Quiz

A family has two children. The younger child is under a year. The child has developed spastic cough attacks. Similar clinical presentation was observed in the elder preschool child one month ago. The doctor suspects pertussis infection. What method enables retrospective diagnostics of this disease?

A patient with peptic ulcer disease was prescribed famotidine. As a result his gastric juice acidity significantly decreased. What is the mechanism of action of this drug?

Examination of a patient shows decreased leukocyte and erythrocyte count and low hemoglobin levels in peripheric blood, as well as appearance of large cells (megaloblasts). What vitamin deficiency can cause these clinical presentations?

Antileukocytic antibodies are detected in the blood of a patient with leukopenia. What type of Coombs-Gell hypersensitivity reaction developed in this case?

A 34-year-old man died in a comatose state. According to his family after a business trip to an African country he developed periodical jaundice attacks. Autopsy shows the following: dense enlarged spleen with slate-black pulp; enlarged plethoric liver, gray-black on section; cerebral gray matter is brown-gray; cerebral white matter contains numerous small hemorrhages. What infectious disease can be suspected?

An inflammation can be characterized by hemocapillary dilation in the affected area, decreased blood circulation, and increased vessel wall permeability. What cells play the key role in this process?

A patient with periodontitis of the lower molar came to the doctor. It was determined that the inflammatory process spread to the lymph nodes. What lymph nodes were the first to be affected by the inflammatory process?

The mother’s karyotype has 45 chromosomes. It was determined that translocation of chromosome 21 to chromosome 14 had occurred. What disorder is likely to be observed in the child of this woman if the father’s karyotype is normal?

A patient has a pancreatic tumor. During surgery it was accessed by making an opening through the lig .gastrocolicum, but in the process a vessel passing through this ligament was damaged. As a result the surgeon had to stop the bleeding from the following vessel:

Autopsy of a 58-year-old man, who for a long time has been drinking alcohol in large amounts and died at home, is being conducted. Macroscopically the right lung is dense and enlarged, its tissue is gray and homogeneous on section, its pleura is covered with grayish membranous deposits. Microscopically the alveolar cavities contain fibrin threads, neutrophils, and hemolysed erythrocytes. Make the diagnosis:

Domestic accident has resulted in a significant blood loss in the patient, which was accompanied by a drop in blood pressure. What hormones ensure quick restoration of the blood pressure caused by a blood loss?

A patient presents with an acute attack of cholelithiasis. Laboratory examination of the patient’s feces will show the following in this case:

Autopsy of a 30-year-old man shows enlarged spleen (weight -900.0g), enlarged liver (weight -4000.0g), and enlarged lymph nodes. Bone marrow of the femoral shaft is bright red and moist. Microscopically in the liver there are thick infiltrates located along the portal tract. The infiltrate consists of juvenile hemopoietic cells with round nuclei and thin layer of cytoplasm. What disease can be suspected?

Before a surgery the patient was prescribed a synthetic antiprotozoal drug for prevention of wound infection. The prescribed drug is highly effective against Helicobacter pylori. Name this drug:

Human genetic apparatus consists of approximately 30 thousand of genes, while the number of antibody variants can be as high as millions. What mechanism leads to formation of new genes that ensure the synthesis of such a number of antibodies?

Prolonged vomiting resulted in dehydration of the patient’s body. Under these conditons, water retention in the body is ensured primarily due to increased secretion of the following hormone:

Wernicke-Korsakoff syndrome often develops in chronic alcoholics, who have a low-vitamin diet. Decreased transketolase activity can be observed in the course of this disease. What vitamin deficiency causes this development?

Toxic damage to hepatic cells resulted in disruption of the patient’s liver function and the patient developed edemas. What changes of blood plasma are the main cause of edema development?

Autopsy of a man, who had been suffering from mitral stenosis, reveals dense brown lungs. What pathologic process had occurred in the lungs?

A 52-year-old woman came to the neurologist with complaints of loss of skin sensitivity on the right half of her face in the area of the lower eyelid, nasal arch, and upper lip. What branch of what nerve is damaged in this patient?

A 33-year-old woman, who for a long time has been treated for chronic polyarthritis, complains of elevated blood pressure, changes in adipose tissue distribution, and disturbed menstrual cycle. What drug does this patient take?

What diagnostic method should be used in industry to test the raw leather for presence of B. antracis?

Blood test of the patient revealed albumine content of 20 g/L and increased activity of lactate dehydrogenase isoenzyme 5 (LDH5). These results indicate disorder of the following organ:

In the course of an urgent surgery, the vermiform appendix of the patient was excised. The appendix was acutely distended and gray-black throughout its whole length. In the distal segment a defect of the appendix wall was detected, through which a foul-smelling gray-brown substance was being discharged from the appendix lumen. Histological analysis shows necrotization of the appendix wall with hemorrhagic foci; lumen of the mesenteric artery is filled with a trombus. What type of appendicitis is it?

Histone protein synthesis is artificially blocked in a cell. What cell structure will be damaged as a result?

During regular examination of schoolchildren, a scrape from the perianal folds of a 10-year-old girl shows asymmetrical oval eggs with larvae inside. What diagnosis can be made?

A patient has elevated blood pressure due to increased vascular tone. To lower the blood pressure in this case it is necessary to prescribe the blockers of:

A 63-year-old man, who has been suffering from chronic diffuse obstructive pulmonary emphysema for 15 years, died of progressive heart failure. Autopsy shows nutmeg liver cirrhosis, cyanotic induration of kidneys and spleen, ascites, and edemas of the lower limbs. What type of heart failure can be characterized by such changes in the internal organs?

Pathologic material (mucosal excretion from the nasal passages) obtained from a patient provisionally diagnosed with influenza was sent to the virological laboratory. What quick test allows detecting specific viral antigen in the investigated material?

Long-term taking of medicines can affect cells of the liver. Particularly, it can cause marked hypertrophy of agranular endoplasmic reticulum due to the following function of this organelle:

Ingestion of plants and mushrooms that grow along highways is dangerous due to risk of lead poisoning. What is the main source of environmental pollution with this chemical element?

During gastric resection the patient received mixed anesthesia with tubocurarin chloride muscle relaxant; to restore spontaneous respiration the patient received proserin. What pharmacological group does this drug belong to?

The dorsal root of the spinal nerve of a test animal was severed. What changes will occur in the innervation area?

A patient with diabetes mellitus and allergic dermatitis was prescribed a certain fluorinated hormone drug in the ointment dosage form. When the patient asked, how this drug was better than the hydrocortisone ointment, the doctor explained that the prescribed medicine:

To test donor blood for hepatitis B antigens, it is necessary to use highly sensitive detection methods. What test should be used for this purpose?

A woman with allergic neurodermatitis was prescribed a second-generation antihistamine without depressing effect on the CNS. Name this drug:

Some diseases of large intestine lead to the changes in the quantitative ratio between mucosal epithelial cells. What cell types are normally predominant in the cryptal epithelium of the large intestine?

Autopsy revealed a large wedge-shaped patch of a dense dark red tissue with clear margins in the upper lobe of the right lung. Histological examination detected there necrosis of the alveolar walls; the alveolar lumen is tightly packed with erythrocytes. What process occurred in the lungs?

