Krok 1 MEDICINE - Центр тестування при

MINISTRY OF PUBLIC HEALTH OF UKRAINE

Department of human resources policy, education and science

Testing Board

Test items for licensing examination

Krok 1

MEDICINE

Student ID Last name

Variant ___________________

ББК 54.1я73

УДК 61

Authors of items: Andreieva V.F., Antonenko V.P., Arnautova L.V., Artysh Yu.P., Basy R.V.,

Berezniak M.A., Bihuniak T.V., Bohatyriova O.V., Bolhov D.M., Bondarenko Yu.I., Bondarchuk T.I.,

Bredykhina L.P., Chekan S.M., Cherkas L.P., Cherkashyna O.Ye., Chernysheva S.V., ChuikoN.Ya.,

Datsko T.V., Demianenko I.A., Demchenko O.M. , Dieltsova O. I., Dubova H. A., Dutchak U. M.,

Dzhalilova Ye. A., Fedchenko M. M., Fedorchenko O.M., Filipova L.O., Harets V.I., Harhin V.V.,

Holdobina O.V., Hubina-Vakulyk H.I., Hurmak I.S., Huryk Z.Ya., Ivankiv O.L., Ivanova S.A.,

Kachula S.O., Kaptiukh R.P., Karvatsky I.M., Kazimirko N.K., Khara M.R., Khmel L.L., Kiriakulov H.S.,

Koldunov V.V., Kolesnikova C.V., Kolot Ye.H., Koloshko O.M., Korolenko H.S., Koroliuk V.D.,

Kotliarenko L.T., Kovalenko L.H., Kovalenko O.Yu., Kratenko R.I., Kravets D.S., Krushynska T.Yu.,

Kukovska I.L., Kukurychkin Ye.R., Kulakov A.Yu., Kulynych H.B., Kulikova N.A., Kurinna S.S.,

Kurovets L.M., Kutsyk R.V., Kyrychok L.T., Linchevska L.P., Liubinets L.A., Luchko I.M.,

Lukianchuk B.D., Lukovych I.M., Lyla N.L., Lytovchenko L.Yu., Maksymchuk T.P., Malyshev S.L.,

Masna Z.Z., Melnychuk I.B., Mishenko K.M., Mitriaiev A.B., Mozghunov O.V., Mrug V.M., Mykula M.M.,

Nazarenko S.M., Nikolenko O.H., Nikonova A.O., Nykyforchyn R.M., Obraztsova O.H., Oleshchuk O.M.,

Oliynyk N.M., Orel Yu.M., Ovchynnikov S.O., Peleshenko H.B., Perepeliuk M.D., Perfilieva M.Yu.,

Pertsovych V.M., Pobihun A.A., Poliakov K.V., Polianska V.P., Popova L.D., Pryshliak A.M.,

Romanenko O.V., Romashova M.F., Rozghoniuk Yu.D., Rubina L.M., Rusalov V.L., Saiuk N.P.,

Samoilovych I.M., Sas L.M., Savchenko N.V., Savelieva O.V., Semeniuk T.M., Serdiuchenko I.Ya.,

Shavaran S.S., Shcherbak L.F., Shenderiuk O.P., Shevtsov O.O., Shevtsova A.I., Shliakhovenko O.O.,

Shnaiderman O.Yu., Shutka L.A., Skorobohata T.H., Skrypka O.V., Smirnov S.M., Snehir A.H.,

Sokol O.M., Stebliuk M.V., Stepanenko S.I., Stepaniuk H.I., Terekhovska O.I., Tertyshny S.I.,

Tkachuk O.V., Tsehelsky A.A., Tsivkovsky A.O., Tsun M.P., Tusyk O.T., Tverdokhlib I.V., Uhryn O.M.,

Vasylieva A.H., Verkhova O.O., Vilkhova I.V., Vinnikov Yu.M., Voitsekhovsky V.H., Vorobets Z.D.,

Voronych-Semchenko N.M., Yakubyshyna L.V., Yasinsky B.I., Yuzyfyshyn M.V., Zadorozhny S.P.,

Zavhorodny I.V., Zazhaieva V.V., Zdykhovsky I.O., Zelenina N.M., Zhadinsky M.V., Zinchenko O.V.,

Zlenko O.T. and Committees of professional expertise.

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

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

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

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

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

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

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

Zinkovska L.Ya.

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

further use in teaching.

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

faculties and academic staff of higher medical educational establishments.

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

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

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

29.05.2003 №233).

© Copyright Testing Board.

General Instruction

Every one of these numbered questions or unfinished statements in

this chapter corresponds to answers or statements endings. Choose the

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

corresponding Latin letter on the answer sheet.

Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк 1

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

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

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

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

3. A 46-year-old female patient has conti-nuous history of progressive muscular(Duchenne’s) dystrophy. Which bloodenzyme changes will be of diagnostic valuein this case?

A. Creatine phosphokinaseB. Lactate dehydrogenaseC. Pyruvate dehydrogenaseD. Glutamate dehydrogenaseE. Adenylate cyclase

4. A laboratory experiment on a dogwas used to study central parts of audi-tory system. One of the mesencephalonstructures was destroyed. The dog has lostthe orienting response to auditory signals.What structure was destroyed?

A. Inferior colliculi of corpora quadrigeminaB. Superior colliculi of corpora quadrigeminaC. Substantia nigraD. Reticular formation nucleiE. Red nucleus

5. A patient has decreased concentrati-on of magnesium ions that are requi-red for ribosomes connection to granularendoplasmic reticulum. This condition isknown to disrupt the process of protein bi-osynthesis. Disruption occurs at the followi-ng stage:

A. TranslationB. TranscriptionC. ReplicationD. Amino acids activationE. Processing

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

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

7. During postembryonal haemopoiesisin red bone marrow the cells of one ofthe cellular differons demonstrate gradualdecrease in cytoplasmic basophilia as wellas increase in oxyphilia, the nucleus is beingforced out. Such morphological changes aretypical for the following haemopoiesis type:

A. ErythropoiesisB. LymphopoiesisC. Neutrophil cytopoiesisD. Eosinophil cytopoiesisE. Basophil cytopoiesis

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

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

9. A 67-year-old patient with clini-cal diagnosis of chronic bronchitis,pneumosclerosis, and cardiopulmonarydecompensation has the biopsy materialtaken from the suspicious area in his rightbronchus mucosa. Cellular and tissue atypi-sm along with pearly bodies can be histologi-cally detected. What pathologic process ischaracterized by the described histologicalchanges?

A. Squamous cell carcinoma of bronchuswith keratinizationB. Polypoid chronic bronchitisC. BronchiectasisD. Acute bronchitisE. Squamous cell metaplasia of bronchialmucosa

10. A microspecimen of heart showsrectangular cells from 50 to 120 micrometerslarge with central position of nucleusand developed myofibrils. The cells areconnected by intercalated discs. These cellsare responsible for the following function:

A. Function of heart contractionsB. Function of impulse conductionC. EndocrineD. ProtectiveE. Regeneratory


11. Untrained people often have musclepain after sprints as a result of lactateaccumulation. This can be caused byintensification of the following biochemicalprocess:

A. GlycolysisB. GluconeogenesisC. Pentose phosphate pathwayD. LipogenesisE. Glycogenesis

12. Poisoning caused by botulinum toxinthat prevents calcium ions from enteringaxone nerve endings of motoneurons is life-threatening because it can lead to:

A. Respiratory arrestB. Cardiac arrestC. Vasotonic disorderD. VomitingE. Diarrhea

13. Increased HDL levels decrease the riskof atherosclerosis. What is the mechanism ofHDL anti-atherogenic action?

A. They remove cholesterol from tissuesB. They supply tissues with cholesterolC. They are involved in the breakdown ofcholesterolD. They activate the conversion ofcholesterol to bile acidsE. They promote absorption of cholesterol inthe intestine

14. It has been found out that one of a pesti-cide components is sodium arsenate thatblocks lipoic acid. Which enzyme activityis impaired by this pesticide?

