Vinnitsa National Pirogov Memorial Medical University

Department of Biological and General Chemistry

ONLINE EDUCATION

Approvedat the methodological sessionDepartment of Biologicaland General Chemistry

21.05.2020Head of department ___________ Prof. Zaichko N.V.

MSQ FOR EXAM (on-line)

(Attention: option A is correct answer)

1After consumption of rich food a patient has nausea and heartburn, steatorrhea. Thiscondition might be caused by:

A Bile acid deficiencyB Increased lipase secretionC Disturbed tripsin synthesisD Amylase deficiencyE Disturbed phospholipase synthesis

2Galactosemia is revealed in the child. Concentration of glucose in the blood is notconsiderably changed. Deficiency of what enzyme caused this illness?

A Galactose-1-phosphate uridyltransferaseB Amylo-1,6-glucosidaseC PhosphoglucomutaseD GalactokinaseE Hexokinase

3Fatty of phospholipids is disordered due to fat infiltration of the liver. Indicate which of thepresented substances can enhance the process of methylation during phospholipidssynthesis?

A MethionineB Ascorbic acidC GlucoseD GlycerinE Citrate

4Characteristic sign of glycogenosis is muscle pain during physical work. Blood examinationreveals usually hypoglycemia. This pathology is caused by congenital deficiency of thefollowing enzyme:

A Glycogen phosphorylaseB Glucose 6-phosphate dehydrogenase

C Alpha amylaseD Gamma amylaseE Lysosomal glycosidase

5An infant has apparent diarrhea resulting from improper feeding. One of the main diarrheaeffects is plentiful excretion of sodium bicarbonate. What form of acid-base balance disorderis the case?

A Metabolic acidosisB Metabolic alkalosisC Respiratory acidosisD Respiratory alkalosisE No disorders of acid-base balance will be observed

6Methotrexate (structural analogue of the folic acid which is competitive inhibitor of thedihydrofolatreductase) is prescribed for treatment of the malignant tumour.On which leveldoes methotrexate inhibit synthesis of the nucleic acids?

A Mononucleotide synthesisB ReplicationC TranscriptionD ReparationE Processing

7RNA-polymeraseB(II) is blocked due to amanitine poisoning (poison of death-cup). Itdisturbes:

A Synthesis of m-RNAB Synthesis of t-RNAC Reverse transcriptionD Primers synthesisE Maturation of m-RNA

8Pain along large nervous stems and increased amount of pyruvate in the blood were revealed in the patient. Insufficiency of what vitamin can cause such change?

A В1B В2C РРD Pantothenic acidE Biotin

9Patient with encephalopathy was admitted to the neurological in-patient department.Correlation of increasing of encephalopathy and substances absorbed by the bloodstreamfrom the intestines was revealed. Whatsubstances that are created in the intestines cancause endotoxemia?

A IndoleB ButyrateC AcetacetateD Biotin

E Ornithine

10Examination of a patient suffering from cancer of urinary bladder revealed high rate ofserotonin and hydroxyanthranilic acid. It is caused by excess of the following amino acid in the organism:

A TryptophanB AlanineC HistidineD MethionineE Tyrosine

11A mother consulted a doctor about her 5-year-old child who develops erythemas, vesicularrash and skin itch under the influence of sun. Laboratory studies revealed decreased ironconcentration in the blood serum, increased uroporphyrinogen I excretion with the urine. What is the most likely inherited pathology in this child?

A Erythropoietic porphyriaB MethemoglobinemiaC Hepatic porphyriaD CoproporphyriaE Intermittent porphyria

12A 3 year old child with fever was given aspirin. It resulted in intensified erythrocyte haemolysis. Hemolytic anemia might have been caused by congenital insufficiency of the followingenzyme:

A Glucose 6-phosphate dehydrogenaseB Glucose 6-phosphataseC Glycogen phosphorylaseD Glycerol phosphate dehydrogenaseE γ-glutamiltransferase

13Blood of a 12 year old boy presents low concentration of uric acid and accumulation ofxanthine and hypoxanthine. This child has genetic defect of the following enzyme:

A Xanthine oxidaseB ArginaseC UreaseD Ornithine carbamoyltransferaseE Glycerylkinase

14Increased amount of free fat acids is observed in the blood of the patients with diabetesmellitus. It can be caused by:

A Increased activity of triglyceridelipase adipocytesB Storage of palmitatoil-CoAC Activation of the ketone bodies utilizationD Activation of the synthesis of the apolipoproteinsE Decreased activity of phosphatidylcholine-cholesterol-acyltransferase blood plasma

15A 46-year-old female patient has a continuous history of progressive muscular (Duchenne's)dystrophy. Which blood enzyme changes will be of diagnostic value in this case?

A Creatine phosphokinaseB Lactate dehydrogenaseC Pyruvate dehydrogenaseD Glutamate dehydrogenaseE Adenylate cyclase

16A patient is ill with diabetes mellitus that is accompanied by hyperglycemia of over 7,2millimole/l on an empty stomach. The level of what blood plasma protein allows to estimatethe glycemia rate retrospectively (4-8 weeks before examination)?

A Glycated hemoglobinB AlbuminC FibrinogenD C-reactive proteinE Ceruloplasmin

17In case of enterobiasis acrihine - the structural analogue of vitamin $B_2$ - is administered.The synthesis disorder of which enzymes does this medicine cause in microorganisms?

A FAD-dependent dehydrogenasesB CytochromeoxidasesC PeptidasesD NAD-dependet dehydrogenasesE Aminotransferases

18A 10-year-old girl often experiences acute respiratory infections with multiple spottyhaemorrages in the places of clothes friction. Hypovitaminosis of what vitamin is present atthe girl?

A СB В6C В1D АE В2

19Hydroxylation of endogenous substrates and xenobiotics requires a donor of protons. Whichof the following vitamins can play this role?

A Vitamin CB Vitamin PC Vitamin B6D Vitamin EE Vitamin A

20The formation of a secondary mediator is obligatory in membrane-intracellular mechanism ofhormone action. Point out the substance that is unable to be a secondary mediator:

A GlycerolB DiacylglycerolC Inositol-3,4,5-triphosphateD CAMPE Ca2+

21A 4 y.o. child with signs of durative proteinic starvation was admitted to the hospital. The signs were as follows: growth inhibition, anemia, edemata, mental deficiency. Choose a cause ofedemata development:

A Reduced synthesis of albuminsB Reduced synthesis of globulinsC Reduced synthesis of hemoglobinD Reduced synthesis of lipoproteinsE Reduced synthesis of glycoproteins

22Researchers isolated 5 isoenzymic forms of lactate dehydrogenase from the human bloodserum and studied their properties. What property indicates that the isoenzymic forms wereisolated from the same enzyme?

A Catalyzation of the same reactionB The same molecular weightC The same physicochemical propertiesD Tissue localizationE The same electrophoretic mobility

23On some diseases it is observed aldosteronism with hypertension and edema due tosodium retention in the organism. What organ of the internal secretion is affected onaldosteronism?

A Adrenal glandsB TesticleC OvariesD PancreasE Hypophysis

24An experiment proved that UV-radiated cells of patients with xeroderma pigmentosum restorethe native DNA structure slower than cells of healthy individuals as a result of reparationenzyme defection. What enzyme helps this process?

A EndonucleaseB RNA ligaseC PrimaseD DNA polymerase IIIE DNA gyirase

25A patient with suspicion on epidemic typhus was admitted to the hospital. Some arachnidsand insects have been found in his flat. Which of them may be a carrier of the pathogen ofepidemic typhus?

A Lice

B SpidersC Bed-bugsD CockroachesE Houseflies

26A businessman came to India from South America. On examination the physician found thatthe patient was suffering from sleeping-sickness. What was the way of invasion?

A As a result of bug's bitesB As a result of mosquito's bitesC With contaminated fruits and vegetablesD Through dirty handsE After contact with a sick dogs

27Tere is observed inhibited fibrillation in the patients with bile ducts obstruction, bleeding dueto low level of absorbtion of some vitamin. What vitamin is in deficit?

A КB АC DD ЕE Carotene

28A 52 year-old patient with bronchial asthma was treated with glucocorticoids. Fever reactionappeared as a result of postinjective abscess. The patient had subfebrile temperature, whichdidn’t correspond to latitude and severity of inflammatory process. Why did patient have lowfever reaction?

A Inhibited endogen pyrogens productionB Violation of heat loss through lungsC Inflammatory barrier formation in injection placeD Violation of heat-producing mechanismsE Thermoregulation center inhibition

29A 35-year-old man under the treatment for pulmonary tuberculosis has acute-onset of rightbig toe pain, swelling, and low-grade fever. The gouty arthritis was diagnosed and highserum uric acid level was found. Which of the following antituberculosis drugs are known forcausing high uric acid levels?

A PyrazinamideB CycloserineC ThiacetazoneD RifampicinE Aminosalicylic acid

30During metabolic process active forms of the oxygen including superoxide anion radical areformed in the human body. With help of what enzyme is this anion activated?

A Superoxide dismutaseB CatalaseC Peroxidase

D GlutathioneperoxidaseE Glutathionereductase

31A patient presents high activity of LDH1,2, aspartate aminotransferase, creatinephosphokinase. In what organ (organs) is the development of a pathological process themost probable?

A In the heart muscle (initial stage of myocardium infarction)B In skeletal muscles (dystrophy, atrophy)C In kidneys and adrenalsD In connective tissueE In liver and kidneys

32Buffer capacity of blood was decreased in the worker due to exhausting muscular work. Entryof what acid substance to the blood can this state be explained?

A LactateB PyruvateC 1,3-bisphosphoglycerateD α-ketoglutarateE 3-phosphoglycerate

33While examining the child the doctor revealed symmetric cheeks roughness, diarrhea,disfunction of the nervous system. Lack of what food components caused it?

A Nicotinic acid, tryptophaneB Lysine, ascorbic acidC Threonine, pantothenic acidD Methionine, lipoic acidE Phenylalanine, pangamic acid

34A13-year-old boy complains of general weakness, dizziness, tiredness. He is mentallyretarded. Increased level of valine, isoleucine, leucine is in the blood and urine. Urine hasspecific smell. What is the diagnosis?

A Maple syrup urine diseaseB Addison's diseaseC TyrosinosisD HistidinemiaE Graves' disease

35Increased breaking of vessels, enamel and dentine destruction in scurvy patients are causedby disorder of collagen maturing. What stage of modification of procollagen is disordered inthis avitaminosis?

A Hydroxylation of prolineB Formation of polypeptide chainsC Glycosylation of hydroxylysine residuesD Removal of C-ended peptide from procollagenE Detaching of N-ended peptide

36A 62-year-old female patient has developed a cataract (lenticular opacity) secondary to thediabetes mellitus. What type of protein modification is observed in case of diabetic cataract?

A GlycosylationB PhosphorylationC ADP-ribosylationD MethylationE Limited proteolysis

37Aspirin has antiinflammatory effect due to inhibition of the cyclooxygenase activity. Level ofwhat biological active acids will decrease?

A ProstaglandinsB LeucotriensC CatecholaminesD Biogenic aminesE Iodinethyronyns

38At the aboratory experiment the eukocyte culture was mixed with staphylococci. Neutrophileleukocytes engulfed and digested bacterial cells. This processes are termed:

A PhagocytosisB PinocytosisC DiffusionD Facilitated diffusionE Osmosis

39Examination of a patient revealed typical presentations of collagenosis. This pathology ischaracterized by increase of the following urine index:

A HydroxyprolineB ArginineC GlucoseD Mineral saltsE Ammonium salts

40Marked increase of activity of МВ-forms of CPK (creatinephosphokinase) and LDH-1 wererevealed on the examination of the patient's blood. What is the most likely pathology?