ABO blood group is being determined. Erythrocyte agglutination occurred when standard sera of group I and group II were introduced into the blood being analyzed, while group III serum caused no agglutination. What agglutinogens do these erythrocytes have?

Human brain produces endogenous peptides that are similar to morphine and can reduce pain perception. Name these peptides:

A patient with inoperable lung cancer accompanied by unbearable pain was prescribed an analgesic. Against the background of analgesic therapy the patient developed signs of intestinal obstruction. What analgesic could have caused this complication?

A 48-year-old man is unconscious. He has a history of several syncopal episodes with convulsions. ECG shows deformed QRS complexes unconnected with P waves, atrial contractions are approximately 70/min., ventricular contractions - 25-30/min. Name the type of arrhythmia in this case:

After a certain CNS structure had been destroyed in a test animal, this animal lost its orienting reflexes. What structure had been destroyed?

Disturbed activity of trypsin and chymotrypsin leads to disturbed protein breakup in the small intestine. Activity of these enzymes depends on the presence of the following factor:

A man has been working for a long time in oil processing. What type of carcinogens does he encounter at his workplace?

A patient with severe poisoning was brought into the intensive care unit. In the course of complex treatment the subclavian vein needs to be catheterized for medicine administration. This vein is located in the following topographic structure:

On examination the patient was determined to have a strong, balanced, inert type of higher nervous activity according to Pavlov’s classification. What temperament according to Hippocrates is it?

Urinalysis of a patient with acute cystitis shows leukocytes and a large number of gramnegative bacilli. Inoculation has resulted in the growth of mucous colonies that produce a green soluble pigment. What microorganism is the most likely cause of the patient’s disorder?

Examination of a surgically excised adrenal gland shows large cells that can be impregnated with a potassium dichromate solution. What hormone is being synthesized by these cells?

A patient is diagnosed with severe B12deficiency anemia resulting in disturbed hematopoiesis and appearance of atypical erythrocytes in the blood. The patient has a history of total gastric resection. This diagnosis can be confirmed if the following cells are present in the peripheral blood:

The first-aid center has received a victim of a traffic accident diagnosed with closed displaced fracture of the middle third of the thigh. For repositioning of the bone fragments the patient received 10 mL of 2% dithylinum solution intravenously, which resulted in the prolonged period of apnoea and muscle relaxation. What enzyme is deficient, resulting in such pharmacogenetic enzymopathy?

A 7-year-old boy is diagnosed with anemia. Laboratory analysis detects pyruvate kinase deficiency in his erythrocytes. What process is disturbed in this boy, playing the main role in anemia development in this case?

A 36-year-old man provisionally diagnosed with renal tuberculosis has undergone urinary sediment analysis. Microscopy revealed acid-fast bacteria, but Pryce method detected no cord factor. Name the most reliable method of investigation that can confirm or refute this provisional diagnosis:

To treat the burns, a patient was prescribed a drug with antiseptic properties that are based on formation of atomic oxygen in the presence of organic substances. This drug has also an astringent (antiinflammatory) effect due to formation of albuminates. Name this drug:

A student, whose educational achievements throughout the semester were poor, feels emotionally tense during the final test. What is the primary cause that induced the leading mechanism of emotional tension in this case?

A 35-year-old man with a hand injury came to the traumatology department. Examination revealed an incised wound on the palmar surface of the left hand; middle phalanges of digits II-IV cannot be flexed. What muscles are damaged?

A 9-month-old child presents with delayed tooth eruption, improper sequence of tooth eruption, and horizontal maxillary configuration (high-arched palate). Microscopically enamel mineralization pattern is irregular, enamel columns are wrinkled, some of them are vacuolated, predentin zones are widened, single denticles can be observed. What disease is it?

What changes can be expected to occur in the isolated heart of a toad, if excessive amount of calcium chloride is introduced into its perfusate?

Histological analysis of a biopsy skin sample obtained from a 24-year-old patient detects caseous necrosis surrounded with cellular infiltrate consisting of lymphocytes, among which there are single giant cells; proliferation of connective tissue and endovasculites are observed. Characterize this pathologic process:

Parenchyma of an organ is composed of pseudounipolar neurons localized under the capsule of connective tissue. Central place belongs to nerve fibers. Name this organ:

To determine toxigenicity of diphtheria causative agents obtained from patients, the cultures were inoculated in a Petri dish with nutrient agar, bilaterally to a strip of filter paper spotted with antidiphtheric antitoxic serum and situated in the center of the Petri dish. After incubation of the inoculated cultures in the agar, strip-like areas of medium turbidity formed between some of the cultures and the filter paper. What immunological test was conducted?

A 45-year-old woman has an attack of cardiac fibrillation. She suffers from stage II essential hypertension. What is the drug of choice for stopping this attack?

A newborn presents with weak suckling, frequent vomiting, and hypotonia. Blood and urine citrulline are very high. What metabolic process is disturbed?

A patient with streptococcal infection of the gingiva was prescribed a drug with β-lactam ring in its structure. What drug of those listed below belongs to this pharmacological group?

A 25-year-old child is provisionally diagnosed with pharyngeal diphtheria. Smear from the child’s mucosa was obtained and inoculated into a coagulated equine serum. What is the purpose of this stage of microbiological diagnostics?

Collagenosis patients typically present with the processes of connective tissue destruction. The presence of these processes can be confirmed by the increase in:

A man is a carrier of HIV that is an RNA virus. The cells of this patient synthesize viral DNA. This process is based on:

I.M. Siechenov has proven that a tired limb restores its working capacity faster if during its period of rest another limb works. It became a basis for the concept of:

A patient presents with an inner ear inflammation. On examination the doctor states that the 1st neurons of the auditory analyzer are affected. Where are these neurons located?

The bacteriological laboratory has received for analysis a sample of dried fish from a focus of food poisoning outbreak. The bacteriologist inoculated the sample into a Kitt-Tarozzi medium, where growth of tennis racquetshaped microorganisms could be observed. These microorganisms are likely to be the causative agents of:

A 14-year-old adolescent has diphtheria. During the peak of the disease against the background of acute drop in body temperature and tachycardia the blood pressure is 70/50 mm Hg. What type of vascular tone disturbance is it?

In an experiment a laboratory rat was subjected to a stress factor (electric current), which resulted in muscular hypotonia, arterial hypotension, hypothermia, and hypoglycemia in the animal. What period of general adaptation syndrome is it?

A 45-year-old woman exhibits no signs of diabetes mellitus, but her fasting blood glucose levels are elevated (7.2 mmol/l). What should be measured next?

The neurological department received a patient complaining of memory deterioration and loss of mental work capacity that developed after a head trauma. Recommend him a medicine for improvement in cerebral metabolism:

A young woman, a foreign student from Tehran, has made an appointment with the urologist. She complains of the sensation of heaviness in her lower abdomen and a small amount of blood being excreted with urine at the end of each urination. Microscopy of urine detects the presence of parasite eggs, approximately 140х70 micron in size, with a terminal spike. What diagnosis can be made by the infectious diseases specialist?

A patient has been suffering from bronchial asthma for 15 years. What changes in the patient’s leukogram can be expected in this case?

