Quiz

The nasal septum is composed of:

The bony palate is formed by:

The accessory pancreatic duct opens on:

The pancreas lies at the level of:

A series of photographs taken of a middle-aged man over a period of 2 decades demonstrates gradual coarsening of facial features and progressive protrusion of the brows. Upon questioning, the patient reports having to wear larger shoes than he did as a young man. Which of the following pair of hormones normally regulates the hormone responsible for these changes?

A 16-year-old type I diabetic is noncompliant with his required insulin therapy and develops hyperglycemia after eating several pieces of hard candy. The release of which of the following intestinal hormones would most likely be stimulated

Lungs of a preterm infant have areas of atelectasis (pulmonary collapse). The main cause is:

A man presents with increased heart rate, mydriatic pupils, dry mouth. This condition results from the activation of the following system of function regulation:

Brain tomography revealed a tumor in the region of red nucleus. What part of brain is damaged?

A man with an injury of the dorsal area of his neck was admitted to the resuscitation department. What muscle occupies this area?

A 60 years old man, who suffered from pancreatic diabetes for a long time consulted a surgeon. The tissues of the right foot were black, dense with clear edges. What should be the surgeon's diagnosis?

Morphological examination of the soft tissues biopsy of a sick child, 12 years old who suffers from poliomyelitis revealed the following changes: somatic muscles are weak, reduced in volume, skin is dry and pale. Define the character of pathological process of the tissues.

Which of the following injury is reversible:

Which of the following is not a parenchymatous protein degeneration:

A 5-year-old girl who was on vacation in Venezuela with her parents was admitted to the local hospital with fever (103.7°F, 39.8°C), mental confusion, restlessness, and hallucinatory behavior. History revealed that the girl had eaten some honey bought from a local vendor. Physical examination revealed mydriasis; dry, hot, and red skin; and a distended abdomen. A diagnosis of atropine poisoning was made, and an appropriate therapy was started. Which of the following molecular actions most likely contributed to the atropine-induced hyperthermia in this patient?

A 77-year-old man suffering from chronic obstructive pulmonary disease had been taking ipratropium by inhalation. Shortly after inadvertently spraying the medication on his face, which of the following effects did the patient most likely experience?

A patient has arterial hypertension. What long-acting drug from the group of calcium channel blockers should be prescribed?

A pneumonia patient has been administered acetylcysteine as a part of complex therapy. What principle of therapy has been taken into consideration when applying this drug?

The insufficient secretion of what enzyme is the cause of incomplete fats degradation in the digestive tract and appearance of great quantity of neutral fats in feces?

In a newborn's stomach the conversion of soluble milk proteins, so-called caseins, into the insoluble derivatives occurs in the presence of calcium ions and a certain enzyme. Name this enzyme.

Nappies of a newborn have dark spots being the evidence of homogentisic acid formation. This is caused by the metabolic disorder of the following substance:

Examination of a 27-year-old patient revealed pathological changes in liver and bra-in. Blood plasma analysis revealed an abrupt decrease in the copper concentration, urine analysis revealed an increased copper concentration. The patient was diagnosed with Wilson’s degeneration. To confirm the diagnosis it is necessary to study the activity of the following enzyme in blood serum:

Which of the following should be avoided in an iron excess state?

Which of the following is the most common early symptom in aplastic anemia?

Classic electrocardiographic triad in WPW syndrome includes all except?

Which of these loop diuretics is associated with deafness?

The medial wall of the left mesenteric sinus is formed by:

What is the epiploic (omental) foramen bounded above by:

Where can you palpate pulsation of the posterior tibial artery?

What anatomical structure is located on the internal base of the skull between the greater and lesser wings of sphenoid bone?

A 70-year-old woman undergoes a gastrectomy for Zollinger-Ellison syndrome. Her physician informs her that she will need to take intramuscular vitamin B12 shots for the rest of her life. Absence of which of the following cell types are responsible for this vitamin replacement requirement?

A young boy presents with failure to thrive. Biochemical analysis of a duodenal aspirate after a meal reveals a deficiency of enteropeptidase (enterokinase). The levels of which the following digestive enzymes would be affected?

A 30-year-old woman has subnormal concentration of enzymes in the pancreatic juice. This might be caused by the hyposecretion of the following gastrointestinal hormone:

A patient has a trauma of sternocleidomastoid muscle. This caused a decrease in value of the following indicator of external respiration:

A 40-year-old patient complains of intensive heartbeats, sweating, nausea, visual impairment, arm tremor, hypertension. From his anamnesis: 2 years ago he was diagnosed with pheochromocytoma. Hyperproduction of what hormones causes the given pathology?

A patient who suffers from cancer of back of tongue has an intense bleeding as a result of affection of dorsal lingual artery by the tumour. What vessel should be ligated to stop bleeding?