A Miocardial infarctionB HepatitisC RheumatismD PancreatitisE Cholecystitis

41Untrained people often have muscle pain after sprints as a result of lactate accumulation.This might be caused by intensification of the following biochemical process:

A GlycolysisB Gluconeogenesis

C Pentose phosphate pathwayD LipogenesisE Glycogenesis

42A 16-year-old boy was performed an appendectomy. He has been hospitalized for right lowerquadrant abdominal pain within 18 hours. The surgical specimen is edematous anderythematous. Infiltration by what of the following cells is the most typical for the processoccuring here?

A NeutrophilsB EosinophilsC BasophilsD LimphocytesE Monocytes

43ATP synthesis is totaly blocked in a cell. How will the value of membrane rest potentialchange?

A It will disappearB It will be slightly increasedC It will be considerably increasedD First it will increase, then decreaseE First it will decrease, then increase

44The concentration of albumins in human blood sample is lower than normal. This leads toedema of tissues. What blood function is damaged?

A Maintaining the oncotic blood pressureB Maintaining the Ph levelC Maintaining the body temperatureD Maintaining the blood sedimentation systemE All answers are correct

45Examination of a patient suffering from frequent haemorrhages in the inner organs andmucous membranes revealed proline and lysine being included in collagen fibers.Impairment of their hydroxylation is caused by lack of the following vitamin:

A CB EC KD AE D

46A 20 year old patient complains of general weakness, dizziness, quick fatigability. Bloodanalysis results: Hb- 80 g/l. Microscopical examination results: erythrocytes are of modifiedform. This condition might be caused by:

A Sickle-cell anemiaB Hepatocellular jaundiceC Acute intermittent porphyriaD Obturative jaundice

E Addison's disease

47A 48 year old patient complained about intense pain, slight swelling and reddening of skinover the joints, temperature rise up to 38oC. Blood analysis revealed high concentration of urates. This condition might be caused by disturbed metabolism of:

A PurinesB CollagenC CholesterolD PyrimidinesE Carbohydrates

48A patient has yellow skin colour, dark urine, dark-yellow feces. What substance will havestrengthened concentration in the blood serum?

A Unconjugated bilirubinB Conjugated bilirubinC MesobilirubinD VerdoglobinE Biliverdin

49A patient has an increased pyruvate concentration in blood. A large amount of it is excretedwith the urine. What vitamin is lacking in this patient?

A B1B EC B3D B6E B2

50Ammonia is a very toxic substance, especially for nervous system. What substance takes themost active part in ammonia detoxication in brain tissues?

A Glutamic acidB LysineC ProlineD HistidineE Alanine

51A patient has pellagra. Interrogation revealed that he had lived mostly on maize for a long time and eaten little meat. This disease had been caused by the deficit of the following substancein the maize:

A TryptophanB TyrosineC ProlineD AlanineE Histidine

52

Increased production of thyroidal hormones T3 and T4, weight loss, tachycardia,psychic excitement and so on present on thyrotoxicosis. How do thyroidal hormones effectenergy metabolism in the mitochondrion of cells?

A Disconnect oxidation and oxidated phosphorylationB Activates phosphorylation of substanceC Stops phosphorylation of substanceD Stops respiratory chainE Activates oxidated phosphorylation

53A patient with high rate of obesity was advised to use carnitine as a food additive in order toenhance "fat burning". What is the role of carnitine in the process of fat oxidation?

A Transport of FFA (free fatty acids) from cytosol to the mitochondriaB Transport of FFA from fat depots to the tissuesC It takes part in one of reactions of FFA beta-oxidationD FFA activationE Activation of intracellular lipolysis

54An experimantal animal that was kept on protein-free diet developed fatty liver infiltration, inparticular as a result of deficiency of methylating agents. This is caused by disturbedgeneration of the following metabolite:

A CholineB DOPAC CholesterolD AcetoacetateE Linoleic acid

55A patient consulted a doctor about symmetric dermatitis of open skin areas. It was found outthat the patient lived mostly on cereals and ate too little meat, milk and eggs. What vitamindeficiency is the most evident?

A NicotinamideB CalciferolC Folic acidD BiotinE Tocopherol

56A 46 year old woman suffering from chololithiasis developed jaundice. Her urine becamedark-yellow and feces became colourless. Blood serum will have the highest concentration of the following substance:

A Conjugated bilirubinB Unconjugated bilirubinC BiliverdinD MesobilirubinE Urobilinogen

57A 46 year old patient applied to a doctor complaining about joint pain that becomes strongerthe day before weather changes. Blood examination revealed strengthened concentration of

uric acid. The most probable cause of the disease is the intensified disintegration of thefollowing substance:

A Adenosine monophosphateB Cytidine monophosphateC Uridine triphosphateD Uridine monophosphateE Thymidine monophosphate

58A 42-year man suffering from gout has increased level of urinary acid in the blood. Allopurinolwas prescribed to decrease the level of urinary acid. Competitive inhibitor of what enzyme is allopurinol?

A XanthinoxidaseB AdenosinedeaminaseC AdeninephosphoribosiltransferaseD HypoxantinphosphoribosiltransferaseE Guaninedeaminase

59A 38 year old patient suffers from rheumatism in its active phase. What laboratorycharacteristic of blood serum is of diagnostic importance in case of this pathology?

A C-reactive proteinB Uric acidC UreaD CreatinineE Transferrin

60Patient experienced increased susceptibility of the skin to the sunlight. His urine after sometime became dark-red. What is the most likely cause of this?

A PorphyriaB Hemolytic jaundiceC AlbinismD PellagraE Alkaptonuria

61A patient with serious damage of muscular tissue was admitted to the traumatologicaldepartment. What biochemical urine index will be increased in this case?

A CreatinineB Common lipidsC GlucoseD Mineral saltsE Uric acid

6212 hours after an accute attack of retrosternal pain a patient presented a jump of aspartateaminotransferase activity in blood serum. What pathology is this deviation typical for?

A Myocardium infarctionB Viral hepatitisC Collagenosis

D Diabetes mellitusE Diabetes insipidus

63Donor skin transplantation was performed to a patient with extensive burns. On the 8-th daythe graft became swollen and changed colour; on the 11-th day graft rejection started. Whatcells take part in this process?

A T-lymphocytesB ErythrocytesC BasophilsD EosinophilsE B-lymphocytes

64A 30 y.o. woman had been ill for a year when she felt pain in the area of joints for the first time, they got swollen and skin above them became reddened. Provisional diagnosis isrheumatoid arthritis. One of the most probable causes of this disease is a structure alteration of a connective tissue protein:

A CollagenB MucinC MyosinD OvoalbuminE Troponin

65Autopsy of a 12-year-old girl revealed: multiple cutaneous hemmorhages (mostly into the skin of buttocks, lower extremities), serous and mucous memrane hemmorhages, cerebralhemmorhages. Adrenal glands show focal necrosis and massive hemmorhages; kidneysshow necrotic nephrosis, suppurative arthritis, iridocyclitis, vasculitis. What is the mostprobable diagnosis?

A MeningococcemiaB Epidemic typhusC Periarteritis nodosaD Systemic lupus erythematosusE Radiation sickness

66Examination of a 27-year-old patient revealed pathological changes in liver and brain. Bloodplasma analysis revealed an abrupt decrease in the copper concentration, urine analysisrevealed an increased copper concentration. The patient was diagnosed with Wilson’sdegeneration. To confirm the diagnosis it is necessary to study the activity of the followingenzyme in blood serum:

A CeruloplasminB Carbonic anhydraseC Xanthine oxidaseD Leucine aminopeptidaseE Alcohol dehydrogenase

67A patient complains about dyspnea provoked by the physical activity. Clinical examinationrevealed anaemia and presence of the paraprotein in the zone of gamma-globulins. To

confirm the myeloma diagnosis it is necessary to determine the following index in thepatient’s urine:

A Bence Jones proteinB BilirubinC HaemoglobinD CeruloplasminE Antitrypsin

68As a result of exhausting muscular work a worker has largely reduced buffer capacity of blood. What acidic substance that came to blood caused this phenomenon?

A LactateB PyruvateC 1,3-bisphosphoglycerateD 3-phosphoglycerateE -

69A 2-year-old child with mental and physical retardation has been delivered to a hospital. Hepresents with frequent vomiting after having meals. There is phenylpyruvic acid in urine.Which metabolism abnormality is the reason for this pathology?

A Amino-acid metabolismB Lipidic metabolismC Carbohydrate metabolismD Water-salt metabolismE Phosphoric calcium metabolism

70A patient was delivered to the hospital by an emergency team. Objectively: grave condition,unconscious, adynamy. Cutaneous surfaces are dry, eyes are sunken, face is cyanotic. There is tachycardia and smell of acetone from the mouth. Analysis results: blood glucose - 20,1micromole/l (standard is 3,3-5,5 micromole/l), urine glucose - 3,5% (standard is - 0). What isthe most probable diagnosis?

A Hyperglycemic comaB Hypoglycemic comaC Acute heart failureD Acute alcoholic intoxicationE Anaphylactic shock

71Profuse foam appeared when dentist put hydrogen peroxide on the mucous of the oral cavity.What enzyme caused such activity?

A CatalaseB CholinesteraseC AcetyltransferaseD Glucose-6-phosphatdehydrogenaseE Methemoglobinreductase

72A 62 y.o. woman complains of frequent pains in the area of her chest and backbone, ribfractures. A doctor assumed myelomatosis (plasmocytoma). What of the following laboratory

characteristics will be of the greatest diagnostical importance?A ParaproteinemiaB HyperalbuminemiaC ProteinuriaD HypoglobulinemiaE Hypoproteinemia

73A newborn child has convulsions that have been observed after prescription of vitamin B6. This most probable cause of this effect is that vitamin B6 is a componet of the followingenzyme:

A Glutamate decarboxylaseB Pyruvate dehydrostaseC Netoglubarate dehydromineD Aminolevulinate synthaseE Glycogen phosphorylase

74Nappies of a newborn have dark spots that witness of formation of homogentisic acid.Metabolic imbalance of which substance is it connected with?

A ThyrosineB GalactoseC MethionineD CholesterineE Tryptophane

75Pathological changes of the liver and brain were revealed in a 27-year-old patient.The copper concentration is abruptly decreased in blood plasma and increased in the urine. Wilson'sdisease was diagnosed. Activity of what enzyme in the blood serum should be examined toprove diagnisis?

A CeruloplasminB CarboanhydrazeC XanthioxidaseD LeucinamineopeptidazeE Alcoholdehydrogenaze

76A 50-year-old patient complains about general weakness, appetite loss and cardiacarrhythmia. The patient presents with muscle hypotonia, flaccid paralyses, weakenedperistaltic activity of the bowels. Such condition might be caused by:

A HypokaliemiaB HypoproteinemiaC HyperkaliemiaD HypophosphatemiaE Hyponatremia

77An 18-year-old patient has enlarged inguinal lymphnodes, they are painless, thickened onpalpation. In the area of genital mucous membrane there is a small-sized ulcer withthickened edges and "laquer" bottom of greyish colour. What is the most probable diagnosis?

A SyphilisB TuberculosisC LepraD Trophic ulcerE Gonorrhea

78Concentration of pyruvate is increased in the patient's blood, the most of which is excretedwith urine. What avitaminosis is observed in the patient?

A Avitaminosis В1B Avitaminosis EC Avitaminosis В3D Avitaminosis B6E Avitaminosis В2

79Carnitine including drug was recomended to the sportsman for improving results. Whatprocess is activated most of all with help of carnitine?