After a prolonged attack of severe headache the patient lost mobility in his left arm and leg. Muscle tone is decreased in the affected limbs, the muscles are spasmed, spinal tendon reflexes are acutely intensified, reflex zones are increased. What nervous system disorder can be observed in this patient?

An isolated heart was used to study excitation conduction velocity in different areas of the heart. What area had the lowest velocity of excitation conduction?

A 30-year-old woman developed facial edemas. Examination detected proteinuria (5.87 g/L), hypoproteinemia, dysproteinemia, and hyperlipidemia. Such combination of signs is characteristic of:

After an X-ray examination of the tuberculosis clinic patient, he was diagnosed with tumor of the right lung. During operation the surgeon removed the middle lobe of the patient’s right lung. This lobe includes:

A histological specimen demonstrates a vessel with the wall that consists of endothelium, basement membrane, and loose connective tissue. This vessel belongs to the following type:

A patient with obliterating endarteritis has undergone a ganglionic sympathectomy. Positive therapeutic effect of this surgery is associated with development of arterial hyperemia of the lower limbs, which can be described as:

Regional lymph nodes surrounding an infected wound are enlarged. Histological examination shows increased number of macrophages, lymphocytes, and lymphatic follicles in the cortical layer of the lymph nodes, as well as a large amount of plasma cells. What process in the lymph nodes is indicated by these histological changes?

Clinical course of urolithiasis was complicated by the passage of a renal calculus. Where in the ureter is it most likely to stop?

A 27-year-old patient presents with pathologic changes in the liver and brain. Blood plasma exhibits acute decrease in copper levels, while urine copper levels are elevated. The patient is diagnosed with Wilson disease. To confirm this diagnosis it is necessary to measure activity of the following enzyme in the patient’s blood serum:

A 40-year-old man with pulmonary tuberculosis was prescribed isoniazid. Prolonged taking of this drug can result in development of the following vitamin deficiency:

A person has increased pulmonary ventilation due to physical exertion. What indicator of external respiration will be significantly increased compared to the resting state?

During an invasive operation the surgeon needs to access the omental bursa of the peritoneal cavity via the omental foramen (foramen of Winslow). What anatomical structure makes up the anterior border of this foramen?

The Gerontology Institute recommends older people to take vitamin complexes that contain vitamin E. What is the main function of this vitamin?

A 45-year-old woman presents with insufficient secretion of enterokinase enzyme. Enterokinase deficiency can cause disturbance of the following digestive function:

A patient with arrhythmia was hospitalized into the cardiology unit. What antiarrhythmic drug should be prescribed?

A 12-year-old boy with clinical presentation of influenza has developed respiratory mycoplasmosis. What type of infection has developed under these conditions?

A 30-year-old person has been stung by a bee. The stung area exhibits edema, hyperemia, and elevated temperature. What is the initial pathogenetic factor of inflammatory edema in this case?

An experiment was conducted to measure the skin sensitivity threshold. What patches of skin have the highest sensitivity threshold?

A 3-year-old child has been brought by ambulance to the intensive care unit of the infectious diseases hospital. On examination the child is in severe condition, skin and mucosa are dry, tissue turgor is reduced. The patient’s history states that profuse diarrhea and recurrent vomiting were observed throughout the previous day after the child had eaten food products of poor quality. What type of salt and water imbalance is likely to have developed in the patient?

The surgeon noticed aggregated lymphoid nodules (Peyer’s patches) on the intestinal mucosa. What portion of the intestine is it?

A 40-year-old person developed elevated blood pressure after an emotional excitement. What is the likely cause of this effect?

A patient with asphyxia after a brief respiratory arrest developed single infrequent respirations with passive expiration, after which he stopped breathing completely. What type of respiration was observed in this case?

A patient with diabetes mellitus after an insulin injection lost his consciousness and developed convulsions. What will be the result of a biochemical test for blood glucose level in this case?

Cells of a person working in the Chornobyl Exclusion Zone have undergone a mutation in DNA molecule. However, with time the damaged interval of DNA molecule restored ist initial structure with a specific enzyme. In this case the following occurred:

A 45-year old man with acute pneumonia was prescribed a penicillin antibiotic. However, when tested for personal tolerance to this antibiotic, he developed an allergic response. What drug should be prescribed for treatment instead?

Autopsy of a 60-year-old woman, who for a long time had been suffering from essential hypertension, shows significantly diminished kidneys (weight of both kidneys is 80 g) with finely granular surface. Uniform renal cortical thinning can be observed on section. Name the described changes in the kidneys:

A histological specimen shows significant amount of mucous connective tissue (Wharton’s jelly), vessels, as well as remnants of yolk sac stalk and allantois. Name this organ:

24 hours after an appendectomy the patient’s blood test shows neutrophilic leukocytosis with a regenerative shift. What is the most likely mechanism of absolute leukocytosis development in the patient’s peripheral blood?

A laboratory rat with chronic kidney failure presents with osteoporosis, pathologic calcification of the internal organs, and arterial hypertension. These disturbances are associated with increased activity of the following hormone:

A woman with polyarticular rheumatoid arthritis was prescribed a non-steroidal antiinflammatory drug - diclofenac sodium. After the patient has been taking it for some time, her concomitant disease exacerbated, which forced the doctor to cancel the prescription of this drug. What concomitant disease could necessitate cancellation of this drug prescription?

A 39-year-old man presents with hyperkeratosis, disturbed twilight vision, and high risk of infectious processes. What vitamin preparation should he be prescribed?

Ammonia is extremely toxic for human CNS. What is the main way of ammonia neutralization in the nervous tissue?

A 40-year-old man with impaired venous patency in the lower limbs developed edemas. What mechanism plays the main role in the development of this disturbance?

A patient was administered a certain drug for relief of cardiac rhythm disturbance. This drug can be used as a local anesthetic as well. Name this drug:

First-year schoolchildren have received tuberculin skin test (Mantoux test) at the school nurse’s office. The purpose of this test was:

Autopsy of a 3-year-old child shows a tumor in the cerebellum. The tumor has no clear margins separating it from the surrounding tissues. Histologically it is made of small atypical cells with hyperchromic nuclei. This tumor is most likely a:

A patient has been taking bisacodyl for a long time to treat chronic constipation. However, several weeks later the aperient effect of the drug diminished. What is the possible cause of this?

Autopsy of a man, who served on a nuclear submarine, revealed the following pathologies: bone marrow atrophy (panmyelophthisis), anemia, leukopenia, thrombocytopenia, lymphocytic disintegration in the lymph nodes, spleen, gastrointestinal lymphatic system, and hemorrhages into the adrenal glands. What disease had developed in this case?

A patient has gradually developed a skin plaque on his face. In the center of this plaque there are necrotic patch and an ulcer. Histopathological analysis of the biopsy material reveals proliferation of atypical epithelial cells with large number of pathologic mitoses. What is the most likely diagnosis?

A patient with essential hypertension was prescribed a drug that inhibits angiotensin converting enzyme (ACE). What drug is it?

A 6-year-old girl presents with acute onset of a disease. She developed sore throat and high temperature that were later accompanied by a punctate skin rash. Oral examination reveals acute pharyngeal hyperemia, raspberry tongue, and enlarged bright red tonsils with dull gray and yellow foci that spread to the peritonsillar tissues. The submandibular lymph nodes are enlarged. What disease are these changes characteristic of?