END OF ROUND ONE

The sick, 70 years old with atherosclerosis, felt pain in the left foot and did not consult the doctor. While checking up, the foot is enlarged, tissues are slack, black of colour and macerated. Demarcation zone is not evident. Diagnose the pathological process:

The dead who died of chronic impaired cardial function on postmortem examination " tiger heart w' was found. From the side of the endocardium, one can see yellowish-white banding, myocardium is dull and loamy-yellow. What process determined this pathology?

On postmortem examination of a 65 years old sick man, who died of chronic impaired cardiac function as a result of rheumatic heart disease, lungs are brown, enlarged and dense. How are such changes called?

In the mucus of the sick with mitral heart insufficiency, cells with brown pigment were found. Perl's reaction is positive. What pigment is this?

During autopsy the following has been revealed: the meninges of the upper cerebral hemispheres are extremely plethoric, of yellow-green color and are soaked with purulent effluent. What kind of meningitis is characterised by such clinical presentations?

During preparation of a patient to a heart surgery it was necessary to measure pressure in heart chambers. In one of them pressure varied from 0 mm Hg up to 120 mm Hg within one cardiac cycle. What heart chamber is it?

An injection of galantamine hydrobromide was made to a woman 63 years old after ischemic stroke. Her condition has considerably improved. What is the mechanism of this medication effect?

A 50 year old male farm worker has been brought to the emergency room. He was found confused in the orchard and since then has remained unconscious. His heart rate is 45 and his blood pressure is 80/40 mm Hg. He is sweating and salivating profusely. What should be prescribed?

A patient suffering from syphilis has been treated with bismuth preparations. As a result of it some grey spots turned up on the mucous membrane of the oral cavity; nephropathy symptoms were also present. What drug should be used for treatment of bismuth intoxication?

A patient with chronic heart failure with edema has increased level of blood aldosterone. What diuretic would be most effective in this case?

END OF ROUND 2

Periodic renal colic attacks are observed in a woman with primary hyperparathyroidism. Ultrasonic examination revealed small stones in the kidneys. What is the most plausible reason of the stone’s formation?

Which of the following presentation result from both hepatocellular insufficiency and portal hypertension?

Kayser-Fleischer rings in eyes are a finding in?

The patient with diabetes mellitus has been delivered in hospital in the state of unconsciousness. Arterial pressure is low. The patient has acidosis. Point substances, whose accumulation in the blood results in these manifestations:

Untrained people often have muscle pain after sprints as a result of lactate accumulation. This might be caused by intensification of the following biochemical process:

Which of the following is related to Alport’s syndrome ?

Which of the following is the hallmark of “proliferative” diabetic retinopathy?

ATP synthesis is totaly blocked in a cell. How will the value of membrane rest potential change?

A 34-year-old patient was diagnosed with chronic glomerulonephritis 3 years ago. Edema have developed within the last 6 months. What caused the edema?

A patient with serious da-mage of muscular tissue was admitted to the traumatological department. What biochemical urine index will be increased in this case?

END OF ROUND 3

A 54 years old man takes propranolol for the treatment of essential hypertension. He also suffers from diabetes mellitus 2 type. Suddenly severe hypoglycemic coma has developed. Administration glucose solution intravenously was not effectively. You have epinephrine and glucagon. Which drug is preferable in this case and why?

A 37-year-old previously healthy woman presents to your clinic for unintentional weight loss. Over the past 3 months, she has lost approximately 7 kg without changing her diet or activity level. Otherwise, she feels great. She has an excellent appetite, no gastrointestinal complaints except for occasional loose stools, a good energy level, and no complaints of fatigue. She denies heat or cold intolerance. On examination, her heart rate is 108 bpm, blood pressure 142/82 mm Hg, and she is afebrile. When she looks at you, she seems to stare, and her eyes are somewhat protuberant. You note deformation of the anterior neck, a 2/6 systolic ejection murmur on cardiac examination, and her skin is warm and dry. There is a fine resting tremor.

The Kidney is bounded posteriorly by the following muscles:

A 45-year-old man has a blood pressure reading of 160/100 mm Hg on three separate visits. He refuses to take antihypertensive medication but is willing to modify his lifestyle in an effort to lower his blood pressure. He quits smoking, joins a health club, and greatly reduces salt from his diet. Which of the following areas of the adrenal gland would be expected to increase in activity because of his diet?

In the experiment on the animal the part of the cerebral cortex hemispheres was removed. It caused elimination of previously formed conditioned reflex to the light irritation. What part of the cortex was removed?

What is the omental bursa bounded in front by?

A surgeon is first on the scene after a serious automobile accident. He finds a passenger bleeding profusely from the neck and correctly surmises that the bleeding is from the carotid artery. To control the bleeding, the surgeon can compress the carotid artery against the anterior tubercle of which of the following vertebrae?