A Transport of fatty acids to the mitochondriaB Synthesis of steroid hormonesC Synthesis of ketone bodiesD Synthesis of lipidsE Tissue respiration

80A patient with suspected diphtheria went through bacterioscopic examination. Examination ofthroat swab revealed rod-shaped bacteria with volutin granules. What etiotropic preparationshould be chosen in this case?

A Antidiphtheric antitoxic serumB BacteriophageC Diphtheria antitoxinD EubioticE Interferon

81Patient with diabetes mellitus experienced loss of consciousness and convulsions afterinjection of insulin. What is the result of biochemical blood analysis for concentration of thesugar?

A 1,5 mmol/LB 8,0 mmol/LC 10,0 mmol/LD 3,3 mmol/LE 5,5 mmol/L

82A woman who has been keeping to a clean-rice diet for a long time was diagnosed withpolyneuritis (beriberi). What vitamin deficit results in development of this disease?

A ThiamineB Ascorbic acidC PyridoxineD Folic acid

E Riboflavin

83Removal of gall bladder of a patient has disturbed processes of Ca absorption through theintestinal wall. What vitamin will stimulate this process?

A D3B PPC CD B12

E K

84A 63-year-old woman developed signs of rheumatoid arthritis. Increase of which indicatedblood values level could be helpful in proving diagnosis?

A Additive glycosaminoglycansB LipoproteidsC Acid phosphataseD General cholesterolE R-glycosidase

85A 1,5-year-old child presents with both mental and physical lag, decolorizing of skin and hair,decrease in catecholamine concentration in blood. When a few drops of 5% solution oftrichloroacetic iron had been added to the child’s urine it turned olive green. Such alterationare typical for the following pathology of the amino acid metabolism:

A PhenylketonuriaB AlkaptonuriaC TyrosinosisD AlbinismE Xanthinuria

86A patient complains of frequent diarrheas, especially after consumption of fattening food, andof body weight loss. Laboratory examination revealed steatorrhea; hypocholic feces. What can be the cause of this condition?

A Obturation of biliary tractsB Mucous membrane inflammation of small intestineC Lack of pancreatic lipaseD Lack of pancreatic phospholipaseE Unbalanced diet

87On the empty stomach in the patients blood glucose level was 5,65 mmol/L, in an hour afterusage of sugar it was 8,55 mmol/L, in a 2 hours - 4,95 mmol/L. Such indicators are typical for:

A Healthy personB Patient with hidden diabetes mellitusC Patient with insulin-dependent diabetes mellitusD Patient with non-insulin dependent diabetes mellitusE Patient with tireotoxicosis

88A child is languid, apathetic. Liver is enlarged and liver biopsy revealed a significant excess of glycogene. Glucose concentration in the blood stream is below normal. What is the cause oflow glucose concentration?

A Low (absent) activity of glycogene phosphorylase in liverB Low (absent) activity of hexokinaseC High activity of glycogen synthetaseD Low (absent) activity of glucose 6-phosphataseE Deficit of a gene that is responsible for synthesis of glucose 1-phosphaturidine transferase

89A 65 year old man suffering from gout complains of kidney pain. Ultrasound examinationrevealed renal calculi. The most probable cause of calculi formation is the strengthenedconcentration of the following substance:

A Uric acidB CholesterolC BilirubinD UreaE Cystine

90A 65-year-old suffering from the gout man complains of the pain in the kidney's region. Onultrasonic examination the renal calculi were revealed. As a result of what process were theyformed?

A Decay of purine nucleotidesB Protein catabolismC Ornithine cycleD Heme decayE Restoration of cysteine

91A 5-year-old child who often fells ill with respiratory diseases has eczematous appearancesafter consumption of some food products, tendency to prolonged course of inflammatoryprocesses. What kind of diathesis can be suspected in this case?

A Exudative-catharralB HemmorhagicC ArthritismD LymphohypoplasticE Asthenic

92The greater amount of nitrogen is excreted from the organism in form of urea. Inhibition ofurea synthesis and accumulation of ammonia in blood and tissues are induced by thedecreased activity of the following liver enzyme:

A Carbamoyl phosphate synthetaseB Aspartate aminotransferaseC UreaseD AmylaseE Pepsin

93A 35 y.o. patient who often consumes alcohol was treated with diuretics. There appearedserious muscle and heart weakness, vomiting, diarrhea, AP- 100/60 mm Hg, depression.This condition is caused by intensified excretion with urine of:

A PotassiumB SodiumC ChlorineD CalciumE Phosphates

94After intake of rich food a patient feels nausea and sluggishness; with time there appearedsigns of steatorrhea. Blood cholesterine concentration is 9,2 micromole/l. This condition wascaused by lack of:

A Bile acidsB TriglyceridesC Fatty acidsD PhospholipidsE Chylomicrons

95Examination of a man who hadn't been consuming fats but had been getting enoughcarbohydrates and proteins for a long time revealed dermatitis, poor wound healing, visionimpairment. What is the probable cause of metabolic disorder?

A Lack of linoleic acid, vitamins A, D, E, KB Lack of palmitic acidC Lack of vitamins PP, HD Low caloric value of dietE Lack of oleic acid

96A 44-year-old woman complains of common weakness, heart pain, considerable increase ofbody weigt. Objectively: moon-like face, hirsutism, AP- 165/100 mm Hg, height - 164 cm,weight - 103 kg; fat is mostly accumulated in the region of neck, upper shoulder girdle,stomach. What is the main pathogenetic mechanism of obesity?

A Increased production of glucocorticoidsB Decreased production of thyroidal hormonesC Increased production of insulinD Decreased production of glucagonE Increased production of mineralocorticoids

97An experimental animal has been given excessive amount of carbon-labeled glucose for aweek. What compound can the label be found in?

A Palmitic acidB MethionineC Vitamin AD CholineE Arachidonic acid

98

After a serious viral infection a 3-year-old child has repeated vomiting, loss of consciousness, convulsions. Examination revealed hyperammoniemia. What may have caused changes ofbiochemical blood indices of this child?

A Disorder of ammonia neutralization in ornithinic cycleB Activated processes of aminoacids decarboxylationC Disorder of biogenic amines neutralizationD Increased purtefaction of proteins in intestinesE Inhibited activity of transamination enzymes

99Examination of a patient with frequent hemorrhages from internals and mucous membranesrevealed proline and lysine being a part of collagene fibers. What vitamin absence causeddisturbance of their hydroxylation?

A Vitamin CB Vitamin KC Vitamin AD ThiamineE Vitamin E

100A 36-year-old female patient has a history of collagen disease. Urine analysis is likely toreveal an increased concentration of the following metabolite:

A OxyprolineB IndicanC CreatinineD UreaE Urobilinogen

101Albinos can't stand sun impact - they don't aquire sun-tan but get sunburns. Disturbedmetabolism of what aminoacid underlies this phenomenon?

A PhenilalanineB MethionineC TryptophanD Glutamic acidE Histidine

102A patient with continious bronchopneumonia was admitted to the therapeutic department.Antibiotic therapy didn't give much effect. What medication for improvement of immune stateshould be added to the complex treatment of this patient?

A TimalineB AnalginC SulfocamphocaineD BenadrylE Paracetamol

103A patient suffers from hepatic cirrhosis. Examination of which of the following substancesexcreted by urine can characterize the state of antitoxic function of liver?

A Hippuric acid

B Ammonium saltsC KreatinineD Uric acidE Aminoacids

104Vitamin A together with specific cytoreceptors penetrates through the nuclear membranes,induces transcription processes that stimulate growth and differentiation of cells. Thisbiological function is realized by the following form of vitamin A:

A Trans-retinoic acidB Trans-retinalC Cis-retinalD RetinolE Carotin

105Products of some proteins hydrolysis and modification are the biologically active substancescalled hormones. Lipotropin, corticotropin, melanotropin and endorphins are synthesized inthe hypophysis of the following protein:

A Proopiomelanocortin (POMC)B NeuroalbuminC NeurostrominD NeuroglobulinE Thyreoglobulin

106In patients with the biliary tract obstruction the blood coagulation is inhibited; the patients have frequent haemorrhages caused by the subnormal assimilation of the following vitamin:

A KB AC DD EE C

107The study of the genealogy of a family with hypertrichosis (helix excessive pilosis) hasdemonstrated that this symptom is manifested in all generations only in men and is inheritedby son from his father. What is the type of hypertrichosis inheritance?

A Y-linked chromosomeB Autosome-recessiveC Autosome-dominantD X-linked recessive chromosomeE X-linked dominant chromosome

108A newborn child suffers from milk curdling in stomach, this means that soluble milk proteins(caseins) transform to insoluble proteins (paracaseins) by means of calcium ions and acertain enzyme. What enzyme takes part in this process?

A ReninB PepsinC Gastrin

D SecretinE Lipase

109The penetration of the irritable cell membrane for potassium ions has been increased duringan experiment. What changes of membrane electric status can occur?

A HyperpolarizationB DepolarizationC Action potentialD Local responseE No changes

110A sportsman was recommended to take a medication that contains carnitine in order toimprove his results. What process is activated by carnitine the most?

A Fatty acids transport to mitochondrionsB Synthesis of steroid hormonesC Synthesis of ketone bodiesD Synyhesis of lipidsE Tissue respiration

111To prevent postoperative bleeding a 6 y.o. child was administered vicasol that is a syntheticanalogue of vitamin K. Name post-translational changes of blood coagulation factors thatwill be activated by vicasol:

A Carboxylation of glutamin acidB Phosphorylation of serine radicalsC Partial proteolysisD PolymerizationE Glycosylation

112A 4 y.o. boy has had recently serious viral hepatitis. Now there are such clinical presentationsas vomiting, loss of consciousness, convulsions. Blood analysis revealedhyperammoniemia. Disturbunce of which biochemical process caused such pathologicalcondition of the patient?

A Disturbed neutralization of ammonia in liverB Disturbed neutralization of biogenic aminesC Increased putrefaction of proteins in bowelsD Activation of aminoacid decarboxylationE Inhibition of transamination enzyms

113During examination of an 11-month-old infant a pediatrician revealed osteoectasia of thelower extremities and delayed mineralization of cranial bones. Such pathology is usuallyprovoked by the deficit of the following vitamin:

A CholecalciferolB ThiaminC Pantothenic acidD BioflavonoidsE Riboflavin

114Examination of a patient suffering from chronic hepatitis revealed a significant decrease in the synthesis and secretion of bile acids. What process will be mainly disturbed in the patient’sbowels?

A Fat emulsificationB Protein digestionC Carbohydrate digestionD Glycerin absorptionE Amino acid absorption

115The energy inputs of a healthy man have been measured. In what position was the patient ifhis energy inputs were less than the main exchange?

A SleepB RestC Easy workD Nervous exertionE Calmness

116Glutamate decarboxylation results in formation of inhibitory transmitter in CNS. Name it:

A GABAB GlutathioneC HistamineD SerotoninE Asparagine

117In course of histidine catabolism a biogenic amin is formed that has powerful vasodilatatingeffect. Name it:

A HistamineB SerotoninC DioxyphenylalanineD NoradrenalinE Dopamine

118Utilization of arachidonic acid via cyclooxigenase pathway results in formation of somebioactive substances. Name them:

A ProstaglandinsB ThyroxineC Biogenic aminsD SomatomedinsE Insulin-like growth factors

119After a sprint an untrained person develops muscle hypoxia. This leads to the accumulation of the following metabolite in muscles:

A Lactate

B Ketone bodiesC Acetyl CoAD Glucose 6-phosphateE Oxaloacetate

120Myocyte cytoplasm contains a big number of dissolved metabolites of glucose oxidation.Name one of them that turns directly into a lactate:

A PyruvateB OxaloacetateC GlycerophosphateD Glucose 6-phosphateE Fructose 6-phosphate

121Emotional stress causes activation of hormon-sensitive triglyceride lipase in the adipocytes.What secondary mediator takes part in this process?