After a trauma the patient has developed right-sided paralyses and disturbed pain sensitivity. On the left side no paralyses are observed, but pain and thermal sensitivity is disturbed. What is the cause of this condition?

A patient was hospitalized in a comatose state. The patient has a 5-yearlong history of diabetes mellitus type 2. Objectively respiration is noisy, deep, with acetone breath odor. Blood glucose is 15.2 mmol/L, ketone bodies - 100 micromol/L. These signs are characteristic of the following diabetes complication:

A 3-year-old child with elevated body temperature has taken aspirin and developed increased hemolysis of erythrocytes. In this case hemolytic anemia can be caused by congenital deficiency of the following enzyme:

A 63-year-old man suffers from esophageal carcinoma, presents with metastases into the mediastinal lymph nodes and cancerous cachexia. What pathogenetic stage of neoplastic process is observed in the patient?

A patient, who has been subsisting exclusively on polished rice, has developed polyneuritis due to thiamine deficiency. What substance is an indicator of such avitaminosis, when it is excreted with urine?

A 40-year-old woman on examination presents with intensified basal metabolic rate. What hormone present in excess leads to such condition?

People, who for a long time remained in hypodynamic state, develop intense pain in the muscles after a physical exertion. What is the most likely cause of this pain?

The parents with normal hearing have two daughters and a son, who are congenitally deaf. Their other 5 children are healthy. What is the pattern of deafness inheritance in this case?The parents with normal hearing have two daughters and a son, who are congenitally deaf. Their other 5 children are healthy. What is the pattern of deafness inheritance in this case?

KCl concentration in a solution that surrounds an isolated cell was increased. How will resting membrane potential (RMP) and cell excitability change in this case?

An oncology patient is to undergo a surgery on the descending colon. Name the main source of blood supply to this organ:

A patient with myocardial infarction in the acute phase has been hospitalized into the cardiology unit. To induce platelet lysis in the patient’s coronary vessels during the early hours of infarction, the following enzyme should be used:

Systemic blood pressure of a person equals 120/65 mm Hg. Blood ejection into aorta occurs when left ventricular pressure exceeds:

A 45-year-old woman presents with breast cancer. Metastases can spread in this case to the following regional lymph nodes:

Patients with ischemic heart disease are usually prescribed small doses of aspirin. This drug inhibits synthesis of platelet aggregation activator, thromboxane A2. What substance is this activator synthesized from?

Autopsy of a 49-year-old woman who died of chronic kidney failure shows small dense striated kidneys with areas of hemorrhages. Microscopically nuclei of epithelial channels contain hematoxylin bodies; glomerular capillaries resemble wire loops, have thickened basement membranes, and in places contain hyaline thrombi and foci of fibrinoid necrosis. What is the most likely diagnosis?

Dwellers of a village located in the taiga make a living by harvesting berries. Lately the occurrence of alveococcosis in the village population has increased. What is the source of invasion in this case?

After hyperventilation an athlete developed a brief respiratory arrest. It occurred due to the following changes in the blood:

A 59-year-old man, a business manager, developed intense burning retrosternal pain that irradiates to the left arm. The pain occurred in the evening after the tax audit. 15 minutes later the patient’s condition normalized. What mechanism of angina pectoris development is leading in this patient?

An ovarian tumor was detected in a woman. She is prescribed a surgery. What ligament should be severed by the surgeon to separate the patient’s ovary from the uterus?

A 30-year-old man with an incised wound on the plantar surface of the left foot was brought to the traumatology department. Lifting of the lateral side of the foot is limited. What muscle is likely to be functionally disturbed?

A 27-year-old woman has undergone a sector resection of mammary gland tissue. Macroscopy detects a dense white node, 4 cm in diameter, with clear margins in the excised tissue. Immediate histological analysis shows the tumor to consist of a large amount of fibrous stroma with stromal proliferation around the small canaliculi. Canalicular epithelium overlays the basement membrane and retains its polarity. Make the diagnosis:

A married couple came for a genetic counseling. The husband suffers from insulinindependent diabetes mellitus, while the wife is healthy. What is the probability of their child developing insulin-independent diabetes mellitus?

A victim has received a deep incised stab wound to the upper posterior surface of the shoulder. Extension of elbow, hand, and digits is impaired; skin sensitivity of the posterior surface of the shoulder and forearm is lost. What nerve is damaged in this case?

An uconscious young man in the state of morphine intoxication has been brought into an admission room. The patient’s respiration is slow and shallow due to suppression of the respiratory center. What kind of respiratory failure occurred in this case?

In the hematology unit a patient with leukemia was prescribed 5-Fluorouracil. This drug:

A young man has come to the genetic consultation. He complains of abnormalities in his physical and reproductive development. Microscopy of his oral mucosa cells shows one Barr body. What karyotype is the most likely in this young man?

Hematologic study shows the following pattern: erythrocytes - 2,8 · 1012/L, Нb 80 g/L, color index - 0.85, reticulocytes 0,1%, platelets - 160 thousand per microliter, leukocytes - 60 · 109/L. Basocytes - 2%, eosinophils - 8%, promyelocytes - 5%, myelocytes - 5%, juvenile - 16%, stab neutrophils - 20%, segmented neutrophils - 34%, lymphocytes - 5%, monocytes 5%. This clinical presentation indicates the following blood pathology:

A patient developed punctate hemorrhages after a tourniquet had been applied. It occurred due to functional disturbance of the following blood corpuscles:

A 39-year-old man underwent a surgery for peptic ulcer disease of the stomach. He died 7 days after the surgery. On autopsy the peritoneal layers are plethoric, dull, and covered with massive yellow-green membranous deposits. The peritoneal cavity contains approximately 300 mL of thick yellow-green fluid. What pathologic process was detected in the peritoneal cavity?

A patient for a long time was on an imbalanced diet low in proteins, which resulted in hepatic fatty infiltration. This condition is likely to develop if a certain substance is absent in a person’s diet. Name this substance:

During diabetes mellitus and starvation, the number of acetone bodies in blood increases. These bodies are used as a source of energy and are synthesized from the following substance:

Chronic overdose of glucocorticoids leads to the development of hyperglycemia in a patient. Name the process of carbohydrate metabolism that results in elevated blood glucose levels:

The bacteriological laboratory needs to prepare for analysis of materials that are suspected to be contaminated with spores of anthrax causative agent. What diagnostic preparation allows for quick detection of these spores?

A patient with hypochromic anemia has hair with split ends and suffers from hair loss. The nails are brittle. Gustatory sensations are affected. What is the mechanism of development of these symptoms?

Pathogenic staphylococcus was obtained from the purulent wound of the patient. Its antibiotic sensitivity was determined to be as follows: penicillin growth inhibition zone - 8 mm; oxacillin - 9 mm, ampicillin - 10 mm, gentamicin - 22 mm, lincomycin - 11 mm. What antibiotic should be chosen for treatment in this case?