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

15. A drycleaner’s worker has been found tohave hepatic steatosis. This pathology canbe caused by the disruption of synthesis ofthe following substance:

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

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

A. GastrinB. HistamineC. SecretinD. CholecystokininE. Neurotensin

17. Atretic bodies and developed yellowbody can be observed along with folliclesof various orders in an ovary specimen.What stage of ovarian and menstrual cycle ischaracterized by the described ovary condi-tion?

A. PremenstrualB. MenstrualC. PostmenstrualD. RegenerationE. Follicle growth

18. A 16-year-old adolescent is di-agnosed with hereditary UDP (uridine di-phosphate) glucuronyltransferase defici-ency. Laboratory tests revealed hyperbili-rubinemia caused mostly by increased bloodcontent of the following substance:

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

19. Prior to glucose utilization in cells it istransported inside cells from extracellularspace through plasmatic membrane. Thisprocess is stimulated by the followinghormone:

A. InsulinB. GlucagonC. ThyroxinD. AldosteroneE. Adrenalin

20. After implantation of a cardiac valvea young man systematically takes indirectanticoagulants. His state was complicatedby hemorrhage. What substance content hasdecreased in blood?

A. ProthrombinB. HaptoglobinC. HeparinD. CreatinE. Ceruloplasmin

21. A 12-year-old patient has white non-pigmented spots on the skin. The spotsappeared after the patient became 10 yearsold, and they constantly grow. This spotsappeared due to the lack of the followingskin cells:


A. MelanocytesB. AdipocytesC. FibrocytesD. PlasmocytesE. Labrocytes

22. A group of Ukrainian tourists returningfrom Samarqand was bringing with themgerbils. During examination in customs offi-ce ulcers were detected on the skin of theanimals. What protozoa is the most likely tocause the disease in the animals, if mosqui-tos are the carriers?

A. Leishmania tropica majorB. Balantidium coliC. Plasmodium falciparumD. Trypanosoma cruziE. Toxoplasma gondii

23. A 5-year-old child has been diagnosedwith acute right distal pneumonia. Sputuminoculation revealed that the causativeagent is resistant to penicillin and senstiveto macrolides. What drug should be prescri-bed?

A. AzithromycinB. TetracyclineC. GentamycinD. StreptomycinE. Ampicillin

24. To an emergency ward a 7-year-oldchild was delivered in the condition ofallergic shock caused by a bee sting. Highconcentration of histamine is observed inblood. Production of this amine is the resultof the following reaction:

A. DecarboxylationB. HydroxylationC. DehydrogenationD. DeaminizationE. Reduction

25. A 65-year-old man suffering from goutcomplains of pain in his kidneys. Ultrasonicexamination revealed kidney stones. Acertain substance in increased concentrationcan cause kidney stones formation. Namethis substance:

A. Uric acidB. CholesterolC. BilirubinD. UreaE. Cystine

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

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

27. Pure culture of microorganisms wasobtained from pharynx of a child withsuspected diphtheria. Morphologic, tinctori-al, cultural, and biochemical propertiesof the microorganisms were studied andrevealed to be characteristic of diphtheriaagents. What investigation should be addi-tionally performed to make a conclusion,that these microorganisms are pathogenicdiphtheria bacilli?

A. Determine toxigenic propertiesB. Determine proteolytic propertiesC. Determine urease activityD. Determine cystinase activityE. Determine amylolytic activity

28. Autopsy of a man who had tuberculosisrevealed a 3x2 cm large cavity in the superi-or lobe of the right lung. The cavity wasinterconnected with a bronchus, its wallwas dense and consisted of three layers: theinternal layer was pyogenic, the middle layerwas made of tuberculous granulation tissueand the external one was made of connecti-ve tissue. What is the most likely diagnosis?

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

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

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

30. Analysis of sputum taken from a patientwith suspected pneumonia revealed slightlyelongated gram-positive diplococci with poi-nted opposite ends. What microorganismswere revealed in the sputum?

A. Streptococcus pneumoniaeB. Staphylococcus aureusC. Klebsiella pneumoniaeD. Neisseria meningitidisE. Neisseria gonorrhoeae

31. Serological diagnostics of infectious di-


seases is based upon specific interaction withantigenes. Specify the serological reactionthat underlies adhesion of microorganismswhen they are affected by specific antibodi-es in presence of an electrolyte:

A. Agglutination reactionB. Precipitation reactionC. Complement-binding reactionD. Hemadsorption reactionE. Neutralization reaction

32. A 4-year-old child was admitted to anorthopaedic department with displaced shinfracture. Bone fragments reposition requiresanalgesia. What drug should be chosen?

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

33. Doctors make mostly radial incisionsduring mammary gland surgery. What parti-culars of anatomical organization make suchsurgical technique preferable?

A. Lobe apexes converge towards nipplesB. Lobe bases radiate from nipplesC. Transversal position of gland lobesD. Vertical position of gland lobesE. -

34. A 41-year-old man has a history ofrecurrent attacks of heartbeats (paroxysms),profuse sweating, headaches. Examinati-on revealed hypertension, hyperglycemia,increased basal metabolic rate, andtachycardia. These clinical presentations aretypical for the following adrenal pathology:

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

35. A 12-year-old child has developednephritic syndrome (proteinuria, hematuria,cylindruria) 2 weeks after the case of tonsi-llitis, which is a sign of affected glomerularbasement membrane in the kidneys. Whatmechanism is the most likely to cause thebasement membrane damage?

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

36. Several minutes after a dentist admini-stered novocaine for local anaesthesia ofa patient’s tooth, the following symptomssharply developed in the patient: fatigue,

skin itching. Objectively the following canbe observed: skin hyperemia, tachycardia,BP dropped down to 70/40 mm Hg. Whatkind of allergic reaction is this pathology?

A. AnaphylacticB. CytotoxicC. StimulatingD. Cell-mediated immune reactionE. Immune complex

37. A patient with probable liver abscesswas delivered to a surgical department. Thepatient for a long time had been on anassignment in an African country and hadrecurrent cases of acute gastrointestinal di-sturbance. What protozoan disease can itbe?

A. AmebiasisB. TrypanosomiasisC. LeishmaniasisD. MalariaE. Toxoplasmosis

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

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

39. Electrical activity of neurons is beingmeasured. They fire prior to and at thebeginning of inhalation. Where are theseneurons situated?