A Cyclic adenosine monophosphateB Cyclic guanosine monophosphateC Adenosine monophosphateD DiacylglycerolE Ions of Са2+

122A patient has been diagnosed with alkaptonuria. Choose an enzyme whose deficiency can be the reason for this pathology:

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

123A patient diagnosed with carcinoid of bowels was admitted to the hospital. Analysis revealedhigh production of serotonin. It is known that this substance is formed of tryptophaneaminooacid. What biochemical mechanism underlies this process?

A DecarboxylationB DesaminationC Microsomal oxydationD TransaminationE Formation of paired compounds

124A genetics specialist analyzed the genealogy of a family and found that both males andfemales may have the illness, not across all the generations, and that healthy parents mayhave ill children. What is the type of illness inheritance?

A Autosomal recessiveB Autosomal dominantC X-linked dominantD X-linked recessiveE Y-linked

125Analysis of amniotic fluid that was obtained as a result of amniocentesis (puncture ofamniotic sac) revealed cells the nuclei of which contain sex chromatin (Barr's body). What can it be evidence of?

A Development of female fetusB Development of male fetusC Genetic disorders of fetus developmentD TrisomyE Polyploidy

126Vitamin B1 deficiency results in disturbance of oxidative decarboxylation ofα-ketoglutaric acid. This will disturb synthesis of the following coenzyme:

A Thiamine pyrophosphateB Nicotinamide adenine dinucleotide (NAD)C Flavine adenine dinucleotide (FAD)D Lipoic acidE Coenzyme A

127A child's blood presents high content of galactose, glucose concentration is low. There aresuch presentations as cataract, mental deficiency, adipose degeneration of liver. Whatdisease is it?

A GalactosemiaB Diabetes mellitusC LactosemiaD Steroid diabetesE Fructosemia

128According to clinical indications a patient was administered pyridoxal phosphate. Whatprocesses is this medication intended to correct?

A Transamination and decarboxylation of aminoacidsB Oxidative decarboxylation of ketonic acidsC Desamination of purine nucleotideD Synthesis of purine and pyrimidine basesE Protein synthesis

129A 45 y.o. woman suffers from Cushing's syndrome - steroid diabetes. Biochemicalexamination revealed: hyperglycemia, hypochloremia. Which of the under-mentionedprocesses is the first to be activated?

A GluconeogenesisB GlycogenolysisC Glucose reabsorptionD Glucose transport to the cellE Glycolysis

130

Autopsy of a 46-year-old man revealed multiple brown-and-green layers and hemmorhageson the mucous membrane of rectum and sigmoid colon; slime and some blood in colonlumen; histologically - fibrinous colitis. In course of bacteriological analysis of colon contentsS.Sonne were found. What is the most probable diagnosis?

A DysenteryB CholeraC SalmonellosisD YersiniosisE Crohn's disease

131A patient had been ill with bronchial asthma for many years and died from asthmatic fit.Histologic lung examination revealed: lumen of bronchioles and small bronches contain a lotof mucus with some eosinophils, there is sclerosis of alveolar septums, dilatation of alveolelumen. What mechanism of development of hypersensibility reaction took place?

A Reagin reactionB Cytotoxic reactionC Immunocomplex reactionD Cytolysis determined by lymphocytesE Granulomatosis

132Desulfiram is widely used in medical practice to prevent alcocholism. It inhibits aldehydedehydrogenase. Increased level of what metabolite causes aversion to alcochol?

A AcetaldehydeB EthanolC Malonyl aldehydeD Propionic aldehydeE Methanol

133A 1-year-old child with symptoms of muscle involvement was admitted to the hospital.Examination revealed carnitine deficiency in his muscles. What process disturbance is thebiochemical basis of this pathology?

A Transporting of fatty acids to mitochodrionsB Regulation of Ca2+ level in mitochondrionsC Substrate phosphorylationD Lactic acid utilizationE Actin and myosin synthesis

134The patient with complaints of permanent thirst applied to the doctor. Hyperglycemia, polyuriaand increased concentration of 17-ketosteroids in the urine were revealed. What disease isthe most likely?

A Steroid diabetesB Insulin-dependent diabetes mellitusC MyxoedemaD Type I glycogenosisE Addison's disease

135

Index of pH of the blood changed and became 7,3 in the patient with diabetus mellitus.Detecting of the components of what buffer system is used while diagnosing disorder of theacid-base equilibrium?

A BicarbonateB PhosphateC HemoglobinD OxyhemoglobinE Protein

136As a result of posttranslative modifications some proteins taking part in blood coagulation,particularly prothrombin, become capable of calcium binding. The following vitamin takes part in this process:

A KB CC AD B1E B2

137Objective examination of a patient revealed: slender figure, big skull, highly developed frontalregion of face, short extremities. What constitutional type is it characteristic for?

A RespiratoryB MuscularC DigestiveD CerebralE Mixed

138A 38-year-old patient died during intractable attack of bronchial asthma. Histologicexamination revealed mucus accumulation in bronchial lumen, a lot of fat cells (labrocytes) inthe wall of bronches, many of them are in the state of degranulation, there are also a lot ofeosinophils. What pathogenesis of bronchial changes is it?

A AtopyB Cytotoxic, cytolytic action of antibodiesC Immunocomplex mechanismD Cellular cytolysisE Granulomatosis

139Diabetes mellitus causes ketosis as a result of activated oxidation of fatty acids. Whatdisorders of acid-base equilibrium may be caused by excessive accumulation of ketonebodies in blood?

A Metabolic acidosisB Metabolic alcalosisC Any changes woun't happenD Respiratory acidosisE Respiratory alcalosis

140A woman with 0 (I) bllod group has born a child with AB blood group. This woman's husband

has A blood group. What genetic interaction explains this phenomenon?A Recessive epistasisB CodominanceC PolymeryD Incomplete dominanceE Complementation

141Depressions and emotional insanities result from the deficit of noradrenalin, serotonin andother biogenic amines in the brain. Their concentration in the synapses can be increased bymeans of the antidepressants that inhibit the following enzyme:

A Monoamine oxidaseB Diamine oxidaseC L-amino-acid oxidaseD D-amino-acid oxidaseE Phenylalanine-4-monooxygenase

142A 3 year old child with symptoms of stomatitis, gingivitis and dermatitis of open skin areaswas delivered to a hospital. Examination revealed inherited disturbance of neutral amino acidtransporting in the bowels. These symptoms were caused by the deficiency of the followingvitamin:

A NiacinB Pantothenic acidC Vitamin AD CobalaminE Biotin

143During hypersensitivity test a patient got subcutaneous injection of an antigen which causedreddening of skin, edema, pain as a result of histamine action. This biogenic amine isgenerated as a result of transformation of the following histidine amino acid:

A DecarboxylationB MethylationC PhosphorylationD IsomerizationE Deaminization

144A patient with suspected diagnosis "progressing muscular dystrophy" got his urine tested.What compound will confirm this diagnosis if found in urine?

A KreatineB CollagenC PorphyrinD MyoglobinE Calmodulin

145A patient complained about dizziness, memory impairment, periodical convulsions. It wasrevealed that these changes were caused by a product of decarboxylation of glutamic acid.Name this product:

A GABAB Pyridoxal phosphateC TDPD ATPE THFA

146A sportsman needs to improve his sporting results. He was recommended to take apreparation that contains carnitine. What process is activated the most by this compound?

A Fatty acids transportingB Amino acids transportingC Calcium ions transportingD Glucose transportingE Vitamin K transporting

147A doctor examined a child and revealed symptoms of rachitis. Development of this deseasewas caused by deficiency of the following compound:

A 1,25 [ОН]-dichydroxycholecalciferolB BiotinC TocopherolD NaphtaquinoneE Retinol

148Laboratory examination of a child revealed increased concentration of leucine, valine,isoleucine and their ketoderivatives in blood and urine. Urine smelt of maple syrup. Thisdisease is characterized by the deficit of the following enzyme:

A Dehydrogenase of branched amino acidsB AminotransferaseC Glucose-6-phosphataseD PhosphofructokinaseE Phosphofructomutase

149A 9-month-old infant is fed with artificial formulas with unbalanced vitamin $B_6$concentration. The infant presents with pellagral dermatitis, convulsions, anaemia.Convulsion development might be caused by the disturbed formation of:

A GABAB HistamineC SerotoninD DOPAE Dopamine

150It was found out that some compounds, for instance fungi toxins and some antibiotics caninhibit activity of RNA-polymerase. What process will be disturbed in a cell in case ofinhibition of this enzyme?

A TranscriptionB ProcessingC Replication

D TranslationE Reparation

151When blood circulation in the damaged tissue is restored, then lactate accumulation comesto a stop and glucose consumption decelerates. These metabolic changes are caused byactivation of the following process:

A Aerobic glycolysisB Anaerobic glycolysisC LipolysisD GluconeogenesisE Glycogen biosynthesis

152During starvation muscle proteins break up into free amino acids. These compounds will bethe most probably involved into the following process:

A Gluconeogenesis in liverB Gluconeogenesis in musclesC Synthesis of higher fatty acidsD GlycogenolysisE Decarboxylation

153Surgical removal of a part of stomach resulted in disturbed absorption of vitamin $B_{12}$, itis excreted with feces. The patient was diagnosed with anemia. What factor is necessary forabsorption of this vitamin?

A GastromucoproteinB GastrinC Hydrochloric acidD PepsinE Folic acid

154A newborn develops dyspepsia after the milk feeding. When the milk is substituted by theglucose solution the dyspepsia symptoms disappear. The newborn has the subnormalactivity of the following enzyme:

A LactaseB InvertaseC MaltaseD AmylaseE Isomaltase

155Patients who suffer from severe diabetes and don't receive insulin have metabolic acidosis.This is caused by increased concentration of the following metabolites:

A Ketone bodiesB Fatty acidsC Unsaturated fatty acidsD TriacylglycerolsE Cholesterol

156A 4 year old child with hereditary renal lesion has signs of rickets, vitamin D concentration inblood is normal. What is the most probable cause of rickets development?

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

157A 6 year old child was delivered to a hospital. Examination revealed that the child couldn't fixhis eyes, didn't keep his eyes on toys, eye ground had the cherry-red spot sign. Laboratoryanalyses showed that brain, liver and spleen had high rate of ganglioside glycometide. Whatcongenital disease is the child ill with?

A Tay-Sachs diseaseB Wilson's syndromeC Turner's syndromeD Niemann-Pick diseaseE MacArdle disease

158In clinical practice tuberculosis is treated with izoniazid preparation - that is an antivitaminable to penetrate into the tuberculosis bacillus. Tuberculostatic effect is induced by theinterference with replication processes and oxidation-reduction reactions due to the buildupof pseudo-coenzyme:

A NADB FADC FMND TDPE CoQ

159A newborn child was found to have reduced intensity of sucking, frequent vomiting, hypotonia.Urine and blood exhibit increased concentration of citrulline. What metabolic process isdisturbed?