A patient presents with dilated blood vessels of the anterior medial surface of the lower leg. This condition resulted from the dilation of the following blood vessel:

A victim of a traffic accident was received by the intensive care unit. The patient is in a grave condition that can be characterized as a severe pathologic process that leads to exhaustion of vital functions and puts the patient into the marginal state between life and death due to critical reduction of capillary circulation in the affected organs. The patient is in the state of:

A patient suffers from hepatic cirrhosis. What substance excreted in urine should be analyzed to characterize the antitoxic function of liver?

Autopsy of a 50-year-old woman, who had been suffering from systemic connective tissue disease, reveals small dense kidneys with lumpy surface. Microscopy of the renal glomeruli detects there foci of fibrinoid necrosis, hyaline thrombi, hematoxylin bodies, and so-called ”wire loop thickening” of the basement membranes. What disease can be characterized by such changes in the kidneys?

A test animal receives electrical impulses that irritate the sympathetic nerve that innervates blood vessels of the skin. What reaction will it cause in the blood vessels?

Autopsy of the body revealed waxy degeneration of the rectus abdominis muscles. In the terminal segment of the small intestine there are ulcers 3-5 cm in diameter. The ulcer walls are covered in a crumbling grayish-white substance. The ulcer edges are markedly raised above the mucosa. Widal test is positive. Make the diagnosis:

The carotid bodies on both sides were removed in a test animal. Which of the listed factors WILL NOT be able to cause hyperventilation in the test animal?

Encephalopathy has developed in a child with hemolytic disease of the newborn. What substance had increased in the child’s blood, resulting in damage to the CNS?

A traumatology unit has received a patient with a wrist trauma and a clinical presentation of the damage to the nerve that passes through the carpal tunnel. Name this nerve:

A patient with contact dermatitis needs to be prescribed an antihistamine drug without somnolescent effect. Select this drug from the list:

Monoamine oxidase inhibitors are widely used as psychopharmacological drugs. They change the level of nearly all neurotransmitters in synapses, with the following neurotransmitter being the exception:

Kidney X-ray image obtained by means of pyelography shows that the minor calyces converge to form 2 major calyces that adjoin to the renal pelvis, from which the ureter exits. What type of urinary tract is it?

A 30-year-old man complains of suffocation, heaviness in the chest on the right, general weakness. Body temperature is 38.9oC. Objectively the right side of the chest lags behind the left side during respiration. Pleurocentesis yielded exudate. What is the leading factor of exudation in the patient?

From the feces of a patient with acute gastroenteritis a pure culture of microorganisms was obtained. The microorganisms are small mobile slightly curved gram-negative bacilli that within 6 hours grow into a light blue film on the 1% alkaline peptone water. Such properties are characteristic of the following microorganism:

When studying the pulmonary ventilation values, the reduction of forced expiratory volume has been detected. What is the likely cause of this phenomenon?

A toxin neutralized with 0.4% formaldehyde under 37-40oC for 4 weeks is used for vaccination. This preparation was first used by Gaston Ramon for diphtheria prevention. Name this preparation:

A patient was brought into the infectional diseases hospital on the 8th day since the disease onset. The patient complains of headache, malaise, and weakness. A sample of blood was taken for the serological test. Widal agglutination test results with blood sample diluted 1:200 and typhoid fever Odiagnosticum were positive. What diagnosis can be made based on the results of this test?

A boxer had sustained a blow to the left parotid area, after which he developed paralysis of the facial muscles on this side. What nerve had been damaged?

A 20-year-old young man with tall stature, asthenic body type, signs of hypogonadism and gynecomastia, and low sperm count (azoospermia) has karyotype 47, XXY. What hereditary syndrome can be characterized by this chromosomal anomaly?

Histological investigation of the uterine scrape of the 45-year-old woman with disturbed ovarian menstrual cycle revealed increased number of endometrial glands, some of which are serrated, while others are dilated and cyst-like. Make the diagnosis:

In the process of hemoglobin catabolism iron is released and then as a part of special transport protein is returned to the bone marrow, to be used again for hemoglobin synthesis. Name this transport protein:

Regional lymph nodes surrounding an infected wound are enlarged. Histological examination shows increased number of macrophages, lymphocytes, and lymphatic follicles, as well as a large amount of plasma cells, in the cortical layer of the lymph nodes. What process in the lymph nodes is indicated by these histologic changes?

A schizophrenia patient was prescribed aminazine. What pharmacodynamic action of this drug is the grounds for its prescription in this case?

An oncology patient is to undergo a surgery on the descending colon. Name the main source of blood supply to this organ:

A patient has been taking bisacodyl for a long time to treat chronic constipation. However, several weeks later the aperient effect of the drug diminished. What is the possible cause of this?

A patient, who had received a thermal burn, developed painful boils filled with turbid liquid on the skin. What morphological type of inflammation has developed in the patient?

A 19-year-old young man was examined in the nephrology clinic. High calcium was detected in his secondary urine. What hormone is likely to cause such change, if it is produced in excess?

Nitrogen is being excreted from the body mainly as urea. When activity of a certain enzyme in the liver is low, it results in inhibition of urea synthesis and nitrogen accumulation in blood and tissues. Name this enzyme:

Vascular endothelium is characterized by high metabolic activity and synthesizes vasoactive substances. Among these substances there is a potent vasodilator synthesized from L-arginine. Name this vasodilator:

Blood of the patients with diabetes mellitus shows increased content of free fatty acids. Name the most likely cause of this:

A microslide of the lung tissue sample taken from a patient with pneumonia shows damage to the cells that carry out respiratory function. What cells of the alveolar wall are damaged?

In the process of an experiment, vascular resistance to the blood flow was measured in the different areas of circulatory system. The highest resistance was detected in the:

During intensive physical exertion, one of the energy sources for the working muscles is glucose produced as the result of gluconeogenesis. This process is the most intensive in the following organ:

First-year schoolchildren have received tuberculin skin test (Mantoux test) at the school nurse’s office. The purpose of this test was:

A man is a carrier of HIV that is an RNA virus. The cells of this patient synthesize viral DNA. This process is based on:

After a case of sepsis a 27-year-old woman developed ”bronzed” skin discoloration characteristic of Addison’s disease. Hyperpigmentation mechanism in this case is based on increased secretion of:

A woman has been limiting the amount of products in her diet to lose some weight. 3 months later she developed edemas and her diuresis increased. What dietary component deficiency is the cause of this?

Patients with bile duct obstruction typically present with inhibited blood clotting and develop hemorrhages due to insufficient assimilation of vitamin:

A medical student was hospitalized into the infectious diseases unit on the 2nd day after the disease onset; the patient is suspected to have infectious mononucleosis. What results of laboratory analysis can confirm this diagnosis immediately on the day of the hospitalization?

In human organism significant blood loss leads to decreased blood pressure, tachycardia, and weakness. Eventually the sensation of thirst appears. What hormone participates in the development of this sensation?

A patient with streptococcal infection of the gingiva was prescribed a drug with β-lactam ring in its structure. What drug of those listed below belongs to this pharmacological group?

A 54-year-old man complains of general weakness, frequent colds, and bruises constantly appearing on his body. Blood test: erythrocytes - 2.5 · 1012/L; Hb- 80 g/L; color index - 0.9; reticulocytes - absent; platelets - 50 · 109/L; leukocytes - 58 · 109/L; leukogram: basocytes - 5%, eosinophils 15%, myeloblasts - 6%, myelocytes - 10%, juvenile - 18%, stab neutrophils - 26%, segmented neutrophils - 10%, lymphocytes - 8%, monocytes - 2%, ESR - 40 mm/hour. What hematologic conclusion can be made?