A. Medulla oblongataB. DiencephalonC. MesencephalonD. Spinal cordE. Cerebral cortex

40. Electrocardiogram analysis demonstratesthat cardiac cycle of a human equals 1second. It means that heart rate per minuteequals:

A. 60B. 50C. 70D. 80E. 100

41. Glomerular filtration of a person, whohas been starving for a long time, hasincreased by 20%. The most likely cause offiltration changes in the given conditions is:


A. Decrease of blood plasma oncoticpressureB. Increase of systemic blood pressureC. Increase of renal filter permeabilityD. Increase of filtration factorE. Increase of renal plasma flow

42. Cells of healthy liver actively synthesizeglycogen and proteins. What organelles arethe most developed in them?

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

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

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

44. A patient with hypertensic crisis hasincreased content of angiotensin II in blood.Angiotensin pressor effect is based on:

A. Contraction of arteriole musclesB. Activation of biogenic amine synthesisC. Prostaglandin hyperproductionD. Vasopressin production stimulationE. Activation of kinin–kallikrein system

45. A 43-year-old-patient has arterialhypertension caused by increase in cardi-ac output and general peripheral resi-stance. Specify the variant of hemodynamicdevelopment of arterial hypertension in thegiven case:

A. EukineticB. HyperkineticC. HypokineticD. CombinedE. -

46. A patient has been hospitalisedwith provisional diagnosis of virus Bhepatitis. Serological reaction based oncomplementation of antigen with antibodychemically bound to peroxidase or alkalinephosphatase has been used for disease di-agnostics. Name this serological reaction:

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

47. A surgeon has to find the commonhepatic duct during operative interventionfor treatment of concrements in the gallducts. The common hepatic duct is locatedbetween the leaves of:

A. Hepatoduodenal ligamentB. Hepatogastric ligamentC. Hepatorenal ligamentD. Round ligament of liverE. Venous ligament

48. It is known that the gene responsible fordevelopment of blood groups according toAB0 system has three allele variants. Exi-stence of the IV blood group can be explai-ned by the following variability form:

A. CombinativeB. MutationalC. PhenotypicD. GenocopyE. Phenocopy

49. When measuring power inputs of aperson by the method of indirect calori-metry the following results were obtai-ned: oxygen consumption is 1000 ml andcarbon dioxide production is 800 ml per mi-nute. The person under examination has thefollowing respiratory coefficient:

A. 0,8B. 1,25C. 0,9D. 0,84E. 1,0

50. On examination of a newborn boy’sexternal genitalia a fissure in the urethraopening on the inferior surface of his penisis detected. What maldevelopment is it?

A. HypospadiasB. HermaphroditismC. EpispadiaD. MonorchismE. Cryptorchidism

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


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

52. For people adapted to high externaltemperatures profuse sweating is notaccompanied by loss of large volumes ofsodium chloride. This is caused by the effectthe following hormone has on the perspi-ratory glands:

A. AldosteroneB. VasopressinC. CortisolD. TgyroxinE. Natriuretic

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

A. HbSB. HbFC. HbA1D. HbA2E. HbO2

54. Emotional stress causes activation ofhormon-sensitive triglyceride lipase in theadipocytes. What secondary mediator takespart in this process?

A. Cyclic adenosine monophosphateB. Cyclic guanosine monophosphateC. Adenosine monophosphateD. DiacylglycerolE. Ions of ��2+

55. A patient has been diagnosed withalkaptonuria. Choose an enzyme that cancause this pathology when deficient:

A. Homogentisic acid oxidaseB. Phenylalanine hydroxylaseC. Glutamate dehydrogenaseD. Pyruvate dehydrogenaseE. Dioxyphenylalanine decarboxylase

56. As a result of a continuous chronicencephalopathy a patient has developedspontaneous motions and disorder of torsomuscle tone. These are the symptoms of thedisorder of the following conduction tract:

A. Tractus rubrospinalisB. Tractus corticospinalisC. Tractus corticonuclearisD. Tractus spinothalamicusE. Tractus tectospinalis

57. A child is 10 years old. The followi-ng presentations have developed: sharppain during swallowing, swollen neck, bodytemperature rise up to 39, 0oC, bright-red fi-nely papular rash all over the body. Pharynx

and tonsils are sharply hyperemic ("flamingpharynx"), "crimson tongue". On the tonsi-ls surface there are isolated greyish necrosisfocuses. What disease it might be?

A. Scarlet feverB. Meningococcal nasopharyngitisC. DiphtheriaD. InfluenzaE. Measles

58. A patient suffers from intermi-ttent fevers and normalizations of bodytemperature that occur during the day. Thetemperature rise is observed regularly everyfourth day. Specify the type of temperaturecurve:

A. Febris internuttensB. Febris continuaC. Febris reccurensD. Febris hecticaE. Febris remitens

59. A woman with the III (В), Rh- bloodgroup gave birth to a child with the II (А)blood group. The child is diagnosed withhemolytic disease of newborn caused byrhesus incompatibility. What blood groupand Rh can the father have?

A. II (А), Rh+

B. I (0), Rh+

C. III (B), Rh+

D. I (0), Rh−

E. II (A), Rh−

60. A patient is diagnosed with hereditarycoagulopathy that is characterised by factorVIII deficiency. Specify the phase of bloodclotting during which coagulation will be di-srupted in the given case:

A. Thromboplastin formationB. Thrombin formationC. Fibrin formationD. Clot retractionE. -

61. Angiocardiography of a 60-year-old manrevealed constriction of the vessel located inthe left coronary sulcus of his heart. Namethis pathological vessel:

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

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


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

63. During regular check-up a child isdetected with interrupted mineralization ofthe bones. What vitamin deficiency can bethe cause?

A. CalciferolB. RiboflavinC. TocopherolD. Folic acidE. Cobalamin

64. During hystological analysis of thelymph node situated in the posteriorneck triangle of an 18-year-old pati-ent a morphologist detected a clusterof cells including the following: isolatedmultinucleate Reed-Sternberg cells, largeand small Hodgkin’s cells and numerouslymphocytes, isolated plasma cells, eosi-nophils. What disease has developed in thepatient?

A. LymphogranulomatosisB. Nodular lymphomaC. Burkitt’s lymphomaD. Lymphocytic lymphomaE. Chronic lymphocytic leukemia

65. An infant has pylorospasm, weakness,hypodynamia, convulsions as a result offrequent vomiting. What kind of acid-basedisbalance is it?

A. Excretory alkalosisB. Excretory acidosisC. Metabolic acidosisD. Exogenous nongaseous acidosisE. Gaseous alkalosis

66. A 39-year-old man who had beenoperated for the stomach ulcer died 7days after the surgery. Autopsy revealedthat peritoneal leaves were dull, plephoric,covered with massive yellow-greenish films,the peritoneal cavity contained about 300ml of thick yellow-greenish liquid. Whatpathologic process was revealed in the peri-toneal cavity?

A. Fibrinous suppurative peritonitisB. Serous peritonitisC. Fibrinous serous peritonitisD. Peritoneal commissuresE. Fibrinous haemorrhagic peritonitis

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

exception:

A. AcetylcholineB. NoradrenalineC. AdrenalineD. DopamineE. Serotonin

68. A patient with urolithiasis has developedsevere pain attacks. For pain shock preventi-on he was administered an antispasmodicnarcotic analgesic along with atropine.Name this drug:

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

69. A patient with acute myocardial infarcti-on has been administered heparin as a partof complex therapy. Some time after heparininjection the patient developed hematuria.What heparin antagonist should be injectedto remove the complication?

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

70. A 37-year-old woman complains ofheadache, vertigo, troubled sleep, numbnessof limbs. For the last 6 years she has beenworking at a gas-discharge lamp-producingfactory in a lead-processing shop. Blood testfindings: low hemoglobin and RBC level,serum iron concentration exceeds the normby several times. Specify the type of anemia:

A. Iron refractory anemiaB. Iron-deficiency anemiaC. Minkowsky-Shauffard diseaseD. Hypoplastic anemiaE. Metaplastic anemia

71. Despite the administration of cardi-otonics and thiazide diuretic a patient withchronic heart failure has persistent edemasand the risk of ascites arose. What medicati-on should be administered to enhance thediuretic effect of the administered drugs?