A Ornithinic cycleB Tricarboxylic acid cycleC GlycolysisD GlyconeogenesisE Cori cycle

160A male patient has been diagnosed with acute radiation disease. Laboratory examinationrevealed a considerable reduction of platelet serotonin level. The likely cause of plateletserotonin reduction is the disturbed metabolism of the following substance:

A 5-oxytryptofaneB TyrosineC HistidineD PhenylalanineE Serine

161Dietary intake of a 30 year old nursing woman contains 1000 mg of calcium, 1300 mg ofphosphorus and 20 mg of iron per day. It is necessary to change content of these mineralsubstances in the following way:

A To increase phosphorus contentB To increase calcium contentC To reduce fluorine contentD To increase iron contentE To reduce iron content

162Cardinal symptoms of primary hyperparathyroidism are osteoporosis and renal lesion alongwith development of urolithiasis. What substance makes up the basis of these calculi in thisdisease?

A Calcium phosphateB Uric acidC CystineD BilirubinE Cholesterol

163Study of conversion of a food colouring agent revealed that neutralization of this xenobiotictakes place only in one phase - microsomal oxydation. Name a component of this phase:

A Cytochrome Р-450B Cytochrome BC Cytochrome CD Cytochrome AE Cytochrome oxidase

164A patient had hemorrhagic stroke. Blood examination revealed strengthened kininconcentration.The patient was prescribed contrical. It was administered in order to inhibit thefollowing proteinase:

A KallikreinB PepsinC TrypsinD ChemotrypsinE Collagenase

165A 49-year-old driver complains about unbearable constricting pain behind the breastboneirradiating to the neck. The pain arose 2 hours ago. Objectively: the patient’s condition isgrave, he is pale, heart tones are decreased. Laboratory studies revealed high activity ofcreatine kinase and LDH1. What disease are these symptoms typical for?

A Acute myocardial infarctionB Acute pancreatitisC StenocardiaD CholelithiasisE Diabetes mellitus

166Plasmic factors of blood coagulation are exposed to post-translational modification with theparticipation of vitamin K. It is necessary as a cofactor in the enzyme system ofγ-carboxylation of protein factors of blood coagulation due to the increased affinity of their molecules with calcium ions. What amino acid is carboxylated in these proteins?

A GlutamicB ValineC SerineD PhenylalanineE Arginine

167Pharmacological effects of antidepressants are connected with inhibition of an enzymecatalyzing biogenic amines noradrenaline and serotonine in the mitochondrions of cerebralneurons. What enzyme participates in this process?

A Monoamine oxidaseB TransaminaseC DecarboxylaseD PeptidaseE Lyase

168An oncological patient was prescribed methotrexate. With the lapse of time target cells of thetumour lost susceptibility to this drug. There is change of gene expression of the folowingenzyme:

A Dehydrofolate reductaseB ThiaminaseC DeaminaseD Folate oxidaseE Folate decarboxylase

Krok 1 Medicine

1After consumption of rich food a patient has nausea and heartburn, steatorrhea. This conditionmight be caused by:

A Bile acid deficiencyB Increased lipase secretionC Disturbed tripsin synthesisD Amylase deficiencyE Disturbed phospholipase synthesis

2Characteristic sign of glycogenosis is muscle pain during physical work. Blood examinationreveals usually hypoglycemia. This pathology is caused by congenital deficiency of the followingenzyme:

A Glycogen phosphorylaseB Glucose 6-phosphate dehydrogenaseC Alpha amylaseD Gamma amylaseE Lysosomal glycosidase

3An infant has apparent diarrhea resulting from improper feeding. One of the main diarrheaeffects is plentiful excretion of sodium bicarbonate. What form of acid-base balance disorder isthe case?

A Metabolic acidosisB Metabolic alkalosisC Respiratory acidosisD Respiratory alkalosisE No disorders of acid-base balance will be observed

4Examination of a patient suffering from cancer of urinary bladder revealed high rate of serotonin and hydroxyanthranilic acid. It is caused by excess of the following amino acid in the organism:

A TryptophanB AlanineC HistidineD MethionineE Tyrosine

5A mother consulted a doctor about her 5-year-old child who develops erythemas, vesicular rashand skin itch under the influence of sun. Laboratory studies revealed decreased ironconcentration in the blood serum, increased uroporphyrinogen I excretion with the urine. What is the most likely inherited pathology in this child?

A Erythropoietic porphyriaB MethemoglobinemiaC Hepatic porphyriaD CoproporphyriaE Intermittent porphyria

6A 3 year old child with fever was given aspirin. It resulted in intensified erythrocyte haemolysis.Hemolytic anemia might have been caused by congenital insufficiency of the following enzyme:

A Glucose 6-phosphate dehydrogenaseB Glucose 6-phosphataseC Glycogen phosphorylaseD Glycerol phosphate dehydrogenaseE γ-glutamiltransferase

7Blood of a 12 year old boy presents low concentration of uric acid and accumulation of xanthineand hypoxanthine. This child has genetic defect of the following enzyme:

A Xanthine oxidaseB ArginaseC UreaseD Ornithine carbamoyltransferaseE Glycerylkinase

8A patient is ill with diabetes mellitus that is accompanied by hyperglycemia of over 7,2 millimole/lon an empty stomach. The level of what blood plasma protein allows to estimate the glycemia

rate retrospectively (4-8 weeks before examination)?A Glycated hemoglobinB AlbuminC FibrinogenD C-reactive proteinE Ceruloplasmin

9A 4 y.o. child with signs of durative proteinic starvation was admitted to the hospital. The signswere as follows: growth inhibition, anemia, edemata, mental deficiency. Choose a cause ofedemata development:

A Reduced synthesis of albuminsB Reduced synthesis of globulinsC Reduced synthesis of hemoglobinD Reduced synthesis of lipoproteinsE Reduced synthesis of glycoproteins

10Researchers isolated 5 isoenzymic forms of lactate dehydrogenase from the human bloodserum and studied their properties. What property indicates that the isoenzymic forms wereisolated from the same enzyme?

A Catalyzation of the same reactionB The same molecular weightC The same physicochemical propertiesD Tissue localizationE The same electrophoretic mobility

11On some diseases it is observed aldosteronism with hypertension and edema due to sodiumretention in the organism. What organ of the internal secretion is affected on aldosteronism?

A Adrenal glandsB TesticleC OvariesD PancreasE Hypophysis

12An experiment proved that UV-radiated cells of patients with xeroderma pigmentosum restorethe native DNA structure slower than cells of healthy individuals as a result of reparationenzyme defection. What enzyme helps this process?

A EndonucleaseB RNA ligaseC PrimaseD DNA polymerase IIIE DNA gyirase

13A patient presents high activity of LDH1,2, aspartate aminotransferase, creatinephosphokinase. In what organ (organs) is the development of a pathological process the mostprobable?

A In the heart muscle (initial stage of myocardium infarction)

B In skeletal muscles (dystrophy, atrophy)C In kidneys and adrenalsD In connective tissueE In liver and kidneys

14While examining the child the doctor revealed symmetric cheeks roughness, diarrhea,disfunction of the nervous system. Lack of what food components caused it?

A Nicotinic acid, tryptophaneB Lysine, ascorbic acidC Threonine, pantothenic acidD Methionine, lipoic acidE Phenylalanine, pangamic acid

15A 62-year-old female patient has developed a cataract (lenticular opacity) secondary to thediabetes mellitus. What type of protein modification is observed in case of diabetic cataract?

A GlycosylationB PhosphorylationC ADP-ribosylationD MethylationE Limited proteolysis

16A 53-year-old male patient is diagnosed with Paget's disease. The concentration of oxyprolinein daily urine is sharply increased, which primarily means intensified disintegration of:

A CollagenB KeratinC AlbuminD HemoglobinE Fibrinogen

17Examination of a patient revealed typical presentations of collagenosis. This pathology ischaracterized by increase of the following urine index:

A HydroxyprolineB ArginineC GlucoseD Mineral saltsE Ammonium salts

18Untrained people often have muscle pain after sprints as a result of lactate accumulation. Thismight be caused by intensification of the following biochemical process:

A GlycolysisB GluconeogenesisC Pentose phosphate pathwayD LipogenesisE Glycogenesis

19ATP synthesis is totaly blocked in a cell. How will the value of membrane rest potential change?

A It will disappearB It will be slightly increasedC It will be considerably increasedD First it will increase, then decreaseE First it will decrease, then increase

20Examination of a patient suffering from frequent haemorrhages in the inner organs and mucousmembranes revealed proline and lysine being included in collagen fibers. Impairment of theirhydroxylation is caused by lack of the following vitamin:

A CB EC KD AE D

21A 20 year old patient complains of general weakness, dizziness, quick fatigability. Blood analysis results: Hb- 80 g/l. Microscopical examination results: erythrocytes are of modified form. Thiscondition might be caused by:

A Sickle-cell anemiaB Hepatocellular jaundiceC Acute intermittent porphyriaD Obturative jaundiceE Addison's disease

22A 48 year old patient complained about intense pain, slight swelling and reddening of skin overthe joints, temperature rise up to 38oC. Blood analysis revealed high concentration ofurates. This condition might be caused by disturbed metabolism of:

A PurinesB CollagenC CholesterolD PyrimidinesE Carbohydrates

23A patient has yellow skin colour, dark urine, dark-yellow feces. What substance will havestrengthened concentration in the blood serum?

A Unconjugated bilirubinB Conjugated bilirubinC MesobilirubinD VerdoglobinE Biliverdin

24A patient has an increased pyruvate concentration in blood. A large amount of it is excreted with the urine. What vitamin is lacking in this patient?

A B1

B EC B3

D B6

E B2

25Ammonia is a very toxic substance, especially for nervous system. What substance takes themost active part in ammonia detoxication in brain tissues?

A Glutamic acidB LysineC ProlineD HistidineE Alanine

26A patient has pellagra. Interrogation revealed that he had lived mostly on maize for a long timeand eaten little meat. This disease had been caused by the deficit of the following substance inthe maize:

A TryptophanB TyrosineC ProlineD AlanineE Histidine

27Cyanide is a poison that causes instant death of the organism. What enzymes found inmitochondria are affected by cyanide?

A Cytochrome oxidase (aa3)B Flavin enzymesC Cytochrome В5

D NAD+-dependent dehydrogenaseE Cytochrome P-450

28A patient with high rate of obesity was advised to use carnitine as a food additive in order toenhance "fat burning". What is the role of carnitine in the process of fat oxidation?

A Transport of FFA (free fatty acids) from cytosol to the mitochondriaB Transport of FFA from fat depots to the tissuesC It takes part in one of reactions of FFA beta-oxidationD FFA activationE Activation of intracellular lipolysis

29An experimantal animal that was kept on protein-free diet developed fatty liver infiltration, inparticular as a result of deficiency of methylating agents. This is caused by disturbed generation of the following metabolite:

A CholineB DOPAC CholesterolD AcetoacetateE Linoleic acid

30A patient consulted a doctor about symmetric dermatitis of open skin areas. It was found outthat the patient lived mostly on cereals and ate too little meat, milk and eggs. What vitamindeficiency is the most evident?

A NicotinamideB CalciferolC Folic acidD BiotinE Tocopherol

31A 46 year old woman suffering from chololithiasis developed jaundice. Her urine becamedark-yellow and feces became colourless. Blood serum will have the highest concentration ofthe following substance:

A Conjugated bilirubinB Unconjugated bilirubinC BiliverdinD MesobilirubinE Urobilinogen

32A 46 year old patient applied to a doctor complaining about joint pain that becomes stronger theday before weather changes. Blood examination revealed strengthened concentration of uricacid. The most probable cause of the disease is the intensified disintegration of the followingsubstance:

A Adenosine monophosphateB Cytidine monophosphateC Uridine triphosphateD Uridine monophosphateE Thymidine monophosphate

33It has been found out that one of a pesticide components is sodium arsenate that blocks lipoicacid. Which enzyme activity is impaired by this pesticide?

