Disorder of ammonia neutralization

185. An embryo had its external layer of dental saccule experimentally destroye d. What dental structure wont have any further development?

Periodontium

186. An inflammation is characterized by the dilatation of blood capillaries in the region of injury, reduced circulation, increased permeability of vessel walls. What cells play the main part in the development of these changes?

Tissue basophils

187. On the 2-3 day after stomach resection a patient is still experiencing a failure of intestinal peristalsis. In order to stimulate the motility of gastrointestinal tract the following drug should be administered:

Proserin

188. A 65-year-old patient with chronic heart failure has been taking digitoxin in self-administered dosages for a long tim e. She was admitted to the hospital for general health aggravation, arrhythmia, nausea, reduced diuresis, insomni a. What is the primary action to be taken?

To withhold digitoxin

189. Elderly people often complain of joint pain that can be associated with age-related changes of tissue covering the joint surfac e. What tissue is it?

Hyaline cartilage

190. There is a strict time limit for people to stay at a height of 8000 m above sea level without oxigen cyllinders. Specify the life-limiting factor in this case:

Partial pressure of oxygen in air

191. During an acute experiment some of diluted solution of hydrochloric acid was injected into the duodenal cavity of an experimental animal. This will result in hypersecretion of the following hormone:

Secretin

192. Microscopic examination of a parenchymatous organ revealed that its epithelial cords formed glomerular, fascicular and reticular zones. The central part of the organ was presented by accumulations of chromaffin cells. Specify this organ:

Adrenal gland

193. A section of pulmonary tissue has a large-meshed look due to the sacciform and cylindric dilatation of the bronchi; microscopical examination of the bronchial wall reveals a leucocytal infiltration with neutrophil prevalence; elastic, muscle fibers as well as cartilage plates are partly destroyed and replaced by the connective tissu e. The adjacent pulmonary tissue has inflammation foci, fibrosis areas, vascular sclerosis and signs of emphysem a. The right ventricle hypertrophy is present. What is the most likely diagnosis?

Multiple bronchiectasis

194. A 1,7-year-old child with a developmental delay and manifestations of self-agression has the concentration of uric acid in blood at the rate of 1,96 millimole/l. What metabolic disoder is this typical for?

Lesch-Nyhan syndrome

195. Two weeks after haemotransfusion a patient has developed fever. What protozoal disease can be suspected?

Malaria

196. Examination of a kidney tissue sampling revealed leukocyte infiltration of interstitial tissue; miliary abscesses; dystrophic tubules filled with desquamated epithelium and leukocytes. What is the most likely diagnosis?

Pyelonephritis

197. A veterenary attendant working at a cattle farm complains of joint pain, fever, indisposition and sweating at nighttime that he has been experiencing for a month. Giving the regard to such presentations and occupational history the doctor suspected brucellosis. What material taken from this patient is to be analyzed in a common microbiological laboratory?

Blood serum

198. After a tourniquet application a patient was found to have petechial haemorrhages. The reason for it is the dysfunction of the following cells:

Platelets

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

Inspiratory reserve volume

199. A month after a serious operation a 38-year-old patient has recovered and has now positive nitrogen balanc e. Urine of this patient may be found to have low concentration of the following nitrogen-containing substance:

Urea

200. During a visit to a dentist a patient has developed collaps e. What drug can be applied to manage this situation?

 

Mesaton

 

9.0 Фармакологія

A woman with ischemic disease has been taking an antianginal medication that has the

following properties: dilates coronary arteries, peripheral vessels (arterial and venous),

reduces the need of myocardium in oxygen, improves endocardial blood circulation. Name

this preparation:

A Nitroglycerin

A patient has been taking glucocorticoids for a long time. Drug withdrowal caused acute

attack of his disease, blood pressure reduction, weakness. What are these occurences

connected with?

A Adrenal glands insufficiency

A teenger had his tooth extracted under novocain anaesthesia. 10 minutes later he

presented with skin pallor, dyspnea, hypotension. When this reaction is developed and the

allergen achieves tissue basophils, it reacts with:

A IgE

48 hours after tuberculine test (Mantoux test) a child had a papule up to 10 mm in diameter

on the spot of tuberculine introduction. What hypersensitivity mechanism underlies the

mentioned changes?

A Cellular cytotoxicity

A 25 year old patient had in the dentist's room a sudden attack of bronchial asthma. The

doctor gave him salbutamol in the form of inhalation. What is the mechanism of action of

this preparation?

A Stimulates β₂-adrenoreceptors

A patient has myocardial infarction with thrombosis of the left coronary artery. What

pharmocological preparation group should be used to reestablish blood flow?

A Fibrinolysis activators

During the ether narcosis a patient had evident bradycardia with threat of cardiac arrest.

What medication should be used to accelerate heartbeat under condition of narcosis that

shouldn't be interrupted?

A Atropine

 

A patient with stomatitis was prescribed a medication of sulfanamide group. What is the

mechanism of its antibacterial effect?

A Competitive antagonism with para-aminobenzoic acid

A patient with gingivitis was prescribed a gargle with a certain preparation. Its antiseptic

properties are determined by atomic oxygene that slivers in presence of organic

substances. It has also deodorant, adstringent (anti-inflammatory), and in big

concentrations - cauterizing effect. Water solutions are used for bathing of wounds, mouth

gargling and in higher concentrations - for burn treatment. It is also used for gastric lavage

in case of poisoning. Name this preparation:

A Potassium permanganate

The preparation comlex for periodontitis treatment includes the medicine from the group of

water soluble vitamins, bioflavonide derivative, which is prescribed together with ascorbic

acid. This preparation has anti-oxidative properties, decreases gingival hemorrhage. What

preparation is meant?

A Rutin

An unconscious patient was admitted to the hospital. Objectively: cold skin, miotic pupils,

heavy breathing, Chaine-Stokes' periodicity, low arterial pressure, overfull urinary bladder.