A. SpironolactoneB. FurosemideC. AmilorideD. ClopamideE. Manithol

72. Acute renal impairment caused deathof a patient with hemorrhage. Autopsyrevealed enlarged kidneys with broad pale-pink cortical layer expressively demarcatedfrom dark-red renal pyramids. Macroscopicexamination revealed lack of epithelial


nuclei of convoluted tubules, tubulorrhexis,phlebostasis. The cell nuclei of choroidglomus and straight tubules were present.What pathology is it?

A. NecronephrosisB. InfarctionC. GlomerulonephritisD. PyelonephritisE. Nephrosis

73. A 3-year-old child with meningealsymptoms died. Postmortem macroscopyof the pia matter revealed miliary noduleswhich were microscopically represented bya focus of caseous necrosis with masses ofepithelioid and lymphoid cells with largecells containing crescent-shaped peripheralnuclei situated between them. Specify thetype of meningitis in the child:

A. TuberculousB. SyphiliticC. BrucellarD. GrippalE. Meningococcal

74. A 66-year-old woman had intravenousinjection of magnesium sulfate solutionto stop hypertensive crisis. However herarterial pressure did not decrease andafter repeated introduction of the samepreparation she developed sluggishness,slow response to stimuli; the patient isunconsciousness and her respiration is inhi-bited. What preparation is antagonist ofmagnesium sulfate and can remove thesymptoms of its overdose?

A. Calcium chlorideB. Potassium chlorideC. Sodium chlorideD. Activated carbonE. Potassium permanganate

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

A. BalantidiasisB. AmebiasisC. ToxoplasmosisD. LambliasisE. Trichomoniasis

76. An unconscious patient was deliveredby ambulance to the hospital. On objecti-ve examination the patient was found topresent no reflexes, periodical convulsi-ons, irregular breathing. After laboratoryexamination the patient was diagnosed wi-

th hepatic coma. Disorders of the centralnervous system develop due to accumulati-on of the following metabolite:

A. AmmoniaB. UreaC. GlutamineD. BilirubinE. Histamine

77. When playing a child received a hit to thepresternum region. As a result of this traumaan organ located behind the presternum wasdamaged. Name this organ:

A. ThymusB. Thyroid glandC. HeartD. PericardiumE. Larynx

78. A child suffers from dry cough. Whatnon-narcotic antitussive drug will relieve thepatient’s condition?

A. Glaucine hydrochlorideB. Codeine phosphateC. Morphine hydrochlorideD. Potassium iodideE. Althaea officinalis root extract

79. A patient complains of acute pain attacksin the right lumbar region. During exami-nation a nephrolithic obturation of the ri-ght ureter in the region between its abdomi-nal and pelvic segments has been detected.What anatomical boundary exists betweenthose two segments?

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

80. A patient has insufficient blood supplyto the kidneys, which has caused thedevelopment of pressor effect due toconstriction of arterial resistance vessels.This condition results from the vessels beingstrongly affected by the following substance:

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

81. In a village a case of anthrax has beenregistered. Medical services began epidemi-ologically indicated specific prophylaxis ofpopulation against anthrax. What preparati-on was used for this purpose?


A. Live vaccineB. Inactivated vaccineC. Chemical vaccineD. Genetically engineered vaccineE. Anatoxin

82. Experimental stimulation of thesympathetic nerve branches that innervatethe heart caused an increase in the force ofheart contractions because the membraneof typical cardiomyocytes permitted anincrease in:

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

83. According to the results of glucosetolerance test a patient has no disorderof carbohydrate tolerance. Despite thatglucose is detected in the patients’s urine (5mmol/l). The patient has been diagnosed wi-th renal diabetes. What renal changes causeglucosuria in this case?

A. Decreased activity of glucose reabsorpti-on enzymesB. Increased activity of glucose reabsorptionenzymesC. Exceeded glucose reabsorption thresholdD. Increased glucose secretionE. Increased glucose filtration

84. Alveolar space of acinus was invaded bybacteria that interacted with the surfactant.This led to the activation of the cells thatare localized in the alveolar walls and on thesurface. Name these cells:

A. Alveolar macrophagesB. Alveolocytes type IC. Endothelial cellsD. Clara cellsE. Alveolocytes type II

85. Parents of a 5-year-old boy report himto have frequent colds that develop intopneumonias, presence of purulent rasheson the skin. Laboratory tests have revealedthe following: absence of immunoglobuli-ns of any type, and naked cells are absentfrom the lymph nodes punctate. What kindof immune disorder is it?

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

86. Examination of a 42-year-old patientrevealed a tumour of adenohypophysis.

Objectively: the patient’s weight is 117kg, he has moon-like hyperemic face, red-blue striae of skin distension on his belly.Osteoporosis and muscle dystrophy arepresent. AP is 210/140 mm Hg. What is themost probable diagnosis?

A. Cushing’s diseaseB. Cushing’s syndromeC. Conn’s diseaseD. Diabetes mellitusE. Essential hypertension

87. 2 days after labour a woman developedshock along with DIC syndrome thatcaused her death. Autopsy revealedpurulent endomyometritis, regionalpurulent lymphangitis, lymphadenitis andpurulent thrombophlebitis. There werealso dystrophic alterations and interstitialinflammation of parenchymal organs. Whatis the most likely diagnosis?

A. SepticemiaB. SyphilisC. Tuberculosis of genital organsD. Chorioadenoma destruensE. Hydatid mole

88. In case of alkaptonuria, homogentisicacid is excreted in urine in large amounts.The development of this disease is associ-ated with metabolic disorder of the followi-ng amino acid:

A. TyrosineB. PhenylalanineC. AlanineD. MethionineE. Asparagine

89. When blood circulation in the damagedtissue is restored, lactate accumulation stopsand glucose consumption decelerates. Thesemetabolic changes are caused by activationof the following process:

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

90. A doctor examined a patient, studied theblood analyses, and reached a conclusion,that peripheral immunogenesis organs areaffected. What organs are the most likely tobe affected?

A. TonsilsB. ThymusC. KidneysD. Red bone marrowE. Yellow bone marrow

91. A doctor asked a patient to make a deepexhalation after a normal inhalation. What


muscles contract during such exhalation?

A. Abdominal musclesB. External intercostal musclesC. DiaphragmD. Trapezius musclesE. Pectoral muscles

92. A 4-year-old child with hereditaryrenal lesion has signs of rickets; vitaminD concentration in blood is normal. Whatis the most probable cause of ricketsdevelopment?

A. Impaired synthesis of calcitriolB. Increased excretion of calciumC. Hyperfunction of parathyroid glandsD. Hypofunction of parathyroid glandsE. Lack of calcium in food

93. In a cat with decerebrate rigidity themuscle tone is to be decreased. This can beachieved by:

A. Destruction of the vestibular nuclei ofDeitersB. Stimulation of the otolithic vestibularreceptorsC. Stimulation of the vestibular nuclei ofDeitersD. Stimulation of the vestibulocochlear nerveE. Stimulation of the ampullar vestibularreceptors

94. Autopsy of a 5-year-old child revealedin the area of vermis of cerebellum a softgreyish-pink node 2 cm in diameter withblurred margins and areas of haemorrhage.Histologically this tumour consisted ofatypical monomorphous small round cellswith large polymorphous nuclei. Whattumour is it?

A. MedulloblastomaB. MeningiomaC. GlioblastomaD. AstrocytomaE. Oligodendroglioma

95. Surface with an intact toad on it wasinclined to the right. Tone of extensormuscles became reflectory higher due to theactivation of the following receptors:

A. Vestibuloreceptors of utricle and sacculeB. Vestibuloreceptors of semicircular ductsC. Mechanoreceptors of foot skinD. Photoreceptors of retinaE. Proprioreceptors

96. A patient with high-titer antinuclearantibodies died from progressing renalimpairment. Autopsy revealed mesangi-oproliferative glomerulonephritis andabacterial polypous endocarditis. Periarteri-al bulbar sclerosis was detected in spleenand productive proliferative vasculitis in

skin. What is the most likely diagnosis?

