ‘MixMag’ is one of the few drugs which has both a laxative and a cholagogue effect.

 

  1. It is known that individuals with genetically caused deficiency of glucose6-phosphate dehydrogenase may develop RBC hemolysis in response to the administration of some antimalarial drugs. Manifestation of adverse reactions to drugs is called:
  2. Idiosyncrasy
  3. Allergy
  4. Sensibilization
  5. Tachyphylaxis
  6. Tolerance

Reason: Drug idiosyncrasy is untoward reaction to drug that occur in a small fraction of patients and have no obvious relationship to dose or duration.

 

  1. A 40-year-old patient with the progressing staphylococcal purulent periodontitis developed purulent inflammation of bone marrow spaces of the alveolar process, and then of the body of mandible. Microscopy revealed thinning of bone trabeculae, foci of necrosis, bone sequesters surrounded by the connective tissue capsule. What is the most likely diagnosis?
  2. Chronic osteomyelitis
  3. Acute osteomyelitis
  4. Parodontome
  5. Chronic fibrous periostitis
  6. Purulent abscess

Reason: The diagnosis is Osteomyelitis, and it is Chronic because because bone sequesters have appeared and it has been a progressing disease.

 

  1. Curariform substances introduced into a human body cause the relaxation of all skeletal muscles. What changes in the neuromuscular synapse cause this phenomenon?
  2. Blockade of N-cholinergic receptors of the synaptic membrane
  3. Impaired acetylcholine release
  4. C. Blockade of Ca2+ channels of the presynaptic membrane
  5. Impaired cholinesterase synthesis
  6. Depolarization of the postsynaptic membrane

Reason: N- Cholinergic receptors are found in sympathetic nervous system (skeletal muscle).

 

  1. A number of diseases can be diagnosed by evaluating activity of blood transaminases. What vitamin is one of cofactors of these enzymes?
  2. B 6
  3. B2 B1
  4. B8
  5. B5

Reason: Vitamin B6 one of the co factors of blood transaminase.

 

  1. After a car accident a 23-year-old male presented to the hospital with a cut wound of the anteromedial region of shoulder and arterial bleeding. Which artery was damaged?
  2. brachialis
  3. radialis
  4. axillaris
  5. subscapularis
  6. profunda brachi

Reason: This is the route of the brachial artery along the upper arm.

 

  1. During the operation on the small intestine the surgeon revealed an area of the mucous membrane with a single longitudinal fold among the circular folds. Which portion of the small intestine is this structure typical for?
  2. Pars descendens duodeni
  3. Pars horizontalis duodeni
  4. Pars ascendens duodeni
  5. jejunum
  6. Distal ileum

Reason: The longitudinal fold occurs as a result of the invagination of the bile duct running along the wall of the descending part of the duodenum.

 

  1. 14 days after quinsy a 15-year-old child presented with morning facial swelling, high blood pressure, “meat slops” urine. Immunohistological study of a renal biopsy sample revealed deposition of immune complexes on the basement membranes of the capillaries and in the glomerular mesangium. What disease developed in the patient?
  2. Acute glomerulonephritis
  3. Acute interstitial nephritis
  4. Lipoid nephrosis
  5. Acute pyelonephritis
  6. Necrotizing nephrosis

Reason: In acute glomerulonephritis urine is meat slop color, increased blood pressure, edema.

 

  1. A diseased child has a high fever, sore throat, swelling of submandibular lymph nodes. Objectively: pharyngeal mucosa is edematous, moderately hyperemic, the tonsils are enlarged, covered with grayish membrane tightly adhering to the tissues above. Attempts to remove the membrane produce the bleeding defects. What disease are these presentations typical for?
  2. Diphtheria
  3. Catarrhal tonsillitis
  4. Scarlet fever
  5. Meningococcal disease
  6. Measles

Reason: Diptheria has the characteristics symptoms above and has grayish membranes that adhere to the palate and bleeds when they are removed.

 

  1. Study of the biopsy material of an embryo revealed a zone of developmental abnormality in a somite. The zone was located close to the endoderm and the notochord. What formations may have abnormal development in case of pregnancy continuation?
  2. Skeletal tissues
  3. Genito-urinary system
  4. Skeletal striated muscle tissue
  5. Cardiac striated muscle tissue
  6. Fibrous connective tissue of skin

Reason: The zone being asked about is the Mesoderm which is located between the Endoderm and notochord. The mesoderm forms the skeletal muscles through a process called Myogenesis.

 

  1. A smear of sputum from the patient with suspected lobar pneumonia was stained with the use of the following stains and reagents: solution of gentian violet, Lugol’s solution, 96o alcohol, water magenta.What staining method was applied in this case?
  2. Gram
  3. Ziehl-Nielsen
  4. Romanovsky
  5. Neisser
  6. Leffler

Reason: The staining method described above is Gram stain.

 

  1. A patient has normally coloured stool including a large amount of free fatty acids. The reason for this is a disturbance of the following process:
  2. Fat absorption
  3. Fat hydrolysis
  4. Biliary excretion
  5. Choleresis
  6. Lipase secretion

Reason: When fatty stool occurs, there’s a problem with the absorption of fat. Can be as a result of Pancreatitis or Cholecystitis.

 

  1. Examination of the removed stomach revealed a deep roundish defect with regular edges at the lesser curvature of the antrum. The defect reached the muscular tunic and was 1,5 cm in diameter. Within the defect floor there was a translucent dense area resembling of a hyaline cartilage. What process had developed in the floor of the stomach defect?
  2. Local hyalinosis
  3. Amyloidosis
  4. Mucoid swelling
  5. Fibrinoid alterations
  6. General hyalinosis

Reason: Hyalinosis occurs as a result of deposits of hyaline membranes. It isn’t general hyalinosis because the process is occurring in the antrum.

 

  1. By the decarboxylation of glutamate in the CNS an inhibitory mediator is formed. Name it:
  2. GABA
  3. Glutathione
  4. Histamine
  5. Serotonin
  6. Asparagine

Reason: Glutamate is converted to GABA by glutamate decarboxylase.

 

  1. Thermometry revealed that the temperature of the exposed skin is by 11,5o lower than the temperature of the adjacent areas covered with clothing from natural fabrics. The reason for this is that the clothes reduce the heat loss through:
  2. Convection
  3. Radiation
  4. Conduction
  5. Evaporation

Reason: Convection is heat loss through fluids, the parts covered with fabrics will keep the moisture in thereby preventing heat loss.

 

  1. A specimen of pia mater includes a vessel whose wall doesn’t have the tunica media, the tunica externa is adherent to the surrounding tissues, the intima is composed of a basement membrane and endothelium. What vessel is it?
  2. Nonmuscular vein
  3. Muscular vein with underdeveloped muscular elements
  4. Muscular artery
  5. Arteriole
  6. Artery of mixed type

Reason: Veins do not have tunica Media because they do not contract. Tunica media usually contain the muscular layer of arteries.

 

  1. A patient with extensive burns of torso skin exhibits signs of severe intoxication. What stage of the burn disease is this typical for?
  2. Burn toxemia
  3. Burn shock
  4. Burn infection
  5. Burn emaciation
  6. Terminal

Reason: Decomposed burned tissues cause septic toxemia.

 

  1. As a result of a craniocerebral injury a patient has a decreased skin sensitivity. What area of the cerebral cortex may be damaged?
  2. Posterior central gyrus
  3. Occipital region
  4. Cingulate gyrus
  5. Frontal cortex
  6. Anterior central gyrus

Reason: The lateral postcentral gyrus is a prominent structure in the parietal lobe of the human brain. It is the location of the primary somatosensory cortex, the main sensory receptive area for the sense of touch.

 

  1. A histological specimen of the eyeball shows a biconvex structure connected to the ciliary body by the fibers of the Zinn’szonuleand covered with a transparent capsule. Name this structure:
  2. Crystalline lens
  3. Vitreous body
  4. Ciliary body
  5. Cornea
  6. Sclera

Reason: Like duhh! What else could it be?

 

  1. A comatose patient was taken to the hospital. He has a history of diabetes mellitus. Objectively: Kussmaul breathing, low blood pressure, acetone odor of breath. After the emergency treatment the patient’s condition improved. What drug had been administered to the patient?
  2. Insulin
  3. Adrenaline
  4. Isadrinum
  5. Glibenclamide
  6. Furosemide

Reason: Patient is in a hyperglycemic coma and should be give insulin to reduce blood sugar.