What caused the poisoning?

A Narcotic analgetics

A 30 year old patient consulted a doctor about having diarrhea and stomach aches for 5

days, temperature rise up to 37,5⁰С with chills. The day before the patient was in a

forest and drank some water from an open pond. He was diagnosed with amebic dysentery

that was bacteriologically confirmed. Name the medication for treatment of this disease:

A Metronidazole

In course of combined therapy a patient with chronic cardiac insufficiency was taking

digitoxin and furocemid. A a result he had extreme muscular weakness. What electrolyte

imbalances may be revealed in his blood?

A Hypokaliemia

A patient with complaints of dizziness, worsening of vision acuity, sickness, salivation and

spasmodic stomachaches was taken to the admission department. The diagnosis was

poisoning with organophosphorous compounds. What preparations should be included into

complex therapy?

A Atropine sulfate and dipiroxim

A surgeon cleansed his hands with 70% solution of ethyl alcochol before an operation.

What is the main mechanism of preparation's antiseptic effect upon microorganisms?

A Dehydratation of protoplasm proteins

A patient who has been ill with tuberculosis for a long time has an intracellular mycobacteria disposition. What preparation must be included into the complex therapy of tuberculosis?

A Isoniazid

 

A patient started bleeding after tooth extraction. What action is necessary in this case?

A Adrenalin locally

After tooth extraction the blood pressure of a patient fell dramatically, the patient lost

consciousness. Collaptoid state was diagnosed. What drug should be used?

A Cordiamin

A patient who takes tetracyclin was recommended not to consume dairy products. Why did

the doctor give him such recommendation?

A They inhibit antibiotic absorption

A stomatologists examined first-grade pupils and revealed that one of children had yellowish brown teeth, two of them were split. Heretofore the pupil was treated with "some pills" on account of pneumonia. What medication could have had such a negative effect upon teeth?

A Doxycycline

A 50 year old patient with ischemic disease was prescribed an antiaggregant preparation.

The patient was taking overdoses of this preparation. It resulted in nausea, vomiting,

stomach pain during fasting. What preparation was the patient prescribed?

A Acetylsalicylic acid

Name the drug group that can reduce need of myocardium for oxygene, decrease force of

heartbeat and inhibit lipolysis:

A β-adrenoceptor blockers

A patient was attacked by bees. He was taken to the hospital with Quincke's edema. What

antihistaminic medication without sedative effect sholuld be prescribed the patient?

A Diasoline

A patient with thyreotoxicosis was prescribed a medication that inhibits enzyme systems

taking part in synthesis of thyroid gland hormones. What medication is it?

A Mercazolile

A purulent wound was treated with a solution that had antiseptic effect and contributed to

the mechanical wound cleansing. What solution was used?

A Hydrogen peroxide

A patient with tuberculosis was prescribed a certain medication as a part of complex

therapy - derivative of isonicotinic acid hydrazide. Name this preparation:

A Isoniazide

A patient with essential hypertension takes enalapril. What mechanism of action has this

hypotensive medication?

A Inhibitor of angiotensin converting enzyme

After a surgical procedure a patient felt ill with enteroparesis. What medication from the

group of anticholinesterase drugs should be prescribed?

A Proserin

A patient with chronic alcoholism has symptoms of polyneuritis and cardiac insufficiensy.

What vitamin preparation should be prescribed to this patient?

A Thiamine

A patient has a slowly healing fracture. What medcine can be used to accelerate formation

of connective tissue matrix?

A Methyluracil

Removal of a foreign body from patient's eye involves local anesthesia with lidocaine. What

is the action mechanism of this medication?

A It disturbs passing of Na⁺ through the membrane

A patient with myocardium infarction was prescribed an analgetic in order to stop pain

syndrome. The patient felt better but overdose caused weakness, myosis, respiratory

depression. What medication was prescribed?

A Morphine

For treatment of skin diseases with apparent inflammation in the maxillofacial area the

topical glucocorticoids are applied. What preparation has the minimal resorptive effect?

A Flumethasoni pivalas

A patient complains of painful cracks in mouth angles. What sulfanilamide can be

recommended for local treatment of angular stomatitis?

A Streptocide liniment

What antihelmintic medication is used for stimulation of immune system in case of chronic

generalized periodontitis?

A Levamisole

Leukoses are treated with antimetabolite methotrexate. What vitamin is its antagonist?

A Folic acid

Mother of a two year old child consulted a dentist. In the period of pregnancy she was

non-systematically taking antibiotics to treat an infectious disease. The child's examination

revealed incisor destruction, yellow enamel, brown limbus of dental cervix. What

preparation was mother taking during her pregnancy?

A Doxycycline

A 36 year old man with craniocerebral trauma has diminished breath sounds, thready pulse, reflexes are absent. What route of pyracetam introduction is the most suitable in this case?

A Intravenous

A patient is being operated under inhalation narcosis with nitrous oxide. It is known that it

has evident lipophilic properties. What mechanism is responsible for transporting this

preparation through biological membranes?

A Passive diffusion

A patient was operated on account of abdominal injury with application of tubocurarin. At the end of operation, after the respiration had been restored, the patient got injection of gentamicin. It caused a sudden respiratory standstill and relaxation of skeletal muscles. What effect underlies this phenomenon?

A Potentiation

A child suspected for tuberculosis underwent Mantoux test. 24 hours after allergen injection

there appeared a swelling, hyperaemia and tenderness. What are the main components in

the development of this reaction?

A Mononuclears, T-lymphocytes and lymphokines

A surgeon used novocaine as an anaesthetic during surgical manipulations. 10 minutes after it the patient became pale, he got dyspnea and hypotension. What type of allergic reaction is it?