A. Systemic lupus erythematosusB. Nephrotic syndromeC. RheumatismD. DermatomyositisE. Periarteritis nodosa

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

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

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

A. LiverB. PancreasC. ThymusD. SpleenE. Thyroid

99. A patient had a trauma that causeddysfunction of motor centres regulatingactivity of head muscles. In what parts ofcerebral cortex can the respective centrenormally be located?

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

100. During intravenous saline transfusiona patient’s condition deteriorated drasti-cally, and the patient died from asphyxiati-on. Autopsy revealed acute venous congesti-on of internal organs with sharp right heartdilatation. When the right ventricle waspunctured underwater, the bubbles escaped.What pathological process occurred in thepatient?

A. Air embolismB. Gaseous embolismC. Adipose embolismD. Tissue embolismE. Thromboembolism

101. Diseases of respiratory system and ci-rculatory disorders impair the transport ofoxygen, thus causing hypoxia. Under theseconditions the energy metabolism is carri-ed out by anaerobic glycolysis. As a result,


the following substance is generated andaccumulated in blood:

A. Lactic acidB. Pyruvic acidC. Glutamic acidD. Citric acidE. Fumaric acid

102. Examination of a 6-month-old childrevealed a delay in closure of the occipitalfontanelle. When should it normally close?

A. Before 3 monthsB. Before the child is bornC. Before 6 monthsD. Before the end of the first year of lifeE. Before the end of the second year of life

103. Sex chromosomes of a woman didn’tseparate and move to the opposite polesof a cell during gametogenesis (meiosis).The ovum was impregnated with a normalspermatozoon. Which chromosomal diseasecan be found in her child?

A. Turner’s syndromeB. Down’s syndromeC. Patau’s syndromeD. Edwards’ syndromeE. Cat cry syndrome

104. A patient was prescribed loratadine totreat allergic cheilitis. What is the mechani-sm of action of this drug?

A. Blockade of H1-histamine receptorsB. Blockade of adrenergic receptorsC. Increases activty of monoamine oxidaseD. Suppresses activity of Na+/K+-ATPaseE. Suppresses activity of choline esterase

105. During introduction of local anesthesiaa patient has gone into anaphylactic shock.What drug must be administered to the pati-ent?

A. Epinephrine hydrochlorideB. DiazepamC. Atropine sulfateD. PropranololE. Nitroglycerin

106. A patient has been diagnosed wi-th influenza. His condition drasticallyworsened after taking antipyretic drugs. Heis unconscious, AP is 80/50 mm Hg, Ps is140/m, body temperature dropped down to35, 8oC. What complication developed inthis patient?

A. CollapseB. HyperthermiaC. HypovolemiaD. AcidosisE. Alkalosis

107. An alcoholic has alcoholic psychosiswith evident psychomotor agitation. Whatneuroleptic drug should be administered foremergency aid?

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

108. During blood transfusion a patienthas developed intravascular erythrocytehemolysis. What kind of hypersensitivitydoes the patient have?

A. II type (antibody-dependent)B. I type (anaphylactic)C. III type (immune complex)D. IV type (cellular cytotoxicity)E. IV type (granulomatosis)

109. In the course of an experimentthalamocortical tracts of an animal were cut.What type of sensory perception remainedintact?

A. OlfactoryB. AuditoryC. ExteroreceptiveD. VisualE. Nociceptive

110. A 4-year-old child presents withgeneral weakness, sore throat and deglutiti-ve problem. After his examination a doctorsuspected diphtheria and sent the materialto a bacteriological laboratory. To determinethe diphtheria causative agent the materialshould be inoculated into the following di-fferential diagnostic medium:

A. Blood tellurite agarB. Endo’s agarC. Ploskyrev’s agarD. Sabouraud’s agarE. Levenshtein-Yessen agar

111. When treating a patient withchronic cardiac failure a doctor detectedbradycardia and deterioration of the pati-ent’s general state. Such condition is causedby cumulative effect of a drug. Which drugof those listed below has cumulative action?

A. DigoxinB. Diphenhydramine (Dimedrol)C. HydrochlorothiazideD. IsosorbideE. Retinol acetate

112. A doctor was addressed by a 30-year-old man. There is a probability of the patientbeing HIV-positive. To clarify the diagnosisthe doctor proposed to perform polymerasechain reaction. The basic process in this kind


of investigation is:

A. Gene amplificationB. TranscriptionC. Genetic recombinationD. Genomic mutationE. Chromosome mutation

113. Due to the use of poor-quality measlesvaccine for preventive vaccination, a 1-year-old child developed an autoimmunerenal injury. The urine was found to containmacromolecular proteins. What process ofurine formation was disturbed?

A. FiltrationB. ReabsorptionC. SecretionD. Reabsorption and secretionE. Secretion and filtration

114. A 26-year-old female patient withbronchitis has been administered a broadspectrum antibiotic as a causal treatmentdrug. Specify this drug:

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

115. A 65-year-old man suddenly lost visionin one eye due to the retinal detachment.The patient underwent enucleation. Hi-stological examination of the removed eyeretina and choroid revealed clusters of atypi-cal cells with marked polymorphism of cellsand nuclei, with a moderate number of mi-toses including the pathological ones. Thecell cytoplasm and intercellular mediumcontained brown pigment resulting in posi-tive DOPA reaction. Perls’ reaction wasnegative. What is the most likely diagnosis?

A. MelanomaB. Pigmented moleC. HemorrhageD. CysticercosisE. Wilson’s disease

116. During determining the blood groupaccording to the AB0 system with salt soluti-ons of monoclonal antibodies agglutinationdid not occur with any of the solutions. Whatblood group is it?

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

117. One of the factors that cause obesity isinhibition of fatty acids oxidation due to:

A. Low level of carnitineB. Impaired phospholipid synthesisC. Excessive consumption of fatty foodsD. Choline deficiencyE. Lack of carbohydrates in the diet

118. During ventricular systole the cardiacmuscle does not respond to additional sti-mulation because it is in the phase of:

A. Absolute refractorinessB. Relational refractorinessC. HyperexcitabilityD. Subnormal excitabilityE. There is no correct answer

119. A patient is diagnosed with acutemorphine hydrochloride intoxication.Prescribe the oxidizing agent for gastriclavage:

A. Potassium permanganateB. ChloramineC. Sulfocamphocainum (Procaine +Sulfocamphoric acid)D. CerigelE. Chlorhexidine (bi)gluconate

120. During cell division DNA replicationoccurs after a signal is received from thecytoplasm, then a certain portion of theDNA helix unwinds and splits into two indi-vidual strains. What enzyme facilitates thisprocess?