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

34A 38 year old patient suffers from rheumatism in its active phase. What laboratorycharacteristic of blood serum is of diagnostic importance in case of this pathology?

A C-reactive proteinB Uric acidC UreaD CreatinineE Transferrin

35A patient with serious damage of muscular tissue was admitted to the traumatologicaldepartment. What biochemical urine index will be increased in this case?

A CreatinineB Common lipidsC GlucoseD Mineral saltsE Uric acid

3612 hours after an accute attack of retrosternal pain a patient presented a jump of aspartateaminotransferase activity in blood serum. What pathology is this deviation typical for?

A Myocardium infarctionB Viral hepatitisC CollagenosisD Diabetes mellitusE Diabetes insipidus

37Donor skin transplantation was performed to a patient with extensive burns. On the 8-th day thegraft became swollen and changed colour; on the 11-th day graft rejection started. What cellstake part in this process?

A T-lymphocytesB ErythrocytesC BasophilsD EosinophilsE B-lymphocytes

38A 30 y.o. woman had been ill for a year when she felt pain in the area of joints for the first time,they got swollen and skin above them became reddened. Provisional diagnosis is rheumatoidarthritis. One of the most probable causes of this disease is a structure alteration of aconnective tissue protein:

A CollagenB MucinC MyosinD OvoalbuminE Troponin

39Autopsy of a 12-year-old girl revealed: multiple cutaneous hemmorhages (mostly into the skin ofbuttocks, lower extremities), serous and mucous memrane hemmorhages, cerebralhemmorhages. Adrenal glands show focal necrosis and massive hemmorhages; kidneys shownecrotic nephrosis, suppurative arthritis, iridocyclitis, vasculitis. What is the most probablediagnosis?

A MeningococcemiaB Epidemic typhusC Periarteritis nodosaD Systemic lupus erythematosusE Radiation sickness

40Examination of a 27-year-old patient revealed pathological changes in liver and brain. Bloodplasma analysis revealed an abrupt decrease in the copper concentration, urine analysisrevealed an increased copper concentration. The patient was diagnosed with Wilson’sdegeneration. To confirm the diagnosis it is necessary to study the activity of the followingenzyme in blood serum:

A CeruloplasminB Carbonic anhydraseC Xanthine oxidaseD Leucine aminopeptidaseE Alcohol dehydrogenase

41A patient complains about dyspnea provoked by the physical activity. Clinical examinationrevealed anaemia and presence of the paraprotein in the zone of gamma-globulins. To confirmthe myeloma diagnosis it is necessary to determine the following index in the patient’s urine:

A Bence Jones proteinB BilirubinC HaemoglobinD CeruloplasminE Antitrypsin

42Examination of a child who hasn't got fresh fruit and vegetables during winter revealed numerous subcutaneous hemorrhages, gingivitis, carious cavities in teeth. What vitamin combinationshould be prescribed in this case?

A Ascorbic acid and rutinB Thiamine and pyridoxineC Folic acid and cobalaminD Riboflavin and nicotinamideE Calciferol and ascorbic acid

43A drycleaner's worker has been found to have hepatic steatosis. This pathology can be causedby the disruption of synthesis of the following substance:

A PhosphatidylcholineB TristearinC UreaD Phosphatidic acidE Cholic acid

44As a result of exhausting muscular work a worker has largely reduced buffer capacity of blood.What acidic substance that came to blood caused this phenomenon?

A LactateB PyruvateC 1,3-bisphosphoglycerateD 3-phosphoglycerateE -

45

A patient was delivered to the hospital by an emergency team. Objectively: grave condition,unconscious, adynamy. Cutaneous surfaces are dry, eyes are sunken, face is cyanotic. Thereis tachycardia and smell of acetone from the mouth. Analysis results: blood glucose - 20,1micromole/l (standard is 3,3-5,5 micromole/l), urine glucose - 3,5% (standard is - 0). What isthe most probable diagnosis?

A Hyperglycemic comaB Hypoglycemic comaC Acute heart failureD Acute alcoholic intoxicationE Anaphylactic shock

46A 62 y.o. woman complains of frequent pains in the area of her chest and backbone, ribfractures. A doctor assumed myelomatosis (plasmocytoma). What of the following laboratorycharacteristics will be of the greatest diagnostical importance?

A ParaproteinemiaB HyperalbuminemiaC ProteinuriaD HypoglobulinemiaE Hypoproteinemia

47A newborn child has convulsions that have been observed after prescription of vitamin B6.This most probable cause of this effect is that vitamin B6 is a componet of the following enzyme:

A Glutamate decarboxylaseB Pyruvate dehydrostaseC Netoglubarate dehydromineD Aminolevulinate synthaseE Glycogen phosphorylase

48Nappies of a newborn have dark spots that witness of formation of homogentisic acid.Metabolic imbalance of which substance is it connected with?

A ThyrosineB GalactoseC MethionineD CholesterineE Tryptophane

49Parodontitis is treated with calcium preparations and a hormone that stimulates toothmineralization and inhibits tissue resorption. What hormone is it?

A CalcitoninB ParathormoneC AdrenalinD AldosteroneE Thyroxine

50A child has an acute renal failure. What biochemical factor found in saliva can confirm thisdiagnosis?

A Increase in urea concentrationB Increase in glucose concentrationC Decrease in glucose concentrationD Increase in concentration of higher fatty acidsE Decrease in nucleic acid concentration

51After implantation of a cardiac valve a young man constantly takes indirect anticoagulants. Hisstate was complicated by hemorrhage. What substance content has decreased in blood?

A ProthrombinB HaptoglobinC HeparinD CreatinE Ceruloplasmin

52After severe viral hepatitis a 4 year old boy presents with vommiting, occasional loss ofconsciousness, convulsions. Blood test revealed hyperammoniemia. Such condition is causedby a disorder of the following biochemical hepatic process:

A Disorder of ammonia neutralizationB Disorder of biogenic amines neutralizationC Protein synthesis inhibitionD Activation of amino acid decarboxylationE Inhibition of transamination enzymes

53A 50-year-old patient complains about general weakness, appetite loss and cardiac arrhythmia.The patient presents with muscle hypotonia, flaccid paralyses, weakened peristaltic activity ofthe bowels. Such condition might be caused by:

A HypokaliemiaB HypoproteinemiaC HyperkaliemiaD HypophosphatemiaE Hyponatremia

54An 18-year-old patient has enlarged inguinal lymphnodes, they are painless, thickened onpalpation. In the area of genital mucous membrane there is a small-sized ulcer with thickenededges and "laquer" bottom of greyish colour. What is the most probable diagnosis?

A SyphilisB TuberculosisC LepraD Trophic ulcerE Gonorrhea

55A patient with suspected diphtheria went through bacterioscopic examination. Examination ofthroat swab revealed rod-shaped bacteria with volutin granules. What etiotropic preparationshould be chosen in this case?

A Antidiphtheric antitoxic serumB Bacteriophage

C Diphtheria antitoxinD EubioticE Interferon

56A woman who has been keeping to a clean-rice diet for a long time was diagnosed withpolyneuritis (beriberi). What vitamin deficit results in development of this disease?

A ThiamineB Ascorbic acidC PyridoxineD Folic acidE Riboflavin

57Removal of gall bladder of a patient has disturbed processes of Ca absorption through theintestinal wall. What vitamin will stimulate this process?

A D3

B PPC CD B12

E K

58A 1,5-year-old child presents with both mental and physical lag, decolorizing of skin and hair,decrease in catecholamine concentration in blood. When a few drops of 5% solution oftrichloroacetic iron had been added to the child’s urine it turned olive green. Such alteration aretypical for the following pathology of the amino acid metabolism:

A PhenylketonuriaB AlkaptonuriaC TyrosinosisD AlbinismE Xanthinuria

59Feces of a patient contain high amount of undissociated fats and have grayish-white color.Specify the cause of this phenomenon:

A Obturation of bile ductB Hypoactivation of pepsin by hydrochloric acidC HypovitaminosisD EnteritisE Irritation of intestinal epithelium

60A patient complains of frequent diarrheas, especially after consumption of fattening food, and of body weight loss. Laboratory examination revealed steatorrhea; hypocholic feces. What can be the cause of this condition?

A Obturation of biliary tractsB Mucous membrane inflammation of small intestineC Lack of pancreatic lipaseD Lack of pancreatic phospholipaseE Unbalanced diet

61A child is languid, apathetic. Liver is enlarged and liver biopsy revealed a significant excess ofglycogene. Glucose concentration in the blood stream is below normal. What is the cause of low glucose concentration?

A Low (absent) activity of glycogene phosphorylase in liverB Low (absent) activity of hexokinaseC High activity of glycogen synthetaseD Low (absent) activity of glucose 6-phosphataseE Deficit of a gene that is responsible for synthesis of glucose 1-phosphaturidine transferase

62A 46-year-old female patient consulted a doctor about pain in the small joints of the upper andlower limbs. The joints are enlarged and shaped like thickened nodes. Serum test revealed anincrease in urate concentration. This might be caused by a disorder in metabolism of:

A PurinesB CarbohydratesC LipidsD PyrimidinesE Amino acids

63A 65 year old man suffering from gout complains of kidney pain. Ultrasound examinationrevealed renal calculi. The most probable cause of calculi formation is the strengthenedconcentration of the following substance:

A Uric acidB CholesterolC BilirubinD UreaE Cystine

64A 5-year-old child who often fells ill with respiratory diseases has eczematous appearancesafter consumption of some food products, tendency to prolonged course of inflammatoryprocesses. What kind of diathesis can be suspected in this case?

A Exudative-catharralB HemmorhagicC ArthritismD LymphohypoplasticE Asthenic

65The greater amount of nitrogen is excreted from the organism in form of urea. Inhibition of ureasynthesis and accumulation of ammonia in blood and tissues are induced by the decreasedactivity of the following liver enzyme:

A Carbamoyl phosphate synthetaseB Aspartate aminotransferaseC UreaseD AmylaseE Pepsin

66A 35 y.o. patient who often consumes alcohol was treated with diuretics. There appearedserious muscle and heart weakness, vomiting, diarrhea, AP- 100/60 mm Hg, depression. Thiscondition is caused by intensified excretion with urine of:

A PotassiumB SodiumC ChlorineD CalciumE Phosphates

67After intake of rich food a patient feels nausea and sluggishness; with time there appearedsigns of steatorrhea. Blood cholesterine concentration is 9,2 micromole/l. This condition wascaused by lack of:

A Bile acidsB TriglyceridesC Fatty acidsD PhospholipidsE Chylomicrons

68Examination of a man who hadn't been consuming fats but had been getting enoughcarbohydrates and proteins for a long time revealed dermatitis, poor wound healing, visionimpairment. What is the probable cause of metabolic disorder?

A Lack of linoleic acid, vitamins A, D, E, KB Lack of palmitic acidC Lack of vitamins PP, HD Low caloric value of dietE Lack of oleic acid

69A 44-year-old woman complains of common weakness, heart pain, considerable increase ofbody weigt. Objectively: moon-like face, hirsutism, AP- 165/100 mm Hg, height - 164 cm, weight- 103 kg; fat is mostly accumulated in the region of neck, upper shoulder girdle, stomach. Whatis the main pathogenetic mechanism of obesity?

A Increased production of glucocorticoidsB Decreased production of thyroidal hormonesC Increased production of insulinD Decreased production of glucagonE Increased production of mineralocorticoids

70An experimental animal has been given excessive amount of carbon-labeled glucose for aweek. What compound can the label be found in?