A Anaphylactic

A 70 year old patient suffering from cardiac insufficiency has been uncontrolledly taking

digoxin that resulted in extrasystole, vomiting, vision impairment, anxiety, sleep disturbance,

reduction of diuresis. Application of drugs relating to the following group will be

pathogenetically reasonable in this case:

A Donators of sulfhydric groups

A patient was admitted to a surgical department for an operation. He has to undergo

neuroleptanalgesia. To achieve neuroleptanalgesia it would be rational to combine fentanyl

with the following medicine:

A Droperidol

To prevent possible negative effect upon the gastric mucsa a patient with rheumatoid arthritis was administered a nonsteroid anti-inflammatory drug - a COX-2 selective inhibitor. Specify this drug:

A Celecoxib

A patient suffering from chronic bronchitis takes a synthetic mucolytic drug that stimulates

sputum liquefaction. What drug is it?

A Acetylcysteine

A 30 year old woman has been continuously using lipstick with a fluorescent substance that

led to development of a limited erythema on the prolabium, slight peeling, and later small

transversal sulci and fissures. Microscopical examination of the affected zone revealed in

the connective tissue sensibilized lymphocytes and macrophages, effects of cytolysis. What

type of immunological hypersensitivity has developed on the lip?

A IV type (cellular cytotoxicity)

What contraction of upper extremity muscles will be observed during holding (but not

moving) a load in a certain position?

A Isometric

A 5 y.o. child's enamel and dentin are striated with yellowish-brown stripes, the child has

also dentin exposure, multiple caries. It is known that the child's mother had been taking

antibiotics during her pregnancy. What medication might have caused such by-effect?

A Tetracycline

A patient who has been traeted in a neurological clinic with sedatives for a long time has the following complications: cough, rhinitis, lacrimation. What preparation might have caused such disorders?

A Sodium bromide

 

During anaesthetization of the oral cavity mucous tunic a patient developed anaphylactic

shock (generalized vasodilatation, increase in vascular permeability along with escape of

liquid to the tissues). What type of hypersensitivity has the patient developed?

A I type (anaphylactic)

 

Hemotransfusion stimulated development of intravascular erythrocyte hemolysis. The

patient has the following type of hypersensitivity:

A II type hypersensitivity (antibody-dependent)

A patient suffering form tuberculosis was treated with rifampicin, which caused drug

resistance of tuberculosis mycobacteria. In order to reduce mycobacteria resistance,

rifampicin should be combined with the following drug:

A Isoniazid

6.0 Патологічна фізіологія

A married couple applied to the genetic consultation in order to consult about their child

with multiple abnormalities (microcephaly, idiocy etc). The woman has had an illnesses

during her pregnancy but she didn't take any teratogens or mutagens. The parents' and

the child's karyotype is normal. Anamnesis study revealed that the family kept a cat. What

gravidic disease caused the child's abnormalities?

A Toxoplasmosis

A patient who takes a blocker of membrane cytoreceptors of efferent conductor synapses

of autonomic nervous system complains about dry mouth. What receptors are blocked?

A Muscarinic cholinoreceptors

Examination of a patient revealed enlargement of some body parts (jaw, nose, ears, feet,

hands), but body proportions were conserved. It might be caused by intensified secretion

of the following hormone:

A Somatotropin

A patient complains about attacks of laboured breathing, dizziness. He works at a chemical

plant producing hydrocyanic acid. The described symptoms might be associated with

dysfunction of the following enzyme:

A Cytochrome oxidase

After sprinting untrained people feel muscular pain as a result of lactate accumulation. I

may be connected with intensification of the following biochemical process:

A Glycolysis

What vitamin deficiency leads to both disorder of reproductive function and distrophy of

skeletal muscles?

A Vitamin E

Toxic pulmonary edema was reproduced on a laboratory rat by means of ammonium

chloride solution. What is the leading pathogenetic factor of this edema?

A Increased permeability of capillars

15 minutes after a car accident examination of a 35 year old man revealed massive injury

of lower extremities without serious external loos of blood. The victim is in excited state.

What component of pathogenesis of traumatic shock is basic and requires urgent

correction?

A Pain

A patient has disorder of airways patency at the level of small and middle bronchs. What

changes of acid-base balance may take place?

A Respiratory acidosis

The body temperature of a patient with an infectious disease rises once in two days up to

39,5-40,5⁰С and stays so for about an hour and then drops to the initial level. What

type of fever is it?

A Intermittent

A 23 year patient was admitted to the hospital in grave condition with craniocerebral

trauma. His respiration is characterized by a spasmodic long inspiration interrupted by a

short expiration. What respiration type is it typical for?

A Apneustic

Two days after myocardial infarction a patient had a sudden systolic pressure decrease up

to 60 mm, tachycardia up to 140/min, dyspnea; the patient lost consciousness. What

mechanism is principal for the shock pathogenesis?

A Decrease of cardiac volume

After a psychoemotional stress a 48 year old patient had a sudden attack of acute heart

pain with irradiation to the left hand. Nitroglycerine suppressed pain in 10 minutes. What

pathogenetic mechanism is principal for the pain development?

A Spasm of coronary vessels

A 40 year old man who took part in disaster-management at a nuclear power plant fell sick

with paradontitis. What etiological agent is the most important for the development of this

pathology?

A Emotional stress

A woman after labor lost 20 kg of body weight, her hair and teeth fall out, she has muscle

atrophy (hypophysial cachexia). Synthesis of what hypophysis hormone is disturbed?

A Somatotropic

Climbing the mountains at a height of 5000 m climbers started complaining of breath

shortness, palpitation, vertigo, ring in the ears. What pathogenetic factor determines the

development of these occurances?

A Hypoxemia

Damage of one of the reactors at a nuclear power plant resulted in runout of radioactive

products. People who were present in the high-radiation area got approximately 250-300

R. They were urgently taken to the hospital. What blood changes will be typical for this

period?