A. HelicaseB. RNA polymeraseC. LigaseD. RestrictaseE. DNA polymerase

121. A patient has been given atropinesulfate for rapid relief of spastic colonsymptoms. The use of this drug is contrai-ndicated during the followng disease:

A. GlaucomaB. Bronchial asthmaC. BradycardiaD. HypotensionE. Gastric ulcer

122. As an example of specific human parasi-tes one can name Plasmodium falciparum,human pinworm and some others. Thesource of parasite invasion in these cases isalways a human. Such specific human parasi-tes cause the diseases that are called:

A. AnthroponosesB. ZoonosesC. AnthropozoonosesD. InfectionsE. Multifactorial diseases

123. In the course of an experiment therehas been increase in nerve conduction


velocity. This may be caused by increase inconcentration of the following ions that arepresent in the solution around the cell:

A. Na+

B. K+ and Cl−

C. K+ and Na+

D. Ca2+ and Cl−

E. Ca2+

124. An HIV-positive patient’s cause ofdeath is acute pulmonary insufficiencyresulting from pneumonia. Pathohistologicalinvestigation of lungs has revealed intersti-tial pneumonia, alveolocyte desquamati-on and methamorphoses: alveolocyteenlargement, large intranuclear inclusi-ons surrounded by lightly-coloured areas.Transformed cells resemble owl’s eye. Namethe causative agent of pneumonia:

A. CytomegalovirusB. PneumococcusC. Influenza virusD. Candida fungiE. Toxoplasma

125. The organisms to be identified have anucleus surrounded by a nuclear membrane.Genetic material is concentrated predomi-nantly in the chromosomes that consistof DNA strands and protein molecules.These cells divide mitotically. Identify theseorganisms:

A. EukaryotesB. BacteriophagesC. ProkaryotesD. VirusesE. Bacteria

126. A 2-year-old boy is diagnosed wi-th Down syndrome. What chromosomalchanges may be the cause of this disease?

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

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

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

128. As a result of a mechanical injury anover 10 cm long portion of a peripheral

nerve was damaged. This caused an impai-rment of the upper limb activity. The patientwas offered nerve transplantation. What gli-al cells will participate in regeneration andprovide the trophism of the injured limb?

A. Schwann cellsB. Fibrous cellsC. Protoplasmic cellsD. MicrogliaE. Ependymal cells

129. A 47-year-old man developed intesti-nal colic against the background of essentialhypertension. In this situation it would bemost efficient to arrest the colic by admini-stering drugs of the following group:

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

130. Microscopy of a female patient’s swabsmade from vaginal secretion revealed gram-negative bean-shaped diplococci. Whatprovisional diagnosis can be made?

A. GonorrhoeaB. SyphilisC. ClamidiosisD. MycoplasmosisE. Toxoplasmosis

131. A 54-year-old woman was brought to acasualty department after a car accident. Atraumatologist diagnosed her with multiplefractures of the lower extremities. What ki-nd of embolism is most likely to develop inthis case?

A. AdiposeB. TissueC. ThromboembolismD. GaseousE. Air

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

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

133. A 30-year-old man with diabetesmellitus type I was hospitalised. Thepatient is comatose. Laboratory testsrevealed hyperglycemia and ketonemia.What metabolic disorder can be detected


in this patient?

A. Metabolic acidosisB. Metabolic alkalosisC. Respiratory acidosisD. Respiratory alkalosisE. Normal acid-base balance

134. A 15-year-old patient has fastingplasma glucose level 4,8 mmol/l, one hourafter glucose challenge it becomes 9,0mmol/l, in 2 hours it is 7,0 mmol/l, in 3hours it is 4,8 mmol/l. Such parameters arecharacteristic of:

A. Subclinical diabetes mellitusB. Diabetes mellitus type 1C. Diabetes mellitus type 2D. Healthy personE. Cushing’s disease

135. A patient has undergone surgicalremoval of a cavitary liver lesion 2 cmin diameter. It was revealed that thecavity wall was formed by dense fibrousconnective tissue; the cavity containedmurky thick yellowish-green fluid with anunpleasant odor. Microscopically the fluidconsisted mainly of polymorphonuclearleukocytes. What pathological process arethese morphological changes typical for?

A. Chronic abscessB. Acute abscessC. PhlegmonD. EmpyemaE. -

136. A patient consulted a physician aboutchest pain, cough, fever. Roentgenographyof lungs revealed eosinophilic infiltrateswhich were found to contain the larvae.What kind of helminthiasis are thesepresentations typical for?

A. AscariasisB. EchinococcosisC. FascioliasisD. CysticercosisE. Trichinosis

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

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

138. A 28-year-old patient undergoingtreatment in a pulmonological departmenthas been diagnosed with pulmonaryemphysema caused by splitting of alveolarseptum by tissular tripsin. The disease iscaused by the congenital deficiency of the

following protein:

A. α1-proteinase inhibitorB. α2-macroglobulinC. CryoglobulinD. HaptoglobinE. Transferrin

139. A patient, who has been suffering fora long time from intestine disbacteriosis,has increased hemorrhaging caused by di-sruption of posttranslational modification ofblood-coagulation factors II, VII, IХ, and Хin the liver. What vitamin deficiency is thecause of this condition?

A. КB. �12C. �9D. СE. Р

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

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

141. An obstetrician-gynecologist measurespelvis size of a pregnant woman. A caliperwas used to measure the distance betweenthe two iliac crests. What measurement oflarge pelvis was made?

A. Distantia cristarumB. Distantia throchantericaC. Distantia spinarumD. Conjugata veraE. Conjugata anatomica

142. A patient has arterial hypertension.What long-acting drug from the group ofcalcium channel blockers should be prescri-bed?

A. AmlodipineB. OctadineC. PyrroxanumD. AtenololE. Reserpine

143. A patient has been diagnosedwith URTI. Blood serum containsimmunoglobulin M. What stage of infecti-on is it?

A. AcuteB. ProdromalC. IncubationD. ReconvalescenceE. Carriage


144. A 43-year-old patient suffers from acutepancreatitis with disrupted common bileduct patency. What condition can developin this case?

A. Mechanical jaundiceB. Hemolytic jaundiceC. Hepatocellular jaundiceD. Hepatic comaE. Portal hypertension

145. A patient has a tumor of the eyesockettissues behind the eyeball. Disruption ofaccomodation and pupil constriction isobserved. What anatomical structure isdamaged?

A. Ganglion ciliareB. N. nasociliarisC. N. lacrimalisD. N. opticusE. N. trochlearis

146. Lymphocytes and other cells of ourbody synthesize universal antiviral agentsas a response to viral invasion. Name theseprotein factors:

A. InterferonB. Interleukin - 2C. CytokinesD. Interleukin - 4E. Tumor necrosis factor

147. A patient consulted a dentist aboutrestricted mouth opening (trismus).Anamnesis states a stab wound of the lowerextremity. What infection may cause thesesymptoms?

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

148. A patient has damaged spinal cord whi-te matter in the middle area of the posteri-or white column, disrupted propriocepti-ve sensibility of the lower limb joints andmuscles. What fibers are affected?

A. Fasciculus gracilisB. Tr. spinothalamicus lateralisC. Tr. spinocerebellaris anteriorD. Tr. spinocerebellaris posteriorE. Fasciculus cuneatus

149. In an elderly person the change in heartforce and vessels physical properties weredetected; they can be clearly observed ongraphic recording of carotid pulse waves.What method was applied?

A. SphygmographyB. PlethysmographyC. RheographyD. MyographyE. Phlebography

150. A patient has developed paroxysmalventricular tachycardia against thebackground of cardiac infarction. What anti-arrhythmic drug should be chosen to avoidlowering cardiac output?

A. Lidocaine hydrochlorideB. ProcainamideC. VerapamilD. PropranololE. Potassium chloride

151. Electrocardiogram of a young manreveals deviation of his electrical axis ofheart to the left. This phenomenon can becaused by:

A. Hypersthenic body typeB. Asthenic body typeC. Dilation of the right atriumD. Dilation of the right ventricleE. Dilation of the left atrium

152. A 6-year-old child suffers from delayedgrowth, disrupted ossification processes,decalcification of the teeth. What can be thecause?