A Palmitic acidB MethionineC Vitamin $A$D CholineE Arachidonic acid

71After a serious viral infection a 3-year-old child has repeated vomiting, loss of consciousness,convulsions. Examination revealed hyperammoniemia. What may have caused changes ofbiochemical blood indices of this child?

A Disorder of ammonia neutralization in ornithinic cycleB Activated processes of aminoacids decarboxylationC Disorder of biogenic amines neutralizationD Increased purtefaction of proteins in intestinesE Inhibited activity of transamination enzymes

72Examination of a patient with frequent hemorrhages from internals and mucous membranesrevealed proline and lysine being a part of collagene fibers. What vitamin absence causeddisturbance of their hydroxylation?

A Vitamin CB Vitamin KC Vitamin AD ThiamineE Vitamin E

73Albinos can't stand sun impact - they don't aquire sun-tan but get sunburns. Disturbedmetabolism of what aminoacid underlies this phenomenon?

A PhenilalanineB MethionineC TryptophanD Glutamic acidE Histidine

74A nurse accidentally injected a nearly double dose of insulin to a patient with diabetes mellitus.The patient lapsed into a hypoglycemic coma. What drug should be injected in order to help himout of coma?

A GlucoseB LidaseC InsulinD SomatotropinE Noradrenaline

75A biochemical urine analysis has been performed for a patient with progressive musculardystrophy. In the given case muscle disease can be confirmed by the high content of thefollowing substance in urine:

A CreatineB PorphyrinC UreaD Hippuric acidE Creatinine

76A patient with continious bronchopneumonia was admitted to the therapeutic department.

Antibiotic therapy didn't give much effect. What medication for improvement of immune stateshould be added to the complex treatment of this patient?

A TimalineB AnalginC SulfocamphocaineD BenadrylE Paracetamol

77A patient suffers from hepatic cirrhosis. Examination of which of the following substancesexcreted by urine can characterize the state of antitoxic function of liver?

A Hippuric acidB Ammonium saltsC KreatinineD Uric acidE Aminoacids

78Malaria is treated with structural analogs of vitamin B2 (riboflavin). These drugs disrupt thesynthesis of the following enzymes in plasmodium:

A FAD-dependent dehydrogenaseB Cytochrome oxidaseC PeptidaseD NAD-dependent dehydrogenaseE Aminotransferase

79Vitamin A together with specific cytoreceptors penetrates through the nuclear membranes,induces transcription processes that stimulate growth and differentiation of cells. This biologicalfunction is realized by the following form of vitamin A:

A Trans-retinoic acidB Trans-retinalC Cis-retinalD RetinolE Carotin

80Products of some proteins hydrolysis and modification are the biologically active substancescalled hormones. Lipotropin, corticotropin, melanotropin and endorphins are synthesized in thehypophysis of the following protein:

A Proopiomelanocortin (POMC)B NeuroalbuminC NeurostrominD NeuroglobulinE Thyreoglobulin

81In patients with the biliary tract obstruction the blood coagulation is inhibited; the patients havefrequent haemorrhages caused by the subnormal assimilation of the following vitamin:

A KB A

C DD EE C

82A newborn child suffers from milk curdling in stomach, this means that soluble milk proteins(caseins) transform to insoluble proteins (paracaseins) by means of calcium ions and a certainenzyme. What enzyme takes part in this process?

A ReninB PepsinC GastrinD SecretinE Lipase

83A sportsman was recommended to take a medication that contains carnitine in order to improvehis results. What process is activated by carnitine the most?

A Fatty acids transport to mitochondrionsB Synthesis of steroid hormonesC Synthesis of ketone bodiesD Synyhesis of lipidsE Tissue respiration

84Human red blood cells do not contain mitochondria. What is the main pathway for ATPproduction in these cells?

A Anaerobic glycolysisB Aerobic glycolysisC Oxidative phosphorylationD Creatine kinase reactionE Cyclase reaction

85To prevent postoperative bleeding a 6 y.o. child was administered vicasol that is a syntheticanalogue of vitamin K. Name post-translational changes of blood coagulation factors that willbe activated by vicasol:

A Carboxylation of glutamin acidB Phosphorylation of serine radicalsC Partial proteolysisD PolymerizationE Glycosylation

86A 4 y.o. boy has had recently serious viral hepatitis. Now there are such clinical presentationsas vomiting, loss of consciousness, convulsions. Blood analysis revealed hyperammoniemia.Disturbunce of which biochemical process caused such pathological condition of the patient?

A Disturbed neutralization of ammonia in liverB Disturbed neutralization of biogenic aminesC Increased putrefaction of proteins in bowelsD Activation of aminoacid decarboxylationE Inhibition of transamination enzyms

87During examination of an 11-month-old infant a pediatrician revealed osteoectasia of the lowerextremities and delayed mineralization of cranial bones. Such pathology is usually provoked bythe deficit of the following vitamin:

A CholecalciferolB ThiaminC Pantothenic acidD BioflavonoidsE Riboflavin

88Examination of a patient suffering from chronic hepatitis revealed a significant decrease in thesynthesis and secretion of bile acids. What process will be mainly disturbed in the patient’sbowels?

A Fat emulsificationB Protein digestionC Carbohydrate digestionD Glycerin absorptionE Amino acid absorption

89Glutamate decarboxylation results in formation of inhibitory transmitter in CNS. Name it:

A GABAB GlutathioneC HistamineD SerotoninE Asparagine

90In course of histidine catabolism a biogenic amin is formed that has powerful vasodilatatingeffect. Name it:

A HistamineB SerotoninC DioxyphenylalanineD NoradrenalinE Dopamine

91Utilization of arachidonic acid via cyclooxigenase pathway results in formation of somebioactive substances. Name them:

A ProstaglandinsB ThyroxineC Biogenic aminsD SomatomedinsE Insulin-like growth factors

92After a sprint an untrained person develops muscle hypoxia. This leads to the accumulation ofthe following metabolite in muscles:

A LactateB Ketone bodiesC Acetyl CoAD Glucose 6-phosphateE Oxaloacetate

93Myocyte cytoplasm contains a big number of dissolved metabolites of glucose oxidation. Nameone of them that turns directly into a lactate:

A PyruvateB OxaloacetateC GlycerophosphateD Glucose 6-phosphateE Fructose 6-phosphate

94Emotional stress causes activation of hormon-sensitive triglyceride lipase in the adipocytes.What secondary mediator takes part in this process?

A Cyclic adenosine monophosphateB Cyclic guanosine monophosphateC Adenosine monophosphateD DiacylglycerolE Ions of Са2+

95A patient diagnosed with carcinoid of bowels was admitted to the hospital. Analysis revealedhigh production of serotonin. It is known that this substance is formed of tryptophaneaminooacid. What biochemical mechanism underlies this process?

A DecarboxylationB DesaminationC Microsomal oxydationD TransaminationE Formation of paired compounds

96A genetics specialist analyzed the genealogy of a family and found that both males and femalesmay have the illness, not across all the generations, and that healthy parents may have illchildren. What is the type of illness inheritance?

A Autosomal recessiveB Autosomal dominantC X-linked dominantD X-linked recessiveE Y-linked

97Analysis of amniotic fluid that was obtained as a result of amniocentesis (puncture of amnioticsac) revealed cells the nuclei of which contain sex chromatin (Barr's body). What can it beevidence of?

A Development of female fetusB Development of male fetusC Genetic disorders of fetus development

D TrisomyE Polyploidy

98Vitamin B1 deficiency results in disturbance of oxidative decarboxylation ofα-ketoglutaric acid. This will disturb synthesis of the following coenzyme:

A Thiamine pyrophosphateB Nicotinamide adenine dinucleotide (NAD)C Flavine adenine dinucleotide (FAD)D Lipoic acidE Coenzyme A

99A child's blood presents high content of galactose, glucose concentration is low. There are such presentations as cataract, mental deficiency, adipose degeneration of liver. What disease is it?

A GalactosemiaB Diabetes mellitusC LactosemiaD Steroid diabetesE Fructosemia

100According to clinical indications a patient was administered pyridoxal phosphate. Whatprocesses is this medication intended to correct?

A Transamination and decarboxylation of aminoacidsB Oxidative decarboxylation of ketonic acidsC Desamination of purine nucleotideD Synthesis of purine and pyrimidine basesE Protein synthesis

101A 45 y.o. woman suffers from Cushing's syndrome - steroid diabetes. Biochemical examinationrevealed: hyperglycemia, hypochloremia. Which of the under-mentioned processes is the first to be activated?

A GluconeogenesisB GlycogenolysisC Glucose reabsorptionD Glucose transport to the cellE Glycolysis

102Autopsy of a 46-year-old man revealed multiple brown-and-green layers and hemmorhages onthe mucous membrane of rectum and sigmoid colon; slime and some blood in colon lumen;histologically - fibrinous colitis. In course of bacteriological analysis of colon contentsS.Sonne were found. What is the most probable diagnosis?

A DysenteryB CholeraC SalmonellosisD YersiniosisE Crohn's disease

103A patient had been ill with bronchial asthma for many years and died from asthmatic fit.Histologic lung examination revealed: lumen of bronchioles and small bronches contain a lot ofmucus with some eosinophils, there is sclerosis of alveolar septums, dilatation of alveole lumen.What mechanism of development of hypersensibility reaction took place?

A Reagin reactionB Cytotoxic reactionC Immunocomplex reactionD Cytolysis determined by lymphocytesE Granulomatosis

104Those organisms which in the process of evolution failed to develop protection from H2O2 canexist only in anaerobic conditions. Which of the following enzymes can break hydrogen peroxide down?

A Peroxidase and catalaseB Oxygenase and hydroxylaseC Cytochrome oxidase, cytochrome B5

D Oxygenase and catalaseE Flavin-dependent oxidase

105Desulfiram is widely used in medical practice to prevent alcocholism. It inhibits aldehydedehydrogenase. Increased level of what metabolite causes aversion to alcochol?

A AcetaldehydeB EthanolC Malonyl aldehydeD Propionic aldehydeE Methanol

106A 1-year-old child with symptoms of muscle involvement was admitted to the hospital.Examination revealed carnitine deficiency in his muscles. What process disturbance is thebiochemical basis of this pathology?

A Transporting of fatty acids to mitochodrionsB Regulation of Ca2+ level in mitochondrionsC Substrate phosphorylationD Lactic acid utilizationE Actin and myosin synthesis

107A man got poisoned with mushrooms. They contain muscarine that stimulates muscariniccholinoreceptors. What symptom is typical for poisoning with inedible mushrooms?

A MiosisB MydriasisC Bronchi dilationD Heart rate riseE Arterial pressure rise

108

Prolonged fasting causes hypoglycemia which is amplified by alcohol consumption, as thefollowing process is inhibited:

A GluconeogenesisB GlycolysisC GlycogenolysisD LipolysisE Proteolysis

109As a result of posttranslative modifications some proteins taking part in blood coagulation,particularly prothrombin, become capable of calcium binding. The following vitamin takes part inthis process:

A KB CC AD B1

E B2

110Objective examination of a patient revealed: slender figure, big skull, highly developed frontalregion of face, short extremities. What constitutional type is it characteristic for?

A RespiratoryB MuscularC DigestiveD CerebralE Mixed

111A 38-year-old patient died during intractable attack of bronchial asthma. Histologic examinationrevealed mucus accumulation in bronchial lumen, a lot of fat cells (labrocytes) in the wall ofbronches, many of them are in the state of degranulation, there are also a lot of eosinophils.What pathogenesis of bronchial changes is it?