A Lymphopenia

A year after subtotal stomach resection on account of ulcer of lesser curvature the

following blood changes were revealed: anemia, leukocytopenia and thrombocytopenia,

color index - 1,3, megaloblasts and megalocytes. What factor deficiency caused the

development of thos pathology?

A Castle's factor

A 45 year old patient was taken to the hospital by an emergency team with serious cranial

trauma in shock condition. Objectively: unconscious, skin is pale, body t⁰- 35,0⁰С,

low muscular tonus, reflexes are absent, pulse is rapid and weak, AP- 50/30 mm Hg. What

clinical shock stage is it?

A Terminal stage

After traumatic tooth extraction a patient complains of a severe dull pain without accurate

localization in his gum, body temperature rise up to 37,5⁰С. He was diagnosed with

alveolitis. What type of pain does the patient have?

A Protopathic

After poisoning with an unknown drug a 37 year old patient has stereotypical face muscle

contractions that imitate blinking and squinting. What form of motor function disorder of

nervous system is it?

A Hyperkinesia

A 12 year old boy came home from school and started complaining of headache, sickness,

chill, periodical muscle pain, appetite loss, flabbiness. What period of illness are these

symptoms typical for?

A Prodromal

Rabbits lived on food with addition of cholesterol. Five months later the atherosclerotic

aorta changes were revealed. Name the main cause of atherogenesis in this case:

A Exogenous hypercholesterolemia

A patient with primary nephrotic syndrome has the following content of whole protein: 40

g/l. What factor caused hypoproteinemia?

A Proteinuria

A man who took part in disaster-management at a nuclear power plant had hemorrhagic

syndrome at the same time with acute radiation sickness. What is the most important thing

for the pathogenesis of this syndrome?

A Thrombocytopenia

Four months ago a 43 year old patient had a traumatic amputation of his lower extrimity.

Now he complains of sensing the amputated extremity and having constantly grave,

sometimes unbearable pain in it. What type of pain does he have?

A Phantom

In crisis period a 14 year old child ill with diphtheria has AP- 70/50 mm Hg accompanied by

abrupt fall in temperature and tachycardia. What form of vascular tone disturbance is it?

A Acute hypotension

After a long-lasting and grave illness the blood pressure of a patient fell up to 60/40 mm;

he has tachicardia, dyspnea, black-out. How can this state be defined?

A Preagony

A patient ill with jaundice has increased content of conjugated bilirubin and bile acids in

blood, no stercobilinogen in urine. What jaundice are these symptomps typical for?

A Obstructive

A newborn child ill with pylorostenosis has frequent vomiting accompanied by apathy,

weakness, muscular hypertonia, sometimes convulsions. What form of acid-base balance

disorder has developed?

A Nongaseous alkalosis

A 19 year old patient was diagnosed with chronic acquired hemolytic anemia. What is the

leading pathogenetic mechanism of this pathology's development?

A Autoimmune hemolysis

A 56 year old man was taken to the hospital with complaints of general weakness, pain and

burning in the region of tongue, extremity numbness. In the past he had resection of

cardiac part of ventricle. Blood test: Hb- 80 g/L; RBC- 2,0_*10¹²/L; colour index of

blood- 1,2; leukocytes - 3,5_*10⁹/L. What type of anemy is it?

A В₁₂ folic-deficient

After recovering from epidemic parotiditis a patient began to lose weight, he was

permanently thirsty, drank a lot of water, had frequent urination, voracious appetite. Now

he has complaints of skin itch, weakness, furunculosis. His blood contains: glucose - 16

mmole/L, ketone bodies - 100 mcmole/L; glucosuria. What disease has developed?

A Insulin-dependent diabetes

A patient dropped into an ice hole, froze in the wind and fell ill. Body temperature rose up

to 39,7^oC and varied from 39,0^oC to 39,8^oC. Name the type of the patient's

temperature profile?

A Febris continua

A patient has the following diagnosis: renal hypertension. What is the initial pathogenetic

factor of arterial hypertension development in this case?

A Renal ischemia

A diver who has been staying at the depth of 40 m for a long time fell ill with caisson

disease as a result of decompression. The main pathogenetic factor is the following

embolism:

A Gaseous

A 65 year old patient suddenly died. She suffered from thrombophlebitis of deep veins of

shin. Autopsy revealed: trunk and bifurcation of pulmonary artery contain red loose masses

with dull corrugated surface. What pathological process did the morbid anatomist reveal in

pulmonary artery?

A Thromboembolism

Skin samples of a patient with bronchial asthma revealed allergen sensitization of poplar

fuzz. What factor of immune system plays the main part in development of this

immunopathological state?

A IgE

A patient with insulin-dependent diabetes had an insulin injection. Some time later he felt

weakness, irritability, excessive sweating. What is the main reason of these disorders?

A Carbohydrate starvation of brain

For the purpose of disinfection of nonmetallic surgical instruments the formaldehyde

solution was used. What group does this anticeptic preparation belong to according to its

chemical structure?

A Aliphatics

A patient with an acute myocarditis has the clinic presentations of cardiogenic shock. What

pathogenetic mechanism plays the main part in shock development?

A Disorder of pumping ability of heart

A patient with inflammation of trigeminal nerve has been having progressive paradontitis for

some years. What factor is the most important for parodontitis development?

A Neurodistrophic disorders

A patient with streptococcal infection of gums was prescribed a drug that contained

β-lactam ring in its structure. Which drug relates to this group?

A Benzylpenicillin

Potassium cyanide that is a poison came into a patient's organism and caused death a few

minutes after it. The most probable cause of its toxic effect was abnormal activity of:

A Cytochrome oxidase

A patient was admitted to a hospital with poisoning with unsound food. His stomach was

lavaged with solution of potassium permanganate. What is its mechanism of action?