Histological analysis of a removed skin tumor shows clusters and bands composed of atypical stratified squamous epithelium cells that penetrate into the underlying tissue. What preliminary diagnosis can be made?

A person becomes less receptive to pain in physically or emotionally straining situations due to activation of:

A person with the fourth blood group (genotype IAIB) has in erythrocytes both antigen A controlled by allele IA and antigen B controlled by allele IB. This phenomenon is an example of the following gene interaction:

A woman has lost a lot of blood during the childbirth. Her blood group needs to be determined. Erythrocyte agglutination occurred with standard serums 0 (I) and А (II) and did not occur with standard serum B (III). What blood group does this woman have?

A man with ischemic heart disease has been taking his medicine too often throughout a day, which resulted in poisoning. Examination detects cyanosis of skin and mucosa, sharp drop of blood pressure, tachycardia, and respiratory depression. Blood methemoglobin is high. What type of medicine did the patient overdose on?

A 3-year-old girl with mental retardation has been diagnosed with sphingomyelin lipidosis (Niemann-Pick disease). In this condition the synthesis of the following substance is disturbed:

A patient was hospitalized into the infectious diseases unit on the 11th day since the disease onset and provisionally diagnosed with typhoid fever. What biological material should be collected from the patient for the analyzes at this stage?

A 2-year-old child presents with physical retardation and frequent pneumonias. The child was diagnosed with non-closure of the arterial canal. Hemodynamics disturbance in this case is caused by communication between the:

A patient developed pyoinflammatory process of periodontal tissues caused by activation of the microorganisms inherent in the body, which are a part of oral mucosal microflora. What type of infection is it?

Autopsy of the body of an elderly man revealed yellow spots and streaks in the aortic intima and white-yellow protruding plaques in the area of aortic bifurcation. Microscopy (with hematoxylin and eosin staining) shows round cavities in the thickened aortic intima. The cavities color orange when stained with sudan 3 and are surrounded with overgrown connective tissue. What process developed in the aortic intima?

The dorsal root of the spinal nerve of a test animal was severed. What changes will occur in the innervation area?

A mutation has occurred in a cell in the first exon of the structural gene. The number of nucleotide pairs changed from 290 to 250. Name this type of mutation:

A hereditary disease - homocystinuria - is caused by disturbed transformation of homocysteine into methionine. Accumulated homocysteine forms its dimer (homocystine) that can be found in urine. What vitamin preparation can decrease homocysteine production?

A 59-year-old man, a business manager, developed intense burning retrosternal pain that irradiates to the left arm. The pain occurred in the evening after the tax audit. 15 minutes later the patient’s condition normalized. What mechanism of angina pectoris development is leading in this patient?

A 16-year-old girl presents with no hair on the pubis and in the armpits, her mammary glands are underdeveloped, no menstruations. What hormone imbalance can it be indicative of?

24 hours after an appendectomy the patient’s blood test shows neutrophilic leukocytosis with a regenerative shift. What is the most likely mechanism of absolute leukocytosis development in the patient’s peripheral blood?

During the first year of life an infant presents with disturbed process of breast milk curdling. What cells of the proper gastric glands are functionally disturbed?

Representatives of a certain human population can be characterized by elongated body, height variability, decreased volume of muscle mass, increased length of limbs, decreased size and volume of rib cage, increased perspiration, decreased indices of base metabolism and fat synthesis. What type of adaptive evolution is it?

Microscopy of the myocardium of a girl, who died of diphtheria due to heart failure, shows fatty degeneration, multiple foci of cardiomyocytes necrosis, and small foci of cellular infiltrates in the interstitium. What type of myocarditis is it?

A sick child presents with high content of phenyl pyruvate in urine (normally it is practically absent). Blood phenylalanine level is 350 mg/L (norm - 15 mg/L). What disease are these symptoms characteristic of?

A patient was prescribed atropine sulfate to treat intestinal colic. What concomitant disease can be a contraindication for this drug?

A woman with enteritis accompanied by severe diarrhea presents with loss of water in the extracellular space, increased water content in the cells, and decreasing blood osmolarity. Name this type of water electrolyte imbalance:

A 65-year-old woman, who had been suffering from deep vein thrombophlebitis of the lower leg, suddenly died when awaiting her appointment with the doctor. Autopsy revealed loose friable red masses with corrugated dull surface in the main pulmonary artery and its bifurcation. What pathologic process was discovered by the pathologist in the pulmonary artery?

In a township there was registered an outbreak of hepatitis, which had supposedly spread through the water supply. What hepatitis virus could be the cause of the outbreak in this township?

Due to trauma the patient has lost 25% of circulating blood volume. Name the emergency compensatory mechanism against blood loss:

During the skill-building session in microbiology the students need to stain the prepared and fixed sputum smears obtained form a tuberculosis patient. What staining technique should be used in this case?

During cholecystectomy besides a. cystyca another artery was pulled into the ligature. Ligation of this artery resulted in right-sided necrosis of the liver which led to the death of the patient. What artery was mistakenly ligated along with a. cystyca?

The right leg of a 40-year-old woman measured at the shin level is by 2 cm smaller in the diameter than the left leg. Anklejerk (Achilles) and knee-jerk reflexes are absent on the right. What is the most likely mechanism of hyporeflexia development during peripheral paralysis?

Condition of a patient with diabetes mellitus sharply deteriorated after a regular injection of insulin. The patient became anxious and broke out in cold sweat; tremor of the extremities, general weakness, and dizziness appeared. What medicine can remove these symptoms?

A 42-year-old man with gout presents with high content of uric acid in blood. The patient was prescribed allopurinol to lower the concentration of uric acid. Allopurinol is a competitive inhibitor of the following enzyme:

Stool test detects in the patients feces a large amount of undigested fats.This patient is the most likely to have disturbed secretion of the following enzymes:

A patient has been brought into a surgical ward with an incised wound of the anterior surface of the shoulder in its lower one-third. Flexing function was disturbed in the shoulder and elbow joints, which is caused by the damage to the:

After a hand fracture the man has lost the ability to touch his little finger with the thumb on the affected hand. Examination of the palmar surface shows one of the palmar muscles to be atrophied. Name the affected muscle:

The first-aid center has received a victim of a traffic accident diagnosed with closed displaced fracture of the middle third of the thigh. For repositioning of bone fragments the patient received 10 ml of 2% dithylinum solution intravenously, which resulted in prolonged period of apnoea and muscle relaxation. What enzyme is deficient, resulting in such pharmacogenetic enzymopathy?

A 34-year-old man died in a comatose state. According to his family after a business trip to an African country he developed periodical jaundice attacks. Autopsy shows the following: dense enlarged spleen with slate-black pulp; enlarged plethoric liver, gray-black on section; cerebral gray matter is brown-gray; cerebral white matter contains numerous small hemorrhages. What infectious disease can be suspected?

A 40-year-old woman on examination presents with intensified basal metabolic rate. What hormone present in excess leads to such condition?