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

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

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

154. A 25-year-old patient complains ofincreasing pain in his leg muscles occurri-ng during walking and forcing him to makefrequent stops. Objectively: skin of legsis pale, no hair-covering, toenails are wi-th trophic changes, no pulsation of pedalarteries. The most probable cause of thesechanges is:

A. IschemiaB. Venous hyperemiaC. Arterial hyperemiaD. -E. Embolism


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

A. SubfebrileB. HighC. HyperpyreticD. ApyreticE. Moderate

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

A. MicroangiopathyB. MacroangiopathyC. AtherosclerosisD. NeuropathyE. Glomerulopathy

157. Prolonged treatment of hypothyroidismhas caused general dystrophy, dental cari-es, tachycardia, tremor of extremities. Whatdrug is the cause of these side effects?

A. L-thyroxinB. Humulin (Human insulin)C. ParathyreoidinumD. ThyrocalcitoninE. Prednisolone

158. A 3-year-old child has eaten somestrawberries. Soon he developed a rashand itching. What was found in the child’sleukogram?

A. EosinophiliaB. HypolymphemiaC. Neutrophilic leukocytosisD. MonocytosisE. Lymphocytosis

159. A patient has been found to have amarked dilatation of the saphenous veinsin the region of anterior abdominal wallaround the navel. This is symptomatic ofpressure increase in the following vessel:

A. V. portae hepatisB. V. cava superiorC. V. cava inferiorD. V. mesenterica inferiorE. V. mesenterica superior

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

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

161. Obesity is a common disease. Theaim of its treatment is to lower contentof neutral fats in the body. What hormon-sensitive enzyme is the most important forintracellular lipolysis?

A. Triacylglycerol lipaseB. Protein kinaseC. Adenylate kinaseD. Diacylglycerol lipaseE. Monoacylglycerol lipase

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

A. StreptococciB. StaphylococciC. EscherichiaD. MycoplasmaE. Meningococci

163. A man is suffering from diarrhea. Insummer he spent his vacation in the southat the sea coast. Bacteria with the followingproperties were detected in his feces: gram-negative curved mobile monotrichous baci-lli that do not produce spores or capsules.They are undemanding to nutrient mediumbut require alkaline reaction (рН 8,5-09,5).Described are the agents of the followingenteric infection:

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

164. A patient is diagnosed with chronicatrophic gastritis attended by deficiency ofCastle’s intrinsic factor. What type of anemiadoes the patient have?

A. B12-deficiency anemiaB. Iron refractory anemiaC. Hemolytic anemiaD. Iron-deficiency anemiaE. Protein-deficiency anemia

165. A pregnant woman was detected wi-th IgM to rubella virus. An obstetrician-gynecologist recommended therapeuticabortion due to the high risk of teratogenicaffection of the fetus. Detection of IgM wasof great importance as it is these specificimmunoglobulins that:


A. Indicate recent infectionB. Penetrate placental barrierC. Have the largest molecular weightD. Are associated with anaphylactic reacti-onsE. Are the main factor of antiviral protection

166. A patient is diagnosed with cardi-ac infarction. Blood test for cardiospecificenzymes activity was performed. Which ofthe enzymes has three isoforms?

A. Creatine kinaseB. Lactate dehydrogenaseC. Aspartate transaminaseD. Alanine transaminaseE. Pyruvate kinase

167. A 50-year-old man, who has beensuffering from chronic hepatic failure forseveral years, has developed ascites. Whatis the main mechanism of this disorderdevelopment?

A. Increased pressure in portal vein systemB. Decrease of albumin and globulinsynthesis in liverC. Increased content of low-density and verylow-density lipoproteins in bloodD. Neurotoxins appearing in bloodE. Increase of blood oncotic pressure

168. A 30-year-old man has sustained aninjury to his thorax in a traffic incident, whi-ch caused disruption of his external respi-ration. What type of ventilatory difficultycan be observed in the given case?

A. Restrictive extrapulmonary ventilatoryimpairmentB. Restrictive pulmonary ventilatory impai-rmentC. Obstructive ventilatory impairmentD. Impaired ventilation regulation dysfuncti-onE. Cardiovascular collapse

169. A 53-year-old man suffering from di-abetes mellitus has developed a painfulconical induration, bluish-red with yellowcenter, on the skin of his neck. Such changesare characteristic of:

A. FuruncleB. AbscessC. CarbuncleD. PhlegmonE. Empyema

170. Biochemical analysis of an infant’serythrocytes revealed evident glutathioneperoxidase deficiency and low concentrati-on of reduced glutathione. What pathologi-cal condition can develop in this infant?

A. Hemolytic anemiaB. Pernicious anemiaC. Megaloblastic anemiaD. SicklemiaE. Iron-deficiency anemia

171. In winter a 3-year-old child hassharp rise of body temperature up to40oC. Hemorrhagic rash is observed onthe skin and mucosa. Bean-shaped gram-negative microorganisms situated in pairsare detected in the blood. What provisionaldiagnosis can be made?

A. MeningococcosisB. GonorrheaC. Scarlet feverD. InfluenzaE. Diphtheria

172. Microelectrode analysis of nerve fi-ber biolectrical activity revealed, that itsmembrane potential equals 90 mV. Its ini-tial rest potential was 85 mV. What processoccurs in this case?

A. HyperpolarizationB. DepolarizationC. RepolarizationD. OvershootE. Supernormality

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

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

174. Determining a patient’s blood group wi-th monoclonal test-reagents revealed positi-ve agglutination reaction to anti-A and anti-B reagents, and negative reaction to anti-D.What blood group does this patient have?

A. IV (АВ) Rh−

B. II (А) Rh+

C. III (В) Rh−

D. IV (АВ) Rh+

E. I (0) Rh+

175. A patient visited a dentist to extract atooth. After the tooth had been extracted,bleeding from the tooth socket continuedfor 15 minutes. Anamnesis states that thepatient suffers from active chronic hepatitis.What phenomenon can extend the time ofhemorrhage?


A. Decrease of fibrinogen content in bloodB. ThrombocytopeniaC. HypocalcemiaD. Increased activity of anticoagulationsystemE. Decrease of albumine content in blood

176. Name the halogen-containing antisepticwith fungicidal properties, which is used totreat dermatomycosis:

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

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

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

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

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

179. A microslide presents a tissue withspherical cells, each of them containing alarge fat drop covered with thin cytoplasmlayer in its center. Nucleus is compressedand situated at the cell periphery. What ti-ssue is it?

A. White adipose tissueB. Brown adipose tissueC. Mucous tissueD. Pigmented tissueE. Reticular tissue

180. To treat rheumatoid arthritis a65-year-old woman was prescribed animmunosuppressive hormonal drug as a partof her complex therapy. Name this drug:

A. PrednisoloneB. Thymus cytomedins (Thymalin)C. Chloropyramine (Suprastin)D. RiboflavinE. Fercovenum

181. An experiment was aimed at testingflexor reflex in a spinal frog, which wasinitiated by simultaneous stimulation withisolated pre-threshold electrical impulses.The frequency of those impulses was such,that the reflex occurred. What process in thenerve centers can be observed during thisexperiment?

A. Temporal summationB. Spatial summationC. Presynaptic summationD. Postsynaptic summationE. Threshold summation

182. A patient diagnosed with acutedysentery has been treated for 3 days in aninfectious diseases hospital. On admissionthere were complaints of high temperature,stomachache and fluid excrements withmucus as often as 8-10 times a day. Whatsample should be taken for analysis?

A. FecesB. UrineC. BileD. LiquorE. Blood

183. An 18-year-old woman has body di-sproportion, wing-like folds on the skin ofher neck, underdeveloped ovaries, nucleiof her buccal epithelium cells have no Barrbodies. Dermatoglyphics method revealedthat her adt angle is 66o. What provisionaldiagnosis can be made in this case?