A Release of atomic oxygen

Hydrocyanic acid and cyanides are the most violent poisons. According to the dose the death follows after a few seconds or minutes. The death is caused by the inhibited activity of the following enzyme:

A Cytochrome oxidase

Treatment of many diseases involves use of cocarboxylase (thiamine pyrophosphate) for

supplying cells with energy. What metabolic process is activated in this case?

A Oxidizing decarboxylation of pyruvate

A typical symptom of cholera is great loss of water and sodium ions. What mechanism

underlies development of diarrhea in this case?

A Activation of adenylate cyclase of enterocytes

A newborn has signs of dyspepsia after milk feeding. Symptoms of dyspepsia disappear when milk is substituted for glucose solution. The newborn has low activity of the following enzyme:

A Lactase

For the preparation of the burned skin surface of a patient a certain medication was applied. Its antiseptic properties are provided by free oxygen released in presence of organic substances. What medication is it?

A Potassium permanganate

A 30 y.o. patient is diagnosed with amebic dysentery. This diagnosis was bacteriologically

confirmed. Name the preparation for its treatment:

A Metronidazole

For infection prevention a patient who underwent appendectomy was prescribed a cephalosporin antibiotic. Antimicrobial activity of these antibiotics is called forth by the disturbance of the following process:

A Microbial wall formation

It is required to disinfect equipment in a dental room. Choose a preparation without

disagreeable odour and colouring power:

A Chlorhexidine bigluconate

A group of researchers set an experiment and obtained anucleate mutant cells. In the first

place they will have disturbed synthesis of the following compounds:

A Ribosomal RNA

A patient consulted a dentis about a lesion of his oral mucosa. He was diagnosed with

herpetic stomatitis. Which of the following drugs will have an effect on etiotropic factor?

A Acyclovir

A patient consulted a dentist about itching and burning in the oral cavity; high temperature.

The patient was diagnosed with trichomonal gingivostomatitis. What drug should be

chosen for his treatment?

A Metronidazole

A patient is ill with herpetic stomatitis provoked by immunosuppression. What preparation

introduced intravenously, internally and locally can provide antiviral and

immunopotentiating effect?

A Acyclovir

A patient suffering form stomatitis was prescribed oral rinsing. Which antiseptic from the

oxidant group is the most suitable for this purpose?

A Potassium permanganate

 

 

8.0 Мікробіологія

A patient's preliminary diagnosis is toxoplasmosis. What material was used for diagnostics

of this disease?

A Blood

As a result of dehelmintization a 2 m helminth came out with feces. It had segmented body,

small head with four suckers and hooks. Name the type of helminth:

A Armed tapeworm

A scientific expedition in India was guided by a native who had never parted with his dog.

What invasion diseases can be transmitted to the participants of the expedition as a result

of contacts with this dog if it is known to be the source of invasion?

A Echinococcosis

After consumption some tinned meat a patient had diplopia, acute headache, deglutition

disorder, hard breathing, muscle weakness. The diagnosis was botulism. What factor of

pathogenicity are the clinic presentations of this disease connected with?

A Exotoxin

Retrospective diagnostics of old bacillary dysentery required serologic examination of

blood serum in order to determine blood titer to the shigells. What reaction should be

applied for this purpose?

A Reaction of passive hemagglutination

A patient has high sunlight sensitivity of skin. During standing his urine turns dark-brown.

What is the most probable cause of this condition?

A Porphyria

A 62 year old patient with cerebral haemorrhage was admitted to the neurological

department in grave condition. Objectively: increase of respiration depth and rate with its

following reduction to apnoea, thereafter respiration cycle restores. What respiration type

is it?

A Cheyne-Stokes

A 50-year-old male patient suffers from chronic bronchitis, complains about dyspnea during

physical activity, sustained cough with sputum. After examination he was diagnosed with

pulmonary emphysema. This complication is caused by:

A Decrease in lung elasticity

The contents of vesicles from the mucous tunic of a man who has smallpox variola was sent

to the virusologic laboratory. What will be revealed during microscopy of smears?

A Paschen's corpuscles

A laboratory received a material (extract of animal matter) from the region with cases of

anthrax among animals. What serological reaction should be used in order to reveal

antigenes of pathogenic organism in the given material?

A Thermoprecipitation

Bacteriological laboratory has the task to sterilize nutrient mediums containing substances

that convert under the temperature over 100⁰С (urea, carbohydrates). What method of

sterilization should be used?

A Fluid steam sterilization

A patient was taken to the hospital with complaints of headache, high temperature,

frequent stool, stomach pain with tenesmus. Doctor made a clinical diagnosis dysentery

and sent the material (excrements) to the bacteriological laboratory for analysis. What

diagnostic method should the laboratory doctor use to confirm or to disprove the clinical

diagnosis?

A Bacteriological

Bacteriological examination of purulent discharges from urethra revealed some bacteries

that had negative Gram's stain, resembled of coffee corns, decomposed glucose and

maltose up to acid. They were located in leukocutes. What disease do they cause?

A Gonorrhea

A patient in the oral surgery department has got purulent complication. Bacteriological

analysis of the wound material found a culture that produces cyan pigment. What

microorganism is the most probable causative agent?

A Pseudomonas aeruginosa

Sputum smears of a patient with chronic pulmonary disease were stained by Ziehl-Neelsen

method and analyzed in the bacteriological laboratory. Microscopy revealed red bacillus.

What property of tuberculosis myobacteria was found?

A Acid resistance

A patient who suffered form syphilis took a course of antibiotic therapy and fully recovered.

Some time later he was infected again with Treponema pallidum. What form of

infection is it?

A Reinfection

Professional dentists belong to the risk group concerning professional infection with viral

hepatitis type B. Name an effective method for active prevention of this disease among the

dentists:

A Vaccination with recombinant vaccine

A lot of pyoinflammatory processes in oral cavity are caused by anaerobes. What nutrient

medium can be used for conrol of wound textile contamination by anaerobes?