A AtopyB Cytotoxic, cytolytic action of antibodiesC Immunocomplex mechanismD Cellular cytolysisE Granulomatosis

112Diabetes mellitus causes ketosis as a result of activated oxidation of fatty acids. Whatdisorders of acid-base equilibrium may be caused by excessive accumulation of ketone bodiesin blood?

A Metabolic acidosisB Metabolic alcalosisC Any changes woun't happenD Respiratory acidosisE Respiratory alcalosis

113A woman with 0 (I) bllod group has born a child with AB blood group. This woman's husband hasA blood group. What genetic interaction explains this phenomenon?

A Recessive epistasisB CodominanceC PolymeryD Incomplete dominanceE Complementation

114Osteolaterism is charcterized by a decrease in collagen strength caused by much less intensive formation of cross-links in collagen fibrils. This phenomenon is caused by the low activity of thefollowing enzyme:

A Lysyl oxidaseB Monoamino-oxidaseC Prolyl hydroxylaseD Lysyl hydroxylaseE Collagenase

115Depressions and emotional insanities result from the deficit of noradrenalin, serotonin and other biogenic amines in the brain. Their concentration in the synapses can be increased by meansof the antidepressants that inhibit the following enzyme:

A Monoamine oxidaseB Diamine oxidaseC L-amino-acid oxidaseD D-amino-acid oxidaseE Phenylalanine-4-monooxygenase

116A 3 year old child with symptoms of stomatitis, gingivitis and dermatitis of open skin areas wasdelivered to a hospital. Examination revealed inherited disturbance of neutral amino acidtransporting in the bowels. These symptoms were caused by the deficiency of the followingvitamin:

A NiacinB Pantothenic acidC Vitamin AD CobalaminE Biotin

117A 5-month-old boy was hospitalized for tonic convulsions. He has a life-time history of thisdisease. Examination revealed coarse hair, thinned and fragile nails, pale and dry skin. In blood:calcium - 1,5 millimole/l, phosphor - 1,9 millimole/l. These changes are associated with:

A HypoparathyroidismB HyperparathyroidismC HyperaldosteronismD HypoaldosteronismE Hypothyroidism

118During hypersensitivity test a patient got subcutaneous injection of an antigen which causedreddening of skin, edema, pain as a result of histamine action. This biogenic amine is generated as a result of transformation of the following histidine amino acid:

A DecarboxylationB MethylationC PhosphorylationD IsomerizationE Deaminization

119A patient with suspected diagnosis "progressing muscular dystrophy" got his urine tested. Whatcompound will confirm this diagnosis if found in urine?

A KreatineB CollagenC PorphyrinD MyoglobinE Calmodulin

120Cytogenetic examination of a patient with dysfunction of the reproductive system revealednormal karyotype 46,ХУ in some cells, but most cells have Klinefelter's syndrome karyotype -47,ХХУ. Such phenomenon of cell inhomogeneity is called:

A MosaicismB InversionC TranspositionD DuplicationE Heterogeneity

121An oncological patient had been administered methotrexate. With time target cells of the tumourlost sensitivity to this drug. At the same time the change in gene expression of the followingenzyme is observed:

A Dehydropholate reductaseB ThiaminaseC DeaminaseD Pholate oxidaseE Pholate decarboxylase

122A patient complained about dizziness, memory impairment, periodical convulsions. It wasrevealed that these changes were caused by a product of decarboxylation of glutamic acid.Name this product:

A GABAB Pyridoxal phosphateC TDPD ATPE THFA

123A sportsman needs to improve his sporting results. He was recommended to take a preparationthat contains carnitine. What process is activated the most by this compound?

A Fatty acids transportingB Amino acids transportingC Calcium ions transporting

D Glucose transportingE Vitamin K transporting

124A doctor examined a child and revealed symptoms of rachitis. Development of this desease was caused by deficiency of the following compound:

A 1,25 [ОН]-dichydroxycholecalciferolB BiotinC TocopherolD NaphtaquinoneE Retinol

125Laboratory examination of a child revealed increased concentration of leucine, valine,isoleucine and their ketoderivatives in blood and urine. Urine smelt of maple syrup. This disease is characterized by the deficit of the following enzyme:

A Dehydrogenase of branched amino acidsB AminotransferaseC Glucose-6-phosphataseD PhosphofructokinaseE Phosphofructomutase

126A 9-month-old infant is fed with artificial formulas with unbalanced vitamin B6 concentration.The infant presents with pellagral dermatitis, convulsions, anaemia. Convulsion developmentmight be caused by the disturbed formation of:

A GABAB HistamineC SerotoninD DOPAE Dopamine

127It was found out that some compounds, for instance fungi toxins and some antibiotics can inhibitactivity of RNA-polymerase. What process will be disturbed in a cell in case of inhibition ofthis enzyme?

A TranscriptionB ProcessingC ReplicationD TranslationE Reparation

128When blood circulation in the damaged tissue is restored, then lactate accumulation comes to astop and glucose consumption decelerates. These metabolic changes are caused by activationof the following process:

A Aerobic glycolysisB Anaerobic glycolysisC LipolysisD GluconeogenesisE Glycogen biosynthesis

129During starvation muscle proteins break up into free amino acids. These compounds will be themost probably involved into the following process:

A Gluconeogenesis in liverB Gluconeogenesis in musclesC Synthesis of higher fatty acidsD GlycogenolysisE Decarboxylation

130Examination of a patient revealed II grade obesity. It is known that he consumes a lot of sweetsand rich food, has sedentary way of life. That's why anabolic metabolism has the priority in hisorganism. Which of the following pathways is amphibolic?

A Cycle of tricarboxylic acidsB GlyconeogenesisC LipolysisD GlycolysisE Fatty acids oxidation

131Surgical removal of a part of stomach resulted in disturbed absorption of vitamin $B_{12}$, it isexcreted with feces. The patient was diagnosed with anemia. What factor is necessary forabsorption of this vitamin?

A GastromucoproteinB GastrinC Hydrochloric acidD PepsinE Folic acid

132A newborn develops dyspepsia after the milk feeding. When the milk is substituted by theglucose solution the dyspepsia symptoms disappear. The newborn has the subnormal activity of the following enzyme:

A LactaseB InvertaseC MaltaseD AmylaseE Isomaltase

133Patients who suffer from severe diabetes and don't receive insulin have metabolic acidosis.This is caused by increased concentration of the following metabolites:

A Ketone bodiesB Fatty acidsC Unsaturated fatty acidsD TriacylglycerolsE Cholesterol

134

A 4 year old child with hereditary renal lesion has signs of rickets, vitamin D concentration inblood is normal. What is the most probable cause of rickets development?

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

135A patient presents with dysfunction of cerebral cortex accompanied by epileptic seizures. Hehas been administered a biogenic amine synthetized from glutamate and responsible for centralinhibition. What substance is it?

A Gamma-amino butyric acidB SerotoninC DopamineD AcetylcholineE Histamine

136Toxic affection of liver results in dysfunction of protein synthesis. It is usually accompanied bythe following kind of dysproteinemia:

A Absolute hypoproteinemiaB Relative hypoproteinemiaC Absolute hyperproteinemiaD Relative hyperproteinemiaE Paraproteinemia

137A 6 year old child was delivered to a hospital. Examination revealed that the child couldn't fix hiseyes, didn't keep his eyes on toys, eye ground had the cherry-red spot sign. Laboratoryanalyses showed that brain, liver and spleen had high rate of ganglioside glycometide. Whatcongenital disease is the child ill with?

A Tay-Sachs diseaseB Wilson's syndromeC Turner's syndromeD Niemann-Pick diseaseE MacArdle disease

138In clinical practice tuberculosis is treated with izoniazid preparation - that is an antivitamin ableto penetrate into the tuberculosis bacillus. Tuberculostatic effect is induced by the interferencewith replication processes and oxidation-reduction reactions due to the buildup ofpseudo-coenzyme:

A NADB FADC FMND TDPE CoQ

139A newborn child was found to have reduced intensity of sucking, frequent vomiting, hypotonia.

Urine and blood exhibit increased concentration of citrulline. What metabolic process isdisturbed?

A Ornithinic cycleB Tricarboxylic acid cycleC GlycolysisD GlyconeogenesisE Cori cycle

140Dietary intake of a 30 year old nursing woman contains 1000 mg of calcium, 1300 mg ofphosphorus and 20 mg of iron per day. It is necessary to change content of these mineralsubstances in the following way:

A To increase phosphorus contentB To increase calcium contentC To reduce fluorine contentD To increase iron contentE To reduce iron content

141Cardinal symptoms of primary hyperparathyroidism are osteoporosis and renal lesion along with development of urolithiasis. What substance makes up the basis of these calculi in thisdisease?

A Calcium phosphateB Uric acidC CystineD BilirubinE Cholesterol

142Study of conversion of a food colouring agent revealed that neutralization of this xenobiotictakes place only in one phase - microsomal oxydation. Name a component of this phase:

A Cytochrome Р-450B Cytochrome BC Cytochrome CD Cytochrome AE Cytochrome oxidase

143A patient had hemorrhagic stroke. Blood examination revealed strengthened kininconcentration.The patient was prescribed contrical. It was administered in order to inhibit thefollowing proteinase:

A KallikreinB PepsinC TrypsinD ChemotrypsinE Collagenase

144A 49-year-old driver complains about unbearable constricting pain behind the breastboneirradiating to the neck. The pain arose 2 hours ago. Objectively: the patient’s condition is grave,he is pale, heart tones are decreased. Laboratory studies revealed high activity of creatine

kinase and LDH1. What disease are these symptoms typical for?A Acute myocardial infarctionB Acute pancreatitisC StenocardiaD CholelithiasisE Diabetes mellitus

145Plasmic factors of blood coagulation are exposed to post-translational modification with theparticipation of vitamin K. It is necessary as a cofactor in the enzyme system ofγ-carboxylation of protein factors of blood coagulation due to the increased affinity oftheir molecules with calcium ions. What amino acid is carboxylated in these proteins?

A GlutamicB ValineC SerineD PhenylalanineE Arginine

146Pharmacological effects of antidepressants are connected with inhibition of an enzymecatalyzing biogenic amines noradrenaline and serotonine in the mitochondrions of cerebralneurons. What enzyme participates in this process?

A Monoamine oxidaseB TransaminaseC DecarboxylaseD PeptidaseE Lyase

147An oncological patient was prescribed methotrexate. With the lapse of time target cells of thetumour lost susceptibility to this drug. There is change of gene expression of the folowingenzyme:

A Dehydrofolate reductaseB ThiaminaseC DeaminaseD Folate oxidaseE Folate decarboxylase

148A 67-year-old male patient consumes eggs, pork fat, butter, milk and meat. Blood test results:cholesterol - 12,3 mmol/l, total lipids - 8,2 g/l, increased low-density lipoprotein fraction (LDL).What type of hyperlipoproteinemia is observed in the patient?

A Hyperlipoproteinemia type IIaB Hyperlipoproteinemia type IC Hyperlipoproteinemia type IIbD Hyperlipoproteinemia type IVE Cholesterol, hyperlipoproteinemia

149A patient with signs of osteoporosis and urolithiasis has been admitted to the endocrinologydepartment. Blood test has revealed hypercalcemia and hypophosphatemia. These changes

are associated with abnormal synthesis of the following hormone:A Parathyroid hormoneB CalcitoninC CortisolD AldosteroneE Calcitriol

150Increased HDL levels decrease the risk of atherosclerosis. What is the mechanism of HDLanti-atherogenic action?

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