A. Turner’s syndromeB. Cri du chat (cat cry) syndromeC. Kleinfelter’s syndromeD. Patau’s syndromeE. Edwards’ syndrome

184. A 27-year-old patient with injury tothe neck has lost approximately 30% ofthe blood volume. The patient’s condition issevere: blood pressure is 60/40 mm Hg, heartrate is 140/min., respiratory rate is 30/min.,conscious. Characterize the condition of thepatient’s circulatory system:

A. Hypovolemic shockB. Cardiogenic shockC. CollapseD. ComaE. Arterial hypertension

185. A soldier with explosion-caused traumawas delivered to a hospital. Examinati-on revealed his tympanic membrane to be


intact. What defense reflex prevented thetympanic membrane from rupturing?

A. Contraction of m. tensor tympaniB. Relaxation of m. tensor tympaniC. Contraction of m. auricularis arteriorD. Relaxation of m. auricularis arteriorE. Relaxation of m. stapedins

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

A. CodominanceB. ComplementarityC. SemidominanceD. PolymeryE. Epistasis

187. During narcosis a patient developed arisk of cerebral edema. What drug should beadministered in this case?

A. FurosemideB. DopamineC. PhenazepamD. TriamtereneE. Sodium bromide

188. During surgery performed in abdomi-nal cavity a surgeon located ligament of li-ver stretching from anterior abdominal wall(navel) to inferior surface of liver. What li-gament is it?

A. Round ligament of the liverB. Falciform ligament of the liverC. Coronary ligament of the liverD. Venous ligament of the liverE. Triangular ligament of the liver

189. A 9-year-old boy has acute onset of di-sease: sore throat, body temperature rise upto 39, 5oC; on the second day diffuse skinrash was detected all over his skin exept fornasolabial triangle. On examination of oralcavity: crimson tongue, "flaming pharynx",necrotic tonsillitis. What diagnosis is themost likely?

A. Scarlet feverB. MeaslesC. DiphtheriaD. InfluenzaE. Meningococcemia

190. A 49-year-old man complains ofpain in his metatarsophalangeal jointsand joint deformation. In blood hyperuri-cemy can be observed. X-ray has revealedmetatarsophalangeal joint space narrowi-ng, erosion, periarticular calcification ofthe both joints, osteoporosis. Microscopy

has revealed inflammatory granulomatousreaction surrounding necrotizing masses inthe area of the first metatarsophalangeal joi-nt. Choose the most likely diagnosis:

A. Gout (podagra)B. Pyrophosphate arthropathyC. Rheumatoid arthritisD. HyperparathyroidismE. Urolithiasis

191. Granulomas containing lymphocytesand macrophages were detected duringanalysis of skin biopsy material. Amongmacrophages there are large cells with fatinclusions, which contain microorganismsin spheric packages (Virchow’s cells). Thefollowing disease is based on the describedtype of hypersensitivity:

A. LeprosyB. SyphilisC. TuberculosisD. RhinoscleromaE. Epidemic typhus

192. A patient with suspected necrosis ofthe upper abdominal cavity organs was deli-vered to a surgical department. This condi-tion is associated with acute circulatory di-sturbance of the following vessel:

A. Tuncus coeliacusB. A. mesenterica inferiorC. A. mesenterica superiorD. A. iliaca communisE. A. renalis

193. Name the drug that inhibits excretoryfunction of pancreas during treatment ofacute pancreatitis:

A. Contrykal (Aprotinin)B. AllocholC. РаnzynormD. Pancreatin (Mezym forte)E. Festal

194. An 18-year-old patient has developedcandidiasis after the case of pneumoniatreated with β-lactam antibiotic. What anti-mycotic agent should be prescribed?

A. FluconazoleB. StreptomycinC. AmpicillinD. PhthalylsulfathiazoleE. Trimethoprim/sulfamethoxazole (Bi-septol)

195. During autopsy of a 9-month-old girl’sbody, who died due to severe pneumoniacomplicated with sepsis, lack of thymus isobserved. In the lymph nodes the lymphoidfollicles and cortical substance are absent;follicles of spleen are reduced in size with


no light zones and plasma cells. What is thecause of such structural changes?

A. Thymus agenesisB. Accidental involution of thymusC. Thymus hypoplasiaD. Thymus atrophyE. Thymus aplasia

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

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

197. A woman poisoned with unknownsubstance was hospitalised in a toxicologi-cal department. What group of drugs canbe administered to decrease absorption andintroduction of the poison to her body?

A. AdsorbentsB. NeurolepticsC. AntioxidantsD. Organic nitratesE. Cholinesterase inhibitors

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

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

199. A 50-year-old woman is being treatedfor shingles in a neurology unit. What reacti-vated virus causes this disease?

A. Varicella zoster virus (chickenpox virus)B. Herpes simplex virus type 1C. Herpes simplex virus type 2D. Measles virusE. Cytomegalovirus

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

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

INSTRUCTIONAL BOOK

Testing Board

TEST ITEMS FOR LICENSING EXAMINATION: KROK 1. MEDICINE.

Kyiv. Testing Board.

(English language).

Approved to print 23.04/№110 Paper size 60х84 1/8

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

Conditional print pages 20. Accounting publishing pages 24.

Issue. 2448 copies.

List of abbreviations

A/G Albumin/globulin ratio

A-ANON Alcoholics anonymous

ACT Abdominal computed tomography

ADP Adenosine diphosphate

ALT Alanin aminotranspherase

AMP Adenosine monophosphate

AP Action potential

ARF Acute renal failure

AST Aspartat aminotranspherase

ATP Adenosine triphosphate

BP Blood pressure

bpm Beats per minute

C.I. Color Index

CBC Complete blood count

CHF Chronic heart failure

CT Computer tomography

DIC Disseminated intravascular coagualtion

DCC Doctoral controlling committee

DM-2 Non-Insulin dependent diabetes mellitus

DTP Anti diphtheria-tetanus vaccine

ECG Electrocardiogram

ESR Erythrocyte sedimentation rate

FC Function class

FAD Flavin adenine dinucleotide

FADH2 Flavin adenine dinucleotide restored

FEGDS Fibro-esphago-gastro-duodenoscopy

FMNH2 Flavin mononucleotide restored

GIT Gastrointestinal tract

GMP Guanosine monophosphate

Hb Hemoglobin

HbA1c Glycosylated hemoglobin

Hct Hematocrit

HIV Human immunodeficiency virus

HR Heart rate

IDDM Insulin dependent diabetes mellitus

IFA Immunofluorescence assay

IHD Ischemic heart disease

IU International unit

LDH Lactate dehydrogenase

MSEC Medical and sanitary expert committee

NAD Nicotine amide adenine dinucleotide

NADPH Nicotine amide adenine dinucleotide

phosphate restored

NIDDM Non-Insulin dependent diabetes mellitus

PAC Polyunsaturated aromatic carbohydrates

PAS Periodic acid & shiff reaction

pCO2 CO2 partial pressure

pO2 CO2 partial pressure

pm Per minute

Ps Pulse rate

r roentgen

RBC Red blood count

RDHA Reverse direct hemagglutination assay

Rh Rhesus

(R)CFT Reiter's complement fixation test

RIHA Reverse indirect hemagglutination assay

RNA Ribonucleic acid

RR Respiratory rate

S1 Heart sound 1

S2 Heart sound 2

TU Tuberculin unit

U Unit

USI Ultrasound investigation

V/f Vision field

WBC White blood count

X-ray Roentgenogram

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