A Kitt-Tarozzi

Microscopic analysis of tissue sampling from affected area of mucous membrane of oral

cavity revealed bacillus in form of accumulations that looked like a pack of cigarettes.

Ziehl-Neelsen staining gives them red colour. What kind of pathogenic organism was most

likely revealed in tissue sampling?

A M.leprae

A patient with clinical presentations of primary immunodeficiency displays disturbance of

antigen-presenting function by immunocompetent cells. What cells may have structure

defect?

A Macrophages, monocytes

From the purulent exudate of a patient with odontogenic phlegmon a pure culture of

Gram(+) microorganisms was segregated. This culture was lecithinously active, coagulated

plasma of a rabbit, decomposed mannitol under anaerobe conditions. What microorganism

may have contributed to the origin of suppurative complication?

A S.aureus

A doctor examined a patient with recurrent aphthous stomatitis with concominant

candidosis and decided to eliminate a possibility of HIV-infection. What examination can

help to clear the situation up and make a provisional diagnosis?

A Immune-enzyme analysis

 

A patient has pure culture of diphtheria corynebacteria. What immunological reaction

should be used in order to determine bacteria toxigenity?

A Precipitation in agar

An infectious diseases hospital admitted a veterinarian with assumed brucellosis. What

serologic test can confirm this diagnosis?

A Wright's agglutination reaction

In case of many infectious diseases patient's blood may contain antigens of causative

agents. What reaction should be applied provided that the level of antigenemia is low?

A Enzyme-linked immunosorbent assay

A pregnant woman applied to a doctor with complaints typical for toxoplasmosis. The doctor

took a sample of her blood. What serological tests should be performed in this case?

A Complement binding assay

A doctor recorded in the medical history that a patient had hypopnoe (reduced respiration

depth). It means that the following characteristic of external respiration is reduced:

A Respiratory volume

Specific prophylaxis involved application of a vaccine containing microorganisms and

exotoxin detoxicated by formalin. It relates to the following type of vaccine:

A Combined

After continuous treatment with antibiotics a patient got symptoms of stomatitis.

Examination of specimens of oral mucous membrane revealed some oval polymorphous

Gram-positive microorganisms arranged in clusters. What microorganism may be the cause

of such manifestations?

A С.albicans

Examination of a child revealed growth of a pharyngeal tonsil causing the obstructed air

escape from nasal cavity. What openings of nasal cavity are blocked in this case?

A Choanae

 

5.0 Біохімія

A girl who was provisionally diagnosed with Turner's syndrome came to a genetic

consultation. The diagnosis can be specified by means of the following genetic method:

A Sex chromatin test

A patient has mental retardation, small height, brachydactyly, mongoloid slant. Analysys of

his karyotype revealed trisomy 21. What chromosomal anomaly is it?

A Down's disease

Microscopical examination of discharges from the gums of a patient ill with paradontosis

revealed some protozoan pear-shaped organisms 6-13 micrometer long. The parasite has

one nucleus and undulating membrane, there are four flagella at the front of its body. What

protozoan were found?

A Trichomonads

A female patient has symptoms of inflammation of urogenital tracts. A smear from the

vaginal mucous membrane contained big unicellular pyriform organisms with a sharp spike

on the back end of their bodies; big nucleus and undulating membrane. What protozoa

were revealed in the smear?

A Trichomonas vaginalis

Among public catering workers examined by doctors of sanitary-and-epidemiologic station

often occur asymptomatic parasite carriers. This means that a healthy person carries cysts

that infect other people. Such parasitizing is impossible for the following causative agent:

A Dysenteric amoeba

Two weeks after hemotransfusion a patient developed fever. What protozoal disease can

be suspected?

A Malaria

Helminthological examination of patient's feces revealed oval brown eggs with tuberous

external membrane. Name the type of helminth:

A Ascarid

A blood smear of a patient who has recently recovered from flu contains 10\% of roundish

cells 4,5-7 micrometer large with a big round nucleus and basophilically stained cytoplasm

in form of a narrow border around the nucleus. What blood status are they typical for?

A Lymphocytopenia

A child has abnormal formation of tooth enamel and dentin as a result of low concentration

of calcium ions in blood. Such abnormalities might be caused by deficiency of the following

hormone:

A Parathormone

A patient has the sudden decrease of Са²⁺ content in blood. What hormone secretion will increase?

A Parathormone

Hepatic disfunctions accompanied by insufficient inflow of bile to the bowels result in

coagulation failure. This phenomenon can be explained by:

A Vitamin K deficiency

Examination of a child who hasn't got fresh fruit and vegetables during winter revealed

numerous subcutaneous hemorrhages, gingivitis, carious cavities in teeth. What vitamin

combination should be prescribed in this case?

A Ascorbic acid and rutin

A patient has increased permeability of blood-vessel walls, increased gingival hemorrhage,

small punctate hematomas on his skin, falling of teeth. What disturbance of vitamun

metabolism can account for these symptoms?

A Hypovitaminosis C

A one year old child has enlarged head and belly, retarded cutting of teeth, destruction of

enamel structure. What hypovitaminosis causes these changes?

A Hypovitaminosis D

To what total ATP quantity is the full glucose oxidation and its linking with phosphorylation

equivalent?

A 38

A patient with diabetes mellitus had an insuline injection. It caused loss of consciousness

and convulsions. What was the result of biochemic blood analysis on glucose content?

A 2,5 mmоle/l

l

A patient with chronic hypoglycemia had adrenaline introduction. After introduction blood

test hasn't changed essentially. Doctor assumed liver pathology. What liver function may

have been changed?

A Function of glycogen depositing

For assessment of the neutralizing function of liver a patient with chronic hepatitis went

through a test with natrium benzoate load. The excretion of what acid with urine will

characterize the neutrolizing function of liver?