A sportsman spontaneously held breath for 40 seconds, which resulted in an increase in heart rate and systemic arterial pressure. Changes of these indicators are due to activation of the following regulatory mechanisms:

What anatomical structures end the proximal tibia?

A 70-year-old female patient was diagnosed with fracture of left femoral neck accompanied by disruption of ligament of head of femur. The branch of the following artery is damaged:

A patient with neuritis of femoral nerve has disturbed flexion of thigh as well as disturbed crus extension in the knee joint. What muscle's function is disturbed?

Arrange the the structures of the renal hilum (from front to back)

END OF ROUND ONE

A 45 years old male patient with history of coughing and hemoptysis was admitted to hospital. Tuberculin test was positive. The type of necrosis seen in biopsy from lesion is?

Which of the following molecular actions most likely mediated the therapeutic effect of alteplase?

Histologic analysis of uterus mucous membrane revealed twisting glands, serrated and spinned, they were extended by stroma growth with proliferation of its cells. Formulate a diagnosis:

A 52-year-old woman, suffers from COPD. Inhaled ipratropium was prescribed for her treatment. The beneficial effect of the drug is likely mediated by the blockade of which pairs of receptors in the bronchial tree?

Which of the following is the most frequent site of venous thrombosis?

Continuous taking of a drug can result in osteoporosis, erosion of stomach mucous membrane, hypokalemia, retention of sodium and water, reduced content of corticotropin in blood. Name this drug:

Introduction of a pharmaceutical substance to an experimental animal resulted in reduction of salivation, and pupil mydriasis. Next intravenous introduction of acetylcholine didn't lead to any significant changes of heart rate. Name this substance:

Arterial hypertension, hyperglycemia, glucosuria were observed clinically for a long time in the patient with upper type of obesity. Death was due to the cerebral hemorrhage. Basophilic hypophysis adenoma, hyperplasia of adrenal gland cortex was revealed on pathomorphological examination. What is the likely diagnosis?

Granuloma is formed of all of the following except:

Which of the following types of necrosis is most commonly associated with ischemic injury?

END OF ROUND 2

A 23-year-old patient complains of headache, change of appearance (increase in feet and wrists size, face features distortion). His voice grew harsh, memory worsened. The disease set in three years ago without apparent causes. The analysis of the urine is without special changes. A possible cause of this status can be

Which of the following is not a major symptom of ulcerative colitis?

Slate-gray pigmentation to the skin also occurs with ?

A 50-year-old man was under intensive stress. Concentrations of adrenaline and noradrenaline in his blood rose sharply. Which enzymes catalyze the inactivation of these hormones?

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

Major portion of postprandial glucose is utilized by ?

The most common form of diabetic neuropathy is ?

Examination of a patient suffering from frequent haemorrhages in the inner organs and mucous membranes revealed proline and lysine being included in collagen fibers. Impairment of their hydroxylation is caused by lack of the following vitamin:

A 13-year-old boy complains of general weakness, dizziness, tiredness. He is mentally retarded. Increased level of valine, isoleucine, leucine is in the blood and urine. Urine has specific smell. What is the diagnosis?

Increased amount of free fat acids is observed in the blood of the patients with diabetes mellitus. It can be caused by:

END OF ROUND 3

Why is necessary to take atorvastatin in the evening after meal?

A 58-year-old woman comes to the office after a near-fainting spell she experienced 1 day ago. She was outside playing tennis when she vomited and felt lightheaded. She spent the rest of the day lying down with mild, diffuse, abdominal pain and nausea. She had no fever or diarrhea. She reports several months of worsening fatigue, mild, intermittent, generalized abdominal pain, and loss of appetite with a 7 kg unintentional weight loss. Her medical history is significant for hypothyroidism for which she takes levothyroxine. She takes no medications. On examination, her temperature is 37.2°C, heart rate 102 bpm, blood pressure 89/62 mm Hg, and normal respiratory rate. She does become light-headed, and her heart rate rises to 125 bpm upon standing with a drop in systolic blood pressure to 70 mm Hg. She is alert and well tanned, with hyperpigmented creases in her hands. Her chest is clear, and her heart rhythm is tachycardic but regular. On abdominal examination, she has normal bowel sounds and mild diffuse tenderness without guarding. Her pulses are rapid and thready. She has no peripheral edema. Initial laboratory studies are significant for Na 121 mEq/L, K 5.8 mEq/L, , glucose 52 mg/dL (2,9 mmol/L) , and creatinine 1.0 mg/dL (88,4 mcmol/L).

The left testicular vein drains into:

A month after surgical constriction of rabbit's renal artery, considerable increase of systematic arterial pressure was observed. Which of the following regulation mechanisms caused the animal's pressure change?

Which of the following is not a tributary of the superior mesenteric vein?