 

  1. In order to stimulate breathing in a child born with asphyxia, the doctor gave him a drug injection into the umbilical vein. What drug might have been injected?
  2. Aethimizolum
  3. Corazolum
  4. Cordiaminum
  5. Sulfocamphocainum
  6. Coffeinum

Reason: Aethimizolum is an analeptic drug used to stimulate breathing.

 

  1. A patient complains of pain in the right lateral abdomen. Palpation revealed a dense, immobile, tumor-like formation. A tumor is likely to be found in the following part of the digestive tube:
  2. Colon ascendens
  3. Colon transversum
  4. Colon descendens
  5. Colon sigmoideum
  6. Caecum

Reason: This part of the large intestine is located on the right lateral part of the abdomen.

 

  1. A patient underwent biopsy of the soft palate arches for a suspected tumor (macroscopy revealed an ulcer with a dense floor).Study of the biopsy material revealed mucosal necrosis with infiltration of lymphocytes, epithelioid cells, plasma cells, single neutrophils in the submucosa. There were also apparent signs of endovasculitis and perivasculitis. The described changes are typical for:
  2. Primary syphilis
  3. Aphthous stomatitis
  4. Ulcerative stomatitis
  5. Necrotizing ulcerative Vincent stomatitis
  6. Pharyngeal diphtheria

Reason: The bolded sentence describes a “Hard Chancre” which is the characteristic sign of Primary Syphilis.

 

  1. Healthy parents with unremarkable family history have the child with multiple developmental defects. Cytogenetic analysis revealed the trisomy 13 in the somatic cells (Patau syndrome). What phenomenon has caused the defects?
  2. Abnormal gametogenesis
  3. Somatic mutation
  4. Recessive mutation
  5. Dominant mutation
  6. Chromosomal mutation

Reason: Patau syndrome is a syndrome caused by a chromosomal abnormality, in which some or all of the cells of the body contain extra genetic material from chromosome 13.

 

  1. A specimen shows an organ covered with the connective tissue capsule with trabeculae radiating inward the organ. There is also cortex containing some lymph nodules, and medullary cords made of lymphoid cells.What organ is under study?
  2. Lymph node
  3. Thymus
  4. Spleen
  5. Red bone marrow
  6. Tonsils

Reason: lol! By now if you don’t know it’s a lymph node, you might need EPP!

 

  1. A 25-year-old patient consulted a doctor about dysmenorrhea and infertility. Examination revealed that the patient was 145 cm high and had underdeveloped secondary sex characteristics, alar folds on the neck. Cytological study didn’t reveal any Barr bodies in the somatic cells. What diagnosis was made?
  2. Turner’s syndrome
  3. Klinefelter syndrome
  4. Morris syndrome
  5. Trisomy X syndrome

Reason: Turners syndrome- 47X0 Seen in females. Patient has underdeveloped secondary characteristics due to the absence of one X chromosome.

 

  1. To prevent attacks of acute pancreatitis a doctor prescribed the patient trasylol

(contrycal, gordox), which is an inhibitor of:

  1. Trypsin
  2. Elastase
  3. Carboxypeptidase
  4. Chymotrypsin
  5. Gastricsin

Reason: Contrycal inhibits trypsin, kallikrein and plasmin

 

  1. A patient died from progressive heart failure. Autopsy revealed that the heart was enlargedin diameter, flabby. The muscle section exhibited irregular blood supply. Histological study of myocardium revealed hyperemia, the stroma was found to have lymphohistiocytic infiltrates with degeneration of cardiomyocytes.The revealed morphological changes are indicative of:
  2. Non-purulent interstitial myocarditis
  3. Venous plethora
  4. Cardiomyoliposis
  5. Cardiosclerosis
  6. Myocardial infarction

Reason: First of all, We can see it’s Myocarditis, enlarged heart, degeneration of cardiomyocytes …blah blah blah… it’s non purulent because its infiltrated with lymphocytes. In a purulent course, neutrophils will show prevalence in the infiltrates.

 

  1. A 13-year-old teenagerunderwent X-ray examination of the hip joint. Examination revealed a 3 mm wide radiolucent zone between the head and the shaft of femur. This situation should be evaluated as:
  2. Normal (incomplete process of ossification)
  3. Fracture of the femoral neck
  4. Fissured fracture of the femoral neck
  5. Dislocation of the femoral head
  6. Radiographic film artifact

Reason: Normal Ossification between Head and shaft of femur and the three pelvic bones occurs at the age of 14-16 years.

 

  1. A surgeon examined the patient and found the injury of the upper third of the kidney. Considering the syntopy of the left kidney, the intactness of the following organ should be checked at the same time:
  2. Stomach
  3. Liver
  4. Small intestine
  5. Transverse colon
  6. Descending colon

Reason: The other options are not close to the left kidney…it’s that clear..I hope.

 

  1. A patient with urolithiasis has unbearable spasmodic pain. To prevent pain shock, he has been given an injection of atropine along with a narcotic analgesic having antispasmodic effect. What drug was it?
  2. Promedol
  3. Nalorphine
  4. Tramadol
  5. Ethylmorphine hydrochloride
  6. Morphine hydrochloride

Reason: Promedol is a drug which has a narcotic analgesic effect, an antispasmodic effect and can be administered together with atropine.  

 

  1. Despite the administration of cardiotonics and a thiazide diuretic a patient with chronic heart failure has persistent edemata, there is a risk of ascites. What medication should be administered in order to enhance the diuretic effect of the drugs used?
  2. Spironolactone
  3. Furosemide
  4. Amiloride
  5. Clopamide
  6. Manithol

Reason: Spironolactone is an inhibitor of aldosterone and aids in the elimination of fluid.

 

  1. A patient with a pathology of the cardiovascular system developed edemata of the lower extremities. What is the mechanism of cardiac edema development?
  2. Increased hydrostatic pressure at the venous end of the capillary
  3. Increased oncotic pressure
  4. Increased hydrostatic pressure at the arterial end of the capillary
  5. Reduced osmotic pressure
  6. Lymph efflux disorder

    Reason: Hydro(water), Stasis(stagnation) occurs mostly when the blood in veins can’t go back to the heart due to a Cardiovascular disease e.g Right-sided Heart failure, Inferior Vena Cava Syndrome e.t.c.

 

  1. During the fight, a man had a cardiac arrest due to the strong blow to the upper region of the anterior abdominal wall. Which of the following mechanisms has led to the cardiac arrest?
  2. Parasympathetic unconditioned reflexes
  3. Sympathetic unconditioned reflexes
  4. Parasympathetic conditioned reflexes
  5. Sympathetic conditioned reflexes
  6. Peripheral reflexes

Reason: First of all, you should note that this was an unconditioned reflex since one cannot have control over cardiac activity …Secondly, A sympathetic response would cause increase of heart activity not reduction or arrest.

 

  1. A pregnant woman underwent AB0 blood typing. Red blood cells were agglutinated with standard sera of the I and II blood groups, and were not agglutinated with the III group serum. What is the patient’s blood group?
  2. B(III)
  3. 0(I)
  4. A(II)
  5. AB(IV)

Reason: Absence of agglutination in the III blood group indicates the blood group B

 

  1. Amniocentesis revealed two sex chromatin bodies (Barr bodies) in each cell of the sample. What disease is this character typical for?
  2. Trisomy X
  3. Klinefelter syndrome
  4. Turner’s syndrome
  5. Down’s syndrome
  6. Patau syndrome

Reason: Trisomy X =47, XX

  1. A hospital has admitted a patient complaining of abdominal bloating, diarrhea, flatulence after eating protein foods. These signs are indicative of the impaired digestion of proteins and their increased degradation. Which of the following compounds is the product of this process?
  2. Indole
  3. Bilirubin
  4. Cadaverine
  5. Agmatine
  6. Putrescine

Reason: Indole can be produced by bacteria as a degradation of amino acid Tryptophan, it occurs in human feces and has an intense fecal odor.