A Hippuric acid

A patient with high obesity was recommended to take carnitine as a food additive for better

fat burning. What function is fulfilled by carnitine in the process of fat oxidation?

A Transport of fatty acids from the cytosol to the mitochondria

Examination of urine in a newborn revealed presence of citrulline and high ammonia concentration. This baby is most likely to have the disorder of the following substance production:

A Urea

A 57 year old patient with diabetes mellitus was developed ketoacedosis. Biochemical base of this condition is smaller extent of acetyl-CoA utilization. What cell compound deficit causes this effect?

A Oxaloacetate

Examination of a 6 days old infant revealed phenyl pyruvate and phenyl acetate excess in

his urine. What aminoacid metabolism is disturbed in the child's organism?

A Phenylalanine

A patient has painfulness along big nerve trunks and excessive content of pyruvate in

blood. What vitamin deficit may cause such changes?

A В₁

A patient who is ill with scurvy displays disturbed processes of connective tissue formation that leads to loosening and falling of teeth. Disturbed activity of what enzyme causes these symptomps?

A Lisilhydroxylase

Decreased ratio of adenylic nucleotides ATP/ADP results in intensified glycolysis in

parodentium tissues under hypoxia conditions. What reaction is activated in this case?

A Phosphofructokinase

A sportsman was recommended to take a preparation with carnitine in order to improve his

achievements. What process is activated by carnitine to the most extent?

A Transporting of fatty acids to the mitochondrions

A patient has liver cirrhosis. Analysis of what substance excreted with urine may

characterize the state of antitoxic liver function?

A Hippuric acid

Cyanide poisoning causes immediate death. What is the mechanism of cyanide effect at

the molecular level?

A They inhibit cytochromoxidase

 

A patient has the folowing changes: disorder of twilight vision, drying out of conjunctiva and

cornea. Such disorders may be caused by deficiency of vitamin:

A Vitamin A

A patient was taken to the hospital with preliminary diagnosis progressive muscle distrophy.

What substance will be excessively contained in urine and confirm this diagnosis?

A Creatine

A child has disturbed enamel and dentine formation as a result of decreased content of

calcium ions in his blood. What hormone deficiency may cause such changes?

A Thyreocalcitonin

A chiled was diagnosed with acute renal failure. What biochemic saliva indices can confirm

this diagnosis?

A Increased level of rest nitrogen

A child has disturbed processes of ossification and "punctate" enamel. What microelement

metabolism is disturbed?

A Fluorine

Periodontitis is accompanied by activation of proteolysis in the periodontium tissues. The

evidence of proteolysis activation is increase of the following component of oral liquid:

A Amino acids

Examination of an ill child's blood revealed inherited hyperlipoproteinemia. Genetic defect

of what enzyme synthesis causes this phenomenon?

A Lipoprotein lipase

A 28 year old pregnant woman had the enzymes in the cells of amniotic fluid analyzed. The

analysis revealed insufficient activity of $\beta$-glucuronidase. What pathological process is it?

A Mucopolysaccharidosis

A 42 year old woman diagnosed with diabetes mellitus was admitted th the endocrinological

department with complaints of thirst, excessive appetite. What pathological components

are revealed in course of laboratory examination of the patient's urine?

A Glucose, ketone bodies

After implantation of a cardiac valve a young man constantly takes indirect anticoagulants.

His state was complicated by hemorrhage. What substance content has decreased in blood?

A Prothrombin

A patient has increased content of uric acid in his blood that is clinically presented by pain

syndrome as a result of urate deposition in the joints. What process does this acid result from?

A Lysis of purine nucleotides

A non trained man has usually muscular hypoxy after a sprint. What metabolite accumulates in the muscles as a result of it?

A Lactate

Myocyte cytoplasm contains a big number of dissolved metabolites of glucose oxidation.

Name one of them that turns directly into lactate:

A Pyruvate

Chronic overdosage of glucocorticoids leads to the development of hyperglycemia. What

process of carbohydrate metabolism is responsible for this effect?

A Gluconeogenesis

Patient with pigmentary xeroderma are characterized by anamalously high sensivity to ultraviolet rays that causes skin cancer as a result of enzyme systems incapability to restore damages of hereditary apparatus of cells. What process abnormality is this pathology connected with?

A DNA reparation

In compliance with the clinical presentations a man was prescribed pyridoxalphosphate.

What processes are corrected by this preparation?

A Transamination and decarboxylation of amino acids

A 2 year old child suffers from intestinal dysbacteriosis that lead to the development

hemorrhagic syndrome. The most probable cause of hemorrhage is:

A Vitamin K deficiency

Examination of a 30-year-old man's mandible revealed in the region of his molar a dense

tumour-like formation that significantly deformed the mandible. Here and there the

formation wasn't fully detached from the bone tissue. Microscopical examination of a tissue

sampling revealed that stroma had some cords and follicles with odontogenous cylindric

epithelial cells in peripheria and stellate cells resembling of the enamel oragan pulp in the

centre. What is the most likely diagnosis?

A Ameloblastoma

 

A patient has deformation of jaw bones. Histological examination revealed there growth of

fibrocellular tumour-like ill-defined tissue with primitive osteogenesis. What disease are

these presentations typical for?

A Fibrous dysplasia

The first grade pupils went through a medical examination aimed at selection of children

needing tuberculosis revaccination. What test was applied?

A Mantoux test

A 10 year old child underwent Mantoux test (with tuberculin). 48 hours later there apperaed

a papule up to 8 mm in diameter on the site of tuberculin injection. Tuberculin injection

caused the following hypersensitivity reaction:

A IV type hypersensitivity reaction

The activity of parotides reduces with age. Activity of what enzyme in saliva will be reducing?

A Amylase

While the examination of patient's oral cavity the dentist found xerostomia, numerous erosions. What vitamin deficit caused this effect?