Students who are taking examinations often have dry mouth. The mechanism that causes this state is the realization of the following reflexes:

The inferior nasal meatus lies between:

Due to action of electric current on the excitable cell, there is depolarization of it's membrane. Movement of what ions through the membrane caused depolarization?

A woman, 29 years old is 11 - 13 weeks pregnant. Pregnancy is normal. Woman is Rh+, fetus is Rh-. How can normal pregnancy be explained?

A comminuted fracture of infraglenoid tubercle caused by shoulder joint injury has been detected during X-ray examination of a patient. What muscle tendon attached at this site has been damaged?

Microspecimen of spinal cord contains a nucleus that should be analyzed. Its neurons form motor endings in the skeletal muscles. What nucleus of spinal cord is meant?

A 7-year-old girl has signs of anemia. Laboratory examination revealed pyruvate kinase deficiency in erythrocytes. What process disturbance plays the main role in anemia development?

Patients smear shows that, the number of young neutrophils is 20%, quantity of segmented neutrophils is 50%. How is this leucocyte formula change called?

In 3 years after surgery of stomach removal, a 45 years old man has the number of erythrocytes in blood to be 2.0 x 1012/L, Hb -85g/l, color index = 1.27. The violation of absorption of what vitamin caused the changes of erythropoiesis?

END OF ROUND ONE

Local signs and symptoms of acute inflammation include all the following except:

A 56-year-old patient with complains of thirst and frequent urination was diagnosed to have diabetes mellitus and butamin was prescribed. What is the mechanism of action of this medicine?

Programmed cell death is called :

Testosterone and its analogs increase the mass of skeletal muscles that allows to use them for treatment of dystrophy. Due to interaction of the hormone with what cell substance is this action caused?

Types of repair includes all of the following except:

Ascaris eggs have been detected during stool analysis. What drug should be prescribed?

Bacteria are able to transfer genes that confer resistance to each other. This usually occurs via which of the following:

A 22-year-old patient from the West Ukraine complains of labored nasal breathing. Morphological examination of biopsy material of nasal mucous membrane revealed lymphoid, epithelioid, plasma cells as well as Mikulicz's cells. What is the most probable diagnosis?

Examination of coronary arteries revealed atherosclerotic calcific plaques that close vessel lumen by 1/3. The muscle has multiple whitish layers of connective tissue. What process was revealed in myocardium?

Histological examination of a skin tissue sampling revealed granulomas consisting of macrophagal nodules with lymphocytes and plasmatic cells. There are also some big macrophages with fatty vacuoles containing causative agents of a disease packed up in form of spheres (Virchow's cells). Granulation tissue is well vascularized. What disease is this granuloma typical for?

A patient with complaints upon weakness and disturbances of gait has come to the doctor. The doctor diagnosed and prescribed proserinum injectionton the patient. What is the mechanism of action of proserinum.

Aspirin has anti-inflammatory effect due to inhibition of the cyclooxygenase activity. Level of what biological active compounds will decrease?

END OF ROUND 2

Microsomal oxidation is a universal biological system that oxidizes non-polar substances including pharmaceutical drugs, toxins, steroid hormones and cholesterol. Which cytochrome takes part in the functioning of microsomal oxidation chain?

Brain natriuretic peptide (BNP) is present in ?

Blood of a 12-year-old boy presents low concentration of uric acid and accumulation of xanthine and hypoxanthine. This child has genetic defect of the following enzyme:

Sinus arrest means :

A 62-year-old female patient has developed a cataract (lenticular opacity) secondary to the diabetes mellitus. What type of protein modification is observed in case of diabetic cataract?

A 50-year-old man was under intensive stress. Concentrations of adrena¬line and noradrenaline in his blood rose sharply. Which enzymes catalyze the inactivation of these hormones?

A 53-year-old male patient is diagnosed with Paget's disease. The concentration of oxyproline in daily urine is sharply increased, which primarily means intensified disintegration of:

Patient experienced increased susceptibility of the skin to the sunlight. His urine after some time became darkred. What is the most likely cause of this?

Brain natriuretic peptide (BNP) is secreted by cardiac ventricles in response to?

Which of the following site is best for detecting central cyanosis?

Test of choice for documenting eradication of H. pylori is ?

Whipple’s disease is caused by the bacteria named ?

END OF ROUND 3

Two children of 2 years old and 14 years old suddenly have taken high doses of paracetamol in tablets. For which age of children paracetamol will be safety and for whom will be it dangerous? Explain reasons of this and prescribe antidote.

68 year-old man was admitted to the hospital from his long-term care facility after 1 week of dyspnea and cough. He was seen by a staff physician at the long-term care facility and was diagnosed with a COPD exacerbation. He was prescribed azithromycin, but has not improved after 3 days of antibiotics. Has complaints for fever, chills, cough (sometimes productive) and dyspnea (worse than baseline).