After a psychic trauma a woman developed periodical increases in her blood pressure accompanied by headache, palpitations, and general weakness. What mechanism of hypertension development does this woman have?

A newborn presents with weak suckling, frequent vomiting, and hypotonia. Blood and urine citrulline are very high. What metabolic process is disturbed?

A 40-year-old woman suffers from Cushing’s disease - steroid diabetes. On biochemical examination she has hyperglycemia and hypochloremia. What process activates in the first place in such patients?

Microscopy of the puncture sample obtained from the inflammation focus of the patient with cutaneous abscess revealed numerous blood cells of different types. What cells are the first to transfer from vessels to tissues during inflammation?

A 25-year-old woman complains of visual impairment. Examination revealed disturbed eye accommodation, the pupil is dilated and unresponsive to light. What muscles are functionally disturbed in this case?

A patient used an indirect-acting adrenergic agonist to treat rhinitis. After the patient has been putting in the nose drops for several days, the vasoconstrictive effect of the drug gradually diminished. Name this phenomenon:

Renal examination shows the kidney to be swollen and plethoric, with easily removable capsule. Renal pelvis and calyces are dilated and filled with turbid urine; their mucosa is dull and has hemorrhagic foci. On section the renal tissue is variegated, there are yellow-gray areas surrounded with plethoric and hemorrhagic zone. What disease can be characterized by such results of macroscopic examination?

A 60-year-old man diagnosed with chronic heart failure was brought to the hospital. After a long course of treatment the patient developed signs of intoxication: dyspnea, extrasystole, nausea, and disturbed perception of colors. What medicine has caused such side-effects?

An obstetrician-gynecologist measures pelvis size of a pregnant woman. A caliper was used to measure the distance between the two iliac crests. What measurement of large pelvis was made?

Genetic recombination is achieved via several mechanisms. One such mechanism is crossingover. It occurs at the following stage of prophase in the first meiotic division:

A patient has disturbed blood supply to the anterior papillary muscle of the left ventricle. What cardiac artery supplies this muscle with blood?

Ketosis develops in the patients with diabetes mellitus, as the result of activation of fatty acids oxidation processes. What acidbase imbalance can result from accumulation of excessive ketone bodies in the blood?

Due to prolonged stay in the mountains at the altitude of 3000 m above the sea level, a person developed increased oxygen capacity of blood, which was directly caused by intensified production of:

A microslide of the skin sample taken from the finger of a child shows that epidermis is insufficiently developed. What germ layer was damaged in the process of embryo development?

A patient has undergone surgical removal of the pylorus. Decreased secretion of the following hormone can be expected:

During pregnancy a woman has been taking an antiepileptic drug - sodium valproate. It resulted in her child developing a vertebral column malformation - spina bifida. Name the described effect of the drug:

During autopsy of a 34-year-old man, who died of chronic kidney failure due to renal amyloidosis, in the lungs (mainly in the lower lobes) the pathologist detected multiple bronchial dilations filled with purulent masses accumulated in the bronchial lumen. Surface of the lungs section has fine-meshed pattern and resembles a honeycomb. Histologically there is a chronic inflammation detected in the bronchial wall, muscle fibers are replaced with connective tissue. These changes in the lungs can be defined as:

ECG analysis of the patient shows that the T waves are positive in the second standard limb lead and their amplitude and duration is normal. The conclusion can be made that the following process occurs normally in the patient’s ventricles:

A 17-year-old girl suffers from periodical palpitations that last several minutes. Her heart rate is 200/min., rhythmic. What heart rhythm disorder developed in this patient?

An 18-year-old student presents with enlarged thyroid gland accompanied by accelerated metabolism and increased heart rate. These signs can be observed during hypersecretion of thyroxin. What organelles of thyroid cells are primarily responsible for hormone production and secretion?

A patient with pulmonary tuberculosis is prescribed the most effective antituberculous antibiotic. Name this drug:

A laboratory experiment on a dog was used to study central parts of auditory system. One of the mesencephalon structures was destroyed. The dog has lost the orienting response to auditory signals. What structure was destroyed?

After an X-ray examination of the tuberculosis clinic patient, he was diagnosed with tumor of the right lung. During operation the surgeon removed the middle lobe of the patient’s right lung. This lobe includes:

A 25-year-old woman at her third pregnancy with impending miscarriage was brought to the hospital. What combination of Rh-factor of the mother and the fetus can be the cause of this condition?

A 63-year-old man suffers from esophageal carcinoma, presents with metastases into the mediastinal lymph nodes and cancerous cachexia. What pathogenetic stage of neoplastic process is observed in the patient?

Examination of the coronary arteries revealed atherosclerotic plaques with calcinosis that narrow the arterial opening by 1/3. In the muscle there are numerous whitish layers of connective tissue. Name the process detected in the myocardium

To stimulate the labor activity a parturient woman was prescribed a drug - a posterior pituitary hormone that does not affect the blood pressure. As the pregnancy progresses, the sensitivity to this hormone increases. Name the prescribed drug:

X-ray exmination of a 57-year-old man indicates local areas of hard bone tissue resorption in some of the patient’s bones. These changes can be associated with increased activity of:

A 38-year-old man, who has been suffering from systemic lupus erythematosus for 3 years, developed diffuse renal lesions accompanied by massive edemas, marked proteinuria, hyperlipidemia, and dysproteinemia. What is the most likely mechanism of proteinuria development in this case?

A 25-year-old young man came to the doctor complaining of general weakness, rapid fatigability, irritability, reduced working ability, and bleeding gums. What vitamin is likely to be deficient in this case?

A patient, who has been taking βadrenergic blockers, developed a bronchial spasm. What group of bronchodilators should be chosen to stop the bronchial spasm?

What diagnostic method should be used in industry to test the raw leather for presence of B. anthracis?

A woman with the III (В), Rh (-) blood group gave birth to a child with the II (А) blood group. The child is diagnosed with hemolytic disease of newborn caused by rhesus incompatibility. What blood group and Rh does the father have?

Neutralization of xenobiotics and active endogenous metabolites often occurs via introduction of an oxygen atom into the substrate molecule. What process occurs as the result?

One of the causes of pernicious anemia is disturbed synthesis of transcorrin Castle’s intrinsic factor - by the parietal cells of the stomach. What substance is called Castle’s extrinsic factor?

A patient complains of dizziness, thirst, difficult swallowing, and impaired vision of close objects. Objectively: respiratory rate is increased, pupils are dilated, general agitation, talkativeness, though the speech is indistinct. BP is 110/70 mm Hg, heart rate is 110/min. Given symptoms can indicate overdosage of the following drug:

On examination the patient presents with hirsutism, moon-shaped face, stretch marks on the abdomen. BP is 190/100 mm Hg, blood glucose is 17.6 mmol/L. What pathology is such clinical presentation characteristic of?

A woman has come to the hospital with complaints of general weakness, dizziness, and dyspnea. Resently she has been taking levomycetin (chloramphenicol) for prevention of enteric infection. Blood test: erythrocytes - 1.9 · 1012/L, hemoglobin - 58 g/L, color index - 0.9, leukocytes - 2.2 G/L, reticulocytes - 0.3%. What type of anemia is it indicative of?