 

  1. An attack of tachycardia that occurred in a patient was stopped by pressing on his eyeballs. Which of the following reflexes underlies this phenomenon?
  2. Aschner
  3. Goltz
  4. Bainbridge
  5. Hering
  6. Bernard’s

Reason: Aschner reflex is a decrease in pulse rate associated with traction on extra ocular muscles or compression of the eyeballs.

 

  1. A male patient has been diagnosed with acute post-streptococcal glomerulonephritis. It is most likely that the lesion of the basement membrane of renal corpuscles was caused by the following allergic reaction:
  2. Immune complex
  3. Anaphylactic
  4. Cytotoxic
  5. Delayed
  6. Stimulating

Reason: This is the 3rd type of allergy reaction. The complex was formed by the Streptococcal antigen and the human antibody.

 

  1. An unconscious patient was taken by ambulance to the hospital. On objective examination the patient was found to have no reflexes, periodical convulsions, irregular breathing. After laboratory examination the patient was diagnosed with hepatic coma. Disorders of the central nervous systemdevelop due to the accumulation of the following metabolite:
  2. Ammonia
  3. Urea
  4. Glutamine
  5. Bilirubin
  6. Histamine

Reason: In Hepatic coma, ammonia would not be converted to urea. Excess ammonia then crosses blood-brain barrier and causes HEPATIC ENCEPHALOPATHY.

 

  1. A 20-year-old male patient complains of general weakness, rapid fatigability, irritability, decreased performance, bleeding gums, petechiae on the skin. What vitamin deficiency may be a cause of these changes?
  2. Ascorbic acid
  3. Riboflavin
  4. Thiamine
  5. Retinol
  6. Folic acid

 

Reason: Deficiency of Vitamin C leads to the following illnesses.

 

  1. It is known that the monoamine oxidase(MAO) enzyme plays an important part in the metabolism of catecholamine neurotransmitters. In what way does the enzyme inactivate these neurotransmitters (norepinephrine, epinephrine, dopamine)?
  2. Oxidative deamination
  3. Addition of an amino group
  4. Removal of a methyl group
  5. Carboxylation
  6. Hydrolysis

Reason: MAO only catalyze Oxidative deamination of monoamines( Oxygen is used to remove an amine group from a molecule, resulting in aldehyde and ammonia)

 

 

  1. 101. The cellular composition of exudate largely depends on the etiological factor of inflammation. What leukocytes are the first to get into the focus of inflammation caused by pyogenic bacteria?
  2. Neutrophil granulocytes
  3. Monocytes
  4. Myelocytes
  5. Eosinophilic granulocytes
  6. Basophils

Reason: Neutrophils are markers for inflammation due to the fact that they increase in the blood during inflammation caused by a bacteria

 

  1. At the end of the working day a worker of a hot work shop has been delivered to a hospital. The patient complains of a headache, dizziness, nausea, general weakness. Objectively: the patient is conscious, his skin is hyperemic, dry, hot to the touch. Heart rate is of 130/min. Respiration is rapid, superficial. What disorder of thermoregulation is most likely to have occurred in this patient?
  2. Reduced heat transfer
  3. Increased heat transfer and reduced heat production
  4. Increased heat transfer and heat production
  5. Increased heat production with no changes to the heat transfer
  6. Reduced heat production with no changes to the heat transfer

 

Reason: The symptoms show that there was no heat loss from the patient. No heat transfer occurred.

 

  1. Alveolar space of the acinus was invaded by some bacteria which interacted with the surfactant. This led to the activation of the cells that are localized in the alveolar walls and on the surface. What cells are these?
  2. Alveolar macrophages
  3. Alveolocytes type I
  4. Endothelial cells
  5. Clara cells
  6. Alveolocytes type II

Reason: These are the names of macrophages found in the lungs.

 

  1. A 35-year-old male developed acute heart failure while running for a long time. What changes in the ionic composition can be observed in the cardiac muscle?
  2. Accumulation of Na+ and Ca2+ ions in the myocardium cells
  3. Accumulation of K+ and Mg2+ ions in the myocardium cells
  4. Reduction of Na+ and Ca2+ ions in the myocardium cells
  5. Reduction of K+ and Mg2+ ions in the extracellular space
  6. Reduction of Na+ and Ca2+ ions in the

extracellular space

Reason:  Hypercalcemia will cause inhibition of depolarization, it increases the threshold of depolarization and causes abnormal rhythm in contraction, which leads to acute heart failure.

 

  1. Workers of a conveyor workshop received recommendations for the effective organization of working time and higher working efficiency. What peculiarity of work in this workshop causes the greatest stress for the workers?
  2. Monotony of work
  3. State of “operating rest”
  4. Increased intellectual component
  5. Increased responsibility
  6. Social inefficiency of labor

Reason: Monotony of work is the quality of wearisome consistency, routine and lack of variety. Same thing everyday

 

  1. Mother of a boy who had recently returned from a summer camp found some small whitish insects up to 3 mm long on the child’s clothing. Specify the parasite:
  2. Pediculus humanus humanus
  3. Phtirus pubis
  4. Pulex irritans
  5. Cimex lectularius
  6. Blattella germanica

Reason: Only pediculus humanus would adhere to the body of humans, that’s why it is also called Body louse.

 

  1. Histological examination of the removed skin neoplasm revealed clusters and cords of atypical cells of stratified squamous epithelium, growing into the underlying tissue. What diagnosis can be assumed?
  2. Non-keratinizing squamous cell carcinoma
  3. Keratinizing squamous cell carcinoma
  4. Carcinoma in situ
  5. Papilloma
  6. Adenoma

Reason: Skin neoplasms are poorly differentiated squamous carcinomas, they contain more pleomorphic cells and have no keratinization.

 

  1. An 18-year-old male has been diagnosed with Marfan syndrome. Examination revealed a developmental disorder of connective tissue and eye lens structure, abnormalities of the cardiovascular system, arachnodactylia. What genetic phenomenon has caused the development of this disease?
  2. Pleiotropy
  3. Complementarity
  4. Codominance
  5. Multiple allelism
  6. Incomplete dominance

Reason: Marfan syndrome is a genetic disorder of connective tissue. Pleiotropy is when one gene influences 2 or more unrelated phenotypic traits. Basically a multi-system affection caused by mutation of one gene.

 

  1. A patient has severe catarrhal symptoms. Material growth on BordetGengou agar showed mercury-droplike colonies. Examination of the blood smears revealed some small ovoid grampositive bacilli sized 1-3 microns. What microorganisms were isolated?
  2. Bordetella
  3. Corynebacteria
  4. Mycobacteria
  5. Meningococcus
  6. Brucella

Reason: Bordetella on agar has the characteristic mecury-droplike colony.

 

  1. A 66-year-old patient with Parkinson’s disease shows an improvement in locomotor activity after prolonged use of a certain drug which is converted to dopamine by the decarboxylation. What drug has the patient taken?
  2. Levodopa
  3. Naloxone
  4. Celecoxib
  5. Droperidol
  6. Chlorpromazine

Reason:  Parkinson’s disease occurs when there is death of cells in the substantia nigra which leads to decrease amount of dopamine. Levodopa is a precursor to dopamine used to treat this disease.

 

  1. Enzymatic jaundices are accompanied by abnormal activity of UDPglucurony transferase. What compound is accumulated in blood serum in case of these pathologies?
  2. Unconjugated bilirubin
  3. Conjugated bilrubin
  4. Dehydrobilirubin
  5. Hydrobilirubin
  6. Choleglobin

Reason: UDP glucuronyl transferase is in charge of converting unconjugated bilirubin to conjugated bilirubin in the liver. So an abnormal activity of this enzyme will lead to an increase of unconjugated bilirubin in the blood serum.

 

  1. For the study of serum proteins various physical and physicochemical methods can be used. In particular, serum albumins and globulins can be separated by this method:
  2. Electrophoresis
  3. Polarography
  4. Dialysis
  5. Spectrography
  6. Refractometry

Reasons: Electrophoresis is a technique used in laboratories in order to separate macromolecules based on size such as proteins.

 

  1. Negative environmental factors have caused the dysfunction of myosatellite cells. What function of the whole muscle fibre is likely to be changed in this case?
  2. Regeneration
  3. Contraction
  4. Trophism
  5. Contractile thermogenesis
  6. Relaxation

Reason: Myosatellite cells are responsible for the regeneration of muscle fibres.

 

  1. The laboratory for especially  dangerous infections conducts microscopic examination of pathological material from a patient with suspected plague. The sample was stained by BurriGins technique. What property of the causative agent can be identified by this technique?
  2. Capsule formation
  3. Spore formation
  4. Acid resistance
  5. Alkali resistance
  6. Presence of volutin granules

Reason: Capsule formation is one of the most pathogenic effect of a bacteria. Burri-Gins method is used to identify Capsule of bacteria.

 

  1. Autopsy of a 62-year-old woman revealed a dense well-circumscribed node of 6 cm in diameter in the cranial cavity. The node was attached to the dura mater and histologically consisted of clusters and micro-concentric structures of endothelial cells, psammoma bodies. What kind of tumor was found at autopsy?
  2. Meningioma
  3. Glioblastoma
  4. Medulloblastoma
  5. Melanoma
  6. Cancer metastasis

Reason: Meningoma is a tumor usually benign arising from meningeal tissues of the brain. Psammoma bodies are found in the cells.

 

  1. Inherited diseases, such as mucopolysaccharidoses, are manifested in metabolic disorders of connective tissue, bone and joint pathologies. The sign of this disease is the excessive urinary excretion of the following substance:
  2. Glycosaminoglycans
  3. Amino acids
  4. Glucose
  5. Lipids
  6. Urea

Reason:  Mucopolysaccharidoses are a group of metabolic disorders in which abnormal accumulations of glycosaminoglycans occur because of enzyme deficiencies. Glycosaminoglycans are polar and attract water, they will be revealed in urine.

 

  1. An animal has an increased tonus of extensor muscles. This is the result of enhanced information transmission to the motoneurons of the spinal cord through the following descending pathways:
  2. Vestibulospinal
  3. Medial corticospinal
  4. Reticulospinal
  5. Rubrospinal
  6. Lateral corticospinal

Reason: The vestibulospinal tract is responsible for upright posture and head stabilization by sending signals to the extensor muscles of the legs.

 

  1. A specimen of a parenchymal organ shows poorly delineated hexagonal lobules surrounding a central vein, and the interlobular connective tissue contains embedded triads (an 0artery, a vein and an excretory duct). What organ is it?
  2. Liver
  3. Pancreas
  4. Thymus
  5. Spleen
  6. Thyroid

Reason: The liver is the organ with embedded triads an artery, a portal vein and an excretory duct.

 

  1. A patient has been admitted to the infectious diseases department for malaise, fever up to 38oC, jaundice. A few months ago, the patient underwent blood transfusion. The doctor suspected viral hepatitis B. What are the principal methods of laboratory diagnosis of hepatitis B?

 

  1. Serological and gene diagnostics
  2. Virus isolation in cell culture and its identification by the cytopathic effects
  3. Detection of virions in blood by electron microscopy
  4. Isolation of the virus in laboratory animals (neutralization reaction)
  5. Isolation of the virus in chicken embryos

Reason: The gold standard of Hepatitis B Diagnosis is serology, which is checking Antibody Titre against the Antigens of the virus.

 

  1. After resection of the middle third of the femoral artery obliterated by a thrombus the limb is supplied with blood through the bypasses. What artery plays the main part in the restoration of the blood flow?
  2. Deep femoral artery
  3. Superficial iliac circumflex artery
  4. Descending genicular artery
  5. Superficial epigastric artery
  6. External pudendal artery

Reason: Resection in the middle part of femoral artery means that the Superficial femoral artery was resected so in order to restore blood flow, it’s up to the deep femoral artery. Please remember that the common femoral artery gives 2 branches, superficial and deep femoral artery.

 

  1. During the intravenous transfusion of the saline the patient’s condition deteriorated dramatically, and the patient died from asphyxiation. Autopsy revealed acute venous congestion of internal organs with the dramatic right heart dilatation. When the right ventricle was punctured underwater, the bubblesescaped. What pathological process occurred in the patient?
  2. Air embolism
  3. Gaseous embolism
  4. Adipose embolism
  5. Tissue embolism
  6. Thromboembolism

Reason:  One of the dangers of giving Intravenous injections is Air Embolism. Note that bubbles escaped.

 

  1. At the post-mortem examination the stomach of a patient with renal failure was found to have a yellow-brown coating on the thickened mucosa. The coating was firmly adhering to its surface and had significant thickness. Microscopy revealed congestion and necrosis of mucosal and submucosal layers, fibrinpresence. What is the most likely diagnosis?
  2. Fibrinous gastritis
  3. Croupous gastritis
  4. Gastric abscess
  5. Esogastritis
  6. Corrosive gastritis

Reason: Fibrinous gastritis is characterized by small brown-like yellow brown deposits on mucosa.

  1. Infectious diseases are treated with antibiotics (streptomycin, erythromycin, and chloramphenicol). They inhibit the following stage of protein synthesis:
  2. Translation
  3. Transcription
  4. Replication
  5. Processing
  6. Splicing

Reason: These antibiotics inhibit  the Translation stage of protein formation.

 

  1. Diseases of the respiratory system and circulatory disorders impair the transport of oxygen, thus leading to hypoxia. Under these conditions the energy metabolism is carried out by anaerobic glycolysis. As a result, the following substance is generated and accumulated in blood:
  2. Lactic acid
  3. Pyruvic acid
  4. Glutamic acid
  5. Citric acid
  6. Fumaric acid

Reason: Lactic acid is the end product of anaerobic glycolysis

 

  1. A patient has been hospitalized for a suspected tumor of the prostate. During the surgery, it was revealed that the tumor invaded the bladder. Which part of the bladder was affected?
  2. Cervix
  3. Apex
  4. Bottom
  5. Body

 

Reason: The neck of the urinary bladder is the portion of the urinary bladder adjacent to the prostate gland in men.

 

 

  1. A casualty with an injury of the temporal region has been diagnosed with epidural hematoma. Which of the arteries is most likely to be damaged?
  2. Medial membranous artery
  3. Medial cerebral artery
  4. Superficial temporal artery
  5. Anterior membranous artery
  6. Posterior auricular artery

 

Reason:  The medial membranous artery runs along the lateral wall of the tympanic cavity so it will most likely cause an epidural hematoma seeing as it’s so close to be visible when injured.

 

  1. A 19-year-old male was found to have an elevated level of potassium in the secondary urine. These changes might have been caused by the increase in the following hormone level:
  2. Aldosterone
  3. Oxytocin
  4. Adrenaline
  5. Glucagon
  6. Testosterone

Reason: Aldosterone is a steroid hormone, the main mineralocorticoid hormone. It increases reabsorption of ions and water in the kidney, to cause the conservation of sodium, secretion of potassium, increase in water retention, and increase in blood pressure and blood volume.

 

  1. Analysis of the ECG revealed the missing of several PQRST cycles. The remaining waves and complexes are not changed. Specify the type of arrhythmia:

 

  1. Sinoatrial block
  2. Atrial fibrillation
  3. Atrioventricular block
  4. Atrial premature beat
  5. Intra-atrial block

Reason: Absence of a whole cycle of heart waves starting with P wave can only indicate a sinoatrial block.

 

  1. ECG of a patient displays an abnormally long R wave (up to 0,18 s). This is caused by a decrease in the conduction velocity of the following heart structures:
  2. Ventricles
  3. Atria
  4. Atrio-ventricular node
  5. Right ventricle
  6. Left ventricle

Reason: R wave indicates Depolarization of the Ventricles. Atria would’ve been P, AV-node would’ve been Q.

 

 

  1. 6 hours after the myocardial infarction a patient was found to have elevated level of lactate dehydrogenase in blood. What isoenzyme should be expected in this case?
  2. LDH1
  3. LDH2
  4. LDH3
  5. LDH4 LDH5

Reason: This is an isoenzyme which is normally elevated in the blood in myocardial infarction.

 

  1. A 46-year-old female is scheduled for a maxillofacial surgery. It is known that the patient is prone to high blood coagulation. What natural anticoagulant can be used to prevent blood clotting?
  2. Heparin
  3. Hirudin
  4. Sodium citrate
  5. Fibrinolysin
  6. None of the above-listed substances

Reason: Heparin is an anticoagulant.

 

  1. A 50-year-old patient with food poisoning is on a drip of 10% glucose solution. It not only provides the body with necessary energy, but also performs the function of detoxification by the production of a metabolite that participates in the following conjugation reaction:
  2. Glucuronidation
  3. Sulfation
  4. Methylation
  5. Glycosylation
  6. Hydroxylation

Reason: The body uses Glucoronidation to make substances water-soluble in order to make their elimination or detoxification easier through urine or feces.

 

  1. To assess the effectiveness of breathing in patients, the indicator of functional residual capacity is used. It includes the following volumes:
  2. Expiratory reserve volume and residual volume
  3. Inspiratory reserve volume and residual volume
  4. Inspiratory reserve volume, tidal volume, residual volume
  5. Expiratory reserve volume and tidal volume
  6. Inspiratory reserve volume and tidal volume

Reason: Functional reserve volume is the sum of Expiratory Reserve Volume (ERV) and Residual Volume (RV)

 

  1. It is required to evaluate the level of tissue excitability. For this purpose one should determine:
  2. Depolarization threshold
  3. Resting potential
  4. Critical level of depolarization
  5. Action potential amplitude
  6. Action potential duration

Reason: Depolarization causes Contraction of muscles, so therefore shows level of excitability.

 

  1. Due to the use of poor-quality measles vaccine for preventive vaccination, a 1-year-old child developed an autoimmune renal injury. The urine was found to contain macromolecular proteins. What process of urine formation was disturbed?
  2. Filtration
  3. Reabsorption
  4. Secretion
  5. Reabsorption and secretion
  6. Secretion and filtration

Reason: Macromolecules are normally not filtered in the glomerulus. Proteinuria can only occur when there’s problem with filtration, especially injury to glomerulus.

 

  1. A patient has been administered an anti-inflammatory drug that blocks the action of cyclooxygenase. Specify this anti-inflammatory agent:
  2. Aspirin
  3. Analgene
  4. Allopurinol
  5. Thiamin
  6. Creatine

Reason: Aspirin also known as acetylsalicylic acid is an anti-inflammatory drug that inhibits the action of the enzyme COX.

 

  1. A pneumonia patient has been administered acetylcysteine as a part of complex therapy. What principle of therapy was taken into consideration when applying this drug?
  2. Pathogenetic
  3. Symptomatic
  4. Etiotropic
  5. Antimicrobial
  6. Immunomodulatory

Reason: Pathogenetically in Pneumonia, Neutrophiles, bacteria and fluid from surrounding blood vessels fill the alveoli in form of mucous, Acetylcysteine is a mucolytic and expectorant. So use of this is pathogenetic tx.

 

  1. A 26-year-old female patient with bronchitis has been administered a broad spectrum antibiotic as a causal treatment drug. Specify this drug:
  2. Doxycycline
  3. Interferon
  4. BCG vaccine
  5. Ambroxol
  6. Dexamethasone

Reason: Doxycycline is a broad spectrum antibiotic used in the treatment of a number of types of infections caused by bacteria and protozoa.

 

  1. A 65-year-old male suddenly lost the vision in one eye due to the retinal detachment. The patient underwent enucleation. Histological examination of the removed eye retina and choroid revealed clusters of atypical cells with marked polymorphism of cells and nuclei, with a moderate number of mitoses including the pathological ones. The cell cytoplasm and intercellular medium contained brown pigment giving a positive DOPA reaction. Perls’ reaction was negative. What is the most likely diagnosis?
  2. Melanoma
  3. Pigmented mole
  4. Hemorrhage
  5. Cysticercosis
  6. Wilson’s disease

Reason: The Signs highlighted are typical for Melanoma.

 

  1. A child cut his leg with a piece of glass while playing and was brought to the clinic for the injection of tetanus toxoid. In order to prevent the development of anaphylactic shock the serum was administered by Bezredka method. What mechanism underlies this method of desensitization of the body?
  2. Binding of IgE fixed to the mast cells
  3. Blocking the mediator synthesis in the mast cells
  4. Stimulation of immune tolerance to the antigen
  5. Stimulation of the synthesis of antigenspecific IgG
  6. Binding of IgE receptors to the mast cells

 

Reason: Anaphylactic shock occurs when IgE is released in the blood which causes immediate type hypersensitivity, Bezredka method of administering the toxoid would bind it to the mast cells thereby reducing its release.

 

 

  1. Microscopy of the myocardium of a patient who had died from heart failure revealed foci of fibrinoid necrosis located diffusely in the interstitial stroma, and often around the vessels. Such foci were surrounded by lymphocytes, macrophages, histiocytes. Pericardium was found to have signs of sero-fibrinous pericarditis. What is the most likely diagnosis?
  2. Rheumatic heart disease
  3. Myocardial infarction
  4. Cardiomyopathy
  5. Cardiosclerosis

Reason: Rheumatic heart disease is a chronic heart condition caused by rheumatic fever caused by Streptococcus. Macrophages will only be found when there’s something to be engulfed. The other diseases aren’t caused by a pathogen.

 

 

  1. One of the factors that cause obesity is the inhibition of fatty acids oxidation due to:
  2. Low level of carnitine
  3. Impaired phospholipid synthesis
  4. Excessive consumption of fatty foods
  5. Choline deficiency
  6. Lack of carbohydrates in the diet

Reason: Carnitine is a fat transporter, if there’s obesity most likely cause out of all the other options would be its reduction.

 

  1. The genetic defect of pyruvate carboxylasedeficiency is the cause of delayed physical and mental development and early death in children. This defect is characterized by lacticemia, lactaciduria, disorder of a number of metabolic pathways. In particular, the following process is inhibited:
  2. Citric acid cycle and gluconeogenesis
  3. Glycolysis and glycogenolysis
  4. Glycogenesis and glycogenolysis
  5. Lipolysis and lipogenesis
  6. Pentose phosphate pathway and glycolysis

 

Reason:  Pyruvate is first converted by pyruvate carboxylase to Oxaloacetate which is an intermediate in the Citric Acid Cycle. Pyruvate carboxylase is involved in the synthesis of phosphoenolpyruvate during Gluconeogenesis.

 

  1. Deficiency of linoleic and linolenic acids in the body leads to the skin damage, hair loss, delayed wound healing, thrombocytopenia, low resistance to infections. These changes are most likely to be caused by the impaired synthesis of the following substances:
  2. Eicosanoids
  3. Interleukins
  4. Interferons
  5. Catecholamines
  6. Corticosteroids

Reason: Eicosanoids exert complex control over many bodily systems, mainly in inflammation or immunity and as messengers in CNS , growth during and after physical activity

  1. During ventricular systole, the cardiac muscle does not respond to additional stimulation because it is in the phase of:
  2. Absolute refractoriness
  3. Relational refractoriness
  4. Hyperexcitability
  5. Subnormal excitability
  6. There is no correct answer

Reason: Refractory period is recovery time of an excitable membrane to be ready for a second stimulus once it returns to its resting state. That’s why the muscles do not respond to additional stimulus in a normal state.

 

  1. A mother had taken synthetic hormones during pregnancy. Her daughter was born with hirsutism formally resembling of adrenal syndrome. Such manifestation of variability is called:
  2. Phenocopy
  3. Mutation
  4. Recombination
  5. Heterosis
  6. Replication

Reason:  Phenocopy is a type of variation that is caused by Environmental conditions during an organism development.

 

  1. Since a patient has had myocardial infarction, atria and ventricles contract independently from each other with a frequency of 60-70 and 35-40 per minute. Specify the type of heart block in this case:
  2. Complete atrioventricular
  3. Partial atrioventricular
  4. Sino-atrial
  5. Intra-atrial
  6. Intraventricular

Reason: The frequency of beats in the ventricles is reduced which suggest that impulses are not travelling through the AV-node regularly and that is a sign of complete AV block.

 

  1. A 67-year-old male patient consumes eggs, pork fat, butter, milk and meat. Blood test results: cholesterol – 12 , 3 mmol/l, total lipids – 8,2 g/l, increased low density lipoprotein fraction (LDL). What type of hyper-lipoproteinemia is observed in the patient?
  2. Hyperlipoproteinemia type IIa
  3. Hyperlipoproteinemia type I
  4. Hyperlipoproteinemia type IIb
  5. Hyperlipoproteinemia type IV
  6. Cholesterol, hyperlipoproteinemia

Reason: Hyperlipoproteinemia type IIa is observed in patient with increased LDL.

 

  1. A 12-year-old child has a viral infection complicated by obstructive bronchitis. Bronchospasm can be eliminated by inhalations of a drug from the following pharmacological group:
  2. β2-agonists
  3. M-anticholinergics
  4. N- cholinomimetics
  5. β2-adrenergic blockers
  6. Analeptics

Reason: Bronchospasm can be eliminated by beta-agonists e.g Salbutamol, Other options cause bronchospasm.

 

  1. In course of an experiment there has been an increase in the nerve conduction velocity. This may be caused by an increase in the concentration of the following ions that are present in the solution around the cell:
  2. Na+
  3. K+ and K+ and
  4. Ca2+ and Cl
  5. Ca2+

Reason:  Sodium ions cause depolarization of cells, since there is increase in nerve conduction, it can only mean that there’s increase of Sodium ions around the cell.

 

  1. A male working as a blacksmith has been tested for auditory acuity. The tests revealed 50% hearing loss in the low frequencyrange and a near-normal auditory acuity in the high-frequency range. This condition has been caused by the damage to the following structures of the auditory system:
  2. Corti’s organ – closer to helicotrema
  3. Corti’s organ – closer to the oval foramen
  4. Median part of the Corti’s organ
  5. Muscles of the middle ear
  6. Eardrum

Reason: The helicotrema is the part of the cochlear labyrinth where the scala vestibule and tympani meet. The hair cells near this area best detect low frequency sounds.

 

  1. In our country, routine preventive vaccinations against poliomyelitis involve using live vaccine that is administered orally. What immunoglobulins are responsible for the development of local post-vaccination immunity in this case?
  2. Secretory IgA
  3. IgM
  4. IgG
  5. Serum IgA
  6. IgE

Reason: Secretory IgA are found in bodily fluids, please remember polio vaccine is given orally, so in the saliva, stomach juice etc, this immunoglobulin will develop immunity for the body.

 

  1. An experiment proved that UV irradiated skin cells of patients with xeroderma pigmentosum restore the native structure of DNA slower than the cells of healthy people due to the defect in repair enzyme. What enzyme takes part in this process?
  2. Endonuclease
  3. RNA ligase
  4. Primase
  5. DNA polymerase
  6. DNA gyrase

Reason: Xeroderma pigmentosaum is a rare deficiency in endonuclease which us usually repair DNA after damage from UV light.

 

  1. A patient who has recently come from an endemic area presents with elevated body temperature, headache, chills, and malaise. These are symptoms which are typical for a common cold. What laboratory tests are necessary to confirm or to refute the diagnosis of malaria?
  2. Microscopy of blood smears
  3. Study of lymph node punctate
  4. Urinalysis
  5. Study of cerebrospinal fluid
  6. Microscopy of bone marrow punctuate

Reason:  The best way to diagnose Malaria is through Thick Blood drop Smear.

 

  1. What condition may develop 15-30minutesafter re-administration of the antigen as a result of the increased level of antibodies, mainly IgE, that are adsorbed on the surface of target cells, namely tissue basophils (mast cells) and blood basophils?
  2. Anaphylaxis
  3. Antibody-dependent cytotoxicity
  4. Delayed-type hypersensitivity
  5. Immune complex hyperresponsiveness
  6. Serum sickness

Reason: Immediate type hypersensitivity, characterized by release of IgE, basophils, even eosinophils.

 

  1. 10 days after having quinsy caused by beta-hemolytic streptococcus a 6year-old child exhibited symptoms of glomerulonephritis. What mechanism of glomerular lesion is most likely in this case?
  2. Immunocomplex
  3. Cellular cytotoxicity
  4. Anaphylaxis
  5. Atopy
  6. Antibody-dependent cell-mediated cytolysis

Reason: Immunocomplex hypersensitivity occurs when the Antigen of Streptococcus in this case form a complex with an antibody against it.

 

  1. A 22-year-old woman ate some seafood. 5 hours later the trunk and the distal parts of limbs got covered with small itchy papules which were partially fused together. After one day, the rash disappeared spontaneously. Specify the hypersensitivity mechanism underlying these changes:
  2. Atopy (local anaphylaxis)
  3. Systemic anaphylaxis
  4. Cellular cytotoxicity
  5. Immune complex hypersensitivity
  6. Antibody-dependent cell-mediated cytolysis

Reason: Firstly, this is an anaphylactic reaction because of its immediate reaction, then the symptom of itchy rashes which disappeared after one day shows that it wasn’t systemic.

 

  1. A hypertensive patient had been keeping to a salt-free diet and taking antihypertensive drugs together with hydrochlorothiazide for a long time. This resulted in electrolyte imbalance. What disorder of the internal environment occurred in the patient?
  2. Hypochloremic alkalosis
  3. Metabolic acidosis
  4. Hyperkalemia
  5. Hypermagnesemia
  6. Increase in circulating blood volume

Reason: Hypocholermic alkalosis result from either low chloride intake or excessive chloride wasting due to diuretic therapy.

 

  1. A miner consulted a physician about the appearance of body rash followed by a loss of appetite, bloating, duodenal pain, frequent bowel movements, and dizziness. Ovoscopic probes of feces and duodenal contents revealed some eggs covered with a transparent membrane through which 4-8 germinal cells could be seen. What disease is likely to have occurred in the patient?
  2. Ancylostomiasis
  3. Strongyloidiasis
  4. Trichocephaliasis
  5. Hymenolepiasis
  6. Enterobiasis

Reason: Ancyclostomiasis or miners anemia occur when hook worm in their large number causes iron deficiency anemia.

 

  1. Children with Lesch-Nyhan syndrome have a severe form of hyperuricemia accompanied by the formation of tophi, urate calculi in the urinary tracts, as well as serious neuro-psychiatric disorders. The cause of this disease is the reduced activity of the following enzyme:
  2. Hypoxanthine-guanine phosphoribosyltransferase
  3. Xanthine oxidase
  4. Dihydrofolate reductase
  5. Thymidylate synthase
  6. Karbamoyl phosphate synthetase

Reason: Simple! Lesch-Nyhan syndrome is caused by a deficiency of enzyme HGPRT located on the X chromosome.

 

  1. In a car accident a man got injured and lost a lot of blood. What changes in peripheral blood are most likely to occur on the 2nd day after the injury?
  2. Erythropenia
  3. Hypochromia
  4. Anisocytosis
  5. Microplania
  6. Significant reticulocytosis

Reason: Erythropenia is seen due to excessive loss of erythrocytes.

 

  1. In the surgical ward, the dressing material was undergoing sterilization in an autoclave. Through an oversight of a nurse the mode of sterilization was changed and the temperature in the autoclave reached only 100oC instead of the due 1200C. What microorganisms can stay viable under these conditions?
  2. Bacilli and clostridia
  3. Staphylococci and streptococci
  4. Mold and yeast fungi
  5. Salmonella and klebsiella
  6. Corynebacteria and mycobacteria

Reason: Bacilli and Clostridia are resistant to heat, they require a higher temperature to be destroyed.

 

  1. As a result of a mechanical injury an over 10 cm long portion of a peripheral nerve was damaged. This led to the impairment of the upper limb activity. The patient was offered nerve transplantation. What glial cells will participate in regeneration and provide the trophismof the injured limb?
  2. Schwann cells
  3. Fibrous cells
  4. Protoplasmic cells
  5. Microglia
  6. Ependymal cells

Reason: Schwann cells are known for their roles in regeneration of damaged nerves. They participate in phagocytosis of axons of damged cells and then guide regeneration by forming the Schwann tunnel.

 

  1. A 26-year-old woman at 40 weeks pregnant has been delivered to the maternity ward. Objectively: the uterine cervix is opened, but the contractions are absent. The doctor has administered her a hormonal drug to stimulate the labor.

Name this drug:

  1. Oxytocin
  2. Hydrocortisone
  3. Estrone
  4. Testosterone
  5. ACTH

Reason: Oxytocin as a medication, is used to cause contraction of the uterus in order to start labor

 

  1. A patient has recurrent attacks of epileptic seizures and stays unconscious between them. In order to stop convulsions the drugs of the following group should be used in the first place:
  2. Tranquilizers
  3. Neuroleptics
  4. Muscle relaxants
  5. Sedatives
  6. Analeptics

Reason: Tranquilizers are used to treat Epileptic seizures.

 

  1. A patient with arthritis and varicose veins has been taking a non-steroidal antiinflammatory drug for a long time, which caused thrombosis of skin veins. Which of the following drugs might have caused this complication?
  2. Celecoxib
  3. Indomethacin
  4. Aspirin
  5. Phenylbutazone
  6. Ibuprofen

Reason: One of the side effects of Celecoxib is thrombosis.

 

  1. Students study the stages of gametogenesis. They analyze a cell having a haploid number of chromosomes, and each chromosome consists of two chromatids. The chromosomes are located in the equatorial plane of the cell. Such situation is typical for the following stage of meiosis:
  2. Metaphase of the second division
  3. Metaphase of the first division
  4. Anaphase of the first division
  5. Anaphase of the second division
  6. Prophase of the first division

 

Reason:  In metaphase 2, the chromosomes arrange themselves on the metaphase plate which is what is being described in the question.

 

  1. A 35-year-old female patient underwent biopsy of the breast nodules. Histological examination revealed enhanced proliferation of the small duct epithelial cells and acini, accompanied by the formation of glandular structures of various shapes and sizes, which were located in the fibrous stroma. What is the most likely diagnosis?
  2. Fibroadenoma
  3. Adenocarcinoma
  4. Cystic breast
  5. Invasive ductal carcinoma
  6. Mastitis

Reason: Fibroadenoma is a benign tissue of both the fibrous tissue (fibroma) and the glandular structure of the breast (adenoma).

 

  1. Examination of the duodenal contents revealed some pear-shaped protozoa with two nuclei and four pairs of flagella. The organisms had also two axostyles between the nuclei and a ventral adhesive disc. What protozoan representative was found in the patient?
  2. Lamblia
  3. Toxoplasma
  4. Leishmania
  5. Intestinal trichomonad
  6. Trypanosome

Reason: Lamblia is what is being described. Looks like a pear with eyes and two antennas.

 

  1. A specimen of an onion rootlet includes a cell in which the fully condensed chromosomes are located in the equatorial plane making the monaster. What phase of the mitotic cycle is the cell in?
  2. Metaphase
  3. Early telophase
  4. Prophase
  5. Interphase
  6. Late telophase

Reason: Metaphase- In this phase the cell’s chromosomes align themselves in the middle of the cells equator.

  1. When examining a patient, the doctor revealed a tumor of the bronchus which borders on the aorta. Which bronchus is affected?
  2. Left principal
  3. Right principal
  4. Right upper lobar
  5. Left upper lobar
  6. Middle lobar

Reason: The Aorta arises from the left part of heart, the Left main bronchus too arises from the left lung. A tumor would affect them both as they are located on the same side.

 

  1. A 54-year-old female was brought to the casualty department after a car accident. A traumatologist diagnosed her with multiple fractures of the lower extremities. What kind of embolism is most likely to develop in this case?
  2. Adipose
  3. Tissue
  4. Thromboembolism
  5. Gaseous
  6. Air

Reason: The long tubular bones are one of the places for fat storage. Hence the fracture of these bones can lead to adipose embolism.

 

  1. Microscopy of the bronchial wall revealed atrophy of the mucosa, metaplastic change from columnar to squamous epithelium, an increase in the number of goblet cells, diffuse infiltration of the bronchial wall with lymphoplasmacytic elements with a large number of neutrophilic granulocytes, pronounced sclerosis. Specify the morphological form of bronchitis:
  2. Chronic purulent bronchitis
  3. Acute bronchitis
  4. Polypoid chronic bronchitis
  5. Acute purulent bronchitis
  6. Chronic bronchitis

Reason: Atrophy of the mucosa shows that the disease has occurred for a while i.e it is a chronic disease. Then the presence of neutrophilic granulocytes shows that the course of the disease is purulent.

 

  1. Due to the blockage of the common bile duct (which was radiographically confirmed), the biliary flow to the duodenum was stopped. We should expect the impairment of:
  2. Fat emulsification
  3. Protein absorption
  4. Carbohydrate hydrolysis
  5. Secretion of hydrochloric acid
  6. Salivation inhibition

Reason: The blockade of the common bile duct causes the stoppage of bile acids whose main function is the emulsification of fat in the small intestine.

 

  1. Typical manifestations of food poisoning caused by C. botulinum are double vision, abnormal functioning of the swallowing and breathing. These symptoms develop as a result of:
  2. Exotoxin effects
  3. Enterotoxin effects
  4. Enterotoxic shock development
  5. Activation of adenylate cyclase
  6. Pathogen adhesion to the enterocyte receptors

Reason: Clostridium botulinum contains exotoxins A, B, E which affect humans.

 

  1. At the stage of translation in the rough endoplasmic reticulum, the ribosome moves along the mRNA. Amino acids are joined together by peptide bonds in a specific sequence, and thus polypeptide synthesis takes place. The sequence of amino acids in a polypeptide corresponds to the sequence of:
  2. mRNA codons
  3. tRNA nucleotides
  4. tRNA anticodons
  5. rRNA nucleotides
  6. rRNA anticodons

Reason: The sequence of amino acids always corresponds to mRNA codons which consist of 4 bases including uracil, cytosine, guanine and adenine.

 

  1. After the prolonged vomiting a pregnant 26-year-old woman was found to have the reduced volume of circulating blood. What change in the total blood volume can be the case?
  2. Polycythemic hypovolemia
  3. Simple hypovolemia
  4. Oligocythemic hypovolemia
  5. Polycythemic hypervolemia
  6. Oligocythemic hypervolemia

Reason: Polycythemia hypovolemia decrease plasma, increase blood viscosity and hematocrit level due to diarrhea, prolonged vomiting, shock, and hyperventilation.

 

  1. On allergological examination a patient has been diagnosed with pollinosis. Specific desensitization can be performed by:
  2. Intermittent administration of allergen
  3. Antihistamines
  4. Glucocorticoids
  5. Administration of saline

Reason: Desensitization is a method used to reduce or eliminate an organism’s negative reaction to a substance or stimulus.

 

  1. A patient consulted a physician about chest pain, cough, fever. Roentgenography of lungs revealed eosinophilic infiltrates which were found to contain the larvae. What kind of helminthiasis are these presentations typical for?
  2. Ascariasis
  3. Echinococcosis
  4. Fascioliasis
  5. Cysticercosis
  6. Trichinosis

Reason: Ascariasis is a helminthes which spends the larvae stage in the lungs where they later move on to the small intestine.

 

  1. A patient with signs of osteoporosis and urolithiasis has been admitted to the endocrinology department. Blood test revealed hypercalcemia and hypophosphatemia. These changes are associated with abnormal synthesis of the following hormone:
  2. Parathyroid hormone
  3. Calcitonin
  4. Cortisol
  5. Aldosterone
  6. Calcitriol

Reason: Increased PTH( Hyperparathyroidism) causes increased removal of Calcium from bones to blood which causes Osteoporosis and Hypercalcemia and also increases movement of phosphate from blood to bones which causes Hypophosphatemia.

 

  1. Histological examination of the biopsy material obtained from the lower third of the esophagus of a 57- year-old male with the symptoms of continuous reflux revealed the change of the stratified squamous epithelium to the single layer columnar glandular epitheliumwith signs of mucus production. Specify the pathological process in the mucous membrane:
  2. Metaplasia
  3. Hyperplasia
  4. Hypertrophy
  5. Organization
  6. Regeneration

Reason: Any change of normal cell epithelia to another variant or type of epithelium is known as Metaplasia.

 

  1. A 30-year-old female exhibits signs of virilism (growth of body hair, balding temples, and menstrual disorders). This condition can be caused by the overproduction of the following hormone:
  2. Testosterone
  3. Oestriol
  4. Relaxin
  5. Oxytocin
  6. Prolactin

 

Reason: The female is beginning to exhibit the features of a man which can only be caused by overproduction of Testosterone.

 

 

  1. A patient with bacterial periodontitis has been administered iontophoresis with the use of iodine solution. Specify the mechanism of therapeutic action of this agent:
  2. Substitution of hydrogen atoms when the protein amino group contains a nitrogen atom
  3. Reduction of the nitro group under the effect of nitroreductase
  4. Albumin formation
  5. Changing the surface tension of the bacterial cell membrane
  6. Inhibition of the cell wall formation

Reason: Iodine is reduced to hydrogen iodide through substitution.

 

  1. A patient with extensive myocardial infarction has developed heart failure. What pathogenetic mechanism contributed to the development of heart failure in the patient?
  2. Reduction in the mass of functioning myocardiocytes
  3. Pressure overload
  4. Volume overload
  5. Acute cardiac tamponade
  6. Myocardial reperfusion injury

Reason: Infarction occurs as a result of decreased blood flow to the myocardium, after infarction a scar(fibrous tissue) is present on affected part. These parts can no longer function i.e contract.

 

  1. A patient who had been continuously taking drugs blocking the production of angiotensin II developed bradycardia and arrhythmia. A likely cause of these disorders is:
  2. Hyperkalemia
  3. Hypokalemia
  4. Hypernatremia
  5. Hypocalcemia
  6. Hypercalcemia

Reason: In summary, Aldosterone causes hypokalemia by excreting potassium and reabsorbing sodium.  Angiotensin Receptor blockers antagonize  Aldosterone so therefore cause Hyperkalemia, that is they now cause decreased excretion of potassium which will now be excess in blood.

 

  1. A patient has arterial hypertension. What long-acting drug from the group of calcium channel blockers should be prescribed?
  2. Amlodipine
  3. Octadine
  4. Pyrroxanum
  5. Atenolol
  6. Reserpine

Reason: This drug is a calcium channel blocker used to treat high blood pressure, chest pain and other conditions caused by coronary artery disease.

 

  1. Human skin has a high breaking strength. It is known that the skin consists of epithelial tissue and two kinds of connective tissue. Which of the following tissues provides the skin strength?
  2. Unformed dense connective tissue
  3. Stratified squamous epithelium
  4. Loose connective tissue
  5. Single-layer epithelium
  6. Transitional epithelium

 

Reason: Dense connective tissue is composed of type 1 collagen which are rows of fibroblasts, they form strong ropelike structures such as tendons and ligaments, they provide strength.

 

  1. As a result of a home injury, a patient suffered a significant blood loss, which led to a fall in blood pressure. Rapid blood pressure recovery after the blood loss is provided by the following hormones:
  2. Adrenaline, vasopressin
  3. Cortisol
  4. Sex hormones
  5. Oxytocin
  6. Aldosterone

Reason: Adrenalin will increase heart contraction, which means more blood will be pumped. Secretion of Vasopressin will increase fluid in the body which can help for adequate perfusion in cells. Fluid is necessary when blood is being lost.

  1. A patient with constant headaches, pain in the occipital region, tinnitus, and dizziness has been admitted to the cardiology department. Objectively: AP- 180/110 mm Hg, heart rate – 95/min. Radiographically, there is a stenosis of one of the renal arteries. Hypertensive condition in this patient has been caused by the activation of the following system:
  2. Renin-angiotensin
  3. Hemostatic
  4. Sympathoadrenal
  5. Kinin
  6. Immune

Reason: When renal blood flow is reduced, the juxtaglomerular cells in kidneys covert prorenin in rennin and secrete it directly into the blood. Plasma renin then carries out the conversion of angiotensinogen released by liver to angiotensin I, which is now converted to angiotensin II by angiotensin-converting enzyme found in lungs. It then causes Vasoconstriction and increases blood pressure.

 

  1. A patient complains that at the bare mention of the tragic events that once occurred in his life he experiences tachycardia, dyspnea and an abrupt rise in blood pressure. What structures of the CNS are responsible for these cardiorespiratory reactions in this patient?
  2. Cerebral cortex
  3. Cerebellum
  4. Lateral hypothalamic nuclei
  5. Specific thalamic nuclei
  6. Quadrigemina of mesencephalon

Reason: Cerebral cortex is the part of the brain responsible for cardiorespiratory reactions.

 

  1. A patient consulted a dentist about limited mouth opening (trismus). He has a history of a stab wound of the lower extremity. What infection may cause these symptoms?
  2. Tetanus
  3. Brucellosis
  4. Whooping cough
  5. Wound anaerobic infection
  6. Tularemia

Reason: Trismus is the spasm of the jaw muscles causing the mouth to remain tightly close as a symptom of tetanus.

 

  1. Anatomical dead space is the portion of the air that is left in the airways after expiration. The reduction of the anatomical dead space is typical for the following situation:
  2. Tracheostomy
  3. Forward flexion of head
  4. Turning the lying patient on his left side
  5. Turning the lying patient on his right side
  6. Breathing through the mouth

 

Reason: This is a surgical procedure used to reduce anatomical dead space.

  1. Analysis of the experimental spirogram of a 55-year-old person revealed a decrease in tidal volume and respiratory amplitude compared to the situation of ten years ago. The change in these indicators is caused by:
  2. Decreased force of respiratory muscle contraction
  3. Gas composition of the air
  4. Physical build of a person
  5. Height of a person
  6. Body mass of a person

Reason: Easy! Old age causes decrease in muscle force and contraction so with time tidal volume will be decreased.

 

  1. A patient underwent a course of treatment for atherosclerosis. Laboratory tests revealed an increase in the antiatherogenic lipoprotein fraction in the blood plasma. The treatment efficacy is confirmed by the increase in:
  2. HDL
  3. VLDL
  4. IDL
  5. LDL
  6. Chylomicrons

Reason: HDL is a lipoprotein that carries cholesterol from the tissues to the liver. It is an antiatherogenic lipoprotein.

 

  1. A 65-year-old female patient has chronic constipations due to the colon hypotonia. What drug should be chosen in this case?
  2. Bisacodyl
  3. Castor oil
  4. Magnesium sulfate
  5. Neostigmine methylsulfate
  6. Metoclopramide

Reason: It is a drug used for the treatment of chronic constipation.

 

  1. A female patient complains of vision impairment. On examination she was found to have obesity, fasting hyperglycemia. What complication of diabetes can cause vision impairment?
  2. Microangiopathy
  3. Macroangiopathy
  4. Atherosclerosis
  5. Neuropathy
  6. Glomerulopathy

Reason: Microangiopathy is one of the other complications of diabetes mellitus.

 

  1. Analysis of the family history of children with Van der Woude syndrome revealed that in their families one of the parents had the typical for this syndrome defects (cleft lip and palate, lip pits regardless of gender). What is the type of inheritance of this syndrome?
  2. Autosomal dominant
  3. X-linked recessive
  4. X-linked dominant
  5. Autosomal recessive
  6. Multifactorial

Reason: Van der Woude syndrome is an autosomal dominant disease.

 

  1. Administration of doxycycline hydrochloride caused an imbalance of the symbiotic intestinal microflora. Specify the kind of imbalance caused by the antibiotic therapy:
  2. Dysbacteriosis
  3. Sensibilization
  4. Idiosyncrasy
  5. Superimposed infection
  6. Bacteriosis

Reason: Dysbacetriosis is microbial disbalance in the human body normally caused due to a long term use of antibiotics.

 

  1. A 3-year-old child had eaten some strawberries. Soon he developed a rash and itching. What was found in the child’s leukogram?
  2. Eosinophilia
  3. Hypolymphemia
  4. Neutrophilic leukocytosis
  5. Monocytosis
  6. Lymphocytosis

Reason: This because eosinophils are white blood cells which binds with mast cells causing release of cell mediators. They are released during allergies or when you have helminthes.

 

  1. A 12-year-old patient was found to have blood serum cholesterol at the rate of 25 mmol/l. The boy has a history of hereditary familial hypercholesterolemia, which is caused by the impaired synthesis of the following protein receptors:
  2. Low density lipoproteins
  3. High density lipoproteins
  4. Chylomicrons
  5. Very low density lipoproteins
  6. Intermediate density lipoproteins

 

Reason: Familial hypercholesterolemia is a genetic disorder. It is caused by a defect on chromosome 19. The defect makes the body unable to remove low density lipoprotein (LDL, or “bad”) cholesterol from the blood. This results in a high level of LDL in the blood.

 

SUCCESS!!!

…and may the odds be ever in your favour.

 

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