A Vitamin A

A patient with focal tuberculosis of superior lobe of his right lung takes isoniazid as a part of

combined therapy. After a time he started complaining of muscular weakness, decrease of

skin sensitivity, sight and movement coordination disorder. What vitamin preparation will be

right for elimination of these occurances?

A Vitamin В₆

Up to 50% of world population aged above thirty is affected by paradontosis. The leading

part in pathogenesis of this disease is played by:

A Neurodystrophic factor

While examining a blood smear taken form a patient and stained by Romanovsky's method

a doctor revealed some protozoa and diagnozed the patient with Chagas disease. What

protozoan is the causative agent of this disease?

A Trypanosoma cruzi

A 38 year old patient takes aspirin and sulfanilamides. After their intake intensified

erythrocyte haemolysis is observed which is caused by deficiency of glucose 6-phosphate

dehydrogenase. This pathology is caused by failure of the following coenzyme:

A NADP-H

In the mountains some clinically healthy people present with anaemia symptoms. Blood test

can reveal sickle cells. What is the genotype of such people?

A Аа

Active physical work induces rise of concentration of carbonic acid in blood. This causes

deepening and acceleration of respiration thus reducing concentration of carbonic acid

and hydrogen ions in blood. This maintains the following process:

A Homeostasis

During physical exercise people are less sensitive to pain. The reason for it is the activation of:

A Antinociceptive system

A patient was diagnosed with seborrheic dermatitis associated with vitamin H (biotin)

deficiency. The patient has disturbed activity of the following enzyme:

A Acetyl-CoA-carboxylase

Coprological examination of a patient's feces revealed small operculate eggs. It is known from the anamnesis that the patient often consumes fish. What fluke parasitizes in the patient's organism?

A Cat liver fluke

While on holiday in the countryside a boy found a spider with the following morphological

peculiarities: body length at the rate of 2 cm, round black abdomen with two rows of red dots on its dorsal surface, four pairs of segmented extremities covered with tiny black hairs. Identify this arthropod:

A Steppe spider (Latrodectus tredecimguttatus)

A patient applied to a doctor complaining about dizziness, memory impairment, periodical

convulsions. It was found out that such changes were caused by a product of glutamic acid

decarboxylation. What product is meant?

A GABA

A hospital admitted a patient with complaints about abdominal swelling, diarrhea, meteorism

after consumption of food rich in proteins. It is indicative of disturbed protein digestion and

their intensified decaying. What substance is the product of this process in the bowels?

A Indole

A sportsman needs to improve his sporting results. He was recommended a drug

containing carnitine. What process is activated by this compound in the first place?

A Transport of fatty acids

Laboratory examination of a child revealed high content of leucine, valine, isoleucine and

their ketoderivates in blood and urine. Urine had the typical smell of maple syrup. This

disease was caused by deficiency of the following enzyme:

A Dehydrogenase of branched amino acids

In order to speed up healing of the thermal injury it is required to prescribe a drug that

facilitates epithelization of skin and mucous membranes. What drug is it?

A Retinol acetate

A 28 year old woman consulted a doctor about sterility. Examination revealed underdeveloped ovaries and uterus, irregular menstrual cycle. Study of sex chromatin revealed 2 Barr's bodies in most somatic cells. What chromosome disease is the most probable in this case?

A Triplo-X syndrome

Dehelmintization of a patient revealed some long fragments of a helminth with segmented

structure. Mature segments were rectangular, 30x12 mm large, closed-type matrix was in

form of a stem with 17-35 lateral branches. Specify this helminth:

A Hookless tapeworm

A man got poisoned with mushrooms. They contain muscarine that stimulates muscarinic

cholinoreceptors. What symptom is typical for poisoning with inedible mushrooms?

A Miosis

A patient suffering from syphilis was prescribed a drug the action of which based upon

disturbed generation of murein leading to death of the causative agent. What drug is it?

A Benzylpenicillin sodium salt

Examination of a 10 y.o. child revealed on the alveolar submandibular process a fixed

tumourous mass 1,5 cm in diameter closing premolar crown on the vestibular side. Mucous

membrane of its surface is reddish-brown, it bleeds as a reaction to a slight mechanical

intervention. Biopsy results: the mass consists of small size vessels separated by thin

layers of connective tissue and infiltrated by plasmocytes, mucous membrane is here and

there ulcered. What is the most probable diagnosis?

A Angiomatous form of epulis

A 40-year-old male patient had a tumour-like formation 8x7 cm large on his neck. A

surgeon removed it only partially because of close connection with large vessels.

Microscopical examination revealed marked cellular and tissue atypism, lipoblast-type cells

in different stages of maturity, with polymorphism and nuclear hyperchromia, pathological

mitoses, necrosis foci. Specify the histological form of the tumour:

A Liposarcoma

A patient has roundish ulcers on his face, inflammation and enlargement of lymph nodes.

These symptoms turned up as a result of mosquito bites. Laboratory examination of discharge from the ulcers revealed unicellular aflagellar organisms. What is the most probable diagnosis?

A Dermatotropic leishmaniasis

A dentist was examining oral cavity of a 9 year old child in the buccal surface of gingiva in

the area of the lower canine he revealed a red, soft, node-like formation 1 cm in diameter

that started immediately bleeding when touched. Microscopical examination revealed that

this formation consisted of many small vessels like venules and capillaries separated by

thin layers of connective tissue, with focal infiltration by lymphoid and plasmatic cells. Such

changes are typical for:

A Angiomatous epulis

During examination of a 36-year-old woman a dentist revealed a formation in form of a

nodule up to 0,8 cm in diameter, of dark brown-red colour, soft, on a wide base. The

formation was found on the buccal surface of gum in the region of the 2nd molar.

Histological examination revealed that the formation had plenty of sinus