Collagenosis patients typically present with connective tissue destruction processes. The presence of these processes can be confirmed by the increase in:

Preventive vaccination against poliomyelitis is made with inactivated vaccine introduced parenterally. What immunoglobulins create the post vaccinal immunity in this case?

An 18-year-old patient has developed candidiasis after the case of pneumonia treated with β-lactam antibiotic. What antimycotic agent should be prescribed?

A woman with hypophyseal diabetes insipidus developed a water-mineral imbalance. What type of water-mineral imbalance develops in such cases?

A 46-year-old patient suffering from ulcer disease of the stomach is diagnosed with rheumatoid arthritis. What antiinflammatory drug would be the most advisable in this case?

A 40-year-old man developed skin redness and swelling in the neck area, where eventually a small abscess appeared. On section the focus is dense and yellowgreen colored. In the purulent masses there are white granules. Histologically there are fungal druses, plasma and xanthome cells, and macrophages detected. Specify the most correct etiological name of this pathological process:

During inflienza epidemic, morbidity in the schoolchildren, who did not participate in sports, was 40%, while in the schoolchildren, who engaged in regular physical acivities, morbidity did not exceed 20%. What adaptation mechanism ensured low morbidity in the physically active schoolchildren?

A patient demonstrates sharp decrease of pulmonary surfactant activity. This condition can result in:

Autopsy of the body of a 50-yearold man, who had been suffering from tuberculosis and died of cardiopulmonary decompensation, shows lobar affection of the lungs: the upper lobe of the right lung is enlarged, dense, yellow on section, crumbling, with pleural fibrin deposition. What type of secondary tuberculosis can be characterized by this pathology?

A 45-year-old man diagnosed with hepatic cirrhosis and ascites underwent drainage of 5 liters of fluid from his abdominal cavity, which resulted in development of syncopal state due to insufficient blood supply to the brain. What circulatory disorder occurred in the abdominal cavity in this case?

Autopsy of a woman revealed the following morphologic changes: stenosis of the atrioventricular opening, mitral insufficiency. Histologically there are focal cardiosclerosis and ”blooming” Aschoff nodules in the myocardium. What is the most likely diagnosis?

ECG of the patient shows increased duration of the QRS complex. What is the most likely cause?

A child diagnosed with purulent inflammation of the middle ear was brought to the otolaryngology department. The disease started with the inflammation of the nasopharynx. It was determined that the infection had reached the tympanic cavity through the eustachian tube that is located in the:

A 4-year-old child presents with numerous carious cavities and yellowcolored teeth. The mother has a history of antibiotic treatment during her pregnancy. What antibiotic was the most likely taken by the child’s mother?

A patient presents with indigestion, stomachaches, and excessive salivation. Similar simptoms had already been observed in this patient previously. Laboratory analysis detected oval eggs covered with lumpy capsules in the patient’s feces. What is the most likely cause of the patient’s disorder?

A patient with clinical signs of a primary immunodeficiency has functionally disturbed mechanism of antigen-presentation to the immunocompetent cells. What cells are likely to have structural defects?

People, who for a long time remained in hypodynamic state, develop intense pain in the muscles after a physical exertion. What is the most likely cause of this pain?

Acute renal impairment caused death of a patient with hemorrhage. Autopsy revealed enlarged kidneys with broad pale pink cortical layer expressively demarcated from dark red renal pyramids. Macroscopic examination revealed lack of epithelial nuclei of the convoluted tubules, tubulorrhexis, phlebostasis. The cell nuclei of the choroid glomus and straight tubules were present. What pathology is it?

During hypersensitivity skin test a patient received an allergen subcutaneously, after which the patient developed skin redness, edema, and pain due to histamine action. This biogenic amine is produced as the result of the following transformation of histidine amino acid:

During the prestart period an athlete develops increased frequency and force of cardiac contractions. These changes are caused by intensification of the following reflex responces:

A 40-year-old pregnant woman underwent amniocentesis. Examination determined the fetal karyotype to be 47, XY+21. What fetal pathology was detected?

A man has an inguinal hernia. The hernial sac exits through the following opening:

Cell membrane rest potential changed from -85 to -90 mV. It can be caused by activation of the following cell membrane channels:

Histological specimen shows organ parenchyma to consist of lymphoid tissue that forms lymph nodules; the nodules are located diffusely and have a central artery. What anatomical structure has such morphological characteristics?

In an experiment it is necessary to assess neuromotor and muscle excitability. What value shoud be measured to make the assessment?

Preoperative examination revealed prothrombin deficiency in the blood of the patient. What drug should be preliminarily prescribed to mitigate blood loss in the patient during the surgery?

A 40-year-old woman was diagnosed with glomerulonephritis based on her clinical symptoms and the results of urine analysis. Anamnesis states chronic tonsillitis. What microorganisms are the most likely cause for her kidney damage?

A 7-year-old child presents with marked signs of hemolytic anemia. Biochemical analysis of erythrocytes determined low concentration of NADPH and reduced glutathione. What enzyme is deficient in this case leading to the biochemical changes and their clinical manifestations?

A specimen of a 10-day-old human embryo shows two interconnected sacs (amniotic and yolk sacs). Name the structure located in the place where these two sacs connect:

A 56-year-old man complains of thirst and frequent urination. The endocrinologist diagnosed this patient with diabetes mellitus and prescribed him glibenclamide. What mechanism of action does this drug have?

During intensive muscle work there is a large amount of ammonia produced in the muscles. What amino acid plays the main role in the transportation of ammonia to the liver and participates in gluconeogenesis reactions?

General structure of eukaryotic genes is as follows: exon-intron-exon. Such functional structure of a gene leads to certain specifics of the transcription process. What sequence will correspond with precursor mRNA (immature)?

A young woman, a foreign student from Tehran, has made an appointment with the urologist. She complains of the sensation of heaviness in her lower abdomen and a small amount of blood being excreted with urine at the end of each urination. Microscopy of urine detects the presence of parasite eggs, approximately 140х70 micron in size, with a terminal spike. What diagnosis can be made by the infectious diseases specialist?

A young woman presents with a tumor along the auditory nerve. The tumor is node-shaped, 3 cm in diameter, soft and elastic, pink-white colored, and has homogeneous structure. Microscopically the tumor contains bundles of cells with oval nuclei. These cellular fibrous bundles form regular structures made up of parallel rows of regularly oriented cells arranged in the form of a palisade with acellular homogeneous area in between (Verocay bodies). Name this type of tumor:

An electron micrograph of a nephron segment shows cuboidal cells with ciliated lining on their apical surfaces; their basal surfaces have basal striation with mitochondria located between the cytolemma invaginations. Name the described nephron segment:

A 5-year-old child is diagnosed with Bruton syndrome (X-linked agammaglobulinemia) that manifests itself as severe clinical course of bacterial infections and absence of B lymphocytes and plasma cells. What changes of immunoglobulin content can be observed in blood serum of the child with immunodeficiency?

An 8-year-old girl presents with signs of disturbed twilight vision. This condition is caused by the deficiency of vitamin:

Atria of a test animal were superdistended with blood, which resulted in decreased reabsorption of Na+ and water in renal tubules. This can be explained by the effect of the following factor on the